Podcasts about julie it

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

Brielle Brasil is a mama's coach, breathwork facilitator, and somatic trauma resolution therapist. She shares her two birth stories as a foreigner living in the Dominican Republic. Brielle's first birth was an unexpected, traumatic C-section. After putting in the work to heal, Brielle felt ready to explore birth options that she thought were unattainable. She was creative and intuitive throughout the entire process.Julie and Brielle also dive deeper into how trauma is stored in the body, how somatic trauma resolution can help, and why it's important not to try to heal trauma on your own.How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: All right, Women of Strength. You are listening to The VBAC Link Podcast. This is Julie and I am here with a very special guest today, Brielle. I am really excited to hear her stories. She gave birth in the Dominican Republic twice, both her C-section and her VBAC. We were just talking about that because my previous guest who I just recorded with in episode 370 also lived in the Dominican Republic. She had her babies back in the States. She flew back to the States. It was just such a coincidence. I am mind-blown. What are the chances?Brielle: So wild. Julie: I know. Brielle had both of her babies there. I'm so excited to hear about her stories and her experience, but before we do that, I am going to read a Review of the Week that Meagan texted me this morning if I can find it in all of our text messages. Okay, here it is. This review is on Apple Podcasts from janaerachelle. She says, “I am so happy I found this incredible podcast. After having two prior C-sections, I was convinced I would have to have another C-section for my birth this November. I feel empowered, educated, and hopeful I can do this. Thank you for all of the true facts in a safe space where we can all talk about our birth trauma in a space where we don't sound ‘crazy' for doing something that God created our bodies to do.” I love that so much. I think that the birth world is so interesting in lots of different ways and lots of different things. It can be incredibly wild to desire something that can be considered outside of the box. I'm glad that VBAC is becoming more and more common and that we are talking about it more. Sometimes, when I'm so deep in this VBAC world, it can be easy to forget that some people think it is the wildest thing ever. Brielle: Yeah. Absolutely. People in the Dominican Republic for sure fall into that box of, “What? You can actually have a baby vaginally after having a C-section?” People didn't know that was an option.Julie: Yeah. People just don't know. All right, let's get to it. I am so excited to hear your stories. I am really on the edge of my seat right now. Before I have you get into those, I'm just going to introduce you a little bit. This is Brielle. She is a Mama's Coach, breathwork facilitator, and somatic trauma resolution therapist. She helps postpartum and pregnant women heal from their previous birth trauma, forgive themslves, their bodies, their babies, and their previous team so they can go into their next birth confident, free, and in tune with their motherly intuition fully trusting themselves, their bodies, their babies, and birth.I have lots to say about this, but I'm going to wait until the end because I don't want to start going off on too many tangents too soon. But I'm excited. I want to hear more. We will definitely talk about that after the birth stories, and I'm super excited. She lives in Virginia, and we are both commiserating about how things are shifting to the chilly side of the weather today, but I am going to sit here cozy in my blanket while I am listening to Brielle's stories giving birth in the Dominican Republic. Go ahead, Brielle. Take it away, and I am excited to hear. Brielle: Awesome. Well, first of all, thank you so much for having me on here. It's such an honor, and it feels really surreal because I listened to this podcast a ton during my second pregnancy. Yes. I am not Dominican. I am American, and I was a foreigner having both of my babies in a foreign country. As you mentioned about the woman you recorded with earlier, most foreigners who are in the Dominican Republic don't have their babies in the Dominican Republic. I was part of an international community, and my husband was an international teacher. It was just assumed that if you are not Dominican, you are going to go back to wherever your home country was to give birth. Right after that, the fact that I was deciding both pregnancies to give birth there because the most important person for me to have at my birth was my husband and the only way to have him at my birth, because it wasn't a summer baby and he was a teacher. It was an April baby, and then a May baby the next time. The only way to have him there was to have our babies i the Dominican Republic. I'll just start off with the first birth. I went into it very fearful having a baby abroad where the language spoken is not my first language. Spanish is not my first language. It was fearful solely for the fact that I was doing it in a foreign country not even really realizing the fears that I had around birth itself until later. I found a doula, and I really liked her. I didn't know much about the OB/GYNs there. She had recommended a couple of them to me and the one that she had used for her births which were all Cesareans, but she said he was a great doctor and he spoke English fluently. I went to him. I stuck with him. Right away, I didn't feel anything initially wrong. He was very knowledgeable. He was up to date on what seemed like a lot of research. But then as things would progress, he would start to question me asking questions to him which was odd, but at the same time, I was like, “Well, he's fluent in English. I feel comfortable in that regard. My doula recommended him.” It was my first time doing this, I was just going to stick with him. Then at about 37-38 weeks pregnant, I started to get the real red flags. Red flags as in him starting to talk about induction already and I'm only 37-38 weeks pregnant. At that point, I just felt like, “Well, okay.” It was clear to me that these were red flags, but I also felt like I didn't have another option. I felt like at that point I was too far along. It was too late in the game. I had seen him my whole pregnancy. I just needed to stay with him. I had prodromal labor for about a week. During that week, this was weeks 39-40. During that week, I went into that office every other day. It was a lot. We were just a little bit obsessive over the time and the clock and everything. I went in several times. I got three membrane sweeps which were all pretty painful. We were trying to “get things to start naturally” and as natural as possible. I know membrane sweeps aren't really, but we were trying to help things along because I was having that prodromal labor. I would have contractions for hours, and they would stop for hours. Also, my husband and I were trying to have things happen naturally as well, so we were having a lot of sex that last week around the clock. Somewhere, I think, from probably the amount of sex we were having and making sure to go to the bathroom right after, I ended up getting a UTI. I think it was the day before my due date when I started to get sick. I started to get a fever. I started to get a high fever. My husband was like, “We need to go into the doctor.” I didn't want to because I was fearful of knowing what he was going to say. At that point, I didn't feel like I trusted him because of the red flags that were coming up. I begged my husband, “Let's not go. Let's see if it goes away.” We waited 24 hours, and it didn't. He was like, “I don't feel comfortable.” I was like, “I get it. Okay, we'll go.” We went in. Of course, they checked the baby's heart rate which was a little bit high. I just felt pretty much like shit. The fever kept coming and going. Because I had the contractions going on and off, he was like, “We need to get labor underway.” They didn't know yet it was a UTI. They were like, “We need to test and see why you're sick and run labs.” He was like, “I recommend that you go to the hospital and get induced. We will run all of the tests.”He was afraid I had COVID actually, but it wasn't that. He was like, “We just need to run the tests, get you induced, and get this thing going on because that shouldn't be happening.” I didn't know anything about prodromal labor or any of that. I was scared. I was in a foreign country. I just wanted my baby to be healthy. I was like, “Okay, yeah. Let's go.” We all went. I got induced that morning. Looking back on it and having done the healing work I did, I can see that I just wasn't ready. My body wasn't fully ready yet. My baby wasn't ready yet. It was just a rushed timing scenario because I got induced that morning. They did the test. They found that I had a UTI, so they were treating me with antibiotics while pumping me with Pitocin. On and off all day long, my fever would go away, then it would come back, then it would go away, and then it would come back. I would pick up contractions and be in labor. That was hard to deal with when I was sick. I felt zero energy hardly at that point being sick. That was at 9:00 in the morning. I got induced. It went on and off all day. The contractions were doing the same thing all day. They would pick up for a few hours, then they would stop for a long while. What was interesting, I noticed, is that every time my doctor would come into the room to check me, my contractions would completely stop around him. Looking back, I can tell I didn't feel safe with him. I just had past trauma with males. I shouldn't have ever had a male provider personally. I could tell those things in hindsight, but it was just all happening. By the end of the day in the evening, he was like, “You haven't made any progression dilation-wise. The baby's heart rate's really high, so I suggest we go into a C-section.” My husband and I were just like, “Yeah.” Like I said, we wanted our baby to be healthy. We were fearful. We went into C-section, and we had him. I was just numb through the whole experience because I had really desired everything of my first birth to be natural. I actually wanted a home birth my first go around, but I thought it was illegal in the DR because I didn't know there were any midwives. There were no birthing centers in the DR. Nobody I had ever talked to had ever had a home birth in the DR, and I was actually told, and my doula actually thought home birth was illegal because it was so, so, so, so rare in the DR. I was just under the impression that it was illegal, so I didn't plan a home birth. But I tried to plan a hospital birth that would hopefully be as natural as possible. Instead, I got the opposite. I had a lot of the cascade of interventions that I didn't want to have at all. I wanted things to happen spontaneously and to have minimal time in the hospital. I wanted that skin-to-skin right after, and my baby was taken away from me right after he was born which was very traumatic. I had to work really hard to heal all of that. But nonetheless, he was born. He had pooped himself inside of my womb, so there was meconium there. They told me that his cord was wrapped in a way that he couldn't progress, and that's why I wasn't dilating and he wasn't descending. It's like they tried to give me some reasons why that was the right way. It's not that I don't believe that, but in hindsight and after a lot of the healing work I did, I can see why everything went down the path it did because I felt rushed at the end of the day. I felt like that word “induction” was being thrown around so much and I didn't want that. I had to take matters into my own hands and try to do all of the “natural” inductions. Also, at the end of the day, my son was born the week before Semana Fante in the Dominican Republic which is Holy Week which is a huge, huge holiday week, so I did also find out that some of the members of the birth team had plans for Easter week and travel plans, so I knew that there was a bit of a rush from that end which made me feel rushed and just made the whole process one that I needed to heal from in big, big ways. So after I had my son, postpartum was really, really hard. Breastfeeding was hard. Everything was hard. I realize everything was so hard not only because I was a new mom and didn't have the support I needed, but because my birth was incredibly traumatic– and I didn't think of it that way at first because I was like, “My son is born. He is healthy.” But then 6 months after I had my son, I was still having physical pain at my scar site. I got it checked out. Nothing medically or physically was wrong with it, but what I know being in the line of trauma work that I do is that our body holds trauma, and everything is connected physically and emotionally within our bodies and within ourselves. About 6 months after I had him, I was still having that pain. I decided to work on my birth trauma. I worked on it from all different levels. I worked on it from the physical level. I started seeing an osteopath who I worked with for the next several months. Within a matter of weeks, a lot of the pain was gone. I also started working on it with a traumatic somatic trauma coach who is also a birth attendant. I found her because she was in the same trauma certification group that I went through. I worked with her for 6 months to heal everything from that birth and all of the trauma that it caused to forgive myself, to forgive my baby, to forgive my team, to feel safe again in my body, to feel at peace, to feel at home in my body, to connect back to my body, to connect to my baby, and just a number of things that we did together somatically and through breathwork to really peel back all of the layers of my birth, and not just my birth, but all of the births that came before me in my lineage to heal and heal deeply. It was a big, big work that we did together. It was not a small undertaking, but I will say that I feel. I feel that the work that I did to heal my first birth spiritually, emotionally, mentally, and physically was the best catalyst I could have had on my side for my next pregnancy and my next birth. So I got pregnant in August of 2022, or sorry, 2023. It's interesting because I had thought about home birth the first time, and because of the timing, we were again going to have our baby in the DR. Is home birth a thing there? Sure enough, you put it out in the universe, and I started to meet people who were having home birth, mostly foreigners who were having home births in the DR. I think three, which was huge because before, I had not even heard of it. I was like, “​​Wow, okay. This is happening here. This is allowed here. This is legal here. What are you guys doing? What are you guys going through?” I started getting the right contacts of the right people and found out that there is a midwife in Fountaindomingo, one. I met with her. I was so excited because I was like, “​​This is great. She gets to be my midwife.” Then she told me that her dad was sick at the time, and she was going to be helping him. She told me, “I'm not going to be working during the time of your due date.” I was like, “​​Okay, so we just need to look at other options.” Right off the bat, everything I did for my second pregnancy was a 360 from my first one. With my first one, I was like, “Okay, it's this one guy. It has to be.” I was very narrow because I was scared.With the second one, I was like, “​​Okay, it's not her. I'm going to keep my options open. I'm going to keep my mind open. We'll find someone.” My husband just did a Google search of traveling midwives in the US. We had a call with my midwife, Brittany, who is from Texas. Right after the Zoom call, I looked at my husband. I was crying because I felt such a connection with her. I was like, “​​She's it. She's the person who has to be at my birth. I feel so safe with her. I feel so seen and supported. She's everything I would look for in someone to deliver my baby. She's both nurturing and has a calming presence, but she's also direct and not going to sugarcoat things. I need a beautiful blend of both.” I was really excited. We ended up signing a contract with her, and in the meantime, I got my prenatal care from an OB/GYN office throughout my pregnancy, and of course, to have a backup option in place. I switched OB/GYNs three times this pregnancy, and the last time I switched, I think, was as late as 32 weeks pregnant. I had been with the second gal. The first two OB/GYNs I was with– they were all women– were from recommendations from the midwife who wouldn't be working during my birth. She had recommended the first two. The first one, I loved, but she wasn't fluent in English, so neither one of us felt comfortable in terms of communication and being able to fully communicate when it comes to birth. I was bummed, but that one didn't work out. I went to the second one she recommended. This one was a lot more fluent in English. I could communicate with her fine, and she was direct, but her bedside manner was so direct that she didn't have that calming and nurturing confidence. She was confident, but she didn't have the calming, nurturing side that I also wanted. She said a couple of things that didn't vibe very well with me. It was so direct that it was hurtful. At 32 weeks, I was like, “​​You know what, babe? I love my first choice for my team, but if something happens, I don't love my second choice.” I was determined. I just kept looking, and through one of the girls who had a home birth, she had heard of the woman that I went to as my third option. She had recommended, “If you decide to have it in the hospital, here are a couple of people I have heard good things about through friends.” I went to this woman, Lini Capalon, from 32 weeks. I didn't tell her I was planning a home birth. I decided not to tell her. I told the second lady. She had gotten a little iffy about it because it's not illegal there, but again, it's so uncommon there that it's hard for them to wrap their head around it basically. I'll put it that way.With the third woman, I didn't tell her, but she knew I wanted to have a VBAC. She had done a number of VBACs herself, and she had told me before I even started talking to her, she was like, “​​Look. We want this birth to be as natural as possible for your highest chance at VBAC.” She was like, “​​You need to go into labor spontaneously. We don't want to interfere at all. I don't want to interfere with you. I don't want to give any interventions.” She was like, “​​You can go until you're 42 weeks and 3 days before we'll then talk about induction.”I was floored because I didn't think this existed in an OB/GYN in the DR. First of all, that they're doing VBAC, and secondly, that they're for it. We were talking about this, Julie, a little bit before we hopped on that the C-section rate in the Dominican Republic is 90%. 9-0 in private hospitals, and public hospitals are really, really not great. If you have the choice, you wouldn't want to birth in a public hospital. You are already going into a private hospital with a 90% chance of a C-section.Julie: That is so wild. It is so wild. Brielle: Yeah. Yep. Yeah. I learned that through the midwife who was in Santo Domingo. Julie: Well, and I almost wonder if the 10% who are not Cesareans are the ones who go so fast or are on accident. Do you know what I mean? Brielle: Yeah. Yeah. Or just everything progresses, I don't want to say normally, but quickly.Julie: Quickly, yeah.Brielle: Quickly. You're not “late” at all. I did have a friend who actually had a vaginal birth in the DR about a month after me. That was very hard for me as well and very triggering because she also had the same doctor as me the first go-around.Julie: Oh no. That's hard.Brielle: That was a big part of my healing journey too. But yeah, her water broke. She went into labor. She progressed quickly and had the baby. There was not anything out of the “norm”. Anyway, that's how it needs to happen if you're going to have a chance. The fact that I had found her, then she was pro-VBAC and had VBAC experience was really rare because I was also saying that VBACs are unheard of in the DR. After I had my second baby, people were like, “​​What? You had your baby vaginally? Didn't you have a C-section before?” They didn't know that was possible.I went with her for my backup option. Then, here we go. I was 38 weeks and 5 days pregnant. My midwife is scheduled to come. She has her flight booked for the day before my due date. I'm still 10 days out before she's supposed to come. I lose my mucus plug, and I have my bloody show. Of course, I message her. She's like, “​​Well, here's the thing. You could go into labor anytime now. It could be tomorrow, and it could be 2 weeks from now. We just don't have any way to predict that.” I was like, “Okay, cool. Great.” But another thing that I had worked largely on this pregnancy and a big reason why I kept changing OB/GYNs and a big reason why I said no to a lot of things during my pregnancy and started speaking my voice is because I found my intuition or re-found it, and really listened to it every step of the way. Any time anything felt the slightest bit off, I was like, “​​Nope. We're not doing that.” It took an incredible amount of tuning everything out, tuning out all of the noise and opinions and everything that's out there and really just listening within. After that happened, I lost my mucus plug. She wasn't supposed to come for 10 days. She tells me, “It could be tomorrow. It could be 2 weeks.” I slept on it, and then the next day, I was like, “​​Brittany, I think you need to get here sooner. When's the soonest you can come?” This was Friday. She was like, “I can come this Sunday in two days.” I was like, “​​Great. Can you change your flight?” She was like, “​​Yeah. Can you pay the difference?” I'm like, “​​Yeah, that's fine.” She changes her flight to Sunday. Her Airbnb was on the street that I live on. She gets to her AirBnB at 3:00 PM on Sunday. That night, I had about three or four days of prodromal labor before that. That night, at 7-8:00 PM is when I finally started having regular contractions, and my water broke that night at about 11:00 PM the day that she got there. Julie: Your baby was waiting. They just knew. Brielle: They knew. I knew. I was like, “​​You've got to get here sooner.” Baby Alana was waiting. Everything was happening in perfect timing. I told her that my water broke. She came over. Labor started. My contractions were regular. I let my husband sleep because I also didn't know how long it was going to be because I had prodromal with this one too. I had it for a week before. I'm like, “​​I don't really know for sure if it's the real thing. I'm going to let him sleep for now. He supposedly has to work tomorrow, but we'll see.” Things were regular, active, and intense all night long. He ended up waking up at 4:00 AM and coming up and setting up the birthing tub at that point. I didn't know if I wanted a water birth or not, but I knew I wanted to have it as a comfort option and I wanted the option should I want to birth in there when the time came. So he set up the tub, and my doula came over. I had pretty intense contractions until Monday morning. Our nanny came over because my son, my 2.5-year-old was just 2 at the time, he woke up and he had school. She was getting him ready for school. He woke up, and even though the nanny was with him, that slowed my contractions down a little bit because it's hard when your son's not there to be in mom mode somewhat. Things slowed down a little bit while he was getting ready for school. He went to school. I was feeling a little frustrated because things had slowed down. My husband was like, “​​Let's go outside. Let's go for a walk.” We left the apartment. We went for a walk. My husband had me doing squats which I wish in hindsight I had reserved that energy. I didn't know how long labor would go on. I was hunched over. Cars were stopping, “Are you okay?” as we were walking down the street and people were on their way to work because things were picking up again.I'm like, “​​Okay, I think we need to get back to the apartment.” He helped me. We get back to the apartment. We get back inside. Things got really intense again. It was Monday morning. I'm in and out of the birthtub. I'm on the birth ball listening to HypnoBirthing tracks using my breath. I'm a breathwork facilitator, so it wasn't hard for me to tune into different breath patterns that were feeling good and supporting the intensity of everything. Monday afternoon came. My son got off to school. He came home. The same thing happened. They slowed down a bit while he got lunch and got ready for his nap. He went for his nap, then things really picked up. My midwife knew I didn't want to be checked because of the whole thing before of, “You're 1 centimeter,” and a week later, “You're 1.5 centimeters. You're not progressing,” type thing. I knew I didn't want to be checked, but I think she could tell by the intensity and by the look in my eyes that I must be close to needing to push.She said, “I know you don't want to be checked, but do you mind if I check you and not tell you the number just to see where things are at?” This was Monday afternoon. I'm like, “​​Sure, that's fine.” She checked me. I was like, “​​You can tell my husband where I'm at, and he can decide if I should know.She checked me, and then a bunch more of my water gushes out, and then she blurts out, “You're fully dilated. You're ready to push.” I was like, “​​Really? That's awesome. Great. Sounds great to me.” It had been a little over 12 hours at this point. I was like, “​​Okay.” But I also told her, “Really? I don't feel the urge to push. I don't feel like I need to push.” She explained to me that VBAC patients sometimes don't feel that urge. That's possible that you might not feel the urge. I was like, “​​Okay.” I leaned on her a little bit more for what positions to try and stuff like that and the actual mode of how to push because again, it wasn't coming naturally. It wasn't coming instinctively because I didn't feel that urge. For the next, I think, 4 or 5 hours, I pushed at home. I pushed in the tub. I pushed out of the tub. I pushed on my bed. I pushed on the floor. I pushed in kneeling, hands and knees. You name the position. I feel like I probably tried it. I was absolutely exhausted because, of course, I didn't sleep the night before. Eating was hard. I wasn't getting what I needed nutritionally to keep up energetically with how long the labor was getting and how long the pushing was getting, but I also didn't want to eat. I felt like I couldn't get hydrated. I was exhausted. There were a number of times I looked at my husband, and I looked at my doula, “I can't do this anymore.” They were encouraging me, “Yes, you can.” I got on my hands and knees and prayed. I was listening to my tracks. I had my crystals that I work with, and I'm just talking to my spirit guides and all of this stuff. After 4 or 5 hours, I was beat. I was so defeated. I was beat. My midwife was like, “​​Why don't we give it a rest for a little bit?” She was intermittently checking our baby's heart rate and checking me. All of that was fine. The baby was fine. I was fine the whole time, so she kept saying, “Both of you are fine. You can stay here longer. There is no rush because both of you are fine. There is no need to go to the hospital if you don't want to. If you want to, that's an option, and it's fine.” I was like, “​​No. I'm just going to take a break from pushing, and try to rest.” Of course, I'm in active labor, so trying to rest is hard, but I just stopped with trying to push for a couple of hours, then it was getting into Monday night. My son had gone to bed for the night. It had been a few hours of this “resting”, but really intense contractions, and she asked me, “Do you want me to check you again? Do you not? Just to see what's going on. I don't know what's happened.” She checked me.She said, “I have bad news.” I was like, “​​Okay, give it to me, I guess.” She explained to me that there are two layers of the cervix, the outer and the inner. When she had checked me before I pushed for that 4 or 5 hours, she realized she could only feel one layer. The layer that she felt was fully dilated, but then when she was checking me this time Monday night, she was feeling the other layer, and it wasn't fully dilated. It was around a 7. She said that was why our baby– she had been sitting so low for this whole time. She was there, but couldn't get around that other layer which is why the pushing wasn't really doing anything to get her out. I was like, “​​Okay.” It was hard to hear, but also kind of relieving to hear in a way because I was like, “​​Well, I just did all of that work for nothing? What?” That's what it felt like, but then it also felt like, “Okay, well, at least there is a reason why I was pushing, and it wasn't happening. It just wasn't.” I trusted the timing. I was so trusting in this birth. I was so trusting of the timing. I was so trusting of my baby. I was so trusting of my body and myself. I had done so much work around that to trust myself. I was like, “​​Okay.” I rested some more. Everything was fine. I continued to labor at home until about midnight. I was in the birthing tub, and at about midnight, I started to feel absolutely terrible, just incredibly weak. I had now been up for over two days and had two nights with no sleep. The four days before that was bad sleep because it was prodromal labor. My body was really exhausted. I was emotionally exhausted and mentally exhausted in every way.It was midnight. I was going through the second night now. I was just like, “​​Guys, I don't feel well. I feel really bad.” She checked my vitals. Everything was fine. I was like, “​​I feel like my blood pressure was really low. I felt like I was going to pass out.” She was like, “​​Have you eaten any protein today?” I had eaten a lot of carbs and was staying hydrated. I was like, “​​No, I guess not.” She was like, “​​Let's try some protein.” I absolutely didn't want that, but my husband was force-feeding me a ton of chicken. My husband does acupuncture as a side thing. I was like, “​​Can you give me acupuncture to progress things or help with this terrible feeling I have to give me some energy?” He did acupuncture on me. He was force-feeding me chicken. Right after that, I got back in the birthing tub. I projectile vomited everywhere. After I threw up, I was like, “​​Oh, I feel better now.” It was so bizarre. I was going through a whirlwind at this point. I was like, “​​I feel better. I feel like I can continue now.” This was midnight now. My midwife said, “Okay, you can continue.” I continued the next four hours in and out of the tub, on the birthing ball. My husband was asleep at this point. My doula had to leave because her daughter was sick. I'm dozing off in the tub between every contraction which was only every 15 seconds because I was so tired, then the contractions would come. They'd be level 100, insane intensity. They'd be a minute and a half, then I'd get to fall asleep for 15 seconds then wake back up and do it again, and do it again on repeat for 4 or 5 hours. Then it's 4:30 AM. I know it's getting close to rush hour. There's a lot of traffic during rush hour in Santo Domingo. If we tried to go to the hospital during rush hour, it probably would have taken us 2, maybe 3 hours to get there. I told my midwife at 4:30 AM, “Can you check me?” She checked me, and that same layer was still at a 7. It was maybe a 7.5. I told her, “I'm ready to throw in the towel.” What I meant by that was, “I'm ready to surrender to this process,” which means I'm not going to do it here at home anymore. Intuitively, that felt very right to me to go. It was time to try something different. I had been home for 35 hours at labor. We had worked with everything that was there. I had all of my tools that I had, and I felt like something needed to change.Julie: You were so tired. You worked so hard for so long. An exhausted body is just exhausted and not effective at laboring.Brielle: No, not at all.My midwife and my husband packed up my bag. My midwife ended up having to stay at our house because my son was sleeping. Our nanny couldn't get there until 6:00 or 7:00 AM. My doula, her kid was sick, and she had to go home. My husband and I had to go to the hospital. The next two hours were insane. Once I decided I was going to the hospital, I basically had no breaks in my contractions. The time that they were packing my bags, and then we were going down to the car and driving to the hospital which was quick because there was no traffic at 5:00 AM. Those 15 minutes, we thought we were going to have the baby in the car. At this point, I was having zero breaks. The intensity was through the roof. We walk into the hospital. My husband has to do paperwork, so I'm all by myself. I'm just roaring like a lion at this point. I'm barreled over. This is so intense. I don't have my tub or my ball or anything at this point. I didn't have any pain relief medically, but I didn't even have the things I had at home to help me. I'm just barreled over and roaring and screaming and super primal. My doctor finally showed up. He finishes the paperwork. That whole thing was probably 2 hours of me not having any type of relief, really, just to get to the hospital. That was the toughest part, I think.Then my OB/GYN, Leni, comes in. She checks me, and she's like, “​​You're fully dilated. You're ready to push.” She didn't know I had been at home. She didn't know everything that was going on and that I was planning a home birth. I said, “I am not pushing this baby out right now.” I said, “I pushed at home for 5 hours. I've been in labor for 35 hours. I haven't slept in 3 days. I projectile vomited everything.” I'm not saying this. I was huffing and puffing through this, but I looked at her, and I'm just like, “​​Give me an epidural now. I'm not doing this anymore.” She was like, “​​Technically, we're not supposed to. You're fully dilated.” She was like, “​​Okay, all right. We'll get you the epidural.” They wheeled me up. They gave me the epidural. My husband didn't go into the room with me. I thought I was just getting the epidural in this room, but it was the birthing room. I didn't know because I hadn't done the full tour of things beforehand. I mean, I did a little bit, but I didn't put it together at the time where I was getting the epidural. I thought I was going to have a break to take a nap. I was going to get the epidural, then I was going to take a nap, then I was going to push the baby out. That's not how it went. They were like, “​​All right, whenever you feel the next contraction.” I'm like, “No, I can't. Where's my husband? My husband's not here.” They were like, “​​It's hospital policy. Nobody can be in here with you.” I was like, “​​What?”Julie: No.Brielle: Yeah. I lost my shit. I lost my shit. I am like, “​​Absolutely not. Get him in here now! I'm not doing this without him. He's been here every minute beside me for the last 35 hours, but also for the last 7 years of my life. I'm not doing this without him.” They were all looking at each other, like, “​​Look, when it gets close and when he is crowning, we will bring him in.” I was like, “​​Okay,” so I pushed when the contractions came. I was surprised I could still feel the contraction, but after the epidural, thank God. It was what my body needed at that point. I was like, “​​Thank you for modern medicine. There is a reason it exists.” But after 30 minutes of pushing, they just randomly asked me, “Do you have a doula?” I didn't say anything about my actual doula, but I said, “My husband is my doula. Get him in here.” They were like, “​​Okay, okay. We're going to bring him in now.” They brought him in. He started coaching me like a drill sergeant or a CrossFit coach or something, but he was like, “Just do it!” He knew me so well, and he knew in that moment that I wanted a VBAC so badly, and he also knew everything I had been through that previous 35 hours. He knew we needed to do this. He knew we needed to get on with it. He was coaching me and basically screaming at me. It was exactly what I needed in that moment. After he came in, 30 minutes later, I pushed her out. She was born. They brought her to my chest. Everything my OB/GYN told me, she stuck by her word. She was like, “​​You will have skin-to-skin. You will have that hour.” They asked me, “Can we take her to do x, y, and z?” I was like, “​​No, not yet. Don't take her yet.” They did the things they needed to while she was on top of me. Everything they had promised, they fulfilled. That, I feel like, was why I just felt intuitively really good about both options, my first option and my backup option. I went with that, and it was exactly the way it was supposed to be. Julie: Yeah, I love that. I think being able to trust is such an important thing in the birth space, being able to trust yourself, your care team, your partner, all of your different options, your birth location, and all of that is just so connected to how our bodies can work and trust that process, and yeah. That was great. So good. Brielle: Yeah, that was a huge part of my experience. It was learning to trust myself, the timing, my baby, and my body fully. Healing my experience and just following my intuition completely.Julie: Yeah, I love that so much. Do you want to talk a little bit more about what you did to prepare with the breathwork and the somatic trauma work? I mean, did you get into that before or after? I'm assuming before because your baby is pretty young. How old is your baby now?Brielle: My baby was 5 months the other day. In between pregnancies, and I was not pregnant. I was 6 months postpartum from the first one that I started doing it personally for myself. Do you mean as a practitioner when I got into the work? Julie: Mhmm. Brielle: As a practitioner, I got into this work 5-6 years ago. I was already facilitating breathwork and coaching people for trauma, but not birth trauma. I had gotten my trauma resolution coaching certification and my trauma-informed breathwork certification before I ever had kids. I was really excited to get to use my breathwork and all of my tools and everything for my first birth, but that ended up going a completely different way. I did still use it, but it looked a lot different than I thought it would. I got into this work. I was coaching people on their trauma through a somatic way. Basically, trauma lives in the cells of our body, and it stays in the cells of our body unless we somatically move it through our physiology. There are two major ways we can do that. One is through a type of somatic coaching that I do, and the other is through breathwork. They are both somatic practices, but one is using the breath in a very intentional and activating way to help move that trauma through our cells and out. The other one is using a very hands-on– they are both body-based, but one is more of a visualization. I take you through an experience where you are feeling where things are living in your body. Basically, you are attuning to where there are certain activations in your body as I take you through a lived, traumatic experience. We are finding where that trauma lives in your body with a somatic coaching so I'm able to use a lot of tools to help you visualize it and then move that out.Then with breathwork, it's similar, but we are using the breath. The breath is automatically going to the spaces energetically where the trauma is living to help move it out.Julie: Yeah. I love that. I love that so much. It reminds me. I've done a lot of therapy work. My therapist would ask. I've done lots of group therapy, individual sessions, and all of the things. One of my therapists who would lead our group sessions would say, “What do you feel and where are you feeling it?” We would take turns identifying what in their body needs to be addressed. You've got to describe it. What does it feel like? Does it have a sensation or a taste or a smell? Is it heavy or is it light? Does it have a color? Where in the body is it?I hated it, to be honest. It was the worst thing ever. Brielle: It's really deep.Julie: It's crunchy. Yeah. It's deep, and you have to be comfortable getting uncomfortable, and reaching and stopping and being in tune with your body. I hated it so bad for a very long time, but even now, I don't do those group sessions or anything or anymore. Every once in a while, I'll scan my body. “Okay, what do I feel and where am I doing it?” I try to get my kids to do it, and they're like, “I don't know what the freak you mean, Mom.” They're still young, but I know what you are talking about with that work. What is it? Moving it out, how to release it. That's so important. Brielle: It's so great. It transcends as I work with a client. They feel it. They see it in a certain way. It has textures, colors, and shapes, and we stay with it. We don't stay with it beyond the point that they feel they can stay with it. If that's super uncomfortable for them, we go back to our resource which I do at the beginning of the session.I'm not taking them through an experience in a way that is beyond their capacity to move through it. The body won't ever take them through something that they don't feel ready to handle. I think that's really important to specify because if you're just talking about this work and you have never heard of it, that can sound really scary.It is deep work, but at the same time, because of my trainings and with breathwork as well being trauma-informed, I never take a client to a place that their body is not actually physiologically ready to go into. Julie: Yeah, that's really important. It's such an intuitive thing. You talked a lot about intuition too. One thing I wanted to say before we close out the episode is that you mentioned earlier in the episode about learning to forgive yourself. That was something I don't think we talk about a lot or think about a lot, but it's something that I had to go through as well after my C-section. My thing was forgiving myself for not knowing what I didn't know going into my birthIt can sound kind of silly. What do I need to forgive myself for? But sometimes, we focus a lot on forgiving others in the situation and our team or our partner or whatever, but we don't often direct that inward. I think that's such an important part to give yourself grace and mercy and love and forgiveness and go through and not judge yourself too harshly or hold yourself to an unrealistic standard especially when you didn't have the information then that you have now.So I think that's an important part of the process as well.Brielle: That's a big amount of the work I do with my clients as well is that self-forgiveness piece and really forgiving their bodies because a lot of them feel like, “My body failed me or my body is broken.” That was a lot of work I had to do myself personally after my first birth to realize, “No, my body didn't fail me. My body's not broken. Nothing was wrong with me.” But if we don't do that forgiveness work for your body to yourself, that trauma is still going to be living in ourselves and still expecting. I'm not going to say it's going to give you a repeat experience, but we're still having that physiological presence where like attracts like. That's still in there. That's still the drawing factor of something that your body is expecting. It's still holding that past experience.Julie: Right. Yep. That makes a lot of sense. I encourage everybody to do the work, but also, I think's important to mention this a little bit is to find somebody trusted that you can do it with. It's important to not dig too deeply into past traumas or things like that unless you have a solid support around you like a therapist, any mental health professional, an energy worker or people like that to help guide you through it so you don't get too deep into things that you are not prepared to handle or heal.Brielle: Absolutely. That's what I do as well through the lens of breathwork and somatic coaching. Julie: So where can people find you?Brielle: Yeah, it's definitely not something I recommend doing on your own. Have somebody to hold that space for you who knows what they're doing. People can find me on Instagram. It's just my name at Brielle Brasil. Brasil is with an S. You can reach out through there, and that's where I'll be.Julie: Perfect. We'll link that information in the show notes for anybody who wants to go give her a follow as well.All right, well thank you so much for sharing your story. I really appreciate it.Brielle: Thank you so much. Julie: It's so cool to hear your story and your journey and your process. Thanks for being here. Brielle: Awesome. I appreciate you. Thank you so much. It was an honor.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

In this episode, Meagan and Julie tackle hot topics like the VBAC calculator, epidurals, and uterine rupture. What does the evidence actually say? And why do providers give such drastically different statistics from one practice to the next? When you know the facts, you are equipped to take charge of your VBAC journey!VBAC CalculatorACOG: Deciding Between a VBAC and a Repeat CesareanVBAC Calculator Online LibraryEpidural Side EffectsVBA2C PubMed ArticleEvidence Based BirthⓇ: The Evidence on VBACUterine RuptureHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: Welcome, welcome. You are listening to The VBAC Link Podcast, and guess what? We have a special guest for you today, and that is me. It's Julie Francom. I am here today with Meagan, and I am joining her for a really cool information-packed episode debunking some common misunderstandings about VBAC and showing you what the evidence is and where you can find more evidence-based information about VBAC. Without further ado, your host, Meagan. How was that?Meagan: Oh my gosh. Thanks Julie for the amazing welcome. Oh, so fun. It's so fun. Yes. I am so excited for this episode because it's one of the last episodes with you and I. No, it's not one of the last episodes. It is the last episode of you and I of the year which is so crazy. It is so crazy. Julie: This year has flown. Time is wild. Time is wild. Meagan: It's so strange to me, but that's okay. We will welcome in 2025, and we will say goodbye to 2024. We want to say goodbye to it with, like she said just a really great evidence-based packed episode for you guys.I feel like all year we have gotten messages like, “I had a C-section. I'm being told I can't ever have a vaginal birth. Is this true? Is VBAC safe or possible?”We've had, “I've had one and two C-sections. I've had three C-sections. Is VBAC possible? My provider gave me a 20% chance to VBAC. Is that true? Can I VBAC? Do I really have that low of a chance?”How about this one? This one was more recent that I've heard from our last recording. “You have a 60% chance of uterine rupture if you choose to VBAC.” Ugh. Seriously, so many things that we have heard along the way where it's just–Julie: Lies, lies, lies, lies. It's lies. Let's just call it what it is. Meagan: Aggravating. Julie: For the most part, I do not think providers mean to spread lies or misinformation. I do think that there is a lot of information related to birth in general, but especially VBAC about how this is the way we've always done it. They are just regurgitating information that they have heard from some unreliable source somewhere and aren't really taking the time to keep up with the actual facts about VBAC, about birth, and about anything in general. Also, our system is not set up for continuing educating all of the providers in all of the things. Our hospital providers, I feel like in some capacity we have to give them some grace because they are incredibly overworked. They work crazy hours. They see lots of things and deal with a lot. The medical system is that way. But I also feel like who's responsibility is it to make sure that you are providing the best care? But how can you when the system is working against not only the parents but also the providers and the nurses and everybody. It's really hard because it puts the responsibility on you, the parent, in order to really dig and discover what your options are so that you can make the right choices that benefit you because the system is not set up to support you in any other way besides their hospital policies and following their rules, etc. So, yeah. I don't want this to turn into a provider-bashing episode. I don't think it will either. Sometimes, I think with me talking especially with me being more salty now, it can come across that we are anti-provider or whatever which we are not, but the system is just really frustrating. It takes everybody's efforts to try and change it, everybody's efforts. Not one part of the system can be passive if we want to change it and we want to influence it for better.Meagan: I agree so much. Like you said, we don't want to ever shame the hospital system or providers, but a lot of times, the things we are saying definitely does happen. But it's because there is a lot of fault. There is a lot of fault in these areas. Like you were saying, a lot of these things are lies. The biggest and hardest thing that I found when I was going through my VBAC journey. Julie, I wanted to speak for you and probably say that is the same for you, and that's why we created The VBAC Link: How to Prep VBAC Course is because we didn't know what was right and what wasn't. We just didn't know, and there were so many avenues on Google that you could go down, and you could actually find truth on both sides sometimes even. Julie: And trying to figure out which is true and credible and which is not sometimes is really tricky.Meagan: It's really, really tricky. We want to talk more about that today. We recently talked about hospital policies and what that means and how to go about those, but along with hospital policies come a lot of other things that providers do or suggest or say, so we've got this random policy that was created over here, then we've got all of these random things that are being said over here. We want to know our options. We know hospital policies are what they are. If you haven't listened to the episode, go listen. It's back in November, last month. Go look for it. But today, we are going to be talking about what is the evidence. What are the facts?Let's talk about the VBAC calculator. Let's just start right there because this is where a lot of providers actually begin to determine someone's ability or qualifications if they can VBAC. They'll pull out this list, this calculator, that is online. You can actually get it online. If you want to play around with it, I'll try and make sure to put the link in our show notes because I actually find it very interesting to play around with. We used to do that when we would do in-person courses. We would have everyone pull out their phones, type in the calculator, and type in different scenarios. It was pretty mind-blowing to see how much it could change based off of the answer that you give this computer. You want a VBAC. You have determined that a VBAC is something you want to explore. You want to learn what you can do to have a VBAC. You go to your provider and you go, “Hey, I've had a C-section. I don't want that experience this time. I want a different experience. I would like to have a VBAC,” or what they would call a TOLAC, a trial of labor after a Cesarean. And they're like, “Great. That's wonderful.” Then they're like, “Let's talk about it.” They pull up their calculator and they ask you questions like what, Julie?Julie: They ask you questions like, hold on. I was just digging into the history of the VBAC calculator a little bit more because I was curious about it. They ask you what was the reason for your previous Cesarean? How much do you weigh? It used to ask what your ethnicity was then they docked you if you were black or Hispanic. It also asks, let's see. Meagan: It asks if there was an arrest of descent. Arrest of descent is if you needed a Cesarean because your baby didn't come down. It asks about your history as in have you had a vaginal birth before? Have you had a VBAC? What was the reason for your previous Cesarean? It even asks if you've been treated for hypertension. Interesting. Julie: Interesting. Meagan: Yeah. So height, weight–Julie: Oh, because the chronic hypertension requiring treatment is what replaced the race. When they replaced the race question with do you have chronic hypertension requiring treatment? It may serve as an obvious proxy for race and appears to function similarly in the revised calculator in terms of statistical performance. Meagan: Oh my gosh. Yeah, it says that right on the website. “The information on this website describes the outcome of vaginal birth after Cesarean in term pregnancy for population individuals who receive care at hospitals within (blah, blah, blah) network.” It says, “The information on this website is not intended to be the only basis for making care decisions for individuals nor is it intended to be definitive,” meaning it's not going to be yes, you have to have this or this is the exact chance of you having a VBAC, but yet we have so many providers who go off of this as in point-blank fact.Julie: Like it's the law and like it's a crystal ball. Meagan: Really though. It's so frustrating. Sorry, what were you going to say before?Julie: I just sent you this link from what I was digging into. It's so interesting about the VBAC calculator. It's interesting because first of all, a couple things. The likelihood of the VBAC calculator being accurate for you, the higher percentage of having a successful VBAC, the more likely it's going to be. It's more accurate when the predicted success rates are above 60%. The lower success rate, the more likelihood it is to be inaccurate. Do you know what that tells me? That tells me that most people who attempt a VBAC are going to be successful. That's what that tells me. It's just so stupid because I mean, the development of the calculator was in the early 2000s. From the outside, it actually looks like a good sample size. There were 11,856 people with one prior Cesarean between 1999 and 2002. It was analyzed whether they had a successful VBAC or an unplanned repeat Cesarean. It was analyzed retrospectively. Retrospectively means they looked back on births. It doesn't mean that they did the study when people were pregnant. They looked at it after it had already been done. I like retrospective studies because there's a lot. It really removes the chance for bias related to the study. The interesting thing is that the risk factors that they chose were related to BMI, if you're overweight, age, history of prior vaginal deliveries– so did you have a prior vaginal birth or not– if the prior Cesarean was because of labor dystocia, so that's stalled labor, or your race– black or Hispanic ethnicity. They used these criteria to determine whether or not you were going to be successful in having a VBAC. Here's the stupid thing about this. What it doesn't take into account is the bias in our system against people of color and against people who are overweight. It does not take into account the bias and the different ways people who are overweight and people who are not white are treated in the system. I mean, there are just so many flaws against it as well, but also, I don't know. It says here– sorry. Before I get to my also. It says here– first of all, there are only 19 academic hospitals that were included, so I feel like the sample size of 19 academic hospitals, so university hospitals, and it's between 1999 and 2002. Also, there was a lot of backlash from all of the controversies surrounding uterine rupture in the mid-1990s from that carrying over into that as well. If you didn't know this, they started inducing VBACs with Cytotec in the mid-1990s. It increased the risk of uterine rupture like crazy. I'm not going to do a history lesson right now, but this was only 4 years after all of that. There was probably still a lot of fear and everything related to uterine rupture and everything during all of the time that they were collecting this data. Sorry, I'm probably really nerding out right now. But the thing is that when the predicted success rate was over 60%, it tended to be more inaccurate when it was less than 60%. Accuracy of lower estimates was mixed but generally decreased as predicted success rates declined. I said this before and I'll say it again. My first client ever as a doula had a predicted success rate of 4%, like the number 1-2-3-4. You count to 4. That was her predicted success rate, and she pushed her baby out in 20 minutes. So, I think the VBAC calculator is garbage.  Also, ACOG says in their most recent guideline, actually for the most couple VBAC bulletins that they have put out, is that a low chance of success is not a good reason to exclude somebody from attempting to have a VBAC. But yet, there are so many providers who will not take you if your predicted chance of success is less than 60%. But what did we just say? We just said that if your predicted success rate is less than 60%, it's less likely to be accurate. Isn't that stupid?Meagan: Yes. The other thing I have noticed from providers who do the VBAC calculator is that not only if they say your chances are lower, if they are doing it and it is lower than 50-60%, they automatically go in their mind and they're like, “Oh, she has a lower chance.” They may start being tolerant, but I think it's something to watch out for. If your provider is pulling out this calculator and putting too much weight on the calculator, it might be something to watch out for and understand that there may be a bait and switch coming up or that provider may not end up feeling comfortable with you being able to VBAC or TOLAC. We've talked about this with other providers where they say they are uncomfortable. That is a really good time to say, “You are not comfortable with this. I am comfortable with this. We are not a good match.” Julie: Yes. Don't let your provider dictate how your birth goes. I love that you brought that up, Meagan, because I'm in a member of a Facebook group for labor and delivery nurses. There are 12,000 labor and delivery nurses in there. I'm mostly quiet. I mostly watch because I like to see the climate of the profession and the attitudes around VBAC, birth photography, doulas, etc. There was a post actually this morning in there. The nurse asked, “What is your hospital's protocol around vaginal breech deliveries?” I was like, “Oh, this is going to be good.” I went through the comments, and I was stalking the comments because I know that having a vaginal breech delivery in a hospital is a freaking unicorn. It's a unicorn. You don't usually see it. It was interesting to see the labor and delivery nurses' comments. One of them stuck out to me. I almost commented back, but I pulled myself back. I was like, “This is for labor and delivery nurses. I don't want to stir the pot. I'll stir this pot in other places, but I don't want to stir the pot in this community most of the time.” One of the nurses said that vaginal breech delivery carries risks, and it is up to the provider and patient to decide what risks are safest and what risks to assume. I rolled my eyes at that because it should be like that. It should be the provider AND the patient together to decide the risk, but how often is it the provider only who decides the risks that these patients are going to take on? No. It's not the patient and the provider. It's the provider deciding. It's the provider deciding. Nowhere in the normal, typical, standard conversation does it include providers and patients making decisions. Not real ones. Not when they disagree. Not when they want a little flexibility or not when they want to go against hospital policy, right? Meagan: Yeah. Julie: I mean, there are sometimes, but it's really rare. Meagan: This comment reminds me of the many scenarios that I see or hear within my own clients here in Utah of, “Hi, I really want a VBAC. I met with my provider, and they said they would let me do.” It reminds me of the “let me”. This provider looked at me, read my history, and said that this is what I can and cannot do. This is what they let me do. Julie: Or they led me to the calculator.Meagan: Yeah. We're losing that conversation. Women of Strength, I encourage you to go forward and have conversation with your providers, especially if you are getting this kickback and especially if you are not being told the risks for both VBAC and repeat Cesarean, and you're just being told, “Oh, you have a 46% chance of VBAC based off of this calculator, so I'll let you try, but don't count on it.” Seriously? If I hear anymore providers, ugh. It's so frustrating.Julie: They're doing you a favor. “We'll let you try. Okay, you can try.” Or they say, “But you have to go into labor by 40 weeks or we'll schedule a C-section, but we won't induce you.” Come on. Come on. They're trying to be this savior. We'll let you try, but…Meagan: Don't stand for that unless that's what you're okay with. I can't tell you, “No. You can't see anybody like that.” That's not my place, but I will say that if you're having a provider in the very beginning pull out this calculator telling you that they'll let you try, but the chances are low, your pelvis hasn't done it before, don't know if it will do it again, your cervix didn't dilated to 10, these are problems. These are red flags.  Okay, so the VBAC calculator, we talked about it. We talked about the stats. We talked about our rant. Now, let's talk about uterine rupture. This is a big one that I feel like hovers. It's that dark cloud. Julie: The elephant in the room. Meagan: Yeah. It hovers over people and their fear. I see it daily within our community. “I really want a VBAC. A different experience is so important to me, but in the end, I'm so scared. I'm so scared of uterine rupture.” Valid. I just want to validate your fears right now. It's okay that you feel scared. It's valid that you feel nervous about it. Julie: Mhmm. Meagan: It's also understandable that you may feel extra nervous about it because the outside world talks so poorly about it. Julie: Mhmm. Meagan: They make it sound scary. It is scary. Julie: It can be, yeah, when it happens. It is. Meagan: When it happens, it can be, but the chances are actually quite low, you guys. We want to talk a little bit about it. I know we've talked about it in the past, but I feel like you can't talk about uterine rupture enough. Julie: Yeah, it keeps coming up, so we'll keep talking about it. Meagan: It keeps coming up. It keeps coming up.Okay, so let's talk about one C-section. You've had one C-section. Your baby didn't come down. You pushed for 2 hours. You had a C-section. You dilated to a 5. You didn't progress. They did all of the interventions. You had a C-section. You got an epidural. Your blood pressure dropped. Your baby didn't do very well. Decelerations. You had a C-section. There are lots of scenarios of why we have C-sections. One C-section– Julie, let's talk about the evidence of uterine rupture after one C-section.Julie: So here's the thing. There are multiple studies out examining uterine rupture and things like that. It's interesting because I feel like it does vary. There are some studies with very small sample studies that have 0% uterine ruptures in their studies, and there are some studies that show higher rates. Now, what I have found as I have been digging is that the studies that are the most credible and most reliable will usually have a rate of rupture between 0.2%-0.9%. I feel like if you have anybody telling you that your chance of rupture is half of 1% or you have a 1% chance of rupture or that the chance of uterine rupture is less than 1% or 1 in 200 or 1 in 100, all of those, I feel like, are pretty accurate representations of what the actual risk of rupture is. Now, there are lots of things that contribute to that of course, but I feel like if you ever have a provider tell you, “Oh, it's about 1%”, that's pretty cool. Meagan: Yeah. Yeah. That's pretty reliable to know that they are within–Julie: Within range.Meagan: They are looking at some study that is within accurate range. Julie: Or I think 0.4%. One of the bigger studies that we cite in our course is 0.4% or 1 in 250. Those are all that for me, personally, I would feel that yeah, you are presenting the data pretty accurately. Yeah. I feel like you're trying to lead this a certain direction.Meagan: No, I'm not. That's exactly something I wanted to talk about is how it can range. You may see something that's 0.2% and you may see something that's 0.47, and you may see something that's 0.7, so I love that you pointed that out. Julie: Yeah. I think that's why the more I go on, I used to say 0.4% or half of a percent whenever somebody would ask me, “What's the rate of uterine rupture?” Those are the numbers I would go to, but now, I feel like it's a little more fluid, and I feel like there's more nuance to that. Meagan: Yeah. I usually say around 1%. What about people who are wanting to VBAC after two C-sections? Because this is another big ask, then it gets even stickier.Julie: So sticky. Meagan: And when we talk about 3+. The evidence after two C-sections– again, everyone has different reasons, but I was told slightly over 1%. Julie: Right.Meagan: 0.7% to 1.1-1.4%. Julie: Well, here's the thing, too. There are not a lot of studies about VBAC after two Cesareans. There's just not, but there are two large studies in the ACOG VBAC bulletin that ACOG cites, and it actually says that– I'm actually going to quote the guideline right now. It says, “Women who have had two previous low transverse Cesarean deliveries should be considered for a trial of labor after Cesarean (TOLAC). However, other factors should also be considered to determine the likelihood of successful VBAC.”Now, here's the thing. It cites two studies in their bulletin as far as risk of uterine rupture. One study that they cite shows that there is not increased chance of uterine rupture from one to two Cesareans. There is one that shows no statistical differences. Now, the other study that they reference shows double the risk of rupture. So, what? 0.5% to 1%? I think it was 1.2% is what the ACOG bulletin says. I'm not sure. I don't have the actual bulletin pulled up right here in front of my face except for that. Meagan: This is another thing where it depends on what you're reading. Some of them are 0.1-1.5% or 1-1.5% and that's even on the higher end of the chances. Julie: Right. The interesting is that ACOG even says that, yet people are going to go say double and triple, or whatever. They're going to make up all of these crazy statistics. Now, gosh dangit. I literally had that guideline. Do you have it open?Meagan: No. The ACOG? No. I don't.Julie: I'm going to find it exactly because we've been called out for this. We literally quoted the exact phrase from ACOG and got thrown under the bus for spewing misinformation when it was literally a quote from ACOG, but whatever. Meagan: While you are finding that, there is an article showing vaginal birth after two Cesareans There was a systemic review and a meta analysis of the rate of adverse outcomes in a VBAC after two. It talks about how the VBAC after two success rate was around 71.1% and the uterine rupture rate was 1.63%, so that is within this. We will have all of these here. If we are quoting something, we're going to make sure that we have it here in the show notes. Please, please, please make sure to go down and check it out. You're going to want more information. We don't have all the time to go over all of these, but I think these are such great reads.  Sorry, have you already found it?Julie: Yep. Meagan: Okay, go ahead. Julie: Excuse me while I clear my throat and crack my knuckles. I'm ready. Let's go. Oh, do you know what? This is actually a pdf from an actual publication, so it's not going to be the exact page that I said. There is a whole section called, “More than one previous Cesarean delivery”. Now, what it says about the studies, I'm going to quote it exactly. “Two large studies with sufficient size to control for confounding variables reported on the risks for women with two previous Cesarean deliveries undergoing TOLAC. One study found no increased risk of rupture, 0.9% versus 0.7% in women with one versus multiple prior Cesarean deliveries whereas the other noted a risk of uterine rupture that increased from 0.9% to 1.8% in women with one versus two prior Cesarean deliveries. “Both studies reported some increased risk in morbidity in women with more than one prior Cesarean delivery, although the absolute magnitude of the difference in those risks was small.”Meagan: Mmm, send me the link so I can put the exact link in the show notes so everybody can go read more.Julie: Yeah. Yep. It also says, “The likelihood additionally retrospective–”. Remember, retrospective is looking back on data that already exists. “Retrospective cohort data has suggested that the likelihood of achieving VBAC appears to be similar for women with one previous Cesarean delivery and women with more than one previous Cesarean delivery. Given the overall data, it is reasonable to consider women with two previous low transverse Cesarean delivers to be candidates for TOLAC, and to counsel them based on the combination of other factors that affect their probability of achieving successful VBAC.” Meagan: Hey, see? They're even saying that it's reasonable. Here we are. It's reasonable. But then, there are so many people who are like, “Nope. Out of the question. It is not acceptable. We will not support VBAC after two C-sections.” Julie: Actually, I don't think you are supposed to publish this. You might not be able to distribute it. Meagan: Oh. Julie: Because you just do a search on the dark web for ACOG VBAC bulletin 205 pdf and it will pull up. I promise. Meagan: Okay. There you go, everybody.Julie: I just don't want you to do anything illegal. Meagan: Yeah. Get on a search. Get on a search. I do want to talk when it comes to three. When it comes to three, the hardest part for me with three C-sections being shut down is that the evidence is still not there. The concrete evidence is not being studied that much. Julie: Mhmm. Even the studies that do exist, they don't have super large sample sizes. They are very old. They are 20+ years old, so that's the best data that we have to use. Sometimes those studies are just automatically disqualified because of their age, their smaller sample sizes, and things like that so it's hard to make any definitive statements about its safety or risks. Meagan: Yeah. Then there is evidence with induction. Increasing around 1.1% if you use Pitocin. A lot of people say, “We can't use Pitocin. It increases it astronomically.” I mean, to some, 1.1% and having that be their rupture rate, that may make sense, but for a lot of people, 1.1% is still quite low. I did just want to throw it out there that the risk of uterine rupture is not dismissed because you schedule a C-section. It's not. Julie: That's true. In fact, you are more likely to undergo a uterine rupture during the Cesarean than you are by attempting a VBAC. Meagan: You are? I thought it was 0.06. Julie: No, it's in our course. I have the charts from the National Institute of Health. Because of the pressure during the surgical procedure, your uterus is more likely to rupture. Now, granted, it's probably “safer” to have a uterine rupture on the operating room table because baby is already coming out, but there is data that shows it. I'm pretty sure there are graphs and charts in there from the National Institute of Health. Meagan: Yeah. I'm going to go find it. I was reading about it. It was 0.02%. It's just really important to know that it's not just eliminated. Your risk is not just eliminated. Okay, let's talk about– and anything else you want to talk about with that?Julie: Mm-mmm. Meagan: Let's talk about epidurals and the risk that we have with that. Julie: Not ugh about epidurals. That sound was not about epidurals in general. It's about how I know where you're going with this. Sorry. Meagan: No, it's okay. I just want to talk about the risk with epidurals because a lot of people don't know that some of the things that happen after epidurals can be placed or things to do before if you're planning to get an epidural like hydrating and making sure that we're good there. I want to talk a little bit about epidurals. Epidurals can do a few things. They can lower our blood pressure. That's one of the most common that I have seen right out of the gate. But it's given, and the blood pressure drops. Mom's blood pressure drops. Baby's heart stops responding. Julie: Baby's heart rate drops a little bit too.Meagan: Yeah. In fact 13 out of 100 women have epidurals cause low blood pressure. Epidurals can also increase infections. Now, yes. Infections are in our back and stuff, but I'm actually talking about vaginally because I feel like the vagina is an open door. Once an epidural is placed–Julie: Then you have the catheter too. That will give UTIs. Meagan: Yep. Yes. We've got a catheter, then it's like, “Oh, I can check you. You can't feel that.” We keep introducing bacteria. Julie: More cervical checks. Meagan: Yes. Julie: Increased infection.Meagan: Yes. It also can cause problems urinating because we've got this catheter. It can sometimes be placed for hours and hours.Julie: Yeah. 24 hours sometimes depending on how long you're in labor.Meagan: Yes. Approximately 18 out of 100 women will have urinary issues because of cather and things like that. It's kind of interesting. Epidurals can also cause itching. Is there morphine in epidural? I think that's why.Julie: Fentanyl.Meagan: Okay. It wears off, and it can cause itching. It can cause you to go so numb that you're unable to move and groove. Julie: These are small risks. They are small risks. It's okay to have an epidural. Don't be scared out of having one if that's what you want. You can still have a VBAC with an epidural.Meagan: I want to talk about that. I'm still going over these risks. Going into what you were saying, there's an article that I'm reading right now. It says that 75 out of 100 women who had an epidural and they were very satisfied with the pain relief that they received. 75 out of 100 is really great. That's really great. It says, “50 out of 100 women who were very satisfied with the pain relief.”Of opioids, sorry. It says, “Compared to 50 out of 100 women who were very satisfied with pain from opioids.” There are risks to epidurals, but there's also a lot of great things that come with epidurals because we can be more present and have less trauma. It comes to a point sometimes where labor– we talk about pain versus suffering, and if you're suffering, that's not usually going to lead to a positive experience.But, let's talk about the just-in-case epidurals. We have talked about this before. Julie: That's what my sound was for.Meagan: I had a feeling. The just-in-case epidurals are frustrating. We've talked about them before. It just doesn't make sense to me. It doesn't make sense. One of these days, I would like someone to sit down and try to make this make sense. It doesn't make sense to me. Is there anything else you would want to share?Julie: Just-in-case epidurals. I just want to do the math on it though. Just-in-case epidurals don't make sense. It's not logical. The idea is that a lot of hospitals will have a requirement that you have to have an epidural placed but not turned on. If you don't want to have it turned on, you don't have to have it turned on, but you have to have it placed just in case of a uterine rupture so they can give you an epidural quickly and go get the baby out without having to put you under general anesthesia because general anesthesia is riskier. That is true. The problem with that is that in order for an epidural to be dosed to surgical strength, it takes 15-20 minutes to be dosed to surgical strength even if it is turned on already. If you have a catastrophic uterine rupture where baby needs to be out in minutes, 15-20 minutes is not going to do it. You're going to be put under general anesthesia anyways. Even if you have an epidural, and baby needs to be out in seconds or minutes, then you will be put under general anesthesia. If there is time to wait, there is time to do a spinal block in the OR. It takes effect in 5 minutes, and boom. You don't have to be put under general anesthesia. So the math isn't mathing there whenever they do that.I've had clients ask when they say, “Hey, just-in-case epidural,” and my clients will be like, “Even if I have the epidural turned on and need the baby out immediately, how much time would it take to get to surgical strength or would I have to be put under general anesthesia anyways?” They'd be like, “Well, we'd probably have to put you under general anesthesia if it's a true emergency.” Every time you ask somebody, the math doesn't math. You can't explain it. Anyways, that is my two cents about that. I think that is the most nonsense VBAC policy ever because you can't make it make sense. It is not even make it make sense. You have people say that about everything nowadays. Make it make sense, but this one literally doesn't make sense.Meagan: Yeah. It's a tricky one. It's a really tricky one. There are risks to getting an epidural, but don't be scared of getting an epidural. It's still okay. It's still okay. Just know, if you are getting an epidural, do things like hydrate. Wait as long as you can. Make sure you go to the bathroom. Eat before. Get your blood sugar up. I'm trying to think of all of the other things. Don't think that just because you get an epidural, you have to get cervical exams anytime they want. Julie: Yeah. Meagan: Yeah. Yeah. It's okay to turn your epidural down if you decide it's too heavy. Julie: There are also some providers who will tell you that you can't have an epidural with a VBAC because then how will they know if you have a uterine rupture? Anyway, the hospital policies that we see are just so different. They change and they are so drastically different even from one hospital to the next in the same area. Anyways. Meagan: Okay. Anything else that you want to cover or think that we should cover? Julie: No. Is there anything else pressing? I feel like we intended to cover more things, but we just keep chatting about it, but that's okay because there are some good stuff in this episode. Meagan: No, I think it's great. So if you guys have any questions or if you have any studies that you have found that contradict anything that we are saying, share it. Julie: Yeah. Send it over. Meagan: I would always love to read it. There are times where we miss updates studies or there are studies that we haven't seen, so please, if you have a study that either contradicts or goes along or says something slightly different, share it with us. You can email us at info@thevbaclink.com.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

“Hospital Policy means the principles, rules, and guidelines adopted by the Hospital, which may be amended, changed, or superseded from time to time.”Julie and Meagan break down hospital policies today, especially common ones you'll hear when it comes to VBAC. They chat all about VBAC agreement forms and policies surrounding continuous fetal monitoring, induction, and epidurals. Women of Strength, hospital policies are not law. They vary drastically from hospital to hospital. Some are evidence-based. Some are convenience-based. Do your research now to make sure you are not surprised by policies you are not comfortable with during labor!Defining Hospital PolicyBirth Rights ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, everybody. We are going to be talking about policies today. What do they mean? Why are they created? And when do we have the right to say no or do we have the right to say no?And I have Julie discussing this with me today. Hey. Julie: You know I'm a policy fighter. Meagan: Yes, we do. We do. The longer I have gone– in the beginning, I was not a policy fighter. I really wasn't. I was a go-with-the-flow, sure, okay, let's do it, you know best. That's really how I was. Julie: A lot of people are. Meagan: That's true. I think a lot of the time, it's because we don't know what our options are. We just don't know, so I'm really excited to get into this with you today. I always love it because we kind of get into this spicy mood sometimes when we have topics like this that we are very passionate about. We are going to be talking about policies today. I do have a Review of the Week, and this is actually a very recent review which is so fun. We just posted on our social media for Google reviews. We were specifically looking for Google reviews and podcast reviews. These are so, so important for us but also for other people to find this platform. We want people to hear these stories. We want people to feel inspired and get educated and know their rights. Your reviews truly do matter, so if you have not yet, please, please, please do so. You can leave a review on your podcast platform, or you can go over to Google and just type in “The VBAC Link”, and then you can type in a review there. This reviewer is by Savannah, and she says, “I started listening to The VBAC Link Podcast around 16 weeks pregnant and continued throughout y pregnancy. It was so good and encouraging for me as a mama who was preparing for my VBAC. It helped me gain confidence, helped me know what to look for, and what to watch out for in my providers. Hearing others' stories was so encouraging and helped me gain so much knowledge. I had my hospital VBAC unmedicated with my 8-pound, 15-ounce baby.” You guys, 8-pound, 15-ounce baby is a perfect-sized baby let me just say. “And I know that the knowledge I gained from this podcast played a huge role in being able to advocate for myself to get my birth outcome.” Huge congrats, Savannah, on your beautiful VBAC for your perfect-sized baby. I say that because you guys, let's get rid of the “big baby” term. Let's just title these babies as perfect-sized because an 8-pound, 15-ounce baby for some providers may be categorized as larger or maybe even macrosomic. it's really important to know that your baby is the perfect size and your pelvis is amazing. You can do it just like our reviewer, Savannah. Julie: Your pelvis is amazing. Meagan: Seriously. All right, you cutie. Look at you. Did you just get a haircut, by the way?Julie: I did, yesterday. It's a little short. We did some color. It's a little smidgey shorter, but then I think I wanted it to still go in a low ponytail for births. That was my goal. Meagan: I'm totally digging it. Julie: Thank you.Meagan: I should be having fresh hair, but my cute hair lady bailed on me the morning of my hair appointment. Julie: Oh no! Meagan: Sometimes we have matching nails, but we would have had matching nails. We don't have them today. You guys, we just miss each other. I miss you. Julie: Yeah. We need to go to lunch again. Meagan: We do. Yes. We love shopping, you guys. Let's talk about hospital policies. Julie: Let's do it. Meagan: We know that so many people go into– not even just birth, but really a lot of things in the medical world. They just go to a doctor's office visit or go to a small procedure, or whatever it may be, and these places have policies. I want to talk about what it means. What does a hospital policy mean? What is the definition? The definition, according to lawinsider.com, says, “Hospital policy means the principals, rules, and guidelines adopted by a hospital which may be amended, changed, or superseded from time to time.” Julie: Oh, I love that addition. Amended, changed, or superseded. Meagan: Yep. Julie: Yeah. Meagan: Yeah. It can. Julie: And it does. Meagan: And it does. It does. Julie: It does. Meagan: You guys, let's just start off right now with the fact of a hospital policy– or a policy, okay? A policy in general is not law. It is not law. If you decide to decline a hospital policy– Julie: It is well within your rights. Meagan: Well within your rights. You could get some kickback. You could probably expect it. Julie: You probably will. Meagan: But, that's okay. That's okay. My biggest advice is if you are receiving or being told that this is a hospital policy, and you disagree with the policy, or maybe you agree with the policy for someone else, but for you, it's not working, and you say no, and they say, “Well, –”Julie: “It's hospital policy.” Meagan: “This policy is policy, and if you choose to break it, then you can sign an AMA.” Julie: You are so funny. “This policy is policy.” It's like that though. Meagan: That's literally what they say. Julie: They say, “It's hospital policy.” And you say, “Well, I don't agree with that policy.” “Well, it's hospital policy.”Meagan: “Well, it's policy.” Okay. Well, I'm telling you I don't like your stupid policy. Julie: I don't like your stupid policy. We are spicy, huh? Meagan: I mean it, though. I think I maybe shared this a little bit, but I had a client who had a home birth planned. She decided to go to the hospital because she had preeclampsia, and this nurse was not giving her her baby. She kept saying, “It's policy. It's policy. It's policy.” I was like, “This mom's word trumps your policy.” As a doula, I was getting into some rocky, choppy waters I was feeling. I could just feel the tension building. It did not feel comfortable at all. I looked at my client. Julie: You're just like, “Give her her doggone baby.” Meagan: They could kick me out. They could. I need you to know that they really could kick me out. She was like, “That's okay. I want my baby.” So I pushed. I pushed. I pushed and I pushed. We did get her her baby, but we had to fight. We really, really, really had to fight, and it sucks. It really, really sucks. So there is a website called pregnancyjusticeus.org. We're going to have this. I have not actually gone through all of it. It is– how many pages is this, Julie? It is a lot of pages. It is 65 pages, you guys. It's 65 pages of birthright information, going through a lot. Julie: It will be linked in the show notes. Meagan: Yes, it sure will. If you want to go through this, I highly encourage it. It is from Birth Rights and Birth Rights Bar Association, the National Advocates for Pregnant Women. Like I said, it's 65 pages, but what they said in here I just think is so powerful. It says, “There is no point in pregnancy in which people lose their civil and human rights, and yet all over the world, people often experience mistreatment and violations of their rights during pregnancy and birth and postpartum.” We see these things. Julie: You need to make that a social media post. People need to know this. Meagan: Yes. Down here even further, it says, “We also know that doulas and other people providing support to pregnant and birthing people often bear witness to rights violation of clients of loved ones. In a recent survey, 65% of doulas and nurses indicated that they had witnessed providers occasionally or “often” engage in procedures explicitly against their patients' wishes.” This is a serious issue. Julie: It is a serious issue. I feel like it's really frustrating, especially as a birth photographer where my lines as a doula are very separate, but I always doula a little bit at every birth I go to. It's not hands-on stuff always, but it's hard when you see people getting taken advantage of and they don't know they are being taken advantage of and they don't know that they have options or choices and they don't know that they can decline or request changes, and that's probably the hardest part is that people just don't know. I have a little tangent, but I'm in this Facebook support group for this medication that I'm on. It really amazes me continuously about how little people know about a medication that they are taking, a pretty serious medication that they are taking, and how little their doctors inform them of what the medication is and what some of the side effects and issues are, and what they can reasonably expect from it because some people have completely unreasonable expectations because they haven't dug into it at all. The other day, somebody said something like, “I've been really, really tired and fatigued since I started this medication, but I called my doctor and she said that fatigue is not a common side effect with this medication,” and I'm like, “What?” It's literally listed on the manufacturer's website that it's a side effect. It's listed on the insert for the medication. It's talked about all the time in this Facebook group, and it can be caused by a number of things that this medication affects. The fact that either her doctor didn't know or just told her– anyway, it leads me. I promise there's a point to this. It leads me to the fact that your doctor does not know everything about everything, especially a family doctor. This medication is prescribed by family doctors sometimes and endocrinologists. It is impossible for them to know everything about everything. Something like obstetrics and gynecology is more specialized so it is more focused. It is a more centralized area of study, but still, your doctor doesn't know everything about everything. It is not uncommon for them to not keep up in advancements in medications and technology and practices as they evolve. It's very, very common for the medical community to be 10-15 years behind the current research and evidence. It just is. Doctors and nurses and all of these things who have to have to have a certain number of contact numbers per year to keep up with training and education, but it is impossible for them to keep up with everything. It is okay for you to have different opinions than your provider. It's okay for you to want different things than is hospital policy, and it is perfectly reasonable for you to make those requests and for those requests to be honored. It is also okay for you to know more about a particular thing than your provider might. Meagan: Yep. Julie: Period, exclamation point, shazam. Meagan: Well, we've talked about this with other providers. We've heard other stories where people come in. They have stats that their providers haven't even seen. They just get stuck in their own way and their policies, and there are other things going on outside, so they just point-blank say, “No, this is how it is,” and you might have more information. That doesn't mean you are more educated or qualified or whatever to be a doctor. Julie: Yeah, exactly. Meagan: It doesn't mean, “Oh, I might as well be a doctor because I know this information and you don't,” but it means that you may have found information that your provider is not aware of. It is okay for you to bring that to their attention. In fact, do it. Congratulations for them to find out the information that they might not have known yet, so they can do better for the next patient. Julie: I want to say that there is an attitude with some medical care providers of, “Don't confuse your Google search with my medical degree.” Meagan: Yes. Julie: Come on. I really have a big problem when people get like that because first of all, and I've said this before, and I will continue to say it again, we have at our fingertips access to the largest amount of information ever available in humankind ever at our desktops. We can sit down, and you can go and find information and studies related to anything ever. Yes, don't go looking at Joe Blow down the street's opinion about childbirth or whatever. Yes, that might be a credible source. It might not be, but you can literally find these same studies, the same research, and the same information that these providers have access to in their path to their medical degree. Is it extensive? No. Are you going to have the hands-on experience that they have doing these procedures and C-sections and things like that? No, you're not, but you still have access to the same information that they have access to. I have a big problem when providers have this arrogant attitude that they know more. Yes, they do know more generally. They might not know more when it comes down to specific things that have been updated since they have gotten out of school. Meagan: Yeah. I feel like in a lot of ways, we hear these policies and these things come up, and you're like, “But where?” Then they can't show you the policy or stat. Julie: Yeah, then they'll be like, “You're 20x more likely to rupture.” You're like, “Can you send me the research?” They're like, “It's the way we've always done it.” Meagan: I did a one-on-one consult, and a provider told someone that they had this astronomical amount of percentage of rupturing, and I was like, “Wait, what?” Julie: Seriously. Meagan: I was like, “Please challenge your provider and ask them for that.” She did, and they were unable to give her that. We can just hear things, and if we just take them, it can be scary, and it can impact decisions when maybe that's not true. I also want to talk about policy for providers. Their policy should be that everyone should have informed consent. They have policies, too, that not only you have to follow or that they have to follow. It's a whole thing. There are many policies. Your provider really has to explain the risks, benefits, and alternatives for any medical procedure, intervention, or anything coming your way, but we see it not happening most of the time. We just see people doing stuff because it's within their normal routine but it's breaking policy which is so frustrating to me. So you can break policy? I want intermittent monitoring. I don't want consistent monitoring. I'm breaking a policy? Julie: So what?Meagan: So what? Julie: So what? Sorry. Meagan: Let's talk a little bit more about VBAC and policies surrounding VBAC. We know that policies are just there. They've been created. During COVID, holy Hannah. We saw these policies change weekly, you guys. Julie: Daily. Meagan: Yeah, seriously. They went in and they were like, “This is our new policy. This is our new policy. This is our new policy,” and I was like, “What?” Julie: It was freaking whiplash.Meagan: Yes, it was horrible. It was horrible. But they can change a policy just like that. You can say no to a policy just like that. So, okay. Sorry. I digress. Let's go back. Let's talk about what policies often surround VBAC. I know a lot of the time, in hospitals all over, it's a policy that midwives cannot treat VBAC. Or you can't be induced because it's a policy. You can't induce VBAC. We talked about this before we started recording, and I said it just now. It has to be consistent monitoring. Julie: Yeah. Well, can I just do a little bit of a timeout and a rewind for half a second? Hospitals are businesses, okay? I just want to explain this to everybody. Hospitals are businesses. I think we know that. You don't have to have that explained. Businesses, in order for them to run efficiently and smoothly, need to have policies, guidelines, best practices, standards of care, procedures, and things like that. It is a business. It is okay for them to set parameters for which they want their providers and nurses and everybody who is at the hospital to operate under, right? It's okay for them to have those things. It's okay for them to set those because if you didn't have those, the business would fall apart. Everybody would be doing whatever the heck they want. There would be a lot of disorder, right? Meagan: Yes. Julie: So policies and procedures and these best practices and things like that are created in order to keep things aligned and have a nice model of care so that they can be more cost-efficient so that the patients know what to expect so that the providers have a routine and things like that. Meagan: Yeah. Julie: There are reasons for these things. However, when we like to push back, when we are bothered, and the thing that really is frustrating about these policies is when they are put in place so rigidly that there's no flexibility and that it takes away a patient's autonomy, and that it removes individualized care from the birth experience. So this is why we want to talk about this. This is why we don't think all policies are dumb. No, we don't. We see the reason. We understand why they are in place. However, we want you to know that it is well within your rights as a human to decline and request changes for these policies, and to desire something different, and to have that desire respected. It's hard when some providers and nurses get so stuck in the fact that, “This is policy,” that they take away your autonomy and your right to choose. That's what we're pushing back against, and that's what we want you to know. These policies are not law. You have the right to want something different and to request something different, and to have that right respected. Okay.Meagan: Absolutely. Absolutely. I couldn't agree more. I do think it can be really hard because they have these things to keep order and to keep things tidy.Julie: And with the intention to keep you safe. Meagan: Yes.Julie: But sometimes intentions don't always translate well. But anyway. Meagan: Yeah. But really quickly before we get into what policies surrounding VBAC are, when we start questioning policy, there are things that can come into play where there are threats, there is coercion, there is gaslighting that starts happening because they are really panicked that you are questioning their policy. They feel very uncertain that you are questioning that. Julie: They may even feel unsafe, or they might never have had the policy challenged before so they don't know what to do about it. Right?Meagan: Yeah. Yeah. Just know that if people are coming at you with, “Well, if you don't do this, then this,” or whatever it may be, then it can get intense, but you can still say no. You can also ask for a copy of that policy. Again, even though that policy isn't law, you can still ask for it. Julie: Ideally, you can do this before labor begins because it's really hard to fight and bump up against these policies during labor. Meagan: Yeah. Julie: It's going to be a lot harder. Meagan: Yeah. Yeah. Okay, so let's go in. I talked a little bit about fetal monitoring. Julie: Induction. Meagan: Not being seen by certain people. No induction. Or the opposite. Julie: You have to be induced. Meagan: You have to be induced. Julie: By such and such a date. Meagan: Yes. It's just so funny because it varies all over. Julie: It does vary all over. Meagan: Let's talk about it. Okay, so fetal monitoring. Julie: Don't forget epidural placement too. Meagan: Yes. Epidurals. Julie: We can talk about that. That's my favorite one to argue against. Anyways. Okay.Meagan: There are so many. Okay, let's talk about fetal monitoring. What is the policy typically behind continuous fetal monitoring?Julie: Yeah, so most hospitals– in fact, I've never met a hospital where this hasn't been the hospital policy– is that continuous fetal monitoring is required for everybody, but especially for VBAC. They double down for VBAC because one of the first signs of uterine rupture, especially for someone who has an epidural, is irregular fetal heart tones. That can be one of the first signs of uterine rupture. Most hospitals are very, very adamant about having continuous fetal monitoring, especially for people who are undergoing a TOLAC which is a trial of labor after a Cesarean. It's not a bad word. It's just how it's defined in the medical community before you have your VBAC.The reason they do that, like I just said— but honestly, if you don't have an epidural and if you aren't under any type of pain medication, the first sign of uterine rupture for you is going to be really intense pain. That's going to be your first sign. Especially if you are going unmedicated, I think it's perfectly reasonable to request intermittent monitoring. Do you want me to go into why they introduced fetal monitoring in the first place?Okay, in the early 1970s, we saw lots of rapid advancements in the medical field and technology related to the medical field. Things like continuous fetal monitoring got introduced. Antibiotics became more readily accessible. The procedures themselves, especially the C-section procedure, became perfected and easier to do with fewer complications and fever rates of infections. All sorts of things started happening at a really rapid pace in the early 1970s. One of the things that got introduced was continuous fetal monitoring. The intention behind the continuous fetal monitoring when it got introduced was to decrease the rates of cerebral palsy in infants. Cerebral palsy usually happens when during either pregnancy or labor, oxygen is deprived to the brain of the baby. It can cause a stroke and damage part of the white matter in the brain. The idea behind it was if you could catch the reduced flow of oxygen to the baby by monitoring its heart rate, you could intervene and do a C-section in time to get the baby out before cerebral palsy happens, essentially. The interesting thing about that is that after continuous fetal monitoring was introduced, there was no change in the rate of cerebral palsy. It stayed the same. It still is very similar. But what it did do is that it was one component that increased the rates of C-sections and other interventions. They are more likely to take a baby out due to nonreassuring fetal heart tones, and we've seen no improvement in maternal mortality and morbidity rates and infant mortality rates either with the introduction of all of these interventions. Meagan: Yeah. One of the reasons why they say that it's mandatory for VBACs specifically is because fetal heart tones decelerating is one of the signs, one of many, that a uterine rupture may be taking place. Julie: Right, right. I said that. Meagan: Oh, you did. Julie: Yeah. Meagan: I was reading the link. I missed that. Julie: No, no. You're fine. Say it again. It's okay.Meagan: No, you're fine. Okay. So with uterine rupture, fetal heart decels are not always a symptom of uterine rupture. What do you feel like it means? I feel like so many people feel more comfortable having their baby on the monitor so they can hear them. Julie: Oh, they do. You know what? The staff is more likely to do that too. This is really sad, but we have a labor and delivery culture that is very, very comfortable sitting at a desk down a hall watching a monitor to see how a patient is doing rather than remaining in the room and watching them. They rely more on what is going on on the contraction monitor and the heart rate monitor than they do the visible signs of the patient. It's how they've been trained. It's how they monitor dozens of people at once in a labor and delivery unit, and I feel like continuous fetal monitoring and the contraction monitor are other ways that de-individualizes care. I don't know if that's a word. It takes out the individuality. It takes out the rights to the human and it takes out really watching the person, and relies too much on the data. Data is good. I love data. Don't get me wrong. I am a data junkie 110%, but data can only take you so far. I feel like that's why people freak out about the continuous fetal monitor thing. “How are we supposed to know if you're doing okay at the desk because we can't see the chart on the screen if we're not monitoring you continuously?” It puts more work on them, which is okay. I can't imagine being a labor and delivery nurse because sometimes you have more than one patient that you're monitoring and watching, and you've got lots of other things to do including charting and all of this stuff. Meagan: Yeah, this is one of those things that was created that even though the evidence didn't prove that the reason why it was created worked out, it stayed because it brought ease to monitoring labor, and monitoring it not in the same room, and being able to have five other patients while seeing a chart. Okay, so fetal monitoring is one. Let's talk about the induction or the non-induction that we've seen policies on both ways which also is so weird to me. I know it's hospital to hospital, but why aren't we going off of evidence?Julie: Dude, dude. Do you know what is so funny to me? I will also cry this out from the rooftops until I die, but if you really want to understand what maternal healthcare is like in the United States, you've got to talk to a doula or a birth photographer because we see not only hospital births and home births and birth center births, but we see all of the different hospitals and how they vary in hospital policy. It is so funny to me sometimes the conversations that I hear or have with labor and delivery nurses who insist one thing, then the next labor and delivery nurse in the next hospital insists on something completely different. “Oh, it's not safe to go past 20 for Pitocin on VBAC,” then the next hospital will be like, “Yeah, it's perfectly safe as long as you are monitored and the OB signs off on it.” It's so up, down, and sideways based on whatever this specific hospital policy is. It's not their fault which is why sometimes I like travel nurses in labor and delivery units because they go all around the country and have vastly different experiences with all the different hospitals. It's fun to see the culture shift that can come in when that happens. Meagan: Yeah. Okay, so in some hospitals, it is policy that you have to go into labor spontaneously. Julie: Yeah. They will not induce for VBAC. Oh, but if you haven't had your baby by 40 weeks, it's hospital policy to do a C-section. Meagan: Yeah, they will not induce you, but then if you don't go into labor by 40 weeks, they have to schedule a C-section. What's the evidence there, and why is that even being a policy?A lot of providers after 40 weeks fear or they say that VBAC uterine rupture chances skyrocket after 40 weeks because, “Oh, that baby is getting bigger. They're stretching that uterus out,” but that's really not necessarily the case. We're seeing it happen more and more and more where people are then doubting their body's ability to give birth or go into labor. They are so scared that their baby's going to get so big that they're going to cause uterine rupture if they go past 40 weeks. I mean, really. You guys, the amount of things that we see coming in The VBAC Link's DM's– I love that you guys write us. Please keep writing us, but it's frustrating, not that you're writing us, but that these providers are telling people these things. Then we have the opposite that we have to induce by 40 weeks. Julie: Can I read you this thing? There's a post in The VBAC Link Community today. It was a VBAC agreement form. If you're birthing at a hospital, you're more than likely going to have to sign a piece of paper showing all of the risks of VBAC, but they don't ever make you do that for a C-section. This hospital VBAC policy, hold on. I was reading it this morning. Listen to this. This is word for word from this VBAC agreement form from a hospital. “I am aware that the best chance for a successful VBAC is to go into spontaneous labor, and that the risk of Cesarean section is increased past my due date. In an effort to afford me the best chance of achieving VBAC, I agree to be induced the 39th week of pregnancy or sooner if medical issues are present if I am still pregnant.”In that same paragraph, they say that the best chance of a successful VBAC is going into spontaneous labor, but if you don't go into labor by 39 weeks, we're going to induce you. Meagan: It also says that after 40 weeks, Cesarean chances increase so we have to induce a whole week before. Julie: Yeah. Right? Meagan: I'm sorry. Julie: This is real life. How is this even a thing? Blah, blah, blah. That's what I say. Screw your policy. How can you contradict yourself like that? It says, “The risk of a Cesarean section is increased past my due date, but it's also increased if you induce me, so either way I have increased risk.” This is literally what they are telling you in this form that they make you sign. Meagan: You know, those forms are so important to pay attention to, you guys. As you are getting these forms, the VBAC consent forms, or VBAC agreement forms or whatever. They title them all differently. Julie: I'm just reading this hospital policy more. Sorry. “I am aware of the hospital policy requiring two IV access sites.” Meagan: Okay. Today, which you guys, was last– I'm trying to think. It was a month ago. Okay, a month ago– I recorded the episode today, but a month ago, when this is coming out. Go listen to Paige's midwifery episode. She just was talking about that. That is a policy within the hospital that she helps people at. They have two hep locks. This was news to me as of today, and now you are seeing this in this policy. Why? Why? What is the evidence behind that? Why?Julie: This VBAC agreement form is every single thing that we are talking about. “I agree to have continuous fetal monitoring. I am aware of this policy by this obstetric group–.” I won't say it because maybe we shouldn't call them out. Maybe we should. “--to require epidural placement by the time of active labor. I am aware of the implication that certain complications of labor can be life-threatening to myself and my baby. These can only be addressed promptly at the hospital. To lessen the risk of delay during a complication, I agree (in bold)--”Meagan: Yes. All of the agrees are in bold.Julie: “--to come to the hospital immediately if I am in labor or if my water breaks.”Meagan: Ugh. Julie: “I have been adequately about the risks, benefits, and alternatives of VBAC, and have the opportunity to ask questions. I am aware that no one is able to guarantee a successful VBAC and that repeat C-section may be indicated if my baby is breech, I do not adequately dilate, I am able to push my baby out, my baby does not tolerate labor, there is a concern for uterine rupture, or if any unforeseen medical issue arises during my pregnancy which makes labor unsafe–” according to who?Anyways, “certain methods of induction of labor are not permitted to be used in patients with prior Cesarean sections. I understand that if I am induced, the only safe options include medical dilation with a balloon, Pitocin, and breaking my water.” That, I feel like, is accurate. Meagan: That is valid. That is valid. Okay.Julie: That's the only one. Cool. Meagan: Cool. Out of ten. Julie: Are you reading this right now? Do you have it up?Meagan: Yes. I pulled it up. Let's talk about epidural. You guys, this has 86 comments already. One of the commenters said, “You absolutely do not need to get an epidural, have continuous monitoring, or go into the hospital when labor begins. These are often things to avoid when trying for a VBAC.” Julie: Yes. Yes. Meagan: You absolutely can have these things. “You can have these things, but having an epidural before 6 centimeters can put you at a higher risk of Cesarean including continuous monitoring. Your rights override policies.” This is what she said. She said, “Are you in the States? Did you sign this?” Julie: But I love what Flor Cruz with Badass Mother Birth said. “This is atrocious. Run. I would rather give birth in the woods by myself than to agree with this monstrosity.” Meagan: Really, though. We have so many things coming at us. We're so vulnerable when we are pregnant, and we want a VBAC so badly. We have forms like this being given, or we have policies being thrown at us, and we say, “Just say no,” but when you're in that moment, it's really difficult. I think something that I want to say is, as you are learning these policies, as you're learning more, figure out if you are someone who can stand up to these policies and say no, or figure out if there's someone on your team who you need to have be there to help you find the strength to say no. Also, make sure that your family knows and your team knows what's important to you when it comes to these policies. What triggers you? It is very difficult to say no or, “I am not going to do that,” or to not even say a word because they just strap the monitors on you, or call anesthesia because they just did a cervical exam, and the nurse logged that you're 6 centimeters, so anesthesia is just coming down, but you might be doing really well and not want an epidural. Okay, I want to talk about epidurals. Julie: Let's talk about epidurals. Jinx. Let's do it. This is my favorite policy to tear apart and rip apart. Here's the thing. The reason why they tell you they want an epidural placed, but you don't have to have it turned on, just to have it placed just in case, is if a uterine rupture happens, you can dose up the epidural and go back to surgery, and they don't have to put you under anesthesia. It sounds great, right? Cool, yeah. Let's do that. That sounds great. I don't want to go under general anesthesia if I have to have a C-section. Here's the problem with that. First of all, going under general anesthesia does carry more risks than having surgery with a spinal or an epidural. It does. That's just common knowledge. Nobody is going to argue that here. We get that. The problem is that in a true emergency, we're talking about seconds matter. Minutes matter. If you have a catastrophic uterine rupture and baby has to be out now, baby has to be out in minutes or less. They are going to do a splash and dash. They are going to throw the antiseptic, the orange stuff– Meagan: Iodine? Julie: Iodine. They're going to throw iodine on your belly, and they're going to slice you open. Sorry, that was a very not-sensitive way to say that. They're going to take the baby out as fast as possible once you're in the OR. They have to knock you out under general anesthesia. There is not enough time to dose an epidural, especially if it's not ever turned on. But even if it is turned on, it takes 20 minutes or more to get an epidural dose to surgical strength to where you will not feel the incision and the surgery that comes with a C-section. 15-20 minutes at minimum in order to get you dosed to surgical strength. If you have an epidural, and it is urgent where minutes matter, you will have to go under general anesthesia no matter what, period. If a C-section is needed, there is time to give you a spinal which takes effect in just a few minutes, 3-4 minutes. It takes some time to get the anesthesiologist in and the OR prepped and things like that, but usually and realistically, if it's something that's urgent but not emergent, you can get a baby out in 10-15 minutes without already having an epidural placed. Here's the thing. Placing an epidural is preparing you for surgery, period. If there's an emergency, you will have to be put under general anesthesia, period. If a C-section is needed, and minutes don't matter, but we need to get this baby out soon, you can get a spinal, period. So, screw that epidural hospital policy. It's literally for convenience so you already have an epidural placed so that they can take you back to do a C-section. Meagan: Yeah. But again, the epidural just doesn't get in fast enough even if it's placed or not. Julie: Exactly. Meagan: Ugh, I hate it. I hate when it's like, “I don't want an epidural, but I'm getting it just in case.” Okay, then going back to this policy that she was just reading, “will not labor at home. If my water breaks, I have to come right in.” You guys, if you want to labor at home, do your research. I understand. Always, always– I don't even care if you are a VBAC or you're planning an induction or what. Always learn the signs of uterine rupture, always. It's so important to know. Even though it happens very little, it happens, and we need to know the signs. But, it's okay to labor at home. Talk to your provider about that. If they are like, “The second you have a contraction, you have to come in,” that is a red flag. You guys, they also start monitoring and pushing induction even though your labor has been going. They induce your labor more. They get it going further. What if you're having prodromal labor, and it's just going, and then it stops for 5 hours? There are so many things. I'm no provider. I can't say, “You must labor at home,” or “You should really labor at home,” but really look at these things and understand what could happen if you choose to go in the second your water breaks. Let me tell you what happened to me. My water broke. I went straight in. Within an hour, I hadn't progressed too much, so they started Pitocin. They immediately started Pitocin. They kept cranking it up. My body was struggling. I was struggling. My baby had a couple of decels. They called it. It's just really, really frustrating. I mean, you guys. We have so many comments in this here that I could just read all of them because they say a lot. They say a lot. This is fear-based care. I'm sorry that you're having to go through this.” “This is the dumbest thing I've ever heard,” someone said. Julie: Seriously. Meagan: When it comes to hospital policy, it's not a law. It's really not a law. Stand up for yourself. Understand the policies surrounding VBAC. When you are looking for a provider, we cannot stress this enough. Ask them about their policies. If their policy is that you must get that just-in-case epidural, you have to have that baby by 40 weeks or we induce or we schedule a Cesarean, you have to come in the second a contraction starts, if your water breaks, you must come in. You have to come in. They're making people sign these policies like they are the law. Julie: Yeah, like it's a legal document like you can't change your mind. That's what it does. It makes people think they have to agree to things. “I signed the document, so here I go.” Meagan: Here I am. I have a written agreement, but they can change. What did it say? What did the very first definition say? It says, “It can be amended, changed, or superseded.” Supersede. Julie: Superseded. Yes. But here's the thing, too. I'm kind of glad when hospitals do this because it shows you all of the red flags. It lines out the red flags, no questions, black and white, red flags laid out for you. Then you know either how to address them before labor, or how to hightail it out of there and find another practice because nothing is worse than getting blindsided during labor by a policy that you don't agree with and having to advocate to change that during labor.I would encourage you if your provider doesn't make you sign a wonky form, then before you even start care with them, find out what their hospital policies are about VBAC. Find out so that you can address them ahead of time. Have your provider sign off on changes to policy that you want, and put it in your medical records so that if you get a different provider on the day that you go into labor, that provider can access your records and see that it has been signed off, or approved, or whatever your changes are that they are going to make to the policy for you and your specific needs. It is okay to ask for that. It is okay to fight for that. It is necessary to fight for that sometimes. Obviously, it would be ideal for you to find a birth location whose policies align with the things that you want. Sometimes, somebody might want continuous fetal monitoring. Maybe it makes them feel better mentally. Maybe that's just their preference, and that's okay. It's okay to want that, but it's not okay to let a system dictate how you want to birth when you want something different. Meagan: Yes. Absolutely. It's also not okay for you to feel cornered or like you're bad, coerced, or you're a bad mom because you're making a decision that goes against a policy. I don't like that. I do not like that. It's not okay. I highly suggest going and checking out the show notes and reading more about your birth rights, what they mean, and all of it. In part of that little birth rights document pdf, the 65-page document, it talks about down in the first 4 or 5 pages– let's see. It says, “I have the right to–”, and then it has a whole bunch of things. It says, “To say no and be heard. To have my basic needs be met. To labor in the way that works for me. To birth vaginally. To know all of my options. To change midwives, doctors, and nurses. To not be touched. To ask people to leave. To feed my baby human milk. To leave the hospital or the birth center.” You guys, you have rights. You have rights. You are amazing. Use your rights if you are in a corner that feels like they are being taken away or they're gaslighting you, or coercing you, or whatever it may be. You have rights. Check this document out. I highly suggest it. Talk to your providers. Check out their policies. Dissect the policies. Dissect them. Really break it down. What does that mean? Why is this being put on as a policy?In one policy that Julie just read, it said that they will not induce, and that VBAC is not applicable to being induced with certain things other than x, y, and z. Okay, if you do the research and you learn about that, that is pretty dang valid. That is understandable. That policy has been put in place for your safety. Okay? But there are others that I would say no to. They may be thinking that it's for your safety, but there is no evidence behind them. Dissect them. Learn them. Learn how to advocate for yourself. Get your team ready. Know it's not a law, and love yourself because you deserve more. Okay. Anything else you'd like to add, Julie?Julie: No. I love that. Love yourself. Take ownership. Take ownership of your own birth experience. Don't give it to somebody else. Stand up for yourself. Take ownership. I love what you just said. Love yourself. You deserve to have choices in how you are treated during your birth experience. Meagan: Yes, absolutely. Okay, thanks, 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

Guest Bios Show Transcript https://youtu.be/g3j3C25thlcMuch research has been done to address individual trauma. But what happens when trauma is collective—when an entire congregation, for example, is betrayed by a pastor they trusted? In this edition of The Roys Report, Kayleigh Clark, a pastor and a pastor's kid, discusses the impact of communal suffering, which church leaders often overlook. Kayleigh, a doctoral student at Kairos University, is completing her dissertation on congregational collective trauma and paths towards healing and restoration. And what she's learned is ground-breaking for churches that have experienced pastoral abandonment or moral failure and are struggling to recover. As was explained in the popular book, The Body Keeps the Score, unhealed trauma—if unaddressed—will manifest itself as physical and psychological ailments in our bodies. Likewise, unaddressed trauma in the Body of Christ will also manifest as corporate dysfunction and pain. But as Kayleigh explains in this eye-opening podcast, this doesn't have to be the case. Healing is available. But it requires congregants and spiritual leaders who understand trauma and don't try to charge forward before the congregation has healed. Given all the unhealed trauma in the church, this is such a relevant and important podcast. It's also one that discusses dynamics Julie knows all too well, as someone who's in a church with others who've experienced deep church hurt. She discusses her own experience in the podcast, which could be a prime case study. Guests Kayleigh Clark Kayleigh Clark is founder and director of Restor(y), which exists to journey with churches on the hope-filled path of healing and restoration. She completed a Master of Divinity at Northeastern Seminary and is currently a Th.D. Candidate at Kairos University with a focus on the interplay between psychology and theology. Kayleigh and her husband, Nate, love exploring the outdoors with their son near their home in Rochester, New York. Learn more about Restor(y) online. Show Transcript [00:00:00] Julie: Much research has been done to address individual trauma, but what happens when trauma is collective? When an entire congregation, for example, is betrayed by a pastor they trusted. According to my guest today, the impact of communal suffering is often overlooked, but the body of Christ keeps score. [00:00:22] Julie: Welcome to The Roys Report, a podcast dedicated to reporting the truth and restoring the church. I’m Julie Roys. And joining me today is Kaylee Clark, a pastor and a pastor’s kid who’s well acquainted with the beauty, joy, pain, and heartache that exists within the church. Kaylee also is a doctoral student at Kairos University, and her dissertation work focuses on congregational collective trauma and paths towards healing and restoration. [00:00:50] Julie: She also is the director of ReStory, a ministry to help churches heal and embody the hope of Jesus, especially after experiencing a devastating loss or betrayal. I had the pleasure of meeting Kaylee about a week ago, and I was so excited by her insights and the work that she’s doing that I was like, you have to come on my podcast. [00:01:10] Julie: So I am thrilled that she can join me today, and I know you’re going to be blessed by this podcast. I’ll get to my interview with Kaylee in just a minute, but first, I’d like to thank the sponsors of this podcast, the Restore Conference and Mark Horta Barrington. If you’re someone who’s experienced church hurt or abuse, there are few places you can go to pursue healing. [00:01:30] Julie: So, Similarly, if you’re an advocate, counselor, or pastor, there are a few conferences designed to equip you to minister to people traumatized in the church. But the Restore Conference, this February 7th and 8th in Phoenix, Arizona, is designed to do just that. Joining us will be leading abuse survivor advocates like Mary DeMuth and Dr. [00:01:50] Julie: David Pooler An expert in adult clergy sexual abuse. Also joining us will be Scott McKnight, author of A Church Called Toe, Diane Langberg, a psychologist and trauma expert, yours truly, and more. For more information, just go to Restore2025. com. That’s Restore2025. com. Also, if you’re looking for a quality new or used car, I highly recommend my friends at Marquardt of Barrington. [00:02:17] Julie: Marquardt is a Buick GMC dealership where you can expect honesty, integrity, and transparency. That’s because the owners there, Dan and Kurt Marquardt are men of integrity. To check them out, just go to buyacar123. com. [00:02:37] Julie: Well, again, joining me today is Kaylee Clark, a pastor and doctoral student who’s studying congregational collective trauma and the paths to healing and restoration. She’s also the founder of Restoree and she’s a wife and mother of a beautiful baby boy. So Kaylee, welcome. It’s just such a pleasure to have you. [00:02:56] Kayleigh: Thank you. Thank you for having me. It’s an honor and a pleasure to be with you today. [00:03:00] Julie: Well, I am just thrilled to have you on our podcast and I mentioned this in the open, but We talked last week and I was just like, Oh my word, everything that you’re doing, your work is so important. And it’s so where I’m living right now. [00:03:15] Julie: And I know a lot of our listeners are living as well. And so I’m thrilled about it. But as you mentioned, your work is, is unique. We’re going to get into that, but I am just curious, this whole idea, collective trauma, you know, ministering. To the church. How did you get interested in this work? [00:03:33] Kayleigh: Sure. Um, so I am fourth generation clergy. [00:03:37] Kayleigh: So great grandpa, grandpa, my dad, and then me. So are all pastors. Uh, and so I’ve just always known the church, uh, pastors have also been kind of my second family. I’ve always felt at home amongst the church and amongst pastors. Um, but when you grow up in the parsonage and other PKs will know this, uh, you are not hidden from. [00:03:58] Kayleigh: The difficult portions of church and the really hard components of church. And so then when you add on to that, becoming a pastor myself, you know, my eyes continued to be open, uh, to some of the ways that church can be a harmful place as much of it as it is a healing place. And I began to kind of ask the question, well, well, why, um, what is going on here? [00:04:21] Kayleigh: Um, particularly because when I served and we’ll get into more of this, I think, but when I was serving in my first lead pastor, it’s. So I’m a really young, I was like 27 when they, or 28 when they entrusted me when I first lead pastorate, which is kind of wild. And so they kind of threw me in and what they do with most young pastors is they kind of throw us into these dying churches. [00:04:44] Kayleigh: And so, right, it’s a small. Church with, you know, it’s dying, it’s dwindled in numbers. And so this is my first kind of lead pastorate. And, you know, I read all the books, I’m a learner, I’m a reader. I, you know, I know how to do all the things. And so I’m reading all of the books on how to revitalize a church and raise a church up from it and all those things and nothing is working. [00:05:06] Kayleigh: Um, and it started to kind of really raise my attention to, well, maybe there’s something else going on here. Um, And, and maybe we’ve been asking the wrong questions when we’ve been approaching the church. Uh, and so, uh, again, I’m a learner, so I was like, well, I’m just going to go back to school. If that was the only way I knew how to figure this out. [00:05:25] Kayleigh: So I landed in a THD program that focused on combining the studies of trauma theory with theology. Um, and my undergraduate degree is in psychology, so it felt kind of like a merging of my two worlds. Um, and it was there that I encountered collective trauma and. Really in an interesting way, studying, um, more like childhood development trauma. [00:05:46] Kayleigh: But anytime I looked at it, all I could see was the church, um, and seeing the ways in which there might be a bigger picture. There might be a bigger story going on here. And maybe there’s some collective congregational trauma underneath the, these dying, uh, declining churches that we just aren’t aware of. [00:06:04] Julie: So, so good. And this is the thing that, that just stuns me. When I, I, I do an investigation and the top pastor gets fired, sometimes all the elders step down, but the church, it’s, it’s unbelievably rare for one of those churches to thrive afterwards. And I, and I think so much of it is they think, Oh, we got rid of the bad apple. [00:06:29] Julie: And they have no concept of how that toxicity, one, you know, the toxic, often bullying way of relating and everything was, was taught and learned and trained throughout. But then there is that trauma and, and I just, I think of Willow Creek Community Church, I went to their, it was like a midweek service where they were going to deal with, Supposedly, the women who had been sexually harassed and abused by Bill Heibel’s, the previous pastor, and they didn’t even name it. [00:07:08] Julie: They didn’t name what had happened. They didn’t go into what had happened. They didn’t apologize to the women. The women became like this amorphous something out there, the women, you know? Um, and, and then they talked about, they had a repentance time, like we’re supposed to repent for his sins. It was the most bizarre, unhealing thing I had ever seen. [00:07:27] Julie: And I couldn’t imagine how after something that dysfunctional, a church could go, okay, we’re back, you know, reach the lost, you know, seeker sensitive church. It was just bizarre. Um, so, so much of your work is, is resonating with me. And again, We’ve seen a lot in and it’s really important is dealing with individual trauma and which is super important work. [00:07:53] Julie: Um, and my last podcast with Chuck DeGroat, we talked a lot about that. We talk a lot about that on a lot of podcasts, but we often don’t address again, what’s this collective trauma that, that, you know, that it actually has a social aspect. So talk about why is it important that we begin addressing collective trauma and not just individual trauma, though, you know, obviously we each need to heal as individuals, but collectively as well. [00:08:24] Kayleigh: Yeah. So collective trauma is a newer field, even in psychological studies. So it’s, Not as old as individual trauma studies, and it actually became more popular through the work of Kai Erikson, who’s a sociologist. He’s not even a psychologist, but he studied collective trauma in kind of what he refers to as unnatural disasters. [00:08:43] Kayleigh: And so these disasters that are experienced by communities that have a human, like, blame component. So it was due to somebody’s negligence due to somebody’s poor leadership due to somebody’s abuse, and it’s on a community. And so Kai Erickson notes the, the social, he calls it the social dimension of trauma or collective trauma. [00:09:03] Kayleigh: And what he, he details there is that collective trauma is anything that disrupts and ruptures the, uh, relationships within a community. Distorting and taking apart their, uh, he calls it communality instead of community, but it’s their sense of, like, neighborliness. It’s their sense of being together. It’s their, Their shared identity and their, their shared memories are all now distorted. [00:09:26] Kayleigh: And so I think when we’re speaking specifically about the church, and when we’re looking at religious trauma and congregational trauma, we need to remember that the church is first and foremost, a community. And so sometimes I think that’s missed in our kind of American individualism. You know, a lot of people kind of view spirituality as this individualistic thing, but the church is a community. [00:09:48] Kayleigh: And so when we come together as the body of Christ, you know, when wounding happens, when trauma comes, it breaks down the relationships within that congregation, which really. is what makes it a church. The relationships are what make that a church. And so when trauma comes in and disrupts those and starts causing the divisions and the distrust and the he said, she said, and the choosing of sides and the church splits and all of these things have these ripple effects on the community. [00:10:19] Kayleigh: Um, and they really are, are traumatizing. And so what happens is that if we don’t deal, if we’re only dealing with the individual trauma, In part, that’s usually dealing with people who have left the church, right? And so usually the people who are seeking individual healing from their religious trauma, who are able to name that, who are able to say, I went through this, have often stepped outside of the church. [00:10:42] Kayleigh: Sometimes just for a season, which is completely understandable. They need that time away. They need time to heal. They’re, they don’t, feel safe. But what we’re missing when we neglect the social dimension of religious trauma are often the people who stay are these congregations who can’t name it yet, who can’t articulate that what they’ve gone through is religious trauma, who who maybe are still trying to figure out what that means. [00:11:07] Kayleigh: Often it means that we’re missing, um, you know, these, these the church that I served in, you know, isn’t one of these big name churches that’s going to get, you know, newscasted about. And they can’t necessarily name what happened to them as religious trauma because nobody’s given them the language for it. [00:11:25] Kayleigh: And so we’ve often missed these, these declining churches. We’ve missed because we haven’t remembered that Trauma is communal that trauma is relational. And so we need to, yes, provide as much care and as much resourcing as we can for the healing of individuals, because you can’t heal the community if the individuals don’t know. [00:11:44] Kayleigh: But we really need to remember that the community as a whole. impacted, and that especially when we’re talking about the church, we want to be able to heal and restore those relationships. And to do that means we have to address the social dimensions of the religious trauma. And so [00:12:01] Julie: often the people that, that stay aren’t aware of what’s happened to them. [00:12:08] Julie: Are they not even aware they’re traumatized? [00:12:11] Kayleigh: Right, right. Yeah. [00:12:13] Julie: Yeah. You introduced this, this concept, which is great. I mean, it’s, it’s a riff off of the book, The Body Keeps the Score, which, you know, um, just an incredible book by, uh, Dr. Vander Kolk. But this idea that the body of Christ keeps the score. [00:12:33] Julie: Describe what you mean by that, that the body of Christ keeps the score when there’s this kind of trauma that it’s experiencing. [00:12:40] Kayleigh: Sure. So you kind of alluded to it earlier when you were giving an example of the removing of a toxic pastor, right? And then just the placement of a new pastor. And so often what happens in these situations where there’s spiritual abuse or, um, clergy misconduct or any of those things that’s causing this religious trauma, the answer seems to be, well, let’s just remove the. [00:13:00] Kayleigh: Problem person. And then that will solve everything. Um, well, what happens is we forget that trauma is embodied, right? And so you can remove the physical threat. Um, but if you remove the physical threat or the problem person, but this congregation still has this embodied sense of trauma in which they perceive threat now. [00:13:23] Kayleigh: So they’re reacting to their surroundings out of that traumatized position, because that’s what the collective body has learned to do. And so you see this, um, It’s a silly example, but I use it because I think people see it a lot. So you have a new pastor come in and the new pastor has a great idea, at least he or she thinks it’s a great idea. [00:13:46] Kayleigh: And it probably has to do with removing pews or changing carpet color. Okay. And so they present this, what they think is just a great harmless idea. And the response of the congregation is almost volatile and the pastor can’t figure out why. And often, unfortunately, what pastors have kind of been taught to identify is that they must just idolatry. [00:14:11] Kayleigh: They just have the past as an idol for them and they need to kill this golden cow. Right. And so it becomes this theological problem. Sure, there might be cases where that is the truth, but often I would say that there’s, um, a wonderful. So another great book on trauma. It’s more on racialized trauma, but it deals a lot with historical trauma is, um, rest my Mac mannequins book, um, my grandmother’s hands and in it, he addresses this historical trauma that is embodied and he quotes Dr. [00:14:42] Kayleigh: Noel Larson, who says, if it’s hysterical, it’s probably historical. In other words, if the reaction to the thing happening doesn’t seem to match, like it seems out of proportion, either too energized or not enough energy around it, it’s probably connected to some kind of historical trauma that hasn’t been processed. [00:15:03] Kayleigh: And so we see this a lot in churches who are having a hard time being healthy and flourishing and engaging with the community around them. And. The reason why is often because they have this unhealed trauma that nobody’s given them language for. Nobody’s pointed out, nobody’s addressed for them. Um, and so it’s just kind of lingering under the surface, unhealed, unnamed, and it’s informing how they believe, how they act. [00:15:33] Kayleigh: Um, and so this is really What I mean when I say the body of Christ keeps the score is that the body of Christ has embodied this trauma and it’s coming out in their behaviors, in their actions, in their values, and our pastors are not equipped to address it from a trauma informed perspective. They’ve only been given tools to address it from maybe a theological position, or this kind of revitalization remissioning perspective. [00:16:02] Kayleigh: That often doesn’t work. [00:16:04] Julie: There’s so many things I’m thinking as as you’re talking. I mean one. to come in and do something. And then because people react to, I mean, basically that’s shaming them. It’s guilting them to say, Oh, you have an idol or what’s wrong with you that you can’t get on board. And the truth is they don’t know what’s wrong with them. [00:16:23] Julie: They, they don’t. And, and they’re hurt. And all they know is you just, they’re hurt and now you’ve hurt them. So now they don’t trust you. So way to go. Um, but I’m thinking maybe because we brought this up and I don’t mean to beat up on, on Willow Creek, but I’m thinking about. When the new pastor came in, and I don’t think he’s a bad guy, um, you know, they, they were bleeding money. [00:16:45] Julie: Obviously they, they did not have the resources they did before. So one of the first things they did was they centralized, which meant the campus pastors weren’t going to be preaching anymore. They were going to be pumping in video sermons. Here’s the pastor that people trusted on these campuses. Now, that person’s not going to be preaching, which then of course, all of them left. [00:17:06] Julie: They ended up leaving and the trauma you’d now it’s trauma upon trauma. And it just seems like, especially in so many of these churches, you bring somebody in and they want to move somewhere like, right. They want a thriving church. What they don’t want to do is be at a church and sit in your pain. And yet. [00:17:27] Julie: Unless that’s done, I mean, can these churches, I mean, can they move forward? I mean, what’s going to happen if you come in and you don’t? slow down and say, these people are hurting and I need to, I need to be a shepherd. Then that’s the other thing. It’s so many of these mega churches, and I know this isn’t unique to mega churches that this happens, but I, it’s the world in which I report so often is that these mega churches are very mission vision, five year plan oriented and what they’re not capable of doing. [00:17:59] Julie: I think so many of these, you know, and they always bring in the, the pastor. That’s a good orator, maybe not a shepherd at all. In fact, some of these guys even say, I’m not a shepherd, which that’s another, yeah, I mean, but, but to actually, they need a shepherd at that point. Right. I mean, these, these people need it. [00:18:20] Julie: So, I mean, again, what, what do they need to do? And what happens if they don’t do some of these things? [00:18:28] Kayleigh: So the thing that I have really been drawn to, especially as I study Jesus, and I look at what it means to be trauma informed in the pastorate. So I, I do believe that God is still working through pastors. [00:18:39] Kayleigh: Um, in fact, there’s a really beautiful section of scripture in Jeremiah 23, where God is addressing abusive shepherds and God’s response is, I will raise up new shepherds. So God still wants to work through shepherds. There is still a place for a pastor. The problem is, is I don’t think we’ve taught pastors how to lead out of a posture of compassionate curiosity. [00:19:03] Kayleigh: And so if you follow Jesus and you look at the way that Jesus interacts with hurting people, it is out of this beautiful, humble posture of compassionate curiosity. And so I was always struck by like, he asks the blind man, what do you want me to do for you? And it always seemed like a. That’s a strange question. [00:19:20] Kayleigh: Like, he’s blind, Jesus. What do you think he and often it’s preached on, like, well, we need to be able to tell God what we want. And that’s maybe some of it. But I think it’s also the truth that God knows that it can be re traumatizing to somebody to tell them what they need and what they want. Right? So what we learned when we studied trauma is that it’s not. [00:19:40] Kayleigh: So especially when we’re talking trauma caused by abuse is that abuse is so connected to control. And so what has often happened to these victims of religious abuse of spiritual abuse is that they have had control taken from them entirely. And so when a new pastor comes in and tells them, this is what you need to get healthy again, and never takes the time to approach them from this. [00:20:02] Kayleigh: posture of compassionate curiosity, they can end up re traumatizing them. Um, but our pastors aren’t trained to ask these questions. And so, so often if you read, you know, and they’re well meaning books, you know, they’re, they’re trying to get to what’s going on in the heart of the church. They’re trying to get back to church health, but so many of the books around that have to deal with. [00:20:23] Kayleigh: Asking the church, what are you doing or what are you not doing? And trauma theory teaches us to ask a different question. And that question is what happened to you? And I think if pastors were trained to go into churches and ask the question, what happened to you and just sit with a church and a hold the church and, and listen to the stories of the church, they, they might discover that these people have never been given space to even think about it that way. [00:20:52] Kayleigh: You know, where they’ve just, they’ve had abusive leaders who have just been removed or they’ve had manipulative leaders who have just been removed and they’ve just been given a new pastor and a new pastor and nobody’s given them the space. To articulate what that’s done to them, um, as individuals and as a congregation. [00:21:09] Kayleigh: And so if we can learn to, to follow Jesus in just his curiosity, and he asks the blind man, what do you want me to do for you? He, he says, who touched me when the woman reaches out and touches him. And that’s not a, it’s not a question of condemnation. That’s a question of permission giving. He knows that this woman needs more than physical healing. [00:21:28] Kayleigh: She needs relational healing. She needs to tell her story. And by pausing and saying, who touched me? He provides a space for her to share her story that she’s never been able to share with anyone before. And I think if we were to follow that Jesus, as pastors and as leaders, we would begin to love the Bride of Christ in such a way that would lead to her healing, instead of feeling the need to just rush her through some five year plan to what we think is healing and wholeness, and what actually may not be what they would say is what they need. [00:22:02] Julie: So many things you’re saying are resonating with me. And part of that’s because, uh, like I said, we’re living this. Um, I, I told you last week when we talked that our, our house church was going on a retreat, first retreat we’ve ever had. We’ve been together a little over, well, for me, I came in about two years ago and I think they had been meeting maybe eight or nine months before then. [00:22:29] Julie: Some of the people in our group, Um, don’t come out of trauma. Um, you know, one of our, one of the couples in our church, uh, they’re like young life leaders, really just delightful, delightful, delightful people, but they haven’t lived the religious trauma. One couple is, they’re from the mission field and they had a great missions experience. [00:22:55] Julie: The only trauma they might be experiencing is coming home to the U. S. The truth is they love the mission field, right? Um, and then. The remainder of us come from two, two churches, um, that, that had some sexual abuse that was really, you know, mishandled and the trust with the leaders was, was broken in really grievous ways. [00:23:19] Julie: Um, and then there’s me on top of having that, um, living in this space where, I mean, I just report on this all the time. And so, but one of the beautiful things that happened in this, in this group is that it did have leaders when we came into it and it triggered us. Like, you know, and for us it was like, oh, here’s the inside group and the outside group. [00:23:47] Julie: Like, we’re used to the ins and the outs, right? And, and we’re used to the inside group having power and control, and the rest of us just kind of go along with it. And, and we’re, we’re a tiny little group. Like we’re 20 some people, right? But, but it’s just, and, and we’re wonderful people. Wonderful people. [00:24:02] Julie: And yet we still like, it was like, mm. And um, and so. The beautiful thing is that those leaders recognize, like they didn’t fully understand it, but they said, you know, I think we need to just step down and just not have leaders. And I didn’t even realize till we went on this retreat what an act of service and of love that was for them to just say, were laying down any, any agendas we might’ve had, any even mission or vision that we might’ve had. [00:24:35] Julie: And for one of, you know, one of the guys, it was really hard for him cause he’s just like, Mr. Mr. Energy and initiative. And, and he was like, I better not take initiative because like, it’s, it’s not going to be good for these folks. Um, and on the retreat. So then, I mean, it was, it was really a Holy Spirit. [00:24:54] Julie: experience, I think for all of us, because there definitely was a camp that was like, okay, we’ve had this kind of healing time, but can, can we move forward a little bit? Like, can we, can we have some intentionality? And then there were part of us that were just like, oh my word, if we, if we, if we have leaders, why do we need leaders? [00:25:12] Julie: We’re 20 something people. Like we can just decide everything ourselves. And, and there really was somewhat of an impasse, but it’s interesting. The things that you said for me, And it was funny at one point. They’re like, can’t you just trust? And, you know, kind of like, what, what are you guys afraid of? You know? [00:25:29] Julie: And the first thing that came out of my mouth was control control. Like we’re afraid of control, um, or I’m afraid of control. Um, but what was so, so. Huge for me and I think was one of those again, Holy Spirit moments was when, you know, I was trying to like make a point about power dynamics, like you don’t realize power and like we have to be aware of how power is stewarded in a group like this because everybody has power. [00:25:59] Julie: If you don’t realize as a communicator the power that you have, like I’m aware now that because I can, I can form thoughts pretty quickly. That I can have a lot of influence in a group. I’m aware of that. And so, you know, there was even like a part where I was leading and then I was like, I can’t lead this next thing. [00:26:17] Julie: I’ve been leading too much, you know, and then we, and then we gave, we, somebody had a marker and we gave the marker to, to, um, one of the guys in our group who’s fantastic guy. And, um, And at one point, so, so anyway, I was talking about power and, and one of the guys was like, well, I don’t, I don’t really see power. [00:26:35] Julie: I don’t need. And I’m like, you have it, whether you realize it and you have it. And what was huge is that one of the other guys that sort of a leader was a leader was able to say what she’s talking about is real. Everybody has power. This is really important. And he was quite frankly, somebody with a lot of power in that group because he has a lot of trust, used to be a pastor. [00:26:57] Julie: Um, and for him to acknowledge that for the rest of us was huge. And then this, this other guy, I mean, he said at one point, Oh, well, you know, so and so’s holding the marker right now and he has power, doesn’t he? And I was like, yes, you’re getting it. That’s it. That’s it. Thank you. Because he’s like, you just reframed what we said and I wouldn’t have reframed it that way. [00:27:22] Julie: Like I wouldn’t. And I’m like, yes, exactly. It’s like, and it was like, it was like the light bulbs were going on and people were starting to get it. Um, and then another key, key moment was when one of the women who, you know, wasn’t, you know, from our church where we experienced stuff, who said, can you, can you tell me how that, how that felt for you when we used to have leaders? [00:27:46] Julie: And then for people to be able to express that. And people listened and it was like, and I was able to hear from this guy who felt like he was, he had a straight jacket, you know, because he, he like wants to use his, his initiative. Like he, he. You know, and God’s given that to him. It’s a good thing, you know. [00:28:07] Julie: And all I can say is it was just an incredible experience, an incredible moment, but it would not have happened if, and now I’m going to get kind of, it wouldn’t have happened if people cared more about the mission than the people. And they didn’t realize the people are the mission. This is Jesus work. He doesn’t care about your five year plan. [00:28:41] Julie: He doesn’t care about your ego and the big, you know, plans that you have and things you can do. What he cares is whether you’ll lay your life down for the sheep. That’s what shepherds do. And what I saw in, in our group was the willingness to, for people that have shepherding gifts to lay down their, you know, not literally their lives, but in a way their lives, their, their dreams, their hopes or visions, everything to love another and how that created so much love and trust, you know, in our group. [00:29:22] Julie: And we’re still like trying to figure this out, but yeah, it was, it was hugely, it just so, so important. But I thought how many churches are willing to do that, are willing to, to sit in the pain, are willing to listen. And I’m, I’m curious as you go in now, there’s so much of your work has become with ReStory is, is education and going into these churches. [00:29:52] Julie: You know, normally when this happens, And you told me there’s a, there’s a name for pastors that come in. It’s the afterpastor. Afterpastor. [00:30:00] Kayleigh: Yes. The afterpastor. [00:30:02] Julie: How many times does the afterpastor get it? And does he do that? [00:30:07] Kayleigh: So the problem is, and I can tell you, cause I have an MDiv. I went, I did all the seminary. [00:30:11] Kayleigh: I’m ordained. We don’t get trained in that. Um, so, and there is, um, like you said, so you use this guy as an example who has the clear. Initiative gifts. So they’re what would be called kind of the Apostle, um, evangelist gifts in like the pastoral gift assessment kind of deal. You’ve got the Apostle, prophet, evangelist, shepherd, and teacher. [00:30:34] Kayleigh: And right now there’s a lot of weight kind of being thrown behind the Apostle evangelist as kind of the charismatic leader who can set the vision. And so most of the books on pastoral You know, church health and church are written kind of geared and directed that way. Um, so we’re really missing the fact that when we’re talking about a traumatized church, what you really need is a prophet shepherd. [00:30:57] Kayleigh: Um, you need somebody who can come in and shepherd the people and care for them well, but also the prophet. The role of the prophet is often to help people make meaning of their suffering. So if you read closely, Jeremiah and Ezekiel, particularly who are two prophets speaking to people in exile, what they’re really doing is helping people make meaning of that suffering. [00:31:17] Kayleigh: They’re helping people tell their story. They’re, they’re lamenting, they’re crying with them. They’re, they’re asking the hard questions. Um, and they’re able to kind of see between the lines. So prophet, Pastors who have kind of that prophetic gifting are able to see below. They’re able to kind of slow down and hear the actual story beyond the behaviors, right? [00:31:35] Kayleigh: So the behaviors aren’t telling the whole story, but we need eyes to see that. And so the problem, I would say, is that a lot of well, meaning pastors simply aren’t taught how to do this. And so they’re not given the resources. They’re not given kind of the, um. this like Christian imagination to be able to look at a church and say, okay, what has happened here and what healings take place here? [00:31:59] Kayleigh: Um, the other problem is, you know, we need to be able to give space. So denominational leaders need to be able to be okay with a church that maybe isn’t going to grow for a few years. And I think that is whether we like it or not. And we can say all day long that we don’t judge a church’s health by its numbers. [00:32:19] Kayleigh: But at the end of the day, pastors feel this pressure to grow the church, right? To have an attendance that’s growing a budget that’s growing and. And so, and part of it is from a good place, right? We want to reach more people from Jesus, but part of it is just this like cultural pressure that defines success by numbers. [00:32:36] Kayleigh: And so can we be okay with a church that’s not going to grow for a little while? You know, can we be okay with a church that’s going to take some like intentional time to just heal? And so when you have an established church, um, which is a little bit different than a house church model, it can be. A really weird sacrifice, even for the people who are there, because often what you have is you have a segment of the church who is very eager to move forward and move on and and to grow and to move into its new future, and they can get frustrated with the rest of the church. [00:33:15] Kayleigh: That kind of seems to need more time. Um, but trauma healing is it’s not linear. And so, you know, you kind of have to constantly Judith Herman identifies like three components of trauma healing. And so it’s safety and naming and remembering and then reconnecting, but they’re not like you finish safety and then you move to this one and then you move to this one. [00:33:36] Kayleigh: Often you’re kind of going, you’re ebbing and flowing between them, right? Because you can achieve safety and then start to feel like, okay, now I can name it. And then something can trigger you and make you feel unsafe again. And so you’re now you’re back here. And so, um, um, Our churches need to realize that this healing process is going to take time, and collective trauma is complicated because you have individuals who are going to move through it. [00:33:57] Kayleigh: So you’re going to have people who are going to feel really safe, and they’re going to feel ready to name, and others who aren’t. And so you have to be able to mitigate that and navigate that. And our pastors just aren’t simply trained in this. And so what I see happening a lot is I’ll do these trainings and I’ll have somebody come up to me afterwards and go, Oh my goodness, I was an after pastor and I had no idea that was a thing. [00:34:18] Kayleigh: And they’re like, you just gave so much language to my experience. And you know, and now I understand why they seem to be attacking me. They weren’t really attacking me. They just don’t trust the office of the pastor. And I represent the office of the pastor. Okay. And so sometimes they take that personally again, it becomes like these theological issues. [00:34:38] Kayleigh: And so helping pastors understand the collective trauma and being able to really just take the time to ask those important questions and to increase not only their own margin for suffering, but to increase a congregations margin for suffering. You know, to go, it’s going to be, we can sit in this pain. [00:34:58] Kayleigh: It’s going to be uncomfortable, but it’s going to be important, you know, learning how to lament, learning how to mourn. All of these things are things that often we’re just not trained well enough in, um, as pastors. And so therefore our congregations aren’t trained in them either. You know, they don’t have margin for suffering either. [00:35:14] Kayleigh: Um, and so we need to be able to equip our pastors to do that. Um, and then equip the congregations to be able to do that as well. [00:35:20] Julie: So good. And I’m so glad you’re doing that. I will say when I first started this work, um, I was not trauma informed. I didn’t know anything about trauma really. And I didn’t even, you know, I was just a reporter reporting on corruption and then it turned into abuse in the church. [00:35:38] Julie: And I started interfacing with a lot of abuse victims. who were traumatized. And I think back, um, and, and really, I’ve said this before, but survivors have been my greatest teachers by far, like just listening to them and learning from them. But really from day one, you know, it’s loving people, right? It really, it like, if you love and if you empathize, which You know, some people think it’s a sin, um, just cannot, um, but if you do that and, and that’s what, you know, even as I’m thinking about, um, within our own, our own house church, there were people who weren’t trained, but they did instinctively the right things because they loved. [00:36:28] Julie: You know, and it just reminds me, I mean, it really does come down to, they will know you are Christians by your love. You know, how do we know love? Like Christ laid down his life for us. He is our model of love and, and somehow, you know, like you said, the, in the church today we’ve, we’ve exalted the, um, what did you say? [00:36:49] Julie: The apostle evangelist? The apostle evangelist. Yeah. Yes, absolutely. Absolutely. Um, we’ve exalted that person, um, you know, And I think we’ve forgotten how to love. And too many of these pastors don’t know how to love. They just don’t know how to love. And it’s, it’s tragic. Because they’re supposed to be I mean, the old school models, they were shepherds, you know, like you said, like we need apostles, we need evangelists. [00:37:16] Julie: But usually the person who was leading the church per se, the apostles and evangelists would often end up in parachurch organizations. I’m not saying that’s right or wrong. I think the church needs all of those things. Um, and, uh, But yeah, we’ve, we’ve, we’ve left that behind, sadly. And there’s nothing sexy about being a shepherd. [00:37:37] Kayleigh: Yeah, no, I, all, all of the Apostle, I mean that, well, the whole thing is needed, um, and it’s most beautiful when we just work together, and, and when they can respond to each other. So, I mean, me and you’re an example in your house, you’re a visiting example of this. You can’t, even if just listening, you have some clear Apostle evangelists in your group, right? [00:37:54] Kayleigh: I mean, Um, right? And so you have these people wired for that, and yet they’re able to, to learn and respond to some of the people in the group who have more of those prophet shepherd tendencies. And so I think that that’s really what, and that’s loving, right? So we should go back. It’s just loving one another and learning from one another. [00:38:17] Kayleigh: And knowing when to lean into certain giftings and to learn from others giftings. This is why it’s the body of Christ. And so when a component of the body of Christ is left out, we can’t be who God’s called us to be. And so when we neglect the role of the shepherd and neglect the role of the prophet or minimize them, or see them as secondary, then we’re not going to do called us to be. [00:38:44] Kayleigh: You know, we may need all of it to come together to do what God has called us to do. God is working in this church. He’s worked all through this church. He has established it and called it, and He’s going to use it. But we need to be learning how He has built it and how He framed it. For me to love one another and not elevate one gifting above another. [00:39:07] Julie: And it’s interesting too, you mentioned the office of the pastor. Um, I know as we were discussing some of this, we have one guy who’s very, I mean, actually our entire group, and I think this is probably why we’ve been able to navigate some of this. It’s it’s a really spiritually mature group. A lot of people. [00:39:26] Julie: who have been in leadership, um, which sometimes you get a lot of leaders together and it can be, you know, but this hasn’t been that way because I think people really do love the Lord. Um, and they love each other. Um, but one of the things that was brought up, um, is Is the pastor an office or is it a role and have we made it into an office and, and what we realized in the midst of that and I, you know, I, I’m like, well, that’s really interesting. [00:39:57] Julie: I would like to study that. And I find there, there’s a curiosity when you talk compassionate curiosity, I think there’s also a curiosity in, in people who have been through this kind of trauma. There’s a curiosity in, okay, what, what did we do? that we did because everybody said that’s how we’re supposed to do it. [00:40:18] Kayleigh: Yeah. [00:40:18] Julie: Yeah. Do I really have that conviction? Could I really argue it from scripture? Is this even right? And so I find even in our group, there is a, there is a, um, there’s a curiosity and maybe this is because we’re coming through and we’re in, you know, I think a later stage of healing is that now we’re like really curious about what should we be? [00:40:44] Julie: Yes. Yes. What should we be, like, we, we want to dig into what, what is a church, what should it really be, and what, why, how could we be different? Of course, always realizing that you can have the perfect structure and still have disaster. Um, it really does come down to the character of the people and, and that, but, but yeah, there’s a real, Curiosity of, of sort of, um, digging, digging into that. [00:41:10] Julie: And, and let me just, I can ask you, and, and maybe this will be a rabbit trail, maybe we’ll edit it out. I don’t know. Um, , but, but I am curious what do, what do you think of that idea that the, the pastorate may be a role that we’ve made into an office and maybe that could be part of the problem? [00:41:27] Kayleigh: I think that’s a lot of it. [00:41:28] Kayleigh: Um, because when we turn the, the pastorate into an office, we can lose the priesthood of all believers. So that I think is often what happens is that, um, you create this pastoral role where now all of the ministry falls on to the pastor. And so instead of the pastor’s role being to equip the saints for the ministry, which is what scripture says, the scripture describes a pastor as equipping the saints for the ministry. [00:41:56] Kayleigh: Now the pastor is doing the ministry, right? There’s, there’s just all of this pressure on the pastor. And that’s, that’s where I think we start to see this. The shift from the pastor being the one who is, you know, encouraging and equipping and edifying and, you know, calling up everybody to live into their role as the body of Christ where we’ve seen. [00:42:19] Kayleigh: You know, I have a soft spot for pastors. Again, I’m like, they’re all my relatives are them. I love pastors and I know some really beautiful ones who get into ministry because that’s exactly what they want to do. And so what has often happened though, is that the, the ways of our culture have begun to inform how the church operates. [00:42:40] Kayleigh: And so we saw this, you know, when, when the church started to employ business In kind of the church growth movement. So it’s like, okay, well, who knows how to grow things? Business people know how to grow things. Okay. Well, what are they doing? Right. And so now that the pastor is like the CEO, people choose their churches based on the pastor’s sermon, right? [00:43:00] Kayleigh: Well, I like how this pastor preaches. So I’m going to go to that church. Um, so some of it is. So I would say that not all of it is pastors who have like that egotistical thing within them at the beginning. Some of it is that we know that those patterns exist. But some of these men and women are genuinely just love the Lord’s people and then get into these roles where they’re all of a sudden like, wait, I, Why, why is it about me and others, this pressure to preach better sermons and the person down the road or, you know, run the programs and do all of these things instead of equipping the people to do the work of God. [00:43:38] Kayleigh: And so I think it’s, it’s about, and right, I think it’s happened internally in our churches, but I also think there’s this outward societal pressure that has shifted the pastor from this shepherding role to the CEO office. Um, And finding the, like, middle ground, right? So again, like, we can swing the pendulum one way and not have pastors. [00:44:05] Kayleigh: Or we can swing the pendulum the other way and have pastors at the center of everything. But is there a way of finding, kind of, this middle ground where people who are fairly calm and gifted and anointed by God to do rich shepherding can do it in a way that is Zen sitting that church that is equal famous saint that is calling the body of Christ to be what it is called be. [00:44:27] Kayleigh: And I guess I’m, I’m constantly over optimistic and so I’m convinced that there’s gotta be a way , that we can get to a place where pastors can live out of their giftings and live by their callings and live out of their long dreams in such a way. That leads to the flourishing health of the church and not to its destruction. [00:44:45] Julie: Yes. And, and I think if it’s working properly, that absolutely should be there. They should be a gift to the church. Um, and, and sadly we just, we haven’t seen enough of that, but that is, that is, I think the model. Um, let’s talk specifically, and we have talked, or we might not have named it, um, but some of the results of this collective trauma. [00:45:08] Julie: in a congregation. Um, let’s, let’s name some of the things. These are ways that this can, that this can play itself out. [00:45:17] Kayleigh: Sure. So when we’re talking about congregational collective trauma, one of the main results that we’ve talked about kind of in a roundabout way is this lack of trust that can happen within the congregation. [00:45:27] Kayleigh: And this can be twofold. We can talk about the lack of trust for the leadership, but it all also can be lack of trust. Just, In the congregation itself, um, this often happens, particularly if we’re looking at clergy misconduct that maybe wasn’t as widespread. So I think this is some of what you’ve kind of talked about with Willow Creek a little bit, and I’m, I wasn’t in that situation, but I’ve seen it other places where, you know, in our system, the denominational leadership removes a pastor. [00:45:56] Kayleigh: And so what can happen in a system like that is that denominational leadership becomes aware of abuse. They act on the abuse by removing the pastor. And what you have happening is kind of this, um, Betrayal trauma or this, you know, bias against believing. And so because the idea that their clergy person who they have loved and trusted, you know, shepherd them could possibly do something that atrocious. [00:46:24] Kayleigh: That idea is too devastating for them to internalize. So it feels safer to their bodies to deny it. And so what can happen is you can have a fraction of the church. that thinks it’s, you know, all made up and that there’s no truth to it. And they began to blame the denominational leadership as the bad guys or that bad reporter that, you know, the [00:46:45] Julie: gossip monger out there. [00:46:47] Julie: It’s so bad. [00:46:48] Kayleigh: Yeah, exactly. Exactly. So you have this split. Now, sometimes it literally splits and people will leave. Um, but sometimes they don’t and they all stay. And so you have these fractions of people who believe different things about what happened. And so now there’s, there’s a lack of shared identity. [00:47:08] Kayleigh: So I would say one of the key components of collective trauma in a congregation is this mistrust, which is often connected to a lack of shared identity. And so they can’t really figure out who they are together. What does it mean for us to be a community to get there? Um, and so trauma begins to write their story. [00:47:27] Kayleigh: And so when we talk about the embodiment of trauma, one of the ways that that works in individuals, and this is like a mini neuroscience lesson that many of your listeners are probably aware of, because I think you have a very trauma informed audience. Audience, but, um, you know, that it, it makes us react out of those fight, flight, or freeze responses. [00:47:46] Kayleigh: And so that happens individually, right? So something triggers us and all of a sudden we’re at our cortisol is raised. We’re acting out of the, uh, you know, those flight flight places that happens communally too. So a community gets triggered by, you know, a pastor again, having what they think is just a creative idea, you know, but maybe it triggers that time that that pastor. [00:48:09] Kayleigh: Had a creative idea that was, you know, and ran with it without talking to anybody and just like wield the control and manipulated people. And now, all of a sudden, this pastor who thinks they just have this innocent, creative idea is now seen as manipulative. And what are they going to try to do behind our backs? [00:48:27] Kayleigh: And what are they going to try? And, and. What are they going to take from us? Right? And so trauma, trauma takes from people. And so now they’re living kind of out of this perpetual perceived fear, perceived threat, that something else is going to be lost. And so when you have a congregation that’s constantly operating out of, you know, this fight, flight, or freeze response. [00:48:52] Kayleigh: Collectively, I mean, how can we expect them to live out the mission that God has given them? Um, you know, they’re not, they’re not there. They’re not able to, um, they’re not able to relate to one another in a healthy way. And so we, we see a lack of kind of intimate relationships in these congregations, right? [00:49:09] Kayleigh: Because so the Deb Dana, who has helped people really understand the polyvagal theory, when we’re talking about, um, trauma talks about your, your, um, Nervous system, your autonomic nervous system is kind of being like a three rung ladder. And so in this three rung ladder, you have the top rung being your ventral bagel state, which is where you can engage with people in safe and healthy ways. [00:49:32] Kayleigh: And then you move down into kind of your sympathetic nervous system. And this is where you’re in that fight flight freeze and then dorsal bagels at the bottom. And in those two middle and bottom, you can’t build these deep relationships. And again, deep relationships are what make a church a church. And so if you have a congregation that’s stuck in these middle to bottom rungs of this ladder, they’re, they’re fight, flight, freeze, or they’re withdrawing from one another. [00:49:54] Kayleigh: You’re, you’re losing the intimacy, the vulnerability, the safety of these congregations to build those kinds of relationships. And so I would say that, that distrust, that lack of shared identity and that inability to build deeper kind of relationships are three kind of key components of what we’re seeing in congregations who are carrying this collective trauma. [00:50:16] Julie: And yet, if you work through that together, like I will say right now, I feel a great deal of affection for, for everyone. Uh, in our house tours because we went through that chaos together, but also it was, it was an opportunity to see love and people lay down their lives for each other. So to, to be able to see, I mean, you begin writing a new story instead of that old story that’s been so dominant, you know, that you have to tell, you have to work through. [00:50:50] Julie: Yeah, you do. And, and, and you have, you do. I love where you say, you know, people need to, to hear that from you. Yeah. I think that’s really, really important for people to have a safe place. But then at the same time, you can’t, you don’t want to live the rest of your life there. You don’t want that to define, define you. [00:51:09] Julie: Um, and that’s, that’s what’s beautiful though, is if you work through it together, now you, you’ve got a new story, right? You’ve got, you’ve got Dodd doing something beautiful. Um, among you and, and that’s what he does. [00:51:23] Kayleigh: That’s why we call our organization Restory. Um, it is a word used in trauma theory and in reconciliation studies to talk about what communities who have experienced a lot of violence have to do is they have to get to a place where they’re able to, it’s exactly what you’re talking about with your house churches doing is you guys have kind of come to a place where you’re able to ask the question, who do we want to be now? [00:51:45] Kayleigh: And this is this process of restorying. And so what trauma does is in many ways, for a while, it tries to write our stories. And for a while, it kind of has, because of the way that it’s embodied, we kind of, it has to, right? Like we have to process like, okay, I’m reacting to this. trigger because of this trauma that’s happened. [00:52:05] Kayleigh: So how do I work through that? You know, how do I name that? How do I begin to tell that story? And so we, and we have to tell the story, right? Because I mean, trauma theory has been the dialectic of traumas, but Judith Herman talks about is it’s very unspeakable because it’s horrific, but it has to be spoken to be healed. [00:52:22] Kayleigh: Right. And so with this trauma, it can be hard to speak initially. But it needs to be spoken to be healed. But once we’ve done that, once we begin to loosen the control that trauma has on us. Once we’re able to speak it out loud, and then we can get to a place individually and communally where we can start to ask ourselves, Who do we want to be? [00:52:45] Kayleigh: And who has God called us to be? And no, things are not going to be the way they were before the trauma happened. I think that’s the other thing that happens in churches is there’s a lot of misconception. That healing means restoring everything to the way it was before. And when that doesn’t happen, there’s this question of, well, well, did we, did we heal? [00:53:06] Kayleigh: And we have to remember that we’re never going back to the way it was before the trauma happened. But we can begin to imagine what it can look like now. Once we begin to integrate the suffering into our story, and we begin to ask those helpful questions, and we take away the trauma’s control, now we can ask, who do we want to be? [00:53:24] Kayleigh: And we can begin to write a new beautiful story that can be healing for many others. [00:53:29] Julie: A friend of mine who has been through unspeakable trauma, I love when she talks about her husband, because they went through this together, and she often says, he’s like an aged fine wine. You know, and I love that because to me, no, you’re not going back to who you were, but in many ways who you were was a little naive, little starry eyed, a little, you know, and, and once you’ve been through these sorts of things, it is kind of like an aged fine wine. [00:54:01] Julie: You have, you’re, you’re aged, but hopefully in a beautiful way. And, you know, I, I think you’re way more compassionate. Once you’ve gone through this, you’re way more able to see another person who’s traumatized and And to, you know, reach out to that person, to love that person, to care for that person. And so it’s a beautiful restoring. [00:54:26] Julie: And we could talk about this for a very long time. And we will continue this discussion at Restore, [00:54:33] Kayleigh: um, because [00:54:34] Julie: you’re going to be at the conference and that was part of our original discussions. So folks, if you wanna talk more to Kaleigh , come to Restore. I, I’m, I’m gonna fit you in somehow because , I’m gonna be there. [00:54:46] Julie: you’re gonna be there. But do you just have a wealth of, uh, I think research and insights that I think will really, really be powerful? And I’m waiting for you to write your book because it needs to be written. Um, but I’m working on it. , thank you for, for taking the time and for, um, just loving the body. [00:55:07] Julie: And in the way that you have, I appreciate it. [00:55:09] Kayleigh: Well, thank you. Because, you know, when I heard about your work and your tagline, you know, reporting the truth, but restoring the church, you know, I was just so drawn in because that’s what we need. The church is worth it. The church is beautiful and she is worth taking the time to restore. [00:55:24] Kayleigh: And I’m so thankful for the work that you’re doing to make sure that that that happens. [00:55:28] Julie: Thank you. Well, thanks so much for listening to the Roy’s Report, a podcast dedicated to reporting the truth and restoring the church. I’m Julie Roys. And if you’ve appreciated this podcast and our investigative journalism, would you please consider donating to the Roy’s report to support our ongoing work? [00:55:47] Julie: As I’ve often said, we don’t have advertisers or many large donors. We mainly have you. The people who care about our mission of reporting the truth and restoring the church. So if you’d like to help us out, just go to Julie Roy’s spelled R O Y S dot com slash donate. That’s Julie Roy’s dot com slash donate. [00:56:07] Julie: Also just a quick reminder to subscribe to the Roy’s report on Apple podcasts, Spotify or YouTube. That way you won’t miss any of these episodes. And while you’re at it, I’d really appreciate it if you’d help us spread the word about the podcast by leaving a review. And then please share the podcast on social media so more people can hear about this great content. [00:56:29] Julie: Again, thanks so much for joining me today. Hope you are blessed and encouraged. Read more

Happy National Midwifery Week!We are so thankful for and in awe of all midwives do. Great midwives can literally make all the difference. Statistical evidence shows that they can help you have both better birth experiences and outcomes.Meagan and Julie break down the different types of midwives including CNMs, CPM, DEMs, and LPM as well as the settings in which you can find them. They talk about the pros and cons of choosing midwifery care within a hospital or outside of a hospital either at home or in a birth center. We encourage you to interview all types of providers in all types of settings. You may be surprised where your intuition leads you and where you feel is the safest place for you to rock your birth!Midwifery-led Care in Low- and Middle-Income CountriesEvidence-Based Birth Article: The Evidence on MidwivesArticle: Planning a VBAC with Midwifery Care in AustraliaThe VBAC Link Supportive Provider ListNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, hey, hey. You guys, we're talking about midwives today, and when I say we, I mean me and Julie. I have Julie on with us today. Hello, my darling. Julie: Hello! You know, sometimes you've just got to unmute yourself. Meagan: Her headphones were muted, you guys. Julie: Yeah. That's amazing. Meagan: I'm like, “I can't hear you.” You guys, guess what? This is our first month at The VBAC Link where I'm bringing a special subject. Every month we are going to have a week and it's usually going to be the second week of the month where we are going to have a specific topic for those episodes of the week and this is the very first one. It is National Midwives' Week so I thought it would be really fun this week to talk about midwives. We love midwives. We love them. We love them and we are so grateful for them. We want to talk more about the impact that they leave when it comes to our overall experience. Julie: Yes. Meagan: The overall outcomes and honestly, just how flipping amazing they are. We want to talk more and then we'll share of course a story with a midwifery birth. Okay, Julie. You have a review. I'm sticking it to her today to read the review because sometimes I feel like it's nice to switch it up. Julie: Yeah. Let's switch it up. All right, this review– I'm assuming “VBAC Encouragement” is the title of the review.” Meagan: Yes. Julie: “VBAC Encouragement”. It says, “My first birth ended in an emergency Cesarean at 29 weeks and I knew as I was being rolled into the OR that I would go for a VBAC with my next baby. Not long after, The VBAC Link started and I was instantly obsessed.” I love to hear that. “I love the wide range of VBAC and CBAC stories. Listening to the women share honestly and openly was motivating and encouraging. As a doula, this podcast is something that I recommend to my VBAC clients. I'm so thankful for the brave women sharing the good, bad, and ugly of their stories and I'm thankful for Meagan and Julie for holding space for us all.” Aww, I love that. Meagan: I do too. I love the title, “VBAC Encouragement.” That is what this podcast is here for– to encourage you along the way no matter what you choose but to bring that encouragement, that empowerment, and the information from women all over the world literally. All over the world because you guys, we are not alone. I know that sometimes we can feel alone. I feel like sometimes VBAC journeys can feel isolating and it sucks. We don't want you to feel that way so that's why we started the podcast. That's why I'm here. That's why Julie comes on because she misses you and loves you all so much too and we want you to feel that encouragement. Meagan: Okay, you guys. We are talking about midwives. If you have never been cared for by a midwife, I think this is a really great episode to learn more about that and see if midwifery care is something that may apply to you or be something that is desired by you. I know that when I was going along with my VBAC journey, I didn't interview a midwife actually at first. I interviewed OB after OB after OB. Julie did interview a midwife and it didn't go over very well. Julie: No, it was fine. It just didn't feel right at that time. Meagan: What she said didn't make it feel right. What I want to talk about too and the reason why I point that out is because go check out the midwives in your area. Check them out. Go check them out. Really, interview them. Meet with them but guess what? It's okay if it doesn't feel right. It's okay if everyone is like, “Go, go, go. You have to have a midwife. OB no. OB no.” That's not how we are in this podcast. We are like, “Find the right provider for you.” But I do think that midwives are amazing and I do think they bring a different feel and different experience to a birth but even then sometimes you can go and interview a midwife and they're not the right fit. We're going to talk about the types of midwives. This isn't really a type. We're going to be talking about CPM, DEM, and LPM. Julie: In-hospital and out-of-hospital midwives, yeah. Meagan: Yeah, but I also want to talk about the word “medwives”. We have said this in the past where we say, “Oh, that midwife is a ‘medwife'” and what we mean by that is just that they may be more medically-minded. Every midwife is different and every view is different. Like Julie was saying, in-hospital, out-of-hospital, you may have more of a ‘medwife' out of the hospital, but guess what? I've also seen some out-of-hospital midwives who act more like, ‘medwives', really truly. Again, it goes back to finding the right person for you. But can we talk about that? The CPM or DEM? CPM is a certified professional midwife or direct entry midwife, right? Am I correct?Julie: Right. It's really interesting because all over the world, the requirements for midwifery are different. You're going to find different requirements in each country than in the United States, every state has its different requirements and laws surrounding midwifery care. In some states, out-of-hospital midwives cannot attend VBAC at all or they can as long as it's in a birth center. Or sometimes CNM– is a certified nurse midwife which is the credential that you have to have if you are going to work in a hospital but there are some CNMs who do out-of-hospital births as well. There is CPM which is a certified professional midwife which a lot of the midwives are out-of-hospital. That means they have taken the NARM exam which is the national association of registered midwives so they are registered with a national association.Meagan: Northern American Registry of Midwives. Julie: Oh yes. They have completed hundreds of births, lots and lots of hours, gone through the entire certification process and that's a certified midwife. Now, a licensed midwife which is a LDEM, a licensed direct-entry midwife just simply means that they hold licensure with the state. Licencsed midwife and certified midwife is different. Certified means they are certified with the board. Licensed means they are licensed with the state and usually licensed midwives can carry things like Pitocin, Methergine, antibiotics for GBS and things like that which is what the difference is. Licensed means they can have access to these different drugs for care. Meagan: Like Pitocin, and certain things through the IV, medications for hemorrhage, antibiotics, yes. Julie: Right, then CPMs who are certified, yeah. There are arguments for both. And DEM, direct entry midwife means that they are not certified or licensed. That doesn't mean that they are less than, it just means that they are not bound by the rules of NARM or the state. Now, there are again arguments for and against all of these different types. I mean, there are pros and cons to holding certification, holding licensure, and not holding certification and not holding licensure. Each midwife has to decide which route is best for them. Certified nurse-midwife obviously has access to all of the drugs and all of the things. They are certified and licensed. You could call it that but they have to have hospital privileges if they want to deliver in the hospital. You can't just be a CNM and show up to any hospital to deliver with them. They have to have privileges at that hospital. They have to work and be associated with a hospital just like an OB. An OB has to have privileges at any hospital. They can't just walk into any old hospital and deliver a baby. Meagan: Right. I think it's important to know the differences between the providers who you are looking at. Like she was saying, with a CNM, you are more likely to have that type of midwife in a hospital setting than you would be outside of the hospital but sometimes there are still CNMs who have privileges and choose to do birth outside of the hospital. I think it's an important thing to one, know the different types of midwives and two, know what's important to you. There are a lot of people who are like, “I will not birth with anyone else but a CNM.” That's okay. That's okay but you have to find what works best for you. Julie: Sorry, can I add in? Meagan: You're fine. Yeah. Julie: It's also important that you are familiar with the laws in your state if you are going out of the hospital. I don't want this episode to turn into a home birth episode. It should be about all of the midwives in all of the locations, but also, know what the laws are in your state and in your specific area about midwives. In Utah, we are really lucky because we have access to all the types of midwives in all the different locations, but not everywhere is like that. Yeah. Just a little plug-in for that. Meagan: Yes. I agree. I agree. I did mention that I didn't really go for midwifery care when I was looking for my VBAC– Lyla, my second. I don't even know why other than in my mind, this is going to sound so bad but in my mind, I was told that midwives are undereducated. Julie: Less qualified? Meagan: Less qualified to support VBAC. I was told this by many people out in the world and I just believed it. Again, I have grown a lot over the years. It's been so great and I'm glad that I have. That's just where I was.Julie: A lot of people think that though. People don't know. They just don't know. Meagan: No, they don't know so I wanted to boom. Did you hear it? I'm smashing it. Julie: Snipping it. Meagan: That is a myth that is going to be smashed. Midwives are fully capable of supporting you during your VBAC journey. We are going to start going over some stats and things about how midwives really actually do impact VBAC in a positive way but you may even run into and at least I know there are some places here in Utah where providers kind of oversee the midwifery groups in these hospitals and a lot of them will say that midwives are unable to support VBAC. That's another thing that you need to make sure you are asking if you are going in the hospital when you are birthing with midwives because a lot of times you are being seen with your midwife, you're treated by your midwife and everything is great. You've got this relationship with these midwives and then you go into labor and all of a sudden you have an OB overseeing your care because that midwife can oversee your pregnancy but not your birth. Know that that is a thing so make sure that if you are birthing in a hospital with a midwife that you ask, “Will I be birthing with the midwives or am I going to be seen by an OB?” But also know, like I said, you can be seen in a hospital by a midwife. Okay, let's talk about some evidence and what midwives bring to the table and maybe some differences that midwives bring to the table because I do think that in a lot of ways, it is scary to think, Okay. If I have to have a C-section, if I do not have this VBAC and I have to go to a C-section and I have to be treated by an OB– because midwives do not perform Cesareans. They do assist. Let me just say, a lot of midwives come in and they assist a Cesarean, but they do not perform the main Cesarean, that can be intimidating because you want your same provider but I don't know if that's necessarily needed all of the time. Maybe to someone that is. But just know that yes, they cannot perform a Cesarean but they often can assist. That's another good question to ask your midwife, especially in the hospital. If I go to a Cesarean, who will perform it and will you be there no matter what?Okay, let's talk about it. Let's talk about the evidence. Let's talk about experiences and how they can differ. Julie: Do you know what is so funny? I want to go back and touch on the beginning where you said you didn't know and you thought that midwives were less qualified and honestly especially in-hospital, in-hospital midwives– I want everyone to turn their ears on right now– have the exact same training and skills to deliver a baby vaginally as an OB does. The difference between a midwife and an OB in a hospital is a midwife cannot do surgery. I just want to say that very concisely. They are just as qualified. They can even do forceps deliveries. They can do an episiotomy if an episiotomy is necessary. They can do vacuum assist. Well, some hospitals have policies where they will or will not allow a midwife to do forceps or a vacuum but they can administer all different types of medications. They can literally do everything. They can do everything except for the surgery in the hospital.Out of the hospital, I would argue that they still have similar training depending on if they are licensed or not. They may or may not be carrying medications like Pitocin, Methergine, antibiotics, IV fluids, and things like that. But out-of-hospital midwives, many of them, at least the licensed ones, carry those things and can provide the same level of care. The only difference between– not the only difference, a big difference between out-of-hospital midwives and in-hospital midwives is they don't have immediate access to the OR and an OB. But guess what? In states like Utah and many, many states operate similarly, there are very strict and efficient transfer protocols in place so that when a midwife decides you need to transfer, say you are birthing at home, first of all, a midwife is going to be with you a big chunk of the time. They are going to be with you. They're going to be noticing things. They're going to be seeing things. They're not going to be there for just the last 10 minutes of deliveries like these OBs are. They are going to be in your house. I feel like out-of-hospital midwives are more present with you than in-hospital midwives even. They're going to notice things. They're going to see things. They're going to notice trends a lot of the time before a situation becomes emergent if you need to be transferred. There are those random last-second emergencies and there are protocols for how to handle those too, but the majority of the time when there is a transfer needed, you are going to be received at the hospital. The hospital is already going to have your records. They're already going to know what you're coming in for and they're going to be able to seamlessly take over your care, no matter what that looks like there. Now there are rare emergencies when you might need care within seconds. However, those are incredibly rare and that is one of the risks. Those are some of the risks that you need to consider when you think about out-of-hospital versus in-hospital care. But often, I have seen many instances where things have safely gotten transferred to a hospital before they reach the level of needing that severe emergent care. I think that is the biggest thing people don't understand. I don't know how many people I've talked to as a doula and as a birth photographer where they don't want to birth at home because they don't understand the level of care that is provided by out-of-hospital midwives. I'm thinking of a birth I just went to last summer and she was thinking about home birth but the husband was like– this was 36 weeks so they weren't comfortable transferring or anything like that, but I was like, “These home birth midwives are trained in emergencies. They know how to handle all of the same obstetric emergencies in the exact same ways that they do in the hospital. They know how to handle them and address them. If a transfer is necessary, they are going to transfer you. They carry medication. They have stethoscopes and fetal monitors and everything that they do in the hospital to care for you.” The dad was like, “Oh, I didn't know that.” It's not your mom coming to help you deliver your baby. It's a trained, qualified medical professional. I don't know. I saw this quote. Never mind. I'm not circling back. I'm going in a completely different direction. I saw this quote or a little meme thing on Facebook the other day. I was going to send it to you but I didn't. It said something like, “Once your provider and birth location is chosen and locked in place, choice is mostly an illusion.” Meagan: Wow. Mostly an illusion. Julie: Yes. Like the fact that you have a choice in your care is mostly an illusion. I was thinking about that and I was like, Is it really? I've seen some clients really advocate hard, and stuff like that. But I have also seen the majority of clients where providers, nurses, and birth locations have a heavy sway and you can be convinced that things are absolutely necessary and needed by the way that you are approached and if you are approached a different way, then you might make a different choice, right? The power of the provider and the birth location is so big and massive that choice, the fact that you have a choice involved, is mostly an illusion. I was sitting with that because I see it. I've said it before and I'll say it a million more times before I die probably that birth photographers and doulas have the most well-rounded view of birth. Period. Because we see birth in home, in birth centers, in hospitals, in all of the hospitals, in all of the homes, in all the birth centers, with all of the different providers. We can tell you what hospital– I mean, there are nurses at one hospital that will swear up, down, and sideways that this is the way to do things and the next hospital 3 miles down the road is going to do things completely different and their nurses are going to swear by a different way to do things because of the environment that they are in. Meagan: Yeah. 100%.Julie: So if you want to know in your area what hospitals are the best for the type of birth that you want, talk to a birth photographer. Talk to a doula because they are going to be the ones with the most well-rounded view. Period. Meagan: Yeah. We definitely see a lot, you guys. We really do. Remember, if you are looking for a doula, check out thevbaclink.com/findadoula. Search for a doula in your area. You guys, these doulas are amazing and they are VBAC-certified. Julie: What were we going to circle back to? You were saying something. Meagan: Well, there's an article titled, “Effectiveness of Midwifery-led Care on Pregnancy Outcomes in Low and Middle-Income Countries” which is interesting because a lot of the time, when we are in low and middle-income countries, the support is not good. Anyway, they went through and it said that “10 studies were eligible for inclusion in the systemic review of which 5 studies were eligible for inclusion in the meta-analysis. Women receiving–”Julie: I love meta-analyses. They are my favorite. Yeah. Sorry, go ahead. Go on. Meagan: I know you do. It says, “Women receiving midwifery-led care had a significantly lower rate of postpartum hemorrhage and reduced rate of birth–” How do you say this, Julie? It's like asphyxia? Julie: Asphyxia? Meagan: Uh-huh. I've just never known how to say that. It says, “The meta-analysis further showed a significantly reduced risk in emergency Cesarean section. Within the conclusion, it did show that midwifery-led care had a significantly positive impact on improving various maternal and neonatal outcomes in low and middle-income countries. We therefore advise widespread implementation of midwifery-led care in low and middle-income countries.” Let's beef this up in low and middle-income countries. But what does it mean if you are not in a low and middle-income country? Julie: Well, I see the same and similar studies showing that in the United States and all of these other bigger countries that are larger and more educated. It's interesting because– sorry. I have a thought. I'm just trying to put it together. Meagan: That is okay. Julie: Midwifery-led care is probably more accessible and maybe accessible isn't the right word. It's more common probably in lower-income countries. I'm thinking third-world countries and second-world countries because it's expensive to go to a hospital. It's expensive to have an OB. In some countries like Brazil, the C-section rate is very, very high and it's a sign of wealth and status because you can go to this private hospital with these luxury birth suites and stay like a VIP, get your C-section, save your vagina– I use air quotes– “save your vagina” by going to this affluent hospital. Right? Meagan: Yes. Julie: I think in lower-income countries, it's going to be not only an easier thing to do but kind of the only thing to do, maybe the only choice. And here, it's funny because here, out-of-hospital births– first of all, insurance is stupid. In the United States, insurances are so stupid. It's a huge money-making organization, the medical system is. Insurance does cover a big chunk of hospital births and they don't cover out-of-hospital births so a lot of the time, an out-of-hospital birth is kind of the opposite. You have to have a little bit of money in order to pay for an out-of-hospital midwife because your insurance isn't likely going to cover it. More insurances are coming on board with that but it will be a little bit of time before we see that shift. But there are similar outcomes in the United States and in wealthier countries that midwifery-led care, not just out of the hospital, but in-hospital midwifery-led care has lower rates of Cesarean, lower rates of complication, lower rates of induction, lower rates of mortality and morbidity than obstetric-led care. You are going to a surgeon. You are going to a trained surgeon to have a natural, non-complicated delivery. Meagan: It's interesting because going back to the low income, in our minds, we think that the care is not that great. But then we look at it and it's like, the care is doing pretty good over there in these lower-income, third-world countries. Yeah. This is actually in Evidence-Based Birth. It says, “In the United States, there are typically 4 million births each year.” 4 million. You guys, that's a lot. The majority of these births are attended by physicians which are only 9% attended by certified nurse midwives and less than 1% are attended by CPMs, so certified professional midwives or traditional midwives. You guys, that is insane. That is so low. She says in this podcast of hers which we are going to make sure to link because I think it's a really great one, “If you only look at vaginal births, midwives do attend a higher portion of vaginal births in the United States, but still it's only about 14%.”Julie: Yeah. If you have a normal– I use normal very loosely– uncomplicated pregnancy, there is absolutely no reason that you cannot see a midwife either out of the hospital or in the hospital. Now, I would encourage you to go and interview some midwives in your local hospitals. I would encourage you to look into the local birth community and see what people recommend because even if you are going in a hospital and have a midwife, you have the same access to the OR and an OB that can take care of you in case of an emergency. A lot of people are like, “Well, I'd just rather see an OB just in case of an emergency so that way I know who is doing my C-section,” I promise you that the OB doing your C-section, you are only going to see for an hour. They probably are not going to talk to you. It doesn't matter how personable they are or what their bedside manner is or if you know anything because I promise you, when you are on the operating room table, you're not going to be worried about who's doing your surgery. You're just not. I'm sorry. That's maybe a harsh thing to say, but it's going to be the farthest thing from your mind. Plus, in the hospital, your midwife is more than likely going to be assisting with the surgery too so you are going to have a familiar face in the operating room if that happens. I also think everybody knows by now that I am not on board with doing something just in case when it comes to medical care. Just in case things can cause a lot more problems that they are trying to prevent. So yeah. Anyway, that's my two cents. Meagan: Yeah. You know, I really think that when it comes to midwives, there is even more than just reducing things like interventions and Cesareans and inductions which of course, lead to interventions and things like that. I feel like overall, people leave their birth experience having that better view on the birth because of things like that where midwives are with you more and they seem to be allowed more time even with insurance. You guys, insurance, like she said, sucks. It just sucks. It limits our providers. I want to just point that out that a lot of these OBs, I think that they would spend more time with us. I think they want to spend more time with us in a lot of ways, but they can't because insurance pulls them down and makes it so they can't. But these midwives are able to spend so much more time with us in many ways. Okay. Let's see. What else do we want to talk about here? We talked about interventions. Midwives will typically allow parents to go past that 40-week mark. We talked about the ARRIVE trial here in the past where they started inducing first-time moms at 39 weeks and unfortunately, it's stuck in a lot of ways so providers are inducing at 39 weeks and that means we are starting to do things like stripping membranes at 37 and 38 weeks. It seems like providers really, really– and when I say providers, like OB/GYNs, they are really wanting babies to be born for sure by 40 weeks but by 40 weeks, they are really pushing it. Midwives to tend to allow the parents to go past that 40-week mark. That's just something else I've noticed with clients who choose VBAC and then end up choosing midwives. They'll often end up choosing midwives because of that reason and they will feel so much better when they reach that point in pregnancy because they don't feel that crazy pressure to strip their membranes and go into labor or they are going to be facing a Cesarean and things like that. I feel like that's another really big way to change the feeling of your care with midwives is understanding when it comes down to the end of things, they are going to be a little bit more lenient and understanding and not press as hard. Like we said in the beginning, there are a lot of people who do press it– those “medwives” where they are like, “No, you need to have a baby.” We just recorded a story where the midwife was like, “Well, you need to see the OB and you need to do a membrane sweep,” and they were suggesting these things. But really, typically with midwives, you are going to see less pressure in the end of pregnancy. Midwives spend more time in prenatal visits. We were just talking about that. Insurance can limit OBs, but a lot of the time, they will really spend more time with you. They are going to spend 20+ minutes and if you are out of the hospital, sometimes they will spend a whole hour with you going over things. Where are you mentally? Where are you physically? What are you wanting? Going over desires and the plan for the birth. Past experiences may be creeping in because we know that past experiences can creep in along the way. So yeah. Okay, Julie is in her car, you guys. She's rocking it with her cute sunglasses. She is on her way. She is so nice to have the last half hour of her free time spent with us. So Julie, do you have any insight or any extra words on what I was just saying? Julie: You know, I do. Hopefully, you can hear me okay. I'm going to hit a dead spot in two seconds. Meagan: I can hear you great. Julie: Okay, perfect. I have this little– there's a spot on my road where I always cut out so stop me if I need to repeat what I said. I wanted to go back to the beginning and just talk for half a second because we know my first ended in a C-section. For my first birth, I actually started out by looking at birth centers because I wanted an out-of-hospital birth. I knew that from the beginning. I interviewed a couple of midwives and there was one group that I was going to go with at a birth center and I was ready to go but something didn't quite feel right. It wasn't anything the midwives did. It wasn't anything that the birth center was. It wasn't that I didn't feel safe there. It was just that something didn't feel right. So I just stayed with my OB/GYN. I had to get on Clomid to get pregnant. I just stayed with that guy who is the same guy that Meagan had and the same guy who did my C-section because something didn't feel right. I mean, we know now and I can look back in hindsight. This was, gosh, 11.5 years ago. I know that I ended up having preeclampsia and I ended up having to get induced because of it. Had I started out-of-hospital, I would have had to transfer. There was nothing– I would have had to transfer care before I even got to 37 weeks. I had a 36-week induction. That's the thing though. Out-of-hospital midwives have protocols. Each state has different guidelines, but there are requirements for when they have to transfer care– if your blood pressure is high, if you have preeclampsia signs, if you deliver before a certain due date, or after a certain gestational age. You're going to be safe. If you have complications in pregnancy, you're going to be safe. You're going to be transferred. You're going to be cared for. But also, I just want to put emphasis on this which is what I'm tying into the last thing I want to say which is going to be forever long, is that you can trust your intuition. My intuition was telling me that the birth center was not the right place for me even though it checked all of the boxes. Your intuition is not going to tell the future every time, but what I wanted to lead into is that– oh and do you know what is so funny also? I had three out-of-hospital births after that, but with my fourth birth, I started out with the same midwife I had for the other two home births, and for some reason, I felt like I needed to transfer care back to the hospital so I went back to the hospital for two months and all of a sudden, my insurance change and the biggest network of hospitals in my state wasn't covered by my insurance anymore so it felt right to go back to out-of-hospital birth. I don't know why I had to do that whole loop-dee-loop of transferring to a hospital just to transfer back to the same out-of-hospital midwife that I had in the first place but I believe there was a purpose to that. I believe there was a purpose to that. I want to tell you guys that if seeking midwifery care whether in the hospital or out of the hospital feels uncomfortable to you or feels like, I don't know. These midwives still sound like chicken-dancing hippies to me, I would encourage you to go talk to some local midwives whether in a hospital or out of the hospital. Just sit down and talk to them and say, “Hey.” It's easier to talk to an out-of-hospital midwife. Out-of-hospital midwives do free consultations for you. In-hospital midwives, you might have to make an appointment and it might be harder but you should still try and see and get a vibe or just transfer care to them and go to a few appointments and see. You can always switch care back to a different provider or an OB because your intuition is smart but it does not know, it cannot guide you about things that you do not know anything about. I would encourage you to go and chat with these different providers, even different OBs if you want because your provider choice is so, so, so important. It is one of the most important decisions you're going to make in your care for your birth. It should be a good one. Your intuition can't tell you to go see x, y, z provider if you don't even know who x, y, z provider is. Gather as much information as you can. Talk to as many providers as you can. Go see the midwife. Interview the doula. Check out the birth photographer's website. See what I did there? See how it feels because even as a birth photographer, whenever I'm doing interviews with people, I'm not a fly-on-the-wall birth photographer. A lot of birth photographers brag about being a fly on the wall. You won't even know I'm there. No. I don't buy that because who is in your birth space is important. I am a member of your birth team just like every other person in that space, just like your nurses, your OB, your midwife, your doula– everybody there is a member of your birth team. I am a member of your birth team too and I will hold space for you. I will support you and I will love you. I am not a fly on the wall. Now, your provider is a member of your birth team. They probably arguably are one of the biggest influencers about how your birth is going to go and you deserve to be well-informed about who they are. You deserve to have multiple options that you know about and have thoroughly vetted and you deserve to stick up for yourself and do the provider who is more in line with the type of birth you want. How do you do that? You do that by finding out more about the providers who are available to you in all of the different birth locations and settings. Meagan: Yes. So I want to talk more about that too because there are studies and papers out there showing that the attitude or the view on VBAC in that area, in that hospital, in that birth center, both midwives and OBs, but we are talking about midwives here, really impacts the way that a birth can go. So if you don't interview and you don't research and you don't find those connections and even try, you will not know and in the end, it may not be the way you want. Even then, even if we find those perfect midwives, even if Julie went to the hospital midwife, she probably would have had a great experience, but who knows?Julie: Also, arguable too though, you could be seeing the most highly recommended VBAC provider in your area in the most VBAC-supportive hospital in your area that everybody goes to and everybody raves about, and if you don't feel comfortable there for whatever reason, you don't have to see the best, most VBAC-supportive provider if it doesn't feel right and if it doesn't sit right with you. Meagan: Yes. Julie: It goes both ways. Meagan: Yes. Julie: Sorry, I'm really passionate about this clearly. Meagan: No, because it does. It goes both ways. I mean, that's what this podcast is about is conversation and story sharing and finding what's best for you because even with VBAC, VBAC might not be the right option for you, but you don't know unless you learn. You don't know unless you learn more about midwives. Really though, people usually come out of midwifery care having a better experience and a more positive experience. I think that goes along with the lines of they do give a little bit more care. They do seem to be able to dive deeper to them as an individual and what they are wanting and their desires. They are a little less medically minded and a little bit more open-minded. You are less likely to have interventions. You are less likely to have those things that cause trauma and that causes the cascade that leads to the Cesarean. I'm going to have all of the links but I'm just going to read this highlighted. It's a study from Europe actually. It says, “A recent qualitative study in Europe explored the maternity culture in high and low VBAC countries and found that–” I'm talking a lot about high and low countries. Sorry guys, I'm realizing I'm talking a lot about it but a lot of these studies differ. It says, “Clinicians in the high VBAC countries had a positive and pro-VBAC attitude which encouraged women to choose VBAC whereas the countries with low VBAC rate, clinicians held both pro and anti-VBAC views which negatively affected women who were seeking VBAC. Both of these studies have shown that having midwifery care can have a positive influence on VBAC rates with an increase in maternal and neonatal morbidity.”Right there, not only doing the research on your provider, but doing the research within your location, what their thoughts are, what their views are, what their high-VBAC attitude or low-VBAC attitude is. If they are coming at you, even these midwives you guys, and they have all of these stipulations, it might be a red flag. It might not be the right midwifery group for you. Julie: Absolutely. That's where the intuition comes in. I like what you said about the VBAC culture. You can tell at different hospitals. We have been to many, many hospitals in our area. Sorry, can you hear my blinkers? It's distracting. Let's see. I absolutely guarantee you that every hospital has a culture around VBAC. Some of them are positive and supportive and uplifting and some of them are fearful and fear-based and operate on a fact where they are going to be more likely to pull you toward a repeat C-section or other interventions. I encourage you to look into the culture of your hospital but not only hospitals too. I realize it's not just hospital-specific. It's also out-of-hospital midwives. They all have their culture around VBAC. Your out-of-hospital midwives and your in-hospital midwives, all of the midwives, your group whether you see a solo practice or a group OB practice or you see a group midwifery practice or whatever, there is a culture surrounding VBAC. You need to do yourself a favor and figure out what that culture is. I got to my appointment and I need to head in so I'm going to say goodbye really fast. I'm going to leave Meagan alone to wrap up the episode, but yes. My parting words are honoring your intuition, talk as much to your VBAC provider as you can and find out what the culture is surrounding that no matter who you choose to go with and also, do not automatically write off midwives. You are doing yourself a huge disservice if you are not considering a midwife for your care. It doesn't mean you have to go with one, but I feel like everybody should at least look into them. I love you guys! Bye!Meagan: Okay. And wrapping up you guys, I am just going to echo her. I think that completely discrediting midwives without even interviewing them at all is something that is a disservice to ourselves. I'm going to tell you that I did that. I did that. I didn't even consider it. I interviewed 12 providers, 12 providers which is crazy and I didn't interview one midwife. Not one. I was interviewing OBs and MFMs and I realize I don't remember interviewing a single midwife. The only thing I can think of is that I let the outside world lead me to believe that midwives were less qualified. Yale has an article and they say, “First-time mothers giving birth at medical centers where midwives were on their care team were 75% less likely to have their labor induced.” 74% less likely to have their labor induced, 74% less likely to receive Pitocin augmentation, and 12% less likely to deliver by Cesarean which is a big deal. I know most of us listening here are not first-time moms. We've had a Cesarean. Maybe we've had one, two, three, or maybe four, but the stats on midwives are there. It is there and it's something to not ignore so if you have not yet checked out midwives in your area, I highly encourage you to do so. Like Julie said, you don't even have to go with anybody, but at least interviewing them to know and feel the difference of care that you may be able to have is a big deal. I highly encourage you. I love you all. I'm so grateful for midwives. I'm so grateful for my midwife. My VBAC baby was with a midwife and I did have an OB. I was one of those who had an OB backup who could care for me and see me if I needed to. That for me made me feel more comfortable but it's also something that can get confusing. I think we've talked about where sometimes you will do dual care and you will have one person telling you one thing and the other provider telling you the other thing. That can get stressful and confusing so maybe stick with your provider. But do what's best for you. Again, another message. Don't just completely wipe out the idea of a midwife if you have midwives in your area as an option. It may be something that will just blow your mind. Thank you all so much for listening and hey, if you have a midwife who you suggest or you've gone through a VBAC with, we have our VBAC-supportive provider list and we would love for you to add to it. Go check out in the show notes or you can go over to our Instagram and click in our Linktree and we have got our provider list there for you. Or if you are looking for that midwife to interview, go check them out. We definitely love adding to this list and love referring it for everybody looking for a VBAC-supportive provider. 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

