Podcasts about ob gyns

We were joined by Dr. Kimberly McLaughlin, OBGYN with Mercy Medical Group and American Heart Association Volunteer who shared critical insights on maternal heart health prevention strategies.Dr. McLaughlin offered a comprehensive approach topreventing heart disease in mothers by addressing health at every stage of pregnancy—preconception, prenatal, and postpartum. She emphasized the importance of prevention strategies, early detection, and empowering women totake control of their heart health throughout the entire reproductive journey.  Dignity Health, via Methodist Hospital is proud to offer24/7 maternal care through their specialized OB Emergency Department (OB ED). This dedicated unit, one of only three in the Greater Sacramento region, provides immediate access to board-certified or board-eligible OB-GYNs which iscritical for moms to get the care they need immediately.This is a must-hear episode for mothers, families, andanyone committed to improving Black maternal health outcomes. Listen, share the episode with your community, and follow the show to stay connected to more conversations that matter.

Send us a textShattering taboos and exposing medical blind spots, this deeply personal exploration of perimenopause and menopause reveals truths that will validate the experiences of countless women struggling in silence.Amita Sharma, founder of Nourish Doc, shares a shocking revelation from her research interviewing thousands of experts worldwide: OB-GYNs receive virtually no education about perimenopause in medical school, with just eight hours devoted to menopause during fifteen years of studying female physiology. No wonder so many women find themselves misdiagnosed with depression or anxiety when their hormones begin shifting.The conversation delves into the profound physical transformations that receive little attention in mainstream discussions. "Your gut microbiome changes, your brain changes," Sharma explains. "You are fundamentally a different person." These changes extend far beyond hot flashes, affecting everything from cognitive function to weight distribution, yet most women navigate this territory without maps or guides.Most powerfully, Sharma courageously shares her personal awakening during perimenopause – how decades of emotional suppression and people-pleasing suddenly demanded expression. "I was angry at myself for not allowing myself to express, for trying to please other people and not myself," she reveals. This emotional reckoning, while challenging, ultimately led to greater authenticity and self-compassion.The discussion illuminates how these transitions often spark relationship difficulties, with data suggesting 60% of women experience partnership challenges during this time. Difficult but necessary conversations about changing libido, emotional needs, and personal boundaries emerge as women reconnect with their authentic voices.Ready to understand your body's transitions with greater clarity and compassion? Visit nourishdoc.com to explore expert-driven resources designed specifically for women navigating perimenopause, menopause, and beyond. Your journey deserves validation, support, and the wisdom of others who truly understand.Support the showRemember, the strongest thing you can do for yourself is to ask for help.Please help us grow by subscribing to and sharing the Lift OneSelf podcast with others.The podcast intends to dissolve the stigmas around Mental Health and create healing spaces.I appreciate you, the listener, for tuning in and my guest for sharing.Our websiteLiftOneself.comemail: liftoneself@gmail.comFind more conversations on our Social Media pageswww.facebook.com/liftoneselfwww.instagram.com/liftoneselfWant to be a guest on the Lift OneSelf podcast message here on Podmatch:https://www.podmatch.com/hostdetailpreview/liftoneselfMusic by: Opening music Prazkhanal Opening music SoulProdMusicMeditation music Saavane

You're going to be inspired by this episode of The Mile High Podcast featuring a very special guest Dr. Courtney Gowin.   Dr. Courtney is the founder of Free to Be Chiropractic, The Nest Wellness Village, and WanderLearn Retreats. She has dedicated her career to supporting mothers through every stage of life with vitalistic chiropractic care.   A former Division I basketball player, Dr. Courtney was led to chiropractic after a major injury. She originally planned a sports-focused career—until mentorship opened her eyes to prenatal and pediatric care. Now she leads one of the most impactful maternal wellness movements in chiropractic.   She's also launched WanderLearn, a global retreat platform providing CE credits in breathtaking locations like Egypt, Japan, and Switzerland—bringing healing and adventure to chiropractors worldwide.   Dr. Courtney is also completing one of the most comprehensive books on natural pregnancy and birth, inspired by global healing traditions and modern clinical insights.  

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog Menopausal Symptoms I waited to announce the emerging research regarding the safety of post-menopausal hormone replacement therapy for breast cancer patients suffering from severe menopausal symptoms until the research finally supported my belief that women have the right to receive the treatment that they need if they accept the risks of that treatment. The past year of research (2024-2025) has produced a significant amount of research demonstrating the health risks associated from not taking hormone replacement therapy, as well as the safety of using testosterone after breast cancer and the limited risks of hormone replacement therapy following breast cancer. I have practiced women's medicine for over 40 years, and I believe that female patients should have the right to receive post-menopausal hormone therapy if they understand and accept the associated risks and benefits, as long as it is administered safely. Let me pause here to discuss how doctors ethically make decisions about treatment. First, the aim of medical treatment is to improve health and longevity while alleviating symptoms. It is a doctor's responsibility to evaluate, treat, and advise patients on the best course of therapy based on their medical training, practical experience, and the latest research. However, the third factor is often overlooked when advising patients about hormone replacement therapy after breast cancer. Doctors determine the best course of treatment by using this information and weighing the benefits of a treatment against its risks. We are trained to provide this information to patients to facilitate informed decision-making with the patient, not for the patient. This process requires time that doctors no longer have. Ah, and therein lies the problem. Doctors are trained to follow research related to the diseases and conditions they treat and to integrate that research into their practice. The basic decision-making process involves weighing the benefits of treatment (or no treatment) against the associated risks. When the benefits of a treatment outweigh its risks, it is recommended to the patient. “Recommended” means the doctor, based on current knowledge, believes it to be safer and more effective for the patient's health to pursue a specific treatment. However, this does not imply that the patient must follow the doctor's advice. A patient is autonomous and can assess the risks and benefits once informed, allowing them to refuse a treatment or request one that falls outside current medical guidelines. Doctors do not have to embark on a treatment they do not believe is beneficial or safe. Doctors have autonomy as well! Doctors in mainstream medicine adhere to “medical guidelines” established by our specialties, which represent the minimum level of care expected from a physician. However, these guidelines are often decades behind current research, meaning that the risks and benefits communicated to a patient may be outdated. A legal requirement known as informed consent mandates that a doctor inform the patient or include this information in a consent form that the patient reads and signs, detailing the procedure or treatment. If the treatment is newer than the guidelines, it is categorized as “off-label.” It is essential for the doctor to inform the patient that the treatment does not conform to current guidelines, and the patient must acknowledge the known risks associated with the treatment. At BioBalance Health®, we often find ourselves ahead of the guidelines, and my experience indicates it may take up to 20 years for the guidelines to catch up with us. Much of our treatment is considered off-label because it is current and ahead of the guidelines. It is superior to other treatments and remains safe, but risks are inherent in every treatment! Now, let's return to breast cancer and the roles of estradiol, testosterone, and progesterone replacement. Here are the facts about breast cancer: Most breast cancer patients are post-menopausal, and have symptoms of menopause Not all types of breast cancer are stimulated by estradiol or progesterone, and therefore for these cancers hormone replacement therapy is safe. Breast Cancer patients with negative nodes who have had a bilateral mastectomy are candidates for hormone replacement therapy after their treatment. The risks of estrogen replacement for ER+ breast cancer patients may promote the growth of cancer cells, while testosterone replacement lowers the risk of recurrence and alleviates certain menopausal symptoms. When testosterone is combined with estradiol, the risk of developing breast cancer in all women is reduced. Testosterone enhances the quantity and activity of cancer-fighting T-killer and T-helper white blood cells. All breast cancer patients can manage menopause symptoms using testosterone pellet therapy and vaginal estrogen without an increased risk of recurrence. Do you remember when I mentioned that the risks of treatment should be balanced with the benefits of that same treatment? Recently, numerous research articles have outlined the benefits of estradiol treatment, which I included in my 2017 book, “The Secret Female Hormone: How Testosterone Replacement Can Change Your Life.” In early 2025, the safety of taking estradiol for menopausal women confirmed the less publicized research that had come before. The Journal of Endocrinology and Metabolism reported that women who underwent estradiol replacement after the age of 60 live 20% longer than those who do not take hormone replacement therapy. This challenges the guideline that advises OB-GYNs to discontinue hormone replacement therapy before the age of 60. The Benefits of Estrogen replacement after menopause, based on multiple research studies over the last 20 years is as follows: ERT alleviates symptoms such as dry vagina, painful intercourse, insomnia, hot flashes, and night sweats. Estrogen replacement prevents and treats osteoporosis in women. Testosterone replacement in women with osteoporosis can reverse the process of bone loss, bringing bone back to normal strength and decreasing fracture risk. Non-oral Testosterone and Estradiol can prevent arteriosclerotic heart disease. ERT and HRT decreases the risk of diabetes with aging. Estradiol replacement during the first decade after menopause can delay the onset of Alzheimer's disease and dementia by ten years. If you are genetically predisposed to developing Alzheimer's or dementia by age 80, E2 replacement may postpone this onset until you turn 90. Testosterone replacement in the first 10 years after menopause postpones the onset of Alzheimer's disease and dementia for an additional ten years. Testosterone boosts immune function in both sexes and diminishes the onset and severity of infectious diseases. Aging causes cognitive decline, marked by challenges in memory and thinking, and menopause speeds up this process. Testosterone and estradiol replacement therapies may aid in reversing this decline. Muscle mass decreases after menopause due to a decline in testosterone but replacing testosterone with bio-identical pellets restores muscle mass to premenopausal levels.   The latest medical article that inspired me to create this podcast was published in the journal Menopause, which discussed the challenges many women face after breast cancer treatment without hormone replacement for their severe menopausal symptoms. Here are the quotes I think you should hear: (MHT = Menopause Hormone Therapy) “Among 226 breast cancer survivors.. the menopause symptom burden was high and women's experience of menopause-related breast cancer after-care was poor. Few women felt actively involved in menopause treatment decisions.  The NICE breast cancer guideline (NG101) states that women with a history of breast cancer can be offered MHT in “exceptional” circumstances if other treatments have failed (off-label use). However, NICE does not define what “exceptional” circumstances are or who gets to decide. Up to 50% of breast cancer survivors, especially those with debilitating menopausal symptoms, may choose to accept a small increase in risk in exchange for an improved quality of life and/or to mitigate future health risks associated with chronic estrogen deficiency.  “Allowing”. women to have MHT only in “exceptional” circumstance undermines patient autonomy and limits a clinician's ability to integrate clinical knowledge and judgment with the best currently available evidence (which is decades behind clinical guidelines). Clinicians have a legal and ethical responsibility to patients to make informed treatment choices. If you have had breast cancer and are experiencing symptoms you no longer want to endure, my advice is to find a doctor with whom you can make an informed decision based on the latest research. It's important to understand and accept the risks and to sign a High-Risk Consent for HRT.  If you aren't that brave, then seek a physician who will prescribe testosterone pellets along with vaginal estradiol to alleviate some of your post-menopausal symptoms. Life is too short to follow guidelines that are 20 years out of date when you are suffering.

Send us a textPostpartum care in the U.S. is broken—period. Women are left struggling with depletion, hormone imbalances, and autoimmune conditions with little to no real support. What if postpartum care wasn't just about surviving but actually thriving?Today I'm chatting with Jane Baecher, co-founder and CEO of Anya, a revolutionary postpartum wellness brand changing the game for new moms. Jane shares her journey, why she felt called to disrupt the space, and how Anya is helping moms heal at the root—through nutrition, holistic care, and real, evidence-based solutions. We're talking why postpartum recovery is more than just the first six weeks, how the U.S. is failing mothers compared to other countries, and what it will take to truly shift the narrative around postpartum health. Click HERE to check out this episode on the blog. Key Time Stamps:  04:50 What is Anya and how is it transforming postpartum care? 07:28 Why postpartum recovery is more than just six weeks 10:00 The U.S. vs. global postpartum care: What we're missing 13:49 How postpartum providers & brands can work together for better care 16:52 Why postpartum needs a whole-body approach—not just OB care 20:58 The challenges of bridging medical and holistic postpartum support 25:50 The dream of a postpartum specialist model 29:38 Why nutrition & functional medicine are the missing pieces in postpartum care 33:46 How we can push for better postpartum support in our communitiesConnect with Jane:  Jane Baecher, co-founder and CEO of Anya, is a Cornell University graduate who began her career in fashion. Inspired by her own postpartum journey, Jane founded Anya to fill a critical gap in postpartum care. Combining traditional recipes, nutritional science, and food-based healing, Jane began creating products to support mothers through their first year of recovery and beyond. Anya offers a products and educational resources developed with OB/GYNs, pediatricians, nutritionists, herbalists, and doulas, providing holistic support for new moms.Website | IG  Get 20% off your first order with Anya!NEXT STEPS:

Send us a textYour body is sending you signals, but do you know how to interpret them? That overwhelming fatigue, unexplained weight gain, brain fog, and emotional rollercoaster might not be a midlife crisis or mental health issue—it's likely your hormones running the show.This eye-opening episode dives deep into the world of women's hormonal health, particularly perimenopause. What makes this conversation so crucial is the shocking lack of medical education around women's hormones: 60% of OBGYNs receive little to no formal training on menopause during medical school. No wonder so many women feel dismissed, misdiagnosed, or told to simply "welcome to the club" of aging.From the science of estrogen, progesterone, testosterone, and cortisol to the comprehensive list of symptoms affecting everything from your sleep to your sense of self, this episode serves as both validation and education. You're not going crazy—your body is undergoing profound biological changes that deserve proper attention and care. Learn practical strategies for hormone balance, including nutrition adjustments, appropriate exercise (strength training trumps cardio during perimenopause), stress management, and when to consider bioidentical hormone replacement therapy.Most importantly, discover how to become your own health advocate. With proper knowledge and the right specialists, you can navigate this transition without suffering through symptoms that impact your quality of life. Whether you're experiencing these changes yourself or know someone who is, this conversation provides the foundation for understanding what's happening beneath the surface and taking back control of your wellbeing. Share this episode with someone who needs to hear they're not alone—it might just change their life.Connect with Leslie: Follow on IG: @yourjoyfulorderstyle Website: https://www.yourjoyfulorder.com/Email: lmartinez@yourjoyfulorder.com to schedule- Speaking Events, Interviews or Life Coaching SessionsShop my SOAP the Gospels Journal on Shopify: https://shopjoyfulorder.com/Watch this Episode on You Tube: https://www.youtube.com/channel/UCsXoAYIM2mfclNtYiaOzIUw Shop my Journal (Gratitude, Goals & Prayer Journal) on Amazon:https://a.co/d/09Djvaw Book a FREE 30 Minute Discovery Coaching Call: https://tidycal.com/joyfulordermedia/30-minute-meeting

Dr. Thaïs Aliabadi, aka Dr. A, joins Real Pod for an absolute masterclass in women's health! You may have seen her on Keeping Up with the Kardashians (yes, she delivered Khloe's baby!), but today she's here to drop life-changing knowledge on fertility, PCOS, endometriosis, and what you need to be asking your OBGYN. Dr. A shares her incredible journey from growing up in Iran during the revolution to becoming one of the most sought-after OBGYNs in Los Angeles. She opens up about how her past fueled her passion for advocating for women's health, why so many conditions go undiagnosed, and the exact tests and questions every woman should be bringing to her doctor. From understanding your egg count to debunking birth control myths and tackling the link between PCOS and eating disorders, this episode is packed with crucial info that could change the way you approach your health. Get ready to take notes - Dr. A is giving us the ultimate roadmap to self-advocacy, and you do not want to miss it!SHE MD PodcastBreast Cancer Risk CalculatorOvii PCOS QuizVic's Appearance on SHE MDReal Pod InstagramWatch Real Pod on YouTube// SPONSORS // Better Help: Visit betterhelp.com/realpod today to get 10% off your first month. Just Thrive: Visit justthrivehealth.com and use code REALPOD for 20% off your first 90 day bottle. That's like getting a month for free! LMNT: LMNT is offering a free sample pack with any purchase, that's 8 single serving packets FREE with any LMNT order. This is a great way to try all 8 flavors or share LMNT with a friend. Get yours at DrinkLMNT.com/realpod.The Knot: Let The Knot be your partner in all things wedding planning. Get started at theknot.com/audio. Please note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode. Produced by Dear Media. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Ronit Menashe and Vida Delrahim, co-founders of WeNatal, share how their pregnancy losses led to uncovering the overlooked role of male fertility in conception and healthy pregnancies. We unpack how WeNatal's science-backed, functional supplements support both partners and why the preconception window is the most powerful time to biohack your fertility.  Whether you're trying to conceive, pregnant, postpartum, or planning ahead—this conversation is a must-listen. WE TALK ABOUT:  06:00 - The surprising science behind sperm health and longevity 09:00 - How male fertility influences pregnancy loss and placenta health 12:00 - Ronit and Vida's personal miscarriage stories  17:00 - The male biological clock: fact vs fiction 22:00 - Why most OBGYNs still aren't educating men properly 26:00 - Brittany's fertility coaching program and six daily habits for preconception health 30:00 - The truth about AMH levels and egg quality optimization 35:00 - IVF industry pitfalls and how to advocate for your body 42:00 - Daily fertility habits Brittany and her husband used to triple sperm count 46:00 - Why you must continue prenatals into postpartum  50:00 - The future of fertility: prevention, personalization, and male empowerment SPONSORS: Protect your reproductive health with Leela Quantum Tech's EMF-blocking underwear. Use code: BIOHACKINGBRITTANY for an extra 10% discount on all of their products! Feel your best with NOVOS—the only supplement targeting all 12 causes of aging. Use code BIOHACKINGBRITTANY for 10% off your first month! RESOURCES: Optimize your preconception health by joining my Baby Steps Course today! Optimize your preconception health and fertility through my free hormone balancing, fertility boosting chocolate recipe! Download it now! My Amazon storefront WeNatal's website and Instagram The WeNatal Fertility Masterclass LET'S CONNECT: Instagram, TikTok, Facebook Shop my favorite health products Listen on Spotify, Apple Podcasts, YouTube Music

Maria Shepherd is the founder and CEO of Medi-Vantage, which helps companies develop disruptive medical devices and marketing strategies. Every strategy is designed to decrease risk, disrupt existing markets, and drive market share while improving patient outcomes. With clients from Japan, Australia, several EU countries, and the United States, Medi-Vantage has developed a comprehensive approach to global market entry, with services encompassing everything from developing engineering marketing specifications to conducting clinical due diligence for acquisitions.  As a guest on The Global Marketing Show, a Rapport International podcast, Maria shares her best advice from over 16 years of medical device strategy research, covering the commercialization continuum from marketing specifications through reimbursement, pricing strategy, and go-to-market planning. She also provides a roadmap for bringing medical devices to global markets: careful research and strategic pricing built upon a deep understanding of local healthcare systems.  The Complexities of Global Medical Device Pricing  Maria reports that thanks to increased transparency in the digital age, the days of setting different prices for different regions are essentially over. When a medical device is sold at a significantly lower cost in India, for instance, in the US, Germany, France, or Japan, economic buyers can easily access that information.  Transparency has forced companies to develop more sophisticated approaches to market entry in different regions. Some strategies include providing complementary capital equipment with the purchase of disposables or the implementation of subscription models. These approaches must be carefully considered, however, as some markets (like US hospitals) are known to resist certain pricing models. The key is finding a balance across different healthcare systems while maintaining profitability and market access.  Medi-Vantage develops budget impact models to help companies determine pricing and demonstrate value. Maria describes a recent project involving a device to help OB-GYNs make more informed decisions about C-sections. The model factored in:  Current C-section rates (36% in the US versus 24% globally)  Hospital costs associated with C-sections  Potential complications and ICU stays  Impact on mothers and babies  NICU costs  Associated litigation risks  Long-term implications like cerebral palsy  A comprehensive analysis quantifies immediate and long-term cost savings, making it easier for healthcare providers to justify the investment. Such models are particularly valuable when introducing disruptive technologies that require changes to established medical practices, Maria says, adding that:  We quantified all of those and put them into the budgetary impact model because, oftentimes, nobody really sees an alternative to C-section. They don't sit down and figure out, what if we didn't have to do this C-section? Then there are the costs to the mother, of complications, death, extreme impairment, or long hospitalization.  Clinical Due Diligence in Global M&A  Medi-Vantage also conducts clinical due diligence for medical technology companies considering acquisitions. Maria says it's not unusual for a surface-level appeal to fall short of reality, describing a rare instance in which she resisted an acquisition. A new technology promised to reduce a procedure requiring two in-hospital procedures to one hospital procedure plus one office visit, a clear win for efficiency and cost reduction.  During the due diligence process, however, the Medi-Vantage team uncovered significant resistance from both physicians and hospital administrators. The physicians were concerned about losing control of the second procedure to another specialist; hospital administrators worried about lost revenue. The feedback proved invaluable to their client's decision-making process, highlighting the importance of understanding local healthcare dynamics and stakeholder interests.  Advice for Global Market Entry  Medical device companies seeking global expansion face a complex web of challenges that extend far beyond basic market research. Standing out in a competitive market requires working with consultants who have deep expertise in specific medical specialties, she says, and a network of partners who understand both the clinical and business aspects of the device industry.  “It's important to seek out the people who can do the best for you, who understand the medical device specialty,” be it interventional cardiology or gastroenterology, regulatory requirements, translation, or another aspect. This targeted approach helps to prioritize the steps toward market acceptance based on unique workflows and decision-making processes.  The complexity extends beyond clinical knowledge. Market entry strategies must also account for local healthcare systems, reimbursement structures, and regulatory frameworks. “It's not easy,” Maria acknowledges. “You take into account what the reimbursement rates are, what types of insurance plans are available. There are many different factors, but what you want to be sure of is that you've got guardrails in place.”  Communication presents another critical challenge. Even with her own French language skills, Maria insists on working with specialized medical translators for international research. “I would never interview somebody in French and rely on my own French speaking skills,” she says. “I want to be sure that I get every single little nugget.” This attention to detail is particularly important in medical device marketing, where misunderstandings about product specifications or usage could have serious consequences.  While AI translation tools can be helpful for basic understanding, Maria stresses the importance of human expertise in medical translation, particularly for critical communications and research. High-quality translation from subject matter experts should be used for anything affecting revenue, liability, or the company's bottom line. For translation, interpreting, and research, for example, Maria looks for linguists who understand medical terminology in both source and target languages.  Maria's experience in North Africa crystallized for her the importance of understanding local market conditions. Learning the Arabic word “makesh” (meaning “there isn't any”) taught her that assumptions about product availability and market needs don't translate across borders. “In the United States, you can get almost anything, but that's not true in the rest of the world,” she observes. “Makesh is almost the standard.” This insight underscores why thorough market research conducted by experts who understand both the medical specialty and local healthcare environment is essential for successful global expansion.  For companies planning international expansion, Maria recommends a methodical approach:  Find consultants with relevant medical specialty expertise  Ensure all research and communication is handled by qualified professionals with appropriate language and clinical knowledge  Develop market entry strategies that account for local healthcare systems and cultural nuances  While COVID-19 accelerated many changes, Maria notes that these shifts were already underway. Industry leaders like Medtronic and Boston Scientific have evolved beyond traditional multinational models to become truly global organizations with unified branding, marketing, and communication strategies. The path forward is both challenging and clear, she says, adding that success will require moving beyond surface-level market research toward a deep and nuanced understanding of local healthcare dynamics, especially when “makesh is the standard.”  Links: Website: https://www.medi-vantage.com/  LinkedIn: https://www.linkedin.com/in/mariashepherd/ 

Send us a textHow do we ensure kindness and justice in a prison system not designed with women in mind? Join us for a compelling episode where we welcome Colleen Bell, chair of the Ostara Initiative's board of directors, as she reveals the stark realities and urgent needs of incarcerated mothers. Discover the transformative work Ostara is doing to challenge inhumane practices like shackling during labor and high rates of C-sections, setting new standards for maternal and child health within prisons. Colleen shares inspiring stories of change from Minnesota to Alabama's Tutwiler Prison, highlighting advancements in lactation support that not only benefit mothers and babies but also offer financial advantages for states willing to embrace such reforms.In a thought-provoking discussion, we illuminate the vital role of doulas who provide crucial emotional and physical support to pregnant women in prison, empowering them amidst systemic failures. Distinguishing the essential contributions of doulas from midwives and OBGYNs, we confront misconceptions about the adequacy of prison healthcare and spotlight the unique challenges faced by women in a system primarily designed for men. We also tackle broader issues such as societal neglect of the root causes of women's incarceration, from trauma to survival crimes, asking tough questions about the humanity and effectiveness of our current penal system. Don't miss this episode as we advocate for transformative change in pursuit of kindness and justice. If you're interested in more information on women in the judicial system you may want to check out loads of charts, brief reports and a great search function at the Prison Policy Initiative. #justice #women #incarceration This podcast is a proud member of the Mayday Media Network. If you have an idea for a podcast and need some production assistance or have a podcast and are looking for a supportive network to join, check out maydaymedianetwork.com. Like what you hear on the podcast? Follow our social media for more uplifting, inspirational and feel-good content.FacebookInstagramLinkedInTikTok Support the showDid you find this episode uplifting, inspiring or motivating? Would you like to support more content like this? Check out our Support The Show Page here.

Tina Keshani, co-founder and CEO of Seven Starling, joins Kellogg MBA student Kaiya Adam to discuss how Seven Starling is transforming mental healthcare for women, starting with maternal mental healthcare.  LinkedIn(4:57) Exploring Tina's journey cofounding Seven Starling while in business school (10:07) Assessing the current state of maternal mental health in the U.S. (15:15) Understanding Seven Starling's specialized care model, including individual therapy, group therapy, and medication management (19:57) Integrating data to help patients get better faster  (24:39) Partnering with OB/GYNs to enable access to care  (27:08) Contracting with major health plans to support affordability  (34:32) Scaling after the Series A funding round  

In this episode of the You Are Not Broken podcast, Dr. Kelly Casperson interviews Dr. Jocelyn Fitzgerald, a urogynecologist specializing in pelvic floor disorders. They discuss the importance of open conversations about women's health, particularly regarding prolapse and the misconceptions surrounding childbirth. Dr. Fitzgerald shares her journey into social media advocacy, the challenges women face in understanding their health, and the need for better education and separate specialties in women's health. The conversation highlights the systemic issues in healthcare that affect women's treatment and the importance of empowering women with knowledge about their bodies. In this conversation, Dr. Jocelyn Fitzgerald and Dr. Kelly Casperson discuss the complexities of women's health, particularly focusing on menopause, the role of healthcare providers, and the challenges faced in the healthcare system. They emphasize the need for a multidisciplinary approach to women's health, the importance of vaginal health, and the radical nature of urogynecology as a feminist act. The discussion also touches on the future of OB-GYN, reproductive rights, and the necessity for women to take action in advocating for their health. Takeaways Prolapse is often misunderstood and not openly discussed. Education can reduce anxiety about childbirth and its consequences. Women often feel ashamed or broken due to health issues post-childbirth. IUD placement pain is often inadequately addressed in women's health. Obstetrics and gynecology should be separate specialties for better care. The healthcare system often undervalues women's health procedures. Women need to be informed about the risks associated with childbirth. Empowering women with knowledge can lead to better health outcomes. Ob-Gyns often lack knowledge about menopause-related issues. A multidisciplinary approach is essential for women's health. The healthcare system can be toxic and burdensome for providers. Urogynecology plays a crucial role in women's health post-childbirth. Vaginal estrogen is vital for maintaining vaginal health. Incontinence is a leading cause of nursing home admissions. Reproductive rights are under threat and require advocacy. Reliable male birth control could change societal dynamics. https://www.instagram.com/jjfitzgeraldmd/ Sedona in October: https://www.ascendretreats.com/menopause-and-sexual-health-2025 Order my book "You Are Not Broken: Stop "Should-ing" All Over You Sex Life" Listen to my Tedx Talk: Why we need adult sex ed Take my Adult Sex Ed Master Class: My Website Interested in my sexual health and hormone clinic? Starts 2025. Thanks to our sponsor Midi Women's Health. Designed by midlife experts, delivered by experienced clinicians, covered by insurance. Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care. https://www.joinmidi.com Thanks to our sponsor Sprout Pharmaceuticals. To find out if Addyi is right for you, go to addyi.com/notbroken and use code NOTBROKEN for a $10 telemedicine appointment. See Full Prescribing Information and Medication Guide, including Boxed Warning for severe low blood pressure and fainting in certain settings at addyi.com/pi To learn more about Via vaginal moisturizer from Solv Wellness, visit via4her.com for 30% off your first purchase of any product, automatically applied at checkout. For an additional $5 off, use coupon code DRKELLY5. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hello Wonderful Readers,Last week, I interviewed Camilla Sievers, founder of Qi Health. Qi is a Traditional Chinese Medicine (TCM) company that creates personalized blends of natural herbs to solve various problems in women's health.Camilla was inspired to create her company from her journey using TCM to relieve her persistent period cramps and other symptoms. Now, her team has built a seamless digital experience to help people access one of the oldest medical systems in the world.I hope you enjoy our conversation! Feel free to reach out to Camilla on Instagram or LinkedIn to share your healing stories.Check out her interview in Entrepreneur!I hope you have a shamelessly sexy weekend

What skills and disciplines can a surgeon take from their training to succeed in a new leadership / hospital administration role? In this episode of BackTable OBGYN, Dr. Mark Hoffman discusses his transition from a minimally invasive gynecologic surgeon to the Chief Medical Officer at his hospital with co-host Dr. Amy Park. --- SYNPOSIS The doctors cover the importance of high-functioning teams, the unexpected challenges of hospital administration, and the impact of clinical experience on decision-making. Additionally, they explore the broader responsibilities and skill sets required for effective leadership in a hospital setting, and offer advice for others considering a similar career shift. Dr. Hoffman emphasizes the value of servant leadership, the benefits of focusing on strengths, and the necessity of building strong, resilient teams. --- TIMESTAMPS 00:00 - Introduction 05:16 - Transitioning to Hospital Administration 07:17 - Balancing Workload 10:33 - Teamwork and Leaning into Strengths 13:30 - Decision Making in Administration 26:20 - Unique Challenges for OBGYNs in Hospital Administration 31:48 - Engagement in Leadership 35:03 - Focusing on People to Improve Patient Care 44:18 - Building Effective Leadership Teams 45:25 - Transitioning to Hospital Administration 52:07 - Finding Joy in Leadership and Mentorship

