Podcasts about Insertion

Lumière sur la boutique solidaire Interfringue créée par l'association Coop'Agir il y a plus de 20 ans. Initialement située à Dole, dans le Jura, avenue Duhamel, Interfringue déménage et s'agrandit, en s'installant dans la zone commerciale de Choisey, à coté d'Intersport. Interfringue s'apprête à devenir la plus grande boutique de vêtements de seconde main du Jura, fidèle à son crédo: la seconde main locale solidaire et pas cher ! Ouverture demain ! On arpente les allées du nouveau magasin avec Matthieu Cêtre, directeur adjoint du Pôle Insertion pour l'Activité Économique au sein de Coop'Agir Interfringue.

Aujourd'hui, Fatima Aït Bounoua, prof de français, Didier Giraud, éleveur de bovins, et Bruno Poncet, cheminot, débattent de l'actualité autour d'Alain Marschall et Olivier Truchot.

In this episode of ACEP Nowcast, host Amy Faith Ho, MD, MPH, FACEP, interviews Nirajan Nepal, MD, to discuss pulmonary embolism after routine peripheral intravenous catheter insertion, and reminds us that routine is only routine until it is not. We also touch on life in military medicine. Read the full case report at ACEPNow.com. More links: Read more on ACEPNow.com. Revisit ACEP Nowcast podcast episodes.  View job opportunities at emCareers.

Aujourd'hui, Didier Giraud, éleveur de bovins, Bruno Poncet, cheminot, et Barbara Lefebvre, prof d'histoire-géo, débattent de l'actualité autour d'Alain Marschall et Olivier Truchot.

Tristan et Maxime s'entretiennent avec la fascinante Catherine Girard, Co-coordonnatrice du volet prévention de la rechute/réinsertion sociale chez Uniatox. On discute deson cheminement scolaire en ''S'', de sa connexion avec les plantes et de son rôle particulier au sein de son organisation !Site: https://uniatox.org/ Mascouche - Siège socialAdresse: 185, chemin des Anglais J7L 3N8Tél.: 450 968-0363 / Téléc.: 450 968-3407Repentigny - Point de servicesNuméro de téléphone : 450 582-2983⁠Courriel: info@uniatox.org⁠Site: www.cjela.qc.ca Instagram: CJELA_ Facebook: CJELA - Carrefour jeunesse-emploi L'Assomption Numéro de téléphone: 450 581-3785⁠ Courriel: ⁠info@cjela.qc.ca Adresse: 10, rue Notre-Dame (3e étage)Repentigny (Québec) J6A 2N9Musique proposée par La Musique LibreDj Quads - Into My Life : ⁠   • |Musique libre de...  ⁠Dj Quads : ⁠https://soundcloud.com/aka-dj-quads

HEADLINES: Marcos ordered P100B budget insertion – Co | Nov. 15, 2025Subscribe to The Manila Times Channel - https://tmt.ph/YTSubscribe Visit our website at https://www.manilatimes.net Follow us: Facebook - https://tmt.ph/facebook Instagram - https://tmt.ph/instagram Twitter - https://tmt.ph/twitter DailyMotion - https://tmt.ph/dailymotion Subscribe to our Digital Edition - https://tmt.ph/digital Check out our Podcasts: Spotify - https://tmt.ph/spotify Apple Podcasts - https://tmt.ph/applepodcasts Amazon Music - https://tmt.ph/amazonmusic Deezer: https://tmt.ph/deezer Stitcher: https://tmt.ph/stitcherTune In: https://tmt.ph/tunein#TheManilaTimes#KeepUpWithTheTimes Hosted on Acast. See acast.com/privacy for more information.

Emily Slade joins Liam & Ben this week to answer:

5. Lunar Orbit Insertion and the Disappointment of the Moon's Surface. Bob Zimmerman discusses how on Christmas Eve, Apollo 8 approached the moon. The critical moment was Lunar Orbit Injection (LOI), requiring the firing of the Service Propulsion System (SPS) engine. This burn had to occur while the craft was behind the moon, resulting in a dramatic Loss of Signal (LOS) for Earth. Susan Borman particularly dreaded this moment because the SPS engine, which had no redundancy, was their only way into and out of lunar orbit. NASA believed firing the engine would clear any potentially problematic bubbles in the fuel lines, adding another risk. Once in orbit, the astronauts were visually disappointed, with Frank Borman describing the moon's surface as looking like a "skull" or a lifeless sandbox. Their direct observation settled the debate among scientists, confirming that the moon's craters were the result of impacts, not volcanic activity. 1962

Review the indications, contraindications, sizing, and insertion of the nasopharyngeal airway (NPA) to maintain the airway of patients with a gag reflex.The tongue is the most common airway obstruction in an unconscious patient.When the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered.Contraindications and considerations for nasal airway insertion.Measuring a nasal airway for appropriate length and diameter.Insertion of a nasopharyngeal airway into the right vs left nostril.Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Scott Clary is a serial entrepreneur, brand strategist, and the creator and host of the top-ranked Success Story podcast, where he's interviewed some of the world's most influential entrepreneurs, leaders, and visionaries. With an impressive career advising startups and building global brands, Scott has become a go-to voice on growth, leadership, and the mindset required to win in today's competitive landscape. At the heart of Scott's work is a deep belief that success is far more than financial achievement — it's about ownership, purpose, and the relentless pursuit of meaningful goals. He shares practical strategies for building powerful personal brands, creating content that connects, and cultivating audiences that truly care. His insights have helped countless founders, creators, and business leaders not only grow their companies but also design lives that align with their values. Driven by an entrepreneurial obsession and a passion for storytelling, Scott is on a mission to empower others to take agency over their ambitions and turn bold ideas into lasting impact. Whether he's behind the mic, on stage, or advising high-growth businesses, Scott brings clarity, candor, and actionable wisdom to every conversation — inspiring people everywhere to define and achieve success on their own terms. Timestamps: 00:00:00 Cold Open 00:00:08 Title Sequence 00:00:28 Show Notes VO 00:01:13 Intro Into Interview 00:31:36 Insertion 00:32:58 Interview Resumes 01:08:16 Outro

Sortir de prison, c'est tourner une page, mais rarement en écrire une nouvelle seul. Chaque année, des milliers de personnes font face au même défi : retrouver leur place dans la société. Logement, emploi, liens familiaux, confiance en soi… autant d'obstacles qui rendent la liberté complexe. Avec : - Ilan Volson-Derabours, président-fondateur de l'association À Travers les Murs, chargé de travaux dirigés et diplômé de l'Université Paris 1 Panthéon-Sorbonne, juriste- Laure Garnier, directrice de l'association SPILE - Sortir de Prison, Intégrer l'EntrepriseRetrouvez tous nos contenus, articles et épisodes sur rcf.frSi vous avez apprécié cet épisode, participez à sa production en soutenant RCF.Vous pouvez également laisser un commentaire ou une note afin de nous aider à le faire rayonner sur la plateforme.Retrouvez d'autres contenus d'économie et société ci-dessous :Silence, on crie : https://audmns.com/jqOozgUOù va la vie ? La bioéthique en podcast : https://audmns.com/UuYCdISContre courant : https://audmns.com/swImDAMAu bonheur des herbes : https://audmns.com/XPVizmQSacré patrimoine : https://audmns.com/TNJhOETEnfin, n'hésitez pas à vous abonner pour ne manquer aucun nouvel épisode.À bientôt à l'écoute de RCF sur les ondes ou sur rcf.fr !Hébergé par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

NEWS: Zaldy Co budget insertion returned: PNP gives back P500M | Oct. 17, 2025Subscribe to The Manila Times Channel - https://tmt.ph/YTSubscribe Visit our website at https://www.manilatimes.net Follow us: Facebook - https://tmt.ph/facebook Instagram - https://tmt.ph/instagram Twitter - https://tmt.ph/twitter DailyMotion - https://tmt.ph/dailymotion Subscribe to our Digital Edition - https://tmt.ph/digital Check out our Podcasts: Spotify - https://tmt.ph/spotify Apple Podcasts - https://tmt.ph/applepodcasts Amazon Music - https://tmt.ph/amazonmusic Deezer: https://tmt.ph/deezer Stitcher: https://tmt.ph/stitcherTune In: https://tmt.ph/tunein#TheManilaTimes#KeepUpWithTheTimes Hosted on Acast. See acast.com/privacy for more information.

