• Episode 286 Alexis' Peaceful CBAC

    Cesareans can be peaceful, beautiful, and so healing. Though Alexis didn’t have the VBAC she planned for, she still had the euphoric birth she dreamed of. 


    Alexis unexpectedly experienced PPROM and preeclampsia at 36 weeks with her first baby. Trying to labor and push under the effects of magnesium and all of the other interventions was incredibly exhausting. When baby started having decels, she knew it was time for the Cesarean. 


    After a rough NICU stay and having to exclusively pump, Alexis knew she needed to be proactive about healing from her birth PTSD. She went to EMDR therapy and found the healing her heart needed. 


    Alexis shares all of the ways her second birth was different from the first. She went into labor spontaneously. She progressed quickly and felt strong. But when baby flipped breech mid-labor, Alexis knew it was time for another Cesarean. Her team took their time honoring every wish Alexis had and truly gave her the birth of her dreams!


    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    02:05 Review of the Week

    05:29 Alexis’ first pregnancy during COVID

    09:41 PPROM and preeclampsia 

    13:27 Pushing turned emergent Cesarean

    16:54 NICU stay and exclusive pumping

    20:45 EMDR therapy and postpartum healing 

    22:24 Second pregnancy

    26:21 Beginning of labor

    29:47 A picture-perfect labor

    31:26 Baby flipping breech and going for a C-section

    38:03 The game changer

    40:56 A euphoric birth

    43:45 Ways to have a gentle Cesarean

    46:36 Music, skin-to-skin, clear drapes, mirrors, conversation, and maternal-assisted Cesareans

    50:32 Vaginal seeding, advocacy, and backward dilation

    52:29 Swelling in pregnancy and nutrition


    Meagan: Hello, hello everybody. Today’s episode is one that I am actually really excited to hear and share. I think a lot of the time when we are listening to The VBAC Link, we are looking for empowering VBAC stories, positive VBAC stories, and sometimes when we are sharing these stories, it is accompanied by traumatic Cesareans. We know that through all of these stories, I have personal experiences that a lot of these Cesareans are traumatic, and a lot of the time they are traumatic because they are undesired or they are pushed really hard or people feel like they are backed in a corner or so many interventions come into play that they happen in a traumatic manner. 


    But today’s story is going to talk a little bit about how Cesarean doesn’t have to be traumatic and it can be peaceful. I relate personally to it because my second C-section, I didn’t want actually. I didn’t want it at all. It wasn’t what I planned on, but I still found so much healing through that birth and I think that in a lot of ways, it shifted my mindset of how to view Cesarean. 


    I also want to recognize that our community doesn’t always want a VBAC, right? We are here learning about the options for birth after Cesarean but that doesn’t mean we only want VBAC so I’m excited to share this story today for everybody, especially for those who are unsure of what to do or want to maybe go the Cesarean route but want to have maybe a better experience than their last Cesarean. We’re going to talk about how to have a peaceful Cesarean. 


    We have our friend, Alexis, with us today going to be sharing her peaceful journey with you. 


    02:05 Review of the Week 


    But of course, we have a Review of the Week, so I want to dive into that and then turn the time over to her. This is from Apple Podcasts and it says lilylalalala. Lots of la la la. It says, “Inspiring and uplifting.” It says, “I first found this podcast in 2020 in the depths of the postpartum after a very traumatic, unplanned Cesarean with my first baby. I listened to every single episode as I struggled to process what had happened to me. I finally gathered up the courage to seek help for postpartum PTSD that I was experiencing. 


    “This podcast is a treasure trove for inspiring stories which helped me regain confidence in my body to have a beautiful VBAC with my second baby last year. Thank you for being such a huge part of my healing journey.” 


    I feel like so often, we hear little things like, “Oh, I loved hearing it” or “That was inspirational” or “That helped me learn the knowledge” but I love hearing that it was a part of the healing journey. It healed. That is so amazing. Thank you so much lilylalalala for sharing your review. 


    If you haven’t yet, you guys, we would love your review on the podcast. You can review our Instagram or our Facebook community. Give us a review of The VBAC Link. You can leave your review at Google. You can just Google “The VBAC Link” and leave a review there. You can leave a review on the Apple Podcasts. I’m pretty sure you can on Google Play. Or guess what? You can even email us at info@thevbaclink.com subject “Review” and leave us your review there. 


    05:29 Alexis’ first pregnancy during COVID


    Meagan: Okay. I am so excited for you to share with us today. Remind me. Okay, so we are going to be talking about preeclampsia, EMDR therapy which I think is something that is super powerful. We are going to be talking about repeat Cesarean and it can be better. Yeah. Anything else that you’re like, “This is what my story is going to touch on?” 


    Alexis: NICU time also. We had some NICU time. That was a big part of my postpartum experience. Yeah. 


    Meagan: Okay. Yes. Okay, well without further ado, I would love to turn the time over to you to share your story. 


    Alexis: Thank you. Yeah. There is a lot that goes into this story, a lot of different factors that made my first experience really hard, but I got to learn so much through it and I’ve been able to help a lot of other friends and family just through my experience so I’m super excited to share my story with everybody. 


    Meagan: Can you remind us where you are at as well? Where you are located? 


    Alexis: Yes, Joplin, Missouri. 


    Meagan: Missouri. 


    Alexis: Yep, so southwest Missouri. We are originally from Oklahoma City. My husband and I have lived here for six or seven years now and we call it home. Yeah. We got married in 2017 and we were about ready to have a baby around this time the pandemic hit so fun timing there. I’m sure a lot of mamas can relate to that. I think that’s a lot of our story. 


    We got pregnant at the end of 2020. Things were kind of normalizing but not really medically. I mean, I never saw my OB’s face. We were all wearing masks. My husband couldn’t come to our first appointment because the regulations were still iffy on that. I Facetimed him to hear the heartbeat which was so sad for our first pregnancy.


    But as things kind of went on, the rules lessened a little bit, but still, it was COVID. 


    We got pregnant really easily. We were so blessed for that experience. 


    For the most part, my pregnancy was really healthy. I did have a lot of nausea and morning sickness. That kind of lasted the whole pregnancy and it probably was the reason that my nutrition was so terrible. Nothing sounded good. All I really wanted was french fries so I could never– the smell of our gas oven made me gag so cooking really wasn’t happening. 


    Meagan: You’re not alone and that’s one of the reasons why we talk about Needed, our partnership, because there are so many of us who go through this morning sickness and the smell of anything is just barf so we’re not getting those nutrients, right? So we’ve got to try to get them in other ways because we’re not getting them through food because we can’t. 


    Alexis: We can’t, yeah. That is totally me. So yeah. My diet was terrible and I didn’t know at the time. Of course, everyone says to eat healthier and a lot of protein, but I’m already not a good eater of protein, and certainly not when I am nauseous, so yeah. My diet was a big factor. I had pretty rapid weight gain and I’m a petite person so that was not normal for me. My midwife really kept an eye on that, but I was still doing CrossFit my whole entire pregnancy somehow. I felt good enough to do that, but yeah. I was probably just wearing my body down. I was not eating well and working out really hard. 


    What’s funny is I was working out because it is proven to decrease your chances of getting preeclampsia and that didn’t happen. 


    Meagan: Which ended up happening? 


    Alexis: Yeah. I was like, “I’m going to be so strong. This birth is going to be so easy. I’m just going to squat down on the floor and pop this baby out, no problem.” 


    Meagan: I love your confidence, though. That is important in any birth. The confidence in your body’s ability is wonderful. 


    Alexis: For sure. I think that because I was working out so hard, maybe my pelvic floor is tighter. I’ll get into all of that. Anyway, that was the pregnancy. Everything was good and healthy. I didn’t have any other issues. 


    09:41 PPROM and preeclampsia 


    But around 30 weeks, I started swelling really badly. It was a summer pregnancy, so no one really thought anything of it. I knew it was unusual for me. It was a lot of swelling. My midwife was keeping an eye on it. I never had high blood pressure and no protein in my urine. There were no markers and technically, I think according to what ACOG says, swelling isn’t a red flag necessarily for preeclampsia. I think they won’t diagnose you unless, of course, it’s blood pressure and protein. No one was worried about it. 


    Yeah. We were just trucking along. Everything is good, just extremely swollen. My husband travels for work all of the time during the summer so one night, he had gotten back that day and I was about 36 weeks on the dot. He got back that day from California and I woke up in the night to go to the bathroom and sit up in bed and I felt a little bit of a gush. I was like, “That’s weird.” 


    I get up and go to the bathroom. Toilet paper is a little bit pink, watery-tinged so I kind of knew immediately. It smelled different. I knew something was up. I’m calling for my husband to come in there. He is very confused. At 36 weeks, we did not expect that. The chances of your water breaking are less than 10% or something? 


    Meagan: They say 10% or less, yeah, especially before labor begins. You had PPROM and then there is PROM so premature rupture of membranes, PROM, and then premature birth. 


    Alexis: Yeah, so never did I ever think that my water would break and that would be the start of my labor. I knew those facts and I had done a lot of research. I was really well-educated before I had my son. I just– we are all really good birthers and really good parents before we do it. So yeah. My water breaks. I call the midwife. It was my midwife on call which gave me a lot of reassurance too and she just said, “Go ahead and come in since your water broke. It sounds like that’s exactly what happened.” 


    Looking back now, that was such a God thing because my plan was that I wanted to go unmedicated. I planned on laboring at home for as long as possible, but my water breaking just messed up my mind and shifted all of my plans. That wasn’t a part of my plan, so I was like, “Oh, okay. I’ll go in. Sure.” I didn’t think twice about it. 


    When we arrived at the hospital, I felt fine. I had no headaches. I had no vision changes. I felt fine. My blood pressure was I think 200/110. It was insanely high. It was so bad. The nurse was like, “Oh, maybe you’re just excited. We’ll retake it.” We retook it. It was still crazy high and really dangerous. 


    They started the magnesium drip and for any of you girlies who have ever done that, it is a nightmare. 


    Meagan: Yuck. 


    Alexis: I felt terrible. It makes you feel like you have the flu. I threw up the whole labor. I just was seeing double so anytime a doctor or nurse would come in, I would have to cover up one eye to be able to look at them because I couldn’t see straight. 


    I basically could not get out of bed. We had to do an epidural immediately to drop that blood pressure so I was totally bed-bound. The nurses were super helpful with moving me around, so I basically was just side to side on a peanut ball for 20 hours. 


    I had felt some contractions leading up as we were driving to the hospital, but nothing super strong. After a while, my midwife suggested some Pitocin which wasn’t a part of my plan. Again, I wanted to go unmedicated. I wanted to have a super crunchy, awesome birth and I have now had every medication under the sun. 


    13:27 Pushing turned emergent Cesarean


    Alexis: We start some Pitocin. That gets some contractions going. I didn’t mention this. I arrived, I think at a 3 or a 4 when we got to the hospital so not a bad place to start at 36 weeks especially. 


    But yeah, we go through laboring in bed, on my back, on my side. Of course, feeling the pains of labor and contractions in addition to magnesium just felt terrible. I didn’t do the research about positions or what I should be doing. I didn’t have a doula so that’s a big part of it too. 


    But I do progress to 10. Things kind of move along over these 20 hours and we start pushing. I could tell you on that first push, I had the thought, “I need to have a C-section.” I was so exhausted before I really even began pushing just from being awake for 20 hours. That was such an exhausting, long, hard labor. I could not. I had no energy left. 


    The midwife that was there tried a lot of different pushing positions. We did tug of war. I actually got on my hands and knees. She was really great about helping me with pushing, but I had no gas in the tank. I was so exhausted. I don’t know what my son’s position was either. I don’t know how high he was. No one ever told me what station he was at. I remember thinking, “Is station just a silly thing people say on Instagram and it’s not real?” Because no nurses have mentioned his station. Should I ask? I didn’t want to feel stupid. 


    Ask all of the questions. It is your birth. 


    Meagan: 100%. 


    Alexis: Ask. If you are wondering, ask. It’s your body. I don’t know why I felt afraid to ask what station or what my dilation was all of the time when they would check me. They just didn’t tell me which was really weird. 


    I pushed for two hours in every position under the sun and eventually, he started to have some heart decels so the OB on call rushed in pretty quickly. He told me it was time to go to a C-section. I, like I said, was kind of ready for it at this point. It was not my plan, but I wasn’t going to put my baby at risk so I was like, “Okay. Let’s do it.” 


    We go back to a pretty urgent C-section. This was all also, perhaps more traumatic for my husband. I was so out of it with all of the medication and so tired and you are already in labor land anyway, so you don’t remember it all. 


    He relayed this all to me later and he was way more affected by it and that’s such a big part of our story too is him. He’s left in a room alone. They take me back. He does get to come in. I didn’t have to be put under or anything, but that’s got to be so scary as a spouse. You hear that things are dangerous. They take you out and now you’re just waiting. 


    Meagan: Yep, having no idea what’s going on. 


    Alexis: Yeah, he had no idea if I was okay or if the baby was okay. The C-section itself was actually fine. Everything went well. I was just loopy and out of it from everything I had been on so I don’t remember it that well, but when they got my son out, his APGAR was a 2. He was not doing great. 


    They had to do some resuscitation so that was just scary. As he came out just not really responding, but he did start to cry. His APGAR came up on that second check and everything was fine at that point. We also didn’t find out gender so what a way to find out your gender was that moment. We were so scared. It was like, “That’s great. He’s a boy. We don’t care.” We just wanted him to be okay. 


    16:54 NICU stay and exclusive pumping


    Alexis: Yeah. They get him in a good spot breathing and crying. All is well. I did fine. The C-section was not– that wasn’t the traumatic part for me. I got closed up. I don’t remember honestly anything after this point. I don’t know if I fell asleep. Maybe it was just blocked out of my mind, but we eventually got back to our room. 


    They take my son to the nursery and I don’t remember anyone asking us about that. My husband doesn’t either. I’m sure I was not in a good place. My blood pressure was still through the roof. It wasn’t a great time for skin-to-skin. I understand that, but looking back, it’s just really sad that I didn’t really see him. I didn’t meet him then for two days after. My blood pressure was so high, I couldn’t get out of bed from the morning after he was born until about 11:00 at night. 


    Around 6:00 AM, his pediatrician came in and his blood sugar was low so he had to be sent to the NICU. Now we are in separate jails across the hall from each other because he was in the NICU. They wouldn’t let me get out of bed because my blood pressure was just not controlled. It was so bad. So I didn’t meet my son for two days. That’s kind of where– 


    Meagan: I’m so sorry. 


    Alexis: –the trauma. Labor was traumatic. The C-section was fine and then postpartum was really traumatic as well. That’s kind of my story. Eventually, my blood pressure starts to respond to medication and I’m able to go meet him, but seeing your baby hooked up to cords and a feeding tube is awful. It’s terrible. 


    That was really his only issue though. He didn’t have any breathing problems, thank goodness as a 36-weeker. His only issue was blood sugar and feeding. He was just a sleepy guy. He was not taking the bottle. He wasn’t really vigorous at the breast. We had lactation consultants come in, but it wasn’t super helpful when you’re in the tizzy of NICU. 


    The NICU is not set up for breastfeeding success. 


    Meagan: It’s not. 


    Alexis: You’re on a 3-hour schedule. You don’t feed on demand. You need to measure how long and how much they are eating. That is not how breastfeeding works. We feed on demand. We do skin-to-skin. I just didn’t know at the time. I was like, “Oh, every three hours. Okay.” 


    I’m pumping. I didn’t nurse him a ton in the NICU just because it wore him out so much. It’s a lot of work to breastfeed so we were like, “If you can take a bottle and we can get out of here faster, do it.” So I was pumping. 


    Eventually, after eight days, we were able to bust out of there. Feeding was the only thing he had to get over. When we went home, I was still pumping. I would offer the breast, but I was so unsure of it and so overwhelmed with it all. I ended up just exclusively pumping because now, looking back, I can see postpartum anxiety 100%. I was afraid if he wasn’t eating enough, they would stick him back in the NICU which would not have happened. They would have done other things before that. It was not emergent, but that is what anxiety tells you. 


    Meagan: I was going to say that anxiety tells you things that aren’t necessarily true. 


    Alexis: Exactly. 


    Meagan: We are in a state where that’s what we believe. 


    Alexis: Exactly. My husband and I were both so overwhelmed and traumatized from the NICU that it was just easier for us to pump. I remember going back to my six-week appointment and my midwife was like, “How’s breastfeeding going?” I told her, “I’m exclusively pumping.” She was like, “Oh my gosh. That is much harder.” 


    Meagan: That’s a lot of work. 


    Alexis: I was like, “No, you don’t get it. It’s not harder.” When your baby won’t latch and they are crying on the breast, it is so stressful. No, no. This is not harder. But it is exhausting. It’s so much work. I did it for a year. I’m very proud of that, pumping is not for the faint of heart.


    Yeah, that was kind of his whole experience. It was just really overwhelming is what I would say. We didn’t really know what we were doing and the preeclampsia of it all was so scary. It’s such a serious thing that I wasn’t super duper-educated on what that could look like. 


    Meagan: Right. 


    20:45 EMDR therapy and postpartum healing 


    Alexis: After his birth, I just really tried to dive into therapy, and my husband too. We just wanted to work through that because we knew we wanted more kids. I already knew I wanted a VBAC. Immediately, I was like, “This was never my plan to have a C-section so we are going for a VBAC.” I was a great candidate for it. 


    We plugged forward. I did EMDR therapy which I cannot recommend enough. It literally retrains your brain to hop off a thought and get on a healthier track of thinking. My main objective with my therapist was my anxiety around blood pressure because, to me, it felt like blood pressure was something I couldn’t necessarily control. You can do things to support your body like diet and supplements and all of these things, but some of us just have chronic high blood pressure or white coat syndrome which was totally me. 


    So I just wanted to eliminate that piece of it if I could and just calm myself down before appointments, not get stressed about it, and not add more to my plate of trying to be healthy for this next pregnancy. I just wanted to do that work before I even got pregnant. 


    I went through EMDR therapy surrounding blood pressure and also just working through my birth and kind of getting to a place where even if that same exact birth happened again, I would have more peace about it because you don’t know how it’s going to go. The chances of having preeclampsia again the second time are higher than a first birth for anybody else. It could have gone the same way. You don’t know, but I just wanted to be prepared to have a better experience, a better bonding experience with my baby, and a better birth. 


    22:24 Second pregnancy


    That really got me to a healthy place. Around the time I was wrapping that up, I got pregnant with my daughter about two years later. I had just done this whole time in between kids and listened to as many VBAC Link episodes as I could. I tried to diversify the information that I was taking in too so a lot of the Evidence-Based Birth, also Dr. Fox’s podcast is a really great one for a little bit of a different perspective. 


    Meagan: Yeah. 


    Alexis: He’s an MFM. He’s been on this podcast and has a very different perspective. He has seen it all so he’s going to be a little bit more conservative with allowing any patient to VBAC or any type of “complication”. It’s a really good perspective to add to the mix if you are looking for it. 


    I just filled my brain with as many birth stories and as much research as I could. I did everything I could to avoid preeclampsia this time. I ate as close as I could to the Brewer diet. It’s so hard if you’ve ever tried to eat exactly the Brewer diet. It feels impossible at least for me so I just did my best. I tried to eat a lot of protein and started my day with a lot of protein just trying to diversify my diet because I did not do that the first time. 


    Also supplements, so any research that I found, I would take the supplement. So low-dose aspirin, I was on that from the beginning. I took magnesium-glycinate every night. Melatonin– I saw a study that shows a direct link between low levels of melatonin in preeclampsia. Vitamin C is to the strength of your bag of water so I took that every night. My water did not break so I don’t know. That worked for me. I also was a little bit anemic during my first pregnancy so I took a grass-fed beef liver supplement and I had no issues with my iron this time either. 


    Just a lot of different things to support my body so I’m like, “I’m giving you the best opportunity, body, to have a healthy pregnancy and that’s all I can do.” You’ve got to throw your hands up at some point and just say, “I did everything I could.” That’s what I did. I switched hospitals because I felt like going back to the same hospital would be kind of traumatic. 


    Meagan: It can be triggering. 


    Alexis: Exactly. I switched OBs. I switched to– a friend of mine had an OB who had a really low C-section rate. I think the lowest in the hospital and then also with her, she pushed for three hours. He really, really fought for her vaginal birth because he knew she did not want to have a C-section. 


    Meagan: I love that. 


    Alexis: I thought, “That’s the type of doctor that I want.” So I went with him. He was really supportive the whole time. I hired a doula as soon as I could and that was a really great tool as well. Webster-certified chiropractor and all of the things. I just tried to throw everything at it that I could. 


    Alexis: Everything was great. Super healthy. I had no issues again this time. My blood pressure was looking really normal, then a little bit toward the end at the end of 27 weeks-ish, I found out she was breech, my daughter. My chiropractor was on top of it. She was like, “I swear. I have a 97% success rate of flipping babies. I won’t say I flip babies, but I give them the space to flip.” Yeah, so I felt confident in that. My doctor had checked. She turned head down later on so everything was good there. 


    A thing that I’ll say now is my husband and I had prayed my whole entire pregnancy if we were going to have a repeat C-section, let it be because of breech presentation. I’ll get back to that, but that was just something. I’m not against a C-section. I’m against a traumatic birth and everything that we went through. I just don’t want to have that experience. Birth is birth. C-section or vaginal birth. You are having this amazing, incredible experience and C-section is not the enemy. Traumatic birth is the enemy. That is what we were hoping for, but she was head down so we were like, “Okay. This is our sign. We’re going for it. This VBAC is going to work. It’s going to be awesome.” 


    26:21 Beginning of labor


    Alexis: As we got to the end, I was cool with cervical checks. That was something I was just kind of curious about. I wanted to know where I was at because my doctor was pretty anti-induction which is great. I just wanted to know where I was at by the end to see if we could do some sort of natural induction method. 


    At 36 weeks, I think I was at 1.5 and then at 37 weeks, I was at a 2. I opted for a membrane sweep. My plan was, “I’m accepting. There is a small risk of infection or them breaking your water but it is a small, small risk.” You just have to weigh the pros and cons. For all of us who are VBACing, there is a risk of rupture. There is a risk of all kinds of things. You have to decide what is right for you. The risk of a membrane sweep was so worth it to me because if he wasn’t going to induce me, let’s do something natural that can get things going. 


    So for me, I was going to do it every week. I had my first membrane sweep at 37 and 6 then I went into labor the next morning. It worked. I didn’t notice anything that day really. I didn’t have any bleeding which they usually tell you you could. I really didn’t feel any cramps or anything after so I was like, “Oh, well. It didn’t work. Whatever.” 


    I get up for work the next morning and basically, as soon as I was vertical for the day, I was feeling contractions. Everyone says just ignore early labor. Pretend it’s not happening so that’s just what I did. I went to work and had a normal day. Around lunchtime, I was like, “I’m just going to time these and see where we are at.” They were every three minutes really consistently but lasting 30 seconds. 


    They never changed from that rhythm. It was three minutes all day long and intensified throughout the day. I finished my work day. I picked up my son. I went home. My mom was coming up just for a visit and that ended up working out very well. I got home and things really intensified. I was on the ball just tracking things.


    Again, I was like, “Once I go to bed, these are going to go away. I’m 38 weeks on the dot. I’m not having this baby. I’m not that lucky.” But they just kept coming, so they intensified and intensified. They got longer. They were still three minutes apart. That rhythm never changed from start to finish. 


    Meagan: Wow. 


    Alexis: Yeah, so around 10:00, I got in the bath because I was like, “I’m going to sleep tonight. I’m going to take a bath and make these things putter out and then I’ll have a peaceful night of sleep and go on for another week.” 


    Alexis: The bath felt amazing. That really helped me to relax. I listened to some Christian HypnoBirthing tracks and then my husband and I decided we would go to bed. If something pops off, I’ll wake my mom up. She’s got my toddler and we will head to the hospital. But I was sure that things were just going to stop as they often do in early labor. They didn’t. 


    As I was trying to lay there, I went from around– I think we went to bed around 11:00 up until we went to the hospital at 2:30 AM. By that point, I was breathing through them, really feeling them. This was real. I had been letting my doula know, “This is what’s going on.” A few hours before that, she was like, “Okay, let’s give in an hour. If it doesn’t lessen, then we need to start thinking about going to the hospital.” She was two hours away, so she had quite a drive. 


    We were really on top of it and around 2:30 that morning, my husband was like, “Okay, no. We’re done. Let’s go.” He did not like seeing me that way. I probably would have gone a little bit longer if it was just me but he was not on board with suffering all night. 


    29:47 A picture-perfect labor


    Alexis: We headed to the hospital and I was stressed. Am I going too soon? You hear so many stories where contractions are so intense and you get there and you are not dilated at all or something. We get to the hospital in triage. They checked me and I’m at a 3. I’m like, “Okay, cool. That’s great.” They hold you for an hour and check you again. If you progress, then they will keep you.” They checked again in an hour and I’m at a 4. 


    We get checked in and at that exact same time, my doula had arrived from her two-hour drive through the night. Things felt so picture-perfect. What lucky girl would go into labor at 38 weeks? Going past your due date is so very normal. I felt like an anomaly even though I had an early birth the first time. I just never thought I would go into labor or that it would work and that I would have a spontaneous labor and that things would progress so easily. I didn’t need Pitocin or anything. I felt so thrilled that things were going so well. 


    After having such a birth where everything that could go wrong goes wrong, a birth that is just normal feels like you have won the lottery. That’s how I felt the whole labor. Dealing with contractions, I knew how to breathe through them. I never sat down in the bed. That did not feel good and I knew that wasn’t helpful so I was on my feet. I did a lot of slow dancing and squatting. I would pedal my feet. That felt really good. Things just progressed on their own. It felt magical. This labor is just happening. My blood pressure is perfect even. It just all felt so perfect. I felt euphoric during labor. It was just the most amazing thing to experience going through labor like that. 


    31:26 Baby flipping breech and going for a C-section


    Alexis: I mentioned I was at a 4 when we got to stay. We got checked in at around 3:30 AM. They checked me two or three hours later. I was like, “I’m done. This is terrible. I want the epidural.” I planned on getting the epidural just because my issue the first time with pushing was maternal exhaustion so I was like, “I want to be able to give my body the rest it needs so I am all for the epidural at a certain point once we are sure we are in active labor.”


    I was ready for the epidural. I was like, “Forget this. Get the epidural in here. I’m done. I’m tired.” Of course, in labor land, you have no clue what time it is and it had only been two or three hours. If you had told me that, I would have probably changed my plan, but my body knew. It was time. I got the epidural. They checked me once that had kicked in and I was at an 8.5 after two hours. From a 4 to and 8.5 super fast. We were all shocked so we were like, “Cool. We’re about to have this baby.” 


    My nurse was just like, “Okay. Chill out. Let’s labor down.” We were coming up on a shift change with OBs on call in the next few hours and I had a bulging bag as well. My nurse was like, “We will probably, if you are okay with it, break your water and you will be complete at that point. You are very, very close.” So we were like, “Great. Let’s all take a nap and then we’ll do that and then we’ll have a baby.” So smooth. Everything up to this point had been so perfect. That was the plan. I was good with all of those interventions. 


    Yeah. My husband, my doula, and I all just conked out for a couple of hours. I also didn’t mention this. I was GBS positive which I think kind of ended up working in my favor because it gave me more time to labor down. I had to finish the antibiotics. They could have rushed in and just broken my water then and there and bada bing, bada boom, tried pushing and maybe I wouldn’t have been quite as ready, but it bought me three or four more hours to finish the antibiotics. They just left me to rest and to labor down. Even that felt like a treat when I was hoping so hard to not have GBS. I had taken the probiotics and everything. It felt like, “Oh no, one thing went wrong,” but for me, it was great. Just another thing that not everything is bad in these situations. It can be positive. 


    We were able to just labor down. Then around 7:00 or 8:00 AM, I think the next OB on call came in. We broke my water. It was oh my gosh, the biggest gush I have ever heard. It was so much water. We didn’t measure it or anything so I don’t know if it was unusually a lot. 


    Meagan: Abnormal, mhmm. 


    Alexis: But it felt like it was a lot. Everyone in the room felt like it was a lot. She went to check me and she was like, “Okay. You’re at a 6 or a 7.” We were all like, “No, what? No. You’re wrong. Try again. That’s not true.” She was like, “This is what I’m feeling. Maybe the nurse had it wrong.” I was like, “No.” I was so sure. I was like, “Absolutely not. No. I’m not a 6 or a 7. What is happening?” 


    Then she keeps feeling around and she’s like, “I don’t know that I feel the head. I don’t think this is the head.” I knew immediately. There must have been– I don’t know if there has been a story on this podcast of a baby flipping during labor but I have heard it happen before so I knew in my gut. I was like, “She flipped. That stinker.” 


    They bring in the ultrasound machine and sure enough, she had flipped breech after 8.5 centimeters and was breech. This sweet OB was so great and really, really compassionate. She puts her hand on my leg and is like, “I’m so sorry.” She knew I wanted this VBAC. She was like, “I’m so sorry. We don’t have another option. We have to have the C-section.”


    Also, for me personally, I was not comfortable with a breech vaginal delivery. The doctor was not well-versed in it. That did not feel safe to me. Again, my goal was a birth that wasn’t traumatic. My goal was not necessarily a VBAC. While at the same time my goal was a VBAC, number one is, “I don’t want to be traumatized. I don’t want my body to be super messed up and hurting after this like I was the first time. I want my baby to be okay.” 


    That wasn’t a risk I was willing to take. The C-section felt fine. So back to what I said earlier about if we were going to have a repeat C-section, let it be because of breech presentation. I was like, “Lord,” when she said that. 


    Meagan: Very validating I’m sure. 


    Alexis: Totally. I had immediate peace about it. My husband rushes over and he was like, “I’m so sorry. Are you okay?” He knew that it was going to be really triggering for me, but I was like, “No, I’m good. This is awesome. We just went through this amazing labor. I was unmedicated until 8.5 centimeters. I felt amazing. I was controlling my pain with my breath. Everything was perfect. Now we’re just going to go for a C-section. That’s fine.” 


    I just had such a peace about it. It was slow. We got to really prep for it slowly. I brought all of the nurses in and we had a little meeting about– here’s my birth plan for a repeat C-section. I had prepared that. 


    Meagan: Good.


    Alexis: I think people think that is going to jinx them. Make the plan. Make the plan because I hope you don’t need it. 


    Meagan: Put it in the bag. 


    Alexis: Yeah, but if you do need it, it will make your C-section awesome and it did. We went over that repeat C-section plan. The main things were immediate skin-to-skin. I still wanted delayed cord clamping and just the usual stuff but it did not happen with my first C-section so I was like, “Please, please, please can we make skin-to-skin happen? That was my big thing.” 


    So yeah. It was slow. It wasn’t obviously an emergent situation. She was just breech and hanging out. We prepped and slowly went back. We were just chatting with the nurses. I felt very awake and aware. They bolused up the epidural and it worked so I didn’t have to be put under this time either thankfully. I told the OB, “Can you talk through the whole surgery?” That would maybe freak some people out to hear, “Okay, I’m cutting into your uterus now,” but I wanted to know. I wanted to feel involved in the birth. I didn’t want to feel like it was happening to me like it did the first time. 


    I got to be a part of that. She took my daughter out. She held her up in front of us for what felt like a really, really long time. It was because she was doing other things and letting the umbilical cord pulse. They actually took out the placenta still attached to her– 


    Meagan: Awesome. 


    Alexis: –which is awesome. 


    Meagan: Yeah, pretty rare. 


    Alexis: They totally met my wishes of delayed cord clamping. Then my husband got to see the placenta. They brought it over to me to look at. That was something I really wanted too. It was just so peaceful. I felt so a part of it. 


    38:03 The game-changer


    Alexis: Once they checked her out under the warmer for just a second, I got skin-to-skin for what felt like a really long time. It was awesome. It was so awesome. I never ever would have thought. I was so against another C-section like, “I’ve got a toddler at home.” My recovery the first time– I was not okay at 12 weeks postpartum with him. I did not feel good. I was going back to work after 6 weeks this time. I was like, “We cannot have another C-section this time. Not an option.” That was my attitude. 


    Through all the work I did, by the time it happened, I was like, “This rocks. This labor was awesome.” It was such a silly way to have a C-section, but what a cool birth. What a funny story I will tell her whole life, “You flipped at 8.5 centimeters, girl. What were you doing?”


    Meagan: Seriously and the fact that you were able to do the labor, go into spontaneous labor, and see these things, see that your body was doing this and having all of that, that also is validating. 


    Alexis: Totally. 


    Meagan: To have everyone come in, sit down, and be like, “How can we make this special for you? How can we make this a good experience?” That is so empowering and exactly what you said. You can change it to be what may or could have been more traumatic– because honestly looking back, I don’t know if you have ever asked yourself this, but if they didn’t ask you any of those questions, if they didn’t give you any of those opportunities, do you think you’d look at it the same way if they were just like, “We have to go right now”? 


    Alexis: Totally. Yeah. It was a game-changer. 


    Meagan: Yeah. Everything okay. 


    Alexis: We’ve got time. 


    Meagan: Let’s talk about this. How can we make this a good experience for this family? I think that is so important. I think sometimes in the medical system, it’s like, once a decision has been made that a Cesarean is going to take place, it’s boom, bang, boom, boom, boom, baby out and it moves too fast when it doesn’t need to. 


    Alexis: It’s still birth. 


    Meagan: Yes, it’s still birth. Have that conversation and say, “Okay. Your plans just changed a lot. Let’s talk about this.” Or if it’s a transfer from a home birth or a birth center. Let’s embrace what they were wanting, the type of birth they wanted, and still try to help them have a good experience so we have less PTSD in the future. We have less negative opinions of interventions and Cesareans and things like that. 


    I think a lot of the negative thoughts that we have are from the negative Cesareans that happen.


    Alexis: Yeah. You’ve got to advocate for yourself to get that and also, like I said, my doula was really helpful in reminding me of what I wanted and getting things going.


    40:56 A euphoric birth


    Alexis: Another piece that I think is cool to think about is– maybe this is weird to some people, but when do you ever get the opportunity to be awake in a surgery? If you’re not in the medical field, think about it that way. What a cool thing. I’m in a OR. I get to see this thing that who else would get to experience being in a surgery and being awake for a surgery? Maybe that is someone’s worst nightmare, but I was one of those people where I couldn’t touch my C-section scar. It freaked me out afterward. I was truly traumatized by it but through all the work I did, I now am in this mental place where I was like, “This is cool. I am a part of this whole experience that is not a vaginal birth and that is disappointing for sure. I still feel like, “Man, that stinks.”


    However, I got this other experience and it went really well because I told them what I wanted. I got what I wanted. Afterward, postpartum was truly euphoric. I was even the person that was like, “I don’t want the shot of Pitocin after my vaginal birth because that might jack with the way my body responds with natural oxytocin.” I was that girl, but it’s not all or nothing. I still have those emotions. My body still did the work with my hormones. I bonded immediately with my daughter. It took months with my son because of the trauma. I just didn’t feel those emotions yet. It was really hard for me to bond with him. 


    This time, because of this different experience, I was bonded. The skin-to-skin was such a game changer for me. We had a few hours of it. We nursed on and off. Breastfeeding was a breeze this time. I never had a hiccup with it which is so different than my first experience. It was night and day different and I truly don’t feel any sort of regret over not getting my VBAC. I almost feel like I still got it. I got the birth I wanted. I still am so shocked by the story. It’s such a funny thing that happened. Not my plan, but it was an awesome birth. It was so cool. 


    Meagan: I love that that is how you describe it. I love it so much and I hope, Women of Strength, if you are listening, and your birth turns in a different way that you weren’t expecting or that you weren’t desiring that you have the support that you have and all of these things to have a better experience. I think too, even with mine, I didn’t want it. I didn’t want it and still in some ways, I’m like, “Why? Why did I have that?” But at the same time, I’m grateful for it. I’m grateful for that experience. 


    43:45 Ways to have a gentle Cesarean


    Meagan: Okay, let’s talk about a few things. Ways to have a gentle Cesarean. Skin-to-skin, we talked about that right after. Babies can come out and be placed on your chest. They have those big bands where they put all of the monitors on. Sometimes they are straps, but they also have bands. You can ask for that. You wear a tube top. 


    Alexis: Oh, that’s cool. 


    Meagan: Yeah, so you have them up here. Because when you’re in a C-section, a lot of the time your arms are out straight. Sometimes they are strapped down. 


    Alexis: They did do that. I had asked the anesthesiologist. I was like, “I don’t want these. Don’t strap me down.” He explained, “Here’s why. Sometimes your body responds. You don’t want to do it, but your arms reach out and try to stop what’s happening to you, so we’re going to leave these on. They are not tight.” He talked me through why they were that way and after he said that, I was like, “Oh, okay. That’s fine.” He said, “We’ll get you out of them as soon as she’s born. We’ll just do this for now.” I was like, “Okay, that’s fine. That makes sense.” 


    Meagan: That’s another cool thing that your anesthesiologist was literally talking to you and breaking it down. But yeah, so a lot of the time our arms are straightforward or even strapped out to the side so they are like, “No, you can’t have skin-to-skin because you’re not going to be able to hold your baby.” 


    Alexis: Not true. 


    Meagan: That is not true. Ask for the tube top. Buy your own tube top as a backup. You can wear it then they can literally tuck baby right down in and place baby right there on your chest. So if you’re not feeling the strength or you are feeling nauseous but you really want your baby to be on you, they can be right there and your husband can also help or your birth partner can also help support baby right there. 


    Skin-to-skin is possible 100%. If for some reason, you are not doing well or you are vomiting or something like that because as a baby comes out, things shift and we can vomit, encourage Dad. Encourage Dad to do skin-to-skin. 


    Alexis: That was on our birth plan. 


    Meagan: That can be really comforting and healing to see as well. Those are two of the things. Skin-to-skin. We talked about the cord. Keeping the cord attached. A lot of providers will say, “Nope. We have to cut it. There’s a risk of infection because your body is open so we have to cut it quickly and start the next process.” Not necessarily true. We can wait for it to pulse. If for some reason baby is not doing well or maybe there is bleeding or something is going on, they can milk it. They pinch it and they do a mini blood transfusion. They send any blood that is in the cord at the present time to the baby. They pinch it and milk it. 


    Alexis: Cool. That’s awesome. 


    Meagan: That’s a really good option if you can’t have delayed cord clamping. 


    46:36 Music, skin-to-skin, clear drapes, mirrors, conversation, and maternal-assisted Cesareans


    Meagan: Okay, so music. You can ask your nurse or anesthesiologist to play music in the room so it’s not just beep beep.


    Alexis: They did that when my daughter was born. 


    Meagan: You know? So yeah, so have that music. 


    Alexis: Write it down too. You’re not going to remember these things in the moment. I had all of these things written down. 


    Meagan: You won’t. 


    Alexis: If I can’t do skin-to-skin, my husband will. If it’s not written, it might not happen. They’re not going to think you are stupid for having a birth plan. Write it down. 


    Meagan: Yes, so true. When I went for my first VBAC with my second baby, something I said is, “I just want to see it. I just want to see my baby come out.” That was so important to me so a lot of hospitals these days do have the clear drape, but a lot of them don’t crazy enough. Something I said is if they don’t have the clear drape, I want to see it in a mirror. My husband was like, “What?” 


    Alexis: That’s a cool idea. 


    Meagan: So to your point, and actually when we were back there, I did not remember that. All I was seeing was a table I was climbing up on. It just wasn’t in my mind. My husband said, “Hey, is there any way we could get a mirror so she could watch this and participate in the birth?” They were like, “Yeah, no problem.” They brought it over. They made sure before they even started that I could see and that the angle was perfect. 


    Alexis: That’s so great. 


    Meagan: Then they started. My doctor said, “Hey, if at any point you realize what you are watching is happening to you and it weirds you out, just let us know. We will flip the mirror or you can close your eyes.” For me, I didn’t get grossed out. I know a lot of people listening would be like, “No, hard pass.” But for me, that was part of my healing watching it happen and watching my baby be brought up earthside. 


    So I really love that and same with you, I had my provider talk to me. Talk to me about what is happening because, with my first, they were talking about the weather and their vacation and how depressing it was to be back in the snow. I was like, “No, hello. I’m here.” 


    Alexis: My plans specifically said, “No shop talk. I don’t want anything else talked about.” They acknowledged that. They were like, “Got it. We won’t.” 


    Meagan: Love. Love that so much. So yeah, talk to them and say, “Talk to me. Tell me what you are seeing. Tell me what is happening to my body,” as long as that’s something you want. I really wanted my husband to watch. I really wanted my husband to take pictures and so many providers are against pictures in the OR. It honestly is just dumb to me because if anything were to go wrong, don’t they want proof that everything was okay and they did it right? 


    All right, but whatever if they don’t allow it. But it’s something you can ask. “Hey, I want pictures” or “Hey, as soon as my baby is out, I want pictures of my baby.” You can also ask them to bring them up so they can see you and even better like Dr. Natalie who we talked to on the podcast last year in 2023, ask for maternal-assisted. It begins with us. 


    Women of Strength, if you are having a Cesarean, we have to start advocating for those people who do want a Cesarean or even don’t want a Cesarean but it happens. Let’s get some maternal-assisted happening. Let’s see that shift in 2024 in the U.S. I would love it. It’s happening in Australia here and there. I don’t actually know anywhere else. If you guys know of anywhere, if you are listening and you know of somewhere that does maternal-assisted, let me know. 


    That’s where they literally drop everything. They have moms with their hands reaching down and grabbing her baby and pulling it up. 


    Alexis: So awesome. 


    Meagan: How amazing could that be? Oh my gosh, it would have been amazing. 


    50:32 Vaginal seeding, advocacy, and backward dilation


    Meagan: Yeah, so music. Let’s see what else. Oh, there’s more. 


    Alexis: I should have pulled up my birth plan. 


    Meagan: I know. These are just things that stand out to me. Yeah, keeping your baby, letting your baby breastfeed. Vaginal microseeding sometimes. People will say, “Hey, can I swab my vagina before I go into my C-section and then have this?” It’s a gauze. You have to do a sterile gauze. You put it in a sterile bag then baby can literally nurse on this gauze a little bit and wipe it on their eyes. 


    Alexis: Really cool.  


    Meagan: Yeah, there are some really cool things. Know that it is possible to advocate for yourself. Advocating for yourself is going to help you. If you have a doula or your husband or a birth partner or a mom, help them know what you want. Help them know what is important to you and like she said, have a backup birth plan and birth preferences. It’s okay to have them because, at that time, you are not in that space. 


    A couple of other things that I wanted to touch on is you talked about how you were 8.5 centimeters and then they checked you and you were less after your water broke. Sometimes, Women of Strength, this could be a result in this type of situation where the bag is so bulgy that it’s literally stretching like a Foley or a Cook catheter, stretching your cervix, and then it relaxes a little bit. That doesn’t mean it’s not dilated. It means that sometimes it is overstretched, then relaxes, and then it goes forward. 


    Alexis: And that pressure was gone from her head since she flipped. That was part of it too. 


    Meagan: Yep, and the pressure was gone. Yep, exactly. There are situations like that, but that doesn’t mean your body is necessarily regressing a ton and we’ve got big problems. It just sometimes means that the situation has changed. A head isn’t applied as well and your bag broke that was bulging. 


    Okay, and I have all of these little notes here that I was writing. Okay, let’s see. 


    52:29 Swelling in pregnancy and nutrition


    Meagan: Oh, swelling a ton in pregnancy. That’s another thing. I also was like you. I just ballooned. I had people tell me I was unrecognizable but I didn’t have protein.


    Alexis: Don’t you love to hear that? 


    Meagan: Yeah. I was like, “Thanks. I’m so fat. Awesome.” 


    Alexis: Yeah, you already feel awful about it and people comment. Thank you. 


    Meagan: Yes. But that is still something to watch for. Sometimes we think we have too much fluid so we back off on water. Don’t back off on water. Stay hydrated. Add some citrus to it. 


    Alexis: And electrolytes. I took electrolytes every day. 


    Meagan: Yep. Electrolytes and magnesium baths. Do these types of things to help and then of course, just like you said, it doesn’t matter if you had preeclampsia. Dial in on nutrition. Dial in on those supplements because naturally like you were saying, you don’t get enough protein in your day-to-day life and then you are pregnant and you need more. It’s really hard. That’s why I love the collagen prenatal protein from Needed. I love getting prenatals that have protein supplements is what I’m trying to say and things like this. Get the nutrients that you need and your body deserves. 


    Then again, let your body take the lead but give it all that it can to do the best it can. 


    Alexis: Yeah. Do everything you can. That was good for me mentally to just do everything I could to support my body and it’s like, “From here on out, this is on your body.” With my birth, I feel the same way. I did everything I could. I labored textbook how you should and yet, you still flipped. That’s your fault, not mine. 


    Meagan: Yes. It was out of your control. Do what you can. Control what you can. Trust the process. Get the support. Advocate for yourself and love yourself. Love yourself for all of the work that you have done. Women of Strength, we love you. Alexis, thank you so much for being here with us today and sharing your positive birth story. 


    Closing


    Would 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/donations

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    54m | Mar 27, 2024
  • Episode 285 Selah's 48-hour VBA2C + Changing Providers in Late Pregnancy

    During her first pregnancy, Selah’s doctor predicted that her baby would be over 10 pounds. She insisted that it was not safe to deliver vaginally. Selah went right into her first Cesarean. She didn’t even have the chance to try. Her baby went to the NICU shortly after birth due to lung and blood sugar complications.


    When her fluid levels were low with her second pregnancy, Selah consented to another scheduled Cesarean remembering how her first one went pretty smoothly. Unfortunately, a turn of events resulted in an emergent situation, another NICU stay, and once again, Selah was not able to bond with her baby like she thought she would. 


    Selah’s journey to her VBA2C included discovering The VBAC Link, building her supportive community, prenatal chiropractic care, and relentlessly educating herself to make sure she was set up for success. Though her labor was MUCH longer than expected, the spiritual, emotional, and physical transformation she experienced was completely worth it. Selah had a beautiful, empowering VBA2C with no complications. The best part– she got to hold that sweet baby immediately and for as looong as she wanted. 


    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    01:04 Review of the Week 

    04:08 Selah’s first pregnancy

    07:25 First C-section 

    09:36 NICU

    11:10 Second pregnancy

    13:02 Low fluids

    16:29 Scheduled Cesarean turned emergent

    21:39 Surprise third pregnancy

    27:33 Changing providers

    36:33 Going into labor

    39:20 Going to the hospital

    44:54 Pitocin

    48:35 The final hours

    56:47 A crack in the catheter

    1:00:00 The best feeling


    Meagan: Hello, hello everybody. You are listening to The VBAC Link and this is Meagan, your host. We have our friend, Selah, today. Hi, Selah. 


    Selah: Hi. Hello. 


    Meagan: Thank you so much for being here with us. I feel like there are so many parts of your story that truly are things that people are going to relate to. We’re going to be talking about bigger babies. We’re going to talk a little bit about that. We’re going to talk about changing a provider really late in pregnancy. I actually love this topic because I did it myself and it’s one that is scary sometimes to do. 


    Selah: Yeah. 


    Meagan: It’s intimidating. We’ll talk a little bit about low fluid. She’s got a NICU stay. There are lots of little things. 


    Selah: A little bit of everything. 


    Meagan: You are going to have relations to her story. She is a VBAC after two C-section mama story so if you are a VBAC after two C-sections, listen up. It’s going to be amazing.


    01:04 Review of the Week 


    Meagan: We have a review of the week so we are going to get into that then we are going to turn the time over to you, my love. 


    Selah: Yay. 


    Meagan: This review is– if I can find them. I just lost my reviews. It is from hannahargentina and it was on Apple Podcasts back in 2023 in February so just over a year ago. It says, “I have had a natural birth center birth, then moved out to the country and had a very traumatic C-section. I am now 37 weeks pregnant and back stateside working with an amazing birth team. I am really hoping for a VBAC in a few weeks and I love listening to all of the stories. Hearing different perspectives, and outcomes, and gaining wisdom, I feel so much more confident in my VBAC after listening to this podcast.” 


    Well, it’s been just over a year so hannahargentina, if you are still with us, reach out at info@thevbaclink.com and tell us how it went. 


    Selah: Aww, that’s awesome. 


    Meagan: I know right, and here we are for you and your baby’s birthday is in a couple of days. 


    Selah: I can’t even believe it and I got tears in my eyes listening to that review because that was me. That was me listening to every single podcast, your story, all of the stories, and it helped so tremendously. I can’t even tell you. To be on today is such an honor because I was so helped by you and your podcast and the community. I could not have done it without you so thank you. Thank you for having me. 


    Meagan: Yes. Thank you and I also want to toot the horn of the community. They are so special. If you guys have not checked it out yet or if you are not on Facebook, I would say create a secret Facebook just to be in that community because the Facebook community is amazing or join us on Instagram. These other Women of Strength truly do provide so much power. 


    Selah: So much power and help and resources. I mean, I was on there every day just looking and posting every single worry and concern. Yeah. It’s a lot. It’s a lot to learn and to do. You need that community. You need that support. 


    Meagan: Absolutely. Well, let’s dive into that first story of yours that began this journey to you being here right now. 


    04:08 Selah’s first pregnancy


    Selah: Yes, so the back story is I had my first son in 2018 and he was an IVF baby. We struggled with infertility for four years about, I think. Finally, we did IVF and we were successful on our first try which was great. However, toward the end of my pregnancy, my doctor looked at me and said, “How big are you willing to push out as far as baby goes?” 


    Meagan: Oh. 


    Selah: Yeah. I looked at her and by the way, I considered myself very well-educated. I was not in hindsight. I had read a few birth books but I did not know what I know now thanks to you and the community. I did, by the way, do The VBAC Link Course so I did all of it. 


    Meagan: Oh you did? 


    Selah: Yes. Yes. So I was not educated to the point that I am now, but I thought I was. I looked at her and very confidently said, “12 pounds.” I didn’t even flinch. 


    Meagan: I love that. 


    Selah: Her eyes turned really wide and was like, “No, no, no, no, no. You cannot push out a 12-pound baby.”


    Meagan: Then don’t ask me what I’m willing to do here. 


    Selah: Exactly. I was a personal trainer. I was a group fitness instructor. I consider myself very strong so I thought, “I could do that. No problem.” She said, “No. I will not let you do that. This baby is measuring bigger than 10 pounds.” At that point, I think I was just at my 40-week mark so she was like, “He’s only going to get bigger. You’re not going to be able to deliver this baby vaginally. In fact, I won’t even really let you try.” 


    Meagan: Wow. 


    Selah: I know. 


    Meagan: That took a really fast turn from, “Hey, how big are you willing to? Hey, let’s offer an induction” to “Hey, I’m not even willing to let you try.” 


    Selah: Exactly. And looking back, I’m pretty shocked at that that I wasn’t even offered an induction or anything. In fact, my water– so we scheduled the C-section for three days from then and my water ended up breaking naturally the day before the C-section. I know. I was like, “Oh. I’m going to do this. I can do this. I don’t care how big the baby is.” 


    Meagan: Yeah. 


    Selah: Even then, they would not let me try because there was meconium in the water. 


    Meagan: Which isn’t a reason for a Cesarean, right? 


    Selah: It is not. Right. Right. That’s what I know now, but back then–


    Meagan: You didn’t know. 


    Selah: I didn’t know and ironically, I had a doula who said, “Oh, you need to go straight to the hospital.” I know. 


    Meagan: Interesting. 


    Selah: Very interesting. That is also a lesson in really interviewing your doulas, understanding birth more really, and also knowing what the doula’s experiences with both C-sections, of course VBACs, and with everything. This doula, looking back, did not have a lot of experience, I don’t think, especially with big babies, but in general. I think also she was older and not that there is anything– listen. I am older. But I think she was from a medical mindset where that would be very scary to her, meconium in the water, where now, the doula that I had for my VBAC was much more like, “No. This just means the baby is ready to come out and it means a lot of things.” 


    07:25 First C-section


    Selah: I rushed to the hospital. They said, “Yes. There is meconium in the water. Yes, you have a very big baby. We’re going straight to the C-section. You don’t even get to try.” I never even felt a contraction. 


    I was pretty devastated. I had all of these plans for a drug-free birth. I had read The Bradley Method. I had done HypnoBabies. My mom– I’m one of eight kids– had pushed every single one of us out naturally without drugs. I knew I could do it. Do you know what I mean? I just was like, “Wow. This is not happening for me and I’m shocked.” I was very shocked. 


    Meagan: Yeah. Yeah. 


    Selah: So we went into the C-section but I also felt like I had no choice at that point. This was definitely–


    Meagan: You were stuck. 


    Selah: Yeah. “You’re going in. That’s it.” Everything was just black and white to the medical team and even to my doula frankly. So we went in and my doctor was lovely. I have to say she was very empathetic and she knew I really wanted a natural birth. She was as lovely and empathetic as you can be. She let me play music and set up the room in a way that felt very loving. She let the nurse and everyone take pictures and videos which they are not always supposed to do. 


    So it was as good as it could be. I got to hold him right away. We had the first 12 hours together. But then because he was so big– 10 pounds, 15 ounces, his blood sugar started dropping, and his lungs, because of the C-section, weren’t fully developed. You know how they get the practice. 


    Meagan: Yeah. Yeah. Sometimes there is fluid left in the baby’s lungs too so they can have a harder time. 


    Selah: Exactly. There was fluid left in the lungs. It’s like that sponge where not all of the sponge is there. 


    Meagan: That’s a really good analogy. Yes. 


    Selah: That’s what they told me which is what happened. When they go through the canal, their lungs get that practice going back and forth. 


    09:36 NICU 


    Selah: So he went to the NICU after about 12 hours with me and that was a terrible experience for lack of a better word. My heart just goes out to every NICU mama who has had that experience. It’s really, really hard. I was only there for five days. I can’t imagine where you have been there for months. There are so many reasons why it is hard but for me, it was hard because I was recovering from a C-section. We were breastfeeding but now he’s hooked up on wires so that was super hard. I all of a sudden found myself having to bottle feed and pump and now I’m engorged because I’m pumping so much. It just was this crazy cycle. 


    Eventually, like I said, he got out after five days and that was fine. I felt like my healing from that C-section was good because I didn’t have any other children to watch. 


    Meagan: Yep. It makes a difference. 


    Selah: It makes a huge difference and I had peace about the C-section. I really did. When he was pulled out of me, my first thought was, “Oh my gosh. He is humongous. He is a giant. He is so chunky. Maybe this was the right thing. Maybe I couldn’t have.” His head was huge. Everything was huge. 


    You know, you do worry about pelvic floor damage and shoulder dystocia, all of that stuff. So I did have peace. I thought maybe this was the right decision and it was good to have that closure and that peace. 


    11:10 Second pregnancy


    Selah: But then flash forward to my second pregnancy which, by the way, was natural. It was not through IVF. I should have known I could get pregnant naturally but I thought it was a fluke after trying so hard. 


    My second pregnancy was in the thick of the pandemic. In fact, at our first prenatal appointment, she was like, “Don’t worry. By the time you give birth in August 2020, this will all be over.” Little did we know. 


    Meagan: Nope. That was really thick right there. It’s not over. It’s trudging. 


    Selah: Yes. Exactly. Going to all of the appointments alone, I was lucky to have my partner in the birthing room and in the OR. Same OB, by the way. Same OB. I didn’t know what I didn’t know. I just assumed I would have a VBAC. I told her that at the first appointment. “This time, I’m having a VBAC just so you know.” 


    I didn’t prepare anything though. I didn’t– again, I didn’t know what I didn’t know. I didn’t know about this podcast or the community. I didn’t go to a prenatal chiropractor. I didn’t even have a doula this time because I thought, “Well, she didn’t help me.” 


    Meagan: Honestly, I bet your opinion of that was like, “Meh.” 


    Selah: Yeah.


    Meagan: And rightfully so. You didn’t have the best support there. 


    Selah: Exactly. I did not. I just felt like, “Well, this time, I’m just doing it. I know what to do.” I did the HypnoBabies course for the first time. I didn’t even do it again. I thought I was going to do it. Also, it was the thick of the pandemic. I had a two-year-old at home. It was just chaotic. 


    Meagan: It was a lot. 


    Selah: It was a lot. So I do give myself a little slack in that. 


    Meagan: 100%. Please do. 


    Selah: Right? 


    13:02 Low fluids


    Selah: I go along on this pregnancy and he’s not measuring extra big this time around but around week 38, I go to my appointment in the morning and it’s August, very hot in California. I’m probably dehydrated and a lot of things. I remember going on a big walk the night before. 


    Something my doula now has told me is that in the morning, you’re obviously very dehydrated so if you go to your appointment, they may say your fluids are low. 


    I went to the 38-week appointment and she said, “Your fluids are very low. You need to go see a specialist at MFM, maternal-fetal medicine.” Medicine, thank you. 


    Meagan: Mhmm. Maternal-fetal medicine. 


    Selah: Maternal-fetal medicine to go and check your fluid levels. Side note, I went to the same MFM on my first pregnancy to double-check his weight when they said it was a big baby. So I will say that was smart of me to get a second opinion and the MFM on my first pregnancy got the weight right within an ounce so I respected him and thought, “Yeah. I’ll go back.” 


    Sure enough, my fluids were low. He agreed with her that I should get the baby out that night and said, “You know, you have a history of big babies. This baby is measuring big already.” He was not as spot on with this baby, but he said around 9 pounds and my second turned out to be 8lb 11 oz. But it’s not abnormally big, especially 8lb 11 oz is not that big. 


    Meagan: No, and no talk of induction like, “Oh, your fluids are low. Let’s induce.” 


    Selah: No, and that’s what I don’t understand either. But she did say, I guess I do understand because she did say, “No, I will not induce because of your C-section before. I don’t believe in induction.” 


    Meagan: Mmm. So not evidence-based. 


    Selah: Exactly which again, I have learned since then. 


    Meagan: You didn’t know. 


    Selah: Yeah. I didn’t know. I just said, “Okay.” She just said, “There is way too much risk of uterine rupture.” No numbers, just way too much. “This isn’t a good idea.” 


    Meagan: Yeah. 


    Selah: And also she said with the fluids being low, it was too emergent of a situation. We need to get baby out. 


    Meagan: Yeah. It can cause baby stress. It can. 


    Selah: It can, but there was no stress. We did the stress monitor and there was nothing. 


    Meagan: NST? 


    Selah: Yes. There was nothing to be afraid of except for the fluids being low. 


    She did give me an option to go get IV fluids in the hospital, but she did it with a caveat of, “It’s probably not going to work.” Again, I felt helpless and stuck. I thought, “Well, I guess this is just my lot. I’m supposed to just have C-sections. I don’t get to try again.”


    Because I didn’t know what I didn’t know. I didn’t know to ask for a low dose of Pitocin. I didn’t know to ask for anything or just to give it another try or even to try the IV or drink a bunch of water and come back. I didn’t know anything. 


    Meagan: Right. 


    Selah: And I did not have a doula to help me or anything like that. I just went along with it. 


    16:29 Scheduled Cesarean turned emergent


    Selah: And in the C-section, this is where everything started to fall– oh, and I also thought, “Well, my previous C-section wasn’t so bad.” I had peace about it. I healed very quickly. I was okay. It’s going to be fine. Maybe this is just the way it’s supposed to be. 


    Sadly, I had so many friends who had two C-sections and people in my life. So I thought, “It’s not so bad. These people did it.” 


    Meagan: Right. 


    Selah: Right. I go into it. I’m lying there. All of a sudden, it turns into an emergent situation. The doctor starts yelling/screaming for extra tools. “I need a knife. I need this.” Everybody is frantic. She starts yelling for more team members. “I need the NICU. I need this staff and this person.” Everybody starts running in. There are more people in the room. I hear my husband’s voice shaking like he’s going to cry saying, “Is everything okay?” Nobody answered for what felt like an eternity. 


    Meagan: I have chills all up and down my body for you right now. So scary.


    Selah: So crazy. So scary. When I heard his voice, I thought, “One of us is not making it out alive. I don’t know what’s happening.” It was so scary. Obviously, I still get emotional thinking about it because I didn’t know what was happening. 


    Finally, I heard him cry and everything was okay, but they whisked him away immediately. My husband said I did put him on my chest for I think it was a minute, but I barely remember that. That’s how traumatic it was. Yes. I do have a picture of me reaching my arms out to him so I know he did land on my chest, but my eyes are filled with tears reaching my arms to him. 


    They whisk him away to the NICU immediately. Same problem with his lungs. He wasn’t breathing. They were worse than my first actually. 


    Later, I found out– my doctor came to visit me and she said, “What happened was when she made the incision, his head had moved,” so she didn’t want to cut through the placenta from what I understand obviously. So she had to make a bigger incision. She needed special tools. 


    Meagan: Special scar. Is it a special scar or just longer? 


    Selah: It’s just longer, yeah. 


    Meagan: Okay, so it’s not up. 


    Selah: Exactly. Thank God because I think that would have made it scarier. 


    Meagan: A little bit more difficult sometimes to VBAC the next time too to get support. 


    Selah: Exactly. To get support, exactly. Yeah. That was good at least that she just made it a little longer. But that was why it became so emergent. Same thing. He was in the NICU the whole five days. I remember saying to my husband in the NICU. I looked at him and I said, “We are done. We are not getting pregnant again. I cannot go through this again.” I didn’t think I’d ever be able to birth naturally first of all, so I cannot have another C-section. This was way too much. 


    Meagan: Yeah. 


    Selah: And then the healing was awful because I had a two-year-old at home. Everything about this was just not good. I did not want to ever do this again. 


    21:39 Surprise third pregnancy


    Selah: So flash forward to 2022, two years later, I’m still breastfeeding my two-year-old just at night. I had my period back. I should have known, but I was tracking my ovulation cycle. I was not ovulating. I’m 41 years old and I think, “There’s no way. I’m not ovulating. I’m 41. I’m breastfeeding,” but bam. I got pregnant. Surprise, surprise after 20 years of infertility, I’m like, “Why am I fertile Myrtle now?” 


    Meagan: Oh my gosh. 


    Selah: I know. It was crazy. I have a video on my Instagram of my husband’s expression finding out. It was utter disbelief. So yes. We find ourselves pregnant again and I thought, “Oh no. What am I going to do? I can’t in the operating room again. I can’t do it. I will not do it. There has to be another way.” 


    But I crazily called the same provider because I didn’t know who else I was going to go to. 


    Meagan: Right. That’s who you know. 


    Selah: It’s who you know. The receptionist said, “Oh, she’s not delivering anymore.” 


    Meagan: Oh. 


    Selah: I know. I got chills all over my body. I knew this was a sign from God. I just knew it that there had to be another way and that I was going to do something different this time. I was not going to be down that same road of a C-section in the OR and I didn’t have to go through that again. 


    I reached out to one of my friends I knew who had a VBAC. It was actually a home birth VBAC. It was a HBAC. She said, “You have to start listening to The VBAC Link immediately.” 


    Meagan: Oh, tell her thank you. 


    Selah: Yes. These are all of the resources. She knew this MFM in Long Beach. I’m in Los Angeles so it was about an hour away who also delivers and he is very VBAC supportive. In fact, he does all sorts of births. High risk births he is known for. He was an hour away so that wasn’t my top choice, but she sent me a bunch of different ideas for a doula and different doctors. 


    I set about on my journey. I interviewed five different OBs. The first two said, “Absolutely not. We will not do a VBAC after two C-sections and anybody who does is basically a bad doctor. It’s too risky.”


    Meagan: Oh my. That doesn’t make you feel good. 


    Selah: I know. But by then, I had been listening to the podcast so I knew. I’m like, “Mmm, no. These are the reasons. This is the rate of risk for uterine rupture. This is the rate of risk for a third C-section. I am doing this and I’m just going to find someone who is going to let me.” 


    So I then interviewed two more I now know as VBAC tolerant, not as VBAC supportive. They had a list of stipulations that I needed to meet in order to do it. Then the fifth one was a doctor that I had known previously. I was not crazy about him. He just had a weird bedside manner for lack of a better word. I just felt like I didn’t mesh with him. He was very VBAC supportive, another high-risk pregnancy doctor in Los Angeles who is VERY well-known as someone who delivers triplets naturally, delivers twins naturally. He does breech births. I had been in my friend’s breech birth– well, she wasn’t breech when she delivered. He flipped baby before she delivered and I was in the room. This was pre-COVID when he was her doctor so I knew him really well. 


    I just did not mesh with him personality-wise. So I chose the other doctor, one of the VBAC tolerant doctors. He was so kind and so lovely, but he did have a list of what I needed to meet. I was showing this list to the community members on Facebook. Everybody was like, “No. He is not a supportive doctor.” 


    He said, “You’re older. That affects things,” which there is no evidence of that at all. He said, “You have to go into labor by 40 weeks,” which again, there is no evidence of that. All of these stipulations. The worst part was that he made me go see an MFM that he worked with of his choosing by the way. I coudln’t go to that other one that I really respected. I had to go to his MFM and that MFM had to monitor me and look at the uterine wall to see if the wall was okay throughout pregnancy. I know. 


    Meagan: Mmm-mmm. 


    Selah: I had to go to countless appointments. Every week I was in the doctor. I know. That MFM, around 20 weeks said, “Listen. Your uterine wall has a window of I think it was 1 centimeters and 3 millimeters thin. I do not think you are going to be able to do this because there is a window in your uterine wall.” 


    This was at 20 weeks, so I thought, “It’s only going to get worse for me from here.” 


    Meagan: That would make sense for you. That would make sense to think that. 


    Selah: I started thinking of other options because I had a sneaky suspicion that this MFM is not going to clear me which my OB said, “If he doesn’t clear you, I will not do it.” 


    Meagan: “I won’t support it.” 


    Selah: “I won’t support it.” Right. 


    27:33 Changing providers


    Selah: I started getting a little worried now. Pause to say that I had been going to prenatal chiropractor appointments with an amazing Dr. Berlin in Los Angeles. Everybody knows him. 


    Meagan: We love him so much. Yes. We’ve had him on the podcast and I actually just was on his podcast which was amazing. It was just so crazy that it was happening. We love Dr. Berlin. 


    Selah: He’s the best. He is so great. I mean, he was a doula himself and he obviously is such an amazing chiropractor. He was making sure the baby was in the right position, that my body was open, and all that. I was going every week. I mean, he just was so knowledgeable. He said, “Listen. You might want to give that first doctor you didn’t mesh with another consideration. I’ve been in so many births with him. He is so good at high-risk birth. If you really want this VBAC, you might want to go back to him.” 


    I started rethinking. He was in the back of my mind. Meanwhile, I also had this incredible doula this time around named Johanna, Johanna Story. She said the same thing. She said, “Listen.” She had been in 2500 births in Los Angeles. 


    Meagan: Whoa! 


    Selah: Yes. She is also a licensed midwife so she has delivered babies. By the way, I had considered a home birth for a hot second with Johanna, but my husband was not. He was so supportive of the VBAC that I didn’t want to push him. He was the best teammate and not let me, but he was on board with everything I wanted to do. So I just thought, “You know, he’s not crazy about the home birth with our two others running around. I get it.” I said, “Let’s do the hospital birth with Johanna.” 


    The reason I also liked Johanna is she was going to do– oh my gosh, I am blanking on the word– where they monitor you until you are about to– 


    Meagan: Like Monitrice? 


    Selah: Yes Monitrice. So Johanna, because she is a licensed midwife, she could do monitrice. I felt like that was the best of both worlds. Let’s have her monitor me until the last minute then we will go in. As I learned on the podcast, that is the plan. Wait until the last minute so they can’t do anything to you. 


    Meagan: Labor as long as you can at home. 


    Selah: Yes. That was the plan. That was why I had Johanna. She also encouraged me to go back to Dr. Brock. 


    Meagan: I was wondering if it was Dr. Brock. 


    Selah: It was Dr. Brock. He is very quirky, his personality. 


    Meagan: We have had him on the podcast as well. 


    Selah: He is wonderful and he just has a quirky sense of humor so that is what it is. I didn’t know that at first. I kind of thought, “Who is this guy? What is he saying?” But both Dr. Berlin and Johanna encouraged me to go back to him with that frame of mind. He’s just a little quirky. “Just go back and talk to him again.” 


    But I wanted to wait until I went to my last MFM appointment with the MFM that my first OB had. 


    Meagan: The one who said you had a window, that one? 


    Selah: The one I had a window, yes. He said, “This window has only gotten bigger, obviously at 32 weeks. I do not recommend a VBA2C. I cannot recommend it to your OB. Sorry.” I cried in that office thinking maybe there was a miracle and things were going to change. 


    I actually ended up going to see that first MFM who was an hour away for a second opinion. He explained to me, “Yes. There is what you can see a window on an ultrasound.” He said, “First of all, I do not find ultrasounds very accurate. I do not know how big it is and how thick it is. Secondly, even if there is a window, there is absolutely no evidence of a correlation between that and a rupture. There’s no evidence.” 


    Meagan: Yeah. They can’t really do the measuring thing and tell you that you are going to rupture or not. 


    Selah: That’s what he said. He said, “I really think you’re okay to try. You will know in the birth and your doctor should know if something is going wrong and your doula too.” He said, “I really think you should try and you need to try.” Oh, the other cool thing he did– I really love him. Dr. Shivera in Long Beach if anyone is local. He is really wonderful and does a ton of high-risk birth. I just didn’t want to go that far so that was my thing with that. 


    But he said, “I looked at what happened in the operating room with your second C-section, and exactly what you said before, it is not a special scar.” He looked at all of the details. It really made me feel that there was nothing wrong with that birth. 


    Meagan: Or abnormality, yeah. 


    Selah: No abnormality, yeah. He was like, “I really think you are okay to try.” That was really reassuring too. I cried with happiness. I cried everywhere. 


    Meagan: Yeah. Lots of emotions. 


    Selah: Lots of emotion. Then at 32 weeks, I went back to my first OB and he had gotten the results from that MFM and sure enough said, “I cannot support a VBA2C.” There, it was very interesting. I did cry there too but I felt this weird sense of shame like I should not have gotten pregnant. I should not be in this position because they made me feel like you are risking too much. You are risking your baby’s life. You are risking your life. Why do you want this so much? On the other side, I thought, “I can’t go into the operating room. I can’t do it emotionally or psychologically. I just can’t. Put me out then because I won’t be able to be there.” 


    That was where this weird shame came in like, “Why did I even get pregnant?” I even said it out loud to my husband then I even felt shame about that. We had this miracle baby. I couldn’t believe it. 


    But there were all of these weird emotions and things that were associated with that second C-section in particular. 


    I went back to Dr. Berlin. I remember crying in his office too and he was just saying, “Go to Dr. Brock. Go to Dr. Brock,” and Johanna too. Finally, I made an appointment. I think it was at 34 weeks when I saw Dr. Brock. He said, “You’ve never tried to labor. You’ve never felt a contraction. You can do this. I think you can do this and the baby is in the perfect position. He is not measuring big.” I also loved this. He did the fundal measurement. 


    Meagan: Fundal measurement is the whole from the pubic bone-up thing. 


    Selah: It almost felt like a midwife technique to measure the weight and everything, not the ultrasound. I remember being so scared every time I went into the ultrasound, how big is he going to be? Yeah, but he didn’t even want to talk about weight. He said to me, “Well, how big do you think this baby is?” I said, “Uh, 8 pounds. He feels normal to me. I don’t know.” He said, “So then he will be.” 


    He just was very calm and the other huge thing he did which I forgot to mention. The first OB with this MFM changed my due date because they said the baby was measuring early so they changed it to March 17th but according to my cycle, he was due March 31st. 


    Meagan: That’s a difference. 


    Selah: It’s a huge difference. 31st. The last day of the month. 


    Meagan: The last day, uh-huh. 


    Selah: The last day. That is a huge difference. So when I went to Dr. Brock, he said, “No. This baby is due according to your cycle, March 30th or March 31st. You don’t have anything to worry about. You are measuring completely on time. Go on.” 


    Now, in hindsight, he was born at 40 weeks and 3 days. So yeah, I guess it was March 30th. He was born at 40 weeks and 3 days. If it had been according to the first due date, there is no way the OB would have let me keep going. I mean, that was 10 days after. Thank God Dr. Brock changed my due date and was completely relaxed about everything. I never felt stressed. I never felt any anxiety that I felt going to the appointments from the first OB. 


    Meagan: That’s good. 


    Selah: He was quirky, but now I saw him in a completely different light. I saw him as somebody who would support me and let me do my thing. 


    36:33 Going into labor


    Selah: Sure enough, going into the labor, I felt like the night of March 26th, there was bloody show at around 10:00 PM. I texted my doula and she said, “It could be any minute or it could be days still so just hang tight. Relax. Go to bed. Get some sleep.” 


    I went to bed and I woke up with the wetness. It wasn’t a huge gush like the first one. It was just a little bit of wet. 


    Meagan: Trickle? 


    Selah: Trickle, yes. I wasn’t sure. My doula said it could be just a little bit of leakage or it could have been my water breaking. Let’s just wait and see. 


    Sure enough, a couple of hours later, I started feeling contractions and I was so excited. I was just happy. It was so crazy because obviously, most people would be like, “Ow, this hurts,” and I was just like, “Yes.” 


    Meagan: Cheering them on, yes. Well, you had never experienced them before. 


    Selah: Exactly. Exactly. I texted my mom. She was so excited. I just was thinking the whole time, “I can’t believe this is finally happening.” Again, we didn’t know that my water had broken for sure so we just wanted to sort of wait before we told the doctor because he didn’t say, “Oh, there is a 24-hour clock once your water breaks.” He didn’t say that at all, but we were concerned if we told the hospital– whatever. We just wanted to wait and see how labor progressed. 


    The contractions did start progressing. It was about– I don’t know– five or six hours at home and they started getting really fast and strong every four to five minutes. Yeah. I was like, “Oh, this is happening. This is happening fast. I may even have this baby at home,” which is laughable now looking back.


    I went in the shower. She encouraged me to go into the shower and try to rest. I couldn’t because I was so excited then my kids woke up around 6:00 AM. My doula got there around 5:00 AM and the contractions again were coming super strong and hard. She was helping me. She was massaging me, but because they were coming so frequently, they started speeding up to every 2-3 minutes, I thought, “We’ve got to get to the hospital.” I really actually did think, “Maybe this baby is actually going to fly out.” This is crazy. I might have an accidental home birth which is the goal, right? That’s what everybody wants. 


    Meagan: To a lot of people, it’s a dream, yes. 


    Selah: It was. It was actually my dream. “Maybe it will just fly out. It will be fine.” We go. My doula, to give her credit, was like, “I still think you should stay home. You’re just probably really excited.” 


    I was scared too, I think, deep down. I said, “Oh no. I don’t know. We should go to the doctor.” 


    39:20 Going to the hospital


    Selah: We went to the hospital. We had called the doctor. He said, “When did your water break?” I said, “I don’t know. It might have been this morning.” I kind of pushed it a little because I really wasn’t sure. We got to the hospital and at that point, I had labored about 10 hours, but in the triage, a resident checked me and said I was only at a 1 and it had been 10 hours. 


    This is the lesson to everybody. Please try to labor at home longer. I should have stayed at home longer. 


    Meagan: Well and also numbers. We look at 2-3 minutes apart and we’re like, “They’re 2-3 minutes apart. They’re 2-3 numbers apart.” But let’s look at the length and let’s look at that strength. How is coping? Are they so intense that you can’t even focus on what is going on in the space and it takes you a minute to get back into that moment or is it like, “Whoa, this is really, really hard,” and you’re talking through it, but then they’re gone.


    Selah: That’s right. Yes. I should have listened to my doula because I feel like it’s exactly what you just described. I could have labored at home longer as we will see because I ended up laboring. 


    Selah: I’ll tell you the middle of what happened in between but it ended up being 48 hours total of being in labor. It was way too early to go to the hospital. The reason why that was a problem too is because they hooked me up to the monitor because it was a VBAC and because of all of the reasons they do. We insisted on a wireless monitor but they couldn’t get a good connection so I ended up having to walk around with this wire which was not easy and I could only go so far. I feel like if I had labored at home and been able to move and do stretches or whatever more freely, it would have been way better to do that. 


    That was kind of a bummer. 


    Meagan: Yeah. 


    Selah: But that still wasn’t enough to deter me. I stayed very calm. I listened to worship music for the entire 48 hours and also HypnoBabies. I would say my mantras over and over. I was literally singing and praising God for each contraction. It was crazy. I would feel a contraction come on and I would thank God for it because I knew this was just getting me closer. To be in that state of gratitude and have that openness and open heart and be just thankful for it after all of this time and all of these years and wishes and dreams and desires of my heart to experience this– it was incredible– I mean, incredible to have that feeling. 


    I honestly felt no pain. I know that sounds crazy because it was so long. 


    Meagan: It doesn’t. 


    Selah: It was the most intense spiritual, incredible connection to God I’ve ever felt. I don’t know. It was amazing. 


    Meagan: Amazing, yeah. 


    Selah: The doctor and the nurses were all encouraging me to get a catheter for an epidural to put in and I kept pushing it off. I didn’t want it. I said, “I’m not going to need it. I don’t want it.” This isn’t to say there is any shame at all in having an epidural.


    Meagan: You just didn’t want it. 


    Selah: I didn’t want it. I researched with you and knowing that it could cause more of a chance for a C-section, I just didn’t want it. I said, “I’m not going to do it.” I put it off, put it off, put it off.


    I should say this was very interesting. The contractions were happening all day that Sunday 2-4 minutes apart. They felt very intense like they were building up, but again, it wasn’t super painful and my doula kept having me switch positions. She and my husband were incredible with non-stop massages and encouraging words and putting me in positions to really help me. That is another reason I didn’t feel the pain that maybe another person might. They really, really helped. 


    But it was after certainly bedtime. I think it was after 24 hours and my doctor was like, “Okay.” Oh, I should say the contractions slowed down from being 2-4 minutes apart to happening 5-7, even 10 minutes apart. They really slowed down. At that point, after 24 hours, I was at a– I think, I want to say…actually let me look here really quick. Okay, so day turned into night around 8:00 PM that first day. I had dilated to a 4 and I was fully effaced at 0 station. I really thought I was going to keep dilating and I would meet my baby by the end of that night, that first night but soon, it got into I think about 24 hours of labor and that’s when the contractions started to slow down to 5-7 minutes. 


    The doctor wanted to start me on Pitocin. Yeah, it was the 24-hour mark at 2:00 AM to progress more. I did not want Pitocin because of everything I had learned. I just thought, “There’s no way. This is going to lead to another C-section. I don’t want it.” He promised me. He said, “Let me start you very low. We’re just going to try to get these contractions going a little bit faster.” 


    44:54 Pitocin


    Selah: So we started the very lowest dose. They stayed 5-10 minutes apart, but I did get to a 6 that way. I did not feel any pain on the Pitocin which I was very scared of. I know. 


    So he kept upping it and soon, I was at the max level of Pitocin. I did not feel a difference. My contractions stayed 5-10 minutes apart. The good thing about that was between those long contraction breaks, I would literally fall asleep and everybody in the room was laughing because they were like, “She’s snoring.” There was a running joke in my friend circle and family that I can sleep through anything and I’m a very deep sleeper so this is no surprise to them. My husband was laughing. I mean, I was sound asleep and then I would feel a contraction, wake up, and start singing out loud. It was hilarious. 


    There were various positions that were better for me. Being on the toilet was definitely helpful. Being in almost like a child’s pose position, but the best of all was side-lying with the ball in between. That really seemed to help open me up and it was also great because then after the contraction was over, I would fall asleep from that side-lying. That’s how that kept working with the sleep breaks. 


    Selah: But that being said, the Pitocin did not seem like it was doing anything. That’s why he kept upping it. We are now at about 36 hours of labor. I was at a 6. So I was getting a little worried that he wasn’t going to let me keep going, but he did. He kept letting me go and then the one thing he did insist on though, at about 4:30 on day two was that I get that catheter for the epidural in my back.


    That was the only thing that ended up causing pain. I don’t know if it’s where they placed it. I don’t know what, but all of a sudden, I started vomiting from that area. It was really bad. That catheter hurt so bad and there was nothing they could do. There was no epidural in there. I didn’t want the epidural. I didn’t need it for the contractions. It was just that area. They put some numbing cream on it. That kind of helped, but that is what really hurt. I don’t know if it was where the baby was. 


    As he started dropping more, the pain lessened in that area, but that catheter really hurt. Everybody on the community page said not to get it which is why I pushed hard about not getting it. Now, I feel like they were right because again, I understand why people do get it just in case. My doctor said, “Have your seatbelt on. If you go to a C-section, we need that so you do not have to be put under.” You know what I mean?


    But I should have said in retrospect, “You know what? If go to a C-section, I want to be put under.”


    Meagan: Well, and the thing is that it still has to be dosed and that still takes time so–


    Selah: Right. 


    Meagan: I don’t know. Maybe, I guess it’s a little faster but it still has to be dosed. 


    Selah: It still has to be dosed. In retrospect, I don’t understand why he insisted on that so much, but I really appreciated him so much at that moment and all he had done to support me that I thought, “This is the one thing he is insisting on. I’m going to go with it.” 


    I said yes, but again, I wish I hadn’t. It really, really, really hurt. 


    48:35 The final hours


    Selah: The contractions were still 5-7 minutes apart, but all of a sudden, around 5:30 PM– this is on day two, and remember, everything had started around 2:00 AM the night before. So now, we’re almost to 48 hours. At 5:30 PM on day two during one of my little cat naps, I all of a sudden woke up with this involuntary urge to push. I just kept pushing with each contraction. All sorts of stuff was coming out of my body. It was insane like, “What is happening?” 


    Everyone in the room was like, “Oh my gosh. This baby is coming. This is awesome.” Imagine my surprise when the resident doctor came in and checked me and said I was only at an 8 and station +1. 


    Meagan: What? 


    Selah: I burst into tears. I think that was the moment I got really discouraged. Everyone said on the podcast and in the community that means baby is about to be born. You are getting close. 


    Meagan: When you start doubting like that, yeah. 


    Selah: Exactly. Exactly, but I just thought, “There is no way. How could I only be an 8? I don’t know how much longer I can do this. It’s almost 48 hours.” I heard myself saying this out loud. My doula reminded me. She was like, “These are just estimates. The residents want to estimate on the lower side because they don’t want to fool the doctor and have him come in and be like, ‘Why did you say she was complete?’ It would not be good.” 


    Meagan: That happens. Just to let you know, that really actually does happen. I’ve seen it with my own eyes as a doula. 


    Selah: Right? They err on the side that benefits them essentially. 


    Meagan: They fluff it in the backward way. 


    Selah: Yeah. Yes. 


    Meagan: They fluff it like, “Oh, you’re 9 centimeters,” when you’re really 8. It’s like you are 8 centimeters and they are saying you are 6 centimeters. They do this weird thing and it’s like magical progression. 


    Selah: Exactly. My doula kept reminding me of that even when we first got there and they said I was a 1. She said, “No. I think you are a 3 or a 4.” So yeah. Exactly. But I was so discouraged. I do feel like another side note God gave me the nurses at the right point that I needed. They were progressively more supportive. 


    The first nurse I started off with was super intense. She, by the way, was insisting on a– is it called a UEP? A uterine– 


    Meagan: IUPC. Intrauterine pressure catheter. 


    Selah: Yes. That’s right. IPCP. 


    Meagan: IUPC. Yep. 


    Selah: IUPC. There you go. She kept insisting on that. My doctor wanted that too, but he gave up basically because I said, “Nope. I’m not getting that. No.” I believe there is a small, small chance of rupture from that, right?


    Meagan: Well, it causes infection. It goes up into the body so anytime we do any of that, it can increase the chances of things like Cesarean. 


    Selah: Right, so I thought, “I’ve come this far. I’m not doing that. You’re monitoring me with the monitor. I’m not doing this other catheter.” By the way, I was in labor posting that on the community page and people were like, “Do not do that. This is why.” So again, this community is so helpful. 


    So all that to say, the first nurse was very intense. The second one was fine, but the third one that I had during that moment– her name was Shamika. I will never forget. She said, “You are not giving up now. I have seen you. I have seen you singing. I have heard you singing. I have seen you thanking God during these contractions. I’ve seen you laboring with joy. You are doing this. Do not give up.” I am telling you, I felt like God put her in my labor at that moment because I needed that. 


    My husband and my doula, Johanna, were saying, “You’re not giving up now. You’ve come this far. You’ve got this.” And Johanna reminded me again, “This is just an estimate.” 


    So sure enough, I was there. I really thought, I don’t know, “Is it going to happen in another four hours like, 5:30?” Around 8:30 at night, they checked me again and I was complete. The doctor gets called in and he says, “All right. Time to push.” 


    Johanna had warned me about this. She said, “Dr. Brock really likes women to push out on their back.” I know there’s a lot of stuff about that.


    Meagan: Controversy. 


    Selah: Yeah, controversy. “So I just want to warn you that he’s going to have you on your back. You’re going to be in the stirrups but if it doesn’t work, we can go from there. But let’s start in that position.” I’m so glad she prepped me because I have heard a lot in the VBAC communities that you shouldn’t push on your back and all of that stuff. 


    But for me, I actually did like on my back because he had me hold these bars. I don’t know if that’s normal. 


    Meagan: Yeah. I’ve seen them. Yeah.


    Selah: I’m a workout junkie, so for me, it felt very strong to pull on these bars with my upper body muscles and then push with my legs. It felt doable in other words, but I didn’t realize how much this is true which is the two steps forward, one step back. 


    Meagan: 100%. 


    Selah: That is so frustrating. I didn’t know. I know I had heard it but I didn’t realize how true it was. That was very frustrating to see his head come out and then go back in. But again, that’s his little lungs getting more developed and everything. I did have a mirror which really helped to see and it felt like again, it was like you were going to the bathroom. 


    Meagan: Yeah. Yeah. 


    Selah: I feel like more people need to know that that it really is what it feels like. You just have to push it out. 


    Meagan: The biggest poop you’ll ever take. That’s what I say. 


    Selah: Yes. It’s so true. It really is. I was just pushing and pushing. We are nearing the 48-hour mark. I was pushing for three hours. 


    Meagan: Wow. 


    Selah: Yes. It was close to three hours. Basically, the contractions stayed 5-7 minutes apart. I stayed resting in between. I was on the max dose of Pitocin. Dr. Brock was getting a little frustrated so he said, “Listen. You have less than an inch to go to get this baby out. He is going to come out. Don’t worry. He’s going to come out, but I really would like to use the vacuum to get him out all of the way.”


    I thought that was great because a lot of, I’ve heard, VBAC doctors will not use the vacuum because it’s a little bit risky with cranial damage so I was actually grateful and obviously tired so I was like, “Yes. Do whatever it takes. Get this baby out.” “But,” he said, “I want to fill your catheter with an epidural.”


    At that point, now, I should say I had this prayer list and every single thing had been met from the nurses to not using drugs. I did not want the epidural. By the way, not only did I not want the risk of a C-section with the epidural. The other reason was that I had been so drugged with my other two C-sections that like I said, I barely remember holding the baby on my chest. I was so woozy and out of it. I didn’t want that again. 


    But he said, “I want to put some push epidural in so that you won’t feel the vacuum and that he’ll come out.” I was so tired. My fight was so done that I felt like I had to give in and let him do this the way he wanted to and if that meant having a push epidural, then I’d do it. I’ll do the push epidural. 


    56:47 A crack in the catheter


    Selah: In comes the anesthesiologist. She looks at the catheter that’s in my back and says, “There is a crack in the cap of the catheter.” 


    Meagan: No!


    Selah: “We can’t do it. We can’t put an epidural here. There is a tiny crack. Bacteria could get in, whatever. We can’t do it.” Dr. Brock was like, “Are you serious? This is insane.” I said, “Good because I didn’t want it anyway.” My doula–


    Meagan: You’re like, “Let’s just get this baby out.” 


    Selah: Exactly. I said, “It’s fine. Listen. I’ve come this far. I’m sure it’s not going to hurt that much.” He said, “Are you sure? Because also thought it would be good to do any sewing up after from any tears.” I said, “Yes. Just do it. I don’t need it. It’s fine.”


    By the way, there’s no choice. You can’t put it in. She said no. The anesthesiologist was like, “Nope. I’m out.” 


    So I pushed and he said, “All right. You’re going to feel a little pressure. I’m going to push on your stomach. You’re going to push at the same time. I’m going to vacuum and he’ll come out.” 


    I said, “Okay, let’s do this.” 


    Sure enough, it felt almost like the C-section when they pushed on your uterus. Yeah, a little bit. But it wasn’t painful. It was just pressure. It was just a very weird feeling actually of the vacuum. The sewing up of the tear– I had a second-degree tear which isn’t that bad considering he was 9 pounds. 


    Meagan: Very standard. 


    Selah: Very standard. He was 9 pounds, 5 ounces– big baby. He also had a big head so that was pretty good actually that I only tore that much. It didn’t even hurt when he sewed me up at all. It felt a little weird, but it didn’t hurt and it was amazing. I couldn’t believe it, the feeling that he came out of my body that way! He went right on my chest and he was crying so loud. He was so healthy. 


    The best part of all, I mean, I was just so overwhelmed and so happy. I didn’t even really cry. I was just happy. I was just joyful. The best part of all, though, he didn’t have to go to the NICU at all. 


    Meagan: Yes. 


    Selah: He literally laid down by my side the whole night. We were never separated. I breastfed all night and by the way, you know they come in and they want to make sure he’s in his bassinet. I’m like, “Nope.” I kept him right by me. That might be a little controversial, but I couldn’t let go. I really couldn’t let go because this was so mind-blowing that he could be there and that all of my fears, all of my worries, all of my hard work, all of that was over. All of the appointments, all of the wondering, I felt like, “I did it. God did it. We did it.” 


    Meagan: You did it. 


    Selah: It was incredible. Then bringing him home and knowing that there was no worry about his breathing, about his blood sugar, and that so far, my other two have asthma which is so sad. I don’t know if it’s related to the C-sections because my husband also had asthma so it could not be. 


    Meagan: It can be thought. 


    Selah: It can be, yeah. This one doesn’t have asthma so far. No allergies. The other two have allergies. It’s crazy the things that I’ve seen, but most of all, my healing was night and day. I know that’s not always normal for a VBAC or a vaginal birth. 


    Meagan: Yeah. Yeah. 


    Selah: But I personally was up and about on day two. I mean, night and day, no problems. Of course, I was a little sore. It felt like I had just run a marathon, but nothing. And of course, now, I pee a little when I sneeze. 


    Meagan: So pelvic floor therapy will help. 


    Selah: Pelvic floor which I need to do. And that also happens, by the way, with C-sections. I also had that with my C-sections but I feel like all of it was 1000% worth it. Everybody said it would be and they were right. Everybody who I had read the stories or heard the stories about. It was so worth it. 


    1:00:00 The best feeling


    Selah: The feeling of having him come out that way but also being able to hold him and be with him and not have surgery. I mean, it was just night and day and such an incredible feeling of empowerment and for me, my faith, witnessing God do what I thought was impossible and what I felt like was natural. It was just an incredible experience knowing that everything was okay. The uterine wall window didn’t happen. 


    Meagan: Oh yes. Yes. 


    Selah: None of those fears happened. Everything was okay and he was perfect. So perfect and beautiful and such a surprise baby to happen that way. 


    Meagan: I am so happy for you. 


    Selah: I feel like it was so redemptive. 


    Meagan: Yes and it should have been. I’m so proud of you for going through the motions, doing the research, recognizing what’s right, and what’s not right, making the change, embracing the change, and then also still pushing forward through that whole birth. That’s amazing. Such a long birth. Such a beautiful birth. 


    Selah: Such a long birth. 


    Meagan: I’m so glad you had the support. It was and I’m just so happy for you and that you are sharing this story today. 


    Selah: Thank you. Well, and I will say like you said, the support is so– my doula stayed the entire 48 hours. 


    Meagan: Wow. 


    Selah: She did not eat. She did not sleep. She did not leave. She was amazing. Then, my husband– I feel like if your partner is not 100% on board, that you really need that. He was 1000% on board and he did not sleep, eat, or do anything either. 


    Meagan: Yeah. 


    Selah: I really am thankful for that and thankful for this community and The VBAC Link podcast and everything. It was really what was the driving force. I can’t believe I did it. I really can’t and I love helping other women now too. It’s just such a blessing. 