Board-Certified Nurse Midwife Kristin Mallon joins Lesley Logan to illuminate how to bridge the gap between “normal” lab results and genuine wellness by harnessing hormone insights, gut health strategies, longevity medicine, and integrative care. From understanding the nuanced roles of midwives and doulas to exploring advanced testing for a deeper picture of health, Kristin reveals how following your intuition and seeking daily excitement can fuel a truly fulfilling life at any age.If you have any questions about this episode or want to get some of the resources we mentioned, head over to LesleyLogan.co/podcast. If you have any comments or questions about the Be It pod shoot us a message at beit@lesleylogan.co. And as always, if you're enjoying the show please share it with someone who you think would enjoy it as well. It is your continued support that will help us continue to help others. Thank you so much! Never miss another show by subscribing at LesleyLogan.co/subscribe.In this episode you will learn about:The difference between midwives, doulas, and OB GYNs.Turning to personal intuition when seeking healthcare solutions.Why standard labs often miss suboptimal hormone levels.How deeper gut testing supports lasting energy and vitality.Using advanced integrative approaches for longevity medicine.Episode References/Links:FemGevity - https://beitpod.com/femgevityFemGevity on Facebook - https://www.facebook.com/FemGevity/FemGevity on Instagram - https://www.instagram.com/femgevity/FemGevity on Tiktok - https://www.tiktok.com/@femgevityFemGevity on X - https://x.com/FemGevityFemGevity on LinkedIn - https://www.linkedin.com/company/femgevityhealth/FemGevity on YouTube - https://www.youtube.com/@femgevityGuest Bio:Kristin Mallon is a health tech entrepreneur with over 15 years of experience in the industry. As the co-founder and CEO of FemGevity, she is passionate about improving women's health through innovative solutions. Under her leadership, FemGevity has grown into a successful company that provides essential support to women who need it most.Prior to founding FemGevity, Kristin launched Vibrant Beginning, a high-end supplement line of prenatal vitamins. She is committed to making a significant impact in the healthcare industry and enhancing the lives of women around the world. Kristin advocates for transforming the healthcare narrative from solely providing "sickcare" to developing and offering platforms that support optimal health planning. If you enjoyed this episode, make sure and give us a five star rating and leave us a review on iTunes, Podcast Addict, Podchaser or Castbox. DEALS! DEALS! DEALS! DEALS!Check out all our Preferred Vendors & Special Deals from Clair Sparrow, Sensate, Lyfefuel BeeKeeper's Naturals, Sauna Space, HigherDose, AG1 and ToeSox Be in the know with all the workshops at OPCBe It Till You See It Podcast SurveyBe a part of Lesley's Pilates MentorshipFREE Ditching Busy Webinar Resources:Watch the Be It Till You See It podcast on YouTube!Lesley Logan websiteBe It Till You See It PodcastOnline Pilates Classes by Lesley LoganOnline Pilates Classes by Lesley Logan on YouTubeProfitable Pilates Follow Us on Social Media:InstagramThe Be It Till You See It Podcast YouTube channelFacebookLinkedInThe OPC YouTube Channel Episode Transcript:Kristin Mallon 0:00  There's this huge gap between optimal health and chronic care and crisis care and sick care that needs to be filled. You know, which is like what we're doing, and there's so much to be done. There's so much and then obviously it gets into the whole prevention of chronic care and crisis care in the long term. Lesley Logan 0:19  Welcome to the Be It Till You See It podcast where we talk about taking messy action, knowing that perfect is boring. I'm Lesley Logan, Pilates instructor and fitness business coach. I've trained thousands of people around the world and the number one thing I see stopping people from achieving anything is self-doubt. My friends, action brings clarity and it's the antidote to fear. Each week, my guest will bring bold, executable, intrinsic and targeted steps that you can use to put yourself first and Be It Till You See It. It's a practice, not a perfect. Let's get started.Lesley Logan 1:03  All right, Be It babe, I have a great human for you to hear from today. So I have been on a mission to help educate women on how to be it till they see it and part of that is you feeling like you have the health and the body and the strength and the stamina and the hormones that take you to where you want to go. And so today's guest is Kristin Mallon. She is part of the FemGevity team. You definitely have to listen to Michele Wispelwey's episode from last year, if you haven't, because the two combined are just absolutely wonderful. I have never had so much hope about women's health since I met them, and now I just feel educated, informed, supported. And so the first part of this episode is gonna feel medical-heavy, ladies, you gotta listen. Those of you, no matter where you are, what's going on, it's really good information. You can share it with a friend. And then, we have a really great, she blew my mind. I'm not kidding. What I expected her to answer and what she answered, wouldn't have guessed it in a multiple choice. And now that I know her, I would always, her tips and some of these things that she does for her life, have me wanting to reevaluate what I want to do in my year and what I want to call in more of. So this is just a chock-full episode. Thank you, Kristin Mallon from FemGevity for being here. And y'all make sure you let us know how this episode helped you. Share this with a friend. Here's the thing, we all have to educate each other and ourselves and support each other and to the few good men listening. Thank you so much. You should know this about women's health. Send it to your friend, your sister or your cousin, because this is how we all get stronger together. Lesley Logan 2:36  All right, Be It babe, this is going to be just so much fun. I have been sharing the reels that this woman has been putting out on Instagram multiple times. I'm like, I'm gonna share this one. I'm gonna share this one. We have Kristin Mallon in the house. She's a co-founder of FemGevity, and I love her. Love Michele. If you listened to the podcast I had with Michele Wispelwey, you know what they are. If you follow me at all, you know I'm obsessed with them and all that they're doing. So Kristin, can you tell everyone who you tell everyone who you are and what you rock at? Kristin Mallon 3:04  Yeah, I'm Kristin Mallon. I'm a certified nurse midwife, and I've been doing women's health for over 20 years, and really focusing on, obviously, being a midwife, the blend of medicine, but also ancient wisdom. Lesley Logan 3:17  Okay, I have a couple of things I wanna just chat with. Is like, first of all, I think midwives feel like, to me, they're becoming more and more popular and more and more accessible. Is that true? And then for the people who don't know what a midwife is, can you kind of break that down? Kristin Mallon 3:30  So, yes and no. I think there's pockets of the country where they're becoming popular and pockets of the country where they're becoming unpopular. There's a big, I think, problem in general, with the, you know, or challenge, I don't always like to say problem with, a big challenge with reimbursements across the board for all people that practice any type of Obstetrics and Gynecology, and so we're not really educating and training enough midwives. I think the desire is there and the demand is there, but then the burnout is high, and there's the business aspect, because most midwives are really altruistic, and they really kind of go into this type of work, because it's their passion. So that needs a little bit more support and needs a little bit more, you know, kind of hand-holding. Midwives are confusing, because people think midwives are doulas, people think midwives are doctors, and then kind of everything in between. So I am a board certified nurse midwife. So that's kind of like the highest level of midwifery training and education that you can get. I have a nursing degree. I have a master's degree in nursing and then I took a board certification that I maintain. You know, every year, there's a certain level of requirement that I have to attain. I deliver all of my births in a hospital, and I do assist on surgeries, and I do minor gynecological surgeries, and I really do everything that an obstetrician does, not really a gynecologist. So someone who's delivering babies working with babies, that's what I do. There's other types of midwives, so there's certified midwives who are midwives that are not nurses. There's lay midwives, which are midwives that are trained in a variety of different ways, usually kind of more culturally-trained. And then there's professional midwives, and their certification is a little bit different. And then all states have different governing boards about how they allow them to practice and not practice. But pretty much, if you're going to have a home birth, you're having a midwife. I know like one OB GYN in my whole career, and I know thousands of people in the birth space that he is a physician that does home births, but 96-ish, 95% of midwives are doing their births in a hospital setting so it's kind of confusing. They really are a nurse and an OB GYN had a baby and that's a midwife.Lesley Logan 5:41  Okay, I love that. Thank you for explaining it, because I think I definitely was one of the oh, it's like a doula. And I have a friend who's a doula, so I know clearly my friend is now finding out I didn't know what she did. Okay.Kristin Mallon 5:53  Well, and doulas are really, I always like to make this distinction and like the opportunity to educate people, because doulas have no medical training, no medical background, no medical certification, no licensing, they have to maintain and they can't perform any medical procedures. Whereas a midwife can do pretty much everything an obstetrician can do, except they can't be a primary surgeon on a surgical case.Lesley Logan 6:13  Yeah, yeah, that makes sense. Okay, so then you have been, so my other thing with what you've been rocking at is that you've been in, like, women's health medical field for 20 years, and I wonder, what have you seen change for the better, and what still needs changing that we can, you know, make sure we're aware of. I'm 42. This is coming out when I'm 42. I love that people are like, wow, you don't look 42. That's great. I would love to stay looking young as long as possible. That's wonderful. But I don't want to feel, I would like to feel young, too. So I'm just really excited about what you do and what you know about women's health.Kristin Mallon 6:49  Yeah, so we've come so far. So in the last 20 years, I think we've made remarkable strides in miscarriage care, in contraception and fertility care, in reproductive care, in breast health, just kind of an awareness, a lot of mental health awareness, a lot of cancer awareness, cardiovascular awareness. I think the areas where we need to improve on is definitely access. Not all women have access to the types of care they want. There's just not enough OB GYNs. And, unfortunately, there's not enough OB GYNs, there's not enough midwives. We're not graduating enough to replace the ones that are leaving the workforce on a year-to-year basis. It's kind of a big problem. And then, of course, which is what FemGevity is all about, is I know everybody can relate so well to this. You go to the doctor, you don't feel right, and they tell you, your labs are normal, but something's still wrong. And that's really where FemGevity was born, or birthed, so to speak, is from that sensation, because I dealt with that for 20 years. I was like, something's still, like, labs are normal, something's still wrong. Okay, let me look, let me dig, let me keep going. Let me pull from functional medicine. Let me pull from integrative medicine. Let me pull from longevity medicine. And let's figure that out. And a lot of that has to do with how women change decade to decade. So men kind of have this big change at puberty, and then they kind of peak, and then they kind of slowly evolve and change really gradually. And women are so different decade to decade. And once I kind of really started to unravel that and pull that back, it was easy to apply that to all the different things, including menopause care and endometriosis care, PCOS care, fertility care, reproductive care, women's health in general, from head to toe. And you know, a big thing that we do at FemGevity is a lot of gut health, like the gut is such a big overlooked thing. People think oh, I'm tired. I need to check for anemia, I need to check my thyroid. But we're like, no, you need to check your gut. We need to check micronutrient levels. We need to look deeper. So that's where I think we still have a long way to go and a long way to come, and that's what we're doing at FemGevity.Lesley Logan 8:50  Yeah, I think every woman listening is nodding their head when you're like, I went to the doctor and like, everything is normal. I actually had a female doctor in the, I forget what department it was, but it was like in these extreme diseases. And the woman, I got sent to her and she's like, do you feel supported by your doctor? And I'm, no, why am I here? This is the scariest place I could be. I am now very scared. Do I have AIDS? What is going on? And she's like, okay, I think we need to find, it was like a gut doctor who sent me there and because he couldn't figure what's going on, because I kept insisting, I'm not right, something's not right, and so I just got passed off. And, you know, a lot of people have, like, experienced a lot of family or in the holidays or birthdays, and you hear someone going, oh, it's what I ate yesterday. It's what I ate yesterday. I'm like, is it though, or is it something from a week ago? Or is it something? Because the gut is such a complicated, to me, it's complicated, place like it's not necessarily what you ate in the last meal. It could be from another meal that you don't remember.Kristin Mallon 8:51  Yeah, absolutely. And I think what you're talking about is it's really not doctors' faults, because the way that the healthcare system is set up, at least in the United States, is it's really crisis care, sick care, catastrophic care, cancer care, you know, the big C's of care. And if you don't have a chronic condition, you're really going to your doctor and you're saying do I have a chronic condition? And your doctor is telling you truthfully, no, you don't have something like diabetes or high blood pressure or cardiac disease, liver disease, kidney disease, etc. And so there's this huge gap between optimal health and chronic care and crisis care and sick care that needs to be filled, which is like what we're doing, and there's so much to be done. There's so much and then obviously it gets into the whole prevention of chronic care and crisis care in the long term. That's where my passion lies. That's what I'm really just I want for myself, I want for my family, I want for my friends. And I'm just like, so excited to let other women know, and men too, that there's an option. There's someone that can help you. There is a medically trained, licensed professional that can help navigate you through that. Well, everything's fine here, but you still don't feel right.Lesley Logan 10:58  Yeah, thank you for explaining that, because it is true that if you're not one of those big C's, you kind of feel like you're in this abyss. And it is amazing that FemGevity's kind of hope is like trying to fill that gap, which is really great. But I think I wonder, I obviously worry, if you don't get someone like you, eventually you end up in a few C's. The thing that's been bothering you that they haven't figured out, because it's not glaringly obvious, it's going to lead you that way. So let's just say most of the women here are over 40. What are some of the things that they need to make sure that they're checking as they're planning their annuals for this year and things like that, I guess, preventative wise, and then also just so that they're aware and they could be watching things as their body changes.Kristin Mallon 11:34  Well, one of the things that I really noticed working with women for so long is that women are really intuitive, and they tend, you know, some women are born and blessed with this great sense of intuition at the age of six, but most women grow and evolve into their intuition. And so there's so many different things women can focus on in their 40s. And I think a lot of times they know, they know, like, should I be focusing on hormone health? Should I be focusing on gut health? Should I be focusing on exercise, diet, nutrition, sleep? You know, the list goes on. And so what I like to do is, I like to, whenever I meet with a woman, is I kind of like to tease that out of her and try to get a sense from what she's already thinking herself, and really encourage her to go along that path and that trajectory like, you know, well, I've been thinking I should work on my sleep. And I've been thinking I should get a sleep tracker. And I'm like, yes, let's do that. What are your symptoms? Okay, I encourage her and say, I can see how that could be related to sleep, or I can see how that could be related to gut, or that could be related to diet. So I think in your 40s, it's really like you already know, and it's just kind of giving yourself the confidence to be like, okay, I know I need to find someone that's an expert in X that can help me unravel what could this possibly be, and then heading down that path. Lesley Logan 12:49  That's really beautiful. How nice Kristin, we could just listen to the intuition instead of like, sometimes people are trying to get you not to listen to it. It's like, focus on this over here. Focus on this over here. I think that's really wonderful and supportive. Kristin Mallon 13:03  Yeah, I mean, I think if you don't know where to start, sometimes, I think women can also have periods of less intuition, which I think is sometimes, like a leveling up, sometimes a stock will go down before it shoots up. And so maybe if you're caught in that place where you're like, you know, I don't know where to start, my mom says this. My sister says this. My friend said this. Usually it's hormones and gut just start with hormones. Get those checked by someone like myself, who's a hormone expert, who can read between the lines of what a normal lab, because a normal lab is saying, okay, you don't have Addison's disease, you don't have Cushing's disease, you don't have diabetes, you don't have hypothyroidism, but yeah, do you have subclinical fatigue related, a low T3? Do you have not enough conversion of the hormone T3 to T4 which any normal endocrinologist is going to be like, that doesn't matter. You don't have Hashimoto's, you don't have autoimmune disease, but you do have something that's affecting you. So hormones is a really good place to start. And then gut health. I mean, we do so many gut tests every day, and we rarely find someone that has like, a perfectly optimal, normal functioning gut. You know, I would say like, 99% of the time there's room for improvement in the gut.Lesley Logan 14:06  That is so funny. As we are recording this, I'm awaiting like, an update on a gut test, because y'all found a parasite the first time. And I was like, oh, well, that.Kristin Mallon 14:15  Oh, fun. Lesley Logan 14:16  I know. I was like, well, that's, you know, and people are like, oh, which country do you think you got it? I'm like you can get it from sushi, guys. It's not like I have to leave the country for this. Who knows? So I'm excited to see if it's gone. And also I had some dysbiosis, and I am excited, because I can tell when my gut health is strong. I have so much more energy. I feel like a more confident person. I feel more unstoppable. My sleep is absolutely amazing. It's not a surprise to me that, like, I had a little gut situation while I was traveling, and my sleep is off. I'm like, something's maybe something's going on there. So I really love that. If they're not working with you at FemGevity, what are they asking for? Because I know when I try to ask my female general practitioner for a hormone test, she specifically said, oh, you can't test those. They change all the time. And I was just like, I'm paying for this. I don't really know what you're worried about. So what should they be asking for or looking at when it comes to getting those things tested?Kristin Mallon 15:10  Yeah, so hormone health. So really, you kind of just want to get all your sex steroid hormones, which include sex hormone binding globulin, estradiol. If you really want to go deeper, you can get your estrone level done and your estriol level done, which you know maybe might not necessarily be necessary, progesterone, testosterone, free and total thyroid, insulin, cortisol. We do a lot of also functional medicine testing within that so usually, like hemoglobin A1C, homocysteine, CBC, looking at lipid panels, chemistry, liver function, kidney function. That's the general census of like, where you kind of want to go down. Prolactin levels are there too. I can even give you a list, because I'm rattling these off the top of my head, if you want to include it in your show notes, of the hormones I recommend getting. Lesley Logan 15:58  Yeah, we love that. Also, we'll transcribe this guys, so you can just go to the show notes and just take a screenshot. Kristin says.Kristin Mallon 16:05  Yeah, and I want to make sure I didn't forget any there too. Lesley Logan 16:07  Yeah, yeah, we'll love that. Kristin Mallon 16:08  For gut health, so there's really two companies that do, I think, so, you know, my business partner, Michele Wispelwey, her whole background was in the diagnostic lab space, so she is like a lab guru and knows everything. And also myself, like working with women and working with labs gone through so many renditions of labs over time, and labs that closed, and labs that were new and startup labs and labs that merged. And so I think there's a pretty standard gut test called a GI-MAP test, and there's another standard gut test called GI Effects. So GI-MAP is by Diagnostic Solutions, and GI Effects is by Genova Diagnostics. And so you can ask for a GI-MAP that's pretty, most really with it, longevity, functional medicine, integrative medicine, doctors are going to know what a GI-MAP test is, and that's kind of your standard gut test. I always caution women about, this is, like, a really classic thing that I saw with the advent so we do a lot of genomics, and we do a lot of genetic testing too. And so 23andMe came on the scene, and everybody was getting this direct to consumer test, and they were giving it to me, and I'm like, oh my gosh, this is so basic compared to what you can get from a licensed physician. And the same thing is true with like, over the counter gut tests. You can get an over the counter gut test that's probably going to cost you a similar amount of money when you go to a licensed medical provider, and it's just not going to tell you anywhere near as much like GI-MAP does, like 88 different pathogens and microbes. You're looking at yeast, parasites, you're looking for H. pylori, you're looking for dysbiosis, commensal bacteria. So good gut bacteria, bad gut bacteria, so many different things. You're getting virulence levels. So you're getting the actual amount. They're what are called PCR tests, which is like the kind of highest standard of care. So this was, like a big thing in COVID, was your COVID test, RNA, or DNA or PCR testing, and the PCR tests were the best tests. So you're just getting so much more when you go with those two companies. Lesley Logan 18:01  Yeah. So how often should we be doing this? We're getting our hormone test every year. Should we be doing a gut test annually? Is this something you have to do more often? How much is too much?Kristin Mallon 18:12  So I think once a year is probably the minimum, because you will be able to track yourself over time and be able to have data on yourself to look back at and say, okay, when I was 36 or when I was 46 or 56 my hormone levels were this and I felt this way. Some people check them every day. There's a, I just said don't do over the counter. But there is an over the counter test called Miracare, which is kind of like a fertility tracking device, where you can pee on a stick, and it will tell you what your daily progesterone and estrogen levels are. It tells you LH and FSH too, but that's not as important to the overall daily hormone picture. So you can do kind of anything but, once a year. The other thing about hormone testing is that it's important to know, like women get so much confusing information, do I need hormone testing? Do I not need hormone testing? Someone's giving me birth control without hormones or giving HRT without having my hormones tested. Like, why do I need it? Or why do I not need it? And so the gold standard hasn't been set yet. We haven't really come to a consensus as a medical community about how often should this be done. You know, we know in diabetes testing that someone should get a hemoglobin A1C like, every three to six months. We know in when someone's being put on a thyroid medication for the first time, we should check their thyroid every four to six weeks until it's managed and at a normal level. So this hasn't been set, which is why you have so many different clinicians with so many different conflicting views, including you don't need it or you do need it. The way we really use labs at FemGevity is once you've been looking at labs like I have for 20 years, you start to notice patterns. And even though these patterns aren't written down in a protocol by the American College of Obstetrician and Gynecologists, I'm just observationally matching it up with women have been telling me x and here's what the lab data is showing me. And so I'm using my clinical judgment. To kind of make those decisions. Also, it is true that your hormones can change so much, so when we look at an estrogen level, let's say you could be 33 in one blood draw and then in another blood draw with just a couple months apart, you could be like 133 but the main thing is is you're not zero, or you're not almost close to zero, and you're not 400 so you're kind of looking at it like a range versus an exact number. We do a lot of hormone balancing, and we do prescribe HRT and hormone replacement therapy. And so women will start on a hormone and their levels will actually go down. And so they're really confused. Well, I'm taking this extra hormone, but my levels are going down. And so it could just be exactly to what you said, like where we caught them in their cycle when we tested the first time, and then where we're catching them in their cycle and we test the second time. And if they don't have a menstrual cycle and are having a period anymore, they're still having ebbs and flows. Hormones are pulsatile. They pulse even like any hormone, like thyroid or insulin, insulin is a hormone, too. You can think about it, it just pulses into the bloodstream. And so are you catching it up on a trop or on a bow? And that's why we need to know. You know, let's say we give someone testosterone, for example, are you coming back with a male level in your bloodstream? Okay, that's too high. We need to cut down. So we're not waiting for symptoms to come up, symptoms of too much testosterone. We're checking the labs to make sure that we're in a ballpark. It's not so specific, and I think that can help women to interpret their labs and also to understand the big discrepancy. Well, this practitioner says this, and this practitioner says this, and neither of them are probably wrong.Lesley Logan 21:34  Yeah, first of all, I love that you have so much experience. As a Pilates instructor, right, when I was a new teacher, I'm like, okay, I don't know what that is. And then, as I've been teaching for almost 20 years, it's okay most people, when I see that, they have a hard time with this. So let's do this exercise over here, because you start to understand the patterns that are happening, and it makes an art to the science, I think. And also I appreciate you explaining that there isn't a gold standard yet, and that's unfortunate, because they just haven't been testing enough. There just hasn't been we lost a lot of time back when they thought HRT was the worst thing that could happen. I feel like we've we're trying to catch up with I feel like they're in the maybe it's just because now I'm 42 and that's what my algorithm shows. But I do feel like there's a lot more people researching this and coming up and testing things out, so we can have more people explore, and then we can learn more things. So that makes me happy. Okay, you and Michele started this amazing company together. Obviously, you're an incredible doctor. You know so much. What has been the funnest thing about starting a business, and what is the hardest thing that you're that you're like you are trying to because here's why I'm coming at this. I feel like I'm looking at, oh, my God, she is a doctor. She probably has her sleep under control, her hormones under control, all these things. Has it been easy to keep a balance in your own life doing this business and what's been the funnest part about what you guys do?Kristin Mallon 23:00  Yeah, so I would say that the funnest part is really getting to work together. Like, we really like each other, and we really get along, and we really have a lot of fun together. And so when we get to work together, it's like you get to work with your best friend. Like every day. It's really a really fun thing. I think, from the challenge perspective, I personally am a really big believer in like vibration attracts like vibration. And so as long as I'm kind of keeping my vibration in check and keeping my self clean, and I'm looking to reflect that reality outside of me, then everything kind of usually everything works out for me, and everything kind of falls into place. It's just kind of been my experience in life. So the challenge is, is that when things get off track, I usually have to remember to look in the mirror and be like, okay, what is it about me that is like, what thoughts or what influences am I allowing to come into my sphere and my energetic field that aren't in alignment with me, because that's being reflected in my outside world. So that's probably the big challenge, I would say. Lesley Logan 24:08  I so understand that, I really do, because it's not at the plate, and ladies, it's not, oh, everything is our fault. It's the, hold on, what did I bring to this energy that is causing this? Because, you know, there are people who just have force of natures, but I find that if I'm feeling a little nervous, if I'm feeling a little frenetic, if I'm feeling like I don't have control over things, and then I go into the business, the way that I ask for something comes from frenetic, non-controlled, not necessarily a specific place, and then it's a domino effect of the communication is off, and it's hold on, you know? So we do have to kind of take a step back and ask ourselves that, and that's the hardest thing to do in the moment. It's so hard in the moment to go. Hold on. Let me take a pause. How's my vibration? What am I bringing to this? Kristin Mallon 24:52  Yeah, it's hard if you say it's hard (inaudible). I always use a quote that I drilled into my mind, which is, like circumstances don't matter. Only state of being matters. And it's the state of being that makes your circumstances. It's not what happens, it's what I do with what happens. And I can usually, almost always have anything that happens be to my benefit and be to my good. It's kind of like going with the flow and being in the river versus trying to, like, paddle in a specific pattern. You don't know where all the rocks are, and you don't know where all the bumps are, and so if you kind of let the river take you, you usually can, you know, it doesn't look straight, and it always you're like, Hmm, I don't know if I would like go all the way over to the right, but then you realize that, oh, there was dead current in the middle of the river, and you needed to get to the side to get to the fast current. So I kind of try to think of that as much as possible. You know, it's not, I don't always win, but I'm winning most of the time, I hope. Lesley Logan 25:48  Kristin, that is so cool. That is amazing. We're clipping that and I'm gonna put that on my wall, because it is, I, especially, most of the women listening to this, they are caring for young children. They have older parents or family members in their life. They have. Kristin Mallon 26:08  Yeah, they're the in betweens. Lesley Logan 26:09  Yes, they have and they have jobs that they have to do. And then it can feel like the circumstances around you are just hard. And so what you just gave us, is such an amazing gift. Is like the state of being, like, how can I focus on that? So do you have tools? Or is it like a mantra that you say, is it that just that the mantra helps or like?Kristin Mallon 26:30  Oh my favorite mantra, I can give you my favorite mantra that works so well. Two words. So what? So what? Whatever it is like, so what? I mean, it works for 99.9% of things. If you're like this, that I'm going to be late, I didn't put the sandwich in the lunch bag, and I didn't do the permission slip, and I forgot to put these slides in a presentation. So what, you know? And I think that's something that's always really helped me to kind of see the forest through the trees. Lesley Logan 27:03  Yeah, I can see that because I am someone who's like, we're going to be late. And unless it's the plane, probably going to be most things are fine, (inaudible) catches the flight (inaudible).Kristin Mallon 27:16  Even if it is the plane being late might have your benefit, might be to your highest good, because maybe you met someone that now you're sitting on a different flight, or you ended up being able to not miss a phone call that was coming through. So, as long as I allow that type of vibration into my field, I usually end up having those results. The other thing that I think is super helpful, that I also kind of like encourage people to do, is, if you just do it a little bit, it kind of becomes second nature, which is to watch your definitions, watch how you define things. Because even like saying, oh, it's hard to do X, yeah, if you say, I'm working on doing X, or I'm getting better at doing X, or I'm improving my X, it's a much different definition than it's hard. And it's so fun for me. Like, when I first started doing this practice a couple years ago, it was so fun to change the definitions of things and just be like, oh, this happened. Well, that happened because it was so funny. My bra was showing or, I don't know, something happened where I didn't get the job I wanted to get, or I didn't get the client I wanted to get. And instead of it being like a failure, it was a learning experience, or instead of it being a mess up, it was an opportunity for growth or development or internal reflection, or for me to get this thing that I'm talking to you about right now, which is that I can choose how I define things. Lesley Logan 28:38  I really like that, because I do think it's fun. I'm going to keep working on catching myself. But one of the ones that sticks with me, because I was raised in a household that doesn't have a lot of money, and so they'd always say we don't have any money. There's no money for that. No you can't have it. There's no money for that. Kristin Mallon 28:50  I was, too.Lesley Logan 28:51  And I was, so was my husband, and we have been really conscious. I can always tell when one of us is in a bad state, because the words we'll say we can't afford that, which is like a not, like a non-sentence in this house, because the better phrase is, we are choosing not to invest in that right now. Oh, you know what? That's great. I'm not investing in that right now. Or that's actually not something we're spending money on today. So it's not that you don't have the money, it's not that you can't afford it. It's just not a priority in this moment. Kristin Mallon 29:20  That's a perfect example of the definitions. That sentiment. So, do you know the book by Napoleon Hill, Think and Grow Rich?Lesley Logan 29:27  Yes, I love it. I listened to the old tape or whatever. I maybe I should do that again as the year starts.Kristin Mallon 29:33  Yeah. Well, that's the epitome of what you just said. That's one of the big lessons that he talks about in that book. And that book influenced The Secret. So that's (inaudible).Lesley Logan 29:42  And everyone you can go to the original source, it's still out there. Do you remember the part? Because you're, I don't know if you maybe it didn't stick with you, but he mentioned the woman who would always put her hand on her left breast and go oh, I'm gonna get cancer. I just know I'm gonna die from cancer. And she'd always say that, and then she died of breast cancer. She like, literally, she kept putting her hand on herself saying she's gonna get it. It's like not saying that anyone who gets cancer did that to themselves. That's not it at all. But it's just like we, our words, have so much power, and we really do. I love that redefining. You guys, how are you going, like, I wonder you guys have to send in to the Be It Pod and to FemGevity which words you're redefining. I think that'd be really fun for us all to see as an experiment. Kristin, what are you most excited about right now? This is out in 2025. What are you excited that's coming up, that you guys are doing? What's going on? Kristin Mallon 30:30  I'm really excited that this concept of, so I think over the years, we've kind of defined it as functional medicine, and then we defined it as integrative medicine, and now we're defining it as longevity medicine, and I'm just so excited to be a part of that ecosystem and the effects that it has. I mean, I work with women primarily, so the effects that it has on women and the aha moments they have, and that feeling that, I think, that liberation that they've been looking for for so long that they're not just like, going down, down, down, down, down, but that they're actually going up, up, up and getting better is like, so rewarding and so fun that I'm just like, so passionate and excited about sharing that with women as much as possible. Anybody who wants to hear me talk about it, I'm like, do you want to hear me talk about optimization of health? Like, I'm totally down.Lesley Logan 31:20  I also like that it's changed to longevity medicine because the other ones were a bit vague and hard for I feel like this is what people want. It's not when you're like, oh yeah, I want a functional medicine. I guess that makes sense, but it doesn't sound sexy. I want a long life where I have longevity. I don't want to just be old. I want to have be strong and energized when I'm older, you know, I want all those things. So I think that's really cool. Since you love to talk about optimal health, is there anything else about optimizing our health that we didn't talk about that we should know about, that we should check on? Kristin Mallon 31:51  I always say don't give up on yourself, because I think women, so many times have been told no, or they go to the wrong doctor, or they hit dead ends and they think there's no hope. And if you don't give up on yourself, and you hear a podcast like this, and you're like, okay, I need to find a longevity medicine doctor. I need to find a hormone balancing expert. Or they can come over to FemGevity if they're in the United States, we can usually work with them in some way. There is a path to not just feeling better, but feeling like fantastic and great and energized. And I know there's people listening that are like, yeah, this girl's crazy. There's no way I'm so chronically fatigued. My kids are little, my parents are dying or sick. There is, there really, really, really, is just keep going on yourself and don't give up until you find the right person and the right practitioner to help you. It's worth it. So worth it.Lesley Logan 32:41  Oh, I love that. Thank you for that gift. That's a good one. We're gonna take a brief break, and then we're gonna find out where people can find you, follow you, work with you and your Be It Action Items. Lesley Logan 32:51  All right, Kristin, where can people find you? I'm gonna give you the link right now. You can go to beitpod.com/femgevity, because you guys can go and get a call and see how they can help you. But where else on the internet are y'all at?Kristin Mallon 33:04  So our website, femgevityhealth.com and all social media channels @femgevity. So we're on TikTok, Instagram, YouTube, Facebook, LinkedIn.Lesley Logan 33:15  It's probably really fun to be doctors and researchers that have to then learn social media and all the hacks. And I also love that I've got my captions to actually spell FemGevity out correctly. They can't spell my name, they can't spell my dog's name, but they can spell FemGevity. So that's the way to go, ladies. Yeah, okay, you've given us a lot of great stuff already, but for our action takers who are listening, bold, executable, intrinsic or targeted, steps people can take to be it till they see it. What do you have for us?Kristin Mallon 33:48  So my best advice is, whenever in doubt, follow your highest excitement in any given situation. It's a breadcrumb trail that kind of leads you to your biggest and best self. So follow your highest excitement to the best of your ability with no insistence or assumption on the outcome, and it always leads you to the best location, place, time for you.Lesley Logan 34:09  Oh my gosh, you're so cool. Kristin Mallon 34:14  Yeah, you too.Lesley Logan 34:15  Well, thank you, but, yeah, like, what a great tip. That's so fun, because most people say, like, follow your gut. And I've got these people going my gut's off something's wrong. But highest excitement, oh. Kristin Mallon 34:28  It's easy to do, because even if you think about it, you're like, and as soon as we get off this call, right, there's going to be a whole bunch of things you could do. You could check your email, you could take your dog for a walk, you could stretch, you could do Pilates. But if you just tune into like, which one is most exciting, more than any of the others. It'll lead you down a really thrilling and rewarding path.Lesley Logan 34:47  Oh yes, yes, it will, oh yeah, the doctor has ordered that I have to follow my highest excitement. I'm going to do that as soon as I hang up. Y'all please, if you, if this at all has you intrigued, contact FemGevity. It's really nice to have doctors who actually want to look at things and look at patterns, and, you know, don't want to just tell you, it's all good, yep, that problem. I don't know. It's really nice if someone listened to you, and I will just shout out, I was traveling for almost a month, and I got an email from your team going okay, you have to do your call. And I'm like, oh, my God, a doctor that wants me to come for my appointment. They not that other doctors don't. I'm sure I have doctors listening, but you can wait in the waiting room for 45 minutes. You guys make sure. Made sure I made my call, and I'm so glad I did, because I needed that call, and it's just really nice to have someone to look out for my optimal health. So thank you so much for all you do at FemGevity. Lesley Logan 35:40  You guys, how are you going to use these tips in your life? Make sure you tag FemGevity. Tag the Be It Pod. And share this with a girlfriend who, like is frustrated with their health and they're feeling stuck and feeling going in circles. You know, it's kind of nice to be reminded to not give up on yourself. So thank you, Kristin, for that. And until next time everyone, Be It Till You See It. Lesley Logan 35:59  That's all I got for this episode of the Be It Till You See It Podcast. One thing that would help both myself and future listeners is for you to rate the show and leave a review and follow or subscribe for free wherever you listen to your podcast. Also, make sure to introduce yourself over at the Be It Pod on Instagram. I would love to know more about you. Share this episode with whoever you think needs to hear it. Help us and others Be It Till You See It. Have an awesome day. Be It Till You See It is a production of The Bloom Podcast Network. If you want to leave us a message or a question that we might read on another episode, you can text us at +1-310-905-5534 or send a DM on Instagram @BeItPod.Brad Crowell 36:41  It's written, filmed, and recorded by your host, Lesley Logan, and me, Brad Crowell.Lesley Logan 36:46  It is transcribed, produced and edited by the epic team at Disenyo.co.Brad Crowell 36:51  Our theme music is by Ali at Apex Production Music and our branding by designer and artist, Gianfranco Cioffi.Lesley Logan 36:58  Special thanks to Melissa Solomon for creating our visuals.Brad Crowell 37:01  Also to Angelina Herico for adding all of our content to our website. And finally to Meridith Root for keeping us all on point and on time.Support this podcast at — https://redcircle.com/be-it-till-you-see-it/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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

Did you know that 16% of women of childbearing age carry mercury levels high enough to pose a risk of neurological deficits in their children? Research shows a clear linear relationship between mercury exposure and IQ deficits. Despite this, fertility specialists and OBGYNs often assure us it's safe to freeze our eggs and plan for pregnancy, even when heavy metal toxicity is a significant concern. Today, we're diving into mercury exposure—its effects, how to get tested, and why trusting your instincts is the most important step to protecting your health.References: Jane Hightower