How will Sen. Ping Lacson's revelation affect the behavior of his fellow senators and the course of the Blue Ribbon Committee investigation into flood control corruption?

  Crédits :    Réalisation et composition musicale : Julien Tharaud  Rédaction et production : Estelle Lafont Patrimoine sonore : Sylvaine Denis, Laetitia Casanova, Antoine Reclus  Création du visuel : Sidonie Mangin   Remerciements à Roselyne Bellemare et Mariapia Bracchi-Bellemare     Hébergé par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

La loi sur l'assurance-chômage prévoit un délai-cadre de deux ans. Parfois, la période de chômage s'éternise, comme pour Philippe, qui est arrivé au bout de ses indemnités au chômage et est accompagné par le Pôle Insertion +, à Fribourg, pour tenter de renouer avec le marché du travail, après un burnout. Quant à Gabriel Arenas Ruiz, une blessure l'amène à arrêter sa carrière de danseur professionnel au Béjart Ballet Lausanne et à chercher une nouvelle voie. Reportages de Grégoire Molle Réalisation: Jean-Daniel Mottet Productrice: Raphaële Bouchet

ACOG's 2025 consensus finally validates IUD insertion pain. Lisa breaks down what this means for practitioners and how to advocate for evidence-based pain management in cervical procedures. Follow this link to view the full show notes page! This episode is sponsored by Lisa's new book Real Food for Fertility, co-authored with Lily Nichols! Grab your copy here!  Would you prefer to listen to the audiobook version of Real Food for Fertility instead?

Laure Lanvin, Directrice des Ressources Humaines Activité Agence Emploi d'Actual Group, partage son approche innovante pour bâtir une culture commune solide au sein de l'entreprise. Elle explique comment cette vision permet non seulement de renforcer le sentiment d'appartenance des collaborateurs, mais aussi de favoriser l'insertion professionnelle à grande échelle, en créant des passerelles durables entre les talents et les métiers.Hébergé par Ausha. Visitez ausha.co/politique-de-confidentialite pour plus d'informations.

AFL Saturday with Corbin Middlemas, Mick Malthouse and Luke Ball, reviewing and previewing the first weekend of the AFL Finals Series. Today's guests, Geelong Premiership Utility Mark Blicavs, and Ray Chamberlain with his take on the Cam Rayner double free kick controversy.

Mawi and Shelly discuss problems with oxygenating Vape lungs, challenges with cardiologists putting in TEE probes, and use of the Clear Sight device from an anecdotal perspective. Join the hosts for a frank discussion on what's been going on in the medicine. 

Review the indications, contraindications, sizing, and insertion of the nasopharyngeal airway (NPA) to maintain the airway of patients with a gag reflex.The tongue is the most common airway obstruction in an unconscious patient.When the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered.Contraindications and considerations for nasal airway insertion.Measuring a nasal airway for appropriate length and diameter.Insertion of a nasopharyngeal airway into the right vs left nostril.Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. **American Cancer Society (ACS) Fundraiser This is the seventh year that I'm participating in Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission.I hope you'll consider contributing.Every donation makes a difference in the fight against breast cancer! Paul Taylor's ACS Fundraiser Page: http://main.acsevents.org/goto/paultaylorTHANK YOU for your support! Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

durée : 00:06:50 - Le Grand Reportage - par : Aurélie Kieffer - Spécialiste des barres fixes et plus encore parallèles, Axel Augis a arrêté sa carrière à l'été 2019. Comment celui qui fut champion de France ou médaillé de bronze par équipe lors de championnats d'Europe trouve sa place sur le marché du travail ? - réalisation : Annie Brault

Aug. 21, 2025- Dr. Rachel Flink-Bochacki, a board certified OBGYN and legislative chair of the American College of Obstetricians & Gynecologists District II, shares concerns with legislation requiring health care providers to share information about IUDs, including pain associated with insertion, when discussing birth control with patients.

Today after the show, we took a few phone calls unfiltered and then Johnjay told us some stories, a little unfiltered.See omnystudio.com/listener for privacy information.

The tongue is the most common airway obstruction in an unconscious patient.Insertion an oropharyngeal airway helps keep the patient's tongue from falling to the back of the pharynx, causing an airway obstruction.The oropharyngeal airway is sometimes called an OPA or simply an oral airway.Indications for using an oral airway.Contraindication for an oral airway and an alternative airway that can be used for patients with an intact gag reflex.Measuring an OPA and possible complications from inserting one that's too small or too large.Two techniques to properly insert an OPA.The use of an oral airway during CPR.The use of an OPA as a bite block after a patient has an advanced airway placed.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Air Date: 8-1-25 Today, Jay!, Amanda, Deon, and Erin discuss: The impact of A.I. LLM “friend” bots on childhood development How using A.I. LLMs negatively impacts critical thinking and information retention The importance of understanding how A.I. LLM tools work before using them The ways in which A.I. LLM tools could and shouldn't help movements on the Left, and evaluating the risks BACKSTAGE: Beyond the Algorithm (Members Only!) - The Gen Z Stare, and the incidents of A.I. LLM-induced psychosis   FOLLOW US ON: Bluesky Mastadon Instagram Facebook YouTube (This episode drops on YouTube on Friday - please share!) Nostr public key: npub1tjxxp0x5mcgl2svwhm39qf002st2zdrkz6yxmaxr6r2fh0pv49qq2pem0e   REFERENCES: AI Will Never Be Your Kid's Friend - The Atlantic ChatGPT May Be Eroding Critical Thinking Skills, According to a New MIT Study - Time MIT researchers say using ChatGPT can rot your brain. The truth is a little more complicated - The Conversation What Happens When People Don't Understand How AI Works - The Atlantic Steve Jobs on Why Computers Are Like a Bicycle for the Mind (1990) - The Marginalian Progressive grassroots activist groups must adopt AI or risk irrelevance - Sacramento Bee Final Thoughts & A Warning: AI as a Tool, Not a Substitute for Thinking - Harvard Kennedy School - Ash Center for Democratic Governance and Innovation Can AI Chatbots Worsen Psychosis and Cause Delusions? - Psychology Today     TAKE ACTION: One Million Rising Trainings In a blue state? Help stop ICE overreach Use the 5 Calls app for scripts and to reach all your elected officials Capitol Switchboard: 202-224-3121 Find your Indivisible group - or start one Write to the DNC     Join our Discord Server Reach us via Signal: Bestoftheleft.01 Leave a message at 202-999-3991   Produced by: Jay! Tomlinson Thanks for listening! Visit us at BestOfTheLeft.com Contact me directly at Jay@BestOfTheLeft.com Review the show on Apple Podcasts!

Invités : - Alyssa, Actuellement dans un centre de réinsertion sociale, Alyssa cherche un emploi. Distribué par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

In this episode NEW SEGMENT ALERT!!! Miranda brings us the News you didn't ask for. Sarah brings us National Holidays. Miranda is back from vacation and went through a sacred women's ritual. Chris introduces a new Character. Plus, the journey of a fly's life. This and so much more.www.nonewfriendspodcast.comwww.sandpipervacations.com

In this conversation, Jim Leslie discusses the journey of navigating business challenges, the importance of technology and marketing in scaling a business, and the need for a supportive community. They emphasize the significance of focus, execution, and creating value for all stakeholders involved. The discussion also highlights the common pitfalls that business owners face and the necessity of surrounding oneself with the right people to achieve long-term success. Don't forget to register for Tommy's event, Freedom 2025! This is the event where Tommy's billion-dollar network will break down exactly how to accelerate your business and dominate your market in 2025. For more details visit freedomevent.com Timestamps: 00:00:00 Cold Open 00:00:16 Title Sequence 00:00:36 Show Notes VO 00:01:22 Intro Into Interview 00:32:23 Insertion 00:33:32 Interview Resumes 01:01:38 Outro  

Tarrah shares her remarkable three-year journey from trying to conceive naturally to welcoming her miracle IVF baby, Aspen. After starting to try for a family in September 2021, Tarrah and her husband Alexander faced the heartbreak of unexplained infertility, leading them through 10 rounds of IVF, pregnancy loss, and ultimately to their beautiful son born at 37 weeks via planned caesarean. Tarrah's openness about sharing her fertility journey on social media created a supportive community whilst helping others feel less alone in their struggles. This episode offers hope, practical insights, and honest conversation about the realities of fertility treatment, pregnancy after loss, and the overwhelming joy of finally holding your long-awaited baby.See omnystudio.com/listener for privacy information.

