Podcasts about nuchal

Send us a textWelcome to the July Q&A! Today, we kick off the show with a conversation about your experiences of unnecessary, frequent stressors that we have the power to change or eliminate: For Trisha, it's taking phone calls while grocery shopping. Next, we get into your questions, beginning with:Did taking folic acid in pregnancy cause my baby's tongue tie?Is having the cord wrapped three times around a baby's neck a legitimate reason for c-section?Is it true that I can't have a VBAC (vaginal birth after cesarean) if it has been just 18 months since my last birth?And in the extended version of today's episode, available on Patreon or Apple Subscriptions, we discuss:Intrauterine growth-restricted (IUGR) babies and whether induction of labor is the right choice. Also, whether or not a baby needs to be born by cesarean for too low or too high heart rates in labor. And finally, whether fundal massage is still needed even if you a woman is administered  Pitocin in the third stage of labor. As for Quickies, we covered many topics including: Post-breastfeeding bras, OP (posterior) babies, magnesium and pre-eclampsia, fetal ejection reflex with an epidural, supporting the perineum to prevent tearing, our top tip for a successful VBAC. As for the personal questions of the month, we share our favorite ice cream flavors as well as our favorite flowers. In Cynthia's case, she didn't know the name of her all-time favorite flower and had to text a friend urgently in order to answer the question. Just goes to show, some friends can know us just a little better than we know ourselves!**********Our sponsors:Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products for before, during, and after pregnancy. Use this link to save 20%DrinkLMNT -- Purchase LMNT with this unique link and get a FREE sample packUse promo code: DOWNTOBIRTH for all sponsors. Primally Pure: From soil to skin, Primally Pure products are made with down-to-earth ingredients that feel and smell like heaven for the skin. Promo code: DOWNTOBIRTH for 10% off. ENERGYBits: Get the superfood Algae every mother needs for pregnancy, postpartum, and breastfeeding. Promo code: DOWNTOBIRTH for 20% off. Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Watch the full videos of all our episodes on YouTube! Work with Cynthia: HypnoBirthingCT.com Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Send us a textWelcome to the June Q&A with Cynthia & Trisha. This month we kick things off with a conversation about a midwife who dropped her client in early labor because her HBAC labor was taking too long to get going--as you can imagine, we have a lot to say about this! Next we take your questions:One mom writes about her 3rd attempt at a homebirth after two hospital transfers and wonders if it is ok to keep her birth plans from her family with whom she is very close with. We also answer:My midwife told me I should do a cervical check at 36 weeks to help understand the baby's position and offer recommendations based on the findings. Is this really necessary? And, if a baby isn't breathing after a minute of being born and is still attached to the placenta, do babies need to be stimulated or is intervention required?In the extended episode, available on Patreon, we discuss vaginal birth with a nuchal hand, scheduling C-sections for planned VBAC at 40 week, and vaginal birth after a shoulder dystocia.Finally in quickies, we touch on spray tans while breastfeeding, induction vs cesarean, elastic nipples & pumping, third labors, length of umbilical cords, and our favorite seasons and candy (except Cynthia doesn't eat candy).**********Our sponsors:Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products for before, during, and after pregnancy. Use this link to save 20%DrinkLMNT -- Purchase LMNT with this unique link and get a FREE sample packENERGYbits--the superfood every mother needs for pregnancy, postpartum, and breastfeedingPrimally Pure: From soil to skin, primally pure products are made with down-to-earth ingredients that feel and smell like heaven for the skinUse promo code: DOWNTOBIRTH for all sponsors.Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Watch the full videos of all our episodes on YouTube! Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Send us a textToday, we interviewed first-time mum Rachel about the birth of her baby. Initially planning for private OB and hospital care, Rachel explored public hospitals and homebirth midwives before choosing a homebirth after watching Birth Time. She experienced PROM and prodromal labour, and during active labour, transferred to the hospital due to her baby's elevated heart rate. Rachel reflects on the challenges that followed, particularly hospital policy placing her baby in special care. She also opens up about her breastfeeding journey, which ended around 4 months postpartum with the return of her period, and discovering her baby had CMPI.Links:Birth Time Film RANZCOG - Homebirths Transfer to hospital in planned home births: a systematic reviewTen years of a publicly funded homebirth service in Victoria: Maternal and neonatal outcomes. Support the show@homebirthstoriesaustralia Support the show by buying us a coffee! Please be advised that this podcast may contain explicit language. Listener discretion is advised.The information, statistics, and research presented in this podcast are for informational purposes only and are not intended to constitute or replace medical or midwifery advice. All information discussed can be found online and is provided in the links in the show notes. It is always recommended to conduct your own research and make informed decisions. We advise you to discuss any topics or concerns with your healthcare provider. While we strive to incorporate the most up-to-date research in our episodes, we do not warrant or guarantee the accuracy of the information discussed on the show.

