Podcasts about Gestational diabetes

In this episode of The Birth Lounge podcast, host HeHe discusses one of the most requested topics, Gestational Diabetes Mellitus (GDM), with midwife Melissa Chappell. Melissa, who owns Utah Birth Suites and founded Songbird Maternity, offers a holistic view on women's health and is a staunch advocate for informed consent and patient autonomy. The conversation dives deep into what GDM is, how it occurs, the importance of testing, and why the typical 50-gram glucose challenge may not always reflect reality. The duo also covers alternative testing methods, including continuous glucose monitoring, diet and exercise's role, and the impact of GDM on the baby. Melissa sheds light on the myths and truths about GDM, the implications of controlled versus uncontrolled GDM, and the risks associated with traditional medical practices, such as induction. Listeners will walk away feeling informed and empowered to engage in confident discussions with their healthcare providers. Tune in to get evidence-based insights, especially focusing on holistic and patient-centered care approaches for managing gestational diabetes.   00:00 Introduction to Gestational Diabetes 01:27 Meet Our Expert Guest: Melissa Chappell 02:33 Understanding Gestational Diabetes Mellitus (GDM) 03:03 Testing and Alternatives for Gestational Diabetes 03:53 Impact of Gestational Diabetes on Mother and Baby 10:16 Historical Perspective and Current Statistics 12:42 Challenges with Current Testing Methods 16:26 Managing Gestational Diabetes: Diet and Monitoring 24:07 Risks and Misconceptions about Big Babies 31:37 Pitocin Use and Its Implications 39:13 Increased Medical Interventions in Pregnancy 40:17 The Impact of Glucose Restriction on Babies 42:31 Research Findings on Blood Glucose Thresholds 44:24 Managing Gestational Diabetes with Diet and Exercise 48:50 Alternative Testing Methods for Gestational Diabetes 01:00:06 Understanding HbA1c and Its Limitations 01:08:04 Postpartum Care for Babies of Gestational Diabetic Mothers 01:12:42 Connecting with Melissa and Doula Training Opportunities 01:14:40 Conclusion and Final Thoughts   Guest Bio: Melissa Chappell, LDEM, CPM is a midwife and owner of two birth centers in Utah, and as well is a doula trainer of over 22 years. She is passionate about women's health from a holistic and nourishing perspective, and advocates for women's wellness in all areas of their lives. She has worked with midwives and birthing women all over the world, including in Haiti, Ethiopia, and Kenya, and loves seeing how women's lives improve with access to safe and effective midwifery care. She is the mother of 4 children and 4 grandchildren that she adores. In between catching babies, Melissa loves to explore as much of the world as she can – from international travel to exploring the mountains in her backyard. INSTAGRAM: Connect with HeHe on IG  Connect with Melissa on IG    BIRTH EDUCATION: Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience!   Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone!   LINKS MENTIONED: Lily Nichols: Real Food in Pregnancy    Use code HeHe to sign up for doula education and 25% off the Birth Education Library with Melissa at https://www.melissachappell.com/   RESEARCH: https://www.cochranelibrary.com/web/cochrane/content?templateType=full&urlTitle=/cdsr/doi/10.1002/14651858.CD012394.pub3&doi=10.1002/14651858.CD012394.pub3&type=cdsr&contentLanguage=   https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05779-z   Gestational diabetes and the risk of late stillbirth: a case-control study from England, UK - PubMed   https://www.cochranelibrary.com/web/cochrane/content?templateType=full&urlTitle=/cdsr/doi/10.1002/14651858.CD011624.pub3&doi=10.1002/14651858.CD011624.pub3&type=cdsr&contentLanguage=   Big Babies: the risk of care provider fear | Dr Rachel Reed  

Being told you have developed diabetes in pregnancy can be a scary thing, and often means a whole host of medical intervention pushed on to you to prevent "risks", but are they always necessary and how big ARE the risks? I chat to Shellie about the differences between type 1, 2 and gestational diabetes, the interventions that may be recommended, and whether the research backs up early induction of babies. Shellie has been a birth advocate and doula for 20 years and as a full spectrum doula supports people throughout pregnancy, with antenatal education, birth and postnatal support. She qualified in Osteopathic and Naturopathic Medicine in 2005 and has been teaching ever since. She hosts Birthing Biomechanics courses around the country, as well as providing online learning material for parents and birth workers. You can find shellie @theserenitydoula on instagram or her website www.theserenitydoula.co.uk where she uses humour and referenced information to highlight birthrights and important information for pregnancy, birth and beyond. To access Shellie's gestational diabetes lecture to go: https://chipper-teacher-4208.kit.com/products/june-bitesize-gestational-diabetes?promo=SERENITY50 or https://chipper-teacher-4208.kit.com/products/june-bitesize-gestational-diabetes and use the discount code serenity50 for 50% off the usual price, taking it from £30 to £15. It includes a 2 hour lecture and a PDF with lots of helpful information about Gestational Diabetes including supplement, dietary and lifestyle advice and links to further resources. Studies referenced in this episode: AJOG - 2004 - Takoudes et al - Risk of cesarean wound complications in diabetic gestationsAJOG - 2022 Reicher et al - Diabetes Mellitus in pregnancy - a risk factor for perineal injuries, independent of foetal macrosomiaMidwifery Vol 69 2019 - Strandhold et al - Diabetes Mellitus and lower genital tract tears after vaginal birth: A cohort studyBJOG - Stacey et al 2019 - Gestational Diabetes and the risk of late stillbirth: Case control study uk Ye at al - Gestational Diabetes Mellitus and adverse pregnancy outcomes: systematic review and meta-analysisKawakita et al, AM j Perinatol 2017 - neonatal respiratory morbiditiesDr Rachel Reed  - Reference figures for the changing diagnostic range thresholdsBMJ - Benefits and harms associated with an incerase in gestational diabetes diagnosis in Queensland Australia - a retrospective cohort comparison of diagnosis rates, outcomes, interventions and medication use for two periods 2011-2013 and 2016-1028 using a large perinatal databaseCochrane Review into tighter BGL controlBMC 2023 - Luo et al Comparison adverse maternal and perinatal outcomes between induction and expectant management among wimen with gestational diabetes mellitus at term pregnancy: systematic review and meta-analysisNice guidance - not evidence based for recommendation for induction no later than 40+6Disclaimer: The information and provided on this podcast does not, and is not intended to, constitute medical or legal advice; instead, all information available on this site are for general informational purposes only. We reserve the right to supplement, change or delete any information at any time. The information and materials on the podcast is provided "as is"; no representations are made that the content is error-free. Whilst we have tried to ensure the accuracy and completeness of the information we do not warrant or guarantee the accurateness. All liability with respect to actions taken or not taken based on the content of the podcast are hereby expressly disclaimed. Your use of content contained in or linked to this podcast is entirely at your own risk. The Better Birth podcast accepts no liability for any loss or damage howsoever arising out of the use or reliance on the content.

This week we have gestational diabetes on the radar and some things that can be done to prevent it. I also give mindset tips that I used to help me deal with worry and anxiety.  All About Gestational Diabetes Gestational Diabetes with Jaqueline and Realizing its not your fault and controlling it with medication Gestational Diabetes with Twins with Katelyn Gestational Diabetes and controlling it with diet and exercise with Tiera References: Bridget Tyler Pregnancy Week Guide Mama Natural Pregnancy Week by Week Guide **Morning Sickness Mini Course for Mental Health (Formerly the Positive Pregnancy Program)**: This self-led video program, made to help foster positivity durning pregnancy. It is for women who have or do struggle with pregnancy and who want to have strong mental health during and specifically the first trimester of pregnancy during the nausea! This Mini Course will help you mentally navigate the hardships of the physical changes of pregnancy, especially that morning sickness phase. Direct link to Morning Sickness Mini Course for Mental Health Positivity in Pregnancy and Motherhood website: Positiveinpregnancy.com Other Episodes you might like: Anxiety? Stressed in pregnancy? Podcast episode Strategies to Calm Fears and Worries in Pregnancy Success in Second Trimester INTIMACY Pregnancy Affirmation Episodes:  Pregnancy Affirmations and Their Importance During Pregnancy Love Focused Free Affirmations on Pregnancy Pregnancy Affirmations For When It Feels Heavy Episodes on Dealing with Nausea in the first trimester: Puking and Feeling Like I Can't Coping with Nausea in Pregnancy Intimacy in the First Trimester Episode Library of Pregnancy Podcasts that go through pregnancy: (you will have to scroll down, just a little :) ) https://positiveinpregnancy.com/pregnancyishard YouTube for Positivity in Pregnancy: https://www.youtube.com/@PregnancyisHardwithJosly-nd8wd Here is the Facebook Page for Pregnancy is hard: I have documented my journey of my fourth baby on this page and have other juicy and good tips for enjoying pregnancy better. https://www.facebook.com/pregnancyishard Here is the Pregnancy is Hard Support Group on Facebook: Let's offer support, help and fun for those in the trenches of pregnancy! https://www.facebook.com/groups/165102315544693 Instagram: @positivityinpregnancy Email me at: positivityinpregnancy@gmail.com    

Send us a message with this link, we would love to hear from you. Standard message rates may apply.Insulin resistance often precedes diabetes by 5-10 years and serves as an early warning sign of potential damage to your cardiovascular system and other organs. We explore this common condition, its risk factors, and how simple lifestyle changes can reverse it before more serious health problems develop.• Insulin resistance occurs when muscles, liver, and fat cells fail to respond to normal levels of insulin• The pancreas compensates by producing more insulin, eventually leading to beta cell failure• Clinical signs include dark skin patches in body folds (acanthosis nigricans), elevated triglycerides, and increased waist circumference• One in three Americans have prediabetes, with many also experiencing insulin resistance• Risk factors include central obesity, sedentary lifestyle, family history, PCOS, and certain racial/ethnic backgrounds• Sleep disturbances, chronic stress, and fatty liver disease are emerging factors linked to insulin resistance• A 5-7% weight reduction improves insulin sensitivity by over 50%• Regular physical activity (150+ minutes weekly) helps glucose enter cells more efficiently• Diet modifications focusing on whole foods, limiting refined sugars, and following Mediterranean or DASH patterns show significant benefits• "The movement is the medicine, the food is the medicine" when addressing insulin resistanceSupport the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski

In this beautiful episode we get the opportunity to listen to Freyja's 2 incredible birth stories! Listen in to hear a beautiful recount and reflection around the births of her two gorgeous, big baby boys!Her first birth was a difficult one, occurring amongst floods and during COVID and involving an induction due to insulin dependent gestational diabetes and suspected big baby. Ultimately Freyjas' first birth resulted in a caesarean due to 'failure to progress' at 7cm dilation. Freyja recounts her feelings surrounding her birth and all of the hardship in her community at the time of her birth due to surrounding flooding, as well as birthing in the time of COVID. She talked through the journey through processing her first birth experience and how she navigated working towards her next birth, a planned VBAC! Freyja's next birth story is one of triumph, joy and empowerment, involving lots of self-advocacy, flexing her autonomy and pushing forward even when her birth team shifted and changed. Freyja vulnerably shares how she navigated discussions with doctors, balanced the risks of a VBAC with another suspected big baby and also advocated for herself both leading up to and during labour. She talks about the challenges and mindset shifts that led to her VBAC and discusses the importance of educating herself, building strong support systems, advocating for her birth choices and listening to other women' stories as a form of education and inspiration. This episode is full of reflection and information, and Freyja's story is an inspiring reminder that every birth journey is unique and that, with the right support and mindset, women can reclaim control and autonomy over their birthing choices. We hope you love listening as much as we loved interviewing Freyja!Please join us on our journey to bringing you all kinds of VBAC stories from across the country from here on in by subscribing and following us on social media, @australianvbacstories on Instagram and Australian VBAC Stories on Facebook. If you enjoyed this episode, we'd love to rate or review, and tell your friends!If you are feeling that you might benefit from mental health support after listening to our podcast, please reach out to one of the organisations below:PANDA ⁠⁠https://panda.org.au/⁠⁠Gidget Foundation ⁠⁠https://www.gidgetfoundation.org.au/⁠⁠COPE Australia ⁠⁠https://www.cope.org.au/⁠⁠If you've experienced mistreatment or disrespectful care in your pregnancy, birth or postpartum and are seeking advocacy support, please contact one of the following organisations:Maternity Choices Australia ⁠⁠https://www.maternitychoices.org/⁠⁠Maternity Consumer Network ⁠⁠https://www.maternityconsumernetwork.org.au/⁠⁠Thank you for tuning in to our podcast.

Episode 193: Gestational Diabetes IntroJesica Mendoza (OMSIII) describes the pathophysiology of gestational diabetes and the right timing and method of screening for it. Dr. Arreaza adds insight into the need for culturally-appropriate foods, such as vegetables in Mexican cuisine.    Written by Jesica Mendoza, OMSIII, Western University of Health Sciences, College of Osteopathic Medicine of the Pacific. 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.DefinitionGestational diabetes mellitus (GDM) is a condition that occurs to previously non-diabetic pregnant women, caused by glucose intolerance at around the 24th week of gestation. PathophysiologyGDM arises due to an underlying pancreatic beta cell dysfunction in the mother which leads to a decrease in the amount of insulin produced and thus leads to higher blood sugar levels during pregnancy. The placenta of the fetus will produce hPL (human placental lactogen) to ensure a steady supply of sugars to the fetus, creating an anti-insulin effect. However, hPL readily crosses the placental barrier causing the mothers insulin requirement to increase, when the mother's pancreas cannot increase production of insulin to that level needed to counter the effect of hPL they become diabetic, and this leads to gestational diabetes. So, basically the placenta is asking for more glucose for the baby and the mother's pancreas struggles to keep the glucose level within normal limits in the body of the mother. If left untreated, high levels of glucose in the mother can cause glucotoxicity in the mother.“Glucotoxicity” refers to the toxic effect of glucose. Glucose is the main fuel for cell functions, but when it is high in the bloodstream, it causes toxicity to organs. Prevalence of GDM.The CDC reports mean prevenance of GDM is 6.9%. In U.S. mothers the prevenance increased from 6.0% in 2016 to 8.3% in 2021. Many different factors have played a role in increasing gestational diabetes in American mothers, some of those being the ongoing obesity epidemic with excess body weight being a known risk factor for insulin resistance. Another being advanced maternal age (AMA) as more American women have children later in life their body becomes less sensitive to insulin and requires a higher insulin output on top of the insulin that is required for the fetus. The “American diet” is also something that has a big effect in diabetes development. With the increase of high-carb foods that are readily available, the diet of Americans has declined and is affecting the metabolic health of mothers as they carry and deliver their children. Despite ongoing awareness of GDM, 6% to 9% of pregnant women in the United States are diagnosed with gestational diabetes, and the prevalence continues to increase worldwide. It is estimated that in 2017 18.4 million pregnancies were affected by GDM in the world, which then continued to increase to 1 in 6 births to women with GDM in 2019. It was also found that women living in low-income communities were disproportionately affected due to limited healthcare access. Additionally, women with GDM had a 1.4-fold increase in likelihood of undergoing a c-section, with 15% increase in risk of requiring blood transfusion. Screening for GDMGestational diabetes is screened between the 24th to 28th week of gestation in all women without known pregestational diabetes. In women who have high-risk for GDM the screening occurs during the first trimester, these women usually have at least one of the following: BMI > 30, prior history of GDM, known impaired glucose metabolism, and/or a strong family history of diabetes. The screening during the first trimester is to detect “pregestational diabetes” because we have to keep a good glycemic control to improve outcomes of pregnancy. So, if it's positive, you start treatment immediately. If these women are found to have a normal glucose, they repeat the testing again as done normally, at 24-28 weeks of gestation. How do we screen?The screening itself consists of two types of approaches. The two-step approach includes a 50-gram oral glucose tolerance test (OGTT), where blood glucose is measured in an hour and if it is below 140 they are considered to not have GDM, however if the reading is greater than 140 they must then do a 3-hour, 100g oral glucose tolerance test. The 3-hour OGTT includes measuring the blood sugars at Fasting which should be less than 95, at 1 hour at less than 180, at 2 hours at less than 155, and at 3 hours at less than 140. If 2 or more of these values exceed the threshold the patient is diagnosed with gestational diabetes mellitus. The one-step approach includes 75g after an overnight fast. Blood glucose is measured while fasting which should be less than 92, at 1 hour less than 180 and at 2 hours less than 153. If any one of these values is exceeded, the patient is diagnosed with GDM.If the mother is found to be GDM positive during pregnancy she will also need continued screening post-partum to monitor for any development of overt diabetes. The testing is usually 75g 2-hour OGTT at 6-12 weeks postpartum. If this testing is normal, then they are tested using HbA1c every 3 years. If the post-partum testing shows pre-diabetes, annual testing is recommended using HbA1c measurements. Maternal complications Women with GDM are at an increased risk for future cardiovascular disease, T2DM, and chronic kidney disease. GDM is also associated with increased likelihood of developing pre-eclampsia following delivery. Pre-eclampsia is a complication seen in pregnancy characterized by high blood pressure, proteinuria, vision changes, and liver involvement (high LFTs). Pre-eclampsia can then progress to eclampsia or HELLP syndrome, both of which can include end organ damage. Additionally, she can develop polyhydramnios which leads to overstretching of the uterus and can induce pre-term labor, placental abruption, and or uterine atony, all of which additionally put the mother at increased risk for c-section. All of these maternal complications that stem from GDM lead to complications and extended hospitalization. Child's complications Although there is an increased set of risks for the mother, the neonate can also develop a variety of risks due to the increased glucose while in utero. While the fetus is growing, the placenta is the source of nutrition for the fetus. As the levels of glucose in the mother increase so does the amount of glucose filtered through the placenta and into the fetal circulation. Over time the glucose leads to oxidative stress and inflammation with activation of TGF-b which leads to fibroblast activation and fibrosis of the placenta. This fibrosis decreases the nutrient and oxygen exchange for the fetus. As the fetus attempts to grow in this restrictive environment its development is affected. The fetus can develop IUGR (intrauterine growth restriction) leading to a small for gestation age newborn which can then lead to another set of complications. The low oxygen environment can lead to increased EPO production and polycythemia at birth which can then lead to increased clotting that can travel to the newborn brain. Newborns can also be born with fetal acidosis due to the anerobic metabolism and lactic acid buildup in fetal tissues which can cause fetal encephalopathy leading to cerebral palsy and developmental delay. And the most severe of newborn complications to gestational diabetes can lead to fetal demise. Furthermore, the increase of glucose can also lead to macrosomia in the infant which can often lead to a traumatic delivery and delivery complications such as shoulder dystocia and brachial plexus injury. Brachial plexus injury sometimes resolves without sequela, but other times can lead to permanent weakness or paralysis of the affected arm. The baby can be born too small or too big.Additionally, once the fetus is born the cutting of the umbilical cord leads to a rapid deceleration in blood glucose in the fetal circulation and hypoglycemic episodes can occur, that often lead to NICU admission. The insulin that is created by the fetus in utero to accommodate the large quantities of glucose is known to affect lung maturation as well. The insulin produced inhibits surfactant production in the fetus. Upon birth some of the newborns also have to be placed on PEEP for ventilation and some children require treatment with surfactant to prevent alveolar collapse and/or progression to NRDS created by the low surfactant levels. Additionally, neonates who are macrosomic, which is usually seen in GDM mothers, are larger and stronger and when put on PEEP to help increase ventilation the newborn's stronger respiratory effort can lead to higher pulmonary pressures and barotrauma such as neonatal pneumothorax.Long term complications to the child of a mother with GDM also occur. As the child grows, they are also at an increased risk for developing early onset obesity because of the increased adipose storage triggered by the increase in insulin in response to the high glucose in utero. This then can lead to a higher chance of developing type 2 diabetes mellitus in the child. With diabetes, also comes an increase in cardiovascular risk as the child ages and becomes an adult. The effects of GDM go beyond the fetal life but continue through adulthood.What can be done?Gestational Diabetes Mellitus has many severe and lifelong consequences for both the mother and the child and prevention of GDM would help enhance the quality of life of both. Many of the ways to prevent GDM complications include patient education and dietary modifications with a diet rich in whole grains, fruits, vegetables and lean proteins. Benefits of some vegetables in the Mexican cuisine that may be beneficial: Nopales, Chayote, and Jicama. Those are good alternatives for highly processed carbs.Mothers are usually offered nutritional counseling to help them develop a tailored eating plan. This and 30 minutes of moderate exercise daily is recommended to increase insulin sensitivity and lower the post-prandial glucose levels. If within 2 weeks of implementing lifestyle changes alone the glucose measurements remain high, then medications like insulin can be put onboard to manage the GDM. If they require insulin, I think it is time to refer to a higher level of care, if available, high risk OB clinic.Conclusion: Now we conclude episode number ###, “[TITLE].” [summary here]. _____________________References:Eades CE, Burrows KA, Andreeva R, Stansfield DR, Evans JM. Prevalence of gestational diabetes in the United States and Canada: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2024 Mar 15;24(1):204. doi: 10.1186/s12884-024-06378-2. PMID: 38491497; PMCID: PMC10941381. https://pubmed.ncbi.nlm.nih.gov/38491497/QuickStats: Percentage of Mothers with Gestational Diabetes,* by Maternal Age — National Vital Statistics System, United States, 2016 and 2021. Weekly / January 6, 2023 / 72(1);16. https://www.cdc.gov/mmwr/volumes/72/wr/mm7201a4.htm?utmAkinyemi OA, Weldeslase TA, Odusanya E, Akueme NT, Omokhodion OV, Fasokun ME, Makanjuola D, Fakorede M, Ogundipe T. Profiles and Outcomes of Women with Gestational Diabetes Mellitus in the United States. Cureus. 2023 Jul 4;15(7):e41360. doi: 10.7759/cureus.41360. PMID: 37546039; PMCID: PMC10399637. https://pmc.ncbi.nlm.nih.gov/articles/PMC10399637/?utmPerlman, J. M. (2006). Summary proceedings from the neurology group on hypoxic-ischemic encephalopathy. Pediatrics, 117(3), S28–S33.DOI: 10.1542/peds.2005-0620C.Low, J. A. (1997). Intrapartum fetal asphyxia: definition, diagnosis, and classification. American Journal of Obstetrics and Gynecology, 176(5), 957–959.DOI: 10.1016/S0002-9378(97)70609-0.Hallman, M., Gluck, L., & Liggins, G. (1985). Role of insulin in delaying surfactant production in the fetal lung. Journal of Pediatrics, 106(5), 786–790.DOI: 10.1016/S0022-3476(85)80227-0.Sweet, D. G., Carnielli, V., Greisen, G., et al. (2019). European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update. Neonatology, 115(4), 432–450.DOI: 10.1159/000499361.Raju, T. N. K., et al. (1999). Respiratory distress in term infants: when to suspect surfactant deficiency. Pediatrics, 103(5), 903–909.DOI: 10.1542/peds.103.5.903.Burns, C. M., Rutherford, M. A., Boardman, J. P., & Cowan, F. M. (2008). Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia. Pediatrics, 122(1), 65–74.DOI: 10.1542/peds.2007-2822.Dabelea, D., et al. (2000). Long-term impact of maternal diabetes on obesity in childhood. Diabetes Care, 23(10), 1534–1540.DOI: 10.2337/diacare.23.10.1534.Dashe, J. S., et al. (2002). "Hydramnios: Etiology and outcome." Obstetrics & Gynecology, 100(5 Pt 1), 957–962.DOI: 10.1016/S0029-7844(02)02279-6.Long-term cost-effectiveness of implementing a lifestyle intervention during pregnancy to prevent gestational diabetes mellitus: a decision-analytic modelling study. Diabetologia.American College of Obstetricians and Gynecologists. (2018). Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstetrics & Gynecology, 131(2), e49–e64. https://doi.org/10.1097/AOG.0000000000002501Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

