Podcast appearances and mentions of julie well

Originally aired in June 2019 as our 73rd episode, we still often think back to this amazing first conversation we had with Dr. Stuart Fischbein and Midwife Blyss Young!Now, almost 6 years later, the information is just as relevant and impactful as it was then. This episode was a Q&A from our Facebook followers and touches on topics like statistics surrounding VBAC, uterine rupture, uterine abnormalities, insurance companies, breech vaginal delivery, high-risk pregnancies, and a powerful analogy about VBACs and weddings!Birthing Instincts PatreonBirthing BlyssNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, guys. This is one of our re-broadcasted episodes. This is an episode that, in my opinion, is a little gem in the podcast world of The VBAC Link. I really have loved this podcast ever since the date we recorded it. I am a huge fan of Dr. Stu Fischbein and Midwife Blyss and have been since the moment I knew that they existed. I absolutely love listening to their podcast and just all of the amazing things that they have and that they offer. So I wanted to rebroadcast this episode because it was quite down there. It was like our 73rd episode or something like that. And yeah, I love it so much. This week is OB week, and so I thought it'd be fun to kick-off the week with one of my favorite OB doctor's, Stuart Fischbein. So, a little recap of what this episode covers. We go over a lot. We asked for our community to ask questions for these guys, and we went through them. We didn't get to everything, so that was a bummer, but we did get to quite a bit. We talked about things like the chances of VBAC. We talked about the chances of uterine rupture and the signs of uterine rupture. We talked about inducing VBAC. We talked about uterine abnormalities, the desire of where you want to birth and figuring that out. And also, Blyss had a really great analogy to talk about what to do and how we're letting the medical world and insurance and things like that really contemplate where we or dictate where we are birthing. I love that analogy. You guys, seriously, so many questions. It's an episode that you'll probably want to put on repeat because it really is so great to listen to them, and they just speak so directly. I can't get enough of it. So I'm really excited for you guys to dive in today on this. However, I wanted to bring to your attention a couple of the new things that they've had since we recorded this way back when. I also wanted to point out that we will have updated notes in the show notes or updated links in the show notes so you can go check, them out. But one of the first things I wanted to mention was their Patreon. They have a Patreon these days, and I think that it just sounds dreamy. I think you should definitely go find in their Patreon their community through their Patreon. You can check it out at patreon.com, birthinginsinctspodcast.com and of course, you can find them on social media. You can find Dr. Stu at Birthing Instincts or his website at birthinginsincts.com. You can find Blyss and that is B-L-Y-S-S if you are looking for her at birthingblyss on Instagram or birthinblyss.com, and then of course, you can email them. They do take emails with questions and sometimes they even talk about it on their podcast. Their podcast is birthinginsinctspodcast.com, and then you can email them at birthinginsinctspodcast@gmail.com, so definitely check them out. Also, Dr. Stu offers some classes and workshops and things like that throughout the years on the topic of breech. You guys, I love them and really can't wait for you to listen to today's episode.Ladies, I cannot tell you how giddy and excited I have been for the last couple weeks since we knew that these guys were going to record with us. But we have some amazing, special guests today. We have Dr. Stuart Fischbein and Midwife Blyss Young, and we want to share a little bit about them before we get into the questions that all of you guys have asked on our social media platforms.Julie: Absolutely. And when Meagan says we're excited, we are really excited.Meagan: My face is hot right now because I'm so excited.Julie: I'm so excited. Meagan was texting me last night at 11:00 in all caps totally fan-girling out over here. So Dr. Stu and midwife Blyss are pretty amazing and we know that you are going to love them just as much as we do. But before we get into it, and like Meagan said, I'm just going to read their bios so you can know just how legit they really are. First, up. Dr. Stuart Fischbein, MD is a fellow of the American College of Obstetrics and Gynecology, and how much we love ACOG over here at The VBAC Link He's a published author of the book Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife, and a Mom. He has peer-reviewed papers Home Birth with an Obstetrician, A Series of 135 Out-of-Hospital Births and Breech Births at Home, Outcomes of 60 Breech and 109 Cephalic Planned Home and Birth Center Births. Dr. Stu is a lecturer and advocate who now works directly with home birthing midwives. His website is www.birthinginsincts.com, and his podcast is Dr. Stu's Podcast. Seriously guys, you need to subscribe.Meagan: Go subscribe right now to their podcast.Yeah. The website for his podcast is drstuspodcast.com. He has an international following. He offers hope for women who cannot find supportive practitioners for VBAC and twin and breech deliveries. Guys, this is the home birth OB. He is located in California. So if you are in California hoping for VBAC, especially if you have any special circumstance like after multiple Cesareans, twins or breech presentation, run to him. Run. Go find him. He will help you. Go to that website. Blyss, Midwife Blyss. We really love them. If you haven't had a chance to hear their podcast guys, really go and give them a listen because this duo is on point. They are on fire, and they talk about all of the real topics in birth. So his partner on the podcast is Blyss Young, and she is an LM and CPM. She has been involved in the natural birth world since the birth of her first son in 1992, first as an advocate, and then as an educator. She is a mother of three children, and all of her pregnancies were supported by midwives, two of which were triumphant, empowering home births. In 2006, Blyss co-founded the Sanctuary Birth and Family Wellness Center. This was the culmination of all of her previous experience as a natural birth advocate, educator and environmentalist. The Sanctuary was the first of its kind, a full-spectrum center where midwives, doctors, and other holistic practitioners collaborated to provide thousands of Los Angeles families care during their prenatal and postpartum periods. Blyss closed the Sanctuary in 2015 to pursue her long-held dream of becoming a midwife and care for her clients in an intimate home birth practice similar to the way she was cared for during her pregnancies. I think that's , why Meagan and I both became doulas. Meagan: That's exactly why I'm a doula. Julie: We needed to provide that care just like we had been cared for. Anyway, going on. Currently, Blyss, AKA Birthing Blyss, supports families on their journey as a birth center educator, placenta encapsulator and a natural birth and family consultant and home birth midwife. She is also co-founder of Just Placentas, a company servicing all of Southern California and placenta encapsulation and other postpartum services. And as ,, she's a co-host on Dr. Stu's Podcast. Meagan: And she has a class. Don't you have a class that you're doing? Don't you have a class? Midwife Blyss: Yeah. Meagan: Yeah. She has a class that she's doing. I want to just fly out because I know you're not doing it online and everything. I just want to fly there just to take your class.Midwife Blyss: Yeah, it's coming online.Meagan: It is? Yay! Great. Well, I'll be one of those first registering. Oh, did you put it in there?Julie: No, there's a little bit more.Meagan: Oh, well, I'm just getting ahead.Julie: I just want to read more of Blyss over here because I love this and I think it's so important. At the heart of all Blyss's work is a deep-rooted belief in the brilliant design of our bodies, the symbiotic relationship between baby and mother, the power of the human spirit and the richness that honoring birth as the rite of passage and resurrecting lost traditions can bring to our high-tech, low-touch lives. And isn't that true love? I love that language. It is so beautiful. If I'm not mistaken, Midwife Blyss's website is birthingblyss.com.Is that right? And Blyss is spelled with a Y. So B-L-Y-S-S, birthingblyss.com, and that's where you can find her.Midwife Blyss: Just to make it more complicated, I had to put a Y in there.Julie: Hey. I love it.Meagan: That's okay.Julie: We're in Utah so we have all sorts of weird names over here.Meagan: Yep. I love it. You're unique. Awesome. Well, we will get started.Midwife Blyss: I did read through these questions, and one of the things that I wanted to say that I thought we could let people know is that of course there's a little bit more that we need to take into consideration when we have a uterus that's already had a scar.There's a small percentage of a uterine rupture that we need to be aware of, and we need to know what are the signs and symptoms that we would need to take a different course of action. But besides that, I believe that, and Dr. Stu can speak for himself because we don't always practice together. I believe that we treat VBAC just like any other mom who's laboring. So a lot of these questions could go into a category that you could ask about a woman who is having her first baby. I don't really think that we need to differentiate between those.Meagan: I love it. Midwife Blyss: But I do think that in terms of preparation, there are some special considerations for moms who have had a previous Cesarean, and probably the biggest one that I would point to is the trauma.Julie: Yes.Midwife Blyss: And giving space to and processing the trauma and really helping these moms have a provider that really believes in them, I think is one of the biggest factors to them having success. Meagan: Absolutely. Midwife Blyss: So that's one I wanted to say before you started down the question.Meagan: Absolutely. We have an online class that we provide for VBAC prep, and that's the very first section. It's mentally preparing and physically preparing because there's so much that goes into that. So I love that you started out with that.Julie: Yeah. A lot of these women who come searching for VBAC and realize that there's another way besides a repeat Cesarean are processing a lot of trauma, and a lot of them realized that their Cesarean might have been prevented had they known better, had a different provider, prepared differently, and things like that. Processing that and realizing that is heavy, and it's really important to do before getting into anything else, preparation-wise.Meagan: Yeah.Midwife Blyss: One of the best things I ever had that was a distinction that one of my VBAC moms made for me, and I passed it on as I've cared for other VBAC mom is for her, the justification, or I can't find the right word for it, but she basically said that that statement that we hear so often of, "Yeah, you have trauma from this, or you're not happy about how your birth went, but thank God your baby is healthy." And she said it felt so invalidating for her because, yes, she also was happy, of course, that her baby was safe, but at the same time, she had this experience and this trauma that wasn't being acknowledged, and she felt like it was just really being brushed away.Julie: Ah, yeah.Midwife Blyss: I think really giving women that space to be able to say, "Yes, that's valid. It's valid how you feel." And it is a really important part of the process and having a successful vaginal delivery this go around.Dr. Stu: I tend to be a lightning rod for stories. It's almost like I have my own personal ICAN meeting pretty much almost every day, one-on-one. I get contacted or just today driving. I'm in San Diego today and just driving down here, I talked to two people on the phone, both of whom Blyss really just touched on it is that they both are wanting to have VBACs with their second birth. They were seeing practitioners who are encouraging them to be induced for this reason or that reason. And they both have been told the same thing that Blyss just mentioned that if you end up with a repeat Cesarean, at least you're going to have a healthy baby. Obviously, it's very important. But the thing is, I know it's a cliche, but it's not just about the destination. It's about the journey as well. And one of the things that we're not taught in medical school and residency program is the value of the process. I mean, we're very much mechanical in the OB world, and our job is to get the baby out and head it to the pediatric department, and then we're done with it. If we can get somebody induced early, if we can decide to do a C-section sooner than we should, there's a lot of incentives to do that and to not think about the process and think about the person. There's another cliche which we talk about all the time. Blyss, and I've said it many times. It's that the baby is the candy and the mother's the wrapper. I don't know if you've heard that one, but when the baby comes out, the mother just gets basically tossed aside and her experience is really not important to the medical professionals that are taking care of her in the hospital setting, especially in today's world where you have a shift mentality and a lot of people are being taken care of by people they didn't know.You guys mentioned earlier the importance of feeling safe and feeling secure in whatever setting you're in whether that's at home or in the hospital. Because as Blyss knows, I get off on the mammalian track and you talk about mammals. They just don't labor well when they're anxious.Julie: Yep.Dr. Stu: When the doctor or the health professional is anxious and they're projecting their anxiety onto the mom and the family, then that stuff is brewing for weeks, if not months and who knows what it's actually doing inside, but it's certainly not going to lead to the likelihood of or it's going to diminish the likelihood of a successful labor.Julie: Yeah, absolutely. We talk about that. We go over that a lot. Like, birth is very instinctual and very primal, and it operates a very fundamental core level. And whenever mom feels threatened or anxious or, or anything like that, it literally can st or stop labor from progressing or even starting.Meagan: Yeah, exactly. When I was trying to VBAC with my first baby, my doctor came in and told my husband to tell me that I needed to wake up and smell the coffee because it wasn't happening for me. And that was the last, the last contraction I remember feeling was right before then and my body just shut off. I just stopped because I just didn't feel safe anymore or protected or supported. Yeah, it's very powerful which is something that we love so much about you guys, because I don't even know you. I've just listened to a million of your podcasts, and I feel so safe with you right now. I'm like, you could fly here right now and deliver my baby because so much about you guys, you provide so much comfort and support already, so I'm sure all of your clients can feel that from you.Julie: Absolutely.Dr. Stu: Yeah. I just would like to say that, know, I mean, the introduction was great. Which one of you is Julie? Which one's Meagan?Julie: I'm Julie.Meagan: And I'm Meagan.Dr. Stu: Okay, great. All right, so Julie was reading the introduction that she was talking about how if you have a breech, you have twins, if you have a VBAC, you have all these other things just come down to Southern California and care of it. But I'm not a cowboy. All right? Even though I do more things than most of my colleagues in the profession do, I also say no to people sometimes. I look at things differently. Just because someone has, say chronic hypertension, why can't they have a home birth? The labor is just the labor. I mean, if her blood pressure gets out of control, yeah, then she has to go to the hospital. But why do you need to be laboring in the hospital or induced early if everything is fine? But this isn't for everybody.We want to make that very clear. You need to find a supportive team or supportive practitioner who's willing to be able to say yes and no and give you it with what we call a true informed consent, so that you have the right to choose which way to go and to do what's reasonable. Our ethical obligation is to give you reasonable choices and then support your informed decision making. And sometimes there are things that aren't reasonable. Like for instance, an example that I use all the time is if a woman has a breech baby, but she has a placenta previa, a vaginal delivery is not an option for you. Now she could say, well, I want one and I'm not going to have a C-section.Julie: And then you have the right to refuse that.Dr. Stu: Yeah, yeah, but I mean, that's never going to happen because we have a good communication with our patients. Our communication is such that we develop a trust over the period of time. Sometimes I don't meet people until I'm actually called to their house by a midwife to come assist with a vacuum or something like that. But even then, the midwives and stuff, because I'm sort of known that people have understanding. And then when I'm sitting there, as long as the baby isn't trouble, I will explain to them, here's what's going to happen. Here's how we're going to do it. Here's what's going on. The baby's head to look like this. It not going be a problem. It'll be better in 12 hours. But I go through all this stuff and I say, I'm going to touch you now. Is that okay? I ask permission, and I do all the things that the midwives have taught me, but I never really learned in residency program. They don't teach this stuff.Julie: Yeah, yeah, yeah, absolutely. One of the things that we go over a lot to in our classes is finding a provider who has a natural tendency to treat his patients the way that you want to be treated. That way, you'll have a lot better time when you birth because you're not having to ask them to do anything that they're not comfortable with or that they're not prepared for or that they don't know how to do. And so interviewing providers and interview as many as you need to with these women. And find the provider whose natural ways of treating his clients are the ways that you want to be treated.Dr. Stu: And sometimes in a community, there's nobody.Julie: Yeah, yeah, that's true.Meagan: That's what's so hard.Dr. Stu: And if it's important to you, if it's important to you, then you have to drive on. Julie: Or stand up for yourself and fight really hard.Meagan: I have a client from Russia. She's flying here in two weeks. She's coming all the way to Salt Lake City, Utah to have her baby. We had another client from Russia.Julie: You have another Russian client?Meagan: Yeah. Julie: That's awesome. Meagan: So, yeah. It's crazy. Sometimes you have to go far, far distances, and sometimes you've got them right there. You just have to search. You just have to find them.So it's tricky.Midwife Blyss: Maybe your insurance company is not gonna pay for it.Meagan: Did you say my company's not gonna pay for it?Midwife Blyss: And maybe your insurance company.Meagan: Oh, sure. Yeah, exactly.Midwife Blyss: You can't rely on them to be the ones who support some of these decisions that are outside of the standards of care. You might have to really figure out how to get creative around that area.Meagan: Absolutely.Yeah. So in the beginning, Blyss, you talked about noticing the signs, and I know that's one of the questions that we got on our Instagram, I believe. Birthing at home for both of you guys, what signs for a VBAC mom are signs enough where you talk about different care?.Dr. Stu: I didn't really understand that. Say that again what you were saying.Meagan: Yep. Sorry. So one of the questions on our Instagram was what are the signs of uterine rupture when you're at home that you look for and would transfer care or talk about a different plan of action?Dr. Stu: Okay. Quite simply, some uterine ruptures don't have any warning that they're coming.There's nothing you can do about those. But before we get into what you can feel, just let's review the numbers real briefly so that people have a realistic viewpoint. Because I'm sure if a doctor doesn't want to do a VBAC, you'll find a reason not to do a VBAC. You'll use the scar thickness or the pregnancy interval or whatever. They'll use something to try to talk you out of it or your baby's too big or this kind of thing. We can get into that in a little bit. But when there are signs, the most common sign you would feel is that there'd be increasing pain super-cubically that doesn't go away between contractions. It's a different quality of pain or sensation. It's pain. It's really's becoming uncomfortable. You might start to have variables when you didn't have them before. So the baby's heart rate, you might see heart rate decelerations. Rarely, you might find excessive bleeding, but that's usually not a sign of I mean that's a sign of true rupture.Midwife Blyss: Loss of station.Dr. Stu: Those are things you look for, but again, if you're not augmenting someone, if someone doesn't have an epidural where they don't have sensation, if they're not on Pitocin, these things are very unlikely to happen. I was going to get to the numbers. The numbers are such that the quoted risk of uterine rupture, which is again that crappy word. It sounds like a tire blowing out of the freeway. It is about 1 in 200. But only about 5 to 16%. And even one study said 3%. But let's just even take 16% of those ruptures will result in an outcome that the baby is damaged or dead. Okay, that's about 1 in 6. So the actual risk is about 1 in 6 times 1 in 200 or 1 in 1200 up to about 1 in 4000.Julie: Yep.Dr. Stu: So those are, those are the risks. They're not the 1 in 200 or the 2%. I actually had someone tell some woman that she had a 30% chance of rupture.Julie: We've had somebody say 50%.Meagan: We have?Julie: Yeah. Jess, our 50 copy editor-- her doctor told her that if she tries to VBAC, she has a 50% chance of rupture and she will die. Yeah.Meagan: Wow.Julie: Pretty scary. Dr. Stu: And by the way, a maternal mortality from uterine rupture is extremely rare.Julie: Yeah, we were just talking about that.Dr. Stu: That doctor is wrong on so many accounts. I don't even know where to begin on that.Julie: I know.Dr. Stu: Yeah. See that's the thing where even if someone has a classical Cesarean scar, the risk of rupture isn't 50%.Julie: Yep.Dr. Stu: So I don't know where they come up with those sorts of numbers.Julie: Yeah, I think it's just their comfort level and what they're familiar with and what they know and what they understand. I think a lot of these doctors, because she had a premature Cesarean, and so that's why he was a little, well, a lot more fear-based. Her Cesarean happened, I think, around 32 weeks. We still know that you can still attempt to VBAC and still have a really good chance of having a successful one. But a lot of these providers just don't do it.Dr. Stu: Yeah. And another problem is you can't really find out what somebody's C-section rate is. I mean, you can find out your hospital C-section rate. They can vary dramatically between different physicians, so you really don't know. You'd like to think that physicians are honest. You'd like to think that they're going to tell you the truth. But if they have a high C-section rate and it's a competitive world, they're not going to. And if you're with them, you don't really have a choice anyway.Julie: So there's not transparency on the physician level.Dr. Stu: So Blyss was talking briefly about the fact that your insurance may not pay for it. Blyss, why don't you elaborate on that because you do that point so well.Midwife Blyss: Are you talking about the wedding?Dr. Stu: I love your analogy. It's a great analogy.Midwife Blyss: I'm so saddened sometimes when people talk to me about that they really want this option and especially VBACs. I just have a very special tender place in my heart for VBAC because I overcame something from my first to second birth that wasn't a Cesarean. But it felt like I had been led to mistrust my body, and then I had a triumphant second delivery. So I really understand how that feels when a woman is able to reclaim her body and have a vaginal delivery. But just in general, in terms of limiting your options based on what your insurance will pay for, we think about the delivery of our baby and or something like a wedding where it's this really special day. I see that women or families will spend thousands and thousands of dollars and put it on a credit card and figure out whatever they need to do to have this beautiful wedding. But somehow when it comes to the birth of their baby, they turn over all their power to this insurance company.And so we used to do this talk at the sanctuary and I used to say, "What if we had wedding insurance and you paid every year into this insurance for your wedding, and then when the wedding came, they selected where you went and you didn't like it and they put you in a dress that made you look terrible and the food was horrible and the music was horrible and they invited all these people you didn't want to be there?"Julie: But it's a network.Midwife Blyss: Would you really let that insurance company, because it was paid for, dictate how your wedding day was? Julie: That's a good analogy.Midwife Blyss: You just let it all go.Meagan: Yeah. That's amazing. I love that. And it's so true. It is so true.Julie: And we get that too a lot about hiring a doula. Oh, I can't hire a doula. It's too expensive. We get that a lot because people don't expect to pay out-of-pocket for their births. When you're right, it's just perceived completely differently when it should be one of the biggest days of your life. I had three VBACs at home. My first was a necessary, unnecessary Cesarean.I'm still really uncertain about that, to be honest with you. But you better believe my VBACs at home, we paid out of pocket for a midwife. Our first two times, it was put on a credit card. I had a doula, I had a birth photographer, I had a videographer. My first VBAC, I had two photographers there because it was going to be documented because it was so important to me. And we sold things on eBay. We sold our couches, and I did some babysitting just to bring in the money.Obviously, I hired doulas because it was so important to me to not only have the experience that I wanted and that I deserved, but I wanted it documented and I wanted it to be able to remember it well and look back on it fondly. We see that especially in Utah. I think we have this culture where women just don't-- I feel like it's just a national thing, but I think in Utah, we tend to be on the cheap side just culturally and women don't see the value in that. It's hard because it's hard to shift that mindset to see you are important. You are worth it. What if you could have everything you wanted and what if you knew you could be treated differently? Would you think about how to find the way to make that work financially? And I think if there's just that mindset shift, a lot of people would.Meagan: Oh, I love that.Dr. Stu: If you realize if you have to pay $10,000 out of pocket or $5,000 or whatever to at least have the opportunity, and you always have the hospital as a backup. But 2 or 3 years from now, that $5,000 isn't going to mean anything.Julie: Yeah, nothing.Meagan: But that experience is with you forever.Dr. Stu: So yeah, women may have to remember the names of their children when they're 80 years old, but they'll remember their birth.Julie: Well, with my Cesarean baby, we had some complications and out-of-pocket, I paid almost $10,000 for him and none of my home births, midwives, doula, photography and videography included cost over $7,000.Meagan: My Cesarean births in-hospital were also more expensive than my birth center births.Julie: So should get to questions.Dr. Stu: Let's get to some of the questions because you guys some really good questions.Meagan: Yes.Dr. Stu: Pick one and let's do it.Meagan: So let's do Lauren. She was on Facebook. She was our very first question, and she said that she has some uterine abnormalities like a bicornuate uterus or a separate uterus or all of those. They want to know how that impacts VBAC. She's had two previous Cesareans due to a breech presentation because of her uterine abnormality.Julie: Is that the heart-shaped uterus? Yeah.Dr. Stu: Yeah. You can have a septate uterus. You can have a unicornuate uterus. You can have a double uterus.Julie: Yeah. Two separate uteruses.Dr. Stu: Right. The biggest problem with a person with an abnormal uterine shape or an anomaly is a couple of things. One is malpresentation as this woman experienced because her two babies were breech. And two, is sometimes a retained placenta is more common than women that have a septum, that sort of thing. Also, it can cause preterm labor and growth restriction depending on the type of anomaly of the uterus. Now, say you get to term and your baby is head down, or if it's breech in my vicinity. But if it's head down, then the chance of VBAC for that person is really high. I mean, it might be a slightly greater risk of Cesarean section, but not a statistically significant risk. And then the success rate for home birth VBACs, if you look at the MANA stats or even my own stats which are not enough to make statistical significance in a couple of papers that I put out, but the MANA stats show that it's about a 93% success rate for VBACS in the midwifery model, whereas in the hospital model, it can be as low as 17% up to the 50s or 60%, but it's not very high. And that's partly because of the model by which you're cared for. So the numbers that I'm quoting and the success rates I'm quoting are again, assuming that you have a supportive practitioner in a supportive environment, every VBAC is going to have diminished chance of success in a restrictive or tense environment. But unicornuate uterus or septate uterus is not a contraindication to VBAC, and it's not an indication of breech delivery if somebody knows how to do a breech VBAC too.Julie: Right.Dr. Stu: So Lauren, that would be my answer to to your question is that no, it's not a contraindication and that if you have the right practitioner you can certainly try to labor and your risk of rupture is really not more significant than a woman who has a normal-shaped uterus.Julie: Good answer.Meagan: So I want to spin off that really quick. It's not a question, but I've had a client myself that had two C-sections, and her baby was breech at 37 weeks, and the doctor said he absolutely could not turn the baby externally because her risk of rupture was so increasingly high. So would you agree with that or would you disagree with that?D No, no, no. Even an ACOG statement on external version and breech says that a previous uterine scar is not a contraindication to attempting an external version.Meagan: Yeah.Dr. Stu: Now actually, if we obviously had more breech choices, then there'd be no reason to do an external version.The main reason that people try an external version which can sometimes be very uncomfortable, and depending on the woman and her parody and certain other factors, their success rate cannot be very good is the only reason they do it because the alternative is a Cesarean in 95% of locations in the country.Meagan: Okay, well that's good to know.Dr. Stu: But again, one of the things I would tell people to do is when they're hearing something from their position that just sort of rocks the common sense vote and doesn't sort of make sense, look into it. ACOG has a lot. I think you can just go Google some of the ACOG clinical guidelines or practice guidelines or clinical opinions or whatever they call them. You can find and you can read through, and they summarize them at the end on level A, B, and C evidence, level A being great evidence level C being what's called consensus opinion. The problem with consensus, with ACOG's guidelines is that about 2/3 of them are consensus opinion because they don't really have any data on them. When you get bunch of academics together who don't like VBAC or don't like home birth or don't like breech, of course a consensus opinion is going to be, "Well, we're not going to think those are a good idea." But much to their credit lately, they're starting to change their tune. Their most recent VBAC guideline paper said that if your hospital can do labor and delivery, your hospital can do VBAC.Julie: Yes.Dr. Stu: That's huge. There was immediately a whole fiasco that went on. So any hospital that's doing labor and delivery should be able to do a VBAC. When they say they can't or they say our insurance company won't let them, it's just a cowardly excuse because maybe it's true, but they need to fight for your right because most surgical emergencies in labor delivery have nothing to do with a previous uterine scar.Julie: Absolutely.Dr. Stu: They have to do with people distress or placental abruption or cord prolapse. And if they can handle those, they can certainly handle the one in 1200. I mean, say a hospital does 20 VBACs a year or 50 VBACs a year. You'll take them. Do the math. It'll take them 25 years to have a rupture.Meagan: Yeah. It's pretty powerful stuff.Midwife Blyss: I love when he does that.Julie: Me too. I'm a huge statistics junkie and data junkie. I love the numbers.Meagan: Yeah. She loves numbers.Julie: Yep.Meagan: I love that.Julie: Hey, and 50 VBACs a year at 2000, that would be 40 years actually, right?Dr. Stu: Oh, look at what happened. So say that again. What were the numbers you said?Julie: So 1 in 2000 ruptures are catastrophic and they do 50 VBACs a year, wouldn't that be 40 years?Dr. Stu: But I was using the 1200 number.Julie: Oh, right, right, right, right.Dr. Stu: So that would be 24 years.Julie: Yeah. Right. Anyways, me and you should sit down and just talk. One day. I would love to have lunch with you.Dr. Stu: Let's talk astrology and astronomy.Yes.Dr. Stu: Who's next?Midwife Blyss: Can I make a suggestion?There was another woman. Let's see where it is. What's the likelihood that a baby would flip? And is it reasonable to even give it a shot for a VBA2C. How do you guys say that?Meagan: VBAC after two Cesareans.Midwife Blyss: I need to know the lingo. So, I would say it's very unlikely for a baby to flip head down from a breech position in labor. It doesn't mean it's impossible.Dr. Stu: With a uterine septum, it's almost never going to happen. Bless is right on. Even trying an external version on a woman with the uterine septum when the baby's head is up in one horn and the placenta in the other horn and they're in a frank breech position, that's almost futile to do that, especially if a woman is what I call a functional primary, or even a woman who's never labored before.Julie: Right. That's true.Meagan: And then Napoleon said, what did she say? Oh, she was just talking about this. She's planning on a home birth after two Cesareans supported by a midwife and a doula. Research suggests home birth is a reasonable and safe option for low-risk women. And she wants to know in reality, what identifies low risk?Midwife Blyss: Well, I thought her question was hilarious because she says it seems like everybody's high-risk too. Old, overweight.Julie: Yeah, it does. It does, though.Dr. Stu: Well, immediately, when you label someone high-risk, you make them high-risk.Julie: Yep.Dr. Stu: Because now you've planted seeds of doubt inside their head. So I would say, how do you define high-risk? I mean, is 1 in 1200 high risk?Julie: Nope.Dr. Stu: It doesn't seem high-risk to me. But again, I mean, we do a lot of things in our life that are more dangerous than that and don't consider them high-risk. So I think the term high-risk is handed about way too much.And it's on some false or just some random numbers that they come up with. Blyss has heard this before. I mean, she knows everything I say that comes out of my mouth. The numbers like 24, 35, 42. I mean, 24 hours of ruptured membranes. Where did that come from? Yeah, or some people are saying 18 hours. I mean, there's no science on that. I mean, bacteria don't suddenly look at each other and go, "Hey Ralph, it's time to start multiplying."Julie: Ralph.Meagan: I love it.Julie: I'm gonna name my bacteria Ralph.Meagan: It's true. And I was told after 18 hours, that was my number.Dr. Stu: Yeah, again, so these numbers, there are papers that come out, but they're not repetitive. I mean, any midwife worth her salt has had women with ruptured membranes for sometimes two, three, or four days.Julie: Yep.Midwife Blyss: And as long as you're not sticking your fingers in there, and as long as their GBS might be negative or that's another issue.Meagan: I think that that's another question. That's another question. Yep.Dr. Stu: Yeah, I'll get to that right now. I mean, if some someone has a ruptured membrane with GBS, and they don't go into labor within a certain period of time, it's not unreasonable to give them the pros and cons of antibiotics and then let them make that decision. All right? We don't force people to have antibiotics. We would watch for fetal tachycardia or fever at that point, then you're already behind the eight ball. So ideally, you'd like to see someone go into labor sooner. But again, if they're still leaking, if there are no vaginal exams, the likelihood of them getting group B strep sepsis or something on the baby is still not very high. And the thing about antibiotics that I like to say is that if I was gonna give antibiotics to a woman, I think it's much better to give a woman an antibiotics at home than in the hospital. And the reason being is because at home, the baby's still going to be born into their own environment and mom's and dad's bacteria and the dog's bacteria and the siblings' bacteria where in the hospital, they're going to go to the nursery for observation like they generally do, and they're gonna be exposed to different bacteria unless they do these vaginal seeding, which isn't really catching on universally yet where you take a swab of mom's vaginal bacteria before the C-section.Midwife Blyss: It's called seeding.Dr. Stu: Right. I don't consider ruptured membrane something that again would cause me to immediately say something where you have to change your plan. You individualize your care in the midwifery model.Julie: Yep.Dr. Stu: You look at every patient. You look at their history. You look at their desires. You look at their backup situation, their transport situation, and that sort of thing. You take it all into account. Now, there are some women in pregnancy who don't want to do a GBS culture.Ignorance is bliss. The other spelling of bliss.Julie: Hi, Blyss.Dr. Stu: But the reason that at least I still encourage people to do it is because for any reason, if that baby gets transferred to the hospital during labor or after and you don't have a GBS culture on the chart, they're going to give antibiotics. They're going to treat it as GBS positive and they're also going to think you're irresponsible.And they're going to have that mentality that of oh, here's another one of those home birth crazy people, blah, blah, blah.Julie: That just happened to me in January. I had a client like that. I mean, anyways, never mind. It's not the time. Midwife Blyss: Can I say something about low-risk?Julie: Yes. Midwife Blyss: I think there are a lot of different factors that go into that question. One being what are the state laws? Because there are things that I would consider low-risk and that I feel very comfortable with, but that are against the law. And I'm not going to go to jail.Meagan: Right. We want you to still be Birthing Bless.Midwife Blyss: As, much as I believe in a woman's right to choose, I have to draw the line at what the law is. And then the second is finding a provider that-- obviously, Dr. Stu feels very comfortable with things that other providers may not necessarily feel comfortable with.Julie: Right.Midwife Blyss: And so I think it's really important, as you said in the beginning of the show, to find a provider who takes the risk that you have and feels like they can walk that path with you and be supportive. I definitely agree with what Dr. Stu was saying about informed consent. I had a client who was GBS positive, declined antibiotics and had a very long rupture. We continued to walk that journey together. I kept giving informed consent and kept giving informed consent. She had such trust and faith that it actually stretched my comfort level. We had to continually talk about where we were in this dance. But to me, that feels like what our job is, is to give them information about the pros and cons and let them decide for themselves.And I think that if you take a statistic, I'm picking an arbitrary number, and there's a 94% chance of success and a 4% chance that something could go really wrong, one family might look at that and say, "Wow, 94%, this is neat. That sounds like a pretty good statistic," and the other person says, "4% makes me really uncomfortable. I need to minimize." I think that's where you have to have the ability, given who you surround yourself with and who your provider is, to be able to say, "This is my choice," and it's being supported. So it is arbitrary in a lot of ways except for when it comes to what the law is.Julie: Yeah, that makes sense.Meagan: I love that. Yeah. Julie: Every state has their own law. Like in the south, it's illegal like in lots of places in the South, I think in Washington too, that midwives can't support home birth if you're VBAC. I mean there are lots of different legislative rules. Why am I saying legislative? Look at me, I'm trying to use fancy words to impress you guys. There are lots of different laws in different states and, and some of them are very evidence-based and some laws are broad and they leave a lot of room for practices, variation and gray areas. Some are so specific that they really limit a woman's option in that state.Dr. Stu: We can have a whole podcast on the legal decision-making process and a woman's right to autonomy of her body and the choices and who gets to decide that would be. Right now, the vaccine issue is a big issue, but also pregnancy and restricting women's choices of these things. If you want to do another one down the road, I would love to talk on that subject with you guys.Julie: Perfect.Meagan: We would love that.Julie: Yeah. I think it's your most recent episode. I mean as of the time of this recording. Mandates Kill Medicine. What is that the name?Dr. Stu: Mandates Destroy Medicine.Julie: Yeah. Mandates Destroy Medicine. Dr. Stu: It's wonderful.Julie: Yeah, I love it. I was just listening to it today again.Dr. Stu: well it does because it makes the physicians agents of the state.Julie: Yeah, it really does.Meagan: Yeah. Well. And if you give us another opportunity to do this with you, heck yeah.Julie: Yeah. You can just be a guest every month.Meagan: Yeah.Dr. Stu: So I don't think I would mind that at all, actually.Meagan: We would love it.Julie: Yeah, we would seriously love it. We'll keep in touch.Meagan: So, couple other questions I'm trying to see because we jumped through a few that were the same. I know one asks about an overactive pelvic floor, meaning too strong, not too weak. She's wondering if that is going to affect her chances of having a successful VBAC.Julie: And do you see that a lot with athletes, like people that are overtrained or that maybe are not overtrained, but who train a lot and weightlifters and things like that, where their pelvic floor is too strong? I've heard of that before.Midwife Blyss: Yep, absolutely. there's a chiropractor here in LA, Dr. Elliot Berlin, who also has his own podcast and he talks–Meagan: Isn't Elliott Berlin Heads Up?Dr. Stu: Yeah. He's the producer of Heads Up.Meagan: Yeah, I listened to your guys' special episode on that too. But yeah, he's wonderful.Midwife Blyss: Yeah. So, again, I think this is a question that just has more to do with vaginal delivery than it does necessarily about the fact that they've had a previous Cesarean. So I do believe that the athletic pelvis has really affected women's deliveries. I think that during pregnancy we can work with a pelvic floor specialist who can help us be able to realize where the tension is and how to do some exercises that might help alleviate some of that. We have a specialist here in L.A. I don't know if you guys do there that I would recommend people to. And then also, maybe backing off on some of the athletic activities that that woman is participating in during her pregnancy and doing things more like walking, swimming, yoga, stretching, belly dancing, which was originally designed for women in labor, not to seduce men. So these are all really good things to keep things fluid and soft because you want things to open and release rather than being tense.Meagan: I love that.Dr. Stu: I agree. I think sometimes it leads more to not generally so much of dilation. Again, a friend of mine, David Hayes, he's a home birth guy in South Carolina, doesn't like the idea of using stages of labor. He wants to get rid of that. I think that's an interesting thought. We have a meeting this November in Wisconsin. We're gonna have a bunch of thought-provoking things going on over there.Dr. Stu: Is it all men talking about this? Midwife Blyss: Oh, hell no.Julie: Let's get more women. Dr. Stu: No, no, no, no, no.Being organized By Cynthia Calai. Do you guys know who Cynthia is? She's been a midwife for 50 years. She's in Wisconsin. She's done hundreds of breeches. Anyway, the point being is that I think that I find that a lot of those people end up getting instrumented like vacuums, more commonly. Yeah. So Blyss is right. I mean, if there are people who are very, very tight down there. The leviators and the muscles inside are very tight which is great for life and sex and all that other stuff, but yeah, you need to learn how to be able to relax them too.Julie: Yeah.Meagan: So I know we're running short on time, but this question that came through today, I loved it. It said, "Could you guys both replicate your model of care nationwide somehow?" She said, "How do I advocate effectively for home birth access and VBAC access in a state that actively prosecutes home birth and has restrictions on midwifery practice?" She specifically said she's in Nebraska, but we hear this all over the place. VBAC is not allowed. You cannot birth at home, and people are having unassisted births.Julie: Because they can't find the support.Meagan: They can't find the support and they are too scared to go to the hospital or birth centers. And so, yeah, the question is--Julie: What can women do in their local communities to advocate for positive change and more options in birth where they are more restricted?Dr. Stu: Blyss. Midwife Blyss: I wish I had a really great answer for this. I think that the biggest thing is to continue to talk out loud. And I'm really proud of you ladies for creating this podcast and doing the work that you do. Julie: Thanks.Midwife Blyss: I always believed when we had the Sanctuary that it really is about the woman advocating for herself. And the more that hospitals and doctors are being pushed by women to say, "We need this as an option because we're not getting the work," I think is really important. I support free birth, and I think that most of the women and men who decide to do that are very well educated.Julie: Yeah, for sure.Midwife Blyss: It is actually really very surprising for midwives to see that sometimes they even have better statistics than we do. But it saddens me that there's no choice. And, a woman who doesn't totally feel comfortable with doing that is feeling forced into that decision. So I think as women, we need to support each other, encourage each other, continue to talk out loud about what it is that we want and need and make this be a very important decision that a woman makes, and it's a way of reclaiming the power. I'm not highly political. I try and stay out of those arenas. And really, one of my favorite quotes from a reverend that I have been around said, "Be for something and against nothing." I really believe that the more. Julie: I like that.Midwife Blyss: Yeah, the more that we speak positively and talk about positive change and empowering ourselves and each other, it may come slowly, but that change will continue to come.Julie: Yeah, yeah.Dr. Stu: I would only add to that that I think unfortunately, in any country, whether it's a socialist country or a capitalist country, it's economics that drives everything. If you look at countries like England or the Netherlands, you find that they have, a really integrated system with midwives and doctors collaborating, and the low-risk patients are taken care of by the midwives, and then they consult with doctors and midwives can transfer from home to hospital and continue their care in that system, the national health system. I'm not saying that's the greatest system for somebody who's growing old and has arthritis or need spinal surgery or something like that, but for obstetrics, that sort of system where you've taken out liability and you've taken out economic incentive. All right, so how do you do that in our system? It's not very easy to do because everything is economically driven. One of the things that I've always advocated for is if you want to lower the C-section rate, increase the VBAC rate. It would be really simple for insurance companies, until we have Bernie Sanders with universal health care. But while we have insurance companies, if they would just pay twice as much for a vaginal birth and half as much for a Cesarean birth, then finally, VBACS and breech deliveries would be something. Oh, maybe we should start. We should be more supportive of those things because it's all about the money. But as long as the hospital gets paid more, doctors don't really get paid more. It's expediency for the doctor. He gets it done and goes home. But the hospital, they get paid a lot more, almost twice as much for a C-section than you do for vaginal birth. What's the incentive for the chief financial officer of any hospital to say to the OB department, "We need to lower our C-section rate?" One of the things that's happening are programs that insurance, and I forgot what it's called, but where they're trying, in California, they're trying to lower the primary C-section rate. There's a term for it where it's an acronym with four initials. Blyss, do you know what I'm talking about?Midwife Blyss: No. Dr. Stu: It's an acronym about a first-time mom. We're trying to avoid those C-sections.Julie: Yeah, the primary Cesarean.Dr. Stu: It's an acronym anyway, nonetheless. So they're in the right direction. Most hospitals are in the 30% range. They'd like to lower to 27%. That's a start.One of the ways to really do that is to support VBAC, and treat VBAC as Blyss said at the very beginning of the podcast is that a VBAC is just a normal labor. When people lump VBAC in with breech in twins, it's like, why are you doing that? Breech in twins requires special skill. VBAC requires a special skill also, which is a skill of doing nothing.Julie: Yeah, it's hard.Dr. Stu: It's hard for obstetricians and labor and delivery nurses and stuff like that to do nothing. But ultimately, VBAC is just a vaginal birth and doesn't require any special skill. When a doctor says, "We don't do VBAC, what he's basically saying, or she, is that I don't do vaginal deliveries," which is stupid because VBAC is just a vaginal delivery.Julie: Yeah, that's true.Meagan: Such a powerful point right there.Julie: Guys. We loved chatting with you so much. We wish we could talk with you all day long.Meagan: I would. All day long. I just want to be a fly on your walls if I could.Julie: If you're ever in Salt Lake City again--Meagan: He just was. Did you know about this?Julie: Say hi to Adrienne, but also connect with us because we would love to meet you. All right, well guys, everyone, all of our listeners, Women of Strength, we are going to drop all the information that you need to find Midwife Blyss and Dr. Stu-- their website, their podcast, and all of that in our show notes. So yeah, now you can find our podcast. You can even listen to our podcast on our website at thevbaclink.com/podcast. You can play episodes right from there. So if you don't know-- well, if you're listening to this podcast, then you probably have a podcast player already. But you know what? My mom still doesn't know what a podcast is, so I'm just gonna have to start sending her links right to our page.Meagan: Yep, just listen to us wherever and leave us a review and head over to Dr. Stu's Podcast and leave them a review.Julie: Subscribe because you're gonna love him, but don't stop listening to him us because you love us too. Remember that.Dr. Stu: I want to thank everybody who wrote in, and I'm sorry we didn't get to answer every question. We tend to blabber on a little bit asking these important questions, and hopefully you guys will have us back on again.Meagan: We would love to have you.Julie: Absolutely.Meagan: Yep, we will.Julie: Absolutely.Meagan: YeahClosingWould 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

