Podcasts about real food for gestational diabetes

Lauren joins us today from Australia sharing her two Cesarean stories and her surprise unassisted HBA2C story! Lauren's first birth was a crash Cesarean under general anesthesia at 40+1 due to nonreassuring fetal heart tones. Her second birth was a TOLAC going into spontaneous labor at 40+3 under the midwifery model of care. She labored naturally, had an artificial rupture of membranes at 6 centimeters, baby was posterior, and didn't descend. She pushed for an hour then had a spinal given to help baby manually rotate. Lauren's birth ended in a CBAC which she later learned included a special scar along with the diagnosis of CPD (Cephalopelvic Disproportion). Two years later, Lauren was vigorously planning for a VBA2C. She had her birth team picked out and was ready to go to the hospital for when baby would come at what she thought would be 40 weeks again or later. At 38 weeks and 2 days, her husband went on a work trip 3 hours away and her mom, who was planning on caring for her boys during the birth, was an hour away on a day trip. Lauren's labor began in the evening while she was alone with her two boys and ramped up extremely fast. With the help of her doula and paramedics supervising, Lauren labored and gave birth to her baby on the bathroom floor in just 2 hours from start to finish!Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. You guys, we have another story coming from Australia for you today. We just recently had an Australian mama and I love our Australian episodes because I cannot get enough of your accent. I love listening to you guys. We're so excited. We have our friend, Lauren, and we have our little baby. Lauren: Yes. Little Wren's awake and joining us. Meagan: It's 11:00 PM there so she stayed up extra late to record with us today. We are going to get into her stories. You guys, she had two C-sections. Lauren: Yes, two Cesareans. Meagan: And then a surprise. I feel like you really had very unique things. You had an OB and you were under general– Lauren: For my first. Meagan: Then you were with midwifery care and then a surprise which you are going to be sharing here in a second. You guys, I'm really excited to hear her stories. We do have a Review of the Week and it's called, “So Grateful I Found This Podcast” by shinefortheworldtosee. It says, “After having an emergency C-section last year, I struggled with all of these displaced emotions. Here I was so grateful for my healthy baby but I found myself feeling hurt like I had something taken from me that I struggled finding a safe place to share and it felt as if no one around me had ever experienced the same thing I did. This podcast and group of women are my safe place. I am expecting baby number two and am so, so grateful for the empowerment that those stories told here have given me. I am so excited to try for a VBAC this time and the more I learn here, the more confident I become.“Thank you from the bottom of my heart for making this podcast.” You are so welcome. I love this podcast so much. I love all of the stories. I love the empowerment, the encouragement, the education, and also, I'm a big person who relates. I love relating. I think it brings validation to my heart when I can relate to someone because like this listener said, she felt alone. She didn't have anybody else in her space and this space is so amazing because even if it's a different outcome or there are different parts of the story, there are usually little blurbs of each story that you can truly relate to. Thank you so much for your review, shinefortheworldtosee. As always, if you haven't yet, please leave us a review. We are always so grateful for them. Meagan: Okay, cute Lauren. Oh my gosh. Thank you so much for staying up way late because by the time we are done recording this, it's going to be midnight. Oh my goodness. Oh my gosh, thank you. Lauren: That's okay. I got the time and said, “Oh, it is late,” but I was so excited anyway. I just can't wait. With that review, I was thinking the exact same thing. I remember when I found the podcast, I can't even remember. I was trying to think how it popped up. I didn't even know VBAC was a thing after my first birth. I just remember listening to it and so much of it resonated. I could relate to those little bits. It was like I was meant to hear it. I just had that strong feeling when I started listening to the podcast. I'd be crying in the car and it was just so powerful. It definitely was life-changing when I found the podcast. Huge. I feel like there are so many situations where you've never met them ever in your life. Sometimes we don't even know where they are at and it feels like they are literally sitting on the phone talking to you. Lauren: Speaking to you, yes. Meagan: Speaking to you. Yes. Lauren: Yes, exactly. I felt it. I was just like, This is what I'm supposed to be listening to at this exact time because it was speaking directly to me. It is so special what you have created. I think there is a podcast now in Australia for VBAC but there was never anything before and I would just eat them up. I'd be waiting every week for the podcast because I would be–Meagan: Is it Ashley's? Lauren: There's that one. I think I've listened to her podcast with you actually. There's the “Australian VBAC Stories” as well. They are only maybe up to 8 or 10 episodes so they are quite fresh. Meagan: Yay. Lauren: I just love all VBAC stories. I could listen to them all day. Meagan: Absolutely. Well, let's get going on sharing yours. Lauren: Yes. Okay, so my first birth was– I got pregnant in 2017. We've got three little ones now. Nate was our first baby. We had private health insurance. A few of our friends had gone private. Some of them had gone public. Some had Cesareans. Some had natural births. I hadn't really had a plan of what I wanted to do. I always knew I wanted to have children but I hadn't really given much thought to the pregnancy or the way of birth or anything like that. We just signed up with a private OB. I think from our GP, you get a referral then you start seeing them from about 16-20 weeks. You get all the regular scans. Everything was really straightforward. We were really fortunate with our pregnancy. We found out we were having a boy. We found out in– I think I've written it down– January. I had morning sickness for the first 3 months then I had a bit of Vitamin D deficiency so I had to take supplements throughout the pregnancy for that. I had a growth scan around 36 weeks. Now, I obviously know after doing a lot of research that there's no real need for it and it's just something to give them ammunition to schedule the big baby and the scan actually came back that he was measuring fine. I was like, “Yep, that's good.” Being a first-time mum, I was so excited to see him on the ultrasound anyway. Meagan: That's what I was going to say. I feel like they get you especially for first-time moms but really in general because it's so fun to see our baby. Yeah. Lauren: Of course I want to see him. Definitely. Meagan: We get in there and they're like, “We'll do this plus you'll get to see your baby.” You're like, “Well, I haven't seen my baby since 20 weeks, so okay. I'll do that.” Lauren: And you don't know any different so you're just like, “Yep, that seems fine.” I think we even did a gender reveal and I think my husband's cousin mentioned something about her friend doing Hypnobirthing. I remember I just wasn't in the right place to hear that at the time. I'm like, I wish I would have listened but it just wasn't meant for me at that time. I took maternity leave. I had 4 weeks off because I thought, Whoa, from 36 weeks the baby could really come any time. Looking back, I know 40 weeks is not even your due date. It could be any time, anywhere. Meagan: Estimated. Estimated. Lauren: A guess date I've heard a lot of people refer to it. And first-time moms tend to go over the 40 weeks so it's not uncommon. I remember it being such a mind game toward the end when I was getting closer to the due date. I think my OB offered me a stretch and sweep around 38-39 weeks and I was like, “Yep. I'm ready. I'm over it. Anything that we can do to get the baby.” I didn't really think of it as being an intervention. I didn't really know what the word intervention was at that time. I do remember her saying to me afterward something like, “Oh, I hope we're still friends after this,” after she did it. Meagan: Oh. Lauren: I was like, “Oh, that's a funny thing to say.” Then yeah. I think it was around 39 weeks and there was nothing. It didn't get anything moving. I was just automatically booked in for an induction at 40 + 1 for postdates which is not even near postdates but I was just like, “Yep, great.” I think like you said before, being a first-time mom, I was just ready to see my baby and over it so I was like, “Yep. That's great and exciting.” We got booked in. When I went back through my records, I saw on my induction paperwork that it even said, “Small mummy and postdates,” because I was small apparently. Meagan: Nuh-uh. Lauren: Yeah. I'm quite short. But they were already preempting that I probably wouldn't be able to anyway. We went in. I think we got admitted at 7:00 in the evening. We got ready to do a CTG monitoring and just an initial assessment. When we got in, they said I was having uterine activity but I couldn't feel anything. It was showing on the monitor I was having some Braxton Hicks or some contractions. They were concerned that the baby wasn't really reacting very well to that at the time so they called the OB who just happened to continue with the induction. They did a vaginal assessment and I think I wasn't obviously at anything. They did another CTG for the fetal heart rate and it had gone down, I think, to 90 BPM and had recovered within 2 minutes with a change of position and it had come back to what they were happy with. About an hour after that, they did an intravenous drip in and they did another exam. I was 1 centimeter and my cervix was posterior so obviously, I wasn't anywhere near ready. I think maybe half an hour after that, there was another decel and it said, with pointless uterine activity. It wasn't doing anything, but there was something. Then the OB was asked to come in for that. Obviously, the baby wasn't doing very well when I wasn't really even in active labor and they were a bit concerned with that thinking he wouldn't be able to tolerate full-blown labor at that point. So then it was 9:00– so two hours after we got there– when the OB was in the room. They did an ultrasound and were able to determine that I had a calcified placenta and a pocket full of fluid. There was discussion around maybe booking in for a Cesarean just because of the nonreassuring CTG they were having. I awfully now remember feeling a sense of relief and being like, “Oh, good. I don't have to go through labor and all of that,” because I think probably admitting to myself, I was a little bit scared about the whole labor because I hadn't done any preparation or any planning. The only thing we had done was the antenatal appointment– what's the word? The antenatal class at the hospital where they go through it. After we left, my husband was like, “That all sounds awful.” It was just really interventions and how to get the baby out. He was like, “None of those options sound good.” When they said “Cesarean”, I was like, “Oh, perfect. That will be great.” I think at 9:30, we got prepared to go to theater. My husband got in a gown. My mum had actually just arrived into the hospital so it was all exciting. We were going to meet the baby. This was at 9:30. We didn't know it at the time, but there were a few alarms going on outside our room and there were a few people milling around. I don't know. I don't think that was related to us. We got wheeled out on the bed to go to theater and then all of a sudden, Josh disappears and they were rushing us to the theater room. I was like, “What's happening?” I'll never forget. I remember– I don't know who was pushing me, but he said to me, “I don't think you understand. Your baby needs to come out right now.” We just thought we were going in for a normal Cesarean. We didn't realize it was changed to a general anesthetic so I started getting upset. I said, “Can I just say goodbye to my husband?” They rushed him back. I quickly kissed him and said goodbye. He gave them his phone and we went into theater. I was sobbing at this point because I just didn't know what was happening. There was somebody putting a catheter. They were putting the general anesthetic in then I think my OB popped her head in. At least, I knew some sense of calm. She said, “It's me. I'm here. We're just going to get the baby out.” I remember I could see them prepping my stomach under the mirror and the anesthetist was lovely. He rubbed my cheek and said, “It's going to be okay. We're just going to get the baby.” That's it. That's all I remember and then I was gone. After that, I think at the time, I read back on the notes that it was 9:45. It got upgraded to an emergency call. I went under at 9:50 and he was born at 9:52 so it was very quick. He came out. He cried. He was fine. His APGARS were 9 which are healthy. Meagan: That's great, yeah. Lauren: So fine, yeah. I think he was 3,000 grams which is 6.8 pounds and the surgery was complete at 10:05 so it was super quick in and out. Meagan: Wow. Lauren: He went to Josh straightaway. Poor Josh was obviously just waiting and didn't know what was happening. They brought Nate out and he said, “Well, that's great, but where's Lauren? Where is she?” So then I didn't make it into recovery until 20 minutes later which I know is still really fortunate compared to what some people experience. It was really quick. When I came to, I was still sobbing I think it must have been because I went under crying. When I came out, I was in tears and I could just see Josh sitting on the bed next to me holding Nate. Instantly, I knew he was okay and he was fine. I was able to hold him and breastfeed him so I think from then on, everything was really quite lucky. We got in straightaway. I think we were in recovery maybe another 20 minutes and then we got taken to the ward. At the time, I don't think I really registered how full-on it was. I just had a healthy baby. I was okay. Postpartum was a beautiful experience. We were in the hospital, I think, for 5 days together because we were private. Josh got to stay with us. It was like a second honeymoon. We were in there. It was like a hotel where we were getting food. That side of it, I think, was just beautiful and I didn't really feel like I missed anything birth-wise at that point. That was it I guess with that. Then in 2019, we started thinking about having another baby. I hadn't really thought too much about a VBAC or what I would do. I guess I was like most people where you just are once a Cesarean, always a Cesarean and there wasn't another option. I really wish I could remember how I came across it because I can't remember at all, but I must have found your podcast and I remember listening to it even before I was pregnant. I was just like, I have to try and do this because I never got to experience any labor at all with Nate and then with this pregnancy, I really felt like I missed that and I wanted to have something. I wanted to go into labor and at least try and be given the chance. We were really fortunate and fell pregnant straightaway. That was in 2019 and I knew I wasn't going to be doing private obstetrician this time so I did a bit of research before I was even pregnant actually with a public hospital that had a midwifery program attached to it. You attended all of your appointments at a clinic and they had a VBAC-specific clinic then you birthed at the hospital. Meagan: That's awesome. Lauren: Yeah, but you have to apply straightaway. As soon as I got the positive, I filled out the application form and applied directly with them. I got accepted and I was like, If I'm going to go for this, this is going to give me my best chance to go and have a VBAC. I think, I can't remember how far along I was but I still went. The hospital we were going to is a half hour away but all the appointments with the midwives were only 10 minutes away. That was really good. I knew the drive was a half hour but it was going to be okay. I also had signed up to do the VBAC course with you guys. I got my handout for that and I ate it up. I love that. I went through it and was doing it at night time. After listening to the podcast, I also knew I wanted to do Hypnobirthing so I did Hypnobirthing around 7 or 8 months which was when COVID started to come into the picture. It wasn't around in Australia but it was happening. The course was supposed to be a group environment with a few classes. We ended up doing an online course which was actually really lovely because when Nate was asleep, Josh and I would sit in bed. We would do all of the Hypnobirthing courses, listen to the tracks, watch the videos, and then we had one in-house visit where we went through all of the positions and acupressure and things like that that I wanted for pain management during birth. That was really good then I think from 37 weeks, I started doing all of the things. I was doing raspberry leaf tea, eating Medjool dates, and sitting on the birth ball. In my head, I felt like I was really getting prepared in the best way possible. Now I know in my third birth, I thought I was but I wasn't as prepared as I probably could have been. I was still doing more than what I did for my first birth. I had one chiropractic appointment at 38 weeks to get everything balanced and aligned. I never had chiro before so that was all new to me. Then at 39 weeks, I had an acupuncture appointment. I had never done acupuncture before and I loved that. I felt that was really nice. I think it was just my hands and my ankles and then they just put the music on and I felt so relaxed. I really loved that. That was good. I remember when I went in, I said, “I hope I haven't left it at too late.” They said, “You're pretty much a first-time mom. You've never had labor. Your body has never been through that.” He did some statistics and he said to me that from 40-41 weeks was the average time. I remember with Nate, when I got to 40 weeks, I thought the baby was going to come any day so with this pregnancy, I pushed it out to 41 weeks. In my head, that was when my due date was. I don't know what I would have done if I got to 41 and I hadn't gone into labor but I had that I was going to 41 weeks. I had an online hospital tour. We couldn't go in to see it because of COVID then I had an online appointment at 39 weeks. When