Podcasts about inductions

It's the holiday season and inductions are about to skyrocket!  Are you due around the holiday season, you are going to want to listen to this. In this episode, you will learn:  - Where due dates came from  - Why you are pressured to induce  - How to advocate for yourself Don't be dear mongered into induction this year!! Want to learn more about your birthing opions? Check out the Birth Plan Prep Course! https://elizabethjoy.thrivecart.com/birth-plan-prep-course/   Connect with Liz https://www.instagram.com/esandoz/?hl=en Check out the BIRTH PLAN PREP COURSE code JOY20 https://www.Elizabethjoy.co Get the First Trimester Survival Guide https://elizabethjoy.co/freebie Birth Plan Guide https://elizabethjoy.co/birth-plan-freebie   BetterHelp  visit https://www.betterhelp.com/ptps for 10% OFF   References Gina Mundy episode 324: https://podcasts.apple.com/us/podcast/ep-324-lawsuits-and-childbirth-with-attorney-gina-mundy/id1343507855?i=1000658405282 Inductions and Patient's rights with Dr. BIll Chun episode 349 https://open.spotify.com/episode/1UezpwqxrLEQ35rJMFwnE1 EBB Due Dates https://evidencebasedbirth.com/evidence-on-due-dates/

Four bitter beings join together to force in games you peasants decided weren't good enough for our Hall of Fame. Well, bollocks to you, we're sticking four of them in anyway! We also do some thoroughly exciting admin by deciding on the next run of episode themes. You'll love it! You'll also love the email we got from a returning amphibian. Go to @VG_HOF on Twitter or vghof on BlueSky to vote in the poll, and send emails to videogamehof@gmail.com

Welcome back to another episode of your favorite weekly hockey pod Nattering CHEL! Today's episode is a two-man show as Eric and Torrey discuss the latest from the NHL. This week was the Hockey Hall of Fame Induction for the Class of 2024, so we break down all the inductees' accomplishments and memories! Later in the episode, Torrey brings us up to speed on some of the prospects in the Toronto Maple Leafs organization, and we ponder how Auston Matthews can be a little bit tougher to play against! Join us weekly for your dose of the NHL on Visionaries Global Media! You can find us on Instagram @Natteringe!

Are Thinking of Coming Into the Profession of Hypnotism? Click here to view the video for this podcast The post Hypnosis Training Video #661 – Fast, Effective & Modern Hypnotic Inductions for FREE! – No More Progressive Relaxation Inductions! appeared first on Free Hypnosis and Hypnotherapy Training Videos.

Are Thinking of Coming Into the Profession of Hypnotism? Or Do You Want to Be A More Successful Hypnotist or Hypnotherapist! Watch This Video & Discover TWO Modern, Fast & Effective Inductions! “Quick Shortcut Menu” Special Announcements Before the Video… Click These Links… Get Info about Cal's Live In-Classroom & Online Training Schedule! Cal's Live

Thu, 24 Oct 2024 13:25:08 +0000 https://hypnotalks-qa.podigee.io/26-hypnotalk-hypnotic-techniques-inductions afe965c03ed11e4bfbdca3d78f6c0033 26 full no Axel Hombach, Dr John Butler

Dr. Bill Chun is a certified OBGYN who has worked over the past thirty years at hospitals throughout the Greater Boston Area. He has delivered hundreds and hundreds of babies over the course of his career and interacted with patients over 200,000 times. He is a Fellow of the American College of Obstetricians and Gynecologists. He currently treats patients at Women's Healthcare of Woburn, his private practice just north of Boston, where he provides comprehensive gynecologic care including minimally-invasive robotic surgeries. He is answering questions this episode surrounding induction, informed consent and patient's rights.  This is an amazing episode for anyone that is pregnant! Connect with Dr. Chun: https://topmate.io/bill_chun https://www.instagram.com/billchunmd/ https://www.instagram.com/doc_and_doula/ Text Dr. Chun 978-914-4809   Connect with Liz https://www.instagram.com/esandoz/?hl=en Check out the BIRTH PLAN PREP COURSE code JOY20 https://www.Elizabethjoy.co     Get the First Trimester Survival Guide https://elizabethjoy.co/freebie Birth Plan Guide https://elizabethjoy.co/birth-plan-freebie Become a Doula! https://elizabethjoy--theautonomymommy.thrivecart.com/academy-bonus-bundle/

(September 24, 2024 - Hour Two)Full Second Hour: 2024 BBQ Central Show Guest Hall of Fame Nominations and Inductions!The BBQ Central Show SponsorsSchwank Grills - Use Code BBQCENTRAL for $150 off!Primo GrillsPitts & Spitts BBQ Pits - Use "charcoalcentral" at checkout for $150 Off Charcoal GrillsBig Poppa Smokers – Use promo code “REMPE” for $10 off your purchase of $50 or more!FireboardCookin PelletsFamous Dave's All Star BBQ SeriesPit Barrel CookerFranklin BBQ PitsThe Butcher Shoppe - Save 10% When You Mention "The BBQ Central Show"JRE Tobacco – Makers of the Aladino (and other) line of premium cigars!Micallef Cigars – Premium Hand Rolled Cigars

Given that Pitocin contractions can be so intense, most people who have inductions also tend to have epidurals – but not Meredith Finch! Listen as she shares with Adriana how her preparation, flexibility, the crucial support from her husband and her doula, and a profound emotional release with her careprovider helped her through her two inductions, ultimately letting her experience the fetal ejection reflex.Sponsor offers - TIME SENSITIVE! NEEDED - Get 20% off at ThisIsNeeded.com with code BIRTHFULHONEYLOVE - Get 20% off at HoneyLove.com/Birthful FAMILYALBUM APP - Check out FamilyAlbum at family-album.comAQUATRU - Get 20% off at AquaTru.com with code BIRTHFULARTIFACT UPRISING - Get up to 20% off at ArtifactUprising.com with code BIRTHFUL through December 31.Get the most out of this episode by checking out the resources, transcript, and links on its show notes page.  If you liked this episode, listen to our interview on The Induction Process and our episode on Rethinking the Pushing Stage. You can connect with Birthful @BirthfulPodcast on Instagram or email us at podcast@Birthful.com. If you enjoy what you hear, download Birthful's Postpartum Plan FREE when you sign up for our weekly newsletter! You can also sign up for Adriana's Own Your Birth online BIRTH preparation classes and her Thrive with Your Newborn online POSTPARTUM preparation course at BirthfulCourses.com.Follow us on Goodpods, Apple Podcasts, Amazon Music, Spotify, and anywhere you listen to podcasts.Support this podcast at — https://redcircle.com/birthful/donationsAdvertising Inquiries: https://redcircle.com/brands

In this episode of The Pulling Curls Podcast, Hilary Erickson, RN, dives into essential tips for preparing the day before your induction. From packing your hospital bag effectively to getting much-needed rest and staying active, Hilary shares her expert advice to ensure a smooth induction experience. Plus, learn what to discuss with your provider and how to make postpartum preparations. Don't miss these invaluable insights for expectant parents facing induction. Big thanks to our sponsor The Online Prenatal Class for Couples -- if you're planning on an induction a birth class is EXTRA important. This class has a full chapter just on inductions to help you get prepared. Links for you: Grab my hospital packing list: https://pregnurse.com/free-resources/#packing Grab my postpartum checklist: https://pregnurse.com/free-resources/#Postpartum Grab my induction checklist: https://pregnurse.com/free-resources/#induction Timestamps: 00:00 Hospital bag essentials: hair tie, charger, ChapStick. 04:57 Prepare for postpartum, not just childbirth. 06:19 Clarify induction duration with provider to prepare. Keypoints: The importance of packing your hospital bag carefully, including entertainment options like movies, cards, and apps to fill waiting time during induction. Key items for your hospital bag include a hair tie, an external charger, and lip balm to combat a dry hospital environment. The necessity of getting adequate sleep before induction; consider asking your provider for a light sleep aid if anxiety is a concern. Keep physically active the day before induction through activities like walking and doing squats to help position the baby. Eat a satisfying meal before induction; prioritize something enjoyable but light to avoid discomfort. Prepare for postpartum by gathering necessary supplies and creating a postpartum plan, including visitor policies and support arrangements. An induction can take varying lengths of time; communicate with your provider to get an idea of what to expect based on your specific circumstances. Maintaining a positive mindset about induction can make the experience more manageable and less stressful. Inductions have the potential to be a positive and controlled birthing experience with successful outcomes for both mother and baby. Engage with the podcast's community on social media to share and gain insights about preparing for induction. Producer: Drew Erickson PUT TRANSCRIPT HERE: Keywords: induction, hospital bag, prenatal class, pregnancy advice, birth preparation, labor, sleep tips, meal suggestions, postpartum, hospital packing list, external charger, hair tie, ChapStick, relaxation during induction, hospital tour, Kindle Fire, birthing ball,

Send us a Text Message.Manager Jim Leyland, along with all-time greats Adrian Beltre, Todd Helton, and Joe Mauer all were officially inducted into Cooperstown this past Sunday. All 4 made heartfelt and good speeches. It's always great to see the amount of HOFers that show up on a hot July afternoon to sit outside in a jacket and tie to show their respect for the newest inductees. Helton and Mauer played their entire careers for one team only - the Rockies and Twins respectively. Beltre came up at 19 with the Dodgers but saw great years in Seattle and Texas with a quick one year stop in Boston.  Beltre resides in the same stratosphere with Mike Schmidt and Brooks Robinson as overall great 3rd basemen. Intro & Outro music this season courtesy of Mercury Maid! Check them out on Spotify or Apple Music! Please subscribe to our podcast and thanks for listening! If you can give us 4 or 5 star rating that means a lot. And if you have a suggestion for an episode please drop us a line via email at Almostcooperstown@gmail.com.  You can also follow us on Twitter/X @almostcoop or visit the Almost Cooperstown Facebook page or YouTube channel.  And please tell your friends!www.almostcooperstown.com

