Podcasts about iugr

Play Episode Listen Later Feb 5, 2025 38:50

Chrissie always dreamed that the birth of her babies would be the happiest days of her life. But with her first two births, they were among the worst. In today's episode, Chrissie expresses the heartbreak she felt after doing everything to prepare for a VBAC and not get it. Though she wasn't sure how her third birth would go, the healing, research, and advocacy she did made all the difference in her experience. She called the shots, listened to her intuition, and ultimately saved her baby's life by being so in tune with herself and her body. And finally, the birth of her third baby was the most beautiful, joyful, and happiest day. Coterie DiapersUse code VBAC20 at checkout for 20% off your first order of $40 or more.How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We have a CBAC after two Cesareans story coming your way today. This is a story that we felt we should share because it is so important to document our CBAC stories as well. Even though there are a lot of things that are going to unfold within our guest, Chrissie's story, it's so important to see how much she has grown and healed over each experience. Listening to her, a few things came up in my mind as I was listening. It was intuition. We've said it for years, honestly since 2018 when this podcast began. Intuition is so powerful, and sometimes it's hard to turn into and understand what your intuition is or what fear is, but I challenge you right now to start tuning into that. When you're getting the feelings, is it your intuition? Really, really connect with that intuition because it is so powerful. Another thing that I felt was a big takeaway from her story was how much she researched and gained knowledge of her own rights and her own ability to say no or to say, “Not now, not yet. No, thank you.” Women of Strength, I know it's hard, and it's really hard when we're in labor. I know it. But you always have the right to say no. You can always say no. Chrissie really did such a good job at researching and educating herself and arming herself up with the knowledge that she needed to so she could confidently say no when she needed to but also confidently say, “Hey, this is something that needs to change,” and stand up for herself in that time. I do have a Review of the Week, so I want to jump into this, and then turn the time over to Chrissie. Okay, this review is hseller. Hseller, I think is how it is. It says, “Life-changing. I don't even know where to begin. This podcast has honestly been life-changing. I am currently 9 months postpartum after my first Cesarean birth, and I've already binged every episode. I honestly believe The VBAC Link should be a resource for every birthing person, not just VBAC, on how to prevent a Cesarean to begin with. This needs to be part of basic birth education.”Oh, girl. I am with you on this. I am with you on this. It says, “I have shared this podcast and the blog with every friend of mine who is expecting because I wish I would have known about it before my first birth. Listening to the podcast reminds me that I'm not alone in my experiences and that this is possible and to have an amazing, empowering birth is possible. Julie and Meagan deliver facts, stories, and inspiration in such a wonderful way. Hearing their voices when an episode comes on puts me in a happy place. My husband and I have already been talking about baby number two. I can't wait to share my next birth story because with an education and support I now have, I know it will be beautiful and healing regardless of the outcome.”Thank you so much, hseller, for your review. You guys, these reviews really do mean so much. It is now 2025, and we do need updated reviews. You never know. It may be read on the next podcast. We are switching things up this year with educational pieces and topics of reviews and things like that, so you never know. But please, please, please leave us a review. It means the world to us. Meagan: Okay, you guys, I'm seriously so excited. It's always so fun to have multiple people on the show and cohosts, but it's also really fun to have doulas sharing the story or listening to the story with their clients and giving their tidbits. So Chrissie, I'm going to turn the time over to you and then of course, Sarah will be hearing from you, I'm sure along the way as well.Chrissie: All right. Hi, I'm Chrissie. I live in Greenville, South Carolina and I'm going to tell you about my three birth stories. All VBACs and repeat Cesarean stories start with your first C-section. Julian was our first C-section.He was conceived during my husband and I's fourth month of dating. My husband and I both knew marriage and kids were our desire with each other almost instantly, but it was still crazy to think about how fast it happened. Everything was going fine until about 30 weeks when I started to be measuring about a week behind and was scheduled for a growth scan which we couldn't get into until about 32 weeks.During that scan, it was confirmed that Julian was measuring close to the lower 10th percentile and that I, from that point, would be scheduled for regular non-stress tests every week for the rest of the pregnancy. His check at 36 weeks was non-reactive which is not what they like to see. I was sent for a biophysical profile. He was graded so low that I was told to immediately go to labor and delivery and not eat or drink anything, which as a nurse, I know that means they were assuming I may have surgery in the very near future.I was planning to go to work right from my original appointment, so I reported to work, but then went right upstairs and burst into tears of fear. I was given fluid, and he woke up because of the scare. But because of the scare, I was scheduled for an induction at 39 weeks and because I didn't know any better, I was just excited to meet him a week early.On the day of my induction, I showed up bright and early, ready to get things going. I had done no preparation, assuming that my high pain tolerance and grit would serve me well. I wasn't against pain medication, but I was ready to test my limits. Julian passed the non-stress test, so they started Pitocin, and he was doing fine, so they decided to insert a Foley bulb to speed things up.When they inserted it, my water broke, so that kind of put me on the clock. Once I got to about 4 centimeters 12 hours later, I was somehow feeling discouraged and tired and asked for the epidural. My husband said as he was holding my hunched over body that a huge teardrop fell out of my eye as the needle went in and the zing sensation went down my leg.I, was already giving up, but had no idea what I was setting myself up for.Over the next four hours, Julian's heart rate would drop with every contraction while Pitocin was going. They would turn it off, and he would be fine. And then when they restarted it, he would have the non-reassuring heart tones again. I was not explained to why I needed to wear oxygen or keep flipping from side to side or what low heart tones meant. All I know is that at 1:00 AM, they called for a C-section because we were getting close to the 24-hour rupture of membranes.If I had known then what I have learned since then, I would have tried to steer my birth in so many different directions. Unfortunately, birthing people are not given this kind of information upfront, which is. Why I think The VBAC Link is so important for any pregnant person as it could potentially help 1 in 3 women who end up consenting to a C-section to this day. I was devastated. I never thought the dramatic push and bringing baby to my chest at long last was something that wouldn't happen for me, let alone I would mourn missing out on it. I was wheeled into the OR. My arms were strapped down to either side of me. My arms were shaking and pulling uncontrollably to the point that when my Julian was given to me, I was too scared to hold him thinking I would drop him since my arms felt like Jell-O. I've since learned that because my epidural was converted for the C-section that I would feel extremely unpleasant sensations of my innards being pushed and pulled out of my body. All I could think about was my dad saying, "It was the happiest day of my life when you were born," and somehow this was feeling like one of the worst days of my life. I felt a double loss. It took me a long time to get over feeling like a sham for not giving birth the real way, but on the table, they said we gave you a double stitch so you can VBAC the next time. Over the next five and a half years that became an overwhelming objective and purpose in my life. When Julian turned 1, I had my IUD removed. I still had not gotten my period back but was hopeful it would return soon since had started to wean him from breastfeeding. When it did return, it was not normal. I would be spotting for weeks afterward and had a strange dull pain on and off constantly. I was so desperate to get pregnant so that I could get my VBAC thinking that all the horrible feelings I was having would go away. Or so I thought.After what felt like the longest four months ever, I did conceive our daughter, Ellie. It was January 2020. To this day, there are so many songs, books, and kids' shows that I cannot watch because they remind me of the early days of the pandemic. My son and I both got flu A and flu B during the first three months of the year, and it was terrifying to be relieved by a positive flu test.As an ER nurse, I was put on furlough since no one was coming into the ER, and many of us were sent to New York City and hard-hit areas to help where help was needed. I had to tell my manager earlier than I would have liked that I was pregnant and scared to be around some of the symptomatic COVID patients because we did not know what would happen. Sometime in the spring when people couldn't stand quarantine anymore and were going out and socializing again, the patients in the ER spiked, and I went back to work at six months pregnant. Even though it was terrifying, I was glad to be out of the house with somewhere to go and have a purpose.Those winter and spring months were some of the most depressing and hardest to get through in my life up to that point. I spent a lot of the time doing all the things that you can do to achieve a VBAC. I took a mindful birthing course over Zoom because they weren't doing any in-person things at that point.I read several books, did Spinning Babies exercises, hired a doula, etc. The thought of finally getting my VBAC was at times my only motivator to get up and do the things some days, other than the bare minimum to keep my one-year-old and me alive as horrible as that sounds.When I reached 37 weeks, I went into quarantine, and the waiting game began. I walked miles and miles and practiced mindfulness techniques to get through the pain. I was scared that the epidural had led to my son being in distress. So by this point, Ellie had passed all of the extra growth scans. She was head down. Everything looked perfect. By 40 weeks and five days, I became extremely stressed out. I had an induction scheduled for 41 and three days that was making me so nervous. My husband and I attempted to speed things up, breaking my water in the process.As soon as I felt the gush of fluid, I felt my heart sink and was overcome with fear and regret. It was starting just like the first birth I did with the premature rupture of membranes and what I believed would be an inevitable cascade of interventions that would lead to a repeat C-section.The rupture occurred around 3:00 PM, and I decided I should try to rest and wait for things to ramp up. By 10:00 PM, things were regular but not painful. I decided to try and go to sleep, but because of my trauma from the first birth, I wanted to make sure that she wasn't having issues with deceleration. I got my stethoscope out and listened to her heart rate as I had done several times before that point. It sounded normal and I listened to it through a few contractions.Every time, I could hear her heart rate slow very noticeably. I didn't know what to do. I didn't want to go to the hospital because I knew what they would say. I didn't want to tell my husband because I knew he would want me to go to the hospital, but I was genuinely concerned for her. So I let my husband listen, and he started getting dressed immediately to go. I knew it was over.When you arrive at L&D, they ask for a reason for you being there. As a nurse, I knew what I was about to say was going to sound insane, but I said, "I think my baby is having distress. I heard her decelerations on my stethoscope at home."I could see the amusement in the triage nurse's eyes as I said this. But she said, "Okay, let's get you hooked up and see what's going on." Sure enough, she was already having category 2 decelerations, and I was only 1 centimeter dilated. The resident said that my contractions were only about 5 minutes apart, but that because of the decelerations, she would be admitting me right away.She said we could try fluids and some position changes, but it was looking like the C-section was going to be the only safe way to get her out since I was so far from 10 centimeters.Before she left the room, she said, "I know this is going to be very disappointing for you since you wanted to VBAC, but you may have saved your baby's life by coming in when you did. It's amazing that you knew to listen and could interpret what you heard."Long story short, nothing worked, and I was prepped for the C-section. My COVID test was negative, so my husband was going to be allowed to come into the OR. Tears were streaming down my face the whole way. I walked into the OR and sat myself on the table for the epidural. I was still in the clothes I had walked in wearing. That's how fast things were going. The epidural was placed, and they started prepping me after a few minutes. They still had the fetal monitor attached for some reason, and we heard her heart drop into the 70s and not come back up. I could hear the sense of urgency on the other side of the drape. And suddenly, I felt several sharp pricks across my abdomen. I was lying there with so many thoughts running through my head. But thankfully, one of those thoughts was, "I wonder why they just poked me like that. Oh, I guess they're checking to see if I was numb. Wait, I felt that."I yelled, "Wait, I felt that."And they were like, "What? Was it dull or sharp?" I yelled, "It was sharp." They poked me again and again, and I kept saying, "It's sharp." We could all hear her heart rate in the background getting slower and slower, and I yelled, "Just put me out. Just put me out."The pre-oxygenation mask went right onto my face, and the last thing I heard before I went out was, "Someone page the STAB team," which is the group of medical providers they call when they're assuming that a newborn is not going to be doing well. I woke up in a daze when I realized where I was and what had happened. I burst into tears again and asked, "Is she okay?"And she was perfect.They actually said she was screaming before they even pulled her out of me fully. Very strong and healthy baby Ellie. But another day that was supposed to be the happiest day of my life which instead was a day even worse than my first birth. I felt completely defeated, hating myself for all the time, effort, money, worry, hope, and mind space that I had put into something that I still didn't get. A few minutes after I woke up, the surgeon came up to me and said, "Your original scar did not heal right. It was defective, and because of the urgency of the situation, we had to cut through a higher area of your uterus so we wouldn't accidentally cut any arteries because the anatomy was obscured by the first scar. We realized while repairing the uterus that it was in the contractile tissue, and you will never be allowed to VBAC again."I didn't really care because I thought we were done having kids, or so I thought. But it made me feel really bad about myself hearing the words "defective", "obscure anatomy" and "not allowed" hung with me for a long time. I wanted to get out of that hospital as soon as I could. All I could think about was my failure and how all the feelings that were supposed to be fixed by this birth were only made worse at my follow- up appointments. At the 6-week check and the 12-week for IUD insertion, I had to actually be let out the back door both times so that the people in the waiting room wouldn't see me hysterically crying. I honestly didn't even want to go to these follow-up appointments because they just further cemented to me that I had failed. And I'm not someone who can be told that I can't. Even though I was for sure believing we were done having kids, I joined the Special Scars group on Facebook just to see if anyone had had a similar scar as mine.I didn't think we would have more kids, but I still wanted to know if I could. Unfortunately, over the past few years, I've only spoken with one other woman who had a similar scar as mine. The fact that it was so uncommon made me hate it even more because I couldn't find any answers about what it meant for me. I did seek counseling following these events, and eventually, I felt better but I still thought about what happened daily and could not stand to hear anything related to birth.Several months later, I started having pelvic pains. I went to be evaluated for an ovarian cyst, but when they didn't find one, they did see how crazy my first scar had healed. Because of the pain, they had agreed to do an exploratory laparotomy surgery to repair the scar thinking it could be the source of my pain and definitely a reason for the spotting I'd had between cycles. During the surgery, they found a large surgical hernia as well that they had to remove momentum from and recommended surgery to fix it in the future. Whatever the reason for the pain was the scar or the hernia, my pain was gone following the surgery and two weeks later we moved to Greenville, South Carolina. Everything seemed fine.Trying to settle into a new house that needs lots of fixing up with a one and a three-year-old takes time. I knew I didn't have an IUD in at that time, but my period hadn't come back yet since my one-year-old would not take to the weaning and I was still nursing her. I wasn't that worried.In August, my period did come back, and I decided to use ovulation strips to see how long after ovulating I was spotting to see if I could figure out if my cycles were in the normal range again. Strangely, the first strip showed up very dark along with the next several strips I tried and I was like, "Oh great, things are out-of-whack still." But that's when I remembered people sometimes interpreting ovulation strips for pregnancy since LH and HCG are such similar-shaped molecules. I decided to use one of the pregnancy strips that comes with the ovulation pack and sure enough, it was also darkly positive. I was inexplicably excited, and I sheepishly told my husband who was also very excited. We went to our eight-week appointment, and there was nothing on the ultrasound. My HCG was high, but the progesterone was low and they called it a blighted ovum. I eventually did pass whatever was in there. This left my husband and I with a new resolve to a third child and crossed the bridge of a third C-section when we got there. I started listening to The VBAC Link again-- something I had to erase from my memory in the past as it was another reminder of my failure to VBAC and not getting to submit my story of healing and success. There was an episode I got to where I really liked what one of the guests was saying. She was a doula named Sarah, and believe it or not, she was based out of Greenville.I knew that if we conceived again, she would be my doula.A year later, after a chemical pregnancy and a loss at 10 weeks, we conceived our second daughter, Leah. I had established care with the midwifery practice for the first few months until they saw my surgical records and transferred me to the OB practice across the street. Additionally, because I was 37 years old at this point, I was sent to maternal-fetal medicine for my 20-week anatomy scan to double-check that everything was looking normal, which it was.At my first appointment with the OB group, the doctor sat down across from me and said, "Well, your anatomy scan looks great. We will also do a growth scan at 32 weeks and 36 weeks because of your previous history of IUGR."And I said, "Sure, that's fine."He went on to say, "So you understand why the midwives transferred your care to us and that you're not allowed to have a vaginal birth, right?" By this point, I'd done some research on my birth rights, special scars, and hospital regulations, and answered calmly, "Actually, you can't tell me I'm not allowed to let something happen on its own. You're not allowed to force me to have a surgery that I do not consent to."He responded, "Well, I'm not sure anyone in this practice or any practice would be comfortable allowing you to VBAC."And I said, "Well, I'm not comfortable just going straight for a C-section at 36 weeks and not at least seeing how things go." I left the appointment pretty upset and even more determined to decide my own fate. As the appointments went by, each OB would say, "You understand that we would like you to schedule a C-section?"And I said, "Yes, but I'm not ready to make that decision yet. I'm still doing my research. What I have found is that the highest estimated rate of rupture after a classical scar is around 15%, but other studies estimate it to be much lower. Additionally, some studies don't distinguish between true rupture and dehiscence. Furthermore, most ruptures are not catastrophic, meaning loss of life, permanent disability, hysterectomy, and so on. Only about 2% of ruptures end this way, and they're often caught through monitoring or other symptoms before they can progress to anything beyond the risks of a typical C-section." Having done this research on my own, I became more confident in my decision to continue on the path of letting my body decide what it was going to do. Sarah, my doula, gave me more confidence. I had told her everything that had happened in my past and she said I had valid feelings and thoughts, and had made logical decisions based on my research.She sent me along her usual workbooks and resources for creating a birth plan, birthing positions, pain management, Spinning Babies, tea dates, etc. I told her I appreciated it, but I'm not going to do those things. I had done all those things and more and that had ended up being one of the hardest parts of my first repeat C-section having realized it made no difference at all. The last thing I wanted to do was spend time trying to be mindful and stretching instead of being mindful with my kids and family who were already there.This ended up being a decision I was very thankful to have made and Sarah was on board and fully understood my reasoning.Weeks went by. At every appointment, the OB would say, "It looks like you've been counseled on this before, and there's no need to go over everything again. Are you ready to schedule your C-section yet?" And I would say, "No, not yet."Looking back, they really didn't go over anything with me. All they said was because of my special scar and lower segment surgery, I was too high risk and not allowed to VBAC.I had done my own research and there are no actual numbers on a high transverse scar which is just above the lower segment, in the upper segment, or on the lower segment scar resection, which is what they classified my surgery as. I feel it's important to get these numbers as C-section rates continue to rise, more versions of special scars will occur and more people could possibly end up with scar revision surgeries before they're done growing their family.At my 37-week appointment, with some encouragement from Sarah, I finally got an OB who would talk to me about my options. She said, "I know we can't make you have surgery that you don't want. You're right. You're in a gray area. We don't really know the numbers for your kind of situation. I think it's reasonable for you to see what happens. If you show up in labor, we will admit you." And I was overcome with relief. Finally, someone was being honest with me. She knew I had done all my research and was overly informed of my rights. I told her that I just didn't want to be harassed or threatened if I came in because that would discourage me from coming in when I would have liked to which is right when labor started. She said I could come in as soon as I thought anything was going on and I would be treated with respect. Circling back to what I learned about EMTALA, the Emergency Medical Treatment and Labor Act, it basically says if a hospital wants to receive reimbursement from Medicare patients, they may not turn away anyone seeking treatment regardless of their citizenship, legal status, or ability to pay.If a pregnant person arrives in active labor, they must be treated until the delivery is complete or a qualified medical personnel identifies that she's experiencing false labor.Furthermore, the person in labor can only be transferred if there's a hospital that can offer a higher level of care. The hospital I was going to was equipped to deliver VBAC and had a NICU. So I knew they were equipped to handle uterine ruptures, which they do about once a month, I've learned.I did agree to schedule a repeat C-section at 40 weeks and four days. At 40 weeks and one day, I got anxious and tried a half dose of what's recommended for kickstarting things with castor oil. It definitely kickstarted some things, and within about six hours, I was having contractions every four minutes.About two hours later, I was getting anxious to go to the hospital because they just didn't feel right. I felt them from my belly button down, and they didn't feel the same way. I remembered with the Pitocin, they weren't really crampy. They're more burning and sharp. I suddenly started feeling an urgency to get to the hospital so they could do the C-section. I texted Sarah to say, "We're going, but don't worry about coming just yet." My answer for why I had come to the L&D department was painful contractions. I already couldn't talk through them. I was hooked up to the monitors, and we could see that Leah was already having Cat 2 borderline Cat 3 decelerations.It's determined by how much the heart rate drops as a percentage of the baseline heart rate when not in a contraction. We tried some position changes, but I had already felt at peace with the idea of going back for a C-section, and my intuition told me it was time. I was extremely nervous to be strapped down, shaking uncontrollably, and not being able to enjoy my baby again.To my surprise, the spinal worked amazingly. I was calm, my husband was next to me, and I got to make all the decisions. I didn't feel pulling or pressure or tugging at all. It was the first time that I got to cry tears of joy after seeing my baby for the first time. I was informed that I'd had a small rupture and I had a very thin lower segment-like tissue about halfway up my uterus, which is not normal. I ruptured. It wasn't a big deal. We caught it. I knew something was wrong, and I had made the decisions that healed me, and I got my baby here safely. After my second was born, I remember sadly walking around our neighborhood, lost in the thought that I'd met all the important people in my life already and something was not sitting right with that. Never would I have ever imagined that a third C-section would heal everything.What I want people to take from my story is that you have to accept that you might not get your VBAC and work that into the process of attempting a VBAC. You can't put all your eggs in one basket for working towards that VBAC and ignoring the basket that needs some attention in case it doesn't happen.Making your own decisions and being confident in your reasoning makes all the difference. Yes, I did have a third C-section, but I know there's nothing I could have possibly done any differently that would have changed the outcome. I encourage people to do their own research, not just on rupture rates but on birth rights and patient rights.You cannot let your provider decide for you what they think is best for most patients because you're an individual and sometimes there isn't a perfect box to put you in.Your fate should not be determined by a doctor wanting to check a certain box and use that to make decisions that make themselves feel comfortable.Of course, ideally, you can find a supportive provider, but if you cannot, that does not mean that you can't call all the shots. You may rupture it, but it's not always, in fact, not usually some dramatic event. My most dramatic birth was before my special scar and surgery. So keep an open mind. Use the knowledge that you gained to instill confidence in yourself. Not getting your VBAC as a disappointment, but if you go in with the right mindset, it can be beautiful and meeting my third daughter was finally the happiest day of my life.Meagan: Oh, my goodness. I love hearing that. That whole end, I just closed my eyes and can hear you speak. And I was like, yes, all of these things are so, true. And I love that you point out that yes, you had a third C-section. Was it what you wanted in the beginning? Would you have wanted a vaginal birth? I'm sure you did. But, this is what I felt and you followed your intuition yet again. I feel like, along the story, but all stories of, intuition, intuition, intuition. And then hearing that you can have a healing experience. I think that is so important to point out that it can be healing. It can be absolutely healing. And I love that it was for you. I love that you were able to have your husband there and look back and be like, "No, I'm amazing." And you should be really proud of all the work you did, all the research you did advocating for yourself. It's not very easy to advocate for yourself. And I love the message that you gave to the other Women of Strength. Like, learn and advocate for yourself. Know the patient's rights.Chrissie: Yeah. Sarah: I think that's what was so unique and so awesome about your story, Chrissie, because even from us starting to work together from the beginning, you just knew what you wanted, and you weren't afraid to say that. And you told me kind of like, "Hey, look, this is fine." Like you said, I gave you my packet and all of my welcome stuff for my normal clients. And you were like, "Look, I've done this before, and I know exactly what I want, and I know how I want to go forward with this birth." You were just so empowered and confident on your own, and I was just so excited to be along with you. And obviously, like, every birth doula wants to be there for the physical birth, but we also have to listen to our clients and respect their choices and decisions. When you were like, "Hey, we're going to the hospital, but don't come yet," it's hard to hear that. I was like, "Okay," but you knew exactly where you stood and what you want it. And, you know, I think that's just really awesome and amazing to have clients like you who are totally aware of, like Meagan was saying, your intuition and how you were feeling. So, you know, I think you have such an empowering story, and our stories can really go a long way, and you're gonna be that voice for people who are feeling so similar.Yeah, absolutely. It's hard to hear sometimes. Cause you're like, "That sounds so amazing. I would want to do that, but it can't." I think that's how a lot of people think. "Oh, that's good. She must have a strong personality." You don't have to have a strong personality to stand up and advocate for yourself in a lot of ways. I think a lot of it stemmed from you being informed along the way. You were informed. You knew your rights, you knew the evidence along things. I mean, here you are talking about them, and that's super important. It comes down with that education, because I do feel like the education is what helps us feel empowered enough to stand up and say what we do and don't want.Chrissie: I really don't have a strong personality at all. I was always very intimidated, trying to pump myself up for the next week of whatever week it was, visiting the OB practice, like, "Oh God, who am I going to see today?" But I just approached it with full knowledge of everything that's out there, as far as I know, because I've been researching it for a long time and just knowing my rights, I guess, I know that they know what they can and can't do to me.You can't force someone to have surgery if they're not ready for it. A C-section is a major surgery so I just knew to stand my ground in a polite and respectful way. Eventually, at the end of the wire, someone stood up for me in the practice, and I was very grateful for her because she gave me the last final push I needed to just wait for things to happen.Meagan: Yeah. Yeah. Well, you should be so proud of yourself and I'm so happy for you.And how was this postpartum? How's it been?Chrissie: It's been like, nothing.I mean, I have a third newborn, but I don't for some reason with me, subsequent C-sections, the debilitating pain is not there from what I experienced with the first one. I don't know if there are just so many nerve endings that are not there anymore or I don't know why. It's been super busy. So I don't even have time to think about what could have been or any feeling or thoughts. Thoughts about how I wish I could be feeling differently. But, yeah, very busy with the third and just so happy to have her with us today.Well, I'm so happy for you. Congratulations. I'm glad that even though you maybe didn't have Sarah during your birth, you had her along the way because I truly do feel like having that sounding board in that doula and that support along pregnancy can really impact and motivate people to learn how to trust that intuition and learn what they need to do and what's right for them.Chrissie: Yes, and she's actually helped me since birth because I didn't ask her to come during it. She has come and hung out with my kids and me so I could do certain errands or tasks. Our kids are actually obsessed with each other now, so it's kind of nice. Yeah.Sarah: Yeah. We bonded even more postpartum and now our daughters are movie night buddies, and they all like to play together.Meagan: That is so fun. I love hearing that. That is something that I tell my clients when they hire me. I'm like, "Hey, listen, you do not have to be my best friend, but I want you to know that I'm your lifelong friend." I feel like that just right there sums it up. Like, really. No, not everybody's going to be having their kids play together but I love that relationships can form and create in this manner.Sarah: Yeah. Yeah.Meagan: Okay, you too. Well, thank you again so much for being with us today.Chrissie: Thanks for picking my story.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

Episode 374 Julia's HBAC with Labor Beginning at Almost 43 Weeks + The Evidence on Postdates

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Play Episode Listen Later Jan 29, 2025 40:47

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

CMV in Pregnancy

MamaDoc BabyDoc

Play Episode Listen Later Jan 24, 2025 17:30

Join us as we discuss cytomegalovirus infection in pregnancy. CMV is a common cause of hearing loss in newborns and can cause other congenital anomalies. It is a common infection that's easily transmitted. Learn about it and what you can do.

957| Two Positive Unmedicated Hospital Births: COVID Birth and Induction Due to IUGR, Redeeming Postpartum - Carrington Lott

covid-19 positive hospitals postpartum redeeming carrington births lott kyo unmedicated iugr

Play Episode Listen Later Jan 16, 2025 65:37

Sponsor: Use code BIRTHHOUR for 20% off your first order (including their already discounted plans and subscriptions) at thisisneeded.com. The Birth Hour Links: Know Your Options Online Childbirth Course (code 100OFF for $100 OFF!) Beyond the First Latch Course (comes free with KYO course) Access archived episodes and a private Facebook group via Patreon!

Episode 369 Abigail's Healing VBAC with Gestational Diabetes After a Traumatic C-Section

Play Episode Listen Later Jan 13, 2025 71:30

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

404 - For Mom

The Baby Manual

Play Episode Listen Later Jan 8, 2025 22:13

Dr. Carole Keim talks about everything moms need in this episode. More specifically, everything that is needed for pregnancy, labor and delivery, the hospital, and post-partum. One of the most common questions asked is what to pack for the hospital. Dr. Keim answers that question, and many more, with insight, advice, and practical suggestions on which brands are the most useful to purchase. Expectant moms and new moms will find this episode invaluable, as will family members looking for purchases that can support moms.Dr. Keim shares why moms need different clothing for each different stage of having a baby, from pregnancy to delivery, and offers suggestions on what to invest in and what not to bother with. She explains how breast sizes will increase, the differences in maternity pants, when compression socks are useful, what to expect during delivery in terms of what to wear, and how to deal with the immediate aftermath of the effects of having a baby. All the questions expectant moms have are addressed here.In this episode:PregnancyBras ShirtsPantsDon't need: pajamas, swimsuit, dressesLaborLabor gown (Lyla delivery gown)Slippers (crocs)Don't need: really anything, you will probably end up naked by the end anywayPostpartumDepends or overnight pads Period undiesSweatpants or dressesDon't need: pre-pregnancy clothing and bras (put them in a storage bin!) Bring in the hospital bag: For mom: outfits with nursing access, nursing bra or tank tops, nipple cream, breast pump, hands-free pumping bra, super/overnight pads or depends, phone and charger, hard candies to suck on in labor, high-protein snacks and water bottle for after delivery, something to help pass the time like a book, slippers/socks, list of regular medications, toiletry bag, and a copy of The Baby Manual For baby: outfits size preemie (if baby is measuring less than 10th %ile or SGA or IUGR), newborn (if baby is 10-90th %ile), or 0-3 months (baby measuring over 90th %ile or LGA), a warm hat, velcro swaddle blanket, car seatAs an Amazon Associate, I earn from qualifying purchases.Dr. Keim has extensively researched the information presented in this episode. She is pulling on the knowledge of hundreds of thousands of new parents, other pediatricians, doctor moms, the Academy of Pediatrics, and breaking pediatrics news sites. Her insight and knowledge on alternative and holistic treatments can be found in her book Holistic Mamas Handbook, and her first book, The Baby Manual, covers year one of a baby's life. Follow Dr. Carole Keim on her TikTok and YouTube channels for additional tips and advice on babies and toddlers. Resources discussed in this episode:The Holistic Mamas Handbook is available on AmazonThe Baby Manual is also available on Amazon--Dr. Carole Keim MD: linktree | tiktok | instagram

Finding Your Home Birth Midwives and Releasing Fear with Marissa Olivera

amazon ny utica midwives homebirth olivera releasing fear ina may gaskin iugr

Play Episode Listen Later Dec 17, 2024 51:02

In today's episode we're talking with Marissa Olivera, a mom of 2 from Utica, NY, with both a hospital birth story and home birth story. Marissa experienced intrauterine growth restriction (IUGR) with her first pregnancy. That, along with some early signs of labor made for a hospital birth that included a lot of intervention and fear. The way she sees it, baby Maxwell just wasn't ready yet. She planned for a home birth again with baby number two, Miles. With positive reinforcement from resources like Ina May Gaskin and Birth Without Fear, Marissa went into her second birth tuned in to her intuition and gut feeling (and we're not just talking about the contractions!). Marissa's candor and detail with her birth stories compels you to listen and engage. She's a great example of how to plan the birth you're intending to create - like finding midwives even when you're far away from a big city with more options. We even get a little cameo from surprise guest Maxwell! Links From The Episode: Marissa's blogpost on her home birth Birth Without Fear Ina May Gaskin Offers From Our Awesome Partners: Needed: https://needed.sjv.io/XY3903 - use code DIAH to get 20% off your order The FamilyAlbum app: Share your family's precious moments with your loved ones + get 11 free photo prints delivered each month CLICK HERE. More From Doing It At Home: Doing It At Home book on Amazon: https://amzn.to/3vJcPmU DIAH Instagram: https://www.instagram.com/doingitathome/ DIAH YouTube: https://bit.ly/3pzuzQC DIAH Merch: https://www.teepublic.com/stores/doingitathome Learn more about your ad choices. Visit megaphone.fm/adchoices

74-Ally Patrie-Precipitous-IUGR-2 Vaginal Births-Christian & Sara

Birth As We Know It

Play Episode Listen Later Dec 11, 2024 66:36 Transcription Available

Send Kiona a Text Message!In this episode, Aly talks about how she emotionally handled caring for and losing her father during her first pregnancy with her son Cristian. She also gives all the details about how her second labor with her daughter Sara did not go as planned because it was extremely fast as well as touching on how her two postpartum experiences differed from each other. birthasweknowitpiodcast.com/74 Disclaimer: This podcast is intended for educational purposes only with no intention of giving or replacing any medical advice. I, Kiona Nessenbaum, am not a licensed medical professional. All advice that is given on the podcast is from the personal experience of the storytellers. All medical or health-related questions should be directed to your licensed provider. For another episode related to precipitous birth, tune into episode 63-Tessa & Jeff Sanders-IVF-2 Vaginal Births-Marcela & Rosie-5AM MiracleResources:Ally Patrie-Jurado YouTube Channel: https://www.youtube.com/@allypatrie-jurado1859 Perinatal Support of Washington: https://perinatalsupport.org/ Postpartum Support International: https://www.postpartum.net Definitions:Trying to Conceive (TTC) Shingles Membrane /Cervical SweepTongue-TieMastitis Intrauterine Growth Restriction (IUGR)Precipitous BirthFerguson / Fetal Ejection Reflex (FER)Support the showThank you so much for tuning in to this episode! If you like this podcast, don't hesitate to share it and leave a review so it can bring the podcast to the attention of others. If you want to share your own birth story or experience on the Birth As We Know It™️ Podcast, head over to https://birthasweknowitpodcast.com/ or fill out this Guest Request Form. Support the podcast and become a part of the BAWKI™️ Community by becoming a Patron on the Birth As We Know It Patreon Page! And don't forget to join in on the fun in the Private Facebook Group!

