Podcasts about julie you

I loved this conversation with this week's guest – it went deep into topics like what happens to lost souls and ghosts (your jaw will be on the floor) and to help them transition to the other side and natural trance shamanism (yes please!).  I sat down on The You-est You® Podcast with Julie Kramer, a grounded light worker with years of experience — as a gifted shamanic healer, teacher of teachers, and someone who has spent over two decades guiding people into relationship with the unseen world of helping spirits. Julie believes (and I do too!) that we all have access to these compassionate beings — whether we call them spirit guides, ancestors, or allies in the invisible realms.  And even more incredible? We can learn to partner with them in deeply transformative ways. This episode felt like a reunion with truth — the kind that brings goosebumps, peace, and the kindest yes from your soul. And if this episode speaks to your heart, I highly recommend checking out Julie's introductory trainings at www.juliemkramer.com. Use code YOU100 for $100 off!   About Julie Kramer:   Julie is a shamanic healer, teacher, and teacher of teachers who specializes in training people to become professional spiritual healers. During the last 22 years, she's taught more than 70 standalone workshops, along with three cohorts of her signature three-year professional spiritual healer training program. She calls the path of practice and training that she offers “The Ennobling of the Heart” because of how luminous our hearts become when we form alliances with helping spirits.    Julie is an expert at teaching people how to partner with compassionate helping spirits by way of natural trance states. She holds the conviction that everyone has benevolent spirit guides and anyone can learn how to contact them directly by expanding their awareness using drumming, singing, whistling, rattling, and dancing.    The entryway for “The Ennobling of the Heart” is Julie's three-day introductory workshop, “Partnering with Compassionate Spirits.” This workshop is designed for beginners who wish to contact the spirit guides who are dedicated to their individual wellbeing, evolution, and purpose. Please visit www.juliemkramer.com to learn more about Julie's approach as well as her upcoming offerings. Use the code YOU100 for $100 off any introductory workshop with Julie. If you're thinking about attending Julie's upcoming retreat in Bloom in June, use YOU300 for $300 off (just be sure to use the pay in full option to receive the full discount).    Julie lives with her wife, Tami Simon, the Founder of Sounds True, and their two Spoodles in British Columbia, Canada.   About Your Host, Julie Reisler Join Julie Reisler weekly, podcast host, intuitive coach, author, and multi-time TEDx speaker, each week to learn how to access your spiritual gifts and inner guidance to be your You-est You® and achieve greater inner peace, spiritual connection, happiness, and abundance. Tune in to hear powerful, inspirational stories and wisdom from spiritual luminaries, experts, conscious leaders, psychic mediums, and extraordinary human beings that will help to transform your life.  Be sure to subscribe to Julie's YouTube channel https://www.youtube.com/juliereisler and ring the notification bell so that you never miss a powerful episode! Here's to your truest, You-est You! Love, Julie   You-est You® Resources for YOU! See below for free tools, resources, programs, and goodies to help you become your YOU-EST YOU!   FREE Manifest Your Goals & Dreams 7-Day Toolset This stunning free toolset is a 7-day workbook (25 pages full) of powerful mindset practices, grounding meditations (and audio), a new beautiful time management system and template to set your personalized schedule for your best productivity, a personalized energy assessment, and so much more. It was designed to specifically help you uplevel your routine and self-care habits for success so you can radiate and become your ‘You-est You'. These tools are some of Julie's best practices used with hundreds of her clients to help you feel more confident, clear, and connected to your best self so that you feel inspired to take on the world. Get it at: juliereisler.com/toolset   FREE Intuition Assessment  Unlock your unique intuitive super-powers and discover your dominant intuition and language with the unseen. Take the assessment at https://juliereisler.com/intuitiontest-podcast   Intuition Activation Mini-Course - 90% OFF! For a limited time only, get access to Julie's powerful transformative Intuition Activation mini-course for 90% off! You'll have lifetime access to this course that is full of video modules, worksheets, meditations, tools and practices to unlock your intuition and activate your inner guidance! Sign up now at https://juliereisler.com/activation    Join The Sanctuary Membership - Now Open! Join Julie's high vibrational sacred membership, an inner circle for conscious coaches, Lightworkers, and spiritual seekers, a spiritual oasis for change-makers wanting to make a bigger impact in the world. Julie will be leading bi-monthly live calls, including monthly psychic intuitive guided messages, and workshops teaching spiritual tools (like learning how to use a pendulum, muscle test, assess your chakras, open up your psychic abilities) to help you manifest what your heart most desires, manage your energy, develop your intuitive gifts, and connect more deeply with your higher self and spirit guides. Learn more and join now at https://juliereisler.com/sanctuary    You-est You Intention Cards Want your own powerful deck of 33 You-est You Intention Cards? These cards were channeled by Julie. Each card has an empowering intention and deeper questions to ask your ‘You-est You' for greater self-awareness, higher consciousness, and spiritual growth. You can get them now at https://amzn.to/45q14DJ.     Change Your Life Through Gratitude If you are looking for a powerful way to increase your gratitude quotient, prosperity mindset, and quality of life, check out my 15 Days of Gratitude To Change Your Life course. This course is only $47 and will change the way you view, everything! Enroll here: https://juliereisler.com/gratitude   Sacred Connection This community is a sacred, safe place built on love and acceptance. It was created to help you evolve and expand into your highest self. Please share your wisdom, comments, and thoughts. I love hearing from you and learning how you are being your truest, you-est you. Please join us in our FREE Facebook group: The You-est You® Podcast Community.   The Intuitive Life Designer® Master Life Coach Certification Program Are you eager to release self-doubt (for good) and have an intuition upgrade? Do you want to put your head on the pillow at night feeling calm and joyful that you are doing something really meaningful? Check out Julie's Life Designer Coach training. This world-class four-month virtual live coach certification program will give you proven tools, transferable skills, powerful techniques, practices, and the best methodology to be a powerful coach. This transformational coaching program is for aspiring and current coaches looking to fill in the missing pieces and gain real confidence and mastery in coaching. This program infuses integrative health modalities from a mind-body science, positive psychology, and healing arts perspective. To get on the waitlist and learn more, go to lifedesignercoachacademy.com. You-est You Resources & Links:

Have you ever felt like you're doing all the things—yet your soul is whispering, “There's more…”? Yup, I've certainly felt that way too. I hope this week's podcast conversation is what your spirit's been craving. I sat down with the founder of Insight Timer—the world's most beloved mindfulness app (and one I personally adore)—to explore the deeper mission behind it all. What unfolded was a powerful conversation about using technology not to disconnect, but to reconnect… with ourselves, with each other, and with the sacred. In honor of Global Meditation Day, I'm inviting you to hear the heart and soul behind Insight Timer, along with a greater vision for how we navigate this fast-paced, tech-saturated world. We talk about purpose, presence, and how conscious tech can be a vessel for healing rather than numbing. I hope this conversation gives you a glimpse of what's possible when we have conscious tech supporting a more conscious world. And, I hope it serves you in all the ways you need right now. Here's to living with more peace and presence, one breath at a time.

It's wild how close the guidance and love we're seeking really is—often it's way quieter than we expect. In this hear-led episode of The You-est You® Podcast, I had the joy of sitting down with the wise and dear Anjie Hipple, who channels the Judah Channel. We talked all things angels, energy, and coming home to your truest self. My take? You're going to feel seen, supported, and gently reminded of the divine light that's already within you. Together, we dive into: - The reality of angelic presence and unconditional love - Clearing negative energy through divine connection - How chosen family and community elevate your spiritual journey - Remembering your sacred worth and how to do this   This one is pure magic!   Oh, and if you're feeling called to deepen your soul journey in person, I'd love to give you a big hug and guide you in real-time. I'm co-leading ‘Your Truest You-est You', a heart-expanding retreat at the Art of Living Retreat Center in the Blue Ridge Mountains of North Carolina, June 13–15.   ✨ There are still a few sacred spots left: juliereisler.com/retreat2025 Come be part of this high-vibe, soul family experience. I'd love to see you there.

Are you having a negative impact on the value of your business? So many business owners aren't aware of the effect they are having on the value of their business before sale. They take on too many roles across the business, aren't tracking what they pay themselves over the year, and all this impacts what they could be taking home from selling it further down the line. In this episode I go into the fundamentals of financial concepts all business owners should know to be able to sell their business for as much as possible. I cover EBITDA, adjusted EBITDA and the impacts of salaries and dividends on valuations. With enough knowledge and a few adjustments, you can maximise what you can sell your business for.   Listen up to find out how!   "Are the decision you make maximising profit?" – Julie   You'll hear about: Why adjusted EBITDA is crucial for understanding business value during sales. The accruals concept helps match income with costs for accurate financial reporting. Business owners often overlook the impact of their roles on company valuation. Dividends taken by owners can distort profit margins and business valuation.   Connect With Julie Wilkinson   LinkedIn - https://www.linkedin.com/in/juliewilkinson-accounting/ Tik Tok – https://www.tiktok.com/@wasolutions YouTube - https://www.youtube.com/channel/UCUvq6gfNoP_4dfIJulL6C6A Facebook - https://www.facebook.com/wilkinsonaccountingsolutions Website - https://wilkinsonaccountingsolutions.co.uk/   Find out more about our brilliant sponsor Acquisition Masters here - https://www.acquisitionmasters.co.uk/   Before you go, don't forget to leave a comment and review if you got something out of this episode!

Hello radiant one,   Have you heard of the Mother Force? I hadn't—until I was guided to my guest's meditations, which is pure soul nectar.   In this week's episode of The You-est You® Podcast, I sat down with Gareth Duignam, whose spontaneous Kundalini awakening opened him to spirit realms, unseen dimensions, and a deep remembrance of the Mother Force rising within us all.  

This episode on The You-est You Podcast® is next level

What happens when the daughter of the most notorious mobster discovers she's a powerful psychic medium?

What does it take to build a lasting legacy? Hint: It's more than just hard work.   In this week's You-est You® Podcast, I sit down with Lynda Erkiletian & Elizabeth Centenari, the visionary founders behind THE Artist Agency, one of the most enduring talent agencies in the industry.   Celebrating 40 years as women business owners following their heart, intuition, and yes, cosmic timing, they share what it actually takes to make your BIG dreams come true.     About Lynda and Elizabeth    Lynda Erkiletian Lynda Erkiletian is a trailblazer in the modeling and talent industry, best known as the founder and president of THE Artist Agency, which has been a cornerstone of the fashion and entertainment world for over 40 years. With a keen eye for talent and a deep understanding of industry trends, Lynda has built a legacy based on intuition, resilience, and strategic vision. Beyond her work in talent management, she is passionate about mentorship, philanthropy, and empowering individuals to follow their dreams with authenticity and confidence.   Elizabeth Centenari Elizabeth Centenari is a powerhouse in talent representation and business leadership. As vice-president of THE Artist Agency, she has played a pivotal role in shaping careers, fostering creative partnerships, and ensuring the agency's longevity in an ever-evolving industry. With a strong belief in the power of synchronicity, astrology, and intuition, Elizabeth has guided talent and business decisions with a mix of strategy and soul. Her expertise, warmth, and vision continue to leave a lasting impact on the industry and those she mentors.   Enjoy this inspiring conversation with Lynda and Elizabeth!     About Your Host, Julie Reisler Join Julie Reisler weekly, podcast host, intuitive coach, author, and multi-time TEDx speaker, each week to learn how to access your spiritual gifts and inner guidance to be your You-est You® and achieve greater inner peace, spiritual connection, happiness, and abundance. Tune in to hear powerful, inspirational stories and wisdom from spiritual luminaries, experts, conscious leaders, psychic mediums, and extraordinary human beings that will help to transform your life.    Be sure to subscribe to Julie's YouTube channel https://www.youtube.com/juliereisler and ring the notification bell so that you never miss a powerful episode!   Here's to your truest, You-est You!   Love, Julie   You-est You® Resources for YOU! See below for free tools, resources, programs, and goodies to help you become your YOU-EST YOU!   FREE Manifest Your Goals & Dreams 7-Day Toolset This stunning free toolset is a 7-day workbook (25 pages full) of powerful mindset practices, grounding meditations (and audio), a new beautiful time management system and template to set your personalized schedule for your best productivity, a personalized energy assessment, and so much more. It was designed to specifically help you uplevel your routine and self-care habits for success so you can radiate and become your ‘You-est You'. These tools are some of Julie's best practices used with hundreds of her clients to help you feel more confident, clear, and connected to your best self so that you feel inspired to take on the world. Get it at: juliereisler.com/toolset   FREE Intuition Assessment  Unlock your unique intuitive super-powers and discover your dominant intuition and language with the unseen. Take the assessment at juliereisler.com/intuitionassessment   Intuition Activation Mini-Course - 90% OFF! For a limited time only, get access to Julie's powerful transformative Intuition Activation mini-course for 90% off! You'll have lifetime access to this course that is full of video modules, worksheets, meditations, tools and practices to unlock your intuition and activate your inner guidance! Sign up now at https://juliereisler.com/activation    Join The Sanctuary Membership - Now Open! Join Julie's high vibrational sacred membership, an inner circle for conscious coaches, Lightworkers, and spiritual seekers, a spiritual oasis for change-makers wanting to make a bigger impact in the world. Julie will be leading bi-monthly live calls, including monthly psychic intuitive guided messages, and workshops teaching spiritual tools (like learning how to use a pendulum, muscle test, assess your chakras, open up your psychic abilities) to help you manifest what your heart most desires, manage your energy, develop your intuitive gifts, and connect more deeply with your higher self and spirit guides. Learn more and join now at https://juliereisler.com/sanctuary    You-est You Intention Cards Want your own powerful deck of 33 You-est You Intention Cards? These cards were channeled by Julie. Each card has an empowering intention and deeper questions to ask your ‘You-est You' for greater self-awareness, higher consciousness, and spiritual growth. You can get them now at https://amzn.to/45q14DJ.     Change Your Life Through Gratitude If you are looking for a powerful way to increase your gratitude quotient, prosperity mindset, and quality of life, check out my 15 Days of Gratitude To Change Your Life course. This course is only $47 and will change the way you view, everything! Enroll here: https://juliereisler.com/gratitude   Sacred Connection This community is a sacred, safe place built on love and acceptance. It was created to help you evolve and expand into your highest self. Please share your wisdom, comments, and thoughts. I love hearing from you and learning how you are being your truest, you-est you. Please join us in our FREE Facebook group: The You-est You® Podcast Community.   The Intuitive Life Designer® Master Life Coach Certification Program Are you eager to release self-doubt (for good) and have an intuition upgrade? Do you want to put your head on the pillow at night feeling calm and joyful that you are doing something really meaningful? Check out Julie's Life Designer Coach training. This world-class four-month virtual live coach certification program will give you proven tools, transferable skills, powerful techniques, practices, and the best methodology to be a powerful coach. This transformational coaching program is for aspiring and current coaches looking to fill in the missing pieces and gain real confidence and mastery in coaching. This program infuses integrative health modalities from a mind-body science, positive psychology, and healing arts perspective. To get on the waitlist and learn more, go to lifedesignercoachacademy.com. You-est You Resources & Links:

Have you ever felt the pull to see beyond the physical world—to trust your intuition, release judgment, and truly surrender?   This week on the You-est You® Podcast, I interviewed David Hoffmeister, a world-renowned teacher for 30 years of A Course in Miracles, known for his deep devotion to spiritual awakening.   He shares profound insights on forgiveness, intuition, and releasing the ego's illusions to experience true peace, and how spiritual vision can transform our lives.   If you're ready to release control and embrace the path of inner peace, this conversation is for you.   David Hoffmeister is a world-renowned spiritual teacher and expert in A Course in Miracles (ACIM). With over 30 years of deep devotion to spiritual awakening, he shares profound insights on forgiveness, releasing the ego, and trusting divine guidance. His teachings emphasize practical application, helping seekers experience inner peace and true freedom. Through books, retreats, and global talks, David inspires thousands to embrace a path of love, intuition, and spiritual transformation.   Enjoy this conversation with David!     Takeaways A Course in Miracles is a psychospiritual self-study book. Forgiveness in the Course is about shifting one's mind. The Course emphasizes the importance of intuition. Trusting the higher self is a key theme in the Course. Practical applications of forgiveness can lead to transformation. The world is a projection of our interpretations. Spiritual vision allows us to see beyond the physical. Transcendental experiences can deepen our connection to God. The teachings of the Course are universal and applicable to all backgrounds. You don't need a plan; trust your inner guidance. The ego's voice is controlling and demanding, while the Holy Spirit's is gentle. Addiction stems from judgment, which is the core addiction. The world is an illusion projected from the ego's mind. There are many pathways to God, and each is unique to the individual. Intuition is key to spiritual growth and opens the heart. The Course in Miracles offers practical lessons for daily life. Experiences of light can strengthen devotion and clarity of purpose. It's important to do the inner work to reach higher states of mind. Use what resonates with you to connect with your spirituality.     About Your Host, Julie Reisler Join Julie Reisler weekly, podcast host, intuitive coach, author, and multi-time TEDx speaker, each week to learn how to access your spiritual gifts and inner guidance to be your You-est You® and achieve greater inner peace, spiritual connection, happiness, and abundance. Tune in to hear powerful, inspirational stories and wisdom from spiritual luminaries, experts, conscious leaders, psychic mediums, and extraordinary human beings that will help to transform your life.    Be sure to subscribe to Julie's YouTube channel https://www.youtube.com/juliereisler and ring the notification bell so that you never miss a powerful episode!   Here's to your truest, You-est You!   Love, Julie   You-est You® Resources for YOU! See below for free tools, resources, programs, and goodies to help you become your YOU-EST YOU!   FREE Manifest Your Goals & Dreams 7-Day Toolset This stunning free toolset is a 7-day workbook (25 pages full) of powerful mindset practices, grounding meditations (and audio), a new beautiful time management system and template to set your personalized schedule for your best productivity, a personalized energy assessment, and so much more. It was designed to specifically help you uplevel your routine and self-care habits for success so you can radiate and become your ‘You-est You'. These tools are some of Julie's best practices used with hundreds of her clients to help you feel more confident, clear, and connected to your best self so that you feel inspired to take on the world. Get it at: juliereisler.com/toolset   FREE Intuition Assessment  Unlock your unique intuitive super-powers and discover your dominant intuition and language with the unseen. Take the assessment at juliereisler.com/intuitionassessment   Intuition Activation Mini-Course - 90% OFF! For a limited time only, get access to Julie's powerful transformative Intuition Activation mini-course for 90% off! You'll have lifetime access to this course that is full of video modules, worksheets, meditations, tools and practices to unlock your intuition and activate your inner guidance! Sign up now at https://juliereisler.com/activation    Join The Sanctuary Membership - Now Open! Join Julie's high vibrational sacred membership, an inner circle for conscious coaches, Lightworkers, and spiritual seekers, a spiritual oasis for change-makers wanting to make a bigger impact in the world. Julie will be leading bi-monthly live calls, including monthly psychic intuitive guided messages, and workshops teaching spiritual tools (like learning how to use a pendulum, muscle test, assess your chakras, open up your psychic abilities) to help you manifest what your heart most desires, manage your energy, develop your intuitive gifts, and connect more deeply with your higher self and spirit guides. Learn more and join now at https://juliereisler.com/sanctuary    You-est You Intention Cards Want your own powerful deck of 33 You-est You Intention Cards? These cards were channeled by Julie. Each card has an empowering intention and deeper questions to ask your ‘You-est You' for greater self-awareness, higher consciousness, and spiritual growth. You can get them now at https://amzn.to/45q14DJ.     Change Your Life Through Gratitude If you are looking for a powerful way to increase your gratitude quotient, prosperity mindset, and quality of life, check out my 15 Days of Gratitude To Change Your Life course. This course is only $47 and will change the way you view, everything! Enroll here: https://juliereisler.com/gratitude   Sacred Connection This community is a sacred, safe place built on love and acceptance. It was created to help you evolve and expand into your highest self. Please share your wisdom, comments, and thoughts. I love hearing from you and learning how you are being your truest, you-est you. Please join us in our FREE Facebook group: The You-est You® Podcast Community.   The Intuitive Life Designer® Master Life Coach Certification Program Are you eager to release self-doubt (for good) and have an intuition upgrade? Do you want to put your head on the pillow at night feeling calm and joyful that you are doing something really meaningful? Check out Julie's Life Designer Coach training. This world-class four-month virtual live coach certification program will give you proven tools, transferable skills, powerful techniques, practices, and the best methodology to be a powerful coach. This transformational coaching program is for aspiring and current coaches looking to fill in the missing pieces and gain real confidence and mastery in coaching. This program infuses integrative health modalities from a mind-body science, positive psychology, and healing arts perspective. To get on the waitlist and learn more, go to lifedesignercoachacademy.com. You-est You Resources & Links:

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

Hold on to your seat because this conversation is next-level…

In this episode of The VBAC Link Podcast, join Julie as she sits down with Ambrosia to discuss her journey from a teen pregnancy to achieving a VBAC after two C-sections. Ambrosia shares her unique experiences, the challenges she faced, and the importance of advocating for herself in the medical system. Julie and Ambrosia give insights into the myth of a small pelvis and preeclampsia. How is a small pelvis really diagnosed? Does preeclampsia always mean a medically necessary C-section? Listen to find out!The VBAC Link Blog: Overuse of the CPD DiagnosisCoterie Diapers - Use Code VBAC20 for 20% offHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: All right, Good morning, good morning, good morning. It is Julie here today with The VBAC Link Podcast, and I'm really excited about our story today. I have with me Ambrosia. Is Ambrosia how you say it?Ambrosia: Yes.Julie: Okay, good. I didn't want to go the whole episode without saying your name wrong. Okay, we have it. Ambrosia. I'm really excited because today we have a VBAC after two C-section story. I love especially these stories. Her first pregnancy was a teen pregnancy, and I am really interested in hearing her experience about that because I know that it's a very unique circumstance and a very different journey as a teenager, and there are unique challenges associated with that. So I'm excited to hear more about that and about all of her journey through all of her births. But before I do that, I'm going to share a Review of the Week. This one is a throwback to 2020. I was looking through our spreadsheet and saw that we haven't done that one yet, so I'm going to throw all the way back almost four years ago. This review was on Apple Podcasts, and it says "Meagan and Julie and the women sharing their birth stories are amazing. They share real life stories of all kinds of births and helpful, useful, practical information that has really helped me feel prepared for my VBAC which I hope will happen very soon. I highly recommend listening to this podcast to be informed and encouraged. I also highly recommend their online VBAC course. It's self-paced and offers so much valuable information and good resources. It has really helped me feel ready and empowered to birth my baby. Thank you for all you awesome ladies do for women and the birth world."I will say thank you so much for sharing a review. If you haven't already, take some time, pause the podcast right now. Go ahead and leave us review on Apple Podcasts or wherever you listen, and we might just be reading your review on the podcast one day.All right, let's get back to it. I'm really excited to meet Ambrosia today and hear her stories. Ambrosia is a 27-year-old mother of three boys. Boy Mom, that's super exciting. They are ages 11, 5, and 1 month. I'm really excited to hear, especially, about a fresh VBAC after two C-section story. She is from El Paso, Texas, and she is very excited to share her story with us today. So, Ambrosia, why don't you go ahead and share your journey to a VBAC after two C sections with us?Ambrosia: Cool. I'll start off with my first pregnancy. I got pregnant at about 16. And with that, I just wanted to mention that I wasn't really raised by my mom. I had my grandma in my life most of my life since I was two. So with her, I had a lot of freedom with her, in a sense. I did fall pregnant very, very young. But she did support me in so many ways. She helped me out through all of my pregnancy, but it was more providing shelter and food and stuff like that. When it came down to me knowing what to do, that wasn't really a thing. I found myself watching YouTube a lot and getting my information from the Internet, but still, I was just completely naive to what birth was and all of that. I just went straight off of what my doctor would tell me.Once I did find out that I was pregnant, I chose a doctor and didn't really do any research with that. I just chose a female because that's who I was more comfortable with. But little did I know, the doctor that I did choose, she was, from what I've heard around El Paso from other women and their experiences and doctors too, they were like, "Oh, she's really good at C-sections. She's one of the top ladies that you would want to have to do your C-section because she's really good at it." That was later on that I figured that out. But at the time I was just like, however my baby comes out is how it comes out, but I did want to have like a vaginal birth. I didn't want to do no surgeries or nothing because I've never even broke a bone in my body, so just the thought of surgery kind of scared me. My first visit with her was good, but she automatically told me, "Your pelvis is too narrow. You won't be able to push your baby out. There's a chance that he could get stuck," and this and that. I had my grandma with me, so we just gave each other that look of like, "Oh well, whatever is best." I ended up having a C-section with him, and she schedules the C-section. Then on that day that I got it, after everything was done, she mentioned to me, "You want more kids, right?" I told her, "Of course." She told me, "Well, if you wait a couple years, at least one to two or two-and-a-half years, then you could have a vaginal birth if you would still want that."Julie: That is so funny. Hold on. Can I interrupt for a second?Ambrosia: Yeah, of course.Julie: I'm so sorry. I think it's so funny that she told you that after she told you your pelvis was too small.Ambrosia: Exactly.Julie: Isn't that silly? Anyway, we're gonna talk more about that at the end of the episode, but I just had to call attention to that. Anyway. Sorry. Keep going. Thank you. Ambrosia: You're okay. Yeah. I thought that was weird, too, because knowing what I know now, I know that a lot of doctors get more money, in a sense, out of the C-sections rather than a vaginal birth. So I'm like, yeah, that's probably why. And not necessarily that, but it's more convenient for them. They don't have to really wait around and whatnot. And then with my second pregnancy, my son was already about 5-6 years old. And so I was like, well, of course I can. I was pretty excited. I did want to push for vaginal birth, but I did end up going back to her for that pregnancy. I should have known better. But honestly, I didn't know really how to advocate for myself still because I was 21. I feel like I just wasn't adamant enough. I didn't have that confidence yet be like, no, this is what I want. I don't want another C-section. This is what I want. I would mention it to her that at almost every appointment. With the first initial appointment, I told her, "I do want to try for a VBAC." And she's like, "Well, yeah. We can talk about that in your next appointments." As I kept going back for my appointments, she was just kind of like, "It's just an in-and-out type of thing and transactional experiences trying to see if you're healthy and whatnot." I started noticing at around 20 weeks pregnant that my hands would feel pretty weird. They would feel kind of stiff and a little swollen. I started getting very, very swollen. I worked full-time. I'm a nail technician, and so I work at a spa full time, or I did at that time too. I thought, maybe it's just stress from work or normal pregnancy symptoms. But I started feeling very noticeably swollen. I would see a lot of flashes and little stars just floating and bad headaches. Toward the end of my pregnancy, I would start feeling indigestion depending on what I ate. I thought it just wasn't sitting right in my stomach, and sometimes I would end up vomiting. But at the time I just thought, oh, this is just normal pregnancy symptoms or whatever. But knowing what I know now, I'm like, no, that was definitely signs of preeclampsia. But the thing is at every doctor's appointment that I would go in for, my blood pressure was always normal. So it was pretty weird that I had that. I would tell my doctor, I'd be like, "Hey, girl." I'm pretty swollen, and I don't really feel like myself." Obviously you're not gonna feel like yourself with pregnancy, but I felt not what I felt with my first pregnancy. It didn't feel good at all. So she looks at me, and she goes, "Oh, no. I mean, you're swollen, but you're also very slim," because I am very skinny naturally. But she's like, "Maybe your family isn't used to seeing you pregnant, you know?" So I was like, "I don't think that's what it is, but okay." Again, me being not very adamant about sticking up for myself in a sense like, no, I don't think this is. So I just told her. I was like, "Okay, we'll keep seeing." I kept going for my appointments and at 38 weeks, I had one of my appointments, and then I was feeling super bad. That's when I was just like, "No, I really don't feel good. I'm very swollen." She told me during that appointment, "Yeah, I mean, you look a little more swollen than usual. I'll have you go across to the hospital to get some bloodwork done." So I was like, "Okay." So I went. I remember telling my grandma at the time, "She wants me to go do some blood work." She just gave me that looks like, "I don't know," like she knew something. I was blindsided too. So I was like, "Yeah, yeah, I'm just gonna go get this bloodwork done real quick." I took my son with me, and then she ended up having to come pick him up again because I had to be admitted. They wanted to monitor me. She came and picked up my son, and then I went and got the bloodwork done. They took a urine sample, and then a couple of hours later, they're like, "Oh, yeah, you have preeclampsia." I was like, "Oh, no." I kind of knew it was that because I did a little bit of research, but at the same time, I didn't want to self-diagnose myself either. I was like, I don't want to say this is what it is when it really isn't, but I did a little bit of research and every symptom was matching up to that. So when they told me that, I was like, hey, I knew it in a sense, but I didn't really advocate for myself. I was just like, no, maybe it's normal. They did find protein in the urine too. So with that, since she found out, she was like, "Oh, no, we have to do the C-section tonight. There's no way." It was around 4:00 or 5:00 when I went in, and then that around 11:00 or 12:00 at night. That's when they started the C-section. But I was like, "Oh my god." When they did the ultrasound, my baby's head was down, so I was like, "Oh, I wanted to go through with a vaginal," and I was already a centimeter dilated too. I should mention that. I did want to do a vaginal, but she just kept saying, "No, since you have preeclampsia, there's no way we can do a natural delivery. You can start having seizures and your body's already under stress. We just need to get your baby out now." So I was like, "Okay." I ended up having to do another repeat C-section, but I felt like she just put the blame on the preeclampsia for the C-section, and then she has the audacity to say, "Oh it's a good thing I caught this right away. It's a good thing I caught this," and I'm like, "Oh my gosh, yes."Julie: You were trying to tell her almost the whole pregnancy, "I don't feel good. This is not really normal." Ambrosia: And then right when I finally told her again, that's when she was like, "Oh, I'm so glad I caught this." I was like, "Girl, no. If I wouldn't have told you, who knows how the rest of the pregnancy would have gone?" But it was wild to me. That really struck me right there. So I was just like, if I ever got pregnant again, I would not go back to her. Thankfully, my son was good. He was born and healthy. He did have to do a little NICU stay for a while just because he was under stress. And once he was born, like they said, he was grunting a little and having trouble breathing. He did go into the NICU for a little bit, like four or five days. But that whole experience was hard. It was really hard to go through with the NICU stay having a C-section, and then walking back and forth to the NICU. It was also my first time breastfeeding because when I was 16, I didn't have any guidance really. My grandma never breastfed. My great-grandma had never breastfed. My mom didn't breastfeed. I was just new to the whole experience. I didn't have a lot of people to help me out with that. My mother-in-law did breastfeed. She tried to help me, but it was new for me, so I was like, I don't even know. I was still shy in a sense. I was like, oh, people seeing every aspect of me was just weird. But I ended up breastfeeding my second for up to three years. That was the one thing that I took from all of that. It was a super nice bonding experience. But at the time, learning how to do it under the stress from having the C-section and all of that was just so much, but I stuck through that. I was really proud of myself at that time because I had really no guidance or anything with my first. I mean, I did want to breastfeed, but I just didn't know. I thought they were born, and they already knew how to latch and all that.Julie: I know. Sometimes it's hard work, for sure.Ambrosia: Yeah. I didn't know it was a learning experience for the baby and mom to breastfeed and stuff. So that, I missed out with on my first and a lot of other things. So it was nice. But that's what happened with my second. From that point on, I was like, no. If I get pregnant again, I'm going to have a vaginal birth. There's no way that my pelvis is too small. I already knew in the back of my mind that all that was just noise to me. It wasn't anything. I already knew that VBACs were possible just because my mom ended up having a C-section with my brother, and then with me and my sister, she had us vaginally. So I knew it was possible and that people can do it, but it's just finding the right provider that actually wants to take that on and support you through every step of the way. It was another thing, especially from where I am from here in El Paso, because most of the hospitals, will push and push. So this time around, when I did get pregnant, I was like, okay. We're not doing that again. I'm not going back to her. I did all my research and even spoke to some of my clients because 2024 was a really weird year where it seemed like everyone was pregnant in a sense. I was like, oh my god. A lot of my friends were pregnant. My clients and celebrities that I would even see, I'm like, okay, yeah. Everyone is pregnant around here. I would even ask some of my clients who their doctor was and what they were doing in a sense as far as birth with a natural birth or a C-section.One of them just like, "Oh, I had all of my babies as C-sections, and that's what I'm gonna keep doing." I guess it was more convenient for her. So I was like, "Oh yeah, that's that's good for you, but that's not what I want." Another one was telling me that she also wanted a VBAC too because she had a C-section with her first, and then for her second, she was going to Texas Tech University. I guess it's a hospital where they also have the students there, too. Texas Tech. So she said she was going there and that they had OB/GYN and midwives there, too. She was like, "One of the midwives who I'm seeing is totally on board with me having a VBAC." And she was like, "You should go to her." I was like, "Okay," but I don't know what happened with the scheduling. I didn't get her midwife. I ended up getting scheduled with OB/GYN. When I went to that first appointment, she did an exam and everything, and she was like, "Oh, no. Your pelvis is too narrow." I was like, oh my god. I wasn't going to find anybody who was VBAC-supportive.Again, I felt a little bit more comfortable just with a female, so I was limiting my search in a sense. I was just looking for female doctors or midwives who would do VBAC. And then I searched around birth centers, but the idea of that did freak me out because I was looking at one of them. They don't necessarily let you get an epidural. It's totally natural. I was like, I don't know if I could do all that. It just kind of freaked me out. So I was like, I don't know if I can do that. What if I'm in so much pain? That was not an option for me at the time. I ended up just Googling "VBAC", and then a doctor in my area did pop up. When I clicked on the website, it was blasted all over his site, like, "VBAC. Vaginal birth after Cesarean is possible." It was just really positive.Yeah. He had a really good success rate of VBACs and even VBACs after two C-sections because after two C-sections, doctors are a little bit more timid, in a sense, if they want to take that on or not. So I found him, but I was also like, oh, but it's a guy. I don't know how this is going to work or anything.But me just being so adamant in wanting the vaginal birth, because I knew in my heart, I can do this. I'm not too narrow or small. I'm a petite woman, but I'm not tiny. I knew I could do it. I ended up just trying him out. I went to my first appointment with him, and then everything was pretty good. He wasn't invasive either. He just looked at me. He was like, "What are you wanting for this birth?" And I told him a VBAC. And he was like, "Okay. And you've had two previous C-sections?" I was like, "Yep, two C-sections." And then he was like, "And the reason for the C-sections?" I was like, "The first one, basically no reason at all. It was just because the doctor thought my pelvis is too narrow. He chuckled. He was like, "Oh, okay. And the second one?" I was like, "She blamed it on preeclampsia, in a sense," which I feel like she really did. But who knows? I mean, maybe. I know it has its risks and all that doing a vaginal with preeclampsia, but she just wasn't willing to take those in a sense. So I told him, and he was like, "Okay." And then he just was like, "Yeah." He measured my stomach and all that. He didn't do those the pap smears or anything. He wasn't invasive. He's like, "There's no need for me to check and see and all that." That's what the doctor over there at Texas Tech did. Right away, she stuck her fingers in me and she's like, "Oh, no. You're too narrow." I'm like, oh my god. He didn't do none of that. He just looked at me. He's like, "Yeah, you're good. I mean, you're not tiny. I think it's possible." He gave me a lot of reassurance in a sense. I just kept going back and back, and every visit was really fast and simple. He didn't really didn't say much. My pregnancy was pretty healthy. No preeclampsia this time which was really good because I was scared that would happen again and that would be another cause for concern and then end in a C-section or something. There were a couple of little scares. Once I saw my baby here, I was like, no, it was literally just a bunch of scares for no reason, but they have to monitor stuff. But one of them was with the ultrasound, they found an EIF in his heart. I didn't know what the heck that was, so that scared me. But his heartbeat was real strong, so they were like, No, that's nothing to be concerned about or anything. Once he's here the pediatricians will check him out and everything, but it's nothing to be concerned about." So that they found that. And then in another ultrasound, they were telling me that the lower extremities weren't matching up with the upper extremities. So that scared the poop out of me. I was like, oh my god. My baby has these two things. So I was real scared that he was going to have something wrong with him. He told me, and I would ask a lot of questions. I'd be like, "Whoa, what are these things that you found? And what could that mean?" He's like, "Honestly, it's really nothing to worry about. We're just going to keep monitoring you." He had sent me to a specialist, so I would go get my ultrasounds with them. And then also they were like, "You're really small. There's not a lot of room in there for him," because they were seeing that his foot was really squished. They were afraid that he was going to be born with a club foot or something. It was just a bunch of little scares where I was like, oh my god. This is crazy. They always reassured me, "Don't worry if anything comes out," not wrong, but if he does come out with that, it could be corrected and always reassuring me as well. So those were just the only little scares that we really had. But overall, my pregnancy was pretty healthy. No high blood pressure, nothing. None of that. And then when it came closer to my due date, which was September 28th, he was asking me again, "Okay, so you still want to go through with the VBAC?" I was like, "Of course I do."And then he's like, "Do you want to wait for your body to kind of go into labor on its own, or do you want me to induce you?" I just wanted to go through all that naturally and let my body do its thing because I know my body can do it. But my son was just comfortable in there, in a sense. I don't know. I know a lot of women go to labor a little bit early, around 38 weeks. So at 38 weeks, I was just like, okay, you can come out now. I was getting really uncomfortable. Everything was aching. So I was just like, I really don't want to be induced though, because I also knew from my research, because I did a lot of research. I listened to this podcast, too, so much. At the time, I felt like if I can go into labor naturally, I'll have better success with having my VBAC. I know I could do it. The induction part scared me because I was like, I don't want anything to counteract with each other, like the Pitocin and then the epidural and all that. I was being not negative in a sense, but weighing the risks out in my own head. I was kind of overthinking it, too, in a sense. But when that time came, he was like, "All right." Toward the end, he would do cervical exams to see if I was dilated or not. At 38 weeks, I was a centimeter dilated. I stayed like that until 39 weeks. I think maybe even at 37 weeks, I was already a centimeter. I was hoping I could dilate even more and by the time my due date comes, which was the 28th of September, maybe I'll be ready to go. But no, like I said, he was just really comfortable in there. So by the 27th, I was the 27th of September. I had my last doctor's appointment, and he was like, "All right, if you want me to induce you, I can induce you." But I forgot what he said. He was like, "If you want to wait for your body to go into labor naturally, I'm going to be out of town." I was so disappointed. Like, what do you mean you're going to be out of town? That type of thing. He was like, "If you do wait for your body to go into labor naturally, then there's a chance. You'll have the doctor here at one of the local hospitals. It's Del Sol. You'll have one of those doctors, but your chances of having a C-section, like go up higher because it's not me." He stated again, "I have a 95% rate of VBAC success." So I was thinking and thinking, but he told me, "Go ahead and think it over. Talk with your family about it and just let me know what you want to do. Give us a call, but I do want you to go and be monitored." He didn't really mention why for me to go to the hospital to be monitored. He wanted me to get a sonogram and then I forgot what else it was, but he wanted me to go into the hospital to get monitored. I was like, "Okay." I think it was for the next day. So I think it was actually the 26th that my appointment was. And then on the 27th, I had to go to the hospital to be monitored either way. They made it a point to me. They were like, "You need to go to the hospital for that sonogram or whatever." And I was like, okay. I thought it was kind of weird, but I was nervous, too. I was like, okay, whatever. I'm going to go. I end up going. I got myself admitted and everything. They hooked me up to the machines. They checked me with a cervical exam. I was still at a centimeter. The baby's heartbeat was doing good. They came in and did the ultrasound, and then they were like, "Oh, you're having contractions. You don't feel them?" I was like, "No, not really." I really didn't feel them because I guess I had been feeling them for weeks on end. My stomach would tighten. Again, I didn't know what they felt like really just because with my past, I had C-sections, so I was like, no, this is all new to me. I don't even know what contractions even feel like. I just thought the tightening of the stomach-- obviously I knew it was something, but I thought it was like, oh, those are Braxton Hicks contractions. They're fine. They're fine. I guess they were coming on pretty strong, but they were just like that for a long time. They didn't hurt or anything. My stomach was super tight. So, with every contraction, they'd be like, "Oh, you didn't feel that? You didn't feel that? Okay." Well, they ended up telling me, "We are going to keep you overnight just because you are contracting a lot. The doctor sent you in because he wanted us to check your amniotic fluid." He didn't have a lot of amniotic fluid in there, so that's why they wanted me to go in. I ended up staying the night. And then the next day, that's when they were like, "Okay, so do you want us to induce you?" Actually, I think it was on the 27th. I did go in because I ended up staying the night. And then the next day, that's when they were asking me. And I mean, I was just like, "Okay." I guess, honestly, a lot of factors played into that. My mom was coming in from out of town, from California over here, my mom and my sister, and I wanted them to be here. If I would have waited, my thing was if I wait to go into labor naturally and my mom and sister come down and nothing happens, they have to go back, and they would miss a whole birth and everything, and they wouldn't be able to see my son. So I was weighing out all the options, and I ended up agreeing to be induced. Around 11:00 on the 28th, that's when they started Pitocin. And then another thing that I thought was he didn't really mention this to me, or I probably should have asked, too, that when he was doing the induction, it's one of his policies that he has that he would prefer to just have the epidural put. Because I had it in my mind that I want to try it without the epidural, but I wanted it to be there too. Like, if I do end up giving in and being like, oh well, this is a little bit too much pain for my comfort, I have that option if I wanted to get it or not. But my doctor had mentioned before, "You can have the epidural put in, but none of the medicine." I was like, okay. So when the time came, they were like, "Oh well, we can't start the Pitocin without the epidural placed in first." I guess it was for that reason just because if anything were to go wrong or anything and I would need an emergency C-section, that was already placed so they wouldn't have to put me out completely, and I would miss the whole birth." So I was like, "Okay, all right, you guys can place it." Once they did, they're like, "No, we're going to have to run at least just a little bit of the epidural." And I was like, "What the heck? I thought no medicine had to go through or anything." And they're like, "Well yeah, we kind of do. Just because if we don't, there's a chance for it to be a clot, and then we would have to place it all over again." And they were like, "I don't necessarily think that's exactly what you want." I'm like, "Honestly, no, but okay." It was just a little shock to me. I was like, oh, okay. That's not what I wanted. I wanted to be able to get up and walk around to push through the labor in that sense and the contractions because I feel like they would have been more tolerable if I was able to move around. But once the Pitocin started kicking in and the contractions came on, at first they were okay. I was laughing with my mom and my sister because they did come in. They had just gotten there. We were just talking, and my husband was there too. We were all just laughing. It was a nice little beginning to the labor and filled with a lot of laughs. But once I wasn't able to laugh through nothing, I just wanted to focus and for everyone to not even talk. I was like, oh, this is intense. I would have preferred to be up and moving around and stuff, but that was not the case, which I kind of expected before I had went in. You can't really plan for things to go your way because there's always going to be something that ends up not going your way. So I was just going with the flow type of thing. Whatever happens, happens. It's for a reason. So the Pitocin was definitely kicking in, and I was contracting, and then I wasn't really dilating, fast. They didn't really want to do cervical checks a lot because of bacteria. My water wasn't broken yet, so I think I was at a 1 still. They checked and they were like, "Oh, you're at 2." And then., "Oh, you're at 2 still." The doctor ended up coming in himself, and then he ended up breaking my water. He didn't really necessarily, ask or anything. It was just the type of, "Okay, I'm gonna check you," and then, "Okay, we're gonna break the water." I was like, "Oh my god. What the heck do you mean? Like, break my water right here, right now?" It was kind of shocking, too, but I was just kind of like, okay, if this is what's needed to progress the labor, then I'll just go with it, in a sense. Nobody even asked me. That was rude and not really, but I was just like, that's so weird that he came in and just broke my water. And then after that, honestly, things started getting more intense. The contractions were very intense, and I wasn't able to get up or anything. I could feel them because I didn't want them to pump any more than three-- I don't know if it's milliliters or whatever of the epidural. I wasn't pressing that button or anything. I just wanted to do it without it as much as possible, but I could really feel everything. So once the water was broke, I was just like, okay, this is really it. There was a peanut ball there. So I was like, "Get the peanut ball. Let's try to put it in between my legs, and let's see if it does anything." We did that, and it really, really made things worse for me just because it was not comfortable at all. The pain was bad, but it ended up dilating me more and pretty fast too. But it was very, very uncomfortable. I would have to switch positions and just kind of lay on one side and then lay on my other side. I felt all the contraction pain just in my back towards my butt, in a sense. It just felt intense. I'm just grateful I was even able to experience that just because I didn't feel anything with my other ones. You feel just cold in comparison to the C-section and tugging and pulling. It was a weird experience with them. They weren't really traumatic or anything for me, thank God, but it just wasn't what I wanted. So to even be feeling all of the labor pains and all that, I was just grateful to even be there and experiencing that as a woman. It was pretty exciting for me. But like I said, things didn't really necessarily play out the way I was envisioning or how I wanted it to a T, but I was able to experience all of the other things. And then they would do cervical exams. Once I was at an 8 or whatever, that's when I was like, okay, I'm getting closer because I was afraid that I wasn't even going to dilate and I would just have to end up getting a C-section. But I was dilating. And then once he came in, because I guess the nurses were like, "No, yeah, baby's talking to me. He's letting us know that he's moving down and he's gonna come out." One of the nurses was like, "He's going be out by the end of my shift. Watch, guys." We were just looking at her like, "Okay, if you say that, let's see." Eventually, I want to say it was around 5:00 or 5:30, that's when I finally reached 10 centimeters. That's when the doctors came in. They started getting everything ready. And then I was like, oh, my god, I think it's time to push. My body felt like I needed to go to the restroom and I needed to poop. So I was like, oh, my god. I feel like that. They told me before, "If you feel like you need to poop, then you need to push. Let us know." And then I was like, "Yeah, I do." My husband calls them and he's like, "Yeah, she said she feels like she needs to poop". And then they're like, "Okay, yeah." That's when he came in and all the nurses too. They started getting everything ready. I want to say I started pushing and he told me he's like, "It's literally going to feel like you have to use the restroom, so don't hold back or anything. Just push." So I was like, okay. I think after four or five times of pushing my son, I could feel him come out. The head first came out and then finally, the rest of the body. I had that huge relief of like, oh my god. I cannot even believe that I just did that. I did it. Even though all these doctors would tell me like, "No, you're too small. There's no way," I actually did it. I didn't even have any lacerations, no nothing. I didn't tear or anything. It was just unbelievable because I had the biggest fear too, that I was going to tear into two holes. There was no way I was going to not tear at all. But I didn't end up tearing or anything which was good because I know that's an additional recovery in a sense. But after a couple of pushes, he was out. I was just so happy. I was crying. My mom was crying because she was in the room with me, and my sister was in the room with me holding one leg. My husband was holding the other one, and there was just tears. Tears everywhere. It was really, really nice to actually experience that for this birth. I feel like a lot of women, too, can relate. Once you finally do that after people saying, "No, you can't," or not even giving you a chance to try, it was very, very rewarding and a completely different experience to a C-section. I'm just very grateful that I found this doctor and that he actually took me on and was like, "Oh yeah, you'll be fine. We'll do this. You can do this." It was really nice. So my son was born. He was only 6 pounds, 8 ounces. And so he wasn't a really big baby either. But still, I was a petite woman myself, so I thought it was gonna be challenging, but it was good. I didn't have any problems. No, nothing. He was born very, very healthy. Even all the nurses, too were really excited. They're like, "Oh my god, she's a VBAC. She actually did it." I kept hearing that over the course of my stay. They were just like, "You did a VBAC. That's so amazing. Congratulations." It was just so nice to hear. And the recovery, oh my god, was so much better than a C-section, just 100 times better because I was able to get up after the epidural had worn off. I was able to get up because after those contractions started getting really intense, I was pressing that button. I was like, you know what? I need more of the epidural. There's no way. Those Pitocin contractions were just more intense than natural contractions and they really were. So I did only bump up myself from three milliliters to six, I think. I didn't really feel so much pain, but I could still feel things. After the epidural wore off, I was able to get up and walk, and it was nice. It was really nice to get up and do things and not have to have that pain of a C-section and leave the hospital after just a day, the very next day. We were able to leave by like 5-6:00. I was able to go home and was just enjoying my baby. That was pretty much it. But I was very grateful for the experience.Julie: I love that story. That's such an incredible and inspiring story. There are so many things that I could talk about, but we're running a little short on time, so I want to talk about two things. The myth of the small pelvis and preeclampsia. First, I know that preeclampsia is really tricky because the induction is necessary. Preeclampsia is one of the things where you need to get the baby out sooner rather than later. It's a medically indicated thing. If you have a doctor telling you that, you don't have to question it or worry about it because it's really important to get that baby here quickly. However, there are instances where an induction may be appropriate compared to just going straight to a C-section. And again, provider preference is going to play a huge deal into that. But also, as long as your blood pressure is holding steady through an induction and you're progressing well and mom and baby are doing fine, then an induction can be a safe option as well for preeclampsia. So the biggest thing they're just going to make sure is the stress of the induction is not too much on your body because sometimes your blood pressure will go up just naturally with labor because it's a lot of work. But as long as you keep an eye on that, I know that it's a reasonable option at times. So don't think that having preeclampsia just means you automatically have to go to a C-section. But again, talk about your options with your provider. If your provider is not telling you something that you feel comfortable with, question it. Seek out another opinion. But definitely trust your intuition and lean into that. I think that if you've been around with us for long enough, you will know how we feel about the idea of somebody's pelvis being too small. Now, I think it's really sad. I think maybe sad's not the right word, but I feel like with teenage pregnancies, these teenagers who arguably need more help than most because teenage pregnancies are oftentimes unplanned and unexpected. They are in a very vulnerable situation. They need more help and more guidance. But I feel like oftentimes a system will take advantage of that vulnerability, maybe probably even unknowingly. But I feel like it's very easy for teenagers in a hospital system to get railroaded more because they haven't gone through a lot of the experiences that we do later on in life and learn how to navigate through trickier situations and stand up for ourselves and advocate. It's harder and more challenging. And so I'm really sorry that happened to and your provider used her vaginal exam to determine your pelvis is too small. Now let me tell you, there's only one way to determine an actual pelvis size and that's with a pelvic telemetry scan. It's kind of like an X-ray. Vaginal exams are not evidence based. And not only that, we know there's so much more that goes into a pelvis being too small because pelvises move and flex as the baby's being born. Our baby's head squeezes and molds in order to fit through the pelvis, so even a pelvis that might be "too small" before pregnancy can change and shift and expand and grow through the pregnancy, but especially as labor happens. So it's very, very rare for a pelvis to be actually too small or deformed, and usually that happens when mother grows up either incredibly malnourished and their bones are not able to grow properly or through a traumatic injury to the pelvic area. Those are usually the biggest or the most likely times where you'll see a pelvis that is truly too small. A lot of times, it's failure to wait. Maybe the body is just not ready for maybe a too-early induction and things like that. So I would encourage you to ask questions, ask questions, and trust your intuition. We do have a blog al' about CPD which is cephalopelvic disproportion that we're going to link into the show notes. And that just basically means it's fancy words saying your pelvis is too small or maybe your baby's too big to fit through the size of your pelvis as it is. But I'm so glad that Ambrosia was able to stand up for herself and find a provider who would support her in getting a VBAC after two C-sections. So I'm very proud of you and thank you so much for joining me on the podcast today.Ambrosia: Thank you so much. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Maybe you or someone you love has struggled with addiction, self-doubt, or the weight of past wounds.   If so, you are not alone—and there is a path to healing.   In this week's You-est You Podcast, I had a deeply moving conversation about addiction, trauma, and self-compassion. My guest Arlina Allen, host of the One Day at a Time Recovery  podcast and author of The 12-Step Guide For Skeptics, shares her raw and real journey from struggling with alcohol and self-worth to finding freedom, healing, and a life filled with purpose.     We dive into: ✨ How childhood experiences shape our beliefs and behaviors ✨ The power of compassion in breaking free from addiction ✨ Why redefining spirituality can be key to healing ✨ The misunderstood truth about the 12-step journey ✨ How to reclaim your power and create a life you truly love     Takeaways Many people struggle with addiction and need support. Childhood experiences significantly shape our adult lives. Seeking approval from parents can lead to unhealthy behaviors. Trauma can manifest in various ways, including addiction. Creating a life you love is essential for recovery. The 12-step program can be beneficial for some individuals. It's important to approach recovery with an open mind. Sharing personal stories can help others relate and heal. Compassion for oneself and others is crucial in the recovery process. Support systems play a vital role in overcoming addiction. Self-esteem issues often stem from early life experiences. Alcohol provided a temporary escape from guilt and shame. Binge drinking led to alter egos and chaotic behavior. Hitting rock bottom prompted a reevaluation of drinking habits. The 12-step program is often misunderstood due to individual experiences. People's experiences in meetings can differ significantly from the program itself. Redefining concepts like God can make recovery more accessible. Powerlessness refers specifically to alcohol, not life in general. A recovery mindset encourages leaning into discomfort for growth. Anger can signal deeper issues that need addressing. Get specific about the cause of resentment. Every relationship has a 50/50 shared responsibility. People are mirrors reflecting our own traits. Self-loathing often stems from fear and survival skills. Compassion for oneself is crucial in recovery. The 12-step process can benefit everyone, not just those with addiction. Emotional management is essential for personal growth. Synchronicities can serve as signs from a higher power. We can influence others positively through self-care. Recovery is about shedding the armor to reveal the true self.   About Your Host, Julie Reisler Join Julie Reisler weekly, podcast host, intuitive coach, author, and multi-time TEDx speaker, each week to learn how to access your spiritual gifts and inner guidance to be your You-est You® and achieve greater inner peace, spiritual connection, happiness, and abundance. Tune in to hear powerful, inspirational stories and wisdom from spiritual luminaries, experts, conscious leaders, psychic mediums, and extraordinary human beings that will help to transform your life.    Be sure to subscribe to Julie's YouTube channel https://www.youtube.com/juliereisler and ring the notification bell so that you never miss a powerful episode!   Here's to your truest, You-est You!   Love, Julie     You-est You® Resources for YOU! See below for free tools, resources, programs, and goodies to help you become your YOU-EST YOU!   FREE Manifest Your Goals & Dreams 7-Day Toolset This stunning free toolset is a 7-day workbook (25 pages full) of powerful mindset practices, grounding meditations (and audio), a new beautiful time management system and template to set your personalized schedule for your best productivity, a personalized energy assessment, and so much more. It was designed to specifically help you uplevel your routine and self-care habits for success so you can radiate and become your ‘You-est You'. These tools are some of Julie's best practices used with hundreds of her clients to help you feel more confident, clear, and connected to your best self so that you feel inspired to take on the world. Get it at: juliereisler.com/toolset   FREE Intuition Assessment  Unlock your unique intuitive super-powers and discover your dominant intuition and language with the unseen. Take the assessment at juliereisler.com/intuitionassessment   Intuition Activation Mini-Course - 90% OFF! For a limited time only, get access to Julie's powerful transformative Intuition Activation mini-course for 90% off! You'll have lifetime access to this course that is full of video modules, worksheets, meditations, tools and practices to unlock your intuition and activate your inner guidance! Sign up now at https://juliereisler.com/activation    Join The Sanctuary Membership - Now Open! Join Julie's high vibrational sacred membership, an inner circle for conscious coaches, Lightworkers, and spiritual seekers, a spiritual oasis for change-makers wanting to make a bigger impact in the world. Julie will be leading bi-monthly live calls, including monthly psychic intuitive guided messages, and workshops teaching spiritual tools (like learning how to use a pendulum, muscle test, assess your chakras, open up your psychic abilities) to help you manifest what your heart most desires, manage your energy, develop your intuitive gifts, and connect more deeply with your higher self and spirit guides. Learn more and join now at https://juliereisler.com/sanctuary    You-est You Intention Cards Want your own powerful deck of 33 You-est You Intention Cards? These cards were channeled by Julie. Each card has an empowering intention and deeper questions to ask your ‘You-est You' for greater self-awareness, higher consciousness, and spiritual growth. You can get them now at https://amzn.to/45q14DJ.     Change Your Life Through Gratitude If you are looking for a powerful way to increase your gratitude quotient, prosperity mindset, and quality of life, check out my 15 Days of Gratitude To Change Your Life course. This course is only $47 and will change the way you view, everything! Enroll here: https://juliereisler.com/gratitude   Sacred Connection This community is a sacred, safe place built on love and acceptance. It was created to help you evolve and expand into your highest self. Please share your wisdom, comments, and thoughts. I love hearing from you and learning how you are being your truest, you-est you. Please join us in our FREE Facebook group: The You-est You® Podcast Community.   The Intuitive Life Designer® Master Life Coach Certification Program Are you eager to release self-doubt (for good) and have an intuition upgrade? Do you want to put your head on the pillow at night feeling calm and joyful that you are doing something really meaningful? Check out Julie's Life Designer Coach training. This world-class four-month virtual live coach certification program will give you proven tools, transferable skills, powerful techniques, practices, and the best methodology to be a powerful coach. This transformational coaching program is for aspiring and current coaches looking to fill in the missing pieces and gain real confidence and mastery in coaching. This program infuses integrative health modalities from a mind-body science, positive psychology, and healing arts perspective. To get on the waitlist and learn more, go to lifedesignercoachacademy.com.   You-est You Resources & Links:

If you've ever felt stuck in old patterns, triggered by past wounds, or struggled to re-regulate your nervous system, this episode is for you.

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

Have you ever wondered if the universe is speaking to you—through sound, energy, and vibration? What if the key to unlocking higher consciousness is simply tuning in?

I'm so excited to share this transformative conversation on how to create everyday miracles in your life now!   I had the privilege of sitting down with Hakim Hamza, bestselling author of The Eternal Within, for a deep dive into practical techniques, mindset shifts, and daily practices inspired by A Course in Miracles.    Whether you're new to the Course or a seasoned student, this conversation will give you powerful tools to elevate your everyday experience and transform your reality.   And help you experience more miracles! ⚡️   About Hakim Hamza: Hakim was born in 1987 to a Swedish mother and an Egyptian father, and  grew up in Sweden. Growing up multiculturally fostered a deep awareness of the vastness of human experience. Hakim holds a bachelor's degree in social psychology.   Driven by a profound yearning for something eternal that transcends limitations, I immersed myself in diverse Eastern philosophies. I have explored the teachings of Osho (Rajneesh), Papaji, Ramana Maharshi, Jiddu Krishnamurti, Acharya Prashant, and Adyashanti, among others. ​ Through this journey, he understood how spiritual truths can be applied to everyday life. Even though not Eastern, he finally found "A Course in Miracles" (ACIM) and the work of Dr. Kenneth Wapnick, who taught it. The Course has resonated with him more than any other teaching; hence, it has become his primary spiritual practice.  

I'm so excited to share one of my mentors with you!   Rev. Jayne Feldman has been communicating with and connecting to the angels since she was a little girl, and shares in this episode so much powerful information about how you can also connect with the angels!   We talked about the 12 Archangels in great detail as well as how to commune with your Guardian Angel and the beautiful angelic realm who are ALWAYS here for you.   If you'd like to learn more with Rev. Jayne or book your own Angelic Mentoring session, you can email her at earthangel4peace@aol.com. Rev. Jayne is an absolute gem who can share the angel's messages specifically for you.

Are we truly the last generation of humanity as we know it? In this eye-opening conversation with Gregg Braden, we dive into the groundbreaking ideas from his new book, Pure Humans. Prepare to uncover hidden truths that could change everything you thought you knew about our future.   ✨

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

This week's interview with Lynne Twist, philanthropist and bestselling author of The Soul of Money, is a must-listen!   We dive into how money can be sacred, how to break free from the toxic myth of scarcity, and why abundance & sufficiency is a state of being—not an amount.   Speaking of the soul of money and earning money with integrity, intuition, and following your soul's purpose, I have a FREE live workshop on this topic.  Register at juliereisler.com/workshops.   Takeaways Lynne Twist emphasizes the importance of understanding our relationship with money. The journey to writing 'The Soul of Money' was collaborative and rooted in activism. Scarcity is a toxic myth that leads to unhealthy behaviors around money. The original purpose of money was to ensure everyone is taken care of. We can reclaim our relationship with money by focusing on sufficiency rather than accumulation. Generosity and gratitude are key to happiness and fulfillment. Inner riches are more valuable than outer riches. The culture promotes consumerism, which diminishes our sense of community. We can shift our mindset from consumer to citizen to foster responsibility. There is enough for everyone, but not for greed. We often feel we need more to be okay. Sufficiency is a state of being, not an amount. Practicing gratitude can transform our experiences. We live in the conversations we have about our lives. Giving and receiving are expressions of equanimity. Shopping in your house can lead to meaningful gifts. Children value time with their parents over material gifts. Follow your heart and serve the world authentically. Life itself is a gift that should be cherished. Express gratitude for the Earth and its blessings.   ✨

