Podcasts about gestational

Gestational diabetes Overview- Gestational diabetes is diabetes diagnosed for the first time during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health. While any pregnancy complication is concerning, there's good news. During pregnancy you can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can keep you and your baby healthy and prevent a difficult delivery. If you have gestational diabetes during pregnancy, generally your blood sugar returns to its usual level soon after delivery. But if you've had gestational diabetes, you have a higher risk of getting type 2 diabetes. You'll need to be tested for changes in blood sugar more often. © 1998-2025 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.  

Maintaining a healthy weight, eating nutritious foods, and avoiding fast food are key to reducing the risk of diabetes. Currently, nearly one in four adults over 18 is living with diabetes. Women are especially vulnerable during pregnancy due to hormonal changes, making regular screening crucial. Consulting a doctor ensures tailored guidance for managing gestational diabetes effectively. Uncontrolled blood sugar levels pose serious risks during surgery. While sterile procedures generally avoid infections, high blood sugar can delay healing, increase infection risks, and complicate recovery. In surgeries like bypass operations, infected stitches may lead to scarring or further complications. Stabilizing blood sugar before surgery and maintaining it during anaesthesia are vital for safe outcomes. Gestational diabetes results from hormones like human placental lactogen (HPL) reducing insulin effectiveness. During pregnancy, the pancreas must produce up to 50% more insulin to meet rising demands. If beta cells cannot keep up, blood sugar levels rise, stressing the body and increasing diabetes risk. High blood sugar damages nerves, impairing their function and delaying wound healing due to reduced immunity. Nerve damage often starts symmetrically but may affect only one foot. Managing blood sugar is essential for nerve health, faster healing, and preventing infections Recorded on: 11.12.2024 Recorded at: Akashwani Nagpur

For many women, a large chunk of their life is spent trying to conceive, pregnant or in the post-partum stage. During these periods, it's important to advocate for yourself and for this, knowledge is power. In this episode of Vision of Health, General Practitioner and TV Doctor, Dr Sara Kayat shares her evidence-based advice about navigating pregnancy, labour and the post-partum period Dr Sara studied medicine at King's College London, where she also achieved a BSc in Physiology. She is a practicing GP, is resident doctor on ITV's This Morning and is author of How to Have a Baby, an empowering, unbiased, essential toolkit for pregnancy, labour, birth, breastfeeding and your baby's first year.This episode covers:What to do once you get a positive pregnancy testSupplements and nutrition during pregnancy Exercise in pregnancyWhether it's safe to drink coffee in pregnancy Gestational diabetes Questions to ask when thinking about your birth plan How to advocate for yourself during labour Breast feeding Post-partum depression & mood fluctuations This episode will equip you with everything you need to know about having a baby.Watch the full episode on YouTube: https://www.youtube.com/watch?v=Ehv6NbpfGeE If you want to hear more from Dr Sara Kayat follow her Instagram @drsarakayat or website www.drsarakayat.com If you enjoyed this episode please do leave us a like and a review. And don't forget to subscribe to keep hearing from your favourite experts! Hosted on Acast. See acast.com/privacy for more information.

Editor’s Choice: Primary prevention of post-molar gestational trophoblastic neoplasia in high-risk complete hydatidiform mole: A single-dose prophylactic actinomycin D, associated with uterine evacuation - a long retrospective cohort study Editorial: Prevention of Gestational Trophoblastic Neoplasia with Actinomycin -D at the time of evacuation: A Matter of Routine Practice or Reserve for Special Circumstances?

*Content warning: infant loss, birth trauma, medical trauma and neglect, death, pregnancy loss, mature content. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Gestational diabeteshttps://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339 Insights into the U.S. Maternal Mortality Crisis: An International Comparisonhttps://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison March of Dimeshttps://www.marchofdimes.org/peristats/about-us Maternal Mortality, A National Institutes of Health Pathways to Prevention Panel Reporthttps://pmc.ncbi.nlm.nih.gov/articles/PMC10863655/ Maternal Mortality Rates in the United States, 2022https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2022/maternal-mortality-rates-2022.pdf Midwifery Education Accreditation Council (MEAC)https://www.meacschools.org/ National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery Neonatal mortality is more than tripled at planned out-of-hospital births attended by direct-entry midwives. Grunebaum, Amos et al. American Journal of Obstetrics & Gynecology, Volume 222, Issue 1, S45. https://www.ajog.org/article/S0002-9378(19)31440-1/fulltext North American Registry of Midwives (NARM)https://narm.org/ Placental abruptionhttps://www.mayoclinic.org/diseases-conditions/placental-abruption/symptoms-causes/syc-20376458 Preeclampsiahttps://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745 Severe Maternal Morbidity and Mortality Among Indigenous Women in the United Stateshttps://pmc.ncbi.nlm.nih.gov/articles/PMC7012336/ State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ *SWW S22 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookieboo See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this week's issue Retrospective review suggests tocilizumab (interleukin-6 receptor antagonist) may be effective subcutaneously for the treatment of non-infectious uveitis Pre-operative risk factors may help predict which patients are at risk for neuropathic corneal pain after refractive surgery Gestational diabetes mellitus was associated with simple congenital ptosis in a retrospective cohort study, possibly linked to insulin-like growth factor 1 levels

For someone who, like so many out there, had been under the illusion that their hideous cesarean births were ‘just the way birth was' and not justifiably classified as traumatic, Kiki, having just birthed her third baby at home, has quite the story to tell! She and her husband, Adam, share about initially being under the veil of disempowering conditioning, and the journey they went on to achieve an undisturbed home birth just 6 weeks ago. Kiki's is a powerful story of courage and self-determination. The system had her labelled as ‘high risk' due to multiple factors that Kiki came to see were not based on good evidence, didn't align with what she instinctively knew, and were tools in the patriarchal birth machine, designed to keep her scared and under the control of the system. Once she learnt that she was rightfully the one behind the steering wheel, Kiki stood in her power and readied herself for the birth that she and her baby needed and deserved. I had the honour of being a part of Kiki's pregnancy journey, helping her to learn the truth about her earlier births, and sourcing the tools, understandings and wise woman sisterhood that she needed in order to take radical responsibility for the way her birth would unfold. At almost 39 weeks of pregnancy, her midwife dropped her, afraid of Kiki's uncompromising approach to planning her birth. This turned out to be an absolute blessing, opening the door for some incredible midwives to rally around Kiki, supporting her right to birth her way. Kiki now seeks to pay it forward. She has found her voice and has a fire in her belly, and she's determined to do all she can to tear down the patriarchal structures that keep birthing women from accessing their power in the wondrous rite of passage that birth is.  Also discussed in this episode: * NFP ‘The Village NZ' * Australian maternity system - no continuity of care * Artificial rupture of membranes - meconium * Syntocinon augmentation * Epidural  * Crash c section under GA * Lack of initial bond with baby * Gestational diabetes * Inaccurate ultrasound scans * ‘Advanced maternal age' (41 years) * VBAC * Detailed birth plans * Responsibilities  * Soulful Birth course * Freebirth * Doula * ‘Unravelling Your Trauma' session with Healing Birth Practitioner trainee * Born at Home and Birth Time films * Sibling at birth Join the Wise Women Network NZ Facebook group: https://www.facebook.com/groups/538842372367843 Check out The Village NZ: https://thevillagenz.org/ Contact Michelle if you're a birth worker who is interested in becoming a part of the ‘Authentic Midwifery - Wise Women Collective' - email her on info@wisewomennetwork.co.nz. Or connect with her via her Facebook page: https://www.facebook.com/MichelleandIzzy Join my (Carla's) Soulful Birth course: https://www.healingbirth.co.nz/soulfulbirthgroup Look into my Healing Birth Practitioner Training: https://www.healingbirth.co.nz/hb-practitioner-training

Gestational, LADA, Type 2; you name it and this episode has it. JUICE CRUISE 2025 Eat Hungryroot Screen It Like You Mean It Eversense CGM Learn about the Medtronic Champions This BetterHelp link saves 10% on your first month of therapy Try delicious AG1 - Drink AG1.com/Juicebox I Have Vision Use code JUICEBOX to save 40% at Cozy Earth  Get Gvoke HypoPen CONTOUR NextGen smart meter and CONTOUR DIABETES app Learn about the Dexcom G6 and G7 CGM Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Learn about Touched By Type 1 Take the T1DExchange survey *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  How to listen, disclaimer and more Apple Podcasts> Subscribe to the podcast today! The podcast is available on Spotify, Google Play, iHeartRadio, Radio Public, Amazon Music and all Android devices The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here or buy me a coffee. Thank you! Disclaimer - Nothing you hear on the Juicebox Podcast or read on Arden's Day is intended as medical advice. You should always consult a physician before making changes to your health plan.  If the podcast has helped you to live better with type 1 please tell someone else how to find the show and consider leaving a rating and review on Apple Podcasts. Thank you! The Juicebox Podcast is not a charitable organization.  

In this episode, Trista explores the complexities of managing pregnancy with PCOS, focusing on dietary considerations, the safety of medications and supplements, and the importance of mental health during the postpartum period. She emphasizes the need for careful monitoring of blood sugar levels, the role of insulin and metformin, and the significance of support systems for new parents. You'll learn: Why managing glycemic load is crucial for pregnant individuals with PCOS Safe and effective treatments for gestational diabetes How postpartum mental health is a significant concern for new parents Navigating potential chest feeding challenges for those with PCOS Episode Links: How to Manage Gestational Diabetes with Diet and Lifestyle 1-on-1 Nutrition Coaching References: Choudhury, A. A., & Rajeswari, V. D. (2022). Polycystic ovary syndrome (PCOS) increases the risk of subsequent gestational diabetes mellitus (GDM): A novel therapeutic perspective. Life Sciences (1973), 310, 121069–121069. https://doi.org/10.1016/j.lfs.2022.121069 Diabetes Canada. (2024). Gestational diabetes. https://www.diabetes.ca/about-diabetes/gestational Facchinetti, F., Cavalli, P., Copp, A. J., D'Anna, R., Kandaraki, E., Greene, N. D. E., & Unfer, V. (2020). An update on the use of inositols in preventing gestational diabetes mellitus (GDM) and neural tube defects (NTDs). Expert Opinion on Drug Metabolism & Toxicology, 16(12), 1187–1198. https://doi.org/10.1080/17425255.2020.1828344 Ibrahim, I., Bashir, M., Singh, P., Al Khodor, S., & Abdullahi, H. (2022). The Impact of Nutritional Supplementation During Pregnancy on the Incidence of Gestational Diabetes and Glycaemia Control. Frontiers in Nutrition (Lausanne), 9, 867099–867099. https://doi.org/10.3389/fnut.2022.867099 Jorquera, G., Echiburú, B., Crisosto, N., Sotomayor-Zárate, R., Maliqueo, M., & Cruz, G. (2020). Metformin during Pregnancy: Effects on Offspring Development and Metabolic Function. Frontiers in Pharmacology, 11, 653–653. https://doi.org/10.3389/fphar.2020.00653 Koric, A., Singh, B., VanDerslice, J. A., Stanford, J. B., Rogers, C. R., Egan, D. T., Agyemang, D. O., & Schliep, K. (2021). Polycystic ovary syndrome and postpartum depression symptoms: a population-based cohort study. American Journal of Obstetrics and Gynecology, 224(6), 591.e1-591.e12. https://doi.org/10.1016/j.ajog.2020.12.1215 Ryssdal, M., Vanky, E., Stokkeland, L. M. T., Jarmund, A. H., Steinkjer, B., Løvvik, T. S., Madssen, T. S., Iversen, A.-C., & Giskeødegård, G. F. (2023). Immunomodulatory Effects of Metformin Treatment in Pregnant Women With PCOS. The Journal of Clinical Endocrinology and Metabolism, 108(9), e743–e753. https://doi.org/10.1210/clinem/dgad145 Slouha, E., Alvarez, V. C., Gates, K. M., Ankrah, N. M. N., Clunes, L. A., & Kollias, T. F. (2023). Gestational Diabetes Mellitus in the Setting of Polycystic Ovarian Syndrome: A Systematic Review. Curēus (Palo Alto, CA), 15(12), e50725–e50725. https://doi.org/10.7759/cureus.50725 Vanky, E., Isaksen, H., Haase Moen, M., & Carlsen, S. M. (2008). Breastfeeding in polycystic ovary syndrome. Acta Obstetricia et Gynecologica Scandinavica, 87(5), 531–535. https://doi.org/10.1080/00016340802007676

In today's episode, I interview Dr. Rebecca Dekker on diabetes and the role of blood sugar during preconception and pregnancy. She gives a comprehensive overview of diabetes and its impact on fertility and pregnancy while explaining the different types of diabetes and how blood sugar levels can affect conception and pregnancy outcomes. Our conversation dives into the importance of early screening along with practice tips and advice for managing metabolic health through nutrition and lifestyle.  Episode Highlights:  Rebecca's personal journey of experiencing challenging pregnancies.  The different types of diabetes: Type 1 (autoimmune condition affecting insulin production), Type 2 (metabolic issue with insulin resistance), and gestational diabetes. How diabetes can impact fertility and overall health. Blood sugar screening methods. Tips on how to manage blood sugar through nutrition. Gestational diabetes, its risk factors, screening process, and potential impacts on mother and baby.  The HAPO study and the continuous relationship between blood sugar levels and pregnancy outcomes. The importance of postpartum care for those who experienced gestational diabetes. Related Links: Sign up for Private Fertility Coaching with Nora here For full show notes and guest related links: https://www.naturallynora.ca/blog/125 Grab Your FREE Resources: Just starting your TTC journey? Download my Eat To Get Pregnant Guide  Having trouble getting and staying pregnant? Download my Top 3 Things To Do When You're Not Getting Pregnant Wondering what supplements to take to help you conceive? Download my Fertility Foundations Supplement Guide Please Note: The contents of this podcast are for educational and informational purposes only. The information is not to be interpreted as, or mistaken for, clinical advice. Please consult a medical professional or healthcare provider for medical advice, diagnoses, or treatment.  

The Migraine Diet author and expert Dietician, Denise Potter on ⁠#KetoDiet⁠ as a therapy. Sponsor: In-15 Home insulin testing https://metabolica.bio Continuous Ketone Monitor: https://Sibiosensor.com/ContinuousKet... 02:00 Matt Baszucki's Keto diet therapy transformed his bipolar symptoms 04:00 Beth Zupec Kania 05:00 Changing people's lives with foods 07:00 Dr Chris Palmer's Keto diet therapy for Matt Baszucki's bipolar 09:00 Getting people's kids back with Keto Diet 11:00 Emma Williams Matthew's Friends and Beth Zupec Kania Dietician 18:00 Gestational diabetes low-carb diet 19:00 Diabetes ketoacidosis 20:00 Bipolar, anxiety, depression, ADHD, epilepsy treated with ketosis 24:00 How to start a therapeutic keto diet 25:00 Apps and trackers for keto monitoring ie Ketomojo 29:00 Maintaining ketosis 30:00 Carnivore & meat-based nutrition therapy 35:00 Benefits of ketosis 40:00 ADHD improvements 48:00 Keto Diet for migraine Denise Potter: https://advancedketogenictherapies.com Family Health Lab Podcast: Health Trailblazers S2: E2 Host: Claire McDonnell Liu, Nutritionist, https://leafie.com FB / Insta / Twitter: LeafieHealth Tech: www.0ad.com.au IMPORTANT - The content in this video is not a substitute for medical advice. Always consult with your physician regarding your health matters. Individuals' lifestyles, bodies and health histories vary. The author does not assume any liability to any party for any loss, damage, or disruption caused by the choice to implement any of the health strategies.

Gestational diabetes changes the direction of many women's pregnancies.  Once the determination is made, things are not so straightforward after that.  In this podcast we will explore how the path to birth changes once a diagnosis is made and what women can do to have a birth with as few complications as possible. We also look at what women can do to prevent the diagnosis in the first place.  We discussed this important topic with Lily Nichols, who is a Registered Dietitian and Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based prenatal nutrition guidance. Her work is known for being research-focused, thorough, and critical of outdated dietary guidelines. She is the co-founder of the Women's Health Nutrition Academy and the author of two books, Real Food for Pregnancy and Real Food for Gestational Diabetes. Lily's bestselling books have helped tens of thousands of mamas (and babies!). They are used in university-level maternal nutrition and midwifery courses and have even influenced prenatal nutrition policy internationally.     Listen and Learn:  How women can change things in their lives to avoid gestational diabetes What impact exercise has on blood sugar levels  How much education most OBs/MFMs/FMOBs have in nutrition and gestational diabetes  What tests are currently used to look for gestational diabetes and how accurate they are  Why old standards of test outcomes are still in practice and what newer options are available that may be more predictive How the morning meal affects blood sugar levels    Resources & Mentions:  Lily Nichols' Website     Related Products from InJoy: Understanding Pregnancy Curriculum Understanding Birth Curriculum Understanding Prenatal Nutrition 

Many people who want to have children can't, or shouldn't, carry a pregnancy for a variety of reasons. Gestational surrogacy can be a great option for those individuals — if they can endure the lengthy wait times and afford to pay for the costly service. Learn more about your ad choices. Visit podcastchoices.com/adchoices

In this episode Heidi comes on to share her birth story. She planned an unmedicated birth center birth originally however at 36 weeks she developed gestational hypertension and was induced the following week. Heidi shares about her induction and birth process as well as how she developed pre eclampsia postpartum. ____________________ If you enjoyed this episode please subscribe and share with your mama friends! wanna be on the podcast? https://www.whatthebumpclt.com/podcast  connect with me on Instagram: https://www.instagram.com/whatthebumpclt  our website / blog: www.whatthebumpclt.com --- Support this podcast: https://podcasters.spotify.com/pod/show/what-the-bump/support

Today Roisin shares her journey of infertility, IVF experience and her two births - both emergency caesareans. When she fell pregnant with her son, she knew she wanted MGP care in the public system after hearing so many wonderful things about it on the podcast. She intended to have a low-intervention birth but as soon as she was diagnosed with gestational hypertension which escalated to preeclampsia in her third trimester, she accepted that an induction was likely. ____________ Today's episode of the show is brought to you by my online childbirth education course, The Birth Class. What makes The Birth Class so unique? Well, instead of learning from one person with one perspective, we've gathered nine perinatal health specialists to take you through everything you need to know about labor and birth. Realistic information is key to thorough preparation. Learn more here.See omnystudio.com/listener for privacy information.

Sharing an EXTREMELY vulnerable letter that I wrote to myself one year after finding out I was pregnant.Thank you for listening and respecting my story.-------------------------------------------------------------------------------------------------------------IMPORTANT LINKS:- Click HERE for our Mom Club On Patreon!- Connect with ME on Instagram HERE or at @learningtomom.podcast-------------------------------------------------------------------------------------------------------------first time mom podcast, How to prepare for pregnancy, how to prepare for birth, how to prepare for labor, Birth podcast, Motherhood podcast, Best birth podcast, First time mom podcast, Natural birth podcast, New mom podcast, What is the best pregnancy podcast, That pregnancy podcast, Best pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time mothers, Podcasts for expecting mothers, Natural birth podcast, birthing podcast, First time mom podcast, birth podcast, What is the best pregnancy podcast, Podcast for expecting mothers, motherhood podcast, how to prepare for birth, Best pregnancy podcast, new mom podcast, that pregnancy podcast, Pregnancy podcast for first time moms, Pregnancy podcast week by week,  Pregnancy podcast is it Normal, Natural pregnancy podcast,  Pregnancy podcasts for first time moms, pregnancy podcast, that pregnancy podcast, Pregnancy symptoms, First trimester tips, Prenatal vitamins, Pregnancy diet, Safe exercises during pregnancy, Maternity clothes, ultrasound information, Pregnancy apps, Birth plans, Baby registry essentials, Morning sickness remedies, Prenatal yoga, Gestational diabetes, Baby development stages, Pregnancy books, Labor signs, Breastfeeding tips, Postpartum care, Childbirth classes, Baby names, Pregnancy announcements, baby showers, Maternity leave rights, Pregnancy health insurance, Fetal movement, Pregnancy support groups, Safe skincare during pregnancy, Nursery decorating ideas, OBGYN recommendations, Stretch mark prevention, Pregnancy fitness, Birthing techniques, Pregnancy sleep positions, baby gear reviews, Pregnancy meal plans, pregnancy-safe beauty products,, Prenatal classes, Pregnancy relaxation techniques, Pregnancy forums, Baby-proofing home, Preeclampsia symptoms, Baby milestones, Natural birth options, Maternity support belt, pregnancy hydration, Newborn care, Baby feeding schedule, postpartum depression, Baby vaccination schedule, Maternity hospital bag checklist, First-time mom advice, pregnancy tips, postpartum tips, Baby's first year milestones, Pregnancy mental health, Preparing for a newborn, Postpartum depression support, Newborn sleep tips, Birthing classes online, Pregnancy workouts, Healthy pregnancy diet, labor pain, Childbirth education classes, Pregnancy and relationships

Gestational age estimation is foundational for obstetric care. In resource-limited settings, an integrated AI tool allows novice users to improve gestational age estimates. Author Jeffrey Stringer, MD, University of North Carolina, joins JAMA Deputy Editor Linda Brubaker, MD, MS, to discuss Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps. Related Content: Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps Enhancing Obstetric Ultrasonography With Artificial Intelligence in Resource-Limited Settings

In todays episode: Gestational diabetes Creative ways to navigate protein needs first trimester Low carb diets and glucose tolerance tests Soy fertility Vitamin A and pregnancy Postpartum nutrition Connect with Lily and find her resources: https://lilynicholsrdn.com

How to get your partner involved, what they need to be able to do, tips for your birth partner, how to choose the right birth partner, their  role in supporting your labor and birth and more!Today's episode on birth partner support for labor and birth covers: Why is it important to have a supportive birth partner?What things do you need to consider when choosing your birth partner?What are some things that a birth partner should do when you are in labor?Does your birth partner have to be your spouse?What are some ways that you can help GUIDE your own birth partner?How do you prepare your birth partner for birth?& MORE!!-------------------------------------------------------------------------------------------------------------IMPORTANT LINKS:- Sallyann's book: "Labour of Love: The Ultimate Guide to being a Birth Partner" is linked HERE  - Shop HERE for portable breastmilk and formula warmer at BisbeeBaby.comUse code MOM10 for 10% offConnect with them on Instagram HereConnect with them on Facebook Here- Shop HERE for the best breathable, hypoallergenic crib mattress at Pinwheelsleep.comUse code LEARNINGTOMOM for 20% offConnect with them on Instagram HereConnect with them on Facebook Here- Connect with ME on Instagram HERE or at @learningtomom.podcastHow to connect with Sallyann:- Her website is linked HERE-------------------------------------------------------------------------------------------------------------Does your birth partner have to be your husband, birth partner tips, choosing a birth partner, husband tips for birth, preparing your husband for birth, birth partner support, how to best support you in labor and birth, preparing your husband for labor, birth partner in labor tips, the role of birth partner, dad's role in labor, dad's role in birth, husband's role in labor, husband's role in birth, Pregnancy symptoms, First trimester tips, third trimester tips, second trimester tips, Pregnancy diet, Safe exercises during pregnancy, birth plan, how to choose your birth partner, birth partner support, role of birth partner, Gestational diabetes, labor signs, labor prep, labor preparation, Childbirth classes, Maternity leave rights, Pregnancy health insurance, Pregnancy fitness, Birthing techniques, prodromal labor, pain management in labor, Prenatal classes, Pregnancy relaxation techniques, Preeclampsia symptoms, Natural birth options, hospital bag checklist, First-time mom advice, First-time mom pregnancy tips, Preparing for labor and delivery, What to expect during pregnancy, Managing pregnancy symptoms, Pregnancy nutrition guide, Exercises during pregnancy, Pregnancy mental health, Preparing for a newborn, Pregnancy workouts, Labor pain management, Pregnancy myths vs. facts, Partner support during pregnancy, Maternity leave planning, Birth interventions pros and cons, Pregnancy and anxiety, Pregnancy relaxation techniques, Overcoming pregnancy fears, Prenatal exercise benefits, Pregnancy and work balance, Pregnancy cravings explained, Pregnancy mood swings, Postpartum mental health, Labor and delivery tips, Birth center vs. hospital

Episode Overview In this insightful episode, I share my personal and unique journey of health discovery as I uncover my diagnosis with a rare form of diabetes known as MODY (Maturity Onset Diabetes of the Young). Despite its rarity, this story underscores the importance of individualized care and self-advocacy in navigating the healthcare system. Key Takeaways Personal Health Journey: I detail my experience from pregnancy complications to discovering my rare diabetes diagnosis. Healthcare System Challenges: Discussing the limitations of standardized healthcare protocols and the importance of personalized care. Persistence in Self-Advocacy: Encouraging listeners to persist in seeking answers and appropriate care when faced with health concerns. Understanding MODY Diabetes: Providing an overview of MODY diabetes, its genetic basis, and the challenges in diagnosis and treatment. Episode Highlights Early Signs and Pregnancy Complications Three pregnancies with significant complications due to large babies. Initial misinterpretations of symptoms and health indicators. The Journey to Diagnosis Multiple tests and misdiagnoses including PCOS and iron status checks. Persistent high hemoglobin A1C levels despite a healthy lifestyle. Exploration of insulin resistance and the discovery of low fasting insulin levels. Discovering MODY Diabetes Genetic testing leading to the diagnosis of MODY 12, a very rare form of diabetes. Challenges in finding appropriate treatment due to the rarity of the condition. The struggle with healthcare providers reluctant to prescribe the suggested medication (glipizide). Navigating the Healthcare System The importance of advocating for myself in the healthcare system. The need for personalized care and the limitations of generic treatment protocols. Encouragement to seek second opinions and not settle for inadequate care. Reflective Insights Healthcare Privilege: Acknowledging the advantages I had in navigating the healthcare system due to my background and resources. Encouragement for Listeners: Inspiring listeners to remain steadfast in their health journey and to advocate for themselves, recognizing their own knowledge and experience with their bodies. Empowered Nutrition is now called Thrive! A Nutrition-centric healthcare model that helps you leverage the power of food to optimize your health. Learn how we can help you Thrive: linktr.ee/realnutrition Let Thrive support you with medical weight loss: At Thrive, we support you on your healing journey by blending our dietitian-led nutrition care with the efficacy of GLP-1 weight loss medications. Our innovative program harnesses the power of personalized nutrition guidance alongside close medical supervision, to optimize your journey towards a healthier weight. Click here to learn more! When needed, we use compound GLP-1 medication (Semaglutide or Tirzepatide) to help our clients reduce food noise and follow their nutrition plan more successfully. All medical weight loss program participants are thoroughly screened and monitored for safety across their weight loss journey. With or without medication, all weight loss patients work with a compassionate, expert Registered Dietitian for nutrition support. This care protects muscle, reduces side effects, and avoids nutrient deficiencies. It also improves long-term success with weight maintenance. Unlike expensive med spas, our consults for medical weight loss are billed to your healthcare insurance plan. Unlike online/virtual GLP-1 companies, we ensure your safety, both through medical screening/monitoring and by using and FDA-certified safe compounding pharmacy. Unlike with branded GLP-1 medication, compounded medication is not impacted by shortages or delays. With our program, you don't have to worry about a dangerous disconnect between your weight loss team and the rest of your healthcare team. We also serve as your primary care provider. This way, your care is more complete and safe. Lean for Life is now in the App Store! Heal your Metabolism with the Lean for Life app: https://empowered-nutrition.ck.page/193bb2cd67 Help yourself feel aligned using our three phase approach: Lean for Life Membership called Heal, Optimize , and Refinewhere you will be empowered to reverse previous metabolic damage with the assistance of our team of Registered Dietitian Nutritionists. Check out more details on our website! Want to learn more about our one-on-one Empowered Nutrition coaching? Book a free chemistry call to discuss your story and see if we're a good fit. Enjoying the podcast? Please review the Empowered Nutrition Podcast on Apple Podcasts or wherever you listen! Then, send me a screenshot of your positive review to podcast@empowerednutrition.health as a DM on Instagram (@thrive-clinics). Include a brief description of what you're working on with your health and/or nutrition and I'll send you a free custom meal plan! Do you have questions you would like answered on the Empowered Nutrition podcast? You can propose your questions/ideas by email to: podcast@empowerednutrition.health Follow us on: Instagram | Facebook

Mel provides this re-edit of episode 18 about Gestational diabetes screening in preparation for episode 99 with Lily Nichols about real food for gestational diabetes. This episode pairs with her episode for anyone challenged with a gestational diabetes diagnosis To get on the mailing list for the podcast and to access the resource folders for each episode, visit www.melaniethemidwife.com Premium podcast members Hub Being a premium podcast member gives you access to the transcript and additional resources for each episode AND the 'ask Mel a question' button so you can submit questions for the monthly 'Ask me anything' episode. Only available in the premium podcast members hub Find out all the details here You can find out more about Mel @melaniethemidwife Disclaimer: The information and resources provided on this podcast does not, and is not intended to, constitute or replace medical or midwifery advice. Instead, all information provided is intended for education, with it's application intended for discussion between yourself and your care provider and/or workplace if you are a health professional. The Great Birth Rebellion podcast reserves the right to supplement, edit, change, delete any information at any time. Whilst we have tried to maintain accuracy and completeness of information, we do not warrant or guarantee the accuracy or currency of the information. The podcast accepts no liability for any loss, damage or unfavourable outcomes howsoever arising out of the use or reliance on the content. This podcast is not a replacement for midwifery or medical clinical care.