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Episode 356 Jessica's VBAC + Switching Doctors at 37 Weeks + Bait & Switch + Our Supportive Provider List

Play Episode Listen Later Nov 27, 2024 58:13

“In that moment, I knew that was the last time I would see her. I didn't know what I was going to do, but I knew I could not go back to her.”How do you feel when you meet with your provider? Are you excited for your appointments? How does your body react? Are you tense or calm and relaxed? Jessica's first birth began with an induction that she consented to but didn't really want. Her waters were artificially broken, and her baby just was not in a great position. After over 4 hours of pushing and multiple vacuum attempts, Jessica consented to a Cesarean. Listen to Jessica's VBAC story to find out what she did when she realized at 37 weeks that her provider was NOT actually VBAC-supportive.Sometimes difficult situations actually work out even better than we hoped!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, Jessica, to the show. I am so excited that you are here and excited to hear your stories and actually talk a little bit more about what you do. Do you do it for a living, or is this just your passion project or whatever they call it? Is it your side job?Jessica: It's on the side. It's volunteer. My main job is a stay-at-home mom right now. Meagan: Yes. You're homeschooling, right? Jessica: I am. Meagan: Oh my gosh. One of my best friends homeschools. I just praise you guys. Homeschooling is legit. It is very hard. That seems so hard. Jessica: It's definitely a lifestyle. It's different. It's not for everybody, but it's definitely for us. My daughter is only 5 so we are just getting used to it. Meagan: So Kindergarten?Jessica: She just turned 5 a couple of weeks ago, so we are technically doing 4-K right now. We are just getting into it. I'm still wondering every day, “Am I doing everything I should be?” I know as it goes on, I will get more comfortable and confident with it. Meagan: Yes, you will. That's what I've seen with my friend. She was like, “This is what feels right. This is what we are going to do.” It took a little bit of a learning curve, then each kid added in, but she kills it. Yes, you are just a stay-at-home mom, but a full-time teacher. Holy cow. That's amazing. Then yeah, you are doing La Leche League. Jessica: Yes. I have been a leader now for 2.5 years, just over that. I became certified. I think it was on my due date. I was trying to get everything done before my toddler was born. It's been going really great. I really like it. Meagan: Yes. Tell us more about it because when I was– this was in 2014– pregnant with my second daughter. That's when I heard about La Leche League. Tell us more about it and why someone would want to find their local leader, and then what all the benefits are and how to find them. Jessica: Sure. I first heard about La Leche League when my oldest was maybe about 9 months, so right away in my breastfeeding journey, I had no idea about it. I wish I had because it would have been great to have a community of support. I started feeling really passionate about breastfeeding and knew I wanted to help other moms with it because it can feel really isolating, especially because it was in the middle of the pandemic. I started researching ways that moms can help other moms with breastfeeding because I had no other background in it. I'm not a nurse. I didn't work in the labor world. I just stumbled upon it, and I lived in Madison at the time. I saw that Madison had a chapter. They weren't doing meetings at the time because everything was virtual. But I just reached out, and I said, “I want to be a leader. Tell me what I need to do.” They emailed me back, and I got in touch with another local leader there who had been there for a while. She was surprised. She was like, “You want to be a leader, but you don't even know what we do. You've never been to a meeting.” I just said, “Yes. That is what I want to do.” It was kind of a long process to become a leader because everything was virtual. They didn't know how to go about that. Meagan: Yeah. Jessica: So it took a little bit of a long time to become accredited as a leader. Meagan: Does it now or is it in person? Did it stay virtual? For someone who may want to?Jessica: I think everything is back to in-person. At least where I live now, Madison I know is back to in-person now too. Everything is probably running a little bit more smoothly now in terms of if you are interested in becoming a leader. Basically what leaders do is that we get some training within La Leche League, but we are your cheerleaders. We are here to support you. We are the middle ground between if we need to refer you somewhere for some additional help if it's beyond our scope of practice of basic breastfeeding positioning, latching, or if you have questions of, “My baby is doing this. Is it normal?” That's what we do. We have support groups every month for anybody to really join. Meagan: Awesome. Jessica: It's fun. Meagan: Where can someone find it if they're wanting to learn more? When it comes to breastfeeding, it sounds weird because you don't have your baby yet, so why are we talking about breastfeeding? Why are we thinking about it? But I really believe that connecting before we have our babies with an IBCLC or a La Leche group is so important before you have your baby. If someone is looking, where can they find information or try to search for a chapter in their area? Jessica: You can just look up your state La Leche League. There should be a website that has all of the local chapters. They are all over the world, so you should be able to find somebody near you. Even if there's not one near you, you can contact anybody. Let's say they are 2 hours away. You can still call or text or email. They'll usually, if you want to do something more in person, you can do some type of Zoom meeting. You can definitely find anybody to talk to. You're right. It's really important to get support before you even start breastfeeding if you know that's something you want to do. I always say that breastfeeding is natural, but it doesn't always come naturally. You don't know what to do in the beginning unless you talk to somebody. Meagan: Yes. We will make sure to have the website linked in the show notes too, so if anyone is wanting to go search, definitely go check it out. Okay, now we are going to give a little teaser of what your episode is going to be about today. So, with your C-section, give us a little teaser of what your C-section was for. Jessica: So, my first birth went really smoothly and my pregnancy. I really liked my doctor. I really liked the hospital. It was a group of OBs of all women. I met with each of them. I really liked all of them, to be honest with you. They were all very supportive of whatever you wanted to do.Meagan: Which is awesome. Jessica: Yes, it is. I knew I wanted to have a vaginal birth. That was all I really knew, but I was also really young, I think. I was 23 for most of my pregnancy. I didn't really educate myself beyond my doctor's appointments. I trusted them to pretty much tell me what I needed to know, and that was it. That was my bad. Meagan: Yeah. Hey, listen. That is something I can relate to so much. I was also in my young 20s and just went in. Whatever they said, or whatever my app said, is what happened. I think that's a little tip right there that says, “Let's not do that.” Let's not do that. Then for your VBAC, you had a bait and switch. I'm really excited, when we get to that point, to talk about bait and switch because it is something that happens. It can feel so good and then feel so wrong within minutes. It's really frustrating, but I want to talk more about that in just a minute. We do have a Review of the Week, so I want to hurry and read that, then get into Jessica's story. This reviewer is by diabeticmamawarrior. It says, “A podcast to educate the mind, heal the heart, and strengthen the soul.” It says, “Hi. I am writing this podcast from Seattle. We are currently pregnant with my second baby due in March of 2022.” This was a little bit ago. It says, “My first son was born at 28 weeks via classical Cesarean due to severe IUGR.” For anyone who doesn't know IUGR, that is intrauterine growth restriction.“--and after hearing I would never be able to VBAC, I decided to do as much educated research as I could and to find my options was truly needed. I am also a Type 1 Diabetic and have successfully found an amazing midwife who not only feels comfortable and confident assisting in care through my pregnancy with my diabetes, but also with my special scar, and we are aiming for a successful VBAC. I am also receiving concurrent care with an OB/GYN as well to make sure appropriate monitoring of baby looks good throughout pregnancy. Listening to this podcast was one of the first resources I found, and it was a total GAME CHANGER.” It says, “Thank you, beautiful women, who bravely and shamelessly share your stories so that other women can also feel confident in making empowered decisions for their baby and their body. I am soon to join the legacy of women who have fearlessly VBAC'd happy and healthy babies. Much love, Ellen”. Meagan: Wow. What a beautiful review. Jessica: That was powerful. Meagan: Yes. What a beautiful review. That was a couple of years ago, so Ellen, if you are still listening, please reach out to us and let us know how things went. Okay, girl. It is your turn. It is your turn to share, just like what Ellen was saying, your beautiful stories, and empower other Women of Strength all over the world. Jessica: That review just reminded me that a long time ago, I reviewed the podcast, and you read it on one of the episodes. Meagan: Did we?Jessica: We did. I remember thinking, “This is so cool. I wonder if I could be on someday.” I'm sure you hear this all the time, but it's very surreal being here knowing I listened to this podcast to help me heal. I'm just super excited to share my story. Meagan: I am so glad that you are here, and I'm so glad that we were able to read your review. We love reading reviews. It is so fun when we can hear the review, hear the journey, and then now here it is hearing the stories. Jessica: Yes. Meagan: Yes. Okay, well I'd love to turn the time over to you. Jessica: Like I said, I was introducing my story with my first. I just clicked through a birth course breastfeeding course that the hospital provided for me. I clicked through it to get it done and to check it off my list. Meagan: Birth education– yes, I did. Jessica: That's exactly what I did. I'm prepared, whatever. I'm just going to go into this, and everything will happen like it's supposed to. Mentally, everything was going well in my pregnancy. I wasn't super eager to give birth. I wanted to wait to go into labor on my own. I think what started to bother me or what made me a little bit more antsy was when I was 37 weeks. I agreed to have my cervix checked for dilation, and I was 3 centimeters already. I was so excited, and the doctor said, “I don't even think you're going to make it to your due date,” which made me think, “Wow. I'm going to have this baby in the next 2 weeks. I'm not even going to make it to my due date. This is so exciting.” If any of your doctors ever tell you that, don't let it get into your head because that doesn't mean anything if you are dilated. I was 3 centimeters continuously. Meagan: Yeah. You can walk around at 6 centimeters, not even kidding you. My sister-in-law was at 6 centimeters for weeks, and nothing was happening. She was just at 6 centimeters. It can happen when you are just walking around. Try not to let them get into your head, or to get nervous when you're like, “I could have a baby at any second.” It gets in our heads, and then when we don't have a baby, it's infuriating and defeating. Jessica: That is pretty much what happened. When I got to my 39-week appointment, I was still 3 centimeters. I just expressed how I was frustrated. I was tired of being pregnant. My doctor said, “Well, let's set up your induction.” I had never even thought of being induced at that point. It was never mentioned. It never crossed my mind. It sounded so intriguing at that moment to just get this over with. I don't want to be pregnant anymore. My sisters had been induced, and they had a good experience. It will go the same for me. Everything in my head was telling me, “Don't do this. You know you don't want this,” but I did it anyway because I had it in my mind that I should have had my baby already anyway based on what they told me a couple of weeks ago, so it would go so smoothly. She said, “You are a great candidate. You are already 3 centimeters.” We scheduled it. I think it was that Friday I went. It was Monday, on Labor Day, that we had my induction scheduled for. I didn't have a lot of time to even process that. Meagan: Yeah. Did they say how they wanted to do it, or did they just say, “Come in. Have a baby”?Jessica: They briefly told me that they would start with Pitocin and see how my body responded to that. They would probably break my water which is exactly how it happened anyway. Meagan: Yeah.Jessica: Yeah.They started me with Pitocin at 3:00 PM. They kept increasing it, then by 6:00 PM, my body was just not responding to it. I didn't feel anything. The doctor who was on call wasn't my normal doctor, but I saw her a couple of times. I was comfortable with her. She came in and said, “Well, we could break your water. Is that what you want to do?” I said, “Sure. If that's what you think we need to do, let's do it.” Meagan: Yeah, I'm here to have a baby. What's going to get me there?Jessica: Yeah. She was head down, so I thought, “What could go wrong? She's already head down.” I didn't know at the time that just because she was head down doesn't mean she's in a great position. She wasn't. She was– what do they call it?Meagan: Posterior? Jessica: ROT. Meagan: Right occiput transverse. Okay, so looking to the side. Sometimes, when we say transverse, a lot of people think the body is transverse which is a transverse lie, but ROT, LOT, left or right occiput transverse, means the baby's head is looking to the side, and sometimes, that can delay labor or cause irregular patterns because our baby is just not quite rotated around or tucked. They are looking to the side. Jessica: Right. That was pretty much what the obstacle was because when they broke my water, she engaged that way, so her head never was able to turn properly which we didn't know yet. I feel like the doctors could have known that because aren't they supposed to be able to feel and know maybe a little bit of where they are? Meagan: Yeah. So providers can. They can internally, and it depends on how far dilated you are. If you were still 3 centimeters, probably not as well, but at 3 centimeters AROM, where we are artificially breaking it, that's not ideal. Usually, the baby is at a higher station at that point too. I call it opening the floodgates. We get what we get however that baby decides to come down, especially if baby is higher up and not well-applied to the cervix.If baby is looking transverse and hasn't been able to rotate right during labor, then they come down like that, and then we have a further obstacle to navigate because we've got to move baby's head. I will say that sometimes a baby might be looking transverse and mainly through pushing, a provider can sometimes rotate a baby's head internally vaginally, but you have to be fully dilated and things like that. Can they feel through the bag of waters? If they can feel a good head, yes. Sometimes they can. Sometimes they can't, but again, there are all of these things that as a doula anyway, I help my clients run through a checklist if they are going to choose to break their water. Sometimes within your situation, I'd be like, “Maybe let's wait.” But their view was, “Let's get labor going. We are starting Pitocin. The body's not responding,” which we know is a number-one sign that the body isn't ready. Sometimes we still can break water with better head application and with the water gone, it can speed labor up. That's where their mind was. Their mind probably wasn't, what position is this baby in? Where is this baby at? What station is this baby at? It's like, let's get this baby's head applied to the cervix. Jessica: Yes. I mean, it did work. As soon as my water broke, I immediately when into active labor. The Pitocin contractions were very awful. I felt them immediately because not only did my body start going into labor, but then the Pitocin also was making it worse. Meagan: Yes. Yes. Jessica: So I begged for an epidural right away even though I knew that's not what I wanted. I didn't do a lot of preparing for labor, but I know I didn't want an epidural right away. I remember the very sweet nurse I had saying, “Do you want me to run the bath for you?” I said, “Are you crazy? That is not what I need right now.” Meagan: She's like, “I'm trying to help you with your birth preferences.” J: I know. She was so nice. I apologized to her after later on when I saw her. That was the head space I was in. I just needed that pain to be gone. They ended up turning the Pitocin off eventually because my body just did what it needed to do on its own. Meagan: Good. Jessica: I didn't get much rest after that. I couldn't really sleep. I was too excited. But it wasn't very long until I was ready to push after that. I think at about 7:00 PM, I got the epidural, and at midnight, I was ready to push. I kept trying and trying. 4.5 hours went by until she was just not coming over. I don't know if it was my pelvic bone or something. That's when we knew she was not going to turn. They suggested that we try the vacuum. I didn't know what that was. That was very traumatic because the lights were bright. Everyone was in there. I remember my doctor saying, “Okay, we have one more attempt with this vacuum, and that's our last attempt.” Of course, it didn't work because in my mind, I knew it was my last chance. It was not going to work, and it didn't. I was really upset after that. I remember crying saying, “I don't want a C-section.” I was really afraid of it. But, that is just what we had to do to get her out at that point after attempting the vacuum. I remember being wheeled down to the OR and just being so tired and not knowing how I was going to take care of a newborn after having surgery and being so tired. I had been up for 24 hours. The C-section went fine. I was out of it though. I was passing out here and there just being so tired. They had to tell me to actually look up. “Your baby's here. Look up.” I remember opening up my eyes going, “What?” I was forgetting what I was doing. Meagan: Out of it. Jessica: Yeah. I was very much out of it. But after that in the hospital, I wasn't too upset about having a C-section. I was just so excited about having my baby. It really didn't hit me until we were on the way home from the hospital. I started crying and was so upset. I felt like my experience was stolen from me because I felt like I was so mad at my doctor for bringing up an induction at that point knowing if she didn't, I would have never asked for one anyway. I had a lot of regrets about everything. In those couple of weeks after having her, your hormones are very up and down anyway. One moment, I would be fine. One moment, I would be really, really upset crying about it. I wanted to redo her birth so badly that it almost made me want another baby. “If we just have another kid, we can try again,” even though I had this 3-week-old next to me. Meagan: Yeah. Jessica: I was not thinking very clearly. Meagan: You were craving a different experience. That's just part of your processing. Jessica: Yes. And looking back, I wonder if I was struggling with some PTSD because I would lie there at night not being able to sleep, and I would suddenly smell when they were cauterizing the wound. I would suddenly smell that again and think I was back in the OR. It wasn't very fun. Meagan: Yeah. It's weird how sometimes the experience can hit you in all different stages and in different ways, but right after, you're like, “No. No, no, no. I need something different. Let's have another baby right now. Let's do this.” So once you did become ready to have another baby, what did that look like? What did that prep look like? Did you switch doctors? You liked your whole practice. How did that look for you?Jessica: Well, we moved. I knew I had to find another doctor. I would have anyway in Madison. I would have gone with a group of midwives that somebody I knew had a good experience with, and after listening to the podcast, I wanted a midwife. But unfortunately, where we moved, we live in Green Bay now. I was so limited on which provider I could go with. In one hospital, one group, that was all I could do locally. I couldn't go with the hospital that everybody was recommending or the midwives that everybody was recommending for a VBAC. Meagan: Why couldn't you go there?Jessica: My insurance was very limited. It still is. We can only go to this one hospital and one facility for doctors. Meagan: Okay, so it was insurance restrictions. Yeah, not necessarily a lack of support in your area. It just was insurance which is another conversation for a later date. Stop restricting everybody. Jessica: I was very surprised because when we were in Madison, I could go wherever I wanted and see whoever I wanted. I ended up just choosing somebody. I liked her. She was initially very supportive of having a VBAC. I had mentioned it in my very first appointment that this was what I want. She said, “Oh, I'm so excited for you. This is going to be great.” I even mentioned that I was still breastfeeding my daughter when I was pregnant. They just seemed very supportive of all things natural and all things birth. Meagan: Everything. Jessica: Yeah. There were no issues whatsoever. I had already hired my doula when I was 6 weeks pregnant. I had already talked to them before I had even saw my doctor. I told them about how I was really limited and this was where I had to go, but I felt very supported knowing I had a doula and knowing I had somebody on my side It didn't really bother me at the time that I just had to pick whatever doctor I could. This was also a practice where the doctor I had wasn't going to be probably who I would give birth with. That also didn't bother me because I thought, “I have a doula. I have support. I know after listening to this podcast what I need to do to defend myself if that time were to come.” Meagan: Advocate for yourself, yeah. You felt more armed. Jessica: I did. I really did. I ended up seeing a chiropractor as well which was very helpful throughout my pregnancy. I loved going to the chiropractor. Not only did it help get her in a good position, but I also just didn't really feel body aches as much as I did, so there were a couple of benefits to going there. I definitely recommend a chiropractor. Meagan: I agree. I didn't go until my VBAC baby. I started going at 18 weeks, and I'm like, “Why didn't I do this with the other babies?” It was just amazing. Jessica: Yeah. It really is. But my doctor's appointments this time were very different. They were very rushed. They felt robotic. “How are you feeling? Great. Let's get the heartbeat. Any questions? No.” I really kept my questions for my doulas anyway because I really trusted them. I don't know. I didn't feel like I had many questions anyway because I knew what I wanted. I knew I wanted to show up to the hospital basically ready to push. One of the red flags, I will say, that looking back now with this provider that I had initially is that she never asked for any type of birth plan. She knew I wanted a VBAC, and I thought it was a good thing that she wasn't really asking details. I felt like, “Oh, she's letting me do my thing.” But looking back, I think it was just because she knew that's not what was going to happen. She knew. Meagan: Yeah. You know, it's interesting. We've had providers who have told people here in Utah. The client will say, “Hey, I really want to talk about my birth preferences.” The provider will say, “You're really early. We don't need to talk about that right now. We could talk about that later.” Or, “Hey, I was thinking I want to talk about this. Can we talk about that?” “No, not today. It's fine. Whatever you want.” Then it comes, and we'll hear more about your experience. I'm sure it will relate to a lot of people's bait-and-switch stories. Jessica: Yeah. They sound so supportive in the moment, and then it's not looking back. It continued on through my whole pregnancy. Even when I was 35 weeks, she suggested a cervical dilation check. I denied it at that point. I thought it was too early. 35 weeks is very early. Meagan: 35 weeks? Yeah. Jessica: I'm really glad that I stood up for myself and said no, because I was having one of those moments of, do I just do it anyway? I said no, and she was very fine with it. She said, “That's fine. You don't have to if you don't want to. We don't have to.” I also thought that was a good sign. Meagan: You're like, “Yes. If we don't have to, why are we suggesting it in the first place?” But I can also see where you're like, “Well, sweet. She's respecting my wishes. I didn't want to. She's saying, ‘Okay'.” Jessica: Exactly. But I made the mistake of agreeing to it at my next appointment because my curiosity got the best of me. I knew that it wasn't important for me to be dilated, but I was trying to compare it to my last pregnancy. At 37 weeks, I was 3 centimeters with my first. I wonder if I'm going to have a different experience this time. Let's see where we're at. I was at 0. I just thought, “That's totally normal. I have a lot of time left.” Her demeanor changed very much. It was like at my appointments before, she was a different person now. Meagan: Oh. Jessica: She said, “Well, if we're not showing any signs of labor by 40 weeks, we need to schedule your C-section.” Meagan: Oh no. Jessica: She must have noticed I was surprised. I said, “But I don't want a C-section. Did you not remember that I'm going to have a VBAC?” She said, “Well, you don't want to risk your baby's life.” Meagan: Bleh. Barf. No. Jessica: Yes. Yes. I knew that was just a scare tactic. I luckily was not phased by it. I was educated. I mentioned something along the lines of, “Well, wouldn't we try to induce me before we jump ahead to the C-section? There's no medical need.” My pregnancies were so boring. There was nothing that would indicate anything, not even an induction, but I thought, “Why not even just mention that before a C-section?” She said something like, “There are too many risks involved.” That was the end of the conversation on her end. She pretty much wrapped it up and said, “It's pretty slippery out there. Be careful,” and walked out. Yeah. The conversation was over. In that moment, I knew that was the last time I would see her. I didn't know what I was going to do, but I knew I could not go back to her. I went back to the parking lot. I was crying. I texted my doulas right away what happened. I said, “I need to figure something out very quickly. I'm 37 weeks. I know I can't go back to her. Can you please help me figure something out?” They were so, so extremely helpful with helping me figure out my options. I thought that at this point– in the beginning of my pregnancy, I knew, “I'll just stand up for myself. I know what I want,” but when you are very big and pregnant, and you are very vulnerable, you don't want to do all of that arguing. You just want somebody who is going to support you. I just knew I couldn't go back to her. I didn't have the energy to try to defend myself or advocate for myself. I just needed somebody who was already going to support my decisions. They encouraged me to look a little bit further out of Green Bay which I didn't initially want to do. I wanted the hospital to be close. I had a 2-year-old. I didn't want to be far away from her. But knowing I had limited options, I looked a little bit farther out. I texted them, “Hey, there is this doctor who I can go to in Neenah. It's pretty far. I said her name. I don't know if I'm supposed to say doctors' names. Meagan: You can. Yeah. You can. People will actually love it so they can go find support themselves. Jessica: Yeah. I said, “There is this doctor, Dr. Swift, who is down in Neenah. That's the only one who is really popping up on my insurance who I can go to.” They immediately texted back, “You need to go see her. She's amazing.” My doula had actually had her VBAC with Dr. Swift. They were like, “You need to go see her. This your other option.” Meagan: Oh, Sara Swift is on our list of providers. Jessica: She is. She's amazing. Meagan: She is. Okay, so you're like, “I've got this doctor's name.” Jessica: I called them to make myself an appointment, and I wasn't able to get in until the following Friday. It would have been after I was 38 weeks. I told doula– Meagan: That's when you had your last baby, right?Jessica: No, actually my last baby was at 39 weeks, but I didn't know what was going to happen. I told them, and my doula was actually personal friends with her. She said, “No, that's not going to work. I'm going to text her, and I'm going to get you in sooner.” I think it was a Wednesday at that time. I was able to go see her Friday. Yeah. Meagan: A week earlier than you would have been able to. Jessica: Yeah. I helped me to feel more relieved knowing that if I had gone into labor before that next appointment, I would have known where to go. I would have had a doctor established. I was very, very relieved to see her. It was such a different experience than my other doctors. I had to bring my two-year-old with me, and at that point, she was getting antsy, so Dr. Swift actually sat on the ground with my daughter and was coloring with her while we were talking to keep her busy. I just remember thinking, “There's no other doctor out there who would do this for a very pregnant patient.” It felt very much like a conversation between friends. It didn't feel like a robotic type of conversation I had with my previous doctor. She very much upfront said to me, “Our hospital has VBAC policies. Here they are. You can deny anything you want. They're not going to allow you to eat food, but if you say you want to eat food, you can eat. They're going to want continuous fetal monitoring, but if that's not what you want, tell them what you want.” It felt like she just was supportive of what I wanted to do. She said something along the lines of, “I'm going to trust you and your body to make the decisions that you need to, but also know that if I need to step in, trust that I'm going to do what I need to.” It felt so mutual there. I was so excited to go back and see her every week. I'm actually kind of mad that I waited that long to see her. Meagan: Yeah. Mhmm. I'm sure you felt like you were breathing in a whole different way. Jessica: I was. I felt very excited. The drive was longer, but it didn't even matter at that point. I went from a 15-minute drive to 45 and it didn't feel like there was any difference. It was all worth it. Meagan: I agree. It's sometimes daunting with that drive or the time, but you guys, it's so worth it. If you can make it work, make it work. I'm so glad. Okay, yeah. So you found this provider. Everything was feeling good. Jessica: It was feeling great. I actually ended up going past my due date. Meagan: Okay. Jessica: I was feeling a little bit– not defeated– I wanted to make it to my due date because I wanted to make it there with my first. I was excited when I got to my due date, and then I thought, “Okay, when is this actually going to happen? I've got a two-year-old.” My in-laws were coming up to watch her when we were going to the hospital. They live 2.5 hours away. I was starting to worry about, how is this all going to work out? But it really did. I felt my very first contraction two days after my due date. It was a Friday night at 6:30. We were getting my daughter ready for bed, and I felt that first contraction. I knew it was different than Braxton Hicks. I just knew, but I don't even know to say if that's when my labor started because that continued all throughout the weekend every 15 minutes. It was not a fun weekend. I kept thinking things were going to pick up, and then they would die down. Meagan: Prodromal labor maybe. Jessica: Yeah, I think so. At one point, I had my doula come over in the middle of the night. I didn't know when to go to the hospital. I didn't know if it was time or whatever. She came to my house in the middle of the night just to help me with the Miles Circuit and just the different position changes I could do. I believe that was on that Friday night that I started labor. I was also able to get into the chiropractor that weekend. They were closed, but again, my doula was very close friends with the chiropractor and texted, “Hey, Jessica could really use an adjustment. She's not in labor, but it's not progressing. Can you help her?” I went to go see them on Saturday and on Sunday just to get things moving. She was in a really great position. Everybody could feel that she was just in the perfect position. It was just that these contractions could not get closer together no matter what I tried. Something told me, “Hey, you need your water broken for this to progress,” because I couldn't do it anymore mentally or physically. I was exhausted. I didn't want to initially because I knew that's what prevented me from having the birth that I wanted in the first place with my first experience, but something also told me, “Hey, you need to go do this.” My intuition was super strong in those moments where I knew. My intuition was strong enough to switch doctors that late in my pregnancy. There wasn't another option. This time also, my intuition told me, “You have to go in, and they have to break your water.” I knew Dr. Swift would be supportive of that because she was supporting any type of birth plan I really wanted. She told me at any point, I could be induced, but that she wouldn't bring it up again. It was my decision. On Sunday night after we got my daughter to bed, we drove to the hospital. We let them know we were coming. Our doula met us there, and we just told them our plans. Dr. Swift, I remember, said, “Well, if I break your water now, you're so exhausted from the whole weekend. Do you want to try sleeping for a little bit and we will do it in the morning?” I said, “I can't sleep. I'm having these contractions every 15 minutes.” It was really funny. She said, “Well if you want to sleep, I'll give you something to help you sleep.” If anybody has ever met her or knows her, she's got a great personality. It was just funny in that moment. It's what I needed in that moment to have a good laugh. I was like, “Yes. Give me anything I need right now to rest just a little bit before the morning.” In the morning, she came back in around 8:00 or 8:30. I don't remember what time it was. She said, “Yep. Let's do this.” They double-checked me again to make sure she was in a great position. At that point, I was actually 4 centimeters. I forgot to bring that up. Meagan: Yay, okay. Great. Jessica: Yes, so those contractions I was experiencing over the weekend were productive. I felt better about that. I didn't want to break my water with being one of two centimeters. I felt good. Again, my intuition was telling me, “You need to do this.” Yeah. They did, and once again, it immediately put me into active labor. My doula was helping me with counterpressure, then they ended up running a bath for me which was very helpful. I was skeptical. I did not think that was going to work. When they were filling it, I remember thinking, “This is a waste of my time. This is not going to work,” but it was very helpful. At one point in the bath, I just remember feeling, “Okay, now I have to get out and I have to start moving around.” As soon as I got up, I just remember feeling things intensify. I got that feeling in my head like, “I can't do this anymore.” I knew that at that point, it was getting close because of that feeling of, “I can't do this anymore.” Meagan: Yeah, mhmm. Jessica: I had just a moment of weakness and I said, “I want an epidural right now.” Even though I knew in my mind that it was too late, I couldn't help but ask them for that epidural. Thankfully, my doula knew that's not what I wanted, so she helped prolong that process. She said, “Well, why don't we start with a bag of fluids and we'll see how it goes from there? We can ask them, but they might be busy.” That's exactly what I needed. I knew that's not what I wanted. Meagan: She knew that, and she knew how to advocate for you, and she knew you well enough what you needed to prolong it. Jessica: Yes. I'm very thankful for that because she could have said, “All right, let's get it right now.” But she knew and I had made it very clear that was not what I wanted to do. We started with a bag of fluids, and at that point, I could feel my body start to push itself. This was about 3 hours after my water was broken. It was a very quick process from then until that moment. While I was pushing, the anesthesiologist did come in the room. I remember the anesthesiologist did come in the room, and I remember he said something like, “Who's ready for the epidural?” My doctor said, “No, we're having a baby. Get out.” He came in in the middle of me pushing, and I feel like I scared every other mom there with how loud I was, but I couldn't help it. Meagan: Sometimes you just have to roar your baby out. Listen, it's okay.Jessica: I really did. I really did roar her out in 20 minutes. Meagan: Wow. Jessica: After that, I don't remember feeling any other pain. The pressure was gone, and I remember just feeling like, oh my gosh. I did it. She's here, and I get my skin-to-skin with her which I didn't get the first time. I get to have this experience. I can't believe I actually did it. Meagan: And you did. Jessica: I did. Meagan: You did it. Jessica: There is so much more than you just having that VBAC. Throughout the journey, you grew. You grew as an individual. You grew as a mom listening to your intuition. You really, really grew, and then to have that baby again placed on your chest, oh, how amazing and how redemptive. Meagan: It was so redemptive and healing. In that moment, I didn't feel any type of way about my C-section anymore. I wasn't upset about it. I really had a feeling that it happened for a reason because if it didn't, I don't think I would have tried to educate myself about birth. I would have probably done it a second time, an induction, if it went well the first time. I also don't think I would have fought so hard the first time to breastfeed because I felt like I had to make it work. I didn't get the birth I wanted, so I had to make this work at least. I personally think that my C-section happened for a reason the first time. In that moment, I remember feeling a wave of, “I'm not upset anymore. I got this experience.”Meagan: Yeah. You know, it's interesting. I kind of had that same view to a point. I do feel a little grumpy with how my births went because knowing what I know now, I am realizing that they didn't need to happen that way. I likely never needed a Cesarean ever. I just probably didn't. But, it's the same thing like you. I wouldn't have focused so hard on this. I wouldn't have done this. I would not be the person I am today. I would not be the birth doula that I am today. I would not be the podcaster today. I don't think I would have ever started a podcast on any other topic because I'm so deeply passionate about this topic and birth and helping have better experiences, so I really hold onto those experiences and cherish them. It sounds weird because it wasn't the birth we wanted, but it's what brought us here today. Jessica: Yeah, exactly. I also wouldn't be where I am today if I didn't have my C-section. I don't think I would have been interested in birth. I love it now. I think in the future, I would love to be a doula. I just recently took an exam to become a certified lactation consultant. I haven't gotten my results back yet, but I don't think I would have gone down that path yet either if I wouldn't have had my C-section and fought so hard for breastfeeding to work. I felt like I found my passion within that circumstance that was very unfortunate, and it shouldn't have happened, but it did. Meagan: But it did, and you've grown from it. We want to avoid unnecessary Cesareans. If this podcast is for VBAC moms, it's just as much for first-time moms in my opinion because we obviously have an issue with the Cesarean rate. We do. It's a serious issue. Jessica: Yeah, it is. Meagan: But with that said, I encourage you if you are listening, and maybe you haven't been able to process your past experience yet, or you are fresh out of it, and it's very thick, and it's very heavy and dark because we know that can sometimes be that way, I hope and I encourage you to keep listening, to keep learning, and to keep growing, because that darkness will become light again. Those feelings– I don't know about go away, but they will lift. I don't know how to explain it. Jessica: You might feel different about it. You might feel different about it than you did originally. Meagan: Your perspective will change. It's going to take time. It's going to take processing. It's going to take healing. It's going to be finding the education, finding the right team, finding the right support system, but it is possible. It is really, really, really possible, and take Jessica and my word right now, because we really have been there. We really understand so many of the feelings. I know that we all process feelings differently, and we're all in different places, especially depending on the types of births that we had. I know that there are way more traumatic experiences that happen out there, but this community is here for you.We love you. We are here to support you. Keep listening to the stories. Find the groups. Find the healing, and know that it is possible to step out of this space and to grow. It's weird to think, but one day, you're going to look back and say, “I might be grateful. I might be grateful that happened.” Yeah. Like I said, I'm not happy. I'm not happy it happened, but I'm going to cherish that. I'm going to try and flip it. I've made it a positive experience that it's brought me to where I am today. It's brought me to be in a place where I can share my story just like Jessica and all of the other Women of Strength before her to help women feel inspired and to avoid those future devastations and unfortunate situations. Jessica: Yeah. Don't let anybody try to tell you not to feel a certain way about it because I've had plenty of people tell me, “But you're healthy. But you have a healthy baby, you can try again next time.” I just said, “You don't understand. You're not in my position. I know there are people who do understand me.” Most of you who are listening will understand that yes, you have a healthy baby and you're fine, but it was still not what you wanted. That experience is so personal. You want what you want. Meagan: You want what you want, and you're not selfish for wanting it. You're really not. I think that's really important because sometimes I think we are made to feel that we are selfish for wanting a different experience especially out there in the world, a lot of people say, “Why would you want that? Why would you risk that? You are selfish. Just be grateful for what you have. Just be grateful that you do have your baby and that you and your baby are okay.” No. No. The answer is no. Last but not least, I really wanted to share a little bit more about the bait and switch and how to recognize that because you guys, it can be hard to recognize. I don't ever believe that these providers are sneakily trying to fool us, but maybe they are. I don't know. I'll tell you, they do. They do fool us. I don't know if that's because our judgment is clouded or what, but I think it's important to feel that inside. What does your heart do when your provider walks in? What do your hands do? Do they clam up? Do they clench? Do they freeze? What does your body do? Are your shoulders rising up? Are they relaxed? Does your face have a smile on it? Really tune into who your provider is making you be. Are they making you a tense ball, or are they making you relaxed and excited?I mean, really Jessica, the way you are talking about Dr. Swift, it sounds like she is amazing. She's like, “Here. Here are the policies. I want you to know these. These are things that you are going to be up against. You might have to fight for intermittent monitoring instead of continuous. You might have to fight for this and this, but hey. I'm here. I'm on your side. We have these policies, but I'm here. Use your voice.” That was just so amazing. Jessica: It was amazing. I'm sad that I'm not going to have another child because I don't get to go see her for appointments then. I really wish I would have met her sooner. That's the type of doctor your need is when you actually want to go see them. That's a big difference. You're not thinking ahead of your appointment, “Well, I wonder if there is anybody else.” Meagan: Okay, I love that you said that. Check in with yourself and see if you are excited to see your provider. That's how I was. I would look forward. I would look at the calendar and be like, “Oh my gosh. I get to see my midwife this week. This is so exciting,” because I would remember the way that she made me feel when I would get there. She would embrace me with a hug. “How are you doing, genuinely? How are you doing? How are you feeling?” We would chat, and it was a conversation like you said, like two friends. It really should be that connection. I know sometimes, providers don't have the actual time, but tune into how you are feeling about seeing your provider. Are you dreading it? Are you worried about what you're going to say? Are you worried that you're going to have to be educated and come at them and say, “Well, I don't want this, and I don't want that”? What are they making you feel? If they are making you feel those genuine warm fuzzies, lean into that. Jessica: You have a good doctor then. Meagan: If you are feeling tense and anxious, I don't know. It's never too late to switch. You were switching later on. You had a further drive. There were obstacles that you had to hurdle through, but it is worth it. It is so worth it. We have a provider list, everybody. If you are looking for a provider, go to our Instagram. Look at our bio. Click on it. The very first block is supportive providers. If you have a supportive provider that you want to share, I was literally going to put Dr. Swift on this because of your testimonial of her, but she's already on it. Jessica: She was already on it too when I checked. Meagan: Yeah. If you have a supportive provider and you checked this list and they are not on it, guess what? We have made it so you can add it. Definitely add your provider because Women of Strength all over the world, literally all over the world, are looking for this type of support. Jessica: Absolutely. In case you're wondering if my other doctor ever reached out to me, I never heard a single word from her ever again. I canceled all my remaining appointments. Nobody reached out to say, “Hey, we noticed that you're not coming back. What's going on?” Anything could have been wrong when you're that pregnant and you just disappear. It was upsetting that nobody said, “What's going on, Jessica?” I was ready to let them have it because I was wanting them to reach out to say, “Why are you not coming back?” But they never called ever. Meagan: A lot of us stay because we are so worried about how our provider will feel or we have been with our provider this long. They deserve for me to stay. No. Do what's best for you. I love that you pointed that out so much. I just want to thank you again so much for sharing your journey with us and all of these amazing nuggets. I know that they are going to be loved.Jessica: Thank you so much for having me. This just feels amazing to be able to share my story when I've heard so many on here before that were so helpful.Meagan: Yeah, and here you are. I love how full circle this always is, so thank you, again. Jessica: Yeah. Thank you 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

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Episode 350 Wyn's VBAC with a Unicornuate Uterus + Follow Your Intuition