    Meagan: Full circle. Yes. It’s the full circle. 


    Oh, well thank you again so much. 


    Selah: Thank you for having me. It was such an honor. It really was. 


    Closing


    Would 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.





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    1h 3m | Mar 25, 2024
  • Episode 284 Kara's VBA2C With Unexpected Twists

    Kara joins us today from the Los Angeles area sharing her VBA2C story! Kara’s first birth was a scary and chaotic emergency Cesarean. Though her second planned Cesarean went smoothly, Kara did not love how her birth felt like such a medical procedure.

     

    After experiencing a miscarriage during her third pregnancy, Kara experienced heartache and grief, but also shares how she gained a deep reverence for her body throughout the process. She just knew that her body was capable of having a vaginal birth. 


    Kara pulled out all of the stops with her VBA2C prep. She built a birth team she felt great about. She prepared physically. She processed past fears and trauma.

     

    Though her birth had some intense twists, Kara was able to achieve the VBA2C she fought so hard for. She took the leap of faith, trusted her body, and saw what it could do.


    Kara’s Website

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    02:45 Review of the Week 

    05:09 Kara’s first pregnancy 

    08:17 Kara’s second pregnancy and planned Cesarean

    10:57 Miscarriage

    16:45 Fourth pregnancy and VBA2C prep

    22:30 Beginning of labor

    25:08 Thoughts about the hospital system

    28:49 Breaking waters

    32:28 Pushing, hemorrhaging, and the NICU


    Megan: Hello, hello Women of Strength. It is Meagan and we have got a VBAC after two C-sections story. Of course, I love VBA2C stories because I’m a VBAC after two C-sections mama. Her name is Kara and she is amazing. I’m just going to read your bio because you are just amazing. 


    It says, “She is an award-winning creative marketer and mother of three. She is in LA.” If you have been listening for a little bit, she actually was on the show quite a few months ago at this point of being aired with her OB. 


    Kara: Oh yes, with Dr. Brock. Oh my gosh, when I was pregnant. I don’t know why I forgot about that, but we interviewed my practitioner, Dr. Barry Brock, together who is a very VBAC-supportive provider. That was a really fun conversation. I think I was 4 or 5 months pregnant at that point. 


    Meagan: Yeah. We really wanted to ask him some questions about VBAC. He was with you along your journey and he was so gracious to come on and talk with us. So yeah. 


    She has worked on so many amazing things, some of your favorite things I’m sure like Netflix, Stranger Things, which is definitely one of my favorites, Patrone Tequila, and some of your favorite women’s apparel brands at Target which is also my favorite store. 


    She started her own brand consulting agency, Always Friday, in 2019, and after the birth of her first daughter, Hadley, she experienced an emergency C-section with her and then a planned C-section, and then a miscarriage, and then went on to have a VBAC after two C-section story. We are going to hear all of the stories today. Thank you, Kara, for being here. 


    Kara: Yes. I’m so excited to be here. I love this community and I don’t think that I could have gotten to a place where I was having a VBAC without your podcast, without finding The VBAC Link Facebook group and just hearing other women really give me the encouragement to not do a third C-section. I am really happy. I’m just about three months postpartum now, so forgive me if I make no sense. Yeah. I’m just grateful for your guidance, your expertise, and all of the things that you pour your heart into as an expert on all things VBAC. 


    Meagan: Aw. 


    Kara: Thank you for that. 


    Meagan: Well, thank you so much. I’m so excited to hear this story because I haven’t even heard the full story. I just have this little blurb right here on my form, so I’m really excited to dive into it. 


    02:45 Review of the Week 


    Meagan: We do have a review of the week and I put Kara on the spot you guys because she actually took Needed during her pregnancy and first, I’m obsessed with Needed and love and trust Needed. You took it throughout pregnancy and I would just love to hear your review on Needed today. 


    Kara: Yes. I have obviously looked at all of these different types of prenatals and I ended up going with Needed and loved it. I did their prenatal multi and at first, I was like, “This is a little wild.” It’s eight capsules which felt aggressive, but it actually was so much of the nutrients that I needed. I broke it up to four in the morning and four towards the evening. 


    I felt the most energized during this pregnancy. I felt the strongest. I obviously did all of the things, drank all of the tea, had the protein, the dates, and all of that, and my baby was much– I mean, I don’t know if this is correlated or not, but my baby was almost a pound and a half bigger than my previous biggest baby and I felt the strongest, the healthiest that I’ve ever felt during any of my pregnancies. 


    I wish I would have taken it with the other two, but you live and you learn, so yeah. I highly recommend that to all of my friends and I always send people the link for the Needed vitamins whenever I can. 


    Meagan: Yes. I believe it so much too. It’s interesting that you said you have felt the most energy during this pregnancy because I feel like once you have one, two, and three– once we have more kids, during those pregnancies, they are more exhausting because we are not just able to rest and relax. 


    Kara: They are. 


    Meagan: We are being mom, right? So I love hearing that. 


    05:09 Kara’s first pregnancy 


    Meagan: Okay, let’s get into your stories. 


    Kara: Let’s do it. Cool. I’m excited. 


    Meagan: Perfect. Let’s talk about Hadley’s birth. 


    Kara: Yes. I got pregnant pretty easily and had a healthy pregnancy. I think maybe had this false sense of confidence that my delivery would match my pregnancy. I did not do a lot of prep work. I went into maybe how everyone does to some degree, what you don’t know you don’t know kind of thing. 


    I went into labor naturally. I was a little bit overdue and ended up sort of with the classic cascade of interventions. That was challenging. They broke my water and just set off a bunch of other things that then her heart rate went up, sort of the classic stories you hear, and they rushed me into an emergency C-section which was really scary. It felt like a true emergency like Grey’s anatomy style just being rushed down the halls, with no time for really conversation. I finally asked for my operating notes and it was a class 2 which I guess if it’s a class 1, you guys talk about it. If it’s a class 3, you or the baby didn’t make it. 


    It was really scary and honestly, I was terrified after. I think it took three weeks for my shoulders to come down from that C-section. I’ve said this before, but the only way I could describe it was it felt like a car crash and I wasn’t sure if my passenger made it. It was quiet in the room. I didn’t hear a baby crying. Nobody was really talking. I just remember tears streaming down my face while I was on the operating table completely unsure if my baby had made it. 


    Luckily, she’s healthy and fine, but I don’t think that took away from the birth trauma that I experienced with that first baby. 


    Meagan: Yeah. That just gave me the chills when you described it like that. How scary. 


    Kara: It was so scary. I’ve never seen my husband look so afraid before. I’ve never seen him pray out loud before. So yeah. It was just one of those things where I wasn’t mentally prepared for that. I was not up to date on how many women have C-sections and what you can do to prevent it. I guess in this Instagram world that we live in, you see your friends pregnant and they are cradling their bump and then the next square you see in their feed is a baby announcing its name and weight. You never get to hear unless you ask people how you got from point A to point B, right? 


    That was very just this naivety that you go into the hospital and you come out with a baby and you’re fine. I don’t know why I didn’t maybe do a better job researching all of the options. 


    That was baby number one. 


    08:17 Kara’s second pregnancy and planned Cesarean


    Kara: Baby number two– I got pregnant about a year later. Again, quickly and easily thank God and all of that. It was the middle of COVID. It was 2020. I found out I was pregnant in March 2020 so it was sort of the peak of absolute fear and scare tactics to a degree. 


    I kept trying to wrap my head around going into labor again naturally and I just couldn’t get there. I would have borderline panic attacks every time I would think about it. The word birth trauma wasn’t a word or a phrase in my vocabulary so I just thought you kind of toughen up and figure it out. I just really couldn’t get there. 


    COVID every day, a new study came out basically saying that pregnant women are going to die. 


    Meagan: Yeah. Lots of scary stuff was coming out. 


    Kara: I opted for a planned C-section. That just seemed like the logical thing to do at that point. My husband couldn’t come to any of the appointments. I couldn’t have anyone else in the room. I was delivering with a mask on. It was all of these things that just took away from what is a natural birth experience so to speak and all of the things that you need. It eliminated a lot of that and made it this very sterile process that resulted in a great, planned C-section. 


    I can’t describe it any other way than it just felt like surgery. I hate to say that because you get a beautiful baby at the end of it and you created this beautiful baby. I’m not trying to take away anyone’s experience with a planned C-section. But for me, it felt like I scrubbed in for surgery and went into this sterile environment. I was put on a lot of different drugs, laid on the table, cut open, and a baby was handed to me. 


    I have a beautiful three-year-old named Hazel from that experience, but it ultimately left me feeling– I don’t know how to describe it, but not fulfilled in the way I wanted to feel. 


    Meagan: Yeah. I can understand that. I can understand that. Like you said, not everyone is going to experience this, but there is often this disconnect. You went in. You scrubbed in and had a baby. Everyone is sterile and quiet. It’s bright. There is beeping here and there. It just doesn’t feel sometimes like birth. 


    Kara: Right. Yeah. It felt like a surgery. 


    10:57 Miscarriage


    Kara: So then we were going back and forth with if we wanted to have a third and ultimately decided we love being parents. I love being a mom so much. I love my work. I love the branding things I do but nothing compares to the purpose, fulfillment, and joy that I feel raising children and being a mom. 


    I got pregnant again and it felt exciting but it also felt like it was coming at a time during my career that was potentially the busiest. Long story longer, I had a miscarriage with that baby and that pregnancy at almost 12 weeks. That was so surprising to me because once again, so similar to C-sections and all of that, it just was not on my radar. 


    I maybe took a lot of things for granted with my very healthy and easy pregnancies. No issues, truly with the first two. That miscarriage was scary in that I was alone at home with the girls. I put down my children for sleep and then I got in the bathtub and basically delivered the placenta. I saw. It was my first experience and the closest thing I had to delivery so far because I normally have C-sections. I’m seeing a lot of blood. I’m seeing the placenta and I’m seeing what was my unborn child. Sorry to be so graphic. 


    Meagan: It’s hard. 


    Kara: Yeah. Yeah. I felt like– and you have contractions and all of that for anybody who hasn’t ever experienced a miscarriage. It’s not anywhere near the same amount of pain as labor, but it is way above a period cramp or however else anyone might want to describe it at least for me. 


    Weirdly though, I have to say that you would think that experience would make me really sad and it did. The number one thing I took out of it is that I felt incredibly empowered. I felt like my body knew what it was doing. I felt a deep sense of trust in that, “Wow. This was not the right thing to happen and my body was smart enough to get rid of what wasn’t a viable fetus and pregnancy. It knew something was wrong and it got rid of it for me.” It’s like, wow. All of that while I made chicken nuggets. That’s so exciting. 


    I really walked away from it feeling like, “Gosh. The female body is so incredible. It is so strong. It knows what it is doing. It is so powerful. Why wouldn’t I go for having the birth that I want to have which was a vaginal delivery?” 


    So yeah. It was sad but also strengthening in a way. 


    Meagan: Yeah. A really sad situation and unfortunate circumstances, but in the end, it was that healing, empowering thing that happened to get you to this next step. 


    Kara: Yes. There is something about listening to yourself and your own gut and your own body in a way that you really just start to know that you know what’s best. 


    My husband wasn’t there and something took over in me that was like, “Get in the bathtub.” I have no experience. I visualized this pain leaving my body. When I did that and breathed through it, I was able to deliver the unborn baby. It was 12 weeks. 


    Yeah. So for me, it was really incredible. It gave me just the strength to know that I can do it and that our bodies are so, like I said, powerful and women are just so strong. 


    Meagan: Absolutely. Thank you for sharing that. 


    Kara: Yeah. Yeah. 


    16:45 Fourth pregnancy and VBA2C prep


    Kara: So then I got pregnant again and was confident I wanted a VBAC. I took your course and it gave me a sense of confidence and was so intelligently designed to make me think about visualizing fear, letting go of fear, and things that I really wish I would have done almost before I had a baby to be honest with you of just all of the things you don’t realize you are holding inside of you of the unknown, of what could go wrong, what you don’t know, what you want to ask, what you hope for, what you are going to let go of, and just filled with great information. That course was really helpful for me and my husband so for anyone who is looking to achieve a VBAC or do a VBAC, I highly recommend educating yourself with a course like The VBAC Link’s course or just one that can get you to a place where you guys are both really–


    Meagan: Feeling confident too in the decisions you are making. 


    Kara: Yeah. So I did that and honestly, with this pregnancy, I was like, “I’m going to do all of the things.” I think women, if you can, if you have the means to do that, I think you should take care of yourself in a way that is– I wish I could take care of myself when I wasn’t pregnant at the level I took care of myself during this last and final pregnancy. 


    I took the Needed prenatal vitamins pretty religiously. I hired an incredible doula, Lia Berquist at Your Natural Birth who teaches The Bradley Method and is also just such an advocate for VBACs. She actually is a VBAC-certified doula with The VBAC Link. 


    Meagan: Yay. 


    Kara: Yeah. Then I took her course. I read Ina May’s books even though my heart was not dead-set on having a natural delivery which, I think if I had a fourth, I would love to go for that but for me, just getting past the C-sections and being able to have a VBAC was really what I wanted. Like I said, I took your course. I listened to a couple of my friends. My friend, Olga, had a VBAC and she recommended her doctor who I already mentioned, Dr. Barry Brock, who is VBAC supportive, and also her chiropractor, Dr. Berlin who also has a great podcast, The Informed Pregnancy Podcast. It’s great and he is also a great resource and a great person.


    I had all of these people around me. I assembled an all-star team. 


    Meagan: 100%. Holy cow. 


    Kara: I went deep. I read a lot. I took it seriously. I got my head in the game. I did not let fear creep in and I really tried to focus on what I could achieve. I think that you will notice if you are someone who has had two C-sections and you tell people confidently when you are pregnant that you want to have a VBAC, you will get a really, really mixed response even today in 2024. You will get people asking you, “Can you even do that? Is that possible? I thought you couldn’t do that.” It’s not your job to educate them and enlighten them on what you can or cannot do unless you feel like it. 


    Sometimes I was in the mood to tell them, “Yes!” and tell them all of the things I learned, and other times, I was like, “Yes, you can and I will,” and just left it at that and moved the conversation along. But yes. It is important to just not let other people’s fears creep in. 


    Meagan: Absolutely. 


    Kara: I think if you are pregnant in general, people tend to want to tell you their horror stories. 


    Meagan: Yes. Why? I don’t understand. I don’t understand why when you are pregnant, it’s like, “Well, let me tell you how horrible my birth was.” I’m like, “Ahh. Don’t share those things.” 


    Kara: I would actually stop people and be like, “I’m sorry you had that experience. I personally don’t want to hear it.” 


    Meagan: Good for you. 


    Kara: I know that is rude but I had to protect my own space and my own mental sanity. I needed to really do that. 


    Meagan: Protect that. Yeah. 


    Kara: Yeah. I mean, even when I would see people, there are things going on in the world. There are shootings and there are wars. People wanted to tell me that and I really tried to block all of that out, especially in the final months of getting ready to deliver. 


    Meagan: Yeah. Good for you. 


    Kara: Yeah. I was overdue and I went into labor naturally. Basically, contractions picked up. We wanted to wait as long as possible before going to the hospital– another mistake that I definitely made in my first pregnancy of getting to the hospital, getting checked in, and becoming a patient really just too early in the labor process. 


    Meagan: In the labor process, yeah. 


    Kara: What I didn’t know and what I learned through your course, through the Bradley Method course, and through all of the different things that I did to prepare is that your body is not a business and labor is a natural thing that could take as long as it needs to take. Sometimes your contractions stop when the sun comes up. It’s an incredible thing. Sometimes your contractions stop when you get afraid and you go into a space of needing to not– so I learned all of that because my contractions did slow down when the sun came up and my contractions did slow down when I finally did get to the hospital. 


    22:30 Beginning of labor


    Kara: My husband and I went to a hotel actually that was near the hospital because if you have ever been to Los Angeles, the traffic is so scary. Yeah. 


    It gave me peace of mind to be able to labor, be close to the hospital, be in a bathtub, and know that I was going to be okay and that I could also be as loud and visceral as I wanted without my other two children being frightened by my primal-ness so to speak. 


    Meagan: Mhmm. Mhmm. 


    Kara: Yeah. That was a really nice experience. Incredibly painful, but I basically got to the hospital and was able to labor unmedicated until about 7.5 centimeters. 


    Meagan: Nice. 


    Kara: At that point, I started throwing up. I think that’s common. I mean, you would know. 


    Meagan: It is. It’s miserable. 


    Kara: It’s miserable. The other thing I didn’t anticipate is when you throw up as much as I did, you lose that– we’re talking bags and bags to the point where my doula, Lia, was like, “Wow. I didn’t even know you could have that much in you.” We were like, “Whoa.” I felt so weak and so dehydrated and just not ready to run a marathon of pushing and all the things I knew were in front of me.


    At that point, I opted for the epidural. I’m glad I did because I needed to take a rest. I needed the contractions to stop a little bit, to slow down, to be lessened so I could just rest and get a little bit of my strength back before it was time to push. 


    We did that. The contractions slowed down a little bit which was unfortunate because they were so strong for a while, but we did some Pitocin as well which I didn’t want to do because I was trying to have a somewhat unmedicated delivery or birth experience. My wanting of that really was because I felt so helpless during my first delivery where I got an epidural early and then I just couldn’t get up. I couldn’t move and when her heart rate dropped during my first delivery, it just felt like I was at the mercy of the hospital staff and the doctors, and it just, yeah. I didn’t want that. 


    25:08 Thoughts about the hospital system


    Kara: This was a great experience though. It did feel a little bit like I was on someone else’s schedule. Another thing I learned is the hospital is a business. 


    Meagan: It is. Yeah. It’s not a bad place to give birth, right? But there is still a system. There are still policies. There are still things where you come in and you’re not always just looked as an individual coming to give birth and that’s it. 


    Kara: No. 


    Meagan: This is an individual coming in to have a baby and we need to have a baby. 


    Kara: In order to bill. 


    Meagan: Yeah, and move on so we can fill the room with the next person. Yeah. That is the thing. A lot of the time when an epidural comes into play, Pitocin is just in there right in the front saying, “That is the next step ‘naturally’” to them because it can slow labor down. It often does. 


    Kara: Yeah. I really do like my doctor. Dr. Brock is amazing and he is so supportive of VBAC. It’s not his fault. It’s actually just how the system works. He had surgeries planned and he had a schedule to keep so in a way, it felt like my labor was taking too long and it was time to get things rolling. 


    Yeah, that and he recommended pretty strongly breaking the bag so it was just another thing where I mentally, Meagan, was getting to a place where I was like, “Oh my god. I’m going to end up in another C-section.” 


    Meagan: Same situation. Well, and a lot of triggers I’m sure. Even processed births, when things happen, even if you have processed them, they can trigger you very easily. 


    Kara: That is such a good point because even though I feel I processed all of the birth trauma from my first situation, the second my husband and I walked back into that hospital, the last time we were there in labor was with our first one and we both almost started crying. It was so triggering. I did not expect it at all. 


    Meagan: Yeah. You know, I as a doula– I had two C-sections at this one hospital, the same hospital. I as a doula, became a doula and I walked in. I wasn’t even giving birth. I wasn’t even giving birth and I was like, “Whoa.” I just felt that. When you are walking in, you are in a lot of discomfort. You are laboring hard, then you walk in and you feel that overwhelming space like you were saying earlier and sometimes they stop when our bodies are responding. 


    Kara: Right. 


    Meagan: That can happen. 


    Kara: And that is what happened. I went to a place where my body didn’t feel safe and my contractions, even though they were so strong back at the hotel, so strong to the point where I had the classic couldn’t walk in, keeled over, grabbing– really just powerful. The second I got there, it was like I froze up and everything slowed down which is so incredible when you think about your body. If you don’t feel safe–


    Meagan: It responds. It protects you. 


    Kara: It protects you, right? It’s like, “Oh, we are not ready to bring a life into this world if you are in a space of total fear.” 


    Meagan: Yeah. 


    Kara: Exactly. That was so crazy reflecting back on that. 


    28:49 Breaking waters


    Meagan: So you kind of went into that triggering moment of, “Hey, let’s break your water.” We’ve already got epidural, Pitocin and now it’s like, “Hey, we need to break your water.” 


    Kara: I told him, “No.” 


    Meagan: I was going to say, what did you say?


    Kara: I said, “No.” He said, “Well, it’s what I would recommend.” It was a little bit jarring. It was a do you want to have a baby or not kind of a thing. I was like, “Okay. You leave. I’ll think on it. I’ll get back to you.” You know what I mean? I talked with my husband. We were both pretty afraid and ultimately, I decided to have the water broken. I think that if you are making the decision yourself and you are really taking time to come to that decision, it’s not the wrong decision. It’s an informed, empowered decision and you made the decision. 


    Things could go right. Things could go wrong. The point is that you were not backed into a corner and then being forced to choose it. So I chose it because I knew I was getting to a place mentally where I was so tired and I don’t want to say I was giving up on my VBAC, but kind of. 


    Meagan: Yeah, starting to doubt it a little maybe. 


    Kara: Starting to doubt it. 30 hours of labor with exhaustion, vomiting, and contractions were really starting to mess with my mental strength and getting me to a place where I was like, “Maybe I can’t do this. Maybe this isn’t going to happen for me.” 


    Meagan: Yeah. 


    Kara: That sucked. That’s a scary place to be especially after I told you about all of my A student level prep. 


    Meagan: I was going to say, a lot of work and mental prep and physical prep to go into that. It’s hard to have that defeating feeling of, “I don’t know if this is going to happen. I want it to but I don’t know.” It’s hard because we doubt ourselves. I don’t know exactly why we doubt ourselves in labor. It’s so common. I’ve attended hundreds and hundreds of births and the amount of doubt that happens is almost 100%. 


    Kara: Right. Why do you think that is? 


    Meagan: I don’t know. I know it’s getting intense and it’s at the end. Okay, so you have an epidural because that’s a very common stage at 7-8 centimeters to do it when they are unmedicated but here you are even with an epidural internally dealing with that. I don’t know why we always doubt our bodies and our abilities, but for some reason, I’m not kidding you. It’s almost 100% of births that I attend. At some point, there is doubt that crept in. Me too. I doubted it. I was 6 centimeters and I was like, “This isn’t going to happen. This isn’t going to happen.” 


    Kara: I wonder if you are in so much pain at that point that you feel weak. 


    Meagan: And exhausted. 


    Kara: And exhausted. I didn’t realize that your mental strength is almost if not more important than your physical strength during labor. 


    Meagan: Oh yes. 


    Kara: That part of it is just really the trick. 


    Meagan: Well, the mental part can get us through the physical part. If we tell ourselves we are not doing well or we can’t keep going, we physically stop feeling like we can. 


    Kara: Right. Your body listens to everything your mind says and I carry that with me through everything now. It’s the way you talk to yourself and the pep talks you are giving yourself. They are very important. 


    32:28 Pushing, hemorrhaging, and the NICU


    Kara: Anyway, I then ended up going to the pushing stage and the epidural was starting to wear off so I could feel it a little bit. I pushed and pushed and pushed and yeah. A bunch of other things happened in that sort of period but I will spare you and ultimately, I asked for a mirror. I could see her head starting to come and that to me was so encouraging. I was just like, “You can do this.” I really gave it my all and was able to have my daughter. It was really magical and amazing and they put her on my chest. I was so excited that I did it. I was crying and all of that. 


    I did end up hemorrhaging pretty badly and during that hemorrhaging, she had swallowed some of my blood on the way out. 


    Meagan: Oh. Wait, so you were hemorrhaging internally as you were pushing? 


    Kara: Correct. 


    Meagan: Wow. Did they notice like, “Oh, we’re having blood here?” Or bleeding? 


    Kara: I feel like they should have but no one said that. Then all of a sudden, after I delivered the placenta, I had a minor tear internally. He was stitching that up and then all of a sudden, I just felt this huge gush of blood and of warmth around my legs. I was like, “What is that?” Then it became an emergency situation again where all of these people came running in to stop the bleeding. We had one person starting a second IV. The other person was jabbing a needle into your thigh. Someone was holding down your uterus to try and stop the bleeding. 


    The baby at this point was taken and is being looked at because she is not breathing super well because she has my blood stuck in her lungs and stomach. As quickly as that beautiful moment happened, it went away. 


    Meagan: Ugh. Which is so hard. 


    Kara: Oh my gosh. It was so hard. It was so hard. Then the room was quiet essentially. The bleeding they were able to stop. My baby went to the NICU and my husband went with her and I was just there with my doula. I remember looking at her and being like, “Why did I ever want to do this? This was awful. This was terrible.” I just started crying and crying. 


    Meagan: Yeah. 


    Kara: By the way, I don’t feel this way, but in that moment, I was like, “I just wish I would have done another C-section.” I felt this super high and then I felt this huge low. Any mom who has ever given birth, however you do it, when your baby gets put on your chest and you have your baby, you forget all of the pain and you are just like, “Yay!” Then when the baby is taken away from you, you are left with the most depressing feeling. 


    Meagan: Yeah. I can’t imagine. Yeah. Yeah. Like you said, the super high to super low. I mean, I think that’s very normal for you to doubt your decision in that moment. 


    Kara: Right, yeah. Anyway, so she went to the NICU and she was totally healthy and fine. They had to pump some blood out of her lungs and belly. I call her my vampire baby because she was sucking my blood. 


    Meagan: Literally. Oh my gosh. 


    Kara: I ended up doing two blood transfusions to build back my blood supply. My face was white. My lips were drained of all color. It was sort of like looking at a corpse, just absolutely iron-deficient. 


    There was talk of sending me home and keeping my baby there which I just lobbied against. 


    Meagan: To not happen. 


    Kara: To not happen. Then finally I was able to leave and I achieved my VBAC so I took my celebratory VBAC photo in the parking lot of the hospital while I was leaving because I didn’t have her in the hospital bed with me while I was there. 


    Meagan: Yeah. Yeah. Well, I am so sorry that that happened. That’s a lot. That is a lot. I don’t know if you’ve heard our radical acceptance episode, but you should go listen to it not just to radically accept your situation. I think that in turn, it will be very powerful as you are healing through this. I can see right now you are still healing. You still are feeling this. I can see it in your face. 


    Kara: Yeah. Right. 


    Meagan: I can see it and I can hear it in your voice. It’s okay to take time in healing that and also, be really, really happy while being really pissed off. That’s okay. You can have those two feelings together. You can be so happy that you had your VBAC but you can be so ticked that it happened and appreciate the experience while also being angry about the experience. 


    But yeah, through processing, I send you love and I wish you luck through your processing journey. I am so happy for you that you were able to get your VBAC. 


    Kara: I am so, so happy. I really am. I know I just highlighted a lot of crazy things that happened, but ultimately, the way I feel about it when I think about it and when I talk about it is that I really just am so proud and so happy that I was able to have that experience, to trust my body again, and just to deliver my baby the way I wanted to do it. 


    Meagan: Right. 


    Kara: I really hate when people say, “All that matters is a healthy mom and a healthy baby.”


    Meagan: I know, met too. It drives me nuts. 


    Kara: It really bothers me because it’s like, “Well, duh I want a healthy baby and I don’t want to be injured. That is so baseline. I don’t even know why we are saying it.”


    Meagan: I know. 


    Kara: But it’s also taking away the fact of how you’re getting there and the journey. 


    Meagan: Yeah. Yes. 


    Kara: You know. I think it’s just something we say to make ourselves feel better kind of a thing. 


    Meagan: Yeah. I do too. I feel like it’s the same thing with CPD. Providers are quick to just be like, “Oh, we’ve got a too-small pelvis. That’s why there was a C-section,” just because it makes them feel better. I swear it makes a lot of providers better just to say “CPD” because it justifies the– I’m trying to think of the right word– reason why it happened. 


    Kara: Yeah. It makes it so that it’s clearly a cause and effect. It’s a simple black-and-white thing on paper. It simplifies it for everyone. 


    Meagan: It makes it okay. 


    Kara: It makes it okay. But to me, that’s like saying to someone, “You got in a really, really bad car accident and you guys both survived the car accident. Yay!” But all that matters is that you survived. But you’re like, “Yeah, but what about the fact that every time I get in the car now, I can’t drive or I’m terrified?” Or the effects that it had on you? 


    I don’t know why we are so quick with every other trauma, if you are in a shooting or something horrific that you would be given the space to talk about it, process it, and be given that grace but when it comes to birth trauma, it just feels sort of like–


    Meagan: Dismissive. 


    Kara: Very dismissive. Oh, but look at the healthy baby you have now. 


    Meagan: Aren’t you happy? 


    Kara: It’s like, they can exist in the same space. You can be happy to have a baby and be healthy and alive while also still being traumatized, disappointed, and saddened of how it all went down. 


    Meagan: Yes. Absolutely. 


    Kara: Anywho, I’ll get off my soapbox now. 


    Meagan: Amen. Mic drop. I believe that wholeheartedly. Julie and I in the past have talked about that. I’ve talked about that. They can co-exist together and you don’t have to dismiss your feelings. Please, Women of Strength, do not dismiss your feelings because the world says you should. These feelings exist. They are in you and–


    Kara: They’re valid. 


    Meagan: They’re very valid. They’re very valid. Even if to someone else, Jane down the street, it seems irrational or ridiculous because you have that healthy baby, no. She can think that way or someone else can think that way, but you are not wrong for feeling the feelings that you failed. 


    Kara: Right. Yeah. 


    Meagan: Well thank you so much for sharing with us today. 


    Kara: Yeah. I loved chatting with you and am so thankful to this community and you and your podcast and the space that you have created for everyone to talk about it and benefit from it. So yeah. 


    Meagan: Well, good. This space is for everyone here. 


    Kara: Thank you for having me. 


    Meagan: Thank you, thank you and we’ll talk to you later. 


    Kara: Okay, bye. 


    Closing


    Would 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/donations

    Advertising Inquiries: https://redcircle.com/brands
    42m | Mar 20, 2024
  • Episode 283 Danielle From Sakara Life's HBAC + Fill Your Soul With Inspiration

    Danielle Duboise, the co-founder of Sakara Life, has changed millions of lives through her advocacy for wellness and nourishment both of the body and the soul. Danielle is also an HBAC mama and shares with us the valuable lessons she has learned from both of her births about the mother-baby connection, surrendering, and the true meaning of an empowered birth. 


    Danielle and Meagan have just the sweetest conversation that we know will leave you feeling inspired and uplifted. Danielle encourages birthing women especially to care for themselves on the deepest levels. Her words align so perfectly with all of the things that are important to us at The VBAC Link. Meagan had chills throughout the entire episode as Danielle spoke and we know you will too!


    Sakara Life Website

    Danielle’s Podcast

    Eat Clean, Play Dirty

    Spirit Babies Book

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    03:51 Sharing your birth plans with others

    9:13 Danielle’s first pregnancy with vasa previa

    11:29 A humbling birth experience

    14:09 Going into labor

    17:06 Danielle’s C-section

    23:31 Connecting with your baby

    32:26 Surrendering

    36:06 Choices in birth

    39:14 The ripple effect of birth

    42:34 Ways to release fear

    53:02 Which risks are you willing to take?

    56:07 Nutrition and nourishment



    Meagan: Hello, Women of Strength. We have an amazing guest for you today. Her name is Danielle and she is the co-founder of Sakara Life. It is a wellness company providing the tools to achieve optimal health and vitality. If you haven’t caught on already listening to our Needed ads and other episodes, health is so important, and optimal health and getting the nutrients and the things that you need in your life is so important in how we handle life. 


    She is a true pioneer in the health industry and launched the brand in 2012 with her best friend, Whitney. Creating their unique nutrition philosophy which merges modern science with ancient healing wisdom. Since its conception, Sakara has transformed millions of lives through its signature program, functional products, and supplements. 


    Leading the global movement as an advocate for plants and medicine, Danielle became a nationally bestselling author with Sakara’s debut cookbook which is called Eat Clean, Play Dirty, and is the co-host of the wildly popular, which I also am obsessed with, Sakara Life podcast. A certified holistic health coach, nutritionist, and expert in plant-based living and the microbiome, Danielle is currently pursuing her Master of Science in human nutrition and functional medicine. You can continue to see both personal and professional features of Danielle in things like Vogue, New York Times, The Wall Street Journal, and the Couverture– I think is how I say it- and Goop. 


    She was born and raised in Arizona and Danielle is true to her Sedona roots while living in New York City with her husband, daughter, and son. She is joining us today to share with you her journey. She had a C-section and then went on to have an HBAC as well as giving us some more of her amazing wisdom. 


    03:51 Sharing your birth plans with others


    Meagan: Hello, Women of Strength. We have an amazing guest today. Her name is Danielle. And did I say your last name? Is it Duboise? 


    Danielle: It’s Duboise. I think technically, Duboise is maybe proper, but we’ve always said Duboise. 


    Meagan: Duboise. That sounds– I always sat it Duboise in my head because I think I just read it and don’t– anyway. Welcome to the show. 


    Danielle: Thank you. Thank you for having me. 


    Meagan: Oh my gosh. I’m so excited. So so excited. 


    Okay, we were talking a little bit before about HBAC, home birth after Cesarean, so she of course is going to share her Cesarean and her HBAC, but we were talking about how it’s something that happens obviously but a lot of people don’t talk about their plans to do it. They don’t want to share it with people, so we will get into that but I’m curious how you felt about it when you were doing it. When I was pregnant and I had my two C-sections, I didn’t want to tell anyone that I was planning on going out of the hospital because I didn’t want the negative. 


    Danielle: Yeah, I think there are layers. It’s probably multi-faceted. Certainly, when you are pregnant and about to give birth, you have to be very protective of your space. I think people can’t really control their fear. It incites fear in people who aren’t even having children at that moment. It’s crazy how much fear it brings up when you say you’re going to have a home birth. 


    When I was pregnant with my first, I was planning on a home birth and then I could get into the details of why I risked out of a home birth, etc., but before I risked out, I told a dear friend. It was a couple and they were pregnant with their second. I said, “Yeah. We are thinking about a home birth.” I don’t think I said home birth. I said midwife and then later it came out it was a home birth and his response was, “You know your baby could die, right?” 


    Meagan: Right? 


    Danielle: I was 8 months pregnant. I was so emotional. Normally, it wouldn’t have bothered me because I think he learned to put up barriers and that was the fear he was putting on me, but it was such an important reminder of how much you have to protect your space. I think every mother, mother-to-be, parent, and parent-to-be gets to define how they protect their space but I think one of the ways we do it is we don’t talk about how we are going to birth. 


    Meagan: Yeah. It sucks. We shouldn’t have to hide how we want to birth especially if we are making that decision confidently. 


    Danielle: Yeah. I think even after you give birth, it’s still something that I shout from the rooftops because now, I think it has a way, same with prolonged breastfeeding, of making other mothers feel less than when it’s just my story. It doesn’t mean it’s the best way to breastfeed. It doesn’t mean it’s the best way to birth. It’s what worked for me. But I think inherent in the complexities of our birthing system, of our culture, the demands on women, me talking about a home birth might make another woman feel like she couldn’t do it or didn’t do it, so I’m careful about how I talk about it in the world too balancing both I want to empower women who want to make that choice and also empower women who don’t want to choose a home birth. 


    Meagan: Right. That’s what we do here at The VBAC Link. We empower people who want to have a VBAC and women who were like, “This is what I want. I want this.” But then also, we empower those who are unsure and help them find what’s right for them by also not judging anyone for just scheduling a C-section. 


    Danielle: I think the most important thing and what I want for all birthing bodies is just an empowered birth. You get to define it, but inherent and empowered birth is you get to decide. You are in the driver’s seat. You are in control. You feel supported. You feel safe. You can define what are all of the things that make you feel that way, but the point is that you get to decide. It’s very easy to be a victim to the medical system and I’m careful to use that word, but I really think the way most of the medical system is set up is you can feel very bullied in it not even just in birth. If someone in a white coat comes up to you and says, “You have to do it this way, otherwise you are risking the life of your unborn child,” it’s a pretend choice they are giving you. “You could do this. You don’t have to, but your baby might die.” You’re not giving a woman a choice. You’re masquerading a choice. I think you can feel really bullied in those scenarios. That’s the antithesis of an empowered birth. 


    Meagan: I love that you pointed that out. I can connect to that just in my own birth and as a doula watching hundreds of people give birth, seeing that come in and happen. 


    Danielle: Yeah, I bet you see that all the time. 


    9:13 Danielle’s first pregnancy with vasa previa


    Meagan: Okay, so you mentioned that your first birth was a planned home birth and there were some things that happened that shifted, and obviously, it was a C-section. Tell us more about that. 


    Danielle: Yeah, so I live in New York City where I would say home births are not maybe as popular as they are in other parts of the country. The insurance rates for midwives are pretty insane. Even just to decide I wanted a home birth in New York City was a feat and to find the right midwives. I had planned for it. I had a really great pregnancy, but then at around week 32, we went in for one of our scans and they found vasa previa. 


    Vasa previa is kind of like placenta previa but it’s where the veins, the fetal vein come out of the Wharton’s jelly and is in the way of the birth canal. If I were to have gone into labor when that happened, then the fetal vein could burst and they say it’s about seven seconds before the baby would bleed out. 


    So I went from, I had this beautiful home birth planned. I had the bathtub. I had this midwife I loved to, “You have vasa previa. If it doesn’t move–” it had to move a half a centimeter. “If it doesn’t move in the next two weeks by the time you hit 34 weeks, you have to sit in a hospital bed until you are full-term and then we’re going to induce you.” 


    It was one of those moments where you just kind of watch reality melt in front of you. It went from my home birth to the most medicalized birth you could imagine. 


    Meagan: Yeah. 


    Danielle: I wouldn’t say I’m a religious person, but I’m a deeply spiritual person and my husband and I were praying every single day. We were visualizing the vein moving. We were doing so many things. We had this little baby shoe that we would pray over and put all of our energy into just– it could make me cry. Just bring her here. Get her here.


    11:29 A humbling birth experience


    Danielle: That’s where you are very humbled. We can talk more about this later, but this idea that the most important thing is a healthy baby. I very much disagree with that. I think that’s one of the missing pieces in this conversation of empowered births, but in that prayer was, “I want a healthy baby and I want a birth that we both need.” 


    That became my prayer instead of the birth that I wanted. 


    Meagan: Yes, that we both need. 


    Danielle: That we both need. I was humbled. I was born C-section in the 80’s and my mom didn’t breastfeed. It was a different time then. She didn’t breastfeed by choice because the doctors were kind of like, “You have a choice. You could breastfeed or you don’t have to. You could just do formula,” and my mom chose formula because that was right for her. I had a lot of judgment. I had a lot of judgment that she didn’t even try a natural birth. I had a lot of judgment that she didn’t even try to breastfeed and I was very humbled. I was served a dose of humble pie. 


    My daughter and I ended up with the birth that we both needed to work through that karma of this judgment I had. What ended up happening was I had to move from my home birth midwife to a hospital. I found these midwives in New Jersey about an hour away from my house in New York City. They had a birthing clinic that was in a hospital so I could go there. 


    But you know, it’s an hour's drive. It’s New York City. You don’t own a car so you have to rent. It was a whole thing just to get there. Just the change was so monumental to go from what really felt like this beautiful, safe place to give birth with these people I had built a relationship with and then I was thrown into this other practice. I didn’t really vibe with the midwives there. It was so much more medicalized. I just started to feel really scared even before I was giving birth. 


    I will say that my HBAC offered so much peace and forgiveness for myself because I realized in my second birth what I didn’t have in my first and why I couldn’t go to the places I went in my home birth in my hospital birth because I didn’t feel safe there. 


    The vein moved and so I went back to a no-risk, regular pregnancy, but I had already moved to the hospital and it was going to be too much to go back. My husband was kind of freaked out at that moment too like, “What if the baby moved a half a centimeter again? Let’s just be in a hospital.” I understood that. 


    14:09 Going into labor


    Danielle: I went into labor and I think the fear hit us. We just went to the hospital too early. All of the things they tell you not to do that I think most first moms and first parents just do because it all feels so new. 


    Meagan: Well, it does and it’s like, “Well, wait. These signs mean I’m having a baby and I’m having a baby at this place so I should go there.” 


    Danielle: Yeah. Yeah. I knew the moment I went into labor. I wasn’t in active labor for a while. I could just feel waves, but they weren’t painful waves. I was just a little crampy, so I stayed at home for 24 hours there. My water didn’t break, but then it just started getting more and more intense. 


    They started getting closer together, but my water still hadn’t broken so we just decided to go to the hospital because it’s also an hour away. You don’t want to get caught in New York City traffic because it could have easily been three hours away. 


    So we go. I also had to change doulas because the doula in New York City understandably wasn’t going to travel. She had small kids. So it was just all newness. I didn’t necessarily vibe with my doula. I didn’t feel safe in her arms. She was kind of more like– and I always tell people that you have to find the doula that matches and is the yin to your yang. She just wasn’t that for me. She was kind of small and fairy-like and very airy, but I’m very airy. I wanted a lioness that was just going to catch me and hold my hand and be really grounding for me. 


    It just feels off the minute it started. It wasn’t. It was right. It was exactly what was supposed to happen. I went and when I got to the hospital, I was only 2 centimeters. I had already been in labor for about 24 hours. It wasn’t like I couldn’t sleep, but I didn’t sleep well. I was tired. They were like, “You can go home an hour away. You could get a hotel around here.” We decided to get a hotel and as I was leaving, my water broke and they were like, “Just stay.” 


    Danielle: So God bless them, they let me do a natural labor for about 36 hours in a hospital setting. 


    Meagan: That is impressive. 


    Danielle: I’m really grateful. I chose that hospital because it was run by midwives. They definitely delivered. They let me really try. I hit this moment where I just ran out of steam and my contractions slowed. In retrospect, if that had been a home birth, I think they would have just given me some honey and helped me try and take a nap. 


    Meagan: Got to bed. 


    Danielle: Yeah, but that wasn’t what happened. It was C-section time. I was so tired that I just said, “Okay.” 


    17:06 Danielle’s C-section


    Danielle: We went off and it wasn’t as scary as I thought it was going to be. The scariest part was how heavy the medication is and I had been laboring. I think with emergency C-sections, I had been in labor for almost 48 hours and I was so tired. The toll of a C-section is big on anyone, but then especially if you had been in labor for as long as I had been. 


    That was the hardest part and recovery is intense. Recovery, I think, was also emotionally heavy for me too just when you had planned– and they tell you don’t plan for your birth, but of course you do. And then when you have the exact opposite of what you thought, it’s hard not to judge yourself. It’s hard not to wonder what you could have done differently. It’s hard not to be sad and upset and mad and all of those feelings. 


    So it took me a long time to look through those feelings and kind of realize that my daughter and I had the exact birth we were supposed to have. 


    Meagan: That you needed. What did you feel like helped you get through those and walk through them? Was it time and processing and finding that, “Hey, I made these decisions and they weren’t maybe what I thought I’d make, but again, that’s what I needed to have this experience in the end,”? What helped you walk through that?


    Danielle: One book I always recommend to people is Spirit Baby. Have you heard of it? 


    Meagan: No, I haven’t but I’m going to write it down. We’re going to put it in the show notes here. 


    Danielle: It’s a really powerful book about– it’s written by this medium and he talks about sometimes mediums talk to spirits in the past. Sometimes they talk to angels. He realized that the spirits he was seeing and talking to were spirits that were about to come into the world so he called them spirit babies. 


    The book is just this beautiful story after story of how he would talk to these spirits and then he would help couples talk to those spirits that they were about to bring in and he helped so many people who were having trouble getting pregnant, etc. It just reminded me so much of we think because we are here on Earth and I thought, “I’m pregnant. This is what I want to do. This is what I’m going to do.” I really forgot that I’m bringing a spirit into the world. I’m a vessel. I’m not the driver. We are driving together. It’s the same thing. 


    Then they are born and it’s the exact same thing. You are not my child. You are not mine. You are a soul that came to this Earth and you are on your own path. We’re just here to guide each other and help each other. That was a big part of what helped me. I remembered that she also needed a certain type of birth. It didn’t have to be a mistake that we got there together and just trusted that that was what we needed, but also that maybe it was a lesson I needed. I’m not the boss of her, you know? 


    So that helped. There’s also something called havening you can work with. I don’t know if doulas do it. I worked with a midwife, but it’s physical touch to help you work through birth trauma. It’s a lot of just rubbing the arms up and down, having someone just help you physically release the emotions around it. 


    Meagan: Is it similar to tapping? 


    Danielle: Kind of. It’s like this, like rubbing. It can be a lot of different things. It’s havening. It’s creating a safe space for birth trauma. 


    Meagan: Okay, I’m loving this. 


    Danielle: So talking about it was really helpful and one of the ways I found my midwife for my home birth VBAC, there was not a single midwife in New York City that would do it, but I started making this relationship with this woman upstate about two hours away. She was in her 70’s, this midwife, so she did the havening with me. She just was like, “Just tell me what happened, baby. Just tell me what happened. It’s all right. I hear you. Just tell me what happened.” Just that safe space to tell my story to someone who so deeply knew the birth space and could understand and knew exactly how I was feeling and the safe space I needed and that I didn’t have, it was really healing to talk to those havening ears of hers. 


    Yeah, and she was in her 70’s. She was my midwife for my HBAC and I was her second to last birth. She retired shortly after. 


    Meagan: Wow. 


    Danielle: Yeah. You hear the stories about midwifery and women with these powers and the history of how witches have been demonized and you start to see the connections because you start to see the magic. You’re a doula. You have magic. There’s no way I could have done what I did with the birth of my son at home without my doula and my midwife. I really think it’s the most beautiful form of sorcery and magic to create that safe space because I had to go to another world to bring my son here. You have to cross the veil. You have to go somewhere else, so in order to do that, you have to have people holding a safe space for you where your body is and making sure your body is okay, that your soul is okay. 


    Going through that experience was also very healing from my first birth because I was like, “Oh. This is what a safe space looks and feels like.” It’s not what I had in the hospital, so okay. That’s okay. I didn’t have that with my first birth. If I had, I think she would have been born vaginally and that’s okay too. It offered a lot of forgiveness. 


    23:31 Connecting with your baby


    Meagan: I love that you said that it offered a lot of forgiveness. That is something that is very, very, very difficult to do. A lot of the time, we blame ourselves for things like we were talking about, but the forgiveness. I forgive this experience. I recognize I had this. I accept that I had this. It isn’t what I’m having now. I’m recognizing that, but I’m going to forgive that and I’m going to take that step forward and find that healing step in this right direction. 


    Danielle: Yeah, and also I will say two things. One, when my daughter was born and my daughter is the one I had the C-section with. I melted into her. We melted into each other. We were just so connected. It’s inexplicable. When my son was born– and with my daughter, I had the most medicalized birth. I was traumatized after the epidural. I had the worst shakes because I hadn’t eaten so it was just really traumatizing physically, but then my connection with her was immediate. 


    I had the most beautiful home birth with my son. Truly, he was born by a fireplace and my husband and daughter caught him. It was snowing the most beautiful, fluffy snow. It was literally perfect. I did not feel connected. It took a while to build a connection to my son. 


    Meagan: Picture perfect. 


    Danielle: I think also, we have these expectations of, “Oh, if I have this birth, then everything will be just perfect and I’ll feel so connected to my child and my child will latch right away.” None of that means that. So also, releasing those expectations of that. The birth that you want is for you and I think the more you can get clear on that the better, then when you invite the soul of your child to have the birth that they need, that’s when you start to really learn from each other. 


    I don’t know if the birth I had with my son was maybe what he wanted. I don’t know, because it didn’t feel like when he got here that he was ready to be here. He probably could have waited around for a little while. I almost feel like he participated in the birth that I really needed and that my soul really needed. Then he kind of made me pay for it. He didn’t sleep for two years. 


    I mean, he’s the best. I have such a special connection with him now, but it took a while so it doesn’t mean that just because you have the birth of your dreams that that’s going to mean you have the connection of your dreams. There is so much within our power, but there is just also so much outside of it. 


    Meagan: Yeah. Whoa. I just got the chills listening to you. It’s so amazing to look at it that way because I think too a lot of moms that have had C-sections that maybe didn’t have the connection, they are looking for it from a different experience or the same thing where you were like, “I had that immediate connection. I didn’t have the experience that I was desiring or planning on, but I had that immediate connection.” It just differs from everybody. Like you said, what we need, what our babies need, what that journey is looking like, whatever that looks like for us, is usually what is going to unfold. Sometimes it’s not exactly what our minds would write down on a piece of paper or draw. 


    Danielle: Exactly. That’s part of that forgiveness too. It’s just– and this is just I think getting older now is what it’s allowed me to think in this way because the younger me definitely wouldn’t have. It’s just to let things unfold as they are meant to be and trust that they are unfolding in exactly the way they are supposed to. Thank goodness, I had that after my son was born. I think that birth offered me a lot of space for him to be the little soul he needed to be. He wasn’t the kid that was going to melt into me right away. So just letting him be him was medicine for me. It really was to allow him the space instead of me saying, “Oh, I have to have this kind of connection with my son immediately when they are born.” 


    We are taught that. We are taught that equals how good your birth is or how good of a mother you are. That’s not to say– he was a great latcher, but he was energetic. I could tell my son needed some space. He was like, “Let me figure out who I am. Let me figure out who I am.” Yeah. And just offering that I think to our children and to ourselves is such a gift. 


    Meagan: When you were talking about birth plans and planning, if we have this thing in our mind where we absolutely have this plan and we think that we absolutely have to connect with that child or that child has to connect with us, but then we start doubting, “Well, why does that child not like me?” Like you said, “Am I not a good mom? What did I do to fail? Maybe my birth didn’t go as planned and that’s why we are not connecting because I failed my baby.” 


    This is literally where our minds go so often and it doesn’t need to go there. I think in a lot of ways, it’s because the world tells us that that’s what we have to have or that’s what the movies are showing us or Instagram or Facebook is showing us. 


    Danielle: Yes. Exactly. Exactly. None of those things can show your energetic connection. 


    Meagan: No. 


    Danielle: I think having a mantra– and this is a life mantra, but I mean as we all know and I imagine everyone listening is either a mother or going to be soon, but the mantra of– and I say this to my kids all of the time. We are right where we are supposed to be and I’m right here. Even in the middle of a meltdown. “Baby, we are right where we are supposed to be. It’s all right. I’m here. I love you.” 


    The more we can remind ourselves that too, in a birth we weren’t ready for or didn’t think we would have, just remind ourselves that we are right where we need to be. We are safe. This is all part of the cosmic lesson that each of us individually needs and trusting and surrendering. I mean, that is why women and bodies with wombs give birth because we are the feminine– forget gender– the feminine are the ones who know how to surrender. The masculine are the ones that go out and achieve and make things. They use their will. The feminine is the vessel. The feminine call things to it, so the more that you can deeply surrender to that, I think the more we can really embody whatever is happening in that moment instead of feeling like it is happening to us. 


    32:26 Surrendering


    Danielle: It’s just so true in birth too. Talk about the ultimate surrender. 


    Meagan: Oh my gosh, yes. It can be so difficult to put ourselves in that next space of surrendering and accepting. I think a lot of people will say, “No, don’t surrender. You have to fight.” I don’t believe that if we are surrendering, we are giving up. 


    Danielle: No, I think it’s the opposite. 


    Meagan: Yeah. But I think sometimes that’s how it’s looked. Surrender is like, “Here. Do whatever,” or just, “I’ll surrender and I’ll give this experience,” but I don’t think it’s that way.


    Danielle: No, surrender is when you become what you are calling in. If you are calling in an empowered birth, you become that empowered being that has an empowered birth so that you can have it. You surrender to being that empowered person. You don’t surrender to, “Okay, whatever you say.” That is being a victim of circumstance which, by the way, we will also all do that too. I did that many times. 


    Meagan: Sometimes it’s natural. It just happens. 


    Danielle: That’s okay too. I was really grateful in that case to have– there was a part of me when my midwife said, “Okay, it’s C-section time,” I was like, “You know what? Okay.” I think I probably could have fought, but I was just like, “You know what? Okay.” 


    So it’s not to say that– I think victim can be a bad word. I don’t think it’s a bad word. I think sometimes, you just need to fall into someone’s very capable hands and be okay with that, but that is very different to surrender. Surrender is embodying what you want, calling it to you, and surrendering to your embodiment of it. 


    Meagan: Absolutely. I think that is such a powerful message to this community specifically especially because of what a lot of the times we as VBAC moms are going through and where we are mentally through our prep and through our past traumas and through our doubt. A lot of the time we doubt because the world is telling us to doubt. 


    Danielle: To all of the mamas and mamas-to-be out there, just giving birth to a human is the most miraculous, greatest thing in the universe but then to also be up against what we are up against in society and the medical community– and I’m not saying anything bad. I have very dear friends who are OB/GYNs and I love them. They have the best intentions, but that doesn’t mean their actions are the best. 


    As you know, I have a podcast and I had an incredible OB/GYN come onto the podcast and talk about how we have lost reverence for the birthing body, that it’s so medicalized that we are constantly– just by being in a hospital, just by being medicalized, the birthing body is treated like this weird vessel that is just kind of in the way of the baby getting here so you just have to keep the vessel alive. That’s it. You just have to keep the vessel alive and then get the baby out. That’s really why I hate this idea of all that matters is a healthy baby. That’s absolutely not all that matters. 


    36:06 Choices in birth


    Danielle: That’s one of the things that you have to confront when you choose a home birth. You have to confront that. You have to confront that perhaps your choices will lead to outcomes that you don’t want, but you have to choose. I believe that how you choose to birth impacts not just you but your child and not just your child in the moment of birth, but your child for the rest of your life, their imprint. 


    Choose is a really important word there. It’s not like everyone has to choose a home birth otherwise your kid will be messed up. It’s how you choose to birth, how you choose to show up to that situation, how you choose to embody, and how you choose to feel empowered. Those are the makings of magic. I think when we say, “All that matters is a healthy child,” we are treating a woman’s body like it doesn’t matter. We are treating a woman’s experience like it doesn’t matter. It is a trauma that lives through generations. Even my grandmother was born via forceps. Her mother was put out using chloroform. 


    Meagan: Yes. 


    Danielle: We’re not that far from it even today. Especially in America, we have so lost our way on how powerful women are and how powerful birthing bodies are. There have been studies that show the more women that are in the room with a birthing woman, the more positive outcomes there are. There is a magic to women gathering and lifting each other up so that’s my hope for women. It’s not that we have all home births or all one way of birthing. It’s that we feel empowered and we let birth feel like the magical experience it can be even if you choose an epidural. It doesn’t matter. The details almost don’t matter. It’s how you feel throughout it. 


    I have a dear friend who had a very empowered C-section. She was like, “I chose it. I wanted it. I felt great.” She felt in control of her birth. That is an empowered birth. 


    Meagan: Yes. 


    Danielle: I think we can use the best of what the medical system gives us to help you have the birth you want, but the important thing is that you get to choose what you want for your body because your experience as the birthing body really matters. 


    Meagan: Wow. Seriously, I feel like you could be on this podcast for hours and hours and hours. I just keep getting the chills over and over again. 


    Danielle: The world’s longest podcast. 


    Meagan: It’s like my feet are on a cooler or something because I can feel chills from my feet all the way up to my head. It’s such a powerful message here. 


    Danielle: This topic is so dear to my heart because I really felt like I was healing generational trauma. I could feel it. I could feel the trauma. My mom didn’t even know what an empowered birth was, God bless her. She didn’t even know it was an option. I want different stories for my daughter. 


    39:14 The ripple effect of birth


    Danielle: I don’t know how out there you want to go, but I believe it’s connected to our sexuality. I believe it’s connected to the light within each of us, how we birth, how we choose to birth, the space we hold for birth. We tend to treat birth the moment the baby comes out and it is just so much bigger and broader than that in my opinion. It has such a ripple effect. 


    Yeah, so it’s important to me that women know what their options are. A lot of women don’t even know. When I got pregnant with my first, I was like, “What’s the difference between a doula and a midwife?” I didn’t even know the basics. 


    Meagan: Yeah, I mean, people still. It’s 2024 and people will be like, “Oh, what do you do?” I’m like, “Oh, I’m a doula.” They’re like, “Wow. How long did school take for that? How is catching babies?” I’m like, “No, no, no, no. I don’t catch babies.” Even still today, doulas and midwives are completely confused. We don’t even know now. 


    We do have providers saying things and it just keeps carrying. I had one provider ask me after a client of mine had an unexpected, undesired Cesarean after she was holding baby. We got baby nursing which she was so happy about. She was getting some of the things she wanted and he said, “Is she over it yet? I mean, look. Everyone’s healthy right there.” So to your healthy comment, there’s so much more to all of this and like you said, it’s a ripple effect. 


    Where it starts, if we go all the way back to where the baby actually starts and how amazing and beautiful it is, and then all the way up to birth, but then even further and greater. There are so many things in our outside world today that can try to stomp these down and not help us find that empowerment or belief or faith in our bodies. It’s hard to sometimes find that. 


    Danielle: Yeah. I think most women I know are also the best copers I’ve ever met. That’s a problem because I can promise you guys one thing and that’s that your emotions don’t just go away when you cope. They live inside of you and until you work through them and breathe through them and put them out and get them out and move them out and cry them out and talk them out and whatever you need to do to get them out, but if you had a traumatic birth and then you had a practitioner say something like that to you and then you told yourself, “Oh, yeah. No, it was fine because my babies are fine.” It’s not fine. It’s not fine. 


    It’s okay to let it not be fine and there are lots of people, doulas included, who can hold that space for you and let it not be fine. You know, I had to do that before I could even think about having a second and having a home birth because we all know if you don’t work through your fears, they show up in birth. 


    42:34 Ways to release fear


    Meagan: Oh, yes they do. 


    Danielle: I had lots of fears going into my birth so it’s not like they all go away, but I had at least faced them. There were no dark corners. There was no, “Okay, I’m just going to pretend like this never happened and just go into birth,” because those are the things that show up. 


    I think for my first birth one of the things that showed up was, “Okay, anything but a C-section. Whatever it is, episiotomy fine. Just not a C-section,” and then that’s exactly what happened and that’s exactly what showed up. You do have to– and that’s part of back to our conversation about surrender. Surrendering is so hard because it means you had to face all of your fears. You can’t surrender into the places that you won’t go. Surrendering means you’ve made all of the space. You’ve faced your fears. 


    My midwife with my home birth said– because I got to 10 centimeters with my daughter. I was at 10 centimeters for a long time and then it was too painful. I just couldn’t release into the surrender. So because I had worked with her on a lot of my birth trauma, she knew very well about my first birth. She was like, “We’re going to get to this moment and you’re going to have to choose. You’re going to get to 10 centimeters with me and you’re going to have to choose. I’m going to hold your hand and I’m going to need you to choose yes. We’re going to bring this baby boy into this world right here. I need you to choose yes.” 


    That space– we had been through my deepest fears and my deepest fears were that I was going to lose him or I wasn’t going to be able to do it and I was going to have to go to the hospital. We had talked through my deepest fears so I could just surrender into them instead of hide from them. I think that’s why birth asks us to be just so, so brave because you can’t fake your way through your fears. 


    Meagan: You can’t. 


    Danielle: And insecurities and all the things when it comes to birth. It really does strip you down. 


    Meagan: Yes. Have you ever heard of a mother’s blessing? Have you ever heard of that? 


    Danielle: Tell me what it is. 


    Meagan: Okay, so one of my doulas wanted to throw me this mother’s blessing. It was essentially a party for me, but it was very– I don’t even know how to explain it. 


    Danielle: We call it a circle, like a mother’s circle. 


    Meagan: It was very connecting. 


    Danielle: That’s what I call it, yeah. 


    Meagan: Yes. So they called it a mother’s blessing, so a mother’s circle. We did. We got in the circle and we talked about these fears. These are the women within my birth that were welcoming in my birth or women who I was welcoming into my circle of trust along the way because I didn’t feel like I could tell everyone I wanted to have a vaginal birth after two C-sections out of the hospital. 


    Danielle: Wow. 


    Meagan: We had this moment of connection where they asked me, “What are your fears? Let these out. Let these flow through you and not get bogged up.” Then we all connected and created this crazy bracelet. It was really, really amazing. Each one gave me more power in the bracelet and we would wrap it around. We were all connected then cut it and we all wore it together. It was the weirdest thing, but every time I looked down at this bracelet– we talked about it earliest, but the connection, the power, and the magic. I felt this magic of people who weren’t even with me in that very, very moment, but they were so with me. It really helped me face some of those fears and remember that I’ve faced those. 


    Danielle: Yeah. 


    Meagan: They’re still coming in my mind for a minute. 


    Danielle: And you’re not alone. This is the sorcery I’m talking about. This is why most of the “witches” that were burned at the stake were actually women in the birth space because it is magic. You have to have a cauldron and spells and blessings and magic to bring souls into this world. Yeah. I had a baby blessing. It was a baby/mama blessing that was just so beautiful. I wish it were more institutionalized versus a baby shower because you don’t need a baby shower. You need a mama shower. 


    Meagan: Right? I know I felt so uplifted. 


    Danielle: You are the one that’s bringing this baby. Yeah. Yeah. We did a birthing necklace so if anyone listening is wondering, you can Google mama blessings or mama circles. There are some really beautiful things that you can do. You have someone start a string for a necklace and you ask everyone to bring a bead. 


    Meagan: Yep, I had that too. 


    Danielle: You around and everyone puts a blessing and why they chose that bead for you and what they are wishing for you in your birth or in your motherhood and at the end, you have this beautiful necklace. I wore both of my necklaces during both of my births. 


    There’s another thing where all of the mamas who are in your circle are given a flower and they give you one piece of wisdom and then hand you the flower. There are so many beautiful things you can do. 


    Meagan: There’s the candle. Have you heard about the candles? 


    Danielle: No, what did you do with the candles? 


    Meagan: So the flower was the bracelet part and then I also had the beads. I actually have a picture of me in labor holding onto that and I just felt the power within my palm. We did this candle. Everyone has a candle and everyone gives really positive, encouraging words, or a mantra or something, then when you go into labor, you let your team and you let your circle know and everyone lights this candle. 


    Danielle: Yes, they did this too. Yeah. The labor candle. Yeah, it’s just so beautiful and it matters. It really matters so when you say, “All that matters is a healthy baby,” it’s like, “No. How you get to the healthy baby also really, really matters.”


    Meagan: Yeah, I want to say, “No, duh. Of course, a mom that is alive and a baby that is alive and healthy matters. No brainer.” But why are we saying all that matters? Why is it all that? Why that?


    Danielle: There is a lot inherent in birth that is death. I think that really, really scares Americans and we don’t confront it. We don’t talk about it. We hide it. We hide away our elderly. They are not the wise people of our society that they actually are. We hide from death. If you hide from death, you hide from birth. I don’t think you get to choose, so there is a reason that birth is treated the way it is and it’s because there is a lot of fear around what it means to die in this country. 


    Meagan: Yeah. 


    Danielle: I think the part that just makes me the most sad in that conversation is that women are not taught how powerful and capable they are and their bodies are and how much wisdom our bodies have.


    Danielle: I was just talking to a woman the other day and she was like, “Oh yeah.” She is pregnant and she said, “My OB is worried because I have smaller hips.” I’m like, “When you go to the studies, literally, that is just bad medicine. That is like malpractice to make a woman feel like her body made a baby it cannot birth.” 


    So inherently, now she has this seat of fear that her body can’t do it, that her body is not capable, and it’s terrible. I’m so grateful for the role of conventional medicine. I’m so grateful there is a 9-1-1 number you can call if you home birth is going the wrong way. We don’t have to choose. Medicalized birth can be for emergency situations and thank God. Thank God for it. 


    Meagan: Yes. Yes. 


    Danielle: But until you get to that emergency, your body is so capable. Your body can absolutely birth your baby and the more you surround yourself with people that believe that too, I mean, trying to do that, trying to birth a human naturally and just to keep your soul, mind, and body in the face of someone who thinks you can’t do it, might be impossible. It might be impossible. 


    Meagan: That’s what I was going to say. Not only does this woman have this seed of doubt in her mind, but her provider is doubting her before she even begins. It reminds me of that OB you said you had on the podcast on Sakara Life. We are losing this. We are placing doubt before we even get there and I’m going to tell you right now. That provider is probably not going to wait, probably not going to trust the body, probably not going to trust the process, and things are going to be pushed whether she has a C-section or not. I’m not saying that, but if someone doubts someone’s ability before labor even happens that they can’t get the baby out of the pelvis, that is a red flag that is an issue. 


    Think about how many patients that provider probably has that is placing doubt. 


    Danielle: I think connected to everything we are saying, our fear of death, our fear of– we have convinced ourselves that a medicalized birth is a risk-free birth or at least a lower-risk birth. 


    Meagan: Safer. 


    53:02 Which risks are you willing to take?


    Danielle: We just know from the literature that’s not true. In fact, it’s the opposite, but even if it were true, I have a firm belief that for every action, there is a reaction. For every– and what I mean by that is in order to bring a human into this world, it’s going to be hard. 


    People are like, “I’m just going to do a C-section.” There is no world where a C-section is easy. There is no risk-free easy way out. We can tell ourselves that there are, but there is not. So back to this idea of the empowered birth are which risks are you willing to take? Which risks are you comfortable with? Which risks are you okay with for your body? Those are the questions we have to be asking. Not, “Oh, I’m choosing a home birth because I’m just a little bit more risk tolerant.” That’s not what it is at all. 


    Meagan: Exactly, yeah. 


    Danielle: Or, “I’m choosing a C-section because I just want it to be easy.” That’s not what it is at all. I’ve had a C-section. It’s not easy at all. I think we fool ourselves in the conversation by making things seem safer, seem easier, and they’re not. 


    Meagan: Well, I feel like these things we are telling us is a way to justify our actions. A provider who is going to tell someone that they have CPD and their op-reports, it may be a way to justify the action of a performed Cesarean on their part. We say these things to soften what we are doing. 


    Danielle: Yeah. Yeah. Yeah. I mean, I know. I’m sure you’ve had conversations around The Business of Being Born, but that’s very real. 


    Meagan: It’s very real. 


    Danielle: That’s why, in my opinion, conventional medicine is perfect for acute, emergency situations because it is a business, and thank God they are there for those emergencies, but if you are not in an emergency moment which, by the way, birth is not an emergency, then I don’t think– and this is true even outside of birth. I have my Masters in functional medicine and human nutrition. It’s the same with nutrition. There’s no role for pharmacology and conventional medicine when it comes to everyday health and wellness. 


    Thank God that it’s there if someone has a heart attack or God forbid gets hit by a bus or something like that. Thank God for conventional medicine, but they do not have the tools to help with chronic, everyday metabolic issues. What they are trained to do is give pharmaceutical drugs that mask symptoms or change physiology to mask symptoms, but it’s not this “well care” that we need both in birth and outside of birth. 


    56:07 Nutrition and nourishment


    Meagan: And nutrition is such a passion of mine and something that I would love to also have an episode in the future because there is so much to do with exactly what you were saying. It’s not just birth. There is so much more and that’s a big one. That’s a really, really big one. 


    Danielle: I like to talk about it in terms of nourishment because I think that nutrition is scientific and there is nothing scientific– 


    Meagan: Nourishment. 


    Danielle: Yeah, and to think of it that way because I think so many times women are taught from the lens of nutrition that this is what you should eat for your pregnancy and not eat and this is what you should eat postpartum and not eat. Do you feel nourished? Do you feel good? Do you feel whole? Nourishment is inclusive of your emotional connections with your partner, your emotional connections with your community, your connection to why are you on this planet, your spirituality, and your religion. 


    Nourishment is multifaceted where nutrition tends to just be, “Did you get enough protein?” 


    Meagan: Proteins and carbs and fats. Did you hit your macros today? 


    Danielle: Yeah. It’s such a boring conversation that we haven’t been having for most of humanity. This is our small, small, small understanding of what the body needs and it’s one lens into what the body needs. A lot of my work is trying to help people understand that through the eyes of nourishment, we can actually transform our health because they are thinking about both how we feel from not just a physical standpoint, but from an emotional and spiritual one as well. 


    Meagan: Absolutely. I love how you were like, “It’s just a small lens.” There is so much. There is so much. 


    Danielle: I will tell you the deeper I get into literature, the deeper I get into scientific studies, and the deeper we go into the mechanics of the cell, we go one step farther and we are in quantum and then we have no idea what’s going on, so it’s just this constant reminder of how it’s so cool that we can do heart transplants. That is so awesome and the geek in me and the scientist in me is so intrigued.


    I so love understanding the biochemistry of nutrition, what’s really going on, and what our mitochondria need to function. I love that and it’s so, so cool that our kids are starting to understand that and can make real changes in people’s lives by understanding that, but also, we can’t— I personally can’t practice there without having reverence for how much we don’t know and making sure that even though I can say, “Hey, after your labs and this questionnaire, I think you might be deficient in a couple of these things, so let’s put you on these things,” if I don’t then also have the conversation of, “How is your relationship with your mom because you’ve talked about some trauma?”


    Those conversations are so separate from conventional medicine. I hope the new wave of medicine is the whole person and there is a whole assessment. 


    Meagan: Well, yeah. I know time is up, but I was having a conversation about this whole thing. Okay, maybe we are deficient in these areas, but how is our life? How is our sleep? How is our connection? How is our cortisol? What are we doing in addition over here? That’s just not talked about a ton. 


    Danielle: Yeah. I will say this as the nutritionist. I think soul health is way more important than any other health. The more you take care of whatever your soul needs whether it is deep breaths or a vacation or a mantra or a really good book by a fireside or some hot chocolate or a glass of wine or a bowl of french fries after a late night of dancing, answering those questions about what your soul needs, I think, are the most important and then once we can do that, we start to uncover, “Oh, you know what? I want to eat really well because I have this connection to myself.” The way we take care of ourselves is a reflection of our connection to ourselves so I think soul health as our first priority usually ends up being the thing that has the greatest impact because of the ripple effects. 


    Meagan: Yeah, it helps us find the connectivity again because sometimes we are slightly disconnected then we find our soul and we find what we need, and then we flourish through there. 


    Danielle: Yeah, it’s like if you don’t have that, then it’s just another to-do list. “Oh, I need to check off meditating. Oh, I need to check off getting my greens today.” That’s exhausting. 


    Meagan: It is exhausting. I’ve done it. 


    Danielle: Yeah. 


    Meagan: I’m guilty right here. 


    Danielle: We all have. We all have, then you just end up chronically stressed and you have adrenal fatigue and it’s beside the point so it’s trying to anchor people on those soul questions first. 


    Meagan: Absolutely. Well, I encourage everybody listening to tune into your podcast. We’re going to make sure that we have– it’s Sakara Life. Again, that’s how I say it. Is that how you say it? 


    Danielle: That’s right, yeah. 


    Meagan: Sakara Life. We are going to make sure we have that link in the show notes. Don’t forget about us here at The VBAC Link listeners. I’m just saying, don’t forget about us. 


    Danielle: No, you’re work is so important. Thank you. 


    Meagan: You’re immediately going to be hooked. There’s so much amazingness. I mean, everything on there. You guys just do such an incredible job. I’m so grateful for all that you are doing and all that you are helping, your line, and everything. We are going to have everything in the show notes so definitely go click around and go explore. 


    Danielle: Yeah, and just in case people don’t know, I have a company called Sakara. It was started over 12 years ago and it really started as a food company. We delivered the food that changed our lives. We started delivering it to people and then that turned into hundreds of people then thousands of people then millions of people. 


    Meagan: Millions and millions, yeah. 


    Danielle: Yeah, so now we offer fresh food delivery at your door. We offer it to every zip code in the United States. It’s all organic. It’s all plant-rich, really tasty, beautiful food. It’s what I eat every single day. Yeah. Then just on this mission to put people in the driver’s seat of their health to really help you understand what is the toolkit you need to really feel good, to really nourish, so our podcast is also part of that. 


    One of the nourishing conversations we can have is, do you feel lit up at the end? 


    Meagan: Mhmm. Oh, I love it so much. Thank you, seriously, from the bottom of my heart for coming on. I feel like my cheeks hurt from smiling just hearing you speak, feeling you speak. Oh, everything about you is magic. I know you are not the doula, but you have magic too. You are incredible. 


    Danielle: Oh, thank you so much. Thank you and thank you for all the work you do. I told you this at the beginning that I didn’t have your podcast when I was searching for how to have a vaginal birth after my C-section and I think these stories are so important so that we can remind women how powerful they are and that we do have the option and that the best intended medical caregivers who say, “We have increased of blah, blah, blah and rupture,” it’s like, “Do you really understand your risk? Do you really, really understand how much more of a risk you’re taking?” 


    I will tell you the missing part of the conversation is all you are gaining by choosing the birth that you want, so yes. Yes. It’s slightly, very slightly more risky post-C-section, but no matter how you give birth, choosing and feeling empowered is going to give you so much. That’s often the part of the conversation that is missing. 


    Meagan: I agree. Again, another mic drop here. I can’t even. You are just– I need you in my life every day, so that’s why I’m listening to your podcast because you are just so amazing. Again, thank you so much. 


    Danielle: You are so sweet. Thank you. 


    Meagan: We will talk to you later. 


    Closing


    Would 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/donations

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    1h 5m | Mar 18, 2024
  • Episode 282 What You Need to Know About Assessing Risk

    Hearing about risk is hard. Interpreting risk is even harder, but deciding which risks are comfortable for you is an essential part of birth!


    Meagan and Julie discuss how to tell the difference between relative and absolute risk, and what kind of conversations to have with your provider to help you better understand what the numbers mean. 


    They also quote many stats and risk percentages around topics like blood transfusions, uterine rupture, eating during labor, epidurals, Pitocin, AROM, and episiotomies.  


    And if you don’t feel comfortable with accepting a certain risk, that is OKAY. We support your birthing in the way that feels best to you!


    Risk of Uterine Rupture with Vaginal Birth after Cesarean in Twin Gestations

    Journal of Perinatal Education Article

    What are the chances of being struck by lightning?

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    02:52 Review of the Week

    06:08 Determining acceptable risk for you and your provider 

    08:00 Absolute versus relative risk

    15:21 More conversations need to happen

    25:29 Risk of blood transfusion in VBAC, second C-section, and third C-section

    30:37 Understanding the meaning of statistical significance 

    32:05 “The United States is intervention intensive” 

    36:27 Eating during labor and the risk of aspiration under anesthesia

    43:03 Epidurals, Pitocin, AROM, episiotomies, and C-section percentages

    44:43 The perspective of birth doulas and birth photographers


    Meagan: Hello, hello everybody. Guess who I have today? Julie!


    Julie: Hello. 


    Meagan: Hello. It’s so good to have you on today. 


    Julie: Of course. It’s always fun to be here. 


    Meagan: It really is. It’s so fun. When we sit and chat before, it just feels so comfortable like that is the norm still for me even though it has been a while, it just feels so normal and I love it. I miss you and I love you and I am so excited to be here with you today. 


    You guys, we are going to talk a little bit about risk. We know that in the VBAC world, there’s a lot of risk that comes up. I should say a lot of talk about risk that comes up whether it be is it safe to even have a VBAC? Is it safe to be induced? What are our real risks of uterine rupture? Is it safe to VBAC with an epidural or without an epidural? What about at home out of the hospital? Is that safe? I don’t know. Let’s talk about that today. 


    Julie: Let’s talk about it. 


    Meagan: Let’s talk about it. I think it’s really important to note that no matter what— and we’re going to talk about this for sure today, but no matter what, you have to take the risks that you are presented and that is given and still decide what’s best for you. That risk doesn’t mean that is what you have to or can’t do. Right? 


    So I think while you are listening, be mindful or kind of keep that in the back of your mind of, “Okay, I’m hearing. I’m learning.” Let’s figure out what this really means and then let’s figure out what’s truly best for you and your baby.


    02:52 Review of the Week


    I do have a Review of the Week so I want to hurry and read that, then Julie and I will dive into risk and assessing. 


    Julie: Dun dun, we’re ready. 


    Meagan: We are ready. 


    Okay, holy cow. This is a really long review, so—


    Julie: You can do it. 


    Meagan: Thank you to Sara R-2019 on Apple Podcasts for leaving this review. I love how Julie was like, “You can do it,” because she knows that I get ahead of what I’m reading in my mind and then I can’t read, so let’s see how many times it takes to read this review. 


    Julie: You’ve got this. 


    Meagan: Okay. It says, “A balanced and positive perspective.” It says, “As a physician myself I think it is unusual to find balanced resources for patients that represent the medical facts but also the patient experience and correct for some of the inaccuracies in medicine. This podcast does an amazing job of striking this balance!


    “I had an emergency C-section with my daughter 2 years ago. Despite understanding that the CS was medically appropriate and my professional experience, I still found the whole experience to be mildly traumatic and disappointing. This podcast was the main resource I used to help prepare for my second child’s birth and my plan to have a VBAC. I am now holding my new baby in my arms with so much pride, love, self-confidence, and trust because I had a smooth and successful VBAC.


    “I am thankful for this podcast which gave me ideas, confidence, strength, and a sense of community in what is otherwise a very isolating experience. I especially appreciate the variety of stories that are shared, including VBAC attempts that result in another C section so that we can all prepare ourselves for the different outcomes. No matter what happens we are strong women and have a welcome spot in this community, even when we may feel alone with our thoughts and fears. Thank you, Julie and Meagan!


    Julie: Aw, I love that. 


    Meagan: Yes, that was phenomenal. Congratulations Sara R-2019. If you are still listening here, congratulations and we are so happy for you and thank you for your amazing review. 


    06:08 Determining acceptable risk for you and your provider


    Meagan: All right, Julie. Are you ready? 


    Julie: Here we go. Here we go. Can I talk for a minute about something you mentioned before the review? You were talking about risk and how it’s not a one-size-fits-all because we were talking about this before. We all know that the uterine rupture risk is anywhere between .2%-1% or whatever depending on the study and what you look at. The general consensus among the medical community is .5%-1% is kind of where we are sitting, right? 


    Now, some people might look at that risk and be like, “Heck yeah. That’s awesome. Let’s do this,” especially when you look at a lower risk than that that it’s a catastrophic rupture. Some people might look at those numbers and be like, “This feels safe. Let’s go.” Some people might look at those numbers and be like, “This feels scary. I just want to schedule a C-section.”


    Meagan: No, thank you. 


    Julie: And that’s okay. It is okay. However you approach risk and however you look at it is okay. We’re not here to try and sway anybody. Obviously, we’re The VBAC Link, so we are going to be big advocates for VBAC access, right? But we’re also advocates for having all of the information so you can make the best decision no matter what that looks like. But also, I think another very important part of that is finding a provider whose view of risk is similar to your view of risk so that you guys have a similar way to approach things because if you find a provider who thinks that 1% risk of VBAC is really scary, it’s not going to go good for you if you think a 1% risk for a VBAC is acceptable. 


    So yeah, I just want to lay that out there in the beginning. Meagan, you touched on it in the beginning, but I feel like provider choice in risk is really important there. 


    Meagan: It is. 


    Julie: For sure. 


    08:00 Absolute versus relative risk


    Meagan: It is and also, one of the things we wanted to talk a lot about is absolute risk versus relative. So many times when people, not even just the actual percentage or 1 out of 5 is shared, it’s the way it’s shared. The way the words are rolling off of the tongue and coming out can be shared in a scarier way so when we say 1 out of 5, you’re like, “Okay, that’s a very small number. I could easily be one of those 5’s.” It’s the way these providers sometimes say it. 

     

    A lot of the time, that’s based on their own experience because now they are like, “Well, I am sharing this number, but I’m sharing a little extra behind the number because I’ve had the experience that was maybe poor or less ideal.” 


    Does this make sense? 


    Julie: Yeah. 


    Meagan: Sometimes the way we say things makes that number seem even bigger or even worse or scarier. 


    Julie: Right. It really comes down to absolute risk versus relative risk, right? Relative is your risk in relation to another thing that has risk. Absolute risk is the actual number. It’s like 1 in 10. That is an absolute risk. You have a 1 in 100 chance of uterine rupture. That is an absolute risk. Your chance of uterine rupture doubles after three Cesareans. That’s not true. That’s not true. But that’s a relative risk. 


    I really like the example that I feel is really common for people to relate to is stillbirth after X amount of weeks. Evidence-Based–


    Meagan: That’s a huge one. 


    Julie: Yeah, it’s a big one that gets thrown around all of the time and it sounds really scary when people say it. I love Evidence Based Birth. They have this whole article about due dates and risks associated with due dates and why due dates should really be adjusted and look at differently. They don’t say that. They just present all of the data, but what I really like about that is they have a section here about stillbirth and they talk about absolute risk versus relative risk. I feel like that would be a great thing to start with. 


    I’m just going to read it because it’s so well-written. They said, “If someone said that the risk of having a stillbirth at 42 weeks compared to 41 weeks is 94% higher, then that sounds like a lot.” Your risk of stillbirth doubles at 42 weeks than if you were to just get induced at 41 weeks. Your baby is twice as likely to be stillborn if you go to 42 weeks. 


    Meagan: Terrifying. 


    Julie: Okay? 94% higher. That’s almost double. That is scary. For me, I’d be like, “Uh, yeah. That is super scary.” 


    Meagan: Done. Sign me up for induction. 


    Julie: Right? Sign me up for induction. But when you consider the actual risks or the absolute risks, let’s just talk about those numbers. 1.7 per 1,000 births if they are at 41 weeks. Stillbirth is 1.7 per 1000 births. At 42 weeks, it’s 3.2 per 1000 so it’s a .17% chance versus a .3% chance so you are still looking at really, really, really small numbers there. So yeah, it’s true. 3.2 is almost double of 1.7 if you do the math. Sometimes math is hard so that’s fine. We have to get out the calculator sometimes, but while it’s true to say the risk of stillbirth almost doubles at 42 weeks, it could be kind of misleading if you’re not looking at the actual numbers behind it. 


    So I think that it’s really important when we’re talking about risks and the numbers and statistics to understand that there are different ways of measuring them and different ways of looking at them and different ways of how they’re even calculated sometimes. So depending on how you look at them, you could even come up with different risks or different rates which can really sway your decision. 


    We’re not talking about a 5%-10% double which is still true. It’s still double, but it’s just a really small number. Now, I also want to do a plug-in for people who have been in that .3%. It might as well be 100%. I can’t even imagine the trauma of having to have a loss like that. I can’t. I have supported parents through that. I have documented families like that and documented their sweet babies for them. I can’t imagine the pain that goes with that. 


    But I also think it is very important to look at the actual numbers when you are making a decision. Now, maybe that .32% is too high for you and that’s okay, but maybe it’s not and that is a risk you are willing to accept. I feel like approaching it like that is so much better. If somebody ever says to you, “This risk of that is double” or whatever, I don’t know. 


    I’m just going to make up some random stuff here like, “If you drive in your car to school, you have a 1 in 10 chance of getting in a car crash but if you drive on a Wednesday, your risk doubles so now you have a 2 in 10 chance or 1 in 5 chance of getting in the car crash,” so maybe you would want to avoid driving to school on Wednesdays, but maybe you wouldn’t. But if you say you’re risk is higher of dying in a car crash if you go to school on Wednesdays, they would be like, “I’m not leaving the house on Wednesdays or ever.” I’m not leaving the house today because it’s so dog-gone cold and I’m warm in my blanket. 


    I don’t know. I feel like looking at it like that. Actually, 1 in 10 is really high for getting in a car crash, but I don’t know. I just feel like looking at that is really important for providers telling you, “Oh, your risk of uterine rupture doubles if we use Pitocin so I’m not going to use Pitocin.” Okay, we’re looking at a small increase to an already small risk. We know that any type of artificial induction could lead to an increased risk of uterine rupture especially if it’s mismanaged, but what we do know is that it’s not– I don’t want to say that because that might be wrong. 


    When you are presented with the actual numbers, yes. It might double. I don’t know what the actual numbers are, to be honest off the top of my head. I feel like maybe it doubles, but if you are already looking at a .2% to a .4% or a .5% to a 1% chance, what’s the tradeoff there? What are your risks of just scheduling a repeat C-section instead of doing an induction? Is that worth it to you? What are the risks associated with repeat Cesareans? Are they bigger than that of using Pitocin to induce labor? What is that compared to the other one because there is another that is relative risk? The absolute risk is what the percentage is. I’m not even going to say the number. 


    But if there’s a risk of rupture using Pitocin relative to the risks that come with repeat Cesareans, those are risks that are relative to each other, so how does that compare? Because when we talk about it in just that singular form or that singular amount of risk without considering the other risks that might be associated with it because of the decisions we made from that risk– am I making sense here? Then you know, I don’t know. I feel like there is just a lot more conversation to have sometimes when we are talking about risk. 


    15:21 More conversations need to happen


    Meagan: Yes. There are. There is a ton more conversation and that is what I feel like we don’t see happening. There’s a quick conversation. Studies show that 7 minutes are spent in our prenatal visits which is not a lot of time to really dive into the depths of risk that we are talking about when we say, “We can’t induce you because Pitocin increases–”. This is another thing I’ve noticed is significantly. You have a serious–. Again, it comes down to the words we are using. Sometimes in these prenatal visits with our providers, we do not have the time to actually break down the numbers and we’re just saying, “Well, you have a significantly higher risk with Pitocin of uterine rupture so we won’t do that.” 


    When we hear significantly, what do we do? We’re like, “Ahh, that is big.” You know? 


    Julie: Yeah. 


    Meagan: We’re just not having the conversation of risk enough and again, it’s kind of being skewed sometimes by words and emotion. We were talking about this before. I remember we made a post– I don’t know, probably a year and a half ago maybe. It seems like a while ago about the risk of complications in a repeat Cesarean meaning you have a C-section and then instead of going for a VBAC, you go for a repeat Cesarean which as you know, if you’ve been with us, is totally fine and respected here from The VBAC Link. 


    A lot of the time, we don’t talk– and when I say we, I mean the world. We don’t talk about the actual risk of having a repeat Cesarean, right? Don’t you feel like that, Julie? I don’t know. As a doula, I feel like our clients who want to go for VBAC know a little bit more of the risk of having a VBAC, but they have not been discussed at all really with the risk surrounding a repeat Cesarean. We made a post talking about the risks of repeat Cesarean and I very vividly remember a lot of people coming at us with feeling that we were fearmongering.


    Julie: Or shaming. 


    Meagan: Shaming, yep. A lot of people were feeling shamed or disrespected. People would say, “You claim to be CBAC supportive, but here you are making these really, really scary numbers.” Anyway, looking at that post and going into what we’ve talked about, in some of those posts, we did say things like, “You are going to have a 1 out of 10 chance of X, Y, Z,”


    Julie: Or twice as likely to need this. Twice as likely to need a blood transfusion or 5x more likely to have major complications. Things like that. 


    Meagan: Yeah. We would say things like that. I remember specifically in regards to miscarriage. It’s a very, very sensitive topic, but there are risks there. So a lot of people were triggered. In the beginning, we talked about the way providers say things and the way they put them out on paper and the absolute risk versus the relative and way they do that. We’re guilty of that too. Right here at The VBAC Link, we were like, “This is the chance. These are the chances. You are 5x more likely to X, Y, Z.” So know that I don’t want to make it sound like we are shaming anybody else for the different ways that they give the message of risk. Am I making sense? 


    Julie: Yeah, and you know what? I feel like sometimes it’s just about giving people the benefit of the doubt. We want to give providers the benefit of the doubt just because it’s probably something that they’ve continuously heard and spoken and that’s okay because we do it too sometimes. We go on that thing like, “Oh my gosh, maternal death.” I think the risk of maternal death is 10x higher in a C-section than it is in a VBAC which sounds really scary and makes me never ever want to have a C-section again, but when you look at that, it’s .00001% to .0001% or whatever is 10x more. It is such a small level of risk, but it is higher. 


    I feel like trying to look at both absolute and relative risk for any given thing together is really, really important. Yeah. Give people the benefit of the doubt. Give us the benefit of the doubt. We are in such an awful cultural climate right now where it’s easy for people, especially on social media to jump on the attack train for anybody when we feel triggered or when we feel like people are being unjust to us or to other people and I hate that so stinking bad. 


    Whenever I catch myself with those feelings, I try to take a step back and I’ve actually gotten pretty good at that, but it’s so easy for us to get on that bandwagon of just railing against people who present information in certain ways or railing people without getting all of the information about that person.


    Before I go off too much on a soapbox in that direction, yeah. I feel like your provider when they are saying those things is probably not trying to coerce you into anything. Our providers, especially our hospital providers are incredibly overworked. They are incredibly stressed. Their time management skills have got to be off the charts because they are so overloaded with everything and they just don’t have time to automatically sit down and explain things. 


    But you know what I have found? Most of them, when you stop them and ask questions, they are more than happy to answer and explain. Sometimes, they are just repeating things they have heard all the time or that they have learned at some point or another without giving them a second glance. 


    Do you know what? We all do that too. Me, Meagan, you listening right now. We all do that. We hear things. We regurgitate them. We hear things. We regurgitate them and we don’t even think about questioning or challenging those things until somebody else brings it up to us to question or challenge those things. 


    So, don’t be afraid to ask your provider for more information or ask them what the real numbers are to those things. I have a really special place in my heart for our CBAC moms because there are lots of things that they are working through, so many emotional things, but I challenge not just people who have had a repeat Cesarean that was unwanted, but people just in all life, when something triggers you online, stop and explore that. Stop and question because that is probably an area of your life that you could use a little healing and work on. It could be a little bit of work. It could be a lot of work, but usually, when something triggers you, it’s a challenge to look into it more because there is something that your body and mind have an unhealthy relationship with that needs to be addressed. 


    Julie: Anyways, circling it back to risk. Meagan, take it away. 


    Meagan: I just want to drop a shameless plug on our radical acceptance episodes that we did, so kind of piggybacking off of what she just said. We dive into that a little bit deeper in our radical acceptance episode. It really is so hard and like what she said, our heart goes out to moms that have a scheduled C-section that didn’t want to schedule a C-section or felt like they were in a corner or felt like that was the best option, but not the option they wanted. There are so many feelings, but definitely go listen to radical acceptance part one and part two. 


    25:29 Risk of blood transfusion in VBAC, second C-section, and third C-section


    Meagan: I just want to quickly go down a couple of little risks. Blood transfusion– we have a 1.89% or 1 in 53 chance of a blood transfusion with a VBAC. To me, 1.89% is pretty low, to me, but it might not be to some. I don’t know, Julie. How do you say the other? Okay, then blood transfusion in a repeat Cesarean is 1.65% in the second C-section. It’s lower. So for vaginal birth, it’s higher. I’m not good at math. 


    Julie: No, vaginal birth, yeah. That’s true. So 1 in 53 for VBAC versus a 1 in 65 for a repeat Cesarean. Yes, right. 


    Meagan: For a third Cesarean, the chances of a blood transfusion go to 2.26%. 


    Julie: Yes, so it’s like 50% higher than if you have a VBAC for the third Cesarean, but it’s slightly lower for the second C-section. See? I feel like we could have talked about this before, but I don’t know if we say it often enough. When you are talking about overall risk for VBAC versus C-section, when you are looking at just the second birth, right? So first birth was a C-section, what are you going to do for your second birth? The risks overall are pretty similar for vaginal birth versus Cesarean. The overall total risk is pretty similar as far as your chances of having major complications and things like that. 


    But when you get into three, four, five, six C-sections and vaginal births, that’s when you really start to see significant changes in those risks. See? I used the word “significant” again, but we’re going to talk about where the more C-sections you have, the higher your chances of having complications you have. The more vaginal births you have, your chances of complications actually go down. 


    So when you are looking at if you want more than two kids, that might be something that you want to consider. If you are done with two kids, then that might be something that is not as big of a player in your choices. So yeah. 


    Meagan: Yeah. Then there are things like twins. So when I was talking about it earlier, the word significantly, there was a systematic– I almost said something– systemic. 


    Julie: Systemic review? 


    Meagan: Yeah, see? I can’t say it correctly. I can’t. Published– oh, I’m trying to remember when it was published. We will get it in the show notes. It talks about the risk of uterine rupture with twins and it does say. It says “significantly higher in women with twin gestation”. That’s kind of hard, I feel like because again, like we were saying, some reviews and studies and blogs and all of these things wouldn’t say the word significantly. They may share a different one. I’m going to see if I can find the actual– maybe Julie can help me while I’m talking– study. 