Women of Strength, how many of you have “failure to progress” on your operative report as the reason for your Cesarean(s)? Meagan and Julie talk ALL about failure to progress today– how it led to their own Cesareans and how after breaking it down, they both realized that neither of them actually qualified for that label. When is it failure to progress and when is it failure to wait? What does failure to progress actually mean? This is an episode you will want to listen to over and over again. From learning all of the ways a cervix changes other than just dilation to all of the possible positions you can try during a lull in labor, Meagan and Julie share invaluable current research and personal experiences on this hot topic! ACOG Article: Limiting Interventions During Labor and BirthAJOG Article: Safe Prevention of a Primary Cesarean DeliveryThe Journal of Perinatal Education: Preventing a Primary CesareanOBG Project ArticleThe VBAC Link Blog: Failure to ProgressHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello. I am with Julie today and we are going to be talking about failure to progress. If you have been diagnosed with failure to progress– and I say diagnosed because they actually put them on our op reports like it's a diagnosis of failure of progress meaning our cervix does not know what to do. It cannot make it to 10 centimeters or it hasn't or it will not in the future, then I am telling you right now that this is definitely a great episode for you. Even if you haven't been told, it's going to be a great episode because we are going to talk about some other great things in the end about what to do in labor position-wise and all of the things. So we're going to get going, but Julie apparently has a Review of the Week. We weren't going to do one, but she says she has a Review of the Week. So, Julie? I will turn the time over to you. Julie: This is my review. Are you ready? Meagan: I'm actually really curious. Julie: “I'm so excited. Thank you so much, Meagan and Julie. I love The VBAC Link!” Signed, lots of people everywhere. Meagan: I love it. Julie: We don't have a Review of the Week so I just made one up. Boom. There. Signed, AnonymousMeagan: All right, you guys. Failure to progress: what it is and what it isn't. Let's talk about what it is. What does it mean? Essentially, it means that your provider believes that your cervix did not progress in an adequate amount of time and there's also failure to progress as in your body may have gone into or you are going in for an induction and then they couldn't even get labor going which we all know is usually not the case that your body really couldn't do it, but failure to progress is when your cervix does not continually dilate in an adequate amount of time. Would you change anything about that, Julie, or add anything to that? Julie: Sorry, I didn't hear half of that. I was just going through it. I was going through the things just to make sure that we are 100% accurate on what we are about to say. Whatever you said, yeah. That sounds great. Yeah. Let's go with it. Meagan: Failure to progress– the cervix is not dilating in an adequate amount of time. Julie: Basically, yeah. Your cervix isn't changing so you've got to do a C-section because it's not working basically. Meagan: Okay, so what it isn't– do you want to talk about what it isn't? Julie: What it isn't? It isn't– sorry, I'm trying to say it. Meagan: It isn't true most of the time. Julie: Most of the time it's not true. It isn't what we think it is and if it is, it's not a sign that your body is broken. It's not exclusion. It's not a reason to exclude you from trying for a VBAC. It's not your fault. It usually is a failure from the system where people are in a rush or in a hurry and just not knowing how to move past a stall in labor or not understanding the true flow of how some labors take. I mean, I was diagnosed with failure to progress. You were diagnosed with failure to progress and I know that both of our literal clinical outlook at the time we were diagnosed with failure to progress was not true failure to progress. Meagan: Mhmm. Julie: According to what the actual guidelines and requirements are. So I always say, yeah. What you said, it is not true. Meagan: It is not true.Julie: We joke about that and use it loosely. Sometimes it is true. I've seen one true failure to progress diagnosis in over 100 births, but I feel like most of us listening and most of us who have C-sections have them because of failure to progress. Now, mine when I was in labor, I was not told failure to progress. I was told fetal heart tones, but that's another topic for another episode– what we are told versus what is in our op reports. So yeah, let's do a little plug-in about getting your op report. Find out what is actually in the notes that say why your C-section was called because it's not uncommon for what it was written down to be different than what you were told in the moment. I feel like having an accurate clinical understanding of what your Cesarean looks like on paper to another doctor who is reviewing your birth is super important. Meagan: Absolutely. I agree and also, I think that it's important to note that if you have been told this and you have doubt in your body, that it is normal to have doubt because we have been told that we can't do something and that our body can't dilate, but I also want to plug-in that really try not to believe that. Try your hardest. Do whatever you can to not believe that. It's going to help you. Believe the opposite. Believe that your body can do it. Believe that you were most likely set up in a less-ideal circumstance that created that result, right? Like an induction– it was a failure to descend, not progress, but I just recorded a story the other day where her water was broken at 6 centimeters, baby came down wonky. They couldn't get baby out and they diagnosed her with CPD. There are these things that are happening a lot of the time where we are walking in to be induced way too early or really any time we are being induced could be too early especially if it's just an elective. It can definitely be too early and our body is not ready so our body is not responding or our body is overwhelmed because it's been given so much so fast and it doesn't know what to do so it doesn't react the way a provider wants it to by our cervix dilating. It almost is reacting in the reverse way where it's tense and tight and like, No. I'm not ready and I'm not letting this baby out. Don't you feel like you've seen that? Julie: Yeah. We've seen lots of things. I feel like that's the tricky thing. We as doulas and birth photographers really do get to see the whole gamut of everything from home to birth center to hospital and everything. I feel like we have such a unique perspective on how labor is managed in and out of hospitals and how stalls or lulls in labor are managed in both places. Let me tell you, it's often way smoother and in my opinion way better outcomes when you are out of the hospital and that happens. Meagan: Mhmm. Labor at home as long as you can. Yeah. I mean, one of the stories that I just recorded was an accidental home birth. It was not her plan, not even close, and it will for sure come across that way when she is telling the story, but there were so many things that she did within that labor like movement from the shower to the toilet to walking down the stairs to moving back to the toilet. There was all of this movement that sometimes doesn't happen in a hospital or we've got, like I said, “Let's break your water. Let's do these things.” We've got these interventions that may help, but doesn't always. It may also cause problems. Okay, so we have some updates for you on the safe prevention of a primary Cesarean delivery that Julie has found and then we also want to talk about what is adequate labor too? What does that mean and where do we decide or where does a provider decide if labor is not adequate? Julie, do you want to talk about this for a minute on what you found from the OB/GYN Project? Julie: That's just a really nice summary. I really like it because it is all laid out really nicely. I am seeking out different pieces of information because there is updated information so I'm just looking for that. I'm not quite 100% certain I can speak to when it came out. Evidence-Based Birth has some great information. They did a podcast episode on the Friedman's curve. We know that dilating 1 centimeter an hour is based on the study that Friedman did. That's incredibly flawed but there is new updated, more evidence-based information that has come out. I'm trying to find out when it came out actually because the Friedman curve was established I think in 1956 and let's see. In the 2010's there were big shifts in the evidence. In 2014, ACOG had a study. Maternal Fetal Medicine published new guidelines on labor progress. Okay, so 2014 it looks like which is actually not that new anymore because it's 10 years later. That was, I think– I don't think it's actually shifted that much at all. I'm just trying to figure that out right now. I'm sorry. Let's see. The Practice Bulletin– yeah. You go. Safe Prevention of the Primary Cesarean Delivery. Meagan: I think we are looking at approaches to limit interventions during labor and birth, but we know that a lot of the time when we are introducing interventions, that is where we often will receive a failure to progress diagnosis because we are really introducing things, like I said earlier, when the body is not quite ready or the baby is not quite ready. Maybe the baby was already too high and was trying to make their way around and into the pelvis but now we've got an asynclitic baby or a transverse baby or an OP baby.This one, Number 766 which we will have in today's show notes actually originally replaced the committee of 687 in February 2017. The 766 was in 2019 and reaffirmed in 2021. Something that I like that it goes through is recommendations for women who are at term and spontaneous labor it happening. It talks about admission upon labor. It talks about premature rupture of membrane or rupturing of membranes which I think is a big one. Really, through my own experience but also doula experience, I've seen so many people go through membrane rupturing whether artificially or spontaneously and then nothing is happening so we go in and we get induced. Or we are told the second our water breaks that we have to go in, then labor has not started yet so we are intervening. One of the things it says is, “When membranes rupture at term before the onset of labor, approximately 77-79% of women will go into labor spontaneously within 12 hours. 95% will start labor within 24-28 hours.” I just had this experience with a VBAC client just the other day. Her water broke and within about 9 hours, she was starting to contract and within less than that, she actually progressed really quickly. Baby was born. That was really great but then there are situations like myself where it takes forever for labor to even start. It took 18 hours for my very first contraction with my second baby to even start and then by 24-28 hours, I was in a repeat C-section because my body didn't progress fast enough according to my provider.It says that, “The median time to delivery for women managed expectantly is 33 hours and 95% had delivered by 94-107 hours after rupture of membranes.” I think that is something also really important to note that if your water breaks, it doesn't mean we're just having a baby right away. It doesn't mean that our body is failing because we haven't started labor. 94-107 hours after the rupture of membranes is when the baby had been born. That's some time. We need to allow for the time. Julie: That's why I hate it when hospitals say, “If your water breaks, come in right now.” No. Meagan: I know. My provider did that too because it makes sense in our heads. They're saying, “Oh, just come in because we have to monitor baby because of infection and all of this stuff.” But we also have to take a step back and realize that once we go into that environment, one, that's a new environment. We're not familiar with that. All of those germs in that environment, we're not accustomed to. We're not immune to them. And then two, we know that the second we go into labor and delivery units, what happens? They want to check our cervix which means–Julie: Bacteria. Meagan: There is bacteria that is possibly being exposed to the vaginal canal, right? Even if it's a sterile glove, that still raises chances. Julie: Yeah, sterile gloves really are not as sterile as people think. Meagan: There are these things to keep in mind, but it's so hard because for me, I had premature rupture of membranes. My body didn't start labor, but I was told failure to progress after 12 hours for only reaching 3 centimeters. I was told failure to progress. I just really liked that. I mean, I like a whole bunch of this but I really liked that part of the rupture of membranes because I think so often we are told, “Oh, your water is broken. You're not progressing. You are a failure to progress.” Or we are not progressing so we have to break our water to try and speed our labor up and then that doesn't happen and then we are failure to progress. Can you see the problem here? Julie: Total problem. Meagan: It's a problem. Julie: It is a problem. So many problems. It's fine. I just dropped two different links to the updated guidelines because it's really funny. I've been going down the rabbit hole now while you've been talking so if I'm repeating things like I tend to do on you sometimes, please forgive me. I just think it's interesting. There is starting to be a shift in pulling away from Friedman's curve and going into a different way to consider an actual progression of labor which is a really cool, nice little shifty-shift here. I feel like maybe let's talk about what failure to progress really is. What are the guidelines for it? What is real failure to progress versus what you've probably been told about it? First of all, let's just talk about– nothing. Meagan: Can we use my own birth example just as a starting point to what this evidence is showing us or what the guidelines are? My water had broken spontaneously. It took a little bit to start labor. Within 12 hours, I was 3 centimeters and was told that my pelvis was too small and that I was failure to progress. Water broken, I was 3 centimeters 12 hours into labor. all right, Julie. What am I? Am I real, true failure to progress or not? Julie: No, you're not. Absolutely not, are you kidding me? Because you were still in the first stage of labor. That is the number one thing. According to clinical guidelines, it is not failure to progress until you're in the second stage of labor which is at least 6 centimeters dilated. So guess what, friends? If you got called failure to progress before you were 6 centimeters dilated– mine was labeled failure to progress at 4 centimeters so that rules me out. I mean, there are lots of things that rule me out and Meagan. But if you are less than 6 centimeters, it is not failure to progress. Meagan: Yeah, it even says right here. “Active phase arrest is defined as a woman at or beyond 6 centimeters dilation with ruptured of membranes who fails to progress despite 4 hours of adequate uterine activity or at least 6 hours of oxytocin administration with an adequate uterine activity and no cervical change.” Can we talk about that too? Adequate uterine activity. You guys, at 3 centimeters with my water broken, I was still not in an active pattern to progress. It takes time. Our uterus doesn't just start contracting regularly and adequately. It takes time. Then at that, I was only on oxytocin for 2 hours. Julie: Pitocin. You were on Pitocin. Meagan: Sorry. That's what I meant. Pitocin. I'm looking at the word oxytocin administration. Pitocin. Julie: We all know the truth. Meagan: We all know that Pitocin is not oxytocin. Julie: That is a soapbox for another day. Meagan: I was only on Pitocin for 2 hours. 2 hours. At the top, it says, “Slow but progressive labor in the first stage of labor should not be an indication for a Cesarean. With a few exceptions, prolonged late phase greater than 20 hours in a first-time mother and greater than 14 hours in a multi (so a mom who is not a first-time mom) should not be an indication for Cesarean as long. As the mother and the baby are doing well, cervical dilation of 6 centimeters should be the threshold of an active phase of labor.”Julie: Exactly. That's it too. Later on after this, we're going to talk about all the different ways a cervix can change because can I just tell you what? Someone says, “I'm 5 centimeters. I'm still 5 centimeters, great. Cool. What else has your cervix been doing? We're going to talk about that in just a second.” But yes, that's the thing. It's not failure to progress before 6 centimeters. It has to be 4 hours of adequate uterine activity which means strong, consistent contractions. Contractions that are strong enough. We could talk about the Montevideo units which is another measurement of the strength of contractions. We're not going to talk about that because we just don't have time, but are your uterine contractions strong enough? Yes? Then it's got to be at least 4 hours without cervical change. No? Then great. Let's do Pitocin and the inadequate amount of uterine activity. It says 6 hours or more of Pitocin without adequate uterine activity. If you've been on Pitocin for 6 hours and your contractions– which has caused that adequate contractions– and there is still no cervical change, then you are failure to progress Let's talk about cervical change though because the cervix goes through so many things. When I was doula-ing, I talked about this a lot in our second prenatal visit about how a lot of times you'll be like, Oh, cervical change. Yeah, dilation. Am I 4, 5, 6, 7, 8? But listen. The cervix goes through changes in 6 different ways. It moves forward so from posterior pointing backward toward to your spine. It straightens out to a more downward position. It softens so it goes from hard like your forehead to hard like your nose to softer like your chin. It softens. It effaces which means it thins out so it starts thick. It thins out which is effacement. It dilates obviously which is the opening and then baby's station like where baby is in the pelvis. Baby drops down, rotates, and descends. If you were 3 centimeters at your last cervical check and 60% effaced and 2 hours later at your next cervical check, you are 3 centimeters and 80% effaced, your cervix has thinned by 20% which is a good amount of cervical change. Meagan: Good change, yeah. Julie: If you were 6 centimeters and your baby was at a -2 station and at your next cervical check, you are 6 centimeters and your baby is -1 station which means your baby is lower in the pelvis, that is a cervical change. All of these things are shifting so I feel like it's important that when we are talking about failure to progress or when we are talking about labor progress that we consider all of the things the cervix does.I was just at a birth yesterday– not yesterday, two days ago. I don't know. It was all night and it was long for me. All night is long. It doesn't matter if i was there for 6 hours or 20 hours. If it was all night, I'm going to call it long as I'm getting older. The client was still 4-5 centimeters but the cervix was a lot softer or stretchier I think at the one before this. Oh yeah, your cervix is super stretchy now. Those are all great cervical changes even though the dilation number hasn't changed. Meagan: Yeah, so coming forward, thinning out, really softening up, baby dropping– all of these things are signs of progression and so it's something to keep in mind if a provider is like, “Well, you've been sitting at 6.5 centimeters now for 9 hours,” or whatever, but at the same time, your cervix went from 40% to 80% thinned and it went from super posterior to more mid-line and baby went from -3 to a 0. These are changes. These are absolutely changes and there are so many things that go into that. If a baby is high and not well-applied because they are trying to work their way down to the pelvis and our cervix is working on coming forward, there is so much that goes into that where now we're going to have a baby. If that change was made, now maybe we can have a baby that was well-applied to the cervix creating good pressure. Uterine activity is getting stronger. Things are progressing in the right way.So in the ACOG thing, it does say that in contrast to the prior suggested threshold of 4 centimeters which we know is very outdated, the onset of active labor–Julie: Right, that was according to the Friedman's curve. Friedman's curve called active labor at 4 centimeters but now we are getting all of this new information that yeah, it's probably at 6. I feel like when you and me started as doulas 9-10 years ago, it was 4 centimeters, but a couple years after that, everything started shifting into 6. So it's actually not that new, but kind of new. Sorry, keep going. Meagan: Yeah. I want to get into our positions really quickly, but it does say even in here, the onset of labor for many women may not occur until 5-6 centimeters. May not occur until then and then we know that sometimes around 6 centimeters, it takes some time. We're going to make sure all of these links here are in the show notes so you can check it out. Meagan: But we only have a few minutes left so I really want to talk about positions, okay? So positions in my opinion can truly change failure to progress. Julie: Yes. If there is a lull in labor, they're getting close to calling a C-section, what can we do about that? Nobody wants to hang out at 4 centimeters forever. Nobody does so what can we do about that? Yes, Meagan? Sorry, go ahead. Meagan: Movement. If you do not have an epidural, obviously movement is a lot more free. Moving around, just walking. Just flat-out walking. If we've got a higher baby and we're trying to get a baby down, really think about that femur rotation turning out. You can walk and sometimes I've had my clients do this little step dance thing where you step really wide and out and then left and right and left and right. We are doing this weird-looking dance thing, but you're grooving. Julie: You're grooving. Meagan: That can really help. Or thinking about really big asymmetrical movements so put your leg up on the bed or on a stool or on a whatever and leaning over. Bigger movements and outward movements. If you have an epidural at this point, same thing. Rotate on your side and really open those knees up really, really wide. Try to keep those movements consistent. If you're exhausted and you have an epidural because you need sleep, I really, really believe in sleep and I think it's very powerful. Find a good position. Sleep in that position and when you wake up, get going. Get active. But every 5 or so contractions, if you can, if not, make it 8, make some changes. It doesn't have to be too dramatic. It sounds weird, but if you are at home, crawling up your stairs. Crawling up your stairs on your hands and knees is weird but it works or standing up and down going from the side– one side going down, standing back up, turning and walking back up, turning around, doing the other side down and coming back up. Those things are going to help. Doing big figure 8's or hip dips. As the baby gets lower, all of those things are really still important. We are going to be less focused on big open wide because now we're going to want to get baby in and then down. So if you think about a pelvis, when the femur rotation goes out, the bottom goes in. Femur rotation in, bottom goes out. Thinking about these movements as you're laboring and as you're working through these things, as you're in these positions. Think about our hips, our pelvis, and even doing some cat-cows in labor is really good. We know there is the flying cowgirl. That is a really good one in labor too to get baby down and in. Julie: Walcher's. Meagan: Walcher's is not as fun, but it can be very good. Julie: It is magical. I've seen it push labor through so well. I had a doctor once at the U come in. I had a client who was 5 centimeters. Baby wasn't looking too great. She had been 5 centimeters for a while and we were doing Walcher's. They came in because the heart rate– Walcher's sometimes makes it hard to get a fetal heart rate so the nurses come in. They were talking about C-section and they were prepping, bringing in all of the C-section stuff for her partner to get ready. They were like, “You can't do this. Baby's heart rate is not tolerating it.” I'm like, “No. It's just not picking up the heart rate.” I'm like, “Okay, just one more contraction.” One more contraction later, she comes up and starts pushing 2 minutes later and her baby is born. the doctors are freaking out because, “Oh my gosh, the bed's not designed to labor like this.” Not everyone, sorry, but those are a little couple of pushbacks I've gotten sometimes. Meagan: It's weird-looking. It's funky. It's uncomfortable. Julie: Yeah. It's curious and some staff at hospitals do not– if they see something new and they don't know about it, they automatically assume it's not good because they need to keep everything in line and to the protocol and all of those things. But yeah, it's just really a magical thing. Meagan: There's also the abdominal lift. You can abdominal lift. I think actively moving through the contraction which can get really hard in that active phase, but through the contraction can actually help. Hands and knees, sacrum, and all of those things. Holy cow, there are so many positions. Julie: Yeah, can I just touch back? When you said about the epidural, I love when you're not resting, I think sometimes it's easy to get discouraged if you want an epidural but you also want to move during labor. I want to expound on that a little bit because you can move with an epidural still and here's how you do it. My favorite labor position with an epidural is sitting up in the throne. You lay the head of the bed all the way up, drop the feet down, then you crisscross your legs. Put the peanut ball under your right leg. Five contractions later, peanut ball under your left leg. Five contractions later, criss-cross your legs again or stretch them out straight and then repeat. Do you know what? There are so many magical ways that that helps. It keeps your pelvis moving and shifting and growing. I swear that is the most magical position for laboring with an epidural because you are upright. Baby is going to move down. The pelvis is moving and shifting so it creates lots of movement and space and I have seen that progress labors relatively quickly to how they have been going before we set up the throne so many times. I love that. I will swear. I will die on that hill. If you are failure to progress and things aren't moving, sit up, drop your legs, get the peanut ball. It doesn't even have to be the peanut ball. Maybe you don't have one in your hospital but stack a couple of pillows but put one leg up. Put your foot flat on the bed so your knee is making a triangle. I don't know how to describe it the right way and then drop it and put the other leg up and then criss-cross your legs then stick them out straight like two little sticks. Meagan: Every five. Every five, have subtle changes. Every five, subtle changes. Keep that in mind when you are laboring. Women of Strength, know that failure to progress is rarely truly failure to progress. We get it. We've been told the same thing. We see it all of the time as doulas. There's more. There's more and don't feel like you have to say, “Okay” to a Cesarean if your cervix hasn't dilated to a certain amount that the provider is wanting. Assuming you and baby are doing well, you can always ask for more time. Okay, we are on a soapbox. We could probably continue for a whole while longer, but Julie, thank you for joining me today and talking about failure to progress and what it is and what it isn't. Julie: You're welcome. 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

This episode goes back to the basics and is a great place to start on your VBAC journey! Julie joins Meagan today as they talk about many common questions beginning with reasons why providers tell women they can't go for a VBAC. Topics today include: Nuchal cordsBig babiesSmall pelvisesArrest of descentThird-trimester ultrasounds Cervical dilationInductionDue datesThe ARRIVE TrialWhy there is so much contradicting VBAC infoPregnancy intervals EpiduralsMeagan and Julie also reflect on how their perspective toward each of these topics have changed over the years. Allowing for nuance is so necessary when approaching birth. Know that you always have options and never feel pressured to make a decision that doesn't feel right for you.The VBAC Link Blog: Pregnancy IntervalsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:24 Review of the Week07:48 Intro to the basics09:53 Nuchal cords13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasounds17:08 How will this change my care?18:47 Cervical dilation25:54 Due dates28:18 Vulnerability and the ARRIVE trial30:44 Inducing a VBAC36:15 Julie's social media story38:29 Contradicting information41:36 Pregnancy intervals46:38 Epidurals54:13 Allowing for nuanceMeagan: What's up, everybody? This is Meagan. We have Ms. Julie with us today and we are going to be talking to you about what we need you to know about VBAC. We obviously like to talk about different topics but Julie and I decided this morning as we were getting ready to record that we need to do an episode on just the basics again. Don't you feel like it's the basics? It's not to shame anyone for not knowing the information. It's honestly to– I don't even want to say the word shame– but providers are not educating their patients. They are just not. We see it time and time and time again where people just don't know. We saw a post, I don't know, maybe a month or so ago. I think maybe Julie sent it to me. It was just saying, “Hey, so can you have a VBAC no matter what reason the C-section was for?” Someone said, “Well, it depends because if it's something like a cord wrapped around the baby's neck, if that was the reason you had your previous C-section and if your last baby had its cord wrapped around their neck and was having struggle, yes. You have you have a C-section.” Julie: I am getting a little salty. I feel like maybe salty is not the right word, but direct. I jumped in and I'm like, “That's actually not true. The cord wrapped around a baby's neck preventing them from descending is a perfect VBAC candidate because it's not anything to do with the pelvis or labor stalling or anything like that.” Anyways. Meagan: Even with that said, even with that said– Julie: People still argued with me. Meagan: Well, but even if it was due to someone being told that their pelvis was too small or their baby didn't descend– Julie: That's also false. Meagan: That's also false. Julie: I mean with actual pelvis trauma where it's actual CPD and is legitimately diagnosed and that type of thing. Honestly, most people are good candidates for VBAC but we are going to talk about that. Meagan: Yeah, we're going to talk about that today because it's obviously something that we are really passionate about and it's something that we want you guys to know so let's talk about it. 04:24 Review of the WeekMeagan: We do have a Review of the Week. You guys, it's a really long one and I might have specifically been waiting for Julie to come on with me so she can read it because she's a lot better at reading long reviews sometimes. I'm just going to pass the time over to Julie to read this amazing review. Julie: Now I feel pressure, man. Meagan: Don't mess up. Julie: The pressure's on. Are you ready for this? This review says, “This is such a tremendous resource for VBAC mamas.” See? There I go. I knew it. I'm going to start BBAC mamas. Try and translate that, Paige. Anyway, okay. It's fine. I'm going to circle back around. “This is such a tremendous resource for VBAC mamas. I sadly only discovered your podcast after my VBAC in April 2022 but having caught the birth bug during my prep for that birth, I still listened to each episode as if I'm preparing for my VBAC all over again. I think having a special place for this very unique scenario helps those planning and hoping for a successful VBAC feel less alone, more supported, and very well-informed. “The balance of evidence-based information with the age-old practice of sharing birth stories makes this one of the best birth resources out there. I only wish I had this when I was planning my VBAC but maybe someday I'll get to share my own story and help inspire a fellow Woman of Strength. “Prepping for and achieving the unmedicated birth of my daughter absolutely flipped a switch in me and I feel determined to become a birth worker one day.” I feel like all of us go through that, right? “Knowing that this podcast team also has a course for prospective doulas like me thrills me to my core. I want to be there for other anxious, hopeful VBAC mamas like me and the amazing work that you are doing is changing birth and lives everywhere. Keep it up. It is so needed and appreciated. Adrianne.” I love that so much. I feel like that's all of us like you and me. We all go through this journey like, Hey, I had a really bad birth experience or I had a really bad one and then an empowering one and I want to be part of this change so that other people don't have to suffer like I did. I love that and I feel like almost all birth workers' stories start like that. I know mine did and yours too, Meagan. We all are there at some point. Meagan: We are. Yeah. I couldn't agree more. I definitely have been there. 07:48 Intro to the basicsMeagan: Okay, all right. Let's talk about the basics. What basic do you want to talk about first? We were talking about just a second ago where we were like, Hey, this was being told to you and you are being told you may not get to have a VBAC. So maybe we just start with reasons people are told that they have to have a C-section and they can't have a VBAC. Julie: My gosh. I want to speak to a couple of different points in that direction. I have a couple of different ideas in my head. First of all, I feel like it's important to acknowledge that we are all ignorant to things at some point. Right? We all have to learn that VBAC is an option at some point or maybe we always knew. For me, I feel like I never was like, Oh, I can have a vaginal birth? I just always thought I could have one, but I also feel like the age-old “once a C-section, always a C-section” thing is so ingrained in some parts of our culture that you really do have to have that awakening that, Oh, I can do this. It is safe.So I just want to acknowledge that. Sometimes, even for me, I'm scrolling through Facebook and I see this post about something or the ARRIVE trial with induction at 39 weeks is safer and it's really easy to eye roll or it's really easy to be like, Oh my gosh, how come you don't know this? But I feel like let's circle back when I see these things and remember that we all start somewhere. Not all of us have access to supportive providers, supportive hospital systems, supportive families, supportive providers. We don't all have access to those things. If you're advanced in your VBAC thoughts or thinking or whatever, I encourage you to still stay on the episode because you never know when you're going to learn something new. You never know when something is going to click right for you and you never know when you're going to gain the perspective that you need. If you are a seasoned VBAC pro, please also stick along with us. 09:53 Nuchal cordsJulie: I feel like I hear a new reason why someone is told they can't have a vaginal birth every day. Not every day, that's a little dramatic. Meagan: But a lot. Julie: It still surprises me. I've been a doula in the birth scene for 9 years now and I still get that cord prolapse one. I have never heard that as a reason why someone would have a repeat C-section. I mean, I had a VBAC client. She was trying for a VBAC at home and it ended up in a hospital transfer. The baby's cord was wrapped around her neck four times. They had to cut the cord in four places to get the baby out via C-section. Meagan: I remember you saying that. Julie: Yeah, that baby was stuck so tightly in there. In those circumstances, that C-section was necessary. That baby was not coming out, but that doesn't mean she can't try for another VBAC. I think she is done having kids, but that is completely circumstantial and specific to that pregnancy. So I feel like that's a really important thing to note is that most things are circumstantial. Even stalled labor or arrest of dilation or failure to progress or a big baby or whatever these things are circumstantial. The cord around the neck preventing baby from coming down– totally circumstantial. I feel like even the American Pregnancy Association– did I say that right?-- says that 90% of women who have had C-sections are good candidates for VBAC. I think that's important to note is that if you're being told that you are not a good candidate for a VBAC, I would really question why because most of the time, you are a good candidate. Big baby, sure. That's one. We can throw these around. People say, “Oh, your baby is too big. You have to have a C-section.” That is not evidence-based. Even ACOG says that big babies are not a reason for either induction or automatic C-sections. Meagan: Suspected big babies. julie; Right, suspected big babies. Meagan: Let's just say that they're not always big. Julie: They are not always big and we know this is something we automatically know like, everybody knows this but not everybody does. Your ultrasound measurements can be off by 1-2 pounds in either direction. They can measure small or big. The only accurate way to determine how big your baby is is to weigh it after it is born. Meagan: To birth your baby. Right, to birth your baby. Julie: Not only that, but big babies come through petite pelvises all the time. Babies' heads mold and squish through pelvises that flex and open and move to work together. The baby and the pelvis are this really cool diad where they have this great relationship of working together and the pelvis opens and the baby's head smooshes together. Anyway, I feel like that's probably the biggest thing that I'm hearing lately, “My baby's too big and my provider won't let me.” Or there was a post in the community today that Meagan shared with me and she said, “Is it really possible to have a VBAC after a C-section? Because I feel like you always have to have C-sections. Is it really possible to have a vaginal birth after a C-section?” We need to remember that we live in a country and in a world where many people still have this way of thought. Many people don't question their options and many people, most people go in and just automatically schedule a C-section because that's what their provider says, that's what's most convenient, and they don't take the initiative to learn and ask questions. 13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasoundsJulie: it's a failure in the system. We were just talking about this before. Meagan, go ahead. Meagan: Yeah, I was just going to circle back around with the size thing. What I'm seeing more is people doubting their ability because we have people saying, “Well, your baby is this size,” but the reason why they are even saying that is because I'm seeing an increase in third-trimester ultrasounds. Julie: Yes. Third-trimester ultrasounds are trouble. Meagan: They are trouble. Julie: Just routine to check on baby's size and check fluids– no. Just say no to third-trimester ultrasounds unless there is a valid concern for baby. Meagan: Yeah. Yeah. It is getting me. It is getting me that I'm seeing it so often. It's just getting me irked a little bit. Julie: Gosh, Meagan, I swear though. The reason you are getting irked is because we have seen these things go south so many times. Guess what happens? They go in for a third-trimester ultrasound and there are no published statistics for this. I don't know. I haven't looked. But I feel like people go in and they get their third-trimester ultrasound and then they are like, “Well, my baby is measuring big,” and then they start to get worried like, “I don't know if I can have a big baby,” because their provider is like, “Oh, your provider is measuring big.” Their provider is saying it like that. It casts doubt. It casts that doubt in their mind and that little seed of doubt gets planted. That little seed of doubt gets nourished like, “We will let you try for a VBAC but your baby is kind of big so we will just have to see how it goes,” and then these parents get set up for wanting to have an earlier induction for big baby because they don't want their baby to get too big or just scheduling a repeat Cesarean because they are terrified of a bigger baby and the problems that a big baby could have which are not actually that many. The risk of shoulder dystocia I feel like doesn't increase significantly more with big babies. We just think it does. Smaller babies get shoulder dystocia just like bigger babies do. Or, “Oh, my fluids are too big or too little,” and those ultrasound measurements are just so inaccurate first of all, but most of what they find isn't evidence-based either. You're walking into a situation where your provider will cast doubt on you whether intentionally or not. I don't want to villainize providers because most providers I don't think have ill intentions. They are just doing what they know and doing what they are comfortable with. But that happens nonetheless. So if your provider is recommending a third-trimester ultrasound, here is something that I encourage people. Ask them, first of all, why. If they will be like, “Oh, just to check on baby and check the size.” I feel like you can politely decline unless you want to. It's fun to see your baby and things like that, but what would change? This is what you can ask your provider. “What will change in my plan of care based on what we find in the ultrasound?” What will change? What direction would shift? What answers are we looking for? What will change in my care based on what we find in the ultrasound? If your provider says, “Well, we just want to make sure that your baby is not too big,” that's a red flag. Right? Meagan: Yes. Julie: “We want to make sure your waters are okay,” which could be a legitimate reason. If you are measuring more than 10 weeks ahead or behind, it's probably a good idea to get your fluids checked by ultrasound but if you are only measuring 3 or 4 weeks ahead or behind, that's not necessarily an evidence-based reason to do that. I would just ask that. I mean, that's a good question to ask for any type of intervention or checks or whatever.17:08 How will this change my care?Julie: “You want a cervical check at 36 weeks? Okay. What would change in my care? What are we looking for? What would change in my care plan if this happens and if that happens?” because most of the time, cervical checks before labor– actually cervical checks during labor too– don't tell us anything. They don't tell us anything. I just missed a birth a month ago or about three weeks ago because a first-time mom went from 3 centimeters– she was at 3 centimeters for 12 hours and went from 3 centimeters to baby in less than an hour and a half. Cervical checks tell us nothing. Anyway, before I get off on a little more of a soapbox there. Sorry, I've been rambling. Meagan: You're just fine. I absolutely love that you pointed that out and that you specifically said that it can really apply to anything in your care. What does this thing do or how does it change my care? I just think everybody should take that nugget from this episode right now and just hold onto it tightly. Put it right in your pocket and keep that because you nailed it right there. How does this change my care? If you're getting things like she said, yeah. That's dumb. It's silly. Or with a cervical exam, it's like, “Oh, we just want to see what your BISHOP score is. We just wanted to see if you're progressing.” Why? At 36 weeks? First of all, that's preterm. Second of all, to actually be, especially if we never made it to 10 centimeters before in our first labor, the chances of us being very dilated at 36 weeks–18:47 Cervical dilationMeagan: Okay. This is going to lead me to the next thing that we see all of the time. The chances of you being dilated at 36 weeks is pretty low actually. This is something else I see that breaks my heart actually in our community and not even just in our community, in other communities, and honestly even in consults I've had people talk about this. “Oh, I'm 37 weeks or 38 weeks and I'm not dilated so my doctor is telling me that it's probably not going to happen.” Do you see this all the time, Julie? “Oh, guys. I'm so sad because I'm 38 weeks and my provider is telling me that I'm not dilated so I probably need to schedule a C-section the next week.” Women of Strength, if you are not dilated at 36, 37, 38, 39 or even 40, even 41 weeks honestly, that's okay. Your body will do it. Some bodies don't do it until they are in labor. They just don't. Julie: Yeah, and honestly at 36 or 37 weeks, anytime before labor starts and you're not dilated, guess what? Your cervix is doing exactly what it's supposed to do which is keeping your baby safe and keeping your baby in until it's ready to come out. I can't reiterate that enough. You're not supposed to be dilated before it's time for the baby to come out. I say supposed because some bodies shift and change a little bit sooner and that's okay. But whenever I was a doula, I mean I don't get to talk to people prenatally as much anymore since I'm just doing birth photography, but I would always say, “You know what? If you want a cervical check, that is totally fine. You get to decide. You get to make the choice about whether you get a cervical check or not.” But if having a cervical check, if you go in and you have a cervical check and you know that if you're not dilated at all that it is going to make you depressed and frustrated, then don't do it. If you go in and you're like, “Hey, I'm prepared to be low, hard, and closed and I just want the information because I love information,” and you are not going to be sad if you hear that you are low, hard, and closed, then sure. Get one if you want. But just know that anything beyond being low, hard, and closed is just– Meagan: Lucky, great, awesome. Julie: Lucky, sure, great and awesome, but it's also not an indicator because guess what? I've also had a client, a first-time mom, walk around at 4 centimeters dilated for 10 days and then she went into labor and had a 24-hour labor at home and ended up in a hospital transfer and a C-section. I swear. Your cervix is not telling you anything before labor and during labor most of the time, it's not telling you anything. It's telling you that you have progressed this far. It's doesn't tell you how anything is going to go in the future. It doesn't tell you how anything is going to look moving forward. It just doesn't. Meagan: Yeah. So if you are having someone tell you, “You're not dilated” or “Oh, it's probably not going to happen. You should probably schedule a C-section–”Julie: Just say, “Julie Francom said–” Meagan: If you want that, do that. But if it's not what you want, don't let someone bully you into believing that your body is not working when it's actually doing exactly what it's supposed to be doing. Julie: Exactly. that's the thing too. Sometimes at the end of pregnancy, it is hard. Being pregnant is hard. Being close to your due date is hard. Everybody is asking you, “Have you had your baby yet? What are you going to do? What are your plans for induction?” We've all been there and it is really, really hard to stay strong. I feel like some people could just benefit by just saying no. Just saying no because it's so easy if your baby is measuring big or if you feel like your cervix is hard and closed. Be like, “Aw, flip man. I'm going to be pregnant forever and my baby is going to be big and it's going to have a hard time coming out so I might as well schedule a C-section.” If you feel like you could be easily swayed by those things which a lot of people are. It's so easy to be swayed by those things, especially at the end of pregnancy. Then maybe just say no. Obviously there is nuance here so if there is a true medical need and there is some medical concern for baby or if there is some worry for your cervix being in preterm labor or things like that, obviously those are valid reasons but if it's a just because, I'm not a big fan of doing medical things just because. Meagan: Just because I agree. Yeah. Exactly. If there's no real reason, then just because doesn't. Unless you want it. Unless that's really what you want. 25:54 Due datesMeagan: Okay, so we talked about babies. We talked about dilation before due dates and can we also talk about due dates? Julie: Ew. Meagan: Ew. Julie: Yeah, just kidding. That was weird. I don't know why I said that. I'm a weirdo sometimes. Meagan: Well, due dates are hard. Due dates are a really hard topic because especially after the ARRIVE trial which Julie Francom herself wrote the blog about the ARRIVE trial if I recall. I don't think I did. I think you did.Julie: I'm pretty sure I did. Meagan: I think you did. I feel like since the ARRIVE trial, we really have seen a major shift in due dates. Julie: You mean induction? A major shift in interventions? Meagan: Well, sorry. Induction because of due dates. Julie: Right. Gotcha. Meagan: We see people at 38 weeks being checked, not dilated, being told that they either like I said, have to have a C-section or have to be induced in the next week because they are 39 weeks but really, do we have to? We do not. We do not have to. A lot of bodies do go over that 40-week mark. I think it's important to know when you are approaching your due date that you may start getting an influx of pressure to do those things, to sweep your membranes, to induce, to schedule a C-section, and I think that is something that I find frustrating. I mean, you guys, obviously as a doula, I work with a lot of pregnant people and Julie even being a photographer now, I'm sure you have situations where you are like, Oh, this person is being induced now, and now you're planning and induction. We'll get to induction in a second. But the pressure that starts coming at people at 38 or 39 weeks for induction or a scheduled C-section is unreal to me when sometimes we just need to let the body be. Julie: Yep. Meagan: Right? 28:18 Vulnerability and the ARRIVE trialJulie: I agree so much. It's so funny because we all know that induction is safe and we're going to talk about that in just a minute. It's safe for VBAC when it's necessary. it does slightly increase the risk of uterine rupture and a couple of other things, but it's frustrating when we have providers taking advantage of this vulnerable group of people. Meagan: Very vulnerable. Julie: By offering induction at 39 weeks and who doesn't not want to be pregnant anymore at 39 weeks? I think everybody. There's a small group of people who just like being pregnant and that's totally fine. I like being pregnant but by my last one, I was like, Get this baby out! I was content for baby to pick their birthdate every time, but with the last one, I was like, Get this baby out! Anyway, I feel like most providers don't think they are taking advantage of these people when they are offering 39-week inductions, but it really is. It's taking advantage of a woman in a vulnerable position and could skew their birth plans in ways that they don't want. It's hard to say no when you are that pregnant and unless you have a super strong resolve which even the strongest resolve can weaken in that type of emotional and hormonal state. It's really frustrating because we have this ARRIVE trial that was published in– what was it? It wasn't 2020. Meagan: 2019. Julie: In 2019 and the medical world jumped on that so fast. They were like, Yes. Let's induce at 39 weeks. Meagan: It was a leech situation. Julie: Yes. And then now that multiple studies have proved it invalid and it has been picked apart and even ACOG doesn't recommend that anymore. It doesn't stand by the validation of the ARRIVE trial, there have been multiple studies showing otherwise since then, but guess what? Oh my gosh. This is so frustrating. It normally takes 10-15 years for the medical community to catch on to updated information, but this one took on so fast and now it is going to take 10-15 years to undo that. Meagan: To go back. I agree. Julie: Yeah. It's frustrating. Meagan: It is. It's so frustrating. 30:44 Inducing a VBACMeagan: It's hard to see so many people, like you said, in a vulnerable state feel that pressure of induction. I think where I even struggle more is seeing people in the last weeks of their pregnancy which can be hard because they are uncomfortable and Julie wanted to get that baby out. They actually can be some of the most precious times with your other kids before your family grows and your husband before you have a baby and you are a family of three or your partner. They can be really great spaces and a place where we can really get our head in the space for labor and delivery and for birth. But we have so many people out there being scared that they are going to have to have a scheduled C-section. We know that even though evidence shows induction for VBAC is safe and reasonable, there are many people and many providers out there all over the world who absolutely refuse to induce a VBAC. They refuse and induction. It's either a scheduled C-section, spontaneous labor, or that's it. Those are your options. We see so many people out there spending these last few weeks that could be so amazing and getting ourselves in that positive headspace in frantic mode because they are trying to induce themselves. They are trying to do all of the things. Julie: Yeah, they are like, Oh my gosh. My provider is going to schedule a C-section at 40 weeks or induction at 39. Meagan: What can I do to get this baby out? Julie: Yep. Meagan: It makes my heart hurt because it just really isn't where you deserve to be in your last weeks of pregnancy. Let me tell you one thing, when you are so hyper-focused on getting your baby out, tension and cortisol is high in the body and when we are stressed, that's typically not a space where we can let our cervix go and have a baby. So when we are doing those things, we are entering a space full of tension and we are already setting ourselves up for a harder experience. Julie: Mhmm, it's true. You go in there ready to fight then your cortisol levels are high and cortisol is the opposite of oxytocin which gets baby out. Your stress hormones are fighting your baby coming out and it's not optimal. Can it happen? Yeah, sure. People do it. But it's going to be harder. Meagan: It is. Julie: It's just going to be harder. Meagan: It is. Like I said, back to the head space, it really puts us in the wrong head space. It just is not optimal. Know that if you are receiving pressure to have a baby because you're not being supported in an induction that you should just change your provider. No, really. You need to take a step back and decide if that provider is the right choice for you and if that's the right space for you to be birthing in and if what you are doing in your mind and to your body because a lot of people do some crazy things, is really what is going to be the best for your labor journey. Julie: And sometimes, people don't have that much of a choice too. Sometimes, that's the only choice you have. Sometimes, home birth is illegal in your state for VBAC even and– Meagan: You have no providers in your area. Julie: You have one hospital within 6 hours and sometimes that's going to be your only choice and it sucks that people have to choose between that and an unassisted birth at home which I feel like if you are going to have an unassisted birth at home, that's a whole other topic. You should do it because you are educated and informed and that's what you want not because you don't want to have this horrible hospital birth where you are going to have to fight the whole time. Meagan: Yeah. It's a tricky spot. To Julie's point, we understand that. There are so many people who are just flat-out restricted and they feel like they are walking in with their hands tied behind their back and just have no choice. But there are other options too. There are other options. But laboring at home a little longer or just saying no. Just saying no which is really hard. Julie: Yeah, it is really hard especially when you are in labor. Especially, maybe you have this resolve and your partner doesn't have that resolve. Maybe you can't find a doula in your area. You can't afford one. It really sucks to be your own biggest supporter and believer in birth. You have to have other people in the room who are just as resolved and want this for you as much as you do if you are birthing in that type of environment. 36:15 Julie's social media storyJulie: Okay, back to basics. What are we doing next? Oh, let me tell this story about induction. I think this is so funny because there are so many people who think that induction isn't safe and they think that induction isn't safe for a VBAC to go past 40 weeks so you have a provider who won't induce you and won't let you go past 40 weeks so what are you supposed to do? It's really interesting because I hired someone recently to post on my social media recently for my birth photography. She is a birth photographer and doula and has attended many births before. She just recently shifted over to social media and website management for birth photographers. She knows that I'm really passionate about VBAC so I want one post a week to be about VBAC. She'll write up posts for me to approve and one of the things that she wrote up for me about VBAC was things you can do to– I think it was things you can do to increase your chances of having a VBAC or something like that. In her post, she even made the comment and I'm glad I read through these all in detail because she said something that, “We know that induction isn't safe for VBAC because it increases the chance of uterine rupture.” She said in my post that is on my page that is supposed to be written in my words that induction isn't safe. I deleted it. I shot her a little message to be like, Hey, VBAC induction is safe. Does it slightly increase the risk of uterine rupture? Yeah, it does, but as long as it's managed well, the increased risks are very, very small. Meagan: Still pretty low. Julie: Yeah. It was just so funny that someone who has been in the birth world still for so long operating on more of an evidence-based side of things has that view still. I don't know. It's just interesting. We all have things that we need to learn still. Meagan: We do. We are always learning and we are even still learning here at The VBAC Link. It's just important to know that if you see information and you're like, Oh, I already know that, you still need to check it out and see if there is something new to that. 38:29 Contradicting informationMeagan: Okay, so back to the basics. We've talked about the pelvis. We've talked about induction. We're talking about due dates. We are talking about the cervix dilating. We've talked about baby sizes. What else do we have? Julie: Epidurals. Meagan: Oh yeah. Epidurals. Julie: This is so funny. The opposites. It's the same thing about the opposite. VBAC has to be induced before 40 weeks. I will not induce VBAC at all. You have to have a C-section by 40 weeks. All of these things. Epidurals are the same way. You have to have an epidural placed in order to do a VBAC and then we also have you cannot have a VBAC with an epidural. Meagan: Yeah. Yes. I've seen that. Julie: Isn't that so stupid? I'm sorry. I just think it's so stupid, all of these polarizing things. It's so funny because sorry, time out. I will let you talk about that. I promise I will let you talk about that. I think it's so funny because we know that Facebook can do so much good and it can also do so much bad. There will be a post like, “Hey, my provider said I have to have an epidural with a VBAC,” and there will be 50 comments on there and every comment will be different like, “Oh, yeah. You absolutely have to. It's safest in case you have to have an emergency C-section.” Then the next comment will say, “No, you don't. You can't because then you won't notice the signs of uterine rupture.” Everyone says something different and it's really funny because it's the same thing about the length between pregnancies or C-sections to VBAC. People will be like, “My doctor said it has to be 18 months from birth to birth. My doctor said that you can't get pregnant within a year of having a C-section. My doctor said–” or they say. I love it when people say, “They say 18 months birth to birth is best. They say don't get pregnant within 9 months. They say 2 years between births is the best.” Who is they, first of all? Who is they? Whenever someone says they, I say, “Who is they?” Because there are so many sources and everybody is so resolute in their answers. “My doctor said this. They said that this is the right answer. 6 months, 9 months, 12 months, 24 months, 3 years.”Everyone is so firm in their answers. How freaking confusing is that? Meagan: Very. Julie: P.S. the optimal range for births actually hasn't had any definitve say yet because there are different studies that show different lengths, some as short as 6 months between pregnancies. Some are as long as 24 months between births. Is it between births? Is it between pregnancies? I just laugh every time I get on Facebook and see these people who all say, “They say” in their resolve. I don't know. I just think it is so interesting and can be so overwhelming and confusing which is why we started The VBAC Link so we can bring you the evidence so that you know. Sorry, go ahead and let's talk about epidurals. I had to go on that tangent. Meagan: Well, you just brought that up and that's another big basic. When can I get pregnant? 41:36 Pregnancy intervalsMeagan: When can someone get pregnant? We'll buzz back to epidurals. Julie: Yeah, luckily we wrote a blog. We will link it in the show notes with the studies cited. Meagan: A lot of people are confused. Is it birth to birth? Is it birth to conception? Right? Julie: Yeah. Yeah. Meagan: Do you want to talk about that? I'm going to sneeze. Hold on. Julie: Yeah. It's really interesting because you are getting these different numbers– 6 months, 9 months, 24 months, 15 months. You're getting all of these different numbers then you are also getting these different ranges. Between birth to birth, so between the time when your C-section baby is born to when your VBAC or your attempted VBAC baby is born is different than from the time you have your C-section to the time you conceive the baby. 18 months birth to birth is 9 months pregnancy to pregnancy so 6 months pregnancy to pregnancy is 15 months birth to birth. Of course, everyone is confused. That's all I have to say about that. What do you want to add, Meagan? Meagan: It is confusing. It is absolutely so confusing and I think when you are talking to a provider, it's important to talk to them about their view on intervals because there are different views. People, like she said, do have different views. People will say, “If you are pregnant before 15 months from birth to conception” or not before 15, before 24 months even sometimes or before 18 months, that's not okay when it really might be from birth to birth. We do have a blog about it. We're going to link it so you can see the studies and how they view it, but I also want to point out that if you are being told you absolutely can't VBAC because you have a shorter interval, say from birth to conception is whatever, 15 months. You conceived 15 months after your C-section and providers are saying, “No, it's too close,” there are studies that show and talk about an increased risk of uterine rupture but I also want to point out that a lot of people do it with no complications. Julie: A lot of people do it. What it all comes down to is what is the acceptable level of risk to you and can you find a provider who is willing to take on that risk with you? In our blog, I'm just remembering off the top of my head. It might not be 100% true but one of our studies showed that a 6-month pregnancy interval so after you have your C-section, you get pregnant 6 months or beyond, there is no increased risk of uterine rupture. Within that 6 months, there is an increased risk of uterine rupture. I think it is 2.4% up from 0.5%. Now, a 2.4% risk, I think it's that. I think it's 2.4%. You'll have to look at the blog. I'll send you on a treasure hunt for the blog. But that level of risk might be acceptable for some parents and providers and it might not for other parents. For me, I would go totally try it. I would do it because that means I have a 97.5% chance of not having a uterine rupture. Heck yeah. That's pretty solid to me, but it might not be solid to you. That's what matters. The other one showed that an 18-month pregnancy interval is optimal. 24 months birth to birth, I think, was the other one. We are having a bunch of different ranges and all three studies that were cited the blog are credible studies. The real answer to that pregnancy interval question is we don't know what is the optimal pregnancy interval. We just don't know. They say, they will tell you– I feel like most people and most providers are about on the 18 months birth to birth side. Some providers want 12 months between pregnancies. Meagan: Yeah. I see a lot of people saying that. I even see 12-24 months or 12-18 months before conception. I see a lot of conception as well. It's just important to talk to your provider about that and when you are looking at the studies and you see a 15-month, see what it is talking about. Is it talking about C-section to VBAC or to birth or to conception? Julie: Yeah. 46:38 EpiduralsMeagan: Okay, epidurals. We were talking about it a minute ago where so many providers say, “Yes, you have to have an epidural. No, you can't have an epidural.” I think I've shared this story before. The only uterine rupture I have ever witnessed in my life was with an epidural. I'm going to guess that she probably had a delayed feeling because I'm assuming she would have felt it sooner and this pain. She felt it later on and when she felt it, it was above where the epidural site numbed so up in her rib area, up below the breast. That was where she felt it with an epidural. There weren't any heart decels or anything like that. There were other signs of things like a stalled dilation and things like that but she still felt it with an epidural. A lot of providers are telling people that they can't have an epidural. I think that this scares a lot of people. Julie: Mhmm. Meagan: Birth unmedicated can scare someone who doesn't want to birth unmedicated so the thought of going unmedicated can scare someone to the point where they are like, I'll just schedule a C-section. My point in sharing this story is that even with an epidural, you can often still feel a uterine rupture happening and there are usually other signs that are happening even before that that are pointing things out. There is a pretty, I think it's a debate in the medical world, on if epidurals actually increase Cesarean. Have you seen the blogs and different things? Julie: I absolutely do think they do. I've seen it. My gosh. Meagan: I know. I know. A lot of the evidence out there or a lot of the opinions out there on the blogs and the National Institute of Health publications and things like that show that maybe not, but then there are things that show actually it does seem like it can. Julie: I think it's how you act when you have the epidural. If you have a nurse in there who is content on changing your positions every 30 minutes or whatever, I don't know. Maybe not. Keep the pelvis moving. But if you are flat on your back for 20 hours, then yeah. It probably increased that risk. Meagan: Yeah. There's not a lot of evidence showing that it for sure does increase the risk of Cesareans but as doulas and people who have gone into a lot of births– obviously, there are a lot of providers who have gone to way more births than we have as doulas. I don't know if it's a cause, but it does seem to correlate. It can correlate and there are a lot of different things. We see an epidural come into play and I actually have seen moms dilate really fast. I have seen an epidural be the best tool–Julie: That's true. That's true. Meagan: –for a laborer to get a vaginal birth. I really, really, really have seen this, and not even just vaginal birth after Cesarean, just vaginal birth. Julie: That's true. There is a lot of nuance there for sure. Meagan: But to what you are saying, a lot of the time it really does depend on what comes after the epidural. A lot of the time after an epidural comes in, we know that there are two things for sure that have a higher chance of happening. One, you have a higher chance of sitting and doing nothing. Just hanging out like Julie said. Not really moving, working with the pelvic dynamics, and getting baby out and down. And two, we know that PItocin often comes into play after an epidural because a lot of the time, it can stall labor. We want to get labor going again and sometimes instead of just waiting and letting the body– I use the body acclimate a lot, but really, the body has to acclimate so much in labor. We are going from home to a hospital. We have to acclimate from that place to the car to the hospital and then we are getting there and we are not even just acclimating to that space. We are acclimating to new voices. Julie: Mhmm, new smells, new sensations, new temperature, new germs– that's probably not really a thing. Meagan: Yeah. It's not even just being in a different place. It's all of the things that come with the different place. So we get an epidural and our body is like, Oh, cool. I can rest. This is my opinion, okay? I don't have any research to show this. But my opinion is that when an epidural is placed and a body “stalls”, that is our body saying, “Thank you. I'm going to take this opportunity to rest.” Can it continue laboring at some point? Yes. Will it always? Maybe not. Maybe Pitocin does need to come into play at that point because it has decreased our bodies' ability to register and acclimate, but sometimes I feel like with getting the epidural, we need to just acclimate to that and see what happens versus just immediately starting Pitocin and acclimate to new ways to change. But yeah, did you want to say anything, Julie?Julie: It's interesting because I like that and I feel like sometimes that is exactly what a body needs maybe not necessarily for the body as much as for the psyche to just be able to rest and relax and let go because a tense body and a tense mind sometimes isn't going to be very efficient at laboring because of that. Again, we talked about this before with the cortisol levels so if you can get someone to relax easier and let the body take over what it is supposed to do intuitively or instinctually– and it doesn't always and it's okay if it doesn't and it's okay if we need other things to help us, but sometimes just that rest and relaxation and that 30-minute power nap is exactly what the body needs to continue on throughout the rest of it. I think a lot of people when they are going for a VBAC think they need to go unmedicated to have their best chances. While yeah, that may or may not be true, it just is completely dependent on the person and the labor and how things go and how long it is and all of those types of things. I just think about the cascade of interventions. 54:13 Allowing for nuanceJulie: I was going off on a daydream over here when you were talking about the cascade of interventions because we always demonize that a little bit or villainize it like, Oh, the cascade of interventions as soon as you get to the hospital or as soon as you get the epidural or as soon as you whatever. You know, it's true. We've seen it a dozen times, but I've also seen the cascade of interventions help parents have the exact birth that they wanted as well. So like with all things in birth, there is that nuance there. I've used the word nuance a lot and I feel like maybe it's a thing for my life lately and everything that we have to allow for the nuance and we can't be super rigid in our thinking. I think maybe at the beginning of The VBAC Link, Meagan, you and I did a lot of that villainizing of the cascade of interventions. But as we have grown and talked more to people and had more experience as doulas and in the birth space, I feel like we are allowing ourselves to be a little more fluid in that thinking and allow for that nuance to come into play. Meagan: Yes. Yes. 100%. Julie: But I will say this. I will say this with 200% certainty, okay? There is no nuance allowed here. People who tell you that you have to have an epidural for a VBAC are 100% full of crap. This is why. Because the reason why they say you have to have, and I say “they say”, I'm saying they like your provider or anyone who says that. The reason why is because in case of a uterine rupture, the epidural is already placed and they can get you back for a C-section faster and not have to put you under general anesthesia which is riskier. That is true. General anesthesia is riskier than an epidural. That is 100% true. It is safer overall to have an epidural for your C-section than it is to go under general anesthesia. Now, here is where I call B.S. because even with an epidural placed and dosed, when you have an epidural going, it is not at the strength it needs to be in order to do a C-section without feeling any pain. Meagan: It's not enough. Julie: From the moment the epidural is dosed up, now keep in mind it takes time for the anesthesiologist to come in and everything like that too, you're looking at a minimum of 12 minutes if the anesthesiologist is there and pushing the bolus. 12 minutes for the epidural to take effect enough to have surgery. Now, listen to me. If it is a true emergency and a catastrophic uterine rupture, you do not have 12 minutes to save the baby. You will be put under general anesthesia because minutes matter. Seconds matter in those true emergent situations. So, Karen, if you have an epidural placed and it's a true emergency, then you will have to be put under general anesthesia. If it's not a true emergency, then guess what? You have enough time for a spinal block which takes effect in about 3-5 minutes. Go into the OR. You can still have your baby out in 15 minutes or more but usually what we see called an emergency C-section, they're like, “All right. Baby's heart rate is not looking good. Let's get the doctor in here. Let's have you put your scrubs on. Oh, look Dad. Let's get your scrubs on.” You get dressed and you are getting wheeled in the OR 45 minutes later, that's not an emergency. Having an epidural placed when you don't want one or need one– some people need one and some people want one and that's fine. Having an epidural placed is preparing you for surgery. It's preparing you for surgery. That's why I say there is no room for nuance because you just can't magically make an epidural surgical strength in minutes. You just can't. There's no nuance there. It doesn't happen. Meagan: Okay. We'll just end right there. You guys, there are so many things but hopefully, we covered a lot of the basics. Know that you always have options even if you feel like sometimes you don't have options, there probably is another option there. It's crazy, but there really is so keep looking at your options. Look at your blog. Look at the show notes. We'll create and leave the links today. Check out our How to VBAC course. It's going to cover a lot of information and help you hopefully find the right stats and evidence-based information so when you see posts on Facebook or TikTok or anything like that that are saying things like, “If your baby's cord was wrapped around their neck the first time, you can't have a VBAC the second time,” or if you are told that your pelvis was too small the first time and you can't have a VBAC or going on and on, that you will be able to know the evidence-based information. All right, okay. All right. Julie: Yeah. Meagan: See you guys later. Julie: Bye! ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Our Sponsors:* Check out Dr. Mom Butt Balm: drmombuttbalm.comSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Julie Francom joins Meagan on the podcast to talk about checking the validity of the information you see surrounding VBAC. There is so much information out there and so much misinformation that we want to help you figure out what is actually evidence-based! Julie and Meagan draw on their personal experiences with making corrections to information they understood and have shared. They talk about how the structure, size, and date of a study can influence the statistics. Julie shares why Cochrane reviews are her favorite.The VBAC Link is committed to helping you have the most evidence-based and truthful information as you make your birthing decisions. We promise to update you with all of the new information as we receive it!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 03:30 Checking the validity of social media posts08:01 Our corrected post about VBA2C12:56 The production behind a statistic or article18:37 Cochrane reviews19:06 Checking the dates of studies and emailing us for verification23:29 Nuchal cords25:21 Julie's sleep training story29:45 Information at your fingertipsMeagan: Hey, hey everybody. Guess what? We have Julie today on the podcast. Julie: Hey. Meagan: Hey. We're going to be doing a short but sweet, maybe also a little sassy because as Julie has said, she likes to get sassy these days. We're going to do a short but sweet episode on how to tell if VBAC or HBAC or really just anything–Julie: Any. Meagan: Yeah, any information you see online is real or fake. Now, if you're following along on our social media, you likely have seen a lot of our myth and fact posts. I think we share them probably once a week honestly because there really are so many things out there that are myths and things that are facts, but on a whole other side and a whole addition to myth and fact is really what should we be believing? What should we be resharing? Right, Julie? I think that this definitely is something that is close to our hearts at least I'm going to say is close to my heart. I think it's close to Julie's heart. Julie: Oh, for sure. Meagan: We want to protect this community and we want this community to find the real information, and not the false information. We know. You can Google anything. Julie: So much false information. Meagan: You can Google anything and find the real and false information but when it comes to VBAC, like she said, so much false information. We're not even going to do a Review of the Week. We are going to jump right in in just a second after the intro. 03:30 Checking the validity of social media postsMeagan: All right, Julie. Are you ready to get spicy?Julie: Yeah, I think maybe the biggest reason we decided to do this episode and at least for me anyway why I brought it up is because there is so much information out there that looks good, right? You can be like, Oh my gosh, yes. This is amazing. We're passionate. We as in me and Meagan, but we as in you too who is listening. Clearly, you're passionate. But we really need to be careful what we're sharing both from our business accounts and what we're resharing from other people because sometimes if you share this information and it's incorrect and wrong and it goes viral which there is a recent post that has and sparked this thing, and we're not going to call anybody out, but when you share misinformation and it goes big and people start believing this incorrect information, it can really do damage to the efforts that we're trying to make here which is increasing access to VBAC for everybody. If you have this entire group of people who think that their chances of having a VBAC at a hospital let's say are 30% or something like that when really your chances of having a successful VBAC if you get to try– get to try I'm using very loosely– are really between 60-80%. Those are the numbers. But there was a post recently that went viral that said it was around 32% in the hospital and that is just simply not true. The post went viral and everybody is jumping on board like, Look how much better home birth is than hospital birth, but those statistics were very flawed from a flawed study that was super small from Germany 20 years ago. Meagan: Less than 2000 people. Julie: Yeah. Yeah. It could give you some pretty conclusive. Some, but it's not big. It's not a meta-analysis. It's definitely not something to be definitive. It's from Germany and there are a lot of flaws in the study as well. But everybody saw this thing, Oh, HBAC success is 87% and hospital VBAC success is 32%, or whatever the number was. People are like, Look how much better it is at home, and spreading this information which don't get me wrong, having three HBACs myself, I love home birth. I love home birth after Cesarean for whoever feels it is appropriate for them, but I also know that those numbers are just wrong and if you share that information and these people believe it, they might be choosing HBAC out of fear. Meagan: Well, yeah. Absolutely. Julie: Instead of having the right information and making the right choice for them. I don't know. That's what we want to do here. We want to help you spot misinformation easier and learn to question the things that you see on the internet which sounds so silly. For me, I'm like, Okay. Let's challenge everything. But I saw that post and my first thought was, Heck yeah. That's crazy. I'm all for home birth but then I was like, Wait a minute. These numbers don't feel right to me. Meagan: It doesn't make sense. Julie: So then I dug a little bit deeper into it. We just want to equip you with knowledge so you are doing your best to get the most accurate information and spot the information that is not necessarily true. I think we are all guilty of it. I'm just going to keep talking, Meagan::. Meagan: I know. I was going to say really quickly. Just like what you said, you were like, Heck yeah, as someone who is passionate about birth or maybe someone who may have trauma. I'm talking about this specific post but really in any general post, someone who may have trauma surrounding the opposite of what that post is supporting, it's so easy to just be like, Boom. Share. You know?Julie: Yeah, you'd be like, Oh my gosh, yes. I love HBAC. Let's share this. Let's increase VBAC. Everyone needs to hear this. This is important information. We get excited, right? Meagan: Right, but we need to do exactly what Julie said and take a step back and I mean, this goes for anything. It might be sharing the correct age of a child being out of a car seat. I mean, just random and you're like, Yeah, that looks good. Boom. Share. Make sure that you are sharing the right stuff. 08:01 Our corrected post about VBA2CMeagan: So let's talk about this. Keep going, Julie. I know you were on a tangent going into it. Let's talk about how to understand if it's real. Julie: Well, first of all, I think before we do that, I want to admit that we have been guilty of sharing, I don't want to say misinformation because I guess it kind of was. A few years ago, we misquoted an ACOG bulletin about VBAC. Meagan: Yeah. Julie: It was me. I did it. It was me. I'm the problem, Taylor Swift fans. What had happened was that ACOG, in their bulletin about VBAC after two C-sections, cited two studies. One study that they cite– first of all, they say that VBAC after two Cesareans is a safe and reasonable option for parents to attempt and the decision should be patient-based. Anyways, so they cite two studies. One study that they cited about VBAC after two Cesareans shows no increase in rupture rates with VBAC after two Cesareans compared to one. The second study that they cited showed risk of almost double the rupture rate for VBAC after two Cesareans compared to one. It's really interesting because they cite these two studies that are equally credible that had drastically different results. So when I made the post, I paraphrased the bulletin that said something to the effect of, “VBAC after two Cesareans shows no increase of rupture risk.” Now, that was only really kind of half true because I saw the study and I was like, Oh my gosh, like Meagan:: said, This is exciting! Everyone needs to know this. I made the post then we started getting some kickback on it and so we looked again because I was like, Oh, well I will show you where in the ACOG bulletin it says this, and then I went and I was just like, Oh yeah, it doesn't say exactly that. I unknowingly spread this misinformation so what we did is we updated the post and we posted an additional post that was a correction because here at The VBAC Link, we want to make sure we are giving you 100% accurate information all of the time. The reality is that we are humans. We are going to make mistakes sometimes but as soon as we realize that we make these mistakes as long as they are actual mistakes and not just people wanting to talk crap, we're going to correct ourselves. That's the biggest thing. I want to say that it's okay to not be perfect all of the time, but I think it's also important that when you realize you've made a mistake that you correct it in the same space that you made it. Anyway, I just wanted to say that. Meagan: Yes, not wanting to shame anyone for being excited and making these posts. Julie: You should be excited. We're excited. Meagan: Yeah. We were really excited to even see that post earlier and then we had to take a step back. It's not to even shame that person. They are probably really excited to share that information but again, as a poster, one, take a step back before you share, and two, take a step back before you post. If you post and there is question which unfortunately there were a lot of questions on this post, change it. It's okay. It's okay to be like, Oh, I actually misunderstood this. Julie: Update it. I didn't see this. Yes. Meagan: Or, I didn't realize this wasn't as credible as it felt. Julie: Or seemed. Right. Meagan: One of the best ways to find out of the research or the study or what you are looking at is really, really credible is if it's peer-reviewed honestly. Right? Julie: Right. I think before you even go into that is if you see data or information like this post shared and it doesn't seem quite right or even if it does seem right and you don't see a source cited, ask for a source. Meagan: Ask for it. Julie: Mhmm, especially if they are throwing out numbers like, Home birth has an 87% success rate for VBAC and hospital birth only has 32%, everybody wants to get on board with those numbers, but there were no studies posted. There was no anything so I actually went on and made a comment. I asked about it and she posted four different studies. I was like, Three of these studies aren't even relevant at all and this one where you are getting numbers from is incredibly flawed. I think it's really cool to get on board with something that shows these fancy numbers, but it's really important to at least see a source cited I would say. Bare minimum, see a source. Ask for a source and then go through and verify the source. Meagan, yeah. Let's talk about what makes a source credible. 12:56 The production behind a statistic or articleMeagan: Yeah. Julie: These are just some things. Not all of these things are going to be true all of the time for a credible source, but these are things to look for and why they are important. Sorry, go ahead. Meagan: No, yeah. I think one is looking at who even produced it. Who produced this stat or this article or whatever? A lot of the time, someone who produced the article may not be the person who produces the stat or the evidence. That's something to also keep in mind just because if Sally Jane at whatever company shared an article, it doesn't mean that she's not a credible person but I think sometimes when we are digging deep into what is credible and the real original source, it will take us to the original source which then we need to look at. ACOG, right? We pay attention to ACOG. Midwifery groups and things like this, we want to look. Who wrote it? I think one of the things is what is the full purpose? Julie: Yes. Meagan: One of those articles that I was reading actually wasn't in relation to what the post was about. Julie: Exactly. Meagan: I don't know if you saw that. Julie: Three of them. Meagan: The purpose of this article and the goal of why they are one writing it in general and what's their ultimate goal in giving you the information. Julie: Right. Meagan: I mean, when I was reading one of them, I was like, Wait, what? Julie: And when she shared these four links and I called her out, I said, “These three are about this, that, and the other thing. They are not related to the other things that you posted,” she deleted all of the other information that she shared and just kept the one outdated German study up. I felt really salty then. I still feel a teeny bit salty about that. But yeah, I feel like asking the author and the poster. I know that at The VBAC Link, when I was there, I tried to really make sure that we did this and I feel like you still do but whenever we post anything with stats or numbers or anything like that, we try to post a source with that every time. Meagan: Yeah, for sure. Exactly. Julie: It's in the course like that. Sorry. I feel like we are going in different directions there so circle back. Meagan: Yes. I think you really need to break it down and look at the ultimate study. If it is saying that you have a whatever success chance of having a VBAC in the hospital or having a VBAC in general and you're looking at the stats, if you're looking at a review that has 9,000 people and then there is another one that has 400,000 people involved in that study, to me, automatically I'm going to be looking at the difference there because to me, 9,000 is a lot but this one was less than 2,000 specifically. Julie: Right. Meagan: So when we're looking at big studies, if you have a very small control group, it's just not as credible as some other sources. Julie: Right. 18:37 Cochrane reviewsJulie: What I really love is when I can find a Cochrane review of something. Cochrane reviews in my opinion is the most credible place because what Cochrane reviews are is they are a meta-analyses of a bunch of different studies. What they do is they find a whole bunch of different studies or research papers or evidence or just huge collections of data. They go through and pick them all apart and find out which ones are credible or which ones are not credible and then they compile the results in those studies to have a bigger meta-analysis which is a collection of a whole bunch of credible studies pulled apart and data presented. I love if I can find a solid Cochrane review because I know that is just about as credible as you can get. Also realize that most studies have flaws and limitations like Meagan:: was talking about. Who is behind the study? Who funded the study? Who contributed to the study? What were the study controls? How many variables were there? Because if you have a study with more than one variable, then your numbers are going to be skewed anyway because these different variables may influence each other. If you have, for example, the ARRIVE trial. The ARRIVE trial we know had flaws. I'm not going to go over all of them but they were funded by a doctor at a hospital whose goal was to show that induction provides the same or better outcomes than waiting for spontaneous labor. That was the intention of the study. When you go in trying to prove something, you're already introducing bias into the study and you could bring protocols or procedures into the study that might not be realistic in the real world that could influence the results of the study which is one of the things that actually happened in the ARRIVE trial. A lot of studies I feel like could be picked apart and torn apart which is why I really love Cochrane reviews and meta-analyses is because you can compile all of these and get more accurate results and information. Also, here's the thing with that study, that one study that she showed that had less than 2,000 people and is 20 years old and is based in Germany, that's not going to be relevant in the current day in the United States. Meagan: That's another thing that I wanted to bring up. 19:06 Checking the dates of studies and emailing us for verificationMeagan: How long ago was the study? If the study was done in 1990 and we are now in 2024, there is a large chance that things have changed either way. Maybe in favor of that or the opposite. Julie: Right. Meagan: So we need to look also at the date. If you are looking at something and here at The VBAC Link, we know we have stuff that was even published in 2020 that there may be a new article out in 2022 or 2023 and we need to stay up to date on these things so it is so important to also look at that date because something 20 years ago or even 10 years ago, that might actually be the most recent study. Julie: Yeah, and if that is, that's all you can use. Meagan: Right. Right. There's that. But there may be a newer study. So again, before just clicking “share” or “create” or something like that, it just goes back to stepping back and looking at it. Let me tell you, Women of Strength, right now, if you find a study online and you are like, Wow. I am really, really curious about this post or about this study or whatever it may be, but you are unsure, email us at info@thevbaclink.com. Email us. We will help you. We will help you make sure to break it down and tell you the efficacy. Julie: The corrected-ness. Meagan: How efficient and correct it is. Julie: I don't think efficient is the correct word. Accurate. Meagan: Accuracy. Julie: Oh my gosh. You should listen to us. We know how to speak. Meagan: Email us, you guys. I don't even know how to use my words but I can tell you how to break down a study. No, but really. Accuracy. That's the right word. Thank goodness for Julie. Julie: I think that maybe a more appropriate thing for her to have said in that post would be like, “Your chances of having a VBAC are higher at home than in a hospital.” That is accurate, 100% because it is true. Out-of-hospital births, at least around here in Utah. I can't speak to other parts of the country so maybe I should say that. Around here in Utah where we are, I can confidently say probably in other parts of the country too, when you have a skilled home birth midwife and you are a low-risk pregnancy and VBAC does not make you high-risk P.S., you have a much higher chance. Now, there are no studies done here in Utah, but we have seen a lot. I mean, there is this Canadian home birth study that was just done that took a look at VBAC as well that showed some similar things but we know that the American Pregnancy Association says that women who attempt a VBAC have between 60-80% chance of getting a VBAC. Now, around here, we in our birth centers and out-of-hospital births and home births see over 90% of that success rate in all of the midwives and stuff like that who we have seen and talked to who have shared their data with us. That is good data. Meagan: It is pretty high here. We are lucky here. I have only seen out of 10 years of doing births two VBAC transfers and actually, the one was because she really just wanted an epidural. That's the only reason why she left and the second one was because we did have quite a stall. I think it all was a mental thing. I think she actually needed to be at the hospital and then they still had VBACs so that's great. Julie: For sure. I've seen one transfer, but that cord was wrapped around that baby's neck four times and they had to cut the cord before they took the baby out via Cesarean. Meagan: Whoa. 23:29 Nuchal cordsJulie: Nuchal cord, a cord wrapped around the neck most of the time is not a need for a Cesarean, but this mom pushed and pushed and pushed at home for hours. We transferred and got her an epidural. Baby's heart rate started to not do good. They took her back for a C-section. The cord was wrapped around its neck four times and they couldn't even take the baby out because it was wrapped so tightly. They had to cut the cord in four places before they could pull the baby out by C-section. Meagan: Wow, wow. Julie: Wild, right? That was an absolutely necessary Cesarean. That baby was not coming out. Absolutely necessary. And things like that are going to happen and it's cases like that where we are so grateful for C-sections. This is one of those things where if it had been 300 years ago, mom and baby probably would have died because that baby was so wound up in there. This was one of those true cases. Most of the time when people say that, it's not true in my opinion. Don't cite me. Meagan: Okay, well the true takeaway from today's episode is to check your facts and if you see something that doesn't feel right, check it again but don't just share it and ask for the source if there's not a source. Check if it's peer-reviewed. Check if it's a Cochrane review and all of these things. Again, check the date. Check the amount of people who were in it. Really do your research and if you do have a question, please do not hesitate to email us at info@thevbaclink.com. We'd be glad to help you decipher if that is a good and factual or not-so-factual article or stat or whatever it may be. Julie: Whatever it may be. 25:21 Julie's sleep training storyJulie: Do you know what is funny? Let me throw out another example really fast and then we will wrap this thing up. Years and years and years ago, nine years ago– my first VBAC baby just turned 9. After he was born, oh my gosh. All the things. I had all of the mental health things. One of my biggest things was that I thought, this is probably going to be a little controversial. I thought that in order to be a good mom, I had a checklist because I wasn't going to have a NICU baby. I wasn't going to have the same situation. I thought it had to be completely different. I had to breastfeed. I had to go and get him every single time he cried right away instantly and drop everything. I thought I had to do all of these X, Y, and Z things. What is that method called? It starts with a W I think. Anyway, it's kind of a modified version of crying it out. You let them cry for a minute and then two minutes or whatever. It worked really well and he is still my best sleeper to be honest. I thought, Oh my gosh. I am so bad. I can't believe I damaged my child. Yada, yada, yada and there are probably people listening right now who are like, Well, you did damage your child by doing that. But anyway, he's damaged for other reasons but not that one. So with my second, I wasn't going to do it because there was a study that showed that babies who were left alone to cry it out had the stress part of their brain remain activated up to an hour after they stopped crying and all of these things. I was like, Oh my gosh, I can't believe I did that. I'm the most horrible mom ever.Clearly, I think differently now, but I paid a postpartum doula to come in and help me learn how to gently encourage them to sleep. Well, it turned out my stinking baby would cry in his sleep. He would cry while he was sleeping. Meagan: Oh, no way. Julie: I would go in there and I would be like, Oh, super mom to the rescue. I would pick him up and wake my baby up who proceeded to cry for two hours because he couldn't go back to sleep because I was waking him up. Anyway, it was this whole thing. I know, stupid right? Every baby is different. But my point is that this study which everybody was sharing about the damages of crying it out and how we are damaging our children and they are going to grow up to be people who feel unloved– that was the thing. Do you remember that? Do you remember that? It was 9 years ago or so, maybe a little bit more recently than that. The study had four babies in it. Four, Meagan::. Four babies. Meagan: Four? Julie: Four. And these babies were in a hospital environment in those little plastic bassinets so not only were there only four babies, but they were monitoring them in an environment that is unfamiliar and not letting their caretaker come in and soothe them at any time during this study. Meagan: What? Julie: Yes. Don't let your baby cry until they throw up for sure. Go and soothe your baby, but four babies in an unfamiliar environment without their caretaker there at any part of it. Meagan: Wow. That was enough to say that that was– Julie: Yes. This is where all of these advocates for not letting your baby cry at all got their information from. Isn't that ludicrous? That is insane, right? Meagan: That is insane. That just means that we need to take a steb back, look at what we are sharing, don't just share it, and always look at the study. Always, always, always look at the study. Julie: Absolutely. And look at the damage that did to my mental health and not only me, everybody else's. I know I'm not the only one. So seriously, dig in deep and trust your intuition and follow your instincts. You know what's right. Going on the tangent for your baby, but also if you see something that feels a little strange or is showing numbers without information, ask for evidence. Ask for proof. Where did you get that information from? 29:45 Information at your fingertipsJulie: Because we have, I will say this and then we will close it up. I promise. I hate it when people say, “Oh, don't confuse your Google search for my medical degree.” Well, that's B.S. because do you know how many times I've seen doctors Google something while I've been in their office? Yeah, for real. First of all, not saying that a Google search is the equivalent of a medical degree at all. I know way more goes into that. But, we have access to the largest database of information that was ever existed in the entire history of humanity. We have access to Google. There's Google. There's Google Scholar and if you know how to distinguish between credible versus non-credible information, there is so much power in a Google search that you can use to help you in anything you need to know. Anything in the entire world. Should you have a doctor? Sure. You absolutely should. But also, you know yourself and you have access to all of this information and it's a very powerful tool that we have and we should be really grateful for it because we don't have to rely 100% on other people with a different knowledge than us anymore. So don't discount that. Don't discount your ability to find out if something is credible or not because you have access to that power at your fingertips. It's pretty freaking amazing. Okay, done.Meagan: It is. Okay, done. All right, Women of Strength. We are going to let you go. We said it was going to be a quick one. It really was and hopefully, you got some information and will feel more confident in going out and looking at all of the many things that it said about VBAC. I honestly think that is another reason why we created our course, Julie, because we were so easily able to find so many things that were false out on the internet and we wanted to make sure that all of the real, credible sources were in one place. So find those places, you guys. Check out our blog. Check out the podcast. We have lots of links. Check out our course. So many amazing things. So many great stats. And hey, if you find a stat and find something within our blog and you are like, Oh my gosh, I've seen something new, let us know for sure. We want to make sure that the most up-to-date information is out there. So we do not hesitate to take any suggestions. If you see something, question us for sure. Please, please, please because like Julie said earlier, sometimes people misunderstand or misword or whatever and we want to give them credit but we really want to make sure that the right information is given to you. Julie: Absolutely. Meagan: Without further ado, I'm going to say goodbye and I love you. Bye. Julie: Without further ado, we will say adieu. Meagan: We will say goodbye. Julie: Bye. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan::'s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Our Sponsors:* Check out Dr. Mom Butt Balm: drmombuttbalm.comSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

We can hardly believe that we have recorded 300 episodes! Meagan brings Julie on the podcast today to take a look back at how The VBAC Link Podcast started, the growth they have both experienced along the way and where they are now. Since 2018, we have shared laughter, tears, heartache, and joy through your stories. Thank you to all of our listeners and guests for your support. Together, we are changing the birth world for the better through all of our ripple effects!Meagan promises to continue the journey and bring you more powerful stories. It's been quite the ride and we don't plan on stopping anytime soon!Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:11 Review of the Week04:05 How the podcast started12:09 How the podcast has grown 16:40 Changes in birth22:11 Celebrating differences within the birth community28:45 Challenges bring growth35:35 Julie's photographyMeagan: Hello, you guys. Today is a very, very exciting– for me at least and I'm sure for Julie– episode because it's the 300th episode. 300 and Julie is here with me because I couldn't share this exciting episode without her. Julie: I cannot believe it. I seriously cannot believe it. So wild. Meagan: It's so crazy. 300 episodes and we've had so many other crazy things like special episodes so it might even be more than 300, but it is the 300th on my form and I'm really, really excited. We want to share more about where we are today but also recap a little bit about where The VBAC Link started. I know we have a lot of listeners who have joined us in more recent years. We started in 2018. 2018, is that right? Julie: Yeah. Meagan: So we have a lot of new listeners who maybe don't know our full story and know what we are and what we're doing and all of the things. 01:11 Review of the WeekMeagan: So we are going to be talking about that, but we do have a Review of the Week. I'm going to share that. It is from Michelle. She listed this on Google and it says, “Thank you so much for inspiring and informing me through the journeys of VBAC mamas. As I prepare for my VBAC in October after a recent traumatic Cesarean, I feel empowered, motivated, and healed knowing that there are so many women who are out there preparing in the same way that I am. I recommend this podcast to all mamas.” Now, this was about a year ago so I'm assuming Michelle has had her baby. So Michelle, if you are still with us, let us know how it went and as always, if you wouldn't mind leaving us a review, it helps all of these other Women of Strength find these amazing stories and information as well as our blog and all of the wonderful things I believe that we provide. You can do that on Google. You can do it on Apple Podcasts. You can even send us a message or on Spotify. I mean, really wherever you are listening should have a ranking– Google, Apple, or wherever you are, we would love your review. 04:05 How the podcast startedMeagan: Okay, Julie. 300. Julie: 300. I can't believe it. Do you know what is wild? It's so funny because I left. I'm using air quotes right now. I know people can't see it. I “left”. It's been 2 years. 3 years, oh my gosh. 3. I left in 2021. Meagan: It has. 2021. You did. Julie: My gosh. Isn't that wild? When is this episode airing? Meagan: May. Julie: May, so it will almost be 3 years. It's really funny because life is definitely much easier now and more manageable, but there are parts of me that still feel very strongly connected to The VBAC Link. I appreciate you for including me and having me back on the podcast and things like that but it's also sometimes so weird when I'm scrolling through Facebook and I see The VBAC Link recommended, sometimes people talk about Meagan and Julie still which is so cool, but also it's sometimes like Meagan Heaton has The VBAC Link and it's really amazing and she does a great job. I'm like, “Aww,” but also, it's weird. It's this weird little thing because I still believe that I made the right decision. My life has a much better balance and everything I needed it to be by letting go of The VBAC Link. It's right there where it needs to be, but there's also part of me that is just kind of like, “Man, that was a big part of my life for so long,” and it still feels weird not being in it. Meagan: I'm sure, absolutely. I miss you. I love you. Julie: I miss you too. Meagan: I'm so glad that you come on and join me here and there or take random phone calls when I call you to vent or something. Yeah, you guys. It's kind of crazy to think that it's 2024. It's even more crazy to me to think that I've been solo for that long. Yeah. Just thinking back in 2018, I still will never forget the moment that I saw Julie Francom pop up on my phone out of nowhere, out of absolutely nowhere. We knew each other. We knew we were VBAC passionate. We were doulas. I would say we were kind of really kicking off into the prime doula stages of our careers and it was just so crazy. My personality is sometimes where if someone is calling that I don't really know this person super, super well, I'll let it go to voicemail and see what they say. Julie: You're like, “Why is this weirdo calling me?” Meagan: You're not a weirdo, but we weren't the absolute tightest doula friends in the community. We just really knew each other and respected each other through going to ICAN meetings and things like that. I so easily could have not answered. I always wonder if I didn't answer what would have happened. Would you have texted me and said, “Hey, call me?” Julie: Probably. Meagan: Would you have called me right back? Would you have just said, “She didn't answer.” I don't know. Julie: No, it had to be you, my friend. It had to be you. Meagan: I'm so grateful that it happened. You and I personally have grown so much over the years. We also have grown a lot as a partnership. We decided to start this company and it was exciting and if I'm going to be honest, I'm going to say that Julie had more positivity or ambition behind her. I was feeling it. I could feel it inside of me. I was like, “Yes. This is amazing and I want to do this. I really want to be part of this,” but I was reluctant a little bit more. She was like, “Let's do this. Let's do this. Let's do this.” I was like, “Oh, my gosh.” Do you remember the day when you called me? You were like, “So, we're going to start a podcast and it's going to be super easy and I'm going to edit it.” Do you remember that day?Julie: Yes. I remember. I was in Target. I was walking around in Target. Meagan: I remember where I was. I was in my laundry room. Julie: I was like, “Oh my gosh. We should start a podcast.” I was super confident. In my past life, I worked a lot in the tech field. I had edited a lot of videos and audio and things like that before when I was in the military so I knew the technical side of it would be simple. I thought it would be easy. It's very simple for me. I knew that we had a lot to say. We've never not had a lot to say. I knew that the– I don't know what the right word is– whole sphere of audio was growing rapidly, like the digestible content of podcasts was a fast-growing entity or whatever. It just seemed like the right thing to do. It just seemed like the right thing to do. I remember I was like, “Oh my gosh. How am I going to convince Meagan to do this?” We were already so busy writing our course and our manual with our doula contents. I think you had 12 births coming up in October that year because you were putting your husband through law school. I was just like, “I don't know how I'm going to talk Meagan into this.” I feel like you were reluctant but you for some reason just had this hint of, “Okay, let's just see. Let's let Julie do this. I'll get on the phone and talk about it.” Then I was like, “Okay. We'll do this.” I signed up for a free Podbean account and we did a free conference call on our phones and recorded our phone calls. It didn't cost anything at first and things are very different now, but it didn't cost anything at first. I was like, “See?”Meagan: “This is great.” I remember some of the days, I was like, “Okay, sure. I'll jump on and do a podcast, but I'm driving to a prenatal right now. I literally have 35 minutes because my client is 38 minutes away.” We were recording and I remember back in the day when I was in my husband's car and his trunk sensor was bad and it was dinging, so oh my gosh. If you guys have listened back to those episodes, wow. Thank you for sticking with us. Julie: At the very beginning. Well, we used to take turns hosting like we would just do one at a time. I remember the first OB that we had on our episode. It was in the teens. I was out in my car in my garage in the middle of summer because my kids were inside. It was the middle of the day and it was the only time they could do it. I remember hiding in my closet so that the clothes would absorb the sound of the audio echoing around so it was better acoustics on our free conference call. Meagan: Oh my gosh, yeah. I remember sometimes when I was in the closet literally under the clothes and Jess, she was one of our clients from Russia and I was in the closet for that one. In the husbands' episode, I was in the closet on that one. It's just so crazy. We've come so far. Yeah. We had a whole bunch of people who were like, “I want to share my story. I want to share my story.” 12:09 How the podcast has grown Meagan: We were realizing that this is a serious need. Julie: We had to hunt people down at first. Meagan: Yeah, we did. Julie: We would message people at first. Kelsey, what's her name? Is it Likowski? Kelsey, super cute. She was Episode 8 or something. We were like, “Oh my gosh. She has 10,000 Instagram followers and she's so cute and she wants to talk to us.” Meagan: I know. That was so weird to us. We went to this little marketing conference thing and we were watching our Instagram account grow and we were watching our podcast grow. We started getting people like, “Hey, I heard,” and we were like, “Whoa, this is insane.” It was so exciting and so motivating and we really, truly realized that this was such a need. Let me tell you, our heart was there. Our hearts were there so we were so excited to dive in. So we did. We started sharing stories. We tried to get different content-type stories and different types of births. We tried to get OBs. I remember I reached out to this OB and they randomly responded. I was like, “Oh my gosh, this is insane.” We really tried to get the most we could while still doing birth and writing manuals for our VBAC course and– Julie: And wives. And being moms and wives. Meagan: And being moms and wives and friends and humans who were ourselves. Julie: Too much. Meagan: It's so crazy to look back and think about that time and where we were and all that's happened. It's kind of crazy to also think about birth and how we have seen it change and how personally, I think I've even seen it change in some good ways and in some bad ways. We talked about this a little bit before we started recording, but COVID. COVID was a really, really difficult time as moms giving birth, as doulas supporting birth, even as podcasters weirdly enough. We had this entire– we went from this really junky set up all over to having an editor and having a podcast studio and in this really amazing space which– shoutout to our favorite editor. I just have to say that he is amazing for all that he has done for us over the years. But we had all these things that were really helping us and really changed our lives for the better as far as podcasters goes and VBAC Link facilitators or whatever. It all changed. It all changed so fast. Julie: Yep. We had to go back to recording at home. We had to– oh my gosh, getting into hospitals was just nuts and wild. Meagan: A nightmare. Julie: There were so many clients of ours having to switch plans and a lot of people shifted to out-of-hospital birth because the hospital policies were so flip-floppy and so strict. They were limiting who could be in your birth space. I actually think that's a really positive shift. That's just me. Meagan: Yeah, no. I actually agree. Julie: Out-of-hospital birth is still growing. I think it's super cool. At least in Utah, it is. I'm not sure of the numbers in any other state, but I know in Utah, it used to be that 1-2% of births were out-of-hospital, but now as of 2024, so far, just under 5% of births in Utah are happening out-of-hospital which is super cool. But not enough. Meagan: It is super cool. Yeah, I would agree that through COVID, that was one of the positive shifts of helping people see the different options. Julie: Forcing people to really, seriously look hard at them. Meagan: Yes, and then also seeing that those options actually are pretty dang safe. But yeah, so COVID. We've had even so many people on the podcast sharing their stories through COVID. Man, it was rough. We were seeing induction taking off because they could control who had COVID and who didn't. 16:40 Changes in birthMeagan: Then we also went through the ARRIVE trial just before that. Julie: Oh jeez, yeah. Meagan: So there was all of that we saw making changes. You know, birth is constantly changing and evolving and growing. It's pretty cool, I feel like, to say. I've been in the birth world for 10 years now as a doula. It's pretty cool to say that I've been there. I'm here. I don't know how to say that. I just feel like it's really cool to be a part of this community and to see these changes. I've talked to some people who did birth back in the 80's and the 90s and it's kind of crazy to think about how it's changed. I want to go back and listen to some of those earlier podcasts and see, has birth changed? Are we changing and what can we do to make birth change in a positive way? I think this podcast honestly is one of those ways to help people change their birth experience in a positive way by going in and listening to what is happening. What is happening? What to expect? How to avoid those things? Right? Don't you think, Julie, that this is a really great place for all moms and all people preparing for birth to come?Julie: Well, and here's the thing. We all have a threshold for what is and is not acceptable to us. Going back to talking about COVID a little bit. COVID and the things that were happening due to COVID didn't sit right with some people and caused them to question and explore other options. Hearing The VBAC Link Podcast creates realizations for people that could cause them to question the things that they are presented within their own personal life as far as giving birth goes and what their provider is saying and the policies of their hospitals and things like that. I think that is the way that ultimately birth in the United States will change and all over the world really is when people are faced with the things that cause them to feel uncomfortable about their current situation and explore other options and seek out those other things that will resolve whatever their intuition is telling them needs to change and shift. Here's the thing. We don't know what things will make us uncomfortable until we have all of the information available to us. You don't even have to have all of the information, but any information available. That's been the goal here. It's been really cool to see things shift and I mean, there's obviously not a study or research or anything on how much The VBAC Link Podcast is causing a shift or whatever, but I do know that we do hear these stories from people and I do know that it is creating a shift and a change in our birthing culture however small that might be.I just think it's really cool to hear people say that it was this thing that gave them the confidence to stand up to their provider or talk to their husband or their partner or look into other options. Meagan: Mhmm, it really is. It's just– I don't even know. I'm almost speechless to get those reviews or to get people saying those things when we are recording a story and they're like, “It's just so crazy to me that this is coming to full circle that I'm now sharing my story when all of these other Women of Strength's stories is literally what changed my life or my path or whatever.” I think I've said this before, here we are. We started this podcast randomly as you come up with this idea in Target and you're like, “I've got to convince this girl that we've got to do this,” and here we are when really in so many ways, it's you, Women of Strength, who are changing. Julie: Yeah. Meagan: You. So it's like, okay. Yes, it's us at The VBAC Link but then also where is the stat for all of them? All of the listeners and supporters? You guys, it's been a long time and to say thank you isn't enough. I don't know what to say. I feel emotional, but I don't know how to say thank you enough. Julie is laughing at me because I'm always the crier. Julie: I'm not laughing, well I am laughing. Meagan: I don't know how to say thank you enough to this community because it's been absolutely the craziest, sometimes most stressful but most amazing journey and I'm so excited that we can still be on it with you. Like I said, I know these listeners are the people. They are the people. They are the reason. So thank you for making this happen. 22:11 Celebrating differences within the birth communityMeagan: In the midst of meeting all of these incredible people who are sharing their stories, we have also met incredible people throughout our own community who are trying to do the same thing we are trying to do– educate, support, motivate, empower. I mean, all of these words. We have made some amazing connections with people within their own community and I'm just so grateful for that as well. Julie: I agree. I am really proud of all of the people who have chosen to start their own podcasts and their own VBAC education platforms too. There is a home birth after Cesarean podcast. I actually haven't been as good at keeping up with other VBAC podcasts or whatever, but there are people– and I don't know whether it's influenced by us or not but definitely coming after us, there have been other things popping up here and there. I love that and I'm so proud of those people for choosing to pursue their passions as well for VBAC in spaces like this. I think it takes a village. It takes a whole– I don't know, what's the saying? A rising tide lifts all boats. I don't know. It's something like that where the more people talk about VBAC, the more people are talking about VBAC, so yes. Let's bring more people into this space. There is room for everybody. There is room for all of us here to grow and educate and inspire and uplift. We might not always see things the same way and that's okay, right? It's okay if we don't see things the same way as everybody else as long as we are all trying our best to create a positive influence in the birth space. We are not the same as anybody else and nobody else is the same as us and that's cool. That's okay because if you don't resonate with us, there are other people who you can resonate with and vice versa. I think it's really important to say that we welcome everybody here and we want you. We don't have to be the only thing that you follow. Go follow all of the things. Meagan: Well, I love that you talked about that because back when we were going for our VBAC, for me, it was back in 2015/2016 when I had my son and the resources were more slim. Now we have all of these incredible resources and it makes me so dang happy because that is what this VBAC community needs– more info, more support, more people backing them up, more places or people to go and like you said, I mean, we would love to always be in your circle. We love this community so stinking much, but we also know that not everything we say or not everything we do resonates. I mean, it comes down to this podcast where we share CBAC stories and uterine rupture stories. We share stories that are out of the hospital and we've even had free birth stories on this podcast. Not everyone may agree with those types of birth or people advocating for that, right? It's not even that we are gung-ho about anything specific or not gung-ho about anything specific. It's that everyone has a space in this community because if we were to completely eliminate a uterine rupture story, no. I'm sorry, that's just a no for me. Julie: Yeah. Meagan: We want to share those stories and CBAC. The CBAC community is so precious to me and near and dear to my heart. Sometimes, that can be a really hard community to be in. I say that personally. I have been in that CBAC after my two C-sections. I wanted a vaginal birth. I had a Cesarean birth after a Cesarean. It wasn't what I wanted. I had healing to do. I had a lot to overcome, but I'm so glad that people come on this podcast and are willing to share those stories because our CBAC community deserves that. Like we were saying earlier, not every desired vaginal birth ends in a vaginal birth, so we have to learn through these stories. Like Julie said, everybody has a place here at The VBAC Link and yeah. We support everybody else as well. We love this community so much. Julie: Do you know what? Maybe I'm out of line to say this. Please, you can tell Brian to edit this out if you want, but I just think it's no surprise to anybody that our world can be pretty hateful right now. Even people doing the most good things can face criticism or cancel culture or the mob or the mafia– not the mafia, the wokeness, or whatever, all of the things. There are so many things coming at you no matter how pure your intentions are or whatever. I just remember one time a few years back, somebody was talking crap. This was my gosh, 4 years ago and they called us “wholesome-looking podcasters from Utah”. Do you remember that?Meagan: I don't remember that. Julie: I will never forget that phrase. Sorry, I'm laughing now. I'm crying. They said something like, “It's easy to want to trust wholesome-looking podcasters from Utah,” or something like that because it's fine. There's going to be people who don't love us and that's totally fine. But gosh, when you were saying that, I was like, “Are we wholesome-looking?” Meagan: Are we wholesome-looking? I don't know. Julie: I don't know. Meagan: I don't remember that. Julie: It's so funny. I'm sure there's a screenshot of it somewhere, Meagan. My gosh, I can't even. 28:45 Challenges bring growthJulie: I want to circle back to you talking before about the struggle. There has been so much struggle. There have been a lot of challenges. Challenges due to our own creation, challenges due to technical difficulties– do you remember the time I changed the URL of the podcast and the whole thing went down? It was the day that the podcast was supposed to go live and we were meeting with Lynn, our first business coach. Oh my gosh, there have been so many things. Meagan: She broke the podcast, you guys. Julie: I broke the podcast. Things where we have definitely butted heads before and had to do a lot of growth in our relationship. Meagan: Yep. I was going to say you and I. Julie: There have been other VBAC groups out there who railroad us completely. There have been other birth people in our local communities and otherwise who are not big fans of The VBAC Link and I think that– I don't want to get pulling a little bit into saying, sorry. I don't know what I'm trying to say here. No, I do know what I'm trying here. I'm trying to figure out how to say it the right way. There is opposition in all things, right? I feel like, oh my gosh. I'm going off on six different tangents right now. My therapist told me one time– it always comes back to my therapy. Meagan: I love it. Julie: When you want to strengthen a muscle, if you want stronger arms, you can't just sit there and be like, “Hey arms, get strong.” You have to put it under tension and stress. It's lifting the weights. It's under the tension and strain where that muscle grows. Such is life. Such are relationships. Such it is in business. It is everywhere. Things don't grow and become stronger in comfortable times. It's the strain and the tension and the struggle that ultimately causes that strength and that growth. I feel like there have been moments of really beautiful and incredible and empowering moments along this journey for The VBAC Link over the last 7 years now, but there have also been incredible moments of tension and struggle and strain. Meagan: Hardships. Julie: Yeah. Those moments really have the most growth. They are the most identity forming and I don't know. They are the things where it really solidified what we are doing. Sometimes, in the face of people who should be doing the same things as us and sometimes, it's from people who just for whatever reason, don't want to see other people succeed. It's come from a lot of other different places, but also going back to what you said before, I'm so grateful for the people who are still here, the people who support us, the people who love us, the people who are still here and challenge and question the things that might not be 100% true. Yeah. I don't know. I love all of that and I don't know. There is this quote I heard forever ago, probably decades ago because I am old now that said, “Don't compare your backstage footage to someone else's highlight reel.” I feel like sometimes it's really easy to see all of the beautiful things that The VBAC Link puts out and all of these other birth organizations and see the highlight reel and think that everything is sunshine and butterflies, but I know that for us and for everybody else too, everybody else that has any kind of online presence anywhere, there is so much struggle that can go on behind the scenes. Yeah, I just wanted to talk about that. Meagan: It's intimidating sometimes. It's intimidating. But this community, I feel like, offers something special and it truly is the most motivating thing for me where I do wake up and I'm like, “I can't wait to record more podcasts” or “I can't wait to go and see what people are asking in our Q&A's” or whatever. I love that you talked about a little bit how sometimes you are going to make decisions or you're going to do things and some people might not agree with you. I think that applies so much int his community because let me tell you what, when I decided to VBAC after two Cesareans out of the hospital, I had some haters. I had some haters. Julie: Yep. Meagan: Those haters and doubters, some of those were even in my own family. Julie: Sometimes it's the people who are supposed to love you the most, right? Meagan: And support you the most. Sometimes, they were people in my own circle, so it can be really hard when you're getting pressure from people who you love and respect or people who you idolize or whatever, right? But it's up to us to conquer, to have faith, to move forward, to grow, to adapt, and all of those things. I think that as we grow, more people in this community get to experience it. I mean, truly, the community grows through hardships and strengths and podcast-breaking and all of the things.Julie: And wholesome-looking.Meagan: In a wholesome-looking way apparently. Julie: I don't know if that's a compliment or not. Am I wholesome-looking? I guess that's good. We look wholesome. Meagan: We look whole. Julie: I want to look up the definition of that really fast. What is wholesome? What does it actually mean? Meagan: What does wholesome mean? Yeah, and is that supposed to be not a compliment?Julie: I think the intention was that they look good. They look legitimate, but–Meagan: They might not be because they represent some birth stories that we don't support or whatever. Julie: Whatever. “Conducive or suggestive of good health and physical well-being. Conducive to or promoting moral well-being.” Wholesome-looking. Meagan: Interesting. Julie: Hmm, I don't know. I could not not say that. Oh my gosh, I'm sorry. You can have Brian edit it out if you want. Meagan: No, no. You are good. Julie: You're the boss. Meagan: No, I love that. Now I'm going to think about myself being wholesome-looking. 35:35 Julie's photographyMeagan: Okay, we talked a little bit about where we've gone, where we've started, what we've gone through, and all of the things. Now, where are we at today? I just have to gloat a little bit about Julie. She is phenomenal, you guys. If you have not been in our email or if you haven't been on our social media, I definitely suggest you check it out and go follow her because she has taken a step back from The VBAC Link. We are so grateful that you come on here and there. You have taken a step back from doula work, but you are killing it in the photography world. Julie: Aw, it's the best. I love it so much. Meagan: You're doing so good. I'm so impressed. I just love seeing her photos on her Instagram and I love being able to chat with her and even connect more to the story. Sometimes, she will tell me the story that goes with the picture. I'm like, “Oh my gosh.” It's so amazing. I'm so happy for you. Do you want to talk a little bit about what you are doing now that you are not doing The VBAC Link?Julie: Oh my gosh, I have to tell you. I sent you these pictures. I think I texted you. There was this girl. She reached out to me 2 years ago and she was like, “My C-section baby just turned 1. I'm thinking about getting pregnant again.” She wanted to connect with me for doula work. At the time, I was doing doula-tog so I was doing both doula and birth photography. So we talked and we connected. Then I sent her a couple of different local resources to connect to, then a few months later, she reached out and she was pregnant. She was going to hire me for doula-tog then she had a miscarriage, then it was a little while that passed again. She reached out to me again later and she was pregnant again, but by this time, I had phased doula work out completely, so I had referred her to a local doula here that I absolutely love working with. Anyway, super long story short, she ended up hiring this other doula and me as a birth photographer and she switched from hospital birth to a home birth and I just attended this beautiful VBAC birth at home last week. It was so neat to have somebody come full circle and follow their whole journey. She called me and we talked on the phone forever 2 years ago when she was starting on her VBAC journey because she had found The VBAC Link.It was just really neat. I know more about her journey. It's hard sometimes as a birth photographer because I don't have an initial connection with people as much as I did when I was a doula. Sometimes, the first time I see people is when I walk into their birth space with my camera which is okay. I like it when it is a little more than that beforehand, but it was really neat. Her name was Emmy and I'm sure that one day she will share her story on the podcast because I want her to. It was just a beautiful birth. I got called at midnight. The baby was born at 3:45 in the morning and it was just a really beautiful story with really powerful, empowering photos for this girl. She got to 10 centimeters with her first baby and she pushed for 6 hours. She got the epidural when she was 4 centimeters. She got to pushing. She was flat on her back the whole time, a classic story. She didn't know. Anyway, it was a really beautiful and very empowering story. I got to document it and I just think that some of the imagery, I cannot wait for her to tell me that I can share these. She wants to see. I respect everybody's wishes. Some people want me to share everything. Some people don't me to share anything and I respect all of that. Anyway, it's just really cool and really neat. I love being able to document that. I tell people, “My gosh, just hire the birth photographer. These moments are fleeting. They change so fast. One of the biggest days of your life, you're not going to remember what your baby looked like, what their cry sounded like, and the joy on your face as you met them. Just invest. Do whatever you can to be able to invest if that's what you desired. Don't let finances get in the way.” I personally now offer several financing options I can implement and things like that because I know it's not super cheap, but I love being able to capture and preserve people's stories. I also do videos. Videos are my favorite. I love being able to see the motion and hear the sounds of those babies' first little noises. Oh my gosh, there was this cute little baby making fish faces an hour after it was born the other day. I could not believe it. It was amazing. These people wouldn't have that. Sure, there are cell phones and things like that you can take pictures on. There are some cell phone cameras that are really good quality now, but you're going to miss out on so many things because who is going to be taking the picture on your cell phone? Your partner? Your doula? You're not going to be able to see how your doula supported you. You're not going to be able to see the beautiful moments your partner and you had because they are the ones holding the camera. You're not going to be able to see the look on your partner's face because it's all going to be baby or you. Plus, most partners are not really that great at taking pictures, let's be honest. It's okay. It is okay but it's such a fulfilling thing. I love being able to go and witness the power that women have in all of the stories. There is so much power in scheduled C-sections, in unplanned Cesareans, in vaginal births, in medicated births, unmedicated births, hospital, out-of-hospital, all of it. All of it takes so much power and strength, all of it. I get to witness that but not only do I get to witness that but I get to document it. I get to come home and I get to witness it again as I'm editing photos and video. I just think it's a really, really, really cool and really inspiring thing. I love it. I love it. Meagan: I agree. It's actually one of my biggest regrets not having that. We had some candid– not even candid, some photos that were snapped really quickly, but not being able to see, I really wish it was recorded. So dang it. Julie: Yeah, I feel like that's the biggest regret I hear from first-time moms too. They will be like, “I didn't have a birth photographer for my C-section. I wish I would have though. I wish I would have. I wish I would have been like, ‘Well, I'm having an induction now. I was thinking about it, but I really wish I would have had one,'” because there is just so much. Cell phone pictures just don't do it justice. Meagan: I agree. Well, I love what you are doing. I'm so grateful that you are in that space and I'm so grateful for you letting us use your images that of course are approved. I definitely highly suggest going over to Julie Francom Birth Services, right? That's your page, right? Julie: Birth Stories. Julie Francom Birth Stories. Well, it's just Julie Francom Birth on Instagram and on YouTube and on Facebook. Meagan: Go find her, you guys, so you can still follow her journey. Thank you, Julie, for joining me on the 300th episode. I really am so grateful for all that we have done, all that you have done, all the growth that we have seen, and I'm excited to keep going. Julie: 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.Our Sponsors:* Check out Dr. Mom Butt Balm: drmombuttbalm.comSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

In today's very special episode I'm sharing the power of specialization and finding your niche. As we celebrate our podcast's seventh anniversary, we're not only reflecting on our journey but also on how you can refine your business's focus to make a meaningful impact and increase revenue along your journey. I'll share the importance of having a clear, valuable offer and aligning it with your audience's desires. I'll talk about the process of crafting this offer, identifying your ideal buyer, and evaluating your sales strategy. Plus, I'll touch on the common challenges many face when selling—like fear, rejection, and worthiness issues—and I'll offer actionable steps to overcome these barriers. Whether you're struggling with mindset, feeling unworthy, or simply looking for support and accountability, I'll provide insights on how a community, coaching, and internal transformation can catalyze your growth. And since it's our anniversary, we're running an exclusive giveaway! Learn how you can win lifetime access to my program 'Pitch It Perfect' and other incredible prizes simply by engaging with our podcast community. Liked this episode? Make sure to subscribe to our podcast and leave a review with your takeaways, this helps us create the exact content you want! KEY POINTS 00:34 Celebrating the Podcast's Anniversary & Special Giveaway 05:23 Diving Deep into Influence, Building Authority and Strategy 07:12 Solving Common Problems, Niching Down and Specialization 08:06 Introducing the Revenue Growth Lab: A New Support Container 10:19 Specialization vs. Niche: Clarifying the Concepts 14:53 Addressing the 'Meh Offer' Dilemma, Crafting Irresistible Offers 21:40 Overcoming Sales Hurdles, Selling with Ease 27:37 Tackling Imposter Syndrome and Self-Doubt QUOTABLES: “Specialized businesses or industries or brands focus on a specific expertise or skill set, like, say, a unique product or service that demands a technical know-how, that is what specialization means. However, niche is different. Niche actually targets a subset of a broader market with distinct customer needs." — Julie “It's not just about having an amazing offer. It's about having someone in your world who truly wants what it is that you're selling them and they're willing to invest in it." — Julie "It's not about forcing someone to buy something that they don't want or need. Because selling at its core is relationship based. And that's why when we're just selling all the time, we don't even realize that we're selling. Because it is service based. It is relationship based. When we come from that lens, it's about genuinely helping people solve a problem or achieve a goal." — Julie "Are you reaching your ideal buyers effectively? Do you have the right funnels and automations and processes and systems set up to do this in a way where you can actually access your sales approach to ensure that it's consistently bringing money in for you and that it also aligns with your offer and your target audience, which maximizes the chances of your success." — Julie  RESOURCES: [WORK WITH ME?] I am creating a new done with you / for you offer to help you strategize and build out your offers for revenue growth! If you've been in business for a bit and you're ready to grow your revenue and brand authority, I'd love for you to take 5 minutes to fill out this form so I can tweak my new experience to meet your needs. And, if it looks like our upcoming case study cohort would be a fit, I'll have my team reach out to you!  [FREE] Want the step-by-step roadmap to grow your following, monetize your content, and land paid brand deals? Click here to join my brand new free class! This is perfect for you if you want to turn your social media into a profitable & fun career… even if you're starting from scratch! [ORDER] my book or Audible, Get What You Want: How to Go From Unseen to Unstoppable so you can leverage the power of your own influence. Follow Julie on Instagram! Learn more about your ad choices. Visit megaphone.fm/adchoices

Ready to land brand deals regardless of how many followers you have? In today's episode I'm sharing the secrets to successful pitching using the "shine structure", a strategic framework designed to craft winning pitches that prioritize a brand's needs and position you as their ideal partner.  It's about strategy, and focusing on the RIGHT numbers. By focusing on value and proactive engagement, you can unlock brand partnerships regardless of follower size. I believe in the power of starting where you are and building something extraordinary.  Liked this episode? Make sure to subscribe to our podcast and leave a review with your takeaways, this helps us create the exact content you want!  KEY POINTS: 04:20 Small following can lead to faster payments. 08:00 Pitch daily, craft strategy, attract brand deals. 11:34 You're already pitching in daily life interactions. 15:20 Pitching technique emphasizes shining the focus on others. 19:13 Create compelling pitches by showcasing relevant content. 22:11 Thorough research before pitching leads to success. 24:53 Find a knowledgeable coach for success. 30:16 Seek new perspectives, gain success, share insights. QUOTABLES: "I am so passionate about the art form and really the goodness that is pitching, that is putting yourself out there, that is knowing the right way to ask for what you want, to get what you want, and then for people to happily pay you for that." — Julie "In your pitch, you take the shine off you and you put the shine on them. You take the focus off of yourself and you put the focus on them." — Julie "It is your job to figure out what that is and to make sure that your pitch to them is super compelling and that you're showing them, not just telling them how you're able to do that." — Julie "Give yourself permission to learn the right way to pitch, come learn some new strategies, and then start making some money and start getting that freedom and that success and that exposure and that brand recognition that I know that you are craving." — Julie RESOURCES: [WORK WITH ME?] If you've been in business for a bit and you're ready to grow your revenue and brand authority, I'd love for you to take 5 minutes to fill out this form so I can tweak my new program to meet your needs. And, if it looks like our upcoming case study cohort would be a fit, I'll have my team reach out to you!  [FREE] Are you a content creator ready to take your brand collaborations to new heights? Grab the Brand Deal Playbook and unlock the secrets to securing paid partnerships with confidence. You'll gain free access to pitch templates, essential questions, and expert strategies that will propel your content creator journey to new heights, including immediate and lifetime access! [FREE] Want the step-by-step roadmap to grow your following, monetize your content, and land paid brand deals? Click here to join my brand new free class! This is perfect for you if you want to turn your social media into a profitable & fun career… even if you're starting from scratch! [ORDER] my book or Audible, Get What You Want: How to Go From Unseen to Unstoppable so you can leverage the power of your own influence. Follow Julie on Instagram! Learn more about your ad choices. Visit megaphone.fm/adchoices

“If you don't know your options, you don't have any!”April is Cesarean Awareness Month and we hope this month is one of information, empowerment, and love from us here at The VBAC Link to you. Referring to the amazing resources provided by the International Cesarean Awareness Network (ICAN), Meagan and Julie break down the mission of Cesarean Awareness Month. Whether you are a first-time mom, VBAC mom, CBAC, or RCS mom, there is space for all of you! This month is meant to not only reduce Cesarean rates overall. It is also meant to inform everyone about birthing options, hospital rights, and ways to make Cesarean births better. We need all of our experiences to make positive changes in the birthing world for future generations! ICAN's WebsiteCesarean Awareness Month ToolkitInfant Mortality Statistics from 2022Informed Pregnancy PlusNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 07:03 Review of the Week09:29 Why we need Cesarean Awareness Month13:12 ICAN's Cesarean Awareness Month toolkit16:00 Ways to make Cesarean births better21:20 Common reasons for Cesareans25:59 Your hospital rights32:10 The safety of home birth36:52 Lower Cesarean rates = lower infant/maternal mortality rates40:38 A message to the CBAC communityMeagan: Hello, hello everybody. It is Meagan and I have Julie with us today. I always get so happy. Julie: Hello, hello. Meagan: We are going to be talking about International Cesarean Awareness Month. Now, this is sensitive. It's sensitive. It can be sensitive. It's a month, a whole 30 days or 29 days. I don't actually know how long April is. Julie: April is not 29 days you crazy. That's just February once every four years. Meagan: That's just February. Maybe 30, maybe 31. I don't know. Julie: April is 30 days always every year. Meagan: Is it? I don't know my months apparently. Julie: Apparently. Meagan: It can be a long month for people and we're going to talk a little bit more about that. But it stands for International Cesarean Awareness Month and it is a month that is truly just brought to create awareness around unnecessary Cesareans, around advocating for vaginal births after Cesarean, improving Cesarean recovery after, and really just spreading the word and getting the information out there because as someone who has been in the VBAC world before, we have been told many times that VBAC isn't possible and Cesarean is a must. You know, Cesarean isn't desired by everyone, and a VBAC isn't desired by everybody, but it's important to know the options. One of the coolest things is that ICAN which is a nonprofit organization created this mission and I'm just going to read it. Does that sound appropriate? “ICAN is a nonprofit organization whose mission is to improve maternal/child health by reducing preventable Cesareans through education, supporting Cesarean recovery, and advocating for vaginal birth after Cesarean for VBAC.” We are really grateful for ICAN. They do a lot of amazing things and I know that they were a big part of my journey. I mean, wouldn't you say yours too, Julie? I think that's actually where we might have met is an ICAN chapter meeting maybe. Julie: Where did we meet? Now I'm going to think. Meagan: I feel like I can picture you in a living room in a chair up front. You were very involved with the presenter and I was just there. Julie: Wasn't it at your house? Meagan: No. Julie: Okay. Yeah, I remember that one. Meagan: It was at someone else's house and anyway, that's the first day I remember seeing your beautiful face. Crazy, but we love ICAN and we support them. Julie was just looking and they had a t-shirt. One of the things it says is, “You have options.” That is going to be one of the things that we are talking about today. Julie: Yeah. That was last year's theme but they haven't posted this year's theme yet. I mean, we're recording this in February so they haven't gotten a lot of the information out yet, but I love last year's theme. Meagan: I know. You have options. And you do. You have options even though a lot of the time we don't feel like it. 07:03 Review of the WeekMeagan: Julie, do you want to read a Review of the Week before we get going? Julie: I was going to say, yeah. I feel like we are already getting going. Yes. Let me read a review and then we will do the intro and then we will go. Hold on. Now, I've got to get back to it. Perfect. This review is from unhappyggfan so hopefully she's unhappy about GG and not The VBAC Link. Unhappyggfan. She says, “Truy helped me achieve my VBAC.” She says, “I found and started listening to this podcast a couple of days before my due date.” Oh, that's cool. “I was walking a ton every day to encourage labor so I just binge-listened to these episodes one after the other. My due date came and went and I got more worried about having a successful VBAC. I kept listening to these episodes while I walked for hours every day. Fast forward to 12 days past my due date,” oh, poor thing “when my water finally broke right at the beginning of a massive storm and flooding in my city. My doula was unable to make it to my labor and delivery due to flooding on her street and the stories from the women on this podcast truly acted as my virtual doula.” Aw, that's sweet. “As I labored for 16 hours, I thought back to the many stories I had listened to and the words of encouragement and wisdom from the podcast hosts and their guests. I thought of things I had learned and learned as I pushed for an hour and then my son was born. I truly believe that listening to the stories shared on this podcast helped me to have my VBAC. I wish I could thank every guest whose words gave me strength, but I will just say it here. THANK YOU. This podcast truly means so much to me now. A must-listen if you are preparing for a VBAC.” I love that. Virtual doulas. Meagan: I love that. Thank you. 09:29 Why we need Cesarean Awareness MonthMeagan: Okay. All right. I know the motor started and we were gently tapping on the gas before we started reading that review, but yeah. Let's dive into it. So we kind of talked about ICAN and what their mission is, but Julie, when you hear Cesarean Awareness Month, what do you hear or feel? What does it mean to you? Julie: I feel like here at The VBAC Link, it's always Cesarean Awareness Month. Do you know what I mean? We are always focusing on that. But I feel like I love the collective call to action for the entire birth community and hopefully, even the world to focus on this. I was just thinking about this and ICAN hosts this big month for awareness to rally for donations and pushes for things like increased access to VBAC and lower Cesarean rates and things like that, but I was like, “Okay. What more is it? What more is it?” I wanted to get into maybe a little bit more about why we need awareness about Cesareans. What's the point? Why are we worried about this? Why are they worried about this? I really love that they have it on their ICAN website. It's ican-online.org/cesarean-awareness-month-toolkit and I'm sure that will be updated for 2024. I will link it in the show notes, but it has a whole toolkit that you can use with all sorts of things you can do. What I really like about their page is that they talk about why we need awareness for Cesareans in the first place. I love the bullet points that they show. Researchers estimate that almost half of the C-sections performed could be safely prevented. The next one is, “If families don't know these options don't exist, they can't advocate for them.” Obviously, we are huge proponents of that here. If you don't know about your options, you do not have them. You do not have options if you do not know what they are. The next is, “Cesareans can be more or less family friendly depending on the practices and protocols of the facility and the support level of providers. Preventable Cesareans may be responsible for up to 20,000 major surgical complications a year including sepsis, hemorrhage, and organ injury.” I feel like sometimes we forget that C-sections are major surgery. They are a major surgery that comes with all of the risks that major surgeries come with. The last one is, “The future risks to birthing people and their future pregnancies and children are not even mentioned when we are talking about Cesareans.” What are the future risks to these mothers and their kids and their families? I feel like that's the big need to protect our women and the children that are being born and to reduce the amount of people suffering from major birth complications. It's just a medical safety issue. Yes. We probably should put a plug in here that we have literally seen C-sections save the lives of both moms and babies. We have seen it. We are not arguing that. We are not questioning that. What we are questioning is their frequent use, how overused they are, and how quickly they are jumped to for many reasons besides the true risk to life and health of the people they are trying to save. 13:12 ICAN's Cesarean Awareness Month toolkitMeagan: Yeah. Yeah. It's so hard. I feel like there's this line of– I think I still even have anger about how many unnecessary C-sections happen. I kind of want to talk about, okay. We have a large chunk. We are really high. 32% of Cesareans are happening and I want to know that percentage truly how many of those people didn't desire it at all. I'm going to guess a large chunk of them didn't desire it, but I'm also going to guess that a large chunk of those went on to have future Cesareans which again, is fine. But like she was saying, you have options, and a lot of the time, the options aren't presented so if we don't know that we have these options, we just keep having Cesareans. They might not be desired. Julie: You're right. It's true. I feel like everybody listening right now should go and download this Cesarean Awareness Month Toolkit because I feel like there is so much value here. It gives you so much information even when it's not Cesarean Awareness Month. Just go download it. They have obviously links to social media graphics that you can share for Cesarean Awareness Month. There's a t-shirt that you can buy to support the cause. You can become a member of ICAN. It shows you how to donate to the cause. It gives you social media calendars, Facebook groups, and templates for writing a proclamation to your governor or mayor. There is a press release that you can tweet and adjust to send to your local media outlets. There are instructions on how to invite ICAN onto your podcast. We should do that by the way. We've had someone on in the past, but it's been a while. Meagan: We should. Julie: There are webinars that you can follow and listen to. There are ICAN chapters all across the world in 20+ countries. It talks about how to find supportive providers and supportive options. It gives you options. It gives you facts. It outlines things. It tells you how you can have a more peaceful and family-centered Cesareans. It talks about knowing your rights and ICAN and the whole organization there. It talks about how Cesarean can be a lifesaving technique and it's worth the risks involved when it is a true lifesaving measure. It goes into so much, so much. Go download it now. There is going to be a link to the ICAN website to go and download this but I feel like it is so helpful for all birth workers and families to have. I am just really, really impressed with how thorough this toolkit is. Meagan: Yeah, me too. As I'm looking through it, I'm like, “Wow. This is amazing.”16:00 Ways to make Cesarean births betterMeagan: Let's talk about– okay. Their mission is to– they say Cesarean recovery and stuff like that. One of the missions here at The VBAC Link is that we want to make Cesarean birth better. So if you are wanting to have another Cesarean, let's talk about ways that you can make it a better experience. We can make it a better experience by having more people in your OR and having your support people there. Julie: Like your doula and your birth photographer. Meagan: Yep. Yep. Having those people there so when baby is born and birth partner, dad or whoever is there, goes over with baby, you're not just left alone. I mean, okay. You're not left alone. You've got anesthesia there and stuff like that, but you don't know that man or woman. Julie: Yeah. You deserve a dedicated support person for you and there's just not a dedicated support person for you in the OR when your partner has to leave and go with baby. Meagan: Yes. One day in my life, I hope that I can somehow help that policy change because it drives me crazy. Julie: P.S. Layton hospital is working to get doulas in the OR and birth photographers in the OR. It's a steady thing. You can get into the U with no problem as a doula and as a birth photographer because I'm also a doula. But can we just talk about the whole partner thing though? Do you know how many times when I have been in the OR or as a birth photographer, do you see the partner or the husband when the baby is born and taken to the warmer? This is what happens every time, I swear. The husband looks at the baby and then looks at their wife, then looks at their baby, and then looks at their wife. You can see on their face. They want to go with their baby and they want to stay with their wife or their partner. They are making a decision, then the wife inevitably says or the partner, the birthing person always says, “Go be with baby, every time.” Meagan: Yes, or I was going to say that the mom is saying, “Hey, when this baby is born, I want you to go be with baby,” but Dad is like, “Yeah. I want to be with baby, but I need to be with you. Julie: I also want to be with you. I know that probably having an extra person in the OR is not going to alleviate that sense of obligation to two humans at once, but I do know that I have had partners come back and tell me that they are so glad that I have been there because they know that their partner is being watched over and cared for more so than just what the nursing staff can provide and the OBs obviously. Meagan: Yes. Yes. So yeah, having that extra person, not strapping down our arms, right? That's something–Julie: I feel like that doesn't happen too much anymore but sometimes. Meagan: Really? I still see it, but I haven't been in a birth for a minute. Julie: Mm, in the OR. Meagan: I usually see one arm. Julie: That's weird. Meagan: I know. So yeah, there's that and then a clear drape if you want, maternal-assisted deliveries are really, really uncommon but I really hope that we can keep advocating for them and make a change to see them happening. They are happening in Australia and they obviously have pretty strict protocols and reasons for how and why and when, but it's happening. It's happening and it is up to us to ask the question and say, “Hey.” Maybe if enough of us ask the question in our Cesareans for a maternal-assisted Cesarean delivery, maybe someone is going to be like, “Okay. This is being asked for a lot. This is desired,” and maybe someone out there will start making a change. Julie: Sometimes, the way to make change is to keep asking for it. You might 1 of 1000 to ask for it before the change is made, but then with the next person, there will be change. I know that the next person getting the change and not you sounds like a bummer, do you know what I mean? But also, what if that next person is your daughter or your kid? So let's help pave the way for future generations too by continuing to ask for these things. Do you know what? Every time I have a client, regardless of whether it's a doula client or a photography client, I always ask if it ends up that they need to go back to the OR, I always ask. I know what hospitals are going to say yes and I know what hospitals are going to say no. I still ask even the ones that I know are going to say no because you never know why. A few months ago, I got allowed in the OR for a C-section as a photographer in a hospital that I have never been allowed in in the past almost 9 years now and even in the hospital chain. There is a whole chain of hospitals that is notorious for not letting us do that, but they let me in. The doctor and anesthesiologist were on board and it was fine and it was beautiful. I had this image that I took that is one of my favorite images ever. I sent it to the doctor and she is really happy about it. You've got to keep asking. Ask every time. You're going to get a bunch of no's before you get yes's, but you'll get yes's as you keep working and advocating for it. It takes a lot of us to make change. Meagan: Absolutely. I agree. I agree. 21:20 Common reasons for CesareansMeagan: Yeah, that also goes for asking for that extra person, asking for assisted delivery, and asking for music to be played. Always asking. Okay, they might be like, “No,” but if you don't ask, again, you don't know you have options unless you know the options you have. Does that make sense? I'm saying that backward. Julie: You are. If you don't know your options, you don't have any. Meagan: That's it. If you don't ask the question, you might not have the option is what I'm trying to say. Julie: Yes. Yes. Keeping baby, skin-to-skin, doing these things. We can make the Cesarean experience better. That doesn't mean that a Cesarean is always bad or traumatic if we don't have these things, but these are things that can help to make things better. Meagan: Yeah, so doing that and then also learning how to avoid unnecessary Cesareans. What types of things lead to Cesareans? We know that we have 4-5 most common ways that Cesareans are suggested or happen. One is breech. If your baby is breech, then you are more likely to have a Cesarean. Now, we do have things like external versions and Spinning Babies and chiropractic care and things that may encourage that baby to rotate. They may just rotate, but a lot of the time, we have providers just scheduling a C-section and that's it because we are not seeing people having babies vaginally with breech babies much anymore which is heartbreaking. Maybe we are being told, “Well, you're looking a little bigger and you're close to 41 weeks so let's just induce you.” Right? We've got due dates. We have breech fetal position. If you're in labor and your body is not progressing at the timeline that someone wants it to, failure to progress. We have small pelvis. Maybe you're at 10 centimeters and you've been pushing for two hours and your baby is having a harder time rotating, but instead of stepping back and looking at, “Hey, where is this baby's position?” or “Maybe this baby is really high up and we need to rest and descend,” we're just saying no. We're cutting it off and we're going to have a C-section. 25:59 Your hospital rightsMeagan: Let's see. What else, Julie? What are some things that you feel like we can learn to avoid Cesarean? Julie: I mean, all of those things you said are great, but I just want to pull it in a different direction for some reason. I'm so sorry. Meagan: No, that's fine. Julie: But knowing your rights. Knowing your rights. Meagan: That's funny because that's on this toolkit right now. Julie: I know. I'm staring at it right now, but I love where they say, “Consent forms from the hospital or provider are not contracts.” Meagan: I love that. Julie: They are not a replacement for true, informed consent discussion. They are not a replacement for a true and informed consent discussion. They are not. They are not contracts. You can revoke your consent at any time. No one is going to sue you because you signed the consent form. Do you know what I mean? Meagan: You can change your mind. Julie: Gosh, my mind is reeling right now. I feel like consent forms might be another way of coercion. Meagan: Mhmm. Julie: I really do. They are a way of coercing you into feeling like you are locked into this decision or you are locked into whatever consequences might come from that decision. But also, I feel like hospital policies are the same thing. Hospital policies are not contracts. Hospital policies are not an excuse to not have a discussion and get true, informed decision-making. Hospital policies, a lot of the time, are not set up to help the patient. They are set up to cover the butts of the providers and the hospital. I feel like when you are falling back on a consent form or when you are falling back on hospital policy, then that's another form of coercion, of getting people of what you want them to do because it's policy because you signed the consent form. Meagan: Exactly. Julie: Yikes. I can't stand it sometimes how parents don't feel like they can change their mind or how they don't have all of the information and maybe they wouldn't have made the same choices if they had all of the information or maybe not and it's not anyone's place to say what they would or would not have done. I'm not trying to vilify hospitals. I'm not trying to vilify providers or nurses or anybody who sticks to these policies and things like that because it's not their fault. It's the fault of the system that they have been born into. It really takes a lot, I think, for a provider and a nurse and an OB and a midwife or whatever to step up and go against the system. “Hospital policy says you have to have an epidural, but you can do just really do whatever you want. I don't care if you have one.” There is a midwife in our area, a hospital midwife who says that to every VBAC patient. She's like, “The hospital wants you to have an epidural, but you can totally say no. I don't care if you have one or not.” I've never had a client there who has an epidural placed just because they are a VBAC which is a whole other episode I feel like we are going to talk about at some point. Yeah, anyway. That's just where my mind was wandering. You have rights. Just because you are in a hospital doesn't mean you are in jail. You are not in jail. You are a human with rights and feelings that should be respected and talked to like an adult and not like a kindergartner who has to follow a strict schedule and go to recess at a scheduled time. Do you know what I mean? Anyway, sorry. I'm getting a little off-topic there. Meagan: No. I think it really goes hand in hand. Here are the reasons why Cesareans happen. I mean, there are other ones too. These are common ones. Okay, you've been pushing for 2.5 hours. Your baby is not making a ton of progress, but making slow progress. Your provider says, “All right. We're cutting this off. it's time. We're having a C-section. It's time. You have to have a C-section.” What are your rights in that situation? If you are like, “I am totally down for that.” Then, okay. But if it's like, “No, I don't want that,” but a provider is saying, “You have to. You have to. You have to. It's time. I won't do this anymore.” What are your rights in that situation? No one can perform a Cesarean, no one, unless you say, “Okay.” Julie: But they can manipulate and coerce you and tell you that your baby is going to die. You're not in your logical brain. You're in labor land so of course you're going to do a C-section. Meagan: Yeah. Yeah, exactly. There are things like that or there are true emergencies. We don't want to disregard those where it's seriously true and to save you and your baby. But you can say no. You also can say, “Thank you so much for your time. I'm going to keep going. Can you get another provider in here? You're fired.” That sounds crazy, but you can literally let your provider go in the middle of labor and in the middle of pushing. If it's not working for you, you can let them go. You're not in jail like she said. You can still make choices. It's just so important. I love that you brought that up. One, know the reasons why Cesareans are happening, but then really truly know your rights most of all. It's hard. It's so hard.Julie: Ideally— it is so hard. It is super hard. It is especially hard when you are in that position in the first place for one reason or another. But the best thing you can do to avoid getting put in a position like that where you are pushing and pushing and a provider wants to do a  C-section and now you have to fight for it is first of all, hire a doula, but second of all, don't be in that position in the first place. Leave the provider. Surely there are red flags. There are things that are telling you that this is not a right fit and a lot of times, we hear people say, “Gosh, I knew I should have switched, but I didn't.” Listen to that and honor that and honor things ahead of time because odds are by the time you get to that point, you're just going to do the C-section. 32:10 The safety of home birthJulie: I hate to say it, but I'm never going to dance around the issue or tell you a lie but if you are there and you've been pushing, you can't be the only one that wants to keep pushing. Yes, legally you can say, “No”, and legally, they have to provide care for you, but it's going to be a circus. It's going to be really hard to do that.Then what happens to your body? Your body is stressed out because it has to fight then that is not conducive to the natural labor hormones. I don't know. It's a hard fight. I feel like going back to I really like that ICAN is highlighting home birth as a safe and reasonable option after Cesarean because one of their graphics from 2023 highlights that there was a 2021 study that found home birth after Cesarean is associated with a 39% decrease in the odds of having a repeat C-section. 39% decrease, you guys. Meagan: Pretty impactful. Julie: I wish that more people would consider home birth as a safe and reasonable option. We were talking about this earlier before we started our episode. I was watching this show last night. You can tell me if you don't want me to tell you this. Meagan:  You can tell it. Julie: I was watching a show last night about mystery diagnoses where this provider is a doctor. She's a legitimate doctor and she's done lots of really cool things. She's started outsourcing diagnoses for people who have these mysterious medical diseases to social media. She goes through all their medical records and she makes reports and she broadcasts it on a blog and then people send in videos from all over the world about what they think the diagnosis is. It's really, really cool how she is using social media to help them when they are just baffled. There was this girl who has had 9 years without a diagnosis and it turned out to be this really simple thing that she just had to change her diet for. Anyway, I don't remember the name of the show but you can message me and I can tell you if you want. The point is that this provider is a doctor so she's been through all the schooling and everything. She said something that really stuck out to me. She said, “The goal of the hospital is to keep the thing that is trying to kill you from killing you.” I was like, “That is the goal of the hospital to keep the thing that is trying to kill you from killing you.” She said, “If you want solutions outside of that, you have to go outside of the hospital.” It just really hit home for me for birth.I know you guys might get sick of hearing me talk about home birth because most women do birth in a hospital, but the hospital's job is to keep you and baby alive. That is literally their job and it is their main focus. It is what they are going to be focusing on. It's why we intervene so quickly. It's why we rush to Cesarens so fast. It's because it's the easiest and fastest way to keep you alive. Now, out-of-hospital births also really love alive moms and babies. I'm just going to say that. It's not different. The goal is similar, but their focus is not on keeping the thing from killing you. Outside of the hospital, the goal is promoting the physiologic birth process and trusting the body to do the thing that it's made to do. Now, there are circumstances. I feel like we have to say this every time because there are circumstances where out-of-hospital birth is not a safe option for some people. There is a time when labor just needs a transfer to a hospital for additional care. But when the focus on out of the hospital, promoting the physiological birth experience and trusting the body versus the hospital where they are trying to focus on keeping you alive, you're going to have completely different levels of care. Those levels of care sometimes do more harm than good which is why out of hospital, when you're going for a birth after Cesarean out of hospital, your chance of having a C-section is significantly lower. I say significantly in the literal way by the study but also in the way we all think of it. 39% decrease in Cesarean is a huge deal. How are we thinking about birth? How are we addressing it in-hospital and how are we addressing it out-of-hospital? Not everyone is eligible for out-of-hospital birth and it's unfortunate that not everyone has those options, but for women with healthy pregnancies without complications, it is a reasonable option and it's worth looking into even if you just rule it out. There is my home birth soapbox. 36:52 Lower Cesarean rates = lower infant/maternal mortality ratesJulie: What are we talking about? Cesarean Awareness Month, yeah. Meagan: My home birth soapbox. Home birth can be an amazing option. It can obviously reduce the chances of things like interventions and even Cesareans that are unnecessary and pushing those things on people. Typically, I feel like my clients who are in home births really do feel this sense of– I don't know if awareness is right. Connection, maybe. They are more connected with their labor, their birth, and their team. I'm not saying people in the hospital aren't connected with their team or their labor or anything. Julie: It's so different. Meagan: It's different. It is. It's very different and until you've experienced or if you've experienced it, you know what we are talking about. There is something different and it's very unique. Julie: One more thing, sorry, and then I promise I will close it off. Meagan: No, you're just fine. Julie: I really like in here– I think it's worth pointing out because I'm sure there are going to be a lot of people cringing about what I just said about how the goal is to keep the thing from killing you. It's pretty well-known now. The United States has one of the highest infant and maternal mortality rates in the developed world. The highest in the developed world. Okay? But we have also the highest number of C-sections. One of the highest numbers of C-sections. Okay? I love one of these Cesarean Awareness Month graphics from ICAN states that most places that successfully reduce maternal mortality have a lower Cesarean delivery rate. I'm not just spurting out garbage, you guys. There is information and there is information and statistics and evidence to support that higher Cesarean rates do not equal safer births. Higher intervention rates do not equal safety for mom and baby. It's all over the place and I really love it since 2020 especially how there has been more information and more research coming out supporting the safety of home birth and home birth after Cesarean. It's just wild how much the medical system– or not the medical system as much as the people who do these reviews and systemic reviews are getting on board with showing the safety there. I'm not just talking about my anecdotal views as a birth worker. I'm talking about actual evidence for these things. I'm going to read that again. “Most places that successfully reduce maternal mortality have lower Cesarean delivery rates.” It's science. It's just science. Meagan: It's science. Julie: It's science. Okay, now I'm done. Meagan: Okay, it was back in November 2023 and it says, “Infant mortality in the United States provisional data from 2022 period linked/infant death file.” Now, this is going to be a lot but I'm going to have Paige, our amazing transcriber– Julie: Love Paige. Meagan: –and poster of our podcast put this in the show notes for you guys. If you want to go there and read a little bit about where things have gone, it breaks it down between the methods, the gestational age, the maternal race, infant sex, state of residence, maternal age, leading causes of death, and more. It's got a lot of studies and things like that and a lot of stats that could maybe be scary actually to find out, but also nice to know the information. We'll have that in the show notes. 40:38 A message to the CBAC communityMeagan: Then next on the goal of ICAN's mission is to help advocate for VBAC. I think this is one of the areas that a lot of the times our amazing CBAC community struggles with. I do not mean this in any– I don't mean to say this rudely, but a lot of moms who have had Cesarean birth after Cesarean dislike April because of this. I feel like I see it every year. It's a very tender topic and very hard. I mean, I'm going to always– for some reason, the radical acceptance episode that we did relates to so many things, but a lot of the time, we have unprocessed trauma, unprocessed guilt– guilt is a really big one. There is a lot to unpack and a lot of the time, that is not all processed or unpacked, and then April comes around and we're like, “Ugh. Everybody is advocating for VBAC when I wanted a VBAC too but I didn't have a VBAC. I didn't have that option or I didn't feel like I had that option” or whatever. There are so many things. “My body couldn't do it. I tried but it didn't work” or “I couldn't find the support despite looking for provider after provider.” I mean, there are tons of reasons why people have CBACs. I mean, I am a CBAC mom myself. I don't know if anybody knows that, but I am. I've had two Cesareans and I did want a VBAC. I was going for a VBAC and I ended in a Cesarean. Now, I didn't want that Cesarean at all, not even close. That was not what I wanted. But I had it and I tried to make the best of it. It was a healing experience. I am grateful for that Cesarean which a lot of people don't understand how I could possibly be grateful for the birth that I didn't desire, but that's something that I truly am. Julie: You had to work for it though. You didn't just get to be grateful. You had to work for that. Meagan: Really, truly work, and let me tell ya. I was still working pregnant with my third. Really, I was reading my op reports. I was so frustrated. I was bawling. I was like, “Why? Why did this happen? This was not what I wanted. Why didn't anyone tell me?” There were so many things so I get kind of wanting to feel angry about your unprocessed birth or your undesired outcome. I will promise you that in time– it might take years– it can come. It can. This healing can come and you can see Cesarean Awareness Month as a positive thing but also be an active participant in knowing that not only is it to help promote vaginal birth after Cesarean and lower the Cesarean rate, it's also to make Cesarean birth better. Julie: And safer. Meagan: And not have traumatic Cesareans as often and to support the CBAC as well. So I don't know. I feel like I'm talking in circles. I don't know how to say it, maybe, but my message to you is if you are struggling with Cesarean Awareness Month and if you are hating to see all of the posts and all of the things saying, “Yes, I got my VBAC” and “Yes, vaginal birth is better” or whatever. We see those all in the month of April. It's mid-April and again, we are recording this in February. I mean, I guarantee you that we've seen at least a dozen of these types of posts at this point when this is aired. Try your hardest to step back and also find self-healing within yourself so these months don't trigger you. April doesn't have to be a triggering month. It can be an empowering, motivational month to stand up and be like, “Hey. I didn't want that C-section either. It's not what I desired, but here I am and I am here to help people know their options for Cesarean and have a better outcome and reduce the Cesarean rate,” because yeah. I didn't want it either. Okay. I don't really know. I maybe am just off-base, but I just feel so passionately about our CBAC community too and I know. I see them. I see them struggle through April. If you are listening, I don't want you to struggle. I want you to hear a different message when you see Cesarean Awareness Month. Julie: I agree. I agree because it's hard. There is space for all of us here. There is space for all of us. Do you know what? Maybe, in April if you are really triggered with all of the Cesarean Awareness Month things, maybe the best thing you can do for your mental health is mute everything before they are talking about C-sections and VBACs and everything. Maybe you leave the group. Maybe you unfollow the page and then come back when it's a healthier time for you. Maybe that's the thing that you can do to love yourself the most if you're not in the space to confront your triggers head-on. Maybe that's the best thing for you and that's okay. It's okay to create space for yourself to grieve and heal and mourn that loss no matter what form that takes. But when you're in a more healthy spot, we absolutely want you to come back here and rally for us more. Rally with us, not for us. Rally with us more to improve access to better care options for our pregnant people to make Cesareans safer, to allow other support people in the OR, to increase evidence-based practices in hospitals, and things like that. It's just more than just about reducing the overall Cesarean rate. It's about so much more than that. We love you here. I mean, there is space for you here and we have all been there. We've all been there. Some of us are still in that journey and that's okay. We're all in all different spots of our journey and yeah. There's space for you and we love you. But if you also have to take a step back for a little while, we still love you and we honor that journey and we honor that part of you. Meagan: Mhmm, absolutely. Okay. We will leave this here and we will let you know right now. We love you. Just like she said, we honor your journey. We support you. Let's rally together. This month, let's build each other up and let's spread the information, and let's talk about our stories, and let's talk about how someone else can have a better experience based on learning. Download the toolkit. Check out the links right here in the show notes and Happy Cesarean Awareness Month. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

In today's very special episode, I'm joined by our dedicated Pitch It Perfect students who share their journey, from handling vague company responses to landing a single $2k brand deal! We'll discuss strategies like patience and persistence in follow-ups, and how important it is not to take rejections personally. My students bring up the ever-important question of how to strike the right balance between paid partnerships and selling their own services. Together, we explore the art of engaging an audience, the significance of local reputation, and why it's crucial to remain true to opportunities that excite us. Tune in as we talk through actionable insights on mindset, content creation, and growing your following. As well as how to transition from free brand features to paid collaborations and setting boundaries for future partnerships.  Liked this episode? Make sure to subscribe to our podcast and leave a review with your takeaways, this helps us create the exact content you want!  KEY POINTS: 04:25 Refused a bad deal, now grateful for it. 11:28 Focus on problem-solving to tap into emotions. 14:27 Struggling with abundance and exchange of energy. 17:40 Seek clarification regarding next steps promptly. 21:00 Monetizing social media through collaborations and products. 24:55 Pitching is essential for sales and partnerships. 29:45 Disappointment, focus on change, not others' actions. QUOTABLES: “This is showing you that there's always going to be an abundance of opportunity. There's so much. We will never in our lifetime be able to do as much as we would want to do because there's constant new creation coming at us all the time." — Julie “It's either a hell yes or a hell no. If it's hell no, I'm moving on. I don't have to think about it." — Julie "You kind of have to remind people 17 gazillion thousand billion times about what it is that you have to offer because most of the time they have no idea that it exists." — Julie RESOURCES: [FREE] Are you a content creator ready to take your brand collaborations to new heights? Grab the Brand Deal Playbook and unlock the secrets to securing paid partnerships with confidence. You'll gain free access to pitch templates, essential questions, and expert strategies that will propel your content creator journey to new heights, including immediate and lifetime access! [FREE] Want the step-by-step roadmap to grow your following, monetize your content, and land paid brand deals? Click here to join my brand new free class! This is perfect for you if you want to turn your social media into a profitable & fun career… even if you're starting from scratch! [ORDER] my book or Audible, Get What You Want: How to Go From Unseen to Unstoppable so you can leverage the power of your own influence. Follow Julie on Instagram! Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's episode is part one of a very special two-part series where I deep dive into some of our listeners' most engaging questions. If you're eager to turbo-charge your social media presence, you'll most certainly want to tune in as I'll be sharing proven strategies on how to grow your following and land those coveted brand deals in just 30 days, even if you're starting with a modest audience and juggling a hectic content creation schedule. I'll let you in on the secret to crafting a crystal-clear content strategy that resonates and attracts paying brands while blending the latest trends with your authentic voice to serve and truly connect with your audience. You'll learn how consistency, stellar content, and strategic use of insights can transform your social media game.  It's time to shine on social, so let's dive into the nitty-gritty of showing up, serving, sharing, and selling with heart and purpose. Liked this episode? Make sure to subscribe to our podcast and leave a review with your takeaways, this helps us create the exact content you want!  KEY POINTS: 05:43 Limit scrolling, focus on inner creativity, rejuvenate. 14:49 Consistent free content builds trust for sales. 18:15 Offer valuable free content, reserve exclusive method. 22:09 Promote content strategically on social media platforms. 25:18 Good lighting and audio matter on TikTok. On Instagram, curation may be important. 28:43 Check insights analytics to guide content strategy. 32:48 Consistent valuable content builds audience trust and engagement. QUOTABLES: “You can't really allow other people's ideas or directions to really infiltrate what it is that you're meant to show up and share on social media." — Julie  "People will always be able to feel the energy if you're doing something that you love. Enthusiasm leads to sales, enthusiasm leads to connection. Enthusiasm leads to building." — Julie “If you're gatekeeping and saving all of your valuable content behind a paywall, you're not going to build the know, like and trust that is vital to someone buying from you in the first place." — Julie “It's not just showing up to show up, it's showing up with valuable, engaging content that your ideal audience would want. Because that consistency is what helps you build the know, like and trust that you need to further, positively manipulate the algorithm to actually engage with the people that are following you." — Julie RESOURCES: [FREE] Are you a content creator ready to take your brand collaborations to new heights? Grab the Brand Deal Playbook and unlock the secrets to securing paid partnerships with confidence. You'll gain free access to pitch templates, essential questions, and expert strategies that will propel your content creator journey to new heights, including immediate and lifetime access! [FREE] Want the step-by-step roadmap to grow your following, monetize your content, and land paid brand deals? Click here to join my brand new free class! This is perfect for you if you want to turn your social media into a profitable & fun career… even if you're starting from scratch! [ORDER] my book or Audible, Get What You Want: How to Go From Unseen to Unstoppable so you can leverage the power of your own influence. Follow Julie on Instagram! Learn more about your ad choices. Visit megaphone.fm/adchoices

In Episode 55 of the Stronger Bones Lifestyle Podcast, host Debi Robinson welcomes back triple-certified nutritionist and functional medicine expert Julie Olson to discuss Oxalates and how they can affect your bone and body health.Julie 's mission is to help women worldwide restore their health, hope and hair naturally to look and feel their absolute best by linking health, lab results and lifestyle to avoid long-term medications, procedures and products. Listen today as she and Debi chat about demonizing bone healthy foods,  the many factors of oxalate intake, the information overload that can happen when you consult "Dr. Google," and why a healthy gut should be a priority.We hope you join us for this deep dive into Oxalates, including a look at the various studies about Oxalate consumption and a discussion on the importance of finding balance.Key  Takeaways:[2:42] What are oxalates.[4:33] Seed oil[6:17] Balance[8:15] Oxalate studies[9:57] The gut[12:15] Leaky gut[13:34] Vitamin C[15:00] Demonization of food[16:07] Collagen[16:41 Intestinal bacteria/gut microbes[18:53] Spinach[21:41] We just don't know enough about oxalates.[22:47] Detoxifying nutrients[24:51] Dietary factors[26:13] Invalid studies[27:44] Vegans and vegetarians[29:00] It is all related[30:43] What are oxalates made of[31:46] OAT test[34:27] Benefits of the high oxalate foods[38:48] Rhubarb[39:41] Various studies about oxalate consumption[45:17] Eating seasonally[47:35] Cooking for yourselfWhere to Find Guest:WebsiteInstagramEpisode 51 of Stronger Bones Lifestyle PodcastMemorable Quotes:"If your gut's not healthy you're not going only have a problem with absorbing more oxalates than normal you're going to have a lot of other problems too including bone loss." [11:54] – Julie“It's not that you shouldn't eat spinach, its that you need to heal your leaky gut.” [12:45] – Debi“A healthy gut will manage most of this.” [30:14]  -Debi“You can't exclude these foods forever thinking that's going to be the solution because it's not. They're healthy foods. You need to get your gut healthy.” [31:29] -Julie  To learn more about me and to stay connected, click on the links below:Instagram: @debirobinsonwellnessWebsite: DebiRobinson.comHealthy Gut Healthy Bones Program

About Julie Barlow and Jean-Benoît Nadeau: Julie Barlow and Jean-Benoit Nadeau are the award-winning and bestselling authors of The Story of French, The Story of Spanish, and the bestselling Sixty Million Frenchmen Can't Be Wrong. Julie Barlow is the author of 8 nonfiction books. In 2023, Julie published a comprehensive guide to self-employment with her husband and writing partner, Jean-Benoit Nadeau. GOING SOLO: Everything You Need to Start Your Business and Succeed as Your Own Boss, with Jean-Benoît Nadeau, drawing on the couple's three decades of experience as freelance writers. Born in Sherbrooke, Quebec, and a political science graduate of McGill University, Jean-Benoît Nadeau once held a job for 29 days and has been self-employed for 35 years. A regular reporter and columnist for L'actualité (Canada's leading national French magazine), he has also been a past contributor to the Report on Business Magazine. He has signed papers for various American, Canadian, and French publications. His freelancer status has allowed him to live in various venues like Phoenix, Toronto, Paris, and Montreal and undertake radio, film, and book projects, some of which with his spouse and partner Julie Barlow. They currently work as journalists based in Canada. He also published "The Story of French," "The Story of Spanish," and "The Bonjour Effect: The Secret Codes of French Conversation Revealed. " Their books have been translated into French, Dutch, Mandarin, and Japanese. Check out the latest episode of our Conversational Selling podcast to learn more about Julie and Jean-Benoît.In this episode, Nancy, Julie, and Jean discuss the following:Writers' transition from a creative role to the business aspectThe key messages in "Going Solo"Working more hours vs. thinking differentlyThe importance of understanding the client's expectations and needsThe value of negotiating on multiple levels simultaneouslyThe significance of saying "no" as a critical term in negotiationsConstructive refusal tips: polite ways to decline offersKey Takeaways:I'm a writer and a creator, but I'm also a business person, and I realized that I was the hierarchical equal of my client.You won't earn more if you work more; you'll earn more if you think things differently.The important thing that you do when you want to go solo is to understand your purpose and to love what you want to do.You immediately have intellectual property whenever you write something definite and not a list."The book is really for anybody who wants to start a business. But we're working from experience and maybe addressing more people in the creative field. Mind you, starting a business is creative, period. And I think one of the issues probably applies to all entrepreneurs. You know, you want to do something, be self-employed, and work from your passion. And then you very quickly must understand that it's a business. And it's hard for people to switch from being passionate about something to being business-like. And so, the book takes everybody through from the very beginning, writing your business plan through negotiation and operations and management and all the things you need to understand to make your passion make a living for you." – JULIE"It depends on whom you sell. Sometimes, the market that you have is very small. In effect, when we're magazine writers like us, we sell to about five or six publications. A lot of people publish these publications. But the person we must convince, the gatekeeper, is the editor-in-chief. And so, in that case, convincing them is putting together what we call the ingredients of a good idea, what's in it for them, what's so special about it. Sometimes, we have clients who are completely unknown to us. Some people want us to write a book on them. And so, in that case, most of the selling is just teaching the person how our business works because they have no clue. And if we do a good job there, we will have a client that will understand better where they will evolve." – JEAN"The book is about communication, particularly understanding your client's expectations and needs. So, for instance, we have people who want writing projects who don't really understand what involved the time and the work and what is involved in putting together some writing. So, part of our job is finding out how much they understand. And it's important to do that work sort of upstream from signing a contract with somebody and because it's all going to figure into how much you charge for it." – JULIE"I would say that you will quickly be busy once you have your business going. A very important thing is figuring out your purpose. Julie alluded to that. But you know, if you start a school for social dancing, you're not going to make all the hundreds of little decisions, whether your purpose is to start a franchise of school dancing or have your clients win the Olympics of social dancing or create a shoe for social dancing. You will not choose your clients in the same way as your venue, and you won't publicize in the same way. So, the idea of having a purpose, which is what you are doing this for, is very important. It's the essence of a business plan, which is not a 200-page document but a really, really a document about yourself. And knowing thyself better is the old Socrates motto, really applies to self-employed people." – JEANConnect with Julie Barlow and Jean-Benoît Nadeau:LinkedIn: https://www.linkedin.com/in/juliebarlow/LinkedIn: https://www.linkedin.com/in/jean-benoit-nadeau/Website: https://nadeaubarlow.com/Try Our Proven, 3-Step System, Guaranteeing Accountability and Transparency that Drives RESULTS by clicking on this link: https://oneofakindsales.com/call-center-in-a-box/   Connect with Nancy Calabrese:Twitter:https://twitter.com/oneofakindsalesFacebook:https://www.facebook.com/One-Of-A-Kind-Sales-304978633264832/Website:https://oneofakindsales.comPhone: 908-879-2911LinkedIn: https://www.linkedin.com/in/ncalabrese/Email: leads@oneofakindsales.com

Hearing about risk is hard. Interpreting risk is even harder, but deciding which risks are comfortable for you is an essential part of birth!Meagan and Julie discuss how to tell the difference between relative and absolute risk, and what kind of conversations to have with your provider to help you better understand what the numbers mean. They also quote many stats and risk percentages around topics like blood transfusions, uterine rupture, eating during labor, epidurals, Pitocin, AROM, and episiotomies.  And if you don't feel comfortable with accepting a certain risk, that is OKAY. We support your birthing in the way that feels best to you!Risk of Uterine Rupture with Vaginal Birth after Cesarean in Twin GestationsJournal of Perinatal Education ArticleWhat are the chances of being struck by lightning?Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:52 Review of the Week06:08 Determining acceptable risk for you and your provider 08:00 Absolute versus relative risk15:21 More conversations need to happen25:29 Risk of blood transfusion in VBAC, second C-section, and third C-section30:37 Understanding the meaning of statistical significance 32:05 “The United States is intervention intensive” 36:27 Eating during labor and the risk of aspiration under anesthesia43:03 Epidurals, Pitocin, AROM, episiotomies, and C-section percentages44:43 The perspective of birth doulas and birth photographersMeagan: Hello, hello everybody. Guess who I have today? Julie!Julie: Hello. Meagan: Hello. It's so good to have you on today. Julie: Of course. It's always fun to be here. Meagan: It really is. It's so fun. When we sit and chat before, it just feels so comfortable like that is the norm still for me even though it has been a while, it just feels so normal and I love it. I miss you and I love you and I am so excited to be here with you today. You guys, we are going to talk a little bit about risk. We know that in the VBAC world, there's a lot of risk that comes up. I should say a lot of talk about risk that comes up whether it be is it safe to even have a VBAC? Is it safe to be induced? What are our real risks of uterine rupture? Is it safe to VBAC with an epidural or without an epidural? What about at home out of the hospital? Is that safe? I don't know. Let's talk about that today. Julie: Let's talk about it. Meagan: Let's talk about it. I think it's really important to note that no matter what— and we're going to talk about this for sure today, but no matter what, you have to take the risks that you are presented and that is given and still decide what's best for you. That risk doesn't mean that is what you have to or can't do. Right? So I think while you are listening, be mindful or kind of keep that in the back of your mind of, “Okay, I'm hearing. I'm learning.” Let's figure out what this really means and then let's figure out what's truly best for you and your baby.02:52 Review of the WeekI do have a Review of the Week so I want to hurry and read that, then Julie and I will dive into risk and assessing. Julie: Dun dun, we're ready. Meagan: We are ready. Okay, holy cow. This is a really long review, so—Julie: You can do it. Meagan: Thank you to Sara R-2019 on Apple Podcasts for leaving this review. I love how Julie was like, “You can do it,” because she knows that I get ahead of what I'm reading in my mind and then I can't read, so let's see how many times it takes to read this review. Julie: You've got this. Meagan: Okay. It says, “A balanced and positive perspective.” It says, “As a physician myself I think it is unusual to find balanced resources for patients that represent the medical facts but also the patient experience and correct for some of the inaccuracies in medicine. This podcast does an amazing job of striking this balance!“I had an emergency C-section with my daughter 2 years ago. Despite understanding that the CS was medically appropriate and my professional experience, I still found the whole experience to be mildly traumatic and disappointing. This podcast was the main resource I used to help prepare for my second child's birth and my plan to have a VBAC. I am now holding my new baby in my arms with so much pride, love, self-confidence, and trust because I had a smooth and successful VBAC.“I am thankful for this podcast which gave me ideas, confidence, strength, and a sense of community in what is otherwise a very isolating experience. I especially appreciate the variety of stories that are shared, including VBAC attempts that result in another C section so that we can all prepare ourselves for the different outcomes. No matter what happens we are strong women and have a welcome spot in this community, even when we may feel alone with our thoughts and fears. Thank you, Julie and Meagan!Julie: Aw, I love that. Meagan: Yes, that was phenomenal. Congratulations Sara R-2019. If you are still listening here, congratulations and we are so happy for you and thank you for your amazing review. 06:08 Determining acceptable risk for you and your providerMeagan: All right, Julie. Are you ready? Julie: Here we go. Here we go. Can I talk for a minute about something you mentioned before the review? You were talking about risk and how it's not a one-size-fits-all because we were talking about this before. We all know that the uterine rupture risk is anywhere between .2%-1% or whatever depending on the study and what you look at. The general consensus among the medical community is .5%-1% is kind of where we are sitting, right? Now, some people might look at that risk and be like, “Heck yeah. That's awesome. Let's do this,” especially when you look at a lower risk than that that it's a catastrophic rupture. Some people might look at those numbers and be like, “This feels safe. Let's go.” Some people might look at those numbers and be like, “This feels scary. I just want to schedule a C-section.” Meagan: No, thank you. Julie: And that's okay. It is okay. However you approach risk and however you look at it is okay. We're not here to try and sway anybody. Obviously, we're The VBAC Link, so we are going to be big advocates for VBAC access, right? But we're also advocates for having all of the information so you can make the best decision no matter what that looks like. But also, I think another very important part of that is finding a provider whose view of risk is similar to your view of risk so that you guys have a similar way to approach things because if you find a provider who thinks that 1% risk of VBAC is really scary, it's not going to go good for you if you think a 1% risk for a VBAC is acceptable. So yeah, I just want to lay that out there in the beginning. Meagan, you touched on it in the beginning, but I feel like provider choice in risk is really important there. Meagan: It is. Julie: For sure. 08:00 Absolute versus relative riskMeagan: It is and also, one of the things we wanted to talk a lot about is absolute risk versus relative. So many times when people, not even just the actual percentage or 1 out of 5 is shared, it's the way it's shared. The way the words are rolling off of the tongue and coming out can be shared in a scarier way so when we say 1 out of 5, you're like, “Okay, that's a very small number. I could easily be one of those 5's.” It's the way these providers sometimes say it.  A lot of the time, that's based on their own experience because now they are like, “Well, I am sharing this number, but I'm sharing a little extra behind the number because I've had the experience that was maybe poor or less ideal.” Does this make sense? Julie: Yeah. Meagan: Sometimes the way we say things makes that number seem even bigger or even worse or scarier. Julie: Right. It really comes down to absolute risk versus relative risk, right? Relative is your risk in relation to another thing that has risk. Absolute risk is the actual number. It's like 1 in 10. That is an absolute risk. You have a 1 in 100 chance of uterine rupture. That is an absolute risk. Your chance of uterine rupture doubles after three Cesareans. That's not true. That's not true. But that's a relative risk. I really like the example that I feel is really common for people to relate to is stillbirth after X amount of weeks. Evidence-Based–Meagan: That's a huge one. Julie: Yeah, it's a big one that gets thrown around all of the time and it sounds really scary when people say it. I love Evidence Based Birth. They have this whole article about due dates and risks associated with due dates and why due dates should really be adjusted and look at differently. They don't say that. They just present all of the data, but what I really like about that is they have a section here about stillbirth and they talk about absolute risk versus relative risk. I feel like that would be a great thing to start with. I'm just going to read it because it's so well-written. They said, “If someone said that the risk of having a stillbirth at 42 weeks compared to 41 weeks is 94% higher, then that sounds like a lot.” Your risk of stillbirth doubles at 42 weeks than if you were to just get induced at 41 weeks. Your baby is twice as likely to be stillborn if you go to 42 weeks. Meagan: Terrifying. Julie: Okay? 94% higher. That's almost double. That is scary. For me, I'd be like, “Uh, yeah. That is super scary.” Meagan: Done. Sign me up for induction. Julie: Right? Sign me up for induction. But when you consider the actual risks or the absolute risks, let's just talk about those numbers. 1.7 per 1,000 births if they are at 41 weeks. Stillbirth is 1.7 per 1000 births. At 42 weeks, it's 3.2 per 1000 so it's a .17% chance versus a .3% chance so you are still looking at really, really, really small numbers there. So yeah, it's true. 3.2 is almost double of 1.7 if you do the math. Sometimes math is hard so that's fine. We have to get out the calculator sometimes, but while it's true to say the risk of stillbirth almost doubles at 42 weeks, it could be kind of misleading if you're not looking at the actual numbers behind it. So I think that it's really important when we're talking about risks and the numbers and statistics to understand that there are different ways of measuring them and different ways of looking at them and different ways of how they're even calculated sometimes. So depending on how you look at them, you could even come up with different risks or different rates which can really sway your decision. We're not talking about a 5%-10% double which is still true. It's still double, but it's just a really small number. Now, I also want to do a plug-in for people who have been in that .3%. It might as well be 100%. I can't even imagine the trauma of having to have a loss like that. I can't. I have supported parents through that. I have documented families like that and documented their sweet babies for them. I can't imagine the pain that goes with that. But I also think it is very important to look at the actual numbers when you are making a decision. Now, maybe that .32% is too high for you and that's okay, but maybe it's not and that is a risk you are willing to accept. I feel like approaching it like that is so much better. If somebody ever says to you, “This risk of that is double” or whatever, I don't know. I'm just going to make up some random stuff here like, “If you drive in your car to school, you have a 1 in 10 chance of getting in a car crash but if you drive on a Wednesday, your risk doubles so now you have a 2 in 10 chance or 1 in 5 chance of getting in the car crash,” so maybe you would want to avoid driving to school on Wednesdays, but maybe you wouldn't. But if you say you're risk is higher of dying in a car crash if you go to school on Wednesdays, they would be like, “I'm not leaving the house on Wednesdays or ever.” I'm not leaving the house today because it's so dog-gone cold and I'm warm in my blanket. I don't know. I feel like looking at it like that. Actually, 1 in 10 is really high for getting in a car crash, but I don't know. I just feel like looking at that is really important for providers telling you, “Oh, your risk of uterine rupture doubles if we use Pitocin so I'm not going to use Pitocin.” Okay, we're looking at a small increase to an already small risk. We know that any type of artificial induction could lead to an increased risk of uterine rupture especially if it's mismanaged, but what we do know is that it's not– I don't want to say that because that might be wrong. When you are presented with the actual numbers, yes. It might double. I don't know what the actual numbers are, to be honest off the top of my head. I feel like maybe it doubles, but if you are already looking at a .2% to a .4% or a .5% to a 1% chance, what's the tradeoff there? What are your risks of just scheduling a repeat C-section instead of doing an induction? Is that worth it to you? What are the risks associated with repeat Cesareans? Are they bigger than that of using Pitocin to induce labor? What is that compared to the other one because there is another that is relative risk? The absolute risk is what the percentage is. I'm not even going to say the number. But if there's a risk of rupture using Pitocin relative to the risks that come with repeat Cesareans, those are risks that are relative to each other, so how does that compare? Because when we talk about it in just that singular form or that singular amount of risk without considering the other risks that might be associated with it because of the decisions we made from that risk– am I making sense here? Then you know, I don't know. I feel like there is just a lot more conversation to have sometimes when we are talking about risk. 15:21 More conversations need to happenMeagan: Yes. There are. There is a ton more conversation and that is what I feel like we don't see happening. There's a quick conversation. Studies show that 7 minutes are spent in our prenatal visits which is not a lot of time to really dive into the depths of risk that we are talking about when we say, “We can't induce you because Pitocin increases–”. This is another thing I've noticed is significantly. You have a serious–. Again, it comes down to the words we are using. Sometimes in these prenatal visits with our providers, we do not have the time to actually break down the numbers and we're just saying, “Well, you have a significantly higher risk with Pitocin of uterine rupture so we won't do that.” When we hear significantly, what do we do? We're like, “Ahh, that is big.” You know? Julie: Yeah. Meagan: We're just not having the conversation of risk enough and again, it's kind of being skewed sometimes by words and emotion. We were talking about this before. I remember we made a post– I don't know, probably a year and a half ago maybe. It seems like a while ago about the risk of complications in a repeat Cesarean meaning you have a C-section and then instead of going for a VBAC, you go for a repeat Cesarean which as you know, if you've been with us, is totally fine and respected here from The VBAC Link. A lot of the time, we don't talk– and when I say we, I mean the world. We don't talk about the actual risk of having a repeat Cesarean, right? Don't you feel like that, Julie? I don't know. As a doula, I feel like our clients who want to go for VBAC know a little bit more of the risk of having a VBAC, but they have not been discussed at all really with the risk surrounding a repeat Cesarean. We made a post talking about the risks of repeat Cesarean and I very vividly remember a lot of people coming at us with feeling that we were fearmongering.Julie: Or shaming. Meagan: Shaming, yep. A lot of people were feeling shamed or disrespected. People would say, “You claim to be CBAC supportive, but here you are making these really, really scary numbers.” Anyway, looking at that post and going into what we've talked about, in some of those posts, we did say things like, “You are going to have a 1 out of 10 chance of X, Y, Z,”Julie: Or twice as likely to need this. Twice as likely to need a blood transfusion or 5x more likely to have major complications. Things like that. Meagan: Yeah. We would say things like that. I remember specifically in regards to miscarriage. It's a very, very sensitive topic, but there are risks there. So a lot of people were triggered. In the beginning, we talked about the way providers say things and the way they put them out on paper and the absolute risk versus the relative and way they do that. We're guilty of that too. Right here at The VBAC Link, we were like, “This is the chance. These are the chances. You are 5x more likely to X, Y, Z.” So know that I don't want to make it sound like we are shaming anybody else for the different ways that they give the message of risk. Am I making sense? Julie: Yeah, and you know what? I feel like sometimes it's just about giving people the benefit of the doubt. We want to give providers the benefit of the doubt just because it's probably something that they've continuously heard and spoken and that's okay because we do it too sometimes. We go on that thing like, “Oh my gosh, maternal death.” I think the risk of maternal death is 10x higher in a C-section than it is in a VBAC which sounds really scary and makes me never ever want to have a C-section again, but when you look at that, it's .00001% to .0001% or whatever is 10x more. It is such a small level of risk, but it is higher. I feel like trying to look at both absolute and relative risk for any given thing together is really, really important. Yeah. Give people the benefit of the doubt. Give us the benefit of the doubt. We are in such an awful cultural climate right now where it's easy for people, especially on social media to jump on the attack train for anybody when we feel triggered or when we feel like people are being unjust to us or to other people and I hate that so stinking bad. Whenever I catch myself with those feelings, I try to take a step back and I've actually gotten pretty good at that, but it's so easy for us to get on that bandwagon of just railing against people who present information in certain ways or railing people without getting all of the information about that person.Before I go off too much on a soapbox in that direction, yeah. I feel like your provider when they are saying those things is probably not trying to coerce you into anything. Our providers, especially our hospital providers are incredibly overworked. They are incredibly stressed. Their time management skills have got to be off the charts because they are so overloaded with everything and they just don't have time to automatically sit down and explain things. But you know what I have found? Most of them, when you stop them and ask questions, they are more than happy to answer and explain. Sometimes, they are just repeating things they have heard all the time or that they have learned at some point or another without giving them a second glance. Do you know what? We all do that too. Me, Meagan, you listening right now. We all do that. We hear things. We regurgitate them. We hear things. We regurgitate them and we don't even think about questioning or challenging those things until somebody else brings it up to us to question or challenge those things. So, don't be afraid to ask your provider for more information or ask them what the real numbers are to those things. I have a really special place in my heart for our CBAC moms because there are lots of things that they are working through, so many emotional things, but I challenge not just people who have had a repeat Cesarean that was unwanted, but people just in all life, when something triggers you online, stop and explore that. Stop and question because that is probably an area of your life that you could use a little healing and work on. It could be a little bit of work. It could be a lot of work, but usually, when something triggers you, it's a challenge to look into it more because there is something that your body and mind have an unhealthy relationship with that needs to be addressed. Julie: Anyways, circling it back to risk. Meagan, take it away. Meagan: I just want to drop a shameless plug on our radical acceptance episodes that we did, so kind of piggybacking off of what she just said. We dive into that a little bit deeper in our radical acceptance episode. It really is so hard and like what she said, our heart goes out to moms that have a scheduled C-section that didn't want to schedule a C-section or felt like they were in a corner or felt like that was the best option, but not the option they wanted. There are so many feelings, but definitely go listen to radical acceptance part one and part two. 25:29 Risk of blood transfusion in VBAC, second C-section, and third C-sectionMeagan: I just want to quickly go down a couple of little risks. Blood transfusion– we have a 1.89% or 1 in 53 chance of a blood transfusion with a VBAC. To me, 1.89% is pretty low, to me, but it might not be to some. I don't know, Julie. How do you say the other? Okay, then blood transfusion in a repeat Cesarean is 1.65% in the second C-section. It's lower. So for vaginal birth, it's higher. I'm not good at math. Julie: No, vaginal birth, yeah. That's true. So 1 in 53 for VBAC versus a 1 in 65 for a repeat Cesarean. Yes, right. Meagan: For a third Cesarean, the chances of a blood transfusion go to 2.26%. Julie: Yes, so it's like 50% higher than if you have a VBAC for the third Cesarean, but it's slightly lower for the second C-section. See? I feel like we could have talked about this before, but I don't know if we say it often enough. When you are talking about overall risk for VBAC versus C-section, when you are looking at just the second birth, right? So first birth was a C-section, what are you going to do for your second birth? The risks overall are pretty similar for vaginal birth versus Cesarean. The overall total risk is pretty similar as far as your chances of having major complications and things like that. But when you get into three, four, five, six C-sections and vaginal births, that's when you really start to see significant changes in those risks. See? I used the word “significant” again, but we're going to talk about where the more C-sections you have, the higher your chances of having complications you have. The more vaginal births you have, your chances of complications actually go down. So when you are looking at if you want more than two kids, that might be something that you want to consider. If you are done with two kids, then that might be something that is not as big of a player in your choices. So yeah. Meagan: Yeah. Then there are things like twins. So when I was talking about it earlier, the word significantly, there was a systematic– I almost said something– systemic. Julie: Systemic review? Meagan: Yeah, see? I can't say it correctly. I can't. Published– oh, I'm trying to remember when it was published. We will get it in the show notes. It talks about the risk of uterine rupture with twins and it does say. It says “significantly higher in women with twin gestation”. That's kind of hard, I feel like because again, like we were saying, some reviews and studies and blogs and all of these things wouldn't say the word significantly. They may share a different one. I'm going to see if I can find the actual– maybe Julie can help me while I'm talking– study. Okay, it says three out of four studies in a group of zero cases of uterine rupture. Notably, the study with the largest patient population reported cases of uterine rupture in both groups and demonstrated a significantly greater risk of uterine rupture in the VBAC group. Meanwhile, the other three studies found no significant difference between rates of uterine rupture among groups 31-33. Nevertheless, the study shows that electing–”Okay, so I'm just going to say. It says, “Electing to have a PRCD reduces but does not eliminate the small risk of uterine rupture.” So what I'm reading here is that in some of them, it showed significantly greater, but then in 3 out of 4 reviews, and I don't even know actually how many people were in each of these reviews, but in 4 reviews, one had a greater risk and three didn't really show much of a difference, but we see that in the very beginning right here. “Uterine rupture is significantly higher in women with twins.” What do you think? If you are carrying twins and you see that, Julie, significantly higher enters into the vocabulary at all, what do you think?Julie: Well, I think I would want to schedule a C-section for my twins, probably. Meagan: Probably. 30:37 Understanding the meaning of statistical significance Julie: I want to just go off on a little tangent here for a second. I think it's really important when we are talking about studies that we know what statistically significant means because sometimes if you don't know much about digging into studies and things like that which I'm not going to go into too much right now– Meagan: It's difficult. Julie: It is difficult. It's really hard which is why I'm not going to go into it because I feel like we could have a whole hour-long podcast just for that. Statistically significant really just means that the difference or the increase or the change that they are looking into is not likely to be explained by chance or by random numbers which is why when you have a larger study, the results are more likely to be statistically significant because there is less room for error basically. A .1% increase can be just as statistically significant as a 300% increase because it just comes down to whether they are confident that it is a result that is not related to any chance or external environmental factors. I feel like it's really important to clarify that just because something is statistically significant doesn't mean that it's big, catastrophic, or a lot, it just means that it's not likely to be due to chance or anything random. 32:05 “The United States is intervention intensive.” Meagan: Yeah. I love that. Okay. There was one other thing I wanted to share. This was published in the Journal of Perinatal Education and it is a little more dated. It's been 10 years or so, but I just wanted to read it because it was really interesting to me. It doesn't even exactly go with risk and things, but it just talks about your chances which I guess, to me– do you know what I”m trying to say? Julie: They kind of go hand in hand. Meagan: To me, at least, they do. So when I read this, I was like, “Well, this is interesting.” I just wanted to drop it here and I think it's more just eye-opening. It says, “Maternity care in the United States is intervention intensive.” Now, if we didn't know this already, I don't know where I've been in the doula world for the last 10 years. Right? You guys, as doulas, obviously, we're not medical professionals, but as doulas, we see a lot of intervention and a lot of intervention that is completely unnecessary and a lot of intervention that leads to traumatic birth, unexpected or undesired outcomes and then they lead to other unnecessary interventions. It's the cascade. We talk about the domino effect or the cascade of interventions, but this is real so for them to type out, “Maternity care in the United States is intervention intensive–”Julie: You're like, “Yeah, where have you been?” Not you, but the writer. Meagan: Yeah, the writer. Yeah. It says, “The most recent national survey–” Now, again keep in mind it is 2024. This has been a minute since this was written. Julie: About 10+ years. Meagan: 10-12 years. Just keep that in mind. But it was interesting to me that even 10-12 years ago, this was where we were at because I feel like since I started as a doula, I've seen the interventions increase– the inductions, the unnecessary Cesareans increase a lot. Julie: Some of them, yeah. Yeah, especially inductions and Pitocin. Meagan: Not all of the time. I cannot tell you that in 10 out of 10 births that I attend, this is the case but through the years of me beginning doula work and what I have witnessed, it's increased. At least here in Utah, it seems that it has increased. It says, “The most recent national survey of women's pregnancy, birth, and postpartum experience reports that for women who gave birth in June 2011-2012,” so a little bit ago, “89% of women experienced electronic fetal monitoring.” Okay. Julie: That seems actually low to me for hospital births. Meagan: It does seem low because to me–Julie: I wonder if there had been a ton of stop and drops or something. Meagan: I don't know, but I agree. 89%. I feel like the second you get into the hospital, no matter VBAC or not, they want to monitor your baby. Julie: Strapped onto the monitor, yeah. Meagan: It says, “66% continuously.” So out of the 89%, it says 66% were continuously meaning they didn't do the intermittent every 30 minutes to an hour checking on baby for a quick 15 minutes to get another baseline, they just left that monitor on them which makes me wonder why. Usually, when a client of mine goes in and has that, they're like, “Oh, your baby had a weird decel so we are going to leave the monitor on longer,” and then they don't say anything. They just keep it on there. Maybe that's– I don't know. It says, “62% received intravenous fluids.” Julie: IV fluids. Meagan: Which to me, is also a lot. 36:27 Eating during labor and the risk of aspiration under anesthesiaMeagan: “79% experienced restrictions on eating.” 79%. You guys, we need to eat. We need to fuel our bodies. We are literally running a marathon times five in labor. We shouldn't be not eating, but 79% which doesn't surprise me, and “60% experienced restrictions on drinking in labor.” Why? Why are we being restricted from drinking and eating in labor unless we have other plans for how labor may go? Julie: That's exactly what it is. They're preparing you for an emergency Cesarean. That's what they're doing. That's exactly what restricting non-IV fluids is. It's not only that, but it is preparing you for the incredibly low risk of you having to go under general anesthesia, and then even people that go under general anesthesia have an incredibly low risk of aspirating and that is what it's coming down to. Don't even get me started on all of the flaws in all of the studies that went over aspiration during general anesthesia anyway because they are so significantly flawed that we are basing denying women energy and fuel during labor based on flawed studies that are incredibly outdated and on incredibly low risk during an incredibly already low risk. I mean, you probably don't want to down a cheeseburger while you're having a baby. I don't know. Maybe me. Just kidding. Even I didn't want a cheeseburger, but I wanted some little snacks, and some water to keep you hydrated. Yes. Oh my goodness. Let's please stop this. Sorry. Stepping off the soapbox. Meagan: You know, there is a provider here. I actually can't remember her name. It was way back in the beginning of my doula career and actually, it was in an area that is not one of my more common areas to serve. It was outside of my serving area. Anyway, we were at a birth and there was an induction. I remember being in there with her and the provider, an OB, walks in and is like, “Hey, how are you doing?” He was so friendly and kind and asked some questions like, “How are you feeling? What are you thinking about this?” Then she was getting ready to leave and she turned back and said, “Hey. I just thought about this. Have you eaten anything?” The mom was like, “No.” She was like, “Uh, you need to eat.” Julie: Yeah!Meagan: She had an epidural at this point. The mom was like, “Wait, what?” She was like, “You need to eat.” I literally remember my jaw falling, but had to keep my mouth up because I didn't want to look like I was weird. Anyway, I said, “That's something I've not usually heard from an OB especially after someone's had an epidural.” She was like, “Oh, I am very passionate about this.” She was like, “When I was finishing up school and graduating,” she had to write some big thing. Julie: Her dissertation probably. Meagan: Time capsule, I don't even remember what it was called. Some really, really big thing. She was like, “I specifically found passion about the lack of eating and drinking in labor.” She was like, “I did all of this stuff and what I found was you are more likely–” Here comes risk. “You are more likely to be struck in the head twice by lightning–” This is what she said. “Twice by lightning than you are to aspirate in a Cesarean after having an epidural.” Julie: I love this lady. Who is it? Meagan: I can't remember. I will have to text my client. Julie: Where was it? What hospital? Meagan: It was up in Davis County. Julie: Oh, interesting. Meagan: It was not an area for me. I said, “Whoa, really?” She said, “Yeah. You need to get that girl some food.” I was like, “Done. 100%.” Julie: More likely to get struck by lightning. Meagan: More likely to get struck by lightning twice in the head than you are to aspirate in a Cesarean after receiving an epidural. That stuck with me forever. Literally, here we are 10 years later. Julie: I love that because first of all–Meagan: I don't have documentation to prove that. She just said that. Julie: That is 100% relative risk. Aspirating during a C-section relative to getting struck by lightning twice. So that's cool. What are the numbers? I know that the numbers are super incredibly low and I feel like when you put in context like that, getting struck by lightning twice, I don't know anybody that's been struck by lightning once and who has been alive to tell about it. I know of a friend whose sister got struck by lightning and died when she was very young. I only know one person in my entire life who has been struck by lightning. Meagan: I just looked it up really quick. I don't even know if this is credible. I literally just looked it up really quickly. It says that the odds that one will be struck by lightning in the US during one's lifetime is 1 in 15,300. Julie: Wow. Meagan: Okay. Julie: So twice that is 1 in 30,000. That's a freaking low risk. Anyway, what I'm saying is that I love that OB first of all. I feel like from what I've read about aspiration under general anesthesia during a C-section seems right in line with those numbers and those chances because it's so rare, it's almost unheard of especially now with all of the technology that we have. It's fine because I'm not going to go on that soapbox. I love that. I love that analogy and that we're talking about that because 10 years from now or when our daughters are having babies, they're going to talk about how their poor moms couldn't eat when they were in labor because of the policies just like we talk about the twilight sleep and how our poor grandmas had to undergo twilight sleep when our moms were being born. I feel like that's just going to be one of those things where we will look back and be like, “What were we thinking?” 43:03 Epidurals, Pitocin, AROM, episiotomies, and C-section percentagesMeagan: Okay, I'm going to finish this off. It says, “67% of women who gave birth vaginally had an epidural during labor and 37% were given Pitocin to speed up their labors.” Sorry, but come on. That also may go to show, that we're going to do an epidural episode as well, that epidural maybe does really slow down labor. Maybe it really does impact the body's response to continuing labor in a natural way, so 31% of those people had to have help and assistance. It says, “20% of women had their membranes artificially ruptured,” which means they broke your bag of water artificially with the little whatever, breaking bag water hook thing versus it breaking spontaneously. Julie: Amniohook. Is it an amniohook? Meagan: Amniohook, yeah. “17% of women had an episiotomy.” I don't know. Julie: I feel like those numbers are probably lower now. Meagan: I think that's changed, yeah. “31% had a Cesarean.”Julie: That is right in line with the national average. Meagan: It is, still. “The high use of these interventions reflects a system-wide maternity care philosophy expecting trouble. There is an increasing body of research that suggests that the routine use of these interventions rather than decreasing the risk of trouble in labor and birth actually increases complications for both women and their babies.” 44:43 The perspective of birth doulas and birth photographersJulie: I believe it. Do you know what? Can I just get on another tangent here because I know that you all love my tangents? I really wish that somebody somewhere would do something and I don't know what that something is, to get the voices of birth doulas and birth photographers heard because this is why. Doulas and birth photographers– I've said this before. We see births in all of the places. We have a really, really unique point of view about birth in the United States because we attend births at home. We attend unassisted births. We attend births at home with unlicensed providers. We attend births at home and births at birth centers with licensed providers. We attend in-hospital births with midwives and we attend in-hospital births with OB/GYNs and some of us are lucky enough to attend out-of-hospital births with OB/GYNs because there are a handful of them floating around. We see birth in every single variety that it takes in the United States. I really wish that someone somewhere would do something to get those voices lifted and amplified because I feel like yes, a lot of that is going to be anecdotal, but I feel like the stories there have so much value with the state of our system in the relationship between home and hospital birth, how birth transfers happen when births need to be transported to hospitals, the mental health of the people giving birth, the providers and the care, and all of that. I feel like, like I said, somebody should do something to do something with all of that information that we all carry with us. I think it could provide so much value somewhere, right? I don't know what yet, but if anybody has an idea, message me. Find me on Instagram at @juliefrancombirth. Find me. Message me if you have any ideas. Maybe write a book or something. I don't know. Meagan: I've wanted to do an episode and title it “From a Doula's Perspective”. We could do that from a birth photographer and all that, but it's crazy. It's crazy. Julie: We see it all. Meagan: There was a birth just the other day with one of our sweet, dear clients where the provider was saying things that seemed scary even though the evidence of what was happening was really not scary, went into a scheduled induction, and the way they were handling it, I felt so guilty as a doula and I was like, “This is going to turn Cesarean. This is not good.” Sure enough, it did and it broke my heart because I was like, “None of that needed to happen,” but again, it goes to us deciding what's best for us. That mom had to decide what was best for her with the facts that we were giving, what the doctor was giving, and all of these things. Again, we don't judge anyone for the way they birth, but it's sometimes so hard to see people not get the birth they wanted or desired, or to have people literally doubt their ability because someone said something to them. Julie: Yeah. Meagan: You know–Julie: Yeah. I agree. It's just interesting. Anyways. Meagan: We are getting off our topic of risk, but risk is a hard conversation to have because there are different numbers. It can be presented differently and like I said, it can also have a tone to it that adds a whole other perspective. So know that if you are given a risk, it's okay to research that and question it and see if that really is the real risk and if that's the evidence-based information. We like to provide them here like we were saying earlier. We may be guilty and I hope you guys stick with us if we share some that might be a little jarring on both sides of the VBAC and C-section, but we love you. We're here for you. We understand risks are scary. They are also hard to break down and understand, but we are here for you. I love you guys and yeah. Anything else, Julie?Julie: No. I just want to say be kind to each other. Give each other the benefit of the doubt. Do everything you can to make the best decisions for you. Trust your intuition and find the right support team. We're all just trying to do our best– us at The VBAC Link, you as parents, providers as providers, and if you feel like you need to make a change, make it. Meagan: Make it. All right, okay everybody. We'll talk to you later. Julie: Bye!ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