One of our team members, Paige, joins us today to share our first maternal assisted Cesarean story on the podcast! Our favorite Julie joins too sharing her perspective as Paige's birth photographer. Paige tried three times to have the vaginal birth of her dreams. Each time ended in emergency Cesareans due to nonreassuring fetal heart tones. Each time, she missed the golden hour that she so desperately craved. Each time, she learned more and more about birth.With her fourth baby, she exchanged her VBAC dream for a new one. After hearing about maternal assisted Cesareans, she decided to do all she could to pursue one fully knowing it may not happen. But when it did, it was everything she hoped it would be and more. Paige's Full Birth VideoHoum ClinicDayana Harrison Birth ServicesJulie Francom Birth PhotographyYouTube Video: Maternal Assisted Caesarean Section - The Birth of Betty MaeThe VBAC Link Podcast Episode 220: Dr. Natalie Elphinstone & MACsThe Birth Hour Episode 875: Nicole's Maternal Assisted Cesarean in MichiganBaby Baking & Kid Raising Podcast Episode 6: MACs with Lauren BrentonAustralian Birth Stories Podcast: All Maternal Assisted Cesarean EpisodesYouTube Video: Nottingham University Hospitals Maternity Gentle C-sectionCBAC Support Facebook Community How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Oh my gosh, you guys. Today is a very special day. It's a very, very special day. We have our own team member, Paige. If you guys haven't already seen the video floating around, go to Instagram today and watch what we've got posted. We have Paige, and we have Julie, and they are actually in Korea. Now, Paige lives in Korea. Julie flew to Korea to be the photographer for Paige. I was over here in Utah having FOMO as they were Marco Poloing me when she was in labor. You guys, I am so excited. I can't explain to you the love that I have for Paige. She has been on our team for so many years. I'm getting emotional. I have seen this woman transform into the most amazing, strong individual. She has created something so special for her family, and I think, for Korea. This is our first official Maternal Assisted Cesarean story on the podcast. Seriously, my eyes are all watery. I just cannot wait to hear this story. Julie was just saying how she's been dying wanting to call me this week while she has been in Korea, but she didn't want to share her story because it is Paige's story, but I love that I get to have both of them on the show. So hello, you guys. I'm sorry. I just am rambling. Paige: Hi. Meagan: Oh my gosh. Okay. We have Paige. We have Julie. You guys know who they are. Julie, obviously, has been with The VBAC Link for a long time, and so has Paige.Julie: Been with The VBAC Link for a long time? Yeah.Meagan: Yeah, sorry. You created it. Julie: We created it. Meagan: Yeah, sorry. I'm thinking of Paige. Paige has been with The VBAC Link for a long time. If you didn't know, she actually heads the CBAC group, the CBAC Link Community on Facebook, and she transcribes all of these incredible episodes. So thank you, Paige, and welcome everybody.Paige: Thank you. So yeah, I'm just sitting here in my little corner of The VBAC Link team doing my transcribing which I feel like maybe is just a little drop in the birth world bucket until something more happens for me. I've been with The VBAC Link for the last 4 years, and I feel like it's my way of preserving these stories. Spending time with the women on the podcast is such an honor, and it's just one of my favorite things to do. I've learned so much, and truly, we'll get into it, but I wouldn't have had this birth experience in the same way if it were not for The VBAC Link and for being on the team. So truly, thank you to both of you. You've changed my life. All right, what's that?Meagan: I was going to say that you've made our life better. Paige: Aw, thank you.Julie: Yes, absolutely. It is so cool to see this. Me and Paige were just talking last night about this and how it's kind of a full-circle moment. We were going over her other births and how we got here and how she got here. It's just so cool. I am so thrilled about how everything played out. There were so many little miracles. I think miracles is not the right word. There were so many special blessings and things that led her to this point. I cannot wait to hear all of it from her perspective. It's so fun to be here and share on the podcast and really, this story is going to change lives. It's going to change lives. It's going to change birth. It is going to be something that people talk about and use as inspiration and hope as they prepare for their own births, no matter how they birth because there's a lot of advocacy involved. I think that's the biggest thing. There's a lot of advocacy. Paige did a lot of advocating for herself and what she wanted. It doesn't have to be literally the same way that she birthed for anybody to take inspiration from it, so I would just encourage everybody to listen because she is such a good example of fighting for what she wants, and shifting and rolling with the punches. I am just so inspired by Paige. You mentioned it too, Meagan. I am just so inspired by how she has approached all of this. Yeah, there are lots of life lessons. Lots of life lessons in this birth. Meagan: Yes.Julie: Stay tuned, everybody. It's a good one.Meagan: All right, Ms. Paige. We're turning the time over to you. Let's hear it because I cannot wait. Paige: Okay, so I'm going to start with a brief overview of my first three births. I'm a mom to four boys. I never thought that would be my story, with four C-sections. I never thought that would be my story, but it is, and it's beautiful. For my first birth, I got pregnant in September 2015. We were living in Hawaii at the time, but moved to Lawton, Oklahoma. I received prenatal care there at the Army hospital. It was pretty straightforward, just the What to Expect When You're Expecting type prep. They have this program called the New Parent Support Program which is really great for new families.  A nurse comes to your home, educates you, and gives you resources. I did that. That was really nice. I had a friend who was a doula. We took a hospital childbirth class and watched things like The Business of Being Born, but other than that, I was mostly just really afraid of childbirth in general. I was afraid of dying. I just wanted to survive. I didn't really have any specific birth preferences. I have struggled with anxiety and panic attacks throughout my life, so I thought that if I could just survive, that would be a big win. My OB was a family friend, and I felt very safe with him. He had a great bedside manner. I didn't really push any questions. I just trusted him fully and completely. At 34 and 6, I noticed that I started leaking fluids. My New Parent Support Program nurse had advised me that if I had noticed any kind of new discharge or anything like that– colorless, odorless fluid to go and get it checked out immediately. So I did. My husband drove me. I remember I had not eaten lunch, but it was lunchtime. I was like, “Oh, just drop me off. This will be fast, then we will go get lunch.” The midwife there tested the fluids and confirmed it was amniotic fluid. I remember my OB walked in. He said, “You are leaking amniotic fluid. We need to have this baby today. The baby will be fine at 35 weeks, and it's better for the baby to come than for you to stay pregnant basically and risk an infection.” So I was like, “Oh, okay. Yeah. I trust you.” I got a steroid shot for lung development at 35 weeks. Then they started me on an IV with antibiotics because I didn't have my GBS test back yet. Then he also told me that the Army hospital there did not have a NICU to support a 35-weeker and that I would need to be transferred to the civilian hospital in town. So I would have to be transferred. Since I was already on an IV, they were just going to do it via ambulance. It was my first time ever riding in an ambulance. He also said that he legally wouldn't be able to deliver me, but he would go with me and help me make decisions. That was really nice of him to go, but still just the sheer fact that I was going to be riding in an amublance for the first time, I was going to be having the baby that day, and then I was going to have a completely new doctor, was just sheer overload going into a birth that I was already afraid of. Yeah, it was not the best circumstances for a successful induction. I arrived at the hospital. I met the doctor very briefly. I called my doula friend. She came and helped me. We did what we could, but ultimately, my body was just not showing any signs of being ready. I had no contractions at all. I was completely closed and not even soft. No dilation. My cervix was just not showing any signs of progress. After about 14 hours on Pit, they came in. I remember I had the dull cramping from the Pit, but nothing really intense. I also just remember being so painfully hungry, and they wouldn't let me each. But since I hadn't had lunch, I was just so hungry where you get the body chills and stuff. Anyway, the doctor came in, said he was having decels. He recommended having a C-section because my water had been broken for over 12 hours. I consented. I was so afraid. I remember when they were putting in the spinal, I was just heaving sobs into this poor nurse. You go in and prep. The C-section itself was fine. My arms were strapped down. I didn't feel pain, but I remember it was like an elephant was sitting on my chest. It was like, “Oh, it just feels like somebody's sitting on my chest.” It wasn't horrible, and I was pleasantly surprised by that. But then, he was whisked away to the NICU. I briefly saw him swaddled with a hat on, then he was whisked away. No skin-to-skin for my husband or me, obviously. He was 4 pounds, 14 ounces at birth. They wouldn't let me go see him until I felt ready to go. I was just so swollen from all of the fluids. I was so nauseous anytime I would sit up. I just was not ready in any state to try to go walk or be wheeled to the NICU. Finally, 36 hours after delivery, I was able to meet him. We named him before that over FaceTime, but he was in the NICU for 7 days. I wasn't traumatized because I survived and that was my goal. I met my goal, and I was really proud of myself for facing the fear, but hoped for something different the next time. With the second birth, I got pregnant in July of 2017. I had a subchorionic hemorrhage early on that resolved. We were in Texas at the time. It was Fort Hood back then, but I met with many different OB providers at the Army hospital on base there. I felt okay with it because I had a neighbor who was going for a VBAC after two C-sections. She was really supported, and then she had a successful experience there. Because of my 35-week PPROM, they suggested that I go on the Makena progesterone shots once a week from 16 to 36 weeks. I did that. They worked very, very well. I switched to the midwife track because everything was going fine. The midwives were really great. They were really holistic. They supported inducing a VBAC if needed, but they also supported me going into spontaneous labor past 41 weeks. I made it to 41 and 5. The VBAC Link was not a thing back then yet, so I did not have that resource, but I did read Ina May's Guide to Childbirth and the Natural Childbirth the Bradley Way. I read The Birth Partner. I kind of started dipping my toes into real birth education. I was learning about the physiological process of birth, learning how to do it without being afraid, and learning to trust my body. It was really empowering. It was the prep that I needed at that time. I didn't know about bodywork. I ended up having prodromal labor for about a week. It was pretty intense, but I didn't know anything about positioning, posterior, or Spinning Babies. I did find that out right at the end as I was going through it, but I didn't do chiro or any of that. I finally went in for an induction at 41+5 in April 2018. I ended up having to go with an OB on call because the midwife didn't feel comfortable with the NSTs that she saw, so she didn't want to take me on. I was like, “Oh, dangit.” The OB who was there was one who I wasn't really super comfortable with. But he was like, “Oh, well I know you really want a VBAC. We'll try to get that for you.” I was like, “Okay.”I got a Foley. I was barely a 1, but they got a Foley in and I progressed very quickly. I got to a 5 within a couple of hours. Things were going really great. They were very normal labor patterns. I felt like I was managing the contractions really well. I did consent to artificial rupture of membranes, then labored a little while longer. I got an epidural at 7 centimeters. I was told, “Oh, we just had a mom who got an epidural. She relaxed, and the baby came right away.” You hear that and you're like, “Oh, I want that. Yes.” So I did that. I got the epidural at about 6:30ish, and then between that half hour, his heart just wasn't doing well. They were flipping me. I got an amnioinfusion. I got a fetal scalp electrode. I got an IUPC, all the things. Then they gave me oxygen. It was probably about 7:00. He had a prolonged decel. I was lying flat and there were people all around me. The nurse was just like, “We need him now. Do you consent to a C-section?” I was like, “Yes.” Then I surrendered and let it go. I was like, “There goes the VBAC. This is just what needs to happen.” He was born at 7:09, and I was born under general anesthesia for that one. His APGARS were 8/9. My husband was left alone during that surgery. We do have pictures of him holding my son and doing skin-to-skin at 7:27, so about 20 minutes after he was born. I woke up and got to hold him at about 8:45, so about an hour and a half after he was born. I remember it was just really hard to talk after being intubated, but they let me breastfeed right away. I was disappointed, but I don't feel like I had a lot of trauma from that just because I was so empowered. I ended up ultimately making it to an 8. It was so fun for me to see what my body could do. I was like, “Oh, this just means that I was meant for a VBAC after two C-sections. That's what it meant.” Right then in the OR, or I guess it was the recovery room. I committed that that was going to be my story. I was like, “Oh yeah. That's just what it's meant to be. That's why it didn't work out.” I was so empowered. Then when I got pregnant for the third time in September 2019, we were in Germany. We had just moved there. I hit the ground running. I hired a doula right away and a backup doula. The prenatal care was at this small, tiny clinic in a town called Parsberg. I chose not to get progesterone shots. I was like, “I was 41+5. I think I'll be okay without them.” Yep, that's when I discovered The VBAC Link and all of the birth podcasts. I just became obsessed listening all the time, taking notes. I did the bodywork. I watched tons of birth videos. I did cranioscral therapy, chiropractic, and Spinning Babies. I took The VBAC Link Parents Course. I read lots of books. I switched my insurance. I took vitamins. I consumed it all, and I loved it. Every time I did something, I felt like my intuition was confirming that I was on the right path. I specifically would manifest, visualize, and pray, and I just was on this high every time. I feel like that's your intuition confirming to you that you're on the right path. If you feel those things, that's a good sign. You do want to follow that. Meagan: 100%. Paige: I did. Then, COVID. It was September 2019 when I got pregnant. Things were fine, fine, fine, and then COVID started happening. In March, I flew home to Denver to stay with my in-laws. We were supposed to move to Colorado in the spring anyway. My husband was not allowed to come with me. There was a travel ban for 90 days. I just did not want to get stuck in that, so I flew out very quickly with my boys– my two boys. I was 27 weeks pregnant and was living in my in-laws basement. That's a whole thing. COVID was a whole thing for everybody. But it was a scary time and stressful. I didn't know if my husband would be able to make it to the birth, but he was granted an exception to policy leave where he was able to come home. He would have to go back. That was the contingency. But I had rebuilt my team. I had found new bodyworkers. I found a new doula and a new backup doula. I found a team of midwives who were really VBA2C supportive. They were saying things like, “When you get your VBAC,” not if. They really supported all the things, so I felt really comfortable with them. I lost my mucus plug and had bloody show on June 8th. I was 40 weeks. That was my due date. My water broke that night at 11:00 PM. I had a small pop, so it was just a litte bit. I was laboring at home. Nothing really was picking up, but on June 9th, at 40+1, I went into the hospital around 3:00 PM. Labor started picking up pretty quickly after that. About an hour and a half later, my waters gushed everywhere which was really thrilling for me to experience the big gush. I was not very far along, though. My progress is just very slow, but they were not rushing me at all. They were like, “We'll stay patient. We will stay very patient. There is no rush. As long as baby is doing well, we'll just let you do your thing.” My doula was there. After my waters broke, my contractions started coupling on top of each other and getting very intense. They were quite long. I started feeling really lightheaded and dizzy. I tried to sit on the toilet and just felt like I was going to pass out. I threw up a few times. I knew it was time to get some pain relief. They offered the walking epidural option which I took at about 8:00 PM. Baby was doing great. I was really worried about getting the epidural again because I felt like that's what had caused the craziness before, but he was doing great. At 2:00 AM, he started not doing great. He wasn't tolerating the contractions well. I was like, “Oh, not again. What?” I was only 4 centimeters. I just knew that we needed to go in again. I didn't know why, but I was so sad. I didn't want another crash, so I did want to prevent another crash. I knew that if it was going to be a heart thing, I didn't want to mess with that. Especially knowing the signs of pain and coupling contractions and things like that, it just seemed like he was telling me that he needed to come. I consented to the OR and to the C-section. I was wheeled to the OR. I remember as I was being wheeled in, I was just thinking, “This is not what I want. This is not what I want. This is not what I want.” I was so sad. He was born about an hour later. I was so drowsy. I was so tired. I was not present at all. I did not feel strong enough to hold him. My husband held him. I briefly brushed his face. He was wearing his little hat and was swaddled, then they took him to the recovery room. The doula was not allowed in the OR. It was actually a miracle she was allowed at all because they had just lifted the doula ban the week before for COVID. I was like, “Okay, the baby will be in there with her.” I'm not sure why they wouldn't let the baby just stay with Sam, but it's okay. I needed his support. I was really happy that he was there. Closure took longer than usual. They said I had pretty thick adhesions, so I was just laying there trying everything to stay awake. I was fighting so hard. I remember reading words on the light and looking at the letters and just going over the letters in my mind and trying to stay awake. I was fighting so hard to stay awake. I finally got to hold him at 4:00 AM in the recovery room. It was still about an hour after he was born. I missed the golden hour again. I was so sad. I was so sad for a third time to miss it. That recovery was really hard. In the hospital, I was so heartbroken. The trauma this time really hit me emotionally and spiritually. It was physically a lot more traumatic on my body for whatever reason. I mean, just the sheer labor was so intense. My incision was black and blue and puffy. I couldn't walk normally and I didn't feel normal for 5 or 6 weeks, but I also feel like it's because I was so sad. I think how sad you are really does affect how you feel physically. Meagan: Yeah. Yeah, for sure. Paige: I do remember specifically too, my first shower there. My husband had to really help me walk over. I was so sticky from all of the sensors and monitors. He was so tenderly trying to help me wash them off. I was just sobbing. I was so sad. I felt so broken and so vulnerable. It was a beautiful time for my husband to be there and carry me because he knew how badly I wanted the VBAC that time and for him to just carry me through that. But going home, I went home to my in-laws' basement. It was dark. I didn't have a support village because it was COVID. COVID moms know what that was like. Anyway, ultimately, I did reach out to Meagan and Julie. That's when the CBAC group was started. I was like, “Is there any way we could start a CBAC support group where CBAC moms can connect?” You guys were so warm and welcoming. Immediately you were like, “Yes! Why hadn't we thought of that?” Julie, you were so gung-ho about that. I was able to connect to other moms through there which was so healing. Anyway, that was the third story. Then the time between three and four was really, really pivotal for me. The healing that I felt I needed before even thinking about trying to get pregnant was where I feel like this all really starts. When you don't get the birth that you hoped for or when you don't get a VBAC, you just feel embarrassed. You feel ashamed. You feel broken. You feel like your intuition doubted you. You feel dumb. I've seen many women comment how family members would be like, “Oh, I knew it wasn't going to happen for you.” It's hard. It's really hard. You feel very, very broken.I knew that I had to show up for myself and still give myself grace. For this birth, it was good for me because I was able to face not failure, but being wrong. I was able to face being wrong and show myself that I could still be there. Anyway, I started physically diving into healing through pelvic PT and doing a lot of scar adhesion work. The dolphin neurostimulation tools if you haven't heard about those are fantastic. I feel like they worked much better for me than scar massage. I wish I had a provider here now who would do it. I think maybe that would have helped this pregnancy and birth, but it helped my recovery so much.I started having really bad panic attacks and postpartum anxiety, so I went to talk therapy. I got on medication. I went to a chiropractor again. The thing that really, really helped my healing was joining a gym and falling in love with exercise again. I got into all of the things, the yoga, running, learning how to lift, and started really pushing my body again and trusting my body again. I didn't expect exercise to heal that relationship with my body, but I feel like it really did. I learned again that I am physically strong which was really, really nice. I started signing up for some races. I ran my first half marathon. I had a lot of emotional releases during yoga. There was one song that came on one time during a yoga practice. It said, “You can't rush your healing. Darkness has its teaching.” I loved that so much. I just started crying. I was just like, “Let it out.”Part of healing is welcoming the grief when it comes, processing it, and taking it a little bit of a time. It's such a process. You get little glimmers of understanding, but as you keep committing yourself to looking for that and looking for the understanding, it does come. I truly believe that. Anyway, life went on. There is a four-year gap in between my third and my fourth which I really needed. We moved to Korea in that time. We moved to Korea last June, and it's just been lovely. We knew that we wanted one more. I knew I was so happy with the prep and how vigorously I did it. I was proud of myself for that and I knew that I wanted to do it the same way.I knew that after everything I learned, even if it was going to be a C-section, I couldn't just show up to the hospital and have them take my baby. I knew too much. I was like, “I know that there are better ways. I know that providers practice differently from place to place. I know it's not all equal. I know every provider does things differently, even with C-sections.” I started watching videos, and I saw that even the way they performed their C-sections was not the same. I wanted to be really actively involved in how they practiced, and how I was going to be a part of it. My goals for this time were not necessarily VBAC or C-section. I never closed the door completely. I was like, “You never know. Maybe VBA3C, maybe that's my story. Who knows?” However, I did find the episode by Dr. Natalie Elphinstone. As I was transcribing that one, my fire for birth that I held felt for VBAC was coming to life again. That intuition was speaking to me, and I had not felt that fire in a long time. That was the first whisperings of, “You should try this. You should go for this.” The goals that I had for this baby were to be very intentional. I wanted the golden hour. I had to have the golden hour. I had to hold my baby first or within an hour. Please, oh my gosh. I carried so much guilt for not having that three times over. I also wanted to be treated like I mattered. I did not want to be part of a rotation. I wanted continuity of care. I did not want to feel like I was just being shuffled through a system. Whether it was a hospital or not, I knew that I wanted to feel special. Lo and behold, did I know how special I would feel at my sweet birth center. Okay, so with the intention thing, just the pieces of this birth story with number four started falling into place so specifically. I can't deny that spirituality was a big part of this because with number three, my prayers had been very, very specific. I knew that God knew what I wanted. I knew it. I knew that because I didn't get it, there was a specific reason why. That's the only thing I could cling to. As things specifically started falling into place, it started to confirm to me that this was my path and these were the reasons why the other things happened the way they did. But anyway, I got pregnant very quickly with this baby. It was the first time that it wasn't a total surprise which was really fun. I had been taking tests since I knew the day that I ovulated, and then I was just taking tests watching, watching, and watching. I was able to see the first faint line which was so fun. I had always wanted that. I had wanted that moment of, “Oh my gosh, I'm pregnant,” where before it was like, “What? I'm not quite ready,” but I was still excited. That was really fun for that. The Korea birth culture here is very intense. The C-section rate is 50-60%. There are constantly stories being shared on these local pregnancy pages of women just having the most traumatic experiences and my heart aches for them. It's very routine for doctors to suggest first-time moms to, “Go have a C-section. Your baby is big,” and not even trying to labor. Most of it is because there is a doctor's strike going on here. There is a limited number of providers. They are stressed. They don't allow husbands typically in the OR, and very routinely, they are under anesthesia. Then after birth, babies are typically taken away to nurseries, and then postpartum recovery is in an open bay type thing. Meagan: Like, combined? Paige: Exactly, yeah. Your C-section stays are typically about 8 days. I wanted to explore options. We have an Army hospital here that is pretty big and does provide labor and delivery services, but they're often maxed out so you're referred off post. I did not feel comfortable going to any of the places that they typically referred to just from stories I had heard. That's all it takes for me now. I just hear one story and I'm like, “Nope, no thank you.” I know my red flags very quickly now. I went to a tour at this birth center called Houm. It's spelled H-O-U-M. At 8 weeks, I went to go tour it. I noticed a lot of green flags, not red ones where I was just like, “Oh, I'm just going to take a note of that.” Some of the green flags from my tour as I walked in were how I felt right when you stepped off the elevator. It's this calm energy. The lighting is so beautiful. It's such a lovely set up right when you walk in. You take off your shoes because you are in Korea. You take off your shoes, then multiple staff members greeted me with a hug. That's when I met Dayana Harrison who I later ended up hiring as my doula, but she also served as my midwife. She is a student midwife working there right now. She took me on the tour. They have queen-sized beds in their labor rooms. The whole floor was dim and so quiet. It did not have a hospital vibe at all, but they do have an OR on site. I was like, “Oh, this is lovely.” They offer epidural. They have huge birthing tubs with the rope attached from the ceiling. They are so beautiful. Yeah, it's in each room. Then the OR on site does not feel like a hospital OR. It's smaller. They keep it warmer. It feels like– I don't know. It just had such a homey feeling. That's the best way I can describe it. Then some of the things I asked about, in their routine gentle Cesareans, moms routinely get skin-to-skin immediately. They have a little cut open in the curtain where baby is slid through right on your chest. They routinely would keep the placenta attached to the baby in the OR which is–Meagan: Almost not heard of. Paige: Since posting that video, I can't believe how many messages of, “How did you do that?” That's revolutionary in itself. That was a huge green flag where I was like, “Oh my gosh, what?” Typically, what is it? Why do they say you can't do that? Is it because the incision is open too long?Meagan: Yeah. They don't even allow delayed cord clamping most of the time. They just milk it because it's a major surgery. The more time the mom is exposed and open, the higher chance they have of things like infection. Once baby is out, they really want to wrap it up and finish it to be complete. Yeah. To actually leave a placenta attached to a baby is unheard of. It really is unheard of in a Cesarean. Paige: Yeah. So that was super awesome. Then they let you keep the baby. He encourages C-sections past 39 weeks. That's not a routine hard and stop final date. He encourages going into labor before saying that it's good for the baby. He encourages breastfeeding in the OR. The head OB, his name is Dr. Chung. He is also an IBCLC which I thought was so awesome. So he supports breastfeeding.Julie: Wait, wait, wait. Time out. The more I learn about this man, the more I love him. Paige: Did you not know that?!Julie: Oh my gosh. Meagan: I want to meet him. Julie: I want to put him in my pocket and take him with me to deliver every birth I ever go to ever. I love him. Paige: I've literally said the exact same thing, Julie. I wish I could just keep him with me forever. That's the thing. Throughout this whole process, I kept taking note of these green flags. I'm thankful for my other experiences because I don't think a lot of people recognize how green these flags really are. I was like, “Okay, the shoe's going to drop. The shoe's going to drop. There's something.” I'll keep going.Meagan: Can I mention too? You had Marco Polo'd me, “I'm on my way,” then you would leave, and you were like, “This is amazing.” You were just like, “This is right,” every single time. The more you went, the more it verified that you were in the right place. Paige: Yep, yeah. You just know. When you know, you know. During that appointment, he came specifically and talked to me three times. Three times. He shook my hand. I'm like, “Are you not busy? What? Three times, you have time to see someone who is just touring?” He only sees 15 patients. He is very VBAMC supportive and experienced with it. He supports vaginal breech birth. They do ECVs on-site. I didn't even bring up VBAC after three. I just mentioned that I had three C-sections, and he said something like, “Oh, do you want a VBAC? Do you want to try again?” I was like, “Oh, I mean, I don't know. I'm thinking about it.” Then, he made me cry. This was at the tour. He made me cry because he said, “I'm a different doctor because I listen to moms. I listen. They tell me how they want to birth. If you want a VBAC after three C-sections, I will support you. You can do it. You choose how you want your birth to go and I will worry about the bad.” He was like, “You don't need to worry.” I was like, “Oh my gosh,” and I started crying. I was like, “Okay, I'm going to go now.” I was not composed, and then he hugged me. I was like, “What? Who is this guy?” I didn't just jump over there. I did give the Army hospital a chance. I went to a couple of appointments there, and that was kind of all I needed to know for what I wanted. I'm so thankful they are a resource there. I'm thankful that they are here. But I did ask about their routine Cesarean practices and their VBAC practices. It was important to me to find a doctor who supported VBAC even if that wasn't what I was planning to go for. I still love VBAC so much. I think it's so beautiful and such an important option for women to have. I'm so passionate about it. I always will be. They didn't even humor the idea at all of VBAC after three. They were like, “Oh, no. You're going to have a C-section. Of course.” The idea was laughable. The C-sections only allowed one support person, no breastfeeding in the OR, no photographers. Arms are strapped down. I just was like, “Okay.” I was very gently asking questions, but then was like, “Uh-uh. Red, red, red flags.” My biggest piece of advice, and we say this over and over again, is to find a provider whose natural practices align with the things that you want. Julie: That is it. That is it so much. Sorry, I don't want to interrupt again, but let's put bold, italics, emphasis, and exclamation points on what you just said. Say it again. Say it again for the people in the back. Paige: Find that provider whose routine practices align as closely as possible with what you want. Julie: Preach, girl. Preach, girl. I love it. Paige: Because we're not meant to fight. You do not want your birth experience to be a place of fighting or stress. Julie is learning that I am a people pleaser. I'm not anything special. I did not stand my ground. I'm going to do this. I did not come blazing in. I found a provider who I felt very, very safe with, who I felt safe asking for this from, and he said yes. I knew that because his practices were so close to the MAC, he would be the most receptive. But there's a chance that he wouldn't have been, and he was. That's why ultimately it worked out because he was receptive. I couldn't have forced him to do it, but because he practices closely to it already, it wasn't as much of a push. If I tried to go to that Army hospital and introduce this idea, they'd just shut it down. Meagan: You know, that's what is so heartbreaking to me. Providers all over the world really just shut that down if it doesn't match their normal routine and their everyday thing. It's like, well, hold on. Let's listen. Why are people requesting this? Just like Dr. Natalie, she saw this and was like, “This is something that means something to people. Why don't we change the norm and create something different?” Providers, if you are listening, please try and make change in your area because it matters, and it doesn't have to be exactly how it's been. Paige is living proof of this. It just doesn't have to be that. But we can't make change if no one puts forth the effort or allows it. Paige: Dr. Natalie said that exactly. She said, “Let's make every birth the best possible version of that birth that it can be.” Meagan: Yes. Yes. Paige: She said, “If there's a way to make it better, why not? Why not?”Meagan: Why not? Because like it or not, birth impacts us. It sticks with us. You're now explaining four different stories. It's not something we just forget. We don't just walk away from these experiences. They stay with us. Now, we might process and are able to move forward in a different direction, but it's not like we forget, so why can't we make this change? It actually baffles me. Julie: Well, and the mode of delivery is the same. I really want to emphasize that. She has had four C-sections, and they were all very different. But the only one where she left walking out of it really feeling empowered is the last one where she chose a provider who aligned with what she desired for her birth, she had a say in her care, and she felt loved and supported the whole way. She felt like the staff cared about her needs.But also, time out. She didn't just feel like the staff cared about her needs. They did. They did actually, genuinely care about her needs and her experience. I feel like that's such a big difference. Meagan: Mhmm. Mhmm. Yeah. Sorry, Paige. You can continue. We got on a little soapbox. Paige: You're good.Julie: I feel like we're starting to tell the story before the story is told. Paige: No, it's great. We're getting close. I switched to them officially at 20 weeks. My first appointment was the anatomy scan. That's when I also proposed the idea of the MAC officially. After every ultrasound, he comes in, talks to you, looks at it, then you go into his office area where you just chat and ask any questions. That's just the routine setup of the appointments. I had this video prepared, and I was really nervous. It's scary. It is scary to ask your provider for something new and different. I had this video. It's on YouTube. It's by Olive Juice Photography. Everybody should go look at it. It's the birth of Betty Mae. It's the video that I watched over and over and over again because it's the only video I could find of the process from the beginning to the end including all of the prep and including how it was done. I was like, “I saw this online. I was wondering if you could watch it and tell me what you think.” That's how I presented it. It's a long video. It was like, 5 minutes. He just sat there patiently and watched. Then after, actually one thing he did say was, “I don't like how he's using forceps.” I was like, “Oh, green flag.” Then, he asked, “Is this what you want?” I said, “Yeah. I think it would be really special if it could happen.” Then, he said, “Then, we can do that.” Then, he thanked me for giving him the opportunity to grow and try something different. He said, “Will you email that video to me and any other resources?” I emailed Dr. Natalie, and she sent over a MAC PowerPoint that she had prepared of the procedures because from the episode, she was like, “Anybody interested doing this, reach out to me.” She is true to her word. She will do that. If you are interested and you want to contact her, she is very responsive. She sent me also her MAC hospital policy which I forwarded to him. I have to share what he said. He's so cute. In the email response, he said, “I watched the video you sent again. If necessary, we will contact Dr. Natalie to prepare for your perfect Cesarean delivery. Thank you so much for this great opportunity to serve you. I am excited to help your birth and confident it will be a great opportunity for further growth for us.” I was like, oh my gosh. Meagan: That literally just gave me the chills. Paige: I could not believe it. Dayana, who is also a student midwife there at home, told me that she had been planting seeds for maternal assist for a while. They had just been waiting for a mom to ask for it. That was also the time that I hired Julie. I was like, “Julie, that would be so fun if you could come out.” Then Julie was like, “Okay, let's do it.” Then I'm like, “Okay.” Then it happened, and Julie was just so brave to have the gumption to come out. Fun fact, she was previously stationed out here with the Army. It does seem like it all kind of worked out that Korea wasn't so out of touch for her, maybe. Julie: Yeah, no. It was really cool. You had mentioned it briefly, then I was like, “Oh, I wish I could make that work.” Then, I remember I was in the CBAC group. I was like, “Oh, I'm so excited for you,” or something, then you said something like, “I really wish you could come and document it. We would cover your travel out here and everything.” Then I was like, “Oh my gosh, really?” So then I talked to my husband about it. I was going to be gone for a while. He would have to hold down the fort and everything. I talked to him and he was like, “Yeah, I think that would be okay.” I was like, “Oh my gosh, Paige. My husband is fine with it. Let's do this.” I remember the day that you booked my flights and officially signed my contract and locked in and everything, then I told my husband and he was like, “Oh, this is really happening then?” I was like, “Nick, I gave you the change. I gave you the chance to eject. It's too late now.” He's been doing really great. He's a really great dad. The on-call life means he has to just take over the house at random moments. We are set up to where we can do that. It was just really funny. I'm so excited that we could make it work. Paige: This is my public thanks to Nick and all of Julie's children for allowing her to be here because it did require sacrifice on their part, truly. I'm just so thankful. I also found out, Dayana told me that she had been asked to prepare a whole presentation for the staff on MAC which she did. She prepared it for nurses, midwives, and anesthesia walking them through. The fact that she had that connection to Houm and that experience, she served as my doula but so much more. She was so much more as my advocate having that inside access to the staff. We scheduled a surgical rehearsal for 35 weeks. At 35 weeks, this was one of my favorite things. He personally was there to walk me through every step of what it would look like for my security, but I don't feel like I really needed it because I was very, very familiar, but for the comfort of the staff and everybody else too. I got to the appointment. My husband was able to be there with me on that one. The way it's set up– we'll post our video then you can visualize more of what the layout looks like. There's the prep room, then literally 10 steps across is the OR right there. In the prep room, they had a gown ready for me. They had the washing bins ready. So the way that it works, you go in. You put the gown on. You have the IV. They showed me where they would place the IV. Then you scrub up your hands. You wash with the sterile solution, and then they put gloves on top. This was the way that they did it. Then they walked me into the OR. They showed me how I would go sit up on the table, how I would receive my spinal through anesthesia, then they practiced laying me back down. They did everything step by step. It wasn't new to me. I've had C-sections before, so I knew, but it was just so sweet that they were so thorough. They showed me how they would insert the catheter. He showed me exactly how he would lay the drapes over my body. He showed me when the curtain would go up. The way they do it, you're not just watching the whole thing the whole time. You could, I guess, opt for that if you wanted to. You have the drape up, they do the initial incision, get the baby out up to his head, and then they drop the curtain. That's when they pull your arms down. The other thing too, the reason why they do strap your arms down is in case you impulsively reach down and touch your incision and breach the sterile field. That's the reason why arms being strapped down is even a thing. But for MAC, your arms are not strapped down obviously. They have somebody holding their hand on your hands which I don't think I even had. Looking back, I don't remember anybody touching my hands or my arms. But that wasn't an issue. It wasn't something that I impulsively wanted to do, to reach down there. Anyway, then the drape goes down. They guide your hands up and over to put your hands under his armpits. Come up. Bring your baby to your chest. The curtain goes back up during closure, and then they talked about how I'd be transferred back to the recovery room– not the recovery room. No recovery room. You go to the postpartum room immediately. I felt on such a high after that. It was just so beautiful how he did that. At 38 weeks, I had an ultrasound. They do ultrasounds at every appointment. I don't know that there is a perfect practice out there that aligns with absolutely everything you want. But they do routine ultrasounds. I wasn't really concerned about that, but they did flag something called kidney hydronephrosis. It's basically the swelling of the kidney. They had been monitoring that. It had presented late in the third trimester, but it was severe enough that they were starting to get really concerned about it. Basically, it can mean that there is an obstruction, and if it's really severe, it can mean that the baby needs to be evaluated within 48 hours of birth by a pediatric urologist which clearly they don't have on site. It was a whole thing. If it really is severe and there is an obstruction, then they need to do surgery really promptly to prevent kidney damage early on. That was the thing. He did suggest that I could deliver somewhere else, and then the baby would be able to be there and we would be together in the same facility. That's when I felt like the shoe dropped. I was like, “Why would he suggest that? He knows that I would not want to deliver anywhere else. Why would he even bring that up?” I was all a mess. I was alone at that appointment. I felt a little bombarded and ambushed. I was like, “This isn't going to happen. I'm not going to get it.” That night, Dayana called me. I was getting ready to reach out to her, but she called me. She was like, “I just wanted to check in.” I had emailed Dr. Chung a clarification email. I think that's really important too. If something doesn't sit well with you in your appointment, it's okay to follow up in an email just to clarify what happened. Can you lay out these options? Can you lay out what we went through? Can I have a record of the ultrasound and what you saw? Because then you're not just swirling these things in your mind. You're actually looking, then you can do your own research. I dove into research. I dove into studies. I compared the numbers that he gave me versus what I saw, and it all did align. She called me and she was like, “No, don't worry. He is comfortable moving forward. He thought that you would be concerned, so he wanted to present you with more options to deliver somewhere else, but he is very happy to deliver you here still and sticking with our plan. He does want to see you at a follow-up ultrasound at 39 weeks,” which I was comfortable with. I was like, “Sam, you've got to come with me. I can't go alone.” She promised that she would be there. That's another thing. When you have a team that you trust, make sure that you are supported, and it's not just you and your doctor. If there's something that doesn't sit well, it really helps to field it with other people not just in labor, even in your prenatal appointments or anything like that. If you feel like you need some extra support, it does really help to bring some people with you who you trust. So at 39 weeks, we all met as a team and asked lots of questions. We felt comfortable with a care plan moving forward. We ultimately decided that we would move forward with the C-section at 39+5 which would be Monday. I'm trying to think what day that was. Meagan: The 7th. Paige: Monday, the 7th. Meagan: That's what I had in my calendar. Paige: Monday, the 7th was the day. We talked about moving it up. All his colleagues were like, “No, you should deliver this baby now. What are you doing? You're crazy keeping her pregnant.” I was like, “I am comfortable waiting, and I have to wait for Julie, so it can't be until Friday. It can't be until Friday.” She gets in on Thursday. That was Wednesday, at 39 weeks. Thursday was 39 and 1.Julie was on the plane, and then that morning on Thursday, I lost my mucus plug at about 8:00 AM. I was like, “Oh, no.” I wasn't really having contractions or anything, so I was like, “Okay. We'll still make it until Monday. It's fine.” Then, Julie got in at about 7:00 PM. I started having some baby contractions. We were sitting around my kitchen table, and Julie was like, “Are you contracting right now?” I was like, “A little.” She was like, “Go take a bath.” Then, we went to bed. I took a bath, and then I went to bed. I was for sure just contracting. I was like, “But what about these logistics? What is going to happen?” Anyway, my childcare plan was going to be turned upside down and all of the things. I was stressed about the logistics. But then, I was woken up at about 10:00 PM by contractions. They were about 6-7 minutes apart, but they were definitely real. I thought they were prodromal, so I was just waiting for them to just go away. They started getting closer. They were close enough to about 4 minutes and sometimes 3. I was having more bloody show, so I was like, “These are kind of doing something.” The intensity increased. It got to the point where I couldn't lie down. I was on my hands and knees. I was standing up, bracing myself against the wall. I was trying to do different positions. Maybe it was just a positional thing. “Let me try to do flying cowgirl. Let me try to do Walcher's”. I was trying to do different positions to try to stop them. I tried to take a bath at 3:00 AM, and they weren't going away. I was like, “Okay, I can't do this. I can't risk it. We've got to go.” I woke up my husband. I was like, “Today's the day. He's just telling me that it's the day. It's time. I don't know why, but it's Friday. It's supposed to be.” At 4:00 AM, he packed his bags. At 5:00 AM, I felt so bad because Julie had just gotten in from this huge international flight. It was a 12-hour flight plus some because you had a connection. I was like, “Julie, we're going to go,” she was like, “Okay!” She was so excited. “Okay, let's go!”Julie: I wake up to a knock on the door, and they're all dressed and ready to go. I'm like, “Why did she not wake me up sooner? I could have supported you.” Paige: I felt so bad. Julie: Yeah. It was wild. It was so wild. I was ready. It was awesome. Paige: So at 5:00 AM, we left for the birth center. At 6:00 AM, we got there. I messaged my team. Dayana said she was on her way. They led me to my room which is just a beautiful suite. It's right next to the OR. They led me to my room. They said that the anesthesiologist would be ready at about 10:00 AM, so between then, I would be laboring. Dr. Chung came in, and he said, “You need to be prepared for a VBAC to happen. You might have this baby just right here.” It was so funny that he was supportive of that idea even. It was so cute. I labored. It was getting intense, but they weren't super close together. Dayana came. She jumped in, and she immediately just respected the space which was so beautiful. She started doing all of her– she's a Body Ready Method practitioner. She's done some training with Lynn Schulte and the Institute for Birth Healing, so she's very familiar with the specific way to give you comfort measures. She was so great. I felt so safe. We labored, and my husband gave me a beautiful blessing. She said the more beautiful prayer that really invited heaven into the space and made it so spiritual and special. We were playing music, then at 9:00 AM, the head midwife, her name is Joy, came in. She started the IV.Dr. Chung came in and walked me to the prep room. In our rehearsal, I was going to be scrubbing myself, but he just picked up my hands, and he started washing my hands and scrubbing my hands for me. It felt like such a selfless act getting ready to go into this procedure. It felt like he was so respectful, and then I even had a contraction during the washing. He stopped what he was doing and was so respectful of the space. It just felt so Christlike having him wash my hands going into it. Then we walked into the OR, and they got me ready for anesthesia. They put in the spinal, and then they laid me down. They did the pinprick test. They gave me a new gown that was sterile. I'm trying to think of what else. They inserted the catheter. I could kind of feel a little bit with the pinprick test, but the catheter insertion was just pressure, so I felt comfortable moving forward. They got started. We played music. They had ice ready for me on my face because I told them when I get nauseous or anxious, I tend to get a little lightheaded. They had ice ready for me. That was something I had requested, and that was so nice. They started the surgery, and it was very, very intense. I do want to be candid that it was probably my most painful surgery. I had to work through it with labor-coping stuff. I was vocal. I did mention that I was feeling pain. It got pretty intense. I don't know if in Korea in general– I know that they are a little bit more stingy about anesthesia, but it was okay. I don't feel like I was traumatized from that. The baby came out at about 10:24. That's when they say he was born. We were listening to music. I was vocalizing, then Dr. Chung says– what did he say? “Let's meet your baby,” or “Come grab your baby”, or something like that. They lowered the drape, and it was so fast. I bring the baby up onto my chest, and everything just melted away, and this instinctual, primal– all of these emotions I didn't know I had just poured out of me. I lost any sense of composure that I had. I was shrieking. In any other situation, I would have been so mortified, but that moment of not having it three times over, it was this release and this justification or this validation of finally having it. I just got to hold my baby. I was a little nervous about seeing a new baby for the first time without being swaddled and how they would be wet and slippery, and if that would freak me out a little bit, but I wasn't worried about that at all. I was just so happy that I had him and so relieved. During closure, that was also intense too. They put the curtain up. They pulled out the placenta. They put it in a bowl, and then they put it in a bag, and they rest it right there next to you. The cord was so lovely and so beautiful. There is something about a fresh, new cord. It is so awesome to see. I thought it was the coolest. I had my husband. I was squeezing his hand. Honestly, I felt like having my baby in my arms and holding my husband's hand was the best pain relief. In that moment, it was keeping me calm, keeping me steady, and getting me through the closure and the rest of the surgery.Then they transferred me to my postpartum room, and they just let us be there. They didn't push cutting the cord. Dayana gave me a placenta tour. I was like, “When do we cut the cord?” She was like, “Whenever you want.” It ended up being about 2 hours of us just enjoying it and talking about how cool it was. Yeah. She gave us a tour. I was able to wear gloves and touch it and go through it, then Sam was able to cut the cord for the first time which was so awesome. That's the gist of it. Meagan: Oh my goodness. I started crying. I've gotten chills. I have so many emotions for you just watching your video. I've literally watched it 10, maybe 15 times, and I can't wait to see Julie's entire thing that she caught. But I am just so– there are no words. I'm so happy for you. I'm so proud of you, and I've talked to you about this. I've Marco Polo'd you crying before where I can't explain it. I am so insanely proud of you and happy for you that you got this experience. Thinking about, “I've never seen a gooey baby. I've never had that opportunity. My husband has never been able to cut the cord,” and you were able to have this beautiful experience where you got to have all of those things. It took four babies to get there, but you got there. You got there because you put forth the work. You learned. You grew, and you were determined. I think as listeners, as you're listening, sometimes that's what it takes. It's really diving in, putting forth that effort, and finding what's true for you. I know it's hard, and I know not every provider out there is like Dr. Chung. He is a diamond in the rough from what it sounds like on so many levels. But they do exist. Again, going back to what you were saying, sometimes it just talks about Paige going in and saying, “Try to have an open mind. Look at this video. I would like for you to view this. Just take a look at it,” and left it in his hands. Sometimes, it just takes something so simple. But, oh my gosh. I can't believe it. We were Marco Poloing about episodes, you guys, before she was in labor. We were also Marco Poloing about social media posts. She was like, “I just don't want to say anything until it happens.” I think sometimes even then, I wonder if that's where that ultrasound had come in and maybe there was doubt. I don't know. It seems like maybe that aligns pretty well with the time that we were messaging and that. Maybe we were Marco Poloing or texting. I don't know. It's like, could this happen? Is it really going to happen? You want it to happen so bad, and then to see it unfold and to have it unfold in such raw beauty, oh my goodness. I cannot believe it.So in the OR, they let Julie in there, right?Paige: Oh, yeah. Dr. Chung is a photographer himself. Julie had asked me to ask him if she could move around or if she had to be stationary. He was so open to her walking anywhere and having free range of movement and having multiple sources of video and photo. Julie: Yeah, it was really cool. I want to speak a little bit to that side of things if that's okay for a minute. Being a birth photographer is kind of complicated and sometimes logistically crazy especially as the baby is being born because everybody has a job to do. Not every provider and nurse is supportive– maybe not supportive. Not every provider and nurse is respectful of the fact that I also have a job to do and that these parents are paying me not a small amount of money to come in and do this job. That is very important to them to have this birth documented in a special way.It can be tricky navigating that especially times ten when it comes to being in the operating room. I have about a 50% success rate of getting in the OR back home. Some hospitals are easier than others. It's always an honor and a privilege, I feel, when providers create a way for me to go in the OR because Cesarean birth is just as important, maybe even more important to have documented because it comes as a healing tool and a way to process the birth especially when most Cesareans are not planned. It was really cool to hear ahead of time about how supportive Dr. Chung was and how amazing he was going to be to let this happen. When we were in there, I don't think I've ever moved around an OR as much as I have in that OR. Providers will tell you, “Oh, you're not allowed in because the operating room is so small. Oh, the sterile field, we want to make sure you don't pass out when you're in there.” I think all of these excuses that people give are just regurgitating things. They don't want another person in the OR. It's just kind of dumb because that was the smallest OR that I have ever been in. I still was able to document it beautifully. I respected the sterile field. I wasn't in anybody's way. People were in my way which is fine because they had a way more important job to do to make sure Paige didn't bleed out and that the baby was born and that Paige's needs were met and things like that. I'm okay. I'm used to navigating around people in the space. I'm perfectly comfortable with that. It was so beautiful. I was down at her feet. Paige, I've actually been going through your images and choosing ones to include in your final gallery while you've been talking. I cannot wait to show you this. I have images of Dr. Chung pulling his head out, still images, of the head being born through the incision. It's like crowning shots. It is this beautiful image of this baby's head being born. Obviously, you've seen the one of his head all the way out. I just think it's so beautiful. I consider it such a privilege and such and honor to have as much freedom in that room. I was literally at her feet, Meagan, documenting while he was cutting her open the adhesions and all of those things. There is video. There were images. I have chills right now. And then as baby was born, I was able to move up by her shoulders and document that and her reaching down for baby. I have all of that. I think that is such one more reason why Dr. Chung is amazing. It is such a rare gem, a diamond in the rough, because Paige now has the documentation for this beautiful story, and it's just one more thing where we have work to do. We have lots of work to do, lots of work to do, and lots of advocacy with people asking for this. I just think it's so important and so cool. It's such a rare thing. I don't even think I would have been able to do all of this back in the States. Meagan: No. Julie: I just think it was so cool. I'm determined to get these images to you before I leave so we can look at them together. I cannot wait for you to see them. I can't. I'm just so excited. Paige: Well, it just makes me think of how often you've said, “If you don't know your options, you don't have any.” The purpose behind this, and why I felt I really did want to go for this option, and what was pulling me to it, is because I want to create options for women and to show them what's possible. That's why I wanted Julie to come. I wanted her. I told her specifically, “Document every step of the process so that women have more resources to see the ways we do it.” I didn't do it exactly like the Olive Juice photography video. There are little variances between it, and that's okay. But it was still so beautiful, so wonderful, and then also, I asked her to document the surgery itself because so much of it is going back and trying to process it in your mind while you're going through it. I'm so glad she did. We walked through it last night, just the moment when I was in the most pain. It was actually really wonderful to see what he was doing which I wasn't in the space to see at that time, but to go back and see, “Okay, that makes sense because he was maneuvering so much,” and to connect it. The connection piece was so valuable. For every Cesarean, I'm so passionate now that you need a doula. You need a midwife in there. You need a birth photographer. You need everybody in there. I knew it, but now, I'm so passionate that we need to advocate for ourselves just as much for planned Cesareans. Meagan: Absolutely. I still can't believe it. I'm so happy. I love this story so much. I believe everyone should hear it because like you said, we need to be educated so we can apply what we need. We don't know what we don't know. This is what we've heard for so many years, but we can know. We can know our options, and it does take us doing it most of the time. The medical world out there is trying sometimes. Sometimes, they are not trying as well. But they are trying. They are also capped in a lot of ways with resources and with time. There's just a lot that goes into it. So, dive in, you guys. Learn. Follow what you need. Follow what your heart is saying. If your heart is saying, “I want a different experience, it's okay to push for that different experience.” Paige: Yeah, definitely. I'll attach a lot of the resources that I used to help me in my prep. But I did just want to cap off by saying that I don't feel like I'm anything special. I am not a birth worker. I am not a nurse. I don't have a history of medical stuff. Dr. Chung was so cute. He was joking that I was a surgeon and getting ready to go do the surgery, but I've always been squeamish at blood and things like that. Don't feel like you don't want to go for it because you're afraid that it will be a scary thing. It is such a natural, beautiful thing. It doesn't feel as medical as it might seem. And even if you are scared, I was scared. It's okay to do it scared if you think that it might be something beautiful and if your heart is, like Meagan said, calling you to it. We're just moms, and moms are powerful, and that's enough. Meagan: I love that. Julie: I love that. I think it's really important. Paige, first of all, you are special, and this is why. Not everybo

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

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

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

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

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

Description:    Julie Jones was one of the first three females on the SWAT team. She shares how she broke free from the old way of living, not taking no for an answer and following her own dreams. Shownotes:    When Julie Jones joined the SWAT team, she had no idea that a devastating diagnosis would lead her on an unexpected journey to become an entrepreneur. Through courage, resilience, and risk-taking, she has achieved her dreams and encourages others to do the same. But what is the secret to her success, and how can others use it to achieve their goals? In this episode, you will be able to:  1. Discover the significance of resilience and perseverance in your entrepreneurial journey.  2. Uncover the value of networking and forming substantial connections.  3. Recognize the necessity of striking a balance between work and life for all-encompassing well-being.  4. Grasp the art of taking measured risks and capitalizing on opportunities for continuous growth.  5. Realize the essence of nurturing authentic relationships by offering assistance to others in the first place.   Connect with Julie Jones:  Julie Jones Website   Connect with Sabine Kvenberg:  https://www.sabinekvenberg.com/resources  Sabine Kvenberg on FacebookSabine Kvenberg on Instagram Sabine Kvenberg on Linkedin Sabine Kvenberg on YouTube BECOME Podpage   TRANSCRIPT 00:00:00 Julie: He knew about being an employee. And so I grew up with that same mindset, that same mindset of, okay, you work for somebody, you retire, you get the pension, the gold watch, all that kind of stuff. Being an entrepreneur was nowhere. Nowhere, I will say in my world because there wasn't anybody. Again, I was the first one to go to college. Then I get this idea that I'm going to work for myself, that I'm going to have my own business. 00:00:27 Sabine: Hello, my name is Sabine Kvenberg, founder and host of BECOME. The content will inspire you to reach your aspirations and become the best version of yourself. I feature interviews with successful individuals from various industries, delving into their personal and professional journeys and their strategies to achieve their goals. We have to become the person we are meant to be first so we can live the life we are destined to live. That means we must overcome challenges and work through difficult times to learn, grow, and become the new, more fabulous version of ourselves. I'm so glad that you're here. Let's get on this journey together. 00:01:19 Sabine: Hello and welcome, Julie Jones. I love that, the JJ, Julie Jones, the coach that's Getting Shit or the Get Shit Done coaching. So as you can see, she is so lively with her colors and hair and whatnot. So I'm so excited to have you here today.  00:01:38 Julie: Well, I am so excited to be here and thank you. And you know, it's funny because most people don't ever just say my first name. The alliteration Julie Jones just seems to run off, easily off people's tongue. So I'm used to Julie Jones. Whether or not they know me or not, it's Julie Jones. 00:01:59 Sabine: Yeah. Oh, that reminds me, on this one, one of my favorite movies called The Holiday. And she introduced herself as, who are you? Amanda Woods. Oh, Amanda Woods. Amanda Woods. Like her one first name, right? It was funny. Anyways, I digress. So today, I would love to hear your story because your story and your journey is quite exciting. You actually started out before you even get into this coaching. You were a police officer, right? So tell me about, first of all, how you got to become a police officer.  00:02:41 Julie: Wow, we're going back. So that's an interesting kind of journey. I had been best friends growing up, and we're still friends today. So I met my best friend in kindergarten, and her father was a police officer. And I didn't realize how much of an impact that that had on me, like, kind of hanging out in that environment until when I was deciding to go to college. And I was the first one in my family to go to college. I had been very strong in math, technology, science, those types of fields. And so I was going to be a medical technologist. I was going to do labs and all these kinds of things. And then my junior year of high school, I decided to start looking for colleges that offered criminal justice. So I have a Bachelor of Science in Criminal Justice with a minor in psychology. My intention was to go into the Secret Service. And it was during a career fair at my college that I found out you had to have almost perfect vision, almost 20/20 uncorrected for Secret Service, which I had no idea. At that time, I was legally blind. I was 2800 in my one eye and 21,000. I did wear contacts. But you couldn't have corrected vision and have that severe of blindness, I guess, is the best way to put it. So I decided to then pursue a career in law enforcement. Not FBI, not Secret Service. The Feds didn't want me, but the cities did, so that's where I ended up.  00:04:15 Sabine: So you were a police officer and also a SWAT member, right?  00:04:22 Julie: That is correct. So I did spend my career on patrol, and there was an opportunity to be on the SWAT team. And so our SWAT team at the time was an on call position, so we wore pagers. Okay, I'm dating myself because I'm talking about pagers, but we wore pagers 24/7. And then when a serious incident would come in, we would be paged to come in and to handle the call. And boy, now things have really even changed in that department because it's a pretty significantly busier department than even when I was on. And so, yeah, I was on the SWAT team. I often say, and it's a story of my resilience of two, if there's something I really want in life, how I go for it, and I don't take no for an answer. I was only the third female hire on by my department, which I really had no trouble with the men that I worked with, with me being female because I proved myself early on.  00:05:19 Julie: But when I went out for the SWAT team, believe it or not, I'm six foot tall, at that point, I just didn't have enough upper body strength, so I wasn't able to get over the six foot wall. And one of the guys, in his infinite wisdom, decided to give me a little boost, which disqualified me. And the sergeant that was running the obstacle course, he pulled me on the side. I said, I know I'm disqualified. It's okay. I worked out even harder. I improved my upper body strength the second time because I really wanted to be on the team. The second time that I went out for it, I passed everything with flying colors. I officially got onto the SWAT team on my own, and that was how I always wanted to do things, was didn't matter if you were male or female, it was the most qualified that, who was getting on the team. And I proved myself.  00:06:08 Sabine: Absolutely. And it also shows that you had perseverance. You didn't let this incident discourage you or say, well, I cannot make it. No, even more. And that's how you lived your life. Now, how did you make the transition to say, okay, enough with the police stuff?  00:06:31 Julie: Well, it was twofold. So I had been a police officer in Milwaukee, Wisconsin area. And then I moved about 21 years ago to Arizona, which is where I currently live now. And it was during that time that a couple of things happened. First and foremost, I realized that in law enforcement, as much as I loved it and that I was very good at it, I really was. I had great communication skills. There were so many things, yet there was just a lot of negativity for me. And one of the hardest things I ever did as a law enforcement officer was give death notifications. So I saw how quickly life changed, here today, gone tomorrow.  00:07:11 Julie: And when I moved to Arizona, I had the application pulled. I was going to go back into law enforcement. And then it personally hit me that my mom, at the age of, young age of 57, was diagnosed with early onset Alzheimer's. And it was in that moment that my mom's dreams and my father's dreams went to the wayside because they were of the generation that you retired and you waited till retirement to be able to have the lifestyle, to live the dreams, to live the goals, everything you had worked so hard for. And I realized that I wasn't going to wait anymore to start living my life, that I was going to start living in the moment. So that's exactly what happened. I pursued career paths that gave me the opportunity to be able to really help people.  00:08:00 Julie: See, I've always wanted to help people. I've had this strong desire to help and serve and love people. I just wasn't able to do it in law enforcement as much as I would have liked to have done. So that's what made me transition into speaking, coaching. Eventually, now, I have a television show. So all these things and it's been a journey, but it was the personal journey of losing my mom and then eventually losing my grandmother that really got those wheels turning to get off the hamster wheel. 00:08:32 Sabine: And I totally get it. I think things changed in the world that we live today. People are not waiting any longer or don't want to wait any longer, right? They're even frustrated in the jobs that they're in right now because it doesn't give them the security and they are not appreciated most of the time and they just feel that life is passing by. And having that mentality, well, wait until you retire and then you have fun. No, I love that you took that moment in time to make that shift. Now, how hard or difficult was it? Or maybe not, when you made the decision you're not going to go back to law enforcement, you start your own business. How was that journey for you?  00:09:27 Julie: Honestly, Sabine, I think for anybody, life is about ups and downs. It really, truly is. There were moments that I was so excited about what I was doing, and then there were moments where, oh, my gosh, what did I just decide to do? See, because again, my parents, especially my father, because my father worked full time and supported our family. He started working at the age of 25. And he retired at 55, and he put 30 years in for the city of Milwaukee. So that was what he knew. He knew about being an employee. And so I grew up with that same mindset, that same mindset of, okay, you work for somebody, you retire, you get the pension, the gold watch, all that kind of stuff.  00:10:13 Julie: Being an entrepreneur was nowhere. Nowhere, I will say, in my world, because there wasn't anybody. Again, I was the first one to go to college. Then I get this idea that I'm going to work for myself, that I'm going to have my own business, and if there's anything that I know about myself is that I'm a risk taker. I'm like, okay, I don't know exactly what this is going to look like, and I'm going to figure it out. And there were times, like, for all of us, I would want to just curl up and cry because I'm like, okay, maybe this isn't exactly everything that I thought it was going to be, but the one thing that I knew, and I knew so well is that, again, that resilience, that perseverance, the saying yes to life opportunities. Because my mom and dad, both, my mom died with her dreams going to the grave. My dad did as well because he first initially helped my mom take care of her when she was sick. And then, more importantly, when she passed away, that was it. He had all of his dreams built around a life that was going to be spent with her.  00:11:19 Julie: And if I knew one thing, I knew one thing that I was not going to follow that same path. And trust me, there were times that I knew it would be easier for me to fall back on getting an application, filling it out for a police department and going back in, because any department would have been happy to have me based on my experience, based on my communication skills, based on everything that I brought to the table. But I won't quit. I just will not quit. And I will figure out a way to make it happen. And I got support. If you're an entrepreneur listening into this, it's all about the support. One of the biggest things I can say is, don't be a lone ranger. We're not designed to be in it alone. Find the people. Find your tribe that are going to support you in making your dreams and helping you to make your dreams come true.  00:12:13 Sabine: Let me hop in here real quick to share something with you. Have you ever tried to build your own website, start a newsletter, or build a course and charge for it? Have you ever wanted to make money online, but are totally confused by all the different systems you need to have? That's why I use Kajabi. Kajabi is the most popular system for online marketers, coaches, thought leaders, and influencers. Kajabi helps online entrepreneurs take off. Over 100,000 of us use Kajabi and have made over $4 billion. Why not be part of it? The best thing is you don't have to figure out tons of systems or crazy technology to start your online business. Kajabi helps you do all of that, and it's all on one platform. That's why I use it. It makes my life so much easier and I can even earn money while I'm sleeping. You can build your web pages, blogs, and membership sites. You can create offers, checkout pages, and collect money. You can host your videos. You can start your newsletter list, capture emails, start your marketing funnels all in one place. It makes it fun and easy with awesome tutorials and support.   00:13:39 Sabine: Since I've joined Kajabi from the beginning, I have a special affiliate link that I  would like to share with you. A 30 day free trial. So nothing to lose, but everything to gain. Just go to my link that's in the show notes sabinekvenberg.com/resources, and we will redirect you to the free trial page. And if you are just starting out and want to get your offer out for sale in just three days, let me help you do that. Visit my web page, by the way, that I build on Kajabi and apply to making it happen. So now, let's get back to the show.  00:14:24 Sabine: It's so, so important. It's true. You got to have a support system. Now, how did you build your support system? Say, you started out, okay, I'm going to become a coach. I'm going to share my knowledge. But how did you get the support that you needed? And what were the path that you took?  00:14:48 Julie: The biggest support system and the biggest thing that I did was effective networking. See, the state of Arizona is very unique in the fact that everybody is almost a transplant. I do find natives now, but it seemed like 20 years ago. It was very rare to find a native, someone who had been born and raised in Arizona. So I remember growing up in Wisconsin that you always knew who you were going to use. Like, imagine this, the TV repairman. There was a time where TVs got repaired, right? And so with that, everybody in the neighborhood called the same TV repairman, right? We all knew who to call, and that was based on referral, kind of thing, but we just all knew. You came to Arizona. And I had some pretty bad experiences initially with some different services because I didn't know who to use and I didn't know who to call. And even 20 years ago, Facebook wasn't like you didn't go to Facebook and say, hey, who do you use, right?  00:15:52 Julie: So I started networking. I mean, I just kept putting myself out there and I started building relationships and I started connecting with people. And what I discovered, which I've always known about myself, is I'm a master connector of people. So it wasn't so much about what was happening for me. I would get so excited. When I met, like Sabine, I mean, like how we met, right? We met through Melissa Dealy. Melissa Dealy knows both of us. She introduces us as I think the two of you would be a great connection. And now the rest is history. I'm on your podcast. You're going to be on my podcast, right? We instantly had such a great conversation when we met and that's exactly what I love to do. So I have built everything that I have. Some of my best friends, all of my resources, so many amazing things in my life have all stemmed from networking and really caring about people first and helping them first before I ever asked really for support for myself.  00:16:55 Sabine: This is a very important part to really helping others first and then everything else will fall in place. Always start giving and then you will receive on the other end. Maybe not from that same person, but it comes from different sources. If you would give someone advice today who is an entrepreneur or wants to become an entrepreneur, obviously we are living in different times than it was 20 years ago. Now we are in this fast paced, ever so fast changing business models and environment and with social media and so forth. So what would be your advice for a new or aspiring entrepreneur to become successful?  00:17:46 Julie: Well, it's a little twofold. They fall under the same category. But I'm just going to say if you don't ask, you don't get. So it's really about asking and putting yourself out there. I know that that can be uncomfortable at times, but really ask for what you want. And the more you put it out there, you will be surprised at maybe, the person in front of you isn't able to help  you, but they have a contact who can. Because with social media, with everything that's out there, Kevin Bacon said it's six degrees of separation. I think it's two. Especially with social media, it's like you look at somebody's profile, you're like, how do we have all these mutual friends? And we've never had an opportunity to meet each other. But in the asking, I'm always about saying yes to life opportunities and remember that no is a complete sentence. And so by that I mean a lot of times as an entrepreneur, you're going to be bombarded with so many things, so many requests. And remember, that when you say yes to any of those requests, you may be saying no to another priority in your life.  00:18:51 Julie: So with the asking comes knowing what your priorities are and what you're really focused in on. It's very easy to leave sometimes a company and leave corporate America because you're tired of being on the hamster wheel, but then to recreate the hamster wheel because of the fact that you're working 24/7. A lot of it is delegation and some other things. There's so many things, but it's really the art of saying no, saying yes to the get to's, saying no to the have to's, and making sure that you ask for what you want. 00:19:27 Sabine: That was good to the point. You are so right. Especially when we start out, we think we have to grab every opportunity, say yes to everybody, and be on everybody's radar and be on everybody's group. And then you don't do nothing because you can't, you cannot have meaningful conversations or connections. And it's also interesting when you put your intentions into making meaningful connections, those connections will come and be very aware. And that's the first thing to start out, be very aware in setting priorities, as you said. So you mentioned you have your own TV show. What type of show is it? What do you do?  00:20:13 Julie: Well, so my platform or my core message, as I like to talk about, is the premise of stop waiting, start living. So it is based on what I saw as a law enforcement officer and what I saw in my own life and that we don't know how much time we have. So I just really want to inspire people to start taking action in the now. Really, it's all about we can put off everything for tomorrow and we don't know if tomorrow is ever going to come. So the TV show can be found on Roku, Amazon, Apple, on the internet. It's on a station called Zondra. I know people are like Zondra. It's a Z. Z as in zebra. Ondra, O-N-D-R-A. That's the Zondra network. And the basis of the show is very similar to my core message. So I interview business owners and people don't always need to have a business. They may have a passion project where things have happened in their life, have knocked them down over and over and over again, and still they continue to get back up, rise to the occasion, and build the life of their dreams. 00:21:22 Sabine: Was there a time or a period in your life that you went through that, always you were knocked down again, knocked down and came to a point, it's like, oh? Have you experienced something like that?  00:21:40 Julie: I have. And it was around the time that interestingly enough, where, you know, I don't know when this is going to broadcast, but we're taping in March of 2023. And this month, my mom is gone 19 years. 19 years, but a month to the day after she passed away, my grandmother passed away. So now I have two strong female figures in my life that had a big influence on me, passed away within 30 days. And I have never experienced anything like that. Of course. I mean, it was traumatic, but more importantly, what it did was I started to spiral. And my husband at the time, who's now my ex husband, he basically told me. He's like, listen, if you don't go _____ down, our relationship is not going to weather this storm. And so I went to go, see a doctor, and I ended up being diagnosed with depression. And at that time, 19 years ago, I think that there was a different connotation of depression. I really looked at it as a stigma. I was like, oh, my gosh, I'm being diagnosed with depression.    00:22:49 Julie: What does this mean for me in my life? And I had a hard time. I mean, I was put on an antidepressant, and I was on that for a while. And I just didn't have the motivation, the energy. I mean, I remember sitting couch a lot. I remember drinking a lot. There were a lot of things, and it just took me down that rabbit hole. I just spiraled. The medication eventually did start to kick in and start to help. And then, because I'm such a proponent of finding natural solutions, I found some really great supplementation, that helped me get off the antidepressants. And then it was in those moments again that it just became very clear. All right, mom passed. Grandma passed. Again, you don't know how much time you have, so get off the couch and start going after your dreams. And so that's exactly what I did. And it didn't happen overnight. I'm telling you, it was a process. 00:23:48 Julie: My heart goes out to anyone who struggles, and that wasn't my only struggle. That was 19 years ago. And I always tell people, my life is not sunshine, rainbows, and unicorns. Just recently, a little less than two years ago, my husband and I were at a wedding, and he had a massive seizure, and he died at the wedding, and they resuscitated him. And so watching someone that you love, again, it triggers everything back again, right? And so having to deal with that traumatic incident, and I was a week and a half out of releasing my first book. And so having to make the decision, do I release my book or do I put it on hold? And again, because the book was Stop Waiting, Start Living, I knew that I had to put my book out, and I did.  00:24:40 Sabine: Yeah. Wow. I mean, it was something, you see the person that you love die before you. That's stress. That is an unbelievable experience. And thank God that they were able to bring him back, and you were able to have, now continuous love in your life. But you're right. We never know when our time is up. Yeah. Living now is sometimes a decision that you have to make.  00:25:13 Julie: Well, and to your point, that's why I sometimes think that, especially in the United States, it's backwards. I know in a lot of countries, when people take holiday, it's two weeks, three weeks, maybe a month. There are some countries that take siestas in the afternoon. They have a little bit of a slower pace. And I know that things are changing because of technology. But often with my parents, okay, they had the money. Now, they have the time. My mom didn't have the health, right? And so that's where at any given time, our health can be taken away from us. So it's like, I would rather travel now, like you said, have that balancing. Well, I still have my health that I can do the things that I want versus maybe, be in my 70s or my 80s or my 90s because I plan to live a long, long time, right?  00:26:04 Sabine: Yeah.  00:26:05 Julie: But you're not able to get around as much, and maybe you're not able to climb those mountains or go to those waterfalls or do what it is that you want because maybe you're a little unsteady on your feet. So as much as possible, I incorporate. It's like, work hard, play hard.  00:26:23 Sabine: That's right.  00:26:24 Julie: That's what I love to do.  00:26:26 Sabine: That's right. So if people want to get in touch with you, Julie, what's the best way for them?  00:26:32 Julie: The best way is, connectwithjuliejones.com. Just how it sounds. connectwithjuliejones.com.  00:26:41 Sabine: And I'll make sure to put your contact information in the show notes. Julie, thank you so much for being here and sharing your wisdom and your lively energy today.  00:26:52 Julie: You are so welcome. And I have to end with my trademark because this is what I'm all about. I'm known for these googly-eye glasses because you know what? And I've had so much fun with you here today. If you're not having fun, then you need to reevaluate some things, because life is all about making the most of every moment.    00:27:14 Sabine: And that's the mic drop. And for the listeners here, because we have that conversation via Zoom, via video, and Julie just put her lovely, funny eyeglasses on. So you definitely got me giggling here. All right, well, you have a wonderful rest of the day. 00:27:35 Julie: Thank you. Thank you.  00:27:37 Sabine: That was my interview. And if you enjoyed it, give us a five star review, leave a comment, and share it with your friends. Thanks for listening. Until I see you again, always remember, serve from the heart, follow your passion, and live the life you imagine. 