Play Episode Listen Later Nov 6, 2024 30:10

After having an HSG (hysterosalpingogram) due to infertility, Wyn was diagnosed with having a left-sided unicornuate uterus. A unicornuate uterus is a rare condition in which the uterus is smaller than normal and only has one fallopian tube. Common complications from a unicornuate uterus include infertility, IUGR (intrauterine growth restriction), and preterm labor. Wyn had two unsuccessful IVF treatments followed by two miraculous natural pregnancies! Her first pregnancy ended in an unexpected Cesarean due to a fever and tachycardia in her baby. Her placenta was difficult to remove during the surgery and she was told she had placenta accreta. The OB who performed her surgery also said she had “very interesting reproductive anatomy”.Wyn deeply longed for the opportunity to try for a VBAC and experience physiological birth. Her original midwife supported her decision to VBAC and Wyn made sure to prepare physically and emotionally. At 41 weeks and 1 day, she went into spontaneous labor, declined cervical checks and other interventions she wasn't comfortable with, consented to the things she felt good about, and pushed her baby out soon after arriving at the hospital. Wyn also shares her experience with taking Needed products during her pregnancy and postpartum period this time around. Her strongest advice for other women preparing for VBAC is to find a supportive team and really listen to what your intuition is telling you to do. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to the show. We have our friend, Wyn, from Alaska with us today. She's going to be sharing her VBAC story and Wyn has a pretty unique– and maybe Wyn, you can tell me more. Maybe it's not as unique as it feels but a pretty unique situation where you had a diagnosis of a unicornuate uterus. Tell us a little bit more about that. I feel like we hear some uterine abnormalities. I'm quoting it where it's bicornuate and all of these different things and people say, “Oh, you can't have a vaginal delivery with this type of uterus or this shape of uterus,” but tell us more about what it means for you and what it meant for you back then. Wyn: Yeah, so they found it through an HSG test where they shoot dye up through your uterus and through your fallopian tubes. Basically, just one-half of my uterus formed. I guess when the uterus is forming, it's two tubes that connect and open up so just the one half formed so I have a left-sided with a left fallopian tube. I have both ovaries so you can still conceive but there are less chances because you have just one side. Then once you get pregnant, there are higher chances of miscarriages because the blood flow is less. Intrauterine growth restriction and preterm labor are common and then a lot of time, the breech position is common as well. Meagan: With this one, you did experience IVF as well, right? Wyn: Yep. Meagan: Yeah, we'll have to hear more about that too because there are a lot of people who are getting pregnant via IVF which is amazing but there are some things that come with IVF as well. So we want to talk a little bit more about that before we get too deep into things. I do want to do a Review of the Week, then we'll let Wyn start sharing away. This review is from I think it's Amir, I think. It says, “This podcast was my constant source of reassurance and inspiring stories throughout my last two pregnancies. I achieved my VBAC in 2021 and was so empowered with so much knowledge and mental strength going into this birth because of The VBAC Link. I had my second section in 2022 which was not what I wished for but I do plan on having more children and know that VBA2C (vaginal birth after two Cesareans) is a possibility for me because of this podcast. I continue to listen to your inspiring stories each time I hop in the car and I'm so grateful for all that you share. I hope to share my own redeeming story with you in time too.” Well, Amir, thank you so much for your review. I also wanted to mention that for Amir, not only does VBAC after two Cesareans apply, but there are even risks that are lower because she has had a vaginal birth. So if you have had a vaginal birth and then you want to go on to VBAC, your chances are even higher for a VBAC and lower for things like uterine rupture. I wanted to throw that tip out there. But if you have not left us a review yet, please do so. We love them so much. You can leave it on Google or wherever you listen to your podcasts or you can even email them. Okay, Wyn. Let's get going into this story. Wyn: Okay, thank you. Thank you for having me. I feel like it's come full circle. I listened to The VBAC Link Podcast a lot throughout my pregnancy and even before that and I still do today. So I hope that maybe a little detail from my story resonates with somebody and helps them as well. Meagan: 100%. Wyn: Yeah. A little back story, before I got pregnant, we did try for a while and my cycles were regular. I was healthy. I didn't see anything wrong but we went in and got the test done with bloodwork and they suggested the HSG test. I saw my original OB then I had a second opinion with another one. Both said it was still possible but that IVF was probably going to be more likely. And of course, this is all happening in February and March of 2020. Meagan: Right as the world is in chaos. Wyn: Yeah, so I started researching IVF options. We live in Alaska so there isn't a reproductive endocrinologist here and I found a clinic. Our closest option was Seattle or Portland. I found a clinic in Portland that was willing to work with us. In August 2020, I went down for my first transfer or egg retrieval and transfer. That was a chemical pregnancy or early miscarriage. But also, that was the closest I had ever been to being pregnant. It was a little bit hopeful at the same time. We regrouped and went down in October and had another transfer that didn't take at all. We decided to take the rest of the year off and revisit it after the beginning of the year. That brings me to my first pregnancy which was a little miracle and I got pregnant the cycle after my failed transfer naturally without IVF. Meagan: Yay!Wyn: That was very exciting. I was a little bit in shock like, How can this happen? Because it had been a couple of years of trying. I went back to the second OB who I had a second opinion from. We didn't really vibe very well. I went in early at 6 weeks because I was nervous and she was like, “Why are you here so early?” So I didn't end up rebooking with her but I rebooked with a midwife who some of my friends had seen during their pregnancies and explained my situation and she got me in that week. We did an ultrasound and saw a little heartbeat. It was going well. She had me come in the next week too to just make sure things were progressing and everything was good. Meagan: Yay. So it was IVF treatment, IVF treatment, and spontaneous?Wyn: Yep. Meagan: Yay, that's awesome. Wyn: It was pretty exciting and just gave me some renewed faith in my body too that maybe it could do it. Meagan: Yeah. Wyn: So pregnancy went smoothly. I felt great. I loved being pregnant and I was measuring small consistently from about 30 weeks on about 2-4 weeks behind. I wasn't really worried about it because I figured I had a small uterus but they suggested a growth scan. I went ahead and did that and baby was all fine. She was small and we didn't know it was a she. We didn't find out but then my husband and I did some birth prep. We watched The Business of Being Born and that solidified my desire for a non-medicated birth. I was okay being in the hospital because there were unknowns with the uterus and I just wanted to experience it all. I wanted to experience everything without medication. I have a low tolerance to medication so I didn't want anything to derail the birth. I made it to 40 weeks. I made it to my due date because it's common that you go into preterm labor with a unicornuate uterus but I made it to my due date so that was exciting. I was feeling anxious to meet my baby but I was feeling good. I was just listening to whatever the midwife told me or suggested because I was a little bit nervous so she offered a membrane sweep and I thought, Okay, I'll go ahead and do that. It's not medicated. But still, it was an intervention that I learned later. Then we did a non-stress test at 40.5 weeks and she started suggesting induction. I went into my 41-week appointment and I still didn't want to do any medication but she offered the Foley bulb which he offered to put in there at the office and I would just come back the next day if it didn't come out or if it started things then it started labor. Meagan: Then great, yeah. Wyn: Yeah. She went to put it in and my water broke. Meagan: Oh, change of plans. Wyn: Yep. Yeah. It was just a trickle. It wasn't huge. She sent us home and told us to rest and to come back in the next morning. Come in if labor progressed or come in the next morning to start more induction since my water was broken. I went home and relaxed. I woke up about 2:00 in the morning to my water fully breaking everywhere and contractions started pretty instantly. I had adrenaline and I didn't ease into it. They were 5-6 minutes apart, full-on contractions. Within a couple of hours, they were closer like 3-4 minutes so we went ahead and went to the hospital. There was a lot of rushing around and a lot of nurses coming in and out. I was in my own little world. I was stuck on the bed because they wanted to have the fetal monitor on. I was holding on for the non-medicated. I declined the IV because I thought that would be that much easier. Meagan: Easier access, mhmm. Wyn: But I had spiked a temperature from my water breaking. I couldn't keep any Tylenol down so we went ahead and did the IV which took over an hour to get in because I have bad veins and lots of people tried and they eventually got an ultrasound to find a vein. Meagan: I was going to say for anyone who may have harder veins or situations like that, you can ask for the head anesthesiologist if there are multiple and for an actual ultrasound and it can really help them and get that in a lot faster. Wyn: I wish they had started that sooner. I was just being poked. Meagan: Lots of pokes, mhmm. Wyn: Yeah, and trying to labor through at the same time. They got that in. It didn't really calm down. The baby's heart rate was elevated to 170-180. It wasn't really slowing down at all. Our midwife seemed a bit concerned and started suggesting a C-section. Yeah, just laying there, I was ready to give up. I didn't want to, but she checked me and I was only 5 centimeters so I wasn't even close to getting there.They prepped me for surgery. I went in and baby girl was born in the morning at 8:50. Of course, they took her straight away to the warmer then I didn't get to hold her until the recovery room. I was still shaking from medication. Basically, the birth was completely the opposite of what we had hoped for. Meagan: What you had planned, yeah. Wyn: Then later, the OB who did the surgery came in and told me that I have very interesting reproductive anatomy. He confirmed it was a left-sided unicornuate uterus. There was a small horn on the right side and my uterus, I guess, was really stretched out and almost see-through. Meagan: A uterine window. Wyn: Then the placenta was really attached and they had to work to get that out. They labeled that as placenta accreta. I was advised not to labor again if we ever had another baby and just to plan a C-section. I felt like I went through all of the stages of grief after and in postpartum for my birth. First, I was in denial because I just blocked it out. I was happy to have my baby. Then you add the sleep deprivation and postpartum hormones and I was a bit angry at myself for not advocating but also just all of the suggestions. Baby wouldn't have changed anything. It was just a lot of what if's. Meagan: Which is hard. It's hard to what if this and what if that. Sometimes those what-ifs come up and we don't get answers. Wyn: Yeah, but it just fueled my fire to try for a VBAC. Meagan: Mhmm. Wyn: So that was my first birth and C-section then our second pregnancy which again, we felt like our little girl was a miracle so we just didn't know if we would be able to conceive again naturally or if we would have to go through IVF. We waited a little bit and another little miracle came in September 2023.Meagan: Yay. Wyn: Yeah, that was pretty exciting. Of course, I had been researching VBAC from 6 months postpartum with my daughter. I felt like my best option for a physiological birth or as close to it would be at home. I didn't want to fight the whole time in the hospital so I contacted two home birth midwives and they were both very nice and informative. They felt like I could VBAC but neither were comfortable supporting me at home with my previous birth– Meagan: And your uterus, yeah. Wyn: They both suggested I go back to my original midwife. I was a little upset at first that they wouldn't support it but I also understood. I made an appointment with my original midwife. I went in with my guard up and ready to fight for the VBAC. She surprised me and was actually supportive of it. She said that we would just watch and see how things would go. She said there wasn't any reason why we couldn't try. I was a bit surprised but wondered if she remembered all of the details or had looked at my records. I just went with it at first but eventually, we talked about everything that happened during the birth. She got second opinions from people in her office and it was okay. Meagan: Awesome. Wyn: Yeah. I also reached out and hired a doula, Dawn, who was a wealth of information and super supportive. We met regularly. She gave me exercise assignments and movements for labor and positioning. She was just there to help me debrief after each appointment with my midwife. If anything was brought up, she gave me information or links so I could feel confident going forward. That was really cool. I saw a chiropractor and did massage. I drank Nora tea from about 34 weeks on. I just tried to cover all my bases to get the best outcome. This pregnancy, I actually grew quicker and was measuring ahead, not behind. A growth scan was suggested again, but I respectfully declined because I felt like everything was okay. I was just trying to lean into my intuition and I didn't want to get a big baby diagnosis that could possibly–Meagan: Big baby, small uterus. Yeah. I don't blame you. Wyn: Yeah. Eventually, I ended up evening out at 37 weeks and was measuring right on. I just was a little bit quicker I guess. So I made it to my due date again at 40 weeks and I was offered a membrane sweep. I was offered a cervical check. I declined everything. I was doing good. I knew I went over with my daughter so I was prepared to go over again. 40.5 weeks, induction was brought up. I said I wouldn't talk about it until 42 weeks. Meagan: Good for you. Wyn: We scheduled a non-stress test again at 41 but I didn't make it to that because I was starting to have cramping in the evenings. I wouldn't consider them contractions but they were noticeable. Things were happening. I was trying to walk every day and just stay mentally at ease to keep my body feeling safe. So at 41 weeks exactly, I was having cramping in the evening. That was a bit stronger. I was putting my daughter down. My husband and I watched a show. I didn't say anything to him or anything because I didn't want to jinx it. We went to bed at 11:00. I fell asleep and slept really hard for an hour and a half. I woke up to contractions starting again full-on. I thought my water broke but I don't think it was. I think it was just bloody show originally. Meagan: Yeah.Wyn: I got up. I sat in the bathroom for a little bit and I was just super excited that it was starting on its own. I held out. I tried to time contractions a little bit at first. I knew it was happening so I just moved around the house quietly. I went and laid with my daughter for a half hour while she was sleeping because that was going to be our last time as the three of us. Yeah. I kept moving around for another half hour or so. By then, I needed the extra support. I woke my husband up. We texted our doula, Dawn, and she told me to hop in the shower for a little bit and she would get ready and head over soon.She made it about 3:30 AM and I think I was in pretty full-blown labor. I was mostly sitting on the toilet laboring in there but I came out to the living room when she came and I was on all fours. I made a music playlist. I had the TENS unit. I had all of these coping skills prepared and I didn't use anything. Meagan: You were in the zone. You were in the zone. Hey, but at least you were prepared with it. Wyn: Yeah, so about 4:45-5:00 in the morning, she suggested if we felt ready that maybe we would head into the hospital. My body was kind of bearing down a little bit wanting to push. We called my mom to come over and stay with our daughter. We called our midwife. She actually lives in our neighborhood. We called to give her a heads-up to get ready to meet us at the hospital. We got there at about 5:45. They did intake and called a nurse to bring us up to the room, and that nurse was our only real hurdle in the birth. She was not really supportive of natural birth or physiological birth. She made a couple of comments. She was trying to force me to get checked to admit me. I was obviously in labor because I was kind of pushing. I declined all of that. Eventually, she ended up not coming back in. She switched out with another nurse or maybe they told her to switch out, I'm not sure but that was nice that she removed herself from the situation. Meagan: I was going to say, good for her for realizing that her views didn't align with your views and that she probably wasn't needed at that birth. I don't love when people are that way with clients of mine or whatever, but for her to step away, that says something so that's really good. I'm glad she did for both of you.Wyn: Yeah, before she left, she was trying to get an IV too. She couldn't get an IV. I don't know. Meagan: She was frustrated and you're like, “Yeah, you could go.” Wyn: So yeah. Again, I was noticing all this going on but I was in my own little world. We got there. Our midwife, Christina, showed up. She asked if she could check me. I didn't want to have cervical checks but because I was getting pushy, she didn't want me to not be fully dilated and start pushing. I let her check and she said, “You're complete and baby is right there. Lean into it. If you want to push, start pushing.” I couldn't believe it. I prepared for labor. I had a moment that I had to wrap my mind around it because I couldn't believe we were already there to start pushing.I had requested my records so I was able to see all my time stamps. At about 6:30 was when she checked me. I pushed for about a half hour and the baby was born at 7:09 in the morning. It was exactly 41 weeks and 1 day, the same as my daughter. Meagan: Wow, and a much faster and much better experience. Your body just went into labor and was allowed to go into labor. You helped keep it safe to do what it wanted to do. Wyn: Yeah. Yeah. I was really excited to just be able. My body just did it all on its own which was pretty awesome. It was a pretty awesome feeling. Meagan: Very, very awesome. Do you have any tips for people who may feel strongly about not getting cervical exams or not getting IVs or doing those things but may have a pressuring nurse or someone who is like, “You have to do this. You have to do this. Our policy is this.” Do you have any advice on standing up for yourself and standing your ground?Wyn: Yeah, be respectful but also just be really strong. I had my husband and my doula backing me up. We prepared for things like that. I had a birth plan that had my wishes on it so just yeah, standing strong and keep in with what you want. But also be ready to switch gears. Like I said, I didn't want a cervical check but when my midwife got there and suggested it, I felt like, okay. I can go ahead with that. Meagan: You felt like it was okay at that point. That's such a great thing to bring up. You can have your wishes and desires. You can be standing your ground and then your intuition may switch or your opinion may switch or the situation may switch. You can adapt with how it's going or change your mind at any point both ways. You can be like, “I do want this and I actually decided I don't want this anymore. I changed my mind.” We ask in our form, “What's your best tip for someone preparing for a VBAC?” You said, “Find a great support team. Research all of the facts to make informed decisions and really lean into your motherly intuition.” I feel like through your story, that's what you did. You learned the facts. You said even before you became pregnant, right? Your baby was 6 months old and you were starting to listen to the podcast and learn more about VBAC and what the evidence says and the facts then you got your support team. You just built it up. You knew exactly what you needed to do so you felt confident in saying, “No. I don't want that IV” or “No, I don't want that cervical exam for you to admit me. I'm going to have this baby with or without that cervical exam.” I think the more you are informed, the more likely you feel confident in standing your ground. Wyn: For sure. Meagan: Yeah, for sure. Well, oh my goodness. Huge congrats. Let's just do a little shoutout to your midwife and your doula. Let's see, it's Christina? Where is she at again?Wyn: Interior Women's Health in Fairbanks, Alaska. Meagan: Awesome. So great of her to support you with a more unique situation too. She was like, “Let me do some research. Let me get some opinions. Okay, yes. We're good.” I'm so glad you felt that support. Then your doula, Dawn, yes. Where is she again? Oh, Unspeakable Joy. Wyn: Yes. Yeah. Meagan: That is so awesome. I'm so glad that you had them. We love doulas here as I'm sure you have heard along the podcast. We absolutely love our doulas. We have a VBAC directory as well so you can find a doula at thevbaclink.com/findadoula. Then last but not least, in the form, you said that you took Needed. Wyn: Yes, I did. Meagan: Yes. Can you share your experience with taking Needed through pregnancy? Did you start before pregnancy? Wyn: Yeah. Right as I got pregnant with my second one, I took the prenatal. I took the probiotics and I still take them today postpartum. Then also, the electrolytes or the mineral packets and the nighttime powder that my husband and I take. We put it in our tea every night. Meagan: It's amazing. It really is so amazing, huh? It's kind of weird because I don't have to finish it. I'm just sitting there sipping on it and I can just feel everything relax. I have a busy brain. I call it busy brain and my busy brain is a lot more calm when I take my sleep aid. Wyn: Yeah. I slept amazingly through pregnancy. Normally with my first, I had a lot of insomnia. It was very nice. Meagan: Yeah. Then the probiotics, I want to talk about probiotics in general. We never know how birth is going to go. We could have a Cesarean. We may have a fever and have to be given antibiotics or Tylenol or whatever it may be. If we can have a system that is preloaded essentially with probiotics, it really is going to help us and our gut flora in the end so no matter how that birth outcome it, that probiotic is so good for us because we never know what we are going to get or what we are going to receive in that labor. I'm excited. Wyn: Yeah, what is that stuff that they test you for? Meagan: Group B strep?Wyn: Yeah, yeah. Sorry. I didn't want that because I didn't want to have an IV. Meagan: So, so important. I love it. They usually test for that around 36 weeks so really making sure that you are on the pre and probiotic. What I really love is that it is pre and pro so it really is helping to strengthen our gut flora so much. With GBS, with group B strep, they like to give antibiotics in labor. It's sometimes a lot. They like to give rounds every 4 hours so you really could be impacting your gut flora. I love that you took that. You didn't even have group B strep. Well, thank you so, so much for sharing your story. Is there any other advice or anything else you would like to share with our listeners today?Wyn: Yeah, just again, find your support team and lean into your own intuition. You know what is right for your body and your babies. Meagan: It's so true. I mean, from day one of this podcast, we've talked about that intuition. It is powerful. It is powerful and it can really lead us in the right path. We just have to sometimes stop and listen. Sometimes that's removing yourself from a situation. Go into the bathroom and say, “I have to go to the bathroom.” Go to the bathroom, close your eyes, take a breath, and hear what your intuition is saying. It is so powerful. I couldn't agree more. Thank you so much.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

Episode 347 Colleen's VBAC After Fertility Challenges & Navigating Trauma + MTHFR & Velamentous Cord Insertion

Play Episode Listen Later Oct 28, 2024 56:26

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

Episode 346 Katie's Placental Abruption with Twins + VBAC After Four Membrane Sweeps + IVF & Retained Placenta

Play Episode Listen Later Oct 23, 2024 42:23

Katie is a newborn and family photographer based out of Chicago. After going through IVF, Katie was surprised to find out that her first pregnancy was with identical twins. At 33 weeks, she had an unexpected bleed and then another at 35 weeks. Because of placental abruption, she went straight to a Cesarean and her babies were in the NICU for 7 days.Katie wanted to know what a singleton pregnancy and VBAC birth could be like. She found a supportive midwife group through her local ICAN chapter that had around a 90% VBAC success rate! She also hired a doula. As her due date approached, Katie decided to opt for membrane sweeps to avoid a medical induction starting at 38+6 weeks.After four membrane sweeps over the course of two weeks, spontaneous labor began. She arrived at the hospital and her sweet baby was born vaginally just 5 hours later!Though she said she has a low pain tolerance, Katie's VBAC was unmedicated and she also shares her experience with a retained placenta and a second-degree tear. Katie, that is no small feat-- we know you are an absolute warrior and woman of strength!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome to the show, Katie. Thank you so much for being here with us. You guys, Katie is from Chicago, right? Chicago. Katie: Yep. Meagan: She is an IVF mama. She's got three girls. She is a girl mom and two identical twins and then a baby girl. How old is your baby girl now? Katie: She's going to be 3 months tomorrow. Meagan: 3 months so still little tiny. Oh my gosh. I love it. So yeah, and then you guys, when she's not doing the mom thing with all of her girls, she is also a newborn and family photographer which is awesome. Can you share with us your handle so we can come follow you?Katie: Yeah. On Instagram, I'm at katiemichellestudios. Meagan: Okay, katiemichellestudios and we are going to make sure to have that in the show notes so you can go follow her and follow her amazing work. And if you're in Chicago and you need newborn or family photos, hit her up. Is there a specific– Chicago is big. Is there a specific area that you serve?Katie: I'm in the northwest suburbs but I do in-home sessions wherever. I use a studio in Oak Park. Meagan: Okay, awesome. Then with your stories today, we've got a couple of highlights. We have IVF, placental abruption, and sticky placenta. I'm excited to talk about sticky placenta for sure because it's not something a lot of people talk about that could happen. Then, of course, the twins and all of that. We are going to get into that but I do have a Review of the Week. You guys, I know every single week I know you are probably sick of me asking but I love your reviews. Thank you so much for your reviews and remember, we always accept your reviews. Okay, this is from cassie80. It says, “Extremely educational and super empowering.” It says, “After a traumatic C-section in 2016, on my research journey about VBAC, I came across this podcast and instantly fell in love.” You guys, that just says something to me. 2016 is when she had her C-section and 2018 is when this podcast started. It's crazy to think that it's been going for so long but I'm so grateful for all of you guys sharing your stories like you, Ms. Katie, and helping this continue. It says, “I am currently trying for number two and am on a mission to VBAC. Hearing all of these wonderful stories of strength has given me the confidence that I can do it when the time comes. You and all of the women who courageously share their stories are just amazing. You all provide healing and support for all of us mamas.” Thank you so much, Cassie, and I'm so glad that you are here with us and have been with us for so long. Okay, Katie. Thank you again for being here. Katie: Thank you so much. I am so excited to be on this podcast myself because I listened to you guys nonstop my entire pregnancy even before and I always had it in the back of my mind that, Oh, if I get my VBAC, I'm going to come on here and tell my story. I am super excited and thank you for having me. Meagan: Oh my gosh, thank you so much. Let's talk about these twins. Let's talk about that birth. Katie: Yes. They were IVF but they were obviously surprise identical twins. My embryo split into obviously identical twins but they were an interesting pregnancy because usually with IVF, the twins are mono-di which means they share a placenta and have two sacs but my girls are actually di-di so they had two placentas, two sacs, so that meant they were a little bit less of a risky pregnancy and a vaginal birth was a possibility. That's what I was planning on. Everything was pretty smooth up until 33 weeks which is when I had my first bleed. It was just the middle of the night. I got up and I just started gushing. The doctor said that it was a marginal placental abruption. That means it was on the edge of the placenta and it wasn't a risk to them. Obviously, it was super scary. I thought that I was going to lose them both but everything with them was fine. They sent me home after a few days at the hospital. They just told me to take it easy, but they said it might happen again. It did at 35 weeks and 3 days. I had another bleed. At that point, they said, “They are almost to term for twins.” It's technically 37 or 38 weeks is when they like to induce for twins so they just said not to risk going any further and let's just get them out right now. I was planning on a vaginal birth, but because of that abruption and we didn't know what state the placenta was in and what would happen if there was an induction process that was started, so with the doctors, we decided I didn't want to risk induction and then needing a C-section anyway for the other twin so we did the C-section. It was a really, really rough recovery and they were in the NICU for a week. One of them needed breathing support and the other one was there for growing and feeding. Meagan: How big were they?Katie: 5 pounds, 3 ounces, and 4 pounds, 13 ounces. Meagan: Okay, okay. Katie: They were a good size. They were overall healthy but it was for me, super duper rough as a first-time mom to twins especially. The breastfeeding journey was really hard. I dealt with low milk supply and they were so tiny that it was hard for them to latch so I ended up exclusively pumping for 11 months. That's their story. Meagan: Wow. That's a lot of work by the way for someone maybe who hasn't pumped a lot. Holy cow. Good job. Katie: Yeah. So when we decided to have a third which was a tough decision for us, my husband was not on board. We ended up deciding that we wanted to experience what it's like to have a singleton baby and just having a singleton pregnancy hopefully and a VBAC. I definitely knew that I wanted a VBAC and started doing all my research. I found a very VBAC-supportive midwife group in my area. They have a 90-something percent VBAC rate in the hospital which is crazy. Meagan: Wow, yeah. That's amazing. What do you think they do so differently that a lot of other groups don't do that makes them so successful? Or are you going to share about it?Katie: I'm not sure. I think the hospital might be part of it, like the hospital policies might be more supportive. They deliver at Evanston Hospital if anyone is interested. Overall, I think the doctors that they work with because it's a midwife group that they work alongside doctors that when there is a delivery for the midwives, the doctors are also in the hospital. I think the doctors are also very VBAC-supportive so I think that helps when they are working together. Meagan: Yes, absolutely. Katie: That's that story. Meagan: So you found them. You found the providers. Did you go and ask them questions? How did you feel like you realized that they were supportive? Katie: Yeah. I went on– what's that group that have a Facebook group all around the country for different areas about lowering the C-section rate?Meagan: Oh, cesareanrates.org? Katie: I'm not sure. They are an organization. Meagan: Oh, ICAN?Katie: ICAN, yes. I went on my local Facebook group for ICAN and I asked around. I got their info. I first went for an appointment with one of the doctors at that practice before I was even pregnant because I was planning for the transfer and I liked that doctor, but then I realized that they have midwives and people really raved about the midwives. They said if you are looking for a more holistic experience and they spend more time with you than the doctors do. I just decided to go that route and somehow picking the midwives made me dive into the whole unmedicated birth side of things as well. I ended up hiring a doula as well. I never thought I'd be someone interested in unmedicated birth. I consider myself to have very low pain tolerance. Meagan: So tell us more about the birth. You have a low pain tolerance but you did go unmedicated?Katie: Yes. I ended up doing it. Meagan: Okay. Did you go into spontaneous labor?Katie: Yeah, it was interesting. I ended up having four membrane sweeps which is not that spontaneous. Meagan: Well, hey. This is the thing. A lot of people ask about membrane sweeps and sometimes people feel, Hey, this is worth it. Let's do this. Some people don't. Sometimes it works and sometimes it takes many and sometimes it doesn't. It's whatever feels right. So do you remember where you were with the first membrane sweep cervical-wise and how many weeks and things like that? Katie: Yeah, so I wanted to start them. Remember, I had never been pregnant past 35 weeks. Meagan: Right, yeah. Katie: I really thought that I was going to have an early baby again, but that really wasn't the case. I had her at 40 and 5. So the membrane sweep, I started the first one at 38 and 6 so basically at my 39-week appointment. I had no change after that one. Nothing happened. That's kind of what I assumed would happen so I had another one the next week at 39 and 6 and at that point, I was 2 centimeters, 80% effaced, and -1 station. Meagan: Okay, so pretty good cervical statistics there for a membrane sweep. Katie: Yeah. So then it was my due date and I was starting to feel more pressure. The mucus plug was coming out and baby was acting super active which I heard can happen close to when a baby is ready to be born but nothing really happened at that point. So then I decided to get my third sweep. I think that was 40+2 and at that point, I was 2.5 centimeters but the same for everything else. But things were starting to happen. I was having more stuff come out and I was like, Oh my gosh. How much longer am I going to be pregnant? Meagan: I'm sure. This is the thing. When you had either preterm or just early deliveries before and then you go past that, it feels like, No. I cannot be pregnant longer than this. This is eternity. Katie: Yes. It was really hard because I had the two-year-old twins also. It was getting to be a real mental and physical struggle. Meagan: Yes. Yeah. Katie: Also, I was doing pumping to try to induce labor and that wasn't doing anything. Meagan: Yeah. Was it causing contractions at all or was it just causing them and then you'd stop and it would stop?Katie: Yeah, basically it would just cause the Braxton Hicks contractions and nothing else. Meagan: Then it would go away. Katie: Yeah. So I had my third sweep and that one really started to do something because I went into prodromal labor which was a doozy. Meagan: Yeah. You know, that can be a risk of trying a membrane sweep. It can cause some prodromal labor but again, a lot of the time, prodromal labor still does stuff. It's tiring and it's exhausting but it's still doing something. Katie: Yeah, and it definitely did for me. My prodromal labor was a nighttime thing. The sun would go down. I'd put the kids to bed and it would start with irregular contractions. It felt like period cramps then I wouldn't sleep all night with that. I had that for two nights and then I was finally– Meagan: Typical prodromal. Katie: Then it would go away during the daytime. Meagan: It's so annoying. It's like, seriously? Fine. If you're going to do prodromal, at least do it during the day when I'm awake but don't take away my sleep. Katie: I know. At that point, I was getting super disheartened. I decided to schedule my induction because if this was going to happen every night, I would have zero energy for this VBAC. I did schedule my induction for 41 and 3 I believe if I made it to that point but I decided to go back and get my fourth membrane sweep June 3rd so the day before she was born. That started something. The midwife was like, “Okay, if I do this, I might see you back here later tonight.” Meagan: That's a promising thing to hear. Katie: Yeah, so once she did that sweep, I was actually already 4.5 centimeters dilated. That prodromal labor was doing something. Meagan: Um, 100%. Katie: Yep. That morning I had that sweep. We went to get lunch. We walked around. I was starting to right away have contractions and these were during the day so I knew something was up. By 4:00 PM that day, I was feeling it. I was starting to need counterpressure and had to stop what I was doing. Based on what the doula had said, that was when I should call them. I texted her and I told her, “I'm having these contractions that I'm having to stop and breathe through but they are still 10 minutes apart so I don't know what's going on.” She's like, "Okay. I think you need to stay home a little longer. You're probably not in active labor yet.” I'm like, "No, I think I'm there. Things are really intense.” Despite what she said, I headed to the hospital.It's a good thing I did because by the time I arrived at 10:00 PM, I was already 6.5 centimeters. Meagan: Okay, nice. Katie: I was very surprised because usually what the doula community says is sometimes when you head to the hospital when you are not in active labor, things can slow down because of the change of scenery and yeah, your body just shuts down. But in my case, it actually was the reverse. I went from super irregular contractions to walking up to the hospital doors and they started coming super regularly like 2-3 minutes apart. Yeah. Meagan: I do feel like the opposite can also happen where our body gets to that final destination and it's like, Okay. You can do this now. You have this sense of release. What you were saying, yes I've seen that too where the mom has to reacclimate to the space and labor stalls a little bit then it goes on, but this one it sounds like it was the opposite where it maybe brought you relaxation and safety. Katie: Yeah. I think maybe part of it was that this hospital experience was so different than my last one. At the last one, it was rushing to the hospital while I'm bleeding. I get there and there's this rush of nurses. Everyone's checking me and this time, I waddled up to the hospital. The room was dark. There was one nurse checking me in. I'm just chilling on the bed. I was just relaxed. I think a lot of the things that I did with the doulas to prepare, like they did classes about comfort measures and things like that and I was really trying to use those. I got the twinkle lights set up and got the music so that really helped. By 1:00 AM, I was already feeling the urge to push and I was feeling so much pressure, especially in my butt. I needed counterpressure for every single contraction up to that point then I was like, “No more counterpressure.” I was screaming for my husband to stop doing it because it was starting to hurt. I knew that something was happening. I was on my side trying to get some rest in between and I was starting to give up at that point. I know what they say is when you are starting to give up, you're starting transition. Meagan: You're right there. Katie: For me, I was thinking, I need an epidural right now. Meagan: A lot of people do though. A lot of people are like, “I can't do this anymore. I'm done. That's that. I need that epidural. I need relief now.” Katie: Yep. I hadn't had a check since I was admitted. It had been about 5 hours since I showed up or 4 hours since I showed up to the hospital so I was like, This can't be it. I can't be ready to push because I've only been here 4 hours and it's my first labor. I was in disbelief but I was like, “I need a check right now because if I'm not close to pushing, I'm getting the epidural.” The doula was trying to talk me out of it. She was like, "Are you sure? What are you going to do if you're not there?” I'm like, "I'm going to get the epidural.” I was 9.5 centimeters at that point. Meagan: Oh yeah. Right there. Katie: Yeah, and I was like, "Oh my gosh. This is actually happening.” My body was starting to push on its own and it was such a weird feeling. It was so different than my friend's birth that I photographed. She had an epidural and it was an induction. That's the only other birth that I've seen and this was so different because my body was pushing. I can't control it. Yeah. That was about an hour of pushing which felt like an eternity and the contractions were actually fine at that point. I couldn't feel them. I could just feel loads of pressure and the ring of fire which was intense, super duper intense. Then my water broke about 10 minutes before she was born and yeah, she was born. Meagan: You get to 10, your water is probably going out through breaks and baby comes down. Katie: Yeah, I had a bulging bag at the end which is really interesting to feel. She was born at 2:34 AM. Meagan: Aww, that's awesome. So pretty dang quick. Katie: Yeah. If you don't count the two nights of prodromal labor. Meagan: Prodromal labor, yeah. But your body was doing it slowly and surely. Each sweep did give you that extra nudge. It maybe gave you some prodromal labor along the way, but it seemed like it was helping and doing something. Katie: Yeah, if that helped me avoid a medical induction, I'm super glad that I did those. Meagan: Yeah, that's something when it comes to someone facing an induction or facing that hurdle, a membrane sweep might not be a bad idea. But too, with that said, if we go in and we are barely 1 centimeter or our cervix is really posterior and we are 30% effaced, we need to know mentally that if we go for a sweep, the chances of it working is a lot lower. It's just lower because our body is maybe not ready. It also doesn't mean it's not going to work. So like I said earlier, you had that ideal cervical stat. You were that 2 centimeters and 80% effaced. Things were looking good and softer, starting to open and they were able to get a really good sweep but even then, it took time. Katie: Yeah, definitely. My midwives never pressured induction on me. I was pressuring myself mainly because IVF pregnancies– there are differing opinions but some doctors say that you should be induced at 39 weeks and some say you shouldn't go past your due date because of the placenta not being as good. Meagan: Well, yeah. It's so hard because– so twins were IVF and was this baby IVF too?Katie: Yeah. Meagan: Okay, that is hard because there are a lot of people who do say that you should induce at 38-39 weeks with IVF and we do know out there that with IVF, the chances of having placenta issues and abnormalities like abruption are increased. Accreta, previa, and things like that. But if everything is going okay, all is looking well, it's that battle of do we induce? Do we not induce? What do we do?Obviously, your providers weren't pushing it so they didn't see any real medical need but then we have other providers on the complete opposite end where they are pushing it hard. Katie: Yeah, in some of my IVF groups on Facebook, basically every single person is induced or has a C-section. It's pretty rare for a provider to say you can go to 42 weeks like mine did. Meagan: Interesting. I actually don't know the real stats on IVF placental issues after 38 weeks. Had anybody ever talked to you about what your chance of issues really were after a certain point?Katie: No. The abruption was I think more of a risk factor was that it was twins and my uterus was so stretched but no one really mentioned placental issues or even said, “Let's look at your placenta after 40 weeks.” They do have the standard ultrasound to look at baby and do the BPP test, but they said that there is nothing really you can see from an ultrasound after your due date. Meagan: We know that ultrasounds can be off by size and by all the things. Katie: Yeah, and she was measuring bigger. She was 85th percentile which was actually true. She was born 8 pounds, 4 ounces so she wasn't tiny like my twins were. Meagan: Yeah. I Googled really, really quickly. This isn't even a study. This is just an article on it. I'll try to get some more studies and things in here but I'm going to include this article. It's from the Real Birth Company. It looks like they are teachers of birth classes. It's highlighted. It says, “What do you need to know if you are pregnant through IVF and you're being advised to have an induction because you are told that there is a higher chance of stillbirth?” It says, “The only study that we found that gives us the information also noted at higher risk of stillbirth for IVF pregnancies, but crucially, they said no increase in their rate of stillbirth after 28 weeks of pregnancy. It just says, “This research therefore tells us that induction at terms would not necessarily reduce stillbirth rates for babies who are conceived by IVF.”Katie: Yeah. From my understanding, it's hard to do studies on this because a lot of women who need IVF have other health factors which can increase the risk of obviously stillbirth and other issues in pregnancy. Meagan: Yeah, it's showing that sometimes IVF moms have placenta accreta and placental abruption at a higher risk. It shows that IUGR babies have a higher chance for being smaller. It also says that gestational diabetes and preeclampsia have an increased chance. So like you said, there are other things that they may have. I'm just going to throw this in there in case anyone listening is an IVF mama and wants to know more. It's interesting that you're saying that in that group– are they scheduling C-sections?Katie: Yeah. Most women get scheduled C-sections, not scheduled C-sections, scheduled inductions but they end in a C-section because they aren't ready. Meagan: Okay, so they aren't necessarily scheduling them right off the bat just because they are IVF. Katie: Right. Meagan: But again, like you said, they aren't ready and inductions are happening and people are ending up in a Cesarean. Katie: Yes. Meagan: Interesting. Well, this article was written in 2021. I'm also going to put a couple others in here that says actually 2024 so I need to look more into this but it's something to consider because again, this is a space where we are trying to reduce unnecessary Cesareans. We're seeing that it's happening so it might be something that you want to research if you are out there and you are doing IVF, research that and see if it's something that really is necessary for sure. Katie: This is just my personal story, but my placenta looked perfectly fine at 40+5 with this baby. Meagan: Yeah, so everything was looking good at that point. We did talk about that in the beginning– sticky placenta or really retained placenta. Did you have that with this? Maybe you can talk to us more about the placenta. You gave birth to babe. It was a VBAC that was a lot faster than anticipated and you went unmedicated when you didn't think you could. I kind of love that so much that you were like, “I have a low pain tolerance,” but then you did that. It just goes to show how possible it is, right? But yeah, talk to us about your placenta. Katie: Yeah. That was actually worse than the pain of the entire birth and something I didn't expect because I had asked about this because it can be an issue with IVF pregnancies. I had asked about this in one of my prenatal appointments and the midwife said, “We don't know if you're going to have that or not. IVF is a risk factor for it,” but since I had the opposite of a sticky placenta. I had a placenta that was coming off the wall. With my last pregnancy, she was like, “I'm guessing that you're not going to have that,” but I did. After baby was out, my placenta was not coming out after 10 minutes and around 30 minutes, I think they like to have it out by then. So they gave it 10 minutes for it to come out naturally, but my contractions completely stopped. Nothing was happening at that point. My body wasn't expelling it. They were trying to pull on it. Eventually, it came out but I was still having bleeding when they were pressing on my stomach than they would like to see. They gave me the Pitocin and that didn't work and then they tried two or three other medications. Meagan: Did they give you Cytotec at all? Katie: Yeah, I think so and another medication that goes in the back in the booty. Meagan: Oh, yes. They usually will insert it rectally. Yes. Yes. Cytotec is not okay when we are pregnant and we are trying to go into labor, but because it makes the uterus contract so hard which is the whole issue with Cytotec and VBAC, it can help reduce bleeding and help the placenta and all of these things. Yeah. Katie: Yeah. They gave me the max dose of Pitocin in my IV and none of that worked. They gave me the Pitocin in the leg and that didn't work, the Cytotec. Then they brought out the ultrasound machine and scanned around and saw that there were some pieces left inside. So she had to stick her hand up and get them. That was horrible. Meagan: And you were unmedicated. I'm just going to tell you right now that you have a high pain tolerance. I think you might be incorrect on that. Not saying that really, but holy cow. Unmedicated and a retained placenta retrieval scrape– they are essentially scraping and fishing for your placenta. Katie: Yes and she had to go in two or three times. They gave me some kind of IV medication and all it did was make me feel drunk. Meagan: Probably fentanyl. Katie: It was something with a D maybe. Dimerol.Meagan: Dilaudid. Katie: Maybe Dilaudid. It made me feel loopy and nauseous but did nothing for the pain. I was holding my baby the whole time and I just want to forget that horrible experience. Meagan: That is rough. Sometimes placentas “stay sticky” and it really can take up to an hour even for a placenta to come out. Sometimes we don't know why and like you said, IVF stuff maybe could have helped but the placenta usually is in that 5 to 30-minute period and providers do start to worry if it's more than that because after we have our baby, our cervix was 10 centimters. It dilated and everything was open and thinned and then it starts coming back and closing again which is the normal process. Katie: Oh my gosh. I didn't even think of that. Meagan: Yeah, it's just that normal process where it starts closing so providers start fearing that if the cervix is closed or too small, the placenta can't move through and then we've got the placenta inside and retained placenta is a very serious thing. You want to get your placenta out. It's an amazing organ and functions amazingly. It raises these amazing babies through these 9 months. It supports them and feeds them but we need to get it out because retained placenta can make you very sick. They start fearing that and sometimes when they are tugging, it can make it so the blood vessels get ripped off or they weren't ready so then we have bleeding and retained placenta and all of these things. They start fearing it and things like breastfeeding, Pitocin, Cytotec, and all of these things that they are trying to get to help you contract more is an effort to help get that out. But yeah. That is a lot. That's a lot. You had this beautiful birth and then whoa, quite a lot right there. Katie: Yeah, a bit of a turn and in addition to that, I had a second-degree tear that they also had to stitch me up. I don't remember if that was before or after the whole extraction. Meagan: Your provider fishing could have caused more tearing. Yeah. There is also a possibility that if for some reason it doesn't come out that you will have to be taken to an OR which is a more rare circumstance but I've had one client in all the 10 years of doing this and she was a VBAC client too actually. She had a beautiful birth and then had to go in and get it manually removed. So yeah, breastfeeding as soon as you can, changing positions and also emptying your bladder is something that you can do because if your bladder is full then it can hold things up so sometimes it's detached but not coming out so there are things we can do and then of course, taking medication and going a step further if we really need to. Katie: Yeah. Overall though, I don't regret any of that. It was still such a beautiful birth even though the end and the golden hour took a turn, it still was more than I had imagined. Meagan: Yeah. I was actually going to ask you. Even with that which is a lot, would you still suggest doing it or would you have done it differently if you could go back?Katie: No regrets. The recovery was a million times easier even with the tear and all of that. I was going to the botanical garden 4 days postpartum with my family. Meagan: Oh my gosh. You were out walking around. Katie: Yeah. Meagan: Oh my gosh. That is amazing. That is amazing. Katie: With toddlers, you've got to get back to real life. Meagan: I know. It's so hard to take that break and recover when we have life that is still moving around us. Katie: Definitely. Meagan: Remind me, you said you took Needed's collagen, right? Katie: I did. Yeah. Meagan: That actually probably helped healing as well. Katie: Yeah. I love that stuff because I wanted to get more protein in. I just put it in my shakes along with all of the other things that I did like the chiropractor and the dates. I did all of the things. Meagan: Yes. And your doulas, do you want to do a shoutout? Katie: Yeah, 3-1-2 doulas and I worked with Heather. Meagan: Awesome. Katie: Yeah, and they have awesome classes too. If you are a doula customer, they are free and if you're not, you can still sign up for them and they are super great. Meagan: That is so awesome. We love our doulas and to all of those listeners out there, just a reminder. We have a major doula directory from literally all over the US to outside of the US if you are looking for doulas too. You can go to thevbaclink.com/findadoula. We love our doulas so dang much. Obviously, I love doulas so much I became one. Doulas are so amazing. I love that you said you did chiropractic care and dates and all of the things. Are there any other suggestions or tips that you would give our listeners as they are going through their VBAC journey? Katie: Yeah, just listen to these podcasts a lot and you'll learn so much. Join The VBAC Link group on Facebook. Meagan: Yes. I love that community. Isn't it just amazing? Katie: Yeah, it's great. There's also another VBAC Facebook group that I loved as well. Meagan: Do you remember the name?Katie: I don't remember. Meagan: There are a few on there. We love– Katie: VBAC Support Group. Yeah, that one's great. Meagan: Awesome. Katie: Yeah, just believe in yourself. You can do it. You are a badass. Meagan: You are a badass and you can do it. I agree. We'll end on that note because that is such a true statement. Girl, you are amazing and I'm so grateful for you sharing these beautiful stories today. Katie: Thank you so much for having me.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Episode 344 Advice for First-time Moms: How to Avoid a C-section From the Get-go

spotify dreams redemption nicu homebirth freebirth hospital birth traumatic birth iugr