In the latest episode of the Dads with Daughters podcast, we had a heartfelt and enlightening discussion with Kevin Lavelle, co-founder and CEO of Harbor. Kevin shared his experiences and reflections on raising two healthy children—an 8-year-old son and a 6-year-old daughter—while managing the demands of a thriving career. Kevin emphasized the importance of being present for his children despite the time constraints of being an entrepreneur. He has found fulfillment in volunteering as a soccer coach for his son and accompanying his daughter to gymnastics. His philosophy of being "appropriately selfish" underscored the necessity of self-care to be effective in caring for one's family. The Fleeting Nature of Childhood Both Kevin and our host, Dr. Christopher Lewis, resonate on how quickly time passes with young children. Recounting poignant moments like the birth of his son and profound moments in his entrepreneurial journey, Kevin appreciated the urgency of cherishing every moment with family. He shared a personal anecdote about working on a term sheet in the delivery room, highlighting the blend of work and personal life that many modern parents experience. This understanding deepened after a personal loss—his wife's mother—which reinforced the irreplaceable value of family time. Dr. Lewis echoed this sentiment, encouraging fathers to prioritize building strong relationships with their children over work commitments. Challenges of Modern Parenting Kevin tackled the complex challenge of raising respectful and capable children in today's world. He discussed the necessity of discipline, the influence of external factors such as peers and media, and the struggle of maintaining different parenting standards than others. Kevin and his wife take pride in their children's respectful behavior in public, yet they find themselves constantly correcting behaviors influenced by their environments. Dr. Lewis and Kevin also explored the concept of “deprogramming,” or correcting behaviors developed when children are outside the home. This underscores the dynamic landscape parents must navigate to maintain their values. Promoting Healthier Families Through Better Sleep A significant portion of the podcast focused on Kevin's venture, Harbor, which aims to improve parental well-being through better sleep. Inspired by his own experience with sleep deprivation, Kevin developed a product integrating professional guidance and innovative technology. The system offers a reliable baby monitoring solution, avoiding common issues with existing products, and introduces a concept of a remote night nanny service. This service is designed to be affordable and leverages professionally trained nurses to help parents manage nighttime challenges, ensuring better sleep for all family members. Fatherhood's Essential Bonds Kevin concluded by sharing his views on fatherhood—emphasizing a connection, love, and support as the bedrock of raising well-rounded children. He credited his own parents, his wife, and his children as his inspiration, and he offered advice to fellow fathers: Enjoy spending time with your children and cherish the fleeting nature of childhood. Parents today face numerous challenges, but as Kevin's journey illustrates, with mindfulness, appropriate self-care, and innovative solutions, the joys of parenting can indeed be balanced with professional success. For those seeking additional support, the podcast encourages engagement with resources like the Fatherhood Insider and the Dads with Daughters community. For Fathers, By Fathers: A Beacon of Support Dads with Daughters remains committed to helping fathers navigate the beautiful complexities of raising daughters to be strong, independent women. Tune in for more inspiring stories and practical advice from fathers like Kevin Lavelle.   TRANSCRIPT Dr. Christopher Lewis [00:00:05]: Welcome to dads with daughters. In this show, we spotlight dads, resources, and more to help you be the best dad you can be. Dr. Christopher Lewis [00:00:15]: Welcome back to the Dads with Daughters podcast where we bring you guests to be active participants in your daughters' lives, raising them to be strong, independent women. Really excited to have you back again this week. As always, every week, I love being on this journey with you. You and I are walking on this path to help our daughters to be those amazing women that we want them to be as they get into their adult years, and it's a process. It's definitely a process that we walk through to be able to be that dad that we wanna be and to be engaged and to be present and to be there for our daughters as they get older. And you don't have to walk that alone. That's why this podcast exists. It's here to help you to walk alongside other fathers that are either going through the process right now, have gone through the process, or other individuals that have resources that can help you again to be that dad that you wanna be. Dr. Christopher Lewis [00:01:12]: Every week, I love being able to bring you different guests, different people with different experiences that are fathering in different ways. And today, we got another great guest. Kevin Lovell is with us today, and Kevin is the cofounder and CEO of Harbour. It is a company that we're gonna learn more about today. But I love their tagline, we create happier parents and healthier families one restful night at a time. And how many of you remember, especially those young first few years when you felt like a zombie? I'm just going to put it plainly, and you felt like you were not getting any sleep, and probably you weren't getting a lot of sleep. But we're going to talk about this venture that he has been on for the last few years and what he's doing. But first 1st and foremost, we're gonna learn about him as a dad. Dr. Christopher Lewis [00:01:58]: So I'm really excited to have him here. Kevin, thanks so much for being here. Kevin Lavelle [00:02:01]: Thank you. A great opportunity. Dr. Christopher Lewis [00:02:02]: Well, Kevin, it's my pleasure having you here today. And one of the things that I love doing first and foremost is turning the clock back in time. And I know you've got 2 kids. We're gonna focus on your daughter today, but I know you've got a son as well. You got an 8 year old son and a 6 year old daughter. So you had your son first. Now I wanna go back to that first moment that you found out that you were going to be a father to a daughter. What was going through your head? Kevin Lavelle [00:02:26]: Really fun memory. My my wife and I, our son was a little over I don't know. He was maybe 16 months old when we found out we were going to have another child, and we both did that thing. And and I think we meant it. Then we said, you know, whether it's a boy or a girl, it doesn't matter. We're just gonna be so happy that, you know, have another. And to each their own, I wasn't into a big gender reveal party, but I did think it would be fun to learn together. And so we had her doctor email the results to someone on my team at Mizzen and Maine, and I asked him to go get flowers, you know, pink for a girl, blue for a boy, and put them in our garage so that when I came home, I was traveling, I could bring the flowers covered in a trash bag into the house and we could look at them together because my wife loves flowers. Kevin Lavelle [00:03:14]: That was the way that we were gonna learn together. And right as I was about to pull into the garage, I just had this overwhelming thought, god, I hope it's a girl. And, you know, I didn't I hadn't said anything. And right as I went to pick the flowers up in our garage, they basically kind of fell open, and I saw it was pink. And I was just overcome with joy, and I had to pretend that I didn't know. But I walked in and I opened it up, and my my wife was, absolutely overjoyed as well. And at the time, my my first company was an apparel company, so my my colleague had also put a pink shirt in there, one of our pink shirts as a company. So that was a fun way to tie that together. Kevin Lavelle [00:03:54]: And shortly after she learned it was a girl, she said, I really wanted it to be a girl. And I was like, I did too. And by the way, I found out in the garage. And so, a very fond memory, not just learning that it was going to be a girl and and, you know, knowing that we now had a son and a daughter, but, a very memorable time in our lives. And it was a very rough pregnancy for my wife. And I don't know how true this is or an old wives tale that, you know, when it's a girl, they they suck all the pretty and all the life out of you because they're they're bringing it into themselves. And we were joking because it was a much rougher pregnancy with my daughter than my son. So we we we kind of felt it might have been a girl. Dr. Christopher Lewis [00:04:30]: Now I talk to a lot of dads, and a lot of the fathers talk about the fact that they are that there is fear going into being a father to a daughter. Whether found or unfound, it's there. So as you think about the years that you've had with your daughter thus far and you think about your own experiences, what's been your biggest fear in raising a daughter? Kevin Lavelle [00:04:53]: The most direct fear as she gets older, women are more vulnerable in society and all of history than men. That's just the nature of humanity and the nature of life. And so, higher fear that she could have something terrible happen to her than to my son. Although, as parents in an ever crazier and changing world, certainly, the fear exists, for both of them. But my focus, and my wife and I have the same belief, is help our kids there's a phrase, prepare the child for the road and not the road for the child. And I see it so often, especially in some of the schools that we have been in. Whether it's parents or teachers or both, they want to make sure that everything is perfect for their child rather than, how do I make my child resilient and capable of addressing whatever it is that life will bring to them. And so, everything that we can do to make them more resilient and just prepared and understand the risks that exist in the world while not being afraid of the world. Kevin Lavelle [00:05:52]: You could hide out real easily and miss out on a lot of the wonderful things that life has to offer. And and we want them to face the world with head held high and and know what they're capable of. Dr. Christopher Lewis [00:06:02]: Now you're a busy guy. You're a CEO, entrepreneur. You have been involved with a couple of ventures and a couple of companies in your time as a father. And it not only takes time, effort, but it takes balance. So talk to me about what you've had to do to be able to balance all that you're doing in starting and creating a new company, but also in trying to be that engaged father that you wanna be. Kevin Lavelle [00:06:30]: There are lots of people much more smarter and accomplished than me than that probably have lots of specific tips and tricks. But I'll say the thing that has resonated or or stuck with me the most is accepting that I will never get it all done. And I could work round the clock and miss out on life in front of me. We lost my wife's mother now about a decade ago. And that was very young to lose her. And just understanding that life is very short and very precious. And so don't miss out on don't miss out on what's in front of you. And the age old adage, the nights are long, especially when it comes to sleeplessness in those early years, but the years are short. Kevin Lavelle [00:07:10]: And I had quite a few people say that to me when my kids were, you know, 6, 9 months old. And you're not sleeping. And it is a level of exhaustion. Even if your kids are doing well sleeping through the night, it's just so all consuming and difficult and everything is new and stressful. Sometimes, when people tell that to you in that time of life, you're like, thanks. That's super helpful. I'm barely making it in a given day. But just continuing to come back to how fortunate we are. Kevin Lavelle [00:07:35]: We have 2 healthy kids. That is in and of itself a miracle. And then, prioritizing as much as I can. I've been volunteer soccer coach for my son, taking my daughter to her gymnastics classes, and just trying to soak up the time with them because it's moving very quickly. And there's never going to be enough hours in the day to do all the things that I want to do. But making sure that when I'm with them, try to be as as present as possible. I could talk about this for hours, but those would be the biggest things that that really stand out to me. And then, I think I'd also just add, with that said, I heard a Naval Ravikant years ago podcast with somebody was saying that he does a good job of, I think in his own words, he said being appropriately selfish. Kevin Lavelle [00:08:18]: And it comes down to this analogy of put your own oxygen mask on first. If you're not sleeping and eating and taking care of your body and your mind, then you can't take care of your family. You can't be there for them. You can't be a leader. And so, I think some people end up losing sight of that and forget that they still need to have some fun. They still need to take care of themselves. They need to get sleep. Then they need to be able to sit down and read a book or chat with friends. Kevin Lavelle [00:08:44]: And and you it is very easy to lose sight of that, especially in the days of of of young kids. And ultimately, looking at some of my friends whose kids are a bit older, and they're starting to adjust to the fact that they don't spend much time with their kids anymore even though they still live at home. And so that window of time is is very short. Dr. Christopher Lewis [00:09:02]: It is very short. And as your kids get older, you look back and say, dang it. Because, hopefully, you have taken the time to be able to build those really strong relationships, spent the time, and not focus on work or not focus on the things that you think are important at the time to be able to provide for your family, but what you come to find. And I see that even though I've been a very engaged father throughout my entire kids' lives. But as you get into the teenage years and they start pulling away, and you're not able to have as many opportunities to be able to connect and engage on a regular basis, you treasure the moments that you do have to be able to create those opportunities and have those opportunities. And they look and feel a little bit different, But you definitely want to grab them, hold them, and keep doing those things with them when they give you that opening to do it. Now I asked you about if there were any things that you were afraid of and fear in that regard. But being a parent is not always easy. Dr. Christopher Lewis [00:10:07]: We just talked about and we'll talk more about the fact of sleep and the importance of sleep. But it's not always easy to be a father to a son, a father to a daughter. What would you say has been the hardest part for you in being a father to a daughter? Kevin Lavelle [00:10:21]: If I had to sum it up, I think overall, I would pick up 2 different angles to this. And I can hone in on it being daughter specific and also being a father specific. It's not specifically daughter related, but it is very much a central struggle to being a parent. And it's something that I see, I don't say this on a high horse, but it's something I see a lot of other parents neglect. And I can see it coming back to bite them, which is raising good, capable kids who are respectful and that you want to spend time with is there's a pretty significant amount of time that is frustrating and you have to be, you have to be the parent. You have to be the adult. You have to be the rule enforcer. You have to constantly give feedback and it's frustrating and it's challenging. Kevin Lavelle [00:11:03]: But when you don't do that, each passing day, week, month, and year, it's harder to raise good, respectful kids that are capable and, you know, you want to spend time with. Jordan Peterson, I think it was in his 12 Rules For Life, talked about you don't let your kids do things that make you like them less because you love them more than anyone else in the world. And if you let their bad behavior go, their obnoxious behavior, even annoying tendencies, if you don't help them correct those, well, guess what the rest of the world's gonna do? They're not really gonna like them either. They're not gonna want to engage with them. They're not gonna want to be friends with them. They're not gonna wanna help them, mentor them, etcetera. And so I think about this a lot, especially when I have those frustrating conversations or interactions that I have to work very hard to help them grow and flourish. And that means I'm bearing a lot of the brunt of that so that they, in the rest of the world, have people like them and want to be around them. Kevin Lavelle [00:12:01]: And one of the things that my wife and I are most proud of on an ongoing basis is when people are around our kids, they are genuinely surprised at how wonderful they are to be around. They're very respectful. We can go to very nice restaurants with them without an iPad. And they do great. And that I don't know how many times we went to a restaurant where it wasn't awesome before it started to be good. And now, it's great. And so, you know, I think with that, that is not necessarily daughter specific. I'll go with now daughter specific. Kevin Lavelle [00:12:33]: And the other key piece here is you don't raise your kids in a vacuum. And our kids go to school with other kids whose parents are fine with different approaches to language and respect and electronics and vanity and spending. And there's a when our kids spend time with certain kids, they come home with very annoying or inappropriate kind of phrases or responses. And it's getting a little bit better because they know what, they tend to understand more of what's right and wrong and what is and isn't acceptable. But when they are in school all day or they spend time with certain kids, they come home with things that we have to then work to correct. And it's not a huge problem. But, you know, when you send your kids out into the world, you have to remember they're out in the world without you. And that's why it's so important to build those innate characteristics. Kevin Lavelle [00:13:25]: And especially on the little girl front, some parents have no problem with makeup and music and things that are just not appropriate for my daughter's age. And then she's struggling with this back and forth of, well, I see my friends do it and their parents are okay with it. And you have to say, while being respectful, you can't really say, well, those are not good parents in our view. Because there's a way to say that that inspires better decision making. And there's a way to say that that could make them look down upon or feel differently about folks. That's that's not not helpful. People can parent hard, but they want to parent. My job is to take care of my kids. Dr. Christopher Lewis [00:14:03]: Well, and the other thing that I think that all of us have to understand is that each of us come into parenting without a rule book, without a guide book. And depending on the model that you saw in your own experience as a child yourself, the other parents that you surround yourself with, you start to identify and create ways in which you parent based on those. And sometimes parents don't realize what they're doing or are not doing, and unless someone points it out to them as well. But I completely understand what you're saying because sometimes you do have to do that deprogramming with your kids when they get back into your home or if they've spent time even when they go to grandparents and they come home, and the rules are different there. And then they come back and are like, well, grandma and grandpa said it was okay, so why not here? And you have to deal with that as well. So I completely understand what you're saying in that regard. Now we've been talking and kinda hinting about the importance of sleep. And as I mentioned at the beginning, you are the CEO and cofounder of Harbor. Dr. Christopher Lewis [00:15:11]: It is a organization company that is working to create happier parents and healthier families, as I said, one restful night at a time. And I remember those days with both my kids feeling like a zombie when you're trying to go to work, and you're coming home, and, you know, you're getting a few hours of sleep. And, you know, those things are very challenging, and those those days and nights can be long. And that being said, I wanted to ask you about Harbor because, like you said, you spent quite a few years at Mizzen and Main, which is a clothing company. And you pivoted after this to open your own organization and create your own company in that regard and beyond what you did at Mizzen and Main to something completely different. So talk to me about that origin story of Arbor. And what made you decide to move away from clothing and move toward something that we're talking about in regards to helping parents to get better sleep, to be able to stay connected with their children, and be able to create this new product? Kevin Lavelle [00:16:17]: So when my son was born, it was a very memorable time in my life. Also, similar to that very visceral memory of finding out my second was gonna be a girl. We were in the throes of fundraising for Mizzen and Maine. We were assigned the term sheet with our private equity firm in the delivery room for my son. And I remember pieces of that very vividly. And one of them was, I'm not the person who's going to decide the car seat or the stroller. I was helpful with my wife there where she wanted me to. But I'm more of the tech person, and I did a lot of research. Kevin Lavelle [00:16:49]: And there was a company called Nanit that had a lot of recognition and press about their very innovative baby monitor. It's a Wi Fi camera with an app on your phone. And I thought, oh, that's really neat. I like apps on my phone. That's convenient. But while someone was a couple, I don't know, weeks or months old, I can't remember the exact date that it happened. And he was in his own room. And I woke up one morning and the app on my phone, because you have to sleep next to your phone, which I don't like doing to begin with, but you have to sleep next to your phone so the app audio runs in the background. Kevin Lavelle [00:17:18]: The app had just crashed. And look, apps crash. They're not a 100% reliable. And I panicked and ran across the house. And, of course, he was fine. Kids are more resilient than we give them credit for. But it was a very alarming realization that this thing that I'm supposed to be able to rely on, you I can't. And so we went out that day and bought an old school Motorola camera and an old school Motorola monitor that was direct local only communication. Kevin Lavelle [00:17:46]: It does not use the Internet in any way, shape, or form. But we kept a Wi Fi camera. I got rid of the Nanit and ended up just using a Google Home device, a Nest camera, because my wife and I worked together at Mizzen and Maine. And when she came back to work, we wanted to be able to check-in on the nanny with a babysitter. You just you wanna be able to know. And not that I wanna be monitoring 20 fourseven, but technology is supposed to make our lives better. And there have been a lot of promises that have largely failed to deliver for parents. So this idea of why do I have 2 separate systems to be able to just know that I'm monitoring my kid and record and rewind and check out from outside the house? I talked to a lot of parents over the last 8 years and just sort of getting feedback and wondering what they were using. Kevin Lavelle [00:18:32]: And I found out that 20 to 30 plus percent of my friends did the same thing that I did, was have multiple systems. And in an industry and in a time of life when parents want the best for their kids, baby registries are between $3 and probably $15,000 worth of products as a first time parent. Cribs and strollers and car seats and multiple strollers and formula and and pumps and on and on and on and on. The best that parents have to offer or the best that parents have accessible to them is hacking together multiple systems that don't communicate with each other and blah blah blah. So I wanted to solve this problem since my son was born. And so what we've built is a camera and a 10 inch monitor that connect directly to each other without Internet. And both devices also connect to the Internet. So you get the best of both worlds. Kevin Lavelle [00:19:29]: It's a dedicated device that alerts you if you lose connection. And everything connects to the Internet when it's available. So we have an app. You can record. You can rewind. You get all of those benefits and features as well. I've got one right over here. I should have had it right next to me. Kevin Lavelle [00:19:44]: But it is a 10 inch monitor. So you can actually watch up to 4 different streams on one screen. You can control the zoom and the volume of each independently. There's nothing like that that exists today. And I can tell you, however bad the experience was with a Wi Fi camera with 1 child with 2, it's it's almost impossible on a tiny little iPhone screen. And we can watch up to 4. And then we put privacy first. So our camera and our tablet are both built outside of China. Kevin Lavelle [00:20:10]: They're both built with non Chinese silicon. The chips inside the device is basically the thing that powers it from a processor perspective. And then the chip in the camera is able to do all of the advanced analytics and kind of signal to noise sorting that makes our product really unique on the device locally. Meaning, it does not go through our cloud to process your information. And the the best way to think about that is like on a self driving car on a Tesla, they have cameras that process everything locally. Because if you had to send to the Internet, is that a red light or a green light? Obviously, that's not very safe from a decision making time frame. And then we also put a memory chip in the camera. So all of your memories are stored locally on the device itself. Kevin Lavelle [00:20:52]: If you wanna use our app, obviously, if you're outside the house, you will access it, and that will be remote. We're not storing it. We're not processing it. Unlike every other Wi Fi camera that exists, you are paying them to store your footage on their cloud. And in many cases, third party clouds that may not have the same level of security that you would expect. So very unique device, very unique monitor. We've really positioned ourselves as something that does not exist today for parents and started shipping mass production units to customers in September of 2024. And it's going great so far. Kevin Lavelle [00:21:24]: We've shipped thousands of devices in just a few months. And then the other thing I'll touch on very briefly for framing is that's exciting and and we think a game changer for parents. And it's been very well received. But we are using it as the foundation for what we have called a remote night nanny. So if you can afford it, an in home night nanny or night nurse is one of life's greatest blessings. It's also unaffordable for almost everybody. And a lot of people who can afford it don't want someone else in their house, or they heard a horror story and they don't feel comfortable with it. Or even if they can afford it, they can't really find someone that they would trust to come in and help take care of their child. Kevin Lavelle [00:21:57]: And the main purpose of an in home night nanny is they will listen to your baby monitor in another room, and they will go in when it is necessary and appropriate to go in. So if your child starts to fuss or cry a little bit, they'll look at the monitor. Okay. Nothing's wrong. And they basically start a timer and they wait 5, 10, 15 minutes depending on age and stage. Because if you hear a child cry and immediately run-in, you delay their ability to learn how to sleep because sleep is a skill. Just like talking and walking, you have to kind of fumble through it and you and you find your way and you develop the skill of sleeping. There's a lot of really bad information out there on the Internet about sleep. Kevin Lavelle [00:22:36]: And sleep experts, legitimate ones, know you have to help the child learn how to sleep. And so, the challenges in home night nannies, if you can find 1, are $300 to $700 a night depending on where you live in the country. And it's very hard to find them as well. So, what we're doing is because we have built the hardware, after you onboard into our system, you can hire our professionally trained night nurses remotely. You press a button on the monitor, sort of like arming an alarm system, and that turns over the controls of your monitor to our professionally trained night nurses. We turn the volume on your monitor down to 0 all night long and only wake you up when a professionally trained night nurse says it's time to go in. So if something is wrong, like something falls in the crib or the baby's arm gets out of the swaddle and gets stuck in the crib slot, we're gonna wake you up immediately. Otherwise, we're gonna start the timer and we're going to wait until it is time for you to go in. Kevin Lavelle [00:23:33]: And what we have found is the 1st night, parents are adjusting to, okay, this is a little different and a little a little new. But the 2nd night, parents are telling us they've things like, I haven't slept this well since my 1st trimester. And that's because it's not just that I'm not hearing something. Because you may not go in all night long, but your child is going to make noises all night long. Kids make a lot of noise. And if you don't remember it, good for you. That's fortunate. But kids can fuss and cry off and on for hours. Kevin Lavelle [00:24:03]: Now, they're still getting sleep in between, but you're not as a parent. But what we're finding is parents are telling us, especially moms, to have a professional be the one that is helping me know when to go in rather than that anxiety and that guilt and that shame that comes with being a parent and not knowing what to do, It allowed me to really actually get deep, restful sleep for the first time in a long time. And because we have built the hardware, we have a lot of fail safes built in, the system just turns itself back on if it loses connection, And we're hiring professionally trained nurses so that we can have 1 nurse work with multiple families at the same time and bring the cost down to about 5% of the cost of an in home night nanny. So that's Harbor. A lot more to talk about there, but that's a good good roundup of what we've built here. No. Dr. Christopher Lewis [00:24:51]: It sounds like an amazing product, and I have not used it, and I don't need it now. And my kids would be really weirded out if I was using it at this point in their lives. But that being said, when they were very young, this sounds like a game changer. Now one question that I had when you were talking about the technology and, you know, how you had your app and that you were trying to keep it on a phone and and that it was running and then lose power and you you know, all of that story that you told. With your system, are you running off of your Wi Fi in your home, or are you running off of the Wi Fi off your phones? Because if the power goes out, then, you know, how does that all work? Kevin Lavelle [00:25:31]: Yeah. So a couple of points on the technical side. The camera and the monitor or multiple cameras are going to run off your home Wi Fi when it is strong and available. If you don't have Wi Fi, so as a point of comparison, if you have one of these Wi Fi baby monitor systems and you travel to a hotel, you can't use it because hotels will not let you tap your devices onto their Wi Fi. You can put your phone on it, but you can't run your devices on their networks from a security perspective. So the message boards online are full of parents who said, you know, just got to our hotel and realized I can't use my Nanette. I can't use my Owlette. And I had to run to Walmart to get a baby monitor because, you know, get adjoining rooms. Kevin Lavelle [00:26:11]: You gotta be able to look in. And so the camera and the monitor, one camera and one monitor, creates its own Wi Fi signal to communicate directly with each other while not requiring a separate Wi Fi network. So it has direct local communication that doesn't require the Internet. But when you're at home and your your routers are appropriately configured and and everything is running, it will just run through your home home Wi Fi. And one of the benefits there is home Wi Fi tends to be stronger. You've got it across the entire house. And our that feed does not leave your home. So if it's running on your home WiFi, it does not leave your home. Kevin Lavelle [00:26:50]: Again, we are not swearing or processing anything. If your router goes down, if your Internet goes down, then your camera will fail over to direct local communication. So when it's running through your home WiFi, it's saying, okay. I'm running through home WiFi. I've got good signal strength. All of that's measured. When it can't find that home WiFi or it's not working, then it says connect directly to the monitor. Now with a power outage, at that point in time, if you were running an app on your phone, the camera is going to fail because no baby monitor cameras come with batteries. Kevin Lavelle [00:27:23]: I'll say none. Virtually none do because batteries are a severe fire risk, especially if it's running 247. And that's why, generally, you will not see batteries in cameras in homes. And so if there's a power outage, you wouldn't necessarily be notified if you're just using a WiFi camera. But our monitor would know, hey, I've lost connection with that camera because the cameras no longer has power. I'm going to alert the parents that there's no longer a connection. Now, that doesn't mean you can do anything about it because you don't have power in your house. But now you know, and you can choose to maybe open the doors so that you can still hear, maybe bring the crib into your room. Kevin Lavelle [00:28:02]: That's then a parental decision on what happens next. But the important thing is we empower parents to know what's actually happening. Dr. Christopher Lewis [00:28:09]: And about the night nurses, tell me about how do you identify these individuals? What type of background do they have? How are they trained to be able to provide that kind of service for families? Kevin Lavelle [00:28:18]: So we're recruiting actual nurses who have worked in pediatrics, whether in offices or hospitals. And then in some cases, they have in home night nursing experience where they have worked with families and homes. And in other cases, they just have pediatrics medical experience. And then we are training them from our professionally trained night nursing staff. So, our director of nursing has worked for years in hospitals. She was a pediatric oncology nurse. She worked as an in home care manager and as an in home night nurse. She's a Hmong herself. Kevin Lavelle [00:28:49]: And so she is working with one of our advisors and our team on training those nurses that we're bringing in. Dr. Christopher Lewis [00:28:56]: And as you said, those in home nannies or nurses that you might have inside your home can be very expensive. What's the price point on not only your system, but having this type of monitoring with night nurses to be able to assist parents? Kevin Lavelle [00:29:09]: To buy our camera and our monitor and all of our features, we do not require subscriptions or additional payments. You buy a camera and a monitor, you get everything forever. It's $599, which puts us as roughly price comparable to all the other leading systems on the market today because they require annual subscriptions. And then the remote night nanny experience, right now, is about $30 a night. You have to buy kind of packages of nights, and it works out to about $30 a night. And our long term vision is to get the cost down to $20 a night. Once we have enough people in the system and we can hire the staff and have the systems capable of working with many more families at the same time, we will continue to pass those cost savings on to our customers. And it's kind of cool. Kevin Lavelle [00:29:51]: At $20 a night, you could do 3 months of the remote night nanny for the same cost of about 1 week of an in home night nanny. And so we like to say 95% of the benefit and 5% of the cost of an in home night nanny. Dr. Christopher Lewis [00:30:06]: Well, it's a great value for families and definitely gives families peace of mind in regard to being able to be if you are sleeping and you get that good sleep, you're going to be able to be more present and be able to be much more attuned to what your child needs versus trying to struggle through with the lack of sleep that many parents get, especially for the 1st 6 months, 8 months, year, or more, depending on your child, that sometimes you run into. Kevin Lavelle [00:30:37]: Yeah. I mean, there's a lot of different studies and research, but very significant percentage of couples who get divorced say sleeplessness in the early years of childhood was a major contributing factor. The reality is a lack of sleep contributes to or exacerbates postpartum depression. It has very significant immune system impacts, durability, even to be a safe driver. When you are sleep deprived, whether you have a child or not, sleep deprived drivers can be even more dangerous than drunk drivers. And so, there's a lot from the adult side. And then on the child side, we make a big difference for parents. But on the other side, our monitor system is the kind of help parents and kids get more sleep. Kevin Lavelle [00:31:14]: That's the fundamental nature of our system relative to everything else. The single best thing that you can do for your child is obviously make sure they have appropriate nutrition in those early years, in early months weeks years. The second best thing that you can do for them is make sure that they are getting the appropriate amount of sleep on a consistent basis. And that is really hard to do for most parents for a whole host of very obvious reasons. And so, when you think about a well rested child, certainly, we can imagine they are more pleasant to be around. But from a mental development perspective, from a dysregulation perspective, from an immune system perspective, from a physical health development perspective, all of those, you have to have the right nutrition and you have to have the right sleep. And if you are not supporting your child's ability to sleep through the night, you are very much hampering their health and well-being and development. And I'll say one final note on sleep. Kevin Lavelle [00:32:11]: There are some very bad influencers and sleep gurus that will tell you the minute your child is crying, you need to be in there holding their hands and they will feel abandoned. Science has disproven this again and again and again. And similar to this idea of put your own oxygen mask on first, when moms don't get sleep, the propensity for postpartum depression absolutely skyrockets for all the obvious reasons. And when a mom has postpartum depression, it has a very significant impact on her ability to feed her child, nurture her child, love her child. It's a very difficult thing to go through. Obviously, there's no way that I could go through it, but it is a very understandable position that moms find themselves in. And so, these influencers and sleep gurus who, you know, propagate very bad sleep ideas, they're really harming parents' ability to get the right information and support their their families. And so, our focus is how do we help parents who want help? I'm never going to tell a parent, you're doing it wrong. Kevin Lavelle [00:33:15]: Every parent is responsible for raising their own child and we all have our own way. However, most parents are struggling and need some help. And we are here to provide very clear, unambiguous, science backed information. And we do that for free. At our website, harbor.co, we have a ton of free resources. And our mission is happier parents and healthier families. And so, we have a lot of free resources on our website. If you don't want to buy our baby monitor for any number of reasons, that's fine. Kevin Lavelle [00:33:41]: There's still a lot of great resources that you can find. And we have opportunities for parents to sign up for text based sleep coaching. If they just want to text a nurse and get some help, it's a very affordable $30 a month. You don't have to sign up for big hour long sessions or sign up for our full system, although we offer those as well. Dr. Christopher Lewis [00:33:58]: Well, Kevin, I wanna say thank you for sharing all of that. If people wanna find out more about your system, the night nanny services, or anything else, where should they go? Kevin Lavelle [00:34:10]: Harbor.co. And you can find us on on the socials at harbor sleep. And we have so many great resources there. We have very robust sleep guides for infants and also toddlers. We have also formed a harbor council of pediatric sleep doctors, postpartum counselors, pediatricians, OB GYNs that have written many articles for us. And our goal is if you have a question as a parent, we don't have all the answers yet, but we have pushed a lot of great content for free online to be a great resource for parents as they need it. Dr. Christopher Lewis [00:34:45]: Now we always finish our interviews with what I like to call our fatherhood 5, where I ask you 5 more questions to delve deeper into you as a dad. Are you ready? Yes. In one word, what is fatherhood? Kevin Lavelle [00:34:55]: Joy. Dr. Christopher Lewis [00:34:55]: When was the time that you finally felt like you succeeded at being a father to a daughter? Kevin Lavelle [00:35:01]: I don't think I could point to, like, we were at a theme park or we were at a restaurant. To me, it's those moments where my daughter would look at me, come home from work, come home from traveling, I'm tucking her in at night. And I just see that look in her eye that says, you are my safety, you are my home. The level of connection and love there, that success is a dad. Dr. Christopher Lewis [00:35:24]: Now if I was to talk to your kids, how would they describe you as a dad? Kevin Lavelle [00:35:28]: I believe they would say fun, strong, great. And those are the things that that I hope that they would say at their ages with their vocabulary. Some of the kind of underlying things would be that I'm supportive, that we have a lot of fun together. We laugh, chase them around the house, and that they still really want to spend time with me. They've got friends, but generally, they'd rather spend time with my wife and I than anyone else. Dr. Christopher Lewis [00:35:54]: Now let's go 10 years down the road. What do you want them to say then? Kevin Lavelle [00:35:57]: As I think about this phase of life, we no longer have little kids. They're not toddlers, and they go to school full time. And my wife and I have talked about, like, we did it. We got out of the the infant and toddler and very young kid phase as best as we possibly could have. We have wonderful kids. They're respectful. They're resilient. They like to learn. Kevin Lavelle [00:36:22]: They like to have fun. They're great kids. Now, we need to prepare them to be teenagers. And so, what would I hope to feel like at that point in time? That whatever it is that our kids want to do, whether they want to go to college, whether they want to pursue a sport, whatever it is. That they are ready to go face the world and they are as prepared as they possibly could be. As I said, prepare the child for the road. And that they truly understand, as best as a, you know, 18 year old can, what it means to be happy. That they will not chase the superficial. Kevin Lavelle [00:36:54]: That they will chase the core, the meaningful, the spiritual in whatever way that is for them. Dr. Christopher Lewis [00:37:00]: Now, who inspires you to be a better dad? Kevin Lavelle [00:37:03]: Certainly, I feel like I won the parent lottery. My parents raised me right. And I felt my whole life the appropriate balance of support and safety, but also go forth and conquer. My wife, she is an absolutely incredible mother, and I think a better mother than I am father. And, you know, as cliche as it is, my kids. When they show me that they want to spend time with me and that they want more of me and that they're truly grateful for the life that we have as best as young kids can, that, okay, keep going. I want to do more of it. Dr. Christopher Lewis [00:37:34]: Now, you've given a lot of piece of advice today, things that people can think about and look at ways in which they can incorporate some of those pieces into their own experience as a father. If you are talking to a father, what's one piece of advice you'd want to give to every father out there? Kevin Lavelle [00:37:50]: So for the dads that have kids older than me, I'm not sure how much advice I could give. But for those coming up behind me with with younger kids, I think it's a big part of what we talked about. Raise kids that you want to be around and that they love you. Like, that they are the kids that other people want to spend time with and that they want to spend time with you. That that kind of full circle. And if you do those two things, then you're doing all the other things right. And that's a good kind of metric or or baseline to seek. And as cliche as it is, it goes by really fast. Dr. Christopher Lewis [00:38:27]: It definitely does. Well, Kevin, I just wanna say thank you. Thank you for sharing your journey today. And as Kevin said, if you wanna find out more about him or about his company, go to harbor.co to find out more information about this amazing new technology and resource for you as you are working to be the best dad that you wanna be. Kevin, thanks so much for being here today. Kevin Lavelle [00:38:51]: Thanks for the opportunity and and for the inspiring work you do for dads. Dr. Christopher Lewis [00:38:55]: If you've enjoyed today's episode of the Dads with Daughters podcast, we invite you to check out the fatherhood insider. The fatherhood insider is the essential resource for any dad that wants to be the best dad that he can be. We know that no child comes with an instruction manual and most dads are figuring it out as they go along, and the fatherhood insider is full of resources and information that will up your game on fatherhood. Through our extensive course library, interactive forum, step by step roadmaps, and more, you will engage and learn with experts, but more importantly, dads like you. So check it out at fathering together dot org. If you are a father of a daughter and have not yet joined the dads with daughters Facebook community, there's a link in the notes today. Dads with daughters is a program of fathering together. We look forward to having you back for another great guest next week all geared to helping you raise strong and powered daughters and be the best dad that you can be. Dr. Christopher Lewis [00:39:54]: We're all in the same boat, and it's full of tiny screaming passengers. We spend the time, we give the lessons, we make the meals, We buy them presents and bring your AK. Because those kids are growing fast. The time goes by just like a dynamite blast. Be the best dad you can be. You're the best dad you can be.

In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Michael Payette, MD, a dermatologist in private practice at Central Connecticut Dermatology, to discuss practical approaches to managing hidradenitis suppurativa (HS). Dr Payette shares his experience establishing a dedicated HS clinic and provides insights into addressing diagnostic delays, patient education, and emerging treatments. They begin by discussing the importance of outreach and education to raise awareness of HS among non-dermatology health care providers, such as OB-GYNs and urgent care practitioners, highlighting how early referral and intervention can prevent long-term complications such as scarring and sinus tract formation. They then explore the role of GLP-1 therapies and biologics in HS treatment. Dr Payette shares his multimodal approach, explaining how GLP-1s address an underlying cause of inflammation while biologics target active inflammation. He outlines practical tips for managing insurance approvals and counseling patients on the benefits and potential side effects of these therapies. The episode also covers strategies for discussing lifestyle changes, such as weight loss and smoking cessation, while being sensitive to patient challenges. Dr Payette notes that combining weight reduction with biologics can often yield good outcomes, helping patients achieve better disease control and remission. Tune in to the full episode to learn how a systematic, patient-centered approach to HS management can improve outcomes for this challenging condition.