you have midwifery care, you still have to be signed off by an obstetrician in the hospital to give you the okay and run through all of the stats and everything. I was prepared to be up against an uphill battle when I went to that appointment. They were pretty supportive. They just talked about postdates, the risk of rupture, and things like that. I said I was comfortable going to 41 weeks and reassessing then so I think that was around 39-40 weeks and then we were rebooked in for 41 weeks if I hadn't gone in. So then I think I was 40– oh, sorry. I'm jumping around a bit. My due date was a week after Nate's second birthday so in my head, I just wanted to get to Nate's birthday and then the baby could come after. We had a little birthday celebration for Nate a few days before I went into labor. We were happy that was done then at 40+3, in the afternoon at about 4:00 I felt a few little tinges but obviously, I didn't know what anything was so I was thinking this might be it or this could be prodromal labor or Braxton Hicks. I just wasn't sure. I was like, well, I know from the podcast that I don't pay attention to it. I'm just going to go about my normal routine with Nate. I'll get dinner, do bathtime, all of those things, and try not to focus on it too much thinking it might either go away–Meagan: Or fizzle out. Lauren: Yeah. In my head, I'm like, It can take days. By 4:00 it started, then by 7:00, I was getting Nate ready for bed. He was in a cot at this stage. I remember taking a big breath in and slowly exhaling like in Hypnobirthing. I noticed I was having to do that as I put him to bed. I remember being so excited like, This is happening. My body was doing it naturally. I really wanted to try to not get induced if I could avoid it. I remember I really had to focus on my breathing. I was leaning on the bed with my knees on the floor leaning on my bed and just breathing and really trying to relax and listening to my Hypnobirthing tracks. The plan was my mum was going to come over and watch Nate if I went into labor at nighttime. I think it was around 10:00 and I think someone said from one of the podcasts as well to gauge the distance you need to go with how well you are managing and how well the drive is going to take if you're going to be okay. I called my mum to come. I was like, “I feel like I'm not struggling but it is ramping up a little bit.” I was like, “I don't know how much longer I can be at home and sitting in the car for a half hour to go.” She arrived. We called the midwives and we let them know we were going into hospital. My mum came and you could just see she was like, “Oh gosh.” She had me naturally. She had three naturals and then her fourth was a Cesarean. She couldn't understand why I wasn't trying for a Cesarean because I already had one and why would I not just have another one?Meagan: Why would you not just do that, yeah? Lauren: She came and I remember walking out of my room to the front and I had to stop a few times on the way and stand in the garage and just take a few breaths between each contraction. I went to go sit in the car. In my head, I thought I was going to be on my knees leaning over the chair. I just couldn't even fit down in that area so I was up against the back of the chair. Obviously, it was not comfortable but I was just thinking if anybody was driving on the freeway and looking, it would have been such a funny sight. I still had my podcast in and I was really focusing on breathing. Josh was just driving. He had never been to any of the appointments with me because of COVID. He hadn't been to the hospital so we were almost there and his navigation was doing funny things. I had to in the middle of labor try to direct him on how to get to the hospital. We pulled up and I just automatically went to where I would park for all of my appointments which wasn't in the front of the hospital. I went to get out of the car and I was like, “I can't walk to the front of the hospital,” so I had to get back in. We drove right to the front and then we went in and we had to get assessed for the COVID triage which was a real pain. We had to wait and do that before we could walk in and get triaged. I think we arrived at the hospital around 11:00. We got admitted at 11:00 at night and then we were triaged maybe at 11:30. By that stage, my contractions were every 3 minutes and lasting about 40-50 seconds. I had a vaginal exam and I was 4 centimeters. I remember just being so excited because I was already progressing. I was hoping I would be further along, but I was like, “4 centimeters is good.” I was 90% effaced and I was thin and soft so I was like, “Oh, that's good.” I think by midnight we had gone to the labor and delivery suite. They dimmed the lights per my request. I asked to go in the shower because I really wanted to be in the shower. They told me I had to wait until my midwife had come because she wasn't at the hospital. Meagan: They checked you and got everything assessed. Lauren: Yeah, so I had to wait. That was fine. I was at the stage. I was leaning on the bed swaying. Josh was doing a bit of acupressure on my back and I was really enjoying it at that time. My midwife got there at about 1:00. I was still coping well through it. By 1:30, I don't think it was my midwife. I think it was one of the hospital midwives who came in and assessed me again. I was at 6 centimeters and I was -2. There were a little bit of complicated decels on the CTG and momentarily in my head, I was like, Oh no, not again. It evened out and it was okay so I think it just must have been a bad reading because of the bulky monitors that they had to put on. They didn't have the mobile ones. It was the bands that you had to be attached to and monitoring. They suggested to artificially break my waters and I hadn't felt too much about that in my prep. I think I was just focused on going into labor naturally as opposed to actually being in labor. They asked to break my waters. I had gas for that and I remember getting on the bed to do that which I think was one of my first bad things because then I never got off the bed once I got on there to do that. I couldn't manage to get back off. I wish I would have known or asked to be helped to get taken off but I was just not in the position to get off the bed. I was stuck there. Yeah. I didn't remember this but when I read in my notes, they offered me a Cesarean at that point and I was like, “No. I'm trying for a VBAC,” so they said, “That's okay.” We tried repositioning some fluids and then the CTG was back to where they were happy with it. Then at about a half hour later, I was on my side. I felt a bit of pressure and my sound changed a little bit. I remember my midwife saying to me, “Oh Lauren, that sounded a bit pushy.” It felt a bit pushy so I was like, “Oh, that was really exciting.” That was at 2:00 and at 2:30 in the morning, they assessed me and I was fully dilated. I was so excited. They were seeing some complicated decels on the monitor. I think they said– do you know what the normal heart rate is? I've written them all down but they were saying it was 140 without a contraction and then they'd ask the registrar to come in the room so the registrar came in to see what the CTG was doing for progress and pushing. I had a bit of a funny moment. When I was doing the pushing, I was on gas. I must have taken a big inhale of the gas and my vision went dark. I couldn't see anything. I remember getting a bit scared at that point. I didn't know what was happening. I could hear everything and I could feel everything but I just couldn't see. I think it was just from inhaling the gas and the contraction and something. Meagan: It was just too much all at once. Lauren: Yeah. It was really scary but it was a one-off and it was fine after that. Then I think at 2:40, the ped was paged to come in and attend delivery so I think at this stage they still thought things were happening and we were going to have a baby vaginally. 5 minutes later, they gave me an in-dwelling catheter to drain my bladder in case that was creating a blockage for the baby to come down. Meagan: Which is actually something that does happen. Lauren: Yeah. Meagan: If baby is not coming down, sometimes it's urine blocking. Lauren: Yeah. They said, “Only 50mL came out so it wasn't a lot,” but I was like, well that was good. At least they tried that. They said the registrar did an IV and said that it was ROP so right occiput posterior so not in a great position and at my spine. They said there was some descent with pushing but not enough. I think that's when they decided to call to be transferred to theater. The plan was to have a spinal and try for some instrumental assistance to get the baby out. I think at that point, it was quite quick. It was quite intense and I was relieved. I didn't think I had it in me to push anymore so I agreed to go up to theater and have forceps or manual rotation to help assist the baby out. We got up to theater and I think they called them at 2:40. We got to theater at 3:20 so it wasn't that long of a wait but it felt like an eternity when my body was contracting and pushing and they were telling me not to push and just to pant through the contractions. I just remember it felt like a really long time. I will never forget that we got to theater. I had to sit up on the edge of the bed and the person trying to put my spinal in asked me to scoot up the bed. I was sitting there mid-contraction and I just remember looking at my midwife and I was like, “You'll just have to wait until after this contraction and then I can just move up for the spinal.” I got the spinal and they discussed the options of an episiotomy and using forceps to aid the baby. At that stage, I said, “Yep, whatever we need to do,” I would really like to try to get him out. They tried a manual rotation while pushing and his heart rate dropped to 93. They assessed the position and then maybe decided to do the forceps. They must have said that then changed to apply a vacuum because then they did a vacuum and they went to do the first pull and his heart rate dropped to 67. They did another pull and his heart was up at 133. Then a couple of minutes later, they decided to do forceps. They attempted to do the forceps. They applied them and his heart rate dropped to 86 then they reapplied to get a better position around his head and his heart rate again dropped to 75. The baby, even though he had changed position and was now facing– I think his head was facing my back which was OA and he was at a -1 station, they obviously thought he was just not in a great enough position to aid him out so they decided to convert to a Cesarean. I remember at that point, I didn't feel like it was a failure or I hadn't done it because they had given me every opportunity to try and I still got to experience so much more than I had with my first birth. Even though I still didn't end up with a vaginal birth, I got 95% of the way and I was still so happy and proud of my body for getting to that point. I was just like, if they couldn't even get him out with forceps, there was no way I was going to be able to do it. I was quite happy and content with the decision. They did say he had been down there quite a bit so he might come out not great. Because he was so far down, they did have to– and they did write the word “extract” him which I thought was quite an interesting term to use but the extraction was breech because he was so far low. He came out. His APGARs were 8/9. He was 7.4 pounds and a similar size in length to my first. I think we were there maybe for an hour or two in recovery. He fed straightaway and then we returned to the ward. On my notes, it said, “Repeat C-section due to failed TOLAC.” I was just like, I had that word “failed” but I understand that's the terminology they used. It says that about an hour later, we had a debrief. They came back into the room and went through all of the happenings and made sure I was okay with it all. They actually discussed any future deliveries and the recommendation for an elective Cesarean. I don't even remember that conversation. Meagan: Oh really? Lauren: Yeah. I don't even remember so when I went back through my notes, I was like, “Oh, that's interesting.” Then in the notes, it also says, “CPD?” I can't pronounce that word either. Cephalic Pelvic Dysproportion. They said that and then they also said there was a small extension to the upper midline of my Cesarean incision. I had my normal scar and then it obviously had come farther up and it said it was sutured separately on the uterus. I'm reading it in real-time now but I didn't realize that until my recent birth when I went back through my notes with my midwife. I was like, Well, that's really interesting. They obviously told me but I must have not registered that at the time. Then obviously we were in hospital due to COVID so Josh wasn't allowed to stay with us. An hour after his birth, he had to leave and being a Cesarean, I was in hospital for a few days and my other son, Nate, wasn't able to come in to visit us. I really missed out on us being a family of four for those first few days. Yeah. We got home. I think I was in there for two nights then we got discharged. They met us at the hospital and that drive home was really special. That was the first time they met was in the car driving home. We always knew we wanted a third but it was a lot, the transition to two, and we probably weren't ready straightaway. We gave it three years then when Call was two, we decided we would try again for baby number three. We fell pregnant really quickly with the first two so we just assumed that would happen this time and we were trying for a few months and it just didn't really happen. We were trying for 6 months and gave ourselves a bit of a breather and just let it take its natural course because we took the pressure off and then the both of us were saying before the boys were born a week apart in May and we found out we were pregnant with our third in between the middle of their birthdays. It was really special. May has always been a special month but yes, we had Nate's birthday. I found out we were pregnant then a few days later we had Call's birthday. So it was really special timing. I knew I wanted to try again. It would be our last baby. If I was going to have a natural birth, it would be this pregnancy. I went to go through the same model of care that I was with Call, but they had changed their practice. The midwife group that I went to no longer existed. It was the MGP so Midwifery Group Practice. They were based in the hospital this time so all of my appointments were in the hospital and they were VBAC-supportive. I think we went in and then you still have to have your OB appointments around 36 weeks and we didn't find out our gender with this one. We had the two boys and for our third, we weren't going to find out what we were having. I had the same sort of morning sickness with my third. I was a lot sicker this time. I knew this time I was going to have a student-midwife and a doula. I got a visit. Obviously, The VBAC Community group on Facebook, I posted in there and I also posted in a Western Australia VBAC support group there about recommendations for student-midwives and doulas. Then I spoke to a few of them and then obviously whoever I felt that connection with, I went with them. The doula– I did research doulas with Call, but I don't know why I didn't do it that time. I think that would have made a difference. I was like, this is the time I'm going to do it and I'm going to have a doula. We did that. I did a bit of a refresher for the Hypnobirthing as well. I met my doula at about 25 weeks and we sat. We met at a park and we just chatted for hours. She had a VBAC as well herself. Meagan: Oh, that's awesome. Lauren: Her second was a home birth and a surprise as well. She had a boy and then she had a surprise for her girl. So much was similar with our situations. I just felt like she was meant to be our doula. Yeah. So that was at 25 weeks and I think at 6 months, we had a suggestion of a fetal growth scan again which was the same and I was like, they were already preempting that but I was more prepared even if I went to that scan and it was a big baby that I would be okay with that. Then at 28 weeks, I did the normal blood test and the fasting for gestational diabetes. I didn't have it with the two boys and I had it this time around. That was a bit of a surprise. I didn't really know much about gestational diabetes. You have to do your three blood sugars after your fasting and the third one had to be under 8.5 and I was 8.5 so I was just on the cusp. I remember my midwife saying to me, “Who knows? If you had waited another 15 minutes before your blood test, you probably would have been fine.” Meagan: Yeah, it could have been lower. Lauren: I started snowballing with all of the things. I thought it was going to mean I was going to be induced for bigger babies and I didn't want to be induced. I had gone to 40 weeks with the boys so I didn't assume I would be having an early labor so I started really worrying about my chances of having a VBAC at that point. I did a lot of research and listened to podcasts with people who had gestational diabetes. I tried to get in a good headspace again. I just took it as a positive to eat healthier and watch what my weight gain and things like that this pregnancy. I had to check my blood sugar four times a day– after fasting in the morning first thing when you wake up, and then every two hours after a meal. I was able to manage it with just my diet which was really good so I didn't have to have insulin. Meagan: Insulin, yeah. That's awesome. Lauren: That was really good and then the diabetes, they were checking with me and I could change to testing every alternate day. Thankfully, I was able to manage it from that side but it just meant there was increased monitoring of the growth of the baby and my weight and things like that.I also had low iron which I never had with my first two pregnancies but this pregnancy was just a real curveball from the start. Yeah. So then at 29 weeks, I went in for my next appointment. I checked diabetes and everything was still fine. My youngest tested positive for COVID so that was a little bit of an interesting one. None of us got it which was really lucky so I didn't know how that would go being pregnant and getting COVID. I had noticed I started to lose a bit of my mucus plug which I've never experienced before and it was quite early but my midwife said, “That's fine. It doesn't mean anything. It can happen. It builds back up again.” But that was a bit different and exciting. Then I think at about 32 weeks