The risks, benefits, misconceptions and process of placenta pills!Today's episode I sit down with Kirsten with Sacred Lane Birth Services and ask her all our placenta encapsulation  questions:Today's episode on gestational diabetes (aka: diabetes in pregnancy) covers:What is placenta encapsulation?Placenta and breastfeedingWhat are placenta recipes?What are the benefits to placenta pills?What are the risks to placenta encapsulation?How do you encapsulate a placentaAND MORE!-------------------------------------------------------------------------------------------------------------IMPORTANT LINKS:- The two articles she mentioned:1. Heavy metals in the Placenta2. Group B  Strep and the Placenta - Send me a topic idea for season 2 in my DMs HERE (or @learningtomom.podcast)- Fit Mama In 30: Prenatal Workout Program that I'm Doing: Click HERE                   Use code LEARNINGTOMOM for the BIGGEST discount they have!! ($20 off their annual plan)- Shop Tender Seasons for pregnancy and postpartum wear that you'll feel confident and comfortable in!Use code LEARNINGTOMOM for 15% off your oder!How to connect with Kirsten:- Her website is linked HERE-------------------------------------------------------------------------------------------------------------can placenta encapsulation decrease milk supply, how placenta encapsulation, how is placenta encapsulation done, what is placenta encapsulation benefits, what does placenta encapsulation mean, why placenta encapsulation, placenta encapsulation for milk supply, placenta encapsulation worth it, placenta encapsulation with gbs, How to prepare for pregnancy, Birth podcast, Best birth podcast, First time mom podcast, Natural birth podcast, New mom podcast, What is the best pregnancy podcast, That pregnancy podcast, Best pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time mothers, Podcasts for expecting mothers, Natural birth podcast, Best pregnancy podcast, First time mom podcast, new mom moms, How to prepare for pregnancy, What is the best pregnancy podcast, That pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time moms, Podcasts for expecting mothers, Pregnancy podcast week by week, birth podcast, birthing podcast, Pregnancy symptoms, First trimester tips, Prenatal vitamins, Pregnancy diet, Safe exercises during pregnancy, Birth plans Baby registry essentials, Morning sickness remedies, Prenatal yoga, Gestational diabetes, Baby development stages, Pregnancy books, Labor signs, Breastfeeding tips, prodromal labor, preterm labor, first time parent, newborn help, newborn tips, preparing for postpartum, prepare for natural birth, how to prepare for an unmedicated birth, birthing podcast

An update on Gestational Diabetes 

Gestational carriers provide an invaluable service for those who dream of becoming parents but face challenges doing so biologically. Being a gestational carrier is profoundly altruistic and deeply personal journey. In this episode of Time to Talk Fertility, we explore the extraordinary journey of parenthood through the eyes of Alyssa, a gestational carrier who has generously assisted patients of Fertility Centers of Illinois in achieving their dreams of building a family. Dive into the deep emotional connections formed, the intricate medical procedures navigated, and the legal frameworks that protect all parties involved. Whether you're exploring fertility options, seeking understanding, or simply captivated by human connection and science working hand in hand, you won't want to miss this episode!

Show notes: (1:09) What got Lily into the work she does today (2:29) Maternal health and its impact on the baby's long-term health (5:18) Addressing fertility challenges with nutrition (13:56) Role of supplements in preconception and pregnancy (17:29) Recommended foods for fertility and pregnancy (23:52) Managing stress and its impact on fertility (29:41) Toxin exposure and fertility (39:15) Gestational diabetes and how to prevent getting the diagnosis (45:06) Where to find Lily (46:54) Outro Who is Lily Nichols?   Lily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based nutrition. Drawing from the current scientific literature and the wisdom of traditional cultures, her work is known for being research-focused, thorough, and sensible. Lily's clinical expertise and extensive background in prenatal nutrition have made her a highly sought-after consultant and speaker in the field.   Her work in the field of gestational diabetes, which presents a revolutionary nutrient-dense, lower-carb approach, has not only helped tens of thousands of women manage their gestational diabetes (most without the need for blood sugar-lowering medication), but has also influenced nutrition policies internationally.  You can learn more about her approach in her bestselling book, Real Food for Gestational Diabetes (and online course of the same name).   Lily is also the author of Real Food for Pregnancy, which provides an evidence-based look at the gap between conventional prenatal nutrition guidelines and what's optimal for mother and baby. With over 930 citations, this is the most comprehensive text on prenatal nutrition to date. Since its publication, it remains the #1 bestselling book on prenatal nutrition.   Lily's third book, Real Food for Fertility (co-authored with Lisa Hendrickson-Jack), is a comprehensive resource on optimizing preconception nutrition — for both partners — to improve outcomes in fertility, pregnancy, and beyond.    In addition to her books, Lily is the Founder of the Institute for Prenatal Nutrition®, where she mentors other practitioners on perinatal nutrition, and is the co-founder of Women's Health Nutrition Academy, which offers individual webinars on a variety of women's health topics.    You can learn from Lily's extensive library of articles on LilyNicholsRDN.com and her research briefs on Instagram. Connect with Lily: Website: https://lilynicholsrdn.com/ IG: https://www.instagram.com/lilynicholsrdn FB: https://www.facebook.com/PilatesNutritionist Twitter: https://twitter.com/LilyNicholsRDN   Links and Resources: Peak Performance Life Peak Performance on Facebook Peak Performance on Instagram  

Hospital Bag Checklist, What to bring For Labor, and What to pack for your Postpartum stay!This week's episode of the Learning To Mom Podcast we dive DEEP into Hospital Bag Must Haves!-------------------------------------------------------------------------------------------------------------IMPORTANT LINKS:- Sign up HERE for the Learning To Mom Newsletter To Get The Hospital Bag Checklist!!- Fit Mama In 30: Prenatal Workout Program that I'm Doing: Click HERE                   Use code LEARNINGTOMOM for the BIGGEST discount they have!! ($20 off their annual plan)- Connect with ME on Instagram HERE or at @learningtomom.podcast-------------------------------------------------------------------------------------------------------------How big hospital bag, how to pack hospital bag for labour, how to pack hospital bag, how many napes hospital bag, what hospital bag pregnancy, what hospital bag to use, when should hospital bag be packed, when pack hospital bag pregnancy, which hospital bag checklist, hospital bag for mom, hospital bag for baby, hospital bag for mom and baby, hospital bag near me, hospital bag to pack, hospital bag and baby bag, How to prepare for pregnancy, Birth podcast, best birth podcast, First time mom podcast, Natural birth podcast, New mom podcast, What is the best pregnancy podcast, That pregnancy podcast, Best pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time mothers, Podcasts for expecting mothers, Natural birth podcast, Best pregnancy podcast, First time mom podcast, new mom moms, How to prepare for pregnancy, What is the best pregnancy podcast, That pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time moms, Podcasts for expecting mothers, Pregnancy podcast week by week, birth podcast, birthing podcast, Pregnancy symptoms, First trimester tips, Prenatal vitamins, Pregnancy diet, Safe exercises during pregnancy, Maternity clothes, ultrasound information, Pregnancy apps, Birth plans, Baby registry essentials, Morning sickness remedies, Gestational diabetes, Baby development stages, Pregnancy books, Labor signs, Breastfeeding tips, Postpartum care, Childbirth classes, Baby names, Pregnancy announcements, baby showers, Maternity leave rights, Pregnancy health insurance, Fetal movement, Pregnancy support groups, Safe skincare during pregnancy, Pregnancy podcasts, OBGYN recommendations,  Pregnancy fitness, Birthing techniques, Pregnancy sleep positions, Baby gear reviews, Pregnancy meal plans, Pregnancy-safe beauty products, Prenatal classes, Pregnancy relaxation techniques, Baby-proofing home,Preeclampsia symptoms, Baby milestones, Natural birth options, pregnancy hydration, Newborn care, Baby feeding schedule, postpartum depression, Baby vaccination schedule, Maternity hospital bag checklist First-time mom advice, prodromal labor, how to have a pain free birth, how to manage labor pains, labor positions, hyperemesis, hypertension, birthing positions, breathing through labor, pitocin, epidural, birth plans, pain management for labor

