Podcasts about uterine

In this episode of The Birth Trauma Mama Podcast, we are joined by Angel, who shares her powerful story of birth, near-death, and healing after a rare and life-threatening complication: uterine inversion.Angel describes how her labor started smoothly and seemed “perfect" until the unexpected happened. What followed was a cascade of emergencies, including massive blood loss, emergency surgery, a hysterectomy, and days in critical care. Angel walks us through the terrifying moments of saying goodbye to her husband, the prayers she whispered before surgery, and the relief of waking up alive.But her story doesn't end at survival. Angel opens up about the aftermath, the postpartum depression she never expected, the shame of feeling broken despite being grateful, and the ongoing work of therapy, community, and healing.In this episode, Angel shares:

On The Down Low – Season 2: it's time to start talking about uterine cancersThe body often whispers before it screams — and recognising those early whispers can save lives. In this episode, we explore the importance of listening to symptoms like abnormal bleeding, and the role of risk factors such as obesity, hormones, lifestyle, and genetic predispositions including Lynch Syndrome. Through lived experience stories from Carly and Ruth, and expert insights from Professor Alison Brand AM, we uncover how prevention, risk assessment, and early diagnosis can change the future of uterine cancers.Know someone who needs to hear this? Share it, talk about it, and help break the silence around uterine cancers.Season 2 was produced by ANZGOG, with the generous support of GSK and Eisai.

Kimberly Peters, a stage four uterine cancer patient at UC San Diego Health, urges government leaders not to cut science funding. She warns that reduced federal support risks delaying vital research and life-saving cures. [Health and Medicine] [Show ID: 41071]

Kimberly Peters, a stage four uterine cancer patient at UC San Diego Health, urges government leaders not to cut science funding. She warns that reduced federal support risks delaying vital research and life-saving cures. [Health and Medicine] [Show ID: 41071]

Kimberly Peters, a stage four uterine cancer patient at UC San Diego Health, urges government leaders not to cut science funding. She warns that reduced federal support risks delaying vital research and life-saving cures. [Health and Medicine] [Show ID: 41071]

In this episode, Dr. Doug Waterman from Virtus Nutrition explains how management and nutritional strategies influence uterine involution and overall reproductive success in dairy cows. He discusses key factors like inflammation control, calving management, and omega-3 supplementation to improve cow health and future productivity. With today's high value on herd replacements and beef-on-dairy calves, every pregnancy matters more than ever—making proactive transition cow management essential. This episode is sponsored by Virtus Nutrition.

Kimberly Peters, a stage four uterine cancer patient at UC San Diego Health, urges government leaders not to cut science funding. She warns that reduced federal support risks delaying vital research and life-saving cures. [Health and Medicine] [Show ID: 41071]

Kimberly Peters, a stage four uterine cancer patient at UC San Diego Health, urges government leaders not to cut science funding. She warns that reduced federal support risks delaying vital research and life-saving cures. [Health and Medicine] [Show ID: 41071]

Kimberly Peters, a stage four uterine cancer patient at UC San Diego Health, urges government leaders not to cut science funding. She warns that reduced federal support risks delaying vital research and life-saving cures. [Health and Medicine] [Show ID: 41071]

Study Discovers Increased Cancers After MRNA Vaccines, Bret Weinstein- Covid & mRNA: Harms and Damages Exposed Bret Weinstein- Covid & mRNA: Harms and Damages Exposed (NEW!) REMINDER: CDC Didn't Track VAERS Safety Signals John Campbell- Increased cancers after mRNA vaccines   Study- Covid & mRNA: Harms and Damages Exposed (NEW!) | DarkHorse https://youtu.be/zkrbZmYuRoY?si=_0yO0y5ftLacoVJ1 Bret Weinstein 512K subscribers 25,699 views Sep 5, 2025 A new article on the harms and hazards of both SARS-CoV2 and the mRNA biologics said to counter the virus. Full Episode: https://youtube.com/live/wQWkKrM3Dt8 Mentioned in this segment: Zywiec et al 2025. COVID-19 Injections: Harms and Damages, a Non-Exhaustive Conclusion. Journal of American Physicians and Surgeons, 30(3): https://jpands.org/vol30no3/zywiec.pdf ***** Join us on Locals! Get access to our Discord server, exclusive live streams, live chats for all streams, and early access to many podcasts: https://darkhorse.locals.com Heather's newsletter, Natural Selections (subscribe to get free weekly essays in your inbox): https://naturalselections.substack.com Our book, A Hunter-Gatherer's Guide to the 21st Century, is available everywhere books are sold, including from Amazon: https://amzn.to/3AGANGg (commission earned) Check out our store! Epic tabby, digital book burning, saddle up the dire wolves, and more: https://darkhorsestore.org   REMINDER: CDC Didn't Track VAERS Safety Signals | DarkHorse https://youtu.be/u3UAyr6s7xc?si=VUoenskCyMdViArS Bret Weinstein 512K subscribers 16,906 views Sep 5, 2025 RFK Jr. fires the new director, after which other CDC officials resign, and eight former directors of the CDC pen a letter to the New York Times arguing that Kennedy is a hazard to our health. Bret Weinstein and Heather Heying discuss "The Plot Against Kennedy" in Episode 292 of The Evolutionary Lens. Full Episode: https://youtube.com/live/wQWkKrM3Dt8 Mentioned in this segment: NYT op-ed #2 from former CDC directors: We Ran the C.D.C.: Kennedy Is Endangering Every American's Health: https://www.nytimes.com/2025/09/01/op... Bret and Heather 132nd DarkHorse Podcast Livestream: 50 States not in a Roe https://youtube.com/live/usP2D_qGUZs CDC didn't monitor VAERS for COVID safety signals (June 2022): https://childrenshealthdefense.org/de...   Increased cancers after mRNA vaccines Watch this video at- https://youtu.be/3dnIGqUlluc?si=sDbAdXTgOsCiCLev Dr. John Campbell 3.25M subscribers 143,152 views Sep 5, 2025 COVID-19 vaccination, all-cause mortality, and hospitalization for cancer: 30-month cohort study in an Italian province https://pubmed.ncbi.nlm.nih.gov/40881... https://pmc.ncbi.nlm.nih.gov/articles... https://www.thefocalpoints.com/p/brea... The rate of first hospitalization for cancer of any site Unvaccinated group: 0.85% Vaccinated group (one or more doses): 1.15% N = 296,015 population Hospital admission with a cancer diagnosis, 3,124 (p less than 0.001). Vaccination with at least one dose Colon-rectal cancer HR: 1.34 Breast cancer HR: 1.54 Bladder cancer HR: 1.62 After three or more vaccine doses Breast cancer HR: 1.36 Bladder cancer HR: 1.43 All significant After one dose (180 days after) Rate of first hospital admissions for cancers All cancers: up 23% significant Colorectal: up 34% significant Lung: down = 10% Breast: up 54% significant Uterine: up = 75% Ovarian: up = 65% Prostate: up = 1% Bladder: up 62% significant Thyroid: up =58% Haematological: up = 33% After three dose (180 days after administration of third dose) All cancers: up = 9% Colorectal: up = 14% Lung: down = 5% Breast: up=36% significant Uterine: up = 20% Ovarian: up = 86% Prostate: down = 3% Bladder: up=43% significant Thyroid: down = 3% Haematological: up = 5% More about the study Population-wide cohort analysis Evaluating the risk of all-cause death and cancer hospitalization by SARS-CoV-2 immunization status. National Health System official data, entire population, Pescara province, Italy Followed from June 2021 (six months after the first vaccination) to December 2023. 296,015 residents aged ≥11 years Hospital admission with a cancer diagnosis, 3,124 16.6% were unvaccinated 83.3% received ≥1 dose 62.2% ≥3 doses. Compared with the unvaccinated, those receiving ≥1 dose showed a significantly lower likelihood of all-cause death Cancer hospitalization was significant only among the subjects with no previous SARS-CoV-2 infection Some cancer risks went down after 1 year (relative to 180 days) (But breast, ovarian and bladder went up at one year relative to 180 days after 1 vaccine dose) Given that it was not possible to quantify the potential impact of the healthy vaccinee bias and unmeasured confounders, these findings are inevitably preliminary.  

Did you know that you have bacteria in your uterus? And that the types of bacteria there may impact whether you get pregnant or not. We talk all about this and many other things we are discovering are impacting fertility with our guest, Dr. Jaclyn Smeaton. She is a fellow naturopathic doctor who has focused much of her career on fertility, and we can't wait to share this informative episode with you.This episode is sponsored by:Redmond Salt >> Click here and use code HEALTHYMOTHER to save 15% on your order.Needed >> Click here and use code HEALTHYMOTHER to save 20% off your first order.Lumebox >> Click here and use code HEALTHYASAMOTHER for $260 off.Resources From This Episode:DUTCH testWatch the video episode on YouTube HERE!Stay Connected With Us:Healthy As A Mother: www.healthyasamother.comInstagram: @healthyasamotherpodcastDr. Leah: www.womanhoodwellness.comInstagram: @drleahgordonDr. Morgan: www.milkmedicine.comInstagram: @morganmacdermottRedmond LifeRedmond Life | Real Salt & Clay | Re-Lyte Electrolyte Hydration PowderYour one stop shop for all things Redmond. We carry pure, natural sea salt and bentonite clay mined from an ancient salt deposit right here in Redmond, Utah. From Real Salt to Re-Lyte Hydration electrolyte mix, try one of our US-mined products today.needed.Radically better nutrition for fertility, pregnancy, and postpartum.Prenatal vitamins leave most women depleted, so we redesigned the Prenatal Multi from the ground-up, and paired it with the Omega-3 (DHA and EPA), Collagen Protein, and Pre/Probiotic that mamas need. Take them before, during, and after pregnancy (and while breastfeeding) for optimal prenatal and postpartum nourishment.LumeboxLUMEBOX discount linkDutch TestPrecision Analytical (DUTCH TEST) - Test Kits, Providers & PatientsExplore DUTCH Test kits for comprehensive hormone testing, provider resources, patient support, and educational webinars. Contact us for more information.

In this episode of The Dairy Nutrition Blackbelt Podcast, Dr. Doug Waterman from Virtus Nutrition explains how management and nutritional strategies influence uterine involution and overall reproductive success in dairy cows. He discusses key factors like inflammation control, calving management, and omega-3 supplementation to improve cow health and future productivity. Listen now on all major platforms!"Uterine involution typically occurs within 20 to 50 days, but various stressors can significantly extend this recovery period."Meet the guest: Dr. Doug Waterman, Eastern Technical Sales Director at Virtus Nutrition, LLC, brings over 30 years of experience in the dairy industry, specializing in nutrition and supporting field nutritionists. His expertise spans reproductive health, inflammation control, and optimizing cow performance through targeted nutritional strategies.Liked this one? Don't stop now — Here's what we think you'll love!Renee Smith: Omega-3 Benefits in Dairy Dr. Daniel Rico: Vitamin D3 & Omega-3 Effects on Cattle Stress - Part 1Dr. Daniel Rico: Omega-3 & Vitamin D3 for Cow Health - Part 2  What will you learn: (00:00) Highlight(01:39) Introduction(02:37) Uterine involution basics(04:19) Calving difficulties impact(05:09) Key management strategies(07:07) Inflammation and reproduction(08:47) Omega-3 research findings(11:02) Closing thoughtsThe Dairy Nutrition Blackbelt Podcast is trusted and supported by the innovative companies: Virtus Nutrition* Kemin* Afimilk* Adisseo* Priority IAC- Zinpro

In this episode, we dive into the latest research and practical strategies for managing uterine disease in dairy herds. This discussion highlights both challenges and opportunities in managing one of the most common issues affecting dairy cows.

Once a Cesarean , always a Cesarean - you must have also heard this common notion. Fortunately, this is far from truth. Yet , So many women feel cornered and helpless when they become pregnant again, like the decision has already been made for them. In this episode, we're getting real about that phrase and why it's not the whole story.We get into the  actual evidence and physiology behind uterine rupture — what it is, how likely it is (with facts, not fear), and why it's also something that can happen to first-time moms. We'll also share the real advantages of choosing a VBAC over a repeat C-section, and why VBAC is worth considering — even when the system in India is yet reluctant to support itAnd if you're feeling confused, overwhelmed, or unsure what to believe — we've got you. We'll walk you through what actually makes sense and share our best advice for giving VBAC your best shot.Plus, we're giving away a Free Childbirth Guide to support you on your journey — because informed choices start with empowered information. Tune in now, share with a friend, and remember — this is your body, your baby, and your birth. You do have a voice and a Choice!Support the showSign up for Childbirth Preparation Programs! visit https://birthagni.com/services#childbirth-preparation-programs https://birthagni.com/copy-of-services#breastfeeding-preparation-program This episode is supported and made possible by podcast recording and hosting tool Zencastr, it is impeccably made! Use my link : https://zen.ai/vxmuJUgYKKGTF3JuTuFQ0g to sign up and record flawless remote podcast , USE my code : BIRTHAGNI Support the show:https://birthagni.com/birthagnipodcast#donate If you like what you hear, leave us a rating on Spotify app and answer the question at each episode! a review on Apple podcasts. Share on Whatsapp/Insta/FB Share on Instagram and tag us @divyakapoorvox ...

JCO PO author Dr. Alison M. Schram at Memorial Sloan Kettering Cancer Center shares insights into her JCO PO article, “Retrospective Analysis of BRCA-Altered Uterine Sarcoma Treated With Poly(ADP-ribose) Polymerase Inhibitors.” Host Dr. Rafeh Naqash and Dr. Schram discuss relevant genomic and clinical features of patients with BRCA-altered uterine sarcoma and the efficacy of PARPis in this population. TRANSCRIPT Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, podcast editor for JCO Precision Oncology and associate professor at the OU Health Stephenson Cancer Center. Today, we are excited to be joined by Dr. Alison Schram, Associate Attending Physician and Section Head of Oral Therapeutics with Early Drug Development and Gynecologic Medical Oncology Services at the Memorial Sloan Kettering Cancer Center, and the senior author of the JCO Precision Oncology article titled, "Retrospective Analysis of BRCA-Altered Uterine Sarcoma Treated With Poly(ADP-ribose) Polymerase Inhibitors." At the time of this recording, our guest's disclosures will be linked in the transcript. Dr. Schram, thank you for joining us today. I am excited to be discussing this very interesting, unique topic based on what you published in JCO PO. Dr. Alison Schram: Thank you for having me. Dr. Rafeh Naqash: What we like to do for these podcasts is try to make them scientifically interesting but at the same time, keep them at a level where our trainees and other community oncology professionals understand the implications of what you've published. So I'd like to start by asking you, what is leiomyosarcoma for those of us who don't necessarily know a lot about leiomyosarcoma, and what are some of the treatment options for these uterine sarcomas? Dr. Alison Schram: Uterine leiomyosarcoma is a rare subtype of uterine cancer, and it represents about 1% of all female cancers in the reproductive tract. This is a rare malignancy that arises from the myometrial lining of the uterus, and it is generally pretty aggressive. In terms of the standard therapy, the standard therapy for uterine leiomyosarcoma includes chemotherapy, generally combination chemotherapy, but despite a few regimens that tend to be effective, the duration of effectiveness is relatively short-lived, and patients with advanced uterine leiomyosarcoma eventually progress and require additional therapy. I will say that localized uterine leiomyosarcoma can be treated with surgery as well. Dr. Rafeh Naqash: Thank you for that description. Now, there are two aspects to what you published. One is the sarcoma aspect, the leiomyosarcoma, and the second is the BRCA mutation. Since we are a precision medicine journal, although we've discussed BRCA a couple of times before, but again, for the sake of our listeners, could you highlight some of the aspects of BRCA and PARP sensitivity for us? Dr. Alison Schram: Yes. So BRCA is a gene that's important for DNA repair, and BRCA mutations can be either inherited as a germline mutation, so one of your parents likely had a BRCA mutation and you inherited one copy. In patients who have an inherited BRCA mutation, the normal cells tend to have one abnormal copy of BRCA, but if a second copy in the cell becomes altered, then that develops into cancer. And so these patients are at increased risk of developing cancers. Specifically, they are at an increased risk of developing ovarian cancer, breast cancer, prostate cancer, pancreatic cancer, and a few others. These cancers are considered BRCA-associated tumors. Alternatively, some patients, more rarely, can develop BRCA-altered cancers completely sporadically. So it's a mutation that happens in the tumor itself, and that can lead to impaired DNA repair and promote cancer progression. And those patients are not, they don't have any inherited risk, but just a random event caused a BRCA mutation in the tumor. The reason this is important is because, in addition to it being potentially important for family members, there are certain treatments that are more effective in BRCA-altered cancers. And the main example is PARP inhibitors, which are small molecule inhibitors that inhibit the PARP enzyme, and there is what we call synthetic lethality. So PARP is important for DNA repair, for single-stranded DNA repair, BRCA is important for double-stranded DNA repair, and in a patient that has a cancer that has a BRCA mutation, that cancer becomes more reliant on single-stranded DNA repair. And if you inhibit it with a PARP inhibitor, the cancer cells are unable to repair DNA, and the cells die. So we call that synthetic lethality. PARP inhibitors are FDA approved in several diseases, predominantly the BRCA-associated diseases I mentioned: breast cancer, ovarian cancer, pancreatic cancer, and prostate cancer. Dr. Rafeh Naqash: That was very beautifully explained. Honestly, I've heard many people explain BRCA before, but you kind of put it in a very simple, easy to understand format. You mentioned this earlier describing germline or hereditary BRCA and somatic BRCA. And from what I gather, you had a predominant population of somatic BRCA, but a couple of germline BRCA as well in your patient population, which we'll go into details as we understand the study. You mentioned the second hit on the germline BRCA that is required for the other copy of the gene to be altered. In your clinical experience, have you seen outside of the study that you published, a difference in the sensitivity of PARP for germline BRCA versus a somatic BRCA that has loss of both alleles? Dr. Alison Schram: So we will get into what's unique about uterine sarcomas in just a minute. In uterine sarcomas, what we have found is that the BRCA mutations tend to be somatic and not germline, as you mentioned. That is in contrast to the other diseases we mentioned, where the vast majority of these tumors are in patients that have germline BRCA alterations. So one thing that's really unique about the uterine sarcoma population and our paper, I believe, is that it is demonstrating an indication for PARP inhibitors in a population that is not characterized by germline BRCA alterations, but truly these by somatic BRCA alterations. If you look at the diseases that PARP inhibitors are validated to be effective in, including the, you know, the ones I mentioned, the BRCA-associated tumors, there's some data in specific context that suggests that perhaps germline alterations are more sensitive to PARP inhibitors, but that's not universal, and it's really tricky to do because the genetic testing that we have doesn't always tell you if you have two hits or just one hit. So you need more complex genetic analysis to truly understand if there is what we call a biallelic loss. And sometimes it's not a second mutation in BRCA. Sometimes it's silencing of the gene by hypermethylation or epigenetics. Some of our clinical trials are now incorporating this data collection to really understand if biallelic loss that we can identify on more complex genetic testing predicts for better outcomes. And we think it's probably true that the patients that have biallelic loss, whether it be germline or somatic biallelic loss, are more likely to benefit from these treatments. That still needs to be tested in a larger cohort of patients prospectively. Dr. Rafeh Naqash: In your clinical experience, I know you predominantly use MSK-IMPACT, but maybe you've perhaps used some other NGS platforms, next-generation sequencing platforms. Have you noticed that these reports for BRCA alterations the report mentioning biallelic loss in certain cases? I personally don't- I do lung cancer, I do early-phase lung cancer as well, but I personally don't actually remember if I've seen a report that actually says biallelic loss. So after this podcast, I'm going to check some of those NGS reports and make sure I look at it. But have you seen it, or what would be a learning point for the listeners there? Dr. Alison Schram: Exactly. And they usually do not. They usually do not explicitly say, “This looks like biallelic loss,” on the reports. The exception would be if there's a deep deletion, then that implies both copies of the gene have been deleted, and so then you can assume that it's a biallelic loss. But oftentimes, when you see a frameshift alteration or a mutation, you don't know whether or not it's a biallelic loss. And you may be able to get some clues based on the variant allele frequencies, but due to things like whole genome duplication or more complex tumor genomics, it's not clear from these reports, and you really do need a more in-depth bioinformatic analysis to understand whether these are biallelic or not. So that is why I suggest that this really needs to be done in the context of a clinical trial, but there is definitely a theoretical rationale for reporting and treating patients with biallelic losses perhaps more so than someone who has a variant of unknown significance that seems to be monoallelic. The other tricky part, as I mentioned, is the fact that there could be epigenetic changes that silence the second copy, so that wouldn't be necessarily evident on a DNA report, and you would need more complex molecular testing to understand that as well. Dr. Rafeh Naqash: Sure. Now, going to your study, could you tell us what prompted the study, what was the patient population that you collected, and how did you go about this research study design? Dr. Alison Schram: It's actually a great story. I was the principal investigator for a clinical trial enrolling patients regardless of their tumor type to a combination of a PARP inhibitor and immunotherapy. And this was a large clinical trial that was being done as a basket study, as I mentioned, for patients that have either germline or somatic alterations with advanced solid tumors that had progressed on standard therapy. And the hypothesis was that the combination of a PARP inhibitor and immunotherapy would be synergistic and that there would be increased efficacy compared to either agent alone and that patients who had BRCA alterations were a sensitive population to test because of their inherent sensitivity to PARP inhibitors and perhaps their increased neoantigen burden from having loss of DNA repair. So this large study, it's been published, really did show that there was efficacy across several tumor types, but it didn't seem to clearly demonstrate synergy between the immunotherapy and the PARP inhibitor as compared to what you might expect from a PARP inhibitor alone, and in addition to a couple of cases, perhaps attributable to the immunotherapy. So maybe additive rather than synergistic efficacy. However, what really struck me looking at the data was that there were three patients with uterine leiomyosarcoma with BRCA deletions who had the best responses of anyone on the study. So incredible, durable responses. One of my patients with a complete response that continues to not have any evidence of cancer eight years after the initiation of this regimen. And for those of us that treat uterine leiomyosarcoma, this is unheard of. These patients generally, as I mentioned, respond, if they do respond to chemotherapy, it's generally short-lived and the cancer progresses. And so a complete response nearly a decade later turns heads in this field. The other interesting thing was that these uterine leiomyosarcoma patients had somatic alterations rather than a germline alteration with a second hit, and the diseases that are best validated for being responsive to PARP inhibitors include the BRCA-associated diseases, the ones that you're at increased risk for if you have a germline BRCA mutation, including breast, pancreas, prostate, and ovarian. And so it was very interesting that this disease type that seemed to be uniquely sensitive to PARP inhibitors with immunotherapy was also different in that patients with uterine leiomyosarcoma don't tend to have a high frequency of BRCA alterations, and in patients that are born with a BRCA alteration, there doesn't seem to be a clearly increased risk of uterine sarcomas. So this population really jumped out as a uniquely sensitive population that differed from the prior indications for PARP inhibitors. Given this patient and these couple of patients that we observed on the combination, in addition to some other case reports and case series that had started to come out in small numbers, we wanted to look back at our large cohort of patients at Memorial Sloan Kettering to see if we could really get a better sense of the numbers. How many patients at Sloan Kettering with uterine sarcomas have BRCA alterations? Are they generally somatic or germline? Are there unique features about these patients in terms of their clinical characteristics? How many of them have received PARP inhibitors, and if so, is this just luck that these three patients did so well, or is this really a good treatment option for patients with BRCA-altered uterine sarcomas? And so we did this retrospective analysis identifying the patients at Sloan Kettering who met these criteria. So in total, we found 35 patients with uterine sarcomas harboring BRCA alterations, and the majority were leiomyosarcoma, about 86% of them had leiomyosarcoma, which is interesting because there are other uterine sarcomas, but it does seem like BRCA alterations tend to be more often in the leiomyosarcomas. And 13 of these patients with uterine leiomyosarcoma were treated with PARP inhibitors in the recurrent or metastatic setting with about half of those patients having an overall response, so that's a significant tumor shrinkage that sustained, and a clinical benefit rate of 62%. And if we look at the patients that had these BRCA2 deep deletions, which was the patient I had that had this amazing response, the overall response rate jumped to 60% and the clinical benefit rate to 80%. And we defined clinical benefit rate as having maintained on the PARP inhibitor without evidence of progression at six months. So this is really impressive for patients with a difficult to treat disease. And we couldn't do a randomized controlled trial comparing it to chemotherapy, but looking retrospectively at outcomes on chemotherapy studies, this was very favorable, particularly because many of these patients were heavily pretreated. So to get a sense of, you know, how this might compare to chemotherapy, we tried to use patients as their own internal controls, and we looked at how long patients were maintained on the PARP inhibitor as compared to how long they were on the treatment just prior. And we used a ratio of 1.3 to say if they were on the PARP inhibitor for 1.3 times what their previous treatment was or longer, that is pretty clearly better, more of a benefit from that regimen. And the majority of patients did meet that bar. So 58% had a PFS ratio greater than 1.3, and the average PFS ratio was 1.9, suggesting, you know, you would expect the the later lines of therapy to actually not work as well, but this suggests that it's actually working better than the immediately prior line of therapy, to me, suggesting that this is truly a good treatment option for these patients. Dr. Rafeh Naqash: Very interesting. And you mentioned that individuals with tumors having deep deletions were probably more responsive. How did you figure out that there was biallelic loss or deep deletions? Was that part of an extended analysis that was done subsequently? Dr. Alison Schram: So the deletions reported on our report, if it's a biallelic deletion, that is the one biallelic molecular alteration that would be reported. So those are, by definition, biallelic, and I think that that may be one of the reasons that's a good biomarker. But also, what's interesting is that if you have both copies deleted of BRCA, you can't develop reversion mutations. So one of the the known mechanisms of resistance to PARP inhibitors in patients who have BRCA alterations are something called a reversion mutation where, if you have a frameshift alteration, for example, in BRCA that makes BRCA protein nonfunctional, you can develop a second mutation that actually puts the DNA back in frame, and a functional protein is now made. And so a mechanism of resistance to PARP inhibitors is actually reverting BRCA to a wild-type protein, and then BRCA's synthetic lethality no longer makes sense and is no longer effective. But if you've deleted both copies of BRCA, you don't have the ability to restore the function, and you can't develop reversion mutations. And that's perhaps why, you know, my patient and others have had these prolonged responses to PARP inhibitors because you don't have the same ability to develop that mechanism of resistance. Dr. Rafeh Naqash: I remember thinking a year and a half back, I had an individual with prostate cancer and with BRCA2, and using liquid biopsy, I had a reversion mutation that we caught. In your practice, have you seen the utility of doing the serial liquid biopsies in these individuals to catch these reversion mutations? Dr. Alison Schram: Yes, absolutely. And in patients that have the ability to develop a reversion mutation, serial cell-free DNA can catch it, but the caveat is that it doesn't always. So if you see an acquired reversion mutation in cell-free DNA, that can be helpful, particularly if you're planning on putting the patient on another line of therapy that might require a dysfunctional BRCA. So if you're putting them on a clinical trial with a PARP combination and the rationale is that they're sensitive because they don't have a functional BRCA, you would want to know if they developed a reversion mutation, and serial cell-free DNA can definitely identify these reversion mutations. Some of the major clinical trials in ovarian cancer have done serial cell-free DNA and have demonstrated the utility of that approach. The caveat is that some of these reversion mutations are not readily caught on cell-free DNA because they're more complex reversion mutations, or they're not, the part of the gene that develops the reversion mutation is not tiled on the panel. And so it doesn't always catch the reversion mutations. Also, depends on the cell-free DNA shedding, depends on the tumor volume and other factors. And we published a related paper of a patient, it was a really interesting case of a patient with prostate cancer who was on a PARP inhibitor and developed what appeared to be a single reversion mutation on one sample, had negative cell-free DNA, single reversion mutation in a tissue biopsy, and then developed disease progression. And we did an autopsy, and the patient kindly consented to an autopsy, and at the time of autopsy, there were 10 unique reversion mutations identified across 11 metastases. So almost each metastasis had a unique reversion mutation, and only one of them had been seen premortem on a tissue biopsy and not on a cell-free DNA. But that autopsy really drove home to me how much we're missing by doing clinical testing in real time and we really don't know the entire genomic complexity of our patients by doing single samples. And theoretically, cell-free DNA can catch DNA from all the metastases, so you might think that that would be a solution, and it definitely can catch reversion mutations that are not seen in a single biopsy, but you really need to do it all. I mean, you need to do the tissue biopsy sampling, you need to do cell-free DNA, and probably one cell-free DNA test is not enough. Dr. Rafeh Naqash: Thank you, again, for that very nice explanation. Now, one quick provocative question. I remember when I was training, the lab that I used to work in, they used to do a lot of phosphorylation markers for DNA damage response, like phospho NBS, RAD51. Have you seen anything of that sort on these biallelic BRCA mutations where tumors are responding, but they also have a very high signature on the phosphorylation side, and it may or may not necessarily correspond to HRD signatures, but have you noticed or done any of that analysis? Dr. Alison Schram: I think that it would be great to do that analysis. And some of the work we're doing now is actually trying to dig a little bit deeper in our cohort of patients to understand are these HRD-positive tumors? Does HRD positivity correlate with response to BRCA alterations? In terms of the functional assays, I would love to be able to do a functional assay in these samples. One of the challenges is that this was a retrospective study and many of the patients were previously treated as standard of care or off-label with these agents, and so we didn't have prospective tissue collection, and so we're really limited by the tissue that was collected as part of standard of care and the consent forms that the patient signed that allow us to do genomic and molecular testing on their samples. So, I think that is hopefully future work that we will do and others will do. Dr. Rafeh Naqash: Sure. Shifting gears to your career trajectory, I'd like to spend a couple of minutes there before we end the podcast. So Dr. Schram, you've obviously been a trailblazer in this space of drug development, early-phase trials. Can you give us a brief synopsis of your journey and how you've successfully done what you're doing and what are some of the things that drive you? Dr. Alison Schram: Well, thank you for saying that. I don't know if that's true, but I'll take the bait. I've been interested in oncology since college and was always very interested in not only the science of oncology but of course, treating patients. And in medical school, I did basic science research in a laboratory and it was very inspiring and made me want to do research in oncology in addition to clinical care. When I became an oncology fellow, I was presented with a very difficult question, which is, “Do you want to be a lab PI and be in the lab, or do you want to do clinical care and clinical research?” And I couldn't choose. I found a mentor who thankfully really had this amazing vision of combining the two and doing very early drug development, taking the data that was being generated by labs and translating it into patients at the earliest stage. So, you know, phase one drug development in molecularly targeted therapies. And so I became very interested as a fellow in early drug development and this ability to translate brand new molecular insights into novel drugs. And I joined the- at Sloan Kettering, there was the Early Drug Development, it was actually a clinic, it was called something different, and it was very fortuitous. My last year of fellowship, the clinic became its own service with the ability to hire staff at Sloan Kettering, and I was the first ever hire to our Early Drug Development Service. And that really inspired me to try and bring these drugs to patients and to really translate the amazing molecular insights that my colleagues here at Sloan Kettering are discovering, and you know, of course, at other institutions and in pharma. And you know, there 's been an amazing revolution in in drug development over the last several years, and I feel very grateful that I've been here for it. You know, I've been able to take the brilliant insights from my colleagues and put these drugs in patients, and I have the amazing privilege of watching patients in many cases that benefit from these treatments. And so I do mostly phase one drug development and molecularly targeted therapies, and truthfully, I am just very fortunate to be around such brilliant people and to have both patients and labs trust me to be able to deliver these new drugs to patients and hopefully develop better drugs that move forward through FDA approval and reach patients across the country. Dr. Rafeh Naqash: Thank you so much. That was very nicely put. And hopefully our trainees and junior faculty find that useful based on their own career trajectories. Thank you, Dr. Schram, for joining us today. Hopefully, we'll see more of your subsequent work in JCO PO. Thank you for giving us all these insights today. Dr. Alison Schram: Thank you for having me. Dr. Rafeh Naqash: Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Dr. Alison Schram Disclosures Consulting or Advisory Role Company: Mersana, Merus NV, Relay Therapeutics, Schrodinger, PMV Pharma ,Blueprint Medicines, Flagship Pioneering, Redona Therapeutics, Repare Therapeutics, Endeavor BioMedicines Research Funding Company: Recipient: Your Institution  Merus, Kura, Surface Oncology, AstraZeneca, Lilly, Pfizer , Black Diamond Therapeutics, BeiGene, Relay Therapeutics, Revolution Medicines,  Repare Therapeutics, PMV Pharma, Elevation Oncology, Boehringer Ingelheim Travel, Accommodations, Expenses Company: PMV Pharma 