was my appointment with my midwife and that was when we went through all of my previous births just as a debrief. Meagan: Op reports.Lauren: Yeah. That was a bit of an eye-opener because I think those things that we highlighted in Call's birth weren't really brought to my attention until this one. You could see as my midwife was reading it that she wasn't really aware of that either in the notes. It just said there was a sign of obstruction, a loss of station between the manual and the vacuum rotation, an inability to place the forceps, and an understanding of why the labor was abandoned and the vaginal birth. Then it says that a VBAC was not recommended. The midwives would still support me if I wanted to try for a VBAC after two and if I wanted an elective that they would support with that. I remember leaving feeling so disheartened. I was only 4 weeks away from my due date. I came home and I remember Josh and I talking it over and I was like, “Is it worth going through all of that over again just to get to that point of pushing and not being able to fit through my pelvis and being through a scary C-section again?” We went through all of our options and Josh was happy to support what I wanted but I was so torn. I didn't know but I kept coming back to a VBAC. I just didn't feel content with a Cesarean. I just said, “I'll never know if I don't try.” I spoke to my doula and I said that I was just frazzled. My head was all over the place. I had a good chat with her over the phone that stuck with me. She said, “Different baby, different birth.” Meagan: Absolutely. Lauren: I just kept saying that to myself. I think I listened to one of The VBAC Link podcasts and they said the same thing. It just was the right information that I needed to listen to at the time and the whole CPD with the pelvis. She said, “You don't even have an official diagnosis.” She said, “That's just somebody's opinion as to why they are saying that the baby didn't descend. He just wasn't in a great position.” She highlighted that they broke my waters at 6 centimeters before he even descended which maybe led to him being even more stuck. All of these things, and then I remember just trying to focus on positive VBAC stories and get my head in the right space so I was listening to lots of podcasts at this point and I was following a lot of Instagram pages about pelvic mobility. I didn't really do a lot of research about that with my first or my second pregnancies about your pelvic inlet, your pelvic outlet, internal and external rotation. This was all news to me and I really, really enjoyed that. It made sense that the pelvis is not rigid. It can move and I just kept visualizing that when I was trying to be positive toward this labor. I was doing a lot of exercises for only a couple of minutes at night before bed. I was doing a lot of window wipers where you lay back and rotate your knees from side to side, deep squats in the shower, I was doing a lot of lunges and just creating a lot of space and room that I felt like I could in my pelvis. I did a lot of visualization. I remember I just kept putting my hands between my legs and imagining feeling my baby's head. I don't know why I did that and it probably might seem a bit strange but I just really felt that and I was imagining going through labor and having that moment. Yeah. Meagan: It doesn't. Lauren: That was really quite powerful at that point to get back on the right track for having a VBAC. There were two other podcasts I was listening to which are Australian-based– The Great Birth Rebellion and that's really, really good, and The Midwife's Cauldron. They just question a lot of things that are expected or standard and not to question. I thought that was really good. One of the ladies who does The Midwife's Cauldron has a book called Reclaiming Childbirth as a Rite of Passage. I didn't get all the way through it but it was another thing like finding your podcast. It just really resonated with me and everything I read, I felt was meant for me. It was really, really powerful. The two Instagram pages that I followed were The Body Ready Method and they have little reels of exercises and things to do to get your body ready. Then I got to 35 weeks. We went through my last appointment and I was happy to go through with the VBAC and that they would support me. They advised of the standard guidelines of having an IV, CTG monitoring, and regular vaginal examinations. At 36 weeks, I had my OB appointment and I had my growth scan. The baby was in the 90th percentile. I thought I was going to have to say, “I know they can be inaccurate.” But the OB wasn't worried about that at all and he said, “Yep. Baby's size is fine.” He discussed the pros and cons. He pulled out graphs and figures and I was like, oh gosh. Here we go. He's going to tell me all of these problems. He was so pro-VBAC and supportive. He was from the UK and he said, “I came to Australia and I didn't realize what the problem with VBAC is.” They are so supportive in the UK with VBAC and the hospital I was going to has a 60% VBAC success rate which I was like, well that's pretty positive. I did my GBS screening and then he rebooked me in for 39 weeks. I'll never forget he said to me, “I'll see you at 39 weeks if you are still pregnant.” In my head, I was like, Of course, I'm still going to be pregnant because I went to 40 weeks with the boys so we will see you at 39 weeks and reassess.You don't have a set obstetrician either so you get whichever one is there. I was really hoping he would be at my next appointment and when I went into labor. At 37 weeks, we went on a little holiday down south. It was a big drive. We came back. I was having regular chiropractic appointments I should say. I had my chiro appointment when I got back. I had been sitting in the car and she mentioned that the baby was sitting asynclitic which is the head tilted. I thought, Oh no. I was so focused on getting the baby in a good position. She said, “It's probably because you were sitting for such a long time. It's no concern.” She realigned me and then gave me some pelvic tilt exercises to get into the right spot. Then on the 14th of January which was around 37, just before 38 weeks, we had a meet-up with my doula again just pre-birth to run through everything. She got to meet Josh and we left feeling really positive and excited and happy with everything. She was on call. I got to 38 weeks. I had an appointment on Thursday with my chiro and then on Friday, I was working from home. I still had another week. I was sitting on the exercise ball pretty much all day doing lots of circles and pelvic tilts. I had maybe one or two twinges and I was like, Oh, that's interesting. Nothing eventuated from that. Nothing through the night so I didn't really read too much into it. The next morning which was the 20th of January which was 38+2, Josh had to go down south for work which was a 3-hour drive away. A lot of people were like, “Oh, that's a bit dangerous.” I said, “Oh no, I'd rather he go now and be back for my due date.” I said that. I said, “I'd rather have you go now and be around for 40 weeks.” He headed off first thing Saturday morning. He did the drive. He did a full day's worth of work. It just was a normal day. At 4:30 in the afternoon, I got two boys in the car. We went to the shops. I had to do a bit of shopping for a birthday the next day. Then at 5:00, I do Click and Collect. I don't know if you have that but you do your grocery shopping. You pull up. They just put it in your boots and then you drive home. Meagan: Yes. We do have that. Grocery pickup is what we call it. Lauren: They came out from COVID and I just haven't stopped doing that. It's so handy with children. That was at 5:00. We did that. We got home. At about 7:00, I'm getting the boys ready for bed. They were in the bath. I was just tidying up a few things. I squatted down to pick a few things up and I had a bit of a leak. I was like, I just felt like I wet myself a little bit, but not a gush. Not anything. I had a pad on so it was just a little bit of water. I called Josh. I said, “I don't know if this is anything, but maybe just have an early night. If things do start to happen, you might have to drive home early in the morning to get back.” This was at 7:00 then at about a quarter past 7:00, I sent a photo to my friends because they were out. I was just at home. I bought a special birthing robe. I just for some reason put it on that night. I was sitting on the couch in my birthing robe. I took a photo and sent it to them completely oblivious of what was about to unfold. I got the boys in their pajamas and brushed their teeth. We were getting ready for bed and it was about just before 8:00 and I had a little bit of a cramp so I was like, Oh. It was really weird because with my previous birth, I didn't notice the contractions or take note of them for a long time. But at 7:55 was my first contraction and then 10 past 8:00 was my next one. I was like, Oh. That's weird. It was 15 minutes later. The next one came 5 minutes later. I was like, That's weird. The next one was 4 minutes. I was like, That's weird. I stopped writing them down. I was like, Obviously, I'm not writing them down properly. I must be doing something wrong because that just can't be right. During that, I must have gone to the toilet and there was a slight tinge of red in the bowl. I remember taking a photo of it being like, I'll just keep it. Meagan: Like some bloody show?Lauren: Yeah, but not a lot. Really faint in the water. I took a photo because I wasn't even sure if it was there. Then at about 8:20, I called Josh again and said, “Maybe start heading back because things might be happening. The contractions don't seem like they are slowing down but we will just see what happens in the next few hours but it's 3 hours so maybe start heading back.” I called my mum at that point as well. She was an hour up north. She never goes up there but she had just gone for a day trip so she was away as well. At that point, the boys were still awake and I couldn't get them. I wasn't capable of getting them into bed and doing all of that. I said, “Just pop on the couch,” and they were watching Bluey which is a TV show they love. They were watching that and I just hopped in the shower. It must have been 8:30 at that time and I called Megan, my doula. The plan was I was going to labor at home as long as possible and she was just going to meet us at the hospital. I called her and I just said, “Josh isn't here. My mum's not here. I'm alone with my boys. I'm going to try and put them to bed and focus and get into my breathing techniques and then I'll check in and touch base with how I'm going.”That was about 8:30 then 10-15 minutes after that, I jumped in the shower and things started to ramp up quite a bit. I was really upset because I was in the shower thinking that would be my mode of pain relief and it just was not. Meagan: Uh-huh or slow it down. Lauren: Yeah, I've heard that as well. If you hop in the shower, it will slow down if it's not the real thing. It did nothing and I was like, Oh no. This is not good. I remember thinking to myself, I just need to press pause. I just need to stop this because it can't be happening right now because I'm literally on my own. This is not how it was supposed to happen. I was in the shower and then I had a little bit of a bloody show in the shower and then at that point, I called my doula again. I was like, “I think you need to come over. I just need a little bit of support just to watch the boys.” In my head, I was still thinking I had hours to go. In my head, I was like, If you could just watch the boys until Josh gets here, then you can head home and we can give you a call when we head into hospital. At that point, I got out of the shower because it wasn't doing anything. The contractions started to feel different. It felt like I was having to bear down a little bit. I was like, Okay. But I still feel like I was oblivious because I just– it was so quick. In my head, it wasn't happening that fast. I remember thinking, When I get to the hospital, I'm not going to be able to do this all night. I'm going to get the epidural because it's too much. I got out of the shower and Megan had given me a TENS machine. I was like, that is in the bedroom. I'll get the TENS machine. I couldn't even make it to my bedroom to get my TENS machine. I was like, oh goodness. I put a nappy on and then I went and I sat down. I think I must have made it to the toilet so then I sat back on the toilet and that was a really comfortable, familiar place that I was sitting and I was sitting down there. That was really nice for the contractions to break through. My boys wouldn't have known what was going on. They kept coming in and checking and asking if I was okay. I said, “Yeah, mummy is fine. I think the baby is coming.” They knew something was going on because I was making some noises. My eldest was a little bit scared but he was okay and then I was sitting on the toilet and I remember I had locked the whole house up. We've got a side gate security door and a front door. I thought, Oh my god. When Megan arrives, she's not going to be able to get in. Nate found the keys for me and he gave them to me. He was so happy with himself that he gave me the keys and I managed through contractions to walk. It was probably 5 minutes to the front door and I only had a nappy on at this point. I was completely naked because I just got out of the shower and had a nappy on. I unlocked both doors. I was in a little side area and I thought, Goodness if anyone walks past and hears me and sees me– thankfully, it was late and nobody saw it but I don't know how I managed to do that. I got back in and I was on the toilet. I think that was around maybe 8:50 at that point when I had moved to the toilet. The light was off in the toilet and the hospital bag I had packed had lots of candles and LED lights to have to set the mood. In the boys' bathroom, I have one candle on which is just for their nightlight if they need to go to the toilet. That was the little nightlight that I had on in the toilet. That was actually quite nice to have a dark room with a little candle on. At this point, I'm sorry. I unlocked the door at about 9:00 and then it was 9:23 that my doula arrived. She came in and my eldest son, Nate, ran into the door and he was just so excited that somebody was there to help mum. He's like, “Mum's there. She's in the toilet.” I remember Megan coming in and she was so calm and she was so relaxed. She looked at me and she said, “Lauren, are you pushing?” I remember looking at her and I was like, “I think I'm pushing.” She just said, “Okay. I'm just going to call the ambulance.” She was on the phone and she was calling. I think in my head at this point, I still hadn't registered it was that sudden. I still just thought I was– Meagan: And this has been maybe 2 hours. Lauren: Yeah. 2 hours. You can push for hours so in my head, I was like, We've still got hours. We're fine. It was intense, but I was just so excited. Things were happening and it was all going. Then I don't know how we got to it but we called my neighbor to come over because my doula was trying to support me but then the boys were there. She said, “I just need somebody else to watch the boys.” My beautiful neighbor came over. We are friendly but not in the middle of birth naked friendly. She comes and the toilet is off the hallway so I remember her walking in and she's like, “Hi.” I was like, “Sorry, Adrienne.” I was pushing and she was walking off the hallway to sit with the boys on the couch. I was about to have a baby. It was so crazy. Yes. I think that was just about 9:30. Megan gave me some water and she was rubbing my back. She put a cold towel on my back and I was still sitting on the toilet at this point and my legs were quite shaky. I just felt a bit sweaty then I instinctively just got up to move to sit on my knees in the toilet and that toilet's not very big. You can put your arms up and hold the walls. I was on there on my knees. I had one leg up and I was rocking, circling my hips. I was doing all of the things and just instinctively. I didn't really notice that I was doing them. Then I think she had towels and she had pillows. She was still on the phone to the ambulance that were coming. I'll never forget. The guy on the phone was just like, “Put her on her back. She needs to be. Can you get her on her back? You need to be able to see.” They were asking her to tell them when I was having contractions. I remember we were looking and each other and I'm like, “He can hear when I'm having a contraction. I'm starting to make the noises.” Megan would just be like, “Now.” He could tell when I was having contractions. Obviously, he had a script to read off but it was so obvious when I was contracting and when I wasn't. The head wasn't there but I could feel bulging. I remember putting my hand down there and I was just so excited and happy. I was just so calm. I don't know how because none of it was planned. It was happening so quickly. I guess there was no time to really process it or even think about it or get scared about it. It was just happening. There were two paramedics that arrived. This was just before 10:00 at this point. I was there. I could feel bulging. There was still no head or anything yet. They came in and they turned the lights on in the toilet and I was like, “Oh no.” It was too bright. They turned it off. They looked at me and said, “Lauren, are you okay? Do you need anything?” I don't even know if I could speak. I just shook my head. In hindsight, we couldn't have gone. It was too late. We couldn't have gone anywhere anyway but they just stood back. They turned the light off and they literally just watched which was so special. They didn't interfere. They didn't try to take over. They just sort of let me go and I don't know how it happened but the doula gave the paramedics my phone and they recorded the birth. Meagan: Oh that's awesome. Lauren: Yeah, which was not planned. I guess it was so special because Josh was still an hour away. Meagan: Yeah, and your mom? Lauren: My mum wasn't there so at least they could see it. I'm so glad that they thought to do that and to record it. They were recording it and I was getting close. I remember in the video, you can hear me say, “I can't do this anymore.” Obviously, I was very, very close and I put my hand down. I was just saying, “Ow, ow, ow, ow,” because I could feel the stretch. I know people call it the ring of fire but I tried not to think of it like that. I tried to just visualize the stretching of everything. Then I could feel the baby's head and then I just remember