Podcasts about OBS

Forhjulslir præsenteres i samarbejde med Continental Dæk Danmark. Med Continental får du maksimal ydeevne og kontrol – uanset om du cruiser på landevejen eller flyver ned ad bjergene. Gør som Pogačar – og kør med dæk, der er klar til sommerens eventyr. Sikkerhed starter med dækket. Forhjulslir på hjul af Giro d'Italia 2025. En podcastserie under Giroens hviledage med reaktioner og indtryk umiddelbart efter etaperne - set fra en reporters synspunkt samt diverse gæster, eksperter, eksprofessionelle og journalister som er på hjul af Giro-cirkusset. 'Anden uge' strækker sig fra 10. etape i Lucca/Pisa og Toscana og til 15. etape, hvor Carlos Verona tog Lidl-Treks sjette etapesejr i løbet.   Medvirkende: De gode folk fra Eurosport - heriblandt Simon Geschke og Anders Lund.  Stort tak til WB. Discovery / Eurosport, Continental Dæk Danmark, Danish Endurance, Pillar Performance og støtterne på 10er.dk.  OBS. Størstedelen af afsnittet er på engelsk.  Danish Endurance er partner på Forhjulslirs Giro-dækning. Tjek deres nye cykelkollektion – skabt til ryttere, der vil kombinere stil, komfort og performance. Brug koden Forhjulslir10 og få 10 % rabat. Find dem på Instagram @danish.endurance eller ved at trykke her.  Dette afsnit er præsenteret i samarbejde med PILLAR Performance. Ved brug af rabatkoden "Forhjulslir" får du en eksklusiv rabat på 15%, når du handler for første gang på https://pillarperformance.eu/

Explanation of three methods for capturing screenshots for your game. 1. Print Screen key 2. Snipping tool 3. OBS with VLC (VideoLAN). How to use Gimp to crop and scale a screenshot image to the desired size. Links and Notes Open Broadcaster Software (OBS) – https://obsproject.com/ VideoLAN, VLC media player – https://www.videolan.org/ Gimp (GNU Image … Continue reading Screenshots – Knox Game Design, May 2025 →

Video podcasting is booming—but let's be honest: most people are overspending. Between expensive gear, post-production burnout, and trying to emulate studio-level shows, many creators discover the cost just isn't sustainable.In this episode, I break down how to launch a high-quality video podcast as cheaply as possible, especially with a remote-first setup. This isn't a step-by-step tutorial—it's a strategic overview of tools and mindset. The key? Think “live-to-tape.” That means doing as much of the production live as possible, then adding only essentials like intros, ad breaks, and end cards in post. This approach minimizes time, cost, and complexity.I walk through options like OBS (free and powerful), VDO.Ninja (for remote guest routing), Streamyard (simple and intuitive), and vMix (pro-level live switching). Each has strengths—and knowing what fits your needs is half the battle.

Uncle keeps riding the wave of his new TikTak with new customers in the Crack Room, and a first time caller.  Topics include: the comedy hour, wrestlers, Bencha Mentura, vertigo, new water bottle, digital slider down in OBS, sound settings, pressing buttons, knobs, phone calls, TikTak followers, food videos, 3D printing, pig organs transplanted into humans, NFL schedule released, fish tacos in California, Chargers game in Brazil, prank call, Seinfeld episode with Kramer talking about Pig Man, shout outs

Forhjulslir præsenteres i samarbejde med Continental Dæk Danmark. Med Continental får du maksimal ydeevne og kontrol – uanset om du cruiser på landevejen eller flyver ned ad bjergene. Gør som Pogačar – og kør med dæk, der er klar til sommerens eventyr. Sikkerhed starter med dækket. Forhjulslir på hjul af Giro d'Italia. En podcastserie under Giroens hviledage med reaktioner og indtryk umiddelbart efter etaperne - set fra en reporters synspunkt samt diverse gæster, eksperter, eksprofessionelle og journalister som er på hjul af Giro-cirkusset. 'Første uge' strækker sig fra 1. etape i Albanien og til 9. etape til Piazza del Campo i Sienna.  Medvirkende: De gode folk fra Eurosport - heriblandt Jens Voigt og Anders Lund.  Stort tak til WB. Discovery / Eurosport, Continental Dæk Danmark, Danish Endurance, Pillar Performance og støtterne på 10er.dk.  OBS. Størstedelen af afsnittet er på engelsk.  Danish Endurance er partner på Forhjulslirs Giro-dækning. Tjek deres nye cykelkollektion – skabt til ryttere, der vil kombinere stil, komfort og performance. Brug koden Forhjulslir10 og få 10 % rabat. Find dem på Instagram @danish.endurance eller ved at trykke her.  Dette afsnit er præsenteret i samarbejde med PILLAR Performance. Ved brug af rabatkoden "Forhjulslir" får du en eksklusiv rabat på 15%, når du handler for første gang på https://pillarperformance.eu/

[@2 min] Alright, this week…we go Inside the Huddle with Patricia Racette! The newly appointed Artistic Director of Opera Theatre of St Louis returns to the OBS to share her strategy for storytelling and shaping the future of her new home company. [@41 min] And then...a Field Report from The Met's Barber of Seville, described by our on-the-ground correspondent as a Money Machine... [@43 min] Plus, in the ‘Two Minute Drill'…Opera Philadelphia's $11 dollar tickets are back and the 2025 Richard Tucker Award winner is announced. It's a great time for opera in America. No obstacles or challenges for artists at all…. GET YOUR VOICE HEARD operaboxscore.com facebook.com/obschi1 operaboxscore.bsky.social

Denne uka deler vi noen av våre favoritter til 17.mai frokost og andre koldtbord anledninger. Kanskje noen kan la seg inspirere til å lage noe av det samme? Salater og dressinger og annen fargerik snacks, simple as that, - kos dere med feiring på den store dagen!Obs! Silje deler oppskrift på tzatziki og nevner "gresk salat" som en ingrediens, men hun mener selvsagt gresk yoghurt! Whoops! Hosted on Acast. See acast.com/privacy for more information.

Hej, kära lyssnare! Avslutning med Morgan! "Bilringar och Äpplen" Vill också påminna om att ALLA avsnitt, i sin HELHET, och UTAN reklam, finns tillgängligt gratis, bara att gå in på underproduktion.se klicka in på Morgansoffan och aktivera en livstids "prenumeration" för 0 kronor. OBS! Helt gratis. Inga pengar dras, varken nu eller i framtiden. Tipsa gärna vänner och bekanta. Alla är välkomna. Soffan står där den står... Och vill du ha nyhetsbrev från Morgan i framtiden, så dra iväg ett mejl till morgansoffan@gmail.com Vi hörs! Morgan

Världens största musiktävling startar i Basel men hur väl lyckas EBU med att hålla politiken utanför arenan? Lyssna på alla avsnitt i Sveriges Radio Play. Efter förra årets tävling i Malmö som kantades av demonstrationer och politiska budskap, där Israels medverkan blev en vattendelare, riktas nu Europas strålkastare mot schweiziska Basel. Vilken roll spelar politiken i tävlingen i år – och kan Eurovision överleva i ett allt mer splittrat Europa?Samtal med P3:s kulturreporter Esfar Ahmad och idéhistorikern Andreas Jahrehorn Önnerfors.TRUE CRIME I SERIEFORMAT I NY BOKEn morgon i september 1999 hittas en övergiven bil och tre livlösa kroppar i utkanten av ett strövområde i nordvästra Skåne. Rubriken på TT-telegrammet konstaterar: "Tre män funna mördade i Klippan" – och så heter också en ny serieroman av Max Hebert och Steve Nyberg. De gästar P1 kultur för att berätta varför de ville göra true crime på ett nytt sätt.DRAMATENPJÄS UTFORSKAR VÅLDETS EFFEKTERBrittiska dramatikern Alice Birchs pjäs ”Blank” är en mosaik av berättelser som alla skildrar konsekvenserna av våld. Kulturredaktionens Jenny Teleman har sett den och gästar studion.JAZZRADIONS BÄSTA TIPSMäret Öman från Jazzradion i P2 tipsar om ett nytt album med gruppen Cosmic Ear.ESSÄ OM ANDRA VÄRLDSKRIGET SOM FARSFör vissa författare blev komedin det enda möjliga svaret på andra världskrigets tragedi. Mattias Hagberg funderar över hur trauma går ihop med fars i dagens OBS-essä.Programledare: Eskil Krogh LarssonProducent: Karin Arbsjö

Hej, kära lyssnare! Avslutning med Rasmus! Vill också påminna om att ALLA avsnitt, i sin HELHET, och UTAN reklam, finns tillgängligt gratis, bara att gå in på underproduktion.se klicka in på Morgansoffan och aktivera en livstids "prenumeration" för 0 kronor. OBS! Helt gratis. Inga pengar dras, varken nu eller i framtiden. Tipsa gärna vänner och bekanta. Alla är välkomna. Soffan står där den står... Och vill du ha nyhetsbrev från Morgan i framtiden, så dra iväg ett mejl till morgansoffan@gmail.com Vi hörs! Morgan

Hej! Avslutning med gänget! Petra, Erika och David. Vill också påminna om att alla avsnitt, i sin helhet, utan reklam, finns tillgängligt gratis, bara att gå in på underproduktion.se klicka in på Morgansoffan och aktivera en livstids "prenumeration" för 0 kronor. OBS! Helt gratis. Inga pengar dras, varken nu eller i framtiden. Tipsa gärna vänner och bekanta. Alla är välkomna. Soffan står kvar där den står... Och vill du ha nyhetsbrev från Morgan i framtiden, så dra iväg ett mejl till morgansoffan@gmail.com Vi hörs! Morgansoffpotatisarna

Welcome to Super Game Brothers, a family-friendly video game and board game podcast. The weekly agenda covers the board games and video games we played in the last week, industry news, and the games in crowdfunding that stand out to us. This week, we lost one third of the episode due to OBS not liking us. Know that we did have crowdfunding corner, talk about GTA 6, and everything else... you just won't get to hear it. Thanks for listening and laughing with us! Make sure to check us out on Patreon for exclusive episodes, early access, and other perks. Patreon - https://www.patreon.com/SuperGameBrothers Timestamps: 00:00:00 - Intro 00:06:08 - Super Movie Brothers 00:26:45 - Patreon shoutout & Giveaway 00:28:42 - Digital vs physical board games 00:31:06 - New games to subscription services 00:46:55 - Video Game Update / Clair Obscure: Expedition 33, Blue Prince, Red Dead Redemption 2, & Resident Evil 4 Remake 00:55:52 - We're Most Excited About... Space Marine 2, Iliad, and Ichor 01:00:12 - The Great Crash of 2025 Join our giveaway at https://www.supergamebrothers.com. The links below help support our show, without costing you any more: Video games we talked about: Blue Prince Clair Obscur: Expedition 33Red Dead Redemption 2 Resident Evil 4 Board games we talked about: Iliad Ichor Thanks so much for stopping by! Your support is what makes our show possible.

Dagens avsnitt handlar om sidenvägen. Handelsvägen mellan öst och väst som i över ett årtusende var navet i världsekonomin. Här såldes dyrbara varor såsom guld, porslin, papper, kryddor, färgämnen och såklart den mest eftertraktade varan av dem alla - siden. Gäst är Ingemar Ottosson, docent i historia vid Lunds universitet och författare till en bok om sidenvägen. Vi samtalar om sidenvägens tillblivelse, om resterna av utdöda civilisationer och fantastiska grottfynd, om Marco Polos förmodade bluffresor längs sidenvägen till Kina, om svenske upptäcktsresanden Sven Hedins fynd utmed sidenvägen och slutligen om kinesiska planer på att väcka liv i handelsrutten på nytt.Bli medlem på Patreon: https://www.patreon.com/bildningskomplexet för 37 kr/mån och få exklusiva avsnitt och övriga avsnitt reklamfritt före alla andra. OBS! Du som har iPhone se till att köpa medlemskapet direkt på Patreons hemsida och inte i deras app eftersom Apple då tar en extra avgift. Det går också bra att stötta podden på SWISH på 0709262541.Instagram: https://www.instagram.com/bildningskomplexet/ Facebook: https://www.facebook.com/BildningskomplexetE-post: benjaminelfors@gmail.comMusikproduktion: Ivar EddingOmslag: Emma Westin/Matthew Sundin Hosted on Acast. See acast.com/privacy for more information.

Не одними рукисами живём - поговорим в целом от том кто выиграл и проиграл по итогам драфта, а также обсудим последние новости и слухи по трейдам и подписаниям.Состав: • Влад vladsmit.  Многократный стеройдный чемпион еженедельного фэнтэзи казино и ведущий канала Benchwarmers (https://t.me/benchwarm ) • Саша Illmatic. Резидент всем известного FFF (фэнтэзи нюдсы искать на https://boosty.to/fff27 :))) • Артём Mraka. Жму кнопку в OBS и перебиваю экспертов. NFLRUS Fantasy (https://t.me/nflrusfan ) Если вы любите фентази и НФЛ, присоединяйтесь к нам в телеграм, у нас есть свой канал с новостями о фентази, а так же свой чат.#nfl #fantasy #fantasyfootball #НФЛ

Rubrique:contes Auteur: hans-christian-andersen Lecture: Daniel LuttringerDurée: 10min Fichier: 7 Mo Résumé du livre audio: Obsédé par ses habits, le grand-duc se laisse duper par deux fripons qui prétendent tisser une étoffe invisible aux incompétents. Curieux de savoir qui dans son gouvernement est incapable, il leur donne de l'argent, mais les escrocs feignent de travailler avec une étoffe inexistante... Cet enregistrement est mis à disposition sous un contrat Creative Commons.

Too many couples are ready to start a family—only to discover unexplained infertility and dead-end solutions. What does conventional medicine offer? Birth control to "regulate" cycles, IVF to override nature, and little interest in the root causes. Meanwhile, couples spend tens of thousands and deal with painful side effects, confusion, and heartbreak. On today's show, Dr. Marguerite Duane reveals what most OBs completely ignore: natural, effective tools for diagnosing and healing the real causes of infertility. From cervical fluid tracking to simple nutrition and lifestyle changes, this is the empowering, science-backed approach everyone deserves to know. Whether you're trying to conceive, supporting a partner, or just care about real healthcare, this episode is a game-changer. It's time to reclaim fertility, restore health, and demand better care. FACTS Website: https://www.factsaboutfertility.org/NEW: Join our exclusive Rose Report community! https://lilaroseshow.supercast.com - We'll have BTS footage, ad-free episodes, monthly AMA, and early access to our upcoming guests.A big thanks to our partner, EWTN, the world's leading Catholic network! Discover news, entertainment and more at https://www.ewtn.com/ Check out our Sponsors:-Cozy Earth: Better Sleep, Brighter Days - Get the highest quality sleep essentials for 40% OFF at https://cozyearth.com/lila!-Hallow: https://www.hallow.com/lila Enter into prayer more deeply this Easter with the Hallow App, get 3 months free by using this link to sign up! -EveryLife: https://www.everylife.com Buy diapers from an amazing pro-life diaper company and use code LILA and get 10% off!00:00:00 - Intro00:02:44 - About FACTS00:04:30 - The exact day she wanted to go into medicine00:08:47 - Medical Response Was Ecstatic 00:09:11 - Cozy Earth00:10:02 - The start of FACTS00:11:37 - The Pill doesn't get at root cause:00:21:53 - Hallow00:22:50 - What is the 5th vital sign?00:25:14 - Birth Control for Acne00:32:46 - Informed Choice is Essential00:37:00 - Fertility-based Awareness 00:42:07 - Can Birth Control operate as an abortifacient?00:50:54 - IVF and Infertility00:54:20 - Why do miscarriages happen?01:06:19 - Advice for fertility:01:08:30 - NFP Methods:

At NAB Show 2025, OBSBOT showcased the upgraded Tail 2 camera, featuring 5x optical and 12x total zoom, improved AI tracking, integrated I/O ports, and a rotating lens for full-resolution vertical video. It offers 4K60 video, six-hour battery life, and NDI support, making it a powerful all-in-one solution for mobile and studio streaming. Senior Partner and Customer Experience Manager Stefan Yang tells us all about it. Show Notes: Chapters:0:09 NAB Show 2025 Overview 01:41 Osbot TEL2 Features 04:09 Innovative AI Tracking 05:59 All-in-One Streaming Capabilities 06:37 Where to Learn More Links: OBSBOT Tail 2 PTZR NDI Camera 4K@60FPS Camera https://amzn.to/438MNf0 Support:      Become a MacVoices Patron on Patreon      http://patreon.com/macvoices      Enjoy this episode? Make a one-time donation with PayPal Connect:      Web:      http://macvoices.com      Twitter:      http://www.twitter.com/chuckjoiner      http://www.twitter.com/macvoices      Mastodon:      https://mastodon.cloud/@chuckjoiner      Facebook:      http://www.facebook.com/chuck.joiner      MacVoices Page on Facebook:      http://www.facebook.com/macvoices/      MacVoices Group on Facebook:      http://www.facebook.com/groups/macvoice      LinkedIn:      https://www.linkedin.com/in/chuckjoiner/      Instagram:      https://www.instagram.com/chuckjoiner/ Subscribe:      Audio in iTunes      Video in iTunes      Subscribe manually via iTunes or any podcatcher:      Audio: http://www.macvoices.com/rss/macvoicesrss      Video: http://www.macvoices.com/rss/macvoicesvideorss

Omar kontaktar utomjordingar. Ashkan drömmer om China Town. Mustafa fantiserar om Rambo. Chang vill knipsa upp hänglås. Hanif är skeptisk.OBS. Hela avsnittet är 2 tim 25 min. Vill du få tillgång till alla hela avsnitt? Bli medlem på Sista Måltiden. Som medlem får du tillgång till alla nya och gamla avsnitt i sin helhet och utan reklam. Lyssna i valfri podcast-app, inklusive Spotify. Enkelt att komma igång. Ingen bindningstid. Tryck här för att bli medlem eller gå in på https://sistamaltiden.se.  Hosted on Acast. See acast.com/privacy for more information.

Laura Ojeda, directora de Personas del RACC, conversa con la decana de OBS Business School sobre los retos de la gestión del talento en la era digital, en una nueva entrega del videopodcast de OBS y Onda Cero.

OBS. I episoden siger jeg at Aalborg karneval afholdes den 25. maj 2025, men det er forkert. Det afholdes dagen før, den 24. maj. Velkommen til “Dansk i ørerne” - en podcast på dansk, til personer med et andet modersmål end dansk. Denne podcastserie består af korte afsnit, hvor jeg på langsomt og tydeligt udtalt dansk, vil fortælle om emner med relation til Danmark og danskere. Målgruppen er skandinavere, og personer på DU2Mo5-6, samt DU3Mo3-6 (A2-B2). Du finder teksten til episoderne på www.danskioererne.dk. Hvis du har feedback eller forslag til episoder, kan du sende en mail til podcast@danskioererne.dk. Du kan støtte podcasten og finde ordlister og “level 2”-udgaver af episoderne her: www.buymeacoff.ee/danskioererne Tak fordi du lyttede med!

Paulina Neuding är en svensk journalist och jurist. Hon har tidigare varit chefredaktör för magasinet Neo och Kvartal, samt webbtidningen Bulletin. Idag är hon verksam på Svenska Dagbladets ledarsida. OBS. Hela avsnittet är 2 tim 59 min långt. Vill du få tillgång till alla hela avsnitt? Bli medlem på Sista Måltiden. Som medlem får du tillgång till alla nya och gamla avsnitt i sin helhet och utan reklam. Lyssna i valfri podcast-app, inklusive Spotify. Enkelt att komma igång. Ingen bindningstid. Tryck här för att bli medlem eller gå in på https://sistamaltiden.se.  Hosted on Acast. See acast.com/privacy for more information.

In this episode of the Optimal Body Podcast, hosts Doc Jen and Doctor Dom explore the crucial role of doulas in the birthing process with Kelsey and Aurora from Soul Shine Birth. They discuss how doulas provide emotional, physical, and educational support during pregnancy, labor, and postpartum. The conversation highlights the benefits of having a doula, such as improved birth outcomes and a more empowered birthing experience. Kelsey and Aurora emphasize the importance of advocacy in hospital settings and the value of personalized care. They also introduce their comprehensive birth and postpartum courses, offering listeners a discount code for further learning.Jen Health Annual Membership Discount:Don't miss out! We are having a massive discount on our Annual Membership on Jen Health! As our podcast listener, you'll get the best discount of all using code OPTIMAL10 at checkout! If you've been considering getting started on one of our 12 Therapy Plans, now is the time! You'll get over a 50% discount when you use OPTIMAL10 to start your free trial of the Annual Membership. Come move with us!Needed Discount:Although the journey of pregnancy is so personal and individual, Jen's number one question goes back to what she did to help her conceive and maintain the pregnancy. While there were a myriad of factors that contributed, she reliably counted on Needed supplements that supported her journey! Men need support as well via sperm support and men's multivitamins. While women are supported by egg quality supplementation, CoQ10, prenatal Omega 3, iron, and choline in tablet or powder form. Used by over 4000 health professionals, Needed is available to support pregnancy, fertility, and postpartum, as well as women's and men's health in general. Check out needed if you know there's a gap in your nutrition via code ⁠⁠OPTIMAL⁠⁠ for 20% off.Soul Shine's Resources and Links:Soul Shine's WebsiteSoul Shine's InstagramSoul Shine's BlogGet $50 off any of Soul Shine's in person or virtual services with code OPTIMALBODY.We think you'll love:Jen Health Membership DiscountJen's InstagramDom's InstagramYouTube ChannelFor full show notes and resources, visit: https://jen.health/podcast/405What You Will Learn From Kelsey and Rori:3:27 Jen shares her positive experience with doulas and their role in birth support.5:01 Discussion on the definition and historical context of doulas.7:53 Kelsey explains the difference between doulas, midwives, and OBs.10:08 Kelsey shares data showing improved birth outcomes with doula support.11:40 Discussion on how doulas support partners during the birthing process.15:15 Discussion on how doulas advocate for mothers in various birth environments.18:22 Discussion on how interventions can lead to cesarean sections and the importance of informed choices.20:59 Selecting a supportive provider is crucial for a positive birth experience and aligning with birth preferences.24:57 Choosing the right provider impacts birth outcomes; midwives often have lower intervention rates than OBs.27:52 Choosing a doula should be about connection and comfort, not just certifications or experience.33:41 Overview of the services provided by Soul Shine doulas, including personalized support options.35:16 Insights into stages of labor, challenges, and how partners can support during birth.37:27 Sharing personal experiences about the challenges and joys of new parenthood.39:35 Exploration of how doulas assist families in developing flexible birth plans.45:31 Discussing options for families concerned about the costs of hiring a doula.

very important information this episode is that OBS is the software we use to screen-record for the video feed and also people use it to livestream COME TO OUR LIVE SHOW IN BROOKLYN ON APRIL 26TH WITH SPECIAL GUEST BEN DOYLE (JET LAG: THE GAME) https://www.eventbrite.com/e/quorators-afternoon-delight-tickets-1290256224099 --- Comedians Clare O'Kane, Alex Ptak, and Jeremy Kaplowitz explore the mysterious land of Quora.com to answer life's questions. This week's questions include: If you die in your sleep, do you realize that? How can I help my dad avoid prison? Does alcoholism help you accept your lot in life? --- Get even more Quorators when you support the show @ patreon.com/quorators Send quoras and qommunicate on our discord discord.gg/7pPYuKuYCr Watch the show @ youtube.com/@quorators

Martin Kinnunen är riksdagsledamot och Sverigedemokraternas miljöpolitiska talesperson. OBS. Det här är inte hela avsnittet. Vill du få tillgång till alla hela avsnitt? Bli medlem på Sista Måltiden. Som medlem får du tillgång till alla nya och gamla avsnitt i sin helhet och utan reklam. Lyssna i valfri podcast-app, inklusive Spotify. Enkelt att komma igång. Ingen bindningstid. Tryck här för att bli medlem eller gå in på https://sistamaltiden.se.  Hosted on Acast. See acast.com/privacy for more information.