    Okay, it says three out of four studies in a group of zero cases of uterine rupture. Notably, the study with the largest patient population reported cases of uterine rupture in both groups and demonstrated a significantly greater risk of uterine rupture in the VBAC group. Meanwhile, the other three studies found no significant difference between rates of uterine rupture among groups 31-33. Nevertheless, the study shows that electing–”


    Okay, so I’m just going to say. It says, “Electing to have a PRCD reduces but does not eliminate the small risk of uterine rupture.” So what I’m reading here is that in some of them, it showed significantly greater, but then in 3 out of 4 reviews, and I don’t even know actually how many people were in each of these reviews, but in 4 reviews, one had a greater risk and three didn’t really show much of a difference, but we see that in the very beginning right here. “Uterine rupture is significantly higher in women with twins.” What do you think? If you are carrying twins and you see that, Julie, significantly higher enters into the vocabulary at all, what do you think?


    Julie: Well, I think I would want to schedule a C-section for my twins, probably. 


    Meagan: Probably. 


    30:37 Understanding the meaning of statistical significance 


    Julie: I want to just go off on a little tangent here for a second. I think it’s really important when we are talking about studies that we know what statistically significant means because sometimes if you don’t know much about digging into studies and things like that which I’m not going to go into too much right now– 


    Meagan: It’s difficult. 


    Julie: It is difficult. It’s really hard which is why I’m not going to go into it because I feel like we could have a whole hour-long podcast just for that. Statistically significant really just means that the difference or the increase or the change that they are looking into is not likely to be explained by chance or by random numbers which is why when you have a larger study, the results are more likely to be statistically significant because there is less room for error basically. 


    A .1% increase can be just as statistically significant as a 300% increase because it just comes down to whether they are confident that it is a result that is not related to any chance or external environmental factors. I feel like it’s really important to clarify that just because something is statistically significant doesn’t mean that it’s big, catastrophic, or a lot, it just means that it’s not likely to be due to chance or anything random. 


    32:05 “The United States is intervention intensive.” 


    Meagan: Yeah. I love that. Okay. There was one other thing I wanted to share. This was published in the Journal of Perinatal Education and it is a little more dated. It’s been 10 years or so, but I just wanted to read it because it was really interesting to me. It doesn’t even exactly go with risk and things, but it just talks about your chances which I guess, to me– do you know what I”m trying to say? 


    Julie: They kind of go hand in hand. 


    Meagan: To me, at least, they do. So when I read this, I was like, “Well, this is interesting.” I just wanted to drop it here and I think it’s more just eye-opening. It says, “Maternity care in the United States is intervention intensive.” Now, if we didn’t know this already, I don’t know where I’ve been in the doula world for the last 10 years. Right? You guys, as doulas, obviously, we’re not medical professionals, but as doulas, we see a lot of intervention and a lot of intervention that is completely unnecessary and a lot of intervention that leads to traumatic birth, unexpected or undesired outcomes and then they lead to other unnecessary interventions. It’s the cascade. We talk about the domino effect or the cascade of interventions, but this is real so for them to type out, “Maternity care in the United States is intervention intensive–”


    Julie: You’re like, “Yeah, where have you been?” Not you, but the writer. 


    Meagan: Yeah, the writer. Yeah. It says, “The most recent national survey–” Now, again keep in mind it is 2024. This has been a minute since this was written. 


    Julie: About 10+ years. 


    Meagan: 10-12 years. Just keep that in mind. But it was interesting to me that even 10-12 years ago, this was where we were at because I feel like since I started as a doula, I’ve seen the interventions increase– the inductions, the unnecessary Cesareans increase a lot. 


    Julie: Some of them, yeah. Yeah, especially inductions and Pitocin. 


    Meagan: Not all of the time. I cannot tell you that in 10 out of 10 births that I attend, this is the case but through the years of me beginning doula work and what I have witnessed, it’s increased. At least here in Utah, it seems that it has increased. 


    It says, “The most recent national survey of women’s pregnancy, birth, and postpartum experience reports that for women who gave birth in June 2011-2012,” so a little bit ago, “89% of women experienced electronic fetal monitoring.” Okay. 


    Julie: That seems actually low to me for hospital births. 


    Meagan: It does seem low because to me–


    Julie: I wonder if there had been a ton of stop and drops or something. 


    Meagan: I don’t know, but I agree. 89%. I feel like the second you get into the hospital, no matter VBAC or not, they want to monitor your baby. 


    Julie: Strapped onto the monitor, yeah. 


    Meagan: It says, “66% continuously.” So out of the 89%, it says 66% were continuously meaning they didn’t do the intermittent every 30 minutes to an hour checking on baby for a quick 15 minutes to get another baseline, they just left that monitor on them which makes me wonder why. Usually, when a client of mine goes in and has that, they’re like, “Oh, your baby had a weird decel so we are going to leave the monitor on longer,” and then they don’t say anything. They just keep it on there. Maybe that’s– I don’t know. 


    It says, “62% received intravenous fluids.” 


    Julie: IV fluids. 


    Meagan: Which to me, is also a lot. 


    36:27 Eating during labor and the risk of aspiration under anesthesia


    Meagan: “79% experienced restrictions on eating.” 79%. You guys, we need to eat. We need to fuel our bodies. We are literally running a marathon times five in labor. We shouldn’t be not eating, but 79% which doesn’t surprise me, and “60% experienced restrictions on drinking in labor.” Why? Why are we being restricted from drinking and eating in labor unless we have other plans for how labor may go? 


    Julie: That’s exactly what it is. They’re preparing you for an emergency Cesarean. That’s what they’re doing. That’s exactly what restricting non-IV fluids is. It’s not only that, but it is preparing you for the incredibly low risk of you having to go under general anesthesia, and then even people that go under general anesthesia have an incredibly low risk of aspirating and that is what it’s coming down to. Don’t even get me started on all of the flaws in all of the studies that went over aspiration during general anesthesia anyway because they are so significantly flawed that we are basing denying women energy and fuel during labor based on flawed studies that are incredibly outdated and on incredibly low risk during an incredibly already low risk. 


    I mean, you probably don’t want to down a cheeseburger while you’re having a baby. I don’t know. Maybe me. Just kidding. Even I didn’t want a cheeseburger, but I wanted some little snacks, and some water to keep you hydrated. Yes. Oh my goodness. Let’s please stop this. Sorry. Stepping off the soapbox. 


    Meagan: You know, there is a provider here. I actually can’t remember her name. It was way back in the beginning of my doula career and actually, it was in an area that is not one of my more common areas to serve. It was outside of my serving area. Anyway, we were at a birth and there was an induction. I remember being in there with her and the provider, an OB, walks in and is like, “Hey, how are you doing?” He was so friendly and kind and asked some questions like, “How are you feeling? What are you thinking about this?” 


    Then she was getting ready to leave and she turned back and said, “Hey. I just thought about this. Have you eaten anything?” The mom was like, “No.” She was like, “Uh, you need to eat.” 


    Julie: Yeah!


    Meagan: She had an epidural at this point. The mom was like, “Wait, what?” She was like, “You need to eat.” I literally remember my jaw falling, but had to keep my mouth up because I didn’t want to look like I was weird. 


    Anyway, I said, “That’s something I’ve not usually heard from an OB especially after someone’s had an epidural.” She was like, “Oh, I am very passionate about this.” She was like, “When I was finishing up school and graduating,” she had to write some big thing. 


    Julie: Her dissertation probably. 


    Meagan: Time capsule, I don’t even remember what it was called. Some really, really big thing. She was like, “I specifically found passion about the lack of eating and drinking in labor.” She was like, “I did all of this stuff and what I found was you are more likely–” Here comes risk. “You are more likely to be struck in the head twice by lightning–” This is what she said. “Twice by lightning than you are to aspirate in a Cesarean after having an epidural.” 


    Julie: I love this lady. Who is it? 


    Meagan: I can’t remember. I will have to text my client. 


    Julie: Where was it? What hospital? 


    Meagan: It was up in Davis County. 


    Julie: Oh, interesting. 


    Meagan: It was not an area for me. I said, “Whoa, really?” She said, “Yeah. You need to get that girl some food.” I was like, “Done. 100%.” 


    Julie: More likely to get struck by lightning. 


    Meagan: More likely to get struck by lightning twice in the head than you are to aspirate in a Cesarean after receiving an epidural. That stuck with me forever. Literally, here we are 10 years later. 


    Julie: I love that because first of all–


    Meagan: I don’t have documentation to prove that. She just said that. 


    Julie: That is 100% relative risk. Aspirating during a C-section relative to getting struck by lightning twice. So that’s cool. What are the numbers? I know that the numbers are super incredibly low and I feel like when you put in context like that, getting struck by lightning twice, I don’t know anybody that’s been struck by lightning once and who has been alive to tell about it. I know of a friend whose sister got struck by lightning and died when she was very young. I only know one person in my entire life who has been struck by lightning. 


    Meagan: I just looked it up really quick. I don’t even know if this is credible. I literally just looked it up really quickly. It says that the odds that one will be struck by lightning in the US during one’s lifetime is 1 in 15,300. 


    Julie: Wow. 


    Meagan: Okay. 


    Julie: So twice that is 1 in 30,000. That’s a freaking low risk. Anyway, what I’m saying is that I love that OB first of all. I feel like from what I’ve read about aspiration under general anesthesia during a C-section seems right in line with those numbers and those chances because it’s so rare, it’s almost unheard of especially now with all of the technology that we have. 


    It’s fine because I’m not going to go on that soapbox. I love that. I love that analogy and that we’re talking about that because 10 years from now or when our daughters are having babies, they’re going to talk about how their poor moms couldn’t eat when they were in labor because of the policies just like we talk about the twilight sleep and how our poor grandmas had to undergo twilight sleep when our moms were being born. 


    I feel like that’s just going to be one of those things where we will look back and be like, “What were we thinking?” 


    43:03 Epidurals, Pitocin, AROM, episiotomies, and C-section percentages


    Meagan: Okay, I’m going to finish this off. It says, “67% of women who gave birth vaginally had an epidural during labor and 37% were given Pitocin to speed up their labors.” Sorry, but come on. That also may go to show, that we’re going to do an epidural episode as well, that epidural maybe does really slow down labor. Maybe it really does impact the body’s response to continuing labor in a natural way, so 31% of those people had to have help and assistance. 


    It says, “20% of women had their membranes artificially ruptured,” which means they broke your bag of water artificially with the little whatever, breaking bag water hook thing versus it breaking spontaneously. 


    Julie: Amniohook. Is it an amniohook? 


    Meagan: Amniohook, yeah. 


    “17% of women had an episiotomy.” I don’t know. 


    Julie: I feel like those numbers are probably lower now. 


    Meagan: I think that’s changed, yeah. “31% had a Cesarean.”


    Julie: That is right in line with the national average. 


    Meagan: It is, still. “The high use of these interventions reflects a system-wide maternity care philosophy expecting trouble. There is an increasing body of research that suggests that the routine use of these interventions rather than decreasing the risk of trouble in labor and birth actually increases complications for both women and their babies.” 


    44:43 The perspective of birth doulas and birth photographers


    Julie: I believe it. Do you know what? Can I just get on another tangent here because I know that you all love my tangents? I really wish that somebody somewhere would do something and I don’t know what that something is, to get the voices of birth doulas and birth photographers heard because this is why. Doulas and birth photographers– I’ve said this before. We see births in all of the places. We have a really, really unique point of view about birth in the United States because we attend births at home. We attend unassisted births. We attend births at home with unlicensed providers. We attend births at home and births at birth centers with licensed providers. We attend in-hospital births with midwives and we attend in-hospital births with OB/GYNs and some of us are lucky enough to attend out-of-hospital births with OB/GYNs because there are a handful of them floating around. 


    We see birth in every single variety that it takes in the United States. I really wish that someone somewhere would do something to get those voices lifted and amplified because I feel like yes, a lot of that is going to be anecdotal, but I feel like the stories there have so much value with the state of our system in the relationship between home and hospital birth, how birth transfers happen when births need to be transported to hospitals, the mental health of the people giving birth, the providers and the care, and all of that. 


    I feel like, like I said, somebody should do something to do something with all of that information that we all carry with us. I think it could provide so much value somewhere, right? I don’t know what yet, but if anybody has an idea, message me. Find me on Instagram at @juliefrancombirth. Find me. Message me if you have any ideas. Maybe write a book or something. I don’t know. 


    Meagan: I’ve wanted to do an episode and title it “From a Doula’s Perspective”. We could do that from a birth photographer and all that, but it’s crazy. It’s crazy. 


    Julie: We see it all. 


    Meagan: There was a birth just the other day with one of our sweet, dear clients where the provider was saying things that seemed scary even though the evidence of what was happening was really not scary, went into a scheduled induction, and the way they were handling it, I felt so guilty as a doula and I was like, “This is going to turn Cesarean. This is not good.” Sure enough, it did and it broke my heart because I was like, “None of that needed to happen,” but again, it goes to us deciding what’s best for us. That mom had to decide what was best for her with the facts that we were giving, what the doctor was giving, and all of these things. 


    Again, we don’t judge anyone for the way they birth, but it’s sometimes so hard to see people not get the birth they wanted or desired, or to have people literally doubt their ability because someone said something to them. 


    Julie: Yeah. 


    Meagan: You know–


    Julie: Yeah. I agree. It’s just interesting. Anyways. 


    Meagan: We are getting off our topic of risk, but risk is a hard conversation to have because there are different numbers. It can be presented differently and like I said, it can also have a tone to it that adds a whole other perspective. So know that if you are given a risk, it’s okay to research that and question it and see if that really is the real risk and if that’s the evidence-based information. We like to provide them here like we were saying earlier. We may be guilty and I hope you guys stick with us if we share some that might be a little jarring on both sides of the VBAC and C-section, but we love you. We’re here for you. We understand risks are scary. They are also hard to break down and understand, but we are here for you. 


    I love you guys and yeah. Anything else, Julie?


    Julie: No. I just want to say be kind to each other. Give each other the benefit of the doubt. Do everything you can to make the best decisions for you. Trust your intuition and find the right support team. We’re all just trying to do our best– us at The VBAC Link, you as parents, providers as providers, and if you feel like you need to make a change, make it. 


    Meagan: Make it. All right, okay everybody. We’ll talk to you later. 


    Julie: Bye!

    Closing


    Would 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.





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    49m | Mar 13, 2024
  • Episode 281 Emily Shares Her Preeclampsia Story + How to Shift Gears

    “Your diagnosis of preeclampsia is not forever. It will pass. You will get through it. You can do it.”


    Meagan invites her dear friend and doula client, Emily, on the podcast today to share her two very different birth stories and what she has learned along the way. During her first pregnancy, Emily was diagnosed with severe preeclampsia at 27 weeks and 6 days. She talks about specific symptoms to watch for and explains why she advises every pregnant woman to have their own blood pressure cuff. 


    Emily had to shift her home birth plans to focus on staying pregnant as long as she safely could. Six weeks later, Emily shares her daughter’s wild birth story and tough NICU experience. 


    Having preeclampsia the first time around does not mean it will come back in the future. Emily talks about the nutrition and lifestyle changes she made during her second pregnancy and how preeclampsia was not an issue at all with her second delivery. Emily was able to have a beautiful home birth and a big, healthy baby boy!


    Additional Links

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    01:52 Review of the Week

    04:02 Emily’s first pregnancy

    10:25 Preeclampsia diagnosis

    14:48 34-week induction

    21:26 Giving birth

    29:25 Learning about and knowing your body

    34:37 Second pregnancy

    46:16 Working through trauma

    53:36 Shifting plans


    Meagan: Hello, Women of Strength. It is Meagan, and I am so excited to dive into today's episode with you. The episode that we have today, or the guest, I should say, that we have today is someone so near and dear to my heart. And I'm just gonna kind of give a little bit of a spoil alert.


    She is not a VBAC mama so this is not going to be a VBAC story but our guest today is someone that I think is going to leave you guys with a wealth of knowledge through her experiences and so I want to welcome my own personal friend and doula client, Emily. Welcome to the show. 


    Emily: Hi. 


    Meagan: Hi, you guys were going to be talking a little bit, well, a little bit about a lot of things, but we're gonna be talking a little bit about preeclampsia. We're gonna be talking about shifting gears from our birth desires and birth plans and so much more. I wanted her to be on the show because you guys, seriously, she really needs to write a book. She can talk all day to me and I just stare at her with amazement in my eyes, because she just is so incredible to listen to with her knowledge, her research, and all the things to make birth different the second time around, and do what she could do the first time around, which also goes along with mindfulness.


    There are so many things, you guys, about Emily that I just love and adore. I'm so excited to have her on the show today and I know that you're going to be taking a whole bunch of nuggets away from her episode. So make sure to take maybe some notes, or get your pen and paper out and join us in just one moment.


    01:52 Review of the Week


    Meagan: But of course, we have a Review of the Week, so I'm gonna hurry and read that, and then we'll get going. This review was left in 2020, so a few years ago. It says, “I love these ladies and this podcast.”


    She says, “I love listening to your podcast. I listen almost every day in the car so often that my oldest son knows you by both of your names.” I love that. I love that your kids know our names.


    It says, “Since the stories shared here have inspired me so much, I wish that I had the information with my first baby. I've had two C-sections, and I'm not pregnant at the moment but still have to get my husband on board for a third. But I'm so excited to start planning for my VBA2C to see when the time comes. Thank you, Julie and Meagan, for creating the amazing VBAC community. I'm so grateful for the education and support.” 


    This was a really long time ago. So eecc3, if you have talked your husband into another baby and gone on to have your VBA2C let us know. You could email us, at info@thevbaclink.com. If you want to share your story or share your review please do so. You can email us your review again at info@thevbaclink.com. You can Google us at “The VBAC Link”. You can leave us a review on Apple or wherever you listen to your podcast. We love, love, love, love getting them, and can't wait to read yours on the next one.


    04:02 Emily’s first pregnancy


    Meagan: Okay, cute Em. This has been an episode that we talked about forever ago and ever ago, right?


    Emily: Yeah. And ever, it's been a while. It's been a while.


    Meagan: I think you probably think I forgot about you after I talked to you about this, and then never really reached out, but we are here and I'm just so excited to have you on.


    Emily: Thank you for having me. I'm really excited. No, I think that I just realized that mom life happens. It's just busy. I knew you'd get back to me. I knew. 


    Meagan: Yes, yes. Mom life does happen and The VBAC Link has been busy which has been an amazing thing. I cannot believe that we are heading into the 300s episodes here soon. It's been such an amazing journey. But, so, okay. We talked a little bit about why I want you on here, but let's talk a little bit about your first and how the journey has led you to where you are today.


    Emily: Okay, well, I got pregnant back in 2020. Oh yeah, that was a rough year for a lot of us. It was especially rough, I think, for just everything that happened. I initially did not want to do a home birth. I just assumed you would birth in the hospital and then I was like, “No I don't want to. I want do a birth center.” So I was on that boat for a minute then I was like, “No. I’m birthing at home.” I just wanted to stay out of the hospital. I was seeing my midwife, Heather, with Sego Lily Midwifery and everything was really good until it wasn’t. It was fast. It was really, really fast. It was actually so fast that I didn’t call you until after everything had happened. 


    Meagan: Yes. 


    Emily: That’s how fast it happened. I was diagnosed with preeclampsia at 27+6. For those of you who have experienced preeclampsia, that 27+6 is kind of a big deal. People are like, “Oh, so 28 weeks?” No, it was 27+6. Every day counts when you have preeclampsia. Every day your baby is still inside your body growing is so important. It’s a lot of rollercoasters of emotions. I went from my home birth was planned, getting ready to prepare for that last trimester of nesting and my midwife coming in, setting up, and then it just kind of blew up. It blew up. 


    Meagan: Plans changed really fast. 


    Emily: It changed really fast and it was like, “Hold onto your butts.” It was quick. You know, a week before I was diagnosed, I happened to get my teeth cleaned and they took my blood pressure. It was a little elevated. I didn’t even think anything of it because during that time with more blood flow, that is normal for your blood pressure to rise a little bit when you’re pregnant. I just didn’t think anything of it. You feel like garbage. I felt like garbage throughout my pregnancy so I didn’t think anything of it when I wasn’t feeling good because I wasn’t feeling good in general. 


    07:56 Preeclampsia symptoms


    Emily: When I really started noticing when something was wrong, my swelling was insane. It wasn’t normal pregnancy swelling. The best way that I can describe it was my feet felt like they were hotdogs in a microwave. That’s how bad it was. It was so bad. My husband took me on a date to Barnes and Noble and I remember standing in front of the bookshelves like, “I have to sit. I can’t stand anymore.” My feet hurt that bad. I was wearing slippers because I couldn’t fit into any of my shoes. He had to help get me up. It wasn’t like that normal, “Help me up, I’m pregnant.” It was like something was wrong. 


    Meagan: Physically hard for me to do. 


    Emily: I’m in pain. I’m actually in pain. That morning, I was taking a shower and I saw white stars, like white dots everywhere but I was shaving my legs. My head was down. It was really hot. I was starting to rationalize what was happening. This is where preeclampsia really sneaks up on women because a lot of the symptoms are disguised as regular pregnancy symptoms and they’re not. 


    We got home. I was like, “You know what? I’m going to check my blood pressure.” I had a blood pressure cuff. I was a CNA for a while and I had a sister who had preeclampsia so I knew a lot more than some women do. Luckily, I did. I took my blood pressure and it was– oh my gosh. I don’t even remember. It was 120, 130 over 100, and something. It was insane. I remember sitting there looking at my feet. I had no ankles. I took a picture. 


    I texted Heather. I didn’t even call her. I was like, “So this is my blood pressure.” She immediately called me back and was like, “You need to go to labor and delivery. That is too high.” 


    10:25 Preeclampsia diagnosis


    Emily: I went in and the way that they told me too was matter-of-fact. Well, yeah. I remember looking at the nurse and being like, “Do I have preeclampsia?” She was like, “Uh-huh. Yeah. Your bloodwork shows that you have preeclampsia.” I just remember yelling. The anger that I felt, I can’t remember feeling anger like that. I just knew. I knew everything was going to change and it was really hard. 


    They were also kind of panicking too because my platelets were so low as well. My blood pressure was insane, but I did not have the ability to clot. 


    Meagan: Clot, mhmm. 


    Emily: I was on this really thin wire of, “Okay, she could seize and have a brain bleed and then have brain damage,” 


    Meagan: Which is scary stuff to think about and hear. 


    Emily: It really is. It’s really scary. “And then we could do a C-section, but she could bleed out because her blood’s not clotting.” I was in this really weird balance. They gave me magnesium. Ugh. Ugh.” That stuff is the absolute worst. I have never– that’s the closest, I think you could get to being lit on fire. It was pretty terrible. 


    The good news was that Ripley was fine. Her vitals were good. Everything about her was awesome. It was me. My body was just tanking. Things were happening really fast. A lot of things happened that I really wasn’t okay with, but I’ve really learned to work through a lot of that. As a matter of fact, they wanted to keep me in the hospital and I remember telling my doctor, “If you don’t want me to have a baby right now, you need to let me go home.” 


    I had a really good MFM doctor and he trusted me. They did not put me on blood pressure medication. One of the reasons they didn’t put me on blood pressure medication was because they didn’t want to– what’s the word I’m looking for– hide my symptoms or cover up what was happening because when you get preeclampsia, your organs start to shut down because of the high blood pressure. With blood pressure medication, okay, my blood pressure is fine, but my liver is dying. 


    Meagan: That makes sense, okay. 


    Emily: So they wanted to see everything that was happening. My blood pressure was still high. Every time I went into MFM to get the tests for Ripley, I had to go twice a week. I practically had a part-time job there. They’d tell me, “Your blood pressure is really high.” I’m like, “I know. I have preeclampsia. My blood pressure is high.” 


    I was able to keep Ripley in for six weeks. 


    Meagan: Which is incredible. 


    Emily: Even my MFM doctor was pretty shocked. He was like, “I didn’t think you would get this far.” I will tell you, I’m just that person when you tell me, “You can’t do this. You’re not going to be able to do this,” I’m like, “I’m going to show you.” 


    It was hard. I’ve never experienced that kind of exhaustion. I mean, I was tired because I was pregnant, but when you have immediate high blood pressure like that, oh my gosh. I have a tri-level house and walking up and down the stairs was like, “I’m just going to stay right here.”


    14:48 34-week induction


    Emily: At 34 weeks, my doctor called it. He was like, “It’s time. It’s time to have a baby.” I felt a wave of relief oddly enough. It was like, “Okay. I’ve done all that I can. I have done everything to the best of my ability and it’s time.” They did give her a steroid shot for her lungs and I knew that I was now on a new road of having to advocate for myself. 


    It’s really hard to advocate for yourself in a hospital. It’s really hard. 


    Meagan: Especially when they were extra high-alert on you because we’ve got a preemie going on. We have an induction. It’s COVID. There was so much going on. 


    Emily: Yeah and COVID really did not make it easier. It made it that much harder. I knew that initially, I wanted the least amount of intervention possible. I wanted a home birth. I knew that wasn’t going to happen, but that didn’t mean that I didn’t have options. I still actually had quite a few options. 


    For example, the induction. With premature babies and babies with preeclampsia, mothers, like I was, typically are on mag during labor and delivery and after. Magnesium makes babies really drowsy. They usually fall asleep and it’s hard. It’s really hard on babies just like it is on moms. I knew that with her being so young, so little, so preemie, I wanted the least amount of intervention to deal with her so I wanted the least amount of drugs as possible because I knew I was going to be induced so I opted on a Foley bulb instead of Cytotec I believe it is. 


    I also chose not to have an epidural because I just knew the more stuff I was going to be putting in my body than what already was, with the Pitocin and the mag, that it was just up that cascade. So I remember calling you, “It’s time,” and you come in. This is going to sound weird. I think I’m a lazy birther. 


    Meagan: I don’t think so. 


    Emily: That feeling of, “I don’t want to move but I know I need to move.” That exhaustion of being on mag and you being like, “Okay, we’re going to roll you over.” And even rolling over was hard. 


    Meagan: Mhmm. 


    Emily: You know, I didn’t have an epidural but I feel like you had kind of treated me as though I was because I couldn’t–


    Meagan: It was hard, yeah. 


    Emily: It was hard. I felt like I was running a marathon with a 20-pound vest on. It was just that everything was heavy and hard. Having preeclampsia in the hospital, I still had access to the nurse-midwives and there was one in particular I didn’t really get along with and others I did. I ended up kicking a midwife out of my room because she was not agreeing to the things that I wanted. 


    My home birth midwife, Heather, told me something that I will always remember. It was that “You can always ask for another provider. You don’t have to stick with someone who makes you uncomfortable even the littlest bit. Even the littlest bit.” 


    Meagan: How do you feel like you got the confidence to do that?


    Emily: Hearing my husband– Shane was at the door when she knocked. We were having problems with her and she knocked and was just like, “We’re going to break her water.” My husband said, “You’re not going to touch my wife.” The moment he said that I was really stressed but it was like that flood of oxytocin like, “Oh my gosh, you are the most amazing man on the planet right now,” and just felt so protected that I heard her say, “Well, she needs someone to care for her. She needs someone to provide for her.” I remember yelling out, “Then you go find me someone else,” and she did. I didn’t have to see her the rest of the time and it was great. 


    I think that when you’re pregnant in general, just in normal pregnancy, I think you’re in a vulnerable state where you are defending your space. You are trying to keep the peace because you are in a sensitive space and when you are sick like you are, it’s amplified a lot. So I think that a lot of women are like, “Oh, I’m not really happy,” but I think personality and stuff has a lot to do with it and your team and the people that you have in your corner. Luckily, I have a husband who just really doesn’t care about other people’s feelings when his wife is in labor. He’s just like, “She’s my main concern.”


    Meagan: He’s so awesome. 


    Emily: I think having you and Shane as my support made all the difference. I don’t think it would have gone the way it did if I didn’t have you two. Yeah. It made all the difference. 


    21:26 Giving birth


    Emily: I gave birth to her. Oh, do you remember when they didn’t want to let you in?


    Meagan: Oh, I remember. I will never forget in my entire life this lovely nurse who threatened you. She threatened us. That is what she did. She threatened us. 


    Emily: She did. I had such great nurses until the one that had the baby. 


    Meagan: The one that had the baby and keep in mind, you guys, because of the situation, she didn’t have her baby in the hospital room that she was laboring in. We transferred to the OR. 


    Emily: Yeah, which they did not tell me until I was in the middle of contractions. I was in the middle of contractions when they were like, “Oh, so by the way, we are moving you,” and I was like, “What the? We’re moving? No one ever told me this,” and they were like, “Yeah. Yeah, we’re moving you.” They were like, “You can only have one person with you.” I will never forget turning to the midwife who, by the way, her name was Shea. I love her. She was a good midwife. I remember turning to her and saying, “I paid really good money for my doula and she’s going to come in with me, so figure it out.” 


    Meagan: Figure it out. 


    Emily: How crazy is it that at that time, I had to advocate for my doula? 


    Meagan: But that, Women of Strength, that is sometimes that we have to do. You have to advocate to have the people that you want in your birth even when it goes to a Cesarean. We weren’t going in to have a Cesarean. We were going in to have a vaginal birth in an OR, however, a lot of the time, we know that doulas aren’t allowed into the OR and we as doulas fight and we try to get into there, but it really does take it from the patient’s side, the mom’s side to advocate for them and even still, a lot of the times they say no but you do. You have to advocate for your people. 


    Emily: Yeah, you do. Doulas belong in the OR. They belong everywhere in the hospital. That is a hill I’ll die on. 


    Meagan: Yeah, I believe it too. I believe it too. 


    Emily: I think it did. It made all the difference. That was wild. You know, and it’s crazy too. I still remember that people say, “Oh, you forget over time.” No. I remember everything. I remember everything in detail. I remember how I felt. I remember the anger. I’m amazed at how angry I was throughout the whole process. 


    Meagan: I was too, honestly, and I wasn’t even the one giving birth. 


    Emily: You know, but I don’t think for me, I’ve done a lot of work the past three years. I’m still working through that whole process three years later. My daughter just had a birthday on Saturday. I’m still angry. I’m still angry. 


    The difference between then and now is that I have given myself space for that anger. I have space for it. I think when you try to namaste your way through those feelings, it can be dangerous. If you’re angry, feel it. Get it out. Be angry. You’re allowed that. You’re allowed to mourn the birth that you thought that you were going to have. No amount of everyone telling you that you’re just going to be fine makes it so. 


    As a matter of fact, I was so angry that I wasn’t scared. I really wasn’t scared until after. It was postpartum that really kicked my butt and being in the NICU. That was when it really hit me because when you’re pregnant and you have preeclampsia, I felt this really protective, “You have to get through me in order to get to my baby,” because she was still a part of me and then it wasn’t until she was out that I really feel like it got real because I now had to advocate for this little 4-pound human, this beautiful baby girl who could not advocate for herself at all, right? 


    That was a whole other mess of emotions on top of, I was still on mag. I had to be on mag even after birth because you are still at risk of having a seizure. I was moving up and down that freaking hospital because I didn’t want to be in the recovery room. They ain’t comfortable for a reason. I just wanted to be with my daughter. 


    I mentioned earlier that a lot of babies will fall asleep after they are born. They just kind of pass out from the mag. Ripley was loud and proud the entire time. She never fell asleep. Even the doctor was like, “She’s kicking and screaming.” I was just like, “Yeah, because she’s like me.” 


    I will never forget that nurse, that think-in-the-box nurse telling me, “You have 60 seconds.” That was hard. I think about that a lot. “You have 60 seconds to hold your baby.” Golden hour, my butt. 


    Meagan: Yeah, you did not get that. 


    Emily: It’s such an ala carte selling point, “Hey, come deliver with our midwives and you can have the golden hour.” It’s marketing. It’s garbage. I had 60 seconds. You know, the reason why was that they had to make sure she was okay, but she was screaming. Her lungs were definitely working. That was hard. You were amazing and you took pictures, amazing photos. I look at those sometimes and I’m like, “Wow. Those are not exactly Instagram-worthy photos but they are cool.” 


    My placenta was smaller than Ripley and it just fell apart. It just fell apart which is crazy to me. Throughout those six weeks of having preeclampsia, I was pretty angry at my placenta. I was like, “What the heck? Why aren’t you working?” But it wasn’t until after I gave birth that I realized that it was working. Your placenta is amazing. 


    Meagan: It was. It is. 


    Emily: My placenta sacrificed itself for Ripley because Ripley was fine the entire time. It just gave everything it possibly could to make sure she was okay because placentas do have a shelf-life. You grow a new one every time and it did. That, to me, was so phenomenal to experience. Looking at the pictures, it was just so small. It was smaller than my hand. I still think about it and just go, “I can’t believe that that happened.” 


    29:25 Learning about and knowing your body


    Emily: I never had a seizure. I never had issues with preeclampsia after. I don’t struggle with high blood pressure. I don’t have heart problems. It’s really common for women in their first pregnancies to get preeclampsia. During that whole process, I did a lot of research and it’s kind of hard to find. Don’t Google the first page because it just tells you garbage stuff like you’re not eating right and it’s very vague. It’s super vague like, “You’re not eating right.” Well, our culture tells us as women and men that we’re doing that all the time. It’s a little bit more in-depth than that. 


    It’s not just women. I think men also play a role in that because their DNA determines that placenta and that information. So men’s health, your health is also just as important as conception. 


    The idea with preeclampsia is that when the placenta is developing and as it adheres to the uterine wall, something goes awry and that’s what causes the high blood pressure. 


    As a matter of fact, when I went into labor and delivery– I had to go in a couple of times during those six weeks because of headaches, I mentioned that to one of the doctors on staff and she just looked at me and was like, “Well, if you know that preeclampsia adheres to the wall, you know everything that you need to know.” She was like, “Okay, this woman has done her research. She is not medically illiterate. She knows her body. She understands. I was actually treated better by doctors than I was by nurses when it came to that. 


    I had a handful of good nurses, but I had a handful of nurses that I could have done without. What was actually probably the most exhausting was the constant advocating for myself and being like, “Hey, I’m not stupid. I know my body.” You know your body. Yes, doctors have a time and a place. They do have the education. I don’t discount that, but you know your body. You know your body. You live in it every single day. You know when something doesn’t feel right. I knew that something was wrong when my feet felt like hotdogs. I knew something was off when I was seeing stars. I knew it. How many stories of women that I heard where they’re like, “My doctor’s not listening to me and I’m having these symptoms,” and I’m just like, “What?” If you have to scream it from the rooftops, then you have to scream it from the rooftops, but you also don’t have to do it alone. 


    I didn’t do it alone. I had you. I had my husband. My mom is a nurse. She’s been a nurse for over 20 years and that was really helpful in navigating the hospital because she just helped me understand policy and where they were coming from so I was able to map that out every time I went in, what I could and couldn’t do or whatever so I was really fortunate to have the support that I had. 


    34:37 Second pregnancy


    Emily: I was told not to get pregnant until after 18 months so I got pregnant after 15. My plan exploded, but I got to rebuild it. You know, having a diagnosis of preeclampsia does not mean that your birth plan just gets to be thrown out the window. You just get to change it. That’s why we have birth plans A, B, C, D, and E. There are so many options and as a matter of fact, when I talk to other women, they are always amazed like, “I didn’t know that. I didn’t know that we could do that. We didn’t have that when I was giving birth.” 


    We have so many options nowadays. There is so much information. Preeclampsia is pretty common and a lot of the variables are the same with women, but that doesn’t mean that you have to do it by the book because someone says. I made all of my decisions and I let the hospital know that I was going to make my decisions and they were going to help facilitate that or it was going to be hard. 


    There were times that it was really, really hard but preeclampsia showed me what I was capable of. It really tested my grit. It was a really big life lesson for me beyond just normally just having a baby. It really showed me what I was made of. I think preeclampsia will show any woman what they’re made of because it’s hard. It’s so hard. I was really lucky. I was so lucky. 


    After having Ripley, I got in touch with a lot of women who were in places with preeclampsia which just broke my heart. Women that died, babies that died– this is something that can kill you and many times when I came in that first night with high blood pressure, they were like, “What made you think to check your blood pressure? What made you think to check your blood pressure?” Well, what is the first thing that happens when you go to urgent care, when you go to the emergency room, and when you go to doctor’s appointments? They check your blood pressure because it’s that cascade effect of, “We do this first, then we do this, then we do this.” 


    I think every woman should be checking their blood pressure throughout pregnancy. Every woman should have a blood pressure cuff. That is one of my biggest recommendations. 


    Meagan: Not a bad idea. 


    Emily: They are not expensive and they are easy. I recommend every woman to have a blood pressure cuff. Obviously, don’t obsess about it, but check it regularly, weekly. Just once a week because mine happened quick. 


    Meagan: Yeah, and it can. It can happen quick. 


    Emily: It can happen really fast. And to be honest, I probably wouldn’t be here if I didn’t check my blood pressure that night. 


    Meagan: It could have gotten that bad. 


    Emily: They told me so. They said, “It’s very possible that you could have just had a seizure in the middle of the night and died.” 


    Meagan: So scary. 


    Emily: Isn’t that crazy that fear? I didn’t have any of that fear initially because I think I was in that fight or flight and just that all of a sudden, that masculine energy came in and it was just this, this, this. We’re going to go from one point to the next and that very methodical get your butt in gear happened that I didn’t really have time to be scared. I had some moments of emotional grief relief, but yeah. If I wouldn’t have checked my blood pressure, I would have been in a lot of trouble. 


    Meagan: Yeah, I think it just circles back to be in tune with your body. Don’t hesitate if you feel like something’s off. Don’t hesitate because just like with any illness and things like that, it can get bad. We don’t want it to be bad, but if you do get it, there are ways to control it. There are ways to stay safe and sometimes that means your plans change from home birth to hospital birth or maybe spontaneous, unmedicated delivery to a scheduled C-section or whatever. It can always change. Having gone through this really wild twist of a turn of a hurdle and all of these things through this birth, as you get pregnant again, what kinds of things did you do differently for this time? What did they say to you as far as your chances for preeclampsia again? We can’t look at someone and say, “You’re going to have preeclampsia.” We don’t know. 


    Emily: I don’t think that preeclampsia is a “Once you have it, you’ll always have it. That’s just going to be your life while you’re pregnant.” Now, statistically, you’re more likely to get it because you’ve already had it. 


    But this is crazy. So with preeclampsia, what they found is that DNA has a lot to do with it. Typically, the male’s DNA like we mentioned earlier. Now, my husband, because I have already had a baby with him, though I’m more likely to get it a second time, I’m least likely to get it because I’ve already had a baby with him. 


    Meagan: Really? I didn’t even know that. 


    Emily: Isn’t that crazy? So if I had another partner, my chances would be higher. 


    Meagan: Interesting. 


    Emily: Because I’ve had it before and I would not have had a baby with this partner. I am of fair intelligence and I think in my brain, I just think, “Okay, because my body is like, ‘Hey, I’ve seen this before. I’ve seen this DNA makeup. I know how to do this.’” Our bodies are brilliant and they know what to do if you just kind of let them. We can definitely help them out and that’s what I did with my second pregnancy. I found out I was pregnant and I prioritized protein. I think you should do that no matter what, but I prioritized protein and salt. 


    I sprinkled Himalayan sea salt on everything. I was drinking. I was not overdrinking. I think that you can be over-hydrated. Throughout my second pregnancy, I pretty much just looked at my urine and if it was a pale yellow, we were good. If it is dark yellow, drink more water. If it is clear– 


    Meagan: Back off a little or add some electrolytes. 


    Emily: Yeah. Add some electrolytes. That’s where that salt comes in, right? I did the adrenal gland drink, the orange juice stuff. I don’t know if that worked, but I really liked it. It was delicious. You know, Vitamin C, electrolytes, it doesn’t hurt. 


    Supplements-wise, I did not take a prenatal. I decided not to take a prenatal. I did liver. I really like perfect supplements. I think cost-effective wise and where they source their vitamins I think is great, so I did liver. 


    Meagan: Liver pills? 


    Emily: Liver bills, yeah. I did liver and I did fermented beets. Beets and beet juice are amazing for blood pressure. I’ve heard of people drinking beet juice and their blood pressure points going down by like ten. 


    Meagan: Whoa. 


    Emily: Yeah, beets are amazing for blood pressure. I love beets, but I can’t eat beets every day, so I just did a fermented beet supplement and I took that every day. I also stopped drinking coffee, but I did add a collagen supplement in the morning. I did creo-brew which is a cacao drink. It’s good if you like dark chocolate. It was yummy. It was kind of like my coffee substitute. 


    Meagan: Yeah. 


    Emily: I mixed collagen in with that and I really tried to hit a minimum of 30g of protein per meal. Now, I pretty much lived off of Uncrustables my first trimester because oh my gosh. I was really sick the second time around. So sick. My diet was not perfect, but I was pretty religious about the liver, the collagen, and the magnesium. 


    Two eggs, man. Two eggs a day– there’s your prenatal right there. I also drank raw milk. I did raw milk. 


    Meagan: Hmm, okay. 


    Emily: I am a milk snob now. I will never go back to pasteurized milk. We purchase our milk from Utah Natural Meat and Milk in West Jordan. They’re a small, home family company and they’ve got the best milk. 


    Meagan: Awesome. 


    Emily: We would buy our eggs from there too. I really changed to whole foods other than those Uncrustables, man. They just hit the spot. But I really focused on eating whole foods and not eating fast food, not the processed stuff in boxes. I really tried to stay away from that stuff as much as possible. My blood pressure through my second pregnancy was awesome. It was so good. It was fantastic. 


    Even during that into the third trimester where your blood pressure naturally rises, mine didn’t. It didn’t at all. As a matter of fact, the day that I gave birth, Heather checked my blood pressure and it was so low. It was the lowest ever. My pulse was at 60 which it never is. I’m always in the 80’s or 90’s. It’s always high but I prioritized what I put in my body tenfold. 


    46:16 Working through trauma


    Emily: I couldn’t tell you if it was the liver, the collagen, or the raw milk. I couldn’t tell you. I think it was a combination and also working through the trauma of Ripley’s birth. That was hard. I felt like I was really stuck in that masculine energy and I really needed to embrace the feminine side during my second pregnancy. I think mindfulness practice helps a lot. 


    I thought about this last night. I worked a lot. I read Mindful Birthing during my first pregnancy and they talk about mindful pooping. You guys, it’s a thing because guess where I gave birth to my son? On the toilet. 


    Meagan: Yes, you did. 


    Emily: That’s where I had practiced. Thank goodness for magnesium, but I was able to mindfully practice and I would play out my birth and how it was going to go down. I was able to really visualize on the toilet every day. I would do it in the bath, but I didn’t take a bath every day. So that literally was like my birth prep. It was just having my moment to go to the bathroom and then sure enough, it wasn’t until last night it dawned on me. I didn’t give birth in the tub. 


    Meagan: Nope. Me and your husband were standing in the tub. 


    Emily: Yeah, and you guys were standing in the tub. 


    Meagan: We were standing in the tub. You were definitely not in there with us. 


    Emily: At one point, there was 1, 2, 3, 4, 5, 6 people including my son in the smallest bathroom of my house. 


    Meagan: It was so awesome though. 


    Emily: It was amazing and you know what? Not being induced– I will never be induced again if I can help it. Oh my gosh. I remember looking at you. You were standing on the edge of my bed and being like, “Oh my gosh. It’s right here. It feels so normal. Everything feels normal. Everything feels like how it should be.” Night and day difference between my first and my second when it came to how I felt and I think nutrition did play a huge role in that mindset. 


    Having a support system. And you know what? Also, the wisdom of having done it before. Being a first-time mom is really hard. You have nothing to compare it to. Nothing, so my heart goes out to you mamas who are experiencing this for the first time because it’s really hard. It’s really hard. But in the end, you made a human and then you birthed it. They’re there. You’re a mom and it’s a wild trip. 


    It’s crazy to me because I think the hardest part is before and after. Give me giving birth any day. That’s my favorite part. I love giving birth. 


    Meagan: I like it too. 


    Emily: That’s the best part. That’s the bread and butter right there. My placenta the second time around– let’s circle back to my placenta. I had a 10-pound, 2-ounce baby the second time. Asher was 10 pounds, 2 ounces, and my placenta was the size of a Thanksgiving platter. To go from a placenta that was so tiny and just had given everything to the second time, it just beamed this massive– it was huge. I mean, you and Shane heard it. It gushed all over and it was really hard to birth that for me because it was just big. 


    But I really remember looking at it and being like, “That’s because I really took care of myself. I really, really prioritized my health this time.” You know, I just didn’t know then what I know now. Isn’t that just how it goes? 


    Meagan: Right. It really is, yeah. 


    Emily: You really have to give yourself some grace too. That’s really hard for us women sometimes to just give ourselves that credit. You just didn’t know. You can’t blame yourself for what you don’t know. But that second time around, it was just like, “Yeah. I’ve got this.” And I did. It was fantastic. 


    I still didn’t struggle with blood pressure even after that. I have yet to really struggle with that I really do think that diet plays a huge role as well as your spouse’s diet– what they are putting into their body. They play a pivotal role in that. It’s like that beginning part. 


    Meagan: Yeah. I was just going to say that. That’s something that we need to focus on before we are even conceiving. I don’t know. I just think it’s so hard in our day-to-day life. I mean, I think of my husband and his life. It is insane. We were talking about this before the episode started. It’s busy. We’re busy. We’re raising kids. We’re doing things, but when we are also conceiving, growing new babies, and adding to our family, I think it’s always important, but it seems to be extra important to really dial in and focus on that. It can be hard to get the nutrients that we need to give back to our bodies. It’s harder, I think, than it is easy because we have to really dial in and find the best supplements and nutrients that are best for us and figure out what we want to consume and how we can help our husbands know what to consume and get their vitamins and their healthy sperm. 


    Their sperm, like you said, needs to be healthy too so it’s just so important to always remember that there is more than even just prep for labor, birth, and pregnancy. We have to dial in before we have those babies and before we conceive these babies because it can play a really big factor in things. 


    53:36 Shifting plans


    Meagan: Preeclampsia is hard. Like I said, we don’t know who’s going to get it and who’s going to have it and if you’re going to get it, how badly you’re going to suffer from it, but if there is anything we can do along the way to try and avoid and decrease our chances of it, I think it’s worth noting. I love your stories because they are so vastly different and they did take turns. I think it applies so much to this community for a variety of reasons. 


    One, most of us don’t plan a C-section. We might have those one-offs where we’ve got a breech baby or a transverse baby or something’s going on or we do have a medical necessity like preeclampsia that is too severe and a Cesarean is maybe going to be the best mode of delivery. But there’s a lot of us I would say, a good chunk of us that don’t expect a C-section, that don’t expect our plans to change in the way that yours did so dramatically. 


    Or even us planning out of hospital and we transfer. We don’t always plan or hope for those things to happen, so to be able to shift our minds, and I love– that’s something that I just value you so much in that. Your mindfulness and your power to get in this mindset and not only be mindful, but have it connect to the entire body it’s this whole plumline that it goes through and your mind was able to connect. You would start having high blood pressure. You would start having these things and you would be able to get into this mindful space and control that and help that and give, like you said in the beginning, your baby every single day more that she could get. 


    Then, you had this really rocky situation in the NICU and all of these things and then you persevered through that and you learned and you grew. I think you would just be one of the best postpartum doulas, especially for NICU moms. 


    Emily: NICU is a whole other bag. NICU is a whole other bag. And you know what? You NICU moms out there, I hear you. I see you. It is real, dude. It is a whole other rollercoaster, but if I have any advice for a NICU mom, I want you to know that you know when it’s time to leave. You know it. Call it divine intervention, but you’ll know. You will know when it’s time to leave and I knew I had to be there for a while with Ripley, but it got to a point where I was like, “Okay, we’re ready to go. Get us out of here. We’re ready to go home and start being a family.” 


    Meagan: You did. 


    Emily: I mean, I had an amazing NICU nurse. She was like a NICU doula. She was really, really great. But NICUitis is a thing. Get a room with a window. Just know that NICUitis is a thing. It really is and it hits you hard and it kind of sneaks up on you. But yeah, you know when to leave. Don’t let anyone tell you otherwise. You know. 


    Meagan: It goes back to following your heart. Follow your gut. Do what you need to do for yourself because it’s real and it speaks loudly and then also embrace the change even when it sucks and it’s not what we want. Dialing in, getting the education, getting the information that you need to make the best decision for you, and then knowing that like with you, next pregnancy, new adventure, you had this, “I know what could happen. I know that I may have this risk, but I’m going to do these things,” so again, dialing back in and prepping, getting all of the things that we can do to control what we can control. I think that is a really big thing that a lot of the time we forget about. We want to control the things that we can’t control, but we need to reel it in and try to control what we can control, and then if there are those out-of-control moments of, “I need to go home. They are telling me no,” then again, fight for what you and your gut say. 


    But yeah, I just think mindfulness, obviously nutrition. We talk about nutrition a ton. I think it’s so important. Get the nutrition you can. If you are like me, I swear that girl, you kill it with your nutrition. I do not. 


    Emily: I’m going to be honest, this last year has been really rough and it’s just tanked. I’m working back. It’s crazy. Both of my births were so different with preeclampsia and not preeclampsia, but I will tell you that postpartum is so hard. It kicked my butt this time around. I had an amazing, dreamy home birth, but postpartum is still like, “Oh hey, I’m here.” You know? So I think that it’s just really important in your planning to also plan for that. It’s almost– I don’t want to say it’s more important because I think every woman is different. There are some women who are like, “Oh, I had my baby and it’s like the clouds lifted.” I’m just like, “Dang, that’s awesome,” because when I had my baby, I could just see the clouds on the horizon. I’m like, “All right, here we go.” 


    Nutrition is key to that, too. You’ve got to feed yourself and some of you ladies were only getting 30g of protein a day. You need to be getting that meal. 


    Meagan: I know, yes. 


    Emily: But also, I think you need to go back to giving yourself some credit. You’re not going to do it overnight. It takes rhythm. It takes consistency. You’re going to fall off that wagon a couple of times, but you just get back on. 


    Meagan: Just like going to the gym. 


    Emily: What? 


    Meagan: I feel like we’re on it to the gym. We’re going. We’re going, then we fall off the horse and we’ve just got to get back on. 


    Emily: You’ve just got to get back on. There’s one thing that I know about women and you guys, we’re so freaking resilient. We’re so freaking tough. We’re so freaking tough. You’re a badass. You really are even when you don’t feel like it, just know as corny as it sounds, this too shall pass. Your diagnosis of preeclampsia is not forever. It will pass. You will get through it. You can do it. The crazy thing about birth, right? There’s always that doubt, “I don’t know if I can do it,” well, you are. There’s no other option. The end result is you’re going to have this baby. I hope that these women know that it is going to show you how tough you are and how strong you are. You can manifest anything. It’s kind of like fake it until you become it. I’ve thought about that a lot with my first. People are like, “Fake it until you make it.” No. Fake it until you become it. 


    Meagan: I love that. 


    Emily: This is it and we’re doing the thing. Parenthood and becoming a mom, getting pregnant, having babies– none of it is easy. None of it is easy. It wouldn’t be worth it if it was, right? So I think you know yourself best. You know your body. Find your people. Get your people in your corner. You’ve got it. 


    Meagan: You have got it. Women of Strength, you are strong. You have got it. You can get through it even when these things sneak up on us or plans change like we were saying, you can do it. Know that we here at The VBAC Link are here for you. We are here. We are rooting you on. We are here to give you education, information, these empowering stories, tips, and all of the things. We love you and we are so grateful that you are here. 


    Closing


    Would 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.





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    1h 3m | Mar 11, 2024
  • Episode 280 Arianna's VBA2C + Far Travel, PPROM, Short Interval & Gestational Diabetes

    “Birth is birth and we just want our babies here safe, but I also think that we all deserve to be empowered to have the birth that feels right.”


    One night, a few months after her second C-section, Arianna had a dream that she was giving birth vaginally to a sweet baby boy and pulled him right up to her chest. The next morning, she took a pregnancy test and it was surprisingly positive. Coming from a small town in Wyoming, she already knew from her second pregnancy that VBAC was not allowed locally. But at that moment, Arianna knew she was going to do whatever it took to have her VBA2C. 


    Arianna traveled 2.5 hours each way for routine midwife and OB appointments in Montana to have VBAC-supportive providers. She faced many roadblocks including a short pregnancy interval, gestational diabetes, preterm premature rupture of membranes (PPROM), a medical induction, other interventions she wasn’t planning for, and slow progress. But her team was patient and encouraging, Arianna felt divinely watched over, and her VBA2C dream literally came true!  


    The VBAC Link Blog: What to do When Your Water Breaks

    The VBAC Link Blog: VBAC With Gestational Diabetes

    The VBAC Link Facebook Community

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    01:44 Review of the Week

    03:52 Arianna’s first birth story

    07:04 Requesting a C-section

    08:34 Arianna’s second birth

    11:36 VBAC preparation

    15:37 Signs of preterm labor

    20:34 Going to the hospital

    24:04 First cervical check

    27:10 Slow effacement 

    31:05 Catching her baby

    33:59 Importance of support

    36:35 Dual care tips

    44:56 Traveling tips


    Meagan: Hello, Women of Strength. We are on episode two of the week and I am just so excited that we are doing this. It is so fun to bring double doses of VBAC, CBAC, and educational stories to inspire and encourage you during your journey. 


    Today, we have our friend, Arianna, and she is from Wyoming. Is that correct?


    Arianna: Yep. 


    Meagan: Yes, Wyoming. Where in Wyoming?


    Arianna: Buffalo. It sits under the Big Horn mountains.


    Meagan: Awesome. You guys, she actually traveled quite a distance to find her provider and that is something I think we get often in our community where it’s like, “I don’t know how far is appropriate to travel.” I think the answer literally depends on what’s appropriate for your family and your living situation and your needs and everything like that. 


    But Arianna– I just started butchering your name. Did you travel 2.5 hours?


    Arianna: About 2.5 up to Montana. 


    Meagan: Okay, so we are definitely going to want to talk about that because I know this is going to be something that people are going to be interested in. Also, you had gestational diabetes. 


    Arianna: Yes. 


    Meagan: Yes. So okay, you guys, any story right? But if you are looking for knowing how to travel or gestational diabetes or anything like that, this is definitely the episode to listen to. 


    01:44 Review of the Week


    Meagan: But of course, we have a Review of the Week and this is a fresh review, well fresher review. It’s in 2023 so just last year which is crazy still to me to say that this is last year, but it was in 2023 by sayerbaercooks. The review title is “Educating and Empowering.” It says, “Just had my VBAC. My pregnancy and birth changed all for the better thanks to this podcast and the women who shared their stories. This tool gave me the information I needed to advocate for me and my baby. I learned about the medical system and about myself and I had a fantastic birth which was the icing on the cake. I cannot thank you all enough.”


    I love that so much. I love that this podcast is doing exactly what we created it to do. So Women of Strength, one, if you have shared your story on our podcast, thank you. Thank you so much for creating such an amazing space for all of the Women of Strength listening. And if you are interested in sharing your story, definitely email us. Reach out or you can go online at thevbaclink.com/share and submit your podcast story. We’re sharing both on social media and we’re sharing on the podcast. We are hoping to get to some more of our submissions. 


    03:52 Arianna’s first birth story


    Meagan: Okay, darling. I am excited to hear your story. I feel like as I was reading your blurb about your story, I feel like there is so much that you did, truly, that you did between hiring a doula, driving 2.5 hours, going to a chiropractor, reading all of the books, listening to the podcast, eating really well, finding the true support that you deserved– you did a lot and that is hard to do. 


    Sometimes we do all of that and our birth still doesn’t end up the way that we wanted, but sometimes I feel like when we look back, we at least know that we did all that we could, but I’m so excited for you to share your VBAC after two C-section story with us right now. 


    Arianna: Thank you so much for having me. I am so excited. 


    I’ll just start with my first. I feel like that’s where we go. I was a single mom with my first pregnancy and I was young. I was only 22, or almost 22, and I think really the only thing I did was the 2-hour hospital birth class. I think I just had this expectation of, “Well, women push out babies and that’s just what I’ll do.” I didn’t feel prepared. I felt very alone. 


    I was induced at 41 weeks and 6 days because my body was just not having it. I did everything I could think of and acupuncture and he just didn’t want to come out. I had a pretty easy induction. We started with Cytotec and Pitocin. After I got my first dose of Cytotec, my water broke two hours later. I was 2 centimeters. 


    Meagan: Darn it. 


    Arianna: That was rough and the contractions were just insane. Pitocin contractions are the devil’s work, I think. There were super painful. I had my mom with me, but I just didn’t feel like I was in a supportive environment looking back especially. 


    I got the epidural right away because I was like, “Oh my gosh, it’s not supposed to be this painful.” 


    Meagan: Yeah. Well, Cytotec, Pitocin, water breaking– all of those things packed together, that’s tough. 


    Arianna: It was intense. I labored in bed all day. All day long. I progressed really well. I got to 10 centimeters. I started pushing and I was like, “La, la, la. I’m going to have a baby. This is great. I’ve got my drugs. I can’t really feel anything.” But I think within the first hour of pushing, I was like, “Well, I’m doing something wrong because nothing is happening.” 


    The doctor kept saying, “He’s so high up. He’s not coming down.” So I think what broke me though is the older nurse. I will never forget her face, but she just made a snide comment of, “Girls these days just don’t know how to have babies.” 


    Meagan: Oh.


    07:04 Requesting a C-section


    Arianna: I was like, “Oh, okay.” I pushed for three total hours and then I started to just really feel like something was wrong. I asked for a C-section. 


    Meagan: Okay, yeah. 


    Arianna: Looking back, I’m like, “There are so many things that could have gone differently.” We ended up with a C-section and he was OP, so he was face up and he was slanted. 


    Meagan: I was just going to ask that. 


    Arianna: Mhmm. He was a little slanted and OP. You know, later I found out he was kind of having some developmental things and he was struggling with the right side of his body so I ended up finding out that he had actually gone without oxygen and had a blood clot and had a stroke during delivery. I’m grateful for that C-section and trusting my body that things didn’t feel right, but it came with a lot of trauma over all of it. 


    Arianna: Around that time, my son was about 2, I met my now husband and we went down the road of diagnosis and specialists finding out he has mild cerebral palsy. 


    Meagan: I was just going to ask if he has cerebral palsy. 


    Arianna: He is a rockstar, truly. He has saved my life in so many ways. I am so proud of him. He works so hard with PT and OT and all of the things. 


    08:34 Arianna’s second birth


    So moving on, I got married to the most amazing man ever. He loved every part of me. I struggled pretty intensely throughout my teenage years with mental health stuff, suicidal ideation, depression, and all of those things. At the time, I was pretty heavily involved in suicide prevention. That is always a huge part of my life. 


    We got married and we got pregnant right away. I had a miscarriage pretty early on and then we got pregnant again. I had heard of this little fairytale thing called a VBAC. I was like, “Ooh, yeah that’s cool.” I brought it up to my doctor at our little small hospital. Immediately, he was like, “It’s not really safe, but if that’s what you want to do, we don’t do them in the state of Wyoming.” So I was like, “Okay. Well, we’ll just have a C-section,” because I really didn’t know and I was still dealing with the trauma of my first birth. Five years had gone by and I wasn’t aware I was so traumatized until I was having another baby. 


    Meagan: That’s often the case. We don’t really recognize it until we are in that new situation and all of the flooding memories come in and we’re like, “Oh crap. Wow, I have trauma.” 


    Arianna: Yeah. My doctor was amazing. He really validated where my anxiety and my fears were coming from. I didn’t want a C-section, but in my mind, we are told, “If you’ve had one, everyone says you have to have another. It’s the safest option,” so I trusted that.


    At 38 weeks, my water broke. 


    Meagan: Okay. 


    Arianna: I was like, “Oh, my body could do it.” I still had my C-section, but that for me, was redemptive because I was like, “See? My body could do it,” and that was okay. 


    That was an adventure. When my daughter was 6 weeks old, I got mastitis and was septic and in the hospital for a week and a half.


    Meagan: Yikes. 


    Arianna: That was insane and I was on heavy-duty antibiotics for three or four months but I was also on the pill so those two things counteract each other if people don’t know that, so when she was 7 months, we found out we were pregnant in a wild way. I had a dream one night that I had a baby boy vaginally and I caught him and brought him to my chest. 


    The next morning, I took a pregnancy test. I told my husband, “I will not have another C-section. I will not.” That just started this, “I’m going to have a VBAC and I don’t even know if this is real or if people after multiple C-sections do this,” because living in such a small area, I didn’t know anyone who had ever had a VBAC. 


    11:36 VBAC preparation


    So I was like, “Okay. We are doing it.” I got all of the books. I joined all of the Facebook groups. I started listening to The VBAC Link and I hired a doula. I was probably only 8 weeks pregnant when I hired a doula. I found the midwife clinic that was within the hospital in Montana 2.5 hours away. I knew I needed a doula there. 


    I had a pretty good pregnancy. It was scary bringing it up to my provider here. I did see him a couple of times throughout my pregnancy just in case something happened. 


    Meagan: Yeah, that’s called dual care and I think that’s actually a really great option when you are traveling or sometimes if you are going out of the hospital and you just want to be established in the hospital as a backup plan, doing that dual care is actually really good. 


    Arianna: That was the hardest fight of the whole pregnancy because I was so set on getting my VBAC and it wasn’t safe. There were just all of these things and eventually, he got on board, I think, because he knew how serious I was. 


    I had such an amazing experience driving 2.5 hours away. Looking at it now, it wasn’t a big deal at all because I was so set. It didn’t matter. I would have gone anywhere because I was so set. “This is what I am doing.” 


    The midwife clinic was within the hospital so they worked alongside OBs and everything. Sorry, I’m getting emotional. 



    Meagan: That’s okay. 


    Arianna: The midwife clinic was amazing. They never once, every time I would go to an appointment, I’m like, “Okay. This is the time they are going to tell me that I can’t. I can’t have a TOLAC. I can’t even try.” That’s all I wanted. I wanted the chance to try. They were always so encouraging and amazing like, “No, you can do this.”


    It was a clinic so there were several different midwives that you saw on rotation. There were a couple of times I would catch one that was like, “You’ve had two C-sections. We don’t really do this,” then there would be somewhere it was like, “Yeah. You’re going to do great. This is going to be awesome.” I just tried to hold onto that. 


    Really, the whole experience was just a testament to how loving God is in my life. I really had to find peace towards the middle end of my pregnancy and I just had to give it to God because I was starting to really become anxious. 


    Arianna: Then I failed my glucose test and I was just like, “Well, here we go. I’m going to have a C-section now.” Then I really started to dive deep. The thing that got me through the 2.5-hour” drives there and back was The VBAC Link because I didn’t have an army of women who got it in any way really. I needed that. It gave me a sense of community and this distant village of women I’m never going to meet. They’re there. They’re out there and it’s definitely possible. So listening to stories of women who had similar experiences got me through. 


    I had gestational diabetes. It was diet-controlled. I’m a little thicker than I would want to have been through a pregnancy, so the gestational diabetes in a way was kind of a blessing in disguise because it really held me accountable to exercise and eating healthy. It kind of helped in a way. I’m really grateful I didn’t have to be on medication. 


    Meagan: Yeah. 


    15:37 Signs of preterm labor


    Arianna: So at about 30 weeks, I started losing parts of my mucus plug. I was like, “I don’t think this is normal.


    Meagan: A little early, yeah. 


    Arianna: But it grows back, so I was like, “I’ll be fine.” At about 34 weeks, I went and had a big appointment with my MFM and my midwife. I got to tour the hospital and for a small-town girl, I was like, “Wow. This is insane. This is where you have a baby.” The NICU was right there. There were operating rooms right there on the floor in case of anything. 


    We got to see delivery rooms. The lady who gave us our tour thought that I was genuinely insane because I had two C-sections. She was like, “Oh.” 


    Meagan: I don’t understand. When I went to go get my records, they looked at me like, “What? What are you thinking? You are scary,” like I was some plague or something. What? 


    Arianna: Yeah, and I think the biggest thing I faced was, “Why? You had two C-sections. You recovered just fine. Why does it even matter?” 


    Meagan: I know. Mhmm. 


    Arianna: I could never really give them an answer because it wasn’t– I think a lot of people made it sound like I had to prove myself and my ability as a woman and as a mother to have a vaginal birth. I think that’s very valid for a lot of women because there’s trauma in this “I’m not good enough” feeling still surrounded by C-sections which is not true. Birth is birth and we just want our babies here safe, but I also think that we all deserve to be empowered to have the birth that feels right. 


    Meagan: Absolutely. 


    Arianna: And that feels like we are worthy of that, that we could do it or just an opportunity to try. She was the first person that it didn’t bother me. I’m like, “I’m 34 weeks. I am doing all the things and I’m going to have this perfect, totally chill VBAC experience and it’s going to be amazing.” 


    Well, the next week, I really started to have inconsistent contractions. I was really losing my mucus plug. I woke up at 35+4 and definitely had some bloody show. I just felt kind of leaky. Every time someone was like, “What do you mean leaky?” I’m like, “I just feel leaky. I don’t know.” 


    Meagan: You’re like, “Something’s going on down there.” 


    Arianna: Something is going on, but it’s too early, so I was like, “I’m just going to act like everything’s fine.” 


    My daughter had a doctor’s appointment at the clinic that day, a wellness checkup. The doctor was like, “Are you doing okay?” I’m like, “Yep.” In my mind, I’m like, “If I say anything, they’re going to check me and for all I know, I could be dilating. My water probably broke.” I was pretty sure my water broke. 


    Meagan: Were you still inconsistent with your contractions at this point?


    Arianna: Yeah, mhmm so it was like, “No, I’m good.” I don’t want to get stuck here. I don’t want to have a C-section.


    20:34 Going to the hospital


    Arianna: So we finished up her appointment. I called my husband. I called the midwives and the midwife nurse I spoke to just told me, “If you want a chance for your VBAC and there is any chance you are in labor, pack up your stuff.” We are 2.5 hours away and those potty breaks at that fully pregnant, I’m going to have to stop and use the bathroom. It was going to take us a minute to get there. 


    We got the kids situated and it was a beautiful day. It was so beautiful. My contractions were super chill and super inconsistent. We drove. We danced and laughed. I cried. I was nervous. I was excited. We got there and I really wanted KFC because I had just eaten super healthy my whole pregnancy and what were they going to do? So we got some food. 


    We got to the hospital at about 2:30 in the afternoon and it was nice because the midwives had their own nursing staff. It felt so different than my first birth, tenfold and then even my C-section with my second. 


    We got there and the whole time, I was mostly angry because we just drove 2.5 hours and there’s no way I’m in labor. There’s no way. We just wasted all of this time to come up here. 


    The first thing they did was check to see if my water had broken. They did that swab. They sent it off and we just sat in the room for an hour. I was texting my doula and I was like, “Oh my gosh. They’re going to make me have a C-section.” She’s like, “No, just calm down.” She was so amazing. 


    Yeah, they came back and they were standing there. We had the OG midwife and then we had a new midwife to that clinic so she was kind of just taking charge of things, but the nurse came in and she started writing on the board. Then I let out some potty words and I was like, “Oh my gosh.” 


    Meagan: What the heck? 


    Arianna: No. Quit writing on the board. I asked, “Is it negative?” She was like, “Yeah, your water broke.” I was like, “Okay, so I have to have a C-section. You’re going to put me on a clock.” I just started downward spiraling. The stress. I was like, “It’s too early. I’m only 35.5 weeks. It’s too early.” 


    That was the scariest moment because I felt so out of control. I really just had to start praying and listening to some music. So I was too scared to get a cervical check because I remembered not dilating with my first then even with my second, my water broke and I was 2 centimeters before I had my second via C-section.


    Meagan: Right. And you’re not contracting a ton right now. 


    Arianna: Not even. I mean, maybe one every 30 minutes and it was like mild, period cramps. I’d get an intense one every once in a while, but it wasn’t consistent so I was really worried that I wasn’t dilating. My water broke too early and I was like, “Even if they let me try, it’s just going to be this cascade of interventions and everything is just going to go out the window. I’ve worked too hard.” It was awful. My mindset was not great. 


    24:04 First cervical check


    Arianna: I did end up letting her check me. I was 1 centimeter and I was only 20% effaced so there was a whole lot of nothing going on. After a few hours, they had to talk to my MFM because I was early. I had gestational diabetes. They had to talk to the on-call OB. We had to have this checklist of people and what we were going to do. 


    She came back in and she was like, “Okay. I’m going to check you and if we’re still good, we’re going to do a Cook catheter,” which is the double Foley, “and we’re going to do Pitocin.” Immediately, my husband stood up and was like, “She doesn’t want Pitocin. Pitocin is not good. That is her last resort.” 


    I felt really supported. I thought, “Oh my gosh. He’s listened to me this whole pregnancy. These are things we don’t want.” I talked with my doula. I talked with my husband and this was kind of my only shot if I wanted to try, we needed to get things going. But they were very good about never putting me on that clock. 


    Meagan: Good. 


    Arianna: Which was great. Yeah, so at about 7:00 at night, we had been there a few hours. I was 1 centimeter, but I was 50% effaced. She was like, “See? You are doing it.” We did the Cook catheter and they let me wait a couple of hours before starting Pitocin and they started very, very low. 


    Meagan: Good. 


    Arianna: Which was awesome. My doula came and we just walked. As soon as I got that Cook catheter, I was like, “All right. Come on, hubby. We are walking these halls because I’m not sitting down. I cannot.” I couldn’t let my mind get the best of me. We walked for 5 hours. We were just moving. 


    Meagan: Wow. 


    Arianna: We didn’t sit down. There were a couple of times with that Cook catheter where I was like, “Dear Lord, help me. This is the most uncomfortable thing ever.” We were on the opposite side of where my room was on the hall and my water gushed. I mean, it was the movies. I was like, “Uh, what do we do?” It’s 12:30 in the morning and this cute little housekeeper came and she helped me get a little cleaned up. I waddled back up to our room. At that point, my contractions were coming. They were coming. They had upped the Pitocin a little bit and I still did not want to get checked or anything. I still had the Cook catheter, but I would say at about 1:30 in the morning, I was on my dilation station backward on the toilet and that thing just popped out. I was like, “Oh my gosh. It’s happening.”


    That was a moment where I was like, “Okay. I’m going to get to have my baby.” I waited about another hour before I would let her check me because I was scared. I was scared for the discouragement of, “Oh, well you’re only 4 centimeters or something.” She checked me at about 2:30 and I was 8.5 centimeters. 


    Meagan: What?


    27:10 Slow effacement 


    Arianna: I was only 50% effaced. So I had not effaced in that whole time. 


    Meagan: Dilated but still thick. 


    Arianna: Oh my lord. We don’t talk about that I feel like. We hear, “8.5 centimeters” and I was like, “I don’t need an epidural. I’m going to push this baby out in an hour. This is going to be great.” Yeah, no. I stalled. Nothing happened. They kept upping my Pitocin and I let her check me again at about 5:00 and at that point, I was having major back labor which then me and my doula were like, “Oh no. He’s OP. He’s definitely face up.” 


    Meagan: We’ve got to work on this. 


    Arianna: I was trying to walk and move in the bathtub and I was just miserable. I probably let those contractions that were on top of each other, no breaks, for another hour and a half and by 6:30 in the morning, I yelled, “Pineapple!” That was my safety word. My husband was like, “Don’t tap out. You’re doing great.” I instantly was like, “I’m not tapping out. Why would you say that?” 


    He was like, “No, no. I just meant you are doing so good.” Because I had gone all that time without asking for drugs, my night nurse thought I did not want the epidural at all. She was very encouraging and amazing. She was like, “No, you’re doing great.” My doula was pulling out the peppermint essential oils and all of the things and all of the counterpressure. I mean, I just was like, “If I don’t get the epidural, I’m not going to make it. I won’t be able to keep going. I’m exhausted. I’m in so much pain.” 


    So lord bless that anesthesiologist because he was there within 15 minutes and I was struggling. I was like, “I can’t breathe. I can’t do this.” The whole energy of that room was so healing. It was so positive because no one was yelling. It was so stress-free. 


    I got the epidural at about 7:30 in the morning and I slowly, very slowly kept going. Very slowly. I think at about 9:00 or 10:00, I was only about 9 centimeters and 70% effaced. That was a moment where I was like, “I’m going to end up having a C-section.” 


    Meagan: That moment of doubt. 


    Arianna: That doubt just came in and my doula and my husband were like, “No, you’re not.” Once I got my epidural, my doula and my nurses were changing me every 30 minutes. I had the peanut ball. We were flipping positions. We were doing all of the things and my nurse came in at about 11:00. I called her and I was like, “I need you to check me because I need to get up and go number two.” It’s not the baby, I swear. I have to go to the bathroom. 


    She kind of giggled and she checked me. I was like, “Don’t tell me.” It was those magical words that I had waited for my whole pregnancy, “You’re complete and it’s time.” 


    Because I was early, we had to have this whole team of people. We had NICU staff and several nurses. We did a couple of practice pushes and his head was down there and ready. I ended up having to push for probably 45 minutes and my midwife had to just do a little snip because we really started to have some decels. I started to get a little panicked. My husband was just there and I just had to close my eyes and start praying, “God, you know my heart. I can do this.” 


    31:05 Catching her baby


    Arianna: One more push and he was out. I helped bring him to my chest. He did come out with the cord wrapped around his neck so then I knew why he was starting to have some decels. I got to hold onto him for a little bit and then he had to go to the NICU because he was having some breathing issues. 


    I just remember my husband saying, “You did it.” I think any woman listening to it who has had the VBAC, that moment, there’s no moment like it really. It’s not like, “Oh, I just had a baby vaginally,” it’s “I just did something that so many people told me I couldn’t do or that my body wasn’t capable of” or whatever. It was so healing and so amazing. 


    He was only in the NICU for a few days which was a huge blessing.


    Meagan: That’s awesome. 


    Arianna: I feel like just stuttered through all of that. I don’t even remember half of the stuff I said or that I wanted to say, but I think overall, the experience was just a testament to how strong our bodies and our minds can be. I know that in the moments, I really believe I stalled because I got in my head. I was just like, “Okay, I can’t do this. This is hard. I’m not progressing. My body’s not working right.” I just really believe in the power of the mind. 


    I think personally, my only goal in medication was to make it to 6 centimeters. I was like, “I just want to get to 6 centimeters without the epidural” and I made it past that. 


    Meagan: Yes, you did. 


    Arianna: I was very happy to get the epidural because I knew that I needed that break physically and mentally. 


    Yeah, that’s a rundown I guess. It was beautiful. I’m blessed that I have all of my babies here and that they were here safely. My second C-section was redemptive. It was healing. I had a doctor who listened to me and made me feel safe and cared for. In my VBAC experience, I had to fight for a support system that was almost 3 hours away, but what was so beautiful was what came after just this, “Wow,” or having people I don’t know super well messaging me and be like, “Hey, what did you do? How did you go about this?” I’m like, “You know what? This is why it mattered?”


    33:59 Importance of support


    Arianna: It doesn’t matter how your baby gets earthside, in my opinion. 


    Meagan: It doesn’t. It doesn’t. 


    Arianna: C-section is okay. It’s totally fine. It’s okay if you want repeat C-sections because that works for you but I think it also needs to be okay for women to want the opportunity to try for a vaginal birth as long as it’s safe and healthy and everything, but I think for me, the biggest thing was feeling supported. It came in so many different ways but it’s how I made it through for sure. 


    Meagan: Yeah. Support is one of the biggest tools in our toolbag when it comes to achieving the birth we desire. Like you were saying, it doesn’t mean we have to have a VBAC. It doesn’t mean you have to have a C-section. It doesn’t mean you can’t be induced. We have to dial into what we desire and then find the support that surrounds that type of birth. 


    I think that if I’m going to be super honest, that’s where I get really angry in this community because I see time and time and time again people not being supported, people not being given the opportunity to even try to have it. You know what I mean? We just cut people off in this world and it’s just so frustrating to me. Providers, why can we not step up to the plate and offer people support? Why do we have areas that are absolutely not supportive? If they are capable of giving birth to a baby, they are capable of helping someone give birth to a baby in any way, right? It’s just so frustrating and it’s for sure the biggest tool that we can have. 


    That sometimes looks like driving almost 3 hours away or that sometimes looks like hiring a doula further away or whatever. It’s important. It’s so important and Women of Strength, I want you to know you are worth it. You are worth getting the support. You are worth finding the support and


    36:35 Dual care tips


    Meagan: Let’s talk a little bit about traveling. You talked a little bit about how you did a little dual care. I think it’s a really great option to have if you are traveling, but there was something that you mentioned and I wanted to talk about this as well. It can actually sometimes be a little difficult because you’ve got one side that’s not supportive and one side that is supportive. Sometimes, they are saying different things. It’s pulling you in all of these directions, making you question, and that can be really, really, really difficult. 


    I had a client years ago who did dual care at the same hospital for a little bit and then transferred out of the hospital. The midwives and OBs were like, “No, your placenta is going to die. Your uterus is going to rupture.” They were saying all of these really, really big and scary things. She would call me and she was like, “What do you think about this? Maybe I’m making a bad choice,” even though in the end she was like, “I knew better, but they got to me.” That can be something that can be hard to battle within your own mind and doubt that intuition. 


    Know that if you are doing dual care, that can come up. Did you notice that? 


    Arianna: Yeah, hearing you speak, I’m like, “Oh my gosh, that was how I was with my doula.” I would go here and see my provider. I think honestly, it’s not that they wouldn’t support VBACs, I just think the information they have is dated and realistically, it’s not safe because “we don’t have 24-hour anesthesia.” If something happened, they wouldn’t be able to provide the care needed. 


    But also, there were so many times where I felt like the information I was being told or the data was not anything I had found and then I talked with my MFM who was 100% on board and he was like, “Yeah. You’re going to do great.” Then I was like, “Wait, what?” 


    A big thing especially was, I don’t think I would ever do that again if I had another. 


    Meagan: Dual care. 


    Arianna: Yeah, I wouldn’t. It implants so much doubt. It’s not that they weren’t supportive, it’s just that they weren’t the support I needed. I think a big thing was I needed to feel supported because a VBAC is this hypothetical creature that lives somewhere far-off that no one has heard of, so that was the hard part was living in this tiny area where it was not safe, super dangerous, no one does it, especially after two C-sections. 


    Meagan: Right, yeah. I mean, my dual care experience lasted very short-lived because I did end up transferring officially to my midwife, but I went in every time knowing that they were going to have an opinion, but I knew where my heart stood. It was nice to have those options if transfer needed to happen and things like that, but I knew what they were going to say, I was going to hear it but let it bounce off. It was really hard to have to go in there every time and be like, “Okay. You’re going to get doubt and that’s okay. People are going to doubt you and that’s okay. You’re not doubting yourself. Know it.” 


    Arianna: Yeah. It was a mental workout every time. I knew they cared about me and my well-being of myself and my baby 100%, but I knew that in their minds, what I wanted to do was not a good idea and it wasn’t safe. I think my biggest encouragement to people who maybe do dual care is the best option is not to go to their appointments alone. That’s huge. 


    I think I survived it because I had such a huge support system. I had friends who were like, “Nope. Do you want me to come with you? Don’t get discouraged. You can do this.” Really, I had to get to a place in my pregnancy where I think with VBACs, we get really stuck with research and all of the information and the podcast and the forums on Facebook and all of these things, where it’s like, “If you want to have a VBAC, it has to look like this.” Everything I thought was going to happen went out the window. I got gestational diabetes. I had preterm labor. I had to get induced. My baby ended up in the NICU. All of the beautiful aspects that everyone talks about around VBAC were not realistic because every birth is different for everyone.


    I think a big thing for the VBAC community that I didn’t feel supported in is, “What if I have to get induced? What if I fail my glucose test? What if I have these barriers or preterm labor? What if I have all of these roadblocks?” 


    Meagan: Well, you actually had a shorter interval too, but no one ever really said anything. There are so many things that something could come up. 


    Arianna: Yeah, my babies were only 15 months apart. 


    Meagan: There are all of these things and I’m like, “There are so many roadblocks that could have come up along the way.” 


    Arianna: Oh yeah, when I unpack my VBAC suitcase and I look at things, I’m like, “Wow, this is heavy,” because I had also just had this near-death experience with my second child with this mastitis. It was just a God thing. I mean, it was for me. I mean, it was 100%. I know that God knew my heart in the whole experience and He was so faithful to all of it. 


    For me, I like to think that I give things to God but then I slowly take them back and this was the one experience in my life where it was like, “God has to have this 100%” because I look at all of the little roadblocks and they weren’t roadblocks at all. They were just little bumps and we made it through. 


    Meagan: I love that so much. 


    I am so proud of you. I’m proud of you for getting the education, doing the research, and joining the community so like you said in the beginning, you had that community of women all over the world that were in very similar spaces and that you could connect with. That’s something I love so much about our VBAC community on Facebook is you get on there and you’re like, “Whoa. I’m not alone. I feel alone right here, but I’m not alone.” You can turn to that space. You can turn to these podcasts and you really truly become friends with some of these people, right? 


    I’m just so proud of you and so glad that you had your VBAC. I’m so thankful that you were on the show. I wanted to let everyone know that we do have blogs on gestational diabetes. We have blogs on laboring at home, what to know and when it’s not safe, and things like that for people who may be traveling a little distance who are not in preterm labor. We have tons of blogs. 


    I don’t know if you’ve ever had this, but it’s called Real Food for Gestational Diabetes by Lily. 


    Arianna: Yeah. 


    Meagan: You know it? 


    Arianna: I read it. 


    Meagan: That is such an amazing book and we’ve had Lily on the podcast. I just think that one is a really great go-to. She also has Real Food for Pregnancy so that’s a really good one. But yeah, just getting all of the education you can. 


    44:56 Traveling tips


    Arianna: I want to touch really quickly on what it was like traveling in preparation for birth. Obviously, mine didn’t go to plan, but I think the biggest thing that I see people asking is, “Well, when do I leave? How do I know?” My plan was for my midwife to have vouchers for the hotel that was right next to the hospital so there were options available or trying to find a family or friend that you could stay with. My plan was actually to go up there and stay at 38 weeks until baby came. 


    I was intending to labor as much as I could at the hotel or whatever. Obviously, things worked out great, but having a plan like that in place between 37 and 38 weeks is really comforting because like my midwife told me, she was like, “If you want that chance for a VBAC, pack your bags and get up here.” That’s my biggest piece of advice. If you are traveling, try to have a plan set up towards the end. Where can you stay? Do you have a support system up there? That was huge. 


    Meagan: Yeah. I agree so much. Yeah. Having that and having the plan in between like, okay. if labor shifts really fast, know the hospitals in between or know where you can go in between. Be prepared. Have the things in your bag. Have a little bit of a plan. Get the support at home and when you’re there. All of those things are going to add up and create a better experience for you. It is possible to travel. It’s worth it in my opinion. I only had to travel a really short distance, but I’ve had clients that travel literally from Russia to Utah to have these VBACs. I think she would vouch every single day that it was worth it. You just have to figure out what’s best for you and your family. Find the resources, get the support, and rock your birth. 


    Closing


    Would 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.





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    47m | Mar 6, 2024
  • Episode 279 What are the chances if…?

    We know that unique circumstances in pregnancy can make a VBAC feel farther out of reach. Do your chances of having a VBAC go down if you had preeclampsia in a previous pregnancy or your current one? What if you have a special scar? What are the chances of having a VBAC if you were diagnosed with “failure to progress”? What about fibroids or gestational diabetes? 


    Julie Francom joins Meagan on today’s episode discussing evidence-based research around all of these topics. They share personal experiences as birth workers and overall takeaways that can help you confidently navigate your VBAC journey no matter what complications arise during your pregnancy. 


    Additional Links

    Special Scars Studies

    The VBAC Link Blog: Why Failure to Progress in Labor is Usually Failure to Wait

    AJOG Article

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Timestamp Topics

    02:54 Review of the Week

    5:51 Preeclampsia

    08:57 Ask questions

    12:51 Special scars

    17:58 Failure to progress

    26:15 Fibroids

    27:54 Gestational Diabetes

    35:06 Find a supportive provider, ask questions, and educate yourself


    Transcript

    Meagan: Hello, hello everybody. We are getting out of winter and maybe into some spring weather, hopefully. I always hope for spring weather in March because it’s my daughter’s birthday and she always wants sunshine, not snow for her birthday. So I’m crossing my fingers that this is the month we have sunshine, not snow. I hope you guys are having a wonderful beginning– well, I guess it’s not actually spring, but I hope you’re having a wonderful beginning of March. 


    We are kicking off our very first Monday episode for 2024. You guys, we have a little surprise for you. We are going to be sending out two, not just one, but two episodes a week. Make sure to tune in on Mondays and Wednesdays for stories and information. Today, we are kicking it off with Julie. Hello. 


    Julie: Hey. I’m so happy to be here and yes, I’m hoping it’s warm or getting there because I am just a popsicle permanently from November to March so let’s just thaw out a little bit, please. 


    Meagan: Just a little bit. Even if we just get some little sprinkles, let’s have April showers in March. 


    Julie: Yeah. 


    Meagan: You guys, I am so excited for today’s episode. Julie and I feel like these are some questions, I am definitely getting these questions on the weekly Q and A’s, but these are some questions that are often asked and we want to answer your questions today. We’re going to be talking about a whole bunch of things. 


    Julie: A whole bunch of things. 


    Meagan: What are the chances if I have preeclampsia? A special scar? Failure to progress?


    Julie: Gestational diabetes. 


    Meagan: Gestational diabetes and maybe uterine fibroids. We are going to talk a little bit more about those. What are your chances for VBAC or vaginal birth if you have these things or have had them? Maybe you are not pregnant yet and you had preeclampsia last time or gestational diabetes last time. What are your chances? 


    02:54 Review of the Week


    Meagan: So without further ado, I’m going to turn the time over to Julie for a review and we’ll dive right in. 


    Julie: Without further ado, here is Julie. Okay, this review is from Google. It is from Christa and she says, “This podcast is beyond empowering. After my C-section after multiple unnecessary interventions, I knew immediately I wanted a VBAC for my next baby. I found this podcast not long after and have been an avid listener for four years.” 


    Four years, wow! 


    Meagan: That’s amazing. 


    Julie: I know. “The VBAC link lifts the veil on birth and allows women to educate themselves and make their own decisions instead of just blindly trusting providers as many of us have in the past. Because of this podcast, the topic of birth/VBACs has become such a passion of mine and I now feel confident in my knowledge and ability to advocate for myself next time. I recommend this podcast to every mom and expectant parent I know. I am now pregnant with my second due March 2024–” Hey, that’s right now– “and am already preparing and relistening to every episode and have the honor to have Meagan as my doula–” What?! That’s awesome. 


    “Hopefully you’ll hear my successful VBAC story soon.” 


    Meagan, this is your client. That’s awesome. 


    Meagan: I love it. I love it. Thank you, Christa. 


    Julie: Maybe you’ll be at a birth soon for her. Holy cow, that’s amazing. 


    Meagan: I know. I love it so much. I love that she said that we lift the veil. That was so cool. Yes. 


    Julie: Yes. 


    Meagan: Thank you. You guys, these reviews, as you can see, we are over here smiling and gleaming on this Zoom podcast. 


    Julie: Smiling and gleaming. 


    Meagan: Yes, we are. So if you wouldn’t mind dropping us a review, your reviews truly help other Women of Strength find this podcast and find this platform. You can leave it on Google just like Christa did. You can go to Apple Podcasts. You can go to Spotify. Can you? I don’t know if you can on Spotify. Google or you can just email us. Email us at info@thevbaclink.com with the subject “Review” and you never know, you might be read on the next podcast. 


    5:51 Preeclampsia


    Meagan: Okay, Julie. Are you ready? 


    Julie: Let’s do it. 


    Meagan: Always, right? Okay. Let’s talk about preeclampsia. You had preeclampsia with your first that did end up ending in a Cesarean. However, you went on to have three HBACs. HBAC if you are just new with us is Home Birth After Cesarean. So yeah. I guess right there I want to point out is it possible to have preeclampsia and then go on and have a vaginal birth? Yes. 


    Julie: Yeah. Yeah. Heck yeah, it is. 


    Meagan: Yes, it is. 


    Julie: I did it. You are speaking to the girl right here. Now, preeclampsia is kind of tricky because a lot of research shows according to the Preeclampsia Foundation. You can find it at preeclampsia.org. According to them, there is a suggested risk that you have a 20% chance of having preeclampsia again after you’ve had it the first time. However, there are some experts that site a range anywhere from 5% to 80% just depending on when you had it in your prior pregnancy, how bad it was, and any additional risk factors that you have. 


    So I have had clients, most of my clients that have had preeclampsia once don’t have it again, but I have had one client that has had it both times. My pediatrician had preeclampsia in both of her pregnancies. It really just depends on a lot of different risk factors, but preeclampsia also doesn’t exclude you from having a VBAC. You’re just going to have to get induced earlier for the safety of your baby usually around 37 weeks unless it is severe. They might want to induce you a little bit earlier than that. 


    But yeah, I just feel like me and Meagan– I’m going to go off on a little bit of a tangent and then I’ll bring it back. But me and Meagan were just talking about how a lot of these things– the biggest risk of VBAC is uterine rupture, right? That’s what we talk about. But a lot of these other things like gestational diabetes and preeclampsia and big baby and all of these other things, the risks of those or the perceived risk sometimes don’t have anything to do with VBAC. It’s completely separate. It doesn’t increase your risk uterine rupture. Not even big baby increases your risk of uterine rupture. There are no studies that support that. 


    Preeclampsia and VBAC should be treated separately although a lot of times, providers don’t treat it separately. They think, “Oh, you’ve had a C-section and preeclampsia so we should just schedule a C-section.” That is where provider bias comes into play and these perceptions when there are just not a lot of studies and evidence to support any of that, right? 


    Anyways, circling it back to preeclampsia, there are lot of things you can do to make your body healthy overall that may reduce your chances of preeclampsia although I guess we are still not entirely certain about how preeclampsia comes about in the first place. 


    But yeah. I don’t know. What do you have to say about that, Meagan? 


    08:57 Ask questions


    Meagan: Yeah. I think it’s important to do what you were saying and separate the thought of, “If I have this, I have to do this,” when a lot of providers, especially if it is severe and we’ve got really, really high blood pressure and we are severe, they may specifically say, “You need to schedule a C-section,” but that doesn’t necessarily mean you have to and if you have preeclampsia in general, it doesn’t mean you are going to have a C-section. I think that’s one of the biggest takeaways from this episode. 


    Julie: There is no “have to” ever. There are no absolutes. 


    Meagan: There is no “have to”. Yes. There are no absolutes. There are things where you may be at increased risk of Cesarean, but that’s typically because of those things like induction, right? So yeah. There’s really no concrete evidence on what mode of delivery is best if you have preeclampsia. So again, it comes down to your provider. Get a supportive provider. Talk about it. Really ask them. If they tell you, “Okay, because you have preeclampsia, we are going to have to schedule a C-section,” ask them. Do not stray away from getting the evidence and the information that you need. You can say, “Okay. Can we talk about the evidence of why I have to?” Right? Ask questions. Don’t feel bad for asking questions. It’s okay. If you have that question, ask it. 


    Meagan: So yeah, I think that’s kind of it. 


    Julie: Yeah. I think the overall theme of this episode and maybe the whole entire VBAC Link period is asking questions to your provider, talking with your provider, and having a mutual trust with your provider where they trust you and you trust them. Right? It’s a two-way street where you guys can collaborate together and create a plan of care that is comfortable with you and comfortable with them. I know that a lot of care is centered around the provider and what they are comfortable with. Some providers are not comfortable with doing VBAC for preeclampsia or after two or more Cesareans or after a special scar or with gestational diabetes or whatever. 


    You need to have a plan that you are comfortable with and that your provider is comfortable with because I promise you that you don’t want a provider who is nervous about your care because they are doing something they are not comfortable with. I feel like that’s so important to have that mutual trust between yourself and your provider where they trust you that you are not going to do anything dangerous or stupid and you trust them that they are not going to do anything dangerous or stupid. Do you know what I mean? I say stupid loosely. That’s a very medical term, “stupid”, but it’s important. It’s important that there is mutual trust that you can discuss your plan with your provider. If you’re not on the same page with your provider, it might be a good idea to look for a different one. 


    Meagan: Yeah, it’s also important to ask, “Well, what are the chances of the negative outcomes for a scheduled C-section?” because on the NIH, and we’ll make sure to include the links so you can read them, but it did say, “An increased risk of various postpartum complications was found in patients allocated directly to having a Cesarean section including blood loss.” When we have preeclampsia, it seems that we have a higher risk of issues potentially, but bleeding is not a great thing. We have platelets being affected and things like that, we may have increased chances of blood loss which we already know, Cesareans in general have an increased risk of blood loss. So you may want to ask questions about what kinds of risks you have if you do schedule a C-section with a scheduled C-section in general. What are the risks there? What are the risks to you and your baby there? Yeah. Anyway, ask questions. 


    12:51 Special scars


    Meagan: Okay, we’re going to talk about special scars. With a special scar, we do have a blog on that and it does have an attachment of a lot of studies and things that our favorite group of Facebook, Special Scars, Special Hope– is that? Am I brain farting? 


    Julie: Mhmm. 


    Meagan: If you have a special scar meaning you have anything other than a low transverse, so a J, a T, and all of those things, definitely check out that group. The unfortunate thing is that the studies we do have are not really up to date. We don’t have a ton of concrete studies that are really recent or even large particular studies. So we want to talk about just in general, what are the chances if you have a classical or a special scar? The chances are there. You can still VBAC. There may be slightly increased chances of things like uterine rupture, but it is still possible. We have stories on our podcast even of people who have gone on to have vaginal births with special scars. I’ve supported a client that had a special scar. All was really well and they just took a little extra precaution. They wanted to make sure that they knew the signs of uterine rupture and they knew which I think everybody should. They wanted to make sure that baby was doing okay and mom was doing okay. All was well and it ended up beautifully. 


    But all in all, I think in the end, it’s going to come down to finding the support and finding that support. That can be tricky. What are the chances to have a vaginal birth with a special scar? Possible. I don’t have a number for you. What are the chances of finding a supportive provider with having a special scar? 


    Julie: Harder. 


    Meagan: Lower. Yeah. It’s going to be lower and that sucks. 


    Julie: It does suck. It does suck. The special scars website at specialscars.org/studies has links to all of the notable studies, but the biggest studies that are out there show that your chances or uterine rupture are less than 2% with a special scar. 


    I feel like that might be an acceptable risk for some parents and that might not be an acceptable risk for other parents. I feel like that’s really important to acknowledge that what is an acceptable level of risk is different for everybody and each of your providers is going to have a different level of risk that they are comfortable with as well. 


    The hard thing is that there are not a ton of studies on special scars but special scars are not just about if you have different C-section incisions. It’s also about myomectomy, different types of uterine surgeries, and things like that. Basically, anything that is not in the lower uterine segment and has been cut or severed in some way. I don’t know the right way, I don’t know the nice way to say that, but if you have a history of any type of uterine surgery that is not on your lower uterine segment, that is considered a special scar. That could have absolutely nothing to do with pregnancy. 


    Meagan: Yeah. Yeah. 


    17:58 Failure to progress

     

    Meagan: Okay, let’s talk about failure to progress. What are your chances if your last Cesarean was due to failure to progress? Imagine me putting big, giant air quotes around “failure to progress”. You know, I don’t know if this is one of those things I take to heart because it personally happened to me and I was told “failure to progress” and it kind of ticked me off, but your chances if you had a previous diagnosis of failure to progress to have a vaginal birth the next time around are pretty dang, stinking high. 


    A lot of the time, failure to progress is due to certain factors like failure to wait, meaning a provider pushed or a mom– maybe you were like, “I’m done being pregnant. I want to be induced,” and your provider is like, “Cool, yeah. Let’s do it.” Failure to wait for spontaneous labor or failure to wait for labor to kick in while you are in your induction. However, then they are like, “We’ve got to start getting this labor going. Let’s start Pitocin. Let’s start this and they are starting to intervene instead of just allowing the body to receive the induction method and then go forward. I feel like so often in the birth room, I personally, I don’t know, Julie, maybe you would say something differently, but I personally see Pitocin being upped way too fast and often too much instead of going 2mL every 45 minutes or so. We are doing 2-4 mL every 30 minutes and we are not really giving our uterine receptors time to fully, fully react. 


    Pitocin is actually usually quick. It can– what’s the the terrm, Julie? The receiving time? I don’t know. There is a term. 


    Julie; Oh yeah. 


    Meagan: It gets into your body quickly. 


    Julie: Like how long it takes to take effect. 


    Meagan: Yes. You know what I’m talking about. It actually reacts quickly. There is a quick reaction. However, to a full extent, sometimes it can take a little longer than a half hour fot the body to really, really kick in. Or maybe we are like, “Okay, let’s start Pitocin then we will quickly break your water, “ and all of these things so we are not waiting for labor to kick in, we are just forcing labor whether it’s spontaneous labor and things are going slow, then you get in and they check you in and they are pushing it or you are an induction. 


    So, failure to wait. I personally don’t know if there is actually any solid, solid evidence. Julie, you probably would because you are incredible on numbers, but on breaking water too early, I feel like so many times, we will see our clients in our practice be told they need to get their water broken and babies are at -2 station and we’re at 2-3 centimeters. We haven’t even gotten into a solid labor pattern and now we just open the floodgates. Baby is coming down in we don’t even know what position then we have a harder labor. Now we’re trying to intervene even more trying to get labor to go because maybe baby came down in a wonky position so labor is not starting and then it’s the cascade there. 


    I think avoiding AROM, artificial rupture of membranes, is something that we should particularly pay attention to. Maybe have a checklist of what is my contraction pattern like? What is my labor like? Is it all in my back? Is there maybe a sign that baby is in a wonky position right now? Because if so, it’s going to be harder a lot of the time once that water breaks to get that baby to rotate. Not impossible, just harder. 


    Is baby too high? Do we have a higher risk of cord prolapse? We’re talking preeclampsia so “pre” is in my mind. Why are we breaking water at 2 centimeters to begin labor? Why don’t we do something else and do a low-dose Pit or do a Foley to try and get us to a 4-centimeter state? 

    I think that’s something. Failure to wait, inducing too fast, introducing things, and then baby’s position. That’s another one that I think is a lot of the time for failure to progress. 


    A lot of the time when our babies aren’t in an awesome position, it can be harder to put an adequate amount of pressure on the cervix and dilate the cervix properly and in an “adequate time”. Anything else, Julie, that you think about failure to progress? I know I’m probably missing something. 


    Julie: Yeah, no. You pretty much got it. I do have one thing to add though, but first, we have a blog called Why Failure to Progress is Usually Failure to Wait. It’s at thevbaclink.com/failure-to-progress. I just want to say I feel like sometimes failure to progress is actually misdiagnosed because ACOG and the Society for Maternal-Fetal Medicine put out guidelines on what constitutes failure to progress. This is what the guidelines are. 


    I’m just going to read it right from our blog. It’s quoted right there and there is also a link to the guideline if you want to go to the blog and find the guideline. It says, “The new guideline says that a woman is not considered to be in active labor–” 


    Okay, so first of all, you cannot be a failure to progress until you hit active labor. That’s the first thing. Active labor is not until you are 6 centimeters dilated according to all of the guidelines that are out there. I was diagnosed with failure to progress and I was only 4 centimeters dilated so that was a misdiagnosis for sure. 


    It says, “You cannot be considered–”


    Meagan: I was failure to progress as well at 3 centimeters. 


    Julie: Yeah, for real. Everybody is I feel like. You are not considered to be in active labor until 6 centimeters dilated and “cannot be termed as failure to progress until she is at least 6 centimeters dilated–.” We just said that. “Her waters have ruptured and no cervical change has been made in 6 hours of labor.” Okay? You have to be at least 6 centimeters dilated. Your waters have to have been broken and you have no cervical change in 6 hours. 


    Now, listen. A lot of the time we think of cervical change as only dilation. Cervical change is way more than just dilation, okay? Cervical change is where your cervix moves from the posterior to the anterior position. It straightens out. It ripens and softens which means it gets thinner. It not only opens but it gets thinner so that’s effacement. If you go from 80% effaced to 90% effaced in 6 hours, that is cervical change. 


    Meagan: That is change. 


    Julie: That is not failure to progress. It gets softer. It effaces which thins. It dilates which opens. The baby’s head rotating, flexes, and molds are all considered part of cervical change and baby is descending. If your baby goes from -1 station to 0 station and you don’t dilate any further, that is still considered cervical change because the baby is moving downwards. 


    So I feel like a lot of times, failure to progress is misdiagnosed and lots of other things could have helped progress that baby if like Meagan said, we were just patient and given more time. 


    Meagan: Yes. I wanted to add to that. All of those things that Julie just said and sometimes, we might not be making changes like dilation or effacement necessarily, but our cervix that was really once posterior is now more anterior. Our cervix is coming more forward which to me, is a sign of change and that our body is working because sometimes, our cervix has to come forward to do some work. 


    Julie: Yeah, that was the first thing I said. It moves from posterior to anterior. It straightens out. 


    Meagan: Oh, I missed that. Yeah. I totally missed that.


    Julie: That’s okay. 


    Meagan: I just think it’s so important to know that if you’re not dilating, it doesn’t mean you can’t. Sorry, I totally missed your first half. 


    Julie: No, you’re totally fine. 


    Meagan: Okay, anything else? 


    Julie: No, I think that pretty much covers it. Like I said, all of the things that Meagan talked about and the link to those guidelines are in that blog that should be linked in our show notes. 


    26:15 Fibroids


    Meagan: Okay, so let’s see. What else is one of the other ones? We wanted to talk about fibroids. This is something we don’t talk about a ton actually but it’s something that we get on our– did we talk about gestational diabetes? We did, right?


    Julie: We haven’t yet. 


    Meagan: That’s what I want to talk about first. 


    Julie: But fibroids, let’s do fibroids because fibroids is pretty much the same as special scars. You have a surgery to remove your uterine fibroids and it leaves a scar. 


    Meagan: Okay, yeah. 


    Julie: And the scar is on some part of your uterus. It just depends on where the fibroids are. That would be similar to your chances of success with a special scar because it is a special scar. 


    Meagan: Yeah, I guess so. I never even thought about it actually like that. A lot of people will be told that if they have a fibroid, they can’t have a vaginal birth and there are studies that show you might have increased chances of a breech baby or preterm birth or even Cesarean because sometimes those fibroids can grow a lot and can cause some issues so there may be some increased chances of Cesarean, but that doesn’t mean you can’t have a vaginal birth. It should never not be considered. 


    Like she was saying, sometimes people will also get those removed before they get pregnant so there’s that to consider. 


    Julie: Yeah, for sure. 


    27:54 Gestational Diabetes


    Meagan: Okay, let’s go to gestational diabetes now. I feel like this one is a really hot topic and if you are listening and you had gestational diabetes with your pregnancy, with your VBAC, we actually are looking for some stories to share this year because it has been one of the most requested stories to get on the podcast. 


    But let’s talk about what are your chances of having a vaginal birth after a Cesarean with gestational diabetes. I think it is important to note that even despite you can be the healthiest you can possibly be and sometimes you can get gestational diabetes. We don’t know exactly why sometimes. You should never shame yourself for having gestational diabetes. I feel like so many times, it’s like, “Oh, I should have just been healthier.” I’m like, “No, no, no, no. That’s not what we should be doing.” 


    Then I think with gestational diabetes, sometimes we panic with trying to control our numbers and sometimes we cut eating or we don’t necessarily manage the right way. I think with gestational diabetes, number one, try and learn how to manage it properly and to be as healthy as you can with it, but know that you do not have to have a C-section if you have gestational diabetes. 


    However, you may have a provider who wants to induce your labor. When I say may, I don’t know if I’ve ever ran into a client who had gestational diabetes and didn’t get induced. Do you, Julie? Have you ever had a client that was not, even controlled gestational diabetes, that wasn’t induced by at least 39 weeks? 


    Julie: Yeah, but it was a home birth. I mean–


    Meagan: Okay. 


    Julie: It was kind of complicated. There is more nuance to it than that, but yes. She had a home birth. Her gestational diabetes was managed well. It was even managed with insulin. That’s all I’m going to say about that. Sorry. 


    Meagan: No, that is just fine. That is just fine. 


    Julie: Her baby was 6.5 pounds by the way. 


    Meagan: Seriously, no. You haven’t had a gestational client that hasn’t had a provider aka a hospital provider I should say? 


    Julie: Well, no. Actually no, yeah. I just had one but she was induced too. Yeah. The nurse I was telling you about. 


    Meagan: She was induced. 


    Julie: She was induced. 


    Meagan: I’ve never had a client who has not been induced so that is something that you probably need to take note of. If you have gestational diabetes, you may have a discussion coming your way from your provider about being induced. 


    Julie: Well, all of the guidelines and recommendations from ACOG are to induce at 39 weeks right now. 


    Meagan: Exactly. I just want people to know that that could most likely be a thing. It’s not that they are not, like she said, following evidence. That is what is suggested by ACOG, but just know that that can be. We know that potentially an induction could increase the chances of C-section because we have all of the things we were just talking about earlier, all of the interventions that could lead to failure to progress or baby in a wonky position or baby is not tolerating it well or maybe your body wasn’t quite ready to be induced yet and is not responding properly to the medication that they are wanting to give you. 


    But in a journal by the American Journal of Obstetrician and Gynecology which is an off-shot journal of ACOG, they said, “In a total of 1,957,739 women were eligible for TOLAC across the study period, 386,092 underwent a TOLAC. Overall, 74.0% of non-diabetics, 74.0% of non-diabetic, 69.1% of gestational diabetic, and 58.2% of pre-gestational diabetic mothers achieved a VBAC.” 


    I’m looking at those numbers and I’m like, “Okay, those are pretty good.” It says that in general, there were some lower odds with large gestational for age infants, babies, so we already know that the big baby thing, sometimes providers are scared of big babies or babies coming down wonky or there is whatever, so sometimes big babies will be taken by Cesarean. However, it’s also to note that if your baby is suspected as large, that doesn’t mean they are large. Also, if they are large, it doesn’t mean they can’t come out vaginally. We have lots of people who have big babies that come out vaginally. Julie has personally attended a birth. Wasn’t it 11 pounds? Her baby? That home birth, do you remember? 


    Julie: Shoot, I’m trying to remember. Which one? I’ve had several. 


    Meagan: Her name starts with an L. She is little, you guys. 


    Julie: Oh, okay yeah. With an A, not an L. Yeah. Her baby was 10 pounds, 7 ounces I think. 


    Meagan: Okay, yeah. 


    Julie: Her most recent one, but all of her babies– well, not all. One was just a 7-pounder, but 9-10 pounds. 


    Meagan: I totally thought that her other baby was just over 11. 


    Julie: No, not 11. But she is 5’2”. She is little teeny. A little teeny girl. 


    Meagan: Yeah. So it is possible. Knowing that if you have gestational diabetes, you will more than likely be induced, I think that if you do have gestational diabetes, control it as much as you can and prepare for induction and learn all of the things that you can about induction. We will have in the show notes a link for all of the things. We will have the ways to self-induce or all of those things– not self-induce, but induce non-medically and the ways to induce with a provider and the pros and cons on that, so check that out. 


    Julie: Right. Also, I think it’s important to note that there are other complications with gestational diabetes besides just big babies. Inducing at 39 weeks has been shown to reduce the chances of these things happening because the more pregnant you are, the higher your chances are of these things.


    Meagan: Preeclampsia is one of them, right? 


    Julie: Yep. Hypertension which is high blood pressure, preeclampsia, lower blood sugar, obviously, and higher chances of a bigger baby for sure. We just talked about that. Up into needing a C-section as well. There is some pretty sound evidence for inducing at 39 weeks just because it will decrease your chances of developing those complications during pregnancy as well, but yes. 


    Meagan: Yeah, so all around, just doing the education, getting the education, looking at the information, and making the best choice for you. 


    Julie: Yeah. 


    Meagan: Okay. What else do we have? Is that about everything? I think that’s about everything. 


    Julie: Yeah, I think we talked about it all. 


    35:06 Find a supportive provider, ask questions, and educate yourself


    Meagan: All around, at the end of the day, I think some of the biggest things to take away from this episode that you can do is find a supportive provider. How often do we stress that? Find a supportive provider. We have, if you didn’t know in our VBAC Link Facebook group, we actually have a list of VBAC-supportive providers under the Files tab. If you are not part of our VBAC Link Community on Facebook, check it out, answer the questions, and you go find that file. You can find your state or even country and see if there is a provider on there that is supportive. 


    Also, if you have a name of a provider that you don’t see on that list, please send it over to us with their location and name so we can add to that list and help more Women of Strength find the support that they deserve. 


    Ask questions. Asking questions is powerful and it’s not done enough. I feel like if I look back at all of my pregnancies, even my VBAC, I don’t think I even asked nearly enough questions to statements that were made or just in general, so ask questions. If you are unsure of something or something is being told to you, ask the questions. 


    And get the information. Educate yourself. Education is power. It is so powerful and you need it. You truly need it. Check out our blogs. Check out this podcast. Keep listening to all of these stories. Every single episode that we put out every single week is going to have little nuggets of information for you. You might be blown away to find out how many of these stories actually relate so much to yours. We also have a VBAC course that Julie and I spent a lot of hours putting together and wanted to bring all of the evidence to you in a– I want to say regurgitated form from studies because I feel like we read those studies. You can read them and it’s like, “Wait, what?” We regurgitated it back into English and presented these facts to you and gave you all of the things about the history of C-sections, the pros and cons of VBAC, uterine rupture signs, and all of the things, so check out our course. 


    Then, of course, check out our Instagram and Facebook. We are always putting information out there and learning from our community on our Q and A’s on Thursdays. Other than that, I just wanted to thank you guys for being here and of course, Julie, thank you for being with me. I always love when I get to see your face and record with you. It’s just something I miss all the time. 


    Julie: Yay. Always a pleasure. 


    Perfect, well thank you so much for having me. It’s always fun. 


    Closing


    Would 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/donations

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    38m | Mar 4, 2024
  • Episode 278 Rebecca's CBAC + What To Do With a Swollen Cervix

    We love hearing stories of how our Women of Strength navigate birth in an empowered way, no matter the outcome. Rebecca’s story shows how she carefully selected the most supportive homebirth midwife, created a safe birth space in her home, labored hard and beautifully with her husband, took time to process information, assessed her situation, and consented to her second Cesarean when the time felt right to her. 


    Meagan also talks about the different types of positioning and some signs that your baby might be in a less-than-ideal position. Rebecca and Meagan discuss tips and tricks to help prevent a swollen cervix and what options you have if that happens to you!



    Additional Links

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Timestamp Topics

    01:54 Review of the Week

    04:31 Rebecca’s first pregnancy

    07:25 Consenting to an unexpected C-section for breech presentation

    8:53 Fertility Fridays

    11:02 Sparked interest in VBAC and getting pregnant again

    13:53 Planning for a HBAC

    18:00 Tachycardia and GBS positive

    21:27 Early labor

    24:18 Calling the team

    30:10 Laboring through the night

    39:02 Making the decision to transfer

    44:53 Consenting to a C-section

    46:43 Tips for when things don’t go as planned

    50:43 Signs of wonky positioning

    53:31 What to do

    57:00 Why you shouldn’t skip the repeat Cesarean stories



    Meagan: Hello, hello. It is Meagan with another amazing story on The VBAC Link podcast. Thank you so much for listening to us, you guys. I love this community. I know I talk about it. I know it’s weird that I don’t even know you, but I love you. I love you so much and I’m so glad that you are here with us today. 


    We have our guest today from, let’s see, Virginia. I think it’s Virginia. That’s what my mind is saying. 


    Rebecca: Yep. 


    Meagan: This is Rebecca, so welcome, Rebecca. 


    Rebecca: Thank you. Thank you for having me. I’m really excited. 


    Meagan: Absolutely. Me too. Her story, you guys, today is a repeat Cesarean story so if you didn’t know on The VBAC Link, we do share repeat Cesarean stories because they are important to share as well. I’m excited for you to share more about your story and we’re going to talk a little bit about swelling of the cervix at the end of this episode because this is something that we see and is a little bit of a part of your story. 


    01:54 Review of the Week


    Before we dive into the story and all of the things, we of course want to share a Review of the Week. This review is from shotsie3 and it says, “Amazing is not a strong enough word.” That is really awesome. I love that. 


    It says, “I cannot say enough good things about The VBAC Link. Listening to this podcast not only saved my mental health but gave me the knowledge and confidence to take control of my second pregnancy. After my home birth turned into a hospital transfer and Cesarean with my first child, I felt broken. When I unexpectedly found out I was pregnant just 7 months postpartum, I felt scared and lost. I was afraid of failing again and doubted my body’s ability to birth naturally, but I knew I absolutely could not have another Cesarean so I started obsessively researching VBAC. That’s when I found The VBAC Link. I’ve been binging episodes ever since. Listening to these stories has been incredible. Each episode is like giving a shot of confidence into the arm.” 


    Oh, I love that. A shot of confidence into the arm. We’re giving you guys a little vaccine of confidence. 


    It says, “Both my midwives and doulas have commented on how far my mental prep has come and I know it’s all thanks to The VBAC Link. Julie and Meagan have given me lots of tools and resources to control my birth.” 


    I love that. Control your birth. 


    “I am now looking forward to welcoming my second child via HBAC in just five short weeks. I want to shout it from the rooftop, ‘EVERYONE SHOULD LISTEN TO THE VBAC LINK!’”


    This review was a little while ago, so shotsie3, if you are still listening with us, which we hope you are, email us. Let us know how your birth went. 


    04:31 Rebecca’s first pregnancy


    Meagan: Okay, cute Rebecca, thank you so much for being here with us today. 


    Rebecca: Yeah, thanks for having me. I’m really excited to share. 


    Meagan: Absolutely. Well, I’d love to turn the time over to you. 


    Rebecca: All right, well I guess I’ll start with just a little recap of my daughter’s birth who is my first C-section. My daughter was born in January of 2021. We got pregnant with her during kind of the height of COVID. That pregnancy went really smoothly other than it was COVID times so of course, my husband couldn’t come to any of the appointments or anything like that. 


    I didn’t really do much prep with her because I wasn’t going to go to a birth class. There weren’t a lot of resources available. All I really did was watch some YouTube videos. I kind of knew I wanted to try to have a natural birth, but I didn’t prepare that much for it really. I read Ina May Gaskin’s Guide to Childbirth and stuff, but I didn’t do too much preparation. 


    She went to 41 weeks with no complications. I didn’t want to be induced, so my OB was like, “We’ll go to 41 weeks and then we’ll bring you in for an NST and an ultrasound.” So we went in on January 10th for her NST. She passed that with flying colors and I had asked them if they would give me a membrane sweep before they would induce me. They said they could try that, so they were going to come in and give me the membrane sweep, but luckily, one of the doctors there was like, “Well, let’s do her ultrasound first just to make sure that everything’s fine because that just makes sense before going down there and doing the membrane sweeps.” 


    They did the ultrasound and she was like, “Did you know your baby’s breech?” I was like, “No, I did not.” 


    Meagan: News to me. 


    Rebecca: Yeah. Every time the OBs would very quickly, I will say, very quickly palpate me, they’d be like, “Yep. Feels like she’s head down. Everything’s good.” She was like, “Yeah. She’s breech so we’re going to go ahead and schedule a C-section for today at 4:00.” It was around 11:00 or something when this happened, so I just immediately started crying because I did not want a C-section. That wasn’t what I was planning for at all. 


    She was like, “Well, we don’t do the (ECV)s here.” Is that what it’s called? (ECV)? Am I saying it right?


    Meagan: Mhmm, yeah. 


    Rebecca: Yeah. She was like, “We don’t do that here. Your amniotic fluid is kind of low, so yeah. This is your option.” 


    Meagan: I wonder why they don’t do it there. 


    Rebecca: I don’t know. She just said that they don’t offer that service. I guess I didn’t really know to ask for a second opinion or to see what other– I was just like, “Well, she’s telling me that this is my only option,” so we consented to the C-section which was really disappointing. 


    07:25 Consenting to an unexpected C-section for breech presentation


    Rebecca: My husband had to go home and get a hospital bag ready because we didn’t bring it with us or anything. We were like, “Oh, we will have time to go back if they are going to induce me.” I don’t know. We just weren’t prepared. Anyways, around 4:00, she was born via C-section and it was uncomplicated. It was uncomplicated. She did well. She did have some hip dysplasia because she was frank breech and they think she was probably frank breech for a long time, so her hips and the bones weren’t in the socket at all. But other than that, she was completely healthy. 


    But yeah, I remember that night kind of laying in bed with her nursing, and my husband was asleep. I just was quietly sobbing because I felt like everything that I was looking forward to kind of got ripped away from me and I didn’t really have a choice in the matter. 


    So I never got to experience one single contraction or any of that with her. I didn’t even really have Braxton Hicks with her. It almost felt like there was no closure to the pregnancy. It felt like I should still be pregnant. I definitely, yeah. That was a struggle. That was a struggle for a while afterward kind of trying to find closure of that whole experience because it was just like, “Okay, you’re pregnant and now you’re not pregnant.” There was no transition. That was her story. 


    8:53 Fertility Fridays


    Actually, to be honest with you, shortly after her birth, I was kind of like, “Well, if we get pregnant again, I think I’m just going to do a C-section again because I know what to expect. My body’s already been through it. You know, I think I’m just going to do a C-section again.” That was kind of what I was thinking. 


    But as I went on throughout my postpartum time, when I got my period back, I noticed throughout the year that I had some weird issues. I was spotting a lot all throughout the month and just different things were happening that I was like, “This doesn’t seem quite right.” When I went to the OB about it, they were like, “Oh, it’s fine. Your body is probably just getting back into the swing of things.”


    But it would be like, “Okay, well I’ve been postpartum for a while now.” This was two years down the line. I think that there’s probably something going on that needs investigating. They were kind of like, “No, it’s fine. It’s fine.” 


    I ended up finding a podcast actually called “Fertility Fridays”. I don’t know if you’ve heard of it, but it’s really awesome. 


    Meagan: I haven’t. 


    Rebecca: It just teaches women about their bodies. How to track your cycle and what your cycle means, and how to know if you’re actually fertile at that time because that’s another thing. It took us a year to get pregnant with Emma Jean. I was also afraid, “Well, it took us a long time last time. Maybe something was wrong.” 


    I just got really into body awareness and women owning their bodies and the different choices that we make and that our bodies have all of these natural processes that we don’t even really know about all of the time because we are not educated about those things. 


    Meagan: Yeah. 


    Rebecca; So as I educated myself on how my body worked and all of its amazing processes, I also became really interested in physiological birth again. It re-sparked my interest in that and my passion for that. 


    I kind of was like, “Well, my body is set up to do all of these amazing things. Why don’t I let it do that? If I do get pregnant again, I do think I want to try to have a VBAC and let my body do what it’s supposed to do.” 


    11:02 Sparked interest in VBAC and getting pregnant again


    Rebecca: That kind of sparked my interest back into the VBAC and the physiological birth. I got pregnant again in, I guess it was September of 2023. It’s 2023 now, right? 


    Meagan: Mhmm, yeah. 


    Rebecca: It was 2022 that I got pregnant again with the first time trying because I had used these methods that I had learned to actually know, “Hey, I’m fertile on these days.” Unfortunately, that pregnancy did end in a miscarriage so we miscarried that baby in November around this time of year. That was also crushing, but luckily, we started again in January, and again, right away, the first time we tried, we got pregnant again with my son, Arthur who luckily is here with us today. 


    We got pregnant with him in January of 2023 and that was a pretty scary first trimester because I was definitely worried about miscarriage and things of that nature. But as soon as we got pregnant with him, I started listening to The VBAC Link. I also just started to think about, because you guys talk about it all of the time, finding a provider that was friendly to VBAC, truly friendly. 


    Meagan: Yes. 


    Rebecca: Based on my experience with my OB that I was with, I felt like they were tolerant of VBAC but not necessarily supportive. I figured with her, I went to 41 weeks and I hadn’t experienced a single contraction. I think they would have been like, “Well, if you don’t go into labor by 39 weeks, it’s going to be a repeat Cesarean.” 


    I wanted to look for other options and one of my friends had a wonderful home birth for her second child and she recommended Kelly Jenkins who is Blue Ridge Birth. 


    Meagan: What city are you in? 


    Rebecca: I’m in Winchester, Virginia and she works all throughout the surrounding area so the Northern Virginia area. 


    I called her around 7 weeks. I was like, “I know it’s kind of early.” She was like, “No. This is perfect timing because I’m already almost full for October,” which was when I was due. She was just really great about going through all of the fears and concerns we have as VBAC parents going into a home birth. She just made me feel so comfortable. She was just really thoughtful with all of our questions, had a lot of stats and evidence, and just really practical which was what I was looking for. Somebody who really was practical and knew their stuff, but also wasn’t necessarily a traditional OB. 


    13:53 Planning for an HBAC


    Rebecca: We ended up signing on with her for our care. She would come to our house at the normal time and an OB would come and spend a whole hour with us and just answer all of our questions which was awesome. 


    Meagan: Wow. 


    Rebecca: I never felt like, “Oh, well you’re a VBAC so you are a huge risk.” Everything was just supportive and always gave us all of the evidence for all of the choices we had to make all along the way. 


    I also did yoga throughout this pregnancy. I immediately downloaded the Spinning Babies yoga thing. We watched the Spinning Babies parent class because I was trying to do everything not to have a breech baby. 


    Meagan: Yes. 


    Rebecca: I went to the chiropractor a lot and yeah. I just tried to do everything with my posture and all of these things to make sure this baby was not going to be breech. That was my biggest fear. He never was breech, so that wasn’t the problem. 


    We also took a Bradley class. I have mixed feelings about Bradley, especially as a repeat Cesarean parent. 


    Meagan: Yep. 


    Rebecca: I think Bradley is really great, but I will stand on a soapbox just for a minute and say I also think Bradley is pretty dated and somewhat unfair to parents because it really does villainize any kind of drug or anything. Sometimes you have to do things for the safety of your child and I feel like it really villianizes using a lot of medical tools that sometimes you truly need. 


    Meagan: That are necessary. Interesting, yeah. 


    Rebecca: Luckily, we had a great doula who taught our Bradley class. It was Bethany Bagnell. She definitely gave it her own spin and kind of, I feel like, was more open-minded whereas if you read the Bradley book, I feel like he’s very stringent and I just feel like some of the things he promotes are a little bit outdated in my opinion. But I really liked her so it was a very informative class. We felt really prepared going into the birth. 


    18:00 Tachycardia and GBS positive


    We really didn’t have any complications until week– I guess it was 34 or 35. Kelly came to our house to do our normal check-up and the baby’s heartbeat was really fast. She called it tachy. She was really concerned about that and so we actually did go to the hospital to get an NST. They were pretty rude to us at the hospital. They were kind of like, “Why are you guys here? I don’t understand why you are here.” 


    We were like, “Our midwife–”


    Meagan: Just checking up. 


    Rebecca: You know, the heartbeat was really high. I don’t know. They just weren’t very kind to us while we were there. But anyway, they ended up not giving us the test that she asked them for. She wanted them to do an ultrasound and an NST and they refused to do the ultrasound. We ended up having to drive up to Laden to get the ultrasound. Everything was fine. His heart rate had settled back down and he looked fine. He was head down so we were happy about that. But that was the only little scare that we had. 


    The other thing that was a little bit of a complication but not a complication, just something that happened is we did test positive for GBS. That was not a big deal. We could get the antibiotics at home so it did not preclude us from having a home birth or anything. We did research a lot about that because we kind of wanted to avoid antibiotics so we did a lot of research to decide what the best decision was for us whether we wanted to do those antibiotics. 


    We decided we were just going to play it by ear based on how soon my water broke and different things. 


    Meagan: Signs. Yeah, all of those things are really good things to take into consideration. 


    Rebecca: Yeah, exactly. My urine was clear for GBS. It was just the swab so that was another good indicator that it might be okay. Then yeah, we were just going to kind of wait and see. I also went on a really stringent diet. I cut out white foods and a lot of the things that are shown to feed GBS then I added a lot of fermented foods and probiotics and stuff like that. 


    Meagan: Awesome.


    Rebecca: So those were really the only two little bumps in the road. The whole pregnancy, every time, she would palpate which would be a full belly map by the way. When the OB would touch my belly, it would be for 10 seconds. Kelly would actually go in and she would completely map out my belly and be like, “I can feel his neck here and his butt.” Every time she did that, she would be like, “He’s in a great position. He’s in a perfect position.” 


    We were really hopeful going into things. Of course, he did go over the due date but I kind of expected that because Emma Jean did the same thing. The difference with him was I had a lot of Braxton Hicks and I did actually have a few days where I had some prodromal labor or some episodes that I was like, “Maybe this is labor,” and then it kind of just fizzled out. 


    21:27 Early labor


    He went to 41 weeks and I was starting to get a little nervous that we might have to induce. I really didn’t want to do that, so the day that he was 41 weeks, I started feeling contractions every 10 minutes throughout the day. I was at work and I was just kind of breathing through them. They weren’t painful, but I was definitely like, “Okay. These are kind of timable, every 10 minutes or so.” 


    Right after work, I got together with some of my work friends and we went for a really nice, hilly, 3-mile walk and sure enough, by the time I got home from that, I was feeling contractions become stronger and closer together. They weren’t painful yet, but around the time that I was cooking dinner, I went upstairs and I went to the bathroom and I had blood all over my toilet paper. I was like, “Okay. That’s a good sign. Maybe I am in labor. Maybe this is finally it,” because we had a few episodes and we had been trying all of the things to get things going. 


    I told my husband, “Maybe things are really happening.” I texted my midwife and she just told me, “Go to bed early tonight. After you put your daughter down, go to bed and see if you can get some rest because it sounds like this might be it so try to get some rest.” 


    I got my daughter down and tried to lay down probably around– she went to be around 8:00 and I tried to lay down around 8:30. As I was laying in bed, I just couldn’t get comfortable. What it felt like to me was gas pains. I had always heard period cramps, but I was feeling very strong gas pains. I told my husband, “Maybe I just have gas.” He was like, “Your gas doesn’t come in waves like that. I think you’re having contractions.” 


    I was like, “I don’t know.” 


    Meagan: It doesn’t come in waves. 


    Rebecca: He was like, “You’re having contractions. I think you’re really having contractions.” So he started to time those and they were coming every 5-7 minutes and it was too uncomfortable for me to stay in bed, so I was like, “Well, let’s go ahead and go into the basement.” We have a nice finished basement and we were going to birth down there. That’s where we were going to set up the pool. I was like, “You can get the tub set up and I can kind of pace around and we will make sure we won’t wake up Emma Jean,” who is my daughter. 


    We came into the basement probably around 10:00 and pretty much as soon as we got into the basement, my contractions became strong enough that I wasn’t really feeling like I could talk through them anymore. I was leaning over the ball and breathing. My dog, Maggie, was right beside me. Her face is right next to mine the whole time. She was kind of starting to distract me so I was like, “Let’s call my dad to come get the dog.” I was like, “I think this is really happening.” 


    24:18 Calling the team


    Rebecca: We called everyone. We called Kelly and we called my mom and my sister who were going to help and attend the birth. Everybody just started rolling in. My dad came and got the dog. My mom and sister came and then Kelly was coming around midnight. By the time Kelly got there, I was definitely like, Rick was already helping me out with counterpressure because my contractions were so strong in my back. Everything was in my back, not in my abdomen at all. I remember in the back of my head, I was like, “Man, I remember that means position.” 


    Meagan: Usually. 


    Rebecca: It’s probably not what it should be. Kelly, on the phone, had told me to try to do some of the Miles circuit. I had been working through that a little bit when she showed up. When she showed up, I was on the bed in the head down position with the butt up which is part of the Miles circuit and my water broke. 


    My water broke right around midnight when she arrived and that was really cool for me because I had not gotten to experience that with Emma Jean so that feeling is still something that I think of fondly because I never got any of that with my first daughter. 


    Kelly was like, “Just so you know, your contractions might pick up now because your water is broken.” I was like, “Okay,” and they definitely, definitely did pick up. I feel like I almost didn’t even go through that early labor stage. I feel like I kind of went straight into that active, you’ve got to focus. You’ve got to breathe. My husband had to be right there with me with the counterpressure. Things were pretty strong. 


    They were tolerable and I was excited, so I wasn’t like, “Oh, this is really painful.” I was like, “Oh my gosh. It’s happening. This is all happening.” That really, I think, helped with the pain tolerance. I was excited for it. But for most of that part of labor, I was leaning over the bed or the couch, and my sister, I would hold her hands and look at her. My husband would be behind me with the counterpressure. They were getting the tub all going and everything. 


    Then Kelly was like, “Do you want me to check you?” I let her check me, but I told her not to tell me how dilated I was. She checked me and she was like, “Well, he’s really, really, really low. I can already feel his head. You’re almost completely effaced so that’s good.” 


    She didn’t tell me how dilated I was, but I was like, “Okay. He’s low. I’m effaced. Things are sounding good.” Then the nurse got there and we had to decide if we wanted to start the antibiotics for the GBS. My water had broken so I was kind of like, “Um, I don’t know. Let’s see.” Then I asked Kelly, “Can you just tell me how dilated I was so I can kind of get a sense of how much time we have?” 


    She said I was only at a 1. I was kind of disappointed by that, but I was like, “I haven’t been laboring that long. I know that dilation can come really quickly. It’s not the only thing. I’m effaced and he’s low,” so I didn’t let it get me down, but we did decide to go ahead and run the antibiotics. 


    She hooked me up with those and I was able to still be in the tub and everything. She just covered it with a dressing and a plastic so I could be in the tub. I did get in the tub at that point. 

    I got in the tub probably a little after midnight. I don’t know the exact timeframe. 


    The tub was nice, but my husband hates baths so at first, he was like, “I’m not going to get in the tub with you.” I was like, “Okay, well I need your counterpressure so buddy, you’re going to have to.” 


    Meagan: Get in.


    Rebecca: Yeah. I went through a few contractions in the tub without him in there with me and to do the counterpressure, I would press my butt as hard as I could against the bottom of the tub. I was like, “This is not cutting it. You’re going to swim with me now. Get in.” He did. He got in. He’s kind of a germaphobe which is part of him not liking tubs thing. 


    Meagan: Okay, fair. 


    Rebecca: He got in with me and he did what he needed to do. He was awesome. Basically, I would just press against– I was lined up against his pelvis and I would press my butt into him as hard as I could because every contraction felt like my butt would fly apart if I didn’t have somebody holding it together. 


    Meagan: I  can totally relate. I was in labor. I was like, “He’s going to come out my butt.” Everyone was like, “No, he’s not.” I’m like, “Yes, he is.” Those posterior babies. 


    Rebecca: Yep. It just felt like my butt would fly apart if no one held it together. That was how I was getting through each contraction. 


    I labored in the tub for a while then I had to use the bathroom so they were like, “You should labor on the toilet for a while. People love laboring on the toilet.” So I was like, “All right.” I did not like laboring on the toilet. 


    Meagan: Dilation station. 


    Rebecca: I think I just really needed my husband’s body. I don’t know why. I needed to be pressed against him in some form or another. He was definitely my rock through that whole thing. He was really good. He read The Birth Partner book and everything. He really was with me 100% of the way which is another reason I’m so thankful that I got to labor this time because the bonding between the two of us going through that together was just something that I could never replace. It was just amazing. 


    30:10 Laboring through the night


    Rebecca: We kind of went back and forth between the tub and the bed and doing different things. Everything was going well. I remember asking people what time it was a few times and I was like, “Man, the night’s really going by quickly. I feel like I’m laboring really hard, but I’m managing and everything was going well.” 


    We labored all through the night until my daughter woke up at 7:00 in the morning. I wanted to say goodbye to her before she went off to school to daycare. I waited for a contraction to end because I was like, “I don’t want her to come down here while I’m acting crazy.” When the contraction ended, I called up to my mom. I was like, “Bring down Emma Jean.” She was so cute. She was like, “You’re swimming? You’re in the pool? What’s happening?” I was like, “Yeah. Your brother is coming. Kelly is here,” and she was really excited that Kelly was here because she got to know her throughout the pregnancy. She was really excited. She gave us a kiss and we told her, “Probably when we pick you up from daycare, your brother will be here,” so it was really cute. Then my mom took her. She took her to breakfast and was going to take her to daycare. 


    Basically, as soon as she left, that was my permission to make as much noise as possible. 


    Meagan: Let it go, yep. 


    Rebecca: Yeah. My contractions were starting to be really, really strong. I was starting to feel pushy and I was having to basically roar through them. I was really fighting it. I was sounding angry. I was kind of roaring through them with sort of gritted teeth which I know is the opposite. You’re not supposed to grit your teeth. You’re supposed to let your jaw be loose and all of that. I was definitely roaring through those contractions. 


    At that point, Kelly was like, “Look, it seems like you might be getting kind of close. Let’s check you again and see what’s going on.” 


    The intensity of where I was and what I was doing to get through the contractions, I was really expecting and hoping that she was going to say I was maybe a 9 or a 10. She told me later she was fully expecting to tell me, “You’re a 9 or a 10.” But when she checked me, I was only a 4.


    That was kind of crushing to me, but I was like, “Okay.” Actually, I told her not to tell me at first. I was like, “Don’t tell me. Again, don’t tell me unless it’s time to push.” 


    Meagan: Do not tell me, yeah. 


    Rebecca: She said, “Okay, it’s not time to push.” The way she said it, I was like, “Something’s weird. Something’s wrong.” She was like, “I really need you to relax. We’re not going to get back in the tub. I want you to lay in the bed. I want you to be in a side-lying position.” She put me in very specific positions and she was like, “I really need you to rest and relax.” 


    33:09 First signs of swelling


    I was kind of like, “Okay, something is weird,” so I just asked her. I was like, “Well, what am I at?” She was like, “You’re only at a 4.” I was like, “What? I’ve been laboring all night intensely.” She was like, “And the baby’s head is already trying to come through and his head at the top is starting to swell a little bit,” which they called a caput. 


    She was like, “So you know, he’s good. His heart rate’s good. Your heart rate’s good. I’m not worried, but we do have to keep an eye on that.” So she was like, “I’m going to have you go through some different phases of the Miles circuit to see if we can change his position a little bit, get him off your cervix a little bit,” and things like that. 


    I was not able to get those really strong counterpressure that I needed from Rick in that side-lying position, so I was like, “Let’s get some music going. I need some kind of distraction.” I’m a singer. I love to sing and I play music and stuff so we put on our wedding playlist. We were just both lying on the bed. I had him get my comb for me so I could squeeze it and I was just singing through our wedding songs. That was actually a really beautiful part of the labor for me. I was sitting there and singing through our songs. It was kind of a chance to just be quiet and think about things. 


    I just kept saying in my head, “Okay. Dilate. Dilate. You’re going to dilate,” and thinking that over and over again. 


    She had me do 30 minutes in each of these different positions. The one with the head down and the butt up was super uncomfortable I think because my neck was hurting. I was so ready for that to be over. 


    After we went through those, she was like, “Okay, let’s get you up and get you moving again.” This was probably at least an hour later that she was like, “Let’s get you up off the bed and we’ll just move around.” 


    Rick and I danced around. Every time a contraction hit, I would just squat down really low and he would squat down and hold me in a chair almost and just hold onto me, then we would sway and dance. 


    Meagan: How cute. 


    Rebecca: Yeah. It was really special. We did that for probably another half hour, then it was time for me to get another round of the IV which I guess I had been getting every 4 hours is what that generally is. Kelly was like, “How about we do another round of the antibiotics and then I’ll check you again because it will have been about two hours more or so. We will see if you have progressed and what is going on.” 


    At this point, I was starting to feel a little discouraged. I remember I was sitting on the birth ball and Bethany, the nurse, was giving me the antibiotics. I just remember looking at Rick and I was like, “I’m trying so hard.” I was tearful. I was like, “I am trying so hard. I know that I’m a good mom.” He was like, “You’re the best mom.” He was crying and I was crying. He was like, “We’re going to get through this and we’re going to do what we need to do.” 


    Throughout my whole pregnancy, I had told him, “If I don’t get a VBAC, it’s going to be so hard for me. It’s going to be really crushing for me.” His perspective on it the whole time was always like, “Look. We’re going to make the best decisions possible with the information we have.” He was like, “Hopefully, that is you getting your VBAC, but if it’s not, it’s because we had to move to the next plan because it was the best decision.”


    He was kind of like, “Look. That’s the same thing. We’re going to make the best decisions with the information we have. You’re a great mom and you’re doing a great job. I’m so proud of you.” That was just really special. We were just going through the emotions. 


    After we got the antibiotics, she checked me again. I want to say this was around 10:00 in the morning and she was like, “Becca, you’re still a 4.” And she said, “Now, your cervix is swelling.” She said, “Look. You know, you’re not in danger at this point. The baby’s not in danger. This is not an emergency. But, I can’t tell you that if you keep going for a few more hours, you’re going to have your baby here. I don’t know.” She was like, “Chances are your cervix will continue to swell. You’ve also been in labor for a long time. You’re getting tired.” She just kind of started to talk to us about hospital transfer. 


    She was like, “Maybe if we go to the hospital and you get an epidural and you can relax and maybe we can try some different positions with the epidural and get the baby to come off the cervix some.” 


    We started talking about it and I remember I was going through a contraction on the edge of the bed. I had my arms up on the bed and I was just sobbing. I was like, “I tried so hard. I’m trying so hard.” But I remember as soon as I found out I was still just at a 4 and that my cervix was swelling, it is very mental because my tolerance of the contractions, my pain tolerance, just went down. 


    Meagan: Yeah. 


    Rebecca: All of a sudden, they just felt so much more painful because I was going from being like, “Well, maybe I’ll meet my baby any second,” to “Who knows? Who knows what’s going to happen?” 


    Meagan: Starting to feel the defeat and doubt. 


    Rebecca: Exactly. We talked about it and we were like, “Well, we could labor here for who knows how long and still need to transfer, or we could go ahead and transfer and try something new.”


    39:02 Making the decision to transfer


    We made the decision to transfer. Luckily, I only live 5 minutes away from the hospital, so it wasn’t a super long process to do that. We already had our hospital bag packed this time. I was ready with that. I had my hospital bag packed. I had my C-section plan just in case. I had my hospital plan just in case. I at least felt ready to go. 


    Nobody said, “You have to transfer.” It was our decision. We felt like we had the information and we made the decision together. 


    That part of going to the hospital, I remember just wishing I could turn these contractions off now because now, getting in the car, not having the counterpressure, all that, and the funny thing was we walked out onto our patio. I had a contraction on the side of my patio and of course, my neighbors drive by and roll down their windows and are like, “How’s it going?” 


    Meagan: “Are you okay? How’s it going?” 


    Rebecca: Yeah. I was like, “Oh my gosh.” I love these neighbors. They are amazing, but I was like, “This is not what I want to be doing.” But we made it to the hospital. We got to triage. They strapped me all up. I was lying flat on my back in the most uncomfortable position, but basically, we got through triage and everything. From the time I got to the hospital to the time I got the epidural was probably still another hour and a half of labor at least. That was really tough. 


    We made it there. We got there. We finally got the epidural placed. I would say it was around noon when I finally got the epidural placed. I will tell you. I am all about natural labor and if somebody had told me, “You’ll have to labor 10 more hours, but you’re going to push your baby out and everything is going to be fine,” I would have found it in myself to do that.


    Meagan: Yeah? Yeah? 


    Rebecca: I will still say that epidural felt so freaking good. 


    Meagan: I bet. 


    Rebecca: It was just a warm wave of a warm tingling hug. As soon as I got the epidural, all of the pain just kind of melted away. I was like, “This is where we are so I might as well enjoy this for what it is and take this relief.” Yeah. The other thing was that the doctor was, I would say, VBAC tolerant for sure, the doctor on call. 


    He kind of came in and gave us a big spiel about TOLAC and did we know the risks. He was like, “Look, you can try for a VBAC, but if anything goes wrong, we’re not going to try to fix it. It’s just going to be a C-section because we’re going to play it safe.” I was like, “Okay.” I didn’t have any problems with him. He was a nice guy and everything, but as soon as he said that, I was like, “I have a feeling this is going to be a C-section. I think it’s just going to be a C-section.” 


    The nurse was very great. She put me on the peanut ball. She moved me around some different positions to try to get him to back off my cervix. When they checked me again, I was still a 4 even after that time. I labored with the epidural for about two more hours to the point where I was like, “I’m getting kind of bored and antsy. I sort of want to know what’s going to happen. What’s the plan at this point?” 


    At about two hours in, the doctor came back in and he checked me again. He said, “I could push you to a 5, but you’re still basically a 4.” He said, “Your cervix is very swollen.” He said, “I could give you Benadryl or something like that for the cervix to come down.” He was like, “But I really don’t like to do that because at this point, whatever is happening to your cervix is a position thing. It’s a mechanical, positional thing.” 


    Also, the epidural slowed my contractions way down. They went from being 3 minutes apart to being 10-12 minutes apart. He was like, “I’d probably have to give you Pitocin to get this going again.” He was like, “I’m not comfortable doing that.” He basically said, “I recommend a C-section and that’s basically your option.”


    Meagan: I was like, “Okay. Can you give us a few minutes to talk it over?” He did. He left the room. My midwife, Kelly, was still there. She stayed on the whole time as my doula. She basically was like, “You know, I do understand what he is saying.” She was like, “I kind of wish he would have told you that earlier and not made you wait for two hours.” She was like, “I agree. It probably is positional and there’s probably not a ton we can do.”


    Oh, another thing he had said was that the baby was having some decels after my contractions. He was like, “You know, that can show us the baby is in a little bit of distress.” She was kind of like, “You know, I understand what he is saying and I’m not sure that I would give you any other advice. I’m not sure I would tell you anything different.” 


    My husband and I talked it over and we were like, “Let’s just meet our baby. Let’s just meet our baby now.” We had them go over our C-section plan and of course, they weren’t willing to do most of the things that we had on that plan. They didn’t have the clear drapes. There were just a lot of things that they weren’t willing to do, but they did agree that the nurse could take pictures of the surgery for us which was something I didn’t have with my daughter.


    Meagan: Which is nice. 


    Rebecca: Yeah. She took pictures for me and that’s pretty much the only thing, I think, that was really different. She took pictures of everything that happened. 


    44:53 Consenting to a C-section


    Rebecca: Around 4:00, we consented to the C-section, and then yeah. They just prepped me. My sister took a picture of me giving a thumbs up getting ready to go. She took a picture of my husband and his whole suit and everything. I was like, “Okay. Let’s just do this thing and get our baby now.” 


    I did shed some tears while they were rolling me into the OR and I remember the anesthesiologist well-meaning was kind of like, “What? Are you afraid of a C-section? You’ve already done this!” I know she was trying to be like, “There’s nothing to be scared of,” but I was kind of like, I even said to her, “I’m not scared. That’s not why I’m crying.” She was like, “Well, what’s wrong?” I was like, “I’m disappointed.”


    Meagan: This is not what I wanted, yeah. This is not what I planned for. 


    Rebecca: That was a little bit like, “Okay. Come on. Empathize a little bit here. There are lots of reasons why someone could be crying going into this.” 


    Long story short, the C-section all went to plan, but as soon as they did pull him out, they did say he was OP. He was sunny-side up and then they also said, “And he’s 9 pounds.” So he was pretty big. I mean, I could have pushed him out for sure but he–


    Meagan: Yeah, on the bigger side. 


    Rebecca: But he was in sort of a poor position which could be why I had the swelling and everything of the cervix. He came out and he was really, really healthy. Once we got to the recovery room, he nursed right away. He was definitely a hungry little boy right from the beginning so that was awesome. He latched right on and nursed and everything. 


    Yeah, that’s pretty much the story. 


    46:43 Tips for when things don’t go as planned


    Meagan: You know, it’s so interesting how we have these things. We go through all of these things and we end sometimes in the way we didn’t want, right? 


    Rebecca: Yeah. 


    Meagan: I’ve been there too, not nearly as intense as you. You went through a lot. I just had an unsupportive provider from the get-go. I ended up walking down to the OR in general, but we have these experiences, but we still grow from them. 


    Rebecca: Absolutely. 


    Meagan: I mean, I heard little nuggets within your story like bonding with your husband, having faith in your body, working through it, experiencing labor, having support, but are there any other things that you would tell our Women of Strength, our listeners, especially if something doesn’t happen exactly as planned? 


    Rebecca: Yeah. There are a couple of different things. The first one was all throughout when I was prepping for labor in particular, especially for dealing with pain, the word that kept coming up and coming up was surrender. I kept thinking, “Surrender to the contraction. Surrender to the sensation.” I always applied that very specifically to labor and labor pains, but I want people to take it a step further and just be like, surrender to your birth however it’s going to happen because even if you do everything right and you do all of the steps, there are no guarantees in birth that you are going to have the outcome that you wanted. Even if you have a good outcome, most likely, there’s going to be something about it that was unexpected or wasn’t perfect so just try to surrender to the whole experience. 


    Yeah, of course, surrender to the contractions. Surrender to the labor, but surrender to the whole experience and the fact that you can’t control it. That doesn’t mean you are doing anything wrong. 


    Meagan: Yeah. 


    Rebecca: That’s the other thing. I hear it a lot in VBAC and I understand why people use this word, but I feel a little bit, I guess I would say use some caution in using it. A lot of people label their VBAC as a redemption or redemptive. You own whatever experience you have. I’m sure it is redemptive, but I guess what I would say is that we don’t need to redeem ourselves. There is nothing we did wrong that we have to have redemption for. Can the experience feel redemptive? Absolutely, but I don’t want women to then apply that to themselves like, “I need redemption because I failed at something.” 


    You are making the best decision for yourself and your child with the information that you have at that moment. That is what parenting is all about. You can’t control anything when you become a parent either. There are always going to be these little decisions you have to make that are unexpected or huge decisions. 


    I think that was the difference between this C-section for me and the last one was the last one, I didn’t feel like I had a choice. With this one, every step of the way, I was given choices by my midwife with my husband. We had time to talk through things. We had time to think through things. We made the choices that we felt were the best choices at the moment. 


    So those are the two things I would really say. Surrender to your whole experience because you have no idea what it’s going to bring and you don’t need redemption because you are already being the best mom that you can possibly be or the best birthing parent that you can possibly be just by being in the moment and making those good decisions with the information that you have. 


    Meagan: I love that so much. I love that so much. Thank you for sharing that. 


    Rebeca: Yeah, absolutely. 


    50:43 Signs of wonky positioning


    Meagan: I want to dial into that. The swelling of the cervix, the “stalling” of this labor and I’m putting it in quotes, but it does happen and sometimes despite all of our efforts, it doesn’t change and sometimes it does change, but I wanted to talk about the swelling of the cervix and what that really means and what kind of signs we can look out for to know that we’ve maybe got a baby in a wonky position that could cause a swollen cervix and then what we can do. 


    I mean, just like you were talking about, we were talking about how you just needed your husband to hold your butt together. That is a sign. If we are having all back or butt labor, that could mean a sign that a baby is in an OP or occiput posterior position. That doesn’t always cause a swollen cervix or a delay or a stall in labor or anything like that, but it can.


    Another position is called asynclitic and that’s where the head is kind of tipped to the side a little bit and we’re not coming down with a nice chin-tucked position into the pelvis. Another one is where the chin is extended or we’re in that military position. I’ve also seen it sometimes in a transverse. It’s like a transverse asynclitic. I don’t know exactly what that one is where the head is back, the chin is up, and we’re in an asynclitic position. We’re not looking straight up. 


    Those are positions that may mean our babies are in a less-ideal position. Some of the things are prodromal labor beforehand. You had mentioned that. That means sometimes there is a baby that needs help getting in a different position or a back labor or a butt labor. A coupling pattern where there are two contractions and then there is a big break and then there’s a big strong one. Our body is trying to get that baby to rotate. 


    Rebecca: Yep. I did have really long contractions and I did have some double peaks so that makes sense to me.


    Meagan: Yes. Yes. I call them coupling contractions where that’s what they can do. Our body is brilliant. It’s trying to rotate these babies and work with us, but sometimes, it’s more difficult and sometimes we have to help our body by rotating and moving and working with the pelvis in things like this. 


    53:31 What to do


    Some of the things we can do, it sounds really weird and I saw this from a nurse years ago and I was like, “What is she doing?” Then I was like, “Oh my gosh, it worked.” We had an anterior lip where it was swelling on the one side. She said, “I want you to get in the biggest fetal position that you can, the tightest fetal position.” We’re holding her even around and imagine a 9-month belly. So it was a little difficult to wrap ourselves around it, but we brought knees all the way to her chest, had her wrap around her knees like this and she laid there. We had to do a lot of counterpressure. 


    Rebecca: Yeah, I can imagine. 


    Meagan: Because that was not a comfortable position. We did five contractions like that and it was hard, but she said, “I want to do it. I want to do it.” We got into it with lots of counterpressure then we did, I don’t know what you call it, but we did the throne where you sit up feet to feet, knees out, but after that contraction, she got a check and the lip was gone. 


    That was something that was kind of cool that I had never heard of. I had been a doula for years then I saw this and I was like, “Huh, okay.” I haven’t seen anyone do that. 


    Rebecca: Yeah. I read a lot of the books and I didn’t see that anywhere. 


    Meagan: Never saw it anywhere, but yeah. This nurse here in Utah was like, “I know just the trick.” She did it and I was like, “Whoa, okay.” Yeah. Some people will say that sometimes ice, there is a circulation issue and sometimes ice can actually stop circulation. Sometimes ice isn’t the best and then Arnica or Benadryl. You mentioned Benadryl that they wouldn’t give you but they mentioned it. I don’t even know how to say the word. It’s actually something that I just was talking to a labor and delivery nurse in our community who wants a VBAC. It’s Cemicifuga. I don’t even know actually, you guys. I don’t know how to pronounce it, but those, I’ve seen arnica, out-of-hospital midwives will use or getting into a tub. Sometimes that can or sometimes an epidural because it can offer relaxation. 


    But then that always and then yeah, just moving, moving, and working with position. But then sometimes, despite all of our efforts, just like cute Rebecca, for whatever reason it doesn’t change. That’s when we have to surrender on our whole experience and make the choice that is best for us at that point. If that’s a repeat Cesarean, that’s a repeat Cesarean. 


    Repeat Cesareans can also be healing. 


    Rebecca: Yeah. I would say this was because I definitely felt totally different about the experience afterward. I still mourned it of course and you will, but I felt much more empowered and I got so much out of just going through the labor process that I wouldn’t give it up for the world. It still was healing for me for sure. 


    57:00 Why you shouldn’t skip the repeat Cesarean stories


    Meagan: I love that. Well, thank you so much for sharing your stories with us, being here with us today, and talking about swollen cervixes. 


    Rebecca: Yeah. I hope people actually click on this. I know when I was preparing for VBAC, I was kind of guilty of, “Oh, a repeat Cesarean, I don’t want to listen to this one.” So again, hopefully, people will be open because you never know what your story is, or maybe you’ll come back and find it after you’ve had a repeat Cesarean and feel proud of yourself for everything that you did because I think hearing these stories after you’ve had a repeat Cesarean could be really helpful. 


    Meagan: Absolutely. Just like they are helpful after having a Cesarean and preparing for a VBAC, after having a repeat Cesarean, these stories can be very healing and validating as well. These stories, I know that there are so many people out there who won’t click or will avoid them because they don’t want to even think or go there, but a lot of these stories with repeat Cesareans actually offer tools that can help heal if that does happen and ways that you can prepare for if that does happen because it’s any birth. I mean obviously, look at all of us. There are hundreds of us and thousands of us who have had an unexpected Cesarean. We weren’t planning on that 


    Rebecca: No. 


    Meagan: So preparing before for all outcomes is so powerful. 


    Rebecca: Definitely. Definitely. Have that backup plan because I didn’t even have one at all for my first and I was really glad I had it for my second. 


    Meagan: Yes. Oh, well thank you again so much for being here with us today, and congratulations on your baby. 


    Rebecca: Thank you. Thanks for hearing my story. I love what you do and I think it’s really, really important, so thank you. 


    Meagan: Thank you. 


    Closing


    Would 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/donations

    Advertising Inquiries: https://redcircle.com/brands
    59m | Feb 28, 2024
  • Episode 277 Clair's VBA3C + PPROM + Close Pregnancy Duration

    Happy podcast Wednesday, Women of Strength! You do NOT want to miss today’s episode. Clair shares her beautiful journey to a VBA3C. After fully dilating and pushing for hours but ultimately ending in C-sections with her first three babies, Clair finally had the vaginal birth she so badly hoped for with her fourth! Clair shows just how powerful birth can be when a woman’s intuition is combined with informed consent and an open-minded birth team. 


    There were unfortunately some technical difficulties during this episode and part of Clair’s third birth story was not recorded. Clair graciously submitted this written account below.


    24:08 “With my third baby (attempted VBA2C), I dilated quickly and smoothly, baby was descending beautifully, and I started feeling like it was time to push. I pushed for a long time - a couple of hours - and he was coming down, but slowly. We tried many different positions, moving around, etc… but it was taking a while. 


    Looking back, I was having some back labor and it’s likely that when my water broke on its own, he dropped into a posterior position. After several more hours, we could see his head! I thought a VBAC might really happen! But baby’s heart rate started having decels and having a hard time coming back up, so we decided to transfer to the hospital for monitoring. 


    I was pretty exhausted by that point, so I was hoping that IV fluids would help me regain strength and keep going. When we got to the hospital, however, they would only let me labor in the operating room because I was a VBAC patient, so I was very limited in mobility and my options. Baby seemed stable, but they were basically prepping for surgery from the moment I walked in the door and wouldn’t tell me baby’s stats. 


    We eventually called it, opting for a C-section on our terms so we could have delayed cord clamping and a calm environment. Baby boy was almost 10 pounds and had very healthy APGAR scores! I was disappointed I didn’t have a VBAC, but I felt respected by my midwife the whole way through. Postpartum physical recovery was difficult, but emotionally this birth was much less traumatic because I had a supportive birth team. I also took two intentional weeks to do nothing but be with the baby and rest, which I hadn’t done with my previous two births, and that made a huge difference in my mental health and bonding with my baby!”


    Additional Links

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Time Stamp Topics

    01:56 Review of the Week

    04:30 Clair’s first pregnancy and birth 

    07:50 Recovering from a C-section while moving 

    09:24 Getting pregnant at 3 months postpartum & dual care during COVID

    14:39 Laboring at home to complete & hospital check-in

    17:49 Clair’s second Cesarean

    19:08 An emotional recovery

    23:38 Third labor with a home birth midwife

    24:08 Pause in story – read caption!

    24:20 Fourth pregnancy 

    28:49 Moving to Utah 

    35:34 Midwifery care in the hospital

    38:47 Active labor begins

    45:04 Circumvallate placenta 




    Meagan: Hello, hello Women of Strength. We are at the end of February here and we have a story that I swear– VBAC after multiple Cesareans is very highly requested when it comes to this community so we have a story for you guys today for VBAC after three C-sections. Not only was it a VBAC after three C-sections, but it was also a pre-term VBAC after three C-sections. I think in a lot of places around the world if someone came in pre-term and they have had three C-sections, finding that support is going to be hard. It doesn’t need to be necessarily hard, but I know that it can be so I’m excited for this story from our guest, Clair, today because it’s a story that just shows that it is possible even if you have certain things stacked against you that the medical world looks at in a negative way. 


    01:56 Review of the Week


    So we are going to be sharing that story here in just a few minutes, but of course, we have a Review of the Week and this was shared on Apple Podcasts. It’s by brittleesmith. It says, “Highly recommend for both VBAC mamas and mamas in general.” It says, “In 2019, after 30 hours of labor, I ended up birthing my son via unplanned C-section. I was devastated and knew my future birth had to be different. I immediately started digging into VBAC resources and came upon your podcast. I listened to every single episode before I even became pregnant with my second baby. The knowledge I gained from both of you as well as your many guests is truly invaluable. This resource is great for any expectant parent, not just VBAC moms and I wish I had discovered you all before my first child. 


    “I am thrilled to announce that I got my VBAC this past February and I owe a lot of thanks to y’all. Keep it up, ladies.” 


    Oh, I love that. I love when people say, “We found you. We learned and then we got our VBAC,” or “We found you. We learned and I didn’t get my VBAC but I had a better experience.” This is what this podcast is here for to help people have a better experience, to learn the information, to feel more empowered to make the best choice for you, and even sometimes when the experience doesn’t go exactly as we planned, to still have a better experience because we know what our options are. 


    As usual, if you guys have not left a review, we would love them. They actually help Women of Strength find this podcast. They help people find the information and the empowerment for their births, do drop us a review. You can leave it at Apple Podcasts. You can even Google “The VBAC Link” and leave us a review there or wherever you listen to your podcasts, drop a review. 


    04:30 Clair’s first pregnancy and birth 


    Meagan: Okay, cute Clair. It’s been so fun. I just was scanning over your stuff and I was just excited because of all of the people you had at your birth, I know personally because you are also here in Utah. I’m so excited to hear your whole story and your journey. I just want to tell you congrats in advance because it is so amazing. So amazing. 


    Clair: Thank you so much. Yeah. We didn’t expect to be in Utah, but it turned out to be a really great place to birth so we are really grateful to be here. 


    My story actually starts on the East Coast thousands of miles away and I was due with my first in May 2019. I didn’t really know much about birth in general. I’m the oldest child and kind of a rule follower. I was like, “Well, if I just do everything the way I’m supposed to, then birth will just happen.” Yeah. I had a really supportive OB. He has several children of his own. His wife was a friend of mine. He was a really great doctor. 


    But at around 32 weeks, I was flying at the last possible second I was allowed to fly and running through an airport. I kind of felt the baby kind of settled in a weird spot after that. I started having prodromal labor at 39 weeks or something. That went on for about two weeks. What I didn’t realize was that these were all signs that maybe he was posterior and not in a great position. 


    My OB, even though he was really wonderful, wasn’t trained to determine where the baby is, just that the baby is head down. 


    Meagan: Right. 


    Clair: So at 41+1, early in the morning, I was over a week past my due date. I was losing my mucus plug. “Hey hon, we’re going to have a baby today.” I was so excited. We ended up laboring all day at home. We went to the hospital. I had really, really bad back labor so I ended up with a lot of IV fluids. I had a couple more interventions. They broke my water eventually and basically, what ended up happening was that 41+2, so 9 days after my due date, I had dilated to complete, but the baby wasn’t dropping at all. He wasn’t engaged. He was still really, really high and after a while, his heart rate wasn’t tolerating labor well anymore and they recommended a C-section. 


    Meagan: Did they have you push? 


    Clair: I didn’t push. Yeah. They said he was still too high. They didn’t recommend that. 


    Meagan: Interesting. Isn’t that how we get babies down? 


    Clair: Yeah. I’m not really sure. 


    Meagan: Yeah. Yeah. 


    Clair: It definitely was a situation he was not used to or prepared for. He was kind of surprised and honestly very sad that I didn’t have the birth experience that I wanted. He came to visit the next day and just spent a few minutes with us. His wife came to visit who I was friends with. It was really hard and pretty traumatic, but it also could have been much worse. His bedside manner, I was really well taken care of. 


    07:50 Recovering from a C-section while moving 


    So that was really hard. It was a challenging physical recovery because I had 48 hours of labor and most of it was without an epidural. It was really intense. The hardest part of that birth was that the first time I saw my son, I saw a picture of him that the nurses showed me because they took him away to be measured right away. So that was really hard. 


    He was 9 pounds, just that plus not being in a great position and being with a provider that didn’t have a lot of options of what to do if baby is not descending properly. That was a difficult adjustment to motherhood especially because that baby was born in Louisiana. We were moving back to Virginia where we have a lot of family and friends. We were planning on moving two weeks after the baby was born, but because he came late, we actually left the hospital and started driving north. 


    I would not recommend this. Don’t do it. 


    Meagan: That’s a lot. That’s a lot. 


    Clair: It’s a really bad idea. 


    Meagan: Oh my gosh. 


    Clair: His first night out of the hospital was in a hotel in Birmingham, Alabama. Yeah, don’t do it. So yeah, that was just hard because we were moving and I’m trying to physically recover. So it was pretty wild. 


    09:24 Getting pregnant at 3 months postpartum & dual care during COVID


    Clair: That was my first. My second– we surprise got pregnant three months after that baby was born. 


    Meagan: Okay. 


    Clair: He was a cycle zero pregnancy. I had no idea. I just felt off and was like, “Maybe I should take a test,” and I was so shocked that I was pregnant. 


    Meagan: Oh my gosh, yeah. 


    Clair: Like I said, we were in a new state. I found a birth center that would do my prenatal care because I knew midwives knew more about positioning and how to track it and maybe had some recommendations about things they could do to encourage baby to be in a better position because my pregnancy had been great. But because it was right around 12 months between deliveries, they wanted me to have co-care and deliver at a hospital. 


    I kind of just took their word for it like, “Oh, well if that’s what they are recommending, then the risk really must be that much higher.” So then in the middle of all of this, COVID happened and hospitals– I was due in May 2020. Hospitals were kind of changing their– 


    Meagan: Everything. 


    Clair: Yeah, but by the week it felt like. 


    Meagan: By the day. They were changing by the day. It was insane. 


    Clair: Yeah. It was crazy. So it was March. I was due in two months and I had just reached out to the birth center basically begging them to let me deliver out-of-hospital because I was like, “I don’t want to deal with the hospital system right now. I know that they are truly supportive,” but they said that they weren’t comfortable with that. 


    So my plan was to labor at home with the midwife from the birth center, laboring home with me then to transfer to the hospital while I was in labor. She was supposed to be– that midwife was supposed to come with me as kind of like a doula almost in the hospital just as support. 


    Meagan: Yeah. Yeah, a monitrice or whatever they call them. 


    Clair: Yeah, yeah, exactly. So then I had to find a doctor to do co-care with. I had a new friend in the area who had a C-section with her first and she had a not-great experience with this one doctor in the area, but that was the one that the midwives usually worked with so I kind of took her experience as, “Maybe not. I don’t want to work with him.” 


    I found someone else who was really VBAC-supportive historically, but then he had me do an ultrasound to determine scar thickness. This was all in the third trimester. Pregnancy was going really well, but in the third trimester, I had to start doing my appointments with him. Baby was actually breech pretty late on, so I started doing chiropractic care during that pregnancy and she flipped on her own. It was great. I was so grateful. 


    So then at that ultrasound, we determined that yes, she is head down. He was concerned about my scar thickness, although then I did a lot of research and was like, “I’m just not sure that this is actually evidence-based.” 


    Meagan: Yeah. 


    Clair: And then also, they were telling me that she was going to be 12 pounds. I carried a big baby a year before, literally to the day almost and I was like, “This feels just like my first. She’s got to be around 9. I don’t think she is that much bigger than he was.” 


    Meagan: Was the ultrasound saying 12? 


    Clair: Yeah, yeah, yeah, yeah. 


    Meagan: Okay, okay, okay. 


    Clair: Yeah. The ultrasounds measured it and I mean, spoiler alert– it turned out to be way off. She was 9 pounds, 3 ounces. 


    Meagan: Most of the time it can be. 


    Clair: Yeah. Yeah, especially with bigger babies later in pregnancy. I was in a fine headspace with that. I was like, “I know that this can be off. I’m not worried about it,” but they were really nervous and anyway, basically backed me into scheduling a C-section, but I pushed it as far down the due date path as I could because I had gone over with my first and I still really wanted a chance to labor. 


    So chiropractic care this whole time was really helping. I had bad hip pain with my first and I didn’t have any with her after that. They wanted to do another scan at 41 weeks later or another ultrasound at 41 weeks just to check on baby, but I got them to do a non-stress test instead because I was like, “What are we going to look at?” She was healthy at 40 weeks. 


    I was really glad that I had advocated for myself there because that was good. I did have one funky day of pre-labor at 40 weeks where I really thought I was going into labor. It was early labor then it stopped. I was checked after that and I was at 4 centimeters. I was walking around for a week and a half it turned out to be at 4 centimeters dilated so it was kind of interesting to know that that could happen. 


    Meagan: Yes. 


    Clair: The midwives I was with said they see that with VBACs a lot too that the body just takes things slower sometimes which was interesting to hear their experience of that. 


    14:39 Laboring at home to complete & hospital check-in


    But yeah, I went into labor at 41+3– or 41+2 I guess– which was when my son was born a year before. I was in early labor all day. My water broke as I was nursing my one-year-old for bed. 


    Meagan: Oh my gosh. 


    Clair: It was kind of crazy and exciting. I was like, “You’re going to meet your sister.” I put him down for sleep. The midwife came over. I labored from a 6 to a 10 in three hours. By 9:00 PM, I was fully dilated. She was dropping. 


    At that point, looking back, I wish I had just stayed home because she was almost born at that point, but I didn’t because I still had the midwife’s voice in the back of my head, “Oh, it’s only been a year. You’re at a higher risk for rupture.” I just was worried and at that point in labor is not the time to be making decisions like that. 


    Meagan: You’re very vulnerable. 


    Clair: Yeah. We ended up transferring. I get to the hospital. They stick a thing up my nose to check if I have COVID. 


    Meagan: Oh jeez, yeah. 


    Clair: So you’re in labor already really uncomfortable and they’re like, “We’re going to swab your nose.” You’re like, “Thanks.” They wouldn’t let the midwife in which we kind of knew, but she came with us just to see if they would let her in, but they were only allowing one support person so my husband came with me.


    I ended up getting an on-call doctor who wasn’t the doctor that I had been seeing. It actually turned out to be the first doctor that I was trying to avoid in the first place. 


    Meagan: Oh, really?


    Clair: Yeah, so that I was not happy about. He literally takes one look at my chart and says, “A VBAC? This baby is going to be 12 pounds? Don’t even bother trying.” I was like, “Um, okay.” 


    Meagan: You’re like, “But I’m 10 centimeters.” 


    Clair: Right. Everything is fine. I’m healthy. She’s healthy. Heart rates are all good. We’re doing it. It’s not a question of can I because it’s happening. But he started– I mean, I won’t tell you the things he was telling me about what happens if I should have had a C-section and I don’t and the whole dead baby thing. 


    The nurses were trying to keep him out of the room for me. It was so bad. It turns out later that he did talk to the midwives the next day and was like, “Why did you send her in at all? Why did you tell her she could VBAC?” Basically, he confided in them, “You don’t know what it’s like to be sued.” I guess he had something in his past where he had been sued for something that had happened, so he was just really scared but he was taking that out on me. 


    Meagan: Which is not okay. Understandable, but not okay. 


    Clair: Right, yeah. It took a long time for me to get over this and forgive him for some of the things that he said. 


    Anyway, so my body starts having a stress response. Labor starts slowing. My cervix starts swelling a little bit. Basically, my body is like, “We don’t feel safe here. We’re not having this baby here.”


    17:49 Clair’s second Cesarean


    I did push for two hours, but contractions weren’t really working the same way. He started talking about, “Well, if it’s an emergency, we have to put you under general,” and all of this stuff so I did end up getting an epidural. I basically got backed into a corner and eventually, we said, “Let’s just call it and have the C-section because we can do it on our terms and maybe get a couple of the things we still want.” We really wanted delayed cord clamping. I really wanted to be able to see her right away which I didn’t get to do with my son. 


    So we felt like if we just called it, we would be able to do some of those things because it wasn’t an emergent situation. So really, for no medical reason, I had my second C-section. She was 9 pounds, 3 ounces and the doctor actually said to my husband after that, “Oh, by the way, your wife has a fine pelvis. There is no reason she can’t birth vaginally. She can totally do this again in the future.” 


    Meagan: Oh gosh. 


    Clair: My husband was like, “I don’t want to talk to you right now about that.” 


    Meagan: Yeah, like get out of my face. 


    Clair: Yeah, after you just did what you did and backed us into surgery, and he just wanted to be able to control the situation. 


    Meagan: Yeah. 


    19:08 An emotional recovery


    Clair: So emotionally, it was really hard to recover from that. I had a really hard time just working through some of the things that he had said and the images he put in my mind, but it was physically a lot easier. 


    Meagan: Yeah. 


    Clair: We did move again after that baby, but we only moved within the state so that was easier. We move a lot and we’ve moved with every baby at some point which is kind of crazy. 


    21:22 Clair’s third pregnancy


    So that’s my second baby. And then about, I don’t know, 15 months later, we got pregnant with our third. We were pretty excited. We had a really early, early miscarriage between those two and it was still really hard and painful but it was like the day after we found out we were pregnant so that was a surprise and that made us think, “Well, are we ready for another baby?” I kind of just started like, “Yeah, actually I think we are,” even though at the time, I felt totally overwhelmed. 


    So that’s kind of beautiful because if we wouldn’t have had that baby, we wouldn’t have our third right now. We were in the same state. The VBAC laws in the state are pretty lenient so I end up having the opportunity to find a home birth midwife because I just at this point really did not want to go back to the hospital after everything. 


    There really weren’t any hospital practices that I knew of and I kind of looked around a lot that were VBAC-after-two-C-sections supportive. So I look around. I found a home birth midwife. I had a beautiful pregnancy. Kind of in the back of our head the whole time, we were thinking, “If we just stayed home with our daughter, things would have happened naturally. It just would have been fine.” 


    The whole pregnancy, I was a little bit nervous, but I had some really, really awesome supportive friends– the same friend who had a C-section and had a VBAC since then. She was so in my corner and another good friend of ours were just cheering me on the whole time. My midwife was really, really supportive. 


    I did have some fears and worries, but I was just like, “We’re just going to walk it out. I have no reason to believe I can’t birth this baby vaginally.” I was continuing chiropractic care. The friend who had a VBAC had since become a doula. I planned on having her there. 


    23:38 Third labor with a home birth midwife


    Clair: I went into labor six days after my due date after this pretty beautiful, smooth pregnancy in the early morning and then again, I was dilated to 10 by 9:00 in the morning. It was five hours later after my–


    Meagan: You labor beautifully. 


    Clair: Right. At this point, I was like, “I know my body can do this,” but I just had never made it all the way. I was starting to feel pushy. I pushed for hours and hours and hours which turned out to be really hard. The midwife, when I started pushing was like, “We’re going to have a baby so soon,” and then– 


    24:08 Pause in story – read caption!


    24:20 Fourth pregnancy 


    Clair: My son was nine months old when we got pregnant with our fourth. Like I said, we had moved to this mountain town in Colorado. We were far away from a lot of things, so it was really hard for me to find a provider in general let alone one who was going to be supportive of a VBAC after three C-sections. I was really open to if I needed to have a fourth C-section, I was open to that. I just wanted to do what was going to be best so I was looking at all of my options. 


    All of our family was back east though and we were looking at support after the baby was born so we were thinking we might go back to Virginia and have the baby there. I ended up doing remote care with my midwife from my previous birth, my last birth, for all of my prenatals. 


    Everything was looking great. The bloodwork looked great. I was taking my blood pressure and checking with her occasionally. I was doing that with her while also looking for a provider and trying to discern what we were going to do for the birth. 


    I should also mention that during this time, I started going to pelvic floor physical therapy. It had been recommended to me a few times, but I never pursued it before. My chiropractors in Colorado had a really strong recommendation for someone that they really liked, so I started going to pelvic floor PT. She found all of this chronic tension that I didn’t realize I had. Actually, my hip pain had come back this pregnancy and releasing my pelvic floor actually took care of my hip pain. It was all referred pelvic floor pain which was so wild, but I felt relief within a couple of visits. 


    She knew really good exercises to be doing during my pregnancy. It also made me more in tune with the rest of my body. I realized where else I was carrying tension and was better in check with my moods, so that was a huge game changer I think. I want to make sure that I mention that because I think that really, really impacted this pregnancy and birth. 


    So we did an anatomy scan at 20 weeks and everything was looking good. It was a baby boy, but we found out he was measuring big which is normal for my babies at this point. 


    Kind of around the same time, I guess, my husband got this really amazing job opportunity in Utah which meant we would have to move again. I was due in October with this baby and we would be moving during the summer. This time, we would move before the baby was born then hopefully have a couple of months to settle in. 


    Because of that, I switched gears and started looking for providers in Utah so that I could have a pretty seamless transition. I found a really awesome midwife. I told her my whole story and when we were in Utah just interviewing and checking it out during the winter, she heard all of my stories and said, “I don’t see why you can’t birth vaginally. I think you are an excellent candidate for VBAC. I would gladly take you on.” 


    Meagan: She is one of the most amazing midwives in Utah, too. 


    Clair: Yeah. She has a ton of experience, too. I love how she has that much experience, so I really felt like she has seen it all. She has seen a lot and if she says I have a really good chance, but also, I totally trusted her to step in if we needed to step in and try different things during delivery. That’s the one thing I felt like could have gone differently with my third baby was maybe we could have intervened a little earlier and maybe that would have gone differently. 


    She also promised my husband that she would be straight with him because he kind of had an experience of people trying to shield him from the truth or whatever in the past just to kind of protect him in the birth process. He just wants honesty, so she was like, “I’m going to be really honest with you the whole time. I’m going to tell you exactly what I think.” It was just a really good fit for our family.


    28:49 Moving to Utah 


    Clair: I went back and started packing up the house and everything, but I knew that I had a really solid provider waiting for me in Utah. We moved at the beginning of August. I was maybe 30 weeks or so, 29 weeks, 31 weeks, or something like that when we moved. I thought I had two months or so to kind of get settled and unpack the house and everything, then at about 35 weeks, I started having some pre-labor stuff and a few contractions, but I thought they were just really strong Braxton Hicks at night. 


    I lost a bit of my mucus plug and that was consistent for about a week, but because with my second, I had a whole day of labor and then nothing for two weeks, I thought, “Oh, I’ve still got two weeks. Baby will be here right at 37, but that’s fine. I think I still have a couple weeks left.” 


    I checked with my midwife and she was like, “Are you concerned about going into early labor?” I was like, “I don’t think so.” She goes, “Great. Don’t worry about it.” 


    To my surprise on a Sunday night at 5:00 PM coming back from the grocery store to pack lunch for my husband for his first official day of work the next day, my water breaks. I come home and I’m like, “I think my water broke.” He goes, “Uh, okay. This is really unexpected,” because with all of our other babies, I went past my due date and we had been in our house less than a month. 


    I called my friend who is a doula now. I was just kind of out of it. I didn’t really know what to do. She walked me through. “Okay, call your midwife. See what’s going on.” I called her and she was like, “We can check to make sure that your water broke, but if you are pretty sure, you’ve had several children so if you are pretty sure it’s your water, you should just go to the hospital.” 


    She told me exactly which hospital to go to which I was really grateful for because I had no idea where to go and I really trusted her recommendation. 


    Meagan: You were closer to a different hospital, honestly. You could have gone to this other hospital. 


    Clair: Yes. Yeah, exactly. I was so glad that I called her. I walked in and they were like, “Oh, your midwife called ahead for you. Great. Come here. Let’s check you out.” I was at a 5, so I was 5 centimeters dilated already which was crazy. They did an ultrasound just to double-check his position. He was head down which they were happy with. 


    This OB comes in who was on call. She sits down and just says, “Well, frankly, I don’t think a VBAC after three C-sections is too risky, but it’s just risk. I don’t see any health problems right now. You’re fine.” They hooked me up to a monitor. Baby was fine. “So we’re not going to force you to do anything that you don’t want to do. You’re going to make the call.” 


    We were really surprised because when we knew we were going back in a hospital setting, especially after our last two experiences, my husband and I were like, “Whatever happens happens.” He even said, which was so great, “Let me deal with them. You deal with the baby.” 


    Meagan: Mmm, yeah. 


    Clair: “You don’t need to go in fighting. I’ll go in fighting and you deal with the baby.” But then we didn’t even have to fight. They were disarmed right away.


    Meagan: Which is amazing because especially with preterm– 


    Clair: Exactly. I expected a frenzy and it wasn’t. It was peaceful. We just basically said, “We’re not going to do that. We’re not going to just do an automatic C-section. We’re going to labor.” They looked at my ultrasound, saw that he was measuring big, and said, “We actually would have changed your dates in our practice with this ultrasound so we think you are closer to 38 weeks.” 


    I was pretty confident in my dates because I had been using a monitor to check ovulation and everything. I still felt pretty confident that he was 35 weeks, so I really didn’t want to induce or make labor happen any sooner than it started because I knew that his lungs could benefit from another couple of days in utero. 


    We talked that through a little bit and the next day, there was a new on-call OB. The nurses were great. They listened to our whole story and they were like, “We are willing and ready and prepared to support you.” So the next day, we get a new on-call OB and she just says the same thing, “I don’t think this is a very good idea, but I’m not going to force you to do anything.” She listens to our reasoning both why we don’t want to induce and also about a VBAC and she goes and she calls the midwife who had been supposed to deliver or catch the baby. 


    She says to the midwife, “I actually don’t think this is a very good idea. Why did you send you here? It is really, really risky.” The midwife says, “It’s not as risky as you think it is. Actually, go do the research a little bit. There are not great numbers out there, but what we have isn’t what you are saying it is.” So that doctor actually called a maternal-fetal medicine doctor at a different hospital that she knew and asked, “Hey, what do you think about a VBAC after three C-sections? Would you recommend it for a mom?” 


    He basically gave her the statistics of the risk of complications with a fourth C-section versus the risk of uterine rupture with a VBAC and he said, “The numbers aren’t great, but as far as we can’t be 100% confident. We don’t have–”


    Meagan: Enough evidence. 


    Clair: “--a lot of evidence, but I would absolutely support her. It’s actually less risky for her to do this vaginally if she can.” This doctor comes back and tells us that. We were shocked. She said, “I actually think a VBAC is the best thing for you and your baby. I’m going to transfer you over to our hospital midwives–” which was wild and so not what we expected. She was like, “Because I think that’s more like the model of care you wanted.” We were just floored because we never– yeah. We never expected that from a doctor. We had never been respected in that way. That alone was just so healing. 


    35:34 Midwifery care in the hospital


    Clair: This midwife comes in and I chat with her a little bit. She made sure I got some food. I hadn’t really eaten much since I got there. 


    Meagan: I bet. 


    Clair: It was great. They just really attended to me as a person. I still was not in labor. They weren’t checking me because my membranes were ruptured and she just talked me through that. “There’s really not that much of an increased risk of infection if you are waiting longer as long as you are not doing checks. If you don’t have an infection already, you’re probably not going to get one essentially.” 


    We did lots and lots of things in that 24-hour period. We prayed. We asked for so many prayers from our friends. We called the midwife and chatted with her a bunch. My husband– I joke that he was my daddy doula during that time because we learned a bunch of things during our other pregnancies. We were doing a Miles circuit. We were doing Spinning Babies and abdominal lifts and everything we could think of. I was pumping. They got me a hospital pump to use. I was showering and trying to relax. 


    We even discussed leaving the hospital and going home. We talked that through with them, but I felt pretty confident that once I went into labor, it was going to be pretty strong labor and I was confident he was pre-term. I wanted to stay. My kids were able to come visit which was huge. That was so helpful. I did a lot of fear release conversation with the hospital midwife was a big deal. I was just really worried. My oldest was only four and I was really worried about, can I do this? Can I be a mother to these four babies? 


    It’s so much more manageable when you are pregnant. The baby is inside, so I think that was actually really helpful. I think that was kind of keeping me from labor in a sense. 


    We just kind of did that for the next day. I was sleeping, but I was continually being monitored so my sleeping was really fitful. At 2:00 PM the next day, my nurses from their first shift are back. They were like, “Oh no, you’re still here and you’re not in labor and there’s no baby. What can we do?” I just said, “I’m so tired. I just have not been sleeping well. Every time I roll over, this monitor messes up the baby’s heart rate with mine so people come flying in the room and I just can’t really rest right now.” 


    She talked with the hospital midwife who was on call that day and she really wanted to get things going. She was a little bit more nervous about the length of time my waters had been broken and was stronger with recommending inducing or something. She said, “Yeah. Let’s just get her off the monitors. We have two days of great readings from this baby. Let’s get her off the monitors. Let’s turn down the lights. Let’s get her in a new room, fresh environment, turn the lights down, and let her take a nap.” My husband even left. He went to go get a snack or something outside of the hospital just to totally give me my space.


    38:47 Active labor begins


    Around 3:30, I finally get tucked in for a nap and fall asleep immediately. I was so tired. 


    Meagan: I’m sure. 


    Clair: It was just a lot of mental stress and I wake up an hour later at 4:30 to a rip roaring, super strong contraction. I couldn’t even believe it. I was like, “Oh my gosh. Napping worked.” It was just what I needed. It was like my body just needed to be left alone. 


    Meagan: And even probably you mentally needed to just get out of the moment and just be. 


    Clair: Yes. Yeah. No, definitely. I start timing them and within five contractions, they were all lasting over a minute. They were all about a minute and a half to three minutes apart. I call my husband. I’m like, “You’ve got to come back to the hospital right now.” They were really strong too, like super, super strong. 


    Meagan: And keeping in mind you were 5 centimeters so you could be tipping into that transition active labor from no labor. 


    Clair: Right? 


    Meagan: No labor to active labor. 


    Clair: Yeah, just thrown right into it. Yeah, it was wild. I felt like I was kind of behind from the beginning like I couldn’t get on top of it for that reason. It was really intense. I called the nurse in the room because I needed to go to the bathroom and I wanted to stand up, but I was like, “I don’t know what’s going ot happen when I stand up, so I’m going to call her in.” 


    She came. She observed me in between some contractions and was like, “I think the midwife should come.” I was like, “No, it just started. Don’t worry. Don’t bother her.” She was like, “No, really. We should get the midwife in here.” 


    The midwife comes in and checks me. I’m only at a 6 so I was a little bit discouraged because it had been a half hour-45 minutes of these strong contractions at that point, but 90% effaced. Baby was dropping. Everyone in the room was like, “This is really good news.” I was like, “Yeah, there is still a lot of work to do.” I just refused to accept that. 


    So I’m kind of wandering around the room just laboring standing up in different positions and supported by a nurse sometimes, then I end up kneeling on the ground and laboring over a couch just leaning on it. The contractions really picked up. There really was not much of a break between them at all so I felt like I couldn’t release the contraction. 


    Everything you hear is like, “Release the contraction. Let all of the tension out of your body,” and I couldn’t do any of that. So I’m telling my husband, “I need an epidural. I’m not going to be able to do this for a long period of time. I’m not getting any kind of a break. I can’t relax.” 


    Meagan: You were already so tired. 


    Clair: Yeah. I need an epidural. I’m not going to be able to do this naturally even though that’s what I planned. He was like, “No, you’re fine.” I was so mad at him, but he would look at the midwife, I guess I found out later and she was like, “No, this is happening.” She was really encouraging him, so he was like, “Nope, you don’t need it. We’re going to be there really soon.” 


    Meagan: Good daddy doula, I guess, there. He knows what you want and will help you get it.


    Clair: Exactly. Exactly. I’m not saying he was just ignoring me– 


    Meagan: Right, but he was like, “Ah, she’s got this.” 


    Clair: Yeah, exactly. I guess the midwife had observed some kind of a change in me because at 7:00 PM– this is 2.5 hours after these contractions start– she checks me again and she asked to check me. I was at 10. I was feeling pushy, but not in the same way I had before with other labors, so I was surprised. All of the nurses in the room were like, “This is great news!” In my head, I’m like, “I’ve been there before. I’ve been there three times before. It is not over yet.” 


    I was still very much in the mindset of, “No, we’ve got work to do.” I end up trying a couple of different positions to push. I end up pushing on the hospital bed kind of supported by pillows on all fours. They put the back of the bed up and I pushed there for about a half hour or so, maybe 20 minutes in. They were like, “Oh my gosh. We can see the head. This is so great.” 


    Because of my third baby, I was just like, “That’s news, but it’s doesn’t mean it’s over.” 


    Meagan: Not what I need quite yet. 


    Clair: I’ve been here before. So I end up, yeah. I was just kind of like, “I’ve been here before.That’s not news to me, I guess.” But then I really felt a ring of fire and I was like, “Oh my gosh. This is actually happening. This is a new thing. This is a new sensation. This is a new place that I haven’t been before.” 


    So I end up, yeah. He ends up being born. I pushed with all my might. The midwife had to tell me, “Chill out. Slow down a little bit. You don’t want to tear.” But yeah. It was just so beautiful. I was able to birth him vaginally and then they were like, “You have to roll over so you can hold him.” They were telling me what to do because I was in such disbelief when I was born. I got to hold him skin-to-skin for the first time of any of my babies which was such a gift. 