In this conversation, registered dietician Leslie Flannery discusses gestational diabetes, its prevalence, hormonal influences, and the importance of managing blood sugar levels during pregnancy. She emphasizes that gestational diabetes is not a woman's fault and provides practical tips for maintaining a balanced diet without falling into restrictive eating patterns. The discussion also covers the risks associated with high blood sugar, the role of glucose monitors, and how busy moms can manage their nutrition effectively. The hosts, Megan and Chelsea, also weigh in on the challenges and strategies related to nutrition during pregnancy, particularly focusing on gestational diabetes. They discuss the emotional and mental toll of dietary restrictions, the importance of support systems, and practical tips for managing cravings and maintaining a healthy diet. The episode emphasizes the need for a balanced approach to nutrition that prioritizes mental health alongside physical health.Connect with UsFollow Leslee on Instagramhttps://www.instagram.com/gestational.diabetes.nutritionLeslee's Websitehttps://gdmnutrition.com/Follow Chelsea & Megan on Instagramhttps://www.instagram.com/raisingmama_/FREE Postpartum Resourceshttps://raisingmama.com/collections/new-parent-resourcesThis podcast is brought to you by Raising Mama (www.raisingmama.com), makers of the PERFECT Bamboo Baby Pajama. Easy-On, and Easy-Off, our Buttery Soft Bamboo Baby Pajamas Ensure Effortless Changes and have Empowering Prints and Messages to Mamas on them. Plus $1 of each pajama sold supports maternal mental health through Postpartum Support International. 

Struggling with low milk supply can feel overwhelming, isolating, and confusing. In this episode, Dr. Rebecca Dekker talks with midwife and International Board Certified Lactation Consultant Katie James to demystify the realities of low milk supply. Together, they explore the hormonal, medical, and systemic factors that can affect lactation, as well as the critical importance of early postpartum support. Katie shares how birth interventions, lack of education, and misinformation can interfere with lactation—and how reclaiming knowledge, honoring instinct, and receiving timely help can make all the difference.   (07:21) How Birth Interventions Impact Breastfeeding (09:30) Prolactin, Oxytocin, and the Critical First 3 Days (11:18) What is Low Milk Supply—and Can it Be Prevented? (14:58) Medical Conditions That Can Affect Milk Production (19:27) Gestational Diabetes, Cesarean Birth, and Milk Supply (23:42) The Trap of “Perceived” Low Supply (28:48) Why Judgment-Free Support Matters (36:56) When and How to Get Help from an IBCLC (38:16) The Rule of 3s: Key Windows to Boost Milk Supply (44:39) Why Partners Need Breastfeeding Education Too   Resources Follow Katie: katiejames.site | Instagram Listen to her podcasts: The Midwives' Cauldron and The Feeding Couch Find an EBB Childbirth Class: evidencebasedbirth.com/childbirthclass Learn about the EBB Instructor Program: evidencebasedbirth.com/instructor   For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

Pregnancy can be a whirlwind - and when gestational diabetes (GD) enters the picture, it's easy to feel confused by all the numbers, doctor's visits, advice and conflicting information.In today's episode, I'm joined by dietitian Mel Spinella to bust some of the most common myths about gestational diabetes - including how to prepare for testing, when insulin or medication might be part of your care plan, which foods actually support blood sugar balance, and what you can stop stressing about.If this episode resonated with you, we'd love for you to share and leave a review! Episode links:Mel's InstagramMel's Tik Tok Mel's website

Send us a textIn this inspiring episode, I'm joined by Amelia, who shares her powerful birth stories - welcoming both of her daughters in a Midwife Led Unit, despite being labelled ‘high risk' due to a high BMI and insulin-controlled gestational diabetes.Amelia's journey is a testament to what's possible when a woman is supported to trust her instincts, advocate for herself, and remain at the centre of her care.In our conversation, Amelia reflects on:The challenges and judgements she faced due to her BMIHow she stayed informed and confident in her choicesBuilding a relationship of trust with her midwivesNavigating the medicalised narrative around gestational diabetesThe difference respectful, individualised care made in her outcomesThis episode offers hope to anyone who's been told their body isn't capable of physiological birth - and a reminder that evidence-based care and personal autonomy can and should go hand-in-hand.If you love the podcast and would like to support it, then please use the link to 'buy me a coffee' - https://bmc.link/sallyannberesfordIf you would like to buy a copy of either of the books that accompany this podcast please go to your online bookseller or visit Amazon:-Labour of Love - The Ultimate Guide to Being a Birth Partner - click here:-https://bit.ly/LabourofloveThe Art of Giving Birth - Five Key Physiological Principles - https://amzn.to/3EGh9dfPregnancy Journal for 'The Art of Giving Birth' - Black and White version https://amzn.to/3CvJXmOPregnancy Journal for 'The Art of Giving Birth'- Colour version https://amzn.to/3GknbPFYou can find all my classes and courses on my website - www.sallyannberesford.co.uk Follow me on Instagram @theultimatebirthpartner Book a 1-2-1 session with Sallyann - https://linktr.ee/SallyannBeresford Please remember that the information shared with you in this episode is solely based on my own personal experiences as a doula and the private opinions of my guests, based on their own experiences. Any recommendations made may not be suitable for ...

Lily Nichols is a Registered Dietitian and the author three books designed to support healthy conception, birth and postpartum, including how to prevent and manage gestational diabetes.Her books are Real Food for Fertility (co-authored by Lisa Hendrickson-Jack), Real Food For Pregnancy and Real Food for Gestational Diabetes.Lily shares important information all women should know about optimizing their diet for fertility, pregnancy, and postpartum from a scientific perspective. Even for women who aren't currently in the pregnancy state of mind, knowing this information early on helps everyone to make better choices down the road.Connect with Lily Nichols lilynicholsrdn.com | InstagramLearn more The Institute for Prenatal Nutrition | Postpartum Recovery Meals | Fourth Trimester Soups and Stews Collection | Nutrition and Nourishment - The EssentialsResources HelloGaia Parenting Copilot | FREE DOWNLOAD Customizable Birth Plan | FREE DOWNLOAD Customizable Fourth Trimester PlanConnect with Fourth Trimester Facebook | InstagramWant trustworthy parenting data at your fingertips? Download HelloGaia Parenting Copilot for FREE today. The app uses reliable sources like ACOG, AAP, The Society for Maternal-Fetal Medicine. FREE app available now on Apple & Google Play

In this episode of The Weekly Transit, we welcome Andrea Lowell, a self-mastery coach, manifestation expert and former Playboy radio personality, who transformed her life from the path of excess to one of profound spiritual alignment. With raw honesty, Andrea reveals how filling a "spirituality-sized hole" in her life with partying eventually led to a radical awakening. Through her journey of sobriety, she discovered the profound connection between self-mastery and manifestation, developing a unique approach that combines nutritional healing, quantum physics, and unwavering faith in divine guidance. Our conversation explores Andrea's extraordinary manifestation abilities, her experience with gestational diabetes during pregnancy, and her powerful home birth story. This episode offers practical tools for raising your vibration, changing your mindset, and creating the life you truly desire.(00:03:09) Finding Self-Mastery Through Spiritual Awakening – Andrea's journey from party lifestyle to discovering manifestation through consciousness and the divine signs that guided her transformation.(00:08:59) From Drinking to Divine Connection – How stopping alcohol opened Andrea to synchronicities and miracles, leading to her understanding of vibrational alignment.(00:17:17) Hollywood Journey & Career Evolution – Andrea's path from child actor to Playboy model to radio host, and the moment she realized her work wasn't aligned with her soul.(00:26:25) Rock Bottom to Breakthrough – The DUI incident and tearful moment in the makeup chair that catalyzed her complete life transformation.(00:31:42) Manifesting Abundance with Faith – Quitting her job and manifesting $21,000 within two weeks through gratitude practice and unwavering belief.(00:45:28) Raw Food Revolution & Healing – Andrea's journey into nutritional healing, becoming a raw food expert, and helping clients achieve spiritual awakenings through diet.(00:59:48) The Miracle of Car Manifestation – An extraordinary story of manifesting angelic assistance when her car's suspension failed during a family road trip.(01:10:48) Gestational Diabetes & Conscious Pregnancy – How Andrea managed pregnancy complications holistically through diet, exercise, and alternative medicine at 41.(01:22:37) Sacred Home Birth Experience – The powerful story of Andrea's home birth, creating a holy space for her daughter's entrance into the world.(01:31:56) Postpartum Joy & Natural Parenting – Discovering the unexpected joy of motherhood and trusting natural instincts in early parenting.(01:41:15) Final Wisdom: Compassion & Car Consciousness – Andrea's practical advice on using driving as a spiritual practice and changing frequencies through conscious music choices.Find Andrea Lowell:Instagram: @theiameverythingprojectEmail: andrea@andrealowell.comWebsite: andrealowell.comtheweeklytransit.com

Send us a textWelcome to the April Q&A episode! Today's episode begins with your answers to our question: How do you cope when you are at your breaking point in parenting? If you are looking for some creative ideas, you will find them here! And someone, please tell us where one Mississippi, two Mississippi came from?Next, we get down to birth and answer the following questions: Why do some women choose unmedicated, physiological births despite societal pressures and perceived difficulties? Why not just get the epidural?Is it ok to push if you are not fully dilated? How dangerous is this and what is the risk with early pushing?My friend had to have an emergency cesarean when her baby was already in the vaginal canal. They pushed the baby back up and caused severe damage to her vaginal tissue. Was this necessary or were her providers just impatient?In the extended version of today's episode, which you can hear by subscribing on Apple Podcasts or joining any of our Patreon tiers, we answer these additional questions:What are the risks of using castor oil to induce labor?If I had a big baby in my first pregnancy, does it mean I will have gestational diabetes in my next pregnancy? Does it even mean I had gestational diabetes in my first? My doctors put this in my records with no evidence beyond a big, healthy baby.How do I gently night wean?In quickies, we discuss tongue ties and white tongues, hemorrhage and C-section, breath work resources for labor, retained placentas, protein for breastfeeding, decreasing milk supply, risk of infection with broken water, windmilling the placenta, and lastly, if you would only watch one movie for the rest of your life, what would it be?Plus, don't miss today's long and hilarious outtake. Watch the full videos of all our episodes on YouTube!**********Our sponsors:Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products for before, during, and after pregnancy. Use this link to save 20%DrinkLMNT -- Purchase LMNT with this unique link and get a FREE sample packENERGYbits--the superfood every mother needs for pregnancy, postpartum, and breastfeedingUse promo code: DOWNTOBIRTH for all sponsors.Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Watch the full videos of all our episodes on YouTube! Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Send us a textDiscover the unexpected journey of endocrinologist Dr. Divya Yogi-Morren as she navigates gestational diabetes firsthand. Her personal experience offers unique insights and fosters empathy towards those managing this challenging condition. Alongside Dr. Morren's story, we unravel the complexities of gestational diabetes management, from the intricacies of carb counting to the essential lifestyle changes required. This conversation is more than just about coping; it's about empowerment through knowledge, as we uphold our Speaking of Women's Health motto: Be Strong, Be Healthy, and Be in Charge!Whether you're considering parenthood or seeking to understand the long-term health implications of this disease, this episode is your guide to navigating gestational diabetes and a healthy pregnancy.Fit, Healthy & Happy Podcast Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...Listen on: Apple Podcasts SpotifySupport the show

In this comprehensive episode, Dr. Sterling breaks down everything you need to know about gestational diabetes screening during pregnancy. From test procedures to understanding results, this guide helps expectant parents navigate this important aspect of prenatal care with confidence and clarity.Key MomentsOne-Step vs. Two-Step ScreeningTest Preparation & What to ExpectUnderstanding ResultsAlternative Testing OptionsImportant RemindersDr. Sterling emphasizes that abnormal results don't mean you've "failed" a test, and that the majority of people who have an abnormal one-hour test will not be diagnosed with gestational diabetes after the three-hour test. For those who are diagnosed, 70% can manage with diet and exercise changes alone.Connect With Us: Join the Sterling Parents community at sterlingparents.com Follow us on Instagram @askdrsterlingpodcast Email your questions to podcast@sterlingparents.com

You may have read recent articles discussing new data linking maternal diabetes and ADHD and autism in children. Maybe you're planning a pregnancy or trying to conceive and you've never heard of gestational diabetes. Or you're currently pregnant and worried about what this means. So, in this week's episode, I give you an overview of what we know about gestational diabetes and baby's brain development – and how to reduce your risk.___Newsletter sign upCorporate SpeakingHow to Build a Healthy Brain*Unprocessed: What Your Diet is Doing to Your Brain*PatreonOriginal music by Juan Iglesias*Affiliate linksThe information shared on this podcast is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay in seeking it because of something you heard on this podcast. Reliance on any information provided here is solely at your own risk. Remember, your health is unique to you, so consult your healthcare provider for guidance tailored to your personal needs.Support this show http://supporter.acast.com/strongerminds. Hosted on Acast. See acast.com/privacy for more information.

SHOW NOTES: There is nothing more important to our physical health than what we eat, but it's easy to forget that and compromise. When you are pregnant, breastfeeding, or trying to conceive, it's even more important, so today I want to spend some time thinking about this with you so that we can all be more focused on nourishing our bodies well and giving our bodies the good energy they need to function the way God designed them to. My Course - go.yourbirthgodsway.com/cec Free Trial of My Course - go.yourbirthgodsway.com/coursefreetrial Prior episodes to listen to that are related: Episodes 23-26, 93, 103 Book links from this episode: Good Energy by Dr. Casey Means - https://amzn.to/3RRsEnb Real Food for Pregnancy by Lily Nichols, RDN, CDE - https://amzn.to/3RzFjeJ Real Food for Fertility by Lily Nichols, RDN, CDE - https://amzn.to/44lmPWA Real Food for Gestational Diabetes by Lily Nichols, RDN, CDE - https://amzn.to/3YrpNoM 100 Best Foods for Pregnancy - https://amzn.to/4lK5RYz   Helpful Links: — BIBLE STUDY - FREE Bible Study Course - How To Be Sure Of Your Salvation - https://the-ruffled-mango-school.teachable.com/p/how-to-be-sure-of-your-salvation   — CHRISTIAN CHILDBIRTH EDUCATION - Sign up HERE for the Your Birth, God's Way Online Christian Childbirth Course! This is a COMPLETE childbirth education course with a God-led foundation taught by a certified nurse-midwife with over 20 years of experience in all sides of the maternity world! - https://go.yourbirthgodsway.com/cec   — HOME BIRTH PREP - Having a home birth and need help getting prepared?  Sign up HERE for the Home Birth Prep Course. — homebirthprep.com   -- COACHING - Sign up for your PERSONALIZED Pregnancy Coaching Midwife & Me Power Hour HERE  — https://go.yourbirthgodsway.com/powerhour These consults can include: birth plan consultation, past birth processing, second opinions, breastfeeding consultation, and so much more!  Think of it as a special, one-hour appointment with a midwife to discuss whatever your concerns may be without any bias of practice policy or insurance policy influencing recommendations.   — GET HEALTHY - Sign up here to be the first to know about the new Women's Wellness Program coming from Lori SOON! https://go.yourbirthgodsway.com/yourhealth   — MERCH - Get Christian pregnancy and birth merch HERE - https://go.yourbirthgodsway.com/store   — RESOURCES & LINKS - All of Lori's Recommended Resources HERE - https://go.yourbirthgodsway.com/resources   Sign up for email updates Here   Be heard! Take My Quick SURVEY to give input on future episodes you want to hear -- https://bit.ly/yourbirthsurvey   Got questions?  Email lori@yourbirthgodsway.com     Social Media Links: Follow Your Birth, God's Way on Instagram! @yourbirth_godsway Follow the Your Birth, God's Way Facebook Page! facebook.com/lorimorriscnm Join Our Exclusive Online Birth Community -- facebook.com/groups/yourbirthgodsway   Learn more about Lori and the podcast at go.yourbirthgodsway.com!   DISCLAIMER:  Remember that though I am a midwife, I am not YOUR midwife.  Nothing in this podcast shall; be construed as medical advice.  Listening to this podcast does not mean that we have entered into a patient-care provider relationship. While I strive to provide the most accurate information I can, content is not guaranteed to be 100% accurate.  You must do your research and consult other reputable sources, including your provider, to make the best decision for your own care.  Talk with your own care provider before putting any information here into practice.  Weigh all risks and benefits for yourself knowing that no outcome can be guaranteed.  I do not know the specific details about your situation and thus I am not responsible for the outcomes of your choices.    Some links may be affiliate links which provide me a small commission when you purchase through them.  This does not cost you anything at all and it allows me to continue providing you with the content you love.

In this episode of the Adoption Roadmap podcast, host Rebecca Gruenspan and Dr. Sarah Silvestri discuss the complexities of health and medical concerns in adoption. They explore the definition of 'healthy' in the context of adopted children, the impact of prenatal substance exposure, the importance of prenatal care, and the challenges faced by adoptive parents. The conversation also covers the risks associated with STDs and gestational diabetes, as well as practical advice for selecting a pediatrician who understands the unique needs of adopted children.Important Links- ⁠Dr. Sara Silvestri⁠- ⁠American Academy of Pediatrics (AAP)⁠- ⁠RG Adoption Consulting⁠- ⁠Take the “Are You Ready to Adopt?” Quiz⁠Chapters00:00 Understanding Health in Adoption02:53 The Fear of the Unknown in Adoption06:09 Defining Healthy Babies in Adoption09:00 Trends in Maternal Health and Substance Use12:11 Navigating the Adoption Checklist14:53 The Importance of Prenatal Care17:53 Risks of Substance Exposure During Pregnancy21:02 Understanding Opioids and Their Risks23:48 The Impact of Alcohol on Pregnancy26:50 The Nuances of Marijuana Use During Pregnancy36:11 Understanding Hepatitis Risks in Pregnancy39:21 The Impact of Substance Use on Hepatitis Transmission42:25 Neonatal Abstinence Syndrome: Causes and Care46:48 The Long-Term Effects of Substance Exposure on Children53:11 STDs and Gestational Diabetes in Adoption Situations01:00:43 Navigating Medical Records for Adoptive Parents01:05:40 Choosing the Right Pediatrician for Adoptive FamiliesTune in to The Adoption Roadmap Podcast every Wednesday and Friday morning. If you like what you hear, I'd appreciate a follow and a 5-star rating & review!