Play Episode Listen Later Oct 16, 2024 32:20

We hear SO many of our listeners say things like, “I wish every first-time mom listened to these stories” or “I wish as a first-time mom I heard these stories because I truly believe it could have helped me avoid my Cesarean.” First-time moms, we want to educate you to make informed decisions during your birth. We want your first birth to be an empowering experience, no matter the outcome. And if possible, we want to help you avoid an unnecessary Cesarean. Meagan shares some of her best tips for first-time moms regarding induction, big babies, ultrasounds, and more. We also asked members of our VBAC Link Community to send in their best tips for first-time moms. We hope this episode becomes a great starting point for you to then go on and listen to the powerful stories shared in our other episodes!VBAC Link Supportive Provider ListEvidence-Based Birth: Evidence on Inducing LaborThe VBAC Link Blog: The ARRIVE TrialNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. This is Meagan and you are listening to The VBAC Link Podcast. I am so happy that you are here. Normally, we have episodes that are filled with VBAC stories, CBAC stories, and guests sharing educational pieces on VBAC. However, today, I'm going to a quick episode for our first-time mamas out there. For years, we have had people write in a review saying things like, “Oh my gosh, I wish every first-time mom listened to these stories. This is not only for VBAC moms or VBAC-hopeful parents. This is for anyone who is giving birth,” or again, going back to the first-time mom, people saying, “I wish as a first-time mom I heard these stories and learned this education because I truly believe it could have helped me avoid my Cesarean.” Women of Strength, if you know someone who is expecting or if you are a first-time mama, listening on how to avoid unnecessary and undesired C-sections, listen up. This is going to be an episode specifically for you. As always, I have a Review of the Week so I'd like to dive into that but then get back into what first-time mamas and what our community wants first-time mamas to know. Today's review is from Emmalyn. I don't even know how to pronounce the last name, but Emmalyn. It says, “Uplifted and educated. I have been binging this podcast since I found it a couple of weeks ago and I'm addicted. As I prepare for my HBA2C” so for the listeners who are new, HBA2C means home birth after two Cesareans, “I have experienced so much healing and inspiration through hearing these stories after two attempts for vaginal deliveries with my first two kids. One preeclampsia hospital birth and HBAC (home birth after Cesarean) transfer to the hospital. The content they provide is diverse, thoughtful, and inclusive. There is so much stigma around home birth and VBAC and this is the first and only community plus the Facebook group I have found to truly be welcoming and nonjudgmental. I feel like this is going to be an instrumental tool to my birth prep for my baby coming this Christmas Eve.” You guys, I could not agree with her more. This is a place where we want you to know that you are safe, that you are heard, that you are understood. We in no way, shape, or form believe that there is only one way to birth. There just simply isn't. We just want you to know your options and feel empowered to make the best decisions for you along the way. So if you are one of these first-time mamas listening today, I am so excited that you are here and I do encourage you to continue going on through all of the other episodes. Women who are sharing their stories likely have had a Cesarean before and I think this is such a great opportunity for you to learn how to avoid a Cesarean by listening through others who have come before you and have given birth and have also learned along the way. I'll tell you right now that with my first baby, I was not ready to give birth. Although I felt ready, all I knew was that I was pregnant and I was going to have a baby and I could not wait. But there was so much more that I didn't know that I wish I knew. I have learned throughout the way and I'm going to be sharing some more experiences with you along with, like I said, really tips from our own community members. You guys, I reached out on Instagram and asked for tips for first-time moms and I'm going to go over some of those tips along with learning how to avoid a Cesarean and unnecessary interventions. Here we go. Okay, everybody. Welcome to the show. Thank you for joining me. If you are new to the podcast, my name is Meagan Heaton and I am a VBAC after two C-section mom and a doula who wants to help educate and empower anyone who wants to learn more about their options for birth after Cesarean as well as learning how to avoid a Cesarean from the get-go. I had a Cesarean when I was pregnant with my first. I went into labor at 39 weeks and 5 days spontaneously with PROM which is called premature rupture of membranes. What that means is my body went into labor as far as my water broke, but then nothing really followed for quite some time. Contractions didn't really get going and labor itself did not start. I, along with many first-time moms, was told that if your water breaks you go straight to the hospital. I went to the hospital and from then on out, it was induction. They wanted to induce my labor and they wanted to intervene instead of just letting my body do its thing. I started getting Pitocin and that led to an epidural. It unfortunately led to a Cesarean. Now, I want to tell you that Pitocin and an epidural do not always lead to a Cesarean but these are going to be common things that you're hearing in women's stories along this podcast that do seem to impact the end result of a Cesarean. With my second, I really wanted a VBAC, a vaginal birth after a Cesarean, and I went looking more into what it was and what my options were and what I should do. I ended up staying with my same provider who was a great guy. Do not get me wrong, but he wasn't the provider for me and I didn't learn that until after my second Cesarean. I stayed with him and I went into spontaneous labor again with premature rupture of membranes. This one took a lot longer for my body to kick in and unfortunately, I really never was allowed the time. I ended up walking down for a second repeat Cesarean with that one because I was told that my body just did not know how to do it. This is also another very common, common thing that so many Women of Strength are being told. Their body doesn't know how to do it. Their body can't progress. Their pelvis is too small. Women of Strength, if there is any pet peeve that I have, it is someone telling another person that their body is not capable of giving birth vaginally. I might sound grumpy about it. Let's be honest, I am. You are capable of giving birth vaginally. What are some of the things that I would suggest you do as you are going along as a first-time parent?Number one, I really believe that provider is key. If you have a provider who is on board with your birthing desires, that is going to help you so much during your labor and your pregnancy journey. If you have a provider who is very induction-happy, intervention-happy, and pushing you to even schedule an induction before you even reach 39 weeks or 40 weeks or 41 weeks, that's a problem. That is a red flag. Take a moment if you can. Go to thevbaclink.com/blog or just click the link in the show notes and check out how to find a supportive provider. Now, this blog that we have is how to find a provider who is supportive in VBAC, but I think all around it goes in line with any provider whether you are a VBAC or not. You want to find someone who doesn't put stipulations on when you have your baby and what happens during pregnancy meaning that if they are requesting or demanding that you do multiple growth scans in your third trimester and there is really no medical reason to indicate the reason to do that, that's a problem. If they are talking about the size of your baby early on or the size of you and how you look and, “You must be carrying a big baby. You are so petite,” there is already doubt that is being placed. As I mentioned, if they are encouraging an induction at 39 weeks or just getting it on the schedule, let me tell you right now that being pregnant at 39 weeks is not always fun. Being pregnant at 40 and 41 weeks is not fun. There is a lot that goes into it. Your hips hurt. You're tired. Your pelvis hurts. You're peeing all of the time. You can't sleep. Okay, it doesn't sound that great, right? But it really is such a great time and it's a time that we need to cherish and really just embrace but it's hard to do that. That's the fact. It's sometimes really hard to do that so when we have providers giving us an “out” to give birth sooner, it's very enticing. I don't shame anyone for taking that opportunity of being induced and picking your baby's birthday, but there are a lot of things that go into that. Now, as a first-time mom back in 2019 I want to say, a study came out and they called it the ARRIVE trial. The ARRIVE trial is where they had a whole bunch of people, and really actually not that many people, but a whole bunch of people in two groups. They had one group where they induced at 39 weeks and they didn't always have a “favorable” cervix. Favorable versus unfavorable meaning the cervix was showing signs of readiness to give birth. They had these moms in one group who were induced at 39 weeks then they had another group who chose not to be induced or to wait for spontaneous labor but would not let them go past 42 weeks. There were a lot of things that their goals were to point out and study in this trial which you can find out more about on our blog. It's in the show notes. We'll make sure that we have the ARRIVE trial link in there. But they really wanted to also see what it did for Cesarean. In the induction group, 79 out of 82 people were induced at 39 weeks. The people in the expectant management group, meaning they were waiting for spontaneous labor or didn't elect to induce at 39 weeks, 79 out of 80 waited. 44% of them gave birth spontaneously and 56% of them gave birth after induction for medical reasons. Now, medical reasons. There are a lot of things people can talk about or providers can talk about why you should be induced. So let's talk about some of the main reasons for an induction or some common reasons for an induction that you'll see but then always, I want you to know that you can question. If someone is saying there is a medical reason for you to be induced, question them. It's okay for you to question them. It is always okay to say no and question, always. No matter what it is in any medical scene, birth or not birth, you are always able to question and say no or no, thank you. What are some medical reasons? Medical reasons may be preeclampsia. Maybe you're having blood pressure issues or HELLP syndrome where now your liver is being affected. We've got high blood pressure or elevated liver enzymes and it really is best for you and baby to be born and to give birth. So preeclampsia may be one. Maybe you've got a unique health condition that is now impacting your personal health to stay pregnant. That may be a reason for induction. IUGR, intra-uterine growth restriction. Maybe your baby is no longer thriving inside the uterus and inside the womb and needs to come out so they can thrive on the outside. If IUGR is happening, that is a medical reason to consider induction. Those are just a few that you may encounter. Some other things may be low fluid– that one can be debatable for sure. It can be serious, or high fluids. There are so many situations. Just know that if you have a situation or if someone is suggesting an induction at 39 weeks or at any point due to medical reasons, discuss that with your provider. Definitely discuss and question and make sure that you are all on the same page and you are really understanding what the medical reason is for your induction. Don't fear to question the evidence saying that induction is the best route. Okay, so the people in the expectant management group like I said– 79 out of 80 waited. 44% gave birth spontaneously 56% gave birth after induction. So what did this study really show, really, really show about C-section? Well, let me tell you. They really tried to show that it lowered Cesarean rates from 19% to 22% but if you really dig into it deeper, it really doesn't say if Cesarean really is lowered or not. Between the two groups, there really were no significant difference in birth outcomes for the baby so again they showed that maybe 19% versus 22% were likely to end up in a Cesarean and then they also showed that they were less likely to develop high blood pressure– 9% versus 14%. That is a thing. We do know that blood pressure can elevate in the end, but overall, as of 2024, there really are a few studies that have been able to look at the effects of the ARRIVE trial and have concluded that the elective rate has significantly increased or decreased the Cesarean delivery. This is the problem though. It's being so heavily– and maybe heavily isn't the word– done. It's being so heavily performed all over the world now after this trial came out. For some reason, we looked at that and we're like, “Yep. See? It impacts the Cesarean rate. It lowers it.” But we are still having a really high Cesarean rate and first-time moms are still, still, still, still having Cesareans after induction is happening. Induction. Women of Strength, that is what we call the women who listen to our podcast, if you are being proposed for an induction or being offered an induction, maybe take some steps back. Do some research. Read our blog. Talk about induction methods. There are also a lot of different types of induction methods. I want to also say that coming back to your provider, if you have a supportive provider who is willing to induce very gently and understands the process of induction especially for a first-time mom whose cervix might not be favorable or ready, you may have a higher chance of giving birth vaginally. But if you are at a place where they like to push inductions really fast on you and all of the things, increase all of the interventions, you are going to likely have an increased chance of Cesarean. In 2023, the rate of C-sections in the United States was 32.4%. 32.4% which is really the highest it's been since 2013 and just astronomically gross in my opinion. Years and years and years ago, it was 10-15%. Even before that, it was 5%. We are seeing a peak. We are seeing a serious peak and what's happening is we are seeing a lot of the times first-time moms will have a C-section for whatever reason and then people are being told that they cannot have a vaginal birth after Cesarean, that the option is now gone or they won't even approach VBAC as a topic. It's just, “For the future, you will have to schedule a C-section.” Okay, now this is another one. If you are a first-time mom who has a friend who had a C-section and doesn't know their option, please share this podcast with them. This is such a great place for them to come and learn and know their options. Okay, so let's dive in. I asked our community. I mentioned that before. What do our community members want a first-time mom to know? What do they wish they would have known before as a first-time mom?One of our followers, Elizabeth, mentions, “Wait as long as it takes for baby to come and to change positions frequently.” Oh my gosh, I cannot agree more. This is what we are talking about, right? Waiting for our baby to come and not inducing unless it really is medically necessary and letting our bodies do what they are made to do and are totally capable of doing.Changing positions frequently is something I highly encourage and as a first-time mom or any mom giving birth, I highly suggest a doula. Doulas are amazing. I know they are not always affordable and I don't know if you have ever heard of this, but you can go to behervillage.com and you can actually register for a doula so instead of getting all of the million onesies and wipe warmers or a million sized-newborn diapers, you can register for a doula and people can help pay for a doula. It is absolutely amazing. I highly encourage it. Check out behervillage.com. We also have doulas at thevbaclink.com/findadoula. They are VBAC-certified doulas but these are doulas who are trained and educated and certified in helping you avoid a Cesarean so I highly suggest a doula because they can help know what positions to change to and they can help guide you. If you don't have a doula, that is okay. Change positions frequently. I mean, every 5-10 contractions, if you went from hands and knees and you want to stay on hands and knees, go hands and knees but put a pillow under and elevate that left leg or that right knee. Change things up because changing the dynamics of your pelvis is going to help bringing baby down. One of the main reasons for a Cesarean is that babies are in a wonky position or failure to progress or failure to dilate. That, a lot of the time, is because baby is not in a really great position and movement will help baby get in a better position and help your labor speed along. Okay, our friend, Emily, says, “Wait to go to the hospital.” I mentioned this earlier that I was told when my water broke to go straight to the hospital. Do your research to wait. Learn how long to wait, how long is too long, and again, that's when a doula comes into play. They are really great on helping to guide you on knowing when to go. Emily also– she has a couple of tips here. She says, “Trust your own intuition and what your body is feeling in the moment.” I could not agree more. Your intuition is huge and if you continue listening to this podcast, let me tell you that you are going to hear about intuition a million times. Intuition is huge. You have it and it's amazing. It's super important to follow. Sometimes we question our intuition and that is hard. Try not to question your intuition and again, do what your body is feeling in the moment. Emily says, “I didn't have a doula and it's my biggest regret.” Okay, so we were just talking about that. Doulas are amazing, you guys. I didn't have a doula for my first two. That was also a big regret. My husband was not on board with my second. After I learned about a doula and after having a doula, he said that there is no way we would have another baby again without a doula. They are just incredible you guys and there are actual statistics on doulas. They lower the chance of Cesarean. They lower the time of birth by 45 minutes. 45 minutes might not sound like a lot, but 45 minutes in labor is impactful. They also lower the chances of induction and interventions and they overall help you walk away with having a better experience. Okay, another follower says, “Trust your body. Don't accept interventions. Plans can change and breathe.” Love that so much. We have Sarah who says, “Ask for help even if you feel fine.” I love that. It's okay. Use your voice in labor. Use your voice during pregnancy. Use your voice during that postpartum experience. Even if you think you are feeling okay, it's okay to ask for help or if you have a question that is bobbling around in your brain, ask it. Don't be scared to ask it. Another follower says, “Be patient with yourself and your baby. Enjoy your pregnancy and push with an open lotus.” I love that so much. Oh my gosh, that just made me smile. We have a follower named Ash. She says, “Be informed so you can make decisions you are happy with under time and pressure.” Okay, this is something, Women of Strength, that we have found through many of these stories. These first-time mamas are going through labor who have not had a lot of education, me being one of them, going into birth. You guys, birth is a very big event. It is a very important day and impactful day. Sometimes things can change just like what one of our followers was saying. Plans can change and that means sometimes things can be offered to you that you don't really know about. You don't really know what is being offered to you so you feel like you have to say yes or no. You don't really know what you're making the yes statement to so being informed is so important.We have a blog at thevbaclink.com/blog that shares so much information along with this podcast and then we actually have a course for parents to learn how to avoid Cesarean and how to navigate through labor and avoid a Cesarean so if you are interested in learning how to avoid a Cesarean and learning more about what this VBAC stuff is even like, check us out at thevbaclink.com. Gracie says, “Don't let your doctor pressure you into unnecessary induction.” It goes along with the theme in the first part of the podcast. If you can tell, induction and pressure is something that a lot of first-time, even second and third, oh my gosh, many-time moms have. Ash says, “Have a clear but detailed birth plan.” I love that so much. Birth preferences are so important. As you get informed and get educated, you are going to learn what is important to you, what you want, what you don't want. We had a story not too long ago how as a first-time mom, she didn't realize how much her birth experience meant to her until she didn't have that birth experience. You guys, this is such an important day. Oh my gosh, it's just incredible and if you can be informed and you can have that clear birth plan– now, let me tell you that some of these birth plans don't go exactly as you've written them down. Go in with an open mind but know your desires and know the evidence and the information behind those desires and why they are important to you. Okay, M says, “Be open to birth preferences changing.” This is just going right along here. Okay, like we were just saying, sometimes they change and it can be really hard. I have a sweet and sour view on birth plans because birth plans are incredible. It helps our team and reminds them what we need and what's important and what we want, but sometimes if we write them down on paper and they don't go as planned, we can view them or view ourselves as having failed or like we did everything and it didn't work so it failed so what's the use in trying that again or wanting that again? I also want you to know that if you can go into it having an open mind, it can help you. It can help you a lot and knowing again that birth preferences change is so important. Okay, so we have a photographer here. Lilabqz_photography. She said, “It's not pain. It's power. Breathe and it will be all over soon.” I love that. These contractions are powerful. They are amazing. Oh my gosh. Okay, hypnobirthingnorthyorkshire says, “You are amazing. First-time mamas, you are. You are amazing.” Everybody listening to this podcast, let me tell you that you are incredible. You are such a Woman of Strength and you are capable of more than you have ever known. Okay, we have another follower who says, “Give yourself all the grace. You did a big thing. You are your baby's best mama.” Birth is amazing, you guys. It is a big thing and you are incredible for doing it. Another follower says, “Educate yourself and get a doula.” The next one also says, “Hire a doula.” You guys, hiring a doula is a common theme. Like I said, if you are not in a financial means or don't have the financial means, check out Be Her Village. It is absolutely incredible and can make it possible for you to have the support that you deserve. Rachel says a couple of things here. She says, “Just because you feel good to do all the things so soon doesn't mean you should. Find someone who will listen to your birth story without interrupting or opinions.” This is more for postpartum. I agree. Take it easy. Even for pregnancy, take it easy. Just because you feel like you can run a marathon doesn't mean you should. Rest up. Rest easy. Give back to your body. Hydrate. Fuel with good nutrition and find someone who will listen to your birth story without interrupting or opinions. You guys, opinions will come in all around even before you have your baby. I mean, here I am. I'm sharing some opinions. Just find someone who will listen and validate you. You deserve it. Okay, Lauren says, “If you don't want a C-section, listen to The VBAC Link. You'll learn so much.” Oh my gosh, Lauren, thank you so dang much for that. That is what this episode is all about, to help you learn how to avoid a Cesarean. Our friend, Jess, says, “Eat to replenish yourself from birth and pregnancy. Meal trains are great.” Oh my gosh, I can't say that enough. If you haven't set yourself up for a meal train before and you haven't had your baby yet or even if you had, they are incredible and they will help your birthing partners so much. Julie says, “Surrender. Surrender it all. Birth is incredible. You're going to feel so many sensations.” Even if you don't want to go unmedicated, you guys, you're still going to feel so many sensations that are new and somewhat shocking but also incredible. You're birthing a baby. It's just absolutely amazing.Then Rachel says, “Do your research. Be mentally prepared for either type of birth and recovery and have a postpartum plan or a birth photographer and take pics.” Okay, you guys. Such incredible information. I echo all of them. Obviously, we've also been talking about some of those topics. You are strong. You are capable. Don't let anyone doubt you. Okay? Don't let anyone doubt your ability. Keep listening to these stories. These stories are meant for you as well. They are meant to help you learn, to help empower, to help grow, and honestly, one mama at a time, we're going to see the Cesarean rate drop, you guys. We're going to see it drop. Thank you so much for joining me today. I'm absolutely honored that you are here listening to the podcast and like I said, if you want to learn more about The VBAC Link and what we have to offer along with so many free resources, you can join us at thevbaclink.com. We've got the podcast, the blog, the course, resources, and so much more.Oh, and for kicks and giggles, I want to throw out the fact that we have a supportive provider list so if you are looking for a supportive provider whether it's a VBAC or not, don't forget to check out our provider list. You can find us at thevbaclink on Instagram, click on linktree, and you'll find the supportive list there. Thank you so much and take care. 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

True Redemption | Carey's Freebirth After a Traumatic Birth

Healing Birth

Play Episode Listen Later Sep 23, 2024 60:53

During Carey's first pregnancy, her baby was diagnosed with Intra Uterine Growth Restriction (a fairly subjective label that means the baby is thought to be small, and it is not known why). Because of this, she was subjected to multiple ultrasounds during the last few weeks of her pregnancy, and highly pressured to induce. Carey refused to be induced, and went into labor spontaneously. The labor experience was colored by the fears of the medical staff, she was subjected to coached pushing, and a whole team of NICU doctors took and assessed her baby as soon as she was born. Her baby was perfectly healthy and did not need the NICU, but Carey was still robbed of those golden moments post-birth, and bonding between her and the baby was disrupted. Although this kind of birth could have been someone else's “great experience”, it left her with a lot of healing to do. She knew almost immediately that what had happened to her in the hospital was unnecessary and created trauma for her and her baby. She said goodbye to the medical system, consciously conceived her second child, had a wild pregnancy, and a beautiful, healing, freebirth. Be sure to check out the instagram page this week @healingbirth for some really incredible photos of this birth by @novitabirthstories If you love the show, I would greatly appreciate a review on Spotify or Apple Podcasts! Do you have a birth story you'd like to share on the podcast, or would like to otherwise connect? I love to hear from you! Send me a note at contactus@healingbirth.net Check out the website for lots of other birth related offerings, and personalized support: www.healingbirth.net Intro / outro music: Dreams by Markvard

929| IUGR Induction turned C-section & Placental Abruption at 29 weeks with NICU Stay - Julie Bromage [part 2]

nicu c section kyo iugr placental abruption

Play Episode Listen Later Sep 12, 2024 44:19

Links: Mountain Meadow Herbs - use code BIRTHHOUR for 10% off and free shipping on your first order! Know Your Options Online Childbirth Course - use code 100OFF for $100 off Beyond the First Latch Course (comes free with KYO course) Support The Birth Hour via Patreon! (Listen to the Partner Podcast collection here as well at the co-producer level!)

928| IUGR Induction turned C-section & Placental Abruption at 29 weeks with NICU Stay - Julie Bromage [part 1]

nicu c section kyo iugr placental abruption

Play Episode Listen Later Sep 10, 2024 42:18

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

Despite a Breech Baby and IUGR Diagnosis, Hope Trusted her Instincts And Chose Homebirth

Healing Birth

Play Episode Listen Later Sep 2, 2024 27:23

Midway through her pregnancy, Hope's baby was diagnosed as growth restricted (IUGR), but despite concern from her doctors, Hope's intuition was telling her the baby was okay. Her baby was also breech at that point, and never did turn. She was recommended to have a planned cesarean at 37 weeks due to both the IUGR diagnosis and the breech positioning, but this never sat right with her. She kept asking questions to her care team that she felt were not adequately answered. Amazingly, the hospital scheduled her for this cesarean at 37 weeks, after a planned ECV, without her knowledge or consent. A nurse accidentally tipped her off! Around the same time, Hope found stories of other women who vaginally birthed breech babies. Now that she knew it was possible, the question was how to find the right support for her to do it at home. She was able to find a midwife trained with Breech without Borders. Her baby was born perfectly healthy at 42 weeks after a ten hour labor. By listening to her instincts and birthing at home, she avoided what would have almost certainly been a NICU stay necessitated by having a cesarean at 37 weeks. Her story is an amazing testament to how important and valid maternal intuition truly is. Follow Hope @hope_jckson If you love the show, I would greatly appreciate a review on Spotify or Apple Podcasts! Follow me on Instagram @healingbirth Do you have a birth story you'd like to share on the podcast, or would like to otherwise connect? I love to hear from you! Send me a note at contactus@healingbirth.net Check out the website for lots of other birth related offerings, and personalized support: www.healingbirth.net Intro / outro music: Dreams by Markvard

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498 | Katelyn, three babies, private obstetrician, vaginal birth, fraternal twins, cholestasis, IUGR, physiological twin birth, breastfeeding

Australian Birth Stories

Play Episode Listen Later Aug 26, 2024 71:20

Katelyn's first birth was relatively quick - a low-intervention vaginal birth in a private hospital. When she discovered she was pregnant again, she booked in with the same obstetrician but at her eight week scan, she found out she was pregnant with twins, and her obstetrician refused to support a vaginal birth. So began Katelyn's informed pregnancy and birth journey, which led to changing care providers at 25 weeks. She takes us through this experience - the fear and doubt - but mostly the thorough understanding of twin birth, the faith she had in her own body and her determination to birth intuitively. She also discusses her challenging breastfeeding experiences in detail and really highlights the importance of having a lactation consultant by your side. This is a brilliant episode that's both informative and empowering. __________ Today's episode is brought to you by Bliss Birth. Bliss Birth is founded on the belief that women's bodies are incredible things, and that when it's safe, choosing natural options makes for the best outcomes for mums and babies. That's why Ariel has developed a range of products to support your natural birth experience. Introducing the most advanced natural pain management device for labour available in Australia – The Elle TENS Plus. TENS stands for Transcutaneous Electrical Nerve Stimulation and it is the ultimate birth tool as it maximizes your body's natural pain-fighting abilities. Bliss Birth offer both 4 and 8 week hire periods, Pre-addressed, prepaid return (No printer needed). The ‘Mama Bag' valued at $10.95 is yours to keep! You can enjoy 10% off Bliss Birth with the code ABS24. Head over to BlissBirth.com.auSee omnystudio.com/listener for privacy information.

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Sarah Wynn, Emma Baple, Lindsay Pearse and Naimah Callachand: How has a groundbreaking genomic discovery impacted thousands worldwide?