A weekly conversation between (mostly) women about all the different ways to be a mother (or not) with your host Daniella Rabbani. ALL ARE WELCOME.  This Week's Guest: OULA HEALTH - At Oula, we pride ourselves on delivering better maternity care, before, during, and after pregnancy. Midwife or OBGYN?
Medicated or au naturale?
It shouldn't have to be one or the other. So we've redesigned an experience that doesn't have a “right way.” We listen, respect your preferences, and make decisions with you, not for you. Our team of trusted midwives, OBGYNs and dedicated care navigators ensure you get the type of care you need in the moments that matter most. LEARN MORE HERE. And follow along @oulahealth on Instagram. Our Host: Daniella Rabbani (@daniellarabbani) is an award winning storyteller and mother of two.  Daniella has been hailed as "sympathetic and utterly alive" (New York Observer), "hilarious" (Wall Street Journal) and "will leave you twirling in the streets" (New York Times). TV credits: Amazon's The Better Sister, HBO's Scenes from a Marriage, CBS' God Friended Me, FX's The Americans, Fox's Laughs. Films: Oceans 8, Appropriate Behavior and her award winning directorial debut OMA (Available on Amazon Prime Video) and more.   Join the Conversation: * Instagram: https://www.instagram.com/momcurious/ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of Peach Pundit, Jason Pye, Buzz Brockway, and Scot Turner discuss various topics surrounding Georgia politics, including the Georgia General Assembly's priorities, cultural issues, and Governor Kemp's State of the State address. They delve into the controversial topics of tort reform and school speed zone cameras, highlighting the implications for due process and local governance. In this conversation, the hosts discuss the alarming demographic shifts in the United States, particularly the projection of more deaths than births among the native population by 2033. They explore the implications of these shifts on the economy, emphasizing the need for a robust immigration policy to counteract declining birth rates. The discussion also touches on the societal factors contributing to lower fertility rates and the financial burdens of raising children. Additionally, the conversation delves into the political drama surrounding Colton Moore, a state senator, and the implications of his actions that ultimately ended with him getting a mugshot. In this episode, the hosts discuss the implications of campaign finance violations by the New Georgia Project, and the role of Peach Pundit in fostering political discourse. They also delve into the challenges facing Georgia's healthcare system, particularly regarding access to OBGYNs, and conclude with a light-hearted discussion about the upcoming college football championship game.

Discover how maternal mental health care is evolving and why specialized support is critical for mothers with Paige Bellenbaum, LCSW, PMH-C and Rebecca Geshuri, LMFT, PMH-C.   In this episode we explore:   - What dyadic work is and how this can be especially beneficial for mothers and birthing people for developing a bond with their child.   - How Internal Family Systems (IFS) therapy can support mothers in addressing their inner “mom parts” that contribute to feelings of failure and overwhelm.   - How polarized parts and perfectionism can create distress in motherhood and how embracing a “both-and” mentality can offer relief and self-compassion.   - The questions to ask when looking for a provider to ensure they're trained in maternal mental health and understand the complexities of this life stage.   - Why it's so important for pediatricians, OBGYNs, or anyone who often comes into contact with birthing parents to have even a basic understanding of this transformative experience.   Whether you're a mother seeking support, a professional working with birthing parents, or simply someone invested in breaking the stigma around mental health and motherhood, this episode is filled with practical insights you won't want to miss.     REGISTER FOR THE TRAINING ON FEB. 27: Go to upshurbren.com/IFSTraining to register for this 3-hour workshop designed to teach professionals how to integrate Internal Family Systems concepts into maternal mental health services to provide improved support for moms.   LEARN MORE ABOUT THE MOTHERHOOD CENTER: https://themotherhoodcenter.com/   LEARN MORE ABOUT REBECCA: https://www.rebeccageshurilmft.com/get-to-know-me   ADDITIONAL REFERENCES AND RESOURCES: Postpartum Support International Ghosts in the Nursery: A Psychoanalytic Approach to the Problems of Impaired Infant-Mother Relationships   LISTEN TO PAIGE & REBECCA'S PAST EPISODES:

There are internal and societal pressures in making birthing and parenting decisions that are magnified for the BIPOC community. My guest explains how incorporating ancestral practices can be supportive and shares her valuable work and the importance of doulas for people of color. Dr. Suzanne Mungalez (aka Dr. Zann) is a licensed clinical psychologist in CA certified in perinatal mental health, childbirth educator, certified lactation education specialist, and trained doula. She has worked in hospital settings and birthing centers alongside OB-GYNs, midwives, and other birth workers. She is black, Congolese-American, and queer, along with being a gender-expansive woman and mother who has given birth in the comfort of her own home. Her background and experience shape her expertise in clinical work and how she holds space for her patients. Dr. Zann describes herself as “tender with people, tough on systems, and relentlessly committed to our collective liberation.”  Show Highlights: Dr. Zann's path to the perinatal work she does today The need to equip people with knowledge Everyone needs support and community! Pressures in birthing and parenting decisions for people of color Dr. Zann's help includes guided meditation, visualizations, therapy, and education. The benefits of incorporating ancestral background into birth experiences Considerations for people of color in “mom rage” and finding safe spaces to express yourself Understanding the role and benefits of a doula Dr. Zann's unique support for people in the transition to parenthood Ways of telling your birth story that bring empowerment, healing, and community How things are changing for the better for the BIPOC community—but it's still not enough! More support is always needed! Dr. Zann's appeal to people of color Resources: Connect with Dr. Zann: Website and Instagram Call the National Maternal Mental Health Hotline at 1-833-TLC-MAMA or visit cdph.ca.gov Please find resources in English and Spanish at Postpartum Support International, or by phone/text at 1-800-944-4773. There are many free resources, like online support groups, peer mentors, a specialist provider directory, and perinatal mental health training for therapists, physicians, nurses, doulas, and anyone who wants to be more supportive in offering services.  You can also follow PSI on social media: Instagram, Facebook, and most other platforms Visit www.postpartum.net/professionals/certificate-trainings/ for information on the grief course.   Visit my website, www.wellmindperinatal.com, for more information, resources, and courses you can take today! If you are a California resident looking for a therapist in perinatal mental health, email me about openings for private pay clients! Learn more about your ad choices. Visit megaphone.fm/adchoices

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

Dream fans....WE ARE BACK!Season four's gonna be a little different though. We're reimagining The Dream as a weekly interview podcast with guests and segments about, I don't know.... whatever we want? Don't worry! We'll still be focused on the "American Dream" and all the assholes that make it infinitely harder to achieve. We'll just have a bit more freedom in how we present it.Also, today we're bringing you an episode of a podcast I've been producing about abortion, called "Outlawed":Join two OB-Gyns as they explain the science and stories of abortion in the US. Misinformation is unfortunately everywhere. Listening to this podcast will give you the knowledge and tools you need to help navigate these difficult conversations with family and friends at the dining room table. Throughout the season we will interview physicians, researchers, advocates and experts, as we navigate this contentious topic and make sense of the reality of abortion care in the US.And DO NOT forget to check back in a few weeks for new episodes of The Dream! Hosted on Acast. See acast.com/privacy for more information.

In this episode of 'Hot for Your Health,' Dr. Vonda Wright is joined by Dr. Rizwana Fareeduddin (“Dr. Fareed”), a trailblazer in women's health and the Executive Medical Director for Women Services at AdventHealth. With over a decade of leadership experience in Obstetrics and Gynecology, Maternal Fetal Medicine, and healthcare strategy, Dr. Fareed is passionate about addressing health equity and advancing women's care. Together, they dive into the pressing issue of maternity care deserts, where access to OB/GYNs and birthing centers is alarmingly scarce. Dr. Fareed sheds light on the growing physician shortage and how workforce challenges demand systemic reforms, such as integrating telemedicine and multidisciplinary care teams. They also explore changing trends in maternity, including increasing maternal age and rising health risks like obesity and hypertension, emphasizing the need for preventative care and health optimization before pregnancy. The conversation extends to empowering women through better access to healthcare, combatting misinformation online, and embracing innovative solutions like AI in medicine. Dr. Fareed's insights inspire hope for a future where every woman can access compassionate, high-quality care. Tune in to learn how we can collectively improve women's healthcare and advocate for lasting change. ••• Connect with AdventHealth: Facebook:: AdventHealth for Women Instagram: @AdventHealthWomen&Children ••• Make sure to follow Dr. Vonda Wright: Instagram: @drvondawright Youtube: https://www.youtube.com/@vondawright Tiktok: https://www.tiktok.com/@drvondawright LinkedIn: https://www.linkedin.com/in/vonda-wright-md-ms-2803374 Website: http://www.DrVondaWright.com ••• If you enjoyed this episode, Subscribe to “HOT For Your Health” for more inspiring episodes. Apple Podcast: https://podcasts.apple.com/us/podcast/hot-for-your-health/id1055206993 Spotify: https://open.spotify.com/show/1Q2Al27D79jCLAyzp4hKBv?si=b62b374994884eed We'd love to hear your thoughts on this episode! Share your comments or join the discussion on social media using #HotForYourHealthPodcast.  

In this weeks episode we discuss a few things that we think would be a good idea to do in preparation for Trumps new presidency. We also discuss what we are currently doing to prepare. Here are the creators we discussed! pagingdrfran has an excellent sheet of OBGYNs around the country who do tubal sterilization isabella.reilly has a series where she's doing something everyday to prepare for the Trump administration! --- Support this podcast: https://podcasters.spotify.com/pod/show/genzs-guide-to-politics/support

Texas women are paying the price for the overturning of Roe v. Wade. More stories are coming to light of Texas women dying from treatable crisis pregnancies. Meanwhile the state's Maternal Mortality task force announced it's going to ignore maternal deaths for 2022 and 2023. And how OB-GYNs are fleeing the state due to fear of the state's anti-abortion law.

With an estimated 3.8 million breast cancer survivors in the United States, OBGYNs and other women's healthcare providers often are on the front lines of addressing survivorship issues, including the hypoestrogenic-related adverse effects of cancer therapies or early menopause in survivors. Although systemic and vaginal estrogen are used widely for symptomatic relief of genitourinary syndrome of menopause in the general population, among individuals with a history of hormone-sensitive cancer, there is uncertainty about the safety of hormone-based therapy, leading many individuals with bothersome symptoms to remain untreated, with potential negative consequences on quality of life. The term genitourinary syndrome of menopause (GSM) is the term used to describe to a constellation of symptoms that relate to hypoestrogenic effects on the genital epithelium, such as genital dryness, burning, and irritation; potential downstream effects of vulvar and vaginal atrophy such as dyspareunia; urinary symptoms such as urgency or dysuria; and recurrent urinary tract infections. Is vaginal estrogen or estrogen-like therapies safe in these patients? What about in those using aromatase inhibitors? A new Meta-Analysis (AJOG) provides insights. Listen in for details.

Hormones influence everything from mood and energy levels to fertility and long-term health.  Yet for many, hormonal health remains shrouded in mystery. When women do seek guidance from their OBGYNs, they're often told birth control is the only option for treating hormone-related issues like PCOS and endometriosis. But that wasn't going to cut it for Alisa Vitti. On this week's episode of Well, Now Kavita and Maya tackle hormonal health with the FLO Living CEO and see what other options are available when treating hormone imbalances. Well, Now is hosted by registered dietitian nutritionist Maya Feller and Dr. Kavita Patel. Podcast production by Vic Whitley-Berry with editorial oversight by Alicia Montgomery. Send your comments and recommendations on what to cover to wellnow@slate.com. Want to listen to Well, Now uninterrupted? Subscribe to Slate Plus to immediately unlock ad-free listening to Well, Now and all your other favorite Slate podcasts.  Subscribe now on Apple Podcasts by clicking “Try Free” at the top of our show page. Or, visit slate.com/wellplus to get access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hormones influence everything from mood and energy levels to fertility and long-term health.  Yet for many, hormonal health remains shrouded in mystery. When women do seek guidance from their OBGYNs, they're often told birth control is the only option for treating hormone-related issues like PCOS and endometriosis. But that wasn't going to cut it for Alisa Vitti. On this week's episode of Well, Now Kavita and Maya tackle hormonal health with the FLO Living CEO and see what other options are available when treating hormone imbalances. Well, Now is hosted by registered dietitian nutritionist Maya Feller and Dr. Kavita Patel. Podcast production by Vic Whitley-Berry with editorial oversight by Alicia Montgomery. Send your comments and recommendations on what to cover to wellnow@slate.com. Want to listen to Well, Now uninterrupted? Subscribe to Slate Plus to immediately unlock ad-free listening to Well, Now and all your other favorite Slate podcasts.  Subscribe now on Apple Podcasts by clicking “Try Free” at the top of our show page. Or, visit slate.com/wellplus to get access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hormones influence everything from mood and energy levels to fertility and long-term health.  Yet for many, hormonal health remains shrouded in mystery. When women do seek guidance from their OBGYNs, they're often told birth control is the only option for treating hormone-related issues like PCOS and endometriosis. But that wasn't going to cut it for Alisa Vitti. On this week's episode of Well, Now Kavita and Maya tackle hormonal health with the FLO Living CEO and see what other options are available when treating hormone imbalances. Well, Now is hosted by registered dietitian nutritionist Maya Feller and Dr. Kavita Patel. Podcast production by Vic Whitley-Berry with editorial oversight by Alicia Montgomery. Send your comments and recommendations on what to cover to wellnow@slate.com. Want to listen to Well, Now uninterrupted? Subscribe to Slate Plus to immediately unlock ad-free listening to Well, Now and all your other favorite Slate podcasts.  Subscribe now on Apple Podcasts by clicking “Try Free” at the top of our show page. Or, visit slate.com/wellplus to get access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hormones influence everything from mood and energy levels to fertility and long-term health.  Yet for many, hormonal health remains shrouded in mystery. When women do seek guidance from their OBGYNs, they're often told birth control is the only option for treating hormone-related issues like PCOS and endometriosis. But that wasn't going to cut it for Alisa Vitti. On this week's episode of Well, Now Kavita and Maya tackle hormonal health with the FLO Living CEO and see what other options are available when treating hormone imbalances. Well, Now is hosted by registered dietitian nutritionist Maya Feller and Dr. Kavita Patel. Podcast production by Vic Whitley-Berry with editorial oversight by Alicia Montgomery. Send your comments and recommendations on what to cover to wellnow@slate.com. Want to listen to Well, Now uninterrupted? Subscribe to Slate Plus to immediately unlock ad-free listening to Well, Now and all your other favorite Slate podcasts.  Subscribe now on Apple Podcasts by clicking “Try Free” at the top of our show page. Or, visit slate.com/wellplus to get access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hormones influence everything from mood and energy levels to fertility and long-term health.  Yet for many, hormonal health remains shrouded in mystery. When women do seek guidance from their OBGYNs, they're often told birth control is the only option for treating hormone-related issues like PCOS and endometriosis. But that wasn't going to cut it for Alisa Vitti. On this week's episode of Well, Now Kavita and Maya tackle hormonal health with the FLO Living CEO and see what other options are available when treating hormone imbalances. Well, Now is hosted by registered dietitian nutritionist Maya Feller and Dr. Kavita Patel. Podcast production by Vic Whitley-Berry with editorial oversight by Alicia Montgomery. Send your comments and recommendations on what to cover to wellnow@slate.com. Want to listen to Well, Now uninterrupted? Subscribe to Slate Plus to immediately unlock ad-free listening to Well, Now and all your other favorite Slate podcasts.  Subscribe now on Apple Podcasts by clicking “Try Free” at the top of our show page. Or, visit slate.com/wellplus to get access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hormones influence everything from mood and energy levels to fertility and long-term health.  Yet for many, hormonal health remains shrouded in mystery. When women do seek guidance from their OBGYNs, they're often told birth control is the only option for treating hormone-related issues like PCOS and endometriosis. But that wasn't going to cut it for Alisa Vitti. On this week's episode of Well, Now Kavita and Maya tackle hormonal health with the FLO Living CEO and see what other options are available when treating hormone imbalances. Well, Now is hosted by registered dietitian nutritionist Maya Feller and Dr. Kavita Patel. Podcast production by Vic Whitley-Berry with editorial oversight by Alicia Montgomery. Send your comments and recommendations on what to cover to wellnow@slate.com. Want to listen to Well, Now uninterrupted? Subscribe to Slate Plus to immediately unlock ad-free listening to Well, Now and all your other favorite Slate podcasts.  Subscribe now on Apple Podcasts by clicking “Try Free” at the top of our show page. Or, visit slate.com/wellplus to get access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hormones influence everything from mood and energy levels to fertility and long-term health.  Yet for many, hormonal health remains shrouded in mystery. When women do seek guidance from their OBGYNs, they're often told birth control is the only option for treating hormone-related issues like PCOS and endometriosis. But that wasn't going to cut it for Alisa Vitti. On this week's episode of Well, Now Kavita and Maya tackle hormonal health with the FLO Living CEO and see what other options are available when treating hormone imbalances. Well, Now is hosted by registered dietitian nutritionist Maya Feller and Dr. Kavita Patel. Podcast production by Vic Whitley-Berry with editorial oversight by Alicia Montgomery. Send your comments and recommendations on what to cover to wellnow@slate.com. Want to listen to Well, Now uninterrupted? Subscribe to Slate Plus to immediately unlock ad-free listening to Well, Now and all your other favorite Slate podcasts.  Subscribe now on Apple Podcasts by clicking “Try Free” at the top of our show page. Or, visit slate.com/wellplus to get access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hormones influence everything from mood and energy levels to fertility and long-term health.  Yet for many, hormonal health remains shrouded in mystery. When women do seek guidance from their OBGYNs, they're often told birth control is the only option for treating hormone-related issues like PCOS and endometriosis. But that wasn't going to cut it for Alisa Vitti. On this week's episode of Well, Now Kavita and Maya tackle hormonal health with the FLO Living CEO and see what other options are available when treating hormone imbalances. Well, Now is hosted by registered dietitian nutritionist Maya Feller and Dr. Kavita Patel. Podcast production by Vic Whitley-Berry with editorial oversight by Alicia Montgomery. Send your comments and recommendations on what to cover to wellnow@slate.com. Want to listen to Well, Now uninterrupted? Subscribe to Slate Plus to immediately unlock ad-free listening to Well, Now and all your other favorite Slate podcasts.  Subscribe now on Apple Podcasts by clicking “Try Free” at the top of our show page. Or, visit slate.com/wellplus to get access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

Movie studies have always been associated with Hollywood and sunny Southern California, but high costs have driven many companies eastward to states like New York and Georgia in recent years in search of lower costs for filming. A look at the Golden State’s recent moves, including a tax credit just passed in an attempt to revive the state’s marquee industry. Plus, why Texas’s abortion restrictions risk causing a marked decrease in OB-GYNs willing to work in the state. And, we chat with Sara Taylor, president of the consulting firm deepSee, about incivility in the workplace in a time of tense election-year politics.

Movie studies have always been associated with Hollywood and sunny Southern California, but high costs have driven many companies eastward to states like New York and Georgia in recent years in search of lower costs for filming. A look at the Golden State’s recent moves, including a tax credit just passed in an attempt to revive the state’s marquee industry. Plus, why Texas’s abortion restrictions risk causing a marked decrease in OB-GYNs willing to work in the state. And, we chat with Sara Taylor, president of the consulting firm deepSee, about incivility in the workplace in a time of tense election-year politics.

This week we are joined by former astronaut, Senator Mark Kelly to talk about all things Kamala Harris, and his family's personal experience with gun violence and IVF. Kelly also reflects on how new laws are effecting OBGYNs in Arizona, and the danger of qualified doctors closing their practices and moving out of state. We end the the interview by asking Kelly our most burning question about space. Learn more about your ad choices. Visit megaphone.fm/adchoices

I'm thrilled to share the latest episode of The Egg Whisperer Show where I had the honor of chatting with Dr. Justin Thompson, one of the most inspiring and dedicated OB-GYNs I know!  Justin joins me to share his incredible journey through the medical field: early on, he made an unexpected shift from oncology to obstetrics, inspired by personal experiences. He's crafted an innovative practice focused on personalized patient care, and we share similar views on the importance of building close-knit relationships with patients.  Our conversation delves into the challenges and rewards of starting his own practice, the importance of selecting the right obstetrician, and his hopes for the future of obstetrics. Dr. Thompson's passion for his work and his dedication to his patients underscore every topic, making this episode a must-listen for those starting or already on their pregnancy journey. Join us as we explore the profound impact of compassionate and personalized medical care in obstetrics. Here is what we are talking about in this brand new episode: Dr. Thompson shares his inspirational journey from medical school to becoming a beloved OB-GYN. We talk about the importance of building a relationship with your obstetrician before pregnancy. Dr. Thompson discusses the unique needs and care considerations for IVF patients. Insightful advice for couples and individuals starting their pregnancy journey. Our discussion on the future of obstetrics and how personalized care can make all the difference. I hope you'll tune in and hear our thoughts about patient care. You can find the link in my profile. Resources: Dr. Justin Thompson's website: Dedicated Pregnancy Care Dr. Justin Thompson on Instagram Join Dr. Aimee's IVF Class by clicking here Get Dr. Aimee's Fertility Essentials and Supplement List Do you have questions about IVF?Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, November 18, 2024 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom.   Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org. Other ways to connect with Dr. Aimee and The Egg Whisperer Show: Subscribe to my YouTube channel for more fertility tips!Subscribe to the newsletter to get updates

In this episode, we're thrilled to welcome a very special guest, Lanning Ardente, the Co-Founder and CEO of Sorette—the new gold standard for motherhood products. Sorette not only offers a one-stop shop for safe and trusted products but also features their renowned Seal of Approval, developed by a team of leading toxicologists, thought partners, and their Scientific Advisory Board made up of OBGYNs, Dermatologists, Epidemiologists, Nutritionists, and experts in Women's Health.Lanning shares her journey from being a mom to creating Sorette, what inspired her to start this revolutionary brand, and how they developed their high standards to ensure that moms and families are surrounded by trusted products. Their approach allows moms to focus less on scrutinizing ingredient labels and more on what really matters—bonding with baby and taking care of themselves during this precious, transitional time.Shop now at https://shopsorette.com⭐️ Sorette has given our listeners an exclusive discount code. Use code: MOMCHAT15 to get 15% off your order.Make sure to also follow Sorette on Instagram: @shopsoretteJoin the official Mom Group Chat Facebook group: Mom Group Chat | FacebookKeep up with the Moms and join the conversation on our socials:Instagram: @‌momgroupchatTikTok: @‌momgroupchatQuestions/comments/need to vent? Email us at momgroupchat@gmail.com