Peter Springare är före detta polis och tidigare förundersökningsledare hos Örebropolisen och medgrundare till Örebropartiet. I februari 2017 skrev Peter ett inlägg på Facebook som kom att förändra hans liv för alltid.OBS. Hela avsnittet är 2 tim 40 min långt. Vill du få tillgång till alla hela avsnitt? Bli medlem på Sista Måltiden. Som medlem får du tillgång till alla nya och gamla avsnitt i sin helhet och utan reklam. Lyssna i valfri podcast-app, inklusive Spotify. Enkelt att komma igång. Ingen bindningstid. Tryck här för att bli medlem eller gå in på https://sistamaltiden.se.  Hosted on Acast. See acast.com/privacy for more information.

Send us a textPostpartum weight loss isn't what you think it is.We're pulling back the curtain on one of the most misunderstood and misrepresented topics in postpartum health: women's weight. Dr. Beth Westie is here to set the record straight and blow your mind. If you're a provider still talking about “getting your body back” or encouraging calorie restriction after birth—stop what you're doing and listen in.In this episode, we talk about the difference between healing and shrinking, why the weight loss industry fails postpartum women, and how most “health advice” is based on studies done on men. You'll hear how under-eating, fat restriction, and stress can derail hormone health for years, and why functional medicine and body literacy are the future of postpartum care. This is a conversation every provider needs to be part of.Check out the episode on the blog: https://postpartumu.com/podcast/why-women-need-fat-the-truth-about-hormones-weight-loss-dr-beth-westie-ep-211/Key Time Stamps: 00:00 – Intro: Breaking the postpartum weight stigma 01:11 – Meet Dr. Beth Westie and her work in hormone-based healing 02:00 – Differentiating real support from toxic weight loss advice 04:36 – The male bias in nutrition, fitness, and medical research 08:25 – Why postpartum women need more fat, not less 12:23 – The role of stress, depletion, and unmet needs in healing 16:30 – Why most OBs aren't trained in hormones or root cause care 19:04 – Hyperthyroidism, nutrient deficiencies, and missed diagnoses 27:15 – The normalization of postpartum dysfunction 28:48 – How we shift from symptom acceptance to real prevention 29:32 – Dr. Beth's work in hormone testing and functional care 30:49 – Where to find Dr. Beth + bonus podcast episode linkNEXT STEPS:

Camille, alias Noholita, fait partie des premières à avoir transformé un compte Instagram en véritable empire.Aujourd'hui suivie par plus d'un million de personnes, elle est devenue une figure incontournable du monde de l'influence.Mais rien n'a été facile, ni donné.Issue d'un milieu modeste, Camille enchaîne les petits boulots très jeune.Obsédée par l'idée de gagner sa vie, elle jongle entre un job étudiant chez Leclerc, une alternance, ses études en communication… et les réseaux sociaux.Elle lance un blog. Elle partage sans relâche. Et ça commence à prendre.Le jour où elle gagne enfin assez grâce à l'influence, elle lâche tout : ses études, ses plans, sa "sécurité".Elle part s'installer à Paris. Et tout s'accélère : les collabs, la croissance, l'indépendance.Depuis, Camille a lancé (et fermé) plusieurs entreprises, elle partage sa vie entre Paris et Ibiza, et elle continue d'inspirer par son audace, sa transparence et sa capacité à se réinventer.Pourquoi écouter cet épisode ?

Snyggbonde™ från Twitter/X gästar gänget. Per-Ola är bonde och ledarskribent på allehanda tidningar. OBS. Det här är inte hela avsnittet. Vill du få tillgång till alla hela avsnitt? Bli medlem på Sista Måltiden. Som medlem får du tillgång till alla nya och gamla avsnitt i sin helhet och utan reklam. Lyssna i valfri podcast-app, inklusive Spotify. Enkelt att komma igång. Ingen bindningstid. Tryck här för att bli medlem eller gå in på https://sistamaltiden.se.  Hosted on Acast. See acast.com/privacy for more information.

On the latest NFL Players: Second Acts podcast, former Pro Bowl running back Steven Jackson joins hosts Peanuts and Roman. Steven discusses his running style and shares the types of running plays that helped him become the Rams all-time leader in rushing yards. He also explains the significance behind wearing jersey number 39 and how it felt to lose in the AFC Championship game in his final season. Steven discusses his post-NFL ventures, including opening a barber school, starting the NFL Legends YouTube channel, and his apparel company OBS. The NFL Players: Second Acts podcast is a production of the NFL in partnership with iHeart MediaSee omnystudio.com/listener for privacy information.

On the latest NFL Players: Second Acts podcast, former Pro Bowl running back Steven Jackson joins hosts Peanuts and Roman. Steven discusses his running style and shares the types of running plays that helped him become the Rams all-time leader in rushing yards. He also explains the significance behind wearing jersey number 39 and how it felt to lose in the AFC Championship game in his final season. Steven discusses his post-NFL ventures, including opening a barber school, starting the NFL Legends YouTube channel, and his apparel company OBS. The NFL Players: Second Acts podcast is a production of the NFL in partnership with iHeart MediaSee omnystudio.com/listener for privacy information.

Coming up in this episode * The Thunder rolls * We flatten out the History * And Package Up Our Experience 0:00 Cold Open 1:34 Thundermail for Everyone! 23:21 The History of Flatpak - 24:32 From Glick to Bundles - 29:55 From Bundles to xdg-app - 30:54 From Flatpak to the Future! 37:44 Are Flatpaks the Best Solution? 1:02:46 Next Time 1:05:14 Stinger The Video Version (https://youtu.be/_fXr6fCPJ8U) https://youtu.be/_fXr6fCPJ8U Thundermail The Thundermail announcement (https://blog.thunderbird.net/2025/04/thundermail-and-thunderbird-pro-services/)

Hanif är orolig för Liberalerna. Chang har fått nog av samer. Mustafas rötter hinner ikapp honom. Omar har sett en tv-serie. Ashkan gillar Kramer mer än George. OBS. Det här är inte hela avsnittet. Vill du få tillgång till alla hela avsnitt? Bli medlem på Sista Måltiden. Som medlem får du tillgång till alla nya och gamla avsnitt i sin helhet och utan reklam. Lyssna i valfri podcast-app, inklusive Spotify. Enkelt att komma igång. Ingen bindningstid. Tryck här för att bli medlem eller gå in på https://sistamaltiden.se.  Hosted on Acast. See acast.com/privacy for more information.

Erik J. Olsson är professor i teoretisk filosofi vid Lunds universitet och forskar inom kunskapsteori, internetanvändning och akademisk frihet. Han har grundat Academic Rights Watch och är just nu tillsammans med Catharina Grönqvist Olsson aktuell med boken Den mjuka staten - Feminiseringen av samhället och dess konsekvenser. OBS. Det här är inte hela avsnittet. Vill du få tillgång till alla hela avsnitt? Bli medlem på Sista Måltiden. Som medlem får du tillgång till alla nya och gamla avsnitt i sin helhet och utan reklam. Lyssna i valfri podcast-app, inklusive Spotify. Enkelt att komma igång. Ingen bindningstid. Tryck här för att bli medlem eller gå in på https://sistamaltiden.se.  Hosted on Acast. See acast.com/privacy for more information.

Looking to get started streaming or looking for an alternative to OBS?  Consider checking out Meld, a newer option with a slick and simple look!  We go into more details.  Looking to find out more information about subs on Twitch and all of the different promotions?  We have you covered there too!  We also touch on community and coop streaming.  How does it affect views and donations?  Go give us a listen and find out!Follow Alex and Jeremy on Twitter for updates and feel free to interact with us.  We are all very responsive and love feedback, so hit us up!  In Bed By 9 Linktree:  https://linktr.ee/ibb9podcastIn Bed By 9 Merch:  https://inbedby9-shop.fourthwall.com/?Twitter Handles:Alex: @DiabolicTutor01 Jeremy: @jeremycunnings1In Bed By 9:  @InBedBy9PodcastTwitch Channels:Alex: https://www.twitch.tv/diabolictutor01Jeremy: https://www.twitch.tv/jeremycunningsBe sure to leave us a review on Spotify, Apple, or anywhere you get your podcasts!  Be sure to check out our merch store and pick up some cool creator gear.

Ashkan vill inte optimera. Omar försvarar matjättarna. Hanif vill veta hur Ashkan mår. Chang vill inte veta hur någon mår. Mustafa lyssnar. OBS. Det här är inte hela avsnittet. Vill du få tillgång till alla hela avsnitt? Bli medlem på Sista Måltiden. Som medlem får du tillgång till alla nya och gamla avsnitt i sin helhet och utan reklam. Lyssna i valfri podcast-app, inklusive Spotify. Enkelt att komma igång. Ingen bindningstid. Tryck här för att bli medlem eller gå in på https://sistamaltiden.se.  Hosted on Acast. See acast.com/privacy for more information.