Katie Reed - Mom of 2 boys, ages 2 and 4 months shares her journey to motherhood while navigating the grief of loser her grandmother/best friend suddenly from cancer not long after giving birth. Katie had gestational diabetes for both of her pregnancies and navigated colic, silent reflux and a tongue tie with her first son. She shares the differences from going from 0-1 and then 1-2 kids and how she manages being a breastfeeding working mom of 2. Instagram: Brittany Olson @becomingamootherpodcast Katie Reed: @katiereed15

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update   discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.    Coronary Artery Calcium-Guided Primary Prevention Strategy 2.    Health-Related Quality of Life and Health Utility after Metabolic/Bariatric Surgery vs. Medical/Lifestyle Intervention in Individuals with Type 2 Diabetes and Obesity 3.    Suicide and suicide attempt in users of GLP-1 receptor agonists: a nationwide case-time-control study 4.    Self-Monitored Blood Glucose and Continuous Glucose Monitoring in Youth with Type 1 Diabetes and Medicaid Insurance 5.     Gestational Diabetes to Type 2 Diabetes—Is Poor Sleep to Blame?   For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health

In this episode of the Body Grievers Club, hosts Bri and Jana welcome Margaret Dougherty, a licensed marriage and family therapist, to discuss her experiences with pregnancy as a person in a larger body. Margaret shares her journey toward body acceptance, the challenges she faced with medical professionals, and the lack of representation and support for plus-size pregnant women. They also discuss the importance of advocating for oneself in medical settings and the societal pressure on pregnancy. Despite the hardships, Margaret expresses the joy and fulfillment she feels as a new mother and emphasizes that every pregnancy experience is valid, regardless of body size.TIME STAMPS:01:41 Margaret's Journey to Body Acceptance03:42 Pregnancy Fears and Realities04:43 Navigating Doctor's Appointments 10:49 The Fear of Gestational Diabetes 20:20 Navigating High-Risk Pregnancy Concerns21:10 The Changing Relationship of Body Image and Pregnancy23:21 Grief and Expectations of the Body During Pregnancy26:18 Challenges with Plus-Size Maternity Clothing28:38 Hospital Experiences and Systemic Issues35:38 Advocating for Yourself in HealthcareWant more of Margaret?Instagram: @margaretd_lmftWant more of Bri?Instagram: @bodyimagewithbri Website: https://bodyimagewithbri.com/