    My husband cut the cord after it stopped pulsing and it was so peaceful. A couple of the nurses were crying because they had been there and were really invested in our story. The midwife was like, “You reminded me why I’m in this field. This is such a beautiful, redemptive story. I’m so happy for you.” 


    I did have a small, little first-degree tear but it really wasn’t bad. He ended up being 7 pounds, 7 ounces so I’m pretty confident that he was late pre-term because that is still small for my babies. 


    Meagan: Yeah, because they are normally 9. 


    Clair: So he was definitely earlier. 


    45:04 Circumvallate placenta 


    I had a circumvallate placenta which is where part of the placenta turns in on itself when it is developing so there is a smaller area where the placenta can adhere to the uterus. Sometimes that can be related to IUGR and a couple of other things, but it’s really hard to find via ultrasound. 


    I kind of researched it later and sometimes, it’s cause for big concern but there’s really not much to do about it. There’s just not a whole lot to be done. I’m glad I didn’t know that because I feel like would have been a source of worry but unnecessary worry because there’s nothing I really would have done differently in my pregnancy. 


    Meagan: I wonder if that was your body being like, “Okay, it’s time. I’m done doing my job. Now get the baby out.” 


    Clair: Yeah, it can also be associated with pre-term or early labor. 


    Meagan: Okay. 


    Clair: Yeah because I was trying to find a reason. This was so strange. My midwife wasn’t worried about it at all. She was just like, “Oh, interesting. Look at your placenta. This is so cool.” 


    Meagan: In all of the years of encapsulating them, I’ve never seen one like that. 


    Clair: Yeah, it’s kind of rare but also, yeah. They’re not sure why it happens. I don’t know why it happened. Some people say babies that gestate at elevation are sometimes smaller too like at high, high elevation and they come earlier so I’m wondering if maybe that can be connected. I don’t know if there are more placenta abnormalities in that way at elevation. I don’t know. 


    But yeah, he had great APGARs. He latched super well. It was so cool. The first OB that I had called me the next morning in the hospital room just saying, “Congratulations. We’re go excited for you.” My second OB, the one who basically said, “I think this is the right thing for you to try,” came to the room because she was on call again and she congratulated me and just said, “Thanks for letting us be a part of this. This was so impactful to everybody in our practice.” 


    Meagan: Yeah. 


    Clair: I don’t think they would have taken me on as a client upfront. 


    Meagan: Probably not. 


    Clair: For them to see this, and then I talked to the head midwife of that hospital OB/midwife practice and she was just saying that this is their hope that more women who really can labor without intervention or are given the chance to labor without intervention is kind of their goal. She was so happy that so many of the people in her practice got to be a witness to that because they really got to see what happens especially down to napping and leaving me alone is what helped me go into labor. 


    Meagan: Yes. There was a lot of learning happening on all of their behalf, from the OB side, on the nurse side, on the midwife’s side, there was a lot of learning. What I love so much is when places see births like this after– I mean, I’m not saying the midwives or anything. I think the OBs were originally like, “I don’t think this is a good idea,” but then seeing it happen, it’s like, “Okay. Let’s take a step back,” because so many hospitals around the world just shut people out. “No.” They might not, like you said, have supported you walking in. “I’ve had three C-sections. I really want to have a VBAC.” 


    She probably would have said the same. Maybe she wouldn’t have, though. Maybe she would have said, “I don’t know if it’s a really good idea, but we can support you and let you go.” But would it have been the same situtation? I don’t know. They are one of my favorite hospitals in that direction up north, so I love hearing, I love hearing all of this. And then to the point where the OB is like, “Hey, I recognize you are in my care, but I know you came from this care. Why don’t we put you back in that model of care because we offer that here?” Just these fine details that these providers paid attention to was a huge deal. 


    Clair: Absolutely. Absolutely. It’s funny because I had a feeling that whole pregnancy that I was going to have a hospital VBAC. 


    Meagan: Really? 


    Clair: It was in the back of my head. “I think I’m going to end up in the hospital, but I also feel like I’m going to have a VBAC. I don’t know,” but it was this weird thought because I definitely was not going to pursue providers in the hospital, so yeah. The fact that that happened, I was like, “Wow. This is just so crazy for those reasons.” 


    Meagan: So awesome. 


    Clair: Yeah. I just really feel like not being afraid to voice what we wanted was such a big part of this because if we hadn’t spoken up, even though they were very, very willing to listen and were receptive, we didn’t know that so we went in saying, “This is what we want and this is why we want it.” I think that having a conversation where you think the doors might be closed is good to have. 


    Now, it’s also good to be aware of when a provider is not actually going to be supportive of you, but in our case, we really didn’t have any choice. We were where we were and just to, I think, the more calm conversation that is had and the more providers can experience births like this, the more it will become normalized which is really the goal here. 


    Meagan: Absolutely. Well, huge congrats on your beautiful birth and I’m so happy for you. I just love hearing how it all unfolded even though in the beginning and at the end, it wasn’t exactly– well maybe I guess it was something that you envisioned, but what on paper you were putting out that you envisioned this birth center birth with this awesome midwife, but I just love how it unfolded so much. 


    Clair: Yeah. It was so healing for my husband. It was so healing for me. Yeah.” 


    Meagan: Good. Good. Well, thank you again for being here with us. 


    Clair: Thank you.


    Closing


    Would 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.




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    51m | Feb 21, 2024
  • Episode 276 Samantha's VBAC with a Special Scar & Gestational Diabetes

    We are following up on last week’s informative episode on gestational diabetes with a gestational diabetes VBAC story! 


    Samantha’s first labor ended in a traumatic Cesarean with her first baby, but she didn’t find out many details of what happened to her until she requested her operative report months later. Samantha found out that she had a lateral scar extension. 


    Despite this and other odds that felt stacked against her (i.e. her gestational diabetes diagnosis!), Samantha was determined to do absolutely everything in her power to put her in the best position to achieve her VBAC. 


    And she DID!


    Additional Links

    Leslee Flannery’s Instagram

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Timestamp Topics

    2:18 Review of the Week

    6:32 Samantha’s first birth story  

    9:37 Scheduled induction

    13:04 Complete dilation, pushing, and stalling

    15:49 C-section

    22:15 Official reason for C-section

    25:15 Recovery

    26:57 Second pregnancy

    42:46 Labor

    52:34 Feeling pushy

    55:42 “You’re not going to need a C-section today.” 

    1:02:39 Finding supportive providers

    1:05:53 Prep tips for listeners



    Meagan: Hello, hello you guys. It is likely a cold winter morning or afternoon. At least here in Utah, it’s February and I don’t know. It’s not something that was intentional, but it seems like this month we are talking about gestational diabetes. We talked about it last week and coincidentally enough, the story today that we are recording talks about gestational diabetes today. So I’m excited to dive more into that and talk a little bit more about that. 


    We were talking about this just before we started recording. It’s becoming more common but it’s not talked about enough so it’s probably fitting that we are doing two episodes this month on gestational diabetes. We have a really great story for you today. We have a C-section that was begun with an induction then she got a double-whammy with an asynclitic and a posterior baby. I’m really excited to hear what your diagnosis was on that, Samantha, because I always get so curious when we know we had fetal positioning if we get that CPD diagnosis and things like that. 


    2:18 Review of the Week 


    But of course, we have a Review of the Week so I’m going to share this and then we will dive right into Samantha’s story. This was by lindseybrynneohara. Shoot. I always butcher names. It says, “An invaluable resource. I found The VBAC Link shortly after my first daughter was born via Cesarean after a planned birth center birth. My second turned home-birth Cesarean as well. I have found a home in a CBAC (Cesarean Birth After Cesarean).” 


    You guys, for everyone that doesn’t know this, if you’ve had a Cesarean birth after a Cesarean, please know that we have a group for you too. We know that sometimes after not having a vaginal birth, it can be hard to be in a VBAC group, so we have created this Cesarean birth after Cesarean group and it’s amazing. She says, “I’ve found a home in the CBAC group these ladies put together. It helped me through some dark days of postpartum and processing my unplanned repeat Cesarean. You can find VBAC groups all over the place now, but a group for those mamas who are grieving the loss of their VBAC, they can’t find. Not so much. This is a very special group where I feel completely supported, heard, and respected for a birth I sometimes struggle to call mine and my baby’s. I am now diving into all of the VBAC after two Cesarean and VBAC after multiple Cesarean content from over the years and I am finding so much comfort and hope in these brave women who have come before me. I just have this strong feeling I will get to be one of them.” 


    Ooh, that just gave me the chills. 


    “I hope to share my story with you when that day comes. I’m learning so much about birth and myself as a birthing woman. I thought I was informed for the first time, but there are so many layers of understanding past births and planning for future births especially when C-section is involved. Thank you for the well-researched evidence-based content and special stories.” 


    Wow. That review literally gave me chills and made me emotional. You guys, when Julie and I– Samantha can see my eyes. No one else can, but really, they are tearing up. When Julie and I created this group and this podcast and this course, this is why we did it– to help people feel exactly how she was describing. To feel loved, to feel heard, to find a place of education, and to understand that you’re not alone because sometimes it can feel so lonely. Just so lonely. 


    So thank you for that review. I am literally crying. Thank you for that review from the bottom of my heart. As you can see and as you know, we love reviews. They truly make everything that we do. It warms our hearts. It helps people just like you find this podcast. It helps people find the course so they can find the information and it helps people find that Facebook group. You can leave it on Google. You can leave it on Apple Podcasts. You can leave it on social media. You can leave it on Facebook. Message us. Wherever. If you love The VBAC Link and you have something to share, please let us know because we absolutely from the bottom of our hearts love it. 


    6:32 Samantha’s first birth story 


    Meagan: Okay, Samantha. Now that I’m trying to soak back up the tears that wanted to flow, I mean, I don’t know. Yeah. Sorry for being so vulnerable here. 


    Samantha: No. 


    Meagan: Wow. That just touched my heart. But now that I can see the screen again, I would just love to turn the time over to you. And also, thank you for being here with us. 


    Samantha: Thank you so much for having me. I’m so excited. This is my second goal after getting a VBAC. I need to be on The VBAC Link’s podcast. 


    Meagan: Oh. 


    Samantha: But same thing as the review was saying, it’s an invaluable resource. I had no clue what I didn’t know going into my first birth, 100%. My story starts in 2020, I guess. I found out I was pregnant in August on my birthday, actually, I found out. 


    Meagan: Happy birthday to you!


    Samantha: That was so exciting. My pregnancy went super well. I had a bit of leg pain at some point, but I was seeing a pelvic floor physio. She fixed me up really well and everything was perfect. I had an anterior placenta so I learned a little bit about that, but it shouldn’t have been a problem so it was fine. 


    I was due May 7. That was the due date that they gave me. I don’t think it was necessarily accurate. I think I was due a little bit later. I think the 11th or 12th. I was tracking ovulation and stuff like that. So at 39+5, I had my doctor’s appointment. He sent me for a growth ultrasound. Had I known what I know now, I would have said, “Nope. No, thank you.” 


    8:19 Blurry vision and feeling off


    But he was estimated at being 7 pounds, 10 ounces. Then the week after, Tuesday night, I had this weird episode I want to call it. I was sitting on the couch and all of a sudden, my vision got blurry. I ended up with a headache and I was waiting to see if I should go in or not. I felt off. In the end, I went into labor and delivery because it was the height of COVID. I didn’t want to go to the emergency room and all of my symptoms had subsided by then. They thought it was an optical migraine. 


    He said, “Look. We can’t do anything for you. You’re having some contractions. Nothing crazy.” I wasn’t feeling anything, so they were like, “Look. You have your doctor’s appointment tomorrow. Just talk with them.” 


    Meagan: Talk to them there. 


    Samantha: Yeah. 


    So the next day I went in and he was like, “Oh, it was probably just an optical migraine. You’re fine now, so whatever.” 


    Meagan: I’ve actually never heard of that. 


    Samantha: Right? 

    Meagan: Optimal– 


    Samantha: Optical, like in your eyes. 


    Meagan: Optical. Interesting. 


    Samantha: Strange. But it put me a little bit on edge so that’s why I’m telling that part of the story. 


    Meagan: Yeah, set the story. 


    Samantha: He told me, “You’re almost 41 weeks. It means you’re overdue.” I’m like, “Okay.” He’s like, ”The rate of stillbirth goes way up now.” I was like, “Oh, jeez.” Of course, that puts fear right into your heart.


    9:37 Scheduled induction


    He’s like, “We’re going to schedule the induction. It’s going to go great. It’s going to be amazing. You’re going to have your baby in the next few days.” He’s like, “Look. We’re really booked next week so I’ll set you for Thursday. Thursday, first thing in the morning, come in.” They call me. They were like, “We are ready for you.” I got there at 9:00 AM. 


    The plan was to put a Foley bulb in, but the doctor who was on rotation at that time came in and said, “You’re already 2 centimeters. It’s not worth doing the Foley bulb at this point. We’re just going to start you on some Pitocin if that’s okay with you.” I was like, “Okay. Whatever you say. I trust you. You are a doctor.” Had I known. 


    Anyway, we stayed in that room until 5:00 PM that night because they didn’t have a room to start Pit yet. So from 9:00 AM until 5:00 PM, I was just sitting there having random contractions that I never felt and wishing. I had a gut feeling. I told my husband, “We shouldn’t be here. I shouldn’t be induced. This is not what I want to do.” 


    Meagan: Oh really? 


    Samantha: But I didn’t know I could leave. I didn’t know that it was a thing. 


    Meagan: Women of Strength, it’s a thing. It’s a thing. You do not have to be there. 


    Samantha: There was nothing abnormal about the baby’s heartrate. There was nothing going on. They did a mini ultrasound just to check his position. He was head down. That’s all I knew really. I was at a -2 station. I was 60% effaced, 2 centimeters. Everything was fine. My body was fine. He was fine. 


    We started Pit at 5:00 PM, but they were ramping it up quite quickly. I wasn’t feeling anything at this point. 


    Meagan: They took forever and then ramped it up. 


    Samantha: Yeah, they were like, “Hello, welcome.” 


    Finally, they broke my waters the next morning at 6:00 AM. 


    Meagan: Do you know what dilation or what station you were at that point? 


    Samantha: I was around 3.5 centimeters at that point. 


    Meagan: Okay.


    Samantha: Yeah. They were like, “You’ve progressed a little bit, but you are not moving fast enough for us.” Okay, cool.


    Meagan: Oh, so they broke the water real early. 


    Samantha: Yeah, because they checked me at 1:00 AM and he said that baby was still too high to break the waters so he was like, “Okay, we will wait until the morning.” I was still the same dilation so he was like, “Okay, let’s do this.” I was like, “Okay, whatever you say.” 


    They did that, and then all of a sudden, the contractions got real. 100% real. So by 10:30, I decided to get the epidural because they were messing with the Pitocin like crazy. They kept upping it. My contractions were back-to-back. I had no break. It was insane. I was like, “What is this? I can’t survive this.” 


    Meagan: Yeah. 


    Samantha: I was 5 centimeters at that point and I was like, “I still have halfway to go. That’s a lot.” I got the epidural and my nurse was really fantastic actually. She got the peanut ball for me, put me in the bed, was rotating me every 30 minutes. She was actually my biggest happiness point. She was amazing. 

     

    Then my doctor, my actual OB wasn’t on call that weekend and he had left a note in my file saying that if I gave birth while he was there he wanted to attend because he had seen me since I was 18. We had this really good relationship. So he came to see me and he was like, “I’m leaving for the weekend. Good luck. I’ll try to come visit you after the baby’s born.” 


    I was like, “Okay, bye. I wish you had been there, but you know, Cest la vie.” 


    13:04 Complete dilation, pushing, and stalling


    Meagan: Yeah. 


    Samantha: so then at 4:30 PM I was complete. It went pretty quickly from 10:30 to 4:30. I had done the rest of the remaining 10 centimeters, but they said the baby was still quite high, so they gave me two hours to labor down. Well, they said two hours. It ended up being about three. 


    Then there was a change in staff and that’s when things stopped going well, unfortunately. My nurse had to leave. She said her son’s birthday was the next day. I was like, “No, don’t leave.” She was like, “I was asked to do overtime, but I really have to go.” I was like, “I get it. Go ahead.” 


    So then this new nurse comes in with a student doctor, a medical student of some sort. It’s blurry because I was at 10 centimeters and ready to push, but things were really awkward between this nurse and the doctor. He wanted to get in there and help and she was like, “No, this is my job,” so he left and then he came back and he was like, “I was told I have to be here.” She was like, “Okay, fine,” so she came and sat next to my head and let him do whatever he had to do. You know, that type of thing. But it was super uncomfortable in the room. 


    Meagan: Weird. 


    Samantha: Yeah, it was so weird and I was so uncomfortable. Anyways, so then I started pushing and they told me his station was about +1 or +2, but he never moved in the hour that I was pushing. He stopped tolerating when I was on my right side near the end. 


    Meagan: Didn’t like that. 


    Samantha: Yeah. I had horrible heartburn too. I felt like I was going to throw up fire. So fun. 


    So finally, we pushed for an hour. The doctor on call came in, didn’t even look at me almost, didn’t really introduce herself, nothing and just said, “C-section.”


    Meagan: Whoa. 


    Samantha: I was like, “Excuse me?” At that point, I had a bit of a fever. They gave me Tylenol. They said it could have just been from being in labor and from pushing. I was like, “Okay, whatever you say if that’s normal.” They were like, “But we have to get you to a C-section now,” because he had a decel for 4 minutes at 70 beats per minute. They were nervous. 


    At this point, the medical student had his fingers inside rubbing the baby’s head to get him back. 


    Meagan: Yeah, sometimes they do have to stimulate the baby. 


    Samantha: Yeah. Between every push, he was doing that. Then this one was the final, I guess, they called it there. It was really strange. She’s calling a C-section. She was like, “I’m going to call the doctor.” I’m not sure if she meant the OB or the surgeon. She goes off. The nurse is still getting me to push. I’m like, “How is this an emergency if I’m still pushing?” I was so confused. 


    Meagan: Baby’s heart rate returned at this point, I assume. 


    Samantha: Yes, exactly. It was just very strange. 


    15:49 C-section


    Samantha: Anyways, so then they wheel me down to the OR. We had to go to the regular operating room because they only have certain hours during the day from 9:00 to 5:00 which I guess is when they do the special delivery OR. 


    Meagan: Interesting. 


    Samantha: Yeah and it was a Friday night, so we went to the regular OR. The nurse and the anesthesiologist were amazing. They took pictures and stuff like that before. They gave me the spinal, then my husband was allowed to come in while they were doing the test cut. I didn’t feel anything so he was allowed in. 


    Meagan: It worked, yeah. 


    Samantha: Yeah. They didn’t tell me much during the surgery at all. I don’t even remember meeting the actual surgeon other than them saying, “This is so and so. He’s going to do your surgery. He’s great. Don’t worry about it.” I was like, “Okay. Do what you’ve got to do.” I never heard from this man ever again. He didn’t come to see me post-op. 


    Meagan: Stop, really? 


    Samantha: I don’t know who this person was, really. The person who cut into my body never came to talk to me after. I had no clue what happened. 


    Anyway, so it seemed to go pretty routinely. He was pulled out at 9:13 PM. He was 7 pounds, 10 ounces so what they told me he was a week prior was what he was that actual birth. His APGAR scores were 9 and 9 so he was not in distress. 


    Meagan: He was doing okay, yeah. 


    Samantha: Yeah. My husband cut the cord. Everything was fine. Then they brought me to the recovery room, but it was the general recovery room because L&D was closed for the night so I was left alone. My husband took the baby and went to postpartum. 


    When we got there, the nurses said, “Oh no. Not another one.” Yeah. 


    Meagan: Like another C-section baby or another person? 


    Samantha: Any baby. Another person. Yeah, and he was like, “I feel great.” He has all of our bags. I had my boppy. I had his bag. He’s carrying everything. He’s got the baby in the pushing cart thing and nobody is helping him. They just shove him in a room in a corner and they say, “Do skin to skin. Here. Change his diaper. Done.” They left him there for four hours with a baby. 


    Meagan: Four hours?

     

    Samantha: Four hours and didn’t go check on him. 


    Meagan: Oh my gosh, I’m so sorry and you were still in that recovery room for four hours?


    Samantha: My bloodwork and all of my vitals were all over the place because I had hemorrhaged which I didn’t know at the time. I was shaking uncontrollably. I kept on falling in and out of sleep. I guess they had given me morphine. I was so itchy. 


    The whole time, I’m just worried because you hear about the golden hour, the golden hour. I was freaking out the whole time because my plan was to breastfeed and I was freaking out. So then a nurse comes at one point and she’s like, “Here. Call your husband and ask him what the baby weighed.” I was like, “Okay.” So I call him and he was like, “Yeah, he was 7 pounds and 10 ounces.” I was like, “Okay,” then the nurse was like, “Okay, give me my phone back.” I was like, “What’s going on here?” I was so confused. It just didn’t make any sense to me what was going on. 


    So finally after four hours, they brought me back up because I guess the spinal had worn off and my vitals were stable enough that they could move me. I got there at 1:15 AM. I finally got to meet my baby for real. They had only brought him over for a picture. He was on my chest for 30 seconds and they were like, “Let’s go.” That was that. 


    I found a lot of things after the surgery. I found out I had hemorrhaged because I needed a blood transfusion the next day. I never found out about the extension on my scar until I got my reports when I got pregnant the second time. 


    Meagan: Because no one came in and talked to you. 


    Samantha: Nobody. The medical student came to talk to me about the transfusion. 


    Meagan: And in a controlled– an extension for listeners, she now has a special scar. 


    Samantha: I got it after and it was because of my pelvic floor physio that I had an inkling of it because I went to go see her and she said, “Your exterior scar is very long.” I was like, “Oh, well they told me he got stuck. He was pretty stuck.” They said they tried to push him up during the C-section. He didn’t really move so they ended up using the forceps in my C-section which I found out from the pediatrician the next day. I had no clue. 


    Meagan: Really? 


    Samantha: Yeah. 


    Meagan: Wait, so they used forceps externally pushing up or with you cut open?


    Samantha: Yeah, with me cut open I’m pretty sure because he had the marks on the sides of his head. 


    Meagan: So that’s where the special scar came from. 


    Samantha: Yes. They cut me further to get him out and so he ended up with a huge hematoma on the side of his head because he was OP and asynclitic. They told me his chin had been extended as well. 


    Meagan: Triple whammy. 


    Samantha: I don’t know what happened to this poor child. 


    Meagan: The baby was high and we broke waters in a less than ideal position and he came down and said, “Whoa, the flood gates just opened,” and came down in a wonky position. 


    Samantha: Exactly. It was great. 


    Meagan: Then we had Pitocin cramming him down there. 


    Samantha: Yes, exactly. So when he came out, he had that huge hematoma on his head that they told me would resolve on his own. He had a pretty intense torticollis looking back now. In all of his pictures, he’s got his head completely to his shoulders, this poor child so he did chiro and everything for that. 


    Meagan: Sideways, yeah. 


    Samantha: And I burst all of the blood vessels in his eyes by trying to push him out so hard. So poor baby. 


    Meagan: Oh my gosh. 


    Samantha: Yeah, so my milk took a lot longer to come in because of all of the trauma. 


    Meagan: And blood loss I’m sure. 


    Samantha: Exactly. He was jaundiced. He lost more than 10% of his weight because they had pumped me so full of liquid that he probably lost all of the excess weight that wasn’t true weight. 


    Meagan: Yes. 


    Samantha: But they didn’t explain that to me so they were all panicked. 


    Meagan: So in retrospect, he was probably smaller than 7lb,10oz. 


    Samantha: Exactly. Yeah, and he also had a tongue tie that we ended up revising at 4.5 months after trying absolutely everything not to, but we did it and everything went well other than that. Our breastfeeding journey was a bit tough at the beginning. But, you know. 


    22:15 Official reason for Cesarean


    My official reason for Cesarean was the arrest of descent and fetal distress. 


    Meagan: Okay. 


    Samantha: Yeah. The worst part is in the report, they didn’t mention the forceps in some of the reports. Some of them do have forceps in them. Honestly, I don’t know what happened. It was on some reports, some not. It was very confusing, but it did have the extension on there. They said it was a 4cm extension on my uterus. 


    That’s where the hemorrhaging happened because they hit that nerve on the side apparently. 


    Meagan: Oh. 


    Samantha: Yeah. That’s what the doctors at the new hospital where I gave birth to my second told me when they reviewed my chart. She was like, “Okay. This is what happened to you. It shouldn’t be a huge red flag for your next birth. You didn’t hemorrhage just because. There was a reason.” 


    Meagan: Yeah. That probably actually was nice for you to find out and have that validation a little bit. 


    Samantha: Exactly. On the report, it said my waters had been broken at 6:30 on the night of the 13th when they were broken at 6:30 AM on the 14th. They recorded it as being 12 hours longer than I had my waters broken. 


    Meagan: Interesting. 


    Samantha: So I was like, “Hmm. That’s nice. That’s nice to know.” They never mentioned my fever and they reported that I pushed for two hours, not one. 


    Meagan: Wow. Crazy. 


    Samantha: Yeah. I was very upset when I read these reports. 


    Meagan: Did you have gestational diabetes with this baby? 


    Samantha: Nope. My sugars were completely fine. 


    Meagan: Crazy. Crazy. 


    Samantha: In the moment, I didn’t realize how traumatizing the birth was. I was like, “We’ve got to do what we’ve got to do.” Literally, I said, “Put my big girl pants on. Let’s go.” But it’s when I was going through it in my brain and talking about it that I realized how much it affected me. 


    Meagan: Absolutely. 


    Samantha: That was a huge part of my VBAC prep after. I read “How to Heal a Bad Birth”. I did all of that. Yeah. It was intense. And something they never tell you about C-sections– I had the worst gas pain in my shoulder. 


    Meagan: Oh yeah. It gets stuck up there. Me too. With my second C-section, no one told me that either and I was like, “What? Is this my milk? What is this?” I didn’t know. This was literally what I said, “I want to stab a knife in there to release it,” because it was so strong. 


    Samantha: Right? I thought I pulled every muscle in my body from pushing and it was just gas. 


    Meagan: Our body cavities get air after being cut open and sometimes it can get trapped and it travels up to that shoulder. 


    Samantha: It was the worst so just for anybody thinking they are dying from something when they are just healing from a C-section. You know, it’s fun. 


    25:15 Recovery


    Recovery went pretty well. I was seeing a pelvic floor physio and did a ton of scar mobilization. We were always working on the scar especially because it was huge. It was so long. That was part of my prep even before I got pregnant. 


    Then at my 8-week postpartum– it’s supposed to be 6 weeks but it was just delayed and it was on the phone because of COVID so that was fun recovering from a C-section not knowing if your scar looks okay. 


    They had put Steri strips to close the scar and said, “They should fall off within a week.” Four weeks later, they were still on. I wrote an email and I was like, “Do I take these off?” I started Googling and it says it can cause infection. I was like, “Oh, great.” So another thing they didn’t really advise me on so that was fun. 


    Meagan: They didn’t give you good post-op care. 


    Samantha: No and we were in a semi-private room. It was just uncomfortable. It was not a great experience. One of the nurses made me cry and it was hard to make me cry in those first few days. I was completely numb and done. I was a shell of a human, to be honest looking back on it, and she managed to make me cry. She came in and she was like, “You didn’t do this. You didn’t do that.”


    I was so overwhelmed. I had a brand new baby. 


    Meagan: I’m so sorry. 


    Samantha: It was not great. So at my 8-week postpartum appointment, I asked about VBAC. My OB was like, “Yeah, you’d be a great candidate. You got to 10 centimeters. You were pushing. Everything is great.” So I was like, “Excellent.” He was like, “Just make sure that your births have to be two years apart.” I said, “No problem. I have marked it on the calendar. We’re good.” 


    26:57 Second pregnancy


    So then I did end up getting pregnant really easily again. My due dates were a week apart. 


    Meagan: Oh no way. 


    Samantha: Yeah, so this baby was due on the 22nd. 


    Meagan: Okay. 


    Samantha: Because my son was born on the 14th, but his due date was the 7th but they ended up being a week apart. I was like, “Well, I got my two years. There you go.”


    Meagan: So they are 24 months apart? 


    Samantha: Yeah.


    Meagan: Oh, they are. Okay. 


    Samantha: Exactly. I went to see my OB at 10 weeks. That’s when he sees you. He sent me for an ultrasound early around 8 weeks just to make sure everything was good. I was pulled from work because of COVID and for violent children. I’m a teacher, so we just had to make sure that everything was viable and everything. We did that. I went to see him at 10 weeks. First, he tried to date me earlier than I was. I knew for a fact that I was not again. Again. I was like, “No. We’re not playing this again.” 


    Meagan: Good for you. 


    Samantha: I had my appointment with him and he told me. He started saying, “I think your best option would be being induced at 39 weeks. But I can’t make you do anything. But I need you to go into labor spontaneously before 40 weeks if you’re going to have a VBAC.” I was like, “Hmm.” 


    Meagan: Red flag. 


    Samantha: Exactly. I had started listening to The VBAC Link at this point so I was like, “That’s not good. Okay.” 


    I spoke to my chiropractor who was working on my son who had helped him with his torticollis and everything and she said, “The secretary had a VBAC and with this doctor at a different hospital so I’ll text her. I know her well. I’ll text her. I’ll get you in.” She got me in with this new doctor.


    I went to go see her and she was like, “Yeah. You’re a great candidate for VBAC. I don’t see a problem.” I brought her my operative notes because she had to wait for them to be transferred. She was like, “The extension worries me a little. I just want you to get checked with a specialist.” 


    Meagan: I was going to ask you if she said anything about your special scar. 


    Samantha: Yeah, she did. I made an appointment at the special, I guess it’s maternal-fetal medicine. 


    Meagan: MFM, yeah. 


    Samantha: It’s called [inaudible] in French. Everything is in French, so it is at-risk pregnancies. I had to go see a specialist there. I made my appointment. I waited and I was panicking. I was like, “I need to have this VBAC. I need this.” 


    I show up to my appointment. I waited for five hours then we were told the specialist had to be called for a C-section. I was like “I get it. If I were that person and I needed extra hands, I get it.” But then she told me, “You haven’t even had your ultrasound for 12-13 weeks.” She was like, “There’s no point in me looking at your dossier” or whatever.” I was like, “But it’s not about anything except for my extension.” 


    She was like, “No, no. Just make another appointment after your ultrasound.” I left there in tears panicking still. I was like, “I don’t know if I can even try for this VBAC. I may just have to sign up for another surgery. We don’t know.” 


    So I went back a few weeks later. It was about a month later. It was a long time I felt panic and nerves. So then I saw this other doctor and she was fantastic. I literally left that appointment telling her I loved her. She was so nice and evidence-based. She took out files and showed me statistics and everything. She explained my previous birth. 


    Meagan: Wow. 


    Samantha: She was fantastic. She was like, “You made it to 10 and you were pushing. The baby was just in the wrong position. You’re a perfect candidate.” I was like, “Okay.” She was like, “And the extension is lateral so it was all in the same direction.” She said, “Same direction or low, we have no problem with. It’s if it goes up that we start looking at things a little bit more seriously.” I felt super relieved after that. She told me the reason for my hemorrhage. It was her who told me. She asked me, “Did they try different positions?” I said, “No. They moved me from side to side but pushing, I was all on my back.” 


    She was like, “We would have gotten you up on hands and knees. We would have done squatting. Did they try to manually turn him?” I said, “Absolutely not. Nothing happened. They literally left me on my own.” She was like, “We would have tried all of those things.” It really validated my whole experience. 


    Meagan: Absolutely. 


    Samantha: She is known for doing VBAC after two Cesareans as well. She is one of the only doctors at that hospital who will do it. She is amazing. So that relieved me a lot.


    In between that, I hired my doula from a company called Mother Wit. She was fantastic. Her name was Megan Tolbert so I felt like I had a little bit of VBAC Link having a Megan of my own. 


    Meagan: I love that. 


    Samantha: I was seeing a chiropractor every two weeks and near the end, once a week. I did pelvic floor physio once a month. I did acupuncture once every two weeks and near the end, I did three intensive types of get-me-into-labor sessions. I did massage therapy just to relax myself because I was pretty high-strung. I did the dates starting at 36 weeks but that was also with the GD diagnosis. It was rough. I did red raspberry leaf tea. I did pumping and hand-expressing colostrum. I had read how important that could be for a gestational diabetes baby. That was something that was really important to me because I had been separated from my first for four hours. 


    I was like, “This poor child didn’t eat.” I brought my colostrum with me to the hospital and it can help with their sugars. That was really important to me. I walked every day. I did curb walking. I did Spinning Babies Daily Essentials. I read How to Heal a Bad Birth. I read Birth After Cesarean: Your Journey to a Better Birth. There was one story on GD in that book. That’s why I bought it. 


    Meagan: Hey, listen. You’ve got to find the stories, right? 


    Samantha: It was so hard to find gestational diabetes stories at the time. It was really rough. 


    Meagan: Was there a lot of emphasis on your diagnosis of gestational diabetes? Was there a lot of, “Hey, you’ve got to do this? This has to happen,” Or anything like that? 


    Samantha: They weren’t as on top of things as I thought they would be because the doctor I was seeing was a family doctor. She was a GP so everything above a healthy, regular pregnancy, she would send me to the at-risk clinic. They were really the ones who dealt with that. She had sent me for just routine bloodwork. My fasting numbers came back borderline so she was like, “Look. Now you’re going to have to do the 75-gram three-hour test, two-hour test, sorry, here.” I did that. I had a gut feeling my whole pregnancy that I had gestational diabetes for some reason. I had no proof. No proof, but it just kept on popping up. It was so weird. 


    I had a feeling that morning and I got my test results that evening. It was really fast. I did them privately. It was 5.3 so here it is measured a bit differently than in the US, but I don’t remember the conversion. But the cutoff was 5.2. So at 5.3, I was just over but because gestational diabetes usually gets worse before it gets better, they are very safe in diagnosing. 


    But I never actually got an official diagnosis. I just had the prescription sent to the pharmacy for my monitor. 


    Meagan: Insulin? 


    Samantha: No, thank goodness. 


    Meagan: I was like, what? 


    Samantha: They were like, “You are booked for the information session in two weeks.” It was two weeks after and they sent you some documents to read over. So I was like, “Okay. This is not enough. I need to find more information.” I spoke to friends. I ended up on a Facebook group called gestational diabetes Canada which was amazing and I ended up following somebody on Instagram named Leslee Flannery. She was fantastic so if anybody needs her, look her up. She is amazing. 


    Meagan: I’ll have to look her up too. 


    Samantha: She is @gestational.diabetes.nutrition on Instagram and she is just fantastic. She really normalizes it because there is so much stigma with gestational diabetes. You think that you caused it and she really debunks that. I really got in my head about that and I was really afraid for my VBAC chances because if you end up on insulin, they really want to induce you by 39 weeks so I was panicking which doesn’t help your numbers by the way. 


    Meagan: It doesn’t. We talked about this in last week’s episode. We talked about cortisol not helping, lack of sleep not helping, and yeah. It’s crazy but cortisol raises things. 


    Samantha: Exactly and for me, it was only my fasting numbers that were the problem. Those are the hardest to control because apparently, those are the ones that are influenced the most by hormones and by your placenta. So that was really rough. 


    Meagan: Yeah. We talked about that as well. We talked about choline and certain foods and not cutting things that impact our hormones. It’s this cycling thing. 


    Samantha: Exactly. So a lot of people are told to cut carbs completely, but what I learned is that if you do that, then you end up spiking your numbers even further because your body takes over. 


    Meagan: You have to find a balance. 


    Samantha: It was really intense and all of my chances of my VBAC were going out the window. I was crying at every appointment. At his 20-week ultrasound, the big ultrasound, he was measured at the 96th percentile. I was like, “Oh my goodness.” I left there bawling my eyes out. I could not get a hold of myself for three days. Everything was just crazy. 


    I redid my bloodwork three or four times and finally, there were no more antibodies so that was just let go. We don’t know what happened. 


    Meagan: Interesting. 


    Samantha: Yeah. It was just another scary bump. I don’t know. It was intense. The gestational diabetes diagnosis really sent me for a loop too. I found this pregnancy I was very stressed because I was so set on getting my VBAC. But thankfully, I had my doula so I could send her all of my crazy emails late at night when I was panicking and she always talked me down from that ledge of panic. I also listened to a podcast from a somatic therapist who said that stress in your pregnancy can be a contributor to things like gestational diabetes and things like that. I know that put a lot of pressure on me and reading about the facts of gestational diabetes really made me feel a little bit better about that. It could have been, but it’s not something that you can stop. 


    It was nice to know that but gestational diabetes diagnoses really are hard when you are trying for a VBAC, I would say. 


    Meagan: It is. It is which is why we had Lily on last week because we get the question so often. We get the text, “I was diagnosed. Can I still VBAC?” Asking the question, “Can? Is this still possible?” The answer is yes. 


    Samantha: Exactly. So apparently, there is a spike between 32 and 36 weeks most of the time. That’s when your gestational diabetes will be at its worst because apparently, there is something to do with the baby’s growth. They have a growth spurt at that time and then usually, it tapers out at the end. My numbers all of a sudden just got better. It was a relief near the end. I was like, “Okay. Let’s wrap it up. We’re doing all of the things.” I was doing my birth affirmations. One of them was, “I am a Woman of Strength,” let me tell you. 


    Meagan: Yes you are. 


    Samantha: My Hypnobirthing tracks– I did the ones by Bridget Teyler. She’s amazing too. All of the things getting ready. So then that leads up to my appointment at 39 weeks and 2 days. Everything with the gestational diabetes was fine at that point. They told me, “Look. We’re going to treat you like a regular pregnancy. We won’t talk anything until 41 and 4.” My doctor was not a big fan of inductions for VBACs because of the increased risk, but she was like, “Look. If we have to, we will look at it then. Until then, let’s get you to go into labor spontaneously.” 


    Meagan: Let’s just have a baby, yeah. Trust your body. 


    Samantha: Yeah, but I did opt for a membrane sweep because I was getting not close. I wasn’t close because I was only 39 weeks and 2 days but I was like, “Look. I want all of the chances on my side of going into labor spontaneously.” I had started losing my mucus plug so my body was doing what it had to do. I had never had any of that with my first son at all. 


    I was like, “Something is going on.” I started having more intense Braxton Hicks a little bit more often. I was like, “Things are going to happen. We need to do this.” 


    Meagan: You could feel it. 


    Samantha: I had the membrane sweep. After, she checked him on the ultrasound. He was LOA. He was head down. Everything was good. So I was like, “Okay. He’s in a good position. Let’s do this. Okay.” 


    42:46 Labor


    The next evening, I started getting my Braxton Hicks. Looking back, I was probably in super early labor but didn’t realize it because they were starting to get uncomfortable. I’d have to sit there and breathe for a minute. Nothing crazy, but I was like, “Huh. I felt that. That’s weird.” I was at my friend’s house and I was like, “Okay. That felt weird. I’m just going to go to the bathroom and go pee.” I came back and was like, “There’s a bit of blood. I’m going to head home just because I want to sleep.” 


    I went to bed and then I woke up at 4:43 AM with a contraction. I was like, “Oh. That’s uncomfortable.” I had listened to so many stories about prodromal labor that I was just convinced that this could be prodromal labor for three weeks. I was in complete denial. 


    I kept on trying to sleep, but they were coming every 10-15 minutes. They would wake me up each time. I wasn’t resting super well. They started picking up around 6:30. I texted my doula at around 7:30 and I said, “I don’t know if I had a bit of a bloody show. There is a bit of darker blood.” She said, “Probably not considering it wasn’t fresh blood,” and all of those things. “But rest. Drink water. Do all of the things. Move around when you need to,” and things like that. It was fine. I said, “Okay. We will continue and I’ll let you know if things pick up or not.” 


    So my husband got up at 7:45 with my first son and did all of the things. I stayed in bed because my body just kept telling me, “Lie down. Rest.” I could not fight it. I was like, “Okay.” I lay down in the bed. Fine. I didn’t even time my contractions. I was really convinced I wasn’t in labor. It was the weirdest thing. I didn’t eat enough. 


    Meagan: This happens. This happens where we’re like, “No, I can’t be.” We want it to be so bad, but we’re like, “But it’s not. It’s not.” 


    Samantha: Exactly. 


    Meagan: We’re in denial. From having zero contractions from the first that I felt and having just Pitocin contractions, I didn’t know what to think of this. I was like, “They are uncomfortable. They hurt a little, but I’m sure they’re just going to fizzle out and we’re going to be fine.” 


    So then my first son went down for his nap around 10:00 and my husband had to go to work to drop off his keys because he was changing positions so that was his last day. He went to go say goodbye and everything then he came back home and went downstairs to watch TV and kind of left me on my own. He figured it was better to just leave her alone. She’s going to be fine. 


    Meagan: Yeah. Just let her do her thing. 


    Samantha: Yeah. So at 11:55, I texted my doula and I said, “My contractions are still far apart.” I feel like they never got much closer at that point. It was 10-15  minutes, but they were getting more intense. She said, “Okay. Do some hands and knees positioning. Maybe take a bath. Continue breathing. Relax,” and all of those things. So then at that point, I said to my husband, “Okay, call my sister.” She was coming to watch my first son. She was on her way to a hair appointment that I didn’t know she had because she didn’t tell me. She knew I’d freak out, so we called my mom instead. She came. 


    She was like, “Sam, are you timing these contractions? Is your husband? What’s going on?” I was like, “No. I haven’t actually taken out my timer. I don’t know.” She started following me around with a pen and paper. “Those were four minutes apart. You need to leave right now.” She was like, “You’re not going to have this baby on the floor at your house. No. You need to go.” 


    Meagan: Was it active like you were really working through them? 


    Samantha: 100%. I was moaning. I was trying to do a low moan to try to get through them. She said I sounded like a wounded animal at the end of each one because they hurt. She was like

    “You need to leave right now.” I was like, “Well, I need to shower.” She was like, “No, you aren’t showering right now.” I was like, “Yeah, I am.” I had my piece of toast that I took one bite out of. I was like, “Maybe I should eat some more before I go.” 


    Meagan: Yeah. 


    Samantha: I was in too much pain to eat at that point so I was like, “Okay, I’m going to shower. It’s going to be fine.” I got in the shower and it was literally the best feeling of my entire life I think. I was like, “Why didn’t I do this earlier?” But I was not in the mind space to do it earlier. Every time a contraction hit me, I had the instinct to get up and walk or sit on the toilet. I think  my body knew that those were the positions that helped the most and then in between, I would lay down because that’s what my body told me to do. I was just listening. I was along for the ride. 


    Meagan: Hey, that’s good. 


    Samantha: Yeah. So then I texted my doula at 12:45. I said, “I’m going to shower, then we are going to the hospital.” My husband, during this time when my mom got there, was packing his bag because he hadn’t and was getting all of our last-minute things. I had a list like my birth affirmations. I wanted to bring them with me and things like that. 


    I got in the shower and got out. We left for the hospital at 1:06. It took us about 40 minutes to get there so there was a bit of traffic. 


    Meagan: There was a drive. 


    Samantha: Yep, but I was so lucky. I only had about four contractions the whole time. They had spaced out. My body knew what to do, man. 


    Meagan: I was going to say your body knew what was happening. 


    Samantha: Yeah. So then we got there. My doula had gotten there about five minutes before us so I saw her at the entrance. This guy stopped to talk to me for two minutes while I was in active labor waiting to go to labor and delivery. He was talking to me about my day and asking me when my baby was due. I was like, “Today.” 


    Meagan: You’re like, “Right now.” 


    Samantha: I don’t think he realized, but then I met up with my doula and I had a contraction on the way while we were walking. A guy passed by like, “Uh-oh.” I think he realized and put two and two together. 


    So then we got there and went to the front desk. He was doing his paperwork going all slow and whatever then I had another contraction and he said, “Oh.” He got up and he walked away real fast and so they got me to triage and the woman, the nurse who came to check me said, “Look. We’re going to check you really quickly and see where you are at, but I think you are going to be going to a room right away.”


    My sister-in-law had given birth at the same hospital two weeks before me and she showed up at 3 centimeters in a lot of pain. I was like, “If I am at 3 centimeters right now, I don’t know if I can do this.” But I got in my head. I was like, “I’m going to be super low dilation.” 


    Meagan: Those numbers, they mess with us and they really don’t mean anything, but man, they impact us quite a lot. 


    Samantha: Yeah. I remember saying that to my doula. I was like, “If I’m at 3, I’m going to scream and then get the epidural. I can’t continue like this.” The woman was checking me and I’m waiting and I was like, “So?” She was like, “You’re an 8.” I said, “Oh my gosh.” I was like, “I can do this.” It gave me a new spunk. I was like, “I’m ready. Let’s go.” So they put me right into a room and they apologized. They were like, “We have to get everything ready,” so they were bustling around. They turned down the lights. They got me a yoga ball and all of those things. They were like, “Look, we’re really sorry to be in here. We’re going this as fast as possible then we will leave you alone.” 


    They never even saw my birth plan because we got there at 8 centimeters and there was no time, but they wanted to put in the IV and my doula said to them, “Look, does she need an IV?” They said, “We just want the port at the very least.” I guess just the saline lock. 


    Meagan: The hep lock? 


    Samantha: Yeah, the hep lock, sorry. They did that and they wanted to monitor the baby’s heart rate. Those were the two conditions that they wanted to have. Because I was so far along, it didn’t really bother me. I didn’t want to fight that fight. It was not something that was worth it to me. I was like, “Cool.” 


    I was laboring standing up next to the bed, then the doctor came in and said she wanted to do her own checks so that she had her own line of where things were I guess. So she checked me and by then, I was already 9 centimeters. I had already gone up another centimeter. 


    But what’s funny is I guess I went through transition at some point, but I don’t know that it was. Everyone always says that transition is crazy. I didn’t have that. 


    Meagan: Maybe you went in the car with distractions and stuff. 


    Samantha: Yeah. In between contractions in the car, I was falling asleep. I was so tired. I don’t know. Transition was not that bad for me, so I was lucky for that. So then the doctor said, “Look. Your bag of water is bulging. We can either break it artificially or we can wait and see when it breaks by itself.” I said, “Okay, let me wait.” 


    She left and I continued laboring and I was like, “You know what? We are at this point. I’m 9 centimeters. They couldn’t tell me his position yet because my water was still in tact.” 


    Meagan: It was probably so bulgy, yeah. 


    Samantha: So I said, “Just call her back.” She was like, “Well, it’s going to get more intense.” I said, “It’s going to get more intense. Let’s do this.” I’m like, “Okay, hold on. I have another contraction coming.” I was on the bed. I turned over and all of a sudden my water exploded. They even wrote it on my report that I saw after, “a copious amount of liquid”. There was so much. So I was like, “That’s good that that didn’t break in the car because that would have been a mess.” 


    Meagan: Yep. 


    52:34 Feeling pushy


    Samantha: So then they cleaned up. I was standing next to the bed again and then all of a sudden, I felt pushy. I was doing the pushing sounds and my doula said, “Look. You need to concentrate. Tell me if you cannot push.” So the next contraction, I was like, “No, no. I’m pushing.” 


    They wanted to check me again because they didn’t want me pushing before 10 centimeters so they did do a lot of checks, but I wasn’t too worried considering how close I was to the finish line for infection and things like that because I wasn’t a huge fan of cervical checks going in, but I was like, “We’re near the end. Hopefully nothing bad will happen.” 


    So they checked me. I was already 10 and he was at a 0 station at this point, but he was LOA. They checked him, so he was in the right position so that was great. I was worried because my contractions were wrapping around to my back at that point, but I assumed that that is probably pretty standard when you’re that low, I guess and things are getting more intense. But I kept on saying to my doula, “If he’s OP, if he’s OP, if he’s OP–” I was so scared that he was going to end up in the same position as my first son especially because I had another anterior placenta. I read somewhere that that could cause positioning issues. I was like, “No, not another one.” 


    He was fine. That was a huge relief in that moment. Then I tried a few different positions. On my hands and knees, I thought I was going to love that but I hated it. I could not push like that. I ended up on my side. I pushed a lot like that, but I was pulling on the rung of the bed and I don’t know if I was using too much energy like that, but the doctor looked at me at one point and she was like, “Look. I know you don’t want to be on your back, but maybe just try. If it doesn’t work, we’ll try something else, but try it.” 


    I really trusted my team at that point. They had really been very aware of everything I wanted. They gave me choices. They were really evidence-based, so I was like, “You know what? This is a good team. Let’s try.” 


    Meagan: Why not? 


    Samantha: So I went on my back and all of a sudden, my contractions were being used. My pushing was a million times better so I guess that’s what I needed in that moment as much as I really hated to be on my back. I was like, “Maybe this is what I needed.” He descended really well to a +3. I had the whole team there around me. I had my husband up here next to my head and then my doula was next to him, then I had the doctor at the foot of the bed, then I had two nurses on the side and they were so good together. Apparently, they are a team that works together a lot, so they bounce off of each other and it was so supportive. They were always there telling me, “You’re doing it.”


    Pushing was so hard for me though. So many women say, “Pushing was really where I felt empowered and like I could do something with the contractions.” Pushing was the most painful thing I’ve ever experienced, so I don’t think I went in there thinking about that. 


    Meagan: Yeah. 

    55:42 “You’re not going to need a C-section today.”


    Samantha: I was shocked by that, but she also, at one point, said, “You’re not going to need a C-section today. We are past that point. This baby is coming out vaginally. No matter what happens from here on out, you’re good.” My eyes just filled with tears. I was so happy at that point. 


    Meagan: I bet. 


    Samantha: They started getting stuff ready at the end of the bed and I was like, “This is a really good sign. This means that baby is coming.”


    Meagan: Yeah. Constant validation. 


    Samantha: Yeah. They were so nice. They offered a mirror which I accepted. Some people say mirrors really helped them. They were like, “Oh, we see his head.” There was a nickel-sized piece. I was like, “No.” I have so much more to do. I found that not super helpful. The doctor– I don’t know how I feel completely about this, but she did warm compresses and stretching of my perineum while I was pushing. I didn’t end up tearing, so I don’t know if that ended up helping for it or not and they poured a lot of– 


    Meagan: Pelvic floor work before too. 


    Samantha: Yeah, exactly. I did a lot of that. They poured a lot of mineral oil on his head to try to get him to slip out a little bit easier because I was having more trouble. I don’t know if those things are evidence-based necessarily, but in my case, I didn’t tear. They may have helped. They may not have helped. I’m not sure. 


    Though they did tell me I wasn’t using my contractions as effectively as I could have been. I guess they said I was starting to push too early in my contraction and then not pushing long enough. They were really trying to coach my pushing. 


    Meagan: Waiting until it built a little bit more.


    Samantha: Yeah, exactly. I mean, at that point, he was having a few decels so I think they were getting a little bit more serious at that point. They told me every time I put my legs down between contractions that he was slipping back up a little bit. They had the nurse and my husband hold up my legs at some point. 


    I was exhausted at this point. It was 12 hours. It wasn’t super long, but I think because I hadn’t eaten enough or drank enough water. But they did let me eat in labor even though I was already 8 centimeters. They were fantastic for all of those things so I didn’t have to fight that. 


    So yeah, then at one point, his head was crowning, so the doctor actually had to hold his head in position between my contractions because he kept on slipping back in. 


    Meagan: Oh. 


    Samantha: Yeah. It was really intense and the ring of fire when somebody is holding that ring of fire there is no joke. 


    Meagan: Yeah. 


    Samantha: It was rough. Yeah, then at one point, the mood just shifted in the room. She said, “Look, if you don’t get him out in the next two contractions, I have to cut you.” I said, “Excuse me? You have to what?” I was like, “An episiotomy?” She was like, “Yes. He is getting serious now.” He had a few pretty major heart rate decels so she was like, “I’m giving you two more.” They got the numbing stuff, I guess lidocaine ready. They dropped the bed down at that point so it was completely flat. I guess she wanted to have a better view of how she was going to cut. 


    I pushed harder than I’ve ever pushed anything or done anything in my whole entire life and all of a sudden, I felt his head come out. I was like, “Oh, you didn’t have to cut me.” It was right down to the wire. I pushed him out by myself and it was just like, “Oh my gosh.” It was the best feeling in the whole wide world.” 


    Then she said, “Okay, stop pushing,” to check, I guess, for shoulder dystocia because of the gestational diabetes for the cord and everything. She was like, “Okay, he’s good. Go ahead and push him out.” They said, “Grab your baby.”


    I pulled my baby out onto my chest. 


    Meagan: Best feeling. 


    Samantha: It was the best feeling in the whole wide world. I cannot describe it. The best. I had my VBA and I just kept saying, “I did it! I did it! I did it!” Everyone was so happy in the room and I had a very, very minor tear in my labia and that was it. It was night and day for my C-section recovery. 


    They put the baby on me. He didn’t budge from my body for 2.5 hours. 


    Meagan: Oh, such a difference. 


    Samantha: Oh my gosh. It was fantastic. He laid on me and I talked with my doula and my husband for an hour and a half until my doula left and then they came in and weighed him and did all of the things afterwards and checked his sugars which they have to do for gestational diabetes. They check sugars four times. Everything was good. It was just fantastic. It was the best, the best feeling in the world. 


    Meagan: Oh, I am so happy for you. So happy for you and so happy that you found the support and the team and everything. All of the things that you had done did add up to the experience that you had. 


    Samantha: Yeah. I went into this birth saying, “I’m going to do all of the things so that if I do end up in a C-section again, I know I did everything possible.” I needed that for myself. 


    Meagan: Yeah. That’s something to point out too because really, sometimes you can do everything and it still doesn’t end the way you want, right? That’s kind of how I was. I was like, “I want to do everything so in the end, I don’t have the question of what if I did this? What if I did that?” Sometimes that was hard because it meant spending more money on a chiropractor and spending more money on a doula. We had to work on that. Sometimes it’s not possible for some people and that’s okay. VBAC can be done doing those things, but that’s how it was for me too. I mentally had to do all of these things to just have myself be like, “Okay, if it happened. I can’t go back and question.” 


    Samantha: That’s it. You’re at peace with everything you did. It’s funny. The doctor that I switched from, so my original OB, my doula had three VBAC clients all at the same time. We were all due around the same time. Two of us switched from him. We all started under his care and two of us switched. I ended up with a VBAC. She ended up with a repeat C-section but dilated to complete so she was very happy. The third person stayed with him and he pulled the bait and switch on her at 36 weeks. 


    Meagan: So she had an elective? 


    Samantha: She ended up with an elective C-section. I was like, “Oh my goodness. Thank goodness I followed my gut and I switched right away.” Intense. Insane. 


    1:02:39 Finding supportive providers


    Meagan: Yeah. Support really does matter. Support is important and in our Facebook group, we have The VBAC Link Community on Facebook, if you go under “Files”, you can click our supportive provider as well and this provider will be added to that list. Do you want to share your provider’s name? 


    Samantha: Yeah. Her name was Dr. Choquet. She was fantastic. I think I already submitted her name to be added. 


    Meagan: You did, yes. 


    Samantha: I loved her and Dr. Lalande was the one I consulted with for my extension who was super and is known for doing VBACs after two C-sections as well. 


    Meagan: Lalande? 


    Samantha: Yeah. I also submitted her name as well. Both doctors practice at LaSalle Hospital. It was a further drive, but 100,000 times worth it. 


    Meagan: Yes. Sometimes it’s hard to go far or you get worried about it, but usually, something good comes out of it. 


    Well, congratulations again, and thank you so much for taking the time today. 


    1:03:53 3-5 prep tips for listeners


    Before we leave, what 5 or maybe 3-5 tips would you give to the listeners during their prep? What were your key things for prepping? What information would you give and suggest? 


    Samantha: I would say that the mental prep is 100% the work that I did the most that I think benefited me in terms of Hypnobirthing tracks. We did the Parents Course by The VBAC Link which was very helpful, I found, for getting my husband on the same page. He can tell you everything about VBAC now because he took that course. 


    Meagan: I love that. So it helped him feel more confident. 


    Samantha: 100%. He was pretty on board from the beginning, but it just solidified everything in his brain. He was like, “These stats. Obviously, we’re going to go for a VBAC.” He was super on board after that for sure. 


    Meagan: Awesome. 


    Samantha: Then it armed me with the stats. My parents were very nervous about me trying for a VBAC and things like that so it really helped me arm myself. And just mentally, knowing that my chances of rupture and things like that were so much lower than the chances of actually succeeding in a VBAC so really, the mental prep and knowing that doing everything, I was going in there as equipped as I could be with the most education having done all of the prep work and then you have to leave it up to your baby and your body. Really trusting that and I didn’t think the mental game would be that intense. 


    Meagan: Man. It is. 


    Samantha: It is. 


    Meagan: It is intense and really, it can be especially based on what trauma we’ve had or what experiences we’ve had. There can be so much that goes into it and we have to find the information in order to even process sometimes and work through that and then you mentioned all of the amazing things you did. You did pelvic floor. You did acupuncture. You did dates. 


    Samantha: I wrote everything. 


    Meagan: You did it all. 


    Samantha: And for the dates, I did them with peanut butter and a nut on them to balance the protein and the sugars. 


    Meagan: That’s my favorite way. That’s my favorite way that I eat dates as well. 


    Samantha: I broke them into two in the afternoon and then two after supper because that’s when my numbers were the best for my gestational diabetes and I always took a walk after supper so that really helped. 


    Meagan: Oh, I love that. 


    Samantha: Because a lot of people, I would hear say they couldn’t do dates because of their gestational diabetes but as long as you can balance your numbers, it’s still a possibility so that’s helpful and just finding all of the information about gestational diabetes was tough to find, but really important for my mental game as well. 


    Meagan: Yeah. Absolutely. Oh, I love those tips. Thank you so much again and congrats again. We will make sure that we get your docs added to and your doula and everybody added to the list so people can find them because support is a big deal. It’s a really, really big deal. 


    Samantha: And thanks to The VBAC Link. Honestly, the only sad part is that there is not much of Canada that is covered yet, so finding my alternatives that way, but everything else was covered by The VBAC Link 100%. I tell everybody about The VBAC Link. The other day, I went for my COVID shot and I told my nurse– her daughter had just given birth via C-section and she wanted to go for a VBAC. I was like, “Get her a doula through The VBAC Link.” 


    Meagan: Oh, that’s amazing. I love that. Thank you so much. 


    Samantha: Thank you so much for everything you do. It was a game changer, 100%. Absolutely. 


    Closing


    Would 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.





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    1h 8m | Feb 14, 2024
  • Episode 275 Lily Nichols + All About Gestational Diabetes

    We have an incredibly special episode for you today with the one and only Lily Nichols! She is a registered dietitian nutritionist and the author of two books (soon to be three!)-- Real Food for Pregnancy and Real Food for Gestational Diabetes. Lily is truly a pregnancy nutrition expert providing women with access to the most current evidence-based information regarding food. 


    Lily specializes in helping women with gestational diabetes feel empowered with options to help their blood sugar stay diet-controlled. This important work is helping women with gestational diabetes have healthier pregnancies and more birthing options when so much of the conversation around it becomes limiting and fear-based. 


    Whether you have gestational diabetes in your pregnancy, are pregnant, preparing to be pregnant, or just want more nutrition education, this episode is for you!!


    Additional Links

    Lily’s Website

    Real Food for Gestational Diabetes

    Real Food for Pregnancy

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Timestamp Topics

    09:28 What is gestational diabetes? 

    11:15 Are there preexisting signs and ways to prevent it?

    13:59 What can we do? 

    17:00 How much protein you should get in pregnancy

    19:11 Best sources of protein

    22:04 Getting enough protein on a meatless diet

    26:17 Fats & Gestational Diabetes

    31:14 Do we have to have a baby at 38 weeks with gestational diabetes?

    32:28 The problem with the standard gestational diabetes guidelines

    40:20 PCOS and gestational diabetes


    Meagan: Hello, hello everybody. This is The VBAC Link and we have a very special episode for you today. This is a topic that if I were to show you in the inbox, you would be like, “Whoa. I didn’t realize so many people have this question.” The question is– I mean, there are lots of questions– but the topic is gestational diabetes. 


    So if you have any questions about gestational diabetes, this is your episode for sure. And then actually, right before we started recording, I learned there are even other things that make us at high risk or are a known risk for gestational diabetes. Even if you haven’t ever had gestational diabetes, you’re going to want to listen because there are things that we can do preventatively before pregnancy or during pregnancy to avoid it. 


    But you guys, we have the one and only Lily Nichols on today with us talking about this extraordinarily common topic. Lily Nichols is a registered dietitian nutritionist and certified in diabetes education. She is a researcher and an author with a passion for evidence-based prenatal nutrition. Drawing from the current scientific literature with the wisdom of traditional cultures,  her work is known for being research-focused, thorough, and sensible. Her best-selling book is Real Food for Gestational Diabetes


    I absolutely love that the start of this is “Real Food”. Real food is something that I don’t feel like we focus on enough in our every day– not even during pregnancy– lives. We live busy lives, so it’s hard to focus on real food. But Real Food for Gestational Diabetes and you guys, she has an online course with the same name so Real Food for Gestational Diabetes Online Course


    She is absolutely amazing and has even written two books and now what I learned today is going on the third, so Real Food for Pregnancy and Lily, what is the title of your new book?


    Lily: The forthcoming book is Real Food for Fertility. 


    Meagan: For fertility. Oh my gosh, you guys. She is evidence-based. It’s amazing and you know here how much we respect evidence-based information and getting this to you guys so you can know the true facts and go on and make decisions that are best for you. 


    So Lily, thank you so much for being here with us today and talking about this topic because like I said, it is one of the most common questions we get in our inbox. 


    Lily: Yeah, absolutely. I’ve spent a lot of work working on gestational diabetes so I’m happy to speak about it with you today. 


    Meagan: Yes. Can you tell us a little bit more about your course? I’m going to start there because you have an online course. I think this is a great thing for anyone who has either had gestational diabetes or has it to really learn more about it. 


    Lily: Yeah, absolutely. The course is really designed for women with gestational diabetes not necessarily healthcare professionals and it kind of expands upon the information that is in the Real Food for Gestational Diabetes book so additional, practical resources that support the same principles that you learned in the course but takes it to another level so there are additional meal plans. There are three weeks worth of meal plans and several different carbohydrate levels so you can customize them. 


    There is more information on lowering your fasting blood sugar naturally with the hopes that we can reduce or minimize your risk for medication or insulin which, depending on where you are and who your provider is can limit your birthing options. Also, I generally disagree with it, that is often a policy. We really often try to use food and lifestyle as much as possible to enhance our ability to keep our blood sugar under control. 


    Probably some of the biggest benefits, though, of the course is that we do have a private Facebook community just for course participants and I do host weekly office hours. People will share what’s going on with their blood sugar. “Hey, I’m struggling with this with my fasting blood sugar. I’ve tried x, y, and z and it still hasn’t worked. Do you have any tips for me?” We have a really active community in there. 


    Once you are a member, you are always a member. We have some moms who are on their third pregnancies and still in the course that can offer feedback but I also answer questions every single week. I’ve been told that arguably the biggest benefit is you can get my eyes on it and get a second opinion. Since I don’t have a whole lot of availability for one-on-one clients, it’s really the main way you can get my feedback on what’s going on. 


    That’s helpful, I think because there really isn’t a one-size-fits-all intervention for gestational diabetes. Obviously, there are some general truths that work food and lifestyle-wise, but individual tinkering is something where you really need individualized attention versus, “Here is this snack that works for every single woman.” There really is no such thing. I wish there was. It would make my life way easier. It would make everybody’s lives easier. It would make the diagnosis less frustrating. 


    But oftentimes, it’s like, “Okay. I need to get my blood sugar under control in two weeks otherwise they’re going to put me on medication.” People really need that kind of information right away at a really important time point in their pregnancy. 


    Meagan: I love that you say that. We have private groups too and I feel like these groups are just money. 


    Lily: Oh yeah. 


    Meagan: Even just seeing things that other people are asking and you’re like, “Oh, actually I have that same question,” then maybe you reply to them and it just filters down. Those groups are so awesome. I love that you have created that and created a space for people because I don’t feel like in the medical world– and this is not to shame the medical world– they just don’t have time to do exactly what you were saying. “Okay, you’ve got this diagnosis. Let’s break it down for you as an individual.” It’s, “Here’s a sheet of paper,” that you can pull off of Google. 


    It doesn’t mean that it applies to you. You have the diagnosis so it could help you but it doesn’t mean that it’s going to be the best thing for you as an individual. 


    Lily: And moreso than that, sometimes you don’t have a provider that is well-informed on the updated research so I get a lot of women in the course who are like, “Okay, I don’t know if I really need this course, but I figured it would be a good idea,” then they jump in and they are like, “I have my meeting with the dietitian this week,” then they come back in the group and they are like, “What the dietitian said that what I’m doing is wrong and that I need to eat this way, so I’m going to try it,” then they come back three days later and they are like, “My blood sugar was terrible. This advice didn’t work. I feel awful. I need to go back to the original.” 


    It’s just the ongoing thread of community members who have been through the same thing. Ultimately, that’s why I do the work that I do and write the books that I do because the standard of care just doesn’t often work or it’s 20 years outdated. 


    Meagan: Oh, I can so relate to that one when it comes to VBAC. It’s the same thing when we’ve got one provider saying this and then another provider is saying this. It’s a very similar situation. You’re like, “Well, what is it? What does the evidence really say?” 


    9:28 What is Gestational Diabetes? 


    Lily: Right. 


    Meagan: Oh, well okay, so I think I would like to just even start off with what is gestational diabetes. What does that mean? If you get this diagnosis, what does that mean? 


    Lily: Yeah. So at its simplest definition, it is blood sugar that is elevated during pregnancy beyond a certain threshold. The whole diabetes during pregnancy, I think, confuses people a little bit because it is like, “How can I develop diabetes during pregnancy but only during pregnancy?” Really, it’s that your blood sugar is elevated beyond a certain threshold. 


    There are other definitions like insulin resistance during pregnancy or carbohydrate intolerance during pregnancy. They are all speaking to the same thing. Your body has a more limited ability to bring your blood sugar down within the normal range for whatever reason. 


    There can be a number of different reasons. Sometimes there are pre-existing issues before pregnancy that we didn’t know about and during pregnancy, we test for things so there are a whole lot of the population that is walking around essentially with pre-diabetes and has no idea. Then during pregnancy, we screen blood sugar levels to rule out gestational diabetes and then it gets caught on that test. You think that it’s something that developed during pregnancy, but it may have been an underlying blood sugar issue that you had for a while. We are simply identifying it at this point. It can be newly developed or it can be pre-existing and we have identified it at this time point. 


    They are technically both called gestational diabetes regardless of the underlying reason. 


    11:15 Are There Preexisting Signs and Ways to Prevent it? 


    Meagan: Okay. I did not know that. I didn’t know that we could be– it doesn’t just appear. Sometimes it could be preexisting. Are there preexisting signs where we could know that we did have that or are there things that we could do pre-pregnancy to try? Say I have high sugar or whatever right now, but I didn’t know and I get pregnant and I get gestational diabetes, but are there things we can do during pre-pregnancy to– I don’t know the exact way to say it– almost nix it? To try and help reduce it or not have it at all? 


    Lily: There are. There’s kind of a mix when we talk about risk factors because some of the risk factors are things within our control and some of the risk factors are things that aren’t within our control. We can’t control whether our mom had gestational diabetes during her pregnancy or whether we have a lot of Type 2 diabetes or insulin resistance in our family. We can’t control our age. We can’t necessarily immediately change our weight at the time of conception. Over the long term, we can have some influence over our weight, but if we are talking retroactively, we can’t go back four months and be like, “Oh, I wish I weighed 20 pounds less before I conceived.” 


    You can control, of course, the food you are eating. You can control the micronutrients that you are taking in. There are a lot of nutrients that can reduce our baseline levels of insulin resistance like magnesium and vitamin D and inositol and several other things. Eating sufficient amounts of protein seems to be protective. Our sleep habits can impact our insulin resistance and our stress levels can play a role. 


    Gosh, there was one more. 


    Meagan: Does high cortisol impact our sugars and their ability to come down? 


    Lily: Mhmm. High cortisol raises your blood sugar. Physical activity levels both before conception and during pregnancy– the more exercise we get generally speaking, the lower our risk of gestational diabetes. There are things and sometimes we have so many risk factors that are outside of our control like family history stuff and age at conception where perhaps we have a preexisting elevated risk which makes all of those lifestyle factors that are in your control arguably that much more important because those are the areas where we can make a difference. 


    13:59 What Can We Do? 


    Meagan: Make a difference. So what can we do? We can lower our stress. We can increase our sleep. We can be physically active. We can eat real food, but can we talk more about that real food? What can we really eat during that? 


    Lily: Yeah. The biggest thing to keep in mind, I would say, is your macronutrient balance like your balance of carbohydrates, fat, and protein as well as the quality of the food that you are eating. Specifically looking at eating a sufficient amount of protein, protein tends to be the most stabilizing for our blood sugar levels whereas carbohydrates are the macronutrient that raises our blood sugar levels the most. 


    When we eat enough protein, it also has a regulating effect on our appetites since it stabilizes our blood sugar. We don’t get a huge spike and crash like we do with carbs. We don’t get the cravings and that same intensity of hunger leading up to meal time or snack time. So hitting our protein goals is absolutely essential. 


    Then second to that, the next most important thing is thinking about the quality of the carbohydrates you consume. It’s kind of wild but in the US, 60% of calories consumed in the average American diet are from ultra-processed foods. These are things made where the primary ingredient usually is a refined carbohydrate of some kind. It’s refined starch or white flour, corn starch, something like that, maltodextrin, or refined sugar like white sugar, corn syrup, high fructose corn syrup, and then all of the random additives and junk added to it. 


    Basically, a lot of things that are in the snack and dessert aisle and prepackaged food aisles in our grocery store, breakfast cereals, and that sort of thing. If we simply displace even a portion, even 25% of this majority of our diet that’s coming from ultra-processed foods, we will have better blood sugar levels. Even if they are being replaced by carbohydrate foods but they are not highly, highly processed, you’ll have better blood sugar levels especially if we are replacing some of that with protein-rich foods. 


    So I’d say it’s two-fold. It’s like the macronutrients and then it’s the quality of the food reading, trying to eat as many whole foods as possible to displace the processed food items. When you hit your protein food goals, you’re not going to have intense cravings for as much of the processed stuff. 


    I like to hit it from the front end instead of being reactive like, “Cut out the processed foods.” That’s easier said than done. What are you going to eat instead? Try getting enough protein and you’ll find that you are drawn less to those foods in the first place. 


    17:00 How Much Protein You Should Get in Pregnancy


    Meagan: And with protein, do you know on average– I mean, it’s hard because we are all different ages and weights and heights and all of the things. But on average, during pregnancy, how much protein should a pregnant person consume? 


    Lily: Yeah, there are ballpark metrics that we can use and there are some that are more specifically based on an amount of protein based on how much you weigh because protein needs are individualized by a person’s body size. If we just use a standard 150-pound woman, in early pregnancy, you need about 80 grams of protein and then in late pregnancy, you need a minimum of about 100 grams per day. 


    Meagan: Okay.


    This is actually higher than was previously thought. Our first-ever study that directly measured protein needs in pregnancy was done in 2015 and they found that our recommendations are way too low. 


    Meagan: Yeah, 80-100 to me seems really low. I’m not pregnant and typically try to get more protein than that. 


    Lily: Well, 80-100 is a lot more than what the current recommendations are. 


    Meagan: Which is crazy, yeah. 


    Lily: The current recommendations for late pregnancy on average are about 71 grams of protein per day. 


    Meagan: Whoa. 


    Lily: Yeah. 


    Meagan: Wow. So we need to beef it up. We need to get some protein in. 


    Lily: Yep. It depends on the person too. We have some individuals who are highly physically active or maybe if your blood sugar is really, really sensitive to carbohydrates, you might do better having a higher proportion of protein in your diet than another person. So while 80-100 is a good minimum ballpark metric, you might do better aiming for 100 or 110 grams per day in early pregnancy and later on aiming for 120-150 grams. It really depends on the person. 


    Meagan: It all depends, yeah. 


    Lily: Yeah. 


    Meagan: That is pretty crazy. 


    19:11 Best Sources of Protein


    Meagan: Okay, now we know we’ve got to get our protein. What are the best sources of protein? That is something that I do find that sometimes is hard. It’s really hard to get whole protein and sometimes I do have to supplement with a shake or add some protein collagen to my oatmeal or something. So what types of proteins or what sources of proteins or what ideas could we give to our listeners?


    Lily: Yeah. When you think of protein, there are a lot of different foods that contain protein, but they have proteins in different concentrations or there’s a different balance of amino acids within those proteins. Our highest quality, the best balance of amino acids, and the highest concentration of protein per the amount of food you are eating is from our animal foods. So meat, fish, eggs, dairy, seafood– those have your highest concentrations of protein relative to any of the other macronutrients. 


    As you go into your plant source proteins, you’ll have a lower proportion of protein and just a different or more incomplete amino acid balance. You’ll get a lot more carbohydrates along with that protein, but they, of course, have other positive things in them. Plant proteins come with fiber, for example. Our beans and legumes of plant proteins would be the highest quality ones that you can get. We have significantly smaller proportions of protein in our grains, for example. Nuts and seeds are a decent source. 


    You can also get, of course, all sorts of protein supplements. They can extract protein from anything that is protein-rich and market it as a supplement. We have our grass-fed whey protein and our beef protein isolate and we have rice protein concentrate and all sorts of things. You have your pick. If you are not getting enough from food, you can always supplement with additional on the side, but my recommendation really is to try to get a balance of different protein sources since there are pros and cons of all of our different proteins. Just try to get a mix. That amount and forms might be different from person to person based on their preferences. 


    22:04 Getting Enough Protein on a Meatless Diet


    Meagan: Yeah. That makes total sense. Kind of talking about how some things have less, for any listeners that maybe are not eating meat or don’t eat meat, how? I mean, just eating a lot of legumes and beans and nuts and stuff like that? Or how? I don’t know. Is there a higher risk there if we don’t eat meat? Does that make sense? Is it harder to get it in and how can they focus more on getting that? 


    Lily: It is. It is a bigger challenge. Vegeterians and vegans do consume on average significantly less protein than omnivores. You can kind of plan around it by having a higher proportion of beans and legumes versus grains and considering some specific high protein options like tempe, and fermented soy products. I’m not a huge fan of a lot of soy, but fermented soy as long as it is organic can be okay and tempe is quite high in protein and relatively low in carbohydrates. Your nuts and seeds can contribute more and you can consider supplemental protein options. 


    It does definitely get tricky particularly as we talk about gestational diabetes with blood sugar management on a vegetarian and vegan diet simply because most of our plant sources of protein if you are consuming them as a whole food, they have a significant amount of carbohydrates. So sure, you can get protein from beans, but beans also have carbohydrates. 


    Meagan: I’m sure. 


    Lily: There’s some protein in quinoa, but it’s 8 grams of protein per 40-something grams of carbohydrates in that serving whereas if you were going to consume 8 grams of protein from meat, that’s literally a little more than 1 ounce of meat and it has 0 carbohydrates. When you are looking at macronutrient balance, it gets a little bit trickier. 


    So for vegetarians and vegans– I mean, with vegetarians, you have eggs and dairy so you can do more eggs. You can do more low-carbohydrate dairy products like cheeses, cottage cheese, greek yogurt, dairy protein powders, and egg protein powders and that makes the macronutrient balance much easier. 


    With vegans, we generally do need to rely on some supplemental protein powders just so we are not overdoing the carbohydrates. It does get significantly trickier. It’s not that it’s not doable, but there are of course, always different trade-offs with different dietary approaches. 


    Meagan: For sure. 


    26:17 Fats & Gestational Diabetes


    Meagan: So we’ve talked a little bit about the carbs and the proteins and the fats. A lot of, say salmon or even eggs. We’ve got egg whites but then we’ve got yolks which consume a lot of fat. How does fat play into or does it play into gestational diabetes?


    Lily: Similar to protein, fat does not raise your blood sugar levels so generally speaking, fat is not something you need to be overly worried about necessarily. That definitely flies in the face of conventional guidelines that tell you to limit your fat production significantly. We have to be really cautious when we talk about limiting fat in pregnancy. 


    First of all, we are in a situation where your hormone production is higher than ever. Our sex hormones like estrogen and progesterone are built on a backbone of cholesterol which you get in fatty foods, specifically your fatty animal foods. Whatever you don’t consume, your body produces. So if we are cutting out all of the fat out of everything, you actually run into problems with hormone production. 


    They have shown this in studies where they limit fat in women. Estrogen and progesterone production can be 20-50% lower. Even though your body has the ability to create cholesterol from other precursors, it still negatively impacts hormone production to not be consuming it. I do get concerned about that. 


    I do also get concerned that when you start limiting fat from food, you’re also limiting your intake of a lot of micronutrients. Egg yolks– you gave the example of egg yolks. Egg yolks are high in cholesterol, yes. They are also the richest dietary source of choline which is a nutrient we need for optimal placental function and optimal fetal brain development, and when we are not getting enough, it’s linked to many significant problems. I mean, we now have very high-quality studies like randomized controlled trials showing that taking in actually more than double– the current recommended intake for choline improves child brain development through their toddler years all the way– the study has now been extended through age 7. They have followed these kids through age 7 and they have better brain function essentially at those later ages. 


    If you are cutting out egg yolks for the goal of reducing your fat or cholesterol intake, you are essentially setting yourself up for a choline deficiency. Half of the choline an average American takes in is from eggs. It is such a concentrated source. You can extend that to many other examples for many other nutrients in foods that naturally contain fat. It’s a significant concern of mine actually. People get so laser-focused on fat that they lose the big picture on what are you missing out on. 


    Meagan: What it’s actually giving you. 


    Lily: Yes, exactly. I’m not a big fan of limiting the fat intake. Particularly, when you are talking about blood sugar control, if you are reducing your carbohydrate levels, then you are reducing the calories taken in from carbs. You have to eat something else, right? We can only eat so much protein so it always ends up being a dance between– are you eating more carbohydrates or are you eating more fat? That’s always how the balance is made up in terms of our macronutrient ratios. 


    Certainly, I love the protein. I’m all about eating protein, but our protein-rich foods do naturally come with fat, so what I am personally not a fan of is people obsessively taking out the fat of all of their protein-rich foods. Just eat the fat that is in there. You don’t need to add massive quantities of fat to everything you are eating, just don’t take out what is naturally there. 


    Meagan: Yeah. Yeah. I love that you talk about that because one of the things– so I’m a doula and I’ve seen this in all the years of being a doula, but then I’ve also seen this trend of messages coming in like, “I’m scared to eat too much. I’m scared to eat fat. I’m scared to eat these things because I’m scared of a ‘big baby’” or “I’m scared of having to have a C-section because my baby is measuring big,” or they are so scared of shoulder dystocia so they are now having to induce me at 38 weeks which we already know with gestational diabetes, a lot of the times, providers encourage induction early anyway. 


    Ladies, do not cut out your fats. Eat your good proteins. Get the right kind of carbs. 


    31:14 Do we have to have a baby at 38 weeks with Gestational Diabetes?


    Meagan: What does it look like with gestational diabetes? Do we have to have a baby at 38 weeks like many providers suggest? Do we always have a big baby if we have gestational diabetes? 


    Lily: Absolutely not. 


    Meagan: Right? 


    Lily: Absolutely not. 


    Meagan: Can we talk about that and cross out those myths? 


    Lily: Yep. We have very strong data actually that when we are able to keep blood sugar within range as much as possible– it’s not going to be perfect, but as much as possible, keeping your blood sugar within a healthy level and your provider should give you some healthy guidelines. If you don’t, go read “Real Food for Gestational Diabetes”


    Meagan: Seriously. Go get your book and the link is in the show notes, everybody. 


    Lily: Yeah. We see a 50% lower risk of macrosomia. That’s the baby being born larger than expected. 


    Meagan: Too large, yeah. 


    Lily: We see a 60% lower risk of shoulder dystocia. 


    Meagan: Wow. 


    32:28 The Problem with the Standard Gestational Diabetes Guidelines


    Lily: These risks absolutely can be lessened with dietary and lifestyle intervention. What frustrates me the most and it’s why I wrote “Real Food for Gestational Diabetes” in the first place, is that the standard guidelines for dietary management of gestational diabetes fail to improve outcomes because they often fail to control blood sugar levels because they are arbitrarily way too high in carbohydrates. 


    So what ends up happening is you get these women who get a meal plan that says, “Eat 45-60 grams of carbohydrates at a meal, a super minimal amount of protein, barely any fat” because this is all just an off-shoot of the standard dietary guidelines, and their blood sugar goes way too high after their meals. They are like, “What is going on? I’m eating per the guideline.” 


    Meagan: I’m following. 


    Lily: Yeah, exactly. Unfortunately, they are simply consuming way too many carbohydrates for what their body can tolerate. I mean, it makes no sense. If you failed a glucose tolerance test meaning your blood sugar was not able to come down within range when you had anywhere from 50, 75-100 grams of glucose in one sitting? Why are we then giving you 45, 60, 75 grams of carbohydrates which turn into glucose in a sitting at a meal, and saying that this is treatment? It is not treatment and anybody with a toddler-level logic can see that it makes no sense whatsoever. 


    Meagan: No sense. 


    Lily: Ironically, it’s very controversial advice to recommend a lower than that carbohydrate intake and that’s precisely what I present in my book with the evidence to back it up, but that still remains the standard of care. So then what ends up happening, you get these women who end up afraid to eat because they are worried about their blood sugar going too high. 


    Meagan: Exactly, yes. 


    Lily: So they eat the same type of meal but a really, really, really tiny portion and they are starving. 


    Meagan: Yes. And they are malnourished. 


    Lily: Exactly. They are malnourished. 


    Meagan: They are not getting the macro or micronutrients in their bodies. 


    Lily: It is tragic and it is unethical in my opinion, so if you do find yourself in that scenario where you feel like you are having to starve yourself to keep your blood sugar within range, after you check your blood sugar after that meal, you are clamoring for a snack because you are so hungry, there is another way. 


    Meagan: Yes. 


    Lily: It does involve nourishing yourself enough. You have to get enough calories in. 


    Meagan: Yes. 


    Lily: You can get enough calories and micronutrients in without the blood sugar spike just with a different macronutrient balance. You need to be eating a lot more protein. You need to ditch the fear of fat. You need to eat a quantity of carbohydrates that your body can manage in one sitting. Oftentimes, that isn’t 45-60 grams or 75 grams of carbohydrates per meal. That might be 10 or 15 or 20 or 30 grams of carbs in a meal. 


    Meagan: Right. 


    Lily: It might mean eating your protein-rich foods first before you have your carbs at the end of the meal. That can significantly change how your blood sugar responds. 


    Meagan: Okay. 


    Lily: But the standard approach is very ineffective and I can tell you when they have actually done studies where they switch people to a lower glycemic index diet, so better quality carbohydrates, more protein, and the chances that a woman will require insulin to manage her blood sugar drops by 50%. 


    Meagan: Whoa. 


    Lily: That can make the difference between your birth being sabotaged, overly intervened, you being denied a VBAC, them trying to scare you into the “your baby is too big” and that whole conversation. That can make a difference of it. So we really need to get better information out because it’s not fair. Gestational diabetes is poorly managed and it’s overly medicalized when it is diagnosed. 


    Meagan: I feel the same. I feel it is. Some people have described it as, “Oh, it checked off a box saying you are in this category automatically because you tested positive.” Then they do. They go down rabbit holes. Women of Strength, if you are listening and you are someone who feels that they can’t eat a lot or you are in that space and you are the person that we are describing, you are not alone. You are not alone in this world. 


    But, you have more options. That is why I wanted to do this episode because it makes me want to cry because I hate and I feel their frustration. It also makes me want to punch someone, not our listener, but it makes me just want to punch somebody and be like, wake up. give different information and stop putting this pressure of, “You can’t have a VBAC. you’re going to have shoulder dystocia. You have to have a baby by 38 or 39 weeks.” All of these things or “Your baby is too big.” It’s just, why? Instead of just diving in learning how to better manage and to eat better. Eat more real foods. 


    Lily: I mean, if your blood sugar is maintained in a healthy range for the majority of your pregnancy, you are not at any higher risk than anybody who didn’t get a diagnosis. All of these things are potential risk factors, I mean, in the macrosomia conversation, you can have women who passed a gestational diabetes test, but maybe they gained quite a bit more weight than is expected over the course of their pregnancy. They are actually oftentimes at a higher risk for macrosomia than the woman who was diagnosed with gestational diabetes and had excellent blood sugar control. Nobody talks about that, right? 


    To me, the difference is really in how you manage it. I think we have to try to lose the fear over the diagnosis. It is an unfortunate reality that for a lot of providers, you can be treated differently because of the diagnosis even though I disagree with that, but you can maintain actually quite a low-risk pregnancy, sometimes an even lower risk than if you hadn’t been diagnosed because if you see this as a blessing in disguise and take it upon yourself to improve your diet and lifestyle and really buckle down on this and get your blood sugar in a healthy range, you now are having a healthier pregnancy than if you didn’t have the diagnosis because you are taking a moment to be like, “Hmm, yes I’m pregnant and I’d like to eat for two, but you know what? I’m actually full. I don’t think I’m going to have that extra cupcake.” 


    It’s all of those consistent blood sugar elevations without a gestational diabetes diagnosis that is contributing to the baby growing larger than expected. When you bring the blood sugar within range, we see a significantly reduced risk of macrosomia. 


    Meagan: Yeah. This episode, I feel like, has so many really great tips on just how to eat better in general during pregnancy even if you don’t have gestational diabetes. 


    Lily: Yes. Absolutely. 


    40:20 PCOS and Gestational Diabetes


    Meagan: Before we were recording, we were talking about your new book. You said something that caught my ear and I was like, “Wait, what?” because PCOS which is polycystic ovarian syndrome– is that correct? 


    Lily: Mhmm, correct. 


    Meagan: It runs in my family. You were talking about how PCOS could be a sign. 


    Lily: It’s a risk factor for gestational diabetes, yeah. Absolutely. 


    Meagan: Yeah, so can we talk a little bit more about some of those risk factors and how if we maybe have these things we may need to be extra aware and intentional? 


    Lily: Intentional, yep. That’s a good word for it. With that, PCOS is a bit of a complicated diagnosis. There are different subtypes. There are actually four phenotypes and they are all just a little bit different. They share some overlap, but they are all a little bit different. That said, the majority of PCOS cases do have some degree of insulin resistance going on in their body. Your body doesn’t respond normally to insulin and brings your blood sugar down within range with a normal level of insulin. Your body has to release a lot of insulin to bring your blood sugar within range. 


    Meagan: Wow. 


    Lily: This is a risk factor for gestational diabetes because, during pregnancy, your body naturally becomes a little more insulin resistant. So if you are already coming into pregnancy with that baseline challenge with your body responding to insulin, when your body starts pumping out more insulin, your insulin resistance is going up and up and up, it can just compound and be too much for your body to handle. Your blood sugar will surpass that threshold of so-called gestational diabetes. 


    That is a significant risk factor. It also tends to be– PCOS is the most common ovulatory issue in women, so it can make conception a little more challenging. It can make timing sex accurately for conception more challenging because oftentimes, there are really long cycles or delays in ovulation so it’s harder to time it right although women with PCOS can conceive successfully naturally. It can just be a little more tricky. 


    And then when there already is a blood sugar issue going on ahead of time, there is a higher rate of early miscarriage as well. Now, things that you do for managing PCOS, there is a lot of overlap with the same concepts for managing gestational diabetes. If you do have that diagnosis and you are thinking about becoming pregnant, you can implement some of the same tips that we talked about today or blood sugar management. Higher protein, fewer carbohydrates, better quality carbohydrates, eating your protein-rich foods first at mealtimes, and considering supplementing with certain nutrients to reduce your level of insulin resistance. 


    There is some really excellent data on inositol which is a B vitamin compound for reducing insulin resistance and improving ovulation and ovulatory function in these women and that is a supplement that honestly, they’ve done studies where they have put it head to head with metformin which is the most common medication prescribed for women with PCOS. It is also prescribed for gestational diabetes management and it often performs the same or better than metformin so inositol is a really viable option that women can look into and consider supplementing with. 


    We talk about it pretty extensively in Real Food for Fertility as an option along with many other nutrients. There are a lot of other micronutrients that play a role in keeping our level of insulin resistance down as much as possible. So just improving overall the quality of your diet where naturally, you are just displacing more and more of these processed foods from your life because these also are so rich in micronutrients, you’re naturally improving the function of your pancreas and how responsive your body is to insulin and your blood sugar doesn’t spike as much because you aren’t getting as much refined carbohydrates in. 


    There’s a lot of these things that all work in tandem and they work together. They continue to be important during pregnancy as well, so wherever you are, start now. Start thinking about this now. 


    Meagan: Start now. Yes. Start now. It’s never too late to start. Like I was saying in the beginning, we live a busy life so that quick granola protein bar that is easily unpackaged in the car that you can take a bite of might be an okay snack but might not be the best. Maybe carrots. Maybe you can have carrots. 


    Lily: Or maybe having a bag of nuts or some beef jerky. The nuts would be similar to a granola bar, but they are much lower in carbohydrates. They have more protein, fat, and fiber in them so they won’t spike your blood sugar, but they may fill you up better than a granola bar and with a significantly lower blood sugar spike for sure. 


    Meagan: And I guess carrots are a lot of carbs so it turns into sugar. 


    Lily: I mean, carrots do have carbohydrates, but they have quite a bit of fiber in them, so they are a fine option as well. They are just pretty low in protein and have no fat and they are so low in calories that solely as a snack–


    Meagan: It’s not going to help you feel full. 


    Lily: Yeah. It’s not going to keep you full. I’ve got nothing against carrots. Carrots are excellent, but maybe having them with a cottage cheese dip or something like that would at least provide you with a little more sustenance. 


    Meagan: Yes. Going back to the protein. See? We forget about the protein. 


    Lily: Yep. 


    Meagan: Focusing on the protein. Wow, I just adore you. I think this is such a great episode. I need to just go get your books now. I mean, I’m not even pregnant. I’m done with having babies, but I want to dive in more. I want to learn more because like I said, it’s such a hot topic for our VBAC community especially because we have so many naysayers like, “Oh, you can’t do this if you have this.” 


    So okay, tell us more. You’ve got your website, lilynicholdsrdn.com and I know you’ve got the blog, your shop, your books, and all of the things. Tell us more about where we can find you and what resources we can use. We’re going to make sure to put everything in the show notes, you guys. 


    Lily: Yeah, so up on my website, definitely click the Freebies tab. You can download a free chapter of Real Food for Pregnancy if you want to dive more into what is real food. What are you talking about? That is available for free. There is a free video series on gestational diabetes that is really helpful to help you if you have just been diagnosed or are worried about being diagnosed. That will narrow down the starting point. The biggest thing I hear is that people are really afraid and overwhelmed by what to do. It just feels very dire. You are given the diagnosis. You are told that it comes with these risks and you are not told any good news, so I try to be the bearer of good news and empowering information so you can actually take action on that. 


    Meagan: I love that. 


    Lily: Probably those two resources would be of most interest to this audience. I’m also on Instagram. My handle is @lilynicholsrdn so pretty much the same as my website. And yeah, keep an eye out for the new book, Real Food for Fertility in February 2024. 

    Meagan: It’s coming out this month. This episode is being aired in 2024. That is so exciting. That one is on infertility, correct? On fertility. 


    Lily: Yeah. It’s on fertility. That one I actually coauthored this book with my colleague Lisa Hendrickson Jack. She is the host of The Fertility Friday Podcast and author of The Fifth Vital Sign. We joined forces to talk about the food and nutrition part, the fertility hormone/menstrual cycle part and it really is the best of both worlds from our respective specialties. 


    Meagan: I love that so much. Well, we will have the links for both of your books and then like she said, give her a follow so you can know when this new book is coming out. 


    Closing


    Would 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.





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    49m | Feb 7, 2024
  • Episode 274 "I Don't Know Who Needs to Hear This, But..."

    I don’t know who needs to hear this, but…


    You do NOT have to be induced at 39 weeks to have a vaginal birth. 


    You CAN have an induced VBAC. 


    Your cervix DOESN’T have to dilate by 40 weeks.


    Home birth is just as SAFE as hospital birth, even for VBAC.


    Your pelvis is PERFECT. 


    You are capable of doing MORE than you even know.


    Tune in to today’s hot episode to hear Meagan and Julie dive deeper into these topics and many, many more!


    Additional Links

    The ARRIVE Trial and What it Means for VBAC

    Home Birth and VBAC

    Brittany Sharpe McCollum - Pelvic Biodynamics

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Meagan: Hello, hello everybody. We are already a month into 2024 and we are ending the month off with a nice, spicy episode. I think it will be a little spicy. Julie is with me today. Hey, Julie. 


    Julie: The bringer of the spice. 


    Meagan: The bringer of the spice. You know, ever since you stopped doing doula work as well, you have picked it up a notch in your spice. 


    Julie: Because I’m tired of watching people get railroaded by the system. 


    Meagan: I know. 


    Julie: I have picked it up a little bit, yeah. 


    Meagan: I know. 


    Julie: You have to deal with the backlash by yourself if there is some backlash. 


    Meagan: Seriously. No, this episode is going to be a good one. Women of Strength, I think that this episode is going to be very empowering. Yes, it is going to be spicy. We are going to have passion because if you haven’t noticed over all of the years of Julie and I recording, we have passion. When it comes to like Julie was saying, people not being railroaded by the system or not taken advantage of and really knowing what information is true and not, we are pretty passionate about it. 


    So today, we have an episode for you that is going to be amazing. It’s titled, “I Don’t Know Who Needs to Hear This, But…” We are going to be telling you all of the amazing things. 


    Review of the Week


    We have a Review of the Week so we are going to get to that and then we are going to kick it up a notch. 


    Julie: Perfect. All right, yeah. I’m really excited about this episode inspired by all of you really, all of us, and everybody in the birth community around the whole entire world. Anyways, this review is from Apple Podcasts and it’s titled “Highly Recommend.” It says, “Thank you, Meagan and Julie, for creating this podcast. It holds space for mothers with so many different birth stories and as we know, representation matters. After an unexpected emergency Cesarean with my first daughter, I found myself seeking stories similar to my own. I literally binged your show. It  helped me process my own trauma and was incredibly healing. I have since become a labor and delivery nurse and I find myself recommending this podcast to my patients regularly.” 


    What? That’s awesome. 


    “I’m happy to say that this podcast gave me the courage and confidence to TOLAC and I had the most empowering and beautiful VBAC in November. Thank you a million.” 


    That is incredible. I love it. 


    Meagan: That is incredible. I love hearing when labor and delivery nurses or providers will hear the podcast and recommend it to their patients and their friends and their family. That makes me so happy. If you are like our reviewer and you would recommend the podcast, if you wouldn’t mind doing us a solid, pause right now but come back because it’s going to be great. Pause right now and leave us a review. Go to wherever you are– Apple Podcasts, Spotify, or if you are just listening on our website which you can at thevbaclink.com. You can even just Google “The VBAC Link” and leave us a review and recommend us there because your recommendations and your reviews are what help other Women of Strength find this and find these amazing stories and find the information like what we’re giving today. 


    Meagan & Julie


    Meagan: Okay, Julie, I am so excited. I am so excited. This idea is amazing. We were talking about this before. This is kind of like a viral reel. This reel went viral. “I don’t know who needs to hear this…”, but Julie said this. Boom. That is what we are going to do. This is amazing. This episode is going to be so fun. We have actually scrolled The VBAC Link Community which by the way, if you are not in The VBAC Link Community on Facebook, we have a private Facebook group that is very safe and very welcoming to all Women of Strength no matter what type of birth they are wanting, vaginal or Cesarean. You can find us at The VBAC Link Community on Facebook. Answer the questions. You do have to answer the questions to get in because we are very, very strict with that and then we’ll get you in. 


    If for some reason, you have a weird decline because sometimes Facebook is declining them on their own, I do not know why, just message us at thevbaclink.com or on Instagram or wherever and just let us know, “Hey, I’m trying to get in,” because we have definitely been having issues. 


    Julie: Weird. 


    Meagan: I know, right? People are writing us like, “We’ve been trying four times and it’s just declining.” But okay, you guys. Julie, do you want to kick it off? 


    “I Don’t Know Who Needs to Hear This, But…”


    Julie: Yeah, let’s kick it off. Okay, so I don’t know who needs to hear this, but you do not have to be induced at 39 weeks to have a vaginal birth. 


    Meagan: Correct. You do not. 


    Julie: It makes me so mad. It lights my fire. I have a friend who lives in Maryland. He is a major researcher. He researches everything and every topic– politics, home school versus public school, anything. He can give you a one-hour speech on demand because he is on a top-notch level. His head is in the papers. He is just there. But for some reason, we as a culture don’t like to do that amount of research when it comes to having our babies. Right? Why is that? 


    Anyway, so when his wife had their first pregnancy, it was right after the ARRIVE trial came out, and of course, she got induced at 39 weeks. They’ve had two other kids since then. They got induced at 39 weeks every time. Lucky for them, it was super great. They had pretty uncomplicated, straightforward deliveries and everything was fine, but I wanted to scream at him and say, “Friend! You research the heck out of everything. Why are you guys not looking into this for your own babies and your own children and your family, the most important thing in your life?” It’s always been interesting to me for that. 


    So we know by now that everybody is hungry to induce at 39 weeks. We also know by now– I mean, we knew early on, but the rest of the world is catching up now showing that the results of the ARRIVE trial are incredibly flawed. If you don’t know what the ARRIVE trial is, just Google “The ARRIVE Trial, VBAC” and our article on the ARRIVE trial will pop up, but basically it says that induction at 39 weeks lowers Cesarean rates and other complications for mother and baby but there are so many things wrong with that study. 


    There are so many things wrong with that study. I’m not going to get into it because we have a short amount of time, but go look into it. We know now that there have been several research articles from major universities doing research on giant, enormous population groups showing that it actually increases complications and risks associated with induction and it increases the risks of having a Cesarean for mothers. 


    So, guess what though? I hate how fast the ARRIVE trial took on. Everybody is like, “Woohoo! Induction at 39 weeks, let’s do this,” but guess what? Now that we are showing that it is actually harmful to families, everybody is looking away. It’s going to take 10-20 years for this trend to stop. 


    Meagan: But yet it took overnight for it to start. That’s what is frustrating to me. 


    Julie: Because it is more convenient. It is more money. It is easier to manage. 


    Meagan: I have so many feelings. You guys, we have a blog on the ARRIVE trial. We actually have an updated episode on the updates of the ARRIVE trial as well so if you are wanting to learn more about the ARRIVE trial or if you are being told that you need to be induced at 39 weeks in order to have a baby, go check out Episode 247 because we are going to talk more about that topic. 


    Julie: Yeah, absolutely. There’s lots to go into it, but I just want you to know. We want you to know that it’s okay to go past 39, 40, and 41 weeks and wait for your body to go into spontaneous labor. That is really your best chance of having a vaginal birth. 


    Now, there are reasons and times when a medical need for an induction arises that are true and are actually real. Having an induction doesn’t mean you are going to have a C-section, so if you need to go that route for whatever reason that is medically safe for you and your baby, it is safe to do that. 


    “I Don’t Know Who Needs to Hear This, But…”


    Meagan: So on that topic, I don’t know who needs to hear this, but induction is okay for a VBAC and it is possible to have a VBAC with an induction. So yes, it’s more ideal to have spontaneous labor and for things to happen on their own and not to be intervened. But, if medically, there is a reason for an induction, it is okay. You do not have to just have a C-section because there is a medical reason to have a baby. You can be induced. 


    “I Don’t Know Who Needs to Hear This, But…”


    And then sort of on the same topic, but I don’t know who needs to hear this, but your cervix doesn’t have to dilate by 40 weeks. It doesn’t have to. It can dilate after. It doesn’t mean it’s not going to. If you are not dilated or effaced by 40 weeks, it doesn’t mean it won’t, right? 


    Julie: Yep. I hate when people say, “I just left my 37-week check-up and I’m not dilated at all. My provider thinks I needed to schedule a C-section.” I’m like, “Your cervix is doing exactly what it needs to do before it’s time to let the baby out which is stay closed, stay tight, and keep that baby in.” 


    Meagan: Yeah. Yeah. I don’t love that because if a provider is checking at 37 weeks and someone’s not dilated, they’re placing doubt that they are not dilated and placing thoughts of, “Oh, you’re not dilated yet. Oh, you’re 37 weeks.” If they’re already having that tune, that, to me, is a red flag because if you are 40 weeks and you are still not dilated yet, what do you think they are going to say then?


    Julie: It’s just a sign of control. They want to be able to predict and control and yeah. It might not be the best provider to support you. 


    “I Don’t Know Who Needs to Hear This, But…”


    Julie: Okay, I got one. I don’t know who needs to hear this, but home birth is just as safe as hospital birth even for VBAC. I think that a lot of people don’t know this aside from there have been several major studies in the last 10 years or so showing this, but I feel like what most people don’t realize is that home birth midwives, aside from the random rogue ones– you know, here and there you are going to hear a story– but most home birth midwives are incredibly educated and trained at similar levels as hospital midwives are. 


    Now, depending on whether they are certified or licensed, there are different regulations in every state, but midwives at home can carry Pitocin, methergine, and Cytotec. They can carry antibiotics if you are—


    Meagan: GBS positive. 


    Julie: They can give you IVs. They can draw your blood. They can do all of the routine prenatal tests that you can do in the hospital. They have emergency transfer protocols in place. Every state is a little bit different, but in Utah, it is amazing. The seamless transition from home to hospital and transfer of care records and everything like that, a lot of people just don’t know that home birth midwives– like I said, it depends on the state and the regulations whether they are certified or licensed and that type of thing– have access to all of the things except the operation room that you have in a hospital. 


    Meagan: And…


    Julie: Go ahead. You do the and. 


    Meagan: And if there is an emergency like she was saying, there is a transfer protocol in place. Usually, it doesn’t get to anything crazy because we are transferring based on XYZ before there is any true emergency. 


    Julie: Yep. And you know what? Paige is going to be going nuts here because she is going to have to drop so many links into the show notes, but like I said, there have been so many studies that show birth outcomes are similar and some of them are better at home than in the hospital, right? Like a decrease in hemorrhage at home and yes, we can sit here and say that home birth is safe. 


    Meagan: Home birth is safe and a reasonable option for a VBAC. 


    “I Don’t Know Who Needs to Hear This, But…”


    Meagan: I don’t know who needs to hear this, but your pelvis is perfect. 


    Julie: Your pelvis is perfect. 


    Meagan: Your pelvis is perfect. Your pelvis is not too small, you guys. Yes, there are rare occasions where we have a pelvis that is going to be less ideal to get a baby out or harder where maybe they have gotten in an accident and they’ve had a pelvic fracture. We’ve talked about being malnourished as a child or things like that, but it’s really rare for your pelvis to actually not be able to get a baby out of it. It was designed to do that. It can do that. We all have different sizes and shapes and little ingredients to our pelvis–


    Julie: Pelvic ingredients. 


    Meagan: It can do it, you guys. Sometimes it’s changing a position because sometimes our babies need to come out posterior. I learned this in a pelvic dynamics class from Brittany Sharpe. She is freaking amazing and we will drop her Instagram in here as well. 


    But you guys, our pelvises mold. They shape. They move. They form. Babies’ heads mold, but they are all different shapes, and sometimes, our babies have to come into our pelvis in a posterior position to get out vaginally, or sometimes they have to come in looking transverse because of the way they are shaped, but it’s really rare that your pelvis is too small. 


    So if your provider in your C-section said, “Yeah, well while I was in there, I looked and it’s way too small. You definitely should have a C-section here in the future,” just move on from that doctor. Your pelvis is perfect.


    “I Don’t Know Who Needs to Hear This, But…”


    Julie: Move on. All right. I don’t know who needs to hear this, but big babies are not a medical reason for induction and it does not mean that your baby can’t be born vaginally. 


    Meagan: And it’s not a reason for a scheduled C-section. 


    Julie: Yep. 


    Meagan: That goes with any previous C-section because I’ve seen so many people say, “I’ve had a C-section because my baby measured large.” First baby. 


    Julie: Even ACOG says that it’s not a good reason. 


    Meagan: I know. It drives me batty. Why? Why are we doubting our bodies’ abilities? Women of Strength, if you are one and you said, “Okay,” and that’s why you had a C-section, don’t shame yourself, but know that your body creates a perfect-sized baby. 


    Julie: Yeah. Don’t shame yourself because the system railroaded you. Blame the system. That’s who you blame. 


    Meagan: And don’t lose belief in your body’s ability to get your baby out. If your baby is on the larger side, be like, “Well, dang. I’m going to have a good sleeper and likely a good eater.” Be happy about that and not shame yourself and be like, “Oh, I made a big baby,” because also, what I have seen in next babies, I’ve seen Women of Strength stop eating and restrict themselves of the nutrients that they need because they are so terrified. 


    Julie: Scared that their baby will be too big. 


    Meagan: Yes, they are so terrified of having too big of a baby that they are actually not giving themselves the nutrients. We know, especially with all of the Needed prenatal information that I’ve learned, that we are already malnourished as a society today not even just with taking supplements but in our daily food, our soil has changed. Our food has changed. Our nutrients have changed. We don’t want to be withholding those nutrients and food because we are so scared of having too big of a baby. Do not let a provider– this is my “I don’t know who needs to hear this”, but do not let a provider do that to you. 


    Julie: Yeah, we all have stories that we can pull out of anything about these big babies. I was just at a birth last week. It was a scheduled induction at 37.5 weeks because of baby’s size. They thought the baby was going to be almost 10 pounds at 37 weeks. Baby came out at 8 pounds, 3 ounces. Now, that is a little large for a 37-weeker, but my goodness, it wasn’t a 10-pound baby. Okay? 


    This is one of the harder things about being a birth photographer sometimes is that you are not involved in their decisions prenatally so I don’t always have the opportunity to help them learn things. Some people just don’t want to learn and that’s totally fine, but I have another friend who just left an induction. It was a VBAC induction actually and it ended in a VBAC. It was great, but they suspected IUGR which is a small baby. 


    Meagan: Intrauterine growth restriction by the way for whoever does not know that. 


    Julie: Yes. They expected the baby to be super small and I forget. I think it was in the 39th week. They expected the baby to be smaller than 6 pounds. Baby was born at 7.5 pounds, just fine. 


    Meagan: Perfect. 


    Julie: These things are not accurate and if you are healthy, then I think it’s important to know that your body can do this. Now, okay. Okay. I do want to add a little nuance there that all of these things that we are going to be talking about today there are situations where induction is necessary. With uncontrolled gestational diabetes, for example, your baby might be bigger. But what I’ve found most often with gestational diabetes is that we put these women on really restrictive diets and we tell them to be careful about what they eat and to exercise and all of these things. 


    I find that my gestational diabetes clients usually end up having babies that are a little bit smaller than average because of all the restrictions we put on them like you were just talking about. So I just want to add a little nuance there that there are going to be some exceptions to what we are talking about. 


    What we have a problem with here at The VBAC Link is when people take those 1 in 100 or 1 in 1000 situations where extra help is needed and blanket-apply it to 100% of the people. That’s what we’re trying to combat here. 


    Meagan: Yeah. Absolutely. 


    Julie: All right, Meagan. What you’ve got? 


    “I Don’t Know Who Needs to Hear This, But…”


    Meagan: I don’t know who needs to hear this, but it’s always okay to say no. 


    Julie: Yes! 


    Meagan: Always. If you are having someone and it doesn’t even need to be a provider, anybody who is telling you what you are going to do and you are not feeling good about that decision, say no. That is okay. 


    I was in another VBAC group during my own VBAC after two C-sections. I was in multiple VBAC groups. I was in a group and there was someone that wrote into their comment. They said, “My provider told me that I could not be induced. I could not do this. I could not do that,” and these things. Did it just irk you? I know you saw it, Julie. Did that just irk you, that comment? 


    Julie: Yeah. It irks me because why do we as doulas, birth photographers, and patients have to be the ones to show our providers what the evidence says? Why do we? Shouldn’t they be the ones practicing that evidence-based care? Shouldn’t they? 


    Oh, here’s my radical acceptance coming in, speaking of radical acceptance. I need to work on radical acceptance of the system, I think. But why? I don’t want to accept it. I want to change it. So there’s part 3 coming out soon. How to change it. 


    Meagan: Part 3 of radical acceptance. How to find radical acceptance through the system. This is the thing. We talked about this, I think, even before we pushed play but a provider or someone who wants to control you in this situation that you are going to be in– your birth. This is someone who wants to control your birth and is telling you what you are or are not going to do or what they are going to do to you.


    I’m hearing providers saying, “I’m going to strip your membranes at your next visit.” No. No. That is not how it works. 


    Julie: Or they walk into the room while you are laboring, “Okay, we are going to break your water now.” What?


    Meagan: It is okay to say no. It is okay and I know that it is hard. I know. I have been there. I have been there just in life in general where I’m in a situation and I’m like, “Oh, I just don’t want to cause contention and is it really that big of a deal? Maybe I should just say yes.” No. If your gut– and you’ll know. If someone is coming in like Julie said and is saying, “We’re going to break your water now,” and you’re like, “Ugh,” immediately, that is your intuition saying no. 


    Julie: No. 


    Meagan: It is okay to say no. It is okay for you to say, “I do not want a cervical exam right now. I had one two hours ago. Not much has changed. I’m good, thanks.” It’s okay. Women of Strength, please, please, please. This is how we change the system. We have to be strong and we have to stand up for ourselves. We do and it’s stupid that we have to bring the evidence to the table, but we have to say no. We have to stop letting the system or the world, the world, railroad us especially when it’s to our own body. 


    We would never go down the street to the gas station and walk in and tell someone in that store what we’re doing to them. Never. Would you? I would never. Maybe some would. 


    Julie: I need you to drop those prices of the gas for me. 


    Meagan: Yeah, right now because I’m about to pump my gas. I need you to drop it down 50 cents cheaper. You guys, no. We should not, just because we are in birth and just because we are in labor and just because we have a provider that went to a heck of a lot more school than us, right? I’ll give them that. They went to a heck of a lot of school. I’ve never gone to medical school. It is not okay for them to tell us what you are or are not going to do. 


    Okay, that’s my rant. 


    Julie: Oh, I’ve got one that I just came up with. 


    Meagan: Okay. 


    “I Don’t Know Who Needs to Hear This, But…”


    Julie: I don’t know who needs to hear this, but you can gain information from Google– accurate and good legitimate information from Google that is similar to information that other people are getting through school. Oh ho, ho, ho. 


    Meagan: Oh ho, ho, ho. 


    Julie: Yeah, take that. This is going to be a little spicy one here. I hate it. I hate it– okay you’ve seen this sign. I know everyone has seen them before or little bugs that are like, “Don’t confuse your Google search with my medical degree,” then be like, “Why the heck not?” If it’s so easy to pull something up on a Google search, then why should I trust your medical degree then? Okay, that’s a little extreme, but what I’m trying to say here is that we have access to the largest collective database of information to ever exist in the history of the world, right? 


    We can literally sit on our computer and order dinner, put in a grocery order, and have it delivered to our house in an hour. We can find information on anything we want to know from legit, credible sources. Right? I could find out how to build an electric outlet into my fireplace above. That’s my project right now. I need an outlet on my fireplace.


    Meagan: YouTube University. 


    Julie: Exactly. Now, is there a lot of misinformation out there? Sure. But listen, if you know how to find credible sources like Google Scholar, Google Scholar legit has studies and sources and references that university databases pull from. There is accurate information and studies available at our fingertips, so why? The same studies that people are accessing at their universities towards their medical degrees are at our fingertips so I hate when people say, “Don’t confuse your Google search with my medical degree.” 


    Yes, are medical degrees valuable? Incredibly, especially when you can collectively put pieces of information and everything like that together. I feel like there is lots of worth there as well, but when we are talking about individuals, you know your body better than any provider with any level of medical degree is going to know your body. You know it better. Your intuition will guide you better than any provider with any medical degree. 


    I know I’m going to get a lot of cringes right now by talking about this, but your Google search is worth a lot when it’s pulled from a credible source so I hate when people say. That’s one thing I can’t. I usually scroll past the trolls and comments on Facebook now. I just don’t let it be worth my time. I have radically accepted that there are trolls and it’s fine and I’m going to live my life, but when I see someone using those words, “Don’t confuse your Google search with my medical degree,” that is when I’m going to get on there and say, “Why? Why discount these billions and billions and billions of research articles and things like that that we have access to?” 


    Meagan: I think that’s one of the big passions between why Julie and I created The VBAC Link Parent Course and Doula Course because we wanted you to be able to find that information in one spot. It is confusing and it is overwhelming. Those providers, yeah. There are some BS things out there on the internet. It’s really hard to decipher. 


    Julie: Like the ARRIVE trial, right? 


    Meagan: Yes. I think we have three pages of studies and citations and all of these things in our VBAC manual and in our VBAC course so you can take that and take it to your provider and say, “This is what I have found. This is the evidence. Can we have a discussion about this?” Women of Strength, it is okay to have a conversation with your provider. You can ask questions. 


    A lot of the time, you walk in and they are like, “Hey, do you have any questions?” You’re like, “Maybe. Should I have any questions?” You should be encouraging these conversations with your provider. It’s going to help you get to know them. It’s going to help you guys have a better understanding of each other and you’re going to be able to learn about these studies. 


    Julie: I want to cut in here for just a minute before you change gears. I know that when we were putting our course together, this was something that was super important to me and Meagan. You don’t have to take our word for it. I remember uploading lots of studies, the pdf versions of studies and bulletins, and things like that into the course because we wanted you to be able to go and dig deeper on the parts that you wanted to dig deeper from right from these credible sources. 


    I love when I can find a Cochrane review because a Cochrane review is a review of several studies studying the same thing so you can just gather so much more information. We have a Cochrane review in there. We have links to everything. That’s why we are so careful to be so meticulous and cite our sources and where we found this information so that you can go on your own journey to the other parts that resonate with you a little bit more. 


    Meagan: Absolutely. Okay, well we are wrapping up. Is there anything else, Julie, that you are like, “I’ve got to let these guys know”?


    “I Don’t Know Who Needs to Hear This, But…”


    Julie: Yeah, I think one more thing without having to really expound on it too much. I don’t know who needs to hear this, but sometimes trusting and believing your body doesn’t work. I don’t know how to say that the right way. Maybe I’m going to expound on it. I loved this affirmation so much because I used it on my home birth and my first VBAC. It was like, “I trust my body to birth my body,” and things like that. I had a lot of trust, but I feel like reframing it to, “I trust my body to know what to do,” is better because what happens when some emergency comes up and your body doesn’t push it out? What happens when you have a traumatic pelvic floor injury and your pelvis really doesn’t know how to push out a baby? 


    I mean, what happens if your baby’s heart starts tanking and baby has to come out right now? That’s not your body failing you. I feel like sometimes that’s what sets people up for failure. They believe so much in their body, but sometimes emergencies happen. There is some nuance there, so yes. Trust your body, but trust it to guide you on the right journey. 


    Sometimes it sets us up for trauma afterward. You’ll be like, “Oh my gosh, my body is broken. How come trusting my body didn’t work?” I feel like trusting your body is a big part of it, but trusting your body to guide you on the right journey for a nice, healthy delivery is more important than trusting your body to be able to push a baby out. I don’t know. What do you say to that, Meagan?


    Meagan: Yeah. I love that. That, I think, is where a lot of postpartum issues come because we were like, “But, I knew that I could do this.” It’s not that you couldn’t, it’s just that something else happened. Right? 


    Julie: The circumstance. 


    Meagan: Yep. The circumstances changed and that’s hard. That’s hard, yeah. I love that. I love that you said that. 


    “I Don’t Know Who Needs to Hear This, But…”


    Finally, last but not least, I don’t know who needs to hear this, but you are amazing. You are a Woman of Strength. You are capable of doing more than you even know. Than you even know. I truly believe that. I think through life and experiences, especially when things are hard, it feels like you can be at a loss, like you are alone, and like you couldn’t possibly do these things, right? But Women of Strength, VBAC is possible. VBAC after multiple Cesareans– possible. VBAC with twins, VBAC with big baby, VBAC with diagnosed small pelvis, VBAC with medical induction needed, VBAC is possible. 


    If you don’t want to have a VBAC, that’s my final, final. If you don’t want one, that’s okay. 


    Julie: Yeah. 


    Meagan: That is okay. Vaginal birth is not always desired and that’s okay. But you need to learn. You need to find the information and that is what these stories are here for. That is what Julie and I are here for and other birth professionals here that we have on this podcast. That is what the course is for. That is what the community is for, for you to learn, for you to grow, and for you to know that when you are told some of these things, they are necessarily true. 


    Okay. 


    Julie: I love that, yes. 


    Closing


    Would 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/donations

    Advertising Inquiries: https://redcircle.com/brands
    37m | Jan 31, 2024
  • Episode 273 Amina's Incredible VBAC + Dialing in & Following Your Heart

    Amina’s story shows the true POWER of a supportive provider. Both of her birth stories had similar interventions (but given in very different ways) with very different provider reactions and a very different outcome!


    “That was the biggest change for me. It’s not like the second birth was just smooth. There were moments when there was blood. There were moments when her heart rate was in distress, but there was that confidence that this woman could do this. This baby is safe and we are doing this together.” - Amina


    Amina also shares a very special story about visualization during pregnancy and how that can come into play during birth. 


    Her story is a perfect example of listening to the heart, mind, and body in all stages of childbirth. 


    Additional Links

    Needed Website

    Amina’s App

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Meagan: Hello, Women of Strength. We are in mid-January and we have an amazing story for you today. We have our friend, Amina. She and I were talking before we started recording. She was like, “You are changing lives. You are inspiring. You are changing people’s pregnancies,” and I just want to talk on that. One, it’s absolutely an honor to even hear those words, and is so touching, but two, I’d like to counteract that even and say you guys, you, Women of Strength, you, Amina, you– every single person that has been on this podcast, is who is changing lives and these Women of Strength wanting to VBAC and know their options. I’m just here creating the platform. I’m so grateful to do this. It really, really is so amazing to hear story after story, to hear journeys, to hear how people overcome fear and anxiety and doubt.


    You know, we’re not here to prove people wrong, but I do love a good proving someone wrong story when it’s like, “Yeah, you tell me my pelvis is too small. I’m going to show you.” No, but really, it’s just such an honor to be here. I’ve been on the podcast now for a year solo without my partner in crime, Julie, and it’s been really hard without her because I just loved being with her, but I’m still so grateful to be with you guys today. 


    Like I said, our friend, Amina, has a VBAC story. I just want to tell you a little bit about her. She is an International Yoga Teacher. If you haven’t checked out her page, you definitely need to. She’s a mother of two and the founder of Honey Studio and of the Movement and Mindfulness App. We know mindfulness, breathwork, and movement are all things that are going to benefit us through our child-birthing years. She is uncovering the infinite possibilities within your body and mind. I love that. Uncovering the infinite possibilities within your body and mind. 


    Review of the Week


    Amina, we’re going to get into your story in just one moment, but of course, we have a Review of the Week. I love reading these reviews so as always, if you haven’t had a chance to drop us a review, please do so. You can do so on Apple Podcasts. I don’t know, Spotify? Maybe. Maybe. I don’t know if I’ve ever seen reviews on Spotify, or Google, or you can just email us. 


    This is from sydhayes and it’s from Apple Podcasts back in May of 2023. It says, “A Wealth of Information.” It says, “This podcast has so many helpful tools when it comes to birth and especially when avoiding a Cesarean. I listened to it every chance I had when I was planning for a VBAC and I know it helped me achieve my goals. Hearing other women’s stories is so powerful. Thank you for this resource.”


    Look, she’s saying it too. Your stories are so powerful. We love them so much and if you also didn’t know, we are sharing them on social media because we do have so many inquiries on the podcast. We’d like to try to share more stories on social media. So if you haven’t submitted your story, you can do so and you can also submit for social media. 


    Amina’s Stories


    Meagan: Okay beautiful lady. I am just smiling. I feel like my cheeks already hurt just looking at you. You are glowing. I can just see the excitement and the beauty coming out of you to share this story. Well, to share your stories. I’d love to turn the time over to you. 


    Amina: Thank you so much for having me. Like I was telling you before we started recording, this is a dream moment of mine. It’s a very manifestation kind of moment because when I was listening to all of these empowering stories, to get to share mine is a true, true honor. It’s something on my vision board so I’m just so grateful to be here. 


    Meagan: Well, thank you. I love that you are talking about your vision board. I think sometimes when we step back and we close our eyes and we truly visualize our life, our journey, and our goals, we truly can help achieve those by doing so. 


    Amina: Totally. I’m going to track this a little bit later on, but I was sitting with a friend in the very middle of all of this. She was telling me that she visualized her whole birth from the beginning to the end and that she saw it all. When I heard her calmly sitting over coffee saying that, I was like, “Wait a minute.” I went home and did my homework and I wrote down the kind of birth I wanted to have which I ended up having. 


    Yeah, I’m going to walk you through the story. 


    Meagan: Yes. Let’s hear the stories. 


    Amina: Yeah, so basically in 2017, I had very, very painful periods and I decided I wanted to have a baby. I went to just check out just to get a little check-up to see that everything was okay before we started trying. We hadn’t started trying yet. I go to the OB/GYN at the time. It was in Dubai. I’m like, “I have very painful periods to the point that I’m crying on the floor and sobbing. No painkiller is working.” She says, “Are you on birth control?” I’m like, “No.” 


    She says, “Well, if you’re not on birth control, then don’t complain.” These were literally her words. 


    Meagan: What?


    Amina: I was like, “Well, can you check me first just to see what’s going on?” because I was very connected with my body. I had been doing yoga for a few years and I knew something was off. I had this intuition. Something in my body was telling me, “Something is off.” So she’s like, “Sure. Let’s check.” She checks and finds a big polyp in my uterus that would prevent implantation from happening. She’s like, “I’m sorry. You were right. This has to be removed before you start trying to make any babies.” 


    So that was a moment for me where I was like, “This is weird.” We really need to fight for ourselves to be heard. So anyway, we did the polyp removal, and then they said, “Wait three months and then start trying to have a baby.” We waited the three months. It was September 2017. We tried and I got pregnant. 


    Meagan: Yay. 


    Amina: It was just like that. It was amazing. Pregnancy– I felt good. I wasn’t nauseous. I was pregnant with a boy. We did all of the testing and throughout the pregnancy, I started to find my way through Ina May Gaskin’s book. I started to read about it and just learned a little bit more about the system of birthing in the U.S. at the time. I decided I wanted to have a midwife instead of a doctor so I switched out. 


    Again, uneventful. I wanted the birth at a birthing center and I felt like I was super prepared. We did a HypnoBirthing course and on the due date, on the due date exactly, I started to have a little bit of bleeding, not even a period kind of blood but just a little brownish discharge. My mom was like, “Oh, you are not supposed to be bleeding. Why do you have blood?” I’m like, “I don’t know,” but I was super excited. I’m like, “We’re doing this. I’m having the baby.” 


    That was at 4:00 AM. I went to sleep. I woke up soaking in a lot of water. The water had broken. We’re like, “Okay, let’s go to the hospital.” The water was a bit tinted with some blood. I’m still very calm. It’s fine. My body knows what it’s doing. I had all of the mantras and I showed up to the hospital and everybody was panicking at the hospital. I don’t know why, but they were panicking. They’re like, “You’re bleeding. You shouldn’t be bleeding during birth. You have to be monitored.” All of the things that I was prepared for which is to deny interventions, to say, “I don’t want to be checked,” I just remember it being a very intrusive experience where I was constantly being bombarded by nurses and by faces I didn’t know. 


    I was definitely not relaxed and then my doctor was like, “Look, I’m going to give you a few hours to labor on your own because I know what you want.” It was basically a doctor with a group of midwives. A doctor was there and one of the midwives was also there. The doctor said, “I’m going to let you labor for a little longer. I’ll give you the afternoon to labor and we’ll see what  happens.” 


    I go into the room and I start to have very intense contractions that were not stopping. It was just like one long contraction. I was just breathing through it and doing all of the coping tools that I was prepared for. My husband is doing the hip squeezes. We’re in that labor land, but then someone keeps coming in and I have to constantly argue for myself because you know how they monitor your belly with the contractions, something will move and then they won’t get the baby’s heart rate and the panic and they run in all of the time. 


    I wasn’t really relaxed I would say. Then the doctor comes in. She’s like, “Okay, look. We’ve been monitoring your contractions from the office. You should be in the transition phase at this point, but your contractions are very intense and they are not stopping. I’m suggesting to give you an epidural just to help relax you and we see what happens.” 


    At that moment, I was in so much pain that I was like, “I want a way out. Give it to me. Give it to me.” 


    Meagan: Yeah. 


    Amina: They gave me the epidural and within minutes or so, everything started turning black. I heard the monitors starting to beep and 30 doctors were in the room. Everyone was panicking and my midwife’s hand was inside of me moving the baby or doing something and saying, “We’re losing him.” I just remember that moment. I was just fighting, fighting, fighting the whole time. In that moment, I was just like, “Surrender. I just want to see my baby. I want to be okay.” My mom was there with me by my side, her and my husband. My mom is this source of strength for me who is always very strong. She didn’t panic, but her face was just stricken with fear. I was like, “This is not good. I need to let go of my dream of birthing this way. I can’t do it. I give up.” 


    In that moment, my doctor, after they get the baby’s heart okay, was like, “Look, I don’t know what’s going on, but I know that neither you or your baby can handle any more of this labor. We have to get the baby out.” I said, “Okay, go ahead.” I was very okay with it like, “Just do it.” 


    So very quickly, I was in the emergency room or the C-section room. 


    Meagan: The OR. 


    Amina: The OR. I was just in total panic. I was shaking from the drugs and it was just so much. I remember looking into my husband’s eyes. He was like, “Just breathe with me.” It was like yoga. I was breathing in, breathing out. This moment was all that mattered. I was just going to stay present.


    We had the C-section. I had my baby and all of this. He was placed on me in the recovery room and honestly, from then on, it was a very smooth postpartum journey. I healed very well from my C-section. It led me to learning a lot about the core and how to heal and just all of these really amazing things that I didn’t know about before. It strengthened my knowledge of its nature. 


    That journey was great and then I think it took me a little while of, “I don’t think I want to have any other babies. This was the worst experience of my life.” I kind of just shoved it away. I just didn’t think about it. Then he was 3.5 years old. I was like, “Okay. I am starting to miss the baby phase and I would love for him to have a sibling, but I really don’t want to go through another birth.” That was just the trauma. 


    But I think the love for him and bringing him a sibling overcame that fear. I was like, “Let’s just do it.” So 3.5 years later, we tried to get pregnant and I was expecting it to be just like that just like the first time, but it didn’t happen. It was, I think about 6 months that we were trying and when we got into the 7th month, I was like, “Okay. Something’s up. Maybe I have another polyp. Maybe I have a fibroid.” I started going from doctor to doctor to check why I was not getting pregnant. 


    It turns out that they were like, “Everything is great. Everything looks perfect. There’s no reason why you’re not getting pregnant.” Then, in the end, I decided to go the IVF route. I was like, “Let’s just do this. Let’s save some eggs.” I was 34. I said, “Let’s save some eggs in case I want to have future pregnancies and also get genetic tests taken and all of this stuff.” 


    We started doing IVF in July of 2021, I believe, 2022. Yeah. We started doing the first round. We got the eggs out and all of this. It was an easy, breezy IVF cycle I would say. The embryo transfer was in September which was the same time I got pregnant exactly four years apart, almost the same due date so it was crazy. 


    I did the embryo transfer. She stuck and I felt very nauseous for the first few months. I was just super nauseous and I looked up the doctor next to me that was just a great surgeon. I was like, “I’m going to do another C-section. I don’t want any surprises. I just want the easiest, safest option.” 


    I go and see him and he’s like, “Yeah, you probably had a placental abruption the first time.” 


    Meagan: I was going to ask you if they ever gave you an answer and if it was placenta-related. That’s what it sounded like to me. 


    Amina: Yeah, they said that they suspected that the placenta was shaped funny because of my polyp surgery being so close. They said it was a bilobed placenta but they didn’t say anything about it was an abruption. They didn’t mention those words. They were scared of it at the birth and when I would say, “Is my baby okay?” they were like, “Yes.” So okay, they let me labor until it went to a C-section because of the epidural. It was more that it was the epidural that caused a bad reaction to me and the baby. 


    Meagan: Yeah, blood pressure drops which is going black. 


    Amina: Yeah, going black, exactly. I had all of this fear from all of this and I was like, “I want something very low-risk and safe with a great surgeon, but I want to meet with a doctor.” He was like, “How do you want to deliver this baby?” I said, “I would love to have a repeat C-section.” Then I started to get curious. I was like, “But what if I go into labor?” He said, “Well if you go into natural, spontaneous labor on your own, we can do a trial of labor.”


    I was like, “Okay. That sounds fair.” Throughout, I think, once I was in the second trimester, I started to feel really good. I started to feel very empowered and strong. I was working out and I was just loving the pregnancy. It wasn’t like I felt an alien with the first pregnancy. The second time around, I was savoring it a lot more. I was a lot more in tune and a lot more connected. I was pregnant with a baby girl. Yeah. I was just in this confident feeling. 


    I noticed that whenever I thought of the birth, I started to feel fear. I was like, “I’m going to do a repeat C-section because it’s too scary otherwise.” Then I asked myself this question. “Are you avoiding trying for a vaginal birth because you are scared or because it feels like the right thing to do?” It was 100% because I was scared. There was nothing beyond that. There was pure fear. 


    So I started to talk to my therapist. I started to tell her, “I want to dive deeper into my first birth. Why am I feeling this way?” We started to really dive deep and realize that it was a mystery. We’re never going to fully know why it happened. I’m not going to get the answer that I need of the reason for my Cesarean. It was just something. This was how he was meant to be born and there was really nothing in my hands. 


    I started to listen to The VBAC Link as soon as I felt that spark of curiosity. I would get on my treadmill and I would walk for, I think, an hour every single day on an incline listening to the stories of all of these women. I started to feel like, “Wait. Maybe this is a possibility. Why am I so scared? Let me see what’s on the other side of this fear.” 


    So I decided to have a real conversation with my doctor. He was always throwing around the words “39 weeks”. “When you’re at 39 weeks, if you go into labor–” I was like, “Wait a second. The first time, I went into labor at 40 weeks. Why do I have to get to a very small percentage that I go early?” I started to ask him. I was like, “You know what? I would really love to avoid another surgery if possible.”


    His response was, “First of all, don’t glamorize vaginal birth because, with vaginal birth, you’re going to most likely tear because you’ve never had a baby come out of there before. You’re not going to be able to hold your pee. You will be in pain sitting down. It’s not something glamorous. It’s not likely to be the better option,” was what he was telling me. 


    I was skeptical. All the stats that I read was that a repeat C-section is the more risky option. It’s not the less and it’s a major surgery. And then I said, “The reason that I had a Cesarean the first time was a bad reaction to the epidural most likely.” He said, “No, it was placental abruption and you can rupture your placenta again.” Again, I researched this and I was like, “Wait, just because even if you say it was–” because we don’t know it was, “the chances of getting that– it’s a whole new placenta, a whole new baby, and a whole new story, so the chances of this repeating again is quite low.” 


    He kind of scared me with these stats that I wasn’t convinced with because they are very low. Then I said, “Also, I would love to avoid the epidural because it was the reason everything literally turned black in the birth.” He said, “Well, no. That’s not possible because I need access in case I need to get the baby out in 10 seconds.” 


    I realized at that moment that I was just an emergency to this doctor. I am just this emergency case. I’m not seen as a human. I’m not seen as a mother wanting to birth the way that I’m designed to and I’m seen as this scare and this risk. Then he boasted, “I’m very fast. I’m known to be very fast. I don’t waste time.” Also, I asked for a gentle C which is like, “Okay, let’s get the baby out. Give me a few seconds for the pulsation of the cord.” 


    He was like, “Well, absolutely not. You are cut open. This happens in seconds. I’m very fast.” I felt like I was a medical emergency and also, I felt like, I didn’t want someone so fast by my side when I was doing the most intense, intimate thing of my life. I don’t want to have this rushed energy by me so I knew I had to get out of there. That was my screaming intuition, “Get out of this practice. Search for a supportive OB/GYN.” Your podcast, The VBAC Link, helped me realize so much with realizing how much that actually can change the outcome. 


    Meagan: Absolutely. 


    Amina: I felt like I was empowered to know that no matter what happens, even if I wasn’t with a supportive doctor, I would still try to get my way, but I was like, “Let me just search through my options.” I remember I had seen one of the doctors when I was trying to figure out what was going on with why I wasn’t getting pregnant. I had met this beautiful doctor. She was a radiating source of warm, calm energy. I was like, “Why didn’t I go to her?” She’s more holistic and loves HypnoBirthing and all of this stuff, but she is an excellent surgeon which is why I went to see her. 


    I was standing– I remember this moment. While I was standing in a museum, I was like, “I need to do this.” It was a “yes” in my body. I called them and right away, they were like, “We can take you.” I met with her and as soon as I met her, she was like, “We are going to have this VBAC.” It wasn’t “you”. It was “we”. 


    Meagan: As a team. 


    Amina: It was this feeling of a team. She works with a bunch of other female doctors in the same clinic. She was like, “Look, I can’t guarantee that I’m going to be there at your birth, but I want you to know that every single person here will advocate for you here in just the same way.” I felt very in touch with her and I would always book my follow-ups with her. I developed this bond with her. 


    But when I would go for my check-ups with her, my body felt relaxed. I wasn’t feeling that something was intrusive which was also something. I had faith, I would say. 


    At about 38 weeks, we started to check for dilation. One time, I got this email from her clinic team saying that we were scheduling a C-section for 39 weeks just by mistake. I was like, “I would love to not see that or not have that.” She was like, “I’m so sorry. That was an internal error. There is no C-section being scheduled.” I love that she was just behind me every step of the way. 


    We started to check for the dilation and it was 0. I was like, “Okay. This doesn’t mean anything. It’s still gonna happen.” Then I was listening to one of the episodes that was talking about the Foley catheter and the low-dose Pitocin. I was very intrigued because I was like, “Okay.” They are starting to say that the baby was getting to 3 kilos or 7 pounds-ish. In the hospital when they would monitor me, they would start to raise the fear of, “Oh, the baby is getting big,” and starting to hint at that. 


    I want to have at least a plan B that’s not a C-section but maybe some light interventions. I read about the catheter and I mentioned it to my doctor. She was like, “Yeah. If the time comes and we need to use it, I’m totally fine with it.” She was very humble. She would research things that I mentioned to her that maybe she hadn’t tried before and she would be like, “Oh yeah, let me do some research on this,” not as if she knew everything. 


    Meagan: I love that. 


    Amina: She also refers to a HypnoBirthing doula that me and her work with. That’s how I knew her from the HypnoBirthing doula. She is so open to maybe we don’t have all of the answers already right away. We can go explore our options. I was being monitored consistently at the hospital and they were saying because of the history of the suspected placental abruption. They were always saying, “Yeah. Baby seems very happy. Baby seems very happy.” That made me feel good. 


    Then I heard also about the membrane sweeps so I asked her, “Can we do a membrane sweep at 39 weeks?” She said, “Yes. Let’s do a membrane sweep at 38-something.” I went in and I wasn’t dilated at all, but she was having a hard time even doing the sweep so she said, “Let’s try after you are 39 weeks. Maybe you will be a little more dilated and there is another doctor who has longer fingers who is very good with sweeps.” She said, “I want you to try her next time.” So 39 weeks comes and then I do the sweep. I feel some cramping, but nothing really happens. 


    That day, I go to the hospital and they are monitoring and they say, “The baby is getting big. The baby is over 7 pounds and the more you stay pregnant, the less likely you are to be able to birth vaginally.” I said to my doctor, “Okay, can we book an induction with a Foley catheter and the low-dose Pitocin?” She said, “Let’s do it.” 


    I go to the hospital at 6:00 AM with my birthing bag prepared. It ws going to happen. I had read about how painful it is to insert the catheter, but she’s just incredible. I was relaxed. Everything was in and it started to do its job. It started to mechanically dilate me because I was at a 0. I was in the room with my husband and my sister just joking and laughing and watching episodes and just not someone in labor. It had nothing to do with labor. 


    Then they would come in. They would check and be like, “Yeah, okay.” I think after 8 hours, they took it out. I was at the 3.5-centimeter dilation from the Foley but she said, “It might close up a little bit.” She said, “Yeah. Let’s just see.” So they started the low-dose Pitocin and I remember sitting there on the ball trying to ease into contractions even though they were very mild. I was like, “Wow. I have really good pain tolerance the second pregnancy. I’m not feeling those contractions,” because they weren’t real contractions. I’m like, “Oh, wow.” 


    Then I started to feel my baby moving up into my ribs. She was bumping into my ribs. They go and check and they’re like, “Yeah, she’s at a 0 station. She’s not moving down. We have to up the Pitocin a little bit higher.” That day, I had seen an osteopath who had checked me. I was like, “Yeah, I’m going for my induction tomorrow.” She was like, “Why are you going to an induction?” I said, “Because the baby is too big and I need to get the baby out.” She was like, “Your baby is not ready. You shouldn’t have the induction.” She said, “Your baby is not ready.”


    I was like, “Well too bad. I’m not going.” I remembered her words while I was sitting on the ball and feeling the baby move up into my ribs. I was having pain in my ribs. They checked at 6:00 AM. It had been from 6:00 to 6:00, 24 hours in the hospital. My doctor came in. She was like, “Okay, I have the options. You have two options. I either break your water. This has its own risks or you go home. Now you have a more favorable cervix, and let’s let labor start on its own.” 


    I thought about it. I was like, “No. I don’t want that.” My body was telling me just to go home. So this was 39 weeks and 3 days. My due date was on Saturday and I had all of these things planned that the baby was coming out. My son’s birthday, my son’s graduation from pre-K. I show up very pregnant and everybody is asking, “Oh, where is the baby?” That was so annoying. I wanted to switch off my phone because everybody knew my due date and was texting, “Hey, where is the baby? Did you have the baby?” I’m just feeling all of this pressure. 


    She was cozy. She was just there happy and not moving down at all. So I started to go to acupuncture just to soothe my anxiety. In the acupuncture, I was just drifting off and then I started to see this round, black, sticky thing. I was like, “What is this? Why does this keep coming to my head? What is this round, black, sticky thing?” Then I realized, it was a head. It’s a baby’s head. It’s black and sticky and has blood on it. I was like, “Why do I keep seeing this? But this is amazing.” Then I realized it was my baby’s head. I was like, “It’s a good thing I keep seeing a head when I’m doing acupuncture even though I’m not trying to see it.” 


    Two days later, I went back to acupuncture again. I’m drifting off to that space where you’re not asleep. You’re not awake. You’re just in this crazy, floating space. I start to see that I’m feeling my baby’s head with my hands and I’m feeling her come out and she’s on my chest and I’m sobbing, “We did it. We did it. We did it.” I was like, “Okay, this is beautiful, but I don’t know what to do with this. It was just a very cool vision.”


    Meagan: Hold onto it. 


    Amina: Yeah, hold onto it. The due date comes. The baby is not here. The baby is cozy. We go do another sweep a few days later. I started to feel some cramping and the dilation had even moved backward like she had warned me. I was about 2 centimeters. I was like, “Oh, this baby is never coming out. This is so stressful.” But I was trying to stay positive. The wait was so anxiety-producing because I was like, “What’s going to happen? What if I wait all of this time and I end up still having a C-section?” My mind was all over the place. 


    But then I went to see my osteopath four days post-due date. I saw my osteopath. She checks me and she works on all of this deep tissue stuff. She’s like, “Yeah. Your baby is ready now.” I was like, “Really?” She’s like, “Yeah. All of the muscles that are normally hard and tight are very soft and loose now. Your baby is ready.” That’s all she said. 


    Then my mom gets seen by her as well for a session after. She tells my mom, “Make sure you get some rest tonight. Tonight’s going to be a big night.” She knew.”


    Meagan: Oh my. That just gave me the chills. Oh my gosh. 


    Amina: I know. It was crazy. I had no idea. That day, I felt pretty good. I had done the sweep. I had seen my pelvic floor therapist and she was like, “Yeah. Everything looks good. There is no tension.” She was allowed to do internal work at that point. She was like, “Everything looks good.” I was like, “Do you think my pelvis is too small?” She was like, “No. I think everything looks great and you will birth this baby vaginally.” 


    She gave me this boost. It was like someone had seen me on the inside and was like, “You’re good to go.” 


    Meagan: You’re good. 


    Amina: Yes, you’re good. So that day, I went for a walk in the rain with my husband. I came back and I was just suddenly, my mind was somewhere else. I was very distracted. It was like this wave and this film of dreaminess was on top and I wasn’t stressed about the time. I wasn’t stressed about when she was coming. I just felt very relaxed. My body was super relaxed. After that osteopath, I sat on the ball. I was bouncing and I started to feel a little something. 


    It quickly started to intensify. I couldn’t put my son to sleep as I normally do. I was holding his hand while I was on the ball rocking, listening to a playlist that I made that was calming labor music that I liked. While I’m putting him to sleep, I’m holding his hand and I’m just in that world. 


    By the time he fell asleep, it was 9-something and they were ramping up. So my husband was like, “Look. If baby is coming tonight, we should get some sleep.” 


    Meagan: Sleep. 


    Amina: Yeah, right. Yeah right, get some sleep. I got into bed and I tried to start sleeping and it’s very intense. I can’t sleep. Then I’m like, “Oh. That’s the contractions that I forgot about 5 years ago. That’s it.” I started to get on all fours and I tried to lay with the ball between my legs in the bed and it ramped up a lot that by midnight, my husband called the hospital, the doctor, and said, “She’s having 5-minute contractions. They’re getting intense.” 


    The doctor was like, “Okay. Just monitor her for a bit, but if you want, she can come in now and we can get her checked in. She can labor in the room. Let’s see.” 


    Oh, the next morning, I had an induction plan already. They had planned it. 


    So she was like, “We’ll get her in the room early and she can just labor there and be checked.” I didn’t want to go. I said no. I waited for a few hours and I think by 2:00, I was like, “We need to go to the hospital now. Now. This baby is coming now.” I just felt that it was not going to be a long time. 


    We go and this time, the different thing I did from my Cesarean is I had my headphones in and I was not talking to anybody. I was just listening to the song in that dreamy state. I was kind of riding the wave of dreaminess. I was just in that world and listening to the music. My husband was giving them my insurance info, my name, and all of this logistical stuff that didn’t make sense at the time with all of the bright lights. Then I’m having contractions. I’m breathing through them. 


    Then comes a resident who is like, “I need to check you. I need to see if your baby is still head-down.” I said, “My baby is head-down. I know that she is. No one is going to check me except my doctor.” He got very angry and he was like, “You’re risking your life and the baby’s life.” I said, “I know my body. I know my baby. I know that she’s head down. I was just at the hospital this morning. If she flipped, I would know.”


    I was just confident. I was like, “And my doctor can check if she wants, but you’re not doing any exams. Thanks, but no.” My husband is the nicest guy. For him to have this kind of confrontation makes him super on edge. 


    Meagan: Uncomfortable?


    Amina: Yeah. He’s like, “He’s just doing his job.” I prepped him before. “Look. No means no. No one is going to check me. I’m not being nice to anybody that’s in my body or my vagina. No one is looking inside unless I’m comfortable.” We had done also a HypnoBirthing crash course just to remember as a refresher course. We had decided that also, no one can offer me the epidural. If I want it, I’ll ask for it, but hopefully, I’m not going to ask for it. 


    At this point, the contractions are super intense. I have to sign this thing that says I’m okay with me and my baby dying. I’m in my world. I’m like, “Sure. Here you go.” Then we get to the room and the contractions get so much that I start to feel paralyzed. I start to feel like first of all, my intention with this birth is to feel good. I want to have a good experience and if I don’t get the epidural or if I don’t stop this pain, I’m not going to feel good. I tell my husband who is very well-intentioned, I’m like, “Look. I need the epidural now.” He’s like, “Amina. We talked about this. We said you’re going to ask for this and I’m going to tell you that you can do this.” I’m like, “I don’t care what we spoke about. I want the epidural now.” 


    He’s like, “You can do this. You said that this would happen, but trust me. You’re almost there.” 


    Meagan: That’s so cute. 


    Amina: He’s really doing all of the stuff that he was told to do, then he gets kind of upset. He’s like, “Let me go talk to your doctor.” He goes outside and calls her on the phone. She comes and checks me. I’m still at a 2 so she was like, “Okay. It’s going to be a long night.” She explains to him, “Maybe this will help her feel better.” It’s going to be a very long night. Let her have it. Let her relax. She’ll get some sleep. We’re going to be very careful because of the bad reaction last time. We’re going to give you a lot of IV fluids. We’re going to give you a very tiny dose. We’re going to monitor you so well that hopefully, we’ll avoid the blood pressure drop thing.”


    It was very hard to get the epidural in because I was contracting so intensely. It was a lot. They managed to get it in and they were like, “Okay. This is the button. You’re going to press it if you want more.” I was terrified. I’m watching the heart rate monitor and the blood pressure watching it and waiting for the emergency. They were like, “You’re fine. Relax. Everything is good. Now you can rest.” 


    They put such a tiny amount that I could probably move around if I wanted to. I have the ball in between my legs. I was lying on my side and I could still feel the contractions, but they were just a little bit more manageable which was very nice. 


    This was around, I think I got the epidural around 3:00ish-4:00ish. Someone came to check and I was at a 4. I was like, “Ugh.” They were like, “It’s still going to be a long time. Don’t worry.” When I was a 4, a woman came in, a resident, and she was like, “You’re at a 4. Would you like me to break your water?” At that point, I was in this very surrendery kind of state. I was like, “Sure. Do it.” So she did. She broke my water. 


    As soon as I look, there’s red all over the sheets. I was like, “It’s blood!” She’s like, “Yeah. Birth has blood. There’s always going to be blood in birth.” I was just like, “But there’s no one panicking around me that I’m bleeding and it’s a lot more blood than the first birth?” They were like, “Baby is okay. You’re okay. Blood is normal. You’re fine. Just relax.” 


    Meagan: Wow. 


    Amina: It was the reverse situation where instead of me being calm and everyone is panicking, it was the other way around where I’m like, “Guys, look. You should panic now!” They’re like, “You’re okay. Everything is good.”


    That was just such a moment for me where I was like, “Okay. Blood is normal. I have to not freak out when I see blood.” My doctor had warned me. She was like, “I know you’re going to panic when you see blood, but trust me. Bleeding in birth can happen and it’s okay. It doesn’t mean that something is wrong.” That was a very powerful moment for me. 


    She broke the water and then this was at 6:00 AM. At 6:15, I suddenly felt something shift. I’m like, “I feel a lot of pressure.” They had told me it was going to be a few hours. I tell the nurse, “I feel like I have a lot of pressure like I need to poop suddenly.” She’s like, “Poop?” She runs. She gets the doctor and they check. They were like, “You’re 8 centimeters. Baby’s head is right there. You’re almost ready to push.” 


    I start crying. When I heard the 8, I was like, “This has never happened.” That was the first moment that I was like, “This might really happen.” They had this dilation poster on the wall in front of you where you can visualize and see 1 centimeter, 2 centimeters all the way to 10. I would constantly look at it and I was like, “10. It’s possible. It’s going to happen.” That really also helped me, I think.” So when they said 8 and the baby’s head was right there, I had shivers. I was just so happy and so elated. 


    Then they were like, “But it’s still a few hours. It’s not going to be right away. You’re 8. It could take a while until you are ready to push.” 15 minutes later, I was 10 and I was ready to push. 


    Meagan: Oh my goodness. 


    Amina: From 4 centimeters to pushing was in 15-minute chunks. It was very fast, crazy fast. So then at that point, the doctor changed shifts and it was a new doctor, the one with the long fingers who had given me the sweep. She comes in and she’s like, “We’re having this VBAC. Let’s go.” The energy of the room was where everyone was excited for you and cheering for you. It was such a beautiful, beautiful experience. I was like, “I don’t care. I’m just so happy to be here.” The epidural stopped working on one side, so I was feeling everything on the right side of my pubic bone, all of this pressure. They were like, “Yeah. It’s normal. Sometimes it happens. You’re only numb on one side, but the baby is stuck behind the pubic bone, so we need to do some pushes to get her past that.” 


    The pushes, for me, were the hardest part because I felt like I couldn’t do the pushing that I prepared for with my pelvic floor therapist or the stuff that I read. It was all just like, “You’re going to inhale and then you’re going to hold your breath and push, and then you’re going to exhale.” It’s so counterintuitive to what I was taught to do that I was like, “I don’t know if this is doing anything. I don’t feel anything. I don’t know. Am I doing it?” They’re like, “Yes, but you have to keep going.” 


    Her heart rate was kind of in distress in between the contractions and they were like, “You have to push.” She’s like, “I’m not telling you that this is an emergency, but I’m telling you that we can’t stay here for long, so you have to push.” My husband was like, “Come on, Amina. Push!” I’m like, “Okay. I’m trying,” but I can’t connect to it. 


    Meagan: “I’m trying!” 


    Amina: So then I guess I keep purple pushing so much that her heart is going crazy. My heart is going crazy. There is all of this chaos and they were like, “Just forget about all of the monitors. Just push. Push the baby out of your vagina. You can do this.” She moves past my pubic bone and there is a sigh of relief. They start getting out their instruments. 


    There was a guy, a male resident, in the room who started to say, “Can we get out the instruments?” or something like that like the suction. I can’t remember what it was called. 


    Meagan: The vacuum? 


    Amina: The vacuum, yes. He started to say, “Can we get out the vacuum?” 


    Meagan: It goes right on their head like that? 


    Amina: Yeah, I didn’t even see. He just mentions, “Can I get out–?” The doctor says, “I don’t want to hear that word inside of this room.” I was just amazed. 


    Meagan: YES.


    Amina: Then basically, they were like, “Okay. She moved past your pubic bone. Now is the time to really push.” I’m really struggling with the pushes. I have no idea what I’m doing. I’m getting so tired. I’m about to cry. Then I had this moment of, “Let me just reach down and feel my baby.” I put my hand down. I feel my baby. The doctor is not even cueing me to push at this point, and suddenly, I feel her head. My body’s super strength takes over and pushes the baby out without cueing, without noise, and without anything. 


    Just by feeling her head, I don’t know what happened. It was like this super strength of all of the women in the world. I pushed her out of me and then out came her shoulders and then she was placed on my chest. I was just sobbing with joy. It was the same moment as my acupuncture. It was like, “We did it. We did it.” I’m just sobbing. 


    Meagan: I was going to say that. It sounds exactly like your visualization. 


    Amina: It was. 


    Meagan: You saw this head. You saw this head and then boom. Out on your chest. 


    Amina: There was another moment while I was pushing. The doctor was like, “I see her head. She has black hair just like her daddy.” I was like, “That’s the head I saw the first time.” 


    Meagan: Oh my gosh. 


    Amina: My son was born with lighter hair, so I’m like, “This is that moment, the black, sticky head.” I’m like, “This means it’s happening.” She was placed on my chest. My husband cut the cord and it was just the most healing, incredible moment of my life because I felt like in that moment, I was invincible. If I can do this, you just feel like you are so strong, but also so humbled by the experience. Yeah. It was the most beautiful moment of my life. 


    Meagan: You grew right there, right? I think there are so many things to say about birth. We grow through all of these experiences and you grew through your C-section and you have grown through your healing. Look how long this journey has been and you have grown in every single aspect of becoming pregnant, learning how to follow your body from the very beginning, something is not right, and then they find out, “Oh, she has this polyp.” You have grown into this person and you are just amazing. 


    This story is so beautiful and I love how your provider was there to back you up and be there for you and be like, “Nope. Don’t even say that. Don’t even talk about that.” 


    Amina: “Don’t say that word here.” 


    Meagan: “We are here.” Something else that I love is that you recognized. Breaking water is something, especially earlier in labor that we kind of stay away from a little bit, and in your mind and your body, you were like, “I feel good about this. I feel like I’m going to surrender to this. I feel this is right,” and then you did it. Then 15 minutes– and then you have a baby. 


    Amina: So fast, exactly. It’s not this black-and-white intervention or no intervention. That’s what I love about The VBAC Link because I was learning that, “Oh, the Foley catheter balloon can be a great way to have a VBAC.” There are so many different interventions that can actually help you and I think for me, even trusting the epidural again was a big, big, big lesson. 


    Meagan: Huge. 


    Amina: I was like, “This is the moment where I lost all control in my first birth.” Control is an illusion, but that was the moment where I was like, “Just cut me open. I give up.” 


    Meagan: Well, everything went in a different direction from that moment of your blood pressure dropping and maybe there were placenta issues, maybe not. You know, when you were talking about how this may not be something you’ll ever know, you may not ever know the exact reason why you were bleeding in that first pregnancy and things like that, it reminded me of our radical acceptance episodes and me too. There are things about my birth I will never know. 


    It doesn’t take the wonder route, but it doesn’t consume me anymore. 


    Amina: You are accepting.


    Meagan: Yeah, you accepted that it was that birth. That was that experience. You’ve grown from that. You’ve learned from that. You are going on to this next birth with what you know and accepting this next birth as this new birth, right? I think that is so important because so many times in life in general, but birth specifically, especially if we have maybe had a more traumatic experience or a Cesarean or something that really seems to relate just like you were saying. I got this epidural and then my control was lost. I did this and then this happened. I think we can tend to relate and then fear those things to happen ever again. 


    Yeah, I mean, when my water broke for the third time, I mean they say so few people– 10% of people have their water break before labor begins and then it happened again, I was immediately triggered even though my mind knew that my body just needed time. I triggered back and I started having those doubts creep in and all of these things. We have to be able to dig really, really deep and be strong enough to say, “Okay. This is the situation. This is how I feel about it,” and be willing to make different choices. 


    Going in for an induction again, you were scheduled to go in again. I also love that about your doctor that they were like, “Hey, here are your options. We can push this forward and see what happens or this isn’t happening right now. We can send you home.” So powerful. So powerful. 


    Amina: This was unheard of. This was unheard of. 


    Meagan: It’s not very heard of, yeah. 


    Amina: Yeah, yeah, yeah. You know, when I told the nurse that day, “My doctor said I can go home now,” she looked at me and started laughing. She was like, “No, she didn’t.” I’m like, “Go ask her. I’m going home.” She came back and she was like, “I guess you’re going home.” She was baffled. This person was here to have a baby, but they’re going home without a baby because that was how much she honors what her patients want, that they are women, that they are about to have a very important experience in their lives, and that they should be a proactive part of it. That was the part that was so important. To be with a provider that doesn’t inherently believe that vaginal birth is always safer than a C-section, I think that was a trigger moment for me. He believed that they were the same or that one was better than the other. 


    Meagan: Well, he was putting a lot of things like, “You’re going to pee yourself,” and this. Let’s be real here. Those are real risks of a vaginal birth. We can have serious urinary incontinence. We can have serious tearing that needs reconstruction. Those are real. What he was saying is real. He was using them as a fear tactic to steer you away and that’s where it’s wrong. That’s where, okay. I’m sorry. I can’t say it’s wrong. That’s where I believe it’s wrong. We should be educating very well on both sides and also talking about the risks of a Cesarean and the risks of having our bladder cut, our baby cut, and having blood issues like having to have transfusions. 


    Also, uterine rupture is not eliminated with a scheduled C-section. It’s just not, but we don’t talk about those things, right? 


    Amina: We don’t talk about it, yeah. 


    Meagan: It’s just pushed so heavily. You could tell that he was pretty cool, “Oh, you could TOLAC,” until you were like, “Actually, I want to do that.” He was like, “Wait a minute. No, you don’t.” That’s where we are lacking here in the world of medicine and that’s, I think, a lot of the times why some people don’t trust providers and don’t trust the hospital because of things like this. We need to steer more into your second provider’s direction of, “Let’s talk about it. What does she want? We know the risks. We’re going to talk about the risks, but what does she want and how can we help her get that in a very safe manner?” Right? We want everyone to be safe, of course, but yeah. 


    Amina: Totally. Staying open. Staying open. If she hears about something that she hasn’t used before, she has the modesty to say, “Let me research that,” not just like, “I haven’t used this before, so hard no.” It’s like, “Oh, let me do some research. Let me ask my doula friends what they know.” I love that about her. 


    Meagan: I love that so much about what you said about this provider. The fact that she was like, “You know, I don’t know. Let me look at that.” We can have a conversation that’s productive. That’s what that is offering is a productive conversation between the two of you and not just shutting you out. She may have seen a different study about that and be like, “Nope. I’ve seen that. That’s not going to work.” But you’re like, “This study–”. I love that so much. It sounds like your provider was amazing. We had talked about providers. 


    Sometimes I think on this podcast, we sound a little provider-bashing maybe because we are like, “Don’t do that. Why would they do that?” We kind of speak poorly sometimes about certain things that providers do. That is absolutely not the case. We love providers here. We love any provider– OB and midwives both. But what we don’t love is when our community is mistreated, when they’re gaslighted, when they’re completely shut out of any options in their own birth experience, and when they’re really pushed in the direction of trauma or lack of support. That’s what we struggle with. It’s not the provider. It’s that this is happening to people who we love in our community. 


    I know I say this time and time again. I love this community. I love you guys so much. You mean the world to me. I see posts and there have been times at 2:00 in the morning. I’ll be scrolling my phone in the community and I end up crying just feeling, truly feeling those emotions from these people where they are like, “Help. What do I do?” 


    But then I also start crying when I pull up Zoom to record a podcast like this and I see you just gleaming and bursting for joy, so excited to share your story and inspire someone. So I truly love you guys so much. I am so grateful for you being here with us today and sharing this amazing story. It sounds like I might need to connect with your provider because this is amazing.


    Amina: She is amazing. 


    Meagan: Remind me where this provider is located. 


    Amina: New York City. In New York City, it’s hard to find a provider that’s supportive for some reason. I went all over in the first pregnancy even. It’s quite hard, but really finding a provider who believes in you, who knows you can do it, who is excited for you, and who doesn’t just see you as a number and someone who believes you are a woman. 


    Meagan: Or an emergency. 


    Amina: Yes. You’re not just an emergency. That was the biggest change for me. It’s not like the second birth was just smooth. There were moments where there was blood. There were moments where her heart rate was in distress, but there’s that confidence that this woman can do this. This baby is safe and we are doing this together. 


    Meagan: Yes. Which is so powerful. That’s only going to help you during your birth. That’s only going to help build you up and move you forward and help you feel like overall, it’s a better experience. Like you said, sometimes things don’t go exactly as planned or it doesn’t go so smoothly where sometimes you have to move around because baby is struggling or there is blood or whatever, right? But because you were built up in this experience and the support was truly surrounding you, you were able to have that better experience. 


    Amina: Mhmm, exactly. I think also, I just learned so much from this the difference between fear and intuition. If you have that feeling within yourself, you can really easily mistake fear as, “This is my feeling,” but actually, is it fear or is it your real intuition? They can be blurred and when you just sit with that for a bit, you will see your body saying, “Hell yes,” then it’s most likely a yes. 


    Meagan: Yes. I love that you talked about that with your therapist. Let’s dig deeper here. Let’s find out. Is it that I’m scared or is it that this is really what I want? Don’t be scared, Women of Strength, to dig into that and dive deeper into those feelings because sometimes, it can be fear. You’re on social media so much. You’re seeing scary things and you’re like, “Nope. I’m not going to do that,” but once you dive deeper, you might realize something else. 


    Amina: Yep. 


    Meagan: Yes. Okay, well thank you again so much. 


    Amina: Thank you so much for having me. Thank you. 


    Closing


    Would 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. 





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    57m | Jan 24, 2024
  • Episode 272 Grace's Traumatic Cesarean & Beautiful VBAC + Warning Signs for ALL Birthing Moms

    Grace: “'If you are COVID-positive as the mother, you are not allowed to do skin-to-skin, you are not allowed to breastfeed your baby, and you are only allowed to hold your baby two times a day for 15 minutes.'”

    Meagan: "That’s what they told you?"

    Grace: "That’s what they did. That was their policy."


    Today’s episode is a must-listen for everyone in the birthing community. We know 2020 was an especially tough year to give birth and Grace’s first birth story shows exactly why. Grace unexpectedly tested positive for COVID upon arriving at the hospital for a recommended induction after providers were worried about her baby’s size. She was immediately subject to the hospital’s policies for that day. 


    Grace felt like her birthing autonomy was slipping farther away with every intervention. She ultimately consented to a C-section for failure to progress. Her lowest point was watching a nurse feed her new baby a bottle in her hospital room while she felt perfectly fine and capable of doing it herself. Grace was a compliant and obedient patient, but her heart was broken.


    Though she went through so much, Grace’s positivity and commitment to a redemptive second birth experience are so inspiring. Grace is sharing all of the warning signs she wishes she recognized before along with so many helpful VBAC preparation tips. 


    While we wish Grace didn’t have to go through what she did, we are SO very proud of her resilience and strength!


    Additional Links

    The VBAC Link Blog: 10+ Signs to Switch Your Provider

    The VBAC Link Blog: How to Find a Truly Supportive VBAC Provider

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Meagan: Hello, Women of Strength. I am bringing another VBAC to you for you today. I always do that. To you, for you. It is for you today. We have our friend, Grace, and she is actually from New York, right? Yes. 


    Grace: Yes. 


    Meagan: New York. Yes. That too, is something I want to start highlighting on the podcast because we have a lot of people being like, “Well, where are they from? I want that provider. How possible is it for me to get that provider?” 


    She is from New York, everybody, so if you are from New York, definitely listen up extra sharp on this one. Yeah. She is going to share her traumatic C-section story and her healing VBAC. It just tickled me so much when she said in the beginning when we were chatting that this podcast truly helped her so much. It truly is so heartwarming to hear those things because this is exactly why I’m still doing this podcast. 


    It is because I want everyone to have these stories, to be able to feel empowered, and to learn along the way because I think in addition to inspiring, these podcasts really, truly inform and educate. We can learn from other peoples’ stories. We can be like, “Oh, I didn’t even know that was a thing.” 


    Even though birth is really the same, it’s just the same concept. Our cervix gets to 10 centimeters. We get 100% effaced. Our baby comes out through our pelvis and we push a baby out, it’s just treated so differently truly worldwide. That’s what is kind of crazy to me still that we haven’t caught up to evidence-based birth in every state or country and we do things so differently. I think that’s something really cool too to learn where people are from so we can learn what birth looks like in that state or in that country. 


    Review of the Week


    We are going to read a Review of the Week and then we are going to turn the time over to our cute friend, Grace, to share her stories. 


    Grace: Yay. 


    Meagan: This is from stephmeb and her title is “Positive Stories Inspire Birthing Women”. It says, “As a VBAC mama myself, I have to say that one of the things I drew strength the most from were the most positive birth stories. I wish this existed with my previous babies and cannot wait to listen and gain strength from the stories that we are blessed enough to have one another sharing.” It says, “What a beautiful thing to have and it all is in one place.” 


    I love that she highlighted that. That is something that we love to do here at The VBAC Link. That’s why we created it. We wanted you to have all of the things– the stories, the information, the education, the resources all in one place because I too, when I was going for my VBAC, had a hard time scrambling all over the place trying to find out the information. 


    It says, “These ladies are really blessing and inspiring birthing women, VBAC or not.” I love that. Thank you so much. As always, we love your reviews. They truly make us smile. They keep us going. I even still to this day will get a review and send it over to Julie so she can see that her legacy is still carrying on today. So if you haven’t left a review, we would love one. You can help us on Google if you just Google “The VBAC Link”. You can leave us a review there. It helps everyone out there looking for VBAC to find us, to find this podcast, and to hear these amazing stories. Or on Apple Podcasts or you can even email us. Thank you so much for your review. 


    Grace’s Stories 


    Meagan: Okay, Grace. Before we were talking, we talked about not the best C-section experience. 


    Grace: Horrible. It was horrible. 


    Meagan: We talked about being COVID-positive. That was a really hard time. We are still having COVID. COVID is not going away, so I think this is also a really good thing to hear about what things to do or what things to know if you are COVID-positive. Fortunately, the hospital system has changed substantially since then. I was probably one of the most angry people that I have ever been. I was a very angry person during COVID watching what was happening to my clients and what was being told to my clients. It was heartbreaking to see and I can’t imagine going through that. So if you are a COVID mama birther whether you had COVID or not, just know I am sending you so much love because I know you went through hell a lot of the time. 


    And then you had a redemptive VBAC. I am going to turn the time over to you to share with the listeners your stories. 


    Grace: Awesome, yeah. Going back, since my first birth which was a C-section, my first is three and a half. It’s been crazy trying to go over what happened before I started recording with you just so I had all of my points down. I started to cry at one point just because it was so traumatic. 


    I don’t know if other women have gotten as traumatized as I have, but I’m sure some have because it just was terrible. So maybe that’s why it’s good I have everything written down. I don’t know where I should start because it’s just so much. 


    So again, I was COVID-positive. This was 2020 and this was right when COVID started becoming so serious that they shut everything down. So March and April 2020, I had to start working from home. At that point, I was 6 or 7 months pregnant with my first baby. 


    I didn’t think anything of it. COVID at the time was scary, but because of my age– and I didn’t have any other conditions. I wasn’t a diabetic or anything where COVID can be really scary. Other than that, we were just isolating the way we were supposed to. I am a teacher and we didn’t have to go to work so that was actually kind of nice. I got to work from home. I went on really long walks and just enjoyed the end of my pregnancy. Nothing was phasing me. 


    I had a regular OB. I picked this OB. Why did I pick this OB? I think it was that I wanted to give birth at this hospital that when I was picking hospitals in my area, I was told that this hospital has the best NICU. I’m like, “Okay.” 


    I had no reason to think my baby should need a NICU, but when you are picking, you’re like, “What are the pros and cons?” I picked that one and I went with the OB practice that was connected with that one. It was, I think, private. There were a lot of providers in that practice. A few people did say, “Just so you know, a lot of people have C-sections there.” I already knew two women who went there and both had C-sections. 


    Warning sign number one, if you are hearing people say that a particular provider or practice is likely to give you a C-section, just be aware of that. 


    Meagan: Yeah. Yeah. 


    Grace: I didn’t listen to that. So probably in mid-April, I started losing my sense of smell. Immediately, I’m like, “I might have COVID.” My husband and I about a few weeks earlier than that did have five days where we didn’t feel great. We were tired. We were run down. We kept thinking, “Maybe it’s COVID,” but our symptoms were super mild. No fever, no difficulty breathing. 


    And remember, in early 2020, everybody was petrified of COVID and expecting it to be this super terrible thing. You’re going to go on a respirator and all of these things. We had that one week. We weren’t feeling great and then mid-April which was a few weeks after that, I lost my sense of smell so I was like, “Crap. I think I might have COVID.” I hope I can say that. 


    Meagan: Yeah, you can. I just said “hell” so “crap” is good. 


    Grace: I called my OB and I called a few other people. I said, “I don’t know what to do. I lost my sense of smell. I feel fine.” I felt fine. They were like, “Okay. Isolate for two weeks. Let us know how you are doing.” We were. We weren’t going anywhere. We were just working from home. I would go out with my mask and my gloves. We did all of the things then, but we didn’t really go to work or anything. 


    So then those few months go by. This is something I didn’t want to forget to mention. Even at 20 weeks of my pregnancy, almost every appointment that I went to whether it was a checkup or a sonogram, they started saying, “Your baby is very big. It’s big. He’s going to be–” Not that they would give me a weight, but they were like, “He’s going to be a big baby. He’s going to be a big baby.” 


    He was a boy, so I was big in the front. I was gaining weight which was concerning me. 


    Meagan: Also normal to gain weight. 


    Grace: Right. Totally normal, but when they started saying that so early, and then at the time, my sister had her first and her son was, I want to say 8 pounds, something. She really struggled to get him out. I’m not going to tell her story, but the things she had to go through to get him out were tough. She didn’t have a C-section, but when I started hearing, “Oh, he’s big,” it started making me concerned like, “I hope I can get him out.” 


    Again, another foreshadowing that you’re not seeing the right people because they shouldn’t be saying that to you. They should just be letting the baby get where it needs to get and letting you know that everything is going to be fine. 


    So I’m going through isolation. Time goes by and I’m getting into my third trimester. As we all know, women who have been pregnant, when you get to the end, you start to lose your mind. You start to get very vulnerable. You start to be like, “Please get this baby out of me.” By that point, I was rotating OBs so I had met everyone because you don’t know which OB you’re going to get. 


    So I went to this one OB and he was the main OB of a girlfriend. She would only want to see him. He did make a comment that was bad bedside manner and it should have been an indicator that this guy was not looking out for you. He said, “Oh, you’re having a boy? We don’t like when you ladies have boys.” 


    Meagan: Oh, whoa. 


    Grace: Yeah, he said that to me. I giggled out of awkwardness, but after leaving, I was like, “Who says that to somebody?”


    Meagan: Yeah, I don’t like that. I don’t like that at all. 


    Grace: I didn’t like it either. I think that was the first time I had seen him. I only had seen him twice during my whole pregnancy and then the last time was before I got admitted to the hospital. It was at 40 weeks. I think I went in to see them and he goes, “Okay, again. Your baby is really big. Let’s give it a few more days and then we’ll schedule an induction for you.” You know, at the end of your pregnancy, you’re like, “Yeah, get it out.” 


    Meagan: Vulnerable, yeah. 


    Grace: Vulnerable. And because my sister had gotten induced that January, inducing didn’t seem like any kind of fearful thing to me. I had heard stories of women getting induced and getting a C-section, but I just kept thinking, “I’m full term. I’m healthy. There’s nothing wrong.” Again, I didn’t want my baby to get too big. They kept putting that thought in my head. 


    They scheduled my induction and right when I told my mom, my mom had five kids all natural. She never had any chemicals put in her body every. When I told my mom they scheduled my induction, she flipped out. She was like, “No!” Another warning sign for me that I should have listened to. “Don’t do the Pitocin. Don’t do it. It’s not good for you. You don’t need it. Your labor is going to be really hard. It’s going to be really long.” She was telling me, “Don’t. This is a terrible decision.” “You know,” I’m like, “But they’re telling me that this baby is going to get too big. I don’t want it to get any bigger. I don’t want to go too far.” 


    Meagan: It’s scary.


    Grace: And it’s scary. They do say my risk goes up once you go past the 40 weeks and all of these things. But I did it anyway. I go to the induction. We get to the hospital. They’re like, “Oh, you have to do a COVID test when you get there.” I thought it was a good thing. I’m like, “Oh, good. They’re making sure the COVID people are separate. It’s such a good thing.” No thought in my mind that I would ever be positive. I felt perfectly fine. We were keeping ourselves in the house, wearing the masks and doing all of the things. 


    They do the test. Meanwhile, my husband and I are sharing a water bottle in the room. Then they were taking a really long time to get back in the room. I remember thinking, “That’s not good. Where are these people? We took the test at least 30 minutes ago and these tests don’t take that long.” They come back in full get-up, all three– the OB and the two nurses– full get-up of the gown and everything. Immediately, my heart sank. 


    They’re like, “So it turns out that you are COVID-positive. Your husband is COVID-negative so he can stay.” If he was COVID-positive, he would have had to go home. Yes. I’m hearing this. I’m starting to freak out. Remember, I’m a first-time mom. I’m already petrified of giving birth in general, so hearing that, I’m like, “Oh my god. Oh my god.” Then they told us that the policy that day– because the policy with COVID patients was changing every day. 


    They were like, “So if you are COVID-positive as the mother, you are not allowed to do skin-to-skin and you are not allowed to breastfeed your baby, and you are only allowed to hold your baby two times a day for 15 minutes.” 


    Meagan: Shut up. That’s what they told you?

     

    Grace: That’s what they did. That was their policy. 


    Meagan: No. See? This is why I was the angriest doula in my life. It was the angriest time I have ever been because of this stuff. That doesn’t even make sense. 


    Grace: It made no sense especially because I’m thinking, “I’m bringing the baby home with me.” The baby is going to be 100%. I’m going to nurse this baby. I’m going to have this baby on me.” If I was coughing and had a fever and a runny nose and all of these horrible, contagious symptoms, obviously, it’s like, “Yeah. I shouldn’t maybe hold my baby. I don’t want to get my baby sick.” At that time, COVID was scary, so it’s like, “Okay, if I am this COVID-positive, deathly-looking patient, fine. I get it. Baby’s safety first,” but I was fine. 


    I said I was sharing germs with my husband who was negative. I kept saying, “Please retest. Please? Clearly, these tests are wrong.” I actually did all of this research that the COVID-positive gene or swab or whatever it is in you will stay in you for months and I was pregnant. My immune system was not what it normally is. 


    Meagan: Well, and you were pregnant meaning you were sick. You had the antibiotics. Guess who has the antibiotics? Baby is inside of you. I don’t actually know the evidence, so I can’t say that there is no way, but in my head, it doesn’t connect. There’s a disconnect there. How did baby not– anyway. You were the same human– I mean, human in human during that time. 


    Grace: Yeah, like you said, not only could I not do the skin-to-skin, but neither could my husband which all of the antibodies and all of the healthy things, my baby really didn’t get any human skin touch until he got home which was three days later. 


    Meagan: I’m so sorry. 


    Grace: Yeah. I mean, I know he’s fine, but there are these things. Now he’s three and a half, when he has sensory issues or anything, I always go back to how his birth was horrible. Obviously, there’s more. 


    So that hit me like a ton of bricks. I’m just devastated and I’m calling all of my family. I can’t see any family. No one can come to the hospital and I’m just crying. Already, it’s like the downhill is starting. So that happened. I have to just– over the few hours that I’m there getting everything set up, I have to come to terms with, “I can’t have skin-to-skin. I can’t nurse. I don’t know how I’m going to handle that.” Still thinking about that makes me really upset. 


    Meagan: Even the nursing too, those are good antibodies and strong. That’s what helps our babies. 


    Grace: Yeah. I know. It’s completely backward. The OB that was there was actually no one I had met before. She really didn’t seem concerned. She was totally– what’s the word– I use this when it comes to these healthcare workers in the hospitals. They are desensitized. That’s the word. They were desensitized to my reaction and my husband’s and all of it. They were just like, “Yep. This is how it is. Whatever.” 


    Anyway, they get us in the room. We had to be locked in the room. Anytime another nurse came in or whatever, we had to put a mask on. Meanwhile, every time they came in a room, it was the full getup so obviously, I was already a patient that they didn’t want there. That was how you kind of felt. The nurses weren’t nasty or anything, but they gave you the vibe of, “Oh, great. She’s hitting the button. We gotta go help the girl with the whole getup.” You know? I know I’m not the only COVID-positive one there, but you don’t want to feel that. You don’t want to feel like that type of patient. 


    So you know, they started me on Pitocin. We’re trying to get through it. We’re watching TV. The contractions weren’t too bad. I was getting through it. I’m moving around like crazy. The first nurse I had made a joke. She said, “I’ve never seen a pregnant woman move around as much as you.” I was trying so hard to get contractions going. 


    Meagan: Movement is good. We should be moving around in labor. 


    Grace: 100%. I mean, I had to do it in my room. I couldn’t go anywhere which was dumb, but I’m doing all I can do. Hours are going by. Again, Pitocin is slow to go. I think after, I’d say maybe 10 hours of it, I go, “I am so tired and I’m not really progressing.” I think I was only 2 centimeters after 10 hours. I’m like, “I am so tired.” I was feeling contractions at that point that was enough that I needed a break. 


    This is another warning sign that I should have said no to. I was only 2 centimeters. She comes in and maybe it wasn’t 10 hours yet. Maybe it was 8 hours. She comes in. She checks me. She’s like, “Yeah.” I’m only 2 centimeters. She suggested to break my water. She said, “Yeah. That’ll get things going.” 


    I’m like, “Oh, great. Break my water. Totally. Do it.” Now, I shouldn’t have done that. I had read books and I had learned things, but again, you don’t even– it all goes out of your mind when you are trying to have a baby and get from A to B. You’re uncomfortable and you don’t have support around you and all of the things. Already, my vulnerability was so high because of COVID and the fact that I couldn’t hold the baby. 


    At that point, I said, “Great. Break my water.” 2 centimeters? Who does that? Crazy. What was I thinking?


    Meagan: You’re not alone. You’re not crazy because you weren’t in the space to make a “better informed” decision. You were being told by your medical staff that this is what could help so you are not crazy. Offer yourself some grace, but yeah. It’s just one of those things that we take as a learning experience and a nugget for next time. 


    Grace: Yes. That’s what I think is upsetting. She knew that. My OB knew that. She wasn’t technically who I would consider my OB to be because the one woman I was seeing each time, I don’t think would have done that to me. 


    Meagan: The attending OB. 


    Grace: Exactly. It’s like whoever you get in that Russian Roulette lottery of that day. She didn’t even know me. She clearly didn’t care about me. Oh, and she also made a horrible comment to me that day. I don’t remember if it was before or after she broke my water. I think it was after. She breaks my water. Contractions are going again and they are way more intense. At that point, so much time had gone by that I was exhausted. It was maybe 10 hours. I don’t totally remember exactly, but I think it was 10 hours that I spent. I said, “Let me get an epidural because I can’t take it anymore. I need sleep.”


    After I got the epidural, I was in bed and I feel like either the next morning or maybe it was the night right before I went to sleep, I was crying to her. I said, “I’m really upset. Is there anything we can do? I would really like skin-to-skin with my baby.” I said, “Wrap me in a garbage bag. I don’t care. I really hate that I can’t have that with the baby.” 


    She looked at me and she said, “Well, you don’t want to give your baby COVID.” I couldn’t believe she said that to me. I was crying already. I’m like, “Of course not.” It made me cry more. How could you put that out there and look at me right now? If it was you and it was your baby, how would you feel that it got taken away from you and I felt perfectly fine? I’m like, “Obviously, it’s not me. My husband just took a test and he was negative.” For her to say that to me, I didn’t want her back in my room again. 


    So the epidural came and I was under the impression– again, looking at my sister’s birth– that with the epidural, I would go to sleep. I’d wake up at 9 centimeters and I wouldn’t even feel a thing. I didn’t know. Again, because my sister did something similar. I don’t think she woke up super dilated, but she definitely progressed after she had gotten her epidural, so I was like, “You know what? Maybe that’s what I need.” And my water was already broken. 


    I get my epidural. I go to sleep. I get some rest and then the next morning, the OB comes in and I’m relaxed. I’m calm. She checks me and I’m only 3.5 centimeters. I barely moved. It was very disappointing. I couldn’t even handle it. I’m like, “Okay. Will I have more time? There is more time now. It’s okay. It’s okay.” But then, yeah. No. I didn’t progress again. 


    This is another warning sign. The OB comes in around a quarter to 4:00 and I remember hearing this on other podcast episodes that it’s that 5:30 PM C-section time, right? 


    Meagan: It does happen.


    Grace: It’s before the end of the day. I mean, listen. Maybe it was coincidental, but given the fact that she comes in. She checks me. She’s like, “Listen, you don’t have much more time because you broke your water however many hours ago.” I don’t remember the amount of hours after you break your water. You probably know. I don’t remember. 


    Meagan: Well, there’s a lot of other factors than just the time. It’s like, “Are we having signs of an infection? How is baby doing? How is mom doing? Are we making change in other areas?” You know? So after 6 hours of getting in labor, 6 hours after waters have been broken with no progress, they will start discussing things but it doesn’t always have to be a C-section. 


    Grace: Oh, so she definitely gave me a lot of time. She gave me more than 6 hours, but I wasn’t progressing at all. I don’t really know. I will be honest that my timeline will be a little funky because of how long ago it was. This I do remember because of the time he was born. He was born at 4– oh my gosh. I should know the exact time. I think it was 4:36 or something like that. 


    Meagan: Whoa. Really fast after. 


    Grace: That’s just it, right? She comes in. “You’re not progressing. We really don’t have much more time before we’re going to have to give you a C-section. Otherwise, the safety of the baby is going to be at risk.” Now that she says that, I’m freaking out, right? 


    Meagan: Of course. 


    Grace: I’m like, “Oh my gosh.” You know what? A lot of women I had spoken to before said that C-sections are no big deal. It’s fine. Don’t be afraid of them. They’re fine. At that point, I said, “You know? I’m already going through hell right now. Let’s just do it. Let’s just get the baby out.” It’s so crazy how they are so slow to do so many things, but the moment I sign that form, nope. The operating room is ready to go. The team is ready to go. It’s within seconds. They are so ready to get you on that operating table. It’s almost like they want to get you out of the door. She wants to get out of the door. We all know that C-sections are going to bill your insurance way more than if you just had the baby naturally. I hate to think that is how a provider would think, but given the time and given everything that would happen, it’s like, what else am I going to think now? It’s not clear, but I feel like that was a piece of it. They were just trying to get me in and out. 


    Oh, on the operating table, she yelled out, “Just know that this patient is COVID-positive!” to the whole staff. I’m just the diseased person that is in the room. I was walking around like a perfectly healthy person. It was just so awful. 


    So they begin the C-section. I hope I’m not sharing too much and talking about things that don’t have meaning, but I guess I have to live through it a little bit. 


    Meagan: This has meaning. You’re sharing them. We can feel it. Yeah. 


    Grace: Okay. Now, at that point, during the C-section, you’re on a lot of pain meds. I come out of the operating room. Everything is fine. I’m not having any issues. I didn’t throw up or anything. All I wanted was to see and hold my baby. I heard the baby cry. My husband got to see the baby. No one got to hold the baby just yet. We’d get in the room. They immediately put the baby, I think, in the isolette. This is at the time where if you were COVID-positive, the baby could be in the room with you, an isolette I think? Or an isolette? Is that what it’s called? 


    Meagan: Like another room? I don’t know. 


    Grace: You know for NICU babies, they’re in this– 


    Meagan: Oh yeah, I do know what you are talking about. I don’t know what it’s called actually. 


    Grace: I think maybe it’s called an isolate and that’s what the rule was. When you are COVID-positive, your baby would stay in the isolette. You couldn’t hold your baby unless it was those two times during the day for 15 minutes. He went into that. My husband came in. I think that the attending nurse I had at that time–


    Meagan: Your husband wasn’t with you in the C-section?


    Grace: No, no, no. He was. I’m in a bed. I’m just trying to go through it again in my head. 


    Meagan: No, you’re fine. 


    Grace: So the whole time, I kept thinking, “I just want to hold him. Please just let me hold him. I won’t do skin-to-skin. I’ll follow all of your rules, whatever. Just let me hold him. It’s my brand new baby.” Again, I’m a first-time mom. I do think regardless if you are or not, I totally get it. It could be your fourth baby and you would still feel that way. When my mom had my sister who was her second, she was like, “The nursery can have her. I need rest.” There is a sense of, “I’ve been there. I’ve done that. I don’t necessarily have that need to hold them in that moment,” but as a first-time mom, seeing my first baby, that was all I wanted in the world was just to hold the baby. 


    So this one nurse comes in. I don’t know. I think she was just a post-delivery nurse and she was very tough. I was like, “Please, can I hold him now?” She was like, “You need to wash your hands. You are COVID-positive.” Nasty. I’m like, “Okay, fine.” I can’t move becaus I just had surgery. They bring me over this bucket of soap and everything. I’m washing my hands and I’m just constantly looking at him trying to get him. She yelled at me. She was like, “You’re not washing your hands enough.” She was like, “I’m an ER nurse during COVID. You have to take this seriously,” just belating me. It was so horrible. 


    But they did finally let me hold him. It was great, but it was obviously short-lived. Then after that, they took him. The nurse had to feed him a bottle. I wanted to breastfeed. I didn’t want to give him any formula. I remember just seeing her sitting there with him thinking– I’m so sorry– that I failed. My body failed. This woman has to feed my baby for me and I’m right here. I can do it. I couldn’t even give him a bottle. I just felt like such a failure at that moment. 


    I did not think I was going to start crying, but just to see a stranger do that just really upset me. That was pretty much that. Right then, I was there and then that nurse would come and feed him every 15 minutes. You know, it’s a baby. You have to feed them every 30 minutes or something. But then that moment when she first did it, I thought I was such a failure. 


    Meagan: Not a failure. 