In this special episode, Kristin, host of Ask the Doulas podcast and founder of Gold Coast Doulas,  gives tips on building your supportive birth team. Krisin and Meagan talk specifics on HOW to switch providers if you're feeling the push to do so.Once we have our dream team, we're good and don't have to do any more work, right? Nope! We keep educating and preparing ourselves. That's the way to truly get the most out of that dream team. Kristin's book ‘Supported: Your Guide to Birth and Baby' is a one-stop shop where you can get all of the education you need for pregnancy, birth, and postpartum. Her advice is so valuable for VBAC moms and birth workers, too!Supported: Your Guide to Birth and BabyAsk the Doulas PodcastNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello. Hello. We have a special episode for you today. We have my friend, Kristin, who is actually the owner of Ask the Doulas Podcast on with us today. She is going to be talking about establishing our birth team and the importance of it. We're going to talk a little bit more about what to expect when we might not find a provider that's supportive and how to navigate it. She's going to talk more about her book and so many things. You guys, I'm really excited. Kristin is a woman who has always had a passion for supporting other women both personally and professionally. In college, Kristin served on the executive committee of her sorority and organized events on campus related to breast cancer and other women's issues. After the birth of her daughter in 2011, a new passion awoke within her. Kristin began reading and studying birth from all perspectives, philosophies, and medical approaches. She joined organizations like The Healthy Kent Breastfeeding Collation and used her event coordinating skills to build and promote the organization and create community awareness. You guys, she has done so many incredible things. Kristin's research has led her to learn more about doulas, and in 2012, she hired doulas herself for the support of her second birth. The level of compassionate care and comfort that she received from her doulas ignited a spark within her and led her down the path of becoming a doula herself. And man, can I connect to this because this is exactly what happened to me. When you guys have a doula who inspires you and touches you and motivates you the way it sounds like Kristin did and I did, even though my doula wasn't a hired doula, she was just a nurse that was a doula for the time being, it does something to you. She earned the certification and became teaching sacred pregnancy classes in 2013. But as you'll see, Kristin is a firm believer in achieving the highest level of education available when providing a service. Shortly after, she earned the following credentials-- you guys, are you ready for this? She's amazing. Oh my gosh. Certified Sacred Doula in 2014. She is a Certified Elite Labor through ProDoula. She is the Elite Postpartum and Infant Care Doula through ProDoula. She's trained in Spinning Babies, Newborn Specialist, Mother Ship, Certified Health Service Provider, certified in VBAC. She is certified in transformational birth and a birth coach for the Birth Coach Method. She is a certified pregnancy and infant loss advocate and certified gift registry expert through Be Her Village, who we will talk about. We both love them so much.She is also an author of a book which we will be sharing more about. It's called Supported: Your Guide to Birth and Baby. So without further ado, we are actually going to be skipping a review today and an educational topic because this is such a great episode to be educated and learn more about what Kristin is offering in her community. Okay, my love. Hello. Kristin: Hello.Meagan: We're officially getting going talking about this amazing topic. Tell me what you think about this. I think sometimes people want to assemble this dream team, but they let finances or even partners or other opinions get in the way.Kristin: Yes. Partner comfort level, especially with VBACs is key, or with clients of mine who want their dream is to have a home birth and their partner isn't supportive, so then they say, "Oh, it'll be with the next baby if everything goes well in the hospital." But then if they're a complication, they might risk out of the option of home. I think as consumers, we don't fully appreciate the ability to choose all of our birth and baby team. We can change providers. I switched providers with my first pregnancy early on because I didn't feel like that particular OB was on board with my plans to have an unmedicated hospital birth. I ended up switching to Certified Nurse Midwives and completely changed practices, completely changed hospitals in fact. It's a lot. Meagan: Yeah.Kristin: But it was worth it. And I had the time where it was easier to switch, but I've had clients switch very late in pregnancy. It was harder to find the right office to accept them, but with VBACs, it is crucial to have not just a VBAC-tolerant provider, but someone who is fully on board with your unique desires because we are all individuals.Meagan: Yes. I love that you said your unique desires. Everybody is different. I think it's really important to tell these providers what your desires are. We have a list of questions that we give people in our course and, of course, on the podcast. You can go down that list and check and be like, "Okay, this provider seems pretty supportive," but you guys have to tailor your questions and your provider. You have to tailor it to what your individual unique circumstances and desires are because everyone's is different. I would love to know. You said, I was realizing that this wasn't the right place. What kind of things were you hearing or being told or feeling when you were realizing that maybe your first provider wasn't going to be as supportive and in line with your unique decisions?Kristin: Just when I was talking about my wishes, I could tell that that particular provider liked structure and patience to get that epidural, and so once I started talking about movement, delivering in different positions and some of the things I had researched-- I hadn't yet taken a childbirth class because it was early in pregnancy, but I had done a fair bit of research before knowing what a doula was. I didn't hire doulas until my second. But I could just tell in that gut feeling which I rely on. Again, we're all unique. And yes, I do research, but I make decisions on am I comfortable spending my entire pregnancy with someone who can tolerate me and will say, "Okay"? But I could tell it didn't light her up. So once I found a practice where my nurse-midwife spent time with me, I had longer appointments, I could ask questions, and she was 100% on board with me, and then I was able to meet the other midwives and the OBs who oversaw them throughout the remainder of my pregnancy. I felt very cared for. And again, we are consumers. Whether your insurance pays for everything or you're paying for part of it, you don't get a do-over of your birth, and so it is so important, especially with that first birth to get the care team that aligns with you. That could be everything from a Webster-certified chiropractor, a physical therapist, a mental health therapist to deal with any anxieties that may come up with having a VBAC and getting a lot of fear-filled advice from friends and family members. I find that again, my clients are all unique individuals, and my students in Becoming a Mother Course, and now the readers in my book, have different goals, so I want them to choose the best plan for them. I love that you have worksheets and templates, but knowing that every situation is different whether it's a home birth, a trial of labor, or a hospital birth, that setting is different and the type of provider whether it's a nurse-midwife or an OB practice, how likely is the OB that is very VBAC-supportive going to be attending your birth? Are there 12 providers or are there only 4? And so there's just so many things to factor in when deciding what is important to you.Meagan: Yeah. That point that you just brought up, are there 12 providers? Are there only 4? Does your provider guarantee that they'll be there? These are things that I think a lot of people may not be aware of that because they found their provider. They're feeling good about their provider. They're jiving. They're having the feels, but then they may not be the ones to be there, so there are 11 other options. It feels overwhelming to be like, "Wait, wait. Do I interview all 11?" Yeah, guys. Yeah. You set up visits. It's okay. Go and see if you can meet with those. Make sure that that full team is aligned. It is a lot. That's a lot to take on, but it's okay to rotate and say, "Hey, I saw Dr. Jack last time. I'd like to see Dr. Joe this time," or whatever it may be. Really, really dive in, find out more about your provider's team if they have a team, and make sure that they align with your unique decisions and desires.Kristin: Absolutely. And that goes for doulas as well.Meagan: Oh, yeah.Kristin: So for VBAC clients, I, over the last couple of years, I do all of the matchmaking, I like to call it, between client and the birth doulas and postpartum doulas on my team, in fact. I like to find out what they're looking for. If they are attempting a VBAC, then many times, they're telling me they want a VBAC-certified doula. I have doulas that have gone through your program and are certified through you and other different VBAC trainings. They're not just wanting VBAC experience like in my early days of having Gold Coast Doulas. Now, they're wanting that certification because they know that information is being updated as things change. And there's more evidence for VBACs. They also want more than just, "Oh, I've attended four VBACs." They want the education behind it. So I think that is crucial. I'm not going to match, unless there's no one else available on my team, a client with someone who is not certified as a VBAC doula.Meagan: Yeah, I do the same thing with my group here where they're like, "This is really important to me. I want this specific type of doula." Some of my doulas have taken The VBAC Link course. And so I'm like, "Yep, this would be who I would suggest." But I also want to point out that even if you assemble your dream team doula, and they've got all the education and information on VBAC, and they're up to date, I want to just point out that it doesn't mean that you shouldn't inform yourself that you shouldn't get the information because sometimes I feel like it's easy to want to just hire your provider or your doula or your person and let them who know VBAC kind of help and guide you. But it is really important. You're doing yourself a disservice if you personally do not learn more about VBAC and your options as well and rely only on your provider or your doula.Kristin: 100%. The doula, I mean, unless you're paying her for it, will not be attending every one of your prenatal visits during pregnancy. The education that you have to make informed questions and decisions surrounding your birth plan or birth preference sheet, so those conversations are critical. The more information you have as a patient, the better. And as we all know, unless you're having a home birth, your visits are short even with a nurse-midwife. And so it's important to have those questions and to have time to really express concerns. Or if you're finding that that practice or that provider is not in line with your plans, then you can look at other options. And the hospital-- are VBACs even allowed at the hospital that you plan to deliver at? Are they going to induce? What are the Cesarean rates? And looking at all of the different options, and if you need to consider NICUs, that's always a factor in hospital selection as well.Meagan: Yeah, I'm going to kind of go back to where we were in the beginning where you realized based after your feelings and other things that this provider was not the right provider for you, you then changed to CNMs and had a much better experience. Can you discuss your process of that change? How did you change? Did you find the CNMs, have them request your information from the OB? Did you do a formal breakup with your OB? What suggestions would you give to someone who is wanting to do that? I know that sometimes, you were talking about it, in the end, it's a little harder to find, so that's why we stress so importantly to find your provider from the beginning. But we know that sometimes things change. So can you kind of talk about that process in then assembling that dream and getting the steps to get to that dream team?Kristin: Yes. So for me, I had asked friends about which providers they had worked with. So the original OB, a friend of mine, it was her doctor, and she had a great experience. I just wasn't feeling it. She had a student. We have teaching hospitals in my area, so there was a student in the room. I wasn't feeling like she was 100% on board. I could tell that she was very medically driven. I wanted essentially a home birth in a hospital. So I talked to more friends and did research online, and a friend of mine had used this particular practice. I ended up going with the midwife that delivered her three children, and it worked out beautifully because it was early in pregnancy. That practice had openings. It took me a while because I was changing hospitals and practices completely. My insurance, luckily, covered all of the options. But that's another thing to look into. Does your insurance cover the hospital where the provider you want to switch to delivers that if it is a hospital birth? Of course, you can VBAC at home in certain states. So just looking at all of the factors that would come into play. So for me, it was dealing with the paperwork of switching out of that practice, getting admitted, and going to that initial get-to-know-you visit with a nurse and doing my labs before I got to meet with the midwife that I had wanted to work with. And so it took a bit. I mean, no one likes to deal with the paperwork and the phone calls it takes, but your health is so important and especially again, for VBACs.Meagan: Yeah. So you essentially did all the paperwork and the transfer yourself.Kristin: Yes.Meagan: Okay.Kristin: I made all the phone calls, dealt with insurance and made sure that the initial visit was paid for along with the nurse visit, and then that insurance was comfortable with me.Meagan: Yeah. Awesome. Yeah, I did, when I switched, because I switched it 24 weeks, my midwife just faxed a request to my OB office. It took them a while to send it. We had to ask five times which I think probably would have been faster if I, like you, made the phone calls and did all the things, but I was like in this weird, vulnerable spot of like, I don't want to go back there.Kristin: Right. You don't want to deal with it.Meagan: Yeah, I don't want to deal with it.Kristin: Even just talking to the front desk.Meagan: Yeah, yeah. So we waited for it and they eventually got it. But I think that that's important to note. You guys can make the calls too. You can call and say, "Hey, I'd like to request my records to be printed out or to be sent to this place." Kristin: Yes, and that's what I did. Because otherwise it's six weeks oftentimes or you have to keep calling. They get lost. so I just handled it. But it can be challenging. And as doulas and certainly VBAC doulas, we know the providers who would be not only tolerant but supportive of VBAC. So we get those questions frequently from potential clients and clients of, am I at the right place? And of course, we support whoever our clients choose to have care from. But there's also, if asked, I will tell them about the practice and my own experience as a doula or the agency's experience. And again, in those large practices, there might be four who are so VBAC-supportive. They love it, but then there might be some physicians who are not as comfortable. They feel that a surgical birth might be the better route to go, ad so there's that. So what I like to do as a VBAC doula is to have my clients talk to their provider. Again, go over a birth plan or birth preference sheet and have them sign off on it. That way, if they don't attend the birth, then the other physicians know that this was approved. It's not just a birth plan that is thrown out there, but it has been discussed. It doesn't work all the time, but it has been helpful for my clients no matter if they're a VBAC client or this is their first baby, and again, they have certain goals that they want to achieve like potentially avoiding an induction unless medically necessary.Meagan: Oh my gosh. So I'm just going to re-touch on that, you guys, because that was really, really, really good advice and something I've actually never done or even thought about or suggested to my own doula practice clients. Get your birth preference sheet or birth plans everyone calls a difference. I call it a birth preference sheet, which is a list of all your preferences that you desire. Go over that with your provider, and have them physically sign it. Physically sign it and date it showing that your provider went over it. And like she said, every provider may not be willing to do that, but I will say, if a provider is willing to do that, that says something to me.Kristin: It does. Yes.Meagan: Yeah. Super powerful. Oh, my gosh. Okay, nugget. Grab it, put it in your pocket, everybody. Sign your birth preference sheet so you can have it and keep that in your bag, so if you do have that random on-call doctor who may not even know you or not be so supportive, be like, "This has already been discussed. We were aware of this. My doctor has signed off." Also, you could maybe ask if your provider could make a copy of that and put it in your chart.Kristin: Right. Because yes, it's not just the one that they have on file, but it's also for the ones that you have, that copy that you're bringing and showing the nurse so the nurse and everyone is on the same page. Meagan: Love that. Kristin: And again, with teaching hospitals, you might have residents in and out. There can be some difficult conversations with VBAC and residents who have never seen a VBAC. We're not fully trained yet to support VBAC, and so they might be making suggestions while the provider is not in that check-in. So every state, again, every area is different. I just happen to be in an area with multiple teaching hospitals.Meagan: Same here. We have seen it where I think, I don't want to say this badly. The VBAC world is a world that can have a lot of negativities in it, negative things and big words like uterine rupture. We've got residents who may be coming in and may be training under a provider who has seen a uterine rupture or has maybe molded an opinion on VBAC and is projecting their opinion to that student. Whether or not they're consciously doing it or not, they're saying their opinion, and those opinions might morph that resident's opinion into negative for VBAC. You never know. And so they might be doing things or be more hesitant in areas that they don't need to be, but they are.Kristin: Yeah, it's such a good point. And as you mentioned, I mean, we don't know the traumas that our nurses and medical team, even home birth midwives, have experienced, and they carry that with them. And how can they not? Even as doulas, we witness, but we don't have the liability and the medical training to make it, but we are witnesses of trauma and have our own healing to do to be able to better move on and support the next client. So certainly keeping that in mind that they may have seen something that alters the way they practice.Meagan: Yeah.Kristin: It's not just fear of lawsuits.Meagan: It's really not. It's not. There's a provider here in Utah who is literally so scared of vaginal birth herself. She scheduled all of her Cesareans, even the very first one from the get. She never had trial of labor or TOL. She just doesn't. So can you imagine what her Cesarean rate may be? And she kind of reminds me of the provider you're talking about. She really likes it just so controlled. Come in, start Pitocin, and get the epidural. She likes those things, which we know can sometimes lead to those Cesareans. And so really also discussing with your provider, how do you feel about birth? Have you had babies? And then we have another OB who's like, "I work in the hospital, and I love the hospital, and I trust the hospital system, but I actually gave birth at home with all three of my babies," and so really getting to know your provider, I think, is so good. Okay, let's keep going on this topic of assembling your dream team of experts when planning for birth and baby. What other things would you suggest to our Women of Strength?Kristin: Yes. So as we know, birth is as physical as it is mental, and just the opposite, as mental as it is physical. So preparing with a childbirth class, a comprehensive class, even if you took one before, use the lens of your goal of attempting a VBAC, a trial of labor. And so for us, we happen to teach HypnoBirth at Gold Coast Doulas and that mind/body connection that HypnoBirthing or a gentle birth offers where it's more of using the visualization the way an athlete would in preparing for a marathon or a triathlon, you are using things to reduce fear. You're understanding all of your options. It's very partner involved. I think taking a comprehensive childbirth class, whichever meets your individual goals, is great. That childbirth instructor is a great person to add to your birth and baby team. And then moving your body. So taking a fitness class that is appropriate for pregnancy. So prenatal yoga, there are Barre classes for pregnancy. There are prenatal belly dancing classes, whatever it is. Meagan: Aqua aerobics.Kristin: Yeah, water aerobics are amazing. And so thinking about baby's position and helping labor to go on its own or be quicker. There's acupuncture, acupressure, the Webster-certified chiro for positioning or body balancing experts, so many different options. But I am a big fan of educating yourself and preparing because as you mentioned earlier, Meagan, a doula is not your end all, be all. Just because we have the information and the training, we can't think for you. We don't want to think for you. The more informed you are, the more likely you're going to feel like birth didn't happen to you this time around and you were a direct participant, even if you end up having a surgical birth again.Meagan: Yeah, yeah. Yes. Oh my gosh. So talking about courses, you guys, we have our VBAC course. This VBAC course goes into VBAC, the stats about VBAC, the history of VBAC, the history of Cesarean, the stats of Cesarean, the questions, finding the provider, a little bit more of the mental prep, and physical prep. But when it comes to a childirth education course like with the course that she has, they're on different levels. I actually suggest them both.Kristin: Yes, me too. Absolutely.Meagan: But it's so important to know the information that is in your course. I know you go even past preparing for birth and then birth and then postpartum. You go into all of it. We're going to talk more about it. But you guys, we as doulas, love getting information and we love sharing information. But like she said, we don't want to be the only one that knows the information in a team. When our clients come in, at least here in my group, when our clients come in and they are fully educated and we're like, yes. And then we can come in with our education and our experience and knowledge, you guys, it is a powerhouse team. It is a powerhouse team. We have clients who, when they take child birth education classes like yours, they are able to advocate more for themselves. They feel stronger to stand up and say, "Hey, thank you so much, but no thanks" or "Maybe later," when our clients who haven't had that childbirth education or just any information other than maybe what we're providing, which is great, but not enough in the full length of pregnancy, it's a little harder. We have to try to encourage those clients a little bit more because it's harder for them because they don't know everything. We're there to help guide them and help advocate for them and educate them, but it is very different.Kristin: It is. It's so different. And I feel like, again, partners, especially male partners, want to fix things. They don't want their love to feel any pain, and so they may have the fear of a VBAC. So taking a VBAC class course, having a VBAC doula, giving information is just as helpful, if not more for the partner and their comfort level and to have them fully get on board because they may be resisting and just going along for the ride, but if you can get them to be an active participant in education, then they're going to be able to help you. And sometimes in labor, we get to a point in transition where we can't fully speak for ourselves. But if our partner understands, is educated and on board, and if there's time to talk through the risks and benefits and alternatives with your doula, then yes. But sometimes decisions have to be made quickly, and so for that partner to be informed and educated is crucial.Meagan: So crucial. It's so powerful. My husband-- he was not so on board. He was like, "Whatever. I don't care. You can go to the courses. You can do these things."Kristin: And that's very typical.Meagan: It's very typical. And I did. I did do those things. When I said, "Hey, I'm going to birth out-of-hospital," and he was like, "No," I was like, "Well, sorry. I've done the education. I know this is really where my heart is pulling." We touched on this in the beginning how partners really can influence decision making. And in no way, shape or form am I trying to say partners are terrible or don't listen to your partner or anything like that. That's not the goal of what we're saying is have an educated partner. Know that you can assemble a birth team, like a provider, a chiropractor, a massage therapist, a doula, a PT, or whatever it may be, but don't forget about your partner. Your partner is a huge part of your team, and if they're not educated and they're not able to help guide you through, or if they're not being supportive, find ways to help them be supportive by taking a course with them and helping them realize, oh, VBAC actually isn't that scary. Oh, that chance isn't really 50+%. Oh, okay. Hospital birth, out-of-hospital birth. Yeah. They're both reasonable, and really understanding that.Kristin: Absolutely. And sometimes I find that my students and clients may have not had success with breastfeeding the first time and potentially didn't take a class. So if their goal is to breastfeed or pump exclusively, then taking a breastfeeding class and having that IBCLC as a resource for their dream team in case it's needed because many times, you have the lactation consultant who's teaching the class, at least in my practice, and then they're also available for say, a home visit or a hospital visit, depending on where the class is taking place. And so I think that that's something. Even if it isn't your first baby and maybe you breastfed for a little bit or had supply issues or challenges after a surgical birth, that it is important to consider any education during pregnancy because it's much harder to get that education after you have your baby.Meagan: It really is. I love that you're touching on that, really getting into all the things and having your partner go with you. I remember I was like, I had a C-section, and I was swollen and tired, and I couldn't move very well. I was sore and all the things that sometimes come with C-sections. I'm trying to nurse, and I'm engorged.  I don't feel my letdown, and I'm just so engorged. I don't know. All I know is I have really big, swollen boobs. It's all I could tell. I couldn't latch. My husband was like, "That's it. We're going to the store. We're getting formula." Formula is fine. Not anything against formula.Kristin: He's trying to fix the problem and make you feel better.Meagan: Yep, yep, yep. Trying to fix that problem. But I was like, "No, I really want to breastfeed." At that point, I wasn't able to communicate. Like, I didn't get the birth I wanted. I already felt like a failure because I was actually told that your body failed. That's what I was told. So I was already dealing with this mindset that I failed. I had a C-section. I didn't want a C-section. And now the only thing I could try to do because I couldn't take that C-section back is breastfeed my baby. I wanted to breastfeed my baby. And again, we didn't take those childbirth education classes. He for sure didn't download any apps. I at least had an app trying to help me at that point, but he didn't understand. He didn't understand.And I'm like, no.I'm crying, and I'm like, "Please, just help me. I don't know what I need to help me." And he's like, "No, we're going to the store. Our baby's mad. You're crying." He was trying to fix that problem. But if we had already done that information education before and found that IBCLC before and him understanding how important that was to me, he could have been like, "I'm going to call her IBCLC. I'll get her over here right away."Kristin: Exactly. The last thing you want to do is go into the hospital to see a lactation consultant there if you can even get in.Meagan: Exactly. Yeah. So it just could have been so much smoother. Sometimes I feel like we were against each other at that point because he didn't have any education. With our first, I really didn't have much education. But with our third, it was like he really didn't have a lot of education. and I was over-the-top educated, so I was saying these things, and he was thinking I was demeaning him or saying he was stupid because it was just this weird thing. So if we can just come together with our partners and get all the education and get it all before really, find out a postpartum plan. Find out a breastfeeding plan. Right? Find out what you want. You guys, it just makes the pregnancy journey and the postpartum journey, so much better. It truly makes you feel like you're on that team because you are.Kristin: Yes. Absolutely. And certainly, I mean, you mentioned apps. Not everyone has the means or even lives in an area where they can take a comprehensive five, six, ten-week childbirth class. There are, obviously, online classes. There are some Zoom virtual ones where students are all over the place. But there are watching birth videos and YouTube and in my book, Supported: Your Guide to Birth and Baby, we talk about apps, so count the kicks. Especially for VBACs, doing the self-monitoring if there's fear of fetal movement and any sort of distress during the end of the pregnancy, then really understanding your own body and doing monitoring. It's not just when you're in your provider's office being monitored. You can make a difference yourself. So having some different apps and some education on your own, listening to podcasts like yours to get this information and reading books. So there's more than if you can't afford a childbirth class like HypnoBirthing, there are still ways that you can get educated and your partner can get educated. So yeah, take a look at all of your options and your budget.Meagan: Yeah, and we talk about this all the time because I love them, but Be Her Village is a really great resource where you can go fill out a registry and, hopefully, get some help for these things. Childbirth education classes, doulas, IBCLCS. But I want to dive a little bit more into your book, actually, while we're talking about different resources. We talked about the childbirth education, but can we talk about more about Supported: Your Guide to Birth and Baby and how this came into fruition and what all is included in this amazing book.Kristin: Okay, Meagan. So essentially the book came out of our online course. Becoming a Mother launched in the early pandemic when everything was shut down and our classes all had to go virtual. I was fortunate to be in a state where doulas who were certified were able to work thanks to our governor. So we were working, but there was still a lot of isolation even with our clients' prenatal visits. They wanted a connection, so we launched this course. We had talked about and did three live launches, got VBAC from our students, pulled people in from all the moms' groups before creating the first draft of the course. And then the course just led to the book. So the content in Becoming a Mother is what is in the book in a different format. So in Becoming a Mother, we have expert videos, so VBAC specialists and Webster-certified chiropractors talking about what that is. Pelvic floor physical therapists, car seat safety technicians, cord blood banking donation centers.Meagan: Awesome.Kristin: We have the experts speaking for themselves-- a pediatrician. And so in the book, anything that is medical and out of the scope of a doula, we had expert contributors, so I have a pediatrician friend of mine who contributed a newborn procedure section of the chapter and a prenatal yoga studio instructor, she's also a certified body balancer. She contributed to some of the fitness options in the book, and a mental health therapist who is PMA focused and certified contributed to the mental health chapter. We have an IBCLC that contributed to the feeding chapter, and so a lot of involvement, and then sharing client stories throughout the book and then our own wisdom. We have doula tips and wisdom at the end of every chapter. Meagan: Wow.Kristin: And so as clients were asking me for books over the years, I couldn't find anything that was positive. I felt like there were a lot of, this is your cry-it-out method for sleep because we have a whole chapter on sleep and it's very attachment-focused. It's like, one way for feeding, and we wanted our clients, with their unique choices for themselves, to have a book that supports people who want to plan surgical birth like that OB and that's their comfort level and a book for the same person who wants a home birth. You don't have to buy five different books. It's not always Ina May which is a great book but not for everyone. All of her different-- she's got Spiritual Midwifery and so many different books. It is great for grandparents to read and partners but is targeted to the mother or the mother-to-be and is great in preconception in that early planning. But also, we wanted to make it similar to the course and just as valuable for seasoned bombs as it is for new moms. And again, it's affirming. We tried not to have any fear-filled information in a simple, easy-to-read guide that you can pull out for reference and a lot of different, again, apps and podcasts and books to read and resources and evidence-based information about Black maternal health and where we're at in the country now and how the pandemic impacted birth especially, but also that postpartum time.Meagan: Wow. That book sounds amazing. So amazing. And you guys, you can get it in every form, even Audible. I'm a big listener. I like to listen to books. Kristin and Alyssa actually recorded it. She was telling me they had 10+-hour days recording this this book. You can get it, and we will make sure to have the links for that in the show notes. I found it at goldcoastdoulas.com/supportedyourguidetobirthandbaby.Kristin: It's there. You can find it off that website or it has its own page. It's supportedbook.com. Meagan: Supportedbook.com, okay. We'll make sure that's all in the show notes, so you guys can grab that. Okay, so you know a lot. Obviously, you wrote a whole book and a whole course and all this stuff. Is there anything else that you would like to share in regards to just our final assembling of that powerhouse birth team?Kristin: So don't forget, I know we're talking a lot about pregnancy and birth prep, but don't forget your recovery phase. And you had talked about your own personal struggles with breastfeeding engorgement, recovery after a surgical birth. If you have, well, you do have other children at home with VBACs, and so looking at childcare, postpartum doula support, or what kind of family support you're going to have after, it's more than just meal plans and prepping the nursery. We strongly believe that as part of your dream team, the postnatal team is crucial as well. So whether it's a lactation consultant, a pelvic floor physical therapist, if you want to get back to running marathons again or are leaking. I mean, we can all use pelvic floor physical therapy. It's not just the athletes who they support. Some people, again, with building a home or other life occurrences like a wedding or preparing for college, you look at your budget. You look at your main goals. For a wedding, it might be food. For postpartum, it might be sleep. So hiring a sleep consultant when baby's old enough or an overnight postpartum doula or a newborn care specialist. What are your priorities? And take the budget. What might be paid for by insurance or, a health savings flex spending plan that you need to run down? What might be gifted? Like you mentioned, Be Her Village. There are different ways you can budget. And in the book, we talk about all of that and looking at employer plans, how to navigate that, what questions to ask your HR department about other members, like a chiropractor, could that be covered? A therapist? Oftentimes, we don't know our own benefits and certainly, I don't know my husband's benefits fully, so to be able to investigate that early in pregnancy and figure out what might be fully or partially paid for.Meagan: Wow. That is incredible itself. I feel like that's a whole other conversation of, how to navigate how to do that. So definitely go get the book, you guys, because it sounds like there are just so many things in there that are honestly crucial to know. really, really important things to know. You are incredible. Kristin: So are you.Meagan: I just enjoy chatting with you so much. Anything else? Yeah, anything else you'd like to add?Kristin: And obviously, take taking trainings and courses. If I know you have doulas who listen. It's not just parents.Meagan: Yes.Kristin: As doulas go through The VBAC Link. Get certified as a VBAC doula. Keep up with information that is ever-changing. We all want to be the best doula for each of our clients, but I am a firm believer in continuing our own education and that more and more of our clients are choosing to attempt VBACs, and so the more information you can get as a professional, the better you're able to support. It's just not the number of VBACs you've attended anymore. It's clients wanting that knowledge so you can be busier and also a more effective doula by getting that training and then going through the certification process that you offer.Meagan: Yeah, have a directory actually with birth doulas where people can go and find it because when Julie and I created this company way back in the day, we knew that we were just two people here in Utah. We couldn't change the VBAC world. We could give as much information as we could. We could share the podcast. We could do those types of things. But when it comes to birth workers, we wanted to reach birth workers everywhere. It's so great that we have and we're still having more people come on because they're helping people so much. I mean, we know you have doulas that do it all the time. These doulas do help and there are actual stats on doulas that do it. But I agree. If you're a birth worker, stay up to date. Be in the know. Know what's going on because you will likely need to help guide your client through it. Kristin: Then you can charge more. So take that investment in a training like The VBAC Link, and then you're able to charge more because you're more experienced. You have more certifications. So don't look at like, oh, I don't have any money for continuing education. Look at how that's going to change your career.Meagan: Yeah, and I think sometimes too you can charge a little bit more, take less clients, and be more personal with those clients and dive into it. Especially because we do know that VBAC does take some extra stuff that goes on with VBAC. There's some extra work to be worked through. There are some extra things and so yeah, I love that.Kristin: Well, thank you so much for having me on Meagan, I loved our chat.Meagan: Thank you. You as well. As always, I loved our other chat as well. We have to keep going. I think I'm going to order your book today and get going on that. Even though I'm not a mom preparing, I think this would be such a great book to suggest to all of my clients. So thank you for sharing. Thank you.Kristin: Yeah. My secondary audience is certainly anyone who works with families in the birth and baby space, but it is targeted again, just similar to my podcast. It's like I have the listener of the pregnant individual and family, but also birth workers. The book is similar. Thank you for ordering.I appreciate it. Meagan: Yes. And can you also tell everybody where to find you not just in your book, but Instagram, podcast, and all of the social medias?Kristin: So my podcast is Ask the Doulas. You can find us on all the podcast players and you were a guest recently, so very fun. And certainly, we're at Gold Coast Doulas on everything from Pinterest to YouTube to Facebook to Instagram. I don't have separate social sites for my book because I honestly don't have time for that.Meagan: That's okay. Yeah, it's a package. It comes with everything, so you don't need to have another book page. Well, awesome. Well, thank you again so much.Kristin: Thank you. Have a great day.Meagan: You too.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

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Patrik Jarenius var fram till nyligen säkerhetschef för Strängnäs kommun men fick sparken efter att han publicerade bilder på stenkastande ungdomar på Facebook. OBS. Det här är inte hela avsnittet. Vill du få tillgång till alla hela avsnitt? Bli medlem på Sista Måltiden. Som medlem får du tillgång till alla nya och gamla avsnitt i sin helhet och utan reklam. Lyssna i valfri podcast-app, inklusive Spotify. Enkelt att komma igång. Ingen bindningstid. Tryck här för att bli medlem eller gå in på https://sistamaltiden.se.  Hosted on Acast. See acast.com/privacy for more information.

Vi hade mer politik att prata med Hasan Ramic så det fick bli ett En grej till-avsnitt med fokus på det utrikespolitiska. Vi pratar Trumps AI-genererade video om visionen för Gaza, rapporterna om USA och Israels plan att etniskt rensa Gaza genom att flytta den palestinska befolkningen till Östafrika, Rwandas destabilisering av Kongo samt gripandet och den stundande utvisningen av den propalestinska demonstranten Mahmoud Khalil. (OBS, det här avsnittet spelades in dagen innan Israel bröt mot vapenvilan i Gaza, därför tar vi inte upp det.)  Stötta oss på Patreon för regelbundna bonusavsnitt + mer! Hosted on Acast. See acast.com/privacy for more information.