Adenomyosis affects around 10% of women in the UK and is most prevalent in women aged 40-50, particularly those who have had pregnancies. It is frequently found alongside endometriosis and uterine fibroids and can cause heavy, painful, or irregular periods. In this podcast Dr Thomas Round talks to Dr Sharon Dixon, a GP in Oxford with a background in endometriosis research and supporting GPs with female patients suffering with endometriosis and their periods, about the symptoms, initial assessment, diagnosis and treatment of adenomyosis as well as its possible causes and overlap with endometriosis. British Journal of General Practice article on Uterine adenomyosis: an update for GPs RCGP EKU Programme module on Endometriosis: diagnosis and management RCGP eLearning course on Endometriosis RCGP eLearning course on Heavy Menstrual Bleeding

From unbearable pain to feeling no symptoms at all, women with uterine fibroids can have vastly different experiences. While these growths affect a large percentage of women, health advocates say they too often go undiscussed. Ali Rogin speaks with Sateria Venable, a patient advocate and CEO of The Fibroid Foundation, to learn more. PBS News is supported by - https://www.pbs.org/newshour/about/funders

Dr. John C. Lipman and Dr. Yvette White join the Bullpen for a special interview about Uterine fibroids, a condition that disproportionately affects Black women, and groundbreaking non-surgical treatment to change lives.   Host: Sharon Reed (@SharonReedLive) Bullpen guests: Dr. John C. Lipman and Dr. Yvette White *** SUBSCRIBE on ⁠⁠⁠⁠⁠⁠YOUTUBE⁠⁠⁠⁠⁠⁠  ☞ ⁠⁠⁠⁠⁠⁠ https://www.youtube.com/IndisputableTYT⁠⁠⁠⁠⁠⁠ FOLLOW US ON: ⁠⁠⁠⁠⁠⁠FACEBOOK⁠⁠⁠⁠⁠⁠  ☞ ⁠⁠⁠⁠⁠⁠  https://www.facebook.com/IndisputableTYT⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠TWITTER⁠⁠⁠⁠⁠⁠  ☞     ⁠⁠⁠⁠⁠⁠  https://www.twitter.com/IndisputableTYT⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠INSTAGRAM⁠⁠⁠⁠⁠⁠ ☞ ⁠⁠⁠⁠⁠⁠ https://www.instagram.com/IndisputableTYT⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

From unbearable pain to feeling no symptoms at all, women with uterine fibroids can have vastly different experiences. While these growths affect a large percentage of women, health advocates say they too often go undiscussed. Ali Rogin speaks with Sateria Venable, a patient advocate and CEO of The Fibroid Foundation, to learn more. PBS News is supported by - https://www.pbs.org/newshour/about/funders

Bryan Kohberger pleaded guilty to murdering four University of Idaho students. During sentencing, survivors and victims' families faced him in court, including a surviving roommate who delivered powerful testimony. In an interview with Major Garrett, House Speaker Mike Johnson expressed concern over the Justice Department's handling of the Epstein case and called for full transparency and accountability. You can see more of Major Garrett's interview, along with his sharp analysis, on "The Takeout with Major Garrett," weeknights at 5 p.m. ET on CBS News 24/7. Dr. Salvador Plasencia admitted to distributing ketamine to actor Matthew Perry before his 2023 overdose. He is the fourth person to plead guilty in the case and faces up to 40 years in prison. Uterine fibroids affect up to 80% of women by age 50 and can cause painful, life-altering symptoms. Dr. Tara Shirazian joins "CBS Mornings" to discuss how diet, exercise and awareness may help. A new Charles Schwab survey finds many Americans believe they need over $800,000 to be financially comfortable, yet a third have no financial plan. CBS News business analyst Jill Schlesinger joins to explain what to do. After retiring, Erik and Karin Vonk combined their love of farming and spirits to create Richland Rum. Nearly 25 years later, their Georgia-made rum is earning high praise from critics across the globe. To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

Tell us your thoughts on this episode!Dr. Natalie Godbee, gynecologic oncologist at City of Hope in Atlanta, Georgia, talks with Dr. Leah Sherman in a wide-ranging interview on gynecologic cancers. The conversation covers the pros and cons of the HPV vaccine, the symptoms and risk factors for ovarian, endometrial, and cervical cancers, and the benefits of integrative medicine in cancer care. Listeners will gain valuable information on early detection, treatment options, and preventive measures for these complex cancers.Dr. Godbee's bio and links to her social mediaHuman Papillomavirus (HPV) review by the National Cancer InstituteConcerns about the safety of the HPV vaccineDoes the HPV vaccine increase promiscuity in teenagers?Dramatic reductions in pre-cancer of the cervixSupport the showOur website: https://www.thecancerpod.com Become a member of The Cancer Pod Community! Gain access to live events, exclusive content, and so much more. Join us today and be part of the journey!Email us: thecancerpod@gmail.com Follow @TheCancerPod on: Instagram Bluesky Facebook LinkedIn YouTube THANK YOU for listening!

In today's episode we're hearing about Jessi's two vastly different births. Her first - an induction that sent her into uterine hyperstimulation and was heavily influenced by covid restrictions. Her second - an empowering waterbirth in her living room with continuity of care from an amazing homebirth team. She shares how her first birth influenced the choices she made around her second, what a physiological labour was like in comparison to an induced one and how her postpartum healing differed after the two.   Jessi's IG: https://www.instagram.com/tokissthecook/ My website: www.serenalouth.com My IG: https://www.instagram.com/serenalouth/

The incidence of early onset colorectal cancer (EOCRC) has been rising prompting the change in change in screening guidelines to 45 years of age for average risk patients. Join us for an in-depth discussion with guest speakers Dr. Andrea Cercek and Dr. Nancy You, where we provide a comprehensive look at the growing challenge of EOCRC. Hosts: - Dr. Janet Alvarez - General Surgery Resident at New York Medical College/Metropolitan Hospital Center - Dr. Wini Zambare – General Surgery Resident at Weill Cornell Medical Center/New York Presbyterian - Dr. Phil Bauer, Graduating Colorectal Surgical Oncology Fellow at Memorial Sloan Kettering Cancer Center  - Dr. J. Joshua Smith MD, PhD, Chair, Department of Colon and Rectal Surgery at MD Anderson Cancer Center - Dr. Andrea Cercek - Gastrointestinal Medical Oncologist at Memorial Sloan Kettering Cancer Center - Dr. Y. Nancy You, MD MHSc - Professor, Department of Colon and Rectal Surgery at MD Anderson Cancer Center Learning objectives:  - Describe trends in incidence of colorectal cancer, with emphasis on the rise of EOCRC. - Identify age groups and demographics most affected by EOCRC. - Summarize USPSTF recommendations for colorectal cancer screening. - Distinguish between screening methods (e.g., colonoscopy, FIT-DNA) and their sensitivity. - Understand treatment approaches for colon and rectal cancer (CRC) - Understand the role of mismatch repair (MMR) status in guiding treatment. - Outline the importance of genetic counseling and testing in young patients. - Discuss racial, ethnic, and socioeconomic disparities in CRC incidence and outcomes. - Describe the impact of cancer treatment on fertility and sexual health. -  Review fertility preservation options. - Identify the value of integrated care teams for young CRC patients. References: 1.         Siegel, R. L. et al. Colorectal Cancer Incidence Patterns in the United States, 1974–2013. JNCI J. Natl. Cancer Inst. 109, djw322 (2017). https://pubmed.ncbi.nlm.nih.gov/28376186/ 2.         Abboud, Y. et al. Rising Incidence and Mortality of Early-Onset Colorectal Cancer in Young Cohorts Associated with Delayed Diagnosis. Cancers 17, 1500 (2025). https://pubmed.ncbi.nlm.nih.gov/40361427/ 3.         Phang, R. et al. Is the Incidence of Early-Onset Adenocarcinomas in Aotearoa New Zealand Increasing? Asia Pac. J. Clin. Oncol.https://pubmed.ncbi.nlm.nih.gov/40384533/ 4.         Vitaloni, M. et al. Clinical challenges and patient experiences in early-onset colorectal cancer: insights from seven European countries. BMC Gastroenterol. 25, 378 (2025). https://pubmed.ncbi.nlm.nih.gov/40375142/ 5.         Siegel, R. L. et al. Global patterns and trends in colorectal cancer incidence in young adults. (2019) doi:10.1136/gutjnl-2019-319511. https://pubmed.ncbi.nlm.nih.gov/31488504/ 6.         Cercek, A. et al. A Comprehensive Comparison of Early-Onset and Average-Onset Colorectal Cancers. J. Natl. Cancer Inst. 113, 1683–1692 (2021). https://pubmed.ncbi.nlm.nih.gov/34405229/ 7.         Zheng, X. et al. Comprehensive Assessment of Diet Quality and Risk of Precursors of Early-Onset Colorectal Cancer. JNCI J. Natl. Cancer Inst. 113, 543–552 (2021). https://pubmed.ncbi.nlm.nih.gov/33136160/ 8.         Standl, E. & Schnell, O. Increased Risk of Cancer—An Integral Component of the Cardio–Renal–Metabolic Disease Cluster and Its Management. Cells 14, 564 (2025). https://pubmed.ncbi.nlm.nih.gov/40277890/ 9.         Muller, C., Ihionkhan, E., Stoffel, E. M. & Kupfer, S. S. Disparities in Early-Onset Colorectal Cancer. Cells 10, 1018 (2021). https://pubmed.ncbi.nlm.nih.gov/33925893/ 10.       US Preventive Services Task Force. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 325, 1965–1977 (2021). https://pubmed.ncbi.nlm.nih.gov/34003218/ 11.       Fwelo, P. et al. Differential Colorectal Cancer Mortality Across Racial and Ethnic Groups: Impact of Socioeconomic Status, Clinicopathology, and Treatment-Related Factors. Cancer Med. 14, e70612 (2025). https://pubmed.ncbi.nlm.nih.gov/40040375/ 12.       Lansdorp-Vogelaar, I. et al. Contribution of Screening and Survival Differences to Racial Disparities in Colorectal Cancer Rates. Cancer Epidemiol. Biomarkers Prev. 21, 728–736 (2012). https://pubmed.ncbi.nlm.nih.gov/22514249/ 13.       Ko, T. M. et al. Low neighborhood socioeconomic status is associated with poor outcomes in young adults with colorectal cancer. Surgery 176, 626–632 (2024). https://pubmed.ncbi.nlm.nih.gov/38972769/ 14.       Siegel, R. L., Wagle, N. S., Cercek, A., Smith, R. A. & Jemal, A. Colorectal cancer statistics, 2023. CA. Cancer J. Clin. 73, 233–254 (2023). https://pubmed.ncbi.nlm.nih.gov/36856579/ 15.       Jain, S., Maque, J., Galoosian, A., Osuna-Garcia, A. & May, F. P. Optimal Strategies for Colorectal Cancer Screening. Curr. Treat. Options Oncol. 23, 474–493 (2022). https://pubmed.ncbi.nlm.nih.gov/35316477/ 16.       Zauber, A. G. The Impact of Screening on Colorectal Cancer Mortality and Incidence: Has It Really Made a Difference? Dig. Dis. Sci. 60, 681–691 (2015). https://pubmed.ncbi.nlm.nih.gov/25740556/ 17.       Edwards, B. K. et al. Annual report to the nation on the status of cancer, 1975-2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 116, 544–573 (2010). https://pubmed.ncbi.nlm.nih.gov/19998273/ 18.       Cercek, A. et al. Nonoperative Management of Mismatch Repair–Deficient Tumors. New England Journal of Medicine 392, 2297–2308 (2025). https://pubmed.ncbi.nlm.nih.gov/40293177/ 19.       Monge, C., Waldrup, B., Carranza, F. G. & Velazquez-Villarreal, E. Molecular Heterogeneity in Early-Onset Colorectal Cancer: Pathway-Specific Insights in High-Risk Populations. Cancers 17, 1325 (2025). https://pubmed.ncbi.nlm.nih.gov/40282501/ 20.       Monge, C., Waldrup, B., Carranza, F. G. & Velazquez-Villarreal, E. Ethnicity-Specific Molecular Alterations in MAPK and JAK/STAT Pathways in Early-Onset Colorectal Cancer. Cancers 17, 1093 (2025). https://pubmed.ncbi.nlm.nih.gov/40227607/ 21.       Benson, A. B. et al. Colon Cancer, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J. Natl. Compr. Cancer Netw. JNCCN 19, 329–359 (2021). https://pubmed.ncbi.nlm.nih.gov/33724754/ 22.       Christenson, E. S. et al. Nivolumab and Relatlimab for the treatment of patients with unresectable or metastatic mismatch repair proficient colorectal cancer. https://pubmed.ncbi.nlm.nih.gov/40388545/ 23.       Dasari, A. et al. Fruquintinib versus placebo in patients with refractory metastatic colorectal cancer (FRESCO-2): an international, multicentre, randomised, double-blind, phase 3 study. The Lancet 402, 41–53 (2023). https://pubmed.ncbi.nlm.nih.gov/37331369/ 24.       Strickler, J. H. et al. Tucatinib plus trastuzumab for chemotherapy-refractory, HER2-positive, RAS wild-type unresectable or metastatic colorectal cancer (MOUNTAINEER): a multicentre, open-label, phase 2 study. Lancet Oncol. 24, 496–508 (2023). https://pubmed.ncbi.nlm.nih.gov/37142372/ 25.       Sauer, R. et al. Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer. N. Engl. J. Med. 351, 1731–1740 (2004). https://pubmed.ncbi.nlm.nih.gov/15496622/ 26.       Cercek, A. et al. Adoption of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer. JAMA Oncol. 4, e180071 (2018). https://pubmed.ncbi.nlm.nih.gov/29566109/ 27.       Garcia-Aguilar, J. et al. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy. J. Clin. Oncol. 40, 2546–2556 (2022). https://pubmed.ncbi.nlm.nih.gov/35483010/ 28.       Schrag, D. et al. Preoperative Treatment of Locally Advanced Rectal Cancer. N. Engl. J. Med. 389, 322–334 (2023). https://pubmed.ncbi.nlm.nih.gov/37272534/ 29.       Kunkler, I. H., Williams, L. J., Jack, W. J. L., Cameron, D. A. & Dixon, J. M. Breast-Conserving Surgery with or without Irradiation in Early Breast Cancer. N. Engl. J. Med. 388, 585–594 (2023). https://pubmed.ncbi.nlm.nih.gov/36791159/ 30.       Jacobsen, R. L., Macpherson, C. F., Pflugeisen, B. M. & Johnson, R. H. Care Experience, by Site of Care, for Adolescents and Young Adults With Cancer. JCO Oncol. Pract. (2021) doi:10.1200/OP.20.00840. https://pubmed.ncbi.nlm.nih.gov/33566700/ 31.       Ruddy, K. J. et al. Prospective Study of Fertility Concerns and Preservation Strategies in Young Women With Breast Cancer. J. Clin. Oncol. (2014) doi:10.1200/JCO.2013.52.8877. https://pubmed.ncbi.nlm.nih.gov/24567428/ 32.       Su, H. I. et al. Fertility Preservation in People With Cancer: ASCO Guideline Update. J. Clin. Oncol. 43, 1488–1515 (2025). https://pubmed.ncbi.nlm.nih.gov/40106739/ 33.       Smith, K. L., Gracia, C., Sokalska, A. & Moore, H. Advances in Fertility Preservation for Young Women With Cancer. Am. Soc. Clin. Oncol. Educ. Book 27–37 (2018) doi:10.1200/EDBK_208301. https://pubmed.ncbi.nlm.nih.gov/30231357/ 34.       Blumenfeld, Z. How to Preserve Fertility in Young Women Exposed to Chemotherapy? The Role of GnRH Agonist Cotreatment in Addition to Cryopreservation of Embrya, Oocytes, or Ovaries. The Oncologist 12, 1044–1054 (2007). 35.       Bhagavath, B. The current and future state of surgery in reproductive endocrinology. Curr. Opin. Obstet. Gynecol. 34, 164 (2022). 36.       Ribeiro, R. et al. Uterine transposition: technique and a case report. Fertil. Steril. 108, 320-324.e1 (2017). 37.       Yazdani, A., Sweterlitsch, K. M., Kim, H., Flyckt, R. L. & Christianson, M. S. Surgical Innovations to Protect Fertility from Oncologic Pelvic Radiation Therapy: Ovarian Transposition and Uterine Fixation. J. Clin. Med. 13, 5577 (2024). 38.       Holowatyj, A. N., Eng, C. & Lewis, M. A. Incorporating Reproductive Health in the Clinical Management of Early-Onset Colorectal Cancer. JCO Oncol. Pract. 18, 169–172 (2022). ***Behind the Knife Colorectal Surgery Oral Board Audio Review: https://app.behindtheknife.org/course-details/colorectal-surgery-oral-board-audio-review Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Gugs Mhlungu speaks to Dr Neelan Pillay, Gynaecologist & Sub-specialist in Reproductive Medicine & Endocrine about fibroids; what they are, how they develop, why certain groups are more susceptible, and the latest advancements in treatment options for this widespread condition. 702 Weekend Breakfast with Gugs Mhlungu is broadcast on 702, a Johannesburg based talk radio station, on Saturdays and Sundays Gugs Mhlungu gets you ready for the weekend each Saturday and Sunday morning on 702. She is your weekend wake-up companion, with all you need to know for your weekend. The topics Gugs covers range from lifestyle, family, health, and fitness to books, motoring, cooking, culture, and what is happening on the weekend in 702land. Thank you for listening to a podcast from 702 Weekend Breakfast with Gugs Mhlungu. Listen live on Primedia+ on Saturdays and Sundays from 06:00 and 10:00 (SA Time) to Weekend Breakfast with Gugs Mhlungu broadcast on 702 https://buff.ly/gk3y0Kj For more from the show go to https://buff.ly/u3Sf7Zy or find all the catch-up podcasts here https://buff.ly/BIXS7AL Subscribe to the 702 daily and weekly newsletters https://buff.ly/v5mfetc Follow us on social media: 702 on Facebook: https://www.facebook.com/TalkRadio702 702 on TikTok: https://www.tiktok.com/@talkradio702 702 on Instagram: https://www.instagram.com/talkradio702/ 702 on X: https://x.com/Radio702 702 on YouTube: https://www.youtube.com/@radio702See omnystudio.com/listener for privacy information.

Season Five is here, and with it …comes scandal. Not for Josie, no way, but for a national show at KBXV. The time is ripe for a regime change…can the Lonely Hearts nab that precious drivetime slot? If Frank and Joanne want to impress those execs, they'll need more than a foolproof plan. They'll need a scheme-proof plan. Look alive, cuties, there are nefarious forces at work. Our favorite dynamic duo will need to outwit new foes while they catch up with old friends. We welcome back callers to ask, “Where Are They Now?” “How Have You Been?” and, “Is That Covered By Your NDA?” Check in with some of your favorites from episodes past and buckle up for the most surprising season yet. Josie's Lonely Hearts Club was created by Maximilian Clark and Rachel Music. Our cuties this week included Tiffany Cornwell, Tristin Miller, Laura Lee Walsh, Pat Harvey, Jessie Cannizzaro, and Ross Bryant. Produced by Simone Kisiel and Alexandra Grunberg. Executive Produced by Good Story Guild. Learn more about your ad choices. Visit megaphone.fm/adchoices

Season Five is here, and with it …comes scandal. Not for Josie, no way, but for a national show at KBXV. The time is ripe for a regime change…can the Lonely Hearts nab that precious drivetime slot? If Frank and Joanne want to impress those execs, they’ll need more than a foolproof plan. They’ll need a scheme-proof plan. Look alive, cuties, there are nefarious forces at work. Our favorite dynamic duo will need to outwit new foes while they catch up with old friends. We welcome back callers to ask, “Where Are They Now?” “How Have You Been?” and, “Is That Covered By Your NDA?” Check in with some of your favorites from episodes past and buckle up for the most surprising season yet.   Our cuties this week included Tiffany Cornwell, Tristin Miller, Laura Lee Walsh, Pat Harvey, Jessie Cannizzaro, and Ross Bryant.   JOSIE'S LONELY HEARTS CLUB is a semi-scripted audio drama set in New Mexico’s 2nd-best relationship call-in show created by Maximilian Clark and Rachel Music. Our story editor is Lauren Grace Thompson. Produced by Simone Kisiel and Alexandra Grunberg. Executive Produced by the Good Story Guild. Keep track of us on Instagram @goodstoryguild and join our Discord.  If you enjoyed the show, consider leaving a rating and/or review on your preferred podcast listening platform.   Support us by joining the Great Story Guild on Patreon!   Night night, cuties.

The ovarian artery branches from the aorta and supplies blood to the ovary. The uterine artery branches from the internal iliac artery and supplies blood to the uterus. But they link, and in doing so provide a collateral circulation route between the abdominal aorta and pelvic internal iliac artery. Let's discuss.

Have you heard of having a double uterus or double cervix?  The term is Uterine didelphys is a rare condition that happens when you grow two uteruses instead of one. This happens when you are a developing baby. You are born with it. ‌ While developing as babies, girls typically grow a uterus from two channels called the Mullerian ducts. Today's guest was born with a didelphys uterus after 3 laparoscopic surgeries it was confirmed she also had endometriosis, fibroids, and polycystic ovarian syndrome.  That did not stop today's guest from trying to conceive.  La-Anna Douglass began fertility treatments with drugs and still was unable to conceive.  She decided to try IVF and IVF did not work for her leaving her depressed and heartbroken.  In today's episode La-Anna shares her journey to conceiving a baby naturally after 8 years of trying to conceive and her current journey through secondary infertility. This podcast is for you to listen to to learn more about a double uterus and double cervix, but also if you have any underlying conditions like endometriosis, fibriods, and pcos. Become a Sisters in Loss Birth Bereavement, and Postpartum Doula Here Living Water Doula Services Book Recommendations and Links Below You can shop my Amazon Store for the Book Recommendations You can follow Sisters in Loss on Social Join our Black Moms in Loss Online Weekly Grief Support Group Join the Sisters in Loss Online Community Sisters in Loss TV Youtube Channel Sisters in Loss Instagram Sisters in Loss Facebook Sisters in Loss Twitter You can follow Erica on Social Erica's Website Erica's Instagram Erica's Facebook Erica's Twitter

Uterine incarceration in pregnancy, is a rare but troublesome complication. This occurs when a retroverted uterus becomes trapped in the pelvic cavity during pregnancy. This happens when the uterus fails to move forward as it grows, becoming stuck between the sacral promontory and pubicsymphysis. It's more common in women with prior pelvic issues or uterine anomalies. Urinary retention is the most common symptom that occurs because of elongation of the urethra by displacement of the cervix, loss of the urethro-vesical angle, and mechanical compression of the bladder neck. It is estimated to occur in 1 in 3000 patients. How do we release an incarcerated uterus? Is laparoscopy an option? And how can an ultrasound probe help (April 2025publication)? Listen in for details.

Moderator: BobbieJean Sweitzer, M.D. Participants: Jessica R Ansari, M.D., M.S. and Craig M. Palmer, M.D. Articles Discussed: Uterine Tone Numeric Rating Score as an Early Indicator of Major Postpartum Hemorrhage During Cesarean Delivery: A Prospective Observational Study Predicting the Unpredictable: A New Approach to Predict Postpartum Hemorrhage from Uterine Atony Transcript

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Ayman Al-Hendy, MD, PhD, FRCSC, FACOG, CCRP Despite longstanding reliance on surgery, recent advancements have reshaped our approach to uterine fibroids. However, common myths and misconceptions have limited the adoption of newer therapies, leaving many patients unaware of their available options. Join Dr. Charles Turck and Dr. Ayman Al-Hendy as they explain shifting treatment paradigms and patient education strategies in uterine fibroid care. Dr. Al-Hendy is a Professor of Obstetrics and Gynecology and the Director of Translational Research at the University of Chicago Pritzker School of Medicine.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Ayman Al-Hendy, MD, PhD, FRCSC, FACOG, CCRP Despite longstanding reliance on surgery, recent advancements have reshaped our approach to uterine fibroids. However, common myths and misconceptions have limited the adoption of newer therapies, leaving many patients unaware of their available options. Join Dr. Charles Turck and Dr. Ayman Al-Hendy as they explain shifting treatment paradigms and patient education strategies in uterine fibroid care. Dr. Al-Hendy is a Professor of Obstetrics and Gynecology and the Director of Translational Research at the University of Chicago Pritzker School of Medicine.

