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In this episode, Meagan and Julie tackle hot topics like the VBAC calculator, epidurals, and uterine rupture. What does the evidence actually say? And why do providers give such drastically different statistics from one practice to the next? When you know the facts, you are equipped to take charge of your VBAC journey!VBAC CalculatorACOG: Deciding Between a VBAC and a Repeat CesareanVBAC Calculator Online LibraryEpidural Side EffectsVBA2C PubMed ArticleEvidence Based BirthⓇ: The Evidence on VBACUterine RuptureHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: Welcome, welcome. You are listening to The VBAC Link Podcast, and guess what? We have a special guest for you today, and that is me. It's Julie Francom. I am here today with Meagan, and I am joining her for a really cool information-packed episode debunking some common misunderstandings about VBAC and showing you what the evidence is and where you can find more evidence-based information about VBAC. Without further ado, your host, Meagan. How was that?Meagan: Oh my gosh. Thanks Julie for the amazing welcome. Oh, so fun. It's so fun. Yes. I am so excited for this episode because it's one of the last episodes with you and I. No, it's not one of the last episodes. It is the last episode of you and I of the year which is so crazy. It is so crazy. Julie: This year has flown. Time is wild. Time is wild. Meagan: It's so strange to me, but that's okay. We will welcome in 2025, and we will say goodbye to 2024. We want to say goodbye to it with, like she said just a really great evidence-based packed episode for you guys.I feel like all year we have gotten messages like, “I had a C-section. I'm being told I can't ever have a vaginal birth. Is this true? Is VBAC safe or possible?”We've had, “I've had one and two C-sections. I've had three C-sections. Is VBAC possible? My provider gave me a 20% chance to VBAC. Is that true? Can I VBAC? Do I really have that low of a chance?”How about this one? This one was more recent that I've heard from our last recording. “You have a 60% chance of uterine rupture if you choose to VBAC.” Ugh. Seriously, so many things that we have heard along the way where it's just–Julie: Lies, lies, lies, lies. It's lies. Let's just call it what it is. Meagan: Aggravating. Julie: For the most part, I do not think providers mean to spread lies or misinformation. I do think that there is a lot of information related to birth in general, but especially VBAC about how this is the way we've always done it. They are just regurgitating information that they have heard from some unreliable source somewhere and aren't really taking the time to keep up with the actual facts about VBAC, about birth, and about anything in general. Also, our system is not set up for continuing educating all of the providers in all of the things. Our hospital providers, I feel like in some capacity we have to give them some grace because they are incredibly overworked. They work crazy hours. They see lots of things and deal with a lot. The medical system is that way. But I also feel like who's responsibility is it to make sure that you are providing the best care? But how can you when the system is working against not only the parents but also the providers and the nurses and everybody. It's really hard because it puts the responsibility on you, the parent, in order to really dig and discover what your options are so that you can make the right choices that benefit you because the system is not set up to support you in any other way besides their hospital policies and following their rules, etc. So, yeah. I don't want this to turn into a provider-bashing episode. I don't think it will either. Sometimes, I think with me talking especially with me being more salty now, it can come across that we are anti-provider or whatever which we are not, but the system is just really frustrating. It takes everybody's efforts to try and change it, everybody's efforts. Not one part of the system can be passive if we want to change it and we want to influence it for better.Meagan: I agree so much. Like you said, we don't want to ever shame the hospital system or providers, but a lot of times, the things we are saying definitely does happen. But it's because there is a lot of fault. There is a lot of fault in these areas. Like you were saying, a lot of these things are lies. The biggest and hardest thing that I found when I was going through my VBAC journey. Julie, I wanted to speak for you and probably say that is the same for you, and that's why we created The VBAC Link: How to Prep VBAC Course is because we didn't know what was right and what wasn't. We just didn't know, and there were so many avenues on Google that you could go down, and you could actually find truth on both sides sometimes even. Julie: And trying to figure out which is true and credible and which is not sometimes is really tricky.Meagan: It's really, really tricky. We want to talk more about that today. We recently talked about hospital policies and what that means and how to go about those, but along with hospital policies come a lot of other things that providers do or suggest or say, so we've got this random policy that was created over here, then we've got all of these random things that are being said over here. We want to know our options. We know hospital policies are what they are. If you haven't listened to the episode, go listen. It's back in November, last month. Go look for it. But today, we are going to be talking about what is the evidence. What are the facts?Let's talk about the VBAC calculator. Let's just start right there because this is where a lot of providers actually begin to determine someone's ability or qualifications if they can VBAC. They'll pull out this list, this calculator, that is online. You can actually get it online. If you want to play around with it, I'll try and make sure to put the link in our show notes because I actually find it very interesting to play around with. We used to do that when we would do in-person courses. We would have everyone pull out their phones, type in the calculator, and type in different scenarios. It was pretty mind-blowing to see how much it could change based off of the answer that you give this computer. You want a VBAC. You have determined that a VBAC is something you want to explore. You want to learn what you can do to have a VBAC. You go to your provider and you go, “Hey, I've had a C-section. I don't want that experience this time. I want a different experience. I would like to have a VBAC,” or what they would call a TOLAC, a trial of labor after a Cesarean. And they're like, “Great. That's wonderful.” Then they're like, “Let's talk about it.” They pull up their calculator and they ask you questions like what, Julie?Julie: They ask you questions like, hold on. I was just digging into the history of the VBAC calculator a little bit more because I was curious about it. They ask you what was the reason for your previous Cesarean? How much do you weigh? It used to ask what your ethnicity was then they docked you if you were black or Hispanic. It also asks, let's see. Meagan: It asks if there was an arrest of descent. Arrest of descent is if you needed a Cesarean because your baby didn't come down. It asks about your history as in have you had a vaginal birth before? Have you had a VBAC? What was the reason for your previous Cesarean? It even asks if you've been treated for hypertension. Interesting. Julie: Interesting. Meagan: Yeah. So height, weight–Julie: Oh, because the chronic hypertension requiring treatment is what replaced the race. When they replaced the race question with do you have chronic hypertension requiring treatment? It may serve as an obvious proxy for race and appears to function similarly in the revised calculator in terms of statistical performance. Meagan: Oh my gosh. Yeah, it says that right on the website. “The information on this website describes the outcome of vaginal birth after Cesarean in term pregnancy for population individuals who receive care at hospitals within (blah, blah, blah) network.” It says, “The information on this website is not intended to be the only basis for making care decisions for individuals nor is it intended to be definitive,” meaning it's not going to be yes, you have to have this or this is the exact chance of you having a VBAC, but yet we have so many providers who go off of this as in point-blank fact.Julie: Like it's the law and like it's a crystal ball. Meagan: Really though. It's so frustrating. Sorry, what were you going to say before?Julie: I just sent you this link from what I was digging into. It's so interesting about the VBAC calculator. It's interesting because first of all, a couple things. The likelihood of the VBAC calculator being accurate for you, the higher percentage of having a successful VBAC, the more likely it's going to be. It's more accurate when the predicted success rates are above 60%. The lower success rate, the more likelihood it is to be inaccurate. Do you know what that tells me? That tells me that most people who attempt a VBAC are going to be successful. That's what that tells me. It's just so stupid because I mean, the development of the calculator was in the early 2000s. From the outside, it actually looks like a good sample size. There were 11,856 people with one prior Cesarean between 1999 and 2002. It was analyzed whether they had a successful VBAC or an unplanned repeat Cesarean. It was analyzed retrospectively. Retrospectively means they looked back on births. It doesn't mean that they did the study when people were pregnant. They looked at it after it had already been done. I like retrospective studies because there's a lot. It really removes the chance for bias related to the study. The interesting thing is that the risk factors that they chose were related to BMI, if you're overweight, age, history of prior vaginal deliveries– so did you have a prior vaginal birth or not– if the prior Cesarean was because of labor dystocia, so that's stalled labor, or your race– black or Hispanic ethnicity. They used these criteria to determine whether or not you were going to be successful in having a VBAC. Here's the stupid thing about this. What it doesn't take into account is the bias in our system against people of color and against people who are overweight. It does not take into account the bias and the different ways people who are overweight and people who are not white are treated in the system. I mean, there are just so many flaws against it as well, but also, I don't know. It says here– sorry. Before I get to my also. It says here– first of all, there are only 19 academic hospitals that were included, so I feel like the sample size of 19 academic hospitals, so university hospitals, and it's between 1999 and 2002. Also, there was a lot of backlash from all of the controversies surrounding uterine rupture in the mid-1990s from that carrying over into that as well. If you didn't know this, they started inducing VBACs with Cytotec in the mid-1990s. It increased the risk of uterine rupture like crazy. I'm not going to do a history lesson right now, but this was only 4 years after all of that. There was probably still a lot of fear and everything related to uterine rupture and everything during all of the time that they were collecting this data. Sorry, I'm probably really nerding out right now. But the thing is that when the predicted success rate was over 60%, it tended to be more inaccurate when it was less than 60%. Accuracy of lower estimates was mixed but generally decreased as predicted success rates declined. I said this before and I'll say it again. My first client ever as a doula had a predicted success rate of 4%, like the number 1-2-3-4. You count to 4. That was her predicted success rate, and she pushed her baby out in 20 minutes. So, I think the VBAC calculator is garbage.  