Sheryl's first baby was five days late. Her second baby was five days early. From the first contraction to a surprise car birth, Sheryl's third baby was under an hour! Not only were the methods of delivery very different with each baby, but Sheryl's life circumstances were too.Julie and Sheryl chat about preparing yourself not only for the long, marathon labors, but also for the possibility of the fast and furious ones! How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: All right. Good morning, Women of Strength. This is Julie Francom, and I am so excited to be here with you today to share with you a very exciting story. One of my favorite types of birth stories, people might think I'm crazy, but– oh, do you know what? I'm not going to tell you what the story is, but if you have been listening for a minute, you might know when I say what my favorite type of story is, but I'm going to leave it to be a surprise. We are going to go ahead and read a Review of the Week really quickly, then I'll introduce my guest of the day. Okay, let's see. This review is from Apple Podcasts. It's from ccm57, and she says, “I am so thankful I came across this podcast and know it was an invaluable tool when educating myself regarding VBACs and the birthing process in general. My first son was born via Cesarean due to his stubbornness and refusing to turn from his breech presentation. Leading up to his C-section, I was devastated that I wouldn't be able to experience the natural birthing process I had always wanted. “I am in the medical world. I knew about VBACs, and it was never even a thought I wouldn't try for one in my next pregnancy. I found The VBAC Link halfway through my second pregnancy, and it was so addicting. I listened to every episode, sometimes multiple times a day, until my delivery. Every woman's story was amazing and truly helpful to me personally. “Thank you, Meagan, for being as passionate about VBACs and educating women all over the world. I can excitedly say that God was so gracious, and I had my beautiful VBAC this past August. Thank you to every woman who have shared your story on the podcast and for all of the women who are listening and expecting a sweet baby, I am cheering you on.” I am so excited to hear stories and reviews like that. It's really incredible what can happen when you get a group of women together to share stories and to help uplift and inspire each other. I'm grateful to this reviewer today and to all of you listening, to everyone who has shared their story on the podcast, and to everybody who helps spread the word about VBAC and helps increase access to people all over the world, really. All right. Well, guess what? It is very cold today. It's been a very nice 70s and 80 degrees here in Utah for the last little while, but it is now mid-October at the time that we are recording this, and it is raining and freezing. There is supposed to be snow dumping up in the mountains today, and I am just wrapped up tight in my big, poofy blanket and very, very excited to talk to our guest today. Her name is Sheryl, and she is going to share her Cesarean and VBAC stories with us. I am really excited. I am really excited for this story, you guys. I'm not going to tell you what we are going to talk about at the end because I don't want to ruin the surprise. It's going to be a great episode, and I am just going to go ahead and give it over to Sheryl and let her pick it up. Oh, first, hold on. Let me read her bio. I am still getting into the swing of things. Sheryl: Sure. Julie: I need to remember that. Let's see.Oh, yes. Sheryl is a mom of three. She has been married for 10 years to her husband. They live in Sugar Creek, Ohio. I love the Midwest except in the winter. It's getting ready to be not so fun out there. It's beautiful in the spring and summertime. Anyway, okay. She recently returned from living in the Dominican Republic for the last two and a half years which is really cool. I feel like everybody needs to have an experience living abroad. Sheryl: For sure. Julie: You just learn so much when you are in a foreign country experiencing different things. I feel like it's very valuable. Anyway, that was a little bit of a tangent. But now, for real, we are going to give it over to Sheryl. Go ahead, Sheryl. Sheryl: Okay, well thanks so much for having me on. This is super fun.Julie: Of course. Sheryl: Yeah, I'm not sure where you want me to start, but I have had two VBACs and very different experiences with both. My first was a C-section. I'll start with his story a little bit. He's 6-years-old, so six years ago, I knew I wanted to have a natural birth. I took a natural childbirth class. I felt like I had prepared, but I don't think I had mentally prepared for birth very well. I think if I could do it again, I would definitely have hired a doula just to help with the mental aspect. I was five days late. I told my husband, “I'm not going to work tomorrow.” It was Sunday night. I was like, “There is no way I'm going to work tomorrow. I will go into labor tonight because I can't go to work tomorrow pregnant.” He was like, “Okay.” We went on a truck drive on a bumpy road. We played mini-golf. We were like, “Okay.” We started watching a movie. I was like, “I think I'm cramping a little bit. Okay, this is great.” We finally went to bed, and yep. Sure enough, a few hours later, I woke up with contractions, and I was so excited. I was very taken back by how painful they were. Now, looking back, it was like, okay. Those contractions weren't even that bad. It was going to get so much worse. I was progressing great. I think I went to the hospital when they were 3.5-4 minutes apart. I think I got there. I think I was dilated to a 4 or 5, so they were like, “Yeah, you're progressing really well. This is great.” I figured it was 7:00 in the morning. We would have a baby by noon. At 11:00, I said that I wanted to get in the birth tub or just labor, but I wanted to get out to have the baby. I was in the tub. Now, looking back, I think I was in transition. I ended up vomiting a little bit and just being so nauseous and in so much pain. The water did help, then they came and checked me and were like, “You are an 8.” They were like, “You should get out if you don't want to have your baby in the water.” I was so excited. They came and got things ready, then I really got fearful at that point. I was just very scared about what was going to happen and all of the things. They came and checked me, and they were like, “Oh, no. You're not dilated that much. You're maybe a 7.” I just tried to keep laboring on. We ended up doing some different pain management. I was just not progressing anymore. At this point, I think it was 14-15 hours, so I was just exhausted. I was very thankful. One of the midwives at the practice that I was at was off that day. She had actually been on vacation. They let her know, “Hey, just so you know, Sheryl is at the hospital. She is having a really hard time. We can't figure out why she's not progressing further.” She was like, “I'm going in.” She came in. She was so kind, and she worked for hours trying different positions and everything possible. Finally, she was like, “Okay.” I think it was 8:00 at night. She said, “You are exhausted. Let's do an epidural,” which I didn't want because I was like, “I don't want needles. I hate needles.” I got an epidural. I got a little bit of a nap. It worked for about an hour, then it stopped working. The pain came back, but then obviously, there's nothing you can do except lay there. I was at a 9, and it wouldn't go any further. She kept trying different things even with the epidural. Finally, she was like, “Okay, he's actually gone back up. He was down, and now he's back up.” She said she was going to go talk to the doctor and see what he thinks we should do. They came back. It was 10:30 at night. They were like, “I think it's time for a C-section. We don't know why he's going back up, but typically, it's a sign that things are not going well, so we're going to do a C-section.” At that point, you're just so tired that you're like, “Okay, yeah. Whatever we have to do to get him out.” They ended up doing a C-section. I was so tired that I was falling asleep while they were doing the spinal tap. I was just exhausted. The C-section went very well. My postpartum was hard. I think just as a first-time mom with a C-section and all of those, and then feeling like a failure. That was a really challenging time, but right away, the doctor told me that they were one in the area that was known for VBACs. They had successful VBACs. He told me and my husband right away, “You will be able to have a VBAC. There is no doubt in my mind that you will be able to have a VBAC for your next.” Julie: Oh, I love that. I love that they said that to you right from the get-go.Sheryl: Yeah. It was so great, so it was like, “Okay. We know that the next one will be a VBAC.” We actually had a miscarriage between baby number one and baby number two. That was really challenging. It was a surprise. At that point, we had committed to move to Haiti. We weren't planning on getting pregnant, but we got pregnant, then 10 weeks later, we miscarried. Julie: Wow. Sheryl: It was definitely a difficult time, and it was the year 2020. I don't think I need to say anymore than that. It was February 2020 when I miscarried. Julie: Oh, Sheryl. COVID ruined everything. It really did. Sheryl: It was definitely a challenging year. We were ready to go on a mission. That got delayed until we ended up moving to Haiti in March 2021. We were there for almost 6 months, and then their president was assassinated, so the country became really turmoiled and it was becoming unsafe for Americans to be living there. Our mission board thought it would be best to pull us home. At that time, we had planned, okay. We moved in March. If we start trying for baby number two in June, we would have been in Haiti for a year. We'll start trying. We had kind of started trying, then we got pulled out in July, so it was like, man. Do we keep trying? Do we not? We were like, like, “You know what? We'll keep trying. We'll see what happens.” Yep, sure enough, in August, we got pregnant again with our second baby, our little girl named Felicity. Right away, I had that confidence that, “Okay. I'm going to have a VBAC.” I did a really good job, I felt, of preparing mentally. I read so many books, so many podcasts. I decided right away, “Okay. I'm going to have a doula.” I was just really prepared. But during this time, we were planning on going back to Haiti. It's so many details, but long story short, we weren't able to go back to Haiti because it ended up getting worse, not better. So our mission board was like, “Hey, let's find someplace else for you to serve in the meantime before you have your baby back in Ohio.” We connected with a mission in the Dominican Republic and ended up going to the DR. That was a great experience, but also, I waited to come back from the DR until I was 35 weeks pregnant. It was crazy to be in another country and know that you're going back. I definitely did not want to have a baby in the Dominican Republic. If listeners are familiar with the DR, they have the highest C-section rate. I looked at the number really quick. I was actually surprised it wasn't higher, but 58% of births are C-sections. Almost all of their natural births, they do episiotomies. That's just what they do.Julie: What?Sheryl: Yeah, it's nuts. So it's like, there's no way I'm going to have a baby in the Dominican Republic. Thank the Lord, I didn't have a baby int he Dominican Republic. I was very ready to do this. I had affirmations. I had prayers written out. I hired a doula and all of the things. I spent a lot of things praying for very specific things asking the Lord, “Okay, I don't want to go late. I don't want to have a long labor, and I want this certain midwife.” Her name was Leanne. I wanted her to deliver me. She's delivered two of my sisters' children, so she was a family friend. She's known us for 20 years. Those were my prayers that I kept praying. I asked family and friends to pray.I went in at 39 weeks. She was like, “Hey, you're dilated to a 3. You're 50% effaced. Do you want to do a membrane sweep?” I was like, “Yes, let's do it.” We did that. I went home. I felt fine. We did some food prep. I finally got my husband to pack his hospital bag that next day, then I guess I went to the doctor when I was 39 weeks and 1 day, but the next day, my husband was supposed to be working 2 hours from where we lived. He was like, “Should I go?” I was like, “Well, I think so. I don't think I'll feel anything tonight. Let's plan on going. I'll wake up when you wake up and make sure I'm not having any contractions.” He woke up at 5:00. I was like, “Yeah, I'll get up.” I went to the bathroom. “No, I'm fine. No contractions. Go on to work. You'll be just fine.” 6:30 rolls around. Whoa, that's a contraction. “Okay, I'm going to go back to sleep.” At 7:30, a contraction woke me up, and my little boy at the time would have been 3, almost 4. He woke up ready to have breakfst, and I was like, “Oh, that's a contraction.” I tracked my husband, and he wasn't even to the job site yet. I'm like, “Oh no.” Julie: Oh my gosh. Sheryl: Oh no. I made breakfast. I got in the shower. I was like, “Surely, they'll slow down.” At this point, they were 4-5 minutes apart. I was like, “They aren't slowing down. Okay.” My sister texted me. She was like, “Hey, how are you feeling this morning?” I was like, “I think I'm going into labor.” She FaceTimed me. I'm braiding my hair and trying to get ready. She's watching me, and she was like, “Have you let Javen know yet?” I was like, “No. I was trying to let him get some work done.” She was like, “Sheryl, are you timing them?” I was like, “Yeah.” She was like, “That's every 3.5-4 minutes apart. You should probably call him.” I was like, “Okay, yeah, you're right.” I called him, and he immediately knew. He was like, “Ah, she's in labor.” He hopped in the work truck and headed toward me, but there was no way that I could sit here and wait. We had three people lined up to take Riley for us. Unfortunately, those two people both did not pick up their phones, and one was sick. I called number three, and she was like, “Hey, I will come and get you and take you to the midwife office.” They were going to check me there before I went to the hospital just to make sure I was progressing. She had three kids in the car. She added one more of mine in. It was an interesting 30-minute drive trying to labor while there were kids in the car and a lot happening. I got to my midwife practice, and she was like, “Okay, yep. You're dilated to a 5. You need to get to the hospital.”Thankfully, my husband met us there. We headed to the hospital. We got to the hospital. I was a 6. My doula got there at 12:00, and things were just progressing really nicely. At 1:00, I think it was 1:00, my doula was like, “Hey, why don't you go to the bathroom to see if you need to pee or anything?” I did, an at that moment, my water broke. They checked me. They were like, “You're a 9. You're almost there. Two more contractions. Okay, you're ready to push.” So I pushed for an hour, and she was born at 2:15. It was really an amazing birth. It was everything I had prayed for. It was less than 12 hours which I had specifically prayed, “Please, Lord, no more than 12 hours.” It was told, “Oh, you'll probably push for 2 hours,” and I pushed for an hour. It just felt like God was very faithful, and He answered my prayers. The one thing I didn't pray about, and this time I did, was for no tearing. I did tear pretty bad, so that made postpartum pretty rough. After Felicity, we returned to the Dominican Republic and were there for 2.5 years. We'll fast forward to last year, and were like, “Okay, maybe it's time for us to head back to Ohio.” We really loved it in the DR. We had a great community and great friendships. The ministry we were serving with was wonderful, but we felt like, “Okay, this is what we are supposed to do.”We came home for Christmas. We hadn't been home for over a year, so it was really exciting to come back to Ohio and see family. While we were here, I just was like, “Man, I'm one day late,” and I'm never one day late. I had said, “Okay, I'd better get that taste just in case.” I took it, and sure enough, we are expecting another baby. It was very surprising, but also, it was just like, “Okay, we were planning on coming home, so now we are definitely coming home.” We moved back to Ohio in June, and we were due the end of August, August 27th. I think I should have mentioned that with Felicity, our second baby, I was 5 days early. I was 5 days late with the first one, and 5 days early with the second. I think just with this pregnancy, it was so different because we were just in a different phase of life. I didn't prepare as well. I felt like in the last few weeks, I was scrambling mentally. I was feeling anxious and not prepared. I actually listened to The VBAC Link one day. I was really struggling. I was like, “I need to hear some positive stories.”I was driving to the airport to do an airport run, so I just kept listening to episodes, and it was like, “Okay. Other people have done this. I can do this to,” so that was super helpful. I would say that overall, the practice was really great. It was one midwife and one OB/GYN, but I did not love this time around. They were not as supportive as I felt. They were like, “Hey, we are not going to let you go past 40 weeks no matter what. That's our policy. You can't go past 40 weeks.” I was just like, “Aw, well, I don't want to be induced. I don't want Pitocin. I don't want to be induced.” They just kept pressing that, especially the doctor. I just didn't feel super supported. We decided not to do a doula this time. The last few weeks were kind of rough. I didn't feel great. It was the summer. We transitioned. We had two kids. Our second one, Felicity, is two, so it's a lot different being pregnant with a 2-year-old and an almost 4-year-old. Yeah. I kept going to the doctor. At 38 weeks, they checked me. They were like, “Yeah, you're not dilated at all.” At 39 weeks, they checked me, and they were like, “Yeah, there's no way we could do a membrane sweep. You're not dilated at all.” So at my 39-week appointment, they were like, “Yeah, we think it's time to schedule that induction.” They did an ultrasound at 38 weeks, and they were like, “Yeah, you look perfect. Baby is healthy. Not too big.” All of those things. It was frustrating to me because I was like, “If everything is fine, why do I need to be induced?” We were contemplating fighting it, but then me and my husband were like, “Hey, is the stress of fighting the practice worth over going into an induction with a positive attitude?” We decided, “Hey, we're going to schedule the induction. We're going to do our best to do everything we can in the next week to make it happen on our own.” Lots of walking. We tried everything. My induction was scheduled for Thursday, the 30th, I believe, or the 29th. The 29th. I went in on Monday and had an appointment. I was like, “Hey, I just want to get checked one more time. Can I do a membrane sweep? That worked well last time.” I think my appointment was at 2:30 in the afternoon on Monday. They tried, and she was like, “Nope. You're not even dilated more than a 2, and he's way far up. Yeah. You're just going to have to be induced on Thursday.” I was just so devastated. I left so sad, and I was just like, “Okay. We're going to do this. I need to just be positive.” But then that night after we had the kids in bed, I had a little bit of a breakdown. I told my husband, “I'm just so sad. I really thought I could do this. My body is failing me.” You know, all of those things. He was like, “Hey, let's just pray about it.” That night, we specifically prayed that I wouldn't tear, Leanna would get to deliver, and that it would go really quickly. That was at 10:30 at night. We quickly did a lap around outside, just trying to calm me dow and then hopefully a walk would start something. Finally, we went to bed at 11:30. As I was climbing into bed, I felt a contraction. I was like, “Oh wow. That's been the most painful one I've ever had. Okay, I'm going to go to bed.” I had another one about 8 minutes later, but didn't think anything of it. I finally fell asleep, and I kept feeling them, but I was still sleeping. I didn't really worry about it. Again, in my mind, I have to be induced on Thursday. There's no way I'm going into labor. I woke up at 1:30 to an extremely painful contraction. All of a sudden, I felt a pop. I feel like I heard it too, but I felt a pop, and I was like, “That's my water.” I woke Javen up. I'm like, “Javen, my water just broke, and the contractions are very painful.” He quickly called his mom to come over and watch the kids. He called the doctor's office to let them know. I was yelling, “Hey, tell them that Leanne's supposed to deliver.” I got in the shower. I tried to start getting cleaned up, and I'm realizing that the contractions are every 3-3.5 minutes. But in my mind, my water just broke. I'm sure I had plenty of time. I was only dilated to a 2 yesterday. My mother-in-law got there. I got out of the shower and got dressed. Neither me or my husband were in a hurry, but I walked from the bathroom to the kitchen table. Contraction to the kitchen. I couldn't walk more than a few steps without having a contraction. I looked at my mother-in-law and I was like, “Man, I've never had my water break this early. These contractions hurt really badly.” She shook her head and was like, “Uh-huh. Yeah.” She looks at Javen, and she was like, “You need to get her to the hospital.” She's trying to get us to the car. I'm in so much pain. She was like, “You've got to get to the hospital.” The hospital is a 40-minute drive. We left for the hospital at 2:00. I actually rode on a birthing ball in the back of the car which now, I'm like, “Yeah, that probably didn't help slow the progress down,” but that was the only thing that was comfortable. I had my worship playlist going. I was in a lot of pain. I had a few friends who I had told, “Hey, I'm going to text you when I go into labor so you can be praying.” I texted a couple friends. I texted a sibling, “Just so you know, I'm going to the hospital. My water broke.” My one sister does some night work. She was actually still awake, so she started tracking me on my phone. We got halfway to the hospital, and I told Javen, “Javen, we're not going to make it. I need you to pull over. He's coming.” He was like, “No, just wait 20 minutes. You can wait 20 minutes.” I was like, “Nope. There's no way. You need to get the car pulled over right now. He's coming out.”I quickly got off the ball, and within 2 minutes of getting the car pulled over, Javen moving the driver's seat forward, and opening up the door, and calling 9-1-1, we had our baby boy. It was the most crazy experience. I say he came out in three pushes, but really, I didn't push at all. To experience my body just taking over is just an insane feeling. Julie: Oh my gosh. Yep. Sheryl: Yeah. The ambulance was headed our way but they were pretty far away because we were in the middle of nowhere. We were actually pulled over into an Amish farm. We live in the heart of Amish country in the middle of Ohio. I'm praying, “Please don't come outside and watch me give birth.” Luckily, no. We found out who the owner was and through back and forth, they were like, “No, we didn't wake up. We didn't hear anything.” So praise the Lord for that.I actually delivered my placenta before the ambulance got there. Julie: Oh my gosh. Sheryl: Baby Casey was healthy and just immediately had a head full of hair. He was the most beautiful baby boy. I held him on my chest. Javen caught him and handed him to me. Just to hold him, it was such a whirlwind. It was crazy. I got into the ambulance and realized that yes, not only does he have a head full of hair, but he has a head full of red hair. He has very, very red hair. He was just a surprise from every point. We got to the hospital. The midwife came to check on me. She was like, “How did this happen? I just saw you not even 12 hours ago, and you were not ready to have a baby.” Every prayer I prayed was answered again. Now I know, and I'll tell listeners, if you're going to pray, you need to be specific. Be specific when you say, “Get me to the hospital and not in the car.” I learned that. Julie: That is so funny.Sheryl: I did not tear, and that was something I had prayed for which was really cool because my midwife is older, so I think this was baby number 1900 for her or in the 1900s. She had always told me, “Hey, when you go to push, don't push the head out. Just breathe it out. Don't push and you won't tear.” As he was coming out, that's all I could hear in the back of my head was Leanne saying those things. It worked. That was really special. She was really, really proud of me for remembering that. Julie: I love that so much. Okay, you guys know I love a good car birth story. It's my favorite. It would be my dream birth. People might think I'm crazy, but man, I just dream one day of following somebody as they rush to the hospital in labor and then pull over to the side of the road, and I get to document a car birth. Anyway, probably not what you would use to describe it, but what happened when you got to the hospital? I'm assuming you got into the ambulance and drove over. They checked you out. You didn't tear and everything. Did you go home or did you stay in the hospital? Sheryl: We stayed in the hospital because they were like, “It's not necessarily you, but the baby. We have to monitor the baby for 24 hours.” My husband and I looked at each other. We were like, “We have to be here for 24 hours? We should have just gone back home and had somebody check on us there.” But yeah, it was great. I got in the ambulance. My husband had my phone. I looked down, and like I said, my sister was tracking me. I had a text message that said, “Did you just give birth on the side of the road?” I responded, “Yes, I did.” She said that as soon as she saw the car stop moving, she kept refreshing and the car did not move. She just knew. That was fun. I started nursing. I'm laying there in the ambulance, and I'm like, “Well, hand him to me. I want to see if he's going to nurse.” He latched immediately. They were surprised. Also, two of our EMTs were Amish guys, so that's fun. To live in Amish country, you do have Amish EMTs then, so that was fun. Julie: Yeah. Wow. That is so crazy. I think that is just such a way to highlight how every birth is different. We talk about how every person is different. Every pregnancy and birth is so different and unique in and of itself. You had three very different birth experiences. I love that. I was trying to do the math in my head about how long this was from when you woke up at 1:30. What time was baby born?Sheryl: 2:20. Julie: Oh my goodness. Girl. Sheryl: Yes, so less than an hour. I never would have thought. We did joke a couple times, “Hey, if you want your VBAC, just have it in the car, and you for sure will get it exactly how you want it if you don't want Pitocin and all of that.” We joke about that, but now we know that you probably shouldn't joke about that. It might happen. But honestly, I never thought. I'm a little bit crunchy, but not super. I didn't want a home birth or a free birth, but now, I get it. It was super empowering. I had so much adrenaline and just to be like, wow. My body did what it was supposed to do. I can trust it. It knew when to go into labor. Obviously, it doesn't always go that way, but this time it did. It knew what it was supposed to do.Somebody told me that their doctor said, “I never trust third babies.” Julie: I always say that too. Sheryl: Yep. It's definitely true. Julie: I always say that I don't trust babies. I especially don't trust third babies. It's just so unpredictable especially when you let babies do their thing. There are times when interventions are needed. There are times when Cesareans are lifesaving. There are times when induction is necessary, but I feel like the biggest majority of the time, if we just let the body do what it knows how to do, things will happen just beautifully and perfectly. Like I said, there is nuance there. It's important to acknowledge that, but a lot of amazing things happen when we just trust and create space for the body and the baby to do their beautiful labor dance and let things happen as designed. I think it's really neat. I think it's all neat. I'm a birth nerd. I think birth is neat. Birth is cool, and I think there are lots of really cool things to say about all of your stories. I do think it's really important that with VBAC especially, you can have a VBAC in lots of ways. You can have it in the hospital, a planned induction, a planned epidural, planned unmedicated, in-hospital, out-of-hospital, or however you want. A free birth, unassisted or whatever. You can do it all of the different ways, but I think it's really important. We talk a lot about, especially with VBAC, laboring like a first-time mom and being prepared for the long haul. Plan for a 20-hour labor or longer.But I feel like maybe it's a disservice to not talk about the other side when things can pick up and start really fast and go really fast because I feel like the perfect length of labor is a nice 8 hours. 8 hours is a good amount of time where it doesn't railroad you. You don't have to catch up and process. You don't feel defeated because it's taking so long. 8 hours is a really great length. I think it's a disservice to talk about that would happen if there is not time to get to the hospital or if there's not time to get an epidural. Sometimes parents rely so much on not getting a medicated birth that they don't think about what would happen if there is not time for that, then being railroaded by a fast labor and not being prepared for the intensities that come with that can cause birth trauma in and of itself even though the body is doing its thing and we trust the body. It can cause trauma by having something that you didn't prepare for or expect of plan for. I would encourage everybody that if you are planning a home birth, if you are planning a long labor, cool. That's great. It's great to be prepared for things. I always say to prepare for the worst and hope for the best, but sometimes, it's good to prepare for the other things too. Prepare for the things that are opposite of what you want or what you are hoping for or what you are preparing for because at least if you acknowledge them and make a plan A, a plan B, and a plan C, then you will be less likely to be unprepared or caught off guard or have the opportunity for trauma to be introduced to your story. I think it's really fun to explore all of these different things and hear all of the different stories and how different everybody truly is. I love that. What would you say? Sheryl: As far as that, a lot of people were like, “Oh man, my husband could never do that.” One, so many instincts just kick in. So many people said, “How did you know what to do?” One, I've had a baby before. Two, my body knew what to do. I just listened to the cues. Okay, what should I do? What feels comfortable? But then again, my husband was amazing. No fear. He caught the baby. He drove to the hospital with bloody hands, but he is a hunter and a farmer, so he's like, “Yeah, no big deal.” He's known as a cool, calm, collected guy, and he even is when he is delivering his own baby in the back of a car. The other funny thing was that since we had just moved back, we had bought a new vehicle. I had dreamed of being a minivan mom almost my whole life. I had always wanted to be a mom. Finally, my husband got me my first minivan. Baby number three on the way, we finally get a minivan. Luckily, it came with really good mats in it that had a wide lip around the edge. Everybody was like, “What a mess that must be.” Lucky for us, everything stayed right there. The next morning, Javen went and got me breakfast. On his way to get me breakfast, he stopped by the car wash and dumped it out, rinsed it off, and we were good to go. Julie: Perfect. Sheryl: The doctor at our practice was like, “You really should write that company and do a review for them.” Julie: That is amazing. Sheryl: If you are thinking of having kids, you should put that in. Julie: Maybe you'll get a free car. Did you hear the story about a guy who had a Stanley-insulated tumbler in his car, and his car caught on fire? After, he was going back through the wreckage. The car was literally on fire. He has a video of this car. He's looking through it. It's charred and burnt, then he opens up his Stanley cup and there's still ice in it. Then Stanley the company gifted him a new car. Sheryl: Oh, wow. Oh man. Julie: The natural advertisement for that. Can you believe it? Sheryl: Maybe I need to reach out. Julie: Do it. Sheryl: As we were sitting there in the hospital, we can't sleep after that. It takes hours for you to calm down after that much adrenaline. Life for the last four years, really, has been crazy. I think we've lived in six or seven different houses. We have been back and forth to three different countries basically. That part of our story is coming to a close. It was like, yep. Okay. This is a really great way to end this chapter of our life with a carbirth. Our life will continue to be interesting and crazy in other ways. Julie: That is amazing. It sounds like you have quite an adventurous life for sure, and what a story. What a story to tell. Thank you so much. Oh wait. Before we wrap it up, I want you to tell us your best VBAC advice. What is one thing you would tell anybody preparing for a VBAC? What should they do? Sheryl: Yeah, great question. I would say to prepare like it's a marathon mentally. Really think about what you want. What to you is a part of birth? If you follow the Lord, ask Him those things because He does want to answer our requests. He does delight in giving us what we want. Sometimes, He doesn't always answer that, but in my experience, when I've asked in this specific area, He has given me what I wanted. Really pray about it. I know that with every birth, I have gone and gotten a massage. For that hour, I have focused on, “Okay. What is an important part of birth to me?” That would be my advice. Really focus mentally on feeling strong and capable. Julie: I love that. I love that. Well, thank you so much for joining me today, Sheryl. It's been such a joy to listen to your stories. Yeah, so 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

Let's give our new year's intentions a makeover, shall we?   In this week's episode I shared a new way to set intentions that will actually help you manifest what you desire at the deepest soul level!    I also shared why I only have one intention this year and what it is — and how it might help you on your spiritual journey too.   Be sure to listen all the way through – I had a blast pulling a few powerful Oracle cards for you at the end for the year to come. ✨