It's Prostate Week in Podcastistan: what happens when an MRI scan for prostatitis includes the injection of rare earth metals—should you, or shouldn't you? Gadolinium crosses the blood-brain barrier if the barrier is not fully intact—does that affect your decision? Then: a letter from an MD-PhD student at Harvard prompts musings on the federal funding of science, what science is for, how complicit universities and many scientists have been for years, and what to do. Also: uterine transplants for “trans women.”*****Our sponsors:Timeline: Accelerate the clearing of damaged mitochondria to improve strength and endurance: Go to http://www.timeline.com/darkhorse and use code darkhorse for 10% off your first order.Caraway: Non-toxic & beautiful cookware. Save $150 on a cookware set over buying individual pieces, and get 10% off your order at http://Carawayhome.com/DarkHorse10.ARMRA Colostrum is an ancient bioactive whole food that can strengthen your immune system. Go to http://www.tryarmra.com/DARKHORSE to get 15% off your first order.*****Join us on Locals! Get access to our Discord server, exclusive live streams, live chats for all streams, and early access to many podcasts: https://darkhorse.locals.comHeather's newsletter, Natural Selections (subscribe to get free weekly essays in your inbox): https://naturalselections.substack.comOur book, A Hunter-Gatherer's Guide to the 21st Century, is available everywhere books are sold, including from Amazon: https://amzn.to/3AGANGg (commission earned)Check out our store! Epic tabby, digital book burning, saddle up the dire wolves, and more: https://darkhorsestore.org*****Mentioned in this episode:Gadolinium Contrast Dye: https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-gadolinium-based-contrast-agents-gbcas-are-retained-bodyLetter from Harvard: https://naturalselections.substack.com/p/letter-from-harvard/commentsHigher Education Research & Development Survey: https://ncses.nsf.gov/surveys/higher-education-research-development/2023#dataJones et al 2018. Uterine transplantation in transgender women. Bjog 126(2): 152-156: https://pmc.ncbi.nlm.nih.gov/articles/PMC6492192/pdf/BJO-126-152.pdfSupport the show

Send us a textWhat's the one question every woman wants to answer when considering a VBAC? Is it safe for me and my baby? In today's episode, Cynthia & Trisha break down the available data on VBAC, why we should discard the term TOLAC, the actual risks of uterine rupture, whether induced with Pitocon versus a prostaglandin or having spontaneous labor versus expectant management. We present the few cases in which a woman should not choose to VBAC and help mothers understand their decisions should not be driven by statistics alone. If you are considering a VBAC, get a pen and paper and arm yourself with all the stats from this data-rich dialogue. Also: Let's get HavBAC to take! (Inside Joke -- you'll get it when you listen!)**********Watch the full videos of all our episodes on YouTube!**********Our sponsors:Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products for before, during, and after pregnancy. Use this link to save 20%DrinkLMNT -- Purchase LMNT with this unique link and get a FREE sample packENERGYbits--the superfood every mother needs for pregnancy, postpartum, and breastfeedingPrimally Pure: From soil to skin, primally pure products are made with down-to-earth ingredients that feel and smell like heaven for the skinUse promo code: DOWNTOBIRTH for all sponsors.Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Watch the full videos of all our episodes on YouTube! Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

- Benefits of Vaginal Steaming- Practical Tips and Emotional Release Through Vaginal Steaming - Leiamoon Seat : https://www.leiamoon.com/product/order-leiamoon-steam-seat/?sld=56Code "DrLJj " to save Dr. Lj Johnson, is a beacon of hope in the landscape of women's health. Not just an expert in hormonal balance and gut health, but a warrior who has prevailed in the face of her own chronic illness battles. Her 16-year arduous journey to an endometriosis diagnosis has sculpted her into the dedicated, wholistic functional medicine practitioner she is today. Dr. Johnson's mission is to empower, motivate, and educate women in advocating for their health, ensuring no one experiences the delays and dismissals she endured. Dr. Lj's experience teaches more than survival—it inspires a revolution in healthcare, prioritizing understanding, comprehensive care, and a life unfettered by the chains of chronic illness. If you're seeking a partnership on your hormonal health journey that's built on empathy, expertise, and empowerment, look no further. ⁠https://wholistichormoneexpert.com/ ⁠

In this month's EM Quick Hits podcast: Zafar Qasim & Andrew Petrosoniak on whole blood transfusion in trauma, Justin Morgenstern on calcium pre-treatment to prevent diltiazem-induced hypotension, Kiran Rikhraj on dynamic LV outflow tract obstruction, Anand Swaminathan on resuscitative thoracotomy, Andrew Tagg on uterine casts, and Jesse McLaren on scale & proportionality in occlusion MI ECG interpretation. **Please support EM Cases to continue to be free open access by making a donation: https://emergencymedicinecases.com/donation/

On Monday April 7, 2025, the UK's publication The Guardian wrote, “Surgeons are hailing an ‘astonishing' medical breakthrough as a woman became the first in the UK to give birth after a womb transplant. Grace Davidson, 36, who was a teenager when diagnosed with a congenitally absent uterus, said she and her husband had been given ‘the greatest gift we could ever have asked for'. Grace's sister donated her own womb during an eight-hour operation in 2023. Davidson said she felt shocked when she first held her daughter, who was born by planned NHS caesarean section on 27 February. She was first UK womb transplant recipient to give birth”. Since the first successful uterine transplant in 2011, there have been over 70 live births worldwide. These births have occurred following more than 100 uterine transplant procedures. This episode, we will review the fascinating history of this procedure. We will also answer some questions regarding uterine transplant like can the patient has vagina sex after this? How is this procedure done? Are these babies born vaginally? And which location in TEXAS become a world-renowned uterine transplant center? Listen in for details.

Andrea is a full-scope OBGYN who believes abnormal menstruation is a function of metabolic dysfunction. Instagram:  https://www.instagram.com/consciousgynecologist/ YouTube:  @consciousgynecologist   Website: http://www.consciousgynecology.com/ Timestamps: 00:00 Trailer 01:13 Introduction 05:50 Uterus: overlooked end organ in research 08:01 Uterine fibroids: beyond surgical solutions 13:29 Endometriosis: a gut microbiome disorder 14:21 Gut dysbiosis and endometriosis connection 20:08 Misconceptions about pelvic inflammatory disease 21:29 Shaving products harm natural protection 25:53 Unified approach to nutrition science 28:56 Chronic stress impacts female fertility 33:15 PMDD and menstrual cycle cravings 34:33 Carbs, hormones, and menstrual health 37:55 PCOS diagnosis: a hormonal puzzle 41:52 Evolutionary adaptations in pregnancy nutrition 46:14 Pregnancy, ketosis, and health misconceptions 49:14 Abdominal fat's impact on hot flashes 53:29 Carnivore diet considerations for women 56:15 Where to find Andrea Join Revero now to regain your health: https://revero.com/YT Revero.com is an online medical clinic for treating chronic diseases with this root-cause approach of nutrition therapy. You can get access to medical providers, personalized nutrition therapy, biomarker tracking, lab testing, ongoing clinical care, and daily coaching. You will also learn everything you need with educational videos, hundreds of recipes, and articles to make this easy for you. Join the Revero team (medical providers, etc): https://revero.com/jobs ‪#Revero #ReveroHealth #shawnbaker  #Carnivorediet #MeatHeals #AnimalBased #ZeroCarb #DietCoach  #FatAdapted #Carnivore #sugarfree Disclaimer: The content on this channel is not medical advice. Please consult your healthcare provider.