Dr. Christina Pinnock is a Maternal Fetal Medicine Specialist/Perinatologist based in California and creator of the ZerotoFour Podcast. She is here to help us tackle topics like what constitutes a high-risk pregnancy, lupus, preeclampsia, HELLP syndrome, gestational diabetes, fibroids, and bicornuate uteruses and how they relate to VBAC. The overarching theme of this episode is that all pregnancies are individual experiences. If you are hoping to achieve a VBAC and you have pregnancy complications, find a provider whose goals align with yours. By ensuring that your comfort levels are a good match, you are on your way to a safe and empowering birth experience!Dr. Pinnock's Website and PodcastNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 00:58 Review of the Week03:13 Dr. Christina Pinnock03:56 Importance of a VBAC-supportive provider06:36 High-risk pregnancies11:02 Lupus and TOLAC14:31 Preeclampsia 17:19 Varying ranges of preeclampsia20:46 HELLP Syndrome 26:36 Other High-risk situations 27:54 Gestational Diabetes35:00 Inductions with gestational diabetes42:25 Fibroids 46:33 Do fibroids tend to grow during pregnancy? 51:20 Bicornuate UterusMeagan: Have you ever been told that you were high risk, so you'll be unable to TOLAC? Or maybe you can totally TOLAC assuming nothing high-risk comes into play? What does high risk mean? We often get questions in our inbox asking if having your previous cesarean makes them high risk. Or questions about topics like preeclampsiaclampsia, gestational diabetes, bicornuate uterus, fibroids, and more. I am so excited to have board-certified OB/GYN Dr. Christina Pinnock on the show today. She is a high-risk pregnancy doctor passionate about educating women along their pregnancy journeys so they can be more informed and comfortable during their pregnancy. She is located in California and has a podcast of her own called “ZerotoFour” where she talks about topics that will help first-time moms prepare for, thrive, and recover from pregnancy as well as shares evidence-based information and answers everyday questions like we are going to discuss today. 00:58 Review of the WeekMeagan: We do have a Review of the Week, so I'm going to jump into that and then we can dive in to get into these fantastic questions from Dr. Christina Pinnock. Today's reviewer's name is Obsessed!!!! It says, “The best VBAC and birth podcast. I am grateful to have discovered Meagan and this podcast. I definitely believe listening to stories of these amazing women and their parent's course helped me achieve my two VBACs. Thank you for all you do The VBAC Link.”Oh, thank you so much Obsessed!!!!!  And as always if you wouldn't mind, drop us a review leave us a comment and you never know, it may be read on the next podcast. 03:13 Dr. Christina PinnockMeagan: Okay, Women of Strength. I am seriously so, so excited to have our guest here with us today! Dr. Christina, is it Pinnock? How do you say it? Dr. Pinnock: Yes that's perfect.Meagan: Ok, just wanted to make sure I was saying it correctly. Welcome to the show! You guys, she is amazing and has been so gracious to accept our invitation here to today to talk about high-risk pregnancy and what it means. Hopefully, we'll talk a little bit about gestational diabetes because that's a big one when it comes to VBAC. And if we have time, so much more. So welcome to the show and thank you again for being here.Dr. Pinnock: Thank you so much for having me, I'm excited to be here and chat with you and your audience about these great topics, so thank you.03:56 Importance of a VBAC-supportive providerMeagan: Yes! Okay well, this isn't a question we had talked about, but I'm curious. Being in California, do you find it hard to find support for VBAC or do you find it easy? I mean, California is so big and you're in Mountain View. So I don't know exactly where that is. You said the Bay Area, right? So how is it in your area? How is VBAC viewed in the provider world in your area?Dr. Pinnock: Yeah, that's a good question. I actually did most of my training on the East Coast, so it's been a good experience seeing the differences in coastal practices. I think where I did my training we were pretty open to VBACs and supported them. In California, I've had a similar experience and I think it really depends on where you are.  I'm in the San Francisco Bay Area and I work at an institution where we support TOLACs and want our moms to VBAC as long as it's safe and it's what they desire. But I really think the opportunity to TOLAC depends on your individual OB provider that you have and their comfort in offering that. And importantly, the hospital resources that you have available in your area. California's huge and depending on where you live it can be a very, very different infrastructure both geographically and specifically within the hospital. And so I really think that differences in that offering is based around those resources rather than maybe patient desire or even sometimes provider desire. So it really just depends on those things. Meagan: That's so good to know. I mean, we tell our community all the time that provider is a really, really big key when it comes to being supported. But also I love that you were talking about the actual hospital because for me with my second– I had a VBAC after 2 C-sections and with my second, my provider was 100% gung-ho and super supportive. But in the end, I ended up switching because the hospital was going to end up restricting my provider in supporting me in the way he wanted to support me, right? So it's also really important to vet your location and your hospital.Dr. Pinnock: Yes, absolutely. Sometimes, someone may live in a location where they don't have that choice, unfortunately. If you do have that choice and you can choose hospitals and providers that can support it, by all means if you have that ability. 06:36 High-risk pregnanciesMeagan: Absolutely. Ok well, let's dive in more to high-risk. So a lot of the time, I'd love to see what you think about this. A lot of the time, providers will tell moms because they've had a previous Cesarean, not even a special scar or anything like that, that they are automatically grouped into the high-risk category. So I don't know what your thoughts are on that in general, but let's talk more about high-risk pregnancy. What does it mean? What does it look like for TOLAC? How is it usually treated? And are there often restrictions given for those moms? Dr. Pinnock: Yeah, no. That's a really good question. One thing about pregnancy, there's some level of risk in all pregnancies. No matter if you're completely healthy, no medical problems, or you're trying to TOLAC, or you have other medical conditions that exist before pregnancy, all pregnancies carry some level of risk but not all the risks are equal. There are some conditions that the mother can have before pregnancy that can put her pregnancy at a higher risk of developing some complications. There are some conditions that can actually develop during pregnancy that can cause the pregnancy to be at a higher risk of developing complications. Lastly, there are some conditions specific to the placenta, the baby, how the baby developed, or even the genetic makeup of the baby that can contribute to a high risk of having complications. All of these three categories can impact the status of your pregnancy being considered high-risk. So typically, if you have a condition that falls in one of those three boats, then your pregnancy could be considered a higher risk. Usually having a previous C-section or even two previous C-sections by itself is not really something that I would use to classify someone as having a high-risk pregnancy. I do think that definitely talking with your provider about your desire for delivery earlier on can help both people to be on the same page, but if you otherwise have nothing else going on in the pregnancy and you have one previous C-section or even two previous C-sections, I think the pregnancy itself, I wouldn't consider it a high-risk pregnancy. Meagan: That's good to know. Dr. Pinnock: Yeah no, absolutely. And when you think about the delivery, I think about it a little bit differently than the pregnancy. I think for the delivery if you are interested in having a TOLAC and you have a previous C-Section or two, then the management of your delivery and the risk of your delivery isn't the same as someone who hasn't had a C-section. I think about them as like two different boats. But overall, conditions that are related to maternal health can be high blood pressure, diabetes, and autoimmune conditions like lupus. Those things can cause your pregnancy to be considered high-risk. A good example of a few things that can develop in pregnancy that can make your pregnancy high-risk include things like preeclampsia which is high blood pressures of pregnancy. Having twins or having triplets can make your pregnancy a higher risk. In some instances, even gestational diabetes depending on what's going on and where you are can be considered a pregnancy with some high-risk features. And then genetic conditions for baby whether that's a difference in how one of your babies' organs developed, or a genetic condition that's discovered from testing; any of those things can really impact that high-risk status and how your pregnancy will be monitored and managed after that. Meagan: Ah these are all such great topics and actually things that we get in our inbox. Like, “Hey, I have lupus,” or we'll have one of our VBAC doulas say, “Hey, I have a client who has lupus. She really wants to TOLAC and have a VBAC. What does that mean for her?” Obviously, all of these conditions are going to be treated differently throughout the pregnancy and probably even during the labor and delivery portion. 11:02 Lupus and TOLAC Meagan: I don't know if we can touch on a couple of those like lupus. What does that look like for someone? If I have lupus coming in, I'm doing okay right now. I have it. What does that look like for someone wanting to TOLAC and to have a VBAC?Dr Pinnock: Yeah. I think it's similar to your first question about whether a C-section would make your pregnancy considered high-risk. So the lupus diagnosis would increase the risk of certain medical conditions happening in pregnancy relating to both mom and baby. Your doctor may get some extra blood work to monitor how your lupus is progressing in pregnancy. Your doctor may get some extra ultrasounds to make sure that baby isn't too small and add some extra monitoring to make sure that baby is staying safe and that if there is a risk for baby to be in distress that that is picked up. And so the actual monitoring and management of the pregnancy is usually done with the help of a high-risk pregnancy doctor like myself with an OB provider. That is really specific to what is going on with that person. If everything goes smoothly and lupus stays under control and we get to the moment where we're thinking about how we're going to deliver baby, that's sort of a separate boat. In an ideal world, everything goes well in terms of the lupus and pregnancy and if you're interested in having a TOLAC, having a diagnosis of lupus should not restrict you from that option. You can still have that as an option but it really just depends on the specifics of how your pregnancy has unfolded. Have you developed any other conditions like high blood pressures in pregnancy or preeclampsiaclampsia where your doctor is maybe thinking you may need to deliver earlier? Are there things going on with your baby where we think baby is under more stress where we would really need to be very intentional about how we deliver baby? It's a really nuanced thing and it's based on the specifics on that person's condition. I think an overarching theme is whatever is going on with the pregnancy that impacts the delivery if things are not going as smoothly. But if things are going smoothly and you want to try for a TOLAC, that's not necessarily a reason to say, “No, you absolutely can't do this,” unless there are specific conditions that came up in your pregnancy that make it less safe for either you or baby as the mom. Meagan: Yeah. Something that I'm just hearing you say so much that's standing out is that really is individual, depending on that individual and depending on that individual's case. I think that's something important for listeners to hear because someone who may have lupus that's going really, really fine, TOLACs going to be a really great option for them. But someone who may have active symptoms and it's going and it's really hard, that may be a different suggestion in the end. But I like that you're like, We're in this boat and then we travel over to this boat into this time, and then it's a matter of how we float that boat and how we get to our destination.Dr. Pinnock: Exactly.14:31 Preeclampsia Meagan: Would you say that the same thing goes for preeclampsia? Preeclampsia can develop at any stage of pregnancy. I mean, we've had clients in weeks 18-20 develop it and then have to be really closely watched and all of these things. Is that someone also where you would say the same thing? Where it's like, We're in this boat doing these things and these tests and monitoring, and then again we get into this next boat and we have to decide what the best route is?Dr. Pinnock: Yeah, no. That's a good question. I think it's similar but a little different with preeclampsia. It depends on the type of preeclampsia that's going on. Preeclampsia is a spectrum and with the part of the spectrum that's more on the severe side, we still try for a vaginal birth. It really depends on, as you've mentioned, how far along you are in the pregnancy.Maybe you are 28 weeks and you have such a severe form of preeclampsia that your doctor is like, “I don't think we can get any more time with the pregnancy,” that's a very different situation than someone who has a very non-severe form of preeclampsia at 39 weeks who wants to TOLAC and have all of those options available. It really does depend but the overall theme with preeclampsia if you do want to try for a vaginal birth and your health and baby's health are stable in the moment, then usually we do try as much as possible to have a vaginal birth. But things like very early gestational age and really severe complications of preeclampsia make the possibility of having a vaginal birth less likely. It makes the possibility of someone who wants to TOLAC in that setting less likely. It really depends on the severity of that spectrum of preeclampsia, but we always try for a vaginal birth if we can. Meagan: Yeah. This may be too hard of a question to answer, but can we talk about that range and the severity? What does a low to moderate to severe case of preeclampsia look like in a person? What would be considered that severe, “Hey, we might need to reconsider our birth desire here,” to “Hey, you have it. It's really low right now,” or to “We're in choppy waters right now.”17:19 Varying ranges of preeclampsiaDr. Pinnock: That's a good question. Pre-e is defined as elevated blood pressure in pregnancy after 20 weeks. So once you hit 20 weeks, if your blood pressures are elevated, 140/90 times multiple times and we see any evidence of preeclampsia's impact in some organs in your body.One of the most common things that we used to use to diagnose is the presence of protein in the urine. Once we see that, we're like, “Oh, man. I think you may have preeclampsia,” then we do an evaluation of the rest of the body to understand how severe it is. Preeclampsia is a disease that's thought to develop from the placenta when it implanted. It can cause dysfunction or impact on the organs. It can cause severe headaches. It can cause changes in your vision and problems with your blood cells, your liver, your lungs, and your kidneys. We go from head to toe and take a look at how those organs are being impacted by preeclampsia and then we ask you how you're doing. If you're having a headache, if you're having changes in your vision, pain in the belly, and all of that, it helps us to understand the severity. So depending on your symptoms, your blood work, and your blood pressures, those things together help us say, “Is this a severe form of preeclampsia?” and if it is, then we usually have some specific things that we have to do. Generally, you likely are monitored in the hospital. We keep a close eye on your blood pressure and your organs. That pregnancy is considered to be very high risk. Very high risk for a harm for mom, so risk of seizures, impact on the organs that can sometimes be lifelong and risk to baby. The highest risk to baby is that risk of being born early, so pre-term delivery. And usually if you have severe preeclampsia, we usually recommend delivery no later than 34 weeks. So once we do develop that severe form, we keep a close eye on things. If you have the non-severe form, so if your organs look oay and your blood pressures are stable but you have some protein in your urine and we do think you have preeclampsia but it's not severe, then we give you some more time. We still monitor you and baby very closely, but we can maybe try to get the pregnancy up until 37 weeks and after that, the risk of continuing the pregnancy and harm to maybe the mom and baby are a bit higher than some of the risks of being born at 37 weeks. So at that time is when we would say, “Let's have a birthday.” It really depends on those things. Meagan: Okay, that's so good to know. I think sometimes that also can vary like, I've got high blood pressure, but I don't have protein. Or I've got a trace of protein but I'm doing okay, I don't have any symptoms. But we also know with preeclampsia it is important to watch really closely no matter whether severe or not because it can turn quickly. Where you have zero signs and the next morning and you wake up with a headache and crazy swelling and you have that blurred vision with really high numbers. So it's just really important to watch.Dr. Pinnock: Exactly.20:46 HELLP SyndromeMeagan: I really do like to ask that question because a lot of people ask, do I have to have a C-section? Do I have to be induced? What does that mean? Am I severe or not severe? And we also note, we weren't even talking about this, but HELLP syndrome. So we can develop more, right? Preeclampsia affects more the mom, but then alsothe  baby timewise. HELLP syndrome is another really high-risk complication. What would you suggest for that when it comes to TOLAC because we have platelets being affected there? That one is a tricky, tricky one. Dr. Pinnock: I think HELLP syndrome is on that same spectrum of hypertensive disorders in pregnancy. But HELLP syndrome can be pretty life-threatening and dangerous for mom and by extension baby. So HELLP syndrome is when we find that your body's sort of hemolyzing so there are some things in your blood that's causing your blood vessels to sort of open red blood cells. We find also that you have elevated liver enzymes so your liver's being impacted pretty severely and then the platelets or the blood cells that help with clotting get really, really low. And so the combination of that with or without elevated blood pressures make us very concerned about HELLP. So the worry is if we don't deliver the baby pretty expeditiously and deliver the placenta which is thought to be really the source of the diagnosis, mom can get really ill and we really try to deliver as soon as possible. The exact way we deliver is really dependent on the specifics of what is going on. So maybe if your liver enzymes are very, very elevated and there's a high concern for mom's health and safety, your doctor may say, “I don't think we have time to try for a TOLAC, especially if you're not in labor. I think it would be too unsafe. I think I would recommend a C-section at this time because of that,” then that would be that recommendation. Sometimes we do try for a vaginal birth with HELLP, but it would be a case where we would want to limit how long we try but overall we try to deliver as fast as possible either vaginally or with a C-section. And if you do want to try for a TOLAC in that setting, I think my recommendation is to really, really be open to whatever is best for your health and your babys health. That's my advice for all women who are in labor. It's such an unpredictable experience and you can come in with your desires and your doctor can come in with their desires for you, and your baby or your health just dictates something else. And so with HELLP, that's an even more significant moment where if your body's telling us one thing, we have to listen. You may not be eligible for a TOLAC at that point. I think in more cases than not, many providers may not have that bandwidth or think it's safe to try for TOLAC in that setting. Meagan: Yeah. I've had very few clients as a doula who have had HELLP, but one of the clients– they actually both ended up having a Cesarean, but one of the clients' providers was even uncomfortable with even having an epidural and actually suggested general anesthesia. Is that a common thing if HELLP is super severe that could possibly be what's suggested or best?Dr. Pinnock: Yeah, no as I mentioned with that kind of diagnosis, you can have pretty low platelets. And so when we think about a procedure like an epidural or even a spinal, so any sort of neuraxial anesthesia where we're not putting mom to sleep, we're just numbing mom from the waist down, that requires insertion of a needle or a catheter in the back. That's near a lot of important structures so once you have that puncture, you're going to have some bleeding. And if those platelets aren't enough to sort of prevent that bleeding from extending, then our anesthesia team may not be comfortable doing that procedure safely because it's not safe. They may offer to give some platelets etc but often with HELLP, it may not be as fast acting and sometimes you may just hemolyze again. Those platelets may go back to being very low and if we are thinking about having a delivery urgently, delaying for that reason may not be safe for mom and baby. Oftentimes, if the platelets are too low, then our anesthesia colleagues, who are a very important part of the team, may recommend against trying for an epidural or even a spinal and recommend general anestheia.In my experience, I don't do C-sections under general anesthesia often, but when I do, it's usually recommended for a very, very significant reason and it's always with the safety of mom and baby in mind. It's never something that we want to do. It's only something that we do if we have to do for mom's safety or for baby's safety. Meagan: Yeah. So good to know. And they actually ended up doing a platelet transfusion as well specifically for the Cesarean. Obviously, we know blood loss is a thing that's a big surgery so they were trying to help her there. 26:36 Other High-risk situationsMeagan: Okay, well are there any other high-risk scenarios where you feel like truly impact the ability to have a TOLAC offered?Dr. Pinnock: Yeah. I think the highest risk conditions that could prevent mom from having a TOLAC are probably conditions related to the heart or lungs where the physiology or the changes that happen in labor can make it so that a vaginal birth is not safe or recommended for mom or baby. A TOLAC in those high-risk settings is often not recommended. There are a lot of cardiac and lung conditions that we take care of. There are not that many that we would say you can't have a vaginal birth, but sometimes there are blood vessels in the heart that can be dilated or blood vessels near the heart that can be dilated that we may say, “No, you definitely need a C-section,” so if you wanted to TOLAC we wouldn't recommend that. Those are probably the highest-risk conditions that I take care of and where a TOLAC is not recommended or even offered because it's just not considered to be safe. 27:54 Gestational DiabetesMeagan: Okay that's so good to know. Okay, let's jump in a little bit to gestational diabetes. We can have both managed and not managed. Do you have any advice for listeners who may have gestational diabetes or maybe had gestational diabetes last time and they're preparing to become pregnant or wanting to learn more about how to avoid it if possible or anything like that? Do you have any suggestions to the listeners?Dr. Pinnock: Yeah, that is one of my favorite things. I really believe that just paying close attention to your health and taking steps before pregnancy can make a world of a difference in your risk of developing certain conditions. Gestational diabetes is one of those conditions that can be definitely most susceptible to things that we can do before pregnancy. And so I know that this is going to maybe sound like a broken record to those who had gestational diabetes before, but just look at your lifestyle factors. I think that the most undervalued or underestimated intervention is really exercise. It doesn't have to be your training for an Iron Man or a marathon. It could just be like a 20-minute walk every day or a ten-minute job every day and work your way up. We definitely found that aerobic exercise more days of the week than not, and resistance training, it could be with resistant bands, if you have any sort of light weights or even body weight. Any resistance training to help build up that muscle mass can help to reduce your risk of getting gestational diabetes. If you couple that with adjusting your diet, and diet is such a big topic but essentially no matter what your background is, focusing on the whole foods of your cultural background is best. So low processed foods, more homecooked meals with whole grains, fruits, vegetables, fish, and limitations of red meat and processed foods. All of those things can go a long way with preventing gestational diabetes and also reducing the recurrence of gestational diabetes. I'm really passionate about that. Meagan: Yeah, us too. I didn't have gestational diabetes, I had kidney stones weirdly enough because my body metabolizes nutrients differently during pregnancy and anyway, it's totally not gestational diabetes but I had to look at my pregnancies and before as something like that. Really dialing in on nutrition. Really dialing in on my exercise. And I couldn't agree more with you that it doesn't have to be this big overwhelming Iron Man training or running a marathon. It really can be a casual 20, 30-minute stroll around the neighborhood walking the dog or whatever and dialing in on those whole foods. We love the book Real Food for Gestational Diabetes by Lily Nichols. If you haven't ever heard of that, it's amazing. It's a really great one. You might love it. And I definitely suggest that to all of my clients. She even has one for Real Food During Pregnancy. Just eating good food and then we love Needed because we know that getting our protein and getting the nutrients that wer eally need can really help like you said recurring and current and just avoiding hopefully. So we really love that topic, too. But gestational diabetes doesn't just nix the opportunity to TOLAC, correct?Dr. Pinnock: No, it doesn't. Gestational diabetes can be a really tough diagnosis for a lot of women to get in pregnancy. It can be really disappointing especially if you may be a relatively healthy, active person and you don't have a lot of risk factors for developing gestational diabetes. It can kind of feel like a gut punch almost. Meagan: Yeah! And it's very overwhelming because you're like, What? No! Dr. Pinnock: It is! And it happens fast. You're diagnosed and then you have a flurry of things that you have to now do and change and think about. It can be very stressful. But I always tell my patients that there are things that put some people at risk of developing gestational diabetes more than others, but all women because of those placenta hormones can have insulin resistance or your body's just not responding as well to the insulin that you're making. Depending on those risk factors, some women develop it. Some women don't. And once you do develop gestational diabetes, it's something that we really pay attention to because it can increase the risk of things for moms so particularly it can increase the risk of mom developing preeclampsia and it can increase the risk of things for baby. Babies can be on the bigger side or have macrosomia if the blood sugars are too high. They can actually have a higher risk of having a birth injury if we're having a vaginal birth or mom may actually have a higher risk of needing a C-section if you're trying to TOLAC and baby's on the bigger side. Rarely, and this is sort of the thing we worry about the most, is that if those blood sugars are too high for too long, baby can be in distress on the inside and it can increase the risk of having a stillbirth or having baby pass away. So because of those things, once we diagnose it, we do pay attention to it and we try our best to sort of make those changes hopefully with diet and exercise to sort of manage the blood sugars. If we're having perfect blood sugars with those changes, then wonderful. If we're not, and it happens and you need some additional support then your doctor provider may recommend some other management options like medications to help to bring the blood sugars down. But I think, when we think about TOLAC, we want to think about separately managing the pregnancy, keeping mom and baby safe, and then thinking about the safety of delivery. So as long as the baby's size isn't too big, as long as mom and baby are healthy and safe, you can definitely try for TOLAC with gestational diabetes. But those two things are big “buts”. You really want to try your best to manage your blood sugars so baby's size doesn't work against your efforts of trying to have a TOLAC.35:00 Inductions with gestational diabetesMeagan: Yeah, we know that the size can definitely impact providers' suggestions or comfortablity to offer TOLAC. And we know big babies come out all of the time, but we know sometimes there's some more risk like you were saying. So can we talk to the point of inductions?So a lot of providers will, and you kind of touched on it. There can be an increased risk of stillbirth. But a lot of providers seem to be suggesting that induction happens at 39 weeks. Some of the evidence shows that in a controlled situation, meaning all of the sugars are controlled, but what do you see and what do you suggest when someone is wanting a TOLAC, has gestational diabetes, may have a baby measuring larger or may have a provider who is uncomfortable with induction which we see all the time? Any suggestion there and what do you guys do over in your place of work?Dr. Pinnock: Yeah, that's a great question and it's something that I individualize to every patient. So let's think about it in two different buckets or three different buckets. Say you have gestational diabetes that's pretty well controlled with just diet. So with diet and exercise, your numbers are pristine. Baby is a good size, we're not over that 4500-gram mark where we start to say, “Is it really safe to try for a vaginal birth?” and that's okay. If we are in that boat, then I think it's reasonable to allow for mom to go into labor and try for TOLAC if that's their desire. The exact gestational age at which someone goes into labor varies. We don't have a crystal ball. We don't know. Meagan: Nope.Dr. Pinnock: We do have to balance waiting for that labor process with the inherent risk of babies being less happy and distressed and the risk for a stillbirth as the pregnancy progresses. Now, if you have gestational diabetes that's well controlled with diet, we think from the studies that we have that our risk of stillbirth is similar to someone who does not have gestational diabetes which is good. And so for those pregnancies, depending on your specific location and provider, we may do some monitoring with non-stress tests or something like that later in the pregnancy until you deliver. Usually, we start at around 36 weeks or so if you're well-controlled with just the diet and allow you time for your body to go into labor and have a vaginal birth. Now, if we get to your due date and nothing, baby is still comfortable inside. They're like, Oh no. I'm just hanging out, we start to think, How long are we going to allow this to go on? At that length of time, we start thinking about, Okay. We're at 40 weeks. What are the risks to mom and baby? And so at 40 weeks, we're about a week past 39, and we know that the risk of– if things are perfect for anyone, the risk of having babies be in distress, maybe the placenta's just been working for a long time and isn't just working as well and the risk of stillbirth goes up, we don't want to go to 42 weeks. So I think at that moment, it's a good time to think of an exit strategy. If your baby is just so comfy on the inside, think about, when I would say is an upper limit of reasonablility to wait for labor? That varies depending on the person and provider. But I think reasonably, up until 41 weeks. I wouldn't go past that. If we're allowing our body to go into labor up until 41 weeks, then we have to think about, How does that impact my risk of having a successful TOLAC? After 40 weeks, some of our studies suggest that you may be at a higher risk of having a failed TOLAC or needing a C-section and that's regardless of whether you're induced or whether you go into labor. TOLAC-ing does carry that inherent risk so it's really just dependent on your doctor, you,  your provider, and balancing all of those things. I think going until 41 weeks is probably the maximum limit for a well-controlled gestational diabetes with perfect sugars, no medications, and we're still doing monitoring to make sure that baby is doing well.Now, if you're in the camp where you're either gestational diabetes, or even controlled with diet, or if your gestational diabetes is controlled with medication or if you're diet-controlled, but those sugars aren't great, any scenario where the sugars aren't perfect and we need either medications or your sugars aren't perfect, I don't generally go past 39 weeks.The reason being at 39 weeks, baby is fully developed and after that, the risk of having a  pregnancy loss goes up because of that uncontrolled or not optimally controlled gestational diabetes. I think at that gestational age you would want to think about maybe an induction or maybe a repeat C-section depending on how you're feeling if your body isn't going into labor. And that's a personal decision. Now, if you have gestational diabetes managed with medication and your baby is big and maybe let's say over 4500 grams which is sort of that range where we worry about the safety of a vaginal birth. And you're now going into labor, then that becomes a little bit more of a shared decision-making where you want to think of, My baby's big. I would need to be induced. Is this going to be something I want to commit to or is it something I don't want to commit to? That's a personal choice but I think at that gestational age I would say I wouldn't want anymore. ACOG though does recommend or does allow for moms who do have gestational diabetes well controlled with medication, like if your blood sugars are perfect with the medication to go until 39 weeks and 6 days. So technically you can use those extra few days, according to our governing board or the American College of OBGYN. But it's going to really come down to you and the relationship you have with your doctor and what you both are comfortable with. Maybe you have a provider that is open to that recommendation or a provider whose more open or comfortable to a 39-week delivery regardless of how well your blood sugars are controlled once you're on medication. But ACOG does give us that wiggle room to say we can go further. 42:25 FibroidsMeagan: So good to know. Okay, let's see. Is there anything else we would like to talk about high-risk-wise? I know I had mentioned one time about fibroids and heart-shaped uterus. Do you have anything to share on those two topics, because those are also common questions? Can I TOLAC with fibroids? Can I TOLAC if I have a heart-shaped uterus? Where does that land as VBAC-hopeful moms?Dr. Pinnock: Yeah, no. I think those are some great things to consider. So I think we can open with the fibroids. I think if you've have had fibroids and you've had that fibroid removed, so you've had a myomectomy, there are a handful of things where we usually say, “No, we don't want you to TOLAC.” One of them is if you've had a previous uterine rupture or that previous Cesarean scar opened in a previous delivery, that's an absolute no. The risk is too high. We don't think it's safe. The other is if you've had a previous surgery where that surgery included the fundus or the top of the uterus where those contractile muscles are. Usually, with a myomectomy or fibroid removal, that involves that area. If you've had a fibroid removed in that area or you've had a myomectomy, a TOLAC is not recommended. So those are sort of one of the few things or few times where we say, “Absolutely, no.” If you have a fibroid and maybe you just discovered you had it during pregnancy, most of the time fibroids don't cause any problems. They're benign growths of the muscle of the uterus that can vary in size. So generally if they're small to medium size and depending on their location they may not cause any problems. If they do cause a problem, the most common thing women experience is pain. But usually if they're not too big and they're not in a location where we're concerned about, it should not really your ability to TOLAC. Now if the fibroid is like 10 centimeters and located near the lower uterine segment or the part of the uterus where the baby transports through to come out through the vagina, then we're going to take a pause and say, “Is this going to be a successful TOLAC?” Is the fibroid going to compete too much with the baby's head for baby to come down safely and should we just think about doing a C-section? And a C-section in that event is also not straightforward or a walk in the park because either way, the fibroid is present near where we would use to deliver the baby. So short answer is that yes, you can TOLAC with a fibroid. But the long answer is that it really depends on how big the fibroid is, where it's located and whether we think it's going to obstruct that area where baby's going to come from. If it's not, then it's reasonable to try and many women have TOLAC'd with fibroids all the time. So it's definitely not a reason to say, “No, you definitely can't.” If you've had the fibroid removed though, then it's a no. That's just one thing to talk about if you're considering that procedure and you have an opportunity to talk with the provider who is offering that procedure, just knowing that after that for most surgeries that remove the fibroids you won't be able to try for a vaginal birth. 46:33 Do fibroids tend to grow during pregnancy? Meagan: Good to know. Good to know. And is it common for fibroids to grow during pregnancy? Does pregnancy stem them to grow? Or does that impede them because you've got a baby growing in there and the focus is on growing a human and not growing a fibroid?Dr. Pinnock: No, that's a good question. Interestingly enough, we see about a split group so about a third of them stay the same. They don't change in size. A third of them shrink and a third of them grow. Meagan: Oh wow.Dr. Pinnock: We don't know which third it will be. Two-thirds of them either get smaller or stay the same size. But there are women who experience growth of the fibroid and it's actually due to those hormones estrogen, progesterone, and all of those hormones being released by the placenta. It stimulates the fibroid to grow and that's actually when some women experience pain. The fibroid grows. It outgrows its blood supply and then it degenerates or dies off a little bit and it causes this pretty significant pain for some women, but interestingly it's not 100%. A lot of people don't have many symptoms and don't have any pain. When I monitor fibroids, a lot of them don't change in size. Some of them get smaller and sometimes I'm not able to see them later on because they're so small. But there is that percentage who experience the growth of their fibroid and that's usually when pain is experienced from them. Meagan: Okay. And you mentioned that they could. I mean, 10 centimeters is a pretty large fibroid but it can happen, right?Dr. Pinnock: I've seen it. Meagan: Yeah, so it can happen. You said it can compete with baby coming down. Can fibroids also inhibit dilation at all? Can it impact dilation at all?Dr. Pinnock: Absolutely. Some of the things that we see or that we worry about if there's a large fibroid present is other than impacting the area where baby can come through, it can cause dysfunctional labors. So those muscles that are contracting in a uniform way aren't going to be able to contract as uniformly as they would have if the fibroid wasn't there. So sometimes the labor can stall. The cervix isn't dilated as much. Even sometimes we see that fibroid causing babies to actually present head down and so that's also something that we can see with very large fibroids. It can actually increase the risk of baby being breech or transverse or malpresenting in general. Meagan: interesting. And you said that sometimes there aren't even any symptoms at all, so how would one find out if they do? Is that just usually found at 20-week ultrasound? Or is it possible that at 20 weeks you had it but it's so minute and it's so small, that you can't even see it? And then in labor we have some of these symptoms or whatever and it's there but we don't know?Dr. Pinnock: Not usually. Most women, if they didn't know they had a fibroid before pregnancy, get diagnosed in pregnancy at an ultrasound. Either a first trimester or 20-week ultrasound, we look at the uterus in detail and we can pick up fibroids. We are hopefully not going to have a 10-centimeter fibroid present at 10 weeks that's missed that's just going to magically present at 39 weeks and be a surprise. Usually the fibroid, if it's there, is picked up on an ultrasound. That's the most common way it's picked up. Depending on the size, it may be a reason why your doctor or provider recommends for you to have ultrasounds in the pregnancy. Sometimes we monitor the fibroids. We monitor their locations, the size of them, and we make sure that they're not too big to be causing a problem. Rarely if they grow, they don't usually grow from like 3 centimeters to 10 centimeters. They may grow a centimeter or two. It's very unusual to have that big change. And so for the most part, it's picked up on ultrasound. We know the size of it. If it grows, it grows a small amount. It's not going to grow from 5 to 10, and we're going to know the location of it from that first time we evaluate it. It's not going to be a surprise moment at delivery where we're like, Oh my goodness, this wasn't picked up.51:20 Bicornuate UterusMeagan: Okay, good to know. Good to know. Okay and last but not least, I know we're running short on time and I want to make sure we respect that. Any information you have on a heart-shaped uterus? Is TOLAC possible with heart shaped uterus? Have you seen it? Have you done it?Dr. Pinnock: I have not seen it or done it to be honest. I do think a heart-shaped uterus just so we're using the same language that's considered a bicornuate uterus, is that–?Meagan: Yes, a bicornuate uterus.Dr. Pinnock: So for a bicornuate uterus or any kind of situations where the uterus developed differently, interestingly the uterus develops from two different stuctures. It develops from something called the Mullerian Duct and early in development when you are a tiny, tiny baby, those two structures fuse and when they fuse, they come side by side first, and then they fuse. When they fuse there, is a little wall in the middle that gets removed and so when all of that is done you have uterus that is shaped as we know it and we have that cavity on the inside where the baby would come in and grow. Now with a heart-shaped uterus, or a bicornuate uterus, there is an error when those structures come together side-by-side. So sometimes they just stay side-by-side and they don't fuse as well or sometimes they fuse but only fuse partially. So you have the uterus that as we know it, but sometimes you can have two separate structures. So two separate cavities where the prgenancy can grow, or you can have one cavity where there is still some tissue right in the middle there. It can vary depending on the suffix of how that fusion happened. Essentially, if there's less space in the cavity either from that tissue or having two separate but smaller cavities, there's presumably less space there for baby to grow. There's less contractile strength on that one side and so it can theoretically increase the risk of certain things happening in labor. I think the things that we see most commonly with bicornuate uteruses, it can have a higher risk of having a pregnancy loss, so a miscarriage. High risk of baby being born early because that area is just smaller so it's not as strong in holding the pregnancy. And similarly, baby can also be malpresented more commonly because the are is much smaller than a full uterine cavity.Meagan: That's what we see a lot is breech. Dr. Pinnock: Exactly. I haven't seen too many cases. It's a rare thing to see. I haven't seen too many cases where baby's head-down and we're at full-term and wanting a TOLAC. A lot of cases I've had, baby is breech or malpresenting so we end up doing a C-section. The shape of the uterus is not going to change for the next pregnancy so chances are the baby's usually malpresenting. I don't think we have any big databases or big data to say is it safe? Is it not safe to TOLAC? I think the main thing you'd be concerned about it that spontaneous uterine rupture if there is labor going on even if you haven't had a C-section and also if you've had a C-section before. So I think a TOLAC would be a little bit of an unknown for this situation. I would think on it pretty heavily and talk with your doctor about the specifics of your situation. If your previous C-section because baby was breech, chances are baby's not going to be presenting head down because of the shape of the uterus. It tends to have things that recur as to reasons for having a C-section. So we don't have any large databases where we have women who have TOLAC'd with this condition, so hard to say. So maybe give it a try, but maybe thing long on this one. Meagan: Case by case, it all comes down to case by case.Dr. Pinnock: Yes. That's pretty much what I do. Anything in pregnancy that's a little bit more nuanced and any high-risk condition, it's very individualized. And we have to really have that approach with high-risk pregnancies or anything that comes up that makes your pregnancy higher risk of having anything happen to mom and baby for sure. Meagan: Right. Oh my goodness. Well, I love this episode so much and cannot wait to hear what people think about it. I'm sure they're going to love it just like I do. I know I mentioned at the beginning of your podcast and things like that, but can you tell us more? Tell us more about the ZerotoFour podcast and where people can find you. I know you have YouTube and all the things, so tell us where listeners can follow you.Dr. Pinnock: Yeah. You can find me on Instagram @drchristinapinnock, the ZerotoFour Podcast so the zerotofourpodcast.com where I share the episodes with new moms about pregnancy. I really started the podcast with the goal of helping moms to be more informed and comfortable about everything along their pregnancy journey. I share topics from the whole spectrum of that journey to help you feel more prepared and informed and empowered about your pregnancy experience. You can find episodes there, on Apple Podcasts, Spotify, or anywhere that you listen to podcasts.Meagan: Awesome. So important. This is a VBAC-specific topic, but I mean those first-time moms, we have to learn. We have to learn all the things because there is really so much. We just talked about a little nugget of a couple of high-risk situations and there's just so much out there that can happen. It's so good to know as much as you can. Get informed. Learn all the things. Follow your podcast. I definitely suggest it. We'll have all the links in the show notes and thank you for joining us today. Dr. Pinnock: Thank you so much for having me. It's been a pleasure. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Our Sponsors:* Check out Dr. Mom Butt Balm: drmombuttbalm.comSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

DIVING DEEP into Gestational Diabetes, you don't want to miss this!!!Today's episode I sit down with Leslee Flannery from Gestational Diabetes Nutrition and she breaks down all things Gestational Diabetes.Today's episode on gestational diabetes (aka: diabetes in pregnancy) covers:Gestational diabetes explainedGestational diabetes risk factors Gestational diabetes test and how to pass the gestational diabetes testGestational diabetes what to eatManaging Gestational DiabetesPreventing Gestational DiabetesAlternatives to the glucola drink for the gestational diabetes testAND MORE!-------------------------------------------------------------------------------------------------------------IMPORTANT LINKS:- Send me a topic idea for season 2 in my DMs HERE (or @learningtomom.podcast)- Fit Mama In 30: Prenatal Workout Program that I'm Doing: Click HERE                   Use code LEARNINGTOMOM for the BIGGEST discount they have!! ($20 off their annual plan)- Learn more about Babies & Bumps HEREHow to connect with Leslee:- Her instagram is linked HERE-------------------------------------------------------------------------------------------------------------are gestational diabetes big, how to prevent gestational diabetes, how to test for gestational diabetes, how to manage gestational diabetes, are gestational diabetes and preeclampsia related, are gestational diabetes babies born early, can gestational diabetes be prevented, can gestational diabetes be reversed, natural birth podcast, how gestational diabetes occurs, how gestational diabetes is diagnosed, what gestational diabetes means, when gestational diabetes test, when gestational diabetes start, where does gestational diabetes come from, where to do gestational diabetes test, why gestational diabetes happens, will gestational diabetes go away, gestational diabetes can cause, gestational diabetes can lead to, gestational diabetes for baby, gestational diabetes is caused by, gestational diabetes and autism, How to prepare for pregnancy, First time mom podcast, New mom podcast, What is the best pregnancy podcast, That pregnancy podcast, Best pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time mothers, Podcasts for expecting mothers, Pregnancy podcast week by week, Pregnancy symptoms, First trimester tips, third trimester tips, Prenatal vitamins, Pregnancy diet, Safe exercises during pregnancy, ultrasound information, Pregnancy apps, Birth plans, Baby registry essentials, Morning sickness remedies, Prenatal yoga, Baby development stages, Pregnancy books, Labor signs, Breastfeeding tips, Postpartum care, Childbirth classes, Maternity leave rights, Pregnancy health insurance, Fetal movement, Pregnancy fitness, Birthing techniques, Pregnancy sleep positions, Baby gear reviews, pregnancy meal plans, prenatal classes, Pregnancy relaxation techniques, Pregnancy forums, Preeclampsia symptoms, Baby milestones, Natural birth options, preparing for birth, birth podcast, natural birth podcast, how to have a natural birth, natural birth tips,

How to Meal Prep for postpartum during pregnancy!This week's episode of the Learning To Mom Podcast we dive DEEP into meal prepping nutritious postpartum meals that will allow you to recover faster and save you time!In this episode, we talk about how much to make, what to make, how to freeze it, and more!-------------------------------------------------------------------------------------------------------------IMPORTANT LINKS:- Sign up for the Learning To Mom Newsletter HERE:- Shop Tender Seasons for pregnancy and postpartum wear that you'll feel confident and comfortable in! Use code LEARNINGTOMOM for 15% off your oder!- The Postpartum Nutrition/Recipe Book mentioned is linked HERE(I recommend getting the hardcopy, so it's easier to reference the recipes!)- Connect with ME on Instagram HERE or at @learningtomom.podcast-------------------------------------------------------------------------------------------------------------When to start postpartum meal prep, best meal prep for postpartum, best freezer meal prep for postpartum, easy meal prep for postpartum,  postpartum meal prep breakfast, postpartum meal prep freezer, healthy postpartum meal prep, postpartum meal prep guide, postpartum meal prep ideas, postpartum meal prep for weightloss, How to prepare for pregnancy, First time mom podcast, New mom podcast, What is the best pregnancy podcast, That pregnancy podcast, Best pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy,  Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time mothers, Podcasts for expecting mother, Pregnancy podcast week by week, Are postpartum night sweats normal, are postpartum periods worse, can postpartum, depression last for years, can postpartum depression start at 4 months, can postpartum depression start at 3 months, what does labor feel like,  birth podcasts, how to prepare for birth, how to prepare for labor, how to prepare for an unmedicated birth, how to prepare for a natural birth,  what will birth feel like, natural birth experiences,   how to achieve a natural birth, natural birth tips, unmedicated birth tips, preparing for labor as a first time mom in postpartum, postpartum rage, postpartum psychosis,  when does postpartum bleeding stop,  The Postpartum 6 week appointment, Postpartum night sweats, Postpartum intrusive thoughts, Postpartum hormones, Postpartum bleeding (lochia), Postpartum sex, Postpartum hair loss, postpartum red flag,  Pregnancy relaxation techniques,  natural birth tips, newborn care, first time mom advice, birth podcasts, pregnancy podcast, postpartum podcast, best podcast on postpartum care, top podcast for first time moms, Pregnancy symptoms, First trimester tips, Prenatal vitamins, Pregnancy diet, Safe exercises during pregnancy, Maternity clothes, ultrasound information, Birth plans, Baby registry essentials, Morning sickness remedies, Prenatal yoga, Gestational diabetes, Baby development stages, Labor signs, Breastfeeding tips, Postpartum care, Childbirth classes,  Maternity leave rights, Pregnancy health insurance, Fetal movement, Safe skincare during pregnancy, Pregnancy podcasts, Nursery decorating ideas, OBGYN recommendations, Stretch mark prevention, Pregnancy fitness, Birthing techniques, Pregnancy sleep positions, Baby gear reviews, Pregnancy meal plans, Pregnancy-safe beauty products, Prenatal classes, Pregnancy relaxation techniques, Pregnancy forums, Baby-proofi

On this week's listener series, we welcome Brittany. She found out they were pregnant in 2022 after dealing with several early losses. Nearing the end of her pregnancy, Brittany started to notice some symptoms that weren't normal and she was diagnosed with the flu - however, something felt off even after that. They returned to the hospital after she noticed her face was drooping and she was told that she had Guillain-Barré syndrome. Things escalated very quickly from there. Brittany shares her experience navigating a 10+ month healing journey that included learning how to eat, drink, and walk again. On this episode you will hear:- Early losses- Gestational diabetes- Guillain-Barré syndrome- Challenging postpartum- NICU stay for her son- 5-month hospital stay - Re-learning to eat again, drink again, walk If you have a birth trauma story you would like to share with us, click this link and fill out the form. For more birth trauma content and a community full of love and support, head to my Instagram at @birthtrauma_mama.Learn more about the support and services I offer through The Birth Trauma Mama Therapy & Support Services.

Gestational diabetes, a condition that often has no symptoms, catching pregnant women by surprise, and putting their babies at risk. We look at the danger for both mother and baby. Plus, how experts teach expecting moms to protect their metabolic health.