Liz, a mama of two from Long Island, New York, joins us today sharing her experience with preeclampsia, an unexpected C-section, and her successful VBAC with her second. Liz had a perfect health history and never had any surgeries before her C-section. It was so frustrating to feel so out of control. In between her birth and her second pregnancy, Liz's mom unexpectedly passed away. She shares how she has been processing the intense grief from her mother's passing and from the positive birth experience she wasn't able to have. Liz made lots of changes going into her VBAC birth including diet, switching providers, and choosing to birth at home!Liz's DoulaCoterie Diapers - Use code VBAC20 for 20% offHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan Hello, everybody. We have our friend, Liz, from New York with us today. She is a mom of two and almost two years old. Right? Your VBAC baby?Liz: Yes.Meagan Almost two years since your VBAC baby.And then an almost six-year-old. And yeah, like I said, she lives in New York, and she's going to be sharing her stories with you guys today. With her first birth, she actually had preeclampsia, so she's gonna talk more about that. And then with her second birth, she didn't have preeclampsia. I think this is an important thing to talk about because we know that having preeclampsia again is a possibility, and it might be slightly increased if you've had it, but it doesn't mean you will. So I'm hoping that we can talk a little bit more if you did do anything to try to avoid it. The second one, we'll talk more about that in a little bit. But knowing that it's still okay. If you have preeclampsia, you can still VBAC. Now, in her second one, she didn't have preeclampsia, but you can still VBAC if you have preeclampsia. So we're going to talk about that a little bit after your first birth too, because I want to know more. All right. We do have a Review of the Week today, and this is by jess2123. It says "Best Podcast for VBAC". It says, "I listened to the podcast after my son's birth. I learned so much that I knew I wanted a VBAC for my second birth. When I became pregnant again, I would listen to this podcast during my walks. Thanks to the wealth of knowledge that I gained, I had my unmedicated VBAC in 2023." Congratulations, Jess, on your VBAC, and thank you so much for your review. I know this year we're tossing it up between reviews and educational pieces, but I just do want to remind you really quickly that if you haven't left us a review yet, we would love it. You can push "pause" right now and listen or leave a review on Apple Podcasts or Spotify. You can go over to Google. Google "The VBAC Link", and leave us a review there. These reviews really do help us and bring us so much joy. So without further ado, I want to turn the time over to you.Liz: Thank you so much. I guess every VBAC story starts with the Cesarean story, or at least there's one in there. My pregnancy journey did start with a Cesarean as far as the first birth. As Meagan mentioned, I am a mom of two. With my first son, I fortunately have been reproductively very healthy and otherwise healthy my entire life. I was able to track everything. I had regular cycles and really no issues there, so I feel really, really blessed in that regard. I was able to get pregnant pretty easily. I believe I got pregnant in about February 2018 for the first time. I found out mid-March after I tested in my bathroom and just ran out with the test to my husband, nothing super special. I think I was just shocked. I remember I had gone to a St. Patrick's Day parade and felt so tired that I said to my friend, "I'm going to go home and nap in between that and another event." They were all like, "Why are you napping?" I was like, "I don't know, I'm just really tired." I took the pregnancy test to rule out pregnancy. It was immediately positive which was amazing. My EDD, my estimated due date, was supposed to be Thanksgiving that year, so it was November 22nd which was Thanksgiving 2018. That just made me laugh because I was like, wow, what a far cry from Thanksgiving Eve spent even a decade previous. But yeah, so my pregnancy started out pretty status quo, I would say. I definitely experienced that nausea. My morning sickness was definitely an all-day thing, so it was a little tough. I think it threw me for a loop because I didn't know what to expect. I had always wanted to eat healthier, especially being pregnant, but it was like my body would not allow me to eat what I wanted or what my brain wanted me to eat. It was a lot of carbs to start out. I know that's pretty common. I remember when I went for my first appointment, I had called an OB's office. I'm trying to think. I think I had gone for one well-woman visit before, but I had two friends, actually three friends who had delivered with this OB and had good experiences, so I figured I would give it a try. The funny thing is, pretty much from the jump, I could tell that we weren't very aligned. I didn't really see eye-to-eye with him, but he had this nurse practitioner who was wonderful, and I feel like she drew people in because she was just very nurturing and calming, and she just had that great energy. I knew, obviously, she wasn't going to be at my birth, but I still stayed there.Meagan Oh yeah. So can we talk about that a little bit? So you had one provider that you're like, "I don't know, our energy doesn't match." And then one that you're like, "Our energy totally matches." But then they wouldn't be birthing with you. So tell me a little bit more of what that provider was that wasn't matching your energy.Liz: Yeah. So I guess because I had always been so healthy, my experiences with medical professionals were very limited. I had just gone to doctors for routine checkups my entire life, and everything was always fine. I think because I wasn't very experienced in the medical world, I almost had this aversion to it. I just was like, they're there if there's an emergency, but it'll be fine. Everything will be fine. I'm trying to do this as naturally as possible. He seemed very old school. I don't know how to describe it, just very set in his ways. I remember, I'll circle back around, but towards the end of the pregnancy when I had finally gotten the gall to tell him that I really wanted to try and do this unmedicated because I was so nervous to say that, he was like, "Well, don't expect this baby to just fall out of you. You're a first-time mom."Meagan Wait, what?Liz: He literally said that to me. And I was like, "Okay, I didn't think that." Meagan: I wasn't saying that. Liz: Yeah, I wasn't saying that I didn't think I wouldn't have to work hard. That's not what I'm saying. So just comments like that. The bedside manner just didn't seem very nurturing. He was very by the book, quick appointments, and asking me his little checklists of items, and that was it, whereas I felt like his nurse practitioner was very warm, had great bedside manner, and really just cared about mothering the mother in that situation. It wasn't just about the baby and how I was going to give birth or how I preferred to give birth. It was the entire experience. I remember at one point, she even said, "Obviously, there is a need for testing certain things and for keeping an eye on everything, but I really just feel like if we left women more alone to go through their pregnancies, they might be better off because we're so hands-on in the United States, and it just causes sometimes more anxiety throughout a time that's supposed to be really beautiful."So she did mention that she reminded me of, I don't know, a woman who crouched down in the field and gave birth to her babies in the woods. That's who she reminded me of. I don't know if that's the truth for her. I never did ask anything about her birthing experiences, but that's who she reminded me of. Just super warm and nurturing. I think also I maybe just aligned more with a female provider. It could have been just that too.Meagan: Yeah, it could have been. But I mean, what you were saying, comments like that, if I'm being super straight, we've interviewed providers on here that have come across really great, and then the more I've interviewed them, I'm like, "Oh, I don't know if I like that. I don't know."That can just happen. I think that's where it comes with vetting your provider and going with who makes you feel warm and fuzzy. But at the same time you're in this place where you're like, well, we've got this medical. We'll see how it goes. I've got this to also like, I've got this warm, fuzzy, filling-my-cup over here. So it seems like it's an okay match, right?Liz: Yeah. And I also manipulated it to the point where I would only make appointments when she was available throughout my pregnancy where the office was like, "You have to see the OB. You have to. He is going be the one who's attending your birth." I'm just like, "But I don't want to. I don't want to do that."Meagan: Yeah.Liz: I just stuck with the practice, I think, because I was nervous. I was new to it and like you said, I was getting my warm and fuzzy cup filled by that nurse practitioner's presence. Things progressed. I finally outgrew that morning sickness. By the second trimester, it was week 12 or 13 and it let up, and I was feeling good. I was pretty energetic. I was doing yoga on a somewhat regular basis. Nutritionally, I do want to mention because I think this does play a role in how things may have gone with the preeclampsia. But nutritionally, I was actually coming off of a vegetarian diet. I had been a vegetarian for a few years. I had gotten really deep into yoga in the early 2010s, and I became a vegetarian when I was doing teacher training for that. So I was purely vegetarian for a few years, and then I started integrating poultry back into my diet. I ate very little because my husband also doesn't consume a lot of meat, so we just didn't eat a lot of meat. I feel like I'm already a picky eater even as an adult. I definitely was as a child, but even as an adult, I still have things that I just don't like, so I feel like my diet was pretty limited, and I perhaps was not getting the nutrients that I needed, especially when my body underwent this or got pregnant and was going through this stressful event.Meagan: Yeah. Growing a placenta and a baby. Yeah, it needed its nutrients.Liz: Yeah. So I feel like during my pregnancy, especially once I started to feel good again, I ate whatever I wanted. So that whole like, I'm just going to eat so healthy, I was just like, yeah, no. I'm eating for two. I totally knew that's not what you're supposed to do. Meagan: I did the same thing. Liz: Yeah. I was like, whatever. I'm feeling great. I'm going to eat it. It's there. I'm going to eat it. So I get to my 20-week anatomy scan. I'm not even sure if it was exactly at 20 weeks, and everything goes well. Fortunately, no complications with the baby. Oh, I had also gotten a NIPT to find out the sex of the baby, so I knew I was having a boy. The anatomy scan did validate that. But that week, I don't know if it was right before or right after my anatomy scan, I noticed that I was starting to swell just on my right side of my body. My right foot was swollen. My right ankle leg was a little swollen. I remember reaching out to my social media friends. I just put out a status like, "Hey, pregnant lady here. I don't really know what's going on. Is this normal? Is this something I should bring up to my provider? What do you guys think?" There were plenty of people who were like, "No, it's totally normal to be swollen at that point." I even said, "It's only on one side though. It's weird."Meagan: Yeah, yeah.Liz: So they were like, "Just elevate your feet. See what happens." It would always go down, but it was just odd that I happened to notice just the swelling on one side of the body. So definitely interesting. Yeah. So I keep going. I'm getting bouts of pretty much every pregnancy symptom, but it would always be very short-lived. I definitely had some reflux, short-lived. I got sciatic pain so bad one day that I couldn't get out of the car. I remember I was sitting in the passenger seat and I said to my husband, "I can't walk on my right leg right now because of my sciatic nerve." So I was doing all these exercises to try and get the baby off my nerve and all of that, and everything just waxed and waned. Nothing was long-lived by any means. So I get to 30 weeks. I think it was at my 30-week appointment, and I believe it was the medical assistant who come in and took my blood pressure and wait like they always do. I don't know if it was her or the nurse practitioner who said that I had my first high blood pressure reading. Like, "Oh, it's elevated a little bit." And I was like, "Oh, that's so strange. I've been a 120/80 girl this entire time, and my whole life, I've never had blood pressure issues." And they're like, "Okay, well it's something to keep an eye on. Let's see. We're going to let you lay on your side, and see if we can have it come down. We'll take it at the end of the appointment again." And it did. It would come down, but they definitely were like, "We're going to keep this in our back pocket, and we might have to have additional monitoring if this progresses." I didn't really know what high blood pressure and pregnancy could mean, so of course, I go to Dr. Google like a good pregnant lady does, right?Meagan: Yep. A lot of us, I'm guilty.Liz: Guilty. Yeah. I was like, okay, so it could be hypertension in pregnancy or it could turn into preeclampsia. I was reading all the things, how this could turn and what that all meant. So in the back of my head, I always thought like, okay. I'm aware of what could indicate preeclampsia, but that's not going to be me. I am a healthy person, right? I've always been healthy my entire life. There shouldn't be any issues while I'm pregnant. And that wasn't the case, unfortunately. But I did go in a few more times, and I did get elevated blood pressure readings. So I don't know what week I was, but I know it was the beginning of October. I saw this other nurse practitioner who was not warm and fuzzy. She was new to the practice and she saw me. She took my pressure, and you could see the alarm in her face, but she wasn't saying much. This stuck with me to this day. It's just so crazy. She handed me this paper. The hospital that I was delivering at is a small community hospital, but it's affiliated with this Catholic healthcare system where I live, so they have a few different hospitals that are also within that same system. She just gave me this paper that had a listing of all these numbers for these different departments at these hospitals, and she just said, "You need to call them and make an appointment." And I'm like, "I have literally no idea what this is about." She's like, "Your pressure is high. You need to go make an appointment with them," but that's all she said to me. Meagan: For what? Yeah. Liz: Yeah, what is happening right now? I remember even that day, she asked me about my face. She was just like, "Is your face swollen? Does your face normally look like that?" I was like, "I have a very round face. I have big cheeks. To me, my face doesn't look different." Yeah. So she handed me that paper, told me to call, and like the good patient I am, I was like, "Sure, I'll call." So I called. I found out it was maternal-fetal medicine, which for those of you out there that don't know what that is, that's a high-risk doctor, and I had no idea. So this is my first experience with that. I did call. I made an appointment, and my OB office had me do a 24-hour urine drop or urine drip, however you want to call that. Meagan: Urine catch? Urine catch, probably?Liz: Yeah, so for those of you who don't know what that is, they give you a jug from a lab, and you have to put your urine into that jug for an entire 24 hours. They test it, and they're checking to see if there's any protein that is spilling into your urine because that could indicate decreased kidney function. Meagan: Preeclampsia. Yeah.Liz: Yeah. That is a symptom of preeclampsia. So I did do that. I went and saw MFM, and in the office there, my pressures were labile. They even called them that-- labile. It had elevated a little bit, probably in the 130s over 90s, but then by the end of the appointment, it had come down. My labs for that urine catch did indicate that there was protein present, but it wasn't within a diagnosable threshold. It was below that lab threshold, so I basically wasn't diagnosable. But they were like, "Now we're going to watch you." Most people like to see their babies on ultrasounds. That's an exciting thing. I became so fed-up with having to go in. I was, at that point, a frequent flyer. I was going in weekly earlier than a pregnancy that wasn't having any sort of complications. I was getting not only an ultrasound, but an NST every time I went in, so I'd have to lay there for 45 minutes while they looked at the baby's heart tones and everything. Yeah, at that point, I was just really stressed out because I was like, is that what this is turning into? But I don't have preeclampsia. I think I also saw my OB within that timeframe and he mentioned, "If this progresses, we will be doing a 37-week induction." And I was like okay, so I'm going to keep that in mind. But again, this isn't going to progress to that because I'm healthy and we're going to make it past 37 weeks. I probably wouldn't get the type of delivery that I wanted. And that's probably something I should mention. If I was induced at 37 weeks, I was preparing to have an unmedicated birth, a vaginal birth, and I was even taking a HypnoBirthing class to try and labor as long as I could at home. My whole thing was that I didn't want to go to the hospital until I needed the hospital or until I felt I needed the hospital. So here I am thinking, okay. I want this unmedicated, low-intervention birth, but I'm having all these interventions right now because they need to monitor me. There's some sort of issue that might be brewing. Yeah. I already said I went to MFM and all of that. My symptoms, at that point, were mostly swelling. I was getting very swollen at this point. I had that pitting edema in my legs, so I could press my finger into my leg. Meagan: It stayed. Liz: It stayed, and then my feet were like little loaves of bread. My feet will never forget what they went through. My husband would just massage them every single night, trying to get the fluid to move out of my tissues. It was crazy. I had another experience with a different OB who was not my OB, but I was out at a family event at this restaurant, and this woman approached me, told me she was an OB, and asked me if I was okay because my legs and my feet did not look so great.Meagan: What?Liz: Yeah. I was just standing in the lobby minding my business, and she's like, "Are you okay?" as if I'm not being monitored, but do you think I'm just going through this free and unaware of what's happening? Yeah. So that was interesting. She said that she was an OB. Yeah. So I went for weekly NSTs, the ultrasounds, and everything looked great with the baby. He was never under any sort of distress. No concerns of intrauterine growth restriction, nothing like that, but my pressures just kept being labile. I actually borrowed a blood pressure cuff so I could monitor at home. There were some mornings where I'd lay down on the couch after I woke up, and my blood pressures were reaching into those like 140s over 90, 91 maybe. I just would cry. I was just hysterical. Like, why is this happening? I don't want to go to labor and delivery right now. I don't want to be monitored. I'm already being monitored so much. There were probably some weeks towards the end where it was more than once that I went into my OB's office for monitoring. So fortunately, we made it through that 37-week mark. We made it all the way to, essentially, the end. And we get to Thanksgiving Eve, right? So my due date is the next day. I'm at 39 and 6. This was one of those appointments where they said, "You have to see the OB." I know I just kicked and screamed, not really, but in my head like, "F"ine, I'll see him. So the medical assistant comes in, takes my pressure and my weight, doesn't say anything, and leaves the room. He comes in, takes my pressure in my weight, and he asks me to meet him in his office.Meagan: Really?Liz: Yes. So I get myself dressed out of the gown that they had given me, and I go meet him in this fancy office. And he's like, "Your pressure is very high today, very high. So you're going to be going to labor and delivery straight from here." He's like, "I have a few meetings that I have to attend to here, but I will meet you over there in a few hours." And I was like, obviously, on the verge of tears. I'm just like, "Can I please stop home and get my stuff? Like, I have bags, I have a dog."Meagan: If you can go to your meetings, I can go to my house.Liz: Right. And yeah, my OB's was maybe 12-13 minutes away from my house, and the hospital was about five minutes down the road. So I was just like, "Can I just go home and grab my stuff?" And he's like, "No, no, no. Go straight to the hospital." And he goes, "And you're probably going to have a Cesarean."Meagan: What?Liz: This is after I tell him my natural birth, or my unmedicated, definitely wanting a vaginal birth. I was like, what? Literally, that was when the tears of waterworks really started. I was just like, "there's no shot at me having a vaginal birth?" And he's just like, "Well, I'm going to be putting you on medication to prevent seizures, so you can either labor with that and have it cancel out my induction medication, or you can just be calm and go to a Cesarean." Like, go to the OR, essentially.Meagan: What were your pressures?Liz: 170/110 that day.Meagan: Okay. Okay.Liz: So, high. Meagan: Yeah. But he's like, "You can do this, but it's not going to work, or you could just calm down and do this."Liz: Yeah, yeah. It was like, those aren't options, so that's not really an option. Right? That's what you're telling me. Meagan: Yeah. Liz: Yeah. So I called my mom. I called my husband, frantic. I was just flipping out. I get out of the office, I'm crying in the parking lot telling everybody. They're telling me to go right to the hospital. So, of course, my husband rushes home from work. He was at work. It was a Wednesday, and he got my dog. He had to bring my dog to my mom's, grab our bags to the extent that they were packed, and he met me there. I was crying. I walked myself into the hospital. It was the most surreal thing. I checked myself in knowing that I was going to come out with a human being, which was bizarre. And when I finally got to labor and delivery, my nurse was so sweet, but I was crying so much that she was just like, "Are you going to be okay?" And I was like, "I really want a vaginal delivery." And she's just like, "Honey." She goes, "I understand. I do think he's making the right choice. I do think you're making the right choice," which again, I don't really feel like I had a choice in that.Meagan: Yeah, you're like, "I wasn't really given a choice."Liz: She was also trying to relate. She's like, "I've had three Cesareans. I promise you're going to be okay. You're going to be okay." I was just like, "I've never even had a tooth pulled. I don't know if I could do this."So my husband arrived again. I'm just crying. He's trying to cheer me up, trying to keep our eyes on the prize and the fact that we were going to hopefully have a healthy baby at the end of all this. I want to say between check-in and when my OB arrived and scrubbed himself in, it was probably about three hours. Yeah. And I walked into the OR, another bizarre experience. I just walked in.Meagan: Yeah. Yep.Liz: Okay, so everybody scrubs in. There's a whole host of people in there, including my nurse. I had never had surgery, so they're giving me all the instructions as to how I need to lean forward so that they can put a spinal block, I think, at that point, the anesthesiologist, and it was so bizarre. It felt like the most claustrophobic thing. If any of you have ever had Cesareans, hopefully you can relate to me, but feeling the numbness just go up your legs.Meagan: It is very strange. I walked in for my second one. With my first one I just had an epidural, but the second one I had a spinal.Liz: Yeah, yeah. So I mean, so bizarre. Then, like I had already mentioned I was so swollen, so they had to just take my very swollen-- I felt like a beached whale-- body parts and put them onto this operating table because I couldn't move once. Obviously, the spinal had activated. So that was bizarre. But my husband, I mean, this man is the calmest person and the nicest person I know. Thank God for him and his presence on that day. He kept me nice and calm. Everybody was really, really nice in the OR. The only thing I happened to notice at one point was they had my blood pressure cuff on. That's why I'm here, right? Because my blood pressures are so hig,h and it had slipped down to my wrist, so I had my arms out. I don't think my arms were strapped down. I don't remember that. I had them out, and I look over to the extent that I could to the anesthesiologist, like, "Hey, does somebody want to maybe put this cuff on? Because that's why I'm, here. That's why we're in this position right now." But yeah, my husband and I just chatted and laughed the entire surgery. Everything worked out really well with the spinal. I did not feel any pain. They did talk me through to an extent about what I would feel as far as tugging or pulling or pressure. My son was fortunately born really healthy, screaming, great Apgar score, the whole nine. He came, and oh my god, what a feeling. Obviously, I was so emotional because of how the birth had gone and what had led me there. But becoming a parent and seeing your child for the first time, you can't really describe that. It's amazing. I have really nice photos and video that the nurse took. They brought the baby over to me. They did not do skin-to-skin with me. Again, I had all of these birth plans, preferences, and, none of that came to fruition. None of that pertained to my or situation. I was so, so happy and also so sad. I don't know how to describe it. It was like the happiest and saddest day of my whole life up until that point. So recovery was interesting. I feel like I got maybe 5 hours of sleep in the hospital total. I was on a magnesium drip. People had told me that the side effects could be a little bit gnarly with that, but I fortunately didn't find anything abnormal. I think I had so much adrenaline. But I did try to get my son to latch, and he was having a really hard time latching. They had a lactation consultant from the hospital come in and see me, and I could not get him to latch. I happened to notice that his tongue was really tethered, super tethered. I could see the tie was really far forward, and he couldn't lift his tongue. So I kept telling them, I was like, "He can't lift his tongue up the way that I feel like he needs to." They just kept telling me how to hold my own body to try and breastfeed properly. I'm like, "I don't think that that's the problem though." So that was really challenging. They did want me to stay extra time for some monitoring. So the next day was Thanksgiving. I don't think my OB wanted to be there. It was a holiday, right? He took his sweet time coming in because they wouldn't even let me eat. That was the thing. I was on magnesium. They brought breakfast in at like 7:00, and he strolls in at like 10:30. I just watched my breakfast get cold in the corner. So that was interesting. But yeah, I think at that point, if you had had a Cesarean without complications, they were looking at about a 48-hour stay. But they asked me to stay an additional day because my pressures were still labile. They were still elevated. I did get put on-- I can't remember the name of medication, but it was blood pressure medication. I was taking Motrin for pain management, the hospital-grade Motrin for my Cesarean. I cannot even describe what it was like trying to get up and walk around that first time after surgery. It's insane. That was something I didn't expect. But yeah, I didn't get much sleep. The last day that I was there, my dog had gotten into a place in my mom's house that she couldn't get him. He had gotten into something, and she couldn't reach him, so she was flipping out. She called my husband. She didn't call me and just told him, "Listen, you have to come get the dog. I can't get him." So he did. I told him, "It's fine, it's fine, you can leave." While he was gone, I had friends come and visit me. They were still visitors pre-COVID. The covering physician came in. I had my son on Wednesday. Thursday was Thanksgiving and I saw my OB, and then there were covering physicians for Friday and Saturday. So we're at Friday now, Friday evening. He came in and saw me and he's like, "You know what? I might be able to discharge you tonight." I got so excited because I was like, this is my first experience having a newborn baby. My husband is trying to go deal with my dog. How awesome would it be if we could just go home tonight?So I got super excited. He said this right in front of my friends, too. He comes back in a short while later and was like, "I just looked at your chart. I looked at your pressures." He didn't clear out the room, nothing. And he's like, "You know what? I can't discharge you. Not with pressures like this. I can't do that." And he's like, "And the covering physician tomorrow won't be able to discharge you any sooner than late afternoon, early evening because that is when he will be here." I was like, okay. So here I am in my head thinking I could go home tonight, and now you're telling me I might be able to go home tomorrow afternoon or evening. I'm already very hormonal. I'm very emotional. My husband's not here.My friends wound up leaving, and I just sobbed. I just sobbed in my room like, oh my god. this is a nightmare. Why can't my body get it together? Why can't I just have normal blood pressures again?Meagan: Yeah.Liz: Yeah. We did wind up getting discharged the next day, but I remember that physician just being so the last straw for me in that experience. You didn't have to say anything at all, and then you also set it in front of all of my friends.Meagan: Uh-huh. Yeah. So you didn't stay with this provider, did you?Liz: I did not stay with this provider.Meagan: For your VBAC? Okay.Liz: No, absolutely not. Absolutely not. Yeah. I guess I should probably get into that story, right?Meagan: No, this has been great. This has been great. Yeah. Yeah. So you were done. You went home. You're like, last straw, no more, never again.Liz: Yeah. Yeah. And I did have my. My son assessed by a lactation consultant, and she said that was one of the most severe tongue ties that she had ever seen. She did recommend a release. I was four days postpartum at this point. I wound up supplementing with formula which was something I so didn't want to do, but I was just like, this kid is starving. He can't latch properly. I did. I went and saw a specialist, and I had his tongue and lip ties both revised, and it was severe. That was a severe tongue tie. I know people have mixed feelings about that, but he needed it. Even in my opinion, as a lay person.Meagan: Yeah. Yeah.Liz: But yeah, pretty much immediately I knew I wanted things to be different the following pregnancy and birth. I think I started thinking about my VBAC probably that day. It was probably the day I gave birth to my son. This cannot be how this goes every time.So it took me a really long time to even want to conceive again. Not only did I have all these complicated feelings about my birth because yes, I did have a healthy baby. Yes, I ultimately weaned off of blood pressure medication and my body came back to however you want to phrase normal, but I had had this experience that I was holding onto a lot of trauma from, and unfortunately, my son was four months old and my mom suddenly passed away. So yeah, it was unexpected. It was sudden. I still to the day am shocked that I didn't lose my milk supply, but I was able to pump in the hospital and get my son milk. That is a crazy, surreal experience losing a parent, but I don't think that there's much more cruel than losing someone that you care about so much. My mom and I were so close in a postpartum period that's already complicated by birth trauma. So now I had this grief for my mom. I had this grief for the birth experience I didn't have. I think that largely contributed to me waiting to conceive again. I also wanted to try and find out as much as I could about what causes preeclampsia. What exactly goes on in the body that would cause that to happen? Funny thing is the verdict is still out there. They're not exactly sure what causes it.Meagan: Yeah. And there are things that we can do to try to help avoid it, but there's nothing specifically that's like if you do this, you for sure won't have it.Liz: Yeah.Meagan: The same thing with gestational diabetes. It's within the placenta, but we don't know. It needs to be further studied.Liz: Yeah. I have heard that it has to do with the father. Have you heard that too?Meagan: I have heard that as well, that there's a connection. Yes.Liz: Yeah. So I wound up, I remember I saw a home birth my wife just for blood work between having my son and conceiving my daughter. She did mention, "Preeclampsia is largely a first-time pregnancy illness. Largely. It doesn't mean you can't have it a second time," but she was the one who mentioned to me you have a higher instance of getting it again if you have the same father for your child. And I'm like, "Well, I'm married."Meagan: Well, I am going to have the same father.Liz: Yeah. So that was always in the back of my head. It's like, okay well, subsequent pregnancy, less of a chance. But same father, more of a chance. So I was just wondering what my odds were. It definitely was there on my mind for a long time. I studied as much as I could about what could cause it. I've read Lily Nichols, Real Food for Pregnancy, cover to cover. Obsessed with her. Obsessed with everything she has to say. There it is right here.Meagan: And right here and right here. Real Food for Gestational Diabetes. Real Food for Pregnancy. Food is powerful, you guys. It's very powerful. But it's changed over the years.Liz: I know. I love how she presents the research because she's the one who really delves into it and presents it in such a digestible way. It was such an easy read. I was like, okay. Okay, here are some things that I can control. Can I control everything? No. But here are the things that I intend to do the next time.Meagan: Yeah.Liz: So my mom passed away in April 2019. It took, again, a few years, but by spring 2022, I was feeling ready. And my husband and I kind of discussed it. It was in little passing. "Hey, should we try and get pregnant again?" And it was one time. It's not lost on me how lucky I am in that sense that it took me one shot to get pregnant.Meagan: Which is awesome. Liz: Yeah. I found out my EDD for that pregnancy was going to be on Christmas Day.Meagan: Oh my gosh.Liz: Yeah. And I just said, "Wow, I can't avoid major winter holidays, apparently, with my pregnancies."Meagan: Yeah. Oh, my gosh.Liz: So we did not find out that we were having a girl, but she did wind up being a girl. Spoiler alert. But, yeah, I was really not feeling well that pregnancy. It was like aversions times 1000. I had this really bizarre one that I had never even heard anybody discussed before, but I had so much extra saliva in my mouth. I'm sorry. That might sound disgusting. It felt like when right before you're going to get sick, how your mouth fills up with saliva but all day.Meagan: Like your saliva glands were just excess all the time, giving you all the spit possible.Liz: Yeah, it was disgusting.Meagan: That is interesting. I don't think I've ever heard of that.Liz: Yeah, it was terrible. Fortunately, I was working from home. I was working full-time, but I was at home. I would just walk around with a spit cup. Like, how disgusting. It disgusts me to even talk about it. It's just like, what is happening? I was waiting for those aversions to let up because I couldn't stand the smell of coffee, which, I love coffee. Basically the sight of anything that wasn't pure oxygen was disgusting to me. The sight of opening up my refrigerator was like, ugh. Exactly. The gag reflex. That lasted my second pregnancy until 22 weeks. So it was rough. I joked that I was horizontal for 2022, and that's not even a joke. I really was lying down. I had so much guilt because my son was so energetic at this point. He was nearly four years old, and he had so much energy. He wanted to do things, and I could not muster up the energy most of the time. My husband was the default parent, and I never thought that that would be the case. That was really, really hard. That was probably the hardest part of the pregnancy. But yeah, so I started to really actively plan for that VBAC. I started to see a hospital-based group of midwives. I loved them. I had gone for well-woman visits between as well. But every provider that I saw was just amazing. I didn't have any bad things to say. I knew that I would be with them if I was in the hospital. But deep down in my heart, I really, really wanted to be at home. I had seen so many beautiful home birth videos when I did HypnoBirthing. And I also associated hospitals with sickness. I had been there because I developed preeclampsia.Meagan: Uh-huh.Liz: I had been there when my mom was sick and passing away. It was a sick place. I wanted to be at a place where I felt most safe. For me, that was home. I know people have a lot of feelings and opinions about that all over, but for me, that was what I wanted to do. I wanted to do all of the things to keep myself low-risk and able to birth at home if possible while still making plans for transfer and even surgery if it was needed again. So I wasn't ignorant to the fact that it could turn into that, but I was going to try all of the things.Where I live, there actually aren't a lot of home birth midwives who support HBACs, VBACs at home. But I found one and we clicked immediately. When I spoke to her on the phone, I was like, she is my girl. I need her. I need her energy at my birth. We met in person a few weeks later, and she was so, so gung-ho about it. She had mentioned that her mom actually had an HBAC, and she witnessed her mom having that HBAC. It was just ingrained into her. She really supported me with advice on diet. She helped me with supplementation. I was on a lot of supplements for this pregnancy. I'm not even going to front. I had so many alarms set for all my supplements daily. So yes, I was trying to support myself with diet, of course, but I was trying to also fill in any gaps that might be there with supplementation. I just know my diet's not perfect, and it certainly wasn't when I was feeling terrible.Meagan: Yeah, no one's is. No one's is. That's just the reality of it. We can be eating the best we can, and we still are often falling short. That's why supplements are really great.Liz: Yeah. Yeah. I was seeing a Webster-certified chiropractor the entire time to get myself into the best alignment to have that vaginal birth. The supplementation, I was doing reformer pilates. I had started it the year before, and I did it all the way until the very end of November 2022, so I was staying active. I was really trying. I basically said that I will do almost anything to keep myself at home. That was really my motto. Yeah, I really can't say I was totally worry-free. I was waiting for something to go wrong. I was. I was trying to keep this brave face as like, okay. I can do this. I can birth the way that I want to. I can have this complication-free birth and pregnancy experience. And in the back of my head I'm thinking, when is the next shoe go going to drop?Meagan: I mean, it's what you've experienced in the back story, the last story. And it's hard. Even if we've processed through things, there's still sometimes those little creeping thoughts that come in.Liz: Yeah. That is for sure. My midwife did recommend that I get a third-trimester ultrasound. That was more for her, but it was also for me. She never ever said, "You have to do this." Everything was really a conversation. The appointments, especially with a home birth midwife were an hour long or more sometimes. Just amazing. I loved going to see her. So I did get that third trimester ultrasound. It was more to check to make sure that the placenta wasn't compromised in any way and whether it was in a good position. There was no accreta. That was something that we really wanted to rule out to keep me low-risk and at home. I agreed with that. I am not anti-medicine by any means. I just want to put that out there just because I chose to have a home birth. I do respect medical professionals and their jobs and the need for surgery but I also wanted to keep myself in a place, again, that I felt safe, and that's really what it came down to. So in my head, I had mentally prepared to go to 41 weeks. I think that's where I prepared to go because I had learned that many, many women, especially first-time laboring women, because I did not labor with my son, I neglected to mention that I didn't labor at all. So first-time laboring women will go into labor typically, but somewhere between 40 and 41 weeks. Post-dates is very, very common. So in my head I prepared to go to 41 weeks and we got there. We got to Christmas. We through there. I was like, I'm going to go somewhere before New Year's Eve. No, nothing. So we got to New Year's Eve and here I am in my 41st week, and I'm just trying to keep myself calm. What am I going to do? I cannot go to 42 weeks. I can't do it. Mentally, I can't do it. Physically, I can't do it. I'm going to wind up at the hospital. Of course, all of these negative thoughts are swirling. I went for another adjustment with chiropractor. I went for an acupuncture session. I went for a few of them, but I did induction points with my acupuncturist. I was just trying to do all the things-- curb walking, I did the Miles circuit and all the things to try and help this baby engage. So we get to 41 and 1 for me, which is a Monday, and I was woken up with contractions that felt like period cramps. That's how I would describe them. Around 2:00 AM, I started timing them. They were 12 to 15 minutes apart at that point, but they weren't letting up. They were consistent. I woke up my husband getting all excited like, "Oh my gosh, this might be it. Here we are." And they weren't getting closer, but they weren't easing up. So they just continued like that for the rest of the day. I had gotten up from the couch at one point, and I felt like this small trickle. I went into the bathroom, and it didn't look like anything to me. It didn't look like much. There wasn't a huge gush of fluid, nothing. So I was like, oh, I think it's probably just discharge or maybe part of my mucus plug. I have no idea. I have literally no idea. But I was like, nothing seems off to me, and it wasn't enough fluid to be concerning. I did text my midwife to update her and she mentioned to me, "A lot of women will drop into more active labor when the sun goes down. Things get quiet. It starts to get calmer. I can almost guarantee that we're going to have a baby at some point in the next 24 hours." So I go to bed that night and thinking, I'm going to wake up Tuesday probably either be having a baby or have a baby already. I woke up Tuesday, and I was still pregnant. Here I was.Meagan: You're like, this is not what I was thinking.Liz: I remember I would wake up with a contraction, but again, they were 12 to 15 minutes apart. I would go to sleep between no issues and just wake up, breathe through the contraction, and go back to sleep. And that's how the whole night went. I just couldn't believe I was still pregnant. I really was starting to get a little down on myself. I was like, these aren't coming closer together. They're not intensifying. They're not letting up, but there's nothing really happening at this point. I texted my midwife again that morning, Tuesday morning, and she said she needed to come see me for the 41-week appointment anyway, so she said that she would come by that day. She was going to come to my house. And then we get to the mid-morning. It was probably around 10-10:30 and my contractions stopped, like literally up and left. Like, what is happening right now? I can't. I was in shock, literally in shock. Especially because labor had been going on for over 24 hours. It was absurd to me. But she's like, "Don't worry. I'm going to come see you for your appointment anyway." When she arrived later that day, I did ask her to do a cervical check because at this point I'm like, "Something has had to happen whether the baby moved down into a better station or I'm a little bit more dilated or just more engagement. Whatever it is, I just want to know at this point."Meagan:: Yeah.Liz: So she did. She said, "I'll go in there. I can do a cervical check and if I can get in there, would you like me to do a membrane sweep?" And I was like, "I would love that. Anything to get this going. Let's get the party started." I'm at my house. She does the cervical check. She's like, "I can do a membrane sweep." And as she basically finishes up, I feel this gush of fluid.Meagan:: Your water.Liz: Yeah. She stopped, and I said, "Was that fluid?" She's like, "I'm going to make sure it's amniotic fluid. I have the test strip," and of course, it lit up like a highlighter. She's like, "Yes." She goes, "So guess what? We're going to go after baby today. We're going to get this. We are going to get this party started." I had kept telling her, "I can't go to 42 weeks," and she kept saying, "Let's not go to 42 weeks. You'll be fine. We're going to get it moving." And here we are. She did mention, I was at that point, about 3-4 centimeters dilated, so pretty good. But she was like, "I can offer you, I have a Foley. I can offer you a Foley balloon just to put a little bit more pressure on the cervix and maybe we can get those contractions to start to start up again, and then hopefully come closer together." Yeah. So she did. She put that Foley in and she waited with me at my house, and we just chatted. It came out a short time after. It took very little. I didn't have discomfort with that, thankfully.Meagan: That's, good. I mean, your cervix was starting to come forward. Things were going.Liz: It was going. Yeah, yeah. So again, she stayed with me and once the Foley came out, she just advised me to put on some sort of protective underwear whether it was the adult diapers or a pad because now we knew that my fluid was at least leaking, but it wasn't coming out consistently anymore. I don't think it fully came out. It wasn't a big enough gush for it to be all of the fluid, if that makes sense.Meagan: Yeah, yeah, yeah.Liz: So she told me to do a few things. She's like, "I'm going to head out. You're going to call me when you need me," which, at that point, I was like, I have no idea what that means, but okay. And she's like, "Here are the things that you can do. Obviously nothing in there anymore, because we know that your amniotic sac is open.Meagan: It's broken. Liz: Yeah. Yeah, exactly. But she said, "You could do some pumping. You could use some clary sage essential oil." She gave me her TENS machine, and she's like, "You could try the TENS machine." I had never known that you could actually use that not for pain management. I only thought it was for pain management. So I was like, "That's so interesting." So she's like, "Do the pumping. Do that." So I did. I did one session, I think, before I put my son to bed for the last time as an only child. I did. I went and laid down with him and just knew that was probably going to be the last time that he would wake up or the last time he had woken up as an only child. And then I did it one more time, and not only did my contractions come back, I started timing them on the app, and I'm watching them get closer. They're going from 10 minutes to 8 minutes to 7 minutes to 5 minutes. I'm just watching them like, oh, my gosh. So we get to 11-11:30 at night, and it's just me and my husband there, and they are three minutes apart, and they're not easing up, and they are getting intense. So there it was. They came back.Meagan: And labor begins.Liz: Oh, it began. It began. I have so many interesting photos that my doula wound up taking. Thank God for her. Not only for the photos, but for everything that she did during the labor and delivery. It was intense. It gets intense, or in my experience, active labor when you get the breaks between the contractions and you are able to rest. I took every opportunity to rest. My doula was trying to guide me into different positions. She would help by putting a warm compress on my back at times. She would encourage even location changes in my house just to see if I could use the toilet. She told me to get into the shower at one point. I was like, "I'm too claustrophobic in here." I didn't like that, but she was trying to get me to try different things. But it was so intense. The craziest part for me was transition. That was truly an out-of-body experience. Everybody was doing these hands-on manipulations, my husband and my doula. But I could not do anything but just sway. I was standing, swaying back and forth in my living room, arms up. Why were my arms up? I have no idea, but they were up. I was doing that horse lips, breathing. Yep. It was just what my body did intuitively. I just, at that point, wasn't really getting a break. It was just insane. So that was intense. Out-of-body. I cannot replicate that level of pain in my head. There's just no doing that, but I knew that even if I needed to transfer, which I wasn't planning, but even if I needed to do that for pain management, I couldn't sit down in a car. I was at that point, so I thought to myself, the only way to this is through this. Like that is it. You've got to do it. We're just going to do it. So I knew that in my head. At no point did the pain concern me though. I mean, was it so intense and crazy? Yeah, but it was never like, there's something wrong.Meagan: Uh-huh. Yeah.Liz: So that was really good. I didn't think anything negative during that time except that I was in an intense amount of pain. But it was like pain with a purpose, if that makes sense.Meagan: Productive.Liz: Yes, yes. In the meantime, my doula had set up a birth pool because I definitely wanted to try to be in the pool when I gave birth, but I wasn't sure how I'd feel about the water since I didn't really like the shower experience. It took a while because the hose kept slipping off of our faucet or whatever, so they had to boil pots of water. I just remember my doula walking back and forth. In the meantime, they did call my midwife. Somebody did, and she showed up with her assistant. So there were like three or four adults trying to hold me in transition or do some sort of physical manipulations and then pour hot water into this birth pool.Meagan: Oh my.Liz: Yeah, it was very interesting. But yeah, my contractions, at that point, were 30 seconds apart and they were lasting a minute and a half. It was intense, yes. But the pool was finally filled at 6:45 in the morning on Wednesday, and the only reason why I know that is because we have pictures of me right before I got into the pool. When I got in, my body just relaxed. I didn't think I was going to be wanting to be in a supine position at all, beyond my bottom at all because I couldn't have even tried to sit on land. But once I got into the pool, everything relaxed and it was like, oh, this is what I needed. This is what I needed. I needed some relief. I also kept telling everybody how tired I was. Anybody who walked past me, I was like, "I'm so tired." They were like, "Yeah, no. We know. We know, but we're going to keep working."Meagan: Yeah.Liz: But yeah, I was in there for a really short time and I had heard of this before, but to actually experience it is next level. I had the fetal ejection reflex.Meagan: Oh yeah.Liz: So I did not even have another cervical check. Nothing. My body just started pushing that baby down and out. I couldn't have stopped it if I wanted to. I was making the most primal sounds. I have video of it, like low guttural sounds. It was probably going on for about 15 minutes. My son walked down, I heard his little pitter-patter of his feet, and he walked down. My stairs go right into my living room where I was. And the whole time the most nerve-wracking part of having a home birth for me was that I knew he was going to be home with us, and there really wasn't an adult aside from my husband and my birth support team who I wanted in my birthing space. So there was no other option of anybody to take care of him besides my husband if it came to that. I think in the back of my head, that was the most anxiety-inducing part of this.Meagan: Yeah.Liz: So down he walks. And of course, he's hiding. He sees these three other adults in our living room. I'm in the tub groaning.Meagan: Yeah.Liz: He's a little nervous. He's a little guy. Fortunately, I think it was either the birth assistant or my doula handed him his little digital camera that I had actually bought as a gift from the baby for him. Yeah. She encouraged him. She's like, "Why don't you take some pictures? Take some pictures of mommy and daddy." The minute that she said that and he started to do that, he calmed down and just wanted to be in it and part of it.Meagan: Yeah.Liz: Yeah. And I told him, "Mommy's making some interesting noises, but I'm okay. I'm safe. I'm okay." And he was just really good about it. I feel like all that anxiety went away, thankfully.Meagan: Yeah. Yeah. That's awesome.Liz: Yeah. I noticed my midwife was starting to gather her supplies and in my head, I actually probably said it out loud like, "Wait, we're doing this here?" And she was like, "Yeah." I was like, "I'm having a baby here in this room." She's like, "Yeah." I was like, "I don't need to go to the hospital?" She's like, "No, no, no. You're okay."And, yeah. My body just kept pushing the baby out. And it was an hour, not even an hour. It was less than an hour from when I first got into the pool until my daughter was out. My husband got to reach down and put his hands there. As she came out, he felt her really chubby cheeks. She has big cheeks like me and her ear, and brought her up to my chest. I was just in shock. I couldn't believe that I had done that. But then, of course, I look and I see that she's a girl. I just knew my mom had sent me her. That's how I felt.Meagan: Oh, that just gave me the chills.Liz: Thank you.Meagan: Oh my gosh. That is so beautiful. I love that your son was able to be involved, and you could feel your mom. Oh huge. Congrats. Liz: Thank you so much.Meagan: Yes. Liz: My mom's name was Faith, and so my daughter's middle name is Faye because everybody who loved my mom called her Faye. She was Aunt Faye to everybody, every cousin. So my daughter's name is Luna Faye. So she is her namesake, and she's amazing. And like you said, I can't believe she's almost two. I can't believe this was almost two years ago.Meagan: Two years ago. I know. We get so many submissions and sometimes we can't get to everybody, but it does take a while sometimes. I'm so glad that you were able to come and still record your beautiful stories and give us so much detail of each one and guidance, and the experience. Yeah. I'm just so happy for you.Thank you so much. I don't think I'll ever come down from that high, that birth high. Like, I think I'll be riding it out for the rest of my life. I'm not sure I'm going to have any more children. I think we're pretty much done, but I would love to give birth like that a thousand more times. It was the redemptive story that I needed. It helped so much with my previous birth trauma, and it made me feel so strong. I have never felt more strong and more powerful than that experience. I don't think I ever will.Meagan: Yeah, well, and there's so much that went into it-- time preparing, research, finding this team, and then even dealing with the prodromal. I mean, that could be defeating within itself. You're so tired, but then you just kept going.Liz: Yeah, I kept doing the things. I mean, that was one thing that my doula and my midwife both commented on. They were like, "You did everything that you could, and you tried to control everything that you can control, and look what happened. That's amazing."Meagan: Yeah. Thank you again so much.Liz: Thank you. I'm so happy to have been able to talk to you and share my story.Meagan: Me too. Do you have any final advice to any of our listeners?Liz: I think my ultimate advice for any birthing person is to find a provider that you align with. I think they can really make or break that experience. No matter where you choose to birth or where you wind up birthing, have that provider that you trust, that you feel like you could have open conversations with. If you say you want a natural birth, they're not going to scoff at that, and somebody who's going to have conversations with you instead of talking at you.Meagan: Yeah, I agree so much. I want to add to just vet them. If they're feeling good at first, okay, stay. And if something's happening, keep going. Keep asking the questions, and if something's not feeling right, don't hesitate to change.Liz: I know. And I not only hesitated, but I knew I had to change with my first provider, and I just didn't. I think at that point, I was so tired.Meagan: Yeah well, it's daunting. It's a daunting thing. I mean, I was there too, so no shame in it. It's just hard when you realize looking back, oh, I could have. I should have done something different. I didn't, but that's okay. We've learned, we've grown, and we've had healing experiences moving forward.Liz: Yeah. 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