Also, ACOG says in their most recent guideline, actually for the most couple VBAC bulletins that they have put out, is that a low chance of success is not a good reason to exclude somebody from attempting to have a VBAC. But yet, there are so many providers who will not take you if your predicted chance of success is less than 60%. But what did we just say? We just said that if your predicted success rate is less than 60%, it's less likely to be accurate. Isn't that stupid?Meagan: Yes. The other thing I have noticed from providers who do the VBAC calculator is that not only if they say your chances are lower, if they are doing it and it is lower than 50-60%, they automatically go in their mind and they're like, “Oh, she has a lower chance.” They may start being tolerant, but I think it's something to watch out for. If your provider is pulling out this calculator and putting too much weight on the calculator, it might be something to watch out for and understand that there may be a bait and switch coming up or that provider may not end up feeling comfortable with you being able to VBAC or TOLAC. We've talked about this with other providers where they say they are uncomfortable. That is a really good time to say, “You are not comfortable with this. I am comfortable with this. We are not a good match.” Julie: Yes. Don't let your provider dictate how your birth goes. I love that you brought that up, Meagan, because I'm in a member of a Facebook group for labor and delivery nurses. There are 12,000 labor and delivery nurses in there. I'm mostly quiet. I mostly watch because I like to see the climate of the profession and the attitudes around VBAC, birth photography, doulas, etc. There was a post actually this morning in there. The nurse asked, “What is your hospital's protocol around vaginal breech deliveries?” I was like, “Oh, this is going to be good.” I went through the comments, and I was stalking the comments because I know that having a vaginal breech delivery in a hospital is a freaking unicorn. It's a unicorn. You don't usually see it. It was interesting to see the labor and delivery nurses' comments. One of them stuck out to me. I almost commented back, but I pulled myself back. I was like, “This is for labor and delivery nurses. I don't want to stir the pot. I'll stir this pot in other places, but I don't want to stir the pot in this community most of the time.” One of the nurses said that vaginal breech delivery carries risks, and it is up to the provider and patient to decide what risks are safest and what risks to assume. I rolled my eyes at that because it should be like that. It should be the provider AND the patient together to decide the risk, but how often is it the provider only who decides the risks that these patients are going to take on? No. It's not the patient and the provider. It's the provider deciding. It's the provider deciding. Nowhere in the normal, typical, standard conversation does it include providers and patients making decisions. Not real ones. Not when they disagree. Not when they want a little flexibility or not when they want to go against hospital policy, right? Meagan: Yeah. Julie: I mean, there are sometimes, but it's really rare. Meagan: This comment reminds me of the many scenarios that I see or hear within my own clients here in Utah of, “Hi, I really want a VBAC. I met with my provider, and they said they would let me do.” It reminds me of the “let me”. This provider looked at me, read my history, and said that this is what I can and cannot do. This is what they let me do. Julie: Or they led me to the calculator.Meagan: Yeah. We're losing that conversation. Women of Strength, I encourage you to go forward and have conversation with your providers, especially if you are getting this kickback and especially if you are not being told the risks for both VBAC and repeat Cesarean, and you're just being told, “Oh, you have a 46% chance of VBAC based off of this calculator, so I'll let you try, but don't count on it.” Seriously? If I hear anymore providers, ugh. It's so frustrating.Julie: They're doing you a favor. “We'll let you try. Okay, you can try.” Or they say, “But you have to go into labor by 40 weeks or we'll schedule a C-section, but we won't induce you.” Come on. Come on. They're trying to be this savior. We'll let you try, but…Meagan: Don't stand for that unless that's what you're okay with. I can't tell you, “No. You can't see anybody like that.” That's not my place, but I will say that if you're having a provider in the very beginning pull out this calculator telling you that they'll let you try, but the chances are low, your pelvis hasn't done it before, don't know if it will do it again, your cervix didn't dilated to 10, these are problems. These are red flags.  Okay, so the VBAC calculator, we talked about it. We talked about the stats. We talked about our rant. Now, let's talk about uterine rupture. This is a big one that I feel like hovers. It's that dark cloud. Julie: The elephant in the room. Meagan: Yeah. It hovers over people and their fear. I see it daily within our community. “I really want a VBAC. A different experience is so important to me, but in the end, I'm so scared. I'm so scared of uterine rupture.” Valid. I just want to validate your fears right now. It's okay that you feel scared. It's valid that you feel nervous about it. Julie: Mhmm. Meagan: It's also understandable that you may feel extra nervous about it because the outside world talks so poorly about it. Julie: Mhmm. Meagan: They make it sound scary. It is scary. Julie: It can be, yeah, when it happens. It is. Meagan: When it happens, it can be, but the chances are actually quite low, you guys. We want to talk a little bit about it. I know we've talked about it in the past, but I feel like you can't talk about uterine rupture enough. Julie: Yeah, it keeps coming up, so we'll keep talking about it. Meagan: It keeps coming up. It keeps coming up.Okay, so let's talk about one C-section. You've had one C-section. Your baby didn't come down. You pushed for 2 hours. You had a C-section. You dilated to a 5. You didn't progress. They did all of the interventions. You had a C-section. You got an epidural. Your blood pressure dropped. Your baby didn't do very well. Decelerations. You had a C-section. There are lots of scenarios of why we have C-sections. One C-section– Julie, let's talk about the evidence of uterine rupture after one C-section.Julie: So here's the thing. There are multiple studies out examining uterine rupture and things like that. It's interesting because I feel like it does vary. There are some studies with very small sample studies that have 0% uterine ruptures in their studies, and there are some studies that show higher rates. Now, what I have found as I have been digging is that the studies that are the most credible and most reliable will usually have a rate of rupture between 0.2%-0.9%. I feel like if you have anybody telling you that your chance of rupture is half of 1% or you have a 1% chance of rupture or that the chance of uterine rupture is less than 1% or 1 in 200 or 1 in 100, all of those, I feel like, are pretty accurate representations of what the actual risk of rupture is. Now, there are lots of things that contribute to that of course, but I feel like if you ever have a provider tell you, “Oh, it's about 1%”, that's pretty cool. Meagan: Yeah. Yeah. That's pretty reliable to know that they are within–Julie: Within range.Meagan: They are looking at some study that is within accurate range. Julie: Or I think 0.4%. One of the bigger studies that we cite in our course is 0.4% or 1 in 250. Those are all that for me, personally, I would feel that yeah, you are presenting the data pretty accurately. Yeah. I feel like you're trying to lead this a certain direction.Meagan: No, I'm not. That's exactly something I wanted to talk about is how it can range. You may see something that's 0.2% and you may see something that's 0.47, and you may see something that's 0.7, so I love that you pointed that out. Julie: Yeah. I think that's why the more I go on, I used to say 0.4% or half of a percent whenever somebody would ask me, “What's the rate of uterine rupture?” Those are the numbers I would go to, but now, I feel like it's a little more fluid, and I feel like there's more nuance to that. Meagan: Yeah. I usually say around 1%. What about people who are wanting to VBAC after two C-sections? Because this is another big ask, then it gets even stickier.Julie: So sticky. Meagan: And when we talk about 3+. The evidence after two C-sections– again, everyone has different reasons, but I was told slightly over 1%. Julie: Right.Meagan: 0.7% to 1.1-1.4%. Julie: Well, here's the thing, too. There are not a lot of studies about VBAC after two Cesareans. There's just not, but there are two large studies in the ACOG VBAC bulletin that ACOG cites, and it actually says that– I'm actually going to quote the guideline right now. It says, “Women who have had two previous low transverse Cesarean deliveries should be considered for a trial of labor after Cesarean (TOLAC). However, other factors should also be considered to determine the likelihood of successful VBAC.”Now, here's the thing. It cites two studies in their bulletin as far as risk of uterine rupture. One study that they cite shows that there is not increased chance of uterine rupture from one to two Cesareans. There is one that shows no statistical differences. Now, the other study that they reference shows double the risk of rupture. So, what? 0.5% to 1%? I think it was 1.2% is what the ACOG bulletin says. I'm not sure. I don't have the actual bulletin pulled up right here in front of my face except for that. Meagan: This is another thing where it depends on what you're reading. Some of them are 0.1-1.5% or 1-1.5% and that's even on the higher end of the chances. Julie: Right. The interesting is that ACOG even says that, yet people are going to go say double and triple, or whatever. They're going to make up all of these crazy statistics. Now, gosh dangit. I literally had that guideline. Do you have it open?Meagan: No. The ACOG? No. I don't.Julie: I'm going to find it exactly because we've been called out for this. We literally quoted the exact phrase from ACOG and got thrown under the bus for spewing misinformation when it was literally a quote from ACOG, but whatever. Meagan: While you are finding that, there is an article showing vaginal birth after two Cesareans There was a systemic review and a meta analysis of the rate of adverse outcomes in a VBAC after two. It talks about how the VBAC after two success rate was around 71.1% and the uterine rupture rate was 1.63%, so that is within this. We will have all of these here. If we are quoting something, we're going to make sure that we have it here in the show notes. Please, please, please make sure to go down and check it out. You're going to want more information. We don't have all the time to go over all of these, but I think these are such great reads.  