We know that unique circumstances in pregnancy can make a VBAC feel farther out of reach. Do your chances of having a VBAC go down if you had preeclampsia in a previous pregnancy or your current one? What if you have a special scar? What are the chances of having a VBAC if you were diagnosed with “failure to progress”? What about fibroids or gestational diabetes? Julie Francom joins Meagan on today's episode discussing evidence-based research around all of these topics. They share personal experiences as birth workers and overall takeaways that can help you confidently navigate your VBAC journey no matter what complications arise during your pregnancy. Additional LinksSpecial Scars StudiesThe VBAC Link Blog: Why Failure to Progress in Labor is Usually Failure to WaitAJOG ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Timestamp Topics02:54 Review of the Week5:51 Preeclampsia08:57 Ask questions12:51 Special scars17:58 Failure to progress26:15 Fibroids27:54 Gestational Diabetes35:06 Find a supportive provider, ask questions, and educate yourselfTranscriptMeagan: Hello, hello everybody. We are getting out of winter and maybe into some spring weather, hopefully. I always hope for spring weather in March because it's my daughter's birthday and she always wants sunshine, not snow for her birthday. So I'm crossing my fingers that this is the month we have sunshine, not snow. I hope you guys are having a wonderful beginning– well, I guess it's not actually spring, but I hope you're having a wonderful beginning of March. We are kicking off our very first Monday episode for 2024. You guys, we have a little surprise for you. We are going to be sending out two, not just one, but two episodes a week. Make sure to tune in on Mondays and Wednesdays for stories and information. Today, we are kicking it off with Julie. Hello. Julie: Hey. I'm so happy to be here and yes, I'm hoping it's warm or getting there because I am just a popsicle permanently from November to March so let's just thaw out a little bit, please. Meagan: Just a little bit. Even if we just get some little sprinkles, let's have April showers in March. Julie: Yeah. Meagan: You guys, I am so excited for today's episode. Julie and I feel like these are some questions, I am definitely getting these questions on the weekly Q and A's, but these are some questions that are often asked and we want to answer your questions today. We're going to be talking about a whole bunch of things. Julie: A whole bunch of things. Meagan: What are the chances if I have preeclampsia? A special scar? Failure to progress?Julie: Gestational diabetes. Meagan: Gestational diabetes and maybe uterine fibroids. We are going to talk a little bit more about those. What are your chances for VBAC or vaginal birth if you have these things or have had them? Maybe you are not pregnant yet and you had preeclampsia last time or gestational diabetes last time. What are your chances? 02:54 Review of the WeekMeagan: So without further ado, I'm going to turn the time over to Julie for a review and we'll dive right in. Julie: Without further ado, here is Julie. Okay, this review is from Google. It is from Christa and she says, “This podcast is beyond empowering. After my C-section after multiple unnecessary interventions, I knew immediately I wanted a VBAC for my next baby. I found this podcast not long after and have been an avid listener for four years.” Four years, wow! Meagan: That's amazing. Julie: I know. “The VBAC link lifts the veil on birth and allows women to educate themselves and make their own decisions instead of just blindly trusting providers as many of us have in the past. Because of this podcast, the topic of birth/VBACs has become such a passion of mine and I now feel confident in my knowledge and ability to advocate for myself next time. I recommend this podcast to every mom and expectant parent I know. I am now pregnant with my second due March 2024–” Hey, that's right now– “and am already preparing and relistening to every episode and have the honor to have Meagan as my doula–” What?! That's awesome. “Hopefully you'll hear my successful VBAC story soon.” Meagan, this is your client. That's awesome. Meagan: I love it. I love it. Thank you, Christa. Julie: Maybe you'll be at a birth soon for her. Holy cow, that's amazing. Meagan: I know. I love it so much. I love that she said that we lift the veil. That was so cool. Yes. Julie: Yes. Meagan: Thank you. You guys, these reviews, as you can see, we are over here smiling and gleaming on this Zoom podcast. Julie: Smiling and gleaming. Meagan: Yes, we are. So if you wouldn't mind dropping us a review, your reviews truly help other Women of Strength find this podcast and find this platform. You can leave it on Google just like Christa did. You can go to Apple Podcasts. You can go to Spotify. Can you? I don't know if you can on Spotify. Google or you can just email us. Email us at info@thevbaclink.com with the subject “Review” and you never know, you might be read on the next podcast. 5:51 PreeclampsiaMeagan: Okay, Julie. Are you ready? Julie: Let's do it. Meagan: Always, right? Okay. Let's talk about preeclampsia. You had preeclampsia with your first that did end up ending in a Cesarean. However, you went on to have three HBACs. HBAC if you are just new with us is Home Birth After Cesarean. So yeah. I guess right there I want to point out is it possible to have preeclampsia and then go on and have a vaginal birth? Yes. Julie: Yeah. Yeah. Heck yeah, it is. Meagan: Yes, it is. Julie: I did it. You are speaking to the girl right here. Now, preeclampsia is kind of tricky because a lot of research shows according to the Preeclampsia Foundation. You can find it at preeclampsia.org. According to them, there is a suggested risk that you have a 20% chance of having preeclampsia again after you've had it the first time. However, there are some experts that site a range anywhere from 5% to 80% just depending on when you had it in your prior pregnancy, how bad it was, and any additional risk factors that you have. So I have had clients, most of my clients that have had preeclampsia once don't have it again, but I have had one client that has had it both times. My pediatrician had preeclampsia in both of her pregnancies. It really just depends on a lot of different risk factors, but preeclampsia also doesn't exclude you from having a VBAC. You're just going to have to get induced earlier for the safety of your baby usually around 37 weeks unless it is severe. They might want to induce you a little bit earlier than that. But yeah, I just feel like me and Meagan– I'm going to go off on a little bit of a tangent and then I'll bring it back. But me and Meagan were just talking about how a lot of these things– the biggest risk of VBAC is uterine rupture, right? That's what we talk about. But a lot of these other things like gestational diabetes and preeclampsia and big baby and all of these other things, the risks of those or the perceived risk sometimes don't have anything to do with VBAC. It's completely separate. It doesn't increase your risk uterine rupture. Not even big baby increases your risk of uterine rupture. There are no studies that support that. Preeclampsia and VBAC should be treated separately although a lot of times, providers don't treat it separately. They think, “Oh, you've had a C-section and preeclampsia so we should just schedule a C-section.” That is where provider bias comes into play and these perceptions when there are just not a lot of studies and evidence to support any of that, right? Anyways, circling it back to preeclampsia, there are lot of things you can do to make your body healthy overall that may reduce your chances of preeclampsia although I guess we are still not entirely certain about how preeclampsia comes about in the first place. But yeah. I don't know. What do you have to say about that, Meagan? 08:57 Ask questionsMeagan: Yeah. I think it's important to do what you were saying and separate the thought of, “If I have this, I have to do this,” when a lot of providers, especially if it is severe and we've got really, really high blood pressure and we are severe, they may specifically say, “You need to schedule a C-section,” but that doesn't necessarily mean you have to and if you have preeclampsia in general, it doesn't mean you are going to have a C-section. I think that's one of the biggest takeaways from this episode. Julie: There is no “have to” ever. There are no absolutes. Meagan: There is no “have to”. Yes. There are no absolutes. There are things where you may be at increased risk of Cesarean, but that's typically because of those things like induction, right? So yeah. There's really no concrete evidence on what mode of delivery is best if you have preeclampsia. So again, it comes down to your provider. Get a supportive provider. Talk about it. Really ask them. If they tell you, “Okay, because you have preeclampsia, we are going to have to schedule a C-section,” ask them. Do not stray away from getting the evidence and the information that you need. You can say, “Okay. Can we talk about the evidence of why I have to?” Right? Ask questions. Don't feel bad for asking questions. It's okay. If you have that question, ask it. Meagan: So yeah, I think that's kind of it. Julie: Yeah. I think the overall theme of this episode and maybe the whole entire VBAC Link period is asking questions to your provider, talking with your provider, and having a mutual trust with your provider where they trust you and you trust them. Right? It's a two-way street where you guys can collaborate together and create a plan of care that is comfortable with you and comfortable with them. I know that a lot of care is centered around the provider and what they are comfortable with. Some providers are not comfortable with doing VBAC for preeclampsia or after two or more Cesareans or after a special scar or with gestational diabetes or whatever. You need to have a plan that you are comfortable with and that your provider is comfortable with because I promise you that you don't want a provider who is nervous about your care because they are doing something they are not comfortable with. I feel like that's so important to have that mutual trust between yourself and your provider where they trust you that you are not going to do anything dangerous or stupid and you trust them that they are not going to do anything dangerous or stupid. Do you know what I mean? I say stupid loosely. That's a very medical term, “stupid”, but it's important. It's important that there is mutual trust that you can discuss your plan with your provider. If you're not on the same page with your provider, it might be a good idea to look for a different one. Meagan: Yeah, it's also important to ask, “Well, what are the chances of the negative outcomes for a scheduled C-section?” because on the NIH, and we'll make sure to include the links so you can read them, but it did say, “An increased risk of various postpartum complications was found in patients allocated directly to having a Cesarean section including blood loss.” When we have preeclampsia, it seems that we have a higher risk of issues potentially, but bleeding is not a great thing. We have platelets being affected and things like that, we may have increased chances of blood loss which we already know, Cesareans in general have an increased risk of blood loss. So you may want to ask questions about what kinds of risks you have if you do schedule a C-section with a scheduled C-section in general. What are the risks there? What are the risks to you and your baby there? Yeah. Anyway, ask questions. 12:51 Special scarsMeagan: Okay, we're going to talk about special scars. With a special scar, we do have a blog on that and it does have an attachment of a lot of studies and things that our favorite group of Facebook, Special Scars, Special Hope– is that? Am I brain farting? Julie: Mhmm. Meagan: If you have a special scar meaning you have anything other than a low transverse, so a J, a T, and all of those things, definitely check out that group. The unfortunate thing is that the studies we do have are not really up to date. We don't have a ton of concrete studies that are really recent or even large particular studies. So we want to talk about just in general, what are the chances if you have a classical or a special scar? The chances are there. You can still VBAC. There may be slightly increased chances of things like uterine rupture, but it is still possible. We have stories on our podcast even of people who have gone on to have vaginal births with special scars. I've supported a client that had a special scar. All was really well and they just took a little extra precaution. They wanted to make sure that they knew the signs of uterine rupture and they knew which I think everybody should. They wanted to make sure that baby was doing okay and mom was doing okay. All was well and it ended up beautifully. But all in all, I think in the end, it's going to come down to finding the support and finding that support. That can be tricky. What are the chances to have a vaginal birth with a special scar? Possible. I don't have a number for you. What are the chances of finding a supportive provider with having a special scar? Julie: Harder. Meagan: Lower. Yeah. It's going to be lower and that sucks. Julie: It does suck. It does suck. The special scars website at specialscars.org/studies has links to all of the notable studies, but the biggest studies that are out there show that your chances or uterine rupture are less than 2% with a special scar. I feel like that might be an acceptable risk for some parents and that might not be an acceptable risk for other parents. I feel like that's really important to acknowledge that what is an acceptable level of risk is different for everybody and each of your providers is going to have a different level of risk that they are comfortable with as well. The hard thing is that there are not a ton of studies on special scars but special scars are not just about if you have different C-section incisions. It's also about myomectomy, different types of uterine surgeries, and things like that. Basically, anything that is not in the lower uterine segment and has been cut or severed in some way. I don't know the right way, I don't know the nice way to say that, but if you have a history of any type of uterine surgery that is not on your lower uterine segment, that is considered a special scar. That could have absolutely nothing to do with pregnancy. Meagan: Yeah. Yeah. 17:58 Failure to progress Meagan: Okay, let's talk about failure to progress. What are your chances if your last Cesarean was due to failure to progress? Imagine me putting big, giant air quotes around “failure to progress”. You know, I don't know if this is one of those things I take to heart because it personally happened to me and I was told “failure to progress” and it kind of ticked me off, but your chances if you had a previous diagnosis of failure to progress to have a vaginal birth the next time around are pretty dang, stinking high. A lot of the time, failure to progress is due to certain factors like failure to wait, meaning a provider pushed or a mom– maybe you were like, “I'm done being pregnant. I want to be induced,” and your provider is like, “Cool, yeah. Let's do it.” Failure to wait for spontaneous labor or failure to wait for labor to kick in while you are in your induction. However, then they are like, “We've got to start getting this labor going. Let's start Pitocin. Let's start this and they are starting to intervene instead of just allowing the body to receive the induction method and then go forward. I feel like so often in the birth room, I personally, I don't know, Julie, maybe you would say something differently, but I personally see Pitocin being upped way too fast and often too much instead of going 2mL every 45 minutes or so. We are doing 2-4 mL every 30 minutes and we are not really giving our uterine receptors time to fully, fully react. Pitocin is actually usually quick. It can– what's the the terrm, Julie? The receiving time? I don't know. There is a term. Julie; Oh yeah. Meagan: It gets into your body quickly. Julie: Like how long it takes to take effect. Meagan: Yes. You know what I'm talking about. It actually reacts quickly. There is a quick reaction. However, to a full extent, sometimes it can take a little longer than a half hour fot the body to really, really kick in. Or maybe we are like, “Okay, let's start Pitocin then we will quickly break your water, “ and all of these things so we are not waiting for labor to kick in, we are just forcing labor whether it's spontaneous labor and things are going slow, then you get in and they check you in and they are pushing it or you are an induction. So, failure to wait. I personally don't know if there is actually any solid, solid evidence. Julie, you probably would because you are incredible on numbers, but on breaking water too early, I feel like so many times, we will see our clients in our practice be told they need to get their water broken and babies are at -2 station and we're at 2-3 centimeters. We haven't even gotten into a solid labor pattern and now we just open the floodgates. Baby is coming down in we don't even know what position then we have a harder labor. Now we're trying to intervene even more trying to get labor to go because maybe baby came down in a wonky position so labor is not starting and then it's the cascade there. I think avoiding AROM, artificial rupture of membranes, is something that we should particularly pay attention to. Maybe have a checklist of what is my contraction pattern like? What is my labor like? Is it all in my back? Is there maybe a sign that baby is in a wonky position right now? Because if so, it's going to be harder a lot of the time once that water breaks to get that baby to rotate. Not impossible, just harder. Is baby too high? Do we have a higher risk of cord prolapse? We're talking preeclampsia so “pre” is in my mind. Why are we breaking water at 2 centimeters to begin labor? Why don't we do something else and do a low-dose Pit or do a Foley to try and get us to a 4-centimeter state? I think that's something. Failure to wait, inducing too fast, introducing things, and then baby's position. That's another one that I think is a lot of the time for failure to progress. A lot of the time when our babies aren't in an awesome position, it can be harder to put an adequate amount of pressure on the cervix and dilate the cervix properly and in an “adequate time”. Anything else, Julie, that you think about failure to progress? I know I'm probably missing something. Julie: Yeah, no. You pretty much got it. I do have one thing to add though, but first, we have a blog called Why Failure to Progress is Usually Failure to Wait. It's at thevbaclink.com/failure-to-progress. I just want to say I feel like sometimes failure to progress is actually misdiagnosed because ACOG and the Society for Maternal-Fetal Medicine put out guidelines on what constitutes failure to progress. This is what the guidelines are. I'm just going to read it right from our blog. It's quoted right there and there is also a link to the guideline if you want to go to the blog and find the guideline. It says, “The new guideline says that a woman is not considered to be in active labor–” Okay, so first of all, you cannot be a failure to progress until you hit active labor. That's the first thing. Active labor is not until you are 6 centimeters dilated according to all of the guidelines that are out there. I was diagnosed with failure to progress and I was only 4 centimeters dilated so that was a misdiagnosis for sure. It says, “You cannot be considered–”Meagan: I was failure to progress as well at 3 centimeters. Julie: Yeah, for real. Everybody is I feel like. You are not considered to be in active labor until 6 centimeters dilated and “cannot be termed as failure to progress until she is at least 6 centimeters dilated–.” We just said that. “Her waters have ruptured and no cervical change has been made in 6 hours of labor.” Okay? You have to be at least 6 centimeters dilated. Your waters have to have been broken and you have no cervical change in 6 hours. Now, listen. A lot of the time we think of cervical change as only dilation. Cervical change is way more than just dilation, okay? Cervical change is where your cervix moves from the posterior to the anterior position. It straightens out. It ripens and softens which means it gets thinner. It not only opens but it gets thinner so that's effacement. If you go from 80% effaced to 90% effaced in 6 hours, that is cervical change. Meagan: That is change. Julie: That is not failure to progress. It gets softer. It effaces which thins. It dilates which opens. The baby's head rotating, flexes, and molds are all considered part of cervical change and baby is descending. If your baby goes from -1 station to 0 station and you don't dilate any further, that is still considered cervical change because the baby is moving downwards. So I feel like a lot of times, failure to progress is misdiagnosed and lots of other things could have helped progress that baby if like Meagan said, we were just patient and given more time. Meagan: Yes. I wanted to add to that. All of those things that Julie just said and sometimes, we might not be making changes like dilation or effacement necessarily, but our cervix that was really once posterior is now more anterior. Our cervix is coming more forward which to me, is a sign of change and that our body is working because sometimes, our cervix has to come forward to do some work. Julie: Yeah, that was the first thing I said. It moves from posterior to anterior. It straightens out. Meagan: Oh, I missed that. Yeah. I totally missed that. Julie: That's okay. Meagan: I just think it's so important to know that if you're not dilating, it doesn't mean you can't. Sorry, I totally missed your first half. Julie: No, you're totally fine. Meagan: Okay, anything else? Julie: No, I think that pretty much covers it. Like I said, all of the things that Meagan talked about and the link to those guidelines are in that blog that should be linked in our show notes. 26:15 FibroidsMeagan: Okay, so let's see. What else is one of the other ones? We wanted to talk about fibroids. This is something we don't talk about a ton actually but it's something that we get on our– did we talk about gestational diabetes? We did, right?Julie: We haven't yet. Meagan: That's what I want to talk about first. Julie: But fibroids, let's do fibroids because fibroids is pretty much the same as special scars. You have a surgery to remove your uterine fibroids and it leaves a scar. Meagan: Okay, yeah. Julie: And the scar is on some part of your uterus. It just depends on where the fibroids are. That would be similar to your chances of success with a special scar because it is a special scar. Meagan: Yeah, I guess so. I never even thought about it actually like that. A lot of people will be told that if they have a fibroid, they can't have a vaginal birth and there are studies that show you might have increased chances of a breech baby or preterm birth or even Cesarean because sometimes those fibroids can grow a lot and can cause some issues so there may be some increased chances of Cesarean, but that doesn't mean you can't have a vaginal birth. It should never not be considered. Like she was saying, sometimes people will also get those removed before they get pregnant so there's that to consider. Julie: Yeah, for sure. 27:54 Gestational DiabetesMeagan: Okay, let's go to gestational diabetes now. I feel like this one is a really hot topic and if you are listening and you had gestational diabetes with your pregnancy, with your VBAC, we actually are looking for some stories to share this year because it has been one of the most requested stories to get on the podcast. But let's talk about what are your chances of having a vaginal birth after a Cesarean with gestational diabetes. I think it is important to note that even despite you can be the healthiest you can possibly be and sometimes you can get gestational diabetes. We don't know exactly why sometimes. You should never shame yourself for having gestational diabetes. I feel like so many times, it's like, “Oh, I should have just been healthier.” I'm like, “No, no, no, no. That's not what we should be doing.” Then I think with gestational diabetes, sometimes we panic with trying to control our numbers and sometimes we cut eating or we don't necessarily manage the right way. I think with gestational diabetes, number one, try and learn how to manage it properly and to be as healthy as you can with it, but know that you do not have to have a C-section if you have gestational diabetes. However, you may have a provider who wants to induce your labor. When I say may, I don't know if I've ever ran into a client who had gestational diabetes and didn't get induced. Do you, Julie? Have you ever had a client that was not, even controlled gestational diabetes, that wasn't induced by at least 39 weeks? Julie: Yeah, but it was a home birth. I mean–Meagan: Okay. Julie: It was kind of complicated. There is more nuance to it than that, but yes. She had a home birth. Her gestational diabetes was managed well. It was even managed with insulin. That's all I'm going to say about that. Sorry. Meagan: No, that is just fine. That is just fine. Julie: Her baby was 6.5 pounds by the way. Meagan: Seriously, no. You haven't had a gestational client that hasn't had a provider aka a hospital provider I should say? Julie: Well, no. Actually no, yeah. I just had one but she was induced too. Yeah. The nurse I was telling you about. Meagan: She was induced. Julie: She was induced. Meagan: I've never had a client who has not been induced so that is something that you probably need to take note of. If you have gestational diabetes, you may have a discussion coming your way from your provider about being induced. Julie: Well, all of the guidelines and recommendations from ACOG are to induce at 39 weeks right now. Meagan: Exactly. I just want people to know that that could most likely be a thing. It's not that they are not, like she said, following evidence. That is what is suggested by ACOG, but just know that that can be. We know that potentially an induction could increase the chances of C-section because we have all of the things we were just talking about earlier, all of the interventions that could lead to failure to progress or baby in a wonky position or baby is not tolerating it well or maybe your body wasn't quite ready to be induced yet and is not responding properly to the medication that they are wanting to give you. But in a journal by the American Journal of Obstetrician and Gynecology which is an off-shot journal of ACOG, they said, “In a total of 1,957,739 women were eligible for TOLAC across the study period, 386,092 underwent a TOLAC. Overall, 74.0% of non-diabetics, 74.0% of non-diabetic, 69.1% of gestational diabetic, and 58.2% of pre-gestational diabetic mothers achieved a VBAC.” I'm looking at those numbers and I'm like, “Okay, those are pretty good.” It says that in general, there were some lower odds with large gestational for age infants, babies, so we already know that the big baby thing, sometimes providers are scared of big babies or babies coming down wonky or there is whatever, so sometimes big babies will be taken by Cesarean. However, it's also to note that if your baby is suspected as large, that doesn't mean they are large. Also, if they are large, it doesn't mean they can't come out vaginally. We have lots of people who have big babies that come out vaginally. Julie has personally attended a birth. Wasn't it 11 pounds? Her baby? That home birth, do you remember? Julie: Shoot, I'm trying to remember. Which one? I've had several. Meagan: Her name starts with an L. She is little, you guys. Julie: Oh, okay yeah. With an A, not an L. Yeah. Her baby was 10 pounds, 7 ounces I think. Meagan: Okay, yeah. Julie: Her most recent one, but all of her babies– well, not all. One was just a 7-pounder, but 9-10 pounds. Meagan: I totally thought that her other baby was just over 11. Julie: No, not 11. But she is 5'2”. She is little teeny. A little teeny girl. Meagan: Yeah. So it is possible. Knowing that if you have gestational diabetes, you will more than likely be induced, I think that if you do have gestational diabetes, control it as much as you can and prepare for induction and learn all of the things that you can about induction. We will have in the show notes a link for all of the things. We will have the ways to self-induce or all of those things– not self-induce, but induce non-medically and the ways to induce with a provider and the pros and cons on that, so check that out. Julie: Right. Also, I think it's important to note that there are other complications with gestational diabetes besides just big babies. Inducing at 39 weeks has been shown to reduce the chances of these things happening because the more pregnant you are, the higher your chances are of these things.Meagan: Preeclampsia is one of them, right? Julie: Yep. Hypertension which is high blood pressure, preeclampsia, lower blood sugar, obviously, and higher chances of a bigger baby for sure. We just talked about that. Up into needing a C-section as well. There is some pretty sound evidence for inducing at 39 weeks just because it will decrease your chances of developing those complications during pregnancy as well, but yes. Meagan: Yeah, so all around, just doing the education, getting the education, looking at the information, and making the best choice for you. Julie: Yeah. Meagan: Okay. What else do we have? Is that about everything? I think that's about everything. Julie: Yeah, I think we talked about it all. 35:06 Find a supportive provider, ask questions, and educate yourselfMeagan: All around, at the end of the day, I think some of the biggest things to take away from this episode that you can do is find a supportive provider. How often do we stress that? Find a supportive provider. We have, if you didn't know in our VBAC Link Facebook group, we actually have a list of VBAC-supportive providers under the Files tab. If you are not part of our VBAC Link Community on Facebook, check it out, answer the questions, and you go find that file. You can find your state or even country and see if there is a provider on there that is supportive. Also, if you have a name of a provider that you don't see on that list, please send it over to us with their location and name so we can add to that list and help more Women of Strength find the support that they deserve. Ask questions. Asking questions is powerful and it's not done enough. I feel like if I look back at all of my pregnancies, even my VBAC, I don't think I even asked nearly enough questions to statements that were made or just in general, so ask questions. If you are unsure of something or something is being told to you, ask the questions. And get the information. Educate yourself. Education is power. It is so powerful and you need it. You truly need it. Check out our blogs. Check out this podcast. Keep listening to all of these stories. Every single episode that we put out every single week is going to have little nuggets of information for you. You might be blown away to find out how many of these stories actually relate so much to yours. We also have a VBAC course that Julie and I spent a lot of hours putting together and wanted to bring all of the evidence to you in a– I want to say regurgitated form from studies because I feel like we read those studies. You can read them and it's like, “Wait, what?” We regurgitated it back into English and presented these facts to you and gave you all of the things about the history of C-sections, the pros and cons of VBAC, uterine rupture signs, and all of the things, so check out our course. Then, of course, check out our Instagram and Facebook. We are always putting information out there and learning from our community on our Q and A's on Thursdays. Other than that, I just wanted to thank you guys for being here and of course, Julie, thank you for being with me. I always love when I get to see your face and record with you. It's just something I miss all the time. Julie: Yay. Always a pleasure. Perfect, well thank you so much for having me. It's always fun. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

I 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

“I feel that what I would like to add to this radical acceptance part two episode is that yes, it is so important to feel all of the feelings, not judge them, and give them space to exist so that you can work through them and move on, but it is also equally important for you to not live there. You cannot live with those feelings 100% of the time, 24/7. You have to allow yourself space to get out of that funk, go enjoy life, and feel happiness, light, and joy.”Women of Strength, we love you. We are proud of your healing journeys. We wish all the light and joy for you in this difficult, wonderful, exhausting, and rewarding season of motherhood. We are here for you!Additional LinksThe VBAC Link Podcast: Episode 251 Radical Acceptance Part OneJulie's WebsiteThe Lactation NetworkHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello everybody. You are listening to The VBAC Link and guess what? Julie is with me today. Hi Julie. Julie: Hi. Meagan: She's actually looking right now for a message. We are going to do a Part Two of Radical Acceptance because we got so many messages on our social media and in our inbox and then even actually, some people who have my personal cell phone texted me about it and was like, “This episode did so much for me.” We are excited to have a little follow-up. Julie did get a message in her business inbox, right? Julie: Yeah. Meagan: We are going to read a little bit about that. Julie: Yes, so if you are coming in hot right now for the radical acceptance part two, you should go listen to the radial acceptance part one if you haven't already. It's episode 251, so go back, and yeah. It was such a good one. I got a couple of people reaching out to me as well on my business Instagram sharing about it and how much it touched them or helped them. I'm going to read this review that somebody– well, it's not a review. It's a message that somebody sent to me. Meagan: It's a message and it's in place of a Review of the Week. We are reading one of the messages that Julie got on her account. Julie: Yeah, since we are doing Radical Acceptance Part Two, we want to read a message from Radical Acceptance Part One. She said, “Hey, I listened to the radical acceptance as well as your episode about home versus hospital birth–” That is also a good one. Meagan: Yes, it is. Julie: “I wanted to thank you for sharing. My son's first birthday is tomorrow and I feel I got completely railroaded by the medical system. With this birth, I so appreciate you and Meagan sharing your stories and giving me hope that there is light at the end of this tunnel.” I love that. It makes my heart happy. Obviously, since I'm not actively doing The VBAC Link or anything anymore, I don't get as many people reaching out or whatever to connect in that capacity. Meagan: You don't see these messages. Julie: I don't see it, yeah. So it's always fun when somebody pops into my Instagram DM's and gives a little shoutout, so that was super fun. Thanks for that message. I don't want to say the name just in case because it wasn't a public message, but anyway. So yeah, we're going to talk a little bit more about radical acceptance as a follow-up and then I don't know what you would call it, like an addendum to it. Let's do it. It's going to be good. Meagan: It's going to be so great. Even after that episode, it's been weeks now, months. I've had situations and I'm like, “I need to practice radical acceptance. I need to practice radical acceptance.” It's so powerful and it's so easy to use, I think, in all things in life. Julie: Yeah, everything. Meagan: Yeah. I think this episode is going to be super fun to follow up. Julie: Yeah.Meagan: Okay, you guys, it's almost Christmas and we have had so many amazing episodes, but like we were saying in the beginning, this episode is piggybacking off of one of my personal favorites that Julie and I have done together all year. So we're going to get into it. Julie, you said that you had a story. Do you want to start off with that or do you want to talk about feeling everything, and what we were talking about a little bit?Julie: Yeah, yeah. I'll share the story because it's a good segue into the little addition or whatever to it. So I was at– well, it's two stories really. So anyway, I was at a birth circle, and pregnancy group down near me and I like to go every month because I like to meet everybody and adult interaction is always fun because being a stay-at-home mom or a slave to your computer all day can take its toll. I go to socialize and meet people and things like that. One of the girls there had her baby and her birth didn't go as she wanted. This was her rainbow baby. She had a late-term loss with her previous pregnancy, then this pregnancy started taking some– not scary turns– turns where you are just like, “Oh, now we're a little bit worried about the health of mom and the health of baby.” She has a lot of stuff to work through already going into the pregnancy, right? Then the birth, the baby was healthy and everything was well with them physically, but she was triggered by how the birth went. There were some traumatic things that happened during that birth too. She was well-respected and well-cared for. She had a great birth team. All of those things are great, but she left trying to process the whirlwind of this birth along with still holding onto the loss of her prior pregnancy. At the end of the circle, she took some time to share her thoughts and feelings. She was like, “Guys, I just need help. I don't know how to process through this. I don't know how to get through this.” She was like, “I just don't know what to do.” So me, being the talker that I am, I just told her kind of similar things that we talked about in the radical acceptance episode and said, “Just allow yourself to feel it. The fastest way to get through it is to feel it and sit with it and let it happen and be. Don't judge it. Don't give it a morally right or morally wrong. Your feelings are not morally right or morally wrong. They just are. You need to let them be. You don't have to judge them or assign them or logic them or anything. You just have to let them be.” She was like, “I am getting really good at feeling all of the things.” She was like, “I'm doing really good at feeling everything. I just don't know how to get out of it. I feel like I'm stuck here in this cycle of feeling.” It took me to this other conversation that I had with somebody who was similar. Similar things, we all have things. We all have things that we need to work through and process and deal with and radically accept or whatever, right? But it was another conversation I had with a good friend who was going through some really, really hard things. He actually ended up in a really bad, downward spiral and ended up checking himself into a mental health facility for a couple of weeks to do some trauma work and get on the right medications and stabilize himself. When I talked to him after he came out of the things, he said that his problem was that he was spending all of his time in the feeling bad and miserable stage. I don't know if the right word it wallowing, but he was wallowing in that discouragement and that frustration and in that sorrow and in that struggle. He was allowing himself to live there. Meagan: It's consuming. Julie: I think that other friend too, yeah. It was enveloping his whole life. I feel like my friend who was at the birth circle was in a similar situation allowing herself to be overcome by all of these feelings. It's a tricky balance, right?I feel that what maybe I would like to add to this radical acceptance part two episode is that yes. It is so important to feel all of the feelings and not judge them and give them space to exist so that you can work through them and move on, but it is also equally important for you to not live there. You cannot live with those feelings 100% of the time, 24/7. You have to allow yourself space to get out of that funk and to go and enjoy life and to feel happiness and light and joy. You have to give yourself space for that because if you don't, you're going to end up in a downward spiral and you're never going to come out of it. I mean, probably not never, but it's going to be a lot harder too. I told my friend at the birth circle, I'm like, “You can't live there. You can't live there so go and do something fun. Go to a show. Go to a movie. Go paint pottery or get a massage or go on a hike with your kids or something like that to create joy and allow space for the light to enter even though it might feel really hard. You have to give yourself a break from feeling all of those things.” Meagan: Yeah. I think that it can be hard sometimes to recognize that you need that break because we are “wallowing”. Julie: I know that it's a horrible word for this context.Meagan: But it's really easy to get there. It's really easy to be in that space. Sometimes, like the message that you got. She was realizing that there is a light at the end of the tunnel, but sometimes that tunnel is so dark that we see no light. Julie: Well, and sometimes we don't think that we don't deserve the light. Meagan: Yeah. Julie: Right? We're like, “Oh my gosh. I made bad choices. I should not have done this. I deserve to feel like this,” and then we live there forever. I did. I can recognize moments of my life where I was so living in that darkness because I thought I was not worthy of the light. I got chills right now. I feel like we have all probably been there in one context or another. Meagan: Yeah. To some people, that thing that caused us to get there may be minute, right? Just tiny, tiny to somebody else, but it's huge to us. It's the same thing, so it goes back to not judging and understanding that everyone is going through their own journey and not judging. There are some things that you could be like, “Why are you upset about that? That's not that big of a deal.” Julie: You have done that to me before. Meagan: I'm sure. Julie: I have done that to you before too actually. Meagan: It's hard because I don't understand, but it's not up to another person to understand it. It doesn't matter if they don't understand. We are going through it, but we also have to understand that, okay. We feel this. We see this. We recognize this. Now, let's get out and not, like you say, live in this feeling and let that feeling consume us. Julie: Well, and it's so important. You keep going. I have a little ritual I was going to tell you about. Meagan: You're just fine. I was just going to say that back to the first episode when we talked about, were our Cesareans needed? Julie: We have no idea. Meagan: I just had an interview with a mom this morning who had some hypertension. Not preeclampsia, just some hypertension at 36 weeks. At 37 weeks, she went in for her visit. Still hypertension, again, no preeclampsia or anything like that but they said, “We have to induce you today.” You guys cannot see Julie's facial expression right now, but she's like, “Oh, yeah.” Julie: Sorry. Meagan: But yeah, I was listening to this story and I'm like, “Okay, well do you remember what your numbers were?” Anyway, she had hypertension. She agreed to be induced. They did all of the things and after not very many hours said, “Well, this is probably not going to work. We'd better have a C-section.” Had a C-section, and things all happened. She was saying, “At this point, I'm at this spot of, was any of it necessary? Was an induction necessary? Was breaking my water at that time necessary? Was this necessary?” Those things, if we are just living constantly in the hamster wheel of questioning, it can make our hamster wheel dig right down into the dirt and like you say, we have no light. Then we start shaming ourselves because it's like, “Well, I should have known more.” Right? Julie: That's one exhausted hamster, Meagan. Meagan: You know me and my hamsters, Julie. Julie: I love it. Meagan: But then there's no light. We're blaming ourselves and not deserving the light because we've dug it so far. I'm not saying this mom is that deep or anything like that. I'm just saying things like that can make us go so far down and so dark. It's really hard to get out. Julie: Yeah. My gosh, I get that. I see that pattern in my life in all parts of my life. This is the part where radical acceptance comes in. I have gotten to the point where, yes. I have accepted that I will never know if my C-section was necessary or not. I mean, it probably was. I know the baby needed to get out so the induction was necessary, but I don't know. Who really knows? But there are just so many other things in my life. It's really funny because my C-section baby is now 10 and he has some things that he's struggling with, like some mental health things. He's in therapy and we talk. Every once in a while, I let my mind wander and I'd be like, “What did I do in his early life to cause him to have these struggles right now?” If I let myself get into that spiral, I would be a hot mess. I probably didn't do anything, but I might have. I feel like all of our kids are going to need therapy at some point because we're going to mess them up in some way. We all try to do better than our parents. I don't know, maybe not all of us, but I try to do better than what I was given. I want my kids to have a happier life and be more successful and be happier and not have to deal with all of the struggles that I did. At the same time, I realize that in the struggles is where we grow. Meagan: Exactly. Julie: A muscle that does no work doesn't get strong. You have to strain the muscle in order for it to grow and become stronger. That's where the repair happens. When the repairs are happening, that's when the strength comes. He's probably going to be fine. He's a great kid. I love him. But every once in a while, my mind will start down that path and I have to correct it and be like, “We're addressing things now. It doesn't matter what happened in the past. We're going to live in this moment.” I wanted to share this ritual of something that I do before a birth sometimes when I enter the birth space that I think could probably help in this context. Sometimes it's really, really hard when you're in a funk and you're in a mood and you're living your life in a state of regret and in unworthiness and you feel not worthy of the happy things or you feel like you're never going to be happy again, how do you get out of that?This came to my head while we were talking. Sometimes, in fact a lot of time, when we get the call to birth as a doula and as a birth photographer, it's not a convenient time in our lives. Meagan: No. You can say that again.Julie: It's 3:00 in the morning. Meagan: Or a soccer game. Julie: You have to leave a soccer game or you have a football game. Okay, so it's been eight football seasons since I started birth work and I've only had to miss one football game. I got to watch it while my client was in the OR while my client was doing her C-section. I turned it on while my client was in her C-section. That was a few years ago, but anyway. It's not a convenient time. Sometimes, you are in the middle of a fight with your spouse. And it's fine because we do this work. There are lots of other great things about it, but sometimes, it is hard to separate your mind from the rest of your life before you go into the birth space especially if you are in a bad mood or having a hard day, you don't want to walk into that birth space carrying all of your baggage. You just don't. I have this thing I do when I'm on my way to birth or when I get to the parking lot unless mom is pushing, then I'm running my butt into the room as fast as I can. Meagan: You can't even think about anything that's happening in your life at that point. Julie: Yes, exactly. It gets shoved down. What I like to do and what I think is applicable here is after I park my car, I sit down. I take some big breaths in because we know that big breaths give oxygen to all of your body parts and help you. I just like to put my hands to my forehead and just pull out what's going on in my life. I put it in the seat next to me. I physically do this because that physical motion helps so much. I'm like, “Okay. You are not forgotten. I'm going to leave you here until I get back and until I'm done with my work. I am pulling my thoughts out of my head and I”m putting them in a little package on my passenger's seat.” I will be like, “This argument with Nick (my husband), I'm going to get to when I get back. This problem with football, if BYU is losing or whatever, I'm going to leave you right here and I'm going to talk crap about it to Nick when I get home. This problem going on with my son and if he's going to make it to therapy today, I don't know, but I'm going to leave you right here on my seat. I'm not ignoring you. I'm not trying to brush you off. I'm leaving you here so that I can pick you up when I get back or when I'm ready for another thing and when I'm ready to talk to you again. I feel like that practice might be helpful in these circumstances. You can feel your feelings. You have to feel them to get through them, but when you need a break, when it's time for that reprieve and that joy and that happiness, pull them out of your brain. Put them in a little box in the passenger's seat of your car, next to your nightstand, or whatever, and say, “I hear you. You are here. You are real. I'm going to feel you later. Right now, I need a break to go be happy.” Meagan: I love that. I love that. And yeah, like you said, we can apply that to anything. I think when we are preparing for a VBAC, there is a lot of clustered thoughts happening in our mind. We're thinking about who to find as a provider, if we should hire a doula, if we can afford these things, where we should birth, if my risk is okay, and if this risk is okay with me. We're going through all of that and then we have all of the outside people saying, “You're going to what? You can't. How would you even dare?” We already have the pressures of our everyday life, and then we have the other static on top of it when we are preparing for VBAC. I remember multiple nights, especially during pregnancy when I couldn't even fall asleep because I was so wrapped up in my mind. To be able to pull that out and be like, “I'm going to set that right there. I'm going to rest so I can come back to you with a fresh mind so I can tackle this saying or tackle this topic with a fresh mind and fresh body.”Again, like you said, you're going into a birth. You're removing these thoughts. You're going into that birth. You're holding space for that birth. I think that's important to note. We have to hold space for ourselves. We have to. Like Julie was talking about being worthy of even having that light, we have to be worthy of giving that to ourselves and saying, “We're going to stop. We're going to take a minute and put this over here. We will come back when I'm ready, but until then, you're just going to be right over there.” Julie: Yeah, absolutely. Yes. I love that. Sorry, I'm trying to collect my thoughts. I think it's really important that you allow those feelings 100% of your energy and that space, but you can't give it 100% 100% of the time. It's important to allow yourself that space and that break. Carve times in your life. Maybe you have an hour a day where you allow yourself to feel and address and work with those feelings or something like that. Maybe it's before bed after the kids are in bed and you have some quiet time. I don't know about you, but sometimes my self-care is when I get home, I sit in my car in my garage for 5 or 10 minutes before I go into my house to kids and dogs and husband and chaos and everything. I allow myself that break between driving and doing the activities to go back. Do you do that? I feel like moms do that. Meagan: I totally do and then my husband or my kids will open the garage door and be like, “What are you doing?” Julie: Open the door and be like, “What are you doing?” Meagan: “I heard the garage door open 5 minutes ago.” I'm like, “I am sitting. I am just holding my own space for 5 minutes.” Julie: Yes, regrouping. Yes. It doesn't have to be an hour. It can be a few minutes here and there and when you're in it and when you're feeling it, it's important to give it your 100%, but don't do it 100% of the time. Meagan: Well, on that note, we will end with that. But know that is exactly what she was saying, you don't have to feel it 100% of the time. It's okay to take the moments. You do not have to live in this feeling. There is a light at the end of the tunnel. If you are in this space, know that we are here. We are here. If you have a question about VBAC and you want to get that thought out of your mind and that is to get that question answered, email us. Write us on Instagram. Comment on these podcasts on your platform. We get them. We would love to talk about it with you and help you clear out the thoughts and the feelings and the emotions. We're not therapists, though. I remember Julie said that in the beginning. We are not licensed therapists. We are just two ladies who love birth. Julie: Yes. This is not taken as medical advice. Meagan: None of our VBAC Link team members are trained and skilled in therapy or anything like that, but I just think these messages are powerful and thank you so much, Julie. Julie: You're welcome. Always a pleasure. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Meagan and Julie went Live in The VBAC Link Community Facebook Group answering your questions. They recorded the conversation to share with you on the podcast today. Topics include: Risks of VBAC, Repeat Cesarean, and CBACCook versus Foley CathetersCervical lipsMembrane sweepsVBA2C and VBAMCCPDThank you for sending in your questions! An educated birth is an empowered one. You've got this, Women of Strength!Additional LinksThe VBAC Link Blog: VBAC vs Repeat CesareanCook versus Foley Catheter StudyEBB 151: Updated Evidence on the Pros and Cons of Membrane SweepingACOG Article: VBACThe VBAC Link Blog: VBA2CNeeded WebsiteFull Transcript under Episode Details Meagan: Hey, hey everybody! Guess what? It's November which is one of my favorite months because it is my birthday month. I have forever and ever loved birthday months so this is going to be a great month because it is my birthday month. Today we are kicking it off with questions and answers with myself and Julie. Hey, Julie. Julie: Hey, I'm so excited to be here. Meagan: Welcome back. We're going to get right into this review and get some of these great questions answered. We know you guys have so many questions. This review is from bunnyfolife777. It says, “So much hope.” It says, “I'm 16 weeks pregnant and shooting for my VBAC. I've been in The VBAC Link group on Facebook for over a year, but I've only just started listening to the podcast. I don't know why I waited. I'm bawling now just two episodes in. The statistics and advice you share are golden. I'm going to listen to it again and take notes this time. I'm scared about having to advocate for myself living abroad where most doctors push for C-sections so I'm thankful I can arm myself with the knowledge through The VBAC Link. Thank you.”Oh, that makes me so happy. We're going to be talking about statistics on this podcast episode today. Julie: You know I love a good statistic. Meagan: I know. You are the statistic junkie. Julie: I'm a nerd. Meagan: Okay, okay Julie. I love having you back on the show. It just feels so natural. Julie: It's fun. Meagan: It is fun. It's so fun so thank you for being willing to join me again on these random episodes. As we were saying, we are really just wanting to answer some of these questions. So yeah. What is one of the questions right here that you love that you are like, “Let's start this off with”?Julie: Okay, so gosh. I mean, there are so many good ones. I feel like we've talked about a lot of these things many, many times over the years, but I feel like every time we talk about them, we get a new perspective in. There is new information and new evidence. Not everyone goes and listens to every single one of the episodes although lots of people do, but I think it's fun to revisit some of these things. I don't know. There are so many that stuck out to me. VBAC vs Repeat Cesarean vs CBACOne thing that we haven't really talked about directly in this way is, is it really safer to give birth vaginally? I mean, yes. It is. We can go over that but I really like the second part of that question which is, “What if that labor doesn't work and goes to a C-section? Is that more dangerous?” I want to talk about that because we talk about VBAC is safer than a repeat Cesarean statistically. We are talking about all of the numbers when we talk about all of the different things that could go wrong between vaginal birth and Cesarean birth then actually, for the second, whether you choose VBAC or repeat Cesarean, the statistics are actually not that much different as far as safety goes. VBAC is slightly safer overall, but there really isn't a big enough difference to say, “You should absolutely do this.” Right? That's where your intuition comes in. But if you want more than two kids, the more C-sections you have, the higher the chance you have of having severe complications. By the time you get to your fourth or fifth C-section, you have a 1 in 3 chance of having a major medical intervention during your Cesarean. I feel like so many times we as people educating about birth or talking about birth talk about just those two things. VBAC and repeat Cesarean, but there's actually a third thing that's worth talking about. That is a TOLAC– I know it's kind of a trigger word for some, but it's just a medical term we're going to use here– that ends in a repeat Cesarean. Meagan: Yes, because we know that happens. Julie: We know it happens. It does happen. Meagan: It happened with me. Julie: Sometimes it's medically necessary. Sometimes it's not, and you just don't know. We've got to put it in the order of three things. First, the safest is VBAC or a vaginal birth. Second is a scheduled C-section and the third is a VBAC attempt or a TOLAC that ends in a repeat Cesarean. We also call that a CBAC or a Cesarean birth after a Cesarean. Now, if you labor and then have to have a C-section for whatever reason, there are more risks with that including postpartum hemorrhage or bleeding, and needing a blood transfusion. Obviously, the risks to baby are pretty similar but it's just harder to operate on a uterus that is contracting. You're more likely to bleed because that uterus is contracting. Sometimes, if it's an emergency situation, the providers have to do things like a special scar or a special type of incision or they have to put you under general anesthesia. That has more risks in and of itself. I feel like that's a really valid question that she asked. What if? What if? There are always what if's, but what is safer? Meagan: Right, right. For patients or parents that are going for a TOLAC, a trial of labor after a Cesarean, and then may require or end up going to have that Cesarean, there is also a slightly increased risk of postpartum infection. Julie: Yes. Meagan: And also some possible complications. You just touched on it a little bit, but when a uterus is already contracting– so I'm going to backpedal a little bit. When we go in for an elective Cesarean, typically we are not already in labor. We're not already having contractions so performing a Cesarean on a contracting uterus can possibly cause some issues there as well. That is sometimes why a lot of providers don't want an elective Cesarean to even go to 40 weeks or past. They want to have an elective earlier on. That may also help give you some understanding of why providers are saying that. But yeah, it just slightly increases in other ways. Yeah. Anyway, keep going. Julie: No, I love that. I just don't think we've ever– I mean, we do in our course and things like that. We talk about it directly, but that's something to consider. I think that's also really important. I feel like it adds the extra layer of where you want to make sure you have a really good provider because if you have a provider who is not really supportive or who is giving you tons of red flags or who is saying that you have to induce because of a big baby– I'm surprised that big baby isn't in some of these questions, to be honest. We can talk about that a little bit later, but it's really important. That's something to consider. It's all about weighing the risks and what risks are you more comfortable with taking on? Are you more comfortable taking on the risk of going into a vaginal birth attempt– you want to try for a VBAC– and having the possibility of it ending in a repeat Cesarean? The possibility of it ending in a repeat Cesarean varies depending on where you are birthing. If it is a home birth, you have a 10% chance of it ending in a Cesarean. Statistically, nationwide, you have a 30-40% chance of it ending in a repeat Cesarean. But if you have a really good provider, there's probably only a 10-20% chance of it ending in a repeat Cesarean. Sometimes, if you have a really bad provider, you might be looking at a 50 or 60 or 70% chance of having a repeat Cesarean. So what is an acceptable risk for one person is not for another. If that just sounds too scary for you or are risks that you are not willing to take, then maybe scheduling a repeat Cesarean is the right choice for you and that's okay. But if you're a diehard and want to fight the system to prove everybody wrong no matter what the costs are, then maybe you just want to have a VBAC and that's okay. Not that that's a bad thing, but it's also probably not a very healthy way of thinking. I was like that. I'm like, “I'm getting my VBAC and I'm going to do everything I can to safely set up the best chances for me and my baby.” That's why I ultimately chose an out-of-hospital birth with a really amazing provider who had tons of experience in all types of birth situations. But I don't know. I think that's super important and something to consider. We're not trying to scare anyone here, but we are never going to lie to you. We're never going to dance around the issues. We're never going to sugarcoat things. Meagan: Yeah. Yeah. I think that was a good question. Okay, well if it really is safer to have a vaginal birth, what's the safety here? Yeah. I really loved that question a lot. Julie: I wish I had some statistics off of the top of my head, to be honest. I'm pretty sure we wrote a blog about it. VBAC versus a repeat Cesarean. Meagan: Okay. I'm going to bounce to this next question– Julie: Wait, wait, wait, wait. Wait, wait, wait, wait. I have something. Meagan: Did you find a stat? Julie: No. Well, yes actually. I found the blog. If you guys want to know more about the blogs, I'm not going to get into it because we want to move on to all of these other questions. Our wonderful transcriber, Paige, is going to put a link to the blog in the show notes so make sure you check it out and it goes in super, really big detail about all of those statistics, and pros and cons for all of those things. I say our transcriber, but you know what I mean. I feel like it's still us. It's still we, right? I don't know. I'm never going to not feel like that. Maybe one day. No, probably not. I miss it so much. Meagan: Probably not. No, probably not. Julie: Sorry, let's go on. Cook vs Foley CatheterMeagan: No, you're fine. So I want to talk about catheters. Not catheters to drain urine, but the catheters to help with an induction. Someone asked, “What's the difference?” We'll even hear in Utah a Cook versus a Foley. A Foley catheter can also be the type that actually goes into your bladder through your urethra and drains urine but there's also a Foley catheter that can help induce labor. There's Cook and Foley. One of the questions was, “What is the difference between the two?” Really, the only difference is that a Cook has a double-balloon and the Foley is not a double. There's just one. If you can– I don't even know how to give this image. How would you give this image of what a Cook catheter is like? The catheter with two balloons on it? I don't know, like ice cream? Oh, you're muted. Julie: I'm sitting over here dancing. Meagan: She's dancing in this image and I'm like, “She's saying something.” I'm thinking of a double scoop of ice cream.Julie: I'm thinking it's kind of like a barbell. Yeah. Or like a barbell, right? If you think of a cartoon barbell with the balls on the end but much shorter. Meagan: Yeah. Both of them are inflated with saline. It's inserted through the cervix, the balloons are inflated, and then they put pressure mechanically onto the cervix which causes pressure and dilation and effacement and things like that. Yeah. It's been a really long time since these have been being used. We will see, once in a while, providers say that a catheter, Cook or a Foley, is a contraindication for someone who wants to have a VBAC. That is kind of hard. It's really interesting. It's just a balloon that goes in. There's no medicine that is put in at all. It's just saline and like I said, it's a mechanical dilation. So if you are curious about methods of induction that your provider is comfortable with, I would encourage you before you get to the 37th, 38th, 39th, 40th, 41st, and 42nd week of pregnancy to discuss with your provider more about a Cook catheter and what they are comfortable with. It is really hard because sometimes, those catheters can be one of the best ways to help induce a cervix or a TOLAC for someone who is wanting to go for a VBAC because they can't always just do other ripening aids and this can definitely help with the cervical ripening to help get to that further progress of having a baby. Julie: I love it. I think it's silly sometimes how providers will not induce with a Foley for VBAC. I just don't get it because there's no solid evidence that supports not doing that. I just think– me and you, we've seen so many VBACs induced with that. It's been fine and healthy. There is just not anything out there. I know every provider has their things that they will and won't do. If you have a provider that won't do that, then you might want to talk to another provider. Meagan: Now that we kind of know that there are two different types, let's talk a little bit about the differences. There is a difference in what they do. Why would we even use them? Which one is better? I think that is a big question. Which one is better to use? I'm just going to tell you after some evidence that a Cook catheter for cervical ripening has greater results. What have you seen, Julie? What have you seen in the past?Julie: Honestly, I'm trying to think if I've ever seen anybody use the Cook catheter. I think I've only seen Foleys to be honest. I'm trying to think back. Maybe there has been one but I just can't think of any. Meagan: I've only seen one. Yep, I've only seen one and it was up at the University Hospital here in Utah. They used that. She was barely half of a centimeter dilated and 30% effaced, very little. They used that for softening really, but the Cook catheter, I think, through studies has shown that it is more effective or has greater cervical ripening compared to the Foley. However, in fact, I'm going to hurry and pull this up. I'm just going to read this. It shows, “The duration from the balloon insertion to it exiting and delivery was significantly shorter using a Foley catheter.” Julie: Interesting. Meagan: Yeah. So Cook catheter has a greater result of actually ripening the cervix, but the Foley has a greater success rate overall from start to finish. I mean, I have seen so many people with Foleys. It sounds weird because sometimes, everyone is like, “You're suggesting Pitocin?” I'm not suggesting it. I'm just saying that I have seen a Foley placed with Pitocin at 4mL, just a little bit, and it is insane sometimes how great the result is. Sometimes when the Foley comes out– maybe you've seen this– it's a mechanical dilation so it kind of relaxes just a little. It's not like we go backward. It just kind of relaxes like it's overstretched and it relaxes. Then we have to catch up, right? But I have seen where with there is a tiny, tiny lift of Pitocin being involved–Julie: You don't have that relaxing as much, yeah. Meagan: Yeah. I don't see where it's like, “Oh, you're a 4,” and then they check and they're like, “Well, you're kind of a 3.” Listeners, I just want you to know that that's a thing too. If a Foley comes out, remember that it's a mechanical dilation in your cervix. It may be stretchy-stretchy, but you might not be a full 4 or whatever. So talking about top to bottom, Julie you just mentioned that a little bit ago. With me, do you want to talk about that?Julie: Yeah. Well, I mean, the Cook catheter has two balloons essentially that they fill up with saline. The Cook has two balloons. The Foley has one. The idea with the Cook catheter is that it puts pressure on both ends of the cervix. My gosh, I don't know if we even said how they put it in. You insert a catheter in through the cervix and then the Cook has two balloons on either end that they inflate so it pushes to soften and open the cervix. Then, the Foley only has one balloon that they put. They insert it into the top through the cervix inside of the uterus and inflate it there with the balloon. They tape it to your leg and it pulls. Meagan: They tug it. Julie: You've got to tug it and it pulls down. It provides a lot of pressure so that the cervix can soften and open. All of my clients have just been pretty uncomfortable with it in. They feel some relief when it comes out because then it just falls out. It pulls out at some point. Honestly, I don't know. This is maybe making me sound like an idiot but do they tape the Cook catheter to the leg or not? I don't know. Meagan: I did not see it taped to the leg. Julie: I'm wondering if maybe that's why the Foley is more successful because you're having just one downward motion instead of two pressures going toward each other. I don't know. I don't know. Meagan: Yeah, maybe. It's kind of interesting because with the Foley, every 20-30 minutes, they're wanting you to pull on it. Julie: I don't know if they do that with the Cook. Meagan: I don't either because we haven't seen enough. Julie: Yeah. Meagan: So if you're listening today, go comment in today's episode. If you had a Cook catheter, let us know what happened. Tell us about it. Tell us what your experience was. I think they said in the study that really, there was no significant difference in the outcomes specifically between the two having more Pitocin or the mode of delivery or anything like that. It's just that the Cook catheter had a greater result of cervical ripening and the Foley catheter maybe shortened the duration but there wasn't any crazy, significant difference of mode of delivery or your for sure had to use Pitocin with a Cook or anything like that. So that's interesting. Julie: Yeah, interesting. The point is that it is safe for VBAC. This is another thing. I'm going on a teeny little soapbox that I'm going to get off really fast, but why does it take the burn of proof to show that something is or is not evidence-based or is a reasonable patient? Rely on the patient. If your provider says, “No, it's dangerous. We can't do Foley for a VBAC,” make them show you why. Ask them where the source is coming from. I don't understand why we have to bring the stuff to show that it is safe. Why? It's stupid. Meagan: I don't know. I don't know. Why? Julie: Why? Meagan: I mean, even the American Journal of Obstetrics and Gynecology says– Julie: Yeah, and that's ACOG's journey. Meagan: They say, “Foley catheter did not increase the risk of uterine rupture in TOLAC.” It says that. “Similar, uterine scar dehiscence was not associated with a Foley catheter.” I don't ever want to make it sound like we are bashing a provider or it's a show bashing providers, but we're having providers tell people that they have zero option to be induced especially if there's a medical reason. Sometimes there's a medical reason. We've got preeclampsia or something is going on, but this mom wants to have a trial of labor and a VBAC, but then her cervix isn't super great for induction. We're being robbed of these options. They even say, “The data shows the Foley catheter is a safe tool for mechanical dilation in women undergoing a trial of labor after a Cesarean.” If your provider is saying that you're not a candidate or it's a contraindication for VBAC, then maybe I invite you to have a discussion with them. Right? An open discussion of, “Okay, what I have learned is that it's not necessarily a contraindication. Is there new evidence that we're not aware of?” Maybe there is. Maybe there's new evidence. Julie: There's not. Meagan: I know, but right? Maybe they have secret evidence. Julie: Give them the benefit of the doubt, right? Meagan: Is there new evidence that we're not aware of and is there any way that we can have a conversation about it? Can we talk about this because if it is, then okay? But if not–Julie: Well, and honestly, gosh. I just think that it's just something that they've heard or something that their practice does or something that the hospital says. You know, I mean, we all do it in our lives. Our mom says, “Oh, this and this. Oh, you should never cook with refined sugar. You should always use granulated sugar.” I don't know. I'm not a baker so it's probably not a good example. But you know, and then you go throughout your life like, “Oh, my mom says you should never cook with this type of sugar,” but that type of sugar is totally fine. Someone you trust had told you that so it's just ingrained in your belief. I have those things. Meagan: It's like the trans-fat argument. Julie: Yes. It's like, my gosh. How many beliefs do we hold that maybe we know they're just silly, but it's just something we've known for so long that doing it otherwise would feel so foreign to us. There are so many things in the system like that where the providers aren't meaning to do harm, it's just the way that they've been taught. It doesn't give them an excuse. Oh my gosh, there was a quote the other day that popped up in my feed. I was arguing online with some photographer about birth photography and I got a little heated because I was super tired because I'd been to three births in four days and I was awake for 16 hours through the night. Anyway, but a little while later, some unrelated person posted this quote in their stories and I like it because it goes along with what I was just talking about. It says, “Don't assume malice. Assume ignorance. Life is easier. The world is kinder and you can educate. Actual malice is pretty rare, I find.” Then somebody else commented and said, “I always remember Hanlon's Razor. Never assume malice when incompetence will suffice as an explanation. With that said, never forget Fred Clark's lot either. Sufficiently advanced incompetence is indistinguishable from malice. There is a certain point at which ignorance becomes malice at which there is simply no way to become that ignorant except deliberately and maliciously.” I'm going to forward this to you. Meagan: I was just going to say will you forward that because that is amazing. Never just assume malice. Julie: Assume ignorance. They just don't know. It's okay because there are lots of things we don't know too but when it gets to the point where you're just completely refusing to see that there's any other way, then that's where it gets to be malice and aggressive. But I love a provider or a nurse when I'm in the delivery room doing peanut ball or Spinning Babies and the nurse is like, “Oh, tell me more about that.” That is a position of maybe ignorance and they want to learn and do better. They just don't know those things. But when you have a nurse come in who says, “Oh, we don't use the peanut ball before 7 centimeters because it doesn't do anything,” that is a malicious form of ignorance. Meagan: Yeah. Yeah. Okay, I love that so, so much. Thank you for sharing that. Julie: You're welcome. I'm glad I screenshotted it. Cervical LipsMeagan: Me too. Okay, one of the questions is about cervical lips. Julie: Mmm. Meagan: I know, it's a good question. It's hard because it happens and it's frustrating if it doesn't go away. Right? It's like, if I make it to 9.5 centimeters and I have this lip that will not go away, one– why doesn't it go away? Why does it happen? Two– how can I get it away? What are some ways? It sucks if that is the only reason why a Cesarean happens. Julie: Well, first do you want to say what a cervical lip is just in case people don't know? Meagan: Yep, yep. Julie: Oh, me? Well, a cervical lip is just where your cervix is almost fully dilated, but there is just a little sliver of it, or part of it– so if you imagine a crescent moon shape, where part of your cervix is all the way gone behind baby's head and there is just a little sliver of it on some part of the baby's head coming over. Just a teeny bit. Just like a lip. Just like a little lip. Meagan: Yes. So when we have cervical lips, sometimes pressure on that part of the cervix helps it melt away and thin. We work through positions like what Julie was saying by using a peanut ball or we make you more central through a squat or sitting on the toilet. Sometimes it's an anterior lip. Sometimes it's way on the side. Sometimes it's a little puffier in the back. Sometimes we will use positions to help get rid of that lip.But it's really hard because sometimes even through positions, that lip sometimes doesn't go away. Sometimes it can be massaged or it can be advanced. I'm happy to continue but I want to give you an opportunity to talk too. Julie: No, you're good. Meagan: But advancing, right? Julie: The provider will hold it during a contraction and push it back. That's really painful if you don't have an epidural. If you have an epidural, that's a good way to do it. The medical system is going to hate me for saying this, but I've also seen people push through a contraction when they have a cervical lip and it slips right over baby's head. You don't want to push too much with a cervical lip also because it can cause the cervix to swell if it's a positional issue. There are a whole bunch of things you can do, but Meagan, I think you were right on track when you were talking about movement, positions, squatting, and all of those things to help put that pressure on and help straighten baby's head out. I mean, it's not always because of the baby's head, but it could be. Squatting and putting that pressure down is just going to really help. Meagan: Yeah, so when a provider is holding it and helping it, I call it an advance. Advancing it over the baby's head. Sometimes it just needs to slip over the baby's head. It's so stretchy. Julie: It will stay there. Meagan: Sometimes, it's so stretchy that it will just go away. I'm always giving sound effects on this podcast. Sometimes it's like we're trying, trying, and trying, but then we have possible issues because then we're swelling. We're aggravating it. It's tissue. It's the cervix so it can get bogged and it can swell. So if that is happening and your provider is like, “Yes. I think through this push, I can push it. I can help advance it over this baby's head and it's going to go away and we're going to have a baby,” great. It's worth trying. But if it's over and over and over again and we're advancing it and it's just not going, we are risking it to swell. So yeah. Movement. This sounds weird too. Here I am suggesting Pitocin again. Sometimes a little stronger of a contraction, just a little bit stronger of a contraction and a little bit of a lift can just put the amount of pressure on the cervix or cause the cervix to continue dilating. Then the cervix is done and you can turn the Pitocin off. That's always an option to say, “Okay. We've done this, this, and this. Let's move on.” Some providers, usually out-of-hospital providers– Julie, I don't know if you've seen this– will place Arnica. Julie: Yeah. I have seen that. Meagan: If it's starting to feel puffy or maybe have done advancing a couple of times. Julie: I love Arnica, man. It is my favorite. Arnica gel. Meagan: I love it too. Julie: Love it. Meagan: Yes. I love it. Sometimes providers will do some Arnica up there to help reduce inflammation and swelling and things like that. Cervical lips can happen for no reason really other than just it's happening. People say, “Oh, sometimes it's baby's position.” Again, maybe we want more pressure. Sometimes it's the lack of intensity. If I remember right, if you've ever had a LEEP procedure–Julie: Yeah, like some scarring on the cervix can cause that. Meagan: Yes. Yeah. So a LEEP procedure or maybe really bad cervical tearing or trauma to the cervix can create less elasticity. I don't know if that's the right word. But it can cause a cervical lip. I've also seen– this is more for the edema again on the Arnica– Benadryl. Providers give someone Benadryl because it's an antihistamine for swelling. Yeah. There are so many things that you can talk to your provider about. If you have a cervical lip, oh. Go ahead. Julie: I was going to say that sometimes, just doing nothing. Meagan: Just waiting, yes. Julie: Sometimes in labor, even us as doulas, we see, “Oh, well it looks like contractions are coupling. Let's do some abdominal lifts.” But sometimes, that's an intervention. It just is. Spinning Babies® is an intervention. It's a more natural intervention, but sometimes, maybe a lot of the time, you just need to leave it alone. I don't know. I saw this post on social media the other day that was talking about, “I hate Spinning Babies® because it's an intervention and all of these doulas and midwives are like, ‘Oh, let's do Spinning Babies®. Let's do Spinning Babies®.' It's an intervention just like Pitocin or whatever.”I don't think it's just like Pitocin, but it kind of takes away from the trust of the natural labor process when you're like, “Oh, you've got to fix this.” It's kind of, in a way, saying that we don't trust the natural labor process as much. But there are some times when it is good and beneficial to do those things. There are some times when you can't just trust the natural labor process alone, but a lot of times, you can. A lot of times, we just need to let these things be and they will resolve themselves. This is a big thing where knowing all of your options then trusting your intuition and having someone to guide you like a doula will help you know which is the right thing for you whether you want to try squatting, try different positions, try Arnica gel, or just leave it be for a little while. There's no right answer. Meagan: There is no right answer and there are these things that we can do. Sometimes they work and sometimes they don't, but we want you to know that there are things you can do. Sometimes those things just do nothing. Absolutely. Membrane SweepsSo let's talk about sweeping membranes. Talking about interventions, sweeping the membranes. I've heard it called a sweep and a scrape. Julie: Ew. Meagan: Yeah. People say “scraping the membrane”. If you don't know what sweeping the membranes is, it's when a provider will insert typically their fingers inside the cervix and separate the membrane of the amniotic sac from the cervix and do a little sweep around. That releases hormones like prostaglandins and things like that. Sometimes, it's used to induce. It's a more gentle– I don't know if that's how you say it– way of inducing. One of the questions, Julie, was, “Does it work? What are the pros and cons? Should I do this?” We do have a lot of providers that will say, “Oh, we can just strip your membranes.” What do you think? What do you say? Julie: Evidence Based Birth® used to have a great article on this. The one thing that I– okay, I love Evidence Based Birth®. Meagan: I think she still does. Julie: This is the thing though, they took away all of their articles and replaced them with just their podcast transcripts. I wish that they would have their regular blog articles still instead of just having the podcast and the transcripts which makes me a little bit sad because then you have to read through the whole thing in order to find what you are looking for. But I do love me some Evidence Based Birth®.Listen, Evidence Based Birth® does say that there is research that shows that starting regular membrane sweeps at 37 weeks of pregnancy and doing them, I think it's twice a week until delivery can shorten your pregnancy by one to two days. Personally, for me, that's not enough evidence to want to do them because you are getting 10+ cervical membrane sweeps. That is a lot for just a one or two-day shorter pregnancy. But for some people, that might be worth it to them. It's just one of those things where there is that evidence that shows, but this is the thing. Doing one membrane sweep at 40 weeks is not going to shorten your pregnancy by one or two days. It's not going to shorten your pregnancy at all. This is what the studies show. There might be some anecdotal things or your water might break prematurely and that might kickstart labor, but the one-off or the one or two membrane sweeps here and there is not statistically proven to shorten that. You have to start super early. Another thing I want to say–Meagan: Two days to have to avoid going in or having it massaged or swept twice a week? Julie: Yeah, one to two days. It would cause you so much pain and cramping and it would make you miserable. Meagan: That's the thing I wanted to say. Sometimes cervical sweeps or membrane sweeps can actually promote prodromal labor. Julie: Yeah. Meagan: Right? We're up there and we're disrupting the cervix and making it think that we need to start contracting, but our body is not really ready to labor so we're contracting, contracting, contracting, and getting exhausted, but labor is not happening. Then the next day, we're sweeping again or we're contracting again, but then really, we don't have a baby for 2-3 weeks. Right? We're exhausted when labor starts. Julie: Yeah. Meagan: Like you said, they can hurt. If our cervix is posterior, especially at 37 weeks, it's a lot more likely for our cervix to be posterior than it is anterior, they have to go in, back, and around to get to the cervix and sweep. It's not just in and out. That can cause a lot of discomfort that's really unnecessary. One of the questions is, “Does it possibly increase infection?” We are inserting something into the cervix and sweeping around, maybe yeah. Julie: Well, here's the thing though. I'm just skimming through this podcast article on Evidence Based Birth®'s website. If you want to find it, it's super easy. Just Google “Evidence Based Birth® Membrane Sweeping” and it will pop up right there for you. Meagan: They give you updated evidence on it. Don't they have it updated? It was in 2020. Julie: Yeah. It's in 2020 for sure. They break it down. There are 44 studies that they look at. Some of them show no difference. Some of them show 9% increase in artificial rupture of membranes. Premature and accidental. There are a whole bunch of varying interpretations here, but none of them are too conclusive as far as it causing that significant of a difference in when labor will start. Yes. Go and read it if you're curious. It's really good. Or you can listen to it, I guess as well. There is great stuff there. Meagan: Yeah. It's Episode 151 on Evidence Based Birth®. Yeah. Julie: Yeah. Meagan: Yeah. So I think just closing out this question as a whole, it's a personal preference. If you want to try something to encourage labor to begin on more of a natural basis, then it could be worth it. But for my personal suggestion to my doula clients and what I would do– again, I'm me. I'm not you. If I was being faced with a medical reason to induce or a concern, but I was going to be induced anyway, I would maybe try it. Does that make sense? If I was already going to be induced for a medical reason, then I would probably try it. Julie: One or two days might be beneficial for you at that point. Meagan: One or two days might be beneficial. If I can avoid going in and being hooked up to a Pit drip, then that might be better for me. That's one of my things. If I was facing an actual induction, I maybe would try it. For my actual birth, my midwife wanted to. She said, “Hey, why don't you come in and we'll strip your membranes?” I said, “Nope.” I didn't feel like I needed it. I don't know if it would weaken my membranes or accidentally rupture my membranes because that is a possible consequence. We can induce infection. We can accidentally break our water. We can weaken it as we separate it. So those types of things, for me, were not worth it. I was good to just keep going as I was. Julie: Yeah. VBA2CMeagan: Okay. What are some other questions? I know we have a couple more before we end. Julie: There's one about VBAC after two C-sections I know. Meagan: Oh yeah. Yes. Julie: Let's talk about that one. “Why do so many providers not support VBAC after two C-sections? What does the evidence say?” Meagan: Mhmm. Well, the evidence says that it is reasonable. Julie: Yeah. It is. Even ACOG says that it's reasonable. Meagan: Yep. Yep. Yep. Julie: I feel like this goes back to what we were talking to about before with that quote. I feel like most providers have just been told that it is not safe, so they say that it's not safe, so they don't do it and they don't support it. They throw around terms like, “Oh, it doubles your chance of uterine rupture. 50% chance of uterine rupture,” and things like that, right? We have the system that is just content on not wanting to have or support any evidence that will go contrary to the things that they've been taught. You see with the ARRIVE trial. We have been throwing evidence at providers that so many things reduce your chances of C-section for years. Right? Like waiting for labor to start on its own, laboring at home as long as possible, avoiding Pitocin, avoiding elective inductions, and all of those things. We've been throwing these things at providers for years about nice, safe, non-medical ways to avoid Cesareans and providers weren't interested in it all. Then all of a sudden, the ARRIVE trial comes out and they're like, “Oh, inducing at 39 weeks decreases Cesarean rates,” which, it doesn't by the way. As soon as providers are shown something that reinforces things they already know and do, they're like, “Oh, yeah. That's something I can get behind. I can do this because I already do this all of the time anyways. I already schedule inductions. I already do Pitocin. I already do these surgeries.”So when they're shown something that will reinforce their beliefs and things that they already know how to do, they're on board with it. But my gosh, you try and show them these nonmedical ways of improving birth outcomes and nobody wants to buy it because they're like, “Oh well, that's just–”. It's not how they've been trained. Meagan: It's not how they've been trained and sometimes they've seen a scary outcome. Julie: Yeah, of course. Meagan: Studies do say that women requesting for a trial of labor, a VBAC and having a VBAC, should absolutely be counseled and absolutely be offered an opportunity because we know that the success rate is as high of 71%, if not higher. 71% or higher, right? The uterine rupture rate is not much higher and if you compare VBAC after two Cesareans, maternal morbidity is really comparable to a repeat Cesarean. It's low. It's overall safe and reasonable to have a vaginal birth after two Cesareans. Julie: The risks to baby are similar. The risks to mom are actually higher in a repeat Cesarean like increased blood loss, pulmonary embolism, and maternal death is still incredibly low. Maternal death is incredibly low. We're talking about .000-something-percent, but when you're looking at it against VBAC, it's 10 times more likely for a mother to die during a Cesarean birth during a vaginal birth. I don't want to scare you because 10 times more likely sounds like a super scary number like, “Oh, you're twice as likely to have a stillbirth after you're 41 weeks,” but it's an incredibly small increase and incredibly small risk already. It's the same thing with this. It's an incredibly small risk but we don't talk about those things. Meagan: It's even harder to find evidence for vaginal birth after three or more Cesareans. That's where we don't have a lot of information. Most providers out there, to be honest, if you've had three Cesareans, it's going to be harder to find someone that will allow you to give birth vaginally. It's so hard. But it still doesn't mean that you're absolutely not a candidate or that it is a ginormous risk that completely risks everybody out. People do it and again, we were talking about it earlier. If it's a risk that you are willing to take and it's a comfortable risk for you, then that says something. Yeah. VBAC after two Cesareans is totally reasonable and totally possible. We've got lots of stories on the podcast. I'm living and walking proof. Julie: And lots of stories of VBAC after three or four Cesareans too. Meagan: Three or four, yeah. Yeah. It's totally possible. If a provider is trying to tell you that your risk of rupture really is 50-60%, then that is one– not a provider that you should probably be going to for a VBAC, but two– something that probably needs to be changed because maybe they just are really uneducated on the evidence. We're looking at just barely over 1%. It's really low. Julie: And not even that, there are several different studies. ACOG sites two studies in their practice bulletin and one of the studies shows no difference in rupture rates between VBAC and VBAC after two C-sections. The other one shows a slightly higher increase. I don't remember what the numbers are off of the top of my  head, but VBAC Link does have a blog on VBAC after two C-sections. You can probably just Google “VBA2C” and it will pull up in the first or second search results, but I'm sure that Paige will probably also link it in the show notes for us. So take a look at those statistics because even ACOG says that and if ACOG says something, why are we not behind that evidence that ACOG published? Meagan: I know. It's so funny because ACOG goes through a lot to publish these things, these articles and journals, but then we're not having providers– I'm going to say midwives too. We have midwives that don't follow these practices. We have providers that don't follow it. The evidence is there. They're showing that it's there. Why aren't we doing it? CPDI know we're almost out of time, but I just really want to talk about CPD a little bit because lately in our inbox, we have been seeing a lot of people being told that they hear the stories. They see the stories and they wish they could, but they were diagnosed with CPD and they can't. They can't get a baby out of their pelvis. For those who don't know what CPD is, it's cephalopelvic disproportion. It's just pretty much saying that your pelvis is too small. Yeah. Julie and I personally have both been diagnosed. Julie: Told that, yeah, in our op reports. Here's the thing about CPD. It's incredibly rare. It's incredibly rare and most of the time comes from growing up incredibly malnourished like in third-world countries so your bones grow in a deformed way or after a traumatic pelvic injury. It's very rare for a true CPD diagnosis to come from a normal, healthy person. You can't even diagnose it without pelvic imagery exam, like an actual scan. It's not even an x-ray. If you go, “My doctor gave me an x-ray and told me my pelvis is too small.” First of all, that's not the right way to diagnose it. Second of all, pelvises– your body is so pumped full of hormones that our pelvises expand. They literally move around as baby is coming down. Babies' heads overlap, the skulls and these bones in their heads overlap and squish together and smoosh together to come out of that pelvis. Your pelvis is opening in ways that it doesn't normally and babies' heads are smooshing together in ways that they never will again, so how are you even supposed to tell how much a pelvis is going to open and expand and how much a baby's head is going to smoosh together? I will die on that hill. Man, I will die on that hill. No. You were diagnosed with CPD and that's bull crap. That diagnosis was bull crap and unless you grew up in Africa or in these poor countries. All of these African women are still having babies. Sorry, that probably sounded a little bit bad. I didn't mean to say it like that. These women are still having babies even though they were malnourished. You have to have a severe, severe deformity from malnourishment. Rickets is the disease that comes along usually wth CPD or a traumatic pelvic injury like maybe you got in a car accident. Meagan: Thrown off a horse. Julie: Or got kicked hard in there somewhere sometime by something. I don't know. But it's just not as common as people are saying. It's not. Meagan: Right. Yeah. It's just overused. So if you have been told that, I hope that through the evidence– we're going to have links here in the show notes to all of these studies and things. I hope you know that your pelvis is perfect. Julie: Your pelvis is perfect. Let's make a shirt. “My pelvis is perfect.” Make it a shirt. Do it. “My pelvis is perfect. Hashtag why we VBAC.” Meagan: Right. Okay, well thank you for being here. Thanks everybody for submitting your questions. We're going to keep doing these. We're going to bring the questions and answers. We're going to talk about them. We're going to talk about some of the statistics and the evidence behind some of this. So yeah. Make sure to watch out on our Instagram if you haven't followed us on Instagram, and I'll make sure to let you know when the next Q&A with Julie and I will be. Julie: If you're in Utah looking for a birth photographer, come and find me. My Instagram is @juliefrancombirth or you can find me at www.juliefrancom.com. I would love to support you and I would love it even more if Meagan and I could support you. So reach out, we'll give you a deal. We'll hook you up because we love being in the birth space together. Meagan: Yes, we do. We just got our first one the other day and it was awesome. Julie: It was awesome. 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

Have you heard of radical acceptance? Julie Francom leads our episode today alongside Meagan as they discuss what this concept is and how it is helping them process their births even now, years later. Meagan gets especially vulnerable today as she shares a part of her VBA2C birth story that has never before been shared on the podcast. Women of Strength, birth can be all of the things– empowering, euphoric, intense, and traumatic. We want you to know that we are processing and healing right along with you. We all have work to do and we are all in this together. Has radical acceptance helped you process your births? We would love to hear your experiences!Additional LinksAccepting Reality Using DBT Skills ArticleHow to Embrace Radical Acceptance ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode DetailsJulie: Heyo, it's Julie here, your co-host for the day of The VBAC Link Podcast. I am joined by Meagan Heaton, the ever-wonderful, always amazing, always uplifting and inspiring. Man, did I already say your name? I forget. I went on a tangent. Meagan: You did. Hello, everybody. It's so fun. When we were just talking about it, I was like, “Julie, you lead the episode today.”Julie: I'm out of rhythm. Meagan: It's great. You did a great job. Julie: We are here today. We were just hashing over topics that we could talk about something that I am working through always in my life and different things that we could possibly introduce today and we landed on the topic of radial acceptance. I think we're going to tell you about why we chose that topic here in just a little bit, but I'm really excited today because birth is complicated. I feel like everyone coming here in this space with us has probably had a complicated birth or witnessed a complicated birth. Hello, birth workers. Review of the WeekWe're going to talk a little bit about that and what happens when you just can't get over it or overcome it. But before we do any of that and before I ramble on my merry little way today, Meagan's going to read a review for us. Meagan: Yes. Okay, so we have this review from Apple Podcasts. This is from our friend, Tiffany. She said, “VBAC After Two Cesarean” as the subject. She said, “After two C-sections, I doubted if it was possible to VBAC for my third. I listened to your podcast my entire pregnancy and it gave me the strength and the knowledge to advocate for myself. I changed my provider three times before finding a supportive OB. My third baby came into this world on her due date with a successful VBAC after two Cesarean and I couldn't thank The VBAC Link enough.”Oh, I am so happy for you, Tiffany. Huge congrats. This podcast is literally meant for exactly that– to give you the knowledge, to give you the strength, and to just give you the connection and this community. This community is so beautiful, so vulnerable, and obviously so near and dear to both my and Julie's hearts. That is exactly what we want this podcast to do– to build you up, to strengthen you, to educate you, to go on and have the birth that you desired, and if you don't have the birth that you desired, to have a better birth outcome. We don't have to have a VBAC in order to have a better birth outcome. That's really important to talk about too. Through this podcast, we share all of it. We share CBAC stories and elective inductions and all of these things because we know that one size does not fit all. That's exactly what we are going to be talking about today during the episode. Julie: Yep. I love that. Meagan's going to get a little bit vulnerable. Meagan: I am. I'm going to talk about a thing that I don't think I've fully opened up to yet years later. Radical AcceptanceJulie: I'm getting old now. I know that everyone is like, “Oh, you're not old.” I'm 38 though and I'm feeling it. I can't even come home from a birth now without creaking my bones in the shower and into bed. I am feeling it. I know 38 is really not that old, but I feel like I look at my friends who are 28 and I'm 38. That's a 10-year difference, right? I'm starting to see some differences between myself and them just in the space on the time lived and the amount of life lived and the amount of time spent on this twirling rock in the universe. It's interesting because I know it's not a secret here that I've had a huge mental health journey over these last two years. I feel like a lot of that has helped me grow and evolve as a human. Maybe I'm a little bit older and wiser than I was when I was 28. Oh my gosh, I hope so. I don't know. Yeah. I've come a long way since then. But, we wanted to talk today about a term that I learned in therapy called radical acceptance. I'm just going to get right into it. I don't know. Do you want to say anything, Meagan, before?Meagan: Yeah, so are you going to define it? I was going to say that radical acceptance is something that can be defined as the ability to accept situations that are outside of our control without judging them which in turn reduces the suffering that is caused by them. I think, Julie, what we talked about before is that you should start right out there and talk about radical acceptance, how you learned about it, and how it came about. Julie: Yeah. Gosh, I love it. I remember when I was going through my big trauma-processing journey a few years back, that's when I really learned the term “radical acceptance, radical acceptance” and I love it because radical acceptance is where you have to stop fighting reality. You stop responding with impulsive behaviors or destructive behaviors when things aren't going the way you want them to or looking back on the way things happened. You've got to let go of the bitterness that can be keeping you trapped in this cycle of suffering and to truly accept the reality, to radically accept the reality, we have to understand the facts about the past and about the present– like what's going on now– even if they're uncomfortable or if there is something that we didn't want to happen or to be happening. We can examine the cause of this suffering that we have encountered, the events surrounding it, or all of the situations that we went through that have caused us pain or are causing us pain. But by radically accepting them, stopping fighting them, and stopping living in this cycle of suffering, we are better equipped to move forward into a life that is better and that is more promising, and more hopeful and causes us less anxiety and less pain. I feel like it's just all about embracing things as they were, embracing things as they are, and being able to live in that even though you haven't changed any of it. I was telling Meagan before we started– I am saying this. This is a perfect example. I will never, ever, ever, ever know if my Cesarean was necessary. I won't. I think I can list ways and reasons why it probably was and I can also list reasons why it probably wasn't. I'm just never, ever, ever– I can say ever so many times– I will never know–Meagan: Never, ever, ever. Julie: –for certain whether it was necessary or not. Was my induction necessary? I think so, but I mean, I don't know really. That used to really bother me because I'm a very analytical person. I liked fixed facts and data. I like to know things with certainty. I do. That is something I won't ever know. I'm okay with that. I feel like getting to the point of being okay with not knowing and with the certainty that I will never know is very freeing. It's freeing. I feel free. I am not haunted by it. It doesn't keep me up at night. Moving beyond that, I know that I am a good mom even though I didn't know everything that I wish I would have known going into my first birth. I have radically accepted the fact that there were things I didn't know and that's okay. I am okay with that fact. I have radically accepted the fact that I cannot be a human superwoman who can juggle all of the things in my life that I need to– my kids, my husband, my birth photography, doula work, The VBAC Link, and all of these other things. I had to drop these other things and I had to radically accept that I could not keep going in the life that I was doing. It doesn't mean that anything has changed. My C-section was the way that it was. There was no change there, but I have changed the way that I thought about it, the way that I continue to receive it, and the way that I respond to those circumstances. I feel like that's what radical acceptance is all about. You can't just turn on a switch and be like, “All right. Radical acceptance. Schwink”, but I feel like if you move forward with the desire of that radical acceptance, then that will impact how you respond physically and emotionally to the thing that you're trying to accept. I don't know if that makes sense or not. Meagan: No, yeah. It does. This is going to apply to all things. In all things in life, it's really hard because like you said, it's not just a “schwink” like you say. It's not a switch you can turn on and off like, “Okay. It's gone. I accept it. Moving on.” It's not like that. It takes a lot of time and it takes a lot of mind-power and will. You have to be okay to let it go and to let the attachment to the painful past or the pain that you are holding onto go because really what is happening in so many ways is that pain is overcoming you. It's taking over you. Like Julie said, she's not staying awake all night thinking about it. It's not consuming her thoughts anymore. She's let it go and it's in a healthy place. “Okay. This happened. It's not what I wanted. It's not what I would have chosen, but it happened. I don't know if it was needed. I don't know. I really don't know, but I'm going to accept that it happened and I'm moving on.” Yeah, so I think it's so important to know that you can't expect yourself to just do it. Right? But it can be done. So yeah. Keep going. Julie: Yeah, no. I feel like another simple way to say it, and it's not simple, but a simple way to say it is understanding what you have control over and what you will never have control over. I can control how I respond to things. I can control how I do my self-care. I can control whether I meditate or not. I can control what type of clients I take on and what my travel radius is. I can control what provider I choose. I cannot control what provider I chose. It's already happened. I cannot control how Meagan thinks or acts in any situation. One of the things that radical acceptance term really clicked and the first thing that I radically accepted was my sister-in-law and I butt heads a lot sometimes. It's gotten better over the last year and a half because I have radically accepted that she is the way she is. It took me a long time. It sounds easy, but it took me a long time where I just don't worry about it anymore. She does this. She says this and I don't worry about it. I interact with my children the way I want to interact with them. I teach them how to treat other people. I respond to people how I do. I know how to treat other people and try my best to treat other people well although I am not perfect at it because none of us are perfect, but just radically accepting it– I remember the day where I was just like, “Yes. She is the way she is and I'm okay with that.” It felt like a light switch at that time, but it was a lot of things building up to that moment. I feel like we should probably say that we are not medical professionals. We are not mental health professionals. We are just talking about our real-life experiences so I feel like if you have things that you need to process through, you should see a therapist or you should see a mental health professional or somebody that can really help you. Meagan, I just sent you an article. You can link it in the show notes. Meagan: Yeah, I have it. Something that I really love is what is reality acceptance. Julie: Yeah, so drop this in the show notes. I feel like this has got lots of helpful tips there, but I want to skip to the end where it says, “10 Steps for Practicing Acceptance”. I'm using DBT. DBT is just a different type of therapy, but I feel like the first one is such a big deal. I could go off on another therapy tangent, but I won't. The first one is “Observe that you're fighting against reality.” It shouldn't be like this. Every time you say, “I should” or “I shouldn't” or “He should do that. My doctor should know better. I should do this. My kids should go to bed.”Those are requirements that you have for the world and requirements are not usually healthy. They're just not. I could go off on a whole thing, but I won't. “I should do this. He should do that. I shouldn't feel like this. I shouldn't feel sad. I have a healthy baby. I shouldn't feel sad about it.” No, that's a requirement and that is fighting against reality. You're fighting against reality when you say things like that. That's a sign that you're fighting against reality. I feel like sometimes awareness is the first part of it. Or “so-and-so shouldn't post triggering things like that. Those things trigger me. They shouldn't be posting that. They should post a trigger warning with their comments.” Those are all signs that you're fighting against reality, right? Some type of reality that exists somewhere inside of you. And then the second is just reminding yourself when those things happen, instead of sitting with that, “It shouldn't be like this. She shouldn't have said that,” remind yourself that that reality, you cannot change it. You are not in control of it. Sometimes that awareness, being like, “Oh, I'm doing this. Okay no, you're right. This is fine. It's not going to change. I can't change this. I have no control over that.” That's the first step into your radical acceptance path. I'm just going to read through the rest of these really quickly and I highly recommend that you sit with these if you can. “Acknowledge that something led to this moment.” Something happened to you to lead you to have this kind of response. The next one is, “Practice acceptance with not only your mind but your body and spirit.” Be mindful of your breath and your posture. Use your self-care skills. Use half-smiling and take deep breaths. That's a big thing for me. I take deep breaths when I feel those sensations and that tightening and tensing in my body. The next one is, “List what your behavior would look like if you did accept the facts and then acted accordingly.” Imagine what it would be like if these things didn't bother you. Meagan: How would you look? How would you feel? How would you be living your everyday life?Julie: How would your environment change? How would your body feel? How would your breath feel? “Plan ahead with events that seem unacceptable and then plan how you should appropriately cope.” Oh my gosh, we go to my in-laws for Sunday dinner every other Sunday. It was like, every Sunday dinner going in, I would see my sister-in-law. We've had moments where we've been grumpy with each other and moments where we've been fine. But during those grumpy stages, I would walk in bracing for a fight, but when I became aware and was working on my radical acceptance, I would just meditate before, breathe deeply on the way in, and walk in with a posture of lightheartedness and airyness and it helped so much. “Remain mindful of your physical sensations” because your body will respond before your mind catches up to what's going on. So being more mindful of your body is so important. “Embracing feelings of disappointment, sadness, or grief.” It's okay to have those sad feelings and those hard feelings. It's okay. You should sit with them. You should sit with them and explore them and let them move through your body, but don't stay there. Don't stay there with them forever. “Acknowledge that life is worth living even when there is temporary pain.” Things are worth moving forward and moving through. And then the last one is, “If you feel yourself resisting, complete your pros and cons exercise to better understand the full impact of your choices or your experience.” I feel like all of those things, wherever you're at in the process, moving through these steps or these little feelings are going to help you grow and become better. You're going to be released from these things that are burdening you, this reality that you don't like or that you don't accept. But yeah. Meagan: Yeah. That's what I was saying. Radical acceptance doesn't have to mean that you agree with what happened. Julie: Yes. You don't have to endorse it. It doesn't mean you have to like it. Meagan: Right, but it gives you a chance to accept things and not fight against it because it is insane how much we don't realize that sometimes these things will bring us down. They're going to bring us down. There are many times– we were talking before we were recording about how sometimes it's not even to us. As birth workers, we see things and we're like, “No!” You know? Or we have friends and we're like, “No, don't do that.” But we can't control them. We have to know that we can't control them and it's okay that we can't control them. We may not agree with the choice that they are making, but it's okay. We have to accept that. That is a choice that they feel is best for them. That is what they are doing whether or not we would do that or not. So, kind of in the beginning, Julie was talking about, “I will never, ever know if my Cesarean was truly necessary,” and something when we were talking about this is that I'm never going to know blank, blank, blank. I don't know if I've ever really, deeply talked about a part of my birth story that happened and that does affect me. It's really hard. As I'm learning about this radical acceptance, it's like, “Have I done radical acceptance? Have I practiced this or is it still eating at me?” I think it probably is still eating at me. I probably fully haven't. I'm working that way and I'm waiting for my light switch to go on and off, but I'm working up to it. It's like my light switch is half on. It reminds me of Hypnobabies. My light switch is dim. It's coming down but it's still there. So yeah, I'm going to open up to you and just tell you guys. I don't think I've ever talked about this that I know of. Julie: I'm so curious. Sorry. Meagan: You're just fine. So after I had my son, Webster– he's my VBA2C baby– I was so happy. I was so happy and I will never forget that moment of, “You guys! I did it!” and just ugly crying, screaming, and looking around the room and everyone– not a dry eye in the room– looking at me just smiling from ear to ear. And then what happened after is what I may need to work on accepting. I remember sitting there holding my baby and hearing everyone talking and then all I heard was, “Riiiiing.” Yep. I heard ringing, just like that in my ears, high, high-pitched. My ears were just buzzing. I'm sitting on a horseshoe thing holding my baby. We're waiting for my placenta. I'm hearing it and it's getting louder and then everybody started going fuzzy. I woke up on the floor covered in blankets confused. My husband said, “You passed out.” I said, “Okay. I thought I was going.” I knew what was happening, but I didn't want to say anything. He said, “I looked over,” because he was right behind me. He said, “I looked over your shoulder and your arms just went limp so I hurried and grabbed the baby and said, ‘You guys, she's passing out.'” I pass out. I'm on the ground. I wake up and I'm like, “What just happened?” Everyone is still so happy. They're not acting really any differently. They're just like, “You passed out.” I'm like, “Okay, well I did just go through a long labor. 42 hours of labor, pretty intense pushing. I hadn't eaten a ton. I hadn't eaten a ton the day before either because I was not feeling very good.” Anyway, so I was like, “Okay, cool.” A phone was handed to me and they're like, “Your chiropractor is on the phone. You've got to tell her,” so I'm like, “Hi!” I'm telling her how I did it. I'm so excited and back to normal. But laying on the floor, I guess pushing out the placenta, I don't remember. Then they're like, “Okay.” I hang up the phone and they're like, “Okay, let's get you to the bedroom.” I'm at a birth center. I'm like, “Okay great.” We stand up. We walk to the bed and I'm not feeling very good. I'm feeling really funny. I can just feel my heart. It's pounding. I think I made it to the bedroom and I was in the bed. I just remember not feeling very good. They were taking my vitals. My vitals were off, but I was just so happy. I was so elated. I was nursing my baby. He latched really fast and I was so happy. Then they're like, “Okay, we've got to get you to the bathroom.” This was a couple of hours later. They fed me some food and I was hoping that maybe it was blood sugar or something. Anyway, they fed me my food and were like, “Okay, let's go to the bathroom.” I get up and before I know it, I'm waking up. I wake up and the first thing I say is, “I'm on the ground again.” They're like, “Yeah, you just passed out again.” Did you know this, Julie?Julie: Okay, so it's kind of ringing a bell a little bit, but I don't remember.Meagan: You don't remember all of it, yeah. Julie: Well, I remember other little parts, but I just don't want to get ahead of you. But go ahead, you're fine. Meagan: Yeah, you're fine. I'm like, “I'm on the ground again.” They're like, “Yeah, you just passed out again.” I was like, “That's weird.” So I sat on the ground. We're talking about random stuff, you guys. I still remember to this day. Serial podcasts, Adnan Syed, if anyone likes crime, that was my favorite podcast. I was like, “What do you guys think? Is Adnan guilty or is he innocent?” We were just talking about all of this random stuff. They were probably thinking, “What?” It was like my fight or flight was like, “I can't deal with what is happening right now. I have to talk about something else.” So we talked about that. We talked about such random stuff. I was like, “Okay. I feel better.” I had sat up and I was like, “I'm feeling really good.” So I sat up. I walked to the toilet. I sat on the toilet and I was like, “I'm going again.” I could feel it. I communicated it. My doula and my husband run over. I'm literally falling off the toilet and I wake up to an alcohol swab. My doula had an alcohol swab on my nose. I wake up and I was like, “What the heck? What is happening?” I go to the bathroom. I go back in and I'm just not doing very well. My vitals are not good. My pulse is really high and my heart rate was actually really low. My blood pressure was low. I'm actually showing signs of shock is what I'm showing, but it's not clicking in my head. “What in the heck, right?” Needless to say, I go home. I'm not doing really well. The next day, I'm really not doing well. I'm white as a ghost. I have this weird, crazy thing. I stand up. I've got ringing in my ears. I feel like garbage. I'm very dizzy. I can't get my breath. It's just really weird. Anyway, I went to the hospital because I had gone to the midwife the day before. We did a blood draw and she said, “Yeah, you've got low blood counts.” I was like, “Okay.” It was the Fourth of July. I'm really not feeling good. We go to the hospital. We do my blood tests. The doctor comes in and has a very serious face and I'm actually really mad. It's the Fourth of July. I just had this beautiful VBAC and I'm in the hospital emergency room without my baby. Without my baby. My mom stayed with my baby. I'm pissed. I'm like, “What the heck is happening?” So he comes in and he's got this very serious look on his face. He says, “Well, we're going to have to run some more tests.” I said, “Oh, okay. What's going on?” He said, “Well, half of your body's blood is missing.” Julie: This is the part that I remember. Meagan: Yeah. Yeah. He said, “Half of your body's blood is missing. You said you're not really bleeding, right?” I said, “No.” After you have a baby, you're bleeding, but it wasn't bad. I was like, “No, yeah. Pretty normal.” He was like, “Okay. Well, we're going to do some tests to see if we can find internal bleeding and if you're bleeding internally.” I said, “Okay.” So anyway, we did all of these tests. We can't find my blood. It's gone. It's missing. I have no blood– or half of my body's blood. I look like a ghost. I feel terrible. I can't function very well and he's like, “We can't find it. We don't know. You're not bleeding internally. You're not bleeding externally. We have no idea what's happened to you.” I'm like, “Okay.” So they said, “You need four bags of blood. Two blood transfusions. Two bags each.” I don't know why. It freaked me the heck out. It was a lot of someone else's blood. I know we've come a long way. I thank all of the donations. I thank all of the donations out there, but it freaked me out so I actually declined and to this day, I need to have radical acceptance. I question, “Why didn't I get blood? I would have felt better.” Julie: It took you forever to feel better. Meagan: It did. My levels were back to pretty much just above normal at six weeks. Everyone told me it wouldn't happen. Sorry, I'm weird. Yes. I ate my placenta. I did placenta encapsulation. I swear it helped. Everyone told me I was crazy. They were like, “You're not going to be able to breastfeed. You're in bad shape. You're really bad.” And I didn't do it. So I had that. Why didn't I do that? But all in all, I still have this, “What in the heck happened to me? What happened? How did that happen? Why did that happen? How does someone lose half of their body's blood?” Julie: And don't know where it goes because you didn't hemorrhage afterwards. Meagan: No. No. I had very little, normal blood loss after. Anyway, I have lots of questions. I have lots of hypotheses. I have a lot of things. Could this have happened? Could this have happened? I don't know. Maybe this happened. And some days, Julie, it does take over my mind. I get angry. I get confused and I sometimes question my team. Is there something that they know that they're not telling me? I don't know. I struggle. So I need to practice radical acceptance. Julie: Radical acceptance. Yes, you do. Meagan: Because that did happen to me and it is frustrating because I did say– so the signs of lack of acceptance is “This isn't right. It's not fair. It shouldn't be like this. I can't believe this is happening. Why is this happening to me? Why did this happen?” I have all of those feelings still. It's not fair. I had this beautiful VBAC. Now, I have this shitty– yes, I'm saying the word shitty on the podcast– postpartum experience. It was really hard and I was mad. I couldn't believe it was happening. It shouldn't be like this. I should be screaming from the rooftops, “You guys, I had my vaginal birth after two Cesareans!” But instead, I could barely walk. So I need to practice this radical acceptance. I need to recognize these signs and I need to get better because I am angry with the situation and confused. Julie: Yeah. Meagan: I feel stuck. I feel stuck. What happened? But like you don't know if your Cesarean was ever necessary, I may never know what happened to me. Julie: You will never know where all your blood went. Meagan: I will never know where all my blood went. Julie: Nope. Meagan: I will never know why I had ringing in my ears and why I passed out three times after I had him. Right? I will never know. So I have work to do. Julie: We all have work to do. Meagan: I was going to say, it's okay if you have work to do too. Women of Strength, we all have work to do just like Julie said. We have to take one step at a time moving forward and working through it and letting go of the painful past of the unknown. Julie: Oh my gosh. Okay, so I have something to say. Surprise. My therapist is obsessed with his wife. Obsessed. You wouldn't want anyone to be more obsessed with you if you are married to this guy. A few months ago, she came to him and she wanted a divorce. They are getting divorced now. Meagan: Oh my gosh. Julie: I know. It took everybody by storm. I was like, “What is happening?” Anyway, the details are not important, but he came to one of our trauma support groups the other night. He's not affiliated with the company anymore, but he just came because I told him to come and he listens to me because I'm his favorite. We were all going around the room sharing how we were doing and he wasn't going to share, but everyone got done. I came a little bit late and I was like, “Oh, did I miss his check-in?” He said, “Oh no, I wasn't going to share.” Then somebody else came in and they shared, and then he said, “You know, actually, I think I will share.” He was like– anyways, he had some concerns about sharing or not and he decided to share. What he said, I think, will always stay with me. But while he was sharing, he said, “This is the most pain I have felt in a long time, but I am sitting with it and I am letting myself feel it because I know it is the fastest way for me to get through it.” I was like, “Yes. Yes.” Sitting with that pain and that hurt and that discomfort is hard. It is so hard. So, so, so hard, but allowing yourself to sit with it and feel it and hurt and suffer is going to be the fastest way for you to get through that suffering. It's going to shorten the amount of time you have to suffer and it's going to stop it from controlling your life– maybe not right now. Probably not right now, but as you move on and as you go throughout your life, if you don't let yourself sit in that pain and struggle, then it will continue to control you and you will continue to be miserable. I just thought that was so impactful that he said that. I know that is the fastest way for me to get through this is to feel it. Meagan: Yeah, and that's scary, right? That's scary to say, “I'm going to open up and I'm going to welcome this pain.” Julie: And be vulnerable and receive it and hurt from it. Meagan: Yes. Women of Strength, as you are going through your births, you may run into this where you feel cheated or lied to or you are starting to question your own decisions or whatever. We've had an undesired birth outcome or experience and we hurt. They sting. They sting. But it's okay to one, sit with it like she said, and two, be vulnerable and be mad or angry or sad. It's okay to feel the feelings and then it's okay to have radical acceptance and move on. It's okay if it doesn't happen overnight. I love that. He sat with it or he's sitting with it. It's the fastest way for him to heal. Julie: Yeah, because he's a therapist, right? He obviously knows a thing or two. But sometimes it's hard even when we know. Meagan: Even when we know. Yeah. Yeah. So as you walk away from this episode today or drive away or wherever you are listening, we hope you know that we love you. We love you and you need to love yourself too. Offer yourself grace. Sit with it. Sit with it and find radical acceptance. Julie: We wish that for you. Meagan: Mhmm. 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

Meagan and Julie talk about the ARRIVE trial and compare those findings with new research released from a retrospective study conducted at the University of Michigan. Many first-time moms and VBAC moms are being told by their providers that an elective induction at 39 weeks will reduce their chances of a C-section. Is this really true? Meagan and Julie will empower you with information about elective inductions to help you make decisions about your birth that are right for YOU.Additional LinksUniversity of Michigan StudyThe VBAC Link Blog: The ARRIVE TrialARRIVE TrialHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode DetailsMeagan: Hello, hello you guys. Guess what? Julie is on today. I have kind of, well not kind of, really missed Julie. I reached out to her a month or so ago and was like, “Hey, would you like to come on with me and we can do episodes?” And she said, “Yes!”Julie: Yes. Meagan: I should have brought chocolate cake. Instead of her proposing to me with chocolate cake, I proposed to her with my smile. I don't know what I'm trying to say. I don't know. I don't know. But she said yes and I'm so glad that she said yes this time. So welcome, Julie. Welcome, welcome. Julie: Welcome. It's good to be here. Meagan: Yeah. It's good to have you here. It's good to see your face. Julie and I are going to be talking about the ARRIVE trial today. That is something that if you're not familiar with, it was done in 2018, and I think it was published in 2019. Does that sound right, Julie?Julie: Yeah, I think the final analysis was published in 2020. Meagan: Yeah. Julie: The study was completed in 2018. Meagan: Yeah. Yeah. It is where they did a trial to see if elective induction at 39 weeks reduced a lot of things. Not just Cesarean, but because we are in the Cesarean world, it was definitely, I would say, one of the most important topics. Does it reduce Cesarean? But also, does it reduce the chances of preeclampsia, hypertension, and other things? But the big question was does it reduce the chances of Cesarean? So we are going to talk about that today. We have a blog on it today, but there is actually an update. That was done in May of 2023 so we are going to talk about that. Review of the WeekBut of course, we have a Review of the Week and Julie is going to do the honors. Julie: Yes. I'm so happy to be back and joining the podcast anytime. All right. This review is from bethanystaggart or something like that. The title is, “Podcast Was Part of My VBAC After Two C-Section Journey”. She says, “I am so thankful for this podcast. I listened to so many episodes in preparation for my VBAC after two Cesareans. Listening to other women share their stories gave me the courage to keep working and fighting for my upcoming birth. I just gave birth to my third boy and the birth was everything I could have asked for. I am so thankful for this podcast and blog and refer every expecting mom I know to it in hopes that it gives them the courage and confidence it gave me to get the birth they want and deserve.” That just makes me so happy to hear those things and to know that the podcast is making a difference in everybody's lives. I feel like there is such a feeling of solidarity when we sit and listen to other people's birth stories. There is so much we can learn and there is so much that we can be inspired by and there is so much that we can use as we navigate our own birth journeys. So thank you, Bethany, for leaving that incredible review. ARRIVE TrialMeagan: All right, Julie. ARRIVE Trial. I feel like when this came out, you and I– I'm going to say for sure I– was just a little grumpy. I was like, “This can't be. This cannot be.” Being in the birth world, especially since COVID, but this is pre-COVID, we definitely see induction and it can happen just fine, super smooth, with no problems, but then there are a lot of times too where it doesn't. We see the cascade that leads to that Cesarean. I remember when Julie and I started the birth course and the How to VBAC Prep Course, we were teaching in person. We had a mom who came and when we talked about this, she was like, “I was in that. I was in that trial.” We were like, “Oh, how did it go?” She was like, “Well, I'm here prepping for a VBAC.” She had a Cesarean. She talked to us a little bit about it, but Julie, what do you remember about your first feelings when this trial came out?Julie: Well, I had a really hard time because you and I have been to many, many, many, many, many births in a hospital, out of a hospital, inductions, unmedicated, medicated, scheduled C-sections, emergency C-sections, crash C-sections. We've been to all of it. I think that's really the unique perspective that we have as doulas and birth photographers because we get to see the biggest range of births, I feel like, of all of the people that work in the birth world. My first reaction when the ARRIVE trial came out was that it did not reconcile with my real-life experiences and living in all of these types of births. There was this disconnect between what this study said and what I had witnessed. Before I even got into the study and saw all of the flaws and the different little nuances that people be considering that they don't because I just knew that something didn't feel right. This cannot be right. This cannot be right. Meagan: Mhmm, yeah. That is kind of how I felt too. It didn't click. I was like, “So, what? What did they do?” This was my first question as I was reading. I was like, “What did they do to ‘lower the Cesarean rate'? What did they do differently?” I think that one of the most frustrating parts is that we don't really know exactly all of the protocols and all of the exact nitty-gritty details of this study. They haven't released it from my knowledge anyway. Julie: Yeah, and I looked too just a little bit before we started recording. Yeah, sure. It's really interesting because in the study results, the elective induction group had a Cesarean rate of 19%, and the expectant management group, which we'll go into all of the reasons why that is a little bit crazy, had a Cesarean rate of 22%. But here's the thing. The national Cesarean rate is 30% so I feel like already, they were doing things in the study that impacted the chances of having a C-section anyways. But we don't know what those protocols are. We don't know how they were induced. The results said, “When this induction protocol is followed, then the Cesarean rate is reduced,” but the problem is that we have providers all over the country inducing willy-nilly not knowing what the protocol is, and probably being more aggressive in their inductions. We know the providers that led this study. We know who they are. We have worked with them in their space. We know how they practice and we know that the induction protocol was probably– and again, this is me speaking with no real knowledge, just my assumptions. Take that for what it's worth. They probably had a pretty gentle, slow induction process. They were probably pretty patient along the way just from what we know of those providers and the hospital that it originated from. That was also a thought. 22% is not a low Cesarean rate, but it's 8-9% lower than the national average. So that's something I think to consider as well into that. Meagan: Yeah. It is interesting to me because it was 50,000 patients that were screened for this study. Of those 50,000, 22,000 were eligible but only just over 6,000 actually accepted to be in this trial. Those numbers to me are pretty dramatic. 50,000 to 22,000 to 6,000 is a really big thing. I wish I knew more. We know what people have said who were in the ARRIVE trial. They had to do certain things, but I wish I knew more about why all of those people were declining and then why from 50 to 22,000 were eliminated. Why were people eliminated? But maybe it's just because, “Yeah, we don't want to,” because what we had seen is that induction raises Cesarean deliveries. Like Julie said, yes. We are going to share some studies and some numbers and things, but this is all just us brainstorming this out loud really because it is really interesting to me. Like Julie was saying, how long were these people able to be induced? Because induction– I mean, even if you go listen to all of these stories, Julie. Induction is not something that is able to be carried out for days and days and days usually. Julie: But sometimes it is. Meagan: Sometimes it is. Julie: Sometimes and that's what we were talking about or I was talking about earlier. At this hospital where the study originated and where the providers practice that were the authors of this study, I have been to many, many, many two and three-day long inductions there that ended in vaginal deliveries. Meagan: So have I. Julie: And not all hospitals are that patient. In fact, I don't know of any that are that patient in our area. Meagan: Yeah. No. I mean, the hardest thing is that if your client doesn't want to be induced, you want them to not be induced because that's not what they want, but if they are going to be induced, you almost want them to be induced at this specific hospital because we know that they will let these inductions happen. I think the longest induction or the longest birth– well, it is the longest birth I've ever been to, but at that hospital specifically was 52 hours. Julie: Yes. Meagan: I remember crawling up on the ground, putting a towel on the ground and falling asleep trying to take a nap because I as a doula had been there that long. They had called me in the very beginning. That is just not normal. Right? It's not that normal. What kind of piqued our interest in wanting to talk about this again– I mean, we're talking about something that happened in 2018. Now it's 2023. It's that the University of Michigan just released an article talking about this. It's called “Labor Induction Doesn't Always Reduce Cesarean Birth Risk or Improve Outcomes for Term Pregnancies”. So we want to talk about that and update you guys because we believe that updates, as we get more information, is important. So yeah. It was a 14,000– Julie, you were kind of analyzing– births. Julie: Yeah, so what I really liked about the Michigan study that was released is that it was a sort of analysis. This study was looking back at births and how they ended. Births that did not enter into a study. Births that were not set up in order to track. Births that just happened without any care in the world in this regard. They looked back at the data that they had already had. I love that because that's what I love about Cochran reviews. I'm a big Cochran review junkie because Cochran reviews look at a whole bunch of data and a whole bunch of studies and put them together instead of creating a study and moving through it. The ARRIVE trial study was created in order to show if induction reduced the risk of Cesarean or other maternal or fetal mortality rates. How does induction impact that? That's what this study was designed to do, but this study, the Michigan State study, looked back at data that had already existed without any type of bias going into it. Yes, there were 14,000. They looked at 14,135 deliveries in the year 2020. They analyzed all of those to look at the outcomes. Who ended in a Cesarean? Who ended up with hypertension? Who had postpartum hemorrhages? Who had– what was the other one– oh yeah, high blood pressure? Did I say that already? Operative vaginal deliveries– vacuum and forceps? That's how they pulled it. There are different ways of looking at data as accurate so I don't want to say that it's more accurate, but I love that they looked back and that reflection on it. They showed that the group that was induced in the 39th week had a 30% rate of Cesarean which is what I was just saying. What was I just saying? The national average is 31.2%. That fits more in line with the national average of people that went in and got inductions versus 24% of the people who had the expectant management. 24% is not a great Cesarean rate either but it's just a 6% decrease in those amounts of Cesareans. Also, for people that are wanting to know, the rest of it was people who were induced had higher instances of postpartum hemorrhage, so 10% versus 8% for the expectant management group. When we say expectant management group, those are the people who were not induced. They were just going through taking pregnancy as it came and then delivering whenever that looked like. When it was medically indicated to have an induction after the 39th week, those are probably included in those numbers as well. Operative vaginal delivery, vacuum, and forceps were 11% in the induction group versus 9% in the expectant management group. Although people who were induced were less likely to have hypertensive disorder which is high blood pressure. Those numbers are 9% in the expectant management group versus only 6% in the elective induction group. There were no significant differences, no other differences, in neonatal outcomes. No differences. Nothing dramatic, nope. Meagan: Nothing dramatic. The researchers mimicked the exact same framework used in the national trial. A CNM said, “We designed an analytic framework mirroring the previous trial's protocol using retrospective data but our results didn't reinforce a link between elective induced labor in late pregnancy and a reduction in Cesarean births.” Julie: Yep. Meagan: It did not. It's so interesting because even now, today, we are still– as a doula still working in the field– seeing these inductions not even just being offered but flat out just being scheduled. Like, “Hey, we are going to schedule your birth at 39 weeks.” They do. They say, “Because that is going to lower your chance of Cesarean rates.” Julie: That's what they tell you. Meagan: Yes. They do tell you that. When you are expecting for the first time, the second time, or anytime, most of the time, someone is not necessarily wanting to go in for an elective Cesarean, right? I don't want to say that it doesn't happen because it does and that's okay. But it's really not what's happening. People don't just start raising their hands and sign up for Cesareans, especially first-time moms. Julie: Do you mean inductions? Meagan: No, Cesareans. Julie: Oh, okay. Gotcha. Meagan: No. They're not like, “I want a Cesarean. I want a Cesarean.” So when you have a provider say, “Hey, at 39 weeks, we'll go ahead and schedule an induction because that is going to lower your chance of having a Cesarean.” Julie: Then they're like, “Oh, yeah. Absolutely. Go for that.” Meagan: They're like, “I don't want a Cesarean.” Right. So that's where we go but then we're looking at this and we're like, “Mmm, but does it really lower our chances of Cesarean?” Julie: Mhmm. Meagan: That is where it's frustrating and that is where I feel like–Julie: People are being misled. Meagan: Yes. I was just going to say that we have misguided people into doing certain things that actually don't have the most solid data out there. I don't want to discredit the ARRIVE trial. I'm not saying that it's completely false or wrong. I'm just saying, “Let's look at it deeper and why don't we release more about this trial?” It's been how many years now and that hasn't been released but we are still inducing at 39 weeks. Julie: Yep. Well, it's so funny because– okay. I'm going to change my thoughts actually. Strike that. I feel like I want to go back and talk a little bit more about what you talked about in the beginning about how the number of people that were eligible in the trial versus those who elected to be in the trial. 72% of women who were approached to be in the study declined to be in the study. Meagan: Declined it. Julie: So this is what happens. Your doctor comes up to you and says, “Hey, we're doing this study.” Some people are just not going to want to be in studies and that's totally fine. It doesn't matter, right? But your doctor comes up to you and is like, “Hey, we're doing a study. We're going to randomly assign you to a group. You can be induced at 39 weeks or you can be in the expectant management group, but if you hit 40 weeks and 5 days, we're going to induce you anyways,” because that is another thing that they did. They counted those in the expectant management group. If they got to 40 weeks and 5 days and hadn't had their baby, they were indued. Now giving intel, ACOG recommends 42 weeks and 6 days before induction is absolutely necessary. They say it should probably be considered in the 41st week so between 41 and 42 so why are we not waiting until 41 weeks? Why are we not giving them two more days? Why are we not giving them nine more days to get to 42 weeks? But that was the cutoff for whatever reason. Meagan: 75% of the group overall had their babies by that day. Julie: Yeah. That's a big percentage of people that are still being induced at 40 weeks and 5 days. So your doctor comes to you with these two options and you say, “You know what? Sure, that sounds great” or “No, I don't really want to.” 72% said, “No, I don't really want to,” for whatever reason. I know for me– well, first of all, you had to be a first-time mom so there are no VBACs included in this at all. It was all first-time moms. So it doesn't apply to anybody else. This study's risk findings do not apply to anybody else. Same with this Michigan study. The Michigan study only looked at first-time birthers. So as a first-time mom, I know that as I was planning for my first birth, I wanted a Hypnobirth. I was planning on going unmedicated. That was what I wanted. That was my birth plan and my birth desire. It obviously didn't end that way, but I wouldn't have elected into or opted into that study because it went contrary to the things that I knew I wanted for my birth. I feel like the ARRIVE trial automatically excludes it. People will automatically not do it if they are a more naturally minded person who wants a more hands-off birth experience. I feel like you are going to get really honed into a medical demographic that is okay with the medical system, that trusts their doctors, that wants to just go in, get hooked up to an epidural, and have a baby. Not that there is anything wrong with that, but I feel like the mindset going into birth can influence how you respond during birth and how your body responds during birth. That's the other thing that I really like about this Michigan study. I feel like you have a wider demographic in the mindset department of how these people birth. I feel like there are going to be more types of birth plans involved there. There is going to be a bigger variety of people and of experiences that are sought after in the birth space in the data set for Michigan. Meagan: Yeah. You just kind of talked about this. So how does VBAC and the ARRIVE trial even apply or does it? Julie: It doesn't. Meagan: It doesn't. That's the answer, but you guys, we are still seeing so many, so many of our VBAC mamas being told that they have a higher chance of Cesarean or they have to have a baby at 39 weeks in order to have a vaginal birth because they have a higher chance. The ARRIVE trial is actually brought up to these people because they are viewed as first-time moms because they haven't had a vaginal birth. But that's not the case, right Julie? So many people who have had a Cesarean actually labored and dilated to some degree, if not all the way, right? Julie: Yep. Meagan: So why are we applying it at all to anyone– I mean, if I had my way? Julie: They shouldn't. I feel like there is probably something a little bit unethical about doing that. Saying, “Hey, look. There's a study that came out saying that inducing you at 39 weeks reduces your chances of having a C-section.” I feel like when that alone is being said and offered, it's a little bit unethical. Meagan: Yeah. I just don't love it. I don't love it at all. So let's talk about some other ways. I guess let's wrap it up. Does inducing at 39 weeks as a first-time mom or according to the ARRIVE trial, does it really reduce your chances of Cesarean? What would you say, Julie? Based on what we've got, what would you say? Does it really? Julie: I would say, if somebody asked me that, this is exactly what I would say. I would say maybe, but there are a lot better things that you can do to reduce your chance of having a Cesarean besides being induced at 39 weeks. Meagan: Yeah. That would be my thing. Possibly. Possibly. However, it depends on how it's done. It depends on the hours that you're going to be given. It depends on the patience of the provider. Julie: On your doctor, on your provider, on their Cesarean rate. Meagan: Yep. It depends on a lot. So could it actually lower your chances of Cesarean? In my opinion, maybe. Maybe. But does it yes or no? I would say there's not an answer there. No. There's not a yes or no here. Could it? Maybe. But okay, what are other ways to reduce your chances of Cesarean? Right? I think induction really is a hard one because sometimes there are things that are coming up. In this ARRIVE trial study where it's like, “Okay, it seems to lower chances of hypertension and hypertension can be an issue for vaginal birth so if we can reduce our hypertension levels, maybe an induction at that point can reduce a Cesarean.” Julie: Maybe. Maybe, yes. But maybe– here's the thing though to consider because I think this is so individualized. It should be individualized but it's not being individualized. Here's the thing. If you have a history of pregnancy-induced hypertension, then maybe elective induction at 39 weeks is something that you heavily consider. I guess if you're a first-time mom, then it doesn't matter. You don't have a history of anything because it's your first pregnancy. But if you have a history of hypertensive disorders in your family, if your blood pressure is starting to creep up a little bit, if you're having signs of preeclampsia or something like that, if there's a reason where you might be at a higher risk for pregnancy-induced hypertension, then maybe that's something that you consider. Meagan: Right. Julie: If there are other ways to manage hypertension, first of all, there are lots of dietary things that you can do. There is medication that you can take, pharmaceuticals, and things like that if it starts to creep up. That's why I'm saying that it's such an individualized thing but I hate how we apply– we as in our healthcare system– the same standards to every single person. That's my biggest peeve about it I think. Meagan: Yeah, yeah. Exactly. It's the same thing when we look at VBAC. It's like, “Oh, well this, this, and this. The calculator or whatever.” You cannot do that. You have to look at the individual. You have to. You have to. You have to. Because guess what? Julie and I are not the same person. We do not have the same body. Our cervix isn't the same. Our uterus isn't the same. Any of that, nothing is the same. We might have similar characteristics in our bodies or the way our cervix does things, but we are not the same. You cannot say. I don't love and I don't feel comfortable that they are grouping so much in this wide range because it's not necessarily the case. So let's talk about it. What are other ways to reduce your chances of having a Cesarean? I know that Julie and I got a little passionate on an episode in the past about home birth but there is something to be said about home birth and what it can do to a Cesarean rate. We know that it's not for everybody, but it is there. It is there and you are going to have fewer chances of having induction or interventions which can lead to reasons for a Cesarean. So choosing a home birth and a provider. A provider is one of the biggest things you can do to have a vaginal birth and to lower your chances of Cesarean. Mine and Julie's– if you're just new to us, Julie and I actually had the same provider who performed our Cesarean with her first and my first and second. I mean, I don't know Julie. Did you know about him that he had such a high Cesarean rate? I didn't. Julie: No, not until years later. Meagan: Me neither. Yeah, I didn't either, and then obviously, years later when the numbers were actually there for a little bit but also seeing other people go to him and them all having Cesareans. I was like, “Hmm. That's weird.” I still to this day know people who are having babies with him and are still having Cesareans. Julie: Yeah. Meagan: He's not all Cesareans, but he's very high in the Cesarean rate. So choosing your provider who is comfortable with birth, who trusts birth, who trusts you as an individual to make decisions for your baby and body, right? What are some other suggestions, Julie, that you would give? I mean, there are so many. Julie: We know that having a doula decreases your chances of having a Cesarean by 25-39%. I think it's actually 39% but in our blog, it says 25%. It's interesting how they break it down. There's a study about doula support. They break it down by having continuous support and then continuous support from a doula. I feel like the numbers probably got switched out. I think 25% by having anyone with you continuously like your mom or somebody and then a doula is even higher at 39%. Having intermittent monitoring versus continuous fetal monitoring reduces your chance of having a Cesarean by 39%. I could go off on a whole soapbox on continuous fetal monitoring, but I will not so I don't want to turn this into an hour-and-a-half-long episode. But obviously, your provider, like Meagan said, is so, so, so important. Look into alternative methods of pain relief like laboring in the water, different types of counter pressures, different types of birthing positions, and laboring at home as long as possible. I think you already talked about that a little bit too. All of those things– having a supportive environment and being able to move freely is going to help with all of those things. I would also argue that waiting for labor to start on its own and waiting for spontaneous labor is also going to decrease your chances of having a Cesarean just by the things that I have seen in my own practice as a doula and now birth photographer as well. It's not going to get rid of your chances all the way doing any of these things or even doing all of these things are not going to guarantee that you're not going to have a C-section but they're going to drastically reduce your chances of needing lots of interventions including a Cesarean. Meagan: Right. And really too, in all of this, education is so, so important because as you're going through this, you're vulnerable you guys. It's hard. Especially when we are actually in labor, it is not easy. If you have a provider coming in and saying this, this, and that, it's not easy to say, “Oh yeah, well the evidence says this.” It's not, but at the same time, if you have the education in your mind and a provider comes in and says something, you're less likely to get spooked or scared because you're going to know the evidence. Whether or not you're in a spot where you can actually talk about the evidence, you mentally are prepared because you've educated yourself to know that what they are saying is maybe true, maybe not, but you know the alternatives to those things or you know the evidence against those things so you can say, “Okay, I really appreciate the conversation. I'm going to need some time.” Maybe you feel comfortable with that because you know the evidence. I think all of these things along the way are so impactful for you to truly have a better birth experience. Even if it does go the Cesarean route, again, with being educated, feeling supported, and all of these things, you'll likely have a better Cesarean experience because you'll have the options. You'll know and you'll feel better about making the choice and the decision. Julie: And you'll feel like you have made a choice. Okay, so except we're in extreme circumstances where there's a really life-threatening emergency, you will feel like you did everything you could. You will feel like you were in control of what was happening. You will feel like you called the shots. I just had a client a few weeks ago. She was going for a VBAC after two C-sections. She felt like she wanted to be induced in her 39th week. She followed her intuition. She leaned into it. She trusted her doctor. Her doctor was super, super supportive and he was really just trusting her. He had his recommendations, but he also felt good with the choices that she made even though they weren't necessarily always in line with her recommendations. He supported her and it was a really beautiful relationship to see that happening. But she chose to be induced at 39 weeks. Her provider was comfortable with her going beyond that, but she felt like it was time for baby to come. I won't talk about all of the reasons why. So she ended up getting induced and they went for almost 24 hours. She told me the night before– the induction was, she wasn't dilating. They started Pitocin. She wasn't dilating. She told me, “If I'm not dilated to a 3 which is the farthest I've ever gone in my other two pregnancies and my other two inductions, then I'm calling it in the morning.”I was like, “Okay. I support you in your choice.” I was doing doulatog for her, so doula and birth photography. “Just let me know when you want me to come. I will be there.” She ended up not dilating at all overnight so she called it and she had a C-section. Her provider was there along with her the whole way supporting her and he was like, “Okay, well we can do this. We can keep going if you want. We can call it if you want. Whatever you want.” She was literally calling her shots the whole time. I was also her doula for her last C-section and it ended similarly. She was induced a couple of weeks earlier for preeclampsia and she labored for a long time and just didn't dilate. Both of these two Cesareans were relatively calm for her even though it wasn't the end goal that she wanted. She feels confident that she made the right choices all along the way. She had all of the information and all of the knowledge.Here is the thing. On another note, I had another client. No, it wasn't a client of mine. I've had many similar clients. I was just talking to another birth photographer friend a few weeks back. She had a client who was a first-time mom who was 39 weeks. This client didn't have a doula but she was her birth photographer. She called her up one day and she said, “Hey, just so you know, I'm going to be induced at 39 weeks. This is the day that I'm being induced. I'll let you know along the way when I'm ready for you to come.” The photographer said, “Oh, why are you being induced?” She said, “Well, my doctor just told me that it's going to be better for me to avoid having a C-section. It's going to be safer for my baby.” I don't know why they said that. Keep in mind, this is also secondhand information. Then my photographer friend was like, “I just don't know why she's being induced because she says she doesn't want to be induced but she also trusts her provider.” Okay, we trust people too. You have to let people make their own path. Anyways, the long story short is that my friend's client ended up having a C-section. My friend was allowed in the operating room which is really good when that happens, but it's really funny because who knows if it would have been able to be avoided or not? We just will never have the answer for that by waiting but I feel like I tell these two stories. They both ended in Cesareans after 39-week inductions because one didn't want an induction but she was just doing what her provider said and the other worked with her provider and her provider trusted her and she made the choice. Who do you think is going to be the one that has questions about how the birth went or one day wakes up and says, “Wow, I feel like I just got railroaded by the system”?What I wish more parents could understand is that we have a responsibility for our education around birth. Meagan: Yes!Julie: I feel like it's a big disservice that we aren't teaching parents more about these options and choices and what's available to them, but you have a responsibility to step up, to learn more, to figure it out, to trust your intuition, and to ask questions of the people supporting you and if they will not answer them or if they make you feel uncomfortable, then you have the right and the responsibility to seek care elsewhere. Meagan: Yeah. Yeah. Absolutely. We know it's not easy. We know it's not easy, but you have the right. You always have the option. There are so many times when we get hired as a doula and we hear, “This is what happened. I just didn't know I had an option. I just didn't know. I just didn't know.” It's hard because you can't blame yourself for not knowing but at the same time, it is our responsibility for getting an education. It's the hard thing because I didn't know what I didn't know, but at the same time, I could have learned more. It's a really hard topic but get the education. Get a good, supportive provider. If you can, hire a doula. Eat really healthy. Do all of the things you can to lower your chances of having a Cesarean and know that if you are induced at 39 weeks as a first-time mom or a first-time vaginal birther, that doesn't mean that your Cesarean percentage is absolutely factually going to be lower. It just doesn't mean that. We hope that through listening to this, you've gotten some information. You've learned more about the ARRIVE study. As updates come through in all aspects of birth, we want to be here. We want to update you and share these. Julie, thanks for being with me today.Julie: 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

“As you go from one to two to three million, you start stress testing the systems that you've put into place that have gotten you there,” explains Julie Ellis, author, professional speaker, leadership coach and co-founder of Mabel's Labels. It can be a daunting process to scale your business and it does not happen overnight. As you scale more and more, there are certain changes that will need to be made, both in systems used and in the level of formality expected by your employees. Today, Julie shares her tips for successfully scaling your business.As your business grows, it can start to feel more difficult to make decisions. This is why it is important to have strong boundaries for yourself so that you do not get caught up in a loop of over consulting or worse, stuck in decision paralysis. Although growth requires many changes to be made within an organization, particularly when it comes to systems and technology, it also opens up the possibility of hiring more people to help. While you could probably juggle multiple hats at the beginning of building your business, as you grow and scale, this will be more and more difficult to keep up with. Learning how to properly prioritize and delegate tasks is an essential part of being an effective leader.Growing a business is hard work and Julie recommends not trying to do it all alone. Entrepreneurship can be very lonely, especially with so many people now working remote and hybrid schedules. Use the growth of your business as an opportunity to bring on employees with more experience and more clearly defined job roles who you can trust to take over certain tasks for you. This will free up time so you can focus on running your business and will also help shield you from potential burnout.Quotes“As you go from one to two to three million, you start stress testing the systems that you've put into place that have gotten you there.” (1:46-1:55 | Julie)“There's a difference in how people want to be treated and in the formality that you need to have in place.” (3:20-3:26 | Julie)“There are some things you may have to let go of and you have got to prioritize what you really need out of it so that you get the best outcome you can.” (24:39-24:45 | Julie)“The decisions feel bigger, and when they feel bigger, they can feel harder to make.” (25:14-25:20 | Julie) “It's keeping that growth mindset of, there are advantages to being bigger and having struggles, because you can afford to bring people on to help you solve them.” (26:12-26:22 | Julie)“Entrepreneurship can be so, so lonely if you don't build community for yourself.” (27:58-28:02 | Julie)LinksConnect with Welcome to ElomaInstagram: @welcometoelomaWebsite: WelcometoEloma.comWeekly Email Newsletter: bit.ly/RIXEmail Connect with Julie EllisInstagram: https://www.instagram.com/thejulieellis/Instagram: https://www.instagram.com/biggorgeousgoals/LinkedIn: https://www.linkedin.com/in/julie-ellis/Facebook: https://www.facebook.com/julieellisandcoConnect with...

Father Tom Wilson joins Patrick for a conversation about Accepting God's Will When He Says No (2:32)  Discernment of God's will (5:32) what does it mean when God says no (11:46) When it seems like God doesn't care (15:23) How long should we wait for God to answer a prayer? (19:54) Listeners Call into the show Jennifer - Story of how we prayed for children every year it took 7 years, but we eventually had one. Mark - I was going through conversion last year and going to confession daily just to feel forgiven. It took months for it to sink in that I was forgiven. I learned to trust God. Julie - It all comes back to trust. Jesus said he would never leave us, and he does what's best for us, so we have to trust his answer. Debbie - What if God is still telling me NO? I'm patiently waiting on his yes. Nora - God told me NO when I was 8. My dad wasn't a part of my life and I really wanted to know him, but God kept telling me NO. I found out later he raped my mom. Katherine - I'm in my 70's and none of my prayers have been answered. Why is that?

We are bringing you extra episodes all month long in honor of Cesarean Awareness Month! Meagan and Julie kick off the conversation with a passionate discussion about the realities of birthing in a hospital setting. Doulas are birth workers who uniquely experience births in all settings. Meagan and Julie share what they have seen and how it has formed the strong opinions they have now. Additional LinksJulie's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsJulie: Welcome, welcome. You are listening to The VBAC Link podcast. This is your cohost for the day, Julie Francom. I've missed you guys so much. It's so fun to be back here but I am also here with Meagan Heaton, the cofounder with me of The VBAC Link. We are so excited to be on a really special episode with you today. We were actually having lunch together the other day and talking about life, birth, and everything. We just decided that it would be better if we recorded the conversation so that's what we're going to do today. We're going to record our conversations about birth, VBAC, and everything in between. Review of the WeekBefore we get into it though, Meagan has a review for us. Meagan: Yay, yes I do. It's always so fun to have you on Julie. I am excited to have our conversation that we were having the other day only recording it because it is definitely a great conversation to be had and to be heard. If you guys didn't know, April is Cesarean Awareness Month. This month, we're going to be kicking off with some extra episodes in addition to our stories. Here is number one for you. As Julie said, I do have a review of the week. This is from mathletic and it says, “Empowering and Addicting.” It says, “This may be my second time leaving a review, but it is because I am preparing for my second VBAC and felt that it was necessary. I first found this podcast as I prepped for my VBAC in 2019. I religiously listened to a new episode on the way to and from work daily and am always excited for Wednesday morning's new episode.” Julie, that is crazy to me that people have been listening since 2019. Julie: Forever. Meagan: It is 2023. It says, “This podcast has given me so much education and strength that I took going into my TOLAC and achieving my successful VBAC in May 2019. I am now preparing for my VBAC as I am 36 weeks pregnant and due in early June.” This was in 2022 by the way so last year.“Although I have now had a VBAC, I knew starting my mornings off with this podcast again with this pregnancy would be something that would help me get into the right headspace. I sometimes feel like Meagan and Julie are now my new friends.”We are. We are friends with all of you. Julie: We are your friends. Meagan: Yes. “As we commute to work together–” We've been commuting to work with her, Julie. Julie: Yeah. Meagan: “I am very bummed to learn that there was a break, but I am so pumped when I found out that they were returning this May.” So yeah, seriously, this was a long time ago, you guys. We returned in 2022. “Thank you for all that you are doing in helping us mamas feel educated and strong as we go into our next births. I recommend this podcast to all my friends even the first-time mom friends as it's been such a great wealth of knowledge going into any birth.” I could not agree more. This podcast is going to teach you so much and not only how to have a VBAC but how to avoid a Cesarean in the first place. As we know, Julie and I were talking about this, Cesareans are through the roof. It is above 32% here in 2023. It is sad. It's scary and it's concerning. It is concerning. Why are we having so many Cesareans? We are going to take one moment and then we are going to get going into this wonderful new episode. Cesarean Awareness MonthMeagan: Okay, Julie. Hi. I miss you. I love you. I just saw you last week. Julie: It was so great to have lunch with you and just jibber-jabbering away about life, the birth work, getting old, and my salty attitude about birth. We're going to talk about it.Meagan: Your salty attitude. You guys, she has become a little salty and sassy. Julie: I am. I've always been that way, but I feel like I was pretty good at toning it down and being diplomatic, especially doing The VBAC Link and things like that. I definitely have opinions as we all do. I was just making sure that we were including everybody and that everybody has a safe space here. We certainly want to do that on this episode as well, but I will hit 100 births this year. Meagan, you are probably at 600. Meagan: No. Julie: But either as a doula or a birth photographer and you know what? One thing that I wish people could understand a little bit more or take more seriously is that doulas and birth photographers probably have the most unique perspective on childbirth because we see births in the hospital, out of the hospital, at birth centers, with hospital OB/GYNS, hospital midwives, out of hospital midwives, and unassisted births. We have seen a few of those. We have such a unique perspective and we see how things unfold in each environment with each intervention and with each provider. I wish that somebody would hone into that and try and work to collect those experiences and perspectives because if you ever want to hear about the state of childbirth in the United States and probably even in the world because a lot of countries are not too different from ours, talk to a freaking birth worker that does hospital and home births because that is where you're going to find these priceless gems and perspectives that you're really going to learn from. Yeah. I just wish that people could see that. Meagan: It's hard because we have clients hire us as their doula or their birth photographer and we talked about this at lunch the other day how we come in and one of the mean things as a birth worker that we are going to do is talk about what birthing experience that person wants. It is important to us as birth workers and as your friends to help you get the best experience that you can get and help you get a lot of those things that you desire. Am I wrong there? That is one of the biggest things. Julie: No, I think that's right. Meagan: That's one of the biggest things of what being a doula is. It's one of the most important things is helping these clients and helping our parents get these births that they want. We come in and we ask things like, “What would you like for your birth? How do you envision your birth? What kind of things do you desire to happen or not happen in your birth?” It's more often than not a very similar answer. It's usually things like, “I would like to labor at home as long as possible. I would like to go unmedicated. If not, as long as possible before getting an epidural. I would like to have a vaginal birth and avoid unnecessary interventions.” Julie: Don't want to be induced. Meagan: “Don't want to be induced. I want to go into spontaneous labor,” is just what I was going to say so they don't want to be induced. “I want to avoid a Cesarean.”Julie: “I want my water to break on its own.” Meagan: Yep. “I want to avoid a Cesarean. I want to push as my body and myself direct.” Julie: “I don't want to push on my back.” Meagan; “I don't want to push on my back.” Things like this. If you're listening to this episode, I'm assuming you're shaking your head, “Yep. That's what I want too. That's what I want too.” It's not a bad thing that we want these things. It's not a bad thing. Julie: It's a good thing. It's natural. It's instinctual. It's primal. Meagan: Yes. These things are things that we want for a reason. What I hear when I hear these things is, “I want to birth the way my body is going to birth and was made to birth.” Right? Julie: Yep. Meagan: But as birth workers as Julie was talking about, we have this interesting perspective because we've seen things. I'm not going to sit and say that I've seen all of the scenarios and all the things in birth. I'm not. Again, no I have not been to 600 births but I have been to a lot. I'm still learning as I go but there are so many situations where I can see things unfolding. So we have this client and these people that are wanting this type of birth and then what Julie? 37, 38, 39 weeks. Julie: “Oh, we'd better do an ultrasound to see if your baby's measuring big or check your fluids My gosh, I hear you complaining so much about being pregnant. Let's just induce at 39 weeks. You can pick your baby's birthday. You can do this.” Or all of a sudden, maybe your blood pressure is maybe a little bit high so maybe you have preeclampsia so you have to test that. What does that do? It stresses you out so it makes your blood pressure high even more. Everyone starts to get a little anxious because the due date is approaching. Mom, dad, and parents are getting anxious. Providers are like, “Okay, well we don't want you to go past this date” Especially with VBAC. Oh my gosh, it's not safe to go after 40 weeks because that increases your chance of uterine rupture. Not true, by the way. Meagan: Or we've got a big baby. Julie: “Or we've got a big baby and your last baby was 8.5 pounds so we want to make sure.” All of these are non-evidence-based reasons because people treat 40 weeks like an expiration date rather than an average. That's when, in a hospital system, things start to happen that decrease your chances of all of those beautiful, perfect, wonderful things that you want in your birth. Meagan: Yes. Julie: Sorry, go ahead. Meagan: No, you're fine. You're fine. I was just going to say that this is what we see happen so often. We meet with our clients at 24-34 weeks pregnant and these are their desires. This is what their hearts and their souls are saying. Based on a lot of the time, what they have learned too. They know the evidence-based information so they are like, “Based on that, I don't want to do these things.” But then 37, 38, 39, 40 weeks come and we have these new introductions and new seeds being planted.For some reason, those things leave. They leave our minds. Julie: Well, you're tired. You're very pregnant. You're easily influenced and yes you want to be done. Yes, it sounds nice to be done sooner. Oh no, you don't want to have a complication or preeclampsia, or a big baby. That sounds scary. Shoulder dystocia sounds really complicated. In some instances, it is for sure, but when you start planting those little seeds, then they grow into self-doubt. It's easy to confuse our worries and our fears with intuition. Meagan: They're lost. Yes. Yes. That is the hardest part. We are getting these seeds planted and then they're being watered. The seeds are growing and the roots are pushing out what our intuition was saying from the beginning. Then we make choices and decisions. We are human beings that have the opportunity to make these choices and decisions, but sometimes we are backed into these corners because our seeds are being poured on. We are being flooded with overwhelming, scary feelings. As a birth worker, it can be frustrating. I'm going to be super honest. Julie must be spitting the salt at me. I don't know what she's doing here. It's so infuriating to see and heartbreaking to see someone we know and loves go into this space that we know is not where they wanted to go and then see the cascade happen when it didn't need to. The other day, everyone at Zupas was probably like, “Whoa. These two broads are crazy.” We are very animated. Julie: We weren't very quiet. Meagan: We're not quiet people first of all and we are animated. I feel like in the past, Julie has been a little bit toned down with her bluntness. She'll be blunt but I'm over the top and she's like, “Oh my gosh, Meagan stop.”Julie: Now I'm just like, “Heck yeah, girl.” Meagan: So us together, we're at Zupas saying these things. One of my questions is, and I wish I had the power, knowledge, and time to produce this huge study because I really want to know what happens if we do nothing. What happens? What happens? Julie started adding to that. Do you want to talk about what you added to that?Julie: Yeah. Meagan: Do you remember? Julie: Yes. Okay, sorry. My mind is going on 17 different paths right now like it usually does. I think if you really, really, really want to get a good perspective about birth, really sit down and talk to a doula. One that you haven't hired because I know when my clients hire me, they hire me for my knowledge and my experiences and to support them. I'm not going to say my full, unbiased opinion to a client because I don't want them to feel like I'm not supportive of them. I am supportive of them. Meagan: Or jading them. We don't want to jade. Julie: I don't want them to get doubts about their birth plan going into it because everybody else is planting doubts so I don't want doubts to come from the doula. But really, sit down and talk to a birth worker because I'll tell you what. I see way smoother births at home. I see way less need for induction at home. I see more love and support in the birth space at home or a birth center. I see more mother-led pushing, way more mother-led pushing at home. I never ever see anyone birth on their back at home ever. I see more partner involvement. I see kids involved. I see whoever you want at your birth involvement. I see mothers who are satisfied with their birth experiences at home. I see babies healthier and more skin-to-skin time and happier families and happier outcomes at home hands down. Yes. Are there a few here and there where it is hard and they need more help or there is a hospital transfer every now and then? Sure, but I guarantee that you are more likely to have problems and your baby is more likely to have problems in a hospital because it is set up to control things and it's not set up to trust the mother-baby unit, to trust the parent-baby unit, the birthing person, whatever pronouns you choose to use, insert them here. It's not set up like that. It's not your provider's fault. It's not your nurse's fault. It's not anybody's fault. It's the system and the way that it's integrated and taught to these health providers that birth has to look xyz and has to be done by xyz. The baby should be this size. The mother's xyz has to look like this. It is all set up to facilitate a system that does not trust the parent-baby unit. It does not trust it. At home, it is very well-trusted. It just is. It just is. I don't want to sugarcoat it. This is maybe where my saltiness comes in but you are way more likely to have that birth experience at home. Yes, it can be done safely. Yes, there are still providers at home that will keep an eye on you and transfer you as soon as you might need any medical assistance because it does save lives. It has. We've seen it. We know it, but most of the time, you are— yeah. I'm just going to pause that here for a second and go into where you were trying to lead me here, Meagan. Meagan: You're just fine. Julie: Sorry. I just have so many opinions clearly. Meagan: It's passion, Julie. It's passion. You are passionate because you are seeing things. I am too. I'm seeing things that are unnecessary. They are unnecessary. We will circle back to where I was going, but we will start where you were at. There are so many unnecessary things that are happening in the system that is so frustrating as a birth worker to see because we also have seen the other side. We have seen. Yes, Julie and I personally have experienced the other side. She was at home. I was at a birth center. We have seen it and experience it. The passion that is coming to you through this episode is because we believe. We know as we've experienced it ourselves as people who have given birth in a system that is “off” the straight and narrow path as a lot of people will say. When people were hearing that I was going to VBAC after two Cesareans out of the hospital because I kept it quiet from most people. But you know what happened when it happened online. People were attacking me, “How dare you?”Julie: People are going to throw salt at us now for this episode. Message me on Instagram @juliefrancombirth. I will engage with you. Meagan: But no. This is passion coming from you. This is your passion in saying, “I have seen other things. I've seen other opportunities.” Julie: I've seen the other side. Meagan: We know. We know, women of strength. We know that it is not always suitable, comfortable, or appropriate for you to birth outside of the hospital. We know that. We do. We definitely just have seen things outside of the hospital that are incredible. Julie: Way better. They're way better. They are. Hold on. Let me interject here for just a second. People might say, “Oh, well you've only been to a hundred births. Providers do a hundred births a week in a hospital.” Not a hundred births a week. That would be a lot. But significantly more. I am not going to argue that at all. I've only been a doula for 8 years, 100 births. That's 10-12 a year besides having babies in between then as well. Last year, I did almost 30 which was super great. But here's the thing. When you're in a hospital, you're only seeing hospital births. You are only seeing hospital births. You are only seeing, I don't even know statistics for this, maybe 90-95% of people have an epidural in a hospital? I don't know. Maybe 70%? I don't know. I should probably rescind that number. But a lot. And if you don't have an epidural, guess what you have? You're hooked up to an IV. You have continuous fetal monitoring. You are in the very system that we're trying to break away from right now. That is what you see. You don't see hands-off birth. You don't see the normal, physiological process that happens when you do nothing. Yes, at home you have intermittent monitoring every 30 minutes. You do the lab work and stuff like that. The routine tests and everything like that is done at home prenatally and during the birth, but what happens? You don't get to witness that if you work in a hospital in the labor and delivery unit. You don't get to see that. Meagan: Just a quick search by the way, it's 65-80% of people receive epidurals and stuff. Julie: Huh, there you go. Meagan: But yeah. They don't. Their opinions is tainted a little bit. This is why I kind of wish that I had the power to do this study. If there is one and you are listening and you are aware of this study, please let us know. But the study of what happens if we do nothing? We know the ARRIVE trial. We know that if we induce people at 39 weeks, we sort of know what happens. Julie; Do we induce them at 39 or do we induce them at 40 and 5? Meagan: This is the thing. Really, this hasn't really been done for a long time. We know that ACOG says 42 weeks is the cutoff. We've got an increased risk of things like stillbirth and things like that. But okay, so at 42 weeks, we assess. But what happens if, at 38, 39, 40, and 41, we do nothing? What happens if we don't strip our membranes? What happens if we don't even perform a cervical exam until 42 weeks? Julie: What happens if we don't talk about induction? We don't even talk about it. Meagan: Yes. Don't talk about induction. So what happens if we do nothing? What does our Cesarean rate do then? I'm really curious. Do we go down? Do we go up? Do we start having more issues? I don't know. Julie: What does maternal and fetal mortality look like? Because right now, it is a disaster. Meagan: Yes. It just makes me wonder. Cesarean Awareness Month is something that is near and dear to our hearts. We want to bring awareness to it. Cesarean is 32.1% right now. Julie: Yeah. It went up. 2020 and 2021 preliminary data, the Cesarean rates went up. Surprise, because of COVID. Meagan: As a birth worker, what do we know that happened during that time? What did we see? I'll tell you what I saw. Induction, induction, induction. Julie: People's support system's being taken away. They wouldn't even allow partners there. Guess what else happened? Everybody put masks on. Who feels secure? Some people had to push their baby out wearing a mask. Birth, being a very instinctual and intuitive process, anything that creates that feeling of unsafety or difference or fear will interrupt that process. It will make it less efficient. So when you were taking away people's partners from the birth room, when you're making everyone wear a mask in the birth space, when you had a positive COVID test, or if you did not want to do a COVID test, people would come in wearing hazmat suits. Meagan: Even the fear of testing positive and then the threat of everybody being taken away including the baby. Julie: Yeah. All of these things interrupt that process and then yes, people with COVID. I can't even imagine what it was like in the healthcare system. I cannot even imagine what it was like to be a healthcare worker during COVID and having to deal with all of that also. But then needing to also predict and schedule births to control the number of patients coming in and out of a hospital created this “need” for induction and for causing things to be a little more predictable for everybody. I can understand that to a degree but also, but it introduces the need for other interventions to get the baby here including a Cesarean. Meagan: Right. We're seeing this stuff happen and it is just so hard because if you've been with us for a really long time, you know. You know what we're for. We're here to educate on birth after Cesarean. We're here to educate you on your options for birth. That doesn't mean you have to have a VBAC either. Right before this call, Julie and I had another call. We were talking about not necessarily advocating for a Cesarean, but we're also not saying you're bad for having a Cesarean, right? We're not pro-Cesarean people. We're not advocating for unnecessary Cesareans, but at the same time, we're not shaming anyone or wanting to make you feel bad for choosing that route.Julie: Yeah, absolutely. I think it's important to say that. Our intention is not to shame anybody but also there's a certain point where you've got to stop sugarcoating everything. I tell this to my clients too. I'm not going to bounce around the issues with you. I'm going to tell you things. I'm never going to lie to you. I'm never going to say xyz. I'm not going to tell you, “You're wrong for choosing this,” or whatever because I don't think anyone is wrong for choosing this but I feel like it's so easy to get coerced into doing something we normally wouldn't have done. I feel like it's so easy to feel safer in a hospital because that's how we were raised. I feel like some of these things are ingrained so deeply in us that it's hard to break away from them, but I also am not going to pretend that people's choices are conducive to their birth preferences. There are just some things that don't go together. Natural birth in a hospital does not go together very well. It just doesn't. Not natural, but unmedicated, hands-off birth does not happen well in a hospital. It's a lot harder and it's much more of a fight to get that in a hospital versus out of a hospital. Meagan: Yeah. Well and I think too it's important to talk about creating that space and that environment. If it's in the hospital, okay. But let's talk about how to set that up, how to set that space up. We just recently posted about creating a more homey, comfortable environment. We'll make sure to drop all of it if you guys are interested in checking out these awesome things like getting into your own birthing gown. Going to a hospital, taking off your clothing, and Julie you just talked about this and in a second I want you to bring up what you were talking about with me, but naturally, showing up to a new location with new, strange faces. It's maybe a little cold. It's maybe a little foreign. It's maybe a little staged-looking. Everything is folded up on the bed. Then take off your clothing. What does that do to our body and to our mind? It puts us in an uncomfortable feeling.Julie: A little bit of a fight or flight mode. Meagan: We talked about putting on this thing that is open in the back so our butts are showing. So getting into your own gown, into your own soft, cozy, comfortable gown can bring you some comfort even though you are still changing once you're getting there or maybe you go there in that. Maybe you prepare and you get in that before and you go. Or maybe you don't like IVs and the bottom of an IV looks yucky. There are IV covers to take it away and make it feel less hospitalized because you are in a hospital. But Julie, talk about what you were saying earlier. I was like, “Huh. I've actually never thought of that.”Julie: I saw this on Instagram a few days ago. I'd seen it circulating around before. I wish I knew what account it was so I could tell you to go look at it, but I don't remember. Maybe I saved it. I'll have to look it up while I'm talking. But it basically said, “What would happen if we conceived babies in the same manner that we deliver them?” In order to get pregnant, okay. We need to preface this with sometimes how people need interventions to get pregnant and sometimes you have to have IVF or other things in order to have a baby. But for most people, what if in order to conceive a baby, instead of being in the comfort of your own home with your partner, or I guess wherever you decide to conceive in a car or a forest or wherever, a movie theater. Anyways, whatever your choice, not my business. What if instead of that, you first went to a hospital, changed into their gown, got your blood pressure taken, got hooked up to an IV just in case you need to have some kind of medication–Meagan: Have monitors placed on your belly. Julie: Have monitors placed on your belly, have nurses come in and out and tell you that you can't get started until the doctor comes in– Meagan: Asking you lots of questions. Julie: Asking you about your insurance, your cycle, when your last period was, and all of these things. I don't think you're going to make a baby in that situation. You bring your partner and be like, “Okay, partner. Go get changed now.” Your partner gets changed and everybody's watching you. Everybody's watching you. Meagan: You're on the monitor outside. Julie: I mean, when babies are born, everyone's watching. Freaking hands are in the vagina and freaking everything. What happens if we conceived babies that way? How would that work? How would that work? Let's flip this around. Let's flip this around. What happens if we birth our babies in the same manner that we conceived them?We get in our house, movie theater, car, forest, whatever. We go into our home. We turn the lights down. We run a hot bath. We snuggle with our partners. You probably don't want to have your kids or mother-in-law in your space, but what happens if we created that same environment to increase the flow of our natural hormones, to safeguard and protect that process and make it as intimate as it was when we conceived our babies? Meagan: Yeah. It's a big question. Julie: It's way better and I can say that it's way better because I've had my own, but also, I've seen over a hundred almost births and I see the contrast. I see the contrast and it's a beautiful situation when it's allowed to unfold naturally. Every once in a while, I'll get a nice unicorn birth that has a nice, unmedicated, parent-led birth in a hospital but it's very rare. Meagan: I want to talk about that because, with Cesarean Awareness Month, that's what we do during Cesarean Awareness Month. We talk about things. We do see preventable Cesareans and preventable interventions. Talking about advocating for birth after Cesrean and advocating for yourself, here we are. We go into this space, into the hospital, and we are vulnerable. What do we do? We feel vulnerable because I didn't go to school for 4+ years. I didn't study this. I went to the forest and conceived a baby. Julie: Or a movie theater. Meagan: I went in. I have this. I've learned. I've learned, but now I'm in this space and I'm vulnerable. It's bright. Like Julie said, it's this less-ideal space to give birth. We would never conceive there, so why would we give birth there? But if you're in this space, what do you do? What can you do to create a better space? A better environment? We just had a mama. She wasn't a VBAC but her video went viral. Julie: Katelyn!Meagan: Yep, Katelyn. Maybe actually she might not have been– actually, her episode hasn't even aired yet but you guys definitely need to check out the video on our social media because it is so incredible. Chills all the way from head to toe. It went viral because she advocated for herself. She had nurses. Bless their heart, we love nurses. By the way, if you're a nurse, we love nurses. I don't want to say we hate nurses. But she had nurses following their protocol–Julie: Trying to get her on the bed. Getting baby's blood pressure. Meagan: Trying to get blood pressure. Trying to monitor baby. They tried to get her on the bed and tried to give her a cervical exam, because how would it be if she was 4 centimeters and her midwife was called to come? These things are being told to her. She is pushing out a baby as she's being questioned for all of this stuff. She's literally pushing a baby out of her vagina and standing up in this hospital room. That scenario and that story is few and far between because it is hard. It is so hard. You guys, I was a mom in a birthing room the other day at the veterinarian. I had my puppy. We're sitting there and this doctor is like, “We have to do this. We have to do this. We have to do this.” You guys, I'm a doula. I know how to advocate. Do you want to know what happened? This is a real thing. This really happened. Julie: You have a puppy?Meagan: He's like a puppy. He's five but he's like a puppy. My pup. So we're there and he's telling me all of these things we have to do. Not only is he telling me what we are having to do, but he's also doing things to my dog in front of me, then telling the nurse what he's doing and charging me for these things that I did not ask for. I did not consent to them. I left and I literally paused and thought, “Holy blippity bleep, blah blah blah, bleep.” That is what happens in the birth room way too often. Julie: Yep. Meagan: Women of strength, we do not want this to happen to you. Julie has spit her salt all over and it's all over me too. We're feeling it. Julie: Oh, I'm not done. Meagan: We're feeling it. We're feeling it. Don't let these things happen to you. It's okay to stand up for yourself. It is okay to say, “No, thank you.” It is okay to say, “I hear you. I respect you. I feel differently. I don't want to do that.” Or maybe at a later date. Or maybe at a later time. Julie: Or just cancel your prenatal appointments. I'm not advocating for that, but I've had clients be like, “You know what? I know when I go for my 37-week visit that they're going to push for this and this so I canceled. I'm not concerned. Everything's healthy.” Meagan: Yeah, you just don't have to do anything. I think one of the biggest things and one of the biggest places we can start at avoiding these unnecessary Cesareans– Julie: Is by staying home!Meagan: It's by staying home and advocating. You guys, y'all can tell where Julie is. She's feeling it here at home birth. Julie: I just see it. Go ahead. You go then I'll go. Meagan: I'm just saying that it's okay to stay strong. It's okay to stand strong and try your hardest not to let your vulnerability because it's there. You're so vulnerable in the end. You're tired. You're miserable. You're vulnerable. We just want this baby in our arms. We just want this VBAC more than anything. Don't let people break your vulnerability, sneak in there, and take advantage of you because there is no need. Obviously, if there is a medical, true medical reason, we understand that. Right? They happen. Like Julie said earlier, we're grateful. We're grateful.Julie: There's no shame in that. You should have mercy on yourself if you got railroaded either by the system or by an unexpected emergency. Have mercy on yourself. Give yourself grace because it happens. It's not okay that it happens if the system is the cause of that, but it doesn't make you a bad mom. It doesn't make you a bad human. It doesn't make you a bad anything. It's just what happens sometimes. Meagan: Most Cesareans are unplanned because we had no idea what was happening, but a lot of the time these Cesareans are happening because they are sneaking in, these little sneakers. I don't even know what. I was going to call them weasels. They are weaseling their way in and tapping into our vulnerabilities. I was not the vulnerable one with my second C-section. My husband was and my provider saw it. He snatched it and turned him against me. What did I do? I walked down for a second, unnecessary Cesarean. We don't want these things to happen to you. We want to bring awareness and maybe you're like, “Wow. These chicks are coming in strong.” But you guys, we are passionate. We love you. Julie: We want you to have the birth you want. That's why. Nothing hurts me more than loving someone, knowing what they want, and seeing them get railroaded in a hospital setting. We see it a lot. Meagan: That's what we see most of these times. Julie: A lot. Especially more as a birth photographer. As a doula, I was more involved in the prenatal prep. Sometimes I show up to births as a birth photographer and I've never met the people. They fill out my questionnaire. They hired me. I come in and I'm like, “Hey, I'm Julie. You're in labor. It's nice to meet you.” Those are the hardest ones. I'm never going to watch someone suffer. If you're suffering, I'm going to put my camera down and I'm going to help you. But for first-time parents that didn't feel the need to do any type of childbirth education or learn anything about the process, you just sit there and watch them get railroaded by the hospital setting. You're watching trauma unfold and you're just like, “How is this happening?” But you know how it's happening because you've been watching it for years. I'm talking about myself in the third person or second, or whatever person. But here's the thing. It breaks our hearts. We see it all the time. We see it in The VBAC Link Community all of the time. So many times, people are like, “My water broke so I went into the hospital. I'm only 0 centimeters dilated. They started Pitocin. It's at a 10 and I don't know what to do. I'm not dilating and contractions aren't coming. Help me.” This could have been stopped if you knew that it's okay for your water to break without labor starting and to wait at home for 12-24 hours for labor to start on its own and rest, hydrate, and watch for fever or chills or anything like that then go to the hospital. It's a simple thing to learn but people don't think that because they trust their system. They're going to the hospital and getting railroaded. So many times we see that. All of a sudden, you're water has been broken for however many arbitrary hours your hospital decides is important, and then you get a C-section because all of these things happened. If you would have just known that it's okay to stay home, and there is evidence of staying home. We're not just making this up. There is evidence to support this and just takes a little bit of time to learn. But anyways, that's why I'm sounding really salty today is because I see people get railroaded by the system all of the time. All of the time and it breaks my heart. It breaks my heart. I can leave birth and not be super affected by it anymore usually, but these birth experiences are yours. They're going to affect you for the rest of your life. We don't only know that. We don't want you to be railroaded by the system. We want you to know and follow your heart and follow your intuition. If your intuition is telling you, “Unmedicated birth, not pushing on your back, not getting induced, not wanting cervical checks,” then you probably want to birth at home because as soon as you walk out of the door when you are in labor to go to the hospital, your chances of having that birth go down a lot.Meagan: Yeah. I mean, studies show that people are much more likely to have interventions in labor and birth as soon as they are admitted in labor, especially in early labor. If we rush to the hospital, but in your mind, you're like, “I don't want to do this. I don't want to do that. I don't want to be induced. I don't want interventions,” but the second we start contractions, if we run and go in, our chances of interventions are sky high and the chances of Cesarean are high because we're pushing these things that are leading to Cesareans. Don't shame yourself and offer yourself grace if you've experienced an unexpected, undesired Cesarean. You are not alone. You are not alone. But know that you have options. Sometimes I want to say to open your mind a little bit. Whether you come back to that openness or not, you come back to that original idea or birthing location, open your mind a little bit and learn the stats. See the stats. Hear the stories. Hear what it can be like.I don't want to take away from anyone who has birthed in the hospital and had a beautiful experience because they can happen and they do happen. They do. But yes. There are a lot of other things that can happen in the home or outside of the hospital that may not lead to interventions and things like that because we're at home and we're doing those things. We're doing more of nothing. We're not doing a lot of anything. We're doing nothing. We're watching. We're trusting. We're having faith. It's so important to understand that your body is capable of doing this. I've had some consults lately that broke my heart because people have literally told them they can't. They won't. They shouldn't. Those three words. They can't have a vaginal birth. They will never have a vaginal birth. I was told that. Right here, I was told that I would not get a baby out of my pelvis. Hello, okay. They shouldn't and they can't. Don't believe that. If you are listening to this podcast, whether you be a first-time mom, a second-time mom, a VBAC, a CBAC, a HBAC, breech. Julie: A breech BAC. Meagan: Whatever your history is, whatever you're coming from, know that you are capable. You are capable of making these choices. You are capable of doing this. It is totally possible. Totally possible. Yes, we might sound salty today. We might sound aggressive. Julie: We're passionate. We're seeing women get hurt by the system. Meagan: It's really hard, but sometimes, we have to have these hard, raw conversations. Julie: Direct. Meagan: Direct conversations to say, don't let the system get you. Don't let it get you. Don't let it bite you in the butt. It doesn't have to be like that. It doesn't have to be like that. I hate that it even has a label as “the system”. You guys, this is a system. It's unfortunate that it has come to this. It is unfortunate. I wish that we could all just go back to the farm. Let's have the farm everywhere. Ina May's farm. Let's bring back the farm and just give birth like that. Don't you think, Julie? Wouldn't that be lovely?Julie: That would be beautiful. I think it's a double-edged sword because up until the 1940s, 1950s, maybe a little bit earlier than that, probably the 1920s or 30s, most people gave birth at home. You only went to the hospital if there was an emergency or if you were at higher risk. Meagan: And there were some downfalls about birthing back then too. Julie: Right. That's what I'm getting at because there's a reason why people transfer to the hospital. In the advent of the 50s, 60s, and the 70s, mostly the 70s, all of these new technological advancements and things like that provided ways that we could save lives that otherwise would have been lost. For that, we are incredibly grateful. We are so grateful. Like we talked about a little bit earlier in the hospital, with that, it has evolved into a system that tries to control the birth process so it's a trade-off. I feel like an ideal situation would be where everybody births without intervention unless there are true emergencies. We're not talking about emergencies like, “Oh, I was induced at 39 weeks and my body wasn't progressing past a 4 and it's been 48 hours. My baby's heart rate is starting to go down so now I have to have a Cesarean.” That is a hospital-created, emergent Cesarean. That is a system-created circumstance where a Cesarean became necessary. That happens so much. It happens so much. We have been raised to go to the hospital and have babies. We get induced. My mother-in-law was induced on her due date every single time. She had her babies every time on her due date. She had five kids. Everything went perfectly well. She has no trauma. Who really knows? It's been a while since those things but she speaks very fondly of her births and that's okay. That's good. But now, we are a generation of traumatized women from our birth experiences. You go into a room with four people that have had babies, I guarantee that two of them had a really rough experience. That's another number I'm just making up. You're not going to be able to find any resources for this. Meagan: What do they say? Two out of five people have unexpected Cesareans or something like that. Say at a restaurant and have everybody raise their hand that had a Cesarean. That's the question. Have you ever had a Cesarean? A lot of arms are going to go up. How many of those Cesareans were planned? There are going to be some. Julie: Less than half I would say. Meagan: There are going to be some that stay up, but most of them were unplanned. Julie: I have a cousin that had four Cesareans. The first one was unplanned, the three other ones were scheduled. She says, “It's the best way to have a baby. You go to the hospital, go to sleep” because she would go under general “then you wake up and have a baby.” She loves it. She speaks very fondly of it. That's the way that she likes to birth and that's okay. I don't want to come off as romanticizing home birth because birthing at home is hard. Sometimes your baby is in a wonky position or sometimes your body might be not quite ready. It's going to be a longer and harder process. Sometimes emergencies happen and you have to transfer to the hospital. Things like that happen. I don't want to make it sound like that never happens because it does. I think there are three major home birth studies now that show it's just the mortality rates for mothers and babies are similar in the hospital and at home, so there is not enough difference to say that one is better than the other, but also, at home, guess what is less? Less postpartum hemorrhage. Less chance of the baby needing resuscitation. Less chances of severe tearing. Less chance that baby is going to the NICU at home. It's worth considering. It's worth exploring and my gosh, if you are a 100% hospital birther, I think Meagan touched on this a little bit earlier, we encourage you to check out home birth resources in your area. Just check them out. Just go and talk to a home birth midwife. Ask her what she does in the case of an emergency, what would risk you out of birthing at home, and just talk to them. You don't have to hire them, but talk to them and see what else is available. See if your intuition jives with that. If your partner is on board with a home birth because it's going to freak them out, and you feel like it's something that you want to explore more, it's time to sit down and have a serious talk with that partner. Do not let your partner or your provider take away the chance of having the birth that you want because they feel uncomfortable about it. Meagan: Yeah, that's a hard one. That's a whole other–Julie: I know it is because it's important. You should respect each other's opinions. You should. You should respect each other's opinions. You should respect your partner. You should understand where your partner is coming from. You should take their point of view into consideration. You should be able to come to a compromise, but if your partner is not willing to do that for you, then that's a problem. Meagan: I want to just quickly before we end, plug in some numbers. Look, you guys. Are you so proud of me? Julie, you should be proud of me for talking about numbers. Julie: I am proud of you. Meagan: This is what you usually do. Julie: Before we get into that, I want to say one more thing. I understand that some of the things that we've said are probably going to be pretty emotional for some people. Maybe some people have gotten triggered. Maybe some people just hate us now and they've already unfollowed us on Instagram, who knows? I say us but probably me too. Probably a lot of VBAC Link people follow me on Instagram as well. Let me try and figure out how I'm going to circle back around and say this. If you have been triggered by this episode, I really, really encourage you to lean into that trigger. Don't run away from it. Don't slash The VBAC Link. Don't unfollow us. Don't unsubscribe. Don't trash talk to your midwife buddy about us. I guess you can do all of those things. It's really your choice. But I encourage you to really lean into that trigger because I wish that we were a society of owning our triggers instead of blaming other people for our triggers. Triggers are our own emotional responses caused by some sort of unresolved trauma or issue in our life. If you lean into that trigger and explore it and figure out why it's happening and where it's coming from, you're going to be able to heal emotionally and become a better human. It's going to affect your future pregnancies, your future births, and your future interactions with other people. How would it be to not ever feel triggered like that? It would be really cool. I wish that I was never triggered but I also know that when I get triggered, instead of running away from it, I have learned to really lean into it, explore it, figure it out, and resolve that. I encourage you that if something we said has triggered you, then lean into it. Maybe leaning into it is unfollowing The VBAC Link. Who really knows? But I bet you that there is a deeper issue there. I wish or I hope that you would take some of the things that we have said here and consider them. Maybe lean into that too and explore a little bit more some of the things that we are talking about and why we are feeling this way. I also encourage you to talk to a local doula or a birth photographer and ask about their experiences observing home birth and hospital birth. That's my little parting piece. Meagan: Great, you're right. A quick plug-in before we talk about these numbers, if you are not aware, The VBAC Link has VBAC-certified doulas all over the world. I'm serious, all over the world. So if you are looking for a VBAC Link doula or if you are looking for someone that's really educated and knows their stuff about VBAC, knows how to support you, and also to help find a really solid provider and location and help you determine where is best for you, check out our directory at thevbaclink.com/findadoula. Search your area because seriously, these doulas are incredible. Julie and I a long time ago, back in 2018, started–Julie: 2018, 5 years coming up. Oh my gosh, in a couple of more months. Meagan: Yeah, back when we got together and started this company, our goal was to help change the VBAC world. We cannot do this alone as individuals, so we have all of these incredible doulas helping us out there. So if you are looking for a VBAC doula, I have to gloat about them because they are amazing. Julie: Really amazing. Meagan: But let's talk really quickly before you go about success rates. There's a study that has been done. It was published in 2015 but I believe that it was from 2004-2009 which makes me even wonder now after COVID what it would be because home birth and HBAC have skyrocketed since COVID because a lot of people were, just like we were talking about in the beginning, having their people stripped from them, having to wear a mask, having to deal with the fear of losing their baby if they tested positive and all of these things. But this was a while ago. The success rate was examined. It's a lower number like 1050 or something like that but the rate of successful HBACs was 87%. Julie: That is pretty amazing. Do you know what I love? That's higher than APA because APA says that 60-80% of people who attempt a VBAC will be successful. Meagan: Just in general, a VBAC, yes. Julie: That's general. Hospital, home birth, movie theater birth, whatever. 60-80%. But this at home, did you hear that? 87%. Meagan: At home, 87%. Now, I want to talk about transfer rates. They had an average of 18% transfer rate. Julie: That's kind of high. Meagan: It is kind of high but I want to talk about that because a lot of people might think of an 18% transfer rate and they automatically go to Joe Rogan's page and hear, “Oh, what they are saying is so true. All of these terrible things are happening.” You guys, no. Yeah. Did you see it? Julie: No, send me a link.Meagan: There's a video. You'll have to check it out with Joe Rogan and this lady. I don't even want to get into it. It was so annoying. I just rolled my eyes the whole time. Anyway, the majority of these people that were transferred, I want to preface. It was not because there was a crazy emergency. It was most common for failure to progress. Failure to progress we know has a lot of things. We know that sometimes failure to progress can be due to cervical scarring or maybe we've had really long prodromal labor and things like that. There are a whole bunch of different reasons why but failure to progress and they needed to go to the hospital to then benefit from some of the things that the hospital offers like Pitocin or something like that? But still, only 18% which I know sounds high but still, 87% had a successful VBAC at home, so an HBAC. Julie: Okay, so I also want to say two things. First of all, the study might have had certain protocols to follow for a transfer. That might have caused the transfer before it was necessary. I don't know. I haven't seen this study. But also, the second thing is that I heard somewhere, and it might be different with study protocols, but I heard somewhere and I feel like my circumstances support that most hospital transfers are due to maternal exhaustion. They are so tired. They have labored for so long but I don't have a number to back that up. But that's interesting that that study shows that. That's really cool. Meagan: Yeah. There are things. We know that women at home can sometimes lack resources, but you can also talk to your provider if you're birthing at home and talk about, “Hey if I'm not progressing, what kind of things can we do to help progress?” Sometimes that's processing and sometimes that's nipple stimulation. Sometimes that's getting everyone out of a room, turning off the lights, and taking a nap. There are so many things that go into it but it's a pretty small study relatively. But still, wow. It does represent something. It represents something and we can't ignore it. But anyway, we are pro-choice. We are pro everybody making the best choice for them but we do. Julie: We're also pro-not watching the system railroad people. Meagan: I was going to say that we do see so many things that are so avoidable. I've had clients in the past years. One client probably two years ago, she was 38 and 5 I want to say. I'd have to go back and look at my notes and the provider was like, “I don't know. You look big. It looks like this baby is measuring big. It could be anywhere from 8-10 pounds. We should probably induce. I will totally support this VBAC but let's induce.” The cervix wasn't doing much. It just wasn't an ideal spot to be walking in for an induction and they required breaking water. They wouldn't put Pitocin in. When the water was broken, they needed Pitocin after that which is interesting. She got up to a 1 and started Pitocin, had an IUPC placed, an FSC placed, and all of these things. Boom, boom, boom, boom, boom, and it was just so hard because you guys, I adore this person. I adore this person but it was so hard to see these things and see the path that it was going down knowing that the end result was likely coming to a repeat Cesarean when that's not what she was wanting. It was so hard texting my doula community, my resource group that we all have as birth workers saying, “You guys, pray. Pray. Pray that this is just one of those miracles because it's one of those situations that we see too often.” It did. It ended in a repeat Cesarean. It was healing. It wasn't an emergency. She did heal from it, but it didn't need to happen. I can't say that for a guarantee. I can't say something wasn't going to happen, but it didn't need to happen that way. So women of strength, here we are. We love you. We know that you are in a hard situation. We've been there. We've been there. Julie's been told by providers in the hospital that she would rupture. I was told that I would rupture. No. You were told that your baby would die. Julie: Me and my baby would die. Meagan: Yes. We were told these really scary things. Do we hate the hospital? No. Do we hate it? No. Do we hate what we see in it? Yes. Julie: Yeah, a lot of time. Meagan: We hate it. We hate what we see. I mean, not always. I can't say that we always hate what we say but so many times we hate seeing things that are just avoidable. So here we are. Know that we're here. We've got our course. We've got the blog. We've got this podcast. We've got our private Facebook community. We have Instagram. We have so many resources filled with evidence-based information. If you are wanting to up your VBAC game and learn the history of VBAC, learn about Cesarean, the history of Cesarean, learn about VBAC, learn how to find the right provider, learn how to tap into where you want to birth, and really tune into that, this course is going to help you walk through that path. Whether or not you choose a Cesarean, you choose a VBAC, you choose an induction, you choose home birth, hospital birth, midwife, OB, unmedicated, medicated, whatever it may be, we are here to support you but it is so important to us that you find that information that you are filled with the evidence-based information ready to take on the birth and have the birth experience. So if you want to learn more about all of these resources, check the show notes. They are all going to be listed. Go to thevbaclink.com and click around you guys. You're going to get lost in there because there is a lot. There is a lot of incredible information. But yeah. Julie, anything you want to add before we let the listeners go? Julie: I do. I do have something we want to add. Listen. Me and Meagan want to do a birth together, a VBAC. Maybe at home, maybe at a hospital but if you are in Utah, Salt Lake or Utah County, Weber, Davis, Tooele, Park City, and any of those areas, reach out because we have a special bundle discount that we will give to you if you hire Meagan as your doula and me as your birth photographer. Meagan: Yes. We've done a birth together as doulas switching up. We've never done a birth as a birth photographer and a doula. Julie really wants us to work together. Julie: I do. We will be a package deal. We will take some money off of our services for you so that we can have that experience and then you get both of us at your birth which is a total win. Meagan: That would be really fun. It would be really, really fun. Okay, listeners, we love you. We love you so much. Happy Cesarean Awareness Month. It's April. We're going to be posting those stats and all of the things this month so stay tuned. If you have not followed us on Instagram or Facebook, check us out at @thevbaclink. You can find us anywhere and we are so grateful that you are here. Hopefully, after today's episode, you're not unfollowing us on all of this. We love you. We just have to say that. Julie: And you can follow me @juliefrancombirth.Meagan: Yes. You can follow Julie at @juliefrancombirth.Julie: Bye! ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Today we have a longer bonus episode where I chat with Julie DeLucca-Collins, and it is so inspiring.  She is an example of someone who lives in her core value of breathing confidence into women when they can't always see it for themselves and it is magic.     Transcript:  Katie: Welcome to Everyday Happiness where we create lasting happiness in about two minutes a day through my signature method of intentional margins, (creating harmony between your to-dos and  your priorities), happiness, science and musings about life. I'm your host, Katie Jefcoat, and today this is a bonus episode because I get to chat with my dear friend, Julie DeLucca Collins. She's a business and life strategy coach and she's certified in tiny habits.  And I know you are going to love what we're going to talk about today and you are going to love what she's going to share with you over the next five days because it's all about happiness habits. Julie, welcome to Everyday Happiness. Julie: Thank you Katie Jefcoat. Thank you so much for having me. I love that I'm on your podcast. This is my regular weekly, daily rotation. So thrilled. Oh, my God, it's going to be weird. I'm going to have to hear myself in your podcast. Katie: It's going to be amazing and it's going to be so much fun. I'm so glad that you are here. You have always been one of my biggest fans and biggest cheerleaders in getting this message out to people that could use a little boost in their happiness. Julie: Absolutely. And by the way, I was telling somebody earlier this week, I said, you know, one of the gifts of the Pandemic is Katie Jefcoat, because she's one of the first people I met through the pandemic. And if you're not looking at the pandemic as the thing that gave you a gift, go back and rather than looking at it as a white wall, go and find all of the gifts that came from that and you're definitely one of them for me. Katie: Oh, my gosh, I love that so much. And the feeling is absolutely mutual. So if you can remember, tell our listeners a little bit about how we met because it's not in real life. Julie: It's not in real life. Even though you live in an area where I lived, I lived in the DMV area and I love it. And if I had to move out of Connecticut and it wouldn't be New York, it would be that area. But we met through a mutual friend, Keatha, and she is an incredible podcaster and weight loss coach doing some wonderful, wonderful things in the world. But when I launched my podcast Casa DeConfidence during the pandemic, she said, you have to have my friend Katie on the show. And I said, yes, absolutely. And we got on the phone and the first thing you said to me is, what is lighting your hair on fire? And I'm like, what? Oh, my God, I don't even know what to say to that. And I loved it. And I said, this is my person. This is someone that I love because this is just something that is unusual. It will always make me remember her. But it's true. Something has got to be lighting your hair on fire. And that's a great way to get to know someone. I loved our first conversation, and I invited you to the Casa DeConfidence show and you taught me about Intentional Margins®, which, by the way, I use that a lot when I'm talking to my clients and I'll say “Katie Jefcoat says you must create Intentional Margins®”. And, yeah, we've just been collaborating. I joined your community and you have been one of these people that we come alongside of each other, doing life as business besties and doing the work. And anytime that I have a question or a thought, I know that I can always pick up the phone and say, hey, Katie, what do you think of this? Or you'll catch up with me and catch me up. What are you working on? And we really bounce things off of each other. And if you want happiness in the world, I think that you really need to surround yourself with the people that make you better, that grow you, that are aligned with your values. And ultimately, the African proverb I've been saying this a lot, but the African proverb that says “if you want to go fast, go alone. If you want to go far, go together”. And this -- you are one of those people that I'm going far with. So I love it. Katie: Oh, my gosh, I love that too.I love it so much. I love cheering on other people that are doing things that they are passionate about and you have the exact same philosophy. So just meeting was so much fun. And then we've really been steadfast in our connection and walking this path together. So, it lights my hair on fire just to have you in my life. It's so much fun. And we get to test all the things that are going on and be like, does this sound right?Can I have a gut check?  Julie:  Yeah, for sure. And I think that you need that in life and if you don't have it, start to be open to the idea and also be open to meeting new people and it's going to be a little uncomfortable. When you first get on a phone call with someone you don't know, but ask a friend, hey, if you're very cool, who else do you know that's very cool and who can I connect with? And connection is so important. Katie: Oh, my gosh, I cannot agree more. First, behavioral contagion, right? We really do mimic the behaviors of others, so if we're all elevating, that always helps. And social connection is one of the keystones to happiness. Oh, my gosh, all the things I love so much. So if you could share with me a little bit about you, where you started, what you're up to, what's going on in your world, because it feels like it's all the magic. Julie: Well, if anybody checks me up online, the first thing they'll probably see is that I'm a business and life strategy coach. But I didn't start here. I started out as a teacher and then I moved to work in corporate America, still in education, and I grew through the ranks of a company, a national company, in education. And I loved it and they gave me some great opportunities and they had a philosophy of building their team from within and they really invested in training and growing individuals to grow into the seats of their executives. And I was so fortunate to be there. I learned a lot when it came to starting a new business line. I came in as a little corporate coordinator for one of the VPs and eventually I took over. He didn't leave the company, but I took over that job. I was the VP or Executive Director first for the partnerships that we did with school districts nationwide. But the great thing about this company is that they taught all of us and their executives about marketing, they taught us about operations, development, how to be able to be a very well rounded individual growing a business. And I loved it. And then I got to take that experience into another company where I ended my career. I was there for twelve years. My last role was Chief Innovation Officer for the company and I oversaw all of the contracting and work that we did with school districts nationwide as well. I helped to expand the company out of New York into Texas, Massachusetts, Connecticut, New Jersey, and we continue to do work and expand the support systems that we created for school districts, for students, for teachers and administrators. And I loved it. But there was one piece for me that I always felt really called and passionate about. Although education is definitely something that I'm passionate about, helping kids and families was great and I love supporting teachers because I had been in that seat. I also knew that I wanted to help women because as I climbed the corporate ladder, I started to see that there weren't a lot of women, the higher you got, number one. Number two, if they were, and I talk about this in my book because I wrote a book through the pandemic, and that was one of the gifts of the pandemic again from me. Not every woman has been trained or is open to the idea of being supportive. So I wanted to create and listen. I'm guilty. I think that in the very beginning I wasn't as supportive and loving and kind and mentoring as I should have been as an executive. And that's one of the things that I started to do is I started to realize that I wanted to rectify, that I wanted to create an environment in which I help other women build the confidence that they needed either to grow their careers or to become a better version of themselves or to start a business. And many women who are starting businesses don't know where to start, what to do, first, second or third. And when I was laid off through the pandemic, another one of my gifts the pandemic gave me, I knew exactly this is what I was going to do. I was going to start my own business, and I was going to do the type of work that supported women specifically to become more confident in their life and business and become the CEO of their life and business. I wanted to be able to breathe the belief into them, that somebody and so many other women have done for me, have given me that ability to grow, be a better version of myself, and become successful at achieving my dreams. So Go Confidently Services was born out of that. And I launched the podcast Casa DeConfidence, and that was something that my husband sort of put on my plate. He said, hey, you're going to start a podcast. And I was like, Why? He's like, Because you're not having a birthday party. We're in a pandemic. And I was having a big birthday. And I'm like, what? What do you mean? And that kind of put my energy out of planning or being in that slump of not doing the things that I thought I was going to be doing all of a sudden just growing and creating a platform where people like yourself can come in and talk about what is your journey to confidence. Because I think that in a world where social media rules, we see everybody's high points and we are not seeing that. You know, we don't always have it together. And that was one thing that people would say, you're too confident. Look at you growing, getting a promotion, doing great things. But I don't always have it together. And the thing that helps me show up and have it together when I don't feel like it is habits, and that's what I fall back on. Katie: Oh, my gosh, I love this so, so much. I cannot wait to get into your five episodes on happiness habits. It's going to be magic. You also are really an example of breathing life into people and really helping them secure a vision and clarity around how to grow a business, if that's what they want, or how to manage life. You know, you have workshops that you do every so often where you can really dive in with other individuals. Usually there's some offer on Zoom, so I encourage listening to make you follow Julie DeLucca-Collins so that when she does offer something again, you'll know about it. So until next time, you're going to hear from Julie. Remember, kindness is contagious. P.S.  If you are interested in a habits challenge, Julie is starting a free 5-day challenge on Monday February 20th. You get expert coaching from a Tiny Habits Certified coach and a community to help cheer you on and support you with the right accountability.  Register Here for all the details    About Julie:  Julie DeLucca-Collins is the Founder and CEO of Go Confidently Services, the host of the popular Casa DeConfidence Podcast®, and her weekly Radio Show Confident You featured on a global talk radio network. As a Business and Life Strategist Coach, Julie helps women business owners launch or grow their businesses, get clients, be productive, and achieve their dreams. Julie helps her clients create simple habits to achieve goals and change their lives. Julie is also the #1 best-selling author of the book Confident You (simple habits to live the life you've imagined). Julie is a sought-after public speaker, trainer, and course creator. She is certified as a coach in Cognitive Behavioral Techniques, Holistic Coach, and Tiny Habits. She is also certified as a Social Emotional Learning Facilitator and has completed her 200-hour Yoga Teacher Certification. Julie enjoys helping her clients build mental fitness and improve their mindset to beat peace and improve peak performance. Julie has been honored with the "25 Most Powerful Minority Women in Business Award." by the Minority Enterprise Executive Council in Washington, DC. Julie and her Podcast co-host/producer husband Dan reside in Vernon, CT, with their fur babies, Yogi Bear, Junior, and Simba.   Social Media Links: https://www.instagram.com/julie_deluccacollins/ https://www.linkedin.com/in/goconfidentlyjulie/ https://www.facebook.com/jdelucca https://www.pinterest.com/juliedelco/ https://www.tiktok.com/@juliedcbusinesscoach Get Everyday Happiness delivered to your inbox by subscribing at: https://www.katiejefcoat.com/happiness And, let's connect on social at @everydayhappinesswithkatie  and join the community on the hashtags #IntentionalMargins and #everydayhappinesswithkatie on Instagram Links:  https://onamission.bio/everydayhappiness/