Att förstå svenska dialekter och skriva ut det som sägs har varit en utmaning för så kallad taligenkänning baserad på AI. Men nu finns en ny AI-modell, specialtränad på svenska. Lyssna på alla avsnitt i Sveriges Radio Play. Den nya taligenkänningsmodellen, som kallas KB-Whisper, har fått träna på 50 000 timmar inspelat svenskt tal som det finns text till. Inspelningarna kommer från riksdagen, SVT och Institutet för språk och folkminnen, ISOF, och innehåller både ett antal dialekter och knepiga termer.Leonora Vsterbacka, senior data scientist på KBLab på Kungliga biblioteket har varit med och tagit fram den nya modellen, och med hennes hjälp testar vi hur bra den fungerar på svenska dialekter. Hon berättar också vad AI:n än så länge har svårt att klara av.Medverkande: Leonora Vesterbacka, senior data scientist på KBLab på Kungliga biblioteket; Anette Torensjö, chef för avdelningen för arkiv och forskning på Institutet för språk och folkminnen, ISOF.Här går KB-Whisper att ladda ner. Obs att den kräver viss förkunskap för att använda.Här är ISOF:s arkiv Folke med ljudinspelningar och nedskrifter från hela landet.Här finns några av de dialektinspelningar som hörs i programmet och många andra.Reporter: Björn Gunérbjorn.guner@sr.seProducent: Lars Broströmlars.broström@sr.se

Meagan welcomes Dr. Nicole Calloway Rankins, a board-certified OB/GYN, to discuss everything related to pregnancy, childbirth, and the VBAC experience. With over 23 years of experience and more than 1,000 deliveries, Dr. Rankins shares her insights on common questions and concerns from expectant mothers. From the importance of mindset during labor to understanding the implications of the word “allow” in provider-patient relationships, this episode is packed with valuable information. Don't miss out on Dr. Rankins' tips for a calm and confident birth, and learn how to advocate for yourself in the birthing process!Dr. Nicole Rankins' WebsiteNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength, It's Meagan, and I am so excited to be joining you today with our friend, Nicole Calloway Rankins. Dr. Nicole Calloway Rankins is incredible. We've been following her for a long time and have collaborated with her in the past and are so excited to be having her on the podcast today. Dr. Rankins is a board-certified practicing OB/GYN, wife, mom and podcast host here to help you get calm, confident, and empower you to have a beautiful birth you deserve. She was born into a family of educators, and she felt a pull to medical school the day she looked in the mirror and saw a vision of herself in a white coat. And get this, it all happened while she was studying to be an engineer. She says, "I know that sounds crazy, but that vision has led me to exactly where I am supposed to be today- serving pregnant women." She's delivered more than 1,000 babies and has de-mystified childbirth for thousands more through her 5-star rated All About Pregnancy and Birth Podcast which she's going be talking about a little bit more today. I'm so excited for her. She has over 2 million downloads and her online birth plan and childbirth education classes. You guys, she is really changing so much about the birth world. She's incredible. You're going to hear it today. I love chatting with her. You can find her at drnicolrankins.com and of course, we'll have all of her other podcasts and Instagram and all that in the show notes. So get ready, we're excited. We're going to be talking a little bit more about common questions for an OB/GYN, but then we're also going to be diving into questions from you personally. I reached out on Instagram and said, "Hey, what are your questions for this doctor?" She is so excited to answer them, and she did. We went through every single question that was asked on our Instagram community. I'm so excited. I'm going to get to the intro, and then we are going to start with Dr. Rankins. You guys, Dr. Rankins is back with us today and I'm so excited. Funny enough, I keep saying that you're back, but you've never done the podcast with us.Dr. Nicole Rankins: I don't think so. Yeah, I think we did a class.m: We did a class which was phenomenal and everyone ranted and raved about it. So we're back together ,but we have you for the first time on the podcast. So welcome. Dr. Nicole Rankins: Well, thank you. I'm excited to be here.Meagan: We just adore you and I love getting your opinion on things. I think from doulas, from midwives to OBs, we all have different opinions and experiences, and if there's anyone that has hands-on experience, it is you and a midwife, like someone who is physically handling.Dr. Nicole Rankins: Yep. I've done this a couple thousand times. Yes.Meagan: Versus my 300 and something verse.Dr. Nicole Rankins: Don't discount it. That's very excellent.Meagan: It's still super great, but when it comes to thousands and an understanding on an even deeper level, it's just so fun and it's a compliment to the podcast to have your expertise.Dr. Nicole Rankins: Yeah, I've been at this 23 years, so it's a long time.Meagan: And still going. It's still going.Dr. Nicole Rankins: Still going. Yes.Meagan: And okay, tell me we can edit this if you want, but you have a new podcast coming out. I do know it's not going to be by the time this airs. It's not going to be out just yet. But can you tell us a little bit more about it and where people can find this?Dr. Nicole Rankins: Yeah. So it's still going to be in the same feed. So if you subscribe to the old podcast, it's just going to change, keep the same feed, but it's going to have a new name and a bit of a new focus still related to pregnancy and birth, but it's just a bit tighter. I want to say the name so bad, but I'm not going to.Meagan: Okay. Don't let it out. We will find out it is released.Dr. Nicole Rankins: Yes.Meagan: Tell them where to follow right now.Dr. Nicole Rankins: Right now? Yeah, if you follow me on Instagram, even though I'm taking a Little break now, you'll get it there. But the podcast is called All About Pregnancy and Birth. Go ahead and subscribe, and you can be the first one to know when the first episodes come out. I just have lots of new ways to present information about pregnancy and birth and frameworks and things. Okay, I'll give a little hint. One of the first things I'm talking about is one thing that's so important to pregnancy and your birth experience is your mindset. So one of the things I created is this MAMA mindset framework. MAMA stands for meditation, affirmations, move your body, attitude of gratitudes. I have practices, exercises, and things we're going to talk about. That's just one little, tiny sliver of the things that I've been working on and writing, so it's just good, great stuff.Meagan: Yay. Oh my gosh. I'm so excited. That is even more applied with just birth in general. But VBAC, I feel like mindset attitude, and all these things that you were just saying, is so important because even though we're just moms going and having babies, we have some extra things that some extra barriers that sometimes we have to either break through or we run into.Dr. Nicole Rankins: Absolutely. Yeah. I mean, a calm mind creates a confident birth. So when you have that calm mind, that is the first step to helping you create a confident birth experience. So mindset is really important.Meagan: Yeah, it really is. Well, I'm excited to chat with you today, and I'm excited to listen to that sometime here in the near future and listen to more of what you are bringing to the table. Okay, so one of the questions that I would like to go over is the word "allow".What does the word "allow" mean? How does someone navigate something that maybe doesn't feel right for them? And on both sides-- Dr. Fox and I have talked about how sometimes it's not right for the provider. You're not the right patient for that provider because what you want is not comfortable with the provider and vice versa.But we often hear or actually more see it on The VBAC Link Community on Facebook. There are comments of, "My doctor said they will allow" or "My midwife said they'll allow me to." If so when you are saying that or maybe have you said that, what does that mean?Dr. Nicole Rankins: Yeah, I don't say that word.Meagan: Okay.Dr. Nicole Rankins: It's a word that should not be in the discussion about birth because allow implies a hierarchal relationship where I get to make the decisions about what does or does not happen in someone's pregnancy, birth, labor, body, and that is not true. You as the person giving birth are the one who ultimately makes the decisions, not your doctor or your midwife. We can't really allow anything. We're not your parents. Do you know what I mean? So "allow" shouldn't be part of the conversation. It's a left overturn from just a general patriarchal foundation of OB/GYN, particularly when men took over into the specialty and banished midwives is how that language came about is that we need to tell folks and we need to control. So it really shouldn't be the case, but it still hangs around. Words matter, and it's important. Even though people don't necessarily mean it with any sort of ill-intent or that they mean that they're trying to control you, and inherently sort of subconsciously implies that. So I strongly dislike the word "allow".Meagan: Yeah, I am with you too. As someone who has had that word happen to me, it made me feel like I had to do something to meet their standard quota to get that allowance.Dr. Nicole Rankins: Right.Meagan: That just didn't feel great.Dr. Nicole Rankins: Yeah. Yeah.Meagan: So if someone is saying that, are there any tips of advice that you would give?Dr. Nicole Rankins: Yeah, I mean, first off, if you hear it, that's a little notch of a red flag potentially that it's not going to be a shared decision-making process because really, it should be that my role is to give you information and share my expertise with you to help you come up with the best decision for yourself. That looks like various things for different people. Some people want tons of information. They want to think about it and then talk about it. Some people are like, "Just tell me what to do," which if that's what you want me to do, then I can do that too. So if you hear "allowed", then it's concerning that there may not be that shared decision-making. So that's a little bit of a red flag to know.But then to open it up for discussion, it kind of depends on what the situation is. So is it we don't allow you to eat or drink during labor or we don't allow TOLAC? Then the next question is really, why? Especially if it's something that's important for you, why? If you want to use the language back, you can even use it back. "But why is that not allowed? Why is that the case?" And then kind of take the discussion from there.Meagan: Yeah. I think asking the question just in general, "Why?" or "Okay, I hear you. Can you explain to me?"Dr. Nicole Rankins: Yes.Meagan: It really helps there be a discussion like you were saying. I feel like when it comes to birth, like you're saying, I'm not your parent, but it needs to be collaborative effort here. We're trusting you to help us with this really amazing event in our life, but at the same time, we have to have equal trust from you. It's this collaboration of like, let's talk about what we want this to look like.Dr. Nicole Rankins: Yeah. Definitely, tust and collaboration are key in order to have a great birth experience. And ideally, you want to try to work on that foundation during your prenatal appointments so that by the time you get to the hospital, you know that you're going to have that relationship actually, regardless of what doctors there or nurses say. You create this environment of trust and collaboration. So when you ask the question why, don't necessarily start off-- and this is part of the psychology of human behavior. You don't necessarily have to start off with, "Well, why?" attitude because advocacy is not about creating conflict or creating chaos. Advocacy is really about creating that collaboration and creating that trust. It's the end result. So start from a place of trying to connect. Ask, learn information, and then kind of go from there.Meagan: Yeah. Love that. Well, thank you. Okay. Fetal monitoring. I know this is actually going to be a question down the line, or maybe it's a little different, but fetal monitoring with VBAC in hospitals is typically required. Can we talk about the evidence on that of why? Why? Again, here's the question, why? Why is that done? Dive in deeper. We talk about that in our course. But I think it's so great to talk directly to an OB/GYN like you to understand your point of view.Dr. Nicole Rankins: Yeah. The reason that's the case is that one of the first signs of uterine rupture is going to be a change in the fetal heart rate. So that's why we always want to see the fetal heart rate because it's going to be the first indication that there's potentially an issue. So it's really that simple. It may even be potentially before you start having pain. Some people may or may not have bleeding, but fetal heart rate changes and pain are going to be the things that will clue us in and we don't want to miss that if it happens.Meagan: Yeah, so when a fetal heart changes, we know, through labor-- this is a spin-off of the question. We know babies' heart rates fluctuate up and down. Sometimes they might have a compression in the cord that causes the heart rate to go really down during the uterine contraction and that goes up, but it goes really down. It's like, oh, that's low, and then it goes right back up to its baseline. So what is a concerning fetal trace in this scenario?Dr. Nicole Rankins: Right, yeah. So this is the part where I have to say, this is the reason we do four years of OB/GYN residency, why we have to get take fetal heart rate monitoring training every couple of years to stay up on it. This isn't something that can be had in a subtle conversation because it's not just what you see in the moment, it's what you see in the moment. The things we look for in general are a baseline of the heart rate between 110 and 150, 160, roughly. We look for things called accelerations, decelerations, and the variability, which is like the squiggliness of it, that's the big picture. But when we look at it, it's like, okay. We assess it, and then we try to do some things to improve the heart rate. We look at how the heart rate looks over time. Has it gotten worse over time? If we do some things to get it better, then that's considered good. So we can't really say if you see this specific snapshot of a fetal heart rate, then that's going to be the thing that triggers things. It really just depends.Meagan: Makes total sense.Dr. Nicole Rankins: And it can also be contractions because sometimes if you're having too many contractions back to back and there's no time to get a break, so the baby's like, "Can I just have a minute to breathe in between these contractions, please?" So maybe we need to slow down the contractions. So really, it's a lot of things that go into it, and that's where our expertise comes in.Meagan: Yeah, it's a big math equation in a lot of ways when it comes to tracings and things like that. Okay.Dr. Nicole Rankins: I do want to say that a lot of times people think monitoring equals no movement. But more and more, hospitals these days have wireless monitoring so you're able to move. That's definitely a question you want to ask ahead of time if wireless monitoring options are available so that you're able to move around.Meagan: Yeah, yeah. Because they've got, at least I don't know if it's what it's called there, but we call it the Monica.It's just that little sandpaper on your belly and that's kind of nice. Sandpaper sounds harsh. It's a light little scrub so it gets the oils off your skin. So that's a really nice thing.Awesome. Okay. And then scar thickness. This is a really big one, and we've talked a little bit about it with Dr. Fox in the past. But scar thickness and double versus single stitch closure is a very, very common question that we are getting wondering about the evidence that shows that someone maybe shouldn't TOLAC or the evidence on thinner scars because it seems like it's becoming a new standard. It's coming in with the VBAC calculator. That is what we're seeing. It's like we're doing the VBAC calculator and we're measuring the scar and those kind of two things are becoming routine. And then of course, once we review OP reports. Double versus single.Dr. Nicole Rankins: Yeah. So the double versus single doesn't make a difference. So whether you had a double layer closure or a single layer closure, you're still a candidate for a VBAC. So that one is pretty easy. I don't even look at OP notes for double versus single layer. It really just needs to be a low transverse incision on the low part of the uterus. So that's that. As far as the scar thickness, the rationale behind that is that when the uterus ruptures, it literally just thins out. Thins out and thins out until it ruptures open generally. So when we're measuring this scar thickness, the physiology of it makes sense that if it's really thin and then you start to put the pressure of contractions on it, there may be a higher chance of it rupturing. Now, is there hard data that if it's this amount that is definitely going to rupture or you should or shouldn't TOLAC? Not necessarily. In our area, it's not routinely measured or talked about. It's not anything that we discuss, so it's not a routine part of practice, but that's the thought behind it. And typically it may come up if it's noticed, or if it's very noticeable. If the ultrasound, the maternal fetal medicine specialist or whoever does the ultrasound says, "This uterine scar, where it is, is really, really thin," and then it may come up. But in general, I don't see that come up very often.Meagan: Yeah, well, that's good. That's good to know. Yeah, it just seems. Yeah. Like, oh my goodness. Are you hearing that ding?Dr. Nicole Rankins: No.Meagan: Okay, good. I hope you're not hearing it. On my end, my computer keeps dinging, but it's on mute, so I'm not really sure what's going on. I'm having all the technical issues today.Anyway, that's really, really good to know though, because it is something that so many people are hyper-focusing on. Sometimes I think there are other things to hyper-focus on like our nutrition and finding that supportive provider and getting the education and really understanding the choice that we're making when we VBAC.Dr. Nicole Rankins: Yeah, definitely. I'm not focusing on it, so I don't think you should focus on it.Meagan:Yes, yes. But it is. I think it is probably hard for these people when they go to these visits. They're so excited. They want to have a TOLAC or a VBAC, and then they're like, "Oh well, we have to do these things first to see if you qualify."Dr. Nicole Rankins: And scar thickness is just not part of ACOG's recommendation. It's not part of what determines whether or not you can have VBAC.Meagan: I know. It shouldn't be anyway. Yes, yes, yes. But for some reason, we're still seeing it. So I think it's good to know that you guys, if you're having that, maybe just think twice about it.Dr. Nicole Rankins: Or get a second opinion.Meagan: Yeah, I was going to say, get a second opinion.Dr. Nicole Rankins: Yes.Meagan: Okay. So our community asked questions. I went on and said that we were going to have you on. And they were so excited and kind of just asked all of the questions. So one of the questions was, if you don't get an epidural for a VBAC and you need a C-section, will you have to be put fully out, so under general anesthesia?Dr. Nicole Rankins: Yeah, no. Not necessarily, and most likely not. Generally, as long as it's not an emergency, there's time to do a spinal. The difference between an epidural and spinal, the epidural is a catheter that stays in place and medicine continually gets fed through the catheter where a spinal is a one-shot dose of medicine that lasts for two to three hours. So as long as there's time and you can sit up for the spinal or they can lay you on your side for the spinal, then they can do the spinal for the C-section, and you don't have to do general. General anesthesia is only reserved for if it's truly an emergency and there's not enough time to do the spinal.Meagan: Right. And for this is another, I'm adding this. But epidural versus spinal longevity of effectiveness meaning like you're numb enough for them to perform the surgery.Dr. Nicole Rankins: Yeah. The spinal's going wear off.Meagan: Yeah. Quickly, but it's going to go on quicker. Right or no? Or deeper?Dr. Nicole Rankins: Yeah, it's a denser numbing than what you get with an epidural. When you get an epidural before, if you have an epidural and then you go to a C-section, then you just get a bigger dose of medicine that kind of mimics what you get through the spinal. So the thing about the spinal is that it's meant to cover a surgery, so it's going to be a larger dose of medicine, so you're going to be more numb because we don't actually want you to be completely numb during labor. The spinal is really just to make sure you're nice and is numb and don't feel the surgery.Meagan: And how long does it take to kick in to be numb enough? Like 20 minutes? 30?Dr. Nicole Rankins: Yeah, yeah. I would say it's actually pretty quickly. So yes, you're right. It can kick in a little bit faster than epidural because it's a lot more medicine. So typically, I would say within 5-10 minutes, you're going to start feeling numbness pretty quickly. But by the time we've laid you down, washed your belly, put in the catheter, done those things, then you're numb.Meagan: Yeah. So in that non-emergency situation, you're going to have plenty of time to be numb and not have to be put under general anesthesia. In an emergent situation, we have minutes. We have minutes to work with. How many minutes if we're having fetal distress? And obviously, it could vary for a lot of patients, I'm sure, but major fetal distress emergent like true emergent under general anesthesia. What are we looking at a timeframe before we get baby out before we're really concerned?Dr. Nicole Rankins: Yeah. I mean so if it's true, like an emergency, because a lot of people say they had an emergency C-section. It's actually not emergency. Meagan: Right. Baby was born two hours later. D; Yeah, or even 30 minutes later. So emergency is going to be like we're ripping the cords out of the wall. We're running down the hall to the operating room. When we get in the operating room, the heart rate is still in the 60s. So we want baby out in five minutes.Meagan: Okay.Dr. Nicole Rankins: We want baby out as quickly as possible, and the quickest way to get a baby out is general anesthesia and then go, if you don't already have a spinal.Meagan: Right. Perfect. That's also another common question of like, well, how long do I have if I don't have that? Because that's a big deciding factor for people with not wanting to go unmedicated or wanting to go to medicated but not wanting to be in an emergent situation. Those emergent situations, they happen. We can't sugarcoat it. They happen, but they are more rare. I love that you pointed that out. A lot of people say this was an emergent situation and we hear, well, then they went out and they came back, and 25-30+ minutes later, they had a baby.Dr. Nicole Rankins: That's not an emergency. As a matter of fact, emergency C-sections are fairly rare. Knock on wood, I can't remember the last time I've had to run somebody down the hall for a C-section.Meagan: And I call those crash like crash sections. Everybody crashes and goes. Yeah.Dr. Nicole Rankins: Mhmm. Mhmm. Things are moving so quickly.Meagan: Okay. So someone says, do I need an OB for a VBAC? I have lost all trusts in nurses and doctors after being forced into a C-section which breaks my heart that this question is a thing. I see it all the time. People have been "wronged" or bullied, and it shouldn't be that way. Dr. Nicole Rankins: It should not.Meagan: Sometimes it happens for whatever reason. But yeah, like do you have to have an OB? Obviously, we know the answer is no.Dr. Nicole Rankins: No, you can have a midwife. For sure.Meagan: But maybe I want to spin it to more of a positive. If we have an OB, how can we better establish a relationship with them so we're not in a situation in the end feeling pressured or bullied?Dr. Nicole Rankins: Yeah. And actually I want you to even back it up even further, and this is for anybody having a baby. What you want, you don't specifically want a midwife. You don't specifically want an OB. What you want is someone who's going to listen to you, respect your wishes and really center you in your birth experience. So yes, midwives are great at that, but sometimes midwives can be tricky too. The way that the reason I said that is because I know people who were like, "I had a midwife and I thought it was going to be great," and it wasn't. And they were hanging too much weight on that midwife hat.Meagan: The midwife word, yeah.Dr. Nicole Rankins: Yes, yes. So you really need to start with is this person listening to me and respecting me? So whether that's midwife or OB, okay?Meagan: Yeah.Dr. Nicole Rankins: So take that away first. And then if you have an OB, again because the midwife is also going to work with an OB, I'm assuming you're doing in the hospital, you want someone who is not just like, "Oh, if you go into labor, you can have a VBAC. I mean, I guess that's okay." Or you want somebody who's really actually supportive of it. I think you've used this language before, not just tolerant of VBAC that they actually you and don't just tolerate the possibility.Meagan: Yeah, I have kind of been thinking about that. Like we as doulas. It's like, oh, I want someone to advocate for me. That big word "advocate", and what does that look like? But in a lot of ways, I think that's what I want a supportive provider to do is advocate for me. Like I understand, validate me. I understand this is what you want, and we're going to do everything we can in our power to do this. If there's something along the way that is saying maybe we shouldn't, I will have that discussion with you. I will not just tell you what you have to do. Dr. Nicole Rankins: Exactly. Meagan: Again, it goes back to that conversation we were having in the beginning of that collaborative relationship. If that is there, I think you set yourself up for better expectations no matter who it is with an OB or a midwife.Dr. Nicole Rankins: Definitely. Definitely. Yeah.Meagan: Nurses can be tricky. We love our nurses. They're incredible, but sometimes they have opinions, and sometimes they come in and they put it on us.Dr. Nicole Rankins: Here's the thing that people don't realize. You can ask for a new nurse.Meagan: You can.Dr. Nicole Rankins: Yes you can. You can absolutely. There's always a charge nurse who's in charge of making patient assignments. You can ask to speak to the charge nurse, and you can get a new nurse. Don't feel bad or guilty or like you're hurting anybody's feelings. People will be fine. I promise you. They'll go home, and they'll keep going on about their lives if you ask for a new nurse. So I know it can be challenging, especially sometimes for women to speak up about things, and you're worried about hurting people's feelings and things like that, but you can always ask for a new nurse.Meagan: Absolutely. This is not related to birth, but I signed up with a personal trainer at my gym, and I was assigned to this amazing person, and she was great, but I realized a couple weeks into it that maybe we weren't the best fit for one another. I hesitated for two more weeks to say, "Hey, can I switch?" And now that I've switched, oh my gosh, it's the best decision I made, and I get to see her at the gym all the time. I went up to her and was like, "I love you. Thank you so much. This has been great, but this is what I'm doing." It was a wonderful breakup. You don't even have to break up with someone like that, though. You really don't. It doesn't have to be. I was so nervous, but this is your space. This is your birth. This is your experience. You have to protect it and keep it what you need. If someone's not jiving that or that nurse specifically, you can say, "Hey, thank you so much for your services, but I would like to switch." It's okay.Dr. Nicole Rankins: Definitely, Absolutely.Meagan: And you don't want to go back at the end of the day and be like, oh, I had this nurse, and it was the worst seven hours. That's not positive. We want to look at our birth with a positive view, not a negative view.Dr. Nicole Rankins: Yeah. And your nurse is going to be there way more than your doctor. Way more. You definitely want to be in sync with your nurse.Meagan: Yeah. And something else, too. I tell our clients all the time, our doula clients, like, "Hey, upon arrival, if we're not there, say, 'Hey, I would really love a nurse that fits in line with blah, blah, blah.'"Dr. Nicole Rankins: Exactly.Meagan: And a lot of times, they assign it right then, and you're like, "Oh my gosh, you guys are amazing. Thank you."Dr. Nicole Rankins: Yeah, exactly.Meagan: Okay, so next question. What should I consider if my goal would be to have a home birth? So from a hospital OB/GYN, where do you fit in that? What would you suggest? I know a lot of JOBs are like, "Don't go to home."D So yeah, so I personally I would TOLAC at home makes me nervous, but that's because I've seen uterine ruptures before and how quickly things can change. So but however, like in Canada, I think their specialty society guidelines support doing a TOLAC at home after one C-section. So it's not that it's unheard of, but I will say it makes me nervous. Now, if you do want to do it at home, then absolutely have someone who is experienced. This is not the time to have like a brand new midwife. I think you want to have somebody who has some experience in particular with looking for any signs and symptoms of when to go to the hospital. We also need a clear plan for hospital transfer and ideally, that midwife should have a relationship with the hospital so that she feels comfortable going to the hospital in a timely fashion. One of the things that I've seen unfortunately happened during my career with home births that have not turned out optimally is that people are afraid to go to the hospital, so they stay at home too often, and then by the time they get to the hospital it's a train wreck. That's not good for anybody involved. So you want it to be a situation where the midwife feels comfortable going to the hospital in a timely fashion. For example, I work with home birth me bias in my community. I have gone out to the birth centers and things and say, "Hey, if you want to transfer somebody, just let us know. Call."Meagan: I love that you've done that.Dr. Nicole Rankins: Yeah, it's, it's important. So call. Send the records. We have a really smooth process. Nobody bats an eye now when there's a transfer from home birth. Meagan: Oh good.D; So you really want to have those two things in place. A skilled midwife and a good backup plan, preferably with the relationship to the hospital.Meagan: I love that. Such great advice. That's awesome that you're doing that for your community. I just had an interview the other day with a VBAC mom who's toying with the idea, not sure where to go. She asked me and I was like, "Well, you could do dual care. You could establish a relationship with a provider. You can ask your provider out-of-hospital of choice if they do have that relationship," because I do think it is important because sometimes even the midwife is like, "I don't know where to go," so I love that you've done that and gone into the birth centers there. Okay. So we just talked about fetal monitoring, but one of the question was, is intermittent monitoring safe with VBAC just in general?Dr. Nicole Rankins: Yeah. It hasn't really been studied very much, and it's not going to be. That's the thing. It's just not something that anybody's going to sign up for and say, "Hey, you get monitoring. You don't get monitoring," and see what happens in assess that situation for VBAC. So I can't answer that question based on data. I will just say that in general, we want to do continuous monitoring.Meagan: Right. That makes sense. Okay, so small lumps under my C-section scar. What could that be? Would/could it impact the outcome of my VBAC?Dr. Nicole Rankins: It's probably scar tissue.Meagan: That's what I thought when I saw that question come in. I think that dials into like going and chatting with someone like askjanette or a pelvic floor PT or someone who can help massage that scar tissue because anytime we have a cut whether it be from a C-section or you fell and scraped your knee and cut your knee open on a rock or a twig, our body will develop scar tissue, and sometimes it clumps. Sometimes it gets that.Dr. Nicole Rankins: It's probably just scar tissue. And no, it should not impact your ability to have a VBAC.Meagan: Have you ever seen this within your TOLAC world, your VBAC world where sometimes we've got thicker scar tissue and sometimes there's separation within the scar tissue internally as babies coming down and making their way through or uterus is contracting? And so sometimes it can be like, oh my gosh, I've got this burning sensation in my scar which we hear, and it's like, that's concerning because we know that sometimes uterine rupture can be that feeling of burning sensation or pain, and usually that pain doesn't go away and just keeps improving. But have you ever seen that with someone and where they're like, "Oh, I've got this burning sensation," and could it be scar tissue stretching maybe?Dr. Nicole Rankins: Not that I can think of off the top of my head. Definitely, sometimes you have to be careful when you hear people say they're Having pain in their abdomen. Could it be scar tissue stretching? Possibly. That's definitely a possibility.Meagan: It's something that's crossed my mind, over all the years, especially as baby's coming down and putting that extra pressure there.Dr. Nicole Rankins: Right.Meagan: Okay. So again, yeah, this is something that we asked talked about earlier. So to what extent are decels considered normal in early and late labor? Dr. Nicole Rankins: We don't categorize decels based on the stage of labor necessarily. It's based on how they look, and again, over the course of how the tracing looks. Now sometimes right at the end, we're going to tolerate during pushing some decels, because you're pushing and squeezing, so there's going to be decels. So we may tolerate them more towards the end, but other than that, it really just depends.Meagan: Okay, that makes sense. I feel like sometimes as a doula, we're getting into that transition, almost pushing stage and they come in and they're like, "Hey, so we're wondering if maybe you're ready to push here soon or something's going on based off of some decels." Not that they were concerning, but they're seeing them. But really decels in general, overall, you're going to look at a whole versus one contraction or two contractions.Dr. Nicole Rankins: Yep.Meagan: Okay. PROM. So premature rupture of membranes and pre-e with VBAC it says is it still safe? I will answer from my own experience.Dr. Nicole Rankins: Yes, absolutely.Meagan: Yeah, but yeah, time too, with PROM So if we're not having labor begin or we're maybe contracting, like what's handled in that situation, especially knowing that in some hospitals around the world and in the US don't allow Pitocin?Dr. Nicole Rankins: Right, yeah.Meagan: Even though that's also not necessarily a contraindication.Dr. Nicole Rankins: Correct. So with PROM, so water breaking before labor starts, it's not as common, but it does happen. You can do expectant management and roughly within 24 hours, most people will start to go into labor on their own. So you can do expectant management, but Pitocin is actually quite safe in those circumstances. The risk of uterine rupture is low. So Pitocin can definitely be used. You just want to use it carefully.Meagan: Yeah. You mentioned that most people within 24 hours will start contracting and having labor, whether it be active at that point or not. But at what point could it be concerning? And maybe if we have GBS or something like that as a factor, would we be like, "Hey, we could keep waiting for the 24-hour mark," and that's not to go in and have a C-section, that's just maybe to augment. When would you encourage augmentation sooner?Dr. Nicole Rankins: So I'm a little bit of an outlier. I just offer the options, and we can talk about that it may take longer if you wait to augment and that's it. It may take longer, and that's it. That can potentially increase the risk of infection. But we don't really do time limits. I don't do 18 hours or 24 hours. I kind of pick. These are moments for us to have discussions about where things are. So definitely usually 6, 12, 18, 24 and just to touch base and see where things are and develop an ongoing plan. Not necessarily have a hard and fast rule that you have to be delivered or by a certain point makes sense.Meagan: And then preeclampsia. So we have seen this quite a bit in our community, on Facebook and on Instagram where they said, "Hey." There was a post just the other day that said, "Hey ladies, I just wanted to thank you so much for being here in this group. You guys have been amazing. Unfortunately, I have to sign off of this group because my provider said I have to have a C-section now because I've developed preeclampsia," so they didn't even offer the option to TOLAC or monitor. And everyone's like, "Wait, what?" This is a thing? So obviously, we know that we can, and everyone's numbers vary. If we've got severe preeclampsia and maybe that's not gonna be best for the stress of mom and baby and everybody, but do you have anything to say on that? I don't really know if I'm asking a question.Dr. Nicole Rankins: But yeah, no. You can definitely try for a TOLAC in the setting of preeclampsia. Now, if even in severe preeclampsia, it just may take longer. But if we're seeing that you're getting sicker and labor isn't progressing or the baby is under distress, then the safer thing may be a C-section. So if you have severe preeclampsia, for example, and it's affecting your liver and your levels of your liver enzymes are going up, up, up, up, up, and we're not close to delivery, then it's going to be safer for your health to expedite birth, and that's going to be a C-section. So it really depends.But the option of completely taking it off the table, that is not standard or that's not evidence-based.Meagan: Yeah, yeah. And for HELPP syndrome, where it's gone to that extreme. Now we've got platelet issues and things like that. Can someone with HELPP syndrome TOLAC or is that truly a better option to have a C-section?Dr. Nicole Rankins: I would actually prefer if someone ideally is in labor with HELPP syndrome. Actually, a vaginal birth is going to be safer because when your platelets are low and then we're adding surgery, the risk bleeding goes up.Meagan: That is what is so weird to me. My fifth birth was a HELPP syndrome. She was a VBAC, and they're like, "You have to have a scheduled C-section." But then we did all these transfusions and all these things and in my head, I was like, but isn't platelet meaning we have a higher risk of bleeding? But so yeah, that's another question.Okay, I think there's only one or two maybe. Oh, this is a really great question. Is it safe to TOLAC? So again, listeners, TOLAC, if that's new for you, is a trial of labor after Cesarean. I know I've thrown it out a couple times this podcast. After having a hemorrhage in a C-section. So had a C-section hemorrhaged. Now they're wanting to TOLAC. Is that considered safe?Dr. Nicole Rankins: Sure.Meagan: Okay.Dr. Nicole Rankins: Okay. I want to discourage people from using the word "safe" because I think what you really want to know is what are the risks of something happening again? So yeah, because what do you mean by safe?Meagan: Right.Dr. Nicole Rankins: What you really want to know is what are the risks of this thing happening again? So there are no identified increased risks in having a TOLAC after you had a postpartum hemorrhage during a previous C-section.Meagan: Okay, I love that. So that's good because I mean anytime anyone hemorrhages with birth, I feel like it's a little bit on everyone's radar.Dr. Nicole Rankins: Right. Okay, and then I have one more question for you before I let you go, and I don't know if it's Bandl's ring or Bandl's. How do you say that?Meagan: Yeah, Bandl's ring. What is a Bandl's ring for those who it's very new to, and then can you TOLAC or have a VBAC with Bandls ring?Dr. Nicole Rankins: It's a really tight ring of muscle in the uterus where it's just really tight, and it doesn't contract. I can only recall seeing it, like, once in 22 years, so it's not common.Meagan: It's more rare.Dr. Nicole Rankins: Yes, very rare. So it's just really hard to have a vaginal birth if there's a really tight ring of tissue that is preventing the uterus from opening. If the uterus can't open, then the baby can't come out. So that's the issue. It's not like we can release it or clear it up or anything. I don't know why. We don't know why it develops, but it's just, like anything, if it's tightly closed, it's really difficult to open.Meagan: Yeah. Okay. That makes so much sense. And is there a way to find out if we have that beforehand?Dr. Nicole Rankins: Not really.Meagan: Not really. Okay. And the signs of that Bandl's ring is just lack of progression it seems like.Dr. Nicole Rankins: Overall, it seems like lack of progression. And also, the baby usually doesn't come down in the pelvis.Meagan: Yes. Yeah. Okay. Thank you. That was a one-off random one that crossed my mind. I keep seeing that one too. Anything else that you'd like to touch on? I love all of your points of stop considering the word safe and talk about, what are the risks here? What do we need to know to make the best educated decision? Having a collaborative discussion and relationship with our provider. So many great points along the way. Anything else that you'd like to add or say to the community to someone who really is wanting to know all the information they can to VBAC and are unsure of which way to go?Dr. Nicole Rankins: I think that the best thing is just to really find a supportive provider, doctor, midwife, and do that in the prenatal appointments. Ask those questions early, and don't be afraid to change to someone else if you feel. And sometimes you may not have options, but if you have options, then find someone who is the most appropriate for you because that is going to be the thing that most sets you up for success. Oh, also, get a doula.Meagan: Hey. I love it. I will never not advocate for doula, but really, I mean, I love that you're pointing it out again. Before birth, early on, ask those questions. Always have a conversation with your provider. If something is switching, it's okay to switch. I know it's daunting. It is daunting. It really is. I didn't want to cheat. I felt I was cheating on this doctor. We had this relationship. I don't even know what I thought. I thought I was cheating on him by leaving him. And I didn't leave him, and I didn't find myself having the experience that I wanted or feel like I deserved. And, looking back, I probably should have switched. Well, I didn't. I have learned, but I don't want anyone else to be in that situation of, dang it, I saw all the red flags, and I didn't switch because I felt bad.Dr. Nicole Rankins: Yeah. Yeah. I don't mean to sound flippant, but I can guarantee you. Your doctor, if you leave, they're just gonna keep seeing patients. They're just going to go home and keep living their lives. It's going to be fine.Meagan: I know. I had a friend, and she was like, "Looking back, do you realize how it wouldn't have impacted his life at all?" And I was like, "Yes. But in my mind, I had a deeper connection."Dr. Nicole Rankins: I know. In the moment, you can't because you have that emotional connection, and you care about those things? So that's totally natural.Meagan: Yeah. And in a lot of ways, he was saying, "Yeah, sure. I'll support you." But then in a lot of other ways, he wasn't saying this with his words, but he was saying, "No, that's not my thing."Dr. Nicole Rankins: Right.Meagan: So, yeah, you deserve the best and keep doing your research. Find the provider. Get a doula, hands-down. Just a reminder, everybody, we have VBAC-certified doulas on our website all over the world. And yeah, thank you so much. You're the best. And everyone, go follow her podcast and wait it out for these new updates. Yes.Dr. Nicole Rankins: Yes, these new updates are so exciting. I'm so excited.Meagan: I'm so excited for you. That's so awesome. You are just incredible. We really enjoy you. So, thank you.Dr. Nicole Rankins: Thank you so much for having 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