sobbing because I was so happy. I could feel and I was saying, “Ow, ow, ow, ow,” and then her head– I didn't know it was her at the time, but her head sort of popped out through my contraction. You could just see my relief. I was so happy and she cried. Her head was out and she made two little cries. Meagan: She did? Lauren: I've never heard of that happening before. Meagan: I have never seen that ever.Lauren: Yeah, it was incredible. Even the doula was like, “What in the world?” I knew she was fine at that stage. I heard the little cries then it was maybe a minute before the next contraction then I was like, “She's coming out.” The doula had her hand under. She guided her head to me and then her shoulders and I just pulled her up to me. It was just– yeah. The look on my face. I just could not believe it. I had done it. I think I just kept saying, “Oh my god. Oh my god.” I just held her. I keep saying her but I held the baby. I just could not believe that she had come out just so quickly and so easily. I was so worried in the lead-up that the baby would get stuck or I wouldn't be able to get the baby out and none of that was even in my mind at that point. She just was there. I was holding her and it was the most incredible, special moment. Even now, even when I hold the top of her head, I always remember feeling her head coming out. Yeah. I don't even know if I'm doing it justice because it was just the most incredible feeling. I was holding her. Our neighbor brought the boys down so within the first minute, she's walking down the hallway and she had Nate and Call and they were both in the doorway of the toilet looking at me holding their little baby. My youngest sort of looked in and was like, “No.” He just walked away. It was all a bit much for him. Then my eldest walked straight in. Stuff was everywhere and he was so brave. He walked straight in and was like, “Mummy had the baby. The baby is here.” I said to him, “We don't know what it is. Do you want to have a look and see if it's a boy or a girl?” He looked down and I said, “Is there a vagina or a willy?” He looked down and the whole time he said he thought she was going to be a girl. He goes, “I think it's a girl.” He looked down and I don't know what he saw, but he said it was a boy. I was like, “Is it another boy?” He must have seen something that he thought looked like a willy. Meagan: Maybe an umbilical cord or something. Lauren: Yeah, maybe the cord or swelling but they get quite swollen so he might have thought it looked like little testes so he said, “It's a boy,” and Megan whispered something in his ear and in that split second, I was just like, Oh my gosh. It's not a boy. I'm like, “Is it a girl?” I just couldn't believe it. The fact that she was such a surprise, her birth, and the way she came, and then that she was a girl as well and then we were just sitting there in the toilet for so long and then we were like, “Oh, we'd better call Josh.” Megan was like, “I'll call Josh.” She said, “You need to pull over Josh. Can you pull over?” He was on the highway doing 110 to get back to us. He was like, “Okay.” So we FaceTimed him and I'm just sitting on the floor holding Wren on the toilet saying, “She's here. We had the baby.” He was so happy. He was still an hour away. My mum– I think we just sat in the toilet. My mum arrived 20 minutes after she was born. She just came and sat on the floor of the toilet with me. We just sat in there. She couldn't believe it. Then about maybe 40 minutes after, we walked up and I was able to sit in my own bed and I sat in the bed. They were sort of a bit worried about the placenta and things like that. I hadn't birthed the placenta yet. They asked if I wanted to cut the cord. I said that I wanted to leave it as long as possible until it goes white. We were hoping for Josh to come at that point so then I was sitting down. I stood up for a little bit and I remember my mum was in the bed with me and my doula was there. I said, “Oh, I'm so sorry. I think I need to do a number two.” Then she was like, “No, I think that's your placenta.” Meagan: Probably your placenta sitting in there. Lauren: The placenta came straight out and she caught it in one of my mixing bowls because we didn't have anything prepared. She stayed attached to that for a while. Because they had gestational diabetes, they had to do a heel prick on Wren. Her sugars were fine. Josh was still about an hour away. We didn't even have a capsule for the car so I hadn't picked up the capsule so we got transferred because she came so early. We got transferred to the hospital in the amublance and Josh met us there at 10:30. I should say she was born at 10:09 which was just pretty much 2 hours. Meagan: So 7:40-something to 10:09. Lauren: I remember the midwives when we got to the hospital were like, “Why didn't you know?” I was like, “I just had no idea that it was happening that suddenly.” Now looking back, obviously, the signs were all there but it wasn't happening that quickly in my head. We got to the hospital and Josh got to meet us at the entrance and it was so special. I just still could not believe that it had happened and I was on this high. I was just so incredibly happy. We went in and they just didn't know what to do with us. They didn't know to put us in labor and delivery or to take us to the maternity ward. We went to labor and delivery. They did all of the assessments. She was my biggest baby. She was 7.8 pounds so 3.5 kilos compared to the boys so it's quite funny that Call wasn't able to come out but she was able to come out. I think it was just positioning and I was relaxed. I was at home. I didn't have any interventions or anything played a huge part in it. They did an assessment. I think her APGARs were in the hospital but she was 10 and 10. She was perfect. They did assess me for a tear and I remember saying, “Oh, I don't think I teared,” because in my head if I had torn, I thought it would have been a painful feeling. I actually had a 2nd-degree tear which I didn't realize so I had to have some local anesthetic which was probably the most painful part of it all. It was excruciating. I had to have stitches for that and then just a superficial tear at the top. Josh actually went home at that point because we still had a few hours before we could get discharged. He drove 3 hours in the morning, worked the whole day, drove 3 hours, hadn't slept for 24 hours. I said, “You go to your parents. Have a quick sleep.” He came back. They did a few checks on Wren. She had to go to the special care nursery just for some monitoring really quickly because there was a difference on some of her monitoring with her heart rate. They did an echo which came back fine so there was no follow-up. It must have been a funny reading. They were all fine so I think we got discharged at about 9:00 the next morning. She was born at 10:00 at night. We went to the hospital at midnight. We left there at 9:00 in the morning and were back home literally within a few hours with the boys. It was just so surreal and so special compared to the other two birth experiences that I had. One, to be able to get up and walk around and just do things without being conscious of a scar and recovery and things like that and even when I walked in home– because my mum had stayed at home with the two boys, she said, “You don't even look like you just had a baby.” I just felt like I was on top of the world. It was such a different experience. I remember saying to her that obviously I didn't know what it was going to be like but now that I've experienced it, I can't imagine going through life never having experienced that and having birth that way. It was just so– I remember a few of the midwives looked at me as if I had planned to have a home birth and I was like, “Absolutely not. There was no way I would have planned it like that with no support, with nobody here.” Meagan: Yeah. You're like, I would not have planned to do that. Lauren: My boys didn't know anything about natural birth. I was going to the hospital to have a baby and coming back with their baby brother or sister. There was no way that I was– that was a bit funny. I was like, no. It was not planned. It was all very sudden. I remember my doula said to me in the coming days after Wren was born, “How special for Wren to have been born that way and then also for you

Are you pregnant, planning to get pregnant or have you been diagnosed with gestational diabetes? Then you need to give our latest podcast episode, featuring special guest Lily Nichols - a Registered Dietitian/Nutritionist, Certified Diabetes Educator and Author of "Real Food For Pregnancy" and "Real Food For Gestational Diabetes".We had Lily on the podcast a couple of weeks ago, talking to us about Vitamin A and the benefits it provides so give that episode a listen if you'd like to know more. Today, we are so excited to have Lily back, to chat about the really important topic of gestational diabetes! Lily, has done a lot of work with patients with gestational diabetes and has found that the standard dietary guidelines made things worse for them.In this episode, we learn about the various meal plans advised for pregnant women with gestational diabetes and why they aren't actually helpful for them, how to manage blood glucose through food, and how to get good nutrient levels. Lily also shares a little insight into her, "Real Food For Gestational Diabetes", discussing ketosis during pregnancy, and so much more.Join us as we explore the ins and outs of gestational diabetes. Trust me, It's packed with amazing content that you won't want to miss. Something  we cover in this episode:Gestational Diabetes.Dietary guidelines for gestational diabetes. Lily's book: Real Food for Pregnancy.Ways to manage your blood glucose through food.Pre diabetes for women with PCOS.20-50% of people with PCOS test positive for gestational diabetes.Removing highly processed foods.Ketosis during pregnancy. Working with a clinician who has worked with a wide range of patients.Resources and References:Lily's book: Real Food for Pregnancy InstagramThe PCOS Nutritionist InstagramThe PCOS Nutritionist TiktokMy Book: Getting Pregnant with PCOSLinks to our programs:The PCOS ProtocolThe DIY PCOS Protocol1:1 Consultations

I am so excited to have special guest, Lily Nichols on our latest podcast episode! Lily is an amazing Registered Dietitian/Nutritionist, Certified Diabetes Educator and Author of "Real Food For Pregnancy" and "Real Food For Gestational Diabetes", whose approach to nutrition embraces real food, integrative medicine, and mindful eating. I know, many of you are curious about Vitamin A, and whether it is safe to take during pregnancy, so in this episode, Lily will share her expertise on the topic and provide evidence-based information to help answer your questions.  We will cover what Vitamin A is, the different forms it comes in,  where we get it from and why health professionals have been telling us not to take Vitamin A during pregnancy? Lily will also share the important benefits of Vitamin A and how to introduce it into your diet.  So if you're curious about Vitamin A and its role in pregnancy, you need to give this episode a listen and hear Lily's expert advice on this important topic.Something things we cover in this episode:What is Vitamin A? Different forms of Vitamin AShould I be taking Vitamin A during pregnancy? Does Vitamin A cause birth defects?Research on Congenital Diaphragmatic Hernia (CDH)What do doctors tell us about Vitamin A?Foods that contain Vitamin A How to introduce Vitamin A into your dietThe benefits of Vitamin AResources and References:My Book: Getting Pregnant with PCOSMy free Prenatal supplement guideLily's books: Real Food for Pregnancy Lily's blog post: Liver and organ meat: Nutritional benefits and how to make it palatableCod Liver oil - Amazon (3 daily (300mg DHA daily)Cod Liver oil - iHerb (3 daily (300mg DHA daily)Ovie InstagramThe PCOS Nutritionist InstagramThe PCOS Nutritionist TiktokLinks to our programs:The PCOS Protocol1:1 ConsultationsThe DIY PCOS Protocol

During pregnancy, you're more aware of your health, and what's safe and what's not, and you learn about certain conditions that can occur, like gestational diabetes. According to a 2021 study in JAMA, rates of gestational diabetes have increased 30% in the last decade. While there's no denying that gestational diabetes can lead to complications, you may not be getting the whole story.  In this interview, I sat down with Lily Nichols, a registered dietitian nutritionist (RDN), certified diabetes educator, researcher, and author with a passion for evidence-based prenatal nutrition and exercise. Lily is also the author of two bestselling books, "Real Food for Gestational Diabetes" and "Real Food for Pregnancy." Lily talks about why rates of gestational diabetes are on the rise, how your own mother's health can have an effect on your pregnancy, and which tests you should be asking for. She also talks about why a lot of guidance from providers about a gestational diabetes diet and what to eat during pregnancy may be contributing to the problem and what to do instead. 1:26 Let's talk about your story! 3:34 What is gestational diabetes?  7:00 Is there research that shows how many women who are diagnosed with gestational diabetes have pre-diabetes or type-2 diabetes before becoming pregnant? 9:38 How common is gestational diabetes and what are the causes and risk factors? 11:59 Are there certain risk factors that you think are driving up rates of gestational diabetes? 14:17 How should women talk to their providers about which screening tools are right for them?  18:19 If you're diagnosed with gestational diabetes, what are the risks to you and your baby?  22:35 What is the conventional nutritional approach to treating gestational diabetes? 26:16 What is the gestational diabetes diet you think is best?  28:19 What are the best pregnancy superfoods to focus on to manage blood sugar? 33:38 Is keto safe during pregnancy? 37:25 How should women with gestational diabetes approach exercise? 39:03 Studies show gestational diabetes increases your risk for type-2 diabetes. What should women do after pregnancy to reduce their risk?  LINKS MENTIONED IN THE SHOW Lily mentions that the California Diabetes and Pregnancy Program (CDAPP) Sweet Success recommends using HbA1c as a first trimester screening tool for gestational diabetes. Lily talks about this 2015 study in JAMA which found that between 49% and 52% of the population have either type-2 diabetes or prediabetes. Lily mentions the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study. Lily mentions this 2015 study in the Journal of Nutrition that shows protein requirements in late pregnancy (32-28 weeks) are 73% higher than the current recommendations. Julie mentions that the recommendations for exercise during pregnancy are 150 minutes a week yet research shows women aren't meeting them. Purchase a copy of Lily Nichols' books, "Real Food for Gestational Diabetes" and "Real Food for Pregnancy." Learn more about Lily Nichols' online course, “Real Food For Gestational Diabetes.” Learn more about Lily Nichols on her website, LilyNicholsRDN.com, and follow her on Instagram. FROM OUR PARTNERS Kids Cook Real Food eCourse The Kids Cook Real Food eCourse, created by a mom of 4 and a former elementary school teacher, is designed to build connection, confidence, and creativity in the kitchen. The course includes 30 basic cooking skills, 45 videos including several bonuses, printable supply and grocery shopping lists, and kid-friendly recipes. The course is designed for all kids ages 2 to teen and has three different skill levels. More than 18,000 families have taken the course and The Wall Street Journal named it the #1 cooking class for kids. Sign up now for the Kids Cook Real Food ecourse and get a free lesson for being a “Food Issues” listener. Thrive Market Thrive Market is an online membership-based market that has the highest quality, organic, non-GMO,

The Healthy Balanced Mama Podcast is on summer break! We'll be back with fresh new episodes in August, but in the meantime, enjoy replays of the Top 4 episodes of Season 3!Catch the full Top 10 Episodes of Season 3: https://www.healthymamakris.com/post/season-3-top-10Connect with Kris:Instagram: http://instagram.com/healthymamakrisWebsite: http://www.healthymamakris.com/Join the Facebook Community: http://bit.ly/HBMgroup