Julie Brown is a high energy Keynote Speaker who teaches the importance of networking. She is also the author of This Sh*t Works: A No Nonsense Guide to Networking Your Way to More Friends, More Adventures, and More Success, as well as the host of the This Sh*t Works podcast. Prior to her burnout, Julie was overworking herself to the point that she jokingly was jealous of a woman who had awoken from a three day coma, because at least that woman got to sleep. She and her husband were working such hectic schedules that they would not see each other at all during the week. Everything changed when the pandemic hit and Julie realized that the hustle lifestyle had tricked her.    Hustle culture is causing people to overwork themselves until they burn out. Julie was going ‘balls to the wall' for everything every day of her life, except when it came to resting. She shares that the pandemic was a real wake up call, because she and her husband were unsure how they would ever go back to that jam-packed scheduled to the minute lifestyle. In addition to talking about Julie's burnout story, Cait and Julie talk about the importance of networking, how to build a community, and the underestimated strength of weak connections.    Have you ever thought a three day coma sounded appealing? Tune into today's episode of FRIED. The Burnout Podcast for a conversation with Julie Brown about building relationships, the dangers of hustle culture, and allowing yourself to rest.  Quotes • “Your question to me was, ‘Oh, do you have a burnout story?' And it was like, ‘Oh, you mean the time I was getting ready for work, and I heard the story about a woman who had just woken up from a three day coma. And I was jealous of her, because she got to sleep.' And then I said to myself, ‘well, that's what I need. I just need a well timed coma. And then I'll just rest and then I'll be able to get up and I'll be good to go.' And I knew something was wrong in my life where I didn't have time to rest unless there was a medically induced coma in my future.” (2:37-3:21 | Julie) • “There was a point when I was hoping for a coma that I said, ‘Why am I working so hard for someone else? Why do I have this drive to do this for someone else? Can I convert this energy into something else for myself?'.” (6:11-6:29 | Julie) • “You need to have that community in place before a crisis hits, because it's very hard to build a community in crisis.” (19:40-19:48 | Julie) • “Asking for what you need, what would be helpful to you, because you have already given back to your network, because your network wants to be there for you, is invested in your success, whether that success is your mental success, whether it's your financial success, that's not needy.” (21:01-21:19 | Julie) • “It's okay for us to be in places of need sometimes and be in places of abundance sometimes, as long as when we're in places of abundance, we are giving back to our community and giving back to our network.” (21:21-21:32 | Julie) • “If you are keeping score in your relationship, and you are always expecting tit for tat, you're never going to be happy.” (25:08-25:18 | Julie) • “I always tell people to build their network slowly and with purpose, because you cannot manage growing, fostering a number of relationships and do it correctly. And do it without getting tired, because managing relationships takes a lot of time and energy.” (40:04-40:28 | Julie)   Links https://cuely.ai/FRIED https://bearaby.com   Connect with Julie Brown: Website: https://sayhitojulie.com                    https://juliebrownbd.com/ Instagram: https://www.instagram.com/juliebrown_bd/ LinkedIn: https://www.linkedin.com/in/juliebrownbd/   XOXO, C   If you know that it's time to actually DO something about the burnout cycle you've been in for too long - book your free consult today: bit.ly/callcait   https://friedtheburnoutpodcast.com/quiz   Podcast production and show notes provided by HiveCast.fm

Meagan welcomes Julie back today to celebrate 200 episodes of The VBAC Link podcast! They celebrate this milestone with a special live Q&A podcast recording session joined by followers of The VBAC Link Facebook community. Topics include: how to talk to your provider, all about Spinning Babies, adhesions, managing sciatica pain, induction, nipple stimulation to induce labor, VBAMC, C-section consent forms, and much, much more.We can't wait to continue sharing new episodes with you as we stay committed to our mission of making birth after Cesarean better!Additional linksSpinning Babies websiteThe VBAC Link Blog: Pumping to Induce LaborFear Release YouTube VideoEpisode 18 Leslie's HBAC + Special ScarsJulie's InstagramThe VBAC Link Community on FacebookHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Julie: Welcome to The VBAC Link podcast. This is our 200th episode and yes, you are listening to Julie. I'm back just for this episode and probably some more in the future at some point, but we are so excited, Meagan and I, because this is the 200th episode. We are now live in our Facebook group. Not now when you are listening to it, but right now in this moment in our timeline. It took us way too long to get in here live, but we are doing a Facebook Live podcast episode. We have never done that before and we probably will never do it again because this was kind of traumatic.Meagan: Yeah, this was a little rough, but that's okay. Now that we know, now that we know, we are good. We're good. Julie: Now we know.Meagan: It just took 34 minutes to figure it out. Review of the WeekJulie: Oh my gosh. Cool. So, let's get started first. There is a Review of the Week. Meagan, are you ready? Do you have one?Meagan: Yep, I do. This is from blpinto and it's from Apple Podcasts. It says, “Wonderful resources for ALL moms, not just VBACs.” It says, “I didn't have a C-section for my first birth, but I had a traumatic experience with a forceps delivery and an induction that was not at all what I was looking for. I started listening to the podcast before I even got pregnant a second time to prepare for a better experience. Julie and Meagan were a huge part of my process and journey. I ultimately had a beautiful home birth and a 10-pound, 6-ounce baby. I felt this podcast helped me overcome my fear that I couldn't push my baby out without help because many VBAC moms had the same feeling.”I love that. I don't know many first-time or second-time moms who haven't had previous C-sections that have listened and left a review. So that was awesome. We truly believe that this is also a podcast for everybody. Just like wonderful Brian says at the beginning of this podcast, it's for all expectant parents who want to avoid a Cesarean and want to learn their options and learn what's happening out there. So that is so exciting that we had someone who hadn't even had a C-section before. If you know someone who is expecting and has fear or maybe a first-time mom who has some doubts and problems and traumatic experiences in birth, definitely share the podcast. These stories are amazing for all to listen to. I would 100% agree with her.Julie: I love that. Do you remember years ago when we first started and we were trying to figure out how we could make something, maybe not separate, for first-time parents? We were like, “How do we get first-time parents to understand that these are things they need to know?” Because you didn't. I didn't. As a first-time mom, I didn't even think about a C-section until the doctor said, “We need to do a C-section,” and we never really got very far with that because the focus of The VBAC Link is a vaginal birth after Cesarean. Yeah, so we love that. We, I say “we”. I will always say “we” talking about The VBAC Link. Meagan: Literally, just earlier today, I was recording a podcast and I was like, “we”. I mean, “I”, but Julie is just over here. Julie: My spirit and presence exist in the VBAC realm.Meagan: Yes. But it's so much fun. It's so fun to be here and I'm excited. If you guys haven't had a chance or if you are watching live right now, we would love your reviews. Love, love, love your reviews. You can send us an email. You can write right here and I will copy it over and put it in the reviews. We are excited to dive in today on episode 200!Q&AJulie: Yeah. All right, all eight people who are watching. I guess one of those is me and maybe you, so six. Six people. Drop your questions. Nothing is off-limits. We are going to talk about everything you want to know. Everything you want to hear. We are going to get down and dirty with everything VBAC, wives, and kids. If you want to know what Meagan's kid is doing right now in the background, we will talk about it. Meagan: Yeah, drop your questions. I'm posting here letting people know that we actually are live now. Julie: Oh heavens. VBAC: Where do I start?Meagan: Yes. It's so funny. I keep looking on the wrong forum. Okay, who do we have in here? Who do we have? Kathryn, Jen, and AJ thank you so much for being here. Let us know your questions. I want to maybe start off just on VBAC options. We had someone write in yesterday and was like, “One, I didn't know VBAC was an option. I didn't even know what it was.” So that's wonderful that they're starting to find out that VBAC is an option, but let's talk about how we can have a conversation about VBAC being an option with a provider. That's just random, I know. But what would you think, Julie, if you're starting to discover VBAC, learning what it is, feeling like you want to feel it out, maybe you want to learn more about it and do it, how would you suggest approaching your provider?Julie: Oh man, that's a great question. First of all, we've got some good questions coming in too so I'm excited to answer these. Provider, honestly, I would just ask where their thought process is. I would approach them and say, “Hey. this is what I'm considering. What are your thoughts about it?” And I will tell you what. No matter what their response is and no matter what ultimately your birth plan is, you're going to get a really good feeling for how your provider feels about body autonomy, informed consent, and birth in general because if they answer and say, “Oh, well I don't think you are a great candidate. I don't do VBAC. I don't support them,” or anything that's very sounds set in stone, so, “I don't do this. We won't let you do that. We would have to look at this and make sure your percentage is high,” or whatever. Anything that is set in stone shows you that your provider is not as supportive of other options or your provider has a very set way of doing things and may not be a good choice for you. But if they answer and say, “Yeah. We can consider VBAC as an option. Let's talk about some things about what your goals are. I do VBACs a lot. I love VBACs” or anything like that with a more open or a more fluid answer is going to let you know that your provider is going to not only be good with whatever outcomes that you choose but is also very open to having the parent or the mother be part of the birth process and be involved in the decisions regarding their care. That's really what you want to have on your side no matter what type of birth you're having or where you are giving birth. You want to have a provider that is going to be open to your input, be a little flexible, a lot flexible based on what your needs are and the type of birth you want, and is able to accommodate that. Meagan: Yeah, and just that's willing to have that conversation because a lot of providers don't honestly come out and say, “Hey, do you want to have a TOLAC?” which is a trial of labor after a Cesarean. That may be something that you have to take charge of and say, “Hey. I'm learning about this. What are your thoughts? How do you feel about it? Tell me about some experiences.” We always talk about open-ended questions but really, truly if you can ask an open-ended question, you're going to be able to get more information than a “yes” or a “no” or an, “Oh yeah. Sure,” versus, “Yeah. I feel really comfortable with that. We do that all of the time. This is why.” So I love that. I know it was a random question, but a lot of people are asking, “How do I even approach this topic with my provider?”Okay, are you ready? I'm going to read some questions. We'll bounce back and forth. Julie: Yes, let's do it.What is Spinning Babies?Meagan: So Ms. Kathryn says, “I just found your podcast last night.” Yay! And now you're here on the first live one. It says, “Bingeing ever since. What is Spinning Babies? I've heard it talked about a lot on the podcast.” Spinning Babies is a wonderful resource. They have all sorts of circuits and tips and tricks on ways to navigate babies through the pelvis. Breech positions, so if you have a breech baby, they have positions and exercises to do that. We've got posterior. We talk and they also do baby mapping to help figure out where your baby is. Julie: Belly mapping. Meagan: What did I say? Julie: You said “baby mapping.”Meagan: Baby mapping. I meant belly mapping. Julie: They're the same thing.Meagan: That's what I meant. Baby mapping. I almost said it again. Belly mapping to help you figure out where your baby is. They can educate on if a baby is posterior, what types of things to do and what to do if a baby is asynclitic or comes over the pelvis, and what tips and tricks you can do. A lot of doulas are really educated in Spinning Babies. It is so awesome. So awesome when the client, don't you think, is educated in this and they are familiar with it. Julie: Yeah. Meagan: So obviously, we talk about it a lot in the podcast, but we really encourage people to check out their website. They have updated their website and it's really quite great now. It's really friendly to navigate, so check it out. It can be a game changer. I have had positions in labor where things were just hanging out, stalling, not really going anywhere, and then we have done a Spinning Babies technique and boom, that baby rotates and labor is speeding along. Julie: Yeah, I love that. I think one thing that I really like about Spinning Babies too is that it puts less emphasis on babies being in this specific position and it creates more emphasis on creating room and space in the pelvis.Meagan: Balance. Julie: And with the connective tissues and yes, balance and all of those things because sometimes, babies need to enter into the pelvis in a little bit what you would call “less than optimal.”Meagan: “Less than ideal”, yeah. Julie: But as long as baby has enough space and room to wiggle and progress through the pelvis in the way it needs to, then you're going to have a great, not a great, that's a bad promise. You're not going to have a great labor necessarily, but you're going to be able to encounter less problems that are created by a poorly positioned baby or tissues that might be more difficult to move and things like that. So yes, balance, space, and flexibility. Do adhesions impact fertility?Meagan: Yeah, absolutely. Okay, let's see. AJ Hastings. “Do adhesions really impact fertility? Currently trying to conceive for seven months and was told by acupuncture that I need 12 months of weekly treatments. I definitely want another opinion.” So the short answer is yes it can. It can affect things. In fact, we have an episode and I will go find it here. I'm going to go find it. I'm going to drop it. It's so weird because we are on Zoom, but we are on Facebook over here. I'm going to drop it in the Facebook group right here because it definitely impacted her. It impacted her and adhesions, depending on how dense and how thick and everything, it can impact fertility. 12 months of treatment? I don't know. I mean, I'm not a specialist in how intense that needs to be. I have adhesions as well, but I don't know how dense they are. I was fortunate enough to become pregnant, but it can impact it and it's something to look into. I don't think it's bad to get a second opinion for a whole year of treatments, but I also wonder if scar massage, starting with scar massage by yourself, or going to a pelvic floor specialist and starting there might be beneficial. Julie, what would you think?Julie: Yeah, right along with what you said, it can. That's the thing. It doesn't always, but it might. Adhesions, especially ones that are denser or thicker can tug and pull things in the wrong way. They can make it harder for eggs to implant and can cause a whole slew of problems for your overall health depending on the relation to different organs that they might be adhered to. All sorts of things, but it doesn't always, right? One thing that I would ask my provider that's recommending that is what other options are available, what other things might be impacting my fertility? Have you seen any other types of providers? Have you seen an OB/GYN or maybe a fertility specialist in that regard or gotten a second opinion from them? Sorry, I think she said. Yep. I'm trying to see that it was told by acupuncture. Yeah, so I would maybe consult another type of provider. But trying to conceive for seven months is kind of a long time, but it also could take up to a year without there being any problems at all for just any random average to get pregnant too. That is just what was going through my mind. Is that the only thing that you are treating and addressing or is it part of an overall care plan? Are you seeing anybody else? That type of thing. Meagan: Mhmm, yeah. And like she was saying, maybe a different provider, maybe a pelvic floor specialist to even just dig into what those adhesions look like or a care provider, but yeah. It can. I'm going to go find it. I was just scrolling, but I'm going to go find it. Do you remember, Julie, do you remember her name? Julie: You're asking me if I remember anybody's name?Meagan: I'm the name person. I keep thinking it starts with a J. I'm going to find it though and I'm going to drop it in for you, AJ. Okay, “I just had a VBAC a few months ago and,” awww. “I'm so thankful for both of you.” Thank you, Allison. That's so sweet. So, so sweet. Julie: Thank you. How to manage sciatica painMeagan: Congratulations! Okay, Jenn. “I'm 39 weeks. My sciatica only allows me to walk for about 20 minutes without cramping. I see a chiropractor twice a week, but other than that, what can I do to help keep my baby in a good position and get labor going?” I would suggest the Miles Circuit right off the bat. Miles Circuit is wonderful. You can do it multiple times a day. There are three circuits and you want to try to do it for a minimum of 30 minutes but sometimes you have to lead up to that. That would be something that I would suggest. Maybe giving it a try. Also, Spinning Babies is very much a balance factor in creating balance.It sounds like your sciatica is not loving you right now and that is hard. That is hard, so being mindful also of being symmetrical and getting out of the car. I know that sounds really weird, but not stepping out with your left. Stepping out with your right. Trying to move out together because that separation with relaxin and things like that can cause the pelvic to shift, which then causes sciatica issues and all of those things. But I would suggest Miles Circuit. I would also suggest a massage. Getting things relaxed and soft because sometimes when things are tense, we've got that sciatica issue. Julie, what else would you suggest on that?Julie: Yeah. First of all, I would say that if you are in pain, then don't do anything. It's okay to stop. You don't want to hurt yourself and cause pain, tension, and stress in your body because that could interfere with your natural labor hormones. But honestly, I would think going to a chiropractor twice a week and walking 20 minutes a day is great. I think that's great to do. If that's all you can do, then I don't think you need to do anything else. 39 weeks could still be early based on when your baby wants to come, so don't feel like you urgently have to do anything. If your provider is pushing you a little bit, then it might be time to have a conversation about what your boundaries are and where you are willing to go as far as how far along gestationally before you interfere. But yeah, what Meagan says for sure. The Miles Circuit, absolutely. Two positions in the Miles Circuit are that you are resting pretty much and just creating more space in the pelvis. I would say maybe if you want to try changing it up from walking, one of my favorite things is going up and down the stairs sideways two at a time. It's kind of like walking, but you are really opening up that pelvis. So you go up with the right foot first, down with the right foot first, then switch to the left foot first, up and down. That's creating a nice, flexible, open space and lots of equal balance like Meagan said. Meagan: And listening to your body on that. Listening to your body. If it's too much, stop or just do three sets of stairs, three stairs. Just don't push your body. Yeah. But I like that one. I actually did that with a client at a birth center where there were some stairs. We did that to get labor going and it totally helped. It was amazing. Julie: Yeah, I love that. That's my favorite or curb walking. You just walk right foot on the curb and left foot off the curb and then switch with the other foot to keep that balance and stretch both sides of the pelvis. But yeah, change it up a little bit. I think you are doing great, personally.Meagan: Mhmm, yeah. Going to the chiropractor that often is amazing. Realigning. But yeah, 20 minutes, maybe cut it down to 15 minutes. Just a little less before you are in too much agony. Yeah, yeah. Julie: It's okay to take a rest. It's okay to not do it one day too, or a few days, or every other day or twice a week. Meagan: Yeah. I would also say shaking the apples which is a Spinning Babies thing, but that actually really relaxes and softens down there and can help with sciatica pain. That's just where you put the rebozo around your bottom and have someone sift, so you're kind of doing this.Julie: It's so fun. Meagan: This is so hard to be on a Live because I talk a lot with my hands. If you can see this in this video, Julie is very much here and I'm dancing.Julie: I even brushed my hair today. Meagan: You kind of get sifted and it really is nice for that sciatica. Okay, oh let's see. Just listened to all,” oh my gosh, “all 198 episodes of you guys.” Oh yes, yes. I just can't believe that we are at 200 episodes. I was telling my husband today and he was like, “Whoa. That's a lot.” Yeah, that's awesome. So awesome. Okay, do you guys have any other questions coming in on here? What else would you like to talk about, Julie, while we are waiting on any other questions? It's been a minute. It's been a minute since you've been on here. Julie: I know. It was 15 minutes before it was about to start. I was editing photos all day, so I was like, “Oh shoot, I should brush my hair and change my shirt,” because I had this frumpy little shirt on. I'm like, “We're going to be on video today. We never usually do that.” Meagan: Yeah. You don't have to be induced at 39 or 40 weeks!Julie: So it's just interesting. Let me think. I was just trying to think what has been bugging me from The VBAC Link Community lately. Not bugging me, but you know when you just want to grab ahold of people's shoulders sometimes and say, “This doesn't have to be this way. You don't have to do this!” Or just like, “It's okay to stand up for yourself.”I think a lot of the things I have been seeing lately a little bit is when people talk about induction or their doctor not letting them go past a certain amount of weeks. Meagan: Yeah. Julie: That's really kind of heartbreaking because, in America, we have a really frustrating maternal health care system. It's really easy to get trapped in that if you're not comfortable standing up for yourself if you don't know that it's okay to stand up to you're provider, and if you don't have an opinion about everything that you possibly can in birth. It's hard when I see people going in and getting induced. We'll see posts all of the time where people will be like, “Oh my gosh, I'm 6 centimeters. I've been soft for 8 hours. I was induced at 39 weeks. My provider said this and that and the other.” I just want you to know, everybody. You do not have to be induced at 39 or 40 weeks in order to get a VBAC.Meagan: You don't. You don't. I also wanted to talk about the opposite. On the flip side of that, I want to say that you can have a VBAC if you are induced. Julie: Yes. Nipple stimulation to induce laborMeagan: So there are both sides where it's like you have to be induced or you can't go for a VBAC or it's, “I will not induce you.” And so anyway, it's so hard. I was just looking. We have a group member that posted a couple of hours ago and she said, “I have a question about nipple stimulation to induce labor. I've been trying since yesterday and I do get contractions although they might just be Braxton Hicks because they are not really painful. But as soon as I stop, the contractions also stop. Any advice?”I just want to talk about this. In fact, I think Julie wrote a blog about this. I think, didn't you write a blog about nipple stimulation and pumping to induce labor? I'm pretty sure you did. Julie: I'm pretty sure that was you.Meagan: It might have been. I don't remember. Julie: That doesn't sound like anything I would write. Meagan: Well, yes. So this is something that I actually did when I was in early labor. I wanted to talk about that, but my midwife kept saying, “Hook up to the pump. Hook up to the pump.” I hated that thing. That thing was not my friend, but it worked. It helped, I should say. But sometimes it doesn't. And so kind of similar to what this group member is saying is that it sounds like it is releasing oxytocin in your body and it's stimulating something. Something enough to cause your body to contract or have some sort of spasms in your uterus, right? Which is a contraction whether or not it is strong.But when you stop, it stops and so that is– this is what I tell my clients too. That is a sign that your body is not quite ready or it's not going to respond to this type of method right now. Pumping is a really great option, but if it's not going, I would say to pause. Maybe just give it a break and see what happens. You can try again later or follow the advice of your provider. I would say that it's not bad that your body is not responding and it doesn't mean anything like it's not going to work ever, but it just sounds like your body may not be ready. So my advice is to maybe give it a break, try it a little bit more, try it a little bit longer and see, or maybe go have sex instead and try to release oxytocin in a different way in your body. So anyway, I just saw that. Are there other questions that have come in? Do you see any?Julie: Yes, there is. Meagan: Okay.Julie: Hi Paige, by the way! Hi Paige. Paige commented on the pumping to induce labor blog. Meagan: Oh yeah. Julie: Okay, so Tiffany, nope. Not Tiffany. It's before that one. Tiffany, I'm going to get there. Angel said that if we want to read her post in the group that she would love some thoughts. So I found Angel's post and I will read it. I love this. I have lots of thoughts, so Angel, if you are still watching, could you drop your location in the comments so I know? Oh, you're in New Zealand. You already said that. VBA3CJulie: She said, “I would love your opinions. I have contacted 15 midwives in New Zealand and all have said ‘no' to a VBAC after 3 C-sections. The main reason why I don't want a fourth Cesarean is because fentanyl is in a spinal block.” P.S. a lot of people don't know that. When you have an epidural or when you have a spinal block, the epidural is not the medicine. It is the method of giving it into your body. An epidural has lots of different medications in it. Fentanyl is one of them. Tramadol is another one. Sometimes there are antibiotics in there with them. But a lot of people don't know that fentanyl is in an epidural and a spinal block. Okay, so she says, “Tramadol is the pain relief afterward.” Tramadol is a form of morphine. That will be present in the milk which is one of the reasons why she doesn't want it. Antibiotics afterward, milk again, and all of her children have had severe colic and reflux to the point of sleeping four scattered hours overnight until they are 16 months old. All day naps are held upright. This is physically and mentally shattering. Could there be a link between colic, reflux, and antibiotics? It may be a possibility. “I live a 100% organic, tox-free lifestyle. I don't even take pain relief for headaches. Cesareans go against my holistic lifestyle.”“That being said, the first two Cesareans, I believe, were medically necessary.” Cord wrapped very tightly around necks, very thin and short. Babies were wrapped up by their necks tightly and couldn't move down, couldn't descend. Fetal distress straightaway for the first baby, second repeat Cesarean for the same issue. The third, the cord was fine, loosely on my tummy, but the amniotic fluid was a 4. It should have been a 7. She was pressured into a repeat Cesarean in case there was the same issue as the first two. She said, “I just need tough love, realistic answers.” Should she just have a fourth Cesarean and do everything else holistically? Meagan: That's tough. Julie: Yes. Meagan: We had a message come in earlier. I'm wondering if it's the same person because it sounds strangely familiar. New Zealand. I can't speak. But wow, that's tough. That's tough because you have good, solid reasons, beliefs, and feelings. Yeah. You know, it sounds like you are getting a lot of pushback in your area. A lot. That's a lot. There may be somewhere underground there that would allow it, but yeah. I don't know. It seems like you have enough reason to not do certain things. I don't know. I would maybe. I would maybe, actually. What would you do, Julie?Julie: Well, she says she wants tough love and I love tough love. So when I get permission for it, I will fork it out. Meagan: Yeah. Julie: So here's the thing. First of all, vaginal birth after three Cesareans, I love, love, love that we are seeing more stories come out about VBAC after 3 C-sections. Meagan: Me too. Julie: There's not a lot of data to support its safety or not. We have a few studies if you want to google VBAMC. We have a whole blog about the information that is available, but there's just not a lot out there. The way we get a lot of information out there is for more people to do it, right? That might not be a risk that a lot of people are willing to take. Personally, I would probably try it because I kind of know all of the information and everything, but I don't know because I haven't been there.So here's my tough love, okay? It sounds like you have talked to a lot of providers. This sounds like the providers you have talked to do not want to support you in your choice. And so when that happens, and this is for anybody who can't find a supportive provider not necessarily just directed at you, Angel, you have a few options. First is to go into labor and wait as long as you can and go to the hospital and fight and fight and fight. Out-of-hospital probably wouldn't take you on as a patient. But depending on, I don't know how the healthcare system is set up exactly out there. So go to the hospital, show up pushing, which I would never recommend that ideally if you could, but that's an option for you, okay? Go into labor. Go into the hospital. Maybe get a doula. Have your partner on board or somebody there who can really heavily advocate for you and be fighting the whole time. Or you can birth unassisted at home, which I also don't necessarily recommend, but there are a lot of people that can do it and do it smartly. Meagan: They have a lot of solid resources.Julie: A lot of resources, have a really solid backup plan, know everything that you need to look for as far as warning signs in labor, maybe labor close to the hospital or in the hospital parking lot or something like that. Neither of those might be good options for you, but it sounds like there's not really a good option anyway. I think also, sometimes I appreciate and envy, to some degree, the holistic lifestyle that you have. Sometimes, if you don't feel comfortable fighting in the hospital or having a baby unassisted, your third option is to have a repeat Cesarean. Meagan: Make it really special. Julie: Maybe you won't have a holistic lifestyle at that moment. ** You're going to have to get some medications that you don't love, right? You're going to risk having those things *** began with the colic and maybe the upset digestive tract from the antibiotics and things like that, but that also might not be the worst thing to have ***. The only thing that you are going to be able to know is what the best choice is even though there is not a good choice. I don't know if that makes sense or not, but yeah. I mean, you can create a nice, beautiful space like Meagan just said. You can ask for the spinal block and see if there are any alternatives to the fentanyl or other kinds of medication that they can put in there. You can ask for a shorter hospital stay. You can look into ways to heal your baby's gut after the C-section. You can look into vaginal seeding which can get the baby's gut populated with your flora from the vaginal canal which is really helpful for the baby's microbiome and things like that. I feel really angry for you a little bit. Meagan: I know. Julie: –that the system is set up to work against you in such ways. But I feel like this is something that you are really going to have to sit with and tune into your intuition hardcore and figure out what risks you want to accept, right? Because it sounds like you are going to have to accept some whether it's birthing with a C-section and not having the birth you want and introducing those different things to your baby, birthing unassisted without a provider present, or fighting as hard as you can in the hospital for your VBAC. Meagan: It infuriates me that people even have to be in this space at all.Julie: Yeah. Meagan: The providers are so worried about supporting people doing vaginal birth after multiple Cesareans, yet they're pushing people and making people feel like they have no choice other than to birth with no provider. I am not saying that someone who births without a provider– I'm not shaming anybody for sure, but I think it's nice to have that supportive provider behind you, that trained, skilled provider. A lot of people that do go unassisted, I'm not kidding you guys, they dive in deep. They are prepared and that's awesome. Good for them. Absolutely good for them. But it just makes me so mad that someone even feels like they are stuck in making that option. Julie: Yeah, I agree. Angel also asked a follow-up question if she could decline antibiotics. Here's the thing. You can decline anything you want to decline. It's just going to depend on what's going to make your providers nervous and if they're willing to provide care or not. I don't know. I don't know if your provider will be comfortable doing a C-section without having antibiotics available during and after the C-section or not, but that's something that you can talk with your provider about ahead of time and see what that looks like. Or have a minimum dose or only one round or something like that. Meagan: Mhmm, yeah. I love that. Sorry, my little boy, this was also part of our technical difficulties. Look at his head. Show everybody your head. Julie: He got konked. Meagan: And your arms, huh. Yeah, he fell today at recess. Julie: All right, let's move on to the next question. Angel, I give you all of my love and support. Meagan: I wish you luck. Julie: Yeah, I do. Please keep us updated. Us, again. You guys, this is killing me. Meagan, you have to let me know when Angel updates you because I'm invested now. Gentle induction plansJulie: Okay, what's next? We have– oh, yes. Let's get to Tiffany. Hi Tiffany. Tiffany M. Okay, so she said that her doctors told her that they will not allow her to go past 39-40 weeks. She was able to control her blood pressure thus far and she had hypertension in her last two pregnancies. Her doctor doesn't want to induce because it allegedly increases the risk of rupture. Meagan: Your voice. Julie: Sorry. “They've been insanely supportive of VBAC but this contradicts what I've been seeing.” Yes. This is what we were talking about before, right? Induction. You can have a VBAC after being induced, but also you don't want to have to be induced at some arbitrary deadline to have a VBAC. Induction does increase the risk of rupture slightly, but when it's managed appropriately, the risk is very minimal. So definitely look into that. Poke your provider. I say “poke your provider”. Don't poke the bear, right? Don't poke the bear. Ask your provider. Talk with them and see because that might not be a provider that is that supportive. It is sad that when you have a provider that you absolutely love and there's this one thing. There's one thing and it sounds like this is the one thing.Meagan: But that's a big deal. Julie: It is a big deal, yeah. Meagan: A big deal, yeah. Julie: And people won't allow you to go past 39-40 weeks. I would bust out the ACOG bulletins on VBAC and the late-term management of pregnancies or something. Meagan: Yeah, and induction. Yes. I was just going to say. Bring them, even if it sounds over the top because I'm going to tell you, print it all off and take it to them. Julie: Do it. Meagan: And say, “But this is what this says. This is who you are under and this is what they are saying, so why can't we discuss a gentle induction plan?” Or, “Let's observe and do more monitoring with all of these things and take it day by day. Take it every other day. I'll do an NST. Let's break it down so you're comfortable. I'm comfortable. We're all doing what is safe for me and baby of course.” Sometimes it sounds extreme, but it might take bringing it in and saying, “Hey. This is what I have found. Let's talk about it. Let's break it down.”Are you going and getting that for her? Is that what you're doing?Julie: I'm responding to whatever comments. Meagan: Oh okay.Julie: Obviously now, I'll just do it verbally. So she said, “Managed how? Through a slow administration of induction medicine?” Yes, absolutely. Yes, so this is the thing. Sometimes you'll hear the phrase “Pit to distress” where nurses will, this is a real thing. It's sad but it is, where nurses will up the Pitocin so aggressively that it literally forces the baby to go into distress so they just do a C-section. It's a very aggressive way to administer Pitocin. You don't want that. You want to do a nice, slow dose. Increase it by 1 or 2 every 45 minutes to an hour. Give your body a chance to respond before upping it even more. I've seen VBAC inductions where they konk out the Pitocin by 4 every 30 minutes and before two hours happens, you're up at the max dose of Pitocin and then the baby gets so stressed out and you have a C-section.Meagan: And the body isn't responding fast enough. Julie: The body's not responding at all because it doesn't know what the crap is going on. It's being slammed with Pitocin, this artificial hormone. That is not an induction that is managed well. A managed well induction is nice and slow. Start with a Foley bulb. Start with a nice, slow dose of Pitocin. Rest during the beginning of it. Give your body time to catch up. While being monitored, that's a nice compromise and making sure everything is being tolerated well. If your body is responding, stop turning the Pitocin up at all or even turn it off after your body kicks into labor. Meagan: Yes. I was also going to say there is something called a “Pit holiday” where sometimes our uterine receptors get too full and overstimulated with Pitocin. It's okay to do a “Pit holiday” and cut it in half. So say you're at 20, let's cut it down to 10 and see how our body responds because sometimes we can be overstimulated and our body is like, “This is too much too fast. I don't know what's happening.” It's not responding and then we cut it in half, our uterine receptors empty, our body kicks into that natural labor, and then boom. We're in labor and we don't even need 20 mL of Pitocin, right? Or like Julie said, we get into this active phase and we feel like we have to keep upping the Pitocin, but if we're getting into the active phase and we're making progress, we don't need to keep pushing Pitocin. And yeah, slow dose. Sometimes, some people, we recorded a story just now and talked about this. It's coming out in October, so let's talk about it right now. Sometimes we get in a space where induction is what's needed this time, but we're not cervically progressed enough to just put in a Foley or a Cook, right? So sometimes, we have to start a low dose Pit, maybe 2, 4, 6 mL max and just let it be for hours. It could take hours, you guys. I'm not kidding. Not three hours, not four, but ten plus hours it can take sitting at that slow, low dose to get the uterus stimulated enough to open just enough to get a Foley or a Cook catheter in comfortably. And then, we start from there. We work with the Foley and the Cook. Maybe you leave Pit right there or maybe they start increasing it or they just do the Pit at 6 or 8 or 10, and then just let the Foley do its thing until it falls out and then we start from there. There are so many ways that we can manage and take things slowly. Walking in, breaking someone's bag of waters is not necessarily slow, managed, and controlled but that's what a lot of providers will do also. They say, “Oh, I'll just bring you in. We'll just bring you in and break your water.” Sometimes, the body doesn't respond to that and it takes hours, and then we've got Pitocin coming into play anyway. But then sometimes, that's the perfect way, right? So we have to take it slowly. We have to decide what's best for us and where we are at cervically can make a big difference of where we start. Julie: Where we are at cervically, I love that. Meagan: Yeah, where we are at cervically. Julie: Cervically, cool. All right. Thank you, thank you. All right, let's move on. Christine, Christina. She says, oh I think it's maybe more of a review. Thank you. Okay, so she says, “Listening in from South Africa.” We have lots of people from South Africa lately by the way. Meagan: Yay. Julie: I say “we” like I'm, anyways. “Been listening to the podcast, binge listening all the time and so amazed at how much I'm learning in each story and from you both. I also love how listening to everyone's stories, especially the C-section stories have helped me process mine and helped me feel much more peace going into my VBAC at the end of this year. Thank you so much for the podcast and everything you guys are doing. I keep sharing relevant episodes with friends that are currently pregnant with their first. Things I wish I had known despite having done a lot to prepare for my first birth.”Meagan: I love that. Thank you. Julie: Aww. I love that. Thank you. Yes, Meagan. Grab this and drop it into the review spreadsheet. Meagan: I know, will you copy and paste it for me? I'm going to read this. I pulled into the group and found a question that just was posted. We actually got a lot of recent questions here in the group and so I figured I'd throw this one in. Julie: Wait, but there are more in these comments, though. Meagan: Oh, keep going. Julie: Do you want me to do the comments first?Meagan: Yes, sorry. I didn't see it. What happens if you don't sign a C-section consent form?Julie: No, you're totally fine. There's AJ, Juleea, and maybe more. Okay so AJ said, “Hypothetically, what happens if you don't sign a C-section consent form? I know they can't just make you take you back, but how would you handle this if they were being forceful?”Meagan: Now that one's super hard because you have to be strong. You have to be really strong. But how I would handle it, I would break it down. I would ask them to break it down and talk about why. “Why are you asking me to sign this form? Am I in danger? Is my baby in danger? Are we facing death?” Julie: Facing death. “Will I die?” Meagan: Yeah, complications by dying. “Are you telling me that my baby and I are going to die right now? Because if we are having this conversation then that probably means that it's not the case.” But yeah, break it down and say, “No. I don't consent to this. I don't feel comfortable with this. If this is not life threatening right now, and this is not emergent, then I want to continue on the path that I'm going.” This sounds really bad and it's so hard because everyone can be– we've got people all over the world, right?Sometimes it's saying, “Okay. I'm going to leave. I'm going to go somewhere else.” We've had that. Julie and I personally have had clients say, “Okay, I'm leaving then. If we're not going to do this, if this is not what's going to happen, then I'm going somewhere else.” And sometimes they change their tune right there because they don't want you to leave. They usually don't want you to leave, so they change their tune and say, “Okay, hold on.” But sometimes, it takes leaving and going to somewhere else that is supportive. But that's not what you really want to do in labor. Julie: Yeah, this is why you want to figure it out before labor starts. Meagan: Yeah, it's not the space that you deserve to be in during this labor journey, but sometimes it's fighting. It's fighting and it's hard. It goes back to what we were talking about with Angel. It makes me so mad that there's not the support that everyone really deserves. We deserve the support, you guys. We're just going in to have babies. That's all. We're just going in to have a baby just like everybody else, but sometimes we're not viewed as that. So yeah. Any other tips, Julie? I mean, yeah. I would say breaking it down and having that conversation, but what would you say?Julie: I mean, I would kind of say the same thing. A lot of the times, I feel like, they just have you sign all of the forms that you might possibly ever need while you are in labor at the beginning of labor because it saves on admin time and it saves on things you have to do later on and things like that. But what I would ask about the C-section form, when they're going through that whole process is, “Do you make first-time moms sign this form?” Because I bet you, I know their answer because they don't make every laboring person sign a C-section form, but they will if they are getting you ready for a C-section or they think that you are at an increased risk for one.And so, we all know what the numbers are surrounding VBAC and what your chance of success is and how, if given the option to try, you are very likely to succeed. So I would just ask that. And if they say, “No,” or whatever their answer is, I would change my next question or next statement. My next statement after they answered would be that, “I will sign it if it is looking like that is going to be an option, but for now, I am planning on a vaginal delivery. Until a C-section becomes imminent, I will refrain from signing the form.” And then if they raise a big fuss after that, I might go to more extremes like what Meagan talked about. But I mean, this is the thing. If it's a life or death situation and you're not looking great or baby is not looking great and I'm not talking about, “Oh, we have some concerns.” I'm talking about, “We need to do something now.” They're not going to care whether the consent form is signed or not, they're going to wheel you to the operating room and save your life or save your baby's life. And so I think that waiting and asking to wait until it looks like a C-section is needed or necessary is a perfectly reasonable option. Meagan: Yeah, I agree. Okay, so I realized that I didn't see because I only saw one last comment from Tiffany saying that she is anti-Pitocin over there.Releasing fear around childbirthJulie: Yeah. Julie has one. And this is a great one for you, Meagan, too. It's how do you release fear around childbirth? I'm 40 weeks today and I'm anxious for labor. My first arrived via C-section at 37 weeks due to high blood pressure and being breech. I never experienced any part of labor and I'm just fearing the unknown. Fearing uterine rupture, not progressing, tearing, all of it. Meagan: Yeah. You know, fear release is so important. So important and I think I've talked about this maybe on my story or maybe in other things, talking about how I thought I released everything, and then I was in labor and there were still stuff that I was processing and working through and having to go through. But a few tips that I have are actually Julie's fear release that she did a long time ago on our YouTube and it's a smokeless or flameless. Julie: Smokeless fear release except that's used very loosely because we did create smoke at a fear release once. Meagan: We did. We did. We did. Julie: There were a lot of people releasing their fears, but yes. Meagan: Yes, I actually remember. That was really crazy. We did that in a VBAC class actually. Julie: Yeah, at my house. Meagan: Yeah, so I actually really, really, really love that activity and suggest it all of the time. I've actually done it with my own clients in labor. We've done it in living rooms on the floor. Obviously, it's hard to do if you're in a hospital at this place, you can't just break that out. Julie: Light a fire, yeah. Meagan: But doing it, and even if it's every night because for me, when I was preparing, I had different thoughts and being on social media didn't help me quite honestly in that very end. And so some of the tips would be the fear release activity, going through, writing them down, burning them, and truly burning them. Burning your fears. Letting them go. Letting them go and accepting whatever is coming your way. Know that you have done all that you can to prepare for whatever does come your way. So that and I also suggest doing that with partners because sometimes partners' fears will trickle in and create fear. Not that they're meaning to do it, but they have fears and then they say things and our minds are like, “Oh, I didn't think about that.” And we have to process that. Another thing would be a social media break. Sometimes social media in the end is wonderful and motivating and positive and keeps us in a great place, and sometimes, it just starts creating more fear. So sometimes we think that taking a total social media break is really healthy and helps process because you can just be with your own thoughts and not with all of the other hundreds and thousands of people on social media's thoughts because everyone is going to have an opinion. Everyone is going to have an experience. You love hearing those just like we love hearing this podcast and these stories, right? But sometimes, those feelings and those experiences can rub off on us, sometimes in a negative way. So if you're noticing that some of your fears and things you've seen and heard on Facebook or social media, any social media platform, maybe take a break from that. I would say journaling is one of the best things I did for myself in processing fear. I was told by my OB that I was for sure going to rupture. He told me that. As I was on the table, he was so glad I didn't have a VBAC because I for sure would have ruptured. For sure. When I heard the words “for sure”, that was very dominant in my mind and it hung with me. So when I'm laboring with my third, I was feeling that in my head. “What if I rupture? What am I doing? Am I doing the right thing?”I knew in my heart that I was doing the right thing but I had self doubt. And so if that starts creeping in, voice it. I would say that my suggestion would be to get it out. Get it out. I'm sure that Julie has seen it, but as a doula, sometimes we can see our clients are thinking really hard in here and they're maybe having self-doubt and things like that. It's just so good to get it out. Get it out. Processing. Getting it out, talking, saying it out loud, hearing yourself say it is the first step to processing it as well. So if you're doing a fear release, don't just write it down. Write it down. Say it out loud and then burn it. That would be some of my suggestions. And then keep educating yourself. Keep educating yourself. You said tearing, rupture, and these are all valid feelings and fears. I want you to know that. These are all valid and you're not alone. But yeah. Fearing not progressing, that's a big fear. I know that. But again, setting yourself up with a great supportive provider who's going to give you time, trust, and giving you the things you need to progress. That will help. Anything you'd like to add? Julie: No, I love that. I want to get a little bit sciency and nerdy on here. I don't know. It's not a secret or anything but I've been doing a butt load of therapy over the last year and a half and part of the things that, at some point, I learned this in therapy, but your brain, I think we all know that your emotional brain and your logical brain are in separate parts. They do not touch each other. They do not talk to each other. They do not know what each other has going on, right? Your emotional brain is very reactive and responsive. It's where a lot of this anxiety comes from. It's where your fear comes from. It's where all of your negative feelings live, well, all of your emotions live. All of your big things. Your logical brain doesn't know what's going on in your emotional brain. They do not communicate with each other or else we would probably all be a lot more reasonable about our entire lives. In order to process your emotions and reconcile them and get rid of your fears, the best thing you can do like Meagan just said, in lots of different ways, is to get them out there. Get them out. Verbally talking about them, writing them down, talking to a therapist, talking to whoever is a nice, safe space for you. Any safe way that you can get them out of your emotional brain, then your logical brain can say, “Oh. That's what's going on over here.” It gives your logical mind a chance to take over and reconcile a lot of these things that are going on and put this emotional brain at ease so they're not fighting and conflicting. They're able to reconcile with each other. I don't know if that makes sense. That's a big thing for me which is like, “Oh yes. I need to get these things out.” Don't stuff your emotions down or stuff your feelings down. Get them out and it helps your brain process and work through them together so that you're not so isolated and your feelings are not so isolated from the other parts of your body that are a lot more logical. Meagan: Yes. Oh my gosh. I love that. Thank you, Julie. Julie: You're welcome. Meagan: Okay, let's see. She has been thinking about taking a social media break, actually. It's really refreshing. Worried about tearing more than uterine rupture. And yeah, tearing is scary. It is scary to think about. Lots of people do tear and it is repairable, but I would say my tip for that would be to really follow your body when it comes time to push whether it be unmedicated or medicated, really listen to your body and when that baby is crowning, just little, little nudges, assuming all is going well and that will help. And then really, baby position, right? We want to work on baby's position because the more the baby is in an ideal position, the better it is for baby to come out. But sometimes we have these little things where we have babies doing this and sometimes we have babies doing this. Julie: Or doing this. Meagan: Or doing this or they come out like this and they do funny things. Tears happen, but try your hardest and let gravity help. Squatting on your side, positions that may reduce tearing and may focus on centered gravity versus a perfect spot, I don't know the word that I'm looking for. A specific spot of gravity. Does that make sense? On your back, the bottom of your perineum has more direct pressure than when you're squatting. It's more central. So working on positions and even if you have an epidural, you can push on your side. You can push squatting assisted. It's totally possible. But yeah, anyway. Tearing is scary. Julie: Tearing happens. I love that you said that. Meagan: Tearing happens. It does. I mean, I'm going to be honest. Julie: Most of the time, it's not that bad. Most of the time. Meagan: No. Julie: I had a first degree with my first VBAC. I didn't tear with my other two. I heard somebody say once, maybe it was on social media or something recently, but the biggest impact on whether you tear or not and how bad is your provider. Meagan: Yeah. We've got providers that just are a little rough. Julie: They force you to push on your back or stretch your perineum out so much. A lot of people think that helps, but it can actually increase your chance of tearing too. I don't know. But yeah, give that a chance too, and talk to your provider seriously about not pushing on your back. Even with an epidural, you can push on your side. Meagan: Yeah. Totally. Totally. Love it, love it, love it. Okay, any other questions that you are seeing coming in? I love that she was like, “Yeah. People say this and then we just nod and assume they're scheduling a C-section.” They just nod like, uh-huh. We have a ton of questions coming in on social media, so are you okay if we do a couple more?Julie: Yeah, I just have to grab my kids in 25 minutes, so I've got some time. And then I want to wrap up and do a little short catch-up on how I've been doing since The VBAC Link. That would be fun, right? Do you think? Meagan: Yeah. Yes. Julie: Okay. Labor expectations Meagan: Okay, so this is from an Instagram follower and she says, “VBAC after a scheduled C-section. Should I expect labor as long as a first-time mom?” Julie: Can you say that again? You broke up just a little bit. Did she say what should I expect as a first-time mom? Meagan: “After a scheduled C-section, should I expect,” assuming she's going to VBAC, “Should I expect just as long of labor as a first-time mom?” So meaning that she's scheduled the C-section, never went into labor, never dilated, things like that. In short, yes possibly. Julie: Yes. Meagan: Yes, right? So my VBAC was my third baby, my first real labor. It was kind of freaking long. It was long. But then, we sometimes have moms that had a breech baby and it was a scheduled C-section. They go in, right? Yes. Julie: Pick me, pick me. I've got some stories. Meagan: Don't share her story. Julie: Did she talk to you?Meagan: No, but I'm going to talk to her. Julie: Okay, good. Meagan: So anyway, but sometimes it just goes really fast and we don't know. So just like a first-time mom, not everyone goes long. Some people are precipitous. Some people can go really long. That can happen too and so yes, maybe is my answer. Okay, let's see. Julie: Wait, wait, wait, wait, wait, wait, wait. Before you go on. Meagan: Oh, you really wanted me to pick you. I pick you, Julie. Julie: Pick me. Pick me. Pick me. Okay, so I just want to let you know that yeah like Meagan said, you are more likely to labor for longer identical to a first-time mom, but man, sometimes this baby is going to fly out and it's going to catch you off guard. And I have two stories, I'm not going to tell them, but I have two stories where the labors were super short. Moms got their VBACs at home on their bathroom floors because the labor just catches you off guard so much. Meagan: It can happen. Julie: Plan on going to 42 weeks. Plan on a 24-hour labor because it's probably not going to be that long, but the more you can, if you expect that, then anything shorter is just going to be encouraging rather than planning on a shorter amount of time and having a longer thing being discouraging. That's my advice. Double-layer suture versus single-layerMeagan: Yeah, for sure. For sure. Okay, this next question is, “Does the type of suture matter much? I had a single-layer but read that double was better.” Julie: Oh, pick me again. Meagan: Yeah. Julie: Sorry, you're looking at me. Meagan: I'm looking at you. Julie: All right, so here's the thing. There used to be a belief that a double-layer suture is, because there are several layers of the uterus, right? The single-layer versus double-layer. A single-layer closure means they sew all of the layers up with one stitch, one suture. Double-layer is where they close it in two separate layers, right? So there used to be a belief that a double-layer suture was safer and would decrease your risk of uterine rupture if you go through vaginal birth, or I guess, overall because you don't have to go for a vaginal birth to have a rupture. But since then, there have been several studies come out that show that there's no significant difference in rupture rates between single-layer versus double-layer closures. So, no. It doesn't make that big of an impact. Now, there has been one recent study that shows that a double-layer closure is optimal, but that one study isn't very big. It's not very credible. It's not as big and not as inclusive as a Cochrane review and things that show that there are not really big differences. So sometimes, people will say, “There's this one study in 2021 that shows this.” See, probably not in that voice, but anyways. But the majority of information that we have shows that it does not matter. However, ten years ago, people used to think that it would make a big impact. Things have shifted since then. Meagan: Yeah, we still have many providers that say it actually determines eligibility based on that. Like, tons. We get emails all of the time. It's like, “Hey, I really want a VBAC but I found out that I only have a single-layer suture, so I can't. Is this true?” So yeah. Okay, ready for the next one? Julie: Yeah. Special scarsMeagan: Low, transverse uterine incision that extends one side vaginally. Vaginally? Can I VBAC? Vaginally? Julie: Vaginally? I wonder if it's a J? Meagan: That's what I'm wondering. Julie: Except she said, “Vaginally.”Meagan: I've actually never heard of a uterine incision extending all the way. Julie: I don't think it can. It can go down into the cervix. Meagan: Yeah, the uterus is up and then it has the cervix. It goes like this. Julie: Yeah. Meagan: Yeah, and then that comes down into the vagina, but they're separate.Julie: I wonder if there's some word confusion there. Meagan: Maybe. I will ask her, but I'm wondering if this is meaning a special scar. Julie: Well, yeah. Meagan: I'm wondering if maybe there is some confusion about a special scar and yeah. People still VBAC with special scars. They do. We have special scars on the podcast. Julie: Leslie's is my favorite birth story. She goes into such detail about the data and everything about that. Meagan: Yes, Leslie did a home birth, right? Julie: Yeah, I think it's episode 18 or something in the teens I think.Meagan: She was really early on. So yes you can. It's still possible. You still want to educate yourself. Just because you can doesn't mean you are going to choose to or that you're going to want to. Julie: Or that you're going to find a provider that's going to support you. Meagan: Or that you're going to find a provider that's going to support you, and so we encourage everybody to do the research, look at the education. We have some blogs. We talk about special scars in our parent's course. We have some episodes, so there is information out there for you guys. Julie: Yeah, the risk of rupture is a little bit higher with special scars, so that's something to consider too, but what an acceptable risk is to you is going to be different for everybody. So I think it goes from about half a percent to maybe 1.2% or something in that range. It's less than 2% overall, and so is a less than 2% risk of rupture acceptable for you? You're going to be the only one to answer that. Meagan: Yeah. Yeah. Julie: Does that make sense? I feel like I didn't understand the words coming out of my mouth. Meagan: Yeah, no. No, it made sense. Julie: Okay, do you ever do that? Anyways. Warning signs and symptoms for uterine ruptureMeagan: Yes. Okay, next question was, “Warning signs and symptoms for uterine rupture?” This is a really great question because we were talking about that, the fear of uterine rupture, and there are signs. There are, I should say, symptoms. Some of the signs and symptoms may be one, pain. Pain down there and if there's an epidural in place, it might radiate up. The uterine rupture that I attended a long time ago, she had an epidural and they kept calling it a hot spot, but it was way, can you guys see me? Way up here in her ribs where it was hurting which is kind of an interesting spot, but it was just radiating where she wasn't numb, where she could feel. So yeah, pain. And also pain that doesn't go away. Pain and discomfort during a contraction or surge comes and is there, and then it goes away, that may be different than the pain that is there, increases with contractions, doesn't go away, and is still very intense. Bleeding, lots of bleeding, lots of bleeding. Stall of labor, where your labor is just not progressing. Baby going up, so moving stations, but dramatically. Like your baby was +2 and now your baby is -2. Stations can be subjective, they say their baby is a 0 but now it's a -1, and they're saying that maybe it's a 0 to +1. It's kind of subjective. Julie: Yeah, they're just centimeters that we're talking about with baby's station. It can vary from provider to provider. Meagan: If you think about my hand to Julie's hand, right? Our hands are very different. They look different. I have long skinny bony dumb fingers that I can't stand. Julie: Not dumb. Meagan: Really wide palms, so my long, skinny fingers versus someone with shorter fingers may be different. One of the number one things that providers look for, although I will say that this isn't always the number one first symptom is fetal heart tones. Fetal heart tones that are just tanking and not recovering, that is a concern. That is a concern and that is a sign. Let's see, what else am I missing? Julie: I'm trying to think. I think that's it. Meagan: I think that might be all. Julie: Yeah, and that's the biggest reason why they're really particular about continuous fetal monitoring for a VBAC. But yes, if you can feel the head on top of your pubic bone, it's kind of weird to really describe that, but I'm not going to show you. Meagan: You can usually see it. There's a bulge. Baby's not in the right spot.Julie: Yeah. Meagan: We also have a blog on that. So, okay. Are there any other questions in the Facebook group that I'm missing, Julie? Because I'm on Instagram right now. Julie: Let me check. Meagan: This one is, “My C-section was because of failure to descend. Do I still have a chance to VBAC?” Absolutely. Failure to descend means that baby just didn't come down. A lot of the time, that's due to positioning, that's due to more failure to wait and let the baby have time to come down. Just because you've reached 10 centimeters doesn't mean it's time to have a baby necessarily. Sometimes baby needs to have time to rest and descend and come down, but yes. Absolutely. You guys, on Instagram, if you're not there, we did pull over. So if you're over here, yay. If not, then I'm going to try and get these answered on Instagram as well. Do we have any other questions?Julie: I didn't see any. Yep, nope. Still no. Meagan: Okay, any other final questions for the eight of you that are left? We'd love to finish up, but yeah. While we are waiting for any other final questions, Julie, did you want to update everybody on how the last couple of months have been for you? Julie's updateJulie: Yeah, I think it was a little bit of a hard transition for both of us. Meagan is doing amazing trucking along, keeping everything going and I'm super excited to see all of the changes and stuff that are going on over on social media and the website and everything like that. I'm really proud of you. You're doing amazing. Meagan: Thank you. Julie: And welcome the new admin, Katie, helping. She's doing an amazing job too, it seems like so that is really great. Yeah, I mean, I've been trucking along with the birth photography thing. I think we talked about that on the podcast episode where I made the announcement that I was leaving, but it's been going really good. I've been to several, many births since the

We are so happy to be joined by Lindsay on the podcast today who is sharing her birth stories and her chiropractic expertise. Lindsay is a beautiful example of how to create a healing birth experience after a traumatic one. We discuss how making empowered decisions can help you feel more in control in the birth room. Also, as the owner of her own chiropractic practice, Lindsay explains the benefits of the Webster Technique during pregnancy, as well as why every woman and baby should seek chiropractic care during the postpartum stage too. Additional linksLindsay's Practice: Bluebird ChiropracticThe VBAC Link Blog: How to Plan for a Family Centered CesareanThe VBAC Link CommunityHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Happy Women of Strength Wednesday. It is Meagan and Julie. Julie: Hello! Meagan: And we are so excited to bring you another story. Today is actually a CBAC story and we were just talking about this before the episode. We are going to call it an elective CBAC. Is that what we decided? Julie: I don't know. I think we will just leave it at CBAC because she labored. Her plans changed during labor. So I think we are going to keep it at CBAC. Meagan: She did, yeah. Okay, a CBAC story. It was definitely something that she chose and that's one of the reasons why I love the story so much is that she stood her ground, advocated for herself, and chose something that not even her provider wanted her to choose. I am not going to give away too much, but we have a Review of the Week and then we are going to go into this lovely episode with our friend Lindsay.Review of the Week Julie: Yes, a Review of the Week. I like this review. I picked the longest one I could find on our spreadsheet. Meagan: Oh good because I can't read and you know that. Julie: Meagan can read, everybody. Meagan can read. She just has a hard time reading and speaking. But you have actually gotten quite a bit better since we first started The VBAC Link four years ago. You have improved leaps and bounds. I'm actually quite impressed with your skills now. Meagan: Well, thank you. Julie: You're welcome. But this review is a little mini VBAC story in one. I just think it's really cool. This is from Abby from, oh my gosh, an email. It's an email. She said– oh my gosh, we love emails. Guys, email us. Talk to us. We love talking to you and connecting with you guys. We got this in an email which is why it is longer. That makes sense now.  And so she says, “Hi. I've been wanting to send you a message for months now to let you know how you have encouraged me. Your podcast was referred to me near the end of my pregnancy and I listened often while cleaning. The facts and stories shared absolutely solidified my confidence in what my body is capable of despite the exaggeration surrounding uterine rupture. It was by far the most important stuff I learned from you gals, so thank you.” Just a side note, we have a podcast episode and a blog about uterine rupture talking about all of the myths and stuff surrounding there. Anyway, I love that. Sorry, where was I? Oh, there we go. “Thank you for doing the work to learn this stuff and sharing it. My first four children are two sets of twins, naturally conceived.” Wow, two sets of twins. I'm going to have a commentary on the story while I am reading it. Okay, I'm going to get back on track now. “I had two C-sections without issue. In the first one, I barely knew anything. For the second, I was pressured by my doctor just doing all of the textbook things to get me to believe that surgery was the only real option. Both were scheduled, but the second time around, I had gained a lot of knowledge about all things natural birth.  “With this third pregnancy and a new doctor, I knew she was giving me all of the typical fear-mongering, ill-informed information that she could. She did not like that I refused to schedule a C-section. I was planning to wait for labor to happen on its own, even if that meant going two weeks beyond “due”. All indicators pointed to her not allowing me a true trial of labor. She waved all the red flags in her words.  “I had planned to labor at home as long as possible and my dear friend who used to work as a doula offered her friendly and experienced support to get me through the home laboring. My husband couldn't get down with hiring a midwife while we had health insurance to cover hospital birth, so sadly I accepted that we would ultimately not birth at home. Well, I labored at home all day and when the intense contractions hit around the time that our kids were going to bed, my mindset was, ‘These are probably going to be intense for the next four or so hours.'  “I had bloody show around 9:00 p.m. or so and wasn't checking the timing of contractions. None of us even thought about that. Someone called another friend to come and stay with the kids and in what seemed like ten minutes' time, something changed. I told my friend that I guess it was transition. I wasn't going anywhere in the car. My baby boy, Schallom, was born at 10:40 p.m. on the bathroom floor assisted by my friend and my husband. Healthy! That wasn't the plan but was the original hope with a midwife. Knowing we wouldn't have a midwife, having a baby at home was out of the question. “At one point during labor on the bathroom floor, I asked, “Is there someone else we can call?” But I knew that even EMTs would just deliver right there and my husband is a first responder, although he has not delivered nor assisted a birth. Thank you for your encouragement and knowledge that absolutely helped and enabled my mind to be at peace enough to smoothly deliver my baby at home, a VBAC after two C-sections. There are so many other details but I really wanted to let you know how grateful I am for your podcast and the integral part that played in my third birth.” We need this girl on the podcast! Who is she? Abby. Meagan: That is an awesome, awesome story. Julie: Oh my gosh. Well, she is in an email. We have got to find the email. It came in on February 2nd, so I'm going to go scoping through emails. We are going to find Abby and we're going to share her story on the podcast because I was on the edge of my seat just reading the review. I can't even imagine. Oh my gosh. Meagan: Yes.Lindsay's StoryMeagan: Okay. Well, expect a podcast sometime from Miss Abby, but today we are going to share Lindsay's story. So Miss beautiful Lindsay, let's turn the time over to you. Lindsay: Thank you, guys. Meagan: Thank you.Lindsay: Okay, so for my first C-section, I was induced and then had every induction method/intervention under the sun and nothing was working. I wouldn't progress and every time contractions came, they tried to up Pitocin to up my contractions, then my son's heart rate started dropping. At one point they couldn't get it up, so it turned into an emergency C-section after that.For my second birth, I was definitely planning a VBAC. I tried to prepare myself. I read all of the natural things, did lots of chiropractic care, and was mentally prepared. My son was 11 days late and then I got to the point where I was almost 10 days late, I believe. My midwife kept pushing, “Hey, we need to induce you,” but everything was looking good with baby and I knew I just go late with babies. I kept saying, “No,” but my husband and I had talked and we decided that if I didn't go into labor naturally or anything like that, then we just wanted to elect for a C-section. With my son, my first baby, everything was so out of control and very traumatic that we just wanted something in our control. We were just not ready to go down the intervention route. We knew that didn't work for us the first time and who knows? Maybe it would work the second time, but we just didn't want that. Luckily this time, I went into labor on my own. I labored hard for about 12 hours and it got to the point where it was so intent that we figured we should probably head to the hospital. Meagan: Yeah, you even sounded pushy and grunty at some points. Lindsay: My whole pregnancy, I really wanted a home birth and I just didn't like the idea of going to the hospital. I still wasn't fully satisfied with my midwife. I bet I was probably further along when I was at home, but then when we got to the hospital, I think they said I was a 1.5, but 90% effaced. Still, very intense contractions and some were even like, what is it called? Coupling– where they are one on top of the other and no break in between. And so they decided to let me labor a little bit longer. Since I was past due, they weren't going to send me home by any means because, at this point, I believe I was 12 days past due. So I labored for a little bit longer in the hospital. They checked me again and I still hadn't progressed at all. And so my husband and I decided, “Let's just do the C-section.” There was no point to push it off, getting an epidural, trying more interventions, or anything like that. We were very happy with the decision even though it wasn't what we exactly wanted. This felt in control for us. My midwife did not like that. Meagan: She really didn't. Lindsay: She didn't. Meagan: She was not happy. In fact, tell them about how we were waiting. Lindsay: Yeah.Meagan: We were waiting for her, anyway–Lindsay: Yeah, so she wasn't the one on call. They finally called her in and it felt like it took forever. Also, I don't know if she was mad at me, but she gave me her number too to text her at the end of my pregnancy. I told her I was in labor and she didn't respond, so it was just one thing after another. But I think I came out of the bathroom and she was standing against a cabinet or the wall or something with her arms crossed and was like, “Are you sure you want to do this?” And my husband and I were like, “We already made the decision. This is what we wanted.”And so it was just sad that we didn't have the support from her, but with Meagan and my husband, I had plenty of support otherwise. I mean, all of the nurses were super supportive and I just wanted to make sure we were making the decision we wanted for us. We believed it was the right decision and honestly, it was the best decision. If I wasn't going to go into labor or progress through labor on my own, then this was what worked for us because the C-section was so healing. I know not many people can say that but it made me and my husband feel like we were in control and we got to talk about what we wanted in the C-section. It wasn't an emergency and it was just a different experience. My husband feels as well just healed from our first traumatic experience and the recovery was better. It was easier. I'm not saying C-section recovery is easy by any means, but it was easier than my first just because mentally, we were prepared. I got to hold my baby girl as soon as they cleaned her off. They put her on me and I got to hold her the whole time they were stitching me up. I never let go of her which was so fantastic compared to my first where he was swept away to the NICU. I didn't get to see him for six hours after birth, so it definitely was a healing C-section. Meagan: Absolutely. You came back and even though you were so tired and everything, you came back and you looked so bright. Lindsay: Oh yeah. Meagan: And free. It was so good. It was so good to see you that way. Lindsay: Yes. Meagan: Because I was with you after the first and it wasn't necessarily– I don't want to say you looked bad.Lindsay: No, I looked bad. Meagan: You looked different. You looked different. The first time was really rough and it was a lot and this time, it wasn't. We don't know exactly why things didn't progress. Maybe it was a mixture of feeling stressed when you got to the hospital because I swear to you that you were seeming very progressed at home. Even the labor pattern changed once we got there, but I just was so proud of you. Your midwife, yeah. She was like, “Are you sure though? I could just check you right now.” And you were like, “No.”Lindsay: Right. I was like, “I don't want to be checked again.”Meagan: “I'm good. I am good.” And even after, she was like, “Ahhh.” Lindsay: Yeah. I mean she never even came back and saw us. She said she was going to and she never came back and checked on us to meet my daughter or anything like that. Meagan: Yeah, which is just so crazy. I just don't get it. I don't know. Maybe she had a chip on her shoulder. I don't know. Lindsay: I don't know. Meagan: I don't know but I was proud of you for making the decision that you felt was best for you and doing it. I love hearing that it was so healing for you because that is how birth should be, you guys. No matter the outcome of what you want, even if it's not what you desired, I would love for birth to be healing for everyone. I know it doesn't happen to everyone like this, but I would love for it to be a healing experience. My repeat Cesarean wasn't what I wanted at all, but I felt more a part of it and it was healing for me because I felt more a part of it. But I just wanted to drop that message out there to everyone who is listening that it's okay to make these hard choices and do what you can to make your experience a healing one even if it's not what you want. We talk about gentle Cesareans and family-centered Cesareans. We have blogs on it. But really, Cesareans can be healing. They really can. Lindsay: Yes. Meagan: I'm so happy for you. So, so happy for you. Lindsay: Thank you. I mean, I definitely couldn't have gone through it without you and my husband as well. There were definitely hard decisions. I remember laboring in the tub and we went over everything a million times about how this could go. My daughter was also a surprise gender so we got to the point where we were like, “Let's just figure out what this baby is,” after being 12 days late and everything. So that helped too but I know that with labor and delivery and all of pregnancy, you can't be in control. That baby isn't controlled by you, but it just felt nice to be able to make a decision that was something we wanted. Chiropractic CareMeagan: Absolutely. Yep. So we are going to make a little shift. This is a part-birth, part-education episode, but I would love to talk a little bit about what you do as a profession. Lindsay: Yes.Meagan: So for anybody who does not know, Lindsay is a chiropractor. She is amazing. I would love to talk about chiropractic care and anything you would like to share. Maybe discuss why you feel chiropractic care is important, especially in labor and delivery and why it may be important in the postpartum stage. Lindsay: Yes, yes. Meagan: I feel like in all senses, sometimes, we forget about postpartum. We just forget about it and we forget that there is definitely something that happens after. We still have to take care of ourselves and we still have to prepare for that, so is there anything you want to share or would like to talk about with any of that? Lindsay: Yes, thank you. I am a Webster-certified chiropractor which basically means I specialize in pregnant mamas. The Webster name gets thrown out all the time and definitely, if you are pregnant, look for a Webster-certified chiropractor in your area. We've taken extra education and seminars to prepare us to help take care of pregnant mamas, but that technique, basically, is very gentle on mom and baby. First, I'd like to say that I never adjust baby. I'm only adjusting mom, but in turn, to have less tension in the pelvis and motion in your joints and in your spine, you take the tension out of the uterus which then helps baby go head down or just have optimal space. If they have trouble going head down, the Webster technique helps babies go head down. But just in general, it's very safe for mom and baby. We are not adjusting baby. We are just adjusting mom, but it's the one thing that you can really do for yourself that can take away some pregnancy aches and pains, discomforts, anything from round ligament pain, some SI pain or low back pain, pubic symphysis pain, SPD, but then also, that bra line, midback pain just because of the changes that pregnancy does to you. It puts a lot of tension in that midback. Getting adjusted while you are pregnant is– I don't know how I would have survived pregnancy without getting adjusted myself. It brings so much relief when you are growing a human and you can't do much about it. You can't take pain medications or anything like that even if you wanted to. It definitely relieves some pain but is also taking care of yourself during pregnancy. Chiropractic care has been seen to reduce labor times, help with labor, and definitely get baby head down and in a good position so it definitely makes labor a lot easier. But also, get yourself checked postpartum because your pelvis went through a huge shift and change to get that baby out. Even if you had a C-section, once you feel up to it, start getting some bodywork because as moms– I definitely feel like we don't take care of ourselves postpartum. We always get adjusted or get massages or anything like that during pregnancy, and then we just kind of get forgotten about afterward. Chiropractic care, especially some chiropractors can really help postpartum moms as well.I work on moms during pregnancy and during postpartum. I really push that in my office to come to see me afterward because you are always hunched over breastfeeding. Get your pelvis realigned and feel good so that you can take care of baby and be present because you feel good for your family. But also, get checked for diastasis recti and stuff like that. Some chiropractors, including myself, can check for things like that, so that's really good. Meagan: Question on diastasis recti– we had a question from a follower asking about how diastasis recti could impede delivery. Do you know? Julie: Actually, it is on next week's episode too, so you are getting a little sneak peek. Yeah, so that's okay. I love it. Ask, ask. Meagan: Yeah. I'm just curious if that is a thing because I didn't think that it did, but I don't know. Does it? Do you know? Lindsay: Well, from a chiropractic standpoint, I would say that it is pressure management. Your belly, from your diaphragm, your abdominals, your low back, and then your pelvic floor is like a canister. It is pressure management. If you have that separation in your abs, the pressure has to escape somewhere. Instead of down through your pelvis, it is probably going to escape out. Sometimes when it escapes, it is pressed into your SI joints, so a lot of moms have low back pain. But I would say during labor that you wouldn't have good pressure management. You just can't get that good pushing technique that you need to get the baby out. Meagan: Mhmm, okay. Okay good to know. Sorry to interrupt that. I was like, “Oh my gosh, we just read that on another podcast,” so okay. Keep going. Keep going. Sorry. Lindsay: No, that's fine. The other thing I was going to say is also baby adjusting which seems crazy if you ever see an adult getting adjusted, all of the pops and cracks and stuff like that, but baby adjusting is also really important as well. Even if you have the most perfect birth and it's non-traumatic or anything like that, it's still very traumatic to the baby because they go from this nice warm womb to the outside world. Get them checked because chiropractic care, also, is related to the nervous system. We adjust the spine which, in turn, can affect the nervous system. A baby's nervous system is basically on fire when they come out. We have moms that have babies with colic or they have constipation. Anything like that is usually because their nervous systems are going crazy. It's in that fight or flight mode because it was traumatic. And then if you have a traumatic birth, that also goes on to the baby too. They are going to feel that stress and everything. And getting their spines checked helps calm the nervous system. It can help with colic. Like I said, it can help with constipation, but then also latching difficulties. Always check with your lactation consultant, but I always ask my moms if they are sore on one side compared to the other when they are nursing or anything because it could indicate that the baby can't turn their heads enough so they can't get their latch proper and so then, moms get sorer. It could be a combination of some other things too, but it is just one part that you can also check. Like I said, baby adjusting is super safe and super gentle. There is no popping or cracking. It's as much pressure as you put on your own eyeball and it looks like I'm barely doing anything to the baby, but it does so much for their nervous systems and for their little spines. Even though they don't have solid bones, they still have bones. They are just a little bit softer than adult bones. It's still much needed. But then also, if you had a traumatic birth and maybe their shoulder got stuck or they were pulled out, you've just got to get them checked to see if they have a head tilt or anything along those lines. Meagan: Yeah. My second daughter had torticollis and the doctor was like, “Yeah, you need to go to PT.” Nothing against PT, but I did PT forever and it wasn't changing anything. It was actually a fight every day to force her into positions and stretches. We ended up going to chiropractic care. We only went a couple of times and it totally fixed everything. Lindsay: That's awesome. Meagan: And so, yeah. It was so awesome. And I also, my son hadn't pooped forever. Lindsay: Oh yeah. Meagan: He was having constipation issues and my husband's buddy, my friend is a chiropractor and it was 9:30 at night. He was like, “Just come. Just come” Because we were crying, just so desperate. Lindsay: It's so stressful. Meagan: Yes, and so we went, and oh my gosh, biggest poop ever. Lindsay: Yes. Meagan: And then he passed out for hours and hours because it took so much energy to get it out. But yeah, chiropractic can be so big, especially for these babies and like you said, they go through so much. They really do and some births are really, really, really hard on them physically. Lindsay: Right. Yes, absolutely. Love it. Meagan: Love it. Love it, love it. Yeah. We love chiropractic care. We obviously feel that everyone should see a chiropractor if they can. We just love the information. We love what you do. We love that you work on my own personal clients. Lindsay: Thank you for sending them to me. I love them all. Meagan: Absolutely. Lindsay: I get so excited. Meagan: I know. I do too. I'm like, “Okay, great. We've got chiropractic care going on right now.” So it does matter. Even for births that aren't VBAC, chiropractic care still matters. It is a big deal and a big component. Lindsay: Yeah. I just feel like moms don't have to live with discomfort. Some discomforts just don't go away. It just happens, but for the most part, round ligament pain, your mid back pain, your low back pain– you don't have to deal with that. You are growing a human. You should feel good. Not everyone loves pregnancy, but love it as much as you can. Feeling your best and not being in pain is definitely a huge plus. Meagan: Mhmm, absolutely. Well, thank you so much for sharing your story. Lindsay: No, thank you. Meagan: And your advice.Julie: It was great to see you again. Lindsay: Yes, you too. I love you guys so much. Julie: Aww, thank you. We have a great community of birth workers here. Chiropractors, midwives, doulas, birth photographers, out-of-hospital, and in-hospital obstetricians. We really do have a great community here. I just love it, especially when we have local people on that we get to love on a little bit. So thank you. Lindsay: No, thank you. Julie: And how can people find you if they are local to the Salt Lake Valley?Lindsay: Yeah, so my clinic is called Bluebird Chiropractic. You can go to bluebirdchiro.com It's c-h-i-r-o and you can find me there. Look at my website and make an appointment online. 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 Julie and Meagan's bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Today on the podcast we have one of Meagan's local doula clients, Aubree. Aubree's unexpected HBAC story is one of overcoming fears and digging deep when birth moves much faster than planned!We also discuss the risks and benefits surrounding home birth. Julie mentions criteria you can use to help you decide if HBAC is right for you. However and wherever you choose to birth, our mission is to help you feel empowered, peaceful, and safe in that choice. Additional linksThe VBAC Link Blog: HBACMamasteFitJulie's Fear Release VideoHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Happy Wednesday, everybody. It is Julie and Meagan and we are so excited for you to hear this story today. We have our friend, Aubree, on and she has got a really cool story to share. And kind of a little side note or a little teaser, I was actually one of her doulas. It was me and my partner, Melinda, and I sadly didn't get to make it to the birth. Melinda went, but I seriously can't even believe how awesome this story is. I'm actually excited to hear her share it. We actually had scheduled to go to lunch and hear her story, and we never got to have that happen. So I'm so excited today to hear along with you guys her version of the story. As usual, we have a Review of the Week and our amazing Julie is going to share that with you before we dive right in. Review of the WeekJulie: Hello, I am so excited to hear this story too. Meagan was just telling me a titch about it before we started recording and it is always fun to have somebody local share their story with us. I do have a Review of the Week. This is from Apple Podcasts and it is from libbywilger. The title is “My Safe Space”. That makes me really happy– “My Safe Space.”Meagan: And I love her name, Libby. Julie: Libby. I know, that's cute. Okay, so she says, “I have been listening to The VBAC Link from the very beginning and it has carried me through my own VBAC journey (and beyond)! I had an emergency C-section with my first baby in 2017 and knew immediately I wanted to pursue a VBAC with future pregnancies. I tried listening to birth stories on other podcasts, but initially, it was too difficult for me to hear from first-time moms whose stories ended with peaceful, unmedicated, vaginal births. The VBAC Link became my safe space to hear from women who had been through what I had and had come out empowered, triumphant, and healed, even if they weren't able to have a VBAC. “This podcast helped me to heal emotionally from my first birth experience and to surround myself with the research, support, and POSITIVITY that I needed to prepare for my next birth. These stories allowed me to believe in birth again, and they carried me through my beautiful, healing VBAC during the height of the COVID-19 pandemic in April 2020. “Julie, Meagan, and all the women of strength who bravely share their stories are changing the world with this podcast. Thank you for giving so many mamas the gift of education, empowerment, and JOY while they bring their babies Earthside. God bless!”Meagan: Aww, that gave me the chills. Julie: I know, me too. Meagan: That is amazing. I love it so much. Thank you so much for sharing your review, Libby. Julie: Yeah, absolutely. I love that. I love it when people are with us from the beginning. We've been doing this for four years now. Meagan: I know. So crazy. Julie: It's been a really long time and really fun to see people come around full circle. I was at our local ICAN meeting last night. They are starting up ICAN meetings again here. Meagan: Oh yay! That's awesome.Julie: Yeah. So if you're in Utah, look up ICAN of Utah County. There are meetings on the 3rd Monday of every month in Lehi and I will probably come to every single one of them because I just– you know me. I love talking about birth and VBAC and everything. It was fun because a lot of the people there– it's been a while since we've had ICAN meetings– and everybody there knew who I was. It was kind of strange walking into a room where everyone knows you but you don't know them. It was just a little strange. I don't know. It's been a while since we've been in front of real-life people instead of talking on Zoom. So it was just fun to be able to see and connect with people. I'm excited to hear the stories of when people found The VBAC Link. There are people who have found us at the beginning and they had their C-sections, then their VBACs, and VBAC after two C-sections. There was a mom there last night who is preparing for a VBAC after three C-sections and I love that VBAC after three C-sections is becoming more common. We are hearing more stories in our community and more on our podcast. I think it's incredible. Aubree's StoryMeagan: Okay, Ms. Aubree. We are so, so excited to hear your story. We are so grateful that you're here with us today. We are going to turn the time over to you to share this beautiful birth story. Aubree: Oh, yeah. Thank you so much for having me. Meagan: Absolutely. Aubree: I actually was going to say that I've almost been with you since the beginning. My daughter is three and a half. She's my C-section and that's how this all got started. Meagan: Mhmm, that's awesome. We really do. We get emails all the time where it's like, “Oh, I've been with you from the very beginning,” and we are like, “Thank you. Thank you for sticking with us this whole time.”Aubree: I love it. Thank you for allowing me to share my story. I'm super pumped, actually. Meagan: Absolutely. Aubree: I'll just start with my daughter's birth first. She's the C-section one. Right off the bat, I went and actually had an IUI which is intrauterine insemination. It worked on the first round. I'm infertile, so that's why we had to see a fertility specialist but it worked and I had a pretty normal pregnancy with her. Nothing out of the blue or anything. I did find out, though, about two weeks before birth that my doctor told me, “Oh, I'm going to be going out of town.” That was a big surprise to me.Meagan: Shocker, yeah. Aubree: I had never even thought of that being a possibility, so I just assumed. She had told me, “Everybody there that will be there will be awesome. You don't need to worry.” I did not think about it. Fast forward– it actually gets to two days after 40 weeks, so 40+2, and that's when my contractions started. I was visiting the gravesite of my father and it was really special that my contractions started while I was visiting him.It was exciting because I had taken a HypnoBirthing class. I had done a lot of work– what I thought work was– mentally to prepare for it, and so it just felt super exciting at first. The whole car ride back– it was about an hour away and every five minutes, or not five minutes at first. It was about every 7-10 minutes apart. We got to our apartment. I decided to do a little bath and that's when it slowed down and stopped, my labor. I just got bummed. I was super bummed. I was like, “You have got to be kidding me. I have been waiting 40 weeks for this.” So I hopped out of the bath.  I shouldn't have. I should have rested. But I hopped out of the bath and I was like, “Let's get this ramped up again.” So I just started cleaning the apartment, vacuuming, everything like that, and lo and behold, my contractions started right up again. They slowly got closer and closer together. Even though I was working on breathing through them, I was managing them so well. About an hour later, I was like, “These are clockwork. Five minutes apart and they are lasting,” I can't even remember, but they seemed textbook and I was like, “Let's go to the hospital.”I didn't want to wait for them to get even closer. It started to get to the point where I was like, “I'm needing a little bit of help, too.” So we get to the hospital and that's when my anxiety kicked in. It felt really real. We got up to the tower or whatever where we get checked in and the nurse was like, “Why are you here?” I'm like, “Can you not tell? I'm in labor.” I had to do that little bit even though I had pre-done everything. She still asked me a few questions. We finally got our way back and they said, “Okay, we'll check you in triage.” I was like, “Joke's on them because I'm five minutes apart and I'm going to be super far along.” But come to find out, I was only 3 centimeters. They said, “Well, we'll keep you for an hour and then we'll see,” but an hour later, still no progress which makes sense, but the contractions were just so intense for me. I was asking, I'm like, “Can you do something for me? I need something to help with this” and I had forgotten everything, literally, from my HypnoBirthing class. I just remember being in so much fear. So finally, I think they did administer– I can't even remember what it was– a little shot to my bum. It kind of took the edge off, but not really. Meagan: Maybe morphine?Aubree: Yeah. Meagan: Was allotted or something? Sometimes in that earlier stage, if it's really intense, they'll give you a little morphine shot in the bum while you are awake just to take it away a little bit. Aubree: Yeah, that's probably it then. They said, “We'll allow you that, but since you are not admitted, we can't even start an epidural or anything.” I was like, “Why isn't this on-call doctor allowing me to be admitted?” Because they kept saying, “Well, the on-call doctor thinks this,” and “The on-call doctor thinks that.” Already, I'm not liking this on-call doctor very much. And so they said, “We are going to come back in one more hour. I manage through that one hour. I think I progressed to a four. Because I had made some progress, they said, “Okay, we'll go ahead and admit you now.” That's when my mom had gotten to the hospital. My husband was with me in the room and I still was just very fearful. I couldn't find a position that was comfortable for me. And so I basically asked for the epidural right as I got to my room. I just was like, “I need rest.” Meagan: And relief. Aubree: And relief, yeah. I call him a nice, old anesthesiologist because he was pretty old. He actually helped me relax. He administered it and it was actually smooth sailing from there but my body– even though I hated not feeling my legs, I had that relaxation. By I think, so sorry. I should have said. I checked in at about 8:00 p.m. and by 5:00 or 6:00 in the morning, they told me, “You are 10. You are complete.” It actually helped me relax so much that it allowed me to dilate which was awesome. They said, “For an hour, we are going to let you rest and descend.” I had no idea what that meant. I was like, “Okay.” And then around 6:00 or 7:00, we started practice pushing. I think I knew from the beginning, “That is a lie. This is not practice. They really want me to start pushing.” It was the coached pushing because they had me push, push, push for ten whole counts. I had to hold my breath and it just was awful. I had heard and I had told them. I had my whole birth plan and I said, “I prefer not to have coached pushing,” but I don't think anyone cared too much to look at it. I definitely didn't remind them because I was just in the moment. So I am in the middle of quite a few practice pushes and this is the first time I saw the face of my on-call doctor. He comes into the room and he goes, “Push, push, push, push, push, push, push, push!” He sounded like a barking football coach.Meagan: I was going to say, “What are we doing?”Aubree: I am like, “What are we doing?”Meagan: Are we sprinting up a hill right now?Aubree: So shocked. My husband said he wanted to (inaudible), but he was trying to help me, so I just dealt with it. I dealt with all of the coaching. I did not like the coached pushing. In fact, I was holding my breath and they were like, “Oh, she needs more oxygen. Let's put an oxygen mask on her.” That made it even worse. I just felt claustrophobic with that on, and then they would try to rotate me. They were like, “Let's rotate her to her other side,” because I had been on my left. Every time they tried to rotate me, they were like, “We lost baby's heartbeat,” or it had deceled, and so I couldn't move. I had to stay on my left side. I had to keep the oxygen mask on and it just did not feel good. In fact, I knew I was pushing because I am one of those people that pooped on the table. It was like, “Come on. You know I am working!” It was so embarrassing.Meagan: Listen, poop is a good sign. It means you are doing things really well.Aubree: Okay good. I pushed for an hour and a half and that's when the doctor said, “Okay. I need to probably give you the C-section talk,” because she had not descended. She engaged but she had not decided one bit, not even with pushing. There was nothing from her. He said, “You look exhausted. I actually see a little bit of blood in your urine output and we can't get you to move on the other side for your baby's heart rate.” He was like, “I could let you go for another hour and a half,” but he said, “I think the best option for you is just to have a C-section because this will just get even more exhausting.I consented honestly because well, I took a minute with my husband. We talked about it because I did not want a C-section although I had no idea what it entailed anyway. We decided it was the best for the baby and for myself, and we wanted to go through with it. It did go really well. The C-section went fine. I just did not like that right after the procedure, I was so shaky. Literally, so much to the point I couldn't even hold her when they finally brought her back from the NICU for her breathing. I couldn't even hold her. I was violently shaking.Man, I don't want to get emotional, but that was the hardest part. I couldn't even bond with her. I was able to still learn and work through everything and enjoy her afterward. I just feel like I had a rough start, especially being a first-time parent, and especially because two weeks later, we came to find out she had colic. I kept blaming the C-section for her colic because I was like, “She never got the microbiomes from my vaginal canal.” I just knew at the end of all of that and the rough recovery of not being able to lift much or walk around as easily at first. My friend is who introduced me to you guys. That's when I just knew things had to be different the next time. So yeah. That's my C-section story.Meagan: Yeah, thank you.Aubree: Yeah. My son's story is completely still baffling to me because I did not expect it. We had to go back to the fertility center. He took five or six rounds of intrauterine insemination and we were actually close to them saying, “Hey. You probably need to go to IVF after this.” But anyway, we were so lucky and blessed to get him in the fifth round. We had a pretty good pregnancy with him. The only thing that I had fear about was the birth and choosing the right care team.And so at first, I knew for sure, I think I contacted Meagan to be my doula right out of the gate. I think I was only five weeks along.Meagan: Yeah, early.Aubree: Early, yeah. I wanted to secure you and I wanted to secure my provider. I initially went to a hospital here with a midwife because I wanted things a little bit more natural, but when I went to my first meeting with her– I had given her my whole story and she had said, “I don't see a reason to not let you try, but I do want you to consider having an induction at 39 weeks and I would like to monitor you as we get closer.” Things didn't sound VBAC-friendly. It just sounded tolerant and I got that feeling of, “Is this who I really want?” because I don't do well having to fight for myself during labor. I don't want to have that as an additional thing to worry about.I had been keeping this other clinic in the back of my mind and I went and did a couple of interviews with the midwives at a freestanding birth center. They are an amazing team. The thing that made me feel so safe with her was that she said, “The odds are in your favor if you come to be with us.” That sounded really awesome, but I also decided to do one other thing which was that I wanted to go physically stand out in front of each place to see if I could get a feeling. You know, like, “Does this feel right for me?” I stood out in front of the hospital and then I stood out in front of the birth center and I did not feel pulled to either one. I was super shocked. I kind of figured out why later because he didn't get delivered at either. Yeah. I will keep telling my story, but I think that's the reason why my prayers went unanswered because he did not decide to come to either place. I did not make it. I would not have made it. So I decided, “Okay.” Around 20 weeks, you know when you have your anatomy scan, we found out he was not only breech, but that my placenta was anterior and it was also covering my C-section scar at that point. And so they said, “Okay.” This is with the birth center because I had decided to go with them. They said, “We are just going to need to keep an eye on that because we can't have your placenta covering your C-section scar or sticking right there. It needs to move up and away from it,” as well as, breech, right? I did not want to deal with a breech baby. And so I did quite a few things and this is actually something I pulled from your guys' previous podcast which is why they are so amazing. A previous person had said she started talking to her baby throughout the pregnancy and how she created a bond with them, so I was like, “I need to start talking to him.” That's when I started having conversations. I was like, “Hey, honey. You are breech. We need you to turn.” I started to keep him informed along the way, even learning things from MamasteFit, or Gina. I kept telling him at night. I kept saying, “Okay. Remember when it is birth day, you have to tuck your chin in. You have to have the pointiest part of your head face down.”Meagan: Those things work.Aubree: They do. They just do. It did work. I had to have another scan later because we had to check both his position and my placenta at around 30 or 35 weeks. I can't remember, but he did end up flipping. So I went and saw a chiropractor because I wanted to do everything to get him to not be breech. I went and saw a chiropractor here. I did the Spinning Babies Daily Essentials most days. Not every day, but I did that. I had the red raspberry leaf tea and dates. I just wanted to do all of the things I could to make this possible for myself. About one week before, I actually went into labor. My contractions started in the car when we were on our way back from the lantern festival. I was so fearful. I actually was like, “It can't happen now. It can't happen now.” It was a week before my due date. Mentally, I wasn't prepared. The fear came back. Feeling those contractions put me right back in the hospital remembering how scared I was and it was surprising to me because I just kept saying out loud, “I am not ready. I am not ready. You've got to stop. We need to wait.” They fizzled out by the time I got home. That whole week, I worked with, and even throughout my pregnancy, I worked with a life coach about my fears. I did your guys' fear release from your course. I worked through it. I wrote out everything and then I burned it. I burned my piece of paper with my fears and it felt so good.Meagan: Mhmm. Listen, that is such an amazing thing too. In fact, Julie has a whole recording on our YouTube channel about that and how to do that. It's so amazing. It really is.Aubree: Yeah, for sure. I think that's partially what helped me get to be okay with whatever could happen because I was so afraid of things like shoulder dystocia, needing to transfer, all of those things, and so it just needed to get out, be said, and be burned because, at that point, I did all that I could and had to let the pieces play out.Meagan: Just let it go.Aubree: Yep. Just let it go. So a week later, it was still two days before my due date. I had been feeling kind of nauseous all day and I was like, “I feel off. Let's go to bed early tonight.” And by early, I didn't get to bed until 11:00, but it's fine. I said, “Let's go to bed early.” At 11:17, I kid you not. I was not even in bed for seven minutes when the first contraction came. It made me go, “Oh no. Did I dream that?” And then five minutes later, the next one came. I shot up out of bed and I said, “This is it!”Meagan: You can tell a difference.Aubree: Yes. I told him. I was like, “You have got to stay asleep.” I did not expect to be fast. Knowing my C-section and whatnot, I was like, “We have got at least six hours. I want to labor here as long as possible.” I went and started a shower bath for myself with Epsom salts. It was so great. I let myself go for a whole 45 minutes. I was alone and it was awesome until it kind of really started picking up. They were consistently already five minutes apart. The intensity just grew and grew with each one. So 45 minutes later, I was saying, “Justin, can you get out of bed? I am needing help squeezes. Help me.”That's when he was like, “Okay. Let's text the midwives,” so I sent a sweet text like, “I've been pushing for an hour. I'm just going to check–”Meagan: Contracting, yeah. Contracting—Aubree: Oh sorry, not pushing. Yeah, contracting for an hour and things are going well. I said, “Just keep us informed.” Seven minutes later though, I had a freak out because they just were ramping up so much. It's not like the part you want to see in a movie because I was frantic. I was on my knees in my bedroom. I was like, “I can't move. I can't go anywhere.” I was like, “I picked the wrong thing. I need the epidural now. Get me somewhere. Fix it.”Meagan: It was a lot happening really fast.Aubree: Yeah. So my husband, bless him because he knew how much I wanted the VBAC and he said, “We need to remember what we want to try.” He was like, “What can you remember that you want me to help you with?” I said, “All I can think about is how funny it was that Gina said you can turn around on the toilet and sit there while you are in labor.” He was like, “Okay. Let's go try it.” And so I made it there and it actually felt so good to sit there backward. For every contraction, I do not recommend this. But with every contraction, I pushed my forehead into the wall because it gave me some more counterpressure. He was giving counterpressure behind, but it gave me a counterpressure on my head too. It's just what I did to cope. That's when my husband was like, “We need to get places.” So that's when– let's see. I think it was at 12:21, he was like, “Call your mom.” I finally called you guys, my doulas. My mom quickly came and so did–Meagan: Melinda.Aubree: Melinda, yeah.Meagan: She was really close to you so I was like, “It sounds like it is going fast,” and so she was like, “I'm going.” “Yeah. You've got to get to her.”Aubree: I'm so appreciative of her because I don't know if you would have made it, Meagan.Meagan: I don't think I would have. I mean, I wouldn't. I wouldn't have because I'm not that far, but still, with the way things were going, I was far. Do you know?Aubree: All right. You were far enough, yeah. So my mom arrived and she was kind of like, “Wow. Don't you guys have to get going?” Justin was like, “Yes. Yes, we know. We are trying to get everything.” I couldn't really talk. I just was in the zone and saw my mom arrive. The doula arrived and then he called Adrienne. Adrienne heard me grunting over the phone and said, “Is she pushing?” Adrienne is my midwife and I didn't think I was pushing. Honestly, I was just, it's how I was like, “I am just getting through the contractions I am making a grunting noise.” I actually was like, “I think we can make it if you guys just let me go poo really quick.”She goes, “Oh no. I am on my way right now,” because she knew what that meant and I had no idea. I was like, “Guys. Jokes on you. I really have to just go to the bathroom real quick,” but she knew. Anyway, I'm so glad she was on her way. She called us not too long after saying, “Hey. If you need to, call the paramedics. This is going to be quick.” But she luckily made it. So she made it and when she got there, she set up a birthing stool right next to me in my bathroom. It took a little coaxing to get me off the toilet because I did not want to move, but we ended up getting on the birth stool. I was hugging Melinda because I needed to hunch over and hug her. Justin was giving me the counterpressure still on my hips. They just switched back-and-forth so neither one got burnt out, but at one point, and apparently this is when I realized, “Oh, I really am pushing.” At one point during this pushing, I felt my baby boy. I felt him use his legs to push up into my ribs and turn. I felt him twist and turn and I'm like, “Oh my gosh, he's doing it! He's doing what I told him to do.”Meagan: Exactly, yes.Aubree: I told him to get in the position. I was like, “You do whatever you need to, baby. It's fine.” I felt him do that and at first– I should back up a little bit before I felt that. They put a mirror underneath me and at first, I couldn't see anything. I was like, “What if he gets stuck? What if he gets stuck?” I couldn't see anything, so I decided. I was like, “Stop looking in the mirror to check your progress and just let it happen.” After I felt that push, I was like, “Maybe I will check now.” I looked down and that's when I could finally see his head crowning. I was like, “Oh my gosh. This is it. He really is doing it.” And oh man, the ring of fire. Yes. I felt that so much. In fact, every time I would contract, I would probably push a little too hard to push him out because it was just so intense. I should have eased up. I should have probably eased up on it, but it was just so intense. I can't tell you how many pushes it took, but man. He made it out and he did that slippery slide out. My midwife prepped my husband to catch him and that was super shocking because he is not the type of person that was like, “I want to catch the baby or cut the cord or do any of this,” but he was just right there raw and real with me.We were just going through it doing what we had to do with what was presented. I don't want to share the pictures with you, but if you saw the pictures of my face, I was just exhausted. I looked exhausted because it just was a wham, bam, boom. Two hours, I calculated it. It was two hours and 40 minutes from start to finish. It just blew me away. I did not think that it could be that quick.But I should say that after he was delivered, they got my bed all set up and put all of this protection down. After I delivered the placenta, I did hemorrhage, and so I was so grateful for my midwife. She administered IV fluids to me. She stitched me up right there. It was such a turnaround, immediate bonding experience that I missed out on so much with my daughter even though I was purely exhausted. I just was so much empowered. Yeah. I'm trying to think if there is anything else. The recovery– I should say this. One thing that I have learned going through the C-section and a vaginal, it wasn't like one recovery was amazingly better than the other. They just each had their pros and cons. Right? I'm not saying, “Don't have a C-section” or “Don't have a home birth”, but they just have pros and cons. Everybody is different and it just is okay no matter how birth happens. That's the biggest thing, especially through my life coach that was helping me, my friend. She is now a certified life coach. She is the best. I really think that is what helped me. She helped me push through all of the fears I had and that is what started me on my own journey. I actually signed up now. I want to become a doula and I am going to sign up to be a life coach as well because I want to handle not only the birth, but I want to help people through their mental– it's such a mind game for birth. So that's my story.Meagan: Yay. Absolutely. Oh, I love it so much. We have a client that we just recently were talking to and she had a fast birth the first time. Not fast-fast, but it was a 24-hour first-time birth. She is scared of that happening and it just being so fast. I'm like, “There are pros and cons to fast birth,” but when it's fast, it's usually really, really intense. Aubree: Yeah. Meagan: Yeah, and then you're exhausted because it was so intense so fast, but yeah. As I said, there are pros and cons. I don't even know if I would prefer fast and intense or if I would prefer what I had– 42-hour long labor. I”m like, “I don't think I would prefer the 42-hour-long labor.”Julie: A nice, happy medium for me. Meagan: Yeah, just a nice, happy medium. Even just 8-10 hours. Aubree: Yeah. Meagan: Oh man, it can get intense. You are amazing. I remember Melinda was like, “Dude. That was insane!” I'm like, “Yeah. That sounded insane.” But so amazing, too. Like, so amazing. You are just incredible and you just let your body and your baby do exactly what they needed to. I also do. We love Gina. Everyone knows we love Gina so much. Julie: Gina is amazing. Meagan: Talking to your baby, connecting to your baby. There is something to be said about that. It's so real. I feel like I did that so much with Webster and people probably would be like, “What? You're just talking to your stomach?” I'm like, “Yeah.” And feeling your stomach and feeling him and saying like, “Okay, buddy. It's you and me. Let's do this. I'll be okay with however you come, but this is how I would love for you to come.”Aubree: Exactly. Meagan: And that happened and it was amazing. I'm so, so grateful forever. I will be forever. But yeah, I just adore you and I am so grateful for you and your story. I am so excited that you are going the doula route and life coach route. There is so much goodness in life coaching as well. I think it's going to benefit your mamas in the future. You've had it, but probably more than you even know, you are going to change people's lives. Aubree: Aww, thanks. Yes, that's my goal. There are so many friends that I even have that have had C-sections and at first, you don't believe in yourself because you put a lot of stock in what a professional doctor will tell you. They told me, “You have such a small pelvis” and I've been told I'm small my whole life, so I didn't really doubt them at first. I was like, “Well, they're probably right. This is just another curse of the smallness.” But you know what? There's also something to be said for educating yourself with other professionals as well and getting second opinions. Like you are saying, trust your body because when I learned, when I took your course, The VBAC Link course, and I followed people like Gina, you empower yourself with more knowledge. Even though it might not work out how you want, the fact that you empowered yourself to know no matter what way it goes, I think that's what I hope any future client would want. “No matter how it goes, I'll be okay.” Julie: Yeah, absolutely. Meagan: I love that. HBAC Statistics and CriteriaJulie: Should we talk a little bit about home birth? Meagan: Sure. Aubree: Yeah, sure. Julie: Have a little educational piece about home birth? First of all, if you are interested in our VBAC Prep Course for Parents, we also have a VBAC Doula Certification course, you can find all the information for those courses on our website at thevbaclink.com and we also have a blog about home birth after Cesarean. Surprise, surprise. I'm actually looking at it right now so I can go over some of the data because sometimes it will get all smushed around in my head. But it's interesting because we have all of this data about home birth and its safety and things like that, but during the COVID pandemic in 2020 and 2021, preliminary numbers show an increase in out-of-hospital births because I feel like a lot of people were being forced to choose between having their supportive birth team or being really restricted with who they could and could not have in hospitals. So I love that home birth is an option in most parts of the country. You're not going to face much of a kickback. There are a few Southern states that really restrict home birth options there and out in Nebraska. My best friend is getting ready to have a baby in Nebraska and home birth is just illegal there. It's illegal for midwives to attend home births. They really don't have any options out there in Nebraska, so you've got to work hard to create advocacy and change if you're in that state.  In 2019, there was a peer-reviewed meta-analysis. A meta-analysis is a study that looks at a whole bunch of studies together so it's really a more comprehensive view than an individual study would be. In 2019, there was a peer-reviewed meta-analysis of 20 years worth of studies on home birth that contained roughly 500,000 parents. So it is a pretty good size study. The study showed that low-risk parents who have a hospital birth have no difference in the overall birth outcomes than low-risk parents who have a planned home birth. Now, it's really interesting because a lot of times, we'll see and hear a lot, even now. Even last night at the ICAN meeting I was at, people were saying, “Oh my gosh. Home birth scares me. It scares me so much” or “Out of hospital birth scares me.” When you really look down at the difference in mortality rates and birth outcomes, they are very, very similar between birthing and home or birthing in a hospital. So there's that if you are a statistic junkie like me. That is really interesting for you to see. But also, you have got to understand there are different risks associated. Sometimes your risk is a little bit different. Of course, if you're having a home birth, we highly recommend that you have a midwife that has attended many, many home births and that has a solid transfer plan in case of an emergency or if you go the unassisted route that you have a solid transfer plan in case an emergency happens so that you can get to the hospital quickly if it is needed. But it's really cool because this analysis also showed that birthing at home had fewer medical interventions and fewer Cesareans. Meagan, maybe you have a better idea of this than I do, but I know that in some of our birth centers around here and for our out-of-hospital midwives, their Cesarean rate is 5%. Like, 95% vaginal births. 95% successful home births. They go on to have hospital transfers and some clients will eventually need a Cesarean, but we have really, really high VBAC success rates at birth centers and with home birth midwives. Meagan, do you see that?Meagan: Yeah. I don't know the exact percentage by any means because I am not good with numbers, but yeah. Yeah, for sure.Julie: It's incredible. I love that. Home birth is not for everybody but there are four things, four criteria that you need in order for home birth to be a safe option for you. The first one is that you have to have a low-risk pregnancy. Here is a little plug-in: having a prior Cesarean does not automatically make you a high-risk pregnancy. I'm going to say that again. Having a prior Cesarean or going for a VBAC does not automatically make you high risk in your pregnancy. Now, you are at a higher risk for uterine rupture. That is true, but the risk is still fairly low. It doesn't put you in a high-risk category. You don't need to see maternal-fetal medicine. You don't need to see a high-risk doctor or anything like that to manage your pregnancy.The second criterion is chosen, planned, and prepared for. A home birth that is planned and prepared for has better outcomes than accidental homebirths do. The care provider involved is qualified and experienced in homebirth so you don't just have your next-door neighbor come and help deliver your baby. Unless your next-door neighbor happens to be an experienced homebirth midwife, then that's okay.The fourth birth criterion is that your home birth plan includes a backup transfer plan in case of an emergency, as I talked about before. We know that it is relatively safe and most birth is a natural process but every once in a while, things happen where you are going to need more emergent care and you're going to need an expert involved so having a backup transfer plan in place is important in that regard.We have a blog about it. It's at thevbaclink.com/blog. You can just type HBAC in the search bar and it's going to put up right there or you can just go to Google and I think it's the second search result on Google. Meagan, what would you add?Meagan: I love it. Nothing, you're just amazing. I guess I should say when I was preparing to have my VBAC after two C-sections, people told me that I was crazy and that I was going to kill my baby. Really, really awful things, and yeah. It can be scary, but if you prepare it can be just as great. I mean, Aubree was planning on going out of hospital but not at home, but she still had her team equipped and ready to help her and it was still really great. And so yeah. I just think that doing what you feel is best for you and being at the place where you feel safest is going to be the best place too. All right, well Ms. Aubrey, we are so grateful for you. Thank you so much again. We really love your story and are excited to share it with the world.Aubree: Yeah, thank you guys so much. Seriously, I'm so glad you guys have done The VBAC Link and keep doing it because it is so helpful for all of us out there.ClosingInterested in sharing your VBAC story on the podcast? Submit your story at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan's bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

The only predictable thing about birth is its unpredictability! When Carly felt the urge to push at home, she realized that there wasn't enough time to make it to her hospital of choice. She would have to have to fight for her VBAC at the closest hospital– the same hospital where she had her traumatic C-section.Though she wasn't treated with the respect she deserved yet again, this time, Carly held her ground. This time, Carly was in control. This time, Carly birthed her baby how she knew she could.“The first time I became my mom was literally a once-in-a-lifetime experience for me and I felt like that had been stepped on for so many different reasons. The second time around, I was like, ‘I am going to fight for this.'”Additional linksThe VBAC Link Blog: How to Find a Truly Supportive ProviderMamastefit How to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: You guys, it is The VBAC Link. We are back. We are so happy. We are four weeks into this and seriously, it is just making me smile every single time we record with another guest. It is Meagan and Julie with The VBAC Link and we have a guest today. Her name is Carly and she will be sharing her VBAC story. You guys, she is pretty stinking amazing. She does all the things. She does cloth diapers, co-sleeps– all the things. I am reading through her bio and I am like, “She is amazing.” You are so amazing. Cloth diapering is a hard thing to do and the fact that you even do it part-time is amazing. So I am excited to get to know you even better and learn more about you.Right before we dive into your amazing story, we have Julie, of course, with the Review of the Week.Review of the WeekJulie: Okay. So we already know that I have this weird thing where sometimes I feel like I need to be a singer on the podcast this season. This season, I don't know what you even call it. In this next review, I am not going to sing, but I really want to just sing because Carly is from Philadelphia. If you know what song is triggering in my mind right now from Philadelphia, I will not sing it. I have been trying to not because I think it is a little bit weird. I don't want to be weird.I'm really weird. Oh my gosh. I'm weird. Oh my gosh. I'm so weird, you guys. Okay. But anyway, I am just going to read the Review of the Week while you guys can sing the song I am thinking about from Will Smith, and Philadelphia, and all that playground stuff where he spent most of his days. All right, so this review is from Kiley MoMy from Apple Podcasts and it is titled, “Listen If You Are Considering a VBAC.” She said, “My first child was born via emergency C-section and I felt very discouraged and afraid that my next birth could end up being a C-section again. I started listening to this podcast for information and what I got was so much more. The stories shared are so raw, emotional, and amazing. They helped me prioritize a supportive VBAC team, gave me the right questions to ask my providers, and filled me with confidence and knowledge to do what was best for me and my baby. My second child was born via VBAC and I am so grateful to The VBAC Link for helping me overcome the fears I had with my previous birth and helping me to prepare emotionally for my second birth however it turned out.”I love that review. Thank you so much, Kiley. Oh my gosh. All these warm and fuzzies are kind of making me tear up a little bit. I don't realize, I think, how much I have missed that.Meagan: I know. I know. Yeah.Julie: If you are loving the podcast and you love having it back, we would love to hear from you. So please drop us a review on whatever podcast platform you are listening to. Actually, I think not very many of them you can leave reviews on, but you can leave one on Apple Podcasts for sure. You can go to Google. Just Google The VBAC Link and drop us a review there or you could leave us a review on Facebook because not a lot of people do that anymore.Meagan: That's true.Julie: It's so strange. We used to have a ton of Facebook reviews and then all of them kind of tapered off. But I feel like Facebook might be not prioritizing businesses in your newsfeed anymore. Maybe that's a little bit why. But if you want to show us a little bit of love and show us how grateful you are for having the podcast back if you are, we would love to have a review in either one of these places. It definitely makes our day. My cheeks kind of hurt a little bit from smiling right now from all of this. So thanks so much again, Kiley MoMy, and thank you to everybody that has taken time out of their day to put a smile on our faces.Carly's StoryMeagan: Okay. Let's dive into Carly‘s story about her two beautiful girls. I am excited to hear both stories. We always say we are excited to hear the VBAC story, but we are also excited to hear your C-section stories too. We are excited to hear about those births because they matter just as much. So Carly, let us s turn the time over to you and talk about that. I'll just turn the time over.Carly: Okay awesome. Thank you so much for having me. This is amazing. So I will start with my C-section story. I found out that I was pregnant in April 2018. I was finishing up student teaching. I was about to finish graduate school. I was applying for jobs, going on interviews, and putting together my portfolio and demo lessons, so it was a really chaotic time for me. It was stressful, but it was also really exciting. I was wrapping up one period of my life and starting another both in my personal life and my professional life.So I went into the following school year as a first-year teacher and a first-time mom. I was about five and a half months pregnant when I started a new job which was a little overwhelming.Julie: Yeah.Carly: Teaching can be overwhelming as it is, so it was a stressful couple of months. It was an exhausting couple of months for me. I had a normal, healthy pregnancy. I went into labor naturally with my first daughter. It was about nine days before my due date. I was at school and my water broke in the middle of the day. It wasn't a huge rush. It was kind of like slow gushes throughout the day and I wasn't having any contractions. I wasn't even sure at first if it was my water that had broken. So I finished out the school day. I stayed after school for a couple of hours to put some things together for my substitute for the following week and then by the time I got home around 5:00- 5:30, the contractions had started.When they started, they were coming every couple of minutes, so I was having regular contractions once they started. I took a shower. My husband got home and I was like, “Listen, I think I am in labor. We should head to the hospital.” We stopped on the way for him to pick up something for dinner and then by that point, I had called my mom to tell her, “I am in labor. Come whenever you are done.” She was working. “Come whenever you are done with work.” I wanted her in the delivery room with me.At that point, on the way to the hospital, I was timing them. They were coming every three minutes. So I was like, “All right. I am in labor. This is good.” When we arrived at the hospital, that's when things got a little crazy. We arrived at the hospital during a shift change and they didn't know what to do with me, so they left me in a wheelchair in the waiting room. When I say they left me, I mean I was out there for about 40 minutes and no one ever really came to get me.Julie: Oh my gosh.Meagan: Good heavens.Carly: My husband had to go in twice. The first time, I thought I was going to be sick, so he went to see if someone could get me a bag or a trash can. The second time, it was like, “Hey. It's been so much time. We are still out there. Is anyone going to come and get my wife?” They finally came and got me. They took me back to triage. They checked me. I was 6 centimeters. They admitted me. At that point, they gave me an ultrasound to make sure my baby was head down. I just remember my husband being like, “Look! There are her eye sockets. I can see her eye sockets. And I was so out of it that I didn't see, but I remember him saying that. So at that point– it was a doctor who gave me the ultrasound– we knew that she was posterior. No one ever told me she was posterior. I didn't really know that was a thing at that point, but you could see her eyesockets. She was face up.So the nurse was like, “All right. We will get you to your room. We will get you your epidural.” I was like, “Hang on a second. I don't know if I want an epidural.” I had wanted to try to go unmedicated. During my labor class at the hospital, they told me that there were multiple methods of pain relief. They had a shower. You could use the gas or the birthing ball. What I didn't know was that you had to ask for those things and not even just ask, you would have to fight to get those things. No one offered me any other options. It was like, “Get your epidural and stay in bed.” So that's exactly what I did. I got my epidural. The anesthesiologist who gave me the epidural was a butt head to put it very nicely. He was really a whole series of expletives that I probably can't say on your show, so I won't. He yelled at me at one point. First, he came into the room. He didn't even introduce himself. He yelled at me after as he was inserting the epidural because I was hunched over in the middle of a contraction. He yelled at me to lie down and when I didn't, he grabbed me from behind both of my shoulders, / threw me on the bed, and then yelled at me again and was like, “I told you. You need to lay down.”Meagan: What?!!!Carly: And then he left the room.Julie: Whoa.Carly: And that was like—Julie: Expletive, expletive, expletive.Carly: Yeah, exactly.Julie: Oh my gosh. Oh my gosh!Meagan: Oh my gosh.Carly: So it was at that point that I began to feel out of control of what was happening to me. I began to feel like, “This is not what I expected. This is not what I wanted for myself and my baby.” I felt like birth was happening to me. I wasn't really a part of it. So I labored on my back with an epidural for a while. They brought me a peanut ball eventually. My nurse was amazing. It was freezing in the room. She brought me a couple of extra blankets and we found out later on that the thermostat in my room was set to probably about 44°. It was very cold and no one realized it. No one adjusted the thermostat. We just assumed it was normal.The doctor working was a doctor from my practice who I had never met. She was the only one I had never met and of course, she was the one who was on. So I labored. I dilated to 10 centimeters. I pushed for three hours. At one point in the middle of pushing, I was having really bad heartburn and I had asked a couple of different nurses, I had asked the doctor if I could have an antacid and no one acknowledged really that they had heard me. No one answered me. No one told me, “No. You are not allowed to,” or “We can't give you that now.” No one came back with an antacid and at one point, they laid me flat on my back, and all the acid in my stomach came up, and I got sick all over the place.The doctor tried to use a vacuum. It didn't work and at that point, she was like, “It's been three hours. Nothing is happening.” My baby was still tolerating labor well, so I don't really know. I guess it was just like, I was on the clock. Time is up. C-section. So they took me back for a C-section. The anesthesiologist there was much nicer and I let him know he was a lot nicer than the first one. They strapped down my arms. I got sick again and I was shaking just so hard. I couldn't even hold my baby afterward.I remember just feeling totally out of control and just hating the fact that I felt totally out of control. No one explained to me what was going on. And afterward, I asked my doctor, “Hey, what happened? Was baby stuck?” She was like, “Yes. Baby was sunny-side-up and stuck in your pelvis.” I was kind of like, “We knew she was sunny-side-up. You didn't know that?” I feel like looking back now, even if they had thought she was rotating during labor, at some point when I couldn't get her out, it might have, I don't know. This was my own personal– it might have helped for someone to be like, “Hey. Oh yeah. She's posterior. Maybe we should try a different position where it is easier to get a posterior baby out.”Meagan: Yeah. Sometimes a provider can actually help turn a baby.Carly: Yes, yeah.Meagan: Like actually, manually from the inside. I know it sounds invasive and it is. It is, but they can actually help turn. There is a doctor here in Utah. It's amazing. He will be like, “Okay, the baby is going to rotate this way.” And during pushing, he will rotate and baby will just be head down and come right underneath the pubic bone.Carly: Yeah. So it felt like there was no communication from when we came into the hospital to my doctor.Meagan: Yeah.Carly: So it felt afterward like I was devastated. I felt like I had been unheard during my stay at the hospital. I felt misled about needing a C-section. I felt like I wasn't really an active participant in my birth. I wanted to know whether or not I could still have a vaginal birth after that, so I did some googling, and I had talked to my husband‘s cousin who had a C-section and was planning on having a VBAC for her next. She did, actually, five months after I had my C-section. So she was a really great resource to talk to. When I went for my six-week check-up, I had asked my doctor about it and she was like, “Yeah. If there are 18 months between deliveries, it's no problem.” But a couple of months later, she left the practice, and then I wasn't sure whether other doctors would still be supportive of that.So fast forward to a little over a year later, my husband and I started trying for baby number two in February 2020. I got pregnant in March 2020 about two weeks into our quarantine for COVID and I immediately began doing research. That's when I discovered you guys and I listened to you every chance I got. My husband was still working at the time. He is a teacher so he was still working, but he was on a modified schedule. This was the first time they had ever tried to do virtual learning and he is in the city teaching, so a lot of the kids don't have a computer. They don't have access to the Internet. So he was available to help me around the house with the little one when I was in the first-trimester exhaustion and nausea.We had a lot of family time during quarantine which was really cool. I still had to go to all of my doctor's appointments alone and as a second-time mom, it was hard so I can't even imagine first-time moms and what that was like to do that over COVID. I had this fear of COVID, but also still wanted to be social with friends and family after our quarantine had ended, so that was a conflicting time for me as far as trying to balance what was healthy for me and my baby while still wanting to celebrate my pregnancy with my family and my friends. That was a continual thing throughout the rest of my pregnancy. I was healthy. I had a healthy pregnancy. At my 20-week anatomy scan, they had said that my baby's head had a lemon sign, which is when baby's head looks like it is shaped like a lemon. It is characteristic of Spina Bifida. So they said they recommended that I go for a level II ultrasound. I was trying not to Google too much and trying to be positive about it. I was also concerned that my dreams of a VBAC might not be able to happen.I went to maternal-fetal medicine to get a level II ultrasound and I went by myself because I wasn't allowed to have anybody else come with me.Meagan: Yeah.Carly: –which was super stressful. You know, there were other women who were there too and it was kind of like, “Hey. We are alone and in this together.”Meagan: We are in this together, yeah.Carly: My baby ended up being okay which was awesome and I became more determined to get my VBAC after that. I talked to my husband about switching to a midwife because I wasn't totally sure that my provider was VBAC friendly. He wasn't necessarily on board at first. I tried to show him a lot of research that I had done. Women all over the world every day give birth with midwives and I feel like we are one of the only, if not the only, countries where it has become so medicalized where the doctors are the ones primarily delivering babies.We talked to one of his former coworkers who had two home births with a midwife and I think she was really the one who helped convince him like, “Hey. Not only is it safe. It might be safer and you get that level of individualized care that you don't necessarily get with an OBGYN.” So I went to my 24-week appointment with my OB with a list of questions to ask then I was like, “If they answer them the way I think they are going to answer them, they are not really VBAC-friendly.” I have you guys to thank for this because I think this is on one of your blog posts. This has been on your podcast and I have listened to about how to tell if your provider is VBAC tolerant versus VBAC supportive.Julie: Yeah. Yep. We talk about it all day.Carly: Yes. So my doctor answered questions like I thought she would. She started saying, “Well, if your baby isn't too big,” and I was like, “Well, what qualifies as a big baby?” My first baby was a little over 8 pounds and she was like, “Yeah. Well, she was pretty big. So probably if baby is around the same size, we would recommend a repeat C-section.”Now, my sister and I were both over 11 pounds when we were born. My mother birthed us naturally, vaginally. So to me, 8 pounds is not a big baby. So that threw a red flag for me. There were a couple of other questions I asked that I was like, “That's a red flag too.” So I went home and I emailed two groups of midwives that week. I had a couple of virtual interviews with them and I picked one that I really liked and I went to see them for my 28-week appointment. I also switched hospitals at that time, the hospital where I would birth that.My appointments went from about five minutes with my OB to 45 minutes with my midwife which was a huge change and I really felt that level of individualized care with them. I was still feeling a little unsure about whether I had made the right decision and I think it was the week I decided to make the change, I had watched the show Call the Midwife on Netflix. It is about a group of nuns who ran the Saint Raymond Nonnatus house.If you don't know, I am Catholic. If you don't know, Saint Raymond Nonnatus is the patron saint of midwives and women in labor. My husband had gotten me this daily reflection book for Catholic moms. Later that day, I picked up this book before I went to bed. I hadn't read it in months and I opened to the day. It was August 31st and it just happened to be the feast day of Saint Raymond Nonnatus. That, for me, was confirmation that I was making the right choice. I had no doubts after that. I had made the right choice.Julie: That's amazing.Carly: It was amazing. I also, at this time, started seeing a chiropractor. I started Hypnobirthing. I wanted to go fully unmedicated. I was doing Spinning Babies. I was walking every week. I was doing lots of squats. I had made affirmation cards. I read different books. I watched movies. I had a motivational birth song that I listened to which helped pump me up and get excited like, “I can do this. I can do this.” I did a lot of research on the labor process, labor positions, and different stations. I followed this woman on Instagram. Her Instagram account is Mamastefit and I think I found her on your podcast. I'm pretty sure you guys had her on your podcast.Meagan: Yes, Gina!Julie: We love her.Meagan: Gina, we love her. Carly: Yes. She's amazing.Julie: She is amazing.Carly: I screenshotted a whole bunch of her labor stations, positions for labor if you know where baby is as baby comes through the pelvis, I had screenshotted all of these and printed them out and put them together in this birth binder I had where I had everything I would need to take to the hospital with me. I had my birth affirmations. I had ultrasound pictures. It was motivational but also informational. I didn't know whether necessarily I would be able to use it during labor, but I thought at least for my husband, maybe, if he needed some help along the way. So during this time, I was looking forward to this pregnancy, my second pregnancy, being a lot less stressful than my first. I was a stay-at-home mom now. I wasn't teaching anymore. We were living in the city in a duplex. With our neighbors upstairs, the living situation had gone from bad to worse. So we were like, “Let's look for a house.” So we started househunting at the time. My husband was back to school in the fall, fully virtual. At this point, they had a set schedule, but he was working probably from sun up to sun down for months on end trying to adjust all of his lesson plans to be fully virtual, putting together things on the computer which is totally different than in-person teaching.I was taking care of our toddler. I was pregnant. I was doing all of the mortgage paperwork and looking at houses, and it was not any less stressful than my first pregnancy. We found a house in October. I was hoping to make settlement and move in before baby came. Baby was due in the middle of December. We made settlement the week before Thanksgiving and we found out that we weren't going to be able to move until after Christmas. So I was really disappointed about that and unsure about moving with a newborn or potentially moving while having baby at the same time. Leading up to birth, I was having prodromal labor off and on all week. My contractions would start at night, run for a couple of hours, and then fizzle out. I went into labor actually the night before my due date. It was about 11:00 at night. I wasn't sure whether this was real labor or not.So I started timing my contractions. They were about three to four minutes apart. I texted my midwife at maybe 1:00 or 2:00 in the morning and I was like, “Hey. My contractions are about four minutes apart. They texted me back and were like, “Okay. Just try to relax. Try to get some sleep if you can. Lay in the bath. Try not to think about it too much.” I couldn't get comfortable laying down. I went out to the living room. We were decorated for Christmas, so I put on our Christmas lights. It was quiet. I had put on some music and I just focused on breathing and breathing and breathing. At some point, I got up and I had put on my tens unit which was amazing and really helped, and I went back to just breathing. The hours just flew by and before I knew it, it was about 5:00 in the morning. I remember checking the time and thinking to myself. I had read somewhere along the way that second labors average about six hours and I was like, “It's been about six hours for me. Maybe I should wake my husband up and let him know that this isn't false labor. This is really labor. Maybe we should head to the hospital.”The hospital where I was going to deliver was about 40 minutes away. I had to account for that and I wasn't really sure when I should be leaving for the hospital. I hadn't been in contact with my midwives since it was the middle of the night, so I wasn't really sure how far apart my contractions should be or what they should feel like. Around this point, my husband got to the bathroom. He came out and he was like, “Okay. You're in labor.” I was like, “Yes.” And he was like, “All right. I am going to email my principal. I am going to call your sister.” She was going to come and watch our toddler. I said, “All right. I'm going to jump in the shower real quick.” So I got into the shower. The water just felt so good and then all of a sudden, I felt the urge to push and I was like, “Oh boy. Okay. I was not expecting that.” But I just couldn't move. The water felt so good. I just wanted to lay in it. Finally, I managed to crawl out of the tub. I was laying on the bathroom floor trying to call for him and he comes running. I am like, “I am pushing! We've got to go.” So he runs to get dressed. My poor sister– he called my sister in a panic and he was like, “Yeah. You need to get over here now.” She tried to start the car. There's ice on the windshield. It was a whole process for her to get to our house.By the time I finally got dressed and had brushed my hair and made it to the front door, she was just coming into the house. And I guess by this point, it was probably around 7:00 in the morning. We're getting ready to go. My husband calls my midwife and is like, “Hey. Carly is pushing. I don't think we are going to make it to the hospital. It is 40 minutes away and with rush-hour traffic, it is probably going to be about maybe an hour and a half.” My midwife was like, “Okay. I can come to you guys. Do you want to try to go to a different hospital?” And my husband was like, “I am just going to take her to the closest hospital,” which I knew was the hospital where I had my C-section and I did not want to go there. I was like, “No. I don't want to go there.” He was like, “We don't really have a choice. We are not having this baby in the car on the highway on the way to the hospital.”So we got in the car. I ran out the door in between contractions. I ran out the door without my phone. I ran out the door without shoes. I had my hairbrush and my glasses in my hand which were the two things I chose to bring to the hospital with me. My husband had already packed the car. We got there. I jumped out and they took me to the hospital. At the hospital where I was originally supposed to give birth, COVID restrictions for the winter were that when you go into the hospital, you bring everything in with you because you weren't allowed to leave once you were in including baby‘s car seat. So my husband starts trying to grab everything out of the car to come in and they told him, “Oh no, no, no, no. You are not allowed up yet. They will call down when they are ready for you.” So they took me up by myself and I didn't have my phone. He had my phone and he was like, “How is she going to call me?” He had my phone. So they took me up. I had about five people ask me on the way. I go in and I am like, “Hey, I am pushing. Baby is coming.” “Have you given birth?” “Yes. I was here. I had a C-section.” “Okay. So you're having another C-section?” I was like, “No. I am pushing. Baby is coming out.” I had about five different people ask me if I was having another C-section which I thought was ridiculous. And I was all alone in there by myself trying to tell them that, “No. Baby is coming. I am not consenting to a C-section. I am having a VBAC.”Julie: My gosh.Carly: “--and I'm going to push this baby out.” I felt like as soon as I walked in, they put me on the clock. It was like, “You know, we will give you so much time until you have a C-section.”Meagan: Right.Carly: They checked me. I was at a zero station which at this point, I knew what that meant. One of the doctors asked me if I was having an epidural. She said, “Were you planning on having an epidural?” I was like, “No.” And then she laughed at me and she was like, “Good because you are too late.” I was like, “Thank you. Why did you ask me?”Meagan: Then why did you even ask?Julie: Okay. Thank you. Carly: Exactly. Exactly. They finally let my husband up after I was in the delivery room. One of the nurses was talking about a C-section and it felt so good to finally have him because then he could advocate for me. He was like, “No. We are not doing that. She's having a VBAC.” I had wanted to push in certain positions and I wasn't making faster progress for them, so of course, I ended up on my back, but I had learned from Gina that if you do push on your back, roll up a towel and put it under your lower back. So I asked them at some point, “Hey, can you put a rolled-up towel under my lower back?” They did and I felt like that gave me more room to get the baby out. They gave me a mirror. I remember looking and seeing the top of her head and being like, “I think she might be face-up,” but I wasn't sure. When I did push her out, I found out that she was born sunny-side-up.Julie: Wow.Carly: Which for me, I feel totally vindicated because that was the issue I had with my first one. She was sunny-side-up and I couldn't get her out. So to actually push this baby out felt so amazing to me. I got my skin-to-skin. I had asked the doctor if we could wait to cut the cord. She said to my husband, “Do you want to cut the cord?” And I said, “Hey, can we wait a little bit?” And she just looked at me and she was like, “It's been two minutes. How long do you want to wait?”Julie: Oh my gosh. What a peach.Carly: Right? And then at that point, the placenta had found its way out. My husband cut the cord. I was just so happy that none of that stuff even mattered to me anymore. I let it all go. So that's pretty much it. To add to all of that craziness, we moved two weeks later when my baby was just born. To be finally in our house, in our own space, and to get settled in has just been amazing. We have been here for a little over a year. If it's up to me, I will never give birth at the hospital again. If I have another baby, I will absolutely pursue a homebirth. I won't give birth in a hospital again unless I absolutely have to. I have heard horror stories that are way worse than anything I have gone through.Meagan: But still, from being thrown on beds, being harassed and asked multiple times if you are doing something that you are clearly not—Carly: Exactly.Meagan: Being like, “Well, isn't that long enough?” I can understand why where you would be coming from because you haven't been treated the best. You haven't had the best experience personally.Carly: No. Yeah, no. Not at all.Meagan: Yeah.Julie: Absolutely. I understand that. That's why I had home births. It's really interesting. I was going to read a review on this episode but I couldn't find it, so I read a different one. I think I am going to read it on the next episode that we do because it is really interesting. It's actually from a labor and delivery nurse. It talks about how sometimes people who have had a previous Cesarean have an overall mistrust of hospitals, doctors, the system, interventions, and everything like that. She has a really good point because a lot of OBs and nurses really want what is best for you, but then there are experiences like this when there's just complete lack of respect. Clearly, there is a big reason why a lot of parents are learning and being taught to distrust the system. They are being pushed out of the hospital and feel like they have no other option to be respected except for having a homebirth.Now, we know that homebirth is a safe and reasonable option for low-risk parents. There have been lots of studies that have come out in recent years showing that there is no increase in safety for parents and babies for low-risk parents. Of course, there are times when it is medically necessary for both mom and baby‘s health for babies to be born in a hospital, but the overall mortality rates and health issues for low-risk women and their babies born out-of-hospital are similar between hospital and home birth. I use the word “pushed” out of a hospital system to homebirth, but a lot of parents feel that they don't have a choice to be respected except for giving birth at home. That's not good. That's not good at all. I obviously am a huge advocate for a homebirth, but I want people to feel supported where ever they choose to birth and a hospital birth should be a great option. Homebirth should be a great option too. It is a great option. Both are great as long as you have a trusted space that you feel safe in. You should absolutely feel safe wherever you give birth.The reality of our days is that a lot of women are not feeling respected and safe in a hospital birth. Now there are a lot of really incredible hospitals and really incredible providers and nurses all over the country that are working to make the space safer for birthing families, but we still have a long ways to go.Meagan: We do. We are coming there. We are slowly coming. But I also can relate. After my two C-sections, I chose a birth center birth with a midwife and I don't think I would have had the same experience the whole time, but I also think it really was a big part of my provider. My provider was someone that could be there for me all the time and I didn't have all of those different people coming in, asking me different things, and trying to do different things. It was really nice because honestly, I could hardly focus on even getting the baby out let alone anything else going on. So yeah. It's just important to have a good plan and know who you want to go to. I don't blame you at all for wanting to experience a home birth. Plus it sounds like–Julie: It sounds like you are a great candidate. I'm all for that.Meagan: Yeah. Trying to get in the icy car, traveling–Carly: All too much work.Meagan: All of that work when you probably could have just honed in and probably had a baby pretty quickly, yeah.Carly: Yeah.Meagan: Yeah. Well, thank you so much. I am so proud of you. We did. We talked about advocacy last week and everything, but I mean really, it sucks. I am sorry that you had to experience it like that, being alone. COVID just sucked. It just sucked. I hate it. I hate what it has done to so many people. We have so many emails in our inbox from people who have experienced trauma and things like that from being left alone. It was a disservice to mental health in so many ways.Carly: Yes.Meagan: I'm sorry that you had to be in that place, but I'm also really happy for you.Carly: But you know what? Thanks to you guys, you kept me informed about options and my rights so that I had the confidence to stand up for myself and be like, “No. This is what I want and I'm going to get it.”Meagan: Yeah. Yeah.Julie: We are proud of you. We are proud of you for taking the time to gain that knowledge and confidence and putting in the work because it clearly paid off. There were still a lot of things that did not go the way you wanted, but I am proud of you for taking that time and getting that confidence, and doing the work because not everybody does that. Not everybody does that.Carly: No, thank you. I feel like for most doctors and nurses in the hospital, it's routine for them. They see birth every day. They do C-sections every day. But for us, the first time I became my mom was literally a once-in-a-lifetime experience for me and I felt like that had been stepped on for so many different reasons. The second time around, I was like, “I am going to fight for this.” I had a determination. I had a fire in my belly about it. I was informed. I felt confident. I felt confident enough to walk in there and be like, “I know I have the right to say no to you,” instead of just agreeing to whatever they recommended for me. And to have that confidence was pretty empowering. I went in there feeling pretty empowered to be able to stand up for myself. And I am a people pleaser by nature. I am not one to try to ruffle any feathers or rock the boat. So for me, it was huge. It was huge to be like, “I can go in there and I can advocate for myself and my baby and not care what anybody has to say to me about it.”Julie: Yeah. Get it, girl. That's what I like to hear. We love that. I love that. That's speaking my language all day long.Meagan: Mhmm.Julie: Oh, awesome. Well again, we are really proud of you and we know that you are going to inspire a lot of people because sometimes, you just need to hear that other people do this too and that it's okay. It kind of gives you permission to do it for yourself.Carly: Mhmm, yeah. Yeah.Julie: Not that you need permission, but it feels good to know that you are not alone.Carly: Sure.Julie: You're not the first one to do this and you're not going to be the last one to do it.Carly: For sure.Julie: So we are again super grateful for you for coming on and sharing your experience with us and with everybody else who is listening right now.Carly: Yeah. Thank you so much for having me. This has been amazing. You guys are amazing. The work you do changes lives. It really does, so we appreciate what you do.Julie: Absolutely. Well, thank you so much.ClosingInterested in sharing your VBAC story on the podcast? Submit your story at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan's bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Today we chat with Cisco's head of developer content, community, and events, Michael Chenetz. We discuss everything from KubeCon to kindness and Legos! Michael delves into some of the main themes he heard from creators at KubeCon, and we discuss methods for increasing adoption of new concepts in your organization. We have a conversation about attending live conferences, COVID protocol, and COVID shaming, and then we talk about how Legos can be used in talks to demonstrate concepts. We end the conversation with a discussion about combining passions to practice creativity. We discuss our time at KubeCon in Spain (5:51) Themes Michael heard at KubeCon talking with creators (7:46) Increasing adoption of new concepts (9:27) We talk conferences, COVID shaming, and blamelessness (12:21) Legos and reliability  (18:04) Michael talks about ways to exercise creativity (23:20) Links: KubeCon October 2022: https://events.linuxfoundation.org/kubecon-cloudnativecon-north-america/ Nintendo Lego Set: https://www.amazon.com/dp/B08HVXMQ87?ref_=cm_sw_r_cp_ud_dp_ED7NVBWPR8ANGT8WNGS5 Cloud Unfiltered podcast episode featuring Julie and Jason:https://podcasts.apple.com/us/podcast/ep125-chaos-engineering-with-julie-gunderson-and-jason/id1215105578?i=1000562393884 Links Referenced: Cisco: https://www.cisco.com/ Cloud Unfiltered Podcast with Julie and Jason: https://podcasts.apple.com/us/podcast/ep125-chaos-engineering-with-julie-gunderson-and-jason/id1215105578?i=1000562393884 Cloud Unfiltered Podcast: https://www.cisco.com/c/en/us/solutions/cloud/podcasts.html Nintendo Lego: https://www.amazon.com/dp/B08HVXMQ87 TranscriptJulie: And for folks that are interested in, too, what day it is—because I think we're all still a little bit confused—it is Monday, May 24th that we are recording this episode.Jason: Uh, Julie's definitely confused on what day it is because it's actually Tuesday, [laugh] May 24th.Michael: Oh, my God. [laugh]. That's great. I love it.Julie: Welcome to Break Things on Purpose, a podcast about reliability, learning from each other, and blamelessness. In this episode, we talk to Michael Chenetz, head of developer content, community, and events at Cisco, about all of the learnings from KubeCon, the importance of being kind to each other, and of course, how Lego translates into technology.Julie: Today, we are joined by Michael Chenetz. Michael, do you want to tell us a little bit about yourself?Michael: Yeah. [laugh]. Well, first of all, thank you for having me on the show. And I'm really good at breaking things, so I guess that's why I'm asked to be here is because I'm superb at it. What I'm not so good at is, like, putting things back together.Like when I was a kid, I remember taking my dad's stereo apart; wasn't too happy about that. Wasn't very good at putting it back together. But you know, so that's just going back a little ways there. But yeah, so I work for the DevRel at Cisco and my whole responsibility is, you know, to get people to know that know a little bit about us in terms of, you know, all the developer-related topics.Julie: Well, and Jason and I had the awesome opportunity to hang out with you at KubeCon, where we got to join your Cloud Unfiltered podcast. So folks, definitely go check out that episode. We have a lot of fun. We'll put a link in the [show notes 00:02:03]. But yeah, let's talk a little bit about KubeCon. So, as of recording this episode, we all just recently traveled back from Spain, for KubeCon EU, which was… amazing. I really enjoyed being there. My first time in Spain. I got back, I can tell you, less than 24 hours ago. Michael, I think—when did you get back?Michael: So, I got back Saturday night, but my bags have not arrived yet. So, they're still traveling and they're enjoying Europe. And they should be back soon, I guess when they're when they feel like they're—you know, they should be back from vacation.Julie: [laugh].Michael: So. [laugh].Julie: Jason, how about you? When did you get home?Jason: I got home on Sunday night. So, I took the train from Valencia to Barcelona on Saturday evening, and then an early morning flight on Sunday and got home late Sunday night.Julie: And for folks that are interested in, too, what day it is—because I think we're all still a little bit confused—it is Monday, May 24th that we are recording this episode.Jason: Uh, Julie's definitely confused on what day it is because it's actually Tuesday, [laugh] May 24th.Michael: Oh, my God. [laugh]. That's great. I love it. By the way, yesterday was my birthday so I'm going to say—Julie: Happy birthday.Michael: —happy birthday to myself.Julie: Oh, my gosh, happy birthday. [laugh].Michael: Thank you [laugh].Julie: So… what is time anyway?Jason: Yeah.Michael: It's all good. It's all relative. Time is relative.Julie: Time is relative. And so, you know, tell us a little bit about—I'd love to know a little bit about why you want folks to know about, like, what is the message you try to get across?Jason: Oh, that's not the question I thought you were going to ask. I thought you were going to ask, “What's on your Amazon wishlist so people can send you birthday presents?”Julie: Yeah, let's back up. Let's do that. So, let's start with your Amazon wishlist. We know that there might be some Legos involved.Michael: Oh, my God, yeah. I mean, you just told me about a cool one, which was Optimus Prime and I just—I'm already on the website, my credit card is out and I'm ready to buy. So, you know, this is the problem with talking to you guys. [laugh]. It's definitely—you know, that's definitely on my list. So, anything that, anything music-related because obviously behind me is a lot of music equipment—I love music stuff—and anything tech. The combination of tech and music, and if you can combine Legos and that, too, man that would just match all the boxes. [laugh].Julie: Just to let you know, there's a Lego Con. Like, I did not know this until last night, actually. But it is a virtual conference.Michael: Really.Julie: Yeah. But one of the things I was looking at actually on Lego, when you look at their website, like, to request one of their speakers, to request one of their engineers as a speaker, they actually don't do that because they get so many requests for their folks to speak at conferences, they actually have a dedicated part of their website that talks about this. So, I thought that was interesting.Michael: Well listen, just because of that, if they want somebody that's in, you know, cloud computing, I'm not going to go talk for Lego. And I know they really want somebody from cloud computing talking to Lego, so, you know… it's, you know, quid pro quo there, so that's just the way it's going to work. [laugh].Julie: I want to be best friends with Lego people.Michael: [laugh]. I know, me too.Julie: I'm just going to make it a goal in life now to have one of their engineers speak at DevOpsDays Boise. It's like a challenge.Michael: It is. I accept it.Julie: [laugh]. With that, though, just on other Lego news, before we start talking about all the other things that folks may also want to hear about, there is another new Lego, which is the Van Gogh Starry Night that has been newly released by the time this episode comes out.Michael: With a free ear, right?Julie: I mean—[laugh].Michael: Is that what happens?Julie: —well played. Well, played. [laugh]. So, now you really got to spend a lot of time at KubeCon, you were just really recording podcast after podcast.Michael: Oh, my God. Yeah. So, I mean, it was great. I love—because I'm a techie, so I love tech and I love to find out origin stories of stuff. So, I love to, like, talk to these people and like, “Why did that come about? How did—” you know, “What happened in your life that made you want to do this? Who hurt you?” [laugh].And so, that's what I constantly try and figure out is, like, [laugh], “What is that?” So, it was really cool because I had, like, Jimmy Zelinskie who came from CoreOS, and he came from—you know, they create, you know, Quay and some of this other kinds of stuff. And you know, just to talk about, like, some of the operators and how they came about, and like… those were the original operators, so that was pretty cool. Varun from Tetrate was supposed to come on, and he created Istio, you know? So, there were so many of these things that I just geek out knowing about, you know?And then the other thing that was really high on our list, and it's really high from where I am, is API quality, API testing, API—so really, that's why I got in touch with you guys because I was like, “Wow, that fits in really good, you know? You guys are doing stuff that's around chaos, and you know, I think that's amazing.” So, all of this stuff is just so interesting to me. But man, it was just a whirlwind of every day just recording, and by the end that was just like, you know, “I'm so sorry, but I just, I can't talk anymore.” You know, and that was it. [laugh].Jason: I love that chatting with the creators. We had Zack Butcher on who is also from Tetrate and one of the early Istio—Michael: Yeah, yeah.Jason: Contributors. And I find it fascinating because I feel like when you chat with these folks, you start to understand the context of why things were built. And it—Michael: Yes.Jason: —it opens your brain up to, like, cool, there's a software—oh, now I know exactly why it's doing things that way, right? Like, it's just so, so eye-opening. I love it.Julie: With that, though, like, did you see any trends or any themes as you were talking to all these folks?Michael: Yeah, so a few real big trends. One is everybody wants to know about eBPF. That was the biggest thing at KubeCon, by far, was that, “We want to learn how to do this low-level kernel stuff that's really fast, that can give us all the information we need, and we don't have to use sidecars and things like that.” I mean it was—you know, that was the most excitement that I saw. OTel was another one for OpenTelemetry, which was a big one.The other thing was simplification. You know, a lot of people were looking to simplify the Kubernetes ecosystem because there's so much out there, and there's so many things that you have to learn about that it was super hard, you know, for somebody to come into it to say, “Where do I even start?” You know? So, that was a big theme was simplification.I'm trying to think. I think another one is APIs, for sure. You know, because there's this whole thing about API sprawl. And people don't know what their APIs are, people just, like—you know, I always say people can see—like, developers are lazy in a good way, and I consider myself one of them. So, what that means is that when we want to develop something, what we're going to do is we're just going to pull down the nearest API that does what we need, that has the best documentation, that has the best blog, that has the best everything.We don't know what their testing strategy is; we don't know what their security strategy is; we don't know if they use other libraries. And you have to figure that stuff out. And that's the thing that—you know, so everything around APIs is super important. And you really have to test that stuff out. Yes, people, you have to test it [laugh] and know more about it. So, those are those were the big themes, I think. [laugh].Julie: You know, I know that Kerim and I gave a talk on observability where we kind of talked more high-level about some of the overarching concepts, but folks were really excited about that. I think is was because we briefly touched on OpenTelemetry, which we should have gone into a little bit more depth, but there's only so much you can fit into a 30-minute talk, so hopefully we'll be able to talk about that more at a KubeCon in the future, we [crosstalk 00:09:54] to the selection committee.Michael: Hashtag topics?Julie: Uh-huh. [laugh]. You know, that said, though, it really did seem like a huge topic that people just wanted to learn more about. I know, too, at the Gremlin booth, a lot of folks were also interested in talking about, like, how do we just get our organization to adopt some of these concepts that we're hearing about here? And I think that was the thing that surprised me the most is I expected people to be coming up to the booth and deep-diving into very, very deep, technical-level questions, and really, a lot of it was how do we get our organization to do this? How can we increase adoption? So, that was a surprise for me.Michael: Yeah, you know what, and I would say two things to that. One is, when you talk about Chaos Engineering, I think people think it's like rocket science and people are really scared and they don't want to claim to be experts in it, so they're like, “Wow, this is, like, next-level stuff, and you know, we're really scared. You guys are the experts. I don't want to even attempt this.” And the other thing is that organizations are scared because they think that it's going to, like, create mass hysteria throughout their organization.And really, none of this is true in either way. In reality, it's a very, very scripted, very exacting stuff that you're testing, and you throw stuff out there and see what kind of response you get. So, you know, it's not this, like, you know—I think people just have—there needs to be more education around a lot of areas in cloud-native. But you know, that's one of the areas. So, I think it's really interesting there.Julie: I think so too. How about for you, Jason? Like, what was your surprise from the conference or something that maybe—Jason: Yeah, I mean, I think my surprise was mostly around just seeing people coming back, right? Because we're now I would say, six months into conferences being back as a thing, right? Like, we had re:Invent last year in Vegas; we had KubeCon last year in LA, and so, like, those are okay events. They weren't, like, back to normal. And this was, I feel like, one of the first conferences, that it really started to feel back to normal.Like, there was much better attendance, there was much more just buzz and hallway tracking and everything else that we're used to. Like, the whole reason that we go to conferences is getting together with people and hanging out and stuff, and this one has so far felt the most back-to-normal out of any event that I've been to over the past six months.Michael: Can I just talk about one thing that I think, you know, people have to get over is, you know, I see a lot online, I think it was—I forget who it was that was talking about it. But this whole idea of Covid shaming. I mean, we're going to this event, and it's like, yeah, everybody wants to get out, everybody wants to learn things, but don't shame people just because they got Covid, everybody's getting Covid, okay? That's just the point of life at this point. So, let's just, you know, let's just be nice to each other, be friendly to each other, you know? I just have to say that because I think it's a shame that people are getting shamed, you know, just for going to an event. [laugh].Julie: See, and I think that—that's an interesting—there's been a lot of conversation around this. And I don't think anybody should be Covid-shamed. Look, I think that we all took a calculated risk in coming—Michael: Absolutely.Julie: To this event. I personally gave out a lot of hugs. I hugged some of the folks that have mentioned that they have come up positive from Covid, so there's a calculated risk in going. I think there has been a little bit of pushback on maybe how some of the communication has come out around it. That said, as an organizer of a small conference with, like, 400 people, I think that these are very complicated matters. And what I really think is important is to listen to feedback from attendees and to take that.And then we're always looking to improve, right?Michael: Absolutely.Julie: If everything that we did was perfect right out of the gate, then we wouldn't have Chaos Engineering because there'd be nothing [crosstalk 00:13:45] be just perfectly reliable. And so, if we take away anything, let's take away—just like what you said, first of all, Covid, you should never shame somebody for having Covid. Like, that's not cool. It's not somebody's fault that they caught an illness.Michael: Yes.Julie: I mean unless they were licking doorknobs. And that's a whole different—Michael: Yes. [laugh]. That's a whole different thing, right there.Julie: Conversation. But when we talk about just like these questions around cultural adoption, we talk about blamelessness; we talk about learning from failure; we talked about finding ways to improve, and I think all of that can come into play. So, it'll be interesting to see how we learn and grow as we move forward. And like, thank you to re:Invent, thank you to KubeCon, thank you to DevOpsDays Boise. But these conferences that have started going back in-person, at great risk to organizers and the committee because people are going to be mad, one way or the other.Michael: Yeah. And you can see that people want to be back because it was huge, you know?Julie: Yeah.Michael: Maybe you guys, I'm going to put in a feature request for Gremlin to chaos engineer crowds. Can we do that so we can figure out, like, what's going to happen when we have these big events? Can we do that?Julie: I mean, that sounds fun. I think what's going to happen is there's going to be hugs, there's going to be people getting sick, but there's going to be people learning and growing.Michael: Yes.Julie: And ultimately, I just think that we have to remember that just, like, our systems aren't perfect, and neither are people. Like, the fact that we expect people to be perfect, and maybe we should just keep some mask mandates for a little bit longer when we're at conferences with 8000 people.Michael: Sure.Julie: I mean, that's—Michael: That makes sense.Jason: Yeah. I mean, it's all about risk management, right? This is, essentially what we do in SRE is there's always a risk of a massive outage, and so it's that balance of, right, do what you can, but ultimately, that's why we have SLOs and things is, you can never be a hundred percent, so like, where do we draw the line of here are the things that we're going to do to help manage this risk, but you can never shoot for a perfectly, entirely safe space, right? Because then we'd all be having conferences in padded rooms, and not touching each other, and things like that. There's a balance there.And I think we're all just trying to find that, so yeah, as you mentioned, that whole, like, DevOps blamelessness thing, you know, treat each other with the notion that we're all trying to get through this together and do what we think is best. Nobody's just like John Allspaw said, you know, “Nobody goes to work thinking that, like, their intent is to crash everything and destroy the company.” No one's going to KubeCon or any of these conferences thinking, “Yeah, I'm going to be a super-spreader.”Julie: [laugh].Michael: Yeah, that would be [crosstalk 00:16:22].Jason: Like, everyone's trying not to do it. They're doing their best. They're not actively, like, aggressively trying to get you sick or intentionally about it. But you know—so just be kind to one another.Michael: Yeah. And that's the key.Julie: It is.Michael: The key. Be kind to one another, you know? I mean, it's a great community. People are really nice, so, you know, let's keep that up. I think that's something special about the, you know, the community around KubeCon, specifically.Julie: As we can refine this and find ways, I would take all of the hugs over virtual conferences—Michael: Yes.Julie: Any day now. Because, as Jason mentioned, is even just with you, Michael, the time we got to spend with you, or the time I kept going up to Jfrog's booth and Baruch and I would have conversations as he made me a delicious coffee, these hallway tracks, these conversations, that's what no one figured out how to recreate during the virtual events—Michael: Absolutely.Julie: —and it's just not possible, right?Michael: Yeah. I mean, I think it would take a little bit of VR and then maybe some, like, suit that you wear in order to feel the hug. And, you know, so it would take a lot more in order to do that. I mean, I guess it's technologically possible. I don't know if the graphics are there yet, so it might be like a pixelated version, like, you know, like, NES-style, or something like that. But it could look pretty cool. [laugh]. So, we'll have to see, you know?Julie: Everybody listening to this episode, I hope you're getting as much of a kick out of it as we are recording it because I mean, there are so many different topics here. One of the things that Michael and I bonded about years ago, for our listeners that are—not years ago; months ago. Again, what is time?Michael: Yeah. What is time? It's all relative.Julie: It is. It was Lego, though, and so we've been talking about that. But Michael, you asked a great question when we were recording with you, which is, like—Michael: Wow.Julie: Can—just one. Only one great question.Michael: [laugh].Julie: [laugh]. Which was, how would you incorporate Lego into a talk? And, like, when we look at our systems breaking and all of that, I've really been thinking about that and how to make our systems more reliable. And here's one of the things I really wanted to clarify that answer. I kind of went… I went talking about my Lego that I build, like, my Optim—not my Optimus Primes, I don't have it, but my Voltron or my Nintendo Lego. And those are all box sets.Michael: Yep.Julie: But one of the things if you're not playing with a box set with instruction, if you're just playing with just the—or excuse me, architecting with just the Lego blocks because it's not playing because we're adults now, I think.Michael: Yes, now it's architecting. Yes.Julie: Yes, now that we're architecting, like, that's one of the things that I was really thinking about this, and I think that it would make something really fun to talk about is how you're building upon each layer and you're testing out these new connection pieces. And then that really goes into, like, when we get into Technics, into dependencies because if you forget that one little one-inch plastic piece that goes from the one to the other, then your whole Lego can fall apart. So anyway, I just thought that was really interesting, and I'd wondered if you or Jason even gave that any more thought, or if it was just fleeting for you.Michael: It was definitely fleeting for me, but I will give it some more thought, you know? But you know, when—as you're saying that though, I'm thinking these Lego pieces really need names because you're like that little two-inch Lego piece that kind of connects this and this, like, we got to give these all names so that people can know, that's x-54 that's—that you're putting between x-53 and x-52. I don't know but you need some kind of name for these parts now.Julie: There are Lego names. You just Google it. There are actual names for all of the parts but—Michael: Wow. [laugh].Julie: Like, Jason, what do you think? I know you've got [unintelligible 00:19:59].Jason: Yeah, I mean, I think it's interesting because I am one of those, like, freeform folks, right? You know, my standard practice when I was growing up with Legos was you build the thing that you bought once and then you immediately, like, tear it apart, and you build whatever the hell you want.Michael: Absolutely.Jason: So, I think that that's kind of an interesting thing as we think about our systems and stuff, right? Like, part of it is, like, yeah, there's best practices and various companies will publish, like, you know, “Here's how to architect such-and-such system.” And it's interesting because that's just not reality, right? You're not going to go and take, like, the Amazon CloudFormation thing, and like, congrats, you're done. You know, you just implement that and your job's done; you just kick back for the rest of the week.It never works that way, right? You're taking these little bits of, like, cool, I might have, like, set that up once just to see what's happening but then you immediately, like, deconstruct it, and you take the knowledge of what you learned in those building blocks, and you, like, go and remix it to build the thing that you actually need to build.Michael: But yeah, I mean, that's exactly—so you know, Legos is what got me interested in that as a kid, but when you look at, you know, cloud services and things like that, there's so many different ways to combine things and so many different ways to, like—you know, you could use Terraform, you could use Crossplane, you could use, you know, any of the services in the cloud, you could use FaaS, you could use serverless, you could use, you know, all these different kinds of solutions and tie them together. So, there's so much choice, and what Lego teaches you is that, embrace the choice. Figure out and embrace the different pieces, embrace all the different things that you have and what the art of possibility is, and then start to build on that. So, I think it's a really good thing. And that's why there's so much correlation between, like, kind of, art and tech and things like that because that's the kind of mentality that you need in order to be really successful in tech.Jason: And I think the other thing that works really well with what you said is, as you're playing with Legos, you start to learn these hacks, right? Like, I don't have, like, a four-by-one brick, but I know that if I have three four-by-one flats, I can stack those three and it's the same height as a brick, right?Michael: Yep.Jason: And you can start combining things. And I love that engineering mentality of, like, I have this problem that I need to solve, I have a limited toolbox for whatever constraints, right, and understanding those constraints, and then cool, how can I remix what I've got in my toolbox to get this thing done?Michael: And that's a thing that I'm always doing. Like, when I used to do a lot of development, you know, it was always like, what is the right code? Or what is the library that's going to solve my problem? Or what is the API that's going to solve my problem, you know?And there's so many different ways to do it. I mean, so many people are afraid of, like, making the wrong choice, when really in programming, there is no wrong choice. It's all about how you want to do it and what makes sense to you, you know? There might be better options in formatting and in the way that you kind of, you know, format that code together and put them in different libraries and things like that, but making choices on, like, APIs and things like that, that's all up to the artist. I would say that's an artist. [laugh]. So, you know, I think it all stems though, when you go back from, you know, just being creative with things… so creativity is king.Jason: So Michael, how do you exercise your creativity, then? How do you keep up that creativity?Michael: Yeah, so there's multiple ways. And that's a great segment because one of the things that I really enjoy—so you know, I like development, but I'm also a people person. And I like product management, but I also like dealing with people. So really, to me, it's about how do I relate products, how do I relate solutions, how do I talk to people about solutions that people can understand? And that's a creative process.Like, what is the right media? What is the right demos? What is the right—you know, what do people need? And what do people need to, kind of, embrace things? And to me, that's a really creative medium to me, and I love it.So, I love that I can use my technical, I love that I can use my artistic, I love that I can use, you know, all these pieces all at once. And sometimes maybe I'll play guitar and just put it in the intro or something, I don't know. So, that kind of combines that together, too. So, we'll figure that piece out later. Maybe nobody wants to hear me play guitar, that's fine, too. [laugh].But I love to be able to use, you know, both sides of my brain to do these creative aspects. So, that's really what does it. And then sometimes I'll program again and I'll find the need, and I'll say, “Hey, look, you know, I realized there's a need for this,” just like a lot of those creators are. But I haven't created anything cool, but you know, maybe someday I will. I feel like it's just been in between all those different intersections that's really cool.Jason: I love the electric guitar stuff that you mentioned. So, for folks who are listening to this show, during our recording of the Cloud Unfiltered you were talking about bringing that art and technical together with electric guitars, and you've been building electric guitar pickups.Michael: Yes. Yeah. So, I mean, I love anything that can combine my music passion with tech, so I have a CNC machine back here that winds pickups and it does it automatically. So, I can say, “Hey, I need a 57 pickup, you know, whatever it is,” and it'll wind it to that exact spec.But that's not the only thing I do. I mean, I used to design control surfaces for artists that were a big band, and I really can't—a lot of them I can't mention because we're under NDA. But I designed a lot of these big, you know, control surfaces for a lot of the big electronic and rock bands that are out there. I taught people how to use Max for Live, which is an artist's, kind of, programming language that's graphical, so [NMax 00:25:33] and MSP and all that kind of stuff. So, I really, really like to combine that.Nowadays, you know, I'm talking about doing some kind of events that may be combined tech, with art. So, maybe doing things like Algorave, and you know, things that are live-coding music and an art. So, being able to combine all these things together, I love that. That's my ultimate passion.Jason: That is super cool.Julie: I think we have learned quite a bit on this episode of Break Things on Purpose, first of all, from the guy who said he hasn't created much—because you did say that, which I'm going to call you out on that because you just gave a long list of things that you created. And I think we need to remember that we're all creators in our own way, so it's very important to remember that. But I think that right now we've created a couple of options for talks in the future, whether or not it's with Lego, or guitar pickups.Michael: Yeah.Julie: Is that—Michael: Hey—Julie: Because I—Michael: Yeah, why not?Julie: —know you do kind of explain that a little bit to me as well when I was there. So, Michael, this has just been amazing having you. We're going to put a lot of links in the notes for everybody today. So, to Michael's podcast, to some Lego, and to anything else Michael wants to share with us as well. Oh, real quick, is there anything you want to leave our listeners with other than that? You know, are you looking to hire Cisco? Is there anything you wanted to share with us?Michael: Yeah, I mean, we're always looking for great people at Cisco, but the biggest thing I'd say is, just realize that we are doing stuff around cloud-native, we're not just network. And I think that's something to note there. But you know, I just love being on the show with you guys. I love doing anything with you guys. You guys are awesome, you know. So.Julie: You're great too, and I think we'll probably do more stuff, all of us together, in the future. And with that, I just want to thank everybody for joining us today.Michael: Thank you. Thanks so much. Thanks for having me.Jason: For links to all the information mentioned, visit our website at gremlin.com/podcast. If you liked this episode, subscribe to the Break Things on Purpose podcast on Spotify, Apple Podcasts, or your favorite podcast platform. Our theme song is called, “Battle of Pogs” by Komiku, and it's available on loyaltyfreakmusic.com.