We are so excited to be joined by Mikaella as our guest and our dear Julie as a cohost today! Mikaella's VBAC story is one of redemption, healing, and embracing the unexpected. By allowing herself to recognize that her Cesarean birth was traumatic, Mikaella was able to begin her healing journey and prepare for her VBAC. As her birth progressed, plans changed from a faraway hospital to her local hospital to a fast and furious birth at home! Julie, Mikaella, and Meagan share thoughts on the importance of acknowledging our traumas and how to avoid comparing them to others. Additional LinksMikaella's InstagramClark Film and PhotoHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode DetailsMeagan: Good morning and welcome to The VBAC Link or maybe it's the afternoon or evening or I don't even know. Whenever it is that you are listening, welcome to The VBAC Link. This is Meagan, your host, and guess what, you guys? We have Julie today as a cohost!Julie: Yay! Hi. Meagan: It's always so fun to have Julie on and today is actually one of her own clients which is super fun. I love when we have a doula client on the podcast because you can just connect with the story and people are bouncing back and forth, so it is so fun. She is here from Utah, so we are all Utahns today here on the podcast. Review of the WeekWe're going to jump into a review, and then I'm going to tell you more about our guest Mikaella. Julie: Yeah, I'm so excited to be here. I was a little nervous this morning. I'm not going to lie. It's so strange being on here as a guest instead of a regular host. I don't know. It's just this weird little thing, but also I wanted to clarify that Mikaella is actually a birth photography and video client of mine. She had a separate doula, Jenessa who is incredible. But she's going to go into that more in her story, I'm sure about it. I do have a review and I love this review. It's incredible. It was by springr and the title of the review is, “Wow, Just Wow.” I love that. She says, “I'm what I like to consider a still pretty new mama, but I'm also a C-section mom. For a while, I really thought that's what I would always be. I hit some pretty dark places, but this podcast has given me light. I listen to multiple episodes a day and have a long stream of notes on my phone.” Let me add, I'm not pregnant again, but that's how prepared I want to be when we do get there for our next baby. This podcast has given me my first tool to get there. Recently, as quarantine life has become the new normal, I've almost always got an episode buzzing in my ear. My husband says I've got a bit of an addiction. I snapped back really quick and said, ‘I've got hope. It helps me believe in myself.' He quickly got quiet.” Meagan: Oh my gosh, I love that. Julie: Yeah. “These ladies answer personal messages asking for help. I just can't say enough good things. They are that good. This podcast is just that good. Thank you from the bottom of my heart.” This sounds familiar actually, this review. It might be somebody that has contacted me and wants to hire me as a doula when she gets pregnant. Now I'm just thinking because that review did sound a little bit familiar. Anyways, we've been talking for a bit of a year now and she's not even pregnant. Anyways, it might be. Who knows, it might be completely random and somebody else but when she said personal messages, I was like, “Oh, maybe.” Thank you so much to whoever left it. Meagan: Maybe. Well, I love that review. And you know what? That's okay if you are addicted to a podcast. I have podcasts that I'm addicted to and I always have an AirPod that I actually have lost now. There is one missing because apparently, I can't put it right back in the case. I just sit there and I listen to my podcast in one ear and then do life in the other while I'm doing things and that's okay. I love it though. I love that this podcast gives you hope. That is exactly why this podcast is the podcast. That is exactly why it is here. It's to give people hope, inspiration, and motivation, and to empower you to make choices that are best for you for your birthing day. So thank you so much for that review. Mikaella's StoriesMeagan: Okay, Mikaella. We are so excited to have Mikaella on. Mikaella: Hi. Meagan: Hi, yes. Thank you so much for taking the time today. You have a lot of things. You're a photographer, right as well? Mikaella: Yes, yep. Meagan: Okay, and then you have three kiddos and you have been a 911 dispatcher for five years. Love that. That's really cool. I love that you say trash reality TV is your guilty pleasure. That is so funny. I love that you also love Taco Bell because I have this weakness for Taco Bell too. In fact, we just went on a weekend trip for my daughter's gymnastics meet in St. George, Utah and we got a taco from St. George. You guys, it's the best Taco Bell taco I've ever had. Like seriously, St. George does it right. So when you are in St. George next time, you should go to Taco Bell. Julie: Meagan and Mikaella, you guys. I'm sorry but Taco Bell is not very good. Meagan: Do you know what? It depends on the Taco Bell because the Taco Bell by my house sucks. But St. George, holy cow. Even my husband was like, “That was the best Taco Bell ever.” I was like, “Right?” So I love that. I love that so much and I'm so excited to dive into this story because I love hearing the big baby stories. It sounds like you heard, “Big baby, big baby, big baby” for so long and so many people telling you that you're not a good candidate for VBAC, and then boom. Julie: Boom. Mikaella: Basically, that's the best way to put it. Meagan: So let's turn the time over to you to share your stories and how this big baby and a non-VBAC candidate mom rocked her VBAC. Mikaella: So I have three kids. I have a five-year-old Claire, a three-year-old Boston, and then Charlie is my VBAC baby. I feel like Charlie's VBAC story really starts with 21-year-old first-time mom Mikaella who knew nothing. I was along for the ride. I had no interest in pursuing any sort of birth education or anything like that especially with my mom's own traumatic birth history so I was like, “Whatever happens happens. It's fine.” For my first birth, that was okay. It wasn't that big of a deal. I do wish I had been equipped with more knowledge, but it was smooth sailing for the most part. She came on her own the morning of my scheduled induction so I was already in labor when I got there anyway. My body was doing what it was supposed to do. She ended up being vacuum assisted because she was posterior and then it ended up being a trend with all of my babies with them being posterior so that was a really big worry I had with Charlie. It just felt like a normal birth experience. And then Boston because Claire's was so normal, I went in feeling like, “Oh, nope. I've got it, no problem.” Then I was talked into an induction because I was along for the ride. I didn't know the ins and outs and the cascade of interventions and things like that. I was induced about a week early with him. Both he and Claire, my labors were about 12 hours long with lots and lots and lots of pushing. But with him, I felt completely out of control from being induced and having my dura nicked with the epidural. Then I had some major blood loss that was still unexplained there in the middle which was pretty traumatic. With him, I pushed for hours as well and he was just not coming out. He was so stuck. My provider was not pushy at all actually. He was very, “Here are your options. You can keep pushing. We can try a vacuum with him too, but if he gets stuck, it's going to be more complicated with him being farther down the birth canal.” So we opted for a C-section with him. I don't know. I think I reacted really strongly to the extra medication because I was numb from the chin down. It was a very unpleasant experience which just added the whole out-of-control feeling. I went in there and as I'm feeling them tugging, I didn't feel any pain which was great. I was feeling the tugging and then everybody starts laughing. I was like, “This is not the time to be laughing. What is going on?” They pulled him out and were like, “He's huge.” He was. He was a 12-pound baby. There was probably no way I was actually going to get him out on my own, but ever since having him, everyone was like, “Oh you just make big babies,” because my first baby was 8 pounds, 9 ounces. He was 12 pounds. Julie: And he's still such a big kid. Mikaella: He is a really big kid. Julie: He is so cute. Mikaella: He's bigger than all of the other kids in my preschooler's class and he's only three. He's just big like my whole mom's side of the family. So after his birth, it took a long time to be able to talk about it out loud. I posted a really watered-down and foggy version on Facebook as a birth announcement post, but I don't even remember writing half of it. I just remember feeling traumatized but not that the trauma was valid because I knew people with worse stories and that was something that I had to come to grips with. My trauma was still valid despite it not being maybe as bad as somebody else's. Meagan: Totally, yeah. Mikaella: I knew we wanted more kids, but there was so much anxiety surrounding the decision of when to have more kids so there was a little bit more of a gap between Boston and Charlie. I was still pretty afraid of birth until I had a life-changing experience attending a birth as a photographer. It was actually for Jenessa who ended up being my doula later down the road but it was this beautiful, intimate home birth. I found it so healing. She was singing through her contractions and the atmosphere was just so sweet and loving. She was definitely in charge and she knew what she wanted. She was a practical stranger at that point, but it was still such a positive experience to watch her have such a positive birth experience. It was life-changing. So then when I got pregnant again, I knew I did not want a C-section just based on how the last one had felt. I didn't even want an epidural based on the spinal headache I had gotten with my dura being nicked. I felt like having the epidural and not being able to move around during labor contributed a lot to both of my babies getting stuck, so I felt like being able to move in labor was going to be really important to me. My OB who delivered Boston was actually super supportive but I wasn't allowed to VBAC at the hospital. Where I live is a really rural area. He said he would send me north whenever I went into labor, but I really wanted to know my birth team. With that it option, it was just, “You get who you get and hopefully they're supportive of a VBAC too,” which I think we've all come to realize is hard to find VBAC-supportive providers. Meagan: Very, very, yeah.Mikaella: So when I was looking for a provider, I went through so many, but I began my research. I met with multiple providers and I just kept hearing, “You make big babies. You make big babies,” because Claire was 8 pounds, 9 ounces, and Boston was 12 pounds. “You just make big babies and it would just be easier for you to have a C-section. Here are all of the risks and complications of a VBAC,” but no one wants to talk about the complications of a repeat C-section, right? This one particular OB, I don't know if I can shout him out because he might be really upset. I want to make sure that no one else looking for a VBAC goes to him. He didn't even give me the decency of a conversation before completely shutting me down. I had gone in. I spoke with the nurse. She was like, “Whatever you want, you get. You are the birthing mom.” I was feeling on cloud 9. I was even texting my husband, “This is going so well,” as she was checking me in. I guess the casual conversation that I was having with her about my birth history, she relayed to him in the five-minute span before he came into the room and that was all it took for him to decide that I was not a good candidate for a VBAC at all. He didn't want to talk about the preparations I had made, that I had a doula, that I didn't feel as big as I was with Boston. None of that even mattered. Meagan: He just put a label on you and was done.Mikaella: Immediately. Immediately. There was no conversation about any of it. Not about my birth history. Even my original OB who delivered my last baby was like, “No, you can do that. That's fine,” but it just said that it made him and his staff uncomfortable. I ended up at Valley Women's Health, the Orem Midwives' Group at 35 weeks pregnant and I just stuck with them because they were the first ones to not tell me no right away. There were still some things that I was hesitant about. There was a lot of, “You'll have to do this and this and this. These are the requirements, but sure. We'll try,” kind of thing. I did, however, have to go through a VBAC consultation at Utah Valley where they all discuss the risks of a VBAC. Nothing about the risks of a repeat C-section of course. They had me sign all of those forms and then had me do a growth scan which showed Charlie being about three weeks ahead. She was going to be absolutely massive according to them. I did not feel big at all at least compared to my last two. I was more active in this labor. I was eating healthily. I was doing all of the stretches and sitting in the right positions to make sure that she wasn't posterior too. I just felt like I could do it. It really helped to feel like I was going to be in charge of this birth. My doula was very, very supportive all the way through. She was just like, “No. You've got this. You can do this. I know you and I know your willpower,” so she was a huge support that way and as well as my husband. He's never not backed me on anything. He's great. I should also add that the hospital where I was going to deliver is about an hour and a half away from me. Only like what, five minutes away from you, Julie? Julie: Yeah, it's about 20 minutes from me, but super far from you. Mikaella: Okay, you're a little bit further. I was thinking it was only about five minutes away. I was preparing to labor in the car. They had been like, “Are you sure you don't want to be induced?” I was like, “Nope. I don't want to intervene with this at all. My body is going to do its own process.” I was mentally preparing myself to labor for an hour and a half in our van. I had my husband get the puppy pads ready and line the bottom of the van with the puppy pads. I woke up to my strongest contraction at about 4:00 AM and that's when I began timing them. I got in the shower to see if they would get closer together and then they started getting closer together really fast. The timeline is kind of foggy, but the contractions were so strong. I texted my doula at 5:30 letting her know that my contractions were about 5-7 minutes apart and that I was going to try and leave soon. She was going to have plenty of time because she was right next to the hospital, but in reality, I had only maybe two more contractions that far apart. It was just happening and happening really fast. I called my mom. She was getting ready to come over and I woke up Preston and had him load up the car while I was getting dressed. I do actually wish I had had him with me during those moments, but at that point, I thought we were still going to make the hour-and-a-half drive to the hospital, so I was like, “No. Get this. Get my bag. Get my charger. Throw all of the things in there,” the last minute things and grab whatever. Just throw it in the van.So he was running around like crazy trying to make sure he's got everything. I couldn't even get my pants on in between the contractions. I was sitting in the same spot just powering through these contractions. I remember thinking, “There's no way that I can do this unmedicated. I'm going to get that epidural as soon as I get to the hospital,” because all that I've heard in all of my research is that when you think you can't do it anymore, that's when you're at the end. I was like, “Well, I just barely started. How am I supposed to make it any farther than this?” and not realizing that I was actually right there at the end with how quick it was all going. Meagan: Oh my goodness. Mikaella: Yeah. It was about 30 minutes later that I knew we were not going to make it up to Provo. I called my doula and I think that was all I said. “I think we're not going to make it to the hospital.” She's like, “Oh, okay. Well, get to Sanpete Valley,” the one that's only 20 minutes away. “They can't force you to do anything,” because that was my biggest worry. I was like, “I don't want them to just throw me on a table as soon as I get there.” That contraction that I had on the phone with her was actually the only one that I was able to have my husband doing counterpressure for. I was just bracing myself against the tub. He's doing his best because we really thought that I was going to have a doula there. She would be able to walk him through things. I wasn't the most prepared. I'm not going to lie as far as the actual coping mechanisms, I think, that I was going to use. I had a metal comb that is used for dog grooming that I was clutching in my hand as tight as possible. Meagan: Powerful. Mikaella: Yep. I loved having that thing. That was a godsend honestly.  My mom arrived at about 6:15 and I was just holding onto her. It's funny because the two births I attended were so peaceful and one like I said, Jenessa was singing through her contractions. It was a beautiful environment and then another friend of mine was low moaning. It was a quiet atmosphere still and I am just screaming. You could even hear it in the background of the 911 call that my husband had to make. I'm just losing it in the background. I'm like, “This is not the calm, cool atmosphere that I was expecting.”But my mom got there. I had a super strong contraction and I was just feeling the irresistible urge to push. When I sat back up after that contraction, I felt my water which was bulging and that's when I had to tell my husband to call 911. He was like, “Oh, okay. This is happening right now and right here. We are not making it to the hospital.” Because I am a 911 dispatcher, the operator that he called is my coworker, so I knew the instructions she was going to give me. I was not about to lay on my back even though she was about to tell me to. He kept telling me, “She says that you've got to get on my back.” “I am not getting on my back. That is not what I want to do right now. Just tell her to get the ambulance here. We'll make it work.”At that moment, I made it from my bedroom floor back to my bathroom which is the tiniest room in my house. I don't know why I felt like I needed to be in there. But the EMT that lives around the corner arrived as I was crowning. I'm holding onto my mom. I did finally end up laying down, but she arrived as I'm crowning. With one push, Charlie's head comes out and my EMT unwraps the cord that was wrapped around her neck. It was wrapped around twice so she was super nervous– the EMT was. Another push and she was out. She was super pink. She was a really healthy color. What was really cool was that this whole time, despite it not being my plan at all, there was no fear. There was never a sense of, “This is going wrong.” There was a little bit of panic and there were a lot of self-doubts there in that first hour, but there was no fear. I just was able to trust my body and know what I was doing despite none of it going to plan whatsoever which was a really cool experience. Then they load me up into the ambulance. They took me to the hospital which was where I delivered my placenta. We actually were only there for six hours because, for some reason when you don't deliver at the hospital, they're like, “Oh, you can actually go home,” which seemed backward to me but I wasn't about to fight it. Jenessa and Julie arrived around the same time. I didn't even call Julie myself. I just told Jenessa, I was like, “Please call Julie and let her know what's going on.” The rest is history. It was just the most amazing redemptive birth. I got basically everything I wanted. I had written out a list of birth goals that I had wanted and on that list was intermittent monitoring which, I didn't end up having any monitoring. Getting my VBAC was super important which I got. I didn't have to have an epidural. I didn't even have to get an IV. It was just completely and 100% me and that felt incredibly powerful. It's been a really, really cool story to share especially to other moms who are looking to do VBACs and stuff like that, especially after I was told, “You make big babies. You make big babies.” This was another big baby. She was a 9.5-pound baby who came out on my bathroom floor with no tearing whatsoever. I did that.  Meagan: And you did it. You did it very quickly. Very, very quickly. Mikaella: Very, very quickly. From the first contraction that woke me up to her being born was about 2.5 hours total compared to the 12 hours each for my first two kids. Meagan: Oh my gosh. That is amazing. That is so amazing. I'm sure on Julie's end, she was like, “Oh my gosh. I've got to make it. I've got to get there.” Julie: Well, let me tell you. Can I tell you my version really fast?Mikaella: Yes. Julie: So I met Mikaella. Oh, I don't even remember. It was a month or something like that before you had your baby or something like that? I was excited because I've had clients in the past drive up from 2.5 hours away up here to have their VBACs, so I love those stories. I love people that really want to fight for it. We connected and I got pulled onto the team. I was excited to do a birth with Jenessa as well. But that morning, I got a phone call from Jenessa. I want to say it was around 6:00 or 6:30, somewhere around there. It might be a little earlier. She told me that you were in labor, that you had to change plans and go to the local hospital instead, and that you were just going to wing it, push for your VBAC, and fight if you needed to. You were prepared to do that, but things were moving quickly and you weren't going to make it up to Orem. I was groggy and half awake. I'm like, “So does she still want me to come?”I think I asked that or whatever because you know when you're half awake, I'm like, “I have no idea what to say.” She said, “Yeah. Get dressed and start heading down.” She said she was on her way, so I got dressed and I grabbed my cameras and gear, and headed out. It was about an hour and twenty-minute drive for me or maybe just an hour. I'm not quite sure exactly. So I started heading down and then I was just like, “Please don't let me miss this birth. Please don't let me miss this birth.” I was so frustrated because I had missed two other births already this summer because of people having fast babies. I had one VBAC client that went from 3 centimeters to baby in an hour and they didn't call me in until she was pushing. I was like, “Why, why, why?” and then the other client that I missed had only a 41-minute labor and it was a 46-minute drive for me. I was on my way and I was like, “Please don't let me miss this birth. Please not another one. Please not another one.” But I was excited to be going and supporting Mikaella. As soon as I was getting ready to go through the canyon in Spanish Fork which is about halfway there, I got another call from Jenessa and she said, “She just delivered her baby on the bathroom floor.” I was like, “What?! She didn't even make it to the hospital?” I was so surprised. And yes, I was absolutely super sad to miss it, but I'm also super happy that Mikaella got everything she wanted. It's funny because we have pictures and video clips of you reading off your list of everything that you wanted and stuff. That was super fun to go. I still kept heading down and we did a nice golden hour session. I was there for a few hours with them and the kids came in to meet baby and everything. But it was wild. This summer was wild. There were so many crazy things happening with births and babies. I just actually had a 9.5-pound baby born about a week ago even, a 9-pound, 7-ounce birth center birth. I just love seeing these big babies come flying out into the world just as fierce as they want to be. I love it. I love your story. It's so wild. I'm excited that you get to tell it today. Mikaella: It's so fun. I love being able to tell it. I think it's really cool that Charlie's got that story that she can tell now too. Now even, she's got news articles that she can look back on. Meagan: Yes, I was going to say that you said earlier that the news had contacted you and you were on the news. How did that story get out? Were they just like, “Oh my gosh, this accidental home birth.” Did they talk about VBAC in there too? Mikaella: It was very interesting to see how they took my story and spun it. I won't say it wasn't factual, but they definitely put a certain light on it I guess you could say. Our local ambulance, two or three more of my coworkers work in the ambulance too so I'm really close with a lot of them. Meagan: I would really like to see this article. Julie: I'll send it to you or she can send it to you. One of us. Mikaella: I think that there's a video as well as an actual written one. So basically, our local hospital does an EMS highlight at the end of the year and they decided that they were going to highlight Ephraim's ambulance this year which is where I'm from and the story that they were going to highlight was Charlie's story. A big emphasis was put on the EMT which I totally appreciate her. I love her. She was a godsend in that moment that she was there and she knew what to do especially with the cord wrapped around Charlie's neck. There was not a lot about me in the article which I find interesting. It's not as much about the birthing mother despite it being a birth story. So when the interviewers actually came over to my house, we were just having a casual chitchat before the actual filming and the interview began. They were saying, “The hospital was worried that this was going to make people want to have a home birth. They were worried that we were advocating for a home birth.” She's like, “You weren't planning on having a home birth, right?” Julie: What? Mikaella: Yeah. I was like, “Not that there's anything wrong with having a home birth, but no. That wasn't the plan.” I was like, “It is now if I have another one. I'm probably just going to have it at home.” I found it interesting that the hospital was like, “Oh, we don't want to promote home birth because that's risky,” or whatever. Then in the article, it was very much about EMS which is fine because it was their highlight, but they kept saying, “The baby that came early, the baby that came early.” I was like, “She didn't come early.” She came maybe two days early before her due date, but she just came fast. Julie: Oh my gosh. What got me was like, “The cord was around her neck and it was so emergent.” They went and talked about how the cord wrapped around her neck was that they saved your baby's life. That's what people say. That's what people think, but we all know that the cord around the neck, 99% of the time is not a problem. Mikaella: Exactly. The EMT that delivered her is wonderful. I have fostered a relationship now with her after the fact and I know a lot of people that work on the crew, so I didn't mind them getting a little highlight, but it was very interesting to see how they spun it there at the end and how they spliced it together. I know they were trying to work with what they had because I was so nervous about sharing my story that I was kind of all over the place. Preston had to keep anchoring me and be like, “Don't forget about this part of the story. Don't forget about this part of the story.” I'm like, “Oh right. I know.” Meagan: Yeah. Mikaella: It's interesting, yeah. Meagan: It just goes to show just in general with news how things can be spun and taken a little bit more out of context to make it sound different or more desirable in one factor or another. When you have a perfectly safe, beautiful, vaginal birth after Cesarean with a larger-sized baby that was a fast, precipitous labor and then this amazing EMT comes in and they just help. How awesome it was that they were there. There was this nuchal cord and how nervewracking it was for them, but they knew what to do. They were trained and they helped. Instead of just talking like that, it's a little different so it's kind of funny to think about that but still so cool that Charlie can go back and see and be like, “Look. I even made it into the news because I came so fast.”Mikaella: Exactly, exactly. Yep. Not a lot of big things happen in our tiny town. Meagan: Yeah, yes. So oh my gosh, well thank you so much both Mikaella and Julie for being with us today. Julie: Yeah. Meagan: One of the things I just want to talk about really, really fast is something that you were talking about from your second birth. You say that you had trauma but you know other people have more intense trauma or whatever. Mikaella: Right. Meagan: I don't want you to discredit the trauma that you did have because, for you as an individual, the trauma that exists exists. It's okay and sometimes I feel like it's just natural for us to be like, “Well, I know I didn't have to have this, this, this, or this happens like that person which is more traumatic.” It seems more traumatic to the listening ear, but at the same time, you personally went through this traumatic situation. It's okay. You can own that and be like, “This was very traumatic for me and it sucked. I had to work through this.” I want everyone out there to know that it's okay. It's okay to accept your trauma and recognize that it is trauma because that's one of the hardest parts is recognizing that it's traumatic. I'm proud of you for recognizing that, “Yes. This is traumatic for me.” Even Julie I'm sure would have situations with her own births or her clients' births where sometimes we walk away as doulas and we're like, “It doesn't seem very traumatic to them,” but it was really traumatic for me and I wasn't even the one going through it. I was an observer and went through it that way, but it wasn't happening to me. Trauma just exists so differently for everyone. So for everyone listening out there, one recognizing your trauma like Mikaella did is so important. I know for me, I think I told the story of how I was in the driveway stomping around processing trauma that I didn't even realize that I still had. Trauma is one of the best things that you can do, so I want to just really quickly talk about Julie because Julie is on the podcast today too. She actually did a really cool YouTube video on our YouTube at The VBAC Link and it's a smokeless– Julie: Smokeless unless you have lots of people doing it. Meagan: Yes, we did it one time with a lot of people and we definitely had smoke. Julie: We set off the fire alarm. That was awesome. Meagan: Yes we did. But yeah, check it out because even the smallest traumas may resonate largely inside and impact the result. So definitely check that out on YouTube at The VBAC Link. It's smokeless fear release. Julie: Smokeless fire fear release. Can I add something really fast about trauma because you know how I am with trauma? Meagan: Yeah, you've learned a lot about trauma. Julie: I went through a big, massive trauma-processing PTSD thing in 2021 and it was super intense. It was a lot of therapy and a lot of sessions. There were group sessions and everything like that. One thing that is so interesting is how everybody perceives their trauma differently. I feel like everybody feels like, “Oh, my trauma is not as bad” or “This person's trauma is way worse.” Meagan: We compare. We compare. Julie: Yeah, we do. There are people that are like, “I never would have survived the things that you went through in your childhood,” and I was like, “Dude. Are you kidding me? You saw this and this and that and I can't even imagine going through that.” It's really interesting because we do. We tend to compare, but one thing that I've learned through that process and one thing that I tell people, one thing that I want people to remember and know and one thing that I want to remember myself whenever I am feeling like maybe my stuff is not as bad as somebody else's is that trauma is trauma. There's no capital trauma or small trauma. It's trauma. The thing about trauma is our bodies and minds respond the same no matter what that trauma is. There are physical and emotional symptoms that come when trauma happens and those symptoms are the same no matter if you feel like your trauma is more or less than another person's. All of the symptoms are the same. We all go through those same things. Our bodies feel it the same. It may manifest differently and things like that, but trauma responses are trauma responses. And processing through them, it doesn't matter what caused the trauma.The trauma is there and it lives there. That is something that we all have the same. You know what I mean? No matter what the trauma was. I think that I see it so much Mikaella. When you said that, I was like, “I want to talk about this.” But yeah. Don't discount it because it lives inside of you the same as everybody else's does no matter what the circumstances were. Mikaella: Definitely.Meagan: Yes. I love that. I love that and it is pretty crazy to think about all of the women that have experienced birth trauma. I mean, it's upward towards 1 in 9 of people who are actually diagnosed, and then think about all of the people that don't seek help. We've got a lot of trauma out there. It makes me sad that it happens, but I love that you said that. I love that so much. So thank you. Julie: Yeah. Mikaella: Something I've noticed too on the trauma side is that so many women don't recognize it as trauma because they have been conditioned to think that birth is just a big, scary, traumatic thing that happens. When you have that trauma, that's just what comes along with birth, but hey, at least you're still here. My mom has her own traumatic birth history and she would not say it's not traumatic. She would definitely be the first to tell you, “No. That was trauma.” But my mother-in-law and I have sisters-in-law and they have all had one thing or another, but it's like, “Well, but my baby and me are here so it's fine.” Meagan: Exactly. Mikaella: The trauma is still so valid and it took me a long time to realize that and push against what has been perceived as normal for so long to recognize that no, it was traumatic for me. Just because it wasn't as bad as somebody else's or just because the baby and I are here and healthy, that doesn't mean that it wasn't traumatic. Due to that trauma, it took me a long time to even see a doctor when I found out that I was pregnant because I was like, “Nope because that makes it real. That makes this pregnancy real.” So even after having some healing experiences, it was still like my body was postponing calling the doctor and making an appointment. My body was postponing and putting off all of the things that I needed to do to prepare. It had its own kind of trauma response. Meagan: Exactly. That's one of the reasons why I congratulate you for recognizing that because so often, I didn't even recognize it until I was in labor and I was like, “Oh my gosh. I have all of these trauma factors that I'm now letting out in labor.” It's so hard. It's natural, I feel like, for our minds to downplay it and be like, “Well, but I got this so I shouldn't be traumatized or I shouldn't have fear or I shouldn't have sadness because I do have my baby and I'm okay overall,” but that doesn't mean we have to write it off. We don't have to write it off. We don't have to push it down the tunnel and just forget it ever happened because we have a healthy mom and a healthy baby. There was one birth that I was at here in Murray and the mom ended up having a Cesarean. It was a, I would say, pushed Cesarean more than a needed Cesarean. She didn't want it and she was crying. Lots of things were happening and I ended up going into the OR on this. It was a traumatic Cesarean. It really was. And then after, the doctor said to me, he pulled me aside and he goes, “Well, isn't she just happy now that she has her baby? Can't she just let all of that stuff go?” Because I stepped out to give them a moment because they were really upset. I just wanted to let them be together. It was clear to me that they just wanted a moment just the two of them and their baby. I said, “I don't think it works that way.” He goes, “Well, that's how it should work.” Julie: Wow. Meagan: I will never, ever forget that. It was like, “You totally just pushed her trauma aside. You did your job. You got the baby here, but now what happened leading up to that, what happened during it, and what's happening after shouldn't matter because she has her baby here.”Julie: Well, that's totally gaslighting. I mean, come on. Meagan: It was bad. He didn't say that to her. I hope that he never did, not that I know of it, but he said that to me. I was like, “You totally just discredited everything that she just experienced.” I was very frustrated. Julie: I hate the system. Meagan: You know, it's hard.Julie: I really do. Meagan: It's hard because I'm sure overall in his head, he just doesn't understand. He doesn't understand. He didn't experience that. Julie: Yep. Meagan: But that doesn't mean she should just be okay. So if you're one of those moms, and I'm going to tell you that there are lots of us out there that are like, “Okay, well it's okay because it's fine. I'm fine. I'll heal. My baby's here fine and safe.” We all should be glad and happy about that, but it's okay to accept that. It's okay to say, “You know, that was really hard. I didn't like that” or “That was triggering for me.” Like Julie said, the mind and the body and everything, we've got to work through it and we've got to accept it and it's really hard too. Mikaella: I want to add even if it's not necessarily traumatic, you're also still allowed to mourn a birth experience that you didn't get to have. Even if there was zero trauma involved, if you had something in your mind that you were working towards and didn't get it, that's still so valid. I know with Boston, my C-section, at the end I feel like it was necessary. I didn't feel pushed toward it or anything. I don't know that it would have been necessary had I gone without all of the interventions leading up to the C-section. At that point, the C-section was necessary but I definitely mourned the experience of not having a second vaginal birth. I feel like a lot of women feel that way because it's like, “Well, your baby is here and you're fine. Your birth wasn't even traumatic, so what's the matter?” But you're more than allowed to mourn a birth experience that you didn't get to have. Meagan: Right. Julie and I have talked about that all of these years on the podcast. It's okay to be happy for your baby and everything but also mourn. You don't have to only be happy or only be mourning or grieving the experience. They can go together. You can grieve the experience that you didn't receive while also being happy for your newborn baby. Mikaella: Exactly. Julie: Yep. It's complicated. It feels complicated, but it's not morally right or morally wrong to mourn the loss of a birth experience you wanted while being incredibly excited about your new baby. It's not. It's not morally right or morally wrong. It just is. It's okay to feel these things. It's okay to sit with them and it's okay for it to feel complicated. Meagan: Absolutely. Okay, ladies well thank you so much again for being here with us today. I do. I love your story. Honestly, I long for that birth. We're done having kids. We definitely are not having anymore, but I kind of long for it. Those fast, precipitous births can be really, really crazy and very intense because your body is doing a lot but it kind of sounds really fun too. Mikaella: I honestly enjoyed it. Out of all three, that was my most enjoyable birth and the easiest recovery afterward. I got to experience spontaneous pushing or the pushing reflex. The ejection reflex was so incredible because, with my other two, I pushed for hours and hours. It started as, “Let's do practice pushing,” and then it was just pushing and pushing. It was exhausting. So getting to feel the ejection reflex was honestly awesome. Painful, but it was awesome. Getting to just check all of those things off of my list and knowing that I can do it and taking charge of my own birth there at the end was really incredible. Meagan: I love it. Well, thank you. On that note, we will just leave on the positive. It was incredible, that positive note. Thank you again, both of you. Mikaella: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

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/

This week, Julie Bogart is back to talk all about changing our minds in parenting and homeschooling.  Fall 2022 Season Sponsors   We are so grateful to our Fall 2022 Season Sponsors. Use the links below for their special offerings:   Blossom & Root and use code HSUnrefined15 for 15% off your purchase   Outschool and use code Unrefined for $20 off your first class    Night Zookeeper for a 7-day, risk-free trial, as well as 50% off an annual subscription  LTWs    Maren: Good Inside by Dr Becky Kennedy   Angela: Calm Aid   Connect with us!  Visit our website  Sign up for our newsletter and get our Top 100 Inclusive Book List We are listener supported! Support us on Patreon Follow us on Facebook, Instagram, Twitter and see video episodes now on Youtube Angela on Instagram: @unrefinedangela | Maren on Instagram: @unrefinedmaren and @alwayslearningwithmaren  Email us any questions or feedback at homeschoolunrefined@gmail.com   Complete Episode Transcript   [00:00:00] Angela: hi, we are Maren and Angela of Homeschool, Unrefined. Over the past 25 years, we've been friends, teachers, homeschool parents and podcasters. Together with our master's degrees and 20 years combined homeschooling. We are here to rethink homeschooling, learning, and education with an inclusive and authentic lens. [00:00:29] Maren: At Homeschool, Unrefined, we prioritize things like giving yourself credit, building strong connections, respectful parenting, interest led playing and learning, learning differences, mental health, self care, and listening to an EL elevating LGBTQ plus and bipo voices.  [00:00:48] Angela: We are here to encourage and support you. [00:00:50] Whether you are a new homeschooler, a veteran, you love curriculum, you're an unschooler. Whether all your kids are at home or all your kids are at school or somewhere in [00:01:00] between. Wherever you are in your journey, we're the voice in your head telling you, you're doing great, and so are your kids.  [00:01:07] Maren: This is episode 1 98, Changing Our Minds with Julie Bogart. [00:01:14] We had such a good conversation and we're so excited to share this with you, and then we are going to end like we always do with our l t Ws Loving this week.  [00:01:26] Angela: Before we get going, we did wanna let you know about our Patreon classes. We are starting a new series. on Thursday and it's our what We don't do series. Mm-hmm. , if you have been around a while, you probably have listened to one of our, What we don't do messages, we're turning them into a class and we're gonna talk about what we don't do as a, in a class format. [00:01:48] And that is gonna be Thur this Thursday at one o'clock central time. And if you are interested in that, you can join us on, on Patreon for our super squad. That's the $10 level. We [00:02:00] will have links in the show notes for you there, but we'd love to see you if you can't come live. You can get it recorded and video and audio. [00:02:07] We will be putting those out and then, The day or two after that.  [00:02:11] Maren: Absolutely. And you know, we are passionate  [00:02:13] Angela: about what we don't do. we are and spreading one of our favorite things. . It's important. It is. Mar and I both love new and innovative ways to make reading and writing fun. That's why we hope you've tried Night Zookeeper. [00:02:28] Is your child a reluctant writer? Do they struggle with. If the answer to either of these questions is yes, the Night Zookeeper may just be what you've been looking for. Night Zookeeper is an online learning program for children, ages six to 12 years old that uses a gamified and creative approach to help keep kids engaged and focused on developing awesome reading and writing skills, all while having fun at the same time. [00:02:51] Some of the features we love include the educational games, the personalized feedback on writing from Real tutors, the Super Safe Community pages where [00:03:00] children can work with each other and learn together. If night Zookeeper sounds like the perfect learning program for your child, you can try it for free by clicking on the link in the show notes. [00:03:09] When you register, you'll get a seven day risk free trial, as well as a huge 50% off annual subscription. That's a great deal if you ask. When it comes  [00:03:20] Maren: time to decide on whether or not to use a curriculum, we think you should check out Blossom and Root. Blossom and Root is a nature focused secular homeschool curriculum focusing, focusing on creativity, science, nature. [00:03:35] Literature and the arts. Blossom and Root has been gently encouraging in supporting homeschool families around the globe since 2016. Blossom and Root currently offers curricula for pre-K through fifth grade with new levels being added in the future. Additionally, a three volume inclusive US history curriculum told from a variety of viewpoints is [00:04:00] currently in development as of August, 2022. [00:04:03] Volume one is available for purchase and volume two is available on presale. All profits from this history curriculum. A River of voices will be used to support storytellers and artists from historically excluded communities. You can find samples, scope, and sequences and information about each of their levels online at www.blossomandroute.com. [00:04:29] You can also find them on, I.  [00:04:31] Angela: At Blossom and Root,  [00:04:33] Maren: Blossom and Root has created a special discount for our listeners. Use the code Hs. Unrefined 15 at checkout for 15% off your  [00:04:43] Angela: purchase. Over the years, our kids have taken many out school courses that they have loved. Have you given out school a try? We know that kids who love to learn don't just prepare for the future. [00:04:56] They create it. That's why Out School has [00:05:00] reimagined online learning to empower kids and teens to expand their creativity, wonder and knowledge. Empathetic, passionate teachers encourage learners ages three to 18 to explore their in. Connect with diverse peers from around the world and take an active role in leading their learning out. [00:05:16] School has created a world filled with endless possibilities for every schooling journey. Explore over 140,000 fun and flexible live online classes to find the right fit for your family. And join us as we set learning free. Sign up today at Out schooler.me/homeschool unrefined. And get up to $20 off your first class when you enroll with a code Unre.  [00:05:42] Maren: All right. We are so excited to introduce you. [00:05:46] If you don't know Julie Bogart Bogart yet, here she is. Julie Bogart is the creator and owner of Brave Writer, the online writing and language arts program for kids and teens. She's written two books, The [00:06:00] Brave Learner and Most Recently Raising Critical Thinkers, Julie Holy Supports Homeschool Parents Through Her Social Media Channels. [00:06:08] Her podcast, her books and her community. We have always absolutely loved talking to Julie and we're just so glad that she is back. Enjoy this conversation. [00:06:20] Thank you so much, Julie, for joining us again on our podcast. We've had you on a few times and we love having you every single  [00:06:27] Julie: time. Well, the feeling is mutual. Mar, I love being here.  [00:06:31] Maren: Thank you so much. Okay. So I really wanna talk about your book that actually came out quite a while ago, but you and I have both been so busy that we haven. [00:06:41] Able to make time to talk about it, but I'm so excited to talk about your book Raising Critical Thinkers. And we talked a little bit about it maybe on your podcast last time. Yes, yes, Yep. But I just, this was before, I think we read your book though. You were still writing it and we've now since read it and love it. [00:06:59] And I'm just [00:07:00] wondering what made you wanna write this book right  [00:07:03] Julie: now? Specif. Yeah, that's such a fun question for me to answer because you have to go all the way back to the 1990s to answer this question. Mm, okay. Yeah. It really started with the dawn of the internet . So in like 19 95, 96, when the worldwide web was crawling out into the space, homeschool parents in particular were. [00:07:25] We're like the first people to barge through those doors. We were so isolated. Yeah. , there were about 800, right? There were about 800 Absolutely. Thousand families who homeschooled back then in the United States today there's 3.2 million, so that's, That's amazing. A sizeable growth. And we did not have a means. [00:07:41] Of connecting except in local communities. Mm-hmm. . And so you can imagine the numbers were small. You know, you might, in your community have five or 10 people you know who homeschooled. Right. Some people had no one. So we all hopped online. Yep. In these couple of major sort of homeschool watering holes. [00:07:58] And to be fair to [00:08:00] the movement, the truth of the movement at that point is that it was. Yeah, we were white. Yep. Mostly conservative. Politically and religiously. Yep. And heterosexual and married. Right. So that was the demographic, like 98%, 99%. So I imagined we would get on these discussion boards and we would really like each other. [00:08:21] You know, I, I had been to park days. People are friendly, you know, occasionally they mention your child misbehaved, but nobody's getting into big fights about politics at a park day. Sure. And yet I get on these discussion boards and while there's plenty of friendliness, plenty of good advice. Mm-hmm. , there was also a shocking willingness. [00:08:43] Mm-hmm. to really go to battle. Mm-hmm. over things like oxy Clean, whether or not to breastfeed, Oh no. Whether or not you should potty train your child by age two. And that's the tip of the iceberg. When we got, When we got near [00:09:00] religious discussion, like doctrinal issues or theology, the gloves came off. [00:09:05] Wow. People  [00:09:06] Maren: get really brave, don't they, on  [00:09:07] Julie: those sites? Oh my gosh. And this is before we knew about trolls, so I jokingly say homeschoolers and bena trolling. We used to call it flaming, but it was really just a lot of fighting. And so here's the question that sort of grew inside me at that. . Why does everyone think they're right? [00:09:26] Mm. And why do they assume that all they have to do is state their belief and everyone will agree with it. So there was very little curiosity. It wasn't like, Wow, you're a five point Calvinist. I'm only a three point. I wonder why that is. . No, that is not what happened. It would be things like, you know, Julie, I just think you're wrong here. [00:09:46] The actual true theology is X. Mm-hmm. . And so for me, at the time when I was expecting sort of this homogeneous. Kumbaya experience. It was not that. And in fact, I was [00:10:00] so intrigued by this problem. I started my own discussion board. We called it at the time the Trap Door Society. And the reason it had that name Yeah. [00:10:10] Was that I felt like all these women were performing roles on a stage, you know, parent, wife, educator, spiritual or non-spiritual person, whatever you were. And we had no way of. To nurture the individual person that we were. So I wanted a trap door so we could go beneath the stage and like try on different costumes. [00:10:33] Imagine other points of view, read books that were for our pleasure, not for our children. That's amazing. Yeah. And it was, it was amazing. It was. So that was the.  [00:10:44] Maren: You created that safety. That's that's what it sounds like to me when you're talking about that trap door. That's a place of safety where you can try things on without getting completely reprimanded. [00:10:57] Well,  [00:10:57] Julie: that was the goal. Yeah. It did [00:11:00] not go that way. Oh,  [00:11:01] Maren: okay.  [00:11:01] Julie: So I started this community. Mm-hmm. . There was a lot of love. Mm-hmm. . Mm-hmm. . And there were some, I mean, phenomenal discussions that were life changing for me. I will say that right out of the gate, my parenting, my home education, my outlook on the world was shaped profoundly by that community. [00:11:17] But there was also some battles that literally took me out, like days of crying obsessing over responding, trying to craft the perfect words so no one would be mad and still, Oh, I feel that lacking anger. Early days of the internet. Mm-hmm. the early two thousands. And so that persistent experience of why does everyone think they're right? [00:11:43] Right. Stayed with me. And it got me curious about how we form our thoughts. Why we think, how we do, what we believe about other people who think differently. And I, I just got on this serious mission. I've been studying, thinking for over 20 years. I've been so [00:12:00] fascinated by it. I even went to grad school to try. [00:12:02] Understand how we all think so differently. So yeah, that's really what led me to it. So ironically, it came out during the Covid period, , which is a, an important time to think critically. Oh my gosh. It's almost like, you know, we hit the Zer of trolling and flaming and everything else.  [00:12:22] Maren: And it continues. And it continues. [00:12:24] Like for sure we need to, we need this skill. So what is your definition of critical thinking? Why do you think, Well, I mean, we already talked about why we think it's important, but if you have any other thoughts about that, but just what is it to you? What  [00:12:37] Julie: does it look like? Yeah. Critical thinking for me starts in an unusual place. [00:12:41] Like if you go into the education world and they talk about critical thinking, it's always about analyzing something over. , like a piece of literature, a scientific discovery, a mathematical problem. Yes. But I think critical thinking starts closer to home. [00:13:00] It's self-awareness. It's the capacity to notice your own bias as it kicks into gear, right? [00:13:06] To pay attention to what triggers you to be curious, for instance, about why you think you're right. Yes. And it's doing all that before we extend a similar. Attitude, I guess I would say. Yep. To someone else. So if I know that I have these inherent triggers, biases and proclivities, right? That's also true of the person I'm chatting with. [00:13:30] Mm-hmm. , the cuter. And my job is to at least get to a place of understanding how the jigsaw puzzle of their experiences, education, thoughts, socioeconomics, and identity created safety right for them through this. Because that's what our beliefs are. They are a safety protective shield that keeps who I am free of anyone harming me. [00:13:58] Maren: It sounds to me like you're [00:14:00] talking about self-awareness as being one huge key. Totally of critical thinking it is. And then being aware that this other person is also has this other set of aware, you know, self awareness and maybe not, may not be as aware about those is of those things. And then, oh, it's just the, a higher level thinking here. [00:14:21] You know, I just think when you get in those situations and the. The ability to understand yourself, understand this other person and how you work together, and how it, how it's okay that they're thinking differently and it's okay that I'm thinking differently and we can work together in this way. I mean, it's just. [00:14:38] This is what's so needed in our world today. Can you imagine if E the most powerful people in the world, can't even do this, Julie? No. No. Can you train them ?  [00:14:52] Julie: Well, the problem, the problem I really think comes down to the fact that. There are dangerous [00:15:00] thoughts. Mm-hmm. thought worlds that exist, but the criteria for danger varies community by community. [00:15:06] Mm-hmm. , person by person. So a lot of times when I've done these interviews, people have said, So you're really focused on critical thinking, leading to empathy. And my rejoinder is actually, no, this book isn't about empathy. You may gain some empathy. Sure. Come to a place where you look at your child, for instance, and have more insight into why they hold a view, and it creates a feeling of warmth or compassion towards your child. [00:15:31] Mm-hmm. . Mm-hmm. . But mostly it's about understanding because for instance, we love true crime, right? We're all listening to podcasts. We all do movies, and we are doing it because we are fascinated to understand. Why a person imagines that the best solution to a problem in their life is murder. We're not and and we want to understand it. [00:15:56] That's why we watch. Right. We don't just judge it. We're like, [00:16:00] Well, what factors led that person to thinking, I will have a more beautiful life if I off this other person. What we end up feeling at the end is horror, not empathy. Right. Right. It actually engages our deep morality. We. Wow, these factors are problematic. [00:16:19] This person saw the world in a way that is so different than mine. And then it leads us to ask what I think is a very important question, What is it about that person's perspective that we haven't accounted for? Mm-hmm. in the public square. Yep. So if we think about someone like, you know, just to go for the extreme Hitler and go for it. [00:16:40] Yep. Right. What we have, were an entire population. Of German Christian, middle class churchgoing people. Mm-hmm. becoming persuaded that the solution to their economic crisis was genocide. Yeah. And the question we [00:17:00] have to ask ourself is how did that happen? How did that happen? Yep. Because they were persuaded. [00:17:08] There was a structure and a belief system that they were able to inc. That made them think they were on the moral high ground. And so for me, critical thinking is all of that. It's not just empathy, it's accounting for those factors that may possibly lead us into very immoral and scary thought worlds. [00:17:31] But we do it from a place of. Actual desire for a better world. Right. We're not doing it because we're inherently evil. We're doing it because we think life will be better for us and our people.  [00:17:43] Maren: Right, Right, right. And that's why we need to think critically about our history. That's right. So that we can change it. [00:17:50] does not repeat itself. True. Yep. So true. One of our favorite chapters in your book is probably the last chapter, The Courage to Change Your [00:18:00] Mind. We love this idea. We talk about it a lot as parents. So just sitting with that for a minute, changing your mind. Why do you think that changing your mind is important? [00:18:10] Julie: Well, first of all, the capacity to change your mind shows a certain agility in your own ability to process information. So psychological research shows that psychological flexibility is a key component to a healthy ego. Mm-hmm. and healthy relationships. So if we are hardened or rigid, we actually start to eliminate the capacity to relate to a variety of people, right? [00:18:39] Then what we do is we start shrinking the group until we're in a very small corner of the world, well defended against all the attackers. We become victims, right? Of our own ideology. Mm-hmm. . So the courage to change your mind says, I'm actually related to all of humanity. There isn't [00:19:00] the in group, in the out group. [00:19:01] I'm here to hear experiences, data, research, information that is not like the kind I have and understand how it's shaped these people that I am connected to simply by being a human being. I don't think we think that way very often, but one thing I have not, Is that parents are the most likely to change their spiritual, political, social value beliefs when a child. [00:19:32] Tax them. So you have a child? Oh yes. That's me. Example. Right? Totally, totally. All that story, because I think it's so powerful. Well, there are,  [00:19:40] Maren: there are actually, I mean, there's a lot of things I can't even share right now until my kids are grow, grown up. Yes. Until they've given me permission. But I mean, definitely politically, spiritually so many things. [00:19:51] I actually, I wrote down a few things, things that I've changed my mind on as a parent recently, probably hair color. Tattoos [00:20:00] piercings. Not that I'm letting my kids pierce their or get tattoos, but , like, I've changed my mind on it because just talking about it ha has created this big rift and I'm like, I, Why am I so against the, I mean, why am I so I against this? [00:20:18] I do not know. I honestly don't know anymore . So I had to rethink that. Food choices, TV and movie choices, clothing. What body parts can be shown and not shown. You know, these are things and ultimately school choice. Yes, school education choices. Because, you know, if it were up to me, we'd probably, you know, be doing something very different school-wise right now. [00:20:41] And I'm listening to my kids and they're telling me what they need and I'm like, Wait a second. I you. For a while I was like, No kids, we're doing school this way. This is what I see as the best way . And they're like, Mom, listen to us. We're telling you what we need right now. And I'm, and I had to really [00:21:00] go inside myself and evaluate like, why am I, why are my ideals the boss of. [00:21:08] Their education right now, it's their lives ultimately. And I can, That's right. Yeah. So I can make, Obviously I wanna make safe and good, you know, good choices for them. But there are lots of safe and good choices. I  [00:21:22] Julie: think so. No, that is so beautifully expressed. Mm-hmm. . Because part of what happens is we've already lived through those ages. [00:21:31] We were teenagers and young adults. We have regrets, choices we made that we think, Wow, that was a bad decision. Or I wish my mother had stopped me from doing X. Right. And so we come in with this perspective that somehow we can protect our children from right. Regret, mistakes, getting in car accidents, whatever it is. [00:21:49] Mm-hmm. . And yet it is those very experiences that formed and shaped us into the adults we are today. Right. And when we don't give our children the [00:22:00] agency over their choices to some extent, obviously you have some, some room there, but to some extent, Then they feel the need to react that much harder. Yes. [00:22:11] Because they are testing, not you, but the world outside of your home to find out, am I qualified to be admitted as an adult? Yes. And if they don't have the opportunity to make some of those calls and fail. They will not discover what resources they need. I, I did a podcast interview recently with a mom who was raised in the obedience model as a child. [00:22:36] Mm-hmm. . Mm-hmm. . And she told me she got to young adulthood and thought, But how can I know if I'm making a good decision, where's the authority that's gonna tell me I'm doing the thing? Yep. And so our kids need the, the right. I remember Johanna, she had red. She decided to die purple and the culture, not me. [00:22:57] I was like, That's fine. Yeah. Yeah. , the culture told her, [00:23:00] if you're a redhead, you're not allowed to dye your hair because your hair is too beautiful. You're not allowed to get rid of red hair. Yeah. Yeah. And I remember supporting her and saying, You know, it's your hair. Pick a color. So she went in to get it dye, and even the hair stylist was like, Are you sure? [00:23:18] Yeah. And so the hair stylist refused to bleach the hair. She's like, We'll just put purple on top of it. And it came out black. Okay. No. So she didn't end up with her purple hair. She had red hair and black hair, and then she decided to go full goth to support the black hair, you know, early two thousands, [00:23:36] And I look back on that and I think what an interesting moment for her. Yeah. To assert a desire and have the whole culture oppose her and to keep fighting for it anyway. Like this is what we want. How will they build their self confide? If they never have a chance to encounter opposition, to stand up for what they want, [00:24:00] to find out if it matches what their hopes and dreams were. [00:24:03] They need some of those chances, don't they?  [00:24:05] Maren: They absolutely do, and I think our traditional educational system is teaching our kids to obey, yes, meet the standards, do the thing, and perform and not really think critically about themselves. They, it might be thinking critically. One small topic here, one small topic here, but it's not this all-encompassing critical thinker that, that we're raising, you know, in our education system. [00:24:32] And it's, it's tough because then they go to co, they go to college and, and you know, they might not. Go find the resources they need to do well in college because they haven't been taught to be proactive about those things or to figure out what they need or even to find their passion to find the thing they love to do in the world because they've just learned to go through the hoops. [00:24:53] Go through the hoops, do it, get a job, make  [00:24:56] Julie: money, , a hundred percent. In fact, when I taught at Xavier [00:25:00] University, one of the most glar. and obvious lacks in the incoming freshman was a sense of agency about their own thoughts. Mm, mm-hmm. . So they came in having been trained to write essays and how to even do research online or use the, you know, the library correctly. [00:25:18] Mm-hmm. . Mm-hmm. . But they were always trying to find out, but what did I really wanna hear from them? Yeah. What was the angle I hope they would take? And so we. All kinds of writing activities and writing on the board and small group sharing because my goal, Was to hear something genuine from each student. [00:25:35] I needed to hear how did this idea land for you? And if the idea hasn't landed for you yet, I don't wanna hear from you. Like, don't just turn in an essay. Yes. And so part of the training in high school, especially if you've got homeschoolers in this audience, but even in regular high school mm-hmm. . To give agency to a child's voice, and one of the few ways they can feel [00:26:00] they have a voice is opposing your voice. [00:26:03] So even though you think to yourself, This is a dangerous idea, , I want you to step back and think how cool that they felt that they could take the risk to tell me this crazy idea that I would never want them to believe. Because what they're saying to you is, I'm entertaining. The thought world that counters the moral center of this family. [00:26:27] Maren: Yes. I love that. And actually, that's one of the things I was just gonna ask you about, Julie, because I just watched one of your. Instagram reels about encouraging parents to argue with their kids. [00:26:36] So this, I think this is a great example of  [00:26:40] Julie: encouraging critical thinking. Oh, it totally is. And I wanna give credit to one of my staff members because this morning I was having this meeting with Ramona and Ramona said, Julie, one of my kids is in your brave writer movie class on dystopian movies, and she. [00:26:56] The dystopian genre . And I told her, [00:27:00] Take that class cuz it's gonna have your best writing. Yeah. And so she's in there just hating these movies. They're watching them as a family and having huge arguments about them. And I was like, That totally reminds me of when my kids' dad and my kids argued about Nacho Libre for two long, Oh my gosh. [00:27:18] In the middle of summer, on our back deck after a barbecue, just dissecting the characterizations, arguing over whether or not this was a good movie. And so I think we sometimes forget that kids, they love that idea of being an. They love the feeling of being able to take an adult model of something and then shred it. [00:27:38] My son, Jake, totally, as a great example, he today, just to give kind of context, he's a human rights lawyer who works for the in Central Africa Republic.  [00:27:47] Maren: Wow. So you need to be a critical thinker for, for that job.  [00:27:49] Julie: Oh heavens yes. Went to Columbia Law School. Right. So he, he knows how to think, but I remember in junior or in, when he was a junior in high school, he watched this one movie, Some of [00:28:00] your, your listeners could even look it up. [00:28:01] It's called Zeitgeist. It was a thing in the mid two thousands. Okay. It's basically a massive critique of capitalism and it really does promote sort of a communist worldview and you know, eradicating the monetary system, et cetera. And I remember he came to my ex-husband when we were married, my husband and I at the time, And he's like, Mom, this is how the world needs to be. [00:28:23] But we watched it and his dad was saying to me, Oh no, Jacob's gonna end up in this horrible ti world of weird conspiracy theorists with the Illuminati, you know? Oh, totally. And I said, You know what, Actually, John, this is amazing. Not only is he watching it, he's telling us he's watching it, and he is critiquing the system that feels. [00:28:47] Air, like water. Like he didn't know this was a system Yeah. To critique until he heard there was a critique. Like you can criticize money. What, what a thought. Right. He had never known Right. [00:29:00] To do that. Yeah. And so we just leaned in. We just asked more questions, watched the movie, agreed with what we could raise questions about what seemed inconsistent, but we didn't like attack it. [00:29:10] It was more like, Is that working anywhere in the world? You know, like ask kinds of questions. And he evolved through it. He didn't stay there. Of course, yes. It was like a starting place for critique.  [00:29:22] Maren: I think we have to remember that our kids aren't, aren't going to stay in their thoughts for the rest of their lives. [00:29:28] They are, their, their brains continue to develop and it's really the practice of critical thinking. It's the practice of learning. It's the, the, the practice of curiosity and synthesizing and having conversations and growing. That's what they take. To the next level of their lives. A thousand percent. Yeah. [00:29:49] They don't take this one topic and just, you know, think this is life  [00:29:55] Julie: for the rest of their lives. Well, it's easy to do that experiment with yourself. Yes. How [00:30:00] many of your really hard one positions that you took at age 15 or 18 are still identical with how you think about the world today?  [00:30:09] Maren: I'm so glad they're. [00:30:10] No,  [00:30:11] Julie: No no. And in fact, how many I, I ask this in conferences all the time. So if I have a room of a hundred people, I say, How many of you hold the same exact beliefs as your parents in the areas of sex, politics, education, parenting, and food and exercise? And out of a hundred people, only 10 raise their hand. [00:30:31] Wow. So what you need to know is that same ratio is gonna be true in your family. There might be one kid who. Agrees or aligns with you generally, but there are gonna be a whole bunch who don't, and that doesn't mean you can't have a relationship with them. And it doesn't mean they've abandoned their morals. [00:30:49] It means they're thinking deeply.  [00:30:52] Maren: That is so, so, so true. And I I just think what a skill. What a skill to learn and to not have to be [00:31:00] perfect at when you're 15 or 18 or even probably 21 . I mean, this is gonna take a while. This is not a perfection. This is not something that's gonna get perfected. [00:31:09] Early on and it, it, it might not ever, I mean, this is, yeah, this is a process. I was just thinking today, you know, I , you know, made a few mistakes. I'm 46, so,  [00:31:19] Julie: Yeah. I mean, yeah, I'm, I'm 60. I, I've changed my mind countless times and if, and you will continue to, will continue to, and also you can't anticipate what will become an. [00:31:32] So none of us knew what a pandemic was. None of us knew how to respond to a pandemic. We were all jumping into our communities to tell us, these people are trustworthy. These people are not. This information's reliable, this information is not. Yeah. And we were using our blind loyalty to community to guide us because none of us has the expertise to evaluate. [00:31:57] Pandemics epidemics, vaccines, [00:32:00] public health economics, that are the result of this, you know, guidelines for how you run a company. All of that was suddenly up for grabs. Yeah. And when that happens, we stop thinking critically. We actually jump in with both feet to our safest communities. And what I've had to train myself to do, and this is something I write about in the book, Is notice that, Yes. [00:32:25] So when I'm scrolling through Facebook and some high school person I haven't talked to in 35 years, post an article and I think, Oh my gosh, that is the dumbest article I've ever seen. When I feel that smugness come up, yes, I know. I'm not critically thinking, Yeah, I am self protecting in that moment, critical thinking at that moment is, Oh, this is from someone I don't typically trust. [00:32:48] This is a person I haven't thought about in 30 years. Right. I don't really know what she's like anymore. She thought this was worth posting on Facebook. That's interesting. Mm-hmm. . I wonder what that says about her. I wonder if I've ever read this [00:33:00] article with this writer through the lens of this other person. [00:33:03] What, what might there be to learn? In reading it. Now, to be honest, I can't do that a lot. I, it takes so much energy to do that. But to keep myself honest, I try to do it fairly regularly. I try to give myself access to viewpoints that make me cringe. Mm-hmm. and I don't do it to deconstruct them. Yes, I do it to understand them. [00:33:29] Maren: That is so good. And it's also alternatively, when we, I think read, read articles or listen to something that is from somebody we normally do agree with. Like we, I think we also also have to think critically like, Yep, do I agree with this? Or what part of it is, Do I do I think is, you know, real or you know, is there part, are there parts I. [00:33:49] Push back on a little bit or something. So I think it's so good to do both. Absolutely.  [00:33:54] Julie: Great point, Miller. Yeah.  [00:33:56] Maren: Yeah. Okay. So I wanna go back to some of your work, Julie, because I [00:34:00] know Ev, everything you've always put out there, you've always encouraged us to make it our own. And I think you've, from the beginning, have encouraged us all to think critically. [00:34:09] You've inspired. Us all to do poetry, tea, time, , and I'm not kidding you. I have my oldest reads poetry by herself now all the time, and I, I attribute it all to poetry, tea time. I really do. So that you so much, but I know that you also encourage everyone to make. Their own special thing. So what is, What do you think is the key to those magical learning moments like poetry, tea time, or something else that we  [00:34:41] Julie: have come up with? [00:34:43] I think when we're talking about learning, what we're actually talking about is a meaningful connection or relationship. To what is being learned. And so just to deconstruct poetry tee time for a moment. Yeah. I knew that adults hated poetry , [00:35:00] and for some reason my whole life I've loved it. I think because I'm innately a writer, and so any manipulation of language has been interesting to me. [00:35:08] My mother also gave me a a rummy card game that was all. So when I was young, I knew all the names of poets, which then later made me wanna read their poems. My father, my grandfather, gave me a poetry book that was a, I'll read to you if you read to me book. So I would share it with my brother or a friend who came over, or my mother, and we'd read poems to each other cuz of the nature of this book. [00:35:30] Awesome. So my early childhood was really warm towards poetry and then song lyrics became my obsession. Bruce Springsteen, Jackson Brown, Tom Petty, they all write such great storytelling and such great lyrics. So as I was raising kids, I was disturbed to discover that adults didn't like poetry. Oh. And I was so afraid that would happen to my children. [00:35:53] And I was on this email list back in the day in the nineties, and somebody shared that she was teaching geography to [00:36:00] her kids, but they didn't like geography. So she started making tea and cookies for when they studied geography. Yes. And suddenly they all liked geography. And I was. Well, I can do that. [00:36:11] We, I drink tea every day. Exactly. And so I created this whole British tea time and added poetry to it. And so I think really what we're saying is when something seems opaque or difficult, we want to tie it to something that automatically creates a sense of warmth and pleasure and openness. So I wish someone had done that for me with. [00:36:34] That that did not happen with Math , but with my kids, because it never happened to me with math. Mm-hmm. , I put so much more energy into manipulatives and games and cards and dices. That's so great. Yes. And even though my kids would all say, and they will say this openly, that math was not my strong suit. [00:36:54] What is ironic is all five of them have been very [00:37:00] successful in math and they, they came out, two of them are programmers and three of them did calculus and I mean, that's amazing. You did that. Good job, Julia. I take credit, it doesn't matter what they think. No, but honestly, the early years to me are what were the foundation for that. [00:37:18] And then I hired tutors and they did take some math at school. But my point is, I think what you're asking. How do we create the meaningful sense of connection that makes me warm and open this something that feels intimidating. And for me, that would be a great criteria for creating magic in learning. [00:37:37] Maren: That sounds amazing. I mean, I, I could think about that in every scenario. Like, what is gonna cause this to be a warm. Cozy or warm and safe  [00:37:48] Julie: environment. Yes, and and stimulating enough to be interested, right? So, right. You might make tea and cookies to go with math, but if your child's already resistant or sees no purpose in it, they'll eat the [00:38:00] cookies, drink the tea, and still hate math. [00:38:02] Part of what made poetry special is that poetry's easy. You just read it out loud and everybody finds pleasure. But for something that's more of a struggle, I think part of what we wanna do is admit that it's going to be challenging. Provide a lot of support, create as many real life connections as possible, and then do it in small doses so that we don't create a toxic relationship where we're dreading and it feels tiring and I don't wanna do it. [00:38:31] Maren: I love that. Yep. So, so, so true. Okay, so another thing that we, both Angela and I both love about your book. So many other things that you've created is just the activities, but this specific, this book specifically just has so many practical ideas. And a whole book can be intimidating, honestly. Yes. [00:38:50] Sometimes, you know, but if, if you sprinkled out in, you know, throughout the book so many activities that if we. Just pick a few of those activities. I [00:39:00] mean, it would, it could change our home school and I just love that you did that. Did you, did you know you wanted to share practical activities Yes. And ideas when you wrote the  [00:39:10] Julie: book? [00:39:10] Because I just feel that way about everything. Right? Like, I just feel like. We spend so much time reading nonfiction books for information and ideas, but the practical implementation is where transformation occurs. Yeah, Yeah. And for me, a lot of these practices are things that sort of, I stumbled on with my own kids because I was obsessed with thinking. [00:39:32] Yes, I was obsessed with it. So, you know, in that very first chapter where I'm talking about viewpoint and says who, and you know, are we hearing the fairy tale from the Wolf's point of view or the narrator's point of view, or the protagonist point of view? Yes. The reason that I am obsessed with that is that that is the foundation of all critical thinking. [00:39:52] Whose viewpoint Yes. Am I listening to? And what is the criteria by which they create that viewpoint? Mm-hmm. . So we can start that [00:40:00] at age. Totally. Yeah, of course. We would watch these Disney movies and we would analyze the characters to death. Why do we love Ursula? Even though she's the bad character? What is it about her that's compelling? [00:40:13] Why is she more interesting than the good characters? And why would Disney do that? Right? And then you just get into this conversation. What is her sob story? Do we believe it? Does she have some justification for being this angry? Ooh, that's so great. These are great questions. And honestly, they sort of forecast what they'll be encountering in college when they're analyzing. [00:40:35] Absolutely. Lenin versus you know Decart. .  [00:40:39] Maren: I was just gonna say, because it's really easy at five and. To any age, but especially at five or younger where there's this dichotomy, like you said, bad and good things aren't bad and good, and it's, it's really easy to push that thought through, you know, And it's, that can be very scary. [00:40:59] And to [00:41:00] understand that the bad. The bad guys or bad people in movies may have some underlying things going on. What a great discussion and deep thinking for a five year  [00:41:13] Julie: old that Yeah, and you know, they're, they can do that. They're dealing with siblings. Right. How much bullying happens in a family? [00:41:19] Just an absolute ton. Mm-hmm. . Yep. And so if we are only ever treating people in binaries as bad and good, we can easily harden our own families into the good kids, the not good kids. We start scapegoating a child for being disruptive or picking at each other or being loud, and we start treating that child differently because we see them not through a. [00:41:42] Prism of factors, but only through this lens of obedient or cooperative or, you know, creating pleasure for the adult at ease. Right. Versus the child who's taxing and hard. Right? Totally. Yes. And so that's another reason we do this. We want siblings in particular to see a [00:42:00] 360 degree picture of this child. [00:42:02] They have to share a table with, watch a movie, with share a computer, with go on vacations with Right  [00:42:09] Maren: or parents too. Their view of their. Good parent, bad parent, right? Yeah. And it's easy to just say that  [00:42:14] Julie: you're the bad parent.  [00:42:16] Maren: Yeah. You make me do these things. And there's a lot around that too, that they can, they can think criti critically about, which is awesome. [00:42:23] So if there's one thing parents could implement today right now in regards to raising a critical thinker. What do  [00:42:30] Julie: you think that would be? Oh, I love this question. So I'm gonna give you a little story by way of example. This is a practice that you can try. So a lot of people think critical thinking is like opinions about social issues and politics, but that that is just one feature. [00:42:46] Critical thinking is literally every decision you make all day. Mm-hmm. . Mm-hmm. , Which, you know, which way is the fastest to get downtown without traffic is a critical thinking decision. Absolutely. What to eat for. Do I dessert? First, critical [00:43:00] thinking decisions. What we want to do is invite our children to make more of those judgment calls using their own research and data, rather than usurping that role for them. [00:43:13] So I'll give you a a very clear example. Imagine you have an eight year old, it's time for dinner. Mm-hmm. , you say to that child, Hey honey, it's time to wash your hands. It's time for. And this child who has cooperated with this, you know, command for a year sure. Suddenly says, Yeah, I'm not going to, I don't want to [00:43:30] Most parents have one of two ways they respond. There's the authoritarian model which says you have to cuz I said so, right? Mm-hmm. . So you don't really, you could even give a reason, but mostly you're just like, Dude, I'm the mom. You're not. Go wash your hands. The second way is what I call the manipulative obedience model. [00:43:49] What most periods today call cooperation. And what they do instead of requiring obedience is they manipulate it. So what they say is, Oh honey, you must wash your hands. [00:44:00] They're these things called germs and they live on your fingers. And when you touch the food and then eat it, it will go in your body and make you sick. [00:44:06] This is what science tell tells us. Therefore, you must wash your hands right now. In that second model are very proud of that model. Yes. , they're always like, Oh, I would never ask them to do something. I don't explain , but basically what they're doing is they're giving a bunch of information the child doesn't care about. [00:44:25] Nope. And then requiring the child to accept that as better information then the personal experience they're having right now, which is, I don't wanna wash my hands. Exactly. So what I recommend is this. You can't do this every day. Some days you gotta throw 'em in a car seat without an argument and strap 'em in and go. [00:44:41] Mm. But once in a while, go down the rabbit hole. So when your child says, I don't wanna wash my hands, you say, Oh, well that's interesting. Tell me more about that. Why? Why don't you wanna wash your hands? I don't know. I just don't wanna, Is it the temperature of the water? Let me get a thermometer. [00:45:00] Let's measure the temperature, see which temperature is most comfortable for you. [00:45:03] Ooh, I love that. So you start doing that and the child's like, I still hate it. Oh, okay. So it's not the temperature. Is it the wetness? Yeah. I hate how it feels on my hands. Should we try hand sanitizer or it dries faster? Oh no, that's sticky. Well, that's interesting. So here's where I am. I have this belief about germs, but you don't like washing your hands. [00:45:26] I wonder if there's any other information out there about germs and hands. Mm-hmm. . So you do a little research together online, show 'em, and maybe you discover that heat kills germs. And so you say to your child, How would you feel about not washing your hands? And we just blow dry them with a hot blow dryer, , and the child's like that sounds good. [00:45:43] And so you do that or the child still doesn't want to because here's what might be underlying it, your belief in germ. Is actually not a belief. It's propaganda. You've accepted and here's how I know. Didn't your child just eat Cheerios off the [00:46:00] floor without washing their hands? Right? Didn't you at Target watch the baby, spit out the pacifier? [00:46:05] It landed on the floor of Target, you picked it up, sucked the germs off , and then put that pacifier in your baby's mouth. Do you actually believe in germs or you just doing the parental propaganda program where you pass on information, right? Designed to coerce my child. So what I recommend at that point, Either one of these accommodations. [00:46:27] Okay? We're gonna measure the temperature you like it at, You know, 72. We're always gonna wait till it's that temperature or hand sanitizer, or the blow dryer. Or maybe you just roll the dice. You say, You know what? You're right. I don't even know if I believe my own rhetoric. Should we find out if you get sick? [00:46:44] Are you willing for that to be a possible outcome of this? Let's try it for a week. See what happens. Sure. And then see what happens. Right? Right. Give your child meaningful opportunities to collect data, to ask better questions, [00:47:00] to evaluate their experience. To roll the dice and see what the outcome of their hypothesis is. [00:47:07] Now at the start of covid, could you have done this? No. Right, Because we were terrified and we had information our kids didn't have. So at that point, going online, showing them the germs, explaining how people are in the hospital, giving them a meaningful understanding of why you have this level of fear is a great idea, right? [00:47:26] But on the day to day, That's really not what's animating you. Right? And so I think that's where we have to do a better job of interrogating our own positions and our kids give us a chance to do that.  [00:47:38] Maren: Right. And we have to be also, I think careful about imposing our own expectations on their critical thinking. [00:47:46] That's right. Because a five year old may not, even after all that information and all the testing and all the, everything you've done, they might. Yeah. I still don't wanna wash my hands . Right? Because they're not ready for that critical thinking at in that [00:48:00] moment. That's right at for that thing. And that's just where they're at. [00:48:02] You can't force their brain to develop anymore than where they're at right  [00:48:06] Julie: now. No. And that's where, like Dr. Becky Gooden side, Dr. Becky was, is so right on. I'm reading that book right now. Oh, oh, so good. So good. So when. , ask a child to cooperate with your better judgment. Mm-hmm. , you are spending capital in that relationship. [00:48:26] Maren: You are spending capital. Absolutely.  [00:48:28] Julie: And so that's why we want to make some of these demands fewer, you know, we want minimal demands. Yes. And then we want to explore when we can. A child's opposition because maybe it's just that the child was really engaged in a movie and dinner happened and they don't wanna take the time to wash their hands. [00:48:47] Exactly. And dinner delayed. Can we pause the movie? There could be factors here that have nothing to do with critical thinking about hand washing and just convenience that you are tempted to  [00:48:59] Maren: overlook. [00:49:00] Absolutely. And it it, like you said, it also requires us to do our own critical thinking. That's right. [00:49:05] On washing hands or. Eating at 6:00 PM Why does that have to happen, ? That's right. You know there's so many things we can think critically of, and we can be an example of critical thinking. And while our kids might not be like, Oh, mom, you're such a great critical thinker today, , I'm going to follow your example. [00:49:27] The, the consistent, critical thinking every day is going to pay. Them, You know, witnessing that every day and seeing how you are transforming and learning from your own critical thinking. You, our kids can't really help but do that because  [00:49:46] Julie: that's their example. In fact, I have a great story about this. [00:49:51] My son, Jacob, that I mentioned before, when he was in high school, he got very interested in this one social issue that was on the ballot. I'm not gonna name which one it [00:50:00] was just to keep everyone neutral. Mm-hmm. . And so he came to me and he is like, Mom, I can't vote yet, but I did all this research and I wanted to tell you why I think you should vote pro. [00:50:09] So he went through almost a PowerPoint level presentation. He had data and research in his computer was open. Yeah, it was really ad. He was like 16 and it was really good. And at the end I was like, Jake, that makes a lot of sense. I totally get where you're coming from. Thank you for sharing all that with me. [00:50:26] He says, So are you gonna vote pro? I said, No, I'm still voting Con. Yeah. And his eyes squirted tears. And he said, Mom, I count on you to be logical . And I said, Wow. Well, I appreciate you saying that, and I don't wanna discount what you just shared with me, but you, what you shared with me didn't account for all of my concerns. [00:50:51] It accounted for a lot of concerns you have. It didn't account for mine. But don't worry about that because this is my. And I don't have to agree [00:51:00] with you to appreciate the strength of your argument. And I think over time your side's gonna win. But I haven't personally been persuaded yet. Yep. And it was a very difficult moment for him. [00:51:12] Fast forward, you know, he's 30 and I'm older, and interestingly enough, We have just the best conversations. He ended up being the research validator for this book. I let him look. Wow. I paid him to do it. He went through and made sure that my arguments were actually built from solid foundations of evidence and, you know, make sure I wasn't quoting some spurious researcher who mm-hmm. [00:51:38] who happened to find their way onto a webpage I didn't vet. And so just to show. He saw me as a logical person, first of all. Mm-hmm. . Mm-hmm. , which I think is a beautiful credit. Secondly, we had to learn to live with the tension of disagreement, even when we were both being logical. Yep. And then third, we've built a relationship over time that makes it possible for both of us to [00:52:00] respect our capacity to do research and find answers. [00:52:03] And I think if there's anything I would want for parents, that's what it is. It's not agreement, it's not a. It's this dialogical respect for each person's capacity to show up with their own viewpoint while respecting the other person.  [00:52:20] Maren: It's beautifully said. Julie. Thank you so much, and I think that's a perfect place to stop for today, even though I could talk to you for another hour as usual. [00:52:29] But I just appreciate your insight and your encouragement that, you know, we've always, I've always relied on your encouragement through my whole parenting and homeschool journey, so I just thank you  [00:52:41] Julie: so much. Well, you do a great job both on this podcast and with your family, and so I. That you are continuing to put out such good information to your people as you  [00:52:52] Maren: as well. [00:52:52] All right. Take care.  [00:52:54] Julie: Thank you. Bye.  [00:52:56] Angela: All right. Let's move on to our lt [00:53:00] Ws. Yes. Marron. What are you loving this week? Okay. I am  [00:53:03] Maren: loving a book that I actually happen to talk with Julie about Very Oh, very shortly. I mean, we just like, I think Julie just kind of mentioned it in our conversation. You may have. I picked up on it, but I'm actually reading it right now. [00:53:18] And so it was fun to hear Julie mention it. And it's called Good Inside A Guide to Becoming the Parent You want to Be. And it's by Becky Kennedy, Dr. Becky . And it is just a  [00:53:32] Angela: great it is  [00:53:34] Maren: confirming. All of the, all of the healthy things we want to do in our parenting. [00:53:42] And I wanna say homeschooling too. Yeah. I think this is a great book for homeschoolers. It's just a great book. So I just, I, I can't say enough good things about Dr. Becky. She's my new favorite. . Yeah. I feel like she says things first. I was gonna say Angela, she says things that we. [00:54:00] Yeah, I was first gonna say maybe better. [00:54:03] Mm-hmm. , But actually I'm giving ourselves credit, Angela, and I'm gonna just gonna say, she says it in it with a twist, you know, that's, Yeah. On with her specialty, you know, as a doctor for, And I think we have this twist as a specialty, you know, as parents and educators and you know, we  [00:54:17] Angela: have, but we're, we're really share, We  [00:54:20] Maren: really share so much of the same message. [00:54:22] Yes.  [00:54:23] Angela: And so Good. I'm loving. Yeah. You know, people need to hear things in different ways and from different people and I, so I fully support like different people, books and podcast and whatever. Yeah. But she I have not read her book, but I do want to mm-hmm. because what I've really liked about her is you know, she doesn't profess to. [00:54:45] Always do it right, . Exactly. Yep. And she describes that in the book too for sure. Yes. Like she's just coming from a place of like, Look, I'm in the trenches with you too. Like, I get it. Yeah. Things are triggering, things are hard. And [00:55:00] so she's really Supportive in that way. It feels like it feels reachable. [00:55:04] It feels attainable. Yes.  [00:55:06] Maren: And it is good to hear from, you know, a, a, a doctor, a psychologist, you know, who really understands the brain and how it just very intricately.  [00:55:16] Angela: Yes. And so it is, it's, it's science  [00:55:18] Maren: that this is really good parenting and, and it's effective and it's just healthy. Mm-hmm. , it's just healthy for. [00:55:26] Physically, mentally, emotionally,  [00:55:27] Angela: it's all healthy. . Yeah. And her premises, it's called Good Inside because Good inside. Yeah. Because we are all good inside. Yep. Kids too. We're all like wanting to do our Yes. Do good and do our best, so. Yep. Yeah, so I love that. I love that. Yes. Thank you for  [00:55:42] Maren: sharing that. [00:55:43] Yes, of course. I'm, I'm excited for you to read it. I know you will,  [00:55:46] Angela: and it'll be fun. I'll probably listen, Are you listening? I'm listening. Yeah. Yeah. Does she read? Yes. Okay. Yeah, that'll be what I'll do. All right, Angela, what do you loving this week? I am loving something that I think I may have talked to you about in private, [00:56:00] but now I would like the whole world to know about it. [00:56:01] Yes. It's called Calm aid. Oh, yes. And this is a natural supplement for anxiety, overwhelming stress. And you can get it on Amazon and you can get it cheaply. So we have subscribed and saved to it. . That is  [00:56:16] Maren: amazing. You know, it's a, you know, it's a winner. You know, we need it. Subscribe and saved . Yes.  [00:56:21] Angela: And the reason why I like it is because I was. [00:56:25] You know I've been on medication for anxiety and depression. Some of my kids have been on things at different times. Mm-hmm. . Mm-hmm. for different things. And so we have a psychiatrist that we talk to. Yeah. And the psychiatrist was telling me that this calm aid is over the counter, right? Mm-hmm. [00:56:42] it's an over the counter thing, but. In many countries, like European countries, she said it's their first line of defense. For something like anxiety or depression before you, they try other medications. Wow. And so this is just their first go [00:57:00] to. It's real. It's a real, It really works. Yeah. All it is is lavender. [00:57:04] It's lavender. It's a lavender pill. That's all that's in. It is lavender. It's concentrated. It's concentrated. Right. Small capsule that is easy to swallow. Okay. That's what I would need. Yep. Right. So it's in a small, easy to swallow capsule. It's just lavender so you can feel good knowing mm-hmm. , that that's all you're taking. [00:57:22] Yeah. But it really does help. Like I have been taking it every morning. And on the days that I take it, I can tell that I feel much calmer, much less stressed. On the package it says you should take it twice a day. So I think if you were you know, really wanting to be more serious, you could take it twice a day if you were unsure about trying medication. [00:57:42] This could be a good place to start. If you were unsure for one of your kids, this could, this could be a good place to start for one of them too. I just think we more people need to know about it because I had, I had never heard about it until the psychiatrist recommended it, and I just think like, and it gets all these great reviews, so I just think, why [00:58:00] don't, maybe more people already knew about it and I just didn't. [00:58:02] Yeah, right. But. It has really been helpful for me and some of my kids. I was gonna say maybe  [00:58:08] Maren: it's everybody in Europe who's, who's given it all those high stars. I mean, that's, that's amazing.  [00:58:13] Angela: Yeah. So, Well, I'm  [00:58:16] Maren: so glad that you, have you found something for, you know, for Totally. There's so many of, I mean, there are so many of us I think that who could use. [00:58:23] Something like that without a prescription would be  [00:58:25] Angela: great. Mm-hmm. so great. So thank you. And it's just, it's a first, It's, I know it's hard to try medication if you haven't. It is before, it's a hard first step. And so like this, this is something you could try before that if you Yeah,  [00:58:37] Maren: yeah. Mm-hmm. . Mm-hmm. .  [00:58:39] We wanna thank our three sponsors, Blossom and Root Out School and Night Zookeeper. Be sure to check out their links in our  [00:58:49] Angela: show. This podcast is created and hosted by Angela Se and Marrin Gors. [00:58:55] We are listeners supported to get extra content and the Back to School Summit free with your [00:59:00] membership. Go to patreon.com/homeschool on refined. Subscribe to our newsletter and get our free top 100 inclusive booklist@homeschoolonfi.com slash newsletter. You can find Marron on Instagram at unrefined marron and at Always Learning with Marron, and you can find Angela. [00:59:18] Unrefined. Angela