Sorry, have you already found it?Julie: Yep. Meagan: Okay, go ahead. Julie: Excuse me while I clear my throat and crack my knuckles. I'm ready. Let's go. Oh, do you know what? This is actually a pdf from an actual publication, so it's not going to be the exact page that I said. There is a whole section called, “More than one previous Cesarean delivery”. Now, what it says about the studies, I'm going to quote it exactly. “Two large studies with sufficient size to control for confounding variables reported on the risks for women with two previous Cesarean deliveries undergoing TOLAC. One study found no increased risk of rupture, 0.9% versus 0.7% in women with one versus multiple prior Cesarean deliveries whereas the other noted a risk of uterine rupture that increased from 0.9% to 1.8% in women with one versus two prior Cesarean deliveries. “Both studies reported some increased risk in morbidity in women with more than one prior Cesarean delivery, although the absolute magnitude of the difference in those risks was small.”Meagan: Mmm, send me the link so I can put the exact link in the show notes so everybody can go read more.Julie: Yeah. Yep. It also says, “The likelihood additionally retrospective–”. Remember, retrospective is looking back on data that already exists. “Retrospective cohort data has suggested that the likelihood of achieving VBAC appears to be similar for women with one previous Cesarean delivery and women with more than one previous Cesarean delivery. Given the overall data, it is reasonable to consider women with two previous low transverse Cesarean delivers to be candidates for TOLAC, and to counsel them based on the combination of other factors that affect their probability of achieving successful VBAC.” Meagan: Hey, see? They're even saying that it's reasonable. Here we are. It's reasonable. But then, there are so many people who are like, “Nope. Out of the question. It is not acceptable. We will not support VBAC after two C-sections.” Julie: Actually, I don't think you are supposed to publish this. You might not be able to distribute it. Meagan: Oh. Julie: Because you just do a search on the dark web for ACOG VBAC bulletin 205 pdf and it will pull up. I promise. Meagan: Okay. There you go, everybody.Julie: I just don't want you to do anything illegal. Meagan: Yeah. Get on a search. Get on a search. I do want to talk when it comes to three. When it comes to three, the hardest part for me with three C-sections being shut down is that the evidence is still not there. The concrete evidence is not being studied that much. Julie: Mhmm. Even the studies that do exist, they don't have super large sample sizes. They are very old. They are 20+ years old, so that's the best data that we have to use. Sometimes those studies are just automatically disqualified because of their age, their smaller sample sizes, and things like that so it's hard to make any definitive statements about its safety or risks. Meagan: Yeah. Then there is evidence with induction. Increasing around 1.1% if you use Pitocin. A lot of people say, “We can't use Pitocin. It increases it astronomically.” I mean, to some, 1.1% and having that be their rupture rate, that may make sense, but for a lot of people, 1.1% is still quite low. I did just want to throw it out there that the risk of uterine rupture is not dismissed because you schedule a C-section. It's not. Julie: That's true. In fact, you are more likely to undergo a uterine rupture during the Cesarean than you are by attempting a VBAC. Meagan: You are? I thought it was 0.06. Julie: No, it's in our course. I have the charts from the National Institute of Health. Because of the pressure during the surgical procedure, your uterus is more likely to rupture. Now, granted, it's probably “safer” to have a uterine rupture on the operating room table because baby is already coming out, but there is data that shows it. I'm pretty sure there are graphs and charts in there from the National Institute of Health. Meagan: Yeah. I'm going to go find it. I was reading about it. It was 0.02%. It's just really important to know that it's not just eliminated. Your risk is not just eliminated. Okay, let's talk about– and anything else you want to talk about with that?Julie: Mm-mmm. Meagan: Let's talk about epidurals and the risk that we have with that. Julie: Not ugh about epidurals. That sound was not about epidurals in general. It's about how I know where you're going with this. Sorry. Meagan: No, it's okay. I just want to talk about the risk with epidurals because a lot of people don't know that some of the things that happen after epidurals can be placed or things to do before if you're planning to get an epidural like hydrating and making sure that we're good there. I want to talk a little bit about epidurals. Epidurals can do a few things. They can lower our blood pressure. That's one of the most common that I have seen right out of the gate. But it's given, and the blood pressure drops. Mom's blood pressure drops. Baby's heart stops responding. Julie: Baby's heart rate drops a little bit too.Meagan: Yeah. In fact 13 out of 100 women have epidurals cause low blood pressure. Epidurals can also increase infections. Now, yes. Infections are in our back and stuff, but I'm actually talking about vaginally because I feel like the vagina is an open door. Once an epidural is placed–Julie: Then you have the catheter too. That will give UTIs. Meagan: Yep. Yes. We've got a catheter, then it's like, “Oh, I can check you. You can't feel that.” We keep introducing bacteria. Julie: More cervical checks. Meagan: Yes. Julie: Increased infection.Meagan: Yes. It also can cause problems urinating because we've got this catheter. It can sometimes be placed for hours and hours.Julie: Yeah. 24 hours sometimes depending on how long you're in labor.Meagan: Yes. Approximately 18 out of 100 women will have urinary issues because of cather and things like that. It's kind of interesting. Epidurals can also cause itching. Is there morphine in epidural? I think that's why.Julie: Fentanyl.Meagan: Okay. It wears off, and it can cause itching. It can cause you to go so numb that you're unable to move and groove. Julie: These are small risks. They are small risks. It's okay to have an epidural. Don't be scared out of having one if that's what you want. You can still have a VBAC with an epidural.Meagan: I want to talk about that. I'm still going over these risks. Going into what you were saying, there's an article that I'm reading right now. It says that 75 out of 100 women who had an epidural and they were very satisfied with the pain relief that they received. 75 out of 100 is really great. That's really great. It says, “50 out of 100 women who were very satisfied with the pain relief.”Of opioids, sorry. It says, “Compared to 50 out of 100 women who were very satisfied with pain from opioids.” There are risks to epidurals, but there's also a lot of great things that come with epidurals because we can be more present and have less trauma. It comes to a point sometimes where labor– we talk about pain versus suffering, and if you're suffering, that's not usually going to lead to a positive experience.But, let's talk about the just-in-case epidurals. We have talked about this before. Julie: That's what my sound was for.Meagan: I had a feeling. The just-in-case epidurals are frustrating. We've talked about them before. It just doesn't make sense to me. It doesn't make sense. One of these days, I would like someone to sit down and try to make this make sense. It doesn't make sense to me. Is there anything else you would want to share?Julie: Just-in-case epidurals. I just want to do the math on it though. Just-in-case epidurals don't make sense. It's not logical. The idea is that a lot of hospitals will have a requirement that you have to have an epidural placed but not turned on. If you don't want to have it turned on, you don't have to have it turned on, but you have to have it placed just in case of a uterine rupture so they can give you an epidural quickly and go get the baby out without having to put you under general anesthesia because general anesthesia is riskier. That is true. The problem with that is that in order for an epidural to be dosed to surgical strength, it takes 15-20 minutes to be dosed to surgical strength even if it is turned on already. If you have a catastrophic uterine rupture where baby needs to be out in minutes, 15-20 minutes is not going to do it. You're going to be put under general anesthesia anyways. Even if you have an epidural, and baby needs to be out in seconds or minutes, then you will be put under general anesthesia. If there is time to wait, there is time to do a spinal block in the OR. It takes effect in 5 minutes, and boom. You don't have to be put under general anesthesia. So the math isn't mathing there whenever they do that.I've had clients ask when they say, “Hey, just-in-case epidural,” and my clients will be like, “Even if I have the epidural turned on and need the baby out immediately, how much time would it take to get to surgical strength or would I have to be put under general anesthesia anyways?” They'd be like, “Well, we'd probably have to put you under general anesthesia if it's a true emergency.” Every time you ask somebody, the math doesn't math. You can't explain it. Anyways, that is my two cents about that. I think that is the most nonsense VBAC policy ever because you can't make it make sense. It is not even make it make sense. You have people say that about everything nowadays. Make it make sense, but this one literally doesn't make sense.Meagan: Yeah. It's a tricky one. It's a really tricky one. There are risks to getting an epidural, but don't be scared of getting an epidural. It's still okay. It's still okay. Just know, if you are getting an epidural, do things like hydrate. Wait as long as you can. Make sure you go to the bathroom. Eat before. Get your blood sugar up. I'm trying to think of all of the other things. Don't think that just because you get an epidural, you have to get cervical exams anytime they want. Julie: Yeah. Meagan: Yeah. Yeah. It's okay to turn your epidural down if you decide it's too heavy. Julie: There are also some providers who will tell you that you can't have an epidural with a VBAC because then how will they know if you have a uterine rupture? Anyway, the hospital policies that we see are just so different. They change and they are so drastically different even from one hospital to the next in the same area. Anyways. Meagan: Okay. Anything else that you want to cover or think that we should cover? Julie: No. Is there anything else pressing? I feel like we intended to cover more things, but we just keep chatting about it, but that's okay because there are some good stuff in this episode. Meagan: No, I think it's great. So if you guys have any questions or if you have any studies that you have found that contradict anything that we are saying, share it. Julie: Yeah. Send it over. Meagan: I would always love to read it. There are times where we miss updates studies or there are studies that we haven't seen, so please, if you have a study that either contradicts or goes along or says something slightly different, share it with us. You can email us at info@thevbaclink.com.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Welcome to today's Guided Listening Session with Jeff Antoniuk. This podcast was originally released on April 29th, 2022, on the Jeff Antoniuk - Educator YouTube channel. Please subscribe to the YouTube channel and feel free to enjoy the video version as well.FOR ALL INSTRUMENTS!Today, in Episode #7, Jeff asks; what is the difference between composing a song and arranging it? And what is orchestration, which comes first, and who cares? Well, all questions will be answered here as Jeff leads us through a composition of his for big band, the song "Borrowed Time." The world famous One C'Clock Lab Band from the University of North Texas is playing this tune, and Jeff walks us through what it took to bring this song to life for 20 world class players. From the UNT album Lab '92Mentioned in this podcast:• www.JazzWire.net - Since we announced JazzWire back in 2017, it has become an incredible Community of hundreds of adult musicians from over 25 different countries around the world. If you are looking for a plan for your practice, regular insights and wisdom on playing jazz, and a huge COMMUNITY of jazz players from around the world, this is the place for you! • JazzWire Free Trial - All of the new Guided Listening videos are accompanied with 3 week long lessons on JazzWire. Please write us, JandJonJazz@gmail.com if you're interested in checking out JazzWire behind the paywall! Amazing practice ideas, every week, for free. What's not to love!?