Moana's first birth left her feeling traumatized, confused, and like a failure. With her next pregnancy, she was determined to find redemption. She became educated on all of the risks and benefits surrounding VBAC, hired a highly supportive birth team, and affirmed to herself that she could do this.Thanks to her preparation, Moana was able to adapt and utilize the birth tools she needed to achieve the beautiful VBAC she desired. We talk about how to build your own “birth toolbox” and why it's important to allow yourself to use those tools as you need them. And as always, we fully support you in whatever tools you choose to use to have your positive birth experience!Additional linksThe Swiss Army Knife of LaborThe VBAC Link Blog: Natural Birth versus EpiduralFind a VBAC DoulaHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Hello, hello everybody. It's Meagan and Julie. We are back with you today for episode number two of our return and episode number 183. We have Moana today and we cannot wait to get into her story. A little funny thing— I'm totally going to admit what just happened. We went through everything, and we were getting into the story, and guess what? We forgot to push “Record”. So darn it!Julie: My bad.Meagan: We are restarting, but that's okay. We are excited. We have Moana with you today. She is from Hawai'i and she is one amazing mama. You guys, she had a 72 hour labor. I'm just going to say that. How stinking amazing! She is a military wife. She is in the Reserves. They have two kiddos. They love being in the sun, and surfing, and living life up in Hawai'i. We can't wait to hear her stories in just a second. Review of the Week Meagan: We're going to hurry and turn over the time to Julie because as usual, we are going to have that Review of the Week. We really love your reviews and now that we're kicking the podcast off again, we're going to need some more. So feel free to drop us a review on Google or send us a review, whatever it may be. We would love, love, love to read your review on the podcast. Alright, Julie.Julie: Oh my gosh. I am such a nerd. I cannot believe it. I am going to have to put a sticky note in the middle of the computer again and be like, “Push ‘Record'!” so I don't forget.Second of all, Meagan, you say Hawai'i like, “Ha-WHY. She's from Ha-WHY.”Meagan: Ha-waii. I don't say, “Hawai'i.”Julie: Oh, so funny.Meagan: I know. I don't say it correctly. I don't even know.Julie: It's funny. Okay. Oh my gosh. I need to stop talking, so I'll just read this review and then we can have Moana start her story again. Oh my gosh. So, so sorry. Alright.Okay, so this review is from hnp1213 on Apple Podcasts and she says “So thankful. As I prepare for my HBAC this coming September, this podcast has helped me heal so much from my previous C-section. I've laughed, I've cried, and I've celebrated with so many of their stories. Thank you for creating an uplifting and empowering podcast for those of us looking for our redemption birth.”No thank you, hnp1213, and thank you, Meagan and Moana, for being patient with me while we have to restart this over. Alright.Moana's storyMeagan: Okay, Moana. We want to dive back into your story because it's a great one.Moana: Alright. So my husband and I got married in 2016. I was 22 and he was 23. We waited about three years to have a baby and I didn't realize I was pregnant for a while. I was just kind of feeling sick at work and this guy actually told me, “Hey, I think you're pregnant.” I was like, “No, no. There's no way.” So I went and took a test and sure enough, two lines came up right away. It was super dark and I was like, “Oh, wow. I must not be early.”So I scheduled an appointment with my provider and sure enough, I was eight weeks along already. That was pretty exciting. My husband actually wasn't even home at the time. I had to video call him. He was in the Middle East. I was like, “Hey, are you ready to be a dad?” And he was like, “Yeah, I guess.” I'm like, “No, I mean right now.” I showed him my test and he was like, “What?” Yeah.Meagan: “No, I mean right now!” That is awesome. “No, I mean you're gonna be a dad so let me rephrase that.”Moana: Right, yep.Meagan: I love it. That's awesome.Moana: Yeah. So yeah. He was super excited. I was just chugging along, had to keep going to work and I was super sick– puking all of the time, day and night. I was like, “Oh, I guess I know the baby is okay because my hormones are strong.”Meagan: Yeah.Moana: Up until the first and second trimester. Finally in the third trimester, I had just started to feel better, but then I just started to feel big, so one traded off for the other.Meagan: Mhmm.Moana: Yep. I made it all the way to 40 weeks and my provider was like, “Hey, I want to do an induction today.” I was like, “No. I don't think I want to do that,” and she was pretty pushy about it. I told her, “Hey, the baby is fine and it's just an estimated due date, you know? Maybe they didn't even get it right.” She wasn't too happy about that, so she said she was going to schedule an induction for 41 weeks. I told her, “Okay, but I am probably not going to go to the hospital and do it that day either.” So 41 weeks came and yeah. I told her, “No. I really don't want to induce,” and she wasn't too happy about it, but I just went home anyway. About three days later, I finally went into labor.I went to work that day. I just had contractions on and off. I tried to walk around a lot. I went home that night and they started getting stronger, but then they stayed about five minutes apart for a few hours. So I called my doctor and told her, “Hey. My progression doesn't feel normal. What do you think?” She told me to go into the hospital. We got there at about 11:00 p.m. and I was only a centimeter and a half dilated, but she said she didn't want me to leave because I was so far along in my pregnancy, which I didn't really understand because I know from most people that if you are not about 5-6 centimeters, they usually turn you away.So we just labored, my husband and I, together in the hospital and no one really helped us out, or gave us any tips, or anything. We had no idea what we were doing. We were just like, “Oh, you know, everyone has babies. It just happens. Whatever.” Meagan: That's kind of how I approached my birth too. I was like, “Well, I don't know. People have babies every day, so I'm just going to go have a baby, right?”Moana: Right. Exactly. So yeah. We just kind of walked around prayed. We tried to use the birth ball. It is a teaching hospital too, so they were like, “Oh, can students come in?” And I was like, “Sure, I guess. I don't know if they just want to see me in pain or whatever.” And so I kept laboring until the next day. I only got to about 5 centimeters and my contractions had gotten a little bit closer together, but I was just really in a lot of pain and it was really getting hard for me to cope. I would come to find out later it was because he was turning from sunny-side up back over and apparently, that's pretty painful– almost like transition type level of pain when you are going through that.But at the time, I had no idea. I was just like, “Oh man. This is getting crazy.” I got an epidural and then about an hour later, it failed. My baby's heart rate was crashing every time I had a contraction– really, really low and then it would come back up, but they were getting really worried. They called my doctor on the phone and she was like, “Okay. I am going to come in. We are going to do a C-section.” I was like, “No, no. I don't want that if I don't need it.” I really didn't understand what was going on. They didn't really explain if it was really dangerous for the baby or for me or anything like that. About thirty minutes to an hour went by and then his heart rate just crashed completely, so they just ripped us out of the room. They rushed us to the OR. I had no idea what was going on. I was looking at my husband who was just kind of standing there because they didn't tell him to come or anything. They were just moving super fast. I think from the time his heart crashed to them getting him out was about 12 minutes.It was just so shocking. I could feel the hands inside of me. I remember I kept asking, “Is my baby okay? Is my baby okay?” and they wouldn't answer me. I was crying and it was just this huge mess. I was just in so much shock. Thankfully, I heard him cry when they took him out and they had let my husband come in. I remember looking at him and looking at the baby. I was happy in my heart, but outwardly, I was in so much pain, and shock, and all of this stuff, that all I could do was just kind of moan and cry, and then I ended up passing out for a little bit.My husband got to help cut the rest of his cord off since they had to cut it right there at the table. I woke up a few hours later and I was just so upset that I didn't get to hold my baby right away, and feed him, and do all of the stuff. I was so out of it still that I couldn't really speak for a while, but I was able to hold him. So they handed him to me and I didn't actually know he was a boy. We waited to find out, so that was a nice surprise after all this trauma went down.Julie: Oh, how fun.Moana: Yeah. And he was really good. He nursed right away and our postpartum was really great. I couldn't have asked for a better baby. He was super calm and he nursed really well. We were just so happy. He was finally here.My doctor, though, was telling me, “Oh, do you guys want to leave today? You are taking a room for other patients,” but when we had walked around the wing, there were plenty of other open rooms. I don't know why she was really pushy to get me out of the hospital, but I told her, I was like, “Oh, no. I don't feel all that ready. I am still in a lot of pain. I can barely walk.” She was like, “Well, why don't you just take the narcotics?” I told her, “No. I don't want to do that. I will take Tylenol and Motrin, but I really don't want to take anything stronger because of the way I reacted to the anesthesia.” So I told her, I was like, “Hey, just give us another day.” And so actually, the baby‘s pediatrician wrote up something on his chart so that we had a reason to stay one more day. But yeah, my doctor was fairly pushy and she made us feel bad. She was like, “Are you scared to go home or something like that?” That made my husband pretty mad too.Julie: Interesting.Moana: We were like, “No. I'm just not physically recovered enough yet,” because it was pretty violent when they had to pull him out. He had already descended a bit, so they actually had to pull him back out first and then get him up and out. So yeah. But anyway, so that was our first birth. Like I said, thankfully, postpartum was really great, but I knew I never, ever wanted to have a C-section again after that. So I was like, “Okay. I am going to get informed this time. I am going to read all of this stuff.” I found your guys' podcast and it was really awesome listening to everyone's birth stories, and just really getting educated on your options, and body, and all this stuff. I actually hired a midwife to go over my chart with me because I needed closure on my first birth because I really still didn't understand what happened and why I had a C-section, so she went over everything with me. She actually told me, “Hey. You had a placental abruption.” My doctor never even talked to me about that or said that that had happened. I always thought I did something wrong and that was why it happened. But she said, “Oh, no. You can't really prevent these or predict it and you were hemorrhaging, so the crash C-section had to happen.” So that gave me a lot of closure on that and she said, “You know, you are a really good candidate for a VBAC.”That really made me super excited. I just was like, “Okay. I want to do this.” I ended up getting pregnant again at 14 months postpartum which was great because I knew right away. I was so excited, like, “Okay. I am going to really get prepared for my VBAC this time.” I was sick again for the first two trimesters, but then in the third trimester, I felt really good and I was working out all the time. I hired a doula from Best Birth Hawaii and she was really great. She just gave me so much comfort and extra knowledge, and it was just so nice to feel like I had someone on my side who could speak up for me. I also had changed providers at this time too and he had done hundreds of VBACs before, so I just went into this birth super confident. I just knew, “Hey, I am going to do this and I know I can do it.”I went into labor at 39 weeks and 3 days and I was super excited for that too because I was like, “Man, I really don't want to go past 40 weeks. I hope this baby can come early.” So yeah. It was a Wednesday and I started early labor. It was kind of slow at first, so I just tried to take the time to relax and maybe get a nap in. It really became hard to sleep that night though, and so I just kept trying to do what I could– walking around, kept moving and resting on Thursday. Then Friday, my doula finally came to the house and she helped me through a lot of active labor. At about 3:00 p.m. that Friday, we were like, “Okay. I think it's time to go to the hospital.” So we were super excited. My husband and I made it to the hospital. We labored some more, but eventually, I was in so much pain and I hadn't slept, so I just needed to get some rest. I said, “Okay. Let's try an epidural.” I got it and then it was really weird. I felt a click in my back and I got really scared that they did something wrong because my leg twitched too and it didn't really work. It took the edge off, but I could still move. They were like, “Oh, what happened?” I was like, “Oh, I am not really sure,” but I finally got a nap in. I kept moving around and I was like, “Oh, I think it failed,” and then all the pain came back. I labored a few more hours like that and then we tried a second one. Now I was about 8 centimeters dilated. That one only worked for about an hour and it failed too. We were pressing the button and I'm like, “I don't know why it's not working.”Julie: Oh my gosh.Moana: Yeah. So that was pretty crazy. I was really confused and I was so tired. I was like, “Man, I am so jealous of women who have two-hour labors or even eight-hour labors,” You know? I was like, “Oh.” My doula was like, “Don't think about that.” And I'm like, “Okay. I guess I am getting the natural delivery that I wanted,” because, in my heart, I was like, “Man. I just want to be able to do it without interventions and without pain relief,” so I guess that ended up happening in the end. So I started having them help me move around a little bit, lay on my side with the peanut ball, and then I got the squat bar, and we were just doing all the things that we could with the limitation from having the epidural even though it wasn't working anymore. By the time it came to push, I was like, “Man, I am in so much pain. I am just going to get this baby out.” In less than seven minutes of pushing, he came out. Again, we didn't know it was a boy, actually. So that was another nice surprise.I pushed, pushed, and pushed as hard as I could, and then I got him out. I just felt so much relief and excitement. I was bawling and I cried so hard. My husband was like, “It's a boy! It's a boy!”  I reached down to grab him up and he made a few little cries and nursed right away, and we had the skin-to-skin contact. It was just so redeeming and beautiful. Oh, I just want to cry thinking about it. But yeah. I was just so amazed that I was able to do it and now I know that my body can do it. And yeah. I couldn't believe that it actually happened. And so now, I'm about 11 months postpartum and still breastfeeding. Actually, my first baby never stopped breastfeeding, so I'm trying to wean him right now because he's almost three. I plan to wean the second one by no later than two years old. But we are hoping to have more kids so I'm just excited to be able to hopefully have another VBAC and just continue our journey, and keep being informed, and telling other people too like my friends who are having babies now and stuff like, “You can do it. You don't have to be afraid of anything.” There's so much information out there. I think even the medical world is changing too. VBACs are becoming more okay. They're not turning away from it. More people are saying now, “Hey. This is good. It's less risk for a mom in most cases.” So that's just our crazy, traumatic story followed by a long, long labor and thankfully, we ended with a successful VBAC. Julie: Yeah. I love that. Oh my gosh. Such a great story. I love how patient you were in not finding out the gender of your babies! Oh my gosh. Like, I tried. I tried. Or I guess I didn't really try at all. I am a sucker and I'm impatient. And so I'm not very good at waiting to know. I wanted to wait for my last, but I could not hold out. I didn't even make it to 20 weeks before I had to run and make it to my gender scan. Let's be honest. But I think that is so, so fun.To Epidural or Not to Epidural?I want to talk a little bit about epidurals and why I think sometimes it's really easy for people to think– especially when you're going in and planning for a VBAC, and you want to do everything you can in order to set yourself up for success, and everybody's telling you, “Oh my gosh. Hire a doula. Have an unmedicated birth. Make sure you don't go to the hospital until you're pushing. Make sure you don't get induced. Make sure you don't do this. Don't do that. Don't do this. Don't do that. And this.” Right?There are so many things telling you what not to do. It's really important to remember that nothing is inherently good or inherently bad. All interventions have an appropriate time and place and even having no interventions can turn out to not be a good thing. And so I want to talk a little bit about epidurals. I think, oh my gosh. I don't even know how long ago, but it was a while ago in our Facebook group. I did a video or a Facebook Live in our Facebook group about– I called it, “The Swiss Army Knife of Birth.” Maybe you can go to our Facebook group. It's called The VBAC Link Community and you could do a search for it. I think it's maybe just referred to as “The Swiss Army Knife of Birth” or something like that. “Coping Tools for Labor”, I'm not sure exactly. Maybe I'll link it in the show notes. I'm probably going to have to link it in the show notes as I've been talking about it. But it talks about having a little tool kit of just a bunch of different random things that you might need to have available for you when you're in labor. An epidural might be one of the things you want to have available for you in your toolkit for coping with the discomforts of labor and it's neither inherently good nor inherently bad. Being able to have something available for you to make a decision like the acronym, “B.R.A.I.N.”-- so using the Benefits, the Risks, Alternatives, your Intuition, and what happens if you do Nothing– to go through at the time to make a decision.Meagan: Hey, can you help me clean up your room? Sorry, guys. Sorry. Sorry.Julie: Meagan! You are not on mute! Meagan: I'm sorry! No, I'm not. I didn't know. I was like, “Hey. Clean up your room!” I'm even whispering. Okay, sorry. Julie: Mute yourself, girl. Meagan: I'm muted. Well, now I am. Julie: No, you're not. Now you are. Okay. Oh my gosh, what was I saying? So epidural has risks and benefits like every other coping tool in labor. Benefits of an epidural– I'm sure Meagan has seen the same as me. Sometimes, we see epidurals relax mom enough to where she progresses, and is able to dilate further, and push her baby out relatively quickly. Sometimes, not quickly. Sometimes, it takes a little while longer.Meagan: Yeah. Julie: But it's exactly what the laboring person needs in order for the body to progress further because let's be honest. If you've been laboring for a really long time, your body's completely exhausted. It's not going to labor effectively. Meagan: Well, and something else, too, I was going to mention, Julie. Sorry to cut you off–Julie: Yeah. No, go ahead. Megan: Not only physically, but sometimes when we get an epidural, it's also so our mind can emotionally be present because sometimes when we're laboring, especially for a long time, it's like, “I don't know how much longer I can do this. If this is hard now, is it going to get harder?” Our minds keep going to the future and things like that. It's so great to get that epidural sometimes and just let your mind shut off and be present, and then your body can just do its job. Julie: Yeah, that's a really good point. That's a very good point. I've seen that before as well myself. We've also seen epidurals really limit how much a parent is able to move while they're in labor and also how much, sometimes, hospital staff is willing to be able to let the parent move. Sometimes, it can change the entire mood of the room at that point. Also, I've seen it affect the mind negatively. If a parent is really, really set on having an unmedicated birth without an epidural, it can give them the feeling of, “Oh no. I gave up. I didn't achieve this goal that I had in mind.” And so being able to go into birth instead of with a specific set of things you want to accomplish, but having it be a little more fluid and flexible, and being willing to adjust your goals as necessary, I think, is really important as well. One little thing that might not go to your expectations has the possibility to shift your entire mindset and mood. It is so important to be able to keep your hormones balanced and everything to go well as well. So I don't know. Meagan, what would you add about epidurals? Meagan: I feel like there's so much shame in epidural and also like, “Oh, if I get an epidural, I'm giving up. I'm failing.” There's just so much and I don't like it. I don't like it at all. I think that epidurals have a bad rap and yes, are there some serious pros to going unmedicated? Yeah, there are. There are some great pros. But there are also some serious pros of having an epidural, and enjoying the experience, and getting the rest, and also letting your body progress the way it may not be able to at that moment unmedicated. So I hope that if you are preparing for a VBAC or for birth in general, try not to put so much negative–Julie: PressureMeagan: Negative pressure, yeah, when it comes to an epidural because it is okay. It is okay to have an epidural. Like we said, it can be the magic tool in your toolbox. We have lots of tools in our toolbox. Whether we use them or not, they're there and it's okay to use them.There's never been a time where I've tried to use a screwdriver when I need an Allen wrench on my bike, right? I need to raise my seat up and I need an Allen wrench. I don't need a screwdriver. There are different tools for different situations and for birth, an epidural is a great tool that is in the toolbox and it's okay to use it. Julie: Absolutely. Absolutely, yep. And of course, we have a blog all about natural birth and epidural, and comparing both of those things. Like Moana said, her epidural had a hard time getting it to work and that is one of the risks that can come along with an epidural. Sometimes, it doesn't work all the way or right off the bat. You might need to have an anesthesiologist come and make some adjustments, so you might need to be careful with that. But let me tell you, when I first started out as a doula, I was kind of like, really gungho, 100%, unmedicated birth all the way, that's the only way to do this, but man, life has a way of teaching you lessons. And every once in a while, I'll have a client look at me in the eyes and look at me and be like, “I think I need an epidural. I feel, like–” Oh my gosh. They almost feel like they need permission to get one. Does that make sense? Meagan, do you know what I'm talking about?Meagan: Totally. Totally. Yes, it does. They ask. Julie: Like, letting me down if they get one?Meagan: Yeah. There was actually a birth that I was at and the epidural came into my mind. It kind of went from–Julie: But you don't also want to be the first one to bring it up either, right?Meagan: I know, but I did. I did. It was suffering. It went to suffering. She was suffering and one of the biggest things she said when we talked about her goals was to have a positive experience. And when you are past that point, you're not going to have a positive experience. You're just not. Julie: Yeah. It could lead to more birth trauma and that could introduce that. Meagan: Totally. Totally. So I just said, “Hey. Why don't we talk about some options right now?” And we went over it and I did say epidural. She said, “I've been wanting someone to say that for the last four hours.” She said, “I didn't feel I could. I didn't feel I could.” And the fact that you just said that makes me think, “Okay. It's okay.” And I'm like, “No. It's totally okay.” You know? It's totally okay, but she didn't feel that that was okay because her goal was to not. Julie: Mhmm. Meagan: It was to not, but it's okay. Julie: It's okay to change plans. Meagan: It's okay to change plans. It's okay to adapt. Julie: And it's okay to just go into your birth wanting an epidural from the start. It is okay to do that too. Meagan: Yes. Yeah. So, I love Moana's story. I can't say enough about, “Hey. It's okay. Don't let it get you down if you get an epidural and you didn't want one.”Julie: But it's also okay to want a completely unmedicated birth and it's also okay to have one. I mean, both Meagan and I have had unmedicated VBACs, but we've also seen the beauty in all types of birth stories no matter how they unfold and no matter what the outcome is. We support you in however you want to birth. Meagan: Yeah. Yeah. Oh, Moana. Thank you so much. Moana: Yeah. Thank you, guys. I appreciate the opportunity to tell my story. Thanks for all you guys do. I mean, if I didn't find this podcast, I don't know if I would have been as confident going in. And like you guys said, knowing that it's okay to want an epidural because I really did feel like that during my first birth. Even my husband kind of made me feel guilty about it and some of our family, and I really felt like I failed at that point. And just knowing that it was okay going into my second birth, I'm like, “Okay. If it gets to that point, I'm not going to feel bad about that. I'm just going to do it.” That just took one element of stress away from the birthing process. Meagan. Yeah. Yeah. Moana's VBAC Prep TipJulie: Yeah. I love that. Moana, you know we can't let you leave without us asking you one question. What is your best tip for somebody as they are preparing to birth after a Cesarean?Moana: I would say definitely get educated and hire a doula if you can because she just instilled so much confidence in me. Even though maybe I didn't need her there or maybe I did, just emotionally for me, it was so necessary. I told her right afterward when I had my second one that, “I could not have done this without you. You just gave me something that I would have never been able to do myself.” Especially because of my trauma from my first birth, even though I had coped with it, I still just didn't have the confidence that I had when she was there with me. Julie: I love that. Get educated and hire a doula, and wouldn't you know? We have opportunities to do both on our website, thevbaclink.com. We have a VBAC preparation course that is designed to help you gain the full confidence that you need in order to have all of the tools in your toolkit on your birthing day. We also have a directory of VBAC doulas that we have educated on all of the things that you never nuded?Meagan: –that you'd never know you'd need.Julie: We have a directory of VBAC doulas fully trained and educated to perfectly support you on your birthing day. You can find our VBAC doulas at thevbaclink.com/findadoula. Everything you need you can find right on our website, thevbaclink.com. We'll see you there. ClosingWould you like to be a guest on the podcast? Tell us about your experience on thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan's bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

After a LONG break, The VBAC Link podcast is back again! We have missed hearing your stories and feeling inspired by your strength. We promise that you will smile, cry, and celebrate with Francis as she shares her beautiful heart with us today. While pregnant with her hopeful VBA2C baby, Francis created these birth goals:“I wish for a healthy mother and baby, both physically and emotionally. For my intuition to guide me and to be trusted by those around me. For labor to begin and continue as hands-off as possible and to feel heard, empowered, and respected.”She strived for an empowering birth experience no matter what the outcome was, which only made her successful VBA2C that much sweeter. We also discuss why you shouldn't be afraid to birth a big baby and how your intuition can be your greatest asset in the birth room.   Additional linksThe VBAC Link Blog: Get That Big Baby OutThe VBAC Link Shirt ShopThe VBAC Link on Apple PodcastsHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words.  Julie: Welcome to The VBAC Link podcast. We have Francis with us today. And my gosh! I did not sing. I was going to sing a song, “Guess who's back, back again?” Oh, yes. I was going to sing it. I was going to sing it, but I did not sing it. Meagan: Guess who's back? Julie: Back again. Meagan: Oh, I love it. Julie: Julie's back. And Meagan! Meagan: Yeah! Julie: Dang it. I sang it. Gosh. The only other time I have sang on the podcast was when I sang myself “Happy Birthday” for me in Korean on my birthday episode. That was fun. Do you remember that? Meagan: Yeah, that was forever ago. Julie: That was super fun. Julie: Oh my gosh. We are back! Meagan: We're back! Julie: It's been a while. Meagan: Yes it has. Julie: Holy cow. Meagan: We have had a lot going on, but it feels good. It feels really good. It feels a little weird and out of sync, but I am excited to be back. I'm sitting here. I'm so excited to have guests again. I'm excited to be with you. It's going to be great. Julie: Wow. So much has happened since we aired our last episode. Do you want to just kind of give a couple little things about what you have been up to and I'll do the same, and then we will get into our story? Meagan: Yeah. My life is always crazy with children. What have I been up to? Gymnastics meets, soccer games, working on children's mental health. COVID impacted my kids more than I ever even realized. And so, working with kids and their mental health, getting ready to move– a sporadic, spontaneous move. Yeah. Working with my husband, just letting him work, doing doula stuff for my doula business, hiring new doulas. It's been a lot but it's been great. Julie: Yeah. Holy cow. I know all that already and I am starting to feel a little bit overwhelmed for you. Kind of the same for me, keeping up with kids. My oldest has had some mental and physical health struggles as well, and so lots of things going on for him, and soccer, and gymnastics. My oldest two boys are doing bouldering classes, so learning how to climb big rocks. Meagan: That's awesome. Julie: I know. It's super fun. Super fun for them. And I actually have shifted in my role in the birth work field and I am a birth photographer now. So still a little bit of doula-ing, but birth photography mostly and that's been really fun. I really love it a lot. Meagan: And you're great. You're so great at it too. Julie: Thank you. Thank you, thank you. Yeah. It's been really fun. Really interesting, but it's also kind of like starting a whole new business while restarting everything with The VBAC Link so it's kind of been a lot. We have been up to a lot recently. So thanks everybody for hanging in there with us while we took a little bit of a break to catch up, and maintain, and restart some things in our busy lives. We appreciate everybody for supporting us while we were hanging out in the background for just a little bit, but we're back. Meagan: We're back. Julie: We're back. Review of the Week Alright, as always, we have to start the episode with a review of the week. Thank you so much, everybody, for leaving reviews. We love them so much and Meagan is going to share one with us right now. Meagan: Yes. We have a review from holmclaugh90 and the title is “I listen every single day.” It says, “After a traumatic cesarean with my first baby five years ago and multiple miscarriages in between, this is a breath of fresh air as I await my chance to have a VBAC this October with my second. Love every story I hear on this podcast and it makes me feel so much stronger in knowing that I can do this.” I love it. Julie: I love it too. I love it. Meagan: That was in July of last year, so she definitely has had a baby. So holmclaugh90, if you are still listening, email us at info@thevbaclink.com. We would love to know how your birth went. Julie: Yeah. Or tag us in your birth story on Instagram or Facebook and we can share it. Meagan: Yeah. Francis' Story Meagan: Alright. Julie: Alright. Meagan: I can't wait for this new story. Julie: I know. We are really excited. We are bringing it back with a classic story about– can you guess? Drumroll please. Big babies! Meagan: I was gonna say, VBAC with a big baby. Julie: VBAC with a big baby, and we are also going to sprinkle in some talk about maternal mental health, and the importance of trauma processing, and working through prior births, and some cholestasis there for a little bit of variety. But before we do that, I want to introduce our guest, Francis. Francis is a married mother of three from Raleigh, North Carolina. She balances motherhood with a full-time job in international business. Wow. Really need to hear more about that. She enjoys swimming, CrossFit, outdoor adventuring, and traveling. So Francis, welcome. Thank you so much for being with us. We cannot wait to hear more about your story. Why don't you go ahead and tell us a little bit more? Francis: Sure. Well first of all, it's so good to be with you guys. I am so glad that you're back doing this. Julie: Thank you. Francis: It was just such a resource that I used in my pregnancy, and so I am so glad that there are more episodes for women to listen to, and hopefully be inspired by, and learn from. You guys are just amazing and congratulations on all that you guys have been up to. And Julie, I think that's awesome that you are doing birth photography. We had a birth photographer at all three of our births and it's just something that I hold so precious and dear to my heart. So I think it's incredible that you are doing that and giving that back to moms as well. Julie: Aw, thank you. Meagan: I would totally agree with you. It's actually one of my biggest regrets not having one at my birth. I wish so badly that I had someone there to take more pictures and videos so I could experience it from a different perspective too. Francis: Yeah. Meagan: Because when you are in the thick of it, it's hard to even comprehend what is happening. I wish I could have just seen, I don't know. I wish I could've seen it from a different angle. But yeah. She's awesome. Francis: Yeah. And you know, it's funny. I didn't even think about this as part of my birth story when I was thinking about it, but we did have a birth photographer with all three of my births and as you'll hear, my first two births did not go as planned, but I still have the photographs from that and it actually really did help in my healing when I had the courage to go through them to look back and see, you know what? Even though this didn't go as I thought it might, there is still a lot of beauty in my births. Meagan: Absolutely. Yeah. Francis: So I think it is for any woman. To have that moment captured is special, no matter how the birth turns out. You know? Julie: Yeah, I love that. Thank you. Francis: Yeah. Julie: Nice plug-in. Francis: Yeah I know, right? So speaking of– my first pregnancy was in 2012 and prior to getting pregnant, I had been introduced to homebirth by my sister who had a really beautiful homebirth for herself. Prior to her having a homebirth, I honestly didn't really know that that was a thing that people were doing. I just assumed everyone had hospital births and that was just the way it was. And so when I saw her experience and I educated myself on what a homebirth was, I decided I really wanted that for myself. So after I got pregnant, I looked into having a homebirth, but unfortunately in the state where I am at, it's not real easy for midwives to operate in a homebirth setting. So it wasn't in the cards for me, but I did find a freestanding birth center that was about 30 minutes from my home staffed by midwives and then backed up by physicians where I could give birth. I hired a really amazing doula and took a Birthing From Within class with her, and then I hired the birth photographer. We had everything lined up. My pregnancy was super easy and very normal up until I got to about 40 weeks and started stressing out, like a lot of moms do. I knew it was normal and natural to go past 40 weeks, but I don't know. I guess I just thought it would never happen to me. I don't know. But I started to get really stressed out. I hit 41 weeks and my provider wanted to do an ultrasound to check the fluid and check in on baby. Everything was healthy, but they did end up measuring my baby and they estimated that my baby was over 12 pounds. So as you can imagine, I really started to freak out. My provider was still supportive and supportive of me trying for a natural birth at the birth center if I could go into labor on my own, but I do know that it planted some seeds of doubt both with them and honestly within myself. But I do know that women birth big babies all the time and that ultrasounds can be wrong.  So we moved forward. I luckily ended up going into labor on my own right before I hit 42 weeks. I had a long labor, but it was steady. I was at the birth center and everything was normal, kind of until it wasn't. I didn't know this at the time, but I ended up basically stalling at 8 centimeters for a number of hours and then my labor basically stopped. And so we decided to go to the hospital which was really devastating to transfer, but I knew it was necessary at that point. So we transferred. I did get an epidural and some Pitocin to try to pick things back up. But at this point, it had been 36 hours and I was just kind of ready to be over it. There was this question mark of how big my baby was and maybe my baby really wasn't going to fit. So I consented to a Cesarean and my baby did end up being really big. He was a surprise gender. He was a boy and he was 11 lbs. 2 oz. So not quite 12, but still really big. Meagan: Wow. Julie: Really big baby. Meagan: Yeah. Julie: That's a big, chunky baby. Francis: Yeah, exactly. So my Cesarean was fine. You know, physically I was fine. My recovery wasn't bad. But I mentally struggled as I know a lot of Cesarean moms do. I was just really disappointed in the outcome. I went from really wanting a homebirth, to then being at the birth center, to then transferring to the hospital, and then having a Cesarean. I felt like a failure. And I know looking back now that I wasn't, but it felt that way at the time. I've been a physically active person my whole life, and so I think for the first time ever, I really felt like my body failed me. That was really hard. I had a hard time swallowing that. I also felt guilt. I felt like it was my fault, like maybe I ate too much pie and that's why I had an 11 pound baby. Or maybe I should have kept trying at the birth center and not gone to the hospital. But either way, you know, it worked out the way it did. We were healthy, and that, of course, is the most important thing. But I was really– I did struggle for a while with that birth and just processing everything that I went through. Fast forward a couple of years later, my husband and I decided that we were ready for another. I had regained some confidence in myself and in my body, and decided that I did want to go for a VBAC. I was able to go back to the birth center midwives from my prior pregnancy, but in my state, you can't do VBAC out of the hospital, so they have admitting privileges in the hospital. So I knew it meant an automatic hospital birth which was disappointing because again, I really didn't want to be in a hospital environment, but I didn't have much of a choice. But I found the midwives were really supportive and I was ready to go. We had the same doula and the same photographer, and everything was really great. And then at right about 40 weeks, I got cholestasis, which, I know you guys have covered on the podcast before, but it causes insane itching and it can be harmful to the baby. So at that point, we decided I really needed to be induced. That was, again, really devastating, I had hoped to be able to go into labor on my own and labor at home as long as possible before going to the hospital, but having an induction that I knew in my heart was really medically necessary, I had to be at the hospital.  I am super grateful our midwife group– I didn't know a whole lot about VBAC protocol at the time with induction, but what I know now, I know that they really followed it to a T. We did a low and slow induction. We did a Foley and very gentle Pitocin. I was honestly kind of on and off Pitocin for about three days trying to get this baby to come out. At the end of the third day, I think I had gotten to 3 centimeters. I got a cervical check and they felt my baby‘s ear instead of the top of her head, so she was almost completely sideways. Julie: Oh wow. Francis: Yeah. So that was obviously quite unexpected. We spent a little bit of time with the doula and the midwife trying to sort of shimmy and shake and get her to move, but after some time, it just wasn't happening. I had already been there over three days. We had a toddler that was being shuffled around between family at home. I just knew in my heart at that point it was time to consent to another Cesarean. That was a super difficult decision, but honestly, I came to it really feeling genuinely supported and that I had been involved in the decision making every step of the way, so it wasn't a bad experience. Rght about that time, the concept of family-centered Cesareans was coming to the forefront, and so I was able to have a really gentle Cesarean. I did have a clear drape. I think I was the second person at this hospital to have a clear drape and it was fine.  Again, I did end up having another really big baby. This was also a surprise gender. It was a girl. She was 10 lbs. 10 oz. So at that point, I realized I just grow really giant babies. Again, processing the Cesarean was difficult, but probably not as difficult as the first time just because I had been so well supported by everybody. You know? So after that, life moved on. My husband and I weren't entirely sure that we were done having kids, but pretty sure we were done having kids, and so I just fell into life. You know, work, being a mom. I unfortunately had a couple of really difficult personal situations that came about during the couple of years after my daughter was born. The biggest one being my mother was diagnosed with cancer and then passed away. That was really difficult. Meagan: Yeah. That's heavy. Heavy, heavy. Francis: Yes. Yeah, very. Meagan: I'm sorry. Francis: Thank you. I decided I really needed to take some time to work on myself. You know? So I found an amazing counselor who I went and saw very frequently. We just spent a lot of time processing everything. Some of that, of course, was my births, and processing the trauma of my births, and just those feelings of failure, and disappointment, and guilt. And then, we just spent a lot of time processing everything else that life throws at you. Through that, one of the things, and probably the most important thing, that I learned was that I have really good instincts. I think that honestly, most of us do, especially mothers. We have really good instincts, but it takes some time, and some practice, and some patience to learn how to trust them and how to follow them. Going through all of the counseling really helped teach me how to lean in to my intuition and how to trust my gut. That was an experience that just has obviously helped me in every area of life. Julie: That's such a valuable thing to learn. Francis: Yeah. Julie: It's a hard way to learn it, but it's such a good skill to have and a good thing that came out of that. Francis: Yeah, exactly. Yep. So I was in a really good place and then 2020 happened, right? The pandemic and then in July 2020, I found myself surprised pregnant. Obviously, my husband and I had not closed the door on having children, but we weren't really planning on it. So when I found out I was pregnant, it was a bit of a shock. Honestly, it took us a little bit of time to really get excited about it. It was just such a surprise that we weren't really sure how to feel about it, but eventually, we did come to be very surprised. To be honest, I didn't know right away whether I wanted to try for a VBAC again. And honestly, I didn't know whether it was an option for me, like whether the hospital would allow me to or whether my personal circumstances were right for a VBAC. So I started doing a little bit of research and then seeking out some opinions and taking into consideration my personal circumstances. And I do have, like I've mentioned, I have a history of big babies. I had cholestasis in my last pregnancy. I had this “failed VBAC”. I was almost 40 years old and was just like, “I don't know. Is this a good idea for me to try for a VBAC? What happens if I fail again? What does that mean?” So I really spent some time thinking about it and I did briefly check out a different healthcare provider just to see if maybe a change in my provider would be helpful. Also, this one was a bit closer to my house. I'll never forget at that first appointment, I was just trying to feel out what my options would be and they said to me, verbatim, “No doctor at this hospital will ever support you in a VBAC.” I just remember thinking like– I didn't know a lot at that time about a VBAC after two Cesareans, but I knew that that didn't feel right. Meagan: Yeah. Francis: Yeah. That like, “Wait. I don't have a decision in what happens to my body?” I knew that didn't feel right. And so I decided. I was like, “Okay. I'm not going to stay with this practice. Let me do more research and let me seek out additional opinions.” So I ended up going back to the midwives with the birth center that I had been with before for my prior two pregnancies. And again, they only do VBAC in the hospital. I inquired with them whether they would take me on and they said, “Yes.” They did share some of the same concerns as me, but ultimately they did support me in being a part of the process and making a decision of what happens with me and my baby. So at that point, that's when I found you guys. Meagan: That's really how it should be, by the way. When you said that, it reminded me of my conversation with my old doctor. I went to go get my medical records and he said, “Good luck. No one is going to want you out there.” And it was like, “Okay.” And it wasn't even like, “Yeah. Let's talk about it,” or “Let me tell you why I don't feel comfortable with it.” You know? Francis: Yeah. Yeah. Exactly. Well, anyways. Yeah. I felt that someone shouldn't be making that choice for me. If I choose not to try for a VBAC, that's my choice. But for someone else to just say, “No. You must have major surgery.” It just didn't feel right and it didn't sit well with me. Meagan: Yeah. Yeah. Francis: But luckily, I was able to go back to my previous provider and find support. I know a lot of women don't find that, so I was really lucky in that regard. At that point, that's when I really, really start a diving deep into VBAC research and that's when I found you guys. I looked at all of the research you put out. I started listening to your podcasts and all of the other stories, and it really gave me strength and confidence.  One of, perhaps, I think the most important things is in listening to other women's stories, it opened my eyes to this possibility of this perfect “birth” that I had in my head before. It didn't have to be like that. I could accept a hospital birth or I could accept interventions and that could still be a beautiful birth. It doesn't have to be this like, I don't know, what you see in a movie or just that perfect, serene birth. I realized and I accepted that I could open up my mind. Things might turn out not precisely like I hope they do, but that could still be okay. You know? Julie: Yes. I love that. Francis: I really shifted my mindset and in this pregnancy, I didn't worry about all the things that sometimes people do. I really just focused on taking care of my mind and taking care of my body. I did do chiropractic care, and I also did– I don't know if you guys have heard of the Arvigo abdominal massage? I did that. Meagan: No. What is that? Francis: Oh. Yeah, so it's really interesting. It's a Mayan technique and it's an abdominal massage. It's actually really great after a Cesarean. It really helps with scar tissue. But even during pregnancy, it just– I actually don't know all of the benefits of it other than for one, it feels really great. I think it can help with the round ligaments and stuff. It just helps the positioning of your baby and I don't know. I found it really relaxing and comforting, so I did do that. I also did go to an acupuncturist and overall, just stayed active and well. But I did all those things not for some arbitrary reason, but because it made me feel good. So I really just focused on that. With this different approach to this pregnancy and accepting that things might turn out differently than what I had initially hoped, I shared all of this with my provider. I think that was super helpful because I think that they realized that I was in this mental space where I knew I could trust myself and I could trust my instincts and make the right decisions. In turn, they really trusted me. So it really helped in that and having support from them. One of the things, though, that did bring up some concern was that I did do a maternal fetal medicine consult about halfway through just to talk about my prior Cesareans and go over my operative history. One thing that came up that was a bit unexpected was in my second Cesarean, the surgeon had noted that I had really dense adhesions from my first Cesarean. He put almost a note in there to say, “A note to future surgeons, you might experience a prolonged surgery because of all of this dense scar tissue that was in there.” Julie: Interesting. Meagan: Well, and I actually wonder if the dense scar tissue extended– because you said you made it to 8, and you stalled, and you made it to 3. We just had a client that, same thing. She only made it to 3.5 and her body was in active labor. Her cervix just wasn't going and she had super dense adhesions. Francis: Yeah. I mean, for sure. I don't really know, obviously, all of the ways that it can affect you, but I am sure, it's not natural to have all of that scar tissue in your abdomen, right? It's there because you've had this major surgery. So the one thing, though, that they did mention and why it concerned them is they said that if I attempted and it ended up in an emergent situation, it might not turn out well for me because they wouldn't be able to get through all of that scar tissue super quickly either to save my baby or me, right? That was a little bit scary to hear, but my first thought was like, “Well, if I have got all of the scar tissue and it's going to be super hard to open me up, don't you guys just not want to have to open me up? Wouldn't the best case scenario be to just not have another surgery?” Julie: Right? Meagan: And avoid that completely? Yeah. Francis: Right. And add more scar tissue. I know when you have these adhesions, they can accidentally cut into your bladder or things like that. So I was like, “Well, isn't it best case scenario just to not have surgery?” And they were like, “Oh, yeah I guess so.” It was kind of funny, almost like they hadn't really thought of that option, but they wanted me to schedule a repeat Cesarean before I went into labor so they could do it on their own time so they wouldn't have to rush. Which on the one hand, I understand, but the other hand I was like, “Well, let's just try to not cut me open at all.” Right? The other thing too with that was again, I really trusted myself to be able to make the right decision and I trusted that if I were to attempt a VBAC and get to the point where a Cesarean was necessary, that I was capable of making the decision to head to the OR before it was an emergency. I had done that twice before, you know? The other thing too was I had done the research. I know you guys have talked about this before how rare uterine rupture really is and that's kind of like the big deal with VBAC's, right? Also, not only how rare it is, but then when there is rupture, how few of them are really catastrophic. You know? It seemed a little bit silly to go in for a Cesarean just because there was a one in 1000 chance that I might have a catastrophic rupture.  Julie: Yeah, exactly. Francis: Yeah. So ultimately, I respectfully appreciated their professional opinion, but decided I still wanted to go for a VBAC. So anyways, I went for it again. Basically, the rest of my pregnancy proceeded as normal. As far as I know, I did not get the cholestasis again. I did take some herbals that maybe played a role, but I didn't get itchy, so I was super happy about that. Although, I was in my head in it a lot about it. If you think about being itchy, you can find an itch on your body right now. You know? So it was hard not to be paranoid about it.  But ultimately, I avoided getting it which was great. So I didn't have to be induced, because I was worried about that. My pregnancy continued to progress and I did again go past 40 weeks. There were times when I was mentally struggling, but my husband, and my doula, and photographer were super supportive. I was able to lean in on them for support. I did start having a little bit of prodromal labor about 40 weeks and that was really exhausting, but it was reassuring that something was happening. I was taking the wins where I could find them. As I approached 41 weeks, I started to feel a little bit of pressure about how late I was going to go again. I did agree and scheduled an ultrasound to check on the fluid and check on the baby, but I made it very clear that I would not consent to them measuring my baby because I just thought, “What good does it do to talk about the size of my baby at this point? I know I grow big babies. It's got to come out one way or the other.” Julie: Yes! Francis: Let's just not even talk about it. Julie: Absolutely. Francis: There were a couple of the midwives that would make comments about it that rubbed me the wrong way, but I did my best to just brush it off. Because again, this baby is coming out, so what good does it to really think too much about how big it's gonna be? As luck would have it though, I didn't even get to that ultrasound. I didn't have to put my foot down, but I was prepared to, to not have them measure my baby. So I ended up going into labor on my own. It was about 41 weeks. I happened to have an appointment with my favorite midwife and she just put me into this really peaceful place. Sure enough, that night, I went into labor. It started overnight and was kind of slow. My husband was in the other room, so I was up by myself for a bit and about 5:30 in the morning, I realized I was struggling to cope on my own. So I woke him up and he came into the room with me. About an hour later, he ended up calling our doula. Actually this time, we were only allowed one support person in the hospital other than my husband, so our photographer who had been with us before was double dutying as my doula. Julie: Nice. That's called a doula-tog. A doula photographer. I do that sometimes. Francis: Yeah. She's been with us in all of our births and she's had birth experiences of her own that she can really relate to, so she was really great filling both rolls. She came over because my husband, and we laugh about this now, but he was like, “You were making noises that I was really scared of.” So he called her over to help me and my labor did slow down a bit, when things kind of picked up. Some people came over to pick up my other children. I think that's pretty normal.  But then once everyone left and my birth space was undisturbed, my labor really picked up really quickly. I was contracting about every 3 to 4 minutes I think. A solid minute contraction and after a little bit, I started throwing up. In my labor with my son, I started throwing up when I was pretty far along, so I was like, oh my gosh. Maybe this is really happening quickly. Like, we should go to the hospital. We headed over to the hospital which was about 30 minutes and not really a fun drive, but we made it. We got checked in and I knew I wanted to labor in the tub for a little bit. They just have hospital, small tubs but I was allowed to get in and they had the wireless monitors. I wanted to get checked just to know where I was starting from and I was only a 2. I was so defeated. Julie: Oh, that is so discouraging. Oh my gosh. Francis: Yeah. Yeah, I know. There's part of me that regrets finding out but it is what it is, right? But I knew at that point, I was like, “Okay. I am going to switch my mindset.” I already saw drugs in my future which I had decided I was totally okay with, but I wanted to see how much farther I could get. So I got in the tub and it really slowed down my labor, so my doula made me get out. I think I fussed and complained at her. I got out and I tried nitrous, but it did nothing for me. I'm honestly not even sure if that thing was actually working.  I decided at that point, I was like, “Just give me the epidural.” The other thing too is, maybe this is coming from a little bit of an athletic background, I was really having trouble holding tension in my pelvic floor and in my bum. I just couldn't release, and so I knew that the epidural would help with that. That's one of the things that I have learned on this podcast and listening to other women's stories is that sometimes you can use these interventions to your advantage. Getting an epidural doesn't mean that that's the end of it for you. You can use it as a tool in your tool kit. Julie: Absolutely. It's available if you need it. Francis: Exactly. I knew at that point I did need it. So I got the epidural. I was only 3 centimeters and that really scared me because I really wanted to be farther along, but I did it anyway. I labored for a bit and then I got checked again and I was– I probably had been at the hospital about 12 hours at this point. I'm still only 3 cm and I was like, “What am I doing? Like why am I doing this?” The midwife that happened to be on call was such a saint. I look back and I'm like, “I couldn't have landed with a better midwife for me.” She looked me in the eyes. She said, “I will not recommend anything that will put you and your baby in harms way, but I will do everything in my power to help you achieve a vaginal birth.” It was just so reassuring to really know that she had my back. We did start Pitocin at that point, which I know can be a little bit controversial in a VBAC or a VBAC after more than one Cesarean, but we did a really slow Pitocin and I could tell it was working. I did have an epidural, but I could feel it working. I continued to labor throughout the night into the early morning. I tried to catch some rest, but there were definitely times I was looking around and like, my husband was trying to sleep on the floor and our doula photographer was there with us this whole time and I was just like, “Gosh.” I felt almost guilty, like I was putting them through the ringer with me. I just kept having these feelings like, “Will I end up in another Cesarean? I'm doing all this for nothing.” But I tried to quiet those doubts as much as I could and at one point in the middle of the night, I felt a pop and a gush of fluid. I called the nurse and I was like, “Hey, either I've just peed myself or my water broke.” She came in and confirmed it was my waters, so that was exciting. Julie: Yay! Francis: I was like, “Okay. Something's happening, right?” And then, as I was laying there trying to catch some rest, I could feel that I was having some pressure in my bum and my sacrum, but I didn't want to get too excited, so I kept it to myself. It was probably about 3 o'clock in the morning. My midwife had been tending to a couple of other women and she was going to try to catch some rest, so she was like, “Well, let me just check you really quick.” When she was doing it, I knew that it was a do or die moment for me. If I hadn't progressed anymore at that point, I felt like that was going to be it. So I was really, really nervous. She went to check me. She didn't say a word and she had this poker face. She checked me. She went to the sink and washed up. My heart is pounding, right? Like, “Oh my gosh.” She walks over to my bedside and then she looks at me and she said, “Francis? You're more dilated than you've ever been in your life.” Julie: Yay! Francis: And I just– yeah. I let out this scream and everybody in the room was cheering. I think the nurse might have even shed a tear. That was the first moment where I was like, “Oh my god. This might actually happen.” So I did labor down a little bit longer and at one point, the nurse rushed in. She had me change positions and got me on my hands and knees and I knew. She wasn't saying anything, but I knew that that meant they were having some sort of concern about baby. I tried not to panic, but I was really scared. The midwife got called in. She gave me another check and she was like, “You're at 10 centimeters. Let's just get this baby out.” So I was like, “Let's do it.” Julie: “Let's do it.” I love it. Francis: So my doula was like, “Hey, do you want the squat bar?” I was like, “Yes. Give me the squat bar.” Coming from an athletic background, I was so excited to feel useful. I was like, “Alright. Let's go.” I had never pushed before, so I didn't know what that was like. I was being coached. I was using the squat bar, basically squatting on the bed using the bar and apparently, according to the midwife, was really doing a good job. After about 45 minutes, my baby was right there. She was like, “Come down. Touch your baby's head.” I touched his head, and then she had me lean back a little bit. We did some of those slow, panty pushes to do it pretty slowly. I felt my baby's head come out, and then she had me push again for the shoulders. I could tell when I did that that she had a little bit of trouble, but he ended up coming out really without a problem. I really wanted to catch my baby. My husband was amazing support throughout all of it, but he had zero interest in being part of that process. And so I was like, “Well, I want to catch my baby then.” So my midwife was like, “Well, reach down and catch your baby!” So I reached down and she helped me, and I brought him up to my chest. He was beautiful and perfect, and it was that moment that I know we all dream about. Our photographer caught that moment and I have shared it on your Facebook page before. It's a little bit graphic. Not too much so, but it was just– you can see it in my face. I was just in heaven. My baby was on my chest for all of the nurse checks and everything. I remember when he was laying there, I was like, “Oh, I think he's my smallest baby. He's so small.” And then finally, they came and took him to do the weight and the measurements, and he ended up being 10 lbs. 12 oz. and 22.5 inches. Julie: Wow! Francis: He was not my biggest baby, but my second biggest and I just couldn't believe it. You know? Like, “Oh my gosh. I pushed that baby out of my body!” Meagan: Yeah! Francis: I did have some tearing. It was a third-degree tear and my midwife said it was from his shoulders. She did say he didn't have dystocia, but she had to give some traction, I think, is what she said. But I was repaired right there in labor and delivery and honestly, I didn't care because I had my baby with me and I was just in euphoria. The recovery was not a walk in the park, but so much better than a Cesarean. I avoided major abdominal surgery.  One of the things in my birth plan– I had this long birth plan– but at the very beginning, I said that I had birth goals. These were my goals. This is where I'll get emotional. Sorry. I said, “I wish for a healthy mother and baby, both physically and emotionally. For my intuition to guide me and to be trusted by those around me. For labor to begin and continue as hands off as possible and to feel heard, empowered, and respected.”  At the end of the day, my birth checked all those boxes. I couldn't have asked for more. I have no doubt that your podcast played a huge role in my success. If me sharing my story can help just one other woman achieve her own birth goals, then I am just overjoyed. So thank you so much for giving me this opportunity to share my story. Julie: Aww. Meagan: Wow. I have tears in my eyes right now. Francis: Aww. You guys are so sweet. Meagan: I just felt that. When you were talking about when you reached down and grabbed your baby, it was like I was flashing back to my son‘s birth. I just remember that feeling and I was feeling it for you. It's such an incredible feeling to reach down there and feel the baby's head, and pull him out, and have that support, and what your midwife said too. I am so happy for you and so proud of you. Francis: Well, thank you. I appreciate it. Like I said, I really, truly feel like I could not have done it without you guys. I really mean that. I know you've heard that before, but it's the truth. Julie: Well, I just don't think– I can safely speak for Meagan when I say we probably won't ever get tired of hearing that. We love it! Meagan: I don't think we will because this is what we are here for. This is what we want to do. We want to help. We want to empower. We want to inspire. We want to guide. We want to educate. We want to create that community where it's not even just us, right? It's you guys helping others and feeling that support all around the world. You have people rooting for you and you don't even know where they are at. That's what we want. That's what we want. We want our mission here too be better and make birth after Cesarean better. Sometimes, that means a repeat Cesarean and that's okay. Listen to how healing it can be. Francis: Yeah. Meagan: Especially coming back for the first podcast after taking so much time, it's so refreshing to hear, “Hey, this is still what people love and this is what people want. They want to hear the stories. They want to see all the stories.” The emotion I just felt with you sharing your story, and I'm not even pregnant or having anymore kids and I'm feeling it. I'm just imagining being in that room with you guys and cheering as you're the furthest dilated that you've ever been. That's such a huge moment. Just so many fun things. I am so glad to be back. Julie: Yeah. I love it. I think it's so incredible. I just think back– I know Meagan, maybe you are doing the same thing, just all the births I have attended as a doula and now I get to do that as a birth photographer– of parents who have had these babies over 10 pounds. I feel like sometimes maybe the big ones come out a little bit easier because they have gravity working on their side, right? Gravity gets to pull on them a little bit easier. Francis: True. Julie: I am on call right now for a threepeat doula client, my third time being her doula. The babies that I was with for her last two, one was over 9 pounds and one was over 10. It's not a VBAC birth, but her babies– She's 5'1” by the way. She's 5'1” and very petite. She births these ginormous, sumo wrestler babies. It's just so fun to watch her labor and birth because she just doesn't hold still. She's constantly moving. There's a lot to say about giving the birthing person time, and freedom, and space, and ability to let their body do what it needs to do instead of jumping to conclusions about the babies size and the ability of whether it will or will not work. I think that that's really cool that your midwife supported you in that way. It's really just neat when you hear about providers wanting the type of birth you wanna just as much as you do and it really kind of felt like that's what happened there for you. So it's really cool. Francis: Yeah. It did. It's kind of funny because when I was seeking out opinions about whether I should go for a VBAC or not, and then of course just checking myself, honestly, the fact that I grow really big babies was almost not even brought up. It was all of the other things that were more concerning. Like the scar tissue, or my age, or potentially having cholestasis and maybe having to get induced or just go for a repeat Cesarean. So it was interesting to me. One of the things I think I was most fearful of when I was thinking about having a VBAC was whether my baby would be too big, but my provider almost didn't even care. Do you know? Julie: I love that. Francis: That surprised me. Five Tips for Birthing Big Babies Julie: I love that. I love it a lot. Alright well, we are going to wrap it up but before we do, we have a blog all about big babies and how we can have the best chance at gettingg that big baby out vaginally. We are going to link it for you in the show notes. I am going to go over five tips for you right now. The first one is knowing the facts about macrosomia, which just means “big baby”. Macrosomia– it's really interesting because different organizations define what makes a baby big differently. Some places define it as a baby that's larger than 8 lbs. 13 oz. and some places define it as bigger than 9 lbs. 4 oz. I mean, your babies checked both of those boxes. So that's okay. So either way, 8 lbs. 13 oz. or 9 lbs. 4 oz.  So sometimes, there is a little bit of flexibility about what really makes s baby big. And also know that estimated fetal weight– the only way to actually know the actual size of your baby is birthing the baby and getting the measurements after it's born. Ultrasound scans are notoriously inaccurate about measuring gestational weight. They can be off by a pound or two difference like yours. Your first was still really big, but about a pound different than what they measured it, right? Francis: Yeah. Yeah, exactly. Julie: Yeah. The second thing you can do to help get a big baby out is hire a doula. Studies show that having a doula improves just about every single aspect of your birth and delivering a large baby is no exception about that. A skilled doula will help you communicate your needs and your perceptions to help realize your dream of having a healthy, positive birthing experience.  There are actually a lot of statistics that prove how doulas improve birth outcomes. They actually reduce your chances of having a C-section by 39% which is really cool for my data-junkie brain.  The third thing you can do is move as much as possible, even with an epidural. Moving, switching sides, even just moving your legs a little bit every few contractions is going to help keep your pelvis being flexible and help create that space for your baby to move down.  We say in our blog, “ditch the epidural”, but you don't actually have to to have an unmedicated birth in order to birth or to have a VBAC or to have any vaginal delivery. Go as long as you can without getting it, but it's okay if that's a lower number than you want. As we talked about earlier, an epidural is a great tool to have in your toolbox if you need it. Knowing how to use an epidural and how to move, and a doula is a great way to help you utilize this tool properly. As long as you are not laying down and staying still in one spot for too long, that's the biggest thing you need to take away from that. And the fifth one, we say, “believe in your body.” I know I'm probably going to get a lot of eye rolls for this. “Believe in your body. Woosah. You can't always manifest your baby your out.” Yes. That is very true. Sometimes things happen, and interventions are needed, and Cesareans are life-saving. We definitely believe that and we have seen it. But there is a lot to be said in believing in yourself, and believing in your baby, your body that knows that it can do this and that it is designed for the birth process, and having that confidence going into it and having the confidence in yourself, and your birth team, and your support environment. If you don't have that confidence, do whatever you need to do or change whatever you need to change in order to create that confidence and that belief in your environment because where doubt exists, that brings in the uncertainty that can shift your entire birth experience. I'm going to end that with a period and an exclamation point. Meagan, what would you add in there? I've been talking for a few minutes. Meagan: No, you're just fine. I mean, I feel like we have talked about the intuition and mama's gut the whole time. But I love that during your pregnancy and everything, you were able to hone in on that and not only learn what intuition necessarily is, but how to really tune into it because especially for birth and especially for a VBAC– I want to say it's for anyone. It really is, but with VBAC, there is so much coming at us with all the things. For instance, when you went to that different provider and they were like, “Yeah, no. Not one person in this hospital is going to touch you. Like, no.” A lot of people would be like, “Oh, okay. There's that many doctors that won't even see me. I better just have a C-section,” which is totally fine if that's what their intuition is how they feel.  But a lot of the time, I feel like it's hard to tune into that intuition and to be like, “Wait. I still feel like I should probably still get some other opinions.” Right? Versus just being told what I said to you. I think that if we can, in life in general, just learn how to tune in to that intuition and really how to follow it, I think it's going to help us in so many things in life in general. That's one of the highlights of your story that I got because I had to personally work through a lot of that during my pregnancy because I was told that I would rupture if VBAC'd and I didn't realize how much that impacted me, but it impacted me. But my intuition was telling me otherwise, right? Anyway. That was one of the biggest things I took away. One of the biggest takeaways from your story is learning how to hone in on your intuition, following it, and trusting it. Trusting your gut. Francis: Yeah, precisely. Hit it on the nose. Julie: Alight. Meagan: I– yeah. Julie: Oh, go ahead. Meagan: I was just going to say, I love it. I loved everything about your story. So thank you so much for kicking us off with such a great empowering story. Julie: Yes. It was the perfect story for our welcome back. Francis, it was such a joy to have you on and share your story today. But before we leave, we want to ask you– I think I might know what the answer is– but I am going to ask anyways. What is your best tip for somebody preparing for birth after Cesarean? Francis: Well first, I thought you were going to ask whether I was going to have more children. And I am like, “Hard no.” Julie: I'm right there with you. Francis: That door has been closed. Yeah. I think it is, it's what I think– Meagan, what you just talked about is learning, taking the time to focus on yourself and your mental health. I think ideally before you get pregnant, but you can obviously do that while you're pregnant if you're already pregnant. But taking the time to really focus on your mental health and learn how to trust yourself because we all have good instincts. We just have to know where to find them sometimes. Julie: Oh I love that. “We all have good instincts. We have to know where to find them sometimes.” I'm going to make a social media post about that. Just one second while I write it down. Francis: You guys are too sweet. I appreciate it. Julie: Maybe it will go on a shirt. I don't know. I need to start making shirts again. Meagan: I know. Francis: Do I need to trademark that real quick? Julie: Yes, you need to. Meagan: She's like, “Wait a second.” Yeah. Trademark that for sure. Julie: I will credit you. What's your social media? Should I tag you? Francis: No no, not necessary. Thank you though. Julie: Okay. Speaking of shirts, we do have a bunch of VBAC shirts available for you to purchase if you want to rock, and represent, and support the podcast. You can find them at thevbaclink.com/bonfire if you want to head over there and rock some swag from the VBAC shop.  So, Francis. You're amazing. Thank you so much for sharing your story with us today and everybody else, good luck on your journey. We are so excited to be back along for the ride with you.ClosingWould you like to be a guest on the podcast? Head over to thevbaclink.com/share and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan's bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

In this episode, we cover: 00:00:00 - Intro 00:01:56 - How Alex and Kolton know each other and the beginnings of their companies  00:10:10 - The change of mindset from Amazon to the smaller scale 00:17:34 - Alex and Kolton's advice for companies that “can't be a Netflix or Amazon” 00:22:57 - PagerDuty, Gremlin and Crossovers/Outro TranscriptKolton: I was speaking about what I built at Netflix at a conference and I ran into some VCs in the lobby, and we got into a bit of a debate. They were like, “Hey, have you thought about building a company around this?” And I was like, “I have, but I don't want your money. I'm going to bootstrap it. We're going to figure it out on our own.” And the debate went back and forth a little bit and ultimately it ended with, “Oh, you have five kids and you live in California? Maybe you should take some money.”Julie: Welcome to the Break Things on Purpose podcast, a show about chaos, culture, building and breaking things with intention. I'm Julie Gunderson and in this episode, we have Alex Solomon, co-founder of PagerDuty, and Kolton Andrus, co-founder of Gremlin, chatting about everything from founding companies to how to change culture in organizations.Julie: Hey everybody. Today we're going to talk about building awesome things with two amazing company co-founders. I'm really excited to be here with Mandy Walls on this crossover episode for Break Things on Purpose and Page it to the Limit. I am Julie Gunderson, Senior Reliability Advocate here over at Gremlin. Mandy?Mandy: Yeah, I'm Mandy Walls, DevOps Advocate at PagerDuty.Julie: Excellent. And today we're going to be talking about everything from reliability, incident management, to building a better internet. Really excited to talk about that. We're joined by Kolton Andrus, co-founder of Gremlin, and Alex Solomon, co-founder of PagerDuty. So, to get us started, Kolton and Alex, you two have known each other for a little while. Can you kick us off with maybe how you know each other?Alex: Sure. And thanks for having us on the podcast. So, I think if I remember correctly, I've known you, Kolton, since your days in Netflix while PagerDuty was a young startup, maybe less than 20 people. Is that right?Kolton: Just to touch before I joined Netflix. It was actually that Velocity Conference, we hung out of that suite at, I think that was 2013.Alex: Yeah, sounds right. That sounds right. And yeah, it's been how many years? Eight, nine years since? Yeah.Kolton: Yeah. Alex is being humble. He's let me bother him for advice a few times along the journey. And we talked about what it was like to start companies. You know, he was in the startup world; I was still in the corporate world when we met back at that suite.I was debating starting Gremlin at that time, and actually, I went to Netflix and did a couple more years because I didn't feel I was quite ready. But again, it's been great that Alex has been willing to give some of his time and help a fellow startup founder with some advice and help along the journey. And so I've been fortunate to be able to call on him a few times over the years.Alex: Yeah, yeah. For sure, for sure. I'm always happy to help.Julie: That's great that you have your circle of friends that can help you. And also, you know, Kolton, it sounds like you did your tour of duty at Netflix; Alex, you did a tour duty at Amazon; you, too, Kolton. What are some of the things that you learned?Alex: Yeah, good question. For me, when I joined Amazon, it was a stint of almost three years from '05 to '08, and I would say I learned a ton. Amazon, it was my first job out of school, and Amazon was truly one of the pioneers of DevOps. They had moved to an environment where their architecture was oriented around services, service-oriented architecture, and they were one of the pioneers of doing that, and moving from a monolith, breaking up a monolith into services. And with that, they also changed the way teams organized, generally oriented around full service-ownership, which is, as an engineer, you own one or more services—your team, rather—owns one or more services, and you're not just writing code, but you're also testing yourself. There's no, like, QA team to throw it to. You are doing deploys to production, and when something breaks, you're also in charge of maintaining the services in production.And yeah, if something breaks back then we used pagers and the pager would go off, you'd get paged, then you'd have to get on it quickly and fix the problem. If you didn't, it would escalate to your boss. So, I learned that was kind of the new way of working. I guess, in my inexperience, I took it for granted a little bit, in retrospect. It made me a better engineer because it evolved me into a better systems thinker. I wasn't just thinking about code and how to build a feature, but I was also thinking about, like, how does that system need to work and perform and scale in production, and how does it deal with failures in production?And it also—my time at Amazon served as inspiration for PagerDuty because in starting a startup, the way we thought about the idea of PagerDuty was by thinking back from our time at Amazon—myself and my other two co-founders, Andrew and Baskar—and we thought about what are useful tools or internal tools that existed at Amazon that we wished existed in the broader world? And we thought about, you know, an internal tool that Amazon developed, which was called the ‘Pager Duty Tool' because it organized the on-call scheduling and paging and it was attached to the incident—to the ticketing system. So, if there's was a SEV 1 or SEV 2 ticket, it would actually page either one team—or lots of teams if it was a major incident that impacted revenue and customers and all that good stuff. So yeah, that's where we got the inspiration for PagerDuty by carrying the pager and seeing that tool exist within Amazon and realizing, hey, Amazon built this, Google has their own version, Facebook has their own version. It seems like there's a need here. That's kind of where that initial germ of an idea came from.Kolton: So, much overlap. So, much similarity. I came, you know, a couple of years behind you. I was at Amazon 2009 to 2013. And I'd had the opportunity to work for a couple of startups out of college and while I was finishing my education, I'd tasted startup world a little bit.My funny story I tell there is I turned down my first offer from Amazon to go work for a small startup that I thought was going to be a better deal. Turns out, I was bad at math, and a couple of years later, I went back to Amazon and said, “Hey, would you still like me?” And I ended up on the availability team, and so very much in the heart of what Alex is describing. It was a ‘you build it, you own it, you operate it' environment. Teams were on call, they got paged, and the rationale was, if you felt the pain of that, then you were going to be motivated to go fix it and ensure that you weren't feeling that pain.And so really, again, and I agree, somewhat taken for granted that we really learned best-in-class DevOps and system thinking and distributed system principles, by just virtue of being immersed into it and having to solve the problems that we had to solve at Amazon. We also share a similar story in that there was a tool for paging within Amazon that served as a bit of an inspiration for PagerDuty. Similarly, we built a tool—may or may not have been named Gremlin—within Amazon that helped us to go do this exact type of testing. And it was one part tooling and it was one part evangelism. It was a controversial idea, even at Amazon.Some teams latched on to it quickly, some teams needed some convincing, but we had that opportunity to go work with those teams and really go develop this concept. It was cool because while Netflix—a lot of folks are familiar with Netflix and Chaos Monkey, this was a couple of years before Chaos Monkey came out. And we went and built something similar to what we built a Gremlin: An API, a front end, a variety of failure modes, to really go help solve a wider breadth of problems. I got to then move into performance, and so I worked on making the website fast, making sure that we were optimizing things. Moved into management.That was a very useful life experience wasn't the most enjoyable year of my life, but learned a lot, got a lot done. And then that was the next summer, as I was thinking about what was next, I bumped into Alex. I was really starting to think about founding a company, and there was a big question: Was what we built an Amazon going to be applicable to everyone? Was it going to be useful for everyone? Were they ready for it?And at the time, I really wasn't sure. And so I decided to go to Netflix. And that was right after Chaos Monkey had come out, and I thought, “Well, let's go see—let's go learn a bit more before we're ready to take this to market.” And because of that time at Amazon—or at Netflix, I got to see, they had a great start. They had a great culture, people were bought into it, but there was still some room for development on the tooling and on the approach.And I found myself again, half in the developer mindset, half in the advocacy mindset where needed to go and prove the tooling to make it safer and more scalable and needed to go out and convince folks or help them do it well. But seeing it work at Amazon, that was great. That was a great learning experience. Seeing at work at Amazon and Netflix, to me said, “Okay, this is something that everyone's going to need at some point, and so let's go out and take a stab at it.”Alex: That's interesting. I didn't realize that it came from Amazon. I always thought Chaos Engineering as a concept came from Netflix because that's where everyone's—I mean, maybe I'm not the only one, but that's—that was my impression, so that's interesting.Kolton: Well, as you know, Amazon, at times, likes to keep things close to the vest, and if you're not a principal engineer, you're not really authorized to go talk about what you've done. And that actually led to where my opportunity to start a company came from. I was speaking about what I built at Netflix at a conference and I ran into some VCs in the lobby, and we got into a bit of a debate. They were like, “Hey, have you thought about building a company around this?” And I was like, “I have, but I don't want your money. I'm going to bootstrap it. We're going to figure it out on our own.” And the debate went back and forth a little bit and ultimately it ended with, “Oh, you have five kids and you live in California? Maybe you should take some money.”Mandi: So, what ends up being different? Amazon—I've never worked for Amazon, so full disclosure, I went from AOL to Chef, and now I'm at PagerDuty. So, but I know what that environment was like, and I remember the early days, PagerDuty you got started around the same time, like, Fastly and Chef and, like, that sort of generation of startups. And all this stuff that sort of emerged from Amazon, like, what kind of mindset do you—is there a change of mindset when you're talking to developers and engineers that don't work for Amazon, looking into Amazon from the outside, you kind of feel like there's a lot more buy-in for those kinds of tools, and that kind of participation, and that kind of—like we said before, the full service-ownership and all of those attitudes and all that cultural pieces that come along with it, so when you're taking these sort of practices commercial outside of Amazon, what changes? Like, is there a different messaging? Is there a different sort of relationship you have with the developers that work somewhere else?Alex: I have some thoughts, and it may not be cohesive, but I'm going to go ahead anyway. Well, one thing that was very interesting from Amazon is that by being a pioneer and being at a scale that's very significant compared to other companies, they had to invent a lot of the tooling themselves because back in mid-2000s, and beyond, there was no Datadog. There was no AWS; they invented AWS. There wasn't any of these tools, Kubernetes, and so on, that we take for granted around containers, and even virtual servers were a new thing. And Amazon was actually I think, one of the pioneers of adopting that through open-source rather than through, like, a commercial vendor like VMware, which drove the adoption of virtual everything.So, that's one observation is they built their own monitoring, they built their own paging systems. They did not build their own ticketing system, but they might as well have because they took Remedy and customized it so much that it's almost like building your own. And deployment tools, a lot of this tooling, and I'm sure Kolton, having worked on these teams, would know more about the tooling than I did as just an engineer who was using the tooling. But they had to build and invent their own tools. And I think through that process, they ended up culturally adopting a ‘not invented here' mindset as well, where they're, generally speaking, not super friendly towards using a vendor versus doing it themselves.And I think that may make sense and made a lot of sense because they were at such a scale where there was no vendor that was going to meet their needs. But maybe that doesn't make as much sense anymore, so that's maybe a good question for debate. I don't know, Kolton, if you have any thoughts as well.Kolton: Yeah, a lot of agreement. I think what was needed, we needed to build those things at Amazon because they embraced that distributed systems, the service-oriented architectures early on, that is a new class of problem. I think in a world where you're not dealing with the complexity of distributed systems, Chaos Engineering just looks like testing. And that's fine. If you're in a monolith and it's more straightforward, great.But when you have hundreds of things with all the interconnections and the combinatorial explosion you have with that, the old approach no longer works and you have to find something new. It's funny you mentioned the tooling. I miss Amazon's monitoring tooling, it was really good. I miss the first iteration of their pipelines, their CI/CD tooling. It was a great iteration.And I think that's really—you get to see that need, and that evolution, that iteration, and a bit of a head start. You asked a bit about what is it like taking that to market? I think one of the things that surprised me a little bit, or I had to learn, is different companies are at different points in their journey, and when you've worked at Amazon and Netflix, and you think everybody is further along than they are, at times, it can be a little frustrating, or you have to step back and think about how do you catch somebody up? How do you educate them? How do you get them to the point where they can take advantage of it?And so that's, you know, that's really been the learning for me is we know aspirationally where we want to go—and again, it's not the Amazon's perfect; it's not the Netflix is perfect. People that I talk to tend to deify Netflix engineering, and I think they've earned a lot of respect, but the sausage is made the same, fundamentally, at every company. And it can be messy at times, and it's not always—things don't always go well, but that opportunity to look at what has gone well, what it should look like, what it could look like really helps you understand what you're striving for with your customers or with the market as a whole.Alex: I totally agree with that because those are big learning for me as well. Like, when you come out of an Amazon, you think that maybe a lot of companies are like Amazon, in that they're… more like I mentioned: Amazon was a pioneer of service-oriented architecture; a pioneer of DevOps; and you build it, you own it; pioneer of adopting virtual servers and virtual hosting. And you, maybe, generalize and think, you know, other companies are there as well, and that's not true. There's a wide variety of maturities and these trends, these big trends like Cloud, like AWS, like virtualization, like containerization, they take ten years to fully mature from the starting point. With the usual adopter curve of very early adopters all the way to, kind of, the big part of the curve.And by virtue of starting PagerDuty in 2009, we were on the early side of the DevOps wave. And I would say, very fortunate to be in the right place at the right time, riding that wave and riding that trend. And we worked with a lot of customers who wanted to modernize, but the biggest challenge there is, perhaps it's the people and process problem. If you're already an established company, and you've been around for a while you do things a certain way, and change is hard. And you have to get folks to change and adapt and change their jobs, and change from being a, “sysadmin,” quote-unquote, to an SRE, and learn how to code and use that in your job.So, that change takes a long time, and companies have taken a long time to do it. And the newer companies and startups will get there from day one because they just adopt the newest thing, the latest and greatest, but the big companies take a while.Kolton: Yeah, it's both that thing—people can catch up quicker. It's not that the gap is as large, and when you get to start fresh, you get to pick up a lot of those principles and be further along, but I want to echo the people, the culture, getting folks to change how they're doing things, that's something, especially in our world, where we're asking folks to think about distributed system testing and cross-team collaboration in a different way, and part of that is a mental journey, just helping folks get over the idea—we have to deal with some misconceptions, folks think chaos has to be random, they think it has to be done in production. That's not the case. There's ways to do it in dev and staging, there's ways to do it that aren't random that are much safer and more deterministic.But helping folks get over those misconceptions, helping folks understand how to do it and how to do it well, and then how to measure the outcomes. That's another thing I think we have that's a bit tougher in our SRE ops world is oftentimes when we do a great job, it's the absence of something as opposed to an outcome that we can clearly see. And you have to do more work when you're proving the absence of something than the converse.Julie: You know, I think it's interesting, having worked with both of you when I was at PagerDuty and now at Gremlin, there's a theme. And so we've talked a lot about Amazon and Netflix; one of the things, distinctly, with customers at both companies, is I've heard, “But we're not Amazon and we're not Netflix.” And that can be a barrier for some companies, especially when we talk about this change, and especially when we talk about very rigid organizations, such as, maybe, FinServ, government, those types of organizations, where they're more resistant to that, and they say, “Don't say Amazon. Don't say Netflix. We're not those companies. We can't operate like them.”I mean, Mandy and I, we were on a call with a customer at one point that said we couldn't use the term DevOps, we had to call it something different because DevOps just meant too forward-thinking, even though we were talking about the same concepts. So, I guess what I would like to hear from both of you, is what advice would you give to those organizations that say, “Oh, no. We can't be Netflix and we can't be Amazon?” Because I think that's just a fear of change conversation. But I'm curious what your thoughts are.Alex: Yeah. And I can see why folks are allergic to that because you look at these companies, and they're, in a lot of ways, so far ahead that you don't, you know—and if you're a lower level of maturity, for lack of a better word, you can't see a path in your head of how do you get from where you are today to becoming more like a Netflix or an Amazon because it's so different. And it requires a lot of thinking differently. So, I think what I would encourage, and I think this is what you all do really well in terms of advocacy, but what I'd encourage is, like, education and thinking about, like, what's a small step that you can take today to improve things and to improve your maturity? What's an on-ramp?And there's, you know, lots of ideas there. Like, for example, if we're talking about modern incident management, if we're talking Chaos Engineering, if we're talking about public cloud adoption and any of these trends, DevOps, SRE, et cetera, maybe think about how do you—do you have a new greenfield project, a brand new system that you're spinning up, how do you do that in a modern way while leaving your existing systems alone to start? Then you learn how to do it and how to operate it and how to build a new service, a new microservice using these new technologies, you build that muscle. You maybe hire some folks who have done it before; that's always a good way to do it. But start with something greenfield, start small, you don't have to boil the ocean, you don't have to do everything at once. And that's really important.And then create a plan of taking other systems and migrating them. And maybe some systems don't make sense to migrate at all because they're just legacy. You don't want to put any more investment in them. You just want to run them, they work, leave them alone. And yeah, think about a plan like that. And there's lots of—now, there's lots of advice and lots of organizations that are ready and willing to help folks think through these plans and think through this modernization journey.Kolton: Yeah, I agree with that. It's daunting to folks that there's a lot, it's a big problem to solve. And so, you know, it'd be great if it's you do X, you get Y, you're done, but that's not really the world we live in. And so I agree with that wisdom: Start small. Find the place that you can make an impact, show what it looks like for it to be successful.One thing I've found is when you want to drive bottoms-up consensus, people really want to see the proof, they want to see the outcome. And so that opportunity to sit down with a team that is already on the cutting edge, that is feeling the pain, and helping them find success, whether that's SRE, DevOps, whether it's Chaos Engineering, helping them, see it, see the outcome, see the value, and then let them tell their organization. We all hear from other folks what we should be doing, and there's a lot of that information, there's a lot of that context, and some of its noise, and so how we cut through that into what's useful, becomes part of it. This one to me is funny because we hear a lot, “Hey, we have enough chaos already. We don't need any more chaos.”And I get it. It's funny, but it's my least favorite joke because, number one, if you have a lot of chaos, then actually you need this today. It's about removing the chaos, not about adding chaos. The other part of it is it speaks to we need to get better before we're ready to embrace this. And as somebody that works out regularly, a gym analogy comes to mind.It's kind of like your New Year's, it's your New Year's resolution and you say, “Hey, I'm going to lose ten pounds before I start going to the gym.” Well, it's a little bit backwards. If you want to get the outcome, you have to put in a bit of the work. And actually, the best way to learn how to do it is by doing it, by going out getting a little bit of—you know, you can get help, you can get guidance. That's why we have companies, we're here to help people and teach them what we've learned, but going out doing a bit of it will help you learn how you can do it better, and better understand your own systems.Alex: Yeah, I like the workout analogy a lot. I think it's hard to get started, it's painful at first. That's why I like the analogy [laugh]—Kolton: [laugh].Alex: —a lot. But it's a muscle that you need to keep practicing, and it's easy to lose, you stopped doing it, it's gone. And it's hard to get back again. So yeah, I like that analogy a lot.Julie: Well, I like that, too, because that's something that we talked a lot about for being on call, and understanding how to handle incidents, and building that muscle memory, right, practice. And so there's a lot of crossover—just like this episode, folks—between both Gremlin and PagerDuty as to how they help organizations be better. And again, going back to building a better internet. I mean, Alex your shirt—which our viewers—or our listeners—can't see, says, “The world is always on. Let's keep it this way,” and Kolton, you talk about reliability being no accident.And so when we talk about the foundations of both of these organizations, it's about helping engineers be better and make better products. And I'm really excited to learn a little bit more about where you think the future of that can go.For the second part of this episode, check out the PagerDuty podcast at Page it to the Limit. For links to the Page it to the Limit podcast and to all the information mentioned, visit our website atgremlin.com/podcast. If you liked this episode, subscribe to Break Things on Purpose on Apple Podcasts, Spotify, or wherever you listen to your favorite podcasts.Jason: Our theme song is called, “Battle of Pogs” by Komiku, and it's available onloyaltyfreakmusic.com.[SPLIT]Mandy: All right, welcome. This week on Page it to the Limit, we have a crossover episode. If you haven't heard part one of this episode featuring Kolton Andrus and Alex Solomon, you'll need to find it. It's on the Break Things on Purposepodcast from our friends at Gremlin. So, you'll find that atgremlin.com/podcast. You can listen to that episode and then come back and listen to our episode this week as we join the conversation in progress.Julie: There's a lot of crossover—just like this episode, folks—between both Gremlin and PagerDuty as to how they help organizations be better. And again, going back to building a better internet. I mean, Alex your shirt—which our viewers—or our listeners—can't see, says, “The world is always on. Let's keep it this way,” and Kolton, you talk about reliability being no accident. And so when we talk about the foundations of both of these organizations, it's about helping engineers be better and make better products. And I'm really excited to learn a little bit more about where you think the future of that can go.Kolton: You hit it though. Like, the key to me is I'm an engineer by trade. I felt this pain, I saw value in the solution. I love to joke, I'm a lazy engineer. I don't like getting woken up in the middle of the night, I'd like my system to just work well, but if I can go save some other people that pain, if I can go help them to more quickly understand, or ramp, or have a better on-call life have a better work-life balance, that's something we can do that helps the broader market.And we do that, as you mentioned, in service of a more reliable internet. The world we live in is online, undoubtedly, after the last couple of years, and it's only going to be more so. And people's expectations, if you're an older person like me, you know, maybe you remember downloading AOL for a couple of hours, or when a web page took a minute to load; people's expectations are much different now. And that's why the reliability, the performance, making sure things work when we need them to is critical.Alex: Absolutely. And I think there's also a trend that I see and that we're part of around automation. And automation is a very broad thing, there's lots of ways that you want to automate manual things, including CI/CD and automated testing and things like that, but I also think about automation in the incident context, like when you have an alert that fires off or you have an incident you have something like that, can you automate the solution or actually even prevent that alert from going off in the first place by creating a set of little robots that are kind of floating around your system and keeping things running and running well and running reliably? So, I think that's an exciting trend for us.Mandy: Oh, definitely on board with automating all the things for sure. So, of the things that you've learned, what's one thing that you wish you had maybe learned earlier? Or if there was like a gem or a nugget for folks that might be thinking about starting their own company around developer tools or this kind of software, is there anything that you can share with them?Alex: Kolton, you want to go first?Kolton: Sure, I'll go first. I was thinking a little bit about this. If I went back—we've only been at about six years, so Alex has the ten-year version. I can give you the five, six-year version. You know, I think coming into it as a technical founder, you have a lot of thoughts about how the world works that you learn are incorrect or incomplete.It's easy as an engineer to think that sales is this dirty organization that's only focused on money, and that's just not true or fair. They do a lot of hard work. Getting people to do the right thing is tough. Helping with support, with customer success.Even marketing. Marketing is, you know, to many engineers, not what they would spend their time doing, and yet marketing has really changed in the last 20 years. And so much of marketing now is about sharing information and teaching what we've learned as opposed to this old approach of you know, whatever you watched on TV as a kid. So, I think understanding the broader business is important. Understanding the value you're providing to customers, understanding the relationships you build with those customers and the community as a whole, those are pieces that might be easy to gloss over as an engineer.Alex: Yeah, and to echo that, I like your point on sales because initially when I first started PagerDuty, I didn't believe in sales. I thought we wouldn't need to hire any salespeople. Like, we sell to other engineers, and if they're anything like me, they don't want to talk to a salesperson. They want to go on the website, look around learn, maybe try it out—we had a free trial; we still have a free trial—and put in a credit card and off to the races. And that's what we did it first, but then it turns out that when doing so, and in customers in that way, there are folks who want to talk to you to make sure that, first of all your real business, you're going to be around for a while and it's not—you know, you're not going to not be around tomorrow.And that builds trust being able to talk to someone, to understand, if you have questions, you have someone to ask, and creating that human connection. And I found myself doing that function, like, myself and then realized, there's not enough time in the day to do this, so I need to hire some folks. And I changed my mind about sales and hired our first two salespeople about two-and-a-half years into PagerDuty. And probably got a little bit lucky because they're technical engineering background type folks who then went into sales, so they ended up being rockstars. And we instantly saw an increase in revenue with that.And then maybe another more tactical piece of advice is that you can't focus on culture too early when starting a company. And so one lesson that we learned the hard way is we hired an engineer that was brilliant, and really smart, but not the best culture fit in terms of, like, working well with others and creating that harmonious team dynamic with their peers. That ended up being an issue. And basically, the takeaway there is don't hire brilliant but asshole folks because it's just going to cause a lot of pain, and they're not going to work out even though they're really smart, and that's kind of the reason why you keep them around because you think, well, it's so hard to hire folks. You can't let this person go because what are we going to do? But you do have to do it because it's going to blow up anyways, and it's going to be worse in the long run.Kolton: Yeah, hiring and recruiting have their own set of challenges associated with them. And similar to hiring the brilliant jerk, some of the folks that you hire early on aren't going to be the folks that you have at the end. And that one's always tough. These are your friends, these are people you work closely with, and as the company grows, and as things change, people's roles change, and sometimes people choose to leave and that breaks your heart because you've invested a lot of time and effort into that relationship. Sometimes you have to break their heart and tell them it's not the right fit, or things change.And that's one that if you're a founder or you're part of that early team, you're going to feel a little bit more than everyone else. I don't think anything you read on the internet can prepare you for some of those difficult conversations you have to have. And it's great if everything goes well, and everyone grows at the same rate, everyone can be promoted, and you can have the same team at the end, but that's not really how things play out in reality.Julie: It's interesting that we're talking about culture, as we heard about last week, on the Break Things on Purposeepisode, where we also talked about culture and how organizations struggle with the culture shift with adopting new technologies, new ways of working, new tools. And so what I'm hearing from you is focusing on that when hiring and founding your company is important. We also heard about how that's important with changing the way that we work. So, if you could give an advice to maybe a very established—if you are going to give a piece of advice to Amazon—maybe not Amazon, but an established company—on how to overcome some of those objections to culture change, those fears of adopting new technology. I know people are still afraid of holding a pager and being on call, and I know other people are afraid of chaos as we talk about it and those fears that you've mentioned before, Kolton. What would your piece of advice be?Alex: Yeah, good—great question. This will probably echo what I've said earlier, which is when looking to transform, transform culture especially, and people and process, the way I think about is try to not boil the ocean and start small, and get some early wins. And learn what good looks like. I think that's really important. It's this concept of show, don't tell.Like, if you want to, you know, you want to change something, you start at the grassroots level, you start small, you start maybe with one or two teams, you try it out, maybe something like I mentioned before, in a greenfield context where you're doing something brand new and you're not shackled by legacy systems or anything like that, then you can build something new or that new system using the new technologies that are that we're talking about here, whether it's public cloud, whether it's containerization and Kubernetes, or whatnot, or serverless, potentially. And as you build it and you learn how to build it and how to operate it, you share those learnings and you start evangelizing within the company.And that goes to what I was saying with the show don't tell where you're like showing, “Here's what we did and here's what we learned. And not everything went swimmingly and here are things that didn't go so well, and maybe what's our next step beyond this? Do other folks want to opt-in to this kind of new thing that we're doing?” And I'm sure that's a good way to get others excited. And if you're thinking about longer-term, like, how do you transform the entire company, well, that's this is a good way to start; start small you learn how to do it, you learn about what good looks like, you get others excited about it, others opt-in, and then at some point through that journey, you start mandating it top-down as well because grassroots is only going to take you so far. And then that's where you start putting together project plans around, like, how do we get other teams to do it, on a timeline? And when are they going to do it? And how are they going to do it? And then bring everyone along for the journey as well.Kolton: You're making this easy for me. I'll just keep agreeing with you. You hit all the points. Yeah, I mean, on one hand, the engineer in me says, you know, a lot of times when we're talking about this transformation, it's not easy, but it's worth it. There's a need that we're trying to solve, there's a problem we're trying to solve.And then the end, what that becomes as a competitive advantage. The thought that came to mind as Alex was speaking is you need that bottoms-up buy-in; you also need that top-down support. And as engineers, we don't often think about the business impact of what we do. There's an important element and a message I like to reiterate for all the engineers that, think about how the business would value the work you do. Think about how you would quantify the value of the work you do to the business because that's going to help that upper level that doesn't, in the day-to-day feeling the pain, understand that what we're doing is important, and it's important for the organization.I think about this a little bit like remote-by-default work. So, when we founded Gremlin, we decided you know, we didn't want offices. And six years ago that was a little bit exceptional. Folks were still fundamentally working in an office environment. I'm not here to tell you that remote-by-default is easy, works for everyone, or is the answer.Actually, what we found is you need a little bit of both. You need to be able to have good tooling so folks can be efficient and effective in their work, but it's still important to get folks together in person. And magic happens when you get a group of folks in a room and let them brainstorm and collaborate chat on the way to launch or on the way to dinner. But I think that's a good example where we've learned over the last couple of years that the old way of doing it was not as effective as it could be. That maybe we don't need to swing the pendulum entirely the other way, but there's merits at looking at what the right balance is.And I think that applies to, you know, incident management, to SRE, to Chaos Engineering. You know, maybe we don't have to go entirely on the other end of the spectrum for everyone, but are there little—you know, is there an 80/20 solution that gets us a lot of value, that saves a lot of time, that makes us more efficient and effective, without having to rewrite everything from scratch?Alex: Yeah, I like that a lot. And I think part of it, just to add to that, is make it easy for people to adopt it, too. Like, if you can automate it for folks, “Hey, here's a Terraform thing where you could just hit a button and it does it for you, here's some training around how to leverage it, and here's the easy button for you to adopt.” I think that goes with the technology of adopting, but also the training, also the, you know, how-tos and learnings. That way, it's not going to be, like, a big painful thing, you can plan for it. And yeah, it's off to the races from there.Kolton: I think that's prudent product advice, as well. Make it easy for people to do the right thing. And I'm sure it's tricky in your space; it's really tricky in our space. We're going out and we're causing failure, and there's inadvertent side effects, and you need to understand what's happening. It's a little scary, but that's where we add a lot of value.We invest a lot of time and effort in how do we make it easy to understand, easy to understand what to expect, and easy to go do and see what happens and see that value? And it sounds easy. You know, “Hey, just make it easy. Just make it simple,” but actually, as we know, it takes so much more effort and work to get it to be that level of simplicity.Alex: Yeah, making something easy is very, very hard—Kolton: [laugh].Julie: —ironically.Kolton: Yeah. Ironically.Mandy: Yeah, so what are you excited for the future? What's on your horizon that maybe you can share with us that isn't too, like, top-secret or anything? Or even stuff, maybe, not related to your companies? Like, what are you seeing in the industry that really has you motivated and excited?Alex: Great question. I think a couple of things come to mind. I already mentioned automation, and we are in the automation space in a couple of different ways, in that we acquired a company called Rundeck over a year ago now, which does runbook automation and just automation in general around something like running a script across a variety of resources. And in the incident context, if an alert fires or an incident fires, it's that self-healing aspect where you can actually resolve the issue without bothering a human.There's two modes to this automation: There's the kind of full self-healing mode where, you know, something happens and the script just fixes it. And then the second mode is a human is involved, they get paged, and they have a toolbox of things that they can do, that they can easily do. We call that the Iron Man mode, where you're getting, like, these buttons you can push to actually resolve the problem, but in that case, it's a type of problem that does require a person to look at it and realize, oh, we should take this action to fix it. So, I'm very excited about the automation and continuing down that path.And then the other thing that really excites me as well is being able to apply AI and ML to the alerting and incident response and incident management space. Especially our pattern detection, looking for patterns and alerts and incidents, and seeing have we seen this kind of problem before? If so, what happened last time? Who worked on the last time? How did they resolve it last time?Because, you know, you don't want to solve the same problems over and over. And that actually ties into automation really nicely as well. That pattern detection, it's around reducing noise, like, these alerts are not real alerts, they're false alerts, so let's reduce them automatically, let's suppress them, let's filter them out automatically because the signal to noise is really important. And it's that pattern detection, so if something major is happening, you can see here's the blast radius, here's the services or systems it's impacting. Oh, we've seen something similar before—or we haven't seen something similar before, it's something totally brand new—and try to get the right folks involved quickly so that they can understand that blast radius and know how to approach the problem, and resolve it quickly.Kolton: So, it's not NFT's is your PagerDuty profile picture?Alex: [laugh].Kolton: Because that's, kind of, what I—no, I'm kidding. I couldn't help but just like what do I not see—like, I've, I've tried to think of the best NFT joke I could. That was what I came up with. I agree on the AI/ML stuff. That opportunity to have more data and to be able to do better analysis of it, I've written some of that, you know, anomaly detection stuff—and it was a while back; I'm sure it could be done better—that'll get us to a point.You know, of course, I'm here to push on the proactive. There's things we can do beyond just reacting faster that will be helpful. But I think part of that comes from people being comfortable sharing more about their failures. It's a stigmata to fail today, and regardless of whether we're talking about a world where we're inciting things like blameless postmortems, people still don't want to talk about their failures, and it's hard to get that good outage information, it's hard to get the kind of detail that would let us do better analytics, better automation.And again, back to the conversation, you know, maybe we know what Amazon and Netflix looks like, but for us to create something that will help solve a broader problem, we have to know what those companies are feeling in pain; we need to know what their troubles are hitting at. So, I think that's one thing I've been excited about is over the past two years, you've seen the focus on reliable, stable systems be much more important. Five years ago, it was, “Get out of my way, I got features to write, we got money to make, we're not interested in that. If it breaks, we'll fix it.” And you know, as we're looking at the future, we're looking at our bridges, we're looking at our infrastructure, our transportation, the software we're writing is going to be critical to the world, and it operating correctly and reliably is going to be critical. And I think what we'll see is the market and customers are going to catch up to that; that tolerance for failure is going to go down and that willingness to invest in preventing failure is going to go up.Alex: Yeah, I totally agree with that. One thing I would add is, I think it's human nature that people don't want to talk about failures. And this is maybe not going to go away, but there is maybe a middle ground there. I mean, talking about postmortems, especially, like, when a big company has a big outage and it makes the news, it makes Hacker News, et cetera, et cetera, I don't see that changing, in that companies are going to become radically more transparent, but where I do think there is a middle ground is for your large customers, for your important customers, creating relationships with them and having more transparency in those cases. Maybe you don't post it on a public status page a full, detailed nitty-gritty postmortem, but what you do do is you talk to your major customers, your important customers, and you give them that deeper view into your systems.And what's good about that is that it creates trust, it helps establish and maintain trust when you're more transparent about problems, especially when you're taking steps to fix them. And that piece is really important. I mean trust is, like, at the core of what we do. I have a saying about this—[unintelligible 00:19:31]—but, “Trust is won in droplets and lost in buckets.” So, if you have these outages all the time, or you have major service degradation, it's easy to lose that trust. So, you want to prevent those, you want to catch them early, you want to create that transparency with your major customers, and you want to let them in the loop on what's happening and how you're preventing these types of issues going forward.Kolton: Yeah, great thoughts. Totally agree.Julie: So, for this episode of deep thoughts with Kolton and Alex, [laugh] I want to thank both of you for being here with Mandy and I today. We're really excited to hear more and to see each of our respective companies grow and change the way people work and make life easier, not just for engineers, but for our customers and everybody that depends on us.Mandy: Yeah, absolutely. I think it's good for folks out there to know, you're not alone. We're all learning this stuff together. And some folks are a little further down the path, and we're here to help you learn.Kolton: Totally. Totally, it's an opportunity for us to share. Those that are further along can share what they've learned; those that are new or have some great ideas and suggestions and enthusiasm, and by working together, we all benefit. This is the two plus two equals five, where, by getting together and sharing what we've learned and figuring out the best way, no one of us is going to be able to do it, but as a group, we can do it better.Alex: Yeah. Totally agree. That's a great closing thought.Mandy: Well, thanks, folks. Thank you for joining us for another episode of Page it to the Limit. We're wishing you an uneventful day.

In this episode, we cover: 00:00:00 - Introduction  00:02:00 - Carissa's first job in tech and first bootcamp  00:04:30 - Early Lessons: Carissa breaks production—on a Friday! 00:08:40 - Carissa's work at ClickBank and listening to newer hires  00:10:55 - The metrics that Carissa measures and her attitude about constantly learning 00:16:45 - Carissa's Chaos Engineering experiences  00:18:25 - Some advice for bringing new folks into the fold 00:23:08 - Carissa and ClickBank/Outro Links: ClickBank: https://www.clickbank.com/ LinkedIn: https://www.linkedin.com/in/carissa-morrow/ TranscriptCarissa: It's all learning. I mean, technology is never going to stop changing and it's never going to stop being… a lot to learn, [laugh] so we might as well learn it and try to keep up with the [laugh] times and make our lives easier.Julie: Welcome to Break Things on Purpose, a podcast about reliability, asking questions, and learning from failure. In this episode, we talked with Carissa Morrow about what it's like to be new in tech, and how to learn from mistakes and build your skills.Julie: Carissa, I'm really excited to talk to you. I know we chatted in the past a little bit about some horror stories of breaking production. I think that it's going to be a lot of fun for our listeners. Why don't you tell us a little bit about yourself?Carissa: Yeah, so I actually have only been in this industry about three years. So, I come with kind of a newbie's perspective. I was a certified ophthalmic tech before this. So, completely different field. Hit my ceiling, and my husband said, “You want to try coding?” I said, “Not really.” [laugh]. But I did. And I loved it.So, long story short, I ended up just signing up for a local boot camp, three-month full stack. And then I got really lucky; when I graduated there and walked into my previous employer's place. They said, “Do you know what DevOps is?” I said, “I have no idea.” And they still hired me.And it was really great, really, really great experience. I learned so much in a couple years with them. So, and now I'm here at ClickBank and I'm three years in and trying not to break things every day, especially on a Friday.Julie: [laugh]. Why? That's the best day to break things, Carissa—Carissa: [laugh]. No, it's really not.Julie: —preferably at 4:45. Well, that's really amazing. So, that's quite the jump. And as you mentioned, you started with a boot camp and then ended up at an employer—and so, what was your role? What were you doing in your first role?Carissa: So, I started on a really small team; there was just three of us including myself. So, I learned pretty much everything from the ground up, knowing nothing coming into DevOps. So, I had, you know, coding background from the boot camp, but I had to learn Python from scratch. And then from there, just kind of learning everything cloud. I had no idea about AWS or Google or anything in the cloud realm.So, it was very much a rough—very, very rough first year, I had to put my helmet on because it was a very bumpy ride. But I made it and I've come out a heck of a lot stronger because of it.Julie: Well, that's awesome. How about do you have people that you were working with that are mentoring you?Carissa: Yep. So, I actually have been very lucky and have a couple of mentors, from not only my previous employer, but also clients that I worked with that have asked to be my mentor and have stuck it out with me, and helped not just in the DevOps realm or the cloud realm, but for me as a person in that growing area. So, it's been pretty great.Julie: Well, that's awesome. And I guess I should give the disclosure that Carissa and I both worked together, for me a couple of jobs ago. And I know that, Carissa, I've reached out to you for folks who are interested in the boot camp that you went through. And I know it's not an advertisement for the boot camp, but I also know that you mentored a friend of mine. Did you want to share where you went?Carissa: Yeah, definitely. So, I went to Boise CodeWorks, which is a local coding school here in Boise. And they did just move locations, so I'm not quite sure where they're at now, but they're definitely in Boise.Julie: And if I remember correctly, that was a three-month very intensive, full-time boot camp where you really didn't have time for anything else. Is that right?Carissa: Yes, it is absolutely 1000% a full-time job for three months. And you will get gray hairs. If you don't, you're doing something wrong. [laugh]. Yep.Julie: So, what would you say is one of the most important things you learned out of that?Carissa: I would say just learning how to be resilient. It was very easy to want to quit because it was so difficult. And not knowing what it was going to look like when I got out of it, but part of me just wanted to throw my hands up half the time. But pushing through that made it just that much sweeter when I was done.Julie: Well now, when we were talking before, you mentioned that you broke production once. Do you want to tell me about that—Carissa: Maybe a few times. [laugh].Julie: —[crosstalk 00:04:34] a few times? [laugh]. You want to share what happened and maybe what you learned from it.Carissa: Yeah, yep. So, I was working for a company that we had clients, so it was a lot of client work. And they were an AWS shop, and I was going in to kind of clean up some of their subnets and some of their VPN issues—of course, this is also on a Friday. Yeah. It has to be on a Friday.Julie: Of course.Carissa: So, I will never forget, I was sitting outside thinking, “This is going to be a piece of cake.” I went in, I just deleted a subnet, thinking, “That's fine. Nothing's going to happen.” Five minutes later Slack's blowing up, production's down and, you know, websites not working. Bad. Like, worst-case scenario.So, back then we had, like, a team of, I think I would say ten, and every single person jumped on because you could tell I was panicking. And they all jumped in and we went step-by-step, tried to figure it out, figured out how we could fix it. But it took a good four hours of traumatizing stress [laugh] before we got it fixed. And then I learned my lesson, you know? Double-triple check before you delete anything and try to just make Fridays read-only if you can. [laugh].Julie: Well, and I think that's one of the things right? You always have to have that lesson-learning experience, and it's going to happen. And showing empathy for friends during that, I think, is the really important piece. And I love the fact that you just talked about how the whole team jumped on because they saw that you were stressed out. Were you in person or remote at the time?Carissa: I was remote at the time.Julie: Okay.Carissa: Yeah. And we were traveling in our RV, so nothing like being out in the woods, panicking by yourself, and [laugh] roaming around.Julie: So, did you run a postmortem on it?Carissa: So, back then—actually, we ended up doing that, yes, but that was when I had never really experienced a postmortem before, and that's one thing that, you know, when we talk about this kind of stuff—and everyone has a horror story or two, but that's something that I've had to learn to get better at is RCAs and postmortems because they're so important. I think they're incredibly important. Because these things are going to happen again; they're going to happen to the best of us. So, definitely, everything is a learning experience. And if it's not, you're missing out. So, I try to make everything a learning experience, for sure.Julie: Absolutely. And that's one of the things we talk about is now take that, and how do you learn from this? And how do you put the gates in place so that you can't just delete a subnet? I mean, to be fair, you did it, but were there other things that could have prevented this from happening, some additional checks and balances?Carissa: Mm-hm.Julie: And as you mentioned, that's not the only time that you've broken production. But let me ask you was that—did the alerting mechanisms work? Did all of the other—did the monitoring and observability? Like, did everything work correctly, or did you find some holes in that as well?Carissa: So, that's a great question. So, this specific client did not use any monitoring tools whatsoever. So—Julie: Huh.Carissa: Yeah, so that was one of those unique situations where they just tried to get on their own website and it didn't work. And then, you know, it was testing and everything was failing. But it was all manual testing. And I actually—believe it or not—I've seen that more often than I ever thought I would in the last three years. And so with what you guys do, and kind of what I'm seeing with a bunch of different clients, it's not just do they have monitoring, it's how do they use that? And when it's, kind of, bits and pieces here and there and they're not using it to their full potential, that's when a lot of things slip through the cracks. So, I've definitely seen a lot of that.Julie: Absolutely. And it's interesting because I really think that, especially these advanced organizations, that they're just going to have all the ducks in the row, all the right monitoring setup, and it turns out that they don't always have everything set up or set up correctly. And that's one of the things that we talk about, too, is validating with Chaos Engineering, and looking at how can we make sure it's not just that our systems are resilient, but that our tools pick things up, that our people and processes work? And I think that's really important. Now… you're working at ClickBank today?Carissa: Mm-hm.Julie: You want to tell us a little bit about that and about what you do over there?Carissa: Yep. So, I came on a few months ago as a cloud engineer for their team. And they are—I have actually learned a lot of monitoring tools through what they have already set up. And as they're growing and continue to grow, I'm learning a lot about what they have in place and maybe how we can improve it. So, not just understanding the metrics has been a learning curve, but understanding what we're tracking, why, and what's an emergency—what's critical, what's not—all of those things is definitely a huge, huge learning curve.But regardless of if it's ClickBank or other companies that I know people that work out or I've worked at, everyone knows there's a humbling aspect when you're using all these tools. We all want to pretend like we know everything all the time, and so being humble enough to ask the questions of, “Why do we use this? Are we using it to its full potential? And what am I looking at?” That's how I've learned the most, even in the last couple of months here is just asking those very humbling questions.Julie: Well, I have to say, you know, you mentioned that you are really still new; it's three years out of school for you doing this, and I think that there actually is quite a lot to be said about listening to newer people because you're going to ask questions that other folks haven't thought of, like, the whys. “Why are we doing things this way?” Or, “Why are we tracking that?” And sometimes—I think you've probably seen this as organizations—we just get into these habits—Carissa: Mm-hm.Julie: —and we do things because somebody who worked here, like, five years ago, set it up that way; we've just always done it this way.Carissa: Mm-hm.Julie: And it's a great idea to look into some of our practices and make sure that they're still serving us. One thing that you mentioned that I love, though, is you said metrics. And metrics are really important when practicing Chaos Engineering because it's good to know where you are now so that you can see improvement. Can you talk about some of the metrics that you measure or that might be important to ClickBank?Carissa: Yeah. So, a lot of the things that we measure have to do with orders. So, the big thing with ClickBank with how the model, the infrastructure of this company is set, orders are incredibly important, so between the vendors and the buyers in ClickBank. So, we are always monitoring in great detail how our orders are coming in, going out, all the payment information, you know, make sure everything's always secure and running smoothly. So, those are where most of our metrics that we watch where those live.The one thing that I think is—I've noticed is really important is whether you're monitoring one thing or ten, monitor to the best of your ability so that you're not just buying stuff and using 50% of it. And I think we get really excited when we go and we're like, “Yes, this is a great third-party tool or third-party—we're going to use it.” And then 10% of it, you know, you use and the rest of it, it's like, “That's really cool. Maybe we'll do that later, maybe we'll implement that part of it later.” And that's something that it's just, it's like, I know it's painful, [laugh] but do it now; get it implemented now and start using it, and then go from there.But I feel like why do we bother if we're only going to use 10% to 50% of these amazing things that really make our lives easier, and obviously, more secure and more resilient.Julie: I think you're onto something there. That is really good advice. I remember speaking at a conference in New Zealand and one of the speakers there talked about how their organization will buy any new tool that comes out, any and every new tool that comes out. But just buying that—and as you mentioned, just using a tiny, small portion of that tool can really be kind of ridiculous. You're spending a lot of money on these tools, but then these features were built for a reason, and oftentimes—and I saw this, too, at my past company—folks would purchase our tool, but not realize that our tool did so many other things.And so then there are multiple tools that are doing the same things within an organization when in reality, if you look at all the features and truly understand a tool—I would say some folks have a hard time with saying well, it just takes too much time to learn all of that. What's your advice for them?Carissa: Yeah. I think I've caught myself saying that to [laugh] at some point in time. You know, the context-switching, already having our full-time jobs and then bringing on tools, other tools that we need to learn. And it is overwhelming, but my advice is, why make more pain for yourself? [laugh]. Why not make your life easier, just like automation, right?When you're automating things, it's going to be a lot of work up front, but the end goal is make everything more secure, make it easier on yourself, take out the single point of failure or the single-person disaster because they did one wrong thing. Monitoring does the same thing. You know, if you put the investment up ahead of time, if you do it right upfront, it's going to pay off later.The other thing I've seen, and I've been guilty of as well is just looking at it and saying, “Well, it looks like it's working,” but I don't really know what I'm looking at. And so going back to that, you know, if you don't know why things are failing, or what to look out for to catch things from failing, then why even bother having that stuff in front of you? So, it's a lot of learning. It's all learning. I mean, technology is never going to stop changing and it's never going to stop being… a lot to learn, [laugh] so we might as well learn it and try to keep up with the [laugh] times and make our lives easier.There was actually a—I wrote this quote down because I ran across this last week, and I loved it because we were talking about failures. It said, “Not responding to failures is one characteristic of the organizational death spiral.” And I loved that because I sat there and thought, “Yeah, if you do have a failure, and you think, ‘Well, I have my monitoring tools in place. It looks like it worked itself out. I don't really know what happened.' And that continues to happen, and everyone on the team has that same mentality, then eventually, things are going to keep breaking, and it's going to get worse and worse over time.” And they're not going to realize that they had a death spiral. [laugh]. So, I just love that quote, I thought that was pretty great.Julie: I love that as well, who was that from?Carissa: Oh, I'll have to pull it up, but it was online somewhere. I was kind of going through—because really bothering me when we were talking about some of our monitoring, and I was asking some kind of deep questions about, why? What's the critical threshold? What's the warning? Why are we looking at this? And so I started looking at deeper dives into resiliency, and so that popped up, and I thought that was pretty spot on.Julie: I love it. We will find the author of that. We'll post it in the show notes. I think that is an amazing quote. I think I'm going to steal it from you at some point because that's—it's very true.And learning from those failures and understanding that we can prevent failures from occurring, right? So—Carissa: Absolutely.Julie: —if you have a failure and you've remediated it, and you still want to test to make sure that you're not going to drift back into that failure, right? Our systems are constantly changing. So, that's one of the things we talk about with Chaos Engineering, as well, and building that reliability in. Now, have you experienced or practiced Chaos Engineering at all with any of your customers that you've worked on, or at ClickBank?Carissa: There was one, [sigh] one client that we had that I would say yes, but the testing itself needed to be more robust, it needed to be more accurate. It was kind of like an attempt to build testing around—you know, for Chaos Engineering, but looking back now, I wish we would have had more guidance and direction on how to build really strategic testing, not just, “Oh, look, it passed.” It might have been a false pass, [laugh] but it was just kind of absolute basic testing. So, I think there's a growth with that. Because I've talked to a lot of engineers over the years that we say testing is important, right, but then do we actually do it, especially when we're automating and we're using all these third-party tools.A lot of times, I'm going to go with what we don't. We say it's really important, we see the importance of it, but we don't actually implement it. And sometimes it's because we need help to be able to build accurate testing and things that we know really are going to be sustainable testing. So, it's more of probably an intimidation thing that I've seen over the years. And it's kind of going back to, we don't like to ask for help a lot of times in this industry, and so that plays a role there. Sometimes we just need help to be able to build these things out so we're not walking on eggshells waiting for the next thing to break.Julie: Now, I love it because you've drilled down kind of into that a few times about asking for help. And you've worked with some folks that I know you've done a great job. So far, I'm really impressed just seeing your growth over the last three years because I do remember your first day—Carissa: Oh—Julie: [laugh].Carissa: [laugh]. Oh, God.Julie: —and seeing you and in these little corner cubes. That was—[laugh]—Carissa: I was sweating bullets that day.Julie: —quite a long time ago. What advice would you give to senior folks who are helping newer folks or more junior folks? What would you want them to know about working with newer people?Carissa: Yeah, that's a good question. So, in my last job, I actually ended up becoming a lead before I left. And so [sigh] the one thing I learned from my mentor at my previous company that really just brought me up from knowing nothing. One thing I learned from him was, when he looked at me on the first day, he said, “Do not be afraid to ask for help. Period. Just don't. Because if you don't, something bad's going to happen and you're not going to learn and you're not going to grow.”And he also was one that said, “Put your helmet on. It's going to be a bumpy ride.” [laugh]. And I loved that. He even got me a little, uh—oh, it kind of like—it was a little bobblehead, and it had a helmet. [laugh]. And I thought that was so spot-on.I think we forget when we get really good at something or we've been doing something for a while, as human beings, we forget what it's like to be new, and to be scared, and to not know what our left and right hand is doing. So, I would say keep that in the forefront of your mind as you're mentoring people, as you're helping ramp them up, is they're going to be afraid to ask questions or remind them it's okay, and also just taking a step back and remembering when you were really new at something. Because it's hard to do. We all want to become experts and we don't want to remember how horrible that felt when we did not know what was in front of us. So, that would be my couple pieces of advice.Julie: Well, and then kind of circling back to that first time that you broke production, right, and everybody rallied around to help you—which is amazing; I love that—after it was over, what was the culture like? Were they supportive? What happened?Carissa: Yeah, that's a really good question because I've heard people's horror stories where it was not a good response afterwards, and they felt even more horrible after it was fixed. And my experience was a complete opposite. The support was just 1000% there. And we even hung out—we started a Zoom call and after we'd fixed it, there were people that hopped back on the call and said, “Let me tell you about my production story.” And we just started swapping horror stories.And it was 1000% support, but also it was a nice human reminder that we break things and it's okay. And so that was—it was a pretty great experience, I hope the best—we're all going to break things, but I hope that everyone gets that experience because the other experience, no fun. You know, we already feel terrible enough after we break it. [laugh].Julie: I think that's important. And I love that because that goes back to the embrace failure statement, right? Embrace it, learn from it. If you can take that and learn. And what did you learn? So, you mentioned you learn double, triple, quadruple check.Carissa: Mm-hm.Julie: So, have you made that same mistake again?Carissa: I have not. Knock on wood. I have not. [laugh].Julie: [crosstalk 00:21:58]Carissa: [crosstalk 00:21:59]. [laugh].Julie: It could happen—Carissa: Yep.Julie: —as we all are learning so much, sometimes you make the same mistake twice, right?Carissa: Yeah, absolutely. I would say there's two things. So, I learned that, and then I also learned that not just double and triple check before you do something, but going back to the don't be afraid to ask questions, sometimes you have to ask clarifying questions of your client or your customer before you pull the trigger. So, you might say I've done this a million times, but sometimes the ask is a little vague. And so, if you don't ask detailed questions, then yes, you might have done what needed to be done, but not in the way that they hoped for, not in the way that they wanted, your end game results were now not what was hoped for.So, definitely ask layered questions if you need to. To anyone: To your coworkers, to your manager, to your whoever you're using your monitoring tools through. Just ask away because it's better to do it upfront than to just try to get the work done and then, you know, then more fun happens.Julie: More fun indeed. [laugh].Carissa: [laugh]. Yes.Julie: Now, why don't you tell our listeners who aren't familiar with ClickBank, do you want to promote them a little bit, talk a little bit about what you're doing over there?Carissa: Yeah. So, ClickBank is awesome, which is why I'm there. [laugh]. No, they're a great company. I'm on a fairly, I wouldn't say large team, but it's a good-sized team.They're just really good people. I think that's been one of the things that's incredibly important to me, and I knew when I was making a switch that everyone talks about, they have a great working environment, they have great work-life balance. And for me, it's like you can talk the talk, but I want you to walk the walk, as a company. And I want—you know, if you say you're going to have a family environment, I want to see that. And I have seen that at ClickBank.It's been an awesome couple of months. There's a lot of support on the teams. There's a lot of great management there, and I'm kind of excited to see where this goes. But coming with a fresh perspective of working at ClickBank, it's a really great company. I'm happy.Julie: Well, I love that. And from what I'm aware of, y'all have some positions that are open, so we'll post a link to ClickBank in the as well. And, Carissa, I just want to thank you for taking the time to be a little vulnerable and talk about your terrifying breaking production experience, but also about why it's so important to be open to folks asking questions and to show empathy towards those that are learning.Carissa: Mm-hm. Yeah, absolutely. I think that is the number one thing that's going to make us all successful. It's going to make mentors more successful, and they're going to learn as they're doing it and it's going to make—it's going to build confidence in people that are coming into this industry or that are new in this industry to say, “Not only can I do this, I'm going to be really great. And I'm going to eventually mentor somebody someday.”Julie: I love that. And thank you. And thank you for spending time with us today. And, folks, you can find Carissa on LinkedIn. Pretty impressed that you're not on Twitter, so not a huge social media person, so it's just LinkedIn for Carissa. And with that—Jason: For links to all the information mentioned, visit our website at gremlin.com/podcast. If you liked this episode, subscribe to the Break Things on Purpose podcast on Spotify, Apple Podcasts, or your favorite podcast platform. Our theme song is called, “Battle of Pogs” by Komiku, and it's available on loyaltyfreakmusic.com.

Today we are joined by our dear friend, April, who is sharing her second VBAC birth story with us after three previous Cesarean births.April had two traumatic, emergency Cesareans for her first two births and a scheduled Cesarean for her third. Her first VBAC was a very heartbreaking yet tender birth to a stillborn at 36 weeks. She shares the many miracles and sweet experiences that led her to her most recent birth-- her second VBAC to a perfectly healthy, beautiful baby girl.Education, great support, trusting her intuition, finding the courage to be unconventional, and asking questions are all big parts of her story. She is a woman of strength in every way. We know her story will inspire you as much as it inspires us! Additional linksThe VBAC Link on Apple PodcastsHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Julie: Welcome, welcome. It is Wednesday and it is podcast Wednesday. I am really excited for today's story because our interview today is with April. April is actually one of my doula clients and she has-- oh my gosh. We could probably take three or four hours to share the whole story and all of the intricacies of how everything played out in her birth. But we are not. We are going to try to keep it super short. It's probably going to be a little bit hard for us. So bear with us while we try and keep this story to under an hour and get on there with it. But April has had three C-sections, and then she had a VBAC after three C-sections that was a 36-week stillborn, and then she went on to have another VBAC after three C-sections with a healthy baby girl. That's when I supported her as a doula for her second VBAC after three C-sections.I really admire April a lot. I am going to talk a little bit, maybe at the end if we have time, about her relationship with her provider and how she created this really cool, mutual respect and dynamic between them. If not, we are going to have to just have another podcast episode about me just telling about the cool things I experienced there. She is just fresh off the VBAC, like just over a month fresh off of her VBAC. It is such an incredible story, but I don't want to take up too much time sharing about it because I want her to be able to share as much as she can. Review of the WeekJulie: But before we do that, Meagan has a Review of the Week for us.Meagan: Yes I do. This is from holmclaugh90. This is on Apple Podcasts and the title is, “I listen every single day.” It says, “After a traumatic Cesarean with my first baby five years ago and multiple miscarriages in between, this is a breath of fresh air as I await my chance to have a VBAC this October with my second! Love every story I hear on this podcast and it makes me feel so much stronger in knowing I can do this!”And October has passed. This was last July, so if you are still listening, holmclaugh90, send us a message. We would love to hear how it turned out.Julie: Absolutely.April's storyJulie: All right. We are going to get right into April's story. Education, good support, listening to your intuition, trusting yourself, being grateful, giving yourself lots of grace, knowing that it's okay to say “no” and ask questions, these are all big parts of her story. We are just going to let her take it off and then see where this story flows. All right, April. Are you ready?April: I hope so. Yeah. Well, I just want to thank you for the opportunity to be on the podcast and share my story. I hope it will be helpful to at least one person out there. I know that when I found The VBAC Link this past fall actually, at the beginning of this last pregnancy, it was a tremendous resource and I have been telling everybody about it ever since. I'm sure Julie is totally okay with that.Julie: I am totally okay with it.April: But I just can't even tell you how grateful I am that this resource is out there. I am not paid to say this by any means or anything like that. I ended up hiring Julie as a result of listening to the podcast and actually going to your website. I think I actually did a lot of that through your emails and your blogs probably more than even the podcast, just looking at it and finding specific information for the things that I needed at the time because it can be very overwhelming for those of you that are already on a VBAC journey or wanting to pursue that. Sometimes it's just a lot of information and depending on what your circumstances are and maybe what your past history and trauma is, there could just be so much and you can go in so many directions. If you're like me, my brain is really creative and does that on its own anyway, so I was just really grateful for Meagan and Julie and the whole VBAC Link community and team for putting together more bullet-point information where I could find exactly what I needed when I wanted it. So thank you for having me on.Okay. So to get into my story, I already invited Julie and Meagan to interrupt and to help ask questions to keep me on track, but I am going to go over it like a summary first, and then maybe we will just dive into stuff after that. When I was 18, I was pregnant for the first time. I and my husband were expecting our daughter. I really didn't know. You just don't know what you don't know, right? As an 18-year-old who was entering motherhood and really excited and grateful for it but also terrified, it was a big transition in my life at the time too. I just didn't know a lot about birth in general.I really had a lot of trust in providers who I think are really great people, but I just didn't know what to ask and I didn't know how to really prepare for birth other than watching birth story shows and random information like that. Probably not the best resources, guys. Anyway, after a pretty smooth pregnancy, I ended up having an emergency Cesarean with her. Hers was due to a cord being wrapped around her neck which we didn't know until I got to the pushing phase and her heart rate kept dropping and went so low, and didn't want to come back up after the third time. And so we were rushed immediately to an emergency Cesarean.During that Cesarean, I am not sure. I actually only found out when we had our stillbirth later. I was actually given extra insight as to what exactly happened during that first birth but apparently, I had possibly some amniotic fluid or something get into my bloodstream and it caused-- I am still not sure if it was a pulmonary embolism or it was some type of embolism. I still need to go and actually find out exactly what happened. But it was a life-threatening situation as a result of that Cesarean. And so not only was it not the birth story I wanted, my daughter thankfully was healthy and okay after being monitored in the NICU for a little bit because she had meconium in her fluid when she was born, but on top of that, I barely got to see her. I got to say “hi” to her and give her a kiss as my husband brought her around from the drape to me. I looked over at my anesthesiologist who was on my other side and I don't know why but I couldn't move anything other than my head. I looked at him and was just pleading with my eyes because I, for some reason, couldn't even do any type of motion or sound or anything.Thankfully, he realized something was wrong and told me that he was going to put me out and I would be okay. The next thing I knew, I woke up and it was six hours later. She was being brought to me in the recovery area, the mother and baby, and I had missed it. I had missed the first six hours of her life and that was really hard for me. That was really traumatic for me. I did not love that. I was grateful at the time and still am that we had the ability to deliver her by Cesarean and whereas that was probably truly necessary for her to be born that way, it was still really traumatic and it was really sad. I was really hoping when I got pregnant with my second that we wouldn't have to do that again and I would be able to be the first one to hold her-- or to hold him this time. It was my boy. And be able to have those moments together peacefully without the drama around it. I prepared what I thought was preparing for a VBAC. I went and found a different provider and I asked them. That was one of the first things when they ask you, “What do you want and what are your questions and concerns with this pregnancy?” It was, “I would really like to have a VBAC and I will do whatever. Whatever you tell me to do to prepare for that and to hopefully make that successful.” I really wasn't given any information. It was just kind of like, “Oh, okay. Yeah. Sure. We will just plan on that. Just do what you did before and nothing different.” No further information or education. And again, I just trusted that the providers knew best and didn't really seek out any extra information on my own.So I went through that whole pregnancy and again, it wasn't too eventful, and then we got to birth. I went into the hospital and didn't know, but I know now that it wasn't the most friendly for VBACs in general. But again, I didn't know. I was put on an epidural right away even though I didn't really need one, but they were like, “Well, this is mandatory because you're a VBAC.” There were a lot of interventions that were given right upfront that I wasn't really told I had a choice with and I didn't realize it was okay to say, “I don't want to do that,” or to ask more questions, or just get more information about it. I just went with the flow because like I said, I just trusted the providers. I knew that I wasn't a nurse or a doctor and I just figured because they knew that I wanted to have a successful VBAC and was vocal about that, that I assumed everybody was telling me the best advice to get that outcome.So I went and had been laboring really well and progressing really well, and then as soon as I actually got into the hospital and was admitted, with the inventions that they did, my labor started to slow down significantly. It still was progressing but just a lot slower, and then after 17 hours-- so my daughter was 26 hours of labor before a Cesarean and my son was 17 hours. When we got to delivery at the 17-hour mark, we had the opposite happen with his heart rate. So whereas my daughter, when we started to push, her heart rate dropped, my son, they were like, “Okay. He is at a +1 now. Why don't we--” because I was at a +1, but he had been there for an hour and so they were like, “Maybe we should consider starting to push,” and then just before I actually started to push, his heart rate skyrocketed for no reason that we actually could see.And so they immediately were like, “Baby's in distress. Something is wrong.” After-- I don't even know exactly how many minutes because it happened really fast-- they were like, “Okay. We are going in for another Cesarean. We need to get him out right now.” They unhooked me from the epidural and brought me back to the operating room. Before I knew it, he was actually delivered. I wasn't even numbed because they couldn't get the epidural going fast enough. It was just really traumatic and really not what I wanted. But again, I was really grateful that my baby was healthy and here, and I survived it, and we still had, eventually, an outcome where both of us were okay and here. But the getting there part was not fun. So anyway. That was my VBAC experience. It was not great and it obviously had failed. So I just thought, “Okay. That's it.” And then they had made me sign all this paperwork saying, “If it does fail, this is it. You get one chance and then it is Cesareans going forward with any other kids you have.”And so three years later, we decided to have another baby again. I was with a different provider again and I asked them first thing, “Is that still the same rule or can I try for a VBAC” because I had learned more between now and then and I thought maybe I wasn't given the best option. Now, I know I definitely wasn't. And so I thought, “You know, maybe I still could do it.” Maybe we could have a better first moment with baby because my son had been taken into the NICU for monitoring as well and because I had not been numbed during the Cesarean, they knocked me out because I went into shock and I was on narcotic medicine for the first little bit, and so I was very in and out of it at the beginning of his life too.I just really again missed that birth story that I was really hoping for, and those bonding moments at the beginning and everything, minus trauma for them and for me. And so I asked this provider with my baby number three, my second son, if we were still looking at the same thing or if we had to just plan on a Cesarean and they told me, “Absolutely not.” There was no choice for me, just because of the emergency Cesareans beforehand, and that I for sure had to schedule a Cesarean. That was it. We weren't even going to have a discussion about it. I took that for what it was worth and I thought that was it and so I said, “Okay.” I didn't know anybody that had had any VBACs after more than one Cesarean and so I really thought that that was the end-all and didn't know any better. And so we had a planned Cesarean with him. It was the weirdest thing going into the hospital and delivering without being in labor. It was actually a beautiful experience. No drama, no unexpected events. I delivered him and they did take him away to give him his first bath right away, so I didn't quite get the family-centered Cesarean that I think you can do now, but it was still better than it had been. It was very different but it was good. Both of us were safe and healthy and we were good.And then years later, we decided to have our caboose baby, was what we termed it. We got pregnant with our fourth and there was a ten-year gap. The pregnancy went well up until the 20-week mark when we went in for our anatomy scan and we found out that she had a pleural effusion, which I had never heard of before, but it meant that there was fluid in between her chest wall cavity and her lungs. It was on one side. It wasn't multiple pockets which would have been worse, but there was this pocket of fluid that they didn't know what it was. They didn't know what it came from. Of course, I went home and looked up statistics right away. 80% can be lots of scary things and often, not often I should say, but a lot of them don't end up with good outcomes for babies. And then there is 20% that just magically show up and they magically go away, as the specialist put it.And so it was really scary and stressful from 20 weeks on. We had extra ultrasounds to monitor it and we were just hoping and praying that it went away. They did extra bloodwork tests and stuff. We couldn't indicate that it meant anything more than just possibly that 20% that just they don't know why it was there and they don't know why it goes away, but there wasn't anything else that showed that it was going to be anything more than that. But we did have to monitor it to just hope that it went away. They were like, “If it's present at birth, then we can possibly help or leave it then after birth, but in the meantime, we just have to watch it.” So that's what we were doing. We had a lot of extra eyes on baby and me during the pregnancy. She was due in October 2019. Actually, she was due November 5, 2019. Sorry. She was born in October. So we got to our 32-week mark and had another ultrasound at that point. We had felt really lucky and we discovered that the pleural effusion had completely gone away at that point, so we thought we were the 20% that just got really lucky, and it was gone and it wasn't a problem anymore. The specialist at that appointment said, “If we didn't know this had existed in the first place, we wouldn't be able to see any signs that it ever was there in the first place. So you are safe. You're in the clear. You are good.” That was 32 weeks and so if baby does come early, we just thought we were “safe”.And so then we went to our 36-week check-up thinking that, we had a month in between that appointment and that one, thinking that all was well and we were finally out of the woods. We were going to have this baby anytime now, and we were all ready, and had the nursery ready, and had all of the things, and we are really excited to be welcoming our little caboose baby to our family. My kids were, the older kids were 10 and-- gosh, I guess they were 10 and 13 and 15. No, probably 14 actually at the time. Oh no, sorry. Just barely 15.Anyway, oh gosh. Now I am messing it up. Something like that, but teenagers basically. Anyway, it was very much a family affair. I went into the 36-week appointment. My husband had been able to go to most of them, but that one he had to work that morning, and so he went 45 minutes away from where I was to go to a job. I went to that appointment thinking that everything was great and we discovered that there was no heartbeat right at the very beginning. It was devastating to say the least. I don't want to speed over too much but I know in favor of time I need to. So I am just going to sum up with, it was horrible. Child loss is, yeah. I don't know. I can't imagine anything worse than it. So yeah. It was crushing. There were no explanations when we found out and then later, at our six-week follow-up appointment, after they had done lots of testing on her and me, we never got any answers so I don't know what happened or why, but her heart just stopped. It was just crushing in every way. We are religious and spiritual people and none of it flowed with anything that we had felt like we received as far as personal revelation and thinking certain things. It was all just a very confusing and really, really difficult time for all of us. And so that happened and there were miracles that happened out of the tragedy, but it was also hard because it is hard when you're going through something so tough to say that anything good could come out of it because if given the chance you wouldn't do the hard part at any moment. You know?But there were some miracles that came out of it immediately and following in the days, and weeks, and months following. One of them was that our doctor was, I am just so grateful for him, our OB. During that appointment, after the initial shock and discussions about what to do next and everything, he did give me the surprise option of attempting to do a VBAC again. That's where this unexpected VBAC came from with my fourth because he said that really for me, the risks were-- obviously, there was still that uterine rupture risk, but he was like, “The concern is to try and save both of you, and especially the baby if that happens.” So he was like, “I feel comfortable and as the provider--” There was a group of them and so as part of those actually going to be at the hospital if he wasn't there, he wasn't going to be there, so the providers at the hospital were comfortable allowing me to try for a VBAC and just doing it very, very slow, and just hoping that it went well. If it didn't, we would end up doing an emergency Cesarean again, and then the alternative was just to do a Cesarean.My husband wanted, “Let's just go for a Cesarean again and get the baby out. We have waited this long,” and he was really afraid because of the traumatic birth trying for a VBAC before. He was afraid of what could happen, so he was like, “Let's just do that and save ourselves any more drama.” And I don't know-- well, I do know why. The only reason I can say why I felt peace and calm in that moment and why I knew to try for a VBAC again because it was the only option that felt good at the time and felt peaceful. I didn't have any fear about it which was not like me because I usually overthink everything and have anxiety. So I decided when everything else felt so out of control and not my plan anyway, that if that one felt like the first step in something that didn't just seem wrong when my world was upside down, then I was going to trust it and just go with what felt right.And so we ended up going into the hospital and they mechanically induced me with a Foley bulb and a Pitocin drip. They were doing it in increments of 2. I'm not sure what they started me on.Meagan: Usually, they do 2 every thirty minutes. A 2 is considered a low dose. 4 is still low but higher. 2 milliliters an hour every thirty minutes.April: Yeah. That's probably what it was then. I know it was 2 and so if it was every thirty minutes. Yeah, that sounds right. So we did that and then I got an epidural earlier on because my friends were like, “Why?” I had two friends come to visit us there in the hospital and they were just like-- at first, I wasn't getting the epidural and they were just like, “You're already going through so much pain. Why put yourself in any more physical pain on top of that? Let yourself take the edge off with an epidural and let yourself really focus on preparing to meet your baby and for the very few hours that you will have together.” You know, in preparation of that, and everything that was happening, and the loss, and everything.So I did. I got the epidural and it was fine. We ended up after 43 hours, several days, we got our miracle. She was born vaginally and I only pushed for 15 minutes. It was beautiful and crazy. I did stall for quite a bit which was why it was 43 hours just because it was really slow progress from the entire second day, basically. But we had a lot of people praying for us, and we had priesthood blessings and other things, and finally, I actually took a nap which, I wasn't really getting much sleep even at night because of the circumstances. It was difficult to sleep or to do anything really other than cry. And right before I delivered her, I actually was finally able to take a nap. I got a one-hour rest and when I woke up, my body had finally dilated fully. I was already fully effaced the whole time. But I finally dilated to a 10 and they were able to start pushing. And like I said, we pushed for 15 minutes and she was born. It was amazing. I literally had zero prep for a VBAC other than what I had done the 12-13 years before when I actually tried for a VBAC. And so it was truly, in my opinion, by the grace of God that it happened. And here we found ourselves in that terrible circumstance but also a miracle because we didn't ever think we would have that experience. It was really awful and really beautiful at the same time because we were able to have what we never thought we would be able to and we were able to share those moments with our kids and with our newborn daughter who, even though was deceased, we were able to really spend a lot of time with her immediately after. It was all very sacred. There's a lot of words that just don't describe it, but just really sacred.So that was our fourth birth and then this last time, we actually knew before we even went in to deliver that our fourth baby, our stillbirth baby at 36 weeks-- after the appointment, my husband, I called him because like I said, he had been at a job that was 45 minutes away from where we were and had to tell him the news over the phone. He raced to where I was and met us there because we were there for a couple of hours before we went home to prepare to go to the hospital to deliver. And when he met me there, we were talking things over with the doctor and our doctor told us, he was like, “I know that you're not even thinking--” because I was supposed to actually be done.We were planning the fourth and then I was supposed to have my tubes tied and everything because it was supposed to be another planned Cesarean, and so we were totally done and very mentally and emotionally content and prepared to be done having kids. And then when that curveball happened, everything was upside down. There was no discussion or forethought into any decisions past that. And so our doctor told us, “I know you haven't even thought about this and you don't have to make any decision or think about this right now per se, but I just want you to know that I would be willing to do a fifth Cesarean on you if you would like to try again for another child,” because before that, we had discussed that four was really the safest number for me for Cesareans, and so I really should be done after four. That was part of that decision to be done.So anyway, the last thing on my mind during birth for our stillbirth daughter was to get pregnant again and to go through that again. Obviously, now with fear of, “What if this happens again?” and not even knowing why and everything, but after we lost her and spent a lot of time really, really getting close to God about a lot of things, we really felt strongly by the time that we even gave birth to her that we probably would try again. It didn't make any logical sense other than it just was like I said. When so much of my world felt wrong, it was only one thing, and sometimes here and there, just something that would feel right and peaceful. That was one thing that did.And so after we delivered her and we had our funeral and everything, we started having really strong feelings that-- this is going to sound really cray cray, at least it did to me, but my husband and I both started to have really strong feelings that the same little girl that we had lost really still wanted to be a part of our family and that if we were to get pregnant again, that she would come back to us.Meagan: Oh, that just gave me the chills.April: Yeah. It's something that honestly, my husband and I had never, ever considered. We have had friends that have lost babies. Miscarriage and infant loss is not talked about as often as it probably really needs to be and should be, but one out of four women experience loss and that's something that I didn't know before. It's really prominent. I don't know how often this part of our story happens to others. I have no idea why it did for us other than I am just really grateful. I don't think it has anything to do with-- I don't know.I laugh and I am like, “There are so much better people that, I think, probably deserve a miracle like that.” But it did for us. And the farther in after our loss, it was really hard too because we had a lot of support with the people that-- we didn't just share it with anybody. It was really sacred and personal to us and when we did share it, we had-- most people were actually very open and supportive of it, and then occasionally, we would get somebody who was just really worried about us because you know, you love somebody and you don't want them to suppress their grief.They were really worried, I think, that we were going to go off the deep end, and in our grief, we were thinking that our dead daughter was going to come back in another body, and we wouldn't grieve that baby, and we would think the new baby was the other baby. Something like that and there was just concern, right? It was really such a, just a crazy-- in a good way. I don't mean that in a negative way, but a really wild experience.During all of this time, we did decide to go ahead and get pregnant. I actually did this whole detox with the doctor to physically try to prepare as well as I could and do all these things in preparation for it, and at the same time, we were doing a lot of spiritual digging just personally, and as a couple, and as a family. We really got good at really getting comfortable with being uncomfortable, with letting other people being uncomfortable if they had-- I don't know how to put this. Like, if somebody didn't necessarily understand or support what we really felt and knew to be right for us, that it was okay.It wasn't our job to make ourselves uncomfortable or to tell a lie to make them feel comfortable. Does that make sense? And if so, we were like, “Okay.” And for me, I just tried to see everybody as coming from a place of love. You know, just like with our loss. Sometimes, people don't say the most helpful things to you after you have lost because they want so badly to help you but they don't know how and sometimes, what they say can be really hurtful and not helpful.And so I started labeling things from that experience as not “good or bad”, but just “helpful and unhelpful”. I used that as I was preparing for this pregnancy and knowing that I wanted to try to do a VBAC again because we had been able to successfully do it, and now I knew that my body could do it and having that experience, I just knew that that was what we wanted and we could do it again. I felt really good about it again, for no necessarily logical explanation, I just knew that it was possible and that I should look into it more, and not just take everything that was given to me information-wise from a provider or whatever at just surface value. I should just ask questions, and look into it, and follow that intuition.We were getting really good at that on every level, including spiritual, with what we felt was happening with our daughter coming back and in preparing for that. And so we decided to stay with our same provider because he had been there. Even though he wasn't there at the delivery, he had been there through the whole pregnancy and on the day of finding out the news and everything. He had been really awesome. And so we just felt like there were a lot of miracles during the whole time between our provider, and with the hospital, and where we delivered which we loved. Shout out to Timpanogos hospital.But we really just felt okay. God was really there in so many tiny, tiny details. Things that were really personal to us that you couldn't overlook. A lot of it, for me-- I know Julie is kind of the same way. We talked about this. But in the past, I tended to find comfort in statistics and in concrete evidence, case studies. The nerd in me loves to comfort myself with the-- things that would make me more anxious about stuff, I would go and look for numbers. I would look for concrete evidence. I would look for the other in my favor. You know, that kind of stuff. My logic brain would turn on and that's where I would find my comfort.When we lost our daughter, I couldn't go there anymore because we were the less than 1% of stillbirths and when I looked to statistics, the statistics were painful to see that stillbirths hadn't really improved over the last many, many years. Just to see all of these statistics not only didn't bring me comfort, but we're hurtful. They didn't give me any kind of logic. They actually made me more upset and, I hate using the word crazy, but that's what they did. They drove me nuts because nothing about it was logical. It all was just in one, giant, lightning-bolt fluke.And so that was, for me, more upsetting than anything. So I was walking this very personal, you could call it spiritual. You could call it learning to really be one with your own intuition, your gut instincts. You can call it a lot of things, but that's what I had to do this entire last pregnancy. I couldn't look to the numbers anymore just for comfort. I still would look at them, and then I would look to God and I would look to myself, and I would say, “Okay. Does it feel good? Does it feel right? Or does it feel like something is wrong? Do I feel like maybe I need to ask more questions or maybe there is more to that or maybe that is actually not correct information?” And so every doctor's appointment, my OB was aware of what I wanted to do in getting pregnant again and trying for a VBAC. From appointment number one, we discussed it and we were vocal about what we wanted. We tried to get as much support as we could from a really great provider and group, but not the most VBAC supportive as we didn't really know that upfront, but as we got toward the end of the pregnancy, and preparing for delivery, and during delivery actually, as Julie can attest. There was a lot of discussion about uterine rupture and everything. Basically, they talked about it leading up to delivery and our choices with that were put on the line again during delivery. We had to have all those discussions again while I was actually in labor. But it was really neat because it was all just practice to be ready and to be able to say, “Okay. This is what feels right and that doesn't feel right.” It's okay to say “yes” when it does and it's okay to say “no” when it doesn't. You know? Or to ask more questions, and have discussions, and to respectfully disagree with a provider but still have that love and care for each other and realize that we all want the same thing, but we just may not agree on how to get there.Julie: Yeah.April: And so we went into labor this last time, and they were really getting pushy, I will say, the entire last month of my weekly appointments and actually at the weekly appointments, but I also had NSTs, so I was actually getting it double because my NST tech would sometimes discuss, “Have they talked about your induction date yet? Are you doing a Cesarean this time?” And all of the stuff anyway.  It was actually funny, but Julie can tell you because we ended up hiring Julie actually very late in the game. Julie can say. I can't remember exactly how far along I was. I want to say I was 30--Julie: I think it was around 32 weeks. 30, 32.April: Yeah. 32 or 34 weeks or something. Thirty-something like that and I had wanted to earlier on but I wasn't sure with COVID and everything if she would be allowed in the room and with our loss before, I was like, “If I only get one person in that room with me, it's going to be my husband.” And so when I found out I could have two people there physically with me, I was like, “Okay. I really think we need that other person so that when I am laboring, I don't have to have all the discussions again and if they try to railroad me, I don't have to exactly be 100% with all my facts and logic.” Do you know what I mean? Or having these long conversations, but I can focus on what I need to do and I can let my husband and my doula assist me in birthing positions and all the things that I need to help make it successful as well as having those educated conversations on the side with me and with providers.I just felt like I really needed that extra person in our corner. I had really never even known what a doula was until this pregnancy. So it was really a lot of new stuff for us, but I had been reading a lot of birthing books this time. I had done so much research with your guys' website and with other resources out there on what had even happened to my past births and, in preparation for this birth, just options, and learning to ask all the questions and not be afraid to find out the answers, and then to ask more questions. And so anyway, we did. We had Julie with us and I am so grateful. I don't think we actually would have been a successful VBAC had Julie not been there. And not just Julie, but Meagan, I know you behind the scenes and others from The VBAC Link community--Julie: Yeah. There were a lot of people cheering you on.April: I know that we had a lot of people cheering us on and helping when we needed to. We stalled during labor. I know that we had a lot of help with suggestions of different positions to try to help her progress because she got stuck. We almost did the failure-to-progress at six hours when we thought we were about ready to push. I was 95% effaced and we were just before lunch. It was 11:15 or something like that. Julie, do you remember?Julie: Yeah. You were at 9 centimeters for six hours.April: Yeah. yeah.Julie: It was at the six-hour check. Baby moved down just one station. Just enough for them to let you keep going. Just enough.April: Yeah, just enough. It was so awesome. Just enough which was awesome. And so anyway, we did that and I've got to say again, God showed up big time because we literally sent out a text to friends and that entire last 45 minutes, Julie had felt really inspired to change up our plan of what positions we were going to do for this special circuit that worked out perfectly timing-wise. My husband gave me a priesthood blessing and literally during that blessing, which it's, just to say for those who don't know, it is a very personal, specific prayer with added authority. And anyway, during that, we heard her on the monitor totally move which, we hadn't heard movement like that for a long time.Julie: You could literally hear her moving down and into position on the monitor during the blessing.April: It was so cool.Julie: It was the coolest.April: It was amazing. We knew that there were tons of people praying for us at that moment. So it's just so cool and I swear that's how we were successful last time too amongst all the other things. But yeah. And so we got to that part and sure enough, the doctor came in, and it was a doctor who had just got back on shift for the night shift again. We had actually gotten into the hospital the night before, and so it was the same doctor that we had the first conversation with when we went in. Julie and I think he was just the right doctor and she was waiting for him to get there because as soon as he got there, she moved and he checked again, and we were finally ready.He was like, “Okay.” First, he said he was going to help move her. How did he phrase it?Julie: He said he was going to try to turn her head because she was coming down a little asynclitic.April: Yeah. He was like, “I won't use forceps or anything. If you are okay with it, I will just reach up there and try to assist her because she is mid-spin. But I think if I can assist her with this little leftover cervical lip--” which was just a tiny bit. He said, “If I can help her get past that, then I think she will be ready and then we can start pushing.” And just before he did that, Julie was shocked. She told me this has never happened, but he got this look on his face and he said, “You know? Actually, would you be willing to push? Let's just see what happens. Could you just give me a push and we will see?”Julie: Like, push through the lip. No providers ever say that. They don't say like, “Just start to push a little.” As doulas we are like, “Can she just push a little bit? It will probably push it away.” Meagan, do you hear that? It was just so crazy to me.Meagan: Yeah. I hear it. The hard thing is, sometimes it is so stretchy that a little extra oomph will have the cervix slip over and then sometimes it goes the opposite way and it actually swells because you are pushing against a cervix that is not ready to stretch.Julie: Yeah. That's true. Yeah.Meagan: And so once in a while, a provider will say, “Hey, can you just give me a little push, and then I will feel it. And then I will be like, ‘Oh it reduced and it stayed,'” but if it reduces and then it comes back, the cervix is not ready. So continuing to push isn't usually the best idea. But for you, it worked. Yeah.Julie: Yeah.April: Wow, interesting. Yeah. It totally worked. And so yeah. He literally said that and we were like, “Okay. Yeah. We tried it and then he was like-- what did he say? “Oh yeah. We are ready. Okay.”Julie: Oh yep. Cervix is gone. Keep pushing.April: Okay. We need to push. We're going to start pushing. And then they had already pretty much prepped the room hours before. But yeah. Then there was a little bit of extra commotion and he was like, “Okay, let's start pushing-pushing. It's time.” We only pushed for about 20 minutes and then he gave her a good pull at the end there. I was really hoping he wouldn't pull on her and that did cause a little bit-- she had a tiny bit of shoulder dystocia right at the very end. It almost wasn't even enough to call it shoulder dystocia but enough that he did give her a little bit of a pull at the end which was not part of my birth plan, but I don't know that he read it even though I did. I had it all printed out and everything, but I don't know if he saw that. But he did pull on her and we had to have a little bit of bodywork done on her afterward because it did injure a muscle in between her neck and her shoulder. But she is okay now. It's all good. But yeah. We pushed for 20 minutes. He assisted in pulling her out, and she was born and was healthy, and it was great. And for the first time ever, other than with my stillbirth, we didn't have to have her whisked away. Actually, even with our stillbirth, they did still have to take her, and clean up, and do some things before we got to spend time with her directly.This time, she was born and they brought her right up to me, and my husband cut the cord, and I bawled like a baby. You'll see that in the picture that I picked for my story. We both did. It was just awesome. Yeah. It was just a really beautiful experience and the recovery for both of us has been so much better. She, like I said, had a little bit of bodywork that needed to be done, but that was still pretty minor considering all things, and yeah. She's been thriving. Our breastfeeding experience post-birth has been actually amazing. I've always had issues with that afterward.I talked to the lactation specialist we hired. Gosh, I can't even remember the abbreviation. It's like, IBCLC or something like that, right?Julie: Yeah.April: Anyway, we hired one of those to come and actually help us in that first week after birth and I was talking about everything with her and the other births. I've always had problems with drying up at five weeks, my milk, for just no reason. I did this crazy feeding and pumping, and that's all I would do, a routine and everything but no matter what, I would always dry up around five weeks. I am happy to say that I am at five weeks now and we have tons-- well, not tons of milk. We are still working on getting more, but we have way more milk than I have ever had before.I was just talking to her about the difference and if Cesareans affect that. She had worked in a hospital for a long, long time before she actually decided to go solo and do her consulting individually, and she said that there was totally a correlation with that in her opinion from what she had seen professionally and really had helped. So I just thought that was a really cool added benefit that I was like, “No. I don't know if that was part of why we needed to do a VBAC this time too.” I'm not sure what all the reasons are. I feel like they just keep coming, but I feel like that's what this baby needed. It was a really beautiful experience for us and recovery afterward has been night-and-day different I will say.Some people will say a Cesarean recovery isn't that bad. I will not say that it is the worst thing ever but I will beg to differ. Between a VBAC recovery, and a Cesarean, or vaginal birth, I would definitely go with a VBAC for moms. I did get one stitch this time. I am proud of my one stitch.Meagan: That's really good.April: That's nothing. I know. Yeah. I know that there are people that have it way, way worse. So anyway. Every birth is beautiful. I totally think it's just really amazing and always very grateful for everybody's happy outcome. But I do think it's important to go with what you feel is right for you and your baby, and sometimes that's going to look different for each baby. Each pregnancy is not the same. But for us, I'm really glad that we finally did say “yes” to the things like hiring a doula, finding out what a doula was, finding The VBAC Link.Julie: Yay.April: Hiring Julie and really felt a strong-- even picking Julie out actually was an awesome spiritual thing for us too because here was this stranger that I didn't even know was in my state let alone not too far for me doing this VBAC Link that I just randomly found when I was looking up VBAC stuff. I had even emailed her which I didn't even realize that I forgot I had done. When I did go to hire her, she was like, “Oh yeah. You emailed me months ago.” I was like, “I did?” I just knew that Julie was the doula that I needed because not every doula is the same. I think they probably are all amazing but you have got to find the people that are the right fit for you for your team and for your journey, and we did. We are just really grateful that it all worked out.Julie: Yeah. It was a beautiful birth. Beautiful story.Meagan: So, so happy for you.Julie: So many spiritual and amazing experiences happened with the providers and just everything. It was just a really sacred thing and it was an honor to be a part of it. I appreciate you letting me into that space and I appreciate you sharing your story with all of us today.April: Yeah. Thanks for having me on.ClosingWould you like to be a guest on the podcast? Head over to thevbaclink.com/share and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan's bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