Jenny's story is one of pure gratitude and joy. She is so grateful to be a mother, for the miracle of her pregnancies, for a breech baby who flipped late in her second pregnancy, for the chance to experience labor, and for a beautiful, successful VBAC. Jenny talks about all of the ways she prepped and how she even had to travel over a mountain pass during a snowstorm while in labor to get to her VBAC-supportive provider. Meagan shares some statistics about breech birth and why we so badly need more providers trained in vaginal breech delivery.A long-time listener of The VBAC Link Podcast, Jenny shares her story with so much joy hoping to inspire other Women of Strength just as she was inspired by so many others. PubMed Article: Risk of Vaginal Breech Birth vs. Planned CesareanHeads Up DocumentaryInformed Pregnancy - code: vbaclink424Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:58 Jenny's first pregnancy with gestational diabetes06:10 Low amniotic fluid, breech presentation, and a C-section10:22 Healing in different ways14:16 Getting pregnant again and doing all of the VBAC prep22:52 Gestational diabetes test27:59 Breech at 34 weeks32:33 A head-down baby35:11 Traveling the mountain pass in a snowstorm39:43 Checking into the hospital45:42 Fetal ejection reflex49:20 Pushing out baby and postpartum blood loss57:10 Jenny's advice for breech mamas1:00:22 Statistics on vaginal birth versus planned Cesarean for breechMeagan: Hey, hey. You are listening to The VBAC Link Podcast and we have another amazing episode for you today. We have our friend, Jenny. Hello, Jenny. Jenny: Hi. Meagan: How are you today?Jenny: I'm good. I'm so excited. This is just– I am reeling actually that this is actually happening today. Meagan: I am so excited that it is. You know, it's so fun to get submissions in and then when we send them out, people are like, “Wait, what? Really?” Jenny: That is exactly how I felt. I was like, “This is never going to happen, but I'm just going to go for it. I'm just going to submit it.” I mean, The VBAC Link was such a huge part of my whole story and just to be on here and hopefully share something inspirational with somebody else, hopefully it helps somebody. That's my goal today. Meagan: It will. It's absolutely going to. The whole podcast, sorry if you guys hear any noise in the background by the way. I'm getting a new furnace today and he's installing it downstairs literally below me. So sorry if there's any extra background noise. But this podcast is literally something that I wish so badly that I had when I was going through my VBAC. Obviously, that's one of the reasons why we were inspired to create it, but every single story, even though they all might have similarities or even be in similar places, they are so different and unique and I love that. I love that almost 300 episodes in, we can prove that every birth is different. It's true. Every birth is different and you went through a lot with your births. I mean, I've got her list right here of things. You guys, this is going to be a jam-packed episode. She's got gestational diabetes, breech, advanced maternal age, and trusting the process. We're going to talk about traveling literally over a mountain pass. She drove over a mountain pass to find what she needed so I'm so excited to dive into your episode in just one minute after the intro. 02:58 Jenny's first pregnancy with gestational diabetesMeagan: Okay, Jenny. Here we go. You are– are you ready? Are you ready? She is dancing in the background. You can't see her but she is literally dancing. You can see she is so excited to share this amazing story with you. Jenny: I am so ready. Okay, so let me go back four years to my C-section baby. I can't believe it's been that long. Being a mom was never in the cards for me. I'm just going to start out by saying that. My husband and I, we had been married for 15 years. We went on this fabulous cruise and we were just having the time of our lives. We had a conversation that if I was past 30, it just wasn't going to happen for us and that was okay. So we never planned to have babies and then we had the most wonderful surprise of our whole lives. One day– I don't even know it had been since I had my period so I was like, “Oh, I'll just take a test.” He saw it and was like, “What is this?” I said, “I'm 98% positive that it's going to be negative. I just do this sometimes. It's fine.” I get out of the bathroom with this blazingly positive test and he's like, “No way. I don't believe that.” So I had to go the doctor and prove to him that I was. Anyway, I loved being pregnant. It was so incredible. The miracle of just growing a baby is beyond words. Just that first flutter to knowing that you are creating a human inside of you to the first ultrasound– anyway. I started listening to “The Birth Hour” and I went down the rabbit hole. I love it so much because like you were saying before, it shows you so much about the differences. I didn't know what I didn't know, so it was just an education in itself. I went down the rabbit hole and I am such a birth nerd now. I had no idea. When I found out I was pregnant, the first thing that came to my mind was, “I have to give birth. I'm so scared,” because of all the fear. We get so much media fear. You see all the people screaming and pushing. It just looked traumatizing then I remembered I had seen The Business of Being Born and I was like, “No.” I have always been this closet hippie. I was like, “No. I'm going to do this and I'm going to do it right.” I found myself at 28 weeks. We did a gestational diabetes test and I walked into the doctor's office and she was like, “You have gestational diabetes.” I was like, “No I don't. No, I don't.” She was like, “Yeah, you do.” She was like, “You are going to give birth at 39 weeks here. You are going to be induced. You will give birth on your back. You will do this. You will do this.” The language she used with me was so– I felt so defeated and I was only 28 weeks. I was so disappointed and it was a midwife. It was a midwife practicing under a hospital OB practice. But I live in a really small town, so it was the only midwife I could find really. Home birth wasn't an option for me. We do have a home birth midwife, but it wasn't affordable at the time. 06:10 Low amniotic fluid, breech presentation, and a C-sectionJenny: It turns out that I had low amniotic fluid and you know, they send you in for all of these screenings and tests once you know you have gestational diabetes. They were really concerned about it one time when I went in and they were like, “I don't see any amniotic fluid, like any.” They actually kept me overnight and pumped me full of saline.Meagan: A bolus?Jenny: I was drinking water. Yeah, it was crazy. They checked the next morning and they said, “Yeah, you still don't have any amniotic fluid so we're going to send you to an MFM over the mountains,” which is about an hour and a half away in the city. When I got over, the MFM walked into the room. She didn't even say hi to me. I was 34 weeks at the time and she was like, “We're keeping you here. You're going to have this baby. You're not going to leave this hospital until you do.” She hadn't even talked to me. She never said, “Hello.” I mean, she just looked at my chart. She didn't do any tests on me. I was just blown away by how she talked to me. I was just like, “Are you kidding? Hi. I'm a person.” The did the test right there and then. It turns out the city doctor and their tests are so much better. Based on the total amount of amniotic fluid, they released me that day. As I was walking out the door, she was like, “By the way, I'll see you back here for your delivery because your baby is breech and you're not going to have her naturally.” I was just like, “Okay. I'll show you. I'm going to flip this baby.”Anyway, I went down the rabbit hole. I did everything. I even signed up for the ECV. I don't want to traumatize anybody, but there were three people pushing on my belly trying to get that baby to turn and she didn't budge. She was there. I did have some lower amniotic fluid.Meagan: That can be a sign too if baby really, really, really isn't budging that's usually a sign that an ECV– and if it's extremely painful, sometimes the ECV just isn't going to be successful and sometimes we have to trust those little babes, right? There is a reason why. Jenny: Mhmm. Mhmm. I totally agree with you too. I even was mourning the loss this whole time because I so badly wanted to give birth just to experience it. I don't know. It's an innate woman thing. Men can't do it. It's something that I never experienced in my life. What else can we go through in our lives that you have to wait until you're an adult to feel? It was just this phenomenon. I was so curious about it and I wasn't even getting the opportunity. I was telling a nurse about it one day when I was getting a test done, “I just want the chance.” She was like, “Oh, honey. You don't want to ruin your cervix by pushing out a breech baby.” I was like, “Oh, so I would break myself?” I didn't say anything because at the time, I was this pushover. I was just like, “I'll do whatever,” but inside, I was dying. I just wanted the chance at everything. So I got to the point where I just walked into the OR with the MFM because she does five of them a day and I trusted her more than I trusted our small-town hospital. Jenny: The C-section was uneventful. It was really easy. We did the labor baby dance before we went in there and then I saw her come out of my belly and I was thinking, “I don't know this baby.” I felt disconnected but at the same time, I was overjoyed. I cried because they took her right over to the warmer. The anesthesiologist was right by my head and she was like, “Why are you crying? Are you okay? Are you in pain?” I was like, “No, that's my baby and I can't hold her and I'm right here.” The didn't tie me down. Nothing was traumatic. I was very prepared. Meagan: They just didn't bring her over. Jenny: No, I was separated. They were weighing her and laughing about how she was and I was trying to see her. Anyway, it's just not natural. I mean, it's just not how you want to have your baby. They did put her on my chest and everything was great. 10:22 Healing in different waysJenny: Fast forward six months, I was done with it. I was like, “Maybe we'll only have one. Maybe this will be it.” We weren't planning on having a baby anyway and we were just loving being in that baby nest. COVID started and talk about a crazy time. I definitely suffered a lot from postpartum anxiety. I had a lot of expectations maybe about motherhood and stuff. I really learned a lot. The transformation to motherhood is like a phoenix rising from the ashes as a total personality makeover. You're just coming out of this, “This is who I was and this is who I'm becoming and this is what I'm learning.” Kids really teach you that, don't they? They teach you how to fight for yourself and fight for them if you can't fight for yourself, and I just found that postpartum is harder than it should be. We don't have the support we have and it really, yeah. It made me go into a deep dive of what was going on with me. I started listening to The VBAC Link actually. I found it one day when I was listening to a “Birth Hour” podcast. It was six months and I was like, “You know, I'm just going to listen.” I was like, “I love this. I enjoy it,” but I couldn't relate to it anymore. I searched VBAC on Spotify and you were the first person that came up– you and Meagan at the time or, you and Julie. I was like, “This is me.” I could connect to all of the stories because women were sharing the same feelings that I felt and the same things so thank you so much. It was inspirational to feel like, “I can do this. I can do this again.” I remember even talking to the OB when she was stitching me up in the OR. I was like, “I can have a VBAC, right?”At the time, I wasn't really planning it or whatever and she was like, “I'm doing the double stitch, don't worry. You are a good candidate.” I was like, “Okay, that's cool.” It was so far out but just listening to the stories and knowing that I could do it, it was like, “I could do this again.” But I needed to listen for a long time to feel like I was ready and stuff. A lot of your episodes talked about working through past trauma so I started doing that. I started EMDR. I did pelvic floor physical therapy and I just want to talk about that for a minute because I cannot believe how ashamed I was to do it I guess maybe. I just want to say that really quick because I have a vaginismus and that's when your muscles involuntary close into your vagina and it's because of past trauma. So doing EMDR coupled with the pelvic floor physical therapy was really something that was so useful and I was so ashamed to do it because I've had it for years and I remember my GP suggesting it one time and I was like, “Absolutely not. I'm not having anybody touch me.” I just wasn't ready. Meagan: You're vulnerable. Jenny: It is. I was so ashamed and I don't know why. I was talking to my pelvic floor PT about it. It was the first session I had with her. I was like, “I was so ashamed and I'm ready now.” She was like, “I can tell you are ready.” It was so healing to go there and to work through some of that. While it never got better for me, I know how to work with my body now and that kind of comes into play with my vaginal birth because in a way, I was a little bit relieved. Sometimes when I thought about it, I was looking at the silver linings of the C-section. You just walk right in. I was also thinking that I wouldn't have to deal with this problem that I was really afraid of having. 14:16 Getting pregnant again and doing all of the VBAC prepJenny: So anyway, big plug for pelvic floor physical therapy. Since I had gestational diabetes, I read Lily Nichols' book. I just listened to the episode on her. She is amazing. I can't believe I didn't know about her before. I had heard her on another podcast and I just thought, “I need to read this book.” She is amazing. Meagan: Yeah. Jenny: There are so many amazing birth workers out there– her and Rebecca Dekker from the “Evidence-Based Birth Podcast” and the “Down to Birth Podcast”. All of those people taught me something very unique and special about birth. It's just this education, right? All of this knowledge and trust that we really have to get. We have to work through some of our things– traumas or whatever it is. Things that culturally have been accepted in our mind about birth and we get to this point where all of a sudden, I was excited. I was like, “Maybe I could do this again.” I did all of the things. I started eating eggs, Vitamin D, and magnesium and taking the protein supplement, the collagen powder. I even went non-toxic for my cosmetics and my house care. I started this. I heard this girl's birth story. Her name is Bae. She is from Australia. She does this whole program– Core and Floor Restore. I loved her birth episode. I listened to her. I went to her website. She has this whole program on how to help your pelvic floor and how to exercise post-birth. The way she talks to women in there, she is like, “Do you. You do you. Don't push it. Don't force something that you can't do. If you can't do this exercise right now, modify it so that you can.” It was just this education of how to trust your body, how to trust birth, how to–Meagan: Trust our minds, our hearts, and our gut. Jenny: Yes, that's part of it. Yeah, yeah. Anyway, all of this transformation got me to the point where I was like, “I have to be a doula.” It wasn't in the cards for me to be a birth doula even though I am a huge nerd. I have to have a scheduled life. Meagan: Maybe postpartum? Jenny: Yes. Yes. I was like, “I want to be a doula, but I will be a postpartum doula.” I actually really love helping women work through some of these things that were so transformational to me. Just overcoming some things that you didn't know about yourself but you are forced to face in motherhood, so I became a postpartum doula and it is incredible. I love it so much. Then I decided I was ready. I was ready to have this second baby. I was ready to have my VBAC and I did a deep dive into providers because that was what you told me to do. I needed to know if I could do this and so I went to my hometown hospital and I was like, “Hey. Can I have a VBAC here?” They were like, “Absolutely not. We will schedule you for a C-section at 39 weeks so that you don't go into spontaneous labor.” I was like, “Okay.” So I went to the midwife and I was like, “Hey, can I have a VBAC here?” She said, “Well, I could support you but I shouldn't. I don't have the resources. I would want to support you, but ultimately, I shouldn't.” So I was like, “Okay. Okay.” I was like, “I've already established myself at this big hospital over the mountains. I'm going to ask them.” I went to them and they were like, “Yeah, we'll support you.” They had this outlying hospital in the mountains. It is absolutely beautiful, these giant windows looking out over the Pacific Northwest and I'm telling you, I live in the best part of the country but it's really bad so don't move here. That's for anybody that's thinking about moving here because we like it being a small town. I had my heart set on this beautiful outlier hospital. I called them. I'm getting ahead of myself. I had a conversation with my husband after I found them. I was like, “Hey, we should have a second.” He was like, “I don't know. It's really hard. We're older now.” I was 35 at the time. He was actually 44. We have a pretty big age gap. We weren't going to do it in the first place so we had some big conversations. I was like, “Okay. Let's just try for 6 months and if it doesn't work out, it doesn't work out. It wasn't meant to be.” We have a really strong faith so we were just like, “Maybe we weren't meant to have it.” It was really fun actually trying instead of trying to prevent pregnancy. I had never been in that boat oddly enough having a baby and stuff. But it was really hard and I was trying to visualize conception. I was like, “It seems impossible how it all happens.” Meagan: Timing and everything. It's amazing. It's amazing. Jenny: It's incredible just visualizing it all. It's incredible how it can actually happen. At the time, I was thinking, “Man, it's not going to happen.” Five months went by and I was doing all of the testing. I was making sure and it was really fun to nerd out on this side of it beyond the total planning side of it. I love that part. Yeah. Finally, one day seven, six days after I ovulated, I felt all of this cramping and I was like, “Maybe this is the implantation.” I think five days after that, I tested and I had the tiniest, faintest line. I was like, “Holy crap.” I did not think it was going to happen. It was just so amazing. I kept it to myself all day. It was my little secret except I went in and told my little one. She was three at the time. I went over and I was like, “Hey, you're going to be a big sister.” She looked at me and I was like, “But keep it quiet for a day.” Meagan: Don't tell anybody. Jenny: I wanted to take the test the next day that said you are pregnant because I didn't want the same reaction from my husband the second time. I was like, “I'm going to give him the test that says, ‘You are pregnant'.” So I did. I did. I gave him the test and he was like, “Oh my goodness!” Actually, I had her give it to him the next day. It was so cool. It was just this sweet little moment. My age really concerned me. I thought I would be so chill because the first pregnancy was like, “Whatever, I didn't plan this. Whatever happens.” With the second one, I had the fear in me that my age was against me. His age is against me now.I spent more time than I wanted and I regret feeling not anxious but just disconnected. I was really afraid to connect to this pregnancy because I know a lot can happen in early pregnancy and I really want to say that to other people who might have the same feelings that you are not alone in feeling that way because it is really scary. I got to my 20-week ultrasound and I was holding my breath the whole time she was doing the test.  She was looking and looking. She was being really fast and really efficient. They actually asked us to leave the room and go wait out in the lobby for the doctor to come get you. I was like, “This doesn't sound good. I don't think this is right.” I was so anxious and the doctor just walked up to us casually in the lobby and was like, “Everything looks good. See you guys later.” Nothing was wrong. I started bawling and I could not stop sobbing for so long. I'm not really a crier either. It was the confirmation that everything is going to be okay and we did it. I can't believe it. It's so hard to get pregnant and then everything is going good and stuff. I was really excited about that. I was also really hyper-aware of her positioning because obviously, I had this past breech. So from 20 weeks on, I was legit obsessed with sitting upright, leaning forward. All the time, I was turning my chairs around. I was never reclining on my couch. Even in my car, I was sitting straight up. I was like, “I'm uncomfortable 100% of the time.” I was trying really hard not to have a breech baby because even at my 20-week ultrasound, they looked and were like, “Yeah, she's breech but anything can happen.” I was like, “I know, whatever.” 22:52 Gestational diabetes testJenny: I was doing all of the things, right? Spinning Babies, I was going to acupuncture. I was going to pelvic floor physical therapy, the chiropractor, all of it. I was chugging along. At 26 weeks, I get my gestational diabetes test. I talk to my midwife about it and she was like, “Yeah, we can just do the two-hour test because we know you had it last time. You might have it again this time.” I was like, “Okay. I think that's a good idea.” I didn't mention this before, but with my first test, my midwife wouldn't even let me retest. She just said, “You have diabetes.” It was just the one-hour screening. It's not a diagnostic, but I got the diagnosis from it anyway. I was like, “Why wouldn't you let me retest?” She said, “Your number, I just felt like you have diabetes.” I don't know. I was pretty upset about that. They wouldn't even let me try. I know other people who retest all the time and they are negative with the three-hour test. It didn't make sense to me. So anyway, I went into this one pretty informed. I was like, “Hey, I want the three-hour test. I want to know if I have it,” because if you have it, it's not a good thing and you really want to control it. My first one was diet-controlled. She ended up being 6 pounds, 9 ounces. Meagan: Little. Jenny: She was tiny and she was 39 and 6 when she was born. I wouldn't let them take her earlier than that even though they wanted to. I was like, “No.” They were like, “We won't let you go to 40.” I was like, “Okay. You can have her at 39 and 6 then.” I was so mad at them. Anyway, I digress. Jenny: Okay, so I did the two-hour test. I felt so sick. I was like, “For sure, I have it again.” I had been eating a gestational diabetes diet the whole time. I was like, “I'm just going to take care of my body.” I felt amazing taking care of my body like that so it's really kind of a blessing in disguise having it. I would not say that having been diagnosed with it the first time. I thought that I was a failure and whatever, but you're not. Meagan: No. It just happens. Jenny: Yeah, it happens. My mom has diabetes. I shouldn't be surprised, but I was healthy and I was thinking that it would never happen to me and it did. So anyway, I took the test and it turned out negative. I couldn't believe it so whatever Lily Nichols did in her book, I did all of the things that she told me to and it worked so I'm just going to give a shoutout to her. Thank you because you helped me have my VBAC and I couldn't be more grateful for just not having it because then I kind of ate whatever I wanted. It was great. I gained a little weight and it was really fun. It was the opposite of my first pregnancy. I was carefree and I had a lot more flexibility to do things I really wanted. Anyway, that was really cool. But also at my 26-week appointment, my midwife felt my belly and she was like, “You know, your baby is frank breech.” She was like, “I'm just saying that. There is obviously plenty of time for it to turn, but we want to see a head-down baby by 30-32 weeks.” I need to back up just for a second. I wasn't able to use the midwives that I wanted at that outlier hospital from the city because I chose to do a bloodless program and they don't support that even in the outlier hospital. It is only the ones in the city. It was an hour and a half drive through city traffic and a mountain pass. I was due in February and our mountain pass is no joke. It closes for multiple days during the winter a lot of times, so going that far was part of our conversation in having a second. I was like, “I'm not having a VBAC here in town. Can you drive me?” He was like, “I'm not scared. Let's do it.” That comes into play later, but it was a lot. I had to use the bloodless program in the city which meant traffic, snow, ice, all of it. They chose to support me which was great. I found them and I'm grateful that they were but they weren't the dream team as far as being really supportive. I would say they were tolerant of me being there. Meagan: Tolerant of you going for it but not super on board. Jenny: Yeah, exactly. They were like, “Yeah, this is great.” They weren't saying, “This is what we need to see.” They weren't saying, “You need to be in spontaneous labor by 39 weeks.” I was drilling them. I was doing all of the things. I was like, “What do you require of me? Can I go to 42 weeks? I want to know.” I had never felt a contraction before so it was honestly like, I knew I went to 40 with my first so I'm definitely going to go to that with my second at least I thought. I did all of the things to try and flip her obviously when they said that, but at 35 and 6, she was still breech. Actually, it was 34 weeks. I had even gone to acupuncture and felt her physically flip. She did the flip in my belly. I'm not joking. I felt her move the entire way down head down. I woke up in the morning and she was breech again. I was like, “Okay. She can do it. I know this baby can do it.” 27:59 Breech at 34 weeksJenny: I kept doing all of the things until 34 weeks which is when most babies are head down. I was like, “You know what? I've listened to enough podcasts and stuff to know that I needed to let some things go.” I regretted a lot about my first birth. I hoped until the last minute that I was walking into the OR that she was going to flip and she didn't. I was like, “You know what? I want to enjoy this pregnancy. I don't want to feel like I'm doing all of the inversions of my life.” I was doing headstands in my hot tub. I was doing everything and I was like, “I'm going to let this go.” I chose to let this go at 34 weeks and I was like, “I'm going to enjoy this whether I have a C-section or not even though I really want a VBAC.” My faith is a really big part of that because I was just praying, “I believe so much that our bodies are incredible and they were made for this.” And to not have the chance to even try is heartbreaking. It's sad that we don't have breech providers because these OBs are professionals. They are professional. They get trained for years in how to do this and that we don't even have a chance with them boggles my mind a little bit. Meagan: I know. Jenny: Anyway, I've heard a lot about just having the chance to experience what women are made to do and just feel. Even if it's hard and even if it's painful and whatever, I just wanted the chance. I found this renegade OB in a different city. He was willing to do this ECV on me because I heard he had a good success rate. I was like, “I'm going to do it again. I don't care. I'm just going to try.” At 35 and 6, I binged on the Evidence-Based Birth Podcast because she has a couple about VBAC and she has a couple of episodes about birth. I wanted all of the stats in my head. I was like, “They are not going to deny me this ECV because I have this scar on my uterus.” I was dead-set. I knew ACOG by this point. I walked in and I was like, “I'm going to do this. Let's do this.” He was like, “Okay. This girl knows her stuff,” because he was like, “I probably shouldn't do it because of the C-section.” I was like, “No, ACOG recommends that I am not a risk.” I knew and he was like, “Girl, you know your stuff. All right. You know the risks. Let's try it.” Meagan: That is so interesting that he was trying to scare you out of it but because you knew the stats, he was willing to do it, but if you didn't know the stats, what would have happened?Jenny: Right? I wonder and I don't think it's fair that women have to become experts in the field that's not our job. Our job is to grow this beautiful baby in bliss and instead, we've got to fight for everything, something that we should be able to do. 32:33 A head-down babyJenny: I get in there and he puts the ultrasound machine on my belly. As I was driving myself there, I was thinking, “Man, these kicks are weird.” They were fluttering up here and I was like, “That's so weird.” It was under my rib instead of down below. I thought, “That's really weird.” He put the ultrasound machine and he was looking right down where my cervix was because that's where he should see feet and he laughed and he was like, “That's a head. Your baby is head-down.” I was like, “No, it's not. I felt her head last night right under my ribs.” He was like, “No, her head has moved.” I poked, poked, poked and I was like, “Are you kidding me?!” I hit him and was like, “You're kidding me, right?” He was like, “No, girl. You've got a head down baby.” I was like, “I've never felt this before! I've never had a head down baby!”I was in my second pregnancy, 36 weeks along pretty much and I had never had a head-down baby so I just want to say to all of the breech mamas out there, it can happen and maybe it can't. I don't know. I was convinced that I grew breech babies at that point because I was pretty far along there. Anyway, so that was the biggest surprise of my whole pregnancy. At that point, I was like, “I've got to find a doula. I've got to take a birth class. I've got to do all of these things.” I had been holding out for this opportunity to have a chance and now I had it. It was the most incredible, freeing feeling. When I was driving home, I was just like, “I can't believe it!” I was yelling in the car. I called my sister right away, “I have a head down baby!” She was like, “Okay.” It's just not a big deal to people. It was just so thrilling to feel like I could get the chance. So anyway, I took this birth class that B does from Core and Floor Restore and she talks a lot about physiological birth in it and how the movements that we make and the sensations that we feel all help in this balancing act of getting our babies out. I was just like, “I've got to try. I've got to try. I need the chance. I'm getting the chance now and now I've got to try.” So I did all of the dates and I did all of the classes. At 39 weeks, I stopped work and I just lived it up. I was just laying around and I was just having a good old time with my baby girl. That was one day that I had and the next day, I put her down for a nap. 35:11 Traveling the mountain pass in a snowstormJenny: I was at 39 and 4. I told my baby as I put my toddler down for a nap, I was like, “You know, I'm ready. I'm ready to see you. I've got all my meals in the freezer. I've done the work. I feel good.” Meagan: You were prepared. Jenny: I'm a postpartum doula. I had my ducks in a row and then my girl was just starting to sleep and I felt my first contraction. I was like, “No. This cannot be happening. Are you kidding me?” I just laid there super still and I was like, “That was another one. It's happening.”I went to the bathroom and I had a little bit of my mucus plug and bloody show. I texted my doula right away like, “Oh my goodness.” She was like, “Oh, you know. Things are happening. Yeah.” I was like, “I know. I know. I need to go to sleep. I'm just going to go to sleep.” I looked at the pass because that was the biggest factor in what was happening. I looked. It was 2:00 in the afternoon. I looked at the pass and it said it was going to have 7-10 inches that night of snow. I was like, “Okay. Nothing is happening now, but maybe we should.” Our plan was to get over on the other side of the mountains in case it closed on us, we would be on that side. I was going to have this chance for VBAC no matter what. I texted my husband right away and I'm like, “Hey, I had a contraction. I've had several. I've got some stuff going on. Can you head home from work? He never responded.” 6:00 rolls around. My daughter got up. My contractions slowed just like they do when your toddler is awake. I was like, “Did you get my text?” He was like, “No, what?” I was like, “It's going to happen today. I've been having contractions. I feel it.” He was like, “Okay. I was like, “But the pass is starting to snow already up there and I think we've got to go. He was like, “Well, let's just see.” I was like, “Okay. All right. Let's do this. When she goes down for sleep, I bet it's going to pick up.”Sure enough, it did. 7:30 rolls around. I put her down and it started again just small contractions, but I felt it. He went to sleep and by midnight, I was having timeable 5-minute contractions trying to lay there. I was like, “I can't do this anymore. I've got to get up.” So I got up and I got in the shower. He came in and he was like, “Are you okay?” I was like, “I am having some pretty intense contractions. I cannot lay here.” He was like, “Okay.” We were just reading each other's minds at that point. We've been married so long and we were both thinking about the pass. What are we going to do? Who was going to come over at this point and see our kid? I was spiraling and I was like, “I'm going to get in the hot tub. I'm just going to get in the hot tub and slow these down. I know this is probably just prodromal so I'm going to get in the hot tub.”I get in the hot tub and I'm sitting there and it was the most beautiful night. The stars are out. The moon is out. The sun was not out. It was the middle of the night. It was 2:00 in the morning and I was sitting there. It was this surreal, beautiful moment. Having these contractions and the warm water, it was incredible. At that moment, I was so grateful to have the opportunity at this point. I had never gotten this far. It was so cool just to sit there. That was definitely one of the most beautiful moments of my labor. Jenny: Unfortunately, my contractions sped up in the hot tub instead of slowing down. Meagan: So they were real. Jenny: Which is good, they were real. I was thinking, “Oh gosh, what do we do?” They were 2-3 minutes apart by this point lasting over a minute. We called our midwife on the other side of the mountains and we were like, “Hey, this is happening I think.” She was like, “Do you think you can make it?” I was like, “I don't know, but we've got to try.” She was like, “But you pull over right away.” We knew where the hospitals were along the way. She was like, “If you feel like you are going to start pushing, you pull over right away and you call an ambulance.” I was like, “Okay.” We called somebody and woke them up in the middle of the night to come over and stay with our toddler and we started the trek over the mountains and it was insane. It was so insane, the snow. We were all over the place. There were semis in one lane and my husband was passing them on the other side. Just like I thought it would, my labor slowed down. It was a good thing because I was obviously in fear at that moment. I sat in the back. I sat backward. I put my TENS machine on and I was going to be in the zone. 39:43 Checking into the hospitalJenny: When we got there, they checked me and unfortunately, I was only 1 centimeter but I was 70% effaced. She was like, “It's real.” Meagan: Hey, that's good. Jenny: But it's prodromal. I was like, “Awesome. We just spent the whole night getting over here.” It was so crazy, but it felt really good to be on that side of the mountains at that point. That hurdle was overcome for us. We went to our relative's house that was close by. That was part of our plan and we just went to sleep. We just went there and tanked for the morning. I got a couple of hours of sleep. My contractions started to pick up again. She fed me some eggs and I threw them up right away. It was real. It was really happening. It was 2:00 in the afternoon. It started getting really intense. I got in the shower and the whole time, I was trying to stay on all fours. I was trying to lean forward. Part of B's birth class is getting all of that pressure forward and moving your body. It was so incredible. I lost so much more of my mucus plug that I didn't know was possible. I started having more and loose bowels and all of that. By the time my contractions were 4 minutes apart, we looked at traffic and it was insane rush-hour traffic, back-to-back. We called the midwife and she was like, “You'd better start making your way in here.” I was like, “Okay.” We got in the car and it took over a half-hour to get to what should have taken 15 minutes in bumper to bumper. It was so insane just sitting in the car. One of my friends who traveled to do her birth too, I asked her what she did in the car because I knew I was going to be in the car. She was like, “I concentrated on something. I found something to concentrate on and it helped me to cope.”I was like, “I'm going to time these and I'm going to use my TENS machine at the same time. I'm going to keep my mind distracted.” I also kept my birth affirmation cards in front of me and they were so helpful. I'm not one of those people who needs affirmations, but for some reason, telling my mind in that moment, “You're okay. You're safe. It's okay to do these things.” I had one that was a vortex. I don't know if that was on this podcast. I think it was where a girl was looking at this vortex and pictured herself opening. Anyway. It was so helpful. I felt like I was dilating. I really felt true movement at those moments. Of course, I was doing really slow, diaphragmatic breaths and trying to breathe through each one and stuff. Jenny: By the time we got to the hospital, my contractions were 2 minutes apart. They checked me and I was 5 centimeters and 100% effaced. Meagan: Yay!Jenny: I know. It was so wild. But my midwife wasn't on shift yet. They only had OBs. Anyway, they stuck me in triage and just left me on the monitor. It was so cool though. They worked with me. I was like, “I'm not sitting. I can't lay down. I have to keep moving and I have to keep swaying.” She was like, “Good. Let's put this on you and let's keep you in that position then.” She was like, “I think I can get a reading.” While they did have to do continuous fetal monitoring, it was okay. It really worked out. I was really worried about that. A lot of people talk about that and think it was one of the biggest hurdles, but it was really doable if you've got somebody who's going to work with you through it. My doula came and it started to become a blur. My husband started to read me my birth affirmations which was really kind of sweet because he is definitely not that way at all. One of them that came from the VBAC podcast was, “My vag is a waterslide.” I loved that one. We had such a good laugh because he was reading it to me. It was a really funny moment. Things were moving, man but we were stuck in that room for over 2 hours. It felt like 10 minutes to me because I was just in the zone. My doula tried to do a hip squeeze on me and I hated it but I couldn't even tell her because I was so in the zone. I could not verbalize at that moment. My nurse was moving super slowly. I think they were just stalling to get the midwives on staff.At 8:00, they finally moved me to my labor and delivery room. As I was walking by, the nurses were like, “Go, Jenny! You can do it!” It was so cool to hear them cheering me on and stuff. It felt like the victory line running towards the goal. It was really cool. I got in my room and it took her over 10 minutes to find her heartbeat. She was just sitting there trying to find it. I was almost like, “Maybe I should be worried,” but I was too in the zone. I was on all fours the whole time trying to move and just work with my body through it all. When she finally did it, she got the wireless monitors on me. I had been saying for 2 hours straight, “I just want the tub. Please give me the tub.” As soon as we got into that room, my doula went in. She drew the bath. She put the candles in there and all of the things. I was sitting on the bed just moving and I was like, “I've got to poop. I've got to poop. It's going to happen. I've got to go to the bathroom.” They were like, “Okay.” I walked away and I ran into the bathroom real quick. I was sitting on the toilet and I was thinking, “Man, this is insane. I feel like my body is just going to break apart. This is insane, the pressure.” It wasn't super painful, but it was but it wasn't. It's like pain with a purpose. Anyway, I was sitting on the toilet and I was like, “Man, nothing is coming out. This is crazy.” All of a sudden, another huge contraction hit and I jumped onto the floor and sat on all fours looking at the tub. It's right there. All the water was finally filled. I could get in after this contraction was over and my body started bearing down. 45:42 Fetal ejection reflexJenny: It's like I was throwing up from the back of my body. It was like down and out. It was like a feeling that I'd never felt before. It was so incredible. It was happening, the fetal ejection reflex and there was this new nurse next to me that was like, “You're pushing, huh.” I was like, “I'm not trying to but I think it's happening. I'm getting in the tub now.” She was like, “You're going to come back and get on the bed actually.” I was like, “No!” For 2 hours I had been begging for the tub and now I have to push. I was like, “I'm scared. I can't do it. I can't do this. It's all too much at this moment. I'm not ready.” Meagan: Yes. Jenny: I got on the bed. This new midwife just walks in. I had never seen her before. She locked eyes with me and she was like, “Let's do this.” I was like, “Okay, I guess we have to.” She checked me one last time. She was like, “You're 9.5 with a cervical lip, but I think it's time for you to start pushing.” I was like, “Okay. I can't help it. I'm pushing anyway.”I had this big contraction. I was still on all fours. They were trying to get the saline hep lock on me because they hadn't even done any of the things. I was GBS positive and they couldn't even get that in me fast enough. I had a contraction. I looked down and she was in my other arm because that vein had blown in that period of time. I was just like, “What is happening? It is so fast and crazy.” Labor land is such a blur, but at the same time, each time I came out of the contraction, people were like, “What do you want for this? What do you want for that? What's your preference?” I was like, “I want a physiological birth. That's all I know. I just want to do this. Let me do this.” Anyway, they had commented later that they don't normally see that in labor where the mom can verbalize what she wants but I had never met this midwife before and she was like, “I honestly don't know what your preferences are so I'm asking you now.” It was really nice that she was trying, but she was like, “With this next contraction, push.” I was like, “Okay.” I got on my hands and knees and I faced her which felt wrong and weird. She was like, “Okay, push.” I didn't because I was like, “I don't like this. This doesn't feel right to me.” But I couldn't say that. So then she was like, “Okay, with this next contraction, I want you to flip over on your back and I want you to push.” In my head, I'm like, “There is no way I'm going to do that. No,” but I couldn't say that.In the moment, I'm such a compliant person. I was like, “Okay, whatever. I'm just going to give her what she wants.” I flipped over on my back. She was like, “I want your knees up to your ears and I want you to bear down super hard.” I was like, “No, I know that's not right. None of that feels right.” I did and I didn't push at all. I was letting my body do its thing. I was just lying there for a second. She put her hand inside of me and she was like, “I want you to push here.” I was like, “I don't like that either.” As soon as I came out of that contraction, each one I was visualizing the wave coming up and cresting and coming back down. It was a really good visualization for me because I love the ocean. I came out of that and I was like, “I didn't like that. I want to do something different. Can you help me with that?” That's all I said to her. Meagan: I love that you said that. Jenny: It felt so good because I'm not normally somebody who stands up for myself, but I was like, “I want to do something different.” She was like, “Okay. Flip over on your side and hold your leg up and pop your knee out.” Do this crazy maneuver. Immediately, it felt right. It felt like the key in the hole locked into place. With that contraction, I pushed and she started crowning. 49:20 Pushing out baby and postpartum blood lossJenny: All I said with that contraction was, “There's so much pressure!” I was yelling it and yelling it. The contraction was over and instead of letting go, I held her there and clenched down so she would stay there and not go back up or anything because I could tell she moved right down and was right there. They were like, “Feel your baby's head!” I was like, “Okay, yeah. Whatever.” I tried to feel it. Meagan: Yeah, okay. Whatever. Jenny: Yeah, yeah. This is happening right now. I touched it and I was like, “Cool, okay. Yeah. There is a lot of pressure. I can't do this right now. I'm so scared.” At that moment, I was like, “The only way out is through. I have to push. I've got to do this.” With the next contraction, I just barely pushed and she just twisted and flew right out. It was insane, that feeling of a baby coming out of you. I just can't even describe it and I'm so grateful that I can describe it because it's incredible how we are made. I'm in awe. There are so many things that have to go right to get to that point. I am so grateful it did and I got to experience it. She came out right away and immediately, I was in business mode. I was like, “Is she breathing? Is she okay?” I was rubbing her down. People were kind of just hands off letting me do my thing. She started to crawl right up to my nipple. She did the breast crawl. It was all of the things that I wanted and never got with my first and it was so incredible to see this miracle happening right in front of me. I felt like I didn't do any of it. It was like it just happened almost. It was so incredible and unfortunately, I had a tear. She was looking at it and she had to go up and scrape some. I was trying to enjoy my baby at that point, but I was like, “Hey, can you just give me a Tylenol or something?” I hadn't had anything. She started to numb me and I felt all of that. I felt her stitching. I was like, “Can you give me some more of that because this really hurts?” I had an inside tear. After that, my nurse was kind of concerned that I was bleeding a lot, but my midwife wasn't. It was kind of weird. It almost seemed like nobody new my nurse or liked her. I think she was new. She was really slow so they were just like, “Yeah, it's fine. No big deal.” They were tracking my blood loss, but I got up to use the bathroom and at one point, she went out to fill my peri bottle and the water just wasn't getting warm. I was sitting for a long time on the toilet. I felt like a waterfall was just coming out of me. I was thinking, “I'm pretty sure this is normal. I don't know.” Anyway, she came back a minute later and she helped me go to the bathroom. I got back to bed and I was like, “Oh man, I don't know if I feel good.” They were like, “Okay, we're going to move you to your postpartum room.” I got in my wheelchair and I held my baby and I was like, “Hey guys, I think I'm gonna–” and then I passed out. When I woke up, I was having this cool dream and when I woke up, the whole room was filled with people who were all freaking out. My husband was looking at me. He told me later he was like, “I thought you were dying.” It was super traumatizing for him. I was holding the baby and they were trying to help me so they were all diving. He was diving for me with the nurse. Anyway, he was pretty upset having seen that and stuff. It turns out I had lost about half of my blood and they just hadn't been able to track it properly because they couldn't tell why I had passed out at first. They were like, “We don't understand. You didn't lose that much blood.” But they took the test. It came back. Meagan: Okay, this is interesting. This happened to me. Jenny: I know. I remember your birth story about it. Meagan: We still couldn't find it. Jenny: Yeah, isn't that crazy? Meagan: I still to this day don't know where it went. Jenny: I'm convinced mine was the waterfall in the toilet. I know that sounds so graphic. I'm sorry. Meagan: No, but that is a lot. Jenny: Yeah, it just felt like so much was coming out of me and nobody was there to document it. I was by myself. Meagan: Yeah, they were going to find the bottle. Jenny: Yeah, yeah. Meagan: Mhmm, interesting.Jenny: I know. It was crazy. Luckily, I was at a place that would help me with my preferences on blood loss and stuff so they worked with me really well. I'm so happy that there is alternative medicine out there so all of the rest of the people who can't take blood for whatever reason, it's available to them too. I'm grateful for that position and stuff. They work hard to help us in ways that maybe we don't think about. Meagan: I know. In some ways, I had regret that I didn't take the blood, but then I couldn't deny that my gut was telling me not to. It was just the weirdest. It was a disconnect. I still today don't know why. I've let it go and it's fine other than I'd be interested to know why, but we are just so grateful for those abilities to have those options. Jenny: Yeah. I'm really grateful I was where I was too because they were there within seconds to help me. It all turned out okay. I was fine. I was pretty weak and kind of gray for a little while, but I got a couple of iron infusions and that really helped. I was feeling like myself not as soon as I wanted. I was really hoping I felt a little bit better because you have the toddler at home and you want to do all of the things. I felt maybe disappointed in that regard of being so weak. The recovery was harder than I thought just with my tear and stuff too. I was surprised how hard it really was, so I'm really impressed by all those people who say that vaginal birth isn't that big of a deal. I've done both. My husband was like, “I really preferred the C-section honestly. The pass was open​​. We got to walk right in.” I was like, “Yeah, but it's just not the same.” Those moments.Meagan: There is something about it. There is definitely something about it. It's not to say that C-section can't be beautiful or amazing or healing even. My second C-section was completely healing, but yeah. There's something about it. There are no words but then there are so many words to describe it. Jenny: Mhmm, mhmm totally. I could talk about it all day. It's so exciting. Meagan: Well, oh my gosh. I'm so happy for you. I'm so glad you made it over the pass. I'm so glad that you were able to be there and even just find comfort even though you weren't super far progressed at first and that you were able to have this beautiful experience. I am sorry that you had these little hangups. It just goes to show that not every VBAC is perfect in every way just like every C-section isn't perfect in every way, but C-sections can be beautiful and so can VBAC. You just have to ultimately decide what is best for you. For you, you had that feeling and you were called to know what else your body could do. You knew it went through a really tough, tough birth with your first. Then you went through another tough birth, but an amazing one. One where, yeah. You were able to have that experience that you wanted. I'm so happy for you. Jenny: Thank you. Thank you for having us. Meagan: Oh my gosh. Absolutely. I'm so happy that you are here. 57:10 Jenny's advice for breech mamasMeagan: I did want to talk a little bit about breech. You said, “My baby turned. Maybe that's normal. Maybe it's not.” Yes, it can be normal and what breaks my heart is that so many people are left without an option. They are left without feeling like they could even try because we don't have those breech providers. They are few and far between. We love Dr. Berlin and the Informed Pregnancy Podcast and Informed Pregnancy Plus and Heads Up documentary and all of the things that they are providing because I feel like they are advocating. And Dr. Stu, they are advocating for breech birth that it is truly just a variation of normal. Anyway, if you have a breech birth, what would you give as advice for someone who's trying to figure out what to do? Do you have any that you would give?Jenny: Yeah, if they've tried all of the options because even the providers, I've talked to a couple of providers who do support breech birth and even they encourage you to try and get your baby to turn so if you haven't done all of the things, it's a good thing to try and do those things first. I mean, acupuncture, I couldn't believe how amazing that was. She wasn't moving a ton and then she flipped completely. So yeah, there's kind of something to that. Even though she didn't flip again until way later, yeah. I could still feel her moving a lot more during acupuncture than I did with any of the other treatments that I was going to. I was trying to see a Webster chiropractor and all of that too. There's a lot of things you can do to try and get your baby to turn, but I think trusting too is a huge one. Yeah, because I mean, I learned that a lot with my second birth too just to trust your body and if she's not turning or they are not turning, maybe there is a reason and to just go with that. Accept it. I am glad I tried to accept it sooner because maybe I relaxed more and she turned. Meagan: Hey, yes. Jenny: I wonder if that was part of it. I let it go. I really did. I just was like, “You know what? I'm going to listen to her. She's saying she wants to be breech. I'm just going to go with it and I'm not going to care anymore.” Then she turned. I don't know. Meagan: That's how my son was. It's kind of fun that we actually have some similarities here in our birth stories. But yeah, my son too. He kept flipping breech for whatever reason and we would flip him. My midwife would manually flip him and do an ECV, then I would feel those hiccups again up in my ribs. I'm like, “Dang it, he is breech again.” Jenny: That rascal. Meagan: Yes. I found myself very angry and I'm like, “If I have to have a third C-section because this baby is breech,” which I've never had a breech baby before, “I'm going to be ticked.” Then finally, my midwife said, “We have to. We have to trust him.” He flipped head down and stayed head down and it was all good. 1:00:22 Statistics on vaginal birth versus planned Cesarean for breechMeagan: I found a PubMed research paper on maternal and fetal risk of planned vaginal breech delivery versus planned C-section for term breech births. It shows that it was published in 2022 so just a couple of years ago. It goes through. It says, “The meta-analysis included 94,285 births with breech presentation.” Now, that's actually pretty decent. 94,000 births. It's also crazy to me to think that there were 95,285 people who had breech babies and it also just says that isn't that just a variation of normal? These babies are head up. I mean, 94,000 babies. But anyway, it shows the relative risk of perinatal mortality was 5.48 which had a 95% confidence interval. Sorry, 5.48 times higher in the vaginal delivery group compared to 4.12% for birth trauma and then the APGAR results show that the relative risk of 0.30% percent higher than a planned Cesarean group, so in the end which is kind of confusing I'm sure. I'm going to provide this in the show notes. It says, “In the end, the increment of risk of perinatal mortality, birth trauma, and APGAR lower than 7 was identified in a planned vaginal delivery.” We know that breech birth can become complicated. That's one of the reasons why a lot of these providers out there are just not willing to try. However, it says, “The risk of severe maternal morbidity because of complications of a planned C-section was slightly higher.”It's something to consider here where we are like, “Okay, well there is some birth trauma.” We know that sometimes we can have tissue tearing. We can have pelvic floor issues and trauma. We know that babies can come out a little stunned because of what happens when their body is delivered and their head is inside. And APGARS lower than 7 which is less ideal. However, even with a Cesarean, those rates were even slightly higher. In the end, we need to figure it out but what we need is more providers. We need more providers being trained and offered. They need to go to Dr. Stu's course. They need to listen to Heads Up. They need to get informed and offer people these options because just like Jenny and I, and even more Jenny than I, there is a lot of stress that goes into having a breech baby, and think about all of the things that you just said. If you had run out of options, meaning that you had done everything in your own power to try and help this baby flip and are now just relying on faith, which let me tell you, faith is amazing and we need to rely on faith all the time, but even then, if we are still at that roadblock, that is so hard. It's so stressful. I truly believe that we could lower Cesarean rates by a lot. I mean, even looking at these 94,000 people, we can lower that Cesarean by a lot if we just took one little step forward and offered breech birth again and trained providers. Jenny: I totally agree with you. I know. Just listening to all of the things I had to go through to get my VBAC, it could have all been prevented if I just had her, my first, vaginally. All of that stress and all of that, I wouldn't have had to do any of that. It could have just been normal. Instead, it's just this huge, stressful event and I can't say that enough because our lives are already stressful. Why should we stress more? Meagan: Yeah. I mean, it's 2024 which means that 24 years ago, breech birth started fading. We are really behind and it's something that breaks my heart to see if it's going to disappear. We can't let it disappear. We can't. Jenny: I agree. Meagan: Also, side note, if you listen to this episode and you know a provider who is willing to do breech, please message us at info@thevbaclink.com so we can get them on our list so we can help Women of Strength all over the world find a provider that may be willing to help with them. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Our Sponsors:* Check out Dr. Mom Butt Balm: drmombuttbalm.comSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