11/11/24 4PM: (A)ccept Nothing, (B)elieve No one, (C)heck Everything full 2796 Tue, 12 Nov 2024 00:00:56 +0000 O2kitcNM7vvQ8E25LAWn1fSG7W7MWEOA Truth In The Afternoon with Dr. Ken Harris 11/11/24 4PM: (A)ccept Nothing, (B)elieve No one, (C)heck Everything Truth In The Afternoon with Dr. Ken Harris, airing weekdays from 4p-6p on 101.7 The Truth. 2021, Good Karma Brands, LLC False https://player.amperwave

Many clinicians experience a sense of helplessness around effectively managing calls from loved ones of an individual living with a mental illness who is not willing to engage in treatment.  There is frequently an impression that little can be done until the affected individual wants to change.  Dr. Alec Pollard joins us for a discussion of he and his co-authors new book "When a Loved One Won't Seek Mental Health Treatment".  In this conversation we cover:    why Dr. Pollard and co-authors wanted to write this bookthe challenge for clinicians in fielding calls from loved ones seeking treatment for a loved one who is not motivated to engage in changewhere traditional approaches to a treatment avoidant loved one have fallen shortoperationally defining "treatment avoidance" through a lens of non-blameteasing apart the impact of symptoms vs. treatment avoidanceunderstanding how the loop of accomodation-minimization within the "family trap" can keep an individual stuck in treatment avoidancecontextualizing the counterintuitive impact of accommodation considering the extent to which family members are realistically positioned to provide assistance to family members given the complexities involved and the slippery slope of the family trapparallels to the family trap within the client-therapist relationshipthe line between clear, transparent boundaries and minimization on the part of the family member and the temporal course matterswhy their approach focuses almost exclusively on the family member as opposed to the loved one that won't seek treatmentcreating a recovery friendly environmentthe complications that personality challenges in either a family member and/or client can presentunderstanding when a family when should enlisting professional assistancehow to discuss this conundrum with a family member who calls for assistance with a loved oneC. Alec Pollard, PhD, is founding director of the Center for OCD & Anxiety-Related Disorders at Saint Louis Behavioral Medicine Institute, and professor emeritus of family and community medicine at Saint Louis University School of Medicine. He is a licensed psychologist with a special interest in the study and treatment of individuals with anxiety and emotional disorders who refuse or otherwise fail to benefit from evidence-based treatment. Pollard, codeveloper of the family well-being approach (FWBA), has authored or coauthored more than one hundred publications and leads the Family Consultation Team at Saint Louis Behavioral Medicine Institute.