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

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.

It's time to shoot for the stars with Dan Isla, VP of Product at itopia, to talk about everything from astronomical importance of reliability to time zones on Mars. Dan's trajectory has been a propulsion of jobs bordering on the science fiction, with a history at NASA, modernizing cloud computing for them, and loads more. Dan discusses the finite room for risk and failure in space travel with an anecdote from his work on Curiosity. Dan talks about his major take aways from working at Google, his “baby” Selkies, his work at itopia, and the crazy math involved with accounting for time on Mars!In this episode, we cover: Introduction (00:00) Dan's work at JPL (01:58) Razor thin margins for risk (05:40) Transition to Google (09:08)  Selkies and itopia (13:20) Building a reliability community (16:20) What itopia is doing (20:20) Learning, building a “toolbox,” and teams (22:30) Clockdrift (27:36) Links Referenced: itopia: https://itopia.com/ Selkies: https://github.com/danisla/selkies selkies.io: https://selkies.io Twitter: https://twitter.com/danisla LinkedIn: https://www.linkedin.com/in/danisla/ TranscriptDan: I mean, at JPL we had an issue adding a leap second to our system planning software, and that was a fully coordinated, many months of planning, for one second. [laugh]. Because when you're traveling at 15,000 miles per hour, one second off in your guidance algorithms means you missed the planet, right? [laugh]. So, we were very careful. Yeah, our navigation parameters had, like, 15 decimal places, it was crazy.Julie: Welcome to Break Things on Purpose, a podcast about reliability, building things with purpose, and embracing learning. In this episode, we talked to Dan Isla, VP of Product at itopia about the importance of reliability, astronomical units, and time zones on Mars.Jason: Welcome to the show, Dan.Dan: Thanks for having me, Jason and Julie.Jason: Awesome. Also, yeah, Julie is here. [laugh].Julie: Yeah. Hi, Dan.Jason: Julie's having internet latency issues. I swear we are not running a Gremlin latency attack on her. Although she might be running one on herself. Have you checked in in the Gremlin control panel?Julie: You know, let me go ahead and do that while you two talk. [laugh]. But no, hi and I hope it's not too problematic here. But I'm really excited to have Dan with us here today because Dan is a Boise native, which is where I'm from as well. So Dan, thanks for being here and chatting with us today about all the things.Dan: You're very welcome. It's great to be here to chat on the podcast.Jason: So, Dan has mentioned working at a few places and I think they're all fascinating and interesting. But probably the most fascinating—being a science and technology nerd—Dan, you worked at JPL.Dan: I did. I was at the NASA Jet Propulsion Lab in Pasadena, California, right, after graduating from Boise State, from 2009 to around 2017. So, it was a quite the adventure, got work on some, literally, out-of-this-world projects. And it was like drinking from a firehose, being kind of fresh out to some degree. I was an intern before that so I had some experience, but working on a Mars rover mission was kind of my primary task. And the Mars rover Curiosity was what I worked on as a systems engineer and flight software test engineer, doing launch operations, and surface operations, pretty much the whole, like, lifecycle of the spacecraft I got to experience. And had some long days and some problems we had to solve, and it was a lot of fun. I learned a lot at JPL, a lot about how government, like, agencies are run, a lot about how spacecraft are built, and then towards the end a lot about how you can modernize systems with cloud computing. That led to my exit [laugh] from there.Jason: I'm curious if you could dive into that, the modernization, right? Because I think that's fascinating. When I went to college, I initially thought I was going to be an aerospace engineer. And so, because of that, they were like, “By the way, you should learn Fortran because everything's written in Fortran and nothing gets updated.” Which I was a little bit dubious about, so correct folks that are potentially looking into jobs in engineering with NASA. Is it all Fortran, or… what [laugh] what do things look like?Dan: That's an interesting observation. Believe it or not, Fortran is still used. Fortran 77 and Fortran—what is it, 95. But it's mostly in the science community. So, a lot of data processing algorithms and things for actually computing science, written by PhDs and postdocs is still in use today, mostly because those were algorithms that, like, people built their entire dissertation around, and to change them added so much risk to the integrity of the science, even just changing the language where you go to language with different levels of precision or computing repeatability, introduced risk to the integrity of the science. So, we just, like, reused the [laugh] same algorithms for decades. It was pretty amazing yeah.Jason: So, you mentioned modernizing; then how do you modernize with systems like that? You just take that codebase, stuff it in a VM or a container and pretend it's okay?Dan: Yeah, so a lot of it is done very carefully. It goes kind of beyond the language down to even some of the hardware that you run on, you know? Hardware computing has different endianness, which means the order of bits in your data structures, as well as different levels of precision, whether it's a RISC system or an AMD64 system. And so, just putting the software in a container and making it run wasn't enough. You had to actually compute it, compare it against the study that was done and the papers that were written on it to make sure you got the same result. So, it was pretty—we had to be very careful when we were containerizing some of these applications in the software.Julie: You know, Dan, one thing that I remember from one of the very first talks I heard of yours back in, I think, 2015 was you actually talked about how we say within DevOps, embrace failure and embrace risk, but when you're talking about space travel, that becomes something that has a completely different connotation. And I'm kind of curious, like, how do you work around that?Dan: Yeah, so failing fast is not really an option when you only have one thing [laugh] that you have built or can build. And so yeah, there's definitely a lot of adverseness to failing. And what happens is it becomes a focus on testing, stress testing—we call it robustness testing—and being able to observe failures and automate repairs. So, one of the tests programs I was involved with at JPL was, during the descent part of the rover's approach to Mars, there was a power descent phase where the rover actually had a rocket-propelled jetpack and it would descend to the surface autonomously and deliver the rover to the surface. And during that phase it's moving so fast that we couldn't actually remote control it, so it had to do everything by itself.And there were two flight computers that are online, pretty much redundant, everything hardware-wise, and so it's kind of up to the software to recover itself. And so, that's called entry descent and landing, and one of my jobs towards the end of the development phase was to ensure that we tested all of the possible breakage points. So, we would do kind of evil Gremlin-like things. We actually—the people in the testbed, we actually call Gremlins. And [laugh] we would—we—they inject faults during the simulation.So, we had copies of the hardware running on a desk, the software was running, and then we'd have Gremlins go and say like, “Hey, flight computer one just went out. You know, what's going to happen?” And you watch the software, kind of, take over and either do the right thing or simulate a crash landing. And we find bugs in the software this way, we'd find, like, hangs in the control loops for recovery, and we had to fix those before we made it to Mars, just in case that ever happened. So, that was like how we, like, really stressed test the hardware, we did the same thing with situational awareness and operations, we had to simulate things that would happen, like, during launch or during the transit from Earth to Mars, and then see how the team itself reacted to those. You know, do our playbooks work? Can we run these in enough time and recover the spacecraft? So, it was a lot of fun. That's I guess that's about as close to, like, actually breaking something I can claim to. [laugh].Julie: Well, I have to say, you've done a good job because according to Wikipedia—which we all know is a very reliable source—as of May 9th, 2022, Curiosity has been active on Mars for 3468 sols or 3563 days, and is still active. Which is really amazing because I don't—was it ever intended to actually be operational that long?Dan: Not really. [laugh]. The hardware was built to last for a very long time, but you know, as with most missions that are funded, they only have a certain amount of number of years that they can be operated, to fund the team, to fund the development and all that. And so, the prime mission was only, like, two years. And so, it just keeps getting extended. As long as the spacecraft is healthy, and, like, doing science and showing results, we usually extend the missions until they just fall apart or die, or be intentionally decommissioned, kind of like the Cassini project. But yeah.Julie: Well, you've heard it here first, folks. In order to keep funding, you just need to be, quote, “Doing science.” [laugh]. But Dan, after JPL, that's when you went over to Google, right?Dan: Yeah, yeah. So, it was kind of that transition from learning how to modernize with cloud. I'd been doing a lot with data, a lot with Amazon's government cloud, which is the only cloud we could use at JPL, and falling in love with these APIs and ways to work with data that were not possible before, and saw this as a great way to, you know, move the needle forward in terms of modernization. Cloud is a safe place to prototype a safe place to get things done quick. And I always wanted to work for a big tech company as well, so that was always another thing I was itching to scratch.And so Google, I interviewed there and finally made it in. It was not easy. I definitely failed my first interview. [laugh]. But then try it again a few years later, and I came in as a cloud solution architect to help customers adopt cloud more quickly, get through roadblocks.My manager used to say the solution architects were the Navy Seals of cloud, they would drop in, drop a bunch of knowledge bombs, and then, like, get out, [laugh] and go to the next customer. It was a lot of fun. I got to build some cool technology and I learned a lot about what it's like working in a big public company.Julie: Well, one of my favorite resources is the Google SRE book, which, as much as I talk about it, I'm just going to admit it here now, to everybody that I have not read the entire thing.Dan: It's okay.Julie: Okay, thank you.Dan: Most people probably haven't.Julie: I also haven't read all of Lord of the Rings either. But that said, you know, when you talk about the learnings, how much of that did you find that you practiced day-to-day at Google?Dan: In cloud—I've mostly worked in cloud sales, so we were kind of post-sales, the experts from the technology side, kind of a bridge to engineering and sales. So, I didn't get to, like, interact with the SREs directly, but we have been definitely encouraged, I had to learn the principles so that we could share them with our customers. And so, like, everyone wanted to do things like Google did, you know? Oh, these SREs are there, and they're to the rescue, and they have amazing skills. And they did, and they were very special at Google to operate Google's what I would call alien technology.And so, you know, from a principles point of view, it was actually kind of reminded me a lot of what I learned at JPL, you know, from redundant systems and automating everything, having the correct level of monitoring. The tools that I encountered at Google, were incredible. The level of detail you could get very quickly, everything was kind of at your fingertips. So, I saw the SREs being very productive. When there was an outage, things were communicated really well and everyone just kind of knew what they were doing.And that was really inspiring, for one, just to see, like, how everything came together. That's kind of what the best part of working at Google was kind of seeing how the sausage was made, you know? I was like, “Oh, this is kind of interesting.” [laugh]. And still had some of its big company problems; it wasn't all roses. But yeah, it was definitely a very interesting adventure.Jason: So, you went from Google, and did you go directly to the company that you helped start, right now?Dan: I did. I did. I made the jump directly. So, while I was at Google, you know, not only seeing how SRE worked, but seeing how software was built in general and by our customers, and by Google, really inspired me to build a new solution around remote productivity. And I've always been a big fan of containers since the birth of Docker and Kubernetes.And I built the solution that let you run, kind of, per-user workloads on Kubernetes and containers. And this proved to be interesting because you could, you know, stand up your own little data processing system and scale it out to your team, as well as, like, build remote code editors, or remote desktop experiences from containers. And I was very excited about this solution. The customers were really starting to adopt it. And as a solution architect, once the stuff we built, we always open-source it.So, I put it on GitHub as a project called Selkies. And so, Selkies is the Kubernetes components and there's also the high performance streaming to a web browser with WebRTC on GitHub. And a small company, itopia, I met at a Google conference, they saw my talk and they loved the technology. They were looking for something like that, to help some of their product line, and they brought me in as VP of Product.So, they said, “We wanted to productize this.” And I'm like, “Well, you're not doing that without me.” [laugh]. Right? So, through the pandemic and work from home and everything, I was like, you know, now is probably a good time to go try something new.This is going to be—and I get to keep working on my baby, which is Selkies. So yeah, I've been itopia since beginning of 2021, building a remote desktop, really just remote developer environments and other remote productivity tools for itopia.Julie: Well and, Dan, that's pretty exciting because you actually talked a little bit about that at DevOpsDays Boise, which if that video is posted by the time of publication of this podcast, we'll put a link to that in the show notes. But you're also giving a talk about this at SCaLE 19x in July, right?Dan: Yeah, that's right. Yeah, so SCaLE is the Southern California Linux Expo, and it's a conference I really enjoy going to get to see people from Southern California and other out of town, a lot of JPLers usually go as well and present. And so, it's a good time to reconnect with folks. But yeah, so SCaLE, you know, they usually want to talk more about Linux and some of the technologies and open-source. And so yeah, really looking forward to sharing more about selfies and kind of how it came to be, how containers can be used for more than just web servers and microservices, but also, you know, maybe, like, streaming video games that have your container with the GPU attached. The DevOpsDays Boise had a little demo of that, so hopefully, that video gets attached. But yeah, I'm looking forward to that talk at the end of July.Jason: Now, I'm really disappointed that I missed your talk at DevOpsDays Boise. So Julie, since that's your domain, please get those videos online quickly.Julie: I am working on it. But Dan, one of the things that you know you talk about is that you are the primary maintainer on this and that you're looking to grow and improve with input from the community. So, tell us, how can the community get involved with this?Dan: Yeah, so Selkies is on GitHub. You can also get to it from selkies.io. And basically, we're looking for people to try it out, run it, to find problems, you know, battle test it. [laugh]. We've been running it in production at itopia, it's powering the products they're building now.So, we are the primary maintainers. I only have a few others, but, you know, we're just trying to build more of an open-source community and level up the, you know, the number of contributors and folks that are using it and making it better. I think it's an interesting technology that has a lot of potential.Jason: I think as we talk about reliability, one of the things that we haven't covered, and maybe it's time for us to actually dive into that with you is reliability around open-source. And particularly, I think one of the problems that always happens with open-source projects like this is, you're the sole maintainer, right? And how do you actually build a reliable community and start to grow this out? Like, what happens if Dan suddenly just decides to rage quit tech and ups and leaves and lives on his own little private island somewhere? What happens to Selkies?Do you have any advice for people who've really done this, right? They have a pet project, they put it on GitHub, it starts to gain some traction, but ultimately, it's still sort of their project. Do you have any advice for how people can take that project and actually build a reliable, growing, thriving community around it?Dan: Honestly, I'm still trying to figure that out [laugh] myself. It's not easy. Having the right people on your team helps a lot. Like, having a developer advocate, developer relations to showcase what it's capable of in order to create interest around the project, I think is a big component of that. The license that you choose is also pretty important to that.You know, there's some software licenses that kind of force the open-sourcing of any derivative of what you build, and so that can kind of keep it open, as well, as you know, move it forward a little bit. So, I think that's a component. And then, you know, just, especially with conferences being not a thing in the last couple of years, it's been really hard to get the word out and generate buzz about some of these newer open-source technologies. One of the things I kind of like really hope comes out of a two-year heads-down time for developers is that we're going to see some, like, crazy, amazing tech on the other side. So, I'm really looking forward to the conferences later this year as they're opening up more to see what people have been building. Yeah, very interested in that.Jason: I think the conversation around open-source licenses is one that's particularly interesting, just because there's a lot involved there. And there's been some controversy over the past couple of years as very popular open-source projects have decided to change licenses, thinking of things like Elastic and MongoDB and some other things.Dan: Yeah. Totally.Jason: You chose, for Selkies, it looks like it's Apache v2.Dan: Yep. That was mostly from a Google legal point of view. When I was open-sourcing it, everything had to be—you know, had to have the right license, and Apache was the one that we published things under. You know, open-source projects change their license frequently. You saw that, like what you said, with Elastic and Mongo.And that's a delicate thing, you know, because you got to make sure you preserve the community. You can definitely alienate a lot of your community if you do it wrong. So, you got to be careful, but you also, you know, as companies build this tech and they're proud of it and they want to turn it into a product, you want to—it's a very delicate process, trying to productize open-source. It can be really helpful because it can give confidence to your customers, meaning that, like, “Hey, you're building this thing; if it goes away, it's okay. There's this open-source piece of it.”So, is instills a little bit of confidence there, but it also gets a little tricky, you know? Like, what features are we adding the add value that people will still pay for versus what they can get for free? Because free is great, but you know, it's a community, and I think there are things that private companies can add. My philosophy is basically around packaging, right? If you can package up an open-source product to make it more easier to consume, easier to deploy, easier to observe and manage, then you know, that's a lot of value that the rest of the free community may not necessarily need.If they're just kind of kicking the tires, or if they have very experienced Kubernetes team on-site, they can run this thing by themselves, go for it, you know? But for those, the majority that may not have that, you know, companies can come in and repackage things to make it easier to run open-source. I think there's a lot of value there.Jason: So, speaking of companies repackaging things, you mentioned that itopia had really sort of acquired you in order to really build on top of Selkies. What are the folks at itopia doing and how are they leveraging the software?Dan: That's a good question. So, itopia's mission is to radically improve work-from-anywhere. And we do that by building software to orchestrate and automate access to remote computing. And that orchestration and automation is a key component to this, like, SaaS-like model for cloud computing.And so, Selkies is a core piece of that technology. It's designed for orchestrating per-user workloads, like, remote environments that you would need to stand up. And so, you know, we're adding on things that make it more consumable for an enterprise, things like VPN peering and single-sign-on, a lot of these things that enterprises need from day one in order to check all the boxes with their security teams. And at the heart of that is really just increasing the amount of the productivity you have through onboarding.Basically, you know, setting up a developer environment can take days or weeks to get all the dependencies set up. And the point of itopia—Spaces is the product I'm working on—is to reduce that amount of time as much as possible. And, you know, this can increase risk. If you have a product that needs to get shipped and you're trying to grow or scale your company and team and they can't do that, you can slip deadlines and introduce problems, and having a environment that's not consistent, introduces reliability problems, right, because now you have developers that, “Hey, works on my machine.” But you know, they may have—they don't have the same machine, same environment as everyone else, and now when it comes to reproducing bugs or even fixing them, that you can introduce more problems to the software supply chain.Julie: I mean, that sounds like a great problem to solve and I'm glad you're working on it. With your background being varied, starting as an intern to now where you personally are being acquired by organizations. What's something that you've really learned or taken from that? Because one thing that you said was that you failed your first Google interview badly? And—Dan: Yes. [laugh].Julie: I find that interesting because that sounds like you know, you've taken that learning from failure, you've embraced the fact that you failed it. Actually, I just kind of want to go back. Tell us, do you know what you did?Dan: It was definitely a failure. I don't know how spectacular it was, but, like, [laugh] google interviews are hard. I mean—and that's just how it is, and it's been—it's notorious for that. And I didn't have enough of the software, core software experience at the time to pass the interview. These are, like, five interviews for a software engineer.And I made it through, like, four of them. The last one was, like, just really, really, really hard and I could not figure it out. You know, because this is, like, back in the day—and I think they still do this, like, where you're, like, coding on a whiteboard, right? Like, okay, right, this C code on a whiteboard, and it has to work. You know, the dude is, like, right, there compiling it, right? Like, “Okay, [unintelligible 00:23:29], boy.” [laugh].So, not only is a high stress, but it has to be right as well. [laugh]. And so, like, it was just a very difficult experience. And what I learned from that was basically, “Okay, I need to, one, get more experience in this style and this domain of programming, as well, as you know, get more comfortable speaking and being in front of people I don't know.” [laugh].So yeah, there's definitely components there of personal growth as well as technical growth. From a technical point of view, like, my philosophy as being an engineer in general, and software developer, is have a really big toolbox and use the tools that are appropriate for the job. This is, like, one of my core philosophies. Like, people ask, you know, ‘what language do you use?' And I'm like, “Whatever language you needed to solve the problem.”Like, if you're writing software, in a—with libraries that are all written in C, then don't try to do that in, like, Java or something, in some other language that doesn't have those language bindings. Don't reinvent the language bindings. You follow the problem and you follow the tech. What language, what tool will best solve this problem? And I'm always working backwards from the problem and then bringing in the right tools to solve it.And that's something that has paid off in dividends because it's very—problem-solving is fun and it's something I always had a passion for, but when you have a toolbox that is full of interesting gadgets and things you can use, you get excited every time you get to use that tool. Like, just like power tools here, I have a—I don't know, but it's like, “Yeah, I get to use the miter saw for this thing. Awesome. I don't have one? Okay, I'm going to go buy one.” [laugh].Julie: That's actually—that's a really good point, one of the talks that I gave was, “You Can't Buy DevOps.” And it was really all about letting developers be part of the process in choosing the tools that they're going to use. Because sometimes I think organizations put too many constraints around that and force you to use these tools that might not be the best for what you're trying to accomplish. So, I like that you bring up having the ability to be excited about your toolbox, or your miter saw. For me, it would be my dremel. Right? But what tool is going to—Dan: [crosstalk 00:25:39] cool.Julie: Yeah, I mean, they really are—what tool is going to be best for the job that you are trying to accomplish? And I think that that's, that's a big thing. So, when you look to bring people onto your team, what kind of questions do you ask them? What are you looking for?Dan: Well, we're just now starting to really grow the company and try and scale it up. And so we're, you know, we're starting to get into more and more interview stuff, I try to tell myself, I don't want to put someone through the Google experience again. And part of that is just because it wasn't pleasant, but also, like, I don't know if it was really that useful [laugh] at the end of the day. And so, you know, there's a lot about culture fit that is really important. People have to be able to communicate and feel comfortable with your team and the pace that your team is working at. And so, that's really important.But you know, technically, you know, I like to see a lot of, you know—you got to be able to show me that you can solve problems. And that can be from, you know, just work that you've done an open-source, you know, having a good resume of projects you've worked on is really important because then we can just talk about tech and story about how you solve the problem. I don't have to—I don't need you to go to the whiteboard and code me something because you have, like, 30 repos on GitHub or something, right? And so, the questions are much more around problem-solving: you know, how would you solve this problem? What technology choices would you use, and why?Sometimes I'll get the fundamentals, like, do you understand how this database works at its core or not? You know, or why is it… why is that good or bad? And so, looking for people who can really think within the toolbox they have—it doesn't have to be a big one, but do they know how to use the tools that they've acquired so far, and really, just really, really critically think through with your problems? So, to me, that's a better skill to have than just, you know, being able to write code on the whiteboard.Julie: Thanks for that, Dan. And earlier, before we started the official recording here, you were talking a little bit about time drift. Do you want to fill everybody in on what you were talking about because I don't think it was Doctor Strange and the Multiverse of Madness?Dan: No. [laugh]. I think there were some—we were talking about um…clocks?Julie: Clocks skew.Dan: Daylight savings time?Julie: Yeah.Dan: Clock skew, clock drift. There was a time at JPL when we were inserting a leap second to the time. This actually happened all throughout the world, where periodically that the clocks will drift far enough because the orbits and the rotation of the planet are not, like, perfectly aligned to 365 days in a year and 24 hours in a day. And so, every so decades, you have to insert these leap seconds in order to catch up and make time more precise. Well, space travel, when you're planning, you have to—you're planning to the position of the stars and the planets and the orbital bodies, and those measurements are done at such a large scale that you have—your precision goes, like, way out, you know, many, many decimal places in order to properly plan to the bodies up big.And with the Mars Rover, one of these leap seconds happened to come in, like, right, before we launched. And it was like, oh my gosh, this is going to be to—change all of our ephemeris files—the data that you use to track positions—and we had to do it, like, synchronize it all, like, right, when the leap second was going in. And we tested this extensively because if you get it wrong with your spacecraft is traveling, like, 15,000 miles an hour towards Mars, and a one-second pointing error from Earth means, like, you missed the whole planet, you won't even get there. [laugh]. We're not talking about, like, missing the landing site of, like, a few kilometers. No, it's like thousands of kilometers in pointing error.So yeah, things are astronomical [laugh] in units. Actually, that's why they're called AU, astronomical units, when you're measuring the distance from the Sun. So yeah, it was a pretty fun time. A little bit nerve-wracking just because the number of systems that had to be updated and changed at the same time. It's kind of like doing a rolling update on a piece of software that just had to go out all at the same time. Yeah.Jason: I think that's really interesting, particularly because, you know, for most of us, I think, as we build things whether that's locally or in the cloud or wherever our servers are at, we're so used to things like NTP, right, where things just automatically sync and I don't have to really think about it and I don't really have to worry about the accuracy because NTP stays pretty tight. Usually, generally.Dan: Mm-hm.Jason: Yeah. So, I'm imagining, obviously, like, on a spacecraft flying 15,000 miles a second or whatever, no NTP out there.Dan: [laugh]. Yeah, no NTP and no GPS. Like, all the things you take for granted, on Mars are just not there. And Mars even has a different time system altogether. Like the days on Mars are about 40 minutes longer because the planet spins slower.And my first 90 sols—or days on Mars—of the mission, the entire planning team on earth that I was a part of, we lived on Mars time. So, we had to synchronize our Earth's schedule with what the rover was doing so that when the rover was asleep, we were planning the next day's activities. And when it woke up, it was ready to go and do work during the day. [laugh]. So, we did this Mars time thing for 90 days. That was mostly inherited from the Mars Exploration rovers, Spirit and Opportunity because they were only designed to live for, like, 90 days.So, the whole team shifted. And we—and now it's kind of done in spirit of that mission. [laugh]. Our rover, we knew it was going to last a bit longer, but just in case, let's shift everyone to Mars time and see what happened. And it was not good. We had to [laugh] we had to end that after 90 days. People—your brain just gets completely fried after that. But it was bizarre.And there's no time. You have invent your own time system for Mars. Like, there's no, it was called LMST, or Local Mars Standard Time, local mean standard time. But it was all, like, relative to, you know, the equator and where you were on the planet. And so, Mars had his own Mars time that counted at a different rate per second.And so, it was funny, we had these clocks in the Mission Control Room that—there was this giant TV screen that had, like, four different time clocks running. It had, like, Pasadena time, UTC time, Mars time, and, like, whatever time it was at the Space Network. And I was like, “Oh, my gosh.” And so, we were always doing these, like, time conversions in our heads. It was mental. [laugh]. So, can't we just all be on UTC time? [laugh].Jason: So, I'm curious, with that time shift of being on Mars time and 40 minutes longer, that inherently means that by the end of that 90 days, like, suddenly, your 8 a.m. Mars local time is, like, shifted, and is now, like, hours off, right? You're waking—Dan: Yeah.Jason: Up in the middle of the night?Dan: Totally, yeah.Jason: Wow.Dan: Yeah, within, like, two weeks, your schedule will be, like, upside down. It's like, every day, you're coming in 40 minutes later. And yeah, it was… it was brutal. [laugh]. Humans are not supposed to do that.If you're actually living on Mars, you're probably okay, but like, [laugh] trying to synchronize those schedules. I thought you were going from East Coast to West Coast time, working remote was hard. And, like, [laugh] that's really remote.Julie: Dan, that's just astronomical.Dan: [laugh].Julie: I'm so sorry. I had to do it. But with that—[laugh].Jason: [laugh].Dan: [laugh]. [unintelligible 00:33:15].Julie: With that, Dan, I really just want to thank you for your time on Break Things on Purpose with us today. And as promised, if I can find the links to Dan's talks, if they're available before this episode posts, we will put those in the show notes. Otherwise, we'll put the link to the YouTube channel in the show notes to check for updates. And with that, I just want to thank you, Dan, and wish you a wonderful day.Jason: Before we go, Dan, do you have anything that you'd like to plug? Any projects that people should check out, where they can find you on the internet, stuff like that?Dan: Yeah, thank you guys very much for having me. It was a great conversation. Really enjoyed it. Please check out our new product, itopia Spaces, remote developer environments delivered, powered by Selkies. We launched it last fall and we're really trying to ramp that up.And then check out the open-source Selkies project, selkies.io will get you there. And yeah, we're looking for contributors. Beyond that, you can also find me on Twitter, I'm @danisla, or on LinkedIn.Jason: Awesome. Well, thanks again for being a part of the show. It's been fantastic.Dan: You're very welcome. 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.

In this episode, we cover: Introduction (00:00) “Embracing Change Fearlessly” (01:45) Fearless change enabling good work (04:00) The culture change that needs to happen (06:10) How to talk to your leaders (10:45) “The Adolescent Version” of engineering (14:40) How Natalie prioritizes time, speed, and efficiency (18:42) Natalie's keynote (26:48) Links Referenced: Gremlin: https://www.gremlin.com/ gremlin.com/podcast: https://gremlin.com/podcast loyaltyfreakmusic.com: https://loyaltyfreakmusic.com TranscriptNatalie: I like this—I call it the adolescent version of engineering. It's where, you know, we're through the baby part, we need to start to grow up a little bit, we need to go from getting stuff done in some way or another, to something that's repeatable and scalable. And so, it's like, that adolescent years, that's my fun. That's what I enjoy doing. I call it creating something out of chaos.Basically, taming the chaos is what it really looks like because it's very chaotic initially, and that's true of every, like, small organization; they always start like that. And as they start to grow, you know, you've got ten different engineers who have ten different opinions on how something should be done, and so they do it ten different ways. And that's fine when you're only ten, but then when you need to go from 10 to 20 to 30 to 100, it no longer works.Julie: Welcome to Break Things on Purpose, a podcast about reliability, culture change, and learning from failure. In this episode, we talk with Natalie Conklin, head of engineering at Gremlin, about the importance of embracing change, and how we can all work through our fears and work together to build more reliable systems. Natalie, I'm so excited to have you here with us today. And today is actually a really big day because it is the fifth year of DevOpsDays Boise, which you are doing the closing keynote for. So, really excited to have you both on the podcast and at the conference today. And your talk is titled “Embrace Change Fearlessly.” So, do you want to kick off by telling our listeners a little bit about you and what you're going to be talking about?Natalie: Sure. Thanks for having me. I am excited about both, sort of, [laugh] which is exactly what the talk is about. [laugh]. The talk is really about being able to embrace change fearlessly, and that it's rarely ever fearlessly truly, but mostly around being able to do what makes you afraid anyway.I'm not a big public speaker, so that's something I've had to work hard at trying to be able to be more comfortable doing. And so, this is an exciting time for me. But background-wise, I am the head of engineering currently for Gremlin and had been leading engineering teams for growth companies for just over a decade. And a lot of what I end up doing centers around this: It's helping those engineering teams be willing to move forward in risky—because in growth companies, a lot of times you're building things that are brand new, this is not something that, you know, has been out there and done, so they typically have to do something new for the first time. And so, being able to take calculated risks is tough. It's hard stuff. And so, getting into the right mindset to be able to push through that, that's a lot of what I ended up doing.Julie: I love that. And that's actually a really good point that you're bringing up, you know, growth companies and being in the right mindset. So, one of the things you and I talked about when I was starting here at Gremlin and getting to know you a little bit about your background, which is really cool. You lived in India for a few years, correct?Natalie: I did. I lived there for two years. I was working for a company, we were doing big data analytics for telcos, building big, large platform that we would then do some custom development work off the top of for these various telco companies. And the team over there had experienced some turnover, and so there was a lot of quality issues and things of that nature starting to show up for the first time. This had been a very rock-solid team, honestly, and so the company asked if I would be willing to go to India to figure out what was going on. And so, that was what I did. It was a great opportunity; loved doing it.Julie: So now, as you work with teams to embrace change fearlessly, and we talk about you mentioned the ROI and doing things in new ways and building new things, do you have an example of maybe when you built something new or your team built something new, and it changed the way we work?Natalie: Well yes, an easy answer would just be to fall back on the India example for a second, right? So, a lot of what I did when I went there was they were a very waterfall shop, converted them over to Agile practices and DevOps. They had really none of that practice existing. So, when you ask the company—or the, I'll just say the team to go through that sort of transition, you're pretty much asking them to change everything about the way they work. And we focused a lot more —there was a lot of manual processes that they had been doing previously and we were automating all of those had to do the automations, but then also, you know, make sure that work fit into this new automated way of doing things.They also had, just, also the trepidation over am I going to still be needed, right? Those are all those things that come into your mind when you're basically changing from a manual process to an automated process, “Am I still going to be needed? Is my work going to still be important? What am I going to do in this new world, in this new environment?” There's a lot of that that pops up into people's heads.So, a lot of making the change successful, there's certainly the technical aspects of getting it automated and all those things, but to really make a change successful on that kind of scale, it requires getting people to think about it differently and to be okay, and to realize that they can learn new stuff and they'll come out of this better than how they went in. And a lot of that takes a lot of, just, communication and talking, being very personal with people, making sure that they personally understand how to do this, but then just also, things like training and coaching and making sure that there are people there to counter the negative energy that comes along with change. There's always negative energy that comes along with it, people are nervous, they're scared, and you have to be able to counter that in some way.Julie: You know, there was a talk I gave a while ago, and I'm trying to remember the name of it, but one of the things that I talked about was the Pareto Principle, which is, what, 20% of people are going to be amazing in an organization, 60% are going to be, you know, middle of the road, then you have that bottom 20% that are going to kind of fight that change. And you shouldn't really necessarily focus on that top 20%, but you should put a lot of the focus on bringing that bottom 20% along with you. And we talk a lot about just the cultural change that needs to happen when we talk about Chaos Engineering, for example. I mean, there's a huge cultural change that organizations need to switch that mindset into embracing failure. Which we talk a lot about, but it's hard for folks to embrace change fearlessly, embrace failure fearlessly.When you've been going through these experiences in the past—and you mentioned that you really need to think about the people—what's one of the common fears? You said, you know, people worry about their jobs and worry about being left behind. Work us through how do you help folks with that?Natalie: Yeah, I think that's actually one of the most interesting aspects of this. When you start looking at—when I [start talking about 00:07:18] about, you know, people don't change, when it's something that's personal like getting married or having kids or going off to college, you know, these are all huge life changes, and we celebrate those, we have parties, we're super happy, we think they're fantastic, right? And I mean, if I go back to India for a second, these are the same people that are struggling on, you know, the fact that I'm going to change from a manual testing to an automated testing, will actually go through an arranged marriage where they're marrying someone that they don't know super well, but they're very happy about it, right? So, that's one of the things that I like to point out and have a discussion with people about is that you're not afraid of change; you're afraid of change in your work life, right? And we have to be very specific about that because we start talking about humans are afraid of change, I actually don't agree. I think we're just afraid of changing what we do at work.And usually, that's because that's somehow tied to our needs pyramid, right? Like, that's how we get our needs met from food and shelter and all of these other kinds of things. And so, when we start to threaten that, it gets really, you know, sketchy for a minute, right? So, that's when we have to, like, take a minute and realize what we're doing and realize that we're being overly protective of a part of our world that, you know, we somehow feel like it's going to then have us begging on the street, is the example I give in my talk, right? That's not going to happen. Like, you know, that's just an irrational fear.And it's highly unlikely that that's your right answer. So, what I encourage people to do is to actually find a logical, kind of, sounding board, person, a mentor, a friend—and again, if you don't have this person in your life, then you know, find that person, but start talking to them about, like, what's most likely to happen in this scenario? Or, better yet, what can I get out of it? I think if you spent less time on that and spent, you know, more time on, like, what can I actually get out of this, how could this benefit me, and sort of flip that in your brain.Because what our brains are incredibly good at doing is going down that worst possible path. But the real truth is, we're just as capable of imagining the good. It's just a matter of focus. So, why don't we just focus on that instead? We can focus on what's the positive part of this, what could happen, and we're actually much more likely—there's a whole lot of studies around manifestation—and we can manifest that in our life if we want to, right? So, we just need to focus on the positive side of it.So, I—literally it's honestly a bunch of personal conversations, and getting people to just calm down and realize that the likelihood of their worst-case scenario is not really real. And then start to think through, okay, what can you actually learn from this? You know, is there something that you would like to get out of this? Would you like to try a new role? Would you like to try to lead an initiative? Would you like to be part of this in some way, right?So, those conversations—and again, it has to be personal. That's the thing that I think, you know, when you start doing widespread, full organizational changes, which I was doing over there and I had 120 engineers, it's hard to do it personally because you literally have to have one-on-one conversations with everybody and understand what they are going to get out of it. But that is what's required. I think, to really get people to a comfort zone, you've got to make sure that they understand how they fit in, and their why; why they're doing it.Julie: And that is all amazing. Now, as the leader, as the head of engineering and an organization, how do you recommend individual contributors talk to their leaders? Or how do they bring up concerns in a way that's productive in an organization? Because I know for me, sometimes—and you're right, I am excellent at going down that every possible negative outcome path; I've planned it out pretty well, to my peril, but that means that when I bring up concerns with leadership, I tend to do so in a heightened emotional state. So, what's your advice for folks?Natalie: Well, and it's just that. I think it's exactly where you're headed with that is that take the emotions out of it—or attempt to—and try to present your concerns logically. Because there's going to be situations where what you're bringing up is something they need to consider, and if you can present it in a logical way, chances are they will, and they'll take that into consideration. So, I would—like, even if they are going to still move forward with the plans that you've somehow don't agree with, like, let's assume that some portion of this change, you don't feel is correct, which is actually one of the most legitimate reasons to worry about this, then what you should do is say, “Okay, look, I have this concern, so here's the Plan B. But just in case, this doesn't work. But I think it might not, so here's a Plan B.”Like, that's a way of presenting that in a way that's not challenging to the situation. So, I'll give you an example. In the India conversations, one of the things was that I actually did create a Plan B around was the fact that the person was bringing up—I was attempting to have Agile teams where they needed to have very strong ownership, they also needed to be able to self-manage. We talked about self-managed teams in Agile. And India is a very hierarchical culture, and so the thing that they brought up with me is that this isn't going to work here; it culturally isn't a good fit.And frankly, I knew that I was going to—I had this issue it within the company, but was it so widespread within India that I couldn't possibly change it? I hadn't lived there my whole life, I couldn't say, right? So, I needed to actually answer that question. And I thought it was a legitimate question, right? And I thought—but it was presented in, you know, a very factual, logical way, and kind of without the emotions, and so it's like, “Okay, let me think through that.”And so, we did this as a—you know, we created an experimental team where we tried this out to see if it would work. And it actually did, ultimately, succeed with that team. And I love this team because —I mean, to be fair, I did handpick who went on this team. Like, I did, you know, try to pick people who I thought might be the most likely to succeed. I'm not crazy; I did want it to work, and so you know, I did sort of seed it a bit.But at the same time, when they came out of that—and they tend to be a little bit younger than I think some of the, you know—because I think their minds were a little bit more open as part of that, but they came out of that, and after about nine sprints, you started to see the junior engineers challenging the more senior engineers, which in India is not like something that you see all that often. They were also able to —the junior engineers were having opinions, they were contributing to the technical discussions. Like, it was actually a pretty radical shift. But they also kind of walked around with this, like, certain swagger that I cannot describe. But it was, like, super fun to watch.So, you know, you've got to see that this was actually going to work, and it could work. And then it became a really good example, for the rest. So, I think the main thing is to help mitigate risk. If you have a real concern over a change that's coming your way, and it's something you don't feel like the company should do, just understand that they may do it instead and that's not personal, but at the same time, you know, you can help by offering a Plan B or some risk mitigation to double-check that it is going to work or to help it work.Julie: Absolutely. It's kind of that whole testing hypothesis, right? We're going to see if this works; we're going to evaluate it. One of the things that you brought up that I love and it was something that when I was at PagerDuty, we used to talk about a lot with the postmortem process, which was to involve junior engineers because they tend to look at things differently with that fresh set of eyes.Natalie: Right.Julie: And they kind of get us a little bit—the people who've been doing it for a very long period of time—a little bit out of your comfort zone because all of a sudden, maybe you're having to explain something. Jason and I have talked about this a few more times probably than necessary, but just, “Well, we've always done it this way because…” and then having to explain that because. You know, one of the things that I find interesting just from your background is—you know, we've talked about this, where you scaled that engineering team from 0 to 100, to deliver on custom software engineering contracts, and you've done quite a few things over your career. I mean, even working at Oracle—which we were actually just talking about an Oracle outage this morning—but, driving technical programs. And that seems to be a lot of your background. I mean, even at Facet, that you introduced engineering best practices to standardize code reviews and improve test coverage. Do you want to talk a little bit about that?Natalie: Yeah, I think—I like this—I call it the adolescent version of engineering. It's where, you know, we're through the baby part, we need to start to grow up a little bit, we need to go from getting stuff done in some way or another, to something that's repeatable and scalable. And so, it's like, that adolescent years, that's my fun. That's what I enjoy doing. I call it creating something out of chaos.Basically, taming the chaos is what it really looks like because it's very chaotic initially, and that's true of every, like, small organization; they always start like that. And as they start to grow, you know, you've got ten different engineers who have ten different opinions on how something should be done, and so they do it ten different ways. And that's fine when you're only ten, but then when you need to go from 10 to 20 to 30 to 100, it no longer works. And you do have to create some standards and still leave enough leeway for people to be able to have their tool of choice based on, you know, what makes sense, right?So, there needs to be some pragmatism in there, you can't just, like, also go the [unintelligible 00:16:54] where it's just one thing. But at the same time, there is some standards and there is some consistency that needs to be created so that, like, when you're onboarding a new engineer, there's not 20 things to learn; you can reduce that down to something that's manageable and you can get somebody onboard and productive within a reasonable amount of time. Otherwise, that's difficult, even that becomes difficult. So, every part of it that needs to have some level of standards around it—I think the fun in it, too, is finding that balance between introducing enough process that you have some standardization, you have some consistency, but not so much that you slow it down to the point that it's no longer moving. Because you can; you can strangle a small organization with too much process.So, it's finding that middle ground. And yeah, that's what I've pretty much done, like, my whole career in some form or another; it's what I enjoy. And if it gets to the point where things become too standard, too stable, to done, then I'm probably… I'm going to need to move on to something different and new. You know, that's going to be where I go do this again, with somebody else.Julie: Hashtag #startuplife, right?Natalie: [laugh].Julie: [laugh]. That's interesting that you bring up, you know, going from ten people to more, right, where you can just buy any tool you want and reimburse it, and there might not even be a central repo of all the tools that the organization has, to whittling that down into processes that you own, that you control, versus processes that control you. And then bringing those ten people that were there at the beginning that could kind of do whatever they want because the whole goal is to bring this product to market, to refining that organization and helping build out features in service of the customer. So, when you're looking at the new things that you want to do or prioritizing your time or the engineering team's time, what are some of the things that you take into consideration?Natalie: It's kind of actually very similar to performance when you look at the performance of a system, right? The engineering organization is no different. You need to find your bottlenecks and then you work from there. And the bottlenecks are different depending on which team that you're looking at, right? So, I like to start to kind of get a feel for what's working, what's not working, and where things are slow, [unintelligible 00:19:15] oftentimes what I'm trying to do is to get some speed, to get some speed and consistency tend to be really big things without losing quality. You know, all of those kinds of—those are the always the buckets, right?And so, when you start looking at speed, it really starts to look very much like that performance bottleneck exercise where you just start hitting them one at a time until you, you know, you get through the easy ones and then you start tweaking from there. But for instance, I'll tell you when I first started with Gremlin, we had a very large team and because of that, stand-ups were very huge, there was too much conversation, they took too long, people —actually the odd thing is that you'll find people have less ownership when the team is too large because they don't feel like they're as part of something that they're making a huge —as much of an impact on; they don't feel their impact on a team that's too large, so when you're organized in such a way that the teams are very large, you tend to lose some of the qualities of Agile that you're trying to achieve when you're doing these little small Agile teams, or at least that's the thought. So, one of the things I did was split the team. And one of the first things that I did—and that automatically started to create a different dynamic within the teams, and we're starting to see the results of that. And so, I feel like those are the kinds of things that you do.Like, that was an easy one; we have to do this, like, that first. Now, like, what do we do next? It depends. It depends, like, where, like, in some cases—I'll take India, for example—there was a lot of tech debt. So, I had some tech debt that I had to contend with and deal with that was—the way it was built, it was built with this very huge monolithic-style service, and I needed to help them start breaking that into smaller services, mainly because—and they were such a large team, and it was still a monolithic sort of situation, the problem was actually more so than the performance because they had tuned the heck out of that, so that wasn't it.Like, the data was very large, so they had already dealt with performance. But the conflict within the engineering teams was a lot because there was so much coordination. And so, by being able to split this up into services that make sense, then the teams can start to own the services and be able to deliver on that with some speed without having to coordinate so much. And every moment of coordination costs you time, right? So, that's the type of things that you start to look at.And it could be a technical solution, like in this case, it was breaking the technology, from an architectural standpoint, down into something that make the teams operate differently, or it can be splitting the teams itself without changing the architecture. It can be any number of things. But really start to have to look at what's causing this to go slow.Julie: Now, I love that because when everybody owns everything, nobody owns anything, right? And you talked about breaking the teams down into service teams that makes sense. And so, it sounds like it was incredibly intentional; owning your services all the way through into production is really helpful with that speed and that quality. And you mentioned that briefly earlier, which is—what is that? The iron triangle, or whatever they call it, but speed, cost, quality. There's three things; you can only have two. Which two do you pick?Natalie: Right. [laugh]. Exactly.Julie: And I've seen that titled as a fallacy saying that you can really have all three, but I don't really know. What do you think? Speed, cost, quality, can you have all three?Natalie: Well, so you can maybe have speed, cost, and quality, but if you throw scope in there, [laugh] and you throw that into your [unintelligible 00:22:41], right? Like, because [unintelligible 00:22:42] where you have to start throwing that in. Like, if you look at—so, you know, the triangle that we tend to look at is the time that you're going to deliver it in, the scope, and the price. Those are the three that I think you can only hold two of. You can go—so by speed when you say speed, cost, and quality, if you go back to your you know, your original one, depends on what how you define speed on whether or not you get quality out of that, right? [laugh].And so, when you say—but when you start putting deadlines on things, then yeah, you can get quality so long as I can control the scope, right? Because then I can scope it down enough that I can deliver something within that timeline that is of high quality, right? So, those are the trade-offs that you have to make? And no I don't —I still feel like in that particular three-legged stool, you know, there's only two of those you get, that somebody else outside of your organization can handle. You do have to —otherwise, you know, you can't possibly deliver everything in the world within a really short timeframe and expect the quality to be high.Julie: Yeah, wouldn't that be nice if you could, right? But that's why we talk about learning from our failures. That's why we talked about Chaos Engineering and understanding our systems. Because in all reality, we do have timeframes that we need to get things out, and we have to make our systems as reliable as possible. But then where do we find the gaps that we may have missed because of speed, because of that timeliness?Natalie: Well, and when you start looking at things like, you know, quality, there's certainly things that you can do, but if you go back to Chaos Engineering—we talk about that for just a second, and we look at the changes that people are afraid of. What happens when you go in and you tell a place, “To improve your quality I'm going to actually start shutting down your host.” They're like, “I'm sorry, what?” [laugh].Julie: [laugh].Natalie: That's a very difficult conversation, right? So, I feel like it's one of those things where once you see that and why you would do it and then, like, you make the adjustments to that, and then it becomes a part of your—doing this sort of change is actually, you know, something that you just do on a continuous basis; it's no longer something that you're afraid of, right? And I think that's true of just [unintelligible 00:24:48] in general. Like, you know, once you start getting into the habit of it, whatever that habit might be—and automation, by the way, is one of those things—and whether it be automating regular tests, whether it be automating Chaos Engineering tests, like any of this automation, that's actually a key to speed with engineering. And the reason for that is because those are so closely linked.I go back and I talk about automation and confident mindset. This is really the two things that give you speed in engineering organization. And the reason is because if you can automate it enough, you can—you know, obviously there's just some speed that comes from automation, you know, that you're not doing things manually, that's great. But the thing that you miss in that, or that you don't necessarily think of, is the fact that there, like, an automated safety net under you, like, through testing, through, like, you know, the systems-level testing, Chaos Engineering, you know, the engineers now feel more free, they're more confident, they're able to make changes at a much more rapid pace. It feels less risky because they're able to make this change and then they know that the tests are going to catch them, right?So, if they've screwed something up, something else is going to stop it before it heads to production. So, they're just more—they're able to just move forward at a faster pace than they would otherwise, right? So, that automation, the speed that you get out of it goes far beyond just you taking the manual process down to an automated one; it's creating the safety net that gives them the confidence to just move without thinking. And that's huge. Like, that's a big deal.It's also—back to your thoughts on junior engineers—it's also why I think it's really important to make sure there's people in the engineering team who [unintelligible 00:26:26] three years, like, three years of experience. It's like you know enough that you can make really good progress and you can be useful, but you don't know so much that you're afraid. Like, there—laugh] because that confident mindset I'm back to, it really matters. Like, it makes such a big difference in the teams that will move quickly and teams that will not.Julie: I love everything that you just said. And I just saw a tweet from Kelsey Hightower that he tweeted just a couple of days ago; I saw it just before we recorded this. So, he said, “…as an industry we've been pushing… Automate. Automate. Automate. And we haven't been saying… Understand. Understand. Understand. Because if you understand what you're doing, you can automate it if you want to.”And I think you just touched on that. And I think you touched on a lot of the having confidence, that what you're doing—that there's safety and even if there are failures, that they're going to be caught. And I think that all ties together beautifully. Now, with that, because I do realize that we are running out of time, I just want to say, so for you, you are giving the closing keynote today at DevOpsDays Boise. And we've talked a lot about overcoming fear during this podcast, and I know that this was something that made you a little bit uncomfortable. Can you tell me why you chose to do this? Why did you choose to overcome this fear?Natalie: Because of my position and the fact that I'm female, I get offers. And I just made a deal with myself about, you know, a few months ago that said, you know, I wouldn't turn these down. And primarily it's because I feel like it's important that at least some women are out there and are serving as examples for others. Like, I'm not saying that I'm going to have, like, the best things to say all the time, and I think that's okay. I don't think every man that comes on a podcast has the best things to say either, right?So, I feel like it's just one of those situations where we need examples for ourselves, and I think it's important that, you know, we see ourselves in the—in what's—in what's, I guess, the speakers and the participants, right? And so, I want to make sure that I do my part in that, I guess.Julie: Well, thank you. And you heard it here first, folks. If you need Natalie to speak at your conference, she made a deal with herself [laugh] that she would not say no. We're really excited to have you both on the podcast and speaking at DevOpsDays Boise. So, thank you, Natalie, and thank you for joining us on Break Things on Purpose. And good luck on your talk today.Natalie: Thank you. Appreciate it. Enjoyed it. [laugh].Julie: Have a wonderful day.Natalie: You too.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.