Den ojämförlige Aron Flam gästar Sista Måltiden.OBS. Hela avsnittet är 2 tim 59 min långt. Vill du få tillgång till alla hela avsnitt? Bli medlem på Sista Måltiden. Som medlem får du tillgång till alla nya och gamla avsnitt i sin helhet och utan reklam. Lyssna i valfri podcast-app, inklusive Spotify. Enkelt att komma igång. Ingen bindningstid. Tryck här för att bli medlem eller gå in på https://sistamaltiden.se.  Hosted on Acast. See acast.com/privacy for more information.

Jason recaps his visit to the OBS sale on Tuesday and we welcome in Gabe Prewitt from Hoosier Park to talk about the new season and big changes in their betting program. 

Mariah Parsons hosts Taylor Hall, the Marketing Manager at Bagphic, a company specializing in pre-loved authentic designer handbags. Taylor discusses her background in B2B marketing and her role at Bagphic, which involves bridging the gap between Japan and the US. She highlights the meticulous process of authenticating luxury items, emphasizing the importance of customer experience and loyalty. Taylor explains their marketing strategy, focusing on lifestyle and live selling, particularly on platforms like Whatnot and Poshmark. She also touches on the importance of customer retention through personalized service and maintaining a seamless shopping experience.Episode Timestamps:5:01 Taylor's Journey to BagphicTaylor explains how she found the job at Bagphic, highlighting her background in B2B marketing and her dual heritage.She describes the company's structure, noting that it is a brand of a much larger company based in Japan.Taylor shares her excitement about transitioning into a role that leverages her cultural and global perspective.She discusses the intimidating nature of joining a large company and her initial fears about working with luxury handbags.6:40 Bagphic's Product Offerings and SourcingTaylor elaborates on the unique nature of luxury handbags from brands like Dior, Fendi, Chanel, and Hermes.She explains the meticulous process involved in creating these items and the importance of authenticity in sourcing.Taylor describes the rigorous inspection process for authenticating pre-loved items and the expertise required to identify genuine materials.She highlights the sustainability aspect of selling pre-loved luxury items and the rarity of finding certain pieces.18:35 Marketing Strategy for BagphicMariah and Taylor discuss the nuances of marketing luxury handbags, focusing on the lifestyle and experience rather than specific products.Taylor explains how Bagphic leverages the notoriety of luxury brands and emphasizes the unique selection and customer experience.They talk about the importance of inventory management and the challenges of maintaining up-to-date stock information.Taylor emphasizes the role of social media and live selling in keeping customers informed and engaged.19:50 Customer Acquisition and Social MediaTaylor shares insights on how Bagphic uses social media to promote a lifestyle and build customer confidence.She discusses the effectiveness of live selling in providing a more authentic shopping experience, especially for luxury items.Taylor explains the different platforms Bagphic uses for live selling, including Whatnot and Poshmark, and the benefits of each.They talk about the importance of community building and the role of software like OBS for multicasting live sessions.37:14 Customer Retention and ExperienceTaylor outlines the key factors for customer retention at Bagphic, focusing on experience, impression, and relationship.She emphasizes the importance of providing a seamless experience and building trust with customers.Taylor shares her belief in mutual support and loyalty, both from the brand's perspective and from customers.They discuss the emotional connection between brands and customers and how it contributes to loyalty.45:01 Solving Problems and Future PlansTaylor talks about her approach to solving new problems, emphasizing the importance of understanding the customer's perspective.She mentions the value of research, feedback, and leveraging her network to find solutions.Taylor hints at some exciting collaborations and events in the future, including a Whatnot seller event.Mariah expresses excitement for the upcoming developments and thanks Taylor for sharing her insights.