SuperFeast is bringing you another epic episode of the Women's Series today as  Tahnee sits down for an insightful conversation with Lily Nichols, registered dietician, nutritionist, accomplished diabetes educator, author, comprehensive researcher, and mother. Her books Real Food for Gestational Diabetes and Real Food for Pregnancy hone in on evidence-based nutrition for prenatal/pregnancy health and are thoroughly researched assets to the field of maternal wellbeing. Her work stands out for the grounded approach it takes and has not only helped tens of thousands of women manage gestational diabetes but has also influenced nutrition policies internationally. For all women and men currently expecting or thinking about having children in the future, you don't want to miss this episode! Tahnee and Lily discuss: Nutritional research; the benefits to be gained when moving away from a reductionist approach to the observation of traditional cultures who are still thriving. Current Dietary guidelines for pregnant women; are they doing more harm than good? A micronutrient-forward approach to nourishing the body when pregnant. Gestational Diabetes and how to manage it through diet. The evolution of prenatal and pregnancy nutrition. Blood sugar levels during pregnancy; the subsequent effects they can have on the hormonal system, weight gain, and postpartum period.   Different variables that can influence nutritional research and intern misinform people. Epigenetics; how our health is determining the genes of the future generation and their risk of disease. Gut and microbiome health. Carb cravings in the first trimester, why we get them, and why mothers can allow themselves some grace. Postpartum thyroid issues, iodine, and other nutrients to support this gland.  All things methylation; methylfolate, folic acid, folinic acid, and looking to the other groups involved in methylation (Vitamin B12, B6, choline, glycine, betaine, riboflavin, copper, and magnesium). Glycine and the crucial role it plays in all aspects of pregnancy. Who is Lily Nichols? Lily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based prenatal nutrition. Drawing from the current scientific literature and the wisdom of traditional cultures, her work is known for being research-focused, thorough, and sensible. Her bestselling book, Real Food For Gestational Diabetes (and online course of the same name), presents a revolutionary, nutrient-dense, lower carb approach for managing gestational diabetes. Her work has not only helped tens of thousands of women manage their gestational diabetes (most without the need for blood sugar-lowering medication) but has also influenced nutrition policies internationally. Her clinical expertise and extensive background in prenatal nutrition have made her a highly sought after consultant and speaker in the field. Her second book, Real Food For Pregnancy, is an evidence-based book that addresses the gap between conventional prenatal nutrition guidelines and what is optimal for mother and baby. With over 930 citations, this is the most comprehensive text on prenatal nutrition to date. Lily is also the creator of the popular blog, lilynicholsrdn.com which, explores a variety of topics related to real food, mindful eating, and pregnancy nutrition.  Resources: Lily's Blog Lily's Instagram Lily's Facebook Lily's Twitter Lily's Pinterest  Women's Health Nutrition Academy (professional training & webinars) Real Food for Gestational Diabetes Real Food for Pregnancy   Q: How Can I Support The SuperFeast Podcast? A: Tell all your friends and family and share online! We’d also love it if you could subscribe and review this podcast on iTunes. Or  check us out on Stitcher, CastBox, iHeart RADIO:)! Plus  we're on Spotify   Check Out The Transcript Here:   Tahnee: (00:00) Hi, everybody, and welcome to the SuperFeast podcast. Today, I'm joined by Lily Nichols, and I'm really excited to have her here. She's a registered dietician and nutritionist as well as a diabetes educator. But more importantly, I think she's a researcher and a mom herself, and she kind of has created these incredible books that talk about evidence-based nutrition, especially prenatal and during pregnancy.   Tahnee: (00:25) So, I'm just so excited to share her work because I think it's something we haven't spoken about much on the podcast, and there's so much information out there. It's really hard to wade through the studies. It's really hard to understand what's going to be right for you as an individual and for your baby especially during pregnancy, so this is really exciting.   Tahnee: (00:46) Lily's blog is excellent. She's got a really amazing blog that we'll link to in the show notes, and her book, Real Food for Gestational Diabetes and Real Food for Pregnancy, both, well, I've only read Real Food for Pregnancy so far, but it's excellent. It's so readable, which is really good. And also, yeah, just a really dense and interesting read on maternal wellbeing.   Tahnee: (01:09) So, she's also been able to get her work into university. She's been influencing policy. There's people doing studies based on her work, so I'm just really stoked to have her here. So, thank you, Lily.   Lily Nichols: (01:21) Thank you for having me.   Tahnee: (01:22) Yeah. We're really, really lucky. I always like to sort of understand how people got to be where they are, and I'm really curious how you ended up being a dietician. I did hear you on another podcast actually saying that you'd sort of been exposed to alternative ideas around nutrition before you studied dietetics, and one of my most traumatising moments as a pregnant mom was opening up on of my old nutrition and dietetics textbooks and reading the recommended diet which was like fortified cereal and low-fat milk and orange juice and crackers. And I was kind of like, "Ugh," and I just shut the book and put it back on the shelf.   Lily Nichols: (02:04) Yeah.   Tahnee: (02:05) But, yeah, I'm curious how you actually kind of came to want to study dietetics and how you've ended up here.   Lily Nichols: (02:10) Sure. You want the long story, so-   Tahnee: (02:13) Go on.   Lily Nichols: (02:14) Yes. I have been interested in nutrition for a long time. I grew up in a fairly health-conscious home and really started to dive into nutrition in my teen years. Unfortunately, probably a little bit misguided because our dietary guidelines are so backwards, but nonetheless, made the connection that how I feel is definitely related to the type and quality of food I eat. So, that was beneficial.   Lily Nichols: (02:47) It was during that time that I sort of mentored with a nutritionist who was not a dietitian, and that was probably all for the better actually, who recommended I read the book Nourishing Traditions by Sally Fallon. She, goes into a lot of the work of Dr. Weston Price, and that was a really important book for me to read because at the time, I was vegetarian and was not feeling very well. And so, to read this book that was really suggesting that animal foods, particularly fatty animal foods, could be an important but also healthful part of the diet was like completely mind blowing to me. And it took me many years to actually fully buy into that way of eating so to speak. It was just so very different from what I thought as healthy at the time.   Lily Nichols: (03:44) But by the time I went to university, I knew I wanted to study nutrition. I did not change my major, obviously, because here I am, and I used that as an opportunity to sort of see what our textbooks were teaching and then see what the research was saying and to sort of see if there was any overlap with what I had read from these other sources. And by that time, I had changed my diet and eating fairly liberal amounts of animal foods. For most people, probably a fairly high fat diet, but that kept me feeling really quite well with very stable energy levels and good mental health and all that. So, I knew it worked for me, but I was like "Does the research support this?"   Lily Nichols: (04:28) And I can't say I can unequivocally sort of prove that every claim that was in Nourishing Traditions is backed by science, but certainly, a lot of it is. And that definitely coloured my view of nutrition early on, and there was quite a bit. I mean, it was just at the time when studies started coming out on Vitamin K2. I had a professor very involved in research on Vitamin D. So, all this work around fat-soluble vitamins was really, really interesting to me.   Lily Nichols: (05:05) And once I actually became a dietitian, did my internship, and all the boring stuff, I ended up working in the prenatal space a little bit by accident, specifically working with gestational diabetes and California State public policy on gestational diabetes but, also, clinical work. And it was really there that all of the ... It's sort of like everything came together.   Lily Nichols: (05:31) I understood from the work of Dr. Price that cultures living isolated from modern, civilised foods as they would call them or foods of modern commerce I believe he refers to them, were far healthier. And when they started incorporating more processed foods, their health declined, including the health in the next generation. So, there was poorer pregnancy outcomes, higher rates of birth defects, and increased incidents of infection and other issues. And understanding the gestational diabetes component was really pivotal to me because I'd learned that children born to mothers with poorly controlled blood sugar can face upwards of a six-fold higher risk of developing Type 2 diabetes or becoming obese by the time they're 13.   Tahnee: (06:21) Mm-hmm (affirmative).   Lily Nichols: (06:22) And that risk, actually, in some studies, is upwards of 19-fold higher risk, and yet we can pretty much negate that risk if we can maintain well-balanced blood sugar levels in pregnancy. And it was like, "Wow." So, this work of Dr. Price actually, there's a lot to this whole idea of epigenetics and how we can ... The quality of our genes or which genes are turned on and off can, in fact, be influenced by a mother's health. Also, father's health. We can't forget him as well. That was really big for me.   Lily Nichols: (07:00) I mean I can keep going, but ultimately a lot of my work led me to be rather critical of the current dietary guidelines because I was not seeing the gestational diabetes guidelines work very well in practise. A lot of clients' blood sugar would either not improve or get worse following the conventional recommendations, and certainly, I, myself thrived on a real food, moderately lower carb diet with adequate amounts of fat and certainly not like the margarine and other just garbage food that they recommended. And so, that led me to develop an alternative approach for managing gestational diabetes and led to my first book, Real Food for Gestational Diabetes.   Lily Nichols: (07:48) And then several years later, after a lot of pestering for a book on prenatal nutrition and having my first child, somehow, I managed in the midst of baby toddlerhood to get Real Food for Pregnancy out into the world. So, here I am.   Tahnee: (08:06) That was very impressive when I read that you were writing it when your child was one, so I think I was-   Lily Nichols: (08:12) I know. I look back. I don't know how I accomplished that.   Tahnee: (08:15) I think you just got through it, but, yeah.   Lily Nichols: (08:17) Yeah.   Tahnee: (08:17) It's definitely, definitely wild.   Lily Nichols: (08:19) Yeah.   Tahnee: (08:20) I mean I guess that's such an interesting ... I mean I didn't end up studying dietetics, but I was going to. So, I have some of the textbooks and things, and I ... It's such a modern food kind of promoting field, and it feels to me like there's so much focus on kind of these specific nutrients or kind of fortified iron and duh, duh, duh, duh, duh, instead of really looking at, "Well, what did humans eat forever until recent industrialisation, and how would traditional cultures.   (08:56) utilised foods? What would they prioritise? What was a traditional pregnancy diet?" I mean all of these things I studied to the end.   Lily Nichols: (09:03) Right.   Tahnee: (09:03) So, you know?   Lily Nichols: (09:03) And, yes.   Tahnee: (09:03) Alchemy.   Lily Nichols: (09:07) I think that's actually where a lot of the magic lives, actually, in the nutrition field is just as the field evolves, moving away from this let's try to isolate the nutrient in this that is responsible for this outcome, now we understand so much more about nutrient synergy and how different nutrients work together.   Tahnee: (09:29) Mm-hmm (affirmative).   Lily Nichols: (09:30) And it's very hard to study that because the more you can just take this reductionist approach of isolating the one variable that's responsible for the one outcome and try to prove causality, right?   Tahnee: (09:42) Mm-hmm (affirmative).   Lily Nichols: (09:42) That's like an easier model for scientific research, but I think there's a lot of value in that observation of what cultures who are thriving and have great fertility and great reproductive outcomes like, "What are they doing, and/or what did they do before they changed their diet and those outcomes started getting worse?"   Tahnee: (10:08) Mm-hmm (affirmative).   Lily Nichols: (10:09) I mean that's why I think the work of Dr. Price is just so very important, but sometimes, it takes a lot of work to sort of unpack what those observations were and try to unpack from-   Tahnee: (10:25) For sure, yeah.   Lily Nichols: (10:26) ... modern nutrition research what are the factors that are so crucial? So, in my stance, I feel like I almost reverse engineer in a way a prenatal diet that is nutrient dense and going to promote optimal pregnancy outcomes by taking all of those little studies and individual variables like, "Okay. Selenium is associated with a lower risk of pre-eclampsia. Okay. Where do we find selenium in food? Oh, look. That happened to be a food that was really prized in some of these cultures."   Tahnee: (11:00) For sure.   Lily Nichols: (11:00) "What else is in that food? Oh, wait. It has that nutrient. Hey. We have these like 10 studies showing that iodine is really good to-"   Tahnee: (11:09) Exactly. Yeah.   Lily Nichols: (11:11) ... fertility and pregnancy and sort of trying to make those connections for people because there is just so much wisdom in those traditional foods. But I think, I mean as a lover of research myself and as somebody who's always been kind of sceptical of when people claim to have-   Tahnee: (11:30) That they-   Lily Nichols: (11:32) It's just people have so many random dietary claims and superfoods and whatever. To really look at it from like a grounded perspective and take a micronutrient-forward approach versus this reductionist, "Well, the guidelines say we need X, Y, Z percentage of carb, fats, and proteins, so let's build a meal plan about around that. And then, just like fortify our way out of the nutrient deficiencies that will result from such a poorly planned diet." You know what I mean? I'm like, "Let's go micronutrient-forward and just see where the macros ended up," right? And I think that's so much more important.   Tahnee: (12:12) Yeah. Well, that's what I really loved about your Real Food for Pregnancy book is that as you chat a little bit about the macronutrients and just give some context for what the current guidelines say. 40 to 60% carbs, and you're going, "Well, we don't really have proof that that's actually valuable. It actually could be detrimental." You've got this information in there about the protein requirements of pregnant women and how it's much higher than probably what we think and fats. Everyone's so afraid of fat, and again, you're looking at all of these vitamins that are required for a healthy brain and a healthy pregnancy and a healthy spinal cord and a healthy bone system to be developed. Well, they're all fat-soluble, so there's this real sort of ease in your just presentation of that information.   Tahnee: (12:59) But then, this focus on, yeah, really looking for kind of the food sources of these things before we go and take a pill or take a supplement. And I think that's always been an approach I've really respected, and it's difficult to kind of find, I think, in prenatal nutrition because it's, yeah, everything you read about like, "Oh, if you're deficient in this, just take a supplement or this and this. Take one of these."   Lily Nichols: (13:21) Yep. [crosstalk 00:13:22]   Tahnee: (13:22) And I mean I can see that being useful sometimes, but not, yeah, not always.   Lily Nichols: (13:25) Yeah. 100% and in addition to that, people are really afraid to challenge the status quo on pregnancy. I've heard many times like, "I don't touch pregnant women or prenatal nutrition with like a 10-foot pole. I'm not going to mess with it." Because if something goes wrong, if your recommendations are bad and actually causing harm like, "Whoa. That's a major problem," and I think that's one of the reasons that I do rely so heavily on research. I mean, I guess some people might consider my stance extreme, but I feel like I take a very moderate approach to this as well where I'm not jumping to really crazy extremes.   Lily Nichols: (14:12) If anything, I think some of our dietary guidelines are a bit extreme in say like the recommendations on carbs. Like upwards of 65% of your diet on carbs? If you do that and then you have the remaining part of your diet, you're what? 35%, if my math is right, coming from fat and protein, given what we know now about the protein requirements being 73% higher than the current estimated average requirement in late pregnancy and what we understand about the importance of specific nutrients, micronutrients found in foods that have a lot of fat and protein like choline, for example.   Lily Nichols: (14:58) If you eat a diet that's 65% carbs, you are pretty much guaranteed to be micronutrient deficient, and you are probably almost guaranteed to be eating a diet deficient in choline as well as like a huge number of other micronutrients. So, if anything, I would argue that some of our dietary guidelines are actually doing more harm than good if you really take to the extreme of the macronutrient proportions.   Tahnee: (15:30) Recommendations, yeah.   Lily Nichols: (15:32) That they are. Yeah, yeah.   Tahnee: (15:33) And I mean, I guess when you're working with women, I'm sure there's a lot of unravelling of our, I guess, cultural kind of assumptions, or you mentioned like eating for two in the book. And I mean, I even have spoken to women who just, yeah, they're like still afraid to really nourish themselves because they have a hang up around eating disorders and those kinds of things. And I mean are there things that you say that you kind of find help women kind of get to the core of what's really ... I mean the epigenetic stuff for me, I guess, is one of the big things where it's like you're influencing not only your child but all the way down the line multiple generations.   Lily Nichols: (16:16) Right.   Tahnee: (16:16) Is there anything you find really convincing for people to kind of focus on this macronutrient approach instead of their mom?   Lily Nichols: (16:23) Yeah. Really convincing. That's always tricky because I think somebody who's done just so much individual but also group client work, what's motivating for somebody is not motivating for somebody else. So, on one hand, I think taking things from a mindful eating perspective and really driving home the point that you can feel well, have a more positive pregnancy experience when you're better nourished, you'll just you'll feel you just feel better, right? You won't have the crazy blood sugar swings that leave you low energy. That impacts your hormonal balance, so maybe you won't be as snippety at your partner.   Lily Nichols: (17:16) Your blood sugar levels definitely can influence your weight gain. Different foods you eat might change your odds of experiencing heartburn or the severity of heartburn.   Tahnee: (17:29) Mm-hmm (affirmative).   Lily Nichols: (17:30) It might lower your odds of certain pregnancy complications, and certain pregnancy complications have this other carryover effect of sure not only affecting baby but also can have profound differences in the way you're treated within the medical system and what options you're provided with for your birth. It can carry all the way over to your postpartum experience as well and how well you heal and how well just, yeah. Your just general wellness and postpartum definitely has can go all the way back to your preconception health.   