In this episode, we cover: Introduction (00:00) How Chris got into the world of chaos and teaching middle school science (02:11) The Cengage seasonal model and preparing for the (5:56) How Cengage schedules the chaos and the “day of darkness” (11:10) Scaling and migration and “the inches we need” (15:28) Communicating with different teams and the customers (18:18) Chris's biggest lesson from practicing chaos engineering (24:30) Chris and working at Cengage/Outro (27:40) Links Referenced: Cengage: https://www.cengagegroup.com/ Chris Martello on LinkedIn: https://www.linkedin.com/in/christophermartello/ TranscriptJulie: Wait, I got it. You probably don't know this one, Chris. It's not from you. How does the Dalai Lama order a hot dog?Chris: He orders one with everything.Julie: [laugh]. So far, I have not been able to stump Chris on—[laugh].Chris: [laugh]. Then the follow-up to that one for a QA is how many engineers does it take to change a light bulb? The answer is, none; that's a hardware problem.Julie: Welcome to Break Things on Purpose, a podcast about reliability, quality, and ways to focus on the user experience. In this episode, we talk with Chris Martello, manager of application performance at Cengage, about the importance of Chaos Engineering in service of quality.Julie: Welcome to Break Things on Purpose. We are joined today by Chris Martello from Cengage. Chris, do you want to tell us a little bit about yourself?Chris: Hey, thanks for having me today, Julie, Jason. It's nice to be here and chat with you folks about Chaos Engineering, Chaos Testing, Gremlin. As Julie mentioned I'm a performance manager at Cengage Learning Group, and we do a fair amount of performance testing, both individual platforms, and coordinated load testing. I've been a software manager at Cengage for about five years, total of nine altogether there at Cengage, and worn quite a few of the testing hats, as you can imagine, from automation engineer, performance engineer, and now QA manager. So, with that, yeah, my team is about—we have ten people that coordinate and test our [unintelligible 00:01:52] platforms. I'm on the higher-ed side. We have Gale Research Library, as well as soft skills with our WebAssign and ed2go offerings. So, I'm just one of a few, but my claim to fame—or at least one of my passions—is definitely chaos testing and breaking things on purpose.Julie: I love that, Chris. And before we hear why that's your passion, when you and I chatted last week, you mentioned how you got into the world of QA, and I think you started with a little bit of different type of chaos. You want to tell us what you did before?Chris: Sure, even before a 20-year career, now, in software testing, I managed chaos every day. If you know anything about teaching middle school, seventh and eighth-grade science, those folks have lots of energy and combine that with their curiosity for life and, you know, their propensity to expend energy and play basketball and run track and do things, I had a good time for a number of years corralling that energy and focusing that energy into certain directions. And you know back, kind of, with the jokes, it was a way to engage with kids in the classroom was humor. And so there was a lot of science jokes and things like that. But generally speaking, that evolved into I had a passion for computers, being self-taught with programming skills, project management, and things like that. It just evolved into a different career that has been very rewarding.And that's what brings me to Cengage and why I come to work every day with those folks is because instead of now teaching seventh and eighth-grade science to young, impressionable minds, nowadays I teach adults how to test websites and how to test platforms and services. And the coaching is still the same; the mentoring is still the same. The aptitude of my students is a lot different, you know? We have adults, they're people, they require things. And you know, the subject matter is also different. But the skills in the coaching and teaching is still the same.Jason: If you were, like, anything like my seventh-grade science teacher, then another common thing that you would have with Chaos Engineering and teaching science is blowing a lot of things up.Chris: Indeed. Playing with phosphorus and raw metal sodium was always a fun time in the chemistry class. [laugh].Julie: Well, one of the things that I love, there are so many parallels between being a science teacher and Chaos Engineering. I mean, we talk about this all the time with following the scientific process, right? You're creating a hypothesis; you're testing that. And so have you seen those parallels now with what you're doing with Chaos Engineering over there at Cengage?Chris: Oh, absolutely. It is definitely the basis for almost any testing we do. You have to have your controlled variables, your environment, your settings, your test scripts, and things that you're working on, setting up that experiment, the design of course, and then your uncontrolled variables, the manipulated ones that you're looking for to give you information to tell you something new about the system that you didn't know, after you conducted your experiment. So, working with teams, almost half of the learning occurs in just the design phase in terms of, “Hey, I think this system is supposed to do X, it's designed in a certain way.” And if we run a test to demonstrate that, either it's going to work or it's not. Or it's going to give us some new information that we didn't know about it before we ran our experiment.Julie: But you also have a very, like, cyclical reliabilities schedule that's important to you, right? You have your very important peak traffic windows. And what is that? Is that around the summertime? What does that look like for you?Chris: That's right, Julie. So, our business model, or at least our seasonal model, runs off of typical college semesters. So, you can imagine that August and September are really big traffic months for us, as well as January and part of February. It does take a little extra planning in order to mimic that traffic. Traffic and transactions at the beginning of the semester are a lot different than they are at the middle and even at the end of the semester.So, we see our secondary higher education platforms as courseware. We have our instructors doing course building. They're taking a textbook, a digitized textbook, they're building a course on it, they're adding their activities to it, and they're setting it up. At the same time that's going along, the students are registering, they are signing up to use the course, they're signing up to their course key for Cengage products, and they're logging into the course. The middle section looks a lot like taking activities and tests and quizzes, reading the textbook, flipping pages, and maybe even making some notes off to the side.And then at the end of the semester, when the time is up, quite literally on the course—you know, my course semester starts from this day to this day, in 15th of December. Computers being as precise as they are, when 15th of December at 11:59 p.m. rolls off the clock, that triggers a whole bunch of cron jobs that say, “Hey, it's done. Start calculating grades.”And it has to go through thousands of courses and say, “Which courses expired today? How many grades are there submitted? How many grades are unsubmitted and now I have to calculate the zeros?” And there's a lot of math that goes in with that analytics. And some of those jobs, when those midnight triggers kick off those jobs, it will take eight to ten hours in order to process that semester's courses that expire on that day.Julie: Well, and then if you experience an outage, I can only assume that it would be a high-stress situation for both teachers and students, and so we've talked about why you focus so heavily on reliability, I'd love to hear maybe if you can share with us how you prepare for those peak traffic events.Chris: So yeah, it's challenging to design a full load test that encompasses an entire semester's worth of traffic and even the peaks that are there. So, what we do is, we utilize our analytics that give us information on where our peak traffic days lie. And it's typically the second or third Monday in September, and it's at one or two o'clock in the afternoon. And those are when it's just what we've seen over the past couple of years is those days are our typical traffic peaks. And so we take the type of transactions that occur during those days, and we calibrate our load tests to use those as a peak, a one-time, our performance capacity.And then that becomes our x-factor in testing. Our 1x factor is what do we see in a semester at those peaks? And we go gather the rest of them during the course of the semester, and kind of tally those up in a load test. So, if our platforms can sustain a three to six-hour load test using peak estimate values that come from our production analysis, then we think we're pretty stable.And then we will turn the dial up to two times that number. And that number gives us an assessment of our headroom. How much more headroom past our peak usage periods do we have in order to service our customers reliably? And then some days, when you're rolling the dice, for extra bonus points, we go for 3x. And the 3x is not a realistic number.I have this conversation with engineering managers and directors all the time. It's like, “Well, you overblow that load test and it demonstrated five times the load on our systems. That's not realistic.” I says, “Well, today it's not realistic. But next week, it might be depending on what's happening.”You know, there are things that sometimes are not predictable with our semesters and our traffic but generally speaking it is. So, let's say some other system goes down. Single-sign-on. Happens to the best of us. If you integrate with a partner and your partner is uncontrolled in your environment, you're at their mercy.So, when that goes down, people stop entering your application. When the floodgates open, that traffic might peak for a while in terms of, hey, it's back up again; everybody can log in. It's the equivalent of, like, emptying a stadium and then letting everybody in through one set of doors. You can't do it. So, those types of scenarios become experimental design conversations with engineering managers to say, “At what level of performance do you think your platform needs to sustain?”And as long as our platforms can sustain within two to three, you know, we're pretty stable in terms of what we have now. But if we end up testing at three times the expected load and things break catastrophically, that might be an indication to an architect or an engineering director, that, hey, if our capacity outlives us in a year, it might be time to start planning for that re-architecture. Start planning for that capacity because it's not just adding on additional servers; planning for that capacity might include a re-architecture of some kind.Julie: You know, Chris, I just want to say to anybody from Coinbase that's out there that's listening, I think they can find you on [LinkedIn](https://www.linkedin.com/in/christophermartello/) to talk about load testing and preparing for peak traffic events.Chris: Yeah, I think the Superbowl saw one. They had a little QR code di—Julie: Yeah.Chris: —displayed on the screen for about 15 seconds or so, and boy, I sure hope they planned for that load because if you're only giving people 15 seconds and everybody's trying to get their phone up there, man I bet those servers got real hot real fast. [laugh].Julie: Yeah, they did. And there was a blip. There was a blip.Chris: Yeah. [laugh].Julie: But you're on LinkedIn, so that's great, and they can find you there to talk to you. You know, I recently had the opportunity to speak to some of the Cengage folks and it was really amazing. And it was amazing to hear what you were doing and how you have scheduled your Chaos Engineering experiments to be something that's repeatable. Do you want to talk about that a little bit for folks?Chris: Sure. I mean, you titled our podcast today, “A Day of Darkness,” and that's kind of where it all started. So, if I could just back up to where we started there with how did chaos become a regular event? How did chaos become a regular part of our engineering teams' DNA, something that they do regularly every month and it's just no sweat to pull off?Well, that Day of Darkness was 18 hours of our educational platforms being down. Now, arguably, the students and instructors had paid for their subscriptions already, so we weren't losing money. But in the education space and in our course creations, our currency is in grades and activities and submissions. So, we were losing currency that day and losing reputation. And so we did a postmortem that involved engineering managers, quality assurance, performance folks, and we looked at all the different downtimes that we've had, and what are the root causes.And after conferring with our colleagues in the different areas—we've never really been brought together in a setting like that—we designed a testing plan that was going to validate a good amount of load on a regular basis. And the secondary reason for coordinating testing like that was that we were migrating from data center to cloud. So, this is, you know, about five, six years ago. So, in order to validate that all that plumbing and connections and integrations worked, you know, I proposed I says, “Hey, let's load test it all the same time. Let's see what happens. Let's make sure that we can run water through the pipes all day long and that things work.”And we plan this for a week; we planned five days. But I traveled to Boston, gathered my engineers kind of in a war room situation, and we worked on it for a week. And in that week, we came up with a list of 90 issues—nine-zero—that we needed to fix and correct and address for our cloud-based offerings before it could go live. And you know, a number of them were low priority, easy to fix, low-hanging fruit, things like that. But there were nine of them that if we hadn't found, we were sure to go down.And so those nine things got addressed, we went live, and our system survived, you know, and things went up. After that, it became a regular thing before the semesters to make sure, “Hey, Chris, we need to coordinate that again. Can you do it?” Sure enough, let's coordinate some of the same old teams, grab my run sheet. And we learned that we needed to give a day of preparation because sometimes there were folks that their scripts were old, their environment wasn't a current version, and sometimes the integrations weren't working for various reasons of other platform releases and functionality implementation.So, we had a day of preparation and then we would run. We'd check in the morning and say, “Everybody ready to go? Any problems? Any surprises that we don't know about, yet?” So, we'd all confer in the morning and give it a thumbs up.We started our tests, we do a three-hour ramp, and we learned that the three-hour ramp was pretty optimal because sometimes elastic load balancers can't, like, spin up fast enough in order to pick up the load, so there were some that we had to pre-allocate and there were others that we had to give enough time. So, three hours became that magic window, and then three hours of steady-state at our peak generation. And now, after five years, we are doing that every month.Jason: That's amazing. One of the things you mentioned in there was about this migration, and I think that might tie back to something you said earlier about scaling and how when you're thinking of scaling, especially as I'm thinking about your migration to the cloud, you said, “Scaling isn't just adding servers. Sometimes that requires re-architecting an application or the way things work.” I'm curious, are those two connected? Or some of those nine critical fixes a part of that discovery?Chris: I think those nine fixes were part of the discovery. It was, you can't just add servers for a particular platform. It was, how big is the network pipe? Where is the DNS server? Is it on this side or that side? Database connections were a big thing: How many are there? Is there enough?So, there was some scaling things that hadn't been considered at that level. You know, nowadays, fixing performance problems can be as easy as more memory and more CPU. It can be. Some days it's not. Some days, it can be more servers; some days, it can be bigger servers.Other times, it's—just, like, quality is everybody's job, performance fixing is not always a silver bullet. There are things like page optimization by the designers. There's code optimization by your front-end engineers. And your back-end engineers, there are database optimizations that can be made: Indexing, reindexing on a regular basis—whatever that schedule is—for optimizing your database queries. If your front-end goes to an API for five things on the first page, does it make five extra calls, or does it make one call, and all five things come across at the same time?So, those are considerations that load performance testing, can tell you where to begin looking. But as quality assurance and that performance lead engineer, I might find five things, but the fixes weren't just more testing and a little bit of extra functionality. It might have involved DevOps to tweak the server connections, it might have involved network to slim down the hops from four different load balancers to two, or something like that. I mean, it was always just something else that you never considered that you utilized your full team and all of their expertise and skills in order to come up with those inches.And that's one of my favorite quotes from Every Given Sunday. It's an older football movie starring Al Pacino. He gives this really awesome speech in a halftime type of setting, and the punch line for this whole thing is, “The inches we need are everywhere around us.” And I tell people that story in the terms of performance is because performance, at the software level, is a game of inches. And those inches are in all of our systems and it's up to us as engineers to find them and add them up.Julie: I absolutely love everything about that. And that would have made a great title for this episode. “The Inches we Need are Everywhere Around Us.” We've already settled on, “A Day of Darkness with Chris Martello,” though. On that note, Chris, some of the things that you mentioned involve a lot of communication with different teams. How did you navigate some of those struggles? Or even at the beginning of this, was it easy to get everybody on board with this mindset of a new way of doing things? Did you have some challenges?Chris: There were challenges for sure. It's kind of hard to picture, I guess, Cengage's platform architecture and stuff. It's not just one thing. It's kind of like Amazon. Amazon is probably the example is that a lot of their services and things work in little, little areas.So, in planning this, I looked at an architecture diagram, and there's all these things around it, and we have this landscape. And I just looked down here in the corner. I said, “What's this?” They said, “Well, that's single-sign-on.” I says, “Well, everything that touches that needs to be load tested.”And they're like, “Why? We can't do that. We don't have a performance environment for that.” I said, “You can't afford not to.” And the day of darkness was kind of that, you know, example that kind of gave us the [sigh] momentum to get over that obstacle that said, “Yeah, we really do need a dedicated performance environment in order to prove this out.”So, then whittling down that giant list of applications and teams into the ones that were meaningful to our single-sign-on. And when we whittled that down, we now have 16 different teams that regularly participate in chaos. Those are kind of the ones that all play together on the same playing field at the same time and when we find that one system has more throughput than another system or an unexpected transaction load, sometimes that system can carry that or project that load onto another system inadvertently. And if there's timeouts at one that are set higher than another, then those events start queuing up on the second set of servers. It's something that we continually balance on.And we use these bits of information for each test and start, you know, logging and tracking these issues, and deciding whether it's important, how long is it going to take to fix, and is it necessary. And, you know, you're balancing risk and reward with everything you're doing, of course, in the business world, but sometimes the, you know—“Chris, bring us more quality. You can do better this month. Can you give us 20 more units of quality?” It's like, “I can't really package that up and hand it to you. That's not a deliverable.”And in the same way that reputation that we lose when our systems go down isn't as quantifiable, either. Sure, you can watch the tweets come across the interwebs, and see how upset our students are at those kinds of things, but our customer support and our service really takes that to heart, and they listen to those tweets and they fix them, and they coordinate and reach out, you know, directly to these folks. And I think that's why our organization supports this type of performance testing, as well as our coordinated chaos: The service experience that goes out to our customers has to be second to none. And that's second to none is the table stakes is your platform must be on, must be stable, and must be performing. That's just to enter the space, kids. You've got to be there. [laugh].You can't have your platform going down at 9 p.m. on a Sunday night when all these college students are doing their homework because they freak out. And they react to it. It's important. That's the currency. That is the human experience that says this platform, this product is very important to these students' lives and their well-being in their academic career. And so we take that very seriously.Jason: I love that you mentioned that your customer support works with the engineering team. Because makes me think of how many calls have you been on where something went wrong, you contacted customer support, and you end up reaching this thing of, they don't talk to engineering, and they're just like, “I don't know, it's broken. Try again some other time.” Or whatever that is, and you end up lost. And so this idea of we often think of DevOps is developers and operations engineers working together and everybody on the engineering side, but I love that idea of extending that.And so I'm curious, in that vein, does your Chaos Engineering, does your performance testing also interact with some of what customer support is actually doing?Chris: In a support kind of way, absolutely. Our customer call support is very well educated on our products and they have a lot of different tools at their disposal in order to correct problems. And you know, many of those problems are access and permissions and all that kind of stuff that's usual, but what we've seen is even though that our customer base is increasing and our call volume increases accordingly, the percentage decreases over time because our customer support people have gotten so good at answering those questions. And to that extent, when we do log issues that are not as easily fixed with a tweak or knob toggle at the customer support side, those get grouped up into a group of tickets that we call escalation tickets, and those go directly to engineering.And when we see groups of them that look and smell kind of the same or have similar symptoms, so we start looking at how to design that into chaos, and is it a real performance issue? Especially when it's related to slowness or errors that continuously come at a particular point in that workflow. So, I hope I answered that question there for you, Jason.Jason: Yeah, that's perfect.Julie: Now, I'd like to kind of bring it back a little bit to some of the learnings we've had over this time of practicing Chaos Engineering and focusing on that quality testing. Is there something big that stands out in your mind that you learned from an experiment? Some big, unknown-unknown that you don't know that you ever could have caught without practicing?Chris: Julie, that's a really good question, and there isn't, you know, big bang or any epiphanies here. When I talk about what is the purpose of chaos and what do we get out of it, there's the human factor of chaos in terms of what does this do for us. It gets us prepared, it gets us a fire drill without the sense of urgency of production, and it gets people focused on solving a problem together. So, by practicing in a performance, in a chaos sort of way, when performance does affect the production, those communication channels are already greased. When there's a problem with some system, I know exactly who the engineer is to go to and ask him a question.And that has also enabled us to reduce our meantime to resolution. That meantime to resolution factor is predicated on our teams knowing what to do, and how to resolve those. And because we've practiced it, now that goes down. So, I think the synergy of being able to work together and triangulate our teams on existing issues in a faster sort of way, definitely helps our team dynamic in terms of solving those problems faster.Julie: I like that a lot because there is so much more than just the technical systems. And that's something that we like to talk about, too. It is your people's systems. And you're not trying to surprise anybody, you've got these scheduled on a calendar, they run regularly, so it's important to note that when you're looking at making your people's systems more resilient, you're not trying to catch Chris off guard to see if he answered the page—Chris: That's right.Julie: —what we're working on is making sure that we're building that muscle memory with practice, right, and iron out the kinks in those communication channels.Chris: Absolutely. It's definitely been a journey of learning both for, you know, myself and my team, as well as the engineers that work on these things. You know, again, everybody chips in and gets to learn that routine and be comfortable with fighting fires. Another way I've looked at it with Chaos Engineering, and our testing adventures is that when we find something that it looks a little off—it's a burp, or a sneeze, or some hiccup over here in this system—that can turn into a full-blown fever or cold in production. And we've had a couple of examples where we didn't pay attention to that stuff fast enough, and it did occur in production.And kudos to our engineering team who went and picked it up because we had the information. We had the tracking that says we did find this. We have a solution or recommended fix in place, and it's already in process. That speaks volumes to our sense of urgency on the engineering teams.Julie: Chris, thank you for that. And before we end our time with you today, is there anything you'd like to let our listeners know about Cengage or anything you'd like to plug?Chris: Well, Cengage Learning has been a great place for me to work and I know that a lot of people enjoy working there. And anytime I ask my teams, like, “What's the best part of working there?” It's like, “The people. We work with are supportive and helpful.” You know, we have a product that we'd like to help change people's lives with, in terms of furthering their education and their career choices, so if you're interested, we have over 200 open positions at the current moment within our engineering and staffing choices.And if you're somebody interested in helping out folks and making a difference in people's educational and career paths, this is a place for you. Thanks for the offer, Julie. Really appreciate that.Julie: Thank you, Chris.Jason: Thanks, Chris. It's been fantastic to have you on the show.Chris: It's been a pleasure to be here and great to talk to you. I enjoy talking about my passions with testing as well as many of my other ones. [laugh].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.

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.

In this episode, we cover: 00:00:00 - Intro 00:02:23 - Iwata is the best, rest in peace 00:06:45 - Sam sneaks some SNES emulators/Engineer prep 00:08:20 - AWS, incidents, and China 00:16:40 - Understanding the big picture and moving from project to product 00:19:18 - Sam's time at Snacphat 00:26:40 - Sam's work at Gremlin, and culture changes 00:34:15 - Pokémon Go and Outro TranscriptSam: It's like anything else: You can have good people and bad people. But I wouldn't advocate for no people.Julie: [laugh].Sam: You kind of need humans involved.Julie: Welcome to the Break Things on Purpose podcast, a show about people, culture, and reliability. In this episode, we talk with Sam Rossoff, principal software engineer at Gremlin, about legendary programmers, data center disasters at AWS, going from 15 to 3000 engineers at Snapchat, and of course, Pokémon.Julie: Welcome to Break Things on Purpose. Today, Jason Yee and I are joined by Sam Rossoff, principal software engineer at Gremlin, and max level 100. Pokémon trainer. So Sam, why don't you tell us real quick who you are.Sam: So, I'm Sam Rossoff. I'm an engineer here at Gremlin. I've been in engineering here for two years. It's a good time. I certainly enjoyed it. And before that, I was at Snapchat for six years, and prior to that at Amazon for four years. And actually, before I was at Amazon, I was at Nokia Research Center in Palo Alto, and prior to that, I was at Activision. This was before they merged with Blizzard, all the way back in 2002. I worked in QA.Julie: And do you have any of those Nokia phones that are holding up your desk, or computer, or anything?Sam: I think I've been N95 around here somewhere. It's, like, a phone circa 2009. Probably. I remember, it was like a really nice, expensive phone at the time and they just gave it to us. And I was like, “ oh, this is really nice.”And then the iPhone came out. And I was like [laugh], “I don't know why I have this.” Also, I need to find a new job. That was my primary—I remember I was sitting in a meeting—this was lunch. It wasn't a meeting.I was sitting at lunch with some other engineers at Nokia Research, and they were telling me the story about this app—because the App Store was brand new in those days—it was called iRich, and it was $10,000. It didn't do anything. It was, like, a glowing—it was, like, NFTs, before NFTs—and it was just, like, a glowing thing on your phone. And you just, like, bought it to show you could waste $10,000 an app. And that was the moment where I was like, “I need to get out of this company. I need a new job.” It's depressing at the time, I guess.Julie: So. Sam, you're the best.Sam: No. False. Let me tell you story. There's a guy, his name is Iwata, right? He's a software developer. He works at a company called HAL Laboratories. You may recall, he built a game called Kirby. Very famous game; very popular.HAL Laboratories gets acquired by Nintendo. And Nintendo is like, “Hey, can you”—but Iwata, by the way, is the president of HAL Laboratories. Which is like, you know, ten people, so not—and they're like, “Hey, can you, like, send someone over? We're having trouble with this game we're making.” Right, the game question, at the time they called it Pokémon 2, now we call it Gold and Silver, and Iwata just goes over himself because he's a programmer in addition to be president of HAL Laboratories.And so he goes over there and he's like, “How can I help?” And they're like, “We're over time. We're over budget. We can't fit all the data on the cart. We're just, like, cutting features left and right.” He's like, “Don't worry. I got this.”And he comes up with this crazy compression algorithm, so they have so much space left, they put a second game inside of the game. They add back in features that weren't there originally. And they released on time. And they called this guy the legendary programmer. As a kid, he was my hero.Also famous for building Super Smash Brothers, becoming the president of all of Nintendo later on in his life. And he died a couple years ago, of cancer, if I recall correctly. But he did this motion when he was president of Nintendo. So, you ever see somebody in Nintendo go like this, that's a reference to Iwata, the legendary programmer.Jason: And since this is a podcast, Sam is two hands up, or just search YouTube for—Sam: Iwata.Jason: That's the lesson. [laugh].Sam: [laugh]. His big console design after he became President of Nintendo was the Nintendo Wii, as you may recall, with the nunchucks and everything. Yeah. That's Iwata. Crazy.Julie: We were actually just playing the Nintendo Wii the other day. It is still a high-quality game.Sam: Yeah.Jason: The original Wii? Not like the… whatever?Julie: Yeah. Like, the original Wii.Jason: Since you brought up the Wii, the Wii was the first console I ever owned because I grew up with parents that made it important to do schoolwork, and their entire argument was, if you get a Nintendo, you'll stop doing your homework and school stuff, and your grades will suffer, and just play it all the time. And so they refuse to let me get a Nintendo. Until at one point I, like, hounded them enough-I was probably, like, eight or nine years old, and I'm like, “Can I borrow a friend's Nintendo?” And they were like, sure you can borrow it for the weekend. So, of course, I borrowed it and I played it the whole weekend because, like, limited time. And then they used that as the proof of like, “See? All you did this weekend was play Nintendo. This is why we won't get you one.” [laugh].Sam: So, I had the exact same problem growing up. My parents are also very strict. And firm believers in corporal punishment. And so no video games was very clear. And especially, you know, after Columbine, which was when I was in high school.That was like a hard line they held. But I had friends. I would go to their houses, I would play at their houses. And so I didn't have any of those consoles growing up, but I did eventually get, like, my dad's old hand-me-down computer for, like, schoolwork and stuff, and I remember—first of all, figuring out how to program, but also figuring out how to run SNES emulators on [laugh] on those machines. And, like, a lot of my experience playing video games was waking up at 2 a.m. in the morning, getting on emulators, playing that until about, you know, five, then turning it off and pretending to go back to bed.Julie: So see, you were just preparing to be an engineer who would get woken up at 2 a.m. with a page. I feel like you were just training yourself for incidents.Sam: What I did learn—which has been very useful—is I learned how to fall asleep very quickly. I can fall asleep anywhere, anytime, on, like, a moment's notice. And that's a fantastic skill to have, let me tell you. Especially when [crosstalk 00:07:53]—Julie: That's a magic skill.Sam: Yeah.Julie: That is a magic skill. I'm so jealous of people that can just fall asleep when they want to. For me, it's probably some Benadryl, maybe add in some melatonin. So, I'm very jealous of you. Now I—Jason: There's probably a reason that I'm drinking all this cheap scotch right now.Sam: [laugh].Julie: We should point out that it's one o'clock in the morning for Jason because he's in Estonia right now. So, thank you, A, for doing this for us, and we did promise that you would get to talk about Pokémon. So—Sam: [laugh].Julie: [laugh].Sam: I don't know if you noticed, immediately, that's what I went to. I got a story about Pokémon.Julie: So, have you heard any of our episodes?Sam: I have. I have listened to some. They're mostly Jason, sort of, interviewing various people about their experience. I feel like they come, like, way more well-prepared than I am because they have, like, stuff they want to talk about, usually.Julie: They also generally have more than an hour or two's notice. So.Sam: Well, that's fair. Yeah. That probably [laugh] that probably helps. Whereas, like, I, like, refreshed one story about Iwata, and that's, like, my level of preparation here. So… don't expect too much.Julie: I have no expectations. Jason already had what you should talk about lined up anyway. Something about AWS incidents in China.Sam: Oh, my God. The first question is, which one?Jason: [laugh].Sam: So, I don't know how much you're familiar with the business situation in China, but American businesses are not allowed to operate in China. What happens is you create a Chinese subsidiary that's two-thirds owned by Chinese nationals in some sort of way, you work through other companies directly, and you form, like, these partnerships. And I know you know, very famously, Blizzard did this many years ago, and then, like, when they pulled out China, that company, all the people worked at are like, “Well, we're just going to take your assets and make our own version of World of Warcraft and just, like, run that instead.” But Amazon did, and it was always this long game of telephone, where people from Amazon usually, like, VP, C-level people were asking for various things. And there were people whose responsibility it was to, like, go and make those things happen.And maybe they did or, like, maybe they just said they did, right? And, like, it was never clear how much of it was lost in translation, or they're just, like, dealing with unreasonable requirements, and they're just, like, trying to get something done. But one story is one of my favorites because I was on this call. Amazon required all of their data centers to be multiple zones, right? So, now they talk about availability zones in a region. Internally at Amazon, that's not how we referred to things; it'd be like, there's the data center in Virginia, and there's, like, the first one, the second one, the third one, right? They're just, like, numbered; we knew what they were.And you had to have three of them, and then all services had to be redundant such they could handle a single data center failure. In the earlier days of Amazon, they would actually go turn off data centers to, like, make you prove this as the case. It's was, like, a very early version of chaos engineering. Because it's just, like, unreliable. And unfortunately, AWS kind of put the kibosh on that because it turns out people purchasing VMs on AWS don't like it when you turn off their VMs without warning. Which, like, I'm sympathetic, uh… I don't know.As a side note, if you are data center redundant, that means you're running excess capacity. So, if I'm about to lose a data center, I need to be able to maintain traffic without a real loss in error rates, that means I've got to be running, like, 50% excess capacity if I've only got three data centers, or 33% if you're four data centers. And so capacity of course was always the hard problem when you're dealing with data centers. So, when we were running the Chinese website— z.cn or amazon.cn—there was a data center in China, as you might imagine, as required by the complex business regulations and whatnot.And it had, you know, three availability zones, for lack of a better term. Or we thought it had three availability zones, which of course, this is what happened. One day, I got paged into this call, and they were dealing with a website outage, and we were trying to get people on the ground in China on the call, which as I recall, actually is a real hard problem to get. It was the middle of the night there; there was a very bad rainstorm; people were not near internet connectivity. If you're unfamiliar with the Chinese landscape—well, it's more complex today, but in those days, there were just basically two ISPs in China, and, like, Amazon only paired with one of them.And so if you were on the other one, it was very difficult to get back into Amazon systems. And so they'd have places they could go to so they could connect them when they—and so it was pair to. And so it was a very difficult situation. It took us a while to get people on the phone, but basically, we lost two data centers at the same time, which was very surprising. And later we find out what happened is one of the data centers had flooded, which is bad, bunch of electrical machines flooding for a rainstorm that's got whatever else going on.It turns out the other data center was physically inside of the first [laugh] data center. Which is not the sort of isolation you want between two regions. It's not really clear where in the conversation, you know, things got lost, such that this is what got implemented. But we had three data centers and in theory, and in practice, we had two data centers, since one was inside the other. And when the first one flooded, the, like, floor gave away, and the servers crashed down on top of the other one. [laugh].And so they were literally inside of each other after that point. They took down the Chinese website for Amazon. It was an experience. It was also one of those calls where there's not a lot I could do to help, which is always frustrating for a lot of reasons.Julie: So, how did you handle that call? Out of curiosity, I mean, what do you say?Sam: Well, I'll be honest with you, it took us a long time to get that information, to get save the world. Most of the call actually was trying to get ahold of people try to get information, get translators—because almost everybody on the line did not speak either Cantonese or Mandarin, which is what the engineers were working with—and so by the time we got an understanding—I was in Seattle at the time—Seattle got an understanding of what was happening in—I think it was Beijing. I don't recall off the top of my head—the people on the ground had done a lot of work to isolate and get things up and running, and the remainder of the work was reallocating capacity in the remaining data center so that we wouldn't be running data center redundant, but at the very least, we would be able to serve something. It was, as I recall, it was a very long outage we had to take. Although in those days, the Amazon cn website was not really a profit center.The business was—the Amazon business—was willing to sell things at steep discounts in China to establish themselves in that market, and so, there was always sort of a question of whether or not the outage was saving the company money. Which is, like, sort of a—Julie: [laugh].Sam: —it's like a weird place to be in as an engineer, right? Because you're, like, “You're supposed to be adding business value.” I'm like, “I feel like doing nothing might be adding business out here.” It's not true, obviously because the business value was to be in the Chinese market and to build an Amazon presence for some eventual world. Which I don't know if they ever—they got to. I don't work at Amazon, and haven't in almost a decade now.But it was definitely—it's the kind of thing that wears our morale, right? If you know the business is doing something that is sort of questionable in these ways. And look, in the sales, you know, when you're selling physical goods, industry loss leaders are a perfectly normal part of the industry. And you understand. Like, you sell certain items or loss to get people in the door, totally.But as engineering lacked a real strong view of the cohesive situation on the ground, the business inputs, that's hard on engineering, right, where they're sort of not clear what the right thing is, right? And anytime you take the engineers very far away from the product, they're going to make a bunch of decisions that are fundamentally in a vacuum. And if you don't have a good feel for what the business incentives are, or how the product is interacting with customers, then you're making decisions in a vacuum because there's some technical implementation you have to commit in some way, you're going to make a lot of the wrong decisions. And that was definitely a tough situation for us in those days. I hear it's significantly better today. I can't speak to it personally because I don't work there, but I do hear they have a much better situation today.Julie: Well, I'll tell you, just on the data center thing, I did just complete my Amazon Certified Cloud Practitioner. And during the Amazon training, they drilled it into you that the availability zones were tens of miles apart—the data centers were tens of miles apart—and now I understand why because they're just making sure that we know that there's no data centers inside data centers. [laugh].Sam: It was a real concern.Julie: [laugh]. But kind of going back though, to the business outcomes, quite a while ago, I used to give a talk called, “You Can't Buy DevOps,” and a lot of the things in that talk were based off of some of the reading that I did, in the book, Accelerate by Dr. Nicole Forsgren, Gene Kim, and Jez Humble. And one of the things they talked about is high-performing teams understanding the business goals. And kind of going back to that, making those decisions in a vacuum—and then I think, also, when you're making those decisions in a vacuum, do you have the focus on the customer? Do you understand the direction of the organization, and why are you making these decisions?Jason: I mean, I think that's also—just to dovetail on to that, that's sort of been the larger—if we look at the larger trend in technology, I think that's been the goal, right? We've moved from project management to product management, and that's been a change. And in our field, in SRE and things, we've moved from just thinking of metrics, and there were all these monitoring frameworks like USE (Utilization, Saturation, Errors) and RED (Rate, Errors, Duration) and monitoring for errors, and we've moved to this idea of SLOs, right? And SLOs are often supposed to be based on what's my customer experience? And so I think, overall, aside from Accelerate and DevOps, DevOps I feel like, has just been one part of this longer journey of getting engineers to understand where they fit within the grander scheme of things.Sam: Yeah. I would say, in general, anytime you have some sort of metric, which you're working towards, in some sort of reasonable way, it's easy to over-optimize for the metric. And if you think of the metric instead as sort of like the needle on a compass, it's like vaguely pointing north, right, but keep in mind, the reason we're heading north is because X, Y, Z, right? It's a lot easier for, like, individuals making the decisions that they have to on a day-to-day basis to make the right ones, right? And if you just optimize for the metric—I'm not saying metrics aren't helpful; they're extremely important. I would rather be lost with a compass than without one, but I also would like to know where I'm going and not just be wandering to northwards with the compass, right?Julie: Absolutely. And then—Jason: I mean, you don't want to get measured on lines of code that you commit.Sam: Listen. I will commit 70 lines of code. Get ready.Julie: Well, and metrics can be gamed, right? If people don't understand why those metrics are important—the overall vision; you've just got to understand the vision. Speaking of vision, you also worked at Snap.Sam: I did. I did. That was a really fun place to work. I joined Snapchat; there were 30 people at the company and 14 engineers. Very small company. And a lot of users, you know, 20-plus million users by that point, but very small company.And all the engineers, we used to sit in one room together, and so when you wanted to deploy the production back end, you, like, raised your hand. You're like, “Hey, I'm going to ship out the code. Does anyone have changes that are going out, or is everyone else already doing it?” And one of my coworkers actually wrote something into our deploy script so the speakers on your computer would, like, say, “Deploying production” just so, like, people could hear when it went out the door. Because, like, when you're all in one room, that's, like, a totally credible deployment strategy.We did build automation around that on CircleCI, which in those days was—I think this was 2014—much less big than it is today. And the company did eventually scale to at least 3000 engineers by the time I left, maybe more. It was hard for me to keep track because the company just grown in all these different dimensions. But it was really interesting to live through that.Julie: So, tell me about that. You went from, what, you said, 30 engineers to 3000 in the time that you were there.Sam: Fifteen engineers, I was the fifteenth.Julie: Fifteen. Fifteen engineers. What were some of the pain points that you experienced? And actually maybe even some advice for folks going through big company growth spurts?Sam: Yeah, that hypergrowth? I think it's easier for me to think about the areas that Snap did things wrong, but those were, like, explicit decisions we made, right? It might not be the case that you have these problems at your company. Like, one of the problems Snap had for a long time, we did not hire frontline managers or TPMs, and what that did is it create a lot of situations where you have director-levels with, like, 50-plus direct reports who struggled to make sure that—I don't know, there's no way you're going to manage 50-plus direct reports as engineers, right? Like, and it took the company a while to rectify that because we had such a strong hiring pipeline for engineers and not a strong hiring pipeline for managers.I know there's, like, a lot of people saying companies like, “Oh, man, these middle managers and TPM's all they do is, like, create work for, like, real people.” No. They—I get to see the world without them. Absolutely they had enormous value. [laugh]. They are worth their weight in gold; there's a reason they're there.And it's not to say you can't have bad ones who add negative value, but that's also true for engineers, right? I've worked with engineers, too, who also have added negative value, and I had to spend a lot of my time cleaning up their code, right? It's like anything else: You can have good people and bad people. But I wouldn't advocate for no people.Julie: [laugh].Sam: You kind of need humans involved. The thing that was nice about Snap is Snap was a very product-led company, and so we always had an idea of what the product is that we were trying to build. And that was, like, really helpful. I don't know that we had, like, a grand vision for, like, how to make the internet better like Google does, but we definitely had an idea of what we're building and the direction we're moving it in. And it was very much read by Evan Spiegel, who I got to know personally, who spent a lot of time coming down talking to us about the design of the product and working through the details.Or at least, you know, early on, that was the case. Later on, you know, he was busy with other stuff. I guess he's, like, a CEO or something, now.Julie: [laugh].Sam: But yeah, that was very nice. The flip side meant that we under-invested in areas around things like QA and build tools and these other sorts of pieces. And, like, DevOps stuff, absolutely. Snapchat was on an early version of Google Cloud Platform. Actually an early version of something called App Engine.Now, App Engine still exist as a product. It is not the product today that it was back in 2014. I lived through them revving that product, and multiple deprecations and the product I used in 2014 was a disaster and huge pain, and the product they have today is actually semi-reasonable and something I've would use again. And so props to Google Cloud for actually making something nice out of what they had. And I got to know some of their engineers quite well over the—[laugh] my tenure, as Snap was the biggest customer by far.But we offboarded, like, a lot of the DevOps works onto Google-and paid them handsomely for it—and what we found is you kind of get whatever Google feels like level of support, which is not in your control. And when you have 15 engineers, that's totally reasonable, right? Like, if I need to run, like, a million servers and I have 15 engineers, it's great to pay Google SREs to, like, keep track of my million servers. When you have, you know, 1000 engineers though, and Google wants half a billion dollars a year, and you're like, “I can't even get you guys to get my, like, Java version revved, right? I'm still stuck on Java 7, and this Java 8 migration has been going on for two years, right?”Like, it's not a great situation to be in. And Snap, to their credit, eventually did recognize this and invested heavily in a multi-cloud solution, built around Kubernetes—maybe not a surprise to anyone here—and they're still migrating to that, to the best of my knowledge. I don't know. I haven't worked in that company for two years now. But we didn't have those things, and so we had to sort of rebuild at a very, sort of, large scale.And there was a lot of stuff we infrastructure we set up in the early days in, like, 2014, when, like, ah, that's good enough, this, like, janky python script because that's what we had time for, right? Like, I had an intern write a janky Python script that handled a merge queue so that we could get changes in, and that worked really great when there was like, a dozen engineers just, like, throwing changes at it. When there was, like, 500 engineers, that thing resulted in three-day build times, right? And I remember, uh, what was this… this was 2016… it was the winter of either 2016 to 2017 or 2017 to 2018 where, like, they're like, “Sam, we need to, like, rebuild the system because, like, 72 hours is not an acceptable time to merge code that's already been approved.” And we got down to 14 minutes.So, we were able to do it, right, but you need to be willing to invest the time. And when you're strapped for resources, it's very easy to overlook things like dev tools and DevOps because they're things that you only notice when they're not working, right? But the flip side is, they're also the areas where you can invest and get ten times the output of your investment, right? Because if I put five people on this, like, build system problem, right, all of a sudden, I've got, like, 100x build performance across my, like, 500 engineers. That's an enormous value proposition for your money.And in general, I think, you know, if you're a company that's going through a lot of growth, you have to make sure you are investing there, even if it looks like you don't need it just yet. Because first of all, you do, you're just not seeing it, but second of all, you're going to need it, right? Like, that's what the growth means: You are going to need it. And at Snap I think the policy was 10% of engineering resources were on security—which is maybe reasonable or not; I don't know. I didn't work on security—but it might also be the case that you want maybe 5 to 10% of the engineering resources working on your internal tooling.Because that is something that, first of all, great value for your money, but second of all, it's one of those things where all of a sudden, you're going to find yourself staring at a $500 million bill from Google Cloud or AWS, and be like, “How did we do this to ourselves?” Right? Like, that's really expensive for the amount of money we're making. I don't know what the actual bill number is, but you know, it's something crazy like that. And then you have to be like, “Okay, how do we get everything off of Google Cloud and onto AWS because it's cheaper.” And that was a—[laugh] that was one heck of a migration, I'll tell you.Julie: So, you've walked us through AWS and through Snap, and so far, we've learned important things such as no data centers within data centers—Sam: [laugh].Julie: —people are important, and you should focus on your tooling, your internal tooling. So, as you mentioned before, you know, now you're at Gremlin. What are you excited about?Sam: Yeah. I think there's, like, a lot of value that Gremlin provides to our customers. I don't know, one of the things I liked working at Snapchat is, like, I don't particularly like Facebook. I have not liked Facebook since, like, 2007, or something. And there's, like, a real, like, almost, like, parasitic aspect to it.In my work at Snap, I felt a lot better. It's easy to say something pithy, like, “Oh, you're just sending disappearing photos.” Like, yeah, but, like, it's a way people stay connected that's not terrible the way that Facebook is, right? I felt better about my contribution.And so similarly, like, I think Gremlin was another area where, like, I feel a lot be—like, I'm actually helping my customers. I'm not just, like, helping them down a poor path. There's some, like, maybe ongoing conversation around if you worked in Amazon, like, what happens in FCs and stuff? I didn't work in that part of the company, but like, I think if I had to go back and work there, that's also something that might, you know, weigh on me to some degree. And so one of the—I think one of the nice things about working at Gremlin is, like, I feel good about my work if that makes sense.And I didn't expect it. I mean, that's not why I picked the job, but I do like that. That is something that makes me feel good. I don't know how much I can talk about upcoming product stuff. Obviously, I'm very excited about upcoming product stuff that we're building because, like, that's where I spend all my time. I'm, like, “Oh, there's, like, this thing and this thing, and that's going to let people do this. And then you can do this other thing.”I will tell you, like, I do—like, when I conceptualize product changes, I spend a lot of time thinking, how is this going to impact individual engineers? How is this going to impact their management chain, and their, like, senior leadership director, VP, C-suite level? And, like, how do we empower engineers to, like, show that senior leadership that work is getting done? Because I do think it's hard—this is true across DevOps and it's not unique to Chaos Engineering—I do think it's hard sometimes to show that you're making progress in, like, the outages you avoided, right? And, like, that is where I spend, like, a lot of my thought time, like, how do I like help doing that?And, like, if you're someone who's, like, a champion, you're, you're like, “Come on, everyone, we should be doing Chaos Engineering.” Like, how do I get people invested? You care, you're at this company, you've convinced them to purchase Gremlin, like, how do I get other engineers excited about Chaos Engineering? I think, like, giving you tools to help with that is something that, I would hope, I mean, I don't know what's actually implemented just yet, but I'd hope is somewhere on our roadmap. Because that's the thing like, that I personally think a lot about.I'll tell you another story. This was also when I was at Amazon. I had this buddy, we'll call him Zach because that's his name, and he was really big on testing. And he had all this stuff about, like, testing pyramid, if you're familiar with, like, programming unit testing, integration testing, it's all that stuff. And he worked as a team—a sister team to mine—and a lot engineers did not care heavily about testing. [laugh].And he used to try to, like, get people to, like, do things and talk about it and stuff. They just, like, didn't care, even slightly. And I also kind of didn't care, so I wasn't any better, but something I did one day on my team is I was like, “You know, somebody else at Amazon”—because Amazon invested very heavily in developer tools—had built some way that was very easy to publish metrics into our primary metrics thing about code coverage. And so I just tossed in all the products for my team, and that published a bunch of metrics. And then I made a bunch of graphs on a wiki somewhere that pulled live data, and we could see code coverage.And then I, like, showed it in, like, a team meeting one week, and everyone was like, “Oh, that's kind of interesting.” And then people were like, “Oh, I'm surprised that's so low.” And they found, like, some low-hanging fruit and they started moving it up. And then, like, the next year bi-weekly with our skip-level, like, they showed the progress, he's like, “Oh, this it's really good.” You made, like, a lot of progress in the code coverage.And then, like, all of a sudden, like, when they're inviting new changes, they start adding testing, or, like, all sudden, like, code coverage, just seemed ratchet up. Or some [unintelligible 00:30:51] would be like, “Hey, I have this thing so that our builds would fail now if code coverage went down.” Right? Like, all of a sudden, it became, sort of like, part of the culture to do this, to add coverage. I remember—and they, like, sort of pollinated to the sister teams.I remember Zach coming by my desk one day. He's like, “I'm so angry. I've been trying for six months to get people to care. And you do some dumb graphs and our wiki.” And I'm like, “I mean, I don't know. I was just, like, an idea I had.” Right? Like, it wasn't, like, a conscious, like, “I'm going to change the culture moment,” it was very much, like, “I don't know, just thought this was interesting.”And I don't know if you know who [John Rauser](https://www.youtube.com/watch?v=UL2WDcNu_3A) is, but he's got this great talk at Velocity back in 2010, maybe 2011, where he talks about culture change and he talks about how humans do change culture readily—and, you know, Velocity is very much about availability and latency—and what we need to do in the world of DevOps and reliability in general is actually we have to change the culture of the companies we're at. Because you're never going to succeed, just, like, here emoting adding chaos engineering into your environment. I mean because one day, you're going to leave that company, or you're going to give up and there'll be some inertia that'll carry things forward, but eventually, people will stop doing it and the pendulum will swing back the other way, and the systems will become unreliable again. But if you can build a culture, if you can make people care—of course, it's the hardest thing to do in engineering, like, make other engineers care about something—but if you can do it, then it will become sort of self-perpetuating, right, and it becomes, like, a sort of like a stand-alone complex. And then it doesn't matter if it's just you anymore.And as an engineer, I'm always looking for ways to, like, remove myself as a critical dependency, right? Like, if I could work myself out of a job, thank you, because, like, [laugh] yeah, I can go work on something else now, right? Like, I can be done, right? Because, like, as we all know, you're never done with software, right? There's always a next version; there's always, like, another piece; you're always, like, migrating to a new version, right? It never really ends, but if you can build something that's more than just yourself—I feel like this is, like, a line from Batman or something. “Mr. Wayne, if you can become a legend”—right? Like, you'd be something more yourself? Yeah, absolutely. I mean, it's not a great delivery like Liam Neeson. But yeah.Jason: I like what you said, though. You talked about, like, culture change, but I think a big thing of what you did is exposing what you're measuring or starting to measure this thing, right? Because there's always a statement of, “You can't improve until you measure it,” right? And so I think simply because we're engineers, exposing that metric and understanding where we're at is a huge motivator, and can be—and obviously, in your case—enough to change that culture is just, like, knowing about this and seeing that metric. And part of the whole DevOps philosophy is the idea that people want to do the best job that they can, and so exposing that data of, “Look, we're not doing very well on this,” is often enough. Just knowing that you're not doing well, is often enough to motivate you to do better.Sam: Yeah, one of the things we used to say at Amazon is, “If you can't measure it, it didn't happen.” And like, it was very true, right? I mean, that was a large organization that moves slowly, but, like, it was very true that if you couldn't show a bunch of graphs or reports somewhere, oftentimes people would just pretend like it never happened.Julie: So, I do you want to bring it back just a little bit, in the last couple of minutes that we have, to Pokémon. So, you play Pokémon Go?Sam: I do. I do play Pokémon Go.Julie: And then how do people find you on Pokémon Go?Sam: My trainer—Jason: Also, I'm going to say, Sam, you need to open my gifts. I'm in Estonia.Sam: [laugh]. It's true. I don't open gifts. Here's the problem. I have no space because I have, like, all these items from all the, like, quests and stuff they've done recently.They're like, “Oh, you got to, like, make enough space, or you could pay us $2 and we'll give you more space.” I'm like, “I'm not paying $2,” right? Like—Jason: [laugh].Sam: And so, I just, like, I have to go in every now and then and, like, just, like, delete a bunch of, like, Poké Balls or something. Like maybe I don't need 500 Poké Balls. That's fair.Jason: I mean, I'm sitting on 628 Ultra Balls right now. [laugh].Sam: Yeah. Well, maybe you don't need—Jason: It's community day on Sunday.Sam: I know, I know. I'm excited for it. I have a trainer code. If you need my trainer to find me on Pokémon Go, it's 1172-0487-4013. And you can add me, and I'll add you back because, like, I don't care; I love playing Pokémon, and I'd play every day. [laugh].Julie: And I feel it would be really rude to leave Jason out of this since he plays Pokémon a lot. Jason, do you want to share your…Jason: I'm not sharing my trainer code because at this point, I'm nearing the limit, and I have all of these Best Friends that I'm actually Lucky Friends with, and I have no idea how to contact them to actually make Lucky trades. And I know that some of them are, like, halfway around the world, so if you are in the Canary Islands and you are a friend of mine on Pokémon Go, please reach out to me on Twitter. I'm @gitbisect on Twitter. Message me so that we can actually, like, figure out who you are. Because at some point, I will go to the Canary Islands because they are beautiful.Sam: Also, you can get those, like, sweet Estonia gifts, what will give you those eggs from Estonia, and then when you trade them you get huge mileage on the trades. I don't know if this is a thing you [unintelligible 00:36:13], Jason, but, like, my wife and I both compete for who can get the most mileage on the trip. And of course, we traded each other but that's, like, a zero-sum game, right? And so the total mileage on trades is a big thing in my house.Jason: Well, the next time we get together, I've got stuff from New Zealand, so we can definitely get some mileage there.Sam: Excellent.Julie: Well, this is excellent. I feel like we have learned so much on this episode of Break Things on Purpose, from obviously the most important information out there—Pokémon—but back to some of the history of Nintendo and Amazon and Snap and all of it. And so Sam, I just want to thank you for being on with us today. And folks again, if you want to be Sam's friend on Pokémon Go—I'm sorry, I don't really know how it works. I don't even know if that's the right term—Sam: It's fine.Julie: You've got his code. [laugh]. And thanks again for being on our podcast.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.

In this episode, we cover: 00:00:00 - Introduction 00:30:00 - Fastly Outage 00:04:05 - Salesforce Outage 00:07:25 - Hypothesizing  00:10:00 - Julie Joins the Team! 00:14:05 - Looking Forward/Outro TranscriptJason: There's a bunch of cruft that they'll cut from the beginning, and plenty of stupid things to cold-open with, so.Julie: I mean, I probably should have not said that I look forward to more incidents.[audio break 00:00:12]Jason: Hey, Julie. So, it's been quite a year, and we're going to do a year-end review episode here. As with everything, this feels like a year of a lot of incidents and outages. So, I'm curious, what is your favorite outage of the year?Julie: Well, Jason, it has been fun. There's been so many outages, it's really hard to pick a favorite. I will say that one that sticks out as my favorite, I guess, you could say was the Fastly outage, basically because of a lot of the headlines that we saw such as, “Fastly slows down and stops the internet.” You know, “What is Fastly and why did it cause an outage?” And then I think that people started realizing that there's a lot more that goes into operating the internet. So, I think from just a consumer side, that was kind of a fun one. I'm sure that the increases in Google searches for Fastly were quite large in the next couple of days following that.Jason: That's an interesting thing, right? Because I think for a lot of us in the industry, like, you know what Fastly is, I know what Fastly is; I've been friends with folks over there for quite a while and they've got a great service, but for everybody else out there in the general public, suddenly, this company, they never heard of that, you know, handles, like, 25% of the world's internet traffic, like, is suddenly on the front page news and they didn't realize how much of the internet runs through this service. And I feel it that way with a lot of the incidents that we're seeing lately, right? We're recording this in December, and a week ago, Amazon had a rather large outage, affecting us-east-1, which it seems like it's always us-east-1. But that took down a bunch of stuff and similar, they are people, like you know, my dad, who's just like, “I buy things from Amazon. How did this crash, like, the internet?”Julie: I will tell you that my mom generally calls me—and I hate to throw her under the bus—anytime there is an outage. So, Hulu had some issues earlier this year and I got texts from my mom actually asking me if I could call any of my friends over at Hulu and, like, help her get her Hulu working. She does this similarly for Facebook. So, when that Facebook outage happened, I always—almost—know about an outage first because of my mother. She is my alerting mechanism.Jason: I didn't realize Hulu had an outage, and now it makes me think we've had J. Paul Reed and some other folks from Netflix on the show. We definitely need to have an engineer from Hulu come on the show. So, if you're out there listening and you work for Hulu, and you'd like to be on the show and dish all the dirt on Hulu—actually don't do that, but we'd love to talk with you about reliability and what you're doing over there at Hulu. So, reach out to us at podcast@gremlin.com.Julie: I'm sure my mother would appreciate their email address and phone number just in case—Jason: [laugh].Julie: —for the future. [laugh].Jason: If you do reach out to us, we will connect you with Julie's mother to help solve her streaming issues. You had mentioned one thing though. You said the phrase about throwing your mother under the bus, and that reminds me of one of my favorite outages from this year, which I don't know if you remember, it's all about throwing people under the bus, or one person in particular, and that's the Salesforce outage. Do you remember that?Julie: Oh. Yes, I do. So, I was not here at the time of the Salesforce outage, but I do remember the impact that that had on multiple organizations. And then—Jason: Yes—Julie: —the retro.Jason: —the Salesforce outage was one where ,similarly ,Salesforce affects so much, and it is a major name. And so people like my dad or your mom probably knew like, “Oh, Salesforce. That's a big thing.” The retro on it, I think, was what really stood out. I think, you know, most people understand, like, “Oh, you're having DNS issues.” Like, obviously it's always DNS, right? That's the meme: It's always DNS that causes your issues.In this case it was, but their retro on this they publicly published was basically, “We had an engineer that went to update DNS, and this engineer decided to push things out using an EBF process, an Emergency Brake Fix process.” So, they sort of circumvented a lot of the slow rollout processes because they just wanted to get this change made and get it done without all the hassle. And turns out that they misconfigured it and it took everything down. And so the entire incident retro was basically throwing this one engineer under the bus. Not good.Julie: No, it wasn't. And I think that it's interesting because especially when I was over at PagerDuty, right, we talked a lot about blamelessness. That was very not blameless. It doesn't teach you to embrace failure, it doesn't show that we really just want to take that and learn better ways of doing things, or how we can make our systems more resilient. But going back to the Fastly outage, I mean, the NPR headline was, “Tuesday's Internet Outage was Caused by One Customer Changing a Setting, Fastly says.” So again, we could have better ways of communicating.Jason: Definitely don't throw your engineers on their bus, but even moreso, don't throw your customers under the bus. I think for both of these, we have to realize, like, for the engineer at Salesforce, like, the blameless lesson learned here is, what safeguards are you going to put in place? Or what safeguards were there? Like, obviously, this engineer thought, like, “The regular process is a hassle; we don't need to do that. What's the quickest, most expedient way to resolve the issue or get this job done?” And so they took that.And similarly with the customer at Fastly, they're just like, “How can I get my systems working the way I want them to? Let's roll out this configuration.” It's really up to all of us, and particularly within our companies, to think about how are people using our products. How are they working on our systems? And, what are the guardrails that we need to put in place? Because people are going to try to make the best decisions that they can, and that obviously means getting the job done as quickly as possible and then moving on to the next thing.Julie: Well, and I think you're really onto something there, too, because I think it's also about figuring out those unique ways that our customers can break our products, things that we didn't think through. And I mean, that goes back to what we do here at Gremlin, right? Then that goes back to Chaos Engineering. Let's think through a hypothesis. Let's see, you know, what if ABC Company, somebody there does something. How can we test for that?And I think that shouldn't get lost in the whole aspect of now we've got this postmortem. But how do we recreate that? How do we make sure that these things don't happen again? And then how do we get creative with trying to figure out, well, how can we break our stuff?Jason: I definitely love that. And that's something that we've done internally at Gremlin this year is, we've really started to build up a better practice around running Chaos Engineering internally on our own systems. We've done that for a long time, but a lot of times it was just specific teams, and so earlier this year, the advocacy team was partnering up with the various engineering teams and running Chaos Engineering experiments. And it was interesting to learn and think through some of those ideas of as we're doing this work, we're going to be trying to do things expediently with the least amount of hassle, but what if we decide to do something that's outside of the documented process, but for which there is no technical guardrails? So, some of the things that we ended up doing were testing dependencies, right, things that again, are outside of the normal process.Like, we use LaunchDarkly for feature flagging. What happens if we decide to circumvent that, just push things straight to production? What happens if we decide to just block LaunchDarkly all together? And we found some actual critical issues and we're able to resolve those without impacting our customers.Julie: That's the key element: Practice, play, think through the what ifs. And I love the what ifs part. You know, going back to my past, I have to tell you that the IT team used to always give me all of the new tech because if something was going to break for some reason—they used to call me the “AllSpark”  to be honest with everybody out there—for some reason, if something was going to break, with me it would break in the most unique possible way, so before anything got rolled out to the entire company, I was the one that got to test it.Jason: That's amazing. So, what you're saying is on my next project, I need to give that to you first?Julie: Oh, a hundred percent. Really, it was remarkable how things would break. I mean, I had keyboards that would randomly type letters. I definitely took down some internal things, but I'm just saying that you should leverage those people within your organization, as well. The thing was, it was never a, “Julie is awful; things break because of Julie.” It was, “You know what? Leverage Julie to learn about what we're using.” And it was kind of fun. I mean, granted, this was years ago, and that name has stuck, and sometimes they still definitely make fun of me for it, but really, they just used me to break things in unique ways. Because I did.Jason: That's actually a really good segue to some of the stuff that we've been doing because you joined Gremlin, now, a few months back—more than a few months—but late summer, and a lot of what we were doing early on was just, we had these processes that, internally for myself and other folks who'd been around for a while, it was just we knew what to do because we'd done it so much. And it was that nice thing of we're going to do this thing, but let's just have Julie do it. Also, we're not going to tell you anything; we're just going to point you at the docs. It became really evident as you went through that of, like, “Hey, this doc is missing this thing. It doesn't make sense.”And you really helped us improve some of those documentation points, or some of the flows that we had, you would execute, and it's like, “Why are we doing it this way?” And a lot of times, it was like, “Oh, that's a legacy thing. We do it because—oh, right, that thing we did it because of doesn't exist anymore. Like, we're doing it completely backwards because of some sort of legacy thing that doesn't exist. Let's update that.” And you were able to help us do that, which was fantastic.Julie: Oh, yeah. And it was really great on my end, too because I always felt like I could ask the questions. And that is a cultural trait that is really important in an organization, to make sure that folks can ask questions and feel comfortable doing so. I've definitely seen it the other way, and when folks don't know the right way to do something or they're afraid to ask those questions, that's also where you see the issues with the systems because they're like, “Okay, I'm just going to do this.” And even going back to my days of being a recruiter—which is when I started in tech, but don't worry, everybody, I was super cool; I was not a bad recruiter—that was something that I always looked for in the interview process. When I'd ask somebody how to do something, would they say, “I don't know, I would ask,” or, “I would do this,” or would they just fumble their way through it, I think that it's important that organizations really adopt that culture of again, failure, blamelessness, It's okay to ask questions.Jason: Absolutely. I think sort of the flip side of that, or the corollary of that is something that Alex Hidalgo brought up. So, one of our very first episodes of 2021 on this podcast, we had Alex Hidalgo who's now at Nobl9, and he brought up a thing from his time at Google called Hyrum's Law. And Hyrum's Law is this guy Hyrum who worked at Google basically said, “If you've got an API, that API will be used in every way possible. If you don't actually technically prevent it, somebody is going to use your API in a way it wasn't designed for. And that because it allows that, it becomes totally, like, a plausible or a valid use case for this.”And so as we think about this, and thinking about blamelessness, use the end-runaround to deploy this DNS change, like, that's a valid process now because you didn't put anything in place to validate against it, and to guarantee that people weren't using it in ways that were not intended.Julie: I think that that makes a lot of sense. Because I know I've definitely used things in ways that were not intended, which people can go back and look at my quest for Diet Cherry 7 Up during the pandemic, when I used tools in ways they weren't intended, but I would like to say that Diet Cherry 7 Up is back, from those tools. Thank you PagerDuty and some APIs that were open to me to be able to leverage in interesting ways.Jason: If you needed an alert for Diet Cherry 7 Up, PagerDuty, I guess it's a good enough tool for that.Julie: Well, the fact is, is I [laugh] was able to get very creative. I mean, what are terms of service, Jason?Jason: I don't know. Does anybody actually read those?Julie: Yeah. I would call them ‘light guardrails.'Jason: [laugh]. So Julie, we're getting towards the end of the year. I'm curious, what are you looking forward to in 2022?Julie: Well, aside from, ideally, the end to the pandemic, I would say that one of the things that I'm looking forward to in 2022, from joining Gremlin, I had a really great opportunity to work on certifications here, and I'm really excited because in 2022 we'll be launching some more certifications and I'm excited for what we're going to do with that and getting creative around that. But I'm also really interested to just see how everybody evolves or learns from this year and the outages that we had. I always love fun outages, so I'm kind of curious what's going to happen over the holiday season to see if we see anything new or interesting. But Jason, what about you? What are you looking forward to?Jason: You know I, similarly, am looking forward to the end of the pandemic. I don't know if there's really going to be an end, but I think we're starting to see a return to some normalcy. And so, we've already participated in some great events, went to KubeCon a couple months ago, went to Amazon re:Invent a few weeks ago, and both of those were fantastic just to see people getting out there, and learning, and building things again. So, I'm super excited for this next year. I think we're going to start seeing a lot more events back in person, and a lot of people really eager to get together to learn and build things together. So, that's what I'm excited about. Hopefully, less incidents, but as systems get more complex, I'm not sure that that's going to happen. So, at least if we don't have less incidents, more learning from incidents is really what I'm hoping for.Julie: I like how I'm looking forward to more incidents and you're looking forward to less. To be fair, from my perspective, every incident that we have is an opportunity to talk about something new and to teach folks things, and just sometimes it's fun going down the rabbit holes to find out, well, what was the cause of this? And what was the outcome? So, when I say more incidents, I don't mean that I don't want to be able to watch the Queen's Gambit on Netflix, okay, J. Paul? Just throwing that out there.Jason: Well, thanks, Julie, for being on. And for all of our listeners, whether you're seeing more incidents or less incidents, Julie and I both hope that you're learning from the incidents that you have, that you're working to become more reliable and building more reliable systems, and hopefully testing them out with some chaos engineering. If you'd like to hear more from the Break Things on Purpose podcast, we've got a bunch of episodes that we've published this year, so if you haven't heard some of them, go back into our catalog. You can see all of the episodes at gremlin.com/podcast. And we look forward to seeing you in our next podcast.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.