While we can't control many parts of birth, there is so much we CAN do to quite literally change the trajectory of our birth outcome. First: Feel safe with where and with whom you will give birth.Second (but just as important!): Prepare yourself mentally, physically, emotionally, and spiritually. During her first VBAC attempt, Maria hired a midwife. Her second birth had so much more advocacy, progress, and positivity, but there were still missing pieces, new traumas to process, and things she wished had gone differently.You will NOT WANT TO MISS hearing all of the things that changed for Maria from her first two births to her third. The proactive work, the passion, the prep, the healing, the research, the manifesting, the surrendering, the trust, and to top it all off, the beautiful, unmedicated VBA2C outcome. Just like Maria, our greatest hope is for all of you to unlock this birthing power that is already within you, no matter the birth outcome. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello, you guys. It seems like a common theme lately. A lot of people are wanting to submit their VBA2C stories, and I love it. I love it absolutely so much. We know so many of, these listeners in our community are wanting to know, is it possible? Can we VBAC after two Cesareans? I'm sure you've been noticing the theme in January and February, and now here in March, we have another VBAC after two Cesarean stories coming to you today from our friend Maria. Hello, Maria.Maria: Hi.Meagan: Thank you so much for being here and sharing your stories. We were just chatting a little bit before we got started about kind of where her birth took place, and she'll tell you more. But the VBAC was in Texas, right?Maria: It was. Yes, it was in Texas.Meagan: It was in Texas. So Texans. Texans? I don't know. we have Floridians, Utahns. Is it Texans?Maria: Texans. Yeah. Yep. And you know, Texas is a huge state, so this is central Texas in the Austin area. Yeah, because it's such a big state. It is.Meagan: It is very huge. We know people have to sometimes drive really far away to find support. And when it comes to VBAC after multiple Cesareans, we know sometimes that can be really challenging. And when I say sometimes, it's often. It is often challenging to find that support. So I really like to show everybody where you are in a way because we want people who are in Texas or who can get to Texas or who find it manageable, that they know that there is a supportive provider there. We'll learn more about that. But also, just a reminder, guys, if you're looking for a supportive provider, we have a supportive provider list. How many times can I say "supportive provider" in three seconds? A lot, apparently. Go to Instagram and hopefully at this point we'll have it on our website, so check our website too, but we will have that list.If you want to submit your provider, please let us know. Okay. We have a Review of the Week, so I want to get into that. This is by Whitney Goats, and the review title is "Amazing" on Apple Podcasts. It says, "I've been wanting to write a review for a while, but wasn't sure what I could say that would explain how much The VBAC Link meant to me. I had an unplanned Cesarean with my first and for the longest time, I felt broken and defeated. When I heard Julie and Meagan share their VBAC stories on the podcast, I cried. It was the first time that I felt understood and like I was not alone. Listening to their podcast has lifted my spirits, healed my emotional scars from the previous birth, and given me the confidence in myself and my body again. "I am now 28 weeks pregnant and preparing for my VBAC. Instead of being scared for this upcoming birth, I feel excited sometimes. I never thought it would happen. Thank you, Julie and Meagan, for the work that you have done connecting and educating all these amazing moms, and thank you for reminding me that I am a Woman of Strength even when I doubted it myself." Oh, that gave me chills. That gave me chills reading that. Oh my gosh. We love your reviews. That is amazing. And girl, Whitney Goats, I hope that you had the most amazing birth ever, and thank you for being here. Just like Maria and all the storytellers that have become before her, you guys, they're amazing and so are you. These storytellers are here to do that- uplift you, motivate you, educate you, and find the healing within yourself because it can happen, right Maria?Maria: Absolutely. 100%.Meagan: It absolutely can happen. Okay, you guys, as always, if you do not mind and if you are enjoying the podcast, will you leave us a review? You can go to Apple Podcasts. You can go to Google even and leave us a review there. You can go on Spotify or really wherever you listen to your podcasts, leave us a review. If you feel extra special and the platform that you're listening on can leave a comment, leave us a comment. You never know, it may be read on the next podcast. Okay, Maria, I want to turn the time over to you to share these stories.Maria: Thank you so much, Meagan, and I just want to say again how excited I am to be here. I agree 100% with that reviewer. This podcast was so impactful for me, and I hope that it can continue to be that for other women. I was also so excited that you're getting so many VBAC after two stories because I hope that that will continue to normalize that instead of it being this crazy thing that we're doing. Meagan: Yes.Maria: That's so exciting that it's becoming more common.Meagan: I know. It's actually making me smile so big because in the beginning, back in 2018, we had to search, and I mean search. We had to go on forums and type in "VBA2C" and really look for stories and almost had to seek them out. We had to go and ask, "Hey, would you be willing to share your story on the podcast?" And now we're just getting a flood of submissions which is so awesome. I love seeing it, and I would love to hear even more VBAC after three or four or five Cesareans because it is possible. It's not as easy to navigate through, but it is possible. And yes, there are risks. There are risks with anything that we do including a repeat Cesarean, but I want to help normalize this because, I mean, there are so many women just like Maria and myself who have gone on, done the work, got the education, and been able to have a vaginal birth. So. All right, well, we know with every VBAC or VBAC after two Cesareans, there's at least one Cesarean involved, so let's start with that story.Maria: Yeah. Okay. Thank you. So when I got pregnant with my first baby, this was in 2018, it didn't take me very long to find my way to the natural birth world. I watched The Business of Being Born like a lot of women, and I was fully convinced that I wanted to birth vaginally and naturally if possible. So, when my husband and I decided to move to Costa Rica halfway through my pregnancy, the very first thing I did was research the C-section rate versus natural birth rates in the country. I was pretty disappointed, although I wasn't surprised, to find that the rates there are pretty high. I mean, they're about the same as the US but a bit higher in the private hospital setting which is where I was going to give birth.I didn't want to let that deter me, and I was determined to build my team. From when I was still here in the States, I started researching the best OBs and doctors in the area and hospitals. I found two in the city of San Jose which is where we were living, the two most quote unquote natural OBs.Another interesting thing I found out was that midwives are actually not legally permitted to work in Costa Rica independently.Meagan: Really?Maria: Yeah, at least back in 2018. I don't know if things have changed since then, but they are not allowed to work independently. They are allowed to work alongside an OB. So I was like, okay. I went with one of these OBs, and there was one midwife who practiced in the city of San Jose, and they worked together as a team. And so I was like, okay, all right, well, I guess this is it. I have my team, and I thought I was done. I don't think that I fully understood the intensity of birth or the mental and physical stamina that would be required of me because it was my first baby.Meagan: You don't know what you don't know.Maria: You don't know. Exactly. I took a Bradley birth course with my husband, and I just assumed that everything would be fine as long as I had a good team, and I'd be able to escape the dreaded cascade of interventions that I'd heard so much about. I wasn't informed, but I don't know. I was very intellectually informed, but I didn't really know how intense labor is. So intellectually, I knew what I had to do. But anyway, we were living abroad. I went into labor naturally at 40 weeks, and I had a very long labor which began in the middle of the night which was a common theme in all my birth. They always started in the middle of the night which I think is pretty common. And because it was my first baby and I was so excited, I was unable to really stay calm and rest.I got very ramped up way too soon.I burned through a lot of my energy in the first 24 hours of what I now know was very early labor. So by the time it was actually more intense and I made it to the hospital, I was exhausted because I slept so little. We get to the hospital and my labor slowed down, which again, I know is not uncommon, but I think I was also just not feeling very relaxed. I started actually feeling uncomfortable with this midwife /doula as she told me she was. She said, "I'm a midwife/doula." I later learned that is not a thing. It's like, either you're one or the other. I just didn't feel like she was really supporting me as I expected she would. It seemed to me like she wasn't really a doula. I started realizing, okay, this is not what I was expecting. She was more of a quasi-nurse, really, for the OB and just assisting him. She was like his private nurse, basically. She was sitting there in the room either watching me. She'd come in and give me a position, but then just sit back and she was on her phone. At least that's how I was perceiving it. I just started kind of not feeling very safe with her, and I just shut her out. In hindsight, I think I should have asked her to leave. But at the time, I didn't really know that I could do that, and that I could really advocate for myself in that way, so I just kind of shut her out. She probably felt that it just wasn't a good click. So then I began to feel pressure by the team because I'd been there for probably, what is it, maybe 8 hours or so? They started pressuring me to get things going. And so the OB approached me about using what they call natural oxytocin which is what they call Pitocin.Meagan: Pitocin, yeah.Maria: Yeah. But they're like, "No, no, it's natural oxytocin." And I was like, "Okay, I know what that is." I could already see that I was being slowly kind of backed into this corner. I refused it several times, but I finally agreed to it. Of course, my contractions became excruciating, but I just was just determined to not have the epidural so that I could walk, even though I was already plugged into the IV and really not walking as free as I wanted. Eventually, one of the nurses, after a while, came in and she asked me when the last time I peed was. I couldn't remember. That's when I was like, "Oh yeah, it's been a long time." Nobody reminded me. I just didn't think about it. I had been drinking water, so they had me try, and I just couldn't pee. It's like my body just kind of shut down. So they decided to try and insert a catheter to see if it would empty my bladder and help baby descend. So I was laying on the bed. I had five people around me trying to place this catheter in me. I was on Pitocin, so I was having these intense contractions, and they weren't able to insert it. They said it was because of the way my body was. I guess my urethra was towards the back or something, and they just weren't able to do it. That was really disappointing because I was really hoping that that would be the magic thing that would help baby descend. Finally, the OB came in and was like, "Listen, if you want to avoid a C-section, you should just do an epidural so that your body can relax, and maybe that could help us place up the catheter and then, baby will descend." I was like, "Okay, all right. Let's do it." They did it. It felt amazing for a couple of minutes, and then immediately, my baby's heart rate dropped. The OB basically just called in an emergency, and I was whisked off to the operating room for an emergency C-section. I was traumatized because I legitimately thought I was dying. I thought it was a true emergency. I was like, oh my gosh. I can't believe it. I'm gonna die. Of course, I've learned since then that a baby's heart dropping after an epidural is pretty common.Meagan: Pretty common, yeah.Maria: And that it wasn't really a true emergency that merited a C-section right then and there. That's been a really hard thing to process.Meagan: And frustrating, too, because he was like, "If you want to avoid a Cesarean, this is what you have to do," and then you did that, and then it immediately went that way.Maria: Yeah. I honestly thought he was. I think he was probably just prepping me in advance to just have the epidural so we could just go there.Meagan: Yeah, that's hard.Maria: Yeah. After baby was born, the hospital policy required me to go into the post-op room for 30 minutes to recover, and I would then be rejoined with my baby.Meagan: Oh, so your baby wasn't allowed to be with you?Maria: No. Meagan: What?Maria: Yeah. So my first 30 minutes as a mom, I was separated from my baby. He was with my husband. I was taken to this room where I was recovering alongside other people that I didn't know who were also recovering from other types of surgeries.Meagan: Whoa.Maria: Yeah, so I was like on this bed paralyzed still because of the epidural and shivering. It was a really surreal moment because I felt like, oh my gosh. I just had a baby. Wait, why am I here? What is happening? It was really, really traumatizing, and that was just their policy at that hospital. So it was really traumatizing for me. I was eventually joined back with my husband and baby, but needless to say, it really affected me.I did struggle with postpartum depression and anxiety for a long time. I had a very hard time bonding with my baby for that first year. I felt really robbed of that dream birth I had envisioned, and I felt robbed about the golden hour right after when you get to enjoy your baby and celebrate the fact you just had a baby. I felt like I never got that.Meagan: That would be very difficult. There are a lot of people who get their babies taken away, and it is so frustrating. I just wanted to give a little reminder that if you don't have your baby and you want your baby, it's okay to demand your baby and find someone who will do anything in their power to get that baby back to you.Maria: Yeah, so that was my first birth. So the second birth took place about two years later, and we were back in the US due to the pandemic. As soon as I found out I was pregnant, I was actually in Costa Rica when I found out I was pregnant, and then we moved back to the US halfway through my pregnancy. I just knew without a shadow of a doubt that I was going to try for VBAC. I was extremely confident that I could do it because I felt that if I found a truly supportive provider, there just was no reason why it wouldn't go smoothly. I had a lot of unprocessed anger and trauma that I hadn't fully worked through. I was still very angry at my OB, at the midwife, at the hospital, even though I did do therapy actually in Costa Rica, but I don't think I fully worked through this part. Even though none of it was truly 100% their fault, I still felt really let down, and of course, I felt anger at myself even for my perceived failure of my body to birth my baby. My way, at the time, of avoiding a repeat of this was to just completely avoid the hospital setting and go the complete opposite direction. So I opted for full midwifery care and home birth. I just didn't want anything to do with the hospital. It was traumatic. I was like, no hospital. At the time, we were living at my parents' home in their hometown. I basically hired the only midwife that I knew in town. I didn't really interview anyone else. I just went with her. I think in my mind at the time, as long as you were a midwife, she would be 100% better than an OB. Again, I was very angry at OB at the time. But also, I did meet the midwifery team and they seemed experienced and I liked them, so I felt really confident that everything would work out like it was going to work out. There was no plan B. Meagan: Yeah. Maria: In terms of preparing for my birth, I didn't really do much outside of remaining active. I did prenatal workouts. I walked. I was healthy. I thought that was pretty much what you had to do. I just thought again that not being in a hospital would solve all my problems, and that was the only ingredient I was missing for my dream birth, which, of course, I later learned was just part of the equation.So this time, my labor started actually pretty slowly. I had a premature rupture of membranes. It was a very slow trickle. It took over 24 hours of that for my labor to actually start. That was even after some homeopathic pellets. I don't really know what it was, but my midwife gave it to me and some castor oil that I took. I'm a pretty anxious person, so I was getting very anxious about my labor not starting because I had it in my head that I couldn't go too long without my water breaking. In my mind, I was on this timeline. I don't do well under pressure, so right off the bat, I was already in my head about it.Meagan: Yeah.Maria: I was so antsy to get labor going that I just wouldn't let myself rest. I actually went walking in the middle of the night with my husband instead of trying to rest. I was like, I will get this labor to start. I was just not really saving my energy. I was getting revved up again too soon. So again, once labor got going, I was exhausted.This time, I'd opted to give birth at my parents' home which in hindsight was probably not the best idea because I felt their presence in the home. I'd sense their worry and their concern over me, at least in my head. I was mostly in their bedroom, so I started getting claustrophobic in there. I felt like a caged lion at one point. I was like, ah. Now nobody was actually pressuring me, but I felt it. I just felt like my whole family knew I was in labor. Everyone was waiting for me. Again, hindsight is 20-20, right? I was like, man, I could have asked them to just leave for a while, but I just didn't feel like I could.Meagan: Yeah, it's their house. It's their house. It's their space. Yeah, it's weird. But I will just point out that who you have in your space and where you labor can impact your labor for sure because you're in your head.Maria: Yes, 100%. It took me two labors to learn that. Especially if you're a sensitive person and feel energy and if you're anxious, you have to be really aware of is somebody helping you or not? And if they are re not, then you can say you can ask them to leave. I just didn't know that I could do that.Anyway, I powered through it. Even despite that, I think labor was better in my home than it was at the hospital. I definitely felt more comfortable. I was more free. I was trying all these different positions and shower, bathtub, you know, everything. I felt really powerful. It was really positive at first. It was, despite the fact that I was really tired too. But it was a very long labor. Once again, my body shut down and I could not pee even though everybody was trying to remind me to go. I was trying to go, and there just came a point when my body just stopped wanting to go. We got to that point where they were like, "Okay, well let's try and place a catheter." They were not able to do it. I guess I have a very small urethra or something. Something happens in my body during labor. It's hard to get to it. This was a home birth, so they had their equipment on hand. They didn't have all the options that maybe they would have in a hospital of different sizes or something, so they just weren't able to place it. It was very, very disappointing. They also felt that I was getting weak, and I didn't want to eat anymore. They hooked me up to an IV. They gave me oxygen. This started triggering this fear in me that this was heading in a direction that I didn't like. It wasn't feeling like the peaceful home birth I had envisioned. I eventually got to 10 centimeters, and they said I could start pushing even though I didn't really feel much of an urge to push but I was like, okay, I'm 10 centimeters. I guess I'll try pushing. I started pushing for multiple hours, but the baby just wasn't descending. And at one point, the midwife could see the baby's head higher up, and she actually attempted to pull the baby out with her hands.Meagan: Kind of went in like a soft forceps.Maria: Yeah, exactly. It was very painful. Super traumatic. I was like, oh, my gosh. This is not what I envisioned. But she wasn't able to do it. He was just too high up. After that, I just remember seeing her throw up her hands and with her body just kind of say, I give up. There was nothing more that she could do for me. At that moment, with a surprising amount of clarity and conviction, I decided to call it and request to be transferred to the only hospital in my town that accepted VBAC, any other hospital would have had me go straight for a C-section. So this was my last chance because I wasn't done trying to VBAC. I was like, okay, home birth isn't gonna happen, but maybe VBAC will at a hospital. And so, we got to the hospital. When I got to triage, they checked me, and they actually said I was nowhere near complete and that I was 8 centimeters dilated, and that I was very swollen.Meagan: That's what I was gonna just ask. I'm wondering if you got swollen.Maria: I was definitely very swollen, but they also said I wasn't 10 centimeters. I was like, "What? What do you mean?" Because in my mind, I was like, I'm almost there. I'm 10 centimeters. Maybe all I need is an epidural maybe. Maybe I just need that final little push. At that point, I was okay with drugs. I was like, "Give me whatever." I'm so close, right?Meagan: Yeah, yeah.Maria: But no, they were like, "No, you're 8 centimeters." And also, my contractions had really spaced out, so they gave me an epidural. They gave me Pitocin, and they let me rest.Meagan: Did they give you a catheter and empty your bladder?Maria: Yes, they gave me a catheter to empty my bladder, but baby was just not coming down. And also, the epidural did not sit well with my baby again. They didn't whisk me away to a C-section this time, but they were starting to bring up, "Okay, it's been a long time." They also were pretty concerned that my water had broken two days before, and that was a big red flag for them. They started mentioning C-section as the safest route for me. After, I don't know, probably 8 hours there, I just kind of said, "Okay, let's just do a C-section, and we just went with it." This time was less traumatic because it wasn't an emergency. I chose it. I was also never separated from my baby, and that was very huge.Meagan: Yes.Maria: That was huge. Yeah, 100%. Like, I got to carry him immediately after birth. I was able to breastfeed him. I was like, nobody is separating me from this baby right now, and they didn't. So that was very healing, and I was very grateful for that. That was that birth. After the birth, the midwives did come to see me at my house, and when I asked them what happened, they weren't really able to give me an answer. The final consensus was that my hips were likely too narrow. At the time, this diagnosis actually gave me comfort because at that point--Meagan: It validated you.Maria: Yeah, it validated me. I felt like, okay, I tried everything. It felt like an answer. It was a neat and clean end to this journey. There was a lot of mourning still. It was a heavy weight on me, this disappointment of a failed VBAC and something that I would need to process for a long time because I felt really cheated. I really felt like I'd run an entire marathon, and that I could see the finish line only to find myself pulled back to the starting line again and have to run another marathon.I felt like I had gone through two whole births, the super intense home birth and then C-section. So I felt like, oh my gosh. I was wiped out. So, yeah. Those are my two C-sections.Meagan: Yeah. I mean, lots of really forward-moving progress with the second for sure and still work to be done. But also, you had some validation for you at the time. It felt better. Overall, it went better.Maria: Yeah, yeah, yeah. It definitely was better. It was better, but it was, in a way, almost more frustrating though because I got so close. I was like, I'm so close and yet I was pulled back to the exact opposite birth.Meagan: Yeah. I want to talk a little bit about swelling because swelling can happen. You can be 10 centimeters. Swelling can happen. It causes puffiness and causes our cervix to swell which then presents as not 10 centimeters. There are a lot of different factors like a baby that is maybe not putting equal pressure on the cervix during pushing or pushing before our body is really ready for us or going in there and doing that, I call it, soft forceps. This is just me making this up, but my fingers are a lot softer than forceps. So her doing some soft forceps was in effort to help baby come down and move but could have disturbed the cervix a little bit and then sitting in on the way. So I just wanted to point out that is it possible that you could have been 10 centimeters? Yes. Is it possible that swelling could have caused the regression? Yes, there are some hem-- oh my gosh. How do you say it? Hemopathic. Is that how you say it? Hemopathic. They're little tablets.Maria: Homeopathic.Meagan: Homeopathic. Why do I say hemeo all the time? Homeopathics. Just like they had given you those little tablets that can actually help with swelling of the cervix. So if you have a midwife or you want to look into that and have that in your bag at the hospital, if that happens, you might want to check that out. While you're telling your third story, I will see if I can find the exact name because I cannot place it in my mind right now, but I've seen midwives use it, so that's another thing. And then sometimes Benadryl. A lot of the time, I'll see moms be given Benadryl for swelling.Maria: Yeah, I don't think they gave me any of that. I think at the hospital they were just kind of like, "Oh, 48 hours. Okay, let's--".Meagan: Yeah, the typical.Maria: And yeah. I think they knew from the beginning probably that I'd end up in a C-section. I don't know.Meagan: Might have. Yeah. So baby one, baby two. How did things change with baby number three?Maria: Everything changed. So when I found out I was pregnant for the third time, I, was very surprised and excited. But as soon as I actually thought about the birth you, I felt dread. I knew I was out of options mostly because my fate had been sort of sealed with this diagnosis of narrow hips. I was pretty much certain that my only choice was a third C-section. That really filled me with dread because I had a really rough recovery with my second C-section. I was really unhappy with my scar. I just felt really not looking forward to a third C-section. So I was like, okay. It felt very scary. I decided to approach my husband about trying for a VBAC again. I was sort of certain he would be nervous about supporting me about that. I felt like it was gonna be like, "Maria, you've tried twice. Let's just accept it. Let's move on." But surprisingly, he was actually supportive and he told me to just start with doing some research about VBACs after two and to get some opinions. So I did. The first thing I actually did though was I looked into gentle C-sections because I was like, "Okay, I'm going to get my kind of worst-case scenarios out of the way just in case. If I'm going to have a C-section, I want it on my terms." I looked up the best gentle C-section OB in the area. I was like, "Okay, I've got something there." Then I reached out to my midwife for my second birth and asked for her opinion about going for a VBAC again. I reached out to a few birth centers in the area, and my midwife pretty much told me that she did not think I was a good candidate for VBAC again and that I would end up likely in a C-section. Again, because she was like, "You did everything you could. It just didn't work. I just don't think you're a good candidate." And then most of the birth centers in the area declined me because they only did the VBACs after one.Meagan: After one. Yeah.Maria: Only two birth centers in the area accepted VBAC after two. I was like, "Okay, I'm gonna go see one of them and just get a second midwife opinion."Meagan: Yeah.Maria: When I got there, this place inspired a lot of peace and comfort. It was this really cozy little space. It was a little cottage near hospital. The midwife I met with, her name is Galyn. Can we give you the name?Meagan: Yeah, yeah. Uh-huh.Maria: Yeah. So this is called The Family Birth Center. It's just amazing and Galyn is amazing. So she just was very confident. I told her my entire birth story. I was sure to add every single complication and also tell her what my previous midwife had said. I honestly painted a really dire picture for her. I was like, "I have really long labors. I can't pee." You know, blah, blah, blah. I was prepared for her to tell me that I was not a big candidate. Honestly, I almost wanted her to say that so that I could just close that chapter and go get my scheduled gentle C-section and move on because that felt easier and safer. Yet her response was not a no. It was actually a non-hesitant, "Absolutely, you can do this." I was shocked. I mean, she obviously asked for my op-reports and everything, but she said that she didn't see why I wouldn't be able to. She had a ton of experience with VBAC after multiple C-sections. She even said that she had a very special place in her heart for these mamas because, as she called us warrior mamas, who really, really wanted it. She did not believe that I was too narrow because that's actually quite rare. She thought it was likely that the baby was simply badly positioned. So right off the bat, she was like, "Okay, I would start you on some Vitamin C to strengthen your bag," which I didn't even know a thing. She was like, "Pelvic floor therapy right off the bat, and you need a proper doula." I was like, "Yes, yes, yes." I'll do all those things because I realized I had not really had a proper doula in my previous birth. And honestly, every concern or worry that I brought up, she was able to talk through it with me, provide a solution or just remind me that no birth is the same. She couldn't really control or predict the outcome of the birth but there were lots of things that we did have control over.One of the things that I was really worried about was my inability to pee during labor. She was like, "Okay well, we'll place a catheter." I was like, "Yeah, but they tried both times and it didn't happen." And she was like, "Well, I'll get you a really tiny one." I was like, "Okay." So she didn't seem worried about that. I just went with it and went with her confidence. I think I decided then and there that I wanted her because I just felt really heard and I don't know. She provided lots of practical and realistic solutions that we could control. Anyway, this time around, I hired a doula. Shout out to Jenna, my doula. Also an amazing, amazing woman. I went to pelvic floor therapy. I also did therapy again to process my past births. I worked really, really hard on radically accepting whatever this birth came to be. So unlike my first two births where I had a really rigid idea of what it would be, this time I worked really hard to just sort of surrender to whatever it ended up being. I also read several books, including how to Heal From a Bad Birth.Meagan: Yes.Maria: A really good book, and Birthing From Within which I also loved. It was a really impactful book, actually. I started doing some art therapy just to process some of my feelings and just about this pregnancy and birth. I listened to every single episode you guys had on VBAC after two. I took The VBAC Link course. Honestly, I hardly worked out mostly because I had two little boys under four, and I just did not have it in me. But I was still very active with just normal life and taking care of two little kids. I did walk a bunch and did some gentle, prenatal yoga. I also did some exercises recommended by my doula from Spinning Babies. The other thing which was different was that I was really mindful of my body positioning throughout my pregnancy. I was always trying to listen to my body and be mindful of my alignment. When I was watching TV or sitting at my desk, I'd sit on a ball. I'd sit on the floor. I love to go on my hands and knees. That felt really good on my back. So just kind of listening to what my body was asking me to do and just being more aware of my body. My whole motto was, throughout the whole time was, "Get out of my head into my body." Preparation felt really different for me this time. I felt like I was preparing my body from the inside out physically speaking. Like I said, I was going to pelvic floor therapy. I was also making room in my uterus for my baby with these exercises to be in the best position possible but I was also really focused on my mind, my spirit, processing all my fears, my traumas. It felt just so much more holistic. I did HypnoBirthing with an app. I wrote down my own prayer affirmations which actually became a really central anchor during my labor. I felt just really ready this time in a new way. And not just because of my dream team but because I was really just ready to surrender to whatever was to come. And also, what was driving me was this new goal which was this idea of just giving my body a chance to labor was the best thing both for me and my baby regardless of the outcome of the birth. Even if it ended up in a C-section, I was still doing what was best for my body and my baby. That's what I kept repeating to myself. It just gave me a lot of peace because the success of this birth was not tied to what kind of birth it was. You know what I mean?Meagan: Yes, yes.Maria: It removed a lot of that pressure, a lot of that fear, and that was just such a game changer for me. Yeah, that was the preparation. A few weeks before the birth, I'd been starting to get more intense Braxton Hicks, but nothing really consistent. I was really just trying to practice the art of basically ignoring them because my goal for my early labor was to just pretend like they weren't happening. I didn't want to get too excited too fast. I wanted to ignore them for as long as possible especially if they started in the middle of the night which is kind of a theme for me. It ended up being really great practice to do that because on Labor Day, of course, I started getting my first contraction at 2:00AM and I just denied it. I was like, nope, they're Braxton Hicks. I just wasn't allowing myself to get riled up. I managed miraculously to doze off for 20 minutes at a time until they started coming on stronger. Once I realized that this was early labor, I had decided before that I wanted to labor alone for a while. This was actually something that I'd been wanting to do just to have this early early labor be a sacred moment for me and my baby. I wanted to be able to pray, to talk to my baby and to prepare together for the work which we would be doing together, both of us. I went into the living room. I let my husband sleep a bit longer, and it was a really special time for me. I'm so happy that I did that.Meagan: Yeah, I was just going to say that is a very powerful moment. Our babies are so connected and if you can have any time, even if it's just like 20 minutes. "Hey, I'm going to the bathroom." Take 20 minutes in the bathroom and connect with your baby. I just think it's so powerful.Maria: Yeah. Yes. It was amazing because I did feel connected the whole labor in a way that I did not in my previous ones where I was very disconnected to what was happening in my body. I was in my head a lot. So at about 6:00am, my contractions were getting stronger and I was like, okay, it's a reasonable time. I'm going to go ahead and wake my husband up. I also knew that my boys would be waking up soon, so I wanted my husband to focus on them and get them breakfast. And then I explained to my boys that baby was coming soon, that they were going to go stay with their cousins for a night or two. I knew that I wasn't going to be able to fully relax if they were still in the house. It felt really important for me to say goodbye and to make sure that they were going to be happy and in a safe place. As soon as my brother-in-law picked them up, I just really felt my body, okay, let go and things just started picking up. I took a shower. I had breakfast. I knew it would probably be a very long labor, so I wanted to eat. I called my doula. She came over and her presence was just such a game changer because she was just this calm, comforting presence. Not to say my husband was not, but she's just more-- this is her job. She's more objective. She was able to suggest different positions. She knew when to let me be. She pushed me when I had to be pushed and let me be when I had to be left alone. But the best thing she did was she did not let me head to the birth center too soon. I wanted to go and she'd be like, "Okay, let's just wait for 30 more minutes. Can you do 30 more minutes? Yeah, let's try this position. Let's walk a little bit. Let's do this and that." That was so important because I would have gotten there way too soon. She and my husband were in touch with Galyn, the midwife. Everyone was just super chill and relaxed. Everyone ate lunch. I don't think I did, but everyone else did. It was just a nice day. It was a cool rainy day. And then at about 2:00 PM my contractions were about 2-3 minutes apart. They were lasting about a minute, and they were getting intense. I was like, "Okay, I need to go." They were like, "Okay, yeah, let's go." We got to the birth center. I was just wrapped in this fluffy blanket. I just picked it up like I was in this daze. I was listening to my HypnoBirthing app. And Galyn, she was so relaxed about everything. Everyone was just very relaxed. It was during the daytime. She'd come in. She'd leave. I got in the bathtub at point. At one point, she checked my dilation and asked me if I wanted to know. And I said, "Nope, I don't want to know because I don't want to get in my head." She was like, "Even if you're 9 centimeters?" And I was like, "No." Okay. That was so amazing. That was such a push of encouragement. And so that was very helpful. Once again, I ran into the issue of being unable to pee. Of course, not surprisingly. So Galyn asked me want if I wanted a catheter. I said, "Okay, let's try it," but I was super nervous about it.Meagan: Yeah.Maria: But this time it was super easy. It was amazing. It went in right away. She had the right size. I don't know what it was, but--Meagan: Right size, pelvic PT.Maria: Yeah, yeah, yeah. It was easy. I had a ton of pee. After that I was like, oh, my gosh. I surpassed these two huge obstacles of being really well-dilated and also, an empty bladder. Like, I got this. It's amazing. I felt this new surge of energy. After that, I just focused on one contraction at a time. Each one lasted four breaths for me. Each breath coincided with a short prayer that I would say to myself. The hardest breaths were always breath two and three because it was the peak of the contraction. But I knew the pattern in it, and so I knew what to expect. I just remember opening my hands every time and surrendering and just trying to just relax my body and just accept it, and let it wash over me. I was doing a lot of visualization of my body, my pelvis opening, my baby coming down. I was so connected to my body and my baby. I just remember communicating with her and visualizing her coming closer to me. And this, like I said, was something so new for me, this connection. After about two hours of labor, there I was fully dilated. They had me do some focused pushing. Unfortunately, I never really felt that overwhelming urge to push that I'd read so much about and that I had wanted to feel. My pushing was more directed, but it felt a lot less forced than with my second birth. I decided to push on the bed on my hands and knees. My husband and doula were each holding a hand. Galyn was encouraging me. Every time I pushed and she would feel the baby come down, she'd let me know. That was really encouraging to know that it was productive pushing. I was just so focused. After about 40 minutes of pushing, she told me, "Okay, the next push, you're going to feel a burn." Before I knew it, it was the ring of fire I'd heard so much about. Although it was painful, I was just in awe that I was feeling it. I was like, oh my gosh, this means something. I'm so close. It was surreal. I was experiencing it in this weird, out-of-body way. And then the next push, baby was born. I was just in shock. I couldn't believe it. I couldn't fully believe that I did it. They passed her to me immediately. I was still on my hands and knees. I will just never, ever forget the feel of her body and her skin when I held her for the first time. It was the birth of my dreams. I think one of the other things I just loved was just that time afterwards that I never got to experience and that moment of coziness where we were just laying in this queen bed, my husband and I and my baby, and just eating together, holding her immediately, breastfeeding her like it was just a dream. I got to take a bath with some healing herbs. It was amazing. And then, after several hours, we just drove home with our baby.Meagan: Just amazing. That is what birth is about right there. All of those feelings, all of those smells and experiences and bonding moments. I am so happy for you. Let's just say you debunked the myth. Your pelvis was great. Your pelvis and your hips were just fine. It really just took someone educated to know that your baby was in a poor position and that okay, instead of doing this size catheter, let's do a smaller catheter. It's just these little things that made such a big difference. I think it's really important to vet our providers when we are interviewing them. I love that you were like, I gave her all the bad. Like, all of it. I just laid it on her. I wanted her to know everything that I was being told or that was said or that had been done. And then for her to be like, "Okay yeah, I hear those. I see these op-reports, but still don't believe there's anything that makes you not be able to," is just so powerful. So those are the types of providers, and if there really, really, really is a medical reason, they can back it up. "Okay, let's consider something." But I do love that you just came in with all of it, just all of it, and expecting her to be like, "No." And then when she said yes, you're like, "Wait, what?"Maria: What?Meagan: "Wait, what? Can you repeat that?" We really are getting more of that flack and doubt, so it's so great to hear that there's such a supportive provider out there in your area because every area needs it. I would love to see more support coming in because the fact of the matter is, it can happen. It can happen. It is possible, and really, the risk is relatively low, right? It's low, and it's something. And then we do know that to some people, it's not acceptable, and that's okay. But know that the risk is relatively low and that the world paints it to be so much bigger than it is.Maria: Right. Well and also, nobody talks about the risks of repeat sections. Right? Nobody mentions it. I'm like, why is this not being even mentioned at all?Meagan: We talk about it here because it isn't talked about. We have providers say, "Oh, uterine rupture, uterine rupture this and that," but they're not like, "Hey, dense adhesions connecting to your bladder for life, scar tissue gaining for life, back pain that you may discover in your 50s that is related to your Cesarean adhesions and pain." And then, not to mention there are a lot of things like hysterectomy, increased blood loss. You guys, there are things to talk about and complications that can come forth in the future pregnancies as well. We don't talk about those to scare you. We don't talk about uterine rupture here to scare you. We don't talk about uterine rupture or share uterine rupture stories to scare you. We are here to educate you. We want you to know there are pros and cons on both sides. If you find a provider who is all about sharing the risk about VBAC instead of repeat Cesarean, you might not want to be with that provider because there are risks for both sides so if you're getting a one-sided risk, there are some concerns there.Maria: Yeah. Yeah, exactly.Meagan: Well, thank you again so much for sharing your stories. Congratulations. I'm so happy that you found the right provider. You found the dream team. Everyone was on your side and supporting you along the way.Maria: Thank you, Meagan. Again, I think that's only one part of the equation. We as the moms have that other responsibility of really healing ourselves and our past traumas and doing more than just, I guess, working out. A lot of people don't think about the inner work that we have to make for our pelvic floor and even the uterus with making space for your baby in there for optimal positioning. I never heard of these things before you. All of that knowledge was very helpful.Meagan: Yeah, there's a lot of work. Before we started recording you were like, "With my second birth, I just hired a midwife and put it in her hands and was like, hey, I did the work. I hired a midwife," but there's so much more than that. And yeah, finding a supportive provider, getting the education, but there's so much work. We talk about this in our VBAC course-- mental and physical prep. We talk about it early on in the book because it is such a big part of how things can go and if we don't do those things, it can impact us. That doesn't mean you can't get through it and have a VBAC. I don't want to say if you don't go to therapy, you won't get a VBAC or if you don't do these things, but these things will impact you in a positive way more than a negative. I also want to talk about trauma and birth and going through and working through it from the inside out. It's not even birth. It's life. It's affecting us for life. We hold trauma in our body. We hold emotions. We pent them up and yeah, it's just you. We gotta work through them. We can't just shove them in and be like, "Well, that was that. I'll let it go," because it's not going to be let go. It's inside of us.Maria: Yeah.Meagan: Yeah. It'll show up. It will show up. It might be years. It might be months, you never know, but it's important to work through it. Okay, well I will not take any more of your time because I know you've already been with me for a bit, and I just wanna thank you again.Maria: Thank you so much, Meagan. It's been such 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