Rachel is a professor, an author, and a VBAC mom who is here to share her story from a traumatic C-section birth through a VBAC. This episode really dives deep into how picking the right provider is key to improving your chances for a VBAC. They give practical questions to ask your providers, more than just yes or no, to really get to know their birth philosophy and what qualifications and experiences your provider might have that would make them a better fit for VBAC chances. Rachel and Meagan also give a lot of validation and advice on how to start the process of overcoming birth trauma; it's reality and to not be ashamed of it. You're not alone. Through the many important messages of this episode, they both mention many times to trust your intuition. If something feels off, listen to that. And if a change in provider is necessary…it is never ever too late to change. Invisible Labor: The Untold Story of the Cesarean SectionHow to Naturally Induce LaborHow to Turn Prodromal Labor into Active LaborMembrane Sweeps for VBACHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello everybody! Welcome to the show! I am so honored to have Rachel Somerstein on with us today. She is a friend of ours from New York. She is a writer and an associate professor of journalism at SUNY New Paltz. She is an author of Invisible Labor: The Untold Story of the Cesarean Section.  And her writing has also appeared in the Boston Globe, The Guardian, The Washington Post, and Women's Health. She lives in Hudson Valley, NY with her husband and her two children and is here to share her stories with you today. Rachel had an unplanned Xesarean section with her first child and the experience was anything but routine. I know that there are many of us who have been through this journey and on this podcast, maybe listening today, that also had an unexpected experience and it may have left us with trauma, or doubt, or fear, or all the feelings, right? And so she is going to be talking to us today about her experiences, but then also we're going to talk about some guidance on how to find peace and to offer ourselves grace and to set ourselves up for a much better experience next time. We do have a review of the week, so I want to get into that and I'm going to turn the time over to Rachel.This review is by Deserie Jacobsen. The review title is “Thank You.” She actually emailed this in and it says, “This podcast and parents course is amazing. I am not a VBAC mom, but I have been listening since 2020. I binge listen near the end of every pregnancy to remind me of everything I need to remember in birth and process through my previous births. This time around I felt more prepared than ever before, having plans in place just in case. We were able to have a quick birth of my 5th baby. I love the education, passion, and love this podcast gives. I recommend it to everyone I know, and I have learned so much from it. I am so grateful for this podcast, thank you.”Thank you so much Deserie for your review! Seriously you guys, I just love hearing that people are finding the information that they need, they're finding community, they're finding that they can do this too. Just like them, and all these reviewers and all the people that have shared their stories and all these reviewers you guys can too. This birth, VBAC, is possible too. Better experience is possible. A healing CBAC; it's possible. You guys, all it takes is getting the information, the prep, finding the provider, to have a better experience.Meagan: Alright Ms. Rachel, welcome to the show and thank you again so much for being here with us. I kind of talked about this a little bit before we started recording about how I think your episode is going to be so powerful and deep and raw too. You've got these feelings and these words. I love it. I love reading your book and I can't wait to hear it from your own mouth. Which speaking of book, can we talk about that a little bit? What kind of just inspired you, jumpstarted you into writing a book about this?Rachel: Well, I'm a writer. And I wrote an essay about my birth about two years after I had my baby, my first birth, my C-section. And I realized I had a lot more to say and also I heard from a lot of moms when that came out and that made me start thinking that I think there was a bigger project. Meagan: Absolutely. And an amazing project that you completed.Rachel: Yes.Meagan: And remind everybody before we get into your stories where they can find your book. I actually have it here in my hands. It's Invisible Labor. So where all can they find that? And we'll make sure that we link it. Rachel: Sure, thank you! Yeah, so it's Invisible Labor: The Untold Story of The Cesarean Section. And you can get it on Amazon, you can get it from Barnes and Noble, you can get it from your local bookstore, you can get it as an audiobook? Or you can also get it as an ebook.Meagan: For the audiobook, did you record it?Rachel: I did not. The narrator is Xe Sands and she did a great, great job. It sounds excellent. Meagan: Awesome. We'll be sure to link that. I think it's definitely a book that everyone should check out. There's a lot of power in that book.Rachel: Thank you.Meagan: And it's not even just your story. I mean there's a ton. Like if you go through the note section there's a ton of research in there, and history and studies, and so many really great things. Well okay, let's hear about the story that started the inspiration and behind this amazing book.Rachel: Sure! Thank you. So like so many moms, I had an unplanned C-section that I was completely unprepared for, which is another reason I wanted to write this book because I think a lot of people go into pregnancy just assuming they're going to have a vaginal birth and like me, I didn't even read the parts of the books about C-sections, I skipped them. Because I was not going to have a C-section. Which is whatever, hindsight is everything, right? But I had a totally textbook pregnancy. I switched to a different group of midwives and OB's about halfway through because I just didn't have a connection I felt with the providers in the first one. And frankly, I didn't have a connection with the providers in the second one either, but by that point, I was like well whatever, it's fine. Which I think is actually, if I could go back and do it again I would have changed that. But you kind of are like, I don't want to, could I possibly change again? And I think that for people who are VBACing, yes you can and sometimes you actually really need to, even like late on in your pregnancy, people will switch groups or providers even late in the third trimester, so. Meagan: Even if you're changed already, you can do it multiple times.Rachel: Exactly.Meagan: It's not a bad thing to find the right provider for you. It's not. Rachel: It's not. And It's hard. And you can feel like, Oh my god. Am I really going to send all my records over? It can feel like so much effort and it can really be worth it. I just wanted to say that as someone who switched once and then was like, Okay, I'm done, and wished I'd switched again. So anyways, it was late in week 39 I went into prodromal labor but I didn't know that prodromal labor even existed because nobody told me about it.  And it was my first baby. So I was like is this labor? I think I'm having contractions, these are not Braxton Hicks. And in the end, we talked to the doula I was working with, and in the end they ended up petering out. And at that, I think that that for me marked the beginning of, this is not going to look like the way I had expected it to look. And again, hindsight is everything. What I wish I had known at the time– and I think this is really relevant to some VBAC moms is that sometimes prodromal labor means that your baby is not in the best position for having a vaginal birth. And I can't exactly say oh I would have done this or that differently if I'd known it, but it would have helped me understand what I was going into with the labor and the birth. So anyway, I eventually went into labor in the middle of the night. It was exactly my due date and I knew it was different. I could just feel this is labor. And I was really eager to get it going quickly. And again, I wish someone would have said, “Rachel, rest. It's early. You're going to need your strength. You're going to need your energy however your baby is born.” And instead I quite literally was running up and down the stairs of my house to try to push labor along. Which is, I have compassion for myself, I understand why I was doing that. What I really needed to do was get in the bath, or I don't know, lay over the birth ball. Watch a silly movie, right? The feelings I was having were real pain and I was scared. But you kind of can't run through this, especially a first labor as we all know, those take a long time, right?Meagan: Yeah. And if we were having prodromal labor, our body may be kicking into labor, but still might need some time to help that baby rotate and change positions. Rachel: Exactly, exactly. And this is the kind of education that is so missing from birth classes. And that is one reason why this kind of podcast is so helpful because that's how I learned about these different things. I didn't ever learn about them from a provider being like, “Let's talk about what will happen in your birth, and let's talk about why you had prodromal labor.”So anyway, we went to the doctors office where we met a midwife and my doula for a labor check. And I was hardly dilated, I was at a 2 but I was in extreme pain. And I have to say, I have a very, very high pain tolerance and I now know I was having back labor. Meagan: Baby's position.Rachel: Exactly. And the contractions were like boom boom boom boom. They were not, I didn't have any rest in between them. Which again, I think my baby was like I gotta get in the right position, this isn't working out, I'm freaking out, ah! Plus my mom is running around, ah! Right?Meagan: Yeah. Rachel: So we went to the hospital and I was checked in and the midwife who checked me in was like, “Oh you're actually not even 2 centimeters, you're just 1 centimeter dilated.” And they checked me because I was in so much pain I think. And I don't know that that was necessarily wrong,  but again, no one was sort of explaining, “Here's what we think is going on.” And it's partly because I believe those providers thought I was exaggerating what I was experiencing physically. They didn't know me. Well, they didn't know that I'm usually pretty stoic. They didn't know that I'm not a squeaky wheel. And I wasn't like screaming or crying or pounding. I was like quiet and I was like I'm in a lot of pain.Meagan: An intense quiet.Rachel: Intense quiet. Exactly. But that doesn't look like what we think pain looks like to people. And the fact is that people are very individual and how they express pain especially during labor where you're already kind of like leaving the regular plane of reality.Meagan: Yes. Rachel: So an important takeaway is like, even experienced providers cannot read your mind and make mistakes in assessing what's truly going on with you. And this comes up later in my second birth, but my husband now does a much better job of saying, “You might look at Rachel right now and think she looks like she's doing great, but this is what's really going on with her.” And he does that in a way that's not like he's speaking for me in a way that's annoying, but it's like I actually can't advocate for myself, I can't express this. So anyways, I asked for an epidural. They said that the anesthesiologist was busy. Which may have been true, but may have been they were trying to put me off because I was hardly dilated. And they told me to get in the birth tub. And I remember hanging over the side of the tub and staring at the clock on the wall and being like, I actually don't know if I'm going to survive this hour. I was just in so much pain. Incredible pain from back labor that was incessant. Eventually he showed up. They hooked me up to all the monitors. At that point, one of the nurses was like, “Oh, you are having monster contractions.” Like the contractions that were being measured were so intense they were going each time to the edge of what was measurable. And now that the computer said it it was like oh…Meagan: You're validated now. Rachel: Exactly. Right. And the anesthesiologist, it took him three tries to get the epidural working properly which would echo problems to come. But he did, and it took away the pain. And then I was just in the bed and kind of left there. And the nurses and the midwife did not use a peanut ball, they didn't move me around. And obviously, listen, I'm attached to the monitors. You know you cannot really move that well, the belt slips, and that increases the chances you'll have a C-section. And there are still things that can be done. It's not like you're a loaf of bread, you just lay in a bed. But they didn't do that stuff and I wasn't dilating. The nurse and doula eventually basically were like, “Well, we're going to go out for dinner and we'll be back in a few hours and we're going to give you this thing to sleep and if you haven't dilated by the time we get back you're going to have a C-section.” And at that point I was exhausted. It's evening now, I've been up since the middle of the night. I'm totally like, what is happening with this birth? No preparation; I took birth classes, I read books, no preparation suggested that this series of events could take place. I felt completely abandoned by my providers, including my doula who I was paying out of pocket. And one thing that came up at this time also was I had this colposcopy in college, like scraping of cervical cells. I didn't hide it from anybody, I was open. And the midwife said well maybe that's why you're not dilating is because of this colposcopy.Meagan: Do you think you got scar tissue?Rachel: That's what she said. And I remember at the time being like why are we only talking about this now? Why has nobody brought this up in any of the prenatal visits that I've done? And I felt blamed. This thing about your body is defective. After a few hours when the midwife and the doula came back and I rested and it was quiet, I had dilated to a 9. And I think what that's about is that I had been in too much pain to dilate. I was so frozen up and tense and also extremely scared.At this point people are like, “Oh wow.” And finally my water broke,y water hadn't broken. So you know, things are kind of continuing and I am starting to actually feel even more fear and my room is getting really crowded with people. And the midwife asks me to start pushing. And I was afraid and I was excited. They turned on the baby warmer, and they were like, “Okay, your baby is going to come out.” And I started to push but I couldn't feel what I was doing. I had no idea. And the midwife was like, “Do you have an urge to push?” And I was like, “No.” The epidural that hadn't gone well from the beginning had then come down with a very heavy hammer and I felt total numbness. It was not helpful. I needed someone to have turned it off or something, or turned it down so I could feel an urge to push and feel how to push, where to push, what muscles to use. And at a certain point I could tell something was going not right and it turned out that my baby was having heart rate decelerations. So just to sketch the scene. At this point it's 1 o'clock in the morning, I've been awake for 24 hours. I'm exhausted. My husband is exhausted. Neither of us has any idea that things could have gone like this. The midwife says I think it's time to do a C-section. And I don't disagree with her. I don't even know what to think at that point. I'm also feeling tremendous fear. I was like I'm afraid I'm going to die, I'm afraid my baby's going to die. And the overall sense in the room…and people were like, “Oh no, you're going to be fine”. And the sense in the room was that I was hysterical and I was not in my right mind. Which I wasn't in my right mind; I had been awake for a long time, I'd been trying to have this baby, nobody really told me what was going on and I felt totally unsupported. Actually, my response was completely reasonable given the circumstances and nobody really attended to that and saw that and recognized that as completely valid. Plus, I don't have evidence to stack this up absolutely, but I have since come to find out that there is a medication that some laboring women are given to help them rest and one of the side effects is an impending sense of doom. And I have a friend who had a baby at this same hospital and had the same response after having been given something to rest during her labor. I could go back and look at my records and I may do that but I'm like, well that would explain also why I had the response I did. Meagan: Mhmm.Rachel: Anyway, we go to the OR. I hunch my back for the spinal that the anesthesiologist has to do a couple of times to get it right. I'm still contracting at this point. My body is still like, Come on, let's get this baby out. Let's get this baby out. And I'm so uncomfortable. And you know that advice to not lay down flat on your back when you're pregnant, but that's what you have to do when you're in the OR. The whole thing felt like I was going to choke under my stomach and very exposed like you are in the operating room. Meagan: Yeah, it's cold and it's bright and you're very exposed. And you can't move your body normally, especially if you've had a spinal. Rachel: And also in retrospect, again I'm like I cannot believe that the first time I learned what happened in a C-section was in my C-section. I really should have at least learned about this even though it would have still been scary and I still would have been surprised. So when the OB goes to operate, he starts his incision and I say, “I felt that.” And he says, “You'll feel pressure.” And I say, “I felt that.” And he continues operating and I was not numb. I felt the operation. And according to his notes..parts of this I don't remember…but he wrote it down and my husband has also told me that I was screaming, my legs were kicking. There's no question that I was in tremendous pain. And I was moaning and it was horrible. And it was horrible for the people in the room too by the way.Meagan: I'm sure. Rachel: Right? Like it's really important to say that. My OB didn't listen to me. That is a super common thing that happens in healthcare, especially for women. Especially for pregnant women. He's not a sociopath. He didn't want to be evil, but he didn't listen and the consequences were so steep and so dire. And I think that it was traumatizing to him and I know it was traumatizing to some of the other providers in that room, the nurses to watch this. He kept going and when the baby was born, which I don't remember, apparently they held her up to my face and they put me under general anesthesia and sent my baby and my husband away and stitched me up. Then I woke up in recovery. The doula and the midwife had gotten the baby to latch while I was unconscious and were talking about me without knowing that I was awake about her latch which really, really bothered me because it just underscored how it felt like I was just a body. And even people who were supposed to be there to take care of me and be tender and advocates, I felt they disregarded me. And under other circumstances I really would have wanted to breastfeed my baby like right away. But I wasn't even there to say yes I want to do this or no I don't want to do this. It was a terrible birth and I would not wish it on anybody. Meagan: And I think, kind of talking about what you were just talking about with breastfeeding and stuff, these people in their hearts and in their minds were probably like this is what she would have wanted. We're trying to help. But in whole other frame of mind over here, I'm not present. I haven't said those things. And I know you're trying to help and I know that's where your heart is, but I'm not okay with this. Rachel: Totally.Meagan: And I think sometimes as doulas, as birth workers, as any one of you listening, remember that words matter. Actions matter. These moms' feelings matter and it's sometimes in our minds we're trying to do what's best, but it might not be. Rachel: Totally. Absolutely. Yes and I again, it's so important to point out. Yes they were coming from a good place. They really were coming from a good place. But it wasn't the way that I felt it or experienced it. Meagan: And it left you with trauma and angst and heartache. Rachel: Absolutely. Totally. Yeah. Meagan: Well that definitely sounds like a really rough birth. And it's so crazy because it's like you went from not progressing to baby in a poor position, to getting an epidural. I love that you talked about that. That can be an amazing tool. A lot of people are very against epidurals, and there are pros and cons with epidurals. We've talked about those. Fetal heart decels is one of them. I don't think, maybe in this situation it sounds like a lot of other things happened; baby's position being one of the biggest ones. But that can really be a tool that helps you just relax and be more present and have less trauma. We talk about this in my doula practice of where there's a difference between pain and suffering. And pain, progressive positive pain that's bringing our baby to us that's one thing. But when we're suffering and we're so tense that our body's not even able to try; that epidural could come into great play. But again, we're not that loaf of bread in a bed and it is important to move and rotate. And it doesn't have to be drastic. It doesn't have to be crazy big movements. Just subtle movements to change the dynamics of the pelvis and to encourage our baby to keep coming down. So there were so many things that just went poorly but also went well, and then poorly again and then well and then real poorly there at the end. Rachel: And I think like to your point, I went into my birth I should say, I was planning on having an unmedicated vaginal birth. I was like I'm not going to have an epidural. And I think that if my providers had different skills I would have, I may have been able to have that baby vaginally. And I say that based on what happened in my second birth. So it's not just like wishful thinking, right? And I'm really glad I had that epidural. I really needed that. I was suffering. The pain I was experiencing was not productive pain. And an epidural can help you with suffering, alleviate your suffering. But it can't and doesn't substitute for emotional support. And I think that's what was missing for me, throughout that first birth. Even if I had gone on to have ok fine, a cesarean, or even a vaginal birth, I still think I would have been like that wasn't a good birth because I didn't feel emotionally supported. And an epidural can't do that. Meagan: Yeah. No an epidural cannot do that. And I, for anyone listening who supports birth, or even who are going for a birth you kind of mentioned it. You're in this other land and sometimes it's hard to advocate and open. You might be thinking something and you might so badly want to say it. It's right here, coming out. And you can't say it for whatever reason. It's a weird thing, it doesn't make sense sometimes but it can happen. But really being heard, validated, understood; which are so many things you weren't. Right? And when we're not heard and when we don't feel safe, and we don't feel supported, those things leave us with PTSD. In fact there was, in your book, I'm just going to read it. It says, “2022 study by anesthesiology and obstetrics professor Joanna and colleagues found that what's important about women who feel pain during childbirth is how mothers feel about their pain. And how their providers communicate with them overall…”You were communicating, and no one was communicating to you. “...feeling positively about pain and heard by providers protects a mother from developing PTSD.” And I mean it goes on which is why you need to get the book so you can read more about it. Rachel: Yep. Meagan: But really, feeling heard. Rachel: It's not just crunchy whoo-hoo feels good, feels right, sounds good. It really matters. And I have to say that I'm participating in and helping to work with providers on designing some studies about providing different pain options for moms during C-sections. We literally had a conversation about this yesterday. And one of things we were talking about is it's not just the pain. It's not just pain relief. It's also being listened to. Because there will be people who are like, I might say I'm in pain, but that doesn't mean I need an epidural or want an epidural. But I'm feeling pain and I want to be heard and I want somebody to…even if you can't express this. You can't even express it because you're the one having labor. What you're needing is someone to see you and look you in the eye and be like you're going to be okay. And I think as mothers we totally are experienced with that all the time. When your child is hurt or sick, part of your job obviously is to get them the help they need, but it's also to assure them this nosebleed is going to end. You're not going to have a bloody nose for the rest of your life. Which, when you're going through something really hard you can sometimes forget, right? And you're pointing out from the studies this helps to prevent people in birth, in labor, from developing PTSD. The stakes are really high. They matter so much. Meagan: When you were just talking, I don't know if you saw my eyes kind of well up a little, but I connected a lot with my first birth when I was clinging to a bed, literally clinging. And I was looking at my husband and I'm like, “Do something!” I had a baby in a poor position. I was being jacked full of pitocin. My water had broken, there was a lot of discomfort going on. I had told him I didn't want an epidural and he's like what do you want me to do? And I was like I don't know, I just need something! And I was terrified and desperate. And he was just like… It wasn't fair for me to put him in that position either but at the same time he was like I don't know, I don't know what to do, right? And the nurses were just like we'll just get you an epidural. And I was like no, I don't want an epidural. And then it just was like epidural, just went down from there. And I wish so badly that there was something else. Let's get you out of the bed. Let's get you in the shower. Let's give you some nitrous. There was so much more that I could have had, but wasn't even offered. And I think too, I needed someone to tell me that nosebleed was going to end. Rachel: Yes. Meagan: And it was going to end and it was going to come back every five minutes and it was going to end again and I was going to be okay. And I was going to survive that. And just hearing you talk about that, why my eyes got all welly, is that I don't know if I realized how much that impacted me until just barely. And here I am, my daughter is almost 13.Rachel: Just like how powerful these things that, I don't know, this is part of why we have these conversations. They shed different corners of light on our experiences that it's like oh my gosh, I didn't even know I knew that. And that's so why we, even though I'm not postpartum immediately, it's valuable for me to talk about it too; to hear what you're saying, you know?Meagan: Yeah. Ah, so after a not-so-amazing experience, going into that postpartum, you've talked a little bit about that in your book. Well, not a little bit, you've talked about that a lot. Tell us about that journey and then what led you to deciding on VBAC and ultimately going and having a VBAC. Rachel: So I should say, I was really…Talk about not realizing things right away. It took me a long time to figure out how traumatized I had been by that birth. And I was about two years postpartum and I was having a procedure for something else and I just completely, I had a panic attack. I had never had a panic attack before, I didn't know what it was and couldn't have explained what was happening. And when the anesthesiologist who did this procedure was like have you ever had any issues with anesthesia, which is exactly the question that should be asked, and I had said what had happened he was so taken aback. He was shocked and didn't know what to say and walked out of the room.Not in the way of, I'm abandoning my patient, but just like from his perspective here's this kind of routine thing. This patient is crying and shaking and talking about this very traumatic incident which I had not talked about. I didn't go to therapy. I had talked about it with friends and my family, it wasn't a secret, but I felt a lot of shame. I felt like I must have been this total freak of a person that this had happened to me. And after that I remember saying to my husband, I just don't know if I'm ever going to be able to get over this trauma enough to have another baby. And I didn't even know if I wanted another baby, like separate from the trauma. In therapy I started to see that I felt very stuck in my life and that included how and whether to grow my family. And that was actually because of the traumatic birth. It just like made this big block. I think one thing that's important to think about for those who have had a traumatic birth is that sometimes that can show up in your life in ways that you don't expect. Meagan: Yes. Rachel: And so to be compassionate with yourself about that and also to be open to that. We're in the era of warnings and trigger warnings and those are important, but sometimes for a traumatized person the things that are triggering or activating are not what you would think. Like for me, I couldn't watch a scene of a hospital birth even if it was happy without getting very uncomfortable and having to walk away and there wouldn't be a content warning on that. So it's just to say be patient with yourself. Accept that…don't, I guess if you've had a traumatizing birth you don't have to struggle against these things. As horrible as they might feel, as uncomfortable as they might feel it's normal and it's ok and it shows up differently for everybody. Rachel: Yeah so I had this big question and then I was like ok, it took awhile for me to be like I do want to have another baby. But I wasn't ready emotionally. And so I waited. And then about, let's see, October of 2019, I was like I think that I'm ready to try to have another baby. And we had met this midwife who lived in our community, who my daughter actually made friends with her niece at our public pool which is so beautiful. I ran into her one night while she was walking her dog. She was like your husband shared a little bit with me, if you ever want to talk. And this, I feel like, I could not be more grateful that this person came into my life. She just is, her skills are phenomenal. Just as a clinician in terms of trauma-informed care, and I've felt safe enough going to her for prenatal care to decide that I was ready to get pregnant. My joke is that I should tour high schools and be like it only takes once to have unprotected sex to become a parent. And I was really lucky that I got pregnant right away and at that point I was 37. So I should say I had my first baby at 33 and I got pregnant again at 37. And that's not always the case for people. Obviously it can take a long time and especially after a C-section, secondary infertility is real. Meagan: It is. Rachel: Yeah. Not talked about enough. Really not talked about enough. Meagan: There's a lot of things, right, about C-sections that is not discussed about. For personal, for the mom, for the individual, the infertility, adhesions, all those things. Just the emotional and the physical. Then even the baby. There's risks for the baby, the allergies, the microbiome getting messed up. All the risks, it's just not discussed. Rachel: No, it's really not. And you kind of only find out later if you've had a C-section and you've had a problem down the road that you're like, maybe that's because of my C-section. It's ridiculous.So we got pregnant and I was not sure if I wanted to have a VBAC, but I started thinking about it from the beginning. And I also was like, if I don't have a VBAC how am I ever going to get myself into an OR, I just don't know. And I really think that VBAC is the under-discussed pain point for moms. And I'm preaching to the choir here but we're talking about half a million moms every year have to make this decision, if it's even available to them. Meagan: I was going to say, if it's even offered. Rachel: If it's even offered. Which is totally not a given. But theoretically, they do have this decision and I really have not…I should say, in the course of writing this book, but also just being a mom who had a bad C-section and then had a VBAC, I hear from people a lot about their journeys just like on the playground. Every person I've talked to, they agonize over it. No matter what they choose, no matter what. Why is that not talked about more? I mean that part of what this podcast is doing that's so important, but I still can't believe how under the radar it is, yet it's such a big deal when you're going through it. So anyway, I told myself I did not have to decide right away about a VBAC or a C-section. My midwife was like you can totally have a VBAC, you can totally have a C-section. Even if you have a C-section you can keep seeing me. I was worried like oh would I get bumped out of midwifery care. One of the things I'm really fortunate about and that I think is really good about that practice is that she has a very close relationship with one of the OB's there. Like they kind of share patients, I should say that. And that's because she's worked with him for a long time and he really respects her clinical skills and vice versa. The other thing about her that's unique and that I didn't know how important it is she's a Certified Nurse Midwife, so she attends births in the hospital. But she previously had been a homebirth practice and at a birth center as a CNM. So her skills are, like I said are phenomenal. A C-section is truly like we have to do this. I've run out of my bag of skills or like the baby or mom's health suggests that like we need to do this now. She worked with me to work with the scheduler so that I saw her for every visit which helped me to learn how to trust her and she didn't pressure me. Either way she was completely open. She also worked with me to make sure that I could see her for virtually every visit so that way she earned my trust. And I got to show her who I am. She got to understand me which was really important to the birth. Meagan: Yes, which I want to point out. There are a lot of providers these days that are working in groups. And I understand why they're working in groups. They're overworked, definitely not rested. There's reasons why, both midwives and OBGYNs are working in these big practices. But the thing is it's really nice to have that established relationship but for some reason specially for VBAC it's so important to have that one-on-one relationship. So if you can, during your search for finding providers, if you can find a provider that is going to be like Rachel's midwife where she's just like I want to get to know you, I want to establish this relationship. Yes, we have this OB over here but I want to be your person. I definitely think it's impactful.Rachel: I totally agree with you and I didn't even know that was possible. And she works for a big group and even so she told the schedulers, hey make sure you schedule her with me. She didn't just do that with me by the way, it wasn't just a special favor for this traumatized patient. And frankly it's better for the providers too because they're not coming in cold. Like ok who's this person, and she's saying this. And what's her prenatal care like? What's her pregnancy like? Of course they're looking at the notes, but it's not the same. Meagan: It isn't. And I love that she said that. But I also want to point out that you can request that. If you're in a group and you can connect whole-heartedly with someone and you feel it's definitely who you need, it's ok to ask hey. I know that I am supposed to meet Sarah Jane and Sally, but can I stay with whoever. And maybe you might not get every visit, but if you can get more visits than only that one? It's worth asking. Rachel: Totally. And also then you know their style. So like she was not an alarmist. Let's say I was over 35; I had to see a MFM just because of my age. That went fine, but if something had come up, like let's say I had a short cervix or there was something I found in an appointment with an MFM specialist I would know her well enough to take that to her to be like, put it to me straight. How worried should I be about this? As opposed to maybe this one's an alarmist, this one is more like ahh let me put this in…And the only way you're going to learn about that is from meeting with them again and again. And for VBAC that's so so important. Meagan: It is. It kind of reminds me of dating. It's weird. I had said this with my provider when I didn't switch. I was like, I feel like I'm breaking up with him. Like he's my second boyfriend, it's just weird. It's not really boyfriend but you know what I mean. But it is, we're dating them. And anyone, in my opinion, can come off really great for that first date because they're wanting to make that impression. They're wanting you to like them. But the more you get to know them, the more they may show their true colors. And you also may realize, I don't think I'm the right person for you. My desires aren't something that aligns with you and so I don't want to put you in this situation. And so if we date our providers, “date our providers,” a little bit more than just one time it really will help us know. And like you said, if something were to come up you could have that trusted person in your corner, which is so important for VBAC, that you can go to. Rachel: Totally. Yeah. So yeah, so pregnancy went well. And then right as I entered my third trimester it started to be COVID. Meagan: Mhmmm. The joys. Rachel: Nobody saw that coming. And then you know, things for the entire society obviously went completely off the rails. Obviously something like COVID is, we hope, not even once in a generation. Once in a hundred years experience. But given all the stuff that was up in the air, boy was I glad that there was one provider who I trusted. Who I could be like ok what do I do, what do I do. And I have to tell you that she and my daughter's pediatrician…I'm a professor. So I should say I'm in the classroom with young people who, you get sick a lot anyways. They're living in dorms, like they're not taking the best care of themselves. So COVID was circulating, and we live right outside New York City, COVID was circulating early here and I have a lot of colleagues that ended up getting it. And both my midwife and my child's pediatrician told me early you need to stop going in person, it's too dangerous for you. And I trust my daughter's pediatrician a lot, you know we have a nice relationship and I really trusted my midwife. Right? So I followed that advice and was really fortunate because boy. You know what you don't want while pregnant? COVID. And you know what you really didn't want? COVID in 2020 when you were pregnant and nobody knew anything, you know?Meagan: Right? Rachel: So, the blessing in disguise was that I was able to work from home. And it was super stressful because I had my daughter and my husband was here and you know, my husband is a photographer…I mean the funny thing is that I ended up, not my head but my body, being in these different photos he ended up taking and my belly was getting bigger and bigger and we kind of had to hide it. I'd be holding a book, or cleaning something. It was an absurd, crazy, isolating, scary, and also funny time. You know the blessing in disguise was that I wasn't on my feet as much and I think that that was really good for me as a pregnant person. There is also data that preterm birth went down during the lockdowns because people got to stay home and they don't necessarily get to do that leading up to birth, which tells us a lot about what we need and the rest we need and aren't getting. So anyway, at first everything went virtual and then when I started going in again for my appointments I had met the OB who works closely with my midwife. And we talked about what would happen if I went over 40 weeks. And he was like well, we're not going to automatically schedule a C-section, we would talk about potentially waiting or induction. And I really appreciated having that conversation with him because I understood where he was coming from and it wasn't again like we're going to schedule a C-section right now. So we know if you get to 40+3 and you haven't had the baby, bing bang boom. And that was very important information about his risk tolerance and his stance. Just like with my first birth I went into prodromal labor a few days before my due date. I had had a membrane sweep with my midwife. My in-laws came to stay with my daughter and we went to the hospital on a Saturday night. I didn't know this but my father-in-law told my husband I think she's getting ahead of her skis. And he was right in the end. So we get to the hospital and my contractions stop. And I'm like oh no. And my midwife was like, they put me on the monitor to get a strip which is like you know, what happens. Meagan: Normal.Rachel: And my midwife was like listen, your baby, he's not looking that good on the monitor. I want you to rest for a little bit and let's see. So I'll check back in with you in like half an hour. And I was so upset. I remember being like I can totally see where this is going to go and I had learned about VBAC in terms of like what could increase the chance of rupture or not and I was like I'm going to end up with another C-section and I'm going to be caught in the net. I didn't even have a shot, is what I felt. And then she came back half an hour later and she was like, “He looks great. I think he was just sleeping, and if you want to go home you can go home.”  And it was like 1 o'clock in the morning. And I was like, “I think we should go home.” I just felt like he's not ready. He's not ready to be born.  And remember, I trusted her so much. She would not tell me this if she thought that there was something…Meagan: If there was something wrong. Rachel: Exactly. She wasn't trying to be my friend. She was my provider. And so it felt really weird to leave and come home and not have a baby. And I thought was this the wrong thing to do, because I live like half an hour from the hospital, and was like no this is it.And then everything was quiet for a few days. And then just like my first labor, my daughter, I went into labor in the middle of the night and I had intense back labor, and I knew like this is the real deal, here we are. And this time I tried to rest. I did like cat/cow and just like anything, child's pose, just anything to feel more comfortable. And I called my midwife at 7 in the morning and she was like, “Okay, I want you to come in and be prepared to go into the hospital from this appointment.” So we did that and at that appointment, I had a headache, I had higher blood pressure, I was dilated to a 6, and she said to me, “Listen. Just so you know, they're not going to let you go home. You're going to the hospital, no matter what if your contractions stop or not whatever. This is what's happening because of how dilated you are, the fact that you have this headache, this BP readings, whatever.” And I was like that's completely reasonable, I felt that way too. You know what I mean? But I really appreciated she communicated that with me so clearly and explained why. So I planned initially to try to have an unmedicated, vaginal birth. My midwife and I had discussed these saline boluses you can have in your, by your, what's it called. Like the triangular bone in your back? I'm totally blanking. Meagan: Your sacrum?Rachel: The sacrum. Yeah, that that can alleviate some pain. And very quickly the pain was, I found it to be unbearable. And I asked for an epidural. And the anaesthesiologist came right away and did a very good job. And the nurses and the midwife who were at the hospital were using a peanut ball and helping me move and really supportive emotionally. And I was still really scared, right? Because I had had this terrible birth before, I thought something would happen to me. And nobody treated me like I was exaggerating or you know like, unreasonable. And that mattered a lot. And I think what's important is you shouldn't have to have gone through a bad birth for people then to take you at face value. With your first birth, it should be the standard for everybody. Meagan: Such a powerful saying right there. Rachel: And they were wonderful, truly, clinically and beside.Meagan: Good.Rachel: And then my midwife surprised me by showing up. She was not on call, she came in at like 9 o'clock, no she came in at like 5 o'clock, like once she'd seen her patients and I was just like oh my god,  so moved to see her. And you know, I was pretty far along at that point and she kind of helped me get into different positions and then it was like okay, it was time to push. And they had managed that epidural so I could feel when it was time to push, and I could feel how she and the nurse were telling me to like push here, right? Like use this, make this go. The pain was really intense but it wasn't suffering, like okay, I'm getting instruction. And as I was pushing I could feel that it wasn't going to work. I was like he's not, his head…I could just feel it. Apparently he was kind of coming and kind of going back up, like his head forward and back. And my midwife was like do I have permission from you to try and move his head? I think his head is not in the best position. And I said yes, and she tried to do it and she couldn't. Her fingers weren't strong enough and then she went to the OB and she told me this later.She said to him can you come and move his head? He'd been trained by midwives in the military, by the way, which is one reason his clinical skills are so amazing.Meagan: That's awesome. Okay.Rachel: Awesome. And at first he apparently was like, oh she's a VBAC, like I can't believe you're asking me to do this. And my midwife, again they trust each other right, and she was like the baby's doing great and the mom's doing great. I really think this is going to work. And he was like okay. So he came in, asked my permission, I said yes and he moved my son's head. My water had not broken again, right? So it's like the same thing as the first one. And once he got in position and I started pushing my water broke in an explosion all over my midwife. That's why they wear goggles, now I know. And she went and changed her clothes. I pushed for 45 minutes and then he came out.Meagan: Oh my gosh. Rachel: It was amazing and I felt so proud and I was completely depleted. I was so high and also so low. And I think what's amazing to me is that it was almost the same labor as my daughter, which just tells me that's how my body tends to do.Meagan: Your pelvis. And some babies need to enter posterior or even in a weird position to actually get down. So that can happen. Rachel: Thank you. And also my water didn't break until the very end so there was buoyancy to be moved, right? And again who knows what would have happened if I had been with this provider the first time. Like maybe these decels really meant that my daughter had to come out like then. That is possible. And that first team did not have the skills of the second team. None of this was even brought up, wasn't even a possibility. And I should say that first birth, I didn't even mention this. The OB that gave me that C-section, later told me that my daughter's head was kind of cocked when he took her out. Which suggests that it was just like my son. And how I'm grateful for my epidural. I'm grateful for, you know, all the things that technological kept me safe, but it was these skills of facilitating vaginal birth that made the difference for me to have that VBAC. Meagan: Absolutely. And the hardest thing for me is seeing that these skills are being lost. Rachel: Yes.Meagan: Or maybe it's not that they're being lost, they're being ignored. And I don't know which one it is. I really don't know because I see people using them. So I feel like it's got to be there. But then I go to other births and I'm like, wait what? You're not going to do anything to help her right here? Or you know, it probably could have been a vaginal birth if we had a provider come in and be like we have  a little asynclitic head, why don't we change into this position and let me see if I can just ever so slightly help this baby's head turn. It just isn't even offered. Rachel: Yes. Meagan: And that's something that I think needs to be added to questions for your provider. In the event that my baby is really low and coming vaginally, but is in a wonky position, what do you do to help my babys' position change to help me have a vaginal birth. And then even further what steps do you take past then if it doesn't work and my baby's so slow. Do we do assisted delivery? What do we do, let's have this conversation. So if it does come up, you're aware. Rachel: I love that. Meagan: I was going to say if your provider says, I don't know/I don't really help, then maybe that's not your right provider. Rachel: And I think what's so smart about that framing is that it's not putting the provider on the defensive of like, what's your training, right? Then it's like, what is your problem? But you're actually asking about their skills and you're asking about their approach, without coming from a place of seeming doubt. Just like, I'm just curious. Meagan: Yeah. Like what could I expect if this were to happen, especially if in the past. Say your C-section was failure to descend, mostly based off on position, we know that this is a big thing. But if your past cesarean was failure to descend, ask those questions to your provider. What steps can you take? What steps can we do together, you and I, to help this baby come out vaginally? Rachel: Totally. And I think also, that way, let's say the VBAC doesn't work out, you won't then be looking back over your shoulder and being like I should of/could of/why didn't I/if only. And you know, what do you want out of your birth experience? Well a lot, but part of it is a sense of peace. Right? That I did the best that I could. That my team did the best that they could.Meagan: Yes. Yeah and really interviewing your provider. Again, dating your provider and asking them the questions, learning more about them and what they do and their view. Taking out the yes and no questions and really trying to get to know this provider and letting them get to know you. I think it's just so impactful. I also, kind of like what you were saying with your first birth, also learning the other types of birth that could happen, you know learning about assisted birth. This is a new thing. Learning if assisted birth trumps a cesarean for you. Would you rather go for an assisted birth, even if it may end in cesarean, would you rather attempt that? Or would you just rather skip that and go right to the cesarean. Really educating yourself and trying not to push off the scary even though it can be scary. Rachel: Yes, yes. I love that you're saying this and I was just thinking about this and talking about this with a friend; there's stuff we hope doesn't happen. But not talking about it or thinking about it isn't going to protect us from it happening, it's just going to mean you're not prepared. Meagan: Yeah.Rachel: If it does happen. And yeah. Meagan: It's a disservice to ourselves. And it's weird. And it's hard to hear those stories. It's hard to hear the CBAC stories, it's hard to hear the uterine rupture stories that we do share on this podcast. Kind of what you're talking about the trigger warnings earlier, yeah it might be a trigger. It really might. But if we know all the signs of uterine rupture leading up to, we can be aware. And it's not something to hyperfocus on. We don't want it to be like oh my gosh I have this weird pain, right now, I don't know. It's not to make you scared, it really isn't. It's to just help you feel educated. Kind of what you were saying too. I don't know what a C-section looked like until I was in my own C-section. Rachel: Yeah. I've been talking about this recently with an anesthesiologist, some anti-anxiety medicine which you might get during a C-section, can cause memory loss. That's a side effect. So the time to decide…Let's say you're not planning on having a C-section. And then you're having a C-section and you're really anxious, really reasonable. The time to decide whether to take that anti-anxiety medicine which might cause memory loss; you should have an opportunity to reflect on that and talk about that  and think about that not only in the moment when you're scared and should I take it right now or not. Meagan: Yeah.Rachel: It's just like that's not a good way to make a decision, you know?Meagan: Yeah. And also learning about alternatives. Okay, these are the side effects of this medication, and I don't think I'm willing to accept that. So let's talk about other medications and those side effects so we can see if we can switch it up.  They have a whole bunch of things in their toolbox when it comes to medication. Rachel: Exactly. Meagan: For nausea. You know I had a medication and it affected my chest. It went all the way into my chest and I had to consciously focus on my chest moving. It was the weirdest feeling. Rachel: Terrifying, yeah. Meagan: I wish I would have known the alternatives to that. Right? So having these educated discussions, learning as much as you can. It's hard and it's scary and it's intimidating to not learn what you don't want. It's understandable, too.Rachel: Completely, completely. But that's informed consent, right? The risks, the benefits, the alternatives. And to go back to the anti-anxiety thing. You might be like okay, what could you do for me non-pharmacologically? Let's say I have a C-section and I'm feeling really anxious. Can I have a doula with me there who's giving me a massage? Can I have a doula there who's maybe put some lavender essence on a washcloth to hold to my nose. Can the anesthesiologist hold my hand and tell me it's going to be okay? And then you start actually opening up real options. Like wow I can have a doula with me?Meagan: Yes. That is something that I am very passionate about. We need to get doulas in the OR way more than we are. And I understand that it's like oh we don't have PPE, or oh it's an extra body, and oh it's a very big surgery, like I understand that. But I have been in the OR a good handful of times. And I understand my position in that room. I understand and respect my position in that room. And I always let an anesthesiologist know, if at any point something happens where I need to leave this room you just tell me. I will leave. No questions asked. But please let me be here with my client. Please let me stroke her hair. Please let me talk to her when dad goes over to baby so she's not alone. When you were put under general anesthesia to be there by your side, whether or not you were waking up in the OR. Because sometimes you could wake up sooner, or waking up in post-operative. Let's get these people here. Let's play music. Let's talk to them. Let's communicate the birth.I mean with my first C-section, they were complaining about the storm outside, they weren't even talking to me, right? And it would have impacted my birth in such a more positive light if I would have been talked to. And I wouldn't have felt like, what's going on. You know and all those things, you talked about it in your book. This drape that is separating us from our birth, it's just wild. So one of the questions we ask when you sign up to be on the podcast is topics of discussion that you would like to share, and one of those things is you said, why it's important to balance preparation for VBAC with an understanding of the systemic forces that promote C-sections. We're kind of talking about that, but do you have anything else to say on that? Rachel: I think that there is so much self-blame for having a C-section, when you wanted to have a vaginal birth. And go back to pain and suffering, that causes suffering. And it's heartbreaking to see that and to feel that. And when I think about it, I think what's important to keep in mind is like there are the particulars of your experience, right? Like your providers had the skills or didn't. They listened or they didn't. Your baby had decels or didn't. Like all that is real. And you're not the first or only person any of that is happening to. So why are we hooked up to electronic fetal monitoring, EFM, as soon as we walk into the hospital? Well that is because of how technology reigns supreme right now in every aspect of our society, but medicine too. And also that like it's an efficient system and medical birth, medicalized birth is all about efficiency and making as much money as possible frankly. Meagan: And there's even deeper history, we talk about that in our VBAC course, about why that was happening around cerebral palsy and what it actually did for cerebral palsy rates. All of these things. It's pretty fascinating when you get into it and understand one, why they do it and does it work? Does it make sense? They do it and just became practice and norm, but it did it actually impact the things that, okay how do I say this. Does it impact the things that they were originally creating it to impact? Rachel: Right. Totally. And it's actually the opposite; it was supposed to bring down the number of C-section rates, or the number of C-sections, when the number was like 4.5% in the early seventies and it's just gone in the opposite direction.There's so much evidence that you use it and it makes you more likely to have a C-section. And so yeah, okay, not your fault. That's the system. And I don't mean it in this way like, that's the system, give up, lay down, don't try to make your own feet, but also just to accept that that's what you're operating in and that's what your providers are operating in too. Right? Use it as a way to let go of the guilt and the shame and the, I messed up. My body messed up. Meagan: Yeah. Because there's so many of us that feel that. Rachel: Yes. Meagan: And it goes into the next topic they were saying that I think really can help us walk away with less of, I messed up. My body messed up. My baby failed me. You know whatever it may be. And doing effective research about the hospitals and their employment patterns and the chances of you even having a VBAC. That does kind of go into the balls in our court where we have to get the education and understand. But even when we do that, even when we don't have the best experience, in the end we're still going to look back at it as we did, WE did, the best we could. Right? And it takes less of that blame on us in a way because we know we did everything we could. Rachel: Yes.Meagan: And sometimes it just still happens. Even if you have the doula. Take the VBAC course. Read all the VBAC books, listen to all the podcasts, understand all the risks. Sometimes it still happens. Rachel: Totally. And I mean I think about in my case, like let's say my midwife hadn't come in for me and my OB hadn't been the one who had been attending that night, maybe I would have had a C-section. Because maybe the people there wouldn't have known how to effectively move my son's head. Even though I like did my best and that's okay. It has to be okay because you can't kind of change it. And again, not to be defeat-ist. But to find peace, just to find peace. Meagan: Yeah. I wish that for our VBAC community is finding peace and giving ourselves grace along our journeys. Because we've had 100's of podcast stories and there are so many of us who are still searching for peace. And still not offering ourselves grace, and putting that blame on us, or whatever, right? Everyone's so different and again, we talked about this earlier, it's just different. But I would love to see our community offering themselves more grace and finding more peace with their experiences along the way. And I don't exactly know what that healing looks like and how that peace is found. Do you have any suggestions on ways you have found peace with a very very very traumatic experience that not only led to trauma in that experience, but even in future procedures, in future experiences you know. Do you have any tips on just, guidance on finding peace? Rachel: I mean, I struggle with this still. And it sounds counterintuitive, but I think like not pushing away your feelings. And in the sense of not wallowing, but also not like struggling against them, trying to quiet them, make them be like ugh I hate this. Ugh I hate that I feel this way. Ugh if only I could get over it. So I'll say like, when I go to the doctor now, I get really scared especially if it's a new person and my blood pressure goes up and sometimes my heart rate goes up and it just sort of happens. And I hate it. And there are times when I'm like ugh I hate this part of me. I just hate it.But then when I'm kind of more accepting and it's like, this is how my body responds. It's understandable that this is how my body responds. And I take a Xanax actually. I say that to really take away the stigma I think that still exists around medical trauma and taking medication to manage your symptoms. I take a low dose Xanax before I go to see a provider and it helps me with my suffering. And also just like accepting. Because also there's this saying, if you struggle against the feelings of suffering, then you kind of suffer twice over. Right?Meagan: You do. Rachel: So I would say that, and then specifically for people who feel they had a traumatic experience, I've found EMDR treatment to be very effective, to deal with stuff in the body. That was pioneered more to deal with people who've been in like combat trauma, but it's very effective for traumatic birth. Tapping is another thing that can be very effective. And you can find that online, like there are different…Meagan: I was gonna say, you can go to YouTube and google trauma tapping or anything like that, and you can actually find some pretty great videos for free on how to do that. And it's pretty wild actually how well it works. Rachel: It really is. Meagan: Sometimes it's like wait, how is this working? It really does work. Rachel: Totally. And also I would say like in terms of again, peace, I think it's really important to speak openly about what has happened to you. And to the extent possible, we're conditioned to be like I'm just going to tie this up with a bow and it's okay. Someone says to you, you've expressed something hard, and they're like oh I'm so sorry and you're like it's okay, I'm going to be okay. Like you don't have to worry so much about reassuring your listener. You can be like yeah I had this C-section, and I'm still kind of upset about it. And yeah, that's how I feel. You don't have to self-qualify that. You know, but my baby is healthy. But I'm okay. But I love my baby. We do that; there's a lot of pressure to do that. And it's okay not to do that. It's okay to be like these are my feelings. And two things can be true at the same time. You can love your baby, and you can also be like I'm not that thrilled with the birth. Meagan: Awe yes. Julie and I have talked about that for years. They don't have to be separate. They can go together. You can love your baby and feel connected to your baby and really not like your birth experience. And you can also, we have found that people prep and then they have a vaginal birth and they're like I actually didn't really like that either. So you know, they don't have to just always be separate. You can be really happy and really be upset at the same time. It's okay to have those feelings, right? I have had things in my life where I've done something and I'm like dang. I really like how it turned out, but I hated the journey to getting there. And that's okay. So I love that you pointed that out. Rachel: Yes. or if you think about how you feel on your children's birthdays. So like I have very different feelings on my daughter's birthdays then my son's birthday. I had a good birth with my son. And it was good not because it was a VBAC, but because I was respected and I felt safe. That's what made that a good birth. Right? Just to be totally clear. I'm really glad I had a VBAC, I'm happy I got what