Los Angeles graffiti legend Man One C.O.I. joins us for an exclusive interview. We cover his early influences, the origins of his name, joining his crews, writing with other well-known legends, and the business of graffiti. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In our final clip, Los Angeles graffiti legend Man One C.O.I. shares his views on todays Los Angeles Graffiti Culture. He also recalls some well known female artists, before giving us his All Time Top 5 List of writers. We close the interview as he shares what the future has in store and he gives final Shout outs. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. Talks about his CREWEST GAllery and some of the well known artists who had shows there. He also details why the doors of the gallery were eventually closed. We end the segment as MANONE recalls the city wide ban on murals that lasted for well over 10 years. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

WELCOME TO SEASON 12 - PART ONEAt the core of exercising hindsight in any aspect of your life is the hope for BETTER OUTCOMES in the future. Patrick Kagan, author of SELL THE DIFFERENCE - The Ultimate Guide to Increased Sales, Profits, & Customer Satisfaction  -  CREATE THE DIFFERENCE - A Leader's Guide to Strategy, Growth, & Hiring  -  CLEAR LEADER : KIND LEADER, has assembled some of his professional development friends, and amazing thought leaders to create bitesize pieces toward BETTER OUTCOMES. Our roundtable gathered to spend time together, and break down what it takes to reach BETTER OUTCOMES into a comprehensive 3 PART SERIES to be sure enough time was dedicated to all of our listeners.3 PART SERIES:Host: Patrick Kagan: linkedin.com/in/patrick-kagan-cpc-35a673bRound Table:Kevin Kepple: linkedin.com/in/kevinkeppleJulie Lokun:  julie@themediacasters.comBarbara Spector: vipchatwithbarb.comClay Stelzer: clay@15sixty.comPart One: CLARITYPart Two: VISIONPart Three: FOCUSPatrick opens the door to higher levels of income and satisfaction in  his book, "SELL THE DIFFERENCE" and he takes leaders to levels of ABUNDANCE they only dream of in his book "CREATE THE DIFFERENCE" AND IN HIS LEADERSHIP POWERHOUSE, "CLEAR LEADER : KIND LEADER"  Three of the best options to develop personally and professionally in sales and leadership.  Your copy awaits you here:https://pksolutionsgroup.com AUDIOBOOKS SPOTIFY: https://open.spotify.com/show/4idBQ40aqeB0tBvxdSwo0f CHIRP: https://www.chirpbooks.com/audiobooks/clear-leader-kind-leader-by-patrick-kaganGOOGLE PLAY: https://play.google.com/store/audiobooks/details/Patrick_Kagan_CLEAR_LEADER_KIND_LEADER?id=AQAAAECSG0BbwMAS WELL AS MOST AUDIO BOOK PLATFORMS.Want more growth as a professional?  SCHEDULE YOUR FREE CONSULTATION WITH PATRICK: https://calendly.com/pksolutionsgroupOr, just choose "SHOP" at https://www.pksolutionsgroup.com , FOR value added resources available to all our followers.  ©2022 -2023 PK Solutions Group. All rights Reserved.Not to be distributed for commercial use without express permissionEnjoy inspiration that is practical, and strategy that is tactical with the hindsight you need from the experts you trust.  Support the show