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

Pregnancy is a transformative journey, and for those diagnosed with diabetes—whether preexisting Type 1 or 2, or gestational diabetes—it can come with unique challenges. But managing blood sugar doesn't have to mean sacrificing an empowered birth experience.In this episode, I sit down with Megan Peasley, a certified doula, birth photographer, and childbirth educator, to discuss her personal experience navigating pregnancy with Type 1 diabetes and her advice for individuals facing a gestational diabetes diagnosis.In this episode, we cover:✔️ The differences between Type 1, Type 2, and gestational diabetes in pregnancy✔️ The emotional impact of a gestational diabetes diagnosis and how to navigate it✔️ Nutrition strategies to stabilize blood sugar levels without restrictive dieting✔️ How to advocate for yourself when discussing induction and birth options with your provider✔️ The biggest myths about diabetes and birth—and the truth behind themMegan's journey from researcher to doula is an inspiring reminder that with education, support, and informed decision-making, you can navigate pregnancy and birth with confidence.

In today’s episode Naomi takes us through her first pregnancy and admits that she was so focussed on her birth preparation that she didn’t once think about her postpartum journey. Her birth was challenging and the newborn days were full of anxiety, severe sleep deprivation and a lot of not-knowing. Four months later she learnt about traditional postpartum care which inspired her to become a postpartum doula. Her knowledge and experience informed her next pregnancy and birth; she opted for an independent midwife and a doula, planned a homebirth, filled her freezer with nutrient-dense food and employed a postpartum doula to mother her as she mothered her baby. Naomi is wise, warm and a wonderful source of information for anyone who is pregnant and hoping to plan and prepare for postpartum.See omnystudio.com/listener for privacy information.

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

Understanding Gestational Diabetes – Risks, Complications & Treatment In this episode of MamaDoc BabyDoc, we dive into gestational diabetes—a condition that affects nearly 10% of pregnancies. Join our OB/Gyn and pediatrician duo as we break down the risk factors, potential complications for both mom and baby, and the best strategies for managing blood sugar during pregnancy. We'll also discuss how gestational diabetes can impact long-term health and what steps you can take to ensure a healthy pregnancy and delivery. Whether you're currently expecting, planning for pregnancy, or just curious about the topic, this episode is packed with essential information every parent should know!

Welcome back to Dr. M's Women and Children First Podcast, where we dive deep into the latest research and expert insights on health, nutrition, and optimizing well-being. Today, we sit down with an influential voice in prenatal and fertility nutrition, Lily Nichols, RD. Lily is a registered dietitian, researcher, and best-selling author known for her groundbreaking work on real food nutrition for pregnancy. Her previous books, Real Food for Pregnancy and Real Food for Gestational Diabetes, have redefined how we think about maternal nutrition, blending ancestral wisdom with cutting-edge science. Now, with her latest book, Real Food for Fertility, she expands her expertise to help couples optimize their chances of conception and support a healthy pregnancy from the very start. In this conversation, we'll explore the critical role of nutrient-dense, whole foods in fertility, how conventional dietary advice may be missing key elements, and why blood sugar balance, gut health, and micronutrient status are essential for reproductive success. Lily's research-driven approach challenges outdated dogma and offers practical, evidence-based solutions that can make a real impact on fertility outcomes. Whether you're planning for pregnancy, supporting a loved one on their journey, or simply interested in how diet shapes reproductive health, this episode is packed with actionable takeaways. Join me in welcoming Lily Nichols, RD, to the podcast! Dr. M Real Food for Fertility

In this solo episode, I share my updates from week 35 of pregnancy!We talk about:How I'm feeling at 35 weeks pregnantWhat prenatal care decisions I made and whyHow I chose my birth team Hiring a doulaHow I chose my birth plan (and why I'm planning for a home birth)Why birth is not a medical eventManaging blood sugar during pregnancyPrepping for postpartumCreative Resources Mentioned:The Business of Being BornReal Food for Gestational Diabetes by Lily NicholsThe First Forty Days by Heng OuGlucose Goddess

Join the Calm Mama Membership: labornursemama.com/cmsLeave a review and include your Instagram username for a chance to win our monthly raffle!Trish welcomes Sara Alayev to the podcast, a seasoned labor and delivery nurse specializing in gestational diabetes management. They cover everything from the diagnosis of gestational diabetes, to practical tips for blood sugar control, mindset during pregnancy, and what to expect in labor and delivery. Sara shares her expertise on dietary adjustments, exercise, and the importance of prenatal and postpartum support. “ Everyone is different regarding gestational diabetes, but, it's something that can be controlled, and you can still have a healthy pregnancy with this diagnosis.”-Sara AlayevTrish and Sara also emphasize the emotional aspects, dispelling guilt and fear while providing actionable advice for a healthy pregnancy and delivery. 00:57 Meet Sara: The Gestational Diabetes Nurse05:25 Understanding Gestational Diabetes07:22 Managing Gestational Diabetes: Diet and Exercise Tips19:39 Labor and Delivery with Gestational Diabetes21:55 Postpartum Care and Support26:21 Final Thoughts and Where to Find More InformationMore from the Gestational Diabetes Nurse: Follow Sara on Instagram: @gestational.diabetes.nurseResources: First Trimester Secret PodcastGrab a Free Pregnancy/Postpartum Checklist BundleConnect w/ Trish: On InstagramOn FacebookOn YouTubeOn Pinterest On TikTokFor more pregnancy & birth education, subscribe to The Birth Experience on Spotify, Apple Podcasts, or wherever you listen to podcasts.Produced and Edited by Vaden Podcast ServicesNext Steps with LNM:If you are ready to invest in your pregnancy & postpartum journey, you are in the right place. I would love to take your hand and support you in your virtual labor room!If you are ready to dive into a birth class and have your best and most powerful birth story, then Calm Labor Confident Birth or The VBAC Lab is your next step.If you have a scheduled cesarean, take our Belly Birth Masterclass and own that experience. If you are a newly pregnant mama or just had the babe, you want to join our private pregnancy and...

Unlock the secrets to understanding gestational diabetes with our special guest, Professor Fionnuala Breathnach, an associate professor in obstetrics and gynaecology. Join us as we explore the ever-evolving landscape of parenting, particularly for those stepping into parenthood later in life. From the diabetogenic nature of pregnancy to the quirks of glucose tolerance tests, Fionnuala helps us untangle the medical from the natural, changing how we perceive pregnancy-related conditions. Together, we'll challenge the "new year, new me" mantra, embracing a more realistic approach to self-improvement and emotional acceptance.   This episode is packed with insights and revelations as we cover the spectrum of gestational diabetes management. We move beyond the traditional hospital-centric care towards empowering self-monitoring strategies that ensure women can take charge of their health. Misconceptions about gestational diabetes being symptomatic are debunked, highlighting the silent nature of this condition. We examine the role of postnatal glucose tolerance tests in identifying hidden type 2 diabetes risks and discuss how a diagnosis during pregnancy can become a crucial turning point for long-term health and lifestyle changes. Learn more about your ad choices. Visit megaphone.fm/adchoices

Be Well Moments brings you my favorite bite-sized highlights from the season. Enjoy quick insights from our longer conversations in a digestible format. If you'd like to listen or watch the full episode, click the link below.What's behind the rise in autism and ADHD? In this clip, we dive deep into the connection between gestational diabetes, neurodevelopmental differences, and metabolic health. Learn how nutrition, environmental factors like microplastics, and holistic approaches such as the Mediterranean and ketogenic diets might hold the key to prevention and support. Unlock the insights that could change the way we think about mental health and pregnancy.Listen to the full episode here.Watch the full episode on YouTube here.***Thank you to my wonderful sponsors! FREE Ridiculously healthy coffee works well for me.Use code FREETRIALSARAH for your free trialhttps://exhalecoffee.com/pages/sarahSquarespace FREE trial | A website makes it real.http://squarespace.com/LiveWellGet a free trial and use code LIVEWELL for 10% off your first website or domain ***If you enjoyed this episode you might also like:How to Reset Your Vagus Nerve & Unlock Better Mental Health | Radhika Dashttps://www.youtube.com/watch?v=8rUi49Iiq0U&t=2sYung Pueblo's ONE Habit That CHANGED His Life Foreverhttps://www.youtube.com/watch?v=a5_16t0gIlk&t=115sDr. William Li: Can Diet DAMAGE Your Blood Brain Barrier?https://www.youtube.com/watch?v=UrCxdniSLiU&t=115s***Fuel Your Mind Weekly: Subscribe to Our Free Mental Wellness Newsletter