In this episode, we cover: 00:00:00 - Introduction  00:04:30 - Early Dark Days in Chaos Engineering and Reliability 00:08:27 - Anecdotes from the “Long Dark Time” 00:16:00 - The Big Changes Over the Years 00:20:50 - Mandi's Work at PagerDuty 00:27:40 - Mandi's Tips for Better DevOps 00:34:15 - Outro Links:PagerDuty: https://www.pagerduty.com TranscriptJason: — hilarious or stupid?Mandi: [laugh]. I heard that; I listened to the J. Paul Reed episode and I was like, “Oh, there's, like, a little, like, cold intro.” And I'm like, “Oh, okay.”Jason: Welcome to Break Things on Purpose, a podcast about reliability and learning from failure. In this episode, we take a trip down memory lane with Mandi Walls to discuss how much technology, reliability practices, and chaos engineering has evolved over her extensive career in technology.Jason: Everybody, welcome to the show, Julie Gunderson, who recently joined Gremlin on the developer advocacy team. How's it going, Julie?Julie: Great, Jason. Really excited to be here.Jason: So, Mandi is actually a guest of yours. I mean, we both have been friends with Mandi for quite a while but you had the wonderful opportunity of working with Mandi.Julie: I did, and I was really excited to have her on our podcast now as we ran a podcast together at PagerDuty when we worked there. Mandi has such a wealth of knowledge that I thought we should have her share it with the world.Mandi: Oh, no. Okay.Julie: [laugh].Jason: “Oh, no?” Well, in that case, Mandi, why don't you—Mandi: [crosstalk 00:01:28]. I don't know.Jason: Well, in that case with that, “Oh no,” let's have Mandi introduce herself. [laugh].Mandi: Yeah hi. So, thanks for having me. I am Mandi Walls. I am currently a DevOps advocate at PagerDuty, Julie's last place of employment before she left us to join Jason at Gremlin.Julie: And Mandi, we worked on quite a few things over a PagerDuty. We actually worked on things together, joint projects between Gremlin, when it was just Jason and us where we would run joint workshops to talk about chaos engineering and actually how you can practice your incident response. And I'm sure we'll get to that a little bit later in the episode, but will you kick us off with your background so everybody knows why we're so excited to talk to you today?Mandi: Oh, goodness. Well, so I feel like I've been around forever. [laugh]. Prior to joining PagerDuty. I spent eight-and-a-half years at Chef Software, doing all kinds of things there, so if I ever trained you on Chef, I hope it was good.Prior to joining Chef, I was assistant administrator for AOL.com and a bunch of other platform and sites at AOL for a long time. So, things like Moviefone, and the AOL Sports Channel, and dotcom, and all kinds of things. Most of them ran on one big platform because the monolith was a thing. So yeah, my background is largely in operations, and just systems administration on that side.Jason: I'm laughing in the background because you mentioned Moviefone, and whenever I think of Moviefone, I think of the Seinfeld episode where Kramer decides to make a Moviefone competitor, and it's literally just his own phone number, and people call up and he pretends to be that, like, robotic voice and has people, like, hit numbers for which movie they want to see and hear the times that it's playing. Gives a new meaning to the term on-call.Mandi: Indeed. Yes, absolutely.Julie: And I'm laughing just because I recently watched Hackers and, you know, they needed that AOL.com disc.Mandi: That's one of my favorite movies. Like, it's so ridiculous, but also has so many gems of just complete nonsense in it. Absolutely love Hackers. “Hack the planet.”Julie: “Hack the planet.” So, with hacking the planet, Mandi, and your time working at AOL with the monolith, let's talk a little bit because you're in the incident business right now over at PagerDuty, but let's talk about the before times, the before we practiced Chaos Engineering and before we really started thinking about reliability. What was it like?Mandi: Yeah, so I'll call this the Dark Ages, right? So before the Enlightenment. And, like, for folks listening at home, [laugh] the timeline here is probably—so between two-thousand-and-fi—four, five, and 2011. So, right before the beginning of cloud, right before the beginning of, like, Infrastructure as Code, and DevOps and all those things that's kind of started at, like, the end of my tenure at AOL. So, before that, right—so in that time period, right, like, the web was, it wasn't like it was just getting started, but, like, the Web 2.0 moniker was just kind of getting a grip, where you were going from the sort of generic sites like Yahoo and Yellow Pages and those kinds of things and AOL.com, which was kind of a collection of different community bits and news and things like that, into more personalized experiences, right?So, we had a lot of hook up with the accounts on the AOL side, and you could personalize all of your stuff, and read your email and do all those things, but the sophistication of the systems that we were running was such that like, I mean, good luck, right? It was migration from commercial Unixes into Linux during that era, right? So, looking at when I first joined AOL, there were a bunch of Solaris boxes, and some SGIs, and some other weird stuff in the data center. You're like, good luck on all that. And we migrated most of those platforms onto Linux at that time; 64 bit. Hurray.At least I caught that. And there was an increase in the use of open-source software for big commercial ventures, right, and so less of a reliance on commercial software and caught solutions for things, although we did have some very interesting commercial web servers that—God help them, they were there, but were not a joy, exactly, to work on because the goals were different, right? That time period was a huge acceleration. It was like a Cambrian explosion of software pieces, and tools, and improvements, and metrics, and monitoring, and all that stuff, as well as improvements on the platform side. Because you're talking about that time period is also being the migration from bare metal and, like, ordering machines by the rack, which really only a handful of players need to do that now, and that was what everybody was doing then.And in through the earliest bits of virtualization and really thinking about only deploying the structures that you needed to meet the needs of your application, rather than saying, “Oh, well, I can only order gear, I can only do my capacity planning once a year when we do the budget, so like, I got to order as much as they'll let me order and then it's going to sit in the data center spinning until I need it because I have no ability to have any kind of elastic capacity.” So, it was a completely, [laugh] completely different paradigm from what things are now. We have so much more flexibility, and the ability to, you know, expand and contract when we need to, and to shape our infrastructures to meet the needs of the application in such a more sophisticated and almost graceful way that we really didn't have then. So, it was like, “Okay, so I'm running these big websites; I've got thousands of machines.” Like, not containers, not services.Like, there's tens of thousands of services, but there's a thousand machines in one location, and we've got other things spread out. There's like, six different pods of things in different places and all this other crazy business going on. At the same time, we were also running our own CDN, and like, I totally recommend you never, ever do that for any reason. Like, just—yeah. It was a whole experience and I still sometimes have, like, anxiety dreams about, like, the configuration for some of our software that we ran at that point. And all of that stuff is—it was a long… dark time.Julie: So, now speaking of anxiety dreams, during that long, dark time that you mentioned, there had to have been some major incidents, something that stands out that that you just never want to relive. And, Mandi, I would like to ask you to relive that for us today.Mandi: [laugh]. Okay, well, okay, so there's two that I always tell people about because they were so horrific in the moment, and they're still just, like, horrible to think about. But, like, the first one was Thanksgiving morning, sometime early in the morning, like, maybe 2 a.m. something like that, I was on call.I was at my mom's, so at the time, my mom had terrible internet access. And again, this time period don't have a lot of—there was no LTE or any kind of mobile data, right? So, I'm, like, on my mom's, like, terrible modem. And something happened to the database behind news.aol.com—which was kind of a big deal at the time—and unfortunately, we were in the process of, like, migrating off of one kind of database onto another kind of database.News was on the target side but, like, the actual platform that we were planning to move to for everything else, but the [laugh] database on-call, the poor guy was only trained up in the old platform, so he had no idea what was going on. And yeah, we were on that call—myself, my backup, the database guy, the NOC analyst, and a handful of other people that we could get hold of—because we could not get into touch with the team lead for the new database platform to actually fix things. And that was hours. Like, I missed Thanksgiving dinner. So, my family eats Thanksgiving at midday rather than in the evening. So, that was a good ten hour call. So, that was horrifying.The other one wasn't quite as bad as that, but like, the interesting thing about the platform we were running at the time was it was AOL server, don't even look it up. Like, it was just crazytown. And it was—some of the interesting things about it was you could actually get into the server platform and dig around in what the threads were doing. Each of the servers had, like, a control port on it and I could log into the control port and see what all the requests were doing on each thread that was live. And we had done a big push of a new release of dotcom onto that platform, and everything fell over.And of course, we've got, like, sites in half a dozen different places. We've got, you know, distributed DNS that's, like, trying to throw traffic between different locations as they fall over. So, I'm watching, like, all of these graphs oscillate as, like, traffic pours out of the [Secaucus 00:11:10] or whatever we were doing, and into Mountain View or something and, like, then all the machines in the Secaucus recover. So, then they start pinging and traffic goes back, and, like, they just fall over, over and over again. So, what happened there was we didn't have enough threads configured in the server for the new time duration for the requests, so we had to, like, just boosted up all of the threads we could handle and then restart all of the applications. But that meant pushing out new config to all the thousands of servers that were in the pool at the time and then restarting all of them. So, that was exciting. That was the outage that I learned that the CTO knew how to call my desk. So, highly don't recommend that. But yeah, it was an experience. So.Julie: So, that's really interesting because there's been so many investments now in reliability. And when we talk about the Before Times when we had to cap our text messages because they cost us ten cents a piece, or when we were using those AOL discs, the thought was there; we wanted to make that user experience better. And you brought up a couple of things, you know, you were moving to those more personalized experiences, you were migrating those platforms, and you actually talked about your metrics and monitoring. And I'd like to dig in a little on that and see, how did that help you during those incidents? And after those incidents, what did you do to ensure that these types of incidents didn't occur again in the future?Mandi: Yeah, so one of the interesting things about, you know, especially that time period was that the commercially available solutions, even some of the open-source solutions were pretty immature at that time. So, AOL had an internally built solution that was fascinating. And it's unfortunate that they were never able to open-source it because it would have been something interesting to sort of look at. Scale of it was just absolutely immense. But the things that we could look at the time to sort of give us, you know, an indication of something, like, an AOL.com, it's kind of a general purpose website; a lot of different people are going to go there for different reasons.It's the easiest place for them to find their email, it's the easiest place for them to go to the news, and they just kind of use it as their homepage, so as soon as traffic starts dropping off, you can start to see that, you know, maybe there's something going on and you can pull up sort of secondary indicators for things like CPU utilization, or memory exhaustion, or things like that. Some of the other interesting things that would come up there is, like, for folks who are sort of intimately tied to these platforms for long periods of time, to get to know them as, like, their own living environment, something like—so all of AOL's channels at the time were on a single platform.—like, hail to the monolith; they all live there—because it was all linked into one publishing site, so it made sense at the time, but like, oh, my goodness, like, scaling for the combination of entertainment plus news plus sports plus all the stuff that's there, there's 75 channels at one time, so, like, the scaling of that is… ridiculous.But you could get a view for, like, what people were actually doing, and other things that were going on in the world. So like, one summer, there were a bunch of floods in the Midwest and you could just see the traffic bottom out because, like, people couldn't get to the internet. So, like, looking at that region, there's, like, a 40% drop in the traffic or whatever for a few days as people were not able to be online. Things like big snowstorms where all the kids had to stay home and, like, you get a big jump in the traffic and you get to see all these things and, like, you get to get a feel for more of a holistic attachment or holistic relationship with a platform that you're running. It was like it—they are very much a living creature of their own sort of thing.Like, I always think of them as, like, a Kraken or whatever. Like, something that's a little bit menacing, you don't really think see all of it, and there's a lot of things going on in the background, but you can get a feel for the personality and the shape of the behaviors, and knowing that, okay, well, now we have a lot of really good metrics to say, “All right, that one 500 error, it's kind of sporadic, we know that it's there, it's not a huge deal.” Like, we did not have the sophistication of tooling to really be able to say that quantitatively, like, and actually know that but, like, you get a feel for it. It's kind of weird. Like, it's almost like you're just kind of plugged into it yourself.It's like the scene in The Matrix where the operator guy is like, “I don't even see the text anymore.” Right? Like, he's looking directly into the matrix. And you can, kind of like—you spend a lot of time with [laugh] those applications, you get to know how they operate, and what they feel like, and what they're doing. And I don't recommend it to anyone, but it was absolutely fascinating at the time.Julie: Well, it sounds like it. I mean, anytime you can relate anything to The Matrix, it is going to be quite an experience. With that said, though, and the fact that we don't operate in these monolithic environments anymore, how have you seen that change?Mandi: Oh, it's so much easier to deal with. Like I said, like, your monolithic application, especially if there are lots of different and diverse functionalities in it, like, it's impossible to deal with scaling them. And figuring out, like, okay, well, this part of the application is memory-bound, and here's how we have to scale for that; and this part of the application is CPU-bound; and this part of the application is I/O bound. And, like, peeling all of those pieces apart so that you can optimize for all of the things that the application is doing in different ways when you need to make everything so much smoother and so much more efficient, across, like, your entire ecosystem over time, right?Plus, looking at trying to navigate the—like an update, right? Like, oh, you want to do an update to your next version of your operating system on a monolith? Good luck. You want to update the next version of your runtime? Plug and pray, right? Like, you just got to hope that everybody is on board.So, once you start to deconstruct that monolith into pieces that you can manage independently, then you've got a lot more responsibility on the application teams, that they can see more directly what their impacts are, get a better handle on things like updates, and software components, and all the things that they need independent of every other component that might have lived with them in the monolith. Noisy neighbors, right? Like, if you have a noisy neighbor in your apartment building, it makes everybody miserable. Let's say if you have, like, one lagging team in your monolith, like, nobody gets the update until they get beaten into submission.Julie: That is something that you and I used to talk about a lot, too, and I'm sure that you still do—I know I do—was just the service ownership piece. Now, you know who owns this. Now, you know who's responsible for the reliability.Mandi: Absolutely.Julie: You know, I'm thinking back again to these before times, when you're talking about all of the bare metal. Back then, I'm sure you probably didn't pull a Jesse Robbins where you went in and just started unplugging cords to see what happened, but was there a way that AOL practiced Chaos Engineering with maybe not calling it that?Mandi: It's kind of interesting. Like, watching the evolution of Chaos Engineering from the early days when Netflix started talking about it and, like, the way that it has emerged as being a more deliberate practice, like, I cannot say that we ever did any of that. And some of the early internet culture, right, is really built off of telecom, right? It was modem-based; people dialed into your POP, and like, that was the reliability they were expecting was very similar to what they expect out of a telephone, right? Like, the reason we have, like, five nines as a thing is because you want to pick up dial tone, and—pick up your phone and get dial tone on your  line 99.999% of the time.Like, it has nothing to do with the internet. It's like 1970s circuits with networking. For part of that reason, like, a lot of the way things were built at that time—and I can't speak for Yahoo, although I suspect they had a very similar setup—that we had a huge integration environment. It's completely insane to think now that you would build an integration environment that was very similar in scope and scale to your production environment; simply does not happen. But for a lot of the services that we had at that time, we absolutely had an integration environment that was extraordinarily similar.You simply don't do that anymore. Like, it's just not part of—it's not cost effective. And it was only cost effective at that time because there wasn't anything else going on. Like, you had, like, the top ten sites on the internet, and AOL was, like, number three at the time. So like, that was just kind of the way things are done.So, that was kind of interesting and, like, figuring out that you needed to do some kind of proactive planning for what would happen just wasn't really part of the culture at the time. Like, we did have a NOC and we had some amazing engineers on the NOC that would help us out and do some of the things that we automate now: putting a call together, or when paging other folks into an incident, or helping us with that kind of response. I don't ever remember drilling on it, right, like we do. Like, practicing that, pulling a game day, having, like, an actual plan for your reliability along those lines.Julie: Well, and now I think that yeah, the different times are that the competitive landscape is real now—Mandi: Yeah, absolutely.Julie: And it was hard to switch from AOL to something else. It was hard to switch from Facebook to MySpace—or MySpace to Facebook, I should say.Mandi: Yeah.Julie: I know that really ages me quite a bit.Mandi: [laugh].Julie: But when we look at that and when we look at why reliability is so important now, I think it's because we've drilled it into our users; the users have this expectation and they aren't aware of what's happening on the back end. They just kn—Mandi: Have no idea. Yeah.Julie: —just know that they can't deposit money in their bank, for example, or play that title at Netflix. And you and I have talked about this when you're on Netflix, and you see that, “We can't play this title right now. Retry.” And you retry and it pops back up, we know what's going on in the background.Mandi: I always assume it's me, or, like, something on my internet because, like, Netflix, they [don't ever 00:21:48] go down. But, you know, yeah, sometimes it's [crosstalk 00:21:50]—Julie: I just always assume it's J. Paul doing some chaos engineering experiments over there. But let's flash forward a little bit. I know we could spend a lot of time talking about your time at Chef, however, you've been over at PagerDuty for a while now, and you are in the incident response game. You're in that lowering that Mean Time to Identification and Resolution. And that brings that reliability piece back together. Do you want to talk a little bit about that?Mandi: One of the things that is interesting to me is, like, watching some of these slower-moving industries as they start to really get on board with cloud, the stairstep of sophistication of the things that they can do in cloud that they didn't have the resources to do when they were using their on-premises data center. And from an operation standpoint, like, being able to say, “All right, well, I'm going from, you know, maybe not bare metal, but I've got, like, some kind of virtualization, maybe some kind of containerization, but like, I also own the spinning disks, or whatever is going on there—and the network and all those things—and I'm putting that into a much more flexible environment that has modern networking, and you know, all these other elastic capabilities, and my scaling and all these things are already built in and already there for me.” And your ability to then widen the scope of your reliability planning across, “Here's what my failure domains used to look like. Here's what I used to have to plan for with thinking about my switching networks, or my firewalls, or whatever else was going on and, like, moving that into the cloud and thinking about all right, well, here's now, this entire buffet of services that I have available that I can now think about when I'm architecting my applications for the cloud.” And that, just, expanded reliability available to you is, I think, absolutely amazing.Julie: A hundred percent. And then I think just being able to understand how to respond to incidents; making sure that your alerting is working, for example, that's something that we did in that joint workshop, right? We would teach people how to validate their alerting and monitoring, both with PagerDuty and Gremlin through the practice of incident response and of chaos engineering. And I know that one of the practices at PagerDuty is Failure Fridays, and having those regular game days that are scheduled are so important to ensuring the reliability of the product. I mean, PagerDuty has no maintenance windows, correct?Mandi: No that—I don't think so, right?Julie: Yeah. I don't think there's any planned maintenance windows, and how do we make sure for organizations that rely on PagerDuty—Mandi: Mm-hm.Julie: —that they are one hundred percent reliable?Mandi: Right. So, you know, we've got different kinds of backup plans and different kinds of rerouting for things when there's some hiccup in the platform. And for things like that, we have out of band communications with our teams and things like that. And planning for that, having that game day to just be able to say—well, it gives you context. Being able to say, “All right, well, here's this back-end that's kind of wobbly. Like, this is the thing we're going to target with our experiments today.”And maybe it's part of the account application, or maybe it's part of authorization, or whatever it is; the team that worked on that, you know, they have that sort of niche view, it's a little microcosm, here's a little thing that they've got and it's their little widget. And what that looks like then to the customer, and that viewpoint, it's going to come in from somewhere else. So, you're running a Failure Friday; you're running a game day, or whatever it is, but including your customer service folks, and your front-end engineers, and everyone else so that, you know, “Well, hey, you know, here's what this looks like; here's the customers' report for it.” And giving you that telemetry that is based on customer experience and your actual—what the business looks like when something goes wrong deep in the back end, right, those deep sea, like, angler fish in the back, and figuring out what all that looks like is an incredible opportunity. Like, just being able to know that what's going to happen there, what the interface is going to look like, what things don't load, when things take a long time, what your timeouts look like, did you really even think about that, but they're cascading because it's actually two layers back, or whatever you're working on, like that kind of insight, like, is so valuable for your application engineers as they're improving all the pieces of architecture, whether it's the most front-end user-facing things, or in the deep back-end that everybody relies on.Julie: Well, absolutely. And I love that idea of bringing in the different folks like the customer service teams, the product managers. I think that's important on a couple of levels because not only are you bringing them into this experience so they're understanding the organization and how folks operate as a whole, but you're building that culture, that failure is acceptable and that we learn from our failures and we make our systems more resilient, which is the entire goal.Mandi: The goal.Julie: And you're sharing the learning. When we operate in silos—which even now as much as we talk about how terrible it is to be in siloed teams and how we want to remove silos, it happens. Silos just happen. And when we can break down those barriers, any way that we can to bring the whole organization in, I think it just makes for a stronger organization, a stronger culture, and then ultimately a stronger product where our customers are living.Mandi: Yeah.Julie: Now, I really do want to ask you a couple of things for some fun here. But if you were to give one tip, what is your number one tip for better DevOps?Mandi: Your DevOps is always going to be—like, I'm totally on board with John Wallace's [CAMS 00:27:57] to, like, move to CALMS sort of model, right? So, you've got your culture, your automation, your learning, your metrics, and your sharing. For better DevOps, I think one of the things that's super important—and, you know, you and I have hashed this out in different things that we've done—we hear about it in other places, is definitely having empathy for the other folks in your organization, for the work that they're doing, and the time constraints that they're under, and the pressures that they're feeling. Part of that then sort of rolls back up to the S part of that particular model, the sharing. Like, knowing what's going on, not—when we first started out years ago doing sort of DevOps consulting through Chef, like, one of the things we would occasionally run into is, like, you'd ask people where their dashboards were, like, how are they finding out, you know, what's going on, and, like, the dashboards were all hidden and, like, nobody had access to them; they were password protected, or they were divided up by teams, like, all this bonkers nonsense.And I'm like, “You need to give everybody a full view, so that they've all got a 360 view when they're making decisions.” Like you mentioned your product managers as part of, like, being part of your practice; that's absolutely what you want. They have to see as much data as your applications engineers need to see. Having that level of sharing for the data, for the work processes, for the backlog, you know, the user inputs, what the support team is seeing, like, you're getting all of this input, all this information, from everywhere in your ecosystem and you cannot be selfish with it; you cannot hide it from other people.Maybe it doesn't look as nice as you want it to, maybe you're getting some negative feedback from your users, but pass that around, and you ask for advice; you ask for other inputs. How are we going to solve this problem? And not hide it and feel ashamed or embarrassed. We're learning. All this stuff is brand new, right?Like, yeah, I feel old talking about AOL stuff, but, like, at the same time, like, it wasn't that long ago, and we've learned an amazing amount of things in that time period, and just being able to share and have empathy for the folks on your team, and for your users, and the other folks in your ecosystem is super important.Julie: I agree with that. And I love that you hammer down on the empathy piece because again, when we're working in ones and zeros all day long, sometimes we forget about that. And you even mentioned at the beginning how at AOL, you had such intimate knowledge of these applications, they were so deep to you, sometimes with that I wonder if we forget a little bit about the customer experience because it's something that's so close to us; it's a feature maybe that we just believe in wholeheartedly, but then we don't see our customers using it, or the experience for them is a little bit rockier. And having empathy for what the customer may go through as well because sometimes we just like to think, “Well, we know how it works. You should be able to”—Mandi: Yes.Julie: Yes. And, “They're definitely not going to find very unique and interesting ways to break my thing.” [laugh].Mandi: [laugh]. No, never.Julie: Never.Mandi: Never.Julie: And then you touched on sharing and I think that's one thing we haven't touched on yet, but I do want to touch on a little bit. Because with incident—with incident response, with chaos engineering, with the learning and the sharing, you know, an important piece of that is the postmortem.Mandi: Absolutely.Julie: And do you want to talk a little bit about the PagerDuty view, your view on the postmortems?Mandi: As an application piece, like, as a feature, our postmortem stuff is under review. But as a practice, as a thing that you do, like, a postmortem is an—it should be an active word; like, it's a verb, right? You hol—and if you want to call it a post-incident review, or whatever, or post-incident retrospective, if you're more comfortable with those words, like that's great, and that's—as long as you don't put a hyphen in postmortem, I don't care. So, like—Julie: I agree with you. No hyphen—Mandi: [laugh].Julie: —please. [laugh].Mandi: Please, no hyphen. Whatever you want to call that, like, it's an active thing. And you and I have talked a number of times about blamelessness and, like, making sure that what you do with that opportunity, this is—it's a gift, it's a learning opportunity after something happened. And honestly, you probably need to be running them, good or bad, for large things, but if you have a failure that impacted your users and you have this opportunity to sit down and say, all right, here's where things didn't go as we wanted them to, here's what happened, here's where the weaknesses are in our socio-technical systems, whether it was a breakdown in communication, or breakdown in documentation, or, like, we we found a bug or, you know, [unintelligible 00:32:53] defect of some kind, like, whatever it is, taking that opportunity to get that view from as many people as possible is super important.And they're hard, right? And, like, we—John Allspaw, on our podcast, right, last year talked a bit about this. And, like, there's a tendency to sort of write the postmortem and put it on a shelf like it's, like, in a museum or whatever. They are hopefully, like, they're learning documents that are things that maybe you have your new engineers sort of review to say, “Here's a thing that happened to us. What do you think about this?” Like, maybe having, like, a postmortem book club or something internally so that the teams that weren't maybe directly involved have a chance to really think about what they can learn from another application's learning, right, what opportunities are there for whatever has transpired? So, one of the things that I will say about that is like they aren't meant to be write-only, right? [laugh]. They're—Julie: Yeah.Mandi: They're meant to be an actual living experience and a practice that you learn from.Julie: Absolutely. And then once you've implemented those fixes, if you've determined the ROI is great enough, validate it.Mandi: Yes.Julie: Validate and validate and validate. And folks, you heard it here first on Break Things on Purpose, but the postmortem book club by Mandi Walls.Mandi: Yes. I think we should totally do it.Julie: I think that's a great idea. Well, Mandi, thank you. Thank you for taking the time to talk with us. Real quick before we go, did you want to talk a little bit about PagerDuty and what they do?Mandi: Yes, so Page—everyone knows PagerDuty; you have seen PagerDuty. If you haven't seen PagerDuty recently, it's worth another look. It's not just paging anymore. And we're working on a lot of things to help people deal with unplanned work, sort of all the time, right, or thinking about automation. We have some new features that integrate more with our friends at Rundeck—PagerDuty acquired Rundeck last year—we're bringing out some new integrations there for Rundeck actions and some things that are going to be super interesting for people.I think by the time this comes out, they'll have been in the wild for a few weeks, so you can check those out. As well as, like, getting better insight into your production platforms, like, with a service graph and other insights there. So, if you haven't looked at PagerDuty in a while or you think about it as being just a place to be annoyed with alerts and pages, definitely worth revisiting to see if some of the other features are useful to you.Julie: Well, thank you. And thanks, Mandi, and looking forward to talking to you again in the future. And I hope you have a wonderful day.Mandi: Thank you, Julie. Thank you very much 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.

CARA NATTERSON, MD, is a pediatrician, consultant, and New York Times bestselling author of puberty and parenting books. In 2020, she launched OOMLA, a company dedicated to making puberty more comfortable, literally.Cara's journey through health advocacy began at Harvard College, Johns Hopkins Medical School, and the University of California at San Francisco. In 2000, Cara joined Tenth Street Pediatrics in Santa Monica, caring for thousands of kids from birth through their teen years. In 2008, she founded Worry Proof Consulting, a practice that gives parents time their primary doctors often don't have to cover medical, behavioral, and parenting issues in depth. Cara travels the country speaking to both kids and parents about taking ownership of their health and wellness, translating cutting- edge research into understandable, actionable, and even entertaining information.Cara has served on several boards as a Director or Advisor, including Starlight Children's Foundation, The Honest Company, Zemcar, Baby2Baby, and The John Thomas Dye School. And when she's not doing any of this other stuff, she is spending time with the people who make her all the better at it: her husband and two teenage kids.About OOMLA: Julie, the mom of a then fourth grader with budding boobs, called Cara, a similarly situated mom who also happened to be a pediatrician and writer of books about puberty. Julie and Cara didn't really know one another. The conversation went something like this:Julie: Where do you buy your daughter bras?Cara: I don't… because they're categorically terrible! None of them work well or feel good or look anywhere close to cute.Julie: Well first of all, your daughter needs a bra. (Long pause…) And second of all, my mom – who sewed all of the clothes I ever wore as a child, down to my underpants – has made one. Can I bring it by your house so that you can check it out? A few days later Julie, her daughter, and the bra showed up on Cara's front doorstep. At the end of an hour, the two tweens decided they had to be best friends because there were two of them but only one bra. Every other bra they had tried was too pulling, pushing, padded, itchy, wired, scratchy, or so flimsy it didn't do a thing. And all of the bras out there used broken sizing systems like judge-y S/M/L or confusing number/letter combos that make zero sense for kids with barely anything there yet. But the girls wanted a bra they could wear regularly - their morphing chests were super sensitive to tops in a way they had never been before. Not to mention that the area had become so surprisingly tender that if an errant backpack or elbow made contact, ouch!As the girls (and their boobs) grew and grew, Cara and Julie kept iterating and sizing up. By the time they launched OOMLA, the game changing OOMBRA fit perfectly whether breasts were just starting to bud or they'd grown all the way up to bra sizes 34D or 36B. Because the OOMBRA is made from buttery cotton that feels like second skin, it's ridiculously soft and so comfortable you forget you're wearing anything at all. Between the outer layers sits a middle panel to give gentle compression without any tight binding or bulky, awkward pads... an innovation designed to support boobs and hide nipples considered so novel that it received a patent. We invented a bra that felt like hugs for your boobs - sweatpants for your chest - and everyone who tried it on fell in love.

Julie Koepsell came into Horizontal Digital as President of the North America division in December 2020 at a time when, due to Covid, the company was “fully remote.” Horizontal Digital is a 17-year-old global, “experience forward” consultancy that puts people at the center if its efforts by creating deeper, end-to-end-connected, seamless, relevant, and personal customer relationships that boost client ROI. Because Horizontal is a boutique consultancy, clients get a “very high touch experience.” Julie says it is important for leaders to “listen.” One of the first things she did after joining the company was to connect one-on-one with all 50 division employees. Due to continued growth, the division has hired an additional 150 employees over the first part of this year. Globally, the consultancy has 500 employees. Many of Horizontal Digital's B2B clients sell through multiple distribution channels and dealer networks. The desired push-pull challenge is complex – companies want their dealers to recommend their products . . . but they also want customers to ask for the company's products. Horizontal Digital strives to: Create promotional programs that build meaningful relationships with end customers so those customers will go to dealers and ask for a company's products.  Build a martech stack so the customer journey experience is cohesive from sales and marketing through digital POS, web and experience portals, and customer service. The goal is to understand what customers want, anticipate their needs, and grow relationships “at a life level.” Provide client education and get client employees to understand the need for internal changes related to demand generation, customer experience, or “internal digital transformation” initiatives . . . and help them understand how those changes will be implemented. She says, if a company's message is properly set up across all channels, companies can simultaneously control expenses and grow revenue . . . customer lifetime value is increased, customers will advocate for the company, and there will be an increased opportunity to cross-sell and upsell. Julie is passionate about providing women with the opportunity to advance, especially in technology. She believes it is important, as the Horizontal Digital grows, to build the infrastructure and internal scaling to support that growth, to “create an amazing employee experience,” and to make sure clients' experiences with Horizontal Digital surpass their expectations. Julie can be found on her consultancy's website at: https://www.horizontaldigital.com/ . Transcript Follows: ROB: Welcome to the Marketing Agency Leadership Podcast. I'm your host, Rob Kischuk, and I am joined today by Julie Koepsell, President – North America at Horizontal Digital based in Minneapolis, Minnesota. Welcome to the podcast, Julie. JULIE: Thank you, Rob. I'm so happy to be here. ROB: It's awesome to have you here. Why don't you tell us about Horizontal Digital and the journey the firm is on, where you specialize, and what we should know about it? JULIE: I'd love to. Horizontal Digital is an experience-forward consultancy. We operate as a boutique consultancy, which really means that our clients get a very high touch experience from us. And we do it with global teams so we can actually deliver at scale, which is pretty unique. When I say that we're experience-forward, what that means is that we put people at the center of everything that we do. More specifically for our clients, we help them build deeper relationships with their customers so they get better ROI, and we do that by creating end-to-end connected experiences that are seamless, relevant, and personal. If you consider that customer journey, we are able to deliver a cohesive experience all the way from sales and marketing through digital POS, web and experience portals, and then customer experience, and we do that so we can better understand what they want, anticipate their needs, and grow the relationship. ROB: Got it. A lot of the services you're talking about are things that a lot of people are in the business of, but it seems like what might elevate that to the level of a consultancy is the holistic, the big picture, the customer journey not in the sense – some people think of customer journey like “I'm going to send you different emails depending on where you are in the purchase process.” But it sounds like you're talking about more at a life level. JULIE: That's absolutely right. Through the entire experience that any brand has with its customer. ROB: If we zoom in to that just a little bit, is there an example of a client, some touchpoints, what my experience might be in a client that Horizontal has been involved in? JULIE: A lot of things actually come to mind. One of the things is in our conversations – we had a conversation yesterday with a prospective client who is thinking about how they can digitally transform their business. They're selling through multiple channels; they've got distribution channels. They want to make sure that they are building relationships with their end customer so the customers are going to the dealer and asking for them. Through that entire process, they're going through an internal digital transformation. So not only are they working to make sure that they are building a martech stack that enables them to deliver the experience that they want to for their customers, but they also have a lot of internal education that they need to do to make the case for it. There's a lot of misconceptions about what that actually means in terms of whether you're talking about demand gen or digital transformation or customer experience. So there's a lot to it in terms of not only how you're building your technology stack to deliver that experience, but also how you're going through the change management internally to make sure that everybody understands why you're doing that. ROB: I know you said prospective customer, so I don't want to pull too deep into the identity here, but you said dealer. Is this some sort of vehicle? Is there some kind of picture you can fill in to help us contextualize? JULIE: Yeah, a lot of B2B clients right now are selling through dealer networks. What they really want is the end consumer to go to the dealer and ask for them. They want that push-pull, where they want the dealer to be recommending them, but they also want the customer to be asking for them. And then ultimately, they want to make sure that the experience the customer has, if they come to their website or through any other experience, is seamless, anticipates their needs, is transparent, and is really meaningful. Because at the end of the day, customer experience is really what lends to long-term loyalty. One of the things that we talk about a lot around here is that two-thirds of customers actually switch brands not based on prices or features but because of the experience they have. That's really the holy grail of business today. ROB: Absolutely. It's interesting that why you were involved as a consultancy instead of an agency is – I'm going to say something that could be wrong, but if I'm thinking about a car, if I'm thinking about a snowmobile, if I'm thinking about a motorcycle, if I'm thinking about a dealer of just about anything, digital creates the opportunity for an ownership experience. It creates an opportunity for that relationship to start when I announce a new product. It's much more long-term than “Did I show up at a dealer? Did I ask for this thing or not?” My journey may start with my previous ownership experience with that product. How does that tie in to digital? JULIE: That's exactly right. And if you can set it up properly across all channels, you can actually control your expenses and grow your revenue at the same time because you're increasing that customer lifetime value. Not only that, but they're also advocating for you on your behalf, and it creates – I think where you were going is the opportunity to continue to cross-sell and upsell. ROB: Right, because you're talking about digital platforms, you're talking about customer experience, you're talking about social listening to an extent, probably, social customer support, all of those different lenses. Absolutely makes sense. Julie, I think something that is perhaps interesting and unique to your story is the difference – a lot of our guests are founding partners, founding CEOs, and you have a unique story of coming into a business that is successful with an opportunity also to continue making it more successful. What is the background of Horizontal and the origin story there, and then also your personal journey into the firm? JULIE: Horizontal Digital started about 17 years ago. Chris Staley and Sabin Ephrem started the company. I'm going to use a term that you used earlier in our conversation, Rob – it's been a rocket ship ever since they started. It's such an inspiring and amazing story about what they've built, and it's a true testament to the way that they have run their business, the vision that they've had for it, the way they invest in talent, and the way they understand technology and what our customers want. Because it's a relatively tight community, I've known about Horizontal Digital for years, and I actually ran into them at a conference at Sitecore Symposium about three years ago. They were sponsoring a panel about women in technology, and I was actually sitting on that panel, and I got the chance to meet them. I've always had great respect for what they do. They've built an amazing culture here. So I was excited but a little bit hesitant about a year ago when they first reached out to me. I was happy with what I was doing, but as I started talking to them, their ability to deliver globally at scale and yet have a company that feels like a tightly knit family was really inspiring to me. In addition to that, I'm really passionate about advancing women, and particularly women in technology, and they're very supportive of that. What we're really trying to do here is to create an amazing employee experience. We talk about being an experience-forward consultancy, and experience-forward is really about – I mentioned this a little bit ago – putting people at the center. In addition to how we do that with our clients and their customers, it's also got a couple other pillars for me. One of them is making sure that the client experience that our clients have with Horizontal surpasses their expectations. Certainly we expect to deliver on their business needs, but also we want that experience that they have with us to bring a lot of value and, frankly, to have them enjoy the experience along the way. Then the third pillar is – and I just mentioned this – employee experience. Talent is the most important asset that we have in this business. I believe that if you create an amazing employee experience, they will in turn create an amazing experience for our customers, and then that result is growth. So I joined this company with the aspiration of making Horizontal the best career experience that our employees have. ROB: It's a particular challenge. I've seen leadership elevated from within, but how did you approach that process of coming in with a requirement to lead, but also with – you said you were familiar with the firm, but there's a different familiarity that comes when you're actually on the inside every day. How did you balance the movement into leading with the need to acclimate? JULIE: That's such a great question. What I appreciate is all the conversations that Chris, Sabin, and I had in advance about how we were going to do this, approach this. They've been unbelievably supportive every step along the way. But the most important thing to do when you come into a company in a leadership role is to listen. I came in in December, so everything was fully remote, and when it's fully remote, I will tell you it takes so much longer to build that rapport and trust with people because you have to be so purposeful with every experience you have via whatever video technology you're using rather than just running into people by the proverbial water cooler. So I very purposefully did a series of – I think I did more than 50 one-on-one introductions with people. I joined each individual team meeting. We actually hired Gallup to do an employee engagement survey. We went on a listening tour to start to understand what the needs of the team were. One of the challenges is coming in and listening. You get excited and you want to make change, or you want to advance the ball in whatever way you decide to do that. Finding the balance of moving at a pace that feels like you're making progress, but not going too fast that you aren't being thoughtful or purposeful and you aren't damaging something in the organization – it's a tough line to walk, I'll tell you. I actually made a few decisions probably quicker than I should've, perhaps should've moved a little faster on some things. But it's kind of one of the things that I love about it: it's a learning experience every step of the way. ROB: What I hear in there is a recognition that sometimes there are not shortcuts. There's no shortcut – having 50 one-on-one conversations, by some people's reckoning, that doesn't scale well. That doesn't look like an org chart. That looks like 50 one-on-one conversations. Are there any other aspects of getting in and rolling up your sleeves and leading that maybe didn't scale well, but yet were key to getting into the role? JULIE: That certainly was the big one. One of the other things that I am doing around here is weekly having a session with about five or six people from different teams within the organization, and I purposely do it with five or six people because I want it to be small enough that people feel like they can speak up and yet have enough people that I feel like I'm making some progress and getting a group together. So we get together once a week, and I call it “bring your favorite beverage.” We get together and we introduce ourselves and we talk about non work-y stuff. And sometimes it turns into work stuff. But what's been really interesting is since the pandemic started, we've hired – gosh, it's got to be closer to 150 people by now. So not just do I not know a lot of people, but a lot of people don't know each other. One of the things I know – and this isn't specific to Horizontal Digital, but in general – people really miss that sense of community, and people miss the culture. I don't think that means they want to come into the office every day necessarily, but they want very thoughtful and meaningful and purposeful moments of connection to build and feel the company culture. So we try to create opportunities to do that. And selfishly, I want to create opportunities where I can get to know people on a personal level because I believe that my job is not to tell people how to do their job, because they're all quite capable. We hire amazing people. But my job is to support and enable them to do their job, and I can't do that if people don't know me and feel like they can trust me and are willing to come talk to me. ROB: It seems to me that with you coming into the firm and that degree of growth, it almost seems like the company as a whole discovered another capability, another core function, another gear. What do you think is driving that engine so remarkably? JULIE: Well, there's a couple things. Companies understanding the importance of building an amazing customer experience and digital transformation is certainly a thing that's happening beyond our company. That's an industry-wide movement that's happening, so that is a big part of our growth. In addition to that, I have to give the owners a ton of credit because we are independently owned, and their ability to drive the vision for where we're going and see ahead of where we are today, and their willingness to invest in that, is something that I've actually not experienced in over 25 years in this business. I think that's another thing that sets us apart and truly makes us unique. And then again, back to the idea of community and relationships. I believe that relationships are at the center of everything, and when you do a great job, like I was talking about – if we create an amazing experience for our clients, then we're going to grow through that as well. There's just a lot of things that Horizontal Digital is doing right that also made it really exciting to join, and I joined and I'm just trying to continue to build on the momentum. One of the things that we talk about a lot around here is not only keeping up with the pace of growth – because there is an all-out war for talent right now, especially in the digital space – and creating an amazing employee experience, but also, we have to make sure that as we are growing, we're building the infrastructure and scale internally to enable that growth. ROB: One of those key things you mentioned very close to your heart and your passion – it seems like it's really hard to create a substitute for having women in very visible and top-level senior roles. That has to echo down through the organization. It has to be authentic. You can't do it in this demonstrative way. How have you thought about it? You've obviously had to structure for growth and refactor the organization probably a few times in the pandemic time. How have you thought about the thoughtful, intentional establishing of women in leadership as well over that time? How do you do it well? JULIE: That's a good question. I think the important thing is to meet people where they are. And I am all for advancing women, not at the expense of men or anybody else. I believe that all boats rise with the tide. But I think understanding where people are in their careers and their lives is super important, and then meeting people where they are. There is no delineation – in my life, anyway, even prior to the pandemic, there was no delineation really between work and life because when you're passionate about everything that you do, it all kind of melds together and you've got to try to figure out ways to make all of it work. I think the pandemic has exacerbated that, and I think it's been really hard. This is not me; this is clearly very much out there, but it's particularly difficult for women, and moms in particular, which I am as well. So understanding that and making room for conversations around that and – this sounds so simple – asking people how they're doing. Talking to people about their personal lives. Making sure that you are bringing empathy and listening in all those conversations. It seems like things that sound so easy, but they're also the things that are really easy to forget about in the pace of everyday stuff. And particularly, again, if you're not just seeing people in the hall in passing, you get on a call with somebody, you've got a half-hour, you've got a list of things you've got to cover off on, and you want to dig right into that list – when what you really need to be doing is making sure that you're taking time to check in with people on the human side and see how they're doing. Because everybody's at a different point in their journey. ROB: Right. That really is one of those superpower advantages. When people know that you care, when they know that on some level you know the names of the people that are important in life – I will fully confess that I have places where I write this stuff down. There's a lot of things I don't write down, but I write down people's names and what's important to them because I don't want to leave – I still care. I care enough to write it down. I care enough to ask about it. JULIE: Yep. ROB: It makes a difference in where people work and where they stay working. JULIE: I agree with that. I think it was Maya Angelou that said people will forget what you said, but they'll remember how you made them feel. ROB: Yes. JULIE: I think the fact that you make an effort to remember somebody's name and something personal about them makes people feel seen. And that stuff is really important and can't be underestimated. ROB: As you mentioned, that war for talent is real. It's really excellent, I think, that in Minneapolis, you've been able to sustain and grow as an independent business. I'm sure the owners – how many people do you have on board now? I think LinkedIn said over 200? JULIE: Yeah, globally it's nearly 500. ROB: You don't get to that level without a few people coming in and offering to write you a nice check. So there is some intentionality in staying that way, and that also feels very authentically Minneapolis. A lot of the Midwest, I think, has lost some of their anchor tenets. It's a city that seems to have some businesses that they're proud of, and it seems like you get to be a part of that. JULIE: Yeah, and I've done the other side of it, too. I have done the being part of a holding company. At this point in my career, when I made a decision to come here, it was very purposeful because the owners not only fully own the business, but they're very involved in the business, and they care very deeply about it. Like I was saying, they're willing to invest in the future and have vision for where we're going to keep going. That's what drives the inspiration, I think, for a lot of the team in terms of the longevity of careers here. ROB: Wonderful. Julie, this is not even your first time, as you mentioned, running a shop. What are some things you have learned along the journey that you would maybe go back and tell yourself to do a little bit differently if you could reset? JULIE: I think about that question a lot because I have twin girls, and it's really important to me that they have opportunities that I didn't necessarily have. One of the things that I am already talking to them about that I wish I had done more of is just speaking up. Over the course of time I have learned how to ask for things when I need them, and I wish I had started doing that sooner – whether that's asking for the next role or asking for mentorship, asking for help – not easy to do, really important – admitting if you might feel like you're in over your head, and having the courage to call out bad behavior when you see it, making sure that you're listening to your instincts. All of those things, I feel like I wish I would've learned a little bit sooner, and I would encourage people to absolutely do. I'm constantly saying to everybody here, every time I get a chance to address the company, I'm always asking them to please reach out to me. I don't care what channel it is, whether it's Slack or you want to text me or email me or call me, whatever it is. But I really want to hear from people because the only way that we're actually going to make this a truly amazing employee experience is if we understand what's going on in the minds of our employees. So I think it's really important to speak up. ROB: I think that's super helpful. I think that's great for your girls. I think at least a lot of us want to work in a workplace where that is the default behavior. There may be some generational baggage there; I don't think my grandparents wanted that kind of job. But I think about my team, and if someone's going to say when they're in over their head, if they're going to ask for help, if they're going to ask for where they want to go next and help me participate in their future, it seems like that's what a lot of us want. And we want more people to want those things so they can get out of the jobs where they can't have those things. JULIE: Rob, you may be a lot younger than I am, I don't know, but I will tell you I was raised “Don't question authority. You don't ask questions. You do as you're told.” So it took me a long time to try to find a balance with that. I think as a society, that is changing, but I think it's a really important thing to continue to remind people. ROB: Yeah, and it's our opportunity to build workplaces that differentiate by being that kind of place. It's a tremendous opportunity there. JULIE: Absolutely. ROB: Julie, as you're looking forward for the future not only of Horizontal Digital, but also in overall experience for brands and their customers together, what are you excited about, looking into the crystal ball? JULIE: Broadly, I'm just excited about where technology continues to take us and the opportunity to really, truly create amazing experiences. Not only am I trying to help our clients create amazing customer experiences, but I want to experience that with all of the brands I engage with as well. So I get really excited about the pace technology is moving and how that's becoming better and better. As it relates to Horizontal specifically, I'm not even a year in yet, so I'm really excited about the momentum that we continue to have, and again, the way that our founders are willing to invest. But I also hope that in many ways, this year is a building year for me. We set the benchmark on employee experience. We're hiring some new key talent. We're continuing to evolve our capabilities. So my hope is that we can continue to take this to the next level in terms of building a vision that the team gets really excited about, continuing to foster and grow the talent, and then building the infrastructure to scale and grow. Beyond even what we're doing for our clients, we also want to make sure that we're doing purpose-driven work that people are getting really excited about as well, so we have an organization called Horizontal Cares where we give back to our communities. I'm excited about all the opportunities that we have to build community with our employees, with our clients, and with the broader community within which we work. ROB: Horizontal Cares sounds like one of those things that I think any of us would probably wish we had started sooner within a firm. How do you think about allocating resources to that? Is there a rule, is there a budget? And where would you think about starting if you were even quite small? JULIE: Oh, that's such a good question. This started prior to me being here, but you get a few people together who want to change the world and anything can happen. To this point, it's pretty scrappy and entrepreneurial. We do internal fundraising efforts and look to our employees to help us figure out where the need is in our communities. I will tell you we are looking for how we can take this to the next level in terms of scale, so that is very much on the horizon for us and one of the things that I'm excited to work on. ROB: One thing I think probably that comes up repeatedly – it happens in every growing firm, and probably especially for you and Horizontal – is thinking about what types of either new capabilities you're going to say no to versus what you're going to say yes to, and what opportunities you might have taken on three years ago that don't fit with the firm anymore. How do you think about the things you say yes to and the things you say no to? JULIE: Boy, that's a good question, and it's an ongoing conversation that we have at the executive level. ROB: Has to be. JULIE: Of course, you want to make sure that you are continuing to be relevant to your clients and to your future clients, and at the same time, we also have to be really purposeful and thoughtful about not biting off more than we can chew at any given moment. When we are making sure that we are hiring as quickly as we can to keep up with the demand that we have – everything's a balancing act, Rob. It's a balancing act with where we are adding to our capabilities to make sure that we can not only deliver on the work that we have, but then build the future. So really, it's an ongoing conversation, but again, that's one of the things that I get really excited about because the owners here are so well-entrenched in that and willing to place bets where they think it makes sense to place bets. ROB: It sounds like a wonderful journey to be on, an excellent season to be there, in spite of everything everybody's been facing over the past little while. We still have some rough waters around us, but it sounds like you've been able to help Horizontal to be part of the bright spot in your life, and for some other people as well. Thank you for hopping on and sharing that journey. I do appreciate it. JULIE: Thank you for having me on. It was really fun talking to you. ROB: Sounds good, Julie. Be well. JULIE: Thanks. ROB: Bye. JULIE: Bye. ROB: Thank you for listening. The Marketing Agency Leadership Podcast is presented by Converge. Converge helps digital marketing agencies and brands automate their reporting so they can be more profitable, accurate, and responsive. To learn more about how Converge can automate your marketing reporting, email info@convergehq.com, or visit us on the web at convergehq.com.