How to set up and organize your nursery as a first time mom for maximum efficiency and organization! Today's episode on nursery organization / nursery set up covers:How to set up your house for postpartumHow to set up your house for breastfeedingHow to organize your nursery closetNursery organization tipsNursery closet tipsHow to set up your bedroom for babyNursery organization dresserNursery organization hacksNursery organization tipsNursery organization ideasHow to set up your nurseryHow to set up a nursery in your bedroomAND MORE!-------------------------------------------------------------------------------------------------------------IMPORTANT LINKS:- Sign up for the Learning To Mom Newsletter HERE:- Shop Pregnancy and Nursing Safe Skincare HERE at lavendermeadowsco.comUse code LEARNINGTOMOM for 25% off!!Connect with them on Instagram HEREPRODUCTS I TALKED ABOUT:- 3 Tier Rolling Cart linked HERE- Ladybug Haaka linked HERE- Drawer Organizers linked HERE- Hatch Sound Machine linked HERE-------------------------------------------------------------------------------------------------------------- How to prepare for pregnancy , What is the best pregnancy podcast, That pregnancy podcast, Best pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time mothers, Podcasts for expecting mothers, Pregnancy podcast week by week, Pregnancy symptoms, First trimester tips , Prenatal vitamins, Pregnancy diet, Safe exercises during pregnancy, Maternity clothes, ultrasound information, Pregnancy apps, Birth plans, Baby registry essentials, Morning sickness remedies , Prenatal yoga , Gestational diabetes , Baby development stages , Pregnancy books , Labor signs, Breastfeeding tips, Postpartum care, Childbirth classes, Pregnancy announcements, baby showers, Maternity leave rights, Pregnancy health insurance, Fetal movement, Pregnancy support groups, Safe skincare for pregnancy, Pregnancy podcasts, Nursery decorating ideas, OBGYN recommendations, Stretch mark prevention, Pregnancy fitness, Birthing techniques, Pregnancy sleep positions, Baby gear reviews, Pregnancy meal plans, Pregnancy-safe beauty products, Baby bump progress, Prenatal classes,  Pregnancy relaxation techniques, Pregnancy forums, Baby-proofing home, Preeclampsia symptoms, Baby milestones, Natural birth options, Maternity support belt, Pregnancy hydration, Newborn care, Baby feeding schedule, postpartum depression, Baby vaccination schedule, Cord blood banking, Baby room themes, Gestational age calculator, Baby shower games, Maternity hospital bag checklist, First-time mom advice, Pregnancy journals, Best pregnancy podcast, How to prepare for pregnancy, What is the best pregnancy podcast, That pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time moms, Podcasts for expecting mothers, Pregnancy podcast week by week

Gestational diabetes is fairly common among pregnancy women in America. Lily Nichols, author of Real Food for Gestational Diabetes and renowned registered dietician & certified diabetes researcher, covers many important topics regarding how to care for your blood sugar and healthful eating during pregnancy!Resources Mentioned:Lily Nichols' Site https://lilynicholsrdn.com/Lily's Facebook: https://www.facebook.com/PilatesNutritionistLinks to find the guidelines for the 2hr glucose test: CDAPP Sweet Success, PG 153- https://perinatology.com/Reference/CDAPP%20SS%20Guidelines%202012.pdfInternational Association of Diabetes in Pregnancy Study Group-https://www.iadpsg.org/ OR https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4866200/#:~:text=For%20IADPSG%20criteria%20an%20OGTT,%2Fl)%20%5B9%5D.Check out Informed Pregnancy+https://www.informedpregnancy.tv/ Full Well Code: TNBT10https://fullwellfertility.com/Tighten Your Tinkler Testimonial & Signature Program Code: TNBT50https://youtu.be/FjV7KYGv2ag https://www.tightenyourtinkler.com/signatureprogram NOW IT'S YOUR TURN! "Like" our Facebook and Instagram pages- @TheNaturalBirthSite The NaturalBirth Site- TheNaturalBirthSite.com SIGN UP for the NaturalBirth Education course to best prepare your body & mind for natural birth (only $65) Read natural birth stories- and submit your own SHARE OUR PODCAST with anyone you know who is interested in natural birth! Check out our HELPFUL PRODUCTS GUIDE

In this episode of the Dr. Tyna show, we're diving deep into the realm of prenatal and pregnancy metabolic health with registered dietitian and certified diabetes educator Lily Nichols as she unpacks the sobering realities of metabolic health for women and men in their reproductive years and its impact on future generations. Come along as Lily Nichols shares her expertise on gestational diabetes, revealing how maternal blood sugar control affects fetal health and long-term risks. From how we test for and treat gestational diabetes in pregnancy to the significance of metabolic health in preconception preparation, we explore the pivotal connection between metabolic health and the health of future generations. Check Out Lily: Website Instagram Facebook Twitter   On This Episode We Cover: 4:14 - Lily Nichols's education & work experience 7:21- Insulin resistance in utero  13:58 - Long term health effects of insulin resistance  18:06 - Gestational diabetes treatment & testing  24:49 - Insulin levels throughout pregnancy  28:46 CGM & its use in pregnancy  32:32 - The impact of low metabolic health on the fetus  38:18 - Preparing for pregnancy  45:24 - Metabolic health & fertility 48:34 - BMI during pregnancy  55:05 - The long term effects of malnutrition  58:20 - Exercise during pregnancy & managing blood sugar levels Sponsored By: Qualia Senolytic  Go to neurohacker.com/drtyna and use code DRTYNA for 15% off Sundays Get 40% off your first order at sundaysfordogs.com/drtyna with code DRTYNA Momentous  Get 15% off with code DRTYNA at livemomentous.com  BiOptimizers Go to bioptimizers.com/drtyna and use code DRTYNA to save 10% and get a free gift with purchase  NutriSense Get $30 OFF with code DRTYNA at nutrisense.io/drtyna Disclaimer: Information provided in this podcast is for informational purposes only. This information is NOT intended as a substitute for the advice provided by your physician or other healthcare professional, or any information contained on or in any product. Do not use the information provided in this podcast for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or other supplement, or using any treatment for a health problem. Information provided in this blog/podcast and the use of any products or services related to this podcast by you does not create a doctor-patient relationship between you and Dr. Tyna Moore. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent ANY disease.

Breast cancer is the second most common cancer among women in the United States (with skin cancer are the most common). About 9% of all new cases of breast cancer in the United States are found in women younger than 45 years of age. Unfortunately, breast cancer is being diagnosed in women under 40 at an increased rate. This was recently published in a Jan 2024 JAMA population-based, cross-sectional study using data from Surveillance, Epidemiology, and End Results database. Every year, more than 1,000 women under age 40 die from breast cancer. Nearly 80% of young women diagnosed with breast cancer find their breast abnormality themselves. Breast cancer is the most common form of cancer in women who are pregnant or have recently given birth. According to US statistics, Breast cancer occurs about once in every 3,000 pregnancies, with some reports stating it may be as high as 1 in 1,000. For those under the age of 40, most are diagnosed between the ages 32 to 38 years. Because many women are choosing to delay having children, it is likely that the number of new cases of breast cancer during pregnancy will increase. In this episode, we're going to look at breast cancer in reproductive age women with a focus on gestational breast cancer. Is MMG contraindicated in pregnancy? Can chemotherapy be used during pregnancy? What about radiation therapy? And is it better to have a complete mastectomy or breast conservation, during pregnancy? Listen in for details.