    Grace: I know. My husband had no idea what was going on. They never really do. He was very much like, “We have to listen to the hospital.” When they would leave the room essentially, I was like, “Give me the baby. Let me just hold him. What are they going to do? There are no cameras. Even if there were, what are they going to do? Kick me out? I just got cut open.” Honestly, I was so ready to break those rules. The baby was going to be right there. 


    My husband was like, “They could walk in. You could get in so much trouble.” He didn’t know what could happen so we had to just follow the rules. He got to hold the baby, but every time he’d pick up the baby, he had to put on a new thing of gloves, a mask, and a gown, and he ended up having to feed the baby because he was allowed to. That started to drive him crazy because he was also on no sleep. If you go back from when we got to the hospital to when we had the C-section, it had already been two days of time where we were just there. He wasn’t really getting the best of sleep. 


    He has had so much going on, so now he has to care for this newborn baby. He’s never held a baby in his life. That ended up being what was going on at that point. Now at this point, the epidural was still in me and I wasn’t in any kind of crazy pain. 


    Then the nurse comes in. She’s a new nurse and was actually very nice. She goes, “Listen, I have a few other pills.” I can’t remember what they are but then she goes, “I have oxycodone for the pain.” I was like, “I really don’t want to take any opiates because I’m going to try to breastfeed when I get home and I am pumping. I don’t want to have any opiates in my system.” I was saying this while the epidural was still in my system. She looked at me like, “Okay,” and I have a Motrin allergy. I can’t take ibuprofen so all I was taking at the time was Tylenol. 


    She gives me probably the Tylenol at that point. The epidural was still there. I’m like, “This will be fine. I’ll just take Tylenol.” But it was a dumb thing to think. When that epidural wore off, I don’t know how many hours later, I was in so much pain. I could barely talk. Motrin and Tylenol work together because some women don’t take the opiate, but working together helps a lot. But when I wasn’t getting Motrin, all I had was Tylenol. It just was so, so painful that she got to my room. I look at her. I go, “You need to get me the oxycodone right now. I can’t move. I’m in serious, serious pain now.” 


    So she gets it for me, but the thing is with pain– oh, I’m sorry my friend texted me– when you don’t catch up to the pain and you have the pain meds in your system, you kind of can never stay on top of pain. Does that make sense? 


    Meagan: Mhmm. Chasing it.


    Grace: You’re chasing it. So even with the oxycodone in my system, the pain would finally subside, but then once it came back, it came back so bad that I just never felt okay anymore. I just constantly was uncomfortable and in pain. Those moments when the meds would wear off to get your new set of meds, I could barely talk. It was so intense. Then also when you get surgery, you get gas that radiates up and that was insanely painful. 


    The night nurse ended up being late with the oxycodone at that point. It was 3:00 AM. My husband was sitting next to me. He couldn’t even sleep because he was so worried about me because of that pain. I wasn’t myself anymore. I don’t know if other women with C-sections have gone through anything like that, but it was just really bad. 


    He was sitting next to me. It was 3:00 AM and he was like, “I’m really worried I’m going to lose you.” I actually muttered, “I think I’m going to die.” That’s how intense it was. She was probably 45 minutes late with the medication and again with pain meds, if it’s not in your system, you feel everything. 


    That made it even more intense and horrible on top of everything else– all of the emotion, the fact that I didn’t even want a C-section, and it just kept spiraling into horribleness. I will say one positive good bit though that I look back on and I remember. 


    The attending nurse that I had during the day of my C-section actually came in after and was so sweet. She did know that I wanted to breastfeed, so she was trying to get the colostrum to give to the baby. One thing my sister told me to do was she goes, “Make sure before you are planning on giving birth that you start eating lactation cookies and getting your supply to come in.” Because I had done that, when I showed up and she wanted to get colostrum, there was tons of it. He was in shock. He was so happy. He was a bit older, almost like you could tell he was old school. He was like, “I’ve never seen anything like this. This is amazing.” It made me feel like somebody had faith in me instead of some diseased, horrible person. That’s what I felt the whole time. That was nice having that moment. 


    But yeah, so then with the pain, that was starting to make the whole experience really bad. We ended up leaving a day early and even the day we left, the pediatrician made a point to me. He was telling me about the baby and things to do with the baby and everything. I go, “I’m so really worried. I’m COVID-positive. I don’t want to get the baby sick. Everyone is making it like I’m going to make the baby sick and what should I do? Can I hold the baby? Can I do these things with the baby?” She looks at me and says, “Of course you can. You are going to take your baby home and you can nurse your baby. You’re going to hold your baby.” She was like, “Wear a mask,” and was almost looking at me like, “This hospital is crazy. This policy is horrible,” but because this is the routine for them and they are desensitized to everything, I wasn’t getting that from anyone else. It was just common. 


    It made me really look back and say, “How stupid that they put me through this.” I don’t even know. I think there were some COVID-positive mothers where their babies went in other rooms and they couldn’t even see them at all. 


    Meagan: Mhmm. 


    Grace: I mean, I’m sure you’ve heard other horrible stories. 


    So we go. We get to leave and my husband at that point had no sleep either. It was maybe three or four days that we had been there with no sleep. I had no sleep because I was in so much pain. We get home and my mom opens the door because she was waiting there for us to help us. My mother was really upset too. She was crying all night that I was going through that. She looked at me and was like, “Oh my god. What did they do to you?” I had dark circles under my eyes from being exhausted but also from crying. 


    Meagan: Yeah. I was going to say, I’m sure that you instantly knew that you wanted a different experience next time. 


    Grace: Oh my god, yeah. I wanted it different and you know, I have a beautiful, healthy baby so it’s not like it was the worst experience it could have been, but it wasn’t at all what I wanted or what I thought it would have been or that it really should have been. So many things went wrong and I take a lot of blame that I should have researched providers better. I should have researched the policies better. I didn’t know, you know? You never think it’s going to happen to you. You think everything’s going to be fine. 


    My one girlfriend, I think had placenta previa. Something like that, but she said, “I immediately knew I was having a C-section. There was no question there.” That’s one thing. You have physical limitations where it is very dangerous. Okay. It’s fine. You have a C-section. It’s fine. But when you are put in a horrible hamster wheel of horribleness where they already know you are going to have a C-section and they don’t even care, it’s so long. And the COVID-positive on top of it was just really, really hard.


    My husband said, “Honestly, Grace, the C-section wouldn’t have bothered you as much had you been able to actually hold your baby.” Yes, and all of that positive adrenaline and endorphins in your body probably would have helped you heal faster. So when I brought him home, we had to get him latched and that was a whole other hurdle, but I did. I had a lot of nursing issues with him because he had this torticollis. He had all of these issues, but I totally powered through and I still did it. 


    But now with my daughter, I’m sharing her VBAC story, right? I’m sorry. I hope I’m not talking too much. With her, I had no issues. Nursed fine. She is a thriving, wonderful, beautiful baby and I totally believe that it is because of the birth with her and it went so differently that it is just so much better for me and it was better for her. It was better for my husband. It was better probably for my son too. 


    That was my horrible, horrible C-section birth. 


    Meagan: I’m so sorry. 


    Grace: I think I covered everything. I’m sorry too. I keep talking. Yeah. It was horrible. I mean, looking back, I’ve learned so much and hopefully, other women can learn from it. I hope I covered all of those warning signs I want women to look out for. I don’t know but hopefully I did, but yeah. My heart goes out to the COVID-positive mothers who went through something similar or worse. I can’t even imagine. 


    I do think that if you are positive and you are sick– if I were visibly ill, it’s so different to me. My mindset would have been way different. I would have still been sad, but I wouldn’t have felt like my autonomy was taken away from me. 


    Meagan: Stripped. 


    Grace: Yeah, stripped, which is much more where you feel like you are at their mercy. You don’t feel like you have freedom at all and it’s horrible. 


    Meagan: Yeah. 


    Grace: Yeah. So I get pregnant. My son at that point, I think, was about a year and four months. He wasn’t 18 months just yet. I got pregnant with my daughter and again, I knew I definitely wanted a VBAC, however, I had known a lot of other women who wanted VBACs too, and still ended up getting a C-section. They would say, “Yeah, we are going to try for the VBAC, but if it doesn’t work, you will have to have a C-section.” Every woman I spoke to who said that, ended up with one. 


    As I was going through my pregnancy, I was trying to educate over time. I was like, “What is this that they are missing that I don’t want to miss?” I did not want another C-section. I did not want to ever go through that pain unnecessarily again. Obviously, listen. C-sections save babies. I am not against them. 


    Meagan: Absolutely, yeah. 


    Grace: You know that and you know that in so many ways, they are super important, but for me, if I have a healthy pregnancy and a healthy baby and I don’t have anything going on that would require that other than I had a C-section prior, then I am going to do everything I can to not have another C-section. 


    So I discovered The VBAC Link, I want to say it was further into my pregnancy. I want to say I was at least 5 months into my pregnancy. 


    Meagan: Yeah. 


    Grace: How many weeks would I have to be for that?


    Meagan: 20?


    Grace: Was it 20?


    Meagan: 20 weeks is about 5 months so probably a little over. 


    Grace: It was a little over 20 weeks and I discovered The VBAC Link. I am like, “Okay, I will give this a thought.” I already found a midwife. I didn’t want an OB and the midwife that I had, I really liked her. She had VBACs of her own. 


    Meagan: Awesome. 


    Grace: I was super adamant. I’m like, “I do not want another C-section.” She understood. Here’s the thing, though with these providers and I liked her. I’m not trying to make it seem like she did anything wrong, but they don’t educate women on what to do. There are so many things that women can do to get themselves in the best situation to have a nice, vaginal birth potentially not even needing medicine. They don’t. I don’t know if it’s that they don’t on purpose, but a midwife is not an OB. She’s not going to give me a C-section, so why wouldn’t she want to give all of the resources to her patients? I didn’t even know what Spinning Babies was until I listened to your podcast, then I researched Spinning Babies and I used Spinning Babies. 


    So anyways, I discovered you guys or you ladies and I started listening to you every day on the way to work and the stories were just so wonderful. I learned a lot. I learned that one of the big ones was to find a hospital that is more likely to support a VBAC and has a high success rate of a VBAC. Now, the hospital I picked, I was told it was a good one. It is a good hospital. Nothing specific about childbirth or anything. It was very close to me. I had known other people who had delivered there and it was fine, but I’m like, “You know what? Let’s look at their success rate versus other ones.” Their success rate was 7%. Is that high or is that low? 


    Meagan: That’s low. 7% of their success rate of a VBAC, that’s low. 


    Grace: That’s low. That’s low. There was another hospital I heard about from someone who gave birth there and it was an hour away. Most women who gave birth there had the best experience. It’s a hospital and then it had a birthing center connected to it. Because I was a VBAC, just birthing centers wouldn’t have let me go there because if they needed an emergency C-section. That setup was great. I looked at their VBAC success rate and it was 22%. 


    Meagan: Higher than 7. 


    Grace: Now that you say that, it was probably still fairly low, but that was the highest I found. 


    Meagan: Yeah. 


    Grace: Yeah, and now I went ahead and listened to your podcast for a few months and I started getting scared. I was like, “I don’t have a doula. I don’t have a lot of information that a lot of these women had.” Now that I have it, I was already at that point, I want to say 7 months in my pregnancy. Not going by weeks just because I don’t know why months make more sense to me. 


    That’s when I started becoming very much doing more research and being more actively aware of my birth and wanting to make sure that this birth goes better. I find this hospital. At that point, I go, “I’m going with this hospital and no one is going to stop me.” But because I was already so close, I was actually in my third trimester already and I told my– the way it works is I was very lucky. My provider was part of a bigger company. I’m not going to give out any names or anything unless should I? 


    Meagan: If you have a supportive provider that you would suggest, I highly suggest giving the name because also, Women of Strength if you are listening, we have a provider list. We actually have that, so we will be adding this one to your list. But if you guys have a provider that you highly suggest as being VBAC-supportive especially if there are multiple Cesareans, please send us that at info@thevbaclink.com because we want to add them to our list. 


    Grace: Okay. Okay, yeah. I definitely will. At the time, they were called CareMount near the area where I was, but they just got bought out by a new company called Optum. 


    Meagan: Optum, okay. 


    Grace: Most adults of my age remember them as CareMount because it was super recent that it changed. Optum was in my area and because they were big, they also had a practice up near this hospital. I called the practice up near the hospital and I said, “Listen. I’ve been going to midwives down by me, but you have all of my information because it’s all the same system. I want to go to your office because I want to deliver at this hospital.” Can I say the name of the hospital? 


    Meagan: Yeah. 


    Grace: I can, right? It was Northern Dutchess. They are amazing. They have a birthing center. The staff there is incredible and yeah. I said, “That’s what I want.” The immediately were like, “We don’t take on patients so close to the end like this, but given that you are in the system, I guess it’s okay.” I was going to say to them, “I don’t care if it’s allowed or not. You’re going to help me give birth in your hospital.” I also was going to be like, “I don’t want to see any OBs. I only want to see midwives.” They still had me see two OBs and it’s actually fine because even their OBs were just better. They were more understanding. 


    Believe it or not, the male OB was even more. I was scared to see the male. Nothing against men, but the fact that with my son it was a man and he made that comment to me, treating me, I don’t know. They didn’t give him any kind of nickname, but I think he was known for only really doing C-sections. I was so scared to have a man especially because by the time I saw him– so before I even get to that, they do the switch and at that point, again, I was listening to your podcast still and I’m like, “You know, I really should get a doula.” I’m in my 35th week or something. 


    I’m like, “I need to get a doula. I need this birth to be what I want it to be.” I find a doula in my area. She is amazing. She said the same thing. She was like, “We’re meeting pretty late, but it’s okay.” She was super understanding. I told her about my whole horrible birth and she said, “You’d be surprised but that part is super common.” Not the COVID part, but the whole story. 


    Meagan: The whole story, yeah. Yeah. 


    Grace: Also, I think me being allergic to Motrin and that recovery being so– I hate to say it but traumatic for me because when you’re in so much pain and you are already in so much emotional pain, it is just horrible. She was like, “Yep. It’s a super common story. I’m not going to guarantee you a VBAC, but you’re going to get through this birth. It’s going to be beautiful. You’re going to have a wonderful connection with your baby.” She said, “Don’t worry about the COVID thing anymore. It’s not at all what it was in 2020. Try to think of all of the positive things.” 


    She introduced me to Spinning Babies. I started researching so much of my own and I was like, “Should I do all of the dates and tea and the stretching and the walking?” She goes, “Do all of it.” It’s what they say. It’s like an old wives’ tale, but it’s not going to hurt. Do all of it. Take a deep breath. I started to get almost obsessive at the time. I even made a joke to my provider at an appointment. I was like, “I’m sure it says in my file that I’m the crazy VBAC girl.” He laughed. 


    He said, “It doesn’t say that,” but I was very determined. Again, your podcast helped me so much because there were so many women who have gone through so many things and had to work even harder to get the providers that they wanted and get the support that they wanted. It’s so important and it’s so wonderful that you have it. So thank you. 


    Meagan: Mhmm, yes. Thanks for being with us. 


    Grace: So then, yeah. I changed my provider. I get the hospital. I get the doula and then I start those last, I want to say 5 weeks. I’m walking every day. I’m eating a disgusting amount of dates. I don’t think I’ll ever eat a date again. I’m sure you’ve heard that, but it’s true. Doing the tea and I was doing these stretches I saw on YouTube every night. My husband was very supportive. He was a little scared for me. He was kind of like, “Oh my god. If this girl doesn’t get her VBAC, what’s going to happen in the world?” 


    I was very intense about it and then, yeah. We just waited and waited. Toward the end, this part was scary for me. We also joined this Evidence-Based VBAC Facebook group and it was not– I can tell by your face. Yeah. 


    Meagan: Ugh. 


    Grace: It was not what I thought it was going to be. 


    Meagan: No, unfortunately. 


    Grace: Because I did this all kind of late, by the time I was up to 40 weeks, I went on that page maybe a week before or at 39 weeks. I started reading and I’m like, “Oh my god. Now I’m terrified to go into labor.” Note to listeners, please don’t go on that Facebook page. 


    Meagan: Join The VBAC Link Community. 


    Grace: Yes, 100%. 


    Meagan: Shameless plug right there. I think our community is just one of a kind. 


    Grace: 100%. But the thing is at that point in time, to read any of that at 39 weeks put me into a fear mode. At 40 weeks, I started crying every day that I wasn’t going into labor. I wanted to go into labor at 39 weeks, but that likelihood I think was very low because I was late with my son. I never even technically went into labor with my son. With my son, I was 40 weeks and 5 days when they induced me. 


    So from 40 weeks on, again, because of reading those posts, I started really freaking out. I was crying. I was calling my doula every day. I’m like, “I’m not going into labor. I really don’t want a uterine rupture. I’m scared.” This and that. She was so great. She just was like, “You need to relax. Everything is going to be fine.” She said, “If something is going to happen, it could have already happened. 


    One of my best friends is a nurse and she actually was a nurse in an OB’s office for a while. Every time I would go to talk to her, she would go, “You need to stop.” She would be like, “Anything could happen.” 


    Meagan: Spiraling. 


    Grace: Yeah, yeah. But it was good to have that. It was good to have somebody say, “Anything that could happen. You can’t sit there and say that just because you have this thing which is unique to you that you want to have a VBAC doesn’t mean that you’re definitely going to have something happen. You could have a perfectly healthy pregnancy and everything would be fine and then something bad would happen. You can’t worry about it. It’s not in your hands right now. You need to just relax.” 


    That was a tough part though, just going through that week and then I started getting really bad prodromal labor about a week after at 41 weeks. I started getting it really bad and I kept thinking, “Should I go to the hospital? Is this it? Can I get the baby out?” I was so excited and my doula every time would go, “No, no, no, no, no. You’re not going anywhere near that hospital right now.” Thank God she said that. 


    So then I think I had prodromal labor for about three days or four days or something. Then finally, on the final day, my mom was over and I was in so much pain just from all of the prodromal labor. I’m like, “Something is not right.” She looked at me and she was like, “You are in active labor. I can see your stomach contracting.” I’m like, “But I called. My doula said I shouldn’t go. I don’t know what to do.”


    I already lost my mucus plug a few days before that. I had never gone through anything like that. Nothing like that. 


    Meagan: You’re getting into labor though, yeah. 


    Grace: Yeah, but my mom again, has five kids. She goes, “No, no. This is labor now. You really should go.” She even talked to my doula two nights before that because I thought that two nights before that I was going into labor and my doula was saying to my mom, “No, not yet. She’s not ready yet.” I don’t know how she knew that. 


    At that point, I called my doula again. She said, “You know what? Your mom is probably right.” I was timing them. I don’t remember what the times were, but they were so strong. I think my mom was like, “I don’t even think it matters. This is labor now.” 


    I get to the hospital and I was 100% effaced and 5 centimeters dilated. Something to start. 


    Meagan: Yay! Getting ready to get into active labor right there. Turning that transition. 


    Grace: Yes. He tells me that. I was COVID-negative. It was like the clouds were opening up. Things were falling into place. The only thing is and this is a totally okay thing. My doula had another birth that night so she couldn’t go. I forgot to mention this. She already knew she was going to not be there. She actually called a backup doula and this was actually the morning before I went into the hospital. 


    I called her. We had a nice conversation. She was like, “I will definitely be available.” I go, “I’m having a lot of prodromal labor. It’s really uncomfortable. I’m tired.” I’m like, “I just don’t know what to do. When should I go?” She was like, “Okay, at this point in pregnancy, it’s totally normal. Why don’t you just go on a two-hour walk?” What? 


    Meagan: A two-hour walk? 


    Grace: I was walking every day for two months. A two-hour walk? I’m struggling to sit. I’m like, “Okay.” She told me at 9 AM. I went on a two-hour walk and listen, I was at the hospital by 4:00 PM that day. She totally knew. She ended up coming and she was so sweet and amazing. I had never even met her before. I would totally recommend either doula if anyone is asking. If it means anything, their rates were nothing crazy. I listened to a bunch of doulas which again, I got from your podcast that you want to really interview your doulas and make sure you know your doulas. They were super reasonable and both were wonderful. 


    That all fell into place. I was just starting to have my contractions. She was there to do all of the lunges together and all of the movements together. She put me in all of the right positions and I ended up not needing an epidural. Let me rephrase that. I ended up not having to require an epidural even though it was very, very painful. But it was a very welcomed pain. I was in labor for about 14 hours. It was a long, long day. 


    I made a birth playlist which I did for my son too and I never got to really use it. One moment during labor, that particular experience was when the doula goes– this was around 6 centimeters, maybe 7 centimeters. She goes, “Why don’t you go dance with your husband?” I had my birth list on and I think it was a Justin Timberlake and maybe Beyonce song. It was a very romantic, lovey dovey song. We were just standing there. The lights were off. We were dancing and it was just so beautiful. The nurse told me after. When you’re in labor, you’re not totally aware of your surroundings. She told me the next day after the baby was born and everything and she goes, “I almost started crying when I saw you and your husband standing there dancing.”


    Meagan: Such a precious moment. 


    Grace: Both she and my doula I remember were kind of off to the side standing there. It was just so wonderful and yeah. She got me through labor and I had to push for a solid, I think, hour which was fine. It was really painful. At one point, I screamed, “I want someone to help me!” You know, it was really hard, but she was there. I give a lot to her. She did all of these things to help me feel comfortable and safe. I was with someone who was going to make sure I was going to be okay. Yeah. 


    The midwife came and I loved the midwife. She was wonderful. I had met her before. She was very knowledgeable. She wasn’t necessarily the most nurturing. She was much more like, “I’ve given birth to thousands of babies. I’ve done VBACs before. We’ve got this, no problem.” At one point, she came in and she was worried my contractions had slowed down, but right after she left, my doula was like, “All right, let’s go. Get up. Ramp up the speed. We’re going to do this. We’ll put you on the peanut,” and all of the things because she knew I didn’t want an epidural. 


    I am curious about having the doula there if that is why they didn’t push anything on me. They didn’t push anything. 


    Meagan: Good. 


    Grace: Part of me is curious but I also think the hospital is known to not do that. My sister gave her second baby there and they didn’t push anything on her. So now again, you want to go to a good hospital that takes care of you. 


    Meagan: Yes, you do. 


    Grace: She came out and how big was she? She was 7 pounds, 8 ounces. My son was 8 pounds, 5 ounces. He really wasn’t even that big. 


    Meagan: No. 


    Grace: He could have come out. 


    Meagan: He wasn’t. Yeah. 


    Grace: No. I actually forgot to mention that before. He wasn’t even that big. They gave me all of that nonsense and yeah. Everything about her birth was wonderful. She went right on my breast. He latched not right away, but within 24 hours. He latched and was eating fine. It was wonderful. I didn’t have to change rooms or anything. They let me stay in the same room. I got to get up and walk around. 


    Yeah. It was exactly the experience that I had wanted. 


    Meagan: Yeah. 


    Grace: Yeah. 


    Meagan: I’m so happy for you. I’m so happy that you could have that more healing, redemptive experience where you felt the love. You felt that connection. You had the people there for you. You felt safe. You weren’t being pushed. You weren’t having people rushing in like you were some scary alien. You weren’t having these things that honestly doesn’t help our cervix dilate. There are so many things from your first story where I’m like if we can create a special environment, a comfortable environment for us, then that is going to help us progress in labor. 


    We know one of the number one reasons for a Cesarean is failure to progress and a lot of the time, it’s situational. We did this and it’s baby’s position or something like that, but a lot of the time, I think it’s truly the environment and what we’ve got going on and if we feel safe because our bodies are smart. If we don’t feel safe and if we don’t feel comfortable, we are not going to progress. We’re not going to have those things and so yeah. I’m just so, so happy for you. 


    I’d love to touch on a couple of signs when it is time to switch your provider or time to switch your location because I think it is one of the most daunting things to change your provider mid-pregnancy. It can be hard. 


    Grace: Yeah, yeah. 


    Meagan: And/or change your location. I changed my provider and my location at 24 weeks and it was emotional a little bit too. It was just like, “Oh, I hope it’s okay. I don’t want to hurt any feelings and this and that.” Anyway, just so much. We have some blogs on so many topics that we talked about today. But number one, I want to talk a little bit about some of those warning signs because like you said, you were like, “That was a warning sign. That was a warning sign. That was a warning sign,” but you weren’t in that space. 


    Sometimes that’s how it goes. I had the same thing. I go, “Whoa. I should have switched.” 


    One, I want you to know, Women of Strength, that it’s okay to switch. 100%. We do have that provider list if you are looking for a provider in your area or you start hearing some of these signs and you’re like, “Oh crap.” If one of those fits, email us at info@thevbaclink.com and remember VBAC is spelled V-B-A-C instead of V-B-A-C-K. Email us and our team will get you that list. 


    Okay, so warning signs. Recommending a third-trimester ultrasound to check on the baby’s size. When you go in for that 20-week ultrasound and they’re like, “Oh, this baby is big.” Right there, that’s a huge warning sign. I’m just going to say, if your doctor is talking about your baby being big in general, that’s a red flag. That means that they are starting to doubt your ability. Their confidence in you is going down to get that baby out and they will probably push things like induction and all of those things, right? 


    So talking about your placenta dying. They actually use these words. “Your placenta could die if you go past 40 weeks pregnant or past 41 weeks pregnant.” Not true. Not needed. You know? It’s not. You don’t need to have an induction just because you are 40 weeks. Your placenta is okay. 


    Yeah. Making those one-off hand comments of, “Your baby is big. Your pelvis could be too small. You’re looking big. You’re really a petite person.” I don’t like that. Refusing to let you go past 40 weeks. Refusing to induce at all. If your provider is completely refusing to induce you because you are a VBAC, they are not following evidence-based care. I cannot tell you that enough. We see it all the time in our community where it’s like, “I can’t be induced because I’m a VBAC.” False. False, false, false. False. Big F. False. 


    Now, is induction ideal?


    Grace: No. 


    Meagan: It could be less ideal. It is less ideal. Not even could be, it is. It is less ideal. But it is not impossible. If you are facing an induction or a C-section, do the research. Learn about it. Know that it is still possible and you will not just for sure rupture because you are induced with Pitocin. That’s another myth out there. 


    Overemphasizing the risk of uterine rupture. Telling you that you last time didn’t have good success so you are unlikely to have good success this time, putting doubt there, and so much more. We actually have a blog about it. We are going to put it in the show notes today on 10 Signs it Might Be Time to Switch Your Provider. 


    I also think there are some really good tips for preparation. You talked about that. You did the Spinning Babies. You ate dates until you literally probably couldn’t eat any more or you couldn’t stand the smell of them. You did all of these things. Preparing for birth. You got the doula. You found the location. You researched your area. You found your birthing location. You found your hospital and midwife. You found a VBAC doula. Even in the end of pregnancy, you can find a doula and if you didn’t know, we have a resource online at vbaclink.com where you can find a doula that is actually VBAC-certified. They have taken our course. They understand all of the things about VBAC. They can help you find a VBAC-supportive provider. They can help you find that confidence. They can help you and see those moments of, “This is a really great time. Go dance with your husband. Let’s release the oxytocin naturally,” or “This is prodromal labor. Maybe don’t go to the hospital right now. This is what you can do instead.” 


    Okay, you know? Those types of things. Mental– 


    Grace: Get you off the ledge. 


    Meagan: Yes, talk you off of the ledge. Mental preparation– preparing, we have the VBAC Link Course. We have the blogs. We have the stories. We have the communities. This is what this is for. Mental prep, finding the confidence, processing your op reports, and these things. Physical prep– doing those things. Eating the dates, drinking the tea, and making sure you have good nutrients like our favorite Needed. You’re making sure that you are taking care of yourself nutritionally so that you can also prep in other ways and so many more. 


    We’re going to make sure to have that. We’re going to have blogs and books and things to suggest at the bottom of the show notes. I think that this story although it did start off with a heartbreaking experience– I could see you. I could feel it. Your experience is hard. It’s three and a half years ago and it’s still with you. These experiences stay with us. I think that’s where we owe it to ourselves to give us the best experience and to put us in the best situation possible. 


    Sometimes, I think it’s, “Oh, well a doula could be more expensive. Oh, taking a course is a lot,” but in the grand scheme of things, if we look back at our experiences, my first two C-sections and even with my second, I had educated pretty okay. I’d say okay, not great. If I had looked back and taken the course to help me know that information, if I would have hired the doula to help me feel not so backed in a corner, absolutely. Yeah. I would have paid that no matter what. 


    Grace: Yeah. Money is of no value at that point. 


    Meagan: It’s of no value and it is. Money is a huge thing in this world, especially with the way our world is going. Money is a big deal, but in the end, you deserve it. You deserve to get those prenatal massages, to go to the chiropractor, and to get those prenatal vitamins that are going to truly help you. You deserve these things. Women of Strength, it’s okay to spoil yourself for your birth. 


    Grace: Right. 


    Meagan: Recognize these things and get the tools we can so that in the end, even if it ends in a repeat Cesarean, it can hopefully be a more healing experience. You’re going to know the things. You’re going to know your options. You’re going to know you did everything. I just think there is so much power in these two stories all along the way that you can take from this. 


    Grace: I also think too, one thing I never really even thought about is if you are a mother and you have had children and you have had wonderful births, you’ve had wonderful vaginal births, don’t support new mothers that are pregnant to do those things anyway because just as maybe it didn’t work for you, they might need it. My mother had five natural births. She didn’t have a doula. She had none of that and she made it seem like it was like that. She made it seem like, “Just go to the hospital. They will take care of you.” 


    That’s what I did. I read baby books and everything, but I did not think I was going to be one of those moms. 


    Meagan: None of us do, really. 


    Grace: None of us do, but just because it was okay for you and everything was okay for you if you know a mother and she is nervous or something, tell her, “You know what? Get a doula. It’s going to help you. It’s going to guide you. Did I need it? No, but if you are nervous, do it anyway. It’s only going to make things better. It’s going to lessen your stress.” 


    Like you said, take a course. Support women anyway with those resources so that it can prevent them from falling into those pitfalls which now I think maybe it’s a generational thing. I don’t think my mother had a lot of pressure when she was giving birth to children back then. I don’t really know, but that was my guess because she was my main resource. Yeah, if you’ve had good births, still support other new moms to have more support and resources at their luxury even if you didn’t need it at the time because they might. 


    Meagan: Exactly. Yes. 


    Grace: Yes. 


    Meagan: Oh, well thank you so much for being here with me today and letting me go off on this little passionate rant at the end. 


    Grace: Thank you. I feel like I talked so much. I’m like, “Oh my god.” I don’t know what it is that I wanted to share so much. It’s just so important. 


    Meagan: These stories matter to us and they matter to everyone listening. Women of Strength, thank you for listening today. I hope and I’m sure that you took some information out of these stories. Remember that we are always accepting stories also for social media so if you are ever wanting to share your stories on social media, email us at info@thevbaclink.com.


    Closing


    Would 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/donations

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    1h 13m | Jan 17, 2024
  • Episode 271 Dr. Nathan Fox Returns Sharing Evidence on Uterine Rupture, Induction, Cervical Exams & More

    “I think that’s why there is so much discussion about this because it is not the numbers. It is the attitudes. It’s the opinions. It’s just trying to make sure that you have an aligned vision with your provider and with your hospital.” 


    One of the most important things you can do during pregnancy is to find a provider who loves and believes in VBAC. Dr. Fox is back today giving more tips on how to know if an OB is VBAC-supportive and why there is so much variation out there in how practices feel about it.


    Dr. Fox answers questions like: 

    • Why do some providers refuse to induce VBACs? Why do some providers require it? 
    • Are routine cervical exams necessary for VBAC? 
    • Does a uterine window in my operative report mean my uterus will rupture during my VBAC?


    Additional Links

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Meagan: Hello, guys. This is The VBAC Link. Welcome back or if you are new to the show, welcome. We are so happy that you are here. My name is Meagan and I am so excited to have a returning guest with us today.


    We have Dr. Nathan Fox who is a board-certified obstetrician and gynecologist with a sub-specialty in maternal-fetal medicine. He is here answering your guys’ questions. This community is amazing and every time we reach out and say, “Hey, what are your VBAC questions?” We do. We get a ton. I love bringing on guests, especially within the medical world, OBs and midwives talking about these things with you and what they are seeing and what the evidence says. It’s always fun to get a different provider’s perspective and get a better idea on what really the research is showing. 


    Review of the Week


    So welcome back, Dr. Nathan Fox. But of course, we have a Review of the Week so I wanted to quickly get into that and then get into these amazing questions. By the way, they are questions about induction– when or is it really necessary? Can I be induced with a VBAC? We are going to talk a little bit more about uterine rupture and the risk which is, of course, a burning question that everyone always has. We are going to talk about maybe if a provider has told you that they have seen something like a uterine window, dehiscence, or even a niche. We are going to talk a little bit more about those so definitely stay with us because this is going to be a really great episode. 


    This review is by Elizabeth Herrera. Hopefully, I did not botch that. She actually sent us an email. If you didn’t know, we love getting reviews in emails as well. You can leave us a review on social media. On Instagram, you can message it on that. You can email us at info@thevbaclink.com or you can leave us a review on Spotify or Apple Podcasts. You can even Google “The VBAC Link” and leave us a review there. 


    All of your reviews help Women of Strength just like you find us and find these incredible stories and these incredible episodes like today’s episode with these providers to learn more about their options for birth after Cesarean. 


    Elizabeth says, “Thank you so much for creating this whole community. After my emergency C-section in 2019, I looked up everything possible about being able to VBAC. This led me to your wonderful podcast and blog. I devoured everything. I owe my knowledge to you all and my doulas. I’m happy to say that I had my VBAC on March 31st and it was the most magical experience ever. Thank you so much for all of the materials that you have provided which all helped me succeed. I hope to one day share my story on your podcast. Many, many thanks.”


    That was in 2022 so a couple of years ago she left that review. So hopefully, Elizabeth, you are still with us and listening to all of these amazing stories. We would love to share your story which also leads me to remind you that we are always looking for submissions. You can submit your story on our website at thevbaclink.com/share.


    Dr. Nathan Fox


    Meagan: Okay, you guys. We have Dr. Fox back on the show today with us. How cool is that that he has come on now twice with us to talk about VBAC and answer your guys’ questions? Dr. Fox, welcome to the show again, and thank you again for being here. 


    Dr. Fox: Back on VBAC. 


    Meagan: Back on VBAC. Back talking about VBAC. Tell me what you think about this VBAC topic and how VBAC looks for OBs. I think a lot of the time, OBs and midwives and providers in general can get some backlash honestly, even from us here at The VBAC Link where we are like, “Oh, that’s not a good, supportive provider.” I think there is a lot from the community that we really don’t take into account on where a provider is coming from maybe with what they’ve seen or what they’ve gone through. Maybe they want to support VBAC but their location doesn’t support it. Can we talk about VBAC from an OB’s standpoint? What does VBAC look like for an OB?


    Dr. Fox: Yeah, listen. It’s a great question. Thanks for having me again. I’m always happy to come on. I really like this topic medically, but also, it’s just very interesting because there is so much that comes up with VBAC in terms of the medicine surrounding it. It’s also a really good paradigm for how people look at risk. By people, I mean doctors. I mean nurses. I mean hospitals. I mean women who are pregnant, thinking of being pregnant, their families, and their friends because there isn’t a ton of disagreement about the numbers. What is the risk percentage-wise? We have that worked out pretty well. 


    I mean, there are some things that are maybe a little bit more nebulous. There are those situations, but most people agree on what the actual numbers are. The issue is what do you do about that when someone has a small risk of a big problem? Right? 


    Meagan: Right. 


    Dr. Fox: What do you do? That personality comes into that. I think that’s part of the reason that there is so much variation in VBAC practices, VBAC attitudes, and VBAC rules. It’s risk. I talk to people about this all of the time in other contexts like with genetic screening. I tell people, “All your genetic tests are normal. All of the screening tests were normal that we did. Everything is fine which means that your risk of having a baby with a genetic condition now is 1%.” I’ll tell them that. 


    Some people hear that and say, “That’s awesome,” and then they walk out. Other people go, “Oh my god. 1%. That’s unbelievably horrible,” then they sign up and do a CVS and amnio. Neither of them are wrong. 1% is 1%. It’s 1 in 100. People are going to look at that differently based on their understanding of math, based on their personal experiences, based on the stories they’ve heard, based on their own anxieties, based on who is in their family. All of these things contribute to someone’s opinion about a risk that is low. 


    Take VBAC for example. If everything is otherwise ideal– a healthy woman who had a prior C-section that was standard with nothing crazy about it. Pregnancy is going fine and she is deciding whether to attempt a VBAC or whether to do a repeat Cesarean, people are going to talk to her about the risk of uterine rupture. That risk is a ballpark of 1%. Whatever. It’s about 1%. 


    Okay. It’s the same thing. How does everyone look at 1%? I could look at it and say, “Well, 1% is pretty low. It’s only 1 in 100. I really want a vaginal birth because I want it or because it’s going to give me an easier recovery potentially or because I’m afraid of a C-section” or whatever. Or they can look at it and say, “Holy crap. 1%. I don’t want any part of that risk and I’m just going to do a repeat C-section.” I don’t think any of those opinions are unreasonable. I think they are both reasonable based on how you look at it. 


    So if you have a situation where everyone’s aligned– the doctor thinks it is reasonable, the patient, the woman thinks it’s reasonable, and the hospital thinks it’s reasonable, then it’s not a big discussion. Okay, we talk about it and the VBAC happens. Where I practice, that’s the culture in my practice and in my hospital amongst my patient population. We talk about it. Many people want to do a VBAC. They want it. We are supportive. The hospital is supportive. The nurses are supportive. Great. 


    Some patients don’t want to have it. Fine. We’re supportive of a C-section. The hospital is supportive. All is good. I think the issue comes up when there is a disconnect like the patient wants it. The doctor thinks it’s too risky for the patient and the doctor thinks it’s fine, but the hospital thinks it is too risky or whatever. There are all of these situations. 


    Meagan: Yes. 


    Dr. Fox: Since doctors are humans and patients are humans and even though the hospitals are buildings, they are run by humans, you are going to have a lot of humanity and humans and all of our fallabilities and flaws and quirks come into this. That’s a very long-winded answer to your question, but I think that’s why there is so much discussion about this because it is not the numbers. It is the attitudes. It’s the opinions which is why so much about VBAC is not trying to figure out your number. It’s just trying to make sure that you have an aligned vision with your provider and with your hospital. 


    Meagan: Right. I love that you pointed that out. It’s the perspective on this number. We know the number is say 1%, but to some people, that 1% may be 60% in their mind. It might as well be 60. Do you know what I mean? I love that you talked about being aligned. That is something that we talk about here a lot is really being aligned with your team. Find your team because your team is super important. The mom, the doctor, the hospital, the location, and the nurses, everything is aligned so that maybe we don’t have to fight so hard. 


    I feel like this community ends up feeling like they have to fight for their birthing right. 


    Dr. Fox: Yeah. 


    Meagan: Like the way they want to birth, they feel like they literally have to come in with punching gloves and punch their way through to get this vaginal birth. That’s where it is just so hard. We are so vulnerable as pregnant women. 


    Dr. Fox: Yep. That’s an unfortunate reality. It’s obviously a reality, but I would not counter it because I don’t disagree with it. I would advise that instead of coming in with gloves up ready to fight, you need a different provider. I’m not saying this to disparage a provider who is less pro-VBAC. They are humans. Whatever it is. Maybe the doctor had a really bad outcome once with a VBAC and they are scarred from it. 


    Meagan: Exactly. Exactly. 


    Dr. Fox: Maybe where they were trained, the attitude is very anti-VBAC so they are just not used to it. Maybe they would be okay with it, but they practice in an environment where the hospital is not so happy with it or the nurses aren’t. Whatever it might be, if your provider is telling you, “I am not a big fan of VBAC,” they are telling you this. Listen to them. Okay, that doesn’t mean they are a bad person. It doesn’t mean they are a bad doctor. It just means that’s who they are. 


    So if you have an opportunity, seek someone who is more aligned with you. And again, obviously, that is easier said than done. It requires some work. It requires some legwork. It requires asking around, going on message boards, and finding people. If you have a prior C-section and you’re interested in a VBAC, if the doctor says that he or she is uncomfortable, I would first ask why. If they give you, “Listen, normally I am in favor of VBAC, but since you had a classical C-section, it’s too dangerous.” All right, that’s a very reasonable explanation that pretty much everyone is going to tell you, and switching around is probably not going to help you. 


    But if they say, “I just don’t do VBACs or my hospital just doesn’t do them,” they are telling you that for a reason. Say, “Thank you. Have a good day,” then try to ask around and find someone or some hospital or someplace that is in favor of them as opposed to trying to convince someone to do something they are not comfortable with. 


    Meagan: Absolutely. 


    Dr. Fox: That ends up being a combative relationship and ends poorly for everyone. It would be great if all doctors were totally supportive. It would be great if all hospitals were totally supportive. There are sometimes logistical issues meaning since VBAC has the potential for an emergency, hospitals need to have 24/7 anesthesia. They need to have a blood bank. They need to have certain things in place in order to safely offer a VBAC. Some hospitals are just too small to do that. It’s not an attitude. It’s, “Logistically, we just can’t do this.” Fine. Again, try to go to a major medical center that does a lot of VBACs. Most major medical centers are comfortable with VBAC. Most doctors who practice in those centers are comfortable with VBAC. 


    So I think if you do the legwork, you can probably, not always, but probably find someone who is a better match for your VBAC as opposed to trying to convince someone to do something they are not comfortable doing. 


    Meagan: Yes. I love that, so we don’t have to try to convince. That’s why listeners, when you are with your provider– OB, midwife, or whoever it may be– talk to them. Have that discussion. Ask that question. Don’t be scared to ask them why. 


    For me, with my second, I had this feeling that maybe he wasn’t as on board for VBAC as I wanted him to be. I was scared to leave or scared to hurt his feelings. But I think that it probably would have been better for both of us in the end to have found a different provider that was more on board and comfortable versus me trying to go in and push and try and make him do something that again, he wasn’t comfortable with. He wasn’t comfortable with that and that’s okay. 


    For a long time, I had a lot of anger, and a lot of our community has harbored anger, but I’d like to drop a message to our community. Try not to harbor the anger. My provider is a great guy and a great doc and all of these things. He just wasn’t the doc for me, so find the doc for you. 


    Dr. Fox: Right. Listen, obviously, there are a lot of doctors in the world and I’m sure that there are bad doctors or mean doctors or people who aren’t good people out there. I’m sure they exist. But I would say in my experience that most doctors are good people who are trying to do right by their patients. It’s too much work to go into medicine and train to go into it to dislike patients. It just doesn’t make any sense. My experience is that most people are trying to do right by their patients. 


    But we are all human. We all look at risks differently. We all have different experiences. That happens. Humans are varied. It’s part of the reason it’s wonderful to be a human. We are all different. That’s all great. But it’s not complicated to get this answer from your doctor. I think it just requires some preparation meaning ask these questions very early either before you get pregnant or early in pregnancy. Again, they are not complicated questions. 


    I would say the first question you should ask is something related to the numbers. Say, “What is my risk if I try a VBAC? Me, personally?” If they say, “Well, your risk of it is a uterine rupture,” say, “What is the number risk?” The risk is uterine rupture and if they say, “Well, it’s probably about 1%,” okay. That is the number. If they say it is much higher than 1%, well why? Is it because I have had a classical C-section or I have had three prior C-sections, okay, but get the number. 


    Then the second question is very open-ended. Nonjudgmental. Say, “What are your thoughts or opinions about VBAC?” That’s it. Open-ended. They will tell you. Right? No one’s going to hide it from you. They will tell you overtly and say, “I love it. It’s awesome. I’m all over it. This is great. I hope you try it.” Or they’ll say, “Not a big fan. I don’t really like it. It’s not my thing. We don’t do it. I haven’t done it in 20 years,” okay. Or potentially, they will be somewhere in the middle and say, “I kind of like it,” but you’ll know. You’ll know right away what their thoughts are. 


    Then the second question is, assuming they are supportive, about the hospital where you deliver. What’s the attitude there about VBAC? If they say, “You know, I am really in favor of it, but the hospital is awful. They torture me every time there is a VBAC. They make me be there the entire time. They always make me do C-sections. It’s just a terrible environment–”


    Meagan: Maybe not right. 


    Dr. Fox: Right. Either of those two reasons is probably a reason to look elsewhere but if they tell you, “I’m on board. The hospital is on board,” it doesn’t mean you will have a VBAC, but you have a plan in place and you are ready to go. If they tell you, “I don’t like that. I don’t do that,” then turn around and say, “Okay, I really appreciate that. Thank you for your perspective. Thank you for your honesty. I am really interested in VBAC. I might be seeking a different doctor or a different hospital. Please don’t take that personally.” They will probably say, “Thank you.” 


    Meagan: Yeah, exactly. 


    Dr. Fox: Doctors don’t want a situation where they have a combative relationship. That is horrible. We hate that. It’s awful. That is what keeps us up at night. Do it at the very beginning and no one is going to have hard feelings over that. I would say it’s unusual that people are going to try to convince you to stay for the money. Doctors don’t want that. They would rather have you go to someone else than go to them and want something that they don’t want you to have. That’s just how doctors are. 


    Meagan: I love that you just made that point because it is hard to leave. You get worried about hurt feelings and all of that, so thank you so much for saying that. 


    Dr. Fox: Yeah. 


    Induction


    Meagan: Okay, so let’s shift gears a little bit and talk about induction because this is a really hot topic when it comes to someone wanting to TOLAC or have a VBAC. I guess the question is when is it really necessary? What is the evidence on induction and VBAC? Because just like support, it varies all around where some people are absolutely no induction. You have to go into spontaneous labor. Some are like, “Yeah, cool. No problem. You can be induced.” Some are like, “You have to be induced.” Then when it comes to induction, that also ranges. Maybe we can’t do a Foley or a Cook or we can’t use Pit and we can only break your water and all of these things. Can we talk about the evidence specific to VBAC? Induction can be necessary. There are a ton of reasons for induction, but when is it really necessary? 


    Dr. Fox: Right. Instead of talking about when it is really necessary, I think the question is why is it even a question? The reason is that the best evidence we have– it’s not perfect evidence, but the best evidence we have is that for someone who is undergoing VBAC who has induced labor, her risk of uterine rupture is about 1.5 to 2x as high as if she went into labor on her own. 


    For example, if your risk was about 1% for a uterine rupture and you get induced, your risk is now about 2%. 1.5-2%. If your risk was a little bit lower because maybe you have had a vaginally delivery before so if you have had a vaginal delivery before, your risk isn’t 1%. It’s closer to .5%, it will raise it to maybe 1%. Again, I say it’s the best data available because the studies that were done, there is a little bit of a flaw in them because they are not randomized, but it seems to be correct that inducing increases your risk likely. 


    The one exception is if you induce with misoprostol, the risk seems to be much higher so pretty much no one induced with misoprostol if there is a prior C-section. That’s usually something that nobody does, but the other ways of inducing whether that’s breaking the water, whether it’s Pitocin, whether it’s a Foley balloon, and all of these things seem to increase the risk slightly. 


    Again, it’s the same thing as before. If now I have a risk in someone whose risk isn’t 1% but 2%, how do I view that? How does the hospital view it? How does the patient view it? Obviously, 1% and 2% are not hugely different from each other, but you could also look at it and say, “It’s double.” You can think of it in two different ways. Based on that, there are definitely doctors or hospitals who would say, “I’m comfortable with VBAC, but I’m not comfortable with inducing labor in someone who is a VBAC.” 


    In our practice, that is not our position. We will induce someone’s labor. We tell them, “Your risk is a little bit higher. It’s 2% versus 1%,” or something like that, but again, if there is a reason not to, we would induce someone’s labor but different people look at it differently. So again, another question to ask to your doctor is, “Not only how are you with VBAC, but how are you with inductions and VBAC?”


    If they say, “Well, I’m okay with VBACs if you go into labor on your own, but I’m not okay with VBAC if you have to be induced,” does that mean you have to switch doctors? Well, it just means you have a potential limitation.

     

    Meagan: A potential roadblock in the end. 


    Dr. Fox: Right, a potential one. Again, it depends on the circumstances. Obviously, each case might be unique. So that’s number one. 


    Number two, there is some data that when you induce labor in a VBAC, your success rate is lower. That data is weaker and it’s a little bit complicated because the data in non-VBACs is that if you induce labor, the success rate is not lower meaning it does not increase your risk of C-section. Whether it’s different for someone who had a VBAC has not been studied appropriately to know for sure. It either has no effect like in everyone else, or we can use the older data that is flawed and say it does increase the risk of needing a C-section, but that’s really more related to the chance of success not so much related to the risk.


    Now, some people will use in order to make a decision about VBAC, they are weighing the risk versus the chance of success so it may impact the balance of the scales, but that’s really the concern with induction. 


    Now, the only reason that I can think of that someone would insist that someone who is having a VBAC be induced always is only because they are concerned about them laboring at home and they want to have their entire labor watched in a hospital. That’s not the strategy we use, but again, it depends geographically on how far people live from the hospital. 


    Meagan: We talked about that on our last episode. 


    Dr. Fox: Yeah, do they typically wait forever to come to the hospital? Again, is it worth a slight increase in risk of 1% to induce as opposed to having them go into labor and wait four hours before they get to the hospital? That’s a strategic decision that is going to be very individualized obviously, but that would be as far as I can think of off of the top of my head the only reason one would say, “You need to be induced because it’s a VBAC specifically.” There are reasons to be induced all over the place obviously obstetrically, but as someone we are talking about here, if someone needs to be induced then they need to be induced and there is a decision about that. 


    When I counsel people about VBAC, essentially they fall into three groups. Again, assuming it’s a safe option for them. Option one is, “I want a VBAC.” Option two is, “I don’t want a VBAC. I want a C-section,” and option three is, “I want a VBAC, but only if I go into labor on my own. I don’t want to be induced.” That’s based on again, the risk, the chance of success, the experience, all of those things, and those are sort of the three places that people land. That’s fine and obviously, you can switch from one group to another over the course of pregnancy based on how things are evolving, but that’s really the decision that someone is going to make. “I’m trying for a VBAC.” “I want nothing to do with VBAC,” or “I’m into it, but only if I go into labor on my own.” That’s something you want to make sure to see what your doctor thinks about that as well. 


    Meagan: Yeah, okay. I love that so much because yeah. Like we said, there are so many reasons why like preeclampsia and all of these things, but yeah. Just wondering why you would have to be induced in order to VBAC. 


    Cervical Exams


    Okay, so let’s talk about cervical exams. This is also a hot topic in our community about routine cervical exams or having a cervical exam prior to even labor beginning to determine the likelihood or the success of a VBAC. Can we talk about the evidence of cervical exams during labor in general, right? In physiological birth, everyone is like, “We just don’t want to be touched. We just want birth to happen,” but when we come to hospitals, sometimes it’s a little bit more routine where they want to know the data of what’s happening with the cervix and everything like that. What is the evidence on actually determining someone’s success rate before labor even begins based off of where they are dilated? 


    Dr. Fox: Those are two totally separate reasons why we would check the cervix. In terms of someone in labor, there is a tremendous amount of variation in the frequency of cervical exams in labor based on the provider, based on the culture, based on the patient, and so there isn’t one way to do it, but the reason one would have their cervix checked in labor is just to assess how the labor is progressing. Everybody does it. Doctors do it. Midwives do it. Home birth attendants  do it. The question is not do you check the cervix? It’s how frequently do I check the cervix and what do I do about it? That’s going to vary greatly across everything. 


    The evidence is actually that it’s not harmful. Again, I’m not saying it’s not painful or annoying or uncomfortable certainly if you don’t have an epidural. I’m not talking about that. I’m just talking about the risk involved. There are people who say that more cervical exams increase the risk of an infection. The data on that is actually pretty weak amazingly. When we do the exams, we wear gloves. These are sterile conditions, number one. 


    Number two, some of the data that indicates more cervical exams are associated with more infection is really just that more cervical exams are a marker for a longer labor. The longer you are in labor, the more cervical exams you are going to have and a longer labor is definitely a risk factor for infection. So it’s not exactly clear in that sense and also, if anything, if it’s ever going to be a risk, it’s only once your waters are already broken. 


    If your waters are not broken, there is no reason to think that it should increase your risk of an infection or there is at least no good data to support that. I would say in labor, there is a lot of variation in that. Again, it’s hard to say. There isn’t one way of doing it, but the reason to do it is just to assess how labor is progressing to make decisions like do I need to get Pitocin or not? Do I need to do a C-section or not? Is this someone who I want to break their water or not? Is this someone who we can tell, ‘You know what? Just rest and I’m going to go home and come back in the morning’ or not? All of those things, when is she going to deliver? Fine. 


    Before labor, examining someone’s cervix in the office or before we do anything in labor, the data on that is originally meant to give a prediction of when someone’s going to go into labor on their own meaning if you examine someone, the term we use which is kind of crude is “ripe”. If the cervix is ripe versus unripe– for some reason, doctors love to compare things to foods, specifically fruits. I don’t know, whatever. Maybe we grew up in a tree-based society. I’m not sure, but whatever. 


    It’s crude, but that’s the term that is out there. The thought is if the cervix is ripe and the components of that are a little bit open, it’s short,  it’s soft, it’s what we call anterior meaning in front of the head versus all the way behind the head and the head is low, the likelihood that person is going to go into labor on her own in the next week or so is higher than if her cervix is unripe. That’s why it was invented. 


    I personally have found that to be mostly useless because okay. If someone’s chance is, let’s say 40% versus 20%, what does that mean? Nothing. You can have a very unripe cervix and go into labor that night and you could be 3 centimeters dilated and not go into labor for 2 weeks. What’s the difference if your chance is 40 versus 20%? What are you going to do about that? Nothing. 


    In our office, in our practice, we don’t routinely check the cervix before 38 weeks and then after 38 weeks, we offer it as an option. A lot of people want to know what’s going on with their cervix. There is a lot of curiosity out there. If someone doesn’t want to know, that’s fine. We’re not going to do it. But one of the reasons it might be helpful practically might– I’m not saying definitely– let’s say someone called me at night. It’s 3:00 in the morning and they are like, “I’m having some cramping. I’m having some contractions. They’re not so bad. They’re this. They’re that. I live 2 hours away,” and I saw her that day in the office and her cervix was long and closed, I may feel differently than if I saw her and her cervix was already 4 centimeters dilated. So, okay. There is some practical information that is to be gleaned, but it’s not always that useful. 


    When you’re inducing someone’s labor, it does give you a sense of the likelihood of success and what agent you’re going to use or not use, so that’s the reason you’ll do it either on admission to labor and delivery for induction or maybe in the office just before to sort of plan the induction because what we do is based on the cervix. 


    For VBAC specifically, it’s not like it needs to be done, but obviously, my thoughts about someone who is trying to VBAC are going to be different if, at 38 weeks, she’s 3 centimeters dilated, the cervix is soft, and her head is low versus her cervix is long and closed and firm and the head is way up near her nose. I’m just going to think about it a little differently and then I’ going to counsel her a little bit differently and then it may be practical. It may, but it’s not usually tremendously helpful clinically is what I would say. 


    Meagan: Okay. So for our listeners, kind of what you were saying is that you can get the information, but it doesn’t mean that you’re not going to be able to have a VBAC or you’re no longer a good candidate if at 38, we’ll say 38 weeks, you have a long, hard, posterior cervix. It doesn’t mean– you might just have different counsel or have a different discussion. 


    Dr. Fox: Right. Yeah. Again, it might be that. It might slightly change your odds one way or another, but it’s not usually something that we use as a decision-making tool about whether you should or shouldn’t VBAC. Again, let’s say– I’ll give you an example where it might be useful. Let’s say we have a situation where someone has a prior C-section. They’re thinking about VBAC or they’re interested in it, but they have some concerns, right? Like most people, they’re interested but they have some concerns. They’re 38 weeks and let’s say the baby is measuring a little bit small and her blood pressure is a little bit high. I say, “We need to deliver you. We need to induce. We need to deliver you.” 


    At that point, there isn’t an option of being in spontaneous labor. It’s either I induce her and if I don’t induce her, we have to do a C-section. Those are the two options on the table because waiting is not a safe option anymore. Fine. It’s possible that my counseling will be different if when I do her cervical exam, it’s long and firm and the head is high versus the head is low and the cervix is dilated and soft because I’ll tell her, “Listen, inducing your labor in one situation is likely going to take a long time. Your success rate is a little bit lower” versus “It’s going to be a shorter time, again, likely not definitively and your success rate is going to be higher.” 


    It’s possible that she might say, “All right. I don’t want an induction if my cervix looks like this” or “I do want an induction if my cervix looks like this.” It’s part of decision-making potentially, but that’s usually if I’m about to induce her labor versus do a C-section. If she’s going home either way, if it’s just the Tuesday and it’s 38 weeks and there’s nothing wrong and I’m just sending her home and she will either come back in labor or come back in a week, then it’s not going to matter much if her cervix is open or closed on that day. It’s really if I have to make a decision about delivery that I’ll be more practical. 


    Meagan: That’s something that I love about you is just that–


    Dr. Fox: Oh, all right. 


    Meagan: I do. It’s like, “Let’s talk about this.” You offer counsel. I don’t know. You just offer more. It’s not just like, “You have.” It’s the way you talk anyway. I mean, I’ve never been a patient in your clinic so I’m talking very broadly of what I feel like I love about you, but it doesn’t seem like you’re black or white. It’s, “Hey, this is what we have. This is what we’re showing. This is where baby is or where you are and it’s no longer safe to be pregnant for you or for baby. Here are the options and based on that person as an individual, it might be different versus the lady that you had four or five years ago is now the standard for every person that walks into your clinic. 


    Dr. Fox: Right. Right. I mean, listen. Medicine– there’s a lot of balance here. On the one hand, there is this push to be very standardized and that everybody should be the same. There are advantages to standardization. Less mistakes, it’s more clear, everybody has rules versus individualization which has its advantages as well because you can personalize medicine. You can tailor things to the individual. 


    They are not a conflict, but there are two sides to the coin. On the one hand, you want things to be standardized and on the other hand, you want things to be individualized. One of the arts of medicine is knowing which way to lean and that’s where people differ. Experience gets involved. There is also, I would say, this idea in medicine where there are certain times where the doctor is supposed to say to the patient, “This is what you should do,” to be very directive, right? 


    There are other times where the doctor is supposed to say, “Here is option A. Here is option B. Here is option C. Here are the pros and cons of all of those. What do you want to do?” Right? The problem is you don’t want a doctor who is always telling you what to do because that’s authoritative and it’s very–


    Meagan: It doesn’t feel good. 


    Dr. Fox: Right and it’s also usually not appropriate, but you also don’t want a doctor who can’t make up his or her goddamn mind. You see the problems. When we’re training young doctors, we always talk about patient autonomy, patient autonomy, which is correct. Patients should have autonomy to make decisions for themselves, but you also have a duty as a doctor and as a professional that if you believe one option is better than the other, tell them and tell them why. If my plumber said to me, “Well, I could use the copper pipe or I could use the steel pipe. Which one do you want?” I’d be like, “I don’t know which one I want. Which one is better?” 


    Meagan: Which one is best? 


    Dr. Fox: Right. If he said to me, “Listen, you should absolutely have the copper pipe because they are better,” I would say, “Fine, do that.” But if he said to me, “Well, there are pluses and minuses. The copper is a little bit better but costs a lot more,” then I have to make a decision and that’s appropriate. 


    The same is true in medicine. If I have a patient with pneumonia and I said to her, “Well, you could have antibiotics. You could not have antibiotics,” then I’m an idiot. I should be saying to her, “You have pneumonia. You need antibiotics,” because this is why I trained, why I went to medical school, to tell you, “You need antibiotics. This is the one you should have.” Fine. That’s appropriate. 


    But in a VBAC, I don’t think it’s necessarily appropriate to say that. I say, “Okay. You have a 1% risk of uterine rupture. On the one hand, you could try a VBAC. Here are the advantages. Here are the disadvantages. Here are the risks. On the other hand, you could have a C-section. Here are the advantages. Here are the disadvantages. Here are the risks. I think they are both reasonable. Do you have a preference and which risk scares you more?” That is appropriate. 


    I would say for people who are trying out figure out, do you have a good doctor? Do you have a good midwife? It’s not just, “Are they kind?” You want them to be kind. It’s not just, “Are they smart?” You want them to be smart. It’s not just, “Does their office run on time?” You want their office to run on time. It’s also, do you get a sense that they have a good balance between when it’s appropriate to tell you what they think is correct and when they give you options and have you participate in your healthcare decision-making? If they are always telling you what to do, it’s probably too much on one end. If they never tell you what to do, it’s probably too much on the other end. You need to strike a good balance. 


    Getting back to what you said about the reason you love me, I definitely have situations where I tell people, “VBAC is not a good option for you. You shouldn’t do it. It’s a bad idea. I’m telling you it’s a bad idea.” Again, we’re not the police. I can’t force someone to do something. I’m not going to tie someone down and do a C-section, but I will tell them, “This is a bad idea.” I would say that’s the exception. Most of the time, it’s, “All right. Here are the options. Here’s what we are doing.” 


    It’s not that we always tell people, “Here are your options,” and it’s sort of touchy-feely, we do that when it’s appropriate. It’s frequently appropriate, but sometimes, we have to tell people, “It’s a bad idea. This is why it’s a bad idea. You should not choose this option because of A, B, and C.” I’m very comfortable telling someone that, but I usually just don’t have to. 


    Uterine Window, Dehiscence, and Niche


    Meagan: Yeah. I love that. Awesome. Well, we’re going to go into the very last topic. I know we are kind of running out of time, but this is one where we’re going to get stuff like that or we’re going to be like, “You shouldn’t do this” or the other opposite where it’s like, “We could do this. We could see how this goes.” It’s uterine rupture. We talked about uterine rupture, but more specifically to uterine window, lots of people are “diagnosed” or told that they had a uterine window maybe in their first Cesarean or multiple Cesareans later and that they shouldn’t VBAC or that they can’t VBAC or my specific provider told me that I would for sure rupture. He said those words– for sure, guaranteed.


    Then we have dehiscence which is chalked up into a full uterine rupture, but we know it’s not. Anyway, there is some stickiness in there. So can we talk about that? If someone was told or if it was put in an op report that they had a uterine window or a slight dehiscence, as an OB in your practice, what would you suggest or how would you counsel moving forward? 


    Dr. Fox: Right. Right. I will give you the short answer and the long answer. The short answer is if I have someone who I think has a uterine window, I would tell them not to VBAC because I think the risk of rupture is too high. I would never tell someone, “You are for sure going to rupture,” because that is not true with anybody. 


    Meagan: You can’t predict that. 


    Dr. Fox: Even in the worst-case scenario. Someone who has had a prior classical C-section, they have a 10% risk for rupture. Someone who has a prior uterine rupture is not even 100%. I don’t think it’s 100%, but it’s usually too high for comfort. The problem is not so much me making the recommendation, “Don’t VBAC if you have a uterine window,” it’s how do you make that diagnosis? I think that’s part of the trickiness. 


    Some of the confusion is that there is different terminology and some of the reason is we don’t have definitive definitions. So for example, uterine rupture is very clear. That’s when you are in labor and the entire uterus opens up internally and the baby and the placenta come out. It’s exactly what you would think a rupture is. That is pretty clear. 


    The terms dehiscence and window are used interchangeably and what they basically mean is the muscle of the uterus is separated, but the very thinnest outside layer of the uterus, what we call the serosa, which is like a saran-wrap layer on top of the uterus did not open, so the baby did not protrude through this defect in the uterus. 


    Meagan: It didn’t go through all of the layers. 


    Dr. Fox: But it basically went through all of the muscular layers which is basically like one step short of a rupture. Now, we don’t know how many of those people would go on to rupture if you continued laboring then in that labor or in the next pregnancy. No one knows because no one’s really tried it. No one has really pushed that envelope because they are too afraid to. It’s hard. It’s very unusual to be diagnosed with a window on your first C-section because usually, it’s not going to happen unless you’ve already had an incision in a C-section. Usually, it’s someone who has had a C-section, then on their second C-section, when someone goes in to make the incision whether they tried to VBAC or didn’t try to VBAC, they see this and then they are talking about the next pregnancy. 


    Most people are not going to recommend VBAC because the risk of rupture is too high in that circumstance. I fall into that camp as well. I am humble enough to say it doesn’t mean someone will rupture, but I think that risk is too high and I’m not really willing to test it out on someone because I think it’s probably not safe. Now, sometimes, someone may have been told they had a window and they really don’t. It’s hard to know. 


    There’s another situation that is different which is when someone is not pregnant and they have an ultrasound of their uterus and they see some form of a defect in their prior C-section. So someone had one C-section, had the baby, they’re not pregnant. They come to my office and they do an ultrasound. I looked at the area of the scar and it looked like it wasn’t healed perfectly, so instead– 


    Meagan: Properly.


    Dr. Fox: Well, it’s not proper or improper, it just frequently doesn’t heal to full thickness. Let’s say the uterus is a centimeter thick and I see that only half of the centimeter is closed and the other half of the centimeter is open, right? We call that sometimes a uterine niche. We sometimes call that a uterine defect. Some people call that a window, though it’s not technically a window. The question is A) What does that mean? and B) What do you do about it? 


    The answer is nobody knows. That’s the problem. 


    Meagan: Yeah. That’s the hard thing. 


    Dr. Fox: Nobody knows exactly what you would do to allow VBAC, not allow VBAC, this or that, generally, what a lot of people will do is if they have only had one C-section, they’ll usually let them VBAC, but there is some data that if it’s less than 3 millimeters remaining of closed, the risk of rupture is somewhat higher. Again, that data itself is pretty weak. No one knows for sure. Should you use that? Should you not use that criteria? It’s very, very difficult and you’re going to see a lot of variation out there. 


    In our practice, we don’t use that test so much to decide whether someone should VBAC or not after their first C-section because the data doesn’t support that. What we use it for is someone who has had multiple C-sections and they are already not planning to VBAC, but we are trying to figure out if is it safe to get pregnant at all. Do we need to fix this during pregnancy or if they get pregnant, do we need to deliver them at a different time? That’s a much more complicated discussion, but that’s how we use it practically. 


    If someone has had one C-section, I don’t generally recommend doing that test to check the thickness and then making decisions based on that because it’s not clear that your decision-making is going to be any better with that information than without that information. So I don’t use it personally, but definitely, people will find it out there. They measure the thickness and they say it’s too thin. That data is all over the place, unfortunately. Maybe one day, we will work it out, but it hasn’t been worked out yet. 


    Meagan: Yeah. So you can technically fix a niche? 


    Dr. Fox: You can technically fix it, but that doesn’t necessarily mean they are safe to deliver vaginally the next time. 


    Meagan: Because that’s a uterine procedure. 


    Dr. Fox: Yeah. These are all new questions that are being sorted out. It may take a very long time to sort it out, but I would say for the more typical person who has had one C-section that was basically fine, it went well, and she is trying to decide to VBAC or not, the current data does not support measuring the thickness of the scar routinely either prior to pregnancy or in pregnancy and then making decisions about VBAC or not. There are people who do it and I’m not saying it’s wrong, but the data to support that is pretty weak so it’s not something that is universally recommended to do. It’s a different situation if someone had a C-section and then someone saw with their own eyes there is something wrong with this uterus or if someone has had multiple C-sections and then they see it, those are different clinical situations where it might come in handy. 


    Meagan: Okay. Great answers. Awesome. Thank you seriously so much. It’s just such a pleasure to have you. I do. I just enjoy talking with you. I think it’s awesome and I think this community is just going to keep loving these episodes. 


    Dr. Fox: It’s my pleasure. It’s your wonderful Salt Lake City disposition. 


    Meagan: Yes. Next time you are in Salt Lake, come say hi. 


    Dr. Fox: Love it. We’ll do it. I love Salt Lake City. Good stuff. 


    Meagan: Yes. I love it here except for the cold. 


    Dr. Fox: Except for the cold. I hear ya. I grew up in Chicago which is where my pleasant disposition comes from, but yes. It’s also cold in the winter. 


    Meagan: That’s a whole different cold. 


    Dr. Fox: We don’t get the skiing. We get the cold, but not the skiing so at least you get the mountains so you did it right. 


    Meagan: Yes, we did. Awesome. Well, thank you so, so much. 


    Dr. Fox: My pleasure. Thanks for having me. Always a pleasure. 


    Closing


    Would 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/donations

    Advertising Inquiries: https://redcircle.com/brands
    51m | Jan 10, 2024
  • Episode 270 Crystal Nightingale Returns + Postpartum & Lactation Tips

    Crystal Nightingale from The Mama Coach joined us a few months ago and is back again today diving deeper into postpartum and breastfeeding than we’ve ever gone before!


    Did you know that new research is showing that cold compresses are more effective in helping clogged ducts than warm compresses or showers?


    Crystal shares her valuable insight gained as a registered nurse and IBCLC of over 10 years. Meagan and Crystal discuss everything from appropriate newborn weight loss to all types of infant feeding to how to have a successful breastfeeding journey starting even before birth. 


    As we kick off 2024, we promise to bring new topics, deeper discussions, and exciting changes that will empower you even more to continue to have better birth AND postpartum experiences.  


    Additional Links

    Crystal’s Website

    The Mama Coach

    The Lactation Network

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Meagan: Hello, hello you guys. It’s 2024. I cannot believe that 2023 went so stinking fast and we’re already here. I think the new year is super fun because I think about all of the exciting things that we want to do for the year and we have this extra motivation. 


    Today, we’re actually going to be talking about something that we don’t talk about a lot on the podcast. This is going to be postpartum. I’m excited to talk about postpartum because, with The VBAC Link, we are all Women of Strength. You are all preparing for birth. You’re all preparing for pregnancy sometimes. We’re so focused on the birth, but we forget about what comes after the birth. 


    So we have our friend, our dear, dear friend, Crystal. Hello, Crystal. 


    Crystal: Hello, good morning. Happy New Year. 


    Meagan: Good morning. I am so excited to have you on today. 


    Crystal: I’m excited. Thank you. 


    Meagan: Yes. You are a registered nurse, an international board-certified lactation consultant which is an IBCLC and for everyone who has never seen an IBCLC, you guys, I have three babies and I breastfed with all three of them. I’ve seen an IBCLC with each baby because I’ve found that each baby is so different. 


    Crystal: Yes. 


    Meagan: If you haven’t seen an IBCLC before, I would highly suggest it. They can help so much. But Crystal is from The Mama Coach and she is going to be talking with us today about postpartum and mood stuff and breastfeeding and so many powerful things. So hold on tight. We’re going to do a review and dive right in. 


    Review of the Week


    This review is from– I don’t even know how to say it– miralamb04 on Apple Podcasts and it says, “A Must Resource During Pregnancy.” It says, “The VBAC Link was most helpful and encouraging during my TOLAC (trial of labor after Cesarean) preparation. I used all of the episodes to everyone’s different expectations and outcomes to help me prepare for my VBAC. Finding out I was pregnant six months postpartum after a planned C-section due to a breech baby was frightening at first.”


    We have talked a lot about this close duration. It says, “I knew immediately I wanted to VBAC and started doing my research. The VBAC Link was constant during my stroller walks with my baby and helped me mentally prepare for my second pregnancy. I used the resources provided to help open up conversation during my prenatal appointments and ultimately advocate for myself and my baby for a planned, hospital TOLAC. I successfully had my second baby via VBAC a few days ago and I’m so happy that I did. Everything I could have wanted and so much more. Thank you, Julie and Meagan.” 


    I love that so much. You guys, this is what this platform is for. It’s for you to have the education, the information, and the empowerment to go on and make the best decision for you no matter how that is and what your birth outcome looks like. I love how she said, “To advocate for me and my baby.” Right? 


    Crystal: Yes. Love it. 


    Meagan: I love it. That is so cool.


    Crystal: Very, very. 


    Meagan: Thank you so much for that review. They touch me from the bottom of my heart and if you haven’t, please drop us a comment. Drop us a review. Let us know what you think about The VBAC Link. 


    Crystal Nightingale 


    Meagan: Okay, cute Crystal. Welcome, welcome. 


    Crystal: Hi. Thank you for having me. 


    Meagan: Absolutely. I’m so honored that you are here and taking the time out of your very busy day to talk more about that topic that we just don’t talk about. It’s not even that we don’t talk about it. I think it’s just that we don’t think about it. 


    Crystal: Yeah, yeah. 


    Meagan: It’s so far over there because we have such an event to get through. Birth is an event. 


    Crystal: Yeah, it’s huge. 


    Meagan: It’s such an event to get through that we can’t think about what we’re doing here or over here because we are right here in this moment preparing for this event. 


    Crystal: Yeah. Yeah. 


    Meagan: I mean, I have ridden tons of bike rides, races, long distances, and ran half marathons. I’m telling you that at mile 10, the only thing I was thinking about was where that finish line was, not where the next starting line was or that next experience. So I’m excited that you are here with us to talk more about this next journey because it is a whole other journey that leads us down a path through life in general and it can impact us for our next birth. Right? 


    Crystal: Yes. Right. 


    Meagan: It’s a circle. It all goes together. Let’s talk about it a little more. Let’s talk about your professional background. What got you into this? What got you into your passion for postpartum and serving moms and babies through postpartum and through breastfeeding? 


    Crystal: Yeah, so I always knew that I wanted to work as a nurse or in the nursing field. I was just fascinated with labor and delivery and women’s health. Of course, being a woman and all of the amazing things that we can do. I had my oldest children younger so I was very naive. 


    After I became a nurse, I really got into postpartum and mother and baby and just seeing new babies come into the world and helping the parents, the whole family, with breastfeeding and helping them take care of their newborn baby and just all of that fascinates me. It’s just incredible to me. 


    I’ve been working with mothers and children as a nurse for a little over 10 years now and you know, just through my time in the hospital and the clinic, I have seen a trend. A lot of parents have the best intentions. They want to breastfeed and they want to do this, but then there is not a lot of support. The WHO, World Health Organization, and CDC all recommend breastfeeding for at least six months, but what? Then parents go back to work at six to eight weeks maybe? Some even sooner. I’ve seen some moms who have to go back to work within two or three weeks. So just seeing that lack of support postpartum for families just triggered, “Okay.” 


    It’s very frustrating to be in a hospital or a large health organization setting and not be able to do as much as I want to because of all of the policies and regulations and things like that. So I teamed up with The Mama Coach to start my own private practice and being part of The Mama Coach has been awesome. 


    We are a group of registered nurses and some nurse practitioners all around the world helping parents to make parenting easier through education, evidence-informed solutions, support, assessment, individualized plans, and all of the stuff to help support parents from the prenatal period to postpartum to feeding and starting solids, all the way up to five years of age with sleep and CPR and things like that. 


    So yeah. That’s a little bit of my background. I have four kids and I did not get to breastfeed my older two because again, I was young and naive. I didn’t know anything. I “tried” to breastfeed not knowing that cluster feeding was normal. I just thought, “Oh no. I need to give formula because they sent me home with formula.” Then all of a sudden, my milk dried up and I was like, “Oh well. I guess I’ll just formula feed.” That wasn’t what I wanted to do. I just didn’t know how to continue the breastfeeding journey. 


    Meagan: Yeah. This isn’t like anything that we talked about, but I kind of am wondering if you know the answer to this. We are talking about how all of these organizations– big organizations– encourage breastfeeding. We talk about how we don’t necessarily have the support but not only do we not have the support, but we have the alternatives given to us so easily which I think is great. I’m not saying it’s a bad thing, but it makes it easier or if we don’t know. Like with cluster feeding, you think you’re baby is starving. You think, “I’m not giving my baby enough. They are always hungry, always hungry and I have to supplement with formula,” when that’s not necessarily the case. Why do you think these companies are providing so much formula right out of the gate?


    Crystal: You know, I’m not sure. I can say it probably is because they are not thinking of the long-term effects of starting formula. If it’s needed, how I always was taught especially working in the hospital is that really, formula should be used and treated as a medication. Use if absolutely needed. But, when some staff or doctors or whatever see that a mother is struggling maybe, they don’t automatically think, “Let’s support her and see how we can help her reach her goal. Let’s just feed the baby and deal with it later,” not knowing that that can negatively impact the breastfeeding relationship down the road. 


    You know, like you said, that is there for a reason, and if a baby really needs it, of course, use it. I think the organizations are getting better, but they can still be better. 


    Meagan: Yeah. Do you know what I would like to see more? I know that this can be tricky because of all of the things that are put into our bodies and in this world, but I would love to see milk bank donations more. 


    Crystal: Yes. 


    Meagan: There are certain countries that are literally like Winder Dairy and they bring breastmilk to your porch for people who are struggling. It’s so awesome and there are parents out there. There are moms out there who have an insane overproduction, but their baby isn’t necessarily using it and it could go to a preemie baby or to a mom that may have a little bit of a rough start or have had a Cesarean under general anesthesia and isn’t able to really even be present in that moment. I would love to see that happen more. I don’t even know. There are all of the things out there. There are all of the apples off of the tree that I would like to grab and make happen. 


    Crystal: That would be so amazing. 


    Meagan: But they are out there too. So if you are struggling in your breastfeeding journey, it doesn’t hurt to ask, “Hey, is there a breastmilk donation in our area or in this hospital?” because there are situations where some hospitals– it’s not talked about and it’s not big enough yet, but there are banks where people who donate. 


    And because of the craziness in this world, they are really, really strict on who can donate. My cousin did one and you have to check a million boxes to be able to donate. So anyway. 


    Crystal: It makes sense. 


    Meagan: It could be weird to people like, “Someone else’s milk, what?” 


    Crystal: I’ve definitely encountered that before. Everyone has their feelings, beliefs, and opinions, so it’s like, “Well, it’s there.” I am seeing more hospitals in my area up in northern California have donor breastmilk available in the hospital, but the problem with that is they give the donor milk in the hospital, but when they go home, there is still not that support or continuation of care because now, mom’s milk maybe is not quite sufficient yet and how do we help them when they go home? 


    Meagan: Right. 


    Crystal: That’s another thing that we’re seeing too. 


    Meagan: Okay. So that is a question right there even. We can go home, but I’m going to go back and talk about breastfeeding with that. What do we need to not forget about the postpartum journey during the birth preparation? What are some things that people who are pregnant, preparing for birth, and preparing for their birth– they are so excited. They are figuring out if birth is right for them. What do we need to focus on and not forget about during that pregnancy journey? 


    Crystal: Yeah, so of course, like we were saying earlier, getting ready for birth and preparing for birth is a huge event. We prepare for that and all of that, but then we don’t think about like we were saying, the postpartum. Think that postpartum can last a year or two years, sometimes even longer depending on how long you breastfeed if you plan to breastfeed. It takes 9-10 months for your hormones to increase and grow this baby and things like that, then of course, it can take– to me, this is my thinking– at least nine months for it to go back down to somewhat normal levels. 


    If you’re breastfeeding, you’ve still got all kinds of hormones going on. So think about that. Babies have to be fed, so how are we going to feed them? Are you going to breastfeed? Do you know what to expect? Do you know what kind of bottles and what kind of formula to use? Do we know what to expect with just newborns in general and newborn care and diapers? Because babies’ poops look funky. They are different from ours, so it’s like, okay. All of these things, I feel like if parents are a little bit more prepared, then they will have less anxiousness for one because it’s a whole new thing whether you are a first-time parent or even if it’s your third or fourth baby– even with me for my fourth baby, I was like, “Wait. Is this normal?” I’m a nurse and I work in the field, but it’s so different when you’re on the other side. 


    So just to be prepared for that so that way you have the expectations and you know, “Okay, what’s normal? What’s not normal?” Have somewhat of an idea of how to manage some things and know that there is support out there when you need the support. 


    Meagan: Absolutely. Something that I– with my first baby, I ended up going back to work at 12 weeks postpartum. I already wasn’t prepared for a Cesarean, so then I was recovering from that, but when it came to feeding my baby and even my emotional status, I really wasn’t prepared for all that was happening in such a short period of time and then to shift. As soon as I started feeling like I was kind of getting the hang of it and things were in control or I had a routine, it was like my feet got swooshed underneath me and it was changing again. I was all of a sudden in a back storage room pumping every three hours. I was storing my milk in a fridge where everyone stored their lunch and then trying to figure out that and trying to get enough production for my baby while they were with the babysitter. It was so much. 


    Crystal: It’s a lot, yeah. Definitely, going back to work after having a baby, no matter how soon whether it’s six weeks or six months is definitely a big change as well. That’s something that a lot of parents aren’t really thinking about or prepared for which is totally fine. There is so much more going on at the moment, but knowing that, “Okay. I need to prepare and be ready before I go back to work so I know what to expect.” And like I said, getting some support on how to manage that. Get a plan together. Get a schedule together. 


    Meagan: Yeah. So as a doula, I work a lot with my clients right before pregnancy and sometimes they are a little caught off guard when I’m like, “What’s your postpartum plan?” They’re like, “Huh? Aren’t you a birth doula?” I’m like, “Yeah. I am a birth doula, but I know a lot about postpartum and I didn’t plan for it either. Let’s talk about it. How are you going to eat so you can feed your baby? How are you going to get sleep?” because just like you were talking about before, a lot of moms have to go back 12 or so weeks after. Some of them two weeks after. We also have an issue with our paternity leave– 


    Crystal: Paternity leave for the fathers or the partners. 


    Meagan: Yeah. We have one week. Especially if you have multiple kids, we have one week a lot of the time and then they’re gone and we’re like, “What are we going to do?” Get your meal trains. Get your support. Rally up together. Have your birth team. Have your postpartum team. Have a plan. We know plans change no matter what– birth, postpartum, everyday life. I sometimes plan to go to Costco and then I don’t go to Costco that day because something happened. Plans change, but if we can have a baseline of an idea, I will be like, “Okay.” 


    I have a friend who gets mastitis with every baby. 


    Crystal: Oh gosh. 


    Meagan: With her third baby, she was like, “I’m going to do everything.” She had her IBCLC to go to the hospital on day one to get a good, established latch. She met with her as soon as she left the hospital. By day four, she was meeting with her again to make sure. You guys, she was on sunflower lecithin. I don’t know how you feel about that, but that helped her personally to not be so sticky. She was like, “I have got to get this under control. I have two other kids. I cannot be sick with mastitis.” Then she would end up getting thrush after that so she took a probiotic. 


    Crystal: Oh my gosh. 


    Meagan: There are things we can do and it’s really hard to focus on that in the pregnancy stage. 


    Crystal: Yeah, yeah. 


    Meagan: But there are things. We can get on those probiotics. We can contact those IBCLCs. We can have a plan in place so we are not just thrown into the fire. Especially in my case, where I did have a Cesarean and a repeat Cesarean, those were just things that were unexpected so prepare the best you can. I love that. I love your advice. This is so important and get that support. 


    Crystal: Yeah, for sure. I just thought of something because I talked a lot about breastfeeding and feeding your baby, but you brought up a good point. As mothers, we for sure neglect ourselves all of the time so like you were talking about with eating, make sure you eat and hydrate. Moms are recovering too from birth so whether it’s vaginal or a Cesarean, planned or an emergency Cesarean, your body is doing a lot postpartum. It’s just crazy. 


    Meagan: We’re amazing. We are amazing human beings. We are incredible.


    Crystal: Yes. We are. We are. We so are, but then we have to remember to take care of ourselves as much as possible. That’s where the support and village come in because you can’t do it all yourself. I guess you could. I’m sure some women have, but you shouldn’t have to do it by yourself. 


    Meagan: No, and I think like you are saying, we shouldn’t have to but for some reason, we do. 


    Crystal: Yeah. I know. I know. 


    Meagan: We don’t ask for help. We struggle asking for support. We struggle spending money on ourselves. We struggle getting postpartum doulas or going to an IBCLC because it costs so much and insurance doesn’t cover it. You guys, you are worth it. You are worth it. You are amazing. You grew a human. You birthed a human. You are now taking care of a human. You are feeding a human. There is so much to it. It’s okay to get that support and give back to yourself. 


    Crystal: Totally, totally. I 1000% agree. 


    Meagan: Yes and sometimes, that is finding a coach and just getting some advice or talking to someone and just being heard. Maybe you don’t physically need anything, you just need to be heard. 


    Crystal: Yeah, yeah. 


    Meagan: Yes. Okay, so now we’ve had our baby and everything. What can we look for in the first few weeks to know that maybe we need to ask for more help or get more resources or take care of ourselves? What are some things that we can look for in those first few weeks with nursing and postpartum just in general? 


    Crystal: Yeah, yeah. So for moms, I have spoken to a lot of moms who weren’t aware that there would still be bleeding afterward so there is that. 


    Meagan: That is a thing. 


    Crystal: Yes, that is a thing. You are still bleeding. That is normal, but obviously, from a nursing standpoint, if there is excessive blood or you are filling a pad every hour, then for sure, you want to reach out. A lot of women tend to swell postpartum. Some are like, “No, I didn’t have any swelling during the pregnancy,” then all of a sudden postpartum, you just blow up. Your feet are swollen and things like that. That could be due to some IV fluids or other stuff going on, but for sure, you want to reach out to your provider with that. 


    Contractions and cramping afterward are still a thing, especially with breastfeeding. Some women are just like, “Oh my gosh. I did not know about this.” Some women feel great after delivering. They are like, “Yeah. I don’t need to take my meds. I’m feeling okay,” but once they start breastfeeding and they start feeling these contractions, it’s like, “I’m in labor again.” That is normal. I know it’s uncomfortable, but that is definitely normal. If you still feel that when you’re not breastfeeding or it’s not relieved with pain meds, then for sure, I would highly recommend reaching out to the provider. 


    Meagan: That can also get worse with each baby, right? 


    Crystal: Yes. Yes, it can get stronger. 


    Meagan: It can last a little longer and be a little bit more intense, yeah. 


    Crystal: I know which is like, “Why? We already went through this. Why do we have to make it worse?” 


    Meagan: Our uteruses have to shrink down. 


    Crystal: I know. It’s a good thing. The cramping is a good thing. It’s a normal thing. We want that. It controls bleeding. It gets the uterus back down to the normal size and all of that. Engorgement. Even if a mom is not breastfeeding, the body’s natural, physiological response is to bring in milk. With the delivery of the placenta, your hormones drop and that triggers, “Oh, okay. Baby has been born. Let’s make milk.” 


    Meagan: We have to feed it. 


    Crystal: Yes. So whether you breastfeed or not, if you don’t breastfeed, you may not get as much engorgement, but there is still stuff going on there. If you are breastfeeding, you will almost 100% get engorged in the first few days anywhere from day three to five. Sometimes it is a little bit longer, but around there, your breasts will feel really full. Some women say their breast sizes double or triple. 


    Meagan: Mhmm. 


    Crystal: They can get really rock hard. That’s pretty normal because your milk is coming in. Getting support with latching well so the baby can empty it or if you need to, maybe you have to pump a little bit, but like I said, of course. Reach out for lactation support because depending on the situation or what’s going on, the lactation consultant can further guide you on how to manage that. But lumps, you may feel little lumps in the breast. That is pretty normal. Those are just basically milk ducts that are swollen or filling with milk because of the postpartum period with increased swelling and things like that. 


    After engorgement, I’m thinking of the progression of things, a lot of parents see clogged ducts, but now we know that it’s called ductile narrowing instead of clogged ducts. 


    Meagan: Oh. 


    Crystal: Yes. Before, we thought that the milk was getting clogged. 


    Meagan: Getting sticky. 


    Crystal: Yes, then we had to somehow remove this milk plug, but the new research by the Academy of Breastfeeding Medicine is saying that it’s not that. It’s inflammation and swelling of the milk duct itself that causes the narrowing of the channel or the passageway that milk goes through and that makes it back up. It backs up the milk. 


    Management for that beforehand was warm compresses and massage, massage, massage, dangle feeding or something like that. Now, they are saying that we should be using cold compresses. 


    Meagan: Oh, okay to reduce inflammation. 


    Crystal: Exactly, to reduce inflammation. I always tell parents that if we have a swollen ankle and the breasts are swollen, we wouldn’t put a hot or a warm compress on it. 


    Meagan: No. Okay, I’m noting it. 


    Crystal: You would do the ice or the cold compress to reduce the inflammation and when we reduce the inflammation in those milk ducts, now that passageway opens up, everything can calm down, and milk can flow a little bit easier. 


    Meagan: Mind blown!!

     

    Crystal: I know. 


    Meagan: That is amazing. That would have been nice to know a long time ago. 


    Crystal: I know. When I see moms say, “Oh my gosh, I have this lump and my breasts don’t feel empty even with breastfeeding or pumping. I’ve been doing hot showers and massaging it.” I’m like, “No. Try cold.” Almost always, it helps. 


    Meagan: I am totally adding this to my doula toolbox. 


    Crystal: Yes. Yes. 


    Meagan: This is really good information. 


    Crystal: It is. It’s so amazing when parents come back and they are like, “Oh my gosh. It worked. I can’t believe it.” Also, breast tissue is very delicate. It’s soft tissue. Some moms are just aggressively massaging their breasts like, “Oh my god. I have to get this out.” You don’t want to do that because you can further damage and cause trauma to the breast tissues. 


    Meagan: More inflammation. 


    Crystal: Yes, more inflammation, exactly. Light massage. If you need to, cold compresses for that. For moms, I’m going on and on right now. This episode is going to be forever. It’s going to be hours long. That’s kind of the basics of the immediate thing that we need to look for in mom physically. 


    Emotionally and mentally, parents are sleep-deprived so we definitely want to make sure, like you said, have those meal trains. I even suggest adding this to the baby registry when you are pregnant like meal cards, Door Dash cards, a postpartum doula even. It’s like, “Whoa. Instead of giving me all of this, this is what I’m going to need help with in the first couple of weeks.” I know for me, I guess I’m thinking of myself and my baby, but I’m also thinking of everything else in the house that I need to do like, “Oh my gosh, I need to do the laundry. Oh my gosh. The other kids need to get rides to school,” or what have you. 


    If there is anything, you know how friends and family are always saying, “Let me know if I can do anything to help,” please ask for help because moms and parents need sleep definitely. That helps because, for one, sleep is just a human need. Two, for sanity, and three, because the more rest that we can get as mothers, as a breastfeeding and lactating parent, the better our milk supply will be too. 


    Meagan: Yeah, 100%. Like we were talking about, we are not thinking of drinking and that helps our breast supply. That helps our healing physically and keeps us in our minds. On that topic, Be Her Village– I’m sure you’ve heard us talk about it. Check out Be Her Village. You guys can create a registry just like Crystal is describing where you can go and register for a doula or childbirth education or money for an IBCLC or pelvic floor health or mental health. All of these things, if this is your registry– 


    Crystal: Pelvic floor health, oh my gosh, is another thing. We don’t know about that. Most mothers are just– not that we don’t care, we just don’t know. There are just so many things going on down there that for sure you need some kind of pelvic floor rehabilitation afterwards even if you have a C-section. 


    Meagan: 100%. It’s aggravating. I’m not going to spiral off on this tangent. It’s aggravating to me that so many insurance companies do not cover this as a standard part of postpartum. But they’re not covering postpartum pelvic floor issues. They’re not covering this. 


    Crystal: Yeah. 


    Meagan: I went and it was $250 per visit and as a new mom, especially if we invested in a doula and an IBCLC and a photographer or whatever. 


    Crystal: All of those things, yeah. 


    Meagan: It’s like, “Oh, whatever,” and now we have a newborn that has to have diapers at $50/box. It’s really hard. 


    Crystal: Right and that’s where we neglect ourselves again. Not that we want to, but I don’t even know who to blame. Healthcare or insurance or whatever is preventing us from getting the proper care or support. I did the same thing. I just wanted to touch on that. I did the same thing. I was having issues holding my bladder and I asked for a referral from my doctor for pelvic floor health because doing our own research, we’re like, “Okay. I think I need to see a pelvic floor therapist.” They did not. They were like, “Well, normally we don’t do that.” I’m like, “Why?”


    I did the same thing. I tried to look into it myself to pay out of pocket and it was expensive and I just kind of gave up and was just like, “Okay. I’ll just do my own research and find out some exercises on my own and just do it on my own,” which is sad. We shouldn’t have to do that. 


    Meagan: I agree. I agree. 


    Crystal: But okay, so on to what to expect because there are still a couple of other things. There is so much, but I just want to touch on the emotional and the mood disorders because that is very, very important and huge. I always recommend that when moms take classes prenatally they have a partner or a birth partner or something that is along for the ride with them who comes to the classes and things like that. I really recommend that postpartum too. Any time of postpartum class, newborn class, or breastfeeding class, the partner or caregiver should definitely be involved as well as the birthing parent because as moms, we don’t initially see that there is something more going on with us for postpartum anxiety, postpartum depression, and things like that. It’s usually a close family member who notices things going on first. 