What are the typical differences between hospital OB care and home birth midwifery care? Throughout her VBAC prep, Gesa was able to directly compare the two side by side. She was planning a home birth with a midwife but continued to see her OB at the hospital for the insurance benefits. Some differences she noted: Her OB used ultrasound to determine baby's position. Her midwife palpated her belly.Her midwife ran a blood test to check iron levels, and then suggested an iron supplement. Her OB did not track iron.OB visits were typically a few minutes long. Visits with her midwife were an hour or longer in her home. The hospital required cervical checks, laboring in a mask, continuous monitoring, and only allowed one support person. The way Gesa navigated her care is so inspiring. Her midwife was hands-on during pregnancy in all of the best ways and just as hands-off during birth to let the physiological process take over. Gesa's story is exactly why we love HBAC so much!Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie:  Good morning, Women of Strength. I am really excited to be back here with you. This is Julie, and it is my first official episode back doing regular episodes. Just like we talked about a couple of weeks ago, I'm going to be doing– or was it last week? I can't remember what week it is. But we are going to be doing every other episode alternating between me and Meagan for the most part. I'm really excited to be back here. We have a really special guest with us today. But before we get into that, I want to say that I just got back from South Korea two weeks ago. No, two days ago. If you haven't listened to Paige's episode for her maternal assisted C-section, go listen to the episode that launched on December 2nd. I do believe it was maybe episode 357. Me and Paige are talking and sharing her story. I am literally so jet-lagged right now. It is going to be a morning for me for sure. If I'm a little clunkier than usual or my brain doesn't work just right, just be a little patient with me, please, because the jet lag is absolutely real. Before we do get started though and introduce our guest, I want to read a review. Meagan sent me a review this morning, and I think it's really interesting because she sent me this review this morning. It's a 1-star review, and you might be curious as to why I'm choosing to read a 1-star review, but I'll tell you a little bit more afterward why I picked that. This one is on Apple Podcasts. This person said, “Listened to 10 episodes, and found that the stories they choose to share are usually always the same with a twist. Didn't find any episodes that said ‘A C-section saved me and my baby's life' so lots of bias and fear-mongering from people who are selling female empowerment. Maybe I'm missing the episode where the hosts say that sometimes it's okay to have a C-section. With all of these birth stories, you would think I could relate with one, but I find that the anecdotes shared in this podcast are a really easy way to avoid talking about women who are actually statistical outliers.” I think that episode is really interesting. First of all, I appreciate everybody's views and perspectives. But also, I think that review is a little bit interesting because she said she has listened to 10 episodes. I'm just assuming it's a she. Maybe that's not the right way to do that. She said she has only listened to 10 episodes. It's interesting because I wonder what 10 she picked. I feel like, isn't it maybe a sign that all of the stories are similar because our healthcare system needs a lot of work? Clearly, if so many women are having trauma and unnecessary C-sections, isn't that a sign that something needs to change? I know that a lot of us have struggled with unnecessary C-sections and really traumatic treatment in the hospital systems, so I don't know. I wanted to bring that up because first of all, we do have many, many episodes where C-sections were necessary. We've talked a lot about that how C-sections are lifesaving procedures when they are necessary. I feel like we do a pretty good job leaving space for all of the stories, but let me know what you think. Go to the Instagram post today about this episode, and let me know. What do you think? Do you think we do a pretty good job? Do you think we need to have a little bit more talking about C-sections that are actually necessary and lifesaving? Do you think it's unequally represented? Let me know. I want to start a discussion about this. Go ahead and leave a comment. Let's talk about it. But I do know that me and Meagan have been very intentional with sharing a wide variety of stories and outcomes and necessary and unnecessary C-sections. Hopefully, you feel well represented no matter what side of the view you are on. Anyway, we are going to go ahead and get started now. Today, I have a really awesome guest. Her name is Gesa, and she lives in Charleston, South Carolina. She is a mom of two boys. She had a C-section with her first baby. The C-section was because of a breech presentation after she tried everything to turn him. Knowing that she absolutely did not want to have a C-section for her second baby, she navigated the difficult search for a truly supportive provider and ended up having a successful HBAC, or home birth after Cesarean, after having some challenges to get labor started. We are super excited to hear her story. We are going to talk more at the end about how to find the right provider for your birth and your birth after a Cesarean after she goes ahead and shares her story with us. All right, Gesa. Are you there?Gesa: I'm here. Julie:  Yay. I'm so excited to have you with me today. Thank you so much for joining me, and again, for being patient with all of my technical issues this morning. Gesa: Of course. Julie:  But I will go ahead and would like to turn it over to you. You can share your story with us, and yeah. I'm excited to hear it. Gesa: Thank you so much. I'm so excited to be here and share my story. Okay, let's start with my first birth which was my C-section. Everything was going well at the beginning of the pregnancy. I was feeling a little bit nauseous, but overall, feeling well. Then at the anatomy scan, I found out that my baby was breech. I was like, “Wait, what does that mean? What does that mean for birth? What's going on with that?” We had so much time left. The provider was not worried at all. It was around 20 weeks so we thought we had plenty of time at that point. Babies are little. They flip-flop around. I was not concerned at all. As time progressed, he continued to stay breech, so he did not flip on his own. During one of my OB appointments, I was basically told, “Well, if your baby does not turn head down, we're just going to have to have a C-section.” There were really no other options given. At that point, I was actually planning a natural birth at a hospital, so that was not really what I had in mind. We had also taken a Hypnobirthing class which was awesome. We learned so much about birth and pregnancy that I had no idea about. Hearing that I was going to need a C-section if he wasn't going to turn head down was really not what I wanted. I started looking into things I could do to help him turn. I started doing Spinning Babies exercises. I started seeing a chiropractor. I did acupuncture. I even did moxibustion at some point which is really fun. It was a Chinese herb that you burn by your toe, and that's supposed to create fetal movement and help the baby flip which unfortunately did not help. I was out in the pool doing handstands and backflips about every day. I was lying on my ironing board at some point with a bag of frozen peas on my belly. I really tried everything possible to get this baby to flip. Nothing worked. I ended up trying to have the ECV at about 37 weeks. That's the version where they try to manually flip the baby from the outside. She gave it a good try to attempt, and he would not move. It was that his head felt stuck under my ribs. It was very uncomfortable. He was very comfortable where he was at. They had me schedule the C-section which I was really unhappy about, but at that point, I didn't really see any other option. It was about my 37-38 week appointment, and the OB wanted to talk a little bit more about the details of the C-section which made me really emotional because that was not what I wanted. I started crying during the appointment, then the nurse comes in and says, “Hey, we actually forgot to check your blood pressure. Let's do that really quick.” I was like, “I'm sure that's going to be great now that I'm all emotional and crying here.” Of course, the blood pressure was higher than it was supposed to be. The OB started joking, “Oh, maybe we'll have a baby today. Maybe we're just going to do an emergency C-section,” which was not what I wanted to hear at all. It made me even more emotional. I remember sitting in the office crying. Now, I had this high blood pressure. My husband handed me this magazine of puppies or kittens. He said, “Sit here. Chill out and just relax. Look at the kittens. They'll retake your blood pressure, and I'm sure it's going to be fine.” I was like, “Oh my god. Nothing is fine right now.” It ended up coming down a little bit. They still sent me to the hospital for some additional monitoring. It was all good, and we ended up being sent home. But I just felt so unsupported and so unheard in that moment. When I was thinking about the C-section, I was even considering at some point what happens if I just don't show up for my C-section appointment and just waited to see if I'd go into labor? But then I thought, “Maybe an emergency C-section would not be any better than a planned.” I had a friend who had an emergency C-section, and she said that the recovery was really difficult so that's also not really what I wanted. I went ahead and showed up to the hospital for my scheduled C-section at 39 weeks and 1 day. But I was so emotional. I was crying on the way to the hospital. I was crying at the hospital. Everybody was really nice at the hospital, but it was just not what I wanted. The idea of them cutting my body open and removing the baby was just so far away from what I had envisioned. The C-section went well. I really did not have any major issues. But recovery was pretty rough. He was pretty big. He was 9.5 pounds and 21 inches long. Recovery was a little rough. He had also a really difficult time with breastfeeding. He had a really weak suck. I just kept thinking, “What if he was not done cooking? What if they got him too early? He wasn't ready to be born yet.” We found out later that he had a tongue and a lip tie that the hospital failed to diagnose which just made things even more difficult. I, overall, hated my stay at the hospital. I felt like I was not getting any rest at all the whole time I was there. My son didn't like sleeping in the bassinet because why would he? I felt like there were people coming in all of the time and interrupting the little bit of rest that I was trying to get. They were checking on me, checking on the baby, taking temperatures, the photographer, the cleaning people. It was just like people were coming and going. The only person who did not show up who I hoped would show up was the lactation consultant. She did not show up for almost two days which was really, really disappointing. The first few months were pretty hard. I would say they were pretty rough emotionally and physically. When people ask me about my birth, a lot of times, I got comments like, “Well, at least he's healthy” or “Oh, your baby's really big, so it was probably good that you had that C-section.” That really upset me because I understand that it's important for my baby to be healthy. Yes, that is the most important thing. But at the same time, my feelings are valid about it, and my emotions. I felt really robbed of that experience to birth my own child. The fact that I had never felt even a single contraction really was upsetting to me. I felt that my body had really failed me. Yeah. I knew that if I ever were to get pregnant again, I would not want to have another C-section. So let's fast forward to my second pregnancy.I got pregnant again when my son was a little over a year and a half. Like I said, I knew exactly what I didn't want, and that was to have another C-section. When I found out I was pregnant, I pretty much immediately jumped on Facebook group and mom groups trying to do my research and find a truly supportive provider. I did call a birth center here in Charleston, and they told me right away, “We don't do VBACs. Sorry. You can't come here,” which was pretty upsetting because they basically see a VBAC or having had a C-section before is a high-risk pregnancy for your next which really does not make a lot of sense because every pregnancy is different. Just because you had a C-section, there can be so many different reasons. You should not be considered high-risk for your next pregnancy. I found a provider who I thought was VBAC-supportive. It seemed like that was my only option, so I started seeing her. As I was seeing my OB further into my pregnancy, I started asking some questions about birth. I really didn't like some of the answers she had for me. I asked about intermittent monitoring. She said, “No, we can't do that. Hospital policy is that you have to have continuous monitoring.” I didn't love the idea of being strapped to the bed. I wanted to move around freely. That was not going to be an option. I asked about eating. I got the answer, “No, we don't really allow eating while you are in labor. You can have clear fluids.” I was just thinking, “I don't want to eat ice chips while I'm in labor. If I'm hungry, I want to be able to eat.” I asked if I could labor in the bathtub because they did have tubs at the hospital. She said, “No, because of the continuous monitoring, you're not going to be able to get in the tub.” Hearing all of that made me really uncomfortable. Whenever I did ask questions, it almost felt like she didn't really want to talk about it. She didn't really want to talk about my birth plan which was really important to me. Now, at the same time, it was also COVID. I got pregnant with my second literally the week before people started quarantining for COVID. On top of all of these things that I didn't like about the hospital, there were also the COVID restrictions. I had to show up to my appointments in a mask which was totally fine, but the idea of having to labor in a mask made me a little uncomfortable. I was thinking about hiring a doula, and because they were only allowing one support person at the time, that was also not going to be an option. I knew my son wasn't going to be able to see me at the hospital which was something I was really looking forward to. I kept thinking, “Maybe there has to be another option. This can't be my only option here.” I started looking at places farther away. I was like, “Maybe I can travel to another place further away.” I was looking into birth centers around the area and all over South Carolina, really. At some point, I did come across a website that said they were offering VBAC support. I didn't really know what that meant, but I filled out a form. I said, “Hey, I need some help with a provider. I'm seeing an OB, but I'm not feeling super comfortable.” I submitted that form. I want to say that maybe a couple of days or a couple of weeks later, a midwife called me. She was like, “Hey, I'm not in your area, but I actually know a lot of people all over the state. Let me send an email to my network, and we'll see if we can find somebody who can help you.” One day, I got a call from a home birth midwife here in Charleston. She was like, “Hey, I got your message. Tell me how I can help you.” We talked a little bit about home birth. At that point, I was like, “Do I really want a home birth?” It was not something I had really considered.” During that HypnoBirthing class when I was pregnant with my first son, we watched a lot of videos of water births and home births. I always thought it was really cool, and I would love to have that experience, but at that moment, when she asked me, “Hey, would you consider a home birth?” I was like, “I need to think about that for a second.” I talked about it with my husband. I did a lot of research on home birth. I ended up sending her all of my medical records from my first pregnancy. We continued talking and checking. I continued to see my OB, and that was really for a variety of reasons. First of all, I had really good health insurance. All of my visits were covered, so all of the DNA tests, and things like the anatomy scan were covered by my health insurance, and it was just easy to coordinate those things with my OB. I also wanted to continue my care just in case there was something that would pop up that would prevent me from having a home birth and those plans would fall through. I'm a big planner, so I like having not just the plan, but also a plan B and a plan C. Yeah. I also like that established relationship just in case I needed a home birth transfer to the hospital. I've heard stories where moms were treated very differently when they arrived at a hospital with a home birth transfer, and in the case that I would have needed that, I could have just shown up to the hospital and said, “Hey, I'm a patient. I'm here. I'm in labor,” without them knowing that it was really a home birth transfer. I did not tell my OB that I was actually planning a home birth. I think she would have been pretty upset. Maybe she would have fired me. I don't know. But the difference in care that I received from the OB and from the midwife was really, really interesting. It seemed like at my OB appointments, there was a lot of focus on different tests and procedures like my weight. Further down, they wanted to do lots of cervical checks which I all declined. At the same time, when I talked to my midwife, the focus was a lot more on nutrition and on exercise. She was asking, “What do you do to prepare for your VBAC?” Lots of education on birth. There were lots of books that she suggested for me to read. I also started seeing a chiropractor pretty early in the pregnancy. I was doing my homework. I was doing my Spinning Babies exercises. I was so focused on doing everything I could to have the birth that I had envisioned. At some point, my midwife had me do some extra blood draws. She wanted to make sure that my iron levels were okay for the home birth, and they were actually slightly lower than they were supposed to be, so she put me on an iron supplement for a couple of weeks. That was an example of something that the OB never asked about or really cared about. At some point, I was a little bit nervous about the position of my baby. It almost felt like he was lying sideways, and I couldn't really tell. I brought it up to the OB. She was like, “Yeah. Let's get in the ultrasound machine. Let's take a look.” She was trying to feel, but she couldn't really tell. Everything was good. He was head down. Well, I didn't know he was a he because we did not find out the gender. Baby was head down. Everything was okay. I brought up the same thing to the midwife, and it was so funny because she did not need an ultrasound. She just felt. She felt really good. She was like, “Yeah. I know. I feel all of the different body parts. You're head down. You're good.” Of course, she was right. It was just so interesting to see how different things were approached by the two providers. I also hired a doula, and I made sure she was VBAC Link certified. It was really exciting. She was familiar with the podcast that I was, of course, listening to at the time to prepare for my VBAC. At some point, I had a situation with my OB that made me pretty uncomfortable. It was time for the GBS testing, and I had done my research. I made an informed decision. I let her know that I was declining the test. She was not happy to hear it. She kept saying, “Well, if your baby dies–”, and she kept saying that multiple times. It was like, “If your baby dies–”, and I was like, “This is so unprofessional to say it like that.” I totally understand that they need to–Julie:  Oh my gosh. I can't even believe that. Gesa: Yeah. Isn't that horrible?Julie:  That's horrible. Gesa: I understand she needs to educate me on the risks that come with declining certain tests, but that was just not a proper way to communicate that. Julie:  Yeah. Find another way. Find another way. Gesa: Yeah. Right. That situation really confirmed for me home birth was the way to go. I did not want anything to do with this hospital or this OB anymore at that point. I was fully committed to the home birth. I was planning on it. I continued my OB visits more just to check a box. At 37 weeks, my midwife brought over the birthing pool and some supplies. I gathered everything that I needed. She had sent me a list of all of the different supplies that we needed to buy and gather, so I started getting all of that. I created a beautiful birthing space for myself in our bedroom. I had my affirmations up. They were taped to my mirror in the bathroom as daily reminders. I had them hung up in the bedroom with some twinkle lights. I had the picture of the opening flower, and everything was ready. I had my Spotify playlist ready, and I was so excited for baby to come here. Then, at 39 weeks and 1 day, it was early in the morning, like maybe at 6:30 AM. I was lying in bed, and our toddler had climbed into bed with me. I felt a little pop, and I was like, “Hmm, that was weird,” but I didn't really think much of it because pregnancy is weird, and our bodies do all kinds of weird things that we can't explain when we are pregnant. I didn't think much of it. I went back to sleep. An hour later, I got up to go to the bathroom. I sit down on the toilet, and water is gushing out. I was like, “Shoot. What is going on? I'm not peeing. What's happening?” I just realized, “No, my water broke.” I wasn't expecting it at that point because you hear about a lot of women going into 40-41 weeks, 42 weeks, especially with their first pregnancy that they are going into natural labor, so I was so surprised that it happened at 39 weeks and a day. I was feeling a tiny bit of cramping, but definitely did not have any contractions. I texted my husband, “Oh my gosh. My water broke.” He was out for a workout, so he rushed home. I also texted my doula and my midwife just to let them know what was going on, but then the whole day was really uneventful. I was ready and waiting for labor to start. It just didn't. I went on a lot of walks. I tried some curb walking. I bounced on the yoga ball. I ended up getting a last-minute appointment with my chiropractor for a quick adjustment. I really spent all day just trying to get labor started. I took some naps. I also tried using the breast pump for some stimulation to get things going. I got some tiny little contractions. At that time, I thought they were contractions, but now that I know what contractions actually feel like, I realize that was not actually the case. I got some tiny contractions going, but then they fizzled out again. My midwife stopped by a few times to check on me and baby. She had me take my temperature every 4 hours and text it to her just to make sure I wasn't running a fever. Baby was moving normally. She wasn't overly concerned. She assured me that my body was probably just waiting until nighttime when my toddler was in bed and I was relaxed for things to start then. It was weird because I was leaking amniotic fluid all day, so I tried to stay super hydrated and replenish all of that water I was losing. I went to bed and thought, “Okay. This is it. We're going to have a baby maybe early in the morning. Labor is going to start.” Nothing happened. I woke up really early and really disappointed that nothing had happened. My midwife had sent me some information on PROM, so premature rupture of membranes, just to make sure I was making an informed decision. She always gave me the option to go to the hospital. She said that I could go in the evening of when my water broke. She said I could wait until the next day and do whatever I felt comfortable with, but she wanted me to be aware of the dangers with having a long time of broken waters. She also had sent me a recipe to the midwives' brew. That was something we talked about to get labor started. She said, “Something to consider for the next day if you don't have your baby overnight.” My husband went out. He bought the ingredients just in case. It was castor oil, almond butter, apricot nectar, and champagne. It was absolutely disgusting. It actually ruined almond butter for me for at least 2-3 years. I could not have it anymore. It was so gross. Julie:  Oh my gosh. That is so funny. That is funny. Gesa: I took it around 10:00 AM in the morning. At that point, my water had been broken for over 24 hours. I layed down for a nap, and maybe 2 hours later, I started feeling some contractions. They were coming in. I was just laying in bed breathing through them and listening to my HypnoBirthing affirmations and some relaxing music. My husband was actually taking a nap at that time with our son. At some point, things were getting pretty intense. I texted my doula and my midwife. I was trying to time contractions but it was also difficult. They both came over around 2:00 PM and realized pretty quickly that labor was going. They needed to fill that pool because that actually takes a while which was not something I was even thinking about.They quickly got the birthing pool filled. Once I got in the water, it was such a difference. At that point, I had some really, really heavy contractions and I think I got in there around 3:00 PM. It was such a night and day difference. My doula was awesome. She was rubbing my back. She was giving me cold washcloths on my neck. Yeah. She was super helpful. I was laboring in the tub. At some point, I needed to get out to go to the bathroom. As soon as I got out, I instantly regretted that decision because it was so horrible and the contractions were feelings so much stronger when I was not in the water. My husband was still sleeping at that point. I was like, “Okay, is somebody going to wake him up before baby comes?” But I also lost track of time of how long I even was in the pool. They did wake him up at some point. It was really funny because when he lay down for a nap, it was just me laboring in bed by myself. They woke up from the nap, and I was in full, active labor in the birthing pool with the doula and the midwife there, full action going on. He was just like, “Whoa, what's happening?” Yeah. He jumped right into action and helping me out and massaging and all of that good stuff. It was really sweet because my son kept bringing toys. He was a little over 2. He was 2 years and 3 months at that point. He kept bringing over toys. He was playing right next to the pool. He was checking on me. It was just really sweet and really special to have him there. Our dog was also walking around the pool and was really interesting in what was going on. I really lost track of time and of how long I really was in the pool. At some point, I felt some really, really intense pressure. It was almost like my body was pushing on its own without me really actively doing anything. I had heard of the fetal ejection reflex, but I didn't realize that that was what was going on. I didn't realize that baby was already coming. My midwife just looked at me. She was like, “Feeling a little pushy, huh?” I was like, “Yeah, I guess that's what's going on.” It all happened really quickly. My husband got our son situated downstairs because we wanted him to be there, but we didn't want him to be there right as baby was born. We thought that may have been a little bit too much for him, so we got him situated downstairs. Yeah, things happened really quickly. All of a sudden, his head was out. It was really fun because we got to feel his hair, and I did not have another contraction for a minute which was weird because his head was out. It was underwater, and it felt like a really, really long time between contractions. But then he was out with the next one, and my midwife caught him. He came right to my chest. My husband got to announce that he was a boy which I knew all along. We didn't find out his gender, but I just knew he was going to be a boy. My pregnancy was just so similar that I was like, “There's no way he's not a boy.” But yeah. He was born a little after 4:00 PM, so really just 6 hours from when I had the midwives' brew, so that really worked for me. Of course, I cried tears of joy. The amount of emotions I was feeling was just absolutely incredible. The rush of endorphins, I felt so empowered and so strong in that moment, like literally the strongest person in the world. It was awesome. We brought my son up and he got to meet his baby brother within minutes of his birth which was so special and such an amazing experience. Once we got settled a bit, I got to take a shower. I got to eat pasta in my bed, and then also safely cosleep with my baby in my own bed and in my own home which was just the complete opposite of that hospital C-section experience. Yeah, the home birth experience was really healing for me in a way. It gave me closure from my C-section experience. I think because I had the C-section, I just knew what I absolutely did not want, and I think that really helped me fight and prepare for my home birth experience. I still had to call my OB and cancel my 40-week appointment which was probably one of the weirdest phone calls I've ever had to made because I was like, “Yeah, I need to cancel my appointment because my baby is actually here.” They were like, “Wait, where was your baby born? We have no records of this.” I was like, “Yeah, he was born at home.” They were like, “You need to get him checked out immediately.”Julie:  You're like, “Yeah, accident.” Gesa: I was like, “No, we had a professional there. It's all good. Don't worry about it. Let's not talk about it anymore.”Julie:  I love that so much. Okay, I want to talk about a couple of things or maybe just comment. When you were talking about your C-section and how you felt guilty about how maybe he was having trouble nursing or whatever and you were feeling guilty that maybe he had been taken too early or he wasn't ready to be born yet and stuff, I felt that so hard with my C-section baby. I just wanted to validate that because I feel like that is not an uncommon thing. I feel like a lot of us have that concern when we have either a scheduled C-section or an induction that results in a C-section or maybe even an induction that results in a vaginal birth. You can look back at it and feel like, “Oh, maybe I made the wrong choice,” or “Maybe he was taken too early,” or things like that. I just wanted to validate that. Know that I see you, and I hear you, and I feel you. And everybody, not just you, but everybody. Try not to be too hard on yourself. I'm not speaking just to you, but everybody. Try not to be too hard on yourself because you were making the best decisions that you could with the information that you had available to you at the time. So give yourself some grace. Give yourself some love. I think that's really important is that we navigate our pregnancies and birth after having an unwanted C-section or an unwanted birth experience. Giving ourselves that grace is a really, really important part of it. I did want to talk about the difference in care. You highlighted a few things in your episode about the difference in care between a hospital OB and having a midwife or especially a home birth midwife. In the hospital, you're still going to see a little bit of similarities between midwifery and OBs, although midwifery care in a hospital is a lot more hands-on and a lot more personal and a lot more trusting, generally speaking, of the birth process. I just was thinking this morning about a post. There was a post in not even a VBAC group. It was just a local mom's group in my community. This woman was talking about how it was her first baby. She hasn't had an ultrasound or seen the baby since 10 weeks. She had a 10-week scan, and she hadn't seen the baby since then. She wasn't 20 weeks pregnant yet, but she was almost. She was just like, “I'm just wondering if this is normal. Every time I have an appointment with my OB, I only see him for 2 minutes. I don't feel like this is normal. I have some concerns, but I'm not being able to ask questions,” and things like that. It made me sad. It made me sad for this parent not being cared for in the way that she needs to be. It also made me sad because her experience is not that uncommon. I wanted to say that unfortunately, this is normal. You're not going to usually see your OB for more than a couple of minutes per visit. You're not going to have time to ask a lot of questions and get a lot of answers because hospitals are busy and OBs are busy. Most of them don't have the time or intentionally make the time to give you that kind of attention. It's just how it is. Now, I say most of the time because there are some OBs. I saw briefly an OB for my third pregnancy, and I love her. She was always 45 minutes late. Our appointments were always 45 minutes late. My appointment would be at 1:45, and I wouldn't get in there until 2:00 because she was giving everybody the attention that they needed. A lot of people get frustrated because she was an hour late for the visits, but I wasn't frustrated because I knew that she was giving other people the same attention that she gave to me. That is so, so rare in a hospital setting. I love that you highlighted that. I love that you talked about how your midwife took time to address your concerns, how she monitored your iron levels and gave your iron supplements and your OB didn't. It wasn't even on his or her radar. I don't know if your OB was a boy or girl. I can't remember. Their radar, right? And how your OB needed an ultrasound to confirm baby's position, but your midwife just palpated your belly because midwives are more hands-on. They are more intimately connected to the female body, to the baby, and to the physiologic birth process. Gesa: Yeah. She was more hands-on during the pregnancy, but then during the actual birth, she was very hands-off. She let me do my own thing. Julie:  Yeah! Yeah. Gesa: She wasn't constantly in my space and interrupting my labor. Julie:  Right. Gesa: She would come in very quietly and very softly. She would check on the baby and check on me, and if everything was good, she was back out the door. She let me labor in my own space and at my own pace which was awesome. Julie:  Right. I was going to talk about that next actually. I've been keeping notes while you have been talking because during your labor, you said you felt that fetal ejection reflex, and your midwife was like, “Oh, feeling pushy are we?” I know exactly what that looks like. I'm not a midwife, but I'm a doula. I've been a doula and a birth photographer, and I know what it looks like when a woman's body is progressing. But in a hospital setting, what do we do? We connect you to monitors. We put an IV in you. We sit at a nurse's station and watch the monitor. That's how we know how you are doing. We use ultrasounds to determine baby's position. We use data and numbers. We look at data to decide how the parent and the baby are doing. But in midwifery care, especially out-of-hospital midwifery care, you use a completely set of tools. We use observation. We are watching. We are listening. We are seeing. We are noticing the movements that are shifting and the sounds as they evolve and change. We are seeing the belly moved. We are seeing all of the different things, and it's a completely different approach. I know exactly what an unmedicated parent looks like as they are getting close to transition. I know the noises that change, what sounds are made, what different subtleties there are. You just learn these things when you actually just watch a laboring person, and notice what is happening. But they don't do that in a hospital. An OB and nurses– probably nurses because they are in the room a little bit more, but your OB won't show up until you start pushing. They don't know what the signs are. All they have is the data on the machine to see if you are doing. I know what approach I approve. Let's just say that. It's no secret that I'm a big fan of home births, especially for VBAC, when the parent feels comfortable there. I just really loved that. My appointments when I had my three VBACs at home, every time I saw my midwife, we would chat for an hour. She did talk about nutrition. I had preeclampsia for my first. My blood pressure was high. I was like, “I don't want high blood pressure,” so she gave me all of these nutritional things to do to help take care of my heart and help make sure that my blood pressure wasn't high. But then what would happen in the hospital? They wait until your blood pressure is high, then they treat it. They don't work on preventing it or making you healthier or things like that. I just feel like there is such a big difference in care. It's not for everybody. That's not where everybody feels safe, but I wanted people to know that home-birth midwives are very skilled. They are very hands-on throughout the pregnancy and oftentimes hands-off during the delivery because we trust these bodies to do what they need to do. Sometimes they do need help, but also observing and watching can help us know when a little bit of extra help is needed. It's such a fun little dance that can be done throughout pregnancy and labor. It's kind of like an art form as much as it is a medical side of things. Midwives are not chicken-dancing hippies that run around your room with incense and pray for a safe delivery. They are skilled medical professionals that have high levels of training and care and can practice in very similar ways that you see in a hospital setting just without all of the extra crap and interventions that are there. Obviously, they can't do surgery, and depending on your state and where you live, there are different restrictions about what out-of-hospital midwives can and cannot do. But a lot of people are surprised to find out how much training and knowledge and skills and procedures that out-of-hospital midwives have access to, so I wanted to talk about that. Yeah. Anyway, Gesa, do you want to give one piece of advice to anybody preparing for a VBAC right now? What would you tell anybody?Gesa: I think a lot of people, when they go to the doctor, they see their OB and they heavily rely on what they are telling them. They almost glorify the OB's advice in a way. We have got to remember that these doctors work for us. We don't work for them, so if we don't feel comfortable with what they are saying, we have the option to go somewhere else, and to take our business somewhere else. The doctors work for us. We don't work for them. It is never too late to switch your provider. I was going back and forth whenever I was pregnant with my first, and I was very late into my pregnancy. I kept thinking, “What if I just find a provider who does breech births?” In a way, I wish I had, but then you never know what actually would have happened, so it's hard to say how that would have changed my experience. I could have still ended up with a C-section, but I could have. I could have changed my provider at 38 weeks if I had contacted somebody, but I was just so overwhelmed by the whole situation that I didn't. But I was so glad that when I wasn't feeling comfortable with my OB during my second pregnancy and with what she was saying, that I took the step to find somebody who was truly supportive and who was able to help me with the birth that I had envisioned. Julie:  Yes. I absolutely love that. I think that's great advice. You make a very good point. It's never too late to switch providers. I think that the single most important thing that you can do to affect your birth outcome is to choose a provider who operates in the way that you want to birth just naturally. It's just what they do anyway. I feel like if you do that, then that's half the battle. Gesa: Yeah. 100%. I know some people feel very comfortable at the hospital, and a lot of people are not good candidates for a home birth. Julie:  Yeah, and that's where they should be. Gesa: When I told people that I was planning a home birth, I got a lot of people saying, “Are you sure? That's so scary.” If that's scary to you, then you shouldn't do it. If you feel safer in a hospital, go ahead. There's nothing wrong with that. Go to the hospital. Have your baby there if that's where you feel comfortable. For me, just the thought of having to fight for certain things while I'm in labor and very vulnerable wasn't something I wanted to do. I wanted to focus on laboring and birthing and just having that experience. I did not want to get into fights with OBs and nurses over whatever I could or could not do while at the hospital. That just did not sound like a good idea to me. Julie:  Yep. Absolutely. I agree, 100%. All right, well thank you so much for joining me today. Thanks for sharing your story with us. I'm super proud of you. You said that after your baby was born, you felt like the strongest woman ever. I agree. You are the strongest woman ever along with all of the women listening right now. We are truly Women of Strength, and no matter how your birth outcome ends, you are strong. You are powerful. I'm very grateful to each of 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

Katie has had a Cesarean (failure to progress), a VBAC, and most recently, an unmedicated breech VBAC!She talks about the power of mom and baby working together during labor. She is 4'10” and attributes so much of her first successful VBAC to movement. Katie's most recent baby was frank breech throughout her entire pregnancy. After multiple ECV attempts, she exhausted all options to seek out a vaginal breech provider. She was able to work with providers while still advocating for what felt right to her. Though there were some wild twists and turns, this breech vaginal birth showed Katie, yet again, just what her body is capable of! The VBAC Link Blog: Why Babies Go Breech & 5 Things You Can Do About ItThe VBAC Link Blog: ECV and BreechHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: Welcome, welcome. You are listening to The VBAC Link Podcast. This is Julie Francom here with you today. I'm super excited to be sharing some episodes with you guys this year and helping out Meagan a little bit and keeping things rocking and rolling here at The VBAC Link. I am excited to be back, and I am especially excited to be joined by Katie today who has a really, really incredible story about her three births. Her first was a C-section. Her second was a VBAC, and her third was an unmedicated breech VBAC. I absolutely love hearing stories about vaginal breech birth because I feel like it's something that we need to bring back. It's only fair to offer people options when we have a breech baby. I don't think it should just be an automatic C-section. I'm excited to hear her story. I'm excited to hear her journey to find support in that regard. But first, I'm going to read a review. This review is actually from our VBAC Prep course. If you didn't know, we do have a course preparing you all about all of the things you need to know to get ready for birth after Cesarean. You can find that on our website at thevbaclink.com. But this review on the course is from Heather. She says, “This course was so helpful especially with helping to educate my husband on the safety of VBAC as he had previously been nervous about my choice. We watched all of the videos already, but will also be reviewing the workbook again right before birth. I highly recommend.”I absolutely love that review from Heather because I feel like we get a lot of these comments about people and their partners really being on board and invested after taking the VBAC prep course with their partners. This course is chock-full of information about the safety of VBAC, and different types of birth situations. It talks about different interventions and hospital policies that you might encounter. It talks about the history of VBAC. It talks about all of the statistics and information. It talks about mental prep, physical prep, and all of those things. There are videos. There is an over 100-page workbook. There are actual links to sources, PDFs of studies, and everything you can even imagine. It is in this course. I also highly recommend it. Anyway, thank you, Heather, for that review. All right, let's get rocking and rolling. I am so ready to hear all about Katie's birth stories. Katie is right here snuggling her sweet little baby with her. I cannot wait. I hope we get to hear some little sweet baby noises. They are kind of my favorite. But Katie, go ahead and take it away, my friend. Katie: Yeah, thanks so much for having me. I'm excited to be here and hopefully share some things that I would have loved to have shared with me. So let me just start from the beginning with my first baby 5 years ago. I was planning to have a birth. I wasn't quite sure what it would look like, but I thought I wanted unmedicated. It was my first baby, and I wanted to labor spontaneously. The labor was long, so 3+ days of labor. It ended in me getting to 10 centimeters and pushing. However, due to fatigue and the multiple interventions that I had and the cascade of interventions, I believe, resulted in a diagnosis of failure to progress so I had a C-section. It was, I would say, disappointing to me not because of anything except that I would have loved to continue on my path of vaginal delivery. That wasn't in the cards with this one for me. Then with my second 2.5 years later– oh, I should also say that I was at a teaching hospital. There were lots of people. They were very pro-intervention. You name it, I had it across those 3 days. So 2.5 years later when I got pregnant, I thought, “Okay. I know I want to attempt a VBAC.” My husband, my partner, was so on board. He got a shirt that said, “You've got this.” He was wearing it all of the time. We watched a ton of positive VBAC birth stories on YouTube. We listened to podcasts like this one. We followed all of the things on social media and prepared with an amazing doula. I went into spontaneous labor again and this time, I was sure I wanted– actually, I should say I had a membrane sweep, and then I went into spontaneous labor. I was sure I didn't want interventions for this one. My doula was on board. My partner was on board. I labored at home for quite a while. I came into the hospital. It was the same hospital. That doctor was not so supportive of me attempting a VBAC, however, another OB had said that because of our family planning, I said, “I think I want more kids,” another OB told that OB, “Hey, let's make it as safe as possible to do what she wants, so let her give it a try.” My doctor was semi-supportive, but I came in. I was 9 centimeters. It was unmedicated. I was in there for less than 3 hours. I pushed the baby out with a bar. I was squatting. They didn't even know the baby was out. In fact, the baby started crying, and it felt like minutes or hours in my mind, but it was just a couple of pushes. My doula said, “Baby out. Baby out.” Everyone rushed because they were so surprised because normally, I think, folks labor on their backs, and I had requested a bar. That was pretty amazing. It was just me and my son doing the thing. It was incredible. I remember that OB who was skeptical said, “You did it. You've changed my mind.” So that was exciting. 3 years later to now, I became pregnant with my third baby. I went in for my anatomy scan at 20 weeks, and the ultrasound tech said, “Baby is breech. No big deal. Tons of babies are breech.” Because I have some other health complications, I guess they deemed me as high risk. I went to multiple ultrasounds, so that means I get to see my baby once a month which also meant I continued to see that baby was breech each time. Each time, they kept saying, “Oh, don't worry. Plenty of time. Plenty of time to turn.” As we approached my due date, I was like, “I feel his head. I don't think he's going to turn.” So they started to let me know what type of breech he was. My baby was frank breech. There are a few different types of breech positions which I didn't know prior to this baby, but now I'm very well-versed in the different breech positions. Frank breech is basically a pike position. The feet are by the head, and his little rump was just hanging out in my pelvis. I was also hoping to birth at a birthing center with my doulas. This was different than that learning hospital that I shared because I just wanted a different experience where they were less pushy with interventions. I knew that with my last birth that they used the term “something pelvis”, but anyway, I was ready to do something different with less people in the room. However, when they found out that I was breech, I was told what I think is the stock option which was, “Hey, if baby stays breech, but don't worry, there's plenty of time and he'll probably turn, but this is what we'll do. We'll try an ECV, and if that doesn't work, we'll schedule your C-section. We'll give you an epidural, try the ECV one more time, and that way, you can go right into your planned C-section. But don't worry, we have time. The baby is going to turn.” I left and was like, “I don't want that. My baby is healthy. I'm healthy. I am on the fence about this plan.” Now, I'm 36 weeks so at 37 weeks, I go in. We have the ECV. They give me the shot to relax my uterus. The ECV is the external cephalic version where they put their hands and try to rotate the baby. It was unsuccessful. So I said, “Can we try again?” She looked at me like, “What?” She said, “We'll try again with that epidural when you schedule your C-section.” I said, “No, no, no, no, no. Can we try again?” This is where, I think, that advocacy and that information and research are so important. She said, “Sure. We can try it again.” We scheduled another ECV. I went back in, and it was also unsuccessful with her. She could tell at this point, I was grieving what I thought was the end of this journey for me, and also not necessarily on board with the protocol they had put in place. We planned. I said, “Hey, can I try a different provider?” I know that you can do up to four ECVS. I'm not suggesting that people do that. I just wanted to make sure that I did everything possible for me and baby to have a vaginal birth. They seemed pretty gung-ho about not delivering unless baby was head down. She said, “Sure. We can do that.” That was also unsuccessful. At this point, the OB said, and I appreciated this. They said, “I feel really uncomfortable delivering a breech baby. I think you should go to our sister hospital in a city away if you are considering breech because we don't have a NICU here.” That felt reasonable to me because I had said to her previously, “I hear you, and I hear that protocol with what you're suggesting. I also feel really healthy, and I will absolutely change course if me or baby's health is in jeopardy, but unless that is imminent, I consider breech a variation of normal,” so I didn't necessarily think that was the rationale for the C-section knowing what that recovery is like and knowing that I had a 5 and a 3-year-old back at home. Julie: Oh, I love that so much. I love that they gave you options, and they admitted that they weren't comfortable with it. So many times, doctors will be like, “We don't do breech here.” They don't tell you that it's because they haven't been trained or they're not comfortable with it or it's not safe, they just tell you that's not the protocol, and they don't offer you other options. I really love that, and I love the conversation you had where you were like, “I understand the risks, but however, this is how I feel.” I think that's a really healthy way to go about it on both sides. So, cool. Kudos to your provider. Katie: Yeah. Then that doctor suggested this. It was in the underground world. It wasn't like, “Go to the next place.” She also suggested, “Why don't you consult with UCSF?” That's the University of California San Francisco. That's maybe an hour and 20 minutes with traffic, and it can be up to 3 hours, but they do breech birth there. She referred me to have a consultation with UCSF to talk about breech birth which they are very comfortable with. The consultation was great. The people were really helpful. They also had a lot of requirements for me to deliver there. Those requirements were things like an anatomy scan to ensure that the head and rump sizes were comparable for safety of baby. They wanted me to do a pelvic pelvimetry MRI. Julie: Pelvimetry? Katie: Yes. They said, “You have a proven pelvis,” which is the word I couldn't remember earlier, but because I'm very short– I'm 4'10”--, they just wanted that in this case. I said, “Sure. I'll do all of the things if this is the place where I know I can make that birth plan with you and we can do it.” Then they said, “We also give you an epidural. You'll birth in a birthing room, then we'll transfer you to an OR. You'll have an epidural, and that's in case anything goes wrong.” I fully understand the risk and the why behind that, but given with my first baby, one of the interventions was the epidural and I labored on my back, I wasn't quite confident that was the way baby and I were going to do this because what I found in my second birth is me and baby working together and moving together was what, I think, was all of the difference in the world for us to be able to meet each other. That gave me a little bit of pause, but nonetheless, I was like, “Okay. They are being upfront with me about all of the things I need to do.” I had the anatomy scan. Rump to head ratio was 1:1. It looked great. They were scheduling this MRI for me to take. Now, keep in mind, I'm 38 weeks pregnant now. The other things I was concerned about, or more my husband I should say, was that San Francisco, like I said, is about an hour and 20 minutes away from me. With traffic, it can be 3+ hours. Julie: Oof. I've driven in San Francisco during traffic and let me tell you, it is a nightmare. Katie: Yeah. My husband was like, “What if you don't get there in time? How are we going to make this work?” These were all pauses that we had around it. Nonetheless, we were on this track and UCSF was so helpful and wonderful. I'm so grateful for my provider for recommending this consult. Then my doula, as well as other providers, started sharing information with me. I want to say it's an underground network of knowledge where people aren't advocating for vaginal birth on the record because either the hospitals don't want to or don't condone it for whatever reason. I guess you can guess the reasons whether it's money or policy or education and patriarchy, but there is definitely a need. Breech babies are born all of the time. They said, “There are three providers at that sister hospital (that my doctor had initially recommended that was 15 minutes away) who are experienced with breech.” I thought, “Okay. In the event of an emergency and I went into labor, that's where I want to go.” They had a NICU. They had all of the things that made me want to feel more at ease knowing that we were doing something new to me and to keep myself and my baby safe. I still told the UCSF doctors, “Don't worry. I know I'm 38 weeks, but my other babies came at 40 weeks and 1 day, so I've got 2 weeks. He's cooking for 2 more weeks.” Then, at 38 weeks– Julie: Third babies, man. Third babies. Katie: Right? At 38 weeks, 4 days, I wake up. I should say, sorry. The UCSF doctor also said one other thing to me. She said, “Please do one more ECV, and this time, do a spinal.” I was like, “Ugh, this sounds awful.” But I understood the rationale. The safest way to come out was head down. I wanted to compromise and do everything in my power to do that. She said, “Because they hadn't done a spinal previously, there's data that shows it's more successful.” She shared all of that research with me, so I requested that from my local doctor. My doctor was like, “We don't usually do this,” but to their credit said, “We will. We will absolutely do it.” Keep in mind, I went in. I was like, “I know that this baby is loving where they are at. They are not moving, but if I don't try it, I'll never know.” Knowing the risks of ECVs, and knowing all of these things, I did do that because it was a request of the hospital that was going to be potentially the hospital where I give birth, so I wanted to make sure to follow all of the things. I do that. It was also unsuccessful. Then, now fast forward to 38 weeks and 4 days, I wake up and it's been a couple of days since that ECV. The spinal they give you is on your back. I wake up and I have some stomach cramps. I thought, “Man, this is strange, but it's probably from the ECV,” because in the past, it did cause some cramping for me. Because I had the spinal, I wondered if perhaps it just was residual. In my past labors, all of my laboring started with my back. I had a little bit of back aching, but it was again, I chalked it up to the spinal and just recovering from that. I went about my day. It was right before Halloween. I'm telling my partner, “Let's carve pumpkins.” My 5-year-old had a soccer game. I'm trying to get him ready, and I keep getting these cramps. They start to be regular. I thought, “Oh.” I'm 90% sure I'm in labor. This labor just felt different. Maybe it was because it was a breech baby. Maybe it was because it was a third labor, who knows? But nonetheless, it took me a while to get there. Maybe I was thinking it wasn't happening and willing that 40-week mark. Nonetheless, I was laboring. I texted my doula, and I'm timing my contractions. We had agreed that she would come over earlier this time because the baby was breech. All of the doctors said, “Labor at home. Come in during active labor.” We agreed that I would come in earlier than I did last time because of the circumstances. She comes over. She says, “Where I'm laboring, if the contractions are feeling intense, however, I can talk and laugh in between them,” so we agreed that I might be 5 centimeters. I just started to think, “I've got to lie down. I feel super tired. I had this ECV. I want to keep my energy up,” thinking this could be a long labor. Let me eat something. Then she says, “Just go. Sit on the toilet because your body does something different.” I do that. It's 1:00 in the afternoon now, and my water breaks. My husband was packing the bags to get to the hospital thinking, “Where do we go? Do we go to UCSF? Do we go to that sister hospital?” I say, “My water is broken.” I have another contraction. She's watching it. She was like, “We've got to–”, and I started to feel nauseous which are all signs of labor. Julie: Good signs. Katie: Yes, so she was like, “Let's go. Let's go now.” We get in the car. I think this is funny. It's a little on the side, but my husband had set up the car seat right behind me. I'm laboring. I'm definitely contracting and trying to retract my seat. There is this car seat, so I just remember picking it up and tossing it across the side saying, “Why would you set this up here?” He's looking at me, “Oh, you are really in labor. This is clear.” I'm trying to lay down. He has the GPS set. I am in the car. We get going. It's now between 1:00 and 2:00 on a Saturday. There is a ton of traffic and construction. I'm looking at the GPS and I see 25 minutes to the sister hospital, and to San Francisco was 3 hours. We don't have 3 hours. My doula says, “Where are we going?” I say, “That sister hospital. Let's go.” I also happen to know that there are three doctors there through that grapevine and underground network who are experience at delivering breech babies there, so I thought the odds of me having one of them would be beneficial. I would much rather have had conversations with all of them, but I didn't plan to go there thinking I was going to go to UCSF. We get in the car and are driving in this traffic. I'm just looking at the GPS and at the time ticking down. I'm really quiet which was also strange because with my other births, I was super vocal. My husband and I were thinking, “I'm in labor, but maybe I'm just not as far along, even though my water broke.” I've never been quiet. I was dead silent through this whole thing just staring at this GPS. Then all of a sudden, we're going on a bridge called the Causeway and I looked at him, and I said, “I have to push right now.” Julie: No. Katie: He looks at me and says, “No,” which is not very much– he's a very supportive person. What he meant by this was that we didn't come this far to get this far. We're going to get to this hospital. We are driving, and I just remember internally that I was so quiet going inward. I was talking with my baby, talking with myself and saying, “Okay. We've got to get to the hospital. We didn't come this far to get this far. I'm not having a baby breech unassisted delivery.” That was not something that I was comfortable with. We get off the off-ramp, and we're finding the patient drop-off. I'm contracting and I see the sign, and my husband drives right by it. I look at him right after I contract and I say, “You drove right by the patient drop-off. You have to put on hazards. I have to get out now. I have to push.” He's like, “I can't. We're parking.” So he parked the car, and I was like, “What do you want me to do?” He says, “We've got to walk.” Keep in mind, the parking lot where he went is not right next door. It's a block and a half or two blocks away.Julie: No way.Katie: I just was like, “I can't do this. I can't do this.” He says, “Yes, you can. Yes, you can. You have got this.” So I was like, “Okay. I've got this.” I get up, and I walk. When I start contracting, I'm walking down this busy street. I said, “I have to poop.” I had this big contraction, and I think I possibly poop. I'm just looking at these cars thinking, “Why won't somebody stop and help me?” That's when I channeled back to this idea, at the end of the day, It's just you and your baby. You are the team. I contract. We are going. We finally get to the hospital. I have another contraction. I say, “Run in and tell them to help.” He does. I'm holding on to the railing. This lovely woman with her family sees me. She tells her 13-year-old son, “Get her!” I was standing by myself, definitely in labor.” She says, “Get her a wheelchair!” This amazing 13-year-old does just that as my husband runs back. He gets me this wheelchair. I'm sitting in it, but I can't sit down. Again, I think it's because I've had this bowel movement and maybe I'm in transition. I don't know. We get up and pass security, so security is yelling at us. My husband was like, “I've got to go. We've got to go.” We got to L&D and came in. This amazing nurse midwife welcomes us. I don't know if she saw me not sitting down all of the way in my wheelchair or what, but she yells, “Get her a room right now.” She says, “We're going to deliver this baby.” I say, “My baby is breech. Can you help?”She says, “Call this doctor.” My heart is so relieved because this is one of those three experienced doctors who I know is comfortable with breech delivering. He scrubs out of a C-section, I guess. She helps me take off my pants, and then realizes what I thought was poop was really– it's called rumping as a breech instead of crowning. She was like, “Change of plans. Get on all fours.” I just started laboring. The doctor comes in scrubbed out of that C-section. I know that the nurses are saying, “You're doing great. You're going to meet your baby,” and all of the things that are so wonderful. I couldn't speak more highly of the people in that room at that point. My doula joined us because it took her a minute to find us in all of the mayhem. He tells my partner, “Please make sure she goes on her back.” I had this vision of doing breech without borders on your hands and knees, but given that this doctor was very experienced with breech delivery through this underground network of knowledge, I was like, “Okay. We didn't come this far to get this far. I'll do whatever you want. Let's just see this baby.” I turn around after, my husband said, my baby was halfway out. He sees the legs drop which again, in a frank breech position, that happens. You see the rump, and then you see the back and the legs drop. He sees the rest of the body come out as I'm laboring on my back which I didn't do with my first. I wasn't actually, I didn't know if that was something my body was down for. But here I was delivering this breech baby. Of course, I should have known. Women are amazing. We do amazing things, and our bodies are built for this work. I labored, and then I felt him come out completely. I held my breath for a second because what I do know, and excuse me if this statistic isn't 100% accurate, but my understanding is that 1 out of 7 babies born head down might need resuscitation, but 1 out of 3 babies born breech might need resuscitation. So one of the things I was pausing for at this moment was to hear this sweet baby's voice, and so I just start hearing crying immediately. They tell me that his APGAR score was 9/8 which was exactly the same as my first VBAC. Julie: That's great!Katie: Yeah. They were like, “Baby is great. Baby is healthy.” They put him on me. I was trying to feed, but my cord was short, so low and behold, I have a feeling that the reason he was not interested in turning is because my cord was kind of short. He just was sitting fine where he was at with my posterior placenta up high. He and I sat and met each other. We celebrated. The doctor was so funny. He said, “You keep it interesting. You've had every kind of birth you could possibly have.” Julie: You keep it interesting. Katie: Yeah. Every type of birth you could possibly have. The nurses came in after. They said they wanted to come in and watch because they don't see this. They said, “This is amazing. We wanted to respect your privacy.” But they were so supportive of the whole thing. I just felt elated to have the people in the room and around me who believed in me and my baby as much as we believed in us to make it happen. I should say that I came in at 2:10 to this hospital. I delivered at 2:24. When I say it was fast and this was going quickly when all of those things happened, I wouldn't recommend any of those things. However, I think that advocacy and all of those things like knowing all of the data made me feel prepared to do that. That's my breech delivery story. Julie: I absolutely love that. I love that. I was like, “Aw, dang. Too bad she didn't have her baby in the car.” No, I mean that would not have been ideal for you, but it is a dream birth of mine. I mean, I would have loved to have my own baby in the car. It would have been amazing. I love the stories. One day, I dream of documenting a car delivery, but alas, here I am still waiting. But it's fine. Here's the cool thing. I really love how you navigated your birth. You sought out all of your options. You made a choice that you were comfortable with. You heard the risks that the doctors were telling you about. You acknowledged them, but you also stood up for yourself and your plan. I feel like when you can have that mutual respect where you can trust your provider and your provider can trust you, I feel like that's a great place to be. I love how you adapted and changed plans when needed, but you still stood firm for the things that you wanted. It doesn't always work out like that when you have to change plans, but I love that you had the plan and you navigated it with the twists and turns and all of the things that come with the unpredictabilities of birth. I love how you did all of that. I think it's really important and necessary to have strong opinions about how you want to birth. Like I said before, it doesn't always mean that the strong opinions that you have are going to hold true about what you actually end up getting. I think that the value in having those strong opinions about birth is the things that you learn along the way and the things that enable you to navigate through those changes of plans and things like that. I think that's really, really important for us to be able to have and do and be flexible. I do have a few different blog articles on our website related to breech babies. Now, there's one that is just recently published. It was a few months ago. Well, maybe it will almost be a year ago by the time this episode airs. It talks a lot about ECVs, the external cephalic version, in order to try and manually flip a breech baby. It talks about what ACOG recommends and ACOG's stance on it, things you can do, who is right for it, what may exclude you from having an ECV or attempting one and all of those things. It talks about the safety for VBAC and how it's performed, what it feels like, and all of those things. If you ever want to know about ECV, we have a blog for you. It's called ECV and VBAC: What you Need to Know. It goes into all of that stuff. I definitely recommend looking into it because like we said before, you don't really know your options until you have them, and the more information you have in your arsenal, the easier it's going to be for you to navigate those things. Basically, ECVs are pretty safe for most people. They have a success rate of 60% which is a really cool success rate. It's higher than 50%. You're more likely for it to work than not. Sometimes babies are breech for a reason, and they need to stay that way for some reason. There are really only a few things that exclude you which is excessive vaginal bleeding, placenta previa or accreta, if you have really low levels of amniotic fluid, fetal heart rate issues, if your water's already been born, sometimes providers won't do it that way, or if you have twins or multiples, I think that excludes you. It's listed here, and it makes sense. We've got lots of babies tangled up in there. It's absolutely safe for VBAC as well. We also have a couple more blogs about why babies go breech and some things that you can do about it. I'm sure, Katie, you probably tried all of these things, all of the Spinning Babies protocols, all of the forward-leaning inversions and things like that too that can help. There's another article in here about how to turn your breech baby– 8 ways to flip your baby. Like we said, sometimes babies are breech for a reason and they do not want to turn. I'm just really looking forward to the day where breech can be just a variation of normal again. The biggest problem is that our providers are not learning how to deliver breech babies. It does take a different skill in order to do that. You have to be really hands-off. You have to watch for certain things and depending on the type of breech, there are different techniques that you would use. Those techniques are not being taught. Kudos to your original provider who admitted that they were not comfortable or did not have the knowledge to feel comfortable in delivering a breech baby. I'm excited there are organizations called Reteach Breech, Breech Without Borders, and Dr. Stu. If you know Dr. Stu, he is leading a great mission to bring breech back so that women can have options for delivering their breech babies. So what happens if you don't know your baby is breech and your baby is delivered foot first? You can't just stop and go for a C-section right then. It's impossible. So to deliver breech babies safely no matter the circumstances, the knowledge there is important. I'm hoping that one day, that can be an option for anybody if they want that. All right, Katie, I'm so glad that you joined me today. It was so great hearing your story. I love how it all went. I do not pity you having to drive in San Francisco at traffic time. Yeah. I'm glad everything worked out. Katie: We ended up going to this other hospital closer. Julie: Yeah, yeah. But I mean just ever, not even in labor. Just ever. Katie: Yes. Yes. Julie: All right, Katie. Before we sign off, will you tell me, what is your best piece of advice for somebody preparing for a VBAC?Katie: Oh, I think it is so important to do two things. One, educate yourself and surround yourself around folks who are down with that education and believing in you and baby. What I mean by that is knowing what's happening so you can make those important decisions. You understand what consent looks like. You understand those risks. You understand all of the tips and techniques like in this case of breech and turning that baby, and then making sure that you also are advocating and you have people around you who are advocating, but not so stuck on that that you get stuck. You want to do what's best for you and the baby, but as you said, breech is a variation of normal. I think that being around people who are supportive of you, they don't necessarily have to agree with you, but they are working with you, is just so important to empower you because at the end of the day, it's you and baby doing the thing. People who believe in you as much as you believe in yourself and you believe in your baby are so important to get to that finish line in labor. Julie: Yes. I absolutely love that. You have to have people who believe in you and who are on your side and who will support you even if they don't necessarily understand your decisions. They trust you to make those decisions because that is a huge deal. Katie: And give you the information so that if the information you have is not full or complete, you can reevaluate. You don't know what you don't know until you know. I just think that you need to make sure you take it all in if you can unless you don't know your baby is breech and you find out when you are delivering and you make that snap decision, and it'll be great. Julie: Yes. No, I love that. There's something about people bringing you information especially in a respectful way because I feel like in today's world, when people disagree with others, it's very aggressive and condescending and judgmental. I think it's important that we can disagree respectfully but also bring information if you are concerned or if you have another point of view in a respectful way as well. I think it's received a lot better and I think that's where we can really bring that true change and sway people's opinions. It's if we do that in a respectful and understanding way. Yeah, I appreciate that. Good point, Katie. That was awesome. Okay, well thank you so much for sharing your story with me today. I cannot wait for the whole world to hear it. Katie: Thanks so much for allowing me the space to do it. I hope that women are able to explore their options and do what's right for them and their baby and their families. Julie: Yeah. 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