Lily Nichols: (18:11) So, I think some of those factors can be convincing for people. For some people who have a history of disordered eating, I think the points about the epigenetics and sort of this imprinting on your child's future risk of disease is really crucial. I think there's also a lot of unpacking. I tend to find a lot of people with disordered eating also have just kind of messed up blood sugar balance, usually because they've been convinced to really restrict their fat intake because, "Oh, my gosh. Fat has so many calories," right?   Tahnee: (18:55) Mm-hmm (affirmative).   Lily Nichols: (18:56) And once we kind of unpack and sort of reframe the role of fats and protein and their influence on your blood sugar levels and your hunger and cravings, so many of these things balance themselves out when you just have stabilised your blood sugar levels by not overly restricting your fat and protein intake.   Tahnee: (19:21) Mm-hmm (affirmative).   Lily Nichols: (19:22) Which I think that a lot of women do because of fear around fat or fear around eating meat or fear around eating eggs with the yolks. So, some of these things just fix themselves over time. But, yeah, I really think it depends on the client. What is the most motivating factor to them? Because it's so personal.   Tahnee: (19:51) Yeah, for sure. And I think once ... I mean the feeling good factor, I think is such a big part of it because I mean I was a vegetarian for a long time for about 14 years, and I kind of started eating meat just before I got pregnant because I was unwell and it was sort of only thing that I actually could tolerate. And then, I sort of had this vision of my life always being a vegetarian mom, and then my pregnancy, I remember walking down the street being like, "I would kill someone for chicken drumstick right now." I just wanted to attack anybody who had a chicken drumstick.   Lily Nichols: (20:23) Yep.   Tahnee: (20:25) And it was such a strange ... And obviously, I respect my body more than I respect my ideology, and I kind of ended up eating meat through the later stages of my pregnancy. And it was interesting in your book because talk about towards those last trimesters really needing more protein, and that was something that I had a kind of anecdotal experience of. It's just this huge demand all of a sudden for protein foods.   Lily Nichols: (20:50) Yes.   Tahnee: (20:50) Yeah. But I mean I think it's something that now I eat all these foods that you talk about in the book, and I feel so much more nourished on so many more levels. And I just think that's, yeah, as much as there can be this kind of belief maybe that your diet plan or whatever is working, it's like until you've really felt how good you can feel when you have I mineral rich and kind of high micronutrient rich body, it's a really different experience I think. So, yeah.   Lily Nichols: (21:19) I think you're right, yeah. There's so much to be said for experiencing it first-hand, and, yeah.   Tahnee: (21:28) And so, I mean I'm curious when because one of the things I've always struggled with with nutrition is just how poor ... You touched on this a little bit before with this focus on one particular reductionist kind of thing in order to get a "good study" that can be published in a journal and whatever.   Tahnee: (21:48) But when we're talking about nutrition, we're talking about individuals eating foods from such a variety of different qualities and sources like I could eat meat from an organic grass-fed cow in Byron Bay or I could eat meat from a feedlot. That's two very different propositions.   Tahnee: (22:06) So, how do you kind of troll through the research and find validation? I mean one of the studies I remember that really jumped out for me that you mentioned in the book was the one on feeding rats soybean oil and saying that fat was bad. Well, it's like, well, that's to me just ridiculous because we all know that that's one of the worst types of oil you could possibly eat. So, how do you kind of, yeah, you troll through all of this and find what's a good study?   Lily Nichols: (22:29) Yeah.   Tahnee: (22:30) And, yeah.   Lily Nichols: (22:31) Well, in a way, it's hard because so much research is I feel like the researchers behind it are coming into it with certain biases, certainly if they're funded by a certain industry. That can happen as well. But I actually used to work for a research institute in Los Angeles, and there was a lot of people doing rat studies there. And so, they'd have these lunch and learn sessions where the researchers would present on what was happening in their studies, and most of them were like had nothing to do with pregnancy by the way, but I went because I just find it just it was interesting. It was a nice way to spend my lunch break, and what was what I found so frustrating is that a lot of our dietary ideologies find their way into people doing rat studies who have literally no understanding of nutrition. But they're like, "Fat is bad."   Tahnee: (23:32) Mm-hmm (affirmative).   Lily Nichols: (23:32) "So, our hypothesis is that feeding rats a diet that's high in fat is going to cause this problem." So, that's the angle that they take when they're going into the study.   Tahnee: (23:44) Mm-hmm (affirmative).   Lily Nichols: (23:46) Honestly, these researchers are they're like rapt biologists. I don't know what you'd call them, but they're not people who have a deep understanding of nutrition. So, there is almost no thought to the quality of the fat that they would be feeding the rats. What should rats eat?   Tahnee: (24:06) Mm-hmm (affirmative).   Lily Nichols: (24:06) Like an ancestral-   Tahnee: (24:08) Yeah.   Lily Nichols: (24:08) ... where they're definitely-   Tahnee: (24:10) Biologically appropriate diet for a rat.   Lily Nichols: (24:11) Exactly, exactly.   Tahnee: (24:12) Yep.   Lily Nichols: (24:12) So, it's like, "Okay. We're going to start with the standard route chow," which is probably to some degree crap already.   Tahnee: (24:19) Mm-hmm (affirmative).   Lily Nichols: (24:20) "But we're going to enrich this rat chow with a lot of soybean oil," or a lot of pick your poison, whatever fat they want to do. And I've actually really dove into some of these rats feeding studies, particular the ones where they're looking at pregnant rats. And sometimes, when they make these adjustments to the rat chow, they don't adjust the micronutrients supplementation to match it. So, it's like, "Okay. You gave these rats high-fat diet." It was also a horrible source of fat, like soybean oil, you know?   Tahnee: (24:56) Mm-hmm (affirmative), mm-hmm (affirmative).   Lily Nichols: (24:57) So inflammatory, Omega 6 fats no like shown to cause all sorts of pregnancy complications, and I go into that in Chapter 4 of Real Food for Pregnancy.   Tahnee: (25:10) Mm-hmm (affirmative).   Lily Nichols: (25:11) But on top of that, because their diet is now what, I don't know, 60% fat or something that's fairly high, and you're not supplementing the micronutrients that would otherwise be in the regular rat chow. You now have micronutrient deficient rats as well.   Tahnee: (25:27) Mm-hmm (affirmative).   Lily Nichols: (25:27) And there's no discussion of this in the papers whatsoever. We definitely have to have animal studies to learn things about human pregnancy because there's all sorts of ethical issues, obviously, on subjecting human pregnancies to certain deficiencies that we know are going to cause adverse outcomes. That's not ethical. So, we have to rely on rat studies, but a lot of them are poorly designed. And so, I'm just very critical when I'm looking at research, so usually when I approach looking up a certain topic, I have some sort of a hypothesis in my head, or I'm just looking for what is the latest update on choline and pregnancy. So, I'll sometimes use some generic search terms and then see what's out there. And I am very, very critical of the methods that studies use.   Tahnee: (26:28) Mm-hmm (affirmative).   Lily Nichols: (26:29) I'm also critical of the funding sources, and I'm also critical of the way that they explain their results in their discussion section. So, I always try to go back to the actual data, and it depends on how much of that actual data they're able to present on in the study which can be frustrating.   Tahnee: (26:50) Mm-hmm (affirmative).   Lily Nichols: (26:50) Because sometimes there's holes that they don't address. But my long answer or short answer for this long explanation is I'm just very critical of everything that I read. And I find there's often quite a few holes in research studies, unfortunately, and what's interesting is if you go back to studies from like the 1940s and look at how they present their data and how they discuss their data, they are much less likely to explain away a certain finding.   Tahnee: (27:29) Mm-hmm (affirmative).   Lily Nichols: (27:29) They're like, "We observed this," and just they leave it as is. Where if you're looking at say, we'll go back to the rat study studying fat, they might say, "We were surprised to find that the rats fed the soybean oil, although there this happened, they actually had this really advantageous thing happen," or really terrible thing happen that they can't possibly explain because it goes against their hypothesis. So then, they'll spend whole paragraph-   Tahnee: (28:07) What the finding mean.   Lily Nichols: (28:08) ... trying to explain away why that result was because of confounding variables and not from the thing that they tested. So-   Tahnee: (28:16) It's almost editorialising their kind of own-   Lily Nichols: (28:18) Exactly, exactly.   Tahnee: (28:21) Yeah.   Lily Nichols: (28:21) So, I'm just ... I do a lot of reading of scientific studies, but I probably only out of every 10 studies, I might find like one that's really good. It's slim pickings.   Tahnee: (28:37) Yeah, and I think like you said ethically, and I mean even practically, it's very difficult to study human nutrition on a kind of large scale because people aren't reliable really, you know?   Lily Nichols: (28:52) Yes.   Tahnee: (28:53) And you can't lock someone in the room and force feed them. That would be naughty, so, yeah. It's a tricky area I think, and that's why I think I've always been drawn to the ancestral kind of ideas, especially as I've gotten older because it makes a lot of sense to me to look at, well, we got pretty far through nature providing.   Lily Nichols: (29:11) Exactly.   Tahnee: (29:12) And like, "Okay. So, maybe the last couple hundred years haven't been so good for us," but-   Lily Nichols: (29:18) Mm-hmm (affirmative).   Tahnee: (29:18) But, yeah. One thing I found super interesting, which I mean I ... This is a little, I guess, off to the side of it, but similar just thinking about epigenetics. And one thing we hear a lot of in our work is kids with eczema, and I noticed that you made a point of in Real Food for Pregnancy of saying like, "Glycine needs really increase during pregnancy."   Tahnee: (29:41) And one of the things I know is quite effective in treating kids after they've been born is glycine supplementation, and I was curious if you've seen things like that where there's kind of a correlation between the deficiency in pregnancy and then a popular ... I know this is going to be tricky to answer, but I'm going to try. Like a population kind of change in terms of more common because we know we see more ADHD now. We see all these different types of things becoming way more common. Do you think that that's in part due to this kind of prenatal nutrition and even just women's general health as they're bringing the babies in, or is it more to do with what the kids are eating once they're born? Or do you have any thoughts on that?   Lily Nichols: (30:22) I think particularly after having my two kids and knowing how tricky feeding kids gets into later toddlerhood. You have a three-year-old, right? So-   Tahnee: (30:37) I do, yes. I do.   Lily Nichols: (30:40) All these real foodie moms, myself included, sort of smugly-   Tahnee: (30:45) Humbled.   Lily Nichols: (30:45) ... go into early motherhood with like, "My child is going to eat so well, and they're not going to go through a picky eating phase because I'm being really intentional about which foods I'm introducing when. And I'm not exposing them to this processed stuff." And then, just by default, the development, I just have to say it. It is a developmentally normal stage in brain development of exerting independence that you're probably going to go through some degree of picky eating. It'll happen. Just prepare yourself. You didn't do anything wrong, right?   Lily Nichols: (31:21) And so, knowing that, knowing that there's probably going to be times where their nutrient intake is not that great, I think so much of it comes back to at least I know. I'm like, "Well, at least in pregnancy and at least-   Tahnee: (31:37) They sure had a good time.   Lily Nichols: (31:38) ... early infancy, you had really nutrient-dense foods, and you had your breast milk and your ..." Because they just go through those funny food phases where they only want certain things, and you know they're not getting well-balanced nutrition. So, that's just a little aside to start out.   Tahnee: (31:59) Mm-hmm (affirmative).   Lily Nichols: (31:59) I think it is certainly both. Obviously, if a child has a propensity towards food sensitivities or allergies, then, yes, you're definitely going to notice a reaction to certain foods. But there's a lot of things that come back to pregnancy nutrition. I can't say offhand I know something where glycine has any relation to a risk of children's risk of allergies. I have not seen that study, but glycine is an amino acid that I give a lot of big nod to in the book because it's something that becomes very important to provide in pregnancy.   Tahnee: (32:48) Mm-hmm (affirmative).   Lily Nichols: (32:49) And because glycine is a major component of collagen and makes up so many of our bodily structures, so like a third of the protein in our body is collagen.   Tahnee: (33:01) Mm-hmm (affirmative).   Lily Nichols: (33:01) A third of the amino acids in collagen are glycine, so you can kind of use glycine and collagen somewhat interchangeably in that if you're eating collagen, you're going to be getting a lot glycine. Of course, you could supplement separately with it, but in terms of what you get from food, you would be getting it usually in the form of gelatin or collagen.   Tahnee: (33:23) Mm-hmm (affirmative).   Lily Nichols: (33:23) And those amino acids are very important for the formation of organs, for the transcription of foetal DNA, for the development of the gastrointestinal tract, so maybe it plays a role there. For the skin, hair, nails, connective tissue, bones, the entire skeletal system, your liver's ability to detoxify because you require glycine the form of glutathione, one of your major detoxification enzymes. So, you could probably circumstantially make the case that it does play a role in immune system development.   Tahnee: (34:03) Mm-hmm (affirmative).   Lily Nichols: (34:04) I can't say we have direct data on that specifically at this moment. Some of the things we do have pretty decent data on in terms of risk of child allergies would be Vitamin D.   Tahnee: (34:17) Mm-hmm (affirmative).   Lily Nichols: (34:18) Vitamin A very important for the immune system. Probiotics and the health of the maternal microbiome to a large degree affects the baby's microbiome, and some of those bacteria and microbes are transferred throughout pregnancy, although the greatest seeding of the microbiome happens at birth.   Tahnee: (34:43) Mm-hmm (affirmative).   Lily Nichols: (34:43) So, if there are interventions in pregnancy that affect the maternal microbiome, like the use of antibiotics, or if there is antibiotics used during labour or shortly after postpartum because that also affects the breast milk, if baby is born vaginally versus born via C-section, that can impact the microbiome. Whether they're breastfed or formula fed can affect the microbiome, and that is really your immune system is like some estimates say 70% or 80% located in your gut.   Tahnee: (35:21) Mm-hmm (affirmative).   Lily Nichols: (35:21) So, all of these factors that affect gut health and the microbiome I think are just huge, and I have actually been asked before like, "What do you think is the greatest gift you've passed along to your children?" And I think it's my microbiome. I'm not kidding. If it's not my prenatal nutrition, it is the microbiome. It sets the stage for their immune system for their entire life, and I'm grateful for my mom who birthed me at home and didn't jump to giving us antibiotics a whole bunch as kids and practised full-term breastfeeding, breastfed us into toddlerhood.   Tahnee: (36:11) Mm-hmm (affirmative).   Lily Nichols: (36:11) And so, I know I had a strong microbiome, and I think that is literally the greatest gift that we can pass to our children, which is kind of probably a weird thing for some people to think. But once you dive into the research, it's just so fascinating.   Tahnee: (36:26) Yeah. I mean I completely agree, and I mean one thing that I'm curious about. We have a colleague who is a functional naturopath, and he has been recently kind of ... He used to recommend quite an ancestral style diet. And he's been sort of recently doing a lot of research on the microbiome and saying that maybe a higher fat diet is less beneficial for the microbiome. I'm curious if you've come across any of that, or if you know. I haven't actually gone quite deep on it yet. He just, he spoke to my partner about it the other day, but, yeah. It was something that was a bit of a surprise for me.   Lily Nichols: (37:01) Yeah. So, I think, first of all, that we're still in our infancy of understanding the microbiome.   Tahnee: (37:09) Mm-hmm (affirmative).   Lily Nichols: (37:10) And so, I think there's a lot of, kind of like those rat studies, there's a lot of assumptions that are made, right?   Tahnee: (37:15) Mm-hmm (affirmative).   Lily Nichols: (37:15) So, there are assumptions made that the greater diversity of bacteria that we have in the gut, then the better.   Tahnee: (37:25) Hmm.   Lily Nichols: (37:26) And I don't think that is always true. Now, you will have a greater diversity of bacteria if you're eating a diet with a greater diversity of plant foods, especially fibres, because those will feed certain microbes in the gut. But you can shift the microbiome based on what we're eating.   Lily Nichols: (37:46) I always kind of come back to the ancestral thing. Would you have taken that microbiome research? So, say we were at that point where we were studying that in the 1920s, and you were visiting an Inuit population in Northern Canada or Alaska or Greenland. And you were like, "Okay. So, those people be generally a ketogenic diet," particularly in the winter when probably-   Tahnee: (38:19) They may be more.   