The tongue is the most common airway obstruction in an unconscious patient.For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered.Contraindications and considerations for nasal airway insertion.Measuring a nasal airway for appropriate length and diameter.Insertion of a nasopharyngeal airway into the right vs left nostril.Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

The tongue is the most common airway obstruction in an unconscious patient.Insertion an oropharyngeal airway helps keep the patient's tongue from falling to the back of the pharynx, causing an airway obstruction.The oropharyngeal airway is sometimes called an OPA or simply an oral airway.Indications for using an oral airway.Contraindication for an oral airway and an alternative airway that can be used for patients with an intact gag reflex. Measuring an OPA and possible complications from inserting one that's too small or too large.Two techniques to properly insert an OPA.The use of an oral airway during CPR. The use of an OPA as a bite block after a patient has an advanced airway placed.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Let's start your week strong with a quick tip you can incorporate right away. In this Mo's Monday Minute shortie episode, I'm sharing a cool tip that can help you nail your Foley insertions on the first try.  ___________________ FREE CLASS - If all you've heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES...you can thrive in nursing school without it taking over your life! 20 Secrets of Successful Nursing Students – Learn key strategies that will help you be a successful nursing student with this FREE guide! All Straight A Nursing Resources - Check out everything Straight A Nursing has to offer, including free resources and online courses to help you succeed!

The tongue is the most common airway obstruction in an unconscious patient.For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered.Contraindications and considerations for nasal airway insertion.Measuring a nasal airway for appropriate length and diameter.Insertion of a nasopharyngeal airway into the right vs left nostril.Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog If you are receiving testosterone or estradiol hormone pellet therapy, BioBalance Health wants to know if you have any of the following medical conditions that may require you to take antibiotics before any medical or dental procedure that breaks the skin, including pellet insertions and dental cleanings. BioBalance Health is dedicated to providing safe and effective hormone replacement with pellets for both men and women, and we want to ensure your health and safety throughout the process. We use sterile procedure guidelines, but certain conditions still require antibiotics to prevent local infections.   Conditions That May Require Pre-Procedure Antibiotics: If You Have Had a Joint Replacement.Some orthopedic surgeons recommend that patients take antibiotics before dental procedures to prevent infection in the joint that was replaced, while others may not. It is important that you follow the advice of YOUR orthopedic surgeon regarding antibiotics before any procedure. If your orthopedic surgeon has advised you to take antibiotics, please let us know. We can provide you with an antibiotic injection or a prescription to take the day of your pellet insertion that will prevent infection. If You Have Uncontrolled Type 1 or Type 2 Diabetes. If your blood sugar is not well-controlled, you may need antibiotics before your pellet insertion to prevent infection of the pellet insertion area. If you are treated and keep your sugars in good control you may not need antibiotics, however if your diabetes is in poor control, you are more likely to get an infection. It is important that you take antibiotics before your pellet insertion. The following blood sugar levels are considered indicators of poor diabetes control: HbA1c > 9.0 Fasting blood sugar > 150 mg/dL If your blood sugar exceeds these levels, or if your primary care doctor has recommended that you take antibiotics before dental cleanings or procedures, you should also take antibiotics before your pellet insertion to reduce the risk of infection.  If You Have an Autoimmune Disease and are on Immunosuppressive Treatment. If you are receiving treatment for an autoimmune condition that suppresses your immune system, you may be at higher risk for infection at the insertion site. In this case, you will need to take antibiotics before each pellet insertion. If your Rheumatologist does not believe antibiotics are necessary for you, you may proceed without them.  If You Are Receiving Cancer Treatment. Certain cancer treatments, especially those that suppress white blood cell production, can compromise your immune system. If you are undergoing such treatment, you should take antibiotics before or with your pellet insertion to prevent infection.   In Summary: If a doctor has advised you to take antibiotics for procedures, such as dental cleanings, you should also take antibiotics before your pellet insertion. Please inform us of any conditions or treatments that may require this precaution, and we will ensure you are properly prepared for your procedure.

durée : 00:57:42 - Cultures Monde - par : Julie Gacon, Mélanie Chalandon - En 2016, un accord de paix a mis fin à plus de 60 ans de conflit entre le gouvernement colombien et les Forces armées révolutionnaires (FARC). Un an après, les programmes de démobilisation et de réinsertion pour les anciens combattants ont été lancés, mais le retour à la vie civile reste difficile. - réalisation : Vivian Lecuivre - invités : Camille Boutron Sociologue, chercheuse associée à l'Institut pour la paix; Julie Massal Chercheuse indépendante, associée à l'IFEA, spécialiste des mouvements sociaux notamment sur la Colombie; Valérie Robin Azevedo Professeure d'anthropologie à l'Université de Paris Cité et chercheure à l'Unité de recherche migrations et société (URMIS)

The tongue is the most common airway obstruction in an unconscious patient. Insertion an oropharyngeal airway helps keep the patient's tongue from falling to the back of the pharynx, causing an airway obstruction. The oropharyngeal airway is sometimes called an OPA or simply an oral airway. Indications for using an oral airway. Contraindication for an oral airway and an alternative airway that can be used for patients with an intact gag reflex. Measuring an OPA and possible complications from inserting one that's too small or too large.Two techniques to properly insert an OPA. The use of an oral airway during CPR. The use of an OPA as a bite block after a patient has an advanced airway placed.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInOther Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Save money on prescription medications for you and your pets: https://nationaldrugcard.com/ndc3506*Commissions may be earned from the above links.Good luck with your ACLS class!

durée : 00:08:44 - La Question du jour - par : Marguerite Catton - Suite à une controverse concernant des soins du visage offerts à des détenus à la maison d'arrêt de Toulouse-Seysses, Gérald Darmanin, le garde des Sceaux, a déclaré avoir donné l'ordre de suspendre toutes les "activités ludiques" en prison. - réalisation : Félicie Faugère - invités : Matthieu Quinquis Avocat

Lara a quatre enfants, et son petit dernier 3 ans et demi, le jour où elle est arrêtée et incarcérée en Californie. Deux ans plus tôt, elle a rechuté et est tombée dans l'héroïne. Elle a menti, volé des cartes bleues et usurpé des identités pour trouver de quoi payer sa drogue. Elle a tout perdu.Dix ans plus tard, devenue écrivain, Lara Love Hardin raconte son histoire dans « La vie comme un grand huit » (éditions L'Arbre qui marche) : son enfance sans amour, sa jeunesse trouble, ses addictions, la famille qu'elle a construite et la bonne mère qu'elle a cherché à devenir. L'amour inconditionnel pour ses enfants, l'écriture et un livre de méditation offert par une codétenue, lui ont permis de sortir de l'enfer où elle s'était enfermée.C'est une histoire de rédemption et de deuxième chance, un livre qu'on ne peut pas lâcher, sélectionné par Oprah Winfrey parmi ses titres favoris de 2024. On l'a rencontrée à l'occasion de son passage en France pour un entretien sans tabou, traduit en direct par Hélène Joguet.Vous aimez le podcast Mères ?Partagez avec nous votre commentaire avec 5 étoiles sur votre appli podcast : votre avis aide le podcast à remonter dans le classement, à vivre et à s'enrichir de nouveaux épisodes.Pour proposer un sujet ou un témoignage, écrivez à Marine sur contact@leslouves.com.

The tongue is the most common airway obstruction in an unconscious patient. For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered. Contraindications and considerations for nasal airway insertion. Measuring a nasal airway for appropriate length and diameter. Insertion of a nasopharyngeal airway into the right vs left nostril.Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!