    Definitely, I feel like the whole family should be involved in that and if parents are just struggling with coping and with new life as a parent breastfeeding and all of the things, then definitely reach out for support because that can definitely happen with all of the hormones going on and the stress. 


    Meagan: Lack of support. 


    Crystal: Lack of support. 


    Meagan: Lack of sleep. 


    Crystal: Lack of sleep, yes. That’s definitely something big. 


    Meagan: I want to talk just slightly about this. It’s really hard as a new mom to and I hope this isn’t triggering, pass your baby to someone so you can take care of yourself. We had a client years ago that was really struggling. She had a series of things and was really struggling. One of the things that we ended up coming up with was for her to go to her mom’s for the night. We came up with a good plan and had help with dad and the kids for baby. She ended up pumping and coming up with a supply and for one night– she did wake up engorged– she slept all night. All night. 


    She went to bed at 8:30. She pumped before and went to bed. She woke up. I think she said it was at 6:30 which is still early, but 8:30 to 6:30 is a good stretch. She was probably so engorged that she had to wake up, but you guys, she was a new person. She said that. She was like, “Whoa. It’s like my funk was just sucked out of me just by getting that sleep.” That was really hard for her to do that. 


    Crystal: Of course, I’m sure. 


    Meagan: It was really hard for her to be like, “I’m giving up my baby who is four days old overnight.” It’s not ideal. It wasn’t ideal, but she spiraled quickly and she got to a place where that’s ultimately what she thought was going to be best. Anyway, it was amazing. She still had trials to get through because the next night, she had lack of sleep but she was able to build up that foundation a little bit more by getting a good night’s rest. 


    Crystal: Of course. Exactly. 


    Meagan: Her mom seriously had all of these broths and all of this high-protein food and all of these amazing things to fill her being with all of the good things. 


    Crystal: Yeah, because as mom, we are filling everybody else’s cup usually, but we aren’t filling up our cup. 


    Meagan: Yeah. You don’t have to leave your baby with anyone overnight, but going back to that, have someone fill your cup. Have someone fill your cup. Food, all of those things. 


    Crystal: Everything. I’ve heard of some parents when they finally get three or four hours of sleep straight, they’re like, “Oh my gosh. That was amazing.” Same thing. “I feel like a new person.” Just because sleep is a human need, so we need that and if we’re just constantly days upon days upon days of getting only 1-2 hours at a time of sleep, that’s definitely not sustainable and not enough. 


    Meagan: Yeah. Yeah. She started resenting her baby. 


    Crystal: Yeah. Yeah. I’ve heard of that too. 


    Meagan: She started having anxiety at nighttime. 


    Crystal: Yeah. Yeah. I could definitely see how that can come about for sure especially if you’re breastfeeding, especially with that. We all know that of course, breast is best. Breastmilk is best, but we also have to think of the whole picture. I always tell this to all of my clients and patients that I work with. Mental and sleep health is very important. Very. I know breastmilk is too, but you do the best that you can. 


    Meagan: It’s like when we’re on the airplane and they talk about if we’re in an emergency and the masks fall down, prepare your mask on you first before you help someone else. 


    Crystal: Yes. 


    Meagan: It’s a similar concept to me where if we cannot fuel ourselves with the oxygen and the sleep and these things, we cannot 100% take care of this baby. 


    Crystal: Right, yeah. 


    Meagan: We can’t make milk. 


    Crystal: Right. 


    Meagan: Because our body is going to protect us and sometimes we will see a milk dip with stresses and things like that. I have clients who are nursing really, really well and then a stressful event happens in their life and they’re like, “I’m losing my milk. I’m losing my milk. Is my baby not eating enough?” It’s crazy how just mentally our body can do that. It can stop making as much milk. Have you seen that?


    Crystal: Yeah. I have. I have actually. A stressful event or if mom starts a new medication, especially birth control. They don’t know. They just don’t know. When I talk to my doula consultation, I say, “Any new medications?” They say, “Well, I just started taking birth control but my doctor said it should be fine and won’t affect my milk supply.” I’m like, anything new can. It can. 


    Meagan: Hormones. 


    Crystal: It’s not to say that we can’t get the milk supply back up, but at least being aware of it. Okay, this is why. It’s not because of something else or whatever. So yeah. I’ve seen that. 


    Meagan: Yeah. 


    Crystal: Periods, too. Moms starting their period again, it can–


    Meagan: Throw it off. 


    Crystal: Every month during your cycle, yeah. It throws it off. Lots of different things that could happen and will happen, so just something to have in the back of your mind like, “Okay. This is what I remember Crystal, The Mama Coach, saying or whoever saying that this can happen, but there are ways to work around it.” 


    Meagan: This next question is a did-you-know. I feel like this is something actually that a lot of people do not know and that is that babies lose weight in the first few days. They can lose even more than the recommended loss if there was an induction, or a lot of fluids, or a surgery. Can we talk about that? 


    Crystal: Yes. Yes. Correct. 


    Meagan: Can we talk about what is normal? Because I feel like again, mentally, there is so much stress on feeding the baby, getting enough, cluster feeding, and all of these things, then we have this baby that weighed in at 7lb, 12 oz and is now weighing in at 6lb, 15oz, and we are like, “Whoa. This is a big loss.” We’ve got providers freaking out about it, suggesting supplements, and things like that. What’s normal? What is the average loss just without induction and things like that? Can we talk a little bit about that so we can offer some comfort to these mamas who might have a baby that’s losing weight? 


    Crystal: Yeah, yeah. So babies can lose up to 10% of their birth weight within the first three to four days or so. Normal weight loss is about 2-3% per day. So with that being said, when babies are in the womb, they are swallowing amniotic fluid. They are swallowing, swallowing, swallowing, so technically, they are born full and their first stool is that sticky, black, tarry meconium that is just getting rid of all of that amniotic fluid that they were swallowing while they were in the womb. 


    So that’s some weight loss because they are probably pooping five or six times within the first one or two days and it’s super sticky. Then, like you said, if mom was inducted or induced or got a lot of IV fluids, antibiotics, and a Cesarean, then they got extra fluids. Anything that mom gets during labor, baby gets some of it too. 


    Really, some providers are saying that a newborn’s true weight can be seen 24 hours after birth versus one or two hours right after birth. That weight loss takes into account that. Fluids, getting rid of the meconium, and things like that, and then anything more than 10%, then we get kind of concerned. Like you said, some providers are like, “Oh my gosh. Let’s do all of this.” Me, as the lactation consultant, I am less freaked out because I know that especially if a mom is breastfeeding, babies’– we’re getting to probably one of our next questions– bellies are really small, so in the first couple of days, they are only taking 2-10 milliliters per feeding which is less than half of a teaspoon up to two teaspoons per feeding. 


    That is the colostrum that they are receiving from mom, that yellow, thick, first milk that is expressed from mom’s breast and although it’s smaller in volume, it’s really packed with a lot of nutrients and antibodies and things like that. It is nutritionally–


    Meagan: I say dense. 


    Crystal: Dense, yeah. Nutritionally dense. So baby is getting what they need, it’s just a smaller volume because it makes up for the fact that it takes a couple of days for mom’s milk to increase and increase in volume and things like that. Babies are losing all of this excess fluids, pooping out all of this meconium, and then they’re just getting smaller, frequent amounts of colostrum. All of that are factors in weight loss. 


    And then when mom’s milk starts to increase around day three to seven, they start taking in more volume and then we start to see some weight gain there. Now of course, as a lactation consultant, we look at the whole picture. What happened with the mom’s labor and delivery experience? Is this baby number one or two or multiple for them? Do they have any medical background that might be a factor in milk increasing or milk coming in? All things like that and when I look at that, I’m like, “Okay. Maybe we need to supplement just a little bit if we need to.”


    And then I will tell moms, “Let’s maybe have you pump or hand express. Any extra colostrum or transitional milk that you can express, give that to baby first and we will see how that goes,” especially if they are not wanting to start formula. Every baby and family is different so I look at the whole picture, look at their goals, and see how best I can help them. But obviously, if a baby loses a significant amount of weight like 13-15%, then we are like, “Yes. We probably need to supplement.” 


    So like I said in the beginning, formula is used when we need it if we need it, not just automatically, “Oh my gosh. Baby is at 9 or 10% weight loss. We need to give formula.” I definitely disagree with that. And it’s all the parent’s choice as well. I give them the options and they decide what they want to do and then I support them in whatever they decide. 


    Meagan: Right. So as we are kind of working on getting our milk to come in and recovering and things like that, we talked about sleep, mental health, food, water, and things like that. That’s all going to help our breastmilk. But are there other things that we could be doing or should be doing to help our milk to come in quicker or once it comes in, to help it be more– savory comes to my mind, but really rich for the baby? 


    You just talked about how some babies do lose up to 13% and then I guess a side question is, do we know why some babies lose a little bit more? Is there a reason or is there something that we as parents could do or should we just be like, supply and demand? Nurse your baby. Your milk will come in. Your milk is great. Just because your baby is not gaining as much weight doesn’t mean you should shame yourself or your milk is not good enough, because there is a lot of that too. Is there anything you would give us tip-wise to help milk come in? There are a lot of questions within this one question so I’m just going to turn the time over. 


    Crystal: Okay. So yes. The best thing we can do is early hand expression. Typically, after birth, during the first 24 hours, babies are super sleepy. Super sleepy that it’s hard to get them to latch or want to nurse frequently. Thinking about how breastmilk supply works, the more you demand on the breast or remove milk, the more milk you will make. 


    So if the baby is sleeping the first 24 hours, the baby is not expressing as much milk and that is where hand expression is important. Frequently, newborns tend to eat at least 8-12 times in a 24-hour period, so if we break it down by hours, it is just so much easier. Every 2-3 hours or so, attempt to put baby to the breast. Do what you can. If the baby is too sleepy or not latching well, then hand express. Hand expression and get out that colostrum. You can spoon-feed that to baby or cup-feed or syringe-feed that to baby, and then you’re still stimulating your supply. 


    Sometimes, I hear parents say, “Oh my gosh, the first day or two, my baby was just so good and slept for four hours.” I’m like, “Did you hand express or pump at that time?” We just don’t know. They were like, “No, I didn’t. I slept too.” I’m like, “I’m glad you got sleep,” but to help your milk supply increase for baby, it is very, very important to express milk every few hours whether it’s hand-expressed, latching, or pumping. 


    I’m trying to think what was the other question you had. Oh, how we can make it more savory. I always recommend doing breast massage prior to any breastfeeding or pumping or expressing session. That’s just because especially in the first couple of days, colostrum is very thick, so by massaging– and light massage. Not too hard, not too aggressively. You’re basically unsticking or loosening up that milk so that way it can be expressed and you can collect that good, sticky, fatty, colostrum or milk. 


    That’s for even at any time. You might have heard of a foremilk and a hindmilk type of thing. That’s basically when you express, you see a little fat layer in the bottle or in the milk and to increase that, some researchers say that you can’t do anything to increase that, but we can help it to come out a little bit more. That’s by hand-expressing or doing what we call a breastmilk shake. I’ve done this myself with my last baby is just doing the breast massage before breastfeeding or nursing. I have seen a thicker fat layer on the milk, so you can do that. 


    Meagan: That’s really good to know. With my son, he was kind of small to begin with, but when I would pump, I was like, “Oh my gosh. There is this much fat in this milk.” All of it separated and I had someone kind of suggest that, but it was a warm compress, not a cold compress. It was a warm compress, slight massage, and then nurse or even hand-express for just a second, and then nurse. 


    Crystal: Yeah, yeah. Yeah. You can do that too. You can breastfeed or even hand-express a little bit too just to help that milk supply especially if baby didn’t have a good feeding or wasn’t quite latched very well just to ensure we stimulate the breast properly to give that signal of, “Okay, make the milk. Bring the milk in,” and things like that. 


    I just wanted to say as a side note, all breastmilk is beneficial for baby whether you have a thin fat layer or not. 


    Meagan: Good to know. 


    Crystal: Your body still tailors and makes the breastmilk to your baby’s needs. 


    Meagan: Awesome. So hand-expressing during pregnancy, we were talking about postpartum, but is it suggested to do a little bit during pregnancy? 


    Crystal: You can, but you have to be considered at least term which is about 37-38 weeks or so, and of course, check with the OB provider because it depends on what risk factors you have. 


    Meagan: Yeah, because it can stimulate. 


    Crystal: It can stimulate because it does with the hand expression, the same hormone is released when you are having a contraction which is oxytocin so it can cause some cramping or contractions so you definitely want to get cleared by the OB first before just starting the hand expression, but yes. Once you get cleared, you can start antenatal hand expression and start collecting. It may be nothing or you might get drops. I’ve actually tried it on myself before and I didn’t get anything. I was kind of discouraged, but I was like, “No, knowing what I know, it’s fine,” but it’s good practice, too for hand expression postpartum. 


    So practice, collect drops, and then you can freeze it and then bring it to the hospital if for some reason baby needs to be supplemented if they have low blood sugar or jaundice or whatever, so yeah. 


    Meagan: So good to know. Okay, and then last but not least, we have different types of feeding. Bottles, paced bottle feeding, we talked a lot about breastfeeding. Can we talk about all of the different types of feeding?


    Crystal: Yeah, yeah. So of course, you can do exclusive breastfeeding and that’s just feeding baby at the breast, or you can do breastfeeding and pumping so feeding breastmilk in some type of vessel whether it’s a bottle or syringe. I typically see bottle and syringe usually especially when the milk volume increases or you could do combo feeding which is breastfeeding, pumping, and formula feeding so you can do a combination of all three. 


    Some moms do exclusively pumping. They don’t put baby to the breast at all for whatever reason. It could be their own preference or they were just struggling with latch and it just was not working out for them, or sometimes it takes a long time to breastfeed, 30-45 minutes, so some moms feel like that works better for them to just pump for 15-20 minutes and bottlefeed. 


    Or some, whether it’s their own personal preference or medical reasons, exclusively formula feed. With that, when you do any type of feeding other than breastfeeding and you bottlefeed, you want to pace bottlefeed. We do that for several reasons. For one, sometimes, newborns don’t really know how to pace themselves and they will just take that whole bottle. 


    Meagan: Chow it down. 


    Crystal: Chow it down in one minute flat and we don’t want that because I always tell parents to think about how we eat. We don’t just shove food in our mouths. 


    Meagan: Chew your food. 


    Crystal: Yes, chew your food and things like that. One, it can help baby learn how to slow down their feeding and then learn their own hunger cues like signs of fullness which in turn can help in the longer term as they get older knowing their hunger cues and knowing when they’re full and not overeat. Then three, it can help with digestive issues. Gulping too much too fast or drinking too fast, they can take in more air which means they will be more gassy and more fussy and then we are like, “What’s going on? Why is my baby so fussy?” It’s because they are gassy most of the time. A lot of the time, babies are just not very comfortable when they have gas and they definitely express it and communicate that they are uncomfortable, so we want to prevent that. By pace bottle-feeding, we help to remedy that. 


    Meagan: That makes total sense. Sometimes, I feel like when they are gasping all of that air, then they spit up a lot. This is not really one of the questions we talked about, but when a baby spits up, a lot of the time we see it, and it looks like a lot and we are like, “I can’t believe I just fed my baby and it’s right here on this blanket or all over myself.” Is there a rule of thumb to be like, “Okay, really, that is true. Every little ounce of that just came out?” Or is it like, “Okay, your baby still got quite a bit.” 


    Crystal: That’s kind of hard to say because like you said, it does visually look more than it is which is why pace bottle-feeding is important because we want to take frequent breaks, little, quick breaks of a couple of minutes or so to burp, let that move down their belly, and get that excess air out, and then continue feeding. 


    I always recommend that if your baby spits up and it looks like a lot, see how they’re doing and go by their cues. If it seems like they are looking for food again, try and give a little but maybe a smaller amount just to see how it goes. 


    Meagan: Mhmm. That’s a good rule of thumb. 


    Crystal: Keeping babies upright after feeding, if you can,  will help to lessen the chance of spit-up, but then again, sometimes babies spit up out of nowhere an hour after feeding. Parents are like, “I don’t know what’s going on. He spit up.” If that happens and you are burping your baby and keeping them upright after feedings, I would definitely talk to a provider because sometimes it can be the formula if they are drinking formula or something to that effect. 


    Meagan: Mhmm. Yeah. Awesome. We’ve gone over so much. 


    Crystal: I know. 


    Meagan: I want to just end on The Mama Coach. How can people find you? What do you guys offer? How does The Mama Coach? I mean, I know how. It’s in amazing ways and who is a good, qualifier to go and find a Mama Coach?


    Crystal: Yeah, like I mentioned earlier, The Mama Coach is a group of registered nurses all over the world. I am the owner here in Vacaville, California which is in Northern California. Our goal is just to help make parenting easier. Like I mentioned, we do have prenatal services. We have postpartum services and newborn services, helping with any type of feeding even if you are not breastfeeding. 


    Meagan: Sleep?


    Crystal: Sleep, yes. We have sleep. We help with newborn sleep, toddler sleep, potty training, CPR and choking classes, starting solids as well as one-on-one services here. For me, locally, I do home visits and home lactation visits. I can do any of the workshops one-on-one in home or virtually. My niche is breastfeeding– prenatal breastfeeding education and consultations as well as postpartum of course, newborn care, and sleep because those are all important things. 


    Meagan: Very, very important things. 


    Crystal: Very important. 


    Meagan: You guys make it really, so easy. You just go to themamacoach.com. There is a “Find a Mama Coach”. You can search what you are looking for or you can type in your zip code and you can pull up all of the Mama Coaches near you and go over all of their services. I don’t think there is a single one that only does one thing. 


    Crystal: No, we all pretty much do a lot. Yes, correct. Yep. For sure. If you are a new or expecting parent or even a parent of a three-year-old– any parent that is struggling and your baby is five years old or under, we can help you. I am on Instagram. My Instagram is crystal.night.themamacoach. We also have a website like you were saying. The main website is themamacoach.com. We each have our own individual sites as well and I’m sure we’ll post that information somewhere, but yeah. Reach out to any one of us and myself if you are in Northern California in the Vacaville area. We, like I said, almost all do virtual and then also locally in person too. 


    I do ongoing workshops and that’s always posted on my website in the classes or on my Instagram. 


    Meagan: So amazing. You guys are doing so much. You even have a blog where you can look specifically at pregnancy, newborn, sleep schedules, and parenting in general. I mean, these guys have amazing things so make sure to go follow. We’ll make sure to tag you today on our Instagram and our Facebook so you can go and find it. We’re going to have the website in the show notes. We’ll have all of the things we have talked about and seriously, thank you so much for helping our community because like I said, we don’t talk about postpartum as much. We don’t focus on it as much. We don’t focus on feeding and all of the things, so thank you so much for kicking off the 2024 season with a new type of topic. 


    Crystal: Yes. Yes. Awesome. I was so happy to be on here. Thank you. 


    Closing


    Would 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. 





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    1h 6m | Jan 3, 2024
  • Episode 269 The Most Common Questions of 2023

    Meagan finishes out this year of podcasting by answering some of your most common questions! Topics range from the time between births, gentle induction methods, gestational diabetes, “just-in-case” epidurals, home birth, tips for having a successful VBAC, and how to cope if you don’t get your VBAC. 


    “Women of Strength, I just want to thank you so much for all of your continued support. We love your support and we are so grateful that you are here.


    I love you. I feel so passionate about helping you as an individual find the best path for you.


    I want to help you walk through this journey and feel loved, supported, and educated.” 



    Additional Links

    Real Food for Gestational Diabetes by Lily Nichols

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Meagan: Hello, hello. Welcome to The VBAC Link. If you have been with us all year, I just want to say thank you and if you are new to joining The VBAC Link, I’d like to say welcome. Welcome to the show. This is the last episode of 2023 and it’s kind of hard to believe honestly. I went through all of our episodes and we have seriously so many incredible episodes. I am so honored for those who have come and shared their expertise and given us their time. 


    I am so excited today to share this last episode of the year with the most common 2023 questions. We have some pretty common questions, but we have so many others as well. So of course, we have a Review of the Week. I want to dive into that really quickly before I get into those questions. 


    Review of the Week


    This is from cristab. It says, “I am a birth and postpartum doula who is always on the search for a birthy podcast to listen to in my car. I was so excited when I found The VBAC Link so I could listen to these amazing stories from women all over the world who have reached their goals through becoming educated thanks to Meagan and Julie. I’ve recently certified with The VBAC Link and as well, I’m so impressed with the thorough delivery in which their knowledge was shared in their training. I’m super excited to move into this next chapter of my career and I’m thrilled to do so with the amazing community and support.” 


    Thank you so much and thank you for joining our family. Doulas, birth workers, birth photographers, if you love birth and you are wanting to learn more about VBAC and how you can support people out there who are wanting to VBAC, who are wanting to avoid Cesareans, and who are just needing support from the community, we have our VBAC Birth Worker, VBAC Doula birth course where we are going to teach you all of the things about VBAC as well as help you know what us as VBAC moms are up against. 


    And parents, if you want to dive in and get more educated for your future birth, I highly suggest checking out our course. You can check it out at thevbaclink.com.


    2023 VBAC Questions


    Meagan: Okay, you guys. We have so many questions that we get all of the time. If you haven’t also joined us on Instagram, we do Q&A’s almost weekly. We love answering your questions even if it’s a question that we’ve had before. We’re going to get to it and we’re going to answer it. Here are some of the most common questions that we get. 


    Number one on the list is how long after my C-section do I have to wait until I get pregnant? 


    This honestly is a question that I think is personal. Now, there are suggestions out there by providers who are saying anywhere between 18-24 months is what we commonly hear, but we even have some providers who are like, “Yeah, cool. In 15 months, you can go on and have your baby.” There can be an increased risk of uterine rupture with a really small gap or duration. So if you have had a C-section and then three months later, you get pregnant, you may have a provider who is a little bit more skeptical or even six months later, you may have a provider who is a little more skeptical and talking about the risk of uterine rupture, but that still doesn’t mean that it’s not possible or impossible or that you are for sure going to rupture. 


    I think a common rule of thumb is that 18-24 months, but again, it comes down to a very personal decision. If you want closer babies or it happens or whatever, I think that’s more of a personal choice, and then just finding the support out there to support you in your desires. 


    I did a one-on-one consult with a mom back here in the fall and she had a six-month duration. She went from provider to provider to provider and they all said, “No. Absolutely not.” We got her in contact with another provider and they said, “Yeah. No problem. There is no reason.” I was so excited to get a text message from her after saying that she did it. She had her vaginal birth and she was so happy. That was a duration of six months. 


    Okay, another question that is really common is, “Trying to go for a VBAC and really want to go into spontaneous labor, but her provider is saying they can’t go past 41 weeks.” They cannot go past 41 weeks. Now, I’m just going to say that I don’t like the answer to that. The follow-up question to that question was, “Should I switch my provider?” You know, we’re not here to tell you that for sure you need to switch a provider or anything like that, but if you have a provider that is putting stipulations on you like you cannot have a baby past this day and if you get to that day, you have to have a C-section, you may want to look into some other providers because that’s just not evidence-based.


    Going past 41 weeks in general is something that has become more and more controversial, especially after the ARRIVE trial. We have episodes on the ARRIVE trial. We have blogs on the ARRIVE trial, so make sure to check those out as well. It’s kind of weird. They did an induction at 39 weeks for first-time moms to see if it would reduce complications like hypertension, preeclampsia, and even Cesareans. It’s kind of been since 2019, I feel like, more of a hot topic, but it’s actually pretty common for babies to go overdue. I am putting big quotes on this. “Overdue”, past 40 weeks. 


    Know that if you have made it to 40 or 41 weeks, it’s very common and you’re okay. There are common things that a provider may do at 41 weeks. They may suggest a non-stress test just checking in on baby and making sure everything is going well, but it’s still okay. In fact, ACOG suggests, I think it’s 42 weeks, really. So, you know. At 41 weeks, you could still be pregnant or a week or you could have a baby in three days or even three hours. They have not really found any increased risk of uterine rupture or other complications necessarily like that after 40 weeks, however, there are things that can come into play where VBAC after 40 weeks may be lower or require interventions because there may be things like hypertension and things like that that come into play. 


    But even if your provider is saying that you can’t go past 41 weeks and you have to schedule C-section, that right there is a red flag and something that would be concerning to me because induction is, which is also another question– can I be induced and have a VBAC or can a VBAC be induced? VBAC can be induced. It’s very reasonable. There are ways to do it. Some tips that I would suggest are doing as low and slow as possible. 


    Now, we got a message back on one of the days that we did a Q&A from a mom saying that she did not believe that it was possible to do low and slow. I do disagree. I think that it is possible to do low and slow inductions. I’ve seen it. It happens all the time. You do have to sometimes fight for it and be educated so you can have that conversation and understand what that means. 


    So let’s talk about low and slow meaning that if we are starting Pitocin, we are not upping it to 4 mL every 30 minutes. A lot of providers out there will suggest that. 4 milliliters every 30 minutes. Boom, boom, boom, boom. It’s a little overwhelming, first of all. Sometimes it takes our body a little bit longer to respond fully. Now, Pitocin, once it starts going in, it’s in the body, but it may not fully be responding so if we up it every 30 minutes and then we take 45 minutes to respond, then it may be too much, right? 


    And 4 milliliters versus 2. So maybe you say, “Okay, let’s cut that in half. Instead of 4, we do 2 or even 1.” Sometimes there is a lot of pushback on that 1 because they are like, “Oh, it’s pointless. It will take forever,” but it’s still okay. It’s still okay so decide what milliliter is best for you and go for that. Fight for that. Low and slow there. 


    Then another thing is avoiding breaking water or too many interventions all at once meaning we are going to place a Foley, start Pitocin, and break your water all at the same time. That is unnecessary. We really, really, really do not need to do that. That is just going to overwhelm everybody a lot of the time including the baby. 


    But breaking waters. Breaking water in that earlier stage. Maybe we have– in fact, we are sharing a story. It’s coming up in 2024. I just recorded it not long ago where the mom was 2 centimeters and they broke her water. She wasn’t really contracting. They broke her water, started Pit, all of the things, and not a lot of progression. If we break our water early on, it’s not a guarantee that our body is going to go into labor, but a lot of the time, there is a selling factor of this breaking the water where it’s, “Oh, it’s the natural way.” 


    Okay, all right. Breaking our water is natural. However, artificially breaking our water does not mean that that’s natural. That means that we are intervening and doing something that our body did not do at that point. So if we do that and we do that early on and our baby is high or our baby is in a weird position and then we have these floodgates open and the baby comes down, and the baby is in a wonky position, now we’ve got a poor fetal position, not a lot of progression because that often happens, a harder labor, a longer labor, maybe we’re introducing more interventions, so it kind of becomes a cascade. 


    Maybe when I say slow, take it slow. Let’s not intervene with every single thing that there is possible in the labor and delivery unit. Maybe we just do a Foley or maybe we do Foley with a low dose Pit of 2 and we don’t up it from there. That’s it. That’s where we start. We wait for the Foley to come out and then we assess after that. Low and slow inductions and yes. You can be induced and no, you do not have to be induced at 41 or 40 weeks. 


    So okay, one of the other questions– well, there are a ton, but one of the other questions I’m going to go to is about hypertension. “Can I still VBAC with hypertension?” So, yes. Absolutely, you can VBAC with hypertension. Sometimes, providers will come back and say that it can increase our blood pressure and things like that. It’s kind of weird. I don’t know if there actually is a study that shows this, but a lot of doula clients who have hypertension go to be induced, once they start labor, their blood pressure seems to kind of chill out. It’s kind of interesting. I do not know why, but yes, you can still have a VBAC if you have hypertension. 


    So another question is, “If you get induced, does your risk of uterine rupture truly skyrocket to an insane amount?” We’ve heard people give us such crazy numbers like, “I have an 80% chance of rupturing.” I don’t know where providers are getting that, but no. Or, “I have a 60% chance or I have a 25% chance.” Now, if someone is telling you that you have these chances, I would like to challenge you to challenge them. Now, I never want to say to be combative and blah, blah, blah. That’s not what I’m saying, but I’m saying don’t be scared to ask, “Where do you get that information? Is there a link? Can you provide me with printed information on this topic or on this stat? I would like to see that. I would like to go over this so I can make the best, educated decision for myself.” If they are like, “Oh, well I don’t know. I don’t know if I can find that,” well, yeah. It’s because there’s not one. 


    If there is one and you do receive that, will you please email me at info@thevbaclink.com? I would love to see that. I’ve never seen a study that says that someone has an 80% chance of rupture because they have had a previous Cesarean. So statistically, uterine rupture really happens in about 0.4 to approximately 1%, maybe 1.2% depending on some providers and some studies. 


    But overall, that’s pretty dang low. That’s really, really, really low. So if someone is telling you that you have a 60, 25, or 80% chance, that’s just not true.


    Then another common question is about ways to avoid uterine rupture. Now, we don’t always know why uterine rupture happens. It’s hard to say exactly what caused that uterine rupture. I don’t know if you knew this and it’s very, very small, but uterine rupture can even happen in people who have not had a previous Cesarean. So that’s a thing too, but things that we can do are try to avoid those inductions that are absolutely unnecessary and if you do get induced, talk about those best methods like what we were talking about. We have a blog about that as well and we talk about that in our course. Really learn about those methods and avoid aggressive augmentation. 


    Avoid Cytotec completely. That’s a big no. You know, and do everything you can to make sure that your baby is in a better position so maybe Spinning Babies, the Miles Circuit, hands and knees, do pelvic floor therapy so we can help our pelvic floor be in a position where we can push a baby out that way and things like that. 


    Educate yourself. Listen to these stories. Attend our Q&A’s. All of these things can educate you so you can help reduce these things that may increase chances of uterine rupture like Cytotec or aggressive inductions. 


    Okay, another common question is, “If I have gestational diabetes, can I have a VBAC?” Yes, yes, yes, and yes. Yes, if you have gestational diabetes, you can still go and have a VBAC. Sometimes, a provider may suggest an induction at 39 and I’ve even been hearing 38 weeks with gestational diabetes especially if it’s not managed well. One tip that I would highly suggest is really understanding gestational diabetes. Knowing that food and exercise and things like that can impact gestational diabetes and learning how to manage those if you can. 


    Talking with your provider, understanding what they’re going to be looking for, what they’re going to be doing because that’s also going to help you stay more relaxed when you understand the process from them instead of just being caught off guard. I highly suggest checking out the book Real Food for Gestational Diabetes by Lily Nichols. We’ll make sure to put the link in the show notes as well, but that’s a really, really, really wonderful book to check out and it’s going to help you understand a little bit more about how to manage those sugars and just more about gestational diabetes. 


    But also know that you do not have to be induced if you have gestational diabetes. You just don’t, but it’s going to be really common to have that be offered. 


    Okay, so a couple of other questions that we get are, “I had failure to progress. Big air quotes, ‘failure to progress’ and my doctor is telling me that because my body didn’t do it the first time, it won’t ever do it again.” I’m sorry, but your provider is a big, fat liar. Such a big, fat liar. Just because you didn’t progress with one labor doesn’t mean you won’t with another one. Honestly, it’s more likely that you didn’t progress because of an environment, because of a rushed labor, because of a rupture of membranes artificially and baby was coming down so we got a wonky position, lack of ability to move during labor, and things like that. Progressing and trying to push labor on and it’s not progressing because labor wasn’t ready to begin– these are things that truly are going to be more of the reason for a failure to progress other than the reason that your body doesn’t know how to get to 10 centimeters. Truly, it does. 


    Know that if your provider is putting doubt in your mind, that you can’t have a baby because your body didn’t do it before, you may not be with the right provider or you may have to fight hard. And again, it all comes down to, I think, finding that education and support. 


    Another common question is, “Can I VBAC with twins? Is it safe?” Yes, you can VBAC with twins. Yes, it is safe. Sometimes, providers will have some stipulations as far as Baby A needs to be head down and Baby B is okay to be breech, or sometimes it’s like they both have to be head down. They might have some restrictions on that and a lot of the time, they will have you actually give birth in the OR. They’ll have you push and give birth in the OR, but yes. Research shows that a vaginal birth for twins is generally safer than a Cesarean, truly, even though some providers still discourage it. 


    A podcast to check out is Dr. Stu and Midwife Blyss. They have an amazing, I think it’s Birthing Instincts, podcast and they talk about twins and delivery and things like that as well. 


    Okay, so a common question is, “How can I prep? How can I prep for a VBAC?” I’m going to give you a couple of tips right here. I already have said it a couple of times, but your provider. Your provider is really, really, really, really important. You need to find a good provider, a provider that’s going to support you, a provider that wants this birth for you just as much, right? A provider that is not going to disregard you and pull out bait-and-switches in the end with non-evidence-based information to scare you and then make you feel like no one’s going to want to take you because you are already so late in pregnancy. 


    Ask these questions before you settle in with a provider. Ask questions like, “How do you feel about VBAC?” not, “Do you support VBAC?” How do you feel about VBAC? Open-ended questions allow a provider to give you a lot of information without you even saying a word. If they stumble and say, “Oh, yeah, yeah, you know. I feel good. It’s fine. It’s fine. It’s fine.” Okay, know. If it’s like, “I actually feel like it’s a better option and this is something I would suggest and this is why. There are going to be pros and cons to it on both sides. There are going to be cons to having a VBAC for these. Here are the risks. There are going to be cons of having a C-section. Here are the risks.” Yes, there are risks to having a C-section. Also, if your provider ever tells you that there are no risks to having a C-section, that’s bullshit. I’m sorry. I’m saying. It’s the end of 2023. That is B.S. That is not true. 


    So, talking to your provider with open-ended questions. How do you feel about VBAC? Another question, “How do you support your VBAC moms? What does that care look like?” If they’re like, “Yeah, totally. It’s just going to be like normal. We might check you if you go over 41 weeks. We might want to do an NST or we might want to do this,” or something like that and it’s lining up with evidence-based. Okay, that’s to be expected. If it’s like, “Yeah, no totally. We love VBAC, but you have to have the baby by 41 weeks. It has to be spontaneous. You can’t induce. You have to get a just-in-case epidural.” Those are all, again, the B.S. answers that are going to tell you that you’re probably not in the right place. Have open-ended questions for these providers. 


    Number two– get the education. Educate yourself so that if you do have a provider coming in and telling you things that you are unsure of, you will have that resource to go back to and be like, “Oh, I actually do remember that and that’s not true,” or, “Yep, that’s right in line with evidence-based care.” It can also help you have a better discussion with your provider because you want that. They come in and they ask you. They say, “Do you have any questions?” They don’t really have a lot of time, honestly. These poor providers are overworked. They don’t have a lot of time, but too, it will help your time be better when you do go to those prenatals. 


    I remember going and they were ten minutes long and it took a lot of energy to get there. I’m just like, “Why? What is the point of these visits?” Make a point to these visits. Ask these questions. Learn the education so you can have those educated discussions and get a better feel for your provider. They can get a better feel for you. They can learn that they can trust you also because you are educated. They are not going to second-guess you if you are saying no to something that they are offering to you in labor because they know that you are educated. 


    Take a class. Listen to these podcasts. Read the blogs. Get into the Facebook communities. Learn about what people are saying. Read the links that are being shared. Education is important. 


    Another way to prep truly is finding the support even outside of your provider. I feel like if you can have the support and the sounding board, it helps so much. With my VBAC after two C-section baby, I had it, but in places– I loved it in the places that I had it, but it lacked in the places that I wanted it, from my family and friends. That was really hard. I think that’s also another tip for where education comes in because you can help educate your family and friends along the way when they are like, “No. You can’t VBAC. No way.” 


    Truly, finding that support is important, and also, prepping in a way that if you don’t have that support, let those people know that you love them with all of your heart, but unfortunately, you are not going to be sharing your desires and things. 


    Nutritionally and physically, be healthy. Eat good food. Get good supplements like Needed. Drink your water. Stay hydrated. Make sure you are trying to get at least 30 minutes of walking a day and staying active. Of course, if you have certain situations, you want to always make sure with your provider that it’s all in line with your birthing plan and your personal situation, but taking care of yourself is truly important. 


    As we have learned with Needed and things like that, we know we are not getting the nutrients. We know we’re not getting the hydration that we truly need every single day. If we can try and get that, it can help our pregnancy be better. It can help your birth be better. It can help in all areas and also mentally. I think if we are fueling our bodies with the right things, then we are truly going to be in a better spot. 


    Okay, so another question that I have seen here and there and even more in the CBAC community is, “How do you deal or how do you cope with not getting a VBAC?” Now, this can be hard and this can be sensitive. Sometimes we have things in our head or we are told certain things and then it’s in our op report and we were led to believe something that actually didn’t happen or we were led to believe something that actually wasn’t documented. I think that’s a really good way to process. 


    Really undersatnding that it’s okay to be mad or sad. It’s okay to feel those feelings, welcoming them in, and then working through the process step by step. I definitely think that knowing that sometimes we don’t know the answer and accepting that, we talked about that this year with our radical acceptance episodes. Sometimes not knowing the answer can hang us up and really, really impact us and bring us down, but knowing that sometimes we may not know the answer. We may not know the why. We may not know what happened and trying to accept that and let that go is really, really difficult. But trying to practice that radical acceptance is really powerful. 


    Yeah. There are so many questions along the way that we have been asked, but these are kind of some of the most common. Another one, I think probably the last one that I will share today is about an epidural. “Do I have to have an epidural if I have a VBAC?” No, you don’t. No, no, no you don’t. You do not have to have a “just-in-case” epidural if you are wanting to go for a VBAC. You just don’t. It takes time to dose an epidural, so I think if you look at it and you think about it you’re like, “It kind of makes sense. Okay. They place the epidural. It’s already placed. That can take some time.” But then they have to dose it and then wait, what? Maybe it doesn’t make sense, right? 


    Okay, so I’m just going to walk you through it. It sounds like it makes sense until you walk through it. So then they have to dose the epidural which then takes anywhere between 20-30 minutes to really work and get to a point where they can perform a C-section. So a “just-in-case” epidural, although yes, it takes the time of placing it, it doesn’t take the time of dosing. The “just–in-case” epidural is typically placed just in case there is an emergency. If there is a true emergency, they’re not going to have the time to dose the epidural and get it to a point that it is ready for you. They’re going to probably do general anesthesia at that point. 


    The “just-in-case” epidural, I think, is just bull. I don’t like it. I don’t like when a provider puts a restriction on someone like that. Like, “You want to go unmedicated? Well, okay. Sorry, you can’t. You can VBAC, but you can’t go unmedicated or you have to have a ‘just-in-case’ epidural.” Do you have to have an epidural?


    Another common question is, “Can I have a VBAC if I have an epidural?” Yes. Absolutely. Going unmedicated is not for everyone or if you want to go unmedicated and then you have a really long labor or something is happening and you decided to change your mind, that is okay. Women of Strength, plans change in labor. It changes all of the time. I see it time and time again through clients and through things. It doesn’t always mean the plan is to change from an epidural to no epidural. Maybe it’s from this to that. Maybe it’s, “I didn’t want IV fluids and now I need IV fluids because I can’t keep anything down.” It changes. Plans change, but yes, you can have an epidural with a VBAC and still have a VBAC.


    Know that if you are wanting to VBAC, but you are not wanting to go unmedicated, you can still do that. If you are wanting to VBAC and you want to go unmedicated and your provider is telling you that you have to have an epidural or you have to have a “just-in-case” epidural, that is also false. Find what works best for you and it all circles back to education and finding the support in the provider and in the system. 


    Okay, I lied. One more. Home birth. “Is home birth safe?” Yes. You can have a home birth. We have HBACs, home births after Cesareans, all of the time. We have them on the stories. We have them on the blogs. We have them on our Instagram. We see them in the community. Home birth is a reasonable option for VBAC. 


    Now, the providers and ACOG are probably not going to suggest it. We go off of ACOG a lot, but know that these providers are probably not going to suggest and out-of-hopsital birth, but can you? Yes. Can you do it safely? Yes. Are there signs of uterine rupture typically before uterine rupture happens? Yes. Usually, do you have time to get to another location? Yes. 


    So know that if you are desiring a home birth after Cesarean or even a home birth after multiple Cesareans like me, a VBAC after two C-sections, that is possible. It is totally, totally possible. 


    Women of Strength, I just want to thank you so much for all of your continued support. We see it on Instagram. We see it on Facebook. We see it in our group. We get it in reviews here. We love your support and we are so grateful that you are here. We truly are here for you because we love you. I know I’ve said this before. It’s weird for me to say I love you because I’ve never met you, but I do. I love you. I feel so passionate about helping you as an individual find the best path for you whether that is VBAC, whether that is CBAC, whether that is unmedicated, medicated, in-hospital, out-of-hospital, inductions, or spontaneous. I don’t even care what type of birth you have. I want to help you walk through this journey and feel loved, supported, and educated. 


    So again, if you are just with us, welcome. I’m so excited for 2024. We’ve got so many amazing things coming. If you have any questions about anything we offer on our podcast, our course, our blog or anything like that, always know you can email us at info@thevbaclink.com. If you’ve been with us and you’ve had your VBAC or you are still working for your VBAC or you are a birth worker or whatever it may be and you are with us and you have been with us forever, thank you from the very, very, very bottom of my heart. I truly love you and I’m so grateful that you are here. We will see you in 2024. 


    Closing


    Would 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/donations

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    33m | Jan 3, 2024
  • Episode 268 Radical Acceptance Part Two

    “I feel that what I would like to add to this radical acceptance part two episode is that yes, it is so important to feel all of the feelings, not judge them, and give them space to exist so that you can work through them and move on, but it is also equally important for you to not live there. 

    You cannot live with those feelings 100% of the time, 24/7. You have to allow yourself space to get out of that funk, go enjoy life, and feel happiness, light, and joy.”


    Women of Strength, we love you. We are proud of your healing journeys. We wish all the light and joy for you in this difficult, wonderful, exhausting, and rewarding season of motherhood. We are here for you!


    Additional Links

    The VBAC Link Podcast: Episode 251 Radical Acceptance Part One

    Julie’s Website

    The Lactation Network

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Meagan: Hello, hello everybody. You are listening to The VBAC Link and guess what? Julie is with me today. Hi Julie. 


    Julie: Hi. 


    Meagan: She’s actually looking right now for a message. We are going to do a Part Two of Radical Acceptance because we got so many messages on our social media and in our inbox and then even actually, some people who have my personal cell phone texted me about it and was like, “This episode did so much for me.” 


    We are excited to have a little follow-up. Julie did get a message in her business inbox, right? 


    Julie: Yeah. 


    Meagan: We are going to read a little bit about that. 


    Julie: Yes, so if you are coming in hot right now for the radical acceptance part two, you should go listen to the radial acceptance part one if you haven’t already. It’s episode 251, so go back, and yeah. It was such a good one. I got a couple of people reaching out to me as well on my business Instagram sharing about it and how much it touched them or helped them. 


    I’m going to read this review that somebody– well, it’s not a review. It’s a message that somebody sent to me. 


    Meagan: It’s a message and it’s in place of a Review of the Week. We are reading one of the messages that Julie got on her account. 


    Julie: Yeah, since we are doing Radical Acceptance Part Two, we want to read a message from Radical Acceptance Part One. She said, “Hey, I listened to the radical acceptance as well as your episode about home versus hospital birth–” That is also a good one. 


    Meagan: Yes, it is. 


    Julie: “I wanted to thank you for sharing. My son’s first birthday is tomorrow and I feel I got completely railroaded by the medical system. With this birth, I so appreciate you and Meagan sharing your stories and giving me hope that there is light at the end of this tunnel.” 


    I love that. It makes my heart happy. Obviously, since I’m not actively doing The VBAC Link or anything anymore, I don’t get as many people reaching out or whatever to connect in that capacity. 


    Meagan: You don’t see these messages. 


    Julie: I don’t see it, yeah. So it’s always fun when somebody pops into my Instagram DM’s and gives a little shoutout, so that was super fun. Thanks for that message. I don’t want to say the name just in case because it wasn’t a public message, but anyway. So yeah, we’re going to talk a little bit more about radical acceptance as a follow-up and then I don’t know what you would call it, like an addendum to it. Let’s do it. It’s going to be good. 


    Meagan: It’s going to be so great. Even after that episode, it’s been weeks now, months. I’ve had situations and I’m like, “I need to practice radical acceptance. I need to practice radical acceptance.” It’s so powerful and it’s so easy to use, I think, in all things in life. 


    Julie: Yeah, everything. 


    Meagan: Yeah. I think this episode is going to be super fun to follow up. 


    Julie: Yeah.


    Meagan: Okay, you guys, it’s almost Christmas and we have had so many amazing episodes, but like we were saying in the beginning, this episode is piggybacking off of one of my personal favorites that Julie and I have done together all year. 


    So we’re going to get into it. Julie, you said that you had a story. Do you want to start off with that or do you want to talk about feeling everything, and what we were talking about a little bit?


    Julie: Yeah, yeah. I’ll share the story because it’s a good segue into the little addition or whatever to it. So I was at– well, it’s two stories really. So anyway, I was at a birth circle, and pregnancy group down near me and I like to go every month because I like to meet everybody and adult interaction is always fun because being a stay-at-home mom or a slave to your computer all day can take its toll. I go to socialize and meet people and things like that. 


    One of the girls there had her baby and her birth didn’t go as she wanted. This was her rainbow baby. She had a late-term loss with her previous pregnancy, then this pregnancy started taking some– not scary turns– turns where you are just like, “Oh, now we’re a little bit worried about the health of mom and the health of baby.” 


    She has a lot of stuff to work through already going into the pregnancy, right? Then the birth, the baby was healthy and everything was well with them physically, but she was triggered by how the birth went. There were some traumatic things that happened during that birth too. She was well-respected and well-cared for. She had a great birth team. All of those things are great, but she left trying to process the whirlwind of this birth along with still holding onto the loss of her prior pregnancy. 


    At the end of the circle, she took some time to share her thoughts and feelings. She was like, “Guys, I just need help. I don’t know how to process through this. I don’t know how to get through this.” She was like, “I just don’t know what to do.” 


    So me, being the talker that I am, I just told her kind of similar things that we talked about in the radical acceptance episode and said, “Just allow yourself to feel it. The fastest way to get through it is to feel it and sit with it and let it happen and be. Don’t judge it. Don’t give it a morally right or morally wrong. Your feelings are not morally right or morally wrong. They just are. You need to let them be. You don’t have to judge them or assign them or logic them or anything. You just have to let them be.” 


    She was like, “I am getting really good at feeling all of the things.” She was like, “I’m doing really good at feeling everything. I just don’t know how to get out of it. I feel like I’m stuck here in this cycle of feeling.” 


    It took me to this other conversation that I had with somebody who was similar. Similar things, we all have things. We all have things that we need to work through and process and deal with and radically accept or whatever, right? But it was another conversation I had with a good friend who was going through some really, really hard things. He actually ended up in a really bad, downward spiral and ended up checking himself into a mental health facility for a couple of weeks to do some trauma work and get on the right medications and stabilize himself. 


    When I talked to him after he came out of the things, he said that his problem was that he was spending all of his time in the feeling bad and miserable stage. I don’t know if the right word it wallowing, but he was wallowing in that discouragement and that frustration and in that sorrow and in that struggle. He was allowing himself to live there. 


    Meagan: It’s consuming. 


    Julie: I think that other friend too, yeah. It was enveloping his whole life. I feel like my friend who was at the birth circle was in a similar situation allowing herself to be overcome by all of these feelings. It’s a tricky balance, right?


    I feel that what maybe I would like to add to this radical acceptance part two episode is that yes. It is so important to feel all of the feelings and not judge them and give them space to exist so that you can work through them and move on, but it is also equally important for you to not live there. You cannot live with those feelings 100% of the time, 24/7. You have to allow yourself space to get out of that funk and to go and enjoy life and to feel happiness and light and joy. 


    You have to give yourself space for that because if you don’t, you’re going to end up in a downward spiral and you’re never going to come out of it. I mean, probably not never, but it’s going to be a lot harder too. 


    I told my friend at the birth circle, I’m like, “You can’t live there. You can’t live there so go and do something fun. Go to a show. Go to a movie. Go paint pottery or get a massage or go on a hike with your kids or something like that to create joy and allow space for the light to enter even though it might feel really hard. You have to give yourself a break from feeling all of those things.” 


    Meagan: Yeah. I think that it can be hard sometimes to recognize that you need that break because we are “wallowing”. 


    Julie: I know that it’s a horrible word for this context.


    Meagan: But it’s really easy to get there. It’s really easy to be in that space. Sometimes, like the message that you got. She was realizing that there is a light at the end of the tunnel, but sometimes that tunnel is so dark that we see no light. 


    Julie: Well, and sometimes we don’t think that we don’t deserve the light. 


    Meagan: Yeah. 


    Julie: Right? We’re like, “Oh my gosh. I made bad choices. I should not have done this. I deserve to feel like this,” and then we live there forever. I did. I can recognize moments of my life where I was so living in that darkness because I thought I was not worthy of the light. I got chills right now. I feel like we have all probably been there in one context or another. 


    Meagan: Yeah. To some people, that thing that caused us to get there may be minute, right? Just tiny, tiny to somebody else, but it’s huge to us. It’s the same thing, so it goes back to not judging and understanding that everyone is going through their own journey and not judging. There are some things that you could be like, “Why are you upset about that? That’s not that big of a deal.” 


    Julie: You have done that to me before. 


    Meagan: I’m sure. 


    Julie: I have done that to you before too actually. 


    Meagan: It’s hard because I don’t understand, but it’s not up to another person to understand it. It doesn’t matter if they don’t understand. We are going through it, but we also have to understand that, okay. We feel this. We see this. We recognize this. Now, let’s get out and not, like you say, live in this feeling and let that feeling consume us. 


    Julie: Well, and it’s so important. You keep going. I have a little ritual I was going to tell you about. 


    Meagan: You’re just fine. I was just going to say that back to the first episode when we talked about, were our Cesareans needed? 


    Julie: We have no idea. 


    Meagan: I just had an interview with a mom this morning who had some hypertension. Not preeclampsia, just some hypertension at 36 weeks. At 37 weeks, she went in for her visit. Still hypertension, again, no preeclampsia or anything like that but they said, “We have to induce you today.” 


    You guys cannot see Julie’s facial expression right now, but she’s like, “Oh, yeah.” 


    Julie: Sorry. 


    Meagan: But yeah, I was listening to this story and I’m like, “Okay, well do you remember what your numbers were?” Anyway, she had hypertension. She agreed to be induced. They did all of the things and after not very many hours said, “Well, this is probably not going to work. We’d better have a C-section.” Had a C-section, and things all happened. 


    She was saying, “At this point, I’m at this spot of, was any of it necessary? Was an induction necessary? Was breaking my water at that time necessary? Was this necessary?” Those things, if we are just living constantly in the hamster wheel of questioning, it can make our hamster wheel dig right down into the dirt and like you say, we have no light. 


    Then we start shaming ourselves because it’s like, “Well, I should have known more.” Right? 


    Julie: That’s one exhausted hamster, Meagan.


    Meagan: You know me and my hamsters, Julie. 


    Julie: I love it. 


    Meagan: But then there’s no light. We’re blaming ourselves and not deserving the light because we’ve dug it so far. I’m not saying this mom is that deep or anything like that. I’m just saying things like that can make us go so far down and so dark. It’s really hard to get out. 


    Julie: Yeah. My gosh, I get that. I see that pattern in my life in all parts of my life. This is the part where radical acceptance comes in. I have gotten to the point where, yes. I have accepted that I will never know if my C-section was necessary or not. I mean, it probably was. I know the baby needed to get out so the induction was necessary, but I don’t know. Who really knows? 


    But there are just so many other things in my life. It’s really funny because my C-section baby is now 10 and he has some things that he’s struggling with, like some mental health things. He’s in therapy and we talk. Every once in a while, I let my mind wander and I’d be like, “What did I do in his early life to cause him to have these struggles right now?” 


    If I let myself get into that spiral, I would be a hot mess. I probably didn’t do anything, but I might have. I feel like all of our kids are going to need therapy at some point because we’re going to mess them up in some way. We all try to do better than our parents. I don’t know, maybe not all of us, but I try to do better than what I was given. I want my kids to have a happier life and be more successful and be happier and not have to deal with all of the struggles that I did. At the same time, I realize that in the struggles is where we grow. 


    Meagan: Exactly. 


    Julie: A muscle that does no work doesn’t get strong. You have to strain the muscle in order for it to grow and become stronger. That’s where the repair happens. When the repairs are happening, that’s when the strength comes. He’s probably going to be fine. He’s a great kid. I love him. But every once in a while, my mind will start down that path and I have to correct it and be like, “We’re addressing things now. It doesn’t matter what happened in the past. We’re going to live in this moment.” 


    I wanted to share this ritual of something that I do before a birth sometimes when I enter the birth space that I think could probably help in this context. Sometimes it’s really, really hard when you’re in a funk and you’re in a mood and you’re living your life in a state of regret and in unworthiness and you feel not worthy of the happy things or you feel like you’re never going to be happy again, how do you get out of that?


    This came to my head while we were talking. Sometimes, in fact a lot of time, when we get the call to birth as a doula and as a birth photographer, it’s not a convenient time in our lives. 


    Meagan: No. You can say that again.


    Julie: It’s 3:00 in the morning. 


    Meagan: Or a soccer game. 


    Julie: You have to leave a soccer game or you have a football game. Okay, so it’s been eight football seasons since I started birth work and I’ve only had to miss one football game. I got to watch it while my client was in the OR while my client was doing her C-section. I turned it on while my client was in her C-section. That was a few years ago, but anyway. 


    It’s not a convenient time. Sometimes, you are in the middle of a fight with your spouse. And it’s fine because we do this work. There are lots of other great things about it, but sometimes, it is hard to separate your mind from the rest of your life before you go into the birth space especially if you are in a bad mood or having a hard day, you don’t want to walk into that birth space carrying all of your baggage. You just don’t. 


    I have this thing I do when I’m on my way to birth or when I get to the parking lot unless mom is pushing, then I’m running my butt into the room as fast as I can. 


    Meagan: You can’t even think about anything that’s happening in your life at that point. 


    Julie: Yes, exactly. It gets shoved down. What I like to do and what I think is applicable here is after I park my car, I sit down. I take some big breaths in because we know that big breaths give oxygen to all of your body parts and help you. I just like to put my hands to my forehead and just pull out what’s going on in my life. I put it in the seat next to me. I physically do this because that physical motion helps so much. 


    I’m like, “Okay. You are not forgotten. I’m going to leave you here until I get back and until I’m done with my work. I am pulling my thoughts out of my head and I”m putting them in a little package on my passenger’s seat.” I will be like, “This argument with Nick (my husband), I’m going to get to when I get back. This problem with football, if BYU is losing or whatever, I’m going to leave you right here and I’m going to talk crap about it to Nick when I get home. This problem going on with my son and if he’s going to make it to therapy today, I don’t know, but I’m going to leave you right here on my seat. I’m not ignoring you. I’m not trying to brush you off. I’m leaving you here so that I can pick you up when I get back or when I’m ready for another thing and when I’m ready to talk to you again. 


    I feel like that practice might be helpful in these circumstances. You can feel your feelings. You have to feel them to get through them, but when you need a break, when it’s time for that reprieve and that joy and that happiness, pull them out of your brain. Put them in a little box in the passenger’s seat of your car, next to your nightstand, or whatever, and say, “I hear you. You are here. You are real. I’m going to feel you later. Right now, I need a break to go be happy.” 


    Meagan: I love that. I love that. And yeah, like you said, we can apply that to anything. I think when we are preparing for a VBAC, there is a lot of clustered thoughts happening in our mind. We’re thinking about who to find as a provider, if we should hire a doula, if we can afford these things, where we should birth, if my risk is okay, and if this risk is okay with me. We’re going through all of that and then we have all of the outside people saying, “You’re going to what? You can’t. How would you even dare?” 


    We already have the pressures of our everyday life, and then we have the other static on top of it when we are preparing for VBAC. I remember multiple nights, especially during pregnancy when I couldn’t even fall asleep because I was so wrapped up in my mind. To be able to pull that out and be like, “I’m going to set that right there. I’m going to rest so I can come back to you with a fresh mind so I can tackle this saying or tackle this topic with a fresh mind and fresh body.”


    Again, like you said, you’re going into a birth. You’re removing these thoughts. You’re going into that birth. You’re holding space for that birth. I think that’s important to note. We have to hold space for ourselves. We have to. Like Julie was talking about being worthy of even having that light, we have to be worthy of giving that to ourselves and saying, “We’re going to stop. We’re going to take a minute and put this over here. We will come back when I’m ready, but until then, you’re just going to be right over there.” 


    Julie: Yeah, absolutely. Yes. I love that. Sorry, I’m trying to collect my thoughts. I think it’s really important that you allow those feelings 100% of your energy and that space, but you can’t give it 100% 100% of the time. It’s important to allow yourself that space and that break. Carve times in your life. Maybe you have an hour a day where you allow yourself to feel and address and work with those feelings or something like that. Maybe it’s before bed after the kids are in bed and you have some quiet time. 


    I don’t know about you, but sometimes my self-care is when I get home, I sit in my car in my garage for 5 or 10 minutes before I go into my house to kids and dogs and husband and chaos and everything. I allow myself that break between driving and doing the activities to go back. Do you do that? I feel like moms do that. 


    Meagan: I totally do and then my husband or my kids will open the garage door and be like, “What are you doing?” 


    Julie: Open the door and be like, “What are you doing?” 


    Meagan: “I heard the garage door open 5 minutes ago.” I’m like, “I am sitting. I am just holding my own space for 5 minutes.” 


    Julie: Yes, regrouping. Yes. It doesn’t have to be an hour. It can be a few minutes here and there and when you’re in it and when you’re feeling it, it’s important to give it your 100%, but don’t do it 100% of the time. 


    Meagan: Well, on that note, we will end with that. But know that is exactly what she was saying, you don’t have to feel it 100% of the time. It’s okay to take the moments. You do not have to live in this feeling. There is a light at the end of the tunnel. 


    If you are in this space, know that we are here. We are here. If you have a question about VBAC and you want to get that thought out of your mind and that is to get that question answered, email us. Write us on Instagram. Comment on these podcasts on your platform. We get them. We would love to talk about it with you and help you clear out the thoughts and the feelings and the emotions. We’re not therapists, though. I remember Julie said that in the beginning. We are not licensed therapists. We are just two ladies who love birth. 


    Julie: Yes. This is not taken as medical advice. 


    Meagan: None of our VBAC Link team members are trained and skilled in therapy or anything like that, but I just think these messages are powerful and thank you so much, Julie. 


    Julie: You’re welcome. Always a pleasure. 


    Closing


    Would 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/donations

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    26m | Dec 20, 2023
  • Episode 267 Caitlin & Chrisie from The Lactation Network + All About Breastfeeding

    Here at The VBAC Link, we want to empower you with better birth experiences AND better postpartum experiences. The Lactation Network does just that. 


    Caitlin McNeily is Vice President of Consultant Relations at The Lactation Network, working closely with thousands of International Board Certified Lactation Consultants in all 50 states. Her background in medical device sales led to the creation of Ashland Breast Pumps. It was through this work– connecting with new parents desperate for help– that led to The Lactation Network.


    Chrisie Rosenthal is an International Board Certified Lactation Consultant and Director of Lactation Content and Programming at The Lactation Network.

    She has helped more than 7,000 families through her successful private practice, The Land of Milk and Mommy. She's worked alongside large pediatric practices in Los Angeles and as a hospital-based IBCLC. In addition, Chrisie is the author of two best-selling breastfeeding books: Lactivate!: A User’s Guide to Breastfeeding published in 2019 and The First-Time Mom’s Breastfeeding Handbook: A Step-by-Step Guide from First Latch to Weaning published in 2020. 


    Caitlin and Chrisie are both moms who had breastfeeding struggles of their own. They are passionate about helping other moms have the care and advice they wish they had!


    Additional Links

    The Lactation Network

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Meagan: Hello, Women of Strength. We have an amazing episode today for you with our friends, Caitlin and Chrisie. They are from our favorite, The Lactation Network, and are IBCLCs with The Lactation Network. 


    We are going to get into the topic of how The Lactation Network came about but also, all of the questions and what it means to work with The Lactation Network and an IBCLC. We talk so much about preparing for birth and then birth. We talk a little bit about postpartum. We are starting to get more into postpartum because it is a really important topic, but this is a topic that is near and dear to my heart because I have had three babies and three pretty different experiences. I’ve had some challenges along the way, so we are excited to welcome our guests today talking about breastfeeding and pumping and going back to work and all of the things and what it looks like to work with an IBCLC through The Lactation Network. So, welcome ladies. 


    Caitlin: Thank you. We are so excited to be here. 


    Chrisie: Thanks, Meagan. 


    Meagan: So excited to have you. I think maybe we can just start off right off the bat with what is TLN? We’ve been talking about it for a little while now, but what is The Lactation Network? How did it start and where are you today? 


    Caitlin: Yeah. My name is Caitlin McNeily. I am the VP of consultant relations at TLN. TLN stands for The Lactation Network. We are the largest network nationally in the U.S. of IBCLCs, lactation consultants for short, but IBCLC stands for Internationally Board Certified Lactation Consultants. 


    I am based in Chicago and have been with TLN since its inception and have seen it through a couple of iterations and have watched it grow as my fourth baby, as I sort of lovingly refer to it as. I do have three kiddos of my own– 13, 11, and 8. I had very different nursing experiences with all three of them. All three of them were C-sections and all of those were equally as different. 


    So you know, when starting TLN, so much of it was very much in my wheelhouse at the time. I was pregnant with my third baby and going through that whole process. I wish I knew then what I know now about all of the amazing support that a lactation consultant can offer. 


    The way that TLN was born, I think, is relevant to cover briefly but essentially when the Affordable Care Act mandated coverage of breastfeeding support and supplies, I was brought into a company to start a breast pump, what we call a DME which is a durable medical equipment company. I won’t get in the weeds there, but essentially, we provide equipment directly to patients and we handle the insurance component. 


    It started with the breast pump DME, getting parents the essential tools that we need, certainly in the U.S. with limited maternal leave. We certainly need breast pumps if we expect them to continue their breastfeeding journey. 


    That was where the business really started. Roughly 12-18 months into that endeavor, a lot of these parents were calling me back postpartum saying, “Hey, you were really helpful at getting me a breast pump, but now I’m really struggling with my breastfeeding journey. Can you help me?” I myself am not clinical, so it wouldn’t have been appropriate to try and troubleshoot their nursing issues. I leave that to the experts now. 


    At the time, what happened was I reached out to an IBCLC locally here in Chicago and started sending her on some visits. Now, because the Affordable Care Act mandates that this care be covered, it was seemingly going to be a smooth transition from breast pumps into breastfeeding support. There is some lack of understanding, a lack of a pathway into insurance reimbursement for lactation care and I met that head-on by working directly with insurance providers and working through some new pathways that they could adopt to be able to cover this care for patients. 


    As soon as there was progress made there with some insurers, we were sort of off to the races. Then what happened, was more lactation consultants were hearing about us. I was reaching out to more lactation consultants around the country as our patient base started to grow. It was very much an organic growth process, very supply and demand if you will. 


    Now, our first visit was in 2016 so fast forward to 2023 and we’ve helped over 300,000 individuals with their breastfeeding journeys. 


    Meagan: Wow. 


    Caitlin: Yeah. It’s a huge nod to the exceptional care of our IBCLC network. It’s also really just standing up the reality that parents in this country deserve lactation care. I think a lot of times, we get very stuck in the conversation or drama or consideration around breastfeeding when the reality is lactation care is human health care. 


    When you birth an infant, you are going to experience lactation on a variety of levels and in a variety of facets. However, this is a physiological and biological reality of the birth process and bodies that birth babies and lactate deserve healthcare surrounding that. 


    Meagan: Amen. 


    Caitlin: That is just our steadfast mission is to make this care accessible to all birthing families. 


    Meagan: I love that so much. I love that you say lactation care in general because we are all going through different experiences. We all have these babies and then we are like, “What do we do with these things that are making milk? How do we feed these babies and how do we go back to work?” And all of the things, right? I love this network so much. I can literally scream it to the rooftops, you guys. This is amazing and it should be something that everyone gets. 


    So you work with insurance, but are there still insurances that maybe aren’t quite there yet? How does that factor in? 


    Caitlin: Yeah, yeah. That’s an excellent question. We are dogged in our pursuit of expanding lactation care within insurers that we do work with currently and expanding it into different pairs that are not currently working directly with The Lactation Network. We have no intention of stopping that mission or slowing down that mission. Our goal is to hold insurance companies accountable for this very essential care. 


    The economic argument, the healthcare outcome argument– these things are black and white. There really is no gray area as it pertains to the benefit of taking care of lactating parents. In addition to insurance, understanding the importance of this care and the true economic value of this care, employers are starting to perk up as well meaning they want to make sure that when one of their parents goes out on maternity leave that they are set up for success in this arena because the statistics of predominantly women of childbearing age dropping out of the workforce to take care of their infant and their health and their mental health and their homes and all of those things. 


    It can’t be overstated how beneficial it is for employers to take care of their employees in this capacity. They will have easier times recruiting. They will have easier times retaining top-tier talent. This generation of women having babies and families bringing babies into this world are very contemplative when they choose what business they want to enter into agreements with. So much of that right now is based on the benefits base. They want to know that their employer is going to support their endeavors at home to keep them productive at home and happy at work.


    Meagan: Oh my gosh. Yeah, when I was working, I had my daughter and then I went back to work. I just remember the stress of, “How am I going to do this? How am I going to pump and keep my milk supply and feed my baby and do all of these things?” At the time, my work was like, “I guess you could go in the back storage room.” That was about all they gave me, then I was like, “Okay, well the milk has to be refrigerated.” They were like, “No. You can’t. No. Bring a cooler.” 


    So every day, I was trucking in this big pump and this cooler and all of these things. It would have been so nice to have more of that support. I probably would have stayed longer-term maybe. I don’t know but it would have been nice to not feel– I mean, I still felt more support than I know some, but I still was like, “This is weird. They are not gung-ho about this.”


    Caitlin: Yeah. It’s not ideal. 


    Meagan: Yeah. It wasn’t ideal. 


    Caitlin: It’s not ideal. Yeah. I think to paint the picture of what is available through The Lactation Network for those types of parents, it doesn’t matter if you are staying at home or going back to work. It’s not a one-size-fits-all-all, but the lactation care cadence that should be commonplace is that it should be preventative. That is where it falls in the Affordable Care Act. This is preventative care because as I mentioned before, your body is going to do this. 


    Much like we go to scope out a pediatrician prior to the baby being born and then we go for our 7-day check-up and all of these things, we are really passionate about trying to shift the paradigm to match that type of preventative care as it pertains to lactation. What that can look like is a prenatal visit, a 3-day postpartum visit– so the day after you get home from the hospital, and then we can have adjustments because baby adjusts so much as your milk comes in and those first two weeks are so substantially different. You can have a troubleshooting visit. You can have a plan to go back to work and create a pumping schedule visit, storing milk. 


    Occasionally, we’ll run into a case of mastitis or clogged ducts. Oftentimes, when a parent goes back to work, their milk supply can drop a little bit. It can be just trying to engage in a new schedule with your breast pump, engage in a new schedule with waking up early, stress,  hydration, and eating at work. Those things can all play into your milk supply. Working directly with a professional to a) set your mind at ease, but also to adjust that plan accordingly. 


    Those visits can go all the way through weaning. This is really a journey. It’s a personal journey and this is where I would love to kick it to Chrisie because we are so fortunate to have her at TLN. She is just a top-notch human being and IBCLC on top of it. I think she can shed some light as to why TLN is so passionate about the IBCLC certification and why we only work with IBCLCs. 


    Meagan: Yeah and more even on what IBCLCs truly do. We are talking about what those look like, but what more do you do, Chrisie, for parents? 


    Chrisie: Yeah, thank you, Caitlin. I’d love to start with just what an IBCLC is because I think that there is a lot of confusion in the space of lactation caretakers to use that word, right? Lactation providers. IBCLCs are unique in that we are the highest credentialled healthcare providers specializing in lactation. We are truly the gold standard. 


    One of the things that exists– and I always say that I love all of the supporters. I love all of the educators. There is a place for everybody, but I think it is important for families to know what differentiates an IBCLC. IBCLCs typically, it takes about 3-5 years to become an IBCLC. That includes a program that takes 90 hours of education in human lactation, coursework in 14 health science subjects, 300-1000 hours of supervised clinical experience, and then passing boards and recertifying every five years. It is definitely an in-depth program and process. 


    Meagan: Very. 


    Chrisie: Yes, absolutely. At TLN, we only work with IBCLCs. I think that’s important to mention. We connect these families with that gold standard in lactation care. As IBCLCs, we are working with the pediatrician and with the OB. We are focusing on the parent-baby diad and what breastfeeding looks like. Consultations definitely differ from LC to LC. We all do it a little bit differently, but in a typical consultation, we’re going to meet. We’re going to go over your medical history. We’re going to do an in-depth, deep-dive into how feeding has been going. 


    We will probably observe a feed if that’s applicable. We’re going to talk about your feeding challenges, your feeding goals, where you want to go, and what’s getting in the way of that. I always make lots of space for parents to ask whatever questions are on their mind and make sure I share evidence-based information, then at the end, we’re going to create a plan for a follow-up and a plan for how to get from A to B and solve whatever issue it is that we are looking at. 


    That’s typically what a consult looks like. As I said, we’re all a little bit different. I stay in touch with my patients in between consults. You know having been there that questions pop up all the time, just little questions. How long can I leave breastmilk out for? Just little things, especially if you’re a first-time parent. I always say that even for parents who have done this before, every baby is different. Every breastfeeding experience is different so as Caitlin said, really think of LCs as being there from beginning to end, from prenatal to weaning is so important. We know that it makes an incredible impact on the breastfeeding journey for parents and for babies. 


    Meagan: Oh my gosh. Yes. I mean, I wish because I had a baby and then I was meeting with an IBCLC days later but I was already days behind in engorgement and a really upset, hungry baby. It wasn’t that I couldn’t feed my baby, it was just that my boobs were really rock-hard. I remember when I met with an IBCLC, she was like, “It would be really hard for you to latch onto a rock,” with my mouth like this. She was like, “We’ve got to soften these up.” I was like, “I don’t even know.” I was just a mess. If I had had that care before I had my baby, we would have been able to do exactly what you said– go over my plans, go over my goals, and come up with things to look for and what to know, then I would have had your help way before I was days past my breaking point of my husband being like, “I’m going to the store,” and I’m like, “I just want to feed my baby!” 


    Chrisie: Exactly. I think that happens all the time, Meagan. I think that families are starting to take prenatal breastfeeding classes which is amazing. I always recommend my families do that. I think a piece that really needs to come to light is the value of prenatal consultation. It’s exactly what you are talking about. Meet with your IBCLC one-on-one consultation before baby is here. I highly recommend doing it if it’s not your first baby and if it’s your second baby. Talk about what happened last time. Talk about a plan for ideally how to avoid those speed bumps the next time.


    Also, if this is a new IBCLC to you, you’re going to get a chance to connect with them before the baby is here and find out how they work and find out if you will work well together. Is this the person you want to support you in your breastfeeding journey? But to your point, we’re also going to talk about how to navigate those first few days, how to reach out for help, when to reach out for help, common speed bumps that happen including engorgement which you just mentioned, and how to navigate that. It really lays the foundation for getting off to a good start. 


    Meagan: Absolutely. I just think it’s so beneficial and what’s so great about The Lactation Network is that it’s really so easy to get a consult and get going. You’ve made it so easy. It’s a matter of clicking, filling out a form, and starting your consultation. Right?


    Chrisie: Yeah. We have IBCLCs across the nation in every state. If you don’t have an IBCLC, we will connect you with one. We will check your insurance to make sure we can get you covered, then right. It’s just a matter of scheduling. The other thing that I think is really important to mention is that IBCLCs practice in different ways. We have IBCLCs who do home visits, who have offices that you can come to, and who do virtual consults. Many of my families like a combination of those. They might start off with an in-person but then maybe move to some virtuals for follow-ups. There are lots of different ways to do this. 


    I also think that sometimes people if they don’t know what to expect in a lactation consult, they might feel like– I’m just going to give you an example– they have to do a feed or maybe they have to do a feed virtually and that’s not always true. I think maybe they picture a very invasive physical exam. That is not true. 


    So I also think that another thing that comes up is home visits. Sometimes people worry about, “Oh my gosh, postpartum. My house is a mess. I don’t want anybody to come in.” Oh my gosh. Don’t worry for a second about that. That is the farthest thing from our minds as LCs. We will come to you in the space that is most comfortable for you, take care of you, and make sure you have all the information and support that you need. 


    Meagan: And truly make our lives easier and take out the question even before birth. There are different types of birth. Even like Caitlin just said, she had three C-sections. I’ve had C-sections. There are vaginal. There is VBAC. There are unexpected C-sections and planned C-sections. There are a whole bunch of things that happen in birth. We know that medication, fluids, and all of the things that happen– trauma responses and all of these things can impact maybe how and when our milk comes in. 


    Then also, our mental state. I remember with my first, I came out of my C-section and I just remember being in my hospital room dozing off, coming up, and then there was a new person holding my baby. Then I’d doze off and wake up and then a new person was holding my baby. All I could think was, “What’s going on?” That’s all I could think, not, “I need to feed my baby. Everyone needs to leave. How do I feed my baby? I’m not awake enough to feed my baby.” 


    You know? Should I have started pumping? There are all of the things. Do you guys have any tips even before scheduling a consult that would maybe say, “Hey, look out for these or do these things? Different births can impact the way that milk comes in and things like that.” 


    Chrisie: Yeah, I think it is important to acknowledge that especially in the first few days how the birth that you have absolutely does impact your early breastfeeding experience. In fact, I recently found a study that points out that women who deliver by VBAC are 47% more likely to initiate breastfeeding than women who deliver by a scheduled Cesarean. 


    Meagan: Whoa. 


    Chrisie: I know, right? I felt like that was a little shocking when I saw that. We know that women who deliver via Cesarean birth are more likely to experience early difficulties with breastfeeding. They are less likely to have their baby to breast within 24 hours. All of that to say, it’s an added layer of significant complication in terms of initiating breastfeeding. 


    I always like to tell my families, and in a prenatal consultation is definitely something that we cover, what your birth plans are, what your birth history is if you’ve had a baby before and how that will impact breastfeeding and what your struggles were the first time. I’m going to give you another example. If you have a long labor and you have a lot of IV fluids, that can postpone your milk transitioning. It can make it harder for your baby to latch. Your baby is more likely to lose a lot of weight quickly which means your baby is more likely to be supplemented in those early days, especially in the hospital. 


    All of these have a real impact. Those are the things we are going to cover. With a Cesarean, there are positioning considerations. We’re going to probably move that baby off of the torso and find positions that are more comfortable. Typically, these challenges are surmountable in the first few weeks so I never want to paint the picture that these are things that we can’t have a plan for, but I think having a plan is key. Having the support is key. 


    Having those conversations and having somebody that you can reach out to when you are experiencing any breastfeeding difficulty. 


    Caitlin: I would like to piggyback on that. I think that a lot of people are like, “Well, I’m not one of those people who has a birth plan,” because the joke is always as soon as you make your plan, it changes. 


    Meagan: It all goes out the door. 


    Caitlin: Exactly. But I do think to Chrisie’s point, in hindsight, my first C-section was emergent and I was put under for it. All was well. Everything worked out, but even for my second and third, I wish that I had spoken up about different things. If I have to go under again, this is what I want to have happen. Remembering that when you’re in your labor and delivery suite, let everyone know, “Hey if this does have to go to a C-section, I want it communicated to the OR that I want the baby put on my chest immediately after delivery. I want it communicated that my intention in PACU is to immediately initiate breastfeeding and get skin-to-skin. 


    Those are things where we can have all of the best intentions in the world, but it is worthwhile just thinking through some different scenarios. I think it is helpful to quell any of that anxiety because to Chrisie’s point, these things are out of our control and that is totally the job of the medical professionals to take the best care of us and our babies, but it is definitely possible to just have some of those high-level thoughts and conversations. 


    For my daughter, she was my second C-section. I was conscious, but even then, it was sort of not really outwardly known that you could request immediate skin-to-skin, and then in PACU, the nurse wasn’t really working with me on breastfeeding very much. I lost some of that time and skin-to-skin that you only really realize later because you’re so in this mentality. It’s just such a whirlwind in the best possible way. They are the greatest moments ever, but really put pen to paper and think through some of those different scenarios. 


    That’s why that prenatal visit with an IBCLC is so amazing because when you are meeting with your OB, they are really just making sure that everything is going smoothly. That’s not to say that they are not spectacular. Doulas are certainly helpful in getting some of these plans together, but as it pertains to breastfeeding and the potential different delivery methodologies, an IBCLC is really the best person to set you up for that type of success. 


    Don’t overlook it. We can’t get all of the answers from Google. Breastfeeding is a very biological experience. We tend to like a lot of quick answers and quick fixes. Just knowing that you have time, relax into it, and reach out for help. It’s definitely the way to be prepared. You’ve made your Pinterest-perfect nursery. Let’s focus on what the actual delivery and feeding is going to look like because right after that baby arrives, that is where all attention goes. 


    Meagan: Yeah. When we actually started talking about TLN, we had someone write in. She was like, “Can I do a review on an IBCLC and how important it is?” It impacted her. She had three C-sections. She had a history of getting mastitis with every single baby so she ended up working with an IBCLC before she had her third C-section that was planned and they worked on all of these things. She was able to avoid all of the things that she had last time. She was like, “She was literally at my hospital bed the day I had my baby.” They had scheduled it because it was a scheduled C-section so she was like, “I will come. You tell me when.” She was like, “It was so impactful. It made my experience with my newborn so much more powerful,” because she was able to take out the stress and the question and all of those things and have more of that Pinterest-perfect birth experience. It was so powerful for her. 


    I think it’s so important to talk about those things. You know, she said, “If you can, get skin-to-skin in the OR. Do these things and then I’ll meet you later.” She did all of those things. She just said it was totally life-changing. 


    Caitlin: I’m happy that you brought that up, Meagan. I think a great question for your delivering hospital is, do you have an IBCLC on staff and will I be able to see them? Because having one on staff doesn’t mean that you will be able to see them necessarily. If it is an extremely busy, university-setting hospital, they may have four or five lactation consultants, but they are really, really regulated to NICU. So ask those pertinent questions because once you’ve had your prenatal visit with a TLN IBCLC, you have their contact information. You can even, if you’re having a C-section, schedule your first postpartum visit for the day you get home or the day after you get home depending on how long you are going to stay in house. There are really ways to be so prepared in that capacity. 


    For in-hospital care, it’s really important that you know going in if you’re going to have that bedside care from a hospital-based IBCLC. That would definitely be a valuable question to ask when you are preparing to deliver. 


    Meagan: Absolutely. 


    Chrisie: I will also piggyback on that. It’s such a great point because having worked in a couple of big hospitals here in Los Angeles, and I don’t know if this is true for every hospital, but even if there is a hospital IBCLC, we are often stretched pretty thin. One of the things that I tell my families when I connect with them prenatally is to request to be seen by an IBCLC when you move to the postpartum floor. I know from my experience that families requesting to be seen were at the top of the list. The next group was the patients that either the nurses or the doctors wanted to see to round on. 


    The third group who might not get seen are the families that seem to be doing okay and haven’t asked for a visit. Again, that was my experience, but I think it helps to ask. That’s a great thing to have your support person do to advocate for you. Ask your nurse or the charge nurse to have the IBCLC come by every day when you’re in the hospital. 


    Meagan: Yeah. I mean, one of my experiences, and this is why I think having an official lactation consultant, an IBCLC, is because I did request and they said, “It’s the weekend. They’re not here.” So to your point and to Caitlin’s point, asking ahead of time, “Hey, do you guys have IBCLCs? Not only do they have them, but do they work 7 days a week?” Because I was on the weekend and then I had these C-sections and then days later, I finally found an IBCLC and I was so far behind when I maybe could have connected. Maybe it could have even been a virtual like, “Hey, how does this latch look? It’s hurting,” or all of these things. We could have nipped a lot of problems in the butt honestly. 


    Chrisie: Exactly and then to compound that issue, I often hear from families that while they are in the hospital, they will hear a lot of conflicting information about breastfeeding from different care providers and it’s so frustrating for them. Most families are coming from the place of, “I’ll do whatever I should be doing, but please provide a consistent plan.” That is where either the IBCLC on staff or the IBCLC you’ve connected with prenatally can jump in and help you and be the person who clarifies that plan for you and gives you a way forward.  


    Meagan: Absolutely. Well, we have some questions that people from our VBAC Link community on Facebook asked if you don’t mind. I would love to ask some of them. 


    This one was from a mom. It says she is due in April. It says that she is a stay-at-home mom and has a toddler as well. Her goal is to exclusively nurse because she thinks that pumping will be too much. “How do I navigate nursing a newborn and caring for a toddler’s schedules, general trips, etc.” She nursed and pumped last time. 


    Chrisie: Such a great question. First, again, huge plug for a prenatal consult right there. Let’s have a plan. Let’s have a plan. Then, I’ll just share a couple of tips that I give my families in these situations. The first one is babywearing. Babywearing makes such a huge change. It really helps keep that newborn close. Skin-to-skin has so many benefits. We know breastfeeding does better when babies are skin-to-skin. Babywearing is just skin-to-skin while your hands are free and now you can also take care of your toddler. 


    I’m also going to say a huge plug for support. We know where those difficult moments tend to be. The first six weeks, growth spurts, let’s plan for them. If you are alone with your baby and your toddler, let’s have a plan for support. Who is offering to come help? Who can help you take care of the toddler? Can somebody come to relieve you so you can get some shifts? Is it in the budget to hire a postpartum doula to come and support you? Support, support, support especially in those early weeks. 


    Then as we progress a little farther into the breastfeeding journey, I always like to share with my families some tips for navigating feeding times with a baby while also having a toddler because you probably know this, but it tends to happen that you put the baby to the breast or to the chest and then your toddler wants your attention. 


    Meagan: Mom!


    Chrisie: It’s not a coincidence, right? It’s the moment when you’re doing this thing. “Oh, I’m really not available.” So how do we navigate that? Again, having a plan in advance. Maybe we reserve some special toys or activities for nursing time. Make it positive. Maybe that’s also snack time for your toddler. Maybe as breastfeeding gets a little bit easier, you’re able to have your toddler come sit with you and read a book. But basically have a plan to make breastfeeding a positive experience for your toddler as well so it’s not set up as this competition for them trying to get your attention during that time which is really difficult for parents to navigate. 


    Meagan: Yeah. I love those tips. This other question from this mama says, “I will be tandem nursing when my next baby comes. My first daughter has a slight lip tie and has always had a little bit more shallow of a latch. Just wondering if there are any ways to get a solid latch if the next one comes with a slight lip tie. It didn’t seem to affect my first daughter getting milk out while nursing, but I do think it caused my supply to never really come in fully.” 


    Chrisie: Yeah. Yeah. So love that she is asking this question in advance for sure. There is a lot we are still finding about restrictions or ties. One thing I would look into in this situation is if the second child does have a lip tie, is there also a tongue tie happening? Often, we know when there is a lip tie, there is a tongue tie. Not always, but often. That’s when working with an IBCLC, they’re going to help you navigate what’s happening with breastfeeding and do you need a referral to what we call a preferred provider? Typically an ENT or a dentist who specializes in ties. Let’s have that baby evaluated by the specialist. Let’s find out early on. Are there any lingual or bilingual restrictions that are preventing the baby from removing milk both efficiently and comfortably for the parent? Information is key there, right? Especially if we know there is a history. 


    IBCLCs in your community will be able to give you the names and contact information for those preferred providers so that we can find out that information right away. I also love that she brings up an important point about supply. Sometimes, very strong supplies can mask tongue ties and lip ties even and really make those issues not so obvious in the beginning, but then they might show up later on. Like she said, maybe it affected her supply. 


    I often see people who do okay even though their baby has some restrictions, but then the 3-month regulation hits, and suddenly their nipples are sore. Suddenly their supply is really feeling an impact and it’s because there was an underlying restriction this whole time. 


    Meagan: Yeah. 


    Chrisie: So early information, let’s find out. 


    Meagan: Yeah, I was just going to ask you if IBCLCs can technically diagnose a lip or a tongue tie or if they can say, “Hey, it looks like maybe there is something going on.” I also had some restrictions. I had some issues in the beginning with my milk coming in. I talked at the beginning about how I was a little bit out of it. I had a rocky first start, but then when my daughter was five, she went to the dentist and the dentist said, “How did she eat? How did she eat as a newborn?” I was like, “We had our troubles, but we got through it.” He was like, “Good for you. She actually has a severe lip tie. We actually need to take care of it because it’s going to start impacting as her teeth are coming in.” 


    It was so thick. I was like, “Oh.” So yeah, those two questions. Can an IBCLC diagnose or can they just say, “Hey, it looks like we may have some restrictions here. I would suggest you go to this provider.” 


    Chrisie: The latter. We are not allowed to diagnose. It is not in our scope to diagnose, but we do connect you with the appropriate medical provider who does. 


    Meagan: Yes. 


    Chrisie: They will do an evaluation and make a recommendation. 


    Meagan: Obviously, we love our pediatrician and we love our docs, but my pediatrician, I asked and she was like, “No, not at all.” Sometimes, I feel like pediatricians aren’t as skilled as IBCLCs at recognized, so maybe they can’t diagnose, but they can recognize and get you to that next-step provider to help your feeding journey and your supply and all of these things be better in the end. 


    Chrisie: Exactly. Exactly. I second that. I also love pediatricians so much, but IBCLCs are really the experts in navigating the lactation aspect and referring you to again, what we call a preferred provider for evaluating lip ties and tongue ties. 


    Meagan: Yeah. I love that. Again, a whole other reason why we need an IBCLC through The Lactation Network. 


    Okay, so this question, I think again plugs into getting that prenatal or that consultation before. This mama says, “I would like for my husband to take some of the nighttime feedings to allow me longer stretches to sleep.” We know sleep is so important. It says, “He wants to help with this too. Is there any way to do this without negatively impacting breastfeeding or getting up in any way to pump?” You know, having her to actually lose sleep and giving it to the husband in a bottle. It says, “There is conflicting information online and I’ve heard from most mothers that they just end up doing the nighttime feedings anyway. Maybe their spouse could help with diapers instead.” 


    This is such a good one because sleep is a good one we know for our mental health, especially after birth and recovery, especially if we’ve had a long birth or a Cesarean and things like that. We just need that sleep, but how can we help our partners be involved without negatively impacting? 


    Chrisie: Yeah, I love that question. I will also say that it taps into something I hear all the time which is about conflicting information online. There is so much conflicting information about breastfeeding online. To be honest, there is so much bad information about breastfeeding online which again, is a plug for an IBCLC. That’s why you need that expert in your back pocket to be the person who says, “Okay. Here is the deal. Here is what we need to do.” 


    In this specific example, I do have this conversation all the time because I think one thing that is important to note is that I find the first six weeks to be the hardest for so many reasons, right? But if you’re a first-time parent, I know it’s common, and I felt this myself, when it’s your first baby and you’re doing this for the first time, it can feel like, “Oh, this is what it feels like. I’m never going to sleep again. Oh my gosh. This is what breastfeeding is like.”


    I think it’s important to know the different stages, what breastfeeding looks like, and what sleep looks like at the different stages. So just having those expectations and that information can go a long way. In the first six weeks, babies tend to be nocturnal. They tend to be more alert at night. Nights are tough for the first six weeks. Throw in growth spurts where we have all of the cluster feeding. Nights tend to be a little bit harder during those times. We know that. We know that sleep is going to be tough in the first six weeks. 


    It’s important to know that it does get better. It usually does get better after what we call the six-week growth spurt. That is one factor. But to answer the specific question, I like to talk to my families about what I call tag-teaming at night which I think is what she is asking about. Once we introduce a bottle, then you do have a little bit of play in terms of how the partner can support those nighttime feeds. Again, it’s such an important topic to talk about before the baby gets here. How are we going to navigate nighttime feeds? It’s so important. Sleep is so important. 


    One possible scenario and this really depends on the specifics that are happening within the family, but once we are introducing the bottle, it might be possible for the parent to pump before they go to bed. Maybe the partner grabs the next feed with a bottle and then the parent who pumped right before bed is able to skip that feed and then grab the next feed. So we kind of pre-pump essentially. 


    This plan works for some people. We do have to introduce a bottle. Where a lot of people go as well, the standard information is that I shouldn’t introduce a bottle until 4-6 weeks so that plan is not going to help me. My take on that is that we don’t always have to wait 4-6 weeks. Let’s talk about the specifics that’s happening with your baby and your family. 


    But also, it is important to note that in general, we do need a one-to-one ratio,  one pump session for every bottle in order to protect your supply and preserve your breast health. If we go too long, especially in those first six weeks, if we go too long before removing milk from the breast, we can get clogged ducts. We can get mastitis. We can get other issues. 


    Now, unfortunately, prolactin which is the hormone that is driving a lot of this, peaks in the middle of the night. So often, we have our strongest supply right in the middle of the night. So how are we navigating all of that? That’s what comes down to the specifics of the IBCLC putting together a plan for you and your family. I will say that generally, we are usually able to carve out a longer stretch of sleep for the birthing parent after that six-week growth spurt. 


    But absolutely, sometimes we can if we just take that scenario. Maybe the other parent or a support person is giving a bottle and it means you wake up, do a 15-minute pump session, and go back to sleep. That might be a lot faster than the process of feeding a baby from beginning to end. These are all things that we look at creating a plan for. 


    Meagan: Yeah, plans are important. 


    Caitlin: They are. They are. I’m not clinical, so mom to mom we’re saying a lot of things that can be interpreted as overwhelming. I want parents so much to settle into this amazingly delicious life moment and we are very much a fast-moving and fast-paced world. This time is so precious. It’s so amazing. You will just want to inhale your new baby. It’s so– I just think giving yourself permission to take those 4-6 weeks to really just rest, recuperate, and establish that connection. 


    Your brain is going to really go to Target. Find some time to go to Target. Maybe that’s with a support person, so that if you get there and 15 minutes later, you need to ditch your cart and go nurse in the car, someone else can stand with your cart or they can say, “This is totally fine. I’ll put back the items and we’ll meet back in the car.” If you are feeling that real urge to get out and do things, make sure you get out and take a walk. 


    I saw a really funny meme yesterday where it said, “Nap when the baby naps.” It’s this new parent with a stroller outside and she lies down on the sidewalk. Obviously, that’s great advice, but in practice, it’s difficult so just know that you will rest. You will sleep. It is the best, most special time and we are here to help you prepare for it the best we can. It’s not a Google time. It’s not something that you can really search Google for all of these answers. It’s important to go into it knowing you can trust yourself, trust your body, and advocate for help. 


    This used to be done with a huge village. We lost that village a bit. Bring in an IBCLC in early and often to be that outside person who comes in and is solely focused on this feeding relationship to nourish yourself, your baby, and your family to give you, your spouse, the grandparents, the siblings– all will be impacted by this peace of mind and this support. It’s very, very crucial and lovely. I wish all of you tons of snuggles. 


    Meagan: I literally just got the chills. Such a powerful message right there. So, so powerful. Women of Strength, if you want to schedule your consult right now, all you’ve got to do is click in the show notes or you can go to our Instagram and look in our bio. It’s really easy to schedule a consult and start your plan today. 


    Then one last question– if we have IBCLCs maybe who are listening, because we do. We have such a large birth community who listens. They may want to join The Lactation Network. How could they do that or is that possible? 


    Chrisie: Yeah, absolutely. 


    Caitlin: Yeah, absolutely. I would encourage anyone listening to check out our website. It’s tln.care. T as in the, L as in lactation, and N as in network dot care. Come visit us. Come ask questions. We are just so, so passionate about this space and are so grateful that we have had this time. 


    Meagan: Well, we love you guys so much. We are so grateful for your time. We just know that you are literally changing lives all over. Thank you so much. 

     

    Closing


    Would 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.




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    47m | Dec 18, 2023
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