Abigail's first pregnancy turned into a life-threatening birth experience with undetected gestational diabetes and a traumatic ICU stay. On top of that, she unexpectedly had to move homes just two weeks postpartum. Abigail quickly developed intense postpartum depression and struggled to make sense of what happened to her. She was sure she would never have kids again, but after therapy and healing, she and her husband found themselves wanting another baby three years later. Abigail became pregnant right away, and she knew this time would be different. This time, things would be better. From the meticulous monitoring to the candid conversations, Abigail felt heard and supported throughout her entire pregnancy. Her gestational diabetes was detected and very controlled. While a scheduled C-section seemed to be a logical choice, she knew her heart wanted a VBAC. She was able to go into spontaneous labor and pushed her baby girl out in just 13 minutes!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome to the show, everybody. We have our friend, Abigail, from California with us today. She is a 27-year-old stay-at-home mom with a 4-year-old daughter and a 7-month-old son. She experienced a very unfortunate, traumatic experience with her first which really left her not really sure that she wanted any more kids. She's going to dive more into her wild experience, but she had a COVID pregnancy. She had a lot of different stresses through the pregnancy, especially at the beginning– gestational diabetes, preeclampsia, and so many things with her first that really taught her a lot, and had a wild birth experience. Then the second time, she ended up getting gestational diabetes again, but did a lot of different things to improve her outcome like hiring a doula, getting a supportive provider, and all of that. We are going to turn the time over to her in just one moment, but I do want to quickly in place of the review share a couple of tips for gestational diabetes. If you guys have not heard about it so far, check out Real Food for Gestational Diabetes by Lily Nichols. It is absolutely incredible. It is less than 200 pages long. It is a fantastic read and filled with a lot of really great information and studies. She also talks about prenatals, so I wanted to remind everybody that we have a partnership with Needed who we just love and adore. We do have a promo code for 20% off. You can get your 20% off by using code VBAC20. Definitely check that out.Then we are going to be including a lot of things in our blog today like third-trimester ultrasounds, sizes of baby, and gestational diabetes so make sure to dive into the show notes later and check out what we've got. Okay, my darling. I'm so excited for you to share your stories today. I feel like there's part of your story that I want to point out too before you get going, and that is that sometimes you can plan the most ideal birth scenario, and I'm not going to talk about what this scenario is, but a lot of people are like, “Do this. Do this. Do this.” Sometimes you plan it, and then your care falls short or something happens and plans change. If you guys are listening, I just want you to dive in. As you are listening to Abigail share her stories, listen to how sometimes things change and what she did, and then what she did differently to have a different experience. Okay, Abigail. Abigail: Hello. First of all, I just want to say that I'm really happy to be here today. Thank you for having me today. Meagan: Me too. Abigail: Yeah, I guess let's just dive right in. Meagan: Yeah. Abigail: First thing is I am a stay-at-home mom, so my mom is out in the living room with my babies right now, and at this point, my son is 7-months-old, and we are having a really good time over here. I just want to start by saying that. Basically to start with my story, I got pregnant for the first time in January of 2020. Everybody knows what else happened in 2020. I was, I think, about 12 or 13 weeks pregnant when everything completely shifted. Everything started to shut down. There was a chance that I was going to get laid off of work which I did end up getting laid off of work about a week later. It was not a fun time. My husband and I had an apartment. We lived in a place we had just moved to. We had been there for about 3 years. We had a roommate, and everything was totally fine. Everybody worked full-time. I was working out regularly. We had a pretty chill life. Go to the farmer's market on the weekend. I was really excited when I found out I was pregnant. I was like, “Okay, yeah. We are going to bring a baby into this. Let's do it. I love what we're doing.” So again, everything completely shut down and shifted. Our roommate decided he wanted his own space, so he gave us a 30-day notice. We were stuck in a situation where they were raising our rent because our lease was up. We would have had to re-sign. It would have cost us more and everything, so we were looking at having to move because our roommate was moving out. It was all not a very fun time, so we decided to move back to where we were from, rent a room from a family member, and stay with them for the time being. They had a little bit of extra space for us. We thought it would be totally fine and everything. We moved when I was about 20 weeks pregnant. Up until that point, I had regular OB care at a regular office. I had done all of the blood work and everything and the ultrasounds and the anatomy scan and everything up until 20 weeks. When we moved, I decided, “Okay, I think I want to have the baby at home, especially now since the pandemic.” I don't know that I really wanted to go to the hospital, but I wasn't sure that I wanted to do that to begin with. I grew up in a community where home birth was pretty normal. My mom had my younger brother at home. Several of my friends were born at home and their siblings when we were younger. It was a pretty normal thing to me. I reached out to a team of midwives. I talked to them, and got everything set up. I started doing appointments with them. They were coming over to my house fairly frequently. It was pretty nice doing the regular blood pressure checks and the urine samples with the little sticks, and all of that stuff. When it came time for the gestational diabetes testing, I was like, “Okay, is this something I have to do?” I didn't have my insurance set up at that point or anything because we had just moved so we would have to pay out of pocket for it. I would have to go sit in some lab or office some place. Again, during COVID, while I was pregnant, I was like, “I don't know. If I don't have to do it, I don't want to. If I have to, I will. What are we doing here?” They were like, “Well, you're low-risk. These are the risk factors. If you don't want to do it, you don't have to. You just have to sign this form.”I was like, “Okay, cool. I'll sign the form. Seems easy enough.” I totally skipped the gestational diabetes testing. That was on me, but it wasn't on me at the same time because I don't feel like I was given proper informed consent. There was a team of three midwives plus a student, so a total of four that I was seeing. One of the midwives ended up getting switched out at about that point, so it ended up being the student, the same original two, and then one newer one. Everybody was really nice. They were coming over and checking on me and doing all of the things that I thought they were supposed to be doing. I was not weighing myself. We did not have a scale. Again, they didn't tell me that it is important to make sure that you're not gaining too much weight at a time or anything like that. What happened was, I started gaining a lot of weight, but I didn't really realize just how much weight I was actually gaining. I was like, “Oh, I'm pregnant.” I quit going to the gym. I can't even hardly do anything. It's hot out. It's summertime. I was pregnant from January to September, so the bigger I got, the hotter it got.I didn't do much, so I was like, “Whatever. I've gained some weight. It's not a big deal.” I was a pretty small person to start with. Just for reference, I'm 4'8”, and I was 95 pounds when I got pregnant initially, so really small. It started becoming concerning because toward the end of my pregnancy, and toward I guess not even the end, the beginning of my third trimester, I started getting really swollen. Like, really swollen. My feet and my legs up to my knees– not just my feet, but my calves and everything were pretty swollen. Toward the end of my pregnancy, I had swelling up to my thighs. I'm being told this is normal. I'm 23. I've never been pregnant before. I don't have any support groups or anything going because it's COVID. Nobody wants to talk to anybody or do anything. It was a little frustrating for me because they were like, “Just put your feet up. Soak your feet.” If I soaked my feet, they got more swollen. I was not taking proper care of myself either. I went from exercising and eating right and doing all of the things that you are supposed to do to sitting at home and eating a lot of fast food and not walking. I was not having a great time mentally either. We were living some place I didn't want to be living. It was all of it. I didn't think too much of it. Again, I'm like, “Well, I'm being told this is normal. I'm gaining some weight. It's fine.” At one point, one of my urine tests that they did came back positive for glucose, and they were like, “Well, what did you eat for breakfast?” When I told them, I was like, “I had some waffles. I had some orange juice,” and whatever else I had, they were like, “Oh, you just had some orange juice before you got here. That's fine.”I was like, “Okay.” They didn't think to check it again. I didn't think to get a second opinion or anything. At one point toward the end of my pregnancy, I had a blood pressure reading that I checked myself at home with the little wrist cuff. That was really elevated. It was the end of the day. I texted the midwife. I was like, “Hey, my blood pressure is really high.” She was like, “What did you do today?” I was like, “I didn't really do much. I ate this for lunch. I had some soda.” She was like, “Okay, well that's probably fine. Just rest and check it again in the morning.” I checked it again in the morning, and it was still relatively normal, so they didn't do anything. One of the midwives came over at one point and dropped off some herbs for me that they wanted me drinking like some tea or something like that because I was getting swollen. I was standing outside talking to her, and she was like, “Oh my god, I can see your feet swelling up while we are standing here. You need to go back inside and put your feet up.” Again, nobody thought anything of it. How four people missed all of this, I don't know. I feel kind of like the student may have been more concerned, but didn't really know how to say anything or anything, just looking back on the facial expressions she would give and things like that. I go into labor right at 40 weeks. I am planning a home birth. Everything is set up for that. I've got the tub at my house. We've done the home birthing class and how to get everything set up. We've done all that. There was no backup plan in place. They did not suggest that I have one. Again, I did not know any better at the time. I was told that if there was some kind of emergency, I would go to this hospital. That was as far as it went. I didn't have a backup bag ready. I didn't have a hospital bag ready. I didn't have anything planned. There was no, “Hey, this is what we watch out for. This is what you might go to the hospital for.”I go into labor at 3:00 AM. Honestly, contractions started, and they were immediately painful. I've never done this before. I'm like, “Okay well, maybe we're just starting out harder than I thought. That's fine. Maybe there's not going to be early labor.” I labored for a couple of hours. I was really uncomfortable, so I called the midwives. They came over. They checked, and they were like, “Okay, you're only at 2 centimeters, and this is seeming like early labor.” I'm like, “This really painful. I'm not having a good time. This does not feel okay at all.” They checked my blood pressure. My blood pressure was through the roof. They waited a little bit, checked it again, and it was even higher the second time. They were like, “Okay well, this is out of our care. You've got to go to the hospital now.” I'm like, “What do you mean I've got to go to the hospital? That's not part of the plan here. We don't even have a plan B or anything.” Through tears and contractions and everything, I was having contractions maybe every 10 minutes or so, 5-10 minutes. Somewhere around there, I don't remember exactly. I got a hospital bag ready. I got some clothes for the baby together. I got my phone charger, my toothbrush and everything, and we headed to the hospital. I sat in triage by myself for 4 hours because they did not have a bed available for me. They would not let my husband into triage with me because it was COVID. The entire time, I was so uncomfortable. They had me immediately start on blood pressure medication to try to get my blood pressure down. They started me on magnesium, and they told me that the magnesium was going to make me feel yucky which is the biggest lie I have ever been told by a nurse. I don't know if she just never had it or what, but I felt like you have the worst flu you've ever had. My whole body hurt. It made everything feel worse. I felt groggy. I felt sick. It was not fun at all. At that point, I think I got to the hospital at 11:00 AM. They didn't get me into a room until 3:00 or 4:00 that night. So at that point, I'd been in labor for 12 hours. I was still hardly dilated. The doctors, initially when I got there, said, “Your notes say you are only 2 centimeters. Why are you here?” I was like, “I don't know. I was told to be here. I was told that my blood pressure is high or whatever. I don't know. I don't want to be here.” They did all of the things. They ran all of the tests. The doctor comes back in and says, “You are severely preeclamptic. Why did you not get here sooner?” Meagan: So why are you here and okay, why weren't you here sooner?Abigail: Yeah. I was like, “I'm so confused. I don't want to be here.” I'm freaking out. I'm stressing hardcore. My blood pressure went down for a little bit, but it stayed really, really, really high. They put me on fluids and everything which of course, did not help with the swelling. They get me into a room and everything. Things are moving along. It's going fine. I was okay for a little bit, then it got to the point where my legs were so swollen that I felt like they were going to pop. My legs felt like balloons that were going to explode. They were trying to put compression boots on me and stuff in the bed. Every time I was having a contraction, I was trying to get up and get moving because it felt better to get up and move. They were taking the boots on and off. It was miserable. After, I think, 28 hours of labor at that point, I was like, “Okay. I would like an epidural, please. I really don't want to have to get out of bed. I can't do this. I want my legs up. I don't want any part of this.” They got me an epidural. I don't know exactly how many centimeters I was at that point, but things had not moved very far in 28 hours. The doctor kept pushing to try to break my water. I kept telling her, “No, thank you. I don't want that. It will break on its own. I would like to take a nap.” I took a nap. My water did break on its own. That was nice. The water was clear. Everything was fine. We are still moving. I have an epidural. It's working great. I'm laying in bed. My blood pressure was still high. The swelling was still bad, but other than that, everything was maintaining. We were fine.I continued laboring for a while. I was getting checked pretty frequently because the doctors were uncomfortable with the situation. Again, looking back, I realize why they would be uncomfortable with the situation. They kept checking me and trying to want to do stuff. I was on Pitocin at that point. They had started it at some point, I think, shortly before I got the epidural. I had been on that for a while. It had been from being okay to all of a sudden, I was not okay. I don't remember exactly what hour that happened. It was somewhere between probably 36-ish. I was dealing with some stressful stuff with some family members. I was not having a good time. My phone kept going off. I was just trying to rest. It was a miserable time. They said that I was getting a fever all of a sudden. They were like, “You're getting a fever. We're going to see what we can do.”  They tried to give me Tylenol to bring it down. They tried putting a cool rag on my face. They were trying to get me to eat ice. At that point, they had completely stopped letting me eat because initially when I got there, they were letting me eat a little bit, but that stopped. They wouldn't let me drink anything, so they were giving me ice chips and stuff. I started getting to the point where I was feeling really sick, like more sick than I already felt. They checked me again, and depending on which doctor did it, I was at a 6 or a 7 still. They finally called it. They were like, “You have an infection. You are not doing okay. This is not okay. You need to have a C-section now.” Crying, I was like, “Okay, fine. That's not what I want, but let's go.” They prepped me for the OR, got everything moving, got me back. By the time I got in there, it had been 38 hours. I had an epidural for about 12 of those hours, I guess. At that point, it wasn't working super well anymore. It was not working well enough that they could do the C-section, so they put in a spinal as well. I had both of those done. To my understanding, they are two different pokes. Again, I didn't want either initially, and I got both. I was not thrilled about that. I'm laying on the operating table. I was so thirsty. They wouldn't give me anything to drink. They kept giving me this moist sponge. They said that I couldn't suck on the sponge. I could moisten my mouth with it. They gave me some stuff to drink that said it was going to make it so I didn't throw up. I wasn't nauseous at all the entire time. I hadn't thrown up at any point at all. I was like, “I don't want this. I don't need it.” The stuff that they gave me tasted awful, and they wouldn't give me anything to rinse it down. My mouth is dry. I'm gagging from how dry my mouth is, and the stuff tastes bad. They have me strapped to the table. My arms are down. I just laid there crying. The C-section went fine. They got my baby out. She was okay. She was 7 pounds, 12 ounces. For somebody who is my size, I was like, “Wow. That's a really big baby.” That was surprising. So they get me sewn up and everything. They let me look at my placenta, and it was four times the size of any placenta I have ever seen. It was like a dinner plate sized, but a couple of inches thick, like really thick. I was like, “Okay well, that's really weird.” They moved me and the baby to recovery. My husband was with me. Everything was okay. Everything calmed down. We were okay now. We've got this. It's fine. Then all of a sudden, the nurse was like, “I don't like your bleeding.” This is the same nurse I had for two or three nights because at that point, I had been in labor for 46 hours. It was 46 hours by the time they took my baby out. I started labor initially on the 28th at 3:00 AM, and my baby was born on the 30th at 1:00 AM, so almost a full two days. She's like, “I don't like your bleeding.” I'm like, “Okay.” I'm really out of it. I'm not really paying attention. I'm trying to nurse my baby. I can hardly move. I'm uncomfortable. Next thing I know, there are more people coming in, more doctors coming in, more nurses coming in. They take the baby from me. They hand the baby to my husband, and they shove them out. I'm just screaming, “Please don't give my baby formula.” I don't know what's going on. I don't know where they're taking her. I was trying to nurse her, and I'm so confused now. Next thing I know, there are 10 people surrounding my bed. It's three doctors and seven nurses. I had one IV in my hand initially, or in my arm or wherever they put it. Next thing I know, I had two more IVs. There was one in my other arm and in my other hand. They put some pills up my backside, and I'm so confused what's going on at this point. I'm still numb from everything from the spinal and the epidural and everything, so I can't feel what's going on. She's pushing on my belly. She's changing the pads under me. Everyone is freaking out.Meagan: Wow. Abigail: I am fading in and out of consciousness. I don't know what's happening. My husband's freaking out. My blood pressure had dropped to 25/15 I think. Meagan: Whoa. Abigail: I was about to die. They finally got me stable. I don't really know what happened exactly. All I know is the next thing I know, I woke up and I was in the ICU. They wouldn't let my husband come see me. They wouldn't let me see my baby. I'm with a bunch of COVID patients and everything. They gave me two or three blood transfusions. They put a balloon in my uterus to apply counterpressure so that it would stop bleeding, and they had a bucket attached to it. I'm watching them just empty buckets of my blood. It was so scary. I'm laying in the ICU by myself, and the balloon in my uterus hurt so bad, like, so bad. I didn't end up moving. I laid there for the rest of that night, the entire next day, the whole next night, then I think they moved me the next day. It was a night and a half plus a whole day that I just laid there by myself. Meagan: Wow. So scary. Abigail: It was so scary. The nurses came in at one point and were trying. I think it was the lactation consultant maybe. They were trying to get me to pump and everything. I think I pumped once or twice, but I was not up for doing anything. If they didn't come in and sit me up, they didn't really do it. I finally get the balloon taken out because that was what I kept begging for. I was like, “Please take this out. It hurts so bad. The pain medications aren't helping.” I didn't want to give the pumped milk to my baby as it is because I was on so many pain medications and so many antibiotics and everything else. I get the balloon out finally, and I think they took it out that night then they moved me the next day. They moved me to high-risk maternity, and they let me take a shower and eat some food and stuff before they brought my baby back from the nursery because she was fine in the nursery. That was nice to be able to take a shower and wash off all of the blood. I was so covered in blood and everything. I looked at my C-section scar and everything for the first time, and I realized I had a reaction to the tape that was on it and stuff too, so my skin all around it was all irritated. All up and down my arms had been profusely poked and prodded because they were checking my blood every four hours because of the infection and stuff. Depending on the lab tech's skill and everything, it was not going well for some of them. They kept having to poke me. The IVs weren't working for them to take blood from or something like that so they just kept having to poke me more. Again, I was having reactions to some of the tape, so my whole arms are just completely raw and everything. I was still very swollen. I was very, very, very swollen still. They had compression socks and stuff on at this point, not boots at least. They finally bring my baby to me, and then we ended up spending three days in high-risk maternity, so total, that was two days in labor, almost two days in the ICU, and three days in the high-risk maternity. Total, I spent seven days in the hospital. I get home, and they had me on blood pressure medication for a few weeks until I think my six-week appointment when I followed up, and then my blood pressure was back to normal, so I was able to quit taking the blood pressure medication and stuff. I dropped 30 pounds instantly because it was all of the swelling that just came off. I had still gained a lot of weight, but it a huge chunk of it was swelling which is so bad. It was finally over. I was settled. I'm in bed with my baby, and then the family member we were living with decided that they didn't want us living there anymore, so at three weeks postpartum, we had to move. I had only been home from the hospital for two weeks at that point. I didn't know what was going on. I didn't want to be around the situation. My husband was dealing with it. I ended up going on a road trip with my grandma to go stay with a different family member out-of-state just to make sure my baby wasn't anywhere near anything that was going on. Three weeks after a C-section and almost dying, I was driving and doing a whole bunch of other stuff– going out, walking around, and trying to put jeans on. I couldn't figure out why my clothes didn't fit. I didn't realize just how big I had gotten. It was not a fun time. It was about five days out of town, then I moved into a different family member's house temporarily where I was completely isolated by the people that I was living with. They did not understand what I was going through. They thought that I was choosing to be difficult intentionally, so that created additional problems. I ended up getting pretty bad postpartum depression which is really not a surprise. I still didn't understand what had happened to me. I still didn't understand why I had almost died. I still didn't understand. I didn't know if I had done something wrong. I didn't know what was going on. I spent a lot of time really upset over the fact that everything went wrong, and I didn't know why. Life was falling apart around me. I was not doing okay. It turned into really bad postpartum depression pretty quickly. My husband and I got our own apartment when my baby was four month's old. I was like, “Okay, things are finally going to get settled. Things are going to be okay now.” It did not settle. My depression got worse, and I didn't even know what to do. I was eating a lot because I was like, “I'm breastfeeding. I need to eat.” I basically just sat at home, didn't do anything but eat and nurse my baby. I was very thankful I was able to successfully breastfeed my baby after everything that happened to me. All of the nurses at the hospital were surprised about that and stuff. Meagan: Yeah, with the amount of blood loss and everything, that's pretty rare. It's pretty rare. Abigail: Yeah. I never ended up giving my baby a bottle or anything because I was so scared that if I tried to give her a bottle or something that it would mess up my breastfeeding, and that was the only thing that had gone right. I was doing okay for a little while, I thought, but it was not okay. I was really not okay. I was very, very sad. I was fully convinced for a period of time that they should have let me die at the hospital. I was fully convinced that the doctor did me a disservice by trying so hard to save me. Meagan: I'm so sorry. Abigail: Yeah. I finally started therapy. I started trying to get up and do more and not eat so much and get moving. I think finally around the time my daughter was a year or a year and a half, I started to feel a little bit better, and things slowly did start to get a little bit better for me, but I was fully convinced that I did not want more kids. I was like, “I am never going through that again. I do not want another C-section. I don't know what happened to me, so obviously, I would have to have another C-section because we don't even know what went wrong.” It took me until my daughter was almost three. She was about to be three when all of a sudden, my mindset shifted, and I was getting mad at myself for feeling like I wanted another baby because I was like, “I don't want another baby. Of course, I don't want another baby. I made that very clear.” We got rid of all of the baby stuff. I told everybody I wasn't having more. What was wrong with me? I was fighting internally with myself because I wanted another baby, but I did not want another baby. It was insane. I kept it all to myself. I didn't say anything. All of a sudden, my husband was like, “I think we should have another baby. I was like, “What are you talking about? You're insane.” He was like, “No, really. I think we should have another baby.” I was like, “You shouldn't have said that because I want another baby.” Meagan: Yeah. I have been actually thinking the same. Yeah. Abigail: Yeah. I was pretty surprised that I got pregnant right away. Literally, within a couple weeks, I was pregnant. It was a good thing and a bad thing because it didn't give me a chance to overthink it, but also, it was like, “Oh no, I haven't even had a chance to think about this. This is definitely what's happening.”I started going to the doctor right at five weeks. They started doing ultrasounds right at five weeks. They were checking me for everything every time, all of the time. I had so much anxiety. I made that very clear to them. I think that's part of the reason that they checked everything all of the time and were trying to be more reassuring. They did ultrasounds at almost every appointment. Most people don't even get an ultrasound until 12 or 20 weeks. Meagan: And then that's the only one. Abigail: I had four of them before I even went for my anatomy scan. They were trying to watch everything and make sure everything was fine too because again, they didn't do my care last time. This OB place did my follow-up care afterward. They saw the aftermath of everything, and they were concerned and stuff. That's what we were dealing with. I was dealing with some nausea, so they gave me some pills for that. Come to find out, one of the side effects of one of the medications they gave me was anxiety. I was fighting a losing battle with myself because I was taking these pills for the nausea. I wasn't eating because I was anxious, and I wasn't eating because I was nauseous, then I was getting more anxious. It was a rough first 20 weeks I would say. Then I did start feeling better, thankfully, so I was able to start eating and stuff again. Once I felt better, I was eating ice cream and all of those things that I wanted and all of that. It was fine. I was doing fine. I was doing all of my appointments and stuff, then it comes up for my gestational diabetes testing. The doctor says, “You need to do this,” and immediately, I was like, “Yes, please. I need to do that because that's one of the things I didn't do last time. I need to do everything to make sure I'm good.” I need to backtrack a minute, I'm so sorry. At my first intake appointment at five weeks when I met with one of the– they're nurses, but it's not the nurse who actually checks you and stuff. They have an office at the OB's office, and they check in, and they ask, “Do you have transportation for your appointments? Do you need help with anything? Do you have access to food? Are you in a safe relationship?” I let them know what had happened previously with me, and she was like, “Oh, well then you might be interested in this. This is something new your insurance covers. You could get a doula if you wanted since it sounds like you wanted to have a more natural experience last time.”Meagan: That's awesome. Abigail: Yeah. Immediately, I was like, “Hell yeah. Let's do that.” I didn't have a doula last time. Again, last time was COVID. I was already trying to pay for the midwives. It wasn't something I thought about one, because I thought I was having a home birth with a couple of midwives. I didn't think I needed a doula. Also, I didn't fully understand what they were and the actual extent of the benefits of them. I was like, “Yeah, totally.” The first thing I did when I got home was call. They were like, “Yeah, we take your insurance. We can get you set up. We're taking new clients. Let's get you in for an appointment.” I started seeing a doula sometime in my first trimester. I don't remember exactly when, but I remember I pulled up the office and I got out. I was like, “This can't be right. This is too nice. There's no way my insurance covers this.” I was shocked