“There are a million paths to motherhood and there is no right way or wrong way. It is just your way.”Jesse Truelove with @movewithtruelove joins us on the podcast today and drops some serious truth bombs about birth, fitness, social media, and motherhood. We couldn't be happier to have her with us and for you to hear the important messages she has to share! Our mission at The VBAC Link is to empower ALL women in their birthing choices, whatever they may be. We applaud all women for choosing the birth path that is best for THEM. There is no right or wrong way to give birth! Additional linksInstagram Live with Jesse and TVLBirth Words: Language For a Better Birth PodcastVBAC vs Repeat C-Section BlogMove with Truelove: Jesse's websiteAB Rehab courseMove Your BumpFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Happy Wednesday, everybody. You are listening to The VBAC Link. This is Meagan. Julie is on with us and we have a special guest. Her name is Jesse Truelove. We are excited to talk about her episode today because this is something that is actually a first for The VBAC Link. We were just chatting a little bit before. We were like, “Why haven't we had this happen?” because this is totally what we talk about, what we teach about in our courses, and this episode is where she had an emergency C-section, ended up recovering from a really difficult delivery and had very little support. And really, for her next child, when all was said and done, she decided to have a repeat C-section.And I love this. I love this because as The VBAC Link, as Meagan and Julie-- yes, I am talking for you, Julie. We are all about everybody making the best choice for them. That may not be a VBAC. Some people may not choose to have a VBAC. One of my best friends has had three C-sections. The first one was unexpected, two were scheduled. I love and support her in that even though that is not what I chose to do. I chose to VBAC. I support her in that and I am so grateful that she had that opportunity.So we are really excited to dive into this episode today and hear her story. She has done so much good in the world. After her births, she decided to dedicate her focus to helping moms recover fully from their pregnancy and delivery. We are going to talk all about that in the end because she has got some pretty cool stuff that she is in charge of.Review of the WeekMeagan: But of course, we have a Review of the Week before we dive right into it.Julie: All right, yes. The Review of the Week. This is kind of a long one, but I really feel like it goes in line with this episode. I'm going to tell you about how I shamelessly stalked Jesse after this. But this review was actually an email. We got an email from Christina T. We really love getting emails from people who we have helped along the way, and so if you want to reach out to us through Messenger, or email, or Instagram Messages, or leave a review on Apple Podcasts, or Google, or Facebook, or wherever you want. We reply to all of the email messages and DM's that we do get. We love talking to people and hearing their stories. This is a long one, so bear with me, but I really like it. She says: “I wanted to tell you about my repeat C-section. On the podcast, I have heard that term so many times. ‘Hold space.' For me, that's what you ladies have been preparing me for these nine months without me knowing it. For holding space. “For nine months, I prepped for the VBAC of my dreams. I listened to every podcast, was a member of the Facebook group, did ‘all of the things to prepare for the birth I thought I so desperately needed. I was ready to have an unmedicated birth and to roar my baby into this world. At 32 weeks, we found out baby was breech. I had been going to the chiropractor twice a week and felt confident he would flip. He did not flip. I then started to kick on my Spinning Babies®, got acupuncture, did everything online I could come up with and he still would not flip. “Around this time was the week you guys had your repeat C-section podcast and for me, it was a sign to start mentally preparing for what might not be. I spent the next few weeks switching my mindset from feeling sorry for myself and switching it to feeling strong. It was during those weeks I thought to myself, ‘What am I missing? All of this education and research can't have been for nothing.' “That's when it clicked for me. I had been preparing to hold space for what won't be and I have the tools to do that. We scheduled my C-section and when March 8th came, I was as ready as I was going to be. The anesthesiologist came to the room and I knew it was going to be a wonderful experience. Prior to this baby, we had suffered two losses in a row. We needed to have a D&C for the second loss and all day, different staff members asked me to state in my own words what procedure I was having. Each time I would break into tears as it was a very difficult thing.“My doctor came into pre-op and instead of asking the same questions, he simply said, ‘I am sorry you are here for this procedure. Are you doing okay?' The same kind, genuine man was going to be my anesthesiologist now. When I first walked into the OR, my stomach dropped. It was bright, cold, and sterile just like last time. My doctor must have sensed my heightened awareness and said, ‘Your baby is coming.' And with that, I was ready. “We were able to drop the drapes, watch our son come into the world, and have skin-to-skin right away. It was night-and-day from our first experience. It was joyful and blissful, and I left a feeling like a mom and not a patient. I left feeling confident and like a bad-ass. I left holding space for my experience and for our story, and I will be forever grateful for that gift from you ladies. “Birth doesn't always go as planned. Sometimes it is better.”And now, that gives me chills at the end. “Birth doesn't always go as planned. Sometimes it's better.”Meagan: I love that. Sometimes it's better.Julie: I'm going to make that into an image.Meagan: Yes. Let's make that an image and quote her because that same thing. I just got the chills.Julie: I know. I have goosebumps.Meagan: I was like, “Yes.” Sometimes it doesn't go as planned, but it's better. Yeah. I feel like I can connect to that even with my second C-section. I didn't want that second C-section, but guess what? It was such an amazing experience and it healed my first birth experience.Julie: Yeah. I love that.Meagan: I love it. Awesome.Julie: All right. Well, let me tell a little bit of a funny story and then I promise I won't take up much more time. Jesse, we did an Instagram Live with her on her Instagram page.Jesse: It's still there.Julie: Yeah, @movewithtruelove, right? That's what it's called? It was really fun. This was a long time ago. We followed her and I just love her content. She has great content. Super fun. Her reels are amazing. I just love seeing her bright, beautiful face as I scroll through our feed and everything. I just have really enjoyed following along with her Instagram. I knew that she had a Cesarean and that she was pregnant again. I don't even know this whole story, but at some point along the way, Jesse decided that she was going to have a repeat Cesarean instead of attempting a VBAC. I was like, “Oh my gosh. Okay, this is really cool. I need to follow along and see how this all ends up,” because we haven't ever had a story on our podcast about somebody who had decided to have a repeat Cesarean.Meagan: Even though there are tons of people out there.Julie: Even though there are lots of people that do all the time.Meagan: Tons, yeah.Julie: All of our C-section stories--Meagan: In fact, a large chunk of people, the majority do.Julie: Yes. Yes, and we have had three VBAC stories where people have tried for a TOLAC and then ended in a repeat Cesarean, but we have never had somebody that has decided during their pregnancy that a Cesarean was the right way for them to go. And so I was so excited. I am like, “Oh my gosh. I need to follow up with this. I need to make sure she's on my radar,” and then she announced her cute little birth story was on a little reel on her Instagram page. You need to go find it. It is the cutest thing ever. I knew that she had her baby and she had a C-section, and then I was like, “Oh my gosh. I want her to share her story on the podcast, but I don't know if she will be open to it,” because I know, from what I picked up from the reels, it wasn't an easy decision to make. I didn't want to overstep my boundaries. She is super cool and way bigger than us on Instagram. I feel so small and tiny, but one day, I am like, “Okay. I'm just going to reach out, and I'm just going to say how much I love her, and how excited I am that she had a really good birth experience and that I would love to share her story on the podcast if she would like to.” And she said, “Yes.”Jesse: Oh my gosh. I only got good vibes from our last conversation and I literally wanted you guys to do my VBAC. That's what I wanted.Julie: Yeah.Jesse: It was a big change for me. It was definitely a mind shift, but it wasn't as big of a deal as I realized it was once I put it out there on social media.Julie: Well, and I'm sure you got a lot of support. I don't know. Maybe there were some people, but I mean social media. As we are getting bigger, there are people that argue with us and disagree with us all the time. But I just love that you were confident in your decision. You just radiated that security and that confidence. I think that that's what we all want going to birth is just being confident and feeling supported. That's the vibe I got from you when you were talking about it and sharing your birth story and things like that.Julie: Without taking up too much more time, first of all, thank you so much. I'm so excited to have you share your story and to listen to you share about that decision that you made. Then we are going to talk a little bit afterwards about when it might be a good idea to choose a repeat C-section, and then Jesse is going to share some of her really awesome resources.Meagan: Awesome stuff. Yeah.Jesse's storyJulie: Yes. She has lots of really cool stuff. So hang in there with us because this is a really really good story and you want to hear what she has to say at the end. All right, Jesse, you've got it.Jesse: Okay, thanks so much, guys, for having me. I am actually really, really honored to be on your podcast. I had such a good experience chatting with you guys. It felt so, so natural the first time we did it, so it was a very easy “yes” for me.So I guess I will start out with my first C-section which really has paved the way for everything that I am doing now. Really, everything about motherhood has shaped everything that I do now. With my first pregnancy, I was working out really hard. I have been a personal trainer since 2014 specializing in women's fitness. I have taught in multiple states boot camp, and circuit classes, and personal training for abs, and all kinds of stuff, but it wasn't until my own delivery really, because I had a fairly easy pregnancy in respects to working out. I was very active, and so I thought in my head, I had this very clear picture of what my birth story was going to look like. It just seemed really, really easy to picture what it was going to be. I thought if anybody could, this is a really weird thought to have, but if anybody could have a natural birth and if anybody could do it successfully-- it didn't even cross my mind that a C-section could be in my future. Meanwhile, I am the oldest of six kids and my mom has had four kids via C-section. So pretty interesting that I never thought it was going to cross my path.I went Into my delivery, like I said, with a very clear picture of what my birth story was going to look like and it quite literally went the exact opposite. I was in labor for 26 hours. I was bleeding. I got a uterine infection. I had a fever. My placenta was failing. Heart rate was dropping for the baby. They broke my water. I got Pitocin. It was literally my worst nightmare and I was so, so exhausted by the time that my doctor-- well, I couldn't have my midwife anymore who had been with me the entire time. By the end of the 26 hours, I had the OB come in. He was checking me for dilation and I just wasn't dilating. They gave me Pitocin and they broke my water. I think I got to maybe an 8 or a 9 and it just wasn't happening. And then contractions slowed down and I really was so exhausted. He came in. He was checking me for dilation and he asked me to push. I was just so out of it. I didn't even know how to push. I feel like if it's such a medical experience, you go in and you are hooked up to these monitors, it just doesn't feel natural. It feels really really medical.Julie: Yeah.Jesse: Especially when doctors are coming in and nurses are coming in checking your blood pressure, and you've got those monitors, and beeping, and honking, and all of the stuff going on. You don't even know what's actually happening with your own body and then I had an epidural by that point as well, and so you know how an epidural feels. You could kind of feel the contractions coming and going but it's not even close. So your doctor asks you to push and you have no idea what he's talking about. Push what? Most women don't even know what the pelvic floor is and I was one of those women. Before my pregnancy, I was lifting and pushing some heavy weight. I was deadlifting 255. I am a five-foot person. That is a lot of weight for a tiny person and I didn't have the mindset of function.I had one picture of what fit looked like, one picture of what strength looked like, and it was not anything of what strength really is. Motherhood taught me that. He asked me to push and I didn't know what he was talking about. He goes, “Oh. You can't do this. You are going to need a C-section.”Julie: What?Jesse: “It's going to be C-sections from now on.”Meagan: Whoa.Jesse: I laid there completely drugged out of my mind. I look at my husband and tears are just welling up in my face. I could cry just thinking about it. My husband is-- you know, we think that we are the strongest people we know. We love each other so much. He wanted to take that whole experience on himself and it was killing him that he couldn't. He put on a brave face. It is hard for husbands too. They go through this with you and it is so much. He looked at me and he was like, “It's going to be okay. We just have to do what we have to do.” In my head, I am already thinking of the future. I'm like, “What do you mean? All my next pregnancies are going to be a C-section?” I feel like it was the worst possible time to lay that on me and it's just the standard of care. It's just not there for moms. So the OR doctor left. He was assembling his team and the anesthesiologist had to be called in. We are in the middle of nowhere out here in the Oklahoma Panhandle so they have to call the team in. They're not just there waiting for you if something goes wrong. So we are waiting for the team. I am laying there and all I could think was, “I have totally and completely failed before I even got to start. My body has totally failed me and I don't even know. I am supposed to be able to do this. This is what I was made to do and he just told me I can't now and I'm never going to be able to.”That stuck with me forever. And then, we are getting ready for the C-section. I have never had any kind of surgery ever. Never, ever, ever, and so I am terrified. I was already terrified to give birth and now I am terrified to go be cut open. And so they had me hunched over-- oh no, this was after I had my epidural. So they changed it over to where they just have to keep pumping the epidural in, so it wasn't a spinal tap. They put me onto the new table. They strapped me down to the table, which was another thing I didn't expect to happen either. It is all such a mental hurdle to get over. You're like, “Wait. They don't tell you any of this going in.”Julie: Yeah.Jesse: But that just all adds to the mental trauma of, “You have no control in this. We are strapping you down. You are numb. You can't have your baby the way you wanted to. You are getting wheeled out of the room you just got comfortable in. Your husband has to wait out here.” It was hard. It was so hard.And so, anyways. We get rolled into the OR room. Just like your mama said previously in that story you were sharing, it was cold. It was sterile. A bunch of people that you don't know are in there. Your husband is not in there. You get placed onto the table. You get strapped down. You get the blue sheet at your neck and it's an emergency situation because the heart rate is dropping. I had a fever of 103 because they had checked me so many times.Meagan: Wow. Wow.Jesse: I had gotten an infection literally while I was there within 24 hours in my uterus and that's why I was on antibiotics for probably-- I was in the hospital for five days. I was on antibiotics the whole time which, you know. Antibiotics, just the additional medicine. I'm not one to even pop an Advil for a headache, so it was just a lot.So they are doing the surgery. It was all very fast. It was a ton of pressure. A ton of pressure, relief when they took the baby out. They sewed me up pretty quick. Again, I had no idea what was happening afterwards, so they took Radley out and I could hear her screaming. In that moment, it is all totally worth it. It is all worth it because even at the end of your emergency, traumatic, C-section, you still get a baby. The baby that you have been dreaming about for nine months, the baby I've been dreaming about-- for me, it was since I was a teenager. Me and my husband have been together for 12 years, since high school, and we had been talking about our kids forever. So in that moment, I am like, “Oh. I could do it again. I could do it 1000 times the same exact way. I would go through everything the same because at the end of your really shitty experience if it is shitty-- which mine was-- it's still worth it.So they brought the baby over to Shane. Shane just put her on my face because that's the only skin I had accessible. They didn't tell me about skin-to-skin. They didn't drop the curtain. I didn't get to see anything and I felt like I missed out. I felt like I got gypped in my birthing experience, which I did. I think that's okay for moms to feel. I feel like there's so much judgment around feeling what you feel about your birth. I feel like a lot of moms, and myself included-- I didn't talk about my first C-section for a long time and I didn't feel comfortable in sharing the fact that I wasn't just grateful for my baby being alive, but I was really pissed. I was mad about my C-section. I was mad about how I was spoken to. I was mad that I felt like my body had failed me.Nobody made that feel valid for me. Nobody asked how I was really doing. Because after pregnancy, I feel like a lot of moms can attest to this, it stops being about you and it goes all to the baby. You get one check-up postpartum and then that's it. At my six-week check-up, they didn't even check me internally. I got the magic check at six weeks like, “You are good to go to back to whatever you were doing before you got pregnant,” and so I went back to doing those things. I realized quickly that my idea of strength and my idea of being fit was so terribly wrong.I had never felt like more of a stranger in my own body. I got home with this new baby that was beautiful and perfect and I had a brutal recovery from being in labor for so long, and the infection, and all of that, and then recovering from a C-section and major surgery. They don't really explain that to you in the respects that you should be getting rehab postpartum to be rebuilding connections with those muscles, and movement patterns, and muscle recruitment patterns, and all of those things. And so I went into my recovery pretty blind. I realized quickly that moms don't get much support at all through anything postpartum.And then I got really educated and I built courses for moms to rehab their own bodies postpartum, everything that they need. I realized that moms don't need a six-pack, even though if you want one, it's totally possible. What we need to be able to do is sneeze without peeing our pants and nobody could have told me how to do that. There wasn't that information really out there. It was really just Kegels and if Kegels don't work, get a surgery. Another surgery. There's just a lot of room for improvement out there for the standard of care for moms and that's what I get to do now. And so I love that.And then in my interim between my next pregnancy, I had a lot of focus in my mind and talking with my family, and talking to you guys that I wanted to have a VBAC, that I was confident that was just a one-off thing, and that I was going to be able to have a VBAC, and it was going to be successful, and that's what I was going to try for, and all of those things. And then once I actually got pregnant, we did experience one loss after my first baby and we had a miscarriage. I got pregnant pretty quickly afterwards. I was discussing with my husband what we are going to do because you just don't know what you're going to do until you are there.So once I was pregnant and thinking about where we were going to deliver, who was going to do the surgery because the OB that did my C-section the first time didn't live here anymore, which probably was better because this doctor that I got this time is just amazing. And then after I met him, I felt a lot more comfortable with choosing another C-section. After going over my options with him-- which I think is super important. If you want to choose a C-section just because you want to choose one, you have those reasons in your mind about why that is a better choice for you and that should be okay. Those should be valid reasons. But I did ask him some things trying to get his medical opinion on what was the best choice for me even though in my head after I was sitting in the hospital, I was like, “I really don't want to be stuck in the same position that I was last time. I don't want to be in labor for 26 hours to get stuck again and to have to go through another labor, the C-section, and a surgery, and then have to go home and take care of two babies.” And that, in my head, was really important to me to still be able to do everything I needed to do and not have such a tough recovery because I remember my recovery being so, so hard from basically going through two deliveries. The 26 hours of labor and feeling all of that, and then going through my emergency C-section.So when I was talking to him, he basically gave me some options. He did mention uterine rupture. I know the odds are very low, but like I said, we are in the middle of nowhere. He personally had seen some uterine ruptures happen and you just don't know that they are happening until baby's heart rate is dropping and for us, that risk of not having a team on staff because the hospital is so small, that risk of having to call a team just wasn't worth it to me. I had to weigh the options and weigh the risks between a repeat Cesarean, which there are risks and the risks of trying to labor and then ending up in the same position that I was in last time.And so we ended up choosing a repeat Cesarean and I felt really comfortable with that knowing that I was going to be scheduled, knowing that my mom was going to be in town, and being able to watch my other daughter. That was really important to me. My daughter's experience through us being gone because we have never left her with anybody before. I just had a ton of stress surrounding that. Not to say that the second C-section didn't bring me a lot of stress too. I don't know why I had this irrational fear, and moms are really good at this, that I was going to die. I had this irrational fear that I was going to go into surgery and not come out for my toddler.You don't have that fear going into the first one of not getting back to somebody, so that was really hard for me. I was shaking like a leaf laying on the table going in for our scheduled C-section for River, my second daughter. It's funny because just like the mom that you mentioned earlier in the beginning of this show, you can get really lucky with the staff that you have for your experience and I totally lucked out. My anesthesiologist felt like family. It's funny to say because you meet them, and they come in and tell you the risks and stuff for the spinal block and all that, and they talk to you, and you are like, “Gosh, I am so scared but for some reason, you just are calming those nerves.” I think it is so important to have that type of support team. You can just tell this guy had daughters. I went into the OR room. They were in there. I'm leaning over my nurse's shoulder and she is just holding me. They are putting in the spinal tap and they laid me down. Again, you're in there without your husband. The lights are all on, cold, sterile, they are strapping you down, and I just had this fear that I was going to die.They are working and they get her out. I hear her screaming and again, it was the most beautiful noise and sound I had ever heard. They bring her over and in that moment, it was just peace. It was so much peace and again, it was just all worth it. They clean her up and they sewed me up. My doctor was really, really careful with my C-section scar which was really important to me too for adhesions and making sure that everything was sewed up very carefully. They took dad and baby out. I went to recovery and it was probably 30 minutes. I feel like that's something they don't tell moms either that you are going to be in recovery by yourself which is always a little bit sad. It was for me. I had both situations where I was in the recovery room by myself, but the feelings that I had surrounding my second C-section were not failure, were not that my body had failed. I had so much power in the choice that I had to be able to know my outcome and it did heal me from my first experience as well because I mourned that delivery. I mourned that experience that I felt like I missed out on. Even though I didn't get to have a vaginal delivery, I didn't get to have that experience, I still got to experience something beautiful and everybody came out okay.Birth words matterThat's not always the most important thing to bring up to a mom too. She is proud of her baby. She is proud that her baby is happy and healthy, but it is also really, really important to let her feel everything else. I feel like that's what this world needs more of. Instead of-- well, I didn't realize how much judgment there was around choosing a repeat C-section until I put it out there. And I was, oh my gosh. I got shamed so hard by a doula. She told me that I was saying I was too good for labor.Julie: Oh my gosh.Jesse: That labor was beneath me.Meagan: Whoa.Jesse: I thought that this was such a dangerous position for that lady to be in as a women's birth support person and her personal feelings around C-sections to a person that she does not know. She is a mother herself and to shame a mom-- I literally was trying to rationalize in my head during my own time of choosing a C-section that this was really the best thing for me and for my family. We don't have family here in town that can come and take care of our house and our baby, so we needed our family to fly in. That was a really big thing for us. We needed to make sure our toddler was taken care of. That alone could have been my only reason to choose a C-section and it should be okay because I do have other kids to take care of.Regardless, I have my own mental health to take care of and my first experience was crippling. There's nothing like looking at your body after you have this beautiful baby in your arms and thinking, “Gosh. I feel like a failure. I feel like my body failed. I feel like I can't do the one thing a woman is supposed to be able to do. I don't recognize the body that I am in.” I am supposed to be this strong fitness person. I put all this pressure on myself to bounce back. I didn't know how to do that. There's so much pressure. It is so much pressure from not only ourselves because moms do that. Women do that. But especially with social media, it can be a blessing, but it can definitely be a curse with how easy it is to access people and access very vulnerable parts of people's lives. This whole C-section conversation that I have become so passionate about talking about really stemmed from that doula's comment to me because I didn't realize that women were getting so much shame from this. It wasn't until I put my own experience out there that women were like, “You know, yes. That is me. I got shamed by my own mom. I got shamed by my best friend.” People telling me that I didn't really birth my baby. That stings as a mom. Our words quite literally carry weight to the people that we say them to whether it's a stranger, or a friend, or somebody on social media, or somebody in your family, sister-in-law, mother-in-law, all the things. There just has to be more support all around because at the end of the day, we are just moms trying to get home with our healthy baby.Julie: Yes.Jesse: And there's no shame in that no matter how you do it.Meagan: Right. We are honestly-- yeah. A healthy baby and we are wanting to stay healthy, but we are also wanting a good experience for us.Jesse: Yeah.Meagan: When I was choosing to do VBAC, I also got the backlash of, “Just schedule a C-section. Why would you do that? Why would you chance it?” I mean, it goes both ways.Jesse: You just can't win.Meagan: Literally, it doesn't have to be about birth. Vaccines, masks, no masks for COVID--Jesse: Totally.Meagan: No matter what it is, it is this battle. I wish so badly to this day that people could just take a step back, take a deep breath and say, “Okay. I know where I stand. I support where you stand whether it is the same or not.”Jesse: Yeah, totally.Meagan: Because if we could just be validated in our own choice and not be questioned and put down for making the choice that we feel is best, this world would be so much happier and less battley and snarky, right? I chose to VBAC. You chose not to VBAC. Do I think you are any less of a person? Do I think you birthed your baby any less? Hell no. That's the answer.Julie: Meagan just said “hell” on the podcast. It's the first time.Jesse: I was going to say something worse, but I didn't know if that was acceptable.Meagan: I know.Jesse: Yeah, I know. It can get a little raw in motherhood, okay guys? It's pretty crazy. There are a million paths to motherhood and there is no right way or wrong way. It is just your way.Meagan: Exactly.Julie: I love that. There are a million paths to motherhood. Hold on. I need to make some notes for some social media posts later. Hold on.Jesse: Write it down, Julie. It's pretty crazy. We are the largest population. There are so much more that connects us than what divides us. We let those, they are really just subtle and big differences, but we let them divide us. If moms would just come together, like you said, it would just be so much nicer because there is already so much pressure from other moms. We say that we want to support. We said we want to be validated, but it is usually moms that are so vicious to other moms and it's mind-blowing to me.Meagan: Which breaks my heart.Jesse: Yeah. It really is heartbreaking because we have all got the same goal and that is to raise these little people with love. Everybody has a different way to either get to motherhood, because that is a journey all in itself and one to be very cognizant of, again, with the comments. When you are going to have another baby, you really don't know the lengths that either a couple is going to be having to have a second baby or even to have their first baby.Meagan: Exactly, yeah.Jesse: Even a birth experience can really change the way if you want to have another baby or not, and recovery. If you don't feel supported for the first one, it's going to be really hard to feel supported in the second one unless something changes. I think that's what we in this field are trying to do. We are trying to change that. We are trying to change and raise the standard of care for moms because we are the population that raises the next generation, that keeps the world going. If you help moms, you help the future and that's what we are trying to do. That's what every mom deserves.Meagan: Wow. Yeah. I'm going to roll back even to what your provider said. He was like, “Oh, you're going to have to have a C-section because you're not doing this and you're always going to have to have a C-section.” My doctor said, “You were going to for sure rupture. I'm glad you didn't do it.” Right? Those things stick with us and they impact us, and they do impact the decisions that we make and the ways that we view things. This is totally not a sponsor of ours, but Sarah Pixton has a podcast called Birth Words. It is called Birth Words: Language For a Better Birth and just like you have been talking about, these words stick with us. Even though you, as a person, may be sharing something with someone based off of how you feel or whatever, remember that that might stick with them and impact them substantially in either a positive or a negative way. And so when we as people are speaking, we need to be aware of what we are saying, how we are saying it, who we are saying it to and be respectful of everybody's decisions, and choices, and views, and like you said, what they have been through. There are a lot of people with infertility stuff who don't even talk about it because they don't feel like they can.Jesse: Yeah. Everything pretty much about motherhood, I feel like, if you don't feel like you're going to be supported, you're not going to share, and then that creates a situation where you are not going to reach out to the right people and get the support that you need--Meagan: Right.Jesse: -- which creates more unsupported moms, which creates more chances of not getting the experience you wanted because you didn't have the knowledge, and the information, and the support that you needed to possibly have the situation that you wanted to happen actually happen for you. I feel like like you said with the words that he said to me, that pushed me into this prideful position of, “Okay. I am for sure having a VBAC next time.” You know? Like, “I'm going to show you I can have a VBAC.” And then once I got there, I was like, “I don't know.”Meagan: That's actually not what I want.Jesse: That's not actually-- I don't really want to try this again because of this, this, and this. Part of that was the mental space it put me in, the mental position that I put my husband in. It's just, and now we have another baby to take care of, so that was something else to take into consideration. So yeah. Your words carry weight, so be mindful of them even if you are a stranger.Meagan: Yeah. And remember there doesn't always have to be a “because”.Jesse: Yeah.Julie: Yes.Meagan: You don't always have to say, “Well, because this.“Julie: And you don't have to justify it.Meagan: “Well, because I want it because this or I don't want to because of this.” There doesn't have to be a “because”. Because is because. Do you know what I mean?Jesse: Right.Meagan: That is the reason and it's okay and you're confident in that. So yeah. I feel like a lot of people feel like they have to defend their reasons and it's like, no. You shouldn't have to defend your reason. If you're making a choice that is best for you, that's all that matters. That's all that matters.Jesse: Yeah. If you make a mom question her decisions, question her parenthood, question her ability or reasons as a mom, that's not support. That's not advice. It's just mean. It's just mean and it's unwanted, unsolicited, not advice, but just unsolicited speaking.Meagan: I love it.Jesse: Yeah. Moms need support.Maternal mental healthJulie: Yeah. It's important. Well and not only that, but I want to take it off on a little tangent. We have a serious maternal mental health crisis in our country, especially for women one to two years postpartum. When we create this environment where women are scared to share their feelings because they feel judged and they see these comments flying around on social media or wherever about which way is the right way to give birth or all those different things, it makes them more afraid to show their feelings. It also makes them feel like their feelings are wrong. When you are in a mental state where you feel guilty about your thoughts and you feel like you can't share them without being judged, then they are going to sit inside your head and your mind, and fester, and grow.It can lead to really long-term complications. I think we all know that mental health affects our physical health as well, and so we are having moms that are literally getting sick because they are not supported in their decisions. I am sure you have seen this too, Jesse. You have a big social media presence. Our social media presence is getting bigger all the time. I find the bigger that we get the more we get these people that seem like they just want to argue with whatever we say, or they take one little thing and pick it apart, right? I know I have texted Meagan a couple of times because I have anxiety over here. I'm working on it, but sometimes some things really upset me. I will text Meagan and I will be like, “What do you think about this?” Meagan calms me down and lets me know that there are 500 positive comments and one negative one.Jesse: Right.Julie: But I really still even get worked up about those types of things. It's something that I have to actively work on and I'm still learning coping strategies and stuff for, but my anxiety did not start until after I had my VBAC baby which is really interesting because I had what I would describe as a perfect, textbook VBAC. It was a perfect birth and everything was as I wanted it to be, and I had really severe postpartum depression and postpartum anxiety. It was my worst mental health after any of my pregnancies. I had this beautiful birth, but I had all of these expectations I set myself up as a mother based on what other people thought and what I perceived to be the right way to be a mom. And because I could not fit this mold that I had set for myself and because I felt like I didn't have a group of people I could talk to because all of my people were in this little mold, or so I thought, right? I kept it inside and it really did a lot of damage to my mental health. I know I'm not the only one that feels like that. That's why we share stories from all different types of people in all different types of births, in all different types of decisions, from all over the world even, because we want people to know that they are not alone. It's always okay to share your feelings. It is always okay to get help and it's never okay to judge somebody else based on their decision. It's never okay.Jesse: Yeah. I can totally relate to the comment stuff. I honestly can't even go to my comments. I've got a really strong group of moms here and, like you said, it's usually not even from people that are following you. They're not even coming to your page because they like your content.Julie: Oh yeah. They see one post.Jesse: Yeah. They're not coming because they like you. They're coming because you're triggering them. Because the people that I do see, I end up blocking them because I don't want anything negative that they say to affect a mom on my page.Julie: We do that too.Jesse: Or to read the comments or see it, so I will block them. But they are not even following me and I find it so intriguing, like, “Why are you here?”Julie: Yes.Jesse: Why are you here? What are you looking to get? It's usually because just they don't feel supported in their choices in their life, so they are attacking you for your choices or whatever. But yeah. The comment section is a dangerous place to be especially if the post has been up for a while. So every once in a while, I will go back and then I'm like, “Why did I do that?” Because you know? It's just toxic. But I think if I had one piece of advice for a new mom, it would be just to not read every book,  not ask everybody what they did because moms have an intuition and they just need to feed into that a little bit more. Just trust your gut. If you have got a stomachache about something, it's your second brain trying to be like, “Your first brain is not listening to you. I am going to make you throw up over it and I'm telling you, something is wrong here. Something is not right.” If it doesn't sit well with you, the mom, you get to be the deciding factor and if somebody is giving you advice and it doesn't feel quite right, it's not good advice for you.Meagan: For you. Yes, exactly.Jesse: For you, yeah. And that's exactly it. Just because you're getting advice from your mom, just because you're getting advice from your best friend who also has a kid, you're probably also going to get advice from your friend that doesn't have a kid that's imagining how they would be as a parent-- which that always is great-- just because you're getting all that advice, it doesn't mean it is the right advice for you, and your situation, and your kids, and you as a mom. So my advice is to take what you need and ditch what you don't. If you like something that somebody is doing if you like something that your mom told you, or your friend, or your grandma, or whoever, take it. And if the other parts of it don't align with your vision of how you see yourself being a mom, or how you plan on birthing kids or all of the things, just ditch that. It is going to feel so much better if you have that confidence to just put your foot down and be like, “No. I am the mom. This is how it's going to be.” I feel like we need to support moms in those decisions also. Because for some reason, we feel like, “I don't want to be rude, so I'm just going to let this happen.” But it's either your feelings or their feelings and I don't think the mom should have to sacrifice her feelings around her kids, around her birth experience, around everything else because, at the end of the day, it's your experience. It's your journey. It looks a little bit different for everybody else.Julie: And if you see some content on social media that you don't agree with, just scroll along. It's okay.Jesse: You do not have to comment. You don't. I promise. I promise you don't have to leave your opinion.Julie: Well, we hate to cut it off short. I feel like this is something we could talk about forever. But I did want to say that sometimes it is a hard thing to decide whether to try for a vaginal birth after a Cesarean or to schedule a repeat Cesarean. Neither choice is a bad choice, but we did write a blog about how to decide if an elective C-section is best for you and your baby. Jesse, you said, “Don't read all the books,” but you can read this one blog. We are going to drop a link for that blog in our bio or you can just go to our website, to thevbaclink.com, and just search for “elective C-section” and it will be a link there. It will list medical reasons for repeat C-sections and also reasons why people might choose to have an elective Cesarean. There is no right answer for you and like Jesse said, there are a million ways to motherhood.Meagan: There's no wrong answer.Move with TrueloveJulie: There's no wrong answer. But before we go, we do want Jesse to share a little bit more about some of the stuff that she does and how you can find and follow her, because we know you love her by now just as much as we do.Jesse: Aw, thanks, guys.Meagan: Well, and I think that this information that you are going to share is so powerful because it really isn't paid attention to enough. So tell us all about what you have got your toes and hands dipped into.Jesse: Okay, perfect. Yeah, so I have got my own page. It's Move with Truelove. You guys got plugged into that at the beginning of this, but I am also very deeply connected to Nancy Anderson and if you are in the prenatal/postpartum field or realm or if you are a mom, you need to know what we are doing over here. So I am the Program Director and Head Coach for the Move Your Bump app and that is our prenatal and postnatal fitness and nutrition app. We've got over 400 on-demand coached follow-along workouts of every style, every fitness level. We have got multiple, multiple expert coaches that always have your bump in mind. We focus on minimizing excessive diastasis which is the ab separation, which became this really hot topic on social media, but there are about a thousand ways you can get it. We really focus on the prevention of that during pregnancy to help you have a more comfortable pregnancy, but more importantly, we are training you for labor because it is the hardest workout of your life. Whether you are a vaginal delivery mom or a C-section mom, it is going to be a fight and you want to make sure that you are training properly.We also prepare you for a faster recovery and we do that through the Move Your Bump app through workouts, through breathwork routines, through focusing on posture, troubleshooting issues that we see most commonly in prenatal mamas. We also have challenges throughout our app with private Facebook group communities, with thousands of other moms throughout the world that are connected through their sharing bump pics and checking in for progress, and then also the ability to win prizes there. So it is super fun.Meagan: And there's something starting on the third, right? You guys are doing a challenge starting on the third. Is that right?Jesse: Yes. Yeah. We have a bump challenge.Julie: The third of what?Meagan: It's the third of May.Jesse: Of May.Julie: Well, this episode isn't going to air until June.Meagan: But do you do those often?Jesse: We do. We do them every single month, the first Monday of every month. We do multiple challenges. We have a Before Your Bump challenge, which is our trying-to-conceive challenge and we have got all kinds of information on stress management, fertility, hormones, nutrition to optimize your fertility, as well as fitness. We want to make sure that we are staying nice and strong and focusing on the things that are most important to not only support a pregnancy but also recover from your delivery.We also do through the Birth Recovery Center, which is our umbrella company that is going to be having multiple courses including things like sleep support, lactation consultants, mental health, all kinds of stuff that moms are going to need through their journey. So the hero product there is the AB Rehab course. That's our 12-week postpartum recovery course. It helps you to recover and heal fully from your delivery whether you are a C-section mom or a vaginal mom, whether you delivered 10 weeks, 10 months, or 10 years ago. This program is basically for everybody with a pelvic floor, so that's everybody.We focus on the foundational work, on the reasons why diastasis happens in the first place. Pregnancy is definitely something to recover from as well as your delivery because so much is changing in such a short amount of time. Birth is basically a lot of trauma to the body which takes a lot of rehab and a lot of specific coaching, specific protocols to make sure that we are addressing everything that happens during pregnancy and during delivery. So we will focus on postural imbalances, posture habits that happen during pregnancy, and then even pre-pregnancy, probably a lot of these muscle imbalances you have had before you were even pregnant. Pregnancy just has a really good job of showing us where our weaknesses are because we are trying to support a big bump growing out in front of us and our balance changes. Pressure changes, so imbalance, and muscle weaknesses, and compensations tend to really present themselves in the forefront during pregnancy and then stick around postpartum if we are not actively working to correct them. So through the 12-week course, we focus on posture. We focus on breathing patterns which are huge. We focus on the pelvic floor, not only function but the ability to connect with the pelvic floor and lower abs, which we really don't have a lot of access to during pregnancy if you are not actively working to keep that connection. That's why a lot of moms are left with a lower belly pooch or feeling like you can never really turn on your lower abs. That's muscle dysfunction.We have thousands of moms. We probably have about 5-8000 moms join our course every single month, every single challenge. We coach all of them through video communication, through our course, through video assessments. We have a whole entire team of course specialists that help customize the 12-week course to specific needs because like we said, there are a million roads to motherhood, there are a million roads to recovery too and that can't be done with a one-size-fits-all course, which is why we are so passionate about the ability to customize this course with troubleshooting videos if you have a hypertonic or hypotonic pelvic floor or whether you have developed prolapse. There's a lot of things that are happening postpartum and we address a lot of them. We also have an in-house DPT on our staff who can work to coach you through some more difficult things that need a higher level of expertise. So we really are just helping to raise the standard of care for moms postpartum. Moms deserve all of the support and it really does take a village to do that, and so that is why we have got our hands in all the cookie jars with lactation, and sleep, and birth path, and mental health, and of course, our 12-week AB Rehab, as well as nutrition. We have a little bit of everything and we are working to be the top providers for that since we are already doing that with AB Rehab.Meagan: Love it.Jesse: Yeah. We are really proud of it.Meagan: Oh my gosh. So much goodness in there. So awesome. Oh, well thank you so much for sharing your story, and your wisdom, and, obviously, that awesome course, courses. So we really appreciate you. We love your face and we just can't wait to continue our relationship.Jesse: Right back at ya. Thank you so much for having me.Julie: Absolutely. 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

Kay's story is a must-listen for everyone! Hopeful VBAC moms, CBAC moms, first-time moms,  and birth workers will be inspired by Kay's wisdom, beauty, and strength. Kay was Julie's first cross-country virtual doula client. She shares her journey of thoroughly preparing for a VBAC (complete with a color-coded binder!), having 100% confidence in her intuition, and ultimately having a euphoric CBAC. Yes, euphoric! Julie also shares a special lesson learned from Kay that she will never forget.“My biggest piece of advice to anyone would be to have that plan C. Have A, B, and C and be so at peace with all of them. Love every part of them because that made all the difference in the world.“I think it's just as important to listen to all of those beautiful VBAC stories as it is to listen to beautiful CBAC stories because it does not have to be the trauma that most of us have experienced in our first C-section. It can be different.” Additional linksThe VBAC Link on Apple PodcastsHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Community on FacebookFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Happy Wednesday, everyone. This is Meagan and Julie. You are listening to The VBAC Link. I am currently driving in the car and Julie is her usual, very organized self sitting in front of the computer. We are excited to record today's episode. This is Kay. She is actually a virtual client of Julie's, so I'm excited to hear this story from her because I heard the story from Julie. So yeah. We are excited to get into this story. Review of the WeekAnd of course, we have a review of the week. Since I am driving, we are going to turn the time over to Julie, since I cannot read and drive, and then we will jump back into her story.Julie: Yes. We are quite a dynamic duo. We record in the dentist's parking lot, on the road, in our home.Meagan: That's true, yeah.Julie: I remember the early days. Oh my gosh, the episode with Dr. Cormano (Episode 15).Meagan: Oh man. I was in the car going to a prenatal.Julie: I was in my garage in the car and it was 80° outside. I was sweating, but I didn't dare turn the car on because of the AC noise. Oh my goodness.Meagan: Mhmm.Julie: That was so crazy. Oh my gosh. We have come a long way, and then we have regressed a little bit because of COVID. But one day, we are going to be in a studio again and our kids' schedules won't be as crazy, or they will be crazier. When they are all in school during the day, that will just be nice because we won't have to worry about all the preschool shuffling around and all of the things. But for now, this is what you get. We are real-life moms just like you. So, so excited to share Kay's story today, but before we do, like Meagan said, I have a review. This review is from Apple Podcasts and the reviewer‘s name is Matthias.Band. The review title is, “So much love for this podcast.” She says, “I am a mom who has had two VBACs following the Cesarean birth of my firstborn. If I could give a gift to my post-Cesarean self while preparing for my VBACs, it would have been this podcast. I did not discover this podcast until after my last birth, but I have fallen in love with the hosts and the women who come here to share their stories. “Listening to Julie and Meagan feels so often like sitting down with friends due to their candor and obvious passion they bring to this facet of childbirth and early motherhood. I love this community they have created that genuinely understands the emotional impact of birth and the many reasons, both physical and psychological, why women pursue VBAC. Julie and Meagan are so knowledgeable, kindhearted, and obviously hardworking.“Keep up the good work. You are making an impact.”That is so sweet. I love that. Doesn't that just make you feel so good, Meagan?Meagan: I know.Julie: Not going to lie, sometimes business is a little hard and sometimes things get a little bit rough. We love getting reviews like this because it really, really does keep us going. It lifts our spirits when times are more difficult than others and really these kind words just-- I just can't even tell you how many times they have lifted me up when I have just been really struggling with life generally, but specifically some business stuff. So thank you. Thank you, Matthias.Band on Apple Podcasts. We appreciate your review so much.Kay's storyMeagan: Okay, you guys. So, so excited to get into this story. Kay, if you're okay with it, we would love to turn the time over to you.Julie: Wait, can I talk first for a minute?Kay: Sure. Please.Meagan: It would be out of character for you not to say something.Julie: Yes. So I've just got to-- you know how I am. I am going to try to not take up too much time because I want to give Kay plenty of time to tell her story. But Kay was my first virtual client that did not live in Utah. We all know that during COVID-19 and all of the hospital restrictions, and the lockdowns, and the difficult policies, and restrictions that were being placed under the families, most parts of the country don't allow doulas in. There was a time when all of this started that they weren't even allowing birth partners and husbands to be able to be there for these women's birth. It has been a journey. We are out of the part where they don't allow husbands or birth partners into the hospital, but in some areas, most areas are still restricting doulas. We are really lucky here in Utah that most hospitals are allowing one support person plus a doula right now, but in a lot of other parts of the country, it's not like that. So something that has become more emergent in the birth world, in the doula world, is virtual doula support. What most people think of when they hear “virtual doula support” is, “I don't want to be on Zoom or FaceTime with my doula the whole time. That just sounds weird. She is staring at us in the room and being like, ‘good job' on the phone.” Let me tell you, virtual support looks so different than what you would think or would imagine. I have supported a couple of clients locally, virtual support just by force, because of a hospital switching policies the day before they had their baby and things like that. I'm sure, Meagan, you have dealt with the same thing, but it was really neat to have Kay reach out to me from across the country wanting doula support initially because the hospital that she was birthing at wasn't allowing doulas and she was like, “Heck, if I'm going to have a virtual doula, I might as well have The VBAC Link as my virtual doula.”Kay: Right.Julie: So luckily, I had an opening. Let me tell you, it was such a beautiful experience. I am so glad that we connected. The hardest part about virtual support is just not being there when the baby is born. I was literally in tears when Kay was having her baby because I wasn't there with them. But it's pretty amazing. And so I am sure Kay is going to share part of that in her story with you as far as how she prepared and things, but without further ado, I am going to turn it over to my wonderful, digital client who I feel just as close to as if it was an in-person client, Kay.Kay: Thank you. Yes, it was quite a journey. This is my fourth child. So to go through, the first one was a vaginal birth. It took me 38 hours to birth that child and recovery was fine. I had my second birth and with this one, I opted to get an epidural right away. I dilated to 10 cm and everything was going great. I pushed for five and a half hours only to have a C-section after that. It turns out my little guy was wedged diagonally into my hip pocket. When the doctor pulled him out, she goes, “He's sunbathing” because he had his hands behind his head and his legs crossed like he was just lounging at the pool. And then, my third baby was actually adopted in March. We had been trying for about two and a half years and thought adoption was our way to go for the rest of the children that we were going to have in our family. God had other plans. So we adopted my daughter in March and found out, I think it was in April or May, that I was pregnant.It was quite a surprise for both of us. So while I was having my newborn, I started researching VBAC. I came across The VBAC Link and when everything went virtual, I thought, “Hey, what the heck? I'm going to reach out to them and see if there is any chance that you would take a virtual client.” Lo and behold, Julie got back to me and we started our journey together. So once I started to learn everything, I did HypnoBirthing, I did Julie and Meagan's class on The VBAC Link which was absolutely amazing. I did Spinning Babies®. I was doing my exercises. I had practiced how my birthing room was going to look. I had gotten tea lights and my essential oils. It was really important to me because I was planning to birth at Johns Hopkins in Baltimore and I knew that they were a very big hospital and I wasn't sure what type of doctor I was going to get. So I stayed with my provider the whole time because you can see so many different providers at that location. I had just expressed my wants and my needs to have the birth that I desired and everyone was very supportive. But I was still a little iffy on the whole situation. I knew that if I was going to have the birth that I desired, I had to keep training and keep learning. So I am a bit OCD in that I had a color-coded binder with all of the different exercises and all of my notes that I had learned from Julie, and from HypnoBirthing and Spinning Babies®.Julie: I loved that binder. It made me so happy. You are just like me. I feel like we are soul sisters or whatever you want to call it because you are exactly like me.Kay: Yeah. It was great. But that's why I wanted us to have you there so much because I knew as much as I planned and trained, when it came down to labor, sometimes you forget everything all at once. That's why it was so nice to have you there. When the labor actually hit, that was another story. I hit my due date and nothing. I hit week 41 and nothing and girls, I was doing everything. Julie knows. I was doing my Miles Circuit. I was walking. I was doing curb walking and this child just said, “Nope. I just want to stay in you for as long as I possibly can.”At week 41 and, I think it was, five days, they did schedule an induction. I was so nervous. I almost left the hospital twice. I just didn't feel like my body was ready and I think because of all the nerves, I just felt the baby pulling upwards instead of being in that nice, down position he had felt like he was in for the previous week. So after many conversations with Julie and then speaking with the doctors, I thought, “Okay.” We started the process. After talking to Julie, I came up with the idea of, “Hey, can you try to do a membrane sweep first and give me a few hours?” So that was nice. They did the membrane sweep. They did give me a few hours. Nothing really happened. With my previous birth, my water broke after my membrane sweep and things started to progress a little bit, but with this one, it didn't happen.So the next step was the Foley bulb. That went well. I dilated to 4 centimeters fairly quickly, and then I pounced on the ball like crazy and I just wasn't progressing any further, so they said, “Hey, we want to do a slow Pitocin.” So again, during all this time, I had Julie on text with my husband and I was texting with her. I think we did some phone calls too and I kept saying, “What is the best way to do Pitocin?” I couldn't remember even though I had this beautiful binder in front of me about what the best way to do it was and Julie said, “Hey, this is what I recommend if you can do it,” and luckily, the hospital was very accommodating to that. So I think I did two units every hour I think it was.At that point, things were going well. The contractions were getting intense. It had gotten up to a level 8 of the Pitocin and I was going through a pretty intense contraction. Once it clicked up to level 10 of the Pitocin, I was in a lot of pain. I was having a hard time breathing. My husband was texting Julie and she was saying, “Hey, try this position. Try this position.” I labored on the toilet and I labored in the shower. I labored on all fours. I did everything that I could and it was just getting so intense to the point where I was having a hard time breathing in. I could breathe out beautifully, but I couldn't breathe in and that's the point when I said, I needed to get an epidural because it was taking so much out of me that I was a little nervous I was going to pass out or just not have the energy to push when the time came.So that point, I did get the epidural which was a godsend. I don't know if you guys had felt like this if you had an epidural, but once I had it, I felt a little bit out of it. I had oxygen on my face and I felt like I was watching everything from above as I was trying the different positions to get baby to descend. All of a sudden, they asked if they could check me. As soon as I turned onto my back, the baby's heart rate dropped and it wasn't anything super scary. It was kind of a quick drop, and then they were able to stabilize baby and it was okay. They checked me and I was at 7 centimeters, so I thought, “Oh gosh, this is good. This is going really, really well.” But the baby was really high in my belly and after sitting in bizarre positions with the epidural, I didn't feel like I could get him low. So thankfully again, if you have the choice to get a virtual doula or no doula, get the virtual doula because again, I was texting Julie saying, “Okay. What should I try now? How should I do this?”Thankfully, I also had a nurse that was trained in Spinning Babies®, so she suggested some positions. We were going to try the side-lying release. So we got me on my side and we started to do it. I probably was there for about a minute and baby's heart rate dropped again. This time, it was pretty scary. His heart rate went down for what I thought was two minutes and later found out it was five minutes. My husband‘s face was absolutely white as a ghost as they kept saying, “We are not getting his heart rate back up. We are not getting his heart rate up.” There was definite panic in the room. Finally, I switched sides again and his heart rate did come up and they were like, “Just don't move.” So I stayed in exactly the same position until baby was “happy again” and thankfully, he was.But it was every time I even tried to roll a tiny bit into a different position, the heart rate would drop again. I was definitely getting a little scared. So my husband looked at me and said, “I am getting a really bad feeling about this.” My heart dropped a little bit because I had wanted so bad to have a VBAC, but we are very religious people and I kept thinking, “If he's getting this thought, there's something to it.” So we stopped and we prayed the Rosary and we just really thought about what should be the best decision. In the middle, as we were praying the rosary, my husband kept saying, “I feel like somebody is holding the baby's hand and not letting him descend.” I knew as soon as he said that, there was a gut instinct that said, “This is probably not our best solution to go ahead and try to push once I get to 10 centimeters, that it might be better to have a C-section.” I was nervous about this because I know the recovery of having a C-section and I have a 10-month-old baby at home. I didn't want to not be able to pick her up or hold her, but at the same time, I wanted to get through this labor with a healthy baby and a healthy mama. He just kept saying, if we get into the pushing stage and he gets stuck, we are going to be in an emergency and I had that feeling too. I didn't want to voice it because I had trained so hard. I did everything I needed to do and I mean, I ate, I think, six pineapples that week trying to get myself in labor. I ate it every single day. I did the exercises religiously, but you know when you get that gut feeling. and the one thing that I love about The VBAC Link course is that they tell you if you get that feeling, you need to trust your instincts. That's one of the hardest things to do when you want a VBAC so bad.So I was scared. The doctor came in and I told her. I said, “Listen. I am not actually scared of the surgery. I'm scared of the recovery. I am afraid that something catastrophic could happen afterward like a blood clot or something crazy like that.” And because I had that VBAC Link training, I was able to say to the doctor, “Listen. You might think this is silly, but this is what's bothering me and this is why I'm scared.” I literally said to her, “I am scared I'm going to get up and have a blood clot. I am scared you are going to try to get me to walk and I could have an aneurysm or something like that.” She was shocked that I asked those questions and said, “How did you even hear about that stuff?” I said, “Well, I do a lot of research and I have had a C-section before and you hear stories-- horror stories with vaginal birth, and horror stories with a C-section, but I need to know that you are going to look out for these things and be on my side and take care of me after the surgery.” She was really kind. She went through all of the risks, which were so minuscule. When she said the statistics of having something like a blood clot, or an aneurysm, or something like that afterward, it eased my mind big time.I think also having The VBAC Link training because you go over the risk of uterine rupture and then once you hear that the statistics are lower, your mind rests a little bit and it eases your mind. So once I heard the statistics for things that I was probably a little irrationally afraid of, it eased my mind and I don't think I would have been able to do that if I didn't have that training. Once I did get that training, it gave me the confidence to speak with the doctor about that stuff. So we went on and I went to my plan C. I told the doctor, “Listen.” I was not expecting to have a C-section, but because I made a plan A, a Plan B and I didn't want to make a plan C but decided to make a plan C after I took your class, I knew if I had to have a C-section, these were the things that I wanted. The things that I wanted were, I wanted to have a clear curtain so that I could see my son. I wanted to have the cord pulse out for as long as humanly possible in a safe manner and I wanted to listen to music. I didn't want to be in an environment that I was scared of. I also didn't want my hands to be tied down. I don't know if that happened with either of you guys, but in my first C-section, they had Velcro that strapped your arms down and that was traumatic.Julie: Yeah, me too.Kay: It was just a horrible feeling. I felt like I had no control over what was happening and I did not want to experience that again. I have done a lot of work to heal from that, and then I just was adamant about it. They were like, “Yeah. Absolutely.” They were very accommodating. So when we went into the surgery room, the atmosphere of the nurses, and the anesthesiologist, and my surgeon was so light. I mean, my surgeon was literally dancing as she dressed in her gown and stuff like that. Everyone was coming to talk to me and they had my Jesus music on. God bless their souls because I played-- have you guys heard the song Stand in your Love? It says over and over, “My fear doesn't stand a chance when I'm standing in your love” and I played that song on repeat the entire surgery because it was the only thing that kept my mind grounded. My husband talked to me the entire time. The anesthesiologist talked to me the entire time. They were all joking and I was just so relaxed. My hands weren't tied down. I had little straps I could hold onto it if I chose to. I had my Rosary in my hands and everything was just really light. And then they kept pressing down on my belly to try to get the baby out. They were pressing on my rib cage, actually. I kept saying, “You're going to break my ribs.” It didn't hurt that bad, but I could feel the pressure and that baby was so high up in my belly that it took a while to get him out, but once they did, they dropped the curtain. My son locked eyes with me the entire time while his cord pulsed out. They just held him there. That woman's arms must have been so strong because my baby was 8 pounds and 11 ounces and she held him there the entire time. I think we were there for three or four minutes while the cord pulsed. And then as soon as I was done, they let my husband cut the cord and they brought the baby right to me. They didn't do anything else. He came right and was right on my chest and sat there for a long time. They actually did finish the rest of the surgery and close me up and he was on my chest the entire time. In fact, my husband didn't even get to hold him. And then when they were done, they did everything they needed to do. They measured him. They weighed him. My husband got to hold him as they were wheeling me back and it was beautiful. It was the most amazing experience. I was on cloud nine. I had just a calm sense that the peace that was in the operating room and the bubble that me and my husband were in is something I have never experienced before. It was just, it was a miracle. It was quite frankly probably one of the most beautiful births and situations I have ever been in. I attest it all to being prepared beforehand because I am definitely a people pleaser and I would have never went and said, “Hey. This is what I want.” You know? When they gave me, “No, I'm not sure about the clear curtain,” I said, “That is very important to me. Please, can you try to make that happen?” And they did. It was amazing. It was absolutely amazing. So I am so thrilled and so grateful for everything that you guys have bestowed upon me in terms of training and all that good stuff and for Julie being there virtually the entire time.Plan A, plan B, plan CJulie: Yeah. I love that. Before I get into a valuable lesson that you actually taught me during your birth, I want to have you talk more about having backup plans. Plan A, plan B, plan C. Do you want to talk more about that?Kay: Sure, sure. So plan A, for me, was going into spontaneous labor, not using any medications, and having my beautiful vaginal birth that I envisioned. I had a couple of other different ones in there, but that was the gist of my plan A. Plan B was if I have to get induced, to not use the epidural, and to stay as long as possible without the epidural. I had been in a 38-hour labor before with no epidural until hour 28, so I am very well aware of how painful contractions can be with Pitocin, but I was determined to just-- my goal was, okay. Plan B, if they have to induce me and do Pitocin, do two units every hour, and then have them turn it off so that my body could take over. That was my plan B. I also wanted to be able to birth the baby and catch him in my arms and bring him right to my chest. I just love that image. So that was part of my plan A and plan B. I did not want to plan plan C. I was just like, “I am not doing it. I don't want to.” It wasn't until I took your course that I said, “Okay. I probably should do this. It is the responsible thing to do. So I thought about it for a long time, “Okay. If I have to do a C-section, what would make me feel a lot more comfortable?” One of the things was listening to the different podcasts on The VBAC Link of people who had Cesareans that they thought were beautiful and that they enjoyed the process, and then doing my own research of just hearing people's stories, so I came up with little things. Things like music made the hugest, biggest difference in the entire world. It just kept my mind calm and having the sheet-- I didn't even know that there was a sheet before starting to research the stuff about having a clear sheet so you can see everything after they are doing the surgery. They don't let you see it during surgery. But I would say my biggest piece of advice to anyone would be to have that plan C. Have A, B, and C and be so at peace with all of them. Love every part of them because that made all the difference in the world.Julie: Yeah. I really liked that about you. Most people, I mean we have talked about it before in the podcast, but most people are like, “Oh, good vibes only. Positive stories only. I don't want to even think about a C-section because I don't want to manifest something wonky out to the universe.” Something that I really like is your eagerness to learn and get educated, but also your faith.So Kay and I are from different secular backgrounds, but we both believe in God. No matter what you believe in, whether you believe in divine power or you don't believe in anything at all, we all have our intuition that can guide us and trust us. It was really admirable when I was working with you, Kay. Through the whole way, all the way, through our prenatals, through your birth, even post-birth when we had our little visit, you always trusted in God, and you trusted in yourself, and you trusted that you knew what would be the right thing to do if plans ever had to change. And plans did change. That's why having a plan A, B, or C-- I always call them, A is your perfect plan if everything goes perfectly, and then B is the backup plan, and then C is your Cesarean plan. I'd like to encourage all of my clients to have that, but not everybody wants to talk about it. That's one thing we do go over in detail in our course, like you said, about the importance of having one of those. You can make it and know it's available to you, and then just fold it up, tuck it in your pocket and never even think about it again. But if you need it, guess what? You pull it out and it's there. You are prepared and you can enter into your birth in a really more confident way. I really like how you said that you were talking with your providers about your concerns. You were asking questions. They were talking with you. This is the thing, I think, that is hard for us to remember as people when we are working with providers and when we are working with people who do birth all the time is that they have a system. We all know that. You go into the system. You check-in. You labor. If you need an epidural, you need an epidural. If you need a Cesarean, you get a Cesarean, right?All of what they do is very routine and they are used to all of it, so they go through the steps and they go through the motions, but I think what we don't give providers credit for is their willingness to deviate from the standard of normal. Not all of them. Keep in mind, I'm not talking about all of them. But I think most providers have that heart and mindset that if you just talk to them and ask questions about your concerns or about your options or be really insistent. Like for you, it was the clear drape. They were like, “We don't normally do that,” and you were like, “No. I need that.” And they were like, “Okay well, let's figure out how to make it work.” I think most providers if given the chance and if asked questions would respond in a similar way. And so I think that's really great that you were able to stand up for yourself and the things that you knew based on what we had talked about and what you learned in our VBAC prep course for parents is that it gave you the confidence to ask that when you had to pull out your plan C.Kay: Yeah and you know what? I totally forgot to mention this. But before I got pregnant with my son, I went through two and a half years of fertility issues. Unexplained infertility and just went through the gamut of issues. I knew that I couldn't handle it mentally with IVF and all that sort of stuff, so I stayed on more of a holistic path of trying to get pregnant and just do that type of thing. They were always pushing me to get surgery and said, “You know, something is probably going on. You should probably get surgery to look at your ovaries, look at your uterus, look at your tubes to see if anything is going on.” So you know what? When I was on the operating table, I said, “You know, I saw (the doctor's name),” and I said, “Hey, can you do me a favor? I went through two and a half years of fertility issues and they were always pushing me to get surgery to see if everything was healthy on my female parts. Can you take a look for me while you're in there?” It was as if she was in the grocery store and I was like, “Hey, can you grab some milk for me?” She was like, “Yeah, sure. No problem. Let me get through this part and then I will check them for you.” And she did. She went through and she goes, “There are two beautiful ovaries. Your tubes look great.” I said, “What about my intestines? They always mentioned something about my intestines like maybe there was scar tissue?” And then she was like, “Okay, give me a couple of seconds.” And then a minute later she goes, “Oh, your bowels look beautiful.”Meagan: What a weird compliment to have, huh?Kay: Right?Meagan: “Oh, your bowels-- they look beautiful.” You're like, “Thank you. I am glad that my bowels are in good shape.”Kay: It's so true because--Meagan: But it's a really good thing.Kay: Yeah, and after having people question that something is wrong for so long, it starts to get in your head and you think, “Oh my gosh, is there something wrong? Should I have gone through with the surgery?” But I would have never in a million years asked that question if I have not gained the confidence through the parent prep course. There is no way I would've ever done that. But now, they closed me up and I go, “Hey, I know my insides are all healthy too.” It's like a bonus.Julie: Well and I just imagine you sitting there on the operating table. You are literally open and having these conversations with a provider. Oh my gosh, to be a fly on the wall. I mean, hopefully, there are no flies in the operating room. You know what I mean. But just how actively involved in your birth you were throughout the whole process. There are so many more details that I know that I feel like we can talk about your birth for two hours, but I want to share a lesson that I learned from your birth.Julie's lesson So during this process, I was just at home and as Kay said, sending text messages, and taking phone calls from them, and helping them through labor with different position ideas, and different things to do and try, and how to help them through the induction process, and all those things. And so I'm just hanging out, waiting, and checking in if I haven't heard after so long. And then the last I had heard, her husband had sent me a text message asking about a different position because baby wasn't engaging. I am super cool about that. I know all these positions. I sent them a couple of ideas and I am like, “Okay. If this doesn't work, then call me. I know a be-all-end-all to baby engagement that I've only seen not work one time in my entire doula career.”And so I was just waiting, expecting them to say, “Oh yeah! Baby is engaged,” or “Okay, we need to try the one more thing.” But I get a text message from her husband saying, “Baby's heart rate is not doing so great. We are going into a Cesarean. We are at peace with it.” It completely caught me off guard. I was like, “Oh my gosh. What is going on? I started crying to my husband.” I am like, “Oh my gosh. These poor clients. Their birth ended in a Cesarean” because I just made all these assumptions that you were not okay with it because most of the time when people try for a VBAC, they feel at least some degree of sadness at the loss of that birth experience. And so I text back and I'm like, “Okay. If you are confident in that decision, I support you. Let me know if you have any questions,” and then her husband was like, “All right. Pictures are coming next.” SoI could see a picture of the baby and I am like, “Okay well, I guess that's it. It's settled.” And so I was with my husband just watching shows. It was in the middle of the night. We were watching shows waiting to hear the word and I wanted to be able to chat with her for a little bit afterward while she was in the recovery room. I remember when I finally got the call, my doula-self was ready. I was ready to help her cope through the loss of this birth experience that she wanted so badly because that's what we do as doulas. We help people cope through hard things sometimes. Kay, you called me and we were talking. I could hear a little baby cooing in the background and there was hustle and bustle in the room. After you had talked to me for a little while, I was like, “Okay well, I will let you go for tonight. We will talk more tomorrow, but I just want you to know that it's okay to be so excited that you have a happy, healthy baby right now, but also, it's okay to feel sad about the loss of that VBAC experience that you wanted and worked so hard for,” because that is what I usually tell people if they end up in a repeat Cesarean. I am like, “It's okay to feel both of those feelings,” trying to bring this peace to her and say, “It's okay to feel all of the things. We need to feel them.” I will never forget the words that you said to me. You said, “Okay. I will keep that in mind for later, but right now, I am just on cloud nine.”You could tell you were smiling. You were so happy. God was with you through your whole journey. You were prepared. You made all the right decisions and knowing more about what happened now, it's easier for me to look back and see that. Maybe I would have said different things if I was actually there with you in person, but it took me off guard for a little bit. I am like, “Oh my gosh.” Even as doulas-- Meagan, I am sure you are still learning too. Every birth, we take something with us and it helps us be a little bit better of a doula for the next person that we support. That's one thing I'm never going to forget is that, and you're probably the first client I've ever had that's actually said that to me fresh out of the Cesarean. Baby was less than an hour old and you were so confident that you were supported, that you tried your best, and that you were educated, and you made all the right choices that all you were was on cloud nine and that you could look back at your birth so instantly with such happiness. I mean, the conversation has been the same since we have chatted ever since then. It was just a really good thing for you to say that to me because sometimes we just make assumptions about how people feel about their births or how they respond based on other people that we have seen in similar situations.Meagan: Well, and I think that sometimes as a doula, especially doulas who have had Cesareans and then gone on to VBAC or haven't gone and know the passion behind wanting to go on and have a VBAC sometimes can reflect a little bit more in their own experience of how they feel as a doula because they knew that you wanted that, right? So the hardest thing, and this is maybe a message for birth workers. As Julie was saying, you gave this lesson to her. For birth workers, we have to remember not to assume that someone else is going to feel the way we felt about our own birth because I feel like there are sometimes too where I have had a client go in for an induction and I was super bummed for them, but at the same time, they were completely content with it because again, in the end, they look back and they were like, “I did everything and this is the way it happened. I chose this and I feel good about this. I feel confident about this.” And as birth workers, we have to be okay to be confident with them as well and be okay with their outcome.Julie: Yeah. I think that's maybe one of the hardest parts about being a doula is we get so emotionally invested when working with all of our clients, and then when we see clients go through the process of an unplanned Cesarean, no matter if it's a VBAC or a CBAC or just a first initial Cesarean, I think we always start mourning the loss for them-- and not always, maybe, but at least for me, I have to really check my headspace to make sure that I don't start making assumptions about how they feel about their birth before they tell me how they feel about their birth. I totally did that with you, Kay. I totally just had my speech all ready to go. I was getting ready for when you were going to call me and it was just like-- you know, we all learn lessons along the way, and sometimes we have to re-learn these lessons and re-learn these lessons. That was just very valuable to me that you said that. I will never forget it and the happiness in your voice. I hung up the phone after talking with you and I looked at my husband. I was still crying a little bit because I was so sad for you. But why was I sad for you when you were so happy? I told my husband-- he was like, “How did the call go?” I was like, “Well, she's really excited and happy. So I guess I am really excited and happy too for her.”It was just such an interesting change of feelings. Maybe that's just the thing that comes with virtual doula support is that we help, and support, and send information, and call, and answer questions just as if you were to do it in person, but because we are not there sensing the emotions and feelings of things, I pulled in my own emotions. I will remember that conversation after your birth for the rest of my life probably.Kay: But it's interesting too because I have been on both sides of it. I have had a vaginal birth and I had a C-section after not expecting to have a C-section in any way, shape, or form, and then with that C-section, I had all those feelings that you are referring to. I had the disappointment and the “what if.” What if I tried this? What if I tried this? And then having this C-section, because it was my own because I dictated it, the nurses and the doctors, not the doctors, the nurses-- I think they were disappointed when I decided for a C-section, but I knew it was the right decision. We had those instincts. We prayed about it. We had that gut intuition and that is completely why I felt so in control because I know if I kept going that I could have been in a dangerous situation. My gut was just telling me, “This is not the right choice.” And because I had that, my husband had it, it was my plan. It was nobody else's plan except mine, where the first one, I was not in control. So I think it is so normal, but I feel like there should also be a, “your Cesareans can be beautiful too” because this was such a beautiful, beautiful experience. Even though you train for it, it can still be so peaceful, and so I will look back on this birth with nothing but happy memories because I did my best. I trained. I tried everything and this was the path that I was meant to take. I am totally, so at peace with it and I absolutely love it. I feel that Cesarean pride.Julie: I love that you said that. I love how you said that this was your plan. This was not anybody else's plan. Even though it wasn't plan A, it was still your plan because you had taken the time to make a plan C and you had taken the time to get educated and trust your intuition. You really trusted and honored that instinct and what you needed to do. So I just love that, that this was your plan. It was nobody else's plan and I think that's really important.Q&AWell, I think we have a couple of questions to ask you. We have been forgetting to ask questions, Meagan. Last week when we recorded five episodes, I don't think we asked questions in a single one.Meagan: Oh, I know.Julie: So it's been a while.Meagan: I know. I know.Julie: But I remembered this time. Do you want to ask them?Meagan: Yes, sure. So what is your best tip for someone preparing for a VBAC?Kay: Preparing for a VBAC, I would say to make plans A, B, and C. I know it is something we said over and over again, but to have all of those plans, and know that each one of them can be absolutely beautiful, and to kind of revel in each of those plans. If A happens, awesome. Euphoric. If B happens, it's also euphoric and if C happens, it can also be euphoric if you have this, this, and this in place. And to figure out what is going to be important for you. So I think it's just as important to listen to all of those beautiful VBAC stories as it is to listen to beautiful CBAC stories because it does not have to be the trauma that most of us have experienced in our first C-section. It can be different. That would be my advice.Meagan: I love that.Julie: Love it.Meagan: I love it. I also know listening to CBAC stories, or uterine rupture stories, some of the harder stories that we share on here can be hard to hear because it can be something that you are like, “Wait, no. That is not what I want to hear because I don't even want to imagine myself going there.”Kay: Right.Meagan: But there's so much you can learn with those stories. So I try to encourage people to find a space for that. That might take time, but find a space for it because I think you will be pleasantly surprised when you listen. You learn more and you will feel more in control at the end.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

【句子】-- Ok Julie, so now let's start with your childhood. What was that like?-- Well, in a nutshell… 【Friends-S2E4】 【发音】[ˌəʊˈkeɪ] ['dʒu:li] [səʊ] [naʊ] [lets] [stɑ:(r)t] [wɪð] [jɔ:(r)] ['tʃaɪldhʊd] [wɒt]/[wɑ:t] [wɒz]/[wɑ:z] [ðæt] [laɪk][wel] [ɪn] [ə] [ˈnʌt.ʃel] 【发音技巧】childhood不完全失去爆破；that like不完全失去爆破；in a连读；nutshell不完全失去爆破；【翻译】-- 那么，Julie，我们从你的童年开始吧？你童年是什么样的？-- 额，简单说来……【适用场合】Well, listen. This has been great but I'm officially wiped.嗯……今晚挺棒的但是我累死了。这里的这个wiped表示很累，累趴了的意思，在我们之前第250期节目当中有学过，当时是《绝望的主妇》当中Tom的台词。I'm just…I'm wiped out.我只是……我只是太累了，我累趴了。> > 点我复习 < < “累趴了。”英语中wipe out这个动词短语，后面加上某个人作宾语，可以理解成为to exhaust or fatigue someone让某个人累趴了；累坏了；eg: All of that cleaning totally wiped me out—I need a nap.打扫卫生让我累趴了，我需要睡会儿。eg: I'm so wiped out that I just want to go home and go to bed.我超累的，现在只想回家睡觉。之前节目讲过wear sb. out其实也可以替换使用。今天要学习一个新的短语，叫做in a nutshell字面意思是：在一个坚果壳里面；in a very brief statement用简单的话说……in the fewest possible words用最言简意赅的方式表达；eg: She put the matter in a nutshell.她用很简略的方式把这件事陈述了一下。eg: Well, to put it in a nutshell, we're lost.嗯……简单说起来，就是，我们迷路了。动词短语：put it in a nutshell 意思相同；to summarize or describe something in only a few words. 用简短的几个词总结 /描述；【尝试翻译以下句子，并留言在文章留言区】我简单直白点跟你说吧，如果你再迟到，你就可以不用来了/你就被开除了。