Nicole is a military spouse who had her VBAC in England. She shares what it was like to unexpectedly move overseas during pregnancy, how she navigated not receiving her household goods in time, and how she made the choice to deliver on base versus off. Nicole's first birth was a Cesarean during the height of COVID. During pushing, she was required to pause, take a COVID test, and wait an hour for the results or risk being separated from her baby after birth. Labor had gone smoothly up until that point, and Nicole knew something had changed after the pause. Things felt different, progress stalled, and ultimately Nicole consented to the Cesarean. Her VBAC was a surprisingly wild precipitous birth with only 2 hours between her first contraction and pushing the baby out! Meagan and Nicole discuss the unique challenges of precipitous births and how important it is to hold space for every birth experience. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello. Welcome to The VBAC Link. Today is Veteran's Day. If you are just joining us this month for the very first time, then welcome to your first specialized episode week. I don't even know what to call it. What would you call this, Nicole? I don't even know. Nicole: A one-of-a-kind situation. Meagan: Last month in October, we had Midwifery Week and now we have Veterans. Nicole is the wife of a Servicemember and she definitely and experience that I think a lot of military members and moms experience and people don't think about it. I don't think about that. When I was having my baby, it was like, Which hospital should I go to? There are 10-15 right around me. Then you're like, “Oh, hey. I'm pregnant and now I'm moving overseas.” You know? I think it's something that we just don't think about. It's fun to have it be Veteran's Day and to have a Servicemember's wife sharing your story today. We might even talk a little bit about navigating the military healthcare system and what choices you made. We learned a little bit about that before we started recording. We've got her amazing story today. Where are you right now?Nicole: I'm in England right now. Meagan: You are in England, okay. And that's where you had your baby. Nicole: Yes. Meagan: Awesome. So England mamas, definitely listen up for sure. All mamas, really. We do have a Review of the Week so I'm going to get into that then we'll start with your first story. This is from Roxyrutt and it says, “Inspiring”. It says, “Listening to these podcasts has been truly inspiring and I have been on my own hopeful VBAC journey. Listening to other stories has been incredibly helpful in my mental preparation.” We were just talking about that before we started recording as well just how impactful these stories can be for anyone but especially during your VBAC journey. It says, “My due date is April 17th this month–” so this is obviously a little while ago. It says, “I'm hoping to have my own VBAC story to share. Thank you all for what you do.” Thank you so much, Roxyrutt, for sharing your review. As always, we love your reviews. You can email them to us at info@thevbaclink.com or you can comment “Review” on your podcast. I think it's on Apple Podcasts, Spotify– I don't know if Google allows reviews. You might just have to do a rating. But wherever you listen to your podcasts, if you can leave a review, please do so. Okay, Nicole. Let's get going on your stories. I seriously thank you so much for joining me today. Nicole: Oh, thank you so much for having me. Like we mentioned before we started recording, this podcast has been extremely inspirational to me and it really led me to having the VBAC of my dreams. Meagan: And you had a precipitous VBAC, right? Did you have a pretty precipitous VBAC if I'm remembering right? It was 2 hours or something?Nicole: Yeah. It was so quick. Meagan: Okay. We are going to talk about that. Don't let me forget about that in the end. It is something that we don't talk about a lot. Most people think about birth being a long time. Nicole: Yeah. Meagan: Yeah. Precipitous birth can come out of left field and I want to talk about that. But first of course, every VBAC starts with a C-section so let's hear about your first.Nicole: Okay, yeah. So I had my first in June 2020 so literally right as the world was shutting down. Everybody was terrified with reason, right? I go in. I remember I had my baby shower planned and everything was planning and everything was canceled. I just felt depleted and I was scared. I remember watching videos on how to have a birth and what to do and all of the birthing videos and there was like, “Here's a segment on if you have a C-section.” I was like, That will never be me. I don't have to watch this because that will never happen. That is not in my cards. That is not in my birthing plan I typed up and had signed. That is not in my cards. So I decided with my doctor that I wanted to be induced and I said at 40 weeks I had done my time. Get this baby out of me. I had committed to 40 weeks because she kept saying, “Well, we can do it at 38 weeks if you're comfortable or 39 weeks.” I was like, “Nope. I will do it until 40 weeks. I've done my time. At this point, this baby is evicted.” On June 20th, I went in for my induction. Everything went smoothly. I was progressing but not as fast as they would like so we started Pitocin. That went well. I was doing really well and all of a sudden they were like, “I think we need to break your water.” I had heard horror stories about your water breaking and it's super painful and you're miserable after it. So I was like, “Well, let's get the epidural because why would I put myself through that if they have the option to make this smooth and comfortable? Why would I sit there and not be comfortable during this?” So I got the epidural and I just laid there. I laid in bed for a really long time then at about 3:00 in the morning, I got the urge to push. I let the nurses know. They checked. They said I was at 10 centimeters. Everything was good to go. They came in at about 3:10 and I started pushing. I pushed until about 6:00 AM. At that point, at about 5:00 AM, I started getting really hot. I noticed that they had turned the temperature in the room up obviously for baby. I started getting really overwhelmed and really hot. I started to throw up. My doctor turned down the temperature. She was like, “Let's turn down the temperature. I feel like you're just getting hot.” I was like, “I'm just hot. I just don't feel so good. I'm just hot.” They turned the temperature down then a new NICU nurse came in and she turned it up. I was watching her turn it up and I was just so uncomfortable. I started throwing up again and they were like, “Well, we need to pause because everything you're doing is an epidural symptom but it's also a symptom of COVID so we're going to stop you because we have to test you. You can either continue to push–”Meagan: We have to test you.Nicole: Yeah. I had gotten tested before I went in and then during my labor 3 hours in of pushing, they literally stopped me and said, “We need to do a COVID test.” I did a COVID test and it was crazy. You see all of these doctors in scrubs and masks and then all of a sudden they come in in these inflatable suits and everybody has these– which is more terrifying. I'm already scared. Meagan: Yeah, talk about invading your space. Nicole: Yeah, then you're telling me that I have an hour until this test comes back. I can either continue to push but if I push and have my baby, you're immediately going to take her away until my results come back or I can pause, not push for the hour and just let my body do it naturally and then resume pushing if my test comes back negative and I can continue to have skin on skin and the one-on-one time with my baby. Meagan: Hashtag, eye roll. Nicole: Yeah. So during that time, I was pushing well up until the COVID test. My baby was descending correctly. I stopped. I waited an hour and something shifted to where she then twisted a little bit and she– once my test came back negative and I was able to push again– was getting stuck on my pelvic bone and I could not get her out. They were tying blankets together and my husband would hold one end of the blanket and I would push and pull the end of the blanket as hard as I could to try and get her down. I was doing everything to push this baby out. Nothing was working. I started to develop preeclampsia so that was red flag number one. Then my baby's heart rate started to drop in between each contraction which I guess means that it could be around the neck and it's more concerning if it's between contractions versus during the contraction. So after her heart rate started dropping and continuously dropped, they decided to call it an emergency C-section. I just remember feeling devastated. I remember shouting– not shouting, but crying to my husband, “I don't want this. I don't want a C-section.” My doctor was like, “I have to hear it from you that you are okay to have the C-section.” I was like, “I mean, I guess if that's the only way to get this baby out but I don't want it.” I remember feeling the pain from my C-section and feeling so depleted. I pushed from 3:00 to 6:00 then I stopped for an hour. We resumed at 7:00. We pushed from 7:00 to 9:00 and then they called the emergency C-section and I had her at 9:36. It was a lot and I was pushing hard. I just remember getting back to the room, because my mother-in-law was there, and saying, “I haven't held her yet.” I didn't want anybody to hold the baby without me holding her first. I had heard stories of people who were like, “Everybody in my family got to hold the baby before I held my baby.” I just remember crying and I cried for weeks. I just felt like my body gave up on me. My recovery was terrible and that's what my doctor kept saying. She was like, “You have both recoveries. You pushed for so long that you're recovering from pushing and then you're also recovering from your C-section.” Then because I pushed so hard and I was trying so hard, I had tore all of the right side abs so I couldn't even move my legs to get in and out of bed for 4 weeks because my whole ab muscles were just torn. I had to go see therapy for that and I remember trying to drive me and this infant to therapy sessions and I was just in pain and then the drive home– it was so hard. I just felt like I was really bonding with my baby, but I felt like I was so disconnected with myself. I just couldn't do it. I had to have therapy because I went into postpartum depression. It was the hardest moment of my life because I really just felt like everybody was like, “Oh, it's so beautiful though. Your body did its job and it birthed this healthy baby.” I just wanted to scream every time somebody said that because I was like, “But it didn't. I pushed for hours, literally hours, and it didn't do its job. I had to have my baby taken out of me.” Meagan: You didn't feel that way.Nicole: Uh-huh. Yeah. People would be like, “Well, aren't you glad that you didn't have vaginal tearing?” I was like, “No, but I had hip to hip tearing and not just through the skin. It was muscles and layers.” I felt like everybody was trying to comfort me and it just felt like I wanted to scream at the top of my lungs because I didn't feel like anybody was understanding what mentally I was going through. Meagan: Yeah. I think that happens so often in the provider world but also just in our family and friends' world. We get thrown the, “Aren't you just happy you have a healthy baby?” It's like, “Yeah, duh.” But then also that thing, “Well, aren't you glad that didn't happen to your vagina? Aren't you glad you don't have to deal with incontinence?” Or similar things where in people's minds, I don't think they realize that it's causing harm or that there are ill feelings at all. They are just saying these things, but it's like, “I don't feel like I birthed my baby and I don't feel good about it and I'm dealing with a lot of trauma physically to my body, not just even emotionally but physically to my body. No, I'm not feeling great right now and it's okay that I don't feel great. I understand that you're just trying to help and validate me maybe, I don't know.” Maybe that's what people are doing but it doesn't always feel good. Nicole: Yeah, people kept telling me to be mad at my provider. I was like, “I hear you. But at the end of the day, she's new to COVID just like we are. She's going into this trying to navigate it.” I think she did and I think she made the best calls, but everybody was like, “Why are you mad at yourself? Be mad at this person.” I was like, it wasn't her fault necessarily. She didn't know what was happening. COVID was so new and it was just blowing up in Utah. It was just this big thing and it seemed like nobody was listening to the fact that I was upset with my body and how my body handled this. Everybody was just like, “Well, it's a healthy baby. Blame this person or that person. It's COVID.” I was like, “But what about me? You're not listening to me.” That was so tough. I felt like I was screaming it and people were trying to silence it without purposely trying to silence it. Meagan: Right. Okay, so I have some questions for you. So when they were offering you sheets and it sounds like you were maybe playing some tug-of-war. What I call it in my doula mind is tug-of-war where you are pulling and tugging and all of those things. Obviously, they were really trying to help this baby get out vaginally and things like that. Did they offer you changing of positions even though you had that epidural? Were they like, “Hey, let's try to get you on your side or get you on your hands and knees?” You said you kind of felt your C-section a little bit, right? Is that what you said? So it maybe wasn't as deep of an epidural so maybe you could have done hands and knees or something? Did they ever offer anything like that?Nicole: They didn't. They did try the vacuum three times but it immediately would just pop right off of her head because she was shifted. Meagan: Asynclitic a little bit, maybe?Nicole: Yeah, so they said that after three times it was unsafe at that point and it was going to have the same results. Nothing was going to happen. I didn't want to do the vacuum, but once we were at that