Today's episode we're shedding light on and breaking down all things infertility with Dr. Pero, a specialist in reproductive health. Dr. Roxanne Pero is BACK to share some insight into infertility today, in honor of National Infertility Awareness Week -------------------------------------------------------------------------------------------------------------IMPORTANT LINKS:- Sign up for the Learning To Mom Newsletter HERE:- Fit Mama In 30: Prenatal Workout Program that I'm Doing: Click HERE                   Use code LEARNINGTOMOM for the BIGGEST discount they have!! ($20 off their annual plan)- Link to TempDrop, the Temperature Tracking Armband I use: LINKED HERE                   That link will save you $15!- Connect with ME on Instagram HERE or at @learningtomom.podcastHow to connect with Dr. Pero:- Her instagram is linked HERE- Listen to her last episode, How to choose your OBGYN and What Questions to Ask during Pregnancy FROM an OBGYN with Dr. Pero | Ep. 01 HERE on Spotify, HERE on Apple Podcasts-------------------------------------------------------------------------------------------------------------How to prepare for pregnancy, What is the best pregnancy podcast, That pregnancy podcast, Best pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time mothers, Podcasts for expecting mothers, Pregnancy podcast week by week, Best pregnancy podcast, How to prepare for pregnancy, What is the best pregnancy podcast, That pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time moms, Podcasts for expecting mothers, Pregnancy podcast week by week,  Pregnancy symptoms, First trimester tips, Prenatal vitamins, Pregnancy diet, Safe exercises during pregnancy,  ultrasound information, Pregnancy apps, Birth plans, Baby registry essentials, Morning sickness remedies, Prenatal yoga, Gestational diabetes, Baby development stages, Pregnancy books, Labor signs, Stretch mark prevention, Pregnancy fitness, Birthing techniques,  Pregnancy meal plans, Pregnancy-safe beauty products, Maternity photography, Baby bump progress, Prenatal classes, Pregnancy relaxation techniques, Pregnancy forums, Baby-proofing home, Preeclampsia symptoms, Baby milestones, Natural birth options, Maternity support belt, Pregnancy hydration, Newborn care, Baby feeding schedule, postpartum depression, Baby vaccination schedule, infertility, help with infertility, how to get pregnant, getting pregnant tips, am i experiencing infertility, secondary infertility, infertility explained, can infertility be cured, how infertility is diagnosed, where did infertility come from, infertility for women, infertility for men

Unnecessary Cesarean sections are common in India for unjustified reasons and poorly read overdiagnosed factors which in many cases have not been proven to be emergencies. The lack of application of basic evidence based information once applied can in itself lift our rates of natural birth high up. The maternity system today needs to keep up with atleast the guidelines in place as a starter and the experience if not the outcomes may improve.Listen to Lavanya's story to learn about :Story of Changing Doctors and buying time from the OBGYNInduction and its side effects Meconium Working through Postpartum after CesareanBirthtrauma reflected as Postpartum Depression and PTSDBirth trauma and its physical ramificationsLavanya is a Yoga teacher who met with an unnecessary cesarean some 5 years ago and had been looking for answers to align with what she felt in her body. She found answers and shares what she feels really happened.Support the showSign up for Traverse the Labor Land and Own your birth programs! visit www.birthagni.com/contactusSupport the show: If you like what you hear, leave us a rating on Spotify app and answer the question at each episode! a review on Apple podcasts. Share on Whatsapp/Insta/FB Share on Instagram and tag us @divyakapoorvox Support the production by making a donation at https://www.buymeacoffee.com/birthagni. This ensures the continuity and quality and a good coffee on sleepless recording nights! Subscribe to the FREE newsletter at https://www.birthagni.com/#subscribe and receive DISCOUNTS, SALE updates and GIFTCARDS on our premium 'Own your Birth' program You can book a 20 min FREE Discovery call at https://www.birthagni.com/...

Though Karen did research and took birthing classes before her first baby, she didn't realize how much advocating for herself could change the course of her birth. She wanted to be the “good” patient and told herself she could do without the things her body told her she needed during labor. Karen ended up pushing for over four hours and consenting to what she was told was an emergency C-section, even though the actual surgery didn't happen until hours later.Karen had some serious postpartum symptoms of swelling and difficulty breathing that were dismissed and even laughed at until things came to a point where she knew something was very wrong. She was diagnosed with postpartum cardiomyopathy, admitted to the ICU, and transferred to cardiac care. Doctors told Karen very different things about her condition. She went from being told not to have any more children to hearing that VBAC was absolutely safe. Karen discusses how her gestational hypertension came into play with the different advice as well. Karen found her voice. She advocated for herself. She knew what her body was saying and what it was capable of. Her labor was so smooth and she WAS able to birth vaginally!Informed Pregnancy PlusNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 3:46 Review of the Week06:27 Karen's stories08:50 First labor10:47 Pushing for four hours15:11 Karen's C-section17:43 Postpartum swelling and difficulty breathing21:03 Fluid in her lungs23:52 Moving to Florida and getting answers25:13 Getting pregnant again29:53 Advocating for a VBAC32:14 A spiritual dream34:34 Gestational hypertension39:36 Signing an AMA41:31 Going to the hospital45:20 Pushing for 20 minutes47:30 White coat syndrome51:59 Symptoms of hypertension and preeclampsia54:52 Tips for hypertension and preeclampsia 56:55 Karen's final tipsMeagan: Hello, hello. We are getting into almost our 300th episode, you guys. Every single time I'm recording and I'm looking at these numbers, I am blown away. I cannot believe that we have almost put out 300 episodes. Oh my goodness. I am so glad that you are here. I have this energy this year. I don't know what it is. You'll have to let me know if you notice it, but I have this energy every time I'm recording this podcast. 2024 is vibing. I'm vibing with it. I'm really liking it. We have our friend Karen and are you from Florida, Karen? Karen: Yep. I'm in Orlando, Florida. Meagan: Florida. That's what I was thinking. So if we have Florida mamas looking for providers, this is definitely an episode. I feel like probably weekly we would get 10 messages asking about providers and Florida is huge so Florida is actually one that is really common where we are getting messages for supportive providers. So Karen, along the way, if you feel to name-drop some providers that are supportive, feel free to do so but we are going to get into sharing her story in just one moment because we do have a Review of the Week. 3:46 Review of the Week Meagan: This is from louuuhuuuu. So louuuhuuuu, thank you for your review. They say that this is “very inspirational.” It says, “I knew I wanted a VBAC with my third pregnancy, but I wasn't sure if it was possible. However, I knew I didn't feel like being flat-out told, ‘No' at the first appointment. Listening to the podcast was definitely the start of me really researching birth and looking into my options. I ended up with a successful HBA2C and I definitely don't think I would have had the courage or believed it was possible without this podcast. Thank you, Meagan, for all of the work that you do to provide this information.” I love that review so much. I think that through time in my own research, I was told no. I wasn't told, “No, no.” I was told, “Sure, probably yeah. You could VBAC,” but I never really got that positive vibe. I feel like this community that we have created with all of the people on the podcast and all of the people in the community on Facebook truly is something that I lacked when I was preparing for my VBAC. I'm so grateful that we have this community for you today. Thank you, louuuuhuuuu, and huge congrats on your HBAC, your home birth after two Cesareans. If you didn't what HBA2C meant, that's home birth after two Cesareans. Just like louuuhuuuu, you can too. Make sure to follow us in our Facebook community. You can find it at The VBAC Link Community on Facebook. Answer all of the questions and we will let you in. You can find out as well that it is possible. VBAC is possible. 06:27 Karen's storiesMeagan: Okay, Karen. Welcome to the show and thank you so much for taking the time to share your story today, well your stories today. Karen: Yeah. Thank you for having me. It's a little wild actually being on your show. I've been thinking about what I was going to say even before you invited me like, “What would I say if I finally get my VBAC? It's crazy to actually be sharing my story now so I'm really excited to be talking to you today.” Meagan: Well I'm so excited that you are here and sharing your inspirational message. You know, going through your submission, it sounds so similar to so many of us. You went in for a totally planned unmedicated birth that switched to the complete opposite where you had a C-section. There are so many of us. When I was reading that, I was like, “I bet I could probably find hundreds of stories not even just in our own community that start out like that.” Karen: Yes. That's why I love listening to your podcast so much because for the first time, I didn't feel alone. But yeah. I can get into my story now if you'd like. Meagan: Yes. I would love it. Karen: Okay. So back in August– or, I'm sorry. My son was due in August 2023. This was our first baby and he was a little bit of a surprise baby, but he was very much welcome and we were excited for him. At the time, we were living in Virginia. My husband had just gotten out of the Navy and he was about to start law school. I did prepare for the birth but I don't think I prepared enough. I took a Hypnobirthing class and the doula who was leading the class was super supportive. She was just like, “You're just going to birth beautifully. I can just tell.” The midwives, the nurses at the practice were like, “Oh, you're going to birth beautifully. I can just tell.” I just kept hearing that over and over again. My ego was a little over-inflated and I was like, “I don't need to do much. I've got this.” I don't think I was prepared enough. I didn't know what I was really getting into. 08:50 First laborKaren: So when I actually started going into labor, I got there way too early. I got to the hospital too early. Like you mentioned, I wanted an unmedicated birth. I got there, I think my contractions were about every seven minutes. Now I know that I definitely should have waited at home longer. But everything seemed to be going well. I arrived. They admitted me. They seemed a little bit hesitant, but they were like, “Oh, well she's in labor. Let's just bring her in.” My water broke on its own that afternoon. Things seemed to be going well until the pain really started kicking in. I had a really hard time working through the pain even with everything I learned in HypnoBirthing. I still hadn't quite found my voice yet, my mama voice. I couldn't tell people, “Hey, you're distracting me. I'm trying to do HypnoBirthing.” I felt embarrassed about putting up the sign outside my door saying, “Hey, HypnoBirthing in progress. Please keep quiet.” I just didn't speak up. I was just trying to be a good girl and just listen to what everyone says. I heard so many times in different episodes being a good girl and just doing what I've been told. Meagan: Right. We are people pleasers. I think a lot of us are people pleasers. We don't want to ruffle feathers. We want to stay in line. We want to follow this path that we are being told we have to stay on. Karen: Yes. I mean, I just didn't realize it was something I needed to form as a mama to be able to stand up for myself because pretty soon there was going to be a baby that needed me to stand up for them. Like I said, during the birth, there were just so many distractions, people coming in and out, nurses, and visitors. It was too much. I did end up getting an epidural because I just couldn't hold out any longer. 10:47 Pushing for four hoursKaren: Around 2:00 AM, the labor and delivery nurse told me, “Oh, you need to start pushing.” I was on my back. I pushed for about two hours. I had some breaks but the baby was just stuck. For part of it, we could see that he was crowning but he just would not come out. During this entire time, no one really looked at me. I just had this one labor and delivery nurse. She was so sweet, but the midwife didn't come by. The OB didn't come by. No one really came by and I wanted to move into different positions. I felt my body telling me, “Hey, try this. Try this,” and they would tell me, “You can't move. You have to stay like that.” I pushed for four hours. Baby was in distress. I felt fine but the midwife came in and told me, “You're going to need a C-section.” This was the first time I had seen her. She told me. Meagan: Wow. Karen: Yeah. So she says, “You need a C-section. He's not going to come out vaginally.” I didn't know. I didn't know what to do. I mean, I felt that was my only option. I got really upset. I started crying. I felt like a failure. I know now that I'm not a failure. That wasn't it. But that's how I felt at the moment and my husband was devastated. He was such an amazing birth partner and he felt like he failed me. I was like, “No. You didn't fail either,” but at that moment, we just felt so let down that one, I had to ask for an epidural, and two that I was going to need a C-section. Karen: They told me. I don't remember if the word “emergency” was used or not, but they made me feel like it was an emergency and it needed to happen immediately. When I look at the paperwork and all of that stuff, I'm like, “Where was the urgency?” Because the C-section didn't happen until 10:00 AM. Meagan: Yeah. That's not an emergency. This is another thing that I'm going to be honest– it irks me because there are so many of us who are told it is an emergency. When we hear “emergency”, what do we think? Panic. Scary. Right? We divert into asking– divert. I don't know if that's the right word. We stop asking questions and we say, “Okay. Okay. Okay,” because it's an emergency and we are told that. Karen: Exactly. Meagan: I think a lot of times, truly that we are told it is an emergency and that offers some sort of– it's weird, but some sort of validation where it's like, “But it's an emergency, so okay.” We just agree and then we are grateful. We look at them in a way because it's an emergency so they are saving. Does this make sense? I don't know. Karen: No, it does. To me, when I think about it now, it feels like manipulation. Meagan: Okay, yeah. Yeah. Yeah. It can be. Truly, there are real emergent Cesareans. Karen: Agreed. Meagan: We are so grateful for Cesareans that can help us and those are real, true emergent situations, but so many of us are told it's an emergency and then like you said, it's 10:00 AM or they come in and they're like, “We need to shave you,” and it's like, “Okay, that's not an emergency.” If they have time to shave you, talk with you, and leave you for four hours, no. It's not an emergency. Karen: Exactly. So if I had known what I know now, I would have asked for my options, asked to push and change positions. There are so many things I would have done but like you said, I thought it was an emergency. I was treating my baby in danger. I need to do this now even though there was nothing wrong with the baby. There wasn't. Meagan: Or you. Karen: Mhmm, exactly. His heart was fine. Everything was fine as far as I could see as far as I remember, as far as the paperwork says, so it doesn't make sense anymore to me. But yeah. 15:11 Karen's C-sectionKaren: My husband was told to dress in scrubs while they prepped me and then I asked the nurse to make sure that no one was in the room when I got back. When we came back to surgery, they wheeled me over to the OR and they were just checking to see that the epidural was still good. I could feel them touching my belly. I told them and that's the last thing I remember. The next thing I know, I just hear a baby crying in the distance. I was waking up in a different room and there were just these two nurses chatting about their day. To me, it was traumatizing. I couldn't even process what was going on and what happened. That was just so, so scary. Meagan: I'm so sorry. Karen: Yeah. Sorry. So then they wheeled me out and that's where my husband and our whole family were waiting. I was so frustrated because I told the nurse I didn't want anyone here. I knew I would be upset after the C-section and there was everyone in the room waiting. I also found out that my baby got passed around so I didn't even get to be the first to hold him. That was so extremely upsetting. I told my husband, “I want everyone out.” Everyone left and it was just me and my husband and our baby, Luke. We were there for about 15 minutes before they started to prep me to move the recovery room and I was like, “Wait a minute. I thought I got a golden hour where I would get to be alone with the baby for an hour.” They were like, “Oh yeah, you can do that in the recovery room,” and they just wheeled me over. I get so sad when I look at pictures of that time because my baby is so beautiful. I love him so much, but I felt so drugged up that I couldn't connect with him. You can see it in the pictures. I just look like I don't know where I am. I'm in pain. It's just not what I imagined that experience to be. Meagan: Right. Karen: I definitely felt robbed of an experience. I felt extremely traumatized. That was hard in and of itself, but I was trying to come to terms with what happened. It was just a very rough time in the hospital. We had some family drama as well so that didn't help. Meagan: No. Karen: I was discharged less than 48 hours later which now I know is way too early considering the symptoms I was feeling. 17:43 Postpartum swelling and difficulty breathingKaren: My legs were extremely swollen. My whole body was extremely swollen. It didn't even look like I had given birth because I was just swollen all over. One nurse even made fun of my legs and she was like, “They look like baseball bats.” She was just tapping them.Meagan: That's a warning sign. That's something to think about. Karen: Well, I didn't know that. Meagan: Well, of course, you didn't, but as a professional, she shouldn't be tapping on your legs. She should be like, “Hmm, was this like this?” Karen: I've told other medical professionals that story and they are horrified. They are like, “That was a big warning sign something was wrong,” but they discharged me regardless. I felt so completely unprepared. It was just a very bad experience all around. They didn't have a lactation consultant working over the weekend so my baby was crying and crying and crying. He wasn't getting enough to eat when he was breastfeeding. They were just laughing and saying, “Oh, all moms feel like that. He's getting enough to eat.” Sure enough, my son was jaundiced and his pediatrician was like, “No, he needs formula. He's not getting enough to eat.” He had a significant tongue tie so he was not getting enough to eat. When I got home, like I said, baby was starving. I'm not getting any sleep. When he does fall asleep, I can't sleep. I remember explaining to different people like, “I'm having trouble breathing every time I lay down.” Everyone was just like, “Oh yeah. New mom, new baby. Totally normal.” Meagan: What? It is not normal to not feel like you can't breathe. Karen: You're going to love this then. At one point, I called the nurse hotline at the hospital because they gave it to me when I was discharged. I told the nurse, “When I lay down, I can't breathe. It feels like I can't breathe.” Her response was, “Oh, sometimes new moms don't know how pain feels like.” I was just like, “Okay, I guess this is just me.” She was like, “Technically, we're supposed to tell you to come to the hospital if you are having trouble breathing.” Meagan: Technically. Karen: Technically. So I was trying to be the good girl and trying not to ruffle any feathers and I was just like, “Okay. I'll keep pushing through,” but the moment I realized things were not good, I was extremely depressed. I thought that I was going to die and leave my child alone. I was having horrible thoughts like that. Then I realized, “I'm starting to hallucinate.” So after three days of not sleeping, there was one incident where I heard my baby crying and screaming. I went over to the bassinet to look at him and he's sleeping peacefully, but I can still hear him crying and screaming clearly. I'm like, “That's not normal.” 21:03 Fluid in her lungsKaren: Once he woke up because I was trying to be a good new mom, so once he woke up, I packed myself up and my mom and I went to the ER. I explained to them, “I'm not getting sleep. I can't sleep. Every time I lay down, I can't breathe.” They were like, “Okay. Maybe you have a blood clot.” They took me back. They did an MRI scan and when I was lying down for the scan, I started taking these small quick breaths and the nurse was like, “Are you having a panic attack? What's going on?” I go, “I can't breathe.” She finally was the one that was just like, “There is something deeply wrong here. This is not normal at all.” I loved her. She really pushed to make sure that I got seen quickly. They determined that I was experiencing congestive heart failure. The way they explained it is my heart was not pumping strong enough I guess. It wasn't pumping right so that's why I was having trouble breathing because my lungs were filling up with fluid. They were able to give me medication. It was Lasix to help push out all of the fluid. I was kept at the ICU for two nights then they transferred me to the cardiac wing of the hospital. I was there four nights total because they just wanted to keep an eye on my blood pressure and this obviously wasn't normal what was happening. My blood pressure was through the roof. That was a really, really difficult time because one, I was away from my new baby and then I had three different doctors tell me, “There is something wrong with your heart. You won't be able to have more children. Your heart can't handle it.” That was distressing because my husband and I dreamed of having a big family and we were thinking, “This might be our last child.” But weirdly enough, my OB– the one who performed the C-section– disagreed. I don't like how he said this, but he was like, “Oh, don't be dramatic. It was just a little extra fluid. You're fine.” I was like, “Okay.” He said, “You can have a VBAC. You can have as many children as you want. You're going to be fine.” I wasn't a fan of him but that was interesting that he had told me, “You're going to be a great VBAC candidate.” He kind of put that idea in my head. He said that the only reason my son got stuck was because he was 9 pounds, 15 ounces so basically a 10-pounder. I was like, “Okay.” I didn't know what I know now, but that's the reason they gave me. 23:52 Moving to Florida and getting answersKaren: Eventually, we moved to Florida because I'm from Florida so I felt more comfortable with the medical care there. I just kept finding out different ways that I was failed by the medical system back in Virginia. My primary doctor determined that I had postpartum depression. My son was already two years old when she discovered that. It was just like, “Oh, okay.” Here's some medication. Now I feel like myself again. It made me realize, “Okay, what else do I need to look into?” I got a cardiologist. She was saying, “There is nothing wrong with your heart.” She can't definitively say because she wasn't there, but she was like, “They put too many fluids in your body. You are fine. There is nothing wrong with your heart.” She was just like, “You're good to go. You can have a VBAC. You can have another C-section. You can do whatever you want. You're fine. We can keep an eye on you, but you're okay.” I started seeing an OB and I told her everything that happened and I was just like, “I want a VBAC.” I told her everything the cardiologist said, gave her all of the paperwork and she was like, “Yeah. You can totally have a VBAC.” So with both of their blessings, I was like, “Okay. Let's try for baby number two. I'm okay. I'm healthy. I'm fine.” 25:13 Getting pregnant againKaren: So I got pregnant with baby number two and that was very exciting. I thought everything was going well then at 20 weeks, my OB said, “Unfortunately, I can't be your doctor anymore. This practice cannot deliver you. You are too high of a risk for this office.” Meagan: For the office. Karen: Yes. Yes. They only delivered at these smaller boutique hospitals so they said that I needed to deliver at a high-risk hospital or a hospital that accepts high-risk patients. Meagan: Okay, got you. I got you. Karen: I got a little tongue-tied. They told me I needed to deliver at a different hospital that I didn't want to deliver at. I was like, “If I'm going to deliver at a big hospital, it's going to be Winnie Palmer in Orlando.” I'm a huge fan of theirs. So I was just like, “Okay. I can't deliver with this office even though they've been aware of all my situations for a while. I'll find a different office.” But I was already 20 weeks so it's really hard to find a provider at 20 weeks. Meagan: It can be, yeah. Karen: The other disappointing thing they told me is, “Oh, by the way, you can't have any more children. You really shouldn't because, with everything that is going on with you, your body can't handle it.” It was just like, I don't understand where this is coming from. You've been telling me I've been okay. My cardiologist says I've been okay. I didn't really get what was going on. Karen: I called around and only one clinic would take me when I was that far along with this high-risk label on me. Meagan: I was going to say the label. That's exactly the word I was going to say. Karen: Yeah. I didn't feel like it really fit, but that's what they said I was. I found a big practice that had lots of doctors. It is a very prominent practice here in Orlando and I felt like I just had to settle. The first doctor I met with I was already frustrated because I asked for a female doctor and they gave me a male doctor. I don't have anything against male doctors, I just feel more comfortable with a female doctor but he was just like, “Oh. You can't VBAC at all. You had a vertical incision so you have to have a repeat C-section.” I was like, “I don't– I've never heard anyone say that. Where does it say that in my medical records?” He was just like, “I don't see it in your records, but this other doctor said that you had a vertical incision.” I'm like, “Well, how does she know that?” So I had to go and start pulling all of these records and got the surgical notes for my C-section and everything and finally, I found something that said I did not have a vertical incision so once I showed it to him, he was just like, “Oh, okay. Well, you still can't VBAC. Your hips are too tiny. You can't deliver a baby.” Meagan: Oh my goodness, just pulling them all out. Let me just shift this jar around and pull out the next reason. Karen: Yes. I was just like, “Are you serious? Okay.” Meagan: Goodness. 29:53 Advocating for a VBACKaren: So me and my husband were like, “No. I want to try. We want to try.” I'm so glad my husband was there because he is always so good at being an advocate for me. He was just like, “No. She wants a VBAC. What can we do to make it happen?” So he said, “Well, your weight is one thing because your baby was so big the first time because you gained a lot of weight. We can help you try but if after two hours of pushing you can't get that baby out, we're going to give you a C-section.” It was very frustrating, but I felt like I really had no choice. Meagan: Yeah. Karen: I hadn't discovered you yet so I was just like, “Okay. I guess it is what it is. I will try my best to have a VBAC, but this guy's going to stop me.” So I was very blessed that due to a scheduling issue, I had an appointment with a totally different doctor. She was this young female doctor. She was around my age and I felt like I could relate to her. I just really enjoyed talking to her. I don't know if this has something to do with it, but my background is I am Japanese and Colombian and she was Asian, so it was just like, “Okay. I have someone else who is a person of color who understands at least the cultural differences.” So I don't know if that really had anything to do with anything, but it did make me feel more comfortable with her.Meagan: Which is important. Karen: Yes. After years of different doctors telling me there was something wrong with me, it was so nice to have her say to me, “Oh. You want a VBAC? Yeah. You are super healthy. You are going to be fine.” It was just like, “Oh my gosh. You think I'm healthy? Every doctor had been telling me that I'm overweight. There's something wrong with my heart. There's something wrong,” and she was telling me that I was healthy. That just made me so inspired and I just became a lot more proactive with my health. I didn't feel like things had to happen to me. I felt like I had a lot more control over my situation. 32:14 A spiritual dreamKaren: There was also one other event that happened and this was around Christmas. I'm a Christian, so we've been going to God a lot with prayers and I have been asking for a successful VBAC. So Christmas morning, I woke up to a dream but it didn't feel like a dream. It felt more like a vision and I was giving birth vaginally to a little girl. In the dream, I had the knowledge that this was going to be my third child. I was like, “Wait a second. But I'm pregnant right now with my second child. How did that birth go?” I just was told by God, “Oh, that birth went well too. You're going to be fine. You're going to be happy. You're going to have many children.” So I woke up so happy that Christmas morning. I told my husband with everything I've been battling and all of these negative thoughts, there is no way that this could have been something I produced myself or just dreamed of myself because it was such a positive, happy dream when before that, I had just been having constant nightmares about C-sections.It was just this moment of, “Okay. God really is with us and he's going to make sure everything is okay.” So yeah, between having this great doctor and then having that dream, I just was more motivated to really take control of the situation like, “Okay. I don't have to let things happen to me. What can I do?” Which actually led me to The VBAC Link. I was already 33 weeks pregnant when I found you guys so it was kind of late in the game, but I'm so glad I did. I listened to The VBAC Link obsessively in the car, when I was walking my dog, all the time and I would just hear these different stories and notate, “Okay. This is what she did. This is how she got results. This is what happened to her.” I started taking all of these notes about how I should respond in different situations and I'm so glad I did because I did use some of that later on. 34:34 Gestational hypertensionKaren: Unfortunately, I did develop gestational hypertension but I'm still not completely convinced that I actually had it. They diagnosed me the week I had to put down my dog and I had her since I was 15 so it was just devastating. I was under a lot of stress and I tried to explain that to them. They were like, “No. This is gestational hypertension.” I'm like, “Okay. Here is another label.” But I kept on top of my blood pressure readings. I never had high readings. I ate well. I tried to do exercise as much as you can when you are in your third trimester. Unfortunately, this practice had a policy that patients with gestational hypertension must deliver by 37 weeks. Meagan: Whoa. Karen: Yes. They said that if you are a VBAC patient, they won't induce you. So there's another timeline. I had to deliver by 37 weeks. But yeah, things seemed to be going really well. Once I reached around 36 weeks, I actually started having prodromal labor. I'm like, “Okay, yes. Things are going really well.” Because I had gestational hypertension, I was going 3-4 times a week to the doctor at that point. Meagan: For non-stress tests and stuff? Karen: Yes, exactly. They could see that I was already 3 centimeters dilated so I was like, “Great. Everything is going great.” At the 37-week appointment, there was a scheduling issue and instead of being able to see my regular doctor, they assigned me to a different doctor and that just made me really, really nervous. I was just like, “I don't want to go. I don't feel right. Something is going to go wrong. It's not my doctor. I don't want to go.” My husband was like, “No. It's going to be okay. It's going to be okay. Let's go.” He canceled work so he could go with me. He was like, “Everything is going to be okay.” The other thing that happened that morning was my sister who was going to be in the room with us woke up with strep throat. I was like, “This is not a good week. This is not a good day. I don't want to go in.” So when I went in, my blood pressure was 160/113 which was extremely high. This doctor told me, “You need to get a C-section today.” So I was just like, “Okay. I don't want to hurt my baby. That's fine.” I was really, really upset. I was crying and I told her I was scared and she was like, “Why are you scared?” My husband was pretty blunt and was like, “Because the doctors almost killed her last time.”She was like, “How did they almost kill her?” He was like, “They put too much fluid in her body and they caused heart failure.” She laughed and she said, “That's not a thing.” I was like, “Well, my cardiologist said it was a thing. How could you say it's not a thing?” I went to the hospital. I was really upset but the nurse there was amazing. She was like, “What happened?” I basically told her everything like my life story basically up until that point. She was like, “I checked your blood pressure when you came in. You are fine.” She was like, “This is ridiculous. It just sounds like you are stressed out.” At that point, my blood pressure was–Meagan: Reasonably so.Karen: She checked my blood pressure and it was 117/83 so it was great. It was so funny because she kept the blood pressure cuff on me and the doctor who was working that day was the same doctor who told me I'd never be able to VBAC and kept coming up with excuses. My nurse was just like, “Look, her blood pressure is fine.” Then she took my blood pressure again in front of him and it went back up. She was like, “Can you step out?” She took it again and then it was fine. She started advocating on my behalf. She was like, “You guys are causing her heart pressure to go up. You guys are stressing her out. She does not have high blood pressure because of herself. It's you guys.” The doctor was just like, “Oh, well I guess it's fine, but wouldn't you rather just have a birthday today?” I'm like, “No. I would not like to just have a C-section for no reason.” He's like, “I really don't want to send you home though,” but you really should consider this C-section just in case your blood pressure goes back up. I was like, “Look. I can check it repeatedly and if it goes up, I will come back. I'm not going to be stupid and put my son's life in danger. I will come back.” He just kept trying to convince me and finally, we were like, “No. We're leaving.” I told them, “If I'm going to have a C-section, it's going to be with my regular doctor. I trust her. I'm going to have control over this situation somehow. Even if I have to have a C-section, it's going to be by someone I trust. It's not going to be by you.” 39:36 Signing an AMAKaren: He was not thrilled about hearing that but he said, “Okay fine. You have to fill out this paperwork saying you're leaving against medical advice, but it will be fine.” I was like, “Okay, fine.” I filled out this paperwork. I was scared like, “They're probably going to kick me out afterward, but whatever.” I filled it out and I went home. They did make me schedule a C-section for two days later when my regular doctor was on call. I was like, “You know what? If it has to happen that day, it's fine. I did everything I could. I took control of whatever I could. It's my doctor.” She made me feel seen and heard and she had my best interest at heart, so we are going to pray and just do what we can. The next two days, I walked 10 miles. I drank raspberry leaf tea. We had sex. We did basically everything you can do to get labor going. I was still having prodromal labor so we would get our hopes up and then it would stop and then get our hopes up and then it would stop. Around midnight the night before I was supposed to get my C-section, I was so upset. I was just like, “It's not going to happen. I'm just going to have to get a C-section.” I just gave up completely. My husband was just like, “No. God told you this was going to be fine. You're going to be fine. Let's just get some rest because it's already midnight and we have to leave at 3:00 AM so let's just get a little bit of rest and it will be fine. We will talk to the doctor in the morning.” I was like, “Okay.” So we went to sleep at 1:00. The alarm rang at 3:00 and I was in labor. Meagan: Yay! Karen: I was so excited. 41:31 Going to the hospitalKaren: We went to the hospital. They still prepped me for a C-section. They were like, “Just in case,” but I was having regular contractions. It wasn't going away. My doctor came in. She checked me and she was like, “Okay. If you want to TOLAC, I'll send you over.” I was just like, “Oh my gosh, yes. This is my dream!” We were so happy. They wheeled us over and it just felt so surreal. We just kept waiting for the rug to be pulled out from under us and someone came in and was like, “No, you need a C-section now. You're not allowed to be over here,” or something. We were just waiting. I wanted this to be another unmedicated birth, but our midwife came in and she told me her plan. She said she wanted to try a small bit of Pitocin to see if I could make the contractions a little bit stronger and then she saw my hesitation and told me, “It's only a small amount to help move things along, but you are not on a time limit. You can take however long you need to labor. It's just to help move things along. The max is 10. We won't ever get to that point.” I was just like, “Okay. I'm going to put my trust in you because my doctor trusts you.” She also asked if she could break my water to help move things along and I felt at ease so I was just like, “Okay. That's fine.” My husband was really surprised I was consenting to the Pitocin and to the water breaking. I told him, “I don't know. All this time, I'm always fighting against my gut and my gut is telling me I can trust them fine and this is going to be okay.” I listened to her plan and I said, “Yeah, let's do it.” They also kept a really close eye on my fluid levels– the thing that the other doctor said was not a thing. It felt good to know that they were actually paying attention to me and listening to me. Karen: The other thing that happened was at 10:00 AM, my sister completed 48 hours of antibiotics so she was able to join us and I was like, “Okay. Everything is going to be okay.” My husband and I were finally able to relax. Meagan: Good. Karen: Yeah. Again, I wanted to go unmedicated but I noticed something about my body which was that I could not relax my pelvic floor. I was so tired. I was so exhausted from the last 48 hours, from the walking, from not sleeping, and from everything. I was just like, “I'm trying, but I cannot relax it.” I was just like, “I think I want an epidural. I think that will relax my pelvic floor and just relax in general.” They gave me the epidural so I was finally able to get some rest. Without even having to ask them, the midwife would come in, put me in different positions, and just do different things to help me get the baby down on its own instead of last time where they just left me lying in there with no instructions. Then around 4:00 PM, they told me I was fully dilated and they were like, “Let's do some practice pushes. Let's just make sure you know what you're doing with your body. We can troubleshoot and then when you're ready, you know what to do already.” I was like, “Yeah. That's fine.” They get everything ready, start doing some practice pushes, and the midwife goes, “Oh, these aren't practice pushes.” 45:20 Pushing for 20 minutesKaren: She starts getting suited up and the room starts filling up with people and 20 minutes later, my baby was out. Meagan: 20 minutes! Karen: Yeah, 20 minutes of pushing. He was 9 pounds so he was still a big baby and perfectly healthy and beautiful. It was wonderful. One thing that my husband noticed was that the whole room was all women. It was such a cool girl power moment. They were all cheering and so happy for me getting my VBAC and it was just a total girl power that we were all like, “Yes. We did it. Girl power! The doctor is a woman. The pediatrician is a woman. We did this.” It was such a cool, surreal moment and then they had other nurses coming in and they were like, “We heard your story. That is so cool you got your VBAC.” It was so, so amazing. It was just such a huge difference having this supportive environment. I don't know. In that moment, it was like an instant feeling of relief because I felt like all of this trauma that I had been carrying with me for so long was just lifted. I felt like I was finally healed and I was able to forgive myself for the C-section and realize, “Okay. You didn't fail at anything. Things happen. You didn't know. It's okay.” Finally, I didn't have this label that I was defining myself with for so long which was traumatic birth. I finally just got to have the birth I wanted for it to be pretty smooth after the drama of the earlier morning. Everything just went perfectly and it was so, so beautiful. I was crying. We were all crying. The doctor was just like, “Okay, is this pain crying or is this happiness?” I'm like, “This is happiness!” Meagan: Pure joy.Karen: That's my story. 47:30 White coat syndromeMeagan: That is awesome. I love that you truly got to end that way surrounded with women and somebody that you really like and just having everyone rejoicing and happy and crying together and having that space be such a drastic change in your first birth. That is amazing. Thank you so much. Did you have any blood pressure issues during your labor at all? Karen: No. My blood pressure was fine. They were keeping an eye on it the entire time and I was getting nervous because I thought, maybe if it should up they would wheel me over to a C-section, but no. It was fine the entire time. Meagan: I love that. It's kind of interesting because there have been times where I've had clients where they don't have any signs of hypertension or preeclampsia or anything like that, but then they go to their visit and then they are like, “Oh my gosh. My blood pressure was just through the roof.” They go home and they are checking it at home and they are like, “It's fine.” But then they go and it's through the roof every time they go. We just had a client just the other day. She's 34 weeks and she went and her blood pressure was pretty high. It really was. It was high. The reading was high and they did a couple of readings. They said things like, “Well, we might have to go to an emergency C-section.” This and that. Anyway, she was like, “Whoa, whoa, whoa, whoa. Hold on.” She was like, “I want to go home.” She went home and relaxed and had food. Her blood pressure was fine. White coat syndrome is a real thing and it's something to take into consideration like, “I never have blood pressure issues. I don't have any signs. I don't have protein. I don't have these things. What may be going on?” I love how your nurse was like, “Hey, can you step out? Go out.” She was very able to relate to that. Then sometimes, we have it and we don't know why. With your first pregnancy, did you have any high blood pressure at all? Karen: No. It was just a very uneventful pregnancy. Everything was perfect. It was very strange for these blood pressure problems to happen afterward.Meagan: Yeah. I think it's called peripartum so it could happen before or postpartum cardiomyopathy. Karen: Yes. Yes. Meagan: That's what I was thinking it was going where the heart muscles weaken and can lead to heart failure progressively. The symptoms include fatigue, hard to breathe, and feeling your heart rush. Those are common. Karen: Yeah, so that's actually what is on my medical records is that I had peripartum cardiomyopathy but my cardiologist was just like, “I don't believe that for a second. Your heart is fine.” She kept an eye on my heart the entire pregnancy and after the pregnancy. Nothing else happened. Meagan: I almost wonder if your heart was under stress. You talked about fluids. We get an astronomical amount of fluids during a C-section too. I'm just wondering if your body just went under a lot with a Cesarean. There was a lot of shifting and a lot of things happening and then of course a Cesarean. It just made me curious because sometimes if you have hypertension before, it can be a risk factor in that. Interesting. Karen: Yeah. That's something that the cardiologist said is that sometimes it gets confused with fluid overload. She thinks that's what happened. Part of the labeling that was happening is throughout my second pregnancy, I kept having to tell people that I did not have blood pressure issues with the first because they kept going, “Oh yeah, well you had blood pressure issues with your first pregnancy,” and I'd be like, “No, I didn't. Stop assuming that.” Meagan: I mean, I am no medical professional by any means, but it makes me wonder if it could have been related to the birth itself. 51:59 Symptoms of hypertension and preeclampsiaMeagan: I'd love to talk about hypertension and preeclampsia and things like that because hypertension is something that happens during pregnancy and it can be associated with lots of different reasons, but sometimes hypertension during pregnancy can lead to preeclampsia or HELLP or things like that. I want to give a little educational tidbit here. Talking about just hypertension. High blood pressure or hypertension does not necessarily make us feel unwell all the time. You can have that and not know. So you walking into your visit and them being like, “You have hypertension.” You're like, “Oh.” It's not completely abnormal to just walk in, but sometimes we might have headaches or not feel super great. If you are feeling crummy or especially if you are feeling like you can't breathe when you lay down or have shortness of breath, do not think that those are all just normal pregnancy symptoms that people who told you, “Oh, yeah. It's a new mom.” You're like, “No.” So follow your body. Trust your body. Preeclampsia is a condition that does affect pregnant women and can sometimes come on after that 20-week mark where we are having some of that swelling. We are having the high blood pressure. We have protein in our urine. That's when it turns into that preeclampsia stage. It's really hard. It's still unknown exactly why preeclampsia or hypertension come, but it's believe to be placenta-related so sometimes our placenta doesn't attach in the full-on correct manner and our blood vessels are pumping differently so we can get high blood pressure. I want to note that if you are told that you have high blood pressure or if you have preeclampsia, that doesn't always mean you have to schedule a C-section. It just doesn't. It doesn't mean it's always the best decision to not schedule a C-section if that makes sense, but that doesn't mean you have to have a C-section because you have hypertension or blood pressure. I feel like time and time again, I do. I see these comments in our community where it's like, “I really wanted my VBAC, but I just got preeclampsia. The doctor says I have to have a C-section.” That just isn't necessarily true. They can be induced. I know you mentioned your one hospital was like, “No, we can't induce because you are a VBAC,” which also isn't necessarily true. 54:52 Tips for hypertension and preeclampsia Meagan: Sometimes we also want to be aware of hypertension or preeclampsia getting worse because labor can be stressful on our body and all of the things. I wanted to just give a couple of little tips. If you have high blood pressure, increase your hydration. Go for walks. Cut out a lot of salts so really eating healthy and then you can get good supplements to help. If you are in labor and you are getting induced or something like that, sometimes you may want to shift gears. Maybe an epidural can be a good thing to reduce stress or a provider may suggest that it's not abnormal. But know that if you were told you have hypertension or you have preeclampsia, it doesn't always mean it's a for sure absolutely have to have a C-section. Even your provider was like, “Oh yeah. We've got this high blood pressure stuff. I really wanted to keep you.” You were like, “No.” Then your other doctor was like, “We'll kick you over here to 38 weeks,” because everything really was looking okay. Yay for that doctor for not making you stay and have a C-section that day. Know that you do have options. Time and time we talk about this. Don't hesitate to ask questions. Ask questions. Can I get a second opinion? Can I go home and relax and take a reading there? Is there something I can take to help with my blood pressure? Those types of things and then following your heart. What does your heart say? That's just my little tidbit. Do you have anything to add? I know you didn't have high blood pressure in the first pregnancy and then you kind of did sort of maybe have white coat syndrome or blood pressure with the second but do you have any tips on this situation? You were exactly in that space of they are telling you you have blood pressure. He is telling you he doesn't want you to go home and that type of thing.Do you have any messages to the audience?56:55 Karen's final tipsKaren: One thing I started doing during this pregnancy was meditation and that helped a lot. Whenever I felt like, “Okay. I'm going to go into a stressful situation,” which was most doctor visits, I would meditate before the doctor came in and that would really help a lot. Meagan: Yes. Exercising, eating, hydrating, meditation, and doing something to bring yourself back down can help. It doesn't always help. Sometimes we have high blood pressure and we do not understand it. We cannot control it as much as we are trying to. It just doesn't want to listen to what we are trying to do or receive the things we are trying to do, but all of these things can help. I am just so happy for you that you found good support, that you found the true bubble of love in your hospital room at the very end, and that you were able to have your VBAC. Karen: Thank you. Yeah. I do want to make sure. I'm not trying to send a message of, “Ignore high blood pressure! Do what you want!” It absolutely can be a very scary thing. If you need to have a C-section because of it, totally understandable. It's just that my big message that I tell new moms is to listen to your body and you are allowed to say no. You are allowed to say no to people and ask for options. But the big one is to listen to your body. Listen to your gut. You know what is really, truly going on with your body. Meagan: Of course, right. And typically, birth is actually the full cure for things like preeclampsia. Getting baby earthside is typically the end of that preeclampsia and the stop. That doesn't mean you shouldn't say, “No, I'm not going to do anything,” but just know that you have options. Induction is still okay typically. Ask those providers about your individual needs. Talk about your individual case but yeah, I would agree. I'm not trying to say, “Don't listen to your provider.” I'm just saying that you have options and you often will have options if they say one thing or another. Don't hesitate to ask questions. Karen: Exactly. Exactly. 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