Lily Nichols: (38:19) ... some of the only plant foods they have are, and I've lived in Alaska, so I can attest to this, probably some of the only plant foods that you have managed to preserve over the winter. Traditionally, they gathered lingonberries and blueberries, and the wild ones are not very sweet.   Tahnee: (38:37) Mm-hmm (affirmative).   Lily Nichols: (38:37) And some berries called crowberries, which are not sweet at all, and they preserved them in seal oil, okay? So, there's isn't-   Tahnee: (38:46) Blech.   Lily Nichols: (38:46) You're not going to find a lot of plant matter in the tundra. Maybe if you're eating the contents of like a moose's gut, then maybe you'd get some of the things that they were eating. But for the most part, they were eating a lot of fat and protein.   Tahnee: (39:01) Mm-hmm (affirmative).   Lily Nichols: (39:01) And I would argue that their microbiome is adapted appropriately to-   Tahnee: (39:06) With their diet, mm-hmm (affirmative).   Lily Nichols: (39:07) ... break down the foods that are in their diet. I don't think we can unequivocally show that having a more diverse microbiome is always better. However, I think with certainly with a modern diet, if you're comparing the microbiome of somebody eating the so-called standard American or Western diet, which has like a whole bunch of white flour and refined oils and just very low in micronutrients, also low in fibre, probably their animal products are from animals raised on feedlots who are treated with a bunch of antibiotics, eating glyphosate-sprayed, genetically-modified corn and soy.   Tahnee: (39:48) Mm-hmm (affirmative).   Lily Nichols: (39:48) Certainly, you're not going to see a very diverse microbiota, and it's not going to be a very healthy microbiota because a lot of their bacteria have been negatively-   Tahnee: (40:00) Nuked.   Lily Nichols: (40:00) ... affected by their diet of processed foods and things that are killing the microbiome like the antibiotic residues and the glyphosate residues.   Tahnee: (40:08) Mm-hmm (affirmative).   Lily Nichols: (40:10) So, I think it's the bit tricky for us to draw super strong conclusions.   Tahnee: (40:15) Mm-hmm (affirmative).   Lily Nichols: (40:17) I think a lot of people ... I think you have to find your sweet spot. I think there are some people who really who thrive with differing levels of plant versus animal foods, and you find that in the research, too. When they've looked at modern hunter-gatherer diets, they find that the carbohydrate range ... I hope I don't butcher this, but I do cite this in the book.   Tahnee: (40:40) Yeah.   Lily Nichols: (40:41) ... range anywhere from 3 to like 34%, I believe, of their diet coming from carbs.   Tahnee: (40:48) Yeah.   Lily Nichols: (40:50) There might be some groups actually that eat a little higher, but I think the median quartile or whatever was somewhere between, gosh, in the teens up to 34%. So, like probably around a quarter, give or take, of your diet coming from carbohydrates. That would be most of your plant foods since that's where you find your carbs.   Lily Nichols: (41:11) And then, the remainder was your fat and protein, and I think people need to sort of find their own sweet spot with that. And some people do well with a lot more. Some people do well with a lot less, and I think there's also different stages of life where you can tweak that. And if there's certain health conditions you're dealing with for a period of time, sometimes, people do better with a short period of time eating keto. And then, they resolve that health issue, and they can start incorporating a more liberal amount of carbohydrates into their diet. And they feel great.   Tahnee: (41:50) Mm-hmm (affirmative).   Lily Nichols: (41:50) But if they'd done that two years ago, they would have felt really awful.   Tahnee: (41:53) Mm-hmm (affirmative).   Lily Nichols: (41:54) So, I think, I don't know, as a whole, I think we need to be much less dogmatic about nutrition and much more adaptive.   Tahnee: (42:03) Yeah. Well, I think that actually made me think of there's a guy called Jack Kruse. Are you familiar with him?   Lily Nichols: (42:09) Mm-hmm (affirmative).   Tahnee: (42:10) Yeah. He's interesting, but I read his book. And probably the biggest thing I took away from that was he sort of discussed how if you think about a seasonal diet, you might get a lot more carbohydrates and be more insulin resistant during say, summertime.   Lily Nichols: (42:25) Mm-hmm (affirmative).   Tahnee: (42:26) But then, you're going to naturally have a stage of ketosis every year when it's wintertime, and this kind of dance between the two states might actually be beneficial for humans. And I mean there's not really any evidence for this. But it made sense to me that we wouldn't be in ketosis all the time, and we wouldn't be in a state of insulin resistance all the time, and-   Lily Nichols: (42:47) I completely agree.   Tahnee: (42:49) Yeah. And I just, that for me was a really big takeaway that perhaps it's a little bit of both, you know?   Lily Nichols: (42:56) Mm-hmm (affirmative).   Tahnee: (42:57) And I mean probably other things as well, but that was something you'd mentioned in your book about carbohydrate cravings because of the amount women who've written who are really conscious of nutrition who are like, "All I want to eat is toast," you know?   Lily Nichols: (43:09) Yep.   Tahnee: (43:11) For the kind of three months of their pregnancy or whatever.   Lily Nichols: (43:13) Yep.   Tahnee: (43:14) And then, you were sort of saying, "Well, there's naturally this this change in the pancreas." Can you tell us a little bit about that and why maybe it's not the end of the world if you eat a lot of carbs?   Lily Nichols: (43:23) Oh, yeah. Yeah. There're so many, I mean, I've thought a lot about this, of course, because I also experienced that during my two pregnancies, so, yeah. The first trimester is a time of incredible change and adaptation, and the more you dive into the weeds, the more incredible it is that we can pull off this complex feat.   Tahnee: (43:49) Yeah.   Lily Nichols: (43:50) But also, the more reassurance I feel around giving people permission to not be super freaked out about their carb cravings in the first trimester, so, yeah. There's a lot happening not only with the pancreas, but also, all of the major internal organs and organ systems of baby are formed by eight weeks of pregnancy. Pretty much all the cells have differentiated to their like, "I'm going to grow into a liver, and I'm going to grow into a brain. And I'm going to be a bone," and all of that has-   Tahnee: (44:28) Be expecting that.   Lily Nichols: (44:29) Yeah. All of that has pretty much taken place by week eight, which is insane.   Tahnee: (44:33) It's so crazy. Yeah.   Lily Nichols: (44:35) During that time as well, the embryo has implanted into the endometrium, and actually, there's glands in the endometrium that serve as nourishment for the early embryo before the placenta forms. And ultimately, when the placenta forms, which is end of first trimester, beginning of second trimester, that then takes over in supplying nutrients to the foetus. And but until that time point, your baby's actually being nourished by the lining of the uterus. The lining of the uterus that builds itself up, and then in case that you are not pregnant that month is expelled via your menstrual cycle. So, a healthy menstrual cycle really sets the stage for a healthy pregnancy, and I think we can give ourselves a whole bunch of grace in that first trimester when your body might have food aversions or only wants to eat carbs because the endometrium kind of has it covered.   Tahnee: (45:42) Mm-hmm (affirmative).   Lily Nichols: (45:43) In the meantime, your body is working crazy overtime to build a whole new organ, a very complex organ known as the placenta, and that takes a lot of energy. So, the amount of mitochondria being produced and actively those are like the energy producing parts of the cell, but they do a whole bunch of other stuff. It is exponentially higher compared to really any other life stage, and so there's a reason you feel like tired and worn down and just wanting carbs.   Lily Nichols: (46:17) On top of that, insulin sensitivity changes throughout your pregnancy, so in early pregnancy, people tend to be more prone to hypoglycemia. So, your insulin resistance tends to be a little bit less, but also, your insulin production increases a bit. This is going to shift a lot towards the end of pregnancy where your insulin production can be double or triple but also is matched with a pretty high level of insulin resistance. So, in early pregnancy, your body actually kind of can handle more carbs.   Tahnee: (46:53) Mm-hmm (affirmative).   Lily Nichols: (46:54) But also, if it's the only thing you can eat, and you're like, "Oh, my gosh, I'm not eating all these nutrient-dense things," technically, and particularly for people who did a little bit of prep work ahead of time or have eaten a generally nutritious diet, doesn't have to be perfect, in the months and years leading up to pregnancy, you can really just rest assured that your body is taking care of it. It's really relying on your nutrient stores early on more than anything.   Lily Nichols: (47:26) And I don't want to give like a complete like, "Oh, nutrition doesn't matter at all in the first trimester." Of course, it matters, but when you're in the throes of nausea and you really kind of don't have a choice, you have to do what you got to do just to get through the day or get through the hour. And so, we can sort of try to make choices with more nutrient dense carbs. I just recently did an Instagram Live on this if people want to dive in a little more.   Lily Nichols: (47:53) But don't get super hung up on like, "The whole the sky is falling." There's so much hormonally going on. I didn't even talk about the thyroid being hijacked by HCG, which also supposedly contributes to the nausea and the hyperness.   Tahnee: (48:09) And that was something. That was like a wow for me when I read that.   Lily Nichols: (48:13) Yeah.   Tahnee: (48:13) That morning sickness could mean that the thyroid is actually really healthy.   Lily Nichols: (48:19) Yes.   Tahnee: (48:19) I'd never heard that before. Can you tell us-   Lily Nichols: (48:21) No, it's just it's so complex, and so this is one of the fun things about doing the research is you can go into it with a hypothesis, and then you come out with all these random theories that you're like, "Wow." And then looking at everything and that's happening in early embryonic development all the way back to the development of the egg and implantation. It's just incredible. Can we just take a step back and be like, "Wow"?   Tahnee: (48:50) I'll do it.   Lily Nichols: (48:50) Hold this up.   Tahnee: (48:51) Yeah.   Lily Nichols: (48:51) It's cool.   Tahnee: (48:52) Well, sometimes, I look at my daughter, and then I look at me, and I'm like, "How did ..." you know? You're like, "How did that?"   Lily Nichols: (48:59) Yeah. You made that.   Tahnee: (49:00) Yeah, and but-   Lily Nichols: (49:01) I know.   Tahnee: (49:02) Yeah, woo. And I mean on the kind of thyroidy thing, because that's something a lot of women experience postpartum and thyroid issues. Do you have any ... Is there anything we can do nutritionally to support the thyroid? I mean, iodine and selenium obviously are big ones.   Lily Nichols: (49:20) Mm-hmm (affirmative).   Tahnee: (49:21) Is there anything you have to say about that?   Lily Nichols: (49:23) Yeah. Well, the thyroid is just a very sensitive gland, and it's sensitive to all sorts of stressors not only nutritional but life stress as well. And it is under a significant amount of stress in a pregnancy where it has to pump out 50% more thyroid hormone than it usually does, and a lot of that ramping up, going back to the first trimester, happens really early on as well.   Lily Nichols: (49:50) And so, once you have your baby and you're postpartum and you have this sudden crazy drop in hormones, pretty much once you birth the placenta, and you don't have this hormone producing organ hanging out telling your body that you're pregnant, you see a very sudden crash in hormones. And the thyroid has to pretty much completely remodel back to a non-pregnant thyroid that isn't producing as much thyroid hormones.   Lily Nichols: (50:23) So, it goes through a lot of adaptations in that first year postpartum, but especially in the first three to six months. And so, if there was any underlying stressors on the thyroid prior to pregnancy or during pregnancy, sometimes, you see those amplified in postpartum. Most often it's postpartum thyroiditis usually in the form of a hypothyroid state, although some people have an overactive thyroid. So, usually, there's ... And then, it gets complicated because sometimes, it presents in a, they call it a triphasic pattern, where you can experience often a period of hyperthyroidism early on. So, like excessive thyroid hormones early on followed by either a normal thyroid or a hypothyroid state later on in that first year.   Tahnee: (51:17) Mm-hmm (affirmative).   Lily Nichols: (51:17) And so, it's really tricky to toy out even as a clinician in trying to decide what you're working with clinically, so I think as a mom, you want to be really aware of your symptoms so if you need follow up testing because something has changed, to beware. You may have swung to the other side of the thyroid spectrum.   Tahnee: (51:41) Hmm.   Lily Nichols: (51:42) As far as nutrition to support the thyroid, absolutely iodine is so key. I think way under emphasised in our prenatal and postpartum breastfeeding nutrition guidelines. You need more iodine when you're breastfeeding than you do when you're pregnant and more than any other life stage, by the way.   Tahnee: (52:08) Mm-hmm (affirmative).   Lily Nichols: (52:08) And I think our iodine recommendations are very, very conservative. You transfer quite a bit of iodine via your breast milk, and so that's sort of like a just ... It's like a bucket with a hole in the bottom. You take it in. It goes right out.   Tahnee: (52:23) Yeah.   Lily Nichols: (52:23) And so, I think in some cases, of course, there's a lot of things that are preferentially transferred to baby, and that continues to be the case when you're breastfeeding. And I think that might be the case with iodine. Definitely a nutrient to consider, so look and see if your prenatal has any iodine. Hopefully, it does, and hopefully, it has enough. And then, continue that postpartum, but also, seaweed and seafood are going to be your major iodine sources. And next to that but in much lesser amounts, dairy products and eggs.   Tahnee: (53:00) Yeah.   Lily Nichols: (53:00) So, yeah. Postpartum would be a good time to have seaweed snacks as a snack and have your fish and your mussels and oysters and all those nutrient dense foods. And then, the cool thing about those nutrient dense foods is that because things work in synergy, when you're getting your seafood, you're also getting a lot of other nutrients that are supportive of the thyroid so a number of trace minerals, especially selenium. That is a really important one to have in balance with your iodine. You have your Vitamin D. You'll have your Vitamin B12. You have your zinc and copper and a bunch of other nutrients in your seafood products. That's so important for thyroid health.   Lily Nichols: (53:42) And then, I would also emphasise Vitamin A and iron for the thyroid. And again, if you're eating those seafoods, but you're also including nutrient-dense animal foods, especially the organ meats, you're going to get pretty much all of those nutrients you need in the right proportions to support your thyroid health.   Lily Nichols: (54:08) But on the other side of the non-nutrition side of things, postpartum is often very stressful for people and especially if there's not a big community of support.   Tahnee: (54:19) Mm-hmm (affirmative).   Lily Nichols: (54:20) It's just it's a lot for your body to go through and for you to emotionally go through, and in the midst of perpetually interrupted sleep. And I mean, all of it is really a recipe for stress on the thyroid. So, if you can find a way to simply get enough to eat first of all, focus on quality as second. Get enough to eat, very important for your thyroid, and have some sort of community or family support there to help you in the moment, ground level with baby, bringing you food so you can just rest as much as possible. That is X. That's just so important and probably just as important as the nutrients I just mentioned. I think that community aspect in a supported postpartum, the importance of that cannot be understated.   Tahnee: (55:18) Yeah. We talk about that a lot on this podcast because, yeah, I completely agree. It's just it's so essential. I'm in a meal train right now for a friend who just had a little one.   Tahnee: (55:29) I wanted to jump a little bit across to methylation because one thing that I remember reading about when I was pregnant was about folate and how most of the ways in which we supplement it are really not that beneficial because our bodies have to work really hard if they can even absorb it at all. And you recently did a post on your blog about MT. I always get this wrong, MTHFR. I always want to say the dirty word.   Lily Nichols: (55:54) You got it right.   Tahnee: (55:57) You got to spell it out, and how that sort of influences folate absorption in the body as well, especially for people that have that sort of predisposition to poor methylation. So, obviously, I can link to the blog post, but could you give us a quick summary of folate and kind of why it's important and then what we might need to look out for if we are concerned about our ability to methylate?   Lily Nichols: (56:23) Sure. Yeah. I'll try to give you the short version-   Tahnee: (56:26) Yeah.   Lily Nichols: (56:26) ... because that blog post is quite long.   Tahnee: (56:28) Yeah.   Lily Nichols: (56:29) So, folate is one of our B vitamins, and in terms of pregnancy health, it's most famous for its role in the prevention of neural tube defects and other birth defects. And it does this because it's very involved in the transcription of DNA, making sure that all of that goes properly. And when you're lacking in certain micronutrients, folate being one of them, you can have problems with that process. And one of the really devastating outcomes when that happens in early pregnancy is something like a structural birth defect. Of course, folate is important for a lot of other things, but that's where it gets its fame for its role in a healthy pregnancy.   