Caylee joins us from Canada sharing her experience with two VBACs after a twin Cesarean birth. She also shares what it was like having cholestasis in all three pregnancies. Cholestasis is a liver condition that slows or stalls the flow of bile. Meagan and Caylee discuss in greater detail what cholestasis means during pregnancy, what symptoms can look like, and how it is diagnosed. One of Caylee's most intense symptoms was incessant itching. She talks about how it affected her not only physically but mentally as well. While all three of her pregnancies were preterm births and her two VBACs were medically necessary inductions, Caylee advocated throughout her entire labors and was able to stay the course to achieve the vaginal births she knew she was capable of. Cleveland Clinic Article: Cholestasis of PregnancyAmerican Journal of Obstetrics and Gynecology Article: Risk of Stillbirth in U.S. Patients with CholestasisHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to the show. We have our friend, Caylee, with us and her little wee, tiny little newborn. Caylee: Hi everyone. Meagan: Oh my gosh. Welcome to the show. How old is your baby? Caylee: He just turned 3 months. He was born a month early though. Meagan: Okay, 3 months and a month early. We are going to talk about why he was born a month early. You guys, today we are going to be sharing some stores and talking a little bit about cholestasis. This is something that we actually don't have a lot about on the show. When you were listening, Caylee, did you? Caylee: I don't think I've heard a single episode, yeah. Meagan: Did you hear about it in general on other platforms? Was it talked about?Caylee: Not really, no. I found it online on Facebook. I'm in the ICP Care Facebook group and that's super helpful. They are amazing in there and super knowledgeable, but yeah. It's not very common. It's quite rare. I think it's 1 in 1000 women who end up getting it. Meagan: Yeah. Caylee: So yeah. It's not very well known about and even with providers, providers don't know about it very well either. Meagan: Yeah. I think that can be part of the problem, right? Because we've got providers who don't know a lot about it and then it can cause a little bit of a panic and then a lot of the times, it can cause Cesareans or lead, I should say, to Cesarean. We're going to be talking about that today and sharing her stories. Review of the WeekMeagan: But I do have a Review of the Week so I'm going to get into that and then turn the time over to cute Caylee. This is from Cori and it doesn't say where it's from. Somewhere in the universe, it is from. It says, “The VBAC Link is gold.” It says, “Of all of the things I did to prepare in pursuing for a VBAC after two C-sections, I think is one of the most important is that I was listening to this podcast. Hearing these stories and information from Meagan and Julie made the dive into learning about VBAC and birth in general so much easier. I was blessed with my VBA2C” so VBAC after two C-sections “with my sweet Brynne Lynn and I sincerely believe I wouldn't have gotten to that point without this resource and the community. Thank you guys for all that you do.” Oh, that just makes me smile so much because this community– oh my gosh. I mean, Caylee and I were kind of just talking about this. Yes, Julie and I are here, but there is this community, this absolutely incredible community and all of the people coming forth to share their stories. And Caylee, you just said it yourself when you were like,  it's like all of these people who came and shared these stories impacted you. Caylee: Yeah, totally. Meagan: Yeah, they are the reason. You are the reason right here. Caylee, you are the reason why what Cori said in this review is possible by sharing your stories, by coming in the community on Facebook and on Instagram and having these conversations and learning and also being vulnerable. There are so many times where I see posts where it's the most vulnerable, genuine post and I can't explain to you the outpouring of love that I see come in for this person from this community. The VBAC Link Community, just the VBAC community in general, oh my gosh. You are all amazing. Thank you so much and yes, if you want to join that community, check us out on Facebook at The VBAC Link Community. It is a private group. You do have to answer the questions to get in so just keep that in mind. If you are not answering questions, you might not be allowed in. And on Instagram, and of course, if you want to have a review that I could share for the Review of the Week, please do so. We would love that.  Symptoms of Cholestasis Meagan: Okay, Caylee. Are you ready? I'm so ready. Caylee: I am ready, yes. Meagan: Awesome, I would love to turn over the time. Caylee: I don't know where to start. Should we start by talking a little bit about cholestasis so that they understand the risks? Meagan: Yeah, I think that– well yeah, the risks, the symptoms, and then also how it can be missed and then how it can sometimes– well it kind of goes with the risk, but there are other things that can come in I should say from cholestasis and I actually even had a client myself, a VBAC client after two C-sections. She had cholestasis, preeclampsia, VBAC after two Cesareans, and was induced. Caylee: Wow, good for her. Meagan: Yeah, but preeclampsia, right? Okay, let's talk about the things. So what are the symptoms that you one, may be experiencing, and two, that there may be that someone might not experience? Caylee: Yeah, so for me, it was intense itching mainly on the bottom of my feet and on the palm of my hands but I had it everywhere. I have scars on my ankles, up my arms, on my belly just from scratching. Meagan: From scratching? Caylee: Yes, incessantly. It's an itch that you can't really scratch. It's in your blood that is making you so itchy so you can scratch all you want and it's temporary relief but as soon as you stop, it's like, oh. I broke down in tears so many times and had ice packs on my feet and on my hands while I was trying to sleep. Another symptom is darker urine output and some upper right quadrant pain. Meagan: Yes. Yeah. Caylee: Those are very common and some people also experience jaundice. Meagan: I was going to say yellowing, jaundice. Decreased appetite. Caylee: Yeah. You're more likely to get preeclampsia and gestational diabetes. Yeah. Meagan: Mhmm, yeah. So nausea, feeling unwell, dark urine, lack of urine output which a lot of the time, dark urine is the beginning of that. Your kidneys are warning you and then you stop. Yeah. I had a client, not the one I was telling you about, but another client. She said that her bowels like her poop smelled really weird, like abnormal. Caylee: Yeah, I've heard that before too. Meagan: Yeah. That's the first time when she was like– that was actually one of her first symptoms that she noticed. Thinking back, she was like, “Yeah, I guess I was kind of itchy, but I wasn't itchy-itchy until later.” But that was one of the things where she was like, “I just thought I ate something weird.” Caylee: Yeah. Meagan: A decreased appetite. Pain in your belly and your quadrants, jaundice, and of course, itching. Those are the main signs. Caylee: Itching. And the severity of the itching can vary greatly between cases so the first time, it was quite mild and then it progressively got worse throughout my pregnancies. That's different for everyone who experiences that so if you have any itching, you should ask for LST's and bile acid tests from your provider. Itching can also precede the bile acids rising and the elevated bile acids is what's dangerous for the baby. It increases the risks in the baby where they might pass meconium before birth and also stillbirth risk goes up a lot if the bile acids are above 40. Meagan: Too high, yeah. So when you are pregnant, if you are having symptoms, definitely go in and get checked like she said. Get these tests. Then if you have cholestasis, if you test positive and things are looking like you have it, it is something that may increase extra testing and extra visits because you do want to keep a close eye on this. Again, like she said in the beginning, it's really rare. Even right here, it shows on this link that I'm going to put in the show notes, it's from the Cleveland Clinic, but it shows 1-2 in 1000 people during pregnancy will experience this. It's pretty low, but it can be a serious thing. Also, I was going to ask you because I know my clients have in the past. They've been given some things to try and control, to minimize, to control, to lower things to try and continue pregnancy to a good, safe term stage. Were you given anything like that? Caylee: Yeah. I was put on a medication called Ursodiol. It helps lower bile acids to make it a little bit safer for the baby so you can continue. With my last pregnancy, they were very severe levels. They were over 100 so it was kind of touch and go there whether we could get him to 36 weeks or not. They were talking about inducing me at 34 weeks. We ended up opting for non-stress tests and biophysical profile ultrasounds just to keep an eye on him. Meagan: And he did well? Caylee: He was doing well. He had already passed meconium sometime before I was induced though at 36 weeks. It was time for him to come out. He was already in distress so it was good that we did end up taking him out at 36 weeks, but he did great. Really great. Meagan: Good. Good. That's another thing I would like to drop in and note that if you do have cholestasis, it may be something that brings you to something like an induction that is earlier than expected. Obviously here, we're going to share this story in just a second about VBAC and induction. It's possible and totally doable, but that is a thing. Cause of CholestasisMeagan: She's mentioning bile. It is in the liver, right? Am I correct? It's in the liver. Caylee: Yeah. Meagan: We don't really know why. I don't know why. Do we know exactly why it happens?Caylee: They don't. They think it's something to do with pregnancy hormones and the placenta, but they don't know for sure. It's some sort of genetic factor as well, but no woman in my family who I know has had it. So I think it's just something that can happen sometimes. Meagan: Yeah. I have heard the hormones like estrogen and progesterone can be too much in the body. So just to circle back around again, if you have had any of these symptoms or if you are having any of these symptoms, it's okay. Don't hesitate and go in and get checked out. Caylee: And if you go in and get a negative result and still have symptoms, ask your provider to keep testing you. Meagan: Yes. Go back and check again. Okay, so baby number one? First pregnancy: TwinsCaylee: Twins. Meagan: Twins! Caylee: Baby one and two, my first pregnancy. Meagan: So twins. You had symptoms? Caylee: I did, yes. I got it pretty early on and they tested me and it was negative. They just put me on Ursodiol before anything came back positive. They didn't do anymore testing or anything. I didn't have any itching. The medication must have made it go away somewhat. Yeah. I was only 21 when I was pregnant with the twins so I was pretty young. I didn't know much of anything. I knew I wanted a vaginal birth. I had actually switched providers in my third trimester to somebody who was comfortable with vaginal birth with twins and they ended up being breech when they decided they needed to take them out. Preterm Cesarean at 36 weeks due to breech presentation and IUGRIt wasn't due to cholestasis, but I did have them at 36 weeks because one of the twins had stopped growing so they took them out. Meagan: IUGR? Caylee: Yeah. Yeah. He was quite significantly smaller than his brother. Meagan: Okay. That can happen with twins too, I know. Caylee: Yeah, totally. Yeah. My twin A was 6 pounds, 7 ounces, and twin B was 4 pounds, 4 so it was quite a big difference. Meagan: Mhmm. Caylee: Yeah, so it was a C-section with them. We were in the NICU for two weeks. Second pregnancyCaylee: I ended up getting pregnant again when the twins were 16 or 17 months old. I knew I did not want to do that again, having a C-section so I found supportive midwives and got on with them. Unfortunately, I don't know if it's in Canada, but they don't allow home birth for your first VBAC for some reason. Maybe it was just those midwives, I don't know, but I really wanted a home birth and they were like, “No, let's do hospital. It's safer.” I was like, “Okay, as long as I can still have my VBAC. I'll just do that.” The pregnancy went well. I thought I wasn't going to get it again. No itching, then I hit 34 weeks and the dreaded itching started again. I kind of had a feeling that I had it during my first pregnancy too from my own research. I had mentioned it to my midwives beforehand so we were looking for it seeing if it would happen. They sent me for testing right away at 34 weeks. It came back negative so they ended up testing me again weekly and then at 36 weeks, they tested me and my liver function tests were very high. My liver was basically failing and they didn't even wait for the bile acids to come back. They just brought me in for an induction. Meagan: What week again? Caylee: I was 36 weeks and 2 days when they started my induction.Meagan: Okay, so technically preterm. Caylee: Yes, yes. InductionCaylee: When I went in, they started with a Foley balloon to help dilate my cervix and that was awful. It's like a torture device, I swear. But it was effective I guess. It dilated me and then it fell out and I don't know if they didn't have a nurse for me or something, but I was waiting 8 hours for them to continue my induction. The OB came in and he wanted to break my water. I said, “No. Let's start low Pitocin.” He was like, “Well, it's not really going to do anything if you're not going to break your water too.” I said, “Okay, let's see how it goes.” Meagan: Yes. Caylee: We did that. Labor was going smoothly. I loved being in the shower. It was amazing. Then they made me get out because his heart rate was dipping really high so they wanted to get me out and be able to monitor him a little bit better. That's when things got really intense and I felt like I wasn't able to cope as well after I got out of the shower. I think in the back of my mind, I was still pretty young with him too for my first VBAC. I was only 24 and I know that uterine rupture risk is very low, but for some reason, I just couldn't get that out of my mind and every contraction I'd have, I'd just feel like I was being ripped open and was so scared that I was having a uterine rupture. I ended up– it was 32 hours into my induction and I still was at 4 centimeters just because I wasn't letting my body relax and do the work. I was tensing and fighting every contractions because I was terrified. I ended up getting an epidural at 1:00 AM and 5 hours later, I woke up and was fully dilated and pushed for 15 minutes and he came out. Meagan: 15?! 