Ready to Positioning Your Business to Profit? Go to-->>> http://positioningtoprofit.com/Patty: Hello there. Thank you so much for joining us on Her Legacy Podcast this is episode number three with Dr. Julie McLaughlin one of my favorite people in the entire planet. She has helped me so much personally with my health but more importantly the impact that she has had on so many people. It's incredible. She came up with this process for functional medicine.And it's a it's a membership that she has and she has been in practice for 30 years and developed this program called vital health protocol that where she helps other health care professionals fine tune their approach to help their patients. Now the level of help that she has the impact that she has is incredible.I mean she's meeting with different hospitals and different high level people in the medical field to get what she's develop out into the world to so many other people so it is my great pleasure to have Dr. Julie MCLAUGHLIN On this episode is again. She is pretty amazing she truly is a luminary so welcome. And here we go.Welcome to Her Legacy Podcast. Here we celebrate women in business doing more than just climbing the corporate ladder. This is about holding a space where we celebrate what it means to be a female entrepreneur. We share the good the bad the ugly of being in business for ourselves. Our vision is way bigger than just the fancy titles. It's about amplifying the vision. Each one of us has to weave our own dent in the world. And in doing so we're inspiring other women to do the same.My name is Patty Domínguez and welcome to Her Legacy Podcast for legacy leaders like you .Welcome, Dr. Julie McLaughlin to Her Legacy Podcast is such an honor to have you on. You're one of my favorite people because I believe you're such a great servant leader for many many reasons so I'm so happy to have you on the show.Dr. Julie: Thank you. You're one of my favorite people too.Patty: All right so not that I want to get braggy. Tell me what you believe your superpower is?Dr. Julie: Oh my superpower is healing people. People who have pain people who have stuff people who have just crazy stuff going on. I have a really good superpower to figure out what's wrong with them. Totally think outside the box and get them better.Patty: I agree. So we'll share a story about that in just a minute but I definitely agree. You do have that innate ability to connect at a great level. I mean you've had you've been in business for how long. For about 30 years.Dr. Julie: 30 years. And I want to admit it. But 30 years.Patty: And yet you look like you're 32. I mean like we could talk about skin cremator. So what are you working on right now that you were really excited about in your business?Dr. Julie: Oh my gosh. I'm working on so many things because you know who wants to work on one thing. Right. So I am growing my practice even those 30 years old my practice is growing. I do community events be in a band my community because I feel like educating people in health care is super super important because it empowers them.I am working on an online platform to educate doctors. I'm working on an online platform for my patients. I'm working on Facebook lives for my patients. So we have in persons. We have an office staff a little bit of everything just because at the end of the day the more you empower people and teach them the better they can be able to take care of themselves.Patty: Absolutely. So one of the things that you're known for is your vital health protocols and it's something that you came up with it's really your I say it's your life's work and so I don't know if I have that right. But it's so special and I've seen both having spoken at one of your events and just seeing the impact that you had on fellow doctors nutritionists health coaches et cetera with your vital have protocols has been really significant and the the domino effect.You know what I mean like when we talk about legacy we say OK what's going to be here. Well beyond my time right is and I really think that a vital health protocol is a perfect example of that. So can you tell the listeners a little bit about it what makes it so unique and how did you come up with it.Dr. Julie: Well it wasn't on my bucket list. It wasn't something that I decided like hey I'm going to go teach doctors functional medicine health coaches functional medicine. I've been in practicing function medicine for 30 years. And you know back when I started practice there wasn't computers there wasn't the Internet there wasn't this connectivity.So I just did what I knew to do whatever I learned in school I was an associate with a nurse practitioner who was also a chiropractor and she did Labs on everybody. So I did Labs and everybody no one ever told me any different any chiropractic. We have a little secret that's called the chiropractic lifestyle that no one ever spoke about. That is correct. We would do it with our families. And it was nutrition and it was functional medicine but that word didn't exist. And hey just always been happy treating my patients in my office.And so I had a friend who got sick with cancer and I don't treat cancer. I you know I don't treat cancer I treat people. But you get sick with cancer. And he didn't have a very good prognosis. He only had a couple of months. He's 48 and he came and asked me to help him. And I told him I don't treat cancer I treat people. And we went through a whole process. We you know it was a whole big long process. At the end of the day he chose to do some alternative care and he outlasted his prognosis years.He led a big group in our profession and he helped so many other doctors in the profession with what he did. And because he couldn't be just people anymore. Why me to teach him functional medicine. People were asking him about it and he made me promise before he died that I would teach other docs what I do and I agree because like who wouldn't agree you know make a promise to somebody like that.And so I thought oh my gosh this is so hard. So I wrote up all my protocols and at that time the teaching doctors I have to have documented tripe got all the studies I did the whole thing. And I taught the first class and I had 20 docs there and I said you know what. That's it. One and done. I fulfill my promise. I have to do this anymore it's not my bucket list is not my my thing. But their response blew me away. It wasn't what I expected.So those doctors results like mirrored mine they they were getting unbelievable things and they were from all over the country and they were touching way more people than I could personally touch. And the stories they were coming back with were were just I just couldn't believe it. I just I was really like taken back to them and they were like when's your next one and when's your next one. And I was like well I thought it was one and done. But you know so I always say when I'm doing this is my last one there's my last one.I've been doing this for three years now and I'm not having the last one anymore. I'm putting it online and I'm going to make it more accessible to more people because at the end of the day it saves lives.Patty: It doesn't. And here's what I thought was really amazing about it when I spoke at your event I mean I definitely understood the significance of the transformation that people going into. I mean these health professionals going in before a two and a half day event. How long is your event today? Two days.Dr. Julie: Two days Yeah.Patty: Yeah. Well for like two days they walk in not knowing how to read the labs or how to conduct the process and you have such a solid proven process that after two days they can confidently go to work back on Monday let's say and start applying what they're learning.Dr. Julie: Right. That's actually it was my goal. So when I started doing this there was this one Doc that came up to me when I started like right everything up and he said I've never ordered a lab in my life. I'm straight up chiropractic. Do you think you can teach me?And I said you know what I'm going to keep you in my mind as I write this to make it super super simple. Yeah scripted turnkey. This is what it is. So when you leave on Monday morning you can do it on your first patient and you can get success and you can get the results. And you know I wasn't quite sure about that in the beginning but about 100 percent of the time everybody's doing it.Patty: It's so amazing. And so here's where just for the listeners that are out there it's like whatever it is that you know how to do whatever your superpower is and how do you translate into something that is it that could create an impact is easy to understand because you could easily I'm assuming over intellectualizes right. The labs in the speak and the but different nomenclature that is in your space you could have over intellectualized. And instead I know being on the patient side being a patient of yours I can sit across the table and you explain things in such a way that I'm like oh I get it.You know it's easy to remember it's easy to apply. So I so want to acknowledge you for having that system because both on the patients side as well as the fellow doctors that you're teaching they get it. Something happens that's very transformative. And so that proof is after two days that you're not going to see that. And it's really it has substance. It's real. It's not an inch deep and a mile wide.Maybe there's something there that is transformative so that to me that's how you know that you have a solid winner that has a longevity and the sustainability to impact many because you have that that foundation in place. So I just love that. So tell me what were there any hurdle hurdles that you had to overcome when you were implementing this or maybe was a mindset thing or are not enough people. What were some hurdles that you went through?Dr. Julie: Like when I started I thought you know I literally thought I only did this purely out of respect and out of keeping my promise. I mean I did not I didn't do for any other reason. I really I thought OK I made this commitment we're gonna do this and I'm done. And so the hurdle was that that was like in my face after words of of the results of these doctors got that I couldn't be one and done in the end that they had they kept asking me and asked me you got to help me to do this.I was like oh my gosh now I gotta do this I really have to do this. And so that that was my own mind set that I had to say this wasn't my bucket list. This wasn't where I saw my my career path at 30 years and practice going. But I had to instead embrace it and it took me time like I literally would only set one seminar next. I wouldn't say I'm going to have this one and that one and that one and that one I don't. OK I'm only going to do one more. I'm only going to do one more and as I did it.The power of the group and the changes that I saw from them. That's what motivated me. So I started out my y when I started was my friend and my promise. Right. Why now are the results that I'm seeing in patients like across the country that I would never have had any impact on in my lifetime.Patty: That's so amazing. And so how did you overcome in you recognize that you were making it about yourself by saying one more one more. And now you've just it's almost like you surrender to wow this is a gift that I have to share with many. So did you have a lot of struggle with that whole process?Dr. Julie: I did because I know because it would be easy for me just to sit in my little office and see my patients call it a day and go home. Now you know I go home I'm doing this I'm recording I'm answering my lunchtime and answering questions and you know so it's a lot more work. But the reward is someone's life there is better. I mean there's not much there's not a job that you could do that you get at the end of the day you could say I'm making a difference in someone's life. You know I'm making a difference in how they feel and in their outcome their longevity their health span.So yeah. And then also I've been able to make these connections with these other doctors which is really awesome because now we have a group of doctors who are healers and we all kind of brain trust together. And I never did that either. No. In our profession I'm sure a lot of professions there's always been infighting and clashes. And it's not that way. Everybody's so contributing and helpful and so you know it was only it was my own mindset that I had to go get over.Patty: Thank you so much for checking out today's show. We're about halfway done but I wanted to give you the opportunity to engage further as this episode incites some creativity in you if you're interested in leaving your own dent of the world leaving your legacy. I have a very special three part video series for you.That's what I call the Business Trinity an as entrepreneurs. We are looking to create a sustainable business. And what I have found is three distinct pillars to make it happen so I'm sharing that with you. Absolutely complimentary. Head on over to businesstrinity.com again businesstrinity.com. Grab that three part video series for yourself. It includes some downloadable in there and will walk away with clarity on where the opportunities are so that you will meet your legacy. Let's continue with the show.Absolutely. And isn't that always the case right. New level new devil said with a new level new devil what is your what are you recognizing is a next series of challenges that you're having right. What were you with that whole process?Dr. Julie: Oh my challenge is is that I need help in my office I need to get another docken to be able to service the people who I have in front of me. So that's one of my challenges that I need 30 years. You know it's a physical job. I need some help with that. So that's definitely a challenge. And I'm kind of picky because there are going to be taking care of my patients. I have to be really good in an hour doing what to do and then just transferring everything online which you have been super super helpful for me. And we learned more too.Patty: There's definitely more to do. But when my team I'm like God help Dr. Julie like this is really important because it's so much to it. And I just love at the beginning if I may interrupt you even saying like I'm putting all these things on mine that's so huge because most people have such a block about that they get immediately intimidated. And I've told you this personally before you have this insane ability to dive in completely like you're immersed like when you say you're going to do something you're all in and there's no you know putting the toe in the water like you're literally cannonball it.Patty: It's the most remarkable thing I've ever seen. I've never seen anybody like this so I so I just want to acknowledge you because you're so good at harnessing change and as much as you think there's other elements of course where we struggle with change. But this one you're so good at it. I just wanted to acknowledge you and that.Dr. Julie: You well you have a lot of help. You know I you know I mean I think Patty what do you think what if we did this. And what would we do. Now think of all these things but I have no idea how we're going to do all this but I'm like you. And then you're like oh it's great we can do this and this and that you have like his work flow for me and you have this little funnel set. like oh my god this is amazing because you come up with the idea and I work 100 percent on it. You put classes in.Patty: Yeah. So here's where it just too just to kind of cement the idea behind that is it's not the content has to have proper context. And when you have content you can have the best content in the world but if you don't have it positioned correctly that's where people fall short. And so what we've been able to do is having those write type of strategies kind of that eagle eye perspective on how to submit like what it is that you're going to do and how do you position. And so many things like people get caught up in the tools it's not necessary the tools that's going to get you ahead.Patty: It's the strategy behind it. So I'm like so big on that and I'm so happy that you're so receptive. Yes workflow for those of you listening is probably my favorite tool ever. I actually put it in front of my kids and they're like Ma enough with the workflow workflow. Anything is probably the best five dollars a month I spend every month.Dr. Julie: So yeah I love workflow.Patty: I got you addicted didn't I?Dr. Julie: You did I'm addicted. You organize your thoughts so good.Patty: Totally. So. OK. Questions for you what are some of your favorite tools that you're using right now in your business?Dr. Julie: Workflow.Patty: OK. Workflow we're getting a shout out.Dr. Julie: I like Camba. I am. Zoom where doing. Click Funnels I do. Wick's Cad Abby.Patty: So comfortable your name.Dr. Julie: Adobe Yeah illustrator design. Oh my gosh. I use a lot of different yeah.Patty: That's not even an issue for you to just harness the power of what the tools can do so. I acknowledge you for that. OK so pivoting a little bit what is one personal development or growth habit that you have?Dr. Julie: Every day I write down my gratitude every single day. And they have to be different every day. You can't have the same one every day because they get stale. You have to have a different one every day. And then when you're feeling like. You know stressed or something likes that in my mind I think like gratitude. What is a different gratitude?And it could be anything. It could be big little whatever it is. But that always keeps me centered because if you have that gratitude you're not going to be able to get off track. And then we start with like what are my goals for today. What do I want to get done?Know I have a giant to do list but I try to keep my goals to like three to five and then I check them off I double checking them off in work. Well you can check it out at the end. So I do that every day. And then at the end of the day I look at it and I kind of do a recap of like what did I do that was good that I was happy about.What could I change what could I have made better today. Do the goals that I wanted like I had that talk yesterday and I'm my one of my goals yesterday was I wanted five new people to come in the office asked for my talk. And I got nine.Oh my God you're so good, you're such a closer. Can I just say this like I love the fact that you're both offline and online. So you have your brick and mortar practice you connect with the community people know who you are so you're geographically like you have that exposure but then you're also know work on the online thing so if you have a brick and mortar this is it's not letting go of those community connections to call in on line.Patty: It's literally in your case you've been able to leverage both and this is what you're doing for both and I think that's really smart because that online gives you greater scale. But then the the immediate community feels. I mean this is how you're able to close the increase. The people they tell me tell me again what was the speech that you gave?Dr. Julie: I don't know. So it's a 10 minute talk and we are had like a little wellness and my part was on the eat better and I spoke about food poisoning and speeding. So random.Patty: But but let's talk about the strategy there because if it was random. Yeah but you connected with people. You had a structure for how you can close them right. So how many people were in the room.Dr. Julie: 31.Patty: And you close nine.Dr. Julie: I closed nine.Patty: That is pretty damn good. That is really awesome. Right. With a 10 minute talk no less. That is absolutely exceptional. That's amazing. OK so having a gown. What is your definition of success?Dr. Julie: Never stop the journey it's not a destination. Success is not a destination it's a process. And every part of that process when you learn and you never stop learning. That's that's your success because when you at the end of the journey you're dead you're not here anymore right.Dr. Julie: So success really is that journey that you're on. So some people think that way when I do this I'll be successful when I do that I'll be successful. Your success is that ongoing commitment to the journey that you're on to fulfill your purpose.Patty: I love that. Oh my God. I totally agree. It is this journey the ups and downs. It drives you to learn a different lesson every time and as much as you think it sucks. I always go to the Bob Marley song every little thing is going to be alright like it always is you know as ugly as it is.Patty: I mean that's literally my mantra. I love it it's like every little things gonna be alright. So question for you. Last question is after all is said and done because this is Her Legacy Podcast after all. What do you want your legacy to be?Dr. Julie: That's hard. I wanted to be that it helped people that I took really good care of them that I taught doctors how to take really good care people. They took really good care of my kids it's gonna make me cry.Patty: Big question.Dr. Julie: As a big question. And at the end of the day that I left the world a better place.Patty: I love you so much. I like to give you a hug right now. I'm just amazing I adore you. I. Ok so first before I go into my into my hole like I love fashion with Dr. Julie Special but to tell people how they can get a hold of you.Dr. Julie: Oh you can check out my Web site. It's drjuliemclaughlin.com. And there's no period after the drjuliemclaughlin.com.It has about my practice my PHD it has about speaking it has about all of it.Patty: You're amazing. Okay so guys if you are looking for help with functional medicine if there's any doctor's health care professionals I highly encourage you to check out vital health protocols. It is something that you could add to your practice. It really I love you. I mean you've been have a whole webinar talking about how you can absolutely supplement your income in your practice.I mean there are so many brilliant things that you've done. And so this is where somebody like Dr. Julie McLaughlin 30 years in practice she is legit one of an expert in functional medicine. And she's just a phenomenal person. I mean you just got. I always see you like your big heart and legs you're all her. I did it. So Dr. Julie thank you so much for being on her legacy podcast. Appreciate you and again if you want more information on how to connect with Dr. Julie McLaughlin its drjuliemclaughlin.com. You won't be disappointed. She is the real deal. So thank you again for being on.Dr. Julie: Thank you. I'll talk to you soon.Patty: Thank you so much for joining us on this episode of her legacy podcast. Make sure to hit the snooze button if you haven't already done so. That way you won't miss any of the episodes. Also if you're feeling very generous please head on over to iTunes. We have a reading and review. I love the five stars too. More importantly in her review section let me know where are you from. What are you doing? What's your business? How are you leaving your legacy? I want to know bitter so that way I can give you a shout out on my show. So take advantage that would love to hear you say that we're really creating momentum here with what we're doing out here legacy podcast with see you next time. Thank you so much for being here.

Julie Moronuki: @argumatronic | argumatronic.com Show Notes: This episode is a follow-up episode to the one we did with Julie in September: Learn Haskell, Think Less. We talk a whole lot about monoids, and learning programming languages untraditionally. Transcript: CHARLES: Hello everybody and welcome to The Frontside Podcast, Episode 93. My name is Charles Lowell, a developer here at The Frontside and I am your podcast host-in-training. With me today from The Frontside is Elrick also. Hello, Elrick. ELRICK: Hey. CHARLES: How are you doing? ELRICK: I'm doing great. CHARLES: Alright. Are you ready? ELRICK: Oh yeah, I'm excited. CHARLES: You ready to do some podcasting? Alright. Because we actually have a repeat guest on today. It was a very popular episode from last year. We have with us the author of ‘Learning Haskell: From First Principles' and a book that is coming out but is not out yet but one that we're eagerly looking forward to, Julie Moronuki. Welcome. JULIE: Hi. It's great to be back. CHARLES: What was it about, was it last October? JULIE: I think it was right before I went to London to Haskell [inaudible]. CHARLES: Yeah. JULIE: Which was in early October. So yeah… CHARLES: Okay. JULIE: Late or early October, somewhere in there. CHARLES: Okay. You went to Haskell eXchange. You gave a talk on Monoids. What have you been up to since then? JULIE: Oh wow. It's been a really busy time. I moved to Atlanta and so I've had all this stuff going on. And so, I was telling a friend last night “I'm going to be on this podcast tomorrow and I don't think I have anything to talk about.” [Laughter] JULIE: Because I feel like everything has just been like, all my energy has been sucked up with the move and stuff. But I guess… CHARLES: Is it true that everybody calls it ‘Fatlanta' there? JULIE: Yeah. [Laughs] CHARLES: I've heard the term. But do people actually be like “Yes, I'm from Fatlanta.” JULIE: I've heard it a couple of times. CHARLES: Okay. JULIE: Maybe it's mostly outsiders. I'm not sure. CHARLES: [Chuckles] JULIE: But yeah, it's a real cool city and I'm real happy to be here. But yeah, I did go in October. I went to London and I spoke at Haskell eXchange which was really amazing. It was a great experience and I hope to be able to go back. I got to meet Simon Payton Jones which was incredible. Yeah, and I gave a talk on monoids, monoids and semirings. And… CHARLES: Ooh, a semiring. JULIE: Semiring. So, a semiring is a structure where there's two monoids. So, both of them have an identity element. And the identity element of one of them is an annihilator. Isn't that a great word? It's an annihilator… CHARLES: Whoa. JULIE: Of the other. So, if you think of addition and multiplication, the identity element for addition is zero, right? But if you multiply times zero, you're always going to get to zero, so it's the annihilator of multiplication. CHARLES: Whoa. I think my mind is like annihilated. [Laughter] JULIE: So, it's a structure where you're got two monoids and one of them distributes over the other, the distributive property of addition and multiplication. And the identity of one of them is the annihilator of the other. Anyway, but yeah, I gave a history of where monoids come from and that was really fun. CHARLES: Yeah. I would actually like to get a summary of that, because I think since we last talked, I've been getting a little bit deeper and deeper into these formal type classes. I'm still not doing Haskell day-to-day but I've been importing these ideas into just plain vanilla JavaScript. And it turns out, it's actually a pretty straightforward thing to do. There's definitely nothing stopping these things from existing in JavaScript. It's just, I think people find type class programming can be a tough hill to climb or something like that, or find it intimidating. JULIE: Yeah. CHARLES: But I think it's actually quite powerful. And I think one of the things that I'm coming to realize is that these are well-worn pathways for composing things. JULIE: Right. CHARLES: So, what you encounter in the wild is people generating these one-off ways of composing things. And so, for a shop like ours, we did a lot of Ruby on Rails, a lot of Ember, and both of those frameworks have very strong philosophical underpinnings that's like “You shouldn't be reinventing the wheel if you don't have to.” I think that all of these patterns even though they have crazy quixotic esoteric names, they are the wheels, the gold standard of wheel. [Laughs] They're like… JULIE: Right. CHARLES: We should not be reinventing. And so, that's what I'm coming to realize, is I'm into this. And last time you were talking, you were saying “I find monoids so fascinating.” I think it took a little bit while to seep in. But now, I feel like it's like when you look at one of those stereo vision things, like I'm seeing monoids everywhere. It's like sometimes they won't leave me alone. JULIE: In ‘Real World Haskell' there's a line I've always liked. And I'm going to misquote it slightly but paraphrasing at least. “Monoids are ubiquitous in programming. It's just in Haskell we have the ability to just talk about them as monoids.” CHARLES: Yeah, yeah. JULIE: Because we have a name and we have a framework for gathering all these similar things together. CHARLES: Right. And it helps you. I feel like it helps you because if you understand the mechanics of a monoid, you can then when you encounter a new one, you're 90% there. JULIE: Right. CHARLES: Instead of having to learn the whole thing from scratch. JULIE: Right. And as you see them over and over again, you develop a kind of intuition for when something is monoidal or something looks like a semiring. And so, you get a certain intuition where you think, “Oh, this thing is like a… this is a monad.” And so, what do I know about monads? All of a sudden, this new situation like all these things that I know about monads, I can apply to this new situation. And so, you gain some intuition for novel situations just by being able to relate them to things you already do know. CHARLES: Exactly. I want to pause here for people. The other thing that I think I've come in the last three months to embrace is just embrace the terminology. JULIE: Yeah. CHARLES: You got to just get over it. JULIE: [Chuckles] CHARLES: Think about it like learning a foreign language. The example I give is like tasku is the Finnish word for pocket. JULIE: Right. CHARLES: It sounds weird, right? Tasku. But if you say it 10 times and you think “Pocket, pocket, pocket, pocket, pocket.” JULIE: Yes, yeah. [Laughs] CHARLES: Then it's like, this is a very simple, very useful concept. JULIE: Right. CHARLES: And it's two-sided. There on the one hand, the terminology is obtuse. But at the same time, it's not. It's just, it is what it is. And it's just a symbol that's referencing a concept. JULIE: Right, right. CHARLES: It's a simple concept. So, I just want to be… I know for our listeners, I know that there's a general admonition. Don't worry about the terminology. It's… JULIE: Right, right. Like what I just said, I said the word ‘monad'. I just threw that out there at everybody, but [chuckles] it doesn't matter which one of these words we'd be talking about or whatever I call them. We could give monads a different name and it's still this concept that once you understand the concept itself, and then you can apply it in new situations, it doesn't matter then what it's called. But it does take getting used to. The words are… well, I think functor is a pretty good word for what it is. If you know the history of functor and how it came to mean what it means, I think it's a pretty good word. CHARLES: Really? So, I would love to know the history. Because functor is mystifying to me. It sounds like, I think the analogy I use is like if George Clinton and a funk parliament had an empire, the provinces, the governors of the provinces would be functors. ELRICK: [Laughs] JULIE: Yes. CHARLES: But [Laughs] that's the closest thing to an explanation I can come up with. JULIE: I might use that. I'm about to give a talk on functors. I might use that. [Laughter] ELRICK: Isn't that the name of the library? Funkadelic? CHARLES: Well, that's the name of the library that I've been… JULIE: [Could be], yeah. ELRICK: That you'd been… CHARLES: That I'd been [writing] for JavaScript. ELRICK: Yeah. CHARLES: That imports all these concepts. JULIE: [Laughs] ELRICK: Yeah. JULIE: Yeah. ELRICK: So awesome. JULIE: Yeah. Yeah, I have… CHARLES: So, what is the etymology of functor? JULIE: Well, as far as I can tell, Rudolf Carnap, the logician, invented the word. I don't know if he got it from somewhere else. But the first time I can find a reference to it is in, he wrote a book about… he was a logician but this is sort of a linguistics book. It's called ‘The Logical Syntax of Language'. And that's the first reference I know of to the word functor. And he was trying to really make language very logically systematic, which natural language is and isn't, right? [Chuckles] CHARLES: Right. JULIE: But he was only concerned with really logically systematizing everything. And so, he used the word functor to describe some kinds of function words in language that relate one part of a sentence to another part of a sentence. CHARLES: Huh. So, what's an example? JULIE: So, the example that I've used in the past is, as far as I know this is not one that Carnap himself actually uses but it's the clearest one outside of that book… well the ones inside the book I don't really think are very good examples because they're not really how people talk. So, the one that I've used to try to explain it is the word ‘not' in English where ‘not' gets applied to the whole sentence. It doesn't really change the logical structure of the sentence. It doesn't change the meaning of the sentence except for now it negates the whole thing. CHARLES: I see. JULIE: And so, it relates this sentence with this structure to a different context, which is now the whole thing has been negated. CHARLES: I see. So, the meaning changes, but the structure really doesn't. JULIE: Right. And it changes the whole meaning. CHARLES: Right. JULIE: Not just part of the sentence. So, if you imagine ‘not' applying to an entire sentence because of course we can apply it just to a single word or just to a single phrase and change the meaning just of that word or that phrase, but if you imagine a context where you've applied ‘not' to a whole sentence, to an entire proposition, because of course he's a logician. So, if you've applied ‘not' to an entire proposition, then it doesn't change the structure or the meaning of that proposition per se except for it just relates it to the category of negated propositions. CHARLES: Mmhmm. JULIE: So, that's where it comes from. And… CHARLES: But I still don't understand why he called it functor. JULIE: He's sort of making up… well, actually I think the German might be the same word. CHARLES: Ah, okay. JULIE: Because he was writing in German. Because he's looking for something that evokes the idea of ‘function word'. CHARLES: Oh. JULIE: So, if you were to take the ‘func' of ‘function' [Laughs] and the, I don't know, maybe in German there's some better explanation for making this into a particular word. But that's how I think of it. So, it's ‘function word'. And then category theorists took it from Carnap to mean a way to map a function in this category or when we're talking about Haskell, a function of this type, to a function of another type. CHARLES: Okay. JULIE: And so, it takes the entire function, preserves the structure of the function just like negation preserves the structure of the sentence, and maps the whole thing to just a different context. So, if you had a function from A to B, functor can give you a function from maybe A to maybe B. CHARLES: Right. JULIE: So, it takes the function and just maps it into a different context. CHARLES: Right. So, a JavaScript example is if I've got an array of ints and a function of ints to strings, I can take any array of ints and get an array of strings. JULIE: Right. CHARLES: Or if I have a promise that has an int in it, I can take that same function to get a promise of a string. JULIE: Yeah. CHARLES: Yeah. I had no idea that it actually came from linguistics. JULIE: Yeah. [Laughs] CHARLES: So actually, the category theorists even… it digs deeper than category theory. They were actually borrowing concepts. JULIE: They were, yes. CHARLES: We just always are borrowing concepts. ELRICK: I like the borrowing of concepts. JULIE: Yeah. ELRICK: I think where people struggle with certain things, it's tying it back to something that they're familiar with. So, that's where I get… my mind is like [makes exploding sound] “I now get it,” is when someone ties it back to something that I am… CHARLES: Right. ELRICK: Familiar with. Like Charles' work with the JavaScript, tying it with JavaScript. I'm like, “Oh, now I see what they're talking about.” JULIE: Right. CHARLES: because you realize, you're using these concepts. People are using them, just they're using them anonymously. JULIE: Right. ELRICK: True. CHARLES: They don't have names for them. JULIE: Right. ELRICK: True. CHARLES: It's literally like an anonymous function and you're just taking that lambda and assigning it to a symbol. JULIE: Yeah. CHARLES: You're like “Oh wait. I've been using this anonymous function all over the place for years. I didn't realize. Boom. This is actually a formal concept.” ELRICK: True. And I think when people say like “Don't reinvent the wheel” it's a great statement for someone that has seen a wheel already. [Laughter] ELRICK: You know what I'm saying? If you never saw a wheel, then your'e going to reinvent the wheel because you're like “Aw man. This doesn't exist.” [Chuckles] JULIE: Yeah. ELRICK: But if people are exposed to these concepts, then they wouldn't reinvent the wheel. CHARLES: Right. JULIE: Right. Yeah. CHARLES: Instead of calling in some context, calling it a roller. [Chuckles] It's a round thingy. [Laughter] JULIE: Right. Yeah, so that's a little bit what I tried to do in my monoid talk in London. I tried to give some history of monoid, where this idea comes from and why it's worth talking about these things. CHARLES: Yeah. JULIE: Why it's worth talking about the structure. CHARLES: So, why is it worth the… where did it come from and why is it worth talking about? JULIE: Oh, so back when Boole, George Boole, when he decided to start formalizing logic… CHARLES: George Boole also, he was a career-switcher too, right? He was a primary school teacher. JULIE: Right, yeah. CHARLES: If I recall. He actually, he was basically teaching. Primary school is like elementary school in England, right? JULIE: I believe so, yes. CHARLES: Yeah. I think he was like, he was basically the US equivalent of an elementary school teacher who then went on to a second and probably, thankfully a big career that left a big legacy. JULIE: Right. Although no one knew exactly how big the legacy was really, until Claude Shannon picked it up and then just changed the whole world.[Laughs] Anyway, so Boole, when he was trying to come up with a formal algebra of logic so that we could not care so much about the semantic content of arguments (we could just symbolize them and just by manipulating symbols we could determine if an argument was logically valid or not), he was… well, for disjunction and conjunction which is AND and OR – well, disjunction would be the OR and conjunction the AND – he had prior art. He had addition and multiplication to look at. So, addition is like disjunction in some important ways. And multiplication is like conjunction in some important ways. And I think it took me a while to see how addition and disjunction were like each other, but there are some important ways that they're like each other. One of them is that they share their identity values. If you think of, it's sort of like binary addition and binary multiplication because in boolean logic there's only two values: true or false. So, you have a zero and a one. So, if you think of them as being like binary addition and binary multiplication then it's easier to see the connection. Because when we think of addition of just integers in a normal base 10 or whatever, it doesn't seem that much like an OR. [Laughs] CHARLES: Mmhmm. No, it doesn't. JULIE: [Inaudible] like a logical OR. So, it took me a while to see that. But they're also related then to set intersection and union where intersect-… CHARLES: So can… Let's just stop on that for a little bit, because let me parse that. So, for OR I've got two values, like in an ‘if' statement. This OR that. If I've got a true value then I can OR that with anything and I'll get the same anything. JULIE: Right. CHARLES: So, true is the identity value of OR, right? Is that what you're saying? So, one… JULIE: Well, it's false that's the identity of OR. CHARLES: Oh, it is? JULIE: Zero is the identity of addition. CHARLES: Wait, but if I take ‘false OR one' I get… oh, I get one. JULIE: Right. CHARLES: Okay. So, if I get ‘false OR true', I get true. Okay, so false is the identity. JULIE: Yeah. CHARLES: Oh right. You're right. You're right. Because… okay, sorry. JULIE: So, just like in addition, zero is the identity. So, whatever you add to zero, that's the result, right? You're going to get [the same] CHARLES: Right. JULIE: Value back. So, with OR false is the identity and false is equivalent to zero. CHARLES: [Inaudible] ‘False OR anything' and you're getting the anything. JULIE: Right. So, the only time you'll get a false back is if it's ‘false OR false', right? CHARLES: Right. Mmhmm. JULIE: Yeah. So, false is the identity there. And then it's sort of the same for conjunction where one is the identity of multiplication and one is also the… I mean, true is then the identity of logical conjunction. CHARLES: Right. Because one AND… JULIE: ‘True AND false' will get the false back. [Inaudible] CHARLES: Right. ‘True And true' you can get the true back. JULIE: Yeah. CHARLES: Okay. JULIE: And it's also then true, getting back to what we were talking about, semirings, it's also true that false is a kind of annihilator for conjunction. That's sort of trivial, because… CHARLES: Oh, because you annihilate the value. JULIE: Right. When there's only two values it's a little bit trivial. But it is [inaudible]. So… CHARLES: But it's [inaudible]. Yeah. It demonstrates the point. JULIE: Right. CHARLES: So, if I have yeah, ‘false AND anything' is just going to be false. So, I annihilate whatever is in that position. JULIE: Right. CHARLES: And the same thing as zero is the annihilator for multiplication, right? JULIE: Right. CHARLES: Because zero times anything and you annihilate the value. JULIE: Yeah. CHARLES: And now I've got… okay, I'm seeing it. I don't know where you're going with this. [Laughter] ELRICK: Yeah. CHARLES: But I'm there with you. ELRICK: Yup. JULIE: And then it turns out there are some operations from set theory that work really similarly. So, intersection and union are similar but the ones that are closer to conjunction/disjunction are disjoint unions and cartesian products. So we don't need to talk about those a whole lot if you're not into set theory. But anyway… CHARLES: I like set theory although it's so hard to describe without pictures, without Venn diagrams. JULIE: It is. It really is, yeah. So anyway, all of these things are monoids. And they're all binary associative operations with identity elements. So, they're all monoids. And so, we've taken operations on sets, operations on logical propositions, operations on many kinds of numbers (because not all kinds of addition and multiplication I guess are associative), and we can kind of unify all of those into the same framework. And then once we have done that, then we can see that there's all these other ‘sets'. Because most of the kinds of numbers are sets and there are operations on generic sets with set theory. So, now we can say “Oh. We can do these same kinds of operations on many other kinds of sets, many other varieties of sets.” And we can see that same pattern. And then we can get a kind of intuition for “Well, if I have a disjunctive monoid where I'm adding two things or I'm OR-ing two things…” Because even though those are logically very similar, intuitively and in terms of what it means to concatenate lists versus choosing one or the other, those obviously have different practical effects. CHARLES: So, I'm going to try and come up with some concrete examples to maybe… JULIE: Okay, yeah. CHARLES: A part of them will probably be like in JavaScript, right? So, to capture the idea of a disjunctive monoid versus a conjunctive monoid. So, a disjunctive monoid is like, so in JavaScript we're got two objects. You concat them together and it's like two maps or two hashes. So, you mash them together and you get… so, for the disjunctive one you'd have all the keys from both of the hashes inside the resulting object. You take two objects. Basically we call it object assign in JavaScript where you have basically the empty object. You can take the empty object and then take any number of objects. And so, we talked about… JULIE: That would become a disjunctive monoid, right? CHARLES: That would be a disjunctive monoid because you're like basically, you're OR-ing. Yeah. JULIE: You're kind of, [inaudible] CHARLES: Hard to find the terminology. JULIE: Yeah. CHARLES: But like object assign would be a disjunctive monoid because you're like mashing these two objects. And the resulting object has all of the things from both of them. JULIE: Right. So, it's like a sum of the two, right? CHARLES: Right, right. Okay, so then another one would be like min or max where you've got this list of integers and you can basically take any two integers and you can mash them together and if you're using min, you get the one that's smaller. Basically, you're collapsing them into one value but you're actually just choosing one of them. Is that like… JULIE: Yeah. CHARLES: Would that be like a conjunctive monoid? JULIE: No, that's also disjunctive but that's more like an OR than like a sum. CHARLES: Okay. JULIE: Right. So, that's what I said. It's hard to think of disjunctive monoids I think because there's really two varieties. There's some underlying logical similarity, like the similarity in the identity values. But they're also different. Summing two things versus choosing one or the other are also very different things in a lot of ways. CHARLES: Right. Okay. JULIE: And so, I think the conjunctive monoids are all a little bit more similar, I think. [Chuckles] But the disjunctive monoids are two broad categories. And we don't really have a monoid in Haskell of lists where you're choosing one or the other. The basic list monoid is you're concatenating them. So, you're adding two lists or taking the union of them. But for maybe, the maybe type, we do have monoids in Haskell where you're just choosing either the first just value that comes up or the last just value that comes up. So, we do have a monoid of choice over the maybe type. And then we have a type class called alternative which is monoids of choice for… so, they're disjunctive monoids but instead of adding the two things together, they're choosing one or the other. CHARLES: Okay. JULIE: Though we have a type class for that. [Laughs] CHARLES: [Sighs] Oh wow. Yeah. JULIE: Mmhmm, yeah. CHARLES: I'l have to go read up on that one. JULIE: That type class comes up the most when you're parsing, because you can then parse… like if you found this thing, then parse this thing. But if you haven't found this thing, then you can keep going. And if you find this other thing later, then you can take that thing. So, you allow the possibility of choice. The first thing that you come to that matches, take that thing or parse that thing. So, that type class gets mostly used for parsing but it's not only useful for parsing. CHARLES: Okay. JULIE: So yeah. That's the most of the time when I've used it. CHARLES: Is this when you're like parsing JSON? Or is this when you're just searching some stream for some value? Like you just want to run through it until you encounter this value? Or how does that…? JULIE: Right. Say you want to run through it until you find either this value or this value. I've used it when I've been parsing command line arguments. So, let's say I have some flags that can be passed in on my command line command. There are some flags that could be passed in. So, we'll parse until we find this thing or this thing. This flag or this flag. So, if you find this flag, then we're going to go ahead and parse that and do whatever that flag says to do. If you don't find that first flag then we can keep parsing and see if you find this other flag, in which case we'll do something different. CHARLES: Okay. JULIE: It'll take the first match that it finds. Does that make sense? CHARLES: Yeah, yeah, yeah. It does. But I'm not connecting how it's a monoid. [Laughs] JULIE: How is that a monoid? Well, because it's a monoid of OR-ing CHARLES: What's the identity value or the empty value in that case? JULIE: Well, the empty value would be… let's say you have maybes. Let's say you have some kind of maybe thing, so you're parser is going to return maybe this thing, maybe whatever you're parsing. Like maybe string. CHARLES: Yeah, yeah. JULIE: So, it's going to return a maybe string. So well, nothing would be the empty. CHARLES: Okay. JULIE: But nothing is like the zero because it's a disjunction, logical OR. So, only when you have two nothings will you get back a nothing. Otherwise, it will take the first thing that it finds. CHARLES: Okay. I see. JULIE: Yeah. So, the identity then is the nothing, like false is the identity for disjunction. CHARLES: Mmhmm. Okay. JULIE: Yeah. CHARLES: [Inaudible] JULIE: Yeah. If you have nothing or this other thing, then you return this other thing. Then you return the maybe string. If you have two nothings, then you get in fact nothing. Your parsing has failed. CHARLES: Right, because you've got nothing. JULIE: Because you've got nothing. There was nothing to give you back. CHARLES: So, you concatenated all of the things together and you ended up with nothing. JULIE: Right, because there was nothing there. CHARLES: Right. [Laughs] JULIE: You found nothing. So, it's useful when you've got some possibilities that could be present and you just want to keep parsing until you find the first one that matches. And then it'll just return whatever. It'll just parse the first thing that it matches on. CHARLES: Okay, okay. JULIE: Does that make sense? CHARLES: Yeah. No, I think it makes sense. JULIE: I'm not sure. Because I feel like I kind of went down a rabbit hole there. [Laughs] CHARLES: Yeah. [Laughs] No, no. I think it makes sense. And as a quick aside, I think… so, I was, when we were talking about min and max, are min and max also like a semiring? Because negative infinity is the annihilator of min and it's the identity of max. and positive infinity is the annihilator of max but it's the identity of min. JULIE: I guess. I don't really think of min and max as having identities. Is that how [inaudible]? CHARLES: I'm just, I don't know. Well, I think if you have negative infinity and you max it with anything, you're going to get the anything, right? Negative infinity max one is one. Negative infinity/minus a billion is minus a billion. JULIE: Yeah, okay. CHARLES: I don't know. Just off the cuff. I'm just trying to… annihilators sound cool. And so… [Laughter] CHARLES: And so I'm like, I'm trying to find annihilators. JULIE: Yeah, they are cool. CHARLES: [Laughs] JULIE: One of my friends on Twitter was just talking about how he used the intuition at least of a semiring at work because he had this sort of monoid to concatenate schedules. So, he's got all these different schedules and he's got this kind of monoid to concatenate them, to merge the schedules together. But then he's got this one schedule that is special. And whenever something is in this schedule, it needs to hard override every other schedule. CHARLES: Right. JULIE: And so, that was like the annihilator. So, he was thinking of it as a semiring, because that hard override schedule is like the annihilator of all the other schedules. CHARLES: Yeah. JULIE: If anything else exists on this day or whatever, then it'd just get a hard override. So, there's a real world use. [Laughs] CHARLES: Yeah, a real world example. That's the thing that I'm finding, is that all these really very crystalline abstractions, they still play out very well I think in the real world. And they're useful as a took in terms of casting a net over a problem. Because you're like… when I'm faced with something new, I'm like “Well, let's see. Can I make it a functor?” And if I can, then I've unlocked all these goodies. I've unlocked every single composition pattern that works with functor. JULIE: Right, right. CHARLES: And it's like sometimes it fits. It almost feels like when you're working on something at home and you've got some bolt and you're trying on different diameters. So you're like, “Oh, is it 15 millimeter? Is it 8 millimeter?” JULIE: Right. [Laughs] CHARLES: “Like no, okay. Maybe it'll work with this.” But then when it clicks, then you can really ratchet with some serious torque. JULIE: Right, right. Yeah. CHARLES: So, yeah. Definitely trying to look for semirings [Laughs] is definitely beyond my [can] at this point. But I hope to get there where it can be like, if it's a fit, it's a fit. That's awesome. JULIE: Right. Yeah, it's kind of beyond my can too. Semirings are still a little bit new for me and I can't say that I find them in the wild as it were, as often as monoids or something. But I think it just takes seeing some concrete examples. So, now you know this idea exists. If you just have some concrete examples of it, then over time you develop that intuition, right? CHARLES: Right. JULIE: Like “Okay, I've seen this pattern before.” [Chuckles] CHARLES: yeah. Basically, every time now I want to fold a list, or like in JavaScript, any time you want to reduce something I'm like “There's a monoid here that I'm not seeing. Let me look for it.” JULIE: Yeah. Oh, that's cool, yeah. CHARLES: Because like, that's basically, most of the time you're doing a reduce, then like I said that's the terminology for fold in JavaScript, is you start with some reducible thing. Then you have an initial value and a function to actually concatenate two things together. JULIE: Right. CHARLES: And so, usually that initial state, that's your identity. And then that function is just your concat function from your monoid. And so, usually anytime I do a reduce, there's the three pieces. Boom. Identity value, concatenation function, it's usually right there. And so, that's the way I've found of extracting these things, is I'm very suspicious every time I'm tempted to… JULIE: [Laughs] CHARLES: A fold. I'm like “Hmm. Where's the monoid I'm missing? Is it [under the] couch?” Like, where is it? [Laughs] Because it just, it cleans it up and it makes it so much more concise. JULIE: Oh yeah, that's awesome. CHARLES: So anyhow. JULIE: Have we totally lost Elrick? ELRICK: Nope, I'm still here. JULIE: Okay. [Laughs] ELRICK: I'm sitting in and listening to you two break down these complex topics is really good. Because you guys break them down to a level where it's consumable by people that barely understand it. So, I'm just sitting here just soaking everything in like “Oh, that's awesome.” Taking notes. Yes, okay, okay. [Laughter] JULIE: Cool. ELRICK: So, I'm like riding the train in the back just hanging out, feeling the cool breeze while you guys just pull the train ahead in… [Laughter] ELRICK: In the engine department, you know? It's awesome. CHARLES: Yeah. ELRICK: I don't know if they're related. But you were talking about semirings and I heard of semigroups or semigroups. I have no idea if those two things are related. Are they related or [inaudible]? JULIE: They're kind of related. So, a semigroup is like a monoid but doesn't have an identity value. CHARLES: What is an example of a semigroup out there in the wild? Because every time I find a semigroup, I feel like it's actually a monoid. JULIE: Well, you know I feel like that a lot, too. We do have a data type in Haskell that is a non-empty list. So, there is no empty list CHARLES: Ah, right. Okay. JULIE: So then you can concatenate those lists, but there's never an identity value for it. CHARLES: I see. JULIE: Yeah. So, that's a case. There's actually a lot of comparison functions, greater than and less than. I think those are semigroups because they're binary, they're associative, but they don't have an identity value. Like if you're comparing two numbers, there's not really an identity value there. CHARLES: Right. Well, would the negative infinity work there? Let's see. Like, negative infinity greater than anything would be the anything. Well, okay wait. But greater than, that takes numbers and yields a boolean, right? JULIE: Yeah, CHARLES: Right. So, it couldn't be… could it be a semigroup? Don't semigroups have to… Doesn't the [inaudible] function have to yield the same type as the operands? JULIE: Yes. CHARLES: But a non-empty list, that's a good one. Sometimes it's basically not valid for you to have a list that doesn't have any elements, right? Because it's like the null value or the empty value and it could be like a shopping cart on Amazon. You can't have a shopping cart without at least something in it. JULIE: Right. CHARLES: Or, you can't check out without something. So, you might want to say like the shopping cart that I'm going to check out is a non-empty list. And so, you can put two non-empty lists together. But yeah, there's no value you can mash together, you can concat with anything, that isn't empty. JULIE: Right. CHARLES: So, I guess going back to your question Elrick, I don't know if it's related to semiring. But semigroup is just, it's like one-half of monoid. It's the part that concats two values together. JULIE: Right. Well, yeah. And so, it's supposed to be half a group, right? But I don't remember… CHARLES: [Laughs] JULIE: [Inaudible] all of the group stuff is, all the stuff that these types have to have to be a group. And similarly, I forget what the difference between semiring and ring is. [Chuckles] Because a ring and a group I know are not the same thing. But I forget what the difference is, too. So, I kind of got a handle on what semigroups are, and I know all my Haskell friends are going to, when they hear this podcast they're going to tweet all these examples of semigroups at me, especially my coauthor for ‘Joy of Haskell', Chris Martin. He's really into semigroups. And so, I know he's going to be very disappointed in my inability to think… [Laughter] JULIE: To think of any good examples. But it's not something that I find myself using a lot, whereas semirings are something that I have started noticing a little bit more often. So, how a monoid relates to a group is something that I can't remember off the top of my head. And I know how semirings relate to monoids, but how monoids then relate to rings and groups, I can't really remember. And so, these things are sort of all related. But the relation is not something I can spill out off the top of my head. Sorry. [Laughs] CHARLES: No, It's no worries. You know, I feel like… ELRICK: It's all good. CHARLES: What's funny is I feel like having these discussions is exactly like the discussions people have with any framework of using one that we use a lot, which is EmberJS. But if you could do with React or something, it's like, how does the model relate to the controller, relate to the router, relate to the middleware, relate to the services? You just have these things, these moving parts that fit together. And part of… I feel like exploring this space is really, absolutely no different than exploring any other software framework where you just have these things, these cooperating concepts, and they do click together. But you just have to map out the space in your head. JULIE: Yeah. This is going to sound stupid because everybody thinks that because I know Haskell I must know all these other things. But I just had to ask people to recommend me a book that could explain the relationship of HTML and CSS, because that was completely opaque to me. CHARLES: [Laughs] Yeah. JULIE: I've been involved in the making now of several websites because of the books and stuff like that. And I have a blog. It's not WordPress or anything. I did that sort of myself. So, I've done a little bit with that. But CSS is really terrifying. And… CHARLES: Right. Like query selectors, rules, properties. JULIE: Yeah. ELRICK: [Laughs] CHARLES: Again, might as well be groups and semigroups and monoids, right? JULIE: Right, right. ELRICK: Yeah. CHARLES: [Laughs] ELRICK: That is really interesting. [Chuckles] I've never heard anyone make that comparison before. But it's totally true, now that I'm thinking about it. JULIE: Yeah, yeah. CHARLES: Yeah. In the tech world we are so steeped in our own jargon that we could be… we can reject one set of jargon and be totally fine with another set. Or be like, suspicious of one set of concepts working together and be totally fine with these other designations which are somewhat arbitrary but they work. JULIE: Right. CHARLES: So, people use them. JULIE: So, it's like what you've gotten used to and what you're familiar with and that seems normal and natural to you. [Chuckles] So, the Haskell stuff, most of it seems normal and natural to me. And then I don't understand HTML and CSS. So, I bought a book. [Laughter] CHARLES: Learning HTML and CSS from first principles. JULIE: Yes, yeah. I just wanted to understand. I could tell that they do relate to each other, that there is some way that they click together. I can tell that by banging my head against them repeatedly. But I didn't really understand how, and so yeah. So, i've been reading this book to [Laughs] [learn] HTML and CSS and how they relate together. That's so important, just figuring out how things relate to each other, you know? CHARLES: Yeah. ELRICK: Yeah. That is very true. JULIE: Yeah. ELRICK: We can trade. I can teach you HTML and CSS and you can teach me Haskell. JULIE: Absolutely. ELRICK: [Laughs] CHARLES: There you go JULIE: [Laughs] ELRICK: Because I'm like, “Ooh.” I'm like, “Oh, CSS. Great. No problem.” [Laughter] ELRICK: Haskell, I'm like “Oh, I don't know.” JULIE: Yeah. CHARLES: Yeah. ELRICK: [Laughs] CHARLES: No, it's amazing [inaudible] CSS. ELRICK: Yeah. CHARLES: It is, it's a complicated system. And it's actually, it's in many ways, it's actually a pretty… it's a pretty functional system, CSS is at least. The DOM APIs are very much imperative and about mutable state. But CSS is basically yeah, completely declarative. JULIE: Right. CHARLES: Completely immutable. And yeah, the workings of the interpreter are a mystery. [Laughs] ELRICK: Yup. JULIE: YEs. And you know, for the Joy of Haskell website we use Bootstrap. And so, there was just like… there's all this magic, you know? [Laughs] ELRICK: Oh, yeah. CHARLES: Yeah. JULIE: Oh look, if I just change this little thing, suddenly it's perfectly responsive and mobile. Cool. [Laughter] JULIE: I don't know how it's doing this, but this is great. [Laughs] CHARLES: Yeah. Oh, yeah. It's an infinite space. And yeah, people forget what is so easy and intuitive is not and that there's actually a lot of learning that happened there that they're just taking for granted. JULIE: I think so many people start from HTML and CSS. That's one of their first introductions to programming, or JavaScript or some combination of all three of those. And so, to them the idea that you would be learning Haskell first and then coming around and being like “Oaky, I have to figure out HTML,” that [seems very] strange, right? [Laughter] CHARLES: Yeah. Well, definitely probably stepping into bizarro world. JULIE: And I went backwards. But [Laughs] CHARLES: Yeah. JULIE: Not that it's backwards in terms of… just backwards in terms of the normal way, progression of [inaudible] CHARLES: Yeah. It's definitely the back door. Like coming in through the catering kitchen or something. JULIE: Yes. CHARLES: Instead of the front door. Because you know the browser, you can just open up the Dev Tools and there you are. JULIE: Exactly, yeah. CHARLES: The level of accessibility is pretty astounding. And so, I think t's why it's one of the most popular avenues. JULIE: Oh, definitely. Yeah. ELRICK: It's the back door probably for web development but not the back door for programming in general. JULIE: Mm, yeah. Yeah. CHARLES: Yeah. It seems like Haskell programming has really started taking off and that the ecosystem is starting to get some of the trappings of a really less fricative developer experience in terms of the package management and a command line experience and being able to not make all of the tiny little decisions that need to be made before you're actually writing ‘hello world'. JULIE: Right. ELRICK: Interesting. Haskell has a package manager now? CHARLES: Oh, it has for a while. ELRICK: Oh, really? What is it called? I have no idea? Do you know the name off the top of your head? CHARLES: So, I actually, I'm not that familiar with the ecosystem other than every time I try it out. So I definitely will defer this question to you, Julie. JULIE: This is going to be a dumb question, I guess. What do we mean by package manager? CHARLES: So, in JavaScript, we have npm. The concept of these packages. It's code that you can download, a module that you can import, basically import symbols from. And Ruby has RubyGems. And Python has pip. JULIE: Okay, okay. CHARLES: Emacs has Emacs Packages. And usually, there's some repository and people could publish to them and you can specify dependencies. JULIE: Right, yeah. Okay, so we have a few things. Hackage is sort of the main package repository. And then we have another one called Stackage and the packages that are in Stackage are all guaranteed to work with each other. CHARLES: Mm, okay. JULIE: So, on Hackage, some of the packages that are on Hackage are not really maintained or they only work with some old versions of dependencies and stuff like that, so the people who made Stackage were like “well, if we had this set of packages that were all guaranteed to work together, the dependencies were all kept updated and they all can be made to work together, then that would be really convenient.” And then we have Cabal and we have Stack are the main… and a lot of people use Nix for the same purpose that you would use Cabal or Stack for building projects and importing dependencies and all of that. CHARLES: Right. So, Cabal and Stack would be roughly equivalent then to the way we use Yarn or JavaScript and Bundler in Ruby. You're solving the equation for, here's my root set of dependencies. Go out and solve for the set of packages that satisfy. Give me at least one solution and then download those packages and [you can] run them. JULIE: Yeah, yeah. Right, so managing your dependencies and building your project. Because Haskell's compiled, so you've got to build things. And so yeah, we have both of those. CHARLES: And now there's like web frameworks and REST frameworks. JULIE: Oh there are, yeah. We have… CHARLES: All kinds of stuff now. JULIE: We had this big proliferation of web frameworks lately. And I guess some of them are very good. I don't really do web development. But the people I know who do web development in Haskell say that some of these are very good. Yesod is supposed to be very good. Servant is sort of the new hotness. And I haven't used Servant at all though, so don't ask me questions about it. [Laughter] JULIE: But yeah, we have several big web frameworks now. There are still some probably big holes in the Haskell ecosystem in terms of what people want to see. So, that's one thing that people complain about Haskell for, is that we don't have some of the libraries they'd like to see. I'd like to see something… I would really like to see in Haskell something along the lines of like NLTK from Python. CHARLES: What is that? JULIE: Natural language toolkit. CHARLES: Oh, okay. JULIE: So yeah, Python has this… CHARLES: Yeah, Python's got all the nice science things. JULIE: They really do. And Haskell has some natural language processing libraries available but nothing along the lines of, nothing as big or easy to use and stuff as NLTK yet. So, I'd really like to see that hole get filled a little bit better. And you know… CHARLES: Well, there you go. If anyone out there is seeking fame and fortune in the Haskell community. JULIE: That's actually why I started learning Python, was just so that I could figure out NLTK well enough to start writing it in Haskell. [Laughter] JULIE: So, that's sort of my ambitious long-term project. We'll see how that goes. [Laughs] CHARLES: Nice. Before we wrap up, is there anything going on, coming up, that you want to give a shoutout to or mention or just anything exciting in general? JULIE: Yeah, so on March 30th I'm going to be giving a talk at lambda-squared which is going to be in Knoxville and is a new conference. I think it's just a single-day conference and I'm going to be giving a talk about functors. So, I'm going to try to get through all the exciting varieties of functors in a 50-minute talk. CHARLES: Ooh. JULIE: So, we'll see how that goes. Yeah. And I am still working with Chris Martin on ‘The Joy of Haskell' which should be finished this year, sometime. I'm not going to… [Laughter] JULIE: Give any more specific deadline than that. And in the process of writing Joy of Haskell, I was telling him about some things that, some things that I think are really difficult. Like in my experience, teaching Haskell some places where I find people have the biggest stumbling blocks. And I said, “What if we could do a beginner video course where instead of throwing all of these things at people at once, we separated them out?” And so, you can just worry about this set of stumbling blocks at one time and then later we can talk about this set of stumbling blocks. And so, we're doing… we're going to start a video course, a beginner Haskell video course. I think we'll be starting later this month. So, I'm pretty excited… CHARLES: Nice. JULIE: About that. Yeah. CHARLES: Yeah, I know a lot of people learn really, really well from videos. There's just some… JULIE: Yeah. [Inaudible] for me, so I'm a little nervous. But [Laughs] CHARLES: Yeah, especially if you can do… are you going to be doing live coding examples? Building out things with folks? JULIE: Yeah. CHARLES: Yeah. Well, you just needn't look no further than the popular things like RailsCasts and some of the… yeah, there's just so many good video content out there. Yeah, we'll definitely be looking for the. JULIE: Cool. CHARLIE: Alright. Well, thank you so much, Julie, for coming on. JULIE: Well, thank you for having me on. Sorry I went down some… I went kind of down some rabbit holes. Sorry about that. [Laughs] CHARLES: You know what? You go down the rabbit holes, we spend time walking around the rabbit holes. JULIE: [Laughs] CHARLES: There's something for everybody. So… [Laughter] CHARLES: And ultimately we're strolling through the meadow. So, it's all good. JULIE: [Laughs] Yeah. CHARLES: Thank you too, Elrick. JULIE: It was nice talking to you guys again. CHARLES: Yeah. ELRICK: Yeah, thank you. CHARLES: If folks want to follow up with you or reach out to you, what's the best way to get in contact with you? JULIE: I'm @argumatronic on Twitter and my blog is argumatronic.com which has an email address and some other contact information for me. So, I'd love to hear questions, comments. [Laughs] Yeah. I always [inaudible]. CHARLES: Alright, fantastic. JULIE: To talk to new people. CHARLES: Alright. And if you want to get in touch with us, we are @TheFrontside on Twitter. Or you can just drop us an email at contact@frontside.io. Thanks everybody for listening. And we will see you all later.

  Mark sits down with Julie Patterson, a longtime ALPS Business Development Representative, bringing with her two decades of experience helping law firms across the country understand the importance of selecting the right coverage to protect their law firms. In this episode Mark and Julie discuss legal malpractice insurance costs in terms of what a firm should actually be getting for their premium dollar. ALPS In Brief, The ALPS Risk Management Podcast, is hosted by ALPS Risk Manager, Mark Bassingthwaighte. Transcript: MARK: Welcome to another episode of ALPS In Brief, The ALPS Risk Management Podcast. I'm Mark Bassingthwaighte, ALPS risk manager, and I'm sitting down today at the ALPS offices in Missoula, Montana, with JULIE. Julie has been with ALPS on the business development team for 20 years. She brings with her a wealth of knowledge on legal malpractice insurance, and today we are going to talk about the cost of legal malpractice insurance, focusing on what really should you be getting for your premium dollar. Julie, welcome. JULIE: Thank you, Mark. I appreciate that nice intro. MARK: Well, you're very welcome. You're very welcome. I think it's a fair question. Malpractice insurance is … It's an investment. It's not an insignificant line item of business year to year. When I think about I'm cutting this check each year and buying my ALPS policy, really what am I getting, what should I be getting when I think about malpractice insurance? JULIE: Good question. It's very important for your firm to have your malpractice insurance carrier picked out and go through their features with a reputable person at the company to help you out with everything. You want to look for somebody who is going to partner with you, who's going to understand what you do in the course of your day-to-day business and be able to provide support where you need it, but also peace of mind for exactly what you're buying for your firm. MARK: I think that's a great point in the sense … Heaven forbid, if I have some significant claim come up at some time, I mean, I really am counting on the carrier to have my back. What I'm hearing is the relationship here I really should look into. JULIE: You should. MARK: That this is a partner. JULIE: It is, and that's very important because you want to have access to the people when you need to talk to them, or if you have a claim in your firm, you need to be able to talk to that person who can help you, ease your mind, and get the ball rolling for you. MARK: Are there other things that come to mind? JULIE: Absolutely. You want to look at the policy features. You want to see what they offer in limits and deductible. You want to access your clientele and your risk and what you can sleep with at night for your limits and deductible. That's an important factor as well. MARK: In policy features, there's one thing I think that's important and I'm not sure everyone fully appreciates at times. You can sit down and compare policies at times and everything seems to be exactly the same except one is significantly cheaper. What we're really getting at is there's some policies out there that are what we refer to as cannibalizing policies. I think that might be an important distinction. Can you share what I'm talking about, what this issue is? JULIE: Yes. That's very important. A lot of times when you see a quote come in to your firm for a cheaper price, that means that they're trying to buy the business in your area. They may not know what the jurisdiction brings in claims experience. They may be just trying feelers out there to see what kind of business they can bring in the door, but typically if it's a cheaper policy, it's going to be cannibalizing. You are not going to have limits on the outside of your per claim limit, and you will probably have a hammer clause, meaning if a claim were to arise and you don't agree to settle it with the carrier who you've been insured with, they are going to walk away, and you're going to be left holding the bag. MARK: Okay. I want to make sure that we're clear. When we talk about limits being inside or outside, if I have my defense costs inside limits so that every dollar that gets spent on defense is going to erode what's available for the loss payment. JULIE: You're exactly correct. It's going to erode that per claim limit, and you want to look for defense costs on the outside of your per claim limit with the carriers that you are shopping with. MARK: That seems to me to be a pretty important thing. JULIE: That's very important. MARK: Just to understand, so two policies that are on their face may provide a million dollars in coverage, but if the cheaper policy has defense cost inside limits, I'm really not getting a million dollar policy, so that's why it's cheaper. JULIE: That's correct. MARK: Okay. That makes sense. That makes sense. Continue on. We've talked about the relationship, we've talked a bit about some of the features and looking at some of the pricing issues. Are there other things that come to mind yet? JULIE: Well, the add-on to the pricing, responsible pricing. You want to look for a carrier that's had some experience in that jurisdiction, that's been there a while. They know the climate, they know the jurisdiction, and they are going to rate accordingly and responsibly. If you see a carrier come in real low, they're just trying to buy your business, and they might do a bait and switch the following year. Be careful when you're shopping and looking at pricing. MARK: Again, it seems to me, is it worth even asking how long you have been in a market if I'm shopping and- JULIE: Absolutely. The other important factor is if that carrier is endorsed by the state bar. Many state bars around the United States will endorse a carrier, meaning they're giving back to that community, that legal profession in that community, and that's an important factor as well. It comes with a- MARK: Okay. All right, so what I'm hearing on sort of the takeaway with this piece is just looking at commitment to the local market, that I want to work with an insurer that is committed long term. That makes a lot of sense. Okay. JULIE: Customer service plays into it as well. You want somebody who's going to return your calls, who's going to answer your questions, respond to your email in a timely fashion, and hopefully under 24 hours. You shouldn't have to chase them down. They should be willing to talk to you, whatever it is that comes about and you need help with. MARK: Okay. Excellent. Excellent. Boy, I wish I had known that years ago, let me tell you, before I got into working with an insurance company. Are there any final thoughts or other things you'd like to share, Julie? JULIE: Yeah. Probably just a quick input on claims handling. Double check on how they handle the claims, how you report a claim, are you going to be assigned a claims attorney to work with or a claims adjuster, very important. You really want somebody who is a claims attorney, who is an attorney who can talk on your level, and find out who their defense panel is in your jurisdiction, and if you have input there. That's important as well. You really want input instead of them picking an attorney that maybe is somebody you don't respect in your jurisdiction. MARK: Right, right. This has been great stuff. The big takeaway for me is this isn't just like going to a store and picking out some item for home or something. What you're really saying is we're entering into a partnership here and heaven forbid again, something come up in terms of a blown statute or some other type of significant claim. What you're really telling me is that the relationship that I've created with the carrier is really going to be key in terms of how we get through all this in the end. JULIE: It's very key. MARK: Yeah. Good stuff. Good stuff. Well, thank you very much for joining us today. JULIE: You're welcome. Yeah, thank you. MARK: Thanks to all of you for listening to the show. If any of you have any questions about the issues Julie and I have discussed, please don't hesitate to contact me here at ALPS at mbass@alpsnet.com. We'd love your feedback on the podcast including hearing about any other issues or topics you'd like to hear us cover. That's it. Thanks again, Julie. Thanks to all of you. JULIE: Thank you.