Lily Nichols: (57:24) So, folate is an umbrella term that includes all the different types of folate that we get from food. There is over 150 different types of folate in food, the most common being methylfolate, and methylfolate also accounts for at least 95%. Some estimates say 98% of the folate that's in our bloodstream, but there is also a synthetic version of folate that was developed called folic acid. And for some reason, this one got all the fame, is then is the one used in a lot of research studies. It's interesting in that in the gut, it is actually better absorbed than food folate because food folate has this whole food matrix going along with it.   Lily Nichols: (58:19) So, the isolated synthetic folic acid is absorbed quite well, but that doesn't mean that it is utilised well because folic acid has to be converted via several steps into methylfolate for your body to be able to metabolise it. So, this poses a problem for people who have ... It can be a problem for everyone, and I make that case in the folate article, so I recommend people do give that a read. But it's especially problematic for people who have certain genetic variations in the genes that control the enzymes that metabolise folate. So, MTHFR is one of those genes, and there's a couple different mutations that people can have on their MTHFR. I call it MTFHR variations because it's just all of these gene mutations that sound all scary. They're all a variation of normal. 40 to 60% of the population have as a variation of their MTHFR gene and thus has a reduced ability to process synthetic folic acid. So, it's definitely worth talking about.   Tahnee: (59:34) No, well, that's pretty good I'd say. I think what I guess your point in the article was really that we're looking for real food sources, or if we're supplementing, we're looking for folinic acid or methylfolate instead of straight up folic acid. So, was that addition of the folinic that was the difference? Would that be an accurate kind of-   Lily Nichols: (59:55) Yes. That would be an accurate takeaway. So, I mean most supplements will use, if they're going to use "good quality" of folate, they'll use methylfolate instead of folic acid. There is also a form of folate called folinic acid, so it has a little extra IN in there. And that is like in if you look at the biochemistry pathways, and I made a choice not to include that in the article but maybe I should, folinic acid is like one step behind methylfolate. So, your body would still have to convert it into methylfolate, but it doesn't have to do near the amount of work as if you were to take folic acid.   Tahnee: (01:00:42) Mm-hmm (affirmative).   Lily Nichols: (01:00:42) So, yeah. So, there's a lot of really not a lot. There are several good quality prenatal vitamins, for example, that'll use a combination of methylfolate and folinic acid. I think with a lot of people becoming more aware of this MTHFR issue, everyone's like all of a sudden obsessed with methylation, and so they're like, "I need my methylfolate and my methyl B12 and methyl this and methyl that." And some people don't do well with too many methyl groups, especially in supplemental form. So, I think that's why some companies have decided to kind of pull back a little bit on all the methylfolate and do a combination. But it really entirely depends on the person.   Lily Nichols: (01:01:28) And then, I'd say the other point, take home point, that I wanted to make in that article was that folate doesn't function in isolation just like so many other nutrients. There is essentially we're talking about this whole methylation cycle or this whole folate cycle, and there are a lot of nutrients that participate in it. And so, I think we need to look beyond just supplementing with methylfolate and particularly supplementing with really high doses without balancing that out with all these other groups that are involved in methylation, like your Vitamin B12 and your Vitamin B6 and your choline and your glycine, which we talked about earlier, and your betaine and your riboflavin and your copper and your magnesium. I mean there's so many things.   Lily Nichols: (01:02:20) And that's why what's so cool about it is that if you look at what are our most nutrient-dense sources of folate in our diet, and I have a list of those foods and the amount of folate in each of them, liver is top of the list. Sorry to keep talking about liver, but with liver you're also going to get pretty much all of those micronutrients that help your body process folate properly.   Tahnee: (01:02:45) I think it's one of the only other food sources of choline, too, right? Like-   Lily Nichols: (01:02:48) Yeah. Eggs and liver are by far your top two sources of choline in the diet.   Tahnee: (01:02:54) Yeah.   Lily Nichols: (01:02:55) So, yep. And choline is huge. Choline is arguably just as important, possibly more important, than folate for the prevention of neural tube defects. It's just we hadn't identified just how important it was until like the 1990s. The U.S. didn't have a recommended intake for choline until 1998.   Tahnee: (01:03:18) Wow.   Lily Nichols: (01:03:18) So, it wasn't on the research radar. So, if we go back to our earlier conversation about looking at research studies, I mean there's a lot of things I wish were researched that they weren't or should have been researched like 30 years ago, but we didn't know about them yet, right? So, how many things are in our food right now, like our whole foods that we don't know about because we haven't isolated them and named them? I mean-   Tahnee: (01:03:44) Well, that's one of our pet peeves, isolating a standardisation of a herb. It's like, "Well, we've taken herbs in their whole form forever."   Lily Nichols: (01:03:53) Exactly.   Tahnee: (01:03:54) Now, we suddenly look for like one little aspect of them and we-   Lily Nichols: (01:03:58) Right.   Tahnee: (01:03:59) ... standardise that. It just doesn't make any sense.   Lily Nichols: (01:04:01) I agree.   Tahnee: (01:04:02) So, the last thing I kind of really wanted to touch on was gestational diabetes, and obviously, that's a huge topic. But I guess what I really wanted to touch on was for the pregnant women because it's just something that's come up a lot for me lately with friends and people in the community that I talk to wher

Welcome back, listeners! Today we are having a chat with Lily Nichols, a kick-butt registered dietitian nutritionist who wrote Real Food For Gestational Diabetes and Real Food For Pregnancy. Here we learn about Lily’s work and research, her history as a dietitian, and get a nice sample of the wisdom and expertise she has to bring to women who are trying to get pregnant.    This episode starts off with Lily sharing with us her experience with the prenatal dietary guidelines. To sum it up: she’s not impressed with mainstream guidelines. Now she writes about how to actually feed yourself well while trying to conceive or pregnant, in spite of the messed up guidelines. If you don’t know what these guidelines are, Sophia clues you in. Basically RDA and other guidelines, like the ones you find on the back of a food container, are based on what is the minimum amount someone must consume to prevent a major deficiency. The research is done on adult men, and there is no consideration taken for women or people of other races or ages. Boo!   Lily promotes using REAL food to meet your nutrition requirements. She defines real food as unprocessed food made with simple ingredients, as close to nature as possible. Specifically, not processed in a way that removes nutrients. This means not stripping grains of their fiber to make them “refined. Not skimming the fat off of dairy, and not removing the skin or fat from poultry. You get more nutrition when you eat all the parts.   A lot of food in the American diet is not really “food”. Artificial sweeteners, thickeners, stabilizers, preservatives, etc. are made by food scientists to be “safe” to eat, though it’s not necessarily healthy. When we define REAL food, we are talking about what builds your body up with good nutrients, versus how much of a chemical or additive you can consume before it starts doing major harm. We also want to emphasize whole foods vs. isolating specific nutrients in a lab, and then trying to separate them from the rest of the food.   To clarify, we are NOT anti food science here on the FFF podcast! We know scientists have been involved in our food supply for centuries, and that a lot of the work they have done has been amazing! We are about food FREEDOM and fertility, meaning not limiting every food or only eating certain things. We just promote a natural diet of real food. There are very few foods that are 100% of the time a bad idea to eat, and according to Lily that list is limited to: refined carbohydrates and sugars and trans fats. That’s pretty much it!   So, what is it about all this “real food” stuff makes it helpful for women who are TTC? Lily says that all the ways that the primary factor is that increasing the provision of micronutrients in the diet. These nutrients play a strong role in hormone balance, detoxification, egg quality, regulating cycles, and more! Food is powerful, and getting yourself in a healthier place with better nutrient stores can help your body get ready for a pregnancy.    Sophia shares her experience at Bastyr University with helping the school adopt an omnivorous menu, and Lily shares how Bastyr School of Midwifery now uses her books as a part of their curriculum! How cool is that? In fact, both of Lily’s books are now available as book studies for dietitians worldwide to get their continuing education units!    Lily shares a bit of the praise and criticism she has received about her books. Pro tip: anyone giving anything a 1-star review on Amazon is generally someone who did not even read/use the product they’re reviewing. Good to know! It’s no mystery that on this show we are fans of informed consent. Traditional nutrition guidelines are built around the average consumer being too stupid/distracted/disconnected to make good choices. Information is deliberately withheld to keep from confusing people or making things “overly complex”.  I am sure this applies to some people, but we believe our audience (that means YOU!) is interested in learning, growing, and making their own choices. Lily details in her books what research shows is BEST when preparing for a baby, but it’s not hard and fast rules. When you’re empowered with knowledge, you can make whatever choices work best for you, your lifestyle, and your personal beliefs and preferences.    Lily reveals some tidbits she wishes she could have added into her books. One major one is a study on vitamin D. Women who have serum vitamin D levels over 40 have a significantly reduced rate or preterm birth! Boom! On this show, we are big fans of vitamin D, as both Caitlin and Sophia recommend their patients have vitamin D levels in the 50’s and 60’s. If you have pale skin, you can get vitamin D from the sun more easily! If your skin is dark, you’re going to have a harder time making it on your own without a supplement. Finally some good news for you folks who burn easily.   A major thank you to Lily Nichols, and thank you for listening!

Lily Nichols is a Registered Dietitian, Certified Diabetes Educator, and author of Real Food For Gestational Diabetes and Real Food For Pregnancy. She joins the Plus Mommy Podcast to talk about how we can rethink Gestational Diabetes and pregnancy nutrition when you’re plus size. Learn more.

This week Kristen & Talia talk with Lily Nichols who is a Registered Dietitian Nutritionist & Gestational Diabetes Educator. She looks at the advice (or lack thereof) from our doctors when it comes to pregnancy and postpartum nutrition. She has two books Real Food For Pregnancy & Real Food For Gestational Diabetes where she dives into these subjects in a manageable way for the everyday consumer. The girls ask about Vitamin D transfer through breastmilk, how thyroid function is tested in pregnancy, and how to increase iron stores. They discuss how the current recommendations do not take into account the six weeks of bleeding from an internal wound after giving birth. This episode is so informative and every woman should hear it! Connect With Lily Website Instagram Facebook Vitamin D & Breastfeeding Sponsor Great Kids Snacks - MOMPOD25 for 25% off first box Follow Us Instagram Facebook Email Book The Fifth Vital Sign

Today, I have a special guest on the show.  Her name is Lily Nichols. She is the author of Real Food For Pregnancy and Real Food For Gestational Diabetes.  Lily is a Registered Dietician and Nutritionist, Certified Diabetes Educator, researcher and speaker. In this episode, Lily and I talk about: The absolute essential nutrients that you need when you’re pregnant Mistakes to avoid when it comes to prenatal nutrition Gestational diabetes, what the tests and numbers mean, what you can do if you’re at risk for GD or have it currently. For more information on Lily Nichols, please click Here. Other links mentioned: Free Mini-course

I’m excited to have Lily Back on the show for a record 5th appearance! Make sure to check out the resources section below for the list of our previous episodes together. In our previous episodes, we’ve covered gestational diabetes, exercise during pregnancy, a real food diet for PCOS, and breastfeeding nutrition. In today’s episode, we talk about the impact of under-eating on your fertility and your overall health. We talk about how it’s possible to under-eat without knowing it and what to do to ensure that you’re getting enough nutrition in your diet. My Fertility Management Masterclass is designed to help you to master Fertility Awareness and take a deep dive into your cycles. Gain confidence charting your cycles, and gain deep insights into the connection between your health, your fertility, and your cycles. Click here for more information!    Topics discussed in today's episode: Is it possible to under eat and still get enough calories? The connection between flavour and nutrient density Could over-eating be related to eating foods devoid of nutrients? How does under-eating negatively impact fertility? The problem with "low-fat" diets Overcoming the myth that animal fats are bad for us The massive difference between the nutrient density of organ meats compared to regular muscle meats The role of a nutrient-dense diet in building and preserving fertility Why we are so quick to give up animal fats but don't think twice about bingeing on sugar How to reduce sugar cravings in a way that doesn't involve calorie restriction Why breakfast truly is the most important meal of the day How does shifting the focus to eating a nutrient dense diet affect your weight? How to trust that your body is capable of self-regulating your hunger cues Connect with Lily. You can connect with Lily on her Website and on Facebook and Twitter. Resources mentioned Real Food For Gestational Diabetes by Lily Nichols | Book Review Thai Chili Beef Heart Skewers | Lily Nichols Fertility Management Masterclass | Program Details Related Podcast Episodes FFP 016 | Real Food for Gestational Diabetes | Pre-conception & Pregnancy Nutrition | Lily Nichols FFP 025 | How Much Should Women Exercise During Pregnancy? | The Good, The Bad and the Uncomfortable | Lily Nichols FFP 103 | Real Food for PCOS | PCOS, Insulin Resistance & Diabetes | Managing PCOS Naturally with Diet |  Balancing Blood Sugar | Lily Nichols FFP 126 | Does Your Diet Impact Your Breastmilk? | Eating for Two: How to Produce the Most Nutritious Breastmilk | Managing the Postpartum Period | What Breastfeeding is Really Like | Lily Nichols FFP 009 | Sacred Fertility Foods | The key to having healthy babies and a healthy pregnancy | Sally Fallon-Morell FFP 109 | The Reality of Aging & Fertility | IVF & Assisted Reproductive Technology | The Future of Fertility Treatments | Dr. Marjorie Dixon   Join the community! Find us in the Fertility Friday Facebook Group Subscribe to the Fertility Friday Podcast on iTunes! Music Credit: Intro/Outro music Produced by J-Gantic A Special Thank You to Our Show Sponsor: This episode is sponsored by Anova Fertility! In 2016 Dr. Marjorie Dixon created Anova with the goal to be the leader in innovation, education, and communication for high quality and humanized fertility and reproductive care. Anova Fertility has created the first next-generation IVF lab in Canada. Anova is celebrating her 1st birthday this month. If you are in the Toronto area and are interested in learning more about IVF from Anova’s medical team, we welcome you to sign-up for IVF 101 Education Session at our centre. You can visit http://fertilityfriday.com/anova/ for more information. If you live out of the country you can email info@anovafertility.com to request a medical consultation over Skype (there is a fee associated with this service). To learn more about Dr. Marjorie Dixon, tune into our podcast together by clicking this link.   Fertility Friday | Fertility Management Masterclass This episode is sponsored by my Fertility Management Masterclass! Master Fertility Awareness and take a deep dive into your cycles and how they relate to your overall health!

Interview with Lily Nichols, RDLily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, Certified LEAP Therapist and Certified Pilates Instructor whose approach to nutrition embraces real food, integrative medicine, and mindful eating. Her practice focuses on digestive health, food sensitivities, and of course, prenatal nutrition. She's passionate about helping moms with gestational diabetes control their blood sugar using real food, mindfulness, and exercise. Her forthcoming book, Real Food For Gestational Diabetes, will be available in 2015. For more from Lily, including her free ebook, 33 Yummy & Healthy Pregnancy Snacks, visit PilatesNutritionist.com In this episode: Gestational Diabetes (GD) aka "carbohydrate intolerance" A1C test gives an average blood sugar of the past 3 months Testing in the first trimester can predict GD with 98% accuracy By the tenth week, there is a 3 to 3.5 percent increase in insulin production than normal Insulin resistance in the second and third trimester is the body's normal way of shunting glucose to the baby Why the current recommendations don't make sense The difference between nutritional ketosis and diabetic ketoacidosis How you can control you GD with diet Why medicine may be needed Why we don't have enough studies on ketosis and pregnancy Why the studies we do have are poorly designed Gluconeogenesis: Glucose can be made from fat and proteins