The G Word

Play Episode Listen Later Jul 31, 2024 38:08

In this episode, we delve into the impact of the new groundbreaking research uncovering the RNU4-2 genetic variant linked to neurodevelopmental conditions. The discovery, made possible through whole genome sequencing, highlights a genetic change in the RNU4-2 gene that affects about 1 in 200 undiagnosed children with neurodevelopmental conditions, making it more prevalent than previously thought. This discovery represents one of the most common single-gene genetic causes of such conditions. Our host, Naimah Callachand, Head of Product Engagement and Growth at Genomics England, is joined by Lindsay Pearse who shares her journey through the diagnosis of her son Lars. They are also joined by Sarah Wynn, CEO of Unique, and Emma Baple, Clinical Genetics Doctor and Professor of Genomic Medicine in the University of Exeter and the Medical Director of the Southwest NHS Genomic Laboratory Hub. We also hear from the 2 research groups who independently discovered the findings: Dr Andrew Mumford, Professor of Haematology at the University of Bristol Link to the research paper: https://www.nature.com/articles/s41591-024-03085-5 Assistant Professor Nicky Whiffin, Big Data Institute and Centre for Human Genetics at the University of Oxford Link to the research paper: https://www.nature.com/articles/s41586-024-07773-7 To access resources mentioned in this podcast: Unique provides support, information and networking to families affected by rare chromosome and gene disorders - for more information and support please visit the website. Connect with other parents of children carrying a variation in RNU4-2 on the Facebook group. "I think one of the things we really hope will come out of diagnoses like this is that we will then be able to build up more of that picture about how families are affected. So, that we can give families more information about not only how their child is affected but how they might be affected in the future." You can read the transcript below or download it here: https://www.genomicsengland.co.uk/assets/documents/Podcast-transcripts/How-has-a-groundbreaking-genomic-discovery-impacted-thousands-worldwide.docx Naimah: Welcome to Behind the Genes. Lindsay: So, this feeling that like we've been on this deserted island for eight years and now all of a sudden, you're sort of looking around through the branches of the trees. It's like, wait a minute, there are other people on this island and in this case actually there's a lot more people on this island. Yeah, it's very exciting, it's validating. It gives us a lot of hope and, you know, it has been quite emotional too and also a bit of an identity shift. Being undiagnosed had become quite a big part of our identity, and so now that's kind of shifting a little bit that we have this new diagnosis and are part of a new community. Naimah: My name is Naimah Callachand and I'm Head of Product Engagement and Growth at Genomics England. On today's episode, I'm joined by Lindsay Pearse whose son Lars recently received a genetic diagnosis, made possible by research using data from the National Genomic Research Library, Sarah Wynn CEO of Unique, and Emma Baple, a clinical genetics doctor. Today we'll be discussing the impact of recent research findings which have found a genetic change in the non-coding RNU4-2 gene, to be linked to neurodevelopmental conditions. If you enjoy today's episode, we'd love your support. Please like, share and rate us on wherever you listen to your podcasts. Naimah: And first of all, I would like everyone to introduce themselves. So, Lindsay, maybe if we could come to you first. Lindsay: Great, thank you. So, thank you for having me. I'm Lindsay Pearse, I live outside of Washington DC and I'm a mum to 3 boys. My oldest son Lars who is 8, he was recently diagnosed with the de novo variant in the RNU4-2 gene. Naimah: Thank you. And Emma? Emma: My name is Emma Baple. I'm a Clinical Genetics Doctor which means I look after children and adults with genetic conditions. I'm also a Professor of Genomic Medicine in the University of Exeter and the Medical Director of the Southwest NHS Genomic Laboratory Hub. Naimah: And Sarah? Sarah: Hi, thank you for having me. I'm Sarah Wynn, I'm the CEO of a patient organisation called Unique, and we provide support and information to all those affected by rare genetic conditions. Naimah: Great, thank you. It's so great to have you all here today. So, first of all Lindsay, I wonder if we could come to you. So, you mentioned in your introduction your son Lars has recently been diagnosed with the de novo variant. I wondered if you could tell us a bit about your story, and what it's been like up until the diagnosis. Lindsay: Sure, yeah. So, Lars is, he's a wonderful 8 year-old boy. With his condition, his main symptoms he experiences global developmental delays, he's non-verbal. He's had hypertonia pretty much since birth and wears AFO's to support his walking. He has a feeding disorder and is fed by a G-Tube. Cortical vision impairments, a history of seizures and slow growth, amongst other things. So, that's just a bit of a picture of what he deals with day to day. But he's my oldest child, so first baby. When I was pregnant, we were given an IUGR diagnosis. He was breech, he had a hernia soon after birth, wouldn't breastfeed. But all of these things aren't terribly uncommon, you know. But once he was about 3 or 4 months old, we noticed that he wasn't really able to push up like he should, and we were put in touch with early intervention services for an assessment. So, we went ahead and did that when he was about 4 or 5 months old. And as parents, we could just kind of tell that something was off from the assessors. And, you know, they were very gentle with us, but we could just get that sense that okay, something is off, and they're worried here. So, that kind of kickstarted me into making appointments left, right and centre with specialists. The first specialist that we saw was a neurologist. And yeah, again, that's another appointment that I'll never forget. She referred us to genetics and to get an MRI and some lab work but at the end of the appointment, she said to us, ‘Just remember to love your child.' And, you know, that was quite shocking to us at the time because it wasn't something that had ever crossed our mind that we wouldn't do or felt like we needed to be told to do this. But on the other hand, it certainly set off a lot of worry and anxiety of okay, well, what exactly are we dealing with here? So, fast forward, we saw genetics and that was about when Lars was about 8 months old. We went through a variety of genetic testing, a chromosomal micro-array, a single gene testing, then the whole exome testing. Everything came back negative, but it was explained to us that what was going on was likely an overarching genetic diagnosis that would explain his like, multi-system symptoms. And so meanwhile as he was getting older his global delays were becoming more pronounced and we were also in and out of the hospital a lot at this time. At first, he was in day care and, you know, any sort of cold virus would always turn into like a pneumonia for him. So, we were just in and out of hospital seeing a myriad of specialists, trying to put together this puzzle of what's going on and it was really hard to accept that nobody could figure it out. That was just, you know, sort of mind-blowing to us I guess. So, we applied for and were accepted into the Undiagnosed Diseases Programme at the National Institute of Health over here. The NIH as it's commonly referred to. So, we first went there when Lars was 2. He was one of their youngest patients at the time. But that was a really great experience for us because we felt like they were looking at him holistically and across a bunch of all of his systems, and not just seeing a specialist for sort of each system. So, we really appreciated that. We also did the whole genome sequencing through this research study. Although that also came back negative and so at that point, we were told to kind of keep following up symptomatically. Keep seeing the specialists and eventually maybe one day we'll find an overarching diagnosis, but that science just hadn't quite caught up to Lars. It was hard for me again to believe that and to sort of wrap my head around that. But certainly, it was an education from all of the doctors and geneticists and everyone we saw at NIH, to realise like how far there still was to go in terms of genetic research. How it wasn't also that uncommon to be undiagnosed in the rare disease community. I would say that being undiagnosed sort of became part of our identity. And it's, you know, it was something that, you know, you had to explain to like insurance companies and to his school, and it became part of our advocacy around him. Because without being able to say oh, it's this specific thing and if it was someone who hadn't met Lars before, trying to explain to them that, you know, yeah, within the range of this community you can be undiagnosed, and they just haven't found it yet, but I promise you there is something going on here. And I'd say the other thing too without a diagnosis you have no prognosis, right? And so, trying to figure out what the future would look like. Also, family planning. We waited 5 and a half years before we had another child and, you know, it was certainly an anxiety ridden decision. Ultimately after seeing as many specialists as we possibly could, we still were left with the same answer of well, we just don't really know if it will happen again. So, that was a big decision to make. But again, it just kind of became part of our identity and something that you did eventually accept. But I would say in my experience I feel like the acceptance part also of Lars' disabilities perhaps took me a little bit longer. Because again, I didn't have a prognosis, so I didn't exactly know what we were dealing with. Only as he has become older and, you know, you're sort of getting a better sense of what his abilities might be than being able to understand, okay, this is what I'm dealing with. I need to accept that and do what I can to care for him and our family in the best way that we can. Naimah: Thanks so much for sharing that, Lindsay. I feel like you've touched on a lot of really, you know, a lot of complications and difficulties for your family. Especially, you know, with regards to keeping hopeful and things about the prognosis as well, I'm sure it was really difficult. You've mentioned that Lars was able to be diagnosed recently due to recent research efforts. So, Sarah, I wonder if you can tell us a bit more about these and what the findings have meant for patients with neurodevelopmental conditions. Sarah: Yes. So, I think we know that there are lots of families that are in Lindsay and Lars' position where they know that there is almost certainly an underlying genetic condition, and it just hasn't been found yet. And so, I think we know that lots of researchers are working really hard to try and find those causes. I think over time we know that as time goes on and research goes on, we'll find more of these new genetic causes for neurodevelopmental conditions. I think particularly as we start to look at regions of the genome that we haven't looked at so much so far. But I think one of the things that's really extraordinary about this one is that actually it turns out to be much more common than we might have expected, for one of these new conditions that we haven't found before. But I think it's about one in 200 of those undiagnosed children with neurodevelopmental conditions, have this diagnosis so that's not a small number. That's not a rare finding at all actually, that's much more common than we could ever have anticipated. But I think one of the things that we do know is that as we look further and deeper into that genomic sequence, so, we've started off looking at the bits of the sequence that are genes that code for proteins. This changes in a gene that actually doesn't code for protein, so it's less obvious that it would be important but clearly it is important in development because we know when it has a spelling mistake in it, it causes this neurodevelopmental condition. But there will be as researchers look more and more at these kinds of genes, and also the other part of the genome that is not genes at all, we'll find out more and more the underlying genetic causes of these neurodevelopmental conditions. I think it's also really important to stress why this is so important to find these genetic changes and it's because families really need a diagnosis. Lindsay talked quite eloquently and a lot about that knowing something was off and really wanting to know the reason why. Getting these diagnoses might change care management or treatment, but actually really importantly it just gives an answer to families who have often been looking for an answer for a really long time. Naimah: I just wanted to go back to the point that Sarah made that actually this genetic change is relatively common. Emma, I wondered if you could tell us a bit more about maybe why it took us so long to discover it? Emma: That's an interesting question actually. I suppose the sort of slightly simplified answer to that question is we haven't been able to sequence the whole of a person's genetic information for that long. And so, children like Lars would have had, as Lindsay described lots and lots of genetic tests up until they had a whole genome sequencing which is what Sarah was talking about. The types of tests that we had up until the whole genome sequencing wouldn't have allowed us to look at that bit of the genetic code where this RNU4-2 gene can be found. So, we can only really find that using whole genome sequencing. So, before that existed, we wouldn't have been able to find this cause of developmental condition. Naimah: Okay, thanks Emma. Naimah: Now we're going to hear from one of the two research groups who are responsible for these research findings. First of all, let's hear from Nicky Whiffin. (Clip - Nicky Whiffin) Naimah: How were the findings possible using the Genomics England dataset? Nicky: So, most previous studies have only looked at genetic variants that, in genes that make proteins, but only a subset of our genes actually do makes proteins. The Genomics England dataset we have sequencing information on the entire genome, not just on these protein coding genes and that means we can also look at variants in other genes. So, those that make molecules other than proteins. And RNU4-2 for example, makes an RNA molecule. Naimah: These findings translated to direct patient benefit for patients like Lars who were able to receive support from Unique. How does this demonstrate the value of the dataset? Nicky: Yes. So, it was incredible that we could find so many patients with RNU4-2 variants so quickly. This was enabled by access to Genomics England data but also to other large sequencing datasets around the world. So, we worked with people in the US, in Australia and also in mainland Europe. These large datasets enabled us to spot consistent patterns in the data and by looking across multiple datasets we can also make sure that our findings are robust. When we realised how significant this was and how many families would be impacted, we very quickly contacted Sarah at Unique to see if we could direct patients to them for support. (End of clip) Emma: There's one thing I wanted to raise. It's important to recognise the way that was discovered was through the National Genomic Research Library that Genomics England hosts. To highlight the value of that, and the value of having this centralised resource where families have been kind enough really to allow their data to be shared with some limited clinical information that allowed these researchers to be able to pull this out. And I think it highlights the power of the National Health Service in that we were able to create such a resource. It's really quite astounding that we've found such a common cause of a rare genetic condition, and it wouldn't have happened in the same timescale or in this way without that resource. And then to just say that as Sarah talked about the fact that we've been able to get that information out there, also the researchers were able to get out there and contact the NIH and all of these other programmes worldwide. In Australia, America, everywhere in the world and quickly identify new patients who had this condition and get those diagnoses out really rapidly to people. But all that came from that power of sharing data and being able to have that all in one place and making it accessible to very clever people who could do this work and find these answers. It's so important for families like Lindsay's, and all the families in England and around the world that have got these answers. So, I guess it's a big plug for the value of data sharing and having a secure place where people feel that it's trusted and safe, that enables these diagnoses to be made. Lindsay: If I could just echo that, we're so grateful that that exists in the UK. Just acknowledging like the privilege here that we have had to be able to, I mean for our family in the US, that we've been able to, you know, get ourselves into the NIH study and into the study at Children's National. That takes a lot of work. I feel like not everybody has that opportunity to be able to spend the time to do these applications and to go to all the appointments and get the testing done and have the insurance to cover it. So, very grateful that the system exists in a way in the UK that made this sort of research possible. I just hope that that can be replicated in other places, and also to what Emma was saying earlier, come up with a lower cost test as well for this to further the growth of the community and of course then the corresponding research. Sarah: I think firstly we have to sort of thank all of those families that took part and do share their data, because I think it's not always clear why you might want to do that as a family. I think this is really a powerful example of the benefit of that. I also think the data sharing goes one stage further. So, it's partly about getting the diagnosis, but the data sharing going forward about how this condition impacts families, both clinically and sort of day to day lived experience, is how we'll be able to learn more about these conditions. And so, when families get this diagnosis next week or next year, not only will they get a diagnosis, but they'll get a really good idea about what the condition is and how it might impact their child. Naimah: And Lindsay, coming back to you. So, we've talked about, you know, what it meant for your family before the diagnosis, but what has it meant to have a diagnosis and how did you feel? And what happened whenever you received the diagnosis? Lindsay: Sure. Lars was again part of the NIH Undiagnosed Diseases Research study. So, once you attend this programme and if you are not diagnosed like at the end of your stay, they keep your details on file and you're part of this database at the NIH Undiagnosed Diseases Programme. So, if you're undiagnosed after your sort of week-long work up, your samples stay within the research programme. We were also part of a research programme at Children's National Medical Centre, the Rare Disease Institute. So, our samples were sort of on file there in their database as well. And so, at the end of March I was really quite shocked to receive a call from our long time and trusted geneticist at Children's National that they had found a diagnosis. It was quite emotional. I really kind of didn't believe it. I just kept asking, you know, ‘Are you sure? Is this it?' you know, ‘How confident are we?' Because I think in my head, I sort of always thought that we would eventually find a diagnosis, but I thought that Lars would be, you know, a 30- or 40-year-old adult. I thought it would be decades from now. Like I felt like for whatever reason we had to wait decades for the science to sort of catch up to him. So, we were very, very grateful. It felt very validating, I guess. I had always kind of had this intuition feeling that we were sort of missing something and it's more that the science just hadn't quite caught up yet. But, you know, it was validating to know that okay, Lars is not the only person in the entire world with this, it is something that is relatively common in fact within the rare disease community. That is also very exciting to me personally because I'm hopeful that that will lead more researchers to be interesting in this, given how, quote on quote, common it is. I've sort of been describing it as like a mass diagnosis event but also more so this feeling that like we've been on this deserted island for eight years and now all of a sudden, you're sort of like looking around through the branches of the trees. It's like, wait a minute, there are other people on this island ad in this case, there's actually a lot more people on this island. Yeah, it's very exciting, it's validating. It gives us a lot of hope. And, you know, it has been quite emotional too and also a bit of an identity shift. Because I spoke earlier about how like being undiagnosed had become quite a big part of our identity. So, now that's kind of shifting a little bit that we have this new diagnosis and are part of a new community. But yeah, we're just very grateful that the research had continued. And, you know, I think sometimes you sort of have this feeling of okay, our files are up on a shelf somewhere, you know, collecting dust and are people really looking at them? And actually, it turns out that the research was ongoing and yeah, we're just very grateful for that. Naimah: Thanks so much for sharing, Lindsay. It sounds like it's been a real rollercoaster of emotions for your family and I'm glad to hear that, you know, you've got some hope now that you've got a diagnosis as well. So, moving onto the next question. Emma, I wanted to ask you then, how will these findings improve clinical diagnostic services for those for neurodevelopmental conditions? Emma: So, you asked me earlier about why it had taken so long to find this particular cause of neurodevelopmental condition, and I gave you a relatively simple answer. The reality is one of the other reasons is that almost eight out of ten children and adults who have RNU4-2 related neurodevelopmental condition have exactly the same single letter spelling change in that gene. So, actually that in itself means that when researchers are looking at that information, they might think that it's actually a mistake. Because we know that when we sequence genetic information, we can see mistakes in that sequencing information that are just because the machine has, and the way that we process that data, it's not perfect. So, sometimes we find these little mistakes and they're not actually the cause of a person's problems, they're just what we call an artefact or an issue with the way that that happens. So, that is part of the reason for why it was tricky for us to know whether this was, or rather the researchers to know whether this was or was not the cause of this particular condition. But that in itself is quite helpful when we think about how we might identify more people who have this going forwards. Because unlike in Lars' case where we didn't know what the cause was and so we were still searching, and we didn't know where to look in the billions of letters that make up the genetic code to find that answer, we now know that this is really very common. It's unbelievably common. I think we didn't think we would be finding a cause of a rare genetic condition that was this commonly occurring at this stage. But the fact that it's just a single, it's commonly this one single change in the gene means that we can set up pretty cheap diagnostic testing. Which means that if you were somewhere where you wouldn't necessarily have access to whole genome sequencing, or a more comprehensive testing in that way, we could still be able to pick up this condition. And it's common enough that even if you didn't necessarily recognise that a person had it, you could still have this as part of your diagnostic tool kit for patients who have a neurodevelopmental condition. It's common enough that just doing a very simple test that could be done in any diagnostic lab anywhere in the world, you would be able to identify the majority of people who have this. Naimah: Now let's hear from the other research group who are responsible for these findings. Here is Dr Andrew Mumford. (Clip - Dr Andrew Mumford) Naimah: Why are these research findings significant? Andrew: It offers genetic diagnosis not just for a handful of families but potentially for many hundreds of families, who we all know have been searching often for many, many years for a genetic diagnosis. But actually, there are other gains from understanding how this gene causes neurodevelopmental disorder. We know that there's GRNU4-2 in codes, not a protein actually, but a small nuclear RNA which is unusual for rare, inherited disorders. It's a component of a very complicated molecule called the spliceosome which in turn regulates how thousands of other genes are regulated, how they're made into proteins. So, fundamentally this discovery tells us a lot about the biology of how the spliceosome works. We already know that some other components of the spliceosome can go wrong, and result in diseases like neurodevelopmental disorders. This gives us an extra insight and actually opens the door to, I hope, a whole load of more discoveries of genetic diagnosis possible from other components of this complicated molecule. Naimah: Your research group used a mathematical modelling approach. Can you tell me a bit about this, and what this means for other rare conditions, Andrew? Andrew: So, identifying relationships between changes in individual genes and different kinds of rare, inherited disease is notoriously difficult because of the volume of data that's involved and the need to be absolutely certain that observed genetic changes are actually the cause of different rare, inherited disease. So, applying statistics to that kind of problem isn't new. But what my collaboration group have achieved here, is to develop, actually developed some years ago a completely new approach to applying statistics to genetic data. We call that BeviMed and we've been working for many years on the genes in code that make individual proteins. Most rare disorders are caused by genetic changes in genes that make proteins. What this discovery comes from is actually we've applied the BeviMed statistical technique to genes that don't make proteins, they're non-coding genes. For example, genes that make small nuclear RNA, it's just like RNU4-2. What's unusual about the BeviMed approach is that it's very sensitive to detecting links between genetic changes and rare diseases, and it can detect statistical associations really driven by very, very small numbers of families. So, we apply it to datasets like the 100,00 Genomes dataset and identify associations using statistics that have got a very high probability of association. Other members of the team then seek to corroborate that finding by looking at if we can see the association in other datasets, and we certainly achieve that with RNU4-2. But also, assessing biological plausibility by investigating what we understand already about in this case, a small nuclear RNA, and how it can possibly result in a disease. And we normally try and employ other independent evidence such as experimental investigation. Or going back to our families and asking for additional data to help really test this sort of theory that changes in this particular gene have resulted in a problem with neurodevelopment. (End of clip) Naimah: Emma, are there any other ways that we can identify these conditions based on their clinical presentation? Emma: So, Lindsay and I were talking with you just yesterday, wasn't it? And I asked Lindsay about what sorts of things Lars had in common with other children and adults who have been diagnosed with this condition? I actually think Lindsay probably gives a better summary than I would, so I might ask you to maybe repeat what you said to me yesterday. But the bit of it that really stood out to me was when you said to us that a lot of parents have said, ‘I'm not sure how we weren't all put together in the first place because you notice so many things that were in common.' So, maybe if you can give that summary and then I can translate that back into medical terms, if that's okay Lindsay. Lindsay: Sure, of course. Yeah, it been again, kind of mind blowing, some of the similarities. Especially as we've exchanged pictures and such, and baby pictures especially where some of the children like look like siblings. So, definitely some similarities in facial features, you know, everyone seems to experience some of the slow growth, so a short stature or quite skinny. There's feeding issues also that seem to be quite common. Also, you know, things like the global developmental delays, that's certainly across the board and histories of seizures, that's also quite common. Some people have experienced also some, like, bone density issues, that's not something that we've experienced so far, but that also seems to be quite common. But then also, behaviourally, there's a lot of similarities which has been, I think, quite exciting to a lot of us because you've always thought okay, so this is just my child. And of course, some of that is true but it's also interesting to find out some of these other things that are, you know, are quite similar. So, a lot of people have mentioned their child having, like, an interesting sense of humour. Kind of like a very slapstick sense of humour which is quite interesting. Or everyone seems to love water, everybody loves swimming pools and bathtime, and all of that. Lars loves a windy day. Something about the wind, he just loves it and plane noises and things like that have also come up with other people. So, yeah, it's been really interesting and cool to see. Emma: So, I guess Lindsay's sort of very beautifully summed up what is written in the research publication. So, there's only two research publications so far on this condition, it's all really new. And I am definitely not claim to be a clinical expert on this condition, and I don't think there are any yet. It will take people time to see lots of children and adults who have this particular condition. But ultimately what Lindsay summarised was the common clinical features that have been described by parents. In my job as a clinical genetics doctor, part of what we look at is a person's appearance. So, Lindsay described the photographs of children particularly when they were little, looked very similar. In the photographs that I've seen, I would agree with that. And so obviously those children look like their mum and dad, but they have other features that are in common. They have a characteristic appearance and that helps doctors like me to have an idea as to whether a child or an adult might have a particular condition. Then put together with the sorts of information that Lindsay gave us around the low tone, so being a little bit floppier particularly when they're little. The slow growth and growth problems, problems with eating, also with seizures. Those are all common things that were pulled out of both of the two research publications on this condition and putting that all together into one picture helps doctors to have an idea whether somebody may have a particular condition. That would help us in this case to potentially request that simple test I was talking about, if maybe we were practicing in a part of the world where we wouldn't have the resources that we thankfully do have in the United Kingdom, and in the USA. Naimah: So, Sarah, just coming to you next. How does this research spread awareness and help other patients with these conditions? Sarah: So, I think one of the things that's been really great about research now is that we are able to, you know, social media and things like that mean that we can spread this information really quickly across the world basically. I think what that does is that as well as helping bring people together that they've got this diagnosis, what it does is I think it provides hope for all of those people that Lindsay was talking about at the beginning who don't have a diagnosis. So, that piece around people are still looking, the researchers are working hard and that even if you don't have a diagnosis today you might get one in the future. Lindsay talked about your sample being dusty and not being looked at. I think it gives lots of families, not just those that get this diagnosis but all of those that haven't got a diagnosis, hope, that hopefully in the future they will get a diagnosis. I think one of the things we really hope will come out of diagnoses like this is that we will then be able to build up more of that picture about how families are affected. So, that we can give families more information about not only how their child is affected but how they might be affected in the future. That prognosis information that Linsday said is really missing when you don't have a diagnosis. And I think the other thing that hopefully is the next stage in this journey with this discovery is that those two science publications that Emma talked about, what we will want to do here at Unique working with the researchers and those families that have got a diagnosis, is to produce a patient family friendly information leaflet about this condition. One of the things we know is really important about those patient leaflets is including the photos. Because as both Emma and Lindsay have said that idea that they have facial features in common. And so, if you look at a leaflet and you can recognise your child in it, and you can see others that look like it, that can be a really sort of quite heartwarming experience in what often is a lonely experience with a rare condition. Naimah: And I think kind of on that point about it being a lonely experience, I wondered Lindsay if you could talk a bit more if this research has allowed you to connect with other parents and families who have received a diagnosis, and what impact that's had on your family? Lindsay: Yeah. I mean, and I think everything that Sarah has said was spot on. It's wonderful to have resources like Unique to connect families and have those diagnoses on the platform, so other clinicians can look for it and sort of grow this group. I think that has definitely been the highlight of getting this diagnosis at this stage, right. Because there's not much more you can do with it, with someone so brand new so being able to connect with the other families has been wonderful. One amazing mum who with this diagnosis set up a Facebook group, RNU4-2 Family Connect. And, you know, it's just been amazing to see people from all over the world joining this as they receive this diagnosis, you know, sharing their stories. We've spent countless hours on the weekends over the past couple of months on Zoom calls with total strangers, but just you find that you can just talk for hours and hours because you have so much in common. It's great to see what has worked well for other families and, you know, what has not worked. Sharing resources, just kind of all learning together. Also seeing the spectrum of this diagnosis, I think most genetic disorders have a spectrum and this seems to be the same here. So, that's been very interesting. And of course, our son is 8, Lars is 8. There's now a 33-year-old and a 29-year-old in the Facebook group. Speaking for me personally it's just amazing to see them and like it's very cool to see where they're at. That sort of helps you answer some of those questions about that before were quite unknown when you were thinking about the future. Obviously, everybody's development whether you have a genetic disorder or not, it is going to be what it's going to be, and everybody is going to do their own thing. But being able to see what a path might look like is just so helpful. And, you know, we all want community and connection, and so this has been really, really great to have that now. Sarah: I don't think there's much more that I can add because Lindsay articulated so well. But it's really heartwarming for us to hear the benefits of those connections because that's really why Unique and other support groups exist. Is to provide, partly to provide information, but I think predominantly to put families in touch with other families so that they can find a new home and connect and share experiences. And, you know, stop feeling as alone as they might have done before. Naimah: Okay, we'll wrap up there. Thank you to our guests, Lindsay Pearce, Sarah Wynn and Emma Baple for joining me today as we discussed the research findings which found a genetic change in the RNU4-2 gene which has been linked to neurodevelopmental conditions. If you'd like to hear more like this, please subscribe to Behind the Genes on your favourite podcast app. Thank you for listening. I've been your host and producer, Naimah Callachand, and this podcast was edited by Bill Griffin of Ventoux Digital.

When TFMR is for YOUR health. Marie-Laure shares how she lost her baby Juliette to early onset preeclampsia.

Our TFMR Stories

Play Episode Listen Later Jul 22, 2024 73:07

When TFMR is for YOUR health, also called Termination for Maternal Health or Termination for the Pregnant Person's Health, it can bring an extra layer of survivor's guilt. Marie-Laure shares how she lost her baby Juliette to early onset preeclampsia with severe features and IUGR (intrauterine growth restriction). Her symptoms became more pronounced around 22 to 24 weeks pregnant. She shares the roller coaster of her illness and diagnosis and end of the pregnancy with Juliette. TFMR for maternal health can feel less represented in the ending a wanted pregnancy space - let's talk about it! You can also find out more about Marie-Laure and follow along with her story and get support at She Isn't a Taboo instagram page https://www.instagram.com/she_isnt_a_taboo/ Resources mentioned:1. The TFMR Support Circle, our free Facebook group for termination for medical reasons (TFMR) parents. Apply to join here: https://www.thetfmrdoula.com/facebookgroup 2.The TFMR Doula instagram page www.instagram.com/thetfmrdoula Grief circle info: If you are a bereaved TFMR parent looking for group grief support, I invite you to check out our upcoming grief circles starting in August 2024 https://www.theTFMRdoula.com/ascend-apply And if you would like to share your TFMR Story on "Our TFMR Stories," email me here to find out more: sabrina at theTFMRdoula dot com Music clip:Pamgaea by Kevin MacLeodLink: https://incompetech.filmmusic.io/song/4193-pamgaeaLicense: https://creativecommons.org/licenses/by/4.0/

health babies lost kevin macleod taboo termination maternal health preeclampsia marie laure early onset iugr tfmr pamgaea

492: Finding Your Midwives and Releasing Fear with Marissa Olivera (DIAH Classic)

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Play Episode Listen Later Jul 7, 2024 47:27

Marissa is a mom of 2 from Utica, NY, with both a hospital and home birth story. Marissa experienced intrauterine growth restriction (IUGR) with her first pregnancy. That, along with some early signs of labor made for a hospital birth that included a lot of intervention and fear. The way she sees it, baby Maxwell just wasn't ready yet. She planned for a home birth again with baby number two, Miles. With positive reinforcement from resources like Ina May Gaskin and Birth Without Fear, Marissa went into her second birth tuned in to her intuition and gut feeling (and we're not just talking about the contractions!). Marissa's candor and detail with her birth stories compels you to listen and engage. She's a great example of how to plan the birth you're intending to create - like finding midwives even when you're far away from a big city with more options. We even get a little cameo from surprise guest Maxwell! Links From The Episode: Marissa's blogpost on her home birth - http://myeggiscracked.blogspot.com/2015/08/the-story-of-miles.html Birth Without Fear - http://birthwithoutfearblog.com/ Ina May Gaskin - http://inamay.com/ Offers From Our Awesome Partners: Needed: https://bit.ly/2DuMBxP - use code DIAH to get 20% off your order Splash Blanket: https://bit.ly/3JPe1g0 - use code DIAH for 10% off your order Esembly: https://bit.ly/3eanCSz - use code DIH20 to get 20% off your order More From Doing It At Home: Send us your birth story: https://bit.ly/3jOjCKl Doing It At Home book on Amazon: https://amzn.to/3vJcPmU DIAH Website: https://www.diahpodcast.com/ DIAH Instagram: https://www.instagram.com/doingitathome/ DIAH YouTube: https://bit.ly/3pzuzQC DIAH Merch: www.diahpodcast.com/merch Give Back to DIAH: https://bit.ly/3qgm4r9 Learn more about your ad choices. Visit megaphone.fm/adchoices

910| Unmedicated 3rd Birth – IUGR, Coronary Heart Disease, and 70 Days in the NICU - Chelsey Demory

birth nicu kyo unmedicated coronary heart disease iugr

Play Episode Listen Later Jun 25, 2024 78:30

Links: Visit babypeek.com/birthhour to request access to the revolutionary genetic test that unveils your baby's potential traits as early as 10 weeks gestation. Know Your Options Online Childbirth Course (code 100OFF for $100 off) Beyond the First Latch Course (comes free with KYO course) Become a Birth Hour Patreon member for amazing perks!!

Maria: Self-Advocacy for Induction Rather than C-Section, IUGR, Rare Diagnosis

The Golden Hour Birth Podcast

Play Episode Listen Later Jun 24, 2024 49:15

Send us a Text Message.In this powerful episode, Maria shares her incredible birth story that defied medical expectations. Faced with a low-weight baby and pressure for a C-section, Maria advocated fiercely for her desired natural birth. Her journey takes an unexpected turn when her newborn receives a rare genetic diagnosis - Wolff Hirschhorn syndrome. Listen as Maria recounts her experience of navigating medical challenges, trusting her instincts, and ultimately finding joy and purpose in her unique motherhood journey.Inspired by her experience, Maria created the app "Natural Birth by Ecco," offering quick, easy tips for labor and delivery. This episode is a testament to the power of self-advocacy in birth, resilience in the face of unexpected diagnoses, and the transformative nature of unconditional love.Don't miss our exciting announcement! Our new course, "Reclaim Your Birth Story," is now available. For local listeners, join our live workshop and use code WORKSHOP for a 30% discount this week. Get a sneak peek of the course through the link in our show notes.Whether you're pregnant, planning to be, or simply interested in inspiring birth stories, Maria's account offers valuable insights and hope. Tune in to be inspired, learn how to advocate for your own birth experience, and discover helpful resources like Maria's app.Connect with Maria on Instagram HERE and check out her amazing app!Check out our new course and get a free sneak peek HERE and get live workshop info HERE!

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Metabolic mysteries: A treatable condition masquerading as TORCH Infection

JIMD Podcasts

Play Episode Listen Later Jun 5, 2024 3:05

Dr Vykunta Raju K N, Professor of Paediatric Neurology discusses a child presenting with IUGR, microcephaly, cataracts, developmental delay, seizures, and cerebral atrophy. L-Serine Biosynthesis Defect: A Treatable Condition Masquerading as TORCH Infection Vykuntaraju K. Gowda et al https://link.springer.com/article/10.1007/s12098-024-05181-3

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33 | Laura - birth trauma, PTSD, insomnia, panic attacks, Hospital in the Home (HITH), medication, talk therapy, occupational therapy, birth debrief

Perinatal Stories Australia

Play Episode Listen Later May 13, 2024 54:16

After experiencing birth trauma and the isolation of becoming a first-time mother during the pandemic, Laura was both excited and determined that her next pregnancy, birth, and postpartum was going to be different. The experience with her daughter, Millie, was going to be her ‘redo'. Unfortunately for Laura, re-experiencing fetal growth restriction (IUGR) and a precipitous labour broke her. Flashbacks, insomnia, panic attacks, and depression immediately hijacked her second postpartum and left her feeling more hopeless and alone than ever before - an undoing, rather than a redoing. As Millie turns one, Laura and I sit down to reflect on the year that was: the pervasive way that birth trauma impacts our parenting, the incredible and not-so-incredible supports that Laura was able to lean on, the challenges of navigating a mental health system that's not neatly designed to accommodate the logistics of parenting an older child, and the moments Laura can now enjoy with her daughter thanks to the help she did receive. This is Laura's story - a story about reflection and rebuilding - and it isn't one to miss. EPISODE SPONSOR This episode is proudly brought to you by Tommee Tippee Australia. Tommee Tippee knows that for every newborn baby, there's a newborn parent too. Tommee Tippee was founded over half a century ago, born from a mission to make life easier for parents. For decades they've been designing products that enhance a parent's intuition, and engineering solutions to make caring for babies easier, simpler, and more instinctive. You've got this, we've got you. Visit the parent library at tommeetippee.com.au to find expert advice that empowers your intuition. Sign up to become a VIP (a very important parent!) and get 15% off your first order. FOLLOW the podcast on Instagram and Facebook @perinatalstoriesaustralia for more maternal mental health stories, education, advocacy, and community. PLEASE leave a review or rating on your favourite apps or consider buying me a coffee (well, preferably a tea!) :) VISIT the website perinatalstoriesaustralia.com to share your story or to see more content from the podcast guests. MADE WITH LOVE by Rebecca (host, founder, storyteller) x

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Multiple Birth Awareness Month: A Mother's Journey Through Infertility, Twin Pregnancy, the NICU, and Beyond

Empowering NICU Parents Podcast

Play Episode Listen Later Apr 30, 2024 46:14

Dive into the inspiring journey of Deidre, a mom of twins, on the latest episode of the Empowering NICU Parents' Podcast!

478: Natural, Holistic, Spiritual Approach to Birth, Plus Dealing with IUGR with Amy Zhou (DIAH Classic)

Play Episode Listen Later Mar 21, 2024 63:26

How do you prepare for birth beyond the physical factors? Today's guest is Amy Zhou, a certified Health Coach and Medicine Woman who specializes in teaching women (and men) how to heal their body, mind and spirit naturally at home. She's also a new mama to her son Nathaniel, who is three and a half weeks old at the time we recorded this episode. We cover a lot of great things with Amy. For starters, she gave birth in the exact days the situation of COVID-19 dramatically shifted and accelerated in the United States, and specifically in her area of Los Angeles, California. According to Amy, it was like the world was a certain way when they entered the hospital, and then completely different when they emerged. So we chat about initial postpartum during an interesting time in the world and how she's processing that. We also hear about Amy and her husband Ed's preparation process for the birth experience. Their internal spiritual work was vital. Particularly when some challenges popped up, like an IUGR diagnosis (intrauterine growth restriction). This meant there were concerns about baby Nathaniel's small size and how that could impact possibly inducing Amy before her due date. And bonus - Amy shares some of her gifts and expertise with listeners and leaves some tips for pregnant mothers both from her own experience as well as her extensive training and coaching. Links From The Episode: Amy's website: https://www.amyzhou.com/home Offers From Our Awesome Partners: Needed: https://bit.ly/2DuMBxP - use code DIAH to get 20% off your order Splash Blanket: https://bit.ly/3JPe1g0 - use code DIAH for 10% off your order Esembly: https://bit.ly/3eanCSz - use code DIH20 to get 20% off your order More From Doing It At Home: Send us your birth story: https://bit.ly/3jOjCKl Doing It At Home book on Amazon: https://amzn.to/3vJcPmU DIAH Website: https://www.diahpodcast.com/ DIAH Instagram: https://www.instagram.com/doingitathome/ DIAH YouTube: https://bit.ly/3pzuzQC DIAH Merch: www.diahpodcast.com/merch Give Back to DIAH: https://bit.ly/3qgm4r9 Learn more about your ad choices. Visit megaphone.fm/adchoices

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#255 | What's Up with Intrauterine Growth Restriction: An Off-the-Record-Style Conversation with Dr. Stu Fischbein

conversations growth work care speak style birth restriction off the record vbacs intrauterine iugr fischbein stuart fischbein

Play Episode Listen Later Mar 6, 2024 60:21

In this episode, we welcome back Dr. Stu Fischbein for his third appearance on Down to Birth Show. We start the conversation by catching up on some of the latest problems occurring on the birth scene including VBACs, aspirin in pregnancy, the monetization of birth, late pregnancy ultrasounds, big babies, and due dates, before we get into the meat of the episode on Intrauterine Growth Restriction (IUGR). Dr. Stu shares a letter from one of his followers regarding her IUGR diagnosis resulting in an induction at 37 weeks for a 4-pound 14-ounce baby, which launches into a conversation around what IUGR is anyway and the actual risk of IUGR. Would that baby have been better off staying in utero for a few more weeks? How can you know postpartum if the baby was in fact IUGR? There are so many nuggets of great information dropped throughout this episode. You don't miss this one! And for more with Dr. Stu, catch episodes #111 & #128.Dr. Stu Fischbein & Birthing InstinctsDr. Stu on Instagram#128 | Vaginal Breech Birth with Dr. Stu of Birthing Instincts: Why It's Safer Than you Think#111 | The Obstetric Model of Care vs. the Midwifery Model of Care: Interview with Dr. Stuart Fischbein, MD**********Down to Birth is sponsored by:DrinkLMNT -- Purchase LMNT with this link today and receive a free sample kit.Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Optimal nutritional products to nourish yourself before, during, and after pregnancy Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Episode 277 Clair's VBA3C + PPROM + Close Pregnancy Duration