position, I was like, “Let's just try it.” I agreed to three times and then we were done. Keep it safe. That's when we started doing the tug-of-war and we did that for a long time. My husband was holding it and he was like, “The first time, you almost knocked me down because I wasn't expecting you.” I was pulling so hard. I just wanted this baby out. Yeah, they didn't move me in any positions. I was just on my back. Now that I know better, I wish I would have tried. Meagan: But again, you didn't know what you didn't know. For listeners, if you are in a situation where your baby might be tilted to the side asynclitic or transverse and maybe you have done tug-of-war and things like this, and even then, sometimes it doesn't work. For some reason, the baby is where they are, but a little bit of a tilt to the side especially if there is one side where they feel the baby's head or try to get on hands and knees to change that pelvic dynamic can help. But I love that they were like, “Let's do tug-of-war. Let's do these things.” I love that providers are still encouraging other things in other ways. It sounds like they really did try and avoid a Cesarean by doing a vacuum and doing the tug-of-war. That is super awesome. I was also wondering if you have any tips for moms who have maybe pushed for a really long time like you did and had essentially have vaginal pelvic floor trauma and also gone down the Cesarean route. Is there anything you would suggest to moms? Or even for moms who maybe had a C-section and had this possibly happen. Yeah, do you have any tips that you would suggest to help with healing both physically and mentally?Nicole: Yeah. One of the biggest things that we did which was incredibly helpful– I'll give you a funny story after– but one of the biggest things that we did was my husband would get out of bed. We breastfed. He would hand me baby. I would breastfeed her and burp her and then he would get out of bed, change her, and put her back down. That was incredibly helpful because all I had to do was go from laying to sitting. I couldn't pick my legs up to move them out of the bed without it being excruciating, so having him just help me sit up and hold baby made a huge difference. Having that support person there to help do the heavy lifting technically to get in and out of bed was next-level game changer. It helped me. I got to sleep more because he changed the diaper. We took turns then he would sleep during feedings. We were really changing. I do remember going to the pediatrician and my husband talking to the pediatrician and I was like, “Wrong person to ask.” He was like, “She keeps waking in the middle of the night and rocking holding this invisible baby and bouncing it.” It was because I would forget that I gave the baby back to my husband. Meagan: Yeah, because you're so tired. Nicole: I'm so tired and he would be like, “It's freaking me out.” I picked up my little Yorkie and I was rocking her. My husband was like, “That's the dog.” I thought I had fell asleep and the baby was next to me so I picked up the dog. I remember the husband talking to the pediatrician and I was like, “That is the wrong doctor. He knows nothing about my mental state,” and him being like, “It's terrifying,” but it really did help me. It might have scared him, but it just was so helpful and I just felt like I didn't have to worry about dropping the baby walking in and out of bed. It helped speed up my recovery because I wasn't constantly getting in and out at all hours of the night. Meagan: Yeah, that is so impactful. I love that you pointed that out. I know that some postpartum doulas do that too but if your partner is able to help you in that way, I also think it's really great because that helps them bond with the baby too. I mean, they might not be feeding the baby but they are changing and carrying and soothing the baby back to sleep as well. I love that. I love that you did that. How long did you do that until you were feeling better and getting in and out of bed was feasible?Nicole: It took me about 3 weeks until I felt comfortable and confident. That was another thing. I could feel comfortable but wasn't confident to get in and out of bed without worrying about a sharp pain or something glitching or stumbling. Meagan: Mhmm. I'm so proud of you guys for being a team and making sure that you took care of that. Nicole: We'll keep him. Meagan: You needed to take care of yourself and I love that you were like, “This is what we need. This is what we need to do.”Awesome. Well, before we get into your next story which is amazing, we're going to take a quick moment and listen to me, I guess, about our sponsor. Okay, and we're back. Let's get onto this VBAC story. Nicole: So being military, we had decided my daughter was so great and so fun at about 8 months or 9 months and we were like, “Let's do this again. Let's have another one. We want them close in age. Let's try again.” So she turned 1 in June. In May, we decided to go on a long weekend because my husband had just graduated college. He's military and was going to school which is a whole other added pressure. Meagan: That's a lot. Nicole: Yeah. We flew our mother-in-law out. She stayed with our baby for Memorial Day Weekend and him and I went to Tahoe for the weekend. We decided starting in May that we were going to start trying again. We were like, on May 1st, we're going to start trying for a baby. We get back from Tahoe on June 1st. I think it was June 1st. It was right at the end of May and the beginning of June. His coworkers were like, “Guess what? You have orders to RAF Lakenheath in England.” My husband was like, “No, I don't. You're kidding. I don't. That's a joke.”He called me and he was like, “I have bad news.” We had just dropped my car off at the dealership that morning so I was like, “Oh no, what we thought was a minor issue was huge.” He was like, “We have orders to England.” I was like, “That's not terrible news. That's the best news I've heard all month.” He was like, “No, that's terrible,” because he was planning on getting out of the military. Meagan: Oh no. Nicole: We had 2 weeks to decide if he was going to stay in and take these orders or if he was going to get out. We spent 2 weeks going back and forth if this was the best option for our family and if this what we wanted. What could we do over there? We decided that we would go overseas if we decided to wait on having a baby. We cut it off. No more babies at the beginning of June. We were like, “We're done. We're going to have our one. Towards the end of our 4 years is when we are going to start trying for our second. That way, we can get back here and have our baby back in the States.” We were like, “We'll travel with our one child because it's easier to travel with one than two. We'll travel with one kid. We'll do our 4 years there and when we come back, we'll have our next baby.” It wasn't ideal because we wanted them close in age, but at least we were traveling and eventually, we would have our second. He took the orders on June 2nd. I was prepping for my daughter's first birthday. We were having a pool party. I was like, okay. Her birthday's on June 20th. It is June 16th. I wonder when I'm going to get my period because I don't want to be on my period and swimming. Meagan: During the pool party, yeah. Nicole: I looked at my app and I was 7 days late. I was like, What? I don't think that's right, but let's just take a test. I took a test and I was pregnant. So, the joke was on us. Meagan: Oh my gosh. Nicole: Yes. We found out in June that we were having our second and we were due to be in England in November. So at the end of the month in November was our DEROS date or the day that we were supposed to be in England and he was supposed to be signed onto the base. We decided that we would just pack up and do this all while I was pregnant. We moved over there on November 15th. Once I got here, I was like, Well, what do I do now? I am halfway through my pregnancy. I have nothing because COVID again, had stopped all of our furniture stuff because the ports were closed and that whole issue of everything being shut down. The world was still closed so we were like, “What do we do?” We had sent our stuff at the beginning of October to arrive in England and they were like, “Well, you're not expecting anything.” We had bought all of our baby stuff before because we were like, “Well, we'll just buy it here and ship it over there, and then we won't have to worry about trying to buy it over there.” There are different sizes of cribs there, and the bedding size is different. I don't want people to buy us sheets then all of a sudden it's UK sizes and it doesn't fit and it's unsafe for baby. It was a big thing. We bought all of our stuff. I was ready to have it. Then we got here and they were like, “It looks like you're not going to get any of your household goods until April.”Meagan: November to April?Nicole: October to April because we shipped in October. Meagan: Oh my gosh. Nicole: Uh-huh. Yeah. We were living in temporary furniture that was terrible. We had to go out and buy blow-up mattresses because those were more comfortable than the beds that they gave us. It was wild. Then I'm trying to find a doctor. I'm trying to find a provider. I don't know what I'm doing. I've called all of the birthing doulas because of the podcast that I had been religiously listening to. I was like, “I know what a doula is. That's what I need.” They were all booked up because by the time we got here in November and I got the chance to interview them, they were all booked up for the month of February when my baby was due.So now I'm sitting here, “Well, what do I do? Do I have the baby on base? Do I have the baby off base?” I don't know. I don't know anything about where we're living. I don't know anything about the hospitals. I don't know anything. I'm just guessing off of people's posts on Facebook, but they are so hit-and-miss. Somebody is going to post a really great story, then all of a sudden, somebody makes a post of a traumatizing story which scares you. It's like, was the good story one in a million, or was the traumatizing story one in a million? I was just navigating this. I started going to my doctor's appointments on base because I knew that Tricare covered the OB/GYN. I was trying to navigate how it would cover overseas. I had to make a lot of phone calls and all of that fun stuff. I was like, “Well, I'll just start on base and see if I need to transfer off base.” On base was okay. It's way different seeing a military doctor than it is seeing a provider who chooses this field and who wants this field. All of my prenatal care was okay. There were a few things that I wasn't a fan of and if we weren't talking about it, I could tell you what is the strep B test, right? Meagan: Group B strep?Nicole: Mhmm. They test you. They swab you to see if you have a skin infection to see if you need to be on antibiotics. In the states, my doctor performed that on me. Here, they gave me a test tube and told me I had 5 minutes to complete it. I was like, “What? I can't even see down there let alone swab myself.” I just remember crying in the thing and begging people to do it and they were like, “We don't do it. You have to perform it on yourself.” My husband was home watching our toddler, so I had no support with me. It was definitely different. I looked at the hospitals off base and I was really unsure with the way that I had them. You would give birth in a birthing suite with your husband, then they would send him home and move you to this big room with other moms who had their babies. I was really navigating, what is the best fit for me and how am I going to have this baby and my VBAC? I want this VBAC. Who is going to advocate for me? I don't have a doula. I'm doing this by myself. My husband only knows so much. He doesn't understand it all, so he is only retaining half of what I'm saying. I made it to 40 weeks. I was like, “Get this baby out of here.” My mother-in-law was here to watch my daughter. That's another thing. You have to find childcare for your toddler because you don't have family around to watch your baby. We were so new here. We didn't have friends here to watch our baby. My mother-in-law luckily came out and made it for the birth. She watched my daughter. I decided that since she was here, and I needed to get this baby out before she left so I had childcare, I would do a membrane sweep because I was 40 weeks and I think I was 2 days at that point. I did a membrane sweep. That was unsuccessful at 40 weeks and 2 days. I did a second one. That was very successful. We had my membrane sweep in the morning. I remember just doing lunges and squats all day long. We took my daughter to a forest. She just ran, and I did lunges behind her. There are videos of my husband following my daughter around, and I'm in the background just doing lunges and doing anything to keep active, to keep this baby going. I went to bed that night on February 23rd. I went to bed at about 9:00 PM. I woke up at 2:00 AM. It was about 2:30 when I woke up. I felt this really sharp pain in my stomach. I thought he had kicked my bladder, so I stood up on the bed. It was like a movie. You heard the gush, and then all of a sudden, water was just trickling down my legs. I was like, “Well, I still feel like I have to pee, so that was definitely my water breaking not me having to go to the bathroom and him kicking my bladder,” which signaled me having to go to the bathroom. My husband had just come to bed at about 2:00 AM. He had only been asleep for about 30 minutes. I was like, “Hey, no rush. This is going to take hours.” Again, nobody thinks that labor happens fast. I woke him up. I was like, “No rush. I just need you to go downstairs and get my military ID,” because at this point, I decided to have him on base. I was like, “I just need you to get my military ID because they are going to ask for that information in labor and delivery. Let them know that my water broke and that we would be in in a few hours. No rush. I'm going to take a shower. I'm going to go back to sleep. I'm just going to sleep this off. We will wake up in the morning, say goodbye to Naomi, and then go to the hospital.” Again, I had told my daughter that I would see her in the morning, and then I left the room that night saying, “Why did I say that? There's no guarantee.” I had been saying for weeks, “I hope you sleep good,” and that's it. Then of course, the one time that I accidentally said, “I'll see you in the morning,” I wasn't seeing her in the morning. He calls Labor and Delivery and they were like, “Well, because of her past, we want her in now.” I was like, “No. No. I don't want to labor in a hospital. I want to labor as long as I can at home. I want to do this by myself. I want to be comfortable. I don't want people to tell me what I should be doing then it going against what I want to do. I really want to do this by myself.” He's arguing with Labor and Delivery. He was like, “Well, let me talk to my wife, and I will call you back.” I was like, “I'm going to get in the shower real quick and wash myself off because my water just broke.” Meagan: Had you started contracting at this point or just trickling? Nicole: Very minimal. It was every 5 minutes. It was very minimal, nothing crazy. I could totally go clean my car at this point. I was walking on water. My water broke. I'm great. I feel good. I feel nothing. I'm in the shower. All I did was put shampoo in my hair. I didn't even get it rinsed out, and all of a sudden, my contractions went from 0 to 100. I could not breathe. I could not talk through them. I could not even do anything. I felt like my mind was so focused on the pain. My husband was trying to ask me questions, and I couldn't even register what he was saying through each contraction. I told him, “Call them back because we are on our way now. I need to get out of the shower. I need you to throw conditioner in my hair while I have this next contraction. I need to rinse it out, then we need to go.” He's trying to talk to them and put conditioner in my hair. I'm having a contraction. I put my pants on, and as I'm pulling them up, another contraction hit. Then they started going from having a contraction for a minute and a half to a break for 30 seconds, and then immediately back into another contraction for a minute and a half. I was like, “What is happening?” I never felt this with my daughter. I had the epidural. Things went so smoothly and so slowly that it was cake. This was the next level. I waddled into the car. I remember sitting in the front seat and saying, “I can't do this.” I climbed into my toddler's car seat because I had the infant car seat up, and I couldn't fit in between the two car seats, so I had to sit with my knees in my toddler's car seat. I was holding onto the back headrest for support and just standing there. I was on my knees, chest against the back of her car seat, and I'm just holding onto this headrest with every contraction. I'd have three in a row. I'd have one for a minute and thirty, a break for 30 seconds, a minute and thirty, a break for 30 seconds, a minute and thirty, then I'd have a two-minute break, and then they would kick back up again. My husband was just flying. The roads were closed on our normal fastway to base. We lived 30 minutes away, so it was an extra 15 minutes to get to base. He was flying at 2:50 in the morning at this point. I'm sorry, it was 3:50 in the morning at this point. We get to the hospital at 4:05. I am hugging a tree outside because my husband couldn't figure out how to open the wheelchair. Poor guy, he was trying so hard to help me. Meagan: I'm sure. It was a frantic moment. Yeah. Nicole: Yeah. He couldn't figure out how to open it. He had to go to the ER and get somebody in the ER to help him. They were wheeling me up, and I remember yelling at them because they kept saying, “We'll have to do triage and see if you're in active labor before we can bring your husband back.” I remember telling this poor ER nurse, “You'd better not split my husband and I up. I am not doing triage. We are going into a room. We are having this baby.” She was like, “Ma'am, I think we're just going to put you in a room. I don't think we are going to need triage.” I get into the room. I am continuously having contractions. They tried to stop me to do a COVID test. I death-glared this guy because he wanted to do a COVID test on me. I was like, “Been there, done that. Not doing that again.” I remember them trying to put an IV in my hand. I was like, “I don't need an IV. This kid is coming out of me. I know I tested positive for the strep test, but I don't need an IV. He's already out. There's nothing that this is going to help.”I get up on the bed. They tried to get me to lay on my back to push and I couldn't. I remember my husband was like, “No, that's not how she wanted to push. She wants to push with her knees on the bed and her chest against the back holding on. That's how she wants to deliver him.”He was advocating for me which I was so grateful for because I felt the entire time that he didn't know what I wanted because he didn't understand my terms, he didn't understand why, he didn't understand the VBAC world, so I felt like I was talking to thin air. So for him to sit there and be like, “No, that is not how she is going to deliver this baby. She wants to be on her knees hunkering down.” I did. I got up there. I pushed two pushes, and he was out. His hand was stuck to his face. Meagan: Nuchal hand, wow. Nicole: He was holding onto his face. He got a little stuck because of his elbow, so after I got his head out, they made me flip over and deliver him on my back which I was totally okay with because we had done the hard part. I remember my husband saying that was the weirdest thing watching me turn around with this baby hanging out. He was like, “You just flipped around like it was nothing.” I was like, “I knew he was fine.” I tore because his hand was up and it was added pressure. But yeah, he came out in two pushes. He was born by 4:36, so 2 hours and I had my baby. It was absolutely wild. I just remember that I had him. I was just in the chaos of it, and about two minutes later, my husband was like, “Nicole, you had a VBAC.” I just started shouting it. I was like, “I had a VBAC.” It didn't even dawn on me in the craziness of it all that I pushed this baby out of me. I was just like, “Is he okay? Is he healthy? Does everything look good? Are you sure he has 10 toes and 10 fingers? Is everything good?” My husband was like, “Nicole, you had a VBAC. You really did it.” Yeah. It was crazy. He came so fast which was unexpected and nobody tells you about that. It was just wild, but I had a VBAC. Meagan: You had a VBAC with a nuchal hand too. That can be a little tricky sometimes, right? That is amazing, but I love just how intuitively from the very beginning, your body too was like, hands and knees. Forward-leaning position. That's what your body intuitively was telling you to do to get this baby here. I love that you just went with that. I love that he advocated for you despite not really understanding. I can relate to that. My husband did not understand why I wanted to do what I wanted to do, but it's so nice to have them be there for you in that ending moment when it really matters so much. Nicole: Absolutely, yeah. I was shocked. When he started saying it and he was like, “No. She wants to push like this,” I was like, “What? You listened?” Meagan: You listened. I love that. Oh, well thank you so much for sharing that story. Huge congrats and man, precipitous labor like you said, people don't talk about it. It does happen. It's funny because I had a long, 42-hour labor. Someone asked me, “Would you rather have a long labor that took forever like that or would you rather have a precipitous labor?” I had said that I really wanted a fourth and I just hoped it went faster. I don't know. I don't know which one I would prefer because long is exhausting and hard, but man, precipitous– and I have seen them. I have supported them as a doula and seen 2-3 hour-long labors. It's a lot of change in a body to happen in such a short period of time, and it's so intense. I mean, it is the next level. So, I don't know. Nicole: It's crazy. It's crazy that they are so fast, but your body just knows what it's doing. That blew my mind. With my daughter, I felt like I was trying. I was listening to everybody, and they were telling me what to do. I was just following suit, but with this one, there were no decisions being made. My body was like, “This is how it's going to happen and that's it.” I remember shouting for the epidural when I got in the hospital room. I was like, “I want that epidural. Call the anesthesiologist now.” They were like, “Honey, I think he's already here. I don't think we have time for that.” My body was like, “No, you're not sitting down. You're not going to do this. This is how–” I didn't even have time to focus on my breathing. My body was just doing it itself which is crazy thinking back on it. My body just knew. I was so down on myself thinking my body had failed me, but then having a super fast labor, my body was just like, “Nope, this is how we're going to get it done and that's it.” Meagan: Okay, so with precipitous labor too, like you said, it went from 0 to 100 like that. Do you have any tips for moms with that experience of that type of intensity? Obviously, listening to your body and getting to your birthing location on time. I'm assuming that's continuing. Sometimes, I feel like it can be really intense when it feels like they are ramping up and then they piddle out. But it does, it seems to ramp up, like you said, from 0 to 100 and it hangs on. It holds on tight and it is not stopping.Nicole: Yeah. Definitely listen to your body. I felt like I spoke up a lot with what was happening at one point. I've always been this way where there are certain sounds that make me nauseous if I'm under a lot of stress or if I'm feeling sick, so my husband talking– it's funny because he was like, “Say your affirmations. You are brave. You can do this.” His talking was making me nauseous. I was like, “Stop. Stop talking. Although it is what I want to hear, it is not helping.” Being super open about what was happening like when he went to get the wheelchair, I was like, “I can't sit in this car. I have to get out.” He was like, “Just sit in the car. Let me help you.” Being super aware and open about what I was feeling and what my body was telling me to do because going up and holding onto this tree, and every time I walk past this tree at medical, I'm like, “I almost gave birth right there had we not gotten that wheelchair open.” Hunkering down on that tree gave so much more relief that it was sitting in the car waiting for him. Although, I know that the car probably would have been the safest option for me rather than the tree with dirt and bushes–Meagan: Hey, that's actually pretty cool if that happened. Nicole: Right? But knowing what it was and being communicative. Even through all the chaos, every second that I could, I was saying, “This is what I need right now. This is what I'm feeling.” That was helpful not only for myself mentally because I didn't have the option. Things were just happening, but mentally being aware, and also allowing my husband to help me and support me where I needed was also really helpful. Meagan: I love that. Speak up. Follow your body. Have an awesome partner to help guide you through. I think too like what you said earlier, he listened. That goes with speaking up, talking about our feelings, and talking about our desires. Even if you don't think it's being understood or really heard, it probably is. Nicole: Yeah. It was just so crazy to me with him being like, “I'm so confused why somebody would want to push like that,” then him being like, “No, she's going to push like that.” I was like, “What? You remembered.” Even in all the craziness, and he thought for sure when I told him to stop when we were driving, he thought I meant to stop the car because he thought I was going to have the baby before I could finish after my contraction, “Stop talking.” Yeah, so even through all of the craziness and his mind going rampant, because he's going through it too thinking, “Am I going to deliver this baby on the side of the road?” Now that we're in a different country, who do we call? Do we call 9-9-9 or do we call 9-1-1? Do we call base or do we call locals? We're in the middle of the country. His mindset is going, so having him say that in the craziness was even more powerful. Meagan: Mhmm. Oh my gosh. Well, huge congrats again. Thank you so much for coming on and sharing your story. I do know that it's going to impact someone out there, probably hundreds and thousands of people to be honest, so yeah. Thank you so much. Do you have any other tips or any advice that you'd like to give to any moms in regards to VBAC, in regards to birth, in regards to preparation, or in regards to navigating military changes? Delivering on base or off base? Are there any other suggestions that you'd like to give? Nicole: I would say to really trust your instinct. I was obsessed with my first doctor with my daughter and she was my second daughter going into this. Obviously, I couldn't keep her. I tried to get her to come over here, but she wouldn't. Trust in your instinct in what you think is right for you and your baby. It's so interesting to where you believe that this is one thing and this is how it should be, but then when your instincts are kicking in and they are telling you, “This is what's best for you and your baby,” it's a whole other path. I just recommend to listen. Listen to your body. Listen to what your gut is telling you. It will fall into place. Things are scary and sometimes things are wild, especially with the military and moving in the middle of a pregnancy. It is terrifying. I've known spouses who stay after and they bring their baby over when their baby is 8 weeks old and can finally get a passport. But knowing that you can do it overseas, I definitely think it's special because your partner is there. It's just a crazy ride, but if you trust yourself, your self will always guide you in the right way. Meagan: Yeah. We've been saying it since this podcast started in 2018. Your intuition is so impactful. Trust it all the way. Go with it. I love that advice. Thank you. Nicole: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

In this episode, José García-López, VMD, DACVS, DACVSMR, joined us to discuss nuchal bursitis in horses. He talked about the clinical signs, risk factors, treatment options, recovering process, and overall prognosis.The Disease Du Jour podcast is brought to you by Merck Animal Health.Disease Du Jour Podcast Hosts, Guests, and Links Episode 145:Host: Carly Sisson (Digital Content Manager) of EquiManagement | Email Carly (CSisson@equinenetwork.com) Guest: Podcast Website: Disease Du JourThe Disease Du Jour podcast is brought to you in 2024 by Merck Animal Health.

In this episode, José García-López, VMD, DACVS, DACVSMR, joined us to discuss nuchal bursitis in horses. He talked about the clinical signs, risk factors, treatment options, recovering process, and overall prognosis.The Disease Du Jour podcast is brought to you by Merck Animal Health.Disease Du Jour Podcast Hosts, Guests, and Links Episode 145:Host: Carly Sisson (Digital Content Manager) of EquiManagement | Email Carly (CSisson@equinenetwork.com) Guest: Podcast Website: Disease Du JourThe Disease Du Jour podcast is brought to you in 2024 by Merck Animal Health.

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

Today on the Natural Birth Podcast we have Amanda. Amanda is a mama of 2 from Texas. She's a birth photographer, birth assistant, doula and placenta encapsulator and a secretary and social media coordinator for a birth center. She says that she is blessed to mostly work from home and have the ability to homeschool her daughter. In todays episode we get to hear about her two birth stories. The last one I saw powerful photos of on Instagram where Amanda was squatting in such a primal powerful position birthing her baby and I just had to reach out and say ”Hey do you want to share your story on the poddy”, and here she is doing just that. Curious about Amanda? Find her on Instagram as @loverandbeloved   200 Episodes & Special Offer! This is the 200th episode of the natural birth podcast! WOW! And we are coming up to 4 years in a few weeks but first things first! Can you believe it!?! I know many of you listen to each and every one of these episodes to prepare for your natural birth and I am so pleased that I now have 200 unique natural and positive birth stories to help you reprogram your subconscious mind! What an epic resource! And speaking of resources. To celebrate this 200th episode you are welcome into my Online Community The Village for free for a whole month when joining this week! Being a part of my village means monthly live Q&A and sharing circles with me and the village sisters. It means accessing resources and birth nerds, maidens, mothers and magas as well as my sacred birth worker mentees 24/7. It's a warm, friendly, cozy and hearth centered village that truly supports women in all stages of life, especially around birth and child rearing. And this week you can join for free and get a whole month in the village and meet me and hang out totally free of charge! Yay! Curious about Needed? Find out more at thisisneeded.com Use the code THENATURALBIRTHPODCAST for 20% off your first month. Find All of Anna's Links & Resources here: SACRED BIRTH INTERNATIONAL --- Send in a voice message: https://podcasters.spotify.com/pod/show/thenaturalbirthpodcast/message

In today's episode we're hearing from Ellie who had her baby whilst living out in LA. Ellie fell pregnant quickly and went on to struggle with anxiety during her first trimester. She shares her fascinating account of navigating the US maternity system where she had difficulty finding midwifery lead care to support the physiological birth she was hoping for. She hired a doula to help her advocate for herself and finally managed at 37 weeks to find a likeminded OB-GYN who supported her choices. Ellie laboured at home for 30 hours before transferring in to the hospital where, after another exhausting 12 hours, she opted for an epidural. When her daughter was born she was rushed off to the NICU and Ellie reflects how with hindsight perhaps this course of action wasn't entirely necessary.   Ellie's website: https://www.coupld.co/ Ellie's parenting course: https://www.coupld.co/prebaby-bootcamp  Ellie's IG: https://www.instagram.com/coupldco/  My website: www.serenalouth.comMy IG: https://www.instagram.com/serenalouth/

The nuchal ligament is in the back of your neck and you can feel it when you flex your neck forwards. What does it do and where does it come from?

We have all heard "thank god I was in the hospital because the cord was wrapped around the baby's neck!" but how dangerous is a nuchal cord, and why does it happen? And what causes cord prolapse and what can be done when it occurs? Cords wrapped around babies necks and cords slipping out first... they sound like total emergency disaster situations! But whilst one is an obstetric emergency, the other isn't. We talk nuchal cords and cord prolapse with independent midwife Debs Neiger. This essential episode will re-educate and dispel myths, and an important listen for anyone who is pregnant. You can find Debs on instagram @debsagos or online at www.debsneigerindependentmidwife.co.uk Disclaimer: The information and provided on this podcast does not, and is not intended to, constitute medical or legal advice; instead, all information available on this site are for general informational purposes only. We reserve the right to supplement, change or delete any information at any time. The information and materials on the podcast is provided "as is"; no representations are made that the content is error-free. Whilst we have tried to ensure the accuracy and completeness of the information we do not warrant or guarantee the accurateness. All liability with respect to actions taken or not taken based on the content of the podcast are hereby expressly disclaimed. Your use of content contained in or linked to this podcast is entirely at your own risk. The Better Birth podcast accepts no liability for any loss or damage howsoever arising out of the use or reliance on the content.

In today's episode I'm chatting to Monika as she shares the story of Sunny's birth. Monika struggled with awful nausea and vomiting for the entirety of her pregnancy. As the sickness worsened around her due date she opted to be induced and after labouring through the night things ended with an episiotomy and a forceps-assisted birth as her baby's heart rate was dipping due to a nuchal cord. Monika went on to breastfeed her baby and continues to do so 19 months later.   You can find out more about Monika and her beautiful photography here or on her IG: @Monika_Chatterton www.serenalouth.com @SerenaLouth

We are back answering your questions in the June Q&A episode.  We kick it off with a woman's story of multiple non-consented vaginal exams in labor, her complaint to the hospital, and the hospital leadership's response. Next, we jump into our questions including:I really want a home birth, but I am afraid that hospital birth is safer and that home birth is dangerous. How do I determine this risk? My mom had a c-section for a cervix that swelled shut. Is that possible?I am struggling with boundaries and decision-making with my husband around staying home and home-schooling the children versus returning back to work. Could getting in the water too early slow down my labor?  Barbara Harper from Waterbirth International calls in her response. I am ten weeks postpartum and have a positive pregnancy test.  Could this be for real?In the extended version, available on Apple subscriptions and Patreon, one woman asks if she should have listened to her nurse who ordered her not to push.  Could a nuchal hand in labor be a justified cause for a c-section? Should the cord only be cut after the placenta has been delivered? Who should I notify about being dropped as a patient and black-listed in surrounding practices?In our quickies segment, we discuss weight gain in pregnancy, periods returning too soon, precipitous labor and increased bleeding,  birth pools, early pregnancy, red raspberry tea and dates, strengthening the amniotic sac, a fear of sex in pregnancy, and our best marriage advice for after baby. We were also asked to share something we can do that most people don't know about us.Finally, don't miss the outtake!**********Down to Birth is sponsored by:Needed -- Optimal nutritional products to nourish yourself before, during, and after pregnancyDrinkLMNT -- Purchase LMNT today and receive a free sample kit.Love Majka Products -- Support your milk supplySilverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe  Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

S. 2 E. 20 Kathy Urdaz Nuchal Cord & Young Mom Today we are joined by my former Occupational Therapist, Kathy. Kathy has several unique birth stories. With her first she became pregnant with her first and 16 years old and was told “she threw her life away!” Spoiler Alert…she went on to receive her master degree! Also, with her first, he had a nuchal cord (a cord wrapped around the baby's neck). Then went on to have two uneventful deliveries except an uncompassionate triage nurse. Follow Kathy on Instagram: kat_urdaz  Follow Kathy on Facebook: Kathy Urdaz Follow Kathy on Tik Tok: kat_urdaz Follow Birth Trauma Stories on Instagram: ⁠⁠https://www.instagram.com/birthtraumastoriespodcast/⁠⁠ Follow Birth Trauma Stories on Facebook: ⁠⁠https://www.facebook.com/BirthTraumaStoriesPodcast --- Send in a voice message: https://podcasters.spotify.com/pod/show/cathy-garrett/message Support this podcast: https://podcasters.spotify.com/pod/show/cathy-garrett/support

Tania is Mum to Dylan who's 16, Ava who's 12, and her little freshy, Osian, who's just two months. In this episode, she shares about the challenges she was met with when she found out she was unexpectedly pregnant last year, and how she navigated them with a healthy dose of determination and self work, and the help of friends, family and an awesome midwife. Given that Tania had had caesareans with both of her older children and was wanting to plan a home birth with her next one, alongside being a solo mum, and unanticipated time spent in the Special Care Baby Unit with her newborn, there were plenty of hurdles along her journey. She speaks candidly about the highs and lows and offers a good couple laughs along the way. As a long time friend of Tania's, I was given the honour of attending Osian's birth, so sit back and enjoy this convo between two friends, reflecting on a very special birth experience. This episode includes the following topics: Induction at 42 weeks with a (supposedly) large baby Emergency cesarean for fetal distress Postnatal depression and anxiety Repeat cesarean for low liquor volume Solo parenthood at 40 years old Early pregnancy bleed Home birth after 2 cesareans My Soulful Birth pregnancy circle Navigating fearful birth support people Nuchal hand Breathing issues at birth SCBU - CPAP, IV antibiotics, jaundice Milk sharing Here is a link to Tania's Instagram page: https://www.instagram.com/emergefreewithtania/ Here is a link to my book, Where the Heart Is: Stories of home birth in New Zealand: https://www.healingbirth.co.nz/mybook Here is a link to 'Bonnie Grace Create's Instagram page in case you wish to check out her beautiful birth and parenting affirmation cards: https://www.instagram.com/bonnie.grace.creates/ ...or her website: https://bonniegracecreates.com/ My Soulful Birth pregnancy circle is soon to be online. Contact me via my website to find out more: https://www.healingbirth.co.nz/contact Or follow me on Instagram or Facebook: https://www.instagram.com/healing.birth/ and https://www.facebook.com/healingbirthwithcarla

Hannah had a smooth pregnancy besides nausea during the first trimester and restless leg syndrome in the third. She switched providers midway after learning that her OB wouldn't accept birth plans. She switched care to a midwifery team at a birthing center. She experienced prodromal labor for a few weeks before her real labor started. She labored at home for a bit then headed to the birth center to labor in the shower and tub. Hannah used hypnobirthing techniques to help her through contractions but was internalizing and blocking out her pain which in turn made her not able to vocalize when she thought something might be wrong. She progressed quickly but ended up pushing for four hours due to baby having a nuchal hand (hand by face). She had a supportive postpartum experience with her husband as they learned to work as a team. Visit our website and blog: www.thegoldenhourbirthpodcast.comFollow us on Instagram here and hereFollow us on Facebook hereIntro Song by Carpathians (Donny Rodgers): https://carpathians.bandcamp.com/track/lavaman

Wow, do I have a couple amazing stories for you! Nichole is on the show today sharing her three C-section stories, as well as her induced VBA2C, spontaneous VBA2C born accidentally at home, and then her VBA3C born in the hospital! Nichole believes if she can VBAC then any mama can, because she has a complicated medical history. A must listen! Topics Covered in this Episode: NICU baby Placenta Previa Induced VBA2C Spontaneous 2VBA2C born accidentally at home The VBAC King in Las Vegas S Protein Deficiency Preeclampsia Brewer diet Nuchal hand VBA3C in the hospital Connect with Nichole on Instagram here.  Join the VBAC Babes newsletter here! Follow VBAC Babes on Instagram Grab your VBAC Mama shirt here!