at the care I received from my doula service. I'm just going to go ahead and give them a quick shoutout just because they are amazing, but it's Haven for Birth in Sacramento, California, and they do amazing work for a lot of different things. I still attend lactation meetings and stuff with them monthly. Meagan: That's awesome.Abigail: It's such a great team of people. I got the doulas that they set up for me because there are two of them. There's a main one and a backup one. My main doula's name was Heidi, and the backup doula's name was Francine. They were both so sweet and wonderful. Heidi has been doing doula work for a good amount of time. She owns a chiropractic business and Haven. She's the main one, and she's the one who has dealt with higher-risk pregnancies and things like that, so she was my main source of support and throughout everything. I would text her if I needed something. She was so reassuring. She was like, “Yep. You can totally have a VBAC if that's what you want to do.” I was like, “Really? I can do that, okay. I'm going to talk to the OB about it.” The OB was like, “Yeah. It's completely up to you. As long as you are fine and we watch everything, that's fine.” I really did feel like they were supportive. It wasn't like, “Well, if you are okay, then you can.” It was like both of the OBs that I had seen, one of them was a guy and one of them was a girl, and both of them were like, “Yeah, as long as we keep everything in check, you are totally fine. I don't see why you couldn't.”I started to feel a little more confident in that. I had a lot of anxiety about it and for a couple of weeks, I did contemplate scheduling a C-section just to ease my own anxieties, but I didn't feel right with that choice. I really didn't. I was like, “I need to try.” It was tough, though, because I was like, “I don't know how I'm going to deal with the feelings of trying and not succeeding,” so that was the struggle of, “Do I want to just have a C-section that way? I get what I want no matter what,” but I didn't feel like I wanted to do that. I worked really, really, really hard to get my VBAC is basically what ended up happening. Back to where I was, I get my gestational diabetes testing done, and the first-hour one comes back really high. I'm like, “Okay, that's concerning.” I texted my doula about it. She was like, “It's okay. You're going to do the three-hour one. You'll probably pass the three-hour one, but even if you don't, it'll be fine.”I failed the three-hour one really bad. My fasting number was fine, but the rest of the numbers were very elevated, not even just a little bit. I was like, “Oh, okay.” This is all starting to make sense. I had a lot of anxiety initially about what I could or couldn't eat because I didn't feel the greatest, and I was letting myself eat what sounded good to make sure that I was eating. It was a rough week initially when I got that, then it took them a minute to get me the referral in for the program, the Sweet Success program where I was actually able to talk to nurses and dieticians there. Once I finally got in with them, I met with them a few times throughout the end of my pregnancy. I did feel very supported by them. They were very nice. The dietician was willing to meet with me one-on-one instead of a group setting because I was having issues with eating and not wanting to eat and feeling very concerned that I was going to hurt myself or hurt the baby.They did a very good job making sure that I was cared for. We completely changed up my diet. I started walking after every meal. I started checking my blood sugar four times a day, so first thing in the morning, then after breakfast, after lunch, and after dinner. I basically, immediately after eating, would get up and do the dishes or clean up the food I had made or pick up the house or start some laundry or something so that I was getting up and moving. Only a couple of times, there was only once or twice where my blood sugar numbers were higher than they really wanted by more than a point or two. I did a really good job keeping those in check with what I was doing and watching what I was eating very closely and monitoring my portion sizes and realizing what I could and couldn't eat. Once I got to the point of 36 or 37 weeks or whatever where they were like, “Okay, this is the plateau. It's not going to get worse than this,” and I realized I was able to keep it under control and things like that, I would let myself have a couple of bites of a cookie here and there. It wouldn't spike my blood sugar or anything because I was doing everything I needed and that made me feel really nice because I was able to eat the stuff I really liked as long as that was within reason.We met with the doula multiple times. She came over and did a home visit at 37 weeks. I had been having Braxton Hicks contractions from the time I was 19 weeks because we got COVID. We got RSV, and we got a cold. We got a cold. We got COVID, and we got RSV. Meagan: Oh my goodness. Abigail: Yeah. That was the whole first half of my pregnancy along with dealing with nausea and everything else. I found out I was pregnant the beginning of September. We got a cold in October. I got COVID in November, then in December, we got RSV, and my daughter who was three at that point spent five days in the hospital, so I spent five days in the hospital right next to her dealing with RSV while I was pregnant. I feel like the coughing kickstarted Braxton Hicks contractions almost because at that point, I started having them pretty regularly. From 19 weeks on, I had tightenings all the time. Some days, they would be worse than others, but because I was so active, it definitely– I never got diagnosed with irritable uterus or anything, but I think that's what it was because it would get really irritable when I would do pretty much anything, and I was doing things all of the time. At 35 weeks, my contractions started getting fairly intense-ish. They weren't painful at all, but it was every 3-5 minutes, I was contracting. I drove myself to the hospital. I was like, “I'm fine. I'm not concerned.” I didn't bother my husband or my doula or anything. I let her know I was going, but I was like, “Don't worry about it.” They hooked me up. They checked me and everything. they were like, “You're hydrated. We don't need to give you fluids or anything.” They were like, “How are you feeling? You've got to tell us if they hurt or not because we can see them on the monitor, but you've got to tell us how you're feeling.” I was like, “I just feel annoyed. They tighten up, and it's uncomfortable when they do, but nothing hurts. I'm annoyed.” They were like, “Okay, let's check you.” I was still completely closed with no baby coming down. So they gave me a single pill to stop them and sent me home. It worked. It slowed them down for the rest of the night, then they kicked back up to their normal here and there the next day. But for the next couple of weeks, I kept it fairly easy. If I noticed I started I was having more of them, I would try to go lay down. I was able to have my baby shower at 36 weeks which was wonderful because I had not had a baby shower for my first baby because of COVID. I feel like 36 weeks was almost pushing it because my family had asked if we wanted to have it later to have somebody else be able to join us and I was like, “No, no. Please don't push it later. I don't trust that.” It was like I knew that he was going to come just a little early, but I was doing all of the things and still having the regular Braxton Hicks contractions and everything. They were doing multiple growth scans on my baby because he started measuring small at 28 weeks, I think. At his 28-week scan, they noted that his kidneys were slightly enlarged, so they wanted to follow up on that. They followed up on that at 28 weeks. His kidneys were completely fine. We never had another incident with that, but they noticed he was measuring a little smaller so they started doing regular checks. By the end of my pregnancy, I was having a growth scan every week, so they went from, “Let's check you in six weeks. Let's check you in four weeks. Let's check you every two weeks. Let's check you in a week.” They noticed he was measuring small, and he continued measuring small. Meagan: They were regressing, or he was staying on his own growth pattern but small?Abigail: He was growing but not a lot. Meagan: Okay, yeah. He was staying on his own pattern. Abigail: They didn't want him to drop below the 10th percentile, and if they did, they were going to be concerned. He did get right to the 9th or 10th percentile, so they did start to get concerned. They labeled him IUGR. They were doing non-stress tests on me twice a week. Basically, by the end of my pregnancy, I was seeing the OB, the place for the non-stress tests, the gestational diabetes program, the place for the ultrasounds and growth scans, a therapist, a hematologist because I ended up having to have iron infusions and B12 injections, and the doula's office, so seven places. Almost all of them wanted to see me every week. Meagan: Whoa. Abigail: I was running around, super active towards the end of my pregnancy. I was still taking my daughter out and doing all of the things with her as well. I noticed after my baby shower at 36 weeks that my feet were just a little puffy, and I was like, “Huh. That's funny.” It hit me all of a sudden. I was like, “My toes are kind of pudgy.” I'm 36, almost 37 weeks pregnant, and this is the most swollen I have gotten. It was not up my legs. It was not even in my whole feet. It was my toes and the top of my feet, not even my ankles. They were the tiniest bit puffy. I had this moment of clarity where I was like, “How did nobody notice that something was so wrong with me?” I was shocked because I'm looking at myself and I had gained a total, by the end of my pregnancy with my son, of 25 pounds, and that was it. With my daughter, by the end of it, I had gained 70 pounds. Again, how did nobody notice? I am shook. I thought on that for a long time. I'll come back to that, but I thought on that for so long. I ended up emailing the midwives who had provided me care. I was having a day. I went off on multiple people that day. I was not having it, and I emailed them, and I sent them a four-paragraph email about how they let me down. They should have known better. Somebody should have noticed something was wrong. They should have asked for a second opinion. It was ridiculous. I was shook that they didn't push harder for gestational diabetes testing, and all of the things because clearly at this point, I realized that my blood sugars being in control has made all of the difference. Not knowing, you can't do what you need to do which is why I'm such a big advocate for informed consent and gestational diabetes testing. I know sometimes I see people saying that they want to skip it because they are fine. I had zero of the actual risk factors, and I still had it. I'm just putting that out there. That's my main thing for this. Definitely get checked, and stay active, and watch your blood sugars because it's a really, really serious thing. I literally almost died. Sorry, I keep jumping around. My son was measuring small, so they started doing all of the tests and everything, and they couldn't find anything wrong. They were like, “Your cord dopplers look great. The blood flow looks great. Nothing specifically is measuring small. His head is not measuring smaller than the rest of him.” He was very, very, very low in my pelvis. I was waddling from 32 weeks on. He was low the entire time. I could feel him moving regularly. He was super active. I felt confident in myself. I felt safe. I felt good. they were telling me he was fine. Everything was looking fine. My fluid levels were looking good. My non-stress tests were always good. They make you sit for a minimum of 20 minutes, and if they don't see what they need to see in 20 minutes, then you need to stay longer. I never had to stay longer than 20 minutes. It was always in and out. He was always moving. His heart rate was always good. When they started mentioning induction at 37 weeks, I was like, “I don't want to be induced. I don't. There's really no reason.” They were like, “Well, he's measuring small. Your other baby last time was so much bigger. He is so small. This is such a concern.” I was like, “But I think there was something wrong with me and my baby last time. I don't think she should have been that big for me.” I thought that was the problem. I tried explaining that to them that I think they had it backward. They should have been concerned about how big my last baby was because they didn't check my blood sugar when I was in the hospital or anything. They didn't check it. Everything was fine. I was feeling fine. I was having pretty regular Braxton Hicks still. I was convinced I was going to have him early. I told him that. “I will have him early, and you're not going to have to induce me. I promise you. You're not going to have to induce me.” I told the doula that I promised the doctors and the specialists that I was not going to have to be induced. She was on my side. She was like, “Okay. We can try some midwives' brew if we get to that point. We'll talk about it.” I didn't end up getting to that point, thankfully. I had another scan at 37 weeks and 36 weeks. At 37 weeks, the doctor was like, “Okay, well, I specifically want to see you next week. I want you to come out to my other office next week because I specifically want to see you. I don't want you to see the other doctors. I want to follow up with you.” I was like, “Fine. I'll drive to Rosedale. No problem.” It wasn't farther than the other office I had been going to. I didn't get that far. I went into labor at 37 and 6. It had been a normal day. I had taken my daughter to the jumping place and had gone to the grocery store. I messed up when I went to the grocery store and the jumping place. I parked too far out, and I didn't think it through. I jumped near the jumping door, not the grocery door. Walking in was super close, but then I had to walk all the way back carrying my groceries. The carts didn't go out that far or anything. I'm like, “Oh my gosh. This is so heavy.” I'm still having Braxton Hicks the whole time. I'm feeling fine. I haven't had any kind of mucus plug activity or none of that. There was no swelling in my feet or legs. My blood pressure had been good. I checked it regularly. My blood sugar had been good. I had checked it regularly. I get home, and I'm like, “Man, I'm tired.” I got up, and I kept doing laundry and stuff. My husband gets home from work. He's like, “Hey, do you want to go out to dinner? We can go to the restaurant up the street.” I'm like, “Yeah, it's a beautiful day out. It's the beginning of May. That's a great idea.”It's a 3-minute walk from my house to the restaurant. I'm not kidding. About halfway there, I stopped, and I was like, “Oh. Well, that one was a little more uncomfortable than they have been. Okay. I actually felt that.” It felt like a bad period cramp, but also tightening with the Braxton Hicks at the same time. I was like, “I'm fine.” I kept walking. We get to dinner, and I notice at that point, I'm having mild contractions every 10 minutes. We ate food. I had sushi, and I know that rice spikes my blood sugar, so I try not to eat too much of it, but I was like, “You know what? I feel like I'm going to have them. I just need to make sure that I eat.” I ate my dinner. We walked back home. It was still about every 10-12 minutes that I was having mild contractions. We went about the evening as normal. I put my daughter to bed and stuff. I took a shower. My husband and I were watching some TV. I was bouncing on the ball. I wasn't really telling my husband that I was super uncomfortable at that point yet. It hit all of a sudden. It was 11:00 PM. At this point, it was 6:00 PM when I felt the first slightly uncomfortable contraction. It's now 11:00 PM. I'm like, “Okay. This is actually starting to get a little bit more uncomfortable.” I got up, and I paced around the living room. My husband was like, “Uh-oh. We should probably go to bed.” Yeah, we should probably go to bed. That was a good idea. We went to bed, and I did not sleep. I think I slept for about seven minutes because at that point, it went to seven minutes, not 10 minutes. I started timing them on my phone. I texted my doula. I made sure I had all of my stuff ready just to be safe. I made sure the house was picked up. I tried to sleep. I let the doula what was going on. She was like, “Don't worry about timing them, just get some rest.” I was like, “I'm not trying to time them, but every time I have one, I look up and I see the clock. This is happening.” She was like, “Okay, well I'll start getting up, and I'll be ready to head over if you need me. I want you to take a shower.” It took me a good 45 minutes or a half hour or something like that to actually get from hanging around my house to getting in the shower because I started shaking really bad, and I was starting to have contractions pretty quick together. They started getting closer and closer together. My husband ended up texting her at that point, “Hey, she's int he shower. I think contractions are getting closer together. They are two minutes apart at this point. You should probably head over.” She gets here pretty quickly. My daughter is still asleep. At that point, my doula was like, like, “Yeah, I think you're in active labor. We should think about heading to the hospital.” I'm only 10 minutes from the hospital, but my daughter needed to get picked up. I put my bag in the car. We call family. I get my daughter picked up. She hadn't heard anything. She hadn't noticed I was in labor. I wasn't being necessarily loud, but I wasn't also being super quiet or anything. She gets picked up. She's mad she's awake. It's 2:00 AM. We get ready to go, and by the time we get down the stairs, because I live in an upstairs apartment, so I'd been pacing the whole upstairs in my apartment and everything, I was super afraid my water was going to break in the car so I put on a Depends because I was like, “I'm not going to have to clean that up later because I'm going to be the one cleaning it up later, and I don't want to have to deal with that.” My doula was like, “Chris, get her a bag in case she throws up in the car. Let's go.” She tried checking my blood pressure, but I kept moving and stuff, so we couldn't get an accurate reading which made me that much more anxious. I was so afraid that by the time I got there, everything was going ot go bad. I had convinced myself that it was fine, but there was this nagging voice in my head that was like, “No, no, no, no, no. Everything went wrong last time, so surely, you are going to die this time.” I was like, “Nope. I am fine. Everything has been fine. They are aware. They have blood on deck for me. It's going to be okay. I've got this.” We get to the hospital. It's 3:00 in the morning. It's fairly quiet. We parked in the parking garage which was across the street. We walked through the parking garage. We take the elevator. We take the walk bridge across. We get into the hospital, check in with security and everything. they were like, “Oh, sweetie, do you want a wheelchair?” My doula was like, “No, no, no. She's fine. She will walk.” I'm like, “Yeah, okay Heidi. Walking is a great idea.” I mean, that's what she's there for. It's fine that I kept walking, honestly, because we had to walk from one side of the hospital to the elevator to take the special elevator that goes to the 6th floor. We're about halfway to the elevator, and I'm like, “Oh, I think my water just broke.” My water broke walking into the hospital which was that much more convenient. We get in. We get checked into triage. The nurse is so nice, and she was like, “It's okay if you want to give me a hug,” because they wouldn't let my husband or my doula in at first. I gave the nurse a hug. She was so nice. They were like, “We need a urine sample.”At that point, basically, from the time labor started, I couldn't pee. That was an issue, so they were like, “Don't worry about it. It's fine. Let's get you back on the bed. Let's check on you, and see how you are doing.” They said I was a 4 or a 5 depending on who checked and who assessed.They asked me about pain medication and stuff, and I was like, “I'll get back to you. I'm doing okay.” Contractions are about every 2-3 minutes at this point. My water had broken on the way in. They tried doing one of the swabs to check it was my water and not that you peed, and the nurse was like, “I'm not even going to send this in. It's fine. I know that it's your water.” They got me in pretty quickly. By the time I got into a room, I was like, “I would like some pain medication please.” They were like, “Okay, do you want an epidural? Do you want IV medication?” I remembered when I was in labor with my daughter, the nurse had initially offered me what was called a walking epidural, so I asked because I remembered declining that with my daughter. I was like, “No, no, no. I don't want to do anymore walking. That's the point. I don't want walking. no walking.” This time, I was like, “That actually sounds like I wanted to know more about that.” I asked the nurse more about it. She was like, “It's still an epidural. It's put in your back the same. It's just different medication. It's lower doses or different medication or whatever it is. It's going to provide some pain relief, but you're not going to be numb. You're still going to feel everything.” I was like, “Honestly, that sounds like what I would like. That sounds like it's a really good idea.” I was having a very hard time taking a deep breath. I was having a very hard time relaxing because I was so afraid that something was going to go wrong. At that point, my blood pressure was fantastic. Everything had been normal. No protein in my urine, no swelling, no high blood sugars, nothing. I was like, “Okay, this is going to be fine. I'm going to be fine.” I felt a little weird about asking for pain medication because I was adamant that this time, I was going to do it without it, but they called the anesthesiologist. He comes in, and he says, “Okay, are you sure you want the walking epidural? That's definitely not going to get you were you want to be pain-wise.” I was a little ticked off, but I was like, “Just get me what I asked for, please. If I change my mind, I will tell you.” That's the thing. If you change your mind, all they have to do is switch up your medication. It's not continuous with what I got. It's just a bolus of medication, and the little thing is taped on your back. You're not actually hooked up to medication or anything, but if I wanted to be, all they had to do was hook it up. I was like, “I'm fine. I don't need that. Thanks, dude.” They get me that, and they made me stay in bed for the first hour just to make sure I was okay and my blood pressure was fine and everything. My blood pressure was fine. Everything stayed fine. My blood sugar was a little high at this point. It was two points over the max where they want it to be. My husband ran down to the gift shop and got me some trail mix, cheese, and meat things. I ate that. They checked my blood sugar in a little bit, and it was back to a healthy, happy, normal range, so they weren't concerned. I was like, “I ate rice the night before, guys. That's all it was. You checked my blood sugar in the middle of the night after I had rice. Of course, it's going to be a little high.” At this point, it's 4:00 AMish. I stayed in bed for the first hour. My doula was like, “Okay, let's get you out of bed. Let's get you moving.” I was out of bed almost the whole time. I did spend a little bit more time in bed at one point. I had the initial bolus of medication. That was all I had, so at this point, I can feel the contractions are getting stronger, and I can also feel that the medication is also starting to wear off. It started getting more intense. I was on the toilet for a minute. I was still having the issue where I still could not go pee. My doula kept feeding me water after every contraction, so they were keeping an eye on that. My doula was keeping an eye on that and stuff. It got to where it was 8:00 AM, I think, so at this point, I had been in labor for a total of– from the time contractions actually started being painful at midnight to 8:00 AM– 8 hours. I was on the side of the bed leaned over the bed. They had it at my height. My husband was rubbing my back. The nurses were there taking care of me and making sure I was good. All of a sudden, she's like, “Okay, honey, I think it's time to get you back in the bed.” I was like, “What?” She was like, “We've got to get you back in the bed. With the noises you're making, and squatting down, we've got to get you back in bed.” With every contraction, I was bearing down. Meagan: And they just didn't want you pushing standing up, type of thing? Abigail: I think they wanted to check me and see how I was doing and everything. They had me on continuous monitoring, which initially I didn't really want, but up until that point, I hadn't minded the monitors. It was just at that point because I kept moving, and I was so sweaty. I was so sweaty. My IV kept slipping off. The monitors kept slipping off. My gown was drenched. My hair was drenched. They kept re-taping my IV, and I was like, “Can you please just take the IV out? It's bugging me.” At that point, the IV was somehow more painful than the labor. I was coping with labor, but I kept feeling the IV in my arm because they kept having to poke it and mess with it and stuff because it wasn't staying in. They ended up leaving it in which I was annoyed with, but I was in and out of at that point.They get me back in the bed, and they check me. They're like, “Okay. You're already starting to push. Let's get the doctor in here. Let's do this.”I'm on the bed. I've got the squat bar. I'm up on the bed on the squat bar. I'm kneeling in a lunge position. I've got one knee up and one knee down. Every contraction, they were having me switch my knees which started getting really uncomfortable for me. I felt so heavy, and I was falling asleep in between each contraction it felt like. I wasn't all the way there, but they ended up saying that my son's heart rate was dropping just a little bit, and they were like, “Okay, let's get him out. Let's move this along.” They pulled the squat bar, and they had me on my back. The bed was propped up. I was upright, and they had me holding my own legs. I was having a hard time because I was so sweaty that my hands kept slipping off the back of my thighs. They were like, “Okay, you need to push. Let's push.” I wasn't really listening to them. They were trying to do coached pushing, but if I didn't feel like it, I just wasn't doing what they were telling me. I was more listening to my doula than anything else because I felt like I trusted her and what she was saying more than anything else. I told them, I was like, “I feel like it's pulling up. I feel like it's pulling up.” They were like, “Okay, lower your legs a little bit.” It was really nice that I was able to feel everything. I put my legs down a little bit, and that helped a little bit. I don't know exactly how many pushes it was. I don't know if anybody counted, but it ended up being 13 minutes that I pushed for from the time they got me in the bed and were like, “Okay, you're pushing,” to “Let's get you on your back. Give a couple good pushes.” I think it was two pushes once I was on my back and he was out. Meagan: That's awesome. Abigail: He came right out. I had a small right inner labial tear, no perineal tears, and then I don't think I actually tore up, but I noticed I was sore afterward up toward my urethra, but they ended up only giving me one stitch on my right labia. That was fine. They did numbing shots and everything for that, and I could feel the numbing shots and everything, and I didn't like that. It's uncomfortable, but it was fine. I felt fine. I felt good. They put him right onto my abdomen because his cord was so short that they couldn't put him any further up. I wish they would have waited just a little longer to cut his cord, but they were like, “He's hanging out down here where we need to be,” because his cord was so short, which makes sense that he was head down the entire pregnancy and didn't move. He stayed right there. He flipped and rotated. Meagan: Transverse. Abigail: Sideways. He would put his butt back sometimes and toward the side sometimes, but that's all he would do. His head was in my pelvis the entire time. He comes out. Once they cut his cord, they moved him up to my chest and everything. They got me cleaned up and everything. Everything was fine. I got my golden hour, and he didn't want to nurse right away, but he was fine. They were taking bets like, “Does he look like he's over 6 pounds or what?” He ended up only being 5 pounds, 5 ounces. Meagan: Tiny. Abigail: He was a little, tiny guy. He was barely 18 inches. I had him right at 38 weeks, so he was a little small. He was closer to the size of a 35-week baby. Meagan: Mhmm, and he had IUGR. Abigail: I don't think there was anything wrong with him. I think I'm a very small person, and I think my first baby was too big because when I look at pictures, my daughter's head was coned off to the side, and I know that she did not have room to move around in there. She was stuck where she was stuck. Meagan: That would mean it was asynclitic probably. Her head was coming down wrong. Abigail: Yeah, which is probably why it hurt so bad. I know that now, initially, it started even with early labor. I don't think that even once I had an epidural with her, they were using the peanut ball. They were changing my positions. They were doing all of the things, and she wasn't coming down any further. She wasn't moving, and I wasn't going past a 7. I think that she was too big which I think is from having unchecked gestational diabetes. Even though she was considered an average-sized baby. I'm not an average-sized person. I'm really, really, really small. Me having a 5-pound, 5-ounce baby seems about right.He came out perfectly healthy. There was nothing wrong with him. His blood sugars were good. His blood pressures were good. Everything was great. And now at seven months, he's still slightly on the smaller side, but he went from being in the 2nd or 3rd percentile or whatever he was born into all the way to about the 20th. He's almost caught up. He's healthy. He's chunky. There wasn't actually anything going on with him. I think that says a lot to the fact that I'm just really small and my first baby was the result of an unhealthy pregnancy. I didn't have a postpartum hemorrhage. I didn't need any extra medication. I didn't need Pitocin. I didn't end up getting a full epidural. When they asked me about my experience, I made sure to tell them that the anesthesiologist should choose his words more wisely. It went well. I waited two months afterward to see how I was feeling and everything, and I do not have postpartum depression. Meagan: Good. Abigail: No more anxiety than what I regularly deal with. I have had a great time. Everything is just completely different, and my son is already seven months old, and I am already at a point where I'm like, “I want another baby.” I don't know if I'll actually have another one or not. I mean, there are financial reasons to consider and actually giving birth to another baby and raising another human. It's not just a baby. It's a whole other life. It's a lot, but I have baby fever already. I would absolutely do it again, and I just had him. Meagan: Oh, that makes me so happy. I am so happy that you had such a better experience that was more healing and positive and has left you having a better postpartum for sure. Abigail: It was a completely different experience. I mean, night and day. I'm just trying to make sure that I didn't miss anything. I think the only thing that ended up being different was like I mentioned, I couldn't really go pee. I did end up having to have a catheter at the end of my labo