We can't wait for you to hear Nicole's incredible VBAC story! She is a successful, driven mama of two and owner of The Polished Playhouse. You will feel her resiliency over and over during this episode. Nicole shares with us her firsthand experiences with racial bias during her first birth and along her journey to VBAC. You will also be inspired by how Nicole overcame challenge after challenge giving birth at the height of the COVID-19 pandemic. We talk about the reality of racial bias in the birth world, why you shouldn't trust the VBAC calculator and a way that anyone can advocate for change. Have the courage to set yourself up to feel safe with your birth team and get that supportive birth experience you deserve!Additional linksNicole's Instagram: @polishedplayhouse Black Maternal Health Momnibus Act of 2020The VBAC Link on Apple PodcastsHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Julie: All right. Good morning Women of Strength. We are so excited to be here with you today as we always are. I think every guest that we have brings this different kind of excitement with them. Today we have Nicole with us who is amazing in 360°, just all-around. We were just chitchatting with her before we started the episode today and she is an incredible, incredible, incredible woman. I cannot wait to share all of those interesting details and information about her with you. But before we do that, Meagan is going to read a Review of the Week for us.Review of the WeekMeagan: Okay, so this is from holmclaugh90. It says “I listen every day. After a traumatic Cesarean with my first baby five years ago and multiple miscarriages in between, this is a breath of fresh air as I await my chance to have a VBAC this October with my second! Love every story I hear on this podcast and it makes me feel so much stronger in knowing I can do this!”That was put in last July, so that means last October she would have had her baby. So holmclaugh90, if you are still listening, shoot us a message. We would love to know how things ended up.Julie: Absolutely. Oh my gosh, thank you so much for the review. You know we always love them. They are near and dear to our hearts.Nicole's storyJulie: We are so excited today to have Nicole with us. Nicole is really exciting. I just pulled up her bio. We have a form that we have our guests fill out before they come on our show so that we know a little bit about them. The more I read about Nicole, the more I am just like, “Oh my gosh. I need to know more about this. I need to know more about this. I need to know more about this.” The first one that caught my attention was she is a social media content creator. She has a really awesome Instagram page called Polished Playhouse. It's all one word, @polishedplayhouse. You can see the link to that in our bio. We are going to drop it there for you, so you can give her a follow. But she-- oh my gosh. There are so many amazing things. She creates curated boxes for children ages three to five years old with books and all sorts of educational things in them for your toddlers. I am sitting here, I am like, “Okay. I need to order these boxes. I need to sign up for the subscription box when it comes out,” because there are some really amazing things. I think that what really stuck out to me the most is she is including things with diverse backgrounds and diverse cultures. So her books have black children in them as main characters. She is a black woman living in Maryland. I'm excited to talk to her because I want to talk about black birth in America and how bias influences how people of color are treated in the birth space. We can talk about numbers all day how black women are two to three times more likely to have a Cesarean and three to four times more likely to die in childbirth just due to race. Guys, this is straight across the board. It is not influenced by socioeconomic status, education levels, income, any part of the country, there is this bias against people that exist in the birth room and I'm really excited that we are going to talk about that today. One of the things that Nicole said is that having a black provider to support her in a VBAC was very important for her because of that bias that exists. And so I'm excited that we are going to be able to hear about it from somebody who has lived through it, who is living through it, and who has come out on the other side having a hopefully-- I am making some assumptions now. Hopefully, having a very supportive experience for her VBAC. And so I am just going to sit here and geek out over her on her Instagram page while she is sharing her story.But she is incredible and I just can't wait to hear from her. And so instead of keep talking about it, I am just going to go ahead and turn the time over to her so that you can hear amazing Nicole's VBAC story.Nicole: All right. Thank you so much for this generous and kind introduction. I was a member of y'all's Facebook group and then also listened to the podcast all the time, so it is a huge honor to be on your show today.Julie: Aw, thanks.Nicole: As you mentioned, I am Nicole. I have two sons now. I have one who is four years old and then I have the second one who is seven months. I had my first son in 2016 and then had the second one in 2020. For my first son, I started care with a gynecologist that I had seen since college in the DC area. We had a pretty good relationship, so when I got pregnant, I just decided I would continue on with her. I had a pretty healthy pregnancy. There weren't any issues that came up. I was doing prenatal swim classes. I did a lot of walking. I was able to manage my diet pretty well. I didn't have any challenges. The doctor that I was going to was very cautious, so at the time, I had a number of different tests that she was running on me. She never told me why. Just a lot of different things that I wish I would have asked about that I didn't being a first-time mom. I didn't know what to ask. But one of the things that I did ask her-- because she was a very popular doctor in this area. So sometimes, my husband and I would go to appointments and it would be standing room only. There was usually space for all the pregnant people to sit, but if you had a partner with you, they would likely have to stand.One of the things that I asked her is, “If you're not able to deliver my baby, then what happens?” And she just brushed it off and she was like, “Oh, well that never happens.” Looking back, there was no way physically that she could have delivered all of the babies. So that just what is something that was lingering for me. If she wasn't able to be there, what would support look like?So the night that I went into labor, I went walking. I was bouncing on a ball and I started having contractions. I went and sat in the bathtub. I didn't wake my husband up. Usually, if I was having Braxton Hicks contractions, I would go sit in the bathtub and they would go away. These did not go away so I started to feel like, “Well, maybe this is it.”I woke him up and he freaked out. He was like, “Oh my gosh. The contractions are too close. We have to go.” We lived about 40 minutes away from the hospital and I chose the hospital simply because it was where my doctor delivered. I didn't know to do any research into the Cesarean rate or anything like that. So the hospital was about 40 minutes away. We got into the car. My mom was staying with us at that time as well. At this time, it is clear I am in full-on labor. We roll the windows down. My husband is barreling down the highway trying to get me to the hospital. We get there. As soon as I get into triage, I come off the elevator. I get there. My water breaks. I get back and one of the nurses asks one of the other nurses to check me. They check and she quickly starts calling for them to send me back. Then, one of the other nurses said, “Well, how far along is she?” I saw her mouth to the other one to say, “Seven.” Once I got to the hospital, my water broke immediately. I was at 7 centimeters. They took me back. My husband had left our car in the middle of the hospital driveway, so he had to go back and move the car. When he went to move the car, I saw my doctor for the first and only time throughout my entire stay at the hospital. She came in and she said, “You know, I know you're at 7 centimeters, but that was the easy part. I really suggest you get an epidural so that you can calm down so that you won't be in pain.”Leading up to that point, I had really wanted a natural birth, but I was obviously in a lot of pain. But she also really pushed the epidural in a way, looking back, in a way where I wish I would have pushed back. My husband was down moving the car so I'm in there by myself and I'm just like, “Okay. I want this epidural.” So I get the epidural. It took over an hour for them to get it. They poked me several times. They just couldn't get it right. So once they finally got it in, I took a really brief nap, and then they woke me up and told me it was time to push.So I pushed, and pushed, and pushed. The nurses were somewhat supportive. Now that I have had a new experience, I really know what a really supportive team looks like, but I ended up trying to push my son out for about two hours. He never went into distress. I was exhausted, but he was fine the entire time. So as I am pushing, I am starting to feel really discouraged. I don't feel like I'm making any progress. My sister was there and they kept telling me, “Well, we can see his hair, so I think he is close. We can see his hair. We can see his hair.” A doctor comes in that I had never, never, ever met before. I had never seen him before and he walks into the room. He put his hand down. He looks at me and he says, “You are not going to get this baby out. We need to have a C-section.”He didn't say anything else. He didn't introduce himself. My husband said, “Well, I need to talk to you outside.”Julie: Oh my gosh.Nicole: Yes. The only reason I can remember what he even looks like is because my sister has a picture of him.Julie: Wow.Nicole: He didn't tell us his name. Nothing. He was like, “There is no way you will push this baby out. You need to have a C-section.” So at this point, I am just hysterically crying. My husband goes out and talks to him. He told my husband that my son was just too big. There was no way he was going to get out, if it was a risk of him being paralyzed, just all of these things. So I cried, and cried, and cried, and then agreed to the C-section. I went back. First, I had to go back alone and I just remember shaking so bad. I couldn't tell if I was shaking because of the medicine, or if it was because I was afraid, or what. Finally, my husband came back. They let my husband come in and then I had a C-section. He was 9 pounds, so he was a big boy. He was a big boy, but we didn't get any information aside from the fact that “He is too big. You won't be able to push him out. You have to have a C-section.”So afterward-- when I tell the story, I talk a lot about the parts where I was separated from my husband because I think that's where I felt the least supported because I didn't have him there.Julie: Yeah. He was your voice.Nicole: Yes. They separated me from my husband. I went into a separate room and they were checking me, doing all of these things afterward, and they let my husband go with the doctor and the baby, and then a nurse came in. I heard her talking to the doctor that delivered my son and she said, “But she is allergic to this,” and I heard him say, “It's fine.” The nurse said it again, “No, but she is allergic to this,” and he said, again, in this very direct tone to her, “She's fine.” What happened was, they gave me something that I was allergic to. After I had my son, I broke out in hives all over my body.Julie: Oh my gosh.Nicole: I was literally digging into my skin. People say, “Oh, well after you have the epidural, you itch.” I'm just like, “No. I've never had a baby, but I can't imagine you are supposed to itch like this.” So they just kept giving me allergy medicine after the fact, and then they put an allergy bracelet on me. This was after I had already had a C-section, after I heard the nurse tell the doctor twice that I was allergic, they put an allergy bracelet on me. And then after that, I see pictures of myself and I am so tired. It's because I am literally just pumped full of allergy medicine because I had this horrible reaction.So after that, we had a decent stay in the hospital, didn't really have any complications from the C-section, but one thing that always stood out to me even now is until I went to my follow-up appointment, I never saw my doctor again. I never heard from her again. Her shift ended while I was having my son and I literally never saw or heard from her again until I went to the appointment. Ahead of the appointment, she sent a review from her office, so she wanted me to review her. And so I think it was out of four stars. I was very generous and gave her three just because I felt like she abandoned me.Julie: Yeah.Nicole: The entire appointment, my first six-week check-up after my C-section, all we talked about was why I gave her three stars instead of four.Julie: No. No, really?Nicole: She never asked. Yes. Yes. She never asked how I was doing. She never asked anything about the baby. She was just so hurt and upset that I gave her three stars instead of four.Julie: Wow.Nicole: So needless to say, I didn't go back.Julie: You should have gone back and changed the review to one star. That's what I would have done.Nicole: I know. Yes.Julie: Oh my gosh.Nicole: So I was good because I had a really positive healing experience. I didn't have any complications. I really was just like, “Oh, well I am one of the lucky ones. This is okay,” but not until much later did I start to think about the emotional impact of having the birth that I wanted to be changed in really such an insensitive way. So when we started thinking about having a second baby, I knew that obviously, I was not going back to her. I had started researching about VBAC, started listening to y'all's podcast, joined the Facebook group, and really started looking for a provider. I learned a lot about black maternal health which I didn't know before. I learned a lot about biases and a lot of it of just not being listened to, not being heard from black women mirrored my experience.Julie: Yeah, absolutely.Nicole: I really wanted to have a black provider. I found out that I was pregnant in late October 2019. We lived in DC when I had my first son. We had moved to Maryland right outside of DC and I found a practice, all midwives. There were only four. It was a small practice. Two of them were black and then two were white, but they were really, really experienced and from everything I read, it was a really pro-VBAC practice.I went there for care. I had a completely different experience just from the very beginning. With my first doctor, I always felt like I was very sick. With them, I never feel like I was sick. They were just so positive. They kept reassuring me, “You can do this. We think you can do it. We know you can do it.” Never did any type of VBAC calculator, anything like that. They were just really positive.So I was going there. I went there all the way through March, so up until I was about 20 weeks, I went there. I had such a positive experience, always left really happy. March 11th of last year, I went for my 20-week scan. This was right when COVID was just starting. It was just starting to be talks of, “This is a thing. This might change everything for us.” So I went at the 20-week. It was one of the appointments where they were just starting to limit people who could go into offices. So I went to the 20-week scan, everything was great. The next day is when we got an email from work, from my job, that we were going 100% remote. That's when my son‘s daycare closed. It all happened in that same week.And then I was home on my very first day of remote work and I got an email from the midwives that said, “We are so sorry, but after 20 years, we just cannot continue the practice. It's just not financially viable for us, so we will be closing.”Julie: Oh my gosh. This is so much all at once. Oh my gosh.Nicole: Yes. It was the day that the world shut down and I'm sitting here like, “Well, this is the new normal. I work from home. My son is here,” and they sent an email and they said, “This is it.” They would be doing births through May and my due date was July. I could stay on with them until May or I could switch then. I was just completely devastated because I had grown so fond of all of the midwives. I had met with all of them.I knew there was another practice in the same area, so I just thought, “People have positive births with midwives, so I'll just switch to that one.” I continued to get care from them up until around the time that they closed, but I had been researching where I would go. So they closed. I went to my last appointment with them and at that time, I started really looking into also getting a doula. The hospital where I would be delivering had, in maybe April or May when COVID was really bad, they said, “No additional support people,” so, at that time, I couldn't have a doula. I would only be able to have virtual support. I was bummed about that. So I'm looking into the possibility of not being able to have a doula or having a virtual doula and then also finding someone completely new to deliver my baby. I went to one appointment at the new practice. This was, again, the only appointment that I had during my entire pregnancy where my husband was not allowed to come with me. I went to this practice. I went in and immediately it was, I don't know. The energy of the place just did not feel right to me. I went in. I was sitting. I was waiting and then the midwife came in and she said, “I need to do this calculator on you.” And I had heard about the calculator. I heard a lot about the limitations, a lot of the biases that are built into the calculator.Julie: Yes.Nicole: Again, this is someone who did not introduce herself to me. She didn't ask me anything about my--Julie: All she wanted was a number.Nicole: She wanted the calculator. She did the calculator and the calculator said that I had a 30% chance of a successful vaginal birth. She was like, “You know, I mean, I can let you try, but just look at this. Your chances are not good. I'm telling you now.” She said it in a very matter-of-fact way. “Well, I mean, what have you been doing with yourself?” And at this-- I was so sick during my first trimester.Julie: Wait a minute. She said, “What have you been doing with yourself?”Nicole: Yes. She said that because--Julie: Oh my gosh.Nicole: Because I had a big baby before that there was a chance that I would have another big baby and she linked big baby essentially to me eating too much. So, I know.Julie: Oh my gosh.Nicole: Yes. At this point I was--Julie: And this is a midwife.Nicole: Yep. This was May, so--Julie: Was it a white midwife?Nicole: Yes. This was May.Julie: I think this is where bias is coming into play as well for sure.Nicole: Yeah. Yep. Mhmm.Julie: Sorry, I'm going to let you keep telling your story. Sorry.Nicole: That's all right. She made a lot of assumptions. At that point, I had literally gained nine pounds because I was so sick during my first trimester. I didn't gain a lot of weight at all. And even with my son who was 9 pounds, I gained 27 pounds for my entire pregnancy. And then for my entire pregnancy with my son, I gained 27 pounds and he ended up still being a 9-pound baby.Julie: That's still a perfectly average weight gain.Nicole: And so she asked me, “Well, what have you been doing with yourself?” I am like, “I have been walking. I've been eating hardly. I haven't gained a lot of weight.” She said, “Well, I am telling you now. You will have to get a weight scan close to your due date and at that point, we will decide whether or not we can try for the VBAC.” She said, “But based on this calculator, I don't think you have a good chance.”I said, “Well, I have heard that the calculator is inaccurate.” She said, “Well, we have been having some conversations at the hospital about it, but we still think it is the best tool.” I said, “Okay.” I left there. I literally held myself together just to get to the car and I was so frustrated. I called my husband. I am like, “This is not it. I am not doing this with them, so we have to find someone else.” This was right in the middle of the worst of COVID, so a lot of places were not seeing people in person. They were doing a lot of telehealth visits, especially for someone as far along as me. So I don't know what to do. With the first practice where I was, I had to go to an OB/GYN to get essentially cleared for the VBAC, and the one that I went to, I really liked her. I decided that I would transfer to them. I am like, “Okay. I will just move on from midwives and I will transfer to this OB/GYN.” She was also a black woman. I started the process of transferring to that practice. I looked online at the reviews and the reviews were either a one-star or a five-star. So then I looked further and the practice actually was about 30 doctors and you didn't get to decide. It was whoever was on call, so that reminded me a lot of my first birth where it was just this doctor that I had never met that I didn't have a relationship with, so I quickly got over going there. I got over that and I had no idea like, “What am I going to do?”So my husband has a really good friend that was a doula. She is taking a break right now. He called her and she told us about the hospital where I ended up delivering in DC. She said, “If you want to have a VBAC in this area, that's where you have your very best chance.” So the midwife practice in DC, they are very, very popular. They have all of these rules you have to follow. There's a specific diet and they have different groups that meet, so I just was convinced it was too late. I was about 32 weeks at this point. That was so late. It's the middle of COVID. There's no way they will let me join. They wouldn't let me make an appointment with midwives, but they did let me make an appointment with the OBs. So I went and I saw the first OB. I was very nervous. I am 32 weeks at this point. This is my last shot. So she came in and she was asking me about the birth and she is like, “Yeah, I see that the first baby was really big.” And I just was like, “Oh my gosh. Here we go again.” She is like, “Well, that really shouldn't hinder you.” So I just was like, “Oh my goodness. I think I found my people.”Julie: What a relief to hear.Nicole: Yes, I think I found my people.Julie: Yes.Nicole: So she was really great and that was a white provider. She was really great. She was like, “Well, I don't think that will be a hindrance. We deliver 12, 10, 11-pound babies here all the time.” She obviously gave me the risks for the uterine scar tearing, all of those things, but just in a very informative way, but still very supportive and saying, “We think you can do this.” So because they made my initial appointment with the OB's, I just was convinced, “Okay. This is it. I have to go to the OB‘s.” I went to another appointment. I met another one of the OB's. She was also great and then about 35, I think it was 35 weeks, that hospital, in particular, said, “We will allow doula support again.” I was seeing a prenatal massage therapist and she had been watching the hospitals, like, updates for me really closely. She texted me in the middle of the night, “You can have doulas again at the hospital, so make sure you find one.” At this point, I needed a doula within a week's notice. So I went on Instagram, was reading, scrolling, looking for a doula. I found one doula, a woman of color that I reached out to. I sent her an email and I am like, “I know it's completely late. I am delivering here. I'm having a VBAC. Please, will you take me?” She said, “Well, you know, I really don't come to that part of Maryland. I really don't come to your area, but can I think about it? And then I'll let you know.”We had a quick chat and later, she told me she just was making sure, feeling me out. We had a quick chat and then we signed the contract. She was my doula at about 36 weeks. I met her in person only one time and she suggested to me, she said, “I know you have had these two appointments with the OB's and feel comfortable, but I really think you should switch to the midwives.” I am like, “I am 36 weeks. There's no way they will let me do this.”So when I went to an appointment at about 36 weeks or 37 weeks, I asked one of the OB's, I said, “Do you think they would let me switch to the midwives?” She said, “I don't know. We really don't do transfers this late, but I will ask.” So she sent an email to the midwives and she said, “We have a mom here who really wants to be seen by a midwife. She is a VBAC. She seems like a good candidate. Please, will you do this for her? She really wants it.”For some reason, they said, “Yes.” I went to an appointment at 38 weeks. I went to my last appointment with them and my very first appointment with the midwife. I was 38 weeks. I think it was a Tuesday and I met a black midwife that I had heard about. Everybody talked about how amazing she was and she was just this fierce advocate for black birthing people and she is just amazing. And so my first and only appointment with the midwives was with her and it was just so great. I am like, “Yeah, they did the calculator on me.” She's like, “Oh no. We don't use that calculator.” She talked so badly about it.Julie: Yeah. That's what I like to hear.Nicole: Yes. She was like, “We don't do that. Blah blah blah.” So I told my husband, I'm like, “Oh, I really hope we just get the luck of the draw.” It was, I think, six or eight midwives and I'm like, “This is it. This is it. I really, really want her. I think I will have a great experience with her.” So I went home. I was praying, “I want this midwife to deliver my baby.”I started having contractions the very next day after I met her and I am like, “I don't think this is it.” So I actually went and I did some shopping. I went to FedEx and mailed some packages and my contractions started really picking up. I texted my doula and she was like, “Well if they get a little closer, let me know. But I think this might be it, so you should go home. Take a nap. Lay down.”I laid down for a little bit and the contractions just kept picking up, kept picking up and I knew like, “This is it.” So my husband called the doula. She said, “I won't make it to your house. Just hurry and go to the hospital.” On the way to the hospital, I had to roll the windows down and get air. We were playing meditation on the Bluetooth in the car. We get to the hospital. I say all the time that literally every good person that was available in DC was there at that moment in time from the guy who just literally let us leave our car in the middle of the street and asked if I need a wheelchair if I needed anything. My doula was literally standing right there as soon as we got there. We went up and at this point, I am in full-on labor. I am trying to practice my breathing, doing everything. I get checked in. As I am getting checked in, they say, “Can you call the midwife who is on call?” And then one of the nurses said to the other one, “Which one is it?” and she said the name of the midwife that I had met literally just hours before, this black midwife that I told my husband, I am like, “That's her. She is going to deliver the baby.” And she was on call. At this point, I am bawling because I just cannot believe that all of this has worked out in this way. So she comes back. She checks me and I was 9 centimeters. They had to give me a COVID test. They gave me the COVID test. I didn't even get the results.Julie: Yeah, I was going to say.Nicole: They took me right back. My husband went down to move the car and I'm like, “Oh no. This is déjà vu. This is what happened last time.” But I had a doula with me and she was there and she was advocating for me. I honestly didn't even need any advocacy anyway because they were just so great. So I'm like, “I don't know what's happening. I think I have to push.” I remember the nurse said, “Well, push,” just so casually. So I was sitting there and I'm like, “Okay. Maybe I will try to push or just try to breathe into it.” My doula talked me through some breathing. I was on my back. They called the midwife. They said, “You have to come in here. We think this baby is coming.” My husband got back right just in time. I am literally still fully clothed. At one point, I was on all fours and I heard the midwife say, “Okay, his heart rate is dropping.” And I said, “Oh no.” They all slapped me back into reality and they were like, “No. You turn over and you push this baby out.” So I turned over. I did three massive pushes and he came flying out with his perfectly round head, which was the first thing I noticed about him, and a head full of hair. I just could not believe it. My doula was able to get a really great video of it and I said, “Did I do it?” And they all said, “Yes, yes, yes. You did it! You did it!” It was just such an amazing experience the way everything worked out, just the support from all of the nurses. It was such a healing, liberating, amazing, amazing experience. At no point did I ever feel like I would need a second Cesarean. They didn't even mention it. Everyone was just committed to helping me have the VBAC that I really wanted.I was able to do skin-to-skin with him right away, which I wasn't able to do the first time. I had such a different healing experience. It was just a really, really great experience for us.Julie: That's amazing. If everybody would feel so supported in their labor-- you went through a lot of negativity until you found your people. Like you said, “These are my people.” And to feel so supported during your labor and to know the midwife that was going to be delivering your baby, that had to be such a weight off of your shoulders. That alone probably shifted your entire feeling going into the hospital.Nicole: Yeah. It was such a great experience and the midwife, after I had been with her, she had to leave really quickly because somebody else was having a baby, but when she came back in, I just kept thanking her over and over. She was telling me, “No. You did it. You did it.” And I just kept thanking her over and over because I just felt so grateful that she was there and that she listened to me. I am just forever grateful to her.The VBAC calculatorJulie: That's amazing. There are so many things I want to talk about. Holy cow. We just don't have time to talk about it. First of all, the VBAC calculator is awful.Nicole: Yes.Julie: Let's just talk for two minutes about the VBAC calculator and then I want to get into some current legislation to improve maternal health outcomes for everybody, but specifically with a specific focus on reducing the mortality rates for black people and minority populations. The VBAC calculator, we actually created a bit.ly for it. So if you go to bit.ly/vbaccalc, it will bring up the VBAC calculator. Put in all of your information and calculate it and you will get a percentage, right? First of all, if you're preparing for a VBAC, this calculator is not evidence-based. ACOG discourages even using it and if you have a predicted success chance of less than 50%, it doesn't really mean anything. My first client ever as a doula, my very first client was a VBAC. She was an islander and her VBAC success calculator told her she had a 4% chance. Like, a four. F-O-U-R. She pushed her baby out in 20 minutes, guys. She totally nailed it, right? And so don't let that number discourage you, but what I want you to do is go in there, put your in your information, and calculate your number.And then, change your ethnicity. Change it from white to black and calculate it. Just change only that one thing and when you input black as your race, it drops your chances by 20%, roughly.Nicole: Yep. Exactly.Julie: It's always right around 20% just because you are black.Nicole: I did that. Yep. I did that and I had about a 30% chance when I was black. I didn't change anything else, my weight, my height, anything, and when I took out black, it went up to a low 50%. Yep. It went up a little bit over 20%. Exactly.Julie: And my VBAC, just for comparison, so my VBAC calculator was 62% was for my first VBAC and then when I changed it to black, it dropped it down to 48%. Now that I have a way higher BMI when I calculate it now and keep in mind I've had three VBACs, it takes me being white to 42.7% and when I'm black, it drops me down to the mid-20's.The VBAC calculator is based on a sample size of 7,000 people. They just tried to use all of this data to collect to tell what kind of chances people could have because in healthcare, they love data. They love to see the numbers. They like to know what's going on. They like to predict things. But what they didn't consider in that calculator is the bias that comes in the birth room for black women specifically because our black parents are dying at 3 to 4 times higher rates than white women of the same socioeconomic status, education level, income level, and same parts of the country, and Hispanic people are dying at twice the rate. And so we have this big healthcare disparity, but oh my gosh. It is so hard. I am so grateful for the last year. COVID has totally sucked, but I think there have been a lot of good things that have come about, lots of stirrings, and lots of noise, and riots, and challenges, and things come up where black voices are being amplified and we are hearing them more in our healthcare system. We are hearing them more. I think that's a really good thing, but if you are just some white doula from Utah like I am, what are we supposed to do? How can we influence the healthcare disparity in our local communities? I have an answer, something you can do if you want. I don't know, Nicole, have you heard of the Momnibus legislation?Black Maternal Health Momnibus Act of 2020Nicole: No. I need to look into that.Julie: Yeah. So Representative Underwood is a black female representative in Congress and she introduced the Momnibus Act. It's spelled just like it sounds. It's M-O-M-N-I-B-U-S. It's designed to address the overall-- we are one of the greatest nations in the world, but we have one of the highest maternal mortality rates and that's really sad. But what is even sadder is the disparity of those mortality rates between white people and people of color, and black people are in a separate class. They are even more likely to have Cesareans and more likely to die during childbirth. And so this act addresses the overall maternal healthcare system in improving and decreasing that overall maternal mortality rate but also decreasing the bias that exists in our healthcare system. I'm just going to go over-- you can just Google “Momnibus Act”. They introduced it in 2020. They're making some changes to it and they are introducing it again in 2021.I mean, a lot of some good changes have started to be implemented in 2020 just coming from this, but the bill has 12 key points in it. I am going to try and just go through these super quick.The first one is, “Make critical investments and social determinants of health that influence maternal health outcomes.” So housing, access to healthcare, transportation, and nutrition. “Provide funding to community-based organizations.” So community healthcare in underserved populations, community-based maternal health care, rather. They are studying the risks facing pregnant/postpartum veterans, which, I am a veteran. I served in the military for five years, and so I think that's actually a really cool thing that they put in this bill in addition to everything else. But they want to put effort and money into diversifying the perinatal workforce because Nicole, you said it was really important to you to have a black provider to reduce the risk of bias against you. So this bill has a goal to increase the number of black providers and providers of other color that we have access to in our healthcare system because that's another part of the problem.Nicole: Yeah. Mhmm.Julie: “Data collection processes” so we can better understand the maternal healthcare crisis. “Support moms with maternal mental health” because that's a big thing as well. “Improve mental healthcare and support for incarcerated moms.” “Invest in digital tools to help monitor maternal health overall.” It has lots of other things. I'm not going to keep going on, but one of the things I really like is that it talks here about educating providers about these biases that exist in their space because I know that a lot of the time, we are not aware of our own inherent biases that exist around us.Nicole: Yep.Julie: And I think as white people, it's easy to kind of brush off, “Oh, well I am not racist. I don't treat black people any differently than I treat white people,” but then doing that dismisses the idea. Even if that's true, it closes you off to see what other things you might be doing or what other things exist in our healthcare system that are biases against people of color. And so I think that's a big thing for me right now is just being more aware. I have had, I know me and Meagan have both had clients-- other nations, Asian clients.My biggest one I had was a Hispanic client and man, there was such a bias against her. I can't even tell you the amount of crap we had to deal with in the birth room and this is just here in Utah. And so we have seen and experienced it ourselves, but I think when you say, “This is not a problem because I am not a problem,” really closes you off to help fix the problem. So what I want you to do right now if you're listening and you want to help change this big gap in maternal health care for black women and other women of color is I want you to go look up your local state representatives and senate members and send them an email, or just Google “Momnibus Utah” or “Momnibus” in your state because each state has their own ways of introducing the stuff. I know Utah, maybe not all the states do, but most of the states have their own versions of the Momnibus Act they're integrating at the state level as well. Google your state representatives. Google your state Momnibus Act and send a letter to your representative, to your local legislator, and tell them that you support this, that this is important to you, and you want them to vote to move this forward and start implementing this across the country because that is the biggest way to get things to change from the top is letting your state representatives know that this is a big issue for you. When they hear the voice of the people that vote for them, that's the biggest way to get them to change things. Even get a community petition started, or something to where you can bring this up to your local leaders in our country, but also focus on your state as well because there is-- gosh, I wish I had the information in front of me. There are ways to reach out and I don't know. There's somebody here in Utah that was in charge of introducing a Utah version of the Momnibus Act. Gosh, it is just missing from my brain right now, the information. But giving feedback to our leaders, giving feedback to our leaders is what's really, really important and then being aware. Don't say, “Hey, I am not a problem because I don't treat black people differently.” You say, “Hey, this is a problem. Let me be more aware of it,” and just observe. Even observing and being more aware of the actual problems and what they look like is going to help you be more cognizant of things you can do to help change them. And then as birthing people, stand up for yourself. Change providers. Find your voice. I know it's not as easy as I make it sound. It's easy for me to say that, right? But getting educated about your options. Knowing like you knew, Nicole, that the VBAC calculator is crap. It is just crap. But you knew that. But somebody that doesn't know that and doesn't know that it is biased against black people is going to say, “Oh my gosh. I only have a 30% chance of success. Maybe I just shouldn't do this at all,” and then they have a repeat Cesarean which increases your chance of maternal death anyways-- a very small amount, but then, I mean, it's just a huge escalation. So being aware of the racial disparity in our healthcare system, and then observing it, and seeing what it looks like practically in your local area, and then speaking up and emailing your state representatives and your state government leaders about the Momnibus Act are things that you can do right now, today in order to help improve this change, and being aware of it, and stepping up for people. If you witness people of color, whether you are white, black, Asian, Hispanic, whatever your ethnicity or your background of your color is, speak up if you're witnessing this. If you're seeing this happening, speak up and say, “Wait, this is wrong.” I guess it could just be regardless of whether it's due to race or not, but you should always speak up if you see somebody being mistreated in the birth room. But also, don't be afraid to file complaints against the hospital or against the provider because that's another thing that is just going to bring more awareness of what is going on in our local communities. Sorry. I feel like I've been talking for just a really long time. Nicole, what would you add to that?Nicole: I think everything that you said is important, but I really want black women, women of color to know it's okay for you to advocate for yourself. It can be very tiring and very exhausting on top of what should be a very happy and positive experience but don't be afraid to advocate for yourself and don't be afraid to switch providers. If you go see someone and you get a feeling just in your interaction with them that you will not have a positive experience with them, don't be afraid to switch. I switched three times in the middle of a pandemic and it was honestly the best decision that I ever made. I would also suggest if you can, get support from a doula, or a partner, or a trusted family member so you always have someone else there to give voice to what you're saying, what your needs are, what you are experiencing, but just really advocate for yourself. Don't be afraid. Don't think you're being too much, or you're asking too many questions, or you are being too aggressive, this is your life. It's the life of you. It's the life of your baby. Advocate for yourself and don't be afraid to do that.Julie: Absolutely. I think that's so, so, so important. I love that you switched providers twice. But I've had clients, and I know we've had several people on our podcast, switch providers until they find the right fit. If somebody is treating you wrong, you have the right to leave providers and go to a different birthing location, even if it's in the middle of your labor. I know that sounds really hard and scary, but people have done it. It's been done. All right, Nicole. Thank you so much for being on our podcast today. I am seriously fangirling over here on your Instagram. I love your subscription boxes. Seriously, we are going to be doing something with that I think. Like, your monthly subscription. I want to get my hands on these diverse books for my kids. I really do. It's a really important thing for me. I'm happy that we found you, and that we connected, and that you shared your story, and especially for allowing us to talk more about the healthcare disparity with black people in our country. So thank you. Thank you for spending that time with us today.Meagan: Yeah. Thank you so much.Nicole: Thank you. Thank you so much for having me. Thank you.ClosingWould you like to be a guest on the podcast? Head over to thevbaclink.com/share and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan's bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Who is behind the voice of our podcast introduction? Who edits The VBAC Link podcast episodes? Meet Brian Albers, The VBAC Link's secret weapon! Listen to this episode to find out why Brian has earned this title time and time again. We also learn some fun secrets and ask him some of your burning questions. But in all seriousness, we are SO grateful for all Brian does for us. He is a quality, genuine guy that they just don't make these days anymore!   Additional linksThe VBAC Link on Apple PodcastsHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Community on FacebookThe VBAC Link ShopFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: All right, you guys. Guess what? This is an episode that I know you guys have all been waiting for since we posted a picture of our secret weapon wearing, “Don't be all up in my perineum.” If you haven't seen the post, go scroll back in our Instagram. We have Brian, who is our secret weapon. Julie started calling him that, I don't know, forever ago.Julie: Because he is.Meagan: He really is. He has proven it. So we today are going to be recording an episode about Brian. Brian is the voice of our intro on our podcast. Review of the WeekMeagan: We have a review, and Julie is the best review reader. We all know this. I can't read.Julie: Oh my gosh.Meagan: She can. So Julie, go ahead and read your review. I hope you picked a big one. I think strategically, you probably pick the big ones knowing that I can't read them.Julie: Yeah. That's exactly what I do, actually. I pick the bigger ones and leave the smaller ones for you.Meagan: I always hope. I always hope.Julie: We have so many. I don't even think we are going to get through them all, so I am trying to pick more recent ones because I know that you pick older ones and so I feel like maybe we have a little bit of both worlds in our review reading. All right. This review is from Apple Podcasts and it's from carrie.vic so we can totally Facebook stalk her if necessary.Her title is, “OMG, the best VBAC resource out there” and then she says, “Thank you so much to Julie and Meagan for this podcast! I began listening to it right after my C-section in August 2018. Then, when I found out I was pregnant in June 2020, I re-listened to every episode. So. Much. Information. So much positivity and hope. I had my VBAC on 02/11”That was just this year.“and I don't think I could have done it without The VBAC Link. This podcast helped me ensure I had the most supportive birth team and provider, provided so much useful information, and all of these mamas made me truly believe in my capability to do this!“Thank you, thank you, thank you a million! Sending so much love to all you mamas out there! ❤️”I love the heart emojis. I love the reviews. I love carrie.vic from Apple Podcasts. Thank you so much and congratulations on your VBAC.Meagan: Yay. Congrats, congrats. I love when we hear the reviews and we don't have to go stalk them. So if you leave a review or if you have left us a review and then gone on to have your baby, let us know how things are going because we kind of stalk you on Facebook, not on Facebook Facebook but on our Facebook community to see because we love following up and hearing about the stories. So leave us a review and if you have already had your baby, drop us an email or tag us on Facebook and let us know.Julie: Yeah, because we really need closure on these things. Like the ones from last year that you read, I'm like, “Oh my gosh, they had their baby eight months ago. I don't know what happened.” Closure is always good.Meagan: Okay, without further ado, we are going to have Brian give us the intro.Brian: All right, here comes the music. You are tuned into The VBAC Link podcast with Julie Francom and Meagan Heaton, VBAC moms, doulas, and educators here to help you get inspired for birth after having had a C-section. Together they have created a robust VBAC preparation course, along with this uplifting podcast, for women who are preparing for their VBAC. Although these episodes are VBAC specific, they encourage expectant moms to listen and educate themselves on how to avoid a Cesarean from the get-go. The purpose of this podcast is to educate and inform. It is not meant to replace advice from any other qualified medical professional. Here are your hosts, Julie and Meagan after we hear from today's sponsor.Julie: “Here are your hosts, Julie and Meagan”Meagan: Yay. I love it.Julie: I love it. Brian is amazing. I call him “our secret weapon” because he is our very first person that we ever paid to do anything from The VBAC Link. He literally saved my life because when we first started, I was editing our podcast episodes using a free program that I downloaded, and every Tuesday night I would be in a rush trying to get-- I'd spend two hours editing, and trying to crop out “um's” everywhere, and putting the intro and the exit there, and get it in the right spot, and get it uploaded, and get everything posted in time for our Wednesday podcast runs, and then Meagan connected us with Brian.Meagan, you're going to have to tell the story because I don't even remember how you guys met. But then he literally saved two hours of my week and that's why he is our secret weapon. But not only that, he is our video guy. He records the videos for our courses and we also give him a whole bunch of random audio/video stuff to do here and there for us. So he is called “our secret weapon” because he saved our lives and we want to keep him nice, quietly tucked away in our own little package so nobody else can use him because he is ours.Meagan: Brian, you belong to us.Brian: Yep.Julie: We will lock you in a dungeon with a computer and some audio equipment just in case you ever decide you want to stop editing.Brian: And honestly Julie, what you described Julie, just cutting out the um's-- that's pretty much what I do. That's the bulk of it because there are so many, really.Julie: Yeah, because me and Meagan don't know how to not say “um.”Brian: Well, I mean, everybody says “um”.Julie: I know.Brian: It's just a natural, normal part of speaking, but when you're trying to present it as a podcast, you want to sound as pro as you can. And cutting out those “um's” is working towards that goal.Meagan: Yes.Julie: Yeah, and then not saying “um” is another step.Brian: Yeah.Meagan: Yeah.Julie: Maybe when we are grown up we will stop saying “um”.Meagan: It's seriously one of the most, it's one of the hardest things for me. What's funny though is I don't recognize myself saying “um” or “uhh” but I totally recognize anybody else saying “um”. I'm like, “Oh my gosh that person says--” like I recognize “um's” more, but in myself, I don't. I don't know why that's a problem.Julie: Until Brian sends us a message that says, “You guys are saying ‘um' a lot more than usual. Just pay attention.”Meagan: “Can you guys drop the ‘um's?”Julie: And then we are texting each other during podcast episodes and saying, “Oh my gosh I am saying ‘um' so much.” No, but I have learned that I replace that with “so”.Brian: Uh-huh, or “and”.Julie: Yeah. And “and”. Yeah, and “so”. That's awesome.Brian: And that's okay. That's okay too.Julie: Yeah. So let's get going. Um, we-- see? There I did. Oh my gosh, I just said it.Brian: Yep.Julie: You'll probably have to edit that out.Brian: I'll leave that one in.Julie: Yeah, you can leave that one in because, um-- oh my gosh. Now I am going to be so hyperaware. Oh, this is not going to go well.Meagan: Oh my gosh. Okay, so I was just reflecting back on how I got a hold of Brian and I feel like-- okay. So I had a client who, crazy enough, yeah. Anyway. So I had a client and he does video and then his wife does sound. I asked her, I sent her a text or something. I was like, “Hey, do you know about anybody or do you know anybody?” And she was like, “Yeah.” I can't remember if she sent Brian to me directly or if she sent me to someone else, but I'm pretty sure she sent--Brian: You're talking about Michaela, right?Meagan: Michaela, yeah.Brian: Yeah.Meagan: Michaela knew you, right? I thought she sent me directly to you. She was like, “Yeah. I know someone.”Brian: Yeah, because I work at the NPR station here in Salt Lake City and Michaela does as well. She is a weekender and that's how I know her. She still does work there and I still do work there so we still do know each other.Meagan: Yes, yes.Brian: And so she approached me and she asked me if I was interested in helping out some friends of hers start a podcast or do a podcast or something. I don't know if she just didn't have the details or just didn't give me the details, but I had no idea what anything was about. I just knew it was something about audio editing and a podcast and I said, “Yeah, sure.” I love doing audio and I love helping people if I can pursue what they want to pursue. If I can help out, I will help out. Especially when it comes out to audio stuff because I've been doing audio forever. And so I said, “Yeah. Throw them at me. Give them my email. Whatever happens, happens.” And that just got the ball rolling.Julie: And then you became our secret weapon.Meagan: Yeah. She sent me your email. That's right. I was like, “I was pretty sure it was direct.” And then I sent it to you. I remember emailing you and it was such a big step for Julie and I because Julie was our editor before and she did a wonderful job, but she was tired of it. And we are not professional. We are not professional. It's not easy.Julie: It was so much work. Oh, well and Brian can edit a podcast episode in 30 minutes that takes me two hours to do.Meagan: Unless we say “um” all the time and then it's two hours. But yeah. But no, it was just such, I don't know. The stars aligned so perfectly. I will forever be grateful for her and we are forever grateful for you, Brian, and we are so excited that you are with us.Brian: And that was when? That was the fall of 2018?Meagan: Two years, mhmm.Julie: Yeah. Right about that.Brian: And you hadn't done too many episodes before I came on board, right?Julie: I think we were 30 episodes in.Meagan: I was going to say, I think it was 30 or 40.Brian: Wow.Julie: Yeah.Meagan: We really hadn't done that many and they were a mess.Julie: Brian was like, “You guys really need to find a studio and I actually know one that might be available.”Meagan: Yeah. He's like, “You need to have better audio.” So it's just been so awesome and then we were like, “Oh, we are going to do this online course. Hey Brian, do you know how-to video?” “Yeah.”Brian: “Yeah.”Meagan: And you guys, he spent an entire Sunday--Julie: It was like, 10 hours.Meagan: Yeah. With us in an empty duplex sitting there as we were just talking about-- like seriously, yeah. It was amazing and yeah. I am so grateful for you.Brian: And actually, videoing is the easy part. It's all the editing and post-production that takes forever.Julie: And so you know so much about birth, and Cesareans, and VBAC--Brian: And do you want to know? The funny thing is when I started editing the podcast, I, first of all, didn't know it was a birth thing.(Meagan and Julie laughing)It was just a podcast. Seriously, I had no idea--Meagan: He didn't know.Brian: --what it was about until I heard the first audio. I had no idea what a VBAC was. I had no idea what a VBAC was. I had no idea what a doula was. I had to look that stuff up.Julie: And now you know way more than you ever thought you would know about birth.Brian: Oh, I know way more than I thought I would ever know.Julie: Probably way more than you would ever care to know.Meagan: You could be a doula, Brian.Julie: I want to read your bio really fast.Brian: Oh, go for it.Julie: You wrote out a really well-thought-out bio and I want to read it because I think it is transitioning to what we are talking about right now, but I want you guys to know a little bit more about Brian and then we can talk some more, and share some really embarrassing stories, and all that fun stuff.But Brian is a SoCal native which-- I did not know that about you. Meagan probably did. Meagan is a bigger people person than I am. But you moved to Salt Lake City in the summer of 2015. You are a lifelong musician and we have seen some of your stuff on YouTube. It's pretty amazing. You have been an audio engineer since the early 90s. You worked in radio, big-time nationally syndicated stuff as well as small-time local stuff as an engineer and on-air host since the mid-90s. He is currently an on-air host at 90.1 KUER NPR Utah, headquartered in Salt Lake City, heard throughout Utah, and video editor in marketing at Salt Lake community college. I did not know that either.You run Humorless Productions. That's his business name. Remote audio, video recording, and post-production, primarily concert recordings, primarily noisy undergroundy, aggressive, electronic music. Obviously, not recording too many concerts these days. You are an avid skier. I did know that. Avid road bicyclist-- also knew that, and hard-core introvert. Also knew that.And let me tell you, people, Brian‘s never married and has no kids. Brian is such-- this is why I call him “our secret weapon”, right? He literally edits a birth podcast. He has never had kids. He has never seen somebody or helped somebody have a baby, but he is sitting over here being the biggest trooper for us. He came to our first birthday party and took pictures with us in our little made-up photo booth. He is just always so willing to help out and is just so-- I don't know. I just think you are a good-quality, genuine guy. They just don't make people like you anymore. I don't know if that makes sense.Brian: Well, if you think about it though, if you put yourself in my position, I mean, I don't really have to know anything about birth specifically. I'm just doing the audio.Julie: That's true.Brian: You know? I just pull it up on my computer and put it in my editing program and start editing. At that point it's not about birth, it's about audio and it's about making the people sound good.Julie: Which you do a great job of.Brian: So the podcast could be about anything and I'm still going to do the same process.Meagan: Right.Julie: Yes.Meagan: But at the same time, you are so willing to go the extra mile to do so many other things. In fact, even wearing your “Don't get all up in my perineum” shirt.Julie: “Don't be all up in my perineum.”Brian: The perineum shirt.Julie: Actually, can we talk about that shirt? I'm going to have that available in our VBAC Link shop. So if you go to thevbaclink.com/shop, you can see exactly what we are talking about and buy your own. “Don't be all up in my perineum” shirt straight from our VBAC shop. So by the time this episode airs, I will have it up there and live for you. I am pretty sure we can include a picture of Brian rocking it. In fact, that might just be our main product image.Meagan: Yes. Yes. I love it. Okay so, Brian. What got you into-- I mean, you've been doing this for such a long time. What sparked your interest in this? Like as a kid, what did you do as a kid? Did you want to do stuff like this as a kid? Like in editing and audio and video and all that?Brian: No, I mean, as a kid, like as a teenager, I would ride my bike around the neighborhood or ride my bike just as much as I could, so that's always been a lifelong thing. I started playing guitar at 12 or 13 years old and that pretty much instantly became my main focus forever. I wasn't good at it instantly. I wasn't a prodigy, but I got fairly good at it in some short amount of time. I was sort of a natural musician. It was just a language that I understood.Meagan: Yeah, it just came to you.Brian: It just kept going and going from there. I was in bands back in the 80s which-- we didn't go anywhere. We didn't record anything. But I was always playing and I was always getting better. Eventually, the first thing I did out of high school was, I went to a guitar school in Hollywood. It's the premier West Coast guitar school via Musicians Institute and the Guitar Institute of Technology. I graduated in 1990 and from there, that's what got me interested in audio. In playing guitar, and playing with bands, and playing with other people and recording as well, I was interested to know how exactly. You know, you mic up a guitar and why does it sound different if you put the mic here or if you put the mic here? Or if you use this microphone or that microphone? I was interested in that sort of stuff. I just dove into it headfirst while all along being a musician, but also being interested in audio.Once I eventually went to proper college, I was a music major at first, but then I switched to audio engineering and graduated as an audio engineering major. That was in the mid-90s. That's when I started in radio. I eventually did my own music shows in LA and I was an engineer for some big radio shows in LA. It all just came together and that's how it's been since then.Meagan: That's awesome. I didn't know that about you.Julie: Yeah. You're pretty good at it. You've got a natural talent.Meagan: Yeah. Oh my gosh.Julie: Alright.Brian: Isn't that what they say about kids? Because I'm a middle kid. I have an older brother and a younger brother.Julie: Aw, that makes sense too.Brian: Isn't the middle kid supposed to be the artsy one?Meagan: You know, my middle kid is. She is very artsy. I mean she seriously, she was 18 months old and I remember we were in this group of people and there were some coloring books. She sat down and started coloring and this lady was like, “Oh my gosh” because she was color blending and coloring in the lines so perfectly. She was like, “What in the deal?” And then now, she can just look at something and she just draws it. And she's like, “Look, this is--”. The other day, she brought home-- it was Cat in the Hat, Dr. Seuss's birthday, or whatever, and she brings me this Cat in the Hat picture. I am like, “Oh my gosh.” She is so good that way, and then she is really good in the arts like dance, and music, and things like that. She is really good at the piano and she is six. So, yeah. I would say my middle kid is good at it.Brian: Cool.Julie: I have two middle kids and I would say my third is definitely the more artsy one. But again, they are three, four, six, and seven. My seven-year-old has really mild cerebral palsy so he has always hated handwriting. He's always hated coloring because it's hard for him because of his right hand. It's his right side that is affected. He's not severely disabled or anything. It's really, really mild cerebral palsy, but it affects his right extremities and so he is forced to be left-handed when his brain operates in a right-handed way. He's never been good at that type of thing. I wonder if that's true. I don't know. We will see. We will see as my kids get older I suppose.Meagan: So tell us something else unique that no one would know about you that we don't even know.Julie: Yeah. Behind the scenes.Brian: About me?Meagan: Yeah, because you are. Like we said, you are just like this secret weapon. You just have all of these hidden talents. What is something that you-- I don't know. What is something secret?Brian: Well, I have a good one. I don't know if I have told you before, but I lived-- so I am from Southern California. That's what I say. That is the short answer. But the long answer is I was born in San Diego and I grew up in San Diego. But I lived all of my adult life in LA and so LA feels more like my home, which sounds sort of weird than San Diego, but if you press me, if you asked me where my home city is, I will say LA. But then, I also moved to Austria twice.Julie: What?Brian: Yeah. I lived there for most of 2005 and then I moved back to LA, and then I moved back to Austria from late 2009 to late 2010, so another year there for no reason. It wasn't a work thing. It wasn't for anything, I just wanted to live there. So twice, I sold all my stuff and quit all my jobs, and moved.Meagan: Oh my gosh.Julie: Oh, to be free.Meagan: That's amazing. That's amazing.Brian: Yeah. I didn't really know the language too much. I mean, I took some classes beforehand just so I was a little bit familiar, but I went over there and that's actually where Humorless Productions started my mobile audio/video recording system. That's where I really cut my teeth because there were so many more shows over there at that time that I could record as opposed to LA, at least for the music that I was interested in recording. And so I went over there, and I brought some equipment, and I would record all sorts of shows every month. It wasn't easy, but I worked out a system. It's evolved over the years and now I have a really good system.Actually, the first time I lived in Austria was in Vienna. The second time I lived there was Linz, which is a smaller town about an hour and a half west of Vienna. But if you really asked me if there's anywhere in the world that feels more like home than anything else, I would say it's Austria.Meagan: Really?Brian: Yeah. I have five more friends even today in Austria than I do in the States.Meagan: Wow.Julie: That is super cool.Brian: Yeah.Julie: Gosh, I used to travel so much when I was single. I guess maybe it was because I was in the military. I lived in a couple of different places and then once or twice a year before I got married, I would just travel somewhere on a plane. I was just talking to Nick the other night about this and I just miss that so much. You know, you get married, and you have kids, and you're just stuck forever until your kids get old enough to travel with you. I love that.Brian: And actually when I was over there, I wasn't really intent on traveling or going around, but that just ended up where the shows were that I would record. Vienna is fairly centrally located, so I would hop on a train and go up to Prague, or Budapest, or to Venice, or to Zurich, or to Munich, or to Berlin, or wherever. So it was all sorts of fun.Meagan: That's awesome. So cool. Yep. I did not know that.Julie: Yeah. I did not know that either.Q&AMeagan: So I posted on our Instagram what questions people have for you and a couple have come in. Can I ask them to you?Julie: Yeah.Brian: Yeah.Meagan: One, what is the most interesting thing you have learned from this podcast?Brian: I've learned all sorts of stuff. What's the most interesting thing? I don't know the most interesting thing.Meagan: What's something that stands out to you that you've learned? Obviously, you learned what a VBAC is in general.Brian: Yes, in general.Julie: Maybe if somebody asked you, what is The VBAC Link? What would you say?Brian: Well, here's the thing. For anybody listening, Julie and Meagan don't necessarily want you to have a VBAC. They want you to have the birth that you want. If you want a Cesarean, that's super great. More power to you. The thing is, you're going to learn stuff. Even if you do a Cesarean, you will learn stuff for your pregnancy that will benefit you if you listen to this podcast. If you are a first-time mother, you will benefit. You will learn stuff from this podcast. It doesn't matter if you have never had a Cesarean, doesn't matter if you have never had a vaginal birth. There is just so much good information that you will learn in this podcast.Meagan: I would agree. So another question is, do you share what you have learned with any expectant parents in your life?Julie: Wait, wait, wait. Hold on a minute. Hold on a minute. Thanks for that Brian. That was really nice of you to say. I really like that.Brian: Yeah.Meagan: That really was.Julie: Thank you.Meagan: So to me, Brian, you just answered it a little bit, right? Because that's one of the most interesting things you have maybe learned, right? We're pro VBAC, obviously. That's why we are here and that's why we created the course, and the podcast, and the blogs, and all of that jazz, but you nailed it. It's not that we want you to have your VBAC. It's that we want you to have the birth experience that you want, whether that be a VBAC or not. So I totally love that so much and that seems like the answer to me too. Maybe it's not the most interesting, but it is something that you have definitely taken away and realized that through editing our podcast, that's what we are here for. That is exactly what we are here for is to help these people get the birth that they desire no matter what that may look like to them.Brian: And one other thing, it might sound like not the best way to say this, but a lot of these women who come on the podcast have learned lessons the hard way. They want to share their experiences of learning things the hard way so that other women don't have to learn the hard way themselves. You know? You never ever want to say, “Well, I told you so I told you so,” but I think that's one of the best things about this show is that women don't have to go through all the trauma and all the pain that these other women have gone through, not unnecessarily. You know how birth goes. You never can plan it out 100%.Julie: You know how birth goes now.Brian: Yeah, more than I used to.Meagan: Yeah, and I love that. Yeah. I don't think it was saying it like that or anything. It's true. We have all learned things in hard ways a lot of the time and that for sure was me with my second provider. I didn't switch and I learned the hard way to follow my gut. I didn't follow it the first time. I had to follow it the second time. I am glad that I did so I had the outcome and the experience that I had. So, yeah. I love that.Do you share what you have learned through this podcast with expectant parents in your life? Do you have many expectant parents in your life?Brian: Yeah, I would in a heartbeat. I have only had one friend who had a kid last year sometime in 2020 and I definitely recommended it to her when she was pregnant. I said, “Hey if you want to learn some stuff, listen to this podcast.” I don't know what her plans were as far as her birth plans, but yeah. I said, “There is all sorts of stuff that you will learn listening to this podcast.”Meagan: That's awesome.Brian: And she was a first-time mom.Meagan: Yeah. I know, I think that's something that is so interesting. A lot of the times it's like, “Oh, I have had a VBAC so I don't need to listen to that,” but really like you said, the first-time parents can almost learn just as much, if not more, than the people who have had Cesareans. Right?Brian: I mean, how many episodes do you have on the pelvic floor? That is something that every first-time mother can use.Julie: Yeah. At least four I think.Meagan: Exactly. Mhmm. Yeah. And chiropractic care and working through your fear.Brian: Yep.Julie: And big babies.Meagan: Oh yeah and big babies. Things like that and learning what is evidence-based. You know, we really focus on a lot of evidence-based. So yeah. I love that. I love that you referred us. Thank you for referring us. Do you know how her birth turned out?Brian: I don't know.Meagan: Did she talk to you about that? Most people, probably not.Brian: She hasn't talked to me about it. I've seen pictures of the baby on Facebook and everything looks like it's rolling just perfectly.Meagan: Going really well. That's awesome.Brian: Yep.Meagan: So you said you have two siblings. You are the middle child. Did you say, two brothers?Brian: Yes.Meagan: Are they married?Brian: Both of them are. Older brother has no kids. Younger brother has two kids.Meagan: Oh awesome. Do you know how his wife's experiences went?Brian: I don't know. I haven't asked her.Meagan: Right. It's not really something you probably would. I was just so curious if now--Brian: I mean, I don't think she'd hesitate to tell me if I asked because she's an adult. I'm an adult. Yeah. But I just haven't asked.Meagan: Yeah. Okay, what other questions do you have, Julie? Or what else do you want to tell us, Brian?Julie: I mean, I guess unless you want to embarrass us or roast us, I am so disappointed that there is not going to be any roasting. Throw us under the bus. What kind of dirt do you got on us? Tell the whole world.Brian: I don't have anything embarrassing about you. I have something embarrassing about me.Julie: Okay sure.Meagan: That's the thing is, I want to know more about you. I want this episode to be about you. So tell everyone about you.Brian: Well, here's one thing. First of all, I said in my bio there that I am a hard-core introvert and that's 100% true. This story sort of reflects that a little bit. It was when I first started the podcast. I think I had met Julie and I had met Meagan maybe once. I forget. Maybe not at all at this point, but one of you called me. I forget who it was. One of you called me on some afternoon and just wanted to say, “Hi. I just wanted to chat on the phone for a little bit.”Julie: That was definitely Meagan. I don't do things like that.Meagan: Probably me.Brian: I felt so bad because when you called me, I was at the main library and I couldn't really take a call. I couldn't really talk but I was totally whispering. I felt bad because I wanted to talk. I wanted to say “hi” but I was just not in a position where I could do any of that because there were people all around, and I was in the middle of something, and you can't make a whole lot of noise in the library. And so the call ended up being 30 seconds. It was like, “Yeah, hi. Thanks. Okay. That's cool. Okay, bye.” That was more impersonal than I usually am. You know, in the first place, I really am not the most personable person. I am not friendly at first.Meagan: Really? I think you were. You were friendly.Brian: But I felt bad about that call. But now we all hang out and we are all cool.Meagan: Yes. Now it's like, “Brian!”Julie: COVID has put a serious cramp in our style. We don't get to see you anymore.Meagan: I know.Brian: Yeah.Julie: One day. One day, maybe.Meagan: I know. COVID. Darn COVID. How've you been during COVID Brian? What have you been up to during it?Brian: It's been pretty great for me. I call it “working from home”, but at the same time I have been an essential worker at both of my jobs, and so I have really not changed my schedule at all too much. But it's been great for me as an introvert because everybody else in the office doesn't show up. They are all working from home.Julie: So you get to be all alone and enjoy being an introvert.Brian: So at both of my jobs, I pretty much have the whole building to myself. I can work at my own pace and I can play music as loud as I want. So it's been okay.Meagan: That's good. Have you taken on any side projects or anything other than everything that we send you?Julie: Everything that we send you?Brian: Everything you throw at me? No, not really. I mean, I have all my regular stuff. I have about a dozen blogs and a dozen side projects. I have always a thousand music projects at home which don't really have a deadline, so I have a mountain of stuff I can always work on. Sometimes I get to it. Sometimes I don't. Right now it is ski season, so I am skiing every Saturday and every Sunday for months on end. I am working both my jobs quite a lot these days so I don't have much time to do much of anything.Meagan: Where do you like to ski, Brian?Brian: Well, living here in Salt Lake City is pretty much the center of the universe. We have all sorts of good skiing here. I have one of those multi-resort passes so I have gone to Big Sky Montana this year. I've gone to Steamboat Springs this year. I actually have weekends coming up for both of those coming up shortly. I don't think I will hit Jackson Hole this year. I don't think I will hit Sun Valley this year. I don't think I will hit Aspen this year, but I have skied all over the West Coast.Meagan: What's your favorite resort here in Utah? What resort would you suggest of someone to come to Utah and try out?Julie: Megan is our skier. She probably wants to go catch you on the slopes one day.Meagan: Yeah.Brian: It's probably not the one that most people would come up with as the number one resort here in Salt Lake City at least, but I go to Snow Basin.Meagan: Snow Basin is awesome.Julie: I like Snow Basin.Meagan: That's the first place I go.Brian: At least for me. I was going to say, Snow Basin is better than any of the four here close to town. We have Snowbird, Alta, Brighton, Solitude. But Snow Basin is the one I prefer. Just got the best terrain for me. I am an advanced skier. I've been skiing my whole life.↔Julie: You got a lot of that in SoCal huh? Just kidding. I'm sure the slopes were amazing in Austria.Brian: Yeah. Yeah. I went skiing at St, Anton in the alps for a week. I skied Kitzbühel.Julie: Aw, what a dream.Brian: I skied the racecourse. The Hahnenkamm racecourse at Kitzbühel a week before the race. It was the day before they actually shut down the course for the race, which was totally cool. So I skied the Hahnenkamm in Austria.Julie: That's pretty cool.Meagan: That's super cool. I just started skiing this year.Brian: Really?Julie: Did you? For some reason, I thought you've been skiing for a while. I used to snowboard back in the day when I was cool and now I'm just a boring mom. I still have my snowboarding boots. I used to go to Brighton because it was the cheapest one. You could buy a half-day pass for only three of the lifts and it was only $40 instead of having to pay $90 for a full resort pass and so me and my friend would go up almost every weekend. We would go boarding and then we would go to the Porcupine Grill at the face of the canyon afterward and have nachos and hot chocolate which you wouldn't think go together but after you go snowboarding, they definitely do go together.Meagan: Oh wow. That's in my neighborhood. Yeah. No, I actually begged to snowboard as a kid. I begged my mom every year. “Mom, I want to snowboard. I want to snowboard” and she was like, “Nope, nope, nope. Too dangerous. Too dangerous” and refused. And so this year for Christmas, my husband surprised us with also a multi-pass and said, “We are--” because you guys probably know I hate winter. I hate it. I hate it. I hate being cold. I like being at the pool feeling the sun and going outside on hikes, and sports, and obviously, as of last year I really took up cycling, and so I just like to be on my bike. So yeah. “We are going to make your winter better.” I will just tell you right now, if you haven't ever skied before and you have snow In your area and you are listening, go skiing. It has changed my winter life completely. So I love that you ski, Brian. I always remember we would always try to get the podcast recorded at the end of December, or really November, so we weren't driving in the winter and we would try to get enough through February because we were like, “We don't want to drive to the studio in winter.”Julie: The studio is an hour away from my house. In some of the snowstorms, it took me two hours to get home, and then there was that one time Meagan made me run out of gas on the freeway.Meagan: Yes.Julie: That was at midnight. It was awful.Meagan: Yeah. We were recording with Brian. This is how much of a champ Brian is. He would literally stay with us at the studio until 11:30 PM. It's insane what this man does for us. So we just are overly grateful for you. But I always remember he was telling me-- I swear there was two years or something that you were like, “Yeah. I'm going to Jackson this week.” And you would go and ski in Jackson. It's one of my dreams to go and ski because we have a cabin there and now that I ski, I want to go skiing there because I have heard it's amazing. I've also heard it's pretty steep though. Is it steep?Brian: Great one. Yeah. They have something for everybody.Meagan: Good, because I am still not as advanced or confident. My husband says I am a really really good skier. I just lack confidence.Julie: We need to get your confidence for skiing just like we want people to have their confidence for birth.Meagan: I know. Okay, one last thing. What advice would you give to parents listening to the podcast? What do you feel is one of the most important takeaways from listening to all of the stories?Brian: The biggest takeaway, and it's the most obvious thing in the world. Birth is not easy. It is a monumental challenge. You can only be as prepared as you can. You could write down every single thing that you think is going to be a part of your birth plan and both Julie and Meagan will tell you there is not a single birth plan in the existence of the history of the universe that didn't go 100% according to that birth plan. There's always going to be some curveball in there that you were not prepared for. It's impossible to prepare. You can't prepare for absolutely everything. You can make a birth plan. You can make a backup plan. You can make a backup backup plan. The best thing you can do is just learn, research as much as you can, listen to the podcast, I don't know what else to tell you. You can't be prepared for everything but you can just try.Julie: And trust your intuition.Brian: Yeah. And the other thing is that-- I'm sure you've said this Meagan or Julie in the past on one of your episodes and I know it's easy for me to say, “Well, keep this in mind.” But keep in mind that you are the mother. You are in charge. All the nurses, doctors, the providers-- they can tell you, “Okay. We need to do this,” and if that doesn't line up with your birth plan, you say, “No, wait a second. I am doing it this way.”Julie: Boom.Brian: “I'm doing it this way.” You say it twice. You say it loud if you need to. “I'm doing it this way.” And if they say, “Okay. We'll work with this.” It might get to a point where they say, “You know what? This is medically unsafe or medically unwise.” At that point, you say, “Okay. I will listen to what you have to say.” Otherwise, you are saying, “I'm doing it this way. I'm doing it my way.”Meagan: Yeah. And it's okay to say, “Why is this medically unwise?” It's okay to question that.Brian: Yeah. You are in charge. Not them.Julie: Love it.Meagan: Okay. You're awesome, Brian. We love you. We love you so much.Julie: Yep. Don't ever go anywhere. We are going to keep you forever as our secret weapon. Our not-so-secret weapon anymore but I am still going to call you our secret weapon.Brian: Awesome. Okay.Meagan: If you ever decide to go back to Austria, are you still going to stay with us, or are you going to be like, “Peace out Meagan and Julie?”Brian: Well I mean, we haven't actually ever been in the same building for a year now.Julie: Yeah, so I'm pretty sure it doesn't matter where he lives.Brian: And we're still making a podcast, so whether I'm in Salt Lake City or in Vienna, we can still work it out.Julie: Boom.Meagan: Perfect. All right, okay. Well, if you guys want to know more about Brian after this episode, message us and we will get your answers. And Brian, seriously, you are just a miracle in our lives. So, we love you. We appreciate you. Thanks for joining us today and telling us more that we didn't know about you. And for the ski trips.Brian: Totally awesome.Julie: Wonderful.ClosingWould you like to be a guest on the podcast? Head over to thevbaclink.com/share and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan's bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Katherine's unassisted VBA3C was truly redemptive in every way. After three unwanted Cesareans and a traumatic VBA3C, she decided that her fifth birth had to be different. When Katherine's intuition told her that she was not getting the support she deserved, she knew that birthing unassisted was the path for her. Katherine worked hard to research, plan, and prepare as safely as possible. Her birth was intense, healing, and just what she needed. We talk about the risks and benefits of unassisted births and what things you can do to make sure you are making the best (and safest!) choice for your situation. While we will always advise birthing with a VBAC supportive provider over birthing unassisted, we also ALWAYS applaud women for following their intuition!  Additional linksThe VBAC Link on Apple PodcastsHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Julie: Good morning, Women of Strength. It is Women of Strength Wednesday and let me tell you, I couldn't be happier to say that. I love that alliteration, Women of Strength Wednesday. I don't know if that's exactly an alliteration, but it feels really cool to me. Women of Strength Wednesday. No matter what day you are listening to this on, this podcast was released on Wednesday and so you can proudly be a part of Women of Strength Wednesday.We have a really, really, cool, cool, cool story to share with you today. We have Katherine with us. She has five kids. She had three Cesareans and then two VBACs. Her first VBAC was a traumatic and really hard experience for her and her second VBAC after three Cesareans was a planned, unassisted birth. And so, we are going to talk about all those things. We're going to talk about when you might need to consider an unassisted birth and how to do that safely, although we always recommend first if you can possibly find a supportive provider to support you in your VBAC, we always are going to recommend that first. But we realize that that's not possible in every area and so we want to talk about it instead of going into an unassisted birth irresponsibly, let's talk about options. We'll go over the risks. We will talk about how to do it responsibly if you find yourself in that position. Review of the WeekKatherine's going to share her story with us, but before we share her story and before we get to meet sweet Katherine, Meagan has a Review of the Week for us.Meagan: Yes I do. I was scrolling through reading and I was like, “Oh, I totally want to show this one, and then we like to show who it is from. I scrolled over and guess who it's from? It's from Paige.Julie: Our Paige?Meagan: Yeah.Julie: Aww.Meagan: Yeah. I'm excited to read this. So the subject is “Best birth podcast in all the land.”Julie: She's so sweet.Meagan: And I love that. I was like, “That is the cutest.” It says, “The VBAC Link is THE most empowering space on the internet. The birth prep content combined with the safe, beautiful sisterhood and support is truly unmatched anywhere else. I have prepped twice for a VBAC-- once before The VBAC Link existed and the other having podcasts in my ear multiple times a day every day during my pregnancy. The transformation I was able to have physically from doing the bodywork they recommend and in my heart and soul has changed me forever.“Julie and Meagan become your virtual doulas. They hold space for YOUR story and stay with you every step of the way. I can't express enough what a catalyst their podcast was for me to find my strength, find my voice, listen to my intuition, and have the confidence to completely throw myself into a journey without a guaranteed outcome. I didn't get my VBAC or my VBA2C, but The VBAC Link gave me so much more than the natural birth I hoped for. Forever and ever grateful for these two women. For their hearts. For their mission. For this safe and uplifting community in a world that has never needed it more.”That gave me chills.Julie: Oh my gosh, Paige. You're the best.Meagan: Seriously.Julie: She's going to be transcribing this.Meagan: As you transcribe, can you say, “I am the best”?Julie: Give yourself a high-five from us because we love that review. I just wish I could be a fly on the wall when you are transcribing this episode so I can see your reaction to us reading your review on the podcast and how much we loved it.Meagan: I know. It's beautiful. Yes and we love reviews so if you haven't yet, please drop a review. We have tons of podcasts that we have to record and we love to read reviews of the podcast on each recording. So leave us a review. No matter where it is, just drop it even if it is just a message. Message us and say, “Put this on your review.” We would love it.Julie: We just read one of those the other day.Meagan: Yes we did.Julie: An email review. We never share email, instant messenger, or direct messages without asking permission first, but if you leave a review on Apple Podcasts or Google Podcasts or Google, just regular old Google, it's free game. So you're probably going to get your review read on the podcast one day. We are really excited about that. The warm and fuzzies really keep us going and we are grateful for our sweet Paige for giving us that wonderful review.Katherine's storyJulie: All right, all right. Now it is time for Katherine. We are really, really, really excited for her to share her experiences with us. She lives in Georgia. In Georgia and other states in the south like Florida, Louisiana, and Alabama, the Cesarean rates are really high. The VBAC rates are really, really low and it's hard to find a truly supportive VBAC provider. There are a few gems here and there, but you're a lot more limited in your options there than you would be in some other parts of the areas just because of legal guidelines, VBAC policies, and de facto VBAC bans where the hospital will allow VBAC, but no providers will support you through a VBAC or they are really barely tolerant best. And so, Katherine is going to share her journey with us navigating through all of that in the south and then she's going to talk about her to VBAC after three Cesareans, one in hospital and one unassisted. Before I just start rambling on anymore, I'm going to turn it over to Katherine.Katherine: Okay. I do want to add something. So I am in Georgia currently, but I was born in Virginia where I had my first two kids and my husband is military, so we moved to California and we had our third, and then our last two were in Georgia. So it's going to be kind of all over the place.Julie: You'll fit right in.Katherine: Yeah. My first two, I was 17 turning 18 with my first and like a lot of people on The VBAC Link podcast talk about, at that age, you don't know a lot. No one tells you anything. You just think about the movies and you think, “It's just going to happen like this,” and you don't realize that there is so much that goes into it. So where my story goes is, I didn't actually see a provider until I was 19 weeks. I found out instantly we were having a girl and had my first obstetric abuse type thing where a doctor called me “stupid” because I didn't want to get the genetic testing done.Julie: Oh my gosh.Katherine: Fast forward towards Christmastime when I was 36 weeks, I ended up moving back home because I was in college at the time. I moved back home and I switched to a practice that was well known around us and everyone heard good things. I was born at the hospital, all the classic stuff. I wanted to see as many providers as I could, but they kept scheduling me with the same lady. My daughter was breech all the time, essentially. Every appointment she was, but I kept telling them that she would flip at night. I felt it. I knew she was flipping every night and then for some reason in my morning appointment, she would be butt down again. And so, at my 38-week appointment, I remember talking with the doctor and I really didn't like this lady, but that's all put aside. She told me that I could have an ECV, but I asked her what was her honest opinion on it, and, of course, she gave me her honest opinion which is that it is really risky and it might end up in a C-section anyways.So with that being said, my mom had three C-sections, I am her VBAC baby, but because of her traumatic experience, she ended up having more C-sections. All I was told is, “Oh well, just have the C-section. It is okay.” I showed up at 39+4 to the hospital. You know, a scheduled Cesarean. They didn't check her position. We had a C-section and one of the things I can clearly remember is the doctor saying, “This baby isn't breech.” And so, there's that. I had an unnecessary C-section. I didn't know I could ask for an ultrasound. Didn't know it was supposed to be done. I just thought, “They know what they're doing.” Recovery for that was really easy, nothing traumatic. I didn't even really think about the trauma of it until years later.My second C-section was when I was 20 right before I turned 21. It was with my son. Normal pregnancy, everything was great. I wanted a VBAC but didn't know a lot. My mom was constantly in my ear about how traumatic her VBAC was. I still wanted it. I got to my 39-week appointment and I was still high and closed. I still didn't know a lot about birth and I remember asking if I could go another weekend. They were perfectly fine with it and then for some reason, they ended up calling me that night with C-section dates for that week.My then-boyfriend, now-husband was going back to school and I didn't want to do it by myself, so at 40 weeks exactly, we had another C-section. Probably the best C-section I've ever had. They made me feel like a person and not like someone just laying there on a table. The anesthesiologist got awesome pictures of my son. It was just a really good experience. Recovery was rough. But I feel like I guess, I don't know. It just came and went. You know? It was normal, kind of rough. I remember getting shots that were in my shoulders, I don't know how they did it. It just made my shoulders really stiff, so the first week of my son's life was rough because I couldn't really pick him up.But going past that, my next C-section was when I was 23. It was 2016. No, 22. I don't know. But with him, I really wanted a VBAC after two Cesareans. I was dead set on it. It was going to happen. I traveled 45 minutes to a provider who backed me up, didn't talk about C-sections until well, you know. She wasn't supposed to talk about C-sections until 42 weeks, but we ended up hitting a speed bump at 40 weeks. But before that at 37 weeks, he flipped to breech. 38 he flipped back on his own and then at 40 weeks he had severe decreased fetal movement. Our appointment came and we tried to do a non-stress test and he was really non-reactive on it. We had a serious talk about what we should do and how we should proceed. I was really scared because even though he had a heartbeat and he was doing fine, he wasn't moving like he was supposed to and I just decided that a C-section would probably be best.We had it the next day at 12. He was born perfectly fine. He had a double nuchal cord which sounds scary, but knowing that it happens in 30% of births, they said, makes it seem not as bad and that it is normal. So yeah, that happened. I had a really bad recovery, postpartum depression. I remember in my six-week check-up, my doctor who did my C-section was really supportive of me and she told me that the day before she had a VBAC after three Cesareans. She assisted one. I thought that was really cool because she was essentially telling me, “There is still hope.” Now, we were in California this time and where we're about to move to Georgia. I met a lady who was a doula who had a home birth after three Cesareans. We had met out of coincidence and she told me in Georgia about a well-known doctor there. So I was really excited to find out we would only be two hours away from him. We move and unexpectedly get pregnant almost immediately as we move. So thus, the panic set in. I decided that I was tired of being ignorant to birth, and what can happen, and how it works, and things like that, so I took a birth class. It was a really good one. It was The Bradley Method birth class. That ended up being probably one of the best decisions I ever made. I learned a lot. I learned coping techniques and then I spent a lot of my time healing my past traumas. So, working on the fact that I have to forgive myself for things I didn't know and for things that were always said to me and that I just kept believing. You know better, you do better. So I had my provider, had really good support. We were on top of things. I had a really healthy pregnancy until 35 weeks. At 35 weeks, I ended up having high blood pressure and my swelling was out of control. We had to have a serious talk about how we were going to proceed because he couldn't induce me because the hospital, even though it was a medical thing. We decided on a 24-hour protein.We did that and it came back that it was just above the line for what is diagnosed as pre-e. From there, we chose to do weekly monitoring, so BPP, NST, and at 39 weeks, my son flipped to breech. That was the biggest shocker of my life. I cried, and cried, and cried and got through the weekend, and then just decided, “It's going to happen as it's going to,” because my provider wasn't pushing me. He was breech supportive. It was like, everything was there and even when we were talking about our options, ECV was still an option, even though I was 39 weeks and I had semi-on the lower end of fluid.I declined that. I just knew he would flip back on his own. So I decided to wait and at 40 weeks he was back head down, to everyone's amazement. And then after that essentially, 41 weeks came and went, 42 weeks came and we had to have another serious talk about, “How are we going to proceed? Did I want to just settle for a C-section?” Because nothing was happening. I didn't do cervical checks at all for this pregnancy because, in past pregnancies, they just made me feel really defeated because nothing was happening. No effacement, nothing. He asked if I wanted one and I told him, “No.” He asked if I wanted the membrane sweep and I told him, “No,” because that goes with having a cervical check too. And so we decided no more appointments because at that point, it was sort of like I was meeting a goal each week. Every single week, I was just meeting a goal. So I said, “No more appointments.” On that day I had my NST, I swore I was having contractions, but none of them were picked up on the NST.I drove home. I woke up the next morning. I was 42+1 at that point, and I cried my eyes out because nothing was happening. I remember telling myself, “I should just do the C-section. On Monday, I'm just going to call. I am just going to get it over with. I can't do this anymore.” I remember I ate a pint of ice cream. I folded some clothes. This is at four in the morning. And you know, me and my husband did our thing. I took a nap and I woke up in labor. So from there, I did 19 hours out of the hospital. We labored at home for 11 or 12 hours and then, we moved to Atlanta, so we had to drive for two hours. Made one pit stop because I had to go to the bathroom and then, we got to the hotel. Spent 5 to 7 hours there. That's where our doula met us. I remember that deciding moment for us going to the hospital was my husband. I had just woken up from a nap. I guess I had passed out in the bathroom sitting on the toilet, best place to labor ever, and my husband and doula, I can hear them talking. He was like, “When do we go to the hospital?” She was like, “Oh, I guess it's whenever she wants to.” I really didn't want to. I honestly didn't even want to go to Atlanta. I wanted to stay home. I really didn't-- I don't know. I guess I was afraid, or I was just comfortable, or something.We go to the hospital. When I get there, I was 7 centimeters, -2 station and my water was bulging. I remember being in so much shock because I didn't think anything was going on. I was totally in denial that I was in labor even though it was really hard to get through. We ran into a couple of bad nurses. The first ones that we met were awesome, but the nurses that when shift change came were rough, but I'm not going to go into that too much.Yeah. Essentially from there, it took us five hours to go from 7 to 10 because I assume he was posterior. No one ever actually said that, but I was on my back a lot because I was really tired. This was going to 25 hours of labor. I remember the nurse looked at me and she asked if I wanted fentanyl. Mind you, I had no idea what that was. The way it was advertised to me was, “Oh, it will just take the edge off.” And you know, that could mean anything, but my tired self took it. From there, I remember passing out multiple times because I was so exhausted. That was part of where a lot of my trauma came from because I felt like I was really out of control. I could still feel all of the pain, but I couldn't control or focus on anything anymore. It was like the room was spinning and I would pass out, wake up to pushing. It was bad.So I had a cervical lip. We pushed that over the baby's head and then we did two more rounds of pushes. It was coached pushing. Not really my favorite thing, but I guess I needed it because I couldn't really control anything anyways. I think by the third set-- it was like, the first push did nothing, the second push got his head out, and the third push got him out. I suffered a second-degree tear. Recovery wasn't terrible. It was definitely way better than a C-section, but it took me a good eight weeks to feel anywhere close to back to normal. And then after that, I sat with myself and had to figure out how to process everything that had just happened. I noticed that the more I talked about it, the more I cried because it was just hard to deal with everything that happened. So we ended up getting pregnant again, Father's Day of 2019. We ended up losing that baby and then we immediately got pregnant with our son Logan. That pregnancy, I tried to stay with people closer to the area because I didn't want to travel again. I guess from my experience, I just couldn't do it again. I didn't want to go back there. It wasn't even the provider. It was the hospital. And so I didn't want to go back there, but I tried to look around. Essentially, I already knew most of the places around here were going to tell me, “No.” I knew that for a fact. I even looked into a midwife, but the backup that she wanted doesn't support VBAC for herself. I just decided that wasn't for me and I didn't want to go with that midwife. So I ended up at a teaching hospital and they had midwives there. They were just starting it and I was really excited. I kept hitting dead ends with them because they follow ACOG guidelines and ACOG doesn't have a stance on VBAC after three Cesareans So they kept saying, “No” even though I had already had one. Then from there, I decided reluctantly to go back to the old place. I was like, “Maybe it will be different this time.” So I went back and I met a new midwife who, in my first appointment with her, shamed me for everything that I had gone through with my son. Like the fact that we chose weekly monitoring instead of just getting a C-section and she was like, “Well, that's really dangerous. You shouldn't have done that because it could have changed any second,” to which we planned for that. I would've just gone to a hospital near me and just gotten a C-section. It wasn't like I was all or nothing.I didn't really feel comfortable anymore. When I finally got to see the doctor for the first time, the one that was so supportive, I didn't really like the answer he gave me when I talked to him about how to help myself from the nurse side when going to the hospital because obviously you can fire and nurses, sure, but it doesn't mean that your next nurse is going to be someone that supports your decision either.In that moment where I was so panicky and I needed someone to be calm, it was like I felt like they were yelling at me because I couldn't-- I don't know. I was really panicky and I just felt like they were yelling at me instead of going, “Hey, calm down,” and talking me through what was going on. So when he had said to me that, “Well, you just need to use your voice more,” I was like, “Oh. Well, that is not what I wanted from you.” I want you to tell me like, “Okay, we can try this this time,” or give me actual ways to try to work on what was going on. It sat with me for a while. I remember going to my ICAN meeting and talking to the leader there. She was really someone that helped me with my first VBAC after three. This time around, I just told her that I couldn't do it and I was really leaning towards unassisted. It was calling to me. I felt in my heart that I had to do it. Everything with my first VBAC after three Cesarean and wanting to stay home was the right choice. I should have done it the first time around.So from there, I joined a Facebook group that was recommended to me. I looked around for a little bit and I thought stuff out, and then I started doing my research on unassisted birth stuff going beyond what you learn in a birth class. My husband was on board the whole time. He actually was telling me today that if I hadn't known my stuff and made him feel comfortable, he wouldn't have been comfortable. So he trusted me explicitly to make this decision and know how safe that was. And that's okay. Because it really was my body, my birth, so I'm just happy that he was really supportive of me. And really, everything went great. I remember doing Brewer's diet for my last birth also because I wanted to make sure that pre-e wouldn't be a thing again and if it did, I would have gone to the nearest doctor and gotten stuff sorted out. But everything went well. No swelling, no BP issues. I just kind of sat through it and my doula was behind me also.So it was really nice to have all that support for something that is so, I guess, I don't know the word to use for it. Like, man. I don't know. I don't want to say risky because it's not risky. I mean, you determine your level of risk and for me, it didn't--Julie: It's just not common. It's just not common.Katherine: Yes, uncommon. I don't know. So essentially going past that, like I said, everything was great. I was wondering how far I was going to go this time because the last time was 42 weeks and I was getting really antsy. I was so hoping I would go into labor sooner, which I did, but it wasn't by much. It was only by like a week. So I went into labor at 41+1 weeks. This was after two days of spotting. Oh man, I feel like things went so differently because I chose to do the Miles Circuit and I chose to do Spinning Babies actively. I went into labor at nine at night and had him at 5:18 in the morning. It picked up so quickly and I think it was just because I tried to keep off my back and keep myself moving. I remember that I wanted to do a water birth and so we had our tub and everything set up. My husband was filling it and everything and I remember getting that feeling like something was between my legs, like that bowling ball feeling that I had never felt before, and I was like, “Oh, I have to get in the tub.” So I got in the tub and I think within 30 minutes, he was born.That was interesting to me because it's so night-and-day to the experience I had the first time around. One of the things that I always found so interesting too is with my first one, I remember feeling nauseous, but I never puked and I feel like that's something that's hardly talked about in birth, but then with this one, even though I hadn't eaten anything, I remember puking at least two or three times before he was actually born. And that was so uncomfortable, but you don't even think about it once they are born. It's just like, “Oh my God, you're here.” He was perfect. Honestly. It was so nice to finally be able to have that time with my baby. No one is messing with you. No one is touching you. He was just so perfect. I can't even tell you how beautiful that moment was for me because it's hard to even explain. For such a night-and-day experience, it was just the best thing that has ever happened to me to be surrounded by love, and support, and people that aren't doubting you or putting unnecessary pressure on you to stay in bed. No one is offering medicine to you. I actually just had my experience. It was me, the labor, and the baby. We were together and we were one. It was just so nice.But yeah. I have been doing, I guess, as much support as I can on the VBAC side for other moms since then because I feel like after my first VBAC I didn't feel that, not responsibility, but I didn't feel like I was ready to because I still had a lot to process and to deal with from my first VBAC. So the fact that my second VBAC went so well, it's like, okay. There is a redeeming factor for some people. Just because you had one bad VBAC doesn't mean that your next one has to be horrific also. So, yeah. I think that's it. I am sorry if I rushed through anything. I just didn't want to get into too much.Meagan: No, you didn't rush.Preparing for an unassisted birthJulie: No, you did great. Yeah, I want you to talk a little bit more about things you did to really prepare for that unassisted birth and what you would recommend people do if that is an option that they are considering.Katherine: Okay. That's a fun one. Okay. So first I would start with-- I think when you're first considering that, you should really sit with yourself and evaluate your own risks for your births. Like past births and even possibilities for a current birth. Once you sit with yourself and if you feel in your soul and in your heart, however, you want to explain it, your gut, if you feel like that's a good feeling and that it's possible, then from there, it's finding the right outlet. So for me, it was asking people who have had an unassisted birth what groups they went to for support. There is one group on Facebook that I really loved. It's not like something where they sit there and tell you how to do everything. It's more of how you should look at this resource or if you really have a question that you can't find the answer to, they point you in the direction of resources you can use. It was also really nice to see so many like-minded women talking about herbs and tinctures, delayed cord clamping, or even just going full-on lotus birth. It was so nice to see that and experience that environment. And then from there, you just do your own independent research on birth emergencies, and how often they happen, and how to handle them if you can handle them because sometimes you can't and that's just a fact of life. There are certain things that you can't handle and you do need to get medical attention for. And then from there, so specific to me, one of things I really looked up was breech birth because I've had three breech babies. I have no idea if my fifth ever flipped to breech because I wasn't seen by anyone. I did all of my own prenatal care. I didn't really feel like he ever flipped, but it's possible that he did.So I needed to look that up for myself and to say, “Okay. How is breech birth handled?” And you know, a lot of the time you'll see it's hands-off. And so doing that research about hands-off and what to look for in an emergency with a breech birth, I am very thankful I didn't have to do that because I feel like my husband would have freaked. And then I think after you do your research, then comes making sure you know how to handle prenatal care and learning about how to take your blood pressure, what urine test strips you look for, and what everything on it means. And then from there, I took my weight religiously. I took my blood pressure religiously. I had my own Doppler. Lots of unassisted birthers use fetoscopes instead, but I had not even heard of that until after he was born. So I used a Doppler and we tracked his heart tones. During his birth, I wanted to check it more, but it ended up being something where we tracked it in the beginning and how I was feeling. If something felt wrong, I would have asked, but we only checked my blood pressure and his heart rate one time throughout the eight hours because I didn't feel like anything was wrong. I feel like a lot of unassisted birth, that's what it is. It's going off your intuition and how you feel. You have to feel secure in yourself when you're going for an unassisted birth because if you don't feel secure, that's where the problem lies. You can't go into it not knowing what's going on with yourself and your baby. I don't know. I think that's where I would cut that off because it goes, I feel, so much deeper than that too.Meagan: Yeah. It's a big decision. It's a very big decision and you have to be prepared. You have to be prepared on all aspects. You have to be prepared for a great outcome, a not-so-great outcome, and a bad outcome. And yeah, it's hard for some. You know? But then there are some people that are like, “Nope. I've got it.” And then they do. They dive in and they do. They just sponge it all up and they are ready.Katherine: Yeah. I love those types. I love those women. I am so serious. I have met a few of them and they are just beautiful people. I love how they're just so solid in themselves. And I understand. You can be a mom and not be solid in yourself and that is perfectly fine because I mean, it took me what? Four births to even feel that way about myself? So, you do. You have to understand, and really trust yourself, and trust your baby, and you have to trust that things are going to work out how you want them to and if they don't, how to handle those outcomes.Meagan: Yeah, but it happens. There's seriously some areas where there's not even a provider if they wanted a provider.Katherine: Yep.Meagan: They can't even get where-- like the times right now that we live in, it's wild. It's just wild. And it's scary sometimes when you're like, “I don't know what to do.” So the only thing you can do is educate yourself and prepare yourself.Katherine: Speaking specifically towards a VBAC after three or more Cesareans, the ICAN leader I had hosted a really beautiful seminar on what to do when you are going for a VBAC after three Cesareans and you keep hitting dead ends. That largely lies in knowing your rights. So if you are in a place where they are telling you, “No, you can't do this. Hospital policy won't let you do this. Yada, yada, yada,” it's then knowing your rights and that they can't deny you care if you are in labor. They can't force a Cesarean on you, but coercion is a thing. They will say and do very scary things to make you submit to what they want. It's knowing that you have to fight for the right. That's terrible to say, but you have to fight for that. You have to fight for the birth that you want. I think that's interesting how unassisted birth and that ties together because it's, I don't know. I don't know how to explain it. It's just interesting. If you're not going unassisted, that's what you're doing essentially is, you're telling doctors, “No. I am doing this,” and it's being okay with that. That's interesting to me.Megan: Oh, thank you so much. Julie, is there anything else that you want to say? I know you were wanting to close it up?Julie: No I just want to say, we always encourage you to do your best to find a provider that is going to support you and your VBAC journey, but here's the thing. You need to be able to trust your provider, but if you can sense that your provider doesn't trust you back, there is a big disconnect there and it's going to cause a lot of problems. We know like I said earlier in the episode, that there are some states and some parts of the world where it's not easy or even possible to find a VBAC supportive provider. Especially now, in the COVID area where hospitals are forcing parents to birth alone. Now, husbands are allowed at least, or birth partners, or baby's fathers, or the other parent, whatever you want to call it, are allowed in the hospital now, but at the beginning of this coronavirus, women were birthing alone and providers were coming into the room in hazmat suits. Women were being forced to choose and not always making responsible decisions about their care. And so I think the thing that we really want to hit home here is, we don't necessarily say, “Hey, if you can't find a supportive provider, go have your baby by yourself,” but what we do want to encourage is finding that provider that you can trust. Interview as many providers as you need to, but if you feel like you are forced in this position between birthing in an environment that you feel is hostile, or that does not support you, or give you the autonomy over your own body and birthing unassisted, you need to get busy. Get educated and learn all of the things and then there's going to be more and more to learn. The more you learn, the more there is to learn about all of these things. You have to be diligent. You have to know all about different types of emergencies and how to handle them, and how to react in different types of situations, and really trusting your intuition and your gut instincts about what's right and what's not right, and learning how to follow that really really well. And then, there you go. If it feels like that's the right thing for you, then trust that. We always encourage people to trust their intuition. If your intuition is telling you to go down that route, do it, but do it in a very prepared, and educated, and smart way. All right. Well, Katherine. We are so grateful to you for sharing your story with us today and being an inspiration for people who might choose to birth a little bit outside of the box. We always want to make sure that we are covering all types of birth scenarios and all types of birth outcomes on our podcast. We are happy you shared your story with us here today and we hope that those listening learn something from you. I think that everybody should.ClosingWould you like to be a guest on the podcast? Head over to thevbaclink.com/share and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan's bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Alysa is a prime example of how every birth is its own unique story. With her first birth, Alysa had a very medicalized vaginal birth. During her second pregnancy, Alysa unexpectedly developed placenta previa, resulting in weeks of hospital bed rest and a very necessary Cesarean. After knowing firsthand how unpredictable birth can be, Alysa’s third birth was exactly the empowering, unmedicated VBAC she had envisioned. We also talk about placenta previa and accreta-- what it is, how severe it can be, and what the chances are that it will happen to you based on the most current research. *Additional links* How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) Episode 124: Elyssa’s CBAC + Birthing in a Pandemic ( https://thevbaclink.podbean.com/e/elyssas-cbac-birthing-in-a-pandemic/ ) Expecting and Empowered Fitness Guides ( https://www.expectingandempowered.com/fitness-guides ) National Accreta Foundation ( https://www.preventaccreta.org/ ) *************** Full transcript *************** Note: All transcripts are edited to correct grammar and to eliminate false starts and filler words. *Meagan* : Happy Wednesday. It is The VBAC Link with you today, Meagan and Julie, and of course, we have another amazing story to share with you today. We have our friend, Alyssa, on the line. She actually-- we just were talking about this. She has actually been with us from the beginning, which is so fun to have someone that we recognize and we know. She posts and everything, so thank you, Alyssa, for being so amazing on our social media outlets. We are so excited to have you here today. She did have a VBAC and it was after a situation that was unexpected. It is placenta previa. We are going to talk about that as well after she shares her story because this is something that is really necessary to have a Cesarean. It truly is. And so, we want to talk a little bit more about that, what it means, what it looks like, and also touch on placenta accreta and talk about the two differences. ------------------ Review of the Week ------------------ *Meagan:* Before we jump into the story, of course, we have a Review of the Week. Julie will be sharing that with you today. *Julie:* Hey, hey. I am so excited. I really get excited when we interview people that have been with us from the very beginning. *Meagan* : It is so fun. *Julie:* I recognize Alysa’s Instagram handle and I am like, “I know who you are.” It’s so exciting. But do you know what is also really funny? The review I picked to read for this episode is from-- remember back when we shared my client Elyssa’’s story? Elyssa’s VBAC story? This review from Apple Podcasts ( https://podcasts.apple.com/us/podcast/the-vbac-link/id1394742573#see-all/reviews ) is about Elyssa’s story and now, after we read the review about Elyssa’s story, we are going to hear Alysa‘s story. *Meagan:* Elyssa, we have Alysa. *Alysa:* Perfect. Julie: So don’t be confused. But this is from Cristin Anna on Apple Podcasts and the title is “Thank you for sharing Elyssa’s story.” She says, “Today I listened to the episode when Elyssa shared her story and I found myself identifying with her story so much, and I cried multiple times as she described how she felt, as it was word-for-word the feelings I felt after my first birth. I planned for a home birth, ended up going two weeks late, and ended up having to have a C-section at the hospital after finally going into labor, but my son’s heartbeat started dropping during contractions.” “Thank you for allowing Elyssa to share her story. The fact that she was able to share her second Cesarean and the fact that it wasn’t like the first one gives me hope that even if for some reason my VBAC is not successful, I can still have a better experience than my first birth. I struggled with feeling like a failure after my first birth and hearing from her, (and from you guys) that she did what she needed to do for her baby, and she is not a failure, but was still able to exercise her own power during her labor, was all so encouraging. I think reminding women who are trying for a VBAC that they aren’t a failure because they weren’t able to have a vaginal birth the first time around is so important and so healing for them. Thank you for empowering women and also encouraging them to do what is needed for their baby.” And I love that. I love that. We have talked about before how important it is for us to share all of the stories about VBAC with you including VBAC attempts-- I don’t know, for lack of a better word-- that don’t end in a vaginal birth, repeat Cesarean stories, and we even have a couple of uterine rupture stories. We want you to be prepared for all of the different outcomes that your birth could take. And so, we really appreciate that review from Cristin and we obviously appreciate Alysa for sharing her story with us. And now, we are going to hear from Alysa. ------------- Alysa’s story ------------- *Alysa:* All right. I just have to say I am so grateful to be with you both. I said before we started that it is just surreal to be talking to you both since I have listened to all of the birth stories. It has meant so much to me through my pregnancy and leading up to this third birth of mine. I guess I will start with just a little bit about my first, and obviously second birth, and mostly my third birth, but my first I just wanted to touch on. I did have a vaginal birth with my son, but I was a very typical first-time mom and I just was like, “I will go with the flow and see what happens.” I think for some people that can be okay, but looking back, I wish I knew more. I wish I had a podcast like this that I had listened to or something to just know that-- I knew there was something inside of me that wanted something different for my birth, but I was too afraid to go against the norm or to not be a good patient, which is so silly. It’s funny because I myself am a healthcare provider, but I struggle with that sometimes of not wanting to disappoint my providers. I realize now more than ever that that’s not why they’re there. I wouldn’t want my patients to feel that way. So anyway, I had a vaginal birth, but it was very medicalized. I was induced starting at 0 centimeters at 37 weeks for not really great reasons. I ended up getting an epidural and I pushed for almost three hours. He was born. He was healthy and it was great, but it just wasn’t what I wanted. So fast forward with my daughter, my second birth. I was so gung-ho. I was going to have a natural birth. I was going to have an unmedicated hospital birth, and I was reading all of the books, and doing all the things, and I got the absolute surprise of my life with that pregnancy. At 20 weeks we did the anatomy ultrasound and they said my placenta was low-lying, which is actually very, very common at the 20-week mark. So my doctor said, “Don’t worry about it at all. 90% of the time it moves out of the way by the time you deliver, so don’t even stress.” I looked up all of the research on it and it matched what she said so I was like, “Yep. I’m not going to even worry about this.” I exercised. I went on a vacation. We did all of the normal things not worrying about it. But then at 28 weeks, I was actually at work. Right in the middle of standing up to examine a patient of mine, I felt a gush and then a subsequent gush. I excused myself from the room and I thought initially it was going to be my water, but I looked down and I saw blood pretty much down to mid-thigh. *Meagan:* Wow. Scary. *Alysa:* Yeah. It was terrifying. The only saving grace was that because I was 28 weeks, I could feel her move so much. I am a relatively petite person, and so I could see her move and I could feel her move, so I got that comfort right away of knowing like, “Okay. She is still doing okay.” But it was a lot of blood. And so, we obviously rushed right to the hospital right up to OB and I was admitted for five days. I lost about a unit of blood, but it stopped and it slowed. I got the steroids. I got the whole thing. NICU came in and talked about delivering, but they were able to keep her in there and she did okay. Eventually, I went home with the direction that I could only be within a 20-minute radius of the hospital and, yeah. So we just kind of laid low and then eventually at just shy of 34 weeks, I had my second bleed and my doctor said, “If that happens, this is where you stay now.” So then I stayed in the hospital, had another bleed in the hospital, but eventually did make it to 36 weeks which was the goal, and delivered her by Cesarean. And so like you said, it was a very necessary Cesarean, but it doesn’t certainly mean it was easy by any means. *Meagan* : Right. *Alysa:* I mean, I had a vision of what my birth was going to be like and it was obviously-- I went from wanting a very hands-off birth to having one of the most hands-on experiences you can have. Being in the hospital for a total of about four weeks over that pregnancy was incredibly hard emotionally, but also just being constantly in the world that things are being done to you was really hard. It was super hard. It made me not want to be anywhere close to that situation again. And so, I knew right away that if I was going to have another birth, I had to have a VBAC and I had to do everything in my power to make sure that was going to happen. I really thought for me, that was going to be out-of-hospital. That was confirmed when I had an annual physical about a year later and I talked to one of the providers about having a VBAC. I started asking some of the questions really that you guys layout and your resources about how to see if your provider is VBAC tolerant or VBAC friendly. I very quickly found out they were tolerant. I mean, I asked about going past 39 weeks and they were like, “Oh no, no, no, no. But yeah, yeah. We can let you try.” And induction, they just didn’t even really-- yeah. *Meagan:* They weren’t following evidence-based practices. *Alysa:* No. No, and it was very clear to me that if I attempted to have a VBAC with them, it was not going to happen. So that day I had that appointment, I called-- there is a wonderful, wonderful birth center in my area called Authentic Birth Center, and so I called them and said, “Hey, do you guys even take VBAC people?” They were like, “Yeah, of course.” So I was like, “This is what it is going to be.” So I got pregnant and started seeing the midwives and they were absolutely wonderful. As you know and you have talked about in other podcasts, this third baby, I had my son and it was COVID, so COVID was part of this journey as well. But I was so, so, so, so grateful that prior to COVID I had already started care with them because during that time with all of the restrictions that were happening in hospitals, there were so many women who were trying to switch it up and change to an out-of-hospital birth. The fact that I was already with them was amazing because they were really struggling to keep up with the amount of women who wanted to switch out of the hospital. *Julie:* We saw that a lot here too. A ton of our clients switched. It was just nuts. *Alysa:* Mhmm. I can’t imagine. Those midwives were probably just so busy. They have to try to care, they want to care for everyone well, so it’s not like they can take every single person. I just have to say too, and I told my midwives this, but I am so, so grateful that while COVID was going on during my pregnancy and birth, it was never a huge part of my story. I am just so grateful for that-- that they still focused on my healthy pregnancy, my healthy body, this healthy baby and continued to make every appointment about that, about us, and about our care, and about that well-rounded care that midwives are so well-known for. It was so empowering and it was everything I hoped it would be. So I’m just-- I am so grateful. I did have a lot of anxiety through the pregnancy of feeling like I had all these hurdles to get over in order to make it to my VBAC, which I am sure a lot of women feel with any VBAC, but at the ultrasound, here I am thinking, “Okay, I just have to-- the placenta. Please, please let the placenta not be in the way,” because I knew that there was no changing that and thank God at 20 weeks it wasn’t. It was seven whole centimeters away and I was so, so, so grateful. *Julie* : A great distance. *Alysa* : Yes, exactly. Every step of the pregnancy was just another hurdle to overcome in my mind. I got to do the glucose tolerance and that was good. My blood pressure kept being good. Baby was head down, and so everything was just lining up. I guess that brings me towards the end of the pregnancy. I can honestly say that the difference between this pregnancy and my previous two is, I just did so much to prepare between listening to you guys, and general mindfulness, and staying educated on what was true, and then also, I was so physically active. There is a wonderful exercise program called Expecting and Empowered that I absolutely adore and they have a postpartum program too. That helped a ton. I reread all the typical birth books that were just so helpful too, but definitely towards the end, just lots of mindfulness and lots of visualizing. Visualizing my birth and lots of really just digging into God’s word and his faithfulness. As a Christian, that was a big part of my journey too of trusting in His plan and His amazing way He created women to give birth. So, yeah. I guess that leads me to birth. I think I stayed pretty patient. I think the main reason for that too was I was just so grateful to have a really normal pregnancy. I got to all these points in pregnancy where I was like, “Wow. I was in the hospital at this point,” or “I had already had my daughter at this point.” It was just so amazing to be past those dates. So I had my son-- I was induced at 37 weeks and my daughter at 36. So once I got past that 37 weeks, I was like, “I have never been this pregnant.” It was also exciting for me in a way. Of course I, like every woman, was ready at the end physically and emotionally, but I was overall just very grateful. But, yeah. I guess that brings us to the week. The week of my due date, I had days on and off where I would get contractions. I would get contractions, they would be 10 minutes apart, and then 8 minutes, and 10 minutes, and I am like, “Oh, maybe this is turning into something,” and then, of course, I would fizzle out. Then on the Monday prior to my due date, my due date was on a Wednesday, I had an appointment and I was getting a lot of contractions during the appointment. When they were listening to baby, his heart rate was going down during some of the contractions and they didn’t love that. They were like, “How much have you eaten and drank today?” And I hadn’t. I was super slammed at work. Obviously, with COVID, I am a PA. I am a healthcare provider, so COVID was just so stressful for many reasons, but just mentally stressful of everything was going on. So they said, “Why don’t you come back later so we can just take a listen again?” And so, I drank a bunch, and ate a bunch, and came back later and they were reassured by that. I got to my due date and I was just doing all the things. I was exercising and going on walks, doing squats. I was drinking red raspberry leaf tea. I had been doing dates for weeks in advance. And again, just really trying to prep my mind more than anything. I kept thinking, “If I am so stressed at work, baby is not going to come when I’m stressed. So I need to do everything possible to reduce stress.” And so, I had decided that week that no matter what, this week was going to be my last week of work. The following week, I was going to be 41 weeks and I’m like, “I just need to not have so much stress.” And so again, that week I had a couple days where I would get some contractions and they would fizzle out. I thought, “Okay. It’s going to happen. Everything that my body is doing, is doing something.” I just need to be happy that it’s doing something. My last day of work was Thursday and while I was at work, I was, again, having some of those contractions, but I did not think anything of it. This was the day past my due date. I was 40+1. I was having some contractions on and off, but obviously, I was working, so it wasn’t a big deal. It wasn’t enough to make me stop or really even think that much about it. I literally joked with my coworker like, “I bet since this is my last day of work, when I leave today, I’m going to have this baby.” I got home at around 6:00 p.m. that night. I walked in the door and I had a contraction that was different. I was like, “That was different.” I sat down at dinner with my husband and my kids. I was noticing, but I didn’t want to say anything quite yet. But I knew it was different. We got the kids to bed and I told my husband, “I think this is it, so let’s start gathering some things.” He’s like, “Don’t you want to actually know if this is it?” I am like, “No. I really think this is it.” He did not understand how you can just know. *Meagan:* I swear they never believe. You’re like, “Are you sure?” I am like, “Yeah. I am positive.” *Alysa:* Exactly. So right after, I called my midwife and she is like, “Great. Just let things get longer, stronger, closer together. Keep doing your thing.” I went to the bathroom and definitely had more of that bloody show, so I was really encouraged that this was it. So I was like full-on, just packing, getting everything ready, getting all this, and, like I said, this was probably 7:30, 8:00 p.m. Around 8, I finally got everything I wanted together, so I decided, “I’m going to rest.” I laid down on the couch and I told my husband, “Use this contraction timer app. I will tap you,” just so we’d know what was going on. As soon as I attempted to lay my head on the pillow on my couch, pop. Like, just a major pop. Water gush. I hopped off the couch like a ninja because I did not want to get my couch all messy. *Meagan:* You wanted to save it. I would have done the same thing. *Alysa:* Yes, exactly. I went into the bathroom and jumped in the tub. It was definitely a lot of water. But the water was-- it did have some meconium in it. It was kind of yellowish. And so, that was the first time I was stressed. Prior to that, I was like, “Everything is exactly how it should be going,” and I felt like I was really handling things well, but then I felt stressed. I called my midwife right away and I told her what was going on and I was like, “Honestly, I am just really stressed out.” All she said to me was, “Okay. I am not stressed out.” It was just perfect. Her response was perfect. *Meagan* : Exactly what you needed. *Alysa:* Yes. Yes. And you know, she has had a couple of lines like that through my pregnancy. One other time, I broke down to her about how I felt like there was no way everything was going to go right. I felt like there was no way. Was I being irresponsible with having an out-of-hospital birth after the last birth I had? You know, all these things. All these fears we all have. She just said, “I wouldn’t absolutely love my job, I wouldn’t love doing what I do every single day if I had fear. I have no fear when it comes to you and I love doing my job. And so, we wouldn’t be here and we wouldn’t have you as a patient if anything about you made us afraid.” It was just wonderful. So, she is wonderful. But back to that night. So since my water broke, we decided to call over a friend so that if we needed to leave quickly, we could. My parents were on their way down too. They live about a couple of hours away. They came over and I was just swaying through the contractions. I was handling things really well. I felt really good. It was really great to be able to. I had really wanted to experience that because I really didn’t get that with my other births. And so, yeah. I would rock and sway through the contractions. I remember right before we left I went upstairs and my kids were sleeping, and I just checked on both of them and then had a contraction right in their bedroom. It was just, yeah. It was great. I walked outside just to get some fresh air. It was the most beautiful night. It was probably 75°, stars in the sky. It was beautiful. We went through some contractions outside too and then we decided, I decided, “I want to go.” I think at that point, contractions were probably three to four minutes apart and getting close to that one minute but I am like, “I don’t-- I have heard horror stories about the car and so, the sooner we can get there, I think I will feel better.” Everyone is right about the car. The car was so tough because there’s just no way to get comfortable, but like, again from your podcast, it was so helpful to hear from different people what they had done and I did just that. I got on my knees and I faced backward in the passenger seat because being on your bottom is not fun when you’re having a contraction. *Meagan:* No. *Alysa:* We got to the birth center and we walked outside for just a little bit more before even going in. I think that was my biggest thing is I just didn’t want to pull everyone together too quickly or something. I didn’t want to waste our time or something. Again, that goes back to me not wanting to be a needy patient or something, which is silly in hindsight. But, I wanted it to be right when we got there. So we walked outside before we actually went in for a little while and then a few more, and then I thought, “Okay. I really need to pee. We have got to get in there. Let’s do this.” We got in there. My midwife was there. A student-midwife was there and then I had a birth photographer who is also a doula. She wasn’t technically acting as my doula, but she also said, “I am a doula, so anything I can help with along the way if you would like me to, I will.” And so, that was wonderful. So I didn’t really need someone to be super hands-on. My husband was really good about that. Plus, I didn’t really need that a lot in labor and in birth, but she was just wonderful support in other ways. So, yeah. We got to the birth center. They checked baby and everything was good. This was a surprise, also. I did not know if “he” was “he” at the time. So we got into the birth center-- let me look at my notes here. I think that was at 10, 10:30, yeah. We got in at 10:30. Everything was good and they just let you be, which was again, so incredibly different than, obviously, my other experiences in the hospital. They were just like, “You’re doing great. You keep doing your thing. Everything is looking really great.” And so, we just continued to labor. We walked around the birth center. I would squat with contractions and sway with contractions and overall, I felt like I was coping really, really well. There was that one point where I knew based on the way I was feeling and where the contractions were at, I knew I had to be pretty far along, but I also doubted myself for a second. I thought, “There’s no way that I can be doing this well. I am not strong enough. There’s no way. There is no way. I am probably 3 centimeters. I don’t know.” They didn’t check me. They didn’t say they needed to check me and I didn’t want to be checked at that time, so we just didn’t. We decided to forego that. But then I am like, “No. I really do think this is going exactly the way it should go.” I talked to my doula a little bit about what I should be doing, like if I should be trying to push things along and doing a bunch of squats, or lunges, or different things, or if I should try to rest and she was like, “If you feel like you can rest, you should rest.” So I laid down for maybe five minutes and then I wasn’t loving that. But she just really reminded me too, during contractions, just to really relax my pelvic floor as much as possible, so during contractions then, that was exactly what I would do, which is a really odd feeling because most of us as women are used to holding that in. You know, like with coughing, or sneezing, or things like that, or keeping that tight for different reasons. Yeah, so truly just letting the floor feel loose was crazy. But it was also-- this is another thing that I can totally speak for the exercise program that I referred to before, Expecting and Empowered, is every single one of their-- you do three different exercises a week, or days a week that you were supposed to do their program, and they always have pelvic floor exercises. They helped me so much be able to actually target those muscles during birth which was awesome. I did that a lot and I had music playing. You know, just some Christian music that I love, worship music playing, which was really wonderful. I remember things were getting pretty intense and I had these cards that just had different scripture on them. I remember reading through those right before things got really intense. It was just what I needed at that time to really feel like, “No. You can do this.” One of my favorite ones about, “Pain may endure for the night, but joy comes in the morning” and I just remember thinking like, “That’s where I am in right now and so soon I’m going to meet this baby and there’s going to be so much joy.” My midwife came back in. They watched me have a couple of contractions where I was definitely vocalizing through the contractions and they were definitely intense. They said, “I think it would be a good time to get into the tub.” My husband tells me later that he literally thought they were crazy. He was like, “Why are we getting in the tub? We have like 6 to 12 more hours of this.” He, of course, is thinking of our first birth and again, also thinks there’s no way this can go as fast as it’s going. So I get into the tub and that was-- I got into the tub and I was only in the tub for about 20 minutes until he was born, actually. But I got into the tub. Everyone asks me if the tub was helpful and I think it was. The hard part to tell-- the reason I say I think it was is because it was hard to sometimes tell if the water was super helpful because at the same time they were by far the most intense contractions. I mean, transition is. And so, while I was in the tub, I very much felt out of control. It was very much the first time where I was like, “I could crawl out of my skin.” *Meagan:* Some people say if you are in there before the transition hits, it is more manageable, but man, I would be with you. I was in the tub and I was like, “I just need to move.” *Julie:* And I loved the tub. I loved it. My whole labor was in the tub. Birthed in the tub, all of it. It’s so funny how it’s so different for everybody. *Alysa:* Yeah. Well, and I think if I had another, I would probably get into the tub sooner. I think I didn’t want to use it too soon and then it wouldn’t help me or something, but I think I would get into the tub sooner, like you said, Julie. But you know, it was that moment where I said, “I can’t do this.” I was like, I told my husband, I am like, “Joe, I don’t think I can do this.” He was like, “You’re doing this.” I remember having a very vivid thought in my head like, “Alysa, the only way is through. This is it. There’s no going back. There’s no changing where I’m at right now and so, just try to lean into that.” My doula, like I said, was also taking pictures, but she saw me again have a very intense contraction. My midwives had left. I mean, they were literally outside the door, but they were like, “You know what? I am going to go grab the midwives,” my doula said. Of course, they just know. They have done this so many times. They have seen so much unmedicated birth that they just-- they know. They came back in and my midwife was like, “You’re going to meet your baby so soon,” and seriously, I still was in complete disbelief that this was actually happening and the way everything had gone. I did get pretty nauseous at one point and I thought I was going to throw up. I did that with my son with my first birth, but I didn’t throw up. They had peppermint oil and I was able to work through that. I’m glad I didn’t throw up, but that’s a pretty normal feeling, I think. And then, the craziest feeling I’ve ever had in my entire life is when my body started pushing. I say that I had no part, zero part in pushing my baby out. My body completely took over. All I can say, like the way I have described it to people is that it literally felt like a vice had a hold of my insides and was rocketing something out of my vagina. It was the craziest feeling I have ever felt and it was both an intense-amazing, but also a scary, out-of-control feeling. But yes, the fetal-ejection reflex was insane. When my body started pushing, I was like, “I am pushing,” and I screamed louder than I have ever screamed. My throat was literally sore from just like letting out this unbelievable roar. I remember I pushed. I had a little bit of a break and I was like, “I’m sorry for being so loud.” My midwife was like, “Don’t ever be sorry. Just think about tennis players like Serena Williams, Venus Williams, they roar when they are doing their sport. You roar.” *Meagan:* I love that. *Alysa:* I was grateful for her, yeah. But yes, two big pushes, like I said, which were completely my body pushing in two minutes. I started pushing at 12:29 a.m. I was 40+3 and at 12:31, he was born. His head came out and I said, “Come and get him out. Get him out. Get him out. Get him out,” and then the rest of his body came out and he came right up on my chest. It was incredible. My husband was right there next to me. I looked over at him and I just kept saying, “I can’t believe I just did that.” I had visualized my birth so much over the previous 10 months, but especially in the last month leading up to my birth, and the fact that it had gone so much of the way I had visualized was-- I mean, I felt so grateful. But also, I think it was telling that that was helpful. Not that that happens for everyone, obviously. I know full well things don’t always go as planned or as you want them to, but in this case, it really did. I was just overwhelmed. Overwhelmed with joy and gratefulness. We were just hanging out a little bit and my husband again later tells me that he was like, “Are we going to find out if it’s a boy or a girl?” because I was just so wrapped up in what had happened, and snuggling this new baby, and I didn’t even care. I was like, “I don’t even care.” I didn’t even think of whether he was a boy or a girl. But yes, we took a look and he was a little boy. 6 pounds 1 ounce which also, I was like, “What in the world? He is so tiny.” He was smaller than my other two and I had carried him three weeks longer than any of my other kids. *Meagan:* Crazy. *Alysa* : It just shows how crazy that is. But my little peanut, Silas Cecil was born on August 14th. It was just so cool. The birth center experience was just so amazing, being able to chill there and truly have that golden hour of hanging out with him, and looking him over, and then getting out and just snuggling in bed, and then they just let us be for a while. Then, they came back and did all of the checks and measurements right there, right on the bed. It literally felt like family was around me and it was so wonderful. So much so that I-- you know, I still follow the social media pages of the birth center that I was at, and whenever I see women who are close to their due date, or in labor, or whatever, I almost have this like-- I am jealous of them in a way. I know that sounds crazy, but just because I know they are about to experience something, yes, hard, but really amazing. I felt like after my first, and not that either of my first births were horrible or traumatic. I am so grateful for, especially with my second birth, the medicine that was there that really, truly in years past-- well, decades, centuries past, we could have not lived through, so I am grateful for those advances. But just to be able to experience the beauty of truly no interventions was so awesome and I am just so grateful. *Julie:* That’s incredible. There are parts of your stories that I can really relate to. I really love when you said when you got past the point of your longest pregnancy, you were so excited to be pregnant that long because you had never made it to that point. With my first VBAC baby, I was like that. My first was born via Cesarean at 36 weeks on the dot and when I got to 36 weeks and 1 day, I almost let out a breath, like, released air. Like, “Okay. I made it. We can do this. I am good now.” I am like, “I have never been this pregnant before. This is so cool.” People would ask me, “How are you feeling? Are you just so miserable?” And I am 39 weeks pregnant-- well, I didn’t quite make it to 39 that time, but I was 38 weeks pregnant, waddling around, and I’d be like, “No. I am just so happy to still be pregnant,” and people just looked at me so strange. *Alysa:* Yep. *Julie:* It’s just really funny what perspective you have when you have dealt with or been through a birth with complications. Every single milestone you hit, like you said, gives you another release of air. *Alysa:* It does. *Julie:* Until all of the things are gone and you can just enter into your birth space worry-free and without any other type of concerns. So I was totally right there with you when you were talking about that. *Alysa:* Yeah, it was. I feel the exact same way. --------------------------- Placenta Previa and Accreta --------------------------- *Meagan:* So Alyssa had placenta previa. Placenta previa is-- I don’t know if anyone has ever had this, too. I am going to backtrack even more. At the 20-week ultrasound, one of the things they look at is where the placenta is lying. If you have ever heard about a low-lying placenta, it’s likely that they are looking at where it is in conjunction with your cervix. Sometimes the placenta attaches low by the cervix and sometimes it even attaches over the cervix. Which, the cervix has to open, and dilate, and efface in order to get a baby out vaginally. So if you can understand what that means if it’s covering the cervix, you know, this is our baby’s home, and how they breathe and eat, and everything. And so, if it is covering the cervix, it is a true need for a Cesarean because they cannot deliver a baby through a cervix that is covered with a placenta. Sometimes when it is low, it’s low, but it’s not covering the cervix quite yet or it’s really, really close. But then as pregnancy continues, and the uterus grows and stretches, and the baby grows, it goes up with the uterus. That happens a lot of the time, in fact, most of the time, but once in a while, like Alysa‘s case, it did not. She had accreta. She mentioned bleeding and that’s one of the number-one signs that there are accreta issues. If you have ever experienced anything where you are experiencing blood like that or things like that, don’t hesitate to go in immediately and get things checked out. I’m so proud of you, Alysa, that you were able to keep that baby in nice, safe, and sound until your goal because that is hard work and it’s amazing. So, congrats on that. And then, so there is previa and then there is accreta. Julie, you may have to help me out because you are the statistic guru. But accreta is when it is actually, it is partially in and grown into the scar of the uterus-- *Julie:* The uterus. It doesn’t have anything to do with the scar. *Meagan* : That’s true. It’s not the scar. It is just in the uterus. It has grown in, sorry. Cesarean moms have a higher risk of it because we have had cuts. So that is where my mind is going. But, yeah. It grows into it. That can be very, very dangerous as well. Do you know the stats, Julie, on how many people get accreta? Just stats? *Julie* : Yeah, I actually have some information up right here on my computer right now. I want to direct you guys to a really good foundation called The National Accreta Foundation and its website is preventaccreta.org ( http://preventaccreta.org/ ). It’s spelled a-c-c-r-e-t-a, accreta. Preventaccreta.org and their whole mission is to reduce the Cesarean rate, which in turn, reduces the chance of having accreta. And so, it goes over a lot about the statistics about Cesareans. 87% of women that had a Cesarean will go on and have a repeat Cesarean which increases the risks for placenta accreta in future pregnancies. Now, 1 in 272 births will develop placenta accreta. Placenta accreta ranges in severity. It can be just barely growing into the uterine lining and in the most severe cases, it actually can grow through the uterus, and outside of the uterus, and start attaching to other organs, which is when it is very, very dangerous. The cases of a placenta accreta have actually quadrupled since the 1980s, which is really interesting because you can see the rates of accreta increase right along with the Cesarean rate as the Cesarean rate rises. *Meagan:* Cesarean rates, mhmm. *Julie:* Right. In 1980, it was 1 in 1200 pregnancies that had accreta, and in 2016, 1 in 272. So quite a big difference. *Alysa:* I know that the risk of previa after a Cesarean is 1 to 6 times higher and the reason, like you said, is exactly right, Maegan. Because of that scar, no matter where the scar is, almost all Cesarean scars are lower or closer to the cervix. *Meagan* : Right, the cervix. *Alysa:* And so, when the placenta first wants to place itself somewhere in the uterus, it tends to want to go to that spot where that scar is. Normally the placenta, the best place is to be far away from the cervix because that’s where the best blood supply is. And so, when it’s down there, it’s not a great place for the placenta to be in general, but also yes, like you said, as the cervix changes and stretches throughout pregnancy, that’s where that risk of bleeds goes up, too. *Julie:* Well, and I have a source from ICAN right here. We have a little graphic that we made on the risks of C-section with each Cesarean. Your risk of placenta accreta after your first C-section is .24%, so 1 in 417. Just listen to these numbers. They increase exponentially. Instead of saying one-in-so-many, I’m just going to say percentage, okay? Just for full transparency. After your first C-section, your risk of accreta is .24%. After your second C-section, your risk of accreta is .31%. Not too big of a jump there, .24% to .31%. Your third C-section, it doubles to .57%, so half a percent, which is actually bigger than your chance of rupture I will say there. But by the time you have your fourth Cesarean, your risk of having placenta accreta is 2.13%. 1 in 41 people who have four or more Cesareans will have placenta accreta. *Meagan* : Pretty wild. *Julie:* Which it obviously necessitates, makes necessary-- it is necessary to have another C-section because it is not safe to deliver vaginally at that point. It is not safe for you just to contract at that point, so you are at a higher risk because of that, just because of having that major surgery. But also, it’s a big risk for the mom and the baby. A big increase in postpartum hemorrhage for mother, higher instances of loss of life for mother and loss of infant life as well with those. And so, when you are considering VBAC versus repeat Cesarean, look into the complications that come with each subsequent Cesareans. Now, some providers will say, “Oh, I don’t do VBAC, but I am only going to let you have four Cesareans because it is dangerous to have more than that.” But then there are some providers-- I know one in our state who told a friend of mine, “Oh yeah, I am not worried about your family size. I have done eight Cesareans on someone before.” I am like, “Eight Cesareans?” My jaw hit the floor. I just can’t even imagine. I can’t even imagine. *Meagan:* Well, and something too that I just want to point out to you is, a lot of the times providers won’t do VBAC because of the “risks”, right? But when you say, “Well, what are the risks of Cesareans?” They’re, “Oh, there are no risks.” Just this right here alone with each pregnancy, because this can happen with pregnancy, right? And so, then it can cause issues. I mean, look at what was happening with Alysa. She had to fight to keep her baby in. Just keep in mind that it happens and there are risks. If a provider-- (dog growling) oh my gosh. My dog really wants the mailman driving around out there. There really are risks associated with both. And so, f you ever have a provider that says there are no risks for a VBAC and there are no risks for a Cesarean, then maybe question them a little bit. *Julie:* Well, and I think a big part of that is the biggest risks that providers will see with a Cesarean is when they are doing the Cesarean which is your increased risk of blood loss, right? You will need a blood transfusion. But they see the immediate consequences of a Cesarean which aren’t as significant as the long-term effects of having multiple Cesareans. *Alysa:* Correct, yeah. *Julie:* And so, you have a provider that sees you and he does your Cesarean, but then you might have another provider for your next pregnancy that you get accreta and your provider that did your C-section might never even know you developed accreta. And so, why would they not be afraid to do eight Cesareans? Because they don’t see the long-term consequences that come with that. I’m sure they’re educated in that. I am sure they learned it in OB school, but when it’s not right in front of your face, it’s harder to keep that in the forefront of your mind. *Alysa* : Absolutely. *Meagan:* Well, thank you so much for sharing your story with us and letting us talk about this topic on your story because it’s important to know the differences. It’s important to know the risks. We are so happy for you that you got the birth that you wanted and you deserved. I mean really, you had a very medicalized, and then you had a necessary Cesarean, and then you had an unmedicated VBAC, and so you have a little bit of everything. It’s fun to hear your story and hear that not every birth is alike. This is one thing that I mention to my clients. People are like, “Oh, I really want to deliver at home, but because it’s my first, I want to see how things go.” I always just think to myself, “Go where you feel most comfortable.” *Julie:* “Just in case” *Meagan:* Go where you feel most comfortable and where you can picture that birth because just because it’s your first birth doesn’t mean it will likely be different for your second, third, fourth, fifth, sixth, eighth, you know? *Alysa:* Yes. Yes. *Meagan* : Your story right there is a prime example of how different each birth can go. *Alysa:* Yes. I want to say to that too, like, I would encourage anyone who wants something, don’t be afraid if you want something. I have had friends who were like, “I could never do that. I could never have an unmedicated birth,” and I am like, “You know, you could, but you have to want to.” *Meagan* : Exactly. *Alysa:* That’s the only difference between me and you. I am not anyone special. But if you want to and you feel like you want to, then do it. I think, maybe it was you guys who said it or I heard it somewhere else, you would never walk up to the start of a marathon having never trained and just being like, “Let’s see how this goes.” *Meagan:* Let’s do it, yeah. *Alysa:* And if you think it’s something you might want to do, you can do it. Just surround yourself with the people, and the knowledge, and the resources, like you guys, to accomplish those goals. I mean, it’s okay to want that and that doesn’t make you-- yeah. It’s okay to want that. *Meagan:* It doesn’t make you crazy. It doesn’t make you unrealistic. It doesn’t make you selfish to desire something different. It does not. So, I love it. I love that you went out and you got that something different and I love that it was all the good things, so thank you again. *Julie:* Absolutely. *Alysa:* Thank you guys so much. ------- Closing ------- Would you like to be a guest on the podcast? 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Joining us today from Canada is our friend, Jessica. Determined to avoid another brutal Cesarean recovery, Jessica researched extensively and fought for her VBAC rights. When she experienced PROM for the second time, Jessica didn’t allow different opinions from different providers dictate what she knew she deserved. She refused a scheduled Cesarean, reminded providers that their hospital did in fact support VBAC induction, knew when her body needed an epidural, and got the VBAC of her dreams. Jessica’s preparation made all the difference in her outcome. We want that to be the case for you too! Topics discussed today include: * How to know if all providers at a practice have the same views * Why you should ask open-ended questions * PROM: what it is and what to do if it happens to you Additional links How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) The VBAC Link T-Shirt Shop ( http://thevbaclink.com/bombfire ) 3 Game-Changing Things to do When Your Water Breaks: The VBAC Link Blog ( https://www.thevbaclink.com/water-breaking/ ) Episode sponsor This episode is sponsored by our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and Julie have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head over to thevbaclink.com ( http://www.thevbaclink.com/ ) to find out more and sign up today. Sponsorship inquiries Interested in sponsoring a The VBAC Link podcast? Find out more information here at advertisecast.com/TheVBACLink ( https://www.advertisecast.com/TheVBACLink ) or email us at info@thevbaclink.com. Full transcript Note: All transcripts are edited to correct grammar and to eliminate false starts and filler words. Meagan: Hello, hello, and welcome everyone. This is The VBAC Link with Julie and Meagan. We have a guest with you today from Canada. Her name is Jessica. She has an awesome story for you today. We were chitchatting a little bit before the episode began. We found out that she found us in the very beginning. It was right after her Cesarean, which is exciting to us because we want people to be able to find us during their journey of healing before they start preparing as well. So, that was really fun and exciting to hear. She has a fun story today. A cool highlight of her story is PROM. If you don’t know what PROM means, it means Premature Rupture of Membranes. That’s something that I actually had personally as well. But she was ruptured for quite a while. In fact, I think it was 40-- was it 48 hours? 40 hours? Jessica: I think 72. Yeah. (Inaudible) Meagan: 72! 72. But when-- (inaudible) before you started getting things going. Yeah. So, really cool because a lot of times people think that if their waters are broken for longer than 12 or 18 hours, even 24 hours, that it is need for an immediate Cesarean and it is not. I am excited to hear you share that part of your story. Review of the Week Meagan: As always, we have a Review of the Week, so we are going to dive into that review from Julie really quick before we get into this juicy story. Julie: Yeah, I love reviews. I think we say it every episode. I can’t speak enough about the reviews because I want to get a little vulnerable here for a minute. Running a podcast is not always sunshine and butterflies. We absolutely love doing it. We love talking to the people that share their stories with us and we love being able to share their stories with you. But these reviews really, really are the things that keep us going when it gets to be a little bit difficult for us. So, if you haven’t already, please leave us a review on Apple Podcasts ( https://podcasts.apple.com/us/podcast/the-vbac-link/id1394742573 ) or Google ( https://www.google.com/search?ei=Mq0oYOaqGuq-0PEPxq-T0AM&gs_lcp=Cgdnd3Mtd2l6EAMyBAgjECcyCgguEMcBEK8BECcyBAgjECcyBQgAEJECMgIIADIICAAQFhAKEB46CwguELEDEMcBEKMCOgQIABBDOggIABCxAxCDAToOCC4QsQMQgwEQxwEQowI6CAguELEDEIMBOgUILhCRAjoECC4QQzoHCAAQhwIQFDoICC4QxwEQrwE6BAguEAo6BAgAEAo6CgguELEDEIMBEAo6BwguELEDEAo6BwgAELEDEAo6BggAEBYQHlCiCVikE2CBFWgAcAB4AIABrgOIAboQkgEHMi01LjEuMZgBAKABAaoBB2d3cy13aXo&iflsig=AINFCbYAAAAAYCi7QktASJ1eDaW-lyA8fmrzk3Amjn1L&oq=the+vbac+link&q=the+vbac+link&sclient=gws-wiz&source=hp&sxsrf=ALeKk01Q6y51WCKDOK0QwrfXGXVYxN_fHg%3A1613278514471&uact=5&ved=0ahUKEwjmi5vmyujuAhVqHzQIHcbXBDoQ4dUDCAk ) or Facebook ( https://www.facebook.com/thevbaclink/ ). You just never know when you’re going to make our day with a glowing review. This review is from Apple Podcasts and it’s from futureballad. It’s called “VBAC Support at its Finest.” Just the title makes me smile. She says, “I absolutely love listening to these birth stories and I love how positive Julie and Meagan are! They give facts to go along with each story. They also include birth stories where the VBAC didn’t end up happening. It’s so important to acknowledge it doesn’t always work out. But, a woman of strength is someone who has become empowered by knowledge and uses that knowledge to advocate for herself no matter what the outcome is. I am going to VBAC like a boss in November when I birth our second son. I will be doing it knowing I have the support of The VBAC Link community.” That makes me so happy. Okay, “VBAC like a boss”-- that is a shirt. It’s in our shop at thevbaclink.com/bombfire ( https://www.bonfire.com/store/tvl/ ). That shirt came from our friend, Emily, who shared her story with us a while back. She said-- there is a “TOLAC like a boss” or a “VBAC like a boss”. I love our little bonfire shirts. We have some new designs coming out from some of our most recent previous episodes. Also, I want to tell you about an episode that is coming out in the next two or three weeks. We are actually interviewing a few CBAC moms, so parents who tried for a VBAC but ended up in a repeat Cesarean. We are going to talk to five or six of them. They’re going to share with us their stories about what it is like coming out of a birth that didn’t end up like they wanted to, what it’s like to not to get your VBAC, and what they wish people would know about parents who tried so hard for a VBAC but didn’t get the birth that they wanted. It’s such a powerful episode and we are really excited to put it out to you. That review just reminded me of that. It’s important to us to share that things don’t always go the way you want. While a lot of birth is preparation and education and confidence, some of it is just dang luck. Meagan: Yeah. Julie: I mean, some of it is just the cards you are dealt and knowing how to deal with those things is important to us to share with you, so that’s why we do it. Meagan: Yeah, and I love how she said we even-- like you were just highlighting, we even share those stories. We have gotten a lot of messages and actually, I am trying to think of the word. Julie: How to say it nicely-- Meagan: Really angry. I’m going to say really angry that we do share CBAC stories and it makes me sad when we receive these messages. Although we respect everyone’s opinions and feelings, we want to remind everybody that, just like Julie said, it doesn’t always turn out exactly how we wanted to. But guess what? Even sometimes those experiences-- like my second C-section was not what I wanted. I didn’t want to be on that table again, but it was a healing experience for me and a much more positive experience. I felt so much better walking out of that situation. These are learning experiences. They are growing experiences. They are healing experiences and even though-- yes, we do. We promote VBAC and we want you guys to know your options for VBAC. It is not fair for us to forget CBAC. It’s just not and it’s important. So, if you are angry, I want to say we are sorry, but we are not sorry at the same time. We respect your decision not to listen to those episodes, but it’s just so important to learn and hear. A lot of times when we are struggling, I know for me personally when I was struggling, I realized there was still a lot of processing that I needed to do and that’s why I was struggling. So, know that we are here for you and we are sorry if you are one of those angries, but we love you. Julie: One of those angries. Meagan: But we love you. Julie: We love you, no matter if you are angry, or happy, or sad, or excited. We love all of you. If you are looking for stories that are VBAC stories only, you simply have to look at the title. If it says, “So-and-so‘s VBAC”, it’s a VBAC story. If it says “So-and-so‘s CBAC” or “So-and-so’s Uterine Rupture”, then it is a CBAC or a uterine rupture story. And so, that’s an easy way to sift through them if you’re looking for certain advice. Meagan: We respect your decision not to listen to whatever ones. Julie: But we wish you would because it will really help you better prepare. Episode sponsor Julie: Do you want a VBAC but don’t know where to start? It’s easy to feel like we need to figure it all out on our own. That’s what we used to do, and it was the loneliest and most ineffective thing we have ever done. That’s why Meagan and I created our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) , that you can find at thevbaclink.com ( http://thevbaclink.com/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and I have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head on over to thevbaclink.com ( http://thevbaclink.com/ ) to find out more and sign up today. That’s thevbaclink.com ( http://thevbaclink.com/ ). See you there. Jessica’s story Julie: We should probably stop talking about this. You can tell it’s been a while since we have recorded because we are really super chatty right now. Meagan: We are going to turn the time over to Jessica. Alright, let’s dive in. Ms. Jessica, would you like to start sharing your story and stop listening to us gab? Jessica: I mean, I am enjoying the conversation, but I only have so much time, so I will get started. I got pregnant with my C-section baby when I was 19. I really thought that I was invincible. I know a lot of teenagers have that mindset. You don’t really think that bad things can happen to you. I thought that I was going to have an all-natural, medication-free birth, and was preparing for that, and would tell my friends how excited I was to be planning this med-free birth. My aunt recommended that I went with midwives, so I found local midwives that I went with. Here in Canada, they are covered by a provincial health insurance, so that’s definitely a perk when you are a young mom being able to plan a home birth. So, that’s what we talked about. I wasn’t opposed to a hospital birth, but they were pushing home birth on me, so that was the plan if everything was going well. We would have a home birth with a baby and then if not, we would go to the hospital. But I didn’t think we would end up at the hospital because I thought everything would go as planned, being young and not understanding how births can be complicated. I was 39 weeks and four days pregnant when my water broke. My first thought was, “Oh, the baby is going to be here in 12 hours now. Everybody goes into labor when their water breaks.” But it didn’t happen. The midwives confirmed the water broke and they said, “Oh, just rest. Sleep it off.” Labor usually starts anywhere between 48 to 72 hours. Most people within 24 hours, but they said we could wait until Friday. And then, the next day we woke up. I had a new midwife on-call and she said, “Oh well, we should just go in and induce.” I was eager to meet my baby. I was tired of being pregnant and I didn’t know what an induction was or that there were risks with an induction. I just thought, “Okay, I will get some medication, and get it going, and the baby will be here in a couple of hours.” But, that wasn’t the case. I was 4 centimeters dilated when I showed up to the hospital, which they said was great, and that labor would probably be quick, and the baby would be here soon. But 12 hours after starting Pitocin, I was still only 4 centimeters. They suggested that we throw the natural birth plan out the window and get an epidural, but that vaginal birth was still possible. After getting the epidural, my baby started having non-reassuring heart rates and because of the lack of progression, they suggested a cesarean. I agreed, not knowing that there was anything else we could try to get me to dilate. I had been laying on my back for hours at this point. We didn’t try turning the epidural down. We didn’t even try a peanut ball. We just went straight for the OR. The surgery was three hours after they were concerned about the non-reassuring heart rate. So, looking back I am like, “Was it really that urgent?” They made it seem urgent, but I always question if maybe we could have tried more things. I didn’t know that there were things to try. I thought birth just happened and that you couldn’t really have any power to change that. My recovery was horrible. My incision didn’t close properly and it took three months before I was healed enough to function normally. I found that recovery really traumatizing and never wanted another surgery like that again. When I got pregnant 15 months later, my goal was VBAC all the way. I really didn’t want to end up on the table again, mostly because of the recovery and my fear of missing out on a summer with my toddler. I planned a home birth again. I was more adamant this time that it was going to be a home birth. I rented a pool this time. I made a whole binder filled with resources from The VBAC Link. I printed out stuff from ACOG and SOCG, which is a Canadian version of ACOG, and had all the documents I could about VBAC. I would bring it to the midwives because they were more cautious and on the medical side. They said a hospital birth might be a better choice for VBAC, but I was adamant that I wanted to be at home. They supported me with that decision, but then I was 40 weeks and I had been doing everything. Walking every day, The Miles Circuit, bouncing on my ball, drinking all the red raspberry leaf tea, everything I could to get my labor going and then my water broke again. I was in denial the first day. I didn’t even tell my husband. I kept it to myself. I was like, “This can’t be real.” My water can’t break before labor again because I knew that that wasn’t a good sign for me. Eventually, I did call my midwife and I let her know, but I told her my water had been broken significantly less time than it had because I didn’t want her to push induction. I didn’t want her to push a repeat Cesarean. So, she came. Confirmed that my waters had been broken and we agreed that the next day we would go to the hospital for a non-stress test. When we went there, we had a consultation with the OB who looked at me and said, “We have to do a C-section. There is no other option. If we do another induction, you are going to fail. Your body couldn’t birth your first baby.” I guess I had an ultrasound at some point in my other trimester and they were estimating that the baby was going to be in the 97th percentile. Meagan: Oh man. Jessica: Yeah. They were like, “This baby is too big. She is not going to--” or, we didn’t know it was a girl. But they said, “The baby is not going to fit. You need a C-section.” I said, “Well, do I have any other options?” They were like, “Well, we can’t force you to have a C-section, so you can go home. And so, we went home.” Meagan: Good for you. Good for you though. Jessica: The OB and the midwife weren’t that happy, but I said, “I will come back for NSTs every day until I go into labor. I’m not opposed to that,” but I didn’t want to agree to a C-section. The next morning, I woke up with a green tinge on the pad that was collecting amniotic fluid and I knew that wasn’t a good sign. So, I called the midwife and let her know. I guess they had been scheduling C-sections for me every day in case I agreed to one, so she was like, “We have an OR ready.” Meagan: Are you serious? They were just doing that behind your back? Jessica: Yeah. They were just preparing. Meagan: Interesting. Jessica: So they said, “You can show up at the hospital at 11:00 a.m. and the baby will be here by 2.” It was the day-- like, when I got pregnant, I was hoping that the baby would come that day. So, I was like, “Okay, I guess at least I got the birthday I wanted.” But in the car, I was crying to my husband saying, “I really don’t want to do surgery and I know that I can’t be pregnant longer with meconium or an infection. It’s not fair to the baby to put my birthing desires ahead of their safety.” But I said, “I will take tomorrow as the baby’s birthday if that means I can birth this baby vaginally. What happened was, we showed up at the hospital and it was a different OB on-call. He was the one that had done the big baby ultrasound and predicted the size, so I was like, “Oh shoot. He is definitely going to want to do the C-section. There is no getting out of this now.” We show up and everybody is telling him how my birth was “failure to progress” last time, that the induction didn’t go well, and all of the stuff and the reasons why I should have the C-section. He asked them, “Oh, well how long have the membranes been ruptured?” They said, “About 48 hours at least at this point.” He said, “Why haven’t we done a Cesarean yet?” They said, “She doesn’t want a C-section.” He was like, “Well, why haven’t they done an induction?” They said, “All of the other OB‘s refuse induction because she can’t give birth essentially.” And so, he asked for my operative report and looked it over. They didn’t list “failure to progress” as the reason for the C-section. Julie: Awesome. Jessica: They only listed the non-reassuring fetal heart tones, so he said, “Okay. Based on that, we will do an ultrasound and see how big this baby is.” But he was like, “I think an induction is a reasonable option here.” Julie: That’s awesome. Jessica: “And even though there is a low success rate, we will go ahead with it if that’s what she wants.” And so, they did an ultrasound. They were guessing that the baby would be around 8 pounds. We went ahead with Pitocin. They did a low dose. It was going really well until I hit transition. I made it to 8 centimeters unmedicated and then I was begging for the epidural. But this was during COVID. I was wearing a mask and it was just me and my husband. My husband wasn’t the greatest support. He was freaking out the whole time. So, I got the epidural and then within two hours of the epidural, I had a really pain-free, easy pushing and birth. They did take her to the NICU for half an hour just because the membranes had been ruptured so long. They wanted the pediatrician to look her over, but she was totally healthy and only weighed 8 pounds, 9 ounces. So, not 97th percentile at all. Meagan: Go figure. You know what? Sometimes they are spot on. Sometimes they really are. They are really close, right? But it seems like nine times out of 10-- this is my own number, they are not. Jessica: Yeah, they are way off. No failing in birth Meagan: Yeah. That is so awesome. I love how you’re like, “You know, I worked through this. I was working really hard and I found the spot. I needed something different and I got that.” Because I think a lot of people that want to go unmedicated but choose an epidural, in the end, they really can beat themselves up. I loved hearing that you were like, “Yeah. I had a mask on. I was hot. I was 8 centimeters. I have been doing this for a long time, and I need an epidural, and I want an epidural, and I feel good about that.” I love that you pointed that out because it’s not-- you used this word earlier when you were like, “Or if we induced you, you would ‘fail’,” which clearly you didn’t, but that “fail” word. We let that “fail” word creep into the birth world way too often in my opinion. Because if we don’t go unmedicated, we “fail”. If we don’t have a vaginal birth, we “failed”. If we don’t go into spontaneous labor or get induced we “failed”, you know? If we don’t breastfeed our baby, we “failed”. There are so many “fails” out there. I just want to wipe them all the way. Get the biggest bottle of Windex and wipe it all down because there’s no failing in birth. There is no failing in birth. If you step back and you look at what we as humans are doing, wow. It’s incredible, right? So, I love it. I love that you took charge and you’re like, “I’m going home and I will be back. I know when I need to be back and hey, these are the options,” and I’m glad that he was willing to induce and supported you in that. You deserve that completely. Jessica: Yeah, but it definitely goes to show the luck of the draw because if it had been a different OB, it would have been a different story. Finding supportive providers Meagan: A totally different story. Yeah, no I agree. That is something when we talk about finding providers. I am just going to be talking about a whole bunch of random stuff, Julie. Julie: I love it. Well, I have some stuff too. So when you are done, I will do my stuff. Meagan: Yes, perfect. So, finding providers right? With VBAC specifically, and I encourage first-time parents to go out there and find a provider in the way that a lot of VBAC parents find a provider if that makes sense. Go out there and ask some of the questions and really from the very beginning, see what this provider’s thoughts are on Cesarean. So, when it comes down to it when you find out like Julie and I did that your provider has a 46% C-section rate-- Julie: After the fact-- Meagan: Yeah, after the fact that you could know these things before the fact and save yourself a lot of potential heartache in different ways, right? So anyway, I encourage everyone to go out there and find their provider. One of the questions that I feel is super important when you are looking for a provider is, “Will you be at my birth no matter what?” If the answer is, “No,” “Who will be at my birth? Do they have the same views as you?” Honestly, don’t hesitate to say, “I need their names. I want to meet them.” Don’t hesitate to interview them and say, “What are your thoughts on C-section?” Not, “Do you support C-section, yes or no?” “What are your thoughts?” Or, I mean VBAC. Julie: You mean VBAC. Meagan: I mean VBAC. Even as I am saying, I’m like, “Wait. On VBAC. Do you support VBAC, yes or no?” Those are just easy questions to be like, “Of course I do, yeah. We do them all the time.” Julie: “We can do whatever type of birth you want.” Meagan: Yeah. But like, really. “What are your thoughts on VBAC? What is your experience with VBAC?” Asking them these open-ended questions, but do not hesitate if your provider says, “You know what? It could be me, John, Jack, or Jill.” Julie: Joe. Meagan: Really, it could be any of these people. Don’t hesitate to interview them because like she said, it was the luck of the draw, and luckily she got the good one that was willing to work with her and support her. So, that is my little snippet on-- Julie: Meagan was painting condos all day yesterday, so she is a little tired. Meagan: I know. I am so tired. I couldn’t even get my butt up this morning on time to get to the gym. I went to the gym, but not on time. Julie: Oh, right. Wait, can I add something to that really fast? Meagan: Yeah, of course. Julie: And then I will let you go back on your snippets. Meagan: My snip bit? Julie: Snip bit. I had a client yesterday text me. She is going to her 36-week appointment today and at my first prenatal appointment with my clients, I always give them a list of questions to take to their provider. I actually stole Meagan‘s idea. I stole it from Meagan. Meagan: You did? What idea? Julie: Meagan does this too. The one where you’re just like, “Oh, ask your provider about IV access, eating and drinking during labor, induction, due dates, what to do after your water breaks, all of those questions.” I use them too now. So, she texted me and she was like, “Okay. I have my 36-week appointment tomorrow.” We are having our second prenatal tonight actually which is really fun. But she said, “I am having my 36-week prenatal. Are there any specific questions I should ask my provider?” I’m like, “Okay. Well, if you already asked the questions that I gave you at our last visit and you have a different provider today, then ask them the same questions,” because she’s in a practice with three different providers that rotate, three different OBGYNs, which is actually really a small number, which is great because you have less chance of getting some random person you’ve never met. But every provider differs a little bit in how they approach birth or sometimes a lot. Sometimes they differ drastically. Like clearly with Jessica‘s providers, the one was just so anti-VBAC. We’ve got a scheduled Cesarean. The other provider came in and was like, “Well, why haven’t we started inducing her yet?” Those views and opinions are so important. As many providers’ views you can know ahead of time going into your birth, will help you be able to navigate through those views and opinions as you navigate through your labor. You’ll be able to anticipate, “Oh, so-and-so isn’t really a fan of induction,” or “So-and-so would rather me have a VBAC,” or “So-and-so wishes I would go into labor before 41 weeks,” or whatever it ends up being. But the more providers to talk to and ask questions to, ask the same questions to all of the different providers. Just because one provider answered your question in a way that is satisfactory to you doesn’t mean another provider in the practice will. Then I also told her, and this is something I started telling all of my clients. Question everything. Everything they suggest or recommend, ask, “Why? Why are we doing this?” Or you can use the BRAIN acronym. “What are the benefits? What are the risks? Are there any alternative options?” And then really I only say, “What happens if we do nothing?” Just question everything even if you don’t think it’s a bad idea. Question, “Why are we doing it?” because that creates a really positive dialogue between you and your provider and lets your provider know that you are an educated and informed decision maker and participant in your birth. It creates trust between you and your provider. Your provider is going to learn to trust you and your ability to think critically and make decisions surrounding your circumstances. You are going to create more trust in your provider or maybe you’ll find out that you don’t trust your provider and then you’ll have to make a change there. And so, that was on my mind from my conversation last night with my client. She was like, “What questions do I ask?” Well, ask the same exact questions to a different provider who may be at your birth. What’s your next snippet, Meagan? PROM Meagan: No, I love everything that you said. I wanted to also talk about PROM like I talked about at the beginning of the episode. Because, yeah. 48 hours before labor had started and before anyone was willing to do anything, right? So, PROM. This is something that when it happened to me, I was told it happens to 10% of people. It happened to me three times. I was like, “What? How is that even possible?” Julie: It happened to two out of three of my spontaneous labors as well. Meagan: Yeah, it’s so crazy. We have a study here. It says that it actually only happens in 8% of term pregnancies. It does typically start within 24 to 46 hours of water breaking. But if it doesn’t, what can we do? What are some things that we can do to maybe try and get things going while we are waiting? Rest. One is rest. As Jessica did, she went home. Where is the best place to rest? At home where are you are comfortable. You are in your space and you can have your bed and everything right there. So rest, rest, rest. It is so important to just rest because when labor does begin, as I am sure Jessica will contest, it is hard work. Julie: You are going to need that energy. Meagan: We need that energy and so, really, really rest. Now, it doesn’t mean you need to be out cold snoring, okay? Although that is great. If you can actually sleep, that is great because as you are sleeping, the oxytocin hormone is kicking in and producing. It is just so great. But, rest. Just rest your body. Don’t go out and feel like you have to run up the hills trying to get labor going. The number two suggestion would be, get that baby in a good position. Now, as we have been learning over the 2020 year and even 2019 year, we don’t have to have these babies in any specific spot. It is called balance. We need to find balance for this baby to find the right spot for them. We really always suggest to our own clients and people out there, Miles Circuit ( http://www.milescircuit.com/ ) , Spinning Babies®, The Three Sisters ( https://www.spinningbabies.com/pregnancy-birth/techniques/the-three-sisters-of-balance/ ) , going in, resting on each side, doing side-lying, and things like that to really encourage baby is getting in that good position. Number three is, avoiding routine cervical checks and watch your temperature. As Jessica mentioned in her story when she was going to the hospital, she didn’t want to-- I’m trying to remember, Jessica, the exact words, but you didn’t want to risk the health of your baby based on infection, and meconium, and things like that for the birth that you desired. Something that we can do to watch and make sure that things are going okay and we are not getting into a risky situation is avoiding cervical exams. Now, with Jessica being at home, she was avoiding those cervical exams. A lot of the time, now this is here in Utah, I am not sure what is very standard in other states and countries. But every two hours or so, providers or nurses will suggest a cervical exam because they want to see what progress is being made in those two hours. Sometimes it is a, “I will just listen to your body and see what is going on, and then we will check and see if anything dramatic changes,” but a lot of the times, especially when we are waiting to see what is going on, if labor is going to really be going, and what we are wanting to do, they will encourage it every couple of hours. Avoiding that is the best we can do because we don’t need unnecessary bacteria going into our vaginas, right? Jessica: That is the one thing they did well. They didn’t do a cervical check until we went for the scheduled C-section. So, even at the NST the day before, it was completely hands-off. Yeah, they really waited until we knew that the baby was going to be coming within a reasonable timeframe before anybody did anything to increase the risk of infection. Meagan: So great. Julie: That’s really awesome. Meagan: Yeah. That’s really, really great. It’s okay to say, “I don’t want my cervix checked right now. I’m not feeling anything different or nothing has really changed to the point where I feel that it warrants a cervical exam.” Also, watching your temperature. So, especially if you’re going to labor at home, it’s a good idea if your water breaks to just check your temperature and be mindful of how you’re feeling. We say this because if bacteria starts growing and an infection begins, it is common to get a fever. That is our body‘s natural reaction to fight against infection. Sometimes we can get fevers even in labor because we are laboring really, really hard so our body temperature can go up, but a lot of the times we can get a fever with an infection or the baby’s heart rate can get really high. Julie: A fever can also be a side effect of an epidural. It can be a side effect of an epidural and not be a sign of an infection at all if you do have an epidural. So, that is something to remember. Meagan: Yes, it is. Exactly. Yeah, something to remember. Another sign that infection could be present is the baby’s heart rate is actually high. So, anyway. Taking your temperature and being mindful of how you’re feeling. If you’re feeling great and then all of a sudden you’re feeling really awful like you’re getting the flu, and you have a fever, and you are at home, it may be a good idea to go into wherever you are going. Unless you’re at home, then you would discuss this with your provider. But, go to the hospital or your birthing location and further assess and see what next steps need to be taken. Those are three ideas that you can do when your water breaks to try and help things get going. And obviously, activity and things like that, will all help as well. Pumping, but those are some of our three tops. Julie: I mean, I think I wrote that blog ( https://www.thevbaclink.com/water-breaking/ ). Meagan: You did write that blog. Julie: I think it might be due for a rewrite because I think it needs to be updated. I was reading through it earlier and I was like, “Well, I write a little differently now.” Did you notice that, Meagan? Meagan: Yes. You guys, we have so many blogs. If you haven’t checked out our blogs, check it out. It’s at vbaclink.com/blog. ( http://thevbaclink.com/blog ) We have tons of blogs. Yes, we are rewriting blogs. We are writing new blogs. So, give it a look. I mean, seriously. We have them on almost all of the main topics and even then some. Same start, different outcomes Julie: I want to make note that Jessica’s Cesarean birth and her VBAC birth were both induced births. They both started out in a similar way and she still had very different outcomes. A lot of times we, when we are preparing for VBAC, are hung up on mental hurdles, and whenever we get past the point of where a Cesarean happened, we can finally mentally release that, right? I dilated to a 4 before my Cesarean and so, once I was in active labor, I was riding high. I’m like, “This is great. I am totally going to do this.” I see that with a lot of my clients. Sometimes they get to 10 and pushing before they have their Cesarean, but sometimes they weren’t even given a fair chance at all. When labor starts all the same-- like Meagan, I remember with your third birth, your VBAC after two C-sections baby, your water broke before labor started again, for the third time. I remember you saying how frustrated you were that you felt like it was all happening again. Meagan: Yeah. I was throwing a fit in the driveway, like throwing my arms up in the air, stomping. My neighbor was out and just looking at me. My husband was just like, “Just let her. Just let her.” But, yeah. Well, it was just hard and that’s fine. I had a couple of contractions before, but really nothing. My water broke. I was just like, “Why does it have to happen like this again? Why can’t I just go into labor before this happens?” And just throwing a fit. But, you know, it was great. Julie: It ended up great and you got your vaginal birth. And Jessica, you got your VBAC after your Cesarean. I just want to say that just because your birth starts out similarly to your Cesarean birth does not mean it is going to end the same way. Sometimes we get hung up on that and mental blocks can hang up labor. So, do your best as you prepare, going into your birth and your VBAC journey, that you are ready to accept all different ways for labor to start whether it’s induced, whether it’s natural, whether you plan on going unmedicated but end up deciding to get the epidural because that’s the best choice for you and your baby. Be prepared for your birth to take a number of different journeys because the more journeys you can imagine and prepare for, the less likely you are to be caught off guard if those things happen during your birth. Jessica: I had the same meltdown when my water broke. I was crying holding my toddler, complaining about how this could happen twice. Meagan: Yes. It was so frustrating. I think that is something that maybe we needed to get out. Maybe we needed to just get all of that emotion out for us to take the next step and the next direction. Even though that wasn’t contractions really going right away, it was a release that needed to happen so when they did start, they could start. Julie: I think you make a really good point too. I am remembering something that I read a while ago. I used to have all my clients do a fear release or something like that if I felt like they were hung up on emotions. But now, I am finding myself more telling them to just do something that makes them cry. Just anything. Watch The Notebook at the end. My husband laughs at the end of The Notebook, but I am crying every time. Watch your wedding video or birth video. Read a letter that your partner wrote you years ago or something. Anything else to cry, because once those tears start flowing, your body releases whatever emotions it is holding onto through your tears. And so, who knows? Maybe you guys throwing fits and screaming and getting angry and upset and frustrated about that let your body release what it needed to in order for your labors and your birth to turn out the way they did. Who knows? Meagan: Yeah, exactly. Q&A Julie: Okay, but Jessica. I’m going to ask you these questions now. I want to read the answer that you read for the first one, but you can say whatever you want for the second one. The first one is, what is a secret lesson or something no one really talks about that you wish you would have known ahead of time when preparing for birth? I absolutely loved how you worded this, so I’m just going to read it word for word. You said, “This is a hard one. I wish I would have known the statistics about complications that arise in birth as a first-time mom and what a doula was. Now that I am in the birth world, everything feels like common sense. But as a young mom, I didn’t even know what Pitocin induction was or that an emergency C-section could happen to anyone.” I love that because I feel like all of us first-time moms can echo that sentiment of your message. Now that you are in the birth world and you are starting to become a doula and all those things, it feels like common sense, because it really does. Even sometimes when I’m working with clients or especially first-time moms, I have to remind myself that they don’t know what they don’t know. Going into birth as a first-time mom is just a whole different ball game. But, I really loved how you worded that. So, thank you for that. Now the second question is, what is your best tip for someone preparing for a VBAC? Jessica: I think finding the information to be able to make informed decisions or finding a doula or knowledgeable person who can help you make those informed decisions because you would hope that providers act in your best interest, but I know in my birth cases they were telling me-- I had to pull up the documents and show them themselves when they said, “Oh, we don’t induce VBACs,” and I was like, “This is supported right in your policy here.” So, it would be helpful if I didn’t do all that work myself to have somebody who was knowledgeable, like a doula, to be there to provide the information and the knowledge needed to make empowered and informed decisions. Meagan: Oh, so many good messages in this. Thank you so much Jessica again for sharing your story and for being with us today. Jessica: Thank you for having me. Closing Would you like to be a guest on the podcast? Head over to thevbaclink.com/share ( http://www.thevbaclink.com/share ) and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com ( http://www.thevbaclink.com ). Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

They invested so much of their time, energy, money, and hearts into their VBAC preparation. They craved immediate skin-to-skin, fought for their rights, and advocated for themselves. They labored hard, sacrificed for their babies, and felt the heartbreak that comes from an unplanned repeat Cesarean. They found healing, and they found each other. Now, these 7 Women of Strength want to share it all with you. How does it feel to have a CBAC? We invite you to sit in this space with us and find out. Additional links Advanced VBAC Doula Certification Program ( https://www.thevbaclink.com/product/advanced-doula-certification/ ) CBAC Support - The VBAC Link Community Facebook Group ( https://www.facebook.com/groups/cbaclink ) Episode sponsor This episode is sponsored by our very own Advanced VBAC Doula Certification Program ( https://www.thevbaclink.com/vbac-doula-training/ ). It is the most comprehensive VBAC doula training in the world, perfectly packaged in an online, self-paced video course. Head over to thevbaclink.com ( http://www.thevbaclink.com ) to find out more information and sign up today. Sponsorship inquiries Are you interested in sponsoring The VBAC Link podcast? Find out more information here at advertisecast.com/TheVBACLink ( https://www.advertisecast.com/TheVBACLink ) or email us at info@thevbaclink.com. Full transcript Note: All transcripts are edited to correct grammar and to eliminate false starts and filler words. Meagan: Alright, alright. Hello, everybody. This is The VBAC Link, and you are with myself, Meagan, and Julie. We have a special treat. You are with a whole bunch of other people today, and we are so excited that you are going to be able to hear from all of them. This episode is going to be powerful. It’s going to be emotional. It might be something that fuels fire and something that you totally relate to. I want to start the episode off by encouraging you to have an open mind and an open heart as you’re listening to these people’s stories. We are going to be talking about CBAC today. If you didn’t know, I had a CBAC. I wanted a VBAC with my second, and it ended up in a Cesarean. In so many ways, I feel like I can relate to all of these people. I can’t wait to hear their personal journeys, and feelings, and stories. We do have a special message. We are going to skip over our review of the week, and Julie is going to go over the differences between CBAC, VBAC, and scheduled C-section. Is that what you said? Julie: You got it. Meagan: Yes. Alright. So, we are going to get into that, and then we will get into these awesome stories. Episode sponsor Julie: Birth workers, listen up. Do you want to increase your knowledge of birth after a Cesarean? We created our Advanced VBAC Doula Certification Program ( https://www.thevbaclink.com/vbac-doula-training/ ) just for you. It is the most comprehensive VBAC doula training in the world, perfectly packaged in an online, self-paced video course. This course is designed for birth workers who want to take their VBAC education to the next level so you can support parents who have had a Cesarean in the most effective ways. We have created a complete system, a step-by-step road map that shows exactly what you need to know in order to support parents birthing after a Cesarean. Head over to thevbaclink.com ( http://www.thevbaclink.com ) to find out more information and sign up today. That’s thevbaclink.com. See you there. Defining VBAC, CBAC, RCS, and ERCS Julie: Alright. I just cannot tell you how much I love this group of women that are in this conference right now. I am looking at our little recording screen. Everyone has different colored circles with their first initials in it, and it warms my heart because today-- I am going to share a little bit. Not too many personal details, but we had a Facebook group for all the people that were sharing their stories today just to relay information and make sure everyone is on the same page. So, I filled everyone in earlier this afternoon on the details, and I left to go about doing all my other things. But when I came back to Facebook Messenger, there were dozens and dozens of messages from these moms talking about what they were going to say on the show, and how their feelings are, and getting really vulnerable with each other, and honestly creating some of the strongest connections. I could literally feel the connections growing and strengthening just in the Facebook conversation. It was so-- I don’t even know the right word. Meagan: Powerful. It was really cool. Julie: So endearing. Yes, powerful. I love it. And so, I am looking forward to this episode. These are all moms who attempted a vaginal birth after a Cesarean but ended up with a C-section rather than a VBAC. Before we get into the stories, I want to go over some terminology because the acronyms are pretty nuts, right? You have VBAC, HBAC, CBAC, RCS, VBA2C, HBA2C, and sometimes it can be really confusing. Generally, VBAC is obviously vaginal birth after cesarean. RCS or ERCS refers to parents who choose to schedule a repeat Cesarean whether they want to have a Cesarean or whether it’s because of medical reasons. They may not want to do it, but they feel like it’s the best thing for them. And then CBAC stands for Cesarean birth after Cesarean, which is defined as parents who attempted a trial of labor, or labored after a Cesarean and ended up with a repeat Cesarean. We want to go through and identify the unique challenges that these parents face and the different struggles and emotions that they go through, and maybe bring some things up that you might not have considered as you prepare for your own VBAC. We encourage you to listen-- birth worker, parent, anybody, stay tuned because there is going to be some really, really good information here from some really, really strong and powerful women. Paige Alright. I made Paige go first. Paige transcribes our podcast, so we can read them now. Meagan: Yay. Julie: Wherever you listen to podcasts, you can also read them too, and she is going to be transcribing this one. We absolutely love Paige. Paige was a member of our VBAC Link Community. Well, she still is. But, she suggested that we create a CBAC group just for parents who were in the community that ended up with a repeat Cesarean so that they could have some support and like-minded people. Paige is the founder of our CBAC community as well. We are so grateful for her for everything that she does. We are just going to talk about Cesarean and ask questions. Alright. So, Paige. What is something you wish people would know about your CBAC or just CBAC in general? Paige: I would say that first off, it wasn’t our fault. The reality is that some birth outcomes are just the luck of the draw in spite of the best prep. I can only speak for myself, but I know that I did everything under the sun and more to set myself up for a successful VBAC after two C-sections. I was going for my second VBAC attempt this time around. This was in June of last year. Some Cesareans truly are necessary. There’s a trend right now in the birth world to avoid a C-section at all costs, and it can feel really painful to moms that did everything to do just that but didn’t get it. So, it sounds really simple, but sometimes we need a reminder that Cesareans truly can be necessary. Meagan: That’s so true and not only necessary but a positive experience too, right? They don’t have to be scary and negative. Okay, so question number two is: What is one of the biggest emotions you are working through or had to work through post-birth? Paige: I narrowed it down to two, actually, which are confusion and embarrassment. I was mostly so confused how my intuition told me so strongly this would happen for me, and then it didn’t. Literally, I woke up from general anesthesia after my second birth, so my first CBAC, and I was so empowered from the labor experience. My first words were, “Can I do that again? I want to try that again”. From that moment on, that’s when I started preparing for my VBAC after two C-sections. I felt so good after every prenatal once I got pregnant. Every chiropractic appointment, every pelvic floor, I knew that I was on the right path. I had every reason to be confident it was going to happen. So now, learning to trust that those feelings were real, the journey with something that I needed in spite of the outcome and that my intuition didn’t lead me astray is something that I am still working on. And then, that level of embarrassment. One of the main reasons I was going for a VBAC was because I wanted to be a champion of VBAC. I wanted to be a walking example of empowered birth. With my first pregnancy and birth, I was so afraid of birth in general. I literally did not think I would survive. So, I wanted to be the success story of going from complete fear to complete confidence and then showing women that this was what we were made to do. I feel like I still came a long way in how confident I was, and how much I have grown, and how strong I am now. But now, with my outcome, it’s tempting to feel like my story makes people afraid to go for a VBAC instead of feeling inspired to do it. But, I still believe in VBAC. I am still so passionate about it. I love it, and I will always long for one. Julie: Yeah. That is some really real stuff. I think it is really important. I think we will probably talk a lot about this during the episode where people get told, “Oh, at least you have a healthy baby,” or, “Aren’t you so grateful for your Cesarean? It saved your life.” I think it’s really important to recognize that there are so many emotions surrounding this, but also-- also, we are grateful that we have a happy, healthy baby and mom. Sometimes, people don’t consider that mental health comes into play when we talk about the health of baby and mom. Sometimes babies aren’t healthy, and sometimes moms aren’t healthy. I’m glad you talked about that. Thanks. The next thing: What is something positive or uplifting you have found in your story, or have you even gotten to that point yet? Paige: Julie, you touched on this a little bit, but The VBAC Link CBAC Support Group ( https://www.facebook.com/groups/cbaclink ) has been the highlight and the greatest source of healing for me, honestly, this time around. I have found women that I know needed to come into my life during this time, and a few of them are on the episode today. It’s so fun to be able to talk to them and see them on here. I just love you all, and I am so grateful for each of you. Especially during COVID, when it’s very isolating, it’s a very difficult time to be going through postpartum. These women helped me feel like I had a tribe like I was seen and understood. This group-- it wasn’t me. It was a joint effort. Julie and Meagan, you don’t know that. But, I was messaging some other women personally, and we talked about how we felt forgotten. We talked about how we wanted to have a space. I still personally message some of these women just to check in on how they’re doing. It meant everything to me to have these women checking in on me during some really dark and lonely days right after my birth because they were going through it too. And I typically stay away from sharing too much on social media, but this CBAC group is such a safe place. It was also really healing to know that you, Julie and Meagan, were both so supportive of creating this group because throughout my pregnancy, you two were some of my biggest mentors. When I got my CBAC, there was this feeling of, “I let them down,” which I know is not true, and obviously, you had no idea who I even was, but seeing the way that you are champions of not just VBAC, but empowered birth and CBAC included in that, just means everything. Meagan: Aw, thank you. Julie: Aw, well, we are so grateful for you. Honestly, when you brought up the group, I texted it to Meagan and our admin, Sarah, and I am like, “Why have we not done that yet?” Meagan: Yeah. Julie: it was an instant “yes” from everybody. We created it, I think, the exact same day. We are really excited to have a space for you because I don’t even understand what you are going through. I know I have seen it with my clients. I obviously hear stories and we see your conversations in the group, but Meagan can relate a little bit more because she had a second Cesarean after trying for VBAC. But, being able to just be a silent lurker, not to sound creepy or anything, in the group really helps me understand better where CBAC moms are coming from. It helps me understand a little bit better how to approach them. And so, I just want to thank everybody, not only on this call but in the group for being there and being in that space. It really is such a supportive space, so thanks. Paige: Yeah. Meagan: Yeah, when I didn’t get my VBAC, I was in the group that caused me a lot of issues emotionally at the time Julie: A different group, not our group. Meagan: Not our group, but a different group back in the day. I mean, it’s still around. But, I remember posting in there that I did not get my VBAC and I remember pretty much in a way being told, “I told you so. Why were you so stupid for trying in the first place?” And so, when you said, “We want a place for us. We feel like there’s no place for us,” I remember leaving every VBAC group. Every single one, and unsubscribing to everything VBAC because I couldn’t be in that space. I couldn’t hear it. I couldn’t be there. I was sick of the, “I told you so‘s.” Like Julie said, when this was proposed, it was a no-brainer and a, “Where the heck have we been?” type of a thing. A moment of-- why didn’t we even think of this? So, so, so grateful for you. Last but not least, I know we have got lots of amazing people to share. Is there anything else that you would like to share or that you feel like people need to know? Paige: I just want to reiterate how strong these women are, how resilient they are. Not by choice, but because they have to be. There is an extra level of courage and deeper strength that we have to tap into to not get the birth outcome that you want not only once, but often multiple times in some cases. But for women who are prepping for their VBAC right now, I want to advise you to not be afraid, especially listening to this episode. We don’t want you to be afraid of a CBAC or a VBAC in general. I want to say, fight for it. Invest your heart in it. Go 100% all-in if that’s what your tuition is telling you to do. Follow that because the chances really are that you will get it. The odds are literally in your favor. And if you don’t get it, if the doctors label you a “failed TOLAC”, we are here. Now that this group is made, we are here for you. We will hold the space for you. We will catch you and you are never a failure to us. You will be okay. You might not feel it and it might take some time, but I promise that you will be okay. Julie: Me and Meagan are over here texting each other about how much we love you. Paige: Oh my gosh. I love you guys. It’s mutual, very much so. Julie: Before we go on to our next person, who is Kristian, I want to touch on something that I actually forgot to mention at the beginning. Most of preparing for birth is getting educated, having the right provider, having the right support team, knowing all your options, etc., etc., etc. But there is a part of it that is just pure, freaking luck. I have seen it myself with my own clients. Sometimes you can do everything and you can work so hard, and you just get dealt a really rough hand and end up in a repeat Cesarean. But I have also seen clients who-- how do I say this? They don’t work as hard or care as much into putting the effort in, and they get lucky and they have their VBAC. Sometimes that is a really hard thing to process, even as a doula. Even as a doula, I sometimes have a really hard time processing, “Why did this birth go that way but that birth went this way?” I know I have talked to Meagan about this several times and I know some of you are going to talk about this, but it’s really hard when you have worked so hard and get dealt a bad hand, and get that bad luck on your side. I think that what Paige touched on is exactly important, is that sometimes it’s just bad luck. That’s all it is. There is no one to blame and it’s nobody’s fault. It’s just bad luck. Alright, next up, Kristian. Kristian Meagan: Kristian! Kristian: Hi, guys. Julie: Hi, Kristian. Meagan: Hello, hello. Julie: Alright, Meagan, why don’t you start? We can alternate so that we don’t keep asking the same questions. Meagan: Well, the questions are kind of the same. Julie: But no, I mean you ask one and three this time. I’ll ask two and four. Change it up. Meagan: Gotcha, perfect. Okay. What is something that you wish people would know about your CBAC and CBAC in general? Kristian: Paige touched on it a little bit and you both have touched on it, but I think you can do everything “right”, I use that in quotes, and still end up with a CBAC. I never thought I would have one Cesarean birth, much less two. I literally planned my VBAC in the hospital with my oldest. Both of my babies were footling breech and both times I went into labor the night before my scheduled ECV. In both scenarios, I thought I had done everything right to have the birth outcome that I had hoped for. But yeah, that luck was not on my side either time. Julie: I agree. I think that's a really important thing to note. Okay. What is one of the biggest emotions you are working through now or had to work through after your birth? Sorry, I am just going to go off on a little, teeny tangent. I think that processing a birth is an ongoing process, but where are you at in your journey right now? What is the hardest thing you are working through or had to work through? Kristian: Yeah. I think the biggest emotion I have had and I’m still processing is just the frustration of that I spent so much time, energy, money trying to get my son in the right position. Even before I knew he was breech, I thought I was hopefully going to prevent him from ever being breech like my daughter. Ultimately, even after doing all of those things, I ended up with the same results. And so, unlike my first birth, I don’t have the “what if‘s” of like, “What if I had tried X, Y, or Z?” But I have the frustration of, I tried all of those things. For me, they didn’t work. And so, that I am still working on. I think if I hear one more person tell me about Spinning Babies®, or chiropractic, or any number of things that I tried, I might just scream at them. Everyone is trying to be so helpful and thoughtful, but when you have tried all of those things, and you’ve done all the things that people do to get a VBAC, and it doesn’t end up being that, hearing them one more time is just too much. So, still working through that frustration piece. Julie: It’s definitely understandable. That’s a really hard thing to go through because like you said, even though you know people are well-intentioned, it’s still like, “Yes. Yes, I did that.” I had that with my breastfeeding journey. Breastfeeding never works for me, ever. All four times and despite all of my-- I tried all the things, literally. I think I can relate to your sentiment when if I hear anyone say, “Did you ever try fenugreek?” I would like, “Alright, let me just punch you in the face right now.” Anyways, I can relate to that. Alright, Meagan, you are up. Meagan: What is something positive or uplifting that you have found in your story, or nothing if you have not gotten to that point, and is there anything you’d like to share on that? Kristian: Even though the physical aspects of my labor and birth were almost identical, like both times footling breech baby, both times going into labor the night before my scheduled ECV, how quickly my labors progressed, and then ultimately having a C-section. Even though the physical aspect of it was so similar each time, the fact that I had a different provider the second time, and that provider was truly amazing, it was such a healing experience that I never thought was possible with a CBAC. If you would have told me when I got pregnant with my son that I would have a CBAC and I’d feel okay about it because of my provider, I don’t think I would have believed you. I know I wouldn’t have believed you. In my first birth, I felt really unsupported, sort of like I was that unwanted statistic of a C-section because I was with midwives that deliver at a birth center. With my second provider, he was there the whole time. I think he was as disappointed as I was that I needed to have a C-section. I also knew that if it came to that and I had to have a C-section, it wasn’t for any other reason than that it was medically necessary and he gave me the best shot. He did an ECV while I was in labor. He let me labor as long as possible to see if the baby would flip and he would have delivered a breech baby if my son had been frank breech. So, all of those things I just felt really, really supported. Afterwards, he was there. He was there to explain what happened, and to talk it through with me, and spend the time, and tell me right away that I could try to have a VBAC if and when I have another baby. The physical aspect was the same, but the mental aspect was so different. Julie: I think that’s important to understand. Meagan, do you want to add anything about your second Cesarean or do we want to just go on? Meagan: For the sake of time and everybody else’s story, we’ll just go on. Julie: Okay, cool. Alright, Kristian. Is there anything else you want to people to know about your birth specifically or cesarean birth after cesarean in general? Kristian: Both things have been touched on already. The CBAC Link has been such an amazing community to join. Like Paige, I am not really a social media poster. I don’t really typically do that, but the group has been such an amazing place to process that. So I would say to listeners, if you have had a CBAC or if ultimately you end up in that situation, the community is here and it’s an amazing community to lift you up. And then I think for people out there that are trying to support CBAC women, I would say just to listen and not add the added advice. I had a lactation consultant after my son was born that said, “Oh, I wish you lived in Canada because you would have had two vaginal births because they don’t do C-sections for breech babies.” Julie: Whoa. Whoa. Kristian: First, I don’t live in Canada and I don’t think that that’s necessarily true. So, I would just say, whether it is true or not, it is not helpful in the situation. Just let the CBAC mama have her story and not add to it. Julie: Thank you. Thank you so much for that. I think that’s really important. Marie Julie: Okay, let’s see. Next up is Marie. Alright, Marie. Marie: Hi there. Julie: Welcome. Marie just moved away from us which makes me sad, but that’s okay. Marie, we still love you. What is something you wish people would know about your CBAC or just CBAC in general? Marie: I would say more often than not that we would love to share if you asked. I just wanted to give a little context to share about my CBAC because my CBAC was very traumatic for me. Paige touched on this, but it was necessary because it saved my son and that was part of that trauma. I had labored naturally because my body doesn’t respond really well from epidurals. That’s what I found out with my first one. Anyway, I labor naturally for 18 hours and then I eventually had to have an epidural placed because right before my transition phase was exceptionally painful and I felt everything. My son was having heart decelerations in between contractions. Then, they were happening so frequently that we realized we just had to get him out as soon as possible. Again, my body wasn’t responding to the epidural, so I felt a good deal of my surgery and I couldn’t help but be very vocal. Eventually, when they got him out he wasn’t crying, so I had that mentality going on as well. Our son was okay, but he was diagnosed with hypoxic-ischemic encephalopathy which is brain damage caused by lack of oxygen. He was driven to Primary’s and put on a cooling pad for four days to slow down his brain activity to try and let it heal optimally. The following week, he had tests for his heart and brain until finally, they let us know he had miraculous results and overall his brain damage was little to none. So, while my CBAC was traumatic, it saved my son. C-sections really are a blessing sometimes. I would want people to know that C-sections are really, really amazing. My first one felt unnecessary because it was failure to progress, so I was left feeling really empowered to get a vaginal birth the second time, but the second time I really needed that C-section. Julie: Absolutely. Meagan: She really has experienced the two opposite ends of like, “Oh, maybe not” and, “Okay, totally necessary.” What is one of the biggest emotions that you are working through or did work through? Marie: I would say it’s a mixture of both because I feel like I have worked through it, but then every once in a while it pops up. I would say that’s bitterness. My bitterness comes from skin-to-skin. I had looked forward-- my cousin once told me the most magical feeling in the whole world is having that skin-to-skin right after you deliver your baby. I just could not wait to experience that. With my daughter, during my first C-section, I didn’t get a hold her for a couple of hours, and then with the second one, as I was preparing for this VBAC, I accepted the small possibility of having a repeat Cesarean because all I really wanted was to be awake and lucid, which I wasn’t with my first, and to get to hold him skin-to-skin immediately after his birth. So, during his Cesarean, not only did I not get a gentle Cesarean, but I didn’t get to hear him, hold him, or behold his face for four days. When I first held him four days later, I was a ball of emotions trying so hard to just savor the moment, and holding his hand that was all bruised by all the needles, and looking at his face, and his oxygen mask. I went to bed that night feeling like we had both been cheated out of that moment between mother and son. I was fighting resentment that I had, but I soon discovered that lots of NICU parents feel the complex, dual emotions of being both angry and grateful. As time has passed, I would say that the bitterness is mostly gone. It still pops up from time to time that I didn’t get to be with him the first two weeks of his life, but overall now, I’m left feeling more gratitude than anything. Meagan: Yeah. And during all of that time, I just have to congratulate you on how amazingly strong you were because I can’t even imagine how hard that was. But you were a rock. Marie: Well, you are one of my doulas, so you definitely knew that. Meagan: I know you are a rock, yes. Okay Julie, do you have the other question? Julie: Alright, Marie. What is something positive or uplifting you have found in your journey or have you not really gotten to that point yet? Marie: It’s an astute question because the word “positive” is used. It’s difficult to find joyful, memorable moments when your goals or expectations are not met. So, what you’re left doing is finding gratitude, validation, and positivity in your CBAC story. But first and foremost, I am forever deeply grateful for the miracle of my son. Looking back, I am so grateful I had a provider who helped me go into labor on my own and that I fought for that too, because he did introduce induction options. I really fought for going into labor on my own because I didn’t with my first. I feel validated that I did everything I could to get a natural, vaginal birth. There’s a lot of things I have found. There’s a lot of positive things I found in my story, you know. I found a family among NICU parents and the CBAC Facebook group. I learned that there are better experiences and there are sacred experiences. It all comes down to what your story is, what your experience is. It belongs to you and it is special to you. It’s nobody else’s. So I guess, there you go. Julie: No, I love that. I think you answered that perfectly. Maybe I worded the whole question wrong for everybody. Everybody else, you are free to interpret question number three however you would like. Marie: No, it was great. No, you hit it on the head. Julie: I love it. I love everything you said. Meagan: Is there anything that you would like to add? Marie: I would want people to know, throughout The VBAC Link Podcast, we have been uplifted and inspired by so many women, including wonderful Meagan, who had successful vaginal births after multiple Cesareans and a very high success rate. It’s a great goal. I don’t have any regrets trying for a VBAC. I would do it all over again. But anyways, I would want people to know that there are some CBAC women who might end up choosing or needing to do an elective Cesarean for any subsequent pregnancies. With that being said, I would want people to know, especially coming from a strong VBAC mentality, it’s a very scary and difficult decision to come to. It’s something that I am having to face right now because I do want more kids, but having the VBAC and the Cesarean were both scary. I am really having to juggle with what I’m going to do next. But if I end up wanting to do an elective Cesarean, or if I need to do one, then I would want my VBAC community, my VBAC sisters, to be supportive of me and excited for me and be excited that I am doing elective Cesarean. I would hope that I would have support from that. Meagan: You deserve that, yeah. You deserve that support. Julie: Yeah, I agree. Marie: Thanks. Julie: Well, thank you, Marie. Next up, we have Anne. Anne Meagan: Yes. Anne, we have: What is something you wish people would know about your CBAC? Anne: You guys, first off, can I just say that I am really fangirling here because I have listened to The VBAC Link, oh my goodness, for as long as I can-- from the get-go, probably. Julie: Thank you so much. Anne: You guys have been there through my first VBAC. I did have a C-section, then a VBAC, and then I got pregnant with twins. That put a rudder in everything. I was going for a 2VBAC, which is difficult in itself with twins. So, I guess that’s one thing I would like to touch on which is different in my story is that with multiples. A vaginal birth is already hard enough to get supportive providers for, but with the twins, it was even harder. I really had to fight tooth and nail to even get the chance to try for my VBAC. For me, it was about facing fear head-on whether you are trying for a VBAC or having that CBAC which I ended up with ultimately. I want people to know that it’s never an easy choice whether you decide to get it or whether it’s an emergency in the end. Having that C-section is not the easy way out like other people can see. That’s what I can say on that. Julie: Absolutely. I agree with you 100% because sometimes you have to choose. Sometimes choosing a repeat Cesarean is just as difficult as going through labor and ending up with a CBAC. So, no. I agree 100%. Anne: Yeah and definitely. I did the TOLAC and everything. We got to that 7 centimeters and we elected to have the CBAC. I cried my heart out. It’s never an easy choice. Julie: Yeah, it never is. Never, along the way. For sure. Alright. What is one of the biggest emotions you are working through or had to work through post-birth? Anne: I would say mine would be shame, I guess. I don’t know if anybody else feels this way, but I love telling my birth story because it has so many cool and different things that happened along the way. We were induced with a Foley bulb and the labor was just like-- oh my gosh, it was textbook. Like, beautiful labor. I didn’t even feel my contractions before I got the epidural. It was a good experience. But then, when I get to the point where I have to tell people that we stalled out at 7 centimeters and we decided to get a C-section, you just see peoples’ faces turn a little bit. I am still processing that. Not feeling ashamed and being proud of how hard I fought, and how wonderful it was anyways. Julie: Yeah, I think that’s really important. I am glad you brought that up. I think that’s a really hard thing to work through. Meagan: Absolutely. Okay, next question. What is something positive or uplifting that you found in your story? Anne: Well, it’s like I said, I did have a really good labor to begin with and I felt supported in all my choices. That was something really positive for me because, with my first, which ended up in a C-section, I didn’t feel that support at all. It was healing in that way. I am just happy overall that I got to have that experience and got to give my babies those labor hormones. That was my ultimate goal to have them receive that and go from there. I’m happy overall that I got my number one goal. Julie: Yeah, that’s awesome. Alright. Is there anything else you want to add or that you wish people would know? Anne: Even if a CBAC wasn’t your first choice-- heck, which obviously if we are going for a VBAC, it probably wasn’t, that having that supportive provider is just as important as having a supportive provider with your VBAC. I feel like my provider definitely made the whole difference for my recovery and how I feel about my whole experience because when push came to shove, and we decided to have the C-section, and I cried, she was there for me. Whatever I asked, she made sure that we would try and get whatever possible to make me feel comfortable. I asked her to go through everything she was doing, to narrate as she was doing it. She said it was an odd request, but she did do it. So, just being heard from a provider and having that support is just-- it is so important. When you’re looking for a provider, not just thinking about how they will support you through a VBAC, but also trying to figure out if they are going to be there if plans don’t go as you planned. Julie: I really love that thought. I think that’s really important. I honestly don’t think I ever thought about it in that perspective before. So, thank you for sharing that. Joleen Julie: Okay, next up we have Joleen. Joleen: Hi there. Julie: Hi Joleen. How are you? Joleen: Doing well. Julie: So good. I am so good just to be surrounded and listening to you ladies. I am smiling the whole way through this. I just love it. Okay, question number one. What is something you wish people would know about your CBAC or just CBAC in general? Joleen: So, a quick briefing. I had my CBAC in October 2020 following a spontaneous 33-hour labor. My water ruptured naturally at home at 38 weeks and 4 days. I never dilated past 1 centimeter and baby never descended past -2 station even with five hours of a Pitocin induction during that. A hospital birth, so I had no food and pretty much no sleep. So, I did have my CBAC called failure to progress, but it was my choice because of the exhaustion. Overall, I think as a CBAC parent that we all had this goal set and probably had small goals in between and we had to reach those goals. We researched and we prepared and we advocated. We did “all of the things” and in the end, no matter what our outcome was, we all have our experiences and our stories. However we feel about these experiences, I just want people to know that our feelings are valid. It’s okay if you need to mourn your birth experience. It’s okay to love your birth experience too. We just have to find a healthy output for those things. Meagan: Absolutely. And it’s okay to take as much time as you need to mourn that birth experience. Question number two is: What is one of the biggest emotions that you are working through or have already worked through? Joleen: I would say, being recently postpartum from my CBAC, when I have time to think back at my whole journey, it’s not really an emotion, it’s more of a gnawing, “What if?” I originally wanted a home birth. I wanted the twinkle lights and the affirmations, the HypnoBirthing and the birth tub. I had a hospital birth. I constantly ask myself, “What if I stayed home longer? What if I hadn’t gotten the epidural? What if I had the doula that I wanted?” That’s really the one thing that weighs on me. I think a doula would have changed my outcome. “What if I had gone a few more hours before agreeing to have a surgery?” It gnaws and it eats at me. I will share a quick story. Before they took me back to the OR, I turned to my boyfriend and I said, “Do you remember how I was after our first daughter?” Her name is Elowen. He said, “Yeah.” I said, “You need to prepare for me to be like that again.” He was like, “I know.” I said, “I don’t know how I’m going to be after this. I might be struggling. I just want you to know that. I want you to prepare for that if you have to help me through this.” They took me back to the OR and as they were taking baby out, I had heard my midwife’s voice. I had no idea that she was the attending midwife during my surgery. She said, “You know, I told you that she was going to try to come on my birthday.” I just felt so calm in that moment. I said, “Heather, is that you?” She said, “Yeah, it’s me.” Immediately, the first thing that came out of my mouth was, “Heather, I didn’t get my VBAC.” And I cried. I was bawling. I could feel her emotion behind that blue veil. She said, “I know, hon. I am so sorry.” That was the first time I realized that I didn’t get my VBAC and it really sunk in. Meagan: It’s crazy how that can happen and you are like, “Wow. Alright. And here we go. That just sunk in right there and I am processing this now.” Julie: Yeah. Honestly, I am so invested in this story, I don’t even know what question we are on anymore. Meagan: I think three. What is something positive or uplifting? Julie: Yeah. Have you found something uplifting or positive in your journey? If not, that’s okay too. Joleen: Yeah, so a positive thing that I took out of my whole experience and my whole journey was that I found this strength that I never knew that I had. I so often hear the phrase, “Use your voice even if it shakes.” I learned to advocate for myself and thankfully I had two wonderful providers, and OB and a Certified Nurse-Midwife who gave me no pushback. They supported me the entire way from the get-go. Meagan: Okay. Is there anything you would like anyone to know about CBAC? Joleen: Yeah, so it’s like the other ladies have mentioned-- you can prepare all you want. It’s going to be the luck of the draw. That’s even what OB had told me at my two-week postpartum visit. I asked, “Was there anything physically wrong with me inside? Anything wrong with my pelvis?” He said, “You know, it was just the luck of the draw. I have no idea why things went the way they went.” You can eat all the dates you want. You can go to the pelvic floor therapist. You can go to the chiropractor every single week. You can bounce on your ball. You can walk. You can take the red raspberry leaf. You know, it’s not going to give you the outcome that you want. You’re not always going to get that outcome. Meagan: It doesn’t always happen, yeah. Joleen: Yeah, you have to accept it. Meagan: Mhmm. Joleen: It is a hard pill to swallow, too, if it doesn’t happen the way you want it to. But just know that you are not alone in your struggles. Julie: Absolutely. I think that’s really important. You’re not alone in your struggles. I actually was taking notes while you were talking because I want to make some social media posts from some things you said. Actually, all of you guys, I have been taking notes. But, I think that’s really important to know. Okay, well thank you so much, Joleen, for sharing your story with us. You’re right, I want to chat with everybody so long. But Meagan is like, “Come on. We have got to get back on track.” Okay, okay, okay. Meagan: I want to make sure everyone gets their time. Brett Julie: Alright. Next is Brett. Brett: Hey. Julie: Hi Brett. I am so glad you’re with us. You are one of the people whose names I am familiar within the community. Now I’m familiar with all of your names, but Brett, I think I just remembered you from-- Brett: I think I was there from the beginning. I was one of the first people. Julie: Yeah, I love it. Let’s get right into it. What is something you wish people would know about your CBAC or CBAC in general? Brett: I think one of the hardest things for me to deal with after my CBAC was everyone saying, “Well, at least you have a healthy baby,” because yes, I have a healthy baby and that’s amazing. I am thrilled he’s okay and I don’t have to worry about him, but “at least you have a healthy baby” can be absolutely true, but it can also be very unhelpful to women who are going through birth trauma and the pain of losing the birth experience that we fought so hard for. Meagan: Absolutely. Julie: Yeah. I agree 100%. Meagan: It discredits, I feel like. Brett: Yeah, it takes away from all of the hard work that we went through. It takes the mom out of it and it makes it all about the baby. Birth isn’t just about the baby. Birth is also about the mom. Julie: I agree. I feel the same way about the phrase, when everyone in my life tells me, “It will be okay. It will be okay.” I’m like, “It will be okay. I know that. It will be okay, but right now it’s not okay.” Meagan: It doesn’t feel okay. Julie: So, I need help now. Brett: I love the concept of toxic positivity and how being positive is good, but you can be too positive. If you don’t give people the space to talk about their emotions and talk about their trauma, you are not helping. You are just silencing them and shutting them down. I feel like that happens a lot to women who go through traumatic births. Julie: Yeah, totally. Alright, Meagan. Next question. Meagan: What is one of the biggest emotions you are working through or have worked through? Brett: I think for me it was probably the feeling of failure and the guilt that came along with it. I chose to switch to a home birth VBAC around 35 weeks mostly because of COVID, but I was honestly using that as an excuse. I really wanted to try for a home birth VBAC. I paid for the midwife in addition to the OB. I spent all the extra money on all the extra things. You all know what I am talking about. Julie: Yeah. Brett: I still failed to get my VBAC despite having perfect conditions. I was at home with my mom, and my husband, and a midwife who is supportive. I did everything and I still failed to do it. Knowing that in having two C-sections now, I am limiting the number of kids I can most likely have, it hurts. The guilt for all of the effort and money that I put into something that I “failed at”, it is real. Julie: It is real. No, those are very real things. I agree with you guys 100%. Everything you have said has touched me in a whole bunch of different ways. So, thank you for sharing that with us. Okay, my turn. What is something positive or uplifting you have found in your story or have you not even gotten to that point yet? Brett: Honestly, even though I didn’t get my VBAC, my CBAC birth was super healing for me. My first birth was just hell. 29 hours of induced labor with every medication side effect in the book. The magnesium made me feel like I had the flu. I puked over 40 times during labor. Then, our son came out not breathing and I didn’t get to meet him for five hours. I was a drugged mess and don’t remember pretty much most of it. S With this birth, I went into labor on my own. I had a wonderful labor at home. My husband made burgers in the middle of labor and I devoured a whole burger in two minutes in the middle of labor. Even when we made the decision to transfer, that part was emotionally traumatic, our son came out screaming and I heard his voice right away. I got to hold him right away and we got skin-to-skin, which I didn’t get with Landon. I didn’t get to meet him for the first five hours and it just made a really big difference in healing after the first for me. Julie: I think that’s really important. I just had a chuckle when you said cheeseburgers because I am a big fan of cheeseburgers. I always joke about that. When I tell my clients about eating and drinking during labor, I am like, “I like smoothies and stuff because if you’re going to throw up, they generally come up smoother than a cheeseburger does.” And so, I am always talking about cheeseburgers and birth. Brett: I actually ate a cheeseburger. My husband was making them. My husband is a chef and so we said, “Well, you can make food for the midwife and stuff. It will distract you while I am in labor.” So, he made burgers. They asked if I wanted one and I was like, “You know what? Yes. I would love one.” I literally ate the whole thing before the midwife had even sat down with her plate of food. It was great. Julie: Good for you. Brett: It was awesome. And then because I ended up with a C-section, I didn’t get to eat and I had all the side effects to the medication again, so I didn’t get to eat for 24 hours after that cheeseburger. it was a good thing I had the cheeseburger. Meagan: Yeah, that’s so awesome. Okay so, is there anything uplifting? Look, I am not even looking at the questions now. Yes, something positive or uplifting you have found in your story? Julie: What else do you want people to know? Meagan: I thought it was number three. Oh yeah, duh. She just said that. Brett: That was number three. Meagan: Okay. What else do you want people to know? Julie: Cheeseburgers. I know we got distracted. Sorry. Brett: That’s alright. I wish that people understood that the emotional healing from a Cesarean is just as important as the physical healing. A Cesarean incision heals over long before the emotional wounds stop hurting, but nobody really thinks about that part. We are kind of just left on our own to try and muddle through that. That’s hard. Meagan: Yes. Yes. I think that is so powerful. I had a provider once tell a client, “Oh, as soon as she feels like she can stand up and walk she will be fine.” I was like, “Uh, OK.” Julie: So nonchalant about it. Brett: Yeah. My incision didn’t heal for three months this time. The first time, it was within a couple of weeks and this time I think it was September before my incision fully healed. Honestly, I think it’s because we went to the beach and I spent three days in the saltwater. I think that’s the only reason it actually finally healed over. I don’t know why it took so long, but even then, the emotional stuff was still there when the incision finally healed. Meagan: Yeah. Well, thank you. Thank you, thank you. I love all of your points. Grace Julie: Alright. Up next, last but not least, or maybe it is the best of all the game. Right? Alright, Grace. Meagan, do you want to ask the first question? Meagan: Yes. Okay, Grace. What is something that you wish people would know about your CBAC or just CBAC in general? Grace: Hi. So first, I just wanted to say thanks for having me on along with these other warrior women. Something I think I wish people knew was how much we all actually invest in fighting and trying for our VBAC and getting there emotionally, physically, and in some cases, financially. I think like someone had said earlier, I was planning my VBAC while I was still in the hospital after having my daughter. I knew I needed a new provider and a new hospital. I wanted a doula. Right from that day on, it was a journey for me for sure. Julie: That’s amazing. Thank you so much for sharing that. Okay, second question: What is one of the biggest emotions you are working through now or had to work through after your birth? Grace: My CBAC was definitely emotionally healing in comparison to my first Cesarean. My first Cesarean was from an induced labor, a long labor, my doctor was very impatient. He made me push way before I was ready to. I ended up under general anesthesia, so I really have no positive feelings from my daughter’s birth, unfortunately. This time, I went into labor on my own. I got to labor at home before I went to the hospital. I was pushing. I got everything that I wanted other than literally just pushing a baby out myself. So, that was that. But then I think about, “Well, what if?” All of the what if’s are what I am really struggling with most days is, “What if I got the epidural this time that I really was so strongly against based on my first experience with it? Maybe it would have let me labor a little bit longer,” or, “What if I had just pushed longer instead of making that decision myself to opt for the Cesarean?” My son this time ended up being OP and I knew he was going to be pretty big, so both my midwife and my doula were like, “Well, if it was one or the other maybe we could work through it,” but I think the combination of the two was really stacked against me. At the end of it, they let me make the decision if I wanted to keep trying or to do the Cesarean. I remember my midwife asking me, “Deep down, dig deep. Do you feel it inside if you can push the baby out?” Honestly, I self-reflected and I really didn’t think I could, so that’s why we chose the Cesarean. But then again, what if? What if I would have just stuck with it? What if I would have just pushed a little longer? It kills me. Meagan: Yeah. Yeah, I know. Those “what if‘s”, they can really get to us. It is hard not to ask the “what if‘s”. I feel like we start the “what if‘s” before we even go into labor. Even in the decision to VBAC or to CBAC, “What if I do this? What if I could deliver vaginally? What if I have something bad happen?” You know, there are just those “what if‘s”. It’s personally something so hard to get through. Grace: Yeah. I think at the end of the day, I was like, “I really want this VBAC, but I really want my baby here healthy more.” It’s putting my wants aside for, “Yeah, I would love the VBAC, but I really would love my baby to be here now, healthily instead.” Meagan: Mhmm. Yeah, definitely. Okay, question number two is: What is one of the biggest emotions you are working through or have worked through post-birth? Grace: I think we just did that. Meagan: See? This is what the thing is. I do the wrong question every time. Nope. It’s number three. It’s: What is something positive or uplifting you have found in your story? I am just listening to the answer and not knowing what the next question is. Julie: I know, we just get so lost in all of these amazing answers. Meagan: I’m just relating, yes. Grace: My whole journey this pregnancy, leading up to even getting pregnant and then my whole pregnancy, I just felt empowered. I was self-advocating. I researched a ton. With my first pregnancy, I was under the care of doctors and I just naïvely trusted them. They said to do this and I’m like, “Well, they are the experts. Okay.” This time, I really educated myself. I knew what my rights were and what I could get. I switched to a midwife. I hired a doula. I went to a different hospital. I did literally all of the things that I could do and that were there for me. Even though I ended up with a CBAC like I said, it was healing for me and I felt confident that I exhausted all my options. I left no stone unturned so to say in what I could have done. So, I was proud of myself for all of those things. Meagan: You should be. Grace: Thank you. Julie: I think it’s great that you can look back on your birth like that and feel confident in your choices. That’s really important. Grace: Yeah, for sure. Julie: Alright, last question. Anything else you want people to know? Grace: I think the biggest thing is that we can still love our babies unconditionally and yet still yearn for a certain birth story. I think some other women have said, people always say, “Well, at least the baby is healthy.” Yeah, of course. That should just not be not even said. That is number one for everybody. Mom and baby, yes. Number one. That should just be taken off the table. But, vaginal births have been part of women forever and ever. That is what we are “made to do”. I am saying these things with air quotes. So I just feel like, we can love our kids no matter what and we can still love to have a certain birth. Meagan: Absolutely. Absolutely. You guys, so many incredible words and thoughts. I feel like, Julie, if you have been writing these down, we’ve got a lot of amazing Instagram ( https://www.instagram.com/thevbaclink/?hl=en ) posts. Julie: Oh yes, yes. There were a lot. We want to wrap it up. Unfortunately, we have to go. I really wish we could just sit and talk with you ladies all day. I just love you guys so much. VBAC and CBAC birth plans I want to close it off because I want to take it back to something that Anne said. When you interview your provider for your VBAC, don’t just think about how they will support you through a VBAC. Consider how they will support you if things don’t go the way you want and if you end up with a repeat Cesarean. Maybe start asking those questions too, while you are talking about your birth plan and you’re preparing for your VBAC. Talk about a back-up Cesarean plan with them. What happens if something comes up and a Cesarean becomes necessary? Then how are you going to be supported? You might not like their answers, but you might feel just as supported as you are when they are talking about your VBAC preparation. And so, I just wanted to-- I just really loved that when you said that, Anne. Like I said, I have lots of notes from all you others too. But, I just really want to emphasize that to close this off because sometimes births don’t go the way you planned. In fact, I would say, every birth doesn’t go as planned. Sometimes it’s in really little, teeny ways, but sometimes it’s in really big ways. Having support all along the way, no matter how it goes is very, very important. I encourage you, you listeners right now, to get educated about repeat Cesareans, to know the reasons why they may be necessary, and to have those conversations with your provider along the way. Closing Would you like to be a guest on the podcast? Head over to thevbaclink.com/share ( http://www.thevbaclink.com/share ) and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com ( http://www.thevbaclink.com ). Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What if your wedding was designed using a holistic approach focused on people and not things? How could you make sure that everyone at your wedding will feel like their presence is an integral part of the celebration? Listen in as Michelle interview's Experiential Designer, Julie Comfort, and learn how to do all this and more. As a destination wedding photographer for ten years, Julie Comfort attended over 250 weddings in 15 countries across 5 continents, covering a staggering number of cultures, traditions, and venues, yet often feeling a huge missed potential for more personalization and connection. Ready for a new adventure, she moved to Berlin in 2015 and studied experience design at Kaospilot, where she immediately recognized that a holistic design approach focused on people not things was the missing ingredient for truly meaningful and magical weddings. Julie founded Comfort Studio, an experience design consultancy dedicated to designing celebrations with intention, heart, and wild creativity. Julie designs weddings that elicit the desired emotion in your guests. Joy, happiness, peace, etc. This helps create weddings that are an entire experience. Big Takeaways * Think about how you want people to feel. Start with how you DON'T want them to feel and work from there. * If you don't want your guests to feel awkward at a table of strangers, have a table host for each table! Someone assigned to welcome people to the table, pour wine, make introductions, etc. Think of which of your friends, at each table, that would be great at doing this and reach out to them before hand. Tell them why you chose them. * People love to help in small and big ways. Having come from the world from destination weddings, Julie really recommends including the guests in meaningful ways. When they just feel like an audience, the wedding is less of an experience and more of a show, they won't feel as important to the big day. * In the future, it will be even more important to design around the people, and less on the spectacle of the big day. Think about a dinner party and how people are engaged. Connection is key. Links We Referenced comfortstudio.com (https://www.comfortstudio.com/) - Use code: BIGWEDDING for a 20% discount 15toasts.com (http://15toasts.com/) instagram.com/comfortstudioberlin Quotes “Connection doesn't happen automatically, you have to help people connect.” - Julie “One of the weird paradoxes about weddings is that the couple, that's getting married, they're both the hosts of the event and the guest of honor.” - Julie "I think it's really important that we don't just treat our guests like an audience. [...] How can we insure that everyone there feels like their presence is integral to what is happening?” - Julie “It's okay to have moments where nothing much is happening.[...] Then what happens after the boring moment will feel more exciting.” - Julie The Big Wedding Planning Podcast is... * Hosted and produced by Christy Matthews and Michelle Martinez. * Edited by Veronica Gruba. * Music by Steph Altman of Mophonics. * On Instagram @thebigweddingplanningpodcast and be sure to use #planthatwedding when posting, so you can get our attention! * Inviting you to become part of our Facebook Group! Join us and our amazing members. Just search for The Big Wedding Planning Podcast Community on Facebook. * Easy to get in touch with. Email us at thebigweddingplanningpodcast@gmail.com or Call and leave a message at 415-723-1625 and you might hear your voice on an episode * On Patreon. Become a member and with as little as $5 per month, you get bonuse episodes, special newsletters and Zoom Cocktail Hours with Christy & Michelle! Our Partners (https://www.thebigweddingplanningpodcast.com/partners) Special Deals for Listeners - TBWPP Enthusiastically Approved! Susan's Travel Services (https://susanstravelservices.com/ready-to-book/) FlowerMoxie (https://flowermoxie.com/pages/the-big-wedding-podcast) The Flashdance (https://www.theflashdance.com/virtual-party-the-big-wedding-planning-podcast) Cactus Collective (https://www.cactus-collective.com/the-big-wedding-planning-podcast/) Unboring Officiant (https://www.unboringofficiant.com/bigwedding/) Special Guest: Julie Comfort.