OH SNAP! I'M PREGNANT?!?!?! I'm not just stopping at the announcement though, I'm also sharing:- How we found out- What's different this pregnancy- What I'm doing differently this pregnancy and birth- And more!!!-------------------------------------------------------------------------------------------------------------IMPORTANT LINKS:- Sign up for the Learning To Mom Newsletter HERE:- Shop HERE for the BEST Montessori toys and furniture at mylittlesongbird.com                  Use LEARNINGTOMOM15 for 15 percent off!!!                  Connect with them on Instagram Here- Fit Mama In 30: Prenatal Workout Program that I'm Doing: Click HERE                   Use code LEARNINGTOMOM for the BIGGEST discount they have!! ($20 off their annual plan)- Link to the Temperature Tracking Armband I use: LINKED HERE                   That link will save you $15!                   - Connect with ME on Instagram HERE or at @learningtomom.podcast-------------------------------------------------------------------------------------------------------------How to prepare for pregnancy, What is the best pregnancy podcast, That pregnancy podcast, Best pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time mothers, Podcasts for expecting mothers, Pregnancy podcast week by week, Best pregnancy podcast, How to prepare for pregnancy, What is the best pregnancy podcast, That pregnancy podcast, Natural pregnancy podcast, Pregnancy podcasts for first time moms, Pregnancy podcast is it Normal, Podcasts for early pregnancy, Pregnancy podcasts, Podcasts for expecting mothers, Pregnancy podcasts for first time moms, Podcasts for expecting mothers, Pregnancy podcast week by week, Pregnancy symptoms, First trimester tips, Prenatal vitamins, Pregnancy diet, safe exercises during pregnancy, ultrasound information, Birth plans, Baby registry essentials, Morning sickness remedies, Prenatal yoga, Gestational diabetes, Baby development stages, Labor signs, Breastfeeding tips, Postpartum care, Childbirth classes, baby names, Pregnancy announcements, Maternity leave rights, Pregnancy health insurance, Safe skincare during pregnancy, OBGYN recommendations, Stretch mark prevention, Pregnancy fitness, Birthing techniques, Pregnancy sleep positions, Baby gear reviews, pregnancy meal plans, Pregnancy-safe beauty products, Baby bump progress, Prenatal classes, Pregnancy relaxation techniques,  Baby-proofing home, Preeclampsia symptoms,Natural birth options,  Pregnancy hydration, Newborn care, Baby feeding schedule, postpartum depression, Baby vaccination schedule, Cord blood banking,  Gestational age calculator, Maternity hospital bag checklist, First-time mom advice

Episode 165: Early-Onset Sepsis Part 2Dr. Lovedip Kooner explains how to use the Kaiser Permanente early-onset sepsis calculator and explains other useful tools to assist in the diagnosis of EOS. Dr. Arreaza adds comments about the usefulness of this calculatorWritten by Lovedip Kooner, MD. Comments and editing by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction: As a recap, Early-onset sepsis is diagnosed within 72 hours (or within 7 days, according to some experts) after birth. We talked about GBS as the main culprit of EOS. 28% of EOS by GBS are babies born 2 hours to maintain oxygen saturations > 90% (outside of the delivery room)After all that information is entered into the Kaiser Permanente calculator, the options for management are clinical monitoring, laboratory evaluation, or antibiotic administration. Example: -Incidence: 0.5/1,000 live births -Gestational age: 36 6/7 weeks-Highest maternal antepartum temperature: 102 F-ROM: 5 hours-Maternal GBS: Positive-Intrapartum antibiotics: Broad spectrum 3 hours prior to birth-RESULT: EOS risk at birth 2.34.Recommendations based on physical exam:1. Well-appearing baby, risk 0.96, RECOMMENDATIONS: No culture, no antibiotics, vitals every 4 hours for 24 hours.2. Equivocal, risk 11.61, RECOMMENDATIONS: Start empiric antibiotics and vitals per NICU.3. Clinical Illness, risk 47.46, RECOMMENDATIONS: Start empiric antibiotics and vitals per NICU.The Kaiser Permanente neonatal early-onset sepsis calculator was analyzed in a meta-analysis, as published in the American Family Physician in 2021. Six high-quality, non-randomized controlled trials were evaluated, including more than 170,000 neonates. The calculator was compared to the standard approach recommended by the CDC guidelines. The analysis showed there was a statistically significant reduction in antibiotic use, a reduction in the number of laboratory tests, and a reduction in NICU admission in neonates who were managed following the sepsis calculator compared with the standard approach. There was no difference in readmission rates to NICU and no difference in culture-positive sepsis between neonates treated using the sepsis calculator and those treated with the standard approach. In summary, I recommend using the Kaiser Permanente calculator as part of your evaluation. BTW, I received no money from KP. It is important to know that depending on resources and institutional policies, your management may change.Use of CBC and CRP.CBC interpretation in neonates: Remember that CBC in newborns needs to be evaluated following the normal parameters for neonates. For example, WBC up to 30,000 per mm3, and hemoglobin up to 19.9 gm/dL can be normal in neonates. Serial white blood cell counts and immature–to–total neutrophil ratio (I/T ratio) generally greater than or equal to 0.2 by some experts is considered positive for sepsis. Complete blood cell counts taken 12-24 hours after birth are associated with increased sensitivity and negative predictive value compared to a sample taken 1-7 hours after birth. C-reactive protein (CRP) is also often used and it rises within 6 hours of infection and peaks at 24 hours. Two normal CRP levels, one taken between 8-24 hours of age and the second 24 hours later, have an over 99% negative predictive value. Single values of CRP or procalcitonin obtained after birth to assess the risk of EOS are neither sensitive nor specific to guide EOS care decisions.Procalcitonin: Procalcitonin may be difficult to interpret within the first 3 days after birth due to elevations caused by noninfectious etiologies and the physiologic rise after birth. It is important to note that neither single values of CRP nor procalcitonin after birth should be used to guide the management plan of infants undergoing evaluation for EOS>.Extreme values in CBC: Extreme values (total WBC count 0.3; ANC

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

In today's episode :we hear the story of a first time mother who has a by the book pregnancy which slides off the tracks in delivery and postpartum. In this first part of our conversation, she shares: * how she and her husband managed the uncertainty that seemed to come without much warning. We'll also hear from a fantastic OB (Dr. Hector Chapa) who gives a wider medical context to this story and helps us understand gestational hypertension that appears after delivery. Catch Dr. Chapa's podcast, Clinical pearls here

Pregnancy can be such a beautiful time. But it can be scary, stressful and is filled with things that are unknown. When complications come up, you always blame yourself. In this weeks episode, Christina does a brief breakdown of some common pregnancy complications and where exercise fits. Some of the complications: Gestational hypertension Pre-eclampsia HELLP Subchorionic hematoma Placenta Previa She talks about her new research studies too that!! This episode is jam packed you don't want to miss it! ___________________________________________________________________________Don't miss out on any of the TEA coming out of the Barbell Mamas by subscribing to our newsletter You can also follow us on Instagram and YouTube for all the up-to-date information you need about pelvic health and female athletes. Interested in our programs? Check us out here!

On this week's episode of our Listener Stories Series, Alisa joins us to share her experience. Alisa is a LCSW who worked as a social worker for the local children's hospital. She shares about her experiences with both her premature daughter and full-term son and how healing is still a journey 8 years later.What you will hear on this episode:- Advanced maternal age - Rheumatoid arthritis in trimester one- Gestational hypertension and preeclampsia- 25-day NICU stay- Subsequent pregnancy with preeclampsia If you have a birth trauma story you would like to share with us, click this link and fill out the form. For more birth trauma content and a community full of love and support, head to my Instagram at @birthtrauma_mama.Learn more about the support and services I offer through The Birth Trauma Mama Therapy & Support Services.