1-5? Caylee: Yeah, 1-5. Meagan: Oh my goodness. Caylee: As he was coming out, I pulled him up to my chest and it was just this amazing feeling like, Oh my god, I did it. The high that comes with that is unbelievable. Meagan: Yeah. Caylee: I just kept looking at everyone saying, “I did it. I did it.” Meagan: Absolutely. Caylee: It's an amazing feeling. Meagan: It really is. Caylee: I fought with the OB who was on call a little bit, the one who wanted to break my water. He kept saying, “Does she want to do this? Let's just go for a C-section.” I'm like, “Yeah, I can do this all night long and he can stay out of my room until I'm pushing. My midwives have got this, thanks.”Unfortunately, because I had to be induced, I had to be overseen by an OB so my midwife ran the show and was able to be with me and do everything, but he had to be there in case anything went wrong I guess. Meagan: That's kind of normal. A lot of the times, when there is a hospital midwife, there are OBs who oversee them. Caylee: Yeah. Yeah. So yeah, that was my first VBAC, first induced VBAC. Second Induced VBACCaylee: I just recently had another induced VBAC. With this one, my levels went up high. I think it was 28 weeks that I tested positive so it was sooner. Meagan: Significantly sooner. Caylee: Yeah. They went from 0 to 100 within a matter of days. They put me on Ursodiol immediately as soon as it came back positive. I was being monitored weekly with NSTs, non-stress tests, and they were sending me for biophysical profiles as well weekly which is an ultrasound to check on the baby's well-being. He was doing well so they just were keeping going with that and unfortunately, the Ursodiol did not help my itching this time around. It was so severe. I was in tears pretty much daily from the severity of the itching. Yeah. It was really bad this time. The mental health aspect of having that incessant itching I don't think is talked about a lot either. It really gets to you. It's depressing. Meagan: Oh, I would not do well with that. I would find myself getting very anxious probably and out of control. Caylee: Even now, if I get an itch, I get PTSD. It's like, Oh my god. It's not going to stop. I freak myself out and work myself up. I remember that after my second pregnancy as well. It was like I'd get a bug bite and I'd just have to itch and itch and itch until it was bleeding. Oh, it was just bad. I don't know how to leave itching alone now. His levels were very severe, or my levels I guess. My liver function tests were some of the worst that my OB had ever seen. Meagan: Interesting. Caylee: So yeah, it was just really bad. Caylee: I had actually applied for midwives. We had just moved from Alberta for BC pretty much as soon as we found out we were pregnant with Henley here. I applied pretty much as soon as I found out I was pregnant for the midwives here. I ended up hearing back from the midwives in Edmonton which is an hour and a half away that they could see me up there but once I got the itching and cholestasis, I was like, “Just transfer me to an OB where I live. It's just easier for me then all of my appointments will be out here and I don't have to drive 1.5-2 hours to appointments in the middle of winter.” Yeah, so they scheduled my induction for exactly 36 weeks because of the high levels. They didn't want me going past that because with levels over 100 bile acids, the stillbirth risk goes up very high after 37 weeks. Meagan: Did they give you a percentage or anything like that? Caylee: Yeah, I think it's upwards of 15% with very severe levels. Meagan: Oh wow. Caylee: If levels stay under 40, your risk of stillbirth is around the same as anyone else's. They go up 3% over 40 and over 100, it's even more. So it was a bit touch and go there. They were talking about inducing at 34 weeks and we were able to get to 36. Still preterm, but a higher likelihood that he wouldn't need additional support. InductionCaylee: I was induced at exactly 36 weeks. I actually had influenza B when I had to be induced. Meagan: That's miserable. Caylee: As if labor isn't hard enough alone, I had to have influenza B. It was great. Meagan: Miserable. Yes. Caylee: Yeah, one perk though was that we got a private room right away. I didn't have to labor in triage until I was far enough along to get my delivery room or whatever. They put me right in there. I was able to get set up and feel like it was my space and get more comfortable. So yeah, they started with the Foley balloon again to open the cervix. They can't do Cervadil or a few of the other cervical ripening– Meagan: Cytotec. Caylee: Yeah, because it really does increase the risk of uterine rupture with induction, but the Foley balloon is a safer option and it works. Within an hour and a half this time, my cervix was 4 centimeters. Meagan: Wow. Caylee: From barely a 1. It was kind of funny. I was standing there talking to my husband and I took a step toward the bathroom and it just flopped out and there was this line of blood up and down the floor. It was like a total bloody show. Meagan: Mucus. Caylee: In a perfect line. Meagan: Oh my gosh. Caylee: Because they attach the tube to your leg. They tape it to your leg so when it falls out, it makes a long, smooth line. My husband pulled the nurse call button and she's laughing. She ended up cleaning me up. Things picked up pretty quickly from there this time. I felt it was much more manageable though. I don't know if the nurses were nicer this time and they were doing the Pitocin a bit slower because I remember with my first VBAC, the contractions just felt back to back like I wasn't getting a break at all and it was really mentally wearing me out after 32 hours. I hadn't slept. I ended up getting the epidural but this time, it felt like more of a natural progression. I don't know. I've never had natural labor, but for me, I was able to handle it a lot better. Maybe that's because I knew what to expect this time so it wasn't as scary. Meagan: It could be. Caylee: Yeah, I don't know. Or I've heard too that with cholestasis that the bile acids or something make Pitocin more effective so maybe I didn't need as much of it this time because my levels were higher. I don't know but it was much more peaceful this time and I knew what to expect even though I was sick. I labored in the shower for a little bit with the mobile monitor because with inductions, they want to be able to monitor the baby constantly which I know is talked about a lot on here as something that is not ideal. Meagan: Yeah. Even if no induction with VBAC, it's really, really common if not 100% that your hospital is going to want that monitoring. Caylee: Yeah. And having that mobile monitor though is so helpful if your hospital has one of those. Definitely ask because oh my gosh, it's so nice to be able to get up and walk around and move and shower. Unfortunately, because of the flu, we were battling a fever. I had a fever so as soon as my Tylenol would wear off, my fever would spike and then his heart rate would go up. I had an anterior placenta so it was kind of in the way of the monitoring and it was hard to get him constantly so they ended up wanting to do the electrode. Meagan: The IUPC and the FSC? Caylee: Yeah, I think so. It's the one that they put on the scalp. Meagan: Okay, that's an FSC, fetal scalp electrode. Caylee: Yeah, that unfortunately didn't work very well. I was bed-bound but I was so sick that I didn't even really care. I was just switching sides laboring through, using the gas. I loved the gas this time.Yeah. I ended up getting to an 8, 8 centimeters and the OB unfortunately was not the OB who I had through my pregnancy. She had gone on vacation for my induction, unfortunately. I was really sad about that, but the OB on call came in and he was like, “You know, this is taking pretty long. I think it's time that we start thinking about a C-section. I'm getting worried about your scar.” I'm like, “I've done this before and it took longer last time. I am not having a C-section.” Meagan: Good for you. Caylee: I don't think he really liked that though because he was like, “Well, then you're getting an epidural because at least if you have the epidural and something happens, we can rush you in and open you up faster,” and blah, blah, blah. I'm like, “It has to be at least 24 hours and it's only been maybe 12 hours of hard, active labor here. My C-section scar is strong. It's been over 7 years since my first C-section. We are both doing well. Yes, I'm sick. Yes, his heart rate keeps going up when we have a fever but when the Tylenol kicks in, his heart is going back down and his tracing is normal. Why would I have a C-section?” Meagan: The fact that you're having a fever is more likely to the fact that you are sick versus that you have an infection.Caylee: Yeah, exactly. They tested me when I got there and they knew that I had influenza B and I tested for Group B strep so I was just having to fight with another OB again which is really frustrating, but yeah. He ended up leaving the room and my doula and my nurse were both like, “Wow, you're amazing. I'm actually so impressed with you saying no to him.” I guess a lot of people just go with what the doctor says. Meagan: Well, I guess. Caylee: That is why there are so many unneeded C-sections. Meagan: Well, we've talked about it on the show where it's like, I didn't go to years and years of medical school, so okay, I guess. Same thing with me, I was like, Okay, and went down and had a C-section when I completely did not need a C-section. Caylee: You hope that doctors are saying that when it is actually medically necessary and not when it's convenient for them. I think he was getting like, It's been 24 hours. I'm almost off-shift. I don't know, but I was not having it. It was actually funny. When he texted me, he was like, Oh, you're 8 centimeters, but he's -2 position and not coming down. He was like, It's probably time to do a C-section. I was like, “No, it's not actually.” Meagan: Oh my gosh. He really wanted to do a C-section. Caylee: Yeah, so I was like, “No, I'm not having a C-section.” He ended up leaving the room and pretty much immediately, I had a super strong contraction. I jumped off the bed trying to get away from it because apparently, that can help. I kind of grabbed my nurse's shoulders, the poor thing. She is this tiny, little 20-something nurse. I grabbed her shoulders and my body was pushing. I was farting and things were moving down there. Meagan: I bet that baby was coming down quickly too. Caylee: Yeah, that quick movement. Popping up just brought him down and she was like, “Are you pushing?” My doula was like, “Well, that's a good sign.” I was like, “I don't think so.” But my body was just doing it and then I barely made it back on the bed before his head was out. Meagan: Oh my gosh. So was the provider even in there? Caylee: No. Nope, he was just leaving the room telling me that I needed a C-section because I wasn't progressing. Meagan: I know that he had left but I didn't know if she was beeping him back in like, “Come back in!”Caylee: I guess he was down the hallway at that point and his head was out. I made it back onto the bed thankfully. My nurse was down there taking the fetal electrode out of his scalp panicking a little bit being a nurse. She was like, “You need to keep pushing.” I'm like thinking in my mind, No, I need to rest for a second. His head's out. He's fine. I knew in my soul that he was okay. I took half of a second to rest and then my body was pushing again and he was out. Meagan: Oh my gosh. Caylee: He had the umbilical cord wrapped around his neck and his armpit. I thought that maybe was why he wasn't coming down. Meagan: It could be. Caylee: Maybe he was tangled up in there a little bit and couldn't come down fully but maybe that quick movement that I did to pop out of bed was just enough to let him come down. It was so quick. I was looking around. My doula ended up riding out into the hallway to call my OB back and my nurse was frantic. She was like, “This was my first baby I caught!”Meagan: Aw, and it was a VBAC. Caylee: Yeah, yeah. I'm looking around the room like, “Whoa. What just happened?” I went from 5 minutes ago being told it was time for a C-section to my baby on my chest. Meagan: Yes. Oh, that is amazing. You know, maybe that person needed to leave to also relieve some stress so baby could come down. That's another thought I had. Caylee: Yeah, I think that was it and maybe my baby was like, Yeah, we're not going for surgery, mom. Let's show this OB what's up. Meagan: Yeah, seriously. It reminds me– is it the tiger or the lion? I can't remember the thing, but when you are being chased or when you are in a hostile environment, you either tense up or you run or whatever. We've got all of these senses and you could have been like, Nope. I am not having this baby with you in this room. I've had enough of your C-section talk. So cool. So after, with all of the babies, but especially with this one because your levels were so bad, were there any complications? Caylee: I guess I did touch on this a little bit before. I forgot though during my birth story there, when they broke my water, because I did allow it earlier this time because I felt with my first VBAC that that actually helped speed things up a little bit. I did allow them to break my water and start Pitocin at the same time this time. When they broke my water, it was full of meconium. They weren't too worried about it. Thankfully, that OB seemed pretty C-section happy and he was still like, “Oh, no big deal. We'll just monitor him. It's okay. There is a risk there for aspiration, but it's not a total risk that that will happen.” So they were just monitoring that. When he came out, he was fine for being 36 weeks. He was breathing good. They wiped his face because there was the meconium on his face, but no. He was great. It was more me that I was worried. I was like, “Is he okay?” They were like, “He's fine.” Meagan: Good. That's so good to know. I was just curious because he was early, high levels, induction, fevers, all the things so that's so good to hear that he was really great. Caylee: Mhmm, yeah. Even my twins were 36 weeks, 2 days when I had my C-section. They were in the NICU for 2 weeks and that was just for feeding and growing. They didn't know how to suck and then with my now 5-year-old, he was totally healthy when he came out too. He was 36+4 at the time he was born because my induction took so long with him, but yeah. He was healthy. He did have jaundice quite badly though so he needed the bilirubin lights and then with my baby now, he also had jaundice but he was able to stay off of the lights. He was just under that level for needing phototherapy. That's pretty common with early babies anyway. I don't know if that had anything to do with cholestasis in general or if that was just them being early that it was more likely to happen.Meagan: Yeah, that makes sense. Oh, well thank you so much for sharing your story and talking more about cholestasis with us. Like you said, there is not a lot out there. It is not very common so it makes sense that it is not talked about that often. However, uterine rupture isn't very common but it is talked about all the time. Caylee: Yeah. Meagan: So you know, but it's good. It's good to be aware. It's good to understand the symptoms and what's going on and why so I'm so grateful that you shared your stories. I'm so grateful that everyone is healthy and happy and wonderful and you are smiling and have some good birth experiences and maybe some healing birth experiences. Caylee: Yeah, totally. Meagan: You showed yourself that you could stand up to pressuring doctors. Caylee: Yes. I honestly thank my doula for being there for my last birth because I don't know if I would have had the confidence to be that firm with such a pushy, “this is what's going to happen” doctor. We had talked about it previously that she can't say anything for me but that she will be there to support and give me the power to advocate for myself. I totally felt that power from her. She was amazing. I'd like to shout her out to Little Loves Doula in Red Deer. She was amazing. Stephanie, she's great. If anyone is in Red Deer, Alberta, definitely contact Stephanie from Little Loves. Meagan: Well, you know that we love doulas here and always encourage checking out a doula. We do have VBAC Link-certified doulas. She's got her doula. Yeah. Caylee: I think she was also VBAC Link certified. Meagan: Was she or is she? Caylee: Yeah. Meagan: That's so awesome. You can check out The VBAC Link doulas at vbaclink.com/findadoula. Let me tell you, it's so fun to see all of the doulas in all of the different states. We are growing within the States. And if you have a doula in mind who is not on the VBAC list, send them the link. We would love to have them and have them support our VBAC clients and our VBAC community. Thank you so much again. Caylee: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Vous avez surement déjà vu Messmer claquer des doigts, ou tirer le bras de quelqu'un et en un mot la personne est en transe. Comment est-ce que ça fonctionne ? Est-ce de la manipulation ? De la simulation ? Et surtout, comment est-ce que vous pouvez vous aussi apprendre à faire ça ? Dans cet épisode de l'art du mentaliste, Taha et Alexis explorent divers inductions, leurs éfficacités et discutent de leur utilité dans la vie quotidienne. Un épisode qui vous donnera envi d'essayer. Références : - Jacquin, Anthony. "Reality is Plastic!." (2007): 2004-2010. - Braid, James. The Discovery of Hypnosis: The Complete Writings of James Braid, the Father of Hypnotherapy. UKCHH Ltd, 2008. - Elman, Dave. "Hypnotherapy." (No Title) (1964). - « The Predictive mind : An introduction to Bayesian Brain Theory » de Hugo Bottemanne, Yannick Longuet et Christophe Gauld (Encéphale, Paris, 2022) L'art du mentaliste, un podcast animé par Taha Mansour et Alexis Dieux, musique par Antoine Piolé. Retrouvez Taha Mansour : - Ses spectacles : L'effet Papillon : https://www.billetreduc.com/326581/evt.htm La mystérieuse histoire de Thomas Polgarast : https://www.billetreduc.com/275400/evt.htm - Son site : www.tahamansour.com - Instagram / Facebook : @TahaMentalisme Retrouvez Alexis Dieux : - Son site : https://www.alexisdieux.com/ - Instagram : @alexisdieuxhypnose