The tongue is the most common airway obstruction in an unconscious patient. Insertion an oropharyngeal airway helps keep the patient's tongue from falling to the back of the pharynx, causing an airway obstruction. The oropharyngeal airway is sometimes called an OPA or simply an oral airway. Indications for using an oral airway. Contraindication for an oral airway and an alternative airway that can be used for patients with an intact gag reflex. Measuring an OPA and possible complications from inserting one that's too small or too large.Two techniques to properly insert an OPA. The use of an oral airway during CPR. The use of an OPA as a bite block after a patient has an advanced airway placed.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!

"PREVIEW: MERCURY: Colleague Bob Zimmerman details BepiColombo, the ESA-JAXA Mercury mission, now preparing for orbital insertion and data collection. More later." 1954

durée : 00:06:18 - La Revue de presse internationale - par : Catherine Duthu - Près de 800 détenus servent de pompiers volontaires et aident à lutter contre les incendies qui ravagent Los Angeles. Ces prisonniers gagnent entre 5 et 10 dollars par jour, plus 1 dollar de l'heure pour les urgences.

Initial Insertion Short Take Jessica's question is common for new Givers. She's concerned about getting the toy in so the fun can begin! Initial insertion doesn't need to be unpleasant for the receiver. For the giver, when you take the right steps to open up the ass, initial insertion goes more smoothly. This can give […] The post Short Take on the Initial Insertion appeared first on Ruby Ryder - Pegging Paradise.

The Alan Cox Show

The Alan Cox Show

Holmberg's Morning Sickness - Thursday November 14, 2024 Learn more about your ad choices. Visit podcastchoices.com/adchoices