What if tiny, subtle movements during labor could give your baby extra centimeters of space in your pelvis? Those centimeters just might make all the difference in getting your VBAC. Brittany Sharpe McCollum is an expert on educating women about pelvic biomechanics. This episode is packed with valuable, mind-blowing information that will put you, the laboring woman, back in control of your labor and ready to have an exhilarating birth. “It doesn’t matter if somebody is birthing with an epidural or without an epidural. They should come out of their experience feeling like they did something amazing. It doesn’t matter if somebody has a Cesarean or vaginal birth. They should come out of it feeling like they did something awesome rather than feeling like something happened to them.” Today’s topics include: - Your pelvis shape and optimal fetal positioning - Subtle movements during labor - Closed knee pushing - 5/4/3 Rule of Movement Additional links How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) Brittany Sharpe McCollum’s website: Blossoming Bellies Birth ( https://www.blossomingbelliesbirth.com/ ) Blossoming Bellies Birth Instagram ( https://www.instagram.com/blossomingbelliesbirth/ ) Baby Got VBAC ( https://www.amazon.com/Baby-Got-VBAC-Inspiring-Collection-ebook/dp/B08PVQDNY2/ref=sr_1_1?dchild=1&keywords=baby+got+vbac&qid=1611542420&sr=8-1 ) Free Webinars ( https://www.blossomingbelliesbirth.com/webinars-for-parents.html ) The VBAC Link T-Shirt Shop ( https://www.bonfire.com/store/tvl/ ) Episode sponsor This episode is sponsored by our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and Julie have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head over to thevbaclink.com ( http://www.thevbaclink.com/ ) to find out more and sign up today. Sponsorship inquiries Interested in sponsoring a The VBAC Link podcast? Find out more information here at advertisecast.com/TheVBACLink ( https://www.advertisecast.com/TheVBACLink ) or email us at info@thevbaclink.com. Full transcript Note: All transcripts are edited to correct grammar and to eliminate false starts and filler words. Julie: Welcome to The VBAC Link podcast. This is Julie and Megan with you today and we are really thrilled about the guest that we have today. We have Brittany Sharpe McCollum who is a pelvic dynamics specialist. We first learned about Brittany when we were at the Evidence Based Birth® conference. Meagan attended one of her workshops there and instantly fell in love. Meagan: Like, madly in love. Julie: Don’t tell Meagan this, but she is kind of obsessed. We are really excited to have her on today because a lot of Cesareans happen because of big babies, small pelvis. We have all heard it. If we had a quarter for every time we heard that excuse for a Cesarean, we would be rich women. We are going to talk about that. We are going to talk about that today with Brittany. Brittany is a childbirth educator. She is a doula and a pelvic biomechanics educator. Her work with expectant families centers around supporting people and exploring their options, developing their preferences, and navigating the tools and information necessary to make them a reality. In her trainings for birth professionals, she takes a research-based, multidisciplinary approach to exploring pelvic dynamics in relation to labor and facilitating the understanding of movement as a benefit to medicated and unmedicated labors. Guys, the things that she does can help you whether you have an epidural, whether you are unmedicated, home birth, hospital birth, birth center-- anywhere and everywhere you give birth. We are going to have some really, really awesome tips for you by the end of this episode, so get your pen and paper out. This is going to be one you want to take notes on. Review of the Week Julie: But before we do that, Meagan has a review of the week for us. Meagan: Yes, I do. This one is going to be one of those episodes that you likely listen to and then have to go relisten to it and relisten to it. You are going to learn things every single time you listen. I am so excited for this review, too. It is from drFL0W and the subject is “Phenomenal.” So, thank you. It says, “Meagan and Julie are amazing! I love the knowledge they share on their podcast and their enthusiasm for helping women have amazing VBACs.” Thank you, drFL0W. Julie: Do you know what? Dr. Flow, Flow Chiropractic. Meagan: Flow Chiropractic! Julie: Steven Roushar. I wonder. I bet. Meagan: Dr. Flow. That makes sense. Julie: I may have kind of made him write this review at a chiropractor appointment. I asked him to and he said he did it on Google and Apple Podcasts ( https://podcasts.apple.com/us/podcast/the-vbac-link/id1394742573 ). Meagan: Well, then that’s his one. Thank you. Thank you, thank you. We love him. Julie: Thanks, Steven. Meagan: But yeah, seriously, this podcast is going to be filled with tons of knowledge. So, gear up. Buckle in and get ready to roll. Episode sponsor Julie: Do you want a VBAC but don’t know where to start? It’s easy to feel like we need to figure it all out on our own. That’s what we used to do, and it was the loneliest and most ineffective thing we have ever done. That’s why Meagan and I created our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) , which you can find at thevbaclink.com ( http://thevbaclink.com/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and I have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head on over to thevbaclink.com ( http://thevbaclink.com/ ) to find out more and sign up today. That’s thevbaclink.com ( http://thevbaclink.com/ ). See you there. Pelvic dynamics with Brittany Sharpe McCollum Julie: Alrighty. I absolutely love what Meagan said before our intro. Buckle up. It’s going to be a bumpy ride. But do you know what? It’s the best woman to take a bumpy ride with because Brittany is going to help us get our pelvises ready for the bumpy ride of childbirth. How was that? Was that a little bit too corny? Meagan: There you go. See, and in my head, I am looking at it as we are going to be going full speed and your mind is going to be like, “Whoa!” Julie: Alright. Well, Meagan, you set this up. So, I want to let you drive the car. Is that okay? I am going to pop in with oogly-ness wherever it is appropriate. Meagan: Sure. Well, I just love Brittany. I loved her the second that I technically met her in Lexington. You guys should have seen this room. It was this little conference-type classroom in a hotel. We were shoulder to shoulder. It never would’ve happened during COVID because we were definitely not social distancing. We were packed. Everybody wanted to come and learn what she had to say. We only got one tiny little hour and, of course, she had this big line of people to ask her questions after. As soon as I left, I told Julie, I said, “I need more. I need more.” Julie: Yes, she was. Even now when I am at a birth I’m like, “Hold on. Remind me. Is it knees in or knees out? Is it asymmetrical movement or symmetrical movement for this stage?” Meagan: We are going to learn so much. I was so fortunate even during to COVID to be able to attend one of her workshops live this year in 2020. She just continues to amaze me and when Julie says I am obsessed, I really am obsessed with her. I love her. I can’t get enough of her and I’m so excited that she is here with us today. Pelvis shape and optimal fetal positioning Meagan: First of all, I have this one thing that I would like to talk about because this is something that I personally get stuck on myself, even as a doula. As a doula, I was trained this. So when I learned about this, I was like, what? If you have ever heard that your baby has to be in a LOA position, then you really want to turn the volume up right now because you are going to learn some stuff. Julie: Lightbulb. Lightbulb. Meagan: During my pregnancy with Webster, I did not sit on a couch or a chair other than my actual car literally the entire time. So, all the way up until 40 weeks and 5 days, I did not sit on a chair, a couch, nothing. I sat on the ground. I didn’t even sit on the birthing ball. I sat on the ground and was tipping my pelvis up, and sitting so uncomfortably that it hurt my stomach and my back. I killed myself. And guess what? My baby was OP. He was posterior. I was doing all the things to get this baby in LOA because we had to have this baby in LOA and he was posterior. After taking Brittany‘s course, I realized that’s how he needed to be. Then we worked through labor, worked with my pelvis and him, and got him where he needed to be. So, my first topic of discussion that I would love Brittany to touch on is position of the baby and how yes it matters, but how there is so much that we can work with. Brittany: Thank you so much. That introduction, oh my gosh. I would love for you to introduce me everywhere I go like that. Julie: We will come with you. Meagan: I will totally come with you. If I could be a fly on the wall in your life, that would be a dream come true. Brittany: My goodness. That was crazy. I want you in my back pocket to boost my self-esteem every day. Julie: We’re there. We’re there. Just tell us. Brittany: I am so honored that you feel this way. We have only met in person twice and I am just incredibly honored that you feel that way and that I have had such an impact on your excitement about positioning in the pelvis. Meagan: But not even just me. You have had an impact on my clients' births. Brittany: Well that I think is where the real importance of this information comes into play is that once you have these seeds planted, then we go out and share this information. We use it and we share it with providers. We share it with nurses. We share it with clients and then it spreads, and it starts to infiltrate the entire childbearing reproductive care system and hopefully make some serious change. That’s why, like you were talking about the workshops that I teach-- that’s why I love them so much because even if you have a workshop with 20 or 30 people in it, there’s a potential to impact hundreds of births. I think that’s really amazing. Oh my gosh. That Evidence Based Birth® conference was incredible. That conference was phenomenal. That room, when you said-- we wouldn’t have been able to do that in COVID. Absolutely. We would not have been able to pack in there if it was COVID time. I am happy that we are able to get that workshop in before COVID. Meagan: Me too. Brittany: Yeah, yeah. So, you had mentioned LOA. Let me talk a little bit about that. Maybe I should give a little bit of a background on what I do first. When you introduced me-- I am a pelvic biomechanics educator, a child educator, a birth doula, and when I am talking about pelvic biomechanics, what I am really referring to are the laws that govern the push and pull that occurs within the body to change the bonds of the pelvis and change the space between the bones of the pelvis, particularly during labor and birth. So, that’s what biomechanics are-- these biological laws that govern the effects of movement in the body. Then, I take these ideas and incorporate them into understanding how we can change space for the baby in the pelvis and encourage a baby to continue to descend and rotate. The goal in everything that I do is, of course, to decrease unnecessary intervention because when we have unnecessary intervention, we tend to have a whole lot more risk than benefit. As anyone knows who does childbirth education and works with pregnant people, it is a constant weighing out of benefit and risk with every choice that is made. But anyway, that’s really important to me, is decreasing unnecessary intervention. But another really important part of what I do is restoring the autonomy of the birth process back to the person giving birth. It doesn’t matter how that person is giving birth. It doesn’t matter if it is a medicated birth. Julie: Yeah, absolutely. Brittany: Well that could be a whole other hour-long podcast. But it doesn’t matter if somebody is birthing with an epidural or without an epidural. They should come out of their experience feeling like they did something amazing. It doesn’t matter if somebody has a Cesarean or a vaginal birth. They should come out of it feeling like they did something awesome rather than feeling like something happened to them. Yeah, so it makes no difference how someone is giving birth. They should feel like they have done something awesome in that experience. And then, I feel like that then translates into how they parent and how confident they feel moving forward through their entire parenting journey. That impacts the relationships that they have within their family dynamic. I mean, we carry our births with us for the rest of our lives. So, if we can help people to feel more empowered in their experience, that’s a really amazing thing. So, that’s my goal. A lot of what I do focuses on really two things: the importance of movement in all births and the importance, the opportunity for informed consent and refusal. To actually answer your question or provide some insight into your question about positioning of the baby, I can offer a little bit of background first. I definitely talk with my clients in pregnancy about the importance of aligning their bodies. So, Meagan, you had mentioned you didn’t sit on the couch your entire pregnancy and for a lot of people, I think particularly people who maybe have had a past certain experience that they want to have differently the next time, they’ll do extreme things like not sit on a couch at all. What I love to do is offer people modifications for their everyday things that can help them to be better aligned when they are preparing for labor rather than giving someone a to-do and not-to-do list. I try really hard to encourage people to be aware of how they are holding their body and how they are balancing the weight of their body and whether they are getting up to move frequently or getting stuck in positions for a long period of time. The things that I talk about with my clients prenatally to encourage alignment are not geared towards getting a baby positioned a specific way, which kind of ties into what you were saying about, “Oh no. What if my baby is not LOA?” What the most current anthropological research tells us is that most people have variations of four basic pelvic shapes. What is so interesting is that according to the research that we have, which we could question this research to an extent because, how good could this research be? But, according to the research that we have, about two of the four pelvic shapes-- again, we are thinking about variations of pelvic shape. But, two of the four pelvic shapes actually favor a baby moving into the pelvis in a right side-lying, posterior position. Meaning that, for those people that have pelvic shapes similar to the pelvises that favor those positions, their babies need to be positioned that way in order for them to start their journey descending and rotating through the pelvis. So, when we encourage babies to be positioned one specific way, we discount a significant number of people‘s pelvises that will not favor a baby being positioned a specific way. Julie: Yes. Well, and I see that so many times where my clients, or maybe they are even looking transverse, but that is just the way that the baby has to enter their specific pelvis shape. And I know that maybe we will touch on this a little bit sooner, but the more we interbreed with each other, the less distinct the pelvis shapes are becoming. So, there are not necessarily four distinct pelvic types anymore, but there are many variations of those. That is why after Meagan came back and told me all the things that she learned from your workshop, I have been focusing more on helping my clients create space in their pelvis, loosening up those pelvic ligaments, their connective tissues, the tuberosacral ligament or is it sacrotuberal? I don’t remember. Brittany: Sacrotuberous. Julie: Yeah, and just creating looseness, and freedom of movement, and flexibility rather than focusing on a specific position for baby to be in. Right? Brittany: Yeah, yeah. Absolutely. I am a non-clinical provider. I am a doula and a childbirth educator. I don’t do soft tissue releases or things like that. That is not my wheelhouse. Everything that I do in classes and workshops is all non-clinical information, education-based stuff that then people can continue to share. So all of that stuff, that soft tissue release-- that is amazing stuff also. That is complementary to everything that I do and that is definitely something that people should be exploring and seeking out resources for in pregnancy. A lot of the things that I like to suggest are simple bodily movements or changes in ways that they do everyday things, which I think of more as alignment. I think it is a complement to soft tissue release work, and chiropractic care, and all of that. We want to utilize as many resources available to us as possible so that we can best prepare our bodies to give birth in a way that is healthy, and may be efficient and really positive too. So yeah, all of that stuff is really important. It is so much less about getting the baby positioned a specific way because no one knows what pelvic shape they have unless they have had x-ray pelvimetry, which most people haven’t. Even if they have had x-ray pelvimetry, it is unlikely that they would have looked at anthropological research to compare that to variations of pelvic shape. I have had experience with clients who have had x-ray pelvimetry in the past and still they don’t know what variation of pelvic shape they have. My goal is to really take information that is more tangible and usable rather than saying, “Theoretically, I think your pelvis might be like this, so your baby should be like this.” No way. I don’t know what pelvic shape someone has. They don’t know what pelvic shape they have. Their provider does not know what pelvic shape they have. So, rather than focus on getting a baby specifically positioned a certain way, I like to give people the tools to allow their body, like you said, to create space as much as possible, so that then their baby can find the most ideal position to move through the pelvis that the baby is working with. Meagan: Exactly. I feel like that is so powerful. To me, anyway. I was like, “What? Wait, whoa. Okay, I love it.” Brittany: Yeah. One thing that is so interesting is that posterior babies get a really bad rap. In the longer workshops that I teach, we go into a lot of the history of this with obstetrical bias and things like that, but I think it’s really important to recognize that as soon as a provider-- and this has to do with really honestly, in my opinion, inadequate training when it comes to understanding bodily mechanics. I’m not saying that for all providers. Many providers seek out this information on their own, but conventional training does not include an anthropological look at pelvic shape or anything. But anyway, I am digressing. My point was that we have all, especially as birth professionals, probably been in the same situation, or maybe someone as a birthing person has been, where a provider comes in and maybe does an internal exam or does a quick palpation of the belly and they say, “Oh. This baby is posterior. Well, we will give it a little more time and see if we can get the baby to turn.” And what happens then? The energy in the room deflates. I think of that as such loaded words. Like, yeah. Sure. The provider is saying they will give it a bit more time. But really, what the provider is saying is that “I already don’t think you can have a vaginal birth.” Meagan: Yes, and something is wrong. They are saying, “Oh. Your baby is posterior.” Julie: And what does that do for hormone levels? Right? Brittany: Totally. Julie: Adrenaline levels rise, oxytocin levels crash, and then what happens? A need for interventions like Pitocin to get contractions stronger and all of those things. Oh my gosh, yes. Brittany: Yep. And then also, that seed is planted in support people that this is not likely to wind up in a vaginal birth and how does that affect the way the support people provide support? Julie: Because then they try and fix it right? Brittany: Say that one more time. I didn’t hear you. Julie: Sorry. Then we try to fix it, so we get our rebozos out and we start doing all these different types of movements that we learn in our doula trainings and everything like that. Our moms are like, “Oh my gosh. I’ve got to do all of this work to get my baby in a better position,” and providers or support people are like, “Okay. Well, something needs to be fixed. Something needs to be fixed,” when it might not necessarily be that something needs to be fixed. It might just be the way that that baby has to move through the pelvis. Brittany: Yeah, and the focus shifts from being physical and emotional support for the laboring process and, just like you said, focuses on, “Now, we have to fix something. Something is wrong.” For other support people like a partner or a family member that is there, now that seed is planted that this is probably or possibly going to end up in a Cesarean. It is now making that support person “okay” with that idea, which then means they may be less likely to advocate for things like more time. So, when we have a provider that does not fully understand how babies rotate and descend, why some babies are posterior, and how that is totally okay, and when we have the tools to work with that then it is awesome. When we have a provider that doesn’t have that knowledge, we potentially impact not only the outcome vaginal or cesarean, but we also potentially impact how someone feels about their birth. We have taken the power away from that laboring person and that is really, I feel like that is really detrimental. I think what we really need to do is continue to restore that power to the laboring person. So, a big part of what I really emphasize is helping people understand not how a baby should or should not be positioned, but instead to understand how they can move their body in a way that works with where their baby is in the pelvis to create space for the baby. Then, trust in that process that the contractions, and the pressure on the pelvic floor, and the movements of the baby are going to work together to help encourage efficient labor progress. So, yeah. It’s a lot of information. Meagan: Yes, but powerful. Powerful information. So good. Julie: Well, and I think if we can change the way we think about birth and think about baby positioning. I think the biggest disrupter of birth is the mindset of the birthing person. If we can just say, “It’s okay. Let’s see how the next couple of hours go because this might just be the way your baby needs to come out.” If we can set that tone instead of, “Let’s start doing sifting. Shake the apples. This is really fun. It will get you laughing. We can do asymmetrical movements,” although I don’t know if that is good. I still can’t remember which way asymmetrical movements are good for. You know what I mean? If we can step away from fixing things and be like, “Alright, that’s okay. It looks like your baby needs this, this, and that.” If we can change the conversation about that, then it will do so much good for balancing out the hormones that are part of birth. Brittany: Yeah, and I tell people all of the time that the same positions-- me, personally as a doula, the same positions that I’m going to suggest to work through a potential positioning issue are the things that I’m going to suggest to prevent it in the first place. I don’t have these magic tools to pull out in certain situations. My goal is to help us recognize the wide variation of normal in terms of how babies descend and rotate, and to have a toolbox full of ideas for encouraging that continued descent and rotation and progress. It’s not so much like, “Let’s have things just keep moving along. Everything is fine. Oh my god, everything is not fine. Now we have to jump in.” It’s more like, “Let’s incorporate movement throughout the entire laboring process so that we can continue to work with descent and rotation.” One of the things, too, that I think is really important-- a lot of times, I’m thinking of a few clients that I have had where they are really into the idea of movement, but they are also like, “I am going to be really tired.” And so, I try to emphasize that when I’m talking about movement, I am not necessarily referring to walking up and down the stairs sideways 20 times, and then doing a whole bunch of lunges, and then doing curb walking. I am not referring to all of those things, although sometimes I am. Subtle movements during labor Subtle movements can be really impactful as well. Even something as simple as shifting how far apart the legs are from one another, or standing in a staggered leg position instead of with your feet evenly in line with each other, or something as simple as somebody is sitting in a semi-reclined position with the soles of the feet together, and then sitting in a semi-reclined position with the leg draped over the peanut ball. We can take really simple, subtle little movements and make really big opportunities for descent and rotation. So, although I do love really big dramatic movements sometimes, I also recognize that labor is exhausting. My goal is not to make people more tired in labor, but instead for them to realize that simple, tiny movements throughout the whole process are what helps to keep things going. Meagan: Definitely. Just last week, I was at a birth. Second-time mom and starting in a really good position. 3 centimeters, favorable cervix, whatever. She was going in for an induction. The baby was really, really high. She was making progress, but the baby just wasn’t coming down, wasn’t coming down. And so, we started doing these ever so slight movements every five contractions, and seriously, it was dramatic. Brittany: Yay! Meagan: The last two positions, the nurses-- in fact, they pulled out their phones and pulled up your Instagram because I was like, “You have to, yeah.” Because they were like, “Where did you learn that?” I was like, “Oh my gosh. I just have to tell you.” I couldn’t even get into it as deep as I wanted to because I needed to respect the space of the room, because she was in labor. She was 10 centimeters. But anyway, she was hanging out at 9 centimeters. For a second-time birth, you don’t expect to hang out at 9 centimeters, but sometimes that happens. This baby just wasn’t quite low enough and engaged. Anyways, we ended up moving ever so slightly. We did knees together because baby was getting lower, so we were doing both. Alternating, right? Then the last one, I was like, “If you could, even just for three,” I said. “I just want you to lift your foot up and we are just going to do this little lunge thing,” and she was like, “Okay”. So we did that, and I was like, “Okay. Now I want you to put your knees back together.” She did that and it was two contractions. She was like, “Oh, yeah. He is coming. He is coming!” Julie: Oh my gosh! Meagan: I was like, “Boom. Yeah!” Julie: That’s amazing. Meagan: The nurses were watching this happen and you could see them. There was one nurse in training. She was like, “I need to learn all of that.” I am like, “Yes, you do.” One nurse was like, “So, is this just a Spinning Babies®?” And I was like, “No. You need to come here. Give me your phone. This is it.” Julie: You know that is exactly how it went down because I can see Meagan doing that. Meagan: It is legitimately how it went down. But then they were like, “We can’t let you touch our phone because of COVID.” I’m like, “Okay. Here it is.” I pulled out my phone and I set it aside on the bed as I continued to support. I said, “Go like her right now.” Seriously, you guys. It was dramatic. Yeah, it took a minute. Because it was seriously like, every five contractions we were changing it up ever so slightly, and then she was like, “Boom. He is coming.” Sure enough, he did. She pushed this cute little baby out so well in such control. Even the doctor was like, “Whoa. This control is incredible.” I think it was just because the baby was set up to come out in the perfect position for that baby. Brittany: Yeah. It sounds like you did a lot of restoring that power back to the person who was laboring, which gives her that confidence to be like, “Yeah. I can totally birth this baby.” Meagan: Yeah. She was questioning. She was like, “I don’t think I can do this anymore.” She got an epidural at 8 centimeters last time and I was like, “No. You are doing this and you can do this. It’s amazing, and you are going to do great.” Julie: That’s awesome. Meagan: She just kept doing that. And I said, “Okay. We are going to take it one at a time. I don’t want you to think about the next one after this.” It was beautiful and I loved it. I was like, “Yeah. That is Brittany for you.” She was with me. Brittany: Aw, that’s awesome. Meagan: I just love you. I love what you were saying. It doesn’t have to be dramatic. It is hard. Labor can be exhausting. Standing up or moving your whole body over to the other side can just seem daunting and so sometimes we are like, “No. I would rather just stay here,” which isn’t bad. It’s not bad. Brittany: Yeah, absolutely. Right. I mean, it can be something like-- let’s say somebody is in a side-lying position. They could be lying with the peanut ball between their knees and then there are five contractions in that position, and then we take the peanut ball out and they straighten out their top leg. That’s a position change. That makes space in the pelvis. It changes space. It’s not always about creating the space where the baby needs it, although the majority of the time that is what I am thinking about, but it is also just about changing the space in general. Movement is more important than any specific position. So again, when I am telling people if there is something to allow to guide your labor, movement is so important. It doesn’t have to be crazy movement. It doesn’t have to be remembering all of the specific positions to do at different points depending on where the baby is. It can be as simple as remembering to move. It doesn’t have to be only in unmedicated births. That is such a myth that is out there. Once someone gets an epidural, they are limited to lying on their back or lying on their side. There are a million things that you can do in the bed. Pretty much any position you can do standing or on the floor, you can modify in some way to do on the bed. Meagan: Really though, yeah. Brittany: It is really important to recognize that movement is an optimal part of all births. The reason I say that is because movement helps to encourage progress in labor. This is all research-based. Movement helps to encourage progress in labor. Movement helps with comfort in labor. That’s mainly people that are birthing unmedicated. But comfort in labor, progress in labor, and then also, it helps with oxygenation of the baby. It helps to keep everybody healthy and happy. That is a really important part of it too. That’s why movement is something that I really feel like clinical providers can, may, should jump on board with because not only is it about progress in labor and comfort, but it’s also about optimizing outcomes for the laboring person and the baby. I think that’s a really important goal for clinical providers is to make sure the process is safe. When we encourage movement, we give the baby more opportunity to make subtle shifts and changes which allows the umbilical cord to move around more freely and helps to oxygenate the baby. I also love to say this too because I think this is often an overlooked part about the importance of movement, but prenatal education about movement and labor can help support people to be more invested in the process. It gives them something to do as support people. It gives them something they can offer and suggest throughout the process, and it helps support people to feel more useful in labor which is important for them feeling positive about the birth experience. When they are more invested and they feel more positive, then it decreases anxiety and allows for that great hormonal release in labor for the laboring person too. It’s about everyone in the laboring room. Movement is just such an important part. Meagan: It really is. When you talk about prenatally too, I feel the familiarity. If they have been in that position before labor has begun, they are more comfortable trying that position in labor. Julie: It will be something that they go to by default, too. It will be something that they naturally go to. Meagan: Birth workers out there, if you teach this in your prenatal courses or your meetings and things like that-- I don’t know if you realize that there is so much power behind that because it is going to help that couple. It is going to help that birthing couple to be okay and comfortable in trying new things. Closed knee pushing Okay, I am going into the “knees all the way back, spread open-wide in your armpits” thing. We have always seen in all the movies. Literally, where are your knees? When you see someone pushing in Friends or a movie-- I’m thinking of Rachel in Friends. Your feet are up in the sky. Your knees are in your armpits. Your head is trying to touch your belly button. Seriously, this is the position, right? And so, when we are like, “Hey, so I actually need you to close your knees.” They’re like, “What? You want me to do what?” Then their provider is like, “No, no, no, no. We don’t want to do that. Why would we do that?” But there is so much to it. And so, if you can, educate them before, and show them, and teach them. Do the dot trick from lovely Gina who we just love from mamastefit. Do the dot trick and show them in their prenatals. “Look at what your pelvis is doing,” and they are like, “Oh, okay.” So, when you are like, “I want you to put your knees together and your feet out,” they are not thinking we are smoking something. They’re like, “Do you want me to keep my baby in or get my baby out?” You’re like, “Actually, we want you to get your baby out. We are going to help you do that by putting your knees together.” Can we talk a little bit about that too? Maybe segue a little bit into closed knee pushing. Brittany: Yes, that is one of my favorite topics. I actually did a webinar for ICEA for their virtual conference all on closed knee pushing. It was straight up, a half-hour just on closed knee pushing. It was so awesome. Closed knee pushing is when we push with the knees closed. Honestly, it is less about the knees being closed, but more about the internal rotation of the thighs that happens when our knees are closer than our hips. This internal thigh rotation actually pulls out on the hips which opens up space side to side at the bottom of the pelvis, or at the pelvic outlet, which is where the baby is coming out. The way that I love to share this with especially pregnant people is to actually think about late pregnancy. When you are 36, 38, 42 weeks pregnant, you are sitting on your birth ball. Maybe you are sitting on your couch or a chair. You’re sitting with your knees really far apart because that is what feels better. Our bodies are telling us in late pregnancy it feels better to sit with the knees far apart. Internally, what is happening when we sit with our knees far apart is external thigh rotation which opens the top of the pelvis, the inlet of the pelvis, which is what the baby is settling into in the last few weeks, or sometimes the last few days of pregnancy. And so, when we sit in late pregnancy with our knees really wide, not only does it feel better, but also inside, it’s giving the baby space at the top of the pelvis to settle in. Now, if that is working at the end of pregnancy to help the babies settle into the top of the pelvis, why would we do the same position when the baby is at the bottom of the pelvis? It wouldn’t make sense to do the same thing when we are pushing a baby out versus when we are in late pregnancy encouraging baby to descend into the pelvis. So, in late pregnancy, our bodies instinctually get into this wide-legged position. But also what I have found, especially when we have been in situations with really supportive providers, is that instinctually, when people are pushing their babies out, they do bring their knees together or they get into an asymmetrical position. People do not typically-- and this is my experience. People do not typically get into really wide-legged positions when they are pushing their babies out. They bring their needs together. Think about going to the bathroom. The next time you go to the bathroom, you’re sitting on the toilet. Think about how you’re positioning yourself. Probably knees together, maybe a little bit of asymmetry there. You’re just trying to allow that space for your bowel movement to come out. Same thing is happening. Meagan: It might be the easiest poop you ever took. Just saying. Julie: Alright, who is going to play around with new positioning next time she is sitting on the toilet? I don’t know about you. I totally am. Meagan: I’m telling you. Brittany: It is so important to connect this stuff to everyday life and to what our bodies are instinctually doing because when we do that, it restores that confidence. When we feel more confident then, even though every single image we have ever seen of birth in the movies has the knees far apart, even though a provider is like, “Oh, no. You have got to pull those knees far apart,” what we start to realize is from a biomechanical standpoint, pulling the knees apart actually doesn’t make sense. So, we need to tie this stuff into everyday life and into the end of pregnancy so that we start to see, “Oh. Well actually, our bodies know exactly what to do in labor.” We just have to be willing to tap into that and work with that. Closed knee pushing is pretty awesome. It is something that you can do no matter what position you are in, whether you are in a standing position or side-lying position. You can even do it in a reclined position, all fours, and it is really instinctual. Again, going back to what I said earlier about how movement is more important than any specific position, I don’t think that we should be in one closed knee position for three hours. Then, it loses its benefit. But when we incorporate that into the different positions that we adapt to during the pushing part of labor, when we recognize that bringing the knees closer together and internally rotating the thighs creates space at the outlet, then we can put that into our toolbox of positions for pushing. Yeah, so closed knee pushing is all the rage right now. Meagan: It really is. I really have witnessed it for a recent VBAC client of mine. She was pushing great. She was totally pushing great and baby was making good progress. You know how it is natural for them to come back in a little bit and come back out. He stopped coming out further. He would come out, go back in, come out, but never go that one step further. I love this midwife so much. I felt very, very comfortable saying, “Close your knees. Close your knees.” And that baby-- next push, boom. Way further, and then the next push was out. Julie: Holy cow. Meagan: It is just so cool to see. That was easy for me as a provider with someone that I had a good relationship with. I work with this midwife often and I could be like, “Close your knees.” But in a hospital setting with many providers and nurses who are unfamiliar, or even birth centers, or just in general, when we are with providers who are unfamiliar with this technique and the reason behind it, what would you say is a way-- because I would love for us-- obviously what you’re doing. You’re getting out there. You’re in the community. You’re educating. It is only going to spread. But how can we as people and as birth workers try to facilitate this even more in a position where the doctor is like, “Nope. Get those knees opened wide. Butt in the air!” What suggestions or advice would you give? Because as birthing people, we have the right to say, “This isn’t working for me. I want to try this.” But many times, we have a provider say, “Well now, if you really want me to be able to support your perineum and avoid tearing, then you need to be on this back. Or you need to be in this position so I can get to your perineum.” Well, but the thing is, guess what? If I close my knees and open my legs, I am pretty sure you could still get to my perineum if you really wanted to, and I don’t think you need to be up in my perineum. I am just saying here. What would you suggest as birth workers? Julie: Wait. Can we just wait a minute? Hold on. I think we need to make a shirt that says, “Don’t be all up in my perineum.” For real. Meagan: I love that. Brittany: I would wear it. I would wear that shirt. There are so many things that I want to touch on with what you said there. First, I will start with what you last said and then I will go back to the beginning. In terms of preserving the perineum, which I think is probably a goal for most people that are birthing vaginally, what we actually know about perineal tearing, and increasing or decreasing the likelihood of tearing, is that when the thighs are internally rotated, it actually can decrease the likelihood of tearing because the skin, the perineal area, is not stretched side to side. Instead, it’s given the opportunity to stretch more front to back. Although many babies do move into the pelvis posteriorly, most babies do wind up eventually rotating around to come out facing backwards. The crown of their head is right underneath the pubic bone there and they are facing backwards, which means the bigger area of their head is front to back, which means the perineum needs to be able to have more give front to back rather than being stretched side to side. So, when we pull the knees closer together, we actually allow the skin to be stretched less side to side, which gives us the opportunity to stretch more front to back. Closing the knees or internally rotating the thighs helps to decrease the likelihood of tearing as well which is huge for people planning a vaginal birth. Meagan: It really is. Brittany: It really is. Going back to what you said about providers that are maybe not so familiar with the idea or the concept of bringing their knees together for pushing, I think it really comes back to prenatal education. It is not just about educating about the biomechanics, but like you said, it is about educating people about their rights. It’s about educating. If they have a partner or a support person there with them that is not their doula, it’s also important to educate that person because that person is going to become a really big part of the advocacy in the laboring room. So, when people realize they have the right to birth in whatever position that they choose and when they have the information to understand how to create more space within their pelvises-- Julie: --and have a supportive partner or doula that will advocate for them because when you are in the pushing stage, you are not always able to speak for yourself. Brittany: Absolutely. If they have somebody else in their court there as well saying, “No, she is comfortable like this,” or, “No, she is not going to get into that position.” That can really help. It also provides a buffer for that laboring person to stay in the zone which is right where they need to be when they are pushing a baby out. I think prenatal education is a really, really important part of that. Also, this might sound really silly but practice the conversation surrounding informed consent and refusal, and advocacy for your rights. Literally, have practice conversations with partners or with friends about what you would do in that moment. What words are you going to use in that moment? As a birthing person, what words are you going to use in that moment to let your provider know that you are not going to be on your back with your legs hiked far apart, or maybe you’ll be on your back with your legs hiked closer together, or whatever. But practice those conversations ahead of time because it’s much easier when you have the language easily available than it is in the moment to try to come up with that. I think a lot of people in the moment wind up being in a situation mentally when they’re pushing their baby out where if they are faced with being encouraged to do something that does not feel right to them, they have to choose where they’re going to put their energy. Are they going to put their energy into pushing their baby out or are they going to put their energy into debating with a provider about what they want to do? Unfortunately, I think that position puts people in a place where they have to focus on pushing their baby out, so they will do what their provider suggests. This is when partner support or friend support, whoever is there in addition to a doula can absolutely step in and be like, “Actually, she has thought a lot about pushing positions and this is how she would like to be.” If a provider is like, “Well, she is going to tear.” “This is how she would like to be.” Julie: Then let her tear. Let her tear. Brittany: Right. Yeah. I think prenatal education, practicing how you’re going to actually word things-- and that is a partner activity too, not just the person who is giving birth-- and really being willing to stand up and speak up. But then, a huge part of it too, and this is a given, is to find a provider that you can have open conversations with prenatally and you can really either help them figure out what your priorities are or maybe you have a provider already that is open to pushing positions that are not the stranded beetle position. But finding a provider that truly is on the same page with you and respectful of your rights as a laboring person is really important. Meagan: Yes. Yeah. In the birth that I was telling you about, the provider was like, “So, I was really trying to get in there to help you support, but if this is the approach you want to take, I mean, I guess we will just sit here and wait.” Julie: Whoa. Oh my gosh. Meagan: That made the birthing parent feel like, “Okay. Am I doing this wrong?” I just looked at her and winked and said, “You’ve got this. Keep on going.” Sure enough, she did. But, it is so hard. We fall in love with these providers, but we need them to be there for us 110% until the very end. The very end meaning you are done, six weeks postpartum, plus. To the very end. As a birthing professional, I feel like we need to educate prenatally and give questions to these parents so they can find the right provider. Obviously, we can’t go and pick them, but if we can get questions. Don’t be scared as a birthing parent to ask questions and say, “This is how I want to do it. Do you support that?” or “Hey, what have you seen in the past? Have you ever seen this happen?” If they are like, “Oh, no. That would never work.” Well then, maybe you’ve got a provider that is maybe not right for you if that is what you’re wanting to do. Brittany: Right. Julie: It reminds me of the time I had this provider come into the room and we were trying some less traditional methods to get labor to progress on its own. There were flyers up all over the labor and delivery floor. “This provider has delivered 5000 babies.” “5000 babies” all over the floor. You can’t walk outside the door into the bathroom without getting slapped in the face with this celebratory flyer about this provider delivering 5000 babies. She walks in the room and she’s like, “I have delivered 5000 babies and I’ve never seen this work before. I’ve never seen this happen,” and I’m like, “Well.” That was my birth trauma provider and the first literal birth obstetric violence I’ve seen. That was that birth. I’m like, “Well, have you ever seen anyone try this before?” and she’s like, “This is ridiculous. This is not going to work.” I am like, “But 5000 babies, huh?” That’s all I could think in my mind. I feel like it’s easy for providers to get set in their ways and a routine. Ideally, we would like providers to be open and understand that parents can have their intuition and that they can adjust as needed, and they can try different things, but a lot of providers see birth one way and one way only. Whenever anything deviates from that way, it feels uncomfortable for them. I can relate to that. I have really bad anxiety. Ask Meagan. Anytime we try and do something different than we normally do, I’m like, “No, no, no, no, no. We can’t do it that way because we’ve always done it this way,” and Meagan is like, “Well, let’s just go with the flow on this one.” I’m like, “No, no, no, no, no, no, no.” But, you know what? I can see a provider kind of reacting like that too. And so, figuring out how to overcome those things, like you said, prenatally is really, really important especially when we have providers that have been doing things their way for a really, really long time. Brittany: Yeah, and I think exactly like you said, providers have been doing something and seen some things work the majority of the time for potentially a really long time. The training that providers are getting is somewhat limited in terms of the different alternatives that are explored. It’s really easy to very, very strongly believe in the way that you were trained and the way that you have practiced for many years. But, I also think there’s a lot of opportunity to plant little seeds. As a doula, I love to say things like, “Actually, I learned this new technique. Do you think we could give it a try just for maybe a couple of contractions?” And in my experience-- Julie: How does that go? Brittany: Yeah, a couple of contractions-- actually, Meagan was hinting towards this, the five contraction thing. A couple of contractions is usually all that you need in one position. I developed this rule that I call the Blossoming Bellies 5/4/3 Rule and it is literally like a guideline for movement. Change position every five contractions. Choose one of four basic positions and change them up in three different ways. When I say to a provider, “I learned this really cool thing. Do you think we could try it just for a couple of contractions?” Usually, they’re like, “Okay, fine. We will give it a try.” And really, all I want is a couple of contractions because then I would want someone to get into a different position anyway. So, I think planting that seed of change for a provider, and then when they see it work-- that’s when now they are going to put it into the next birth that they go to. But if we don’t stand up, and if we don’t offer, and if we don’t suggest and ask, then we lose that opportunity to plant a seed. Even if that provider is not on board with it in that birth, maybe the next time they hear that they’ll be like, “Oh, this is now the second time I am hearing this. Maybe we should just give it a try.” I have seen that happen with doula colleagues of mine. I have seen things happen where I have suggested something at a birth and there was a hard “no” from the provider and then actually-- a friend of mine who is a doula. We were talking about this birth and she had the same provider there, and that provider suggested that they do the thing that I just suggested a week before that she was like, “No. Absolutely not.” I am not going to take the credit for that, but I do like to think that maybe a little seed was planted. I think there is opportunity for change especially with providers that are really interested in again helping to restore that power back to the laboring person. When we remind providers how beautiful of a thing that can be for someone to come out of their birth just feeling amazing about it, we can help providers to become excited about what they are doing rather than just feel like they are tired, and that they are exhausted, and they’re on call, which is all true, but they’re also really lucky to be part of such an amazing experience like birth. Meagan: Absolutely. I love it. Oh, you give me chills. You make me so happy. You make me happy. Julie: I have a lot of questions, but I’m just going to ask one since we are kind of running short on time. Going back to closed knee pushing, is it closed knee, ankles out? Or does it matter where the ankles are? Brittany: In order for the thighs to internally rotate, generally the ankles have to come out. The knees come closer than the hips and the ankles come wider than the hips. But, there are different degrees of variation. I would even encourage everybody to experiment with this on themselves. You could just sit in a chair, bring your knees together and get a sense as to where your ankles are, then bring your ankles farther apart and you’ll get a sense of how even more deeply internally rotated the thighs are. But, you could also have your feet hip-distance apart, your ankles hip-distance apart, and bring your knees together, and we get internal rotation. So, the knees come in closer than the hips and closer than the ankles, and that is what causes that internal thigh rotation. That’s what pulls on the hips and allows for more space side to side at the outlet of the pelvis. Julie: That’s what I was figuring. I just wanted to double-check because-- and well, now that I am sitting here on my chair-- if you can hear my creaky chair in the background, that’s why. If you move forward and sit on your sitz bones, sitting on the edge, you can feel that even more. Your sitz bones moving around and your pelvis opening and closing as you move your ankles and knees. We can’t really widen your hips on purpose, but you can do those things. You can feel the adjustment just by sitting on your sitz bones. It’s really cool. Brittany: Yeah, absolutely. It’s a couple of centimeters of space change, but when you’re pushing out a baby’s head, you want every bit of space that you can get. Julie: Yes. You need it. I had a midwife tell me once at a home birth-- I am like, “What station is baby at?” Because we know that what we need to do with the pelvis depends on where the baby is and I was like, “Is she zero or plus one?” The midwife was like, “Well, it is really only a 1-centimeter difference.” And I’m like, “Okay, so we are generally mid pelvis, right?” She was like, “Yeah, I would say mid pelvis.” I’m like, “Well, centimeters matter.” Oh my gosh, we should make another shirt. “Centimeters matter.” “Get all up out of my perineum.” But really though, even the smallest amount. That’s why I-- sorry, I am just connecting all the dots right now in my mind. When you’re talking about-- it doesn’t matter what kind of movement, just move. That movement creates those little shifts that help the baby move because the baby is working with your body, and as your body and baby work together, those little minute spaces of movement can make the biggest difference in how the baby descends. Brittany: Yeah, absolutely. Absolutely. Generally, we think of it as pelvic inlet, mid pelvis, and pelvic outlet. Providers can’t always tell exactly what centimeter station the baby is at, but I think it is really important also, especially like you were mentioning in a home birth, that as birth support people, we are able to watch someone laboring, observe someone laboring and recognize where they might be. When you even just said that you said to the midwife, “Is the baby at a zero, or a plus one?” you already knew that baby was at mid pelvis, probably by what you were seeing. Then, we can use that information from an internal exam to further hone in on what positions we may suggest. I hate to overwhelm people too with all these specific positions that are great at certain points. I don’t like to set people up to think that they could do anything “wrong” in labor. I always like to tell people the first level is just recognizing that movement is really important. The next level would be getting comfortable and familiar with different movements that help when the baby is at different stations. But really again, even if that feels like way too much to remember, especially as a partner, or a friend, or something supporting someone labor, just remember movement because even the process of getting out of one position and into another-- it’s just like you said. Creating these incremental space changes that give the baby more wiggle room. Meagan: Absolutely. Julie: We don’t have to over-complicate it, just like you said, because I am the one that would get overwhelmed. Like Meagan said earlier, she did not sit down at all during her pregnancy. I feel like that in some sense was a certain type of overwhelm, right? And so, if you just say, “Hey, just move, and if you are pushing and it’s not going well, try putting your knees together.” Tada! That’s all you’ve got to remember. I feel like those two things alone can make big shifts in a labor that is not progressing as you normally would like to see it progress. Brittany: Yeah, definitely. And remember not to stay in any position for too long. I think that’s another thing. I think too, just along the lines like you were saying, getting overwhelmed with things. Sometimes we also get so set on specific things, like how great the all-fours position is, and the all-fours position is great, but not if you’re in it for three hours. Meagan: Exactly. Brittany: It is so much about remembering that we don’t want to get hung up on one thing. Labor requires so many different variations, and different suggestions, and a lot of intuitive listening to what the body needs if that is possible-- particularly, like again, an unmedicated birth. But then, if somebody is birthing medicated, we can take those same principles or concepts and apply them to medicated birth too. Again, it doesn’t have to be something that is just for unmedicated labors. Meagan: Absolutely. We talked about it a little bit earlier, with an epidural. I have actually had a mom squat her baby, deliver squatting with an epidural. We put a rebozo underneath her thighs to hold her up and give her some support and then gave her a squatting bar. Remember, if you are birthing with an epidural, you really, really are not limited to just side, side, back. You are really not. It might take some effort from your support people, but it is okay. You can do it. Brittany: Yeah. On the other end of the spectrum too, if somebody is birthing without an epidural, side-lying positions can be really awesome for them too, just like they could be for someone with an epidural. I wouldn’t want people to think like, “Well, if I am committed to giving birth without an epidural, I also have to be committed to being upright and in a million different positions.” Upright positions are awesome. I am a big fan of upright positions. But also, sometimes at the end of labor, people need to rest in between pushing contractions. Meagan: Yes. Brittany: We can take some of the things that we do with people who have epidurals and also apply that to people who are birthing without epidurals, but remembering the dynamics piece of it, which is how we allow the body to shift and move so that we can create the space where the baby needs it. 5/4/3 Rule of Movement Meagan: Definitely. So, I know we are running out of time. I have a really quick question for you. I was at a birth one time and the birthing parent kept going to her hands and knees all the time. Her knees were bruised. She would not get off her hands and knees no matter what. Anything we did-- I was like, “Let’s do this. Let’s do that.” She would not get off her hands and knees. The midwife was like, “I don’t know what it is,” and she is a first-time mom. “I don’t know what it is with first-time moms.” She was like, “But I see this pattern.” She was like, “I see that everyone always goes to their hands and knees.” Do you think because this is instinctually what our bodies are telling us to do and our babies are speaking to us and saying, “Hey, mom. You need to get on your hands and knees position to help me come down,” or do you think this is something-- because again, it’s more like the movies where you see people laboring on their hands and knees. Do you feel like hands and knees during the entire course of labor is effective? Even slight movement with hip to hip-- do you feel like it should be more? I don’t know. What do you think about hands and knees all the time? Brittany: That’s a really good question. The first part of your question was, why do I think people tend to assume that position? I think that position, first of all, from an emotional standpoint, you’re focusing on just what is directly in front of you, so it gets rid of all that stimulation that is happening around you. I think it can help people stay in the zone. I also think that it tends to take some pressure off the low back, which most people, even if the baby is not posterior, or there are not tight uterosacral ligaments, people still tend to feel some pressure in their back with contractions. So, that can decrease that pressure. Also, it may, because it is not a direct upright position, it may decrease the intensity of pelvic floor sensation too. So, I think it can be a little bit of a protective position, but it is also a really great position for progress because it still allows for a little bit of gravity. It still opens up space in the pelvis. Although it may be a protective position in terms of allowing someone to manage sensations more easily, I think it’s also a really great progressive position too. But, I think you’ll know my answer to the second part which is, what about people staying in that position the whole time they’re in labor? I would say no. Meagan: Move, yeah. No. Brittany: Move. But here’s the thing. So, let’s say someone loves that position. Well, if they’re getting up to go to the bathroom once every hour, then there is a movement. That’s great. Then they can go back into their all-fours position. But also, if we remember-- and you hinted at this with the swing of the hips. If we remember that there’s a million different positions within that all fours position, that’s really important. For example, when I was talking about the 5/4/3 rule with the four basic positions that I use as my starting points-- there is standing, seated, all fours, and reclined. The three variations that we suggest for those for basic positions are thigh rotation and how we rock the lower back, whether we do sacral nutation or counternutation, iliac nutation or counternutation-- basically like pelvic tilts-- and then also whether we are creating asymmetry. So, if we have this all-fours position, and we cycle through different degrees of variation within those three things-- the thigh rotation, the pelvic tilt in the asymmetry-- we can still stay in all fours, and changeup that position every five contractions, and do a modification of all fours, and then remember to get up once every hour and go to the bathroom. And then, if that’s the position the person wants to stay in, great. But they are not staying in a stagnant all fours the entire time. They are still changing it up, staggering their legs, bringing their knees farther apart, bringing them closer together, elevating one leg up on a yoga block, elevating one leg up more dramatically on a peanut ball, putting your upper body at a 45-degree angle then doing a flat tabletop back, rocking the lower back to do some pelvic tilts. We’ve done all those things for five contractions. It’s definitely time to get up and use the bathroom now, and then you can come back in that position and do it all agai

Julie DeLucca-Collins, the founder and CEO of Go Confidently Coaching, host of the popular Casa De-Confidence podcast and author of the new book, “Confident You.” Julie's been a successful executor for 20 plus years, and recently completed her tenure as Chief Innovation Officer for an academic solutions company based in New York city. Her goal is to help others re-imagine their life. She has extensive experience in business development, strategic planning, staff development, leadership skills, life coaching and a vast history of assisting people in finding success. Her individualized positive approach helps her clients identify and attain their goals. Learn more about Julie. Learn more about The Passionistas Project. Full Transcript: Passionistas: Hi, and welcome to The Passionistas Project Podcast, where we talk with women who are following their passions to inspire you to do the same. We're Amy and Nancy Harrington. And today we're talking with Julie DeLucca-Collins, the founder and CEO of Go Confidently Coaching, host of the popular Casa De-Confidence podcast and author of the new book, “Confident You.” Julie's been a successful executor for 20 plus years, and recently completed her tenure as Chief Innovation Officer for an academic solutions company based in New York city. Her goal is to help others. re-imagine their life. She has extensive experience in business development, strategic planning, staff development, leadership skills, life coaching and a vast history of assisting people in finding success. Her individualized positive approach helps her clients identify and attain their goals. So please welcome to the show, Julie DeLucca-Collins. Thanks. Julie DeLucca-Collins: Thank you ladies. It's so exciting to be joining you again for some amazing conversation. Passionistas: We're so happy to have you here. What's the one thing you're most passionate about? Julie: My most passionate, uh, thing that I can talk about is just becoming a better version of myself because there are so many directions that life can pull us. And I have found that when I am just stagnant and not growing and, and in my growth takes place through a lot of different things, right? But it takes place through anything that I read or my, my trainings, or, but for me, I'm passionate about being the best version of me, because then I can show up better for the people that I love and I can show up better as a wife, as an auntie or as a community leader. And that's, that makes me super passionate. And again, things that make me better also include traveling, which we're not doing. I'm a, I'm an avid traveler. And I miss that a lot and I can't wait because I think what I have gained from being in other places, learning other cultures and meeting people from around the world has definitely changed me. And I'm passionate about that overall. Passionistas: How does that translate into what you do for a living? Julie: It was a, a small transition really, because everything that I am doing now is everything that I've done in my career before, while working for an educational company, I really had to figure out one how to strategize for the organization and grow the organization. And number two, I had to really be able to also learn some things that maybe were a little bit out of my comfort zone. And the organization grew from a small mom and pop to a large organization, a multi-million dollar organization. We expanded to provide services, but I wanted to make sure that everything that we were creating was something that was going to be meaningful to wherever our partners were in education, whether it'd be a school district or a parent or teachers, and in the same way in how that translates right now to what I'm doing is I know that I need to continue to learn right. And strategize, like, how do I, how can I help these women in this group that I'm helping. Through self-love right. Or a lot of women that I'm working with as well are dealing with overwhelm because let's face it. It's a little bit of a, what everyone has been experiencing right now. So it translates in the sense that I have been learning so much more about for myself and growing myself. How, how can I be more peaceful? How can I grow my mindfulness practice? And then translate that into giving those things to the people that I partner or, or work with in my practice. And again, strategizing helping them strategize. I'm really good about you. Tell me what you want to do or what your goals are, or maybe you're not sure how to figure it out. My mind works in such a way like, “Ooh, have you ever thought of?” and then I start to, you know, maybe you could partner with this or this may be an opportunity. This is really a great gift for you. And this is a way to go. And my mind just starts to put pieces together that then I help people work through in the same way that I did in business. Right? “Oh, Pat, how about we offer this service and be able to support principals and maybe training their teachers and yoga or mindfulness or whatever it might be.” Passionistas: Why did you choose a career in education? Julie: For me, it was something that was just a neat. My grandparents who were a big influence in my life were both educators. My grandmother in particular, she was born in 1905 at the turn of the century and she was in El Salvador, but she came from a very affluent home. Her father was a well, very well-regarded engineer. He was very well known in the country and traveled extensively. He came from Spain. He studied in San Francisco as a matter of fact, and created this life from my grandmother of comfort. And as most women in that age, she was encouraged to just follow her passions. She was, she loved to play the piano, but she also wanted to become an educator. She wanted to be a teacher. It was something that she felt passionate about. So my grandfather continued to encourage her to go to school because he wanted to keep her busy and not necessarily go out into the workforce. Cause that was really unseen for someone, um, of my grandmother's background. Eventually my grandmother said, okay, I'm done. I really want to teach. So he built a school for her. So growing up in El Salvador until I was about 10, although we traveled to New York to see my dad's family, I really had this amazing influence in my life in which I saw her as a teacher. I saw her as a community leader or principal. So for me, I started teaching my sisters and my cousins in a very early age. I also, we used to play kingdom with my cousins and my sisters and I was not the queen. I was the prime minister because my grandmother would always say to me that, you know, the prime minister is the one that has the power. So I learned from that early age that I wanted to definitely teach. And it, it comes very naturally to me. However, I also liked the leadership component and that's something I was always told that you better be a leader, not a follower, my grandfather, and the same way he came from a very different background. He was an educator, but he really came from a very poor environment. He was a child out of wedlock and had to fight for everything. His brother wanted him to be a Shoemaker and sent him to the capital city from their small village to learn the trade of being a Shoemaker. But my grandfather wanted more. So everything that he earned in the Shoemaker and shop, he actually saved. So he could put himself through school. And that's what my grandparents met when they were both teachers. And in a, again, I, he went on to teach at night at the university and, and, and at night school, but he also went into business and was an executive in a large company. So I had those two examples. So growing up, I definitely had no choice. I started my career as a teacher, as a preschool teacher. I later on worked with middle school and I loved it, but I also had this sense that there was more in me and there was more so I sort of floated through life in my late twenties. And when I was living in New York, I was hired by a company that sort of took both of my skills in education. And also because I put myself through school, working in retail, my retail business background. And from there, this company does a really great job at just growing people from within training them, building them. And I grew through the company for the next, almost 10 years to the executive level and learned a lot from them. Passionistas: And what was that company? Julie: Huntington Learning Center. So it's, it's a, it's a national tutoring company and the tutoring company itself. It's, I mean, I, I, I do, you know, worked for them and I have great passion for them because I know how well they do what they do. Actually. I just had in Huntington, who is the daughter or the founders on my podcast, it's amazing to see her because when I first met her, she was in elementary school getting ready to go into, into junior high and or middle school rather. And now she is the president of the company cause she's taken over the legacy of her parents. And she's so passionate as well as, as far as education and everything that she does. And it has been a phenomenal journey and reconnecting with her and being able to work together because she, she is a supporter of arts and programs and a philanthropist. So it's amazing to see that, but that company really helped me come into my own in, in meld both of the sides of me, the education part, but also the, the entrepreneur or that business like, and I, and throughout the company, I had the opportunity to really, they were exploring, entering into contracts with school districts. So I helped to develop this brand new line of business for them. And I went from being just the coordinator of the program to grow into the manager, to then, uh, training the national franchisees, to developing a whole strategy for expanding this business side, to partnering with school districts. By the time I left the company, I actually had helped to create over 157 school district contracts, which they didn't have before and get us approved in over 40 States to be a provider of services and partner with them. So it was a great experience and I loved it. And, but I also wanted to move into a different direction as far as not traveling as much. And I wanted to also the woman who the company that I went to was very similar, but she was based in New York. And she was a woman who was passionate about also teaching, but also didn't have the experience and expanding in the business side. So it was a great marriage for me to be able to come in and help her expand her business. Passionistas: And what business was that? Julie: The name of the company is Brienza's Academic Advantage and Mrs. Brienza or Lillian as, uh, every money knew her was a former educator. And she was just an incredible mentors. Another mom, if you, if you would. And, uh, she, she did such an amazing job at just by sheer force and passion starting this, this business out of nothing. And she grew it to also be a multi-million dollar company, but she wanted to really be able to bring other people in. And I had met Lillian doing some advocating in Capitol Hill. As a matter of fact, we had both representing our individual companies. We're talking to lawmakers on education issues and things that mattered when it came to funding and how they should hopefully send some fund to help underprivileged kids. So that's how I met Lillian. And I was with Lillian. I was with her company for over 12 years. The difficulty is Lillian passed away three years ago. So, you know, the, the vision and, and obviously changes in the company came about. And really we scaled a little bit back. And at this point with COVID things really took a, a challenging turn. And for us, it was a mutual path that I started to had been doing some of the stuff that I'm doing now, working with women, leadership programs, coaching and mentoring. And it was a good time for me to, you know, unfortunately they had to let me go. And it was something that I, I, it was a difficult partying, but a mutual, you know, beneficial in the sense that they needed to grow and continue. And obviously it's hard to keep everybody on staff on your programs have been scaled so rapidly. Passionistas: So the good news is that you struck out on your own. It's not always an easy transition. We've there before too. But sometimes it feels like the universe is telling you that you're supposed to be doing something else, whether you think you're ready for it or not. Julie: Oh, Amy. I totally agree. I think that in the last year, and as I was going through my social, emotional learning facilitator training in the yoga teacher certification, which I did in order to, to create programs, to support the schools and districts that we worked with, I really found that I was so passionate about, wow, I really loved working with these women. I really love in this mentoring program. Wow. I'm working with this private client. And I thought, you know what, someday, maybe this is something I can transition to it some day. Maybe this is something that I could do, but of course the fear of, Ooh, how would I do this? And you know, what would that look like? Now? Obviously, if I were coach and myself, I would have been able to lay out a plan and say, this is how you do it. This is how you go about, it's no big deal. You can do it. It does, you know, and it wasn't until I was faced with a choice of, okay, I have to do something. And I thought, well, no time like the present. So here we are. Passionistas: Since you do, do this for a living, you do, do this for other people. And I don't think this is unique to you. Why do you think it's so hard to be that cheerleader for yourself when you can do it for so easily for other people? Julie: Because I think that when we are dealing with other people, it is easier to be able to say, okay, take the leap. It's no big deal, but when you're doing it for yourself, you're also dealing with that imposter syndrome. And you have to really be able to overcome that negative voice that says, Oh, who are you to do that? And who are you to go out and, and, uh, speak at a, at a conference. And who are you to think that you can get this up and running? And there's a lot of evidence that we create for ourselves. And sometimes we need to just be able to look back when you're self-coaching yourself, you have to find that evidence and look at it when you're coaching somebody else, you can show them that evidence, and you can talk about it where it really takes a lot of introspection to be able to find that for yourself. Passionistas: For the people who don't know, describe what a life coach is. Julie: I think that Amy kind of hit it on the head. I'm sort of your cheerleader. I am the person that when you are at a place that needs clarity is able to, out of stepping out of the main picture, be able to say, this is what I'm seeing. This is where you are. And also breathe some belief into you. And an end will be that cheerleader that you need, because sometimes we are. So as women's sport in particular, we're so hard on ourselves. We're so quick to say, I can't do it. Or who am I? Or we get caught up in the minutiae of the, every day that we don't see that there is possibility. And I think that sometimes as well, we need someone to hold our hands through the process, right? Because like, for me, yes, I had to do a lot of self-coaching, but I will tell you that the process of jumping onto my own really was also possible because I have a very supportive husband who he would say, well, what would you say to a client if you're a coaching them? So he really reminded me. So he in essence became a little bit of a coach for me. And that's what happens. And that's what a coach does for you. A coach is not going to be a therapist, is not someone who's gonna, you know, revisit your past the past. When you're coming, when you're doing life, coaching defines you, it creates some habits and the coach will help identify what are the habits that don't serve you. And really for me, with cognitive behavioral techniques is really being able to use the mind and some of the mindset that it takes to be able to re shift your brain and create some of the new thought process that will help you go after what you're looking to do and could be accountability. A life coach also provides us very important. Passionistas: We're Amy and Nancy Harrington, and you're listening to The Passionistas Project Podcast and our interview with Julie DeLucca-Collins. To learn more about her one-on-one coaching, the Casa De-Confidence podcast and her new book, “Confident You” visit GoConfidentlyCoaching.com. Now here's more of our interview with Julie. Are there some tips you can give people if they're feeling stuck? Julie: One of the things that I want people to see is especially like, Oh, I'm so down. I'm so depressed. You are not the feeling. And foremost a feeling does not define who you are, what defines who you are, is a lot of other things. The first and most important thing that you should do is if you're feeling sad is we sometimes try to push all of that away. Or if we are angry at someone, uh, again, that inner critic will say, Oh, you're not a good wife. If you're going to yell at your husband, right. Uh, it's not true. What happens is all of our emotions are really driven by what we're thinking. Most importantly. So for instance, if I trip over my husband's size 15 shoes, then maybe he perhaps left where he shouldn't have. And my first reaction is going to be to snap and be angry. And if he's not there, like be really annoyed, like, Oh, so sloppy. Why would he leave his shoes here? And I can't believe he did this. Right? And then all of these thoughts that I'm beginning to think of what he did, then create that feeling of anger or annoyance or whatever. Once we have a feeling and for most of us, we feel a lot of different things. And we also have over 60 to 80,000 thoughts a day, that's a human nature. And what happens is we don't realize what our thoughts are. And we more importantly begin to experience these feelings. And then two things happen. One they're the people who actually act on a feeling in that action, right? So if he comes in the door and I'm feeling really annoyed at his shoes being there and me tripping over them, the first thing I'm going to do when he comes in the door, it's going to snap at him and that's going to also, you know, generate a reaction from him, or I can choose to like, well fine, I'll put these away. And then I'll be angry. And I'll stuff, these feelings inside. And I, when he comes home, I'm that, you know, inaction is also an action. And that is also going to have a result on what we're doing. So your thoughts will generate your feelings, your feelings generate an action, and then your actions typically create a result in your life. So if I'm thinking my husband's a slob and my, my action was to snap at him and he just drops his, uh, drops his jacket on the ground. And I puffs over Mike, it's going to start to prove that, right? And I think that for us, really being able to feel and be more aware, you can't go from feeling, you know, things. And then all of a sudden switching them off, like you, you would have switch. You really have to one become really aware and really start to recognize what are the things that you're feeling and really not try to push them away, not try to change them, but really become more understanding of what is going on because we live our lives in this autopilot. We live our life. A lot of our feelings becomes a white noise of sorts that we don't pay attention to. And what we need to do is once we identify what we are feeling, and then we can start to explore, what am I thinking that is making me feel this way? What is that thought? And then we have to start to really evaluate, is that true? So for instance, with me losing my job and at first, uh, not thinking that I could go out on my own, I really had to say, wow, are you really incapable? Are you really not able to? How is that thought true or not? And proving that belief becomes something that if you start to shift what you're thinking, then you're feeling a little more confident. So for me, wait a minute. I know how to, I know how to do marketing. I know how to coach someone. I know how to working with a business person, show them how to create a business plan, help. I know I have these skills. So as I started to see that, then what started to happen is my feelings like, Oh, wait a minute. I can do this. And then the more that you feel that you can do this and your actions begin to sort of resonate and become in line with what you want your result to me, here's what I usually start my sessions with. And if you had told me 20 years ago that I would be this person, and I still don't think I am in a way, because I think I'm a little too New York times for people, but some people would call me a little woo, woo. Right. Because when I start a session with a client, the first thing is, yes. Hey, how was your week? Let's, let's talk about that. But I stop. And I say, okay, let's take a deep breath and come into this moment because we go through life, just, you know, jumping from moment to moment from meeting to meeting from, or from lunch to, okay, let me check email or here and that instant thing. Right. Whereas we need to really be able to regroup. We really need to be able to take a moment. For instance, I found myself, uh, Tuesday and I, I really did not want this to happen, but I found myself feeling a little anxious. And I started to do some of the things that I typically do when I, when I, when I'm anxious, right. I started to clean incessantly and I, then I thought, Oh, maybe I'm going to have some wine and then just kind of relax and take the edge off. Right. And then I thought, no, I, I do, I did plan to have a glass of wine tonight, but really I'm working on being a little healthier and dropping my COVID-19 pounds that I gained. And I, I, um, I decided, okay, I need to finish my water. That was my goal for today. And really like, as, as I was drinking my water, I started to feel that anxiousness. Right. And I started to feel my heart and I thought, okay, what does that anxiousness feel like? Where is it in your body? And really taking a moment to relax in the same way with a client when they start. And they come in, I want to make us aware, how are you feeling? Let's be in this moment, let's take a deep breath and kind of resetting our nervous system. And that's been something that's very important. Passionistas: What do you think is the most common obstacle that people have that prevents them from achieving their goals? Julie: I hate to break it down to this, but having worked with both male and female clients, I can tell you that the obstacles are different from male and female. For most females. One of the biggest obstacles that we have is that we tend to want to do it all. And then we give ourselves a real hard time when we don't do it all. We want to keep all these balls in the air. And as we're juggling all these balls, we also think we're terrible at it. So that, that, uh, Oh, I just know, you know, I just, I'm a terrible mother or I'm a terrible wife. And, but really did you give yourself credit for the volunteering job that you were doing or for the little distance learning that you were working on or the project that you did at work? Or did you also give yourself credit for the house that is clean? And here's what I tell my clients typically, uh, to overcome some of these obstacles as one, you really have to be able to prioritize. You really have to be able to understand one. If you're looking to accomplish something, you need to identify what that is. Number one, I think that all of us have an idea like, Oh, I want to retire rich someday. That's not specific. Right? You have to really be able to figure out what do you want, why you want it as well, because everybody wants to have money and retire and be, you know, safe. But you know, is it because you want to spend more time with your spouse or is it because you want to provide for your children, whatever it is, identify what your why, and what's pushing you because when you don't feel like doing something, understanding the reason behind your goal is gonna give you that ability and motivation to move forward. And I think that that's the first thing for women. And the other thing too, is prioritizing and realizing, okay, when you say yes to one thing, you're going to say no to something else. And really being able to evaluate if these are my goals, this is where I'm going. What are the actions daily, weekly, monthly, and maybe even yearly that are going to take me there and identifying all of that. And that's really the process with our clients now with males, uh, they don't, they don't necessarily have the same obstacles in the sense that, you know, they, they do juggle stuff. I won't give you that in, but they don't feel like, Oh, I'm a terrible person for not doing it. All right. So I go, okay, well, I gotta do this. I gotta do that. But for them, it's being more again, reverse engineering the process for them. And, and I think that with males, a lot of times they don't explore their, their why at times, or they don't create a realistic plan for themselves. And they allow themselves to get sidetracked. At least that's been my experience so far with them, with, with my clients. Passionistas: Tell us about your podcast and what inspired you to start that? Julie: I always knew I wanted a podcast. I, a podcast listener and I thought, well, what would it talk about? And then when I worked for my company, I thought, Oh, we should do a podcast on education, but I couldn't get anybody on board. So when COVID hit and we went into lockdown, I guess, March. And, um, and then I got laid off two weeks later. It really like, I, my husband really, he cause he's really the brains here. Sometimes he realized that it was going to be a little challenging for him. He has a wife who had lost her job, who is really a high level achiever, who is, you know, also an extrovert who loves to be socially involved in different things. Um, I was turning 50 in April and I had planned a big birthday party. And as the days continue to come, the likelihood of me having this 50th birthday party was looking very slim. So he decided that he was going to buy podcast equipment as a birthday gifts. So when the equipment he came, he's like, I got you this great birthday gift. And I opened it. I'm like, what is this? He's like his podcast equipment. So you can start a podcast. And then I thought, okay, what would I do a podcast about it? And then I thought, huh, wait a minute. I definitely can do a podcast. Yeah. And it just, and I know for me, when I travel, for instance, one of the things that I love is connecting with people. And I have met some amazing, especially women who are not necessarily on Instagram with millions of followers, but in their life, they have some amazing stories and they have faced fear and they have like most of us have faced fear here and there kind of push through those discomfort feelings and gone and achieved some of the things that we love or have maybe failed terribly and have learned great lessons from it. And I wanted to create and bring stories of these every day in some, you know, I have some great women that have come on board that have large platforms too, but I wanted to gave the stories of voice and Casa and the confidence, our house, my mom, DeLucca-Collins. My husband has Collins and we have always joked that our houses, Casa, the Collins. So when it came to, it came to, um, naming the podcast cast, the confidence just seemed like it was a natural transition. My coaching practice is called Go Confidently Coaching because the Henry David Thoreau quote, has been my life code forever as a quote that my dad told me early on in my life. And I have driven, I have every time that I think I needed some bravery, I go back and I use that as a mantra in my life. So Casa, the confidence was an, uh, AC transition. And again, I aim to bring these stories and I've had friends who are doing amazing things. I have also, you know, for instance, and Huntington, who we talked about, who I saw as a young girl in blossom into now the president of a multi-million dollar national company on. So it's great to have them. I just had also someone who I, uh, I was a colleague as well. She was running for school board and she has grown into someone who at first sort of questioned where she was going. And, you know, she was sort of growing into her own and now is a COO of a, of a company that works with people with disabilities and she is running for school board. She's a great mom. And then she talked about juggling her, her life. Right. And, and what it was like to deal with infertility as well. So yeah, I try to mix it up and have people of all walks of life. The podcast is Dan and I, my husband and I, we do the intro and we chat up a little bit and the Altro and people people know is, you know, they, they tend to give us a lot of feedback on how funny we are. And I said, well, we're not trying to be funny. We're just being us. So that's, that's also one of my favorite parts of the podcast is having him be my co-host. One of the biggest things that I learned about myself, and I don't know if anybody is familiar with a disc personality profile, but, uh, there there's two tendencies in the disc profilers for, but I am, uh, to most, and, and most people tend to have one, uh, very high in another one second, but mine are tie one. So the disc is dominant in, um, the eye is influential and those are my two personalities. And I, I have learned that the dominant person in me, the bossy lady in me is also the extrovert friend, fun girl in me in those two sides tend to fight a lot as to who's in charge. And that, that definitely, I am great at seeing a big picture and just, uh, saying, okay, this is the big picture. And now the, the extrovert in me is like, Ooh, shiny, let me move on to the next thing. So what I've learned is that the other two personalities, which are the supportive and, and, and the, really the, the other part is the C, which is really just compliant, but also very detail oriented. I realized that we may have parts of our personalities are prone to certain things, but we also take need to take a look at our less dominant parts and work on those because all of these parts work together to make us a better person. So that's one of the biggest things that I've learned. And, you know, it's interesting because I, I tend to have my clients take disc, but in our initial conversation, I'm pretty good about figuring out where their personality lies. And we really use some of the tendencies. You know, for instance, I have a client who is very shy, but she's also a very, um, a very, a people person too. So she has to fight her tendencies to be friendly, but also push past the fear of, you know, out of her comfort zone to talk about her business or talk about, or stand up for herself or really create some boundaries. So it, it's interesting. Passionistas: Tell us about your new book. Julie: I wrote this book a long time ago, and it's about my grandparents. It's a story of my grandparents and I, I don't know how it had happened, but I started speaking to somebody about my love for writing. And they said, Oh, what do you, do you ever think of doing a book? And I said, well, I know someday. I always said I was going to write a book. And I said, I wrote one, but I never really, you know, it's not something that I've ever focused on. Then we got into a different conversation about me traveling to Spain and doing the Camino de Santiago. And I said, you can read my experiences. I'll send you that blog. Cause I kept the blog. So I sent him that and then he came back and he said, you're an amazing writer. You really should talk to my friend who is literary agent and so on and so forth. I'm like, what? Anyhow. So long story short, the literary agent and this person helped me put together a book proposal. And then I met someone who has a small publishing firm and is helping me put together this book. And I've been working to what I wrote originally was a story of my grandparents and a story of their life and how they have influenced me. But it's sort of evolved into something more of, especially with a podcast. I get to meet so many amazing women. And I think that there is an overarching theme, right? I may not have grown up in, in, in new England like you did, right. I may not live in California now, but there are some universal themes that we all have when it comes to confidence. When it comes to managing our fears and in the book talks about law, these lessons, and how to be able to one, you cannot have confidence if you don't have that peaceful, if you are not a peaceful person, if you are not in connection and being aware of what you're feeling and thinking in, in how you're reacting, right? And the second thing is that once you begin to have more peace, then you can become more of a purposeful person and really be able to connect to where am I going and why am I here? And how am I doing that? And once you begin to focus on what your purpose is, then you become a stronger person and you begin to, um, and I think that strength comes not only from intellect or what, you know, but also from physicality and being able to be in the best shape, whether you're feeding your body, the right foods or whether, and sometimes as women, we are so lacking in confidence when it comes to our self image and loving our bodies and loving what we see in the mirror that is very important to gain that power for ourselves, through what we are eating and how we nourish and what we, how we move our bodies as well. And once we have all of that kind of put together, then my next pillar to, to that confidence is, is something that you guys probably relate to and that's passion, right? So begin to really live in your passion and begin to really go after the things that you love, knowing that you have the strength to do it, knowing that you have direction through your purpose and that you have the ability to really center yourself. And last night lists, at least as we find the prosperity that we want for our lives, and it's not necessarily money, but is being grateful and being filled with the right things. Then, you know, at the end of the day, when you're sitting at home and you're getting ready to close your eyes at night, you just feel like my life is good. And that's what prosperity is. And knowing that you may not be living in a million dollar house, or maybe you are, but it is not the house or the material, things that make you, but it's really what's on the inside. Passionistas: What advice would you give to a woman who wants to follow her passion? Julie: Find someone who is going to be your advocate, your cheerleader, your partner, who is going to laugh with you, who is going to cry with you and who is going to also give you the tough love and, and remind you how great you are and show you in the mirror and say, listen, stop putting yourself down. And you can do this. And even if, if you can't believe in yourself, find the person that can believe in you. And one of my guests and friends, Valerie, she has a one woman show. She is in LA and she talked about believing mirrors. And I think that we need to be believing mirrors for each other. And for the woman who can believe that she can find someone that will reflect the greatness in you. Passionistas: Thanks for listening to The Passionistas Project Podcast and our interview with Julie DeLucca-Collins To learn more about her one-on-one coaching, the Casa De-Confidence podcast and her new book, “Confident You” visit GoConfidentlyCoaching.com. Now here's more of our interview with Julie. Please visit the ThePassionistasProjectPodcast.com to learn more about our podcast and subscription box filled with products made by women-owned businesses and female artisans to inspire you to follow your passion. Sign up for our mailing list, to get 10% off your first purchase. And be sure to subscribe to the passionate justice project podcast. So you don't miss any of our upcoming inspiring guests until next time stay well and stay passionate.