Dr. Natalie Crawford discusses uterine factor infertility, emphasizing the importance of understanding uterine development and potential abnormalities. She explains various uterine anomalies, including unicornuate, bicornuate, and uterine septums, and their impact on fertility. Dr. Crawford highlights the significance of proper diagnostic tools like saline sonograms and MRIs for accurate detection. She addresses common issues such as polyps, fibroids, and adenomyosis, and their effects on fertility. Want to receive my weekly newsletter? Sign up at nataliecrawfordmd.com/newsletter to receive updates, Q&A, special content and my FREE TTC Starter Kit and Vegan Starter Guide! Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page @nataliecrawfordmd. You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today!      Thanks to our amazing sponsors! Check out these deals just for you: Quince- Go to Quince.com/aaw for free shipping on your order and 365-day returns Ritual-Go to ritual.com/aaw to start Ritual or add Essential For Women 18+ to your subscription today. Air Doctor - Go to AirDoctorPro.com and use promo code AAW to get UP TO $300 off today! If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram @nataliecrawfordmd, check out Natalie's YouTube channel Natalie Crawford MD, and if you're interested in becoming a patient, check out Fora Fertility. Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us a textCynthia and Trisha are back with the March Q&A episode! This one kicks off with a fun discussion on things that our Instagram followers think people should know but don't—like how, when you say you're eating a kiwi, you're actually referring to either a kiwi bird or, worse, a person from New Zealand!In today's Q&A episode, we answer these questions:Do I need to schedule a cesarean at 40 weeks if I'm planning a VBAC? My OB says I do.How do I know when it's time to wean from breastfeeding, and how can I do it without feeling guilty?What are my options if my state says it's illegal to give birth at home after a previous cesarean?In the extended, ad-free version, available on Patreon and Apple subscriptions, we cover:My second birth was only 45 minutes long, and my baby was born in the car on the way to the hospital. How can I prevent or better prepare for a rapid birth with my third baby?Will dropping a pumping session with my eleven-week-old baby affect my milk supply?How long is too long to wait to deliver the placenta, and how can I help it come out more quickly?Finally, in the "quickies" segment, we touch on a variety of topics, including alternatives to Pitocin, botox while breastfeeding, swimming in public pools during the third trimester, finances & family planning, and dealing with the awkward situation of being told your baby can't attend a baby shower—and much more!Remember you can watch all our episodes now in full video format on the Down to Birth YouTube channel! Thank you, as always, for your fantastic questions! Keep them coming to our hotline at 802-438-3696. We promise we won't answer! :)**********Our sponsors:Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products for before, during, and after pregnancy. Use this link to save 20%Use promo code: DOWNTOBIRTH for all sponsors.DrinkLMNT -- Purchase LMNT with this unique link and get a FREE sample packNot a Sponsor but HIGHLY recommended: ENERGYbitsRemember to watch our full episodes on YouTube! Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Watch the full videos of all our episodes on YouTube! Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Originally aired in June 2019 as our 73rd episode, we still often think back to this amazing first conversation we had with Dr. Stuart Fischbein and Midwife Blyss Young!Now, almost 6 years later, the information is just as relevant and impactful as it was then. This episode was a Q&A from our Facebook followers and touches on topics like statistics surrounding VBAC, uterine rupture, uterine abnormalities, insurance companies, breech vaginal delivery, high-risk pregnancies, and a powerful analogy about VBACs and weddings!Birthing Instincts PatreonBirthing BlyssNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, guys. This is one of our re-broadcasted episodes. This is an episode that, in my opinion, is a little gem in the podcast world of The VBAC Link. I really have loved this podcast ever since the date we recorded it. I am a huge fan of Dr. Stu Fischbein and Midwife Blyss and have been since the moment I knew that they existed. I absolutely love listening to their podcast and just all of the amazing things that they have and that they offer. So I wanted to rebroadcast this episode because it was quite down there. It was like our 73rd episode or something like that. And yeah, I love it so much. This week is OB week, and so I thought it'd be fun to kick-off the week with one of my favorite OB doctor's, Stuart Fischbein. So, a little recap of what this episode covers. We go over a lot. We asked for our community to ask questions for these guys, and we went through them. We didn't get to everything, so that was a bummer, but we did get to quite a bit. We talked about things like the chances of VBAC. We talked about the chances of uterine rupture and the signs of uterine rupture. We talked about inducing VBAC. We talked about uterine abnormalities, the desire of where you want to birth and figuring that out. And also, Blyss had a really great analogy to talk about what to do and how we're letting the medical world and insurance and things like that really contemplate where we or dictate where we are birthing. I love that analogy. You guys, seriously, so many questions. It's an episode that you'll probably want to put on repeat because it really is so great to listen to them, and they just speak so directly. I can't get enough of it. So I'm really excited for you guys to dive in today on this. However, I wanted to bring to your attention a couple of the new things that they've had since we recorded this way back when. I also wanted to point out that we will have updated notes in the show notes or updated links in the show notes so you can go check, them out. But one of the first things I wanted to mention was their Patreon. They have a Patreon these days, and I think that it just sounds dreamy. I think you should definitely go find in their Patreon their community through their Patreon. You can check it out at patreon.com, birthinginsinctspodcast.com and of course, you can find them on social media. You can find Dr. Stu at Birthing Instincts or his website at birthinginsincts.com. You can find Blyss and that is B-L-Y-S-S if you are looking for her at birthingblyss on Instagram or birthinblyss.com, and then of course, you can email them. They do take emails with questions and sometimes they even talk about it on their podcast. Their podcast is birthinginsinctspodcast.com, and then you can email them at birthinginsinctspodcast@gmail.com, so definitely check them out. Also, Dr. Stu offers some classes and workshops and things like that throughout the years on the topic of breech. You guys, I love them and really can't wait for you to listen to today's episode.Ladies, I cannot tell you how giddy and excited I have been for the last couple weeks since we knew that these guys were going to record with us. But we have some amazing, special guests today. We have Dr. Stuart Fischbein and Midwife Blyss Young, and we want to share a little bit about them before we get into the questions that all of you guys have asked on our social media platforms.Julie: Absolutely. And when Meagan says we're excited, we are really excited.Meagan: My face is hot right now because I'm so excited.Julie: I'm so excited. Meagan was texting me last night at 11:00 in all caps totally fan-girling out over here. So Dr. Stu and midwife Blyss are pretty amazing and we know that you are going to love them just as much as we do. But before we get into it, and like Meagan said, I'm just going to read their bios so you can know just how legit they really are. First, up. Dr. Stuart Fischbein, MD is a fellow of the American College of Obstetrics and Gynecology, and how much we love ACOG over here at The VBAC Link He's a published author of the book Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife, and a Mom. He has peer-reviewed papers Home Birth with an Obstetrician, A Series of 135 Out-of-Hospital Births and Breech Births at Home, Outcomes of 60 Breech and 109 Cephalic Planned Home and Birth Center Births. Dr. Stu is a lecturer and advocate who now works directly with home birthing midwives. His website is www.birthinginsincts.com, and his podcast is Dr. Stu's Podcast. Seriously guys, you need to subscribe.Meagan: Go subscribe right now to their podcast.Yeah. The website for his podcast is drstuspodcast.com. He has an international following. He offers hope for women who cannot find supportive practitioners for VBAC and twin and breech deliveries. Guys, this is the home birth OB. He is located in California. So if you are in California hoping for VBAC, especially if you have any special circumstance like after multiple Cesareans, twins or breech presentation, run to him. Run. Go find him. He will help you. Go to that website. Blyss, Midwife Blyss. We really love them. If you haven't had a chance to hear their podcast guys, really go and give them a listen because this duo is on point. They are on fire, and they talk about all of the real topics in birth. So his partner on the podcast is Blyss Young, and she is an LM and CPM. She has been involved in the natural birth world since the birth of her first son in 1992, first as an advocate, and then as an educator. She is a mother of three children, and all of her pregnancies were supported by midwives, two of which were triumphant, empowering home births. In 2006, Blyss co-founded the Sanctuary Birth and Family Wellness Center. This was the culmination of all of her previous experience as a natural birth advocate, educator and environmentalist. The Sanctuary was the first of its kind, a full-spectrum center where midwives, doctors, and other holistic practitioners collaborated to provide thousands of Los Angeles families care during their prenatal and postpartum periods. Blyss closed the Sanctuary in 2015 to pursue her long-held dream of becoming a midwife and care for her clients in an intimate home birth practice similar to the way she was cared for during her pregnancies. I think that's , why Meagan and I both became doulas. Meagan: That's exactly why I'm a doula. Julie: We needed to provide that care just like we had been cared for. Anyway, going on. Currently, Blyss, AKA Birthing Blyss, supports families on their journey as a birth center educator, placenta encapsulator and a natural birth and family consultant and home birth midwife. She is also co-founder of Just Placentas, a company servicing all of Southern California and placenta encapsulation and other postpartum services. And as ,, she's a co-host on Dr. Stu's Podcast. Meagan: And she has a class. Don't you have a class that you're doing? Don't you have a class? Midwife Blyss: Yeah. Meagan: Yeah. She has a class that she's doing. I want to just fly out because I know you're not doing it online and everything. I just want to fly there just to take your class.Midwife Blyss: Yeah, it's coming online.Meagan: It is? Yay! Great. Well, I'll be one of those first registering. Oh, did you put it in there?Julie: No, there's a little bit more.Meagan: Oh, well, I'm just getting ahead.Julie: I just want to read more of Blyss over here because I love this and I think it's so important. At the heart of all Blyss's work is a deep-rooted belief in the brilliant design of our bodies, the symbiotic relationship between baby and mother, the power of the human spirit and the richness that honoring birth as the rite of passage and resurrecting lost traditions can bring to our high-tech, low-touch lives. And isn't that true love? I love that language. It is so beautiful. If I'm not mistaken, Midwife Blyss's website is birthingblyss.com.Is that right? And Blyss is spelled with a Y. So B-L-Y-S-S, birthingblyss.com, and that's where you can find her.Midwife Blyss: Just to make it more complicated, I had to put a Y in there.Julie: Hey. I love it.Meagan: That's okay.Julie: We're in Utah so we have all sorts of weird names over here.Meagan: Yep. I love it. You're unique. Awesome. Well, we will get started.Midwife Blyss: I did read through these questions, and one of the things that I wanted to say that I thought we could let people know is that of course there's a little bit more that we need to take into consideration when we have a uterus that's already had a scar.There's a small percentage of a uterine rupture that we need to be aware of, and we need to know what are the signs and symptoms that we would need to take a different course of action. But besides that, I believe that, and Dr. Stu can speak for himself because we don't always practice together. I believe that we treat VBAC just like any other mom who's laboring. So a lot of these questions could go into a category that you could ask about a woman who is having her first baby. I don't really think that we need to differentiate between those.Meagan: I love it. Midwife Blyss: But I do think that in terms of preparation, there are some special considerations for moms who have had a previous Cesarean, and probably the biggest one that I would point to is the trauma.Julie: Yes.Midwife Blyss: And giving space to and processing the trauma and really helping these moms have a provider that really believes in them, I think is one of the biggest factors to them having success. Meagan: Absolutely. Midwife Blyss: So that's one I wanted to say before you started down the question.Meagan: Absolutely. We have an online class that we provide for VBAC prep, and that's the very first section. It's mentally preparing and physically preparing because there's so much that goes into that. So I love that you started out with that.Julie: Yeah. A lot of these women who come searching for VBAC and realize that there's another way besides a repeat Cesarean are processing a lot of trauma, and a lot of them realized that their Cesarean might have been prevented had they known better, had a different provider, prepared differently, and things like that. Processing that and realizing that is heavy, and it's really important to do before getting into anything else, preparation-wise.Meagan: Yeah.Midwife Blyss: One of the best things I ever had that was a distinction that one of my VBAC moms made for me, and I passed it on as I've cared for other VBAC mom is for her, the justification, or I can't find the right word for it, but she basically said that that statement that we hear so often of, "Yeah, you have trauma from this, or you're not happy about how your birth went, but thank God your baby is healthy." And she said it felt so invalidating for her because, yes, she also was happy, of course, that her baby was safe, but at the same time, she had this experience and this trauma that wasn't being acknowledged, and she felt like it was just really being brushed away.Julie: Ah, yeah.Midwife Blyss: I think really giving women that space to be able to say, "Yes, that's valid. It's valid how you feel." And it is a really important part of the process and having a successful vaginal delivery this go around.Dr. Stu: I tend to be a lightning rod for stories. It's almost like I have my own personal ICAN meeting pretty much almost every day, one-on-one. I get contacted or just today driving. I'm in San Diego today and just driving down here, I talked to two people on the phone, both of whom Blyss really just touched on it is that they both are wanting to have VBACs with their second birth. They were seeing practitioners who are encouraging them to be induced for this reason or that reason. And they both have been told the same thing that Blyss just mentioned that if you end up with a repeat Cesarean, at least you're going to have a healthy baby. Obviously, it's very important. But the thing is, I know it's a cliche, but it's not just about the destination. It's about the journey as well. And one of the things that we're not taught in medical school and residency program is the value of the process. I mean, we're very much mechanical in the OB world, and our job is to get the baby out and head it to the pediatric department, and then we're done with it. If we can get somebody induced early, if we can decide to do a C-section sooner than we should, there's a lot of incentives to do that and to not think about the process and think about the person. There's another cliche which we talk about all the time. Blyss, and I've said it many times. It's that the baby is the candy and the mother's the wrapper. I don't know if you've heard that one, but when the baby comes out, the mother just gets basically tossed aside and her experience is really not important to the medical professionals that are taking care of her in the hospital setting, especially in today's world where you have a shift mentality and a lot of people are being taken care of by people they didn't know.You guys mentioned earlier the importance of feeling safe and feeling secure in whatever setting you're in whether that's at home or in the hospital. Because as Blyss knows, I get off on the mammalian track and you talk about mammals. They just don't labor well when they're anxious.Julie: Yep.Dr. Stu: When the doctor or the health professional is anxious and they're projecting their anxiety onto the mom and the family, then that stuff is brewing for weeks, if not months and who knows what it's actually doing inside, but it's certainly not going to lead to the likelihood of or it's going to diminish the likelihood of a successful labor.Julie: Yeah, absolutely. We talk about that. We go over that a lot. Like, birth is very instinctual and very primal, and it operates a very fundamental core level. And whenever mom feels threatened or anxious or, or anything like that, it literally can st or stop labor from progressing or even starting.Meagan: Yeah, exactly. When I was trying to VBAC with my first baby, my doctor came in and told my husband to tell me that I needed to wake up and smell the coffee because it wasn't happening for me. And that was the last, the last contraction I remember feeling was right before then and my body just shut off. I just stopped because I just didn't feel safe anymore or protected or supported. Yeah, it's very powerful which is something that we love so much about you guys, because I don't even know you. I've just listened to a million of your podcasts, and I feel so safe with you right now. I'm like, you could fly here right now and deliver my baby because so much about you guys, you provide so much comfort and support already, so I'm sure all of your clients can feel that from you.Julie: Absolutely.Dr. Stu: Yeah. I just would like to say that, know, I mean, the introduction was great. Which one of you is Julie? Which one's Meagan?Julie: I'm Julie.Meagan: And I'm Meagan.Dr. Stu: Okay, great. All right, so Julie was reading the introduction that she was talking about how if you have a breech, you have twins, if you have a VBAC, you have all these other things just come down to Southern California and care of it. But I'm not a cowboy. All right? Even though I do more things than most of my colleagues in the profession do, I also say no to people sometimes. I look at things differently. Just because someone has, say chronic hypertension, why can't they have a home birth? The labor is just the labor. I mean, if her blood pressure gets out of control, yeah, then she has to go to the hospital. But why do you need to be laboring in the hospital or induced early if everything is fine? But this isn't for everybody.We want to make that very clear. You need to find a supportive team or supportive practitioner who's willing to be able to say yes and no and give you it with what we call a true informed consent, so that you have the right to choose which way to go and to do what's reasonable. Our ethical obligation is to give you reasonable choices and then support your informed decision making. And sometimes there are things that aren't reasonable. Like for instance, an example that I use all the time is if a woman has a breech baby, but she has a placenta previa, a vaginal delivery is not an option for you. Now she could say, well, I want one and I'm not going to have a C-section.Julie: And then you have the right to refuse that.Dr. Stu: Yeah, yeah, but I mean, that's never going to happen because we have a good communication with our patients. Our communication is such that we develop a trust over the period of time. Sometimes I don't meet people until I'm actually called to their house by a midwife to come assist with a vacuum or something like that. But even then, the midwives and stuff, because I'm sort of known that people have understanding. And then when I'm sitting there, as long as the baby isn't trouble, I will explain to them, here's what's going to happen. Here's how we're going to do it. Here's what's going on. The baby's head to look like this. It not going be a problem. It'll be better in 12 hours. But I go through all this stuff and I say, I'm going to touch you now. Is that okay? I ask permission, and I do all the things that the midwives have taught me, but I never really learned in residency program. They don't teach this stuff.Julie: Yeah, yeah, yeah, absolutely. One of the things that we go over a lot to in our classes is finding a provider who has a natural tendency to treat his patients the way that you want to be treated. That way, you'll have a lot better time when you birth because you're not having to ask them to do anything that they're not comfortable with or that they're not prepared for or that they don't know how to do. And so interviewing providers and interview as many as you need to with these women. And find the provider whose natural ways of treating his clients are the ways that you want to be treated.Dr. Stu: And sometimes in a community, there's nobody.Julie: Yeah, yeah, that's true.Meagan: That's what's so hard.Dr. Stu: And if it's important to you, if it's important to you, then you have to drive on. Julie: Or stand up for yourself and fight really hard.Meagan: I have a client from Russia. She's flying here in two weeks. She's coming all the way to Salt Lake City, Utah to have her baby. We had another client from Russia.Julie: You have another Russian client?Meagan: Yeah. Julie: That's awesome. Meagan: So, yeah. It's crazy. Sometimes you have to go far, far distances, and sometimes you've got them right there. You just have to search. You just have to find them.So it's tricky.Midwife Blyss: Maybe your insurance company is not gonna pay for it.Meagan: Did you say my company's not gonna pay for it?Midwife Blyss: And maybe your insurance company.Meagan: Oh, sure. Yeah, exactly.Midwife Blyss: You can't rely on them to be the ones who support some of these decisions that are outside of the standards of care. You might have to really figure out how to get creative around that area.Meagan: Absolutely.Yeah. So in the beginning, Blyss, you talked about noticing the signs, and I know that's one of the questions that we got on our Instagram, I believe. Birthing at home for both of you guys, what signs for a VBAC mom are signs enough where you talk about different care?.Dr. Stu: I didn't really understand that. Say that again what you were saying.Meagan: Yep. Sorry. So one of the questions on our Instagram was what are the signs of uterine rupture when you're at home that you look for and would transfer care or talk about a different plan of action?Dr. Stu: Okay. Quite simply, some uterine ruptures don't have any warning that they're coming.There's nothing you can do about those. But before we get into what you can feel, just let's review the numbers real briefly so that people have a realistic viewpoint. Because I'm sure if a doctor doesn't want to do a VBAC, you'll find a reason not to do a VBAC. You'll use the scar thickness or the pregnancy interval or whatever. They'll use something to try to talk you out of it or your baby's too big or this kind of thing. We can get into that in a little bit. But when there are signs, the most common sign you would feel is that there'd be increasing pain super-cubically that doesn't go away between contractions. It's a different quality of pain or sensation. It's pain. It's really's becoming uncomfortable. You might start to have variables when you didn't have them before. So the baby's heart rate, you might see heart rate decelerations. Rarely, you might find excessive bleeding, but that's usually not a sign of I mean that's a sign of true rupture.Midwife Blyss: Loss of station.Dr. Stu: Those are things you look for, but again, if you're not augmenting someone, if someone doesn't have an epidural where they don't have sensation, if they're not on Pitocin, these things are very unlikely to happen. I was going to get to the numbers. The numbers are such that the quoted risk of uterine rupture, which is again that crappy word. It sounds like a tire blowing out of the freeway. It is about 1 in 200. But only about 5 to 16%. And even one study said 3%. But let's just even take 16% of those ruptures will result in an outcome that the baby is damaged or dead. Okay, that's about 1 in 6. So the actual risk is about 1 in 6 times 1 in 200 or 1 in 1200 up to about 1 in 4000.Julie: Yep.Dr. Stu: So those are, those are the risks. They're not the 1 in 200 or the 2%. I actually had someone tell some woman that she had a 30% chance of rupture.Julie: We've had somebody say 50%.Meagan: We have?Julie: Yeah. Jess, our 50 copy editor-- her doctor told her that if she tries to VBAC, she has a 50% chance of rupture and she will die. Yeah.Meagan: Wow.Julie: Pretty scary. Dr. Stu: And by the way, a maternal mortality from uterine rupture is extremely rare.Julie: Yeah, we were just talking about that.Dr. Stu: That doctor is wrong on so many accounts. I don't even know where to begin on that.Julie: I know.Dr. Stu: Yeah. See that's the thing where even if someone has a classical Cesarean scar, the risk of rupture isn't 50%.Julie: Yep.Dr. Stu: So I don't know where they come up with those sorts of numbers.Julie: Yeah, I think it's just their comfort level and what they're familiar with and what they know and what they understand. I think a lot of these doctors, because she had a premature Cesarean, and so that's why he was a little, well, a lot more fear-based. Her Cesarean happened, I think, around 32 weeks. We still know that you can still attempt to VBAC and still have a really good chance of having a successful one. But a lot of these providers just don't do it.Dr. Stu: Yeah. And another problem is you can't really find out what somebody's C-section rate is. I mean, you can find out your hospital C-section rate. They can vary dramatically between different physicians, so you really don't know. You'd like to think that physicians are honest. You'd like to think that they're going to tell you the truth. But if they have a high C-section rate and it's a competitive world, they're not going to. And if you're with them, you don't really have a choice anyway.Julie: So there's not transparency on the physician level.Dr. Stu: So Blyss was talking briefly about the fact that your insurance may not pay for it. Blyss, why don't you elaborate on that because you do that point so well.Midwife Blyss: Are you talking about the wedding?Dr. Stu: I love your analogy. It's a great analogy.Midwife Blyss: I'm so saddened sometimes when people talk to me about that they really want this option and especially VBACs. I just have a very special tender place in my heart for VBAC because I overcame something from my first to second birth that wasn't a Cesarean. But it felt like I had been led to mistrust my body, and then I had a triumphant second delivery. So I really understand how that feels when a woman is able to reclaim her body and have a vaginal delivery. But just in general, in terms of limiting your options based on what your insurance will pay for, we think about the delivery of our baby and or something like a wedding where it's this really special day. I see that women or families will spend thousands and thousands of dollars and put it on a credit card and figure out whatever they need to do to have this beautiful wedding. But somehow when it comes to the birth of their baby, they turn over all their power to this insurance company.And so we used to do this talk at the sanctuary and I used to say, "What if we had wedding insurance and you paid every year into this insurance for your wedding, and then when the wedding came, they selected where you went and you didn't like it and they put you in a dress that made you look terrible and the food was horrible and the music was horrible and they invited all these people you didn't want to be there?"Julie: But it's a network.Midwife Blyss: Would you really let that insurance company, because it was paid for, dictate how your wedding day was? Julie: That's a good analogy.Midwife Blyss: You just let it all go.Meagan: Yeah. That's amazing. I love that. And it's so true. It is so true.Julie: And we get that too a lot about hiring a doula. Oh, I can't hire a doula. It's too expensive. We get that a lot because people don't expect to pay out-of-pocket for their births. When you're right, it's just perceived completely differently when it should be one of the biggest days of your life. I had three VBACs at home. My first was a necessary, unnecessary Cesarean.I'm still really uncertain about that, to be honest with you. But you better believe my VBACs at home, we paid out of pocket for a midwife. Our first two times, it was put on a credit card. I had a doula, I had a birth photographer, I had a videographer. My first VBAC, I had two photographers there because it was going to be documented because it was so important to me. And we sold things on eBay. We sold our couches, and I did some babysitting just to bring in the money.Obviously, I hired doulas because it was so important to me to not only have the experience that I wanted and that I deserved, but I wanted it documented and I wanted it to be able to remember it well and look back on it fondly. We see that especially in Utah. I think we have this culture where women just don't-- I feel like it's just a national thing, but I think in Utah, we tend to be on the cheap side just culturally and women don't see the value in that. It's hard because it's hard to shift that mindset to see you are important. You are worth it. What if you could have everything you wanted and what if you knew you could be treated differently? Would you think about how to find the way to make that work financially? And I think if there's just that mindset shift, a lot of people would.Meagan: Oh, I love that.Dr. Stu: If you realize if you have to pay $10,000 out of pocket or $5,000 or whatever to at least have the opportunity, and you always have the hospital as a backup. But 2 or 3 years from now, that $5,000 isn't going to mean anything.Julie: Yeah, nothing.Meagan: But that experience is with you forever.Dr. Stu: So yeah, women may have to remember the names of their children when they're 80 years old, but they'll remember their birth.Julie: Well, with my Cesarean baby, we had some complications and out-of-pocket, I paid almost $10,000 for him and none of my home births, midwives, doula, photography and videography included cost over $7,000.Meagan: My Cesarean births in-hospital were also more expensive than my birth center births.Julie: So should get to questions.Dr. Stu: Let's get to some of the questions because you guys some really good questions.Meagan: Yes.Dr. Stu: Pick one and let's do it.Meagan: So let's do Lauren. She was on Facebook. She was our very first question, and she said that she has some uterine abnormalities like a bicornuate uterus or a separate uterus or all of those. They want to know how that impacts VBAC. She's had two previous Cesareans due to a breech presentation because of her uterine abnormality.Julie: Is that the heart-shaped uterus? Yeah.Dr. Stu: Yeah. You can have a septate uterus. You can have a unicornuate uterus. You can have a double uterus.Julie: Yeah. Two separate uteruses.Dr. Stu: Right. The biggest problem with a person with an abnormal uterine shape or an anomaly is a couple of things. One is malpresentation as this woman experienced because her two babies were breech. And two, is sometimes a retained placenta is more common than women that have a septum, that sort of thing. Also, it can cause preterm labor and growth restriction depending on the type of anomaly of the uterus. Now, say you get to term and your baby is head down, or if it's breech in my vicinity. But if it's head down, then the chance of VBAC for that person is really high. I mean, it might be a slightly greater risk of Cesarean section, but not a statistically significant risk. And then the success rate for home birth VBACs, if you look at the MANA stats or even my own stats which are not enough to make statistical significance in a couple of papers that I put out, but the MANA stats show that it's about a 93% success rate for VBACS in the midwifery model, whereas in the hospital model, it can be as low as 17% up to the 50s or 60%, but it's not very high. And that's partly because of the model by which you're cared for. So the numbers that I'm quoting and the success rates I'm quoting are again, assuming that you have a supportive practitioner in a supportive environment, every VBAC is going to have diminished chance of success in a restrictive or tense environment. But unicornuate uterus or septate uterus is not a contraindication to VBAC, and it's not an indication of breech delivery if somebody knows how to do a breech VBAC too.Julie: Right.Dr. Stu: So Lauren, that would be my answer to to your question is that no, it's not a contraindication and that if you have the right practitioner you can certainly try to labor and your risk of rupture is really not more significant than a woman who has a normal-shaped uterus.Julie: Good answer.Meagan: So I want to spin off that really quick. It's not a question, but I've had a client myself that had two C-sections, and her baby was breech at 37 weeks, and the doctor said he absolutely could not turn the baby externally because her risk of rupture was so increasingly high. So would you agree with that or would you disagree with that?D No, no, no. Even an ACOG statement on external version and breech says that a previous uterine scar is not a contraindication to attempting an external version.Meagan: Yeah.Dr. Stu: Now actually, if we obviously had more breech choices, then there'd be no reason to do an external version.The main reason that people try an external version which can sometimes be very uncomfortable, and depending on the woman and her parody and certain other factors, their success rate cannot be very good is the only reason they do it because the alternative is a Cesarean in 95% of locations in the country.Meagan: Okay, well that's good to know.Dr. Stu: But again, one of the things I would tell people to do is when they're hearing something from their position that just sort of rocks the common sense vote and doesn't sort of make sense, look into it. ACOG has a lot. I think you can just go Google some of the ACOG clinical guidelines or practice guidelines or clinical opinions or whatever they call them. You can find and you can read through, and they summarize them at the end on level A, B, and C evidence, level A being great evidence level C being what's called consensus opinion. The problem with consensus, with ACOG's guidelines is that about 2/3 of them are consensus opinion because they don't really have any data on them. When you get bunch of academics together who don't like VBAC or don't like home birth or don't like breech, of course a consensus opinion is going to be, "Well, we're not going to think those are a good idea." But much to their credit lately, they're starting to change their tune. Their most recent VBAC guideline paper said that if your hospital can do labor and delivery, your hospital can do VBAC.Julie: Yes.Dr. Stu: That's huge. There was immediately a whole fiasco that went on. So any hospital that's doing labor and delivery should be able to do a VBAC. When they say they can't or they say our insurance company won't let them, it's just a cowardly excuse because maybe it's true, but they need to fight for your right because most surgical emergencies in labor delivery have nothing to do with a previous uterine scar.Julie: Absolutely.Dr. Stu: They have to do with people distress or placental abruption or cord prolapse. And if they can handle those, they can certainly handle the one in 1200. I mean, say a hospital does 20 VBACs a year or 50 VBACs a year. You'll take them. Do the math. It'll take them 25 years to have a rupture.Meagan: Yeah. It's pretty powerful stuff.Midwife Blyss: I love when he does that.Julie: Me too. I'm a huge statistics junkie and data junkie. I love the numbers.Meagan: Yeah. She loves numbers.Julie: Yep.Meagan: I love that.Julie: Hey, and 50 VBACs a year at 2000, that would be 40 years actually, right?Dr. Stu: Oh, look at what happened. So say that again. What were the numbers you said?Julie: So 1 in 2000 ruptures are catastrophic and they do 50 VBACs a year, wouldn't that be 40 years?Dr. Stu: But I was using the 1200 number.Julie: Oh, right, right, right, right.Dr. Stu: So that would be 24 years.Julie: Yeah. Right. Anyways, me and you should sit down and just talk. One day. I would love to have lunch with you.Dr. Stu: Let's talk astrology and astronomy.Yes.Dr. Stu: Who's next?Midwife Blyss: Can I make a suggestion?There was another woman. Let's see where it is. What's the likelihood that a baby would flip? And is it reasonable to even give it a shot for a VBA2C. How do you guys say that?Meagan: VBAC after two Cesareans.Midwife Blyss: I need to know the lingo. So, I would say it's very unlikely for a baby to flip head down from a breech position in labor. It doesn't mean it's impossible.Dr. Stu: With a uterine septum, it's almost never going to happen. Bless is right on. Even trying an external version on a woman with the uterine septum when the baby's head is up in one horn and the placenta in the other horn and they're in a frank breech position, that's almost futile to do that, especially if a woman is what I call a functional primary, or even a woman who's never labored before.Julie: Right. That's true.Meagan: And then Napoleon said, what did she say? Oh, she was just talking about this. She's planning on a home birth after two Cesareans supported by a midwife and a doula. Research suggests home birth is a reasonable and safe option for low-risk women. And she wants to know in reality, what identifies low risk?Midwife Blyss: Well, I thought her question was hilarious because she says it seems like everybody's high-risk too. Old, overweight.Julie: Yeah, it does. It does, though.Dr. Stu: Well, immediately, when you label someone high-risk, you make them high-risk.Julie: Yep.Dr. Stu: Because now you've planted seeds of doubt inside their head. So I would say, how do you define high-risk? I mean, is 1 in 1200 high risk?Julie: Nope.Dr. Stu: It doesn't seem high-risk to me. But again, I mean, we do a lot of things in our life that are more dangerous than that and don't consider them high-risk. So I think the term high-risk is handed about way too much.And it's on some false or just some random numbers that they come up with. Blyss has heard this before. I mean, she knows everything I say that comes out of my mouth. The numbers like 24, 35, 42. I mean, 24 hours of ruptured membranes. Where did that come from? Yeah, or some people are saying 18 hours. I mean, there's no science on that. I mean, bacteria don't suddenly look at each other and go, "Hey Ralph, it's time to start multiplying."Julie: Ralph.Meagan: I love it.Julie: I'm gonna name my bacteria Ralph.Meagan: It's true. And I was told after 18 hours, that was my number.Dr. Stu: Yeah, again, so these numbers, there are papers that come out, but they're not repetitive. I mean, any midwife worth her salt has had women with ruptured membranes for sometimes two, three, or four days.Julie: Yep.Midwife Blyss: And as long as you're not sticking your fingers in there, and as long as their GBS might be negative or that's another issue.Meagan: I think that that's another question. That's another question. Yep.Dr. Stu: Yeah, I'll get to that right now. I mean, if some someone has a ruptured membrane with GBS, and they don't go into labor within a certain period of time, it's not unreasonable to give them the pros and cons of antibiotics and then let them make that decision. All right? We don't force people to have antibiotics. We would watch for fetal tachycardia or fever at that point, then you're already behind the eight ball. So ideally, you'd like to see someone go into labor sooner. But again, if they're still leaking, if there are no vaginal exams, the likelihood of them getting group B strep sepsis or something on the baby is still not very high. And the thing about antibiotics that I like to say is that if I was gonna give antibiotics to a woman, I think it's much better to give a woman an antibiotics at home than in the hospital. And the reason being is because at home, the baby's still going to be born into their own environment and mom's and dad's bacteria and the dog's bacteria and the siblings' bacteria where in the hospital, they're going to go to the nursery for observation like they generally do, and they're gonna be exposed to different bacteria unless they do these vaginal seeding, which isn't really catching on universally yet where you take a swab of mom's vaginal bacteria before the C-section.Midwife Blyss: It's called seeding.Dr. Stu: Right. I don't consider ruptured membrane something that again would cause me to immediately say something where you have to change your plan. You individualize your care in the midwifery model.Julie: Yep.Dr. Stu: You look at every patient. You look at their history. You look at their desires. You look at their backup situation, their transport situation, and that sort of thing. You take it all into account. Now, there are some women in pregnancy who don't want to do a GBS culture.Ignorance is bliss. The other spelling of bliss.Julie: Hi, Blyss.Dr. Stu: But the reason that at least I still encourage people to do it is because for any reason, if that baby gets transferred to the hospital during labor or after and you don't have a GBS culture on the chart, they're going to give antibiotics. They're going to treat it as GBS positive and they're also going to think you're irresponsible.And they're going to have that mentality that of oh, here's another one of those home birth crazy people, blah, blah, blah.Julie: That just happened to me in January. I had a client like that. I mean, anyways, never mind. It's not the time. Midwife Blyss: Can I say something about low-risk?Julie: Yes. Midwife Blyss: I think there are a lot of different factors that go into that question. One being what are the state laws? Because there are things that I would consider low-risk and that I feel very comfortable with, but that are against the law. And I'm not going to go to jail.Meagan: Right. We want you to still be Birthing Bless.Midwife Blyss: As, much as I believe in a woman's right to choose, I have to draw the line at what the law is. And then the second is finding a provider that-- obviously, Dr. Stu feels very comfortable with things that other providers may not necessarily feel comfortable with.Julie: Right.Midwife Blyss: And so I think it's really important, as you said in the beginning of the show, to find a provider who takes the risk that you have and feels like they can walk that path with you and be supportive. I definitely agree with what Dr. Stu was saying about informed consent. I had a client who was GBS positive, declined antibiotics and had a very long rupture. We continued to walk that journey together. I kept giving informed consent and kept giving informed consent. She had such trust and faith that it actually stretched my comfort level. We had to continually talk about where we were in this dance. But to me, that feels like what our job is, is to give them information about the pros and cons and let them decide for themselves.And I think that if you take a statistic, I'm picking an arbitrary number, and there's a 94% chance of success and a 4% chance that something could go really wrong, one family might look at that and say, "Wow, 94%, this is neat. That sounds like a pretty good statistic," and the other person says, "4% makes me really uncomfortable. I need to minimize." I think that's where you have to have the ability, given who you surround yourself with and who your provider is, to be able to say, "This is my choice," and it's being supported. So it is arbitrary in a lot of ways except for when it comes to what the law is.Julie: Yeah, that makes sense.Meagan: I love that. Yeah. Julie: Every state has their own law. Like in the south, it's illegal like in lots of places in the South, I think in Washington too, that midwives can't support home birth if you're VBAC. I mean there are lots of different legislative rules. Why am I saying legislative? Look at me, I'm trying to use fancy words to impress you guys. There are lots of different laws in different states and, and some of them are very evidence-based and some laws are broad and they leave a lot of room for practices, variation and gray areas. Some are so specific that they really limit a woman's option in that state.Dr. Stu: We can have a whole podcast on the legal decision-making process and a woman's right to autonomy of her body and the choices and who gets to decide that would be. Right now, the vaccine issue is a big issue, but also pregnancy and restricting women's choices of these things. If you want to do another one down the road, I would love to talk on that subject with you guys.Julie: Perfect.Meagan: We would love that.Julie: Yeah. I think it's your most recent episode. I mean as of the time of this recording. Mandates Kill Medicine. What is that the name?Dr. Stu: Mandates Destroy Medicine.Julie: Yeah. Mandates Destroy Medicine. Dr. Stu: It's wonderful.Julie: Yeah, I love it. I was just listening to it today again.Dr. Stu: well it does because it makes the physicians agents of the state.Julie: Yeah, it really does.Meagan: Yeah. Well. And if you give us another opportunity to do this with you, heck yeah.Julie: Yeah. You can just be a guest every month.Meagan: Yeah.Dr. Stu: So I don't think I would mind that at all, actually.Meagan: We would love it.Julie: Yeah, we would seriously love it. We'll keep in touch.Meagan: So, couple other questions I'm trying to see because we jumped through a few that were the same. I know one asks about an overactive pelvic floor, meaning too strong, not too weak. She's wondering if that is going to affect her chances of having a successful VBAC.Julie: And do you see that a lot with athletes, like people that are overtrained or that maybe are not overtrained, but who train a lot and weightlifters and things like that, where their pelvic floor is too strong? I've heard of that before.Midwife Blyss: Yep, absolutely. there's a chiropractor here in LA, Dr. Elliot Berlin, who also has his own podcast and he talks–Meagan: Isn't Elliott Berlin Heads Up?Dr. Stu: Yeah. He's the producer of Heads Up.Meagan: Yeah, I listened to your guys' special episode on that too. But yeah, he's wonderful.Midwife Blyss: Yeah. So, again, I think this is a question that just has more to do with vaginal delivery than it does necessarily about the fact that they've had a previous Cesarean. So I do believe that the athletic pelvis has really affected women's deliveries. I think that during pregnancy we can work with a pelvic floor specialist who can help us be able to realize where the tension is and how to do some exercises that might help alleviate some of that. We have a specialist here in L.A. I don't know if you guys do there that I would recommend people to. And then also, maybe backing off on some of the athletic activities that that woman is participating in during her pregnancy and doing things more like walking, swimming, yoga, stretching, belly dancing, which was originally designed for women in labor, not to seduce men. So these are all really good things to keep things fluid and soft because you want things to open and release rather than being tense.Meagan: I love that.Dr. Stu: I agree. I think sometimes it leads more to not generally so much of dilation. Again, a friend of mine, David Hayes, he's a home birth guy in South Carolina, doesn't like the idea of using stages of labor. He wants to get rid of that. I think that's an interesting thought. We have a meeting this November in Wisconsin. We're gonna have a bunch of thought-provoking things going on over there.Dr. Stu: Is it all men talking about this? Midwife Blyss: Oh, hell no.Julie: Let's get more women. Dr. Stu: No, no, no, no, no.Being organized By Cynthia Calai. Do you guys know who Cynthia is? She's been a midwife for 50 years. She's in Wisconsin. She's done hundreds of breeches. Anyway, the point being is that I think that I find that a lot of those people end up getting instrumented like vacuums, more commonly. Yeah. So Blyss is right. I mean, if there are people who are very, very tight down there. The leviators and the muscles inside are very tight which is great for life and sex and all that other stuff, but yeah, you need to learn how to be able to relax them too.Julie: Yeah.Meagan: So I know we're running short on time, but this question that came through today, I loved it. It said, "Could you guys both replicate your model of care nationwide somehow?" She said, "How do I advocate effectively for home birth access and VBAC access in a state that actively prosecutes home birth and has restrictions on midwifery practice?" She specifically said she's in Nebraska, but we hear this all over the place. VBAC is not allowed. You cannot birth at home, and people are having unassisted births.Julie: Because they can't find the support.Meagan: They can't find the support and they are too scared to go to the hospital or birth centers. And so, yeah, the question is--Julie: What can women do in their local communities to advocate for positive change and more options in birth where they are more restricted?Dr. Stu: Blyss. Midwife Blyss: I wish I had a really great answer for this. I think that the biggest thing is to continue to talk out loud. And I'm really proud of you ladies for creating this podcast and doing the work that you do. Julie: Thanks.Midwife Blyss: I always believed when we had the Sanctuary that it really is about the woman advocating for herself. And the more that hospitals and doctors are being pushed by women to say, "We need this as an option because we're not getting the work," I think is really important. I support free birth, and I think that most of the women and men who decide to do that are very well educated.Julie: Yeah, for sure.Midwife Blyss: It is actually really very surprising for midwives to see that sometimes they even have better statistics than we do. But it saddens me that there's no choice. And, a woman who doesn't totally feel comfortable with doing that is feeling forced into that decision. So I think as women, we need to support each other, encourage each other, continue to talk out loud about what it is that we want and need and make this be a very important decision that a woman makes, and it's a way of reclaiming the power. I'm not highly political. I try and stay out of those arenas. And really, one of my favorite quotes from a reverend that I have been around said, "Be for something and against nothing." I really believe that the more. Julie: I like that.Midwife Blyss: Yeah, the more that we speak positively and talk about positive change and empowering ourselves and each other, it may come slowly, but that change will continue to come.Julie: Yeah, yeah.Dr. Stu: I would only add to that that I think unfortunately, in any country, whether it's a socialist country or a capitalist country, it's economics that drives everything. If you look at countries like England or the Netherlands, you find that they have, a really integrated system with midwives and doctors collaborating, and the low-risk patients are taken care of by the midwives, and then they consult with doctors and midwives can transfer from home to hospital and continue their care in that system, the national health system. I'm not saying that's the greatest system for somebody who's growing old and has arthritis or need spinal surgery or something like that, but for obstetrics, that sort of system where you've taken out liability and you've taken out economic incentive. All right, so how do you do that in our system? It's not very easy to do because everything is economically driven. One of the things that I've always advocated for is if you want to lower the C-section rate, increase the VBAC rate. It would be really simple for insurance companies, until we have Bernie Sanders with universal health care. But while we have insurance companies, if they would just pay twice as much for a vaginal birth and half as much for a Cesarean birth, then finally, VBACS and breech deliveries would be something. Oh, maybe we should start. We should be more supportive of those things because it's all about the money. But as long as the hospital gets paid more, doctors don't really get paid more. It's expediency for the doctor. He gets it done and goes home. But the hospital, they get paid a lot more, almost twice as much for a C-section than you do for vaginal birth. What's the incentive for the chief financial officer of any hospital to say to the OB department, "We need to lower our C-section rate?" One of the things that's happening are programs that insurance, and I forgot what it's called, but where they're trying, in California, they're trying to lower the primary C-section rate. There's a term for it where it's an acronym with four initials. Blyss, do you know what I'm talking about?Midwife Blyss: No. Dr. Stu: It's an acronym about a first-time mom. We're trying to avoid those C-sections.Julie: Yeah, the primary Cesarean.Dr. Stu: It's an acronym anyway, nonetheless. So they're in the right direction. Most hospitals are in the 30% range. They'd like to lower to 27%. That's a start.One of the ways to really do that is to support VBAC, and treat VBAC as Blyss said at the very beginning of the podcast is that a VBAC is just a normal labor. When people lump VBAC in with breech in twins, it's like, why are you doing that? Breech in twins requires special skill. VBAC requires a special skill also, which is a skill of doing nothing.Julie: Yeah, it's hard.Dr. Stu: It's hard for obstetricians and labor and delivery nurses and stuff like that to do nothing. But ultimately, VBAC is just a vaginal birth and doesn't require any special skill. When a doctor says, "We don't do VBAC, what he's basically saying, or she, is that I don't do vaginal deliveries," which is stupid because VBAC is just a vaginal delivery.Julie: Yeah, that's true.Meagan: Such a powerful point right there.Julie: Guys. We loved chatting with you so much. We wish we could talk with you all day long.Meagan: I would. All day long. I just want to be a fly on your walls if I could.Julie: If you're ever in Salt Lake City again--Meagan: He just was. Did you know about this?Julie: Say hi to Adrienne, but also connect with us because we would love to meet you. All right, well guys, everyone, all of our listeners, Women of Strength, we are going to drop all the information that you need to find Midwife Blyss and Dr. Stu-- their website, their podcast, and all of that in our show notes. So yeah, now you can find our podcast. You can even listen to our podcast on our website at thevbaclink.com/podcast. You can play episodes right from there. So if you don't know-- well, if you're listening to this podcast, then you probably have a podcast player already. But you know what? My mom still doesn't know what a podcast is, so I'm just gonna have to start sending her links right to our page.Meagan: Yep, just listen to us wherever and leave us a review and head over to Dr. Stu's Podcast and leave them a review.Julie: Subscribe because you're gonna love him, but don't stop listening to him us because you love us too. Remember that.Dr. Stu: I want to thank everybody who wrote in, and I'm sorry we didn't get to answer every question. We tend to blabber on a little bit asking these important questions, and hopefully you guys will have us back on again.Meagan: We would love to have you.Julie: Absolutely.Meagan: Yep, we will.Julie: Absolutely.Meagan: YeahClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Dr. Fiona Lovely is a longevity, health and wellness expert with specialties in menopause medicine, functional neurology and functional medicine.  She is speaking to the topics of women's health around perimenopause and menopause.   Uterine fibroids are a very common concern for women who are still menstruating.  They are the cause of extreme and chronic pain, heavy bleeding and there aren't great treatment options available.  Today I welcome Dr Suzanne LeBlang to the show to discuss a novel therapy for treatment of fibroids - focused ultrasound.   I had never heard about this treatment until Dr. LeBlang shared her knowledge.  This conversation highlights how the non-invasive technique can treat uterine fibroids using thermal ablation, without the need for incisions or injections.  This is also available for many other health concerns such as thyroid nodules,  Parkinson's disease, breast tumours, tremors and others.  It has been FDA approved since 2004.  Overall, this episode underscores the importance of non-invasive treatment options for women's health concerns, with focused ultrasound emerging as a promising alternative for various conditions. Dr. LeBlang is the Director of Clinical Relationships at the Focused Ultrasound Foundation (FUS) and was trained as a neuroradiologist.  You can find out more about this treatment option at fusfoundation.org or on Instagram here.     Thank you to our sponsors for this episode:

Send us a textIn this deeply personal and emotional episode, host Deborah Niemann shares the heartbreaking story of her goat, Coco, who experienced a uterine rupture and hemorrhage during a challenging kidding in 2013. Deborah takes listeners on a journey through Coco's life, from her birth to her tragic passing after giving birth to quintuplets. This episode not only honors Coco's memory but also provides valuable insights into the risks of uterine tears and hemorrhages in goats, how to recognize the signs, and what steps can be taken to prevent or address such emergencies.Key TakeawaysUterine ruptures can occur during difficult births, especially when there is excessive pressure or improper handling during interventions.Goats are horizontal animals, so internal bleeding may not be visible externally. Instead, blood collects in the abdomen.Warning signs include mental absence, lethargy, pale eyelids (indicating anemia), and disinterest in kids or milking.Lessons Learned from Coco's ExperienceRecognizing Symptoms: If a goat seems mentally absent or unresponsive after kidding, check for anemia by examining their eyelids. Pale eyelids can indicate severe blood loss.Importance of Veterinary Relationships: Having an established relationship with a vet ensures quicker access to help during emergencies.University veterinary hospitals can provide 24-hour care and specialized expertise if local vets are unavailable.Risks of Certain Tools and Procedures: Tools like kid pullers (wire nooses) can be effective but carry risks of causing uterine tears if not used carefully.Procedures like fetotomies (cutting up a fetus for removal) are especially risky in small goats like Nigerians due to limited space in their uterus.Postpartum Care: Small uterine tears can heal naturally but may lead to infections.Severe tears often require surgical intervention or result in fatal hemorrhaging.Preventative Measures: Avoid breeding smaller does with larger bucks to reduce the risk of oversized kids causing birthing complications.Always ensure hands are clean, nails are trimmed short, and gloves are worn when assisting with kidding to minimize risks of tears or infections.Resources MentionedDeborah's book: Goats Giving Birth Previous podcast episodes: Blood Transfusion in GoatsAnemia in GoatsSee full show notes here >> https://thriftyhomesteader.com/uterine-rupture-and-hemorrhage-in-goats/ To see the most recent episodes, visit  ForTheLoveOfGoats.comWant to support the content you love?Head over to -- https://thrifty-homesteader.ck.page/products/love-goats-tip-jarThanks for listening!No one ever said raising goats was easy, but it doesn't have to cost a fortune or drive you crazy! You just need the right information. Click here to learn more about our Goats 365 membership.