We are now OBs.All links and info here: https://linktr.ee/jadeandxd

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

J&K Engines talks all things Powerstroke with us on today's episode! From the 7.3 OBS to 6.7L - and the 6.3L stroker - they walk us through build options from towing and reliability, to all out performance. We also ask why some 6.7L's have bearing failure that wipes out an engine. Learn more about your ad choices. Visit megaphone.fm/adchoices

If you are looking for VBAC inspiration, Kelsey's episode is a MUST-LISTEN.Kelsey is a VBA2C mom and speech-language pathologist living in Erie, Pennsylvania. You will feel literal full-body chills as she tells her birth stories on the podcast today. As a first-time mom, Kelsey chose a Cesarean over physiological birth thinking it was the safer, easier route. But after experiencing the reality of two C-sections, she went from fearing vaginal birth to trusting in the labor process even more than her providers did. With her VBA2C, Kelsey got just about every type of pushback in the books. She was coerced, persuaded, questioned, and fear-mongered by multiple providers. Yet Kelsey was able to ground herself by listening to VBAC stories on The VBAC Link Podcast, seeking refuge in her doula and Webster-certified chiropractor, and connecting with other VBAC moms. Kelsey knew her body could do it. She just wanted a chance. Going up against a hospital practice that was saturated with skepticism, Kelsey's labor was beautifully textbook. Her labor progressed quickly, and her biggest baby yet came out in two pushes– “like butter” as described by her doula!VBAC-Certified Doula, Tara Van Dyke's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We have another amazing story for you today. And actually, it's stories. We have a VBA2C mama coming your way. And as you know, this is a hot topic because lots of people want to know if vaginal birth after two Cesareans is possible. So Kelsey will be sharing her stories with us today. But guess what, you guys, I have a co-host today and it's Tara. Hello, Tara Van Dyke.Tara: Hello. Hello.Meagan: She is one of our VBAC link doulas. As you probably heard back in 2024, we are going to randomly be having co-hosts from our VBAC Link doulas. I think it's so awesome to have them on. I love hearing the topics and things that they want to suggest to talk to you guys about because again, just like we talked about years ago, we just in Salt Lake City, Utah, can't share enough. And so we want other doulas from all over the world to share as well. So Tara, tell us more about where you're from and then your topic on partners and being prepared.Tara: Yes. So thank you for having me here with you. This is so fun to hear a story live. I'm a doula working in the Chicagoland suburbs. I've been doing that for 20 years and now moving to more of childbirth education as well as like a lower caseload of doula work partly because I just welcomed my first grandchild this week, so I want to be available in a different way in my life. Meagan: Congrats. Very valid. Tara: So I do a lot of childbirth education. But along the way, what's always been really important to me and I feel really passionate about is the partner connection with the person giving birth and their preparation. The research supports it too, that a prepared partner makes a really big difference in outcomes too. I know we talk a lot about doulas and increasing the positive outcomes of birth, and that's been shown over and over in studies, but the actual dream team is a doula and a prepared partner.Meagan: Yeah. I love that.Kelsey: I tell the dads who come to my classes that the doula is important, but we are replaceable in this situation. The partner is so important because of that connection because they bring the oxytocin. They bring the safety. They have that history with you already. And what even bumps that up to being really helpful in the birth room is their preparation and their understanding of what to expect and being completely on board. So theres lots of ways for partners to get prepared, but they get left out a lot. So I feel really strongly that partners are so much better in the birth room when they're not feeling anxious about what's going on, when they know what to expect and they have a few good tools in their pocket for how to help.Meagan: Oh yes, I could not agree more. I always talk about, I make things up, and I call it the doula sandwich. So it's just what I call it in my practice of my doula work. One bun has all the oxytocin and all the knowledge of who you are, and then the other side is the doula who has the education in birth work and the ideas of how to help navigate through the birth space, but also can then support the partner in doing that and educating the partner. So then, we've got two really great sides and then we sandwich the doula. We have great buns. We have really great buns. And we sandwich that mom together and with love and support and education and oxytocin. Like you said, it really creates that dream team. I love that so much. My husband didn't educate himself. He was just, "Okay fine, if you want a VBAC, go do it. You do the research." I did HypnoBirthing with my cousin who luckily was pregnant around the same time, but we did that together, and he just really didn't know. When I told him, "Hey, I want to VBAC after two caesareans out of the hospital," he was like, "Yo, what?" because he was uneducated. I truly feel that it is so powerful. That's why I encourage partners to take the VBAC course with, the mom or an education course in childbirth. Really understand what the mom is going through, but also know how you can help because I do feel like a lot of those dads kind of get shoved aside. They want to help, but they don't know how to help, and they don't really know what's going on. Is that noise good or is that noise bad?Tara: Yes. Yeah. And they're going through the birth, too. This is the birth of their child. So they can also feel, as far as traumatized, hopefully not trauma, but they can feel a lot more dissatisfied or upset by a birth if they didn't know that what was happening was normal. So it's good for them, too, to learn how to take care of themselves as well as their partner.Meagan: Love it so, so much. Everybody, get your partners educated. It is so, so important. Thank you so much for that tip. Meagan: Okay, Ms. Kelsey, it is your turn, my love.Kelsey: Okay, so as you know, I had a VBAC after two C sections which I didn't even know was a thing. You played such a huge part in giving me education and the motivation to pursue this. My story starts in October 2018. My husband and I found out we were pregnant with our first. It was really special because it was actually our two-year wedding anniversary. It was that morning that we found out and we had a special trip plans to Niagara Falls, just up in Canada. It's a special place for us. It was where he proposed to me. It was just a really special time. It was also kind of crazy because up until that point, up until just prior to that, we had been together eight years, and we didn't think we were interested in having kids. I'm so grateful that our mindset had shifted, but it was just kind of a lot at once. We had agreed that we did want to start a family, but it happened really quickly, and it was just a lot to process. I didn't educate myself at all about birth. My husband and I took a class in the hospital, but it was pretty much just how do you take care of a baby. It wasn't how to bring a baby into the world.Meagan: Yeah, yeah. Sometimes those can be a little more what to expect after than really what to expect during.Kelsey: Exactly. And, I don't know what it was. I don't know if I just couldn't really picture myself giving birth just because we had just kind of come into this or if I just was not believing in my body, but I just felt the opposite of a lot of people on this podcast. They say, "I never thought I would have a C section. I never expected that for myself." For me, I just went into it thinking I'm intimidated by all of this. A C-section sounds easier and I cringe saying that now. But, I just thought not having to go through labor and not having to push a baby out, I just always had that in my head. That comes into play with how my first ended up. I was told throughout my pregnancy that my baby was big and specifically it was driven home, "The head is big. The shoulders are big." They were telling me about shoulder dystocia, and I didn't know anything. So I'm thinking, oh my gosh, not only am I already intimidated by the idea of birth. I know nothing about birth, but now you're telling me I have this big baby. My OB was really telling me maybe a C-section should be considered. And then she threw it out there. "Well, we could induce 39 weeks and see how things go." And again, I was just trusting her. She had been my gynecologist since I was a teenager. To me, I thought, okay, that makes sense. Baby's big. And again, I hadn't done any research on my own. So we did what I referred to as a half-hearted induction. I feel like it was just done to humor everyone. Like, "Oh, we tried." But I went in the night before at 39 weeks on the dot. Nothing was going on with my cervix. Surprise, surprise at 39 weeks. They did Cervadil and I just lay in the bed. My husband and I watched the fireworks out the window. It was the fourth of July. We were just completely not prepared for anything. Just going along with this and thinking, oh, we'll just have a C-section tomorrow if this doesn't happen. They came in the morning and nothing had happened. So they were like, "Oh, well, we could start Pitocin. We could do this." I just wasn't interested in any of that. I wasn't motivated to have a vaginal birth. I guess that's okay. That's just where my head was at the time. I've accepted that's just where I was at. So we had the C-section. It was a surgery. Just being there and as baby comes out, just hearing everybody in the OR talk about, "Oh, look at her cheeks and look at the hair." It was minutes before I'm ever able to get a quick flash of her around the curtain before they swoop her off. It was just a weird experience, but it was all I knew. I was grateful that it went okay, but it just makes recovery so hard, so painful. When I think back to it, just think about just crying while my husband's trying to do my abdominal binder, not being able to get in and out of bed, struggling to breastfeed, even getting in a position of breastfeed with that searing surgical pain. We struggled, and I ended up exclusively pumping. So it was tough as a first-time mom just dealing with all of that. But again, I didn't know any different. I think that was a blessing that I didn't know what I was potentially missing. For my second birth, we knew he wanted more than one child. You just never know how things are going to happen. We just weren't trying to not get pregnant, and it happened right away. The babies were 16 months apart, so when I showed up to my appointment, my OB, the same one who had said, "You have this big baby, and you should have a C-section or induce at 39 weeks." Oh, the ARRIVE study was hot off the press at that point too. So he was excited to show me the ARRIVE study back.Meagan: Oh, yeah, but you're not even a first-time. I mean, you were a first-time vaginal mom. So the ARRIVE trial, you know. You've been with us. Hashtag eyeball.Tara: Yeah, yeah, it changes. It's changed everything.Meagan: It really has. And I don't know if it really has changed for the better in my opinion.Kelsey: So sorry, that was for my first birth. I forgot to mention.Meagan: Oh, oh, oh, sorry. Yes, that would make sense. Yes.Kelsey: So with the second, it was the same OB, and she's like, "Okay, since your births are so close together, you'll just be a repeat C-section. You can make appointments with me, and I'll do your surgery. Easy peasy." I'm thinking, oh, okay. That makes sense because she's talking about uterine rupture, and they're so close together and I didn't research on my own. Is there another option? How risky really is this compared to a repeat C-section? I just trusted her so much. I had been with her for so long. I figured she must have my best interests at heart.Meagan: Yeah.Kelsey: I didn't even think to myself, my own mother had a VBAC with a 13-month age gap. I was a C-section, and my brother was a VBAC at 13 months 30 years ago. Meagan: Uh-huh.Kelsey: You only know what you know at the time. And so even though I didn't look into it in the ways that I should have, I did know that I wanted the experience to be a little different. So I found out about gentle C-section which I think is a funny term. Meagan: I was happy to see that you could request a clear drape, and you could request not to be tied down to the table. We did implement a few of those things. I had the clear drape. It was nice to see her coming out just for a quick flash before they swooped her away. It was nice not to be completely-- I had one arm free which is funny these things that we consider luxuries when you're having a C-section. So it was a little bit better in that way, but there were things that were also worse. They couldn't get the needle in, and they had a resident doing things. I was having trouble. I was starting to pass out during. They were having to adjust. It was stressful in its own way. I had some things that were a little better. But also, it's just's a C-section. Also, during, my OB made a comment as she has me completely open, all seven layers of me. She said, "Yeah, who was it the did your last C-section?",I told her and she made no comment. I said, "Why are you asking me this as you're inside my uterus?" She said, "There's just more scar tissue than I would have expected." She said, "Hey, you can have another baby if you want, but just wait more time in between. Just not so close together." So that was something that got in my head too. Anyway, we thought there was no way we would ever have a third. It was really hard having two under two recovering from another C-section. It was November 2020, so it was the first COVID winter. It was cold. It was dark. Everything was closed down. Everybody was in masks. It was so depressing. It's like, postpartum isn't hard enough. As if two under two isn't hard enough, then adding COVID.Meagan: Yeah, adding zero support and zero resources. Yeah.Kelsey: Nowhere to get out and do anything. It was a bummer. So anyway, it was a lot, and we thought, no way are we ever going to have three. It was just a hard season. So I donated everything. I put all my carriers and all my stuff out on the porch and said, "Come get it," to the local moms group. I just couldn't see myself having a third. Well, then the years pass, and things get easier. You come into an easier season. All of a sudden, we're not dealing with diapers and bottles. It's like, we could leave the house. Things are opening back up. My husband and I had talked about a third and toyed around with the thought of it, but it's just hard to pull the trigger once you've come into this easy season. The thought of hitting the reset button is intimidating. But all it really took was watching him take down my youngest's crib with her. And it was like, okay, this is something that we want to do. It was a funny conversation that night. I said, "If we were to get pregnant this cycle, we would have a June baby, and that would be really nice." So that's what happened. I was playing it with my third. That's when I realized. I mean, I had thought about it, obviously, but I realized, oh, my gosh, I have to have another C-section, a third C-section. Talk about being years away from it and thinking about how you're all healed. It's been a few years, and to think about them cutting open again and just knowing what that entails, I was just in a whole different headspace. I was thinking, how is there a way that I can avoid this?Before my first appointments, I did a quick Google search, "vaginal birth after two C-sections" just to see if this was something anybody had done or was doing or was even possible. I was so excited to see that people were doing this. It looked like it was actually potentially a good possibility. So I was thinking, I've got to be the right candidate. I didn't even need those first C-sections. I knew this now, reflecting back. Yeah, I had my first screening where they do your intake, and they were asking a bunch of questions. And I had said at the RN, I said, "Would I be able to maybe have a vaginal delivery after two C sections?" And she was like, "Oh, they consider it after one, but once you've had two, you're a C-section for life."Meagan: Oh, jeez.Kelsey: Something about her saying that and the way that she said it, I went from being a little bit curious and oh, this might be good, to no, this is something I'm going to pursue. It just didn't feel right. She didn't know my history. She didn't know why I have my C-sections. So to tell me, "Oh, no. You need to have a third major surgery for sure. No option." Tara: It was this moment when it brings a fight out in you. Like, I am gonna do this now.Kelsey: I'll never forget how I felt at that moment. So I started to have my appointments with the OBs, and I would bring it up. Everything was perfect. It was going really smoothly. So the appointments would be like two minutes, and then at the end they'd say, "Do you have any questions or concerns?" And I'd say, "Yeah, I wanted to see what my options are for delivery." They were like, "Well, we decided as a practice to support VBAC after one C-section, but we actually have a policy against VBAC after two C sections."Meagan: How did I know that was coming? The policy, I swear, every time it's like, "We decided as a practice or as a practice, we--". It's always like, they created this stupid policy that actually is against evidence based care. But okay.Kelsey: I'm thinking to myself, so then what do you do? Anyway, I was just mind blown by that. I went to a couple of more appointments there. You'd go every month and they'd say, "Any questions?" I'd say, "Yes. I'm just really not feeling good about the idea of a third C-section." I said, "The risks of a third Cesarean intimidate me much more than doing a trial of labor." I've never given my body a chance. It's not like I've been through this before and things went wrong. I've never been given a fair chance. They were very nice, but they just look at me and smile and nod and say, "Well, it's gonna be okay. It's gonna be okay," and not even entertain the idea for a second. So I'm thinking to myself, okay. I've gotta figure something out. So at that point, when I had talked to a couple of providers, and they were all very consistent about, "Nope. Nope, not even going to entertain it," I knew something had to change. I'm reaching out. I'm searching in the local moms group about C-sections. Has anybody had a VBAC after two? It was crickets. Nobody was responding. I was looking back years trying to find anybody who had done this, in the area. Wat I was finding is, "No, it's not going to happen in Erie. You need to go to Pittsburgh or try a home birth." And I'm just really not comfortable with the home birth even though I know that's a perfect option for plenty of people.Meagan: It didn't feel right for you.Kelsey: Yeah. It just wasn't what I was feeling like I wanted to do. So I reached out, and I had not known anything about doulas until your podcast. I hardly even knew what they did before listening. I just searched "doulas in Erie." I called the first one I saw. I left a message that was probably pretty unhinged just like, "Help! What do I do? Is this something I can do?" She called back, and it was the first time that I had any validation at all. Up until then, it was just people telling me no, people telling me policies and not safe. It was the first time that I was heard. I was heard. She said, "There's really no reason why you can't have a chance. We'll figure this out." I kept doing my research. I dug really deep, and I found a few people who had referred to providers being supportive. I was reaching out. I was sending people DMs saying, "Hey, sorry to be huge creep, but can you tell me more about your experience?: I found out that at the other practice there were providers who would consider this. So it wasn't looking super promising, but it was better than where I was at. So I kind of took a chance. I switched practices at 28 weeks. Prior to that, I had an amazing appointment at 24 weeks. I had one last appointment at that office with the policy. He was amazing. If you could have just copied and pasted him, he was just like a midwife. I mean, he was very upset about the policy. He said, "How do you even enforce that?" He said, "What are we going to do? What are we going to do, strap you down and take you to the OR?" I wish that he had a podcast episode because he took so much time. He explained to me  the history of C-sections and how, in his words, the pendulum has swung so far from only doing C-sections when they were needed to they're safe now. Let's do them whenever we can. He talked about the whole policy thing and how they met as a group. He said, "Some of these younger JOBs have only been practicing now that C-sections are so common. They haven't seen the success." He said, "You have just as much of a chance of success as a 20-year-old walking off of the elevator because our C-section rate is so high. You have just as much of a chance." He laughed at the fact that macrosomia was in my chart, which I forgot to mention with my first. She was 9 pounds, 1 ounce. She was big.Meagan: Okay. I wanted to ask you though because they had said, "Oh, big baby, 16 months apart." I wanted to ask, but 9 pounds, 1 ounce is actually not macrosomia. It's a bigger baby, but it's not a huge baby.Kelsey: Exactly. It's not 12 pounds, which also, people have done. But anyway, he put so much wind into my sails, and he fully supported me switching. He said, "Honestly, I think this is great. I think this is the best option for you. You need to go for it." He said, "But if you were to stay here, you would face nothing but doubt and bullying and scary." He said, "If you were my wife, I would tell you to switch over to this other practice." So that's what I did. I also forgot to mention in my anatomy scan, the sonographer is going about doing it and she said, "Were your other babies big?" I'm like, no, we're not gonna start this. It was already with the big baby comments. So they had me do a growth scan to switch practices. It was refreshing to be in a place where they entertained the idea. They said that they decided as a practice to follow what ACOG says, but it was also very clear the difference between support versus tolerance. So although I was grateful that they were entertaining the idea, I still had, "Oh, 90th percentile. Oh, you've never labored before. You don't have a proven pelvis."Meagan: Proven pelvis. Tara: Yeah, proven pelvis.Meagan: There's a lot of eye rolls in this.Kelsey: Thank goodness, again, if it weren't for this podcast, all of those little comments would have swayed me. I would have said, "What am I doing? Listen to all these things they're saying. This isn't right for me." Once you know, it's just so hard to listen to the VBAC calculator. "Oh, let's just type your stuff in and see." I think it gave me, like 50% chance. Like, I don't know. So anyway, I'll get back on track. My low point was at 32 weeks. It was with my provider who was convincing me that a C-section or induction was right, and then telling me, "Oh, you'll just be a repeat. We'll schedule it." I was dreading my appointment with her. I knew that I needed to meet with her because she could possibly be the provider who was on call. I wanted to tell her what my plan was, and assess her thoughts. I thought that I was invincible because now I knew all of these things, and I wasn't going to let anybody bring me down. That appointment was pretty terrible. She came in hot. She said, "You're 32 weeks. Baby is 5 pounds, 4 ounces, and he's off the charts." She actually referred to him as massive. She said, "He's massive. He's huge." She said, "Put him in a room with 100 babies, and he is enormous."Meagan: Enormous. Tara: She's comparing him to other babies already. Meagan: And he's not even born. Tara: Can I just add a little tidbit here because there's so much talk in your story about the fear of big babies, and the research has shown that what leads to more problems or interventions in a birth with a big baby is not the actual size of the baby, but the provider's fear of the big baby. They're already getting themselves stirred up, and nothing has even happened. Kelsey: I was really discouraged by that because I had come across those facts too. And looking at the research and looking at what are the real risks of a big baby, that's actually just the providers. Yeah, se was just disgusted with my plan. She said, "Are you sure?" I said, "Yeah." I really stood my ground. I was so proud of how I stuck to my guns. She pulled out all the stops. She just kind of sighed and she said, "Okay." And then she pulled it out of me as I was  trying to justify. I said, "We're not sure how much we want to grow our family." I said, "If I have three C-sections, I'm not going to want a fourth." I said, "I just think it's worth a try." So she took that and she ran with it. She said, "Well, for what it's worth, I would rather do two more planned C-sections. I would do two more planned C-sections on you, and I wouldn't bat an eye. I'd rather do that than have you TOLAC." I thought, oh, my gosh. So again, I stood my ground. She went out. She was visibly upset. I was so proud of myself. But then I spiraled that whole day. It just chipped away at me all day. I came home.  