The Golden Hour Birth Podcast welcomes it's first guest, Hannah, to tell her birth story about her first baby. Hannah had a fairly easy pregnancy amid Covid-19 and scheduled an induction towards the end, feeling done with being pregnant. She had second thoughts immediately but went into spontaneous labor the morning before her induction. Her labor went well until it was time to push and they discovered her baby had a nuchal cord. She was able to still have a vaginal birth and her baby was born healthy. Her postpartum period was met with anxiety but was able to find relief through connecting with other moms. Hannah's favorite parenting resources:Big Little Feelings on Instagram hereA community for working moms on Instagram here Visit our website and blog: www.thegoldenhourbirthpodcast.comFollow us on Instagram here and hereFollow us on Facebook hereIntro Song by Carpathians (Donny Rodgers): https://carpathians.bandcamp.com/track/lavaman

While there are routine ultrasounds that almost every pregnant person gets. There are specific ultrasound that are ordered if there is an issue seen. Today we're going to go through those issues and what they might be interested in. Today's guest is Marybeth. She picked up an ultrasound probe for the first time in 1998 and has really enjoyed every minute of it. She has a Bachelor's of Science degree from Southern Illinois University, and has worked in Hospitals, Outpatient imaging centers, OBGYN offices, and now in a private Perinatology office. She started in general ultrasound and slowly found her way into high-risk OB. Marybeth is certified in Ob/GYN, Fetal Echocardiography, Nuchal translucency screening, Nasal bone, Uterine artery Doppler, and CLEAR. She is a huge advocate for patient education and teaching new sonographers tips and tricks of optimizing their scanning. Big thanks to our sponsor The Online Prenatal Class for Couples — if you're looking understand more about pregnancy and labor, this is the class for you. I'll take you and your partner through each step, both explaining and simplifying it — so you can have the confident birth you're hoping for! Don't miss out on my Free Birth Prep Kit that gives you a FREE lesson on this testing and what to expect during it. In this episode What type of testing we are talking about, and what they are for. BPP NST AFI Fetal Size Other things that might interest you My other episode on routine ultrasounds.

While there are routine ultrasounds that almost every pregnant person gets. There are specific ultrasound that are ordered if there is an issue seen. Today we're going to go through those issues and what they might be interested in. Today's guest is Marybeth. She picked up an ultrasound probe for the first time in 1998 and has really enjoyed every minute of it. She has a Bachelor's of Science degree from Southern Illinois University, and has worked in Hospitals, Outpatient imaging centers, OBGYN offices, and now in a private Perinatology office. She started in general ultrasound and slowly found her way into high-risk OB. Marybeth is certified in Ob/GYN, Fetal Echocardiography, Nuchal translucency screening, Nasal bone, Uterine artery Doppler, and CLEAR. She is a huge advocate for patient education and teaching new sonographers tips and tricks of optimizing their scanning. Big thanks to our sponsor The Online Prenatal Class for Couples — if you're looking understand more about pregnancy and labor, this is the class for you. I'll take you and your partner through each step, both explaining and simplifying it — so you can have the confident birth you're hoping for! Don't miss out on my Free Birth Prep Kit that gives you a FREE lesson on this testing and what to expect during it. In this episode What type of testing we are talking about, and what they are for. BPP NST AFI Fetal Size Other things that might interest you My other episode on routine ultrasounds.

There are a few routine ultrasounds that are indicated during pregnancy. They give us important facts about our pregnancy, and today we have a maternal fetal medicine stenographer who's going to tell us what they're for, and what to expect! Today's guest is Marybeth. She picked up an ultrasound probe for the first time in 1998 and has really enjoyed every minute of it. She has a Bachelor's of Science degree from Southern Illinois University, and has worked in Hospitals, Outpatient imaging centers, OBGYN offices, and now in a private Perinatology office. She started in general ultrasound and slowly found her way into high-risk OB. Marybeth is certified in Ob/GYN, Fetal Echocardiography, Nuchal translucency screening, Nasal bone, Uterine artery Doppler, and CLEAR. She is a huge advocate for patient education and teaching new sonographers tips and tricks of optimizing their scanning. Big thanks to our sponsor The Online Prenatal Class for Couples -- if you're looking understand more about pregnancy and labor, this is the class for you. I'll take you and your partner through each step, both explaining and simplifying it -- so you can have the confident birth you're hoping for! In this episode What an stonographer does. The difference between a regular stonographer vs one who does high risk OB ultrasound When people have routine ultraounds How they create a due date for the baby. Why your due date matters What the nuchal translucency test shows What they're looking for at the 20'ish week anatomy scan Why you might end up getting another ultrasound to see a specific part better. Other things that might interest you Producer: Drew Erickson

When there is a loop of umbilical cord around the baby's neck in the womb it called a nuchal cord.  This is actually a common ad normal finding during labor and delivery. Medically speaking the term nuchal cord is define as:  an umbilical cord that passes 360 degrees around the fetal neck. They are classified as single or multiple and tight and loose.  Single is more common than multiple and loose is more common than tight.  The incidence of nuchal cords is roughly about 25 percent at term and is associated with increased fetal movement and longer umbilical cords.  Listen in as Dr. Abdelhak and Kristin talk about their experience with umbilical cords around the neck with over 10,000 births between them. We would love to hear from you about your birth experiences or anything you would like us to address about labor, birth pregnancy or postpartum on this podcast. Reach out to us at www.truebirthpodcast.com Integrative OBSTETRICS Social Facebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn Maternal Resources Social Facebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources Subscribe to the podcast on Apple Podcasts, Spotify, Google Podcasts, & Stitcher and leave a review!    

What happens when you were born at home, and then you grow up to realize that it's actually not considered “normal” for most people? For Morgan Oberstein, home birth was a very normalized thing within her family. Not only was she born at home, but she and other home birth children amongst the extended family would often be at attendance for other home births within the group. In this interview, Morgan shares her own home birth journey with her daughter Brooklyn. A perinatal chiropractor, Morgan had the experience of supporting many women through their own motherhood transitions. Even with her expertise and background, Morgan still wanted to have the experience and process of being a birthing person on her own -- so that meant taking classes and educating herself as well as honoring her own unique fears and challenges. One of the largest being a limiting belief around first-time mothers choosing home birth.  Morgan tells us how she moved through going past “due date,” plus her vision for her birth and how it ultimately unfolded Things we talk about in this episode: chiropractors, use of water in birth, cervical checks, birth team support, pushing, en caul, nuchal cord, nuchal hand and pets at your birth Links: Morgan's website: www.drmorganblackburn.com Morgan's chiropractic practice website: www.connectioncafechiropractic.com Mogran's Instagram: https://www.instagram.com/dr.morganjade/ Our website: https://www.diahpodcast.com/ Facebook Group: https://bit.ly/3jKtIYv Instagram: https://www.instagram.com/diahpodcast/ Donate to DIAH: https://bit.ly/3qgm4r9 DIAH Shop: ttps://bit.ly/3qhwgAe

Today's birth story includes a nuchal cord, where the umbilical cord is wrapped around baby's neck one or more times. This amazing home birth comes from Megan Rothenberg who you might remember from episode 15, where we learned of her traumatic first birth. Megan is now a seasoned Home Water Birth Mama and she's back to retell the fresh birth of her 3 month old Eliana.   A Nuchal cord might sound pretty scary, but we hope to put you at ease in this episode by sharing some statistics and educating you on the incredible physiology of the women's body. In addition, if you've had any interest in learning about home birth, today Megan and I talk a bit about midwifery practice, how it might differ from the Western medicine OB practice you are used to, and how to get your spouse on board.   We hope you enjoy the magic of this episode and walk away feeling like you've learned something. If you loved it, please let us know by writing a review!   All the love, Sarah   Want to share your own story?  SUBMIT THIS FORM     FIND SARAH… info@mamainspired.com FB Community: Mama Inspired- The Collective IG: @mamainspiredpodcast www.mamainspired.com  

In this episode, we discuss a new article about the possible benefits of nuchal translucency screening in women who have undergone cell-free DNA testing and two new articles about using negative pressure dressing systems. Mainly, we focus on the link between estrogen and breast cancer. Does estrogen cause breast cancer? Can women with breast cancer use vaginal estrogen cream? And more.

Tiffany shares all about her struggles with infertility, including an ectopic pregnancy where she lost one of her tubes. She goes on to share about her breech Cesarean and her VBAC, both in military hospitals. Tiffany was able to labor at home for awhile, and arrived at the hospital at a 5. She goes into great detail about her labor, and what she was feeling both physically and emotionally every step of the way. The pushing stage came differently than Tiffany expected, so she adapted and was able to get her baby here vaginally. How to VBAC: The Ultimate Prep Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) Topics/Keywords: Nuchal Hand, Military, Infertility, Doula, Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

On today's episode, Dr Joseph Sgroi (OBGYN) talks with Vanessa about her birth story. Vanessa's birth story features discussions around NIPT testing, nuchal translucency, amniocentesis, induction, syntocinon, vaginal birth, postnatal anxiety, braxton hicks, External cephalic version (ECV), prostaglandin.Dr Joseph Sgroi is a highly experienced obstetrician, gynaecologist and fertility specialist in Melbourne. You can find Dr Joseph Sgroi on Instagram @drjosephsgroi or his website at www.drjoseph.com.au.This episode is proudly brought to you by Tiny Hearts Education; our mission is to bring education to all Australian parents through first aid and birthing courses so they can move through pregnancy, childbirth and parenthood with confidence. Visit www.tinyheartseducation.com for more information.