Aisha's episode is full of wisdom and inspiration! With her first two births, Aisha worked so hard to deliver vaginally, but ultimately had two undesired Cesareans. She was told in the operating room that she had uterine dehiscence, was given a special scar, and should never try to deliver vaginally. But her intuition was telling her a different story. She dove into research. She found a community and listened to podcasts like The VBAC Link. She knew a VBA2C was possible, and she knew she had to try. Aisha's VBA2C journey involved interacting with supportive and very unsupportive providers, hiring a fantastic doula, being proactive with labor comfort measures, planning for the unexpected, staying firm in her desires, asynclitic positioning, and pushing her baby boy out in just 45 minutes with a nuchal hand!Aisha's WebsiteThe VBAC Link Blog: VBA2CNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. It's The VBAC Link, and we have a VBA2C story coming your way. Have you ever wondered what VBA2C means? If you haven't noticed, in the VBAC world, there are a lot of acronyms. VBA2C is one of them. That means vaginal birth after two Cesareans, meaning that you have had two Cesareans and want to go for a vaginal birth. Big question, what are the chances of having a vaginal birth after two Cesareans? Is it possible? The answer is simply, yes. It is totally possible. Myself and Aisha are living proof today that it is possible. In fact, your chances of a successful VBA2C are similar to those of just a VBAC with one Cesarean. ACOG recommends that VBA2C is a safe option, so today, I want to quickly go over a little bit more instead of a review about some education on vaginal birth after two Cesareans and share a little bit more of our blog. Like I said, ACOG recommends that vaginal birth after two Cesareans is actually a safe option. They say, “It is reasonable to consider women with two previous low transverse Cesarean deliveries to be candidates for TOLAC.” Now, again, there's another one of those acronyms. TOLAC- trial of labor after a Cesarean. I know that is triggering for some. It is pretty much just the medical term of saying that you are having a trial of labor after a Cesarean, so try not to let it impact you too much. But, “for TOLAC and to counsel them based off of the combination of other factors that affect their probability of achieving a VBAC.” There are lots of things that people might go look through to see if you are eligible for a VBAC after two Cesareans. Now, I'm sure you have probably heard this before, but proven pelvis. If you haven't had a proven pelvis, meaning that your baby has come out vaginally before you've had a vaginal birth or a Cesarean– now when I say this, sometimes we have a vaginal birth, then we will have two Cesareans, and someone wants to go for a VBAC again, so they would be considered a proven pelvis or cervix to a medical staff. But if you haven't had a “proven pelvis”, I hope you guys can imagine my air quotes right now, that doesn't mean that you shouldn't be considered as someone who should have a VBAC. It says in our blog, “More important to note, there is no mention of a requirement to have had that previous vaginal delivery.” I wanted to point out that it really is not a necessary thing. I hadn't had a vaginal birth before. My cervix also hadn't made it to 10 centimeters before, so just know that it is still possible. Quickly, there are things that you can do to reduce uterine rupture, and there are also things you can do to increase your chances of VBAC. Again, it's going to be in our blog. I'm going to send you over there after the episode so you can go and read more about it, but some of the things that you can do to minimize the risk of uterine rupture is staying away from induction. Now, can VBAC be induced? Yes, they can. Yes, yes, yes, yes, you can, so I don't want you to totally freak out right now. But, staying away from induction for VBAC is better than going to get induced. It does increase our chance of uterine rupture, and it does increase our chances of other things like interventions that are unnecessary. Unless it's absolutely necessary or totally desired, try to stay away from induction. Avoid augmentation of labor so things like Pitocin and other drugs to cause the uterus to contract more than it naturally would. Okay, let's see. Avoid providers who aggressively intervene or want to manage your labor or come at you with fearmongering tactics. You guys are going to hear some of that here, and honestly, I think it's a common thing with these stories. We are getting a lot of fearmongering here. Providers, if you are listening, knock it off. Goodness gracious, we do not need to add fear to something that has been looming over us because VBAC has such a bad rap in the world, and it's so scary. Again, air quotes, guys. Just stop with the fearmongering. Avoid providers who are going to build you up with things– I should say tear you down, but fill you up with things like, “Your baby is looking too big. I don't know. We should probably induce. I don't know if your baby is going to be able to come out because you are really small, and that baby is looking really big. Oh my gosh, you have to have an epidural. Oh my gosh, you have to have your baby by 39 weeks.” There are so many things. It's annoying. Okay, going back to avoiding rupture. Avoid or delay things like getting an epidural until at least the end if possible because we do know that sometimes when we get an epidural early in labor, it can bring things like interventions, and we are getting Pitocin that is too high and other things like that. There are so many other things here, you guys. I'm going to make sure that the link is in the show notes. I don't want to take too much of our time, so we can make sure that Aisha can share her beautiful VBAC after two Cesarean stories and all that she had done to lead up to this experience. You guys, it's a good one. Something that is very different about this episode is that she actually had a dehiscence with her second which in a lot of the studies and literature for rupture, a dehiscence is often confused or combined with uterine rupture.I really love that this is a different type of story here, so gear up and enjoy. All right, Aisha. Thank you again so much for being here. As we were talking about earlier, VBAC after two Cesareans is so highly requested in our community. So without further ado, I want to turn the time over to you. Aisha: Thank you so much for having me. This is surreal. I feel like this pushed me in some ways. It was a goal of mine. I'm like, “If I make it and do my VBAC after two Cesareans, I'm going to send my story to The VBAC Link.” Yeah. I've listened to you guys. It's been literally almost four years listening to you guys all of the time trying to visualize my birth after hearing other people's stories. It's such a blessing, and I'm honored to be here to be honest. Meagan: Well, thank you so much. Aisha: Of course. Yeah. I mean, if we start from the beginning with my whole birthing journey, I got pregnant in 2018. I really wanted to try out the whole natural route, so I went with a midwife here in Canada. It's covered by the government so whether you go to a midwife or OB/GYN, it's honestly the same thing. It depends on what type of care you want to have. I chose to go with the midwife, and I chose to give birth at a birthing center for my firstborn. Labor started. I never ended up giving birth naturally obviously. I ended up having a 60-hour labor. Yeah. After 60 hours, they declared me failure to progress, and I think my cervix was a bit swollen at that point. The baby had made the meconium in my tummy. Meagan: Oh, yeah. Stressing out is common. Babies poop sometimes, and it doesn't always mean an emergency or anything like that, but when it's happening and other things are happening–Aisha: Exactly. I think I started having a fever and other things like that. At that point, they came to see me. They were like, “Before things turn into an emergency, let's go and have a simple C-section.” I felt very defeated. I worked very hard for a natural birth. I did 40 of those 60 hours all-natural, but after seeing I wasn't progressing– when I was with my midwife, I was 2 centimeters after 40 hours, and at that point, I requested to be transferred to the hospital to get an epidural. When I got the epidural, it worked a little bit on half of my body, but I was having back labor. My baby was posterior, so it did not do much for those pains there. I can say in the moment, I was quite relieved to have the C-section, so everything could be over, but I know afterward, I know womanhood is not defined by how you birth your baby, but I think at that point because that's what I envisioned, I never envisioned a C-section ever in my life, and it affected me. It affected my self-esteem a little bit. Right after that, me being me, I'm such a planner and such a researcher. I researched to see if it's possible to have a vaginal birth after a Cesarean, and I discovered the whole VBAC world. I signed up in all of the Facebook groups that I could find about VBACs all around the world. I was reading stories. I discovered The VBAC Link at that point. I started listening to the podcast. I also requested, through my midwife, my notes to see what happened. Meagan: Your op reports. Yes. Aisha: I'm like, “Okay. I need to know why I had a Cesarean, why a Cesarean was made, etc.” I checked. I sat down with my midwife at six weeks postpartum. Honestly, it wasn't anything really. They just said it was failure to progress. I had dilated to a 7, and that was that. She was like, “Okay. You can come back when you get pregnant again. You need to wait 2 years or 18 months before you get pregnant again.” Meagan: Mhmm. That's very common.Aisha: That's what I did. I got pregnant when my firstborn, I think, was 15 months. I gave birth exactly two years later almost to the dot. That labor started. Everything was going great. I remember for that pregnancy, I tried to always sit leaning forward, doing all of those exercises because my baby was posterior. I wanted a good posture. I did all of the things. It was in winter here, and in winter, Canada is not the best. I wasn't walking as much and it was COVID too. It was the COVID lockdown. With my first, I was going to the mall a lot, but during the lockdown in 2021, all of the malls were closed. I wasn't going outside much, but I was doing rounds in my house going up and down the stairs and stuff like that. When labor started, I really tried to focus. I think I was doula-ing myself. I never got a doula, but I was doula-ing with all of my research what I knew to do. At some point, I felt like it was time to go to the midwife. I was going there. They checked me. I was at 2 centimeters again. After laboring for 15 hours, then I was a bit defeated. I was like, “No, the same story is going to happen twice.” I continued laboring there. At some point, the contractions were back-to-back with no breaks. At that point, I was like, “Let me be a smart girl and get the epidural again.” She checked me. I was at 3 centimeters. I wasn't progressing fast enough for me. I think I was just in too much pain. I wasn't getting any breaks.I went to the hospital. I think the car ride there did something because it was a 20-minute car ride from the birthing center to the hospital. I was 7 centimeters. Meagan: Whoa. You went from a 3 to a 7 in 20 minutes? Aisha: In 20 minutes. Then I was like, “Okay, it's happening.” I got there. My midwife had already called the hospital and sent my papers. The anesthesiologist was waiting for me. I got the epidural within 5 minutes. They checked me. I was at a 9. Yeah, it went really fast. I was like, “I'm getting this VBAC.” Everybody was excited. I was giggling and laughing. My midwife came in. We were waiting for the last little bit. They checked me. I was 9.5, but baby was stationed pretty high. They were like, “Okay, let's try to bring baby down.” They made me change positions, but as they were doing that, the baby's heart rate dropped. It wasn't picking back up. At that point, it turned into an emergency C-section. The doctor looked at me. She was like, “Your baby is in distress. We don't know why. Nothing is going on. Nothing is changing. We are bringing you to the OR and get baby out. We don't have a choice.” I was so sad. I was at 9.5. I was almost there, but it did not happen. When I was in the operating room, the doctor screamed to me, “Aisha, never do this again.” I'm like, “Why?” She never gave me any more explanation, so me being me, when I was done giving birth, I requested the notes again.Meagan: Hey, listen. This is what I would suggest for anybody and everybody who has had a C-section. Go get your notes. Go get your notes. Aisha: They give so much insight because nobody knows unless this is the only thing that remains with you. You don't have the people to talk to. I saw the notes. I saw that my C-section scar had started to open. I think they called it a dehiscence. Meagan: Dehiscence? It was past a window. It wasn't just stretched. It actually had dehissed. Aisha: Yes. My midwife was like, “Probably that's the reason why she told you to never do this again and not to go for a VBAC again because the uterus had started to open.” Because it had started to open, when she cut me up, it gave me a J-scar so my scar–Meagan: You have a special scar too. Aisha: I have a special scar too. At that point, I'm like, “Okay.” My midwife told me, “If you have a third baby, unfortunately here, we can only follow a VBAC after one Cesarean. We cannot follow a VBAC after two C-sections so you will have to go the OB/GYN route.” Then I got scared because I'm like, “My God, I'm going to have to go to the medical professionals. They're going to turn me down,” and stuff like that. Me being me, I contacted my own personal OB/GYN. I went to see her. I wasn't pregnant or nothing. I wasn't planned on being pregnant anytime soon, but I knew I wanted a third child. I went to him. I was like, “Listen. This is my story. This is my situation. I really want to try for a vaginal birth. I know it can happen.” I went on the Facebook groups again. I registered in all of the VBAC after multiple Cesareans. I went and checked VBAC special scars. I went into all of those groups. I saw it was possible. Women were doing it all over the world. I was like, “Why not me? My body is also capable. Plus, I got to 9.5. That means my body is working. I just had unfortunate circumstances.” That's what I thought. My doctor was like, “You know what? Get pregnant. Come back, and we'll talk about it.” She wasn't closed off to the idea. Fast forward, I got pregnant earlier in 2023. I lost that baby due to miscarriage. I got pregnant again in September. That was a surprise pregnancy. I wasn't really planning for it. When I got pregnant, I was like, “Okay, this is it. This is it. We're going to try to do everything we can to make it happen.” I know for the first 20 weeks, I also tried to relax and release. I felt like my body held so much tension, and I feel like that can hold up to birth. I was trying to go and deal with all of those traumas and things like that that I hadn't dealt with in my previous births. Meagan: Traumas, triggers, past experiences, the tension that is being harbored in our body. It's weird to think that, but really, we can harbor tension whether we relate to it as trauma or not, and it can really impact us. Aisha: It can really impact us. After my second birth, I had gone to pelvic floor therapy. I had been to that for a couple of months, then stopped 6 months prior to getting pregnant officially with my last baby. When I got pregnant, I went back to see my pelvic floor therapist. I'm like, “Listen. I'm pregnant. This is what we are planning. Right now, I just want to make sure that my muscles down there are okay. I want to do the exercises. I don't want to do too much, but just prep my body slowly and surely.” We did exercises. That was the first 20 weeks. The second 20 weeks, I'm like, “Okay. Now is the time to ask the questions.” I would see her every 6 weeks, and within those 6 weeks, every question that would come in my head, I would write in down in my notes and go and ask her the questions so she could answer. I asked her to review my op reports so I could have another opinion. I was asking her a lot of questions about VBAC after two Cesareans. I got that my doctor wasn't VBAC-friendly, but I think she's pro-women's choice. She goes with what you want, and she supports you wholeheartedly in your decisions. I remember asking her questions about VBACs after two C-sections. She kept telling me, “Aisha, I think you need to realize that new studies have shown that there is not much risk after one or two Cesareans. It's almost the same. The percentage doesn't go up. There's not much difference. If you've had a C-section, you have the same chances as if you've had a second C-section. That's what the studies are showing.”I asked her about my dehiscence, and she's like, “A lot of women who didn't have a C-section can have a dehiscence, but with some women, we don't see it because they're not getting opened up.” She's like, “It happens more than you think. It doesn't mean that it's because of your scar that you had the dehiscence. It could have been that's just how your body reacted.” After all of those affirmations, that reassured me a little bit. I was not risking my baby. At the same time, you read stories, and you just don't want to make foolish decisions even though in your heart, you know what you want. When you listen to the outside world, it can influence a little bit of how you are thinking, and you are trying to make a wise decision. That was me in that second part of my pregnancy. However, the one thing she told me was, “The one thing that can make or break your VBAC, though, is getting a doula.” Every time she would see me, she was like, “Did you get your doula? Did you get your doula? Did you get your doula?” So I went. I got a doula who also had a VBAC. It was very important to have someone who had the experience of having a VBAC. I feel like when your team knows how badly you want it and what it means to you, I feel like it changes a lot for your game. I remember having my little prebirth classes with her, and she kept telling me, “You need to build a team who believes in your goal more than you believe in your goal because at some point during the birth, you're going to doubt yourself, and you need people who are going to reinforce you with confidence and positivity.” Meagan: Positivity, yes. Aisha: Yes, and that you can do it and that your body was meant for this. Of course, within that too, we also prepped for the occasion of a possible C-section, how to have a gentle C-section, and things I wanted to have. For me, it was very important for me to see my baby's being born. That's something I never experienced with both of my daughters. I heard them cry, but it was this wall in front of me. I never saw them come out of me. We also prepped for that, but yeah. We did a lot of prepping. She suggested that I go see an osteopath. With my second daughter, and my first VBAC, I had seen a chiropractor, but she told me that an osteopath might help loosen up some muscles. I went to see that person. It felt good, then I did acupuncture at the same time which I think was maybe just to release and relax and let go. I think there were a lot of little things that I did in order to just not hold on to all of the stress– writing letters and closing up chapters. I feel like it allowed me to just let go of the traumas that I had. Fast forward to my due date for my second baby. I lose a good part of my mucus plug. I sent it to my doula. She was like, “Okay, I think your body is starting to work.” Now, I can say I was starting to have contractions, but my way that I think I handled this birth was denial. The whole time that I was having those contractions, I kept saying, “They are painful Braxton Hicks. They are painful Braxton Hicks, and that's what we are going to do.” I kept walking a lot and every day, I was taking an hour walk. During those hour walks, that's when I was listening to the podcast and listening to stories and literally looking for VBAC after two Cesarean stories and hearing what women went through and their tips and tricks. That happened at my 40-week due date. Then the contractions kept going. During the daytime, they would spread out a little bit. At night time, they would be every 10-15 minutes. They would wake me up from sleeping, so I knew deep down that something was going on, but I was not trying to put my heart into it. I'm like, “They are just Braxton Hicks.” That kept on going for two days. At 40 weeks and 3 days, I had my doctor's appointment. I remember waking up that morning and being like, “Oh, those Braxton Hicks are really pushing.” I remember my husband was like, “Do you think we should go and drop of the girls at their godmother's?” I'm like, “You know what? No. I don't think this is it.”I had my appointment that afternoon. I have a friend of mine who lives next to my doctor's office. She had a 6-month-old baby at that time. I'm like, “Let's drop the girls off at my friend's, then afterward, I can snuggle up the baby because I heard oxytocin might help everything get going.” I went to see my doctor. My doctor asked if I wanted to get checked. That's one thing too, I went through the whole pregnancy not wanting to get checked. I knew that dilation means nothing. Meagan: Yes. Aisha: There is also how effaced you are and the baby's station. Those are also other things that you must know. You can be at a 10 and be stationed at a -2. It doesn't mean your baby is still coming. There are a lot of little details that I discovered. Meagan: We don't talk about it. We don't talk about it. We focus so highly on that big 10 number when there is so much more. It's funny because with my clients, they'll be like, “Oh, I got checked, and I was only this centimeter.” I'm like, “I don't even care about the centimeter. What were you effaced?” They're like, “I don't know. They didn't say anything.” Next time you get checked, ask because that number is a cooler number. Let's get effaced. Let's do that. Even then, we know that can change. We can go from thick, hard, and posterior to completely open and thin. It all varies, and it varies quickly, but there are so many other things to focus on than just that big 10 number. Aisha: Exactly. That's why I never asked to get checked the whole time. I'm like, “I'm going to go like that without checking. That will be bad.” When I got there, my doctor knew. She was like, “You're not getting checked, right?” At every appointment, she would ask, and I'm like, “No, I'm not getting checked today.” She asked, “Are you having contractions?” I'm like, “I lost my mucus plug last night. I'm having painful Braxton Hicks.” She's like, “How painful?” I'm like, “Well, people contract and call it Braxton Hicks.” She's like, “Keep doing what you're doing, however, when you go to the hospital if ever you don't give birth by 41 weeks, we have to send you to do a non-stress test to the baby, and the hospital will read your report, and they're going to force you to have a C-section. Be ready.” She was prepping me. She was like, “I'm going to write in your file that it's VBAC after two Cesareans. We've talked about it. You're going to do a trial of labor. I'm letting it go.” She was okay with letting me to go at least 41+5 and 42 weeks. Meagan: Or what evidence shows, okay. Aisha: She wasn't giving me any stress. She told me that the one thing that was giving me confidence was the fact that my body went into labor twice, and my body knows what to do. I left that appointment. I went to my friend's house. I snuggled up with the baby. Every time I would take the baby, my contractions, the painful Braxton Hicks, would be every 5 minutes. They would come more often than not. The moment we left her house, I'm like, “Okay, I don't have the baby no more, but the painful Braxton Hicks keep going.” In the car ride, it was a 20-minute car ride to my house. I got to my house. I didn't say nothing to my husband. I took my daughters. I went to give them a bath. I was showering with them actually. It was a shower. I was showering with them. I was on my knees, and at some point, I had to stop and be like, “Okay. Those Braxton Hicks are quite painful.” I gave the girls a shower. I dressed them up. They went to bed. I came downstairs to my husband and was like, “You know what? Yeah. The Braxton Hicks are becoming more and more painful.” He was like, “Okay. Do you want me to pack up the car?” I'm like, “No, they are still Braxton Hicks. We are not there yet.” Then what really made me believe that I was in labor was whenever I am in labor are my bowel movements. I think my body releases and cleans out.Meagan: Common. That's very common. Aisha: I went to the bathroom twice in the span of 30 minutes. I looked at him, and I was like, “I think we're in labor.” That's the moment I used contractions for the first time. The contractions were there. I just went to the bathroom twice. Okay. Eat and drink because those are two things I never did with my previous labors. One thing my doula told me during the prep was, “You need to hydrate your body because the muscle that is dehydrated is a muscle that is going to contract even more. Maybe that's why you were contracting and your contractions with your second labor were back to back with no breaks.” I'm like, “Yeah, I wasn't drinking water. I was so dehydrated. My lips were all cracked. I was not drinking an ounce of water.” When my husband heard, “Okay, labor is starting,” we started drinking. I ate dinner. It was around 9:00 PM. We bought those maple waters because we heard maple water is filled with electrolytes. I started drinking that. Then we went upstairs. I'm like, “I'm going to get some rest and try to sleep a little bit since it's nighttime.” I went to bed. It wasn't comfortable. I stayed for 15 minutes, then I'm like, “Okay, I'm going to go in the shower.” My husband ran a shower. It wasn't helping. We ran a bath. I went in the bath. I stayed there for maybe 30 minutes. It was not comfortable, then I got up. I went to pee, and then I had my bloody show. Everything was out. I sent a photo to my midwife and my doula. She was like, “Okay. Get ready. I think your body is really doing a lot right now.” In my head, I'm like, “Since my body is doing its work right now, let me help it. I'm going to sit on the toilet.” I heard it's a dilation station, so I'm like, “I'm going to sit there, then hopefully, if I'm in pain, let me make it effective.” I go. I sit there. Believe me or not, that was the best position for me. Meagan: I loved it too. I loved it too. Aisha: I loved it. I was at peace. I had the light turned off, the rain sound going, and I was literally sleeping. When I say sleeping, I was snoring. I was waking up slightly just for contractions, then I was going back to bed. I never timed any of my contractions. We were not going to focus on timing. We were going to go with how we feel, and the sounds and stuff like that. Yeah. I stayed there, I think, for 2.5 hours or 3 hours on the toilet. Meagan: Wow.Aisha: It felt so good. I had a pillow. I slept there. At some point, you can hear in my sound that it was a bit more there. My doula was hearing me. She told my husband, “You know what? I think this is time. You guys need to pack up the kids and go to the hospital.” We are about 35-40 minutes away from the hospital, so we had quite a drive. My husband packed up the car, and around 2:00 AM, we left to the hospital. I remember prior to labor, I told myself, “I'm going to give myself a coping mechanism. As long as I'm home, I'm just going to do nothing and try to take it in.” Once I'm in the car, I bought those combs. I was going to have the combs in my hand for the car ride, then once contractions are really unbearable, I'm going to grab the second comb. In the car ride, I had that one comb. I took it.  We went to the hospital, but the contractions were so great. I had time to do curbside walking around the hospital when we got there. My girls' godmother came and met us at the hospital so we could transfer the girls. While they were doing that transfer, I was doing curbside walking. I was taking photos. I was like, “I need to take photos of my girls.” I was in such a happy mood. The contractions were spread out which was a first for me because with all of my other labors, the moment I got to the hospital, it was an emergency and I could not control myself. We got there. We got to the hospital. I was able to give them my name and fill out my papers. I was really clear-minded. I went into triage and I was a bit scared because with my other labors, when I got checked, I was at 1 centimeter or 2 centimeters. I was going to see what I am, but you know what? We can handle it because the contractions were still spread apart. If I was a 2, I would still be good. I lay down. I got checked, and they told me I was at 5 centimeters. I thought, “Oh my god.” I asked, “What is the station and how effaced am I?” Then they were like, “You are 80% effaced, and you're at the station -2.” I'm like, “Okay. This is it. We're doing it.” They were like, “We are admitting you. You're not going to go home.” I was so excited. However, that's when the battle started. They took my file and came back. Meagan: Darn it. Aisha: They said, “We see you had two Cesareans already. Usually, you need to have a C-section after two C-sections.” I'm like, “I discussed with my doctor, and she was okay with me doing a trial of labor. They were like, “Well, no. This is not usually how things go. We usually don't do that. There's a lot of risk for your baby.” I'm like, “Yeah. I know the risk and I'm okay with it. It's something my doctor and I discussed. We are very at peace with it.” Then they sent me the doctor on call. The doctor came, and she was like, “I need to explain to you the dangers of what you are about to do. Your baby might die when you have a second C-section.” Then they brought up the dehiscence. “After a trial of labor, you had a dehiscence. This is not good for your body to have a dehiscence. You are more prone to uterine rupture.” All of those notes were observed by my doctor, and she was completely fine with it. Literally, the doctor looked at me, and she was like, “I can see nothing I'm going to say will change your mind. You're quite informed.” I'm like, “Yeah.” She was like, “I'm going to have you sign these release papers so you can release the hospital of anything.” At that moment, you feel like you're doing something not great because you're like, “They're making me sign this paper.”Meagan: Yeah, you feel like you're pushing against everyone in the professional world who have done multiple years of school and what they are suggesting. It feels off. Aisha: It feels off, but you what? That's why I was talking about releasing and really listening to me. That made me feel so much more at peace because I'm like, “I have to listen to that voice inside. Aisha, you can do this. You have prepped for this literally for four years in the making since your first C-section. You're educated. You know the risks. This paper is not going to make the risks change. You were okay with it before they presented that paper to you. You can still be okay with it after.”They gave me the paper. I signed everything, and then they asked me, “Well, we need to keep you monitored, however. We need to keep you monitored, and we need to have the easy access port installed in case.”Meagan: The hep lock, mhmm.Aisha: I told them that I didn't want it because it wasn't in my birth plan. I was like, “I don't want that.” I also had a super cute pink, floral hospital gown. I was like, “I'm going to wear that. I don't want to wear their hospital gown.” I think it was just mentally to feel like you are the birther, and you are the principal actor in the event. I didn't want to feel like a patient.They came. They were like, “You need to change.” I'm like, “I don't want to change. I want to keep my gown.” I had to sign a release paper that it was okay if they cut off my gown. I said, “Listen, the gown is made for that. There are buttons all around the back, but if you have to cut it off, cut it off, but I'm keeping this on.” At the end, I felt like I had to be somewhat political a little bit and give them a little so they could stop bugging me because they were breaking my bubble with the constant questions and the constant arguing.Within all of that, I was still having contractions. I'm like, “You know what? I'm going to let them monitor the baby, and I'm going to let them do the easy port so they can stop casting their opinions on my VBAC.” I know my doula was a bit scared especially for the monitoring because they were like, “The second the heart rate drops, they're going to use it as a way to send you to the operating room.” I know the second they put the monitor on, the baby's heart rate went down during the contractions, and it went right back up after. One of the nurses was like, “See? Your baby's heart rate is already going down. This is why we need to keep it.” I had the doula on the other line. She was coming to the hospital. I asked, “The baby's heart is going down.” She was like, “Aisha, it's normal that your baby's heart rate is going down during a contraction. He's literally getting squeezed. It's just normal practice. If it comes back up, it's completely fine.” Every time, they would pass those comments. The baby's heart rate dropped a couple of times, probably 7-8 times over the whole labor process, but every time, they would make a comment, “Oh, see? It dropped again. Oh, see? It dropped again.” But it kept picking back up the whole time.Anyway, I got admitted to my room. They tried to do the easy access port. I have small veins, so it literally took the anesthesiologist to do it. The whole nursing team failed to do it. I kept telling them to do it in one spot that people usually have better luck. They did it everywhere else, and in the end, it was that part that functioned.By the time they did the easy port access, it was around 7:00 AM. I got to the hospital around 4:00. It was around 7:00 AM. I asked to be checked again because, at that point, I was doing dances. The contractions were so intense, I was not happy. I was not laughing no more. I was still having breaks between them, but it was really taking everything out of me. At that point, the whole time before that, I was really enjoying the contractions. They were coming. I was like, “Oh, this is nice. I'm getting to meet my baby.” I loved the feeling to be honest. People find me weird when I say that I love contractions, but at that point, it was not fun anymore. I was going against the wall and doing those squat dances and moving my body left to right. I requested doing a check. They checked me. They were like, “Oh, you're at 9.5 and 100%.” However, baby was still stationed at -2. I'm like, “Oh no, baby is pretty high up.” My doula and I started to do some positions to get baby down. We did those for 30 minutes, but like I said, the contractions were really, really, really pushing it. I requested to get checked again. I know my doula was like, “Nothing probably happened.” She was right. Nothing happened. It was still the same, 9.5 and effaced at 100%, and still stationed to -2. At that point, I'm like, “Okay, I'm going to request the epidural.” I was seeing stars. Every time I would go through a contraction, I would see stars. At that point, I was literally, I think, mentally checked out. I was fighting against the contractions because every time a contraction would start, I would tell myself, “Okay, now you need to survive this next one.” It was no longer about enjoying it. Meagan: Surviving it, yeah. Aisha: It wasn't, “You know what, Aisha? It's four breaths. Take four deep breaths and it's done.” It was more of a survival mindset. I was like, “I'm going to take the epidural and be calm and be good.” They came. They gave it to me. They gave me a very tidbit because I was still walking. I could still feel. Yeah. I was still walking with the epidural. I could still feel everything. It just took off the edge. I think the contractions and the pain was in the front of my belly, and the back pain was gone, but I could still feel the pressure. While the anesthesiologist was giving me the epidural, my body was starting to push. I would have that feeling and everything. I think he gave me a tiny bit. Anyway, the second epidural was done, it was already shift change, so the night nurses were gone. The new nurses were in, and I think when I say the team makes a difference, they were angels sent. They were so kind. My doula went to see who was the doctor on call for the daytime, and she came to see me. She was like, “If you didn't have your own personal OB/GYN, this is the one who you would have wanted to have. This one here, that doctor here.” Then she came. She was super happy.She was like, “Okay, I see you're trying for a VBAC. The whole floor, when I heard about your case, they were saying that you had a uterine rupture. I'm like, ‘That's not right. Her doctor wouldn't have let her do a trial of labor after a rupture.' I went through your file, and I saw that you only had a dehiscence. It's very common.” She literally repeated the same thing that my doctor said. She was like, “A lot of women who didn't even have a C-section end up having a lot of dehiscence. It's just that we never know because they are never opened for a C-section to mark it down.” She was like, “It's completely common. We're going to do this.” She was like, “You've been at 9.5 for 2-3 hours, and your baby's station hasn't descended. Let's see what's going on.” She brought an ultrasound machine, and she performed the ultrasound on me. She literally saw that it was the baby's head's position. His head was slightly crooked to the left. Meagan: Asynclitic, mhmm. Aisha: Exactly. That's when I'm telling you that I love these people. I'm still having butterflies thinking about them. They came with the Miles Circuit. They came with the sheet with the images, and they're like, “We're going to do those.” I'm like, “The Miles Circuit!” They're like, “Yes.” I'm like, “Oh my god. You guys are my people.” We started doing the Miles Circuit. I did every movement for 30 minutes. I held it for 30 minutes. I did the cowgirl, I think they call it. Meagan: The flying cowgirl. Aisha: Exactly. Then after that, they came back. My doctor thought the baby's position had changed, but my water hadn't broken yet. She was like, “I'm going to break your water. The worst case scenario is that your baby's heart doesn't handle it, but I think that's going to make us go to the next level.” She broke my water. Literally, within the time she broke it and went to check, I was ready to go. That was literally all it took. She was like, “Okay, we're going to start pushing.” I know in my birth plan, I said that I was not going to push on my back lying down. I went on my four knees. I went first in my knees. I was holding onto the bed, and I was pushing that way. But I was so tired. I hadn't eaten in a while. I was still drinking, so drinking was good, but I hadn't eaten. My doula gave me candy. That helped me, but I remember in that exact moment, in my thoughts, “Aisha, your baby did it. This is your time now to help your baby. This is it. You've waited four years for this moment. This is it. This is all you've wanted. You need to find strength somewhere and make it happen.” I looked at them. I'm like, “I'm going to lie down.” I laid down, and my doula gave me this blanket. They attached this. Meagan: Mhmm, some tug-of-war. You did some tug-of-war, mhmm. Aisha: I was pulling on it when I was pushing, and my mom and a nurse were pushing my legs up. Yeah, then I pushed. I pushed. I pushed, and at some point, my body was pushing automatically whenever the contraction would come. It would literally do that. I would bear down by myself. I know the doctor kept looking at me. She was like, “Wow. This is awesome.” Yeah. I think I pushed for 45 minutes, and then he was born. My husband is actually the one who caught the baby. Meagan: Oh, yay. Aisha: That's what we wanted. We caught him. We did not know the gender, so it was really fun to see that it was a boy after two daughters. Once he was born, they put him on my chest. Everybody was crying. I know the nurses were crying. The doctor was crying. I've never had a hug from a doctor, and she literally came to my bedside and hugged me. She was like, “This is the moment. We don't see this often, so thank you for letting us experience this.”I know for a lot of the nurses, it was almost the shift change. It was almost 3:00 PM when he was born. One of the nurses looked at me. She was like, “My shift is ending in about 30 minutes. I need to see this. I need to witness this happening.” Then, yeah. He was born, and I think I had a first-degree tear, but it was on the outer labia. It was because when he was born–Meagan: Superficial. Aisha: Yeah, he had his hand on his face like a Superman. Meagan: Oh my goodness, so you had a nuchal hand, too? Oh my gosh.Aisha: Yeah, in the photos of it, it's so precious. My doula took photos, and you can literally see his hand coming out. Yeah. It was great because that evening, that night, the doctor came back on her shift. She heard that I gave birth. She came to apologize, literally. She was like, “I heard that you gave birth vaginally. Congratulations. I'm so sorry for not supporting you in that sense. There is a risk, and not every woman ends up having great stories like yours.”Meagan: Oh gosh. Aisha: “But we are happy for you.” I was just happy that I proved them wrong and that I made history in that hospital having a VBAC after two Cesareans. It happens. It's possible. I'm just happy that I listened to that voice inside, and that all of the noise around me did not affect my initial desires. Meagan: Yeah, and overall, your final decision, right? We've talked about this. I call it static. There's a lot of static that, I feel like, looms over VBAC moms. At least it did for me, and I do see it sometimes with my clients. It's their friends, their family, their providers, or whoever it may be, they are looming with this unnecessary static. Aisha: Yes. Meagan: A lot of it is, “Well, there's risk and what if's.” Oh, you name it. So many of these things, and really, I took a whole bunch of notes of little nuggets of your story. I can relate in a lot of ways with your story. It's similar to mine with how things unfolded. From the very beginning, you started off right. You started off right. You found the provider. You found the team. You got the support. You got the education. You dove in, and like you said, this was four years in the making. It took you four years to learn and grow and have this experience that you wanted. Sometimes, it takes one time to try. I say “try” with quotes, but to go and have a trial of labor, and it maybe not work out like mine and your situation. And then, okay, we learned from those two situations. Now how can we learn and grow from those situations and change and develop this next situation? It's so weird. My mind right now is really heavy on my daughter's reflections. They do reflections at school. It's a big art thing. Her topic is overcoming imperfections. Sometimes, in the birth world and especially as women, as you were saying earlier in your story, we have this thing that if we don't do it this way or if it doesn't happen this way, maybe our motherhood is stripped away, or we failed, or our baby failed. We can go as far as our baby failed us or whatever it may be. Overall, no situation is perfect. There are just always imperfections, and what do we do with the situation to grow and transform?I mean, really. I went over some of it, and then just learning more about hydration and how important food is and fueling our bodies. Aisha: Yes, yes. It's a marathon. You cannot run a marathon without an ounce of water or without food. You see it when you see people doing half marathons. There are people on the sidelines giving them water. Meagan: They're fueling. Aisha: Right. They're fueling. It is important and necessary. Knowing that the providers, as much as yes, we do have faith in them, they are there to help us, and they are there. I don't want to say this in a bad way, but they are working with us and for us. Do you know what I mean? They don't have the final say. We have the final say. That doctor who was there, when I told you about the dream team, she never ever does hospital rounds. She usually just does prenatals. Even the nurses said, “We usually see her once or twice a year. She never comes.” That ended up being the one time a year that she came. She looked at me and said that she is a pro-choice woman. She was like, “When a woman makes a choice, even if they fail, she will be happier, and she will be able to cope with the results way better than if someone strips her of that choice and obliges her to do something she did not consent to do. The outcome of that will be way harder to overcome than if she is the one who made the decision regardless of the result. That is way better.” Meagan: It's so true. Aisha: I wholeheartedly believe that. I know I had to really see in myself if that doesn't work. I know sometimes, we go into labor very naively. I feel like every first-time mom and even second-time sometimes, that can happen especially if let's say you were going for a vaginal birth, then you have a C-section, then you're trying for another vaginal birth, it's still in some sense the first time that you are going to experience this sort of experience. You're still going into it naively and blindly. Like I said, I never knew a C-section could be an option. The second time, I'm like, “It cannot happen to me twice.” After it happened to me twice, I planned for it. I planned in the circumstance that there would be a C-section, what do I want to happen? I knew I had my guidelines, and at least it wouldn't be a shocker and a hard pill to swallow. I would have been okay because I had my trial of labor.At the end of the day, your baby does decide how they want to be born. I feel like one thing I would advise all mamas and even fathers or partners, we need to include them to that. I feel like talking to your baby makes a whole lot of a difference. I got that advice from my osteopath where he told me a story about his wife about to be wheeled into a C-section. He came. He spoke to their daughter who was in the womb. He was like, “This is your moment. You decide. If you want to go to a C-section, do it. If not, this is the moment to change things.” His wife ended up having a vaginal birth right at the moment that they were going to. I pulled my husband up at some point I remember when I was starting to push. He came and saw the baby, then he was like, “This is your moment. You decide how you want to be born. You choose, and your mama is going to help you do this.” I feel like having that communication, our babies sense everything, so being connected to that too is so important. It's so important. Meagan: Absolutely. Absolutely. Circling back really quickly, if we do all of the things, if we take the VBAC education course, listen to the stories, learn more, read more, learn the stats, hire the team, and all of the things, we do our fear clearing processing about past experiences and all of that, and then we go in and be fearmongered like they were trying with you, and fearmongering by definition is that “it causes fear by exaggerated rumors of impending dangers”. There were big things that were said, but if you hadn't done the research and the education, you easily may have been fearmongered. Sometimes, it's even easy to be fearmongered even with the education. I will say that straight up. When you are being told that your baby could die, that word is very, very triggering. But you were able to have the education and be like, “No. I understand what you are saying. I respect what you are saying. I am going to continue moving forward this way.” But if we would be fearmongered and not have the education and then later learn the education, overall, our experience and view and our feelings postpartum would be a little bit rougher because we are learning these things that we could have learned before. That's why education is one of the biggest tips that we can give because you need to be educated along the way because it is easy for someone to come in. Look at you, Aisha, “No, no, no, no.” How many times did you have to say, “I understand, but no, no, no, no.” It sucks that that's the reality, and trust me, it ticks me off so much. Aisha: It is. Meagan: I wish it would change, but if we aren't educated and armed with that team, with that power, with our experience, then we are more likely going to fold in those situations. Aisha: It is completely true. At some point, even one of the nurses told me when they were trying to do the easy port that I needed to stop moving because this was going to end up with a C-section, and they really need to do the easy port. I had to tell her to never repeat the word “C-section” in front of my face. It sucks that for women or people experiencing multiple Cesareans or even one Cesarean when they are trying to do a vaginal birth that they need to constantly fight for it. Meagan: Yes.Aisha: But you do need to stand your ground and really focus on what you want. The fears will come, but that's a moment where you need to rely on the education that you have and all of the process. You spent 9 months preparing yourself, and all of those months must count for something. You're not going to be that one person. That's what I was telling myself. In the case that yes, the unfortunate happens, I was at the best place at the best time, and I had the best team. That was my thing. I trusted in my team that everything would be fine. But no, definitely. Yeah. You need to believe in yourself and in your project. Meagan: Yes. Oh my gosh. Well, this episode is just jampacked with all of the nuggets of information, guidance, suggestions, and empowering feelings. Oh my gosh. Thank you so much for being here with us today and sharing with us your beautiful story.Aisha: Thank you. Thank you for having me. Thank you so much. It's a dream. Meagan: Oh my gosh. Well, congratulations again.Aisha: Thank you so much.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.  Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