Play Episode Listen Later Feb 21, 2024 51:55

Happy podcast Wednesday, Women of Strength! You do NOT want to miss today's episode. Clair shares her beautiful journey to a VBA3C. After fully dilating and pushing for hours but ultimately ending in C-sections with her first three babies, Clair finally had the vaginal birth she so badly hoped for with her fourth! Clair shows just how powerful birth can be when a woman's intuition is combined with informed consent and an open-minded birth team. There were unfortunately some technical difficulties during this episode and part of Clair's third birth story was not recorded. Clair graciously submitted this written account below.24:08 “With my third baby (attempted VBA2C), I dilated quickly and smoothly, baby was descending beautifully, and I started feeling like it was time to push. I pushed for a long time - a couple of hours - and he was coming down, but slowly. We tried many different positions, moving around, etc… but it was taking a while. Looking back, I was having some back labor and it's likely that when my water broke on its own, he dropped into a posterior position. After several more hours, we could see his head! I thought a VBAC might really happen! But baby's heart rate started having decels and having a hard time coming back up, so we decided to transfer to the hospital for monitoring. I was pretty exhausted by that point, so I was hoping that IV fluids would help me regain strength and keep going. When we got to the hospital, however, they would only let me labor in the operating room because I was a VBAC patient, so I was very limited in mobility and my options. Baby seemed stable, but they were basically prepping for surgery from the moment I walked in the door and wouldn't tell me baby's stats. We eventually called it, opting for a C-section on our terms so we could have delayed cord clamping and a calm environment. Baby boy was almost 10 pounds and had very healthy APGAR scores! I was disappointed I didn't have a VBAC, but I felt respected by my midwife the whole way through. Postpartum physical recovery was difficult, but emotionally this birth was much less traumatic because I had a supportive birth team. I also took two intentional weeks to do nothing but be with the baby and rest, which I hadn't done with my previous two births, and that made a huge difference in my mental health and bonding with my baby!”Additional LinksNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Time Stamp Topics01:56 Review of the Week04:30 Clair's first pregnancy and birth 07:50 Recovering from a C-section while moving 09:24 Getting pregnant at 3 months postpartum & dual care during COVID14:39 Laboring at home to complete & hospital check-in17:49 Clair's second Cesarean19:08 An emotional recovery23:38 Third labor with a home birth midwife24:08 Pause in story – read caption!24:20 Fourth pregnancy 28:49 Moving to Utah 35:34 Midwifery care in the hospital38:47 Active labor begins45:04 Circumvallate placenta Meagan: Hello, hello Women of Strength. We are at the end of February here and we have a story that I swear– VBAC after multiple Cesareans is very highly requested when it comes to this community so we have a story for you guys today for VBAC after three C-sections. Not only was it a VBAC after three C-sections, but it was also a pre-term VBAC after three C-sections. I think in a lot of places around the world if someone came in pre-term and they have had three C-sections, finding that support is going to be hard. It doesn't need to be necessarily hard, but I know that it can be so I'm excited for this story from our guest, Clair, today because it's a story that just shows that it is possible even if you have certain things stacked against you that the medical world looks at in a negative way. 01:56 Review of the WeekSo we are going to be sharing that story here in just a few minutes, but of course, we have a Review of the Week and this was shared on Apple Podcasts. It's by brittleesmith. It says, “Highly recommend for both VBAC mamas and mamas in general.” It says, “In 2019, after 30 hours of labor, I ended up birthing my son via unplanned C-section. I was devastated and knew my future birth had to be different. I immediately started digging into VBAC resources and came upon your podcast. I listened to every single episode before I even became pregnant with my second baby. The knowledge I gained from both of you as well as your many guests is truly invaluable. This resource is great for any expectant parent, not just VBAC moms and I wish I had discovered you all before my first child. “I am thrilled to announce that I got my VBAC this past February and I owe a lot of thanks to y'all. Keep it up, ladies.” Oh, I love that. I love when people say, “We found you. We learned and then we got our VBAC,” or “We found you. We learned and I didn't get my VBAC but I had a better experience.” This is what this podcast is here for to help people have a better experience, to learn the information, to feel more empowered to make the best choice for you, and even sometimes when the experience doesn't go exactly as we planned, to still have a better experience because we know what our options are. As usual, if you guys have not left a review, we would love them. They actually help Women of Strength find this podcast. They help people find the information and the empowerment for their births, do drop us a review. You can leave it at Apple Podcasts. You can even Google “The VBAC Link” and leave us a review there or wherever you listen to your podcasts, drop a review. 04:30 Clair's first pregnancy and birth Meagan: Okay, cute Clair. It's been so fun. I just was scanning over your stuff and I was just excited because of all of the people you had at your birth, I know personally because you are also here in Utah. I'm so excited to hear your whole story and your journey. I just want to tell you congrats in advance because it is so amazing. So amazing. Clair: Thank you so much. Yeah. We didn't expect to be in Utah, but it turned out to be a really great place to birth so we are really grateful to be here. My story actually starts on the East Coast thousands of miles away and I was due with my first in May 2019. I didn't really know much about birth in general. I'm the oldest child and kind of a rule follower. I was like, “Well, if I just do everything the way I'm supposed to, then birth will just happen.” Yeah. I had a really supportive OB. He has several children of his own. His wife was a friend of mine. He was a really great doctor. But at around 32 weeks, I was flying at the last possible second I was allowed to fly and running through an airport. I kind of felt the baby kind of settled in a weird spot after that. I started having prodromal labor at 39 weeks or something. That went on for about two weeks. What I didn't realize was that these were all signs that maybe he was posterior and not in a great position. My OB, even though he was really wonderful, wasn't trained to determine where the baby is, just that the baby is head down. Meagan: Right. Clair: So at 41+1, early in the morning, I was over a week past my due date. I was losing my mucus plug. “Hey hon, we're going to have a baby today.” I was so excited. We ended up laboring all day at home. We went to the hospital. I had really, really bad back labor so I ended up with a lot of IV fluids. I had a couple more interventions. They broke my water eventually and basically, what ended up happening was that 41+2, so 9 days after my due date, I had dilated to complete, but the baby wasn't dropping at all. He wasn't engaged. He was still really, really high and after a while, his heart rate wasn't tolerating labor well anymore and they recommended a C-section. Meagan: Did they have you push? Clair: I didn't push. Yeah. They said he was still too high. They didn't recommend that. Meagan: Interesting. Isn't that how we get babies down? Clair: Yeah. I'm not really sure. Meagan: Yeah. Yeah. Clair: It definitely was a situation he was not used to or prepared for. He was kind of surprised and honestly very sad that I didn't have the birth experience that I wanted. He came to visit the next day and just spent a few minutes with us. His wife came to visit who I was friends with. It was really hard and pretty traumatic, but it also could have been much worse. His bedside manner, I was really well taken care of. 07:50 Recovering from a C-section while moving So that was really hard. It was a challenging physical recovery because I had 48 hours of labor and most of it was without an epidural. It was really intense. The hardest part of that birth was that the first time I saw my son, I saw a picture of him that the nurses showed me because they took him away to be measured right away. So that was really hard. He was 9 pounds, just that plus not being in a great position and being with a provider that didn't have a lot of options of what to do if baby is not descending properly. That was a difficult adjustment to motherhood especially because that baby was born in Louisiana. We were moving back to Virginia where we have a lot of family and friends. We were planning on moving two weeks after the baby was born, but because he came late, we actually left the hospital and started driving north. I would not recommend this. Don't do it. Meagan: That's a lot. That's a lot. Clair: It's a really bad idea. Meagan: Oh my gosh. Clair: His first night out of the hospital was in a hotel in Birmingham, Alabama. Yeah, don't do it. So yeah, that was just hard because we were moving and I'm trying to physically recover. So it was pretty wild. 09:24 Getting pregnant at 3 months postpartum & dual care during COVIDClair: That was my first. My second– we surprise got pregnant three months after that baby was born. Meagan: Okay. Clair: He was a cycle zero pregnancy. I had no idea. I just felt off and was like, “Maybe I should take a test,” and I was so shocked that I was pregnant. Meagan: Oh my gosh, yeah. Clair: Like I said, we were in a new state. I found a birth center that would do my prenatal care because I knew midwives knew more about positioning and how to track it and maybe had some recommendations about things they could do to encourage baby to be in a better position because my pregnancy had been great. But because it was right around 12 months between deliveries, they wanted me to have co-care and deliver at a hospital. I kind of just took their word for it like, “Oh, well if that's what they are recommending, then the risk really must be that much higher.” So then in the middle of all of this, COVID happened and hospitals– I was due in May 2020. Hospitals were kind of changing their– Meagan: Everything. Clair: Yeah, but by the week it felt like. Meagan: By the day. They were changing by the day. It was insane. Clair: Yeah. It was crazy. So it was March. I was due in two months and I had just reached out to the birth center basically begging them to let me deliver out-of-hospital because I was like, “I don't want to deal with the hospital system right now. I know that they are truly supportive,” but they said that they weren't comfortable with that. So my plan was to labor at home with the midwife from the birth center, laboring home with me then to transfer to the hospital while I was in labor. She was supposed to be– that midwife was supposed to come with me as kind of like a doula almost in the hospital just as support. Meagan: Yeah. Yeah, a monitrice or whatever they call them. Clair: Yeah, yeah, exactly. So then I had to find a doctor to do co-care with. I had a new friend in the area who had a C-section with her first and she had a not-great experience with this one doctor in the area, but that was the one that the midwives usually worked with so I kind of took her experience as, “Maybe not. I don't want to work with him.” I found someone else who was really VBAC-supportive historically, but then he had me do an ultrasound to determine scar thickness. This was all in the third trimester. Pregnancy was going really well, but in the third trimester, I had to start doing my appointments with him. Baby was actually breech pretty late on, so I started doing chiropractic care during that pregnancy and she flipped on her own. It was great. I was so grateful. So then at that ultrasound, we determined that yes, she is head down. He was concerned about my scar thickness, although then I did a lot of research and was like, “I'm just not sure that this is actually evidence-based.” Meagan: Yeah. Clair: And then also, they were telling me that she was going to be 12 pounds. I carried a big baby a year before, literally to the day almost and I was like, “This feels just like my first. She's got to be around 9. I don't think she is that much bigger than he was.” Meagan: Was the ultrasound saying 12? Clair: Yeah, yeah, yeah, yeah. Meagan: Okay, okay, okay. Clair: Yeah. The ultrasounds measured it and I mean, spoiler alert– it turned out to be way off. She was 9 pounds, 3 ounces. Meagan: Most of the time it can be. Clair: Yeah. Yeah, especially with bigger babies later in pregnancy. I was in a fine headspace with that. I was like, “I know that this can be off. I'm not worried about it,” but they were really nervous and anyway, basically backed me into scheduling a C-section, but I pushed it as far down the due date path as I could because I had gone over with my first and I still really wanted a chance to labor. So chiropractic care this whole time was really helping. I had bad hip pain with my first and I didn't have any with her after that. They wanted to do another scan at 41 weeks later or another ultrasound at 41 weeks just to check on baby, but I got them to do a non-stress test instead because I was like, “What are we going to look at?” She was healthy at 40 weeks. I was really glad that I had advocated for myself there because that was good. I did have one funky day of pre-labor at 40 weeks where I really thought I was going into labor. It was early labor then it stopped. I was checked after that and I was at 4 centimeters. I was walking around for a week and a half it turned out to be at 4 centimeters dilated so it was kind of interesting to know that that could happen. Meagan: Yes. Clair: The midwives I was with said they see that with VBACs a lot too that the body just takes things slower sometimes which was interesting to hear their experience of that. 14:39 Laboring at home to complete & hospital check-inBut yeah, I went into labor at 41+3– or 41+2 I guess– which was when my son was born a year before. I was in early labor all day. My water broke as I was nursing my one-year-old for bed. Meagan: Oh my gosh. Clair: It was kind of crazy and exciting. I was like, “You're going to meet your sister.” I put him down for sleep. The midwife came over. I labored from a 6 to a 10 in three hours. By 9:00 PM, I was fully dilated. She was dropping. At that point, looking back, I wish I had just stayed home because she was almost born at that point, but I didn't because I still had the midwife's voice in the back of my head, “Oh, it's only been a year. You're at a higher risk for rupture.” I just was worried and at that point in labor is not the time to be making decisions like that. Meagan: You're very vulnerable. Clair: Yeah. We ended up transferring. I get to the hospital. They stick a thing up my nose to check if I have COVID. Meagan: Oh jeez, yeah. Clair: So you're in labor already really uncomfortable and they're like, “We're going to swab your nose.” You're like, “Thanks.” They wouldn't let the midwife in which we kind of knew, but she came with us just to see if they would let her in, but they were only allowing one support person so my husband came with me.I ended up getting an on-call doctor who wasn't the doctor that I had been seeing. It actually turned out to be the first doctor that I was trying to avoid in the first place. Meagan: Oh, really? Clair: Yeah, so that I was not happy about. He literally takes one look at my chart and says, “A VBAC? This baby is going to be 12 pounds? Don't even bother trying.” I was like, “Um, okay.” Meagan: You're like, “But I'm 10 centimeters.” Clair: Right. Everything is fine. I'm healthy. She's healthy. Heart rates are all good. We're doing it. It's not a question of can I because it's happening. But he started– I mean, I won't tell you the things he was telling me about what happens if I should have had a C-section and I don't and the whole dead baby thing. The nurses were trying to keep him out of the room for me. It was so bad. It turns out later that he did talk to the midwives the next day and was like, “Why did you send her in at all? Why did you tell her she could VBAC?” Basically, he confided in them, “You don't know what it's like to be sued.” I guess he had something in his past where he had been sued for something that had happened, so he was just really scared but he was taking that out on me. Meagan: Which is not okay. Understandable, but not okay. Clair: Right, yeah. It took a long time for me to get over this and forgive him for some of the things that he said. Anyway, so my body starts having a stress response. Labor starts slowing. My cervix starts swelling a little bit. Basically, my body is like, “We don't feel safe here. We're not having this baby here.”17:49 Clair's second CesareanI did push for two hours, but contractions weren't really working the same way. He started talking about, “Well, if it's an emergency, we have to put you under general,” and all of this stuff so I did end up getting an epidural. I basically got backed into a corner and eventually, we said, “Let's just call it and have the C-section because we can do it on our terms and maybe get a couple of the things we still want.” We really wanted delayed cord clamping. I really wanted to be able to see her right away which I didn't get to do with my son. So we felt like if we just called it, we would be able to do some of those things because it wasn't an emergent situation. So really, for no medical reason, I had my second C-section. She was 9 pounds, 3 ounces and the doctor actually said to my husband after that, “Oh, by the way, your wife has a fine pelvis. There is no reason she can't birth vaginally. She can totally do this again in the future.” Meagan: Oh gosh. Clair: My husband was like, “I don't want to talk to you right now about that.” Meagan: Yeah, like get out of my face. Clair: Yeah, after you just did what you did and backed us into surgery, and he just wanted to be able to control the situation. Meagan: Yeah. 19:08 An emotional recoveryClair: So emotionally, it was really hard to recover from that. I had a really hard time just working through some of the things that he had said and the images he put in my mind, but it was physically a lot easier. Meagan: Yeah. Clair: We did move again after that baby, but we only moved within the state so that was easier. We move a lot and we've moved with every baby at some point which is kind of crazy. 21:22 Clair's third pregnancySo that's my second baby. And then about, I don't know, 15 months later, we got pregnant with our third. We were pretty excited. We had a really early, early miscarriage between those two and it was still really hard and painful but it was like the day after we found out we were pregnant so that was a surprise and that made us think, “Well, are we ready for another baby?” I kind of just started like, “Yeah, actually I think we are,” even though at the time, I felt totally overwhelmed. So that's kind of beautiful because if we wouldn't have had that baby, we wouldn't have our third right now. We were in the same state. The VBAC laws in the state are pretty lenient so I end up having the opportunity to find a home birth midwife because I just at this point really did not want to go back to the hospital after everything. There really weren't any hospital practices that I knew of and I kind of looked around a lot that were VBAC-after-two-C-sections supportive. So I look around. I found a home birth midwife. I had a beautiful pregnancy. Kind of in the back of our head the whole time, we were thinking, “If we just stayed home with our daughter, things would have happened naturally. It just would have been fine.” The whole pregnancy, I was a little bit nervous, but I had some really, really awesome supportive friends– the same friend who had a C-section and had a VBAC since then. She was so in my corner and another good friend of ours were just cheering me on the whole time. My midwife was really, really supportive. I did have some fears and worries, but I was just like, “We're just going to walk it out. I have no reason to believe I can't birth this baby vaginally.” I was continuing chiropractic care. The friend who had a VBAC had since become a doula. I planned on having her there. 23:38 Third labor with a home birth midwifeClair: I went into labor six days after my due date after this pretty beautiful, smooth pregnancy in the early morning and then again, I was dilated to 10 by 9:00 in the morning. It was five hours later after my–Meagan: You labor beautifully. Clair: Right. At this point, I was like, “I know my body can do this,” but I just had never made it all the way. I was starting to feel pushy. I pushed for hours and hours and hours which turned out to be really hard. The midwife, when I started pushing was like, “We're going to have a baby so soon,” and then– 24:08 Pause in story – read caption!24:20 Fourth pregnancy Clair: My son was nine months old when we got pregnant with our fourth. Like I said, we had moved to this mountain town in Colorado. We were far away from a lot of things, so it was really hard for me to find a provider in general let alone one who was going to be supportive of a VBAC after three C-sections. I was really open to if I needed to have a fourth C-section, I was open to that. I just wanted to do what was going to be best so I was looking at all of my options. All of our family was back east though and we were looking at support after the baby was born so we were thinking we might go back to Virginia and have the baby there. I ended up doing remote care with my midwife from my previous birth, my last birth, for all of my prenatals. Everything was looking great. The bloodwork looked great. I was taking my blood pressure and checking with her occasionally. I was doing that with her while also looking for a provider and trying to discern what we were going to do for the birth. I should also mention that during this time, I started going to pelvic floor physical therapy. It had been recommended to me a few times, but I never pursued it before. My chiropractors in Colorado had a really strong recommendation for someone that they really liked, so I started going to pelvic floor PT. She found all of this chronic tension that I didn't realize I had. Actually, my hip pain had come back this pregnancy and releasing my pelvic floor actually took care of my hip pain. It was all referred pelvic floor pain which was so wild, but I felt relief within a couple of visits. She knew really good exercises to be doing during my pregnancy. It also made me more in tune with the rest of my body. I realized where else I was carrying tension and was better in check with my moods, so that was a huge game changer I think. I want to make sure that I mention that because I think that really, really impacted this pregnancy and birth. So we did an anatomy scan at 20 weeks and everything was looking good. It was a baby boy, but we found out he was measuring big which is normal for my babies at this point. Kind of around the same time, I guess, my husband got this really amazing job opportunity in Utah which meant we would have to move again. I was due in October with this baby and we would be moving during the summer. This time, we would move before the baby was born then hopefully have a couple of months to settle in. Because of that, I switched gears and started looking for providers in Utah so that I could have a pretty seamless transition. I found a really awesome midwife. I told her my whole story and when we were in Utah just interviewing and checking it out during the winter, she heard all of my stories and said, “I don't see why you can't birth vaginally. I think you are an excellent candidate for VBAC. I would gladly take you on.” Meagan: She is one of the most amazing midwives in Utah, too. Clair: Yeah. She has a ton of experience, too. I love how she has that much experience, so I really felt like she has seen it all. She has seen a lot and if she says I have a really good chance, but also, I totally trusted her to step in if we needed to step in and try different things during delivery. That's the one thing I felt like could have gone differently with my third baby was maybe we could have intervened a little earlier and maybe that would have gone differently. She also promised my husband that she would be straight with him because he kind of had an experience of people trying to shield him from the truth or whatever in the past just to kind of protect him in the birth process. He just wants honesty, so she was like, “I'm going to be really honest with you the whole time. I'm going to tell you exactly what I think.” It was just a really good fit for our family.28:49 Moving to Utah Clair: I went back and started packing up the house and everything, but I knew that I had a really solid provider waiting for me in Utah. We moved at the beginning of August. I was maybe 30 weeks or so, 29 weeks, 31 weeks, or something like that when we moved. I thought I had two months or so to kind of get settled and unpack the house and everything, then at about 35 weeks, I started having some pre-labor stuff and a few contractions, but I thought they were just really strong Braxton Hicks at night. I lost a bit of my mucus plug and that was consistent for about a week, but because with my second, I had a whole day of labor and then nothing for two weeks, I thought, “Oh, I've still got two weeks. Baby will be here right at 37, but that's fine. I think I still have a couple weeks left.” I checked with my midwife and she was like, “Are you concerned about going into early labor?” I was like, “I don't think so.” She goes, “Great. Don't worry about it.” To my surprise on a Sunday night at 5:00 PM coming back from the grocery store to pack lunch for my husband for his first official day of work the next day, my water breaks. I come home and I'm like, “I think my water broke.” He goes, “Uh, okay. This is really unexpected,” because with all of our other babies, I went past my due date and we had been in our house less than a month. I called my friend who is a doula now. I was just kind of out of it. I didn't really know what to do. She walked me through. “Okay, call your midwife. See what's going on.” I called her and she was like, “We can check to make sure that your water broke, but if you are pretty sure, you've had several children so if you are pretty sure it's your water, you should just go to the hospital.” She told me exactly which hospital to go to which I was really grateful for because I had no idea where to go and I really trusted her recommendation. Meagan: You were closer to a different hospital, honestly. You could have gone to this other hospital. Clair: Yes. Yeah, exactly. I was so glad that I called her. I walked in and they were like, “Oh, your midwife called ahead for you. Great. Come here. Let's check you out.” I was at a 5, so I was 5 centimeters dilated already which was crazy. They did an ultrasound just to double-check his position. He was head down which they were happy with. This OB comes in who was on call. She sits down and just says, “Well, frankly, I don't think a VBAC after three C-sections is too risky, but it's just risk. I don't see any health problems right now. You're fine.” They hooked me up to a monitor. Baby was fine. “So we're not going to force you to do anything that you don't want to do. You're going to make the call.” We were really surprised because when we knew we were going back in a hospital setting, especially after our last two experiences, my husband and I were like, “Whatever happens happens.” He even said, which was so great, “Let me deal with them. You deal with the baby.” Meagan: Mmm, yeah. Clair: “You don't need to go in fighting. I'll go in fighting and you deal with the baby.” But then we didn't even have to fight. They were disarmed right away.Meagan: Which is amazing because especially with preterm– Clair: Exactly. I expected a frenzy and it wasn't. It was peaceful. We just basically said, “We're not going to do that. We're not going to just do an automatic C-section. We're going to labor.” They looked at my ultrasound, saw that he was measuring big, and said, “We actually would have changed your dates in our practice with this ultrasound so we think you are closer to 38 weeks.” I was pretty confident in my dates because I had been using a monitor to check ovulation and everything. I still felt pretty confident that he was 35 weeks, so I really didn't want to induce or make labor happen any sooner than it started because I knew that his lungs could benefit from another couple of days in utero. We talked that through a little bit and the next day, there was a new on-call OB. The nurses were great. They listened to our whole story and they were like, “We are willing and ready and prepared to support you.” So the next day, we get a new on-call OB and she just says the same thing, “I don't think this is a very good idea, but I'm not going to force you to do anything.” She listens to our reasoning both why we don't want to induce and also about a VBAC and she goes and she calls the midwife who had been supposed to deliver or catch the baby. She says to the midwife, “I actually don't think this is a very good idea. Why did you send you here? It is really, really risky.” The midwife says, “It's not as risky as you think it is. Actually, go do the research a little bit. There are not great numbers out there, but what we have isn't what you are saying it is.” So that doctor actually called a maternal-fetal medicine doctor at a different hospital that she knew and asked, “Hey, what do you think about a VBAC after three C-sections? Would you recommend it for a mom?” He basically gave her the statistics of the risk of complications with a fourth C-section versus the risk of uterine rupture with a VBAC and he said, “The numbers aren't great, but as far as we can't be 100% confident. We don't have–”Meagan: Enough evidence. Clair: “--a lot of evidence, but I would absolutely support her. It's actually less risky for her to do this vaginally if she can.” This doctor comes back and tells us that. We were shocked. She said, “I actually think a VBAC is the best thing for you and your baby. I'm going to transfer you over to our hospital midwives–” which was wild and so not what we expected. She was like, “Because I think that's more like the model of care you wanted.” We were just floored because we never– yeah. We never expected that from a doctor. We had never been respected in that way. That alone was just so healing. 35:34 Midwifery care in the hospitalClair: This midwife comes in and I chat with her a little bit. She made sure I got some food. I hadn't really eaten much since I got there. Meagan: I bet. Clair: It was great. They just really attended to me as a person. I still was not in labor. They weren't checking me because my membranes were ruptured and she just talked me through that. “There's really not that much of an increased risk of infection if you are waiting longer as long as you are not doing checks. If you don't have an infection already, you're probably not going to get one essentially.” We did lots and lots of things in that 24-hour period. We prayed. We asked for so many prayers from our friends. We called the midwife and chatted with her a bunch. My husband– I joke that he was my daddy doula during that time because we learned a bunch of things during our other pregnancies. We were doing a Miles circuit. We were doing Spinning Babies and abdominal lifts and everything we could think of. I was pumping. They got me a hospital pump to use. I was showering and trying to relax. We even discussed leaving the hospital and going home. We talked that through with them, but I felt pretty confident that once I went into labor, it was going to be pretty strong labor and I was confident he was pre-term. I wanted to stay. My kids were able to come visit which was huge. That was so helpful. I did a lot of fear release conversation with the hospital midwife was a big deal. I was just really worried. My oldest was only four and I was really worried about, can I do this? Can I be a mother to these four babies? It's so much more manageable when you are pregnant. The baby is inside, so I think that was actually really helpful. I think that was kind of keeping me from labor in a sense. We just kind of did that for the next day. I was sleeping, but I was continually being monitored so my sleeping was really fitful. At 2:00 PM the next day, my nurses from their first shift are back. They were like, “Oh no, you're still here and you're not in labor and there's no baby. What can we do?” I just said, “I'm so tired. I just have not been sleeping well. Every time I roll over, this monitor messes up the baby's heart rate with mine so people come flying in the room and I just can't really rest right now.” She talked with the hospital midwife who was on call that day and she really wanted to get things going. She was a little bit more nervous about the length of time my waters had been broken and was stronger with recommending inducing or something. She said, “Yeah. Let's just get her off the monitors. We have two days of great readings from this baby. Let's get her off the monitors. Let's turn down the lights. Let's get her in a new room, fresh environment, turn the lights down, and let her take a nap.” My husband even left. He went to go get a snack or something outside of the hospital just to totally give me my space.38:47 Active labor beginsAround 3:30, I finally get tucked in for a nap and fall asleep immediately. I was so tired. Meagan: I'm sure. Clair: It was just a lot of mental stress and I wake up an hour later at 4:30 to a rip roaring, super strong contraction. I couldn't even believe it. I was like, “Oh my gosh. Napping worked.” It was just what I needed. It was like my body just needed to be left alone. Meagan: And even probably you mentally needed to just get out of the moment and just be. Clair: Yes. Yeah. No, definitely. I start timing them and within five contractions, they were all lasting over a minute. They were all about a minute and a half to three minutes apart. I call my husband. I'm like, “You've got to come back to the hospital right now.” They were really strong too, like super, super strong. Meagan: And keeping in mind you were 5 centimeters so you could be tipping into that transition active labor from no labor. Clair: Right? Meagan: No labor to active labor. Clair: Yeah, just thrown right into it. Yeah, it was wild. I felt like I was kind of behind from the beginning like I couldn't get on top of it for that reason. It was really intense. I called the nurse in the room because I needed to go to the bathroom and I wanted to stand up, but I was like, “I don't know what's going ot happen when I stand up, so I'm going to call her in.” She came. She observed me in between some contractions and was like, “I think the midwife should come.” I was like, “No, it just started. Don't worry. Don't bother her.” She was like, “No, really. We should get the midwife in here.” The midwife comes in and checks me. I'm only at a 6 so I was a little bit discouraged because it had been a half hour-45 minutes of these strong contractions at that point, but 90% effaced. Baby was dropping. Everyone in the room was like, “This is really good news.” I was like, “Yeah, there is still a lot of work to do.” I just refused to accept that. So I'm kind of wandering around the room just laboring standing up in different positions and supported by a nurse sometimes, then I end up kneeling on the ground and laboring over a couch just leaning on it. The contractions really picked up. There really was not much of a break between them at all so I felt like I couldn't release the contraction. Everything you hear is like, “Release the contraction. Let all of the tension out of your body,” and I couldn't do any of that. So I'm telling my husband, “I need an epidural. I'm not going to be able to do this for a long period of time. I'm not getting any kind of a break. I can't relax.” Meagan: You were already so tired. Clair: Yeah. I need an epidural. I'm not going to be able to do this naturally even though that's what I planned. He was like, “No, you're fine.” I was so mad at him, but he would look at the midwife, I guess I found out later and she was like, “No, this is happening.” She was really encouraging him, so he was like, “Nope, you don't need it. We're going to be there really soon.” Meagan: Good daddy doula, I guess, there. He knows what you want and will help you get it.Clair: Exactly. Exactly. I'm not saying he was just ignoring me– Meagan: Right, but he was like, “Ah, she's got this.” Clair: Yeah, exactly. I guess the midwife had observed some kind of a change in me because at 7:00 PM– this is 2.5 hours after these contractions start– she checks me again and she asked to check me. I was at 10. I was feeling pushy, but not in the same way I had before with other labors, so I was surprised. All of the nurses in the room were like, “This is great news!” In my head, I'm like, “I've been there before. I've been there three times before. It is not over yet.” I was still very much in the mindset of, “No, we've got work to do.” I end up trying a couple of different positions to push. I end up pushing on the hospital bed kind of supported by pillows on all fours. They put the back of the bed up and I pushed there for about a half hour or so, maybe 20 minutes in. They were like, “Oh my gosh. We can see the head. This is so great.” Because of my third baby, I was just like, “That's news, but it's doesn't mean it's over.” Meagan: Not what I need quite yet. Clair: I've been here before. So I end up, yeah. I was just kind of like, “I've been here before.That's not news to me, I guess.” But then I really felt a ring of fire and I was like, “Oh my gosh. This is actually happening. This is a new thing. This is a new sensation. This is a new place that I haven't been before.” So I end up, yeah. He ends up being born. I pushed with all my might. The midwife had to tell me, “Chill out. Slow down a little bit. You don't want to tear.” But yeah. It was just so beautiful. I was able to birth him vaginally and then they were like, “You have to roll over so you can hold him.” They were telling me what to do because I was in such disbelief when I was born. I got to hold him skin-to-skin for the first time of any of my babies which was such a gift. My husband cut the cord after it stopped pulsing and it was so peaceful. A couple of the nurses were crying because they had been there and were really invested in our story. The midwife was like, “You reminded me why I'm in this field. This is such a beautiful, redemptive story. I'm so happy for you.” I did have a small, little first-degree tear but it really wasn't bad. He ended up being 7 pounds, 7 ounces so I'm pretty confident that he was late pre-term because that is still small for my babies. Meagan: Yeah, because they are normally 9. Clair: So he was definitely earlier. 45:04 Circumvallate placenta I had a circumvallate placenta which is where part of the placenta turns in on itself when it is developing so there is a smaller area where the placenta can adhere to the uterus. Sometimes that can be related to IUGR and a couple of other things, but it's really hard to find via ultrasound. I kind of researched it later and sometimes, it's cause for big concern but there's really not much to do about it. There's just not a whole lot to be done. I'm glad I didn't know that because I feel like would have been a source of worry but unnecessary worry because there's nothing I really would have done differently in my pregnancy. Meagan: I wonder if that was your body being like, “Okay, it's time. I'm done doing my job. Now get the baby out.” Clair: Yeah, it can also be associated with pre-term or early labor. Meagan: Okay. Clair: Yeah because I was trying to find a reason. This was so strange. My midwife wasn't worried about it at all. She was just like, “Oh, interesting. Look at your placenta. This is so cool.” Meagan: In all of the years of encapsulating them, I've never seen one like that. Clair: Yeah, it's kind of rare but also, yeah. They're not sure why it happens. I don't know why it happened. Some people say babies that gestate at elevation are sometimes smaller too like at high, high elevation and they come earlier so I'm wondering if maybe that can be connected. I don't know if there are more placenta abnormalities in that way at elevation. I don't know. But yeah, he had great APGARs. He latched super well. It was so cool. The first OB that I had called me the next morning in the hospital room just saying, “Congratulations. We're go excited for you.” My second OB, the one who basically said, “I think this is the right thing for you to try,” came to the room because she was on call again and she congratulated me and just said, “Thanks for letting us be a part of this. This was so impactful to everybody in our practice.” Meagan: Yeah. Clair: I don't think they would have taken me on as a client upfront. Meagan: Probably not. Clair: For them to see this, and then I talked to the head midwife of that hospital OB/midwife practice and she was just saying that this is their hope that more women who really can labor without intervention or are given the chance to labor without intervention is kind of their goal. She was so happy that so many of the people in her practice got to be a witness to that because they really got to see what happens especially down to napping and leaving me alone is what helped me go into labor. Meagan: Yes. There was a lot of learning happening on all of their behalf, from the OB side, on the nurse side, on the midwife's side, there was a lot of learning. What I love so much is when places see births like this after– I mean, I'm not saying the midwives or anything. I think the OBs were originally like, “I don't think this is a good idea,” but then seeing it happen, it's like, “Okay. Let's take a step back,” because so many hospitals around the world just shut people out. “No.” They might not, like you said, have supported you walking in. “I've had three C-sections. I really want to have a VBAC.” She probably would have said the same. Maybe she wouldn't have, though. Maybe she would have said, “I don't know if it's a really good idea, but we can support you and let you go.” But would it have been the same situtation? I don't know. They are one of my favorite hospitals in that direction up north, so I love hearing, I love hearing all of this. And then to the point where the OB is like, “Hey, I recognize you are in my care, but I know you came from this care. Why don't we put you back in that model of care because we offer that here?” Just these fine details that these providers paid attention to was a huge deal. Clair: Absolutely. Absolutely. It's funny because I had a feeling that whole pregnancy that I was going to have a hospital VBAC. Meagan: Really? Clair: It was in the back of my head. “I think I'm going to end up in the hospital, but I also feel like I'm going to have a VBAC. I don't know,” but it was this weird thought because I definitely was not going to pursue providers in the hospital, so yeah. The fact that that happened, I was like, “Wow. This is just so crazy for those reasons.” Meagan: So awesome. Clair: Yeah. I just really feel like not being afraid to voice what we wanted was such a big part of this because if we hadn't spoken up, even though they were very, very willing to listen and were receptive, we didn't know that so we went in saying, “This is what we want and this is why we want it.” I think that having a conversation where you think the doors might be closed is good to have. Now, it's also good to be aware of when a provider is not actually going to be supportive of you, but in our case, we really didn't have any choice. We were where we were and just to, I think, the more calm conversation that is had and the more providers can experience births like this, the more it will become normalized which is really the goal here. Meagan: Absolutely. Well, huge congrats on your beautiful birth and I'm so happy for you. I just love hearing how it all unfolded even though in the beginning and at the end, it wasn't exactly– well maybe I guess it was something that you envisioned, but what on paper you were putting out that you envisioned this birth center birth with this awesome midwife, but I just love how it unfolded so much. Clair: Yeah. It was so healing for my husband. It was so healing for me. Yeah.” Meagan: Good. Good. Well, thank you again for being here with us. Clair: 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

#252 | A Father's Perspective on his Baby's Inaccurate IUGR Diagnosis

Play Episode Listen Later Feb 14, 2024 37:25 Very Popular

IUGR or Intrauterine Growth Restriction is the latest trend on the obstetric scene--a diagnosis that has afflicted many mothers unnecessarily. Eric, a father of two daughters, joins us on the show today to discuss his experience with his wife's IUGR experience. When an early ultrasound told them their baby was measuring smaller than expected, they were sent to maternal-fetal medicine and their baby was labeled as growth-restricted. As their dreams of a birth center birth quickly vanished, they started having regular ultrasounds and non-stress tests to monitor their baby. While Eric's intuition told him everything was ok with their baby, he had to balance the forceful voice of the medical system and his wife's nerves and unease, given the pressure and fear-tactics she was relentlessly subjected to, while having to make constant trips to and from the doctor to continually check on the baby. At forty-two weeks they scheduled a hospital induction, birthing a perfectly non-growth-restricted baby who was estimated to be just forty weeks' gestation, indicating the doctors incorrectly estimated the due date at the outset. This story illuminates the excessive fear and risk put upon parents and the common inaccuracies of IUGR diagnoses. **********Down to Birth is sponsored by:Modern Nursery--Your one-stop shop for eco-friendly, stylish baby gearDrinkLMNT -- Purchase LMNT with this link today and receive a free sample kit.Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Optimal nutritional products to nourish yourself before, during, and after pregnancyConnect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

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#250 | January Q&A: Cervical Massage, VBAC Provider Red Flags, Due Date Calculation, Infant Sleep, Sufficient Milk Supply, RhoGAM and More

Play Episode Listen Later Jan 31, 2024 45:23 Very Popular

Hello and is it too late to still say Happy New Year?! Cynthia & Trisha are back with the first Q&A of 2024 in season five of the Down to Birth Show! We kick it off today by sharing some of your highs and lows from the holiday season. Next, we get into our questions beginning with a mother who had low milk supply with her first baby and wonders what she can do in pregnancy and birth to prevent it from happening again; one curious listener wants to know if she can check her own cervix to help determine at what point she should go to the hospital; another caller asks us to explain why due dates are based on your last menstrual period rather than your ovulation date--what happens to those two weeks? In our extended version, available on Apple subscriptions and Patreon, we first answer a question about normal, healthy sleep patterns for infants and the pressure mothers face to have the baby "sleep through the night." Then we answer if and when "cervical massage" is indicated for a cervix that might be scarred from a previous cervical procedure. Another mom is concerned that her midwives missed a case of early jaundice in her newborn and inquires if getting the RhoGAM shot in pregnancy could have prevented the jaundice. Finally, one mother explains her OB's behavior around her choice to have a VBAC and we chime in with our take on his audacity!Last, we close with a round of quickies addressing morning sickness, postpartum hemorrhage, GBS swabbing, IUGR and the strangest things we've ever eaten!Thank you for your great questions and keep them coming at 802-438-3696 or 802-GET-DOWN.**********Down to Birth is sponsored by:Modern Nursery--Your one-stop shop for eco-friendly, stylish baby gearDrinkLMNT -- Purchase LMNT with this link today and receive a free sample kit.Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Optimal nutritional products to nourish yourself before, during, and after pregnancy Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

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Episode 274 "I Don't Know Who Needs to Hear This, But..."

They Say It Takes A Village

Play Episode Listen Later Jan 31, 2024 37:34

I don't know who needs to hear this, but…You do NOT have to be induced at 39 weeks to have a vaginal birth. You CAN have an induced VBAC. Your cervix DOESN'T have to dilate by 40 weeks.Home birth is just as SAFE as hospital birth, even for VBAC.Your pelvis is PERFECT. You are capable of doing MORE than you even know.Tune in to today's hot episode to hear Meagan and Julie dive deeper into these topics and many, many more!Additional LinksThe ARRIVE Trial and What it Means for VBACHome Birth and VBACBrittany Sharpe McCollum - Pelvic BiodynamicsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello everybody. We are already a month into 2024 and we are ending the month off with a nice, spicy episode. I think it will be a little spicy. Julie is with me today. Hey, Julie. Julie: The bringer of the spice. Meagan: The bringer of the spice. You know, ever since you stopped doing doula work as well, you have picked it up a notch in your spice. Julie: Because I'm tired of watching people get railroaded by the system. Meagan: I know. Julie: I have picked it up a little bit, yeah. Meagan: I know. Julie: You have to deal with the backlash by yourself if there is some backlash. Meagan: Seriously. No, this episode is going to be a good one. Women of Strength, I think that this episode is going to be very empowering. Yes, it is going to be spicy. We are going to have passion because if you haven't noticed over all of the years of Julie and I recording, we have passion. When it comes to like Julie was saying, people not being railroaded by the system or not taken advantage of and really knowing what information is true and not, we are pretty passionate about it. So today, we have an episode for you that is going to be amazing. It's titled, “I Don't Know Who Needs to Hear This, But…” We are going to be telling you all of the amazing things. Review of the WeekWe have a Review of the Week so we are going to get to that and then we are going to kick it up a notch. Julie: Perfect. All right, yeah. I'm really excited about this episode inspired by all of you really, all of us, and everybody in the birth community around the whole entire world. Anyways, this review is from Apple Podcasts and it's titled “Highly Recommend.” It says, “Thank you, Meagan and Julie, for creating this podcast. It holds space for mothers with so many different birth stories and as we know, representation matters. After an unexpected emergency Cesarean with my first daughter, I found myself seeking stories similar to my own. I literally binged your show. It helped me process my own trauma and was incredibly healing. I have since become a labor and delivery nurse and I find myself recommending this podcast to my patients regularly.” What? That's awesome. “I'm happy to say that this podcast gave me the courage and confidence to TOLAC and I had the most empowering and beautiful VBAC in November. Thank you a million.” That is incredible. I love it. Meagan: That is incredible. I love hearing when labor and delivery nurses or providers will hear the podcast and recommend it to their patients and their friends and their family. That makes me so happy. If you are like our reviewer and you would recommend the podcast, if you wouldn't mind doing us a solid, pause right now but come back because it's going to be great. Pause right now and leave us a review. Go to wherever you are– Apple Podcasts, Spotify, or if you are just listening on our website which you can at thevbaclink.com. You can even just Google “The VBAC Link” and leave us a review and recommend us there because your recommendations and your reviews are what help other Women of Strength find this and find these amazing stories and find the information like what we're giving today. Meagan & JulieMeagan: Okay, Julie, I am so excited. I am so excited. This idea is amazing. We were talking about this before. This is kind of like a viral reel. This reel went viral. “I don't know who needs to hear this…”, but Julie said this. Boom. That is what we are going to do. This is amazing. This episode is going to be so fun. We have actually scrolled The VBAC Link Community which by the way, if you are not in The VBAC Link Community on Facebook, we have a private Facebook group that is very safe and very welcoming to all Women of Strength no matter what type of birth they are wanting, vaginal or Cesarean. You can find us at The VBAC Link Community on Facebook. Answer the questions. You do have to answer the questions to get in because we are very, very strict with that and then we'll get you in. If for some reason, you have a weird decline because sometimes Facebook is declining them on their own, I do not know why, just message us at thevbaclink.com or on Instagram or wherever and just let us know, “Hey, I'm trying to get in,” because we have definitely been having issues. Julie: Weird. Meagan: I know, right? People are writing us like, “We've been trying four times and it's just declining.” But okay, you guys. Julie, do you want to kick it off? “I Don't Know Who Needs to Hear This, But…”Julie: Yeah, let's kick it off. Okay, so I don't know who needs to hear this, but you do not have to be induced at 39 weeks to have a vaginal birth. Meagan: Correct. You do not. Julie: It makes me so mad. It lights my fire. I have a friend who lives in Maryland. He is a major researcher. He researches everything and every topic– politics, home school versus public school, anything. He can give you a one-hour speech on demand because he is on a top-notch level. His head is in the papers. He is just there. But for some reason, we as a culture don't like to do that amount of research when it comes to having our babies. Right? Why is that? Anyway, so when his wife had their first pregnancy, it was right after the ARRIVE trial came out, and of course, she got induced at 39 weeks. They've had two other kids since then. They got induced at 39 weeks every time. Lucky for them, it was super great. They had pretty uncomplicated, straightforward deliveries and everything was fine, but I wanted to scream at him and say, “Friend! You research the heck out of everything. Why are you guys not looking into this for your own babies and your own children and your family, the most important thing in your life?” It's always been interesting to me for that. So we know by now that everybody is hungry to induce at 39 weeks. We also know by now– I mean, we knew early on, but the rest of the world is catching up now showing that the results of the ARRIVE trial are incredibly flawed. If you don't know what the ARRIVE trial is, just Google “The ARRIVE Trial, VBAC” and our article on the ARRIVE trial will pop up, but basically it says that induction at 39 weeks lowers Cesarean rates and other complications for mother and baby but there are so many things wrong with that study. There are so many things wrong with that study. I'm not going to get into it because we have a short amount of time, but go look into it. We know now that there have been several research articles from major universities doing research on giant, enormous population groups showing that it actually increases complications and risks associated with induction and it increases the risks of having a Cesarean for mothers. So, guess what though? I hate how fast the ARRIVE trial took on. Everybody is like, “Woohoo! Induction at 39 weeks, let's do this,” but guess what? Now that we are showing that it is actually harmful to families, everybody is looking away. It's going to take 10-20 years for this trend to stop. Meagan: But yet it took overnight for it to start. That's what is frustrating to me. Julie: Because it is more convenient. It is more money. It is easier to manage. Meagan: I have so many feelings. You guys, we have a blog on the ARRIVE trial. We actually have an updated episode on the updates of the ARRIVE trial as well so if you are wanting to learn more about the ARRIVE trial or if you are being told that you need to be induced at 39 weeks in order to have a baby, go check out Episode 247 because we are going to talk more about that topic. Julie: Yeah, absolutely. There's lots to go into it, but I just want you to know. We want you to know that it's okay to go past 39, 40, and 41 weeks and wait for your body to go into spontaneous labor. That is really your best chance of having a vaginal birth. Now, there are reasons and times when a medical need for an induction arises that are true and are actually real. Having an induction doesn't mean you are going to have a C-section, so if you need to go that route for whatever reason that is medically safe for you and your baby, it is safe to do that. “I Don't Know Who Needs to Hear This, But…”Meagan: So on that topic, I don't know who needs to hear this, but induction is okay for a VBAC and it is possible to have a VBAC with an induction. So yes, it's more ideal to have spontaneous labor and for things to happen on their own and not to be intervened. But, if medically, there is a reason for an induction, it is okay. You do not have to just have a C-section because there is a medical reason to have a baby. You can be induced. “I Don't Know Who Needs to Hear This, But…”And then sort of on the same topic, but I don't know who needs to hear this, but your cervix doesn't have to dilate by 40 weeks. It doesn't have to. It can dilate after. It doesn't mean it's not going to. If you are not dilated or effaced by 40 weeks, it doesn't mean it won't, right? Julie: Yep. I hate when people say, “I just left my 37-week check-up and I'm not dilated at all. My provider thinks I needed to schedule a C-section.” I'm like, “Your cervix is doing exactly what it needs to do before it's time to let the baby out which is stay closed, stay tight, and keep that baby in.” Meagan: Yeah. Yeah. I don't love that because if a provider is checking at 37 weeks and someone's not dilated, they're placing doubt that they are not dilated and placing thoughts of, “Oh, you're not dilated yet. Oh, you're 37 weeks.” If they're already having that tune, that, to me, is a red flag because if you are 40 weeks and you are still not dilated yet, what do you think they are going to say then?Julie: It's just a sign of control. They want to be able to predict and control and yeah. It might not be the best provider to support you. “I Don't Know Who Needs to Hear This, But…”Julie: Okay, I got one. I don't know who needs to hear this, but home birth is just as safe as hospital birth even for VBAC. I think that a lot of people don't know this aside from there have been several major studies in the last 10 years or so showing this, but I feel like what most people don't realize is that home birth midwives, aside from the random rogue ones– you know, here and there you are going to hear a story– but most home birth midwives are incredibly educated and trained at similar levels as hospital midwives are. Now, depending on whether they are certified or licensed, there are different regulations in every state, but midwives at home can carry Pitocin, methergine, and Cytotec. They can carry antibiotics if you are—Meagan: GBS positive. Julie: They can give you IVs. They can draw your blood. They can do all of the routine prenatal tests that you can do in the hospital. They have emergency transfer protocols in place. Every state is a little bit different, but in Utah, it is amazing. The seamless transition from home to hospital and transfer of care records and everything like that, a lot of people just don't know that home birth midwives– like I said, it depends on the state and the regulations whether they are certified or licensed and that type of thing– have access to all of the things except the operation room that you have in a hospital. Meagan: And…Julie: Go ahead. You do the and. Meagan: And if there is an emergency like she was saying, there is a transfer protocol in place. Usually, it doesn't get to anything crazy because we are transferring based on XYZ before there is any true emergency. Julie: Yep. And you know what? Paige is going to be going nuts here because she is going to have to drop so many links into the show notes, but like I said, there have been so many studies that show birth outcomes are similar and some of them are better at home than in the hospital, right? Like a decrease in hemorrhage at home and yes, we can sit here and say that home birth is safe. Meagan: Home birth is safe and a reasonable option for a VBAC. “I Don't Know Who Needs to Hear This, But…”Meagan: I don't know who needs to hear this, but your pelvis is perfect. Julie: Your pelvis is perfect. Meagan: Your pelvis is perfect. Your pelvis is not too small, you guys. Yes, there are rare occasions where we have a pelvis that is going to be less ideal to get a baby out or harder where maybe they have gotten in an accident and they've had a pelvic fracture. We've talked about being malnourished as a child or things like that, but it's really rare for your pelvis to actually not be able to get a baby out of it. It was designed to do that. It can do that. We all have different sizes and shapes and little ingredients to our pelvis–Julie: Pelvic ingredients. Meagan: It can do it, you guys. Sometimes it's changing a position because sometimes our babies need to come out posterior. I learned this in a pelvic dynamics class from Brittany Sharpe. She is freaking amazing and we will drop her Instagram in here as well. But you guys, our pelvises mold. They shape. They move. They form. Babies' heads mold, but they are all different shapes, and sometimes, our babies have to come into our pelvis in a posterior position to get out vaginally, or sometimes they have to come in looking transverse because of the way they are shaped, but it's really rare that your pelvis is too small. So if your provider in your C-section said, “Yeah, well while I was in there, I looked and it's way too small. You definitely should have a C-section here in the future,” just move on from that doctor. Your pelvis is perfect.“I Don't Know Who Needs to Hear This, But…”Julie: Move on. All right. I don't know who needs to hear this, but big babies are not a medical reason for induction and it does not mean that your baby can't be born vaginally. Meagan: And it's not a reason for a scheduled C-section. Julie: Yep. Meagan: That goes with any previous C-section because I've seen so many people say, “I've had a C-section because my baby measured large.” First baby. Julie: Even ACOG says that it's not a good reason. Meagan: I know. It drives me batty. Why? Why are we doubting our bodies' abilities? Women of Strength, if you are one and you said, “Okay,” and that's why you had a C-section, don't shame yourself, but know that your body creates a perfect-sized baby. Julie: Yeah. Don't shame yourself because the system railroaded you. Blame the system. That's who you blame. Meagan: And don't lose belief in your body's ability to get your baby out. If your baby is on the larger side, be like, “Well, dang. I'm going to have a good sleeper and likely a good eater.” Be happy about that and not shame yourself and be like, “Oh, I made a big baby,” because also, what I have seen in next babies, I've seen Women of Strength stop eating and restrict themselves of the nutrients that they need because they are so terrified. Julie: Scared that their baby will be too big. Meagan: Yes, they are so terrified of having too big of a baby that they are actually not giving themselves the nutrients. We know, especially with all of the Needed prenatal information that I've learned, that we are already malnourished as a society today not even just with taking supplements but in our daily food, our soil has changed. Our food has changed. Our nutrients have changed. We don't want to be withholding those nutrients and food because we are so scared of having too big of a baby. Do not let a provider– this is my “I don't know who needs to hear this”, but do not let a provider do that to you. Julie: Yeah, we all have stories that we can pull out of anything about these big babies. I was just at a birth last week. It was a scheduled induction at 37.5 weeks because of baby's size. They thought the baby was going to be almost 10 pounds at 37 weeks. Baby came out at 8 pounds, 3 ounces. Now, that is a little large for a 37-weeker, but my goodness, it wasn't a 10-pound baby. Okay? This is one of the harder things about being a birth photographer sometimes is that you are not involved in their decisions prenatally so I don't always have the opportunity to help them learn things. Some people just don't want to learn and that's totally fine, but I have another friend who just left an induction. It was a VBAC induction actually and it ended in a VBAC. It was great, but they suspected IUGR which is a small baby. Meagan: Intrauterine growth restriction by the way for whoever does not know that. Julie: Yes. They expected the baby to be super small and I forget. I think it was in the 39th week. They expected the baby to be smaller than 6 pounds. Baby was born at 7.5 pounds, just fine. Meagan: Perfect. Julie: These things are not accurate and if you are healthy, then I think it's important to know that your body can do this. Now, okay. Okay. I do want to add a little nuance there that all of these things that we are going to be talking about today there are situations where induction is necessary. With uncontrolled gestational diabetes, for example, your baby might be bigger. But what I've found most often with gestational diabetes is that we put these women on really restrictive diets and we tell them to be careful about what they eat and to exercise and all of these things. I find that my gestational diabetes clients usually end up having babies that are a little bit smaller than average because of all the restrictions we put on them like you were just talking about. So I just want to add a little nuance there that there are going to be some exceptions to what we are talking about. What we have a problem with here at The VBAC Link is when people take those 1 in 100 or 1 in 1000 situations where extra help is needed and blanket-apply it to 100% of the people. That's what we're trying to combat here. Meagan: Yeah. Absolutely. Julie: All right, Meagan. What you've got? “I Don't Know Who Needs to Hear This, But…”Meagan: I don't know who needs to hear this, but it's always okay to say no. Julie: Yes! Meagan: Always. If you are having someone and it doesn't even need to be a provider, anybody who is telling you what you are going to do and you are not feeling good about that decision, say no. That is okay. I was in another VBAC group during my own VBAC after two C-sections. I was in multiple VBAC groups. I was in a group and there was someone that wrote into their comment. They said, “My provider told me that I could not be induced. I could not do this. I could not do that,” and these things. Did it just irk you? I know you saw it, Julie. Did that just irk you, that comment? Julie: Yeah. It irks me because why do we as doulas, birth photographers, and patients have to be the ones to show our providers what the evidence says? Why do we? Shouldn't they be the ones practicing that evidence-based care? Shouldn't they? Oh, here's my radical acceptance coming in, speaking of radical acceptance. I need to work on radical acceptance of the system, I think. But why? I don't want to accept it. I want to change it. So there's part 3 coming out soon. How to change it. Meagan: Part 3 of radical acceptance. How to find radical acceptance through the system. This is the thing. We talked about this, I think, even before we pushed play but a provider or someone who wants to control you in this situation that you are going to be in– your birth. This is someone who wants to control your birth and is telling you what you are or are not going to do or what they are going to do to you.I'm hearing providers saying, “I'm going to strip your membranes at your next visit.” No. No. That is not how it works. Julie: Or they walk into the room while you are laboring, “Okay, we are going to break your water now.” What?Meagan: It is okay to say no. It is okay and I know that it is hard. I know. I have been there. I have been there just in life in general where I'm in a situation and I'm like, “Oh, I just don't want to cause contention and is it really that big of a deal? Maybe I should just say yes.” No. If your gut– and you'll know. If someone is coming in like Julie said and is saying, “We're going to break your water now,” and you're like, “Ugh,” immediately, that is your intuition saying no. Julie: No. Meagan: It is okay to say no. It is okay for you to say, “I do not want a cervical exam right now. I had one two hours ago. Not much has changed. I'm good, thanks.” It's okay. Women of Strength, please, please, please. This is how we change the system. We have to be strong and we have to stand up for ourselves. We do and it's stupid that we have to bring the evidence to the table, but we have to say no. We have to stop letting the system or the world, the world, railroad us especially when it's to our own body. We would never go down the street to the gas station and walk in and tell someone in that store what we're doing to them. Never. Would you? I would never. Maybe some would. Julie: I need you to drop those prices of the gas for me. Meagan: Yeah, right now because I'm about to pump my gas. I need you to drop it down 50 cents cheaper. You guys, no. We should not, just because we are in birth and just because we are in labor and just because we have a provider that went to a heck of a lot more school than us, right? I'll give them that. They went to a heck of a lot of school. I've never gone to medical school. It is not okay for them to tell us what you are or are not going to do. Okay, that's my rant. Julie: Oh, I've got one that I just came up with. Meagan: Okay. “I Don't Know Who Needs to Hear This, But…”Julie: I don't know who needs to hear this, but you can gain information from Google– accurate and good legitimate information from Google that is similar to information that other people are getting through school. Oh ho, ho, ho. Meagan: Oh ho, ho, ho. Julie: Yeah, take that. This is going to be a little spicy one here. I hate it. I hate it– okay you've seen this sign. I know everyone has seen them before or little bugs that are like, “Don't confuse your Google search with my medical degree,” then be like, “Why the heck not?” If it's so easy to pull something up on a Google search, then why should I trust your medical degree then? Okay, that's a little extreme, but what I'm trying to say here is that we have access to the largest collective database of information to ever exist in the history of the world, right? We can literally sit on our computer and order dinner, put in a grocery order, and have it delivered to our house in an hour. We can find information on anything we want to know from legit, credible sources. Right? I could find out how to build an electric outlet into my fireplace above. That's my project right now. I need an outlet on my fireplace.Meagan: YouTube University. Julie: Exactly. Now, is there a lot of misinformation out there? Sure. But listen, if you know how to find credible sources like Google Scholar, Google Scholar legit has studies and sources and references that university databases pull from. There is accurate information and studies available at our fingertips, so why? The same studies that people are accessing at their universities towards their medical degrees are at our fingertips so I hate when people say, “Don't confuse your Google search with my medical degree.” Yes, are medical degrees valuable? Incredibly, especially when you can collectively put pieces of information and everything like that together. I feel like there is lots of worth there as well, but when we are talking about individuals, you know your body better than any provider with any level of medical degree is going to know your body. You know it better. Your intuition will guide you better than any provider with any medical degree. I know I'm going to get a lot of cringes right now by talking about this, but your Google search is worth a lot when it's pulled from a credible source so I hate when people say. That's one thing I can't. I usually scroll past the trolls and comments on Facebook now. I just don't let it be worth my time. I have radically accepted that there are trolls and it's fine and I'm going to live my life, but when I see someone using those words, “Don't confuse your Google search with my medical degree,” that is when I'm going to get on there and say, “Why? Why discount these billions and billions and billions of research articles and things like that that we have access to?” Meagan: I think that's one of the big passions between why Julie and I created The VBAC Link Parent Course and Doula Course because we wanted you to be able to find that information in one spot. It is confusing and it is overwhelming. Those providers, yeah. There are some BS things out there on the internet. It's really hard to decipher. Julie: Like the ARRIVE trial, right? Meagan: Yes. I think we have three pages of studies and citations and all of these things in our VBAC manual and in our VBAC course so you can take that and take it to your provider and say, “This is what I have found. This is the evidence. Can we have a discussion about this?” Women of Strength, it is okay to have a conversation with your provider. You can ask questions. A lot of the time, you walk in and they are like, “Hey, do you have any questions?” You're like, “Maybe. Should I have any questions?” You should be encouraging these conversations with your provider. It's going to help you get to know them. It's going to help you guys have a better understanding of each other and you're going to be able to learn about these studies. Julie: I want to cut in here for just a minute before you change gears. I know that when we were putting our course together, this was something that was super important to me and Meagan. You don't have to take our word for it. I remember uploading lots of studies, the pdf versions of studies and bulletins, and things like that into the course because we wanted you to be able to go and dig deeper on the parts that you wanted to dig deeper from right from these credible sources. I love when I can find a Cochrane review because a Cochrane review is a review of several studies studying the same thing so you can just gather so much more information. We have a Cochrane review in there. We have links to everything. That's why we are so careful to be so meticulous and cite our sources and where we found this information so that you can go on your own journey to the other parts that resonate with you a little bit more. Meagan: Absolutely. Okay, well we are wrapping up. Is there anything else, Julie, that you are like, “I've got to let these guys know”?“I Don't Know Who Needs to Hear This, But…”Julie: Yeah, I think one more thing without having to really expound on it too much. I don't know who needs to hear this, but sometimes trusting and believing your body doesn't work. I don't know how to say that the right way. Maybe I'm going to expound on it. I loved this affirmation so much because I used it on my home birth and my first VBAC. It was like, “I trust my body to birth my body,” and things like that. I had a lot of trust, but I feel like reframing it to, “I trust my body to know what to do,” is better because what happens when some emergency comes up and your body doesn't push it out? What happens when you have a traumatic pelvic floor injury and your pelvis really doesn't know how to push out a baby? I mean, what happens if your baby's heart starts tanking and baby has to come out right now? That's not your body failing you. I feel like sometimes that's what sets people up for failure. They believe so much in their body, but sometimes emergencies happen. There is some nuance there, so yes. Trust your body, but trust it to guide you on the right journey. Sometimes it sets us up for trauma afterward. You'll be like, “Oh my gosh, my body is broken. How come trusting my body didn't work?” I feel like trusting your body is a big part of it, but trusting your body to guide you on the right journey for a nice, healthy delivery is more important than trusting your body to be able to push a baby out. I don't know. What do you say to that, Meagan? Meagan: Yeah. I love that. That, I think, is where a lot of postpartum issues come because we were like, “But, I knew that I could do this.” It's not that you couldn't, it's just that something else happened. Right? Julie: The circumstance. Meagan: Yep. The circumstances changed and that's hard. That's hard, yeah. I love that. I love that you said that. “I Don't Know Who Needs to Hear This, But…”Finally, last but not least, I don't know who needs to hear this, but you are amazing. You are a Woman of Strength. You are capable of doing more than you even know. Than you even know. I truly believe that. I think through life and experiences, especially when things are hard, it feels like you can be at a loss, like you are alone, and like you couldn't possibly do these things, right? But Women of Strength, VBAC is possible. VBAC after multiple Cesareans– possible. VBAC with twins, VBAC with big baby, VBAC with diagnosed small pelvis, VBAC with medical induction needed, VBAC is possible. If you don't want to have a VBAC, that's my final, final. If you don't want one, that's okay. Julie: Yeah. Meagan: That is okay. Vaginal birth is not always desired and that's okay. But you need to learn. You need to find the information and that is what these stories are here for. That is what Julie and I are here for and other birth professionals here that we have on this podcast. That is what the course is for. That is what the community is for, for you to learn, for you to grow, and for you to know that when you are told some of these things, they are necessarily true. Okay. Julie: I love that, yes. 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