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

It's day 3 of the 12 days of birth! This week I chose to re-air a solo episode talking all about spontaneous labor versus inductions, and why spontaneous labor is typically preferred. I also touch on the timeline of medical inductions and what that entails. You'll learn about a few things you can do during your pregnancy to prep your body for labor, too! And then at the end of the episode I share the quick version of what I personally did with both of my boys to get myself into labor. Want to erase anxiety and actually feel excited about birth? Get instant access to my FREE Birth Workshop to learn tons of pain-coping strategies and actionable tips today! Have an even better birth! CLICK HERE to learn more about our online birth classes that will help you feel prepared and in control - no matter how you deliver. And be sure to follow @mommy.labornurse on Instagram to join our community of over half a million for education, tips, and solidarity on all things pregnancy, birth, and postpartum!

This episode of Kiwi Birth Tales is proudly brought to you by Huggies NZ.In this episode of Kiwi Birth Tales, I speak to Courtney. Some of the topics we cover:Coming off the pillChanging midwife at 10 weeksLocal Antenatal course Cholestasis of Pregnancy (itchy hands and feet first symptoms) Gestational Diabetes Stretch and Sweep Induction after spontaneous waters breaking EpiduralQuick Pushing Positive Induction stories Cystic Fibrosis diagnosis after newborn checks with Luca Please seek support for any mental health concerns, some helpful links are below:Mental Health in PregnancyPerinatal Depression and Anxiety Aotearoa Plunket - Dads Mental HealthLittle Shadow - Private Counselling NZYour Birth Project Online Hypnobirthing CourseFind me @kiwibirthtales and @yourbirthproject Hosted on Acast. See acast.com/privacy for more information.

In this episode of the MamasteFit Podcast, hosts Gina, a perinatal fitness trainer and birth doula, and Roxanne, a labor and delivery nurse and student midwife, discuss the polarizing views on birth. They emphasize the importance of understanding and balancing the extremes of both highly medicalized births and no-intervention births. Sharing insights from their professional experiences and their personal birth stories, they advocate for educating expectant parents about the risks and benefits of all birth options to empower them to make informed decisions.  Find Needed's Prenatal Comparison Guide Here: https://thisisneeded.com/pages/prenatal-vitamin-reviews Preorder Gina's New Book, Training for Two, HERE!: https://amzn.to/3vsdJIR In This Episode 0:00 Welcome to MamasteFit: Empowering Your Birth Journey 01:12 Navigating Birth Extremes: From Medicalized to Natural 04:51 Personal Birth Stories: Overcoming Fear and Finding Balance 05:38 Understanding Interventions: Pitocin, Inductions, and Making Informed Choices 11:53 The Power of Education: Transforming Fear into Confidence 17:23 Sponsor Break: Optimizing Nutrition with Needed 19:15 Reflecting on Birth Experiences: Learning and Growing 45:13 Finding Your Middle Ground: The Importance of Open-mindedness in Birth —— This podcast is sponsored by Needed, a nutrition company focused on optimal nourishment for your perinatal journey. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Use code MAMASTEPOD for 20% off your first order or three months of subscription.⁠ ⁠⁠⁠⁠⁠⁠⁠⁠  ****Freebies***** Early postpartum recovery course:  https://mamastefit.com/freebies/early-postpartum-recovery-guide/  Pp sample  https://mamastefit.com/freebies/postpartum-fitness-guide/ Prenatal Sample:  https://mamastefit.com/freebies/prenatal-fitness-program-guide/ Pelvic Floor  https://mamastefit.com/freebies/prepare-your-pelvic-floor-for-labor/ Birth Prep for Labor Guide  https://mamastefit.com/freebies/prepare-for-labor-guide/ Birth Partner Guide  https://mamastefit.com/freebies/birth-partner-guide/ Birth Plan  https://mamastefit.com/freebies/birth-plan-guide/

Are you hiring your first staff member in the beauty industry and have no idea how to do it?Inductions help to ensure not only the success of your therapists but also the success of your business long term!Call me a millennial boss but I want to help my staff to flourish, feel purpose & enjoy their workplace as well as empower them to do well!In turn as my business grows financially, I will support my team financially! As I employ my third therapist, I'm sharing how I induct them into my business for the best chance of success for everyone!ENJOY! Love Kelly xxBeauty Business & Beyond CTAAre you looking for a Facebook group that will help you grow your business? Then click the link below to join the Beauty, Business & Beyond Facebook Group:https://www.facebook.com/groups/689976828528358PhorestWant to Receive 50% off your set-up fee with Phorest Software as well as 2,000 Free SMS to use on SMS marketing campaigns of your choosing? Click the link below to take advantage of this exclusive Beauty, Business & Beyond listeners offer and someone from the Phorest Grow team will be able to assist you! Phorest Salon Software, #TogetherWeGrowSubmit the linkMUCH LOVE!! XxxSkinQueen xo

Audrey Ross is a Birth keeper and advocate diving into some topics challenging the status quo. Maternal health continues to decline in the United States while medical interventions increase. Audrey is tackling some common birth questions such as interventions, home birth, midwifery care and more.  Connect with Audrey: https://stan.store/ajoyfulbirth https://www.instagram.com/Ajoyfulbirth Connect with Liz https://www.instagram.com/esandoz/?hl=en https://www.Elizabethjoy.co Get the First Trimester Survival Guide https://elizabethjoy.co/freebie Join the Waitlist https://elizabethjoy.co/join-waitlist Sponsor BetterHelp dot com slash PTPS today to get 10% off your first month

Today we're getting into the background on inductions, elective vs. medically necessary, induction benefits vs. risks, and finishing up with 3 tips to help you ROCK your induction if it is needed!! --- Send in a voice message: https://podcasters.spotify.com/pod/show/lexizuo/message

Join us as we talk with Dr. "Bill" Chun the founder of Doc & Doula. We discuss the maternal health crisis, birth inductions and how we can work together to provide better care for women nationwide. Dr. Bill has created a foundation called Douls for Everyone which aims to have doulas become accessable to all birthing people. Doulas for Everyone provides doula support and childbirth education to low-income and at risk families at an affordable rate. Dr. Bill is the founder of Doc & Doula and Doulas for Everyone. Find him online at https://www.docanddoula.com or https://www.doulasforeveryone.org/.

On this episode, we talked about: Homebirth is safer for my and my baby You can make decisions on your own, but you have to own the outcomes of those decisions Even tho the placenta ages, it is supposed to age We don't need to intervene unless it's absolutely necessary We have no idea what happens whenever a woman goes into labor What's happening with the placenta? Inductions tend to hurt a lot more The baby knows when and how to get out The pain is super complicated "If I can't talk to you about the realities of what we do and don't know, then I can't do my job"   "Just because the placenta it's starting to calcify, does not mean the baby is compromised"   "When a person doesn't feel supported, they don't feel seen and cared for, pain is actually far worse"     About Nathan: Nathan is a father of two, the second of home was born at home. He's married to his high school sweetheart, Stephanie. He grows food, reads more than he probably should, and enjoys coffee, mountain biking, and being in nature. He and his wife are perennial Burners. Nathan is also a psychonaut, procuring his own ceremonial medicines for fellow travelers. Nathan has a history of athletics, including triathlon (Ironman distance) and rock climbing. He also served as a CrossFit coach for 6 years. He has dedicated himself to the study of exercise science and nutrition since he was 16 (yes, really). In his spare time, he supports clients through fertility challenges, pregnancy, childbirth, and postpartum. He also supports fathers-to-be through the spiritual transformation of childbirth. He manages a private practice called Beloved Holistics, a private contract association. He also attends home births, and he provides collaborative care for midwives across the country who struggle to find a friendly OBGYN with whom to consult on clients. He also recently started training in jiu-jitsu. He left the conventional medical model for a few reasons. For one, he was tired of renting out his time to bean counters and administrators at the minimum wage they could afford to pay him while maximizing profits for their c-suites. Second, he despises the insurance model that characterizes BigMed in the United States. Lastly, he was fired twice during the COVID pandemic. 1st: for calling medicare fraud on his hospital. 2nd: for taking off his mask while visiting with a dying 95-year-old on hospice.  

To send us a yarn or a voice memo - Click on the link below. https://bitly.ws/YYGt  1:30 - Crook Book with Jay. 5 - Jay's Shambolic Life. 15:20 - Urban Legends. 19:19 - What Price would you put on your nuts? 30 - Site Inductions. Give us a follow if you haven't already ~ Jay and Dunc. Want to get in touch? Hit us up, here: https://linktr.ee/notforradioSee omnystudio.com/listener for privacy information.

Inductions are a hot topic in the labor and delivery world! There is a lot of information floating around (both positive and negative), and it seems like every person has their own, differing opinion.  And I would venture to say that a lot of people get a sour taste in their mouth when they hear the word induction. But I am here to tell you that it's possible to have a positive and uncomplicated birth experience with an induction. Trust me mama, I see it happen all the time! In this episode, I will spend some time exploring the ARRIVE Trial with you and will also cover the pros and cons of induction vs. spontaneous labor. Want to feel more in control of your birth experience? No matter how you plan to deliver, the FREE Birth Prep Guide is here to help you prepare. Have an even better birth! CLICK HERE to learn more about our online birth classes that will help you feel prepared and in control - no matter how you deliver. And be sure to follow @mommy.labornurse on Instagram to join our community of over half a million for education, tips, and solidarity on all things pregnancy, birth, and postpartum! Related Resources ACOG: Induction of Labor at 39 Weeks

In this episode Darby comes on the podcast to share both of her induction birth stories and how they have propelled her into becoming a doula! ____________________ 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  Darbys website: https://boundlessgracebirthky.com/ --- Support this podcast: https://podcasters.spotify.com/pod/show/what-the-bump/support

Welcome back to another episode of The Pulling Curls Podcast: Pregnancy & Parenting Untangled. In today's episode, we have a special guest, Mama Nurse Tina, joining our host, Hilary Erickson, to discuss the importance of having the right mindset during labor. Hilary shares her personal experiences and recommends taking a birth class to gain knowledge and confidence. They discuss the need to lower expectations, create a comfortable labor environment, and surround yourself with supportive people. They also emphasize the importance of being prepared with a birth plan and practicing for different scenarios. Tune in to learn more about labor mindset and how it can positively impact your birth experience. Plus, stay tuned for upcoming episodes on organizing mindset and postpartum. As always, thank you for listening, and don't forget to review, share, and subscribe to help us grow. Now let's dive into the episode! Big thanks to our sponsor The Online Prenatal Class for Couples — if you're looking to get your mindset in the right space — come join us! Today's guest is Tina B. She's been a labor and delivery nurse for more than 11 years now and has been working hard lately on bringing people all over the world evidenced based information to help them navigate pregnancy, childbirth and their postpartum journey through her three social media platforms. Find her: Tiktok https://www.tiktok.com/@mama_nurse_tina Youtube https://youtube.com/@mamanursetina Links for you: Timestamps: 00:00:00 Podcast discusses labor mindset with guest nurse. 00:06:09 Disneyland trip: 50% good, 50% awful. Birth trauma and disappointments stem from high expectations. 00:08:31 Creating a personalized environment for hospital birth. 00:12:18 Transitioned to more inviting rooms since 1990. 00:14:57 Supportive people are crucial during labor. 00:18:06 Having supportive people in the room matters. 00:20:30 Inductions can be long, requires preparation. 00:23:18 Be flexible and prepare for different scenarios. Keypoints: Importance of taking a birth class to increase knowledge and confidence during labor. Mindset plays a crucial role in having a positive birth experience. The speaker recommends joining an online prenatal class for couples to help with mindset. Upcoming episodes on organizing mindset and postpartum. The importance of lowering expectations and the difficulty of preparing for childbirth. Creating a personalized and comforting environment in the labor room. Importance of having supportive people during labor who understand their role. The speaker shares personal experiences with supportive family members during labor. The significance of having a well-prepared birth preferences list or birth plan. The importance of practice and muscle memory in high-pressure situations during childbirth. Producer: Drew Erickson

Holmberg's Morning Sickness - Monday November 6, 2023 Learn more about your ad choices. Visit megaphone.fm/adchoices

Holmberg's Morning Sickness - Monday November 6, 2023 Learn more about your ad choices. Visit megaphone.fm/adchoices

Gary Graff on the new Beatles Song, Stones album, Rock Hall inductions, and Huey Lewis' musical by 102.9 The Hog

Today on the show I speak with mother of 3 Mary Allen. After becoming a Doula, understanding real birth and seeing the abuse that occurred in hospitals, she began accepting freebirth clients. When she became pregnant with her third, after having two inductions, she knew  she wasn't stepping into a hospital. Her baby came when she was ready, at 40 weeks and 4 days and was caught into her daddy's arms. She says it was the most beautiful and incredible experience she could have wished for and would do it again and again just for the experience itself! Mary Allen is exactly the kind of freebirth doula you'd want - someone who's lived it themselves!  More about Mary Allen:  I'm Mary, a mother of 3 in the beautiful Fraser Coast, QLD. I'm a doula who supports women who choose to birth undisturbed and completely on their own terms. Insta - wbdoulaservices

Today we're talking about inductions around the holidays and how to be mindful of falling into an unnecessary induction.Please feel free to reach out to us with any recommendations for show episode ideas. If you'd like to be a guest, email us with some information about yourself and what type of podcast you'd like to record together. Thank you for all of your support and don't forget to follow and review our podcast, Birth, Baby!Instagram: @‌BirthBabyPodcastEmail: BirthBabyPodcast@gmail.comWebsite: https://birthbabypodcast.transistor.fm/Intro and Outro music by Longing for Orpheus. You can find them on Spotify!

In this episode, Russ and Steve look back at Steve's article prior to the game against the Bills.This show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/3351377/advertisement

✨ Is it time to transform and dissolve your anxiety? Book your complimentary consultation with Kimberly at www.calendly.com/consultinghypnosis ✨ DISCLAIMER! Please pause and read! All media content provided by Kimberly Ann O'Connor (consultinghypnosis.ca) is intended for entertainment or educational purposes only. None of this content is intended to offer or replace qualified medical or health-related advice. All hypnosis or guided meditation is self-hypnosis and must be regarded as such. The author accepts no responsibility or liability whatsoever for any injury, loss or damage in any shape or form incurred in part or in whole, as a direct or indirect or use or reliance upon information and material presented here. DO NOT WATCH OR LISTEN TO THIS MATERIAL WHILST DRIVING OR OPERATING MACHINERY, OR WHERE IT IS NOT SAFE FOR YOU TO RELAX. Please leave your GOOGLE REVIEW here: https://g.page/r/CbzG8obmL1UmEBM/review Tiny Trance Time Hypnosis Podcast HERE: https://podcasters.spotify.com/pod/show/consultinghypnosis Twitch Streams: Consulting Hypnosis THANK YOU! Join this channel to get access to perks: https://www.youtube.com/channel/UClVV... Well hello, everyone! Welcome to this ASMR Sleep Hypnosis Session! My name is Kimberly Ann O'Connor, I am a professional hypnotist living in Toronto and working with clients globally since 2012. Today, I will guide you into a brief but powerful trance designed to serve your mind, body & spirit. During this sleep hypnosis experience, you will be guided deeper and deeper into hypnosis and sleep with multiple hypnosis inductions. Thank YOU so much for being here! Let's work one-on-one & solve your problem with trance. Book your COMPLIMENTARY HYPNOSIS CONSULTATION over the phone here: https://calendly.com/consultinghypnosis ___________________________________________ CHECK OUT MY WEBSITE! www.consultinghypnosis.ca ...for information, rates, and testimonials and to learn more about how hypnosis can powerfully and positively serve you and your life. BECOME A PATREON SUPPORTER FOR FULL SESSIONS! www.Patreon.com/ConsultingHypnosis PLEASE LEAVE ME A REVIEW ON GOOGLE! Search: Kimberly Ann O'Connor: Consulting Hypnosis Please LIKE, SHARE & SUBSCRIBE if you are so inspired! I HAVE A PO BOX! I don't exactly know why. :) Kimberly O'Connor CYQI-6VW6 2-120 Eglinton Ave East Toronto ON M4P4E0 *** Enjoy and explore more of my hypnosis and ASMR experiences: ASMR (Whisper): ENJOY THE JOURNEY: Hypnosis /w Professional Hypnotist Kimberly Ann O'Connor: https://www.youtube.com/watch?v=SdOFq... *** Please always review the disclaimer posted at the beginning of each HYPNOSIS video and do not listen to this recording whilst driving or operating machinery. Original vocals and video by Kimberly Ann O'Connor © 2022. Excepts from Esther and Jerry Hicks, Daily Guidance From Your Angels by Doreen Virtue and inductions from American School of Hypnosis. #hypnosis #sleephypnosis #asmrhypnosis #hypnoticinductions

Welcome back to another heartwarming episode of The Labor Room Podcast, where we discuss everything you ever wanted to know about the world of birth and babies. Today, we've got a truly inspiring guest with us—Elizabeth Presta.

Sponsor: Needed: Use code BIRTHHOUR for 20% off at thisisneeded.com. The Birth Hour Links: Know Your Options Online Childbirth Course Beyond the First Latch Course (comes free with KYO course) Support The Birth Hour via Patreon!

You don't hear VBAC stories with gestational diabetes very often, but we want to change that! Charlotte joins Meagan on the podcast today sharing her experience with gestational diabetes and a surprise preterm delivery at 32 weeks. Though she had some pretty significant curveballs thrown at her, Charlotte's commitment to controlling what she could along with an amazingly supportive team allowed her to have an empowering birth experience. Charlotte knew she wanted a VBAC for an easier recovery. What she didn't know was truly how much of a blessing in disguise it became during the intense weeks she spent as a NICU mama. Additional LinksReal Food for Gestational Diabetes by Lily NicholsReal Food for Pregnancy by Lily NicholsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode DetailsMeagan: Hello, hello. You are listening to The VBAC Link and I am excited to be sharing a story with you today that we have gotten a lot of requests about. It's something that we don't see very often and my question is why? I don't really know why we don't see these stories popping up. Even in the community, I've had to search through our VBAC Link Community on Facebook to find these stories. There are three I think.So I'm excited to talk about this story today because I know that it's very much requested. We're going to be talking about gestational diabetes. Gestational diabetes again, is something that we don't see but it's actually pretty common. Crazy enough, we're seeing a rise in fact. Last year, in 2022, there was an article published talking about the actual rise that we're seeing. They said, “The new analysis of 3.25 million birth records follow a string of studies that suggest gestational diabetes has become increasingly prevalent over the last three decades,” which is kind of crazy. Every year anywhere from 2-10% of women will be diagnosed with gestational diabetes. We know that the Cesarean rate here in the U.S. is just above 32%. If you think about the 32% and 2-10%, you've got to think that people who are going for a VBAC are having gestational diabetes. My question is, are we not seeing VBAC with gestational diabetes because providers aren't allowing us? That's my question. Charlotte, today, welcome to the show. She is going to be sharing her story about gestational diabetes and her VBAC. Right, Charlotte? Charlotte: That's right. I'm super excited. Meagan: Yes. Yes. I'm so excited. I'm so glad that we connected. Charlotte lives in South Carolina in Greensville specifically. They have two baby boys– not baby, baby but they are young. She has a very baby and then a younger baby. She works in healthcare administration for a very large healthcare system and has truly become a birth nerd outside of work. This is something that birth just does to a lot of us. It captivates us. Right, Charlotte? Charlotte: Totally. Meagan: Do you feel that your birth is what brought you into your obsession with birth and VBAC in general? Charlotte: It's life-changing. Once you've been through it, it was such a seismic shift for me and it opens your eyes to what women are going through. Then you hear people's stories and everyone has something that has stuck with them. People who are years and years older remember exactly how their birth story was. I'm very Type A, so I just turned to research. I love it. Meagan: Yeah. Yeah. That's why I became a doula, through my own birth experiences and I know that's why a lot of other doulas become doulas or midwives or why OBs become OBs. It's really awesome and we are really excited to have your episode on the show. So thank you for being here today. Review of the Week I have a Review of the Week as usual so I'm going to get into that and then we will share Charlotte's birth stories. Today the review is from Blanely and it says, “There For Me When I Needed Support.” It says, “I got pregnant right at the start of the pandemic in 2020. It was a very lonely time isolated with my toddlers. I couldn't even hug my mom or get her support in the beginning. I had to switch providers due to insurance changes and I was scared. The VBAC Link became my companion at this time. Julie and Meagan, my friends, I would listen with one earbud while caring for my boys. It was educational and encouraging just when I needed it. I learned tons about birth and how to advocate for my VBAC. “In January 2021, I had my successful VBAC. It was a wonderfully redemptive process. Even though they aren't being produced right now, it is still the first thing that I recommend to any of my friends who are expecting. VBAC or first baby, I just love it and I hope it comes back soon.” Well, this was back in the pandemic and we did take a break and we are back. So thank you, Blanely. I hope you are still with us and I hope you just heard your wonderful review. We really do appreciate these reviews so much so if you haven't had a chance, I always ask. Stop and go check out on Apple Podcasts, Google, or wherever you're listening, and leave us a review. We absolutely love them. Charlotte's StoriesMeagan: Okay, Charlotte. Oh my gosh. I am serious– you're going to be the first episode, I believe. I don't recall any other episodes of gestational diabetes. Charlotte: I think that's right because I looked when I was diagnosed. I found a birth story that was a VBAC not on a VBAC podcast about gestational diabetes. It was one that I could listen to. Meagan: Yes. Yeah, and we've got some that had diabetes previously before pregnancy, but none with gestational diabetes. So congratulations on being our first. I hope you are not the last. If you are listening out there also, and you had gestational diabetes and you had a VBAC, we do want to share your story. We want to help people just like Charlotte when she was out there looking for these stories and only found one, we really want to add some stories because it's really not something that we are seeing or hearing. I'd like to turn the time over to you. We know that every VBAC has to start with a C-section, so if you want to talk about your firstborn's birth, we would love that. Charlotte: Absolutely. Well, thank you for having me. I, once again, was telling you that this podcast really started my journey. There was the C-section and then some conversations with providers that fueled the fire. Then after that, The VBAC Link was one of the first things that I turned to. It's super surreal being here today. I'm married to my husband, Hunter, and in 2020, my father had– before the pandemic started– two back-to-back major surgeries which put things into perspective. Then the pandemic hit and a lot of things got canceled. It's the same story for a lot of people. We were like, “Okay.” We had been putting it off. We'd been together for 11 years at that point and we were like, “Let's just go for it.” We got pregnant very quickly in the first month. We were super excited. It was an uncomplicated pregnancy other than just the general stuff from the pandemic. It's tough to be pregnant and not have the support or feeling like you can go and be out with your friends or see your family without potentially killing them or being scared of that. Meagan: I know. There was all of this fear. And even then, for a lot of my doula clients here in Utah, they were being told that if they went out and they got COVID, they were threatened. They were like, “You won't have your baby. You won't have your husband. You could kill your baby.” They were saying these very, very scary things. Charlotte: Yeah, so that wasn't great. In hindsight, with that pregnancy, I had a lot more time to myself worrying. Overall, it went very well. Right around the time that they were making sure with no questions that you had a birth support partner and all of that you were starting to see– even though he was delivered in January 2021 which was almost the worst of it. We were at a normal OB practice. As I mentioned, I worked in healthcare administration and academic medicine. I work remotely now, but back then, prior to the pandemic, I was going to the hospital. I was very comfortable with physicians. My mother was a physician. So yeah, I had no issue with that. I really had no reason to question medical care. Meagan: Right. Charlotte: There was also a new birthing center, a new birth wing of our hospital. They had always delivered babies but they had delivered at the other hospital in town for whatever reason. I was one of– within the last year, it had opened 11 months ago. They were still– I mean, it was amazing. Meagan: Getting on their feet. Charlotte: They were. I think there were just some growing pains but they had everything you could think of in this new center. So anyway, I was 30 weeks pregnant so I did deliver a little early with this guy. My son, Auggie. Augustus is his full name. Meagan: I love that. Charlotte: Yeah, I had a trickle come out in the middle of the night around 38 weeks and I was like, “What is that?” It could be pee. It could be whatever. Nothing started. We went back to bed, no big deal. I finished up some things with work the next day. We just said, “You know, why don't we just get this checked out?” We went to labor and delivery. They tested it and it was negative for amniotic fluid so we were like, “Okay, great.” We went back. We got home around 9:00 PM that night. I went to bed early. I just was tired from being in triage. It always takes longer than you expect and then woke up at 1:00 AM to pee as everybody does in the last trimester of pregnancy. There was more of a gush at that point. That's when I knew for sure that the startings of my labor started with water breaking. Now I know, that can be the start of a ton of positioning issues which is what happened with me. Yeah, so then I really quickly went into labor. I had actually done a birth class virtually with a doula. I didn't have a doula, but I felt like, “Okay, I'm going to try to go as long as I can without an epidural.” That was always my thing. “I'll go as long as I can, but I'll still probably have one.” I always had this disclaimer. I started laboring. It felt very primal and very natural. It was dark. I was on all fours, but it felt intense from the beginning. I say this now to my husband, “I never feel like I've had early labor with either of these labors. It just goes straight to intense for me personally.” So I was feeling really like, oh my gosh, grunting and moaning and doing all of the things. We did that for about 4-5 hours. Then I started to feel nervous. I wanted to go ahead to the hospital. We made our way there. When I got there, they checked me. They checked the amniotic fluid. It was the amniotic fluid. I believe it had been the time before as well. They checked me and I was 4 centimeters so I was super excited. I felt like, “Oh, this is moving super quickly and I'm going to have this baby today.”I was on the birth ball. I was prepared, or so I thought. I got to my room and felt, “This is super intense. I am nervous that this is going to move super fast that I won't be able to get an epidural, so I'd better go ahead and get anesthesiology to come. There were a bunch of people coming in and out. I'm sure it slowed things down at that point, but I had a medical student and an attending come in and ask if I wanted to be part of a cervical check study. I work in academic medicine so yeah, of course. Definitely. Let's sign up because that matters for students. You learn all of these things after the fact. You don't want to say no to things like that. Meagan: It's kind of awkward because you're like, “I know you need to learn and I want to help you.” Charlotte: Yeah, but it's like, “No. I don't need more checks. I don't need more people interrupting me.” Meagan: Especially with your water broken. Charlotte: Now I know. Right. Right. So anyway, there were things like that and they come in. I'm feeling very intense still and I'm 7 centimeters. Meagan: Wow! Charlotte: I'm feeling amazing. I'm going to keep moving this along. This is great. I'm texting all of my family and friends, “Hey, this is easy. I'm getting my epidural and in a couple of hours, this is done.” So they gave me my epidural. It worked great and I just chilled. I knew about the peanut ball and I did do the peanut ball, but I think I just laid around. I had my catheter. I was drinking all of the fluids and the popsicles, and just the normal things. You're hooked up to everything at that point. We were just chilling and then time passed and it was the whole day. They checked me again, “You know, okay. You're taking some time but it's still normal.” I actually had a midwife that was the person on call, or the 24-hour provider, so I did have a midwife caring for me. They just kept saying, “This is normal for a first birth.” I was like, “Okay.” More time passed. They decided, “Okay. Let's get some Pitocin to keep this going.” So I started Pitocin. I'm sure you're hearing the same old story, the cascade of interventions. Meagan: You know, it does. It does happen like that. Not always, but it does where it's like, “All right. We've been going. We've been going. We do need to get this labor going.” Pitocin is the next option, right? Charlotte: Yep. And so yeah, then it started with that. I knew, “Okay, let's do the peanut ball. Let's move around.” I didn't know. I thought a peanut ball was enough. It wasn't with the right positions and had I known all of the positioning issues I came to find out my son had, if I had a doula and if I had the right tools at my disposal, I would have held off on the epidural. There are so many things I would have done and that's tough for me. That's something I struggled with. What if I could have done better if I had known? Meagan: But you can't blame yourself. You can't blame yourself. Charlotte: No, you can't. So anyway, time passes. All in all, the labor was 27 hours. I don't know exactly the duration of time, but at one point we got multiple checks. “Okay, you've gotten a little farther. Great. Let's do internal monitoring. Let's do this. Let's see. Okay, the baby is not coming down as much as we would like. He's OP, asynclitic.” I come to find out that I think he had a nuchal hand because he came out like this and his hand was super bruised up. Meagan: Oh yeah, so when your water broke, he just [inaudible]. Charlotte: Yep. And asynclitic, your head is tilted to the side. He had all of those things. He was not coming down. An OB manually tried to push him up and switch him and was sweating and working hard for 30 minutes on that so you can imagine my body going through it. My epidural kept breaking through so I'd go from zero to 100 Pitocin, 9-centimeter contractions, and just pain. Meagan: And messing with things. Charlotte: Mhmm. Tons of meds. They'd try to get it all back and I'd be fine again. But it's like, in hindsight, we did throne position. They let me push on all fours. They let me push. I did end up getting to 9 centimeters or so when we started pushing. They let me push for 4 hours. So in hindsight, there is a lot that they let me do with an epidural, just things I think would be part of a positive story. All in all, 27 hours passed. I'm exhausted. Nothing is wrong with me. Nothing is wrong with the baby, but the midwife comes in and says, “Look. I think we need to call it. I don't think he's coming down. He's super high still.” Right or wrong, I don't know if more time would have helped, but he was starting to get a swollen part on his head and they just said, “I think it's time. You can definitely have a vaginal birth one day.” She said that to me and I was like, “Okay. I'm done too.”I definitely was tearful. You always have those angels in your story. I had an angel nurse that came and said, “Oh, honey. I've had 3 C-sections and it's great.” At the time, it's what I needed just the right person at the right time to comfort you. Meagan: And being able to relate. I think being able to relate and be like, “Okay, you did it. You're here.” Charlotte: Exactly. I was whisked away into the C-section. Usually, the husband doesn't follow you right away. They do all of the things and then they come in. Well, my husband never comes in. Meagan: Oh. Charlotte: My husband had not eaten and had not slept. He ended up getting lightheaded and almost passing out in which case he was being cared for by the midwife that was caring for me in the PACU. Meagan: Oh no. Charlotte: He never came in. They got his phone which was a godsend and I had this amazing CRNA that took the most amazing pictures of the C-section that ended up being a big part of my healing process, being able to see everything. Meagan: Yes. Yes. Yeah. It's weird because sometimes you don't even think or know if you want to see that, but it is so healing, or at least it was for me. Charlotte: Mhmm. It helps you piece things together. Once again, parts of that were a really positive thing. I had a clear drape. I didn't ask for that. They did the clear drape. They did skin-to-skin to some extent, or delayed cord clamping– not as much as you would want, but they did all of that. But I was so out of it by that point. I was shaking. I was passing out constantly, so I was holding my baby, but I thought he was suffocating on me, so I was just like, “Just take him to his dad.” It was uncomplicated and exactly what we thought. It was all positioning issues. No big deal, really. They take me to PACU and wheel me in. The Type A person in me goes, “Okay, forget recovering from that. Now I need to take back control of my experience. Hunter, get me a cold brew coffee.” I just shake my head like, “Why didn't you just sleep when you could have? I drank a cold brew in PACU and put that kid to my boob and they were like, “Wow, you know how to do that already?” I just was like, “Yep. I want to be the mom now. I want to get back to normal.” Well, that was the beginning of a very traumatic couple of days when I didn't sleep at all in the hospital. I got very engorged. He had latch issues. I was told to start pumping. I got an enormous oversupply, like 90 ounces in one day. Meagan: Oh my gosh. Charlotte: A couple of weeks in, yeah. It changed our experience. Obviously, he ended up getting a milk protein intolerance. It layered on. I don't blame the C-section on that, but I do blame my mindset a little bit– and probably got some bad advice from lactation. They didn't know I was going to have an oversupply and go crazy like that. But yeah, I had trauma from that too. I'm like, “Okay, I'm recovering from a C-section and I'm pumping around the clock and all of that isn't coinciding with me caring for my baby.” My husband learned to do everything in the hospital. Meagan: Or caring for yourself. Charlotte: Yep. It was all focused on my recovery. Anytime he needed to eat, it coincided with me needing to pump. It was heartbreaking, really. The second I allowed myself to stop, we started bonding luckily. After that, our relationship truly began. But yeah, it was a traumatic experience. You don't expect that you're going to have this life-changing thing and then have to have you recovering from a C-section too. Meagan: Right. Charlotte: That's kind of that story. I definitely feel good over time with therapy. I'll give a plug to EMDR therapy. It's a type of eye movement therapy. I had one session of that and it helped me get down to a rational level why I was so upset by that experience and just starting to talk about it with people and watch everything helped over time. Looking at those pictures, it no longer became such an emotional thing as time went on. But I still felt sad when I saw people having what I wanted– a good breastfeeding experience and a typical birth. But more and more, I did have a typical birth. In my close friend group, maybe four or five of us have had a C-section. Several were breech, but it started to be like, it wasn't that I was feeling alone. It was that I started to question, “What's going on? Why is this happening?” Meagan: Right. Yeah. That's how it was in my tight friend group. There are four of us from high school. Three out of the four of us have had multiple C-sections. Charlotte: Yeah. Yeah. And more and more so, I'm rooting for people to get a vaginal birth. I'm like, “Get a vaginal birth, please. Have a routine situation.” Meagan: I know. Charlotte: You don't see it very often, at least not in my close group. That's what really made me question things. Fast forward to January 2022 and I'm not quite thinking of having a baby yet, but I had a routine OB appointment. I asked about VBAC. I said I wanted to probably stop taking my birth control and that maybe sometime this year, we would start trying. They said, “Yeah, we're a VBAC-friendly practice.” I told her maybe a one-minute spiel on what happened to me. She said, “Just based on what you've told me, I would say you have a 20% success rate.” Meagan: Oh. Charlotte: I guess she can calculate it in her head without even doing the calculator. I guess they're super friendly like that. They do so many. Come to find out, they have a super high episiotomy rate and a lot of other things, and they're not friendly really at all. Meagan: You're like, “You are ‘friendly'.”Charlotte: Yeah. So I felt completely gutted by that. I hadn't even really committed that I wanted a VBAC, but feeling that I was told that just was so upsetting. It made me start listening to The VBAC Link. Through a couple of episodes, I heard about requesting your operative notes so I did that which was amazing. On that note, it said a bunch of things that I didn't know. I didn't know asynclitic. I didn't know some of the terms which made me able to speak to it in a more educated way. Then yeah. I messaged the doctor. She was like, “No, absolutely. Nothing was wrong. You could totally do it.” She still gave me a success rate of 54% but she was like, “That's just a conversation topic. You can absolutely do it.” I was like, “Okay, great.” She told me I was 10 centimeters, so they saw. I got there. I can do this again. I started interviewing doulas even before I was pregnant. I just started to hear positive things like, “If you can get through an OP, asynclitic baby, water breaking, 27-hour labor, you've got this. With a well-positioned baby, it would not be like what you experienced.” Hearing these things, I started to get hyped up like, “I can do this.” Meagan: Excited, yeah. You felt the empowerment back. You were feeling empowered. That is what is so important because on that first visit, any empowerment that you had was wiped like an erase board. It's like, “Oh, you're 20%.” Okay, great. So that's so good to hear that you were being built back up. Charlotte: Absolutely. So yeah. So then months passed and then in July-August we decided to start trying again. Luckily, again, we were pregnant again and came to find out we were having another boy, another son. We were very excited and that's when my preparation started. I did all of the things. I joined a midwife practice. It was a midwife practice that delivered at the most acute hospital. They were actually affiliated with the big health system here. So that gave me comfort that I would be able to birth in a suite that had a pool but it would be in a hospital right down the hall from an OR if I needed it. That was great. I hired a doula that had VBACs, that was the VBAC whisperer in town. I went to Webster-trained chiropractic and did prenatal yoga. I did everything I could think to do. I tried not to go overboard with eating and then yeah. I even went to a pelvic floor specialist to practice pushing. I did everything I could think of. That was how I could control it. My control thing with me– I just wanted to feel like I did everything in my control to get this. If it doesn't happen, I think I could come to peace with that. That's what I felt would be the case.  So anyways, fast forward. Routine pregnancy up until 28-29 weeks when you get the gestational diabetes screen. Did it, failed it. I was bummed by that, but also heard, “Oh, so many people fail it.” So then I did the 3-hour test. I think I failed three of the four that you needed in the time. You needed two to pass. So yeah. I failed it. I was surprised how gutted I was. I was devastated by that because I kept waiting for the other shoe to drop the whole pregnancy because I hadn't had any barriers. You know all of the barriers that people have where you have to advocate for yourself. I hadn't experienced that even having a VBAC consult with their OB group that helped them out. I supposedly went to the doctor who is all pro-C-section. He was even surprisingly very supportive. So what's going on? Meagan: What's going to give? Charlotte: Yeah. The midwife said, “Nope. You can still see us. You can still come to us even if you have to go on insulin, but you really need to try and stay diet-controlled.” That was what I heard. “Diet control is what will help you stay a normal-risk patient.” That's easier said than done I've come to realize. It's challenging too because time passes. You have to get an appointment with the dietician. You have to get your supplies through insurance so it takes a while to get in the routine of taking your blood sugar multiple times a day and then maybe weeks pass before you can figure out what's causing you to have spikes.So it's a whole new thing. I'm trying to focus on VBAC, prenatal yoga, and all of the things that help you be super zen, but now I have multiple appointments and tracking logs. It was very stressful for me. There are certain things– your fat and blood sugar, for example. There is very little you can do to control that. It's very challenging to get that control because it's all about your placenta and how it is metabolizing quicker. It's not what you ate in pregnancy. There are a lot of misconceptions about it. The best thing that I can share is Lily Nichols has Real Food for Pregnancy and then Real Food for Gestational Diabetes and maybe you can link to those, Meagan. Those two books were super helpful for me because of what I can find out– they probably work for some people, but the dietician stuff you get just from the hospital in one visit, and the handout is really high carb. Considering it's the carbohydrates and the sugars that are causing issues, it doesn't work. The plan just on paper doesn't work for everybody to control their gestational diabetes. That was too high for me. When I followed that plan, I wasn't in control of my diet. Lily Nichols, you can take bits from each, but I found that that book, and that's what my midwife suggested, was lower carb and all about real foods. It had stuff about supplements and all of that. I found that super helpful to staying diet-controlled. In hindsight, even though I probably had it the whole time, I ended up only doing diet control for two weeks before I gave birth. So lucky for me in some ways, it was one of the silver linings. I didn't do the diet for very long but I did get all of the information I needed. Eventually, they were telling me, “If you became insulin-dependent or needed insulin or were out of control,” I think it was 90% of your readings needed to be in control. You could have a one-off here and there. If they weren't then you needed to start seeing a maternal-fetal medicine doctor who could consult on your diabetes and insulin. You could still deliver with the midwives, but my perspective was if you're on insulin, you have to start having NSTs weekly. You have to start having– I can't remember what it is called– BP or some other weekly testing for the baby. I can't remember. It's some acronym just to check their heart rate and all of that. I can't remember what it's called but there are two types of weekly testing you would have to have if you were on insulin. I don't think you have to have growth scans, but I think they would probably start to offer them to see how baby was doing. That's where I feel like maybe people start to get discouraged by their providers when their growth scan is large or when they start to have NSTs obviously. There's much more surveillance and then they encourage you to get induced. If you are on insulin, it's a lesser time that they allow you to go. They make you go anywhere from– I'd have to look it up but it's like 37 if it's really out of control to 39 if it's insulin-controlled. Diet-controlled, you're treated like any other birth. That's where, I think, maybe you're seeing not as many VBACs. You have a lot of barriers that come in. Meagan: Yeah, because they're not in control or they've been transferred to MFMs and they're like, “At this point, it's just better to get this baby out earlier and control blood sugar and have a repeat Cesarean.”Charlotte: Yeah, and I might have made that decision myself. You just start to get medicalized again and it's discouraging. You worry, “What's happening to the baby? Is it okay? The NST is not looking good.” I just think it takes that from you. It's needed sometimes, I'm sure. In some ways, it was a blessing in disguise. I would have had a C-section if my son could have stayed in for two more months. It was a blessing in disguise in some ways that it happened when it did. So anyways, I guess I'll continue unless you have other things you want me to talk about. Meagan: No, I just pulled up the book and sent it to myself, so we're going to make sure that we have it in the show notes. Charlotte: Yeah, great. Meagan: Because I think that's really important to have. Charlotte: Yeah, yeah. Just more tools at your disposal. Lily Nichols is a dietician and she even says, “Some of the stuff that they are still teaching is archaic. We've found that there are better ways to do these things.” She helped develop the gestational diabetes stuff for the ADA so she has major credentials. Yeah. I think she is legit. Anyway, two weeks pass. 32 + 2 and I feel huge. I'm not, but I feel pressure low. I told my mom, “I can't do this for much longer,” the night before which is weird. I had also bought some Easter stuffies with names on them for my son and I bought one for my other son which was foreboding. He was here by Easter and wouldn't have been otherwise. Meagan: Yeah. That is interesting. Charlotte: I don't know if my body knew or if I knew in the back of my head that he was going to come early. I started to feel pressure and just weird but nothing like I would have noticed. I just started to feel like, “Oh, gosh.” I had a pedicure for later that day. That weekend, I was going to have my baby sprinkle. I didn't have an in-person shower with my son and didn't end up having one with my second son. But I had all of these things planned. I had a pedicure, of course, and all of that stuff coming up. I don't think that's what put me into labor, but it was kind of funny. I'm like, “If I ever have another kid, I probably wouldn't get a pedicure.” Meagan: Yeah. You're like, “It's a little coincidental for me.”Charlotte: Yeah, so I was just like, “I need my back massager,” because I was already feeling something in my back. I was like, “Oh my god, it feels so good.” I get home. My husband and my son are home and we have just learned about rebozo. I was taking a Hypnobirthing class. That was the other thing was my hypnosis class. So he was doing rebozo shifting for me and it felt so good. I was like, “Okay, great.” I was practicing my hypnosis and I was just like, “This is Braxton Hicks I think, but man. These are crazy.” I never remember someone saying that Braxton Hicks hurt. It's waves. It's definitely a wave each time. I lay down and I told my husband, “I'm just going to rest for a second and I'm going to get in the bath.” Well, when I get to the restroom, there's blood. That freaked me out, obviously. I still don't think I'm in labor, but I'm like, “Something might be wrong.” Meagan: Especially at 32 weeks, right? You're like, “Uhh.”Charlotte: So I go get in the car. I told my husband, “I just need to go to triage.” It's 30 minutes away. I always knew we were going to have a little bit of a drive to get to the hospital. I drive myself to the hospital in labor now that I've come to find out. I was doing my hypnosis techniques. I was just like, “Let me just get there as fast as I can.” Luckily, I got there fast. I think I got there in 25 minutes. I got there super fast. My mom had me a month early and drove herself to the hospital. That was always her claim to fame. I had to do it too. Meagan: You're like, “I'm going to do it too.” Charlotte: Yeah. I had to do it too. My parents live in town, so they came over to watch my son so my husband wasn't far behind me. I get to triage and they put me on the monitor. Baby was fine. It doesn't look like I'm having contractions which is good news. They're like, “Okay. Let's get the midwives in. I'll check you if that's okay.” She's like, “Oh, yeah. These are not really typical waves.” Then she checks me and I see her face go white. She's like, “You're 5 centimeters, so I'm going to need to call the doctor because we can no longer help because you're preterm,” which was a bummer. I'm like, “Okay, great.” Then she says, “Ope, there's a contraction.” For whatever reason, it wasn't showing contractions, I think that happens sometimes in preterm births apparently because they are so far up or small or something. Meagan: Yeah, I was going to say that they are used to tracking them lower and it's not. The uterus is smaller. Charlotte: So anyways, the doctor comes in. He's a resident. All of these things could have been bad, but it's so funny. I ended up having the most amazing providers. It was just interesting to me. All of the things I was worried about– I don't know if VBAC is becoming more of a thing now or because they work so closely with the midwife practice and they see it happen and they see it happen well with success— the midwife group in town has an 80% success rate. Meagan: That's awesome. Charlotte: Anyways, yeah. So they come in and they're just like, “We're so sorry. You're 5 centimeters. You're having this baby. We can try and just slow it down. There's not really anything we can do but you can just lay there and let's just hope you stay in labor for 24 hours.” Meagan: Did they try to stop your contractions or anything like that? Charlotte: No, I think I was right over the cusp of when they would do magnesium. I don't know exactly why they do or don't, but they said they do it with younger than that or I think cerebral palsy or something like that. Meagan: They didn't try to do any steroid injections for lungs? Charlotte: They did do steroid injections, but– it went too quickly for it to matter. I go in. We'll just see what happens. I didn't know what to do. I was like, “Should I be doing labor things or should I just be sitting here?” The nurses were like, “Don't go to the bathroom. We don't want you to start going on dilation station.” I was like, “I need to go though.” So I was feeling conflicted. We called my doula. She was in a four-day induction supporting another person, so she was not able to come and she said, “Well, do you want me to send a back-up doula?” I said, “Yeah. Bring them on. Whatever.” That doula ended up being amazing. She gets in. She gets right in. I'm starting to feel really uncomfortable. They checked me again. I'm 7 centimeters. This is moving so much faster than my last birth. This all started around 4:00 PM with not really anything except for the waves. By the time I got there at 7:00, it was starting to feel more intense and I had the baby by midnight, so 12:30. It was fast for me. I wouldn't say precipitous or whatever. Meagan: But still, 27 hours, right? Charlotte: Mhmm. She gets in there. The doctor says, “No, you can do whatever you want.” Oh, let me back up for a second. When they said, “The baby is coming this early,” I said, “Do we need to do a C-section? Whatever. If we need to get the baby out, let's just get the baby out.” They said, “No. If you want a VBAC, that's totally fine,” and that it would be beneficial for the baby at this point. Having a vaginal birth at this gestation is better for the baby's lungs than doing a C-section. Of course, they'll do a C-section, but there are some benefits to pushing out. I was so excited by that and then they were like, “You want to go unmedicated, right? Do you?” I said, “Yeah, I do. Can I move around?” He said, “Yeah. There is no stopping this baby at this point. Just do what you need to do.” So I was able to get on the birth ball. I wasn't in a birth room with a pool, but I was able to do my thing and move around at least. This time, I had really committed that I was going to do unmedicated because of the hypnosis and all of the things that I had done. So yeah, I labored very quickly. I had a very intense transition pretty much the whole time I was there. There was a lot of blood coming out which was scary. I was out of it, but I was like, “Is this okay?” There was blood dripping everywhere and they were like, “Yeah, you're probably having a placental abruption.” Meagan: Did they say anything about your placenta?Charlotte: Yeah. They said, “This is probably a placental abruption, but if you're having it and the baby is fine, it's fine. If the baby is not fine, you'd go to a C-section.”Meagan: Then it's not fine, yeah. Charlotte: That was interesting. I had never heard of placental abruption. That was probably why I was going into preterm labor because the placenta was starting to separate. So yeah. I just kept moving around and doing my thing. All fours were most comfortable for me and then I was 10 centimeters and the doctor came back in. The NICU staff came in and they never freaked me out about how preterm he was. That was the comforting thing. They said, “32-weekers do amazing. They do well.”Luckily, we were at a hospital that takes care of 22 weekers. We were at the best hospital for this so that was super comforting through the whole experience. I think I would have had a lot more fear had they not said those things to me. So yeah. They broke my water and they were like, “This might take a second for him to come down. We've got the squat bar up.” I did two practice pushes. I was feeling so much pressure. It's like pushes that were semi-productive. And then all of a sudden, I just felt this fire in me to just push him out in one push. I pushed so hard and apparently, I screamed. I don't remember screaming, but I screamed so loud and he shot out. Meagan: Oh my goodness. Charlotte: We got all of this on pictures too, so yeah. He came out. I don't know if he was screaming, but he came out. Leo is my second son. He was 5 pounds, 2 ounces so he was a big boy. Meagan: Okay, yeah. That's a good size. Charlotte: I don't know if it was gestational diabetes or whatever, but he was a good size. They did bring him over to me briefly. All of these things, I understand. Meagan: Right, right. Charlotte: They let me hold him for 10 seconds because they needed to go get him some oxygen of course. Meagan: They needed to make sure that his little lungs needed some extra care. Charlotte: Yes. He was whisked away to the NICU where once again, there's trauma and things. Of course, I wish that my baby could stay with me but in the moment, it was rational. He needed to go to the NICU so in the moment, I felt back to myself. I was a little stunned, but I was like, “Oh my god. I feel my body. I feel no drugs, no fluid.” I mean, I think I did have a little bit of fluid, but it was just so different than my last experience where I was so drugged up. Meagan: Yeah. Charlotte: I got to see my placenta which they sent off for pathology and they found nothing. There's no answer. It was just challenging like, “Why did this happen to me?” But it just happens sometimes. I did have COVID two months before. The gestational diabetes even– no symptoms from it, but I just wonder. I had it in February. I was diagnosed with gestation diabetes in early March and I had him in late March. It just feels like as time goes on, they're finding placental issues. They didn't see anything obvious.So yeah. He came. He's healthy. We spent 39 days in the NICU which was a challenge. It really was. I don't wish that experience on anybody. You're postpartum and pumping and going home without your baby, being there for my son but having to be at the NICU all day every day. It was a huge challenge for us, but he had a very routine time in the NICU. He just needed time to grow. He came back to us not this past Sunday, but the Sunday before and we were just so happy. He's eating well. He's 8 pounds. He's amazing. Meagan: Wow, good! Charlotte: So yeah. Now we're on our healing journey of now it's postpartum, the typical postpartum things. But I just can't be thankful enough that I didn't have to deal with all of these challenges with a C-section recovery on top of that. I mean, I felt physically back to myself very quickly. I had a very small two-stitch tear up, not down but I felt fine. I'm just grateful for that and I'm grateful for all of those providers who let me do my thing and trusted me and my boy to work together to get him out safely so yeah. That's the story. Meagan: Yes. Your team sounds really, really awesome. Charlotte: Yeah. Meagan: Like really awesome. We hope that those types of teams are cloned all over the world, but we know that it doesn't always happen that way, so if you're listening and you've got gestational diabetes and you don't have as supportive of a provider, know that you can always keep looking, but too, know that you can do exactly what Charlotte did. You can control what you can control. Control what you can control. You read the book. Learn how to control your diabetes. Learn all about that and then try and just take baby steps along the way even when random things are thrown at you like early term or preterm labor. That could have been where you are like, “Here's the boot. Instead of a shoe, here's a boot. It's being dropped. Now I'm going into preterm labor.” But you didn't let it. You just put those boots on and kept walking. Right? Charlotte: Mhmm, yep. Meagan: That's so awesome. So, so awesome. Did you have any symptoms of gestational diabetes before you got tested? Charlotte: I don't think so. No. I tried to think back on if I did. I think I caught it so early. I got the testing done. That's another thing too. I would recommend trying to get your screening done as early as possible because the earlier you catch it, the earlier you can control it with diet. It becomes harder to control as time goes on, but you can stop that baby potentially. You can maybe diet-control enough that the baby doesn't get too big. There's a lot of really supportive Facebook groups. Gestational diabetes, nutrition, and all of these things because it's hard to find information out there and it's helpful to hear those stories of, “Hey, my baby came out and was small or was 8 pounds,” just not these huge babies that you hear of. I'm sure a lot of people aren't diagnosed or are borderline and maybe have similar things. Meagan: Yeah, there are undiagnosed where we are like, “Whoa.” I had a client whose baby was 11 pounds. Charlotte: Yeah. Yeah. I mean, I think one way I started to feel was that this may be a blessing in disguise. Had I not just been on the borderline, maybe I would have had an 11-pound baby, and whoa, to be honest. Leo would have been big if he had gone to term. But the earlier you find out, you can diet control. You maybe can control your weight gain and have a healthier pregnancy overall. Meagan: And have fewer issues after. Charlotte: Because I felt amazing. Just the fact that I had such a high-protein diet and things in that time period, I feel like that made me even better equipped to have a vaginal birth. So yeah. I think there are positives if you can get past that initial challenge of it that, “Okay, this is just going to keep me on track to have a healthy pregnancy,” you can do it. You really can do it. I think as long as you just say, “Look. They're going to do screenings. They're going to offer things.” It may end up in an induction but I think it's still worth pursuing if it's something that you want to do. Meagan: Yeah. That is one of the things. It may end up in an induction and that is still possible. They may be telling you that your baby is big. That doesn't mean that vaginal birth is not possible. Right? Big babies come out of pelvises all the time. Inductions and VBAC– Yes, it's not as ideal as spontaneous labor but still very possible. Know that if you are listening, you're not alone out there even if you might feel alone because there are not a ton of stories out there. That makes me sad so we are going to change that here on the podcast. It's starting right here with Charlotte. Awesome, well thank you so much for sharing your story today. Charlotte: Absolutely. Thanks for having me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

We've got one more round of '90s Movie Hall of Fame inductions (for now), focusing on our actress nominees. See who made the cut and be sure to follow us on social @revengeof90spod!

Tim on NFL HOF inductions and Chris Berman by 102.9 The Hog

We continue our series on nominations for the 2023 class into the '90s Movie Hall of Fame, focusing this week on a couple directors who made '90s film so memorable. Be sure to rate, review, subscribe, and then check us out on social too @revengeof90spod.

Though we wish every family could enjoy a straightforward and smooth arrival of their little one, that is not always the case. Oftentimes, doulas find themselves supporting clients requiring high interventions. In this episode, fellow doula Lexi Zuo and I share our best tips for supporting inductions and other high-intervention birth scenarios. 

SF Chronicle's John Shea joins Talkin' Baseball with Marty as Cooperstown welcomes two more of baseball's greats Sunday with the inductions of Scott Rolen and Fred McGriff into the National Baseball Hall of FameSee omnystudio.com/listener for privacy information.

SF Chronicle's John Shea joins Talkin' Baseball with Marty as Cooperstown welcomes two more of baseball's greats Sunday with the inductions of Scott Rolen and Fred McGriff into the National Baseball Hall of FameSee omnystudio.com/listener for privacy information.

We've started the '90s Movie Hall of Fame (naturally), and we're rolling out our 2023 class, starting with our character actor inductions. Be a part of this vital public service by checking out our latest episode, and let us know which character actor you'd induct by reaching out on social media @revengeof90spod.

This episode is a continuation of the episode #104 on "What to Expect When Getting Induced" a step by step guide from getting admitted to delivery of the baby.  This episode focuses mainly on how an induction of labor dosen't need to drag on for days when it is actively managed and how Maternal Resources goes about utlizeing an active induction plan of care for their clients.  Pregnancy is a beautiful and transformative time in a woman's life. However, there are situations where labor induction can be a better choice for the health and well-being of both the mother and the baby or for avoiding a cesarean birth. When it comes to labor induction, actively managing the process can lead to a more efficient and safer delivery. In this epsiode, we explore why active management of labor induction is crucial and how it can contribute to a 24-hour timeframe (or less!) for a successful delivery. Understanding Labor Induction Labor induction is the process of stimulating contractions to initiate and accelerate the progression of labor. It is typically recommended when there are concerns about the health of the mother or the baby, such as preeclampsia, gestational diabetes, post-term pregnancy, or fetal distress. It can also be performed for medical or personal reasons, including logistical considerations or maternal preference. Active Management of Labor Induction Active management of labor induction involves a proactive approach to monitor and encourage progress during the induction process. It incorporates several interventions to ensure an efficient and timely delivery. These interventions may include the administration of medications, such as prostaglandins or oxytocin, rupturing the membranes (breaking the water), and continuous fetal monitoring. Labor induction is an essential medical intervention that can be necessary for various reasons. However, it is crucial to actively manage the induction process to ensure optimal outcomes for both mother and baby. Active management, involving prompt interventions, close monitoring, and timely decision-making, offers several benefits, including reduced risks, time efficiency, psychological support, and better birth experiences.   Disclaimer: It is important to note that each pregnancy and labor is unique, and the duration of labor can vary significantly based on individual circumstances.    Our practice can be found  at www.maternalresources.org Reach out to us at (201) 487-8600   As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org     Remember to subscribe wherever you listen and considering leaving us some feedback at info@maternalresoruces.org or writieng a review.  Our Social Channels are as follows Twitter: https://twitter.com/integrativeobYouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB https://www.truebirthpodcast.com

Cowboys owner Jerry Jones spoke at the team's head quarters at The Star on Monday. 

Today's Homebirth story features Bekah Yawn. She shares her story of her two medical inductions and how she ended up choosing to Homebirth with her now 6 week old. This is an encouraging story that goes to show being cherished by your support team can mean the world and make all the difference in your birth experience.    Bekah Yawn has worked with dozens of women and couples nationwide to empower them in their fertility health. With a Bachelor of Arts in Psychology and graduating top in her class in FEMM certification, she is well respected in the fertility education community. As a FEMM teacher and certified Hormone Coach, she can help any woman learn magnitudes about her body and how to support it naturally through utilizing her FEMM Hormone Harmony program.   Connect with Bekah:   www.fertilitysetfree.com IG: @bekah.yawn   15% OFF Finding Joy in Pregnancy and Birth E-Book with code EMPOWEREDBIRTH : https://www.birthblissbeyond.com/product-page/finding-joy-in-pregnancy-and-birth   Connect with Aly:   IG: @empoweredbirthpodcast FB Group: Facebook.com/empoweredmamastribe  Email: birth.bliss.beyond@gmail.com

It's time to set the standard. The Midnight Boys are here to induct their personal picks into the Midnight Meter Hall of Fame. They choose, debate, and vote on the absolute best movies in fandom that deserve the coveted 12 ranking on the Midnight Meter (06:03). Hosts: Van Lathan, Charles Holmes, Steve Ahlman, and Jomi Adeniran Social: Jomi Adeniran Senior Producer: Steve Ahlman Additional Production Support: Arjuna Ramgopal Learn more about your ad choices. Visit podcastchoices.com/adchoices

On this episode of the Turn on the Jets podcast, host Will Parkinson is joined by ESPN's Rich Cimini to talk about the Jets big night at NFL Honors, Aaron Rodgers, Derek Carr and much more. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Derrick Kosinski & Scott Yager are joined by Cara Maria, Paulie, Wes, Mark, Emily, Brad, Jacquise, Randy, Tina & Nehemiah for an awesome Hall of Fame induction Ceremony!For MORE Challenge Mania, head to www.Patreon.com/ChallengeManiaJOIN US IN VEGAS on December 3rd! Tix available at www.ChallengeMania.Livewww.ChallengeMania.Shop

Derrick Kosinski & Scott Yager are joined by Arissa, Trishelle, Veronica, Yes, Tina, Wes & Cara Maria! This is Part 1 of the Challenge Mania Hall of Fame Induction Ceremony for the class of 2022. First up, It's Arissa & Trishelle inducting their Vegas Housemate ALTON WILLIAMS. Then Hall of Famer VERONICA PORTILLO joins us, inducted by Tina & Yes. Plus some special surprise guests along the way!To win a copy of How To Win the Challenge & Life, listen to the podcast and follow the instructions!For FREE SHIPPING on www.TaylorChipCookies.com use the code MANIAFor weekly Bonus Podcasts on Ride or Dies, head to www.Patreon.com/ChallengeManiaFor tix to our events in BALTIMORE, VEGAS & MIAMI head to www.ChallengeMania.LiveFor SWAG head to www.ChallengeMania.Shop