How can we make life-changing treatments like uterine fibroid embolization (UFE) more globally accessible? To help answer this question, Dr. Janice Newsome and Dr. Azza Naif share what they're doing in Tanzania to make UFE a standard option in fibroid care. Dr. Newsome is a Professor at Emory University and Dr. Naif is an IR attending physician at Muhimbili University of Health and Allied Sciences (MUHAS) and a member of the first generation of Tanzanian IR trainees. --- This podcast is supported by an educational grant from: Varian, a Siemens Healthineers company https://www.varian.com/ --- SYNPOSIS The doctors focus on patient education, overcoming cultural barriers, training of IR specialists, and the economic aspects of UFE. The discussion highlights the importance of making women's health treatments accessible worldwide and adapting procedures to fit local resources while maintaining high standards of care. --- TIMESTAMPS 00:00 - Introduction 05:25 - Patient Care in Tanzania 16:28 - Challenges in UFE Adoption 21:38 - Equipment and Techniques for UFE 34:26 - Post-Procedure Follow-Up Care 41:16 - Cost and Accessibility of UFE 47:01 - Future Goals for Fibroid Care --- RESOURCES BackTable VI Podcast Episode #318 - Back on the Road2IR with Dr. Janice Newsome, Dr. Judy Gichoya and Dr. Fabian Laage Gaupp: https://www.backtable.com/shows/vi/podcasts/318/back-on-the-road2ir BackTable VI Podcast Episode #104 - Bringing IR to East Africa: The Road2IR Story with Dr. Fabian Laage Gaupp: https://www.backtable.com/shows/vi/podcasts/104/bringing-ir-to-east-africa-the-road2ir-story Road2IR: https://www.road2ir.org/