In today's clip, Los Angeles graffiti legend Man One C.O.I. recalls opening day at his CREWEST Gallery and the hundreds of people who showed up. He also talks about Police paying him a visit, and he details a tense closed-door meeting with the Mayor of Alhambra. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. talks about how corporations would use his artwork for marketing campaigns without his permission. He also talks about the key to his successful business career as a working artist. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. talks about starting CREWEST.com to fill extra art jobs with his talented friends. He also goes on to mention how he opened the first full-time graffiti art gallery in Los Angeles, CREWEST. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. talks about what led to COI slowing down. He also shares a story about telling his friends about selling artwork but being laughed at for bringing up the suggestion. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. shares one of the reasons he believes FLEECE changed his name. He also shares his thoughts upon seeing OILER in the FOX 11 News special with the legendary DECLINE COI. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. Talks about SAHL COI and his landmarks all over Los Angeles. He also shares a story of bombing one night with OILER & SACRED and getting shot at in the middle of nowhere. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. shares more about SACRED and when the KNB Crew and COI Crew decided to merge. He also recalls meeting a young 14 year old who later turned into L.A. Graff Legend SAHL COI. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles Graffiti Legend Man One C.O.I. talks about how C.O.I came to Alhambra and how a writer from Hollywood came to join the soon to be Legendary crew. He also speaks on SACRED C.O.I and his Legendary career in L.A. Graff History. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles Graffiti Legend Man One C.O.I. reveals the origins of the Legendary Los Angeles Crew COI. He recalls who started the crew, some of the original members and the day he first joined. As a bonus, he remembers when a legendary writer first got his own name on the very same day. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles Graffiti Legend Man One C.O.I. tells us why and when he transitioned from doing letters to characters. He also talks about starting a piecing crew with VYAL One and reveals how that crew was short-lived due to joining the Legendary C.O.I Crew. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Man One C.O.I. recalls the first battle in Los Angeles between the two graffiti Legends, Hex and Slick. He goes on to share who he thinks won the battle and retells what a judge for the battle shared with him. He closes the clip by recalling when the two legends met up again at the Grand Opening of Hex's show at The Crewest Gallery after years of not speaking. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. talks about how he drastically improved his style and where he would practice. He also recalls some of the writers who visited the Belmont Tunnel and remembers its final days. We end this clip with a story of when Dr.Dre paid a visit to the Belmont Tunnel for an exclusive photo shoot. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. talks about ego trippin and writers starting beef over similar names. He also racalls painting a giant STK at the Belmont Tunnel and finding out the next day their rivals had gone completely over it. trippin'recalls --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. Talks about first visiting the Sandborn yard and the two writers he saw there first. He also recalls when his parents found out about his secret life as a graffiti artist and the tense confrontation with his father. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. tells us what happened after walking out of the Paint Store with a duffel bag full of stolen spray cans. He also talks about MURAL STK's early influence and he names the biggest crews in Los Angeles when he was coming up in graffiti. spray cans --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. remembers how he'd steal paint at the local hardware stores. He also recalls first meeting Los Angels Graffiti Legend TEMP when he worked at a hobby shop and later running into him at the Paint Shop. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. talks about leaving STK and starting his own crew with VYAL. He also recalls first seeing VYAL's sketch book and describes his early style. The clip ends as Man One shares his thoughts on first hearing VYAL was changing his name. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. remembers first meeting Los Angeles Graffiti Legend VYAL ONE and reveals his original name before becoming a worldwide phenomenon. He also talks about VYAL ONE judging his first piece and giving him a score. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. racalls visiting a hidden graffiti yard to take pictures and being confronted by members of the STK Crew, with Chains, Crowbars and bats. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

Ó Wagatha Christie go branda Beckham, tá Áine, Sinéad agus Siún ag caint faoi thionchar na tréimhse seo orthu mar dhaoine.