Episode 39. Challenges Of Pregnancy & Pre-Term Delivery With Special Guest Dr George Michailidis

Play Episode Listen Later Dec 6, 2023 61:06

On today's episode I had the honor to sit down with the best of the best, world renown, Dr. George Michailidis and ask him to do a deep dive on IUGR(Intrauterine Growth Restriction) and Pre-Term deliveries. Intrauterine Growth Restriction- IUGR occurs in about 24% of newborns world wide; approximately 30 million infants are affected from IUGR every year. The stats show that an estimated 13.4 million babies were born too early in 2020. That is more than 1 in 10 babies. These staggering numbers prompted the topic for this week's episodeDr George specialises in the best management of high-risk pregnancies. With his combined Fetal & Maternal Medicine skills and extensive obstetric experience, he provides the comprehensive care needed for both mothers seeking a doctor with a full spectrum of expertise in complex maternal and fetal medicine as well as those considered high-risk.This is conversation that needed to be had and understood. We'll be exploring the intricacies of prenatal diagnosis, cutting-edge ultrasound techniques, and the specialised care required for High-Risk pregnancies. Dr. George, who is the mastermind behind the dedicated team at Genesis Healthcare Center in Dubai, will share his expertise, providing valuable insights into what Interest Uterine Growth Restriction and Pre-Term deliveries.Don't miss this episodeIf anyone would like a consultation with Dr George, head over to www.genesis-dubai.com to make an appointment. You can also follow Genesis on Instagram for some great content and updates. @genesis_dubai

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9. Nine Months in, Nine months out: My Postpartum Journey

About Health and Hormones

Play Episode Listen Later Dec 5, 2023 52:03

The postpartum experience is wild. There are so many changes that happen so quickly- going through labor, having a new human to take care of, recovering from birth, feeding the baby, all while your body has been completely changed from experiencing pregnancy and birth. This was my second time giving birth and being postpartum, but the first time I really struggled with my body image, which felt shocking, confusing, and disappointing to me. I thought I was unaffected by diet culture, and my postpartum experience really busted that myth. I realized just how deeply diet culture is embedded into our brains and how it manifested during my postpartum experience. This episode details my postpartum struggle to love and accept my new body as a mom of two and hopefully will give you some tips and insights if you're in the same boat.Listen in to hear me share:How I struggled to gain enough weight in my first pregnancy and my baby was diagnosed with IUGR (intrauterine growth retardation)How I ate really differently in my second pregnancy and gained 50 lbsHow I struggled with thoughts around dieting and not feeling like myself after giving birthMy struggle to accept my postpartum bump when I had been totally fine with the baby bump while pregnantHow women of all shapes and sizes are susceptible to the dangerous messaging of diet culture Why I ditched my postpartum workout programWhat I actually focused on for recovery during my postpartum period How I work on my relationship with my body and make sure that the foundation of that relationship isn't based on how big or small it is or how it looks in the mirror+ so much moreThank you so much for listening to the About Health and Hormones Podcast! If you loved today's episode, I would love to know! Please leave a rating and review so I can make this podcast even better for you all. I would love to connect with you.Follow me on Instagram or and head to my website to get 60+ free hormone healthy recipes, download my free Ebook, How to Boost Your Egg Quality, learn about my coaching programs and stay up to date on all my latest workshops and courses!I'm so glad you were here today and I wish you all health and happiness!This episode was edited and produced by Intent Media.

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441 | Maria, fraternal twins, ovulation induction, cervical stitch, bed rest, IUGR, caesarean birth, NICU

Australian Birth Stories

Play Episode Listen Later Dec 4, 2023 54:07

In today's episode Maria shares her fraternal twin pregnancy which required her to spend 14 weeks on bedrest. Her pregnancy was considered normal until 20 weeks when a routine scan showed her cervix was shortening, exacerbated by the pressure of excess amniotic fluid. The following day a cervix stitch was inserted and Maria spent the next 10 weeks in hospital. She talks about the power of meditation and the practises she embraced to stay present and positive. Her boys were born at 33 weeks and are now healthy, happy four-year-olds who speak three languages. Follow us on Instagram at @australianbirthstories for helpful articles, behind the scenes, and future episodes. Today's episode is brought to you by my online birth education course The Birth Class.Featuring 10 audio lessons with perinatal health specialists, you can listen from the comfort of your home when you're relaxed and receptive to new information. The Birth Class is a conversation starter between you and your birth partner that informs, encourages and empowers you to journey towards labour with knowledge and confidence. Learn more here.See omnystudio.com/listener for privacy information.

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#89 - Part II - Obstetric Emergencies - SGA (Small for Gestational Age Babies) and IUGR with Senior traditional Midwife KL Goode

MommyTrack Daddy Whispers

Play Episode Listen Later Dec 3, 2023 43:31

This episode is a part of our conversation on Obstetric Emergencies which are critical situations during pregnancy, labor, or the postpartum period that require immediate medical attention to safeguard the health and well-being of the mother and/or baby. But are these really emergencies or is there more to it?In Part I of this episode we discussed, Large for Gestational Age babies and its link with Gestational Diabeties with Senior Midwife KL Goode who is a Hawaain traditional midwife with over 53 years of experience and having assisted over 1400 births. Her transfer for surgery rate has been as low as 4% . She has served in India on and off and is currently based in Kolkata. She is currently training a batch of traditional midwives aka birth keepers. If you have not yet, hear part I first: Listen to Part IToday, we discuss Small for Gestational Age Babies (SGA) and IUGR (Intra uterine growth retardation, we speak about the following:1. What is the difference between SGA and IUGR?2. Is SGA really just an unnecessary label?3. Is IUGR something one should seriously look at?4. Can Ultrasoud detect any of these fully?5. What do the research papers say?Support the showPrepare for Birth, explore Prenatal and Postnatal Preparation Classes, visit www.birthagni.comSupport the show: If you like what you hear, leave us a rating on Spotify app and answer the question at each episode! a review on Apple podcasts. Share on Whatsapp/Insta/FB Share on Insta and tag us @divyakapoorvox Support the production by making a donation at https://www.buymeacoffee.com/birthagni. This ensures the continuity and quality and a good coffee on sleepless recording nights! Subscribe to the FREE newsletter at https://www.birthagni.com/#subscribe and receive DISCOUNTS, SALE updates and GIFTCARDS on our premium 'Own your Birth' program You can book a 20 min FREE Discovery call at https://www.birthagni.com/bookfreesession ...

438 Postpartum | Alex, one baby, solo parenthood, donor-conceived, MGP, IUGR, physiological birth, donor milk

Australian Birth Stories

Play Episode Listen Later Nov 24, 2023 53:27

In this episode Alex shares his pregnancy and birth journey as a trans man, including his choice to embark on solo parenthood. He sought guidance from an IVF clinic and embarked on a number of tests to ensure his egg quality and reserve were favourable before deciding on a sperm donor. Once pregnant, he opted for MGP care through his local public hospital and was induced at 38 weeks due to intrauterine growth restriction (IUGR). Alex shares the challenge and joy of labour and birth, his choice to access donor milk and his body dysphoria in postpartum. Follow us on Instagram at @australianbirthstories for helpful articles, behind the scenes, and future episodes. Download our many free pregnancy and labour tips guides hereSee omnystudio.com/listener for privacy information.

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#88 - Part I - Obstetric Emergencies - Big Baby - A curse or boon ? | Big baby and Fitting through the Pelvis | Induction | Gestational Diabetes with Senior traditional Midwife KL Goode

MommyTrack Daddy Whispers

Play Episode Listen Later Nov 24, 2023 41:41

Obstetric emergencies refer to critical situations during pregnancy, labor, or the postpartum period that require immediate medical attention to safeguard the health and well-being of the mother and/or baby. But are these really emergencies?Many women today are being told they either have a Large for Gestational Age Baby (LGA) or Small for Gestational Age Baby (SGA). IUGR is another term thrown around independently that needs fixing. It is important to note that these issues are often figured out at a scan at 36 wks or so and one diagnosis is often considered as the standalone complexity and women are then presented with options to fix it, mostly an Induction.Now, big babies have all been born through history vaginally without any issues. Similar is for small babies, why is then these are seen as problems?We sit down today with KL Goode, a Hawaain traditional midwife with over 53 years of experience and having assisted over 1400 births. Her transfer for surgery rate has been as low as 4% . She has served in India on and off and is currently based in Kolkata. She is currently training a batch of traditional midwifes aka birth keepers. She takes us through the following significant points in Part I of this discussion1. Is Big baby or Small Baby really an issue?2. If not, when is it that it becomes an issue?3. What's the truth behind the claim that big babies can't fit through the pelvis?4. What has Gestational Diabetes to do with a Large Baby?5. What is a midwife's way of working with a Large or Small BabyTune in to learn more. In Part II , we discuss Small for Gestational Age babies and IUGR at length and conclude our discussion.We would also like to thank our supporters, Dr Sreenath and Giridharan co founders of Nasobuddy for supporting the production of this episode and enabling a special discount for its listeners. They are the pioneers in making natural and non invasive baby products for one of the most daunting baby issues early postpartum such as sleep, colic, cough and more. They have a wide range of products, my favorite being the nipple healers! Visit www.nasobuddy.com to know more!Support the showPrepare for Birth, explore Prenatal and Postnatal Preparation Classes, visit www.birthagni.comSupport the show: If you like what you hear, leave us a rating on Spotify app and answer the question at each episode! a review on Apple podcasts. Share on Whatsapp/Insta/FB Share on Insta and tag us @divyakapoorvox Support the production by making a donation at https://www.buymeacoffee.com/birthagni. This ensures the continuity and quality and a good coffee on sleepless recording nights! Subscribe to the FREE newsletter at https://www.birthagni.com/#subscribe and receive DISCOUNTS, SALE updates and GIFTCARDS on our premium 'Own your Birth' program You can book a 20 min FREE Discovery call at https://www.birthagni.com/bookfreesession ...

Episode 260 Jessica's Precipitous HBAC After Vasa Previa

Play Episode Listen Later Nov 8, 2023 32:22

The chances of having vasa previa in a spontaneous pregnancy is about 1 in 2500. Our friend, Jessica, shares her experience with vasa previa during her first pregnancy which led to a scheduled Cesarean. While Jessica's Cesarean experience was difficult and traumatic, she knows it is what her intuition was telling her to do. Meagan gives important advice about listening to that intuition with every pregnancy.When the anatomy scan results showed that Jessica's second pregnancy was completely normal, she went all in to achieve the HBAC she deeply desired. Jessica didn't expect her birth to be so painfully intense and wildly fast as it was, but now she says that she “would love to do it again!” Additional LinksThe Lactation NetworkHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello you guys. This is Meagan and today I am recording in a very different spot. Normally, I am in my office at my home, but today, I am recording from my car. We have our friend, Jessica, and she is from California. She is going to be sharing her HBAC story with you guys today. If you don't know what HBAC is, if you're new to all of the terms, it's a home birth after a Cesarean. She has a unique situation with her first C-section so I am excited to talk a little bit about that and have her share more information and then with her home birth, it was precipitous. Jessica, was it a planned home birth? Remind me, or was it so precipitous that it ended up being a home birth? Jessica: It was definitely planned. Meagan: Definitely planned. Review of the Week Meagan: She will be sharing that story but of course, we have a Review of the Week. This review is by Ashley and it's actually on our doula course. So birth workers, if you're listening, if you didn't know, we have a birth worker course to become certified in VBAC. It says, “TOLAC/VBAC should be treated just like any other birthing person, but there is a certain preparation and information that needs to be offered to them. Your course covered that. The value is held in your careful recognition of how best to support our client who is doing a TOLAC. I cannot praise you two enough for the fear-release activity. Honestly, it is something I can apply to even myself before and after birth and even in life in general. Thank you for that. It has already helped me with three of my VBAC clients.” That is so awesome. That is one of the biggest things we do in our course. We do a fear release. If you didn't know, listeners, a fear release is so impactful really processing your past births and working through any trauma. Even if you don't recognize it as trauma, it may resonate as trauma so working through those fear-release activities is super amazing. Jessica's Stories Meagan: Cute Jessica, thanks for joining me from my car today. I kind of had a crazy day where my husband got thrown into coaching another team and we had soccer tryouts. As we are recording right now, it's actually May so we are in the thick of soccer tryouts and all of the chaos of the last week of school. I ended up being at the soccer field so that's why I am coming from my car. So yeah, Jessica, I'd love to turn the time over to you to share your beautiful story. Jessica: Yes. Thank you. Thank you so much for having me. I'm very excited. I'll just get to it. Basically, I got pregnant with my first son and he was due in July of 2020, well actually, the beginning of August. He was a COVID baby. My husband didn't get to go to any appointments with me. But that was supposed to be at a birth center. I watched The Business of Being Born. I got down that rabbit hole. We decided we wanted to be at a birth center. Everything was fine, then I had my anatomy scan and they found vasa previa. I had never heard of it. I never really even considered something being– you know, you worry about something being wrong with your baby. You never think about you having something wrong. So we were very shocked and all I remember was the sonographer saying, “It's detrimental to your baby.” That was very devastating because I had no idea what that meant. I had to wait to get a referral to see a specialist. It was, I think, 4-6 weeks away. In that timeframe, I had to basically just sit and wait and not know what was going to happen. I joined a Facebook group, did research in the meantime, and I realized, “Holy crap. This is a big deal.” I went to the specialist and they said, “Yeah. You have vasa previa but it could still move.” I left with no answers. It didn't feel any better hearing that. So basically vasa previa is you know, you have your placenta and your umbilical cord. It was explained to me that typically with a placenta and an umbilical cord, the umbilical cord is like a tree trunk. But when you have vasa previa, it's like tree roots. So basically it's an unprotected umbilical cord and vessels that could potentially be ruptured with a vaginal birth. Meagan: Yeah. They're very exposed. Jessica: Yes. Very exposed. I did also learn that I had a velamentous cord insertion which goes hand-in-hand I think. So yeah. Basically, the moral of the story was that it was a big deal on how I was going to birth this baby even more so because his life was at risk. I eventually saw three doctors at the same practice just for follow-ups. They eventually cleared me for vaginal birth. You think that you would be super excited about that, but everything that I was reading was saying that it has to move a big amount for it to be safe. The vessels could still rupture and all of that stuff. So then I got two second opinions at different practices. They also cleared me. I don't know. Everything that I was reading, I was reading different stories on this Facebook group. I just felt in my gut that I needed to still have a C-section. That is not what I wanted. I still stayed with the specialist because I was still considered a high-risk pregnancy. She said that I could deliver vaginally, but I told her, “I feel like I would feel safer doing a C-section.” She said, “Okay, but we are going to wait until 39 weeks.” With vasa previa, you deliver much earlier than that just because they don't want your body to go into labor at all. Basically, that whole pregnancy was full of anxiety and fear. I was worried every single time I went to the bathroom. I was worried there was going to be all of this blood. I felt invalidated and like I was silly for still wanting a C-section by this doctor. Yeah. It was really hard and then my husband couldn't even be at the appointments to hear what was being said. So yeah, it was really hard. Meagan: Yeah. That is a really hard thing to hear. Especially when you are not even planning on giving birth in a hospital. It's like, “So wait, wait, wait. I have to completely shift all gears.” But what I love was that your intuition was like, “I need a C-section. This is what I feel is best for me and my baby.” You followed that. That is so important. One of the messages here at The VBAC Link is that we strive to say that we don't shame anyone for having a C-section. We know that they are happening a lot, but especially when your gut is saying, “This is what I should do,” we have to follow that. Women of Strength, we have to follow that. Jessica: Yep. Yep. So ultimately, yeah. I followed my gut and I'm really glad that I did. The nurse who was by my side in the C-section said that she had never seen a placenta like mine. The doctor, of course, said that it looked normal, but every person that I've shown, and some of them are birth workers, are just like, “Wow, yeah. I've never seen a placenta like that.” I had a ton of exposed, very fragile-looking vessels. I don't know where they were in my belly, but still, they were very fragile-looking. I feel like I made the right decision. My doctor said that it was normal, but I don't think that it was. Meagan: Was your baby IUGR at all with the velamentous cord on top of it? Jessica: No. Meagan: Okay, sounds good. Let me just– there are lots of abbreviations in this episode. IUGR is intrauterine growth restriction and that can be a baby that is being restricted of growth. Sometimes with a velamentous cord, a baby can be on the smaller side or have growth restrictions so it's awesome that your baby didn't. Jessica: Yeah, he was 7 pounds, 3 ounces at 39 weeks. Yeah. I mean, it was a fine C-section. Nothing eventful happened, but it was still traumatic being strapped. I wasn't even strapped down. My arms weren't, but still, the experience was. I didn't get to hold my baby for an hour and when I did, I was super shaky. I was nervous to hold him.I looked up at the monitors and I feel like my blood pressure was super low at one point. I thought I was dying. It did not feel great. It was traumatic for us. I know that trauma looks different for everybody, so for us, the whole experience was traumatic. My doctor did say, “You know, I'm giving you this incision so that if you do have another baby, you can have a VBAC.” It was always in my head that when we did have another baby, it would be a VBAC. Jessica: So yeah. Fast forward to April 2022, my husband and I were trying and I got pregnant. It was kind of a surprise but kind of not. I toyed with the idea of possibly giving birth in a hospital, but it was for a very short while like maybe five minutes, then I was like, “No. I think I need to do a home birth this time.” Just because of our experience at the hospital, I don't know. I didn't want to have to fight to have a vaginal birth. I didn't want to be held to the hospital policies and whatnot. I follow a lot of birthworkers and see physiological birth and whatnot so we just decided to have a home birth. We found our midwife and she was a midwife. She's been a midwife for 46 years so had lots of experience. She's had lots of VBAC babies and it was just really exciting. It felt right to book her as our midwife. I had her, I think, from 9 weeks on and nothing exciting happened in my pregnancy. I was nervous about the anatomy scan, but they did a very thorough check and I could have cried hearing the news. I was just very confident knowing that the placenta was good, the umbilical cord looked good, and all of that. We went on to have an uneventful pregnancy. I would say from 37 weeks on, I would have cramping and whatnot. I always had Braxton Hicks from 15 weeks on, but around 37 weeks, it changed to that more period-like cramping. I tried not to read into it. I was just like, “This is my body preparing.” There were a couple of times where I was like, “Oh my gosh. Is this happening?” I was listening to lots of podcasts and birth stories and stuff to just kind of prepare myself for every scenario. I think I went to my midwife at an appointment the day before I turned 40 weeks. I was toying with the idea of getting checked or not because I didn't want to be disappointed or get my hopes up. Ultimately, we– I keep saying we. My husband was a big part of this. I decided to get checked and I think I was a 2 and 70% effaced or something. I was in the right direction but I also knew, “Okay, that doesn't really mean anything. It could be a week.” But they did want to schedule me for a membrane sweep the following week just in case because you can't give birth at home past 42 weeks. I really did not want to do that, but I also really wanted to have the baby at home. I was just really anxious. Now I felt like I was on a timeline. My due date came and went. I was disappointed. I knew that it's totally normal for your baby to not come at or before 40 weeks, but you have that hope that maybe they will. Your body is starting to have all of these symptoms so you're hoping that this is it. My midwife had said, “Make plans because babies like to come when you have plans. They don't like it when you're waiting around for them.” Meagan: I love that. Jessica: Yeah. I tried to get out of the house and then one day, I was like, “Okay, do you know what? We have to go do something.” I planned for me and my toddler to go to the aquarium. We had to buy tickets. The day after my due date, I lost some of my mucus plug so I was very excited about that. Two days after my due date, I listened to Bridget Teyler. She has an induction meditation on YouTube. I just did it because when my husband was putting my toddler to bed, that was my time to get in the zone, drink my red raspberry tea, and prepare for birth. I just did it because it was something to do. I didn't expect it to work. I thought, “You know, if nothing else, I'm bonding with my baby.” It was really great. The next day, I woke up and I was pregnant still. My mucus plug still kept coming out. It was pink and I was like, “Oh, is this my bloody show?” but my midwives were like, “No, that's still your mucus plug.” I was kind of disappointed about that. I talked to my husband about all of the anxiety and how people were wondering where the baby was and all of that stuff. We had a steak dinner that night. That was the meal that I envisioned that I would have before I went into labor. That was 40 weeks and 3 days. The next day, at 40 weeks and 4 days, I woke up still pregnant with no signs. I was emotional about it but that was the day I was supposed to take my son to the aquarium. We get ready and we're driving. On the way there, I'm starting to get cramps every four to every 30 minutes. They were 30 seconds long. I was like, “Oh my gosh. What the heck?” We get to the aquarium and my son wants me to hold him. Meanwhile, I'm having these contractions. I'm just like, “Oh my gosh. I wasn't timing them because obviously, I had my hands full.” We ate at the aquarium and I remember feeling dizzy and nauseous at one point. But then we went home and my toddler fell asleep in the car which is pretty rare. That means it's going to be a short nap, so I was like, “Oh if he takes a short nap, he's going to go to bed earlier. Maybe this is meant to be. Maybe if I go into labor tonight, this is meant to be.” I had always envisioned that I would give birth at home while my toddler was sleeping just because he's a very sensitive little guy. I figured that my being in labor would scare him. So I was just like, “Oh my gosh. He's going to go to bed earlier than normal.” I got home and my husband got home from work. I was like, “I'm going to go rest and lay down to try and take a nap in case.” I couldn't sleep, but I did lay in bed for an hour and a half. I went downstairs. I tried to make dinner and I kept having to stop and lean on the counter. My husband was like, “Do I need to turn the lights down? You're going inward.” I'm like, “No, I'm not.” I was in total denial. He eventually took over because I was just like, “Yeah, I'm trying to cut raw chicken here and I'm not feeling too hot.” They still were pretty inconsistent. I still hadn't really been timing them. They were probably every 4-20 minutes for 30 seconds. So then we ate. I think I ate on my birth ball and then I texted my doula who was also a student-midwife with my midwife. I saw her at every appointment which was pretty convenient. She was just like, “You know, don't really worry about timing them. Just try and rest. Eat some snacks and let me know when they pick up in intensity.” It was 6:00 PM and I was just waiting for bedtime because I knew that once my toddler went to bed, I could really focus and not have to hide that I was in labor. But I still don't think I realized how far along I was. So we did the bedtime routine. I do want to note that I was leaning over on a pillow and my toddler was rubbing my back and saying, “Baby brother, I help you.” It was the sweetest thing. Meagan: Aw, that's adorable. Jessica: Yeah. So finally put him in bed and I told my husband, “Maybe you should just go to sleep with him just in case. Well, I don't know. I'll text you.” I didn't know if he should go to bed or if he should come downstairs and act as my doula. So he was putting my toddler to sleep. I tried to get in the bath. I could not get comfortable. Our bathtub is so tiny and they were definitely picking up in intensity. I just could not get comfortable. That didn't last long. I texted my doula and told her, “I feel like they're on top of each other, my contractions, but they're not quite a minute long.” I think I texted her, “I've had four in a matter of five minutes, but they're short.” She was just like, “Try different positions. Maybe try a shower.” At that point, I had already gone downstairs to try something else. I could not find a comfortable position. So my husband texted me, “What's the situation?” I don't know. All I said was, “Come.” Yeah. I was just like, “Come,” because it was just so uncomfortable. I could not find a comfortable position. I could see him on the monitor because we already had the monitor set up but he was just lying in bed taking his time. I'm like, “What is this man doing?” He did not realize how intense things had gotten. He came downstairs and we tried different positions– laying down on my side and on all fours on the couch, on the ball, and I just couldn't get comfortable. So after 15 or 20 minutes of him trying to help me, I had him text the doula. She got over there around 8:30 and she was helpful with having me take sips of water and giving us ideas for different positions. She tried doing the Spinning Babies side-lying release and that was unbearable, but we did it. Then she had me move to the ball. Actually, I think while we were on the couch and I was lying down doing the side-lying release, I felt something come out. I had a diaper on at this point because I just kept having bloody show. I was like, “Something just came out. What was that? What was that?” It kind of felt like I pooped but it was out of my vagina, so I was just like, “Was that the baby? What just happened?” She looked and it was my bag of water, but it was still intact. It looked like a boob implant to me. Meagan: Yeah, like it was bulging out of you. Jessica: Yeah, but it came out in a bulge, so that was wild. So that was cool. I knew that because she was the student midwife, she would be the one to tell the midwives to come. We weren't even worried about that. She was timing contractions, but I had no idea how fast they were coming. I said at one point, “Why are they coming so frequently?” She was like, “Well, you're in active labor.”Then we moved to the ball and that was unbearable. I felt him move down which was so wild and then I had a birth pool. It was already blown up, but we hadn't even added water or anything. I was like, “Should we start setting that up?” My husband went and got the pool and tried to start putting water in it and whatnot. I was like, “I feel like I need to move to the couch,” so I did. I got on all fours and I had pillows up by my face. It was just so intense. I just remember thinking, “I'm never doing this again.” I asked my husband, “Whose idea was this?” meaning to have another baby and to do it vaginally because I was like, “This is awful.” It was so painful. Then you know, I just stayed in that position. I knew that once I was in that position, there was no way that I was going to be able to move. My husband was setting the pool up for no reason because I was like, “I don't know how I'm going to make it in that pool.”I think one of the midwives showed up around 9:30ish. At that point, I was having the fetal ejection reflex. I was making these guttural noises. You hear about what that feels like and how you just can't control it and it's so true. I felt like when you feel like you have to puke and you puke uncontrollably. It felt like that in my vagina. The noise I was making was totally uncontrollable. There were some intense sounds. The midwife showed up and before I knew it, she was saying, “You're going to feel the ring of fire.” My husband, in hindsight, was like, “I thought she was just saying that. Of course, she's going to feel the ring of fire.” He didn't realize she was saying it because the baby was crowning. He was up by my head holding my hand and stuff. Finally, he realized that the baby's head was coming out. My baby's head popped out and then you heard a tiny little cry, but then it went back in. She had me get in the runner's lunge to try and help him out. I think I pushed maybe three times. She had to remind me to breathe because the fetal ejection reflex was taking over. I just couldn't stop having that feeling to push, so she reminded me to breathe. He came out. He was born at 9:58 so I had, I guess, 12 hours of labor, but I think active labor probably started around 4:00 or 6:00. Again, I'm not really sure because we weren't really timing contractions. He was 8 pounds, 7 ounces. Yeah. It was insane but in the best way. It was so empowering. I couldn't believe that I had done that. One of my affirmation cards was like, “You're a badass for having an HBAC.” My husband was just like, “Yeah. You're a badass. I can't believe you just did that.” Yeah. It was just wild. So amazing. Meagan: Absolutely. I'm sure it was very different for him, too just with the whole situation. “Okay, I'm going to set up the birth pool. She's telling me to come but I'm going to take my time.” It's just a very different experience. Then he's like, “Okay, wow. We're in labor. Let's go.” Then it's like, “Yeah, of course she's going to feel that. Oh, you mean that now she's going to feel that.” Jessica: Yeah, I think neither of us knew how far along I was and how quickly things were progressing. It just happened so fast. Meagan: Yeah. I want to talk about this too because sometimes we get diagnosed with failure to progress. We get to 3 or 4 centimeters and we're told that we'll likely never progress and whatever, then we go to have a C-section. Then we fear having a VBAC sometimes because we are like, “Well, maybe we won't progress past what we've progressed.” But a cool factor about your story is that you never even went into labor, right? You had never even dilated or gone through that whole process. This whole birth, this whole HBAC was essentially like you're a first-time mom. Your cervix was doing this the first time.When we've already progressed in maybe previous labor, that's an even greater chance of a VBAC. You went in and your body did exactly what it needed to do to get this baby out even though you hadn't had any labor previously. Jessica: Yep. Meagan: Pretty cool. Jessica: Yeah. I was very excited to see how it was all going to unfold. Meagan: Mhmm. Well, it sounds like it unfolded beautifully. Now you've got two cute babes and a beautiful home birth under your belt. So now– you were explaining that you were like, “Wow. Why did we do this? Why did we choose to get pregnant? Why did we choose to give birth vaginally?” After it is all said and done, are you like, “Yeah. I would do it again. I'm super happy we did it”?Jessica: Yeah. I actually want to do it again just because it was amazing. At the moment, yeah, it felt like the most painful thing of my life, but after that baby's out and you do it, it's like, “Wow. I did that. I am capable. My body isn't broken. Just because this happened one time doesn't mean it's going to happen again.” It was very empowering. Yeah. It was just amazing. I would love to do it again. Meagan: I love that. Well, huge congrats. Huge, huge congrats. I want to talk a little bit more about vasa previa because I don't think we've had anyone on the podcast who have actually had that before. Usually reasons for a Cesarean– we talked about this before we started recording– are “big baby”, small pelvis, failure to progress, or breech. We don't see these because it is really, really rare. It actually only occurs in 1 in every 2500 deliveries. I don't know if you said anything about IVF but it's more common in IVF which is about 1 in 200 but even then, it's a pretty rare chance. It can happen randomly or if IVF was going on, there is definitely a chance that it could increase your chances. Did you do any IVF at all or was it a spontaneous pregnancy? Jessica: It was spontaneous. I didn't have any of the risk factors for vasa previa so it was totally random. Meagan: Totally random. You were just one of the really rare cases, but it worked out really well. Jessica: Mhmm, it did. Meagan: Well, thank you so much for sharing your stories with us today. Jessica: Thank you 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

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456: Overcoming Diagnoses of “Incompetent” Cervix and IUGR with Sarah Schade (DIAH Classic)

amazon overcoming diagnose schade incompetent cervix iugr

Play Episode Listen Later Oct 11, 2023 78:03

How do you plan for a positive hospital birth experience, when you were originally intending to have a home birth? This is such a great topic to cover. For many who start out with a home birth plan, sometimes that changes for various reasons. Sarah Schade shares her story with us. From a diagnosis of an “incompetent” cervix (definitely not a term we're fond of around here) to another diagnosis of IUGR (intrauterine growth restriction), Sarah and her husband Jeremiah went through a lot of ups and downs. She shares all the thoughts and emotions that came up, and ultimately the arrival of her daughter Clementine. Things we talk about in this episode: incompetent cervix, cervical cerclage, IUGR, D&C procedure for placenta removal, home birth plan, hospital birth From Sarah: “It was really difficult being labeled as “incompetent”, or “high risk”, especially because being healthy and active is something really important to me, and I never thought I would have any problems with my pregnancy, being so young and healthy. We shifted from working only with our midwife, to the medical treatment model, which neither of us envisioned for our pregnancy… My pregnancy was filled with joy, sadness, fear, and anger. Our baby is healthy, and we are so in love with our little fighter, and her strength. But we have learned so much about the health care system, how women are treated, and why women need to be given more options in treatment. We had a lot of positive aspects to her birth, but were also threatened with an episiotomy, forceps, and vacuum. Our midwife and the hospital nursing staff was amazing, but the doctor on call severely violated some of my wishes without consent. I want to share my birth story, because it's not enough to believe that “doctors know best” when in actuality birth experiences matter to the mental and physical health of women and their babies.” Links From The Episode: Sarah's Schade's website: SarahSchade.com Offers From Our Awesome Partners: Needed: https://bit.ly/2DuMBxP - use code DIAH to get 20% off your order Splash Blanket: https://bit.ly/3JPe1g0 - use code DIAH for 10% off your order Esembly: https://bit.ly/3eanCSz - use code DIH20 to get 20% off your order More From Doing It At Home: Send us your birth story: https://bit.ly/3jOjCKl Doing It At Home book on Amazon: https://amzn.to/3vJcPmU DIAH Website: https://www.diahpodcast.com/ DIAH Instagram: https://www.instagram.com/doingitathome/ DIAH YouTube: https://bit.ly/3pzuzQC DIAH Merch: www.diahpodcast.com/merch Give Back to DIAH: https://bit.ly/3qgm4r9 Learn more about your ad choices. Visit megaphone.fm/adchoices

"Personal & Professional Reflections on Suspected Fetal Growth Restriction" - with Dr. Mariam Naqvi

Healthful Woman Podcast

Play Episode Listen Later Aug 28, 2023 44:14

Dr. Mariam Naqvi, a Maternal-Fetal Medicine Specialist in Los Angeles, joins Dr. Fox to discuss fetal growth restriction (IUGR). Mariam is both an expert in the diagnosis and management of suspected IUGR, and is also someone who had suspected IUGR herself when she was pregnant with her first. In this episode, she gives her personal and professional reflections on this important topic.