Listen to today's episode to hear Meagan talk all about bicornuate, unicornuate, arcuate, and septate uteruses, uterine didelphys, and more.Though there can be complications, research is limited, and vaginal birth is often possible. Chat with your provider about your birthing desires, and don't be afraid to get multiple opinions!A Case of Vaginal Birth after Cesarean Delivery in a Patient with Uterine DidelphysUterine DifferencesSuccessful Vaginal Delivery after External Cephalic Version in a Woman with a Large Partial Uterine SeptumNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to The VBAC Link. This is Meagan, and I am solo today. We will not be sharing a VBAC or CBAC story, but we're going to focus on our topic of the week. That is uterine abnormalities. So if you haven't listened to Flannery's episode last week, or I should say earlier this week, go check it out. Flannery has a bicornuate uterus, and we talked a little bit about the different types of uteruses, and her journey, and what happened or what was most common with her bicornuate uterus. But today, I wanted to talk a little bit more about the different types of uteruses. It's kind of weird to think about, but we do. We have multiple shapes of our uteruses. I don't think it's really talked about a lot, so I thought it would be cool to jump on today and talk a little bit more about the uteruses. But, we do have a Review of the Week, so I wanted to jump on and share this review. It says, “I now recommend this podcast to every mom who will listen, even first-time moms. I tell them this is the podcast I wish I would have listened to before our first traumatic birth. It helped me process, learn, and heal so much after my son's birth. Two years later, pouring into numerous books, online courses, and more, we are preparing for our October VBAC. Their podcast has by far been the most favorite resource hands down. Thanks, Julie and Meagan, so much for what you do.”Thank you guys for your review. That review was left on Google, so if you wouldn't mind, press pause in just one moment, and go leave us a review. Your reviews help other Women of Strength come and find this podcast, find the blogs, find the course, find the doulas. You guys, I love this community so stinking much and believe that every mom, just like the reviewer said, and even first-time moms should be listening to this podcast. These stories that you guys share are absolutely incredible. The information that we share is invaluable. If you can, go to Google. Type in, “The VBAC Link” and leave us a review, or leave us a review wherever you are listening to your podcasts. Okay, everybody. Like I said, we are going to be diving into uterine abnormalities. We talked a little bit about Flannery. She had a bicornuate uterus. What is a bicornuate uterus? A bicornuate uterus is a heart-shaped uterus meaning the uterus has two horns making it look like the shape of a heart. With bicornuate uteruses, there are some things to know. There can be a higher chance of a breech baby. I'm going to share my source here with you. It's pregnancybirthbaby.org. We're going to have this in the show notes. I think that it is just so great. It's such a great visual and understanding on the different types. So yeah. They've got two horns. It doesn't reduce your chances of having a baby or getting pregnant. It can increase things like early miscarriage or an early preterm baby, or like I said, it can impact the position of the baby. But it's possible. VBAC is possible with that. The hardest thing about uterine abnormalities is there is not a ton of evidence or deep studies to dive into how it's impacting people who want to go on and have a vaginal birth or go for a, in the medical world, TOLAC or trial of labor after a Cesarean. If you have a uterine abnormality, it's something to discuss with your provider. Know you don't have to go with that first answer. You can get multiple opinions. Okay, another uterine abnormality or shape is– oh my gosh, you guys. Don't quote me on this. I will butcher how to say these. I will try my best. It's a didelphys uterus. It means that your uterus is split in two, and each side of your uterus has its own area. it also can increase your chance of having a premature birth, so if that is something that you have, I think that's something you want to discuss with your provider knowing that you could have a premature birth. We also know people who have premature VBACs all the time, but it's something to discuss. There's acruate, and that is a uterus that actually looks really similar to a normal-sized uterus but has a deeper dip in the top of the uterus in the womb. It doesn't affect your fertility. It can increase just a little bit of a later miscarriage. That is something to discuss, although sometimes providers will want to induce if everything is looking well at an earlier gestational age. Also, this one can impact the position of your baby, so being aware of that. Then there's septate. Again, I don't know. Sorry for butchering this, you guys. If you're a medical professional, sorry. It says, “A septate womb has the wall of a muscle that comes down the center of the uterus, and then it splits into those two areas and is divided by a membrane or a tight band of tissue.” It reminds me of a rubber band. It splits it down. It can also impact fertility and, again, increase the possible risk of miscarriage in the early stages or cause a premature baby. Once again, discuss with your provider if you have this what that means and what that means for VBAC birth in general. Then, let's see. There's also retroverted. That's a uterus that tips further back instead of that forward stage. Again, there are so many different types and shapes of uteruses. Sometimes we don't know what we have until we have a baby who is born. Sometimes it's once we have a Cesarean where they are like, “Oh, hey. You have this type of shaped uterus.” If you really feel like you need to know or you are having issues or anything like that, dive in with your provider and see if they can tell you what shape of uterus you have.Like I said, little is known about the outcome of VBAC with uterine abnormalities, but there is an article and it was back in 2019. It's called “A Case of Vaginal Birth After Cesarean Patient Who Has a Uterine Didelphys”. I want to talk a little bit more about that. As a reminder, that is the one that is split in two. If I recall, I think they even have their own cervixes. That can be interesting. But this is going to be a little bit more on this. They talk about it. There are only a few studies. The studies are low, like 165 women in the one study. It shows that those women with abnormalities found were statistically less likely to have VBAC. Again, we know that a lot of the time, these people have babies who are in less ideal positions or they are going into early preterm labor. There are things to be said about that. But the other small study is literally teeny tiny. It had 25 women with uterine abnormalities reported, and a VBAC rate was similar to women with a “normal” uterus. There are things to say there.Now, the other study showed that they were less likely to experience uterine rupture than women with normal uteruses, but then this one said that the uterine rupture rate was higher. So such little information. I mean, really, it's little information that I have been able to find so far. I'm going to dive in deeper and update you, but yeah. It says, “The actual rates in VBAC and uterine rupture in women with uterine abnormalities are more likely to be similar or less favorable than those women with normal uteruses.” So, keep that in mind. It goes on and says, “Some authors hypothesized that uterine abnormalities, especially unicornuate uteruses, are associated with decreased uterine muscle mass. So when we have decreased uterine muscle mass, that means it may not contract as effectively or strongly as it needs to, so that can lead to other things like arrest of descent or we were not getting into that active phase of labor, needing things like Pitocin and things to augment labor or they may have a harder time pushing out the baby because the uterus isn't helping as well. So we may have a higher chance of an assisted delivery like a vacuum or forceps. With all of this said, you guys, I want to leave it here with you to encourage you to speak with your provider, and get multiple opinions. If you have been told that you can't VBAC because of a certain situation, dive a little deeper with questions with your provider because again, the hardcore evidence is not really there. It's just low. I mean, it's there, but it's low. There's another article that says that uterine abnormalities are common in the general population with an estimated range of 1-15 per 1000% women. We know that there are people out there who have uterine abnormalities. I don't feel like it's talked about a ton, and that's why I wanted to come on today and talk a little about the different types, and of course, share with Flannery's episode with a bicornuate uterus showing that she still did go on to have a VBAC and it is possible. So if you have a uterine abnormality, please know that it doesn't mean you're just completely off the table. It still can be an option. Discuss it with your provider. Check out the links. I will include them in the show notes today more on those uterine abnormalities, and what it means, and what these studies are showing. There was another one that said that a septate uterus is clinically significant because it has been shown to be associated with adverse pregnancy outcomes including, like I said, that preterm labor and malpresentation. So it's a thing that can cause malpresentation and can cause preterm labor, and even miscarriage. But does that mean that you can't have a vaginal birth? Another thing to ask your providers if you have any of these things are, “Okay, if my baby is in a less than ideal position, say, breech or transverse, does my uterine abnormality or my specific case rule me out of having something like an ECV?” Varying rates of ECV success have been reported, and we're also not doing them enough. We are not seeing them being done enough, even though they have a lot of success. But the question is if you have a uterus that is a little different, do you qualify? Ask the questions. Be informed, and if you have any questions, let us know.And hey, if you have a uterine abnormality and you are listening, and you had a VBAC, I would love to hear from you because we have people who are searching for stories with uterine abnormalities. I know that our community would love to hear your story. You can message us at info@thevbaclink.com or if you are a provider who maybe knows a lot more and specializes a lot in uterine abnormalities, I would love to chat with you and discuss a podcast episode in the future. Thank you guys!ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Flannery joins us today from Connecticut sharing her story of an unexpected C-section at 35 weeks due to oligohydramnios, breech presentation, and concerns with her baby's kidney functions. She was also transferred to an unfamiliar hospital for its surgical capabilities. Though she was terrified, her anesthesiologist was calm and reassuring. The toughest memory of Flannery's birth was not being able to kiss her baby before he was swept away to the NICU. She was determined to do everything in her power not to have that happen again the second time. Knowing she had a bicornuate uterus, she worked hard to keep her baby's head down from the very beginning of her second pregnancy. She switched to a midwife practice, carried her baby past her due date, went into spontaneous labor, and had an intensely beautiful unmedicated hospital VBAC!NICU Free ParkingTypes of Uterine ShapesAFI ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. We have our friend from Connecticut. And you know what? I didn't ask. How do you say your name? Flannery: It's Flannery. Meagan: That's how I was going to say it. Flannery: Yes, good job. Meagan: We have our friend, Flannery, here from Connecticut and she has a bicornuate uterus. This week's focus is on different shaped uteruses or uterine abnormalities as I'm air quoting. We know that people have them. People have different-shaped uteruses. Sometimes that can impact things like breech babies or even a provider's ability to support– I don't want to say ability. It's their willingness to support, especially in VBAC. We're going to be diving into that. She's also a NICU mama so for other NICU mamas, she might have some tips for you along the way. She just told me before this that she was a labor and delivery nurse before she had her first. Flannery: Yep, and then I switched over. Meagan: Now she switched over to postpartum. She knows the field, so we might talk a little bit about labor and delivery nursing and the postpartum world. Flannery: Yeah, definitely. Meagan: Awesome. Okay, well let's get into your stories. Flannery: Okay, thank you. I'm so excited. I would listen to this podcast all the time when I was pregnant. At the end, when they say, “If you'd like to share your VBAC story–” and I would say, “I will be sharing my VBAC stories someday.” Meagan: I love that. “I will be sharing my story”, and here you are sharing with all of the other Women of Strength coming to learn and grow and feel empowered. Flannery: Yeah, I loved it. My first pregnancy was actually an unplanned pregnancy. I had just gotten married. I just started a labor and delivery nurse job. I was noticing that I wasn't feeling great, that I had some bleeding which I thought was my period, so I just was like, “You know what? Let me take a pregnancy test just to reassure myself because there is no way that it will be positive.” It was, and I was so shocked. I remember taking the tests, seeing the two lines, and my heart dropping. I thought to myself, “I am not ready to be a mom. I can't believe that I am having an unplanned pregnancy. This is so crazy.” I was only 25 which I know is not that young, but up here in Connecticut, it's pretty young. Meagan: Is it really? What's the average for first-time moms? Can I ask?Flannery: I'm guessing 30-32. Meagan: Okay. Flannery: None of my friends had babies yet or anything, so I felt very alone and obviously very shocked. Yeah. I had no idea how far along I was. I went to the dating ultrasound with my husband at the hospital where I worked, and they put the wand on my belly. There was a full baby in there. It wasn't a bean. It wasn't a little heartbeat, but it was a baby. They said, “You're 11.5 weeks along.” Meagan: Oh my gosh. Really?Flannery: Yeah. I was beyond shocked. Meagan, I had no idea that I was pregnant. I didn't have any symptoms. I was having some bleeding, so I thought that had been my period, but nope. Meagan: Oh my goodness. Was it implantation bleeding? But then that would be too late. Flannery: I don't know. I think maybe just how some people get first-trimester spotting or bleeding after sex or exercise or something. I'm thinking that's what it was. Meagan: Crazy. Flannery: I know. I had skipped the first trimester, and that terrified me because I wasn't on a prenatal. I was having some wine. I was just like, “How could I have missed this? This is embarrassing. I'm a nurse.” Meagan: “I'm a nurse.” Hey, listen. It happens. People talk about it. I'm sure that was such a shock not only to see those two pink lines and that you were not having babies with any of your friends, but then you skipped the whole first trimester. Flannery: Crazy. It was crazy. It took a while to wrap our heads around it. Then during the ultrasound, hearing the ultrasound tech saying, “Have you ever had an ultrasound of your uterus before?” I was like, “No,” not thinking anything of it, just focusing on the baby, and then I got a call from my doctor a few days later, and she was like, “So, it looks like you have a bicornuate uterus. Have you ever heard of that?” I was like, “No. I've never heard of that before.” She said, “Basically, your uterus is shaped like a heart, and it should be shaped like a balloon.” I was like, “Okay. That doesn't sound too bad.” We hung up. I went on Google and Googled “bicornuate uterus”, and let's just say the stuff that comes up is not reassuring at all. It's so scary. It says things like, “Risk of preterm delivery. Risk of stillbirth. Risk of infertility. Risk of malpresentation.” It just went on and on. Postpartum hemorrhage, and all of this stuff, so I really broke down. I remember just crying and crying to my husband, “I've had this crazy birth defect my whole life, and I've never known it.” I didn't know how it was going to impact my birth or anything. That was definitely scary.Meagan: Did they tell you anything about how it could impact your pregnancy or your birth? Flannery: Not really. This was a general GP doctor that I was seeing, so she didn't really go into it with me, but I definitely spoke about it to the midwives that I was seeing once I established care with them. They were just like, “Yeah, it can cause baby to be breech.” That was all they told me about it. Meagan: Okay. Flannery: Yeah. I was doing a lot of research looking for podcasts and everything about bicornuate uterus and all of the things that go along with it, but I couldn't really find much. This was a few years ago, so maybe three or four podcast episodes about bicornuate uterus, breech, and malformation. I think now there are more, but at the time, it was really hard to find information. Meagan: Yeah. I still feel like it's 2024. What year are we in? We are almost in 2025. We are in 2024, and it still is. There is still not a ton. It's not a beefy topic. Flannery: No, it's really not. I think that some people don't know they have it until they get pregnant which was in my case, and they have an ultrasound. It's hard to tell later on in pregnancy if you have it because your baby will stretch out the uterine space, so you can really only tell in the first trimester if you have an ultrasound. Meagan: Interesting. Good to know. Flannery: So my pregnancy progressed pretty normally after that. I was very stressed at this new job in labor and delivery that I was working in. I was seeing really scary births all of the time, traumatic births, and some good ones too, but it put this idea in my head that you cannot plan your birth. Things are so out of your control that there's no reason to have a plan because you're just going to be disappointed anyway. All you can do is go with the flow. That was my attitude at the time. It's definitely changed since then. It was definitely interesting trying to be a first-time mom and also learn how to be a labor and delivery nurse and reconcile the two experiences that I was seeing. Meagan: I bet. Flannery: Yeah. Meagan: I bet that would be really challenging. Flannery: It was. It was interesting. I established care with some midwives who I worked with. They were highly recommended, but I didn't really feel like they were giving me the midwife experience that I had heard so many people rave about. I felt like they really treated me like a coworker instead of a first-time mom when I was going to their appointments. I was fine with their care. I wouldn't say it was the best or the worst by any means. Then I realized around 25-26 weeks, “Gosh. I'm really feeling this rock under my ribs all the time. I think that's the baby's head. I think the baby is breech.” Then at 28 weeks, I had a growth scan because you have to have growth scans if you have a bicornuate uterus, and they were like, “Yeah, sure enough, the baby is breech.” The midwives told me, “Okay, you can do some Spinning Babies and put an ice pack near the baby's head and play music down low,” and all of those crazy things that you hear. I was like, “Yeah, sure. Okay, I'll try it.” I did a few inversions, but they gave me terrible heartburn, so I was not super consistent with that. The baby just wasn't budging week after week. Eventually, it came to about 35 weeks, and I was getting another growth scan. I had just worked a very tiring shift at work. I went to get my ultrasound. I was dozing off as she did it. She stopped the ultrasound, and she said, “I'm going to send you over to your midwife's office. Go over right now.” I walked over, and the midwife was like, “Girl, what's going on?” I was like, “I don't know. I just had this pit in my stomach, but I had no clue what was going on.” She was like, “You have no fluid. Get back to the hospital. You're going in as a patient now, and we're going to try to rehydrate you.” I was like, “What? What is going on? No fluid? What does that mean?” I guess they had found in ultrasound that my baby's left kidney was super dilated, and my fluid was low which is called oligohydramnios. I know you've talked about this on the podcast before, but I think they measure it with an AFI. It's supposed to be over 8. Mine was a 4. Meagan: Really low. Yeah, below 5. But they were just going to rehydrate you. They weren't going to induce you? Flannery: Not yet, no. They wouldn't have induced me anyway because my baby was breech. Meagan: Which is good. They wouldn't. Yeah. Flannery: They were going to try to rehydrate me first and see how that went. It did, and they decided to give me some steroid shots too. My favorite midwife came in, and she said, “We're going to do these steroid shots, and we're going to see if the rehydrating works. I know you've been working hard. Maybe this is just a dehydration situation because you haven't been able to take care of yourself properly.” I was like, “Okay”, then she made a comment about delivery at 37 weeks. I was like, “Oh, this is a delivery-type situation.” It had really not sunk in with me yet that this was that serious. She was like, “Yes. Oligohydramnios can cause stillbirth. It's very serious. Probably what we are looking at is two weeks of monitoring, and then delivery at 37 weeks which will be a C-section unless your baby flips.” I was like, “Oh my god. Okay.” Meagan: Yeah. But with the fluid, did they want to continue giving you fluid? Did they encourage your hydration with electrolytes and everything? Flannery: Yes, they did. I was chugging water like a maniac for a few days and coconut water and all of this stuff and getting IV fluid. It did come back up a little bit to a 6, maybe. Meagan: I was going to say, did it fix it at all?Flannery: I was still getting a bunch of ultrasounds, then it went right back down to a 4. They said, “We're going to have you consult with maternal-fetal medicine at a bigger hospital on March 9th. My baby was due April 11th, but this was a lot earlier than I was expecting anything to happen. We went to this appointment to get this more detailed ultrasound, and the doctor comes in. She seems very nervous. That's not what you want. You don't want a doctor to seem nervous.No. She's like, “It looks like your baby's left kidney is non-functional. It's just a cluster of cysts.” Meagan: Oh no. Flannery: I was like, “Oh my god.” I was so terrified. I just had no clue. This didn't show up on the 20-week ultrasound or anything. She was like, “And your fluid is still super low.” We did an NST. They sent us home, and I was just waiting around at home with my husband for my midwife to call to make a plan. I was like, “Am I going back to work tomorrow? Am I going to be having this baby?” She called me, and she was like, “So, this isn't what I was expecting to tell you today, but I've been consulting with the neonatologist here and some OBs. Since you've already had your steroid shots, we want you to go to the hospital now to have your baby tonight.” She was like, “Don't rush down the highway in the snow. This is an urgent, not an emergent situation. You'll be in good hands.” I was like, “What in the world?” I was so taken aback. I didn't believe it. They were also transferring me to a different hospital from the one that I had worked at and had planned to deliver at. Meagan: Is it because of the NICU situation?Flannery: Because of the NICU, yeah. This bigger hospital had the capability for surgery, and my hospital did not. It was a situation where it was a small hospital and a situation that they weren't really comfortable with. We hopped in the car and drove through this big snowstorm. I was just crying and shaking. We had no idea. We were both terrified. We had no idea what we were about to walk into.When we met our OB, she walked into the room. She just radiated calmness and kindness and peace. She was just an angel. She made us feel so safe. They were monitoring the baby and putting my IV in. I was still trying to wrap my head around the fact that I was having a baby tonight. Meagan: Yeah. Flannery: I was wondering, “Is this baby going to be okay? What is going on here?” We walked down the hall to the OR. I kissed my husband goodbye. I remember just thinking, “Okay. Here we go. There's no going back now.” The only way I could stay calm was to surrender any of the control that I thought I had and really just trust in God and trust in the people who were going to do the surgery on me. I lay down on the table and the anesthesiologist was so kind. He was petting my head and talking to me. My husband came in and they were setting up the drapes. My doctor who I had just met leaned her head over and she said, “This is where I had my first daughter.” That just made me feel so happy. Things are going to be normal again. She had a C-section too. It made me feel very safe. Everything went really well during the operation. I remember I could see the reflection of the operation in the lights that they have above you. I bet other moms will know what I am talking about, but they have these big OR lights, and I could kind of see what they were doing which was crazy.Meagan: You can. They're like mirrors. Flannery: I know. They should come up with something better. Meagan: Yes. For those who don't want to watch or see anything, just turn to the side. Flannery: Close your eyes. Meagan: Close your eyes. Turn to the side. Flannery: Yeah. They said, “After a few minutes, okay. Here he comes. Then he's out.” I didn't hear anything. I heard someone say, “Okay. I need to take him.” I could tell that was the neonatalogist saying they needed to work on him a little bit. They took him over to a corner where we couldn't see or hear anything that was going on. We could just hear people talking. Eventually, we heard a little cry. My husband started to cry. I looked at him, and I smiled. I just felt relief that he was alive, but I didn't feel anything. I just felt this nothingness. Meagan: I can so relate to that. Flannery: Yeah. It's so strange. It's just not what you're hoping to feel in this big important moment. Meagan: Mhmm. Flannery: I remember the neonatalogist after a while, he was breathing on his own. He had peed and pooped. They showed us pictures of him. She walked over with him in his arms in this little bundle of blankets. She stood pretty far away, maybe 6 or 10 feet away. She was like, “Okay. You know the plan. We need to check his kidneys in the NICU. What's his name?” I said, “I don't know. I need to see his face.” She flashed the blanket at me and flashed it down so I could see his face. I couldn't see anything. I said, “I don't know. I don't know what his name is,” and she walked out with him. That is just the worst memory from that whole experience. The surgery itself was really good. The care I had was great, but I'll never get that moment back. She could have brought him over to give me a kiss or see his face. It was hours until– Meagan: Touch or kiss his face.Flannery: It was so long until I could see him and meet him in the NICU. I just think about that all of the time. I did get to go meet him after a few hours. He was doing great. I didn't recognize him at first when my husband rolled me over to his isolet in the NICU which was hard, but as soon as I held him, I just had this overwhelming rush of love. It hasn't changed to this day. He's just such a joy.He turned out to be fine. His kidney was normal. It's resolved on its own, and it wasn't a cluster of cysts like they had thought. Meagan: Yay.Flannery: Yeah. He's doing great. He's a very rambunctious, very smart 2.5-year-old now. Meagan: Good. Flannery: Yeah. I'm so grateful that I have him now. I'm so grateful that I accidentally got pregnant with him.Meagan: Yes. He was meant to be, and he was going to make sure that he was.Flannery: He totally was. Yeah. Yeah. Meagan: I'm sorry that you had that experience. I want to say it's unique, but it's not. That sucks. Flannery: It's totally not. Meagan: I hope that as people are listening, if they are in the birth world of labor and delivery nurses or OBs or midwives or whatever it may be, please be mindful of mom. Please be mindful of mom. Don't forget that she doesn't feel these things because does. She needs to see her baby. She needs to touch her baby. She needs to kiss her baby. If it is a true emergency, true emergency, understandable. But in a sense of this, it doesn't sound like it was a true emergency.Flannery: It wasn't. It wasn't. Meagan: They went over, and they took a lot of time with your baby, and then came and left. They didn't need to just come and leave. Flannery: Right, right. Especially when baby is breathing on its own and stuff, you can take 10 seconds to let mom give baby a kiss.Meagan: It will impact mom. Flannery: It totally will. Meagan: Here you are 2 years later still feeling mad. You're like, “I still think about that.” I saw it. I saw it in your eyes as you were telling that story. You feel that still. That's there. I hope that people can remember that protocols and what you think needs to happen and all of these things do not trump mom. Flannery: Totally. Totally. Meagan: Right. Yeah. So, having a NICU baby, how long– what was the exact gestation?Flannery: He was 35 and 5. Meagan: Okay, so it was a preterm Cesarean as well. Flannery: Yes. Meagan: Did they have to do any special scar or anything like that because it was preterm? Flannery: No, thankfully not, but he was very stuck up in my ribs. He had the cord around his neck, and there was meconium. I know that he needed to come out that way because I don't think he could have flipped if they did an ECV. I don't know if he would have tolerated labor if he was head down even. Meagan: Yeah. That's definitely an early baby, but good that all is well for sure. Flannery: Yeah. He did great. It was a rocky start, but he's doing great now. Meagan: Yeah. Yeah. Do you have any advice for NICU moms listening? Flannery: Yes. There is this foundation that will pay for your parking costs while you're in the NICU. I didn't know about it in time. Parking can get very expensive when you are visiting your baby. If you just Google, “Parking Foundation for NICU parents,” I'm sure it will come up because I can't remember the exact name. Meagan: I'm going to look it up. I'm going to look it up while you start your next story. We'll make sure to have it in the show notes if I can find it. Flannery: Yes. Yes. Meagan: Okay, keep going.Flannery: My next pregnancy, I was determined to do everything right this time. I was like, “You know what? The last pregnancy was so rocky and so unexpected that this time, I'm going to do everything right, and therefore nothing can go wrong.” I think people have that feeling a lot which is so irrational, but we can't help it. I did go back to see my OB who delivered Freddy, my son. I just loved her. I thought she was wonderful. I just wanted to see what her opinion was about why I had those complications in my pregnancy and see what she thought about a VBAC because even though I wasn't sure if I could have a VBAC, I was interested in it. She listed out all of these rules that she had about VBAC, about, “You can't be preterm. You have to go into labor naturally,” and all of the things that you say are red flags on the podcast. Meagan: I'm like, all of the normal things, but they are all red flags. Flannery: Yes. I mean, I loved this doctor, and I think if I was going to have a repeat C-section, I would have gone back to her because she is awesome, but that wasn't the experience that I wanted to have this time. I did a little research, and I found this midwife practice that everyone recommended to me. I decided to go with them instead. This pregnancy was super uneventful. I was very conscious of taking care of myself and taking walks a lot and prenatal yoga and being on top of my vitamins and all of that sort of thing. I was very religious about positioning and Spinning Babies because I was like, “If I can just get my baby head down from the beginning, I think that I can do the VBAC,” because with a bicornuate uterus, you have less time to flip them, so with a normally shaped uterus, baby can flip up until the very last minute if they are breech, but with a bicornuate uterus, first of all, you have more of a chance of baby being breech and less of a chance for them to flip based on the shape of your uterus. There's just not as much room. I was trying to sit on my yoga ball and doing all of these stretches. I was thinking, “Gosh. This is so unrealistic. Who's not going to sit on their couch for 9 months? I have to be sitting on my couch. I can't be walking 3 miles every day,” but then I'd go back and forth in my head like, “Do you want a VBAC or not? You have to be religious about this.” You don't have to do everything I guess is what I'm trying to say. You'll try your best, but you have to do what's right for you, but you can't go to the extremes.Meagan: I love that you pointed that out. With my second baby, I was doing the red raspberry leaf. I was doing the dates. I was doing all of the things, and even with my third baby, I was the one who didn't sit on the couch for 9 months. I still had a posterior baby. I will just say that I still had a posterior baby. I had a head-down, but still a posterior baby. Actually, he was still going breech too throughout pregnancy. Yes. He was such a stinker. But, I did do all of those things. I did the dates. I did the tea. I did all of it. For me, With my third, I had to dial back a little bit and say, “Okay. I'm going to do everything I feel is right for this pregnancy.” Dates wasn't one of those. I actually didn't do the dates thing. I know there is some evidence on that, but I just didn't do it. It didn't feel right to me, but I did other things like chiropractic care. I did drink tea. I hired a midwife and decided to go out-of-hospital and hired a birth team. I did birth education. I think the biggest thing is to do all of the things that stick out and call to you. There are so many things. We give so many tips. Some tips might not apply well to you. Walking 3 miles is a lot. Flannery: It is a lot. Meagan: It's a lot, but if you can walk a mile, that's better than not walking any. Flannery: Right. Meagan: Right? So trying to go and find what is sitting right for you in this pregnancy, this baby, and in this birth, and doing those things and then knowing you did all of the things you could that felt right for you. Flannery: Yes. Totally. I totally agree. Meagan: I knew I could do all of these things and baby might still be breech. Baby was breech at my anatomy scan, and then again at 28 weeks at my other growth scan. I remember going into the midwife and just saying, “What can I do?” She was kind of saying, “Nothing will supersede the shep of your uterus. You can do everything. Why don't you just visualize because at least then you will feel like you're doing something?” I was so mad after I left that appointment. I was like, “You can't tell me that I can't do anything to make this baby flip and that it's all down to the shape of my uterus.” I kept trying. I was 28 weeks and I was going to the chiropractor and acupuncture and inversions. This time, I was really good about the inversions even though it gave me heartburn. It worked. The baby did flip. I remember actually listening to a podcast episode from The VBAC Link, and it was about someone who was trying to flip a breech baby. She flipped her breech baby. I was like, “Okay. This gives me so much hope. I can do it.” It paid off because baby did flip. I was so happy. Yeah.At one ultrasound, they did pick up an issue with the kidney. I remember being so upset because it was the same issue that my son had, but very mild. The baby had been breech at that point. I was like, “I'm trying so hard. I'm doing everything right, and it's not working.” History is just repeating itself. That's what it felt like to me, but we ended up finding out that the kidney resolved at the next ultrasound and the baby had flipped. It was like, “Oh, my prayers are being answered.” I couldn't believe it. I was so happy when we got the results from that next ultrasound.We just continued doing the prep. I had planned. I was planning to deliver in the hospital. I had a doula who was amazing. She was just with me every step of the way talking me down when I was anxious and telling me all of the different things I could try and come up with plans for repeat C-section or vaginal birth. I had really wanted to go without the epidural because I didn't mention this, but I had gotten a spinal headache from my spinal last time, and that was just awful. It was almost worse than the C-section pain. Meagan: I've actually heard that because nothing really takes it away full-on. Flannery: Yeah, except lying down. Meagan: Lying down, yeah.Flannery: I was trying to visit my baby in the NICU. I couldn't just be lying in the hospital bed all day. So I was like, if I can avoid an epidural just so that I don't even have the chance of having a spinal headache again, that's what I'm going to do.I was reading Ina May. I was watching all of the YouTube videos and doing everything that I could, but it got to be a lot. It got to be like, oh my gosh, so much work to prep for this birth. The whole time, you don't know if it's a given if you're going ot get that VBAC.Meagan: I know. Flannery: Sometimes, it can feel like, why am I doing this?Meagan: Yeah. Yeah. It is hard. It is hard because we don't know until it's done. Flannery: Exactly. Until it's 100% over. Yeah. Meagan: Yeah. Flannery: Yeah, so you know, 37 weeks came. 38 weeks, 39 weeks. I was feeling overdue basically since 35 weeks. Meagan: I'm sure. I bet you were like, “I don't know how much longer I can go.” Flannery: I mean, I was definitely hoping to make it to term this time and I was so happy that I did. It was a big, big moment when I hit that 37-week mark, but then I just kept going and going and going. I was like, “Am I ever going to go into labor? What am I doing wrong?” I was walking. It was the end of July and it was so hot out. It was hard to get out there and walk. I eventually hit my due date which was July 25th. I got a membrane sweep on that day which was not super fun. It made me lose my mucus plug and have a few cramps, but nothing else. I was very hopeful that it would kickstart labor, but it did not. Eventually, I thought, “I just have to let go. The baby will come. You might have to have an induction, but you just have to relax.” Finally, finally, 5 days after my due date, which I know is not that long, but it felt long. Meagan: It feels long. It feels long when you are almost 6 weeks after you had your first baby.Flannery: Yes, exactly. I woke up in the middle of the night and I had this period cramp feeling. I was like, “Oh my god. Is this it? Am I in labor?” I managed to calm down and go back to sleep. I put my hand on my belly and was like, “Am I going to get another cramp?” They came, and they came, and they started coming every 20 minutes. Eventually, I had to wake my husband up because it was pretty painful at that point. Maybe 2-3 hours in, I squeezed his hand. He was still sleeping, and he was like, “What's going on?” I was like, “I think I'm in labor.” He said, “I was having a dream that your water broke.”Meagan: Oh my gosh. You guys were both willing it in.Flannery: Yes, exactly. It was like we were on the same wavelength. The contractions kept coming, but they just felt like mild period cramps. I had a midwife appointment at 8:15. They said to go in to see if I was in early labor. She checked me and said I was 3 or 4 centimeters dilated and almost completely effaced. She said, “Your cervix feels labory.” I said, “I think that today is the day.” I was convinced it was prodromal labor or going to fizzle out or something. We went all the way back home. My plan was to labor at home for as long as possible and have my doula come over. I said goodbye to my little 2-year-old. My mom was taking him to hang out with her while we were in the hospital, and I remember she had him say to me, “Good luck, and be strong.”The sound of his little voice saying that to me literally just sustained me through the entire labor. It was replaying in my head in the hardest moments. I could just hear him saying that and it meant so much to me. Yeah. We just hung out at home. I was getting pretty irregular timed contractions. I was wondering why they weren't getting closer together because sometime they would be close together. Sometimes they would be spaced apart, but they were definitely getting stronger. I got in the bath or the shower. I was leaning over, and swaying and moaning, doing all of the things that you're supposed to do– the low-toned moaning and the breathing. I eventually had my doula come over after one really bad contraction. I was like, “What's going on? Why isn't it picking up? Why aren't they getting closer together? Should I go to the hospital? What's going on?” I was really afraid of the car ride because it was about 40 minutes in the car. She said, “I think what is happening is that you have this mental block about the car ride,” because this whole time, I was like, “What if I have the baby in the car? What if I have the baby in the car?” I heard a lot of stories about car babies, and I actually recently had a patient who had a car baby at work. She was like, “I think you have this mental block, and once you get to the hospital, your body is going to let you get fully into labor. So I do think you could go.” I was like, “Okay, okay. Let's go.” I called the midwives and let them know we were coming. My favorite, favorite midwife was on, the one I had hoped this whole time was going to deliver my baby.She was only on for a 12-hour shift, and it was already halfway through her shift. I was like, “Oh gosh. I'm glad she's going to be there.” We drove to the hospital. It was this very hot, very bright, and humid day. I was like, “I don't want to be here. I just want to be in a cold, dark room.”I remember as we turned onto the street that the hospital is in and pulled in the driveway, my contractions boom, boom, boom were ramping up. I was like, “Ashley (my doula), you are so right. This is exactly what happened.” I got into triage. I was making a lot of noise. It was very intense at that point. They checked me. I was 4 centimeters and 100% effaced. I wasn't too disappointed that I wasn't further along because I was like, “This feels pretty intense. I think things are really happening.” But they said, “You picked a very popular day to give birth. There are no rooms available on labor and delivery.” I was like, “No.”Meagan: What?Flannery: I was especially nervous because working in the field, I've seen how a busy unit can really affect the care that is given. It shouldn't be that way, but it totally is. Meagan: It's the reality sometimes. Flannery: Yep. My sister-in-law had recently given birth on a very busy day. She had a very difficult birth, and a very not attentive staff, so that was one of the things I was really afraid of is that I was going to give birth on a super busy day, but my care was excellent thankfully. We eventually waited in triage for a room to be ready, and it was a tub room that became available. There was one tub room in labor and delivery. I was so excited to get in that tub. I jumped right in as soon as we got there. Not jumped, waddled right in. It felt so good. The water felt amazing, but I did find it very hard to maneuver and get in the right position to work through a contraction in the tub because it was weirdly shaped. I didn't stay in there super long, but I was very surprised at how intense the contractions were which sounds silly, but they just really took over. I was hoping to use some coping techniques like music or my rebozo. I brought my massage gun. I brought this whole toolkit of stuff, but in the moment, all that was going through my head during a contraction was cursing and, “I need the epidural. I need the epidural.”I was squeezing my husband's hand so hard. My doula had this spiky, silver ball that you could use for counterpressure so I was squeezing that in my hand so hard breathing. I labored on the toilet for bit. I was in the bed. I was moving around. I could not be lying down. They were having to use continuous monitoring which I didn't really mind. The nurse was very good about not being intrusive about that. She would just follow me around with the monitor. The midwife, who I was hoping to have, was just there with me the whole time. She was holding the monitor onto my belly and speaking kind words to me. I remember going through this terrible contraction and looking over at her. She is just sitting serenely in her rocking chair just looking at me. In my head, I was like, “How can you be so calm? Help me. Do something.” Meagan: I can relate. Flannery: Being present. Meagan: Do something. Help me.Flannery: Help me. Help me. Meagan: Sometimes just being present is what you needed. Flannery: It is. It totally was. She was super hands-off, but in the moment, you're like, “Come on. Somebody do something to help me.” Eventually, I was just sitting on the toilet. The midwife had dimmed the lights. My husband was there speaking to me. I had been making these very loud moans through each contraction, and then during one of them, I started grunting, and I knew exactly what that meant. I was pushing involuntarily. I had been hoping to feel the fetal ejection reflex, and I think that's what this was because my body completely took over. There was no way that I could have not pushed during these contractions. The pain of the contraction was so intense, but it would go away when I pushed. Then I would just feel this really uncomfortable pressure, but at least the pain of the contraction was going away. I had been pushing for maybe 5 minutes, and my midwife was all excited. I was like, “Okay. Please, can you check me?” She was like, “No, just go with your intuition. Listen to your body.” I was like, “No. I need you to check me.” I did not want to be pushing on an incomplete cervix. She did, and I was a 9 and 100% effaced. She was like, “Okay, you can definitely push. That cervix is just going to melt away.” Yes. I tried the nitrous while I was pushing, but I really hated how it restricted my breathing. It also made me throw up everywhere. Meagan: Really? Flannery: Yes. Meagan: Interesting. Flannery: Yes. So much puke. It was so embarrassing. It was splashing on everyone's shoes. I was like, “Oh my god. I'm so sorry.” I pushed on the toilet for a little bit, and then I moved over to the bed. I went over to the bed because when I was on the toilet, I felt something coming out between my legs. I reached down, and it was the bubble of amniotic fluid. It hadn't popped yet. Meagan: Your bag of waters, yeah. Flannery: My bag of waters was coming out. I think I said to my husband, “Do you want to touch it?” He was like, “No.” Meagan: It just feels like a water balloon.Flannery: It felt exactly like a water balloon. I went over to the bed. I got on my side, and I was pushing so hard just totally going with my intuition, but it wasn't the type of peaceful breathing that people tell you to do like the J breathing or anything. There was no way I could breathe through these contractions and these pushes. I was totally holding my breath and bearing down, but that's just what was right for me in the moment. They were saying, “Can you feel the baby moving down?” I was like, “No. Not at all.” I think that's because the bag of waters was still intact. I couldn't feel anything except this really uncomfortable pressure. They said, “Put your fingers inside of yourself and see if you can feel a baby's head.” I put my fingers past the bag of waters, and I could feel the baby's head right there. I pushed, and I could feel the baby move down. It was the most incredible, coolest moment of the birth. I loved that. My midwife said, “Okay, baby's definitely feeling the squeeze.” Her heart rate was going down a little bit. She said, “Turn onto your left side, and with this next contraction, let's have the baby.” I pushed as hard as I possibly could, and just felt this release of pressure. I had no idea what was going on, but I had this cold cloth over my face so I couldn't see anybody, but I heard cheering. Then I felt this warm, wet baby come up onto my belly. I was laughing and crying, and everyone was saying, “Yay! You did it!” I was just like, “Oh my god, what happened?” Meagan: Just like that.Flannery: It was surreal. It was incredible. She started crying right away. We didn't know she was a girl. My husband looked down between her legs. We both looked at the same time and said, “It's a girl.” I said, “I knew you were a girl.” She just stayed with me the whole time right onto my chest. It was just the best feeling. I was so, so overjoyed. Meagan: That is so amazing. It's so amazing with VBAC how the whole room sometimes can just erupt with joy and, “You did it!” and screams and joyful laughs. Oh, man. Flannery: Yeah. It was beautiful. It was so, so intense in a way that I hadn't been expecting it to be. It was a calm, beautiful birth, but the intensity of the contractions and the way that my body completely took over, and I was just along for the ride. I was just riding the waves. It was crazy. Meagan: Truly riding that wave. We talk about it in HypnoBirthing and riding the wave, but that wave came over, and like you said, your body was just like, “Okay, I've got this. Let's go.” Here you went, and this baby came out pretty quickly it sounds like.Flannery: Yeah, she was born at 7:23 PM. I had felt my first contraction at 2:00 AM or something. It wasn't the shortest labor, but once I got to the hospital, it was 5 or 6 hours. It was pretty quick in the end there. She came out en caul. Her head did. Meagan: She did?Flannery: As her body came out, it popped, so she was almost en caul I guess which I thought was so cool. Meagan: Oh my goodness. That is so awesome. I love that. I've seen a couple in my doula career, and it is so cool-looking. A lot of people have said, “Oh, vaginal birth can't have encaul babies.” Oh, yes they can. Yes, they can. 100%. Flannery: Yes. Meagan: I love that you had mentioned, “Once I got to the hospital–”. Sometimes I've had this with doula clients where I'm noticing this pattern of inconsistency and a lot of the times, the client is saying things like, “Should I go? Should I go? Is it okay to be here still? How much longer should we stay?” They are saying these questions because inside, there's a lot going on. I had a client where I said, “You know what? I think we should go. I think you are going to feel safer there. It seems like you are going to feel safer there.” The second we got there, things ramped up. Doctor didn't even make it. The baby slipped out on the bed. Seriously, the second she got there, her body released. It was almost like her epidural. Sometimes, with an epidural, we get an epidural and our body is able to relax. If our mind is not confident or comfortable, we can't let our bodies sometimes. So I love that you pointed that out. I wanted to talk a little bit more really quickly on the types of uterine abnormalities or different types of uteruses. As she was saying, you have a bicornuate uterus which means it's a heart-shaped uterus. I'm probably going to butcher these names especially if you are a provider and you are listening. I don't really know how to say these words. There's an arcuate uterus which is similar to a bicornuate uterus, but with less of a dip in the heart shape. It's like an oddly shaped heart. It's asymmetrical in my mind. That's how I envision it. There's an arcuate uterus, which means there's a divide down the two parts of the membrane wall. Then there's a unicornuate uterus, which is when the fallopian tube has an irregular shape to it. Then I always butcher this one. It's didelphys. I don't even know how to say it. Flannery: Sorry. I can't help you on that one. Meagan: I'm going to stop trying. That is when you are born with two uteruses which does happen. One baby can be in one uterus, and we can have another uterus over here. Those are all abnormalities of the uteruses. Of course, we have different shapes, sizes, and all of the things. I wanted to just have a link in the show notes for that as well so you can read more on each of those types of uteruses. Then tell me if this is the right link. I found Jackson's Chance Foundation.Flannery: Yes. That's what it is. Meagan: Why parking matters. Flannery: Yes. Meagan: It looks like this is inspired. It's a foundation inspired by another person's story, another NICU baby's story. It said that–Flannery: Yeah. I believe that Jackson's parents set it up. Meagan: Yeah. Wow. This story is precious and inspiring. Wow. These parents are incredible. Then it does show that you can donate or sponsor a parking pass. They talk about the why and all of that. This is so awesome. I'm going to make sure that we have that in the show notes. If you know a NICU baby, or you know someone who is going to have a NICU baby, don't be like Flannery and find out later. This is how we all learn, and this is how. We find out when it's too late, then we have to go to show on. So, thank you for sharing that tip. I've actually never heard of it, but that's probably because I'm not a NICU mom.Flannery: Yeah. Yeah. I hope it helps someone. Meagan: Yes. Thank you again so much for sharing your story.Flannery: Oh my gosh, this is amazing. Thank you so much. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