In this episode Elise shares about how she managed a gestational diabetes diagnosis, advocated for the birth plan she wanted, and navigated an induction. ____________________ 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

Join us in this episode where Dr. Clementina Asamoah from Riverside Women's Health unpacks the essentials of gestational diabetes. Learn about the condition, its risks, and how to manage it effectively during pregnancy. This episode is a must-listen for any expecting mother seeking clarity on gestational diabetes.

Links: Get your breast pump, lactation support, and maternity compression garments for free at aeroflowbreastpumps.com/birthhour and use promo code BIRTHHOUR15 at for 15% off supplies and accessories. Know Your Options Online Childbirth Course - use code 100OFF for $100 off Beyond the First Latch Course (comes free with KYO course) Support The Birth Hour via Patreon!

Join our 7 Days of NCLEX Free Review and let ReMar help you every step of the way. Sign up for FREE today at ReMarNurse.com/7Days. In this must-watch video, Prof. Regina Callion, MSN, RN, breaks down everything that we need to know about Acute Renal Failure (ARF). ARF happens when the kidneys suddenly stop working properly, which can lead to serious health problems. Prof. Callion will explain what ARF is in simple terms, walk you through its stages and phases, and help you understand how it's classified based on what causes it. You'll also learn about the best ways to manage ARF, including important medical treatments, lifestyle changes, and nursing priorities to provide the best care for patients. Don't forget to like, comment, and subscribe for more informative content on nursing and healthcare topics. Download the ReMar V2 App: ►For iOS: https://apps.apple.com/us/app/remar-v2/id6468063785 ►For Android: https://play.google.com/store/apps/details... ► Find JOBS: http://ReMarNurse.com/jobs ► NCLEX for Africa - http://ReMarNurse.com/KENYA ► Get NCLEX V2: http://www.ReMarNurse.com ► Get Quick Facts Next Gen - https://bit.ly/QF-NGN ► FOLLOW ReMar on Instagram: https://www.instagram.com/ReMarNurse/ ► LIKE ReMar on Facebook: https://www.facebook.com/ReMarReview/ ► Subscribe Now on YouTube - http://bit.ly/ReMar-Subscription #AcuteRenalFailure #NCLEXVirtualTrainer #nclexprep #nclexnursing #remarreview

Happy 2025! We're starting the new year on an emotional note with this episode all about gestational diabetes - aka the diabetes you can get diagnosed with in pregnancy. I explain what it is, my experience of getting diagnosed and working with a diabetes clinic, and how all of this is feeling like some diet culture BS that is really not good for my mental health! Want to share your pregnancy or TTC journey? Have feedback for the podcast? Have an episode idea? ⁠Leave your feedback in this form:⁠ https://forms.gle/XyBgaf9JwgvcfH5p8 Disclosure: I'm in no way, shape or form an expert on anything. None of this is advice. Take it all with a grain of salt and consult your own healthcare provider or topic expert!

#133 Childbirth Reimagined - From Academic to Family Advocate with Dr. Rebecca Dekker In a pivotal life event, Rebecca Dekker, found herself deeply dissatisfied with the childbirth experience after giving birth to her first baby.  Even though she had a PhD in nursing and was an assistant professor, she vividly recalls feeling restricted—unable to move or eat during labor, and then being separated from her newborn daughter for three crucial hours post-birth under the guise of monitoring. This stark experience ignited her quest for answers, leading her to uncover that these practices lacked evidence-based support. Driven by her personal encounter, Rebecca embarked on a mission to transform childbirth practices. Founding Evidence Based Birth, she dedicated herself to ensuring that families have access to empowering, evidence-based care during childbirth.  Her book, "Babies Are Not Pizzas. They're Born, Not Delivered," and her popular podcast amplify her commitment to making childbirth research accessible to all. Rebecca's journey underscores the importance of challenging outdated norms and advocating for informed decision-making in maternity care. Throughout the episode, Dr. Dekker passionately emphasizes the need for evidence-based practices in childbirth. Her transition from academia to entrepreneurship was not merely a career shift but a calling fueled by personal experience.  By sharing her story and research, she empowers expectant families to question prevailing norms and demand respectful, informed care during one of life's most transformative moments. Join us as we explore Dr. Rebecca Dekker's remarkable journey and the profound impact of evidence-based advocacy in childbirth. Subscribe, Share & Review: If you enjoyed this episode, please hit that subscribe button, share with others, and leave us a review! Your support helps us reach more listeners eager to improve their health. *Lilly Nichols Books: https://lilynicholsrdn.com/books/  *Gestational Diabetes blogs: https://evidencebasedbirth.com/gestational-diabetes-and-the-glucola-test/ https://evidencebasedbirth.com/evidence-on-induction-for-gestational-diabetes/  Want to connect with Dr. Rebecca? Website: www.evidencebasedbirth.com  and podcast https://podcasts.apple.com/us/podcast/evidence-based-birth/id1334808138 Instagram: @ebbirth Youtube: https://www.youtube.com/@EvidenceBasedBirth The primary purpose of The Pretty Well Podcast being to educate. This content is for informational and educational purposes only. It is not intended to provide medical advice nor to take the place of such advice or treatment from a personal physician. By listening to this content, you agree to consult your own physician or qualified health professional regarding specific health questions. Neither Lisa Smith, The Pretty Well Podcast, nor any guest takes responsibility for possible health consequences of any person or persons following the information in this educational content. All listeners of this content, especially those who are pregnant or taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement, or lifestyle program. The Pretty Well Podcast is for private non-commercial use and our guests do not necessarily reflect any agency, organization, or company that they work for. In addition, opinions of interview guests do not necessarily reflect the opinions of Lisa Smith and/or The Pretty Well Podcast. This content is not guaranteed to be correct, complete, or up to date.

This episode is PACKED with evidence-based information about real food for fertility with Lily Nichols, RDN! We dive right into some of the most confusing and controversial nutrition topics, including protein for fertility, vegetable oils, and iron supplements! We also talk about how to support your body postpartum so that you can get back to feeling your best after baby. Timestamps:[4:34] Welcome Lily Nichols[7:18] Does protein intake alone have a beneficial impact on fertility?[9:50] Is it that important that we focus on high quality bioavailable protein or is it that if we just up protein intake overall it will benefit fertility?[26:06] What does the research say when it comes to vegetable oil consumption, specifically how it relates to fertility and/or inflammation?[30:49] How do you know if a vegetable oil is damaged or not?[35:10] What foods or types of food should you focus on when going through fertility treatments?[39:43] Can you talk about using adaptogens and mushrooms while pregnant?[41:50] Can you give some suggestions for anemia during pregnancy?[51:10] Do protein goals go up during pregnancy and/or postpartum?[53:47] Curious about nutritional needs while breastfeeding. I've heard that breastfeeding mama's need 800 additional calories a day, but what about under producers? [58:39] How do you support your body and hormones to decrease postpartum hair loss?[1:02:47] How long should nutrition be a priority postpartum realistically for a new mom?Episode Links:Visit Lily's WebsiteBook Website: Real Food for FertilityBuy "Real Food for Fertility"Buy "Real Food for Pregnancy"Buy "Real Food for Gestational Diabetes"Episode #235: Preconception and Prenatal Nutrition with Lily Nichols, RDN (Part 1) Episode #237: Nutrition for Pregnancy, Postpartum Recovery, and Breastfeeding with Lily Nichols, RDN (Part 2)Article: How much iron do you actually absorb from food?Article: The Truth about Postpartum Hair LossArticle: Protein Requirements in Pregnancy are higher than previously thoughtArticle: 5 Fertility Diet MythsBotanical Medicine for Women's Health 2nd Edition by Aviva Romm Sponsors:Go to drinklmnt.com/wellfed and use code WELLFED to get a free 8-pack with any drink mix purchase!Go to https://thisisneeded.com/  and use coupon code WELLFED for 20% off your first order.Go to http://mdlogichealth.com/chocolate and use coupon code WELLFED for 10% off and you always get free shipping on orders of $59 or more.Go to wellminerals.us/adrenal-stress-less/ and use code WELLFED to get 10% off your order.

Today i'm thinking out loud with you as I talk about my thoughts regarding gestational diabetes.  Is it really "gestational diabetes" or is it underlying, undiagnosed, metabolic dysfunction?  Here's some of what you will learn today: What is metabolic dysfunction How is gestational diabetes, prediabetes, and type 2 diabetes diagnosed What are the shortcomings of the way we diagnose and treat gestational diabetes in our maternity system What do I think is really going on  Sign up for updates about the new program - https://go.yourbirthgodsway.com/yourhealth   Good Energy by Casey Means, MD - https://a.co/d/bBiHddp   A Guide to Effective Care in Pregnancy and Childbirth by Enkin, et al. - https://a.co/d/9OVGWYZ     Helpful Links:   3 WAYS TO WORK WITH LORI:   --> Sign up HERE for the Your Birth, God's Way Online Christian Childbirth Course! This is a COMPLETE childbirth education course with a God-led foundation taught by a certified nurse-midwife with over 20 years of experience in all sides of the maternity world! Learn more or sign up HERE!   —> Having a home birth and need help getting prepared?  Sign up HERE for the Home Birth Prep Course.   --> Sign up for your PERSONALIZED Pregnancy Coaching Midwife & Me Power Hour HERE These consults can include: birth plan consultation, past birth processing, second opinions, breastfeeding consultation, and so much more!  Think of it as a special, one-hour appointment with a midwife to discuss whatever your concerns may be without any bias of practice policy or insurance policy influencing recommendations.   Get Christian pregnancy and birth merch HERE   Lori's Recommended Resources HERE   Sign up for email updates Here   Be heard! Take My Quick SURVEY to give input on future episodes you want to hear --> https://bit.ly/yourbirthsurvey   Got questions?  Email lori@yourbirthgodsway.com     Socials: Follow Your Birth, God's Way on Instagram! Follow the Your Birth, God's Way Facebook Page! Join Our Exclusive Online Birth Community -- facebook.com/groups/yourbirthgodsway   Learn more about Lori and the podcast at yourbirthgodsway.com!   FREE Bible Study Course - How To Be Sure Of Your Salvation       DISCLAIMER:  Remember that though I am a midwife, I am not YOUR midwife.  Nothing in this podcast shall; be construed as medical advice.  Listening to this podcast does not mean that we have entered into a patient-care provider relationship. While I strive to provide the most accurate information I can, content is not guaranteed to be 100% accurate.  You must do your research and consult other reputable sources, including your provider, to make the best decision for your own care.  Talk with your own care provider before putting any information here into practice.  Weigh all risks and benefits for yourself knowing that no outcome can be guaranteed.  I do not know the specific details about your situation and thus I am not responsible for the outcomes of your choices.    Some links may be affiliate links which provide me a small commission when you purchase through them.  This does not cost you anything at all and it allows me to continue providing you with the content you love.

Infertility is on the rise. Polycystic Ovarian Syndrome (PCOS) and postpartum depression is, too. Can diet help address these issues? And what's the best diet to enhance fertility? Lily Nichols is a Registered Dietitian/Nutritionist and the author of Real Food for Fertility, Real Food for Pregnancy and Real Food for Gestational Diabetes. Today, Lily offers practical advice for tackling the issues mentioned above and more. Lily covers how to maximize micronutrients for mothers and mothers-to-be, even when on a budget. She gets specific about foods to include in the diet that enhance fertility and combat insulin resistance (a central factor in PCOS). She also goes over why a protein-rich diet is critical for nourishment pre- and post-partum for better energy, satiety and to combat nutritional deficiencies. Finally, she offers insights on breastfeeding and how to deal with overwhelm in the first few months following giving birth. Visit Lily's website: lilynicholsrdn.com Go to Nourishing Our Children Check out our sponsors: Gray Toad Tallow and New Biology Clinic

This is the second part of our two-part series all about Gestational Diabetes with Lily Nichols RDN. In this episode, we do an overview of testing options and discuss some of the lesser-known nuances of normal pregnancy metabolism - getting into some fascinating details around low blood sugars, continuous glucose monitors, and nutritive ketosis in pregnancy. We then discuss the conventional dietary recommendations and how they are insufficient and outdated and discuss the method of blood sugar management that Lily recommends to her clients to achieve the best outcomes. Also discussed is how this diagnosis of gestational diabetes can really come to wreck birth plans, even when it may not be applicable anymore - and how one can manage that best with their provider. Here we go!RESOURCES FROM THIS EPISODE:Learn more from Lily Nichols:Website - www.lilynicholsrdn.comInstagram - @lilynicholsrdnLily's BooksLily's CoursesLily's article on Breakfast MistakesLily's article on CGM Experiment Part 1 & Part 2Healthy as a Mother Episode #87: Gestational Diabetes Part 1 with Lily NicholsHealthy As A Mother Episode #13: Baby Brain Support in Pregnancy with Ari CalhounEvidence-Based Birth Episodes on Big Babieshttps://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/https://evidencebasedbirth.com/what-are-the-birth-implications-for-a-suspected-big-baby-podcast/Stay Connected With Us:Healthy As A Mother: www.healthyasamother.comInstagram: @healthyasamotherpodcastDr. Leah: www.womanhoodwellness.comInstagram: @drleahgordonDr. Morgan: www.milkmedicine.comInstagram: @morganmacdermott

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

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.  

This episode is part 1 of an interview all about gestational diabetes with registered dietitian and well-known author, Lily Nichols. We discuss the ins and outs of how pregnancy metabolism changes insulin function and levels, and what happens when this process results in elevated blood sugar levels over time. We discuss risk factors for developing gestational diabetes, prevention, early screening that should be taking place but is not, lab lists, the risks to the baby if the mom's blood sugar continues to stay elevated, and the problems with certain testing methods. We also go on an all-too-important rant about vitamin D3 supplementation that you'll not want to miss. Be sure to check out part 2 next week as well - and now let's jump in!This episode is sponsored by:Redmond Salt >> Click here and use code HEALTHYMOTHER to save 15% on your order.Kudos Diapers >> Click here and use code HEALTHYMOTHER to save 15% on your order.Needed >> Click here and use code HEALTHYMOTHER to save 20% off your first order.RESOURCES FROM THIS EPISODE:Learn more from Lily Nichols:Website - www.lilynicholsrdn.comInstagram - @lilynicholsrdnLily's BooksWomen's Health Nutrition AcademyLily's article on Vitamin D and PregnancyOrder micronutrient testing via Dr. Leah's websiteHealthy as a Mother episode discussing blood sugar more: #78 Lifestyle Hacks of Hormone BalancingDr. Morgan's Immune Wellness for the Pregnant or Nursing Mother CourseStay Connected With Us:Healthy As A Mother: www.healthyasamother.comInstagram: @healthyasamotherpodcastDr. Leah: www.womanhoodwellness.comInstagram: @drleahgordonDr. Morgan: www.milkmedicine.comInstagram: @morganmacdermott

TODAY'S SPONSORBEAM Minerals: Head to beamminerals.com and use the code DANIHEALTH to get 20% offMake sure to check out this link to Fullscript.com to get your lifetime 10% discount!TODAY'S GUESTLily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based prenatal nutrition. Her work is known for being research-focused, thorough, and critical of outdated dietary guidelines. She is the founder of the Institute for Prenatal NutritionTM, co-founder of the Women's Health Nutrition Academy, and the author of three books: Real Food for Fertility (co-authored with Lisa Hendrickson-Jack), Real Food for Pregnancy and Real Food for Gestational Diabetes. Lily's bestselling books have helped tens of thousands of mamas (and babies!), are used in university-level maternal nutrition and midwifery courses, and have even influenced prenatal nutrition policy internationally. She writes at https://lilynicholsrdn.comWebsiteInstagramBook websites: realfoodforfertility.com, realfoodforpregnancy.com & realfoodforGD.comON TODAY'S EPISODEWhat are the common misconceptions surrounding gestational diabetes that expectant mothers should be aware of?How do conventional dietary guidelines fall short when it comes to managing blood sugar levels during pregnancy?What personalized nutrition strategies can be implemented to control gestational diabetes effectively?Can you explain the significance of testing methods for gestational diabetes and the alternatives available?How does gestational diabetes impact long-term health for both mothers and their children?What role does protein intake play in managing insulin levels and overall metabolic health during pregnancy?Why is it important for women to start preventative measures for gestational diabetes before pregnancy?How does breastfeeding influence insulin sensitivity and the risk of developing type 2 diabetes later in life?What are some key nutritional needs that mothers should prioritize during breastfeeding?How can maintaining electrolyte balance during breastfeeding prevent nutritional depletion?STAY IN TOUCH WITH ME:You can find me:On Instagram @daniellehamiltonhealth On Facebook at Danielle Hamilton HealthMy website is daniellehamiltonhealth.comOn my YouTube Channel (make sure you subscribe!)Sign up for my Wellness Wednesday Newsletter: https://www.daniellehamiltonhealth.com/newsletter

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

I remember when I first started practicing as a midwife—way back in the '80s—there was barely a whisper about how nutrition could impact pregnancy. I taught my first prenatal nutrition class in 1990, and the hunger for information was almost palpable. It's amazing to me that, fast forward to today, we're still facing a gap in understanding just how much food and lifestyle choices affect both mom and baby. But here's the thing—there's so much hope and possibility when we're armed with the right information, and today's guest has dedicated her life to providing just that.I'm beyond excited to introduce you to Lily Nichols. Lily is a registered dietitian, nutritionist, and certified diabetes educator who is passionate about making pregnancy health both understandable and achievable. Her journey into this work is rooted in a deeply personal mission: she saw firsthand how powerful nutrition could be in preventing complications like gestational diabetes, and she wanted to share that knowledge with as many women as possible. Her books, Real Food for Gestational Diabetes and Real Food for Pregnancy, have helped countless women take control of their health during such an important time.In today's episode, Lily and I dive deep into some powerful truths about gestational diabetes—how it's on the rise but, more importantly, how it can be prevented and even reversed with simple, mindful changes. We'll talk about why so many women still aren't given this information, how the right nutrition can truly change the trajectory of your pregnancy, and practical steps anyone can take. We'll even touch on how blood sugar testing is done differently around the world—and why those differences matter.Whether you're pregnant, planning to be, or just curious about how your body responds to food, there's so much to take away from this conversation. It's about more than just numbers on a blood test; it's about learning to listen to your body, trust yourself, and make small changes that have a lasting impact on your health—and the health of your baby.So grab a cup of tea, settle in, and let's get into this empowering and eye-opening conversation with Lily Nichols. I think you're going to walk away feeling hopeful, informed, and ready to take charge of your health in a whole new way.Looking for supplements for yourself and your family, including some of those I talk about in episodes? You can find those - and your 15% discount on every order here: avivaromm.com/supplementsThe Mama Pathway is not your average childbirth education program. It's a powerful virtual membership community and online education experience where traditional midwifery wisdom and modern medicine meet to support you on your most empowered path through pregnancy, birth, and beyond. Go to avivaromm.com/mama-pathway to learn moreMentioned in this episode:Looking for supplements for yourself and your family, including some of those I talk about in episodes? You can find those - and your 15% discount on every order here: avivaromm.com/supplements