Colleen's first pregnancy ended in a miscarriage at 6 weeks. At 12 weeks along with her second pregnancy, Colleen and her husband found out that their daughter would be born with a genetic condition called Trisomy 18. Colleen shares her experiences with Trisomy 18 and how she found the right support to help her navigate through it all. Due to IUGR and other medical concerns, Colleen had her daughter via Cesarean with an 85-day NICU stay afterward. To her surprise, Colleen had a third pregnancy just 6 months after her daughter's delivery which ended in a heartbreaking second-trimester miscarriage. After discussing her pregnancy and birth histories at an appointment, Colleen's doctor referred her to be screened for a MTHFR gene mutation for which she came back positive. MTHFR (methylenetetrahydrofolate reductase) is a gene that impacts your ability to process and absorb folate. It can be responsible for complications during pregnancy and is detected through a simple blood test. Colleen and Meagan talk more about what MTHFR means, and what Colleen was able to do to have a fourth uncomplicated pregnancy and a beautiful, smooth VBAC delivery! Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome to the show, everybody. We have our friend, Colleen, on with us today sharing her stories and navigating through this amazing journey that we call birth. Birth is such a journey, wouldn't you agree, Colleen?Colleen: Absolutely. Meagan: One of the most unique things about it is obviously through the stories we all hear. They are all unique and individual to us and even one birth that you've given doesn't mean the next birth is the same. So we're going to be talking today about navigating through birth and we know that a lot of the times through these journeys whether it be because of a Cesarean or because of how we were treated or because of how our body responded or whatever it may be, sometimes and a lot of the times, we experience trauma. Trauma is viewed differently from everybody and processed differently. We are going to be talking about navigating through trauma. Then Colleen is actually going to share some of her fertility journey as well. I think that's also a really important thing because we have so many mamas out there– we know. We know. We see it. They have to navigate through fertility challenges. We're going to be talking about that along with a VBAC. Let's get into that here in just a minute. We do have a Review of the Week then like I said, I'm going to introduce Colleen and turn the show over to her so she can share her beautiful stories. This review is from lexieemmarie. It says, “So thankful. I just wanted to say thank you for creating this podcast. I had my baby girl via emergency Cesarean at 30 weeks due to several medical complications with my baby. We spent 95 days in the NICU and while in there waiting for my sweet girl to grow, I started to research VBACs to see if it was right for me. Once I found this podcast, it sealed the deal. I absolutely can't wait to VBAC with my next pregnancy. You all are incredible to listen to because you provide the wealth of knowledge and positivity but are also fun and entertaining to listen to. Amazing job, ladies.” Aww, that just made my heart so happy. Oh my goodness. Thank you so much, Lexi, for your review. As always, we love these reviews. They make our hearts and our minds so happy. You guys, this is what we want. We want you to have that wealth of knowledge. We want to have you feel inspired and guided and uplifted and educated along the way through all of these stories. As usual, leave a review if you haven't yet. We would be so grateful. Meagan: Okay. We have Ms. Colleen. She lived in Michigan. Did you have your VBAC baby in Michigan? Colleen: I did, yes. Meagan: You did. Colleen: My husband and I live in a suburb of Detroit in Gross Point so that's where I gave birth in August of 2024. Meagan: Awesome. Awesome. Okay. Wait, 2024? Just right now?Colleen: Yeah, I'm 2 weeks postpartum. Meagan: Yes, I love it! So really, really fresh. Colleen: Fresh. Meagan: I love sharing stories that are so fresh like that. It is right there in your brain. Colleen: Exactly. Meagan: Oh my gosh. Okay. She has two beautiful children now and one two-week-old baby. Your two-year-old daughter is Gianna? Colleen: Gianna, yes. Meagan: She was born via Cesarean due to chromosomal abnormality. Do you want to share what that means?Colleen: Yeah, I would love to. Gianna has a chromosomal condition called Trisomy 18 that we did find out about through the genetic screening early on in pregnancy that she was considered high risk for coming down with Trisomy 18. As the pregnancy progressed, it became pretty evident that it would be the reality. For those of you who don't know, Trisomy 18 on its surface means that the baby will have an extra 18th chromosome in some or all of their cells. How that manifests itself is through some pretty serious medical complexities that require quite a bit of care. I will get into that a little bit more with my story but that is the quick version of Trisomy 18. She is also now 2 years old and a bubby, sometimes sassy, little girl. Meagan: Is there another name for it with an E?Colleen: Edwards Syndrome, yes.Meagan: I have another friend who has that and I seriously adore him. He is thriving and doing amazing in life. Colleen: Yes. She is a warrior. She is so strong. She is so beautiful and has brought nothing but love and joy to everyone who knows her or who don't know her. There are so many people from near and far who love her. It's great. Meagan: Yes. Awesome and then we've got Sonny who was born via VBAC just two weeks ago you guys. She says, “As a mama of a medically complex child, she is passionate about awareness and education for those within her daughter's condition. She also enjoys running, reading, cooking, and volunteering.” Colleen: Yes, that's a little bit about me. Meagan: I love it. Welcome to the show and thank you so much for being here with us. I would love to turn the time over to you to start sharing Gianna's story. Colleen: Amazing. Thank you so much for having me on. The VBAC Link was a staple on so many of my walks when I was getting ready to give birth. I just found it to be so uplifting and empowering and I'm so glad that I found you as a resource. A little bit of background before getting to my VBAC– it really does begin in about 2022. It starts out with some of those fertility issues that you had mentioned at the start of the podcast. My husband and I decided to start trying after about two years of marriage and we got pregnant pretty quickly. That ended early in a miscarriage at about 6 weeks. But we said, “Okay, let's try again.” We had processed and accepted that miscarriages do happen so we quickly said, “Let's give it another go.” But we had those reservations and that in the back of our mind of moving forward cautiously. We did get pregnant quickly again. Throughout the first trimester, we just kept it tight-lipped. We just told immediate family and then decided we wanted to do the genetic testing of course to find out the gender. We didn't really give too much thought to what else you learn from that bloodwork. As my pregnancy progressed throughout the first trimester, I was feeling confident then at about 12 weeks, we received a call from my midwife. She told us that it was a girl and that she came back high-risk with Trisomy 18. We weren't expecting that. It was scary and a shock and the more we learned and the more we read in those early days was devastating to us. We were just coming off the heels of a miscarriage so then to have this thrown at us was just a real curveball. In order to move forward and navigate that, my husband and I were always planning on keeping the pregnancy so it just meant, what does that mean going forward? After talking with more specialists and maternal-fetal medicine at the health system that I was at at the time, it became very apparent that they weren't really willing to help. We needed to find another health system. We are so fortunate because we were living out of state for quite some time then moved home before we started to try. We were living in Chicago and then moved back to Michigan. University of Michigan, so CS Mott Children's Hospital is for sure the best in the state and one of the best in the country for caring for kids with my daughter's condition. We switched all of my prenatal care there and they provided us with hope and were willing to monitor me and have a very wonderful NICU. They were willing to provide interventions and things after she was born. But as it related to my pregnancy, it completely deterred any sort of plans and any sort of “normalcy” that one might have. It was shrouded in sadness and anxiety and fear and unknown. Each ultrasound and each week was closer and closer to meeting her but also closer and closer to what does this mean for her? What does this mean for our family? I completely abandoned any apps or what size fruit she was going to be at a certain week because she had intrauterine growth restriction. That rulebook and those guidelines went out the window. I was really afraid to connect with her when I was pregnant. A lot of the time I would say, “Okay, be in tune with her. Read to her and rock her and listen to music with her,” and I would just end up in the nursery that we decorated in tears because I just had so much fear and sadness around what was to come. With that being said, because my plans had been derailed, I really threw myself into learning about her condition and learning about what would come afterward. That gave me hope as a very Type A person. I needed to be doing something to prepare and connected with other families from around the country to give me and my husband hope and learn about what life with children with Trisomy 18 looks like and what they are capable of really was our main driver throughout pregnancy. With that said, I did not prepare for birth at all. I didn't learn about how it could possibly go. I really just, like I said, focused on what care for her would look like. Just as a very small example of what that even looked like was when I came to write my birth plan, I probably wrote a couple of things like, “Oh, open to epidural. Do you have a birthing ball?” I honestly had a line in there that said, “If she is born not breathing, resuscitate her.” That is where my head was throughout pregnancy and it just came to however she was going to arrive, that was second to her being here and us starting to care for her. Meagan: Yeah. Colleen: That said, my care team, obviously I was being seen by the MFM department at CS Mott. They were very supportive. I never felt like they weren't looking out for both me and her. I think they wanted me to deliver vaginally and with the understanding that if it came to a Cesarean that would be what it was. My husband and I made it very clear that we wanted to be treated however they would handle a typical pregnancy. Meagan: Anybody else, yeah. Colleen: Yes. Yes. If it meant a C-section, that's what it was going to be kind of thing. She was showing that she wasn't tolerating labor. We got to the end of pregnancy and we were discussing what birth would look like. We all agreed that an induction at 37 weeks was going to be the plan for a couple of different reasons. From our perspective, we wanted to just start caring for her knowing that she was going to have complexities. We were in the best place possible to start that process. There is some research that would show that the longer that babies with Trisomy 18 are in utero, you could run into a stillbirth situation. Now again, it's a little bit more on the anecdotal side because many, many kids with Trisomy 18 are born vaginally at 40-41 weeks and it's how you want to play it. Meagan: You have to weigh it out for what's best for everybody. Was IUGR becoming a problem at all or was she still small but staying within her own growth chart?Colleen: Toward the end there, we were seeing some stagnated growth so yeah, they were very much of the mindset, “Let's just get here here,” kind of thing. She was born at 3 pounds, 12 ounces. She was just a peanut. Meagan: Little tiny, yeah. Colleen: I was induced at 37 weeks without having much knowledge of what the induction process was going to look like for me and I went in at a centimeter. They started with a cervix softener so that they could then insert the Foley balloon. I was in bed a lot. I utilized the tank of nitrous oxide. I labored that way for a while just to mitigate that pain. I was walking around a little bit but honestly, the Foley balloon for me in the whole induction process was probably the worst part. I was in quite a bit of pain after that. Meagan: Were you dilated at all before when they tried to insert that or was it a closed, posterior cervix? I'm assuming at 37 weeks, it's not doing much. Colleen: I was a centimeter when I came in and I was maybe a 2 when they inserted it I believe. Yeah. It was very apparent that my body was probably not ready for that process. Meagan: Yeah. Colleen: Yeah. That also became apparent once the Foley balloon came out but then pretty much I got to 5 centimeters and just parked it there for quite a bit. The pain was pretty intense so I received an epidural after laboring I would say probably 14-16 hours or something like that. The attending OB wanted to take additional steps by breaking my water and my husband and I were talking. We said, “If they break my water and then I don't progress, then what situation are we in?” We also knew beforehand that my daughter did have a confirmed heart defect. We wanted a more gentle approach to induction especially when it came to Pitocin. We really wanted to take it slow and monitor her to make sure she was tolerating it and things like that. We opted for Pitocin before breaking my water and took it slow. I would say probably another 6-8 hours went by. We were taking it very slow. I wasn't progressing and then we started to see some sporadic, not super consistent but enough to keep make us aware of her, decels that she was having. Again, the attending OB really wanted to continue on. She wanted to break my water. She wanted to optimize my chances for a vaginal birth, but again, I think my husband and I were so zeroed in on having her here safely that even the attending OB after observing some of the decels into the night was like, “Okay, I think–”Meagan: That was enough. Colleen: Exactly. She arrived via C-section on October 28, 2022 at 3:18 in the morning which we find incredibly special because 318 is a universal number around Trisomy 18. We just feel that she was meant to be here just as she is. That was enough for us to say, “Okay. We did what we think we needed to do to get her here safely.”Meagan: And happy birthday to her today. She will be 3?Colleen: She's actually turning 2. She's turning 2. Yep, yes. So that was my obviously first birth experience and it was– I can't even say different than what I expected because again, I really went into that not having much of a reference or much preparation at all. I say, “Okay. That was my experience. It was a C-section.” We weren't thinking at the time. We always knew we wanted future children but with the timeline, we had an 85-day NICU stay with her. There were other things that we were focusing on. Meagan: You and the reviewer. You NICU mamas are amazing. Colleen: Perfect review for today. After 85 days, we came home in January of 2023. We were getting settled into home life and then fast forward to about 6 months postpartum. We had just been home for a couple of months and much to my husband and I's surprise, we were pregnant again. From the first miscarriage to my daughter, we had that hope and that mentality of, “We have no reason to think that anything is going to go wrong so let's just operate from the stance that everything is going to be okay.” We took a similar approach this time around. We said, “Okay. We're going to roll with the punches. Gianna's going to get a sibling a little bit sooner than we initially had thought. Let's just play it like everything is going to be okay.” We had met with a geneticist and knew our risk for having another child with Trisomy 18. We were just slightly above the general population when it comes to the statistics there. We weren't super concerned. It was a very, very low risk. We decided to do the genetic testing anyway. I didn't consider myself to be high risk so I moved my care to a little bit closer to home. The University of Michigan is a little over an hour for us. I had a great experience but wanted to move just a little bit closer to home to a practice that is very utilized on this side of town by many women. I did the genetic testing and everything was good. We were having a boy and then the very next day, I woke up to a very large gush of blood. I went to the emergency room. This was on a Saturday. They did an ultrasound and said, “Baby is looking good.” I was again, about 12 weeks at this point. They said, “Sometimes just bleeding in the first trimester happens.” I took that at face value. I came home Now mind you, with my daughter's condition, she has a lot of medical equipment and lower muscle tone so it's a lot of carrying her around and at that point, she was still pretty small but again, I'm pregnant and I'm hauling her medical equipment plus her some days. I'm a stay-at-home mom so I'm trying to navigate all of that. I'm going about my daily life not really thinking much of it just saying, “Okay, that's what it is. The first trimester bleeding.” I went back to the OB that week and they also confirmed, “Oh yeah, it could just be bleeding.” I said, “Okay.” Then about 2 weeks later I'd say, again on a Saturday, it happened again. The bleeding had tapered off then it happened again. I went back to the emergency room to make sure everything was okay and it was a different emergency department. The nurse practitioner came back in after the ultrasound and said, “You have a really large subchorionic hematoma.”Meagan: I was going to ask if that's what it was. Colleen: Yes. We had done research obviously between the two ultrasounds and people said, “If you do, it likely will heal on its own.” Meagan: It takes time, but if you do activity and things like that. Colleen: Yes. I would say probably about 2.5-3 weeks went by with me not knowing I had it. I hemorrhaged again. This time, I really tried taking it easy leveraging my husband, my mom, and my mother-in-law to really help care for my daughter so I would be able to rest and recover. When I had gone to the OB that Monday just because I had been in the emergency room over the weekend, they painted it like there was not much you can do. If you can take it easy, great. If not, I actually went in that Monday and I had brought up the subchorionic hematoma and the provider that I met with said, “Oh, yeah. You have it but actually, I want to talk to you about something else.” It was a potential marginal cord insertion or a velamentous cord. Meagan: Okay. Colleen: She said, “I actually want you to be more aware of this than the subchorionic hematoma.” Again, it was pushed to the side. At that point, in partnership with some other pretty inappropriate and I would say frankly bad bedside manner from the practice, I was looking to move again. They were very insensitive around my daughter's condition. They made me to be othered because of her. I just didn't appreciate that. I was like, “This is a different birth.” I didn't appreciate that treatment. They asked very inappropriate questions about her and her life expectancy and things that were very triggering for a) someone who was fresh out of birth and a very traumatic pregnancy. I just felt that was very inappropriate to ask those things especially when we are also not talking about my daughter. We are talking about this pregnancy at hand that was having some issues. I was looking to switching providers. I have my best friend in the area. I loved her. She was pregnant at the time as well. She loved her OB so I was looking to switch. I couldn't get in for a couple of weeks so I just said, “Okay.” At the next month's appointment, I would switch practices away from where I currently was. In the meantime, I would say about a week and a half later, I was bleeding again. It was on a Monday so I got in that day and I personally had a little bit of peace around it because I just said, “Okay, this has happened before. Baby has always been okay, but let's get in.” So I got in that Monday and I was given an ultrasound and the ultrasound tech put the wand over my belly and then very quickly went out of the room. My heart sank. I just knew what that meant. She came back and I asked, “Was there a heartbeat?” She just shook her head no. I was by myself because my husband was home with my daughter and it was just completely unexpected and devastating. It crushed us because we again had just come off of something so difficult and had so much hope and for that to be the result was quite crushing. I had reached out to the OB that I had planned to switch to and I just explained the situation. She said, “I'd like to still see you.” I went in about 2 weeks after my miscarriage and just laid everything out for her. She shook her head after me telling her about my first miscarriage and then my daughter and this most recent miscarriage. She took it all in and she goes, “I think there is something going on. I don't think these are just flukes so I want to run some tests.”She ordered some pretty extensive bloodwork mostly in the autoimmune space but she also ran for MTHFR. After many vials of blood and a few weeks of waiting, I came back negative for anything autoimmune but I did in fact come back for MTHFR and she is a provider who believes that it does make a difference. She said at the time that she provided us with this glimmer of hope. She said, “If I know that a patient has that, I start them ideally on a pretty ‘easier' regiment or something to get them started to see if that makes any difference in their pregnancies. If not, we can build with Lovenox injections and things like that.” Basically she said, “I want you on additional folic acid.” I took methylfolate and a baby aspirin. But she posed it to my husband and I. “Do you just want to go the Lovenox route? Once you go on Lovenox, I won't be able to walk you back on additional pregnancies. If you have a successful pregnancy–”. Again, knowing this wasn't going to be the answer and that we could potentially have another loss or more issues with pregnancies but we wanted to start on that first step before jumping forward.She said, “Pick up those supplements when you feel like you are ready.” We needed time. We