“Whatever happens, I just want it to be peaceful, and I want to be present.”Kerri is a labor and delivery nurse born and raised in Kentucky. The only thing on her first birth plan was not to have a C-section, yet it became her reality. We know many of you can relate.She had a medically necessary induction at 36 weeks due to preeclampsia. Kerri describes her experience with getting magnesium, aka a “flu in a bag”, seeing double and going in for a C-section. Her surgery was straightforward, but Kerri felt very out of it and disconnected. Kerri was very intentional about her plans for a VBAC. Her birth team was on board and supported her requests. Throughout her pregnancy, Kerri's greatest desire was to feel present for the moment of birth no matter the outcome. When labor stalled and baby had a hard time engaging, Kerri felt peaceful about requesting a second C-section. With things happening on her terms, Kerri's birth was the peaceful and healing experience she hoped it would be.Evidence Based BirthⓇ - The Evidence on VBACEvidence Based BirthⓇ - COVID ResourcesNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We have a CBAC story coming your way today. If you did not know what CBAC means, that is Cesarean Birth After Cesarean. This is a topic that a lot of people avoid. I don't know, tell me, Kerri, who is sharing her story today. Do you feel like CBAC stories are sometimes avoided when you are preparing for a VBAC?Kerri: I think so. I know I avoided that as I prepared for my own attempted VBAC. Meagan: Yeah. Kerri: Yeah. I think that CBAC is something that we try to avoid because we all hope for that VBAC. Meagan: Yeah. We overlook it and it actually breaks my heart. I encourage everyone to listen, especially if they are wanting to VBAC, every VBAC story, but as well as every CBAC story for a lot of reasons. One, understanding maybe what led to another CBAC and two, the healing and the fact that it can be a peaceful experience. It's not the end. There are so many things to CBAC, I think, that are missed. It's the same thing with uterine rupture stories or things like that. I'm not wanting that, so I don't want to listen to that. Now, I don't want to shame anyone if they skip over a CBAC story, but I really encourage everybody to listen to all of these stories because they are empowering. They are uplifting, and they are going to help you grow in ways that you may not even know. Before we get into cute Kerri's episode, I wanted to share a review. This was actually left a little bit ago too, actually. It was in 2022. No, 2021. It says, “Going for my VBAC after two C-section in 2022”. It says, “Thank you so much for this valuable resource. I have been listening to your podcast since early in my second pregnancy. I found out I was expecting again 9 months after my CBAC, and I was immediately and depressed that I would be going through all of that all over again very soon. I am now 14 weeks, and I'm drawing strength every day from the stories you share. Thank you, thank you, thank you. I have hope this time that it will be different.” Now, that's another good note to have. Even if you do have a CBAC, that doesn't mean that's the end. That also may mean you find healing in that, and you want future CBACs, right? You want to schedule that CBAC. I love that note about healing and strength. That's what all of these episodes are doing. Okay, Kerri. I am so happy that you are here. You are in Kentucky.Kerri: Yes. Meagan: Okay, were you in Kentucky for both of your births? Are you from Kentucky?Kerri: I have lived in the same small town my whole life. I live just outside of Lexington. It's a little bit bigger than it used to be, but it's still a small town to me. Meagan: Okay. Kerri: I have lived in Lexington my whole life. I gave birth at the same hospital where I was born. Meagan: Yeah, me too. I would say I'm boring. I'm boring. I haven't been anywhere, but I don't think it's boring, actually. I love Utah. I've been born and raised here. I actually gave birth at the same hospital for my C-sections and with the same provider who gave birth to me. Kerri: Oh, that's so funny. That's wild. Meagan: Kind of crazy, huh. Well, thank you so much for being here today and sharing your beautiful stories. I'd love to turn the time over to you. Kerri: Yeah. I'm so excited to share. I've listened to this podcast quite a bit since my first C-section, so I'm really excited to be on today.Meagan: Well, thank you for being here. Kerri: My first pregnancy was already a surprise pregnancy. Me and my husband had just gotten married, and a month and a half later found out we were pregnant. It was already quite a bit of a surprise being pregnant. You know, pregnancy went well. The first trimester went well. Around 28 weeks, I had gotten COVID. This was November of ‘21. COVID was still fresh. I had gotten COVID, and I made it through that. I thought everything was going well, but from that point on, I just was feeling more and more sick. I had been a nurse for a while, but I was a new nurse to labor and delivery. I was working night shifts, so I just really attributed the way I felt to working nights. I'm just pregnant. I'm working the night shifts. This is probably what's wrong with me. Around 35 weeks, I just started feeling miserable. I had an appointment with a provider who wasn't my provider, but he was a provider I had worked with. At that appointment, my blood pressure was elevated. He said, “Let's just get a preeclampsia panel, and do a 24-hour urine just to be safe and see what's going on.”I did that, and I turned in my 24-hour urine. I went to work that night. That shift was miserable. I don't know how I made it through that shift, but I did. I got off that morning, and the provider called me that morning. He was like, “You have preeclampsia. You cannot work anymore. You're on light duty at home, and you're being induced at 37 weeks.” That was already quite a bit of a shock. I had been around birth just enough as a labor and delivery nurse. I had just already in my head pictured this beautiful birth experience that you see on Instagram, and I'm like, “This is already not happening for me.” He tells me that. I'm home for a few days, and I'm just feeling more miserable as I'm home. After that phone call a few days later, I checked my blood pressure, and it's severe at home. It's over 160/110. Being the nurse I am, they say nurses make the worst patients. I was just like, “I'm going to ignore this for a little bit, and we'll just see if this gets any better.” I check it again later that afternoon, and it's still super high. I called my husband, and we decided to go to the hospital. We get there, and my blood pressure was high, but it was not severe enough to do anything about it. They were like, “Let's just keep you overnight and see what you do.” Over the 24-hour period of being there for observation, my blood pressures just went up and up. I had some more severe, and they were like, “You know, it's time to have a baby.” I was just shy of 36 weeks at this point. They started a magnesium infusion to help with the preeclampsia.Meagan: Blood pressure. Ugh, did it make you feel yucky?Kerri: Oh, yes. Magnesium is awful. I feel for anybody who has to be on that. It was awful. We call it flu in a bag, and it truly is that. Meagan: Flu in a bag. Okay. I've never heard of that, but I can understand that based off of the way I've seen my clients feel. Kerri: Yeah, that's exactly how you feel. Flu in a bag. It just makes you feel yucky. We started that, and we started the induction process. We started with the Foley bulb. We put that in. That was in until the next morning, and it comes out. When it came out, I think I was 3 centimeters, but not very effaced. It was just an artificial 3, a Foley bulb 3. They were like, “You know, your cervix isn't very favorable. Let's do some Cytotec.”We did a few doses of Cytotec. They rechecked me after that. It was still not very favorable. I think this was the evening at that point. They were like, “Let's just take a break, let you have a meal, and we'll try this again.” We do that, and then we start Pitocin. We did that all night. The next morning, my provider checks me. I'm finally a 4. I was ecstatic. I was like, “Oh, I've made some change.” I was really excited. They checked me. I was 4. They break my water, and they're like, “Let's just see what happens.” I had gotten an epidural at that point because I was already pretty miserable from being on magnesium and all of these induction agents. I was like, “I really need some rest.” I was already epiduralized. The nurse who was taking care of me at the time was a really good friend of mine. She was like, “Let's do everything that we can to try to have this baby vaginally.” She did Spinning Babies. We did all of the positions that we could. They checked me again later and I was a 5. I was ecstatic, like, okay. We're doing something there. A few hours later, I'm starting to feel pretty miserable, more miserable than I had felt before. I look over at the computer, and I'm seeing double. I call out to my friend. I'm like, “I don't know if this is normal, but I'm seeing two of everything.” She was like, “No, it's not.” She calls my provider. He said, “Let's draw a magnesium level. Let's see what's going on.” So they did. My magnesium level was high. They decided, “Let's just recheck you. We'll see you if you made change. If not, we'll have to have a section.”They checked me. I was still a 5 at that point. They decided with everything that was going on, it was probably in the best interest of the situation to have a section. I agreed, but I was heartbroken. My whole pregnancy, my only birth plan was don't have a C-section, and at that moment, that was my reality. Everybody who was with me that day, they were my coworkers. They witnessed me have a full-blown panic attack over it, but everybody made it through that with me. They loved on me, then we finally went back to the C-section. I'm pretty out of it from the magnesium at this point and just having labored so long. They started the section. I felt like I could feel more than what I probably should have been able to feel. I let them know, and once they got the baby out, they gave me ketamine just to help with my pain. I was knocked out for 12 hours, so I don't remember my baby's birth at all. Meagan: That's hard. Kerri: Yeah. It was really hard. I feel like the moment I actually realized I had a baby was the next morning. There's a video where I'm like, “Oh my goodness.”Meagan: Yeah. Yeah. Were you feeling any better by then?Kerri: I was still under magnesium, but I was feeling better. Meagan: Good. Kerri: The protocol, at least at the hospital that I work at in, is magnesium 24 hours postpartum just to make sure you still don't– Meagan: Yes, that is how it is here too, then they'll recheck things and if blood pressures are still elevated or anything like that, and if levels are elevated, then they'll remain, and if not, then they'll take you off. Kerri: Yeah, we did that for 24 hours. Once that was off, I finally got to go up to the mother/baby unit. I started to feel more normal at that point, but just that whole experience, I felt like I was just not even a part of. I was just there having the baby, but I didn't feel like I was actually there having a baby. Meagan: Yeah. Yeah. Did that carry onto the postpartum and future as stuff to process for you, or did it feel okay? Kerri: That was very hard for me because I worked with birth every day. I got to see these beautiful moments of people having their baby, and I didn't feel like I had gotten that. I don't remember my baby being born. You know, it's different. I had pictures, but nothing quite as good as remembering that. That was very hard, and it really affected me for a long time. You know, it still does. I would have loved to have been present in that moment. That just wasn't the reality for me. Meagan: Yeah. Have you done things to work through that, or anything to suggest for someone who maybe have experienced that or have been put under anesthesia where they just couldn't remember or be present in their birth?Kerri: For me, my faith is something that is very important to me. Praying and talking with God about it has really been helpful for me. It was still a beautiful moment. I've come to terms with that. Meagan: Good. Good. Okay, so baby number two. Oh, I was going to ask you, with being preterm, did they do a special scar or anything, or were they able to do a regular low transverse?Kerri: Just a regular low transverse incision. Meagan: Awesome. Awesome.Kerri: Yeah. So baby number two, we knew we wanted another one, and honestly, as soon as we were in that hospital room, I remember I told my husband that I never wanted to have a C-section again. When we started thinking about number two, we were going to start working towards having a VBAC. When she was around 20 months, I found out I was pregnant. Prior to the pregnancy, I had done a ton of research on what is the best way to get a VBAC, and what is the best way to prevent preeclampsia which is silly because we know preeclampsia can't necessarily be prevented. Meagan: Yeah, there are things we can do to try to reduce the chances, but there's nothing that we know for sure, concrete that this is what you can do to make sure you don't get it. Kerri: Yeah. My provider did have me start taking low-dose aspirin early on in the pregnancy, and I didn't get it again, but you know, I did all of this research like, what can I do? Looking back now, I think I put too much pressure on myself to try and prevent it. I found out I was pregnant when she was 20 months old, and we were so excited. We were just thrilled. We just couldn't even describe that. I was so excited to start doing what I could in the pregnancy to get my VBAC. That's all I could think about was my VBAC. I remember praying to God. I just prayed that this pregnancy I could have my successful VBAC. Then as the pregnancy got closer to delivery, in my head, I'm like, “I could have another C-section. I need to start thinking about this.” So then I shifted my mindset. I was like, “You know, if I have to have another C-section, it's okay. All we want is a peaceful delivery.” So that's what I kept telling myself every day in my prayers. I was like, “Whatever happens, I just want it to be peaceful, and I want to be present.”Meagan: Yeah, I bet that was a really big deal for you.Kerri: Yes. I just kept saying that every day. That's what we're going to do. Peaceful delivery. Present delivery. I kept telling my coworkers because they were rooting for me. We were going to make this a better experience. My provider the whole pregnancy was great. She was very VBAC-supportive. I did a lot of research prior to the pregnancy about who I wanted to see, and I worked with these providers. It was a hard choice to make. I work with great providers, but I feel very confident in the provider I picked. She took such great care of me, and I'll forever be grateful for her. Towards the end of the pregnancy, me and her had a chat about what are we going to do to get our best attempt at having a VBAC? I ultimately decided that I wanted to be an induced VBAC. Not necessarily that I wanted to be induced, but I needed the peace of mind. I already had a lot of anxiety just because of the last pregnancy, and I just needed an experience where I could at least expect something. This may not end in a successful VBAC, but I really want to try. We scheduled the induced VBAC, and she was like, “This might not work.” We had a lot of conversations about that. She was like, “Induced VBACs aren't always successful,” which I appreciated her saying as a provider. I was like, “This is what I need just for my peace of mind.” We scheduled an induction. Everything was going great. I went in at night. I had gotten a Foley bulb again. My cervix wasn't favorable necessarily. I was 39 weeks on the dot. Maybe if I would have waited a little longer, I would have been more favorable. At that point, I wasn't the most favorable, but I still wanted to go through with it. I had wrapped my head around that that day was going to be her birthday and we were going to go through with it. We started with the Foley bulb, and it stayed in for what felt like forever. They put it in at midnight. It did not come out until 11:00 AM the next day. I was not expecting that because last time, the Foley bulb did not stay in that long. This time, I had made it to 39 weeks, and I was thinking that my cervix would do more, and it just didn't. My provider came in. She was able to get it out. She broke my water, and I was at a 4 at that point. It was ready to come out, but it didn't on its own. I wasn't expecting that. I was expecting a little bit more. Meagan: That can happen. It can be in for up to 12 hours and not fall out. That can happen, but I'm sure after your previous experience, you're like, “Wait. Why isn't this out yet?” Kerri: Yeah. We did that, and I decided she was going to break my water. Me and her and my nurse who was taking care of me was a really good friend. We were like, “Let's just get an epidural because we know that there is a bit of a higher chance for uterine rupture for being an induced VBAC or TOLAC.” Meagan: Were you feeling contractions at this point?Kerri: I was. I was feeling contractions. That was something, I kept telling my husband, that I was really excited about. With the last experience, I was really out of it having been on magnesium and having gotten an epidural so early. I just didn't even feel like I got to experience labor at all. Like I said, I didn't feel like I was a part of that experience. I was really excited this time to be able to experience contractions. While they were very, very painful, I was very grateful to have that experience. I had asked for a few doses of fentanyl. Meagan: Fentanyl?Kerri: Fentanyl, yeah. We used to do [inaudible], but right now, we have fentanyl. I had asked for a few doses of fentanyl, but I really tried to tough it out because I was like, “I really want this experience.” The whole pregnancy, I had been prepping for how I was going to manage labor while I didn't have an epidural. I had a friend who I worked with. She is also a doula, and she is going to school to be a midwife. She had talked me through a few different things that I could do. I had really prepared, and I was really excited to be able to experience some contractions. Meagan: Yeah. Kerri: But we had decided, “Let's get an epidural just to be safe.” We got an epidural, and everything was smooth sailing. We got the epidural. We started some Pitocin. I had asked for peace of mind for me, an IUPC which is the intrauterine contraction monitor because I wanted to know what my uterus was doing. If I was going to be an induced VBAC and I'm going to have a higher risk of rupture, I wanted to know exactly what my uterus was doing, so I asked for one of those to be put in. They put one in. My contractions were adequate. We were moving along. I'm just ecstatic at this point because I'm like, “I have never had adequate contractions. Last time, I made progress, but nothing like this.” I was very, very excited. Throughout the course of the day, me and my friend who was taking care of me decided that we were going to do every Spinning Babies position that we could do. My epidural was just perfect enough. I was able to help move by myself and do all of these positions that I had planned on doing. It was great. I was so excited. They checked me, and I was a 5. I was excited that I had made it a little bit farther than what I had thought I would because last time, I had stayed at a 5 forever. I was at a 5, and I was expecting to just keep making progress. A few hours later, they checked me again, and I was still a 5. My provider is like, “Your pelvis feels very tight, and your baby's head is not applied at all.” So then, I felt crushed in that moment. I had been planning on having this successful VBAC, and it doesn't feel like it's going to happen. Prior to the induction, I had been living in the Miles Circuit and doing everything I could to get her the best engaged she could be. She wasn't doing it. She said, “We'll give it a few more hours.” Meagan: What were your MVUs at this point? Sorry, I just interrupted you. Kerri: I think they were 200. They were adequate. Meagan: Mhmm, cool. Kerri: My contractions had been adequate for a while, and I wasn't on very much Pit. Meagan: Good. Kerri: I was thinking that things were going great. She was like, “We can keep going if you want. I'm going to stay with you. I'm going to do your delivery regardless of the outcome.” We decided we were going to keep going. A few hours later, I get checked again. I'm still 5. Her head's still not applied. My friend who was taking care of me was about to leave because her shift was over. She was like, “We can call it right now, or we can give it another shot.” She said, “You'll never get this experience again, so if you want to keep going, keep going, but if you don't, it's fine.”Kerri: I decided, “I want to keep trying.” I kept trying. Then a few hours later, I was checked again. I was still a 5. Her head was still not engaged, so we decided that we were going to have another C-section. That was heartbreaking. I remember in the moment feeling a little heartbroken, but also feeling at peace about it all in one. Meagan: Yeah, which is important. Kerri: Yeah. We go back for the section. I was nervous about having another section just because my first one was so traumatizing. I wasn't sure how it was going to go. I was really nervous about anesthesia. Is it going to hurt this time? Am I going to be knocked out because I'm feeling too much? The anesthesiologist who took care of me decided, “Let's just give you a spinal.” My epidural had fallen out actually, so she said, “Let's do a spina. Let's make sure you are the most comfortable you can be.” They did that. They started the section. I couldn't feel anything which I'm already thrilled for. I remember just laying there, and I felt so present during the whole thing. My baby came out, and I remember being a part of that moment. There was a clear drape, so I was able to see what was going on. My provider– I feel like we had developed such a good bond. She did everything to make sure that it was a good experience for me and to make sure I was present. Something that was important to me was that my baby would be with me a little bit longer while I was in the OR. I didn't have my baby with me last time, so I really wanted that. I didn't necessarily do skin-to-skin, but I got to hold her. She got to be with me the whole time, and it was perfect. She got to be with me during recovery. That whole birthing experience was just the most beautiful thing.Meagan: Good. So you have been able to walk away feeling positive about a birth experience. Kerri: Yes. That's not something I thought I would get with a C-section. After my first, I had a lot of postpartum anxiety. I had very negative feelings towards C-sections. I didn't enjoy seeing my scar. To me, that was just a reminder of what my body had done to me. I felt betrayed by my body, and for the longest time, I just was ashamed of the fact that I had a C-section. After that experience with my second, I was very proud that I did have a C-section because reality hit me that this isn't the most ideal way to give birth to a baby, but it happens, and thank God they are available, and I have two beautiful babies because of my C-sections, so I'm very, very thankful for them now. Meagan: Yes, good. Good. Kerri: When my husband and I decide to have another one, I'm like, “This will be great because I think that for me, I'll just have another repeat section, and it will be scheduled. It's going to be great, and I'm excited about it.” But it's just something to be able to look back and be able to think of this as such a positive experience as opposed to my first. I wasn't proud of my birth story at all. It was something I carried with me for a long time, and now, I'm thankful that I can have a different perspective about it. Even about my first, my first birth was beautiful in its own way.Meagan: Yeah. It's hard because you don't want to only think about those births as negative or traumatic. You want to pick out the positivity from it, but sometimes it is hard to see all of that, so it's been so great to hear that you– one, it sounds like with your labor, it really was a lot of your choice along the way. You decided this was something you wanted. Your team went with you and then walked with you along the way. In the end, it was able to be something that was a lot more healing. Even though it was still a Cesarean, it was a healing experience for you. You got to have your baby that whole time, and you got to grow through that experience. Like you said, you may choose to have a third C-section, and that's okay. I think that's one of the things I love about this podcast is that it's not if you choose a C-section, you are shamed. That's just not how it is. Everyone needs to choose what is best for them and their individual circumstances. I love that you've been able to go from the furthest end of the extreme to coming back, and then possibly if you have another baby, it sounds like something that you are already looking forward to having an even different experience. I love that you've been able to have that and you can share these stories and you can hold onto these good feelings because it really is important. Kerri: Yes. Even as a labor and delivery nurse, I feel more positive about taking care of women who have C-sections because for the longest time, every time I went into the OR, it brought up feelings from my own first C-section. It was hard to be the best nurse that I could be when I was dealing with my own feelings, so I'm thankful now that I have this perspective of, “This is beautiful in its own way.” Every birth is beautiful. You're bringing your baby into the world. Who cares how it happens? I think we get so wrapped up in God made our bodies to give birth a certain way, and that's just not the reality for some people. I'm thankful we live in a society where C-sections are readily available and we can have them. They can be just as beautiful.Meagan: Yeah. CBACs really can be. My second C-section was very, very healing. I think it was exactly what I needed to have healing from my first birth that I didn't realize I didn't heal from. I was really, really grateful that I had the experience. Again, it wasn't the birth I desired, but it was such a better and healing experience for me. I was really, really grateful for those. Okay, I have two things that I want to talk about. One is preeclampsia. Not even just preeclampsia, but COVID. I was just wondering, as a labor and delivery nurse, have you seen things like preeclampsia or placental issues or anything like that from people who have had COVID during pregnancy? Rebecca Dekker has such an incredible blog, and I'm going to make sure to link it here. I have seen this weird connection with pre-e with a placenta or placental issues that have had COVID. I was just curious if you've seen anything like that. Kerri: You know, I feel like that is something that we've seen more of. I will say I started working as a labor and delivery nurse in 2021, so I can't speak for what nurses saw prior to this, but I do feel like I see a great deal of preeclampsia, especially during that COVID time. Women were having more complications. More women are getting more sick. I don't know if there's a correlation, but I will say that as far as pregnancy goes, it does seem like a lot of pregnancies are becoming more high-risk.Meagan: Because of that? Because of COVID?Kerri: I don't know if it's necessarily COVID or just the way we eat, the way we take care of ourselves, but I feel like during COVID, there were a higher number of combinations whether there's a correlation or not. Meagan: Yeah, that's interesting. I just barely read the most recent update. I need to dive into that more, but I was wondering as a labor and delivery nurse if you had seen that. You mentioned with your first that they had tested you, and your magnesium levels were too high. Are there things that can reduce magnesium levels? Obviously, maybe lowering the magnesium levels that are given, but are there things that can be done in that situation to lower their magnesium levels?Kerri: If your magnesium level is high, we can give you the reversal drug which is calcium gluconate. We can give you that, but we are already inducing, you and it's high, and you're not making very much progress, at that point–Meagan: The provider may not be wanting to do that. Kerri: Yeah, delivery is the best option.Meagan: Yeah, for preeclampsia, which we do know. I was just wondering if there was such a thing that could help. Kerri: Yeah. Ideally, just do what you can to deliver. But you know, that's something that people should talk to their provider about in that moment. Meagan: Yeah. I agree. I agree. Then last but not least, I just wanted to share a little bit more because I think a lot of people do question induction and VBAC. What are the risks? Sometimes, the risks seem astronomical, and sometimes they are not to some people. Everyone takes it differently. I wanted to share some evidence on that. With the risk of induction, it does increase just like you had mentioned. It does increase the risk of uterine rupture when we are induced. It's about a 1.1% if you have Pitocin and about a 2% if you have prostaglandins, and then of course, we know misoprostol. How do you say that?Kerri: Misoprostol, but however you want. Meagan: Yeah. I saw misoprostol, but I've heard people say MYsoprostol. It is about 6%. It definitely increases with certain things that you do. It's about a 1.1%. Uterine rupture in general is just around 1%. It increases it ever so slightly, but it's really important to take the right precautions. A Foley bulb is a fantastic way to start jumpstarting labor, but sometimes it does need to have a little bit of an opening, at least 1 centimeter. Kerri: Where I work, we don't do Cytotec for TOLACs. Meagan: Most people shouldn't.. Kerri: It's a 1 to 1 assignment. Your nurse who is taking care of you wouldn't have another patient. Meagan: Interesting. Kerri: They make sure that all hands are on you and make sure that your uterus is okay. When it came down to me when I was thinking about wanting to TOLAC and hopefully have a VBAC, I looked at the risk. I think it's important. I listened to a podcast. I think it was by Jordan Lee Doulie. She had an OB on her podcast talking about VBAC. He said, “It's important to remember that there is a risk whether you're having a repeat section or you're having a TOLAC.”I really took that to heart. For me, the risk of uterine rupture is small enough that I want to try. I know that I'm going to be in a hospital. I know I'm going to be monitored, and if that's something that's happening, I know I'll be taken care of quickly. I was okay taking the risk. I think that has to be such an individual choice. It does carry risk as well, so that's why I needed to at least give it a shot. I'm somebody that I fully support whoever wants to have a VBAC after two sections, but for me, that's not something I want to do. But as with everything, you have to look at both sides of it and make your decision. Meagan: Yeah. I think that's what we talk about on this podcast. Learn the risks. Learn the facts. Learn what the evidence says, and then follow your heart. What feels right? I appreciate you so much for coming on and sharing your journey. I do love how much you were able to be a part of your birth that second, and then also your postpartum experience is so important. Kerri: Oh yeah. I'm 11 weeks postpartum now, and I just have to say that my mental health this time is so much better, and my recovery post-C-section was so much better. I really have such positive things to say. It was such a good experience. I'm forever grateful for everybody who took care of me. I'm forever grateful for my provider. I just love her dearly and am just so thankful for her. Meagan: Good. I'm so grateful for you. I'm so glad you had that support and that loving team. Thank you again for sharing.Kerri: Yes. Thank you so much for having me on here.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Dr. Natalie Crawford answers common questions about the uterus.  Questions answered: What are the implications of having uterine scarring now that I am done having children? What are your thoughts about finding fluid in your uterus after beginning your IVF cycle?  How long does it take for the body recover and go back to its normal period after hysteroscopy? Could having a tight uterus be a factor in unexplained infertility? Should I consider surrogacy after multiple failed transfers? Want to receive my weekly newsletter? Sign up at nataliecrawfordmd.com/newsletter to receive updates, Q&A, special content and my FREE TTC Starter Kit and Vegan Starter Guide! Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page @nataliecrawfordmd. You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today!      Thanks to our amazing sponsors! Check out these deals just for you: Quince- Go to Quince.com/aaw for free shipping on your order and 365-day returns Ritual-Go to ritual.com/AAW to start Ritual or add Essential For Women 18+ to your subscription today. Hello Fresh - Get 10 FREE meals at HelloFresh.com/aaw. If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram @nataliecrawfordmd, check out Natalie's YouTube channel Natalie Crawford MD, and if you're interested in becoming a patient, check out Fora Fertility. Learn more about your ad choices. Visit megaphone.fm/adchoices