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#220 | Catrina's HBAC: A Mother's Triumph Over Medical Intervention

Play Episode Listen Later Jul 5, 2023 33:56

Catrina's first pregnancy was labeled high risk when a routine ultrasound revealed a two-vessel cord, leading to repeat ultrasounds and a diagnosis of IUGR (intrauterine growth restriction) and low fluid at 35 weeks. Her doctor immediately sent her in for an induction, and because her baby was still breech at that point, she ended up with a C-section. Catrina felt completely "checked-out" during the whole experience, as this was the exact opposite of the birth she had planned for. Her baby ended up in the NICU for five days and over 24 hours of time passed before she held her newborn. After this experience, she was sure she would never have another baby. Just over a year later, she was pregnant again, chose home birth and had the HBAC (home birth after cesarean) of her dreams.**********Down to Birth is sponsored by:Needed -- Optimal nutritional products to nourish yourself before, during, and after pregnancy DrinkLMNT -- Purchase LMNT today and receive a free sample kit. Stay salty.Love Majka Products -- Support your milk supply with nourishing protein powder, hydration boosters and lactation bites.Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort after vaginal birth. Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWNWork with Cynthia: 203-952-7299 HypnoBirthingCT.comWork with Trisha: 734-649-6294Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

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Episode 240 Abby's VBAC + Choosing Your Birthing Location

Play Episode Listen Later Jun 21, 2023 55:05

Abby Inman is a pelvic floor therapist, a soon-to-be mother of four, and one of the authors of the book Baby Got VBAC: An Inspiring Collection of Wisdom for Better Births After Cesarean. Located in Milwaukee, Wisconsin, Abby is advocating for hospital policies to make pelvic floor therapy more accessible to all birthing women. As a VBAC mom herself, Abby talks with Meagan about why every woman should have a pelvic floor physical therapy consult in the hospital before going home. Abby also tells us some obvious as well as more commonly missed signs indicating that you could benefit from pelvic floor physical therapy. Additional LinksBaby Got VBAC: An Inspiring Collection of Wisdom for Better Births After CesareanAbby's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsMeagan: Hello, hello you guys. This is Meagan with The VBAC Link. I apologize that I sound a little hoarse today. I have totally caught a darn bug. I have been trying to get away from it all year not getting sick and apparently, I couldn't get away with it. So here I am. I sound kind of froggy today but that's okay. We're still going to carry on. You guys, we have our friend, Abby, with us today and I'm really, really excited because I was just telling her before we started recording, she is just a big ball of everything. She's got a lot of amazing things to talk about and share so it is such an honor, Abby, to have you on our podcast. Abby: I am so excited to be here. Meagan: Yes. Oh my gosh. I just want to talk a little bit even before we jump into the review. I don't want to talk too much about your story because I want to give you all of the time but have you guys heard, Baby Got VBAC? Have you guys heard of that book? If you haven't, go check our highlights or on our blog because we have it on there and it is such an incredible, uplifting book. And guess what, Abby? I don't know if you know this. I don't know if you were actually the one that contacted us, but forever ago, someone contacted Julie and me about being in this. We had so much going on. We were in our course and we were like, “We can't take anything more on,” and we declined the opportunity and now we are kicking ourselves in the pants. We're like, “Dang it. We should have been in this incredible book.” It has so many incredible people and stories and information in it. I mean, it's amazing, right? Do you want to tell us a little bit about it?Abby: Yes. Baby Got VBAC. I don't exactly know what is the subheader. It's like, “A Collection of Wisdom for Better Birth After Cesarean.” Meagan: Yeah. “An Inspiring Collection of Wisdom for Better Birth After a Cesarean.” Abby: And it was the brainchild of a VBAC mom herself who is also a writer and an independent publisher, so she just got us all together, found us likely through various social media channels as things are done these days–Meagan: Yes, yes. Abby: And yeah. It's a combination of VBAC stories from all different kinds of people as well as some awesome chapters done by various birth professionals so some birth educators, some doulas, some chiropractors, PTs–Meagan: Brittany is in it and we love it. I've taken her course. She's on our podcast. She's in it. Brittany Sharpe, yeah. Abby: Her chapter is awesome. So even though the stories are all VBAC stories, I mean really, a VBAC is the first time going through the whole process and having a successful vaginal birth so I also think it's a great resource for first-time parents who haven't necessarily had a Cesarean in their past as well. Of course, it's awesome for if you're preparing for a VBAC. Meagan: Yeah. I love that you touch on that. We talk about this on the podcast. This is a VBAC-specific podcast. We discuss vaginal birth after Cesarean, but all of us on this podcast– I'm telling you, except for maybe the providers are people who haven't had a Cesarean, but all of us were in that spot of preparing and had these Cesareans. It is a way to learn how to avoid a Cesarean, your options for birth, your options for location, and all of that. So yes, it is VBAC-specific, but just like this book, it is for all parents that are expecting and working and wanting to learn and grow their education. I love this book. It's amazing and it's so fun to have you today on the podcast. Review of the WeekMeagan: Before we jump in, we have a Review of the Week so I want to hurry and review this and then I will introduce you. Abby: Sounds good. Meagan: Okay, guys. This actually came in 12 days ago via email and this is from our friend, Jessica. She says, “Hello, VBAC Link. I wanted to write about my appreciation of The VBAC Link Podcast. I had a C-section in September 2020 due to an arrest of descent. It definitely affected my postpartum mental health. When I found out about being pregnant in July 2022, I Googled VBAC resources and found your podcast. I signed up for your emails, read your blogs, your Instagram, Facebook page stories, and listened to your podcast on my morning jogs and walks. I cried. I smiled. I empathized with the moms telling their stories and more importantly, learned so much. I followed many of the tips from you and the moms. “On 3/14,” which was not that long ago from the day that I am reading this today, “I was on my morning walk listening to the last VBAC Link episode and switched to my birth music playlist. Five minutes later, I started having contractions. After getting home and calling my doula, my husband took me to the hospital and I was able to achieve my VBAC and had a baby girl. Thank you for setting up this resource. I will continue to listen to the stories even though I don't plan on having more children. I love the stories, the information, and all of the passion for helping women like me. Thank you, Jess.” Oh my gosh. Jessica, congratulations on your VBAC, and a little part of me is so happy that we got to be a part of your birthing day. That is so awesome that you were listening to these amazing stories and went into labor. So congratulations, Jessica, and yes. Just like Jessica, you guys can too. You can VBAC too. Just like she said, we have blogs, Instagram, and Facebook. We even have a private Facebook group so if you are looking for a special space that is protected and filled with people just like you wanting to learn more about your options for birth after Cesarean, head over to Facebook and search “The VBAC Link Community,” answer the questions, and then we will get you in so you can start learning. Abby Inman, PT, DPTMeagan: Okay, Ms. Abby. Abby: That was awesome. Meagan: I know. Wasn't that so awesome? That was such an awesome review. I got it and I just left it in the inbox unread because I'm like, “That's going on next week's podcast.” It was so amazing. I was like, “Oh my gosh.” And we love reviews. We love the reviews so I always encourage people. Maybe you don't want to drop it on the podcast app. That's fine. You can send it in an email, but we would always love a great review so that we can read it on the podcast because it makes me smile so much. So much. I remember when Julie and I were together, we would get a review and we would just be texting. Our cheeks would hurt. They would hurt because we were like, “This is what we are wanting to do. We are wanting to inspire and motivate people to find their options,” because so many people around the world feel that their options are taken away or that they are robbed of them and that is not how we ever want anyone to feel. I do feel that through this podcast, you get to learn your options and you get to take back that power that maybe once was lost. Abby: Mhmm. Meagan: So oh my gosh. Well, Abby. You guys, I tell ya. She is just a ball of it all. She is involved in pregnancy and postpartum and pelvic health, writes in a book, and teaches classes. She works in the hospital system. Abby, you're just amazing. I'm going to turn the time over to you. You're in Milwaukee, is that right? Wisconsin? Abby: I am. Meagan: Tell us it all. Share your story. I would love to know more about working in the hospital system and teaching birthing classes and stuff like that as well. You guys, she does this all while having little kiddos and is expecting. So seriously, good on ya girl. You're killing it. Abby: Yeah. I like to describe my life as beautiful chaos. Meagan: I love that. Yes! Can I just take that with me and be like, “Yes. Beautiful chaos. That is what I live.” Abby: So yeah. I am a physical therapist. I specialize in pelvic health. I've been doing that for almost 8 years. Crazy how time goes by. Nobody at the time that I was going to PT school goes into PT school thinking they want to do the pelvic floor. People definitely do because it's becoming more common which has been such an awesome progression in the 8 years that I've been doing this. But I was lucky in that I was able to do an internship in pelvic health before I graduated which again at the time was super rare. I've been treating, again, in pelvic health my entire career. Really now though, my specialty or even my niche is pregnancy, birth, and postpartum just because that's the season of life that I'm in and just where my passion is drawn and where there is such a need. I could for sure argue that there's a need for all pelvic health, but this field is growing so there are a lot of other people doing all pelvic health and there are not quite as many people focused pretty fully on pregnancy and postpartum and just that specific time. Meagan: Yeah. I was talking to a friend of mine the other day and you know how we have a six-week gap like, “Oh, you have your baby. Okay, see you in six weeks! Hope you're doing okay.” The two things that I wish that we could fill the gap with are mental health and pelvic PT. Abby: Yeah. Meagan: Right? There's such a gap that needs to be filled so it's so good to hear that there's a little bit more and that it's starting to come around where people are focusing a little bit more on pregnancy and postpartum. Abby: Yeah. I have a lot of theories about different things related to how we get here but I just think that there is still this saying, “It takes a village,” but a lot of people really don't have the village–Meagan: I know. Abby: I think that's what has created the gap. You used to have your other female relatives around who would make you dinner and help you with your baby. Obviously, we just have to live in the reality and that's why people need help and need services because that's just not the norm anymore. Meagan: It's not and we're expected to just bounce back like, “Oh, you had a baby. Okay, great. Keep going as fast as you can.” That's how it feels. We just had a mom hire us for 80 hours of postpartum and I was like, “Wow. That's amazing that you are focusing so much on your postpartum.” She's like, “I want continuous for 80 hours,” and we're like, “Great,” so we made this work because her mom is from Korea. She was like, “People don't leave their bedroom. They don't leave their bedroom. They are with their baby and just like you said cleaning the house and making food,” but here we are. So many of our birth stories, our couples, and our parents, literally have to go back 3 weeks later to normal life or work. Abby: I know. It's crazy. That's not normal. It's not how it was meant to be. Yeah. I work at a hospital-based clinic part-time and one of my projects is just now really coming to fruition. We're still in the pilot phase but we're already seeing really great results and an increase in referrals and again, these are people we would have otherwise not seen. The program is for a PT to see moms in the hospital before they go home, not necessarily as a rule, not as, “You can't go home until you see the PT,” but just as a support service. We started it to be a standard or trigger a referral for anyone who has had a Cesarean and anyone who has had a third or fourth-degree perineal tear. I mean, obviously, this is The VBAC Link so we talk a lot about the birth after the Cesarean, but a Cesarean is a major abdominal surgery. Some people, of course, are expecting it and have been through it before and that obviously makes it easier a little bit because you know what is going to happen, but there's just about no other surgical example that you can compare to the care of a Cesarean. It's possible that you could have an appendectomy and see a PT in the hospital before you go home. Such a benign procedure is often done laparoscopically now. There is just nothing that compares to the gap in care after a Cesarean. It's literally like, “Oh, we just cut open several layers of your body.” Again, whether you were expecting it or not, you're also just recovering from being pregnant or if you labored at all and then having this major surgery. Oh, and you're going to stay here for two days or three days, but now you have to take care of this other human. Meagan: Yeah. Yeah. But don't forget to take care of yourself. Abby: But also, here's no direction about how to do that. Meagan: Exactly, yeah. Abby: That's slightly not fair because I don't mean to imply that postpartum nurses–Meagan: They send you with nothing. Abby: Yeah, that they're not doing their job or taking good care of you. It's actually that I'm making the argument that it's why there is room for this kind of program because PTs are movement and rehab and recovery experts. That is what we do. That's what we are trained in. All PTs graduating now are doctors in physical therapy. I have a doctorate. Just like your dentist is a doctor, I am a doctor. Like I said, it's really an expertise in this area of care and that's why we're just the most well-equipped to do that. You don't have to actually even be a pregnant or postpartum or even really pelvic health trained PT to do this work. You could be a hospital-based acute care or inpatient therapist it's sometimes called because you really teach people the same sort of things that you would teach your other patients in the hospital like early things about scar tissue healing and scar tissue work. Meagan: Scar tissue massage. Abby: How to lay flat in bed because guess what? You're going to have to lay flat in bed when you go home but sometimes they don't even do that. Meagan: And then how to get up. Abby: That's right. For sure how to get up, how to hold your baby when you walk, if you're having pain, how to go upstairs. Again, if that's painful, what to do? Just really practical things that people are going to have to do after they are discharged from the hospital and go home. I just think it is invaluable. Obviously too then part of our program is to at least get the scheduled for outpatient pelvic PT as well to make that transition really seamless. So yeah, it's been really cool. So far, it's going well. Meagan: That's awesome. So awesome. I hope that all around the world, a program like this can be implemented as a standard, just as a standard thing because like you said, it's invaluable. I also want to say that my nurse and my doc sent me home with a paper that was like, “Keep your wound this. Keep your wound that,” with wound care and instructions like, “Don't lift more than 10 pounds,” and stuff like that. That is so wonderful but no one told me about the things I was going to feel or even encouraged walking. Abby: Or breathing. How to breathe.Meagan: Or breathing. It wasn't encouraged. Yeah, get up and go to the bathroom, but it wasn't like, “Get up and move as much as you can within a certain range and that's going to help recovery and breathing and scar massage.” Never. Not once in either of my C-sections did anyone ever talk about the adhesions that could happen and the scar mobilization and things like that. That is where it lacks. We just lack so much so I would love to see programs like this happening all over the world. So if you are listening and you are in the medical world, this is something that you could try because it is so important. Abby: I'll send you some articles that are being published about it. There is just a handful of PTs who are really pioneering this work and again, trying to get stuff published because obviously, that's how it works in this medical world, so yeah. Just to have some scientific journal articles. Meagan: Yeah. We'll drop them in the show notes too. Awesome. So yeah. You've got the PT. You're influencing this amazing program. You've had a VBAC. In the book, you talk about– and this is not word for word what you are saying– recognizing your birthing plan and then also recognizing your birthing location and making sure that they match because if you are wanting certain things and then you choose– say you want an epidural. You're not going to have a home birth. You're not going to have a birth center birth. Maybe you're like, “I absolutely do not want to be induced with Pitocin. I don't want it to be discussed,” then a hospital birth may not be your best option. I want to also say that sometimes it is possible to avoid that, but it doesn't always go super easy. It's often times where you have to fight about it. So yeah. I would love to know if there are any highlights of your birth story or talking about birthing location and how it impacted your– remind me, you were induced with your first for, was it IUGR or was it preeclampsia?Abby: Yeah, I think it was a pretty common story. I was trained in pregnancy, pelvic floor, and postpartum before the first time I got pregnant. I had taken some coursework about all of this stuff so I don't want to say that I was cocky at birth, but I felt like I knew more than the average person. Meagan: Confident. You were confident. Abby: But as we know, birth is a very humbling experience. My first daughter was, I think I went to my 38-week appointment and I had been measuring fine. Her 20-week ultrasound was fine. I don't think I had another one since then, but it was 38 weeks. My OB did the portable ultrasound to see if she was vertex. I don't even know. I really should probably ask her. She probably doesn't even remember at this point because my daughter is about to be five. She saw something that she didn't like. Her suspicion was that maybe the amniotic fluid was low or something. So she wanted me to have a real ultrasound which I ended up doing. All of those things came back fine. The blood flow was fine. My fluid levels were fine, but of course, they measured her as well in the full ultrasound and they said that she is very small and we don't know why. That was their reason for wanting to induce me. Again, being the stubborn person I am, I was scheduled to give a presentation at the Wisconsin State PT conference later that week. I was like, “Well, I'm not staying to be induced because I have a presentation to give in four days so I'll do that and then we'll talk. I'm not having a baby before then.” I'm sure my team already didn't like that so I gave my talk on Friday and then we went for the non-stress test on Saturday afternoon and that's when they told me, “Yeah. You should stay and be induced.”I was really not super early or anything.Meagan: Two weeks?Abby: Yeah. That was a Saturday, so she would have been 39 weeks on Monday, I think. But really, I mean, my induction story is just that my body was not ready. I mean, I tried to do everything I could to make it slow. It just, like I said, that's just really what it comes down to. My body really just was not ready. I did not progress. I was doing all of the things that I know how to do and teach people how to do, but at that time, because I hadn't gone into labor myself, she just was nestled in there. I obviously have some qualms about the saying that you hear a lot, “Well, at least you have a healthy baby and at least the mom is healthy.” That should be the low bar. That's the minimum. That's not the goal. Meagan: I have feelings toward that comment too. I want to be honest. I kind of want to punch people when they say that because I'm like, “Yeah, duh. Duh.” Yeah. Abby: Yeah. The birth itself again, was not necessarily traumatic in that I did actually choose. They were like, “Okay. I guess you could keep going. I'll let you do this for however many more hours, but we're not getting anywhere.” I was tired and just was like, “Okay. I'm just ready to meet her. Let's have the Cesarean.”Meagan: Let's do this. Abby: It wasn't like she was in distress and they rushed me to the OR, so it was not an emergency in that sense, but again, just like this is going to happen whether it's right now or in a few hours and then it probably would have been more of an emergency things just because of the timeline of how that goes. I would say that my trauma from the birth was more just mental and emotional. Yeah. Really from there, I knew I wanted to basically get pregnant again relatively soon. I knew as we were starting to grow our family, we were going to do that by several children if we could. I knew I was not going to elect to have a repeat Cesarean. So basically, my mindset was, “Well, I have to be somewhere where that's essentially not an option unless it is absolutely necessary.”Meagan: It's an emergency, yeah. Abby: I made the choice then when I got pregnant again. My two older ones are almost 18 months apart to the day, so also about as close as you're supposed to have babies after a Cesarean. I chose to have my care with midwives at a birth center in town which is not an option for everyone because sometimes it doesn't exist. Meagan: I know. Yes. We've got states right now taking midwives away from the hospital even. Abby: Oh, totally. That's all kinds of crazy. I'll get on that fight. Actually, so now I'm pregnant again. We are expecting our fourth in July and that's why I'm still with the midwives at the same birth center and preparing for my third VBAC. Even though I've now had two successful vaginal deliveries, I'm always considered a VBAC patient which is just crazy. Meagan: We're always going to be a VBAC, yep.Abby: I mean, it's not crazy. Obviously, it's a definition but it's crazy that there is risk associated with it. Meagan: It's hard to think that it's still considered, yes. Abby: So that risk, I don't know. I mean, I'm assuming that this is just the insurance that my midwives use but their insurance company charges them $1500 just for accepting a VBAC client. Meagan: Are you serious?Abby: Right? It's completely insane. That's new. That wasn't true for my last two. It's new for this one. So that's crazy. Like I said, it's a definition but it's always going to be with me no matter how many children I have. I just think that's one of the things that's sort of a part of informed consent, too. You just don't realize how that's going to affect you. You know? Anyway, not that again, I would have chosen differently in the moment but things that you don't think about and don't realize are going to affect your childbearing experience for then the rest of that time. Meagan: Yes. And on the other end, could potentially affect a provider's ability or choice to accept, right? These midwives could say, “$1500 a person, we're not going to do this because we don't want to up our prices,” or whatever. “We can't take the risk that the insurance is putting on us.” Not that they're scared of the risk of birthing out of the hospital with a VBAC, but that could change. That could impact things so much as well. Abby: Very much. Meagan: Yeah. Abby: Yeah. Meagan: Interesting. It makes me sad. Abby: Yeah. When my kids are maybe a little older or just after I have this one and can think about things, after that, that's my next thing. I need to get embroiled in the legal battles of this then I can be like, “This is totally ridiculous.”Meagan: That is what I want to do. I always say that I have a bucket list of if I have all of the time in the world type thing. I have this bucket list and there are so many things surrounding it. It's birth. It's where I'm at in birth. I'm even done having kids, but as a doula and stuff, I'm seeing this. I'm listening to these podcast stories and I'm like, “We need to make a change.” I'd love to start facilitating more change in policies and things like that. One day when I have all of the time in the world, we'll get there together. Abby: We'll get together again. Mhmm. Meagan: Yes. We'll get together again and start to make some changes. I mean, we are moving in a forward progress. There is change happening. Abby: We are. Meagan: Okay. I'm going to bounce really quickly back to some PT. I would love to know any tips that you would like to share with your listeners. You mentioned, “Yes. We're The VBAC Link so we're talking about birth after Cesarean,” but what kind of PT things can we do prior to? Because I know for me I didn't even think. It didn't even cross my mind that I should consider a pelvic floor PT before giving birth and then of course, after having my Cesarean, again, I told you that there was nobody to tell me anything about anything and then here I go, and have another Cesarean and then even with that, nobody. So I had two Cesareans without knowing anything. Any tips for previous and/or after that you can give anybody?Abby: Yeah, so really in my ideal world, every person sees a PT in her first pregnancy and the reason for that is because your body, of course, just has to make these natural changes in your posture. Your various muscle groups have to change to accommodate the growth of the baby. That changes your center of gravity and center of motion which affects how you move and aspects of movement. Again, like I said before, PTs like me are the experts in movement. Again, it's not to imply that somebody currently is not doing their job, but nobody else is looking at that. So right now, I would say that providers are generally pretty good about offering a PT referral, and again, with things like social media, people are advocating for themselves better as well. But they're pretty good about putting something in if a patient raises an issue. “Oh, I'm having this back pain” or “I'm having pubic symphysis pain and I'm having hip pain. I'm having bladder leakage,” or whatever. XYZ things.Again, yes. If you are experiencing some symptom in your pregnancy like that that you think would be muscle or posture related, you should see a PT. But like I said before, I really think that everyone deserves that consultation because again, the natural changes that are happening are natural and we're not going to stop them, but I can teach you strategies to mitigate the effects of that. How do you consciously move your abdominal muscles and the connection between your diaphragm and your deep abdominal muscles and your pelvic floor and your glutes? How are you sitting at your desk or how are you standing? Starting those things when you're pregnant then carries over to how you move postpartum. Obviously, postpartum is a lot. It's hard for a lot of reasons, but to also have pain or these other symptoms, any bladder or bowel/pelvic pressure sort of symptoms is just going to make it harder. Again, I really think by learning about these things consciously and applying specific strategies even if you're the pregnant person who is exercising and running right up until the day she gives birth, that's obviously wonderful and I support you. Maybe it's just this one-time consultation sometime around, I usually say around the beginning of the third trimester is a good time to do it. You meet the PT. We talk about these strategies and things to implement for the rest of the pregnancy, and then now you've met that person and have a relationship with them, so you at least have a resource then postpartum to then be like, “Oh, Abby mentioned this could happen and guess what? It's happening. Now I know that I'm just going to call her and get on her schedule,” instead of Dr. Google in the middle of the night when you're nursing and all of this XYZ stuff comes up. Meagan: A lot of the time, it says that it's normal. It's normal to have these things. It's like, “Oh, well duh. It's normal. Yeah. You just had a baby. Yeah, it's normal.” But it's like, “No. No, no, no.” Too, I want to mention that sometimes athletes have these tighter pelvic floors and we need to actually learn how to calm and release for effective pushing so that we won't have more damage. So one of the big things that I think is really good, even if it's just once, is coming in and learning about your pelvic floor. Your actually pelvic floor, not just the pelvic floor in general. Your pelvic floor and learn where you're at. Do some practice pushes and learn some breathing techniques and learn what's normal. Learn what's not so you're not on Google thinking that your uterus is falling out. Do you know what I mean? It can go that extreme where you're like, “I'm having this.” You Google it and it's pure panic which is not going to help anything. It's not going to help recovery. It's not going to help our mental health. It's not going to help breastfeeding if you're breastfeeding because we're stressed. It's crazy how there's a cycle. It's a domino effect, so yeah. I think it's so, so, so important as well. I wish I would have known that. I wish I would have known that.I did that with my son, with my VBAC babe, and yeah. There was a lot to learn. Abby: Yeah. You know, I mean while I'm so grateful when I get clients that are done having children and they're like, “I'm finally prioritizing me. I've been having these symptoms since I was pregnant or since the birth of my first,” or whatever. I'm like, “Yes. Good for you. I'm so glad that you're here.” But it also just breaks my heart because I really think that maybe the symptoms are not entirely preventable. The dysfunction is not entirely preventable, but potentially it could have been less. Or again, now these women have lived “x” number of years– 1, 3, 5, 15, 20 years–Meagan: I know. Abby: Like I said, I really think that early intervention is key. Again, the changes happen in your first pregnancy. Even if you don't necessarily have symptoms in your first postpartum period. Meagan: Yes. Yes. That's the thing. Is it possible to not have any symptoms but to have some pelvic dysfunction or pelvic issues or scarring? Especially with C-sections, I have a friend who was like, “I have never had a diastasis recti. I've never had pelvic floor issues. I've never had adhesions. I don't have adhesions.” She's had multiple Cesareans and is like, “I do not have adhesions.” I'm like, “Yeah. Yeah, you probably do.” But you know, she says she has no symptoms. Then sometimes I wonder, “Do you know what symptoms to look for?”Abby: Right. Are you just living with things?Meagan: Yes. Yes. Abby: Right. Obviously, yes. That can definitely be true. The symptoms don't have to be so severe that they are really affecting your day-to-day life or quality of life. Of course, usually, people seek care when they're so fed up with it. But there can be sneaky symptoms or again, things that people view as not that bad, I would consider as not normal. Meagan: It's just our new normal because we had a baby and we're being told that. Abby: Knowing where every bathroom is in the stores that you go to is actually not normal. That fact that you have a map of where the bathrooms are in your brain– now again, the same argument could be made for people that are potty training their children. But okay, they're learning for the first time. Meagan: Or the second you walk into a store, the first thing you say is, “Where's the bathroom?”Abby: Right. “Where's the bathroom? I've got to go to the bathroom.” That's a symptom. Again, it doesn't have to be that way. You can change that. This was certainly true for me and I did lots of scar work and stuff, but I basically could not wear normal pants or jeans– definitely not jeans– until I was postpartum with my second, and that had been all stretched out again and everything was slightly less sensitive. That's a modification that I made and that lots of people make. That becomes your new normal that you sort of forget about, but it's like, “Oh, well I would just never wear jeans.” Well, that's not normal. Meagan: Why? Is it because you didn't want to or is it because you didn't feel like you could or you weren't comfortable? What types of signs? Just for our listeners because we're in this spot of, “Do I have anything?”. What kinds of signs or symptoms would be a sure sign? If you are finding the restroom the second you walk into a store, this is a sign. Yes, 100%. Maybe we'll go from an extreme guarantee that this is a sign to more of the subtle, hidden, could this be a sign? Abby: Sure. Meagan: Yeah. What symptoms and signs would you say for people listening? Abby: So anything obvious would be any sort of daily pain. Just pain every day anywhere. Related to pregnancy and postpartum, hip pain, low back pain, people will say SI pain which is your sacroiliac joint which is the back lower down in your butt, pubic symphysis pain, and tailbone pain. If you feel like you cannot sit on any surface for any given period of time and it's because your but is hurting, again, not normal. Meagan: Yeah, or even pressure. I remember after I had my baby I would be standing up and I would want to sit. This is so weird, I know. But I would want to sit on the corner of something right at the vaginal opening to support it or feel my hand like, “Oh, I just look like a little girl that needs to go pee but I'm just pushing,” because I'd have this pressure after more than 30 minutes or standing after more than 30 minutes. Or sometimes even just going to the restroom, I'd be like, “Oh, I have some pressure down there.” Abby: To support it. So that's a common symptom of the medical diagnosis we call pelvic organ prolapse so if you Google that, it can seem like, “Oh my gosh, things are falling out of me.” But again, that's not necessarily abnormal especially in postpartum because all of those organs were shifted while you were pregnant so some of it is the settling back into place. Some of it is that your ligaments are still relaxed from again, what your body does in order for us to have babies. Some of that for sure continues postpartum especially if a person is breastfeeding, that laxity. But yeah, it's like learning strategies about how to help that. So certainly, yeah. Pressure, heaviness, any obvious bladder and bowel stuff. If you for sure had to go change your underwear and pants after you sneezed, again, not normal. Meagan: Not normal, yes. Abby: If you're a year postpartum or six months, a year, 18 months, 2 years, 5 years, whatever and you are one of those people that's like, “Oh, I can't go jump on the trampoline with my kids. I can't run. I had to stop running.” Again, that's not normal. We can help you. Meagan: Yeah. What about even the inability to hold your core? Abby: Uh-huh. Meagan: It's like a big plumb line. It's all connected. If we had this ability to maybe hold a plank or run or ride a bike and we were able to hold our core in and not feel it release and start taking pressure in our back, but now all of a sudden we've had this baby and we're a year, two years, even three years or more down the line and we're like, “Jeez.” Abby: Why do I still look pregnant? Where are my abs? Meagan: Why do I still look pregnant? Where are my abs? Why can't I hold a plank for 60 seconds anymore when I could hold it for three minutes? Would you say that's connected to your pelvic floor? I feel like I know the answer. Abby: Yes. You mentioned diastasis. It doesn't matter how you say it. Meagan: I know. Everyone says it differently. Abby: That's the condition you're describing which again, almost everyone has a little bit of that the last several weeks of pregnancy because it's related to the baby growing. But it's a pressure management problem and tissue laxity, muscle coordination problem postpartum. Meagan: I recently was reviewing my op reports over some things and so talking about Cesarean, we don't think pelvic floor naturally because we didn't have a baby come out of our vaginal canal. We don't think that. We don't think about abs as much either. I think a lot of the time, even though we were cut down low, I feel like our minds are like, “I wasn't pushing and using my abs in my Cesarean,” but listen and sorry as a disclaimer, it's a little blunt. It's a little aggressive. Abby: It's okay. I mean, all of the pelvic floor therapy is TMI. Meagan: Yes. Abby: It's a no-judgment zone and no topics are off-limits. Sometimes you've just got to put it out there. Meagan: Yes. I don't want anyone to feel triggered by the words that I'm using because the words that I'm using are directly from my op reports, but this is how they describe my first C-section. It says, “The fascia opened in the middle and extended laterally with mayo scissors. Fascia was separated from the rectus muscles superior and inferior with sharp and blunt dissection. Rectus muscles were entered sharply and opened and then extended bluntly.” Abby: Yep. Meagan: And then a low incision was made above the bladder. That's where they go on. But I read I was dissected bluntly with sharp scissors. Abby: Yep. Meagan: Right? My abdominal muscles were literally stabbed and cut through. As I've been reading this, this was my first C-section and she's 11. 9 years ago tomorrow as of this recording is the anniversary of my second Cesarean, the birthday of my second Cesarean daughter. 11 and 9 years later and I have abdominal issues and I have pelvic floor issues and I'm working on things. I have pain with intercourse sometimes that I would have never related to my pelvic floor, right? And sometimes I read this and I'm like, “Well, no flipping way. No wonder I have a diastasis recti way above my belly button because I was manually cut with sharp scissors.” Listeners, I want you to know that if you've had a Cesarean and you're not having any pain, that's wonderful but that doesn't mean your body hasn't received trauma like this. It means it has if you've had a Cesarean. You may benefit from pelvic floor PT more than you ever know. And if you haven't learned about scar mobilization and things like that, it's time. It's time to learn about it. So yeah. Any other symptoms? I know we're cutting short on time, but any other symptoms that you would say to listeners, “If you're experiencing this, go check out your local PT”?Abby: Your C-section scar can cause shoulder pain because of that word you used “fascia”. Fascia means connective tissue. It's basically the thing that connects the whole body. Any good pelvic floor therapist is going to look at your whole body. They're going to look at you from head to toe. People typically, you mentioned pelvic floor tightness can have dropped. Feet issues, so plantar fascia issues. Your pelvis is in the middle of all of these areas. It's a highway interchange for things to happen. So again, yeah. You might have a collection of weird symptoms that you maybe didn't put together as related to pregnancy and birth and postpartum. Maybe you're even seeing another PT and you've made some progress, but there's still whatever sort of issue. You know, it might be worth it just to have a consult and have that area checked out. Or to just be looked at from that perspective. Meagan: Absolutely. Such good information. Always, women of strength, remember that you never have to deal. You never have to deal with this. You can take care of yourself and I encourage you to do things for you. Like Abby was saying, she's like, “Yay! You're finally coming in. You're finally taking care of yourself.” But dang it, it's taken so long. I am guilty of that in so many areas. Abby: Yeah. Again, that's not your fault though. Meagan: Nope, nope. Abby: Like I said, it's a problem with our healthcare system. Meagan: And not being informed. Abby: And not even the individual provider's fault. That's why I'm working so diligently and passionately to make it more of a standard because I think that everybody deserves this care. Just because you were pregnant, it doesn't even matter how your birth went. How it went will mean different things, will do different things, and address different things. Some of it will be similar because the common denominator was that you were pregnant. You grew a baby in your body. Meagan: Yep. Your body changed. Your body made amazing changes and did amazing things. It is okay to give back to yourself and thank yourself. Thank your body for doing this amazing thing multiple times for a lot of people. It's so important. Oh my gosh. Well, thank you so much for sharing these tips and a little bit about your story and choosing a birth location and all of the things. Abby: I didn't really even get to my VBAC story but you can read it in the book. Just pick up a copy of the VBAC book. Meagan: A copy of Baby Got VBAC right here. You can find it in our show notes today. You can find it on our blog. You can find it on our Instagram highlights. You can Google it. We've got it right here. Baby Got VBAC. It's an amazing one. So thank you so much and good luck for this next amazing journey, your third VBAC. And yes, thank you again. Abby: Yeah, thanks so much for having me. I could talk about this all day long. Meagan: Right? We could talk for hours and hours about this. We'll just have to have you on again after you have your VBAC and we'll just share about each VBAC. Abby: Sure. Yeah, that would be great. That would be great. Meagan: Okay. 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

#206 | March Q&A: Choosing a Midwife, HELLP, Cold Sores, Drying the Baby, Lindsay Clancy, Covid & Aspirin, IUGR, Bottles, Parent Resources

Play Episode Listen Later Mar 29, 2023 47:23 Transcription Available

We are back with the March Q&A, and it is packed with your awesome questions! How do I go about choosing a midwife? Are there red flags?I had pre-eclampsia and HELLP syndrome. Can I still have a home birth?Is it safe to take Valtrex in pregnancy for cold sores or is there an alternative?Is it necessary to rub and dry the baby after birth or can baby just be handed to me?Can we talk about the Lindsay Clancy situation and how do we know if we are suffering postpartum psychosis?Does Covid cause decreased blood flow and does Aspirin help?And for those who subscribe on Apple podcasts or Patreon, in the extended version we answer:How do you know when IUGR is a legitimate diagnosis?Is there a way to pump enough to delay the return of your period when breastfeeding?Can you prevent the loss or decrease in milk supply when pregnant but still nursing?When should you introduce a bottle or transition a breastfeeding baby to the bottle and how do you do both?Do you have resources that you recommend for continuing education for parents?In a home-to-hospital transfer for the mother, does the baby go too and if so, does the baby get evaluated? Can the baby stay home?And in our quickies segment we touch on:Surrogates and co-sleeping, young midwives, periods and breastfeeding, induction for gestational diabetes, favorite items for new moms, keepsakes, hiccups in pregnancy, retinol in breastfeeding, Vitamin K alternatives and our shoe collection. Thank you as always for calling in your awesome questions! Don't forget to join us on Patreon for the extended version and twice monthly live Q&As on all kinds of topics!Thanks for joining us, and remember you can call our phone line with your questions 24/7 at 802-GET-DOWN. (That's 802-438-3696)**********DrinkLMNTLove Majka Products Silverette Nursing Cups Postpartum Soothe Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

covid-19 babies apple work speak parent bottles midwife get down clancy aspirin drying surrogates vitamin k hellp cold sores iugr lindsay clancy does covid valtrex

Episode 227 Brenda's VBAC + Heart-Shaped Uterus