needed months of healing and of focusing on my daughter's care to just really level-set for our family. But in December of last year, we felt strongly that we wanted Gianna to have a sibling so we decided to try again. I got pregnant and began those supplements. From that perspective, my pregnancy was very difficult. Now, it also gave me that time both prior to getting pregnant and then throughout my pregnancy to really– I really wanted to level-set my approach and my outlook on pregnancy. I had felt like I had been always in this cycle of seeking out information or researching based on issues and I think my and as well as my husband, the trauma aspect always played into it of, okay. Here's a symptom. It could be something very normal or it could be these very unique, rare things that we got used to feeling comfortable in that space. Meagan: Yeah. Colleen: I sort of recognized that as something that I needed to work through. I needed to work through some things that were either emotions I pushed aside. I pushed aside the thoughts and feelings around especially that second miscarriage because I said, “Okay, I have a daughter with medical complexities.” I needed to jump back in and I think that distraction helped me push those thoughts away but then I will say they came back. They reared their head and I said, “Okay. It's time for me to deal with them.” So going back to talk therapy has been really helpful for me for working through some of those emotions as well as unprocessed things with my daughter's pregnancy and birth and care and things like that, the realities around her life and how it's impacted myself, my family, and things like that. I went back to talk therapy and then also got pregnant. I thought that was the perfect time to really sort of level-set my outlook on pregnancy. We forewent the genetic testing around. We just said, “What will be will be.” For now, the fourth time, we are choosing to believe that all will be well. We will have these feelings. My first trimester almost felt like the closer I got to the end of my first trimester, the more anxiety I had because I had that second-trimester miscarriage that I just had the opinion that it could happen at any time and why wouldn't it just happen to me again?There were some friends who didn't know that I was pregnant until my anatomy scan just because I felt like I needed to hold it close to my chest. Meagan: Just keeping your space safe. Colleen: Exactly. Exactly. And protecting my own emotions. So the first trimester for my son did have some of those thoughts and feelings. The OB who I had switched my care to was very accommodating. She had a little portable ultrasound machine in her office if I felt like I needed that reassurance that she would provide the ultrasound for me. She asked me how often I wanted to come see her. She was just very understanding and accommodating based on my previous circumstances. It also allowed me the space, especially as I moved through pregnancy, to really think about birth and think about how that process could be healing as well. In my second trimester, I remember going on a walk because I needed to clear my head and just feeling so overwhelmed by not knowing where to start and then I was being hard on myself because I was like, I should have done this with my daughter. I should know these things already. This is my second birth. I was being very self-critical as if I didn't have other things to focus on with her. That's when I came across The VBAC Link. I actually came across it because my husband and I had taken some on-demand birthing classes through Mommy Labor Nurse and we very much so said that we needed a refresher and probably to take some more diligent notes this time around. It was a resource that she has promoted so I checked it out and I just immediately felt like it was going to be so helpful as it was throughout pregnancy just listening to the podcast episodes, referencing the blog, getting your emails, and just really feeling like I had a resource that was going to support me. I can't express how grateful I am for that because– and I'm about to get emotional– of how along pregnancy and that journey has felt. I've constantly felt like I've been up against walls that it's been exhausting to have to overcome and to break down. Meagan: Yeah. It's a terrible feeling to feel so alone in this really big moment in your life and not feel like you know the direction all the time and then also making decisions and then having the world pretty much question why you are making that decision. It's so heavy and that's why I love this community so much because they make you feel connected to people that are not even within reach. They are hundreds and thousands of miles away. Colleen: Absolutely. Absolutely. Just to have that support because it very quickly became my goal to VBAC because I flipped the script after finding The VBAC Link. I said, “There is nothing pointing to my body not being able to do this. I'm going to go for it.” I'm a competitive person and sometimes I'm competitive with myself and I said, “This is going to be a competition and I'm going to do this.” I will say getting into the true VBAC part of it, my OB was very supportive. She said, “I think you are the perfect candidate to VBAC.” She did want to see what my body did closer to which made me a little bit nervous. She was like, “I'm not for induction but I would do augmentation.” I was like, “Okay. Let's see.” Again, it was a motivator to me to do all of the things that I could do to edge myself along kind of thing. The biggest thing I leveraged was walking. I walked a ton and I just found a routine in the business of life that worked for me that I could rely on each and every day and say, “Okay, these are the three things that I'm going to do throughout the rest of pregnancy to a) give myself peace mentally and physically, but also just to say life is busy, but this is what I'm going to do to move myself forward.” It was a lot of walking. It was a prenatal that I just really adored and I just committed to a pretty nutritious diet to make sure that I was nourishing my body in all the ways that I could. Around 36 weeks, I received a cervical check and was starting to dilate and efface. I was about 2 centimeters. Meagan: Wow. Colleen: Yes, with about 70% effacement at that time. My OB said, “Things are looking good. You are on the right track here.” I just kept doing what I was doing. I did opt for a membrane sweep at 38 weeks and I will say having never labored before, between that 36 and 38-week mark, I was having a ton of prodromal labor which was very frustrating because I never knew what was real. We went to labor and delivery once. I got turned away and sent home. I thought it was the real deal. Yes. Prodromal labor is a tease. But after the membrane sweep, it became very apparent that I was actually in labor. That afternoon, my husband and I and my daughter lay on the couch. I was having closer and stronger contractions and we joke that it was absolutely the real deal because all the times leading up with prodromal labor, everything was squared away. My meals were prepped. Everything was squared away with my daughter. My in-laws and my parents were ready to go and jump in. The day that I started to be in labor, our basement flooded with our sewage backed up. Meagan: Oh no. Colleen: I'm actively in labor and my husband comes up and says, “This is absolutely the real deal because this wouldn't have happened if you weren't.” I'm in labor and my father-in-law are bleaching the floor and scrubbing. It was a whole thing and I was like, This isn't funny right now but it will be funny one day. And it's funny. I was able to labor at home for a few hours. I got to the hospital. I had the membrane sweep at noon that day. I got to the hospital around 9:30 PM and was at a 5. I was feeling pretty good about that. I was feeling those contractions of needing to pause. I wasn't really able to talk through but still at that point now knowing what later labor felt like that it was just the beginning of things. I had a wonderful labor and delivery nurse who was super supportive. I never felt being there like I had to convince anybody. They knew that my plan was a VBAC. The attending OB was cool with it. My OB lived just a few minutes away from the hospital and said that she would be there within a moment's notice when I did deliver so I would have her for the moment of. I got to a 5. They did put me on the monitors and had me hooked up so my movement was pretty limited which kind of limited what I was able to do. I wanted to walk a little bit more. I was only able to sit on the birthing ball in a certain area of the room. That was a little bit tricky. The shower was really nice and I did appreciate laboring in the shower but it was the attending OB who had checked me when I first got there and determined I was a 5. A few hours later, the labor and delivery nurse checked me and said, “Oh, I think you are a 7.” My goal was to get to active labor before I decided if I wanted an epidural but ideally, I wanted to go unmedicated. So when they said I was a 7, I was like, “Oh, okay. All right. That's the motivation I needed to keep pushing on. I can do this.” My contractions were becoming more frequent but they weren't getting stronger. It almost felt like at a moment's notice when they had to put the IV in or if the pain was too intense that I would start to space out again which I found to be interesting. But when a few hours went by, the pain was intensifying. They wanted to check me again and it was the OB this time who had checked me earlier and she said, “Oh, you're a 6.” My husband and I said, “Well, they said I was a 7 when they checked me last time.” She said, “Yeah, but I've got the frame of reference and you're more of a 6.” That messed with my head. Meagan: I'm sure. Colleen: My breathing was no longer effective. The pain was getting to me. The next step they wanted to take was breaking my water. I just didn't feel like I was in the headspace to continue on without the epidural. Meagan: You were mentally derailed. That can happen. Colleen: Yeah. When it came to my birth plan this time around, I was a little bit more descriptive because I had done more research. I wanted to go the unmedicated route if I absolutely could. If not, at least active labor. I really didn't want any augmentations or interventions when it came to breaking my water or Pitocin. I really wanted to be able to do it on my own but I will say and I think this is one of my bigger takeaways from this birth is that even when things don't go according to plan, you really have to trust your gut. I will say in those moments, my gut was telling me I think what needed to happen to service the overall goal which was my VBAC. I said, “Okay. I think in order for my body to relax, I want the epidural.” I get the epidural. My body did just that. I was able to relax. My contractions were getting closer together again. They did break my water and now we were into the morning hours here. I get a call from my OB and she said, “Hey, I'm aware of your situation. I see that your contractions are getting closer together but they are still not at that strength that we are really wanting to see.” She said that, “If you are okay with it, they want to start me on very low doses of Pitocin.” She said, “I think you will need a whiff of it in order to get to where you need to be.” My husband and I looked at each other and I think because of our experience with Pitocin previously and not wanting to stall out or anything go wrong, we really struggled with that piece but I think ultimately, we said, “Okay, we're already here. If this is what my OB thinks this is what I need–” and again, I personally felt okay with moving forward in those directions, “then, let's give it a try.” She was absolutely right. They started at a 1 and bumped it up 45 minutes later. I was feeling some pressure and I wanted to switch positions. I had the nurse come in to help me. She lifted up the blanket to move me and she said, “Oh, his head is right here.” He had been crowing for we don't know how long.Meagan: Oh my gosh. Colleen: My husband looks down and he goes, “Yeah, his head is poking up.” My OB gets there. It was super relaxed. She just walked in. She had her sunglasses on. She was just like, “Okay, let's do this.” She was getting set up. He had a bunch of dark hair and she was giving him a faux-hawk while she waits for things to get set up. For the moments that led up to that with anxiety around the interventions, the moment of his birth was very relaxed, very calm– Meagan: Lighthearted. Colleen: It had this great energy around it. I pushed for about 15 minutes and he was born. Meagan: Oh my gosh. That is amazing. What a way to end such a lead-up to get to this moment in your life. Colleen: Yes. His birth, the moment of his birth and the half-hour leading up was so joyous and healing like I had always hoped it would be and exactly what I think my heart needed. Just not necessarily VBAC-related, but I think I also struggled with all of the needs of my daughter and having now split time, I think going from one to two for some mamas can conjure up those feelings and that guilt around what your firstborn is not getting especially with all of her extra needs and things. I was really feeling that guilt. Now he's here and he is exactly what my family needed. He is just this puzzle piece that was missing. We didn't know it. We didn't know it until he was here and now we feel that way on so many levels. Meagan: Isn't that crazy sometimes? This is one of the coolest things I think about being a doula is that we see these couples and they think that their life is so amazing and it is. Don't get me wrong. It is amazing. They think that they love each other more than they ever could love each other. I can see the love in their eyes. I can see the support as the labor goes and then this human being enters their family and like you said, it's just this puzzle piece that fit that you didn't know you were missing. It's this extra joy and this deeper love that they didn't even know existed and it's one of the coolest things to see families transform. Yeah. It's absolutely amazing. Even from no kids to one kid and from one kid to four kids, it doesn't matter. Like you said, it's the puzzle piece that they didn't know they were missing. Colleen: Absolutely. I just can't wait to watch my daughter learn from him and him learn from her. That relationship– I even had the thought where I was like, “I'm the most important thing to my daughter,” then I'm like, “Okay, but she's going to have a sibling and that is such a gift in and of itself that I just am happy to be able to provide that,” but to your point, it is. It's a love unlike any other love. You will always obviously hold your partnership with your partner. It's so important and so instrumental to providing that love for your children as well but that love that you get from birthing a child is unparalleled. Meagan: Oh my gosh. It's so amazing. It is so amazing. I feel so grateful as a doula and as someone who is done having kids– my youngest is 8 years old now but I get to keep living through all of these couples. It's just so amazing. Oh, well congratulations. Colleen: Yes. It's so beautiful. Again, it didn't go on the micro-level according to plan, but on the macro-level and in my big-picture goal of having a VBAC, it was all I could ask for. Rolling with the punches and I will say again, going back to the beginning of the podcast and sharing that I'm a very Type A person, I think had my past not happened, any of these little interventions that were needed throughout this birth could have also derailed me or discouraged me and I just think all of these experiences I had up until this point taught me that rolling with the punches and just understanding that things might not always go according to plan but healthy me, healthy baby– Meagan: And a good experience. Colleen: Exactly. Meagan: Rolling with the punches while trusting your intuition because some of those punches might look like punches but it's actually what you need. Colleen: 100%. Trusting your gut, advocating for yourself, also important to keep in mind. Meagan: Super important. Well, before we go, I wanted to quickly give some more depth into some of the things that you had brought up along the way. We talked about your daughter's condition and then there was something that you said that is a really big tip that I give to my clients when it comes to breaking the waters versus starting Pitocin. It's okay if you don't agree with me, everybody out there. A lot of people would rather break water over starting Pitocin because it's the “more natural way to get things going”. But I'm such a person of, let's try a whiff of Pitocin that we can turn off, but if we are artificially meaning we are breaking the bag of waters by ourselves against mother nature's choice, we can't patch that back up and we don't know what's going on so we don't know if baby's in a weird position. We don't know if baby is too high. We don't know what's going on so sometimes I think just starting that 1-4 mL drip of Pit and then you can always turn it off and it's gone. I was going to say that's weirdly one of my suggestions that over all of my years of doing this, I would weirdly suggest that sometimes over breaking your water. That really depends on where we are at too. If we are 9 centimeters and baby is +2 station, we're really engaged, I dont know. It might change. But if we are at the point where you were at, I actually would suggest that. I wanted to really quickly talk about VCI and marginal. So velamentous cord insertion. You mentioned that the OB was like, “Yes, subchorionic and we're here but then we've also got this.” With VCI, that is where the cord is inserted abnormally into the placenta. It can cause things like IUGR which we talked about earlier so intrauterine growth restriction. I don't know if they gave you any stats on this but it's a 1% chance of that happening with a singleton baby, a 6% chance with twins and then if they do share the same placenta, it can go up. I want to say it's upward of 15%, so much higher. But a lot of the time, even VCI babies carry to term and everything is okay. I do want to throw it out there that a lot of providers do suggest a Cesarean with VCI. I don't know if you've ever heard of that. People can have vaginal births but a lot of providers will suggest Cesareans. If you have VCI or are being told that you have VCI, just know that might be a conversation and you want to discuss that with your provider earlier on. She also mentioned a marginal cord insertion which is where that attaches to the side I believe so also an abnormal insertion. I don't know. Did your provider tell you anything about that? Colleen: Not the statistics around it but they also said that I was 6 months postpartum, post-C-section when I did get pregnant again so their recommendation I think regardless was going to be a repeat C-section. Meagan: Yeah, so it can happen. Then last but not least, I just want to throw out anything that you have about MTHFR to the listeners who may have gone or are going through experiences like you. MTHFR really depends on a provider. Some people still roll their eyes at it but it's definitely a thing. Do you have any suggestions toward anybody who may have it or maybe finding out that process?Colleen: Yeah. Meagan: Or going through the process?Colleen: For sure. Just through my own research, again, my OB was like, “Just additional folic acid.” Meagan: I love that you mentioned that by the way. Colleen: So I obviously am no expert or dietician or nutritionist but when you do have MTHFR, you can either have homozygous or heterozygous mutations. There are also two different variations. There's the A variant and the C variant. I think there is research around the severity or the impact of each of the variants on fertility and things like that but sort of the biggest takeaway when it comes to MTHFR is that it can make you more prone to clotting issues as well as malabsorption or the inability to use folic acid effectively. That is why a lot of research will indicate that you should be on the purest form of folate which is methylfolate because it's so easy for your body to absorb when you do have the MTHFR mutation and then when it comes to having additional methylfolate, essentially I found a prenatal that had methylfolate and was just chock-full of a bunch of good stuff. I was also taking additional micrograms of methyl folate on the side just as a pure supplement. Personally, I found that to be helpful and again, that is something that I baked into that consistent routine of mine making sure I was on a really optimal prenatal as well as taking the methylfolate every day. In addition to the baby aspirin, that was to mitigate some clotting issues. The other thing I will plug is a resource and a follow on Instagram if you don't already follow is Lily Nichols. Meagan: Yes. We love her. She has been on the podcast. We have her books. Colleen: Yes, exactly. In addition to when you know you have MTHFR, just really ensuring that you are getting proper nutrition and that is top of the line in pregnancy when you are trying every day of your life basically. I definitely broke and cheated with my little guilty pleasures here and there of course. But I really largely throughout pregnancy tried to stick to a really vitamin and nutrient-dense diet. Meagan: Yes. I don't know what prenatal you took and I don't judge you for any other prenatal of course. We love Needed but you said the optimal amount. That's what we are finding. So many of these prenatals don't have the optimal amount and they don't have the purest forms. We love Needed and truly 100% suggest it. But yeah, exactly what you said. It's so important. It's so important.Colleen: Exactly. That would be my advice to anyone who wonders. I would also advocate and press to be tested if you are having issues. I just think it would be so beneficial just to have that piece of information in your toolbox so that if you do want to ask either on your own or you do want to press your provider to take it seriously, then I would definitely recommend just saying, “Hey, can I get the bloodwork to find out?” Then you can go from there. Meagan: Yeah. Yeah. Bloodwork. You can start there and know. Colleen: Exactly. Meagan: Oh my gosh. Thank you so much for this amazing information along the way, your beautiful stories, and thank you for taking the time to share with us. Colleen: Thank you so, so much for having me. It was such a pleasure. Meagan: Absolutely. 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