Happy New Year, Women of Strength! Meagan and Julie share an exciting announcement about the podcast that you don't want to miss. While they chat about topics to look forward to this year, they also jump right in and share stats about cervical checks and duration between pregnancies. We can't wait to help you prepare for your VBAC this year!Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: Ready? Meagan: Happy New– Julie: Oh, are we supposed to say it together? Oh, sorry. Okay, I'm ready. Let's go again. Meagan: No, you were just saying okay, but let's do it together. Okay, ready? Remember I did this last time? Julie: Okay, 1, 2, 3– Meagan and Julie: Happy New Year!Julie: No, it was not right. Meagan: Well, we're going to leave it. You guys, we've been trying to say Happy New Year at the same time. There is a delay, I'm sure, on both sides, but Happy New Year, you guys. Welcome to The VBAC Link. It is 2025, and we are excited for this year. Oh my goodness. Obviously, you have probably caught on that there is another voice with me today. Julie: Hello. Meagan: I have Julie. You guys, I brought Julie on today because we have a special announcement. I didn't let her get away for too long. I didn't want her to go. I couldn't. If you haven't noticed, I've been bringing her on. I'm like, “Can you do this episode with me? Do you want to do this episode with me? Do you want to do this episode with me?”And now, at least for the next little bit, she's going to be doing her own episodes. She is helping me out. Julie: Yeah. Meagan: We have been doing two episodes a week for almost a year now, and it's a lot. It's a lot. Julie: You have been such a champ. Meagan: Oh my goodness. So that's what we've been up to. I decided that Julie needed to help me. She was so gracious to say, “Yeah, I'll do it.” Get this, you guys. She was nervous the first time. Julie: I was like, “I don't know what I'm doing.”Meagan: But she totally does know what she's doing. But yeah, so you will be hearing every so often Julie's voice solo. She is going to be hosting the show solo, so you will be hearing a little bit of a new intro with her and I where we are both talking so you don't get confused, but I don't think it is very confusing. Julie has been with us since the very beginning because her and I created the company. It's been so fun to have her here, so thank you, Julie, for helping me out. Julie: You are always welcome. It's always a pleasure. Meagan: I'm trying to think. I want to talk about 2025 and some things that we have coming up as far as stories go. As a reminder, if you have not subscribed to the show, please do so. As you subscribe, it will send you the episodes weekly. Right now, like I said, we are doing two a week, so soak it all up. We have so many great stories. We have stories from OB/GYNs. They are doing Q&As. We have polyhydramnios. Julie: Polyhydramnios. Meagan: Yes. I always want to say dramnios. We are going to be talking about that because we have a lot of people who have been asking about more unique things. Poly is not necessarily unique, but it's not talked about, so we are going to talk about the high fluid, low fluid, unsupportive providers, and if you have been with us for a while, the biggest thing that we talk about is supportive providers. Julie: Mhmm.Meagan: Maybe it's not the biggest, but it's one of the biggest. We talk about finding a supportive provider all of the time. It is so important. Then we've got vaginal birth after multiple Cesarean, twin births, gestational diabetes, PROM– if you're new to that one, that is premature rupture of membranes meaning that the waters break, but labor doesn't quite kick in. Whave else do we have? We actually are going to do some re-airing. We are going to rebroadcast some of our older episodes that we just think are gems and wonderful or have connections with people like Ali Levine. She came back on recently and we want to bring back her episode. Dr. Stu– just some really great episodes from the past and thinking about how long ago that was, Julie– Julie: Oh my gosh. Meagan: As I've been going through these podcasts, holy cow. Some of these are in our 70's or there was actually one that was out 17th episode or something like that. Julie: We need to re-air the dad's episode. Do you remember that one time when we had all of those dads on? Meagan: Yes. Julie: That was so good. Meagan: That was so good. It was a lot of fun. Julie: You need to put that in a spot. It was so good. I remember, I can just be taken back to us in the studio recording and calling each of these dads. It was so cool. Meagan: It was. It was really fun to hear their take on it and their opinion of doulas, their opinion of VBAC, their opinion of birth and how they were feeling going into birth, and how they felt when their wives were like, “Hey, I want to do this.” Yeah. Do you know what? That's for sure. We will make sure that is re-aired as well because I do know that we get people saying, “Are there any episodes that can help my partner or my husband?” because they want to really learn how to get the support for them or help them understand why. Or Lynn. Guys, there are so many of these past episodes that we will be bringing back. Julie: Lynn's episode was so great. Meagan: That was so great. We're going to be having home births. Forceps– VBAC after forceps or failure to progress or failure to descend or big baby. We've got so many great things coming this year, so I'm really, really excited. I also wanted to share more about what we've going on the blog. We have had weekly blogs, so if you haven't already subscribed to our email list, go over to thevbaclink.com and subscribe. We send out weekly emails filled with tips or recent episodes. We have a lot of questions in The VBAC Link Community on Facebook. We see some repetitive questions in there, so we respond to those via email. Those are really good. We've got cervical checks. When is it good to do a cervical check? When is it not good? Julie: Umm, never? Meagan: When is it not good to do a cervical check? When are they really necessary? What do they tell us? We're going to be diving into that. We have a blog about that. Do you want to talk about that for a second, Julie? Let's talk about that. Julie: Okay. I understand that there is nuance. That's the thing about birth. There is nuance with everything. There is context with everything. It just reminds me of the recent election and things like that while we are recording. There are all of these one-liners are being thrown around on both sides. One sentence can be taken out of context in big ways when you don't have the context surrounding the sentence. For both sides, I'm not pointing fingers at anybody. I'm sorry if that's triggering for anybody. I know there are a lot of people upset right now. But the same thing with cervical checks. Isn't that true with all of life? All of life, all of birth, and all of VBAC, there is nuance and context that's important. I would say that most of the time, most of the time, cervical checks are not necessary. They only tell us where you've been. They don't tell us where you're going. They are not a predictor of anything. I've had clients get to 8 centimeters and not have a baby for 14 hours. No kidding. I've had clients push for 10 hours. I've had people hang out at 5 centimeters for weeks, then go into labor and have the baby super fast and also super slow. It doesn't tell us anything. However, there are times when it might be helpful. I use that really, really carefully because it can only give us so much information. I feel like sometimes the cervix can swell if you've been in labor for a really long time, or if the baby is in a bad position, so if labor has slowed or hasn't been progressing as much as expected– and I use that term very loosely as well. There might be a suspicion for cervical swelling. Having a cervical check can confirm that, and having a swollen cervix will change the direction of your care. I would say that maybe an important question to ask– and this is a good question for any part of your care– is, “How will this procedure, exam, intervention, etc. influence my care moving forward?” Because if it's not going to influence your care moving forward at all, then is it necessary? Meagan: Why do it?Julie: Right? So, a swollen cervix, maybe checking baby's position. You can tell if baby's low enough. You can see if their head is coming asynclitic or with a different type of presentation. Again, with a suspicion that it might be affecting labor's progress.Meagan: You can check if they are asynclitic. Julie: But, how would your care change if you find out that baby is asynclitic? What would you do if that is the result of the cervical check? If the answer is nothing, then I don't know. But also knowing that baby's position or knowing that you have a swollen cervix, there are things that you can do to help labor progress in the case of a malpositioned baby or for a swollen cervix. First of all, back off on Pitocin or take some Benadryl or things like that that can help with those things. But honestly, I think most of the time, cervical checks are another way for the system to chart and keep records, that they are doing their job, that things are happening normally (in air quotes, “normally”) so they can have their backs covered. It's really funny. There are other ways to tell baby's position. There are other ways to notice. Midwives, especially out-of-hospital midwives know all of these things. They can gather all of this data without cervical checks, without continous monitoring, and all of that stuff. But in the hospital setting, they can literally sit at a desk and watch you on the strip. That's the only way they know how to get information. They don't know how to palpate the belly. They aren't as familar with– I mean, probably nurses more so than OBs. Meagan: Patterns. Julie: Right? Labor patterns, the sounds, how mom is moving her body and things like that. Those are all things that you can use to tell where a laboring person is at in their labor without having to do cervical checks. But anyway, that was a long little tangent. Meagan: No, that's good. I love that you are pointing that out. Is it going to change your care? If you are being induced, a lot of times, they are going to want to do a cervical exam. You may want a cervical exam as well so you can determine what induction method is going to best fit your induction. Julie: Yeah, that's true. Meagan: Like starting that, but even before labor, I want to point out that when it comes to cervical exams, I see it time and time again within the community, within Instagram, within Utah here– we have birth forums here in Utah– I see it all of the time. “I am 38 weeks. I got checked to day. I am not dilated. It's not going to happen. My provider is telling me that my body probably doesn't know how to go into labor and that I should be induced or that my chances of going into labor by 40 weeks (that's a whole other conversation) is low because I'm not dilated yet at 38 weeks,” or they are the opposite and they are like, “I feel like I can't do anything because I'm walking around at 6 centimeters.”Then they don't go into labor. Julie: Baby will come right away as soon as labor starts. Meagan: Yeah, or the person who has been walking around at 38 weeks, 39 weeks, 40 weeks, 40.5 weeks at 0 centimeters has their baby before the person who has been walking around at 6 centimeters. It really doesn't tell you a whole lot other than where you are in that very minute and second that you are checked. Now, if it is something that is going to impact your care, that is something to consider. Also, if it's something that's going to impact your mental health, usually it's going to be negatively. Sometimes, it's positive, but I feel like we get these numbers in our head, and then we get them checked and– Julie: You get stuck on it, yeah. Meagan: You get stuck on it which is normal because of the way that we have been taught out in the birth world. Think about it also mentally. Is a cervical exam in this very moment to tell you where you are right now worth messing up your mental space? Maybe. Maybe not. That's a very personal opinion. But really, it's so important to know that cervical exams really just tell you where you are right now. Not where you're going to be, not where you're going to get– Julie: And not how fast you're going to get there either. I do not trust babies. I always say that. I do not trust babies. Meagan: You don't trust babies? Julie: They have a mind of their own. They are so unpredictable. Yeah, I don't trust them. I'll trust them after they are born, for sure. But before, no way dude. They trick me all of the time. I really appreciate how you brought up the induction thing because I feel like a cervical check at the beginning of an induction and after a certain amount of time that the induction is started is helpful information because it tells you where you started from. It tells you if the induction methods that they are using are working. I feel like that's helpful to know because you don't want to sit there with an induction method forever if it's not working. I feel like also, why the induction is being recommended is important too. If baby needs to come out fast because something is seriously wrong, then more frequent cervical checks or a more aggressive induction may be needed. But if it's something that you can wait a few days for, then is the induction really necessary. But that's really the context there too. Context and nuance, man. Meagan: Yep. I also think really quickly before we get off of cervical exams that if you are being induced, a cervical exam to assess if you are even in a good spot to induce, assuming that it is not an emergent situation where we have to have this baby out right now. You are like, “I want to get induced,” then you are maybe half a centimeter. Julie: The BISHOP score, yeah. You are low and closed and hard. Meagan: You're maybe 40% effaced. You're really posterior. You guys, that might be a really good indicator that it's not time to have a baby.Julie: Right. Meagan: There we go. Okay, so other things on the blog– preparing for your VBAC. We talk about that a lot. We also talk about that in our course, on the podcast, in the community, on Instagram, and on Facebook. That's a daily chat. We have blogs on that. Our favorite prenatal– you guys have heard us talk about Needed now for over a year. We love them. We truly, truly believe in their product, so we do have blogs on prenatal nutrition and prenatal care. What food, what drinks, and what prenatal you should take. Then recovering from a C-section– I think a lot of people don't realize that our community also has a whole C-section umbrella where we understand that there are a lot of different scenarios. Some may not choose a VBAC which is also a blog on how to choose between a VBAC and a Cesarean. They might not choose a VBAC or they might go for a VBAC and it ends in a repeat Cesarean, or they opt for an elective Cesarean. These are situations that lead to recovering from a Cesarean. We have blogs and a section in our course, and then we even have a VBAC– not a VBAC. Oh my gosh. I can't get Facebook and VBAC together. We have a CBAC Facebook group as well called The CBAC Link Community, so if you are somebody who is not sure or you maybe had a Cesarean or you are opting for a Cesarean, that might be a really great community for you. I believe that it's an incredible community. Let's see, the length between pregnancies is one. Do you want to talk about that?Julie: Oh my gosh. I see this so much. Meagan: Daily. Julie: People are asking, “How long should I wait? I want to have the best chances of a VBAC. How long should I wait before getting pregnant?” Or, “My doctor said I have to have 18 months between births and I will only be 17 months between births so it excludes me from VBAC.” Meagan: Well, and it gets confusing. Julie: Yes. It does get confusing. Meagan: Because is it between or is it conception? What is it? Julie: Right. Is it between births? Is it between conception? Is it from birth to conception? Birth to birth? Conception to conception? I don't think it's conception to conception, but thing is that everybody will have their thing. I hear it really commonly 18 months birth to birth. I hear 2 months birth to birth quite a bit. Meagan: 2 months? Julie: Sorry, 12 months. Meagan: I was like 2? I've never heard that one. Julie: 12 months birth to birth. Oh man. Meagan: 24 months. Julie: I need some caffeine. 2 years, not 2 months. 2 years between births. Meagan: 24 months. Julie: There are a whole bunch of recommendations. Here are the facts about it. The jury is still out about what is the most optimal time. There is one study. There are three credible studies that we link in our blog. There are three credible studies. One says that after 6 months, there's no increased risk of uterine rupture. So 6 months between– I'm sorry. 6 months from birth to conception. Meagan: Birth to conception. Julie: So that would be 15 months from birth to birth. There's another study that says 18 months from birth to birth, and there's another study that says 2 years from birth to birth. These are all credible studies. So, who knows? Somewhere between 15 months to 2 years. I know that the general recommendation for pregnancies just for your body– this is not talking about uterine rupture– to return to its– I wouldn't say pre-pregnancy state because you just don't really get back there, but for your body to be fully healed from pregnancy is a year after birth. From a year from birth to conception is the general recommendation. But we know that there is such a wide variety of stories. There is a lot of context involved. There are providers who are going to support you no matter your length. This is circling back to provider choice and why it's so important. If one provider says, “No,” and they want 2 years from birth to birth, then bye Felicia. Go find another provider because there is someone who is going to support you. There is someone who is going to do it rather than be like, “Oh, well, we will just let you try.” They are going to support you and be like, “Yeah. Here are the risks. Here is what I'm willing to do, and let's go for it.” I think that's really important as well. Meagan: Yeah, this is probably one of the most common questions. Sorry, guys. I was muted and chatting. It's one of the most common questions, and like she said, there are multiple studies out there. It's kind of a complicated answer because it could vary. Overall, the general studies out there are anywhere between 18 to 24 months. 24 months being what they are showing is probably the most ideal between birth to birth. A lot of people out there still think that it's birth to conception, so they have to wait 2 years before even trying to get pregnant. Then I mean, I got a message the other day from someone. They were like, “Hey, our hospital policy,” which I thought was interesting– not that she was saying this, but that it was a policy. “Our hospital policy is that if I conceive sooner than 9 months after a Cesarean, they will not accept me.” Julie: Boom. Go find another hospital. Meagan: I was like, okay. That's weird. Julie: I know. Meagan: And that's 9 months, so that would be 18 months from birth to birth. Julie: Right. Meagan: Then you can go to another provider, and they're different. This is my biggest takeaway with this. Look at the studies. We have them in our blog. They're there. Look at them. Tune into your intuition. What do you need for your family? What do you want for your family? What feels right for you? Julie: Yeah. Meagan: I mean, we have many people who have had VBACs before the 18th-month mark. Aren't you 15 months? Julie: No, mine was 23 months birth to birth. Meagan: Oh, birth to birth. Okay. I thought you were a little sooner. Julie: I conceived, what was that? Meagan: Mine was 22 and 23. I was a 22 and then my other one was 23, I think. It was something like that. It was right around 2 years. Tune into what it is. Yes, we say this, and someone has said, “Well, yeah. People have done it, but that's not what's recommended.” Okay, that's true. Julie: Yeah, recommended by who? Recommended by who? Because like I said, three different studies have three different recommendations. What does ACOG say? I don't think ACOG even has an official recommendation do they? Meagan: My mind says 24 months. Julie: I think they say something like a pregnancy window doesn't automatically exclude somebody from having a VBAC. Meagan: Yeah. You guys, we have that. We also have stories coming up with shorter durations. We have epidural blogs, and how to choose if you want an epidural or not, and then what happens when an epidural comes into play. Maybe I need caffeine too. I can't even speak. But when they come into play, and so many facts, stats, and stories on the blog and on the podcast. You guys, it's going to be a great year. It's 2025. I'm excited. I'm excited to have you on, Julie. It's going to be so great. I'm excited to bring some of our really old, dusty episodes back to life. Julie: Polish them up. Meagan: Yeah. I'm really excited about that. And then some of the weeks, we've been doing this since October, I think, we've got some specialty weeks where it's VBAC after multiple Cesarean week, and you'll have two back to back. We might have some weeks like that in there that have similar stories so you can binge a couple in a row that are something you are specifically looking for. Okay, as a reminder, we are always looking for a review. Before I let you go, you can go to Google at “The VBAC Link”. You can go to Apple Podcasts and Spotify. I don't know about Google Play. I actually don't know that because I don't have it. Julie: I don't think Google Play has podcasts anymore. But also, you can't rate it on Spotify. Meagan: You can rate it, but you can't review it. Julie: Oh, yeah. You can rate it, so you can give it 5 stars. That's right. Meagan: If you guys wouldn't mind, give us a review. If you can do a written review, that's great. Honestly, you can do stars then go somewhere else and do a written review. We love your reviews. They truly help. I know I've said this time and time again, but they help other Women of Strength find this podcast, find these inspiring stories, and find the faith and the empowerment and the education that they need and deserve. Thank you guys for sticking with us. Happy New Year again, and we will see you soon. 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