In today's clip, Los Angeles graffiti legend Man One C.O.I. remembers how difficult it was to meet other writers when he was coming up. He also talks about first walking into The Panic Zone, a well-known graffiti yard at the time, and mentions some of the writers he saw on the walls. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. recalls first seeing graff on the bus and how he came up with his famous street name. He also shares how he causght his first taggs. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. talks about moving from East Los Angeles to Alhambra at a young age. He also tells us what his early life was like in the new city and attending school where he displays early signs of talent. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

In today's clip, Los Angeles graffiti legend Man One C.O.I. is welcomed to the studio where we discuss his recent appearance with PRIME K2S. He also educates us on PRIMES history and his contribution to Los Angeles graffiti history. --- Support this podcast: https://podcasters.spotify.com/pod/show/richard-castro63/support

Tá Sinéad, Áine agus Siún ag caint faoi choincheap na fírinne, coincheap atá níos doiléire ná riamh.

C.W. Goodyear, Author

Nickel continues trading either side $21,000 as LME inventories continue to creep lower towards 37,000 tonnes despite talk of large surpluses.  China saw inflow of Russian cathode – 7,000-8,000 tonnes – will be see how this flows through Chinese market or ends up overhanging Chinese market.Debt deal helped put bounce back in copper and floor under nickel prices.  Given global slowdown, still think test of $20,000 possible before we trend higher by year-end. Battery restocking – lithium prices up 13% week-over-week as seeing restock well underway.  As I've said before, collapse in lithium caused destocking and drop in battery demand through first half and that we'll see an aggressive restocking which looks like is now well underway.“Great convergence” continues – discounts narrowed again with nickel prices lower and sulphate prices higher – sulphate discounts now less than half of what they were 6 weeks ago.  NPI discounts also narrowed slightly.Indonesia – part of conference and series of site visitsKey takeaways:Nickel price index – government not going to put export tax on NPI, but establish Indonesia reference price – think this is the way government will extract additional value for Indonesia. Important as no floor price for limonite (HPAL) unlike saprolite (NPI) – part of reason building MHP capacity. There will be ONEC – way for Indonesia captureFocus on growing battery supply chain volumes starting with HPAL/MHP, matte.  No further talk of more stainlesss capacity – good for US/European stainless producers who have healthy price premiums. Taking advantage of limonite being mined to get to saproliteLots of capacity coming – 4 million tonnes approved through 2030 (we'll need all of it as no western supply growth coming yet).  But will need 500 million tonnes – presenter from Indonesia government bureau doubtful that can supply that much. Ore grades definitely the risk – some of plants we went already using 1.5%, most using 1.6-1.65%.  Was 1.8% 2 years ago – don't think people factoring in derating of plant.  33 MW furnace used to 8ktpa, at 1.6% is 7ktpaLots of open property – don't seem to be rushing to reclaim – not good for runoffBrimob – Indonesia special forces at each facility

Boston Dave controls his inner deamonToe Hang is a thingBreaking clubs is an art formtalesfromthefirsttee.comSpotify : Just Talesapple podcasts: Just TalesAmazon Music and Podcasts: Just Tales

Tá na BAÉs ag caint ar an tacaíocht a theastaíonn in am a ghátar, ó bhás go huaigneas.

I talk about Castles and Crusades, an alternative to D&D. --- Send in a voice message: https://anchor.fm/radio-grognard/message Support this podcast: https://anchor.fm/radio-grognard/support

Buckle up for our SPECIAL 100TH SONG! In this special episode, Mike and Paul make a special announcement before debuting their extra-special 100th song “X-One-C!” “X-One-C” Written and sung by Michael Cassady and Paul Rust Piano and organ by Michael Cassady Bass by Paul Rust Drums by Tony Thaxton Guitar by Emeen Zarookian Song produced by Emeen Zarookian Show produced by Michael “Mookie” Blaiklock

Always Day One đem lại một cái nhìn thú vị về phong cách lãnh đạo, văn hóa doanh nghiệp, quy trình và công nghệ của những gã khổng lồ công nghệ, thông qua cách viết và kể chuyện hấp dẫn, trực tiếp của tác giả. Cuốn sách này không đề cập tới sự phát triển, cách để phát triển, hay cách đánh bại các công ty nhỏ hơn. Cuốn sách này nói về việc xây dựng các nền văn hóa sáng tạo, mà tôi tin rằng mọi người đều có thể học hỏi được. Và đối với những người đang tìm cách chế ngự các công ty này, việc hiểu được cách hệ thống nội bộ của họ hoạt động cũng có thể là một lợi thế mang tính chiến lược. Nếu tri thức của những gã khổng lồ công nghệ vẫn chỉ nằm trong tay họ, thì thế giới kinh doanh rộng lớn hơn, cùng các cơ quan quản lý, sẽ gặp bất lợi. Nhưng nếu nó nằm trong tay chúng ta, thì chúng ta sẽ có cơ hội cân bằng sân chơi. Tải ứng dụng để nghe trọn bộ Sách nói : voiz.vn/download

Nuair a thagann sé chuig cinneadh a dhéanamh sa saol, an mbíonn muid ag tabhairt aird ar na guthanna seachtracha seachas an glór inmheánach?

Racoons: Swingers and Delicious #shorts #podcast #humor #funny #racoonsRacoons. First off, how do you spell the name? One C? Two C's? D efinitely a double O, it's probably worth looking into. If I was going to be any other mammal, it might be a raccoon. There's a few reasons. They still have all their five little digits. They can really do some skillful things,  like they can unlatch a cage, they can untie a knot, they can pick your pocket, it's true. They get pretty big to about 57 pounds. They, they're nocturnal, so they, you know, they kind of like to party. They're kind of like swingers to you know, they don't have life partners, this kind of do what they want and do it when they want. I liked a little bandit eyes too. You know, they kind of look like they're always up to mischief. I bet they're pretty delicious, too. I think all you'd really need is maybe garlic salt, pepper, mela cumin, slow roast those little gains on a fire. Maybe indirect heat. Not really sure that's legal. I was trying though. That's raccoons by a sexy voice guy. It's nice baby!Support the show

Racoons: Swingers and Delicious #shorts #podcast #humor #funny #racoonsRacoons. First off, how do you spell the name? One C? Two C's? D efinitely a double O, it's probably worth looking into. If I was going to be any other mammal, it might be a raccoon. There's a few reasons. They still have all their five little digits. They can really do some skillful things,  like they can unlatch a cage, they can untie a knot, they can pick your pocket, it's true. They get pretty big to about 57 pounds. They, they're nocturnal, so they, you know, they kind of like to party. They're kind of like swingers to you know, they don't have life partners, this kind of do what they want and do it when they want. I liked a little bandit eyes too. You know, they kind of look like they're always up to mischief. I bet they're pretty delicious, too. I think all you'd really need is maybe garlic salt, pepper, mela cumin, slow roast those little gains on a fire. Maybe indirect heat. Not really sure that's legal. I was trying though. That's raccoons by a sexy voice guy. It's nice baby!Support the show