Welcome to the SYNC Your Life podcast episode #288! On this podcast, we will be diving into all things women's hormones to help you learn how to live in alignment with your female physiology. Too many women are living with their check engine lights flashing. You know you feel “off” but no matter what you do, you can't seem to have the energy, or lose the weight, or feel your best. This podcast exists to shed light on the important topic of healthy hormones and cycle syncing, to help you gain maximum energy in your life.  In today's episode, I interview Stephanie Berman, founder of the AZIZA Project, on her experience with gynecologic pain, gaslighting in this arena in the medical space, and her foundation that aims to connect women with proper specialists on the subject.  For more than 13 years Stephanie suffered with multiple gynecologic pain generators. Eleven medical practitioners, from naturopaths, general practitioners, OB/GYNs, dermatologists, and  physical therapists were unable to provide answers, much less relief. That all changed when she met Dr. Corey Babb at the Haven Center in Tulsa, Oklahoma. Not only is she feeling better than she has in years, but more importantly, she has hope. Hope for a full and rewarding life without pain. It is estimated that 32% of women experience gynecologic pain. That's why she started The AZIZA Project. She wants to offer other women the same hope by connecting them with medical professionals and funding their travel and procedure expenses. To learn more about the AZIZA project, check out their website here. To donate to the AZIZA project, click here. To learn more about my favorite 3rd party tested endocrine disruption free products, including skin care, home care, and detox support, click here. To learn more about the SYNC fitness program, click here. You will need access to the core program before moving into the monthly membership.  To learn more about virtual consults with our resident hormone health doctor, click here. If you feel like something is “off” with your hormones, check out the FREE hormone imbalance quiz at sync.jennyswisher.com.  To learn more about the SYNC Digital Course, check out jennyswisher.com.  If you're interested in becoming a SYNC affiliate and Certified Coach mentored by me, you can learn more here. Let's be friends outside of the podcast! Send me a message or schedule a call so I can get to know you better. You can reach out at https://jennyswisher.com/contact-2/. Enjoy the show! Episode Webpage: jennyswisher.com/podcast 

“Inhale peace, exhale tension.”Did you know that the cascade of interventions can not only contribute to a Cesarean but may cause one? Melanie believes that was the case with her first birth. Her difficult recovery included going to EMDR therapy to help with her PTSD. Her OB/GYN did mention that she would be a great VBAC candidate. Not knowing VBAC was a thing, Melanie's research began. Cue The VBAC Link!Melanie vigorously dove into VBAC prep before she was pregnant again. Her journey is one that shows just how powerful intuition and manifestation can be. Melanie went from having PROM with her first to arriving at the birth center at 7 centimeters and even being able to reach down to feel her bulging bag of waters as her baby began to emerge en caul!Other talking points in this episode include:Achieving a VBAC without a doulaHusband support Birth affirmationsRecommended podcasts and booksSpecific ways to avoid PROMHypnobirthing by Siobhan MillerThe VBAC Link Blog: 9 VBAC Books We RecommendThe Birth HourDown to BirthNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Happy VBAC Link Podcast day, whatever day it is that you are listening. We are so happy that you are here. We have our friend, Melanie, from Texas. Texas, is that where you are? That's where my mind is thinking. Melanie: Yep. Yep. Wiley, Texas just outside Dallas. Meagan: Perfect and did you have your VBAC in Texas?Melanie: Yes. In Dallas. Meagan: In Dallas, okay. We have her sharing her stories with us today you guys. At the end, we're going to be talking about PROM. Right before we got recording, I was talking about how important I think talking about PROM is which if you haven't heard lately what PROM means, there are all of these acronyms all over the place when it comes to VBAC birth, but it's premature rupture of membranes. We are both PROM moms here and so we are very passionate about the topic. If you have had your water break before labor really started and got going in the past, definitely hang on in the end because we are going to be talking more about that and maybe some ways that could or maybe not, we are hoping these are the ways that helped us avoid premature rupture of membranes. We are going to be talking about that and of course, her beautiful VBAC story. I do have a Review of the Week and this is by milka. It says, “VBAC Podcast Review.” It says, “Hi. I love listening to your podcast. I had an unplanned C-section with my first birth and am preparing for my second birth now. I didn't know what to do to make sure I didn't end up with the same situation. Hearing so many women's stories and experiences validated mine but most importantly, I learned so many tips and ideas to help my VBAC. I had a successful VBAC and now recommend this podcast to all expecting moms. Just such a great no-pressure and enjoyable way to learn.” I love that she talked about no pressure because that is what this podcast is about. This is a place where people share their stories, where they share information both on VBAC and CBAC, and all topics when it comes to birth. We want you to just be here, be in this space, and have it connect with you how it connects with you and take these women's stories and these providers who are coming on and the information given and apply it however, it looks for your journey. Melanie and I were just talking a little bit before the episode about how it just feels so full circle. So many of these Women of Strength who have come on before Melanie here and have shared their experiences and people listening, it really is so impactful. Right, Melanie? You were saying that I was in your ear. We were in your ear and these people's stories were in your ear doing what? Empowering you. Melanie: Mhmm. Oh yeah, it's incredible. It feels very full circle to be here. Meagan: Yes. We are very excited that you are and you guys, we are going to jump right into her story in just a second. Okay. The table is yours. Melanie: Okay, so happy to be here. Meagan, like you said, you guys have been in my ear for over a year so it just feels incredible to be here. As I was listening to these stories, I was always hoping to find that birth story that was like mine just to find out what went wrong with mine and also on the flip side, what did people do? What were people seeing in things that went right and how they were able to get a successful VBAC? I was very motivated and inspired by the podcast. I listened to every episode so hopefully, my two stories out there can hit home with anyone. But yeah. I'll start with, of course, the C-section just briefly. I got pregnant in March 2021 so everybody remembers it was COVID times still. Meagan: Wild times. Melanie: Wild times. Actually, at the beginning of my pregnancy, my husband wasn't able to come to the appointments. But thankfully, it being 2021, by halfway he was able to come. That pregnancy, I was really healthy. I ran. I'm a big runner so I ran every day. I had no morning sickness. I was very active. I never even until the very end– I ran the day my water broke and I never had that feeling like I didn't want to be pregnant.Not the case the second time as we'll hear, but the first time—Meagan: And you do that competitively, right? Did you compete during pregnancy at all? Melanie: I've ran my whole life so I ran cross country and track division one in college. Now, I do more marathons. Yeah. I ran both pregnancies. Not anything too crazy. During the second pregnancy, I did run a half marathon. I was 16 weeks but then it went downhill after that. But yeah. I run pretty competitively. I take it really seriously and it's a passion of mine. Yeah, the only thing I got the first time and the second, but I did. I've heard it before on the podcast is SPD, symphysis pubic dysfunction. The first pregnancy, so the one I'm talking about, a prenatal chiropractor literally cured it. I had to go back a couple of times because it would get out of alignment again, but for anyone who is suffering from SPD like I was both times, it's amazing. I would just call them witches because they would literally cure it and it would get me back to running. It was amazing. So my birth education the first time around, I thought I was educated like so many women here. I read the typical What to Expect When You're Expecting. I did a podcast but it was more so of what size is your baby? What's going on in utero? I didn't listen to many birth stories and I became so obsessed with that the second time. And truly, I feel like you get the best birth education through birth stories because you just get the whole shebang. We did take a hospital birth class and now I know that a hospital birth class is really just the hospital policies. I remember there was a section that they had mentioned very quickly in passing, “If you're going to have a C-section, you should take this class. Okay, the next thing.” I thought like so many women, That's not going to be me. I'm not going to have a C-section. I'm healthy. I feel great. Most C-sections are not planned so I feel like it really did a disservice to not even mention anything about a C-section in that class, but anyway, I just assumed that you have a baby in the hospital. You get an epidural. You take a nap and then you wake up and you push out a baby. I was not against hospitals or anything. I was not against the epidural or anything like that. I mentioned that I ran the day my water broke. This was past 40 weeks. 40 weeks came and went. A couple of cervical checks I got I was not dilated at all. They had scheduled a 41-week induction date. When I was checking out at the front desk at the time, I just remember it feeling really, really wrong scheduling that date. Meagan: Your intuition was speaking right there. Melanie: 100%, yeah. Of course, I didn't realize it at the time. It was my first baby and everything but when I look back, that just felt so wrong. 41 weeks came and I was supposed to go in at 9:00 PM that night but the interesting thing is that my water broke actually 4 hours before I was supposed to go in. It was 5:00 PM and I was supposed to go in at 9:00. Like you mentioned Meagan, it was PROM so it was a trickle. I was like, Wait. Am I peeing? What is happening here? No contractions at all. And with the little education I did, I knew that just because your water breaks, it doesn't mean that you have to go in and you should labor at home as long as possible. However, because I was set to go in and I guess because I was 41 weeks, I called them and I just remember they were like, “No. You're in labor. Come in.”I was like, “Okay.” Meagan: This is labor? Melanie: Yeah, I was like, “Oh, okay.” So I got to the hospital literally not dilated at all. I was maybe half a centimeter and they inserted the Cervadil at 9:00 PM which hurt really bad because it turns out if you are not dilated, it really hurts to get Cervadil inserted. Meagan: And if your cervix is posterior, it's hard for them to get it into your cervix so that can also cause a lot of discomfort. Melanie: That's exactly what it was too because I think they had a hard time. I didn't even think about that. It was probably posterior. Man. Yeah, see? My body just wasn't ready for that. But contractions did come eventually. I don't know if Cervadil can cause it or if it was just time. I was going into labor but that was around 1:00 AM. The contractions started to get uncomfortable. I had not practiced coping with contractions at all because I was planning to get an epidural. I never had any inkling of going unmedicated or anything so this is where I think everything went south.This is where I just think it was the cascade of interventions. First I had fentanyl which I don't know why because I think I was trying to delay the epidural for whatever reason. I don't know why. I had fentanyl first. It was awful. It felt like I was so drunk. The room spun and it was terrible. Then an epidural, which has fentanyl in the epidural. That was fine. After the epidural, of course, you feel amazing, but you are stuck on your back forever. I just think this cascade of interventions, being stuck on my back, not moving, I never ever take medicine as it is. I think my body and my baby just hated all of this. So then eventually, terbutaline was given around 6:00 AM. Meagan: To stop the contractions. Melanie: Yep. I think that's when some decels started happening then they did pull the Cervadil to stop the contractions. There were some decels then yeah, eventually it's all a little bit fuzzy but at 6:45 AM the decision was made for a C-section. At 8:01, he was born. They called it an emergency C-section and now I look back and I'm like, yes. I do believe that it was needed. However, I'll never really know but I really think it was caused and also, if it's an emergency, I understand that they don't wait hours like they did for me and they usually put you under. I think it was more unplanned and I look back and I really think it was caused. Meagan: That is the hard thing to know. A lot of these Cesareans, I would agree with you that they are caused by the cascade of interventions and things like that and then a lot of providers will say “emergent” so there are emergent Cesareans where we need to get this baby out quick and then there is a crash where they do put people under with crash Cesareans. But if they are waiting for hours, it's almost like they gave the emergency title to make themselves feel better or make it look valid to justify that Cesarean. Melanie: Yeah, I definitely agree with that. That experience was really awful for me. I think for some women, I think it's awful for a lot of women and then I think for some, it's not that awful. For me, no skin-to-skin. I know that's not very common at all. It felt like it was forever for them to bring him to me. No one was talking to you in this moment and I just don't think these doctors realize in the moment that you're being robbed of something that you envisioned and a really important experience. It just felt like forever for them to give him to me. It was 30 minutes or so. He was fine. He came out completely fine with great APGARS. I was fine. It just ended up in the way I didn't want it to. I did have PTSD from that experience because I was having a lot of flashbacks to it. I went through some EMDR therapy. I had a great therapist and of course, I talked to her about it. She was there for my VBAC as well. But yes. That postpartum was just– the healing sucked. I just felt really awful and I think mentally, it took a really big toll on me. Breastfeeding was really hard. A lot of that I attributed to my C-section. It was not desired. It was just not great. So that was the first birth. I never knew VBAC was a thing or a big deal at all. I don't even think I knew the term VBAC. I went to the 6-week post-doctor's visit and I remember she was like, “Yeah, you'd be a great candidate for a VBAC. However, you have to go into spontaneous labor by 39 weeks.” I'm sitting here like, okay. He was just a 41-week baby. My mom has a history of going late. I don't think that's very likely that I'll go into spontaneous labor by 39 weeks so I already made up my mind that I wasn't going to go with her. I learned later that that is a very common thing that hospitals and OB/GYNs will say to you. Yeah, that was the first one. So then cue The VBAC Link. I started listening to The VBAC Link Podcast before I was pregnant. Maybe my son was a year old and I binged every episode. You and Julie were in my ear a ton. The thing that I heard from The VBAC Link was that the likelihood of a successful VBAC for many of these women did happen out of the hospital and like you yourself, Meagan. That's not to say that of course, you can be in the hospital. You can have an epidural and get induced and have a successful VBAC, but when I just heard the overwhelming thing was how much of a better chance you have. I should also mention that my husband works in medicine too. He's a physician assistant. I will talk about that. He had a little bit of a hard time just with the safety aspect of it. But once I let my mind go toward the possibility of an out-of-hospital birth– because I wanted a VBAC so badly. I was so motivated. Then I realized that it was something that I actually really desired, a physiologic birth and unmedicated. When I look back, I think that's why I had such a hard time mentally with my first birth because I think I didn't know that I cared how my babies come into the world and I wanted to experience that. I don't know and in some weird way too, it felt like doing an unmedicated out-of-hospital birth made me almost feel connected to my ancestors. It seems really weird, but I was like, this is what they did. I just think it's something really cool that our bodies do. I wanted to experience that. But I do. I recognize that it was a trauma response for me for sure to become obsessed with research. I binged all of the episodes. I would look for anything related to VBAC. I read so many books and I actually toured. I had a neighbor and a friend who was pregnant at the time and she was going with the birth center that I ended up going with. We would go on walks and she would talk about her experience and how amazing and wonderful it was. I was just like, man. I want that, especially knowing that we were planning to most likely have just one more child. I hated to have that thinking of, this is my last chance, but I did. Meagan: I understand that so much because my husband told me that too and I was like, “I really want this VBAC. I really want this VBAC.” Melanie: Yeah and that's okay. We're okay. It's okay if we have these desires and these wishes. You only get one life. It's okay to want what we want. I'll never forget. I toured the same birth center that my friend was at and again, I was not pregnant yet. It was an education class. I was like, let me just see what these midwives are all about and what birth centers are like. It just immediately– again, it's that intuition. It immediately felt so right. I remember I walked in and just before even finishing the class, before we even really heard them out, I just knew that this was where I wanted to give birth in my next pregnancy. It felt so right. And also, I'll never forget. I had asked questions about VBAC because unfortunately, not all birth centers support VBACs which I don't understand, but I had asked a lot of my questions related to VBACs and I remember the midwife saying, “Well, unfortunately and fortunately, we do a lot of VBACs.” I'm thinking, why would I not want to be with a provider who does the most VBACs? Hospitals don't do a lot of VBACs comparatively. A lot of people are like me. They go to a birth center because they really want a VBAC. That just was really calming to me. I felt like I was with experienced hands. I was safe and there also was not really anything different about a VBAC. I'm with people who understand and trust birth. I brought this up to my husband and I mentioned that he had his reservations because he's a physician assistant and he works in orthopedic trauma but he was in PA school, he had to do OB/GYN rotations. He unfortunately saw some bad birth outcomes so to him, the hospital was a safety net but I was so, so grateful that he was supportive of my desire to go out-of-hospital even though it seemed kind of crazy to him. He came to– we had one meeting with the midwife so he could ask questions and everything. She was so great and answered all of his questions and I actually was unknowingly pregnant at the time. I didn't know it.Meagan: No way. Melanie: It's really weird. I toured the birth center first by myself and it's almost like my body needed that to be like, boom. You found the place where you are going to give birth and then I got pregnant. It was really weird. We were trying but also, it takes my body after coming off birth control some time so it still was a shock. I was like, oh wow. So anyway, the second pregnancy was much harder as I mentioned. I was not able to be nearly as active. I ran that half marathon like I mentioned and then– it was the Dallas half– then my body just went downhill. It was much, much harder. My sleep was horrible. I have an Aura ring and it tracks your sleep and everything then at the end of the year, it will give you a summary of every month's sleep. I will never forget because I got pregnant in September and it's like, January, February, March, April everything is fine and you look at the bar graph time series and it plummets in September. It stayed that way. It was my deep sleep. My deep sleep really, really decreased a ton. Maybe that's normal and I just didn't know that the first time, but I did not tell many people I was going with a birth center. I lied about my due date which I learned from this podcast which is very smart to do. I highly recommend it just because I didn't want to let in any of that negative energy or anything. The couple people I did tell, I did get a couple of people who would be like, “Oh, they're going to let you do that,” like the “let you” language. Meagan: We both did the same thing at the same time with the air quotes. The “let you”. Melanie: Yeah, exactly. I don't blame them. I just think that a lot of people don't have that birth education. And in hospitals, it's very normal to do a repeat C-section even though we all know it's not evidence-based. So very briefly, I want to talk about the prep that I did in this pregnancy that made such a huge difference for me. Number one, all of the podcasts like I mentioned. This one, of course. The VBAC Link, I binged it. I found the Down to Birth podcast at the end and that's a really, really good one. I know everybody does The Birth Hour as well which is good but that one has everything. I loved the more VBAC-specific ones. Then also, they haven't produced any episodes in a while but the Home Birth After Cesarean Podcast was really good too because they were all unmedicated. I was hoping to do that and they were all VBACs. Then books– I read a lot but these were my favorites. Of course, Ina May's Guide to Childbirth. Emily Oscar's Expecting Better is really good. Natural Childbirth the Bradley Way is a little outdated but that one I really loved. It really taught me what productive contractions looked like because I didn't really experience labor the first time. I never made it past a 3 the first time. I didn't know what that meant. I didn't have coping mechanisms. They really focused on breathing. The best book I read and I hadn't heard this one on it. Maybe you know of it but I had never heard about it but it was Hypnobirthing by Siobhan Miller. There are a lot of books on Hypnobirthing but Hypnobirthing by Siobhan Miller. I was just thinking of Hypnobirthing as a possible way to cope. That book was the best book because I really like the science, the physiology, and what is actually happening in your body when you're getting contractions and how do you work with your body. It just had such a great way of explaining all of that.That was the last book I found. I was 3 weeks away from my guess date. That one was great. She also creates the Freya app if you've heard of that. The Freya app times contractions and it helps you with breathing. They give you a lot of mantras. Yeah. That book was amazing. I did get the Freya app too. I did not know I was going to rely on it so much in labor. Also, in that book, it was really big on affirmation cards. I would make affirmation cards then I would read them in the bath and sometimes practice my breathing through the app. I did some pelvic PT and then, of course, the prenatal chiropractor like I mentioned, I continued to do that. Like I mentioned, the care with the midwives was great. Very positive language. I noticed what was really important to me was not, “I hope I can do this,” because of course, I hope that. But my midwives were amazing because every time, they would just speak it. They would say, “You are going to have a beautiful, redemptive VBAC.” They would just say that. Of course, I know I am 50% of the birth story. The baby is the other 50%. Of course, I know that but it was so important for me to have that positive language. I really worked on my mindset this time around. I only followed accounts that served me. I unfollowed news accounts. I had to be very careful about what I watched and things like that. I don't think women realize how important our mental state is. I get very sensitive. Meagan: Yes. So talking about that, protecting your space, our bubble, or whatever it may be. Protecting our space is so important because mentally, like you were saying, I don't know if people really understand how precious our mental space is but mentally, if we are thrown off, it is sometimes really difficult to get back onto that rail. I had a situation on Facebook in a VBAC-supportive group. I've talked about it in the past. I was so excited to announce that I was going to birth outside of the hospital. I also wasn't telling people that I was birthing out of the hospital. I didn't really tell people my plan I thought I could in that group and I wasn't supported. I had to leave that. Sometimes it means leaving groups. Sometimes it means staying off social media. Sometimes it means muting people who may be sharing their opinions or telling people flat-out, “I appreciate you so much but unfortunately, I can't have you in my space,” because mentally, they are not serving you well. Melanie: 100%, yeah. I hate that that happened to you and I know that happens to so many women. It's just so unfortunate and I hate that there is such a stigma with VBAC because if you do the research which people who have really “easy” births don't have a reason to really do the research but if you are like us where we are all very motivated to have a VBAC because we already have this stigma going against us, it's all unwarranted. It's not evidence-based to not be supportive of a VBAC and if you really research and do the stats, you realize that it's not a big deal. The craziest thing that I heard on the Down to Birth Podcast was, “You have a chance of uterine rupture even as a first-time mom.” Meagan: Yes, you do. Melanie: It's not that much higher as a VBAC and first-time moms go their entire pregnancy never once hearing about uterine rupture but yet if you are a VBAC mom, that's all you hear about. So it's so crazy to me. Meagan: Yeah. Yeah. So mentally, you were unfollowing. You protected your space there. Is there anything else that you would give tip-wise to protect your mental space?Melanie: I think just believing in your body and believing that we are made to give birth. I think that's a really big one. Of course, like you said, unfollowing and maybe not talking about it with people, unfollowing accounts that do not serve you. I think the most important thing, I know we've heard it a million times on this podcast, but where you give birth and who you give birth with is the single most important thing because you want to be with a provider who believes that you can do it, whoever that is. Yeah, believing in yourself. I think that's going to look different for everybody of what they need. For me, I am a data person so I needed the stats. I needed to read the books and also listen to lots of women who have done it before me. Meagan: Mhmm, love that. Melanie: So okay, here we are. I was 40+5 so again, not 39 weeks with spontaneous labor but 40+5. I woke up at 5:00 AM to what I thought was contractions. I had some Braxton Hicks at the very end which I never experienced before. I didn't know if maybe it was prodromal labor but it didn't feel like Braxton Hicks because it was waking me up. I just tried to move through them a little bit. They were coming very, very sporadically. I would get a short contraction one time an hour and this went on for most of the day and they were not long at all, like 30 seconds. In my mind, I'm thinking, I'm a hopeful first-time vaginal birther. So I'm like, okay. This could be 24 hours. It could be 48 hours. Who knows? But I did not want to waste any energy timing the contractions so I was just guessing the whole day. It was a Sunday. I stayed home with my toddler. Yeah, I should mention that he is 2.5 so I waited about 2.5 years between the two births. So yeah. I just labored at home with my toddler and my husband. We are big track fans so it worked out perfectly. There was a Diamond League track meet on so I did the Miles Circuit while I was watching that. I texted my midwives and kept everybody updated but I think again, we all thought I still had a ton of time. Then I would say around 4:00 PM that day, I started to notice them a little bit more. They were still pretty inconsistent. I would say maybe 8-10 minutes apart and still only 30-45 seconds long. That was something I learned from again, that Bradley Method book I read is that productive contractions for most women– I will say not for me. We will get into that. But for most women, they are a minute plus. Those are the most productive contractions. I texted my midwife then that I felt like it would likely be that night. I felt pretty confident that they were coming but I was like, it could be the middle of the night. It could be tomorrow morning. Who knows. She texted back and she advised that I take some magnesium, take an Epsom salt bath and then go to bed and try to reserve my energy for when they are 4-1-1. We had a birth photographer this time so I texted the birth photographer. I texted our friends who I'm so grateful for. We had a neighbor and a friend who was going to come to our house and be with my toddler. So, so sweet. Yeah. I took the magnesium and then my husband, Brandon, drew me a bath and then disappeared with our toddler. I sat in the bath and I was reading my affirmation cards. This makes me so emotional but I discovered that my husband had snuck in his own affirmation cards into my pile and that's when I found them. Oh, it was so sweet. Meagan: That's adorable. Melanie: I know. It still makes me cry when I think about it because it just meant so much. It makes me so emotional. It was super sweet and one of the best things he's ever done for me. I found those and was reading through them in the bath and just trying to relax and really work with the contractions. I know from my research that you need to relax. To get them to be productive contractions, you have to relax. You have to get your body out of the way and it will go faster that way. They really started to ramp up when my husband was putting our toddler to bed around 7:30. I got in the bed and I put the pregnancy pillow in between my legs. I lay there and was trying to establish a pattern. Yeah. I know manifestation sounds pretty woo-woo but I want to say and this is where I'll start sprinkling these in because there were 10 things that I had manifested or really, really prayed would happen and I was very intentional that I really, really hoped that this happened. This was the first one. I don't know why I had envisioned laboring with my dog. You have a dog. You understand. My dog is my firstborn. She is my baby. I love her. You know, birth is so primal so I was just like, She's going to know. She's going to know when I'm in labor and she's going to know what to do. She did. She followed me. I didn't even realize it at the time. She followed me in my bed and I took a picture with her at 8:19. She was lying next to me on the bed as I was going through these contractions and it's a very, very special memory for me. I was already starting to get the labor shakes at this point. It's 7:30 and laying down in bed did really help to establish more of a pattern but they still were not a minute long. They were 40-50 seconds long. Then I moved to the toilet as many women do at this point, backward on the toilet. I lost more of my mucus plug because I had lost it sometime earlier in the day then at some point, I looked down and realized that I was having my bloody show. Again, none of this I had ever experienced before with my first. My husband was an absolute rockstar in this moment. He was so cute. He was running back and forth between the toilet and then packing up the car because I think he realized it was starting to get pretty serious. He brought me water and he put on the back of the toilet, cleaned it, gummy worms and things. That was not what I wanted at that moment but it was super cute. Oh, and I should mention that I did not have a doula so he was kind of like my doula. I was trying to prepare him as best as I could beforehand but he didn't need it. He did really well. I know the hip squeezes are great and I learned that from this show of course. As they were coming, I would scream at him, “Hip squeezes! Hip squeezes!” He would come over and do it and he did awesome. He was saying that I left my body in this moment and I was possessed because when I was having a contraction, again, I was trying to do the deep moans and really trying to relax but it's just funny. He was telling me about it after and he was like, “Yeah, it was like if you were looking at it from the outside, it's like you were possessed then you would scream at me and just moan.”Then by 9:24, they were coming. I mentioned they were not a minute long, but they were coming on top of each other. So every 2.5-3.5 minutes apart, but still not quite a minute long so my husband was calling the midwives and she still was like, “Well, they're not quite a minute. Just have her keep laboring at home until they are a minute.” Eventually, he called her back and I think he put it on speaker so she could hear me and that's what did it. Meagan: Uh-huh. She's like, “Load her up.” Melanie: Yes. Because we live outside of Dallas. The birth center was in downtown Dallas so it's pretty far. It's usually a 45-minute drive for us so I think my husband was just like, “I don't want to have a car baby.” Meagan: Sure. Melanie: Yeah. It was ramping up. So yeah. She called back. I mentioned the Freya app. I really relied heavily on the Freya app because when you are timing the contractions, it helps you with the breathing, in for 4, out for 8, and then one of the mantras I learned from that Hypnobirthing book that I did not know I was going to rely on so much– and I think you never really know when you're going into it and when you're in labor. You never know what's going to stick. My mantra that I must have repeated to myself 500 times was, Inhale peace, exhale tension. Every single contraction, I just repeated that over and over and over. I was trying to make it until 10:30 PM when we called them again, but that's when we got in the car and started heading there. He made it to the birth center in 33 minutes. The car ride was not fun like many women talk about. I think I hardly opened my eyes and I was just timing them, repeating my mantra, Inhale peace, exhale tension. I arrived at the birth center at 11:00 PM. I had a contraction on the step right there as I was trying to get out of the car and trying to make it. I eventually made it inside and I had my first cervical check of the whole pregnancy. I again, something I had manifested was that my two favorite midwives would be there and they were. One of them, she wasn't even on call but she came anyway. So many sweet things happened. I got on my back. She asked if she could check me and I was like, “Yes. I really want to know.” One thing again, I manifested that I really wanted to be at least a 6 when I showed up. The first thing she said was, “You are much farther along than you ever were with Rhett.” You are a 7 and you are very stretchy. I can feel your bulgy back of waters and the baby's head is right behind it. That's the other thing. We mentioned PROM. Here I am and my water still had not burst and it was amazing. Being on my back felt awful by the way. That's why I just don't understand. Being unmedicated in a hospital must be so, so hard because I know a lot of the times they want you to be on your back and I just can't imagine because that was the worst position ever. She started filling up the tub right away. Like many women, I was like, “I have to poop.” I get on the toilet and I was like, “I swear I do.” But no, I don't. Nothing was happening but it feels like I do. I got in the tub right away. I did a couple of contractions. They were still coming on top of each other. I was sitting down and eventually, I moved to hands and knees. Very shortly after, that was very fast. That was only about 5 minutes after getting checked. Very shortly after, my body was starting to push and I was like, “This can't.” I mentioned something. I don't really remember this but I mentioned something to my midwife about how it seemed to soon to push. I was like, “You just checked me and I was a 7-8. Why is my body pushing right now?” I was really wary of a cervical lip or a swollen lip which I learned from this podcast. I can't remember exactly but she said something to the nature of, “If your body is ready to push, let it push. This is your body getting ready to birth your baby,” which is again, something else I had really, really envisioned. I would have loved my body to do the pushing and it did which was amazing. My water had not broken still at this point and the really cool moment was that the baby was en caul for a while. I remember her saying something on the phone about baby being en caul. I was birthing the sac before I birthed the baby. It felt like a water balloon. She kept telling me, “Feel down. Feel the sac.” It felt like a water balloon coming out of you. It was so weird. Yeah, my midwife stayed behind me so quietly the whole time. I never knew she was there. My husband set up my birth playlist and music and he just was such a rockstar in this moment. He was getting a cold rag and putting it over my shoulders which felt amazing, getting water and electrolytes and continuing to help me with that. Yeah. My body pushed for about 30 minutes and I don't want to scare anybody, but truly, that was the worst part. I remember– I guess maybe it's the ring of fire, but I just remember feeling like my body was ripping in half. But then it goes away. Meagan: Yeah. It's intense. It's intense. Melanie: It's so intense. I don't think anything can really prepare you for that. I follow that account, Pain-Free Birth. I don't understand and I would watch videos of women who were smiling and they look great. I'm like, oh my gosh. That part was so, so painful. Handling and dealing with the contractions is one thing and I felt like I was really strong. I felt like I did a good job with that, but that pushing part is something else. His head was out. It was a boy. His head was out for a little while but nobody panicked and my husband was ready to catch him. His hand was right there. At some point, I remember my midwife was like, because again, my body was doing all of the pushing. I didn't do any of it. I guess after the head was out of a little bit, she was like, “You can try to push.” My husband told me because his hand was right there that my pushes were nothing. They were baby, tiny little pushes compared to the ones my body was doing. Then at some point, my midwife asked if she could help or something and I was like, “Yes, please.” I don't know what she did. My baby was kind of big which I'll say in a second, but I think maybe his shoulder was stuck or something. She did something that was pretty painful but then within a second–Meagan: A sweep. Melanie: Yeah, like a maneuver because I definitely felt more stretching then a second later, he shot out. He did have the cord wrapped around his neck one time but nobody freaked out and they just literally took it off then he pinked up right away, cried, and he ended up being 9 pounds, 5 ounces. My first was 6 pounds and 14 ounces. I'm like, “No wonder running felt awful. He was pretty big.” I look back and I just feel very proud. I was never once scared for myself. I never once thought about uterine rupture and I never was scared for my baby. I do have some memories of– they did the intermittent checking and I have this memory of the decels. That is why I ended up having the C-section so I was always very curious to see how he was doing during the check. He was always fine and I was never scared. Yeah. We got out of the tub quickly. They waited for me to deliver the placenta on the bed. It was about 30 minutes and yeah. My baby latched right away which was such a relief because I mentioned we had some struggles the first time. The crazy thing was– we sat there. We ate. We chatted for a little bit then once they did all of the newborn tests right there, we were home by 3:45 AM. My toddler went to bed as an only child and then he woke up to a little brother. And that's his story. The postpartum has been so different and it's been so much better. I can't help but think that a lot of that is because of such a smoother birth and the recovery has been so much better than a C-section. Different, but still so much better. Meagan: Yeah. Melanie: Yeah. I just thank this community so much. I also was on the Facebook page and I just got so much strength from all of the women before me. Meagan: Yes. Oh my gosh. Such an incredible story. I love– okay, a couple of things. One, we talk about it on the podcast. I love when people go and look for providers before they are pregnant. I absolutely love it. I think it's very powerful. But two, you were actually pregnant and you didn't know it. Melanie: I know. Meagan: That's so cool that you were doing that and it felt so right and not only was your intuition before pregnancy kicking in but you were actually pregnant and it felt right. You were like, this is the place. This is the place. Then you showed. You went past that 39-week date. You never had gone past 3 centimeters before. So much strength and power happened through all of this and then you pushed out a 9-pound baby. All of these things that a lot of the world doubts. Did you look at your op report? Melanie: I did and everything was normal. Then the main thing was the decels and that's why they said was the reason. Meagan: Decels. I just wondered if they said anything like CPD or failure to progress. Melanie: Yeah, no they didn't. I was looking for that specifically. I just barely made it. I was 2-3 centimeters before the decels started happening and then they called it. Meagan: Yeah. A lot of the time we are told and the world doubts us in so many ways so if you told a lot of people who are uneducated about VBAC the things that happened with the first and then the stats of your second, I bet people are like, “You did that?” But you guys, this is normal. This is beautiful. This is what you deserve. You deserve these experiences and these joyous moments. I'm just so proud of you. I'm proud of you. I'm proud of your husband. He sounds absolutely adorable. Shoutout to him. Melanie: He's so sweet. Meagan: Your midwives and everybody. You did it. Melanie: Aw, thank you. Meagan: I'm so happy for you. Melanie: Thank you. Thank you so much. I'm glad I didn't know how big he was before but also with my midwives, there was no pressure at all to even see how big he was. Meagan: Mhmm, yeah. Melanie: The second baby, I always say that he healed me because he really did. My first birth was really traumatic for me but then my friends all laugh because they say, “You're the only person who would say a 9-pound baby would heal you.”Meagan: Seriously, though. But how amazing. It's so amazing. Our bodies are incredible. Okay, we talked about PROM. This time, total opposite. Encaul for a little bit. I did some things. You did some things. Let's talk about if you've had PROM, premature rupture of membranes, there are things you could do to try to encourage no PROM next time. I am PROM, PROM, then with my third, I was contracting. My water did break way earlier than pushing but it still waited a little longer. I still feel like my efforts in a lot of ways helped. So anyway, tell us what you did. Melanie: Yes. So mainly two things. Again, being with providers who are more holistic, they are more likely to mention nutrition. We talked about nutrition a ton during the whole pregnancy. I think two main things. The first thing was collagen. They got me on collagen from the get-go. I know research shows that upping your collagen helps a strong sac. Then the second thing was Vitamin C. I didn't take any Vitamin C supplements or anything, but again, your body is amazing. I was craving oranges in my pregnancy so I think that's part of it. My body was craving oranges. I ate a lot of oranges so I think the combination of collagen and oranges really made my sac strong. And it was. It literally did not break until he came out. It was so different. Meagan: So incredible. I would echo that. Vitamin C and you can supplement with Vitamin C 100mg a day starting anywhere between 18-20 weeks. Some providers even say to do it from the very beginning as the placenta is forming and things like that. Collagen absolutely and protein. Protein and collagen. I know you guys have heard about Needed but I absolutely love their protein collagen. As pregnant women, we don't get enough collagen and we don't get enough protein in our daily eating habits so supplementing with that and getting more collagen really, really can create a healthier, thicker sac. Something that was interesting that I found out after my second– so back story. I had kidney stones. I don't know if you had any infections or anything like that with your first that made you be on antibiotics but antibiotics is what an OB told me can also weaken membrane sacs. I got UTIs and kidney stones and was put on antibiotics. The OB described to me that my OB was fighting in other areas so the nutrients that my body was getting was going to fighting and healing versus creating a stronger sac which is interesting. I've never seen any research about it but he was pretty adamant about avoiding antibiotics during pregnancy with my next one and I did. I didn't have what I had before. Melanie: That's interesting. I never heard that. Meagan: I know. I know. This is a doctor who doesn't even practice anymore. This was years ago but I was like, it kind of makes sense. It kind of makes sense. I haven't researched it. Melanie: Yeah. I can see that. Meagan: Antibiotics wipe our gut flora and things like that anyway so I can understand that but protein, collagen, Vitamin C, and possibly avoiding antibiotics. Nutrition is so huge with our bag of water. Then big babies. You guys, big babies come out of vaginas. I just have to say that. It happens. 9 pounds is a healthy, beautiful baby. Melanie: Yeah. When he came out, everybody was very shocked even before weighing him. He's thinned out now but he was swollen. Everybody was taking bets on how big he actually was. Meagan: I love it. I love it. I've seen so many babies when they come out and their cheeks are so squishy and you're like, that's a big baby. You can tell just by their face. Melanie: Yes. That's exactly it. Meagan: Oh my gosh. Well, thank you again so much for completing the circle, for helping other Women of Strength out there. I too believe that women listen to these podcasts and they want to find stories that are similar with theirs in so many ways. You didn't dilate past 3. An induction that didn't turn out to be a vaginal birth so an “unsuccessful” induction that turned VBAC. A lot of people, I think, do doubt their body in that way. They are like, “Well, I was induced. Not even medicine could get me there,” but there is a lot that goes into that. Sometimes our body is just not ready or our babies aren't ready or something is going on. It doesn't mean that's your fate for all future births. Melanie: 100%. Yeah. So well said. Meagan: Awesome. Well, thank you again so much and huge congrats. Melanie: Thank you so much, Meagan, and thank you to everybody. Everybody who has told their story, the community, and everything was so helpful for me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