As we enter 2025, I'm honored to be part of your life journey and spiritual path, especially as we head into a new year full of many unknowns.   I know that when you learn how to access and trust your intuition and higher self, life has a way of flowing, growing, and expanding with the divine that creates greater inner peace, connection, faith, and love.   In this conversation with Sara Landon, the renowned channel of The Council, I know you'll find great inspiration and comfort in what was discussed in this interview and the channeled message at the end, for 2025.   My prayer is that you lean in more deeply in the coming year to your inner strength, guidance, heart, and soul's calling. I've found the answers are always there within us, often at the bottom of fear and doubt.   If you'd like to join me for a more in-depth live experience of learning how to access your divine intuition and use it to create your best life and help others do the same abundantly, see below for further information.   Thank you for allowing me to be part of your life adventure is being your you-est you! May this coming year bless you and all those you are here to work with, impact, and touch.   If you want to stop waiting and take the next step to create a life of greater purpose, prosperity, passion, and power? Doors have opened (with a few spots left) to the 12th cohort of my Intuitive Life Designer® Coach certification (juliereisler.com/certification) and you still have to get $1000 off tuition if you enroll by January 1st!    Takeaways   Sara's journey to channeling began with personal loss and spiritual questioning. The experience of liquid love during her brother's passing changed Sara's perspective on life and death. Channeling was initially a spontaneous experience for Sara, evolving into a structured practice. Overcoming fear and judgment from family was crucial for Sara to embrace her calling. The council's teachings emphasize that everything happens for a reason and for personal empowerment. Affirmations play a significant role in recognizing self-worth and manifesting desires. Sara's experiences highlight the importance of authenticity in spiritual work. The transition from corporate life to spiritual work was filled with challenges but ultimately rewarding. Sara's relationship with her family evolved positively as she embraced her spiritual path. Living in alignment with one's purpose can lead to profound personal transformation. We are the powerful creators of our reality. Shifting perspectives is essential for transformation. Joy is a key component of allowing. Channeling is accessible to everyone. You are not your circumstances; you can change them. The importance of being present in the now moment. Your feelings contribute to the collective consciousness. Expect miracles and allow yourself to receive. Everyone has the ability to channel in various forms. You are everything you wish to be; it is all within you.     About Your Host, Julie Reisler Join Julie Reisler weekly, podcast host, intuitive coach, author, and multi-time TEDx speaker, each week to learn how to access your spiritual gifts and inner guidance to be your You-est You® and achieve greater inner peace, spiritual connection, happiness, and abundance. Tune in to hear powerful, inspirational stories and wisdom from spiritual luminaries, experts, conscious leaders, psychic mediums, and extraordinary human beings that will help to transform your life.    Be sure to subscribe to Julie's YouTube channel https://www.youtube.com/juliereisler and ring the notification bell so that you never miss a powerful episode!   Here's to your truest, You-est You!   Love, Julie   You-est You® Resources for YOU! See below for free tools, resources, programs, and goodies to help you become your YOU-EST YOU!   FREE Manifest Your Goals & Dreams 7-Day Toolset This stunning free toolset is a 7-day workbook (25 pages full) of powerful mindset practices, grounding meditations (and audio), a new beautiful time management system and template to set your personalized schedule for your best productivity, a personalized energy assessment, and so much more. It was designed to specifically help you uplevel your routine and self-care habits for success so you can radiate and become your ‘You-est You'. These tools are some of Julie's best practices used with hundreds of her clients to help you feel more confident, clear, and connected to your best self so that you feel inspired to take on the world. Get it at: juliereisler.com/toolset   FREE Intuition Assessment  Unlock your unique intuitive super-powers and discover your dominant intuition and language with the unseen. Take the assessment at juliereisler.com/intuitionassessment   Intuition Activation Mini-Course - 90% OFF! For a limited time only, get access to Julie's powerful transformative Intuition Activation mini-course for 90% off! You'll have lifetime access to this course that is full of video modules, worksheets, meditations, tools and practices to unlock your intuition and activate your inner guidance! Sign up now at https://juliereisler.com/activation    Join The Sanctuary Membership - Now Open! Join Julie's high vibrational sacred membership, an inner circle for conscious coaches, Lightworkers, and spiritual seekers, a spiritual oasis for change-makers wanting to make a bigger impact in the world. Julie will be leading bi-monthly live calls, including monthly psychic intuitive guided messages, and workshops teaching spiritual tools (like learning how to use a pendulum, muscle test, assess your chakras, open up your psychic abilities) to help you manifest what your heart most desires, manage your energy, develop your intuitive gifts, and connect more deeply with your higher self and spirit guides. Learn more and join now at https://juliereisler.com/sanctuary    You-est You Intention Cards Want your own powerful deck of 33 You-est You Intention Cards? These cards were channeled by Julie. Each card has an empowering intention and deeper questions to ask your ‘You-est You' for greater self-awareness, higher consciousness, and spiritual growth. You can get them now at https://amzn.to/45q14DJ.     Change Your Life Through Gratitude If you are looking for a powerful way to increase your gratitude quotient, prosperity mindset, and quality of life, check out my 15 Days of Gratitude To Change Your Life course. This course is only $47 and will change the way you view, everything! Enroll here: https://juliereisler.com/gratitude   Sacred Connection This community is a sacred, safe place built on love and acceptance. It was created to help you evolve and expand into your highest self. Please share your wisdom, comments, and thoughts. I love hearing from you and learning how you are being your truest, you-est you. Please join us in our FREE Facebook group: The You-est You® Podcast Community.   The Intuitive Life Designer® Master Life Coach Certification Program Are you eager to release self-doubt (for good) and have an intuition upgrade? Do you want to put your head on the pillow at night feeling calm and joyful that you are doing something really meaningful? Check out Julie's Life Designer Coach training. This world-class four-month virtual live coach certification program will give you proven tools, transferable skills, powerful techniques, practices, and the best methodology to be a powerful coach. This transformational coaching program is for aspiring and current coaches looking to fill in the missing pieces and gain real confidence and mastery in coaching. This program infuses integrative health modalities from a mind-body science, positive psychology, and healing arts perspective. To get on the waitlist and learn more, go to lifedesignercoachacademy.com. You-est You Resources & Links:

You can now sign up & take Suzanne Giesemann's ‘Mediumship & Mastering The Flow' Course on The Shift Network ✨

Have you ever wondered what your calling is, whether you have more than one, and how to find it? Or, how to meet your very own inner mentor?   If so, you'll love this episode!   My guest this week, Tara Mohr, author of Playing Big, and I dove deep into how to access your intuition and the power of skilled coaching to actualize your calling.   Spoiler alert: callings can evolve and usually involve a bit of healthy fear.

I could write a whole book on rejection projection, especially as it shows up with people pleasing and saying yes when you mean no.   My mind has been ‘glown' from the healing I've experienced in doing deeper shadow work and learning to own all of myself, including all the parts I've rejected.   My dear, if you've struggled with feelings of rejection (internally and externally), dealing with challenging people who trigger you, or turning against yourself in any way (which often shows up as autoimmune conditions and other ailments), this solo episode is a MUST listen.

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

As we enter a season of greater darkness and less light (for those of us in the Northern hemisphere), it is imperative to spend more time within, connect to your heart, inner pilot light, and the all loving Divine Mind.    This week's episode is with Lars Muhl, spiritual teacher and author of The God Formula and The Sacred Numbers of Initiation, and Naleea Landmann, healer and author of The Love That You Are.   It's all about how to experience divine communion and disappear fear and misconceptions about yourself that are untrue.    More about my guests:   Lars Muhl is an author, musician, therapist and inspirational speaker who since childhood has been connected to spirituality. In his own words: “Very early I had some powerful out-of-body experiences and glimpses into etheric realms which showed me that there is more to life than most people are aware of.” He studied the Aramaic language, esoteric Christianity and the mystery traditions of the Essenes and the Therapeutae for many years, but it wasn't before he started to work with the seer and healer Calle de Montségur, he realized that studying and reading only make up half of what is needed in order to realize our full potential. Only through genuine spiritual practice and experiences will we be able to fully understand that we are already Enlightened Beings. He has worked together with Naleea Landmann since 2017. She started as a translator of his German workshops. Later she edited, translated and contributed to his books The God Formula, The Light within a Human Heart, and The Sacred Numbers of Initiation. They co-write texts about the work and she filmed and produced many of the recent videos. Today they are doing talks, concerts and workshops together under the umbrella of Sacred Seed.   Naleea Landmann is a therapist, musician, author, actor and inspirational speaker. Since early childhood, Naleea had a strong yearning to connect with the Divine and understand the realities of this world and the universe. Her out-of-body experiences lead her to question “reality” already as a young child – her personal experiences as well as our path as humanity. Finding a way to express what she perceived and felt, she first started to use acting as a tool to communicate and reach people, as well as an opportunity to understand the ways of our personality structures. Her vision is to live within a world of heart-centered beings, who listen to their own guidance and share themselves and their gifts in joy, true connection and Divine communion. Her first book, The Love That You Are – Psalm 119 Meditations, is a guide and companion to enter into the I AM Presence through prayer. The paraphrased Psalm can be found as well in the book The Sacred Numbers of Initiation by Lars Muhl.     The prayer recited in this episode:  Psalm 119:89-96   "Heavenly Source of All Being,  I am Light, born within the Light.   89 Your word and wisdom are eternal; their echo fills the spheres of all Heavens. 90 I AM the faith passed on by the Mighty Ones;  the ancient glory of the Earth rejoices in all her splendor. 91 Now and forever, Your Light fills all existence,  and all things radiate Your Presence. 92 I AM the delight in Your wisdom,  it comforts and strengthens me at all times. 93 I AM the remembering of Your love;  it is the sacred breath of my life. 94 Your Presence is my belonging and my safety; I AM the enfolding of Your guidance. 95 If I face wickedness or destruction,  I open Your shield of peace. 96 I raise my senses into Your vibration; I AM the merging with Your boundless Light.”   About Your Host, Julie Reisler Join Julie Reisler weekly, podcast host, intuitive coach, author, and multi-time TEDx speaker, each week to learn how to access your spiritual gifts and inner guidance to be your You-est You® and achieve greater inner peace, spiritual connection, happiness, and abundance. 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What you're seeking ‘out there' is already within you, ready to manifest.   My guest this week, Nathalie Dorémieux, a brilliant tech wiz turned empowered female entrepreneur and coach, shares the faith and courage it took to change gears and listen to her intuition.   If you've been wondering whether it's possible to do what you love and overcome your fears of visibility and putting yourself out there, this episode is a must listen.   Nathalie and I also talk about the missing ingredient most forget about when going for their purpose and passion.   If you know someone who would get value from this podcast and email, please forward it to them!

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

In this special episode, we're changing things up with 5 incredible guests who joined me at our first-ever Inner Child Healing Retreat in Sedona, Arizona. Together with my co-healer Zoe, we dive into the life-changing moments that unfolded, sharing stories of healing, spiritual reconnections, and personal breakthroughs. Listen as these brave women share the impact of the retreat, from unlocking childhood memories to releasing suppressed emotions, and discover the power of nurturing your Inner Child. The Next Inner Child Healing Retreat is November 14-17th, 2014 and as of release date, there are only 6 spots left! Secure yours with one of the two links below:  Early Registration: Followed by 3-monthly payments.  Paid in Full: Which gets you a 1-hour session with Tami or Zoe during the retreat.  Show Notes: 00:51 - This week's special episode features 5 guests from our Inner Child Retreat. 02:36 - Special announcement for the next Inner Child Retreat. 03:26 - Welcoming Zoe, my co-healer, and sharing takeaways from the retreat. 08:42 - Meet the 5 amazing women who attended the retreat. 09:34 - What inspired these ladies to join the first-ever Inner Child Healing Retreat. 17:23 - Colleen's story triggers deep emotions and memories for Sarah. 23:20 - Karen's spiritual moment of reconnecting with her Inner Child. 29:50 - Lisa allows her Inner Child to be heard and validated. 34:19 - Julie identifies when her Inner Child began making decisions for others. 38:03 - Sarah's powerful release of years of suppressed anger. 41:05 - The transformation when your Inner Child and Ego trust you to heal. 41:35 - A group of young girls saves the day during a hike when morale dips. 44:47 - Karen releases shame and embraces self-love, impacting everyone. 49:19 - The healing power of being witnessed by others on your journey. 50:40 - Day two of the retreat: Activating the Highest Self and Sedona's energy. 54:40 - Colleen's transformative healing session experience. 58:00 - Tapping into your unique gifts during the retreat. 59:50 - Sarah's "Sedona High" and its lasting impact on her life. 1:01:25 - Julie's test to stay committed to her Inner Child during the retreat. 1:06:20 - Karen's challenge at work after returning from the retreat. 1:08:39 - The power of vulnerability in a safe, supportive space. 1:12:17 - How Karen integrated energy work with her Christian faith and recovery journey. 1:14:10 - Advice from the women to anyone curious about joining the Inner Child Healing Retreat: Lisa: “You are worth investing in yourself.” Karen: “Nothing is a coincidence. You're listening to this for a reason.” Sarah: “Follow your curiosity because it can change your life.” Julie: “You can't afford not to. It's the best investment you'll ever make.” Colleen: “Go on this journey so you can fully be YOU.” 1:22:33 - The sacrifices these women made to invest in their healing journeys. 1:24:10 - Zoe's wrap-up and final good-byes.  

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

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

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

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

Hello friends! Today we're diving into a powerful discussion that's all about staying true to your passion and leveraging it for growth in the ever-evolving online world. I'm thrilled to walk you through five transformative steps that I have personally used to resonate with, reengage, and profoundly impact my community. We'll discuss how these steps can expand your influence, skyrocket your audience, and establish you as a profitable global leader. I'll share strategies that will propel you, no matter your following or credentials. We're talking beyond the metrics—engagement, authenticity, and making your thoughts work for you, not against you. I'm also teasing the four common mistakes many make while trying to grow in this space and how to catalyze a shift in your approach with actionable insights to rekindle that initial spark, involve your prospects in creation, and respond to their needs with service and action. Get ready to shake off the struggle, embrace service-oriented strategies, and welcome a future-focused mindset for unprecedented success.  Liked this episode? Make sure to subscribe to our podcast and leave a review with your takeaways, this helps us create the exact content you want!  KEY POINTS: 04:04 Choose future over past for successful decisions. 06:18 Money enables impact and change in the world. 12:20 Influence, awareness, coaching for future business success. 15:19 Focus on purpose, future, consistency and support. 16:25 Influence leads to value and wealth. 19:59 Started with no purpose, strategy, followers, brand. 29:31 Connecting with your community creates meaningful relationships. 33:03 Encouraging engagement, seeking feedback, and building community. 35:23 A key step for growth, revenue and learning. 41:07 Create content aligned with your ideal prospect's passion. 42:51 Engage, reframe, request, respond - grow influence. QUOTABLES: “We don't need to be living and making choices and making decisions based on our past. We need to be making choices and decisions based on how we want our future to look like, to feel like in our lives and in our business." — Julie "The more that we have of it [money], the more that we can exchange and put more bountiful and abundant energy into the world." — Julie “You know, when you are able to relate to your audience or your community or your customer or your coaching clients, it has the potential to make both of you more connected and relatable to one another." — Julie “Step one, relate to your prospect. Step two, reengage with your prospect. Step three, reframe their thoughts by asking questions. Step four, request their support. And step five, respond with action in service." — Julie  RESOURCES: [WORK WITH ME?] I am creating a new done with you / for you offer to help you strategize and build out your offers for revenue growth! If you've been in business for a bit and you're ready to grow your revenue and brand authority, I'd love for you to take 5 minutes to fill out this form so I can tweak my new experience to meet your needs. And, if it looks like our upcoming case study cohort would be a fit, I'll have my team reach out to you!  [FREE] Are you a content creator ready to take your brand collaborations to new heights? Grab the Brand Deal Playbook and unlock the secrets to securing paid partnerships with confidence. You'll gain free access to pitch templates, essential questions, and expert strategies that will propel your content creator journey to new heights, including immediate and lifetime access! [FREE] Want the step-by-step roadmap to grow your following, monetize your content, and land paid brand deals? Click here to join my brand new free class! This is perfect for you if you want to turn your social media into a profitable & fun career… even if you're starting from scratch! [ORDER] my book or Audible, Get What You Want: How to Go From Unseen to Unstoppable so you can leverage the power of your own influence. Follow Julie on Instagram! Learn more about your ad choices. Visit megaphone.fm/adchoices

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

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

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

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

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

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

It's just the two of us, and we're talking about how to FEEL YOURSELF! We discuss ways to feel sexier for your partner, for your own damn self, when you're in a rut/on your period/just feeling blah, and more. We cover the “5 senses check” and everything from grooming to lingerie to spray tans to self talk. Before we dive into the topic, we're talking shit on Rayna's celeb nemesis (IYKYK), what we would do if we knew our best friend was cheating on their partner, and supporting friends who are battling an illness.  Follow us @girlsgottaeatpodcast, Ashley @ashhess, and Rayna @rayna.greenberg. Visit our website for tour dates, merchandise, and more. Shop Vibes Only. Thank you to our partners this week: Native: Get 20% off your first order at nativedeo.com/gge or use promo code GGE at checkout. ZocDoc: Go to zocdoc.com/gge and download the Zocdoc app to sign up for free and book a top-rated doctor.  AG1: Get a free 1 year supply of immune-supporting Vitamin D + 5 free travel packs with your first purchase at athleticgreens.com/gge.  Julie: You can go to juliecare.co to learn more or find Julie at your nearest CVS, Target, or Walmart today.

It's another episode about moneeey, and this time, we are joined by financial journalist and best-selling author Nicole Lapin to chat about money and dating – what someone's money style says about what kind of partner they'll be, red flags to look for on a date, how to approach awkward conversations about finances, handling salary disparity with your partner when it comes to rent, vacations, etc., and more. Plus, we're also tackling money issues with friends (like that one friend who never pays you back and why you shouldn't go in debt for someone's wedding). Before Nicole joins us, we are sharing our (and our listeners') wildest cheap date stories, debating another theory about breakup season, and chatting about how friendships change over time. Enjoy! You can now watch our episodes on YouTube! Follow Nicole on Instagram @nicolelapin and check out her podcast Money Rehab. Follow us on Instagram @girlsgottaeatpodcast, Ashley @ashhess, and Rayna @rayna.greenberg. Visit our website for SNACK CITY 2023 tour dates, merchandise, and more. Shop Vibes Only. Thank you to our partners this week: Pretty Litter: Get 20% off your first order at prettylitter.com/gge. Article: Get $50 off your first purchase of $100 or more at article.com/gge. Osea: Get 10% off your first order with promo code GGE at OSEAmalibu.com. Julie: You can go to juliecare.co to learn more, or find Julie at your nearest Walmart today.