I had been doing nightly walks religiously. That's when I would listen to The VBAC Link. That night, I didn't do my walk. I cried in my bed. I was just so upset. I spent the night then going through the groups I was in for VBAC after multiple Cesareans and The VBAC Link searching "big baby, big head circumference" and screen-shooting all of the success and all of the comments to fuel back my motivation. That was definitely the low point, but I did have some great meetings with providers. I was grateful that where I was living, I was able to find enough support where they would let me go for it. Once I got toward the end, there kept being the comments about "big baby". I had an OB do my final measurement and not tell me what it was. I said, "How is baby measuring? There is a lot of drama about baby being big." She was like, "Well, how big were your other two?" I said, "They were 9,1 and 8,4". My second was almost a full pound smaller. She said, "Oh, if you pushed those out, no problem. You don't have anything to worry about." I said, "That's where the drama was. I didn't push them out. I had C-sections." It was like she saw a ghost. She was like, "Oh, well that is drama." She was just beside herself. I say that story specifically because spoiler alert, she was the one who ended up delivering my baby.Meagan: Oh, really?Kelsey: To give a preface to that. She actually said, "Well, it is what it is." She just was very nervous and very upset. I said, "Have you never seen a VBAC after two C-sections? Have you seen that?" She said, "Well, yeah, but it's usually with people who have birthed vaginally before, and not with a big baby." That's what she said. Meagan: Oh my gosh. Kelsey: I just wanted to talk about that because she was the one who delivered Anyway, time went on. As I got to 39 weeks, I started to stand my ground a little bit more because they wanted to do cervical checks. They'd say, "Okay, undress for the provider." I just was like, "No, thank you. I'm good." I would have been really discouraged if they had come in and checked me. I know that got in my head with previous appointments with things that I didn't think would affect me. At 39 weeks, one of the providers who had been trying to talk about how big my baby was and persuade me to have an induction, she said, "What if we did a growth scan at 40 weeks, and you were measuring 10 pounds. Would that change your mind?" I was like, "No. I'm not doing a growth scan at 40 weeks. I've already done too many scans." So just right up until the end, they were trying to get me. They were talking about the size. Meagan: They were really trying to get you to cave. Kelsey: Yes. So after that appointment, because of my BMI, after 37 weeks and beyond, you have to have an NST and a BPP (biophysical profile) every week. Meagan: After 37 weeks?Kelsey: Starting at 37 weeks, you have to have both of those tests every week. It was just a new thing. I didn't do it with my last. Again, I'm worried about this. I know how the testing goes. Sure enough, I go. This is 39 weeks. I go for the biophysical profile, and they were like, "There is a lot of fluid. You have too much fluid." They were talking about all of the fluid. "Look, here are little flakes." They were talking about the fluid. I thought, I've made it this far. This is something that is going to make it a C-section.Baby wasn't also taking enough practice breaths for her which was frustrating. She even said, "I think he's sleeping, but I want to be on the safe side." I said, "I just had an appointment. She could hardly get his heart rate because he was moving so much." I had driven to Cleveland an hour and a half away the night before to go to a Noah Con concert. I felt him moving the whole time. I was like, "I'm pretty confident that he's okay. I was just checked by my OB five minutes ago." She wanted to send me. I wasn't going to mess around this far on, so I went to triage. They hooked me up to an NST. They wouldn't just let me do it in the office. I'm sitting there. Everything is perfect. The nurse comes in and said, "They're just going to place an IV." I stopped and said, "What did you say?" She said, "They're just going to place an IV." I said, "Why would they place an IV? Everything is looking good. I have grocery pickup in an hour. I'm not trying to be here for long." She said, "Just for access." I said, "No, thank you. Please let me out." That was weird.She said, "Okay. We're just going to watch you a little longer." Then this OB who I'd never seen before who was apparently just newer to the practice comes in. I'm like, "How are things going?" At this point, it had been 45 minutes. I'm trying to get out. He said, "Things are looking really good." I could see his wheels turning. He said, "But, since you are 39 weeks and you've had two C-sections, we can do a C-section for you today." Meagan: Oh my Santa. Tara: Here you go. How did you manage all of this pressure, Kelsey? It's extraordinary. Meagan: It is. Kelsey: I should mention that I had an amazing doula, so after these appointments, I would text her a paragraph. She was constantly lifting me back up. I was going to Webster chiropractic care. The chiropractor I saw, shout out to Tori, she's amazing. She's a doula also. She was pregnant going for her VBAC, so we would have these appointments, and it was a mini VBAC therapy session. We would talk about what we were up against, and just the different providers because she was going to the same practice as me. It was just so nice to have her. I was doing all of the things. The chiropractic care. I was eating the dates and drinking the tea because I wanted to know that if I was doing this, I was going to try everything and then I couldn't look back and say, "What if I would have done chiropractic?" Anyway, I basically tell him, "Get out of my room. I'm going." He just was awful. He did all of the scare tactics and all of the risks but none of the risks of a third C-section of course. Only the risks of the very low uterine rupture that he was hyping up. Anyway, that was bizarre, but again, I stood my ground. I was so proud, but then I got home, and I spiraled. I was packing my hospital bag. I was crying. I said to my husband, "I let them get in my head. I shouldn't even bother packing any of this stuff." I had the little fairy lights and things to labor. I was like, "I shouldn't even bother packing any of this VBAC stuff. They're just going to find some reason to do a C-section. Look at this. This whole time, they wanted to do the C-section." Again, another night of spiraling. As he left, he said, "They're going to want to see you tomorrow and repeat all of this testing." Meagan: For what? If everything was okay, what was the actual medical reason? Kelsey: Exactly. It was just out of spite because I shut him down. They were like, "They're going to want you to come back tomorrow." I'm like, "Okay. If it gets me out of here and gets you out of access to an IV and a C-section, fine." Meagan: Seriously. Kelsey: The next morning, I'm on my way to my appointment. I was on the phone with my mom and I told her, "I'm having these weird feelings I've never felt before. I don't know if maybe they're contractions." It was very strange. It was something I never felt. I never had a contraction and had never gone into labor. So I go to my appointment and passed the BPP with flying colors. I'm like, "Well, what about the fluid?" She's like, "Yeah, there's a lot of it, but it's fine." I got an 8 out of 8 score.  I go for the NST. Well now, baby's moving too much, so his heart rate, they can't keep it on because he's moving, and she kept having to move it. So again, I'm just very frustrated that I'm even there. I'm so close to the end. This is now 39 weeks and 4 days. And so the tech says, "I'm going to bring this to him. He might not like the drop offs, but I'll explain to him that the baby's moving a lot."I said, "Who's he? What OB is this?" She said the OB who was in triage the day before who tried to have me do the C-section and I was just like, "Oh my god. He's going to see my name and have any reason to send me back." Sure enough, he comes sauntering in the room and he says, "We meet again," as if I'm this problem child, as if I wasn't just having all these normal tests. He says, "I can't be confident that these aren't decals. You need to go back to triage." I was just again, so frustrated. It's like just a constant of all of these things coming up and none of it being real. It'd be different if it was like, oh, this was actually a risky thing. But again, I'm so close to the end. I know what I know. I knew that the OB that I had seen the day before in the office, I wanted to talk to her about the fluid because I had searched, and I saw that the polyhydramnios could actually be a thing. If your water breaks, there's the risk of cord prolapse. So I knew that that wasn't something that was completely to be ignored, so I wanted to talk to her more about that. I humored him, and I went in. Well, all the while, I'm feeling these sensations more and more consistently. They get me hooked up, and I explain the situation. I said that I was just here yesterday not really for a reason, but I'm back now also not really for a reason. They hook me up. Of course, everything looks good. But she's like, "Are you feeling these contractions?" I'm like, "Is that what they are?" I was excited. They were just cracking up because she's like, "These are pretty consistent and big contractions." I just couldn't believe it. I was just so excited my body was doing it. I'd only ever, at 39 weeks, been cut off and then never been given a chance. All I needed, I guess, was a few extra days. I'm just so excited that I'm having contractions. The nurses are laughing. "We've never seen somebody so excited to have contractions." Anyway, at that point, my OB comes in, the one who had been trying to get me to be induced. She's plenty nice, but the one who said about if we did a scan of 40 weeks and 10 pounds, would you reconsider? So she said, "Kelsey, do you know what I'm going to say? This is the second day you've been in here in two days." I'm like, "Yeah, but for nothing."Meagan: And because you asked me to come in here.Kelsey: Yeah, trying to humor everyone and see that yep, everything's fine. See? But again, I was having these contractions, and as I was there, picking up. She wanted to check me. I said, "Okay, I'll let you check me," because I'm having contractions I never have before, and I want to see what's going on. I went to the bathroom, and I had bloody show, which again, I had never had. So things are really happening. I come out and I told her, "There's blood and I'm having contractions." She's like, "Yay, let's check you," and I was 1 centimeter. She was one of the OBs who was comfortable with a balloon. So she said, "I'll tell you what. You've got a lot of fluid. Things are happening. Let's work on moving things along."Meagan: So she induced you?Kelsey: She wanted to.Meagan: She wanted to. Okay.Kelsey: So she's like, "Let's get you in. I'll do the balloon. We can get things going because you've got a lot of fluid. It's time, Kelsey." I'm like, "Okay." I said, "Well, I'm gonna go home."Meagan: Good for you, girl.Kelsey: Get my kids off with my mom and get my dog off. She sunk when I said that. I said, "I promise I'll come back. I'm not gonna run it. I'll come back just in a little while. Like, maybe this evening." But she said, "Okay, I'm here till 4:00, and then it's another OB coming on who won't want to do the balloon." So just come in before then. Of course, I wait until exactly 4:00. But as I was home, it just kept picking up, and I started timing. The app is like, "Go to the hospital. Go to the hospital." But I've also know from listening to this podcast that that happens. My husband's freaking out because he would see me stop and pause, and he's like, "Let's go. Let's get out of here." I was grateful that everything maintained through the car ride. I got there, and contractions were still happening. My doula met us there because I hear about people going too early and the contractions stop, and then there are problems there. Yeah, things just kept happening. We got in a room. My doula was amazing. We were just hanging out and just laughing. I couldn't believe just how happy I felt to feel my body doing it after all these years of just, "Your babies are too big, and you can't do this," and then all of this pregnancy saying that. It was just amazing.  I definitely had my guard up. The nurse was talking about the IV and the monitors, and especially with being overweight, I was worried about a wireless monitor. That happens. They can't get a good reading, and then they think baby's heart rate's dropping. I was just so worried about any reason, because I knew that they would. They would take it and run, so I was so grateful that the wireless monitoring worked perfectly. I was on my feet. Things just kept getting more intense, but I'm just laughing and smiling through it all. My doula was amazing. It was just such a great vibe in the room. My nurses were amazing. Every little thing that went right, I just embraced. I was so happy that this was happening. My water broke while I was on a video call with my friend. Again, it just like, "Oh, my gosh, my water broke. That's never happened." There was meconium in the water. So again, I'm like, oh, no. You know, any little thing. I was quickly reassured. It was very light. It wasn't anything to be worried about. I labored and stayed on my feet. My doula was amazing with suggesting things I never would have thought or never would have thought that I would enjoy. I was in the shower at one point on a ball. They had this little wooden thing with a hole in it so that it keeps the ball from slipping out and keeps the drain from plugging. I'm just listening to my guilty pleasure music while my husband's outside the shower eating a Poptart laughing. It was just such a funny thing. I was just so, so excited about it all. Things were really picking up. My water just kept breaking and breaking. I mean, it was true. I had so much fluid. It just was just coming out and coming out. I couldn't believe how much there was. I got into the bed on my side, my doula said, "Try to take a break," and then I felt a water balloon in me. I could feel it burst. Just when I thought surely I was out of fluid, it just gushed out. And then immediately it was like, "Oh, my gosh, this is really intense." I handled that for a while. I was squeezing the comb. I was working through contractions, but I tapped out at about 1:00 AM I'd say. So we got into the hospital around 4:00, and the time just flew. They came to do the epidural, and he put it in. I just kept waiting for relief because I felt like I just didn't have a break. They were kind of on top of each other. It was one of those things that if I knew I was only going to have to do that for a short amount of time, but just not knowing how long, I just felt like I was suffering through them at that point. I wasn't trying to be a hero. I was just trying to avoid what I know sometimes happens and just trying to avoid interventions as much as I could. I kept waiting for this relief because I'm like, "I think I just need to rest. I feel like I'm close." The last I've been checked, I was 5 centimeters, but that was before the water broke and before struggling through contractions for a while. I had no idea how dilated I was. The relief never came. I was hoping to be able to relax and maybe take a nap like sometimes I hear. I could still feel my legs. I could have walked around the room if I wanted. I kept pushing the button. I don't know if it was in the wrong spot or what happened. I don't know if maybe there was something that was working because instead of feeling crushing and just defeated through the contractions, I was feeling like I can survive that. I can get through them. There was just no resting, it was just still having to work through contractions. And then my doula at one point said, "Maybe we should call him in and have him redo it." But then I was in my head, "Well, what if he redoes it, and then I'm too numb and I can't push?" So I just went through it. I'm so glad that I did, because it wasn't long after that that I was checked, and I was 8 centimeters. My  nurse kept checking and there was a lot going on down there and a lot coming out. Eventually she checked me and she said, "Hi. Hi, buddy. I just couldn't believe it." She said, "Do you want to feel him?" I got to reach down and feel his head. It was just also surreal. She had me do a practice push once I was dilated enough, and she's like, "O, oh, okay, okay, okay." She said, "I'm gonna go make a phone call."Tara: Wow, that's impressive.Kelsey: And the OB came in. I forgot to say that when I got to the hospital, the OB who was gonna do the Foley balloon, I totally left this out. She checked me, and I was already 2 centimeters. She said, "Your body is doing it on its own. We're just going to let you go."Tara: That was my question, Kelsey. I was wondering this whole time if they did anything to augment. There was no Pitocin. This was all you? Kelsey: Yes. Yes. I can't believe it.Tara: That's amazing.Kelsey: I got there, and I got the monitor placed. She came in. She checked, and she said, "You're 2 centimeters. We're just going to let you go. We're going to let you do your thing." That was just music to my ears just knowing how things sometimes go. Also, the OB coming on, I had told you, was really nervous about my plan. My husband and I joked that she did something to calm herself down before she walked in because she was just like, "You know what? I'm going to do something crazy. I'm just going to channel my inner midwife and do something crazy and just let you go and leave you alone." My doula is like, "Good. Please let us go." Yeah, I forgot to mention that is not only did I not need the induction, but then I had the OB surrendering and saying, "Go ahead, just let's do it. It's fine." So she literally did not come in. I think was as far away as she could pretending it wasn't happening, I guess. When the nurse called her, she came in and she got her gloves on. I just kept waiting for something to happen still. I'd been so, so scared by providers this whole time. So I'm like, okay. She instructed me on how to push. We did it through one contraction, and his head came out. I was like, "Oh, my gosh. This is crazy," and then, during the second contraction, I did it again, and the rest of him came out. It was unbelievable. It was five minutes from start to finish. My doula described it like butter. He was 9 pounds, 3 ounces.Meagan: So biggest baby. OkayKelsey: Biggest baby, enormous head. I didn't have any tears. I had what the OB described as grazes, like little spots that were bleeding. She put one or two stitches on the walls from where there were these grazes and I can't even describe it. I was sobbing. I was like, "We did it. We did it." He came right to my chest and to get to see him, it was unbelievable. It all happened so fast. Going from not believing in my body and just going for these C-sections, I'm so glad I didn't know what I was missing because in that moment, I probably could have done this before. Again, I didn't know what I didn't know and who knows would have gone? But it was just unbelievable to be in a normal room to have him come out and just right to me where he belongs and getting to see him with his cord still attached and he's crying. It just was such a beautiful moment and I just couldn't believe that had after all of that, here he was. It was beautiful. They asked about cutting the cord, and we hadn't even discussed that. I was like, "Can I do it? I really want to do it." I wanted all the experiences that I could never have gotten in the OR. I cut his cord. My doula got an awesome picture of that. I was considering having that be my picture for the podcast. It was just unbelievable, and I was just so happy, too, that that OB was the one who was there because seeing how nervous she was, I'm so glad that she got to experience. Look what you almost deterred me from doing just seeing how perfect it was. Now I'm hoping that if somebody comes to her in the future, she'll remember and say, "Hey, we had this baby, and it was just such a great experience." I was just so grateful for every second. I couldn't believe how things ended up.Meagan: I am so happy for you. Like Tara was saying, I'm so impressed. Standing your ground the way that you stood your ground after just constant-- I'm gonna call it nagging. They were just nagging on you and trying so hard to use the power of their knowledge that we know that they hold. We as beings, and it's not even just in the birth world, just as humans, we have this thing where we have providers, and we know that they've gone through extensive amount of schooling and trainings, so it's sometimes easy as you said, you spiraled when you got back to spiral and be like, wow, they're just all pushing this really hard. Maybe I should listen. Tara, have you experienced this within supporting your clients or just your own personal experience?Tara: You mean the pushback from the providers?Meagan: Yeah, the pushback, and then for us, should we doubt our intuition? Should we doubt what we're feeling and go with what they're saying because they know more?Tara: Yeah, I mean, that's the hardest thing, because you hire them. Like you said with your first provider, you trusted her. You'd known her since you were young. You've built this trust. She's gone to school. It's so hard to stand up against that as just a consumer and as a person who cares about the health of your baby and your family. But then the multiple times that you had to stand up for yourself even in small things like not getting the IV, not getting the cervical exam, those are not small things. You were protecting yourself from having more of that pushback. I am amazed. We struggle with that as doulas too, because we're helping advocate for our clients. It sounds like your doula was a rock for you and a place to feel validated and heard. I'm so glad you had her.Kelsey: Me too. I say to my husband, "No offense, you're great, but what would be done without our doula?" I mean, she was unbelievable just bringing the positive energy. My husband and I were so nervous and we were so worked up. We were third-time parents, but it was our first time doing any of this. My husband wouldn't have really known. He's never seen it before. My doula, she's done this so many times. She was right in there with the massaging and the side-lying. She did the, she called it shaking the apples.Tara: Oh, yeah. Yeah, that's a good one. But Kelsey, it's against all odds. I just think it's amazing because we talk about the power of oxytocin and feeling safe and not having stress hormones going on, and you had all of that. You should be so proud of your body coming in in the nick of time and just proving against all of this. I'm just gonna go ahead and birth this baby, and a bigger baby than your other two which is such a triumphant moment.Meagan: Seriously.Kelsey: His head was 15 inches. That was another thing because they had talked about his head circumference being off the chart. That was another thing I had been searching is people who've had the big head circumference. Those groups, this podcast and just groups and having access to so many stories and people overcoming all of these obstacles because every time I came up against something, I had heard it before. I said, "Oh, this is something that I've heard time and time again with these stories. They make you feel like you're the only one with the big baby and, oh, this is a problem. But it's like, no. They're saying this to so many people. It was just amazing going into this being so informed and motivated and having that confidence that I never would have had. I just so grateful for this podcast and for all the information.Meagan: Well, thank you so much. It's one of the coolest things, I think, not only just the VBAC, but to see where you came from at the beginning of, "We're not having kids. Okay. We're having kids. Okay. This is what I'm thinking. I'm kind of scared of this. Let's do this. Okay. Doctor said this. Let's do this." to this. I mean, you came so talking about the pendulum, right? And what that provider was talking about. You came from one side over here to not even wanting kids or wanting a vaginal birth to swinging so far to the other side and advocating so hard for yourself and standing your ground. When we say that you should be proud, I am shouting it. Be proud of yourself. Girl, you are incredible. You are such a great example. Women of Strength, if you are listening right now, I want you to know that you can be just like Kelsey. You do not have to be bullied. You do not have to be nagged on every single time. Know what's right. Know your gut. Know your heart. Do what you need to do, and you can do it. You can do it. It is hard. I know it's hard. It is not easy, but it is possible. Girl, you're amazing. I thank you so much for sharing your story today and empowering all the Women of Strength who are coming after you and needing the same encouragement that you needed not even years ago. How old was your baby?Kelsey: So he is four months old.Meagan: Four months. Yeah, so a year ago when you were listening. I mean, really, so so amazing. Thank you so much. And Tara, it's always a pleasure. Thank you so much for being here. I couldn't agree more with your advice. Get your partners educated. Create that true dream team.Kelsey: Thank you.Tara: Congratulations, Kelsey.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