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Sometimes we hear so much about birth - all kinds of births - that we can forget it is a normal, biological process. In today's episode, Emily's experience reiterates the ease of physiological birth - both at home with a single baby, and in hospital with twins. She is honest from the get-go when she admits that she wasn't even sure she wanted to be a parent but we follow her journey of acceptance, the grief of misscarriage, the trust in her body and the preparation she did to lean into her intuition and birth all three babies with a profound sense of faith in her breath and body. If you're currently in a period of doubt and fear (both very normal experiences in pregnancy), you'll find so much comfort in this episode. ______ What makes The Birth Class so unique? Instead of learning from one person with one perspective, we've gathered nine perinatal health specialists to take you through everything you need to know about labour and birth. Evidence based information is key to thorough preparation. In The Birth Class you'll learn from:5 midwives and an obstetrician, a women's health physiotherapist, yoga teacher and birth doula.Listen in your own time and as many times as you like so you understand: the process of labour and the hormones involved the benefits and risks of interventions your pain-relief options what happens in an emergency caesarean what to expect in the hours after birth active preparation for a VBAC Plus, you'll be taught practical birth skills that will help you navigate the twists and turns of labour. The Birth Class is accessible birth education that's both conversational and wise. Best of all, it will start a conversation with you and your support person so you can both feel prepared and confident to make informed choices; the foundation of a positive birth experience.See omnystudio.com/listener for privacy information.