In todays episode we've received an email from a listener of the show, John Hall, who shares a personal experience that he and his partner have recently gone through. Today the tone is a little different as we tackle the nuchal translucency test, downs syndrome and the roller coaster journey that is pregnancy. Got a question, story, advice or a pop tip you want to share like John did? Get in touch by emailing: dadknowsbest@nbs.fm Want to watch the show instead? Check it out on Youtube here: https://www.youtube.com/channel/UCevyY2Id5oB1JQ9X5xy_BTw Amazon links to the gear we use to podcast: Zoom H6 Handy Recorder: https://amzn.to/2Jp14uA Audio-Technica AT2020 Cardioid Condenser Microphone: https://amzn.to/2UqvDq1 Adjustable Mic stands: https://amzn.to/2wNODFI Simple Pop filters: https://amzn.to/3arhONJ XLR Cables: https://amzn.to/2UpMVDs SD Card: https://amzn.to/2UFCzhQ Canon EOS R with 24-105 RF Lens: https://amzn.to/3dBmna7 Canon M50 with 15 - 45 M lens: https://amzn.to/2UXmoNd

In this episode, I check in and provide an update on our pregnancy while sharing my thoughts on the "waiting game" of infertility and the added complexity of the COVID-19 pandemic.

Sarah Winward’s story starts with some lovely swing dancing in the living room, and stomping through deep snow with her dog, then gets really intense, having Sarah ask herself over and over “Where is the break?! There’s supposed to be a break. Where is the break?!” Check it out. Get the most of this episode by checking out the resources and links listed on the show notes page at birthful.com/podcast-birth-center-nuchal-hand-story   Support our sponsors: Go to BirthSongBotanicals.com, and use the code BIRTHFUL for 10% off Go to BranchBasics.com and use the code Birthful for 15% off a starter kit   If you enjoy what you hear, make sure to subscribe! Click to join the Birthful Patreon Community, and get the extra content related to this episode Click to grab my free postpartum plan   Title music: “Vibe Ace” by Kevin MacLeod, at freemusicarchive.org/music/Kevin_MacLeod/ (©CC BY) Sponsorship music: “Air Hockey Saloon” by Chris Zabriskie, at freemusicarchive.org/music/Chris_Zabriskie/ (©CC BY)

Nuchal cord (NC) is common, and the vast majority of term deliveries with nuchal cord have normal outcomes. However, nuchal cord associated fetal morbidity is closely correlated to the number on nuchal cords present and the degree of “strangulation”/tightness. Even Hippocrates noted that nuchal cords could be associated with fetal loss in one of his writings, circa 370 BC. In this session, we will review data from the ACOG executive statement on neonatal encephalopathy, as well as a literature review on NCs by Peesay (2017) from the Journal of Maternal Health, Neonatology, and Perinatology.

In part two of our three part “What I Wish I Would Have Known” series, we’re talking about all of the things you wish someone would’ve told you about BIRTH! Here’s what you can expect to hear in this episode: Why it’s so important to prepare to feel unprepared when it comes to giving birth The only two promises that the Birth Kweens can make about giving birth The importance of getting educated and being invested in your birth while also remaining flexible and open about how your baby needs to be born Why you should consider keeping your exact due date to yourself instead of shouting it from the rooftops Basic info about water breaking (including some common misconceptions) How labor doesn’t always proceed in a linear fashion, and why this matters Normal signs of labor progress, including shaking, nausea, and vomiting Nuchal cords (aka – cord wrapped around baby’s neck) The different kinds of heart rate decelerations that can occur in labor, a basic explanation of what they mean, and what you can do when this happens What babies usually look like right after they’re born Some important things to know about the pushing phase of labor Tips for preventing tearing during a vaginal delivery The sensations that people frequently report feeling during labor Things you can expect with a cesarean birth What it’s like to give birth to the placenta Uterine massage (aka – fundal massage) – what it is and how to cope with it Some tips on making decisions regarding interventions during labor (including a reminder to always use your B.R.A.I.N.) A few quotes from parents about their birth experience and how it shaped them --- If you liked this episode of the Birth Kweens Podcast, tell your friends! And go to iTunes, Stitcher, GooglePlay, and Spotify to rate/review/subscribe to the show. For more from us, visit www.BirthKweens.com to sign up for our newsletter. Follow us on Instagram @BirthKweens, join our Facebook group the Birth Kweens Podcast Community, and email us at birthkweens@gmail.com with your questions, suggestions and feedback. Also, be sure to click here so that you can support the show while doing your regular Amazon shopping!

In this edition of the EVJ podcast, Jose García-López discusses their paper, entitled 'Diagnosis, treatment and outcome of cranial nuchal bursitis in 30 horses' (http://onlinelibrary.wiley.com/doi/10.1111/evj.12787/full) and Carsten Staszyk discusses their paper 'Influence of dental materials on cells of the equine periodontium' (http://onlinelibrary.wiley.com/doi/10.1111/evj.12768/full).

A nuchal cord happens when the umbilical cord is wrapped 360 degrees around a baby’s neck. If this does not resolve itself before birth then a baby can be born with their umbilical cord wrapped around their neck. While this may sound like cause for alarm, there are a lot of misconceptions around nuchal cords and whether they are dangerous to your baby. Nuchal cords happen quite frequently, in over 27% of term births and doctors and midwives should be experienced in births where the baby has the cord wrapped around their neck. This episode answers a few questions from a listener about whether a nuchal cord is a big deal, the risks associated with nuchal cords, and how it can affect delayed cord clamping.   Show notes: http://pregnancypodcast.com/nuchalcord/   Thank you to Zahler for their support of this episode. Zahler makes a high quality prenatal vitamin that has the active form of folate, that I prefer after all of the research I have read on folic acid, plus it has omega 3s and DHA. This is the prenatal vitamin I take and the one I recommend. Zahler is offering an exclusive discount to listeners of the Pregnancy Podcast. To check out the vitamin and find out how you can save 25% when you buy a one month supply on Amazon go to http://pregnancypodcast.com/vitamin/

This week we discuss three common complications of delivery: cord prolapse, nuchal cord and shoulder dystocia. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_85_0_Final_Cut.m4a Download Leave a Comment Tags: Cord Prolapse, Nuchal Cord, Obstetrics, Shoulder Dystocia Show Notes Take Home Points If you have a patient with a cord prolapse, elevate the presenting part to take pressure off the cord, place the patient in trendelenburg and fill the bladder. Then, redline it to the OR for a c-section. Nuchal cord is common but likely not too dangerous. Just gently unwrap the umbilical cord and the fetus should be just fine Shoulder dystocia isn't common but it's a true emergency as the fetus can suffer severe hypoxia or death. You've got a bout 5 minutes to deliver. Immediately call for help from OB, place a foley catheter to drain the bladder and place the mom's legs so that her knees are pressed into her chest. This helps to open up the pelvis and give more room for the shoulder to be delivered. If that doesn't work, you can try the wood's screw maneuver or place the mom on all 4s. If you've got an OR ready, pushing the head back in is also an option but only if you have an OR available Read More Core EM: Shoulder Dystocia

This week we discuss three common complications of delivery: cord prolapse, nuchal cord and shoulder dystocia. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_85_0_Final_Cut.m4a Download Leave a Comment Tags: Cord Prolapse, Nuchal Cord, Obstetrics, Shoulder Dystocia Show Notes Take Home Points If you have a patient with a cord prolapse, elevate the presenting part to take pressure off the cord, place the patient in trendelenburg and fill the bladder. Then, redline it to the OR for a c-section. Nuchal cord is common but likely not too dangerous. Just gently unwrap the umbilical cord and the fetus should be just fine Shoulder dystocia isn’t common but it’s a true emergency as the fetus can suffer severe hypoxia or death. You’ve got a bout 5 minutes to deliver. Immediately call for help from OB, place a foley catheter to drain the bladder and place the mom’s legs so that her knees are pressed into her chest. This helps to open up the pelvis and give more room for the shoulder to be delivered. If that doesn’t work, you can try the wood’s screw maneuver or place the mom on all 4s. If you’ve got an OR ready, pushing the head back in is also an option but only if you have an OR available Read More Core EM: Shoulder Dystocia

A nuchal hand is one of several compound presentations where an extremity is alongside the presenting part of your baby at birth.  With a vertex baby, the presenting part is their head, and with a breech baby, it is their bottom. A nuchal hand means that their hand is up by their face when they are being born and this is the most common presentation irregularity.  Ideally, your baby retracts their arm and comes out headfirst.  A nuchal hand doesn't automatically mean a C-section, but it does have the possibility to bring up some complications. This episode answers several questions about a nuchal hand, how it affects your birth and whether there is anything you can do during pregnancy or labor to prevent it.