We have an incredibly special episode for you today with the one and only Lily Nichols! She is a registered dietitian nutritionist and the author of two books (soon to be three!)-- Real Food for Pregnancy and Real Food for Gestational Diabetes. Lily is truly a pregnancy nutrition expert providing women with access to the most current evidence-based information regarding food. Lily specializes in helping women with gestational diabetes feel empowered with options to help their blood sugar stay diet-controlled. This important work is helping women with gestational diabetes have healthier pregnancies and more birthing options when so much of the conversation around it becomes limiting and fear-based. Whether you have gestational diabetes in your pregnancy, are pregnant, preparing to be pregnant, or just want more nutrition education, this episode is for you!!Additional LinksLily's WebsiteReal Food for Gestational DiabetesReal Food for PregnancyHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Timestamp Topics09:28 What is gestational diabetes? 11:15 Are there preexisting signs and ways to prevent it?13:59 What can we do? 17:00 How much protein you should get in pregnancy19:11 Best sources of protein22:04 Getting enough protein on a meatless diet26:17 Fats & Gestational Diabetes31:14 Do we have to have a baby at 38 weeks with gestational diabetes?32:28 The problem with the standard gestational diabetes guidelines40:20 PCOS and gestational diabetesMeagan: Hello, hello everybody. This is The VBAC Link and we have a very special episode for you today. This is a topic that if I were to show you in the inbox, you would be like, “Whoa. I didn't realize so many people have this question.” The question is– I mean, there are lots of questions– but the topic is gestational diabetes. So if you have any questions about gestational diabetes, this is your episode for sure. And then actually, right before we started recording, I learned there are even other things that make us at high risk or are a known risk for gestational diabetes. Even if you haven't ever had gestational diabetes, you're going to want to listen because there are things that we can do preventatively before pregnancy or during pregnancy to avoid it. But you guys, we have the one and only Lily Nichols on today with us talking about this extraordinarily common topic. Lily Nichols is a registered dietitian nutritionist and certified in diabetes education. She is a researcher and an author with a passion for evidence-based prenatal nutrition. Drawing from the current scientific literature with the wisdom of traditional cultures,  her work is known for being research-focused, thorough, and sensible. Her best-selling book is Real Food for Gestational Diabetes. I absolutely love that the start of this is “Real Food”. Real food is something that I don't feel like we focus on enough in our every day– not even during pregnancy– lives. We live busy lives, so it's hard to focus on real food. But Real Food for Gestational Diabetes and you guys, she has an online course with the same name so Real Food for Gestational Diabetes Online Course. She is absolutely amazing and has even written two books and now what I learned today is going on the third, so Real Food for Pregnancy and Lily, what is the title of your new book?Lily: The forthcoming book is Real Food for Fertility. Meagan: For fertility. Oh my gosh, you guys. She is evidence-based. It's amazing and you know here how much we respect evidence-based information and getting this to you guys so you can know the true facts and go on and make decisions that are best for you. So Lily, thank you so much for being here with us today and talking about this topic because like I said, it is one of the most common questions we get in our inbox. Lily: Yeah, absolutely. I've spent a lot of work working on gestational diabetes so I'm happy to speak about it with you today. Meagan: Yes. Can you tell us a little bit more about your course? I'm going to start there because you have an online course. I think this is a great thing for anyone who has either had gestational diabetes or has it to really learn more about it. Lily: Yeah, absolutely. The course is really designed for women with gestational diabetes not necessarily healthcare professionals and it kind of expands upon the information that is in the Real Food for Gestational Diabetes book so additional, practical resources that support the same principles that you learned in the course but takes it to another level so there are additional meal plans. There are three weeks worth of meal plans and several different carbohydrate levels so you can customize them. There is more information on lowering your fasting blood sugar naturally with the hopes that we can reduce or minimize your risk for medication or insulin which, depending on where you are and who your provider is can limit your birthing options. Also, I generally disagree with it, that is often a policy. We really often try to use food and lifestyle as much as possible to enhance our ability to keep our blood sugar under control. Probably some of the biggest benefits, though, of the course is that we do have a private Facebook community just for course participants and I do host weekly office hours. People will share what's going on with their blood sugar. “Hey, I'm struggling with this with my fasting blood sugar. I've tried x, y, and z and it still hasn't worked. Do you have any tips for me?” We have a really active community in there. Once you are a member, you are always a member. We have some moms who are on their third pregnancies and still in the course that can offer feedback but I also answer questions every single week. I've been told that arguably the biggest benefit is you can get my eyes on it and get a second opinion. Since I don't have a whole lot of availability for one-on-one clients, it's really the main way you can get my feedback on what's going on. That's helpful, I think because there really isn't a one-size-fits-all intervention for gestational diabetes. Obviously, there are some general truths that work food and lifestyle-wise, but individual tinkering is something where you really need individualized attention versus, “Here is this snack that works for every single woman.” There really is no such thing. I wish there was. It would make my life way easier. It would make everybody's lives easier. It would make the diagnosis less frustrating. But oftentimes, it's like, “Okay. I need to get my blood sugar under control in two weeks otherwise they're going to put me on medication.” People really need that kind of information right away at a really important time point in their pregnancy. Meagan: I love that you say that. We have private groups too and I feel like these groups are just money. Lily: Oh yeah. Meagan: Even just seeing things that other people are asking and you're like, “Oh, actually I have that same question,” then maybe you reply to them and it just filters down. Those groups are so awesome. I love that you have created that and created a space for people because I don't feel like in the medical world– and this is not to shame the medical world– they just don't have time to do exactly what you were saying. “Okay, you've got this diagnosis. Let's break it down for you as an individual.” It's, “Here's a sheet of paper,” that you can pull off of Google. It doesn't mean that it applies to you. You have the diagnosis so it could help you but it doesn't mean that it's going to be the best thing for you as an individual. Lily: And moreso than that, sometimes you don't have a provider that is well-informed on the updated research so I get a lot of women in the course who are like, “Okay, I don't know if I really need this course, but I figured it would be a good idea,” then they jump in and they are like, “I have my meeting with the dietitian this week,” then they come back in the group and they are like, “What the dietitian said that what I'm doing is wrong and that I need to eat this way, so I'm going to try it,” then they come back three days later and they are like, “My blood sugar was terrible. This advice didn't work. I feel awful. I need to go back to the original.” It's just the ongoing thread of community members who have been through the same thing. Ultimately, that's why I do the work that I do and write the books that I do because the standard of care just doesn't often work or it's 20 years outdated. Meagan: Oh, I can so relate to that one when it comes to VBAC. It's the same thing when we've got one provider saying this and then another provider is saying this. It's a very similar situation. You're like, “Well, what is it? What does the evidence really say?” 9:28 What is Gestational Diabetes? Lily: Right. Meagan: Oh, well okay, so I think I would like to just even start off with what is gestational diabetes. What does that mean? If you get this diagnosis, what does that mean? Lily: Yeah. So at its simplest definition, it is blood sugar that is elevated during pregnancy beyond a certain threshold. The whole diabetes during pregnancy, I think, confuses people a little bit because it is like, “How can I develop diabetes during pregnancy but only during pregnancy?” Really, it's that your blood sugar is elevated beyond a certain threshold. There are other definitions like insulin resistance during pregnancy or carbohydrate intolerance during pregnancy. They are all speaking to the same thing. Your body has a more limited ability to bring your blood sugar down within the normal range for whatever reason. There can be a number of different reasons. Sometimes there are pre-existing issues before pregnancy that we didn't know about and during pregnancy, we test for things so there are a whole lot of the population that is walking around essentially with pre-diabetes and has no idea. Then during pregnancy, we screen blood sugar levels to rule out gestational diabetes and then it gets caught on that test. You think that it's something that developed during pregnancy, but it may have been an underlying blood sugar issue that you had for a while. We are simply identifying it at this point. It can be newly developed or it can be pre-existing and we have identified it at this time point. They are technically both called gestational diabetes regardless of the underlying reason. 11:15 Are There Preexisting Signs and Ways to Prevent it? Meagan: Okay. I did not know that. I didn't know that we could be– it doesn't just appear. Sometimes it could be preexisting. Are there preexisting signs where we could know that we did have that or are there things that we could do pre-pregnancy to try? Say I have high sugar or whatever right now, but I didn't know and I get pregnant and I get gestational diabetes, but are there things we can do during pre-pregnancy to– I don't know the exact way to say it– almost nix it? To try and help reduce it or not have it at all? Lily: There are. There's kind of a mix when we talk about risk factors because some of the risk factors are things within our control and some of the risk factors are things that aren't within our control. We can't control whether our mom had gestational diabetes during her pregnancy or whether we have a lot of Type 2 diabetes or insulin resistance in our family. We can't control our age. We can't necessarily immediately change our weight at the time of conception. Over the long term, we can have some influence over our weight, but if we are talking retroactively, we can't go back four months and be like, “Oh, I wish I weighed 20 pounds less before I conceived.” You can control, of course, the food you are eating. You can control the micronutrients that you are taking in. There are a lot of nutrients that can reduce our baseline levels of insulin resistance like magnesium and vitamin D and inositol and several other things. Eating sufficient amounts of protein seems to be protective. Our sleep habits can impact our insulin resistance and our stress levels can play a role. Gosh, there was one more. Meagan: Does high cortisol impact our sugars and their ability to come down? Lily: Mhmm. High cortisol raises your blood sugar. Physical activity levels both before conception and during pregnancy– the more exercise we get generally speaking, the lower our risk of gestational diabetes. There are things and sometimes we have so many risk factors that are outside of our control like family history stuff and age at conception where perhaps we have a preexisting elevated risk which makes all of those lifestyle factors that are in your control arguably that much more important because those are the areas where we can make a difference. 13:59 What Can We Do? Meagan: Make a difference. So what can we do? We can lower our stress. We can increase our sleep. We can be physically active. We can eat real food, but can we talk more about that real food? What can we really eat during that? Lily: Yeah. The biggest thing to keep in mind, I would say, is your macronutrient balance like your balance of carbohydrates, fat, and protein as well as the quality of the food that you are eating. Specifically looking at eating a sufficient amount of protein, protein tends to be the most stabilizing for our blood sugar levels whereas carbohydrates are the macronutrient that raises our blood sugar levels the most. When we eat enough protein, it also has a regulating effect on our appetites since it stabilizes our blood sugar. We don't get a huge spike and crash like we do with carbs. We don't get the cravings and that same intensity of hunger leading up to meal time or snack time. So hitting our protein goals is absolutely essential. Then second to that, the next most important thing is thinking about the quality of the carbohydrates you consume. It's kind of wild but in the US, 60% of calories consumed in the average American diet are from ultra-processed foods. These are things made where the primary ingredient usually is a refined carbohydrate of some kind. It's refined starch or white flour, corn starch, something like that, maltodextrin, or refined sugar like white sugar, corn syrup, high fructose corn syrup, and then all of the random additives and junk added to it. Basically, a lot of things that are in the snack and dessert aisle and prepackaged food aisles in our grocery store, breakfast cereals, and that sort of thing. If we simply displace even a portion, even 25% of this majority of our diet that's coming from ultra-processed foods, we will have better blood sugar levels. Even if they are being replaced by carbohydrate foods but they are not highly, highly processed, you'll have better blood sugar levels especially if we are replacing some of that with protein-rich foods. So I'd say it's two-fold. It's like the macronutrients and then it's the quality of the food reading, trying to eat as many whole foods as possible to displace the processed food items. When you hit your protein food goals, you're not going to have intense cravings for as much of the processed stuff. I like to hit it from the front end instead of being reactive like, “Cut out the processed foods.” That's easier said than done. What are you going to eat instead? Try getting enough protein and you'll find that you are drawn less to those foods in the first place. 17:00 How Much Protein You Should Get in PregnancyMeagan: And with protein, do you know on average– I mean, it's hard because we are all different ages and weights and heights and all of the things. But on average, during pregnancy, how much protein should a pregnant person consume? Lily: Yeah, there are ballpark metrics that we can use and there are some that are more specifically based on an amount of protein based on how much you weigh because protein needs are individualized by a person's body size. If we just use a standard 150-pound woman, in early pregnancy, you need about 80 grams of protein and then in late pregnancy, you need a minimum of about 100 grams per day. Meagan: Okay.This is actually higher than was previously thought. Our first-ever study that directly measured protein needs in pregnancy was done in 2015 and they found that our recommendations are way too low. Meagan: Yeah, 80-100 to me seems really low. I'm not pregnant and typically try to get more protein than that. Lily: Well, 80-100 is a lot more than what the current recommendations are. Meagan: Which is crazy, yeah. Lily: The current recommendations for late pregnancy on average are about 71 grams of protein per day. Meagan: Whoa. Lily: Yeah. Meagan: Wow. So we need to beef it up. We need to get some protein in. Lily: Yep. It depends on the person too. We have some individuals who are highly physically active or maybe if your blood sugar is really, really sensitive to carbohydrates, you might do better having a higher proportion of protein in your diet than another person. So while 80-100 is a good minimum ballpark metric, you might do better aiming for 100 or 110 grams per day in early pregnancy and later on aiming for 120-150 grams. It really depends on the person. Meagan: It all depends, yeah. Lily: Yeah. Meagan: That is pretty crazy. 19:11 Best Sources of ProteinMeagan: Okay, now we know we've got to get our protein. What are the best sources of protein? That is something that I do find that sometimes is hard. It's really hard to get whole protein and sometimes I do have to supplement with a shake or add some protein collagen to my oatmeal or something. So what types of proteins or what sources of proteins or what ideas could we give to our listeners?Lily: Yeah. When you think of protein, there are a lot of different foods that contain protein, but they have proteins in different concentrations or there's a different balance of amino acids within those proteins. Our highest quality, the best balance of amino acids, and the highest concentration of protein per the amount of food you are eating is from our animal foods. So meat, fish, eggs, dairy, seafood– those have your highest concentrations of protein relative to any of the other macronutrients. As you go into your plant source proteins, you'll have a lower proportion of protein and just a different or more incomplete amino acid balance. You'll get a lot more carbohydrates along with that protein, but they, of course, have other positive things in them. Plant proteins come with fiber, for example. Our beans and legumes of plant proteins would be the highest quality ones that you can get. We have significantly smaller proportions of protein in our grains, for example. Nuts and seeds are a decent source. You can also get, of course, all sorts of protein supplements. They can extract protein from anything that is protein-rich and market it as a supplement. We have our grass-fed whey protein and our beef protein isolate and we have rice protein concentrate and all sorts of things. You have your pick. If you are not getting enough from food, you can always supplement with additional on the side, but my recommendation really is to try to get a balance of different protein sources since there are pros and cons of all of our different proteins. Just try to get a mix. That amount and forms might be different from person to person based on their preferences. 22:04 Getting Enough Protein on a Meatless DietMeagan: Yeah. That makes total sense. Kind of talking about how some things have less, for any listeners that maybe are not eating meat or don't eat meat, how? I mean, just eating a lot of legumes and beans and nuts and stuff like that? Or how? I don't know. Is there a higher risk there if we don't eat meat? Does that make sense? Is it harder to get it in and how can they focus more on getting that? Lily: It is. It is a bigger challenge. Vegeterians and vegans do consume on average significantly less protein than omnivores. You can kind of plan around it by having a higher proportion of beans and legumes versus grains and considering some specific high protein options like tempe, and fermented soy products. I'm not a huge fan of a lot of soy, but fermented soy as long as it is organic can be okay and tempe is quite high in protein and relatively low in carbohydrates. Your nuts and seeds can contribute more and you can consider supplemental protein options. It does definitely get tricky particularly as we talk about gestational diabetes with blood sugar management on a vegetarian and vegan diet simply because most of our plant sources of protein if you are consuming them as a whole food, they have a significant amount of carbohydrates. So sure, you can get protein from beans, but beans also have carbohydrates. Meagan: I'm sure. Lily: There's some protein in quinoa, but it's 8 grams of protein per 40-something grams of carbohydrates in that serving whereas if you were going to consume 8 grams of protein from meat, that's literally a little more than 1 ounce of meat and it has 0 carbohydrates. When you are looking at macronutrient balance, it gets a little bit trickier. So for vegetarians and vegans– I mean, with vegetarians, you have eggs and dairy so you can do more eggs. You can do more low-carbohydrate dairy products like cheeses, cottage cheese, greek yogurt, dairy protein powders, and egg protein powders and that makes the macronutrient balance much easier. With vegans, we generally do need to rely on some supplemental protein powders just so we are not overdoing the carbohydrates. It does get significantly trickier. It's not that it's not doable, but there are of course, always different trade-offs with different dietary approaches. Meagan: For sure. 26:17 Fats & Gestational DiabetesMeagan: So we've talked a little bit about the carbs and the proteins and the fats. A lot of, say salmon or even eggs. We've got egg whites but then we've got yolks which consume a lot of fat. How does fat play into or does it play into gestational diabetes?Lily: Similar to protein, fat does not raise your blood sugar levels so generally speaking, fat is not something you need to be overly worried about necessarily. That definitely flies in the face of conventional guidelines that tell you to limit your fat production significantly. We have to be really cautious when we talk about limiting fat in pregnancy. First of all, we are in a situation where your hormone production is higher than ever. Our sex hormones like estrogen and progesterone are built on a backbone of cholesterol which you get in fatty foods, specifically your fatty animal foods. Whatever you don't consume, your body produces. So if we are cutting out all of the fat out of everything, you actually run into problems with hormone production. They have shown this in studies where they limit fat in women. Estrogen and progesterone production can be 20-50% lower. Even though your body has the ability to create cholesterol from other precursors, it still negatively impacts hormone production to not be consuming it. I do get concerned about that. I do also get concerned that when you start limiting fat from food, you're also limiting your intake of a lot of micronutrients. Egg yolks– you gave the example of egg yolks. Egg yolks are high in cholesterol, yes. They are also the richest dietary source of choline which is a nutrient we need for optimal placental function and optimal fetal brain development, and when we are not getting enough, it's linked to many significant problems. I mean, we now have very high-quality studies like randomized controlled trials showing that taking in actually more than double– the current recommended intake for choline improves child brain development through their toddler years all the way– the study has now been extended through age 7. They have followed these kids through age 7 and they have better brain function essentially at those later ages. If you are cutting out egg yolks for the goal of reducing your fat or cholesterol intake, you are essentially setting yourself up for a choline deficiency. Half of the choline an average American takes in is from eggs. It is such a concentrated source. You can extend that to many other examples for many other nutrients in foods that naturally contain fat. It's a significant concern of mine actually. People get so laser-focused on fat that they lose the big picture on what are you missing out on. Meagan: What it's actually giving you. Lily: Yes, exactly. I'm not a big fan of limiting the fat intake. Particularly, when you are talking about blood sugar control, if you are reducing your carbohydrate levels, then you are reducing the calories taken in from carbs. You have to eat something else, right? We can only eat so much protein so it always ends up being a dance between– are you eating more carbohydrates or are you eating more fat? That's always how the balance is made up in terms of our macronutrient ratios. Certainly, I love the protein. I'm all about eating protein, but our protein-rich foods do naturally come with fat, so what I am personally not a fan of is people obsessively taking out the fat of all of their protein-rich foods. Just eat the fat that is in there. You don't need to add massive quantities of fat to everything you are eating, just don't take out what is naturally there. Meagan: Yeah. Yeah. I love that you talk about that because one of the things– so I'm a doula and I've seen this in all the years of being a doula, but then I've also seen this trend of messages coming in like, “I'm scared to eat too much. I'm scared to eat fat. I'm scared to eat these things because I'm scared of a ‘big baby'” or “I'm scared of having to have a C-section because my baby is measuring big,” or they are so scared of shoulder dystocia so they are now having to induce me at 38 weeks which we already know with gestational diabetes, a lot of the times, providers encourage induction early anyway. Ladies, do not cut out your fats. Eat your good proteins. Get the right kind of carbs. 31:14 Do we have to have a baby at 38 weeks with Gestational Diabetes?Meagan: What does it look like with gestational diabetes? Do we have to have a baby at 38 weeks like many providers suggest? Do we always have a big baby if we have gestational diabetes? Lily: Absolutely not. Meagan: Right? Lily: Absolutely not. Meagan: Can we talk about that and cross out those myths? Lily: Yep. We have very strong data actually that when we are able to keep blood sugar within range as much as possible– it's not going to be perfect, but as much as possible, keeping your blood sugar within a healthy level and your provider should give you some healthy guidelines. If you don't, go read “Real Food for Gestational Diabetes”. Meagan: Seriously. Go get your book and the link is in the show notes, everybody. Lily: Yeah. We see a 50% lower risk of macrosomia. That's the baby being born larger than expected. Meagan: Too large, yeah. Lily: We see a 60% lower risk of shoulder dystocia. Meagan: Wow. 32:28 The Problem with the Standard Gestational Diabetes GuidelinesLily: These risks absolutely can be lessened with dietary and lifestyle intervention. What frustrates me the most and it's why I wrote “Real Food for Gestational Diabetes” in the first place, is that the standard guidelines for dietary management of gestational diabetes fail to improve outcomes because they often fail to control blood sugar levels because they are arbitrarily way too high in carbohydrates. So what ends up happening is you get these women who get a meal plan that says, “Eat 45-60 grams of carbohydrates at a meal, a super minimal amount of protein, barely any fat” because this is all just an off-shoot of the standard dietary guidelines, and their blood sugar goes way too high after their meals. They are like, “What is going on? I'm eating per the guideline.” Meagan: I'm following. Lily: Yeah, exactly. Unfortunately, they are simply consuming way too many carbohydrates for what their body can tolerate. I mean, it makes no sense. If you failed a glucose tolerance test meaning your blood sugar was not able to come down within range when you had anywhere from 50, 75-100 grams of glucose in one sitting? Why are we then giving you 45, 60, 75 grams of carbohydrates which turn into glucose in a sitting at a meal, and saying that this is treatment? It is not treatment and anybody with a toddler-level logic can see that it makes no sense whatsoever. Meagan: No sense. Lily: Ironically, it's very controversial advice to recommend a lower than that carbohydrate intake and that's precisely what I present in my book with the evidence to back it up, but that still remains the standard of care. So then what ends up happening, you get these women who end up afraid to eat because they are worried about their blood sugar going too high. Meagan: Exactly, yes. Lily: So they eat the same type of meal but a really, really, really tiny portion and they are starving. Meagan: Yes. And they are malnourished. Lily: Exactly. They are malnourished. Meagan: They are not getting the macro or micronutrients in their bodies. Lily: It is tragic and it is unethical in my opinion, so if you do find yourself in that scenario where you feel like you are having to starve yourself to keep your blood sugar within range, after you check your blood sugar after that meal, you are clamoring for a snack because you are so hungry, there is another way. Meagan: Yes. Lily: It does involve nourishing yourself enough. You have to get enough calories in. Meagan: Yes. Lily: You can get enough calories and micronutrients in without the blood sugar spike just with a different macronutrient balance. You need to be eating a lot more protein. You need to ditch the fear of fat. You need to eat a quantity of carbohydrates that your body can manage in one sitting. Oftentimes, that isn't 45-60 grams or 75 grams of carbohydrates per meal. That might be 10 or 15 or 20 or 30 grams of carbs in a meal. Meagan: Right. Lily: It might mean eating your protein-rich foods first before you have your carbs at the end of the meal. That can significantly change how your blood sugar responds. Meagan: Okay. Lily: But the standard approach is very ineffective and I can tell you when they have actually done studies where they switch people to a lower glycemic index diet, so better quality carbohydrates, more protein, and the chances that a woman will require insulin to manage her blood sugar drops by 50%. Meagan: Whoa. Lily: That can make the difference between your birth being sabotaged, overly intervened, you being denied a VBAC, them trying to scare you into the “your baby is too big” and that whole conversation. That can make a difference of it. So we really need to get better information out because it's not fair. Gestational diabetes is poorly managed and it's overly medicalized when it is diagnosed. Meagan: I feel the same. I feel it is. Some people have described it as, “Oh, it checked off a box saying you are in this category automatically because you tested positive.” Then they do. They go down rabbit holes. Women of Strength, if you are listening and you are someone who feels that they can't eat a lot or you are in that space and you are the person that we are describing, you are not alone. You are not alone in this world. But, you have more options. That is why I wanted to do this episode because it makes me want to cry because I hate and I feel their frustration. It also makes me want to punch someone, not our listener, but it makes me just want to punch somebody and be like, wake up. give different information and stop putting this pressure of, “You can't have a VBAC. you're going to have shoulder dystocia. You have to have a baby by 38 or 39 weeks.” All of these things or “Your baby is too big.” It's just, why? Instead of just diving in learning how to better manage and to eat better. Eat more real foods. Lily: I mean, if your blood sugar is maintained in a healthy range for the majority of your pregnancy, you are not at any higher risk than anybody who didn't get a diagnosis. All of these things are potential risk factors, I mean, in the macrosomia conversation, you can have women who passed a gestational diabetes test, but maybe they gained quite a bit more weight than is expected over the course of their pregnancy. They are actually oftentimes at a higher risk for macrosomia than the woman who was diagnosed with gestational diabetes and had excellent blood sugar control. Nobody talks about that, right? To me, the difference is really in how you manage it. I think we have to try to lose the fear over the diagnosis. It is an unfortunate reality that for a lot of providers, you can be treated differently because of the diagnosis even though I disagree with that, but you can maintain actually quite a low-risk pregnancy, sometimes an even lower risk than if you hadn't been diagnosed because if you see this as a blessing in disguise and take it upon yourself to improve your diet and lifestyle and really buckle down on this and get your blood sugar in a healthy range, you now are having a healthier pregnancy than if you didn't have the diagnosis because you are taking a moment to be like, “Hmm, yes I'm pregnant and I'd like to eat for two, but you know what? I'm actually full. I don't think I'm going to have that extra cupcake.” It's all of those consistent blood sugar elevations without a gestational diabetes diagnosis that is contributing to the baby growing larger than expected. When you bring the blood sugar within range, we see a significantly reduced risk of macrosomia. Meagan: Yeah. This episode, I feel like, has so many really great tips on just how to eat better in general during pregnancy even if you don't have gestational diabetes. Lily: Yes. Absolutely. 40:20 PCOS and Gestational DiabetesMeagan: Before we were recording, we were talking about your new book. You said something that caught my ear and I was like, “Wait, what?” because PCOS which is polycystic ovarian syndrome– is that correct? Lily: Mhmm, correct. Meagan: It runs in my family. You were talking about how PCOS could be a sign. Lily: It's a risk factor for gestational diabetes, yeah. Absolutely. Meagan: Yeah, so can we talk a little bit more about some of those risk factors and how if we maybe have these things we may need to be extra aware and intentional? Lily: Intentional, yep. That's a good word for it. With that, PCOS is a bit of a complicated diagnosis. There are different subtypes. There are actually four phenotypes and they are all just a little bit different. They share some overlap, but they are all a little bit different. That said, the majority of PCOS cases do have some degree of insulin resistance going on in their body. Your body doesn't respond normally to insulin and brings your blood sugar down within range with a normal level of insulin. Your body has to release a lot of insulin to bring your blood sugar within range. Meagan: Wow. Lily: This is a risk factor for gestational diabetes because, during pregnancy, your body naturally becomes a little more insulin resistant. So if you are already coming into pregnancy with that baseline challenge with your body responding to insulin, when your body starts pumping out more insulin, your insulin resistance is going up and up and up, it can just compound and be too much for your body to handle. Your blood sugar will surpass that threshold of so-called gestational diabetes. That is a significant risk factor. It also tends to be– PCOS is the most common ovulatory issue in women, so it can make conception a little more challenging. It can make timing sex accurately for conception more challenging because oftentimes, there are really long cycles or delays in ovulation so it's harder to time it right although women with PCOS can conceive successfully naturally. It can just be a little more tricky. And then when there already is a blood sugar issue going on ahead of time, there is a higher rate of early miscarriage as well. Now, things that you do for managing PCOS, there is a lot of overlap with the same concepts for managing gestational diabetes. If you do have that diagnosis and you are thinking about becoming pregnant, you can implement some of the same tips that we talked about today or blood sugar management. Higher protein, fewer carbohydrates, better quality carbohydrates, eating your protein-rich foods first at mealtimes, and considering supplementing with certain nutrients to reduce your level of insulin resistance. There is some really excellent data on inositol which is a B vitamin compound for reducing insulin resistance and improving ovulation and ovulatory function in these women and that is a supplement that honestly, they've done studies where they have put it head to head with metformin which is the most common medication prescribed for women with PCOS. It is also prescribed for gestational diabetes management and it often performs the same or better than metformin so inositol is a really viable option that women can look into and consider supplementing with. We talk about it pretty extensively in Real Food for Fertility as an option along with many other nutrients. There are a lot of other micronutrients that play a role in keeping our level of insulin resistance down as much as possible. So just improving overall the quality of your diet where naturally, you are just displacing more and more of these processed foods from your life because these also are so rich in micronutrients, you're naturally improving the function of your pancreas and how responsive your body is to insulin and your blood sugar doesn't spike as much because you aren't getting as much refined carbohydrates in. There's a lot of these things that all work in tandem and they work together. They continue to be important during pregnancy as well, so wherever you are, start now. Start thinking about this now. Meagan: Start now. Yes. Start now. It's never too late to start. Like I was saying in the beginning, we live a busy life so that quick granola protein bar that is easily unpackaged in the car that you can take a bite of might be an okay snack but might not be the best. Maybe carrots. Maybe you can have carrots. Lily: Or maybe having a bag of nuts or some beef jerky. The nuts would be similar to a granola bar, but they are much lower in carbohydrates. They have more protein, fat, and fiber in them so they won't spike your blood sugar, but they may fill you up better than a granola bar and with a significantly lower blood sugar spike for sure. Meagan: And I guess carrots are a lot of carbs so it turns into sugar. Lily: I mean, carrots do have carbohydrates, but they have quite a bit of fiber in them, so they are a fine option as well. They are just pretty low in protein and have no fat and they are so low in calories that solely as a snack–Meagan: It's not going to help you feel full. Lily: Yeah. It's not going to keep you full. I've got nothing against carrots. Carrots are excellent, but maybe having them with a cottage cheese dip or something like that would at least provide you with a little more sustenance. Meagan: Yes. Going back to the protein. See? We forget about the protein. Lily: Yep. Meagan: Focusing on the protein. Wow, I just adore you. I think this is such a great episode. I need to just go get your books now. I mean, I'm not even pregnant. I'm done with having babies, but I want to dive in more. I want to learn more because like I said, it's such a hot topic for our VBAC community especially because we have so many naysayers like, “Oh, you can't do this if you have this.” So okay, tell us more. You've got your website, lilynicholdsrdn.com and I know you've got the blog, your shop, your books, and all of the things. Tell us more about where we can find you and what resources we can use. We're going to make sure to put everything in the show notes, you guys. Lily: Yeah, so up on my website, definitely click the Freebies tab. You can download a free chapter of Real Food for Pregnancy if you want to dive more into what is real food. What are you talking about? That is available for free. There is a free video series on gestational diabetes that is really helpful to help you if you have just been diagnosed or are worried about being diagnosed. That will narrow down the starting point. The biggest thing I hear is that people are really afraid and overwhelmed by what to do. It just feels very dire. You are given the diagnosis. You are told that it comes with these risks and you are not told any good news, so I try to be the bearer of good news and empowering information so you can actually take action on that. Meagan: I love that. Lily: Probably those two resources would be of most interest to this audience. I'm also on Instagram. My handle is @lilynicholsrdn so pretty much the same as my website. And yeah, keep an eye out for the new book, Real Food for Fertility in February 2024. Meagan: It's coming out this month. This episode is being aired in 2024. That is so exciting. That one is on infertility, correct? On fertility. Lily: Yeah. It's on fertility. That one I actually coauthored this book with my colleague Lisa Hendrickson Jack. She is the host of The Fertility Friday Podcast and author of The Fifth Vital Sign. We joined forces to talk about the food and nutrition part, the fertility hormone/menstrual cycle part and it really is the best of both worlds from our respective specialties. Meagan: I love that so much. Well, we will have the links for both of your books and then like she said, give her a follow so you can know when this new book is coming out. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Today on The Natural Birth Podcast we have Sophie. Sophie is a mama of one from the UK, now living in Costa Rica.   In this episode we will hear her story of trusting the maternity care she was given as most first time mamas do and how it only created anxiety and stress, ultimately derailing her home birth to a hospital birth.   This episode will highlight the risks with ultrasounds and inform you to be aware of these as you accept the routine ones as well as the extras. They are not diagnostic!   But despite all of this Sophie had an empowering, positive and natural hospital birth with her baby girl and learned so much during this pregnancy.   She became a hypnobirthing teacher and is now furthering her education by becoming one of my mentees in the sacred birth worker mentorship program starting on the 15th of January.   I love how having a positive natural birth is what ignites a passion for birth work in so many mamas, and we need more passionate women like Sophie waking up to the reality of woman's power and births beautiful magical design.   It's been a magical year the last year for me as I stepped fully into the role of mentor for aspiring sacred birth workers and I feel like I've found my true calling.   I love being on the leading edge of the new birthing paradigm and so excited to have a newly baked cohort out in the world offering their services and another one soon to begin their journey.   I've poured my heart and soul and all my midwifery knowledge and embodied wisdom into this mentorship and I love all the passionate birth nerds that have joined in so far.   If you know in your heart that sacred birth work is your heart's calling then there is still room in the cohort starting in 2 weeks.   Reach out to me ASAP before the doors close. Find the link in the show notes. Curious about Sophie? Find her on Instagram @yogaandhypnobirthingwithsophie Find All of Anna's Links & Resources here: https://www.thenaturalbirthcourse.com/links-podcast --- Send in a voice message: https://podcasters.spotify.com/pod/show/thenaturalbirthpodcast/message

Gestational surrogates provide a valuable service for many couples who want children, but the process has drawn significant criticism. Cato's Vanessa Brown Calder dispels the misconceptions. Hosted on Acast. See acast.com/privacy for more information.

The world's n word, an explosion, the horrors of birth, DSP wins, Roblox's condos, YouTube plagiarism, and Maddox strikes back.

Gestational diabetes is a complication of pregnancy in which individuals with no history of diabetes have persistently elevated glucose levels.  In this episode you'll learn:  Normal physiology of glucose maintenance during pregnancy Who is most at risk for gestational diabetes Complications of gestational diabetes (both maternal and newborn) Signs and symptoms of gestational diabetes Key assessments for a patient with gestational diabetes Screening and ongoing tests, including the glucose tolerance test Treatments for gestational diabetes Important things to teach your patient __________ Full Transcript - Read the article and view references. FREE CLASS - If all you've heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES...you can thrive in nursing school without it taking over your life! Study Sesh - Change the way you study with this private podcast that includes dynamic audio formats that help you review and test your recall of important nursing concepts on-the-go. Free yourself from your desk with Study Sesh! LATTE Method Template - Download the free LATTE Method Template so you can streamline how you study and focus on what a nurse needs to know.