A new study measuring microplastics in organs of the recently deceased found that about two dozen brain samples were 0.5% plastic by weight. Also, having an IUD inserted in the uterus is extremely painful for some people. The CDC now recommends that doctors use local anesthetics.Study Finds A Staggering Amount Of Plastic In Human BrainsIt only takes a quick look at our streets and waterways to be reminded that plastic pollution is a big problem. But that's just the plastic that we can see. An increasing amount of scientific literature points to microplastics accumulating inside our bodies, particularly in organs.A recent preprint published by the National Institutes of Health found a staggering amount of microplastics in livers, kidneys, and brains of recently deceased cadavers. The brains, however, were the biggest shock: They had 10 to 20 times more microplastics than the other organs studied. Twenty-four of the brain samples measured were found to be about 0.5% plastic by weight.Joining guest host Maggie Koerth is Tim Revell, executive editor of New Scientist based in London. The two discuss this and other top stories of the week, including a possible explanation for an “alien” radio signal, a look into how orb spiders use fireflies to lure other insects, and a study that says playing video games is good for you, actually.CDC Updates Guidelines For Managing Pain From IUD InsertionThe Centers for Disease Control and Prevention recently announced updated guidelines for managing pain from inserting a popular form of birth control called an intrauterine device, or IUD. The recommendations now advise doctors to consider using local anesthetics like lidocaine to help manage patients' pain.An IUD is a small T-shaped device that is passed through the vagina and cervix and placed in the uterus, where it can remain for several years. Figures vary, but this insertion process can be very painful for roughly 10%-20% of patients. In recent years there's been an outpouring of patients speaking out on social media about just how painful their IUD insertions were. Many people have recounted how their doctors did not provide anything to help mitigate their pain or, in some cases, dismissed their experiences altogether.Guest host Maggie Koerth talks with Dr. Beverly Gray, associate professor of obstetrics and gynecology at Duke University to discuss the significance of these new guidelines.Transcripts for each segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.