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

In this episode of the Modern Mommy Doc Podcast, Dr. Whitney is joined by two powerhouse OB-GYNs and co-founders of Fem.ed, Dr. Sara Twogood and Dr. Alyssa Quimby from Cedars-Sinai. Together, they tackle the often-taboo topics of sexual health, perimenopause, and the mental load women carry as they navigate motherhood and their careers. This episode breaks down important discussions around:The impact of perimenopause and postpartum changes on sexual health.How to improve communication with your partner about sex and intimacy.Common physical changes women experience, from vaginal dryness to irregular bleeding.Misconceptions around HRT (hormone replacement therapy) and who might benefit from it.Tips on vaginal health, including what to avoid and how to care for your body.The importance of having conversations about mental load, self-care, and sexual well-being with your sexual partner(s).This week's podcast and newsletter are brought to you by Care.com. Care.com connects families with local caregivers, including nannies, babysitters, tutors, senior care providers, dog walkers, housekeepers, and more.Go to www.modernmommydoc.com/podcast for the full show notes.

On tomorrow's episode of The Wholesome Fertility Podcast, I welcome Dr. Sarah Wilson of @embracefertility. Dr. Sarah Wilson shares her personal journey with reproductive health and how she overcame challenges with her period and fertility. She emphasizes the importance of understanding one's own body and advocating for oneself in the medical system. Dr. Wilson discusses the role of the immune system and gut health in reproductive health, highlighting the connection between inflammation, gut bacteria, and hormonal balance. She explains how basic blood work can provide valuable insights into one's health and offers practical tips for addressing gut health issues. Dr. Sarah Wilson discusses the importance of gut health and its impact on overall well-being. She explains how the gut microbiome plays a crucial role in maintaining a healthy immune system and how imbalances in the microbiome can lead to various health issues. Dr. Wilson emphasizes the need to create a hospitable environment for beneficial bacteria to thrive and shares insights on the use of probiotics and spore-based organisms. Dr. Wilson provides practical tips for improving gut health, such as eating whole foods, avoiding processed foods, and managing stress.   Guest Bio:   On today's episode of The Wholesome Fertility Podcast, I welcome Dr. Sarah Wilson, ND. Dr. Sarah Wilson discusses the importance of gut health and its impact on overall well-being. She explains how the gut microbiome plays a crucial role in maintaining a healthy immune system and how imbalances in the microbiome can lead to various health issues. Dr. Wilson emphasizes the need to create a hospitable environment for beneficial bacteria to thrive and shares insights on the use of probiotics and spore-based organisms. Dr. Wilson provides practical tips for improving gut health, such as eating whole foods, avoiding processed foods, and managing stress.   Takeaways:   Advocate for yourself and seek answers when faced with reproductive health challenges. Understanding the role of the immune system and gut health is crucial for reproductive health. Basic blood work can provide valuable insights into one's health and help identify patterns and tendencies. Addressing gut health issues, such as inflammation and imbalances in gut bacteria, can positively impact reproductive health. Maintaining a healthy gut microbiome is essential for overall well-being and a strong immune system. Creating a hospitable environment for beneficial bacteria to thrive is crucial for gut health. The gut-brain connection and the enteric nervous system play a significant role in gut health. Managing stress, eating whole foods, and avoiding processed foods are important for improving gut health.       Dr. Sarah Wilson, ND, is the visionary founder of Advanced Women's Health, leading a healthcare revolution across Canada with clinics in Ontario and British Columbia. Overcoming her own health challenges, Sarah is dedicated to empowering women to reclaim their vitality naturally, merging research-backed expertise with her passion for Naturopathic Medicine. Beyond her professional pursuits, she is the Mom to two latino boys under 5 and is a self-proclaimed personal development and mindset fanatic.   www.advancedwomenshealth.ca Instagram: @embracefertility @drsarah_nd @advancedwomenshealthclinics https://www.youtube.com/@embracefertility https://www.linkedin.com/in/naomi-woolfson/     For more information about Michelle, visit: www.michelleoravitz.com   The Wholesome FertilityFacebook group is where you can find free resources and support:  https://www.facebook.com/groups/2149554308396504/   Instagram: @thewholesomelotusfertility   Facebook: https://www.facebook.com/thewholesomelotus/     Transcript:   Michelle (00:00) Welcome to the podcast, Dr. Wilson.   Sarah Wilson (00:02) Thank you so much for having me. I am so excited. I just really can't get enough of sharing all of the information that women need about reproductive health and empowerment. So thank you for having me.   Michelle (00:14) Love it. So I'd love for you to share your background and how you got into the work with reproductive health.   Sarah Wilson (00:21) It's such a huge conversation, I think such an important one because for so many of us, we get into it because we needed the medicine, right? And we explored that. So my story I always say is a really winding one. I was in and out of hospital my whole life until I was 18 and I was diagnosed with celiac disease, but I didn't fit the bill. And it was a naturopathic doctor that really pushed for that initial diagnosis. And so then, as we all do,   Michelle (00:28) Mm -hmm, yeah.   Mm -hmm.   Sarah Wilson (00:49) I avoided my calling and was trying to figure out how to recover and how to work within this and lost my period for almost five years. And so during this time, I was a researcher and I was seeing different naturopathic doctors. I was seeing different conventional doctors and specialists and people just kept saying they didn't know what was going on and they couldn't figure out why I was, like I wasn't exceptionally lean during much of that period of time. Like they just couldn't piece it together.   Michelle (00:58) wow.   Sarah Wilson (01:18) I had a doctor, think it was 21, 22, that was like, you might never have kids on your own. If you wanna get pregnant, come back to me, I'll give you a pill, we'll wish you the best.   Michelle (01:28) So nonchalant.   Sarah Wilson (01:31) And I just, I always say there's a few breakdown to breakthrough moments in my life and that was a big one where I was just like, absolutely not. I have the world available to me. I have all of this research. There must be something I can figure out. So that proceeded to really get me to push to work and find the research and piece things together. And I did bring back my period. And then when it came back, it was exceptionally painful. I was passing out. I had been on birth control.   Michelle (01:37) Mm -hmm. Yeah, good.   Mm -hmm.   Sarah Wilson (02:00) since I was 13 because of the amount of pain and heaviness. And so that's what it was like, okay, now we have to navigate this world of endometriosis and what that means. so yeah, now fast all the way forward, I became an astrophysicist doctor. I have two babies with two tries. I do not live in chronic pain and I'm just so passionate about taking all that research. I had to figure out myself and...   Michelle (02:09) Mm   Mm   Mm   Sarah Wilson (02:26) had to bring into practice and navigate how to bring into practice to now be able to give that to patients across advanced women's health clinics in Canada. it's just, it's a very empowering end to a really challenging journey, which I think so many people listening have.   Michelle (02:44) Yeah, for sure. What I love about what you were saying is that knowing that inner knowing you're like, no, absolutely not. Like you knew it in your heart. Because a lot of people hear that. And then they're like, okay, I guess that's just my fate. And I love, you know, I love when people are like, no, I'm gonna take no for an answer. I'm gonna figure it out. and it's also an intuition. It's like your own intelligence within you telling you, no, there's more to look into. I had a similar   thing a little different, but similar. so what was it, let's kind of go back just because people might be in similar situations with their period, listening to this. What was it that really caused the five years without period? was it being on a pill for a long time? What was it that caused that?   Sarah Wilson (03:29) So I was actually, my presentation of celiac disease was very different. I was 100 pounds heavier than I am now. I perfectly, I exercised and I was obese. And so what, the brain is such a beautiful thing. And what I believe happened is that being obese, going through puberty programmed my brain for what body fatness, quote unquote, I needed to have in order to be safe to have a baby.   Michelle (03:36) Mm   Mm   Mm -hmm.   Mm -hmm.   Sarah Wilson (03:59) And so for most people, they lose their periods around 16, 18 % body fat. I tend to hover around 23, 24. If I dip below that, then my period starts to go as long, it goes wonky. It's much better now, but the research suggests that when you have inflammation interacting with your brain, when you have cortisol interacting with your brain, what happens is we actually change how sensitive we are to the signals between the brain and the ovaries.   Michelle (04:08) Mm   Mm   Sarah Wilson (04:28) And so I think that in combination with all these set point theories, there's so many things happening now in the world of set points, that combination is what it was. So for me, getting my inflammation under control, which we'll talk about, getting an understanding that I had stress, but it was physiological stress. I had nutrient deficiencies, I had bacterial overgrows, I had inflammation, like I had all of those pieces.   that were interacting with my brain and my hormones. And so I just needed to go through step by step. I needed to work on my gut microbiome. I needed to work on the nervous system component. But fundamentally, I needed to understand that my body, the way it works and its sensitivity is set at a slightly different point than other people's.   Michelle (05:18) Yeah, well, for sure. I mean, I think that that's really at the crux of everything is that everybody has their own different set point and different like, you know, responses, their bodies respond to different foods, different environments, different stress factors, just so many things. And I think that that's the key. I often see a lot of people sometimes come in to see me and they're well, I'm taking this kind of like,   combination herbs that I saw online or, you know, so, that's, that's one of the things that I really try to stress to people is that everybody's so different. And so when you were going through that, you were uncovering it. Obviously you had a natural path that you were working with. Yeah, multiple. So they, you had a team.   Sarah Wilson (05:58) And multiple. Yeah, absolutely. And I think I always say I'm the most energetic scientist you'll ever meet in your whole life. Like data informs every single decision. And then you sit in front of the person in front of you and you say, OK, what's their energy? Right. Like what? How do you need to to build those things together? And so, yeah, I had a team I had.   Michelle (06:09) Mm   Mm right. Totally.   Sarah Wilson (06:23) And I had multiple naturopathic doctors try to work their way through it. I had OB -GYNs and my family healthcare team trying to help navigate it. And it was just, I was in the typical situation. I was in the situation that 90 % of my patients are in. Everyone's like, you're fine. It's fine. Your blood work is fine. Right? And that's, think, even for me doing research, one of the projects I was on was we were studying metabolically healthy people, metabolically unhealthy people.   Michelle (06:41) Right, exactly. Yeah.   Sarah Wilson (06:52) We were studying them in lean and obese categories. And so the labs going through and they're pulling all this data. And it was the first time that I'm sitting there going, huh, okay. So we can have people that are metabolically very healthy and overweight. And we can have people that are very lean and extremely metabolically unhealthy. And this was, it was such a formative experience because I remember sitting there going.   Michelle (06:55) Mm   Mm -hmm, right.   Sarah Wilson (07:20) The blood work, the way we're reading it right now means nothing. Right? Like we need to be rude.   Michelle (07:25) There's so much more. It's just a snapshot. It's like a small, it's a small little slice. And I think that's something that I often see too, is that we make such generalized assumptions based on such a small little snapshot. And while that snapshot is very important, it's, it's kind of a piece to the puzzle. It's not the end all be all it's part of the whole picture.   Sarah Wilson (07:28) Exactly.   Exactly, and if we use a conventional reference range that's defined based on disease, like I think in North America, we've really lost the understanding that there's a line between health and disease. Like you don't just jump from one to the other like long jump, right? It's not like I'm healthy today and tomorrow I have a disease. Like there's this spectrum of dis -ease as we make our way to a condition. And I think identifying patterns in labs.   and identifying tendencies is arguably more important than the snapshot itself, you're 100 % correct. And so we have to look at that data holistically and say, how is that changing? How is that modifying over time? But also I think there's so much research now where we can give people back the keys to the castle with that basic blood work, right? Even for example, everyone has had what we call a complete blood count. We've had multiple of them. So that's...   A complete blood count is when we're looking at your red blood cells and your white blood cells. We're looking at the breakdown of those things. It's the thing you get when you walk into the doctor's office, when you get when you walk into the hospital, et cetera. They're always just saying, what's your white blood cells? What's your red blood cells doing, et cetera. And there's two white blood cells called neutrophils and lymphocytes. They are just representing two aspects of our immune system that are fighting bacteria and viruses and they're helping to support the system.   But there is a ton of research coming out to show that the ratio between neutrophil and lymphocytes can tell us about the inflammatory status of the body. So if your NLR, as we call it, neutrophil to lymphocyte ratio, is higher than 2 .5 or 3, chances are you've got an immunological underpinning to what's going on. And so for me with endometriosis, I was in the hospital a while ago now, and I was having a flare, and I was worried about ovarian torsion, because at one point I had had a 10 centimeter endometrial.   Michelle (09:30) Mm -hmm.   Sarah Wilson (09:40) like it was very, very large and it's not there now, but I just wanted to go in and make sure that there wasn't something happening because it felt different. And my NLR was six, but outside of that, it was one or two. So this is something I always say to patients, you can even empower yourself just looking at that number and being like, if that number is jumping high and it's correlating with my symptoms, if I have worse menstrual pain or worse mood challenges or   Michelle (09:42) Mm -hmm.   Mm   Mm   Mm -hmm.   Sarah Wilson (10:08) I get pregnant and these things jump and then I have a loss, what could that be telling you about your immune system? And I think there's such simple things. Of course, we can run super comprehensive panels of labs and get all of the autoimmune tests. And like I've heard you talk about them on the podcast before, right? You can get really comprehensive panels and that's wonderful. And I love that as a doctor and a researcher, I love data. But what I love even more is saying, let's look at the past two or three years.   Michelle (10:26) Mm   Mm   Right.   Sarah Wilson (10:37) What are these basic blood markers telling us about your tendencies and how much we need to dig into different components of health, like your immune system, your blood sugar, those types of things?   Michelle (10:48) So you could see this basically on just general blood work.   Sarah Wilson (10:53) Exactly. And so that's where I think for me.   Michelle (10:55) And do people often look like, do doctors even know to look for that specific thing? So it's kind of one of those things that people don't really look for, but you can kind of dig up your own stuff and just look at the ratio yourself.   Sarah Wilson (11:07) Exactly. Exactly. And that's why I think I come on these podcasts and I do these things because not everyone has access to a naturopathic doctor. Not everyone can be a researcher. Exactly. So to be able to look at that and start to question, even when I was in the hospital, I was like, are you concerned about that? And they're like, maybe you have a bacterial infection. It's not a big deal. Okay. Okay. Right? But it's...   Michelle (11:16) Yeah, that's very empowering.   Mm -hmm. Yeah.   Sarah Wilson (11:30) It's those things that I want people to be able to grab onto and access for themselves because what I know to be true in my practice, seeing so many people, is when you give women access to information about their bodies, they change communities, households, everything. Like it is the most empowering thing for me to come on a podcast and talk about something and then...   Michelle (11:46) Mm   Yeah.   Sarah Wilson (11:57) get someone message me and be like, my friend of a friend of a friend told me to look at this and now I'm concerned about it. And I'm like, yeah, you should probably get that investigated. And then it's ovarian cancer. You know what I mean? Like this is how powerful just these conversations are.   Michelle (12:08) my God, yeah.   Yeah, it's very powerful. mean, obviously when you do see that something's off, it'll get you at least to take the next steps or to investigate it more because you can't really make, you know that something's going on, but you have to like really move further and see what it is. But at least it's going to be an alarm to let you know something's going on.   Sarah Wilson (12:35) Mmm.   And a direction, right? I, every day, pretty much at this point, I'm talking to someone who's like, everything I was told was unexplained, right? And in the fertility world, if you're unexplained infertility, you either have a baby or you don't, right? So there's clarity in that, no one's saying, your infertility is in your head. But in every other aspect, there's not those clear end points. And so,   Michelle (12:40) Mm   Mm -hmm.   Mm   Sarah Wilson (13:07) if someone's dealing with chronic pain and they aren't getting investigated for endometriosis or some other condition, they can be told it's all in their head. So even if they can see on basic blood work, one or two things that are off, it's like, there, go there, let's do this. And I think that's what's so exciting to me.   Michelle (13:24) Mm -hmm. Right, right.   Yeah, definitely huge. So talk about the immune system. this is one of the things that you can look at, I know that there is a lot of a connection with autoimmune conditions and the gut health and, high inflammation and leaky gut. So talk about that, how people can look into it and how they can address it.   Sarah Wilson (13:53) Absolutely. So I actually also was a microbiome researcher at one point in my profession. It's so important. And even now, like post pandemic, we've seen it so much more important because historically, what do we always say? Is 60 to 80 % of your immune system lives in your gut. Okay. So there is within your gut, there is, it's so interesting. Picture a PVC pipe, right? On the inside, if there's Play -Doh.   Michelle (13:59) awesome. Amazing, though, but it's so important.   Mm   Mm   Sarah Wilson (14:23) that's where the bacteria live, right? But that's actually outside of your body. And so that play -doh is either poop, in those of us who are lovingly chronically constipated, or it's the mucosal lining that the bacteria live within. So that's where the immune system is really, really critical, is within that putty lining. And so what happens is that immune system's job, because it's technically outside of your body, mouth.   Michelle (14:26) Mm   Mm   Sarah Wilson (14:51) all the way down to your anus is outside of your body. Its whole job is to say, are you a food and you're safe? Are you a bacteria and you're safe? Are you a virus and you're not safe? Are you a bacteria and you're not safe? And the whole job of that immune system is to sample and navigate. Do I need to kick off an inflammatory response or do I not? Am I safe or am I not? And so what we're looking at is when we start to have allergies.   and we start to have food responses and all these food sensitivities when we start to have bloating and gas changes in bowel movements. That's all telling us that our immune system either one has identified a bacteria or virus that needs to go and it's kicking off a response to it or two, it has what we call lost oral tolerance. It has lost the ability to know between what's good and what's bad.   Michelle (15:46) Mm.   Sarah Wilson (15:47) And so in both of those situations, that is going to result in inflammation, not just local to our gut, but throughout what we call our peritoneal cavity, right? So that's gonna be your ovaries. I always say, your bowel and your ovaries and your uterus are friends. Like for those of you who can't see it, they're touching, they're friends. So we have that inflammation in our reproductive system. We have that inflammation affecting our liver.   then it goes into our bloodstream. It affects our joints, it affects our brain. That's why we talk so much about the gut brain connection, because there's that inflammation there. But as a practitioner, my job is to sit here and say, is it that we have so much inflammation? There is this absence of an ability to regulate, should I fight this or should I not?   Is it that there's so much damage being caused by inflammation that now we have leaky gut or impermeability, right? Because the immune system will cause damage and it's trying to fight something and there's collateral damage. So is it that or is it that there's bacteria that need to be modified? And so I think it's really helpful, even like thought experiment to think about it in that way, because so much of the time when it comes to the gut, we   Michelle (16:43) Mm   Mm   Sarah Wilson (17:05) are assuming that our symptoms are wrong. Like, what's wrong with my gut? Right? Like, we're a victim to it. Like, our immune system is doing something bad. But nine times out of 10, it's trying its best to protect us. And so our job is to say, what is it protecting you against?   Michelle (17:08) Mm -hmm. Right.   Mm   Mm   Right.   Sarah Wilson (17:25) So when we're navigating and we're going through then, we hear all about probiotics and we hear all about these different things and all of them can be helpful and have their place, right? We hear about armor colostrum all the time these days on different podcasts, right? We hear about all these things. And so I always say, think about them and put them in the context of what I just said. So if we don't have enough good bugs and we add probiotics, which are good bugs,   Michelle (17:36) Mm   Mm right, yeah.   Sarah Wilson (17:52) then that will take us so far. for, again, for those of you who can't see, I've got my hands up, right? Picture it like a bar graph. So if you don't have enough good bugs and that bar is low and you have too many bad bugs, then the dominant state is bad bugs. So if you add a whole bunch of good bugs, then eventually you can turn that dominant state into good bugs. But probiotics are transient, they leave the system. So you still have that low grade bad bug situation.   Michelle (18:06) Mm   Sarah Wilson (18:21) So this is where we hear about berberine, right? We hear about oregano, we hear about black cumin seed, we're hearing so much about all of these herbs now, because what they're doing is they're breaking down the bad bugs to allow the good bugs to grow, to repair the lining. it's, there's such a huge dance with the bugs in the gut and the immune system and how that affects the rest of your body, but what we know for darn sure is that   Michelle (18:23) Mm   Right.   Right.   Sarah Wilson (18:49) There are overgrowths that are happening more than they ever have been before of bad bugs. We know that.   Michelle (18:55) Right. So we're talking about things like SIBO, you know, just that, because that ultimately it starts to kind of go from like the bowels all the way up.   Sarah Wilson (19:04) Yeah, exactly. So SIBO is small intestinal bacterial overgrowth. So it's overgrowth of good bugs in the small intestine. We also have what we call CFO or overgrowth of yeast in the small intestine because the immune system can't defend against the yeast. Then we have bad bugs and parasites, right? So this is where we hear an overgrowth of, I'll throw some names, like Pseudomonas, C. difficile, Clostridium species, E. coli. We have an overgrowth of bad bugs in that situation. And those can be   Michelle (19:11) Mm   Mm   Mm   Mm -hmm. Bye.   Mm   Sarah Wilson (19:34) upper but they can also be lower down. And so that's always what we're navigating is saying, okay, is there, if you have an overgrowth of good bacteria and you add more good bacteria, you're gonna be the person who feels awful on probiotics. You take them, you're gassy, you're distended, okay, in that, yeah.   Michelle (19:49) Right.   Unless, unless they're spore based.   Sarah Wilson (19:56) The SBOs are such an interesting conversation. They're such an interesting conversation because most of the research is coming out of two labs. And so I agree to some extent and I'm pensive. Yeah.   Michelle (19:59) Yeah.   Mm -hmm.   Okay. No, tell me, tell me. I want to hear it because, because I've always been told and I've always learned that spore -based probiotics, because, they, they bypass the small intestine, they go all the way down to, you know, the colon that, and then they, and then they flourish and they change the pH and they, they make it so that it's more hospitable for the good bacteria to grow and not the bad bacteria. A lot of times there's like die -off symptoms and it   Sarah Wilson (20:32) Exactly.   Michelle (20:36) kind of shifts, even though it's transient, it does shift the pH to create it where it's better for a healthier environment.   Sarah Wilson (20:47) Absolutely. So it's just like that bar graph, right? I always say if you give the environment for the good bugs to grow and there's not too many bad ones, then they will grow and take over. If you ever, I always tell people picture like an octopus or a cuttlefish, you know they change colors really rapidly? Our bacteria do the same thing. It's called quorum sensing. And so essentially if you create a hospitalable environment, you have enough mucus. This is the other thing, right? Bacteria need mucus.   Michelle (20:49) Mm   Yeah.   Yeah.   Mm -hmm. Yeah. Mm -hmm.   Mm The mucosal lining. Yeah.   Sarah Wilson (21:13) Exactly. So if you have that integrity, you add probiotics, and then you can change from a red environment, inflamed, the pH is off, there's bad bugs growing to a good environment. If you don't have that mucosal lining, if your immune system is too grumpy, or if you're in a situation where there's too many bad bugs, then you can't fix it by adding more.   Michelle (21:17) Mm -hmm.   Mm   Mm   Mm   Sarah Wilson (21:40) And so that's where we're using antibiotics and antimicrobial herbs and things like that to get that down. Going back to the SBOs, the thing I find really interesting is there's so many, I could like nerd out on this stuff all day long as you can tell, but there's so many factors, right? So when we talk about it bypasses the small intestine, what they mean in that situation is that all bugs are either acid sensitive, temperature sensitive,   Michelle (21:54) It's great stuff though.   Sarah Wilson (22:09) oxygen sensitive or yeah, I went through acid. Those are honestly the main ones. There's nitrogen sensitive, things like that, but those are the main ones. So what they're saying is the acid sensitivity means that they will get, and the temperature and oxygen sensitivity means they're gonna get lower down. But what we're seeing more and more and more is that people's stomach acid is off, their pH is off throughout their whole system. They have all kinds of,   Michelle (22:32) Mm   Sarah Wilson (22:37) you know, temperature sensitivity changes. And we have all kinds of changes in the hydrogen, methane and oxygen levels within our gastrointestinal tract. So what happens is we're not actually controlling where it's going. We're controlling at what environment it takes hold. And because there's so much dysfunction within the gastrointestinal tract in so many of our patients, I'm concerned that it actually could take hold.   and be present at higher levels of the gastrointestinal tract contributing to issues. And I've seen some... Yeah, that's BOs. Yeah.   Michelle (23:10) You mean the spore based ones, the spore based? you, because from what I understand, looking into it is that it won't activate until it gets to the large intestine.   Sarah Wilson (23:23) And that's based on the pH, the oxygen level and the temperature and all of those pieces.   Michelle (23:29) Okay, I see. So you're saying that it could be a different pH and everything will shift if things are so off, up, you know, higher. Got it.   Sarah Wilson (23:36) Exactly.   Exactly. And I've seen severe constipation in patients that take SBOs. It's like the only side effect I see, because you're right, there is a lot less bloating gas, those like three to five day battle between the good and the bad bugs. There's less of that for sure. But I have seen like enough patients that got me saying, okay, what's going on there that take it.   Michelle (23:47) Mm   Mm -hmm. Mm -hmm. Yeah.   Mm   Sarah Wilson (24:04) and immediately they're super constipated. So we actually use them a lot in diarrhea because of the benefit of that. But it's definitely a space I'm watching the research. It's super interesting. I think just like, so I was, my God, how many years ago now was I a probiotic researcher? least 10. It's a different world, right? Like how exactly, so.   Michelle (24:10) Mm -hmm.   Yeah.   Mm -hmm. yeah, they're learning so much so fast. Yeah.   Sarah Wilson (24:30) Exactly. So that's where I always say, you know, you're a good practitioner when you want to refund everyone every five years. You're like, what was I doing? So I think it's just an evolving conversation, but they definitely do have utility for sure. I think there's just, for me, just having been in a research environment, I know how controlled all of those situations are. And so then when they come out into our patient situations,   Michelle (24:35) Yeah.   Yeah.   Sarah Wilson (24:56) We just need to apply different lenses of thought to it.   Michelle (25:01) Or I mean, you can also add something like Trifola while they're doing that so that you're kind of like counteracting the constipation aspect or maybe some more fiber eventually when they're ready, you know, because sometimes too much of that when things are not great can exacerbate.   Sarah Wilson (25:17) Absolutely. And like we have studies now that are coming out to show that it's alarming. Over 50 % of people have what we call retained fecal matter, which is like constipation when they don't know constipation. And so I think there's so much that we're finding out and there's so much that's going on within the gut microbiome world that will be.   Again, I'm just always so curious to see where it goes and to see what happens with it. Because even I wrote a book in 2018, I guess. So I was writing in 2017 on insulin resistance and how that worked. And like I talked about in Cretins in a big section of that book. This was like pre -Ozempic days. And people at that point were like, what is she talking about? And now it's so accepted. And that's what six years later, right? They're just like, of course.   Michelle (26:08) Yeah.   Sarah Wilson (26:11) So, so much changes so quickly. And I think just staying on top of it is something I value so much. Like even today, I'm teaching an intensive on post -viral immunology for other practitioners, right? So, I'm always trying to navigate what do I see in practice? Because we see thousands of people in advanced women's health. And how is that showing up in the research? And how do we mesh those things and adapt with those things? Because things change so quickly.   Michelle (26:14) Yeah, for sure.   Mm   yeah, definitely. No, I agree. mean, everything just kind of out does itself. Something new comes along. what I find really fascinating is the gut brain relationship and the enteric nervous system and also the vagus nerve and how that impacts. It's kind of like the go between our brain and our gut. And, and also   Sarah Wilson (26:50) Yeah.   Michelle (27:01) the research on that where they've done like studies on meditators and like people in Tibet, Tibetan Buddhists, compared to people that are neighbors that eat the same food, they live in the same environment, but the gut microbiome of the meditators is so much more enriched. So it's kind of like a buy between, yes, we could work from the gut to the brain, then we can also work from the brain to the gut. And it's pretty fascinating.   Sarah Wilson (27:12) Yeah. Yeah.   Absolutely, and even to see the amount of research on people's levels and how that is directly related to yeast infections. We know that that whole gastrointestinal tract, vaginal microbiome, they are so, so, so closely tied to our nervous system and stress response. There's so much, I do.   Michelle (27:34) Mm   Mm That's interesting.   Yeah.   Sarah Wilson (27:52) stool testing on myself pretty frequently. I would say even more so than patients, I do it on my family. And it's so interesting to see how it shifts because again, diet and lifestyle can stay very similar. So it's like interesting what caused that shift, what caused that shift, how was stress involved with these things. it's, yeah, it's so fun. It's so fun.   Michelle (27:58) Yeah.   Mm -hmm.   Yeah, it's fascinating for sure. And then also, think about the gut microbiome, I think about the changes, I think about inflammation. I think about the additives we're eating and we're exposed to. mean, those are the biggest things because it feels like it's outside of our control. I mean, it kind of is until we know about it. It's, know, we go eat some places, we have no idea what they're adding and we know that   Sarah Wilson (28:33) Mm   Michelle (28:40) thickeners, I mean, there's so many things that can be added. We know that they can really throw off the gut microbiome and that throws off inflammation. So it's kind of like an unintended consequence because you're not, most of us don't know that unless we're doing what we're doing and learn about it.   Sarah Wilson (29:00) And then you're looking, is there SLS in this? Is this disrupting my microbiome?   Michelle (29:04) Yeah, but that's what it is. And that's why when people say, I guess, to simplify it is just don't eat processed food as much as, try to avoid it as much as possible. Because even like the good kind can impact your gut. mean, like good processed food, because of all of the excess ingredients that they add in there, that could really throw off your microbiome. That's why when people say just, I guess, like, if you want to say something that's more generalized, is more whole foods, foods that come from the   earth and also foods that are not sprayed with toxins, know, I mean, to try to avoid it. It does feel like an uphill battle.   Sarah Wilson (29:44) Patients are so overwhelmed, right? It's you're trying to eat whole foods and then you look and they're like, okay, well, what about genetically modified agents? And then what about what's being sprayed on them? And I always say that in of itself is a stress response, right? So we talk about stress and then we make food such a stress. And so I always say to people, the reality is that you could probably do better than you're doing right now.   Michelle (29:45) Yeah.   Sarah Wilson (30:12) and what feels reasonable, what doesn't feel overwhelming, right? And we'll actually sit there and go through and say, okay, I need you to eat a low insulin demand approach, because insulin is such a huge inflammatory compound. Insulin is the hormone that controls blood sugar, but it's like 75 plus percent of us are insulin resistant in today's day and age. So it's a huge, it's an epidemic. So I'm like, okay, don't eat a ton of carbohydrates,   Michelle (30:14) Mm   Yeah. Yeah.   Sarah Wilson (30:43) I hate good carbs, bad carbs, but berries, all of those highly colorful fruits and vegetables, don't count them. Eat away, enjoy your life. I'm not talking about that. We all know we shouldn't eat as much bread. Deep fried foods are not helping anyone, right? The starchy carbohydrates, rice, like that. We have to watch those things. We built a culture on creating addiction to carbohydrates. So we have to be careful of those things. But it's like, how can you add two servings of vegetables? If you can...   Michelle (30:52) Yeah.   Nope.   True.   Sarah Wilson (31:12) buy local and you know where they're coming from, rock on. Like it's summer here right now. There's farms that I know do not spray anything, but they cannot certify organic because they can't afford it. Okay, wonderful. I can go there, right? Buy frozen organic. It is pretty much the same price to buy frozen organic as it is to buy broccoli right now, right? And saves my life prepping it. It is picked right.   Michelle (31:26) Yeah.   Mm -hmm. 100%.   Yeah.   Sarah Wilson (31:41) It is frozen right away. There's benefits to it. So it's like, do that. Okay, then we look at our meat. How, or if you're eating meat or not, How is it being raised? Would you want to go visit that farm? Because if you would not feel good around that, then energetically that has an impact, right? What hormones are going into it? We look at those things. And the reality is, if you can't...   afford to make those choices wonderful. That happens. What do we do to feel the best about the options that we have in front of us? Fundamentally, I always say balance blood sugar and a nervous system that is stable and you're not having anxiety every time you put food in your mouth because you don't know what's in it. That is going to take us almost just as far as micromanaging every piece and every ingredient. Whole foods more often   eaten away that fills you up, that makes you feel good. And everything else from there is customizable. But I think I hear so many patients, they get so caught up in fresh, organic, grass fed, grass finished, researching the farm, and then they end up in McDonald's.   Michelle (32:57) Yeah, that's not good. Yeah, yeah. Yeah.   Sarah Wilson (32:59) because they're so overwhelmed, right? They're like, I'm just hungry. And so I always say like a happy balance is always gonna be the goal.   Michelle (33:08) Yeah, no doubt, for sure.   Sarah Wilson (33:10) And your microbiome loves colors and there's not many of those at McDonald's, so. Exactly.   Michelle (33:14) Yeah, variety for sure. Yes, totally. And then you were talking about like symptoms even without a diagnosis,   Sarah Wilson (33:24) So the blood work is one piece, right? So even without a diagnosis, you can do complete blood count. You can do something called a C -reactive protein, which is a marker of gut inflammation, liver inflammation. You can do an arethrocytes sedimentation rate. These are blood markers. But I also say, if you are struggling with joint aches and pains, if you feel like you're just getting older, if you are dealing with brain fog, if you...   Michelle (33:26) Mm   Mm   Sarah Wilson (33:53) have pain with your periods that we have normalized so much as a society. If you have period poops, if you have PMS that is affecting your quality of life, like we have so many of these symptoms that we've been told, I'm just getting older, I have aches and pains, I'm just bloated and gassy, it's not a big deal, I just have brain fog, I'm losing my memory, right? I can't remember where I put my keys.   I'm dealing with like menstrual challenge. That is all inflammation based, all of it. And as someone I think who lives in this world all the time, it's so easy to forget what it feels like to feel crappy until you get hit. And I have two small children. I have a two and a five year old. And so we're sick all the time, right? Like it's just the reality, daycare, school, people get sick. And   It's so easy to just again, lose track of what good actually feels like. And it doesn't include those things, right? You should wake up in the morning feeling rested, unless you have a child who has nightmares about monkeys, which happened to me. Right? But you should be able to sustain that energy throughout the day without eating food. You shouldn't have to compromise your activity and your work schedule based on pain.   Michelle (35:05) Right.   Sarah Wilson (35:17) and energy levels and your menstrual cycle or your digestion. And so many people are living in that state where they are.   Michelle (35:22) Yeah.   And so when you do have people that come in with inflammation, what are some of the ways that you address that   Sarah Wilson (35:33) absolutely. So my belief structures, there's only five to seven causes of disease, right? So we go through blood sugar dysregulation and insulin resistance, the gut microbiome, immune dysregulation, we've got liver issues, we have nutrient deficiencies, the nervous system, and then we have the components of cellular energy production, or what we call our mitochondria, right? So these are the components of health. And at the end of every piece of that,   you're going to have a stress response and an inflammatory response, which is what most people are dealing with in today's day and age is they're struggling between that balance of stress response and inflammation. So my job is always going through those components and saying, which are the top two or three for you, right? If we're talking about microbiome issues and the immune system as two key pieces.   And then we say, okay, let's compliment that with the nervous system because we just talked about that. If those are someone's top three pieces, then first and foremost, we have to go through and say, what are the biggest obstacles? What are your gut symptoms? Does that suggest that you might have an overgrowth of methane species? Right? Does that, that tends to be constipation, lots of gas that doesn't smell great. Is it suggesting that you have hydrogen overgrowth? Right?   that's lots of gas that doesn't necessarily have a smell. We can go through, pick those apart. Do you have a history of parasites? Right, do you camp a lot? Those pieces, we're using antimicrobials in those situations to try to create some stability. We're trying to understand how that's gonna relate to blood sugar, et cetera. When it comes to looking at the immune system, there are key nutrients like vitamin D. If you don't have vitamin D,   at the right level, which most of us do not, that's a master controller of your immune system. So we need to have that in place. We also need to look at your viral history. So we know right now, research is showing that you can retain components of viruses for years. We've seen that people have reactivation of chronic viruses and those are directly affecting the lining of their uterus, they're directly affecting their ovaries.   Michelle (37:44) Mm   Sarah Wilson (37:55) and their whole pelvic health. So in that situation, we're saying, okay, what antivirals need to come into the mix? And what do we need, again, to look at from a holistic perspective? I know you've had so many people on here that talk about NAC and N -acetylcysteine and alpha -lipoic acid and CoQ10. And oftentimes what they're doing is just helping with those inflammatory cycles.   Michelle (38:22) Mm   Sarah Wilson (38:22) right, they're helping to restore balance to that inflammatory pathway. And then the nervous system comes in because that affects blood flow that affects your immune system's ability to do its job. And we say what works for you? Is that nerve nerves, right? That's where our valerian our passionflower, our zycephos come into the mix and are so beautiful. Is that going to be something where it's we're looking at meditation and walking?   and all of those pieces. that's really the approach I take, is I say, in those five to seven different causes that someone could have, what are the most important pieces for them? And then we dig into it at depth to say what components, whether that's using blood work, whether that's using functional testing, honestly, at this point, having seen as many patients as I've seen, sometimes it's insane. You're like, okay, I think we need anti -microbials.   some valerian and passion flower, and we need to correct the nutrient deficiencies that are present with respect to vitamin D and some of those antioxidants. We need to get enough protein, more colors, Bob's your uncle. But it's, I always say, health is so simple, and we have so much time and energy dedicated to making it really hard. And...   Michelle (39:31) Right.   Sarah Wilson (39:42) the more sophisticated I get, the more sophisticated the research gets, the more I go down rabbit holes, the more I come back to the same things. And I think there's so much peace in that too, to know that, yes, I have a lot of patients with very chronic health issues, with very significant imbalances, but the body wants to come back to those places and we just need to figure out which levers to pull to get it back to health.   Michelle (39:49) Right.   I love how you put that. It's true. It's just like, are the levers to pull, to try to help it do its job. what it wants to do really, it's like its purpose.   Sarah Wilson (40:24) Exactly. it's so, like sometimes you're pulling the same levers in rotation, right? You're like, okay, blood sugar, stress response, liver. And then you're like, inflammation, gut microbiome, stress response, blood sugar, liver. It's, you sometimes have to cycle back to those pieces. There's like the layers of the healing onion. So as we always say, but it's, there's so much simplicity that can be had within all of it. And I really want people to feel that because I think,   Michelle (40:28) Mm -hmm.   Right. Yeah.   Sarah Wilson (40:50) There's a lot of energy now being dedicated to feeling like health is gate kept and it's not, right? This is why we come on these podcasts. This is why we do these things. If anyone today says, I feel empowered, I can take action here. I'm gonna add more vegetables. I'm gonna add more colors. I'm gonna go for a walk after my meals, ideally in nature. I'm gonna look at what brings me joy.   Michelle (40:57) Yeah.   Sarah Wilson (41:17) and include more of that. I'm gonna work on my boundaries, I'm gonna correct my nutrient deficiencies, and I'm gonna look at my microbiome. You will get so far, so far in your health. And that to me is just, it's so beautiful.   Michelle (41:26) Yeah.   yeah, for sure. mean, it's really empowerment. So, well, this is great. You shared so much amazing information. I could definitely keep talking to you because there's just so much that we can keep unpacking. But if people are interested in working with you, want to find out more about you, how can they find you?   Sarah Wilson (41:53) Yeah, absolutely. Well, thank you. know I was, these are always such loaded conversations because we start and it's like, do we go here? Do we go here? So exactly.   Michelle (42:00) I know. There's just a, a, branches out and it has, it starts to take a life of its own. And then I'm like, okay, well, we still can't keep going, going, going. at one point.   Sarah Wilson (42:11) I know totally. Yeah, so I, as I said, for anyone listening in Canada, I own Advanced Women's Health. So we have clinics across Ontario and BC and we're expanding. I have a whole team of practitioners that do clinical rounds every day and I work with all the time. For those of you in the US, I do have courses where I train naturopathic doctors. So if you like this approach and you want people who are in the US and beyond.   then you can always reach out to my team as well. Their email is just info at advancedwomenshealth .ca and they've got that list of practitioners. So in either situation, we can help you out. I also poke around on Instagram. I do not post on there as much as I should, but it's always a goal. And yeah, I'm just so happy to connect with the audience.   Michelle (42:52) Amazing. Well, Dr. Wilson, this was very informative and I love the fact that you do so much research and this is based on like real data and real information and you really understand it. Your mind tends to work that way, which is awesome because you have to find a career where your mind is really able to absorb that information and then apply it. And it sounds like you found a perfect.   career for what you do and you're passionate about it as well.   Sarah Wilson (43:20) Thank you. Yeah, no, I'm so fortunate. I love what I do. And like, I'm so fortunate that I get to build a team of people that begrudgingly love my brain. They're always on calls because we meet every day. So our team of practitioners meets every day and they're always asking questions and I'll spin out on something and I'll be like, welcome to the Ted Talk. Sorry, that just happened.   Michelle (43:31) No, it's very interesting.   Amazing.   That's great. Well, that's how you know you love it. That's how you know it.   Sarah Wilson (43:44) Yes. Yeah, exactly. Exactly. Well, thank you so much for having me. It's been such a joy. yeah, I just I love sharing this information. I'm happy to come back and share more anytime.   Michelle (43:55) Yes. So thank you so much for coming on.    