Pour ce nouvel épisode des Pacific Hoe, je reçois Aurélie Poisson , enseignant chercheur en science humaines et sociales à l'Université catholique de l'Ouest, ISEPP UCO Pacifique. Cette semaine, nous sommes partis nous aventurer à la frontière entre le réel et le virtuel, une frontière de plus en plus flou quant à nos identités et nos personnalités.  Retrouves la newsletter en lien avec le podcast ici: https://www.pacificventury.com/so/5aNy3-0Jj?languageTag=en#/main  Abonnes-toi dès maintenant, c'est gratuit! 

Originally dropped November, 2020Ep. 12 Rebeca Cerna Cervantes: Only one “C”.Rebeca is a health and equity advocate in a space where public health meets education. We talk about how the focus of her work has been impacted by this trash administration. I ask her if she is able to name any current Latinx leaders/activists which leads us to touch upon colorism/anti-blackness in our community. We discuss recognizing our privilege, why I had to apologize to her back in 2012 and so much more. Episode linksRebeca Cerna CervantesNational Alliance On Mental HealthGASENATE.COMNever Look Back by Lilliam RiveraWTYM is brought to you byWord To Your Mama Store: Use code WTYM at check out to receive 10% off any order WTYM Patreon PageDONATEMEDIA KITAVAILABLE WHERE EVER YOU CONSUME PODCASTSon socials @wtymama | email: hola@wordtoyourmama.com

Episode 102: One C*nt Woman

Janice Ashworth - Project Manager at City of Ottawa Climate Change Unit (99+) Janice Ashworth | LinkedIn Janice has been a tireless advocate of community-owned power for more than decade.  She played an important role in developing 17 solar power projects in Eastern Ontario with a total generating capacity of 1.7 MW. She has been with the Ottawa Renewable Energy Co-op since 2011 and has 10 years of experience in renewable energy. At OREC, she is responsible for business development, project management, and financing. Janice Chairs the Ontario Federation of Community Power Co-operatives, is a member of the Sustainability Committee of the Ottawa Chamber of Commerce, and sits on the Net Metering Working Group of the Ontario Sustainable Energy Association. She coordinated the Nova Scotia Sustainable Electricity Alliance and worked in wind energy with the community-owned Colchester-Cumberland Windfield. Her non-profit experience includes community organizing for Ecology Ottawa and promoting solar energy with the Ecology Action Centre. In her time as General Manager of OREC, Janice has been named as a 40 Under 40 business leader by the Ottawa Business Journal, and was awarded the 2017 Solar Woman of Distinction by Women in Renewable Energy. 1:25 start  2:12 where did the interest come from 7:00 how are we doing energy use, the effect of covid  12:50 Community-owned power what is it? 14:10 Energy democracy  17:45 OREC - solar and wind projects in Ottawa,  18:57 Co-power  19:40 Green Energy Act  22:10 ONEC - community farm  24:45 Farm co-op  - organic vegetables   29:00 Growing our own garden 31:00 Climate refugees   32:30 Project manager -  Ottawa climate unit - what they do  Climate change resiliency  Climate change mitigation  Specific role -  financial modeling, private building retrofits  35:11 Private building retrofits  - better homes loan program - 0% financing to homeowners, Oct 25th loan program starts. 39:43 how does it work, energuide audit 44:00 energy evolution  - strategy to achieve master plan net zero 2040

Dee welcomes trailblazing entrepreneur C. David Moody, Jr., to the podcast this week. David runs one of the largest African American-owned construction companies in America. His firm has built and delivered more than 200 commercial projects valued at $3 billion dollars, including Mercedes-Benz Stadium, home of the Atlanta Falcons. In part one, David talks about how he built his construction empire from scratch, the impact of Maynard Jackson becoming the first African American mayor of Atlanta, and what he's most proud of during his 33 years in business.

X Minus One is an American half-hour science fiction radio drama series that broadcast from April 24, 1955 to January 9, 1958 in various timeslots on NBC. Known for high production values in adapting stories from the leading American authors of the era, X Minus One has been described as one of the finest offerings of American radio drama and one of the best science fiction series in any medium. Overview Initially a revival of NBC's Dimension X (1950–51), the first 15 episodes of X Minus One were new versions of Dimension X episodes, but the remainder were adaptations by NBC staff writers, including Ernest Kinoy and George Lefferts, of newly published science fiction stories by leading writers in the field, including Isaac Asimov, Ray Bradbury, Philip K. Dick, Robert A. Heinlein, Frederik Pohl and Theodore Sturgeon, along with some original scripts by Kinoy and Lefferts. Included in the series were adaptations of Robert Sheckley's "Skulking Permit," Bradbury's "Mars Is Heaven", Heinlein's "Universe" and "The Green Hills of Earth", " Pohl's "The Tunnel under the World", J. T. McIntosh's "Hallucination Orbit", Fritz Leiber's "A Pail of Air", and George Lefferts' "The Parade". The program opened with announcer Fred Collins delivering the countdown, leading into the following introduction (although later shows beginning with Episode 37, were partnered with Galaxy Science Fiction rather than Astounding Science Fiction): Countdown for blastoff... X minus five, four, three, two, X minus one... Fire! [Rocket launch SFX] From the far horizons of the unknown come transcribed tales of new dimensions in time and space. These are stories of the future; adventures in which you'll live in a million could-be years on a thousand may-be worlds. The National Broadcasting Company, in cooperation with Street & Smith, publishers of Astounding Science Fiction presents... X Minus One. The series was canceled after the 126th broadcast on January 9, 1958. However, the early 1970s brought a wave of nostalgia for old-time radio; a new experimental episode, "The Iron Chancellor" by Robert Silverberg, was produced in 1973, but it failed to revive the series. NBC also tried broadcasting the old recordings, but their irregular once-monthly scheduling kept even devoted listeners from following the broadcasts. The series was re-released in podcast form beginning on June 22, 2007. In November 2008, Counter-Productions Theatre Company became the first theater company to stage three episodes, "The Parade", "A Logic Named Joe", and "Hallucination Orbit".