With her first baby, Brittany knew she needed a home birth. She took no shortcuts to ensure that her dream would come true. From hiring the most supportive midwife and doula to routine chiropractic care to practicing HypnoBirthing to blowing up the birth tub and hanging birth affirmations, the level of preparation (especially as a first-time mom!) was truly impressive. Yet in a matter of hours, Brittany’s years of planning turned from a powerful home birth into a heartbreaking Cesarean and traumatic hospital experience. Brittany shares valuable lessons learned, how she found healing, and her beautifully triumphant HBAC story which was redemptive in every way. Today’s topics include: - How to handle insensitive comments - Breech presentation - Relinquishing control - Postpartum grief and healing - Gratitude and perspective - Mother-baby bonding in a Cesarean versus a vaginal birth Additional links How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) The VBAC Link Facebook page ( https://www.facebook.com/thevbaclink/ ) Episode sponsor This episode is sponsored by our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and Julie have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head over to thevbaclink.com ( http://www.thevbaclink.com/ ) to find out more and sign up today. Sponsorship inquiries Interested in sponsoring a The VBAC Link podcast? Find out more information here at advertisecast.com/TheVBACLink ( https://www.advertisecast.com/TheVBACLink ) or email us at info@thevbaclink.com Full transcript Note: All transcripts are edited to eliminate false starts and filler words. Meagan: Hello, hello. It is The VBAC Link. You are going to be hearing an amazing story today from our friend Brittany. We are so excited to hear from her. She had a C-section and then a VBAC. She is from Florida. She is actually a hairstylist and she does it all day. We were just talking about her bio, how cute it is. She says, “Hairstyle by day and mama by night.” We totally get that because that’s how we roll. We are podcasters by day. Julie: Podcaster by day. Podcaster by night. Doula by day. Doula by night. Meagan: Right? Oh my gosh. It’s a crazy life that we all live. But man, we are so excited to hear her story. We do have a Review of the Week. So before we get into it, I want to turn the time over to Julie to read that review, and then we will get right into Brittany’s story. Review of the Week Julie: I am super excited. Brittany, I feel like we could be friends, just from the short time that we have been talking to you before we were recording. Meagan, we have a lot of people we need to go visit, I think, from our podcast. The VBAC Link world tour. Alright, let’s see. Today we have a review from JessieMarie3 from Apple Podcasts ( https://podcasts.apple.com/us/podcast/the-vbac-link/id1394742573 ) and the title is “So Inspirational.” She says, “I don’t even remember how I came across this podcast, but I am so glad I did. The birth of my daughter ended in an unplanned C-section and was very traumatic for me. I’m currently working with a therapist because I think about it every single day and have so many regrets. I asked my doctor about a VBAC almost immediately because I just knew something was missing, if that makes any sense. This podcast makes me feel so empowered and prepared for my VBAC, and I’m not even pregnant again yet. I tear up a little bit with each birth story and hope I can share my VBAC story on your podcast someday, whenever it happens!” Oh, that makes me so happy. I love it when people find us before they are even pregnant again. After their C-section, they just know they want a VBAC. I love that so much. It gives me major warm and fuzzies. If you haven’t had a chance, we would absolutely love for you to leave a review of the podcast. We show up on Google ( https://www.google.com/search?aqs=chrome..69i57j46i39i175i199j0l2j69i60l2.2368j0j9&ie=UTF-8&oq=the+vbac+link&q=the+vbac+link&sourceid=chrome ). You can leave a review on Apple Podcasts and you can always on Facebook ( https://www.facebook.com/thevbaclink/ ). We haven’t gotten Facebook reviews in a little while. It’s been a little while. Meagan: It has been. Julie: We’ve seen lots from Apple Podcasts and a few from Google. If you are hanging out with us on Facebook, go ahead and give us a five-star rating over there. It would make our day. Episode sponsor Julie: Do you want a VBAC but don’t know where to start? It’s easy to feel like we need to figure it all out on our own. That’s what we used to do, and it was the loneliest and most ineffective thing we have ever done. That’s why Meagan and I created our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) , which you can find at thevbaclink.com ( http://thevbaclink.com/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and I have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head on over to thevbaclink.com ( http://thevbaclink.com/ ) to find out more and sign up today. That’s thevbaclink.com ( http://thevbaclink.com/ ). See you there. Brittany’s story Meagan: Okay, Ms. Brittany. We are so, so, so excited to hear your story. Like Julie said in the beginning, just chatting with you, I feel like we are friends. Instant friends. I can’t wait to get to dive in and be even more intimate with your amazing story. Brittany: Well truly, you are my friends. I’m so thankful, thankful, thankful for you guys. There are not enough words to say what having like-minded people can do for you when you are going into something that a lot of people don’t agree with. With a VBAC specifically, that was huge for me. Huge. I held onto our time together. I would walk-- I have a pier. I live in a little beach town is what we call it. It’s beautiful, but there is this pier that is actually on the river. It’s one long strip of concrete. I would just walk back and forth, on that strip of concrete. I’d drop my son off at school, and just walk and listen to other people, and you guys. I mean, you guys just being the heart of it and encouraging, but also other mamas-- many souls out there that had done this journey already. It was so encouraging. It was where I needed to be. It was like a refuel for me because, like I said, I am a hairstylist. I talk to women all day long. We talk in my salon. We friends. They would say to me, “I don’t know. It just makes me nervous.” I wasn’t out to argue, but it was nice to have numbers, facts, and things that I could say, “Well actually,” or, “It’s not quite what you think it is. Did you know?” Meagan: You were educating. You were educating out there. Yes. Brittany: Yes, totally. But I also understand that when you love people, you are concerned for their well-being. People don’t know what they don’t know. I think with my first pregnancy, I learned that everyone has their own opinion and that’s okay, but you don’t have to value it all. You do need to find people you align with and let that feed you. This show was so great because it fed me and was able to keep me focused, encouraged, and on track. I would go into my appointments and I’d be like, “Alright Angie. I’ve got questions.” I would list them out and they would be from the episodes. She would be like, “I love this.” I went into my labor and delivery like, I trust it all because I know any questions that I have. I wouldn’t have known to even ask them had I not have listened. So, thank you. Julie: I love that. Do you know what? I am going to make a word image to post on our social media account with something that you said a few sentences back. You said something to the effect of, everyone has their own views on pregnancy and birth. Everybody loves you. They want the best for you, but you have to find people that align with your views and beliefs about birth to support you and keep close. I just really love that effect. That really spoke to my heart. Because it’s true. People just want the best for you and they don’t know what they don’t know. They want your health, and your safety, and your happiness, but sometimes they just aren’t up to date on the facts. You need to find people that will either get on the same page as you and support you, or that already are on the same page as you that you can hold closer as you prepare for your birth. So, I’m glad you said that. Thank you so much for that. Brittany: It’s all good. Okay. Well, my first child is Nash. He is three years old, just turned three. That pregnancy was an easy pregnancy. There really wasn’t anything big that happened. It was everything “normal”, which is a wide array of things. But it was nothing, no big deal. I wanted to have a home birth for probably six years before I ever got pregnant. My husband and I watched that Ricki Lake documentary, “The Business of Being Born.” Meagan: I was going to say “The Business of Being Born.” Brittany: Yep. From that moment on, I was like, “Yup. Oh, that’s for me. That’s totally for me.” I already have my own fear of hospitals and doctors. Honestly, there is a lot of anxiety associated with a hospital to me. So I knew if birth is mental, that’s probably not going to be good for me. I started seeing my midwife years before I ever got pregnant for my annuals and things. I had developed such a great relationship with her. My pregnancy with Nash was just the next step of our relationship, which was awesome. She became a sister to me, truly. I describe my relationship with my midwives because there were actually two of them, and my doula, who was amazing. Doulas are super underrated. She was amazing. They all became sisters to me. Through that, I went into it like, “Alright. I am going to do this home birth.” I never even once considered a C-section. I didn’t even go to the hospital. I knew that if I had to be emergency transferred where I would go, but I had no idea what the hospital even looked like in the labor and delivery unit. Fast forward to being 40.4 weeks pregnant. I went in for my regular appointment and she’s like, “How are you feeling?” I am like, “Good. Last night I had a big cramp. I thought for sure I was starting labor, but nothing ever happened.” She’s like, “Okay. Anything since?” I’m like, “No.” She’s like, “Okay. Let’s check you.” She went in. She did the doppler and then she’s like, “Do you want me to do a membrane sweep since you’re overdue?” I’m like, “Yeah. That would be good. I’m ready.” She goes in and she’s like, “Let’s pull out the ultrasound machine and just check on how he’s doing.” I had never even seen this little ultrasound machine. I didn’t even know she had it. She pulled it. At this point still, I’m clueless as to what could possibly be happening. I just thought that this was what’s next. She is a very calm, cool, collected person. She’s like, “Alright.” She’s got the wand up at the top of my belly. She’s like, “There’s his head.” I’m like, “Hi baby boy.” Like, totally not even paying attention. She’s like, “And here are his feet.” She’s showing me down. I’m like, still. Finally, she looks at me and she’s like, “You have a breech baby. We need to get you in for an ultrasound at the radiology place in town today to see what kind of breech he is.” To be totally honest with you guys, my memory of what she said in the rest of that appointment is like Charlie Brown’s teacher, “Wah, wah, wah, wah, wah.” I fogged out. It was just like, “Wait, what? What does that mean?” She did sit me down and she called for her office person to make the appointment. At that time, she sat me down and she went over all of the different breech positions and talked about how some of them are safe to do vaginally, and she does feel comfortable doing breech home deliveries. She does it all the time, actually. But, we have to know what kind of breech it is in order to decide whether it’s safe or not. That’s why I had to go get this ultrasound. I was alone at that appointment. My husband had gone to the other previous months of appointments just because it was getting more serious. This one he had to work, of course, and so at that point it was like I was in a fog. I drove to get the ultrasound. While I was driving there, I’m crying, but also just like, “I don’t even know what to think right now.” When I got to the ultrasound place, my midwife-- I love her so much. She called me. She’s like, “I just want to sit with you on the phone while you wait. I just want to talk with you. How are you feeling? What’s going on? What’s Vinny doing? Is he going to be able to--” She was a friend. She took her midwife hat off for a minute and was that sister to me. Oh, I could cry. Because it’s the little things in my journey of home birth and midwifery. It means the most. Man. Julie: That’s amazing. That’s really, really cool. Brittany: Yeah. So, I went in. I had only had two ultrasounds prior to that. This one was the longest one and the tech just seem to be irritated, I would say. Not with me, but just like, “Ugh.” She couldn’t get the picture. Finally, she was just like, “I am going to submit this to our radiologist, or our ultrasound whatever-that-doctor-is. I’m going to submit it to him. They will get it back to your midwife probably before the day is over.” Actually when I left her office, originally she was like, “You go there and I am going to call Jen,” who is my chiropractor that I saw throughout my pregnancy, who specialized in pregnancy chiro care, which is so cool. She’s like, “I am going to call her and set up an appointment with her for immediately after your ultrasound, so you can get the Webster technique going in hopes that maybe we can flip this baby.” I forgot to add this. The night before that appointment, we determined he had flipped because he was head down a week prior. So that feeling of pain, of labor-- that’s when it happened. She’s like, “I don’t know. It’s so late in the game, but he did just flip last night. So maybe he could flip again, you know?” And so, I went straight to the chiro after that. I called my doula, cried to her, and she was just an ear. Just an empathetic, understanding ear. Got the chiro care, which was great. It’s crazy. I was marching up and down, my knees to chest basically for 90 seconds. She’s like, “This is the hardest part.” Then I’d turn and she would invert me. I’d lay on my back and she put a cold pack on the top of my tummy, and then a warm pack at the bottom. I’d lay there for-- I don’t even know how long. However much time, and then I’d get up and she’d adjust me. Then I’d do the whole thing over again, knees to shoulders. She’s like, “You’re going to go home. You’re going to do this in the tub tonight. You’re going to take a warm bath, keep the top of your belly out, and put a cold thing of peas on top of your belly so that hopefully, it will make him want to turn and flip. You’re going to lay inverted. You’re going to come back tomorrow. We’re going to do this again until he flips, basically.” The whole thing was like, “We can do this,” because I had been seeing her the whole pregnancy. I had my team. I got home that night. Angie called me on the way home. She said, “Call me when you get home with Vinny. I want to talk to both of you.” We got home. We sat around the kitchen table and she’s like, “Here’s the thing. He is frank breech. Your fluid level is a 2 and a healthy level is a 15. The low side would be 10. He has basically no amniotic fluid in there anymore. It’s no longer safe to do a home birth. If you want to do a natural birth, you can try a teaching hospital, which is here and here, which is-- both of them are an hour and a half away.” She’s like, “But that’s still not guaranteeing that they’re even going to let you have a natural birth. They will induce you right away. They’re going to watch you like a hawk, basically. If anything goes slightly awry, they’re going to intervene. It’s up to you. Intervening means a C-section. It’s totally up to you. I will be with you whatever you choose to do. But this has to happen tomorrow. You can have a good night’s sleep tonight. Pack your bags. But we have to decide. We have to do this tomorrow.” I literally felt my world fell apart. It was just like, “What?” Still, I don’t think that at that point I had processed that I was losing my home birth. With my birth affirmations already hung and my birth tub up. I’m packing my hospital bags crying, calling family, who say things like, “Oh, hon. I’m so sorry. But at least you know the baby’s going to be safe.” And the “at least”-- I get it. I understand you want to offer some form of hope, or help, or condolence to someone struggling, but it stung me every time because it was like, “There is no at least. I am losing something. I am losing something huge. None of you understand because none of you would want this and that’s okay, but it’s something that I have dreamt of for years. And I’m losing it in a matter of what felt like a few seconds of time.” Julie: Well, and the hard thing is with that, when people say, “At least,” it completely discredits everything that you’re feeling right now. It completely discredits it. Meagan: It weakens, yeah. Julie: It pushes it aside and it takes the focus off of what you are feeling and going through in the moment. Brittany: Yeah. Totally. Totally. Okay, so, I am packed. My husband was-- honestly, God used all of this because it was an area of bonding for us to go through something like this together. He was able to be there for me in a way that I hadn’t really needed him before. I mean, I truly was falling apart. Actually, my midwife was like, “Listen. I think you should have a glass of wine tonight so you sleep well and you can just chill out.” I’m like, “Alright.” So, I did. I had, maybe, a large glass of wine because I was a mess. That night, when I woke up to go to the bathroom, I couldn’t feel him moving. I add the wine in there because I’m pretty sure he was just very sleepy. We jumped up and ran to the hospital, of course. We called Angie and she was like, “Alright. Let’s go to the hospital. I’ll meet you there.” Now, we chose the hospital 45 minutes away because they have a NICU. So we were driving there, and that whole drive was one of just-- it’s surreal. We were both so in shock of like, “Oh my gosh. We are rushing to the hospital right now out of nowhere and there is nobody on the road.” We are trying to-- well, I say we. My husband. I was in prayer and just like, “God please keep my baby safe,” and practicing my deep breaths. He was driving as safely as possible but also pedal to the metal. We’ve got to get there. It was this weird feeling of like-- this is a drive I never wanted to make. Period. But I can’t get there fast enough. Oh, man. So we got there and immediately as we pulled into the parking lot, my son started kicking and moving around. I’m like, “Ugh. You little turkey. This is how it’s going to be.” And it is. We got up to the L&D and they got him strapped on. Everything was fine. Totally fine, which we could take a sigh of relief, but my midwife got there maybe five minutes later. That’s when they’re asking for paperwork and she really dealt with them. She showed up like our advocate essentially, is what it felt like. She called before we came and they were ready for us. They start speaking hospital talk, and honestly-- because like I said, I’m still in the state of shock from the night before, from waking up and him not moving. It’s just like, “What is going on? This is not the world that I dreamed of at all.” And not just that, but I don’t even know what to think because I was fully unprepared for this. I didn’t even let my mind go to the idea of what a C-section would look like. I begged every single nurse and every single doctor. I say every single because there were at least probably six nurses in and out of my room and three different doctors. Well, the anesthesiologist and his tech or-- I don’t think he’s a tech. I think he’s another doctor. And then the surgeon. I begged them plus the whole staff to please, please, please let my midwife come back in the room with me because I was so stressed out. Not even stressed, it was like a panic attack on the horizon. I was just a bottle of nerves. All of them said, “It’s up to the doctor. It’s up to the doctor. I don’t care. It’s up to the doctor.” The final person to come in was, of course, the doctor. And he-- I don’t know this guy from Adam. He’s literally just the guy that was on call for the day. So he’s talking to me like I am Jane Doe. There is no connection whatsoever. “This is what’s going to happen. Do you have any questions?” I was trying to be the nicest patient, but also please honor this wish of mine. “Please,” I said. “She was the person that was supposed to be there. I have had my whole pregnancy with her and she is my comfort zone. Would you please let her just come? She was a labor and delivery nurse for years.” I said that. This what she did before she was a midwife. He said, “It’s up to you, but you can only have one person back there.” I’m like, “Okay, well obviously it’s my husband. You know?” Julie: Whoa. Come on. I mean, come on. We see that all the time though. Especially right now with coronavirus. There have been so many things. I’m sorry you didn’t get to have that support. That’s not okay. Brittany: My husband was also very stressed out. This was not his plan either. Like I said, it all bonds you. We went through it together, but man. It would have been helpful to have her there and to just be able to squeeze her hand and know that she’s got my back. The whole time I felt like, “I can do this. Angie’s got my back.” And then I felt like I was (inaudible). So I got into the OR and that’s when the panic attack came. First, it was-- I’m practicing my HypnoBirthing, which, I’m so glad I did that during my pregnancy because even though I didn’t use it for labor, it is what got me to the place where I could talk myself off the ledge because I felt like they were going to have to— I had to tell myself, “Brittany, keep it together because they are going to put you under because you are going to lose it.” I had that anxiety. It rose up within me. I’m scared and sad and all of the feelings at one time. This is when I am alone in the room and they are doing the spinal because my husband can’t be there, obviously. The nurses were-- it was so sterile. I say they were insensitive because they weren’t trying to be. They were trying to help, but I’ve got tears running down my face. I’m deep breathing and she’s just like, “Oh, honey. Don’t stress out. This is the easy way out. You don’t even have to do the labor and delivery part.” Meagan: Oh, heavens. Julie: Oh no, no, no, no, no. Oh my gosh. Oh my gosh! Brittany: I know. I know. I’m trying to not cry at this point, even though internally I am melting down. I’m nodding my head at her so she will stop and then moments later, the tears start coming. It was after the spinal, so I didn’t really have to necessarily hold it together any longer. Two of them look at each other, acknowledge each other, and they’re like, “Sweetie, we know you’re scared. But this is the quickest way to meet your baby.” I go, “I wanted to have a home birth.” And they’re like, “Oh.” Julie: I feel like “but” is the same as “at least.” Like, “I know you were scared, but you’re going to have a healthy baby. But at least you’re going to--” Brittany: Yeah. It’s terrible. It wasn’t better after that because when I said, “Oh, I’m supposed to have a home birth,” they said, “Oh, well, you’re braver than I am.” I’m like, “What the heck? You guys just should stop talking. You are not helping this situation at all. Where is my husband?” I was so over the whole OR. Thankfully, I had the best anesthesiologist assistant who sat at my head and was the voice of reason and coaching in my ear. He was like, “If you feel any kind of nausea, you tell me as soon as you feel it. I don’t want you to feel that. I don’t want you to throw up. So just tell me.” I’d be like, “I’m feeling it.” And he’s like, “Okay, push it.” He would talk to his anesthesiologist. I never felt like I had to insert my way from that point forward. I felt heard because at least he was there. I said to him when I heard the baby, “Is the baby okay?” He’s like, “He’s safe. He’s good.” I didn’t even know to ask for this, but I guess this is part of a gentle Cesarean. Maybe the midwife told me to say this, but I don’t remember because like I said, I never considered a C-section. They picked him up and over the curtain and laid him directly on my chest when he was born. I had that moment of meeting my baby that way. Whew. That’s the coolest thing ever. Even losing my labor and delivery, that moment when you become a mom, nothing tops that. From that point, it was like the OR room stilled. It disappeared. It was me, my husband, and my son. Thankfully, I was able to get out of that headspace and enjoy that moment, but the rest of the stay at the hospital was like a thorn in my side. They are in your room, every three hours, checking you, checking the baby, waking you up, telling me I can’t sleep with my baby. I’m like, “Um, excuse me? This is my child and he is sleeping on my chest. It’s not even a deep sleep. You’re in here every three hours. You know?” They would walk in and they would be like, “Ma’am, if you are sleeping then he needs to be in the cradle.” I’m like, “I wasn’t. We were nursing.” I was just like, “Come on. Get off of me. I don’t even want to be here.” That’s all I’m thinking the whole time. I don’t want to be here. Just leave me alone. We are healthy. The baby was-- I think it’s the APGAR test?  He was a 10. Like, leave us alone. That’s how I felt. But, you know, you have to. They are doing their job. Internally, because I am dealing with all of this other stuff, this resentment that I definitely had not dealt with yet from losing my home birth. It was just a bad hospital stay for me. I hated every minute of it. Although I also had this beautiful little baby so that’s definitely-- we got through. It was okay. But the nurses were just not super sensitive. The pain of a C-section recovery was horrible for me. I’ve had a lot of people say, “Oh, mine wasn’t bad.” Mine was terrible. I don’t know if part of it was psychological because I was so traumatized from my experience, but it was bad. I couldn’t walk for two weeks. That meant I couldn’t carry my baby. We basically laid like blobs on the couch. Which I know is not, after having a vaginal birth, I get it’s not totally out of reason. The pain was incredible. I just couldn’t even believe it. I was so beside myself. Actually, I was talking to my husband about it, because I said, “Do you remember that time?” I remember it being so dark for me. I cried a lot for like a month. I thought, well it’s like baby blues. It’s just hormonal. But like, I grieved the loss of my home birth. I was very, very sad about it. He said to me last night, “Yeah, I would have called that depressed. You were depressed for a little while.” I’m like, “Hmm,” because that’s not me. I am a very happy person. It definitely took me down a dark road, but I will say in that, down that dark road, my midwife once again-- my post-ops were with her. I never even saw that doctor again because thankfully everything was well and I healed fine. But the appointments were so much more about me. I mean, we would sit for an hour at every appointment, just like every appointment before. She sits with you for a full hour and you talk about how you’re feeling, what’s on your mind and also, labor and delivery, you are prepping for it, but this was, “How are you feeling? How are you doing with this? What’s going on? What have you dealt with this week? How are people?” She wants to know the nitty-gritty of how I am dealing inside because she recognized how valuable that was and how that time could make or break you. I remember one appointment. It was actually the first time we started, so it must have been my first appointment postpartum. It was me, my husband, and the baby. We were sitting on the couch. She sat across in the chair and she asked, “How are you doing?” It wasn’t like a friendly “How are you doing?” It was like, “How are you doing?” I hadn’t really had to answer that question yet and I just started bawling. I am like, “I don’t know. I’m just thankful he is here.” She’s like, “Okay, but there is a ‘not’ because you’re crying.” I’m like, “I know, I just--” and I was able to let it all out. My sadness and my sorrow at the loss. She came and sat next to me. She put her hand in mine. She’d hand me a tissue and at one point, I was balled up in her arms and she was hugging me while I’m crying. She let me say it, feel it, and cry it out. My husband sat there I think, thankful because he doesn’t know what to do with this blubbering mess. To him, it’s just all emotion. And although he lost “what he wanted”, it wasn’t for him what it was for me you know? This was something-- it’s not tangible, but it is. And so, I am so thankful that I had her. She was like a therapist to me in that first month to walk me through dealing with what that meant. Moral of the story, I feel like I got a redemptive birth with my home birth. But I couldn’t have gotten to the redemptive side of it had I not walked through truly dealing with how it made me feel and facing it, talking about it, processing it, and crying when I needed to cry about it. And then, I remember when I first got pregnant the second time around, I had that fear. That brought it up in a whole new way. So then I had to deal with it again. I remember saying to her in my second pregnancy, “Angie, I just wish this wasn’t something that I had to deal with. It’s almost like I am resentful of it.” She was like, “Well, that’s understandable.” She was like, “It does bring up more questions for you to have to ask.” Because I said, “It’s making me more stressed out.” She’s like, “Well, I get it. It’s bringing up more questions, but at the same time, every pregnancy is different. Every baby is different. Nothing is wrong with your body. This did not happen because there is something wrong with you”. She’s like, “You have to begin anew.” It was so good to have her as the same provider as with him because we had already been on this journey together. She knew where I was coming from when I would have fear and anxiety. I think that’s it for Nash‘s birth. I really wanted to emphasize the hardship that it was for me, but at the same time, there were so many lessons. I don’t think I did say this. I took away from that birth, the coolest thing I feel like you can take away from this, is that control is an illusion. We don’t have control over anything. We can plan, and prepare, and make choices that we think are going to work, but ultimately, things happen. To let go of that in my life, which I would say, maybe that’s a struggle of mine. To be able to see life from that perspective now, and I won’t say it’s gone, but I am able to see that even with the best of control-- me planning, down to my birth affirmations hung and my birth tub blown up. I mean, there was not even a shot that was not going to happen and it didn’t happen. It allows me to release and just say, “Okay, God. Your plan. You know best for me.” I am thankful that I was able to have a C-section because my baby is here safely and I don’t know what would’ve happened. Really, we don’t know. I’m thankful that was a possibility. I don’t like the way it happened. I don’t like the way the staff treated me. But I, at the end of the day, can say like, “He is here and I am thankful.” Meagan: I love that. I just posted the other day on our stories just about that. My first C-section baby-- she just turned nine. That is something. I was like, “I am so thankful. I am thankful for my C-section.” It took me a long time to be able to say that. You know? I am grateful for my C-section because it is something that led me to where I am today. It honestly made me stronger. Right? A stronger person, yeah. Brittany: Yeah. I take that too. Meagan: Yeah. So, I love that you said that. Brittany: Yeah. Okay, so, my birth with Rory. Rory is six months old and that pregnancy was also an easy pregnancy. I will say it was harder. The second time around was harder. I remember complaining to all my friends like, “Was your second time just a little bit more intense?” And they would say, “Yes.” Even my midwife, there was two of them at the time in the beginning and then it ended up only being Angie, but I remember Margot telling me a couple of times like, “Yeah. All of the pregnancy symptoms just get a little bit harder each time.” I’m like, “Oh, that’s wonderful. I definitely didn’t know that.” But yes. It was true. It was a relatively easy pregnancy. I worked the whole time up until 36 weeks, which is when COVID hit and we were shut down. That was actually a blessing in disguise. I took it when it happened, like, “Man. Time with just my family. My family of three before the baby comes.” I mean, it was hard because my husband is a personal trainer and I am a hairstylist, so we were both shut down. Of course financially, not a great time right before I’m supposed to have a baby and be out for months, but it also was like, “Okay, Lord. Thank you. Thank you for this time because we are never going to get this back and also, I am super pregnant right now. This is kind of nice to not be standing on my feet for 38 hours a week.” Like I said, that was a pretty good time to be home and experience that time. But, I’m trying to think. I went to 40.4 weeks and I went in for my appointment. Or, it was 40.2 I think I was, and she’s like, “Well?” The appointments already were so different. We would meet in the car. I’d sit in my car and she would come out. We’d both be masked. I’d have to lay my seat back and she would do the ultrasound. She would open the door, and she would do the ultrasound and talk to me outside through the door. At that point, after she had done that, everything was healthy and fine. She was like, “Do you want me to do a membrane sweep on you since you are past due?” I was like, “Well, you know, whatever you think. If you think it’s a better chance of me having a baby sooner, but it’s not putting any risk involved.” She’s like-- I remember her telling me a brief summary of numbers. I was just like, “Yeah. Let’s do it.” She always was like that. She never just answered with a feeling. She would give a statistic or a number to back up whatever it was. At that point I had my membranes swept with Nash and it wasn’t bad. It wasn’t that uncomfortable, so I was like, “Yeah, we’ll do it again.” Well, when she was in there, she was like, “Do you want me to do cervical acupressure?” And I was like, “I don’t know what that is, but does that help a baby come?” She was like, “Yeah it can.” I was like, “Alright, let’s do it.” I was so ready to meet this baby. Like I had said to many people the last few weeks, “I feel like I am a kid going to Disney World.” But it’s frustrating because it’s like, you’re going to Disney World next week, and you’re four years old and you have no idea when tomorrow is. I just want to get there. It was like this excited eagerness that also could easily turn to anxiety. I’m ready to get there. Once she offered that, it was like, “Yes, please.” That night, I had already scheduled a date with a girlfriend. I went over to her house and sat on the ball. We talked pregnancy and birth. She shared her birth story, which I had already heard once, but it was just good to talk about where I was at with a friend that I felt comfortable being myself with. I remember my doula had sent me, which I should add-- the week leading up, my doula was amazing. She was doing guided meditations with me on a video conferencing a few nights a week for a couple of weeks before my birth. We were talking. Sometimes we would call and chat. I would tell her how I was feeling or how the appointment went and she would talk me through things. A lot of times she was just like a therapist, honestly. Not like a you-should-do-this therapist, but just somebody to listen, and care, and understand. She also had helpful birth prep stuff that we did. You know, stretching. She even did a video call. This is so cool. She and her husband went in their living space, got their camera out, and me and my husband got ours out, and they showed us different partner support stretching and pressure points for us to do with each other. They would help my husband basically prepare to help me through before she could get there. That was pretty cool. So anyway, she was awesome. She just definitely helped keep me grounded to where I was ready and I had all the tips. I knew I had all my tools in my tool belt, but they were ready to be used when needed. Okay, fast forward. Sorry, I had to backtrack because I didn’t want to leave that out. Elizabeth is my doula and she is amazing. I don’t want to shortchange her. The morning of, I started feeling— The next day after that cervical acupressure appointment, I started having cramps at 10:00 a.m. They were mild. They basically stayed mild for two to three hours, but they were pretty consistent. I’m like, “Well, this could be something.” I kept her up to date. She basically said, “You know.” I had my sister-in-law come and hang out with my son so I could sit on the birth ball and just breathe and focus on what was happening because twice before that week, I felt like I might be starting labor, and then something stressful happened. I swear my body was like, nope. It’s not time. I told my sister-in-law after the second time, I’m like, “This is so frustrating. I just want to go into labor. I feel like life happens, and then suddenly my body just stops,” because I had, like I said, cramping and probably labor beginning. So this time, she was like,  ‘I’m coming over. I’m going to take care of Nash and you can just do what you’ve got to do.” I got in at my chiropractor at like 12:00 p.m. that day and I told her, “I think I’m in labor, but I’m not really sure. Do what you’ve got to do. Let’s help get these things going.” And so, she did. I left there. I grabbed subs. I went home. We ate the subs and then I felt them come on. I don’t know if this is a thing, but I swear whenever I eat anything during labor or drink anything, including back to the first time, or back to lunchtime, it made contractions worse. It was like, “Whoa.” So after lunch is when I felt like labor kicked in. It was like, “Alright this is happening.” I called my doula I was like, “Yeah. It’s getting real over here. I definitely think this is happening,” but the timing of it was not consistent yet. She’s like, “Alright. Well, call me back in an hour or I will call you if I don’t hear from you.” An hour flew by because she called me and I was like, “It’s definitely getting stronger and longer and more intense.” She was like, “Okay, well. Let’s just hang out on the phone for a little bit. I’d like to hear you have a few and then we will talk.” We did. She was like, “I’m going to get ready and come over. It will be about an hour,” because she lives a little bit away. She’s like, “But I will be there soon.” I was like, “Well, you don’t have to.” I almost felt like, but if this isn’t, I don’t want to psych myself out. She’s like, “Well, it’s up to you, but I think you’re having a baby today.” And it was like, “Oh my gosh. This is happening.” That moment, I switched from “I don’t know, is this?” to “Okay, it’s go-time.” I told myself from the very beginning, make every contraction count. Let your body do what you have to do. Don’t fight it. If you feel yourself fighting it, correct it, and release. I really do feel like I did that other than literally maybe two or three contractions. I feel like I just was in it. I was doing that deep lion, not even lion. It’s like a moaning laborer. I don’t know. What do you guys call it? Singing through labor? Meagan: My husband calls it “mooing like a cow.” That’s what he told me. He’s like, “You were mooing like a cow.” Because I was like, “Ooooh,” you know? But yeah, it’s definitely-- I just call it a rhythm. You find your rhythm. Brittany: Yes. Yes! I remember my midwife made me practice in the office while I was pregnant and I felt so ridiculous. She’s like, “Okay. Now do it after me.” I was just like, “Oh my gosh.” But it felt so good. You just want to keep doing it because it kept me going. You know? It was like, “Oh, yes. That one worked.” I felt like every single one got a little bit more intense, but with my breathing and my noise, I was able to make it through. I felt like labor got intense probably around 12:30 p.m. and at 6:30 in the evening, it had obviously progressed and gotten more intense. My midwife, I think she got there at 5:30. So five hours later, and she was like, “How are you doing?” I said, “I feel good. I feel strong.” I just felt like, “Oh, this is not that bad.” I mean, it was hard, and it’s uncomfortable, and it wasn’t easy by any means, but I felt like, I can totally do this. She checked me. Elizabeth got there at 3:30, my doula. At that point, I was in the bath. They were routine. I don’t even know the timing of it all, but it was probably two to five minutes apart regularly, but lasting for a minute. My contractions were long for the whole time and they got longer than that. I’m sorry, lasting like two minutes because I know a minute is the norm. It lasted two minutes. Anyways, once Angie got there, she checked me. We had talked about how I did not want to know how far along I was. I didn’t want to get in my head about it. I just wanted to know if I was doing better. Since she had checked me the day before, she knew what I was. I was at 3.5. Hindsight being 20/20, 3.5 centimeters dilated, and apparently I was at 1.5 the day before. So I had progressed. But that was at 6:00 p.m. I think, that she checked me. No. I’m sorry. It was 7:00 that she checked me. Labor was intense to me, so I don’t know. But I guess she thought I had a long time to go. She thought we would have an (inaudible) baby, she said. She lives five minutes away. She was like, “I’m going to go home and feed the kids and put them down for bed. Your doula is here, so I told Elizabeth to keep in touch with me, and I will be back.” She was gone and it went from bad to worse. No, it really wasn’t. It went from okay to oh my gosh, like an out-of-body experience. I really felt like I was floating above myself watching this happen. I felt like my skin was coming out of itself. I’m like, I can’t. There is no other description for it. I’m like, “I think I need to go to the bathroom.” I know that that’s a sign, but I really felt like I had to go to the bathroom. I hadn’t gone to the bathroom yet, so she’s like, “Okay, well let’s just go to the toilet.” She had been trying to talk me into the toilet anyway. I was like, “Okay.” So we went there and I definitely had transition on the toilet, hindsight being 2020. But I just thought I was going to the bathroom because that happened simultaneously. I think she did too, but okay. This is TMI, but we’re talking labor and delivery, and this is what we do,I feel like. Okay, I am not want to go to the bathroom in front of people. I am a very private person like that. But I’m literally holding onto her. She is standing in front of me and I’ve got my arms wrapped around her shoulders. She is supporting me as I am contracting and going to a different zone. It was incredible. The intensity was crazy. She just talked to me through it and said things to me like, because we had talked about it before, “This is that crossing bridge that you are coming to. You have to get over it and then you’ll meet your baby.” At that point, I hadn’t thought that Angie should be there, but she probably should have been there and she wasn’t. After maybe 30 minutes of that, I was like, “I just feel like I need to go to the bathroom. I want to get in the tub.” We got in the tub and she’s like, “Okay, well Angie told me to let her know,” Oh no, she said that on the toilet. “Angie told me to let her know when you’re feeling pushy.” I said, “Well, I am pushing,” but I thought I was pushing going to the bathroom. She’s like, “Okay, well.” We went to the tub. I had one contraction in the tub and I was like, “Oh my gosh, I am definitely pushing.” She’s like, “Okay, well do me a favor and reach and see if you feel her. I’m like, “Um, no”. She’s like, “Okay, well reach in there and see if you feel her.” I got one knuckle in and I felt her head. And so, she’s like, “Okay, Vinny, you need to call Angie right now. He called her. My son is home at this point. He had been taken away for the day and was home. He was freaking out in the bedroom because he could hear mommy. I didn’t know this, but he was going, “What’s wrong with mommy?” My husband runs in the room to be there for him while I am-- I mean, this all happened within a matter of 10 minutes while I am in pushing mode. I only pushed four times. And so, she’s stuck at the door. Somebody accidentally locked the door. She’s stuck at the door calling my husband on repeat to let her in. Finally, he does let her in. She was there for a couple of minutes. She walks into the room and I pushed the baby out. It was incredible. Meagan: Holy cow. Julie: That’s amazing. That’s the way to do it. Brittany: She’s like, “You were waiting for me!” I was like-- Honestly though, in my head, she didn’t even have to be there. I was just like, “This baby is coming. She is coming.” Julie: That’s awesome. Brittany: Yeah, it was. It was such a cool and uneventful experience which is exactly what I wanted. You know? Everything happened the way that my body was supposed to. Labor is tough and there were things where you were like, “I’ll take away from that too.” Like, man. I really can do anything. It’s just my mind that gets in the way, but my body is capable of almost anything, which is cool to take away from that. But I also feel like it’s the same. I wouldn’t know how valuable that is had I not have had the C-section and realized that my body is also capable of another kind of hard. So, yeah. That’s basically my story. Julie: I love it. I absolutely love it. There are so many fun things. Meagan: I do too. Julie: Meagan, what do you want to talk about? Meagan: I know. Well, I want to talk about that feeling, right? That “oh crap” feeling, because I sometimes we get it really early and it is so hard and we are not complete, right? It is so hard to fight past it. And then, we get it where you are like, “I really don’t-- I think I just really do need to have a bowel movement,” and then it’s a baby. Brittany: And it was a baby! Meagan: It’s so hard. It’s so hard. It’s so, so hard. But I’m so glad that everyone made it and all is well. But yeah, just like you said. This baby is coming. Following your intuition and knowing that. I really want to go back. I know this is maybe just because I just talked about this the other day, but I really want to go back to the C-section, on being grateful for your C-section. Julie: You are on the same wavelength as me, Meagan. Take it away. Meagan: Because this is not something that a lot of people say, and when you said that-- I don’t know if you saw my story. Did you see my story the other day? On Instagram? Brittany: No. Meagan: So, see? That makes me want to talk about it more because you didn’t even see that. This is something that I want to encourage all of you listeners to do. I want you to step back. And you said it yourself, the C-section recovery-- things were not great. They weren’t easy. It wasn’t an easy journey. It was scary and you were left alone, and your husband was pulled away from you and you were just like, “Oh my gosh,” and you’ve got people saying all of these things that are just-- they are trying to help, but they’re not. You could look at that situation and say, “That was terrible in so many ways. That was not what I wanted in every way, right? I planned this home birth. I had this awesome team. It was terrible and I was not where I wanted to be.” But, you said, “Yeah, that sucked and it was hard, but I am grateful for it.” I want to encourage listeners out there to try and get to that space. I’m not saying it’s going to be easy. I’m not saying it’s going to be, you wake up one day or you wake up the next day and you’re like, “Yeah, I’m over it. What happened to me happened and I’m grateful for it.” And I’m not saying you have to be grateful for what happened. Right? I just want to try and encourage people to be grateful for yourself, and your body, and your baby for getting through that time. Take note and notice where it may have made you strong. Does that make sense? Am I making sense, you guys? Brittany: Yes. Julie: No, it makes sense. I love it. Brittany: The lesson. The lesson in it. What you take from it. Meagan: What you take from it. Especially, everything that is going on with all the politics, social media, and corona, all of these things. It’s so easy to pull from the negative in every direction in life. It really is. It’s okay that these negative things happen. We understand that. I don’t want to ignore that. But if we step back and we pick out the positive, it really gives that a different perspective. This is not VBAC related at all, but this is something I had to do literally today. So, as most of you may or may not know, I’m a really big obsessed person. I don’t know what I’m trying to say. I am obsessed with finding a good deal. Julie: Um, yes. Yes, she is. I can vouch for that statement. Meagan: Right? I’m obsessed with that. And so, as a lot of you may know, we are remodeling our home. I found this microwave that needed to go in my new pantry and it’s a $1200 microwave. Well, I’m sorry, but that is seriously-- no. I’m not doing that. I’m not paying that. And so, I totally just searched Facebook marketplace and our local classified ad here looking for a specific type of microwave. I found one. It was $250 and I was stoked. Julie: No. Really? Brittany: That’s awesome. Meagan: Yeah. It’s brand new. He’s like, “It’s brand new.” I went and got it and it was in the box, still in the plastic, everything. Right? And he’s like, “Yeah, it’s brand new,” and I was like, “Okay, so it does work, right?” He’s like, “Yeah, I mean it’s brand new.” We pulled it out. We tried it. I’m like, “Okay.” So, we brought it back. I bought it. We brought it back. I plugged it in, turned it on, drawer came out. It seemed great. This was two months ago. Well now, we just finished-- we are not finished, but we just finished the space so I can bring this microwave in. Well, guess what? It doesn’t work. It doesn’t heat up. Julie: No. Meagan! Oh my gosh. Meagan: I know. I am devastated. I am like, “How can I do that? How did I not check that? I don’t understand. Why would I? If it turned on, it turns on, right? Why would I think?” I don’t know. Anyway. But all morning, I’ve been fretting. I told my husband, I’m like, “I’m so mad at myself that I had to get this deal and it doesn’t even work.” Now, this guy took $250 cash. I wrote him and he’s like, “Sorry, it’s been too long. I can’t help you,” and blocked me. I’m like, “Oh my gosh. That’s $250! What the heck?” He said it was new. I’m distraught. My husband sends me a text message and says, “I want you to step back and look at our kitchen. Look at how many things went right, and how you crushed it in all the other ways.” I was like, “You know what? You’re right.” It’s the same thing with birth. I didn’t want that C-section. That is not what I wanted. It’s the last thing I wanted. But at the same time, I am stepping back and I’m going to pick through. I’m going to look at all the positive amazing things that came out of that outcome that I didn’t desire. I’ll tell you what, Women of Strength, I really do not believe I would be here today with you and Julie if it weren’t for that original C-section. I would not be an advocate for birth in the way, I’m not saying I wouldn’t be an advocate, but in the way that I am today without that C-section. I don’t know if I would have a connection with my daughter. Now, this is something that a lot of people talk about, right? I don’t feel as connected because I didn’t have this vaginal birth, and it wasn’t this natural baby on my chest. But, I feel like through my daughter, through my healing, and my cesarean, her and I healing together, talking about her birth and processing her birth with her, I have grown closer to her. And so, I just want to encourage you today to step back, pick it apart, and look at the positive because there’s so much negative in the world. Pick out that positive. Hold onto it tight and never let go. Julie: Um, Meagan? I absolutely love how you turned that microwave story around and applied it to birth. That was a spot-on analogy. Like, really though. But secondly, bring me your microwave. Me and Nick will fix the heating element. Meagan: Seriously, it’s so bad. Julie: No, really though. Plus you have to come see my new house anyway. Meagan: I do need to come see your new house. Julie: Awesome job for Ric for saying all the right things and being a good contributor to the podcast today. Meagan: Yes. But yeah. So anyway, so that’s my message today. I love your story in so many ways, but man, I held onto that when you said that. I was like, “Yes. Yes, yes, yes. Everyone needs to have that message.” So, that’s my message for you. Q&A Julie: Well, we get to ask questions now. Meagan: Yes, we do. Julie: Good message, Meagan. I love that. I was just talking to a couple of people actually on Instagram the other day about the mother-baby connection. When they have their VBAC, they look at the stronger bond they instantly have with their VBAC baby, and then it brings grief and guilt because they didn’t have that immediate strong connection with their Cesarean baby. It’s easy to compare the two when you just have two experiences, right? This is what I told both of these mothers that messaged me. I was like, “Listen. I have had four births. One Cesarean and three VBACs. Each of those bonding experiences has gone completely differently. Bonding with your baby is just like any other relationship that you have. It takes work. It takes time. It takes dedication. There’s going to be ups. There’s going to be downs. There’s going to be times where you guys feel like you’re so intimate and close and you love each other. I am talking about the mother and baby connection. And there’s going to be times where you feel like you have no idea what your child is doing or thinking, and how you even wanted kids anyway.” Am I right? The thing is, it takes work. All four of my babies’ connections were different. My third birth, which was my second VBAC, was my strongest connection by far. Right now, she is four and a half, and I have no idea what the crap she’s doing. I’m pretty sure she hates me. Like, really. I’m pretty sure she does. But the thing is, is that my Cesarean baby, he’s my oldest. He’s seven and a half now. I’m starting to have conversations with him about emotions and feelings and talking about decisions we are making as a family. I think that is strengthening our bond too even deeper. And so, I don’t know. I guess that’s just my two cents to add to your perspective because it just takes work. There are good things in all the parts, even in the worst of parts. Meagan: Totally. Julie: Like your gorgeous microwave. I will fix it for you. It is my mission now because I know you’ve been talking about that microwave. I know. I know you. Alright, let’s get to the questions. Meagan: Okay, so one of the first questions is: What is a secret lesson or something no one really talks about that you wish you would have known ahead of time when preparing for your birth? Brittany: A secret lesson. Yes, I guess with my first one, I wish I would have considered possibly what a different story might look like. That maybe I would have had that perception of, “Okay well, if I do have to have a C-section, I want to know what I’m walking into,” because had I have known what those four walls it looks like, I might not have been so shocked by them. Do you know what I mean? When I got there. And, ask all the questions. Because I definitely feel like going to a midwife, she already gives you-- I mean, there are worksheets with ways to prompt you for questioning, and because I was listening to you guys, I had about one million questions. But I know when you’re not dealing with a midwife-- a lot of times I’ve often felt like doctors make me feel silly or almost like, “Why are you asking me that? Don’t you trust me?” Ask anyways. Ask anyways, because you’ll be paying them you want to have those answers. When you are in the throes of labor, you want to feel nothing but confidence. Meagan: Totally. Julie: Absolutely. Meagan: Yeah. In your answer, you said, “Control is an illusion.” I really loved that. Brittany: Yes, it is. That’s my lesson. That is my lesson from my C-section. It really does apply to so many areas of my life. Meagan: I love it. Love it, love it. Okay, and I know you are driving, but the last question is: What is your best up for someone preparing for a VBAC? I feel like you just said that. Educate yourself. Ask all the questions. Anything else you would like to add? Brittany: Okay so, I left this part out. Originally, I was considering maybe we don’t hire the doula this time. We are trying to cut back on finances. My midwife looked at me, she goes, “Do you have confidence in your husband in being a great support system for you at all points during labor?” I was like, “Hmm, I don’t know.” I came home and I asked him. I said, “Do you have confidence in being a great support system?” He was like, “No”. I was like, “Okay.” He was like, “I don’t got this.” He was like, “I don’t know what labor looks like.” He’s like, “I definitely think we should have somebody who is a good support system for you.” Meagan: Alright Brittany, thank you so much. We just love you. We love hearing your story and all of your tips and advice for all the listeners. We know that it’s going to help them. Julie: Absolutely. Thank you so much. It was great to have you on. Closing Would you like to be a guest on the podcast? Head over to thevbaclink.com/share ( http://www.thevbaclink.com/share ) and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com ( http://www.thevbaclink.com ). Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Happy New Year! We are starting 2021 strong with today’s powerful VBAC story. Hallie is a two-time VBAC mom and birth photographer from New Zealand. This 5’0” tall woman of strength fought through a long, hard labor to deliver a 9 pound, asynclitic, and perfectly beautiful baby girl. Hallie talks about how using water as a coping technique was pivotal to her success. Later in this episode, we talk about the biggest barrier doulas face when trying to support VBAC/TOLAC parents. We surveyed over 200 VBAC doulas and almost every single answer was the same. The Birth Wizard herself, Emmy Howard, joins Julie today as her co-host to discuss what that barrier is and how to overcome it. Additional links How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) Emmy, Birth Wizard: Website ( http://birthwizard.com ) , Facebook ( https://www.facebook.com/BirthWizard/ ) , Instagram ( https://www.instagram.com/birthwizard/ ) , Twitter ( https://twitter.com/birthwizard ) Hallie’s Instagram: @nz_birthstories ( https://www.instagram.com/nz_birthstories/ ) The Evidence on: Waterbirth ( https://evidencebasedbirth.com/waterbirth/ ) Episode sponsor This episode is sponsored by our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and Julie have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head over to thevbaclink.com ( http://www.thevbaclink.com/ ) to find out more and sign up today. Full transcriptNote: All transcripts are edited to eliminate false starts and filler words. Julie: Happy New Year, Women of Strength! Can you believe it? It is January 2021. We are recording this in the past and right now I hope our future selves in January 2021 are living in a lot better world than we are in right now, October 2020, because things are a little nuts right now. Let’s be honest, 2020 hasn’t been the best. I was going to say most exciting, but exciting could also not be a good thing. It’s definitely been a tumultuous year. We could say that. So hopefully, 2021 brings us good fortune, lots of love, kindness, and health. For our first episode of 2021, I am missing Meagan again. Do you remember a couple of episodes ago when I told you that she was out with some family stuff? Well, this is the last episode where she will be out. But, I really like having our VBAC doulas co-host with us, so you’ll probably have some more VBAC doulas co-host in the future. Our co-host for today is the Birth Wizard herself, Emmy Howard, who lives in Phoenix Arizona, a.k.a., three feet above hell. I can say that because I’ve lived there. Emmy: It’s the surface of the sun. Julie: Can I say “hell” on the podcast? I know, right? I lived there for a year. I came to Utah to visit my mom during the summer. It was 90° and I was like, “This is so nice, this temperature.” Emmy: That’s so funny. Julie: Anyway, sorry. I digress. But the cool thing about Emmy is, she has lived on three different continents and visited over 20 countries. Emmy, I’ve got to ask you. What was your favorite country that you visited and what three continents have you lived on? Emmy: I’ve lived in North America, South America, and then Europe. The favorite country is a really rough one to answer because you are essentially asking what part of my life I love the most. So, I essentially tell people I loved them all, just like children, for different reasons. Julie: Good answer. Emmy: So, the thing I will say is, I have a special place in my heart for when I lived in Poland, just because I got to travel the most when I was living there. Julie: That’s awesome. I visited Germany once for Christmas. It was really cool. Germany at Christmastime is a really special place. Emmy: Did you go to the Christmas markets? Sorry. Julie: Dude, like three times. Because I went to visit my sister in Heidelberg. They have the Heidelberg castle and in the old castle courtyard, they have a whole bunch of shops. The Christmas markets were just crazy. I would go in and I’d eat like, six bratwursts every time. I’m like, “I am eating bratwursts in Germany at Christmastime.” Emmy: I love Glüwein. That’s actually something I still do at Christmastime, even though we are not at the Christmas markets anymore, which is hot spiced wine. Let me tell you, that thing warms you up on the inside and feels like a hug from your drunk uncle. It’s great. And then freshly roasted chestnuts while you’re walking around. Man, it’s awesome. But you talked about how you moved away from Phoenix because of its heat. I moved to Phoenix for its heat. Julie: No, I had joined the Army. The Army from Phoenix. I moved to Phoenix for my boyfriend. I got kicked out of the house two weeks after my 18th birthday. That’s a really long story. Emmy: Oh, well there you go. Yeah, will get into that one later over a glass of wine. Later. Julie: Much, much later. Emmy: But I moved here because of the sunshine. I came from a place that had three hours of sunlight, so I was like— Julie: Alaska? Emmy: No, Poland. During winter you only get three hours of sunlight. So that’s part of the reason that got me out here. Julie: No, I could not do that. No, no, no, no. Alright, before we get started, we are going to have the Birth Wizard herself, Emmy, read our Review of the Week. Review of the Week Emmy: Awesome. From JamJam1987 on Apple Podcasts ( https://podcasts.apple.com/us/podcast/the-vbac-link/id1394742573#see-all/reviews ). They say, “Inspiring. My first C-section was in August 2019. I recently found this podcast and I find these stories so healing and inspirational. I am so pumped up to get pregnant again and try for my VBAC! I hope I can share a successful VBAC story on the show in the future. Thanks for educating the world on VBAC.” Julie: Aw, I love that. I love that. Do you know what? It’s so fun. I remember when Meagan and I first started the podcast and we would literally— I say we but really, it was just me. I would go stalking VBAC hashtags on Instagram, message people, and be like, “Hey, we just started a podcast. Will you share your VBAC story?” and begging people to record with us. I remember the first time we had somebody who had been listening to the podcast while they were pregnant with their VBAC share their story on the podcast. That was such a special moment for me. And so, I think that’s really cool. Emmy: No, I totally get that. Julie: Yeah. All these people that leave reviews, I love it. I want them to submit their story. I want to hear their journey. Sometimes if their name looks like it might look on Facebook, like it’s their real name, I’ll go look them up, see if they are in our community, see if they have had their baby yet, and how it went. Did they get their VBAC? What was their story? Because I like to have the full circle. It feels like coming full circle, right? Emmy: Yeah. I do the same. I always do the same because I do a thing where people can contact me whenever and I’ll answer your VBAC questions. It’s a half-hour that I do and then if they don’t follow up with me, I just stalk them. Julie: You’re just like, “What happened to you?” I need answers. Emmy: Right, with love and care. I just want to make sure that you were okay, and that you got everything you needed and wanted. So, yeah. I completely understand that. Julie: Alright, we love those reviews. Episode sponsor Julie: Do you want a VBAC but don’t know where to start? It’s easy to feel like we need to figure it all out on our own. That’s what we used to do, and it was the loneliest and most ineffective thing we have ever done. That’s why Meagan and I created our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) , that you can find at thevbaclink.com ( http://thevbaclink.com/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course.  Together, Meagan and I have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head on over to thevbaclink.com to find out more and sign up today. That’s thevbaclink.com. See you there. Hallie’s story Julie: Alright. Speaking of world travelers, I think this is a great match up with the co-host and our guest because our guest today is Hallie Campbell from New Zealand. Let me tell you. Oh my gosh, I am so excited. I am going to mute myself, and sit here and listen to her talk because I absolutely love New Zealand and Australian accents. In fact, when I was young, I just knew that I was going to grow up and marry somebody from Australia so I could hear him tell me “I love you” in the Australian accent every day. I was 12 and in my little church group, we wrote a letter to our future husband, and then at the very bottom of my letter I wrote, “P.S. I hope you’re from Australia.” Like, no joke. I did that. So, I don’t want to take too much of Hallie‘s time. Gosh, I should probably look up her information sheet. Honestly, My favorite thing about her is that she is from New Zealand. I don’t know that much about her yet. Let’s see. Mother of three boys and one little girl. She lives in Auckland, New Zealand and she has a birth photography business. Oh my gosh, I think I stalked you on Instagram actually, @nz_birthstories, and that’s your fifth baby. Perfect, I love that. You have such a passion for photographing— how hard is it for me to talk today? Let’s put that on a scale from 1 to 10— and being immersed in the birth world. Do you know what? I’ve honestly really considered switching from being a birth doula to being a birth photographer just because it feels like it would be less of a work-out maybe but talking to some of my birth photographers here, they’re like, “I don’t know. We are climbing up on couches and doing all sorts of crazy things.” Hallie: There is a bit of climbing, yeah. Julie: Yeah. But I’m really excited to hear your story. I know that birth in Australia is a little bit different than it is here in the United States, but there are a lot of similarities, too. I don’t want to take up any more of your time because I like to do that. I like to talk and this is my adult interaction for the day. So Hallie, talk to us. Please, talk to us. Hallie: Alright. So, my VBAC that I’m going to talk about today was my second VBAC. My first one was a hospital birth. My second one-- I decided to plan a home birth because the first one went really, really well. But this baby decided she did not want to come out. She was very, very naughty. So we got to-- I think it was 41 and 5, and I decided, “Okay, it was probably time to head to the hospital.” I discussed all with my midwife and she was very pro home birth, but obviously very pro my rights. We decided to go in and just see how things were going, possibly break waters, get things started, and head home. But when I stepped foot in the hospital, I started contracting. It was like she was just waiting for me to show up there. I didn’t actually need any more assistance. I didn’t need to be induced in the end. We went about setting up the hospital room just as if it was a home birth. We were thinking to go home, but I then had a call from my mom who was looking after my kids while I was in. She said that the birth ball had been picked up from our house. Well, we had run out of time with it. So, we decided just to set up camp at the hospital. I walked about a zillion laps at the hospital, which really, really helped I think. The difference between that and my previous VBAC was-- yeah. I think just keeping active, keeping upright, and moving helped things progress a lot better. So we headed in. That was around 8 in the morning that we headed in there and walked for a good few hours. Around lunchtime, we decided to jump in the pool. Well, I did. My husband was not very keen. I jumped in the pool and labored in the water for quite a long time. I had decided against continuous monitoring and just asked my midwife to check in on baby quite frequently. She was quite happy to do that. The water was such a relief. It was so, so great as a pain relief. With my previous labors, I had opted for an epidural very early on, but this time I was really hoping to push through that and use other methods of coping with the pain and the water was just amazing. I spent quite a few hours in the water, but as I got into early evening, things were slowing down, which can be sometimes quite common when people jump in the water. So, we jumped out and I was a 6. Things weren’t progressing too fast, but we weren’t worried. I spent quite a bit of time with my midwife doing a lot of Spinning Babies® moves. We did lots of hip squeezes. She got my husband in there and he said that really killed his arms doing it over and over again. We did loads of that, loads of hip rotations on the ball and that actually got me through a lot. I started to feel quite pushy. I think coming into— I think it was around 8 at night, I started to feel like, “Okay, things are starting to feel like they are progressing.” I started to become very vocal. I think I even remember screaming, “Please, help me,” at one point, because my previous labors had been with an epidural, so I had never reached transition in all it’s glory naturally. That was an experience, but it was really great to be able to feel the need to push and to feel my body moving into that next stage of labor. I did push for a little while and then as I started pushing, my waters broke. They hadn’t broken fully when they popped them the first time. She thought that she had popped them, but there was actually a second bag that ended up breaking. I just always hold a lot of fluid. Julie: Yeah, there is a forebag and a hindbag. Sometimes, baby’s head can block the rest of the water from coming out. It’s pretty fun when people realize that or have that second gush of fluid come out. Hallie: It was crazy. I thought, where is this all coming from? I’m a very small person. But anyway, yeah. When that broke, instead of her head coming down into the pelvis, her head shot out of the pelvis. So, yeah. That was just so great. When I was re-checked-- I had previously been checked before I began pushing and I was fully dilated. I was ecstatic to reach that point using other forms of pain relief, but when her head shot back out of the pelvis and I was rechecked, I was then 7 cm. I thought, “No, come on. We have come all this way.” I was stuck in this limbo of transition. We all had a discussion, and I could see some more doctors starting to file into the room. I just thought, “No. I know what’s happening here.” I opted for an epidural at that point. I thought, “If I’m going to sit in this state of transition for quite a while, then I’m going to need to rest.” And so, I chose to have an epidural. It was the best decision I made. We opted for a bit of passive descent and used-- we call it Syntocinon over here. I think you guys call it Pitocin over there? Julie: Yeah. Pitocin. Hallie: We had that cranked up and got those contractions bringing baby back down. That went on for another five hours. So, I was so glad I got that epidural. Julie: Oh my gosh, you poor thing. That’s a long time. Hallie: She was a naughty baby. She still is. That really did do the trick. She came down and I began pushing at-- this must have been about 2 in the morning by this point. It was a very long labor. And then I still had a good 45 minutes of pushing. I was expecting, you know, fourth baby, one or two. No. About 45 minutes later. But she was a bit bigger. She was 9 pounds. I am 5 feet and very small. The big baby thing never worried me at all. That never crossed my mind. But I just knew that I was really going to have to work because she had been in a funny position as well the whole time. So, I was really working to get her out. I was keeping an eye on these doctors that were in the room. I could see the little whispers and the C-section word getting brought up. As soon as I heard it come up once, I pushed and I’ve never pushed like that in my life. This big, chubby head emerged and I just saw the relief on my husband’s face because he was just as behind this VBAC as I was. We had obviously experienced Cesarean recovery, which was fine, but I had these other kids at home that I really needed to be able to pick up. So, we really-- I really dug deep in the end. She was asynclitic, so her head did come down on a really weird angle, but then she was born at 3:30 in the morning. It was just so epic and I looked at her and thought, well you look massive. Julie: I’ve seen 9 and 10-pound babies be born and they look like little sumo wrestlers, or like a toddler. You’re like, “Hey, congratulations. Here’s your two-year-old.” Hallie: Oh, the head on her. She was just huge. My husband showed me-- he had taken a video. I really wished I had got a birth photographer. I really wish I had because this video is very graphic. But he-- her head is just so big. It’s just so big. But it was just, it was such an amazing birth. It was hard. I wouldn’t say it was the hardest, but it was a very hard, long birth. The whole time, I felt like I was in control of the decisions being made. I felt empowered because I had my amazing support team behind me. My midwife was behind me every step of the way. Over here in New Zealand, it’s predominately midwife-led and, yeah. She was just so fantastic. I put a lot of the way I felt after that birth and during the labor, down to just how I was treated and how I was made to feel. Yeah, it was such an awesome, awesome birth. Julie: That’s awesome. So, your first three, were they-- was it two vaginal and then a Cesarean? Or were they all Cesareans? Hallie: My first was vaginal. That was a very hands-on induction, very traumatic first birth. My second was an emergency Cesarean, failure to progress at 7 centimeters. And then a VBAC, then Daisy. Julie: So, first vaginal, then C-section, then two VBACs, right? Hallie: Yep. Julie: Right? Okay. Just wanted to make sure that I got that right because all the letters, numbers, and everything gets mixed around. I think that’s really so important though, what you said just a few seconds ago, that choosing your care provider and making sure that they are 100% supportive of the type of birth that you want is one of the biggest things you can do to make sure that-- as you reflect on your birth, that you feel comfortable and confident. Not only with the outcome, but with how you were treated and how you were cared for. I think it’s really, really important to note that. Find a provider-- if you want a VBAC, you probably don’t want to go to a provider that has a 30 to 40% C-section rate. That provider is probably not doing a lot of VBACs. You want to go to a provider that does a lot of VBACs, that loves VBACs, that loves supporting that, that believes in you, that trusts you, and that you can feel that confidence in you coming from them. And so I think that that’s really important to say. But Emmy, what would you say? Emmy: I am going to echo basically what you’re stating there. We just heard an incredible story where you did a ton of work, Hallie, and why go to a provider that’s not going to work with you? Hallie: Exactly, yeah. Emmy: That’s my big thing with providers is like, yeah. Maybe they are 20 minutes from your house, but I would rather drive six hours to make sure the person I’m working with is willing to work with me. Right? So definitely a huge echo. I think also to throw out there with your story, is knowing your own limits and your own boundaries. You knew you needed rest. You can have really empowering stories with an epidural when the tools are used correctly. So, super awesome. Hallie: Yes, that’s right. Yeah. Julie: Well, I love that too. Because a lot of people are like, “Oh, I can’t have a VBAC unless I want to go unmedicated,” or, “Do I have to go unmedicated?” or, “What about an epidural and VBAC? Will it really decrease my chances?” I’ve seen sometimes epidurals slow labor down a little bit, but most of the time, I’ve seen epidurals used in birth just like Emmy was saying, as a tool and when they were truly needed. Because a pooped out body is not going to push out a baby. It’s just not going to happen. Your body needs rest and an epidural can be a very effective tool when it’s needed. It sounds like you made the right call, your birth team made the right call, and everyone let you labor how you chose to. I really wish that the United States would do that-- have midwifery-led care unless you’re a high risk or need to transfer care for some other reason. I really, really wish that could be our model here. Emmy: Here in the US though, we have about three-- it’s something like 13 OBs to one midwife, so that’s part of the reason we have that going on. Hallie: Wow. Water for pain relief Julie: Well, yeah. That is true. That’s a very good thing to point out. I did not know that statistic, Emmy, and I love statistics. But no, that’s important. I could digress and go on a tangent on our maternity system, but I won’t because what I want to talk about is laboring in the water and water birth. I know you didn’t have a water birth, but you had an epidural. It’s really interesting because there’s been a lot of studies out that evaluate whether laboring in the water can be an effective pain relief tool. How effective is it? What are the benefits? Are there any risks to it? All of those types of things. And so, I just want to talk a little bit about that because it’s been a while since we’ve talked about water birth, but I also want to talk about laboring in the water even versus getting an epidural. I am going to dig deep into this article on the Evidence Based Birth® homepage or you can go to evidencebasedbirth.com/waterbirth ( https://evidencebasedbirth.com/waterbirth/ ) and we will link that in the show notes for you to easily find. It’s a really lengthy article. That’s one thing I really love about Rebecca Decker is she does such a great job of really digging into the research, the trials, the evidence, and tearing it apart and making it easier to digest. Obviously, I can’t dig into the whole article. You should definitely go and read it yourself. Basically overall, it showed that laboring in the water doesn’t show any extra risk for the mother or the baby and it does help relieve pain. It leads to a lesser need for pain medication or less need for pain medication. Does that make sense? “Leading to less use of pain medication.” That’s how she worded it. Another study found that mothers who labored in the water had less anxiety. This is labored in the water, not birth, okay? “Mothers who labored in the water had less anxiety, better fetal positioning in the pelvis, less use of drugs to speed up labor, and were more satisfied with the privacy and the ability to move around.” There’s a lot of water birth studies that they review in that Evidence Based Birth article, but I just love it when you talked about laboring in the water. How it just felt good. It felt natural to you. It felt like what you needed to do, but then you knew at the point when you needed more than the water. You knew there was a point. Hallie: Yep. Julie: Do you know what? Asynclitic babies are such stinkers. You’re right. She was being very naughty. That’s probably why, when your water broke, if her head was asynclitic, that’s probably why things kind of took a little bit longer to fully progress, because man, those asynclitic babies get nice and wedged in there. My point is-- laboring in the water. Most hospitals won’t allow you to labor in the water. I think more and more hospitals are allowing that. There’s a couple here that will. Emmy, do you have any hospitals in your area that allow water birth? Emmy: So they don’t allow birth in water, however, there is a good amount of them that do laboring in the water, which is pretty awesome. But as soon as you get pushy, you get pulled out of the water. However, we also, in our area, have access to about four or five different birth centers that allow you to birth in water. So, we are in a pretty magical area here in Phoenix where we have a lot of choices. Julie: I’m sorry I said it was 3 feet above hell. Emmy: You know, that’s not wrong. Julie: But Phoenix is really— what did you say? Emmy: You’re not wrong. Julie: You know, I didn’t mind my time in Phoenix, but it was just super hot. Like, super hot. But then I went to Basic Training and lived in Georgia, which is just a whole different kind of hot. Sweaty hot. So, anyway. Emmy: Yeah, yeah. I think it’s amazing to have access to water, to have access to an epidural. One of the other ones that I really love to throw out there to my clients to look up is if they would be interested in nitrous, which can also be a really good alternative because it doesn’t stay in your system. It doesn’t pass through the placenta or into baby, but you get that little bit of cutting off the edge of what a true contraction can feel like. Julie: Yeah. Do most of your hospitals offer that? Or do you have to do it pretty much at a birth center in Phoenix? Emmy: We have quite a few that also offer nitrous and only one birth center that offers it. Julie: That’s so interesting because here it’s kind of opposite. One hospital offers it and most of the birth centers do have it in Utah, or at least in my area in Utah. Salt Lake City, Utah County area. So, interesting, yeah. I know that a lot— in England they use nitrous a lot. Australia, what about you, Hallie? Did you have that as an option for you? Hallie: No. Nitrous? Julie: Yeah. It’s like laughing gas, like at the dentist’s. I don’t know if it’s something different down there. Hallie: Yeah, that’s really available to everybody here. Yep. Not everybody, but— Julie: Good. That’s awesome. I really think that they need to make travel-sized bottles of nitrous and give them out by prescription for moms with anxiety. Hallie: Totally. Emmy: So if you want to go in halfsies on that business model, I am down. Julie: Alright. So I am a student midwife. It’s slow-rolling, but once I get certified, I’ll see about the legalities of that. For sure. Q&A Alright, Hallie. I want to ask you two questions before we go. Emmy, don’t go anywhere. Hallie, your questions. We asked you when you filled out your form, but it’s okay if you don’t remember the answers. You can just make new ones. But we try to ask two questions to our guests now. The first question is: What is a secret lesson or something no one really talks about that you wish you would have known ahead of time when preparing for birth? Hallie: I think preparing for VBAC birth, I didn’t know that having an epidural was an option because of what I had read online. There was no epidural and there was no option of anything else. It had to be natural or C-section. So I was really, really happy to hear that I did have that option. Because it was such a big aid in my birth in the end. That’s good. Yeah. No, I think you’re right. I think a lot of people just don’t know that it’s possible. There’s a lot of myths out there about VBAC. But, yeah. Cool. Good answer. Alright, the next question is: What is your best tip for someone preparing for VBAC? Hallie: Yeah, it had to come down to your care provider. It’s finding somebody that fully aligns with the birth that you are planning for. To be able to put your best foot forward, you have to have somebody that’s going to be right in your corner. And not just be VBAC supportive, but a real advocate for you as well. Julie: Yeah. I absolutely love that. I love what you wrote in your response. You said you didn’t realize it until the day you were giving birth, watching your midwife advocate for you over and over, standing at your door like a guard and ushering unnecessary people away. Everybody’s care provider should be like that. She was like a sentinel at your door. Just like, standing there. Hallie: She was like a guard dog. She was, though. She was just barking orders and telling people to step back. It was just incredible. Doulas supporting clients with unsupportive providers Julie: That’s amazing. I wish everyone could have that kind of support. It makes me sad that— I don’t know. Sometimes the stories we share, or witness even, of providers— I am working on an email series for birth workers right now and I asked in our community of VBAC doulas— we have almost 200 VBAC doulas in our community on Facebook now. Hallie: Wow. Julie: It’s just mind-blowing to me. Yeah, it’s crazy. I love our community of doulas. They are a really great group of people. Emmy: Yeah, we are. Julie: I asked them, what is the biggest barrier that you face— yes, you are. What’s the biggest barrier you face when supporting or trying to support VBAC or TOLAC parents? And almost every single answer, I’m telling you. Almost every single answer was from doulas saying, what to do when your client has a provider that is not supportive, and you know they’re not supportive, and your clients know their provider is not supportive, but they won’t change providers. It’s really, really hard as a doula-- clearly for many doulas-- to sit there and watch a parent go through a birth experience that could have gone differently had they chosen another provider. It’s really kind of a fine line. Emmy, maybe you have some opinions on this because I’ve been talking back-and-forth about this with Meagan for some time now, but birth advocacy in the birth room. Ahead of time, obviously, we try to educate our clients as much as we can about what makes a supportive provider and what the red flags are. Sometimes your clients see the red flags and they choose to stay for whatever reason. Sometimes it’s hard to come to terms with that as a doula, even though you don’t know why that client might be staying with that provider. Emmy: Yes. Julie: Who knows? Maybe the universe, or God, or whatever you believe in has a plan and that person has to stay with that provider for whatever reason. But watching them struggle through a birth with an unsupportive provider that everybody knew was unsupportive beforehand is a big struggle. Where do you advocate? Where is the line as a doula? Because I know that as doulas, there’s this big call right now for doulas to be advocates in the birth space, but I feel like we have to really be careful because you can’t go in there with your hammer and your chains saying, “No! Don’t touch her cervix! Turn that Pitocin down! We’re not going to get an epidural! Blah, blah blah. Fill up that tub!” Because that type of advocacy— I mean, there’s a time and place for it, and it’s not in the middle of the birth. Like, obviously yes. If your client is saying, “No take your fingers out of my vagina,” while the provider is refusing to stop doing a cervical check, you can jump in. You should jump in, I believe, anyway. And say, “Hey, she said stop.” There’s a difference between that and trying to navigate through an unsupportive supportive environment. Like, I don’t know. Emmy, what are your thoughts? Where is the balance? Emmy: How I treat it is just like how you treat your friend who’s in a crappy relationship. You just keep bringing it up. Right? Like, “Oh, how is Joe? I’m sure he is— oh, he did that again? Weird. So, I have a guy that you could talk to.” Julie: He’s really cute. Emmy: Or an OB. You could talk to him. The midwife is great. She’s awesome. How about you just do the free meeting? And because they did your well-women’s check does not mean that they should give birth, like, be a part of the birth of your baby, right? And really comparing it. A lot of my clients finally give over once they realize, would you bring your Tesla to a Ford mechanic? No. Julie: I love that. Emmy: Because that’s not their purpose. Their purpose is daily check-ups, that kind of thing. Not a car with a battery. So, right now, you’ve got a car with a battery. More specialized. It’s going to be more expensive, probably. Let’s just get real. This is tougher stuff. So, let’s get someone who is prepared for that and actually can be with you through it. Of course, I get people who don’t listen. And I have to understand why they feel comfortable in that space. That’s where— I think it’s important on our side not to let our biases come through. Julie: Yeah. Emmy: That does happen with me on occasion. I’ve even had it where someone’s like, “Well, I want continuous monitoring and I want movement.” Okay. Those don’t go together. Julie: I mean, it can if you have-- (inaudible) Emmy: Right. So the conversation we had, and then she was like, “Well, my provider said it was possible with the wireless monitors.” I was like, “Oh, now I understand why you’ve been set up with this notion.” Now I can come off of my own biases and like, alright. We have a different tool that I didn’t realize was in the tool bag. And really, that provider was trying to bring comfort to that person while also skirting the lines. So I think that’s also important on a doula level is, remember that providers are also humans trying to do their best, right? Julie: Absolutely. Emmy: Those are the balls you juggle. Treat it like a bad relationship, but also realize maybe they’re also human and they are doing their best to also juggle the balls. Julie: Oh, I love that advice. Juggle the balls. Juggle all the balls. I think that that’s really good advice. Honestly, most of my VBAC clients now, if they have a provider that I know to be not very supportive of VBAC, I intuitively spent a lot of time prenatally. We go over a lot about what a supportive provider looks like, what evidence says for X, Y, and Z, and send them a lot of information. We talk a lot about their plans, what they want, and then before too long, they realize that their provider is not in line with what they want. And then I am ready right there, like you said, with a list of recommendations for new boyfriends, or new providers, new relationships, new car, whatever you want to call it. Emmy: Yeah, exactly. Julie: They end up switching. I can think of so many clients that-- especially VBAC after multiple Cesarean. There is this one provider in the area that everybody recommends and he is not VBAC after multiple Cesareans friendly. He is not. For some reason, everyone refers to him. I even had a client he told once, he sighed a little bit and did a little side-eyes and said, “I don’t know why everyone refers to me for VBAC after three C-sections. He told that to my client who was going for a VBAC after three C-sections. She ended up going with a different hospital and having her VBAC after three C-sections at 41 weeks and 5 days. Had she stayed with that provider, she would not have had her VBAC after three C-sections. I can say that with confidence. And so, I don’t know. It’s just this dance. Emmy: It’s incredible. Incredible. Julie: It’s just a dance to go on and play around because you have to be respectful of the birth space and the staff because the nurses and the obstetricians-- they’re all just trying to do their job the best that they know how and the best that they can do. Sometimes they’re tired and sometimes they’re having a bad day. But I think-- yeah. I don’t know. It’s just a struggle. I’m going to ask Cristen Pascucci from Birth Monopoly to come on the podcast and talk about advocacy, knowing your rights, and things like that. Emmy: Well, there you go. Julie: She’s going to just knock it out of the park. We’re going to all have answers to our questions. Emmy: But that’s a big thing of mine is-- my purpose is to guide you to know how to be an advocate for yourself, right? I am not here to make decisions for people. So, yeah. That’s the hope, right? That would give them the skill of advocacy? Because that’s going to be important for their baby that just arrived and to make decisions for. Julie: Yes, absolutely. Alright, Emmy. Well, it’s about time to wrap up. How can people find you if they are in the lovely Phoenix, Arizona? Emmy: I am Birth Wizard on everything. I am birthwizard.com ( https://birthwizard.com/ ). I am Birth Wizard on Facebook ( https://www.facebook.com/BirthWizard/ ). I am Birth Wizard on Instagram ( https://www.instagram.com/birthwizard/ ). I am Birth Wizard on Tumblr, Twitter ( https://twitter.com/birthwizard ) , and Pinterest. Like literally everywhere .com, I’ve got it. Yeah. Julie: Awesome. Emmy: So, just shout out an email. You can summon me and we can talk about VBAC or whatever birth you need to have. Julie: Summon the Birth Wizard. I love it. Alright. Well Hallie, thank you so much for sharing your story with us. It was great to listen to you and I am so glad that you had the support that you needed for your VBAC. Hallie: Thank you so much for having me. It was really great. Closing Would you like to be a guest on the podcast? Head over to thevbaclink.com/share ( http://www.thevbaclink.com/share ) and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com ( http://www.thevbaclink.com ). Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Brigette, who is also one of Julie’s very own clients, shares her inspiring VBAC story of how she went from being only 1 centimeter dilated upon arrival to the hospital to 10 centimeters dilated, pushing, and a beautiful baby boy in only five hours. In Julie’s words, Brigette’s “VBAC rocked my world. It’s one of those things where in your mind you know certain things work, line up, then the magic happens. But then, when you actually are there witnessing it and doing it, it is magical. I don’t know what other way to describe it. It’s super cool, super empowering. I left that birth all smiles, really, really excited for Brigette.” Also, joining us today as Julie’s co-host is Tara Van Dyke, one of our VBAC Link Certified Doulas. Together, Julie and Tara discuss how to best prepare the cervix for labor, as well as some information about the cervix that most people overlook. Additional links Spinning Babies Abdominal Lift ( https://www.spinningbabies.com/pregnancy-birth/techniques/abdominal-lift-tuck/ ) With U Parenting ( https://www.withuparenting.com/ ) How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) Episode sponsor This episode is sponsored by our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and Julie have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head over to thevbaclink.com ( http://www.thevbaclink.com/ ) to find out more and sign up today. Full transcript Note: All transcripts are edited to eliminate false starts and filler words. Julie: Welcome to The VBAC Link Podcast. This is Julie today. I am missing Meagan with all my heart, but don’t worry, because I have two wonderful people with me here today-- one of our VBAC doulas to co-host and one of my own clients sharing her VBAC story that I’m so excited to hear. I’m going to introduce both of them in just a second, but Meagan-- this is going to be really funny, the way it plays out in the schedule because this episode is coming out in the middle of our three recordings. This is technically the second one that you’re hearing with Meagan absent, but it’s three weeks after the first one that posted, and then there’s another one in two weeks that’s not going to have Meagan on it either. So, just bear with me. I’m missing my security blanket, Meagan. But luckily I have one of our VBAC doulas and one of my clients here to fill in that warm and snuggly that Meagan always helps me with when we’re recording. First, I’m going to introduce our co-host, Tara Van Dyke. She is in Chicago, Illinois. The only thing I know about Chicago is that the airport is really big. I had to run from one end of the terminals clear to the other ones and wait for the little tram thing to come. This was when I was in the military. It was between Basic Training and AIT I think. I had this rucksack, or not rucksack, duffel bag on my back and combat boots just hoofing it. I was in way better shape. No way I would have made it now. But like, back then. It was quite the sprint. But Tara, her business is With U Parenting. A really fun fact about her is that she goes skydiving on all of her milestone birthdays and she takes her kid's skydiving on their 18th birthday. I think that’s the cool mom. You’re definitely the cool mom, Tara. Tara: Thank you. I do it because I love it. Julie: I went skydiving once when I lived in Hawaii. It was 10 years ago and it was super fun. But I’m really excited. What a fun thing to do. So, milestone birthday. What is that, like every five years? Tara: Well, it started on my 30th. There have been a few since then, just to give you a hint. Julie: A few? Tara: A few, yeah. Julie: 31 and 32. Tara: My kids were little then and I didn’t know the side effect of them all watching me do it was that they would all be crazy about doing it, too. So, it’s been a big family tradition that I take them on their 18th birthday. All four of them have reached that milestone now, so I need to find another reason to keep going. Julie: I’ll pretend like I’m turning 18 again, and then I’ll come to Chicago and we can go together. And Meagan, too. And maybe Brigette, later on down the road. Tara: Totally. Yeah. Brigette: Yes. Julie: It will be fun. Okay, skydiving. Oh my gosh. This story is just about as exciting as the time I went skydiving. Maybe even a little bit more so. My very, very own client, Brigette. I say my favorite client, but I call all my clients my favorite client. Sooner or later they’re going to start calling me out and be like, “I’m pretty sure you called her your favorite client.” But I really do love my clients so much. They really do get to be like my family and friends. Tara, I’m sure you can relate. It really just makes my heart happy whenever one of my clients wants to share their story. Review of the Week Julie: Before we get into Brigette’s story, I’m going to have Tara, the master skydiving, best mom ever, read a Review of the Week for us. Tara: Okay, I’ve got it. There is a review from koalababy21 on Apple Podcasts ( https://podcasts.apple.com/us/podcast/the-vbac-link/id1394742573#see-all/reviews ) and she says, “Amazing. I am so happy I found this podcast! I had a scheduled C-section with my first daughter because she was measuring large. I wish I had found this podcast before I agreed to it! Next baby, I’m definitely trying for a VBAC. This podcast has made me feel so empowered and informed. Thank you, ladies!” I love when people are planning their VBAC before they’re pregnant. Julie: I know. Me too. We’ve had— in fact, I think it was our very first or our very second course when we were doing in-person courses before the coronavirus. She wasn’t even pregnant yet. Her C-section baby was four months old and she came to our in-person course because she wanted to be that prepared ahead of time. And I’m like, “You rock. You rock.” That’s definitely awesome. Yes, thank you so much for the review. We love reviews, as you know. We love hearing how we are helping you. It really keeps us going and keeps this podcast rocking and rolling for you. Episode sponsor Julie: Do you want a VBAC but don’t know where to start? It’s easy to feel like we need to figure it all out on our own. That’s what we used to do, and it was the loneliest and most ineffective thing we have ever done. That’s why Meagan and I created our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) , that you can find at thevbaclink.com ( http://thevbaclink.com/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and I have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head on over to thevbaclink.com ( http://thevbaclink.com/ ) to find out more and sign up today. That’s thevbaclink.com ( http://thevbaclink.com/ ). See you there. Brigette’s story Julie: Brigette, I had no idea. How did I not know that you met your husband in Belgium? Brigette: Yes, technically the Netherlands, but it was on our mission. We both served a mission up there and that’s how it happened. Julie: Oh, okay. Brigette: Yeah. I like to get that little hook out there, you know? Julie: Yeah, the Netherlands, and Belgium. That’s really cool. You love to travel. I love to travel too, but you know what puts a damper on that? Children. Brigette: COVID? COVID and children. Julie: One day. Maybe that’s what will make me the cool mom, is on their 18th birthday, I’ll take them to whatever country they want. That would be so cool, right? Actually, that would be really expensive. Tara: It does get more expensive. Julie: Maybe I’d better find something else. I’ve got 11 years to figure it out, so I think I’m good. But she is the wife of a former Marine and she loves cooking, baking, and taking care of her babies. She loves being outside. She has two boys-- two years old and three weeks old. And, you guys. Her VBAC rocked my world. It’s one of those things where in your mind you know certain things work, line up, then the magic happens, but then, when you actually are there witnessing it and doing it, it is magical. I don’t know what other way to describe it. It’s just super cool, super empowering. I left that birth all smiles, really, really excited for Brigette. But before I start telling her story for her, I will turn the time over to her. Brigette: Thank you. It’s so crazy to hear you say what you said about it. I was just excited to have you as my doula. It’s cool to be here on the podcast, and then have you talking about it like that. It’s fun being on this other side having already had the birth and I can just reflect on it now. I have to just say, I was totally that person that before I got pregnant, I was researching all the things. After I had my first C-section, I didn’t really know what a VBAC was actually, to be honest. I didn’t know that it was a thing. I just thought I was going to have to have a C-section with all the rest of my kids and just super bummed about it, but I actually searched VBAC something, I can’t remember, on-- I think it was on Instagram, and you guys popped up. I was like, “Oh, wow. This has a lot of information.” So I just delved into it and read everything on your guys’ blog posts, and listened to all of your podcasts to and from all of my appointments, at home, on walks, and everything. So, really cool. But anyways, to start off. I had my first C-section in 2018. It was with my first son that was born in August 2018. I had a really healthy pregnancy. I want to say that I did plan for my birth, but in all reality, I didn’t really seriously plan for it. I just kind of looked up videos and Googled things and stuff, and thought I was prepared for it. And thought I was prepared for the hospital experience I guess I should say because no one really prepares you for that. No one tells you what it’s going to be like with doctors and nurses, and just finding a doctor that’s going to be the type of doctor that you want to help you get the birth that you want. I totally just was-- I just went to a clinic that was in my small little town that we lived in Arizona that was close by because we were kind of far away from the big city. So I was like,” Oh sure. I’ll just go there.” They were great. They were really good. But, I think I kind of just settled with that location-wise and it turned out to be just a little bit of a bummer. Fast forward to actually having the baby. I was 40 weeks and 1 day. I thought that I was having contractions one night. I just thought that they were building up to contractions, I should say. They were Braxton Hicks. They weren’t painful or anything, but they were kind of tight and getting a little bit intense. I laid down and they went away. I was able to sleep through the night and then the next morning my husband was like, “Let’s go on a walk. Let’s see if we can get anything going.” So we went on a walk and walked the curb. I thought that I felt a little bit of water-- fluid coming out. I didn’t feel a gush or anything, but I was like, “Oh, I wonder if that was my water. I’ve heard that it can trickle out.” So we were like, “Okay. Let’s go home and see if more comes out.” A little bit later, nothing happened. But I had tested positive for GBS in this pregnancy, so they were like, “As soon as you think your water broke, make sure you come to the hospital so that we can get you started on the antibiotics.” So I called the hospital and they were like, “Yeah, might as well just come in and get checked.” And so that’s what we did. We kind of took our time to get there. They checked me. I was also 2 centimeters dilated before, at my last appointment. When I got there, they checked me. While we were waiting for the results-- we were just in triage-- all of a sudden, a ton of beeping happened and the baby’s heart rate went down. It decelerated to like 60 bpm. Everyone comes rushing in and puts oxygen on me, flipping me over, like, five times to try to get his heart rate found, or just trying to get it back to see if it went back to normal and it did after a minute or so. it went back to normal. They permitted me and they told me that I was going to be induced that night. I was like, “Okay, sure. I am all for it. I want this baby out of me.” I didn’t really know much about the cascade of interventions. So that was like around 3:00 p.m., and around 11:00 is when I actually got Cervidil inserted into my cervix by the doctor that was on-call. I hadn’t even met her once, to be honest. That was kind of-- yeah. She was great, but yeah. I didn’t really know her, because my other doctor wasn’t there. So as soon as she-- I just remember, as soon as she inserted the Cervidil, I swelled up down there in my lady bits. It was like golf-ball-sized swelling. Julie: Miserable. Miserable. Brigette: It was so painful. Yes. I couldn’t sit upright because I couldn’t sit on that, and so the birth ball was out of the picture. I couldn’t really walk around much because it hurt to walk around. So I was really just stuck on the bed, which is not ideal at all when it comes to this. You know, you want to be walking around and able to be bouncing or doing a side-lying position and I wasn’t really able to do anything to help baby come down. Then, they put me on Pitocin, and contractions started happening. They were like, “Well, if the contractions are very intense right at the front, then we will take the Cervidil out,” and they were. It was insane. All night I was up contracting, so they eventually took the Cervidil out and I-- every single time they checked me, it was super painful and I didn’t realize why. It was just because he was super high up. Nobody really told me that. Anyways, I just wish I would have known that. But I got checked again by a new nurse that came in and she was super gentle. It didn’t hurt when she checked me, which was strange, but I was only 3 centimeters at this point. I opted for the epidural because I think that the contractions were a minute apart and they were insane still, even though they took out the Cervidil. I was trying to breathe through them, like low and controlled breaths, but I wasn’t able to do it any longer. I was only 3 centimeters and I got an epidural. I didn’t know what else to do. I didn’t have anyone else there to help me now. I rested the rest of the day and I took a small little nap. That night they upped my Pitocin a little bit more. Eventually, the epidural wore off and I was up the next night again, all night. Oh, I forgot to say. Before I got the epidural, I had eaten the breakfast that they brought in. Before I got the epidural, my nurse was like, “Did you eat breakfast? Okay good, because this is the last thing you’re going to eat until after you have this baby.” I was like, “Oh my gosh.” “Yeah, also, you can’t really drink any water.” And I was like, “Okay.” I took her word for it and she was great. I really liked this nurse, but I just thought that’s how it was. I got the Pitocin later that night, or, they upped it. I can’t remember to how much. I labored all night again and then the next morning I finally got dilated to a 10, but he was still very high up. I don’t remember what station he was at or anything. But the doctor-- they had switched shifts so there was a new doctor on shift and before she had to even come in, she heard what was happening. She hadn’t even come in to talk to me or anything and the nurses came back and they were like, “Dr. So-and-so wants you to have a C-section. She heard what was happening and she wants you to just have a C-section. She thinks it would be best.” And I was like, “Are you serious? I got this far…” Julie: Without even coming to talk to you or see you. That’s what really bugs me. Sorry, I’m going to interrupt you for a minute. That’s one thing that really bugs me about our modern obstetric care is, we rely more on what we can see on a monitor than what a person’s body is telling us or by getting a feel for the situation by actually being present. You know? Anyways, rant over. Go on. Brigette: No, totally. It really made me frustrated because-- just the fact that she didn’t even take the time to come in and talk to me and see how I was feeling. She was just like, “You need to have a C-section.” I told the nurses, I was like, “No. I’m going to try to have this baby vaginally. I’m going to try as long as I can. I want to push to see if I can get him to come down.” They were like, “Good. Yeah, I think that’s what you should do.” I pushed for like an hour, and he did come down a little bit. He budged just a little bit. They could see his hair. They could see his head and stuff. My husband was able to see his head and see how much hair he had. But then the doctor came in and she was-- this part’s really annoying and frustrating too. She was standing over in the corner just kind of watching, and just looking. Not supportive whatsoever. Not even there helping me push or anything. She was just standing over there watching and she’s like, “Yeah, it looks like he’s like having some head trauma. His head looks a little red and stuff. I don’t know if you want to put him through this much longer.” And I was of course like, “I don’t want to hurt my baby.” Of course, I don’t know if that would have been bad for him, but babies’ heads can shift I’ve learned. The plates can move around for them to come out vaginally. I just didn’t want to put him in any danger, or pain, or trauma. I prayed about it and I opted for the C-section. The C-section was fine. I was shaking a ton, which sounds like it is pretty normal. I healed really well-- good, I guess. I don’t know. I had a good recovery with my C-section, but I still-- just the emotional aspect of it was hard for me. Every time I had a friend who had a vaginal birth-- this is probably selfish of me. But I was just like, “Why couldn’t I have had that? Why couldn’t my body have done what it was supposed to do to have this baby come out of me this way?” It was just hard. I would cry every time I thought about it for at least five months after. Eventually, I kind of got over it and I was just like, “Okay, I’m going to have a VBAC with my next baby.” Which is what I did. But anyways... Julie: Boom. That’s what you did. That’s right. Brigette: So, I just kind of took notes on my phone. Everything I learned about VBACs, and prep for it and everything before I was even pregnant like I said. We moved from Arizona to Utah. We thought we were going to live here just for a little bit before we go to California for military things, but that got changed because of COVID. I was in the process of trying to find a doula and a midwife over in this area in California where we were going to move, and I wasn’t able to find anyone that was VBAC experienced or anything. That scared me, so I was really happy that we stayed here in Utah because then I got Julie. Was so great. Julie: You had a really good doula. Brigette: It’s funny because I had actually— what’s that? Julie: I said, “You had a really good doula.” Brigette: I had a really good doula, yes. I’m so glad. Julie: Just kidding. No, but really though. I think we were a great fit. Brigette: Yes, for sure. That’s the thing. You want to find someone who’s a great fit for you, and you were. Actually, I messaged you guys about finding a midwife because I was-- I just didn’t even know where to start and I wanted to find a midwife. I wanted to go with a midwife this time because I had heard really good things about midwives. You guys had referred me to a midwife in Salt Lake. Am I allowed to say her name? Julie: Yeah, you totally can. We just don’t like to bad-mouth providers, but since we really love her and I know you’re not going to say anything negative about her, then definitely. Definitely. Brigette: Well, we love her, yes. Her name is Kira Waters. It sounds like Julie has had actually a few births with her before mine. She actually didn’t even end up being at my birth, but she was still great to be able to ask all my questions to you and then I was able to hire Julie as my doula, which I was so excited for. I keep saying that. I really was, just because it was cool to be listening to your podcast and every time I’d listen, I’d be like, “She’s going to my birth!” Not everyone will get to have you. People are all around the world, or around the country, and I’m sure that they have great doulas too, but I was lucky to have you. Anyway, so, fast forward to this birth, I had a good pregnancy and I had actually tested positive for GPS as well with this one, which I was really worried about, but ended up being just fine. It wasn’t that big of a deal besides that I had to be on antibiotics because my plan was just to labor as long as I could at home. I was 38 weeks and 3 days. I had just put my son down for a nap and was taking a nap myself. I woke up to a really strong contraction right at 4:00 p.m. I was like, “Oh, I wonder if that’s just my bladder telling me I need to go to the bathroom,” because sometimes that would happen with Braxton Hicks. So, I went to the bathroom and I actually had a little bit of bloody show— may be TMI. But, the day before, I also thought that I had lost my mucus plug and so, once I saw the bloody show, I literally looked at myself in the mirror and I was like, “My body knows what it’s doing. This is happening. I’m going to go into labor on my own,” which is what I wanted the whole time. I’m sure everyone wants that, or most people, you know? Tara: That’s the best moment. Isn’t it? That’s awesome. It did it on its own. Brigette: Yes. Yes, for sure. Because then you’re not-- yeah. It’s just good. So I was like, “Okay. Well, let’s just see if I have any more contractions.” I was already laying down, so I-- I don’t remember what I did after this. But anyways, I had another contraction 15 minutes later, and then it was 6 minutes later, then it was 10 minutes, and then it eventually just got more normal, like 5 minutes apart, 5 minutes apart. Then it was 4, and then 3. Then it was 2 minutes apart and they were starting to get to where I couldn’t really talk through them. I had to stop and breathe through them. My husband had just gotten home from work and my son had woken up from his nap. We were kind of just chaos-- didn’t really know what we were doing. I was cleaning the kitchen. I had chicken on the table that was dripping off to the floor that was raw chicken because I was going to make freezer meals. I wasn’t planning on going into labor, and so I had to clean that up through all of these contractions. So, I texted my midwife and she was like, “It sounds like it’s labor. You can go in. I would go in once you feel like you need support and help with labor.” I texted Julie and was just keeping her filled in. She was like, “Okay, I’m going to take a nap so that I am charged up to go at your birth.”  I was like, “Okay, I’m not going to bug her. I’m just going to labor.” That’s what I did. Then, she texted me and she was like, “How’s it going?” I was like, “We are on our way to the hospital. I didn’t want to call you and wake you up because I knew that you were sleeping.” She was like, “How are your contractions? Do you feel like you are having to vocalize through them?” I was like, “No, not really, but I’m definitely breathing through them really hard. Or, I don’t know. Just trying to have the controlled breathing.” You were like, “Okay. Well, I guess just let me know what you want me to do,” because-- I think you said that you could stay at your in-laws’ up there or something. Julie: Yep. Brigette: I just said, “Okay. I’ll let you know how it goes after the drive there,” because we had a 40-minute drive to the hospital. I was laboring in the back seat. It’s funny because right after I hung up the phone with you, all of a sudden I was like, “Okay, I can’t be quiet anymore. This is what she means. This is what vocalizing is.” My husband was like, “Okay.” I remember at one point he was driving through that crappy Lehi traffic or whatever it’s called-- Julie: It’s awful. Brigette: Yes. It’s so bad. It was 60, I think, that you had to go, and I was like, “I need you to go at least 70.” I looked at him in the rearview mirror and he was like, “Okay.” I was like, “You need to go faster,” just because it was going to be a long drive there. I finally got there, and I told Julie to come to the hospital because I was like, “This is getting really, really hard. I want you to be there.” They checked me in, and I was 1, maybe 1.5 centimeters, and I was crushed. I was like, “Oh my gosh, are you kidding me? It feels like I should be at least like a 4 or a 5 right now because these contractions are on top of each other.: They were only lasting 30 seconds, but they were very strong contractions that were about 1.5 to 2 minutes apart I think. Julie got there, and she was-- as soon as I saw her, I was relieved because it wasn’t just me and my husband in that room with the nurses knowing that I was only dilated to a 1 or whatever. She was like, “This is what we can do. We can do abdominal lifts or we can do Walcher’s.” She explained to me what they were and abdominal lifts— I don’t know if you want to explain what they are, Julie, because you are the expert here. Julie: Yeah. I remember I just pulled in the parking lot to the hospital when you texted me, or your husband, that you were at 1 and I was like, “She’s a 1? Like, how?” You had been working so hard and so soon as I got in, I’m like, “Alright. It’s time to get to work because something is preventing this baby from engaging,” just knowing how hard you were working. Abdominal lifts are a Spinning Babies® technique and so, before you attempt to do them, definitely lookup on their website, spinningbabies.com ( https://www.spinningbabies.com/ ) , so that you can learn the proper techniques. Your pelvis has to be tucked a certain way. You have to pull a certain way. If you do it wrong, it could-- I mean I guess it could just not do anything, but it also could cause some issues if baby’s head is wonky or something like that. But basically, you get behind the laboring person and you lift right at the very bottom of their belly. You lift upwards and then slightly backwards toward their spine. The pregnant person has their pelvis tilted in a posterior pelvic tilt, so their back is flat. That helps the baby engage, and get into the pelvis, and the cervix open, and all of those good things. But they really suck. They’re hard. Brigette: They were hard, but after we-- because we did 10 of them in a row, during 10 contractions I should say, but after-- I was like, “These contractions are painful anyways. I want to do something to help get him in a better position.” It was totally worth it because I got checked again, like 30 minutes later and I was 3 or 4 centimeters. We were all just like, “Yeah! This is going. Okay. Let’s do it!” Julie: That was a great moment. Boo-yah. High-fives all around. Brigette: Yes, for sure. Yeah. At this point, I was not able to relax at all between these contractions because they were so close together still. They were like, “Well, this is what you can do. You can get a dose of Fentanyl” or, I think that was my only option really. I was like, “Okay. I just kind of want anything at this point.” They were like, “Oh, it’s going to make you feel a little bit high, but won’t really drown out your pain at all, or very much.” Which is exactly what happened. I felt super loopy and on the bed, but I could still feel the exact pain from every contraction, so I don’t know if I would suggest that. It was a little bit of a distraction for me, so maybe that helped. I don’t know. I was on the bed and she had me doing a side-lying position-- like where you’re laying on your side with one knee up to try to get baby in a better position, which sounds maybe comfortable, but it wasn’t at all because-- it just wasn’t my choice position for contractions. But that helped too, because then-- I can’t remember how much later it was. Not much later, probably 45 minutes I think, maybe? I was 6 or 7 centimeters dilated. Then I was like, “Okay. I would like to get the epidural so that I can rest, so that baby doesn’t get super high heart rates or whatever.” I just needed the rest. That was my thought going into my VBAC was, I wasn’t against getting an epidural, but I wasn’t against going unmedicated. I just wanted to get my VBAC, however, that really needed to happen. If I felt like I needed to get my body rest so that it could progress more quickly, then I would opt for the epidural. That’s what I did. I should say, my midwife wasn’t there. She was actually out of town. None of us expected me to go into labor this early, at 38 weeks and 3 days. So another midwife was there, and she was awesome. Her name was Marnae. She was just as supportive as Kira was, and wanted me to have my VBAC, and didn’t rush me to anything. She came in and brought my waters. That really helped baby come down because I could feel the pressure of his head coming down, which was cool to be able to feel that, even with the epidural. Eventually, I got to complete. I pushed for 30 minutes and out came this beautiful baby boy. I did tear a little bit. I got a second-degree tear, but recovery has been fine. A little bit painful, but manageable for sure. I did a ton of daily birth prep from 34 to 35 weeks. Every single day, I went through my list and I think that really helped me. I don’t know if it really helped me or if I was just lucky to go into labor this soon, but yeah. That’s my story. Tara: Yay, that’s amazing. Brigette: I don’t know if I missed anything. Julie: Do you know what I think is just so funny? Reflecting back on that day, it was a little bit of a crazy day for me, but I didn’t want to tell you that. I never tell clients. Even if I am really struggling with something huge, which I wasn’t that day. It was just a difficult day. But I’ll turn on heavy metal music and scream on my way to the hospital. Then, I’ll ground myself, breathe it out, and leave everything in the car, so that I can come into the birth space with a clear mind and no negative energy. But when you were in the parking lot, I had just finished my clearing routine and I was like, “I’m okay. I’m ready to go in,” and then I got the text that you were 1 cm, I was like, “Dang it. I need to do a little more clearing.” Brigette: More hard rock music. Tara: What was the timeline then, from the time you got admitted until the time the baby was born? Julie: Yeah, do you have the notes? Brigette: It was 9:00 when I got there. It was 9, like straight up 9. He was born at 2:45-ish in the morning. Julie: Yeah, not long at all. Girl, you dilated 10 centimeters in less than five hours. Tara: That’s incredible. Brigette: My first contraction was at 4:00 p.m. that day. Tara: Yeah, but that’s when a 1 is not really a 1. You were doing good work. Your body was doing a lot more than you thought. Julie: Yeah. Absolutely. I’m just looking back at our text messages that day because I told my husband-- huh? What was that? Brigette: Oh, I was just saying that you had told me to do the Miles Circuit. I think that helped too during labor. Julie: Yeah. It’s so fun. You said you had lost your mucus plug and I’m like, “Woohoo! Your body is getting ready. In my mind, I had another client and her due date was four days before you had your baby. She didn’t give birth until eight days later. It was so weird. In my mind, I am like, “There is an order to things. She’s losing her mucus plug. That’s great.” I lost my mucus plug for three weeks with my third baby. Brigette: Your body’s getting ready. You told me that a couple of times and I was like, “Okay.” Julie: I’m like, “Your body is getting ready. That’s really good.” Because in my mind, I’m like, “This poor mama who’s four days past her due date is definitely going to go because you’re a VBAC and your first baby didn’t come until after 40 weeks.” I was so sure, but then you said you were starting to have bloody show and contractions. I’m like, “Hey, cervical changes.” Then you’re like, “Are you moving today?” Because that was when I moved and we had just gotten done. It was right before we moved. Yeah. So anyways, it was just so fun going through all of that. But she did. She had her baby two weeks early. It’s just so funny because you just never know when these babies are going to come. Tara, am I right? I think my first back to back birth was with clients that were due 13 days apart and I went straight from one birth to another. It’s nuts. Tara, I just called you Tara again. Tara: That’s okay. Yeah, that’s okay. Definitely. I’ve had clients due more than a month apart who have given birth close to the same day and vice versa. You never know. But that’s so nice when it goes earlier than you expect. That’s amazing. Preparing your cervix for birth Julie: Yeah. I love it. We are running out of time, but we want to talk about cervixes a little bit. Your cervix did some really cool things— or some really, I don’t know. It probably was not cool when it swelled up like a balloon in your first pregnancy. But, cervixes are pretty cool. They are pretty amazing organs. I think we don’t give them enough credit for what they do. Why don’t you tell everyone-- I just want, straight from your mouth, what did you do? Because I know you had done some certain things to get your cervix ready so that you could have your best chances of having a vaginal birth. Brigette: Yeah. One thing that I did-- well, I did a lot of things, but something that I definitely suggest doing is going to see a chiropractor to make sure everything‘s aligned and stuff. I really think that that helped. I was seeing a chiropractor once a week starting at 36 weeks. I know some people go more often than that. That’s what I chose to do and then I also started drinking red raspberry leaf tea. I was eating 6 to 10 dates a day. I was drinking as much water as I could. I actually was eating pineapple and the center of it. I can’t remember what it’s called. It’s like the hard part, you know? I guess it has bromelain in it or something that is supposed to help your uterus. I don’t really know. I did it. Julie: Bromelain. I didn’t know that it helped your uterus. I think it improves digestion. I’m not quite sure actually. Never mind. Brigette: I don’t know what it does. Yeah. I don’t know, but I was like, “Okay. Well, I’m going to try it. It’s not going to hurt me. It’s just pineapple.” And then I did the Miles Circuit every day starting at 36 weeks. Almost every day. It wasn’t every single day. I did most of these every single day. I would do the Forward-leaning Inversion on the couch. I’d have my husband help me. Julie came over and showed me how to do it and showed him how to come up out of it. We would do that before we would go on walks at night. I would do the Forward-leaning Inversion and then make sure baby was in a good position so that when I was walking, it was helping him come down better. So we would go on walks, at least a mile, almost every day. Then also, on my birth ball, I would sit on my birth ball for everything. Folding laundry, watching a show. Just playing with my son, my toddler, I was doing hip circles on it, and the pelvic tilts, like forward and back, and figure eights. I would do that a lot. That’s pretty much what I did. We didn’t-- this is maybe also TMI. I was not down for having sex very often, so I don’t think that was a big player of it. Tara: I don’t think there’s any TMI on this show. Julie: Yeah, seriously. There’s not TMI. Brigette: True. That’s true. This is all about birth. But, yeah. Some people like, “I think I had good success with that,” but I, no. That wasn’t really on my list. Tara: Pineapple core all the way. Julie: Yeah. Do you know what? Sometimes, I’ve seen with my clients and Tara, maybe you can relate too, and then I’m going to have you share a little bit in just a second. Sometimes you can’t say whether it’s that certain thing that made the difference, or whether the act of just having something to do put your mind at ease or put your mind towards like, “Hey, I’m doing something that will help,” that actually gets your mind psychologically ready. Maybe it’s both. I mean, I’m sure it’s both. There have been lots of benefits shown with the dates and the sex— obviously, semen is a prostaglandin— and the pineapple core, and all of those things. Yeah, bromelain, I think that’s the pineapple. I think that’s an ingredient in pineapple, right Tara? Tara: Yeah, an enzyme. Yeah. Julie: So anyways. Tara, go ahead. Your last two cents. Anything about the cervix. You can say anything about the cervix and then for anyone who is in Chicago, let them know how they can contact you because you are an awesome VBAC doula. Tara: Well, I have a lot to say about the cervix. But I thought it was very interesting, Brigette, in your first birth, that you said those cervical checks were so painful and that partly was because the baby was high, but also it can be when your cervix is posterior. A lot of people don’t realize that the cervix starts out pointing towards our back and then it moves forward as labor progresses. It moves back and forward during our menstrual cycle too. So if they have to reach up and behind baby’s head essentially to find your cervix, way in the back, that’s super painful. Brigette: Okay, that makes sense. I remember them telling me that too. Tara: Yeah. So, one of the reasons that it might have been less painful that third time or whatever was because maybe it had moved forward and it was easier for the nurse to find, although sometimes there are nurses that are just really good at that— being gentle. Yeah. I think that’s really interesting about the cervix. I love that Julie is talking about the psychology. You know, it’s doing the things, but it’s also what’s in our head about doing the things. I think that is a fascinating mix of the psychology of not trying too hard because I think when we-- when we are trying too hard, we also can work against our body‘s natural rhythms, but it sounds like what you did worked for you. Also, being all in. You were all in. Brigette: Yeah, for sure. I was. I was making sure that I wasn’t stressing myself out about it. I enjoy doing these things and so, just the release of oxytocin too probably helped calm my nerves. Yeah. So, anyways. I agree. Julie: Absolutely. Well, it was so lovely to chat with you ladies today. Tara, throw down your website right now. What is the best way for people to get a hold of you? Tara: Yes. My website is withuparenting.com ( http://withuparenting.com/ ) and that’s U, just the letter U because it’s all about being together, being with each other. We can’t promise what’s going to happen or promise outcomes, but we can promise you won’t be alone and that you’ll have somebody with you. So, that’s the idea behind my business. My email is withuparenting@gmail.com. Julie: I love that. That is a great sentiment. I would talk about it for longer, but since we are out of time, Tara, thank you so much for helping me co-host today and Brigette-- I just love your little family. I am so glad you are hanging around in Utah and not in California. I just appreciate both of you so much. Tara: Thank you. Congratulations, Brigette. Brigette: Thank you so much. Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Can crying really help solve prodromal labor? Is it possible that an emotional release can suddenly turn manageable contractions into full-blown pushing? YES! Listen to our friend, Liz, share her incredible surprise HBAC story that will reinforce your confidence in the power of a woman’s ability to birth. Liz was prepared to birth at the hospital without her husband due to COVID restrictions, but her baby had other plans. She says, “I got to have my baby in this completely natural way that I didn’t even realize how much I needed. I went from having a birth where I had literally zero control, zero-knowledge, and everyone else telling me what to do, and then a birth where I caught my own baby, suction bulbed him, and walked out carrying him while he was still attached to me. It’s so incredibly empowering.” We also discuss specific ways to find fears within yourself and how to release them. There truly is physical power in just letting go. Additional links How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) The VBAC Link Blog: How to Turn Prodromal Labor into Active Labor ( https://www.thevbaclink.com/how-to-turn-prodormal-labor-into-active-labor/ ) VBAC Without Fear: Five Minute Fear Release Video ( https://www.youtube.com/watch?v=c9-WIkEls5U ) Natural Hospital Birth: The Best of Both Worlds by Cynthia Gabriel ( https://www.amazon.com/Natural-Hospital-Birth-Best-Worlds/dp/1558328815 ) Episode sponsor This episode is sponsored by our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) , that you can find at thevbaclink.com. It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and Julie have helped over 800 parents get the birth that they wanted and they are ready to help you too. Head on over to thevbaclink.com ( http://thevbaclink.com/ ) to find out more and sign up today. Full transcript Note: All transcripts are edited to eliminate false starts and filler words. Julie: Happy Wednesday, women of strength. We are really excited for our story today, as usual. I don’t think we’re ever not excited about anything, really. But today we have a really cool story. We just love our friend, Liz. Her story is really, really exciting because it was an unplanned, unassisted home birth after Cesarean and I’m dying to hear all of the details of this story. Liz is from Houston, Texas and she is the mother of two boys. Her youngest boy’s name is the same as my oldest boy’s name. I thought that was really, really cool. They have a dog and she’s a Montessori teacher. What is that like right now? Liz: Oh my god, to add more stress to the situation, right? We are still doing it virtually right now and it’s pretty wild because, in Montessori, you’re teaching three different levels. Not only are you teaching three different levels, but then every individual child has their own path that they’re on. And trying to do that via Zoom-- it keeps you on your toes. But thank God I’ve been doing it for a while. It’s a good challenge. It’s keeping me busy. Review of the week Julie: Oh my goodness. Well, we can’t wait to hear your story, but before we get into it, I am going to read the review of the week. The review of the week this time is from Jill Dash. It’s actually a Google review. If you didn’t know, you can find us on Google ( https://www.google.com/search?aqs=chrome.0.69i59j46i39i175i199j0i20i263j46i67j0l3j0i10.1341j0j15&ie=UTF-8&oq=the+vbac+link&q=the+vbac+link&sourceid=chrome ). Just search for The VBAC Link and our business will pop up on the right side. You can click there and leave a review for us if you do not have Apple Podcasts ( https://podcasts.apple.com/us/podcast/the-vbac-link/id1394742573 ). Or if you do, that would be awesome too. Jill Dash on Google says, “I started listening to the VBAC Link about four weeks before my due date, during the COVID-19 pandemic. Knowing I couldn't have a doula at my birth or attend in-person birth classes, I was desperate for as much knowledge as I could gain from the internet. I listened to The VBAC Link on my nightly walks as I prepared for my own birth and was so inspired, encouraged, and comforted by hearing everyone's stories. I love how supportive Julie and Meagan are of their guests and of everyone's stories. There is so much to learn from this podcast! Thank you for existing.” Oh, my gosh. Jill Dash, thank YOU for existing. Thank you so much for writing this Google review. I know we probably say it all the time, but when we get reviews— Monday, we get our podcast reviews, all of them in our inbox. Whenever you leave a review on Google, it pops up at that time you leave it in our notifications. It really does bring a smile to our faces. I know it has turned my day around more than once for sure. It makes the harder things about running a business like this a little bit more bearable when we get those really awesome reviews. So thanks again Jill Dash and everyone else who has left a review. If you haven’t already, go ahead to Apple Podcasts, Google or even head over on Facebook and leave us a rating. Let us know how The VBAC Link is helping you on your birth journey or as a birth worker. Episode sponsor Julie: Do you want a VBAC but don’t know where to start? It’s easy to feel like we need to figure it all out on our own. That’s what we used to do and it was the loneliest and most ineffective thing we have ever done. That’s why Meagan and I created our signature course, How to VBAC: The Ultimate Preparation Course for Parents, that you can find at thevbaclink.com ( http://thevbaclink.com/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and I have helped over 800 parents get the birth that they wanted and we are ready to help you too. Head on over to thevbaclink.com ( http://thevbaclink.com/ ) to find out more and sign up today. That’s thevbaclink.com ( http://thevbaclink.com/ ). See you there. Liz’s story Julie: Alright. Well, you guys. I don’t even know enough details about this story to even start telling the story for her. I guess that’s a good thing, but I’m going to turn it over to Liz to start sharing her story with us. I am going to be sitting on the edge of my seat waiting to hear the details of this really exciting story. So go ahead and take it away. Liz: Cool. I think it’s important to tell the highlights of the birth of my first son first. My older son is almost exactly two years older than my son who was just born. They’re two years and six days apart. With my older son, first, off he was “late”, which, as someone who’s been through pregnancy and birth twice now understanding that that’s no big deal, but when you’re in your first pregnancy, it can seem like the longest amount of time ever. I had an OB who seemed to be pretty pro-natural birth and then throughout the time of my pregnancy, it became more clear that she was not as supportive of that and letting things run its natural course as I was hoping. I had found a doula who I think was really not much of a doula. She was a wonderful massage therapist but when it came to knowing me, having a relationship with me, giving me advice on anything, I didn’t really have that. Meagan: This sounds like Julie‘s first doula. Liz: Yeah? Julie: My husband calls her the most expensive foot rub I’ve ever had because she rubbed my feet for an hour in labor. I mean, she was great. She’s a nice person. She’s not a doula anymore. I think I was her last birth so she might have been like, “I’m out of here,” after that. Liz: It’s funny that you say that. I feel like this was kind of the end of the run as well. I’ll get more into it as I talk about my experience with my second son, but it’s one of those things that if you don’t have frame of reference, you’re like, “Well, I guess this is how it works,” if you don’t have a lot of other people that you can go and talk to. She had a lot of boundaries around being a doula in that I was only to see her one time and if my labor went over a certain amount of time then that would cost exponentially more. There was a lot of stress going on. Oh gosh, this was the other thing. It would cost more for her to come to my house first and labor with me at home and then go to the hospital with me as well, which was a pretty weird thing considering the fact that we lived down the street from each other. Meagan: I was going to say, was she in another super far away city? What? Liz: No. We’re literally in the same neighborhood and we live in the medical district. With that all being said, I didn’t have a lot of guidance. With my first son, I experienced a lot of— what I came to have found out as prodromal labor. Laboring at night, going through the whole process of contractions that feel very legitimate and have patterns, but then waking up in the morning and your body just going, “Well, it’s time to go back to work, right?” and slowing down again. That went on for a while until I went into what seemed like full-on labor. I’m texting my doula. She texted me back. We are talking about it and then get to the “five minutes for an hour” situation. I go to the hospital and I am not even near ready to be even admitted. I don’t even think I was 2 centimeters. They sent me back home and they said, “Don’t even come until you are two minutes apart because you’re so close. You’re going to have lots of time.” That was really good advice. Hours went by. They got closer. I’ll get into it more when I’m talking about my second birth, but these were totally manageable contractions. Were they contractions? Sure. Was I needing to moan through them or bend over? Not even close. I think that that’s notable. Meagan: Did your doula give you any advice? Like, “Yeah, I think it’s time to go,” or “Actually, I think it would be beneficial to do this, this, and this and then reassess,” or anything like that? Liz: No. She was very hard to get a hold of and you’ll understand why in a minute. It was just like, “Okay, we’ll go if you want to.” I go back and I am barely a 3 when they admit me. Once I get admitted, I text her and I’m like, “Hey I’m here. Ready for you when you’re ready to come.” And then she decides that now is the time to tell me that she’s in another birth. Meagan: Okay, so not being totally honest along the way. Liz: Right. With anyone, I try to consider that they’re coming from a good place, so she was probably trying to not upset me. Meagan: Yeah, I could see that. But at the same time, being honest is good. Liz: 100%. So the deal was, if this were to happen because this happens all the time as y’all know as people who work in the birth industry, you’d have backups, right? But instead of a backup doula, she sent one of her massage therapists which was awesome and felt nice, but this person didn’t have a lot of experience when it came to birth stuff. I am actually backing up and remembering that I went into labor the day that they were going to induce me because I was “late”. We get to the hospital. Of course, all the checking in, everything, labor stalls like it totally does all the time. This is when I found out that my OB was really not on board because she goes, “We were already going to induce you today, so we might as well just start some Pitocin.” Julie: What?! Liz: “We might as well start some Pitocin because you’re not in full labor.” She then decides to tell me that she has to leave soon-- you guys are going to love this-- because she had to get her windshield of her car repaired. Julie: Okay. Do you know what? I guess nothing because I am at a loss for words. I thought I had words, but I just don’t have words. That makes my skin crawl. It just makes all doulas look bad. Liz: No, this is the OB, not the doula. Julie: Oh shoot, okay. Meagan: It’s just unique. This is the frustrating thing. Obviously, doulas and providers are all different, but this just happened the other day with a client of mine. I was going to her birth. She called her provider. Her provider’s phone went right to voicemail and was like, “Here, call this person. I am out of town.” She was like, “I literally saw this person yesterday and she said nothing about this.” I don’t know why, but that frustrated me so much because as a doula, a provider, and a person on call-- I’ll just say, it’s hard to be on call, but at the same time it’s really important if you’re going to have that profession. It’s important to take it seriously. Be honest and open, not just not show up. Do you know what I mean? It’s just frustrating. Liz: I think their thing is that when you’ve worked in a profession especially like healthcare for so long, you don’t even realize that it’s the other person‘s first experience with it. So you’re like, “Yeah well, I’m going on vacation because whatever”. Not excusing this, but more just understanding that this happened a lot to me. With nurses, even just the way people would talk about your birth and your experiences. It’s so new, fresh, and terrifying to you in so many ways and you’re not even on their radar. Meagan: You’re like, “Listen this is my first time. These things are scary. I’ve never done this. It’s all new. Please talk in a gentle way.” Liz: Right, totally. I did not know and this is not my bad, but just a new experience. I didn’t do all this research on all of these other things because it never occurred to me that they would happen. I never researched Pitocin and what that would do because I was like, “Oh, well I’m just going to have a natural birth with this doula and everything‘s going to be fine.” Which, yeah. Pitocin kicks in and it’s terrible. The IV popped out of my vein and infiltrated my arm. I had all of the liquid going through my arm instead of into my vein. Meagan: Were you just puffing up? Liz: It was terribly painful. It made the contractions look like nothing. Everything goes terribly. I’m done. I’ve been in labor for a good amount of time now, probably 12 to 15 hours or something. Doula finally shows up and I’m at my peak. I’m already on Pitocin. I’ve already had this infiltration. Oh, and my OB told me that I only had a 40% chance of giving birth naturally because my son hadn’t dropped yet. There was so much stuff thrown at me. Meagan: What?! Because he hadn’t dropped yet? You weren’t even… Liz: Yeah, it was bad. She got there and I was like, “I’m done. I’m done. I want an epidural. I’ve hit my peak.” Anyhow, long story short, I had my son in the most common, over-told story like, “Goes into distress because that’s what happens all the time when this set of interventions gets thrown into play” and ended up with an emergency C-section which I never prepared for. I don’t think I was too emotionally broken by it because, at the end of the day, I just wanted everyone to be safe. He was there and it was wonderful, but I didn’t realize how painful a C-section is and I didn’t realize how completely unable I would be to walk and do things. Notably, my husband was in a cast in his right arm at the time. I just did not have the support that I needed. So that’s that story. Kid was fine. Everything was fine, but it was very “meh” at the end of the day. Meagan: Man, I am sorry that you had frustrating things like that. That’s just so hard. Liz: I am grateful that everyone was okay. I’m grateful that— I don’t know. I mean, I could sit here forever and talk about how terrible and horrible it was. And it was. There were traumatic moments of it. And those-- I didn’t even realize I was so upset by it until I got very close to having the birth of my second son. But what I can say, is that what was more important, is you should research every kind of possible situation that could happen to you and birth because so often, things could go in all of these different ways. I just wasn’t prepared and I didn’t have the support. I didn’t have anyone on my side. My dear husband just wants me to not be in pain, right? So he’s going to do anything I say. Meagan: Right, yeah. This is something that we talk about on the podcast all the time because we share stories of all types. We share VBAC, CBAC, we share uterine rupture. We really share all types of stories. We have had people write to us and say that it actually upsets them that we share these stories. We talk about it and say that the reason we share these stories is because we want to prepare you in all the ways. So no, you don’t have to listen to this story at all, but it’s important because we also felt like we were there too. We didn’t plan on having a C-section. C-section wasn’t even in the midst of what we were imagining. I’m sure Julie didn’t plan on getting preeclampsia. That wasn’t her plan. Julie: I was superwoman when I was pregnant until I wasn’t. Meagan: Right. I also didn’t know the difference between a VBAC supportive versus a VBAC tolerant provider. There are so many things along the way that I think it’s so important that we research because we don’t expect them to happen to us. We hope that these things don’t happen to us, but they can. If we are prepared a little bit mentally-- not like we’re planning on that happening-- but if we’re prepared that it’s a possibility, then it doesn’t hit us like a freight train when it happens if it happens. Liz: Right. It’s all about informed decision making too. You can 100% end up, not even attempting a VBAC, you can just decide, “Oh I want to have another C-section.” But to be able to go through the process of understanding what that means and what consequences, either negative or positive, come from that, it’s a peaceful way of understanding. I think that I was just like, “Oh, well I am young, I am hip. I am just going to have this baby.” There’s so much of motherhood from breastfeeding to discipline to everything. It doesn’t come naturally. You do need to reach out and talk to people and ask for support and learn all of these different ways because that’s how you can make the decision that you can feel okay with and feel at peace with. Meagan: Exactly. I couldn’t agree with that better. Liz: Oh, and the baby came. The end. Y’all want to dive into this crazy story? Meagan: Let’s hear it. Liz: Cool. I think everything about my second kid has been this exciting surprise. The irony being that probably a week before we got pregnant with him, we had just sat down and had this conversation about how we were going to wait another year and it wasn’t the right time right now. Then surprise! There he is. So, a surprise pregnancy. I just kind of assumed, “Well, I had a C-section with the first one so I guess this one will be a C-section too. That’s nice because I can schedule it and I know when he’s coming. It’ll make teaching easier because I can say, ‘Oh this is when I’m going to take off and blah blah blah.’” It never even occurred to me. A few people had mentioned VBAC to me and I was like, “I don’t know.” I feel like I had kind of just given up on that whole idea of having that type of birth because everything just went so wonky with my first kid that it was like, “Well I guess that’s just not in the cards for me.” But I did switch OB’s. The OB that I switched to was actually the woman who ended up doing my C-section for my other child because, as I mentioned earlier, my OB had to leave. So this other doctor swooped in at the last minute when things were actually going awry. My kid was not doing well and she saved his life. In the hour that I spent with her, I felt more connected to this woman than I had in the nine months that I had with my other OB. Julie: That’s when you know you’ve met the right one. Liz: Yeah. She was funny, we were joking around, she was holding my hand and she was just so in tune. I didn’t even know this woman. She randomly just walked in. So I sent her an email. I had to go through an actually kind of silly process to switch OB’s. It wasn’t as simple as saying, “I’d like this one now.” I had to get permission. Anyhow, so I switched to her. I walked in and it was a totally different experience right away. She was the one who was like, “Do you want to try and go for a VBAC? Because you are a perfect candidate. You should do this.” And I was like, “Really?” She said, “Yeah!” Well, I hadn’t really thought about that. So I went home, thought about it for a while, talked to some people and I was like, “Okay sure, yeah. Let’s do this. This doctor seems to think it’s a good idea so why not, right?” I kept going through the pregnancy in a much more calm way thinking, “Okay, at some point I’m going to have to start thinking about this whole VBAC thing.” As we got closer, she started talking about how interventions are to be avoided the best we can to have a successful VBAC and how she wants me to stay on my feet for as long as possible. She wants me to labor at home for as long as possible. She wants me to start working on my squats and all of the stuff and I’m like, “Okay, okay. So no epidural, no Pitocin. That’s good. Okay,” and thinking about it. I was at home and I stubbed my toe. My sweet husband— I was crying, “Oh, my toe hurts.” And my husband was like, “There, there.” And I go, “Oh my god. I have to hire a doula.” Because I realized that this man was not going to be able to support me enough through unmedicated labor. Julie: That’s funny. That’s really funny. Liz: I was like, “Nope. There, there is not going to work for me.” When I call epidural, I’m going to need someone to say, ”No.” So I started researching and then everything started clicking. I was like, “Oh my gosh. I have to have a relationship with this woman. She’s going to see me and my most vulnerable state. I should like her. We should agree on the same things fundamentally.” All these things that just didn’t even occur to me when I was looking for a doula the first time. Then I met this super awesome chick named Jolie. We talked right away and both of us were like, “Oh, this is going to be great.” She had a lot of success with VBACs and I just loved her. Everything was wonderful. We met I think one time, maybe twice, and in one of those first or second meetings she mentioned, she was like, “Hey we are watching this COVID thing.” I was like, “Oh yeah, that’s a thing.” She was like, “Yeah. I don’t think it’s going to be a big deal especially because you are due in May. No big deal. But just so you know.” Meagan: Little did she know… Liz: Little did anyone know! Meagan: I know, right? Liz: She was like, “I’m sure this will all be taken care of, but you should know that in some states they are starting to limit hospital visitors. Just be aware of that.” So after a long discussion, we decided, as things got worse with COVID and especially in Houston. Actually, we didn’t even really get bad until July, but my husband and I decided that it would be better for him to stay home with our older son because I didn’t want someone else coming into our home and for Jolie to go to the hospital with me because I wasn’t going to be able to have both of them. And I was like, “If someone’s going to be with me while I am in labor, I love my husband, but I think I would rather have my doula.” That was the plan. I’m trying to think. I was around 39 weeks and then I started having that prodromal labor again. Laboring patterns through the night every ten minutes, sometimes every eight minutes. It got down to five minutes. Wake up in the morning, nothing. Meagan: Prodromal labor is terrible. We actually wrote a blog ( https://www.thevbaclink.com/how-to-turn-prodormal-labor-into-active-labor/ ) about it because a lot of people don’t even know about it. There are things you can do to help, but sometimes it doesn’t even help then. I’m sorry that you’ve had this twice. Liz: It just makes you feel crazy because you’re like, “Okay, this is it. We should start really thinking about it. It’s going to happen tomorrow.” Then you wake up and nothing. But what ended up really happening is that yes there was some prodromal labor, but what was really happening is, it would seem as if it was stopping during the day, but really my contractions were spreading out so much that I wasn’t taking note of them. So I think really I was in labor a lot longer than I thought I was, which is why everything ended up happening the way it did. So it would happen, I labor at night, wake up in the morning, and then it was Mother’s Day. It was Sunday. It was Mother’s Day. Over the night, I was having pretty strong contractions. Jolie had finally said, she goes, “Look. Don’t even text me or call me unless you have to moan through these contractions because at this point you’re just going to drive yourself crazy thinking, ‘Oh this is it. Let me text Jolie. Oh, now it’s not it. You’re going to be disappointed. Relax, and let it happen.’” Oh man, guys. I almost skipped the best part. Whew! That would have been rough. Okay, back up. She came up around Saturday before Mother’s Day and she said, “Can you think of anything emotionally that is keeping you from maybe fully going into labor?” And I was like, “No I think I’m really good. I think I feel really comfortable and confident about all of this.” She was like, “Why don’t you just take a long bath tonight and maybe find a way to let some emotional release happen? Maybe you watch a movie that always makes you cry or listen to a song or something like that.” I went into the bath and when I was in the bath, I started talking to the baby. I was like, “Hey kiddo. It’s time. You’re ready, almost 40 weeks. You can come out now.” And through that conversation I told my husband, I said, “It felt like I was reciting a monologue, this memorized monologue of a character that wasn’t even me because it was so tucked away in my feelings that I didn’t even know I felt this way.” I started talking about how I didn’t know who this baby was and he was just this stranger who was coming in. I was so sad about losing my alone time with my older son and how we had gotten to a place where everything was so good with him. I had such a strong relationship with him and who’s this new kid who’s going to come in and mess this whole thing up? Is my kid going to be mad at me and resent me for having this other child? We finally figured it all out and now we’re going to start this whole process all over again. I just burst into tears in the bath, just crying, crying, crying, crying about it, and then went to sleep and started having pretty regular contractions. I woke up the next morning for Mother’s Day and they kept going so my husband, my son and I had a picnic in the front yard while having contractions. I called my doula and said, “I think I am actually in labor now. I think it’s time to come over.” She goes, “Okay, well, I’m going to take my time.” I was like, “Yeah I’m not worried. We’ve still got time. No big deal.” So she started to head over. I think it took her like an hour, an hour and a half to come over, nothing too big. We were sitting in my son’s playroom and I was building blocks with him and talking with him. I would stop and have a contraction.  I would lean over and I would moan through it and then get back to talking with my son. I go, “Oh Jolie, I have to tell you this story. I have to tell you. I think I figured out the emotional thing that was keeping me from going into labor. I told her the story about how I was just so sad about missing time with my kid and then I started crying to her. Literally, right after I finished that story and wiped my last tear, I leaned over and went from having a 45-second contraction every four minutes to having a minute and a half long screaming, so intense contraction. My two-year-old came over to me and put his hand on my back and held my back while I was having the contraction. Then my water broke. It was like I finally let everything go and I said, “Okay, I think my water broke. It’s time to go to the hospital. These are getting closer.” It was like they were starting to speed up. I was like, “Let’s get ready to go. Let’s start packing things.” I tried walking to the bathroom and fell to the ground and was like, “Whoa. Something is different. This is wild.” I was scared. It went from manageable contractions, not great, but I could deal with them to, “I can’t think straight, this is so painful. So I think I made my way to the bathroom after that next contraction. I reached in to feel what was going on and the baby’s head was right there. Jolie was like, “We need to go to the hospital now.” I said, “We are not making it to the hospital.” She was like, “Oh, okay.” So you know, doula. Not a medical professional. She’s like, “We need to call the EMTs. We need to get someone here.” They call them and I had two more contractions and then was crowning after that. Meagan: Oh my gosh! Liz: Yeah. My house was built in 1940 and I have this little tiny half-bath underneath the stairs that’s smaller than Harry Potter‘s bedroom. Jolie is somehow standing in there and my husband is off holding my kiddo who’s like, “Why is mommy screaming?” I start pushing because here’s the thing. This was the labor that I knew existed out there in the world that when you’re ready to push, you have no other choice than to push. You don’t need anyone to tell you, “Hey it’s time to push now.” You know what to do. My husband started repeatedly telling me that he loved me and I very kindly told him to shut the explicit up. Julie: That’s when you know you’re getting close when the F-bombs start dropping. Liz: Yep. I was like, “Don’t you talk to me.” Jolie was rubbing my back. I said, “Get your hands off me. Don’t touch me.” I was on hands and knees. The EMT came in after my son‘s head was out and in, I think it was three pushes, baby came out. I caught him, then the EMT who— gosh bless them but they had no idea what they were doing. They were just so out of their element. They were like, “We are used to car crashes, ma’am. I don’t know what this is.” Oh, at one point he goes, “Ma’am just push.” I said, “Sir, I know that.” Meagan: “Leave me alone. I know what I’m doing. You just sit there.” Liz: “You just be there.” So he takes the baby and I’m like, “Hey can you pass him to me?” He goes, “How?” And I said, “Through my legs.” I suction bulbed him. I rubbed him and Jolie was like, “Holy moly.” I was like, “I know!” We are holding this baby and then it’s like, “Oh my gosh what do we do now?” Because I had no plan to give birth at home. I mean, I had Jolie there but no medical professional. I just got this baby. What are we to do now? And placenta is still in, blah blah blah. So this is where, depending on who you ask-- It is so interesting guys, how many people have opinions on a birth that has nothing to do with them. Julie: Oh my gosh. Say it again because that is so true. I just can’t even. Liz: It’s fascinating. There was a picture that my doula put up of me from this birth that kind of went vaguely viral and I would have people talking about how irresponsible it was of me to have a VBAC at home, and that this was clearly planned by me and my evil witch doula. We were just trying to cheat the system, right? Julie: Oh, girl. I got called a selfish cow on my YouTube video of my home birth. Liz: Isn’t that nice? Julie: Yeah. I think the same girl commented on Meagan’s video that court-mandated Cesareans are a good thing. That’s what she said on Meagan’s video. Meagan: Yeah. She attacked my VBA2C. I swear she told me that I deserved to go to jail because I had my baby at a hospital. Julie: People are just awful. Liz: Yeah. It’s wild. It is wild. So we had that and then on the completely other end of the spectrum-- So I ended up going to the hospital after I had the baby because I want to make sure everything‘s okay. It’s a VBAC. I don’t know if everything is cool with me. I don’t know if everything is cool with the baby. The placenta is still in. I got up and walked myself out of my house carrying my baby still attached to a gurney and that’s where my doula took this picture of me getting on there. I got him breastfeeding. I am lying on this gurney and the sun is bright. It’s Mother’s Day. It’s really cool, right? Then, on the other end of the spectrum, this other person was commenting so much on this picture about how ridiculous it was that I would go to the hospital and how it was that patriarchy that had made me think that I need medical assistance blah blah blah. The point is, is that you can’t win. I am either irresponsible because I had a home birth or irresponsible because I went to the hospital. You know? It’s interesting. Julie: Yeah. I feel you on that one, especially right now. Liz: There’s no good choice. So I went. Everything was fine and it was good I went because I had some tearage that I needed to get taken care of. But the point is, is that I had this accidental, Mother’s Day, COVID-19 home birth. The cool thing was that I didn’t have to pick between my doula or my husband because everyone was there. I got to keep my kid safe. I got to have my baby in this completely natural way that I didn’t even realize how much I needed. I went from having a birth where I had literally zero control and zero-knowledge and everyone else telling me what to do, and then a birth where I caught my own baby, suction bulbed him, and walked out carrying him while he was still attached to me. It’s so incredibly empowering and on Mother’s Day. It was so cool. It was so cool. Meagan: So special. One that you won’t ever forget. That’s for sure. Julie: Okay, I have got to ask though. Is that picture the one you attached to your story? Liz: Yeah. Julie: Okay. So if you want to see the picture, go to our-- Oh my gosh, I love it. I just opened it. Wow. Okay, if you want to see this picture which, trust me you do, go to our Facebook ( https://www.facebook.com/thevbaclink/ ) or Instagram ( https://www.google.com/search?aqs=chrome.0.69i59j69i60l3.1939j0j7&ie=UTF-8&oq=vbac+link+instagram&q=vbac+link+instagram&sourceid=chrome ) pages. Search for The VBAC Link and look for her episode picture because wow. Like, wow. This is a really impactful picture. Liz: It’s pretty cool. Julie: I’m glad you shared it. Meagan, are you looking at it? Meagan: No, I actually had just closed out of my thing so I’m going back in. As soon as you said that I was like, “I am going to find out.” Julie: Well, we are just about out of time but before we wrap up and while Meagan‘s looking at the picture... Meagan: Oh wow! Julie: There you go. There it is. Liz: We joke about how we want to frame it. Meagan: Wow. Wow. I have chills. I have freaking chills. Oh, amazing. Look at your legs and the door, the patio steps. How awesome is that? Liz: I know. Julie: Yep. Oh my gosh. Liz: It’s pretty cool. It’s pretty cool. Yeah, we want to frame it and put it in the bathroom he was born in so we can be like, “This was you.” Julie: The look on your face-- It’s like the stillness and the peace but then clearly you just had a baby because of how your legs are and the patio steps and everything. There’s so much emotion and power in the picture. Liz: Yeah, I love it. It is really good. I am so glad she caught it. I wasn’t even thinking about it. She just clipped it on my phone. When I got to the hospital later, I was looking through my phone and there was that picture. I was like, “Holy moly.” It’s a good one. Emotional release Julie: Well Meagan, do you want to do a really quick review on emotional fear releases? Not even necessarily fear releases but just releasing emotions. Meagan: Yeah. You experienced talking about these things. You said, “It was like I didn’t even know. I said it and it changed everything.” Sometimes we don’t think. Like you said, “No I’m fine. I’m good. I feel good about this.” But sometimes there are other things. I had an experience with a client of mine who’s actually on the podcast as well. She is a VBA2C mom. She had started a podcast for stories of C-section birth. She’s had two of them. She feels inspired that C-section moms need to be able to share stories as well. Anyways, so she’s in labor, her water breaks and nothing happens. The next day, nothing happens. The next day, nothing happens. I mean, she’s contracting on and off, here and there. It’s been three days with her water broken. She’s being monitored very closely by a skilled professional midwife and she even did dual care in a hospital. Everything was going great. The weird thing is she would start contracting, start contracting, start contracting, and then it would stop. Then she’d start contracting again, stop. We are like, “What is going on?” The midwife said that she could feel the tension in her cervix. Like, actually feel it. She sent her home and everything and she’s like, “Come over. Just come be with me.” I was like, “Okay.” We go over and she is talking a lot about her podcast. She’s like, “Well if I have a vaginal birth then how can I have a podcast for C-sections?” I was like, “Whoa whoa whoa. You can absolutely have a podcast for C-sections.” She’s like, “Yeah but then they’ll probably think I’m not really supportive because I chose to have a VBAC.” She started like going over what is in her head. I was like, “Okay. Let’s hold up.” I got some paper and we started writing things down. I said, “Write down all your thoughts.” So we wrote them all down and then we solved them. If that makes sense. We solved each of them. Right after she read them and we solved them, she burned them right there. On hands and knees, she burned them in this pot on her floor. Her, her mom, and I. We were all just gathered around her. It was so interesting. After each piece of paper that she burned, her contraction would pick up. And not just happen, like intensity. So after we processed all of this, it really seriously did make a big difference. She went on and she totally rocked her VBA2C after five days of labor but there was a lot that she needed to let go emotionally and physically to allow this baby to come. I also had an experience myself. There’s actually a picture of my midwife hugging me and talking to me. She’s like, “You’ve got to get out of your head. You’re going to be okay. Stop doubting yourself.” She kept saying, “Stop doula-ing yourself.” I’m like, “Oh okay.” I got out of that space and things changed. You processed this thing that you weren’t super thinking about all the time, but obviously, it was there. Your subconscious was thinking about this and then it changed everything. I think that the more you can work through things, fear release before you enter birth, the better. But know that it’s okay to work through it during labor too. It’s okay to stop and let labor go if that makes sense. Let it just be and then process what’s going on. Talk about it. That’s another reason why it’s so important to have people in your birth space that you trust, can discuss and talk about because once you discussed this and you said it out loud, to the point where someone was listening, boom. Things went from 0 to 90 it sounds like. We talk about it in our course and we talk about it with our clients because it’s important. There are tons of ways you can do it. Like I said, you can burn them. Julie has a video on our Y ( https://www.youtube.com/watch?v=c9-WIkEls5U ) ouTube, right? It’s on YouTube, not Instagram stories right? Or maybe it’s on both. Julie: Yeah. Well, I think it’s on Instagram stories or IGTV ( https://www.instagram.com/tv/B4TJsSkASx5/?hl=en ) and on our YouTube Channel ( https://www.youtube.com/watch?v=c9-WIkEls5U ) , The Smokeless Fear Release. But notice, it’s only smokeless if you are only burning a small amount of paper because one time we did it in a class at my house. There were six people burning their papers and we totally set off my smoke alarms still. Meagan: Yes. So there’s that, writing it down. In our course, we have a fear release activity that we do where we try to figure out where the stem of the fear is coming from because sometimes there’s a lot of static and it seems like it’s so much more than it really is. If we can break it down and find the stem, or the root I should say after last year, then all the little leaves on the fear tree don’t seem so big. Don’t we have a free download, Julie, on our blog? Julie: I don’t think we have the fear release worksheet as a free download. Meagan: Oh, maybe we don’t. Darn it. I was going to say, “We have one to download.” Julie: It doesn’t have to be anything formal. You can just write down your feelings. Write down all the things that are on your mind. Just write and write and write. It doesn’t have to be perfect writing. It doesn’t have to be punctuated correctly. It doesn’t even have to be legible. Just write it down on paper. Don’t even go back and reread it. Write it down, then burn it or flush it down the toilet or-- probably rip it into small pieces before you do that-- or bury it, throw it into a river, shred it and toss it into the wind, or something to get rid of it. There’s a lot of power in doing that. Q&A Meagan: We have some questions that I would love to ask you. We did go over maybe what some of the answers would be, but the first one is, what is a secret lesson or something that no one really talks about that you wish that you would have known ahead of time? What we just said pretty much covered that. You didn’t know all of these things, but is there anything you’d like to add to that? Liz: Read the books. It’s a happy medium between making yourself crazy by hearing a bunch of different stories that could go wrong and just understanding the scope and sequence of birth. Meagan: Right. Totally. The other question is, what is your best tip for someone preparing for a VBAC? We personally love this answer that you wrote down, but I love every single one of them. What would you say? Liz: Listening to The VBAC Link religiously and I can’t-- Oh, I know how I found you. I had to think about it for a second. Meagan: Yeah. How did you find us? We love learning how people find us. Liz: It all just came from a hashtag. I started getting really into it. I got onto Instagram and started looking at VBAC as a hashtag. Y’all are right up there at the top. Julie: Boom. Liz: You have all your little tips and I was like, “Who are these people?” I think I started following you and reading the stories. At some point, I saw a picture and it was like, “Listen to so and so‘s birth story.” I hopped on over. It was perfect timing with COVID happening. There was all this time to walk around and listen to podcasts all of a sudden. So that’s how it happened. I would say, do that. I would say, find a book that resonates with you. There are lots and lots of different books that give you all kinds of advice. The one that I really loved and worked for me really well was-- I can’t remember who wrote it-- but it was Natural Childbirth in the Hospital or something to that extent. It talked about how to have a birth without medicine in the hospital. It was really cool. Meagan: I am looking it up right now. Having a natural birth at the hospital does that sound-- Liz: That sounds really really familiar, yeah. Julie: I think it’s Natural Hospital Birth or something. Liz: That’s it. Meagan: Natural Hospital Birth: The Best of Both Worlds by Cynthia Gabriel. ( https://www.amazon.com/Natural-Hospital-Birth-Best-Worlds/dp/1558328815 ) Liz: The coolest thing about it is that it’s a workbook in a lot of areas. It has you do this thing that was so helpful to me. It had you write down your dream birth. Not like your dream reasonable birth, but your dream if space and time didn’t exist. You could do fantasy kind of things. Like, “Oh, well here you are in Arizona during the early birth.” Then when you’re transitioning, you were here. This music’s happening. I got to write down this crazy, ridiculous could never actually happen birth, like my ideal birth. Going through that process I was able to find things that I could actually take into real life that would be important for me to experience during birth. I thought that was really cool. Megan: I love that. I need to read more books. Sometimes I am just like, “Man.” You guys, I swear I just can’t read. Julie: We all know that you don’t like to read by now, I think, and it’s okay. You don’t have to like to read. That’s what podcasts are for. Meagan: I know. I know I just can’t do it but you learn such valuable things. Julie: You know, I used to love to read. I buy books and I intend to read them, but now by the end of the day, kids are in bed, I crash and I’m like, “Reading is too much work.” Liz: Book on tape, book on tape. Meagan: Yeah, I do listen. I do listen to that and I cycle. So I sometimes will listen to books that way. It’s kind of nice. But yeah. Oh, another thing you added on that was fitness and good health. I love that. I am a big advocate for that. I’ve seen a big difference in my own births because of that. Liz: That’s huge. I think that’s one of the amazing things that COVID contributed to because again, I had all this time now. It happened in this beautiful time in Houston where it actually was great weather. It was not hot in March when all this started. I was going on two hour walks every day with my two-year-old all around the park. That was so incredibly important to having a successful VBAC. Meagan: I love it. Yep. With my first pregnancy, I gained 42 pounds and was really swollen. I was a hot mess. With the next one, I really dialed into nutrition, fitness, and all that stuff. I didn’t have a VBAC with that but I don’t think it was because of anything. I think that my all-around pregnancy and everything was so much better because of where I was at. Liz: Yeah. I gained 50 pounds with my first so I hear you girl. Meagan: Yeah. It’s funny. I have people in my neighborhood-- They didn’t know me when I was pregnant with my first. They’ve seen pictures and they’re like, “You’re unrecognizable.” I am like, “Yeah. I know. I was an Oompa Loompa.” But yeah. Well, awesome. Thank you so much. Liz: Thanks guys, it was awesome talking to you. Closing Would you like to be a guest on the podcast? Head over to thevbaclink.com/share ( http://www.thevbaclink.com/share ) and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com ( http://www.thevbaclink.com ). Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Jill from Alberta, Canada. She is a homeschooling mother to 3 children, a birth doula, and a recently certified birth support coach through the Birth Coach Method. She is excited to use her newly learned coaching tools to help her clients achieve their desired birth experience even if they cannot have a doula attend their birth. Jill works with pregnant women in their last trimester to coach them around their desires for their birth, their current reality, and circumstances and closes every coaching session with an action assignment designed to reach their goals.   Aside from sharing her incredible VBAC story, we discuss: -What birth coaching is and how it is different from childbirth education. -How hiring a birth support coach can help you, even if you can't have a doula attend your birth. -How birth support coaching places the pregnant parent as an expert on their body and their birth.   Find Jill and learn more about birth coaching on her Instagram page: @jillmcknight_birthdoula ( https://www.instagram.com/jillmcknight_birthdoula/ ) Episode Sponsor: This episode is brought to you by @Nourisher, formerly known as Milkful nursing bars, Nousrisher believes that moms deserve the most nutritious food. Their pre and post-natal bars are made to nourish her unique needs throughout motherhood, without sacrificing flavor. Their delicious flavors include Papaya Turmeric: A tropical treat! Folate-packed Papaya + anti-inflammatory Turmeric. Spirulina Ginger: Sweet and spicy! Nausea-soothing spicy ginger plus energy-boosting Spirulina, and Strawberry Rosehip: OMG flavor! Yummy strawberries plus immune-boosting Rosehip. Check them out at thevbaclink.com/go/nourisher ( https://www.thevbaclink.com/go/nourisher ) Meagan: Happy Wednesday, women of strength! It is Julie and Meagan. We have Jill with us today. She’s in Canada and we cannot wait to hear not only her stories, but we want to dive in a little bit more on birth coaching-- something that she has gone into during her journey. She actually has three kids. She had a C-section and then two VBACs. We can’t wait to hear that story. She is a certified birth coach and a birth doula. We’re really excited to hear more about the coaching, what that entails and how we all can learn more because I know as a doula, for me, I think that would be something really fun to add to my offerings and my skills. I can’t wait to hear that. Julie has a review of the week, so we’ll turn the time over to her. Review of the week Julie: I’m Julie and I have a review of the week and I’m also interested in learning about birth coaching. I’m just really excited. I’m not going to start asking questions and things because it’s the very beginning of the episode. But at the end we might just pick your brain a little bit, Jill. This review is from Apple Podcasts and the reviewer name is Khuxx. The review’s name is “Success.” Khuxx says, “This podcast helped me in so many ways. I had my VBAC baby in the early morning on Thanksgiving four days past my due date. I was religiously listening to this podcast in those three days leading up to labor as I felt my chances of my perfect labor were being ripped away. Putting my headphones and pushing play on The VBAC Link when I would start to doubt my ability my whole pregnancy was honestly my lifesaver. I told my midwives that this was helping me stay positive and I recommend it to EVERYONE. Thank you SO MUCH for creating the perfect podcast for all pregnant moms, not just moms wanting to VBAC. If I would have known about this with my first, maybe the outcome would have been different.” Thank you so much, Khuxx, for that review. We were just talking about that before we started recording. We wish this had been around when we were having babies. And Jill, same thing. It always makes me feel really good when we hear that we are helping people and that our stories that we share on the podcast are helping others as well. Thank you, Jill, for sharing your story today. And thank you to everybody who has ever shared their story on our podcast and in our Facebook ( https://www.facebook.com/thevbaclink/ ) community and in our Instagram ( https://www.instagram.com/thevbaclink/?hl=en ) stories. We wouldn’t be The VBAC Link without every single one of you. So, thank you. Episode sponsor This episode is brought to you by Nourisher. Formerly known as Milkful Nursing Bars, the company has rebranded and expanded to bring you new bars. New flavors to meet all of your needs throughout the motherhood journey. Nourisher products are made to “nourish her.” Each of the products are super nutrient dense while still being a very tasty snack that moms can look forward to. Their delicious flavors include Blueberry Coconut, Chocolate Banana, Maple Walnut, Papaya Turmeric, Spirulina Ginger, and Strawberry Rosehip. Let’s talk about flavor. My favorite, guys? Strawberry Rosehip hands down. Not only are these bars delicious and tasty, but they have amazing benefits for both you and your baby in the pre and postnatal stages. They increase your energy. They support tissue repair and brain building. They improve gut health with fiber, probiotics and healthy fats. They give you a nutritional lift from sprouted grains and seeds that provide essential nutrients. They are packed with superfoods like turmeric, spirulina, and rosehip to support a healthy immune system and reduce inflammation throughout the pregnancy and postpartum stages. Go ahead and give Nourisher a try. You can get right to them by clicking the link in our show notes or going to thevbaclink.com/go/nourisher. ( https://www.nourisher.co/?rfsn=4803705.3f03cd ) Give them a try. You will not regret it. Jill’s story Meagan: Okay, you guys. It’s podcast Wednesday and Jill has an awesome episode for you. Jill, we’re going to turn the time over to you to share your amazing story and then let us pick your brain at the end. Jill: Great. Thank you so much, Julie and Meagan. Thanks for having me. I am a VBAC mom. I had my first child in 2009. I didn’t have a doula. I didn’t really have a birth team set up. I went into it to see how it goes, kind of thing. I felt like an absolute goddess being pregnant, I’ll tell you that. But I always felt really deflated every time I left my prenatal appointments with my obstetrician. I felt like it was so run of the mill, going through the motions. I always felt really sad afterwards. I felt like, “Hey, I feel really great. I feel like I’m glowing. I feel amazing.” If I had a doula or if I had someone to talk to and download about it afterwards, that would have felt really nurturing to me. So I went along and my pregnancy was actually really great. I was healthy. I was strong. I never considered that I would have a C-section. I remember going through the hospital for the tour and the last stop was the operating room to show us expectant moms where it is and things like that. I was like, “Yeah, sure. I’ll look at it. But there’s no way. I’m just not going to have one.” My mother didn’t have one. My grandmother had ten babies and I just thought, “It’s not happening,” so I didn’t have any information about how to prepare for a C-section. Meagan: A lot of times in these prenatals, there isn’t really any education given on C-sections. First time moms go in to have this baby and they’ve heard about a C-section but they don’t really know what it entails. That’s something that could be added to prenatal care. Jill: Yes. I think so for sure. Based on conversations that I’ve had with women throughout the years, it’s the same thing. At least to have had it as part of the prenatal, that would have been helpful for sure. I guess I can just skip to the birth. Pretty uneventful pregnancy, it was fine. My baby was late. The first time around when you go over the 40 week mark, it’s like, “Oh my gosh. When is this going to happen, right?” I did end up going into spontaneous labor at 41 weeks. We just had my in-laws arrive from Scotland. They had planned their trip to come for when the baby was born. Since baby was late, they showed up on the day that I started going into labor. So I had a house full of visitors. I started in the middle of the night feeling the early signs of labor. I did some of the things that I learned in my prenatal classes-- moving around when I could, trying to lie down when it felt comfortable. I ran a bath. I sat in the bath for a little while and then the contractions started to get a little bit intense. My husband and I decided to go into the hospital, which was just around the corner, so really close. I got checked into triage. The part that always sticks out in my head was that the nurse that was there didn’t look at me. She had her head down and asked, “Are you having an epidural?” I was like, “Uh, I don’t know.” She was like, “Well, you don’t need one. But if you don’t get one now then the anesthesiologist might be busy so I would suggest that you say yes.” Julie: Oh my gosh, I hate when they do that. Meagan: It’s added pressure in a vulnerable moment. Even if you didn’t plan on that, you feel vulnerable and think, “Well, what if I end up wanting one and they’re not here?” I don’t like that. Jill: There was another woman that was laboring in the room and it was quite intimidating. I could hear her. She was pretty close, I think, to giving birth. The nurse then said, “So that woman there, that’s not her first baby. You can hear she’s going through some painful contractions. So if she’s feeling pain, what do you think you’re going to feel?” So I was like, “Wow. Okay.” Julie: Labor and delivery nurses-- I don’t think they mean ill intent when they say these things. I think they’re really trying to be helpful. But there should be a class about tact in the birth room. Maybe not. But I’ve heard things like that in the birth room. What are you supposed to say as a parent and you’re a first time mom? It’s so frustrating. Jill: Yeah. That’s it. All of those things led to me getting an epidural, but I was only at 4 centimeters. Knowing what I know now, that was quite early. But for me, at that stage, it felt really painful. I had never felt anything like that before, so it felt like, “Oh yeah. I want this pain to go away. I want to be more comfortable.” I got that epidural administered and then was hooked up to the IV, the machines, and all the things. I was strapped in and lying down on my back. From there, I continually was progressing and I did dilate. I don’t have the notes with me right now, but long story short, eventually, I got to the point where baby was going into distress. They had to insert that fetal scalp electrode. I just felt like a rag doll. At the beginning, when the epidural was administered, it worked really well. For some women it doesn’t work really well and they still feel the contractions. But I felt nothing and I thought, “Oh, this is cool. I’m going to lie here and the baby is going to come. Wow!” I just had no idea. Then there were more interventions. There was the fetal monitor, then baby was in distress. They were giving me oxygen, then there were several doctors, students, nurses, and more students coming to observe me. That moment is so clear in my mind when I’m lying in the bed with the oxygen mask and I have what felt like eight people surrounding me. I’m freaking out and my husband’s like, “It’s okay,” but we’re like, “I don’t know what’s going on.” That was quite scary. But I did get to the point where I was 10 centimeters and was able to push with directed pushing. I didn’t feel anything, so I was going based on what the labor and delivery nurses were telling me to do as my feet were up in stirrups and still lying on my back. I spent hours doing that. Eventually they were able to lift me up and put me over one of those bars where I was sitting upright to try and get some gravity on my side. Then they started talking C-section at that point because I was pushing for about two hours and because he was in distress. I kept asking for more time. I asked for another hour and then after that third hour, they could see his head. I remember them bringing a mirror and you could see the head, but he wasn’t far enough down that they could use a vacuum or forceps. That led to that moment where I had to sign off for surgery. I still feel quite emotional just remembering. Meagan: That was a hard moment. Jill: Yeah. Then wheeled into surgery. As C-section moms, we all know that feeling. It feels really cold when you go into that operating room and everything is very quiet, very eerie. Everybody’s in their full scrubs and it’s a scary place. I was shaking at that point. I think there was something about the drugs they administer to you and they have to strap your arms down. I remember shaking and I felt very nauseous. When they did the surgery, it was quite a weird feeling. Because my son was descending down the birth canal, they actually had to pull him out. So his head came out in that cone kind of way. Julie: You kind of had to recover from a vaginal birth and a Cesarean at that point. Jill: It was almost that way, right? He was very large. He was 9 pounds, 4 ounces. Knowing what I know now, birthing a 9 pound, 4 ounce baby on your back, for 18 hours… Meagan: It doesn’t leave a lot of room for baby to get down in the right spot. Jill: I didn’t know much about birth until after that moment and I did my research. I was like, “What was that? Why did that happen?” I blamed myself a lot and I went through a lot of really negative emotions. I felt very disappointed. I felt ashamed. I felt really ashamed. I didn’t expect that I would have a C-section and I didn’t like that I felt ashamed to tell people that. It was really confusing. It was a crazy start to motherhood. I absolutely adored my son. Thankfully we bonded well with breastfeeding and skin to skin, but I remember those nights that I stayed in the hospital. It was really quite traumatic. There are lots of other details, but I think that’s mainly the gist of it. After that, it really drove me to research and find out why. I got a hold of my records of my birth to find out what actually happened, what led to it. Megan: Which is such a good idea to do. It’s really important to get those records. We encourage all of our personal clients to do that. Jill: Yeah, I found it really helpful. Then you can research and you can find out what all these terms mean. In the moment, you’re not really absorbing all the terminology that they’re throwing at you. You’re just scared. There’s the shock that takes over and you can’t absorb anything. Even in a straightforward labor, you’re not taking in information. I did a lot of work with the resources that were available at the time. It was 2009. I ended up stumbling into home birth which wasn’t anything I would ever have thought I would get into. I didn’t know anybody who had home births. I was actually quite intimidated by the thought of a home birth. But my research led me there. I started to really get into that world, which is quite an interesting place to be and a lot to learn there. I guess that’s what led me to want to be a doula because I’m reading all of these amazing books written by midwives and I thought, “I would love to be able to support somebody in a way that…” Meagan: The way you wish you had been able to be supported? Jill: Exactly, because I know exactly what I would have done for myself back then. That was part of my healing too. Like I said earlier, I really beat myself up a lot. It’s so common for moms who have unplanned C-sections or planned C-sections as well. As I did my research and I learned more, I started to forgive myself. I thought, “I did the best I could with what I had.” I didn’t know anything about epidural other than that it takes the pain of labor so I’m like, “That can’t be bad.” After I learned what I did in my doula training, I’m like, “Oh, so maybe 4 centimeters was a bit early.” If I had somebody there to support me for a few more hours to get to seven or eight centimeters,  maybe the epidural would have been a great thing for me. So I was able to slowly heal from some of that negativity that I was holding onto and that shame and that disappointment. I could see my C-section as the catalyst for change in my life that helped to guide me towards birth work. I’m thankful for it in that way. Meagan: I feel you. It’s kind of the same. I had two C-sections before I landed into the birth world but even though they were not my desired birth or my desired choice, I would not have changed anything because it led me to where I am today. Julie: Me too. Jill: Then for my first VBAC, I waited 18 months because that was the recommended time. I don’t know if there is one recommended time, but for me, it was the 18 month wait after my first C-section to then try and get pregnant with my second child. I did that and then thankfully we got pregnant easily. I set myself up right away with midwives. In Canada, we have a public healthcare system which is great, but also stressful because you have to get your care provider the day you pee on the stick. You cannot mess around. I got myself into a really great midwifery practice right from the beginning. I was planning a home birth. I felt that was the best place for me. The midwives at this practice were  supportive and actually really loved working with VBAC moms. I was in really, really good hands. Just the way life goes, my husband got transferred to Melbourne, Australia for work. So when I was six months pregnant with my second child, we moved to Australia. Julie: Oh my gosh! I love Australia, but what a horrible time to move to another country. Jill: I know. We had actually been there already temporarily before my pregnancy and then we came home for a bit. I knew it was coming so it wasn’t completely out of the blue at the point, but I did have to navigate a completely new healthcare system there in Australia. Julie: Australia is completely different for Cesarean, VBAC and birth in general. It’s a completely different mindset even from the United States. Different parts of Australia have different birth cultures as well. It’s something I’ve been interested in learning more about, actually. When Meagan and I upgrade our VBAC van to a VBAC jet-- we’re dreaming really big right now. We’re going to have a VBAC Link jet and then fly to Australia and figure out the Australia birth world, VBAC, Cesareans, all that. And maybe we’ll go doula some people in the Outback. That would be awesome. I’m dreaming big. This is like, 50 years down the road if we’re still kicking around. Jill: That’s great to dream big. Julie: I’m going to stop talking now. Go on with your story. Jill: I’ve never lived in the States but I can imagine Australia’s system to be a mixture of the United States and Canada because they do have public healthcare and private. It’s a nice little hybrid which was good for us because we weren’t residents of Australia so public health care, we still had to pay for anyway. We actually went private and I actually hired private midwives because the midwives there at that point weren’t covered under public healthcare like they are in Canada. I found some great midwives supporting my VBAC home birth. Everything was great. Totally crazy that we now lived down under. We were in Melbourne. It was a great city and I was in good hands. My husband took a little bit more time to get adjusted to the home birth, but we managed to come to an agreement. We planned the home birth and there was a concern that I had a front lying placenta early on in the pregnancy, so I just needed to get an ultrasound at about 36 weeks to check on that. I got some more interesting news at that ultrasound which was that my baby was breech. Meagan: Not always a fun thing to find out. Jill: No. And that’s the thing from my experience with my second child. I went to the ultrasound by myself and my husband was at the pool with my son. It was like, “Oh, you know. It’s all good. You go play with him. I’ll go to the ultrasound and meet you later.” Oh God, could I have used somebody there with me. I obviously did not expect that either. Breech? What? I was a complete hot mess after finding that out. But my midwives were totally cool and they were like, “That’s okay. You’re only 36 weeks. Lots of babies are breech. They do somersaults. They go all around. It’s no big deal.” They were able to help me calm down and explore options. Then I was into a whole other level of not just VBAC, I was then looking into breech which is a little bit more frightening when you look on the internet about breech birth. This was in 2011 when breech was considered very high risk and almost always a C-section. I was quite devastated because I was so scared of having another C-section. So I did all of the things. Spinning Babies-- I was lying down every day with my ironing board propped up on my couch. You lie down on your back with your head down and your feet up. Julie: The Breech Tilt, yes! Jill: Yep. Lots of hands and knees, doing all of the cat-cow hands and knees positions. I did everything. I did handstands in the pool which got me some pretty weird looks at the public pool. I did chiropractic care specifically for breech. I did Moxibustion, an acupuncture procedure where they put these needles in your pinky toes and then they have this charcoal cigar-lit thing that lights up and heats up the needle in your toes. I did all the things. She was not having it. She remained in the breech position. Julie: That’s frustrating after you do all that work. Jill: I know. The private/public system actually worked in my favor because I ended up getting in with an obstetrician in Melbourne who specializes in high risk. He does breeches, twins, VBAC’s, so he took me on as one of his patients. He was really great. I still had my midwives too but they weren’t able to be my primary care providers in the hospital because of the breech. It was more like she was a doula to me which was really great too. With breeches, the rule for my obstetrician was an eight hour labor or less but if it goes over eight hours then there is probably something going on. Julie: Well, that’s not fair. Lots of labors are longer than eight hours. Jill: Yeah. That was scary and no epidural. There were a bunch of other rules, but eight hours was the limit. She was late too. She was about six days overdue. I started to feel the discomfort in the evening. I went to bed. I woke up sometime in the middle of the night, sometime between midnight and 2:00 am. I thought, “I’m going to get up now. We’re going to move around.” My husband was making oatmeal. We called the midwife to let her know I was starting to feel the early stages of labor. By about 3:00 am, I said to my husband, “You have to call the midwife NOW.” She was asking him, “Ask Jill to rate between 1 and 10 the intensity of the contractions.” It was literally, “7. Okay, no 8. Okay, no 9. No, 10.” It came that quickly. I got into the shower. Then interestingly enough, there was meconium coming out of me because my baby was in the breech position so bum down. Julie: That way baby doesn’t get aspirated. Jill: It’s crazy, right? That was freaky. We still had to get to the hospital because I still wasn’t having that home birth. It was very fast. That was 3:00 in the morning, then we had to rush off to the hospital. I was that woman. No seatbelt, I was holding myself up with my hands, my arms fully straight, like, “This baby’s coming!” She was coming. When we got into the maternity ward, the nurses welcomed me. I remember them talking to me so sweetly saying, “It’s okay, honey. You’re just having a contraction.” I’m like, “Ugh, yeah. Okay.” When they checked me, the bum and the legs were coming. They were coming. They had to get me to wait until the obstetrician came because she was breech. So they had to wait for him to come. He lived about a five minutes drive away. We had the breathing and the “look deep into my eyes”. I think everybody was a bit panicked. This was a two hour labor. It started at about 3:00, then about 5:15 in the morning, I was directed to push. I really wanted to stand up. That was my urge-- to stand up, but I did have to go on the bed. Everything was moving. Everything was coming anyways. It didn’t really make a difference. But I think for me, with my first birth, I just was like, “I don’t want to lie down.” She was born bum first, then legs popping out. Then you see that the body is there and the head is still the last to birth. When she was born and they placed her on my body, she was upside down. It was the feet up at my chest. So that’s the way she was born. Meagan: That’s awesome. I didn’t realize that your first VBAC was breech. Jill: Yeah. She was a breech baby. That was that birth. It was a healing birth for me. It was a stressful birth. The lead up to it, with it being a VBAC and with being breech-- but I could see what my body was capable of. That’s what really healed me. I was quite surprised with how quick the labor was, just the two hours, really. Julie: That’s super fast for a first time vaginal birth and for a breech baby. That’s super speedy, as my four year old would say. Jill: Yeah. But it’s funny because I think the personalities shine through. My daughter now is going to be nine and I’m like, “Of course you were born breech. Of course you were born the complete opposite way than most.” Julie: I agree 100 percent with that sentiment, I really do. Jill: She’s our cannonball. She bursts into the scene all the time. I’m like, “Well, that’s how you were born.” It makes sense. Then my son, who was the C-section, we have to drag him out everywhere. So I’m like, “Oh yeah, you wanted to stay. You were good. We had to pull you out.” Meagan: That’s so funny how they all fit their births. Jill: For sure. Then for my third birth, we stayed in Australia for a couple more years after that, almost three years after my daughter was born. We got transferred back to Canada, but to a completely different part of Canada. As you know, Canada is a huge country. I was then home kind of, but still a four hour plane right from my home. Still quite foreign, but the same healthcare system and things like that. I planned a home birth again for my third birth and had really amazing midwives again and very supportive and really, really loved working with VBAC moms. I think I always shock people when I tell them about my birth story of my second child. They’re like, “Hold on, what? A VBAC and a breech? Okay, wow.” Then they knew about me having a really quick labor for my second child. So they were expecting another quick labor. For my third birth, she completely surprised me and came ten days early. My first was seven days late. My second was six, so I thought she was going to be five days late. I don’t know, I just couldn’t think any other way, but she was ten days early. Completely different scenarios. We have two kids now, almost six and three, planning a home birth so we didn’t have anywhere to go. It was Easter Sunday. We did the Easter egg hunt in the morning. At about 10:00 in the morning I said, “I think, maybe, could you send the kids over to the neighbors to play?” Because I thought I might like to have the kids there for the birth, but then when I got down to it, I said, “I think I need to just not have to think about that so let’s send them over to the neighbors to have some space.” Contractions got pretty intense at about 11:00 in the morning. I was pacing up and down in my bathroom. Again, similar to the first birth, I said, “Contractions are getting pretty intense.” I said to my husband, “You’d better call the midwife.” The midwife was like, “Well, what’s going on?” And literally, as she was on the phone, my body just couldn’t help itself and I went straight into pushing. My husband was there on the phone. Meagan: Wow. Jill: I know. He had had a shower earlier and left his towels on the floor. Which, we get so upset with our husbands for doing stuff like that, but I’m like, “Oh wow, so you left the towels on the floor,” and that was where our daughter was born, just right on those towels in the bathroom with the midwife on the phone. She was able to hear her first cry. She knew it was good. She didn’t have to call the ambulance or anything like that. She just said, “I’m going to come over as soon as I can.” She was coming from the hospital from another birth just ten minutes away. So she came and showed up. She was so cool. She was so calm. She was so like, “Everything is great. Everything’s fine.” She ran my bath for me. I had my daughter with me and my placenta was still attached. I still hadn’t birthed the placenta yet. She got me through that. It was just amazing. It was another very healing experience for me. Very shocking. Meagan: It sounds amazing though. Sounds like a lot, but amazing. Jill: Yeah. Unplanned, right? Not expecting that. That was a one hour labor from start to finish. Meagan: You have an amazing cervix. Your cervix is like, “Listen, I’m ready and when I’m ready, I mean I’m READY.” Jill: We’re done now. I said to my husband, “Listen, if we’re going to have another baby, it’s going to be a Walmart baby. Seriously, I won’t even make it home. I don’t want that. We’re good.” Meagan: That is crazy. And then there’s a cervix like mine that takes days and days and days. I always told my husband that we should have another one because I want to know what my cervix would do now that it’s done it. Julie: We are still holding out hope that there will be another Heaton baby. Meagan: It’s not looking like it. Julie: I know, but I am still hoping. You know my plan for you. Meagan: Oh my gosh. So C-section, breech, VBAC, unassisted, unplanned home VBAC for your second VBAC. Holy smokes, what a ride. Well, thank you so much for sharing. I know we have a few more minutes. I would love to talk more about the coaching. Tell us more about what you’re learning, how people could find that or how you found that, how people can find you and all of the things. Julie: And how that’s different from doula support. Jill: I trained with the Birth Coach Method, it’s called. My teacher was called Mary Life Trauma. She was a doula for years and then trained to be a life coach. She’s merged birth support work with life coaching. It’s different from what a doula would provide because it’s not about giving information about birth, although you can if your client requests that, but it’s more about getting to her belief system about what she holds true about birth. You’re using coaching tools and asking really strong questions to get to planning your most optimal birth experience. Normally, a doula would offer maybe two or three prenatal visits and one or two postnatal. I’m not sure. There’s a range. For coaching, it would be six prenatal visits of one hour long and two postnatal. We’re really getting a full picture of where she is in her pregnancy. Things around relationships, with support systems, nutrition, health. Just getting a full picture of where she’s thriving and where there’s challenges-- ways that we can come up with establishing goals for how she can be at a 10 in a certain area as opposed to a 5. How can we get her feeling empowered? Also, there is a component of understanding her reality-- what sort of health conditions she has or if she has any personal issues or anything that’s getting in the way of her reaching her goals. Then you can work on finding different options to reach her goals and then, just like with life coaching, there’s always action steps. There’s always a way forward. The coach is helping the client to stay accountable to their goals. When you’re working with your client, most likely in the third trimester, you’re giving an action assignment and then you’re checking in with them saying, “How are you doing with XYZ?” It’s just really about empowering and inspiring the client as opposed to teaching or educating. It’s not about giving more information. It’s about pulling back the layers of yourself to see what you hold true within you. Julie: That’s interesting. Do you attend the birth or not? Jill: Either way. Meagan: Can you extend that option? Can they be like, “Okay, I really want to have you attend my birth?” Julie: But it’s not necessarily a part of what a birth coach would do unless you’re specifically requested for that, right? Or is that what I’m understanding? Jill: Yes. That’s it. I think it’s an interesting time right now because of COVID. Some hospitals can have doulas, some can’t. There’s so much confusion, right? So I think it’s a nice alternative at the moment to then get all the support that you need to feel ready even if the doula cannot be there to attend your birth. Julie: It sounds like a really valuable toolset to have even as a doula. I’ve heard it said by one of the midwives that have been on our podcast before that two prenatal visits as a doula is not enough. It’s just not enough. I usually end up spending a lot more time with my clients than the two one and a half hour prenatal visits because, especially with VBAC, there’s just so much to do. I’ve been trying really hard to know how to reconcile that. Anyways, I’m not going to brain dump right now on you, but it sounds like this could be a way to supplement that and help add value to what you’re bringing to the birth community and your individual clients. Maybe they don’t want a doula at their birth but they do want some help in figuring out what birth looks like and feels like to them and how to gain that confidence. It sounds really cool. Jill: Yeah, it is really cool. I think it’s like 20 years ago or whatever when people didn’t really know what a doula was and they’re like, “What’s a doula?” It seems like it’s that kind of way with birth support coaching. People are like, “What is that? I’ve never heard of that.” So we’re just working on trying to get the word out so people know that it’s available. It’s just in the early stages, but I’m really excited. Julie: That’s really cool because you could technically take clients all over the world. I just supported, informally, somebody in India last night to have her VBAC because she knew all of the doulas in her area and she didn’t feel comfortable having one of them be her doula. I was on Facebook Messenger helping her feel supported until her team got there. Maybe I’m saying too much information because it’s illegal to have a home birth in the country that she’s birthing in. I think I already said the name of the country. So it was a really cool experience to be able to be involved that way even though she is halfway around the world from me. It sounds like something that can be done virtually as well where you don’t necessarily even need to be in person. Is that right? I don’t know if that’s part of the program. I know there’s a specific training. Meagan: That’s really cool. Super, super cool. I’ll have to check that out. Awesome. Well, thank you so much for sharing all of your amazing stories. Q&A Julie: Questions! Meagan: Oh yes! Guess what. I always forget. We have questions for you. We asked in your submission when you submitted. I don’t know if you remember answering them, but one of them is, what is a secret lesson or something no one really talks about that you wish you would have known ahead of time when preparing for birth? Jill: For my first birth, it’s definitely the importance of a supportive birth team. Hands down. For sure, that would be my answer. Meagan: Awesome. Then the other one is, what is your best tip for someone preparing for a VBAC? Jill: My best tip is really sitting with and naming your emotions that you have about any emotional scars that you have after your C-section because I think the emotional healing is unexpected. I think it takes time. It takes quite a lot of time. Really pointing out those negative emotions, naming them, really sitting with them and being able to really talk about your birth story-- and be held and validated in all of your feelings, not rushed off by the classic, “Healthy baby. That’s the best outcome.” You know? Megan: Definitely. I think working through all of those things prior can really help the next birth just in general to go smoother. Because for me, there was actually a lot of stuff I didn’t realize I hadn’t worked through and then I had to work through it right then in labor. It was really hard to have to backpedal a little bit to work through all of that. Alright, well thank you, thank you. You are just darling and we are so glad that you were with us today. Jill: Thank you so much. It was nice talking with you. Thank you for having me, Julie and Meagan. Closing Would you like to be a guest on the podcast? Head over to thevbaclink.com/share ( http://www.thevbaclink.com/share ) and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com ( http://www.thevbaclink.com ). 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We have both been so busy with moving, remodeling kitchens, parenting, soccer, gymnastics, being a good wife, (trying to do) self-care, record podcasts, keep up with business, and EVERYTHING that we haven't even been able to catch up with each other. So, we decided to have a fun episode about life and what's been going on with us and the different births we have attended. You will be sure to get to know us a little better and have fun while we shoot the breeze. Birth topics we discuss: Our doula careers at @tinyblessingsdoulaservices ( https://www.instagram.com/tinyblessingsdoulaservices/ ) and @juliefrancombirth ( https://www.instagram.com/juliefrancombirth/ ) Overcoming emotions as birth approaches How we feel as doulas when our clients don't get the birth they prepared for Inappropriate things we have heard providers/staff say to parents in labor Video content on our YouTube Channel ( https://www.youtube.com/thevbaclink ) Clearing our minds as doulas and for parents as we enter the birth space Releasing fears and emotions Our signature course How to VBAC: The Ultimate Prep Course for Parents ( https://www.thevbaclink.com/vbac-class/ ) Episode Sponsor: This episode is brought to you by our very own VBAC Doula Certification program! Find out more about how to support parents who have had a Cesarean in the most effective ways at thevbaclink.com. Full Transcript Julie: Good morning, women of strength. It is Julie and Meagan here today and we are just going to talk because we have both been so busy moving, remodeling kitchens, doulaing parenting, soccer, gymnastics, trying to be a good wife somewhere in there… Meagan: And still trying to do self-care. Julie: And podcasts. We really haven’t even had a chance to catch up with each other and find out what we’ve been doing birth-wise, doula-wise and things like that. So we wanted to have a fun episode where we talk about life, different things that are going on with us, some births we’ve attended and different things like that. Hang along the ride with us. You’ll get to know us a little bit better and brain dead Julie, man. That’s my life right now. But first, before we do that, Meagan has a review of the week. Review of the week Meagan: Yes I do. This is actually from Google, so I was excited to see this. We are on Apple Podcasts ( https://podcasts.apple.com/us/podcast/the-vbac-link/id1394742573 ) and that’s probably where we get the most reviews. But this one is from Google and it’s from Hannah Troyer, Doula. Her subject is “5 Million Stars”. She says, “If I could give the VBAC Link 5 million stars, I would. It’s just that good. I have been a doula for three and a half years now and have supported multiple VBAC mamas. The evidence-based information, positive attitude, professionalism, education, encouragement and JOY I have received from Julie and Meagan leave me at a loss for words. I have tried to listen and read other podcasts, blogs, and trainings done by other doulas and most of them have left me with a bad taste in my mouth. As soon as I stumbled into the VBAC Link podcast, I could hear the joy of the doulas who actually LOVE their jobs. This was the first step into grabbing my attention and eventually making me fall in love with you two. Your podcasts are so educational and it brings a smile to my face every time I hear your voices. I could listen to them over and over. I am grateful I found the incredible source of information on VBAC’s. I am sharing it with everyone I know. Thank you, thank you, thank you VBAC Link.” Julie: Aw, that makes me so happy. Meagan: Yes. We do love our jobs. We love our lives, even though they’re crazy. And we do love bringing this podcast to you guys. The stories, the people that we meet all over the world. It’s just been so much fun over the last couple of years. Julie: Oh my gosh. It’s been two and a half years. I can’t even believe it. Meagan: Crazy, right? We’ve come a long way. Thank you so much, Hannah. We’ll dive right into the episode. Episode sponsor Julie: Birth workers, listen up. Do you want to increase your knowledge of birth after a Cesarean? We created our advanced VBAC doula certification program ( https://www.thevbaclink.com/vbac-doula-training/ ) just for you. It is the most comprehensive VBAC doula training in the world perfectly packaged in an online, self-paced video course. This course is designed for birth workers who want to take their VBAC education to the next level so you can support parents who have had a Cesarean in the most effective ways. We have created a complete system, a step-by-step road map, that shows exactly what you need to know in order to support parents birthing after a Cesarean. Head over to thevbaclink.com ( http://www.thevbaclink.com ) to find out more information and sign up today. That’s thevbaclink.com. See you there. Doula careers Julie: Alright. It’s been a little while since we’ve had chitter chatter. Meagan: I know. This is going to be a really random episode for you guys, catching up with what we’re up to. Julie: Why don’t you tell a little about yourself, Meagan? Then I will share a little about me and we’ll see where we go. Meagan: A little bit about myself. Crazy, all the time. I for some reason, like to be an energizer bunny with a half-full battery. Even today, recording podcasts, I’ve had to bail four times because I’ve had the paint people here, the countertop people here and the appliance people coming. All the things. I’m always crazy and I love projects. I struggle when my life doesn’t have a project in it. I have three kids and they keep us pretty busy. They’re all in soccer right now, so Saturdays look like us being at the soccer field all day long, because they’re each an hour plus games and we’re going from back to back to back. Then my daughter’s in gymnastics, and my other daughter is in dance. It’s been so much fun. They’re all out of the house a couple days a week because they’re all in school. That’s been really different for me, but honestly really fun. I get to do self care, work, do podcasts, go do prenatal cares with my clients, things like that. It’s been super fun. That’s kind of what we’re up to. Always crazy and going. My husband has been quite the trooper for supporting me through all of it. Julie: Don’t forget, Meagan the doula, supported her husband while he was in law school by being a doula. She’s awesome. Meagan: Yes. Doula life was crazy there for a little bit. But it’s been awesome. It’s been nice to take a little step back. Last month, I only had one client due. It was really nice to be here and take care of the family. Julie: I think taking breaks is so important as a doula. Meagan: Yeah. It’s how you avoid burnout. Julie: Totally. I’m Julie, mom of four. I had four kids in a little less than five years. Not on purpose. I mean, well, you kind of half to do certain things to get pregnant, obviously. But the timing of baby number three-- she wanted to come sooner than we were planning. So, we have them all squished, right together. Currently their ages are seven, five, four, and two and a half, which is much better than when they were four, two, one, and a newborn. That was nuts. That was really nuts. But it all works out. It’s fine. Sometimes you hear kids running around in the background when I’m recording podcasts. That’s just the way it has to be during the digital age of quarantine and coronavirus. I also have a dog and a husband. My kids do soccer, just my two boys. One of my daughters is enrolled in gymnastics. Then the two and a half year old destroys everything in the house. That’s her hobby. My kids are very creative and problem solvers. I get caught off guard a lot by them-- which is probably a good way to say it. I am an Army veteran, computer geek, data junkie, very analytical, and I just moved. Same town, really exciting move. I am really excited, actually. We’re getting everything unpacked and unloaded still. I feel like lately my life copies Meagan’s. Whatever Meagan is doing, my life will naturally get there. She was remodeling her kitchen while I was looking at houses and then I kept coming back to this house with an ugly kitchen. An ugly, ugly kitchen. We even called it the “ugly kitchen house”. My seven year old was like, “We’re not moving to the ugly kitchen house, are we?” Then my four year old would say, “It’s a beautiful house!” Then Meagan got me in contact with her kitchen guy. Now we are moved in. We are remodeling the kitchen as well. Meagan’s my hero. We each have our own doula businesses, too. Let’s do a plug-in. Tiny Blessings Doula Services ( https://tinyblessingsdoulaservices.com/ ) is Meagan’s doula company and she has a partner that she runs her doula business with. My doula business is called Julie Francom Birth ( https://www.juliefrancom.com/ ). You can find us both on Instagram and Facebook. We would love the “likes” if you want to “like” us. Overcoming emotions leading up to birth Meagan: If you want to follow our personal doula careers, check us out. This month, I have a lot of VBAC’s coming up, actually. So it’s quite exciting. At Tiny Blessings, we do a lot of first time moms, fifth time moms, but it seems like we go in spurts where we’ll have no VBAC’s, then the whole month is VBAC. It’s so fun. But it also brings a busy month because, as a VBAC parent, there’s a lot of stress that comes in the very end. Do you find that, Julie, with your clients? Julie: Yeah, a lot of emotion. Meagan: It’s a lot of emotional stress at the end. It can be heavy, but it’s fun. It’s not fun to be stressed for them, but it’s fun to work through it with them because when it comes down to the birth, we’re that much closer with our clients because we’ve been able to work through the nitty-gritty with them. Julie: I think that with VBAC parents, it’s definitely a little more natural to fall into that more intimate knowledge of them. But  I’ve had a really strong connection with a recent first time mom and I had a four-peat client, so a client that’s been with me four times. My last three births, which have actually been in the last four weeks, have been a four-peat client, so her fourth baby with me as her doula, a VBAC, then a VBAC attempt that ended in a repeat Cesarean. It’s really fun because I love connecting with these people. Even the repeat Cesarean mom, she entered into her Cesarean smiling. She was so happy, laughing and confident. We created a really great environment for her. Her midwife was very supportive. It was night and day difference, she had said, from her first Cesarean to her second-- how she felt more supported and she felt like she was the one making the decisions. Meagan: Which is a powerful thing. Julie: It really is. It’s really different to go from an experience where you feel completely out of control and that decisions are being made for you to being an active decision maker in your care and being the final one to say, “Okay, let’s do this.” Even if your provider is offering you all different types of suggestions and things like that, being able to be the one to say, “Okay, let’s do it,” instead of your doctor being the one to say, “Well, we need to do this now.” It’s great and I love it. That mama was wheeled into that Cesarean with a big smile on her face and wheeled out of it with a great, big smile on her face. It was a totally, completely different experience for her. That makes me happy. When clients don’t get the birth they prepared for Julie: I’m always sad when somebody doesn’t get their VBAC. It always makes me sad, especially when I’m sitting alone in the empty birth room whenever I’m not allowed in the operating room. You sit there and reflect, “Did I do enough? What could I have done differently?” I put a lot of responsibility on myself. But I know that a lot of these things are not in my control and that I support the best that I can. I’m always sitting there questioning and trying to see what we could have done differently. It’s kind of a lonely time when you’re just waiting. But coming back and seeing them so happy-- baby was so happy, and dad was so happy. It makes my heart more full when I can see that. Meagan: Any birth workers out there, you may be able to relate. If things don’t go exactly as planned or desired, we sit back there and we take it home. It’s hard not to take it home with us and question, “Could we have done something more?” It’s my absolute favorite when the client says, “Yeah, it didn’t turn out exactly how I wanted it to. However, that was the most healing experience for me and I wouldn’t have changed it.” You know? Because they were in control, or because they felt like they were advocated for, or they were given options and they were able to make the decisions. It’s a powerful thing to be as in control as you can in a birth situation. Julie: I agree with that. That’s actually a number one indicator about whether someone will have post-traumatic stress related to birth. It’s not necessarily the birth outcome as much as whether they felt like they were listened to, heard, and that they were a decision maker in their care. Even VBAC’s, you can have post-traumatic stress disorder if you feel like you weren’t in control of what was being done to you or what was happening to you, as much as you can be in control with birth. But I mean as far as the decisions go, your care team, and all of those things. Inappropriate comments said during labor Julie: I’m going off on a little bit of a tangent, but can we talk about inappropriate things that we have heard providers, nurses, or hospital staff say to parents while they are in labor? Do you want me to start? Meagan: Yeah, go ahead. Julie: I actually had a client tell me that somebody had said this to her before, two years ago or so. But this same birth that I was just talking about, the nurse was a little rough around the edges. I think she was just really nervous about VBAC. There were two things she said that didn’t really sit very well with me. I know that she had good intentions. I want to preface it with that. I don’t think that this nurse had any ill intent or anything at all. But when my client was in labor, before it had been decided that she was going to have a repeat Cesarean, the nurse came in and she was like, “Oh my gosh, I’m so sorry. I come in here every time the baby falls off the monitor. I just get so nervous with TOLAC moms because I had one TOLAC mom, when her baby fell off the monitor, I came in to check on them and baby was outside of the abdomen and her uterus had ruptured. It was really scary and we had to do a repeat crash Cesarean.” She said this to my client while my client was laboring with a VBAC. So every time that baby dropped off the monitor, that nurse rushed in there as fast as she could. And now we knew why. I feel like part of that created a subconsciously stressful environment for my client. Every time the nurse would rush in, we would change positions, baby would fall off the monitor, nurse would rush in, and then there was all of a sudden that fear of uterine rupture again coming in with that nurse. The other thing she said-- I really had to bite my tongue, hard, during this speech she was making. Before my client was wheeled back for her Cesarean, they were getting everything prepped. The anesthesiologist was in there and everything. You know how they do. The nurse put her hand on my client. I really do think she was trying to be nice, kind and supportive. She said, “You know, sometimes things just have to go like this and we don’t know why. But we’re so grateful that we have these life saving measures like Cesarean birth. Because if this would have been 200 years ago, you and your baby would have died. You and your baby would have died if it was a couple hundred years ago. So we’re grateful that we have these Cesareans so that we can save your life and we can save your baby’s life.” Well, I’m not going to analyze that birth to death because I’ve been analyzing that birth to death in my head. 200 years ago, things would have been very different. I had a client who said a nurse had said that to her before, but hearing it directly come out of her mouth, I was like, “No. Not the right time. Very inappropriate.” Even if it WAS true. EVEN IF it was true. And who knows? Maybe it is true. I don’t know. But not the right time. Bad timing. That was hard. Meagan: I had a client, it was really hard. She had a different ethnicity. She was a VBAC. She was doing really well, actually. She just needed some more time and more support. They kept telling her that due to her ethnicity, the likelihood of her getting her baby out vaginally was extremely low, but the likelihood of her having rectal incontinence for the rest of her life was extremely high. They encouraged her to really think about if she was willing to poop her pants for the rest of her life for a vaginal birth. Julie: Oh my gosh! Meagan: Yeah. I was dying. I was sitting there cringing inside. “Due to her ethnicity.” Julie: Can we talk about ethnicity and inappropriate comments? I had a client who was a TOLAC and oh, this nurse. I love labor and delivery nurses. I think that they are undervalued. But I think that some of them don’t understand the impact that they have on the overall birth process. The vibe, the energy, and everything like that. I had a nurse once who still gives me the creepy crawlies every time that I talk about it. My client was Mexican and her husband was Mexican. They were born in Mexico and they were here working in the United States legally-- work visas, and everything. My client was a VBAC. But every time I would say the word “VBAC”, the nurse would look at me. I think she just had a problem with doulas. She must have had a bad run-in with a doula or something. I don’t know. But she would look at me and be like, “It’s a TOLAC.” And I was like, “Okay, TOLAC. I need to remember to call this a TOLAC.” So I would start trying to remember to say TOLAC instead of VBAC just so that we could get that negative tone out of the room. My client was very fluent in English and she understood English very well. But that nurse would speak to her like she was a kindergartener, with slow sentences. She said, “You have this. Do you know what that means? Do you understand what that means?” and my skin was crawling. This was probably one of my most educated clients that I have ever had. She was speaking to her like she was completely ignorant just because she had a really heavy Mexican, Hispanic accent. It was really frustrating. She was an older nurse. She had been around the block a time or two. She wouldn’t use the machine to administer the IV fluids. She preferred to let them drip instead of go through the machine. She thought it went better that way. They didn’t have the Monica Novii monitor, but when the next nurse came in, she said, “Oh, let’s get the Novii monitor out for you to use.” You could tell she was set in her ways, from an older generation. Especially in Utah, where we have a very, very, very high population of white people and not very much diversity, it was really hard to see her treat my client like that. It was hard. Meagan: It’s hard as a doula to see stuff like that and hear things. But as a doula, we have to stay professional and we have to respect the entire birth room. It can be hard and it can be super easy. It just depends on the staff and everything. Julie: I think it goes without saying that different personalities don’t vibe well together perfectly. As a doula, it’s very hard to change your personality to match the vibe of the staff’s personality and learn how to interact with them. Sometimes, you just can’t match your personality. But I do a pretty good job. I think that’s one of the only times that I have really not been able to be happy with a nurse. And not only be happy with, but I mean, be fun, and part as friends. You know what I mean? Leave feeling that everybody in the room was supportive and enjoyed the experience together and things like that. That one nurse was particularly hard. Clearing minds for the birth space Meagan: I wanted to touch really quickly on a couple of questions. This last week on Instagram, it was my weekend and I asked to have people ask me questions, and one of the really frequent questions that came through was how to prepare mentally and let go of past experiences. I wanted to talk on Julie’s Youtube video up on our channel on YouTube about releasing fear, tension and past experiences and things like that. Because I think it is so valuable and it’s something that you may have to do multiple times, but it’s something that can be very powerful during your preparation. I encourage you to not even wait until you are pregnant. Do it now and process what is going through your mind now. As more things come up, do those. Same thing with birth workers. We see a lot. We hear a lot. We go through a lot. I think it’s important to notice that for birth workers, there are a lot of things that we need to release because just like providers, we’ve talked about this before, providers see a lot of stuff. They see things that are amazing and things that are so scary. Sometimes they can let those experiences come into other people’s births. Julie: Yeah, like that nurse who kept coming in when the baby would drop off the monitor. Meagan: Exactly, and it’s hard. That’s life. It’s human. It’s normal. I have a very relative personality and so I tend to relate from my own experience to relate to people. So it’s so important for us in the birth space to keep other situations and other stories separate from what’s happening then. Now you can take those experiences as learning experiences and use them as a tool to certain points, but it’s so important to not bring either negative feelings or negative situations and things like that that you’ve seen into a new birth that is completely different. After I saw my friend who did rupture, I was nervous to go to my next VBAC because I was nervous that I was going to overanalyze things. Does that make sense? I didn’t want to make anything that was happening from my friend’s birth go into my mind and think, “Oh my gosh, maybe this client is rupturing too.” I feel very proud of myself. I would give myself a cookie for not carrying that in, but I was nervous that I would. Of course, my education and things like that have helped me not have that situation. Anyway, I just think it’s so important to go and do these fear clearing releases and things like that. So Julie, do you want to tell them where we can find those? Julie: The fear releasing activity video? Meagan: Yeah, on YouTube. It’s your video. You did it really well. YouTube video content Julie: Thanks. I love it. It’s a really fun fear release activity that you can do. It’s on our YouTube channel ( https://www.youtube.com/thevbaclink ). You can go and subscribe to our YouTube channel. Our podcasts are also published to YouTube automatically, so if you subscribe to our YouTube channel, you’ll automatically get notified when a new podcast episode comes out there if that’s easier to watch than listen wherever you are listening right now. We also have it on our IGTV, videos on Instagram and I think it’s on Facebook somewhere, but probably the best place to find it would be on YouTube. It’s under the education playlist. Meagan: I’m going to look right now. I want to figure out exactly what you can type on YouTube. Painless fear release. Actually, you can just search the VBAC Link and it’s on there. It’s number four. VBAC Without Fear: 5 Minute Fear Release ( https://www.youtube.com/watch?v=c9-WIkEls5U ). So get on there, check it out. You’ll see cute Julie’s face, pretty much everywhere, because let’s be honest. I have been terrible at making videos and she has been amazing at making them. Releasing fears Julie: Do you know what else, Meagan, that I have figured out for getting emotions out? The nervous system, our brain and our body, the neurological system and the sympathetic nervous system, is that what it’s called? I don’t know, I’m not a brain junkie. But there are feelings and emotions stored in our body. Sometimes you don’t even know what those feelings and emotions are, but they need to get out. One of the ways for them to get out is by crying. Sometimes, if I don’t have time to do a full fear release with my client, or they don’t quite know what’s bothering them or what they would even write down, I just tell them, “Go do something that will make you cry.” Watch the Notebook. The Seven Minutes movie with Will Smith in it is the only time I have ever left a movie theater sobbing. Or, I don’t know, slow dance with your partner, or watch your wedding song or your birth video or whatever. Do something that makes you cry. Your body will do the rest. It will turn into this huge cry fest and emotional release for you. You don’t even have to write it down or burn it or do anything because your body will process it once that release starts. Pretty, pretty cool. Just cry. All you’ve got to do is cry about it and then it will be better. How to VBAC: The Ultimate Prep Course for Parents But yes. The smokeless fire fear release. We have a fear release activity in our course for parents at How to VBAC: The Ultimate Prep Course for Parents ( https://www.thevbaclink.com/vbac-class/ ) and you can find that on our website thevbaclink.com ( http://www.thevbaclink.com ). But this is in addition to that. There is also a supplementary video in our course that you can find on our YouTube channel and it talks about a really cool, smokeless fire fear release. Basically you put Epsom salts and rubbing alcohol in a fire-proof bowl. I usually use a glass bowl. You light it on fire with a lighter. Obviously fire safety is encouraged. Then you shred up your paper that you have written down all of your thoughts on and burn it. It burns without smoke unless you have, like, eight people putting their papers in. Then there’s some smoke and you might set off a fire alarm when you’re doing an in-person class. Hypothetically. But it’s super fun and super easy. When you’re done you just flush it down the toilet. The Epsom salts dissolve in the water and it’s perfect. Meagan: Awesome. Is there anything else that you want to add for this really quick, random, short episode? Julie: This is something that is good for doulas and parents. Whenever you leave a birth, write it down on paper. Brain dump everything on your mind. It doesn’t have to be legible. Don’t go back and read it. Write it all out. Don’t proofread. Don’t worry about punctuation or capitalization or anything like that. Write it all down as fast as you can. Off load it from your brain and then destroy the paper. You can burn it using this five minute smokeless fire fear release. You can shred it up and throw it into the wind. You can flush it down the toilet, whatever you want. Just destroy it and then your brain creates this dopamine response. The brain dump, with the dopamine response by destroying it, actually causes your body and brain to process and heal the things that just happened. That would be my last tip. Meagan: We are going to start doing more of these where we randomly chat with you. We want to answer questions or talk about topics. If you have a topic that you would like us to touch on, send us a message either on Instagram ( https://www.instagram.com/thevbaclink/?hl=en ) or Facebook ( https://www.facebook.com/thevbaclink/ ). We’ve got some that have come in and we’re going to get them rolling out on episodes here soon, probably towards the end of the year or the beginning of 2021. Holy cow, hopefully by then it’ll be a lot better than 2020. We are excited to keep talking to you about things you want to hear about. Julie: And as always, we love you and we believe in you. We are proud of you. Meagan: Do you want to do me a really quick favor? We are needing more reviews to read on the podcast. If you could go over to Google, Facebook, or wherever, leave us a review and let us know what you think of The VBAC Link. Julie: Do you know what else you could do? If you’ve taken our course, go to our course page on our website, thevbaclink.com ( https://www.thevbaclink.com/product/how-to-vbac/ ) and leave a review there. We should start reading some course reviews as a review of the week. Meagan: Yeah, let’s do it. Closing Would you like to be a guest on the podcast? Head over to thevbaclink.com/share ( http://www.thevbaclink.com/share/ ) and submit your story. For all things VBAC, including online and in person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com. 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Jennifer says: "In 2015, after 41 hours of labor, I ended up having a C-section. I was sad that my birth plan hadn't ended the way I wanted it to but so happy to meet my baby boy finally! Fast forward 3.5 years, a miscarriage and secondary infertility- I was yet pregnant again! I found the most VBAC friendly doctor in town, went to a webster certified chiropractor every other week, hired a doula, listened to ALL the VBAC podcast, and I was ready! I had prepared myself and my body for birth. I was 100% confident that I would accomplish a VBAC- so was my entire birth team! Then I found out my doctor was going to be on vacation for 1.5 weeks- I was pretty sure he would not be attending my delivery, which made me so sad since he was so VBAC positive. Labor started just after midnight on my due date. I progressed slow and steady- at the 25 hrs mark, my water broke, I was 8 cm dilated. My husband and I were so excited; my body was doing what it was MADE to do! "We were going to find out the gender of our baby soon! "Within 10 minutes, everything changed. Nurses and doctors rushed in. The baby's heartbeat couldn't be detected. The fear was that my uterus had ruptured, which is a slight risk you take when attempting a VBAC. My team decided that a crash C-section was necessary; it wasn't going to be a "gentle" section. I was going to be put under general anesthesia. My husband would not be able to attend the birth. I was put under terrified thinking about how I would tell my four-year-old that his brother or sister wasn't going to be coming home. Bad things weren't supposed to happen to rainbow babies. "My doctor acted swiftly, and he said he was able to remove my baby within 43 seconds of putting me under... 43 seconds! Thankfully, my uterus hadn't ruptured. The cord was wrapped twice around the baby's neck. When I saw my baby for the first time, I quickly noted the pink hat in her warmer and realized I was now a girl mom, which was so shocking because I thought it was another boy. "Soon after, the tears of joy went back to tears of sadness. Thankfully I had a great support system and reached out to a counselor right away. I knew that I wanted to sort my feelings about my failed VBAC and traumatic birth before those thoughts consumed me. I saw a counselor who specializes in postpartum issues four days after delivering my baby girl. She has helped me work through the fears of almost losing our baby and has been a tremendous asset in keeping my mental health in the right place." We go on to talk about the difference between a Crash Cesarean and an Emergency Cesarean, and why it is important to know the difference. You can find out more about How to Cope When You Don't Get Your VBAC ( https://www.thevbaclink.com/how-to-cope-when-you-dont-get-your-vbac/ ) on our blog. We want to thank this episode's sponsor, Betterhelp Counseling ( https://www.betterhelp.com/vbac/ ) , whose mission is to make professional counseling accessible, affordable, convenient - so anyone who struggles with life’s challenges can get help, anytime, anywhere. Get 10% off your first month by going to betterhelp.com/vbac ( https://betterhelp.com/vbac ). Full transcript Meagan: Hello, hello! You are with the VBAC Link with Meagan and Julie, and our friend Jennifer today. We’re excited to have her sharing her story. She is a CBAC. For anyone who doesn’t know what a CBAC is, it’s Cesarean birth after Cesarean. She was going for a VBAC, was getting so close, and had a turn in a completely different direction. We’re going to be talking with her today about her story and also splitting up the difference between an emergency C-section and a crash C-section. A lot of times, a non-emergent and emergent is jumbled into one. So we’re going to talk about the differences there. We’re really, really excited. Of course, Julie has our review of the week. I’m going to turn the time over to her to read that. Julie: Yeah, I’m really excited about this story. We’ve said it before and we’ll say it again. We are not here to share just the sunshine and butterfly VBAC stories. If that’s what you want, and that’s okay if you want that, then this is probably not going to be one that you would want to listen to. But we encourage you, if you can, to take a minute to ground yourself and try and listen to the harder stories because VBAC, TOLAC, trying a vaginal birth, whatever you want to call it, doesn’t always go as planned. Sometimes a repeat Cesarean is necessary, sometimes it’s wanted, and sometimes it’s an emergency, like a true emergency. Knowing the difference, like Meagan said, is really important between an emergency Cesarean and a crash Cesarean. This is sure to be a really vulnerable and raw story. I am so grateful to Jennifer for being willing to share that story today. Review of the week Before I do that, I’m going to share a review from hellomissbliss, on Apple Podcasts ( https://podcasts.apple.com/us/podcast/the-vbac-link/id1394742573 ). Doesn’t that take you back to your high school days, Meagan? Miss Bliss? Saved by the bell? Totally there. So hellomissbliss, I’m going to read your review. The title is “Invaluable”. She says, “As soon as I had my C-section, I knew I wanted to VBAC for my future births. I searched other birth podcasts for VBAC stories specifically, and then one day I found The VBAC Link. The information, honesty, support, and evidence-based advice that Julie, Meagan, and their guests provide are invaluable. I make my husband listen and feel so much more empowered and secure in my decision to VBAC. I’m eight weeks pregnant now and I can’t wait to share my VBAC story next year. Thank you so much for this amazing resource.” Now we’ve got to do what we do. We calculate the dates. She was eight weeks pregnant on November 1st, so that’s two months. She probably just had her baby! In June. Hellomissbliss. If you had your VBAC, let us know. We would love to hear your story. Meagan: We are so excited to get started. I do want to give you a fair warning before we turn the time over to Jennifer. If you’ve been following our stories and my Friday updates, you know that I am completely under construction. My entire top floor, which is what’s above me, is under construction. We had to rip up all of our tile and they are prepping the floor to re-lay it right now. So you may hear hammering, you may hear sawing, you may even hear a dog bark, and I’m sorry. Just a fair warning. Julie: There’s always the chance of crazy kids. Meagan has one home and I have three at home. My two-year-old is currently resisting naptime, which should be coming up in about 45 minutes. So it’s just, you get what you get. Sometimes we’re good and sometimes we are a hot mess! Meagan: I just wanted to give that fair warning. If you hear the knocking, I am guilty. It’s me. But Jennifer, we’re so excited to have you here and we can’t wait to dive into your story. We’d love to turn the time over to you. Jennifer’s story Jennifer: Thank y’all so much. I guess I’ll start with my son, with my first C-section. I went into labor at 40 weeks, 5 days. I had a really great pregnancy, no real issues. I labored at home for 21 hours with a doula. We finally went to the hospital and I was only 1 centimeter. That was very discouraging, but I walked around and they ended up keeping me because I was able to get to 3. Long story short, it was about 35 hours that I had been in labor. I was about 8 centimeters and my doctor said my cervix was swollen. She said that we’ll try some Pitocin, but my baby didn’t handle the Pitocin well, so they stopped. I wasn’t really progressing after that. At about the 43-hour mark, she said I had to have a section. There was no talking to her, letting me have any more time or anything like that. She said it was just too swollen. It wouldn’t have happened. We had a C-section and it went very smoothly. My doula was able to be in the room with us. She took some great pictures. After delivery, he was perfect and we had a really good hospital stay. I knew after having him, though, that my first question was, “Okay, can I have a VBAC?” And of course, the doctor at the time was like, “We don’t even need to be talking about this right now. You just had a baby.” Life went on and it was okay. I wasn’t too sad. I knew I would have kind of like a redemption. I’d be able to try for a VBAC in a few years when we decided to have another child and we were hoping for that. A few years later, we were ready to have another baby. I had a miscarriage and then we had about 13 months of infertility. We finally were able to start an oral medicine to help us get pregnant. I got pregnant the first month, and I knew that I needed a VBAC friendly doctor. In my town, we really only have two, and one is much more VBAC friendly than the other, so I chose him. He was great. He said I had a really high chance of delivering the way I wanted to and that he didn’t see anything stopping us at the time. So I hired a doula again. I saw a Webster-certified chiropractor a few times a month-- pretty much throughout my whole pregnancy. It was a very textbook pregnancy. There were no signs that would indicate anything would happen. Then, I found out towards the end of my pregnancy that my doctor was going on vacation. He was going to be gone from when I was 39 weeks to 41 weeks. I knew at that point that my chances of a VBAC-- it was very discouraging knowing he wasn’t going to be there. But my doula calmed me down because the doctor who was going to be on call for him was the other VBAC friendly doctor in our town. That kind of helped me out a little bit. So I knew that I would be delivering with the other doctor. I had met him before, when I had my miscarriage, so I did vaguely know him. I was just going to wait and see what would happen. I knew going in that I wasn’t going to be induced. My doctor was giving me until 42 weeks. We were planning on riding it out until I went into labor naturally. At 40 weeks exactly, at 12:00 am, I went into labor. I guess early labor is what you’d say. My contractions started, but they were coming on really, really strong. They had always said, if you’re getting them less than five minutes apart, come in, because you are a VBAC candidate so we want to monitor you a little bit more. We went into the hospital after only a few hours of contractions and I was only one centimeter. We walked around. We got to about two or three centimeters, and they were like, “We will keep you,” but at that time, it was overnight. At our hospital, we have a hospitalist who sees you until early morning hours when you would see your regular doctor, as long as everything’s going as planned and smoothly. The hospitalist kept us and I continued to progress pretty well. I mean, very slowly. By about the 12-hour mark I think I was 5 or 6 centimeters, but it was still so much faster than with my son in my previous pregnancy. Everything was going well. The doctors I had were a little bit more VBAC tolerant versus okay with it, but they were letting me do what I wanted to do and labor on my own. They kind of just waited it out. I ended up getting an epidural and that helped progress me a little bit. They would turn me every two hours. They were doing minimal checks and everything was going smooth until about 2:00 am. I was about 8 centimeters, they had just checked me. The nurse had just come in to re-dose my epidural and my water broke. My husband and I just laughed. We were so excited because I finally felt like it was happening. I was getting my VBAC. My body was doing what it needed to do. I was on the right path. We knew that at 8 centimeters, if your water breaks, it’s going to progress pretty quickly, so we knew she was coming. About eight to ten minutes later, nurses swarmed into my room. I mean, we probably had about eight to ten in my room. They couldn’t find my baby’s heartbeat. They were trying to get me on all fours to try to figure out if it was just a positional thing or what. And that’s very hard when you’ve had an epidural and can’t move. I had people touching me in all kinds of places trying to turn me over. My doula had actually left. She had taken a little bit of a break because it was in the middle of the night. We had been progressing but it had been slow and she lived right by the hospital. Meagan: Can I just say, that’s a really awesome thing for you to have done? A lot of doulas burn out and they get so exhausted. They’ll be there for a really long time, but when things are moving slow and they’re not as necessary, it’s a really good idea to send your doula home or send her somewhere to go rest. That’s really, really good. Jennifer: For my first one, she was with us the whole time. She was a saint. I mean, she was literally with us for 40 something hours. Meagan: Doulas will power through. Jennifer: Yeah, so my doula this time had a few breaks. She was only a phone call away. I mean, she lived so close that it didn’t matter if she left for a little bit, because no one was expecting to have this baby super fast. So the hospitalist comes in. It was like he had been sleeping all night. He was very slow with his speech. He was like, “There seems to be a problem. We’re not quite sure what.” And I’m like, “Okay, you need to get my baby out if you can’t find the heartbeat.” So, thank God, my stand-in doctor, the on call doctor, has monitors at his house and also lives right near the hospital. And for whatever reason, at 2:00 am on this Saturday morning, he was awake and looking at the monitors. So before the nurses even had a chance to call him and tell him that something was wrong, he was already in his car on the way to the hospital. Meagan: That’s amazing. Jennifer: He barged into my room and it was literally like something out of a movie. He and this other doctor, the hospitalist, were arguing over what to do. From what I remember, the hospitalist was saying, “We’re going to take the baby out right here in the room”, and the on-call doctor was like, “No you’re not, the OR is right down the hall.” They’re arguing. The nurses are unplugging everything from the bed and trying to wheel me out of the room. They were able to find the heartbeat at one point, but it was only 30. So they were thinking that my uterus had ruptured and the doctors had agreed on that. Julie: Yeah, that’s a scary heartbeat. Jennifer: Yeah and then they couldn’t find it after that. They were basically screaming at me that it was a uterine rupture and I was thinking that it was all my fault, that I did this. I could have just had an easy C-section but I chose to do this. Because prior to this happening, earlier in the day, every time the doctors would come in, even the VBAC friendly one, they’d talk about it. “Well this is the risk. Are you sure you don’t want to just have a section? Are you sure you don’t want to have a little bit of Pitocin?” And I’m like, “No.” So I go in thinking that my baby has died. How am I supposed to tell my four year old that we don’t have a baby anymore? It was chaos. There was cursing, not by me, by the doctors and the staff, because I guess things just weren’t falling into place as quickly as they wanted it to. They were finally able to put me under and of course, I don’t know what happened after that. The doctor did tell me that from the time I was put out until my baby was here, it was only 43 seconds. They were able to get her out super quickly. And she was good. She was fine. Her APGARS were the highest they could be. She was okay. Now we know that the cord was wrapped around her neck twice, which was why her heartbeat was so low. Before my water had broken she had all that cushion to bounce off of, but once my water had broken, the cord was too tight. There was nothing for her to float around in, so that’s why it happened right after my water broke. Meagan: That makes sense. I was going to say, it’s like there’s a floodgate opening. They’re in this nice little hot tub, this floodgate opens, and they move. Water comes out, and it could have just gotten too tight. Did they try to change your positions or anything or was it just kinda like, “We’re going”? Jennifer: They did. That’s when they tried to get me on all fours before the doctor had come in the room. But because I had an epidural, it was just too hard to move. They didn’t really get a good response from that. They couldn’t find the baby’s heartbeat. They tried checking me, just to make sure the cord hadn’t prolapsed too, because that could have been one of the issues, they said. But that didn’t happen. She was fine. My doula wasn’t there. My husband, poor thing, he was by himself for that part. Thankfully, I told him as they were wheeling me into the OR, “Call her! Get her to come. You need someone here with you.” Because I didn’t know how he would be either, especially if my baby hadn’t made it. He did say though, that he was able to hear her cry, because he was standing outside the door. It seems like it took forever in the OR, but he said it didn’t because literally, once I was in there, it took five or so minutes for them to put me under and all of that, and he was able to hear her cry. He knew at that point that she was okay. We didn’t know if she was a girl or a boy at that point. We didn’t get our moment of her coming out and being put on my chest and being able to look together, which we were so looking forward to, because that was the incentive for a VBAC too. You know, how exciting it is to have your baby and not even know if it was a girl or a boy, then being able to look. He found out via a picture. The nurse got his phone and took some pictures for him. I found out when I was wheeled into the room. There was a little pink hat on her head, so I knew it was a girl at that point. Meagan: How long did it take for you to come back to and be present again? Jennifer: Honestly, I think it was less than an hour. I was in the recovery room by 3:00. She was born at 2:00, and by 3:00, I was in the recovery room, which is basically the amount of time it took with my son as well. It was like a normal C-section. He was actually able to cut on my old C-section scar, so everything was pretty textbook. Instead, it was a lot faster than a regular C-section. As far as post C-section, everything was textbook. I was in the room about an hour after, nursing her, and she was feeling so good. That part was kind of normal, if you would call it that. Emergency vs. Crash Cesareans Meagan: Good. Yeah and I want to talk about, really, that difference. There are emergency C-sections, then there are true, true emergent, crash C-sections. You had a crash C-section. One of the first indicators of a crash C-section is if they have to knock you out and there’s no time to even talk and discuss or do anything like that. Baby was out in, what did you say, 43 seconds? Jennifer: 43 seconds. Meagan: Yeah, that is a true, crash C-section. A lot of times with crash C-sections, partners are not allowed to be there either because there’s no time and there’s so much happening that they don’t even have time to allow that person in. Fetal heart tones are one of the biggest reasons for a crash C-section. Really low heart decels that cannot be recovered or found. Obviously, it’s a very scary situation and we want to get baby out. So that’s what they did. They rushed and it sounds like they did a very good job rushing. We are so glad that she was okay. Jennifer: Thank you. It was very scary and still it’s very hard to even talk about. I was so grateful-- we have a great perinatal mental health specialist in town that, four days post-delivery, I saw her for the first time. I saw her every two weeks for the first month. I went every month and I still see her. Now we talk more about husband and children issues, but for a long time, we just talked about the birth. Trying to help me to just realize that it was okay to have those feelings. The sadness. Because even in the hospital, talking to my nurses, I was very tearful all the time. But they were just like, “She’s here, she’s okay.” It was true. But I was also kind of mourning the birth that I didn’t get to experience. I am so happy that my little girl was okay, and I would do anything. I would go back and have another crash C-section just to have her healthy, but after preparing and feeling like I am a great candidate for a VBAC, I didn’t really set myself up for what if it doesn’t happen? You know? Julie: Yes. Oh my gosh, yes. Jennifer: I guess that’s one reason why I wanted to share my story too. Because for nine months, even longer than nine months, before I even got pregnant, VBAC was what was going to happen and I had no doubt about that. That was one of the things we’ve worked on a lot in counseling too. It was okay to have those feelings, but it’s okay too that it didn’t go the way I wanted it to or the way I expected it to. Julie: Yeah, I agree. I think it’s so important. That’s one of the reasons why we like to share all of these different types of stories and different birth outcomes, because while uterine rupture is incredibly rare and a catastrophic rupture is even more rare than that, it still happens. When you’re the 1 in 100 or a 1000, it might as well be a 100% chance for you, because that’s what your story is and that’s what’s happened to you. We’re grateful that yours didn’t end up in a uterine rupture. But there’s still that trauma there. The minutes leading up to that 43 seconds probably felt like an eternity, and there’s a whole lot of stuff there to process. Jennifer: It did. When they’re putting you in the OR, you’re having to switch over beds real quick and you can’t move, because they’re trying to get you all set up. You’re literally laying there naked because they’re in a rush. They’re throwing betadine on you and cleaning you up and getting you ready. All of those things, while you’re sitting there and you’re trying to think through it. You’re thinking the worst of what’s going to happen and how you’re going to tell people. How you’re going to tell your little ones at home-- just the worst thoughts. Then my doctor came in the next day and said, “Oh, well, you did have a uterine window.”And I’m like, “Gosh. First of all, do we really need to talk about that? Because that had nothing to do with my delivery at all.” Meagan: A lot of people have uterine windows. Julie: Yeah, Meagan did. Jennifer: I’ve heard you can even have one if you’ve never had a C-section. Meagan: Absolutely. A lot of first time moms probably have them and they would never know if they didn’t have a C-section. Jennifer: He’s basically telling me that, “Look, you’re never going to have a vaginal birth.” I don’t know if we’ll have another child. I think we’re good. But I just had a baby 12 hours ago. You don’t need to be telling me this. Meagan: Right. My provider told me that on the table. During my C-section he told me he was so happy that I didn’t VBAC because I “for sure would have ruptured.” And that I have this window. But what he doesn’t understand is what that did to me for my next birth. It stuck with me. And you’re like, “I just had a baby. Can I just focus on this for this very moment?” Jennifer: Exactly. Because even if we choose to have another one, or are blessed to have another one, I’d probably worry my whole pregnancy that, “Oh gosh, I have a uterine window.” Even if I wasn’t trying for a VBAC, I’d probably be thinking, “Okay, I can rupture any moment.” Some things just don’t need to be said. Julie: I think that providers sometimes don’t realize the impact that their words have on these pregnant people and I think sometimes it comes out of misinformation. They just don’t know. These guys, they’re surgeons. Most obstetricians have done hundreds, thousands of C-sections, perhaps, and have seen a lot of really abnormal things. I can’t imagine that it would be comfortable for someone doing a C-section to see a uterine window and see through the uterus. That probably would be really hard. They would probably be thinking, “Wow. It’s a good thing we’re doing this C-section because this uterus is really thin.” I think it’s more of a defensive mechanism-- a subconscious, primal thing. Seeing that is scary and there’s not a lot of information. There’s no information. There’s no way to tell if a uterine rupture or a uterine window leads to a rupture. There’s just no way. You’d have to know if the uterine window was there before the rupture happened. You can’t do that unless you have a C-section. And so, there’s just no evidence. At all. You just have to assume. When you make assumptions, you get misinformation and misguided providers. It’s really frustrating. I wanted to tell a quick story. I had a client who had a crash Cesarean. There’s so much stuff I want to talk about. It is all in our course. My mind is going on all these different tangents like epidural placement, crash Cesarean, emergency Cesarean, preparing mentally for a different outcome, all of these things. But I want to talk about my experience. I had a client and she had a two-vessel cord. Normally the umbilical cord has three vessels, two going in and one going out. Hers only had one going in and one going out of the cord which, usually, is not a problem. And, usually the cord around the neck is not a problem. Most of the time, you just slip the cord off the neck as the baby comes out and everything’s fine. But sometimes it is a problem, like in your case and, it turns out, in my client’s case. She was going along perfectly in her VBAC and everything was fine. She was pushing for two hours. She just could not get the baby past the pubic bone. She finally decided she wanted an epidural so that she could get some rest. Rest and descend to let the body do some work on its own while she could get some much needed rest. The anesthesiologist came in and she was pushing. She finally got the baby past the pubic bone. The anesthesiologist was there getting ready to do the epidural. By this time, the OBGYN had come in. She was with a midwife and the baby’s heart rate was super tachycardic. 60bpm, 240bpm, 180, 40bpm, 90. It was up, down, up, down, up, down. It was so crazy, all over the place. Baby was under a lot of stress. The OB said, “How long is it going to take you to get an epidural where we could do a forceps delivery?” He’s like, “Well, probably about 20 minutes.” She’s like, “I don’t have 20 minutes. I have 2 minutes.” Once she said that, everything changed. They dosed up her IV. They flattened the bed out. They wheeled her to the OR. It was like, this baby is not doing well. Now we need to get the baby out. There’s no time for an epidural. There’s no time for anything else. We need to get the baby out now. And so, they rushed everybody. It was busy chaos, just like you said. Everybody flooded into the room. Me, the birth photographer, and the birth partner stepped back, got out of the way, and they rushed her away. The baby was born three minutes later, after the obstetrician had said, “I only have two minutes.” It ended up being three minutes, but I’m sure she was just throwing out a short amount of time. It was a good call because the baby was born with an APGAR of 0. Literally, they had to resuscitate him. His two minute APGAR was 5, he was in the NICU for six weeks. There was a lot of crazy stuff. It was not a uterine rupture. It was the two-vessel cord. The cord was wrapped around his neck twice, so once he got past that pubic bone, all of the pressure was super restrictive and he wasn’t getting oxygen. That’s a crash Cesarean. Baby needs to be out in minutes. Minutes, even seconds, matter. That’s why we kind of laugh at the “just in case” epidural, because even if an epidural is dosed and turned on, in order to get it up to a dose where you wouldn’t feel it during surgery would take 20-30 minutes, even if it is already turned on. If it’s not turned on, it could take 40 minutes. If you only have two or three minutes to get baby out, you’re going to be put under whether you have the epidural or not. Jennifer: Exactly. See, I had asked my doctor that at one of my appointments because I was going to try to go without an epidural. I said, “If I go without, what happens if I end up needing a section?” He said, “If you need a section that quickly, it would be a crash section and you’re going to be put under regardless.” He said, “Do not make up your mind on whether or not you want an epidural on the basis of a section or not. If you want it, get it for pain management. Don’t get it because, you think, okay well, what if something happens and I need a section?” Julie: This is where people can get confused. The medical definition of a crash Cesarean is baby has to get out now. We can’t wait. We can’t do anything. We need to knock mom out, cut baby out as soon as possible. That’s a crash Cesarean. Emergency Cesarean is, “Oh gosh, baby is not looking great. You’re only 4 centimeters. Let’s call the OR and get the anesthesiologist in here. Oh, he’s in another surgery, so you’re going to have to wait 30 minutes.” That’s an emergency Cesarean. But when people hear the word emergency, it’s not a good word. It’s not a good thing. Emergency is bad in our minds. An emergency Cesarean really just means, “We don’t think baby is going to come out vaginally and so we need to get it out through a Cesarean.” In that case, if there’s time to wait, then there’s time to get a spinal block, which takes five minutes to take effect. It’s much different than an epidural. It wears off a lot quicker too, which is why it’s not their first go-to, but a spinal block takes effect rather quickly and you can still have your Cesarean in 30-40 minutes with a spinal block. Then, of course, we have planned Cesareans which are scheduled. So you have your scheduled Cesarean, your emergency Cesarean, which is not an emergency. It just means, “Oh, well, we don’t think baby is going to come out vaginally”, or maybe there are problems, like mom has a fever, there’s pre-eclampsia, blood pressure, swollen cervix, etc. Crash Cesarean is, “Alright. This is an emergency. There is a risk to the life of mom or baby. Baby has to come out right now.” That’s where seconds matter. Jennifer: I think it’s important for people to know the difference. Not that any one is worse than the other, but some nurses and doctors don’t even know the difference. Because my regular doctor was on vacation, I had a stand-in doctor every day. They would call it an emergency C-section, often. It was so close and so fresh in my mind that I would correct them every time. “No, it was a crash section.” There’s a difference. The fact that they call it an emergency section over and over, I was like, “Gosh y’all. It wasn’t just an emergency.” It didn’t feel like that, at least to me. Julie: Yeah. Significant difference. Very big difference. Thank you so much for sharing your story with us. Before we forget, we want to ask you our questions that we try to remember to ask people. Meagan: I actually want to share just one more thing really, really fast. We have a blog post. I believe Julie wrote it. It’s about healing after a birth that didn’t go the way that you wanted it to. Julie: It’s How to Cope When You Don’t Get Your VBAC ( https://www.thevbaclink.com/how-to-cope-when-you-dont-get-your-vbac/ ). That’s what it’s called. I just barely linked to it in the blog I’m writing right now. Meagan: It’s How to Cope When You Don’t Get Your VBAC ( https://www.thevbaclink.com/how-to-cope-when-you-dont-get-your-vbac/ ) and there’s Healing From Trauma After a Difficult Birth Experience ( https://www.thevbaclink.com/how-to-heal-from-birth-trauma/ ). We have two different blogs that may benefit you if you are in this situation as well. So go check it out. It’s at thevbaclink.com/blog ( http://www.thevbaclink.com/blog ). We’ve got oodles and oodles of blogs in addition to that, but those are two specific ones that I thought related to this awesome story. Julie: There’s a search bar on the blog. You can go in and search for whatever you want, really. Enter in the search term you are looking for. On mobile, I think it’s at the bottom sometimes. If you are on a desktop, it’s on the right side. Click on the blog page and it will pop up there for you. Q&A Meagan: Yes, yes, yes. And then we do. We ask questions. We always forget to ask, so I’m excited that Julie remembered. One of them is, what is a secret lesson or something no one really talks about that you wish you would have known ahead of time when preparing for birth? Do you remember what you answered? Or do you want to answer something random, too? We have what you answered if you want us to read it. Julie: I don’t remember. I wrote that so long ago because we had to reschedule a few times. I don’t even remember what I put. Meagan: You said that you wish you had prepared yourself for the possibility that you would have had to have a C-section. You were so positive that you would have had a VBAC that you didn’t think of any other complications. I think that is such a big and powerful tip. Our secret lesson, as we are calling it, because there are a lot of times where people write their birth plans and they’re like, “This is how my birth is going to go,” and then birth doesn’t necessarily go that way. It’s actually a lot of trauma for them because they had only prepared for this one way. This is why we believe that hearing CBAC stories and uterine ruptures are really good to hear. They’re really scary to hear when you’re preparing, sometimes, but they’re so beneficial in so many ways. What is your best tip for someone preparing for a VBAC? Jennifer: I think it would be, like I said, to have an open mind. Labor never goes really how you plan, but definitely have a very pro-VBAC team. You know, a doula, your doctor. Go in knowing that it may not go the way you want it to, but it’s okay. There are so many resources after that can help you, like my counselor. My husband was a big support system. Just making sure you have a good support system, whether it’s family or otherwise. Meagan: Definitely. I love it. Jennifer, thank you so much for sharing your story. We love it. We love you and thanks for being with us. Closing Would you like to be a guest on the podcast? Head over to thevbaclink.com/share ( http://www.thevbaclink.com/share ) and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com ( http://www.thevbaclink.com ). Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Alan recently discussed immersive learning with his partner in life and business, Julie Smithson, on her sister podcast, XR for Learning. We thought it was a good episode, so this week, we're sharing it here for XR for Business listeners. Julie: Hi, my name is Julie Smithson. Alan: And I'm Alan Smithson. Julie: And this is the XR for Learning podcast. Alan: Well… which podcast are we on? Is it mine or yours? Julie: I think it's mine. Alan: Yours, so the XR for Learning podcast. Julie: Yeah. Alan: I'm going to interview you. Julie: Yes. Alan: OK, cool. Julie: Hi, my name is Julie Smithson, and I am your XR for Learning podcast host. In all of my episodes, I talk about the way that we need to change the way that we learn and we teach, to adapt to the immersive technologies that are being implemented in enterprise and business today. So today, my guest — my special guest — is Alan Smithson. Alan: Hello. Julie: My partner and husband of almost 20 years. And we're going to talk about education. So welcome. Thanks for being on *my* podcast. Alan: Thank you so much for having me. I'm a little nervous, I'm not going to lie. This is an interesting podcast dynamic. Julie: It really is. We've never done this before. Alan: No, we have not. So I want to ask you questions, because you are the guru in immersive learning systems. So we'll hopefully kind of dig up where this lies, and what we have to do as a society to really push the needle forward. Julie: So what I like to do with all my podcasts is start with a baseline technology. Where are we today? Like, what's going on today? Which is really good question, because it's definitely different than it was six months ago. Alan: I would say, in the industry– I'm coming from the business side of things. What we've seen is there's been a hyper-acceleration of digitization. So in retail and e-com, it has been decimated. People couldn't go to a store physically, and so everything moved online. And in e-commerce, we're seeing shopping trends that would have existed in 2030 happen today. This is trickling down to everything, not only retail, but then also meetings. Everybody's meeting on Zoom these days. Everybody. There's just– we're moving to digital and we're moving to these things much faster than we had ever, ever hoped to do. Plans of digital transformation that would have taken five years are now happening today. So it's an interesting time to revisit and relook at what does education look like in an exponential world of digital transformation. Julie: And this is where the skillsets that are now needed — in enterprise, business, and organizations today to digitally transform — those skillsets are not being taught in the school system today. So COVID coming in and forcing people to virtually connect online, the education systems were forced to actually be online and rethink how they're teaching things. But the unfortunate thing is, is that we didn't get to the point of talking about what we were actually teaching. It was just more of a digital connection for the past six months. Alan: Well, I think since this thing has hit, it's been really just how do we make the technology work in a seamless way that is comfortable for both the teachers and the students? And to be honest, we're not quite there yet. My kids

Alan recently discussed immersive learning with his partner in life and business, Julie Smithson, on her sister podcast, XR for Learning. We thought it was a good episode, so this week, we’re sharing it here for XR for Business listeners. Julie: Hi, my name is Julie Smithson. Alan: And I’m Alan Smithson. Julie: And this is the XR for Learning podcast. Alan: Well… which podcast are we on? Is it mine or yours? Julie: I think it’s mine. Alan: Yours, so the XR for Learning podcast. Julie: Yeah. Alan: I’m going to interview you. Julie: Yes. Alan: OK, cool. Julie: Hi, my name is Julie Smithson, and I am your XR for Learning podcast host. In all of my episodes, I talk about the way that we need to change the way that we learn and we teach, to adapt to the immersive technologies that are being implemented in enterprise and business today. So today, my guest — my special guest — is Alan Smithson. Alan: Hello. Julie: My partner and husband of almost 20 years. And we’re going to talk about education. So welcome. Thanks for being on *my* podcast. Alan: Thank you so much for having me. I’m a little nervous, I’m not going to lie. This is an interesting podcast dynamic. Julie: It really is. We’ve never done this before. Alan: No, we have not. So I want to ask you questions, because you are the guru in immersive learning systems. So we’ll hopefully kind of dig up where this lies, and what we have to do as a society to really push the needle forward. Julie: So what I like to do with all my podcasts is start with a baseline technology. Where are we today? Like, what’s going on today? Which is really good question, because it’s definitely different than it was six months ago. Alan: I would say, in the industry– I’m coming from the business side of things. What we’ve seen is there’s been a hyper-acceleration of digitization. So in retail and e-com, it has been decimated. People couldn’t go to a store physically, and so everything moved online. And in e-commerce, we’re seeing shopping trends that would have existed in 2030 happen today. This is trickling down to everything, not only retail, but then also meetings. Everybody’s meeting on Zoom these days. Everybody. There’s just– we’re moving to digital and we’re moving to these things much faster than we had ever, ever hoped to do. Plans of digital transformation that would have taken five years are now happening today. So it’s an interesting time to revisit and relook at what does education look like in an exponential world of digital transformation. Julie: And this is where the skillsets that are now needed — in enterprise, business, and organizations today to digitally transform — those skillsets are not being taught in the school system today. So COVID coming in and forcing people to virtually connect online, the education systems were forced to actually be online and rethink how they’re teaching things. But the unfortunate thing is, is that we didn’t get to the point of talking about what we were actually teaching. It was just more of a digital connection for the past six months. Alan: Well, I think since this thing has hit, it’s been really just how do we make the technology work in a seamless way that is comfortable for both the teachers and the students? And to be honest, we’re not quite there yet. My kids

Olivia Wenzel may be Julie’s youngest guest yet, but her youth hasn’t stopped her from launching a startup — AltruTec — or teaming with Julie on the VRARA’s Parent & Student Resource, or using VR to combat dementia. Julie: Hello, everyone, my name is Julie Smithson and I am your XR for Learning podcast host. I look forward to bringing you insight into changing the way that we learn and teach using XR technologies, to explore, enhance, and individualize learning for everyone. Today, my special guest is Olivia Wenzel, a student and founder of AltruTec, developing video games for adults suffering from dementia. Thank you so much, Olivia, for joining me today on this podcast. Olivia: Thank you so much for having me. I'm excited to be here. Julie: It is so great to have somebody from the next generation join me. You happen to be the youngest one of my guests. So thank you so much for being here. And I'm really excited to be able to share with everyone some of the works that we've been doing, since you and I have been working together for the last year and a half on the student committee with the Virtual and Augmented Reality Association, developing and building out resources for everyone. So first of all, I'd like to give you a chance to introduce yourself and then we'll step into a little bit about some of the work that we're doing. Olivia: Absolutely. I just graduated from high school and I'm headed to Harvard this fall. I'm interested in studying at the intersection of health and technology. So I'm thinking computer science and neuroscience, or computer science and psychology. I'm not quite sure yet. I have a startup called AltruTec. I'm really interested in improving the quality of life for older adults. But perhaps what's most relevant to today's discussion is my co-leadership of the student committee with Julie. I have the great pleasure of leading this committee of students, parents, and VR and AR industry professionals with Julie, an amazing mentor. We aim to support parents, students, and schools in adopting immersive technologies and 3D learning. But let me take a step back and answer your question about how I got involved. My interest in virtual and augmented reality is actually heavily tied to AltruTec. I have a family history of dementia, and when I first started exploring other approaches to improve people with dementia's quality of life, I ended up coming across several virtual reality applications. Long story short, they were using this immersive platform to deliver non-pharmacological therapy, such as reminiscence and music therapy. I found the mediums to be extremely promising. The early research that was coming out was so exciting. And so I ended up reaching out to some universities and companies in the area, because I really didn't have any background in technology or virtual/augmented reality, especially at the time. And I met someone in Cleveland named Reynaldo Zabala, who was involved in the VR/AR Association. And after some further correspondences, he helped me develop my ideas some more. I ended up being introduced to the committee, and soon I was heading it up. [laughs] Julie: [laughs] Which has been a long time coming for us, to finally put a project together that we can work on. And I think it was over a good six, seven months period of time of us just talking to each other, and then figuring out what kind of mission could we work on together, that could give back to the community. And that's where we came up with the parent and student resource. Olivia: Yes, yep. Julie: So, yeah, we came up with a few ideas on how to do this, but this was kind of a zero

After a short hiatus, Julie is back with a special episode, where she interviews (is interviewed by?) her partner in business and life, Alan Smithon, who you may know from our sister podcast, XR for Business. Julie: Hi, my name is Julie Smithson. Alan: And I'm Alan Smithson. Julie: And this is the XR for Learning podcast. Alan: Well... which podcast are we on? Is it mine or yours? Julie: I think it's mine. Alan: Yours, so the XR for Learning podcast. Julie: Yeah. Alan: I'm going to interview you. Julie: Yes. Alan: OK, cool. Julie: Hi, my name is Julie Smithson, and I am your XR for Learning podcast host. In all of my episodes, I talk about the way that we need to change the way that we learn and we teach, to adapt to the immersive technologies that are being implemented in enterprise and business today. So today, my guest -- my special guest -- is Alan Smithson. Alan: Hello. Julie: My partner and husband of almost 20 years. And we're going to talk about education. So welcome. Thanks for being on *my* podcast. Alan: Thank you so much for having me. I'm a little nervous, I'm not going to lie. This is an interesting podcast dynamic. Julie: It really is. We've never done this before. Alan: No, we have not. So I want to ask you questions, because you are the guru in immersive learning systems. So we'll hopefully kind of dig up where this lies, and what we have to do as a society to really push the needle forward. Julie: So what I like to do with all my podcasts is start with a baseline technology. Where are we today? Like, what's going on today? Which is really good question, because it's definitely different than it was six months ago. Alan: I would say, in the industry-- I'm coming from the business side of things. What we've seen is there's been a hyper-acceleration of digitization. So in retail and e-com, it has been decimated. People couldn't go to a store physically, and so everything moved online. And in e-commerce, we're seeing shopping trends that would have existed in 2030 happen today. This is trickling down to everything, not only retail, but then also meetings. Everybody's meeting on Zoom these days. Everybody. There's just-- we're moving to digital and we're moving to these things much faster than we had ever, ever hoped to do. Plans of digital transformation that would have taken five years are now happening today. So it's an interesting time to revisit and relook at what does education look like in an exponential world of digital transformation. Julie: And this is where the skillsets that are now needed -- in enterprise, business, and organizations today to digitally transform -- those skillsets are not being taught in the school system today. So COVID coming in and forcing people to virtually connect online, the education systems were forced to actually be online and rethink how they're teaching things. But the unfortunate thing is, is that we didn't get to the point of talking about what we were actually teaching. It was just more of a digital connection for the past six months. Alan: Well, I think since this thing has hit, it's been really just how do we make the technology work in a seamless way that is comfortable for both the teachers and the students? And to be honest, we're not quite there yet. My kids are more tech savvy than-- Julie: Our kids. Alan: Our kids. I'm sor

Learning complex STEM concepts like physics or chemistry off a chalkboard is no easy task, because it removes a key factor from the equation - presence. Inspirit VR’s Aditya Vishwanath explains how giving that presence back ignites a learner’s innate curiosity. Julie: Hello, my name is Julie Smithson, and I am your XR for Learning podcast host. I look forward to bringing you insight into changing the way that we learn and teach using XR technologies to explore, enhance, and individualize learning for everyone. Today my guest is Aditya Vishwanath. Aditya is a PhD candidate in Learning Sciences and Technology Design and a Knight-Hennessy Scholar at Stanford University. He's the co-founder of Inspirit, a company that develops virtual reality learning content. And his research focuses on developing technologies that support universal access to immersive learning content. Welcome to the show. Aditya: Thank you. I'm so excited to be doing this. Julie: That's great. And we've had a couple of conversations about education, and the courses that need to be implemented into classes, and that sort of thing. Why don't you tell me a little bit about Inspirit, where you started from, and where you guys are today? Aditya: Inspirit was actually a research project that I started out with a friend and now co-founder of mine -- her name is Amrita -- and the two of us were both researchers in a lab at Georgia Tech in Atlanta. And we really stumbled upon this opportunity to explore and study what it would take to bring immersive VR to a few public schools in the city of Atlanta. And it was really just a phenomenal experience for the two of us, because what we thought was going to be just a few weeks of a project -- where we were playing the roles of research assistance -- exploded into what is Inspirit today. Our mission -- and my research too, at Stanford -- is really trying to be that bridge between the best of academic research and what we know about virtual reality and education, and then cutting edge technologies that can be used in industry and go straight into classrooms and learning environments. Inspirit was founded with that goal of accelerating the pace at which we could bring research findings of VR and education into schools, into universities, into learning environments around the world. Julie: It's definitely a big concern now, the speed of education. And not just how much we're learning, because I feel like every day it's like a firehose of things to learn. Now it's a matter of how did the education systems keep up with the demands of change that's taking place, both through innovation and changes within a company? It sounds like that's something that Inspirit is trying to address? Aditya: STEM education is what we do at Inspirit. And fundamentally, somewhere down the road, STEM education stopped becoming a hands-on interactive learning experience. And this was largely due to the needs of supporting larger and larger classrooms, more and more students, both in an online and an offline learning environment. And suddenly that personalization, that hands-on, that immersive interactive aspect to science and STEM education was completely lost. But a lot of the science learning today happens in a very passive way, with a video lecture or somebody giving you a passive lecture with a set of PowerPoint slides. And very rarely, are you interacting or actively solving a problem outside of a science lab. So our goal with Inspirit really was to bring back that hands-on piece and that interactive piece in a self-based, in a comfortable, and in an immersive environment using the power of virtual reality, both offline in schools and universities, and also online, if you're learning anything from anywhere in the world.

In this episode, Kari and Julie answer the top 5 questions they get asked on a regular basis. 1. What is the easiest way to meal plan and prep because just planning is overwhelming? Julie: Start simple!  Make one simple change for a week or so before trying to change everything in one week. Choose simple recipes and upgrade your ingredients. Kari: Have key staples on hand and embrace leftovers! 2. What do you feel is the healthiest food lifestyle?  Julie: There is no one size fits all. Eating whole foods is the right way to eat for everyone but you have to be a student of your body and find what works for you. Educate yourself on the pros/cons of each eating plan and make an informed decision. Kari: Focus on eating whole foods. Think of what is sustainable and what you can incorporate into your life for years.   3. How are you modeling healthy habits for your children? Julie: The key here is to lead by example.  Don’t ask them to do something you wouldn’t be willing to do.   Kari:  Let your kids have some control and make choices about what they eat. Explain why some choices are better than others and empower them with information so they truly understand.  4. How do you stay motivated in your health journey? Julie:  I really envision how I want to feel, how I want to show up in life,  and how I want my life to look. When you really become clear on those things, for me that is what has made the biggest difference and I know that those healthy habits are what will get me there.   Kari: You have to stay connected in how you want to feel and really become laser focused. I want to be a good steward of the body/time God has given me and I want to make the most of every day. In this journey to stay motivated, you have to have small wins. It’s very important to have an accountability partner to help keep you motivated and on track. 5. How do you go from craving sugar day and night to cutting it out? Julie: It is possible for you to quit refined sugar, not just for us or your friends. The cleaner your body becomes by upgrading what you eat, the less you crave sugar.  Kari: Learning how toxic sugar is for your body really motivated me. Once you participate in cleanses/detox programs, you will begin to notice how sugar negatively affects how you feel.  Podcast with Greg (on quitting sugar): https://anaturalshift.com/episode78/  Podcast with Karalee Glore on quitting sugar: https://anaturalshift.com/episode31/ the effects of sugar on your body: https://anaturalshift.com/episode30/  Link to purchase the course:    Connect with us→ via social media

  How to Put a "Twist" in Your Brand with Julie Cottineau (Archive) Julie Cottineau is the Founder and CEO of BrandTwist, a brand consultancy group that helps entrepreneurs and corporations build stronger, more profitable brands. Prior to launching her own business, she was the VP of Brand at Richard Branson's Virgin Group, overseeing branding strategy for new and established Virgin companies in North America. About the Interview: Ever wonder how Richard Branson manages to shake things up every time, in so many different industries? Julie Cottineau, spent 5 years as the VP of Brand for Virgin in North America helping to grow this iconic brand. Now the best-selling author of TWIST: How Fresh Perspectives Build Breakthrough Brands (Panoma Press 2016), Founder & CEO of BrandTwist will show you how TWIST your non profit's brand  for maximum impact. Fresh ideas come from looking at old problems from new perspectives. In this podcast, Julie will teach you how to: Go beyond “me-too” marketing, and get stand out Make the most of every brand touch-point – large and small Connect with target more deeply to create loyal brand ambassadors Walk away with tangible new ideas for your organization Why nonprofits should care about brand A unique, compelling brand can make or break even the strongest, most worthy enterprise. Once you understand the true nature of your brand, you achieve clarity and focus. You are in a much better position to serve the cause and the people you're really passionate about. Literally, it can change a life. Your charity, church or synagogue needs a strong brand – one with a TWIST. The TWIST is your unique story that will help you stand out, get the attention your good work deserves and build a loyal community of followers, donors, and volunteers.   Read the Interview Transcript Hugh Ballou: Welcome to The Nonprofit Exchange. It's Hugh Ballou and Russell David Dennis. Russell, how are you out there in Denver, mile high Colorado? Russell Dennis: The sun is shining, but you step outside and it's very cold. I'm having Northern Maine flashbacks with these single digit temperatures here. Hugh: We are recording in the wintertime. People listen at all places. It might be warm in the other hemisphere, and it might be summer in the northern hemisphere when you listen to it. But the message is that we give you the techniques and strategies and information. It doesn't have a season. It's stuff you can use any time. This is a real important topic today, like all of them, but we tend to skip over this thing of branding. We tend to think it's a picture, a logo. We got a brand, we got a logo. We are going to explore the different facets of branding and give you a top level view of what it looks like and what it is. One of the best people I know has this great book out called Twist. Julie Cottineau. Did I say it right, Julie? Julie Cottineau: Close enough. Hugh: I have a good memory, but it's short. Thank you for being our guest today. Tell the people listening a little bit about you and a little bit about brand twist. Julie: I think I have been branding since I was eight years old. When I was a little girl growing up in Massachusetts, my parents wouldn't let me have a pet because my brother was allergic. I went out in my garden and took a rock and put it in a Cool Whip container. I poked holes in it so it would be able to breathe. I invented the pet rock. Two years later, some guy named Gary Dahl in San Francisco invented the official pet rock because he was also fed up with regular pets. He was in a bar after work, he worked in advertising, and all his friends were leaving to feed their cats and walk their dogs. He said there has to be a pet with no hassle, so he created the official pet rock for no hassle. I created the non-allergic pet rock. Ever since then, I have been creating solutions with a twist from a different angle. Hugh: Twist. How did that name come about? Julie: That's another story. I was working as a branding consultant for Interbrand, a large branding agency. I was traveling all over the country. I was at Newark Airport one day. I looked out of the window and saw this 747 with these golden arches on the tailspin. I stopped in my tracks and thought, That would be a really interesting airline. It would be different than all these other airlines that had the same color seats and stewardesses and the same experience. A McDonalds airline, maybe I could buy a regular economy seat and supersize it to a premium seat. I looked up again and realized that it was a mirage. It was actually the reflection of the food court sign on the window, and there happened to be a plane. You following me? It was a hallucination. But it started me thinking, if you are in the airline business and want to break through, stop worrying about your other airline competitors and twist with other brands. Find brands that you admire that are doing cool things outside of your category, and twist those lessons with your brand. That started it all. Hugh: We put a snazzy title for this. The top mistakes. What are some of the things that people do that you wish they wouldn't do? Julie: We put the top three mistakes; it was hard to keep it to three. Hugh: I'll bet. Julie: You can grow to four. These were mistakes nonprofits are making. The first one is what we were just talking about: not really understanding what a brand is. In fact, confusing your branding with your marketing. That is a big mistake. Your marketing is how you get your message out there, but your branding is your fundamental story. What are you about? Why should people care? All great stories, if we think about our favorite movies and books, they have a twist. They have something unexpected in the plot. The number one mistake is stop saying if I only had ten times the marketing budget, I could build my nonprofit. Well, I could throw 20 times the marketing budget at you, but if your brand isn't in shape, your fundamental story of who you are, who you serve, and what's different about you, then it's a waste of money. Hugh: It's a waste of money. What happens when- I guess one of the fundamental branding issues with a nonprofit is the word “nonprofit.” It really puts us in a negative twist of scarcity thinking and nonprofit, we gotta have profit to be able to run this church or synagogue or community charity. How do we start out on this journey of creating our brand? Talk about brand image, brand promise, brand identity. There is a lot of facets to this besides the logo. Julie: Your brand is not your logo. Your brand is fundamentally your story, and your logo and name should help reflect that. I think a very unique challenge of nonprofits is the second mistake. They really try to welcome everybody. People who work in the nonprofit world are attracted to it because there is this inclusive instinct. Branding is actually about choices. If you have a page of your website that tries to tell everybody about everything that you do, you will connect with no one. It's like the twist on AT&T: reach out and touch someone. It's like reach out and touch no one. What I say the most important thing about branding is be clear on who you want to serve and the issues you want to promote. Be very choiceful. Narrow them down. Most nonprofit websites look like someone threw spaghetti up on the website and wanted to see what sticks. Branding is like an onion. Just tell me a little bit for me to get to know you, and then I will keep peeling the layers back to continue to get to know you. Less is more. Particularly in nonprofit branding. Hugh: Russell, we see lots of funky things, don't we? Russell: Yeah, it gets really interesting. If your target is everyone, you're marketing to no one. What it's about is really having people understand what it is that you do. A confused mind always says no. From a perspective of nonprofit, what is it precisely that a brand should do for a nonprofit? What is that main benefit that they get? I don't think people always understand the benefit in taking time to actually build a brand. What is that main benefit, and how does that really empower nonprofits? Julie: The main benefit is your brand promise. Getting clear on your brand promise. Getting specific on your brand promise. It's not we want to help people, or we want to make everyone feel included, or we want to make life better. Those brand promises are not gonna stick because not that they're not valid, but they're just so overused. It's like when Charlie Brown hears the teacher talk, and all he hears is “wah wah wah.” When I work with nonprofit clients, what problem are we trying to solve? Can we get really specific on that problem? Not that we want to give people shelter or help homeless people, but keep digging deeper. We want to help people feel at home. We want to help people feel that they can realize who they are in their minds versus how other people are seeing them. We keep digging. We get to one brand promise. The main thing we do with that brand promise is we don't validate it by looking at all the other nonprofits in our space, and we don't create it by committee, which is hard for nonprofits. Nonprofits love committees. What we try to do is say if there is a leader of the nonprofit, whether it's the president of the board or head of marketing, they need to own the brand. Everybody else can contribute their ideas, but at some point, someone needs to make a decision and get everybody on board. Versus we need a direction that everybody can live with, but no one hates. That is the definition of weak branding, when you go to the lowest common denominator. Hugh: She has good sound bites here, doesn't she, Russ? Russell: Brilliant. It's quite a field. I have done some marketing myself. I started out working in market research and sold some advertising on television and in print. But that doesn't really speak to brand. I was just fascinated by why people do some things. Describe to us what attracted you to the career of helping others build brands. How did that particular piece of marketing expertise jump out at you? Julie: I've always liked storytelling. I studied communications and creative writing. When I was little, my rockstar was Judy Bloom. I won a contest at the library to go hear her speak. To me, that was winning the Super Bowl. I was so excited by it. I've always been interested in storytelling. Branding is a very unique way to tell your story. I am in my office. I like to use all the different tools that I have. My brand is purple because it's the twist of red and blue. I tell my story not just in words, but also in images. You will never see me on stage without some purple on. The walls of the office are purple. The cover on my book is a twist of pink and purple. Nonprofits, one of the mistakes I see them making is they use stock photography because it's cheap, and I understand that. But they build websites. Don't invest a lot of money in them, but build them with a lot of images. The minute they set up their nonprofit, they are saying we're just like everybody else. There are inexpensive ways to take stock photography but frame it differently, treat it with a different color. We learn those lessons by looking at brands like Tiffany's. Tiffany's is a great brand to twist with. If someone gives you a blue Tiffany's box, I say to my husband, it almost doesn't matter what's in the box. The blue is their brand. Tiffany's robin egg blue. It sets up this expectation of an experience. I think that nonprofits should look at things like that, like owning a color. As soon as you see the red Target ad, you know right away, even if you don't hear the name and only see a slice of the logo, you know right away it's a Target ad. Hugh: It's funny you bring that up. They are changing their colors in Lynchburg to white. I don't know where I am. I was so into the red. The doors are still red, and people still wear the red and khaki. You were vice president of Richard Branson's Virgin. What are some of the important things you learned from that experience? That's powerful. Julie: It was an amazing experience. I think the biggest thing that I learned from Richard is not to be afraid to fail. He has an expression, “Fail harder.” Another one he has that is hopefully ok for this podcast, and is the title of one of his books is, “Screw it, let's do it.” If you have a good idea, and it feels like it's going to make an impact, don't test it to death, don't run it through 10 different committees, just try it. It might be successful, and it might not be. We know that we learn the most from the things that go wrong. It really opened me up to being more adventurous. I came home from my corporate job. I had been there five years, and I was having a great time. I said to my husband, “Screw it, let's do it. I am going to start my own company.” He said, “I don't think that's what that means. We have two children to put through college.” I said, “No, that's exactly what that means. I have an idea to create a branding consultancy and a book and a learning program, and I'm going to do it. If it's successful, great. If it's not, I am going to learn a lot.” That's what I did seven years ago actually. Hugh: Wow, you're still there doing it. Your book is called Twist: How Fresh Perspectives Build Breakthrough Brands. I remember you kindly sent me a copy to preview it. I think I did a respectable interview a couple years ago on the Orchestrating Success podcast for business leaders. This is a wholly different focus today. Really it's not. Good branding, good leadership, good marketing is probably the same. We do have a lot of hang-ups when we are working for a nonprofit that we shouldn't have. Where can people get your book? Julie: You can get it on Amazon. The easiest place. Hugh: And the color makes it stand out. I was amazed, Russell, that she finds a way to twist that word “twist” into pretty much every page of that book. It's phenomenal how this plays out. Before Russ goes into another question, I want to ask you. You do board retreats. There is a tension between different perspectives and an apparent contrast. When you have this side and this side, when you start looking at the intersection, there is some real finite truth or wisdom. We have a different outcome, but we also have ownership at some level. When you do a board retreat, I would assume it's a branding retreat, talk about the dynamics of how the board plays into the decision and how it goes from the retreat to the final decision. That is where a lot of us get stuck. Julie: Board retreats are interesting dynamics. The first thing I do is get everybody out of whatever the location is, whether it's the church or synagogue, into a relaxed atmosphere where they can think differently, to use the apple. I also get them to start thinking about other brands. We don't think about our organization as a brand, as a story, as something unique. We get bogged down into that won't work, we tried that, I'm not sure about that. We have to remember that the people we are trying to engage, whether it's members, donors, or volunteers, they don't live in this box with only our brand. They live in the wider world with a wider brandscape. I ask the board members ahead of time, “What brands do you admire, and why?” If you admire Starbucks because it customizes your order or Nike because it motivates you or Uber because it helps you get around when you are on a business trip, why wouldn't you bring some of those qualities to your organization? Why wouldn't you twist some of those things? Why shouldn't our church or synagogue or nonprofit also be customized and seamless to use and have clever impactful messaging? When I get them to think beyond their nonprofit to his larger brandscape and twist those ideas, then it breaks through. We come up in a short amount of time with solutions we hadn't had for months and months of board meetings. The second part of your question is the trickier part, which is how do you move it forward? That is where I would say it shouldn't be a democracy. The president of the board or the head of the nonprofit should get the input of everybody. If they are in a position of leadership, they have to take the leadership and say, “I have listened to everybody. This is what we're going to do. You don't have to agree with it 100%, but you have to understand why we're doing it and help us tell the story to a larger group.” Russell: That's an interesting perspective. There is a tricky balance to strike as far as getting by it. Obviously, you want your people to go with that. Who exactly is brand twisting for? With nonprofits, you have multiple audiences. You have multiple constituencies. You have your board, volunteers, donors, other people who fund your work, staff. How do you make that marriage work for all of those different audiences? Who is twisting specifically for? How do you do that? Julie: I like to work in brand development committees. I just rebranded a school system. We created a brand development committee that had the superintendent as the leader. Ultimately, she is the leader of that brand. She had to buy into it. We had two members of the board represented, not all 12, just two. We had a few practitioners represented, so some principals and teachers. We had some staff, the people, if we were going to change the website, on a daily basis, who are going to have to program it, and things like that. We had a committee of about 8 or 10 people. We worked in that committee and got through surveys and other strategic planning input from the community, parents and students. You can pull in input as data points, but don't make your committee 30 people sitting around a table. You're not going to get anything done. The 8-10 people worked on the branding solutions. We led them through the process. We committed as a group with the superintendent's opinion counting the most to the one recommendation we were going to go back to the school board and make, with a lot of great rationale of how we got through the journey. It worked because we had a process. We had representation. Ultimately, we went with a recommendation and a clear rationale on that recommendation. Russell: When it comes to communication, eight people is about the span of control. Once you get beyond eight, the wheels start to come off the wagon. Julie: What we did was when we rebranded, we didn't ask everybody, “Do you like this?” Branding is like naming your kids. You never tell anybody your intended names until the birth announcement comes out because all those opinions won't be helpful. It's your opinion as the parent that really counts. We named the new logo and gave it a story. We created a video that explained the change. We launched internally first so all the teachers beyond the committee got the preview first. Then we went out to the larger group. It wasn't like the brand launch was overnight. It wasn't just throwing up a logo and saying, “What do you think?” It was a really carefully crafted story that we told over and over for about a year until everybody understood it and got it and got behind it. Russell: One of the things that you mentioned in the book is that people have blinders on around branding. What is it that you mean by blinders? How do we work around these? Julie: It's like a horse, if you're trying to lead a racehorse out and put the blinders on so they can't see anything beyond them, it keeps them going forward. But the downside of that in branding is we work in nonprofit that has to do with cancer. We spend all our time looking at nonprofits that have to do with cancer and we worry about being seen as legitimate. Because we worry about being seen as legitimate, we end up being very safe but also using the same words and images as everybody else. That is what I mean by brand blinders, is only thinking in your category. If you lift your head up, I mean honestly your next board meeting, have it in a Starbucks. That would be a good use of everybody's time, or your favorite restaurant, or your favorite brand experience. Say, Look around. Why are we spending twice as much on a coup of coffee? Why is this an experience that we all come to? Why is everybody else hanging out here? What are they doing? Look how they are naming the baristas. Look how they are using the color green. Look how they are creating an atmosphere of welcome. What are the specific things that they're doing to make us feel like this is not just a cup of coffee, but an engaging experience? How can we twist those with our nonprofit? Russell: What do you think are some of the more common mistakes that nonprofit leaders have? I imagine that these blinders have a lot to do with it. But what are the most common ones? Julie: Sticking within the category is a really common one. Another thing is taking too much input, trying to do too many things, like I mentioned. Most nonprofit websites, the front page will give you a headache because they are talking about everything. Setting a clear vision and using that as a funnel. I would say there is some overlooked brand touchpoints that nonprofits should think about. In my book, I talk about these vomit bag moments, which came from Virgin Atlantic, which was one of the brands that I looked after as part of Virgin Management. Virgin Atlantic did a very clever thing. They had these air sickness bags, which they had to provide anyway. It's an FAA requirement. They have to be in every seat pocket for every flight over six hours, I think. Most airlines, well, what color are they for most airlines? Hugh: White? Julie: White, plain, no message. What Virgin Atlantic did was brand them. They made them red, which was the brand color, and they wrote a little story on them about how flying used to be fun, people used to get dressed up, and what happened to flying in terms of taking away all the peanuts. They twisted it back to a story about on how Virgin Atlantic, you will always feel great flying. I say to for-profit and nonprofit clients is: What are your vomit bag moments? What are the things you're doing anyway as part of your brand experience, but you could add a twist? Whether it's an invoice that you send, whether it's a thank-you note, whether it's a gift, on-hold music. If you have a phone calling as part of your nonprofit. Those are the little moments where you could add something that supports the brand and stands out. Hugh: When did this word “twist” come in your present thinking? How did that get so deeply embedded in your being? Julie: I think it was that airline experience. The McDonalds airline, I needed to look in a different way. I needed to look at things from a different angle. The more I started using it, the more people played it back to me as something that was helpful to them. Hugh: I like how she uses it instead of other words and twisting ideas into something that is unique. Part of what you all are talking about is back when you started this interview today, who do we serve? It's our avatar, so to speak. Russell talked about marketing. We have to have a target. We want to attract certain people. We tend to think everyone needs us. How do you help your clients narrow down to that specific person that they want to attract? Julie: We create brand avatars. We look at up to three targets, and we create personas for each of them. Instead of saying, if you're a medical nonprofit, it's health care practitioners, we will say it's Dr. Bob, and we will give Bob a backstory, and what keeps him up at night, and who lives in his household, creating a character in a novel. We will do that up to three times. What we're looking for though is to turn this target into real people with real problems we can help solve. Hugh: When we're talking to a specific person, we're talking to the person who is sitting in the community nonprofit trying to figure out how to attract donors and volunteers and the next board member. Russell hit on it earlier, he says a confused mind says no. How many times have we had people ask for donations and board and all they get is excuses because all that person sees is I'm going to get sucked into this vortex? Russell: Endless time commitment and bottomless blank checks. People aren't clear. The brand is important. The one question I have about brand is is a brand what you make it, is a brand forever? Are there appropriate times to look at it to see what you have is outdated or not working? Julie: That's a great question. I think you do need to update your story every once in a while, or at least take a look at it. I do a lot of rebranding, if organizations merge, when there are major changes in the segment that organization serves, when there is new leadership. I think it's a very worthwhile exercise every five years or so to check in and say, “Is that story we're telling now relevant to the people we're trying to serve? Is it relevant to who we are at this moment? Have we become something different?” Even if you go through one of those exercises and don't change anything with the outwardly facing part of your brand, you will have validation that you're telling the right story. I think that's a really important exercise to do. I would say if you look at great brands in the for-profit world, like Coca-Cola for example, their core brand promise has always been about happiness. But every once in a while, they will update their advertising. “We'd like to teach the world to sing,” or “Open a Coke and a smile,” or “Happiness.” The fundamentals are there, but there is a bit of a refresh. People get excited about the refresh. People pay attention to brand refreshes or rebranding. It's a great opportunity to get out in front of your targets and your donors and say, “Let us tell you what's new. You might have noticed we made some changes. It's not because we just needed cosmetic changes, but our vision is evolving. We wanted the brand to reflect that vision.” Hugh: We've talked around these terms. Let's clarify. You've used the phrase “brand promise” a few times. There is a brand image, brand identity, brand promise. There are different facets. How do you segment the different parts of a brand? Julie: Your brand identity is everything. It's the way you show up, the way you present yourself to the world, not just in your logo and website, but in the way your people behave, etc. I look at it as a house. The brand promise is the roof. That is the main thing you stand for. There is a diagram in my book of the roof of a house. That is what you enable. If you look at Nike, for example, they sell sneakers, but their brand promise is “Just do it.” Supporting that roof, you have three brand pillars. Those are your values. Why should I believe that you're someone who can help me just do it? You have three pillars that support that. Hugh: When we're doing strategy, we nail down the problem we're solving. Why do we exist? What is our solution? What is our unique value proposition? What do we do that's different from others? Is that the building block to a brand? How does that fit into the branding that you do? Julie: Yeah, I think your unique value proposition is your brand twist. That is your brand promise. When I do it, I like to make them succinct and easy to remember. I'm not a big believer in mission, vision, values, 10 layers of the brand. When I do it, I answer four questions. The first is “Who are we trying to serve?” and dig into that psychographic. What are we promising them? That is your brand promise or your unique value proposition. Why should they believe us? That is your brand values. Who, what, why? The last question I answer is how, how do I bring it to life? What is my website? What is my tagline? What is the way I dress? What are the cuts of people I hire? One of the biggest mistakes I see for nonprofits and for-profits is they say, “We want to update our website.” If you are creating a new nonprofit, they are creating a new website. They go right to the how, how are we going to bring this to life? But they don't do the who, what, and why. They don't have a strategy. They spend hours and hours on versions of websites and logos, and they waste a ton of money. They think they'll just know it when I see it. It's not a great way to create a brand. You have to have a strategy. Once you have a strategy, the execution is actually pretty easy. Hugh: That's so common. Russ and I see that a lot. We had David Corbin on here a while back. David has a book called Brand Slaughter. We have seen that happen with another airline; we won't mention their name, but their initials are United. That one person destroyed the brand. It's happened a few times. But there are other companies where one person acted in a way that violated the way the company wanted to represent their value proposition and brand identity. What we do, we do values and principles. Part of that is how do we behave in the culture? How do we make decisions? Talk a minute about taking this brand promise we have and how to get people who are volunteers, board members, committee members represent that brand. We can violate that brand with our behavior, can't we? Julie: Yeah. You asked me what I learned from Richard Branson. That's the second biggest lesson besides taking chances. Your employees are the ambassadors of your brand. They bring the brand to life in their behavior. I do a lot of internal brand activation, meaning I train employees on the brand. I train them how to behave based on the brand. If our brand stands for teamwork, we actually look at all of our systems and evaluate where we are acting as a team and where we are breaking down. I had one client who was standing for teamwork, but we realized their office had an open plan with lots of cubicles. There were no nameplates. Somebody new to the team, it was taking them months to learn everybody's name. That's not a way to create a team. They'd see each other in the cafeteria, and they were embarrassed because they didn't know each other's names. Something as little as that. Definitely hiring. I use my brand values, even if I am hiring an intern. I ask them questions. Tell me a time that you twisted. Tell me about a time that you solved a problem from a different angle. Hiring, training, and rewarding on brand. Don't keep your brand values in a notebook somewhere. People will start really paying attention to them if they know their compensation or advancement is tied to them. Hugh: I just remembered when I was in high school, the twist was a dance. Russell, rescue me, will you? Russell: Thank god for the power of good video editors and sound editors. The first couple of months, I was co-hosting. This is Hugh, and old what's-his-name in Colorado somewhere. But it's important for people in the organization to have all the tools. If your organization is firing on all cylinders, even the person that comes in and sweeps the floor at night can talk to you about what that organization does and how it works. We have had good discussions. The brands that stick out in our minds are large, a lot of them larger than life. A lot of small nonprofits are resource-starved. They are listening to this, thinking, this is all well and good if you have 100 grand to throw at your marketing. But if you are like us, you're small and don't have a lot of resources, how do we build a brand? How do we bring this about with limited resources? Julie: Having a strong brand is even more important if you have limited resources. If you have limited resources, you can't afford to have things that don't tell a really tight story. I work with a lot of small businesses and nonprofits, 1-3-people sized companies. We spend that time on the brand promise and the brand pillars because that allows you to use every tool in the toolbox to tell the same story. Branding is harder, but more important, when you're smaller. It allows everything to work together. When I worked at Virgin, we actually spent way less than all of our competition on advertising. Way less. Virgin Atlantic spends way less than British Airways. But those ads would stand out, and they would create a loyal following. They would punch above their weight because they were very clear about who they were going after. The twist was very clear. What was different about the experience was very clear. Russell: What are some of the tools as a bare minimum that someone in the nonprofit should have to be able to talk about their organization in a compelling way? Are there one or two tools that you would say are absolutely essential? How important is it that these are simple and easy to use? Julie: I think your website is probably the biggest tool. For good or for bad, people come in, even if they are going to meet you in person, they will look at your website. Your brand walks in the room for you, and it sticks around after you're gone. I think having a smaller website, one or two pages, that are just super clear and really visually engaging, is important. The same thing for business cards. As you said, a confused mind doesn't remember anything. Keep it really simple, really streamlined. Your website, your business card, and your presentation. You can do a lot with live presentations. But talk on your elevator pitch. Have your elevator pitch be concise. Help people understand what you do in three floors, not in 35 floors. That comes from being clear on your brand and practicing it. I was telling Hugh at the beginning that I have done a lot of work lately with personal branding. I am teaching a class at Stanford with Tyra Banks who has built a huge personal brand as an entrepreneur and model. I think that nonprofit leaders need to embody their personal brands, and show up as their brands, whether that is wearing a color, a tie, or a pin. Don't go around saying your nonprofit is caring or innovative and not acting that way. One reason Richard Branson has been so successful is his business brand is about shaking things up, but his personal brand is about shaking things up. He spends a lot of time- he is the most followed executive on Twitter. He tweets about business and also life. He is frustrated about things, and is finding new ways to solve old problems. Russell: I follow Richard Branson on LinkedIn. He has a lot of interesting things to say. A lot of people think about them. I think most of us have interesting things to say. A lot of people who may not be clear on how interesting the stuff they have to say is, or how to put it together. We talked about the people of stories. How do you work with people who are having difficulty finding their voice, what it is they stand for, what it is they want to communicate? Julie: The first thing I do is offer brand health checks. These are the best place to start. You wouldn't go into your doctor and say, hey, help me fix everything. You go in once a year and say, “These are the things I feel good about. Here are some of the things I think need attention.” We offer these brand health checks through the website. What we do is spend some time asking you some questions. We look at your materials, whether it is your LinkedIn profile or your website. We will triage: What are the areas you need to look at? Maybe your brand promise is pretty good, but you are not expressing it right. Maybe your targeting is all over the place. Maybe you need to use social media in a slightly different way, or colors in a slightly different way. These brand health checks are a great place to start. Hugh: In your book, you talk about brand blinders. Can you say more about that? Julie: Sure. Those are when you are looking in your category and not outside of your category for inspiration. Taking off your brand blinders means that you are looking beyond your segment to the larger world for inspiration. Hugh: We want to make sure you highlight this offer. You say you work with a lot of individuals on personal branding, small businesses, and nonprofits. We have probably a mixture of all of those that follow us and listen to us and watch this. Where do they go first off for this brand checkup? Julie: We have two diagnostic products. One is a brand health check. That is 60 minutes. That is if you want to talk about your overall nonprofit. Go to BrandTwist.com. Get Started. Brand Health Check. If you are interested just in your personal brand, we have a personal brand plan call. That is half an hour. That is very similar, but we will ask you more personal questions. That is great for people who want help with their leadership, who are changing careers, who are job seekers. We talk a lot to recent graduates who want to get into the nonprofit or another space. That is for people who want to focus on their personal brand. But all roads lead to BrandTwist.com. We will have a special promotion for your listeners. Hugh: You are? Behind your head, it says Brand School. What is that? Julie: Brand School is our online school that we offer a few times a year for small businesses and nonprofits. It's a 10-week program. We get you all of the consulting that a big company would get, but we do it in groups of 10-12 students at a time. More heavy lifting on your side. It becomes more affordable and also creates a community of entrepreneurs. Hugh: Do you have a blog or podcast or anything people can tune into to get more of Julie? Julie: Yeah. If you go to BrandTwist.com, we have a blog that we update all the time. I am pretty active on Twitter as well. @JCottin on Twitter. You can Google Twist. We have good branding. There is lots of information that comes up. Hugh: Yay. Russell, why don't you have another question? He's got one cooking, I'm sure. Russell: All those wrinkles in my forehead are just common creases. They don't have any particular significance. For those of you who are watching this now, there is a branding twist school coming up. A semester in a couple weeks. If this is something of interest to you, look at it. One of the things I saw as I was looking through this website, which has a wealth of information, there were some things we didn't talk about. Julie says there are three mission-critical reasons why you should have a twist. I'd like for her to share those if she could. Julie: The first is a twist will help you stand out. I think it's really hard to stand out today in the competition. The second is bringing a twist to your business means you will have more fun. It's hard work. We should be having fun and doing things differently. I would say the third thing is think about your personal twist. Many of us will change careers or work for different nonprofits over the course of our lives. Paying attention to your personal and professional twists will always serve you. A lot of us are serial entrepreneurs or serial nonprofit professionals. You want to build not just a reputation for your nonprofit, but also your own reputation. Hugh: We talked about the symphony a little bit. There is a composite here. Maybe that's the wrong word. But you have the symphony, which needs a brand. We have 750 orchestras in this country. I bet you most of them want to play classics, so they want people to come. They complain they are not attracting millennials at all. There is a real interest in millennials for authentic historical church and culture. The orchestra has its identity, but the conductor also has an identity. That is the person that shapes the sound of the orchestra and is the figurehead for the orchestra, even though there is a huge culture. Is that a contrast or a conflict? Is there a synergy? There are lots of examples, but I tend to know a little bit about this one. Julie: I think there should be a synergy. I think it's great that you have an organization that has its identity. They don't have to be identical, but there should be a synergy between the face of the organization and the group. The other thing I would say is that orchestra who is looking to attract millennials, this is a great example. Take off your brand blinders. Stop looking at what other orchestras are doing. Look at brands that are attracting millennials. Twist those lessons. Hugh: Whoa. What do you think of that, Russ? Russell: I think that she is absolutely spot-on. Only Virgin Airways can be Virgin Airways. Everybody can't be exactly the same. When you are focused on what everybody else is doing, you are probably leaving your own unique talents on the table. It helps to go through a process. We lead people through a process with our own success framework, and brand twisting will help you do that as well. It's looking through that unique lens of what you bring to the table. Hugh: Our SynerVision brand is based on creating synergy through the common vision. We know who we are. We know where we're going. We know who we want to influence. It not only builds the synergy on our team, but it's building the synergistic interaction with our audience, our supporters. *Sponsor message from SynerVision's Community for Community Builders* We are going to let Julie give you a final thought or challenge or tip as we close out this really helpful interview. Julie, thank you for such great information. Julie: My pleasure. I would say if you feel that your brand isn't as healthy as it should be because you should build the brand that your business deserves, then I'd love to talk to anybody listening to this. You can go to BrandTwist.com and look at our brand health check or personal brand plan. If you put in the code SVLF, then you will get 15% off any of our products, and you will go to the top of the queue in getting something scheduled. I would love to check up your health and support your community however I can. My final thought is your brand is your business, whether your business is for-profit or nonprofit. You can't separate the two. You can't say, I'm working on building the business over here, and the brand over there. Strong brands are connected. Your brand is your business. Make it a priority. Russell: Great. If you haven't visited this website, go check it out. BrandTwist.com. There are cool tools here. Don't think you have to trip over half a million dollars to do something about your brand. Learn more about your ad choices. Visit megaphone.fm/adchoices