We have received so many messages and emails from you requesting more VBAMC stories and today, we are giving you just that. Susana joins us from Mexico sharing her VBAC story after five Cesareans!Each of Susana's Cesarean experiences was unique in their own way, but the dream of a vaginal birth never left her heart. When she found a supportive midwife and doctor during her VBA5C pregnancy, Susana knew this was her chance to finally achieve that goal. With her husband by her side encouraging and supporting her, Susana powerfully pushed her baby out. The hospital staff and community buzzed with shock and amazement over what she had achieved!“That moment was unlike any other moment in my life.”ACOG Article: Dr. Angelica GloverEvidence-Based Birth: The Evidence on VBACNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength, this is the moment so many of you have been waiting for. We have a VBA5C so for anyone who doesn't know what that means, it is a VBAC after 5 Cesarean story for you today. This has been requested so much. We received emails in our personal email. We have gotten it on social media saying, “Please, can we get some stories that have VBAC after more than 3 Cesareans?” We know so many people out there don't know that this is an option or they know it's an option but they don't find the support or they can't find the support. They are few and far between but we have our friend Susana today who is going to be sharing her VBA5C story. Welcome, Susana. How are you?Susana: Hi. Thank you so much for inviting me. I'm so excited. Meagan: Oh my gosh. I am so excited. Yes. I am so excited and you are in Mexico, correct? Is that where your VBAC was? Susana: I'm sorry? Meagan: Was your VBAC in Mexico?Susana: Yeah, but it was a very, very hard way. I'm going to share what I did. First of all, I can't separate this way from my faith because I prayed so much for this and I trusted so much and also, I trusted so much in the process and in the body and those things But okay, I'm going to tell you what happened with me and why I had five C-sections. First of all, I got pregnant in 2009. My pregnancy went very healthily with no problems at all. I was 41+5 weeks and I had a doctor who was– well, he said he was for natural birth. I don't know how to say it. He was pro-birth. Meagan: Yeah, that he's pro. He's supportive. Susana: Supportive. Yeah, that's the word. But in reality, he was more C-section-supportive. While we were passing a very difficult part of our life because my father-in-law passed away exactly on my due date. We were very emotional and very sensitive. Labor wasn't starting so the doctor said, “No, baby is not engaged. You are only 3 centimeters. I can say that baby is not going to birth naturally. I say that it is better for you to go directly to the C-section.” I was disappointed because I was walking so much every day, but for the situation for my husband and all of the family, I accepted. We went to the C-section. I got pregnant again in 2010 8 months later and I was very excited to now get a VBAC. The doctor said he wasn't going to support me but in the end, I had a TOLAC, a trial. I was progressing well. I was 5 centimeters when I went to the hospital and the doctor was a little bit nervous because the C-section that I had before was one year and five months before so he was like, “You have to be fast because we have the risk of uterine rupture.” He started to make an impression on me and I was starting to be stressed. After 5 hours I think, he said, “Baby is not getting down. You are still at 5 and we are going to the C-section again.” I cried a lot and my husband said, “We tried and we can't do this anymore. It can be dangerous. Go to the C-section.” It was very traumatic because they put in the epidural and it only worked in half of my body. I started to scream, “No, please. No. I can feel everything.” They put the epidural in again. It was difficult. Then I got pregnant again in 2012 but I didn't fight anymore. I decided for a repeat C-section. The good part is that it was peaceful because I was accepting the situation. Everything went well. Then I got pregnant in 2013. Also, we were going to opt for a C-section because I didn't have any other chance but the doctor started saying, “No more babies. Four C-sections is a thing,” and things like that but my husband and I were talking about it and we thought that it wasn't an option for us to have– I don't remember the word. Tying the tubes. Meagan: Oh yeah, a tubal. Susana: Yes. The sterilization. So we went to a repeat C-section. It wasn't as smooth as the one before because my baby was 37.5 weeks so we had a little problem with maturity. Is that the word? She was very small. Meagan: She was technically preterm. Susana: Yeah. Preterm. She showed signs of preterm. She was whimpering and something like that. We had to go to the neurospecialist. Everything was going well and there was no problem at all, but we were careful for another pregnancy. We waited a lot and we got pregnant again in 2017. I spent the half of my pregnancy with the same doctor, but at half of the pregnancy when I was 20 weeks, some friend told me, “Oh, you know what? There is a mom in Brazil who had a VBAC after four C-sections.” I was like, “What?” I didn't know that existed. I started to inform myself and I found a supportive midwife but she said, “We aren't going to chance it to go to the hospital. We have to have the birth in your house.” We prepared everything for the home birth and the bad thing is that I was anxious at 39 weeks and had prodromal labor. I passed the due date. I was 41 and 42 and then 42.5 weeks so stress started to play a role here. I started labor but I passed three days in labor so that was really, really hard. I passed two days at 5 centimeters dilation. Then my midwife said, “I don't know what has happened. I think we can't wait anymore. You have to go to the hospital. Baby is good.” The heart rate was optimal but I didn't know what to do anymore. We went to the hospital. It was the only public hospital. Oh, the doctors were freaking out like, “What are you doing? Come on. You have to get the C-section 2 weeks before.” I suffered very, very much obstetric violence. It was very traumatic. Baby was very low. I was at 8 centimeters when I got to the hospital. I was begging for them to let me try and let me push but they said, “No. You are crazy. We have to go to the C-section right, right now.” When they pulled baby out, they broke the uterine artery and I lost a lot of blood. I was very weak and it was very painful. That was a disaster. We were like, “No more babies I think”, but by the grace of God, I got pregnant again in 2021. Sadly, I had a miscarriage on Christmas actually. It was very sad. But I don't know. That miscarriage let me know that my body works and that I would be able to have good contractions and my body was able to give birth. I prayed, “God, if you want, I want another baby.” In November of 2022, I got pregnant again and that time, I was totally strong to fight for another try to have a vaginal birth. My husband was totally against the trying. He was so scared. Also, I was a little bit scared, but I was trusting at that time. I was trusting so hard. I was praying so hard. I decided to not go to the doctor because I was so scared of the doctor. I was hesitant. I don't know why I didn't want to hear, “You are in danger. No. This is so dangerous. You can't try. You have to go directly at 38 weeks to the C-section and you have to have a blood transfusion and you are of advanced maternal age,” because I am 41 years old, but I don't know. I said, “I don't want that in my pregnancy.” Actually, I had a friend who had seven C-sections and then had four home births. She was telling me, “No. Trust God. You have to know when they talk from fear and when they talk from the truth.” I could tell that a lot of people were speaking to me from the fear they felt, not from the truth. I stayed with that doctor until 28 weeks. I found a doctor who wasn't judging me and who was open but he didn't have experience with VBAC after multiple C-sections so he said, “I can check you and support you but not in the birth. I can't do that. I have no experience.” Well, for me, it was like, “Oh, I'm at the beginning of the way.” Okay, so I kept praying and when I was 34 or 35 weeks in the pregnancy, I had a doula who gave me a contact of a midwife that she was supporting VBAC after three C-sections in a hospital with a doctor. I said, “Maybe there's a chance for me.” I contacted her. I talked to her and she was very optimistic. She said, “Yeah. Of course. I can support you. We can prepare a home birth. I can support you. I can be your attendant.” I don't know the word. Meagan: Maybe advocate? Susana: Not advocate. I mean, she was the one who received the baby. Meagan: Oh, like catching. Yeah, attending. Susana: Yeah, attending the birth. But my husband was like, “No, not a chance.” Because for my husband and also for me, it was very difficult and not secure. We were scared. We thought about what if something happened. That midwife told me, “I can speak with the doctor and maybe we can have a plan.” I said, “Okay.” I was 36 weeks so it could be difficult that he started to attend me in these late weeks. But I still had trust and confidence in God. I kept praying all of the time. One day, she called me and said, “Susana, good news. The doctor said yes. I told him all of the truths. I didn't hide anything and he said, ‘Okay. If you are with me, I can attend this birth. But I need to watch her in the next days.'” So we went to the doctor. The doctor was in another city 40 minutes to an hour away from here. My husband couldn't be with me so my parents went with me. My parents were so scared. Meagan: I bet. Meagan: They were very against trying. My husband wasn't completely confident about it. All of my environment was against the VBAC. When we went to the doctor, the doctor was so supportive and so humane and so good and so kind. He said, “We are going to try. We are going to make our best. We are a good team. The midwife and I work together very good and very successfully but I'm going to keep all of the team here if we need the C-section in the last moment.” We agreed on that. My parents were so relieved. We talked with my husband and he was relieved also but he also had doubts. But in the environment of a hospital and– oh, I don't know the word. The place where they make the C-section? Meagan: The operating room? Susana: Yeah, the operating room. In the side of the room, if everything was good, we trusted. He was supportive for the first time. He said, “Okay.” Two weeks passed after this visit and there was the moment when I started getting excited with things with labor. It was on the 11th of August last year in 2023 when I saw my mucus plug and the bloody show. I said, “Oh. I think things can be starting at any moment.” But in my last experience when I had the bloody show, it was two or three days before the labor really started. I patiently waited and the contractions started to be hardest but there was a half hour in between them. It was very manageable and still manageable. I passed the day with my normal activities. I had lunch with my parents and my five kids. I went to gymnastics class with my daughters and actually at night, we went to mass with friends and families that we know. A friend of ours invited us to dinner and I said, “No. I want to go home.” My husband was like, “What? You don't want to go anywhere.” My husband started to sense that something was wrong. We returned to home and contractions started to be closer and intense. I wrote to my midwife and she said, “Okay. You have to count how many contractions happen in one hour,” so I started counting and from 10:00 PM to 11:00 PM, I had nine contractions. I wrote her and she said, “Okay, you are starting. I'm going to go to your home.” By the way, she lives 2 hours from my city so she came to my place at 2:30 AM and checked me. I was only 3 centimeters and 60% effaced. She went and she said, “Oh, congratulations. You are a 3. We only have to wait 7 more.” She was so positive and so kind and so lovely. But for me, it was like, What? 3 centimeters. There's a long way to go. I was so disappointed and I started to have a crisis thinking, Okay. This is going to be three days of labor. It's starting to be unbearable. I don't know what I'm going to do. My husband told me, “You have to know that this is not going to be easy.” I was like, “Oh my god. What is going to happen?” I wrote a friend and she told me, “Maybe you were wrong. Maybe you are not in labor yet. Maybe it is prodromal labor so calm yourself and keep making your activities as normal.” I said, “Yeah, maybe that's true. Maybe I'm not in labor yet.” One of the things is that my contractions don't hurt in the uterus or in the belly. They hurt in the legs. Meagan: Oh. It radiates down. Susana: Exactly. I felt like it started in the hips and ran into the legs but I felt like– I don't know how to say– but a burning. Yeah. It was burning pain. It was very, very intense. My friend told me, “Put one leg on the chair and one leg on the floor and balance side to side while a contraction comes.” I made that and that was really, really helpful. I could have a contraction very easily that way. I was telling myself, “My pelvis can open. My baby can know how to birth. Everything is okay. God is with me,” and things like that. That affirmation worked very, very good because it calmed myself and that's how I passed the contractions all day long. Not the day, only the morning. My daughter, that morning, had a science fair so we decided it was at 8:00 AM so we went. It was the worst time for me having those contractions every seven minutes and very painful. All of the parents were like, “What is happening to her?” Meagan: That's amazing that you went. Susana: It was because I thought, I'm going to have three days in labor. My midwife had told me that when there's a labor after so many C-sections, there's a lot of times that it lasts three, four, or even five days so in my mind, that was my expectation. While I was at the science fair, I said to my husband, “Please take me home. Let's go home. I am in a lot of pain.” I called my midwife again and she came. She checked me and I was 6 centimeters so for me, I was like, “What? Whoa!” Yeah. She said, “We have to go to the hospital.” Oh, before that, we were planning to rent an AirBnB in the city which is Leon, Mexico to spend with all of the family those days that I was supposed to be in labor. So she said, “Forget about that plan. We will go directly to the hospital.” We called the doctor and the doctor said, “I need to check her with an ultrasound. You need to go to the office with me.” I thought it was useless, but we went to the office. It was the worst travel because I had contractions every 4 minutes and we were traveling in the van, but the good thing was that my midwife was making pressure on my hips and that released the pain. After 1 hour and 20 minutes, we arrived to the doctor. He checked me really fast and he said, “You are 6 centimeters.” Again, I was so disappointed because I thought, “Oh my god. One hour and I'm still a 6.” But my midwife told me, “No, I don't think so. I think you are maybe a 7 or an 8.”She is very wise. She had a lot of intuition. So we went to the hospital and it was 20 minutes away from the office. We arrived at the hospital at 12:35 PM. When we arrived at the hospital, he wanted to put me in an emergency room, but the doctor arrived immediately and told them, “No. Put her directly in a room because it was going to be a room birth.” I gave birth in a room, not in an operating room, but in a labor and delivery room. Meagan: They had you labor the rest of the way and give birth in the operating room?Susana: Yeah. In Mexico, all of the births happen in the operating room. Actually, it's not an operating room but it looks like it. It only has that stuff that they put the woman with the legs up. Yeah, I don't remember the name, sorry. Meagan: Like just the position? Susana: Yeah. Meagan: Okay, gotcha. Susana: So we went to the room. My midwife said, “Do you want to go to the shower?” I said, “Yeah, please.” I went to the shower. At that time, my water broke like a balloon because I felt something really big getting out. It was shocking and I was like, “What? Is that the placenta?” She said, “No, let me see what it is.” It was the amniotic sac almost complete. It was amazing because my midwife told me, “I've never seen something like this.” It was amazing. After that, the contractions felt very different with no pain and I started to feel to push. It was very different for me and very scary because I never felt something like that. Meagan: Right. Susana: My midwife told me, “You're going to birth now. You have to choose your position.” I stayed on my knees on the floor with the arms on the bed and started to push my baby out. I can say I didn't feel any pain in this moment. I only felt the pressure. I think I had the reflex, the fetal ejection reflex.Meagan: Yeah, mhmm. It's like where the baby just comes out. Susana: Yeah, because I wasn't pushing and my body was pushing. It was an amazing feeling but also, I was scared because I didn't know how to do that. My husband was praying with me and he was very supportive and very loving in that moment. That moment was awesome. I know God was there. I knew all my prayers were answered in this precious moment. I only let my body make its worth. I felt incapable of pushing a baby out. That was an amazing feeling. I don't know how to say it. It's like you are here but you are not. Meagan: Yeah. It's surreal. It's really– when you realize you're in that moment of pushing your baby out and I can't even imagine after five Cesareans, just that moment of, Wait, is this really happening? Susana: Exactly. It was like a dream. My husband was telling me, “Yes. You are so strong. You are telling me the truth. The miracle is done. Come on love. You can do it. You are so close.” I can't remember exactly but I think it was four or five pushes and baby was out. Baby had two wraps of the cord. Meagan: Double nuchal cord, okay. Susana: Yes. Then the body was out and it was a relieving feeling. It was magical. Everything was done. Every pain, every pressure, and every fear was gone. I felt that very warm and wet body in my arms. It was a magical moment like, I can't believe this is happening. Praise to God. I was crying. That moment was unlike any other moment in my life. Meagan: I can't even imagine. Wow. So was everyone very pleased and shocked? That's not a normal thing. For VBAC after one and two, it's like, okay. After three, providers are like, “I don't really know. Risks do go up so we are nervous about this,” so after five, how was your community around you?Susana: Yeah. They were very shocked. Actually, the hospital didn't allow VBAC after multiple C-sections, but the doctor said because in the lobby, they asked, “How many pregnancies and how many births? All those were natural births?” The doctor said, “Yeah.” Everything was happening very fast. After the baby was born, everyone was screaming, “Vaginal birth after five C-sections here!” The nurses and the doctor and the people in the lobby said, “What?! It's a miracle.” Everybody was so happy. Everybody was shocked. I don't know. It was amazing. Meagan: I'm sure they had a lot of feelings. I'm sure they were so happy for you and so shocked and even probably still questioning, “Wait, really did that just happen?” Because even we as a mom pushing in that moment, I think it's very much for the providers too, “Wait, is this happening?”Susana: Yeah, actually the doctors said the medical community was pretty– I don't know the word but they were saying, “What did you do? You didn't do another C-section? What's wrong with you?” They didn't do the episiotomy and I didn't tear at all. Meagan: Amazing. Susana: What else? He said, “It was a perfect birth.” Nothing went wrong. Nothing. So for him, for my doctor, he was very proud. He was not scared of sharing the evidence or the support and my case. Meagan: Right. He wasn't scared of sharing that he was supportive of you doing that. Susana: Exactly. He put on social media what we did. A lot of people were like, “What?” But he told me, “I only supported you because of your midwife because she is amazing. She is very wise. She has a lot of intuition. She had a good eye to know when it can happen and when not. Meagan: Yeah. Susana: She is awesome. Meagan: I wonder if they work together often now. Susana: Not too often because she usually goes to home births but when a couple wants a hospital or a VBAC, she works with him. Meagan: Oh my gosh. That's awesome that they can work together and it really truly makes it possible for those who want to. We know that not everybody will and we know that the risk is not acceptable for others. Susana: Right. Right, exactly. Meagan: Something that I love on ACOG, there is a website that is called acog.org so the American College of Obstetricians and Gynecologists so it's more here in the U.S. but there is a provider called Dr. Angelica Glover. She wrote an article on VBAC and one of the things that I enjoyed about her article was the very end. It says, “One size does not fit all. If you are pregnant and have a previous Cesarean birth, talk through all of these questions with your OB/GYN. Weigh the risks and benefits of each birth option like you would with any important healthcare decision.” I love that. Just like you would with any healthcare decision. It says, “Think of this as an ongoing conversation with your OB that starts early in pregnancy and evolves over time. Your feelings may change and your risk factors could change too. There is no one-size-fits-all answer when it comes to choosing between trying for a VBAC or a repeat Cesarean birth. What matters is that you are comfortable with your decision and you feel supported through your pregnancy and birth.” I love that because really in the end, VBAC after three, four, five, or whatever may not be comfortable for someone else but it may be for someone like you. Then the biggest factor is finding the support and we know that can be really hard so I love hearing that you had two providers who were on board with you, trusted you, and trusted the process. I do love that your midwife talked to you about how it can take time and you made it to 8 centimeters before right? Your body had done it. It just still needed time. It has gone through a lot and there was scar tissue and all of the things. It can take time, but you were allowed that time. You were allowed that time. They trusted you and they trusted themselves even. I am just so happy for you and I appreciate you sharing your story because it is one of those things that is really desired. A lot of people don't know it's an option then they find out and they are like, Wait, is this really possible?Yes, it is so it's really nice to hear a story here and there as they come along to show that yes. Women of Strength, it is possible. Are there risks? Yes. There are risks. Are they more than VBAC after one or two Cesareans? Yeah and honestly, we don't even know the exact evidence on specifically VBAC after five Cesareans because they are not studied and they are not happening. Susana: No, they are not but I can say that I read a lot. I found very good information from the Royal College of Gynecology and Obstetrics in the United Kingdom and it said that as a provider, you have to let the mom share if they want to try or do the repeat C-section, but always the vaginal birth is less risky than a repeat C-section especially after too many C-sections. Meagan: We do know that there are increased risks with repeat Cesareans as well. We know that is also very much a thing so we want to make sure that we are taking into consideration that as well because we've got issues where uterine rupture actually can also happen in a repeat Cesarean and that risk can be there. Bleeding and hysterectomy, there are risks that are sometimes actually higher for a Cesarean than a vaginal birth. It's just important to know all of the risks. I think sometimes we hyper-focus on the risk of VBAC instead of going through and looking at things. Evidence-Based Birth has such an amazing article and I think it was actually even a podcast episode on VBAC. She talked about how there are a ton of studies within here. She goes through the maternal outcomes here. Susana: That's awesome. Meagan: Yeah. It shows the maternal outcomes and the newborn outcomes. It says, “Maternal adverse events or bad outcomes were more frequent among women who had a C-section birth after Cesarean,” meaning they attempted a VBAC but it ended up in a Cesarean compared to those who had a VBAC. That's another risk. We have Cesarean risks. We have VBAC risks and then we have where we are going for a VBAC and it goes into a Cesarean. There is also risk there. We really need to just pause and stop and look at everything. I mean, literally, everything before we make a decision. There are so many times like with your first birth, there was so much going on. You had such an unfortunate event happening with the loss of your loved one and a provider was saying, “Oh, you're only at 3 centimeters and 60% effaced so this is probably not going to happen,” when in reality, that vaginal birth probably very much would have happened but we just didn't know. We didn't know. Susana: Yeah, totally. Yeah. Meagan: It's so hard because there are so many times where we hear these things from a provider. Me too. I did too. I was like, okay. We trust them and we don't want to not trust our provider but at the same time, we want to make sure that we do get informed. I'm so proud of you for along the way getting informed and learning about your options and I'm so happy for you that you were able to have your vaginal birth. Susana: Yeah, thank you. Thank you so much. I can say at least here, I think younger OB/GYNs are more open to support VBAC than the older OB/GYNs. I don't know how it is in the United States, but here, I think that is happening. Meagan: Yeah. I think it takes us all continuing to advocate for ourselves to have these providers stop and change their point of view because I believe that so many times, even if the evidence is there, there are so many times that it takes seeing it to believe it. You can look at a piece of paper and look at the evidence and you can see that, but at the same time, you're like, Okay, yeah. Sure. That probably can't happen, even though it's right there on the form, but seeing it really can change a lot of people's perspectives and just opinions. I think that is what you probably did to that entire hospital. Like you said, “Vaginal birth after five Cesareans in here!” Yeah. They were all blown away and you really did. You changed their perspective. Susana: Yeah. I am so happy to help another woman, to inspire, to read, to find information, real information. Don't let the doctors scare you. There is risk in all of pregnancy. It can be risky. Life is risky. Meagan: Life is risky. You're not wrong there. There is risk everywhere. It's just important to know the risk and then decide if that risk is acceptable to you. If that risk is acceptable to you, then great. Go for it. If not, that's okay. Susana: It is worth every moment and every pain. Everything, it was worth it. Meagan: Yeah. Well, I'm so happy for you. Congrats again and thank you for being with us today and sharing a VBAC after five Cesareans story. Susana: Oh, thank you so much. I'm so happy and I hope that a lot of women hear this podcast and are inspired themselves. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

It's been two years since the U.S. Supreme Court overturned the right to an abortion, triggering a parade of restrictions and bans in conservative-led states. Today on the show, how the medical labor force is changing post-Roe and why graduating medical students, from OB-GYNs to pediatricians, are avoiding training in states with abortion bans. Related listening: What's the cure for America's doctor shortage? KFF: Medical Residents Are Increasingly Avoiding Abortion Ban States For sponsor-free episodes of The Indicator from Planet Money, subscribe to Planet Money+ via Apple Podcasts or at plus.npr.org. Music by Drop Electric. Find us: TikTok, Instagram, Facebook, Newsletter. Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy