“We are pieces of an important puzzle and there are a lot of pieces. Working together, we can effect a lot of change.”

Joining Meagan on the podcast today is Dr. Elliot Berlin, a renowned prenatal chiropractor based out of Los Angeles who is making a huge impact on the birth community. Dr. Berlin is extremely knowledgeable and experienced in holistic birth preparation and advocacy. He is a birth doula, hosts the Informed Pregnancy Podcast, and his most recent project is the Informed Pregnancy Plus streaming service where birth documentaries and other educational videos can be found on one online platform. 

Dr. Berlin and Meagan discuss TONS of topics that come from your questions! 

Topics include: 

• What happens during an adjustment
• When to start prenatal chiropractic care
• Bodywork
• Adjustments during labor
• CPD
• Breech Presentation
• Pubic Symphysis
• Support at home
• Breastfeeding

Additional Links

Dr. Berlin’s Website

Informed Pregnancy Plus

Pediatric Chiropractic Search Website

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello everybody. You guys, we have a very special episode for you today. We have Dr. Elliot Berlin with us today and he’s actually live with me so that’s pretty cool that I actually get to see his face live via Zoom.

 

Dr. Berlin: It feels like we are in the same room. I’ll be honest.

 

Meagan: Right? As live as you can get through a computer. I feel like this is our new norm these days. This is how live works.

 

Dr. Berlin: Yeah. And you know, we got used to it.

 

Meagan: Yeah, we did. We got used to it pretty dang fast actually. We’re so excited to have you on today and we have so many amazing questions that our listeners and followers have asked. But I first want to just talk a little bit about you and who you are so if anyone doesn’t know who Dr. Elliot Berlin is, you need to know and you need to go follow his page right now.

 

Push pause unless you are driving. You can do that later and go follow @doctorberlin on Instagram because he’s amazing and has so many incredible things and has done—I mean, for years—so many incredible things in the birthing community.

 

Dr. Berlin is an award-winning pregnancy-focused chiropractor. If you don’t know yet, on this podcast, we love chiropractic care. He’s a certified birth doula and host of the Informed Pregnancy Podcast. So again, if you haven’t followed his page or his podcast, press pause. Go follow along and go—what’s the word? Subscribe to his podcast— Informed Pregnancy Podcast.

 

He combines his passion for entertainment with his desire to educate and spread awareness about important issues in the birth industry. We know that in the birth industry, we have a lot of issues that need to be talked about. His latest project is the brand new streaming channel on Informed Pregnancy Plus dedicated to all things fertility, pregnancy, labor, and parenting.

 

Informed Pregnancy Plus

 

So, Dr. Berlin, I would love to actually start right there before we get into these questions. Will you tell us more about this new project that you’ve got going on?

 

Dr. Berlin: Thank you for having me and for the incredible work that you do. I was just telling you recently that I feel like we are pieces of an important puzzle and there are a lot of pieces. Working together, we can effect a lot of change.

 

The Informed Pregnancy Plus is a streaming platform. Everything grew organically from me really being a very medical-minded person wanting to go to medical school. Sometimes little arrows pop up. I see my son play video games and he’s not sure where to go, then a big arrow pops up and says, “Go this way.”

 

I get those arrows sometimes and it led me on a more holistic path. I fell in love with chiropractic and massage. I smooshed them together to make chirossage. I ended up with my wife and I having a fertility struggle. We ended up overcoming that with natural means when medical options ran out— and she is a psychologist. We started this mind/body program together, wellness care, with an eye on helping people boost fertility. Over time, that turned into babies and pregnancy. Again, coming from a much more medical background—I used to work in ambulances and emergency rooms—everything was brand new to me on the more natural front.

 

Meagan: Mhmm, yeah.

 

Dr. Berlin: I had never heard of doula. So I would get questions a lot that I didn’t know answers to. It still happens regularly. I would go on to research. I’d talk to experts, read, and try to prepare an answer that was not, “This is what you should do or not do,” but “These are the facts as we know them. What do you want to do?”

 

As I’d get the same questions over and over again, I started to write that as a blog. It became a magazine for a minute when people still printed stuff and then before I knew anything about podcasts, I was doing a podcast.

 

Then I made a couple of documentaries, one of them about VBAC, Trial of Labor. It’s a beautiful film and when we finished it, I realized that the only thing I know less about making a documentary is what to do with it once you have one. How do people get to see it? Right when it came out, there was this big flash of excitement about it. There were screenings and all sorts of people were buying it in lots of different ways and showing it in lots of different ways, but then that excitement fizzled out. It was out there in the blogosphere and the webosphere but people weren’t finding it.

 

I was getting these crushing emails saying, “Hey. I saw your movie, Trial of Labor, and I really loved it. I just wished I would have seen it before I had my baby.” I was like, “No, I made it so you could see it before you had your baby.”

 

Meagan: Right.

 

Dr. Berlin: So after talking to some of the other filmmakers in the space, I realized that I’m not the only one having this problem. There’s not an easy place where people can go and get iconic films like The Business of Being Born, Orgasmic Birth, The Mama Sherpas, Breastmilk, so on and so forth. So I just decided, “Why not make it easy for anybody to access from anywhere without having to pay $25 for each film?” and just boom. You can have it on your phone or your TV. That’s how Informed Pregnancy Plus was born.

 

Every day, we are working on acquiring licensing for more great content. It’s expanded from film to also web series, also mind and body like yoga and meditations and workshops. My wife has a workshop on there on relationships how to still like your partner after you have a baby together. We have one on birth plans. We have one on sleep. It’s just growing all the time. Anybody can try it absolutely free at informedpregnancy.tv. It also has apps for Apple, Android, and Roku. After that, it’s very affordable. It’s $7 a month.

 

Meagan: That’s what I was going to say. It’s $6.99 a month or $59 a year. That’s pretty dang affordable.

 

Dr. Berlin: That was our goal. If you have an internet connection, a device, and $60 for the year, you have access to all of this great content. That’s what we were hoping to achieve. I don’t know how I’m going to survive. It’s like each element of this is a full-time job.

 

Meagan: A full-time plus.

 

Dr. Berlin: Full-time plus like Informed Pregnancy Plus but thankfully we have a small crew here but very dedicated to the project and very hardworking, very savvy. It’s growing both in terms of content and in terms of viewership. The films are finally having an avenue where they can make a greater impact.

 

Meagan: Absolutely. I love that so much. I wish I had something like this back when I was in my childbearing years or having babies, I should say because even the time. In my opinion, how much time I spent researching VBAC and all of the things during pregnancy, even those courses like yoga classes and all of these things, I spent way more time than I would have money. It would have been so much more worth it to just buy a subscription like this and have it all in one great platform.

 

Dr. Berlin: I mean, that’s the goal. Especially for people who live in areas where there aren’t prenatal yoga classes. We don’t have a ton yet, but we are always adding more. We have Baby by Simone on there for people who can’t go to a prenatal workout class. She’s got great workouts. The whole idea is that no matter where you are, these tools should be accessible to everybody.

 

Thankfully, they are trickling their way through the internet and people are finding them. I’m getting fewer messages about, “I wish I had seen your film before I had my baby,” so that’s very rewarding in the way that finances can’t reward.

 

Review of the Week

 

Meagan: Okay, so we do have a Review of the Week so we are going to get into that before we jump into all of the amazing information that Dr. Berlin has. This is from 471046246me and it says, “My Labor and Delivery Nurse Told Me About The VBAC Link.” Oh my gosh, that makes me so excited. If you’re a labor and delivery nurse, thank you, thank you, thank you for the love and we would love for you to continue sharing with your patients.

 

It says, “I had an emergency C-section six months ago with my first baby. I planned and prepared my entire pregnancy for a non-medicated, vaginal birth with midwives in a hospital. I had an amazing team. Labor was going great. Hard, but I felt strong. But my son had other plans that involved wrapping himself in his umbilical cord so the sunroof exit he went. Ha ha,” she says.

 

“In my recovery room, my nurse told me that she had an HBAC and told me to listen to The VBAC Link. I am so thankful that she recommended y’all to me because I already am stoked for my VBAC and I’m not even pregnant yet. Thank you for the work you do. I can’t wait for y’all to come back from your break.” This was back in 2022.

 

It says, “These stories fill my day with so much joy when I take my son for my daily walks.” Oh, thank you so much for your review. You guys, we do love these reviews. We appreciate them so much. We always welcome them in wherever you leave them. You can Google “The VBAC Link” and leave us a review. You can do it on Apple Podcasts. You can message us. You know it. Wherever, we love your reviews so bring them over and maybe they will be read on the next podcast.

 

Q&A

 

Meagan: If you guys are wondering, we will make sure to have all of his links for his platforms in the show notes so make sure to check out the show notes.

 

Dr. Berlin: Thank you.

What Happens During an Adjustment?

Meagan: Without further ado, I mean there are so many questions. I don’t know if we’ll get to all of them today, but I was shocked, but then I thought, “Oh well, from someone that had never gone to an adjustment before during pregnancy, I didn’t know either.” One of the questions is, “What happens during an adjustment? What does that look like?”

 

Dr. Berlin: These, I’m sure, are going to be amazing questions because they come from real people who are very curious. This is a great question. The answer is it’s different from chiropractor to chiropractor. Generally, the one thing we all have in common is that we’re all looking for restriction in the bones—so where two bones come together, they form a joint. There should be good movement between those two bones, a certain amount of good movement. If they become restricted or totally locked up, they can create problems for you.

 

It may be a problem like you feel like a loss of range of motion or swelling around that restricted joint that starts to become an issue that presses on nearby things like nerves or other tissue. Or it may be a problem that you don’t feel. It might just be restriction where you should have fluid movement. If you’re talking about your low back, hips, and pelvis, those kind of restrictions, that’s the baby’s studio apartment. So where the baby should be able to move freely, your body may not be able to accommodate that.

 

So what we all have in common, really, is that we look for those restrictions and we try to release them. We try to restore motion between those restricted bones around the joint. There are a lot of different ways to find them diagnostically, a lot of different ways to restore movement therapeutically so if you go to a bunch of different chiropractors, you might have very different experiences.

 

Then sometimes, chiropractors also add on top of that other modalities that they do whether it’s a physiological therapeutic thing like electric stim or heat or ultrasound or other types of body work like massage. We tend to combine those two together in our practice. What the adjustment is a restoration of movement where it was previously restricted where two bones come together. Any two bones in the body can pretty much be adjusted but many chiropractors primarily focus on the spine and pelvis and maybe the major extremities.

 

Meagan: Yeah. Like you said, it’s the baby’s apartment. I remember my chiropractor telling me how my pelvis shifted. My right side would shift forward, so it would kind of be off. She was like, “You need to have it aligned for the baby to come out of the apartment.”

 

Dr. Berlin: Yeah.

 

Meagan: I actually wasn’t having a ton of pain. I couldn’t have told you that my pelvis was wonky like that, but she was like, “It’s so easy. You can do it getting in and out of a car or walking up stairs or putting a laundry basket on your hip.” There is so much that happens during pregnancy.

 

Dr. Berlin: That’s before the baby gets there sitting on your hip.

 

Meagan: Right. Your body can get out of alignment through pregnancy.

 

Dr. Berlin: That’s one of the interesting things though. If you come in even if you do have pain but there’s nothing restricted, then on the pure chiropractic front, there’s really nothing for us to do. Sometimes it’s the opposite. You can have hypermobility where things are moving too much. There are ways we can treat that as well, but the adjustment wouldn’t be one of them in that direct area.

 

But on the other hand, you could have restrictions that you don’t feel. We would still want to address them if that’s what you want to do.

Bodywork

 

Meagan: Yeah. You touched a little bit on bodywork. That was kind of a question that was answered a little bit farther down on our list, but what all does bodywork look like with that? You talked about massage and things like that. Is there more to it or is it just more like prenatal massage and then a chiropractor?

 

Dr. Berlin: Bodywork is a vague term, even more vague than chiropractic. There are a lot of different kinds. In our office, what we do is massage therapy. It’s more of a clinical massage therapy so it’s focused. It’s usually 25 minutes long. It’s targeted in a specific area.

 

When it comes to musculoskeletal health in general, I see myself as WD-40. I look for things that are stiff, tight, and restricted, and try to get more motion in there. The other side of that coin is duct tape where things are too weak or unstable, somebody’s got to help bring that back together again. That’s more like a personal trainer or a physical therapist. When we are working together, we can get really good balance and function and strength around the muscles and bones of the body. You can really feel wonderful even through all of the different stages of pregnancy, sometimes even with multiples all the way until the end.

 

When things are out of whack, sometimes not even a month into pregnancy, you start to feel weird things happening to your body. Bodywork can be a lot of different things. For us, it’s that more clinical medium to deep tissue, finding muscles, tendons, and fascia that are too stiff, tight, and rigid and trying to use massage strokes to elongate them, lengthen them, and restore normal tone.

 

Other things that we infuse are trigger-point therapy. Sometimes you have a tendon coming to a bone or the center of a muscle where there’s an accumulation of all of the tension in one area so we use trigger-points to release that. Back when I was doing birth work, we would also do a lot of reflexology, cranial massage, craniosacral therapy, jaw releases, and anything that’s going to release the mind and the body through the process.

 

Not so much in the office, we do craniosacral therapy a lot. We have two pediatric chiropractors that work from newborn through adolescence and they do a lot of craniosacral.

 

Meagan: Yeah, my daughter had torticollis from my C-section actually.

 

Dr. Berlin: Oh, interesting.

 

Meagan: It was literally after birth when she was little. Then it just kept getting worse and all of a sudden, her ear was touching her shoulder but her shoulder wasn’t going up. Her ear was going down.

 

Dr. Berlin: Right. Taco neck, they call it.

 

Meagan: Yeah. It was pretty dang bad. We went to PT and that was great, but ended up finding a craniosacral one. Anyway, it was amazing. They did this adjustment and suddenly she was back up. She wasn’t fussy and having acid reflux and all of these amazing things. It is really cool.

 

Dr. Berlin: It is so gentle yet powerful at the same time.

 

Meagan: Right! PT was actually hard on us. It was a lot of forcing her to get in these positions and things then just a few chiropractor adjustments of craniosacral work was a game changer for us.

 

Dr. Berlin: That’s amazing.

 

Meagan: And a lot more sleep for this mama, right?

 

Dr. Berlin: Yeah. It’s not just great for the baby. It’s great for the parents.

 

When to Start Chiropractic Care During Pregnancy

 

Meagan: Yeah. Well, awesome. So when should someone start chiropractic care during pregnancy? Is it something like, “Hey, I’m thinking about conceiving. I should start now.” Should we always be seeing? What does it look like?

 

Dr. Berlin: A lot of that depends on your goals. If you want to optimize your body for pregnancy, it would be great to know ahead of time when you’re definitely not pregnant because there’s a lot of stuff that we can work on that we can’t get to once you’re pregnant like all of the core muscles, psoas, hip flexors, and the ones that go behind the baby. Loosening that stuff up if it’s tight before you get pregnant is ideal.

 

That happens in my case more frequently either if people are on a fertility journey or they had a pregnancy that was either difficult or birth that was difficult and now they’re thinking about getting pregnant again. They’ll come in for some pre-pregnancy bodywork.

 

Once you’re pregnant, it really depends on the goals. If you’re coming for maintenance, in my view, there’s not really a time that is too early. We do make modifications in the first trimester then we make modifications again at different times as you get bigger and your body changes, but there are always ways that we can, almost always, get you comfortable, situated on a massage table and/or a chiropractic table and find those restrictions and release them.

I would say our typical patient comes in the second trimester so maybe somewhere around 20 weeks unless they are coming for something specific like sciatic pain or positioning issues or just getting ready for birth and they come later. They tend to come maybe twice a month during that middle part of the pregnancy then at the end in the last month or two, they’ll come once a week to get ready for birth.

 

We don’t prescribe a hard and fast number of visits or frequency of visits. It really depends on your goals, how you’re feeling, and what your life looks like—what kind of resources you have or want to put into it.

 

Meagan: Yeah. That’s what I did at the end of my pregnancy. I did every other week so twice a month then in the very last few weeks, like my 39th to almost 41st, I ended up going a couple of times because I started getting some discomfort and feeling some sciatica pain and things like that. My baby proved his point. He was hanging out in my back.

 

Dr. Berlin: Ouch.

 

Meagan: Yeah. In labor, he did that for 42 hours.

 

Dr. Berlin: Oh my goodness. Ouch. Ouch. I’m sorry.

 

Meagan: It was fine. I was adjusted twice during my labor.

 

Dr. Berlin: Wow.

 

Meagan: I full-on believe—I mean, I believe that my team and everything and that space I had created was an impact, but I swear that my chiropractor really did impact my VBAC.

 

Dr. Berlin: Some people swear by us and some people swear at us.

 

Meagan: I know.

 

Dr. Berlin: I’m really grateful that you were able to have the VBAC. Structure and function are important when you’re trying to get a baby through.

Can We Get Adjusted During Labor?

 

Meagan: Yeah. I mean, I saw switches in my labors with both adjustments. It’s so awesome. That was one of the questions. Can we get adjusted during labor? As a doula, I’ve been to a few births where we’re seeing this lag in this labor and the same thing. We’re working through all of the positions, but something is not quite working. We say, “Hey, let’s go get an adjustment.” We’ll go to the chiropractor with them and things big-time shift and we’ve got a baby. But yeah, are there signs that someone could use an adjustment?

 

Maybe we’ve got people in a rural area where they can’t have access to a chiropractor or maybe they’re already in the hospital and sometimes chiropractors can’t come in.

 

Dr. Berlin: Yeah, nowadays they don’t let too many people in. Always, ideally, that’s why we switch to once a week as you’re getting closer to the end so that ideally, you go into as a labor freely moving ball with enough WD-40 to carry you through. But yeah, there’s no problem generally doing adjustments during labor. Some people just schedule it and say, “Hey, will you come check on me when I’m in labor?”

 

Other times, we get called when there are some signs that labor slows if there is no progression like things don’t progress in a “reasonable time frame”, if the baby’s not in a great position, and if there’s back labor like what you were talking about. Those are all signs that it’s worth checking. Are there restrictions here in the pelvic bones? Your pelvis is not a solid bone. It is a bunch of bones connected by soft tissue. It has the ability to expand and contract and accommodate or even facilitate the baby’s movements but if everything is just in a vice grip, then it may not be able to do that the same way. It can be more resistant to the movements.

 

So we don’t do anything to the baby. We’re musculoskeletal specialists. We do things to your muscles and bones and make them more functional. That could make you a lot more comfortable. It could provide an environment in which the baby is better able to line up with the runway and things like that. Yeah.

 

So you know, it’s never a guarantee. Sometimes I’ll get to a birth and there’s really nothing to adjust. In my case, I also do body work so at the very least, I can do some body work. There are a lot of reflexology points that are just calming. There are those famous hip squeezes or counterpressure on the sacrum and lots of different massage stuff we can do to open up muscles.

 

A lot of what I do in the office I’ve learned from birth. When someone is in labor and they’re having these weird muscle spasms during contractions, you realize, “Oh, that is so tight.” I never would have guessed ahead of time that it was going to be so then as part of labor prep, I’ll explain to somebody, “Do you want to release these muscles because they can play a role?” Sometimes you can’t see what looks like the direct effect. It’s all anecdotal. No one studies on this but all of a sudden, things start to loosen up where those spasms are occurring during labor and they loosen up, then all of a sudden, you start to see a healthy progression.

 

The other thing you see a lot with bodywork is somebody, especially in unmedicated birth—I don’t think there is anything like unmedicated birth. Either you get medications or you make your own. The ones that you make look pretty cool. But if there’s someone who’s not medicated medically, there’s this major transition that you can see when a surge comes through and she doesn’t feel totally safe or relaxed and she’ll start to tighten up and sort of not consciously but fight the surge and fight herself, really. That can look pretty violent sometimes.

 

With bodywork, you can sort of help the nervous system relax to a point where it doesn’t feel like it’s in danger. It doesn’t feel like it has to fight even when intensity comes. That’s the most rewarding thing to me from being at a birth. When I see that shift is when it’s like, “Wait a second. This is more tolerable, much more tolerable if I don’t fight it.” They get the confidence to relax into it and they realize, “Okay. I’ve got this.” So it’s not always, in my case at least, the adjustments and bodywork.

 

Things that people can do on their own, there are all of the doula tricks if the baby is not wanting to come down with the peanut ball but sometimes you can actually roll different parts of the low back, glutes, and piriformis if they’re acting up. There is some stretching you can do. Some of the Spinning Babies exercises come in really handy. There is other stuff that you can do even if you can’t get a chiropractor over there.

 

Meagan: One of the clients that I went to, her chiropractor went during labor. He showed me this-- I don’t even know what it was—tight ligament or something right down next to the bone.

 

Dr. Berlin: Yeah, above it?

 

Meagan: Kind of on the side. It was honestly by the butt crack. That’s where it was, this tight thing. He was like, “Do you feel that?” I would feel it and it was so tense.

 

Dr. Berlin: A spasm, mhmm.

 

Meagan: He said, “During a contraction, press on that.” I would press and eventually, it just released and all of a sudden, we had transition coming. It was really interesting. I don’t even know what that is. He said, “Press right here.” I could feel it. It was tight. It was really interesting.

 

Dr. Berlin: Yeah. You’ll find little things like that in labor. With permission, a little trial and error, you can sometimes really find a gem that is helpful for birth or that you can do ahead of time or that you can train a partner or doula to do. It can make a huge difference.

CPD

 

Meagan: Yeah. Absolutely. So we were just talking about our pelvis and how it moves and shifts and all of these things. CPD, cephalopelvic disproportion is a common, as you probably know, diagnosis in C-sections and people wanting to have a VBAC. It’s given a lot. In my opinion, too often. I was given it myself. I was told I would never get a baby out of my pelvis.

 

Dr. Berlin: Oh wow.

 

Meagan: So that’s a big question. How can someone tell the shape of their pelvis? Does it matter? How can we make our pelvis “bigger” during birth and what can we do to help these babies navigate through this pelvis without getting this diagnosis of, “Your pelvis is too small”?

 

Dr. Berlin: Well, I think the first and most important thing always with a VBAC is to line yourself up with a provider who is really VBAC supportive, not just tolerant. If you feel really trusting that your provider is like that, then they are only going to tell you things. They know your goal and they are supportive of your goal. They are only going to tell you things that are well thought out or that aren’t just fear-based.

 

There are a few things coming together here. Number one, there is the pelvic paradox. You see someone with really tiny hips give birth to a 9 or 10-pound baby with no hiccups really smoothly. Then you see somebody who has big hips. Maybe they’ve been told their whole life, “Wow. You’re going to have great hips for birthing,” and a 6-pound baby gets stuck and doesn’t come out. How do you explain the pelvic paradox?

 

One of the explanations is that there is a big difference between structure and function. Structure is your pelvis, the bones themselves, the soft tissues themselves, and how big they are. It is measurable to a degree and your baby and how big they are is measurable to a degree. But if you’re just looking at structure without function, you’re going to see what looks like cephalopelvic disproportion a lot partially because we don’t have great measurements on these things. We have approximate measurements and partially because you’re not taking into account function. The baby’s head is not a solid bone. It’s a bunch of bones meant to smoosh through a smaller passageway than it is at its full size and the pelvis is not a solid bone. It’s a bunch of bones meant to expand and transmit something bigger than itself through while you’re in labor.

 

If those functions are working, then for sure, a larger baby can get through a smaller space even though on paper structurally, you have what looks like a baby that is too big to come through a pelvis that’s too small. Sometimes they are too big and that’s the issue. That’s why it’s really important, I think, to be with a provider who really gets you and supports you and is on board with you because if that provider is saying, “Wait a second. You have a head that is like this or the entryway to your pelvis is a concern,” then you’re really going to not be second-guessing them in the moment which is really important, I think, for safety.

 

That’s the number-one thing is if you want to have a VBAC or even a vaginal birth the first time, is to have a provider that is really supportive.

 

Number two—this is again really anecdotal. I see a lot of pregnant people every single day. What I did was a little poll on social media like, “How many people told you that your baby was going to be 9 pounds and it was substantially smaller?” A huge number of people came up. I don’t think it’s nefarious at all. I think that doctors in general and obstetricians in particular are trained to look or what might become a problem at some point which is sort of good. We want them to predict those things.

 

But then it could get carried a little too far away because it’s like, how likely is that to become a problem and what are the interventions that we take to prevent that and what are the side effects of those interventions? That’s a much more complex equation where there’s not always a clear answer. It is sometimes presented as a clear answer rather than, “These are the pros and cons, the risks and benefits as we know them. What would you like to do?”

 

I think that’s something all practitioners can learn over time. I’m certainly still a student every day 25 years later learning how I can do things better and more comfortably and more effectively. I think towards the beginning of practice for me too is that you know what you know and you want to be so helpful, but sometimes, the person on the receiving end of that doesn’t want that and that’s okay. That’s your choice. It’s 100% your choice. Even if it’s not the choice that I would make, at the end of the day, I’m supposed to support whatever choice you want to make. That’s a lesson that at least for me, took time as both a chiropractor and a massage therapist and as a doula especially.

 

Meagan: Yeah. That’s what I was going to say. It’s taken a lot of time for me as a doula.

 

Dr. Berlin: Yeah.

 

Meagan: It can be really hard.

 

Dr. Berlin: Yeah. It’s really hard. And very well-intentioned practitioners who want the best for you, who would do the same exact thing for their wife or their daughter are trying to help you, but at the end of the day, it’s an informed consent situation.

 

What happens with the measurement is that there’s no scale for the baby before it’s born. It’s a computer doing calculations. The calculations have a margin of error. Let’s say that margin of error is a pound or a pound and a half. If I tell you that your baby is going to be 7.5 pounds at birth, based on those calculations, that means it could be anywhere between 6 and 9 pounds if the margin of error is a pound and a half.

 

A) I could have probably told you that without the ultrasound. B) The problem with that is if it’s ticking upwards if the baby is measuring 8 pounds in there, now all of a sudden I’m thinking, “What if it’s 9.5? That could be too big. It might get stuck. We might have problems. We don’t want an injured baby.” Nobody wants an injured baby, so maybe we should just induce you or do a C-section or whatever to prevent that. How many of those babies are actually going to come out at 9.5 pounds? That’s the end of the margin of error on that side.

 

On the other side, you have the same issue. If a baby is measuring 6.5 pounds, you start to think, “What if it’s 5?” because of the margin of error. Maybe the baby’s not getting enough nutrition. These are all logical things to think about and important things to talk about, but we can’t forget that there is this margin of error and that there is a person who really should be the one at least involved if not making the decision. 

So that, I think is what happens and anecdotally what I see in the office happens with cephalopelvic disproportion. Either we’re doing measurements and we’re guestimating that the baby is a certain size but they may not really be that size and we’re not really looking at function. There’s a great episode of our podcast called “Labor Day Surprises” where there are two women who have both had surprises at the very end of their pregnancies and they are sisters-in-law. 

One of them had a breech baby and had quite a very interesting story there and the other one had a surprise 11-pound baby. 

Meagan: Whoa. 

Dr. Berlin: Now she is 5’8” or so. She is tall but very petite with tiny, small hips. She gave birth to the baby vaginally, unmedicated and are you sitting down? She didn’t even tear. 

Meagan: Oh my gosh. See? That’s amazing. 

Dr. Berlin: It was the most incredible thing to watch and it’s one of the few where you saw a very ecstatic birth almost orgasmic birth at the hospital. She really talks about how she got into that mind frame. Her doctor knew the baby was going to be on the larger side and said, “What do you want to do with this?” She said, “I want to try.” He goes, “Well, if you don’t try, we won’t know.” 

Meagan: Oh, that just gave me the chills. If you don’t try, we won’t know. 

Dr. Berlin: We won’t know. 

Meagan: Like you were saying, it’s informed consent. It should be up to that mama to decide if she feels that it’s a good thing to try, but we also have to respect that if we have a provider who is not comfortable with it, we have to respect them too. Maybe that’s finding a new provider or working with their partner or something but yeah. It’s interesting. 

Dr. Berlin: I mean, I know that I’m not a good match for everybody out there who is looking for a pregnancy chiropractor. I’m not a good doula for people who are looking for a doula. What’s really important is that you find providers that you feel are on the same page and that they are a good match. This happens with dating all of the time. It’s like, “You’re not for me but I have a friend and they would love you.” I don’t think– I’m never insulted if I meet somebody and they’re like, “I don’t want this type of care.” Great. Let me find someone you would love to see. 

It’s the same with obstetricians. There are some obstetricians who are very paternalistic. They make all of the decisions for you and there are people who love that who don’t want to make the decisions and who don’t want that responsibility. You guys are a great match together, but you’re not going to be a great match for my Prius-driving, vegan, hippie mom, who wants to have her baby hanging from a chandelier over a tub. You know? She’s not going to be a match for them. 

Meagan: Not so good of a match. 

Dr. Berlin: It’s not an insult. Neither one of you wants to be with someone who’s not a great match. 

I always encourage people that if you’re not with a provider that you feel comfortable with, if they’re not on the same page or your interests are conflicting, then try to find a provider who is on the same page. It makes a huge difference and you don’t get to do this very often. 

Meagan: I know and it’s worth finding that provider. Just like it’s worth dating and dating and dating until you find the one, it’s worth going out and continuing to find that provider because like you said, my best friend went to a provider that may not be the best for me. I’m happy that she found him, but I might need to find someone else and that’s okay to take that time and find that provider. 

Dr. Berlin: Totally and if you’re going a more natural route, even psychologically if you end up having a Cesarean, which I don’t think is the worst thing on the planet. I think it’s a great thing. I’ve been known to say that I think one thing worse than a Cesarean being forced on someone who doesn’t want one and doesn’t need one is not having one available to somebody who does need one. A Cesarean is a great medical marvel of our time. The doctors who learn how to do them perfect them and do them with very little risk and a lot of skill. They’re heroes to me. 

But you know, if you want a more natural birth and you end up with a Cesarean and you’re not with somebody who you felt like you are on the same page with, you’re very likely to leave that birth feeling like, “Did I really need that?” It leads to a lot of not-good mental thoughts at a time that you are already going through a tough– for most people, a big transition. 

Meagan: Yeah. 

Dr. Berlin: I can’t say it enough. Having a provider that is good for you and that is a match for you is so important on all fronts. 

Breech Birth

Meagan: Beautiful. I love that. I couldn’t agree more. Finding that provider is so important. We were just talking about these two cute sister-in-laws. They had a surprise breech and that is a question. If the baby is breech, what things could someone do on their own to help their baby turn? How soon should they start to worry? How could chiropractic care truly help that baby turn? We know that there’s not a lot. Breech is kind of dwindling away. It’s unfortunate and it’s really unfortunate that we’re not having as much support in the breech world, but we’re not. 

 A lot of people get put in a corner that if they have a breech baby, they feel like they have to have a Cesarean whether they want one or not, but they want options. How can we work with these breech babies? 

Dr. Berlin: It’s truly interesting. I think if there were more options for safe, vaginal breech delivery– not everybody’s a good candidate for that– but if there was more of an option, primary Cesareans would be down. 

Meagan: I wonder too. 

Dr. Berlin: Substantially and as a result, secondary Cesareans would be down because all of those people who had C-sections are told, “Once a Cesarean, always a Cesarean.” They don’t even get a chance. I think it would bring down the Cesarean rate greatly as a whole. The question is, what is a safe breech birth? There is a lot of debate around that but one thing is for sure. There are some people who are much better off seemingly having a Cesarean birth but they’re breech and other people who are much better off with the option to try and deliver vaginally but they’re breech. 

Meagan: You have an episode on your podcast talking about that specific topic with Dr. Brock and some other providers talking about what that looks like. 

Dr. Berlin: Yeah, we have a 3-part series called Breech 101. It’s two midwives and two obstetricians just talking everything breech from all angles. With Dr. Brock, we have another episode called “Vaginal Breech After Cesarean Breech” with a mutual patient, Dr. Donna Lou who had a breech with her first and ended up in a Cesarean because her doctor didn’t. She went into labor and didn’t have the chance to meet Dr. Brock. At the hospital, her doctor just doesn’t have the confidence or the comfort to deliver breech babies. He was very apologetic but she had a C-section. 

One of the few people I have seen over 20 years who was breech again with no known reason, with her second, Dr. Brock also equally baffled said that she is a great candidate for VBAC and a great candidate for breech birth. The two, the risks that come along with those, don’t compound each other. It’s just two different sets of risks. What would you like to do? She opted for the vaginal breech birth after a Cesarean breech birth. I have them both on and they talk about the decision-making that went into it and what the process was actually like. 

When it comes to breech, I have a premise which is that– let’s talk about a singleton baby in a first pregnancy. That’s where we have the most data. I have a premise that at the end of pregnancy, babies generally want to be head-down. The reason I have that premise is because according to Williams Obstetrics, these numbers are a little bit old, but still seemingly relevant. 

At 28 weeks into a singleton first pregnancy, about 50% of babies are not head-down yet. 

Meagan: 50%. 

Dr. Berlin: 50% at 28 weeks. Now, at 32 weeks, about 10% are not head-down yet. You go from 50 out of 100 babies that are not head-down to only 10 out of 100 babies in a 4-week period of time. 

Meagan: That’s a lot of babies that turn in a very short period of time. 

Dr. Berlin: It’s a big migration and it’s seemingly because they run out of space. When they have space to move around, they can move all over the womb. It doesn’t really matter. Nobody really cares. They are exploring so no big deal. As they start to run out of space, they have to pick a position that is most accommodating in the space that they have and generally in a typically-shaped uterus for a typically-shaped baby, that is head down. That is where they try to go. 

At birth, at 37 weeks and beyond in that first pregnancy, the breech rate is 3-4%. So it goes all the way down to 3-4 out of 100 from 50. That’s where the premise comes from at the end of pregnancy, babies generally want to be head-down. If they don’t go there, there must be a reason for it. There’s usually a reason. It could be something structural. It could be something functional. Sometimes when we have no idea why, like in the case of Dr. Donna Lew. Why would babies structurally? Well, there’s a lot to consider. Maybe the cord is wrapped around them funny. Maybe the placenta is in the way especially when it’s on the front wall, it seems to pose more of a getting-in-the-way factor. 

None of these, by the way, are absolute factors. I have a lot of people that come in with a placenta in the front and the baby does turn. But it seems like of the ones that don’t turn, more of them have the anterior placenta. 

Amniotic fluid seems to play a role. So if the amniotic fluid index normal is somewhere between 8 and 24, with all of those being normal is a big range. 8, 9, and 10 are healthy but not so much fluid volume for baby to move around. 18, 19, and 20 are also healthy but so much fluid volume that even after 32, 33, and 34 weeks, your baby may have a lot more room to move around than other babies and not have a trigger to pick a position and get head-down. 

If you add other things to that like it’s your third pregnancy so there’s more room in the uterus anyway and if you’re tall and if the baby’s measuring small, you can take all of those things into account. Not all breeches are exactly the same. 

The shape of the uterus is a big deal too. Sometimes if the shape is different, it seems not conducive for the baby to get head-down or for the baby to be able to. Functionally, it’s your body. Your lower back, hips, and pelvis are supposed to be pretty loose, relaxed, and open at the end of pregnancy. Your body is doing that hormonally in several different ways but if everything is stiff, tight, and rigid for various different reasons– injuries or excessive workouts or other things like that without enough stretching, then especially if you’re strong, you can have a pelvis that is strong, tight, and rigid. As the baby’s running out of space, maybe down there is not where they are being invited to go. Maybe the end of the rib cage is a lot more inviting or if they’re trying to move as we said before, the body may not be able to accommodate the movements the same way. 

When I work on breech, I’m not doing anything for the baby itself. I’m not doing anything to the baby. I’m not trying to turn a baby or move a baby. I’m working on the musculoskeletal structures of the baby’s surroundings which is the mom and if they’re stiff, tight, and rigid, we’re creating more functional space using massage to loosen up the soft tissues and chiropractic adjustments to open up those restricted joints and maybe gravity. We have tables that invert so maybe a little bit of gravity if something is really stuck trying to give the baby an opportunity to move naturally with gravity. 

We also in our office have acupuncture so we also do moxibustion which seems to stimulate more natural movement so it’s synergistic. I can create more functional space and they can create more movement in that space. It gives those babies a chance to turn more naturally. When do we start? Usually around 32 weeks but I always tell people, “Look. At this point in that first pregnancy, 10 out of 100 babies roughly statistically are breech, and in birth, it’s only going to be about 3.” If I was a betting person, I would still bet that your baby’s going to turn. The stuff that I’m doing is really insurance. It’s going to be helpful for birth anyway but I tell them not to panic at that point. And then of course, you have to look at all of those factors that we mentioned to see who is more or less likely to turn and you can tell based on the fluid, the uterine shape, the placenta location, and so on. 

Meagan: My VBAC baby kept going breech. At 32 weeks, he was going breech. She would motion him and he would flip then the next visit, I was like, “His hiccups are up here again.” He would be breech. He did that until 36 weeks. I think it was 34.5 or 35 and she was like, “We have to trust this baby. We have to trust that this baby needs to be head-up for whatever reason” and I was kind of grouchy because I was like, “I don’t want to have another C-section just because I had another breech baby.” I really wanted this VBAC, but yeah. At 36 weeks, I went in and he was head-down and he stayed head-down. 

Dr. Berlin: Do you remember if your fluid was toward the more generous side, middle side, or lower side?

Meagan: It wasn’t super high, but it was on the higher of the normal. He did have a shorter cord when he came out, so I don’t know if maybe something was bugging him there, but yeah. He flipped head-down. It was great, but it was hard. It was hard not to get panicky. 

Dr. Berlin: Sure, yeah. That’s the thing. A lot more people have to think about breech than actually have breech at the end. 

Meagan: Yeah. Yeah. 

Dr. Berlin: So if there are 4 million births in the United States every year and 10% of them are breech at 32 weeks, that’s 400,000 people every year thinking about breech but only about 3-4% are breech at the end like 160,000. 

Meagan: Yeah, I even had a client. I’m going to jump off of the breech topic, but I had a client who was breech and was scheduled for a version the next morning but went into spontaneous labor that night. We went in at 1:00 AM and baby was head-down. She was 9 centimeters when we got there. Her body just needed contractions to finish rotating the baby. I have no idea but sometimes it can happen. 

Okay, so let’s see. Post C-section. This is in regards to cupping fasical release and stuff like that that you guys do in your office as well. Is that something that you would suggest? This is another type of bodywork essentially. 

Dr. Berlin: New mama TLC. I think whether you have a Cesarean or a vaginal birth, it’s a lot on the mind and body, and nervous system, so I try to do a longer session soon after usually by two weeks regardless of the mode of delivery unless there is some kind of injury then you are good. We can do most things. The goals are to– sometimes there are smaller injuries from birth like injury to a tailbone or pubic bone or something like that. We can address those right away. I’ve had people pop a rib out pushing so hard so we obviously can pop that back in after a vaginal birth right after birth. 

Meagan: Wow. 

Dr. Berlin: The goal is if there are any injuries, we deal with them right away. After that, it’s sort of like the sports massage when you’ve run a marathon. Just wear and tear on the body and trying to move that excess fluid around and have it be reabsorbed so we do some lymphatic work and finding those overworked muscles and to relax those muscles and at the same time, if we can work it in, a little sensual nervous system relaxation work to help reboot the system. 

Meagan: Yeah. 

Dr. Berlin: And to come back online with calm and quiet. So either a little meditation and/or some cranial work. While our normal visits are 25 minutes at that point, we do an hour-long session to try and get all of that in during the first one or two postpartum visits. There’s also a great opportunity at that point, especially for people with more chronic things that they deal with pain-wise. You still have the pregnancy relaxation hormone for a bit. You don’t have the baby inside there pushing on you 24/7. You’re kind of more moldable clay. I’ve had several instances of somebody who had a lifelong chronic thing from an injury and during that period, we have a better shot at making a lifelong correction there. 

Meagan: I’ve never even thought of that. I’ve got this long-term back issue. I’ve got this relaxin and great stuff in my body. Let’s work with that. 

Dr. Berlin: Yes. Let’s use that advantage. I had a patient who was really eager to do that and then she got COVID and she couldn’t come back. It created a whole bunch of problems for her and she’s like, “Damn. I’m going to have to have another baby.” 

Meagan: I was going to say. That’s what I would say. Now I have to have another baby. That is really awesome. Like you said, it doesn’t matter. C-section or vaginal, our bodies go through quite an event and take a lot of shifts and changes so chiropractic care can be beneficial after as well. We’ve talked about it with babies as well. They go through a lot and that can be impactful. My little boy didn’t poop forever. It was 9 or 10 days. We got him adjusted and he had the biggest poop in the world. 

Dr. Berlin: We see that all the time. 

Meagan: He passed out and slept all night. I woke up all engorged and I was like, “Oh my gosh.”

Dr. Berlin: I know. It’s the number-one feedback. “My baby slept so well after the adjustment.” 

Meagan: I know. We need it. Babies need it. It’s so impactful. Back in the day, way, way, a long time ago, I didn’t love the idea. Chiropractic care scared me. It can be scary because you can hear some people talk about it. Like you say, someone is yelling at you. It can be scary sometimes how people talk about it but it doesn’t have to be scary and if you find that really good, skilled chiropractor, they’re going to take care of you. They’re going to help you through this process. 

Pubic Symphysis

They’re going to help you with pubic symphysis which is another question. I know we’re running out of time but if you have anything you’d like to share on pubic symphysis, that is a really big one. The more babies we have, sometimes it starts earlier. 

Dr. Berlin: Yeah. And then it’s weird also. Sometimes it doesn’t happen at all. It’ll plague somebody in the first pregnancy and then not be there. Just a comment on the scared about chiropractic bit, certainly chiropractic isn’t for everyone, but it comes back to finding a good match. As I said at the beginning, there are a lot of different ways to find and release those restrictions. Some of them are very, very gentle. It doesn’t have to be that cracking noise that a lot of people are off-put by or violent-looking maneuvers. If you want the benefits of chiropractic but that’s what’s holding you back, find someone who does a low-impact technique or network or activator. 

Meagan: Drop table. 

Dr. Berlin: Drop table. 

Meagan: Yes, I was going to say the activator. 

Dr. Berlin: Sacro-occipital technique. There are so many that are gentle. The neuro-emotional technique. Okay, so in terms of the pubic bone, there is a right and a left side to the pubic bone. They are separated by pubic cartilage. I’ve learned over time that there are different types of pubic pain and they present differently. It’s still definitely a work in progress. I’m learning new things all of the time. 

The most common one that presents during pregnancy is pain on sort of the lower pubic bone, the underside of the pubic bone where the fine meets the bone. It’s usually only on one side or substantially worse on one side and it’s like when you separate your knees. When you bring that pubic bone apart, that right and left side apart, so if you get out of bed one leg at a time or if you get out of the car one leg at a time or when you engage it to roll over in bed if you haven’t been moving for a while. 

A very common one is to lean over to put on pants and lift one leg then ouch, it’s very painful. What seems to be happening there in most cases is that you have an imbalance in the right and left side of your pubic bone. Let’s say that you have the muscle coming up your thigh attaching to the underside of that pubic bone and pulling harder on one side than the other side. When you’re totally stable, your body can accommodate that. But as the relaxation hormones kick in and they kick in pretty early, the pubic cartilage that is holding it together maybe can’t compensate for that imbalance so the right and left sides end up not lined up with each other anymore but they torque so every time you engage it and pull them apart, it’s very painful. If you could get them to line up again, then it would be either not painful at all or less painful. 

The combination that I use in that case that tends to work pretty well but not always is either massaging out the upper adductor like a deep massage to lengthen that adductor so it’s not pulling so hard and then a trigger point right where that adductor inserts to the underside of the pubic bone. It’s sort of an act of release trigger point as I’m pressing into it. They engage the muscle and then release the muscle. Engage and release a couple of times and then there’s a little test that I do for it also which is if you’re laying on your back or in a semi-reclined position and your knees are bent, feet on the massage table, or a yoga mat, or anything like that, I’ll try to gently pull the knees apart against resistance from the mom. If that is weak, first of all, it doesn’t really have a lot of strength. It elicits that sharpness in the place where the pain has been bothering them. That’s a pretty good sign that this is the mechanism and that doing that combination of massage and trigger point and then adjusting the pubic bone with a drop table will give significant relief. 

Meagan: Wow. Okay, so that could be a test to say, “Okay. This could be impactful if you do this technique.” 

Dr. Berlin: Right. Then if it’s not, I wouldn’t do it necessarily because it’s not the most comfortable thing. It’s always up to them. I could still offer it and see if they want to do it even if it’s a long shot or not do it even if it’s a sure bet. 

But other types of pubic pain that I have identified are definitely the pubic symphysis cartilage itself sometimes gets inflamed. It’s not one side or the other. It’s right in the middle and it’s higher up on the pubic bone. Oh, that’s you. 

Meagan: That was me. It was ow. 

Dr. Berlin: I find acupuncture and I’ll tell you something else in a second. Acupuncture, icing, and a support belt that lifts the belly up off of the pubic bone are some of the things that are more relieving there. 

The third type is the round ligament. They attach to the soft tissue right near the pubic bone on sort of the top ledge of it towards the outside, the upper corners of it. If you have a round ligament that is tight and pulling all of the time, then that becomes very sensitive. In those cases, we try to massage out or gently stretch the round ligament until it relaxes. That usually takes the pressure off there. 

One thing I would also say if you’re feeling it there in the pubic symphysis cartilage and especially if you’re also feeling it in the back by the sacrum or tailbone is to look for hyperactive pelvic floor muscles, a hypertonic pelvic floor. The pelvic floor runs from the back of the pelvic floor to the front of the tailbone. When it gets really tight, it will pull on both of those areas. Especially athletic women but not only– sometimes you have a hypertonic pelvic floor from all of the activities to strengthen and tighten. You might also be doing that to your pelvic floor. 

Up until not that long ago, all we knew about pelvic floor was that it can get weak so everybody is instructed to do these kegels and strengthen them but if it’s already hypertonic and you strengthen it, you might be making it worse. So thankfully, we have these pelvic healthy physical therapists as a specialty now. People are just training on that and how to strengthen the weaker ones and loosen the tight ones, making pregnancy and birth more comfortable, more functional, and postpartum wellness. Postpartum sometimes can be treated. 

Meagan: Yeah. So as you are saying this, I have a weird question. I had all of that during labor and then since, I am really active. I am a road cyclist and I like to lift and all of these things. I get adductor pain now where it’s not as tight and burning right in that pubic symphysis but right in that adductor. Do you think something could still be connected through that pelvic floor?

Dr. Berlin: It’s always worth checking if you haven’t had it checked. The adductor by itself could just be the adductor. Sometimes just from the workouts that you’re doing– lifting especially could make it really tight and it just needs to be rolled out or dug out and you might benefit from those trigger points too on the ends or the inserts on the top and the bottom. Pelvic floor could be a factor. There sometimes are other factors too. Even a little drop incontinence when you get the urge, it’s like, “I’ve got to go right now.” 

Meagan: Yeah. 

Dr. Berlin: Or pain during intercourse or things like that or if you jump on a trampoline or you sneeze and you pee, those are signs that something is up with the pelvic floor. It’s not functioning quite right and worth investigating with a specialist. 

Meagan: Yeah. I think a lot of people don’t even remember that even C-sections can impact that pelvic floor and our whole body and create that tension and restrict us from having good mobility. 

Dr. Berlin: That is an amazing point because it is absolutely true. The end of pregnancy puts a lot of strain on the pelvic floor no matter how you deliver. 

Body Support at Home

Meagan: Yeah, so again, definitely check out the chiropractors in your area. So for those who maybe can’t have chiropractors or can’t have access, are there any tips or maybe places on the Informed Pregnancy Plus channel where people can learn not to adjust themselves but do stretches and do those things that can help create that mobility and help them have these vaginal births that they’re wanting? 

Dr. Berlin: Yeah, there are tons. Spinning Babies has a whole bunch of great exercises that you can do. It’s a good idea. We have a course that we do called Labor Kneads. We only do it live right now, but it’s where we’re teaching partners and doulas and other support people to do bodywork before, during, and after birth. That’s a great idea for us to shoot that and put it up on the streaming service. I can’t promise it for one, but I will certainly try to do that. 

The other thing is that there is a great listing of chiropractors with separate post-graduate training. You should know that anybody who is a licensed chiropractor can work on pregnant people. It doesn’t have to be a specialty. 

Meagan: Or Webster-trained. 

Dr. Berlin: Yeah, it doesn’t have to be Webster-trained or it doesn’t have to be somebody who is a prenatal chiropractor. There are some chiropractors who don’t feel comfortable working on pregnancies. Some don’t have all that much experience, but there are a lot who are not prenatal. They are just family chiropractors and as a result, they see a lot of pregnancies. You don’t have to have a specialty to do it. So unless there’s no chiropractic in your neighborhood, then there might be people who can work on you even if it’s not a specialty clinic like in our case, we call it pregnancy-focused chiropractic. 

The other thing is that there’s a great website by the International Chiropractic Pediatric Association that does a lot of postgraduate training in pediatric and prenatal chiropractic care. They have a listing by zipcode and their website is icpa4kids.com. You can search by zip code in the United States and Canada and maybe some other international options. 

Meagan: We’ll make sure to also put that in the show notes for everyone listening. Last but not least, the big question is does anybody not qualify to receive chiropractic care? 

Dr. Berlin: Yeah, I mean, I would almost say that there are some conditions during pregnancy that come up that are delicate. During those very delicate conditions, I love to work together with the obstetric provider. At that point, it’s usually going to be an OB/GYN or a maternal-fetal medical specialist and just access their comfort level with the things that we do. Almost always, it’s going to be modifications. It’s not that we can’t adjust them at all or do any bodywork with them, it’s going to be modifications. Sometimes we’ll just wait a couple of weeks and then do the treatments but for the most part, you can do something for everyone who has things that are stiff, tight, and rigid and are either uncomfortable or want to improve their function. 

Meagan: Awesome. Well, thank you so much for taking this time out of your day with all of your projects. You’ve got so many hands in buckets. You wear so many hats these days so it’s really been such an honor to have you on the show and answer all of these amazing questions. I full-on believe in chiropractic care. Like I said, a long time ago, I was like, “Ah!” and then I started getting into chiropractic and I’m like, “No, this is really impactful on so many levels.” 

Dr. Berlin: It is. 

Meagan: I mean, I’m not even pregnant or planning on conceiving but I still go to the chiropractor because it really does impact my life in a better way. 

Dr. Berlin: We have moms come in here and they make an appointment. They say, “I want to make a postnatal appointment with Dr. Berlin.” The reception team will say, “Oh, how old is your baby?” They’ll say, “13 years old.” I’m like, “Yeah.” You don’t have to only be pregnant or postnatal to come here. 

Meagan: A postnatal visit. How old? 13. Okay. That’s just called a chiropractic visit. That’s all that you have to say. 

Dr. Berlin: It is, but once you have the baby, you have all of the bending, lifting, holding, feeding, emotional stress, and things like that. The maintenance during that active phase of life is important. 

Breastfeeding

Meagan: Yeah. Oh my gosh. I just said I’m going to end. I feel like I could talk to you all day. 

Dr. Berlin: Same. 

Meagan: But something I feel that impacted me and I know a lot of our doula clients is breastfeeding. When we’re breastfeeding, we’re hunched and curled. Our neck is down and we’re in wonky positions then we’re out and we’re stretching then we’re like, “Oh, this is painful” or all of a sudden, my milk supply is not that great, and weirdly enough, chiropractic adjustments can help your body and you nurse better and help your production because your baby is going to nurse easier. You’re going to nurse easier. Everyone’s going to be better. 

Dr. Berlin: When you’re in a lot of pain, the stress hormones put you more in emergency mode, and making milk is not an emergency function. There’s that and there’s literally just the– here’s one tip I would say that seems to help a lot of people. If you have a nursing station, especially in those early couple of months, you can put a full-length mirror in front of you so you can see what’s happening without looking straight down. That seems to be helpful for a lot of people. 

Meagan: Absolutely. Yeah. To just be able to see and not be curled over. I mean, you are looking at your baby, but you can look down at your baby versus– 

Dr. Berlin: Across. 

Meagan: Yeah. 

Dr. Berlin: Yeah. One thing that gets a lot of people is that you’re trying to get some sleep and the baby is in a comfortable position and it’s not comfortable for you but you don’t want to move because you don’t want to wake them up. That’s gold for the chiropractors. 

Meagan: It is. It is. Oh, well thank you so much again. It’s such an honor. We’re going to make sure to have all of the links to your channel, to your page, and to your website. This chiropractic search forum and everything. Everything will be in the show notes so everybody will be able to find you. 

Dr. Berlin: Thank you. 

Meagan: Like I said, if you’re listening and you haven’t been able to yet, hopefully now you’re not driving if you were driving. Stop and go follow Dr. Berlin. 

Dr. Berlin: Thank you so, so much for having me and the incredible work you do. I could also talk to you all day and I’m going to have you back on our Informed Pregnancy Podcast and I can’t wait to hear your full story. 

Meagan: I would love to share it. It’s quite the story. 

Dr. Berlin: Awesome. Thank you. 

Meagan: Awesome. 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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Today on the podcast, Sarah joins us from Minnesota. Sarah got COVID-19 very early on in her first pregnancy during the height of the pandemic. The protocol at her practice was to recommend a precautionary 39-week induction. Sarah trusted her doctor and consented to the induction along with other interventions that were suggested. Her birth ended in a Cesarean under general anesthesia. 

During recovery, Sarah’s knees would buckle to the point where she needed assistance walking and fell until the problem slowly resolved. When she achieved her VBAC, Sarah was able to immediately walk unassisted. She wasn’t groggy from just having had anesthesia. Her throat didn’t hurt. She got the immediate skin-to-skin she missed the first time.

Sarah is such an amazing example of how powerful a VBAC birth can be, especially with the right prep and the right team. We just love how hands-off and supportive her doctor was. Sarah went into her birth mentally and physically strong. She labored hard, stayed calm, and pushed her baby boy out in 20 minutes!

Additional Links

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Welcome to The VBAC Link. We have a story for you today coming from Minnesota. We have our friend, Sarah. And Sarah, tell me. Did you have your babies both in Minnesota or have you moved since then? 

Sarah: Yes, both in Minnesota. 

Meagan: Both in Minnesota. All right, so Minnesota parents, listen up. This is a wonderful episode in your area. 

Review of the Week

As always, we have a Review of the week but first I want to talk a little bit about COVID-19. Sarah and I were just talking about how we have seen so many COVID-19 stories coming through. They had their C-section through COVID-19 or even had their VBAC during COVID-19 and then now they have gone on to VBAC. 

There is definitely a trend of situations that we are seeing so I’m just so curious today. Go comment on today’s episode and let us know if you have any relation, but a lot of providers are wanting to induce if you have the virus, COVID-19. Sarah, that was kind of the case with you, right? They wanted to induce because you had COVID-19. 

Sarah: Yes. That was kind of the standard of care at that point. 

Meagan: Yes, which is kind of interesting to think about the new standard of care. I really am curious to see one day what the Cesarean rates did during COVID-19. You know, there is some evidence here and there on it, but I’m really curious to see what the Cesarean rate did because we do have a lot of people saying that they were induced because they had COVID and then they ended in a Cesarean. So we’re going to talk a little bit. She’s going to share her birth and her induction story that then led to her VBAC. 

But of course, we have that review. It is by Raving Abbeh and the title is “Confidence.” It says, “I found this podcast at 34 weeks pregnant and it helped me gain the confidence to fight for my chance and get a VBAC. I hope to submit a success story in a few weeks.” 

And guess what? This was also during 2020, so Raving Abbeh, if you haven’t submitted your story, we would love you to and as always, you guys, we’re always accepting stories. We definitely record in chunks, so know that if it takes time, that doesn’t mean you haven’t been chosen or you will never be chosen, but if you want to submit your story, go to thevbaclink.com/share. 

Sarah’s Stories

Meagan: Okay, Sarah. Welcome to the show. 

Sarah: I’m so excited. 

Meagan: I’m so excited. I’m so, so excited. Well, tell us more about this 39-week induction and why they were saying it was the new norm. It was the protocol, right?

Sarah: Yes. So at this time, I was working full-time in the hospital where I gave birth as a radiographer– an X-ray tech. I was kind of in the world a little bit. It was definitely not a fun time to work in the hospital. I actually tested positive when I was 8 weeks pregnant, so very newly pregnant. 

I was seeing family med for my provider and what they were doing at that time, they said, “Okay. This is what’s going to be different. You’re going to meet with a high-risk OB who specialized in COVID.” I would have growth ultrasounds every 4 weeks and then also, they were recommending this induction at 39 weeks. 

When I asked about that, what she said was that they had seen issues with the placenta. That was the reason that they had. I actually looked back on it now and I think in the study, they really only had 16 pregnant people so that was what they were basing this all off on. 

Meagan: Which is really nothing to start making a protocol so wide-ranged. 

Sarah: Right. Right. And actually, right now, my sister-in-law had COVID and she’s pregnant. She had COVID at the same time I did at 8 weeks, but now it’s 2023 and her doctor is not doing the growth ultrasounds. They’re not recommending induction. There actually is nothing different with her current, right-now pregnancy which I find interesting. 

Meagan: Interesting, right? Right? 

Sarah: But again, it can range. 

Meagan: In 2020, it’s interesting because they were like, “Oh, we’re going to have you with this provider who specializes in COVID pregnancies,” but how does someone specialize that fast? 

Sarah: Right. The person that was the specialized person was the highest-up person in the department of OB. 

Meagan: Okay, so definitely a specialized OB. Okay. 

Sarah: Right. I actually only ended up meeting up with her one time because if there was anything abnormal, that’s when I would go to her but my pregnancy was completely normal. I had no issues related to COVID or related to anything else which was obviously a blessing, but kind of also a bummer because now, I’m going to have this completely unnecessary induction at 39 weeks.

Meagan: Yeah. 

Sarah: She did mention at the time that if I wanted to go past 39 weeks, I could definitely make that choice but she would do NSTs. Now after learning so much and being where I am now, I would have been like, “Okay. Let’s go longer and do NSTs,” but at the time as a first-time parent, I was like, “That sounds kind of weird. Let’s just do what you think.” 

Meagan: It sounds intense with all of these extra visits. It’s a lot. It sounds like a lot. 

Sarah: Yeah. Otherwise, about that pregnancy, being a first-time parent and having this medical background, it’s no surprise probably that my attitudes towards the doctors were that I completely trusted their knowledge with the COVID stuff because it was so new. 

Meagan: Oh yeah, and scary. 

Sarah: Yeah, definitely, but I was completely unaware that there was such a wide range of ways to treat pregnancies and so many different attitudes on how to birth babies. I was just clueless to the whole thing about the cascade of interventions and why do inductions have an increased risk of C-section? I was completely clueless to it. I am just used to with a doctor, you have a certain condition and there are ways to treat it. It was very narrow. 

But with birth, there are midwives. There are doulas. There are so many different ways to treat someone’s birth and pregnancy that was just over my head. When people would ask me, “Oh, why are you having an induction?” and tell me that maybe I shouldn’t do that, I was like, “Oh, well why wouldn’t I when they say that is the best thing to do for this COVID situation?” For me, it was like, “Well, they know better than me.” 

Meagan: Right, yeah. 

Sarah: I think you say all the time that you don’t know what you don’t know. 

Meagan: You don’t know what you don’t know and you can’t judge yourself for not knowing what you don’t know. 

Sarah: Yes. I definitely had to work through forgiving myself for sure. 

Meagan: Yeah. You have to take the information. I think I talked about this too. My husband had said this. We took the information we were given and made the best choice that we felt we had with the information provided. 

Sarah:  Yes. 

Meagan: Right? And that’s what you did. 

Sarah: Right. Honestly, it’s funny now. Even just preparing for birth in general, take away the COVID part, it’s kind of funny how I did basically nothing to prepare for birth. I just focused on my registry and other things like that after the baby got there. 

It was kind of because I had this, “Oh if I go with the flow, I’ll have the best outcome. I don’t want to put too many expectations on myself. I don’t want to pressure myself. I’m just going to go with the flow. I don’t know how my body is going to handle it,” which does have a place. There is a goodness to that, but I think I was a little too extreme where I was like, “My mom had C-sections. I know if that happens, it happens.” It was just very, “Whatever happens, happens.” 

Now, I look back and I’m like, “Well, now all I did was have no tools in my toolbox to deal with pain, labor, or resources to help make those hard decisions that I was going to have to make.” I had nothing in the background to help me with that. 

Meagan: No tools in your toolbox. 

Sarah: Exactly. That’s why it was very different for my second birth but at that time, I was like, “Okay, whatever happens, happens. I don’t know what’s going to happen to me or how my body is going to take it, so we’ll just see what happens.” 

I was scheduled at 39 weeks on a Monday and actually, that Friday before, they called me and said, “Hey, do you want to come in early? We have a lot of people scheduled on Monday.” I was like, “Oh, I’m excited to meet my baby. I’ll go in even earlier,” which is like, oh. Okay. 

That weekend, we were actually moving into our new house an hour away. 

Meagan: Oh my gosh. 

Sarah: We actually spent one night at our new house and the next day we drove back to Rochester to have our baby but we were so excited. 

Meagan: Yeah. Absolutely. 

Sarah: I wasn’t even thinking about anything else. We were scheduled for a 7:00 PM Saturday appointment then. When I got there, I was completely 0% dilated. Closed. 0, 0, 0, -3 station. Furthest from ready. 

Meagan: Not ready to have a baby, yeah. 

Sarah: No. So they started me with Cytotec overnight and in the morning, they placed the Cook catheter then they started Pitocin right after. I faintly remember watching Beauty and the Beast bouncing on a ball, but that was the extent of any movement in my labor. Like I said, I didn’t prepare for anything. I just was like, “Oh, bounce on a ball. Everyone says that’s good.” I didn’t do much. 

But what did start happening was the baby was having decels, not liking the Pitocin, so I had to get moved from side to side. I was lying on the bed– not the best position to have the baby not be so high up. 

Meagan: Right. 

Sarah: But then by 10:00 AM, they took out the Cook catheter. I was 4 centimeters dilated. Things were moving along. 

But then at 11:00, they had to turn down the Pitocin because again, the baby was still not tolerating it very well. Then I felt a big pop in my belly and I was like, “Oh, is this what it feels like when your water breaks?” I was excited. I’m like, “Oh, that sounded like a balloon popping.” 

So they came in and they were like, “No, we don’t see anything. Your water didn’t break.” I was like, “Oh, okay sure.” 

Meagan: I felt something. 

Sarah: So then a half hour later, they came back in because they had to actually turn off the Pitocin because the baby still wasn’t happy. They checked me and they’re like, “Oh, there’s all your water,” and it gushed out on them. So I was like, “Okay, well at least I know that I can trust my intuition even though you didn’t quite believe me.” 

Meagan: Yes. 

Sarah: But I’m not crazy. It did break. 

The contractions were getting really intense at this point. I tried laughing gas. It didn’t really work. At that point, I decided, “Okay. I’m ready for an epidural. I feel like I’ve gotten as far as I can with what I prepared,” which was nothing. I actually found out this after the fact, but at this point, they actually gave me medicine to stop my contractions. 

Meagan: Like terbutaline or something?

Sarah: Yes, exactly. They gave me that at this point. I actually have no recollection of this, but I was able to look at my records after the fact and I was like, “Oh, I never knew they even gave me that.” Apparently, they gave me that to stop things or slow them down or whatever. 

I was about 5 centimeters dilated at this point and they placed the epidural. Everything went smoothly with that and then an hour later, they were like, “Oh, we’re going to start the Pitocin again.” I was like, “Okay.” I was 5 centimeters at that point and then 40 minutes later, they checked me and I was 9 centimeters. 

Meagan: Whoa, so your body went into total relaxation mode and dilated. 

Sarah: Yes. Yes. I was like, “Cool. That was fast.” They had just sent away the doctor. They had to call her back. Shortly after that, I was at 10 centimeters, ready to go. This is when they had me start pushing. One important part that I know now is that I don’t remember ever feeling pressure or the urge to push or anything like that. They were just like, “Okay. It’s time to push.” I’m like, “Okay.”

I did end up pushing for about 3 hours. They did let me try a few different positions. They tried to turn down my epidural to help too, but she never really progressed past that zero station. So nothing was happening. I was mostly on my back for all of it.

I remember them saying that they would let me push for the most at 4 hours, but at the 3-hour mark, I was exhausted. I felt like we had made no progress. I was just like, “Nothing’s going to change in another hour at this point for me. I don’t know what I’m doing. You try to tell me how to push. I still don’t know.” 

Meagan: Yeah. You’re just like, “I’m tired.” 

Sarah: Exactly. The contractions were beginning to be really painful. Again, I didn’t really have a way to cope with them. The pushing wasn’t working so I consented to the C-section. I just remember feeling so defeated and just crying, being wheeled into the OR. My doctor stayed right by my head and talked to me until my husband was supposed to come in because I kept saying, “Hey, I feel these contractions. They are strong.” They were trying to give me all of the medicine to numb me enough. They were doing the prick test to make sure that I couldn’t feel it and I just remember it was really hard because my nose was plugged up from crying. I felt like I couldn’t breathe anyway. I wasn’t sure about the pokes. I was like, “They are sharp to me. I feel them. They don’t feel like pressure. They feel sharp.” 

They were like, “Okay. Well, we’re going to have to put you under.” They put the mask on me. I breathed in and went to sleep. 

Meagan: And you were gone. 

Sarah: Yep. Then I was gone. 

Meagan: Your husband probably never came in then? 

Sarah: So he did get to go into the OR. She was born. They let him go in so he was all gowned up. He was in the OR. He kind of tells it like, “Yeah, it was so weird. I looked over and there you were on the table.” He wasn’t so close to me. 

Meagan: Sleeping. 

Sarah: But yeah. I was sleeping. He did get to do skin-to-skin. They let him do that in the OR which was really nice. They got a bunch of pictures of her getting weighed and him cutting the cord in there so it was nice to have some of those pictures that I can look back on. 

Meagan: Right. 

Sarah: That’s something. 

Meagan: Right, yeah. It helps you relate, too, when you’re not awake. 

Sarah: Exactly. It was definitely a weird experience. But when I did come to, apparently, I had been awake longer but you know how that works. When you’re waking up from anesthesia, it’s kind of weird. But apparently, when I woke up, they told me that I was just like, “Where’s the baby? Where’s the baby? Where’s the baby?” They rushed me back. 

I don’t remember any of that, but what I do remember is when I woke up, my throat was so sore and hurt so bad. But she was on me and she latched immediately and started feeding so that was really special. 

Meagan: Yes. 

Sarah: Just how she was able to eat right away and I didn’t have any problems with that which was really nice. I know that can happen sometimes. That’s basically that birth. 

Meagan: An unexpected ending and a less-ideal situation, but then to come out and have things work out really nicely was probably really healing and comforting. 

Sarah: Yes. Right away, I was definitely happy. She was healthy. I was okay. She was eating. But I remember just recovering from a C-section, you’re in a fog. I remember my legs being in those machines to keep the blood flowing, having a catheter, having my sore throat, and whispering to talk. That kind of thing was definitely not a fun recovery in that aspect right immediately after. 

Meagan: Yeah. 

Sarah: I actually had a really weird thing. I had problems with my knees. 

Meagan: Oh. 

Sarah: I have never heard anyone else talk about this. 

Meagan: Interesting, like wobbly and strong? 

Sarah: So what happened was once they took out the catheter and then they give you the, “Okay, it’s time to try to go to the bathroom for the first time.” When I tried to stand up, my knees would just buckle. The first day, I had to have two people assist me to the bathroom. The second day, it was also a two-assist. Slowly, they started to not always buckle. I was in the hospital, I think, for four days. Four or five days. 

Eventually, they wouldn’t buckle but when I got home, they would buckle when I went upstairs. I did fall twice but slowly, they did get better. It was fine. It was just if I unexpectedly took a step. My cat scared me and I stepped and then I would fall because my knee wasn’t expecting it. 

Meagan: I just looked it up because I am legitimately curious. It says, “Acute lower limb compartment syndrome after a Cesarean.” 

Sarah: Oh. Hmm. 

Meagan: Interesting. So it can happen. 

Sarah: Interesting. I was just kind of assuming it was a mix of me being numbed from the waist down for hours and then my legs being up in the air for hours and then being in the C-section, and then also laying down. Do you know what I mean? Something with that, but no doctor or anything ever said anything to me about it. They were just like, “Oh, okay. That’s weird.” 

Meagan: Yeah. Really, really interesting. It says that it’s rare. 

Sarah: Oh. 

Meagan: It’s pretty rare, so you get to be in one of those rare groups. Thank you for sharing. 

Sarah: Yeah, so otherwise, I hadn’t really fully processed the birth but every time I would tell my birth story, I would choke up or cry and that’s when I realized, “Oh, maybe I didn’t really like that very much” because at first, you’re just happy the baby is okay and you’re okay. I actually remember right afterward, I was like, “Oh, okay for any other baby, I’ll just schedule a C-section. This time it will be planned and I’m going to be awake for it.” 

I honestly wasn’t even thinking about VBAC right away. I was just like, “Oh, the future will be easier. It will be fine.” But when my daughter was around 6 months old, I started to listen to The Birth Hour and I found myself searching C-section stories, looking for things like mine which led me to hearing VBAC stories, searching those out, and then finally finding The VBAC Link. That was the big game changer. 

I am so appreciative of you guys having this podcast and keeping it going on and all that. 

Meagan: Absolutely. 

Sarah: Such an inspiration. I learned so much even from both podcasts about interventions, doulas, birth teams, and most importantly, trusting in a woman’s body. It kind of leads me to this big thing. It’s like, why do we have to go through some sort of trauma to become an advocate for women and educate ourselves? 

Meagan: Right? 

Sarah: I feel like that’s such a theme. 

Meagan: It’s so true though. It’s so true. Why do we have to go through a really crappy experience? It doesn’t always have to be crappy. I’m not saying C-sections are crappy, but a big experience to have passion and to feel that motivation behind that.

Sarah: Exactly. Yep. Sometimes, it’s so hard because it’s like when you talk to someone who hasn’t been affected by this kind of situation where it doesn’t go their way in the hospital, it sounds like a conspiracy theory. “You can’t trust the doctors.” That’s not what we’re saying. It’s so much more than that. 

Meagan: It is. It really is. It’s not even just in birth. Truly, right? My husband does not do what he does, I think, mainly just because he didn’t want to do it one day. It was like, “Hey, this really unfortunate situation happened to someone I love and I want to be available in a different manner to help them or help anybody else.” So he took on his profession. It’s like IBCLCs– I’m sure a lot of them have had unfortunate or poor nursing experiences and are like, “We want to help other people have better experiences.”

Sarah: Yes, because it’s the information that, “Oh, wow.” It makes complete sense that, “Oh, things might go a little bit better if you let your body naturally do it.” Oh, well yeah. That makes sense. It makes sense that, “Oh, if I have someone who’s trained in positioning, maybe if I move my body in this way, then I can get my baby in a better position to come out better. Oh, that makes sense. Why didn’t I know that? Why didn’t my doctor say, ‘Hey, there are some positions that can help.’” 

It’s confusing to me. It’s like, well that makes sense. 

Meagan: Yeah. 

Sarah: Yeah. So obviously, I just dove right into all of the VBAC stuff and learning all about that and listening to different stories. I was super excited for my next pregnancy because I had made the decision, “Yes. I’m going to go for a VBAC and I’m super excited about it.” I was ready to do all of the things to make it more successful. 

We got pregnant when my daughter was around 15 months old. We wanted a two-year age gap and they’re both two years apart in April so that worked out for us. 

Meagan: Perfectly, yeah. 

Sarah: So the things I did to make it more successful– they are all things that people on this podcast talk about. For physical things, it was workouts that focused on birth prep. I didn’t do anything crazy like walking for miles and miles every day. I just did the minimal which was doing some exercises every day for hips opening, cat/cow, and all of that stuff. I did the Miles Circuit later on in pregnancy every day. I ate my dates every day. I drank my tea.

Then I think the biggest thing, too, is mentally preparing. For mentally preparing, I got my doula. I really love that the doula does the meetings before the birth. I didn’t even know that when I had heard people talk about doulas but meeting before and talking about what birth plan I wanted, what things– 

Meagan: Your desires. 

Sarah: Exactly and what things could happen. I’m like, “This would be so helpful for a first-time parent to know all of this stuff.” I wish I had gotten her with my first. Also, just talking about coping mechanisms, what are some positions that we are going to do, talk about scenarios. It was great. 

Then I also, for mentally preparing, I looked up a bunch of different coping mechanisms. I actually did Hypnobabies. I wasn’t consistent with the meditation, but it was very helpful to practice the breathing and visualization. 

Meagan: I did too. I did it as well. 

Sarah: I was really bad at the meditations so that didn’t stick with me, but it was really, really great to practice the breathing and all of that. And honestly, just listening to birth stories is mentally preparing because I would really only focus on positive stories toward the end of my pregnancy. I was like, “Okay, now we are in the home stretch. We are just going to stick to all of the positive ones.”

The big thing, too, was finding my provider. I joined The VBAC Cesarean Support Group on Facebook way earlier and everyone had all of the recommendations of who to go to. My provider is actually family med, but he is more like a midwife. Actually, my doula said that he’s actually more crunchy than a midwife as a family med. 

For all of the births that she attended, she said, “He is more hands-off than a midwife.” I’m like, “Wow.” 

Meagan: Wow, that’s cool. 

Sarah: And what’s great is that he attends all of his births so there is no rotating call schedule. 

Meagan: Which is huge. 

Sarah: There’s no, “Who’s going to be there?” He’s very trusting of women’s bodies. I did my due diligence and I asked him, “How often have you personally seen a uterine rupture? How often do you use the vacuum? How often have you done episiotomies?” You know, so just asking him all of the things. He had really great responses and I felt really solid with him. 

Meagan: Which is really important, right? To have those conversations also. We know that when they come in and they say, “Hey, do you have any questions?” It’s really okay to ask questions. 

Sarah: Yes. That’s the big thing. So because he’s not an OB, I had to go do a consult with the OB that he works with in the hospital. The OB who works in the hospital definitely wasn’t making me fearful, but there’s a certain form you have to fill out that says, “Hey, obviously if you’re successful with your TOLAC, that’s going to be the safest option for you. But if you’re not successful, that’s the least safe.” 

It’s easy to plant doubt, but after I saw him again, I asked my provider, “How often do you see it?” It was such a small amount and since he’s one of the VBAC go-tos, I felt very confident with him. It was really nice to have that fear taken away in that way. 

Meagan: Yeah. Yeah. 

Sarah: And then this is kind of interesting. Just for fun, I did message my old provider at my previous hospital just to see what she would say about my chances for VBAC. I actually messaged her before I was pregnant. I said, “Hey, I am kind of processing and struggling from my C-section. What do you think about my chance for VBAC?” It was just on a message. 

What she said was, “You did everything you could at that time to have her vaginally, but she just didn’t fit your pelvis for whatever reason. We think of fitting as a lock and key situation. Both pieces have to work together to open, so there’s no way to know if a future baby would ever fit your pelvis better than she did.” Then she kind of went on. I thought, “Nope.” I’m like, “Nope. I’m not taking that in.” 

Meagan: Yes. 

Sarah: It was interesting. 

Meagan: Thank you so much, but no thanks. 

Sarah: Exactly.

Sarah: Exactly. I’m like, “I don’t think she didn’t fit my pelvis. That’s not a thing.”

 

Meagan: But you know, it’s an easy thing for people to say or diagnose. It’s like, “Oh, well your baby was perfect. You were perfect, but the two together didn’t really match that time.”

 

Sarah: Right.

 

Meagan: That doesn’t necessarily mean that’s true. We just don’t know.

 

Sarah: Again, we can’t go back in time and have me try something different.

 

Meagan: Yes, yes.

 

Sarah: But I think it’s interesting that she said that.

 

Meagan: It is.

 

Sarah: Again, I talked to my doctor. He’s like, “Oh yeah. Great. Let’s do it.”

 

Meagan: Yeah.

 

Sarah: He said, “You’ve got this.” So you know. Otherwise, I’m preparing. This is the funny thing too, again. At first, I didn’t have any intention of trying to go unmedicated. At first. I was like, “I definitely want to VBAC,” but I wasn’t trying to do that. I was just focused on the VBAC part. But once you hear enough birth stories, you know that if I do all of this preparation and I go as long as I can without this intervention, I’m going to have the best possible chance of a healthy vaginal birth. If it still ends in a C-section, it’s because that was what had to happen not because I didn’t know any better.

 

Meagan: Right.

 

Sarah: So that’s when I was like, “Yes, okay. It makes sense for me to try. I should just try to go unmedicated. I should just do it. Whatever happens, happens.” I still am keeping my go-with-the-flow but with a lot of preparation. It was kind of funny because when I would tell people that, “I’m trying to go unmedicated,” people will say the craziest things to you.

 

Meagan: Right? “I could never.”

 

Sarah: Yes, or “I know someone who did and it was the worst thing they ever chose to do. They said, ‘Never do that.’” It’s like, I know and I’ve heard many, many stories of people doing it and are very happy with the outcome. So definitely right before, I was 37 weeks. I was like, “I’m going to read Ina May’s Guide to Childbirth.” Everybody talks about it, but I just wanted to hone in and focus on those unmedicated birth stories and just say, “How did you guys do this? How was it successful?”

 

That was really helpful. I really liked that book. That was really good.

 

Meagan: Yeah. I really like it too.

 

Sarah: Yeah. Otherwise in this pregnancy though, I physically felt really good. I got Braxton Hicks contractions which I didn’t have in my first pregnancy. That was definitely new.

 

Meagan: Yes. Probably exciting.

 

Sarah: It was exciting. I was like, “Okay, yeah. Every birth is different.” That was one of the Hypnobabies thing that stuck with me. Each baby is different. Your birth is going to be different. Don’t let that fear creep in on you. But at 33 weeks, I found out the baby was breech so that was scary.

 

Meagan: Yeah. It throws you for a loop, right?

 

Sarah: Yes. When I found out that he was breech, I immediately messaged my doula. She gave me Spinning Babies exercises to do every day. I was making sure I was sitting forward and all of that stuff. Then I went to see a chiropractor first and then she also gave me this massage therapist who was trained in breech balancing massage. I went to both of those and the baby was flipped at my next appointment at 35 weeks.

 

Meagan: Yay.

 

Sarah: So I was very happy. The coolest thing with the massage therapist—in our state, I’m pretty sure she is maybe the only one who does this breech balancing massage. She told me because I actually went to do a follow-up appointment. Even though he was already head down, I was like, “Let’s just go again to make sure.” She said that she was treating six other breech moms at that time and they had all flipped when I came back from my second appointment.

 

Meagan: Oh my gosh.

 

Sarah: Yeah. I’m always in the groups. I’m like, “If anyone is breech, try this specific breech balancing massage. Yeah.” It’s really interesting just listening to her talk about it because she is so knowledgeable about, “Hey, your baby is breech for a reason. You have these muscles that get tightened. Your pelvis is this bowl and if things are in the wrong position, the baby wants to be head down. If I can release all of these muscles and make more space in there, even if the massage might not on its own make your baby flip, but giving your baby that space, then your ECV is more successful if you do that.

 

Meagan: Right.

 

Sarah: I was very happy because I had done all of this work and hyped myself up. I wouldn’t want to have to schedule a C-section for this reason after all of that but if it happened, it happened.

 

Meagan: Yeah.

 

Sarah: So everything was going good then until my 39-week appointment. I had a high blood pressure reading so I was like, “Oh great.” But my doctor was not worried. He had me do an NST, labs, and monitor at home. I came back in a few days and everything was good. That was nice.

 

Actually, the day that I went back for my follow-up for my high blood pressure was the day that I got my birth records. They had my birth records there for me. I had gone this whole time. I was almost 40 weeks and I was like, “I still really want to see.”

 

Meagan: You had requested them?

 

Sarah: Yeah, and it just took a really long time to get them. When I had that appointment, I was able to get my birth records earlier than I thought. I didn’t think I was even going to get them by the time I had the baby. I was able to read through them and kind of work through it. My doula was like, “Oh, do you want to call and talk about it?” I was like, “Yes.” It was kind of like a fear release for me because that night I went into labor.

 

Meagan: Yeah. Did you find anything in there that you didn’t know before?

 

Sarah: I mean, that one thing was that terbutaline. I didn’t know that. And then I was just curious about some of the dilation. Also, I saw on my records too that the surgeon who did my C-section put, “This patient is a candidate for a TOLAC.”

 

Meagan: Oh yeah.

 

Sarah: It was nice just to have that and to see that the surgeon who did my C-section would put that on my note like, “Yeah. They are a candidate.”

Meagan: Yeah, it’s helpful.

 

Sarah: Just working through it too was nice to see it in a timeline.

 

So that night was the night I went into labor. At 2:00 AM, I woke up with my contractions. Right away, they were 3-7 minutes apart. I had the same situation three weeks before where I woke up and had contractions that were 3-7 minutes apart, but they fizzled out and didn’t come back. I only had that situation one time earlier. So I was like, “Oh, this could be another practice. This could be the real thing.”

 

But they were stronger than the last time. That’s the biggest thing too. Even though they were so close together, I was handling them so well that I was like, “I think I’ll just wait this out,” which is interesting because if you’re a first-time mom, you’re like, “Hey, this is 4-1-1. I’m having them.”

 

Meagan: You have to go!

 

Sarah: And they’re long. A lot of them were long like at least a minute, but they just weren’t strong so I was like, “Okay, well I’ll wait.” Then my husband woke up at 4:00 AM. I was like, “Hey, I’m having these contractions.” His response was, “I’d better hurry up and go work. I’ve got some work to get done.” He’s like, “Oh no. I gotta go.” So then he went away to go work on stuff.

 

Then by 6:00 AM, I was like, “Okay.” I had a couple really strong ones so I was like, “Oh.” Then I was also getting back labor so I was like, “All right. Time to text the doula.” I was like, “Hey, this is what’s going on.” She was like, “Well, your back pain might be because of the baby’s position, so try to do the Miles Circuit. Eat a good breakfast. Hydrate. I’m preparing you for possibly a long day.” I said, “Okay, sounds good.”

 

I had my bagel with cream cheese. I got my Body Armor drinks out, but when I tried to do the Miles Circuit, it was so intense. I could not. The minute I laid down and I had a contraction in the Miles Circuit position, the laying down one, it was like, “Whoa, no.”

 

Meagan: Not gonna happen.

 

Sarah: I’m like, “I think this is time for me to start going into some prep mode here.” So I dimmed the lights in my room. I had my ball but I actually didn’t like bouncing on it so I never bounced on it.

 

Meagan: Was it uncomfortable?

 

Sarah: Yeah. For me, that seated position was uncomfortable. For me, I was in a forward-leaning position. I’d lean against the wall and sway or I’d have my husband come. I’d hug him and sway. I’m like, “This is working out okay.” The back labor was a different aspect that was like, “There’s got to be something I can do for this back labor.”

 

I messaged her and she’s like, “Okay, well obviously have him try to do hip squeezes,” but he wasn’t really getting the job done with the hip squeezes. She recommended the shower to also help us see if it’s going to calm down or if it will keep going. I got in the shower and it was magic. The heat on the back was perfect. My favorite thing ever, but the hot water ran out after 15 minutes and I was so sad.

 

Meagan: Oh shoot.

 

Sarah: So the hot water ran out and I was like, “Oh man.” I got out of the shower and I was like, “Now we might just have to go to the hospital right now because I need hot water. I want to get in that tub.” That was my dream was getting in the tub.

 

Meagan: Right.

 

Sarah: So my doula checked in with me at this point and asked about the shower. I was like, “Yeah.” I think I was kind of in denial because I was like, “Oh, it’s medium intense,” but they were still happening. She was like, “Okay, well maybe you should start heading in as long as they are staying 3-4 minutes consistently for an hour. Go ahead and start heading in.”

 

At this point, she also tells me that she is actually in another birth. Then she joined me with the backup doula so she was at another birth. I was like, “Oh bummer.” But my backup doula ended up being amazing as well. But you know, when you’re preparing with someone—

 

Meagan: Can I just say right there that is a real thing? It’s usually if you have to have a backup doula, it usually works out so well. Right?

 

Sarah: Yeah, it was so good.

 

Meagan: But like you were saying as I was cutting you off, as you were preparing with someone else, it’s hard.

 

Sarah: Yeah, it’s kind of a bummer because you know this person so well and you had worked with them, but it worked out perfectly fine too. I really like my backup doula. She’s great as well. She told me, again because I was like, “Hey, what can I do for now? We’re going to head in probably soon but what else can I do for this back pain?” She was like, “Do you have a heating pack?” I’m like, “Ooh, yes.”

 

I was putting a hot pack on my back which again, wasn’t hot enough for me.

 

Meagan: You needed a hot tub.

 

Sarah: It did something. At this point, my daughter had actually woken up because we were still at home. It was about 8:00 and she was so sweet. Every time I’d have a contraction, I’d go into my room. I’d have my calming music on and my swaying but then I would leave and I’d come back out with her. She was just so sad. She wasn’t crying, but she had these big tears welling up in her eyes. I would hold her and she would pat my back. She was like, “It’s okay.” It’s like she knew that something was going on.

 

I was like, “I’m okay. It’s okay.” She was just kind of like, “What is going on?” I wasn’t making loud, loud noises but I would be doing horse lips through them or moaning.

 

Meagan: Coping.

 

Sarah: Yeah, nothing too crazy, but for her, she could tell that something was going on. Luckily, my mother-in-law and sister-in-law came over shortly after that around 8:30ish. My sister-in-law took my daughter and was like, “Let’s go play,” so she was good. She was good. My mother-in-law saved me because she said, “Oh, I will boil hot water.” So she got a big pot and boiled hot water. She put cloths in them and put those on my back. That was amazing.

 

Meagan: I bet that felt really good.

 

Sarah: Right. So at this point, my husband probably should have been getting the cars ready for us to go to the hospital, but instead, he was cleaning the house frantically.

 

Meagan: That was probably his way of coping. “Oh my gosh, this is happening. I’m going to go work and then I’m going to go clean the house.”

 

Sarah: Yes. Yes, so we’re like, “Okay, it’s time. We’ve got to get going.” I’m like, “Yeah. I’ve got to get going.” So finally, we get in the car. My back is soaking wet from these hot towels but they are saving me. Luckily, the drive was only 10 minutes. I had my hot towel in there. It wasn’t the most comfortable, but we got there. They checked us in and they moved us to triage.

 

At this point, again, the sitting position was not my position for labor. It was, “Nope, not happening.” I was always kneeling, facing the back of the bed. The back of the bed was up. I held onto it. Then when I was in triage, though, I didn’t have my coping mechanisms. I didn’t have my hot towels. My next plan that I had was the comb technique.

 

I had packed a couple of combs. I was telling my husband, “All right. Your hip squeezes—” he was trying to find the combs and of course, he couldn’t find the combs that I brought. But he did remember that he brought his own comb.

 

Meagan: Hey!

 

Sarah: So I was able to take his comb which I can say RIP to his comb. I used it. There were little comb tings, whatever they are called, the teeth of the comb were everywhere at the end of my birth but it definitely worked. So then every time I would have a contraction, I was pushing on the comb and breathing as they were checking me into triage. But they were able to kind of get the band on me. They gave me an ultrasound to make sure the baby was head down while I was in triage.

 

Then they checked me. The nurse checked me and when she was down there, she was like, “Oh, it’s really hard to tell how dilated you are because you have a bulging bag of waters and I really can’t tell what you’re doing.” She was like, “I think you’re almost complete.” I’m like, “Okay.”

 

Meagan: Whoa.

 

Sarah: I’m like, “Okay.” This whole time, she’d been trying to call someone on her radio, but they were really busy. At that point, she was like, “Okay, let’s get this room.” She was like, “I’ll just wheel you on this bed unless you want to walk.” I’m like, “Actually, I want to walk.” I was actually thinking, “You know what? I think I want the bed that is in the room. The triage beds aren’t probably as comfortable.” That’s where my mind was so I was like, “Let me just walk.”

 

Meagan: No.

 

Sarah: So they get me in the room and again, my doula is on her way but she’s not there yet. It’s about, I think, 10:00. My doctor comes in. They put the little IV on my arm in case I need any medicine. All I’m doing right now-

 

Meagan: Hep lock.

 

Sarah: Yes, exactly. All I’m saying is that I just wanted to get in the tub. This is me the whole time in triage.

 

Meagan: I just want the water.

 

Sarah: I want to get in the tub. I want to get in the tub. The comb is helping, but I want to get in the tub. So he comes in. I’m like, “Hey, can I get in the tub?” He’s like, “Well, you can but I should probably check you first if you want me to. If you’re really close like the nurse thinks, then you’ll have to push soon possibly.” I’m like, “Yes. Check me because then, if I’m not, I can get in the tub.” That was in the back of my mind.

 

He checked me. He’s down there for a while and I’m finally like, “Okay, you’ve got to get out.” He’s like, “I understand why they are having a hard time. Yes. You have a big, bulging bag of waters. I can tell why she had a hard time and I think you’re maybe 7 or 8 centimeters but I can’t tell. As soon as the water breaks, you’re going to be fast.” I was like, “Sounds like I can get in the tub.” He was like, “Yes, you can.”

 

Meagan: You’re like, “Perfect.”

 

Sarah: Perfect. This is when my doula came around this time. She helped get the tub in motion because they were like, “Well, it’s going to take a while. We’ve got to get you on these mobile monitors.” She went in and she got the water going and I was able to get in the tub. The only problem is that once I got in the tub, I was like, “Oh, I think I have to poop,” which is the magic—

 

Meagan: Means you’re going to have a baby!

 

Sarah: She was like, “Well if you want, you can sit on the toilet and see if you actually do poop.” I was like, “Sounds like a plan.” I sat on the toilet facing the back of the toilet. I had my hands on my comb. My comb was with me everywhere. That’s when I had the scary, scary transition contraction. I was so happy I had her there because she was saying all of the right things and at this point, I can’t remember any of them except for her saying to me, “This is the hardest part, but it’s also the shortest. You are in transition.”

 

When I heard her, I was like, “Okay, that makes sense.” I was a little shaky. You just feel so out of control. I was like, “Whoa. I don’t know about this. I’m not sure about this.”

 

Meagan: You start questioning. It’s weird.

 

Sarah: It is really, yeah. But she was saying all of the things I needed to hear, so I was good. So then I was like, “Okay, no poop is coming. Let’s get back in the tub.” So I got back in the tub, and then I had probably one contraction and then a lab person came to the door and was like, “I’ve got to take your blood.” We’re like, “Uh, okay. Let’s just wait until she’s in between contractions.” I’m like, “That’s a good idea.”

 

So she comes in. She turns on the light. I’m like, “This is throwing off my vibe.” She sits down next to me and she scans my band and then they were like, “Okay, let’s wait for the next one.” The next contraction came and it was the, “My body is pushing! I’m pushing. Help!” I had that fetal ejection reflex, but my water was still intact so it was more of the water ejection reflex.

 

Meagan: It was pushing that, yeah. Exactly.

 

Sarah: My body did the thing where it pushed on its own. I’ve always heard about this when I’ve listened to the podcasts that this happens. I was always like, “Oh, I want that. That sounds nice. Do it for me,” but I did not like it. Nope. Especially because I was in the tub, maybe that’s why, but I just felt so out of control. I was like, “Whoa. I’m not controlling this pushing,” but I was also very excited because I knew that meant it was time.

 

The lab person promptly left the bathroom and they never got my blood. I don’t know why they needed it, but they never got it.

 

Meagan: I know. It’s so weird, “We need your blood right now.” It’s like, “Really? Why?”

 

Sarah: Yeah. Especially when, “Oh, I’m in transition about to have a baby.” I think you’re okay.

 

Meagan: Seriously.

 

Sarah: I had that. So that happened and then my doula was like, “Well, do you think you want to get in the bed?” I’m like, “Yes. If a baby is coming, I need to be on the bed.” So again, my favorite position—even my tub position was my hands and knees. I was draping my hand on the back of the bed kind of in that—I wasn’t really hands and knees because I started that way and then I ended up hugging a pillow and kind of squatting back.

 

Meagan: Yeah, okay.

 

Sarah: Yeah. I started pushing. Again, my waters hadn’t broken yet which was obviously, this is a big thing with my provider. He is hands-off. Any other provider would have said, “Do you want me to break your water?”

 

Meagan: Absolutely.

 

Sarah: That would have been a thing. It was kind of interesting that “Nope. I’m just doing it all on my own what my body wants to do.” I was pushing for about 10 minutes and then my waters exploded. They all knew it was coming, so no one got drenched, but it was so loud.

 

Meagan: Everyone was probably a little sensitive in that area. They were probably like, “I’ll walk over here.”

 

Sarah: Yes. They expected it. My doctor was like, “I might get drenched, but I’m ready for it.” But he didn’t.

 

Meagan: That’s okay.

 

Sarah: It was so loud. I was shocked. It was like a gunshot. It felt like it was just like BAM when I pushed it out. So that was great. Then about 5 minutes after that, he was born. I pushed the waters out and then pushed him out. His head was right there and they were like, “Oh, you can reach down and feel the head.” I’m like, “I can’t.” I had to reach down. I’m like, “My arms are too short.” So then I pushed him out. It was about two pushes I think.

Yes, as soon as that water was done, yeah. He was two pushes after that. It was about 20 minutes of pushing total.

 

Meagan: Whoa. That’s like nothing.

 

Sarah: Yeah, then I got to flip around. They put him on me and they didn’t cut the cord until it was done pulsing. They did delayed cord clamping. They did the golden hour. He was just on my chest the whole time. I birthed my placenta which was fine. I did have a small tear which was just something I was scared about with an unmedicated birth. I’m like, “Oh, that will be not pleasant. I hope I don’t but again, no idea. I probably will. Most people do.”

 

It was a very small, I guess, second-degree tear but he numbed it. It just felt like a bunch of little bee stings. He numbed it and stitched it. It was fine. Baby was on my chest for that whole hour. What was crazy to me—I also consented to having the Pitocin drip afterward to get the—

 

Meagan: The uterus to contract down, mhmm.

 

Sarah: Yes, yes. I had that. Once that was done, I was able to just stand up and go to the bathroom.

 

Meagan: Amazing, right?

 

Sarah: I could just get up to go to the bathroom. I felt good. I felt fine. This was about 10:50 in the morning, so yeah. I was at the hospital for an hour and a half before he was born. Later that night around 5:00, we had family come over to see the baby that night. I felt as great as could be with still normal postpartum stuff.

 

Meagan: Right. You did just push a baby out. But you weren’t knocked out and coming too and all of those other things.

 

Sarah: Yes. So yeah. That’s about it for that.

Meagan: Aw, yes. Well, congratulations. I’m sure that was a very different experience. I mean, I’m sure both babies were, right? We all cherish our babies’ births but to be more present in your baby’s birth, I’m sure definitely left an impact.

 

Sarah: Yeah. Even my husband told me that for this time, he actually teared up and felt like it was just such a more of an emotional experience even for him which is completely understandable. It was actually really scary for him with the C-section he told me. They tell you, “Hey, we’re going to go put your wife out. We’re going to come back and get you and then you’re going to come and be part of it.” He’s sitting there waiting, waiting, waiting. They just kind of say, “Hey, you can’t go in anymore. We knocked her out. You have to wait here. It’s going to be a while.” Then he’s just like, “Oh, is she going to be okay?” It was a little scary for him too, that first one. This was a lot, obviously, more emotional and just a really cool experience for both of us.

 

Meagan: Yeah. I’m sure it was very healing for both of you like you said. That couldn’t have been easy for him walking in and seeing you in that manner. I mean, the fact that he even brought it up. “It was weird when I walked in and you were laying there but then I’m over here doing skin-to-skin with this baby.”

 

Sarah: Yep.

 

Meagan: I’m sure it was so healing for both of you. Huge congrats.

 

Sarah: Yeah, thank you. Oh, and one thing to mention with the doctor is that because I gave him all of my birth plan too, at no point in this hospital situation was I ever offered anything. They knew what my preferences were. They never said anything about any interventions at all. They never said, “Do you want us to break this water?” Everyone was on board. It was great.

 

Meagan: Yeah. You really didn’t feel like you had to fight along the way.

 

Sarah: Yeah. It was all supportive which is what I wanted.

 

Meagan: Yeah, and what you deserved.

 

Sarah: Yeah. It was really great to have that. Honestly, the thing I also really liked about pushing in that position where you are facing the back of the bed was that I didn’t see all of the people staring at me. It was nice because—and not that it would have mattered—but I’m kind of socially anxious in that situation so it was nice to just be focused on my husband’s hand holding me. I’ve got my comb. I’m breathing. I’m totally in it. I’m not looking around. With the C-section, that labor was like everyone was staring at you. You’re pushing and trying and nothing is happening. It was so nice to just be here in my world. I never even saw anyone.

 

Meagan: Yeah. Sometimes you see people’s faces and they are not wanting to communicate with their mouths so they communicate with their faces. So when you are just staring at all of these people surrounding you, you find yourself, “What are they saying?”

 

Sarah: Yeah, exactly.

 

Meagan: You start questioning it. It pulls you out of that space. It sounds like you were really able to stay in that space because maybe you didn’t see any of that.

 

Sarah: Yes, exactly. When I was pushing, it was really hard. I’m not saying it was easy. “Oh, unmedicated in 20 minutes.” No. It was hard work. There were times when some doubts would creep in and I was like, “What if he’s in the canal too long? Will he be okay?” It would be easy for those doubts to creep in, but my doctor and my doula were all saying the things that I needed to hear. “You’re doing it. Your body knows what to do. Keep pushing this way. Push like you’re going to poop.”

 

They were saying all of the things to keep me focused. It would be so easy if you’re not ready to give birth to a baby, that feeling would be very scary. You would feel very out of control. I could see how easy it would be for that to be very, very scary. Having the people there that knew what to say to me was very helpful.

 

Meagan: Yeah. Absolutely. The team is really that powerful though. It really, really is.

 

Sarah: Mhmm.

 

Meagan: So get a team. If you’re looking for a doula, we’ve got doulas on our website that are VBAC-trained and certified. Get a good provider who is supportive and loving and willing to just like Dr. Ryan, just yeah. “Let’s do this. Let’s do it.” Super supportive from the get-go. “Yeah, we have to have this consult, but I’m not not supporting you by sending you to this consult.”

 

Sarah: Exactly. Yep. He’s like, “This person knows that I do a lot of VBACs. They’ve been through this before.”

 

Meagan: Yes. Yes.

 

Sarah: Yeah.

 

Meagan: Well, huge, huge congrats.

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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Women of Strength, believe in yourselves!

Brittani shares her inspiring two VBAC stories with us today-- one where she mostly prepared physically and one where she focused on intense mental preparation.

While all three of her birth stories are wildly different, each taught Brittani valuable lessons.

The image of Brittani standing in her bathroom being held up by her husband and doula while she pushes out her baby girl is absolutely unforgettable. We are so proud of you, Brittani!

Additional Links

Brittani's Clothing Website - Nunuy Apparel

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Hello, hello. We have another VBAC story. We actually have two VBAC stories for you today. We have our friend, Brittani and she is in Oregon. She has had two VBACs. Brittani, tell me. You grew up in Florida. Did you have your babies in Florida or were you in Oregon when you had your babies?

 

Brittani: All three babies here in Oregon. I lived in Florida until I was 21-22.

 

Meagan: Okay, all right. So all three babies in Oregon, so Oregon parents.

 

Brittani: We are.

 

Meagan: Listen up here. We have some VBAC stories for you. I don’t know if you will share along the way but feel free to share where you gave birth. We have a lot of people a lot of the time write in and say, “Oh my gosh. I heard this story. I am in the same area. I would love to find a provider. Do you know their provider?” So if you feel that you want to share, feel free in your story to share.

 

Brittani: I am happy to give shoutouts, yes.

 

Meagan: Perfect. Perfect. Well, Brittani is a stay-at-home mom with her three children. They are all under the age of four, right?

 

Brittani: Four and under, right? Our oldest will be five at the end of June.

 

Meagan: Yay. Oh my gosh. You are busy.

 

Brittani: Yes, we are.

 

Meagan: Not only are you busy with three beautiful children, but you have created an amazing business. I just want you to share a little bit about this because I think a lot of people will for sure want to go check you out and make sure to know that if you guys miss it while you’re driving or something, the link for all of her stuff will be in the show notes.

 

So yeah, Brittani. Tell us a little bit about your clothing line.

 

Brittani: That’s so kind. Thanks, Meagan. I don’t know if it’ll come up in conversation but I had a really, really tough go at breastfeeding. All three babies, but especially with my first, I was really self-conscious about nursing in public. I got really into sewing at home and just had the inspiration to create my own line designed for breastfeeding. I have three pieces currently. They are all ethically made in my husband’s home country of Peru. We use organic pima cotton which is the world’s finest cotton.

 

I’m working on two new designs, a jumpsuit, and a sweater. It’s called Slow Fashion for a reason. It’s taken forever because I need to let go of the perfectionism.

 

Meagan: I know. But at the same time, it’s your baby.

 

Brittani: Yep. It’s my fourth baby. Yep, yep. Maybe fifth if you count my husband.

 

Meagan: Right.

 

Brittani: Yes. I would even be happy to provide a discount code special to the listeners of this podcast, but yes. It’s called Nunuy Nursing Apparel. I have an Instagram that I wish I could be more active on, but I have all of these babies.

 

Meagan: You have three kids under the age of four.

 

Brittani: Yes. Yes. I will get there. I will get there. The baby is going to be a year old next month, so yeah. Thank you for letting me touch on that.

 

Meagan: Yay. Happy birthday.

 

Brittani: Thank you.

 

Meagan: Yeah, absolutely. I think It’s so important. From one entrepreneur to another, I think it’s so important to share. Especially, this is something that really does apply to all of our moms out there who want to breastfeed.

 

Brittani: Yes, totally.

 

Meagan: Well, thank you.

 

Brittani: Thanks, Meagan:

 

Review of the Week

 

Meagan: Yeah, yeah. We’ll get into a review and then we’ll get into sharing these babies’ stories. Obviously, they’re all amazing. Okay, so we have a review and it was on Apple Podcasts from sydmobley. It says, “Grateful to have found The VBAC Link. I was recently able to have a successful home VBAC—” so HBAC. H-B-A-C. “—due to a large part of Meagan and Julie and the stories of the ladies featured in The VBAC Link. I cannot say enough about the comfort I found in knowing I was not alone in what I was doing and going through. That so many ladies had come before me and found peace in their empowered birth. What a lifesaver these testimonies were for me.”

 

Oh, I love that. I love that so much. You know, we were talking about this before. I wish—there were birth story podcasts and things like that out when I was going for my VBAC after two Cesarean births. I wish so much that there was something like this that was more specific to VBAC. Something that I can relate to and not feel alone just like Syd because the VBAC world can feel very lonely.

 

Brittani: It is.

 

Meagan: It can feel really lonely and then if you’re in an area that is really not supportive—I mean, I felt lonely in Utah where VBAC is supported. I can’t imagine how those who are in rural areas or non-supportive areas or even where there are VBAC bans where they feel—

 

Brittani: The bans blew my mind. Someone made a comment to me, “They let you have a VBAC?” I was like, “Let me?”

 

Meagan: Let me, yeah. Yes. You’re like, “Hold on. Hold on. No one let me.” But so many people feel so stuck that they have no option. If financial means or whatever are not to a place where you can just pick up your family or yourself and go to another state and have a baby, that can really be terrible. So anyway, thank you for your review, Syd. I really appreciate it and as always, if you love the podcast as well, we’d love your review.

 

Brittani’s Stories

 

Meagan: Okay, Brittani. Let’s share these baby stories of yours.

 

Brittani: Thank you. I do just want to start by saying thank you for inviting me here. It feels really surreal to tell my—I also never thought I’d have three babies—but to tell my three stories on this podcast that literally gave me all of the strength and guidance to get through my VBACs.

 

Meagan: Oh, it warms my heart.

 

Brittani: We always have a VBAC story because of a Cesarean birth story. I had a primary Cesarean with my oldest, Olivia. The pregnancy was so easy and I did feel like one of those women that were like, you’re just glowing and everything’s fantastic. But around 28 weeks, my well-established OBGYN told me that she was breech. I didn’t really understand what that meant. I’m a very anxious person so I went into full-on panic mode.

 

Meagan: Research mode?

 

Brittani: Yes, yes. You don’t really think about Cesareans. I was more terrified to get the epidural because I hate needles. I did try everything. I followed Spinning Babies techniques. I was tortured with needles in my toes and moxi with the acupuncture. I did chiropractic work.

 

Meagan: Bladder 6.

 

Brittani: Yes, yeah. I lay upside down on an ironing board. I did inversions on the stairs and she just was determined to come into the world feet first. My OB wanted me to schedule a Cesarean for 39 weeks. I somehow talked her into going to 39 weeks and 5 days. Her due date fell on a Sunday and they “refused to let me go past 40 weeks.” If I knew what I know now.

 

So we did it on a Friday super early in the morning. I was so terrified. They would not let my husband in for the spinal injection so thankfully, I had established rapport with my doctor. She held my hand through the whole thing. The spinal was done. They did all of the things. I had written a gentle Cesarean birth plan. My doctor followed most of it, but her colleague just started chitchatting her up asking about summer plans. I wish I had the—I don’t want to say the guts, but I wish I had spoken up for myself and said, “Yeah, this is my baby’s birth. Can you just walk me through what’s happening?” because it’s so bizarre for half of your body to feel numb.

 

Meagan: Ability, yeah.

 

Brittani: My heart was racing. Oh my goodness. So baby was born. Everything was fine. They did take her from me and wiped her all off before they gave her to me. While the experience wasn’t traumatic rushing into the OR, it was planned, but the actual Cesarean experience was pretty traumatic for me. I’m sure some of that still carries on in my nervous system today but because of that experience, we knew we were going to have a second. I just knew. I was like, “I’m never going through that again.”

 

I found your podcast and started preparing. About 15 months after our first was born, I got pregnant with our second. I started out with the same care team, but my doctor had moved on then you get rotated around. I stayed for the first trimester, but every new midwife or OB that I got was just saying all of these bad things about VBAC. I was like, “This is not the place for me.”

 

Meagan: Good for you for recognizing that. It’s a really hard place to be.

 

Brittani: Yeah. It’s not easy to switch.

 

Meagan: It’s really not. It’s daunting. It’s scary, right? Yeah.

 

Brittani: Totally. I do live in an amazing place with very supportive providers and lots of options. We have several free-standing birth centers. There are birth centers with midwives, so I chose to do an out-of-hospital birth center. The birth team there is called “Omnum Midwifery” and they are just right there in southeast Portland.

 

So they had four midwives at the time. Also, appointments were an hour long. They cared about you and asked you questions. The OB appointments were just so fast. You forget to ask things. It’s kind of like a whirlwind. This was a much slower pace. You feel really involved.

 

Meagan: Really, really cared for.

 

Brittani: So different. I wish I knew more about this, but my husband says, “Hindsight’s 20/20,” so you just work with what you’ve got.

 

This pregnancy was really bad with nausea in the beginning, so I kind of had this feeling, “I hope it’s a boy,” because we already had a girl. We had two so we thought—

 

Meagan: One girl, one boy.

 

Brittani: Perfect, yeah. He stayed head-down. They found him at his anatomy scan head-down. He stayed there the whole time which was awesome because I was so worried about that, another breech baby. I naturally went into labor at 40 weeks and 2 days. It was pretty early in the morning. I went to the bathroom. I had been having—I don’t love the work Braxton Hicks—practice contractions and when I wiped, I had some blood-tinged mucus. I just knew it was different.

 

I called my mom. She came over to be with our oldest. I touched base with the midwives. They actually came and did a home visit to check on me and baby first and then said, “Okay. Let’s meet at the birth center in a few hours.”

I was already experiencing contractions where I had to hold onto something and I couldn’t talk and had to breathe through it. I think that kind of psyched me out. I was like, “If it’s this hard right now, what’s going to happen in active labor?” I really did trip myself out that way.

 

But we got to the birth center which was so lovely. They had the bath ready for me. I was in and out of the bath, but after struggling pretty hard, I think I was in labor at this point for 15+ hours, I asked for a cervical check. They hadn’t even offered or touched. I was at 7 which was pretty exciting.

 

Meagan: Wow, yeah.

 

Brittani: Yeah. It was the first time I had been in labor. I didn’t labor with our first. However, things started to get really, really difficult and I had double-peaking contractions for hours on end.

 

Meagan: You weren’t getting a break.

 

Brittani: Not even close. And oh, Meagan. I lost my doula because of COVID. They stopped letting people come into the hospitals as a “guest” or “visitor”. I’m putting that in quotation marks because I feel that every single birthing woman on this planet deserves support. It’s not a visitor. It’s part of your birth team.

 

Meagan: It’s essential.

 

Brittani: I agree.

 

Meagan: I know. I know. I was the doula on the other end during COVID dropping at the door just bawling my eyes out—

 

Brittani: Because you feel so invested, yeah.

 

Meagan: Or feeling very angry because someone was like, “Hey, they just told me that you can no longer be with me.” But our hospital did start finding that people were dropping the hospital, so they started making doulas essential. That’s why they were like, “They are essential to this plan.”

 

Brittani: So essential, mhmm.

 

Meagan: That is so hard to have a plan and then lose your doula.

 

Brittani: Yes. I guess I should backtrack slightly. I hired a birth photographer because that was super important to me and then I hired a doula. The company my doula was working for offered virtual services, but I’m like, “I’m going to end up throwing the computer at the wall.”

 

Meagan: It’s really hard. It’s really hard.

 

Brittani: I wanted hands-on. I wanted to be touched. I wanted to be talked through it. So I did lose our doula, but anyway, I really believe that if she had been there, it would definitely have given me a little more strength because nobody was there to just be like, “You can do this.”

 

Meagan: Yeah, your cheerleader. Your husband probably needed her too.

 

Brittani: Yeah, doulas are totally for the partner as well, my goodness, because sometimes they feel totally lost and just don’t know what to do. When I was going through contractions, I just started rhythmically tapping on things. I wasn’t counting out loud, but I would count in my head because it just helped me feel really present and grounded like I was in control of something.

 

But that counting and tapping in my head turned into pounding on the wall and every time I knew that second surge was coming, my butt would just clench.

 

Meagan: Just tense up, yeah.

 

Brittani: I just couldn’t relax. I had some glute pain throughout the pregnancy and at this point, it felt like there were just electric shocks going down my legs. I don’t want to scare anybody, but it was so taxing that I literally begged to transfer to the hospital. It took a lot longer to get a call back from the hospital than I expected.

 

When I first asked to transfer, by the time we got there, it had been 4 hours with these double contractions. It was awful, Meagan.

 

So the midwives also couldn’t transfer with me because of COVID, so my husband and I were on our own—

 

Meagan: With a new team.

 

Brittani: Yeah, just the two of us there. We get to the hospital. The anesthesiologist was busy so even if you transfer, it still takes a long time to get the epidural.

 

Meagan: So prepare for that mentally, for sure.

 

Brittani: Yes, absolutely. I also forgot to mention they gave me some of the laughing gas at the birth center.

 

Meagan: Oh, nitrous oxide?

 

Brittani: It didn’t help. It didn’t help. I think I was just too deep into it to get my rhythm back, unfortunately. I prepared so much physically for the VBAC that I really didn’t take the time to prepare as much mentally as I could have.

 

So we get to the hospital. I go. I get in. They hook me up to the IV. The nurse offered me Fentanyl. She said it would take the edge off.

 

Meagan: Even at 7 centimeters, I’m shocked.

 

Brittani: It was brutal. I wish I hadn’t done it. It made me so dizzy and really disoriented.

 

Meagan: Kind of foggy.

 

Brittani: Yes. I hadn’t eaten since the morning and here we were at 7:00 at night. So we’re moving on. Everybody’s like, “Oh, you transferred from the birth center.” At some point, I wanted to slap somebody. I’m like, “Can we just let me have my baby instead of telling me where I came from? I know that I transferred to the hospital.”

 

Meagan: I just came here to have a baby. That is where I came from. I came here.

 

Brittani: Let’s just do this. But really, Meagan, I felt like I should have just gone in with this flashing neon sign, "Danger VBAC, Danger VBAC.”

 

Meagan: Really?

 

Brittani: So I got the epidural placed. I had the machinery hooked up. If you’re not breathing well or if you move a little too much, those machines get so wonky. They wanted to break my bag of water to put the little internal monitor on. I really educated myself when I knew our doula wasn’t coming. I made a hospital birth plan. I made a backup Cesarean birth plan. We really just advocated for ourselves. We declined the monitor. They ended up bringing in closer to full dilation a piece of paper saying I had a 79% success rate for my VBAC.

 

Meagan: What? In the middle of labor, you’re at 7 centimeters.

 

Brittani: I think at this point I might have been at 9 because she checked me and my bag of water hadn’t broken yet.

 

Meagan: Oh my goodness.

 

Brittani: So I happily signed saying that I do not want a repeat Cesarean. They did give the risks of VBAC and a repeat C-section which most people don’t talk about the risks for both. Both carry risks. Yep. So I agreed to let them break my bag at 9 centimeters. There was some meconium in the water. My poor baby had just been put through the wringer with these double-peaking contractions.

 

She tells me, “Let’s do a practice push,” and when I did that, I felt my stomach acid come up into my throat. I was so exhausted, Meagan. I was just like, “I’m going to end up in the OR.” I just was ready to give up.

 

Meagan: You just felt defeat.

 

Brittani: Yeah. My husband was so tired but still there the whole time. I did again advocate for myself and was like, “Look. You guys have been in and out of this room. I’ve had zero rest. I’ve been in labor for over 24 hours.”

 

She said, “Well, we’ll give you an hour.” But someone was probably in every 15 minutes because they were getting all of the birth stuff ready and there was meconium in the water so they were prepping the NICU team. Somebody was supposed to be there for the actual birth to make sure he didn’t need to be suctioned.

 

So they let me rest but I didn’t really rest. Then the midwife comes back in and says, “Since this is your first vaginal birth, we’re going to prepare to push for 2-3 hours.” I was like, “Nope. That’s not happening.” I had this whole vision of me birthing the baby. It was not in a supine position with both of my legs in the air and a nurse on one side and my husband on the other. She’s telling me, “Hold your breath. Push as hard as you can.”

 

They call it purple pushing because—

 

Meagan: Your face goes purple. You lose your oxygen.

 

Brittani: Sometimes blood vessels will break. Yes.

 

 

So thankfully—my son’s name is Enrique—he handled the pushing really well. I got him out in 45 minutes.

 

Meagan: Which is awesome.

 

Brittani: Yeah. The weird thing was—my poor little guy. He had a really rough start. My midwife stepped away. I must have watched dozens of birth videos. My baby is crowning. She asked if I wanted to touch his head which gave me so much more strength. I was like, “Oh my gosh. I’m right there. I know I can do this.” They turn the epidural off when you start pushing, so I got to feel all of that pressure. I felt like I needed to take a really big poop. It was kind of scary.

 

So as he is crowning, I could just feel everything stretching. I don’t know why, but she stepped away. We had been doing three pretty valiant pushes. We. I was doing pretty valiant pushes with each contraction. I hated that feeling of him just sitting right there and I needed him out. Usually, just the head is born, so I gave a fourth push even though the midwife had walked away and my little boy just came shooting out. Nobody was there to catch him.

 

Meagan: Oh my goodness.

 

Brittani: His cord was so long and I’m so grateful because they take the bottom of the bed off and what if he had fallen on the floor? My little dude--

 

Meagan: So did he stay on the bed?

 

Brittani: He did. He did not fall, but my poor little guy. He screamed and screamed for a whole hour. He didn’t want to breastfeed. The staff wasn’t super duper attentive, but the recovery from that birth was just so much different. I had some pelvic floor damage that I’m still dealing with a little bit today but it’s because I’ve had back to back to back babies and I really do think that athletic pushing just might not have been the sole cause, but it did some damage to my pelvic floor.

 

Meagan: Yeah.

 

Brittani: So after his birth, my husband got a vasectomy.

 

Meagan: Yeah, I was going to say are you going to mention what happened after? Yeah, okay. Okay.

 

Brittani: It was so crazy. In November 2020, he got a vasectomy. We were just two babies, that’s it. A boy and a girl. A couple of months go by and he’s taking his samples back to the lab. They were like, “You still have lots of activity and it’s really plentiful.” I’m just like, “How does this happen?”

 

Meagan: How does this happen?

 

Brittani: Oregon is a great state though. They cover sterilization at 100% when you have insurance so at least we didn’t have to pay a ton of money to have it done, but as odd as it sounds, I just kind of felt like I questioned everything in my life. I have two siblings. My husband, Gonzalo, has two siblings and so just literally joking, Meagan, one night, I said, “I think I want another baby.” I thought he was going to say, “We got a vasectomy for a reason. Why would we go for a third?”

 

Meagan: No! Yeah.

 

Brittani: He was like, “Well, we probably would need a bigger car. If it’s a boy, he’d have to share a room with Enrique. So he started talking about all of these things and I was like, “What?”

 

Meagan: The logistics of it almost like he had thought about it before.

 

Brittani: So it took us a couple of months and we agreed to have one more baby. I never thought I would have three children ever, but our little girl just really wanted to be here so we did get pregnant with our third. This was by far my hardest, most unpleasant pregnancy. I gained a ton of weight but I was nauseous almost to the end of the second trimester. Awful.

 

So I’m actually really glad. I’m going to miss having life inside of my belly because it’s just amazing, but that pregnancy was rough enough that I’m like, “Okay. I think that’s good. I’m satisfied.”

 

Meagan: You’re like, “Let’s make sure that vasectomy is 100% this time.”

 

Brittani: That’s right. So this time around, as I stated in my earlier VBAC birth story, I prepared so much physically, so this time unfortunately, the weight gain got the best of me, but I was really dedicated to mental preparation.

 

Meagan: Yeah.

 

Brittani: I chose a home birth midwife team. Their names are Alicia and Nicole and they are with Flourish Midwifery also in Portland. They are amazing home birth midwives. I started with them really early on and my whole deal with this home birth was that I changed my language. I stopped using contractions. I said “surges”. I was just using different terms to describe birth and I went in just feeling like, “This doesn’t have to be scary. This could be an amazing experience.”

 

Surges just feel like really intense period cramps and you can literally feel the energy coming down. I don’t know if you’re a Bruno Mars fan but his 24-karat Magic was like, “Don’t fight the feeling. Invite the feeling.” So I just kept saying, “I can do this.”

 

I have a friend. She’s a hypnosis coach turned friend and she does Hypnobirthing. My husband also wasn’t super involved in the prep for Enrique’s VBAC, but he was very involved with this one. So I did Hypnobirthing with my friend, Christy. Her business is called Enter Into Calm. She’s also local-ish. She’s a couple of hours away from me here in Oregon.

 

So I just meditated to their rainbow—it’s Hypnobirthing—relaxation every day. I listened to birth affirmations literally in the car back and forth anywhere I was going. Ina May’s Spiritual Midwifery book—I rented it from the library three times and I read all of those birth stories. I dedicated myself so much to all of these positive, amazing birth stories and just gathered that collective strength. I just truly felt it in my bones. I was like, “I’ve got this.”

 

Then 36 weeks, I had an anterior placenta. I didn’t feel—Sophia’s her name. I didn’t feel Sophia move as much during this last pregnancy, so I was always a little like, “What’s going on?”

 

Meagan: Yeah.

 

Brittani: At 36 weeks, we had the placement of my placenta checked and baby was breech. 36 weeks. I have chills all over my body right now just saying it out loud. My husband didn’t go with me because it was just going to be a quick check of my placenta. I felt so defeated. I broke down crying and called my midwives.

 

I took a day to just feel really crappy and sorry for myself. Then I decided to do something about it. I was like, “You know what? I prepared so hard for this. I’m not just going to give up these last four weeks or whatever.”

 

Meagan: Right. Right.

 

Brittani: Again, I’m so lucky to be where I am. I declined an ECV, external cephalic version-- I think I’m pronouncing that right—where they manipulate your belly to move the baby with our first because the OB just straight up told me that I’m going to want an epidural placed. “We’re going to numb you, give you muscle relaxers and by the way, I have less than a 10% success rate.”

 

So I was like, “I’m not going to do that.” But this time around, my midwives knew another home birth midwife who has her own acupuncture and chiropractic practice as well as delivering babies.

 

Meagan: Breech babies?

 

Brittani: Well, I did find breech home birth midwives but she does ECVs and she’s incredibly successful.

 

Meagan: Awesome.

 

Brittani: So I went to her office at 38 weeks. I had done Spinning Babies. The information is all free on their website, but they have a specific program where you can pay a little bit of money to have it all on one sheet. My husband helped me do some belly sifting. I did all of these things for six days which is supposed to give more space in the womb. It’s not always going to turn the baby because she didn’t turn, but also just creates that extra space to help the ECV have a higher success rate.

 

Meagan: Right.

 

Brittani: So we get there. One of my midwives came with me which was so lovely. We brought some oil. The midwife put those darn needles in my pinky toes and it does hurt. She left us for 10 or 15 minutes. Alicia just massaged my belly and we talked to the baby. It was actually really beautiful. I took some really deep breaths.

 

Meagan: Sounds like it.

 

Brittani: While it was incredibly intense, I ended up with some bruising around my ribcage because she got Sophia transverse then she slipped back. So we had to do a second go and I was really worried it wasn’t going to work, but she just had some kind of magic. I remember the rhythmic rocking when I knew she was just getting to the head-down position.

 

My heart is even racing just retelling the story. So when she gets her head down, just busted into tears of relief and disbelief. Then I sat on the stool and she checked the baby’s heart rate. Her heart rate never dipped and I just accredit that to me being so calm. I talked to her. I practiced for 5 months at this point doing this meditation and breath work so it was such a crazy, amazing experience.

 

I ended up going into labor on her due date. During my meditation—you can’t plan, but in my mind, I was like, “I’d love to go into labor when the older two are asleep and they wake up to a new baby sister.” I went into labor just as the kids were going to sleep. It picked up really quickly. I had the tub, but we didn’t have time to fill it up. I was in my tub. I ended up getting out and we called the midwife around 3:00 AM. The midwife and doula got there between 4:00 and 4:30.

 

I was on the bed at this point. I remember feeling this—I don’t know how to describe it right at this point, but it was just such an intense feeling in my back. I now know it was her coming through the birth canal, but I screamed and I was like, “Somebody squeeze my hips!” I can’t remember how many hours, but instead of doing the tapping like I did with my other when I was unmedicated at the time, it was really crazy. I was so loud. I can’t believe the kiddos didn’t wake up. It was like, “I can do this,” with this really low voice trying to bring the baby down.

 

Meagan: And opening your throat.

 

Brittani: I was such a low almost like a growl.

 

Meagan: Yeah.

 

Brittani: It was either, “I can do this” or “I’ve got this”. I felt it in my body, Meagan. I was like, “This is happening.”

 

Meagan: Oh, that’s amazing.

 

Brittani: They somehow got me off my bed because they wanted me to move. I think they could tell I was getting ready to push and I was like, “I can’t do it.” So the three of them somehow helped me to the short walk into my bathroom. This big birth tub is in there with four adults and they get me to sit down on the toilet. I’ll never forget this. My doula who also was a VBAC mama and my acupuncturist for both my second and third pregnancy, she came to be our doula.

 

I was completely naked also which I never thought would happen but that’s just what happened. She wiped my sweaty hair off my face and told me how beautiful I looked. I can’t even describe how that just changed everything because I was feeling really scared and I said at one point, “I don’t think I can do this.” Those women just—I could not have done it without their presence.

 

Anyways, I sat on the toilet and I heard this really loud pop. My water released then the rest of it was kind of just a blur. She’d only checked Sophia’s heartbeat twice. I didn’t have one vaginal exam and here I am and my baby’s getting ready to be born. They asked me to stand up and I was like, “Not happening.”

 

So I’m holding on with one arm on my husband, my doula on the other and I actually sunk my teeth into my doula’s arm as I was standing up. It was so intense.

 

Meagan: I was bit one time as a doula!

 

Brittani: Oh my gosh.

 

Meagan: After, she was like, “Did I bite you or did I imagine that?” I’m like, “Yeah, you did. That’s okay though.” She bit into my hand. She grabbed my hand.

 

Brittani: It’s just such a primal thing. You’re not really in control. Things happen.

 

Meagan: Yeah, that’s what she said. She said, “I thought I maybe did it but then maybe I imagined it.”

 

Brittani: Crazy. I actually felt the same way. I was thinking about it, then I did weeks later apologize to her, but it was just like, what are you gonna do? What are you gonna do?

 

Sophia was born so quickly. When I stood up, my legs were shaking. I had my husband and my doula. Alicia was like, “Do you want to reach down and touch your baby?” I just couldn’t gather the strength to let someone’s arm go, so I said, “No.” Then she offered to let my husband catch her and I was like, “You’re not going anywhere.”

 

Meagan: He’s holding me up!

 

Brittani: I really thought that I pushed for a long time, but she told me it was less than 5 minutes.

 

Meagan: Whoa.

 

Brittani: She just came right out. She had a nuchal cord. She had a really short cord too and she was just placed directly on my belly. They helped me walk from there to the bed and I just couldn’t believe I did it. It was so surreal.

 

Then I went through this—I had really bad shakes after. They said, “It’s just the hormones.”

Meagan: Adrenaline.

 

Brittani: But it was wild. I felt so cold. They popped towels in the dryer for me and got me all warm. Wow. Just what a crazy experience. And Meagan, the second vasectomy worked.

 

Meagan: See? This baby girl just wanted to be in your family.

 

Brittani: Not even kidding. She just made our little family complete.

 

Meagan: So complete.

 

Brittani: Yeah. She really did want to be with us, our sweet Sophia.

 

Meagan: Oh my goodness. I love that too that you were all in this bathroom, everybody hands-on right there and you could feel their strength obviously.

 

Brittani: Amazing.

 

Meagan: Yes, and then just boom. Baby’s out.

 

Brittani: I still can’t believe it. Intact perineum actually. Both births, intact perineum.

 

Meagan: I think that has something to do with position and control as well.

 

Brittani: Totally. Gravity was so in my favor.

 

Meagan: Mhmm and then not being stuck on your back in a crazy position.

 

Brittani: Yes, which goes against all of the laws of gravity. Yeah. Being on your back is hard but for an epidural, it’s kind of the only choice you really have, unfortunately.

 

Meagan: Yeah. Yeah, for sure. They can move you side to side but a lot of the time, the providers don’t feel comfortable with that. They really don’t.

 

Brittani: Of course. They want you in a laid-back position. I totally understand which is bad for what do they call it? Biological birth. I can’t think of the word right now.

 

Meagan: No, I was going to say physiological birth.

 

Brittani: Yes, thank you. I think you’re right. I think you’re right. Yep. Yep.

 

Meagan: Physiological. Yes, anyway. Yes. That is also to say if you guys are wanting an epidural and you’re like, you know, you can still fight for other positions. Speak up and like she was saying in the OR, we wish that we could. It’s just hard. We want. We’re here in our heads saying things, but we can’t vocalize it so if you are one of those people that feel like you would get there, I was too. My doctor was also in the OR talking about how sad they were that it was snowing outside and how they just got back from Hawaii.

 

Brittani: Oh my goodness.

 

Meagan: But have someone else, your birthing partner, your husband or your doula, or someone else there to say, “Hey, I know that this would mean a lot to her,” and communicate that, right?

 

Brittani: I love that. Yes. You absolutely can and should.

 

Meagan: And should. If you feel like you can’t articulate it or there’s not someone with you, just move as much as you can, right?

Brittani: Right. I should have mentioned that I did ask for a peanut ball and we rotated while I had the epidural back and forth. They wanted me to push. I asked for some rest. I didn’t get great rest, but you can absolutely advocate for yourself and ask for what you want. And yes, doulas or birth partners are the ones that get to be the bad guy. Let them do it. You do your thing and let somebody else do the uncomfortable things. Let’s do it this way.

 

Meagan: Yeah, yeah. We talk about it. I’m happy to be the bad guy. I’m happy to be the bad guy. It’s not bad for someone to say something, but unfortunately, sometimes we are looking like the annoying ones but I’ll be annoying for you. Well, congratulations.

 

Brittani: Thanks, Meagan.

 

Meagan: Congratulations on the completion of your family. I mean, I would usually say that would suck to not have it work but it sounds like it did not suck to not have the vasectomy go through. It’s perfect and is exactly what you needed.

 

Brittani: I quite possibly might have the world’s best husband so I wouldn’t have done it had I not married him.

 

Meagan: Yes. Well, congratulations. You talked about how with the second VBAC, the third pregnancy, you really focused more on the mental aspect. This is where it’s really hard because we want to find this balance between physically and educationally preparing for our VBACs but then also emotionally preparing. So is there anything that you—I mean it sounds like you did a lot. But is there anything that you are like, “This is something that I did that I truly felt I carried through my entire birth?”

 

Brittani: Definitely believing in myself. When you have that self-efficacy, nothing can really stop you. It is important to prepare physically as well because our bodies go through a very physical process and it is physically taxing to be pregnant and then give birth regardless of how your baby enters the world. So just finding that balance of also not overwhelming myself because I get overwhelmed really easily. I just picked one main thing to focus on and where I found the most strength was reading all of the birth stories and listening to your podcast.

 

I even went in the Facebook community, your Facebook group, and told my son’s birth story and just sharing things because you really aren’t alone. There is somebody else going through it. You can find your little village of people and my biggest thing is I always didn’t entertain any negativity. If I talked about, “I’m going to have my baby at home,” or getting the looks or, “Ooh, is that safe?” I’m such a “Let me tell you why I’m right” kind of person. I chose silence at that point. I was like, “I believe in myself. I know I can do this,” and I just kind of put a wall up if you will to any of that negativity.

 

And just know the facts. There is plenty of great information on your website. I knew all of the statistics and I was so educated and when I ended up in the hospital, it worked to my benefit because I was able to advocate for myself.

 

Meagan: Yeah, especially with your team changing. Crazy. I love that. Believe in yourself.

 

Brittani: Women of Strength, yes.

 

Meagan: Women of Strength, you are strong and you can do it. You can get through anything. It’s okay if plans change.

 

Brittani: Totally. Mine did several times.

 

Meagan: But also, know that if plans change, it doesn’t mean that everything is just out the window. It doesn’t have to be that way. We know that sometimes, things happen and it feels like everything just went out the window. It feels defeating and it feels frustrating but know that there are still options. There are still options.

 

Brittani: Always.

 

Meagan: And you are strong.

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

Have you heard of radical acceptance? Julie Francom leads our episode today alongside Meagan as they discuss what this concept is and how it is helping them process their births even now, years later. 

Meagan gets especially vulnerable today as she shares a part of her VBA2C birth story that has never before been shared on the podcast. 

Women of Strength, birth can be all of the things– empowering, euphoric, intense, and traumatic. We want you to know that we are processing and healing right along with you. We all have work to do and we are all in this together. 

Has radical acceptance helped you process your births? We would love to hear your experiences!

Additional Links

Accepting Reality Using DBT Skills Article

How to Embrace Radical Acceptance Article

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Julie: Heyo, it’s Julie here, your co-host for the day of The VBAC Link Podcast. I am joined by Meagan Heaton, the ever-wonderful, always amazing, always uplifting and inspiring. Man, did I already say your name? I forget. I went on a tangent. 

Meagan: You did. Hello, everybody. It’s so fun. When we were just talking about it, I was like, “Julie, you lead the episode today.”

Julie: I’m out of rhythm. 

Meagan: It’s great. You did a great job. 

Julie: We are here today. We were just hashing over topics that we could talk about something that I am working through always in my life and different things that we could possibly introduce today and we landed on the topic of radial acceptance. I think we’re going to tell you about why we chose that topic here in just a little bit, but I’m really excited today because birth is complicated. I feel like everyone coming here in this space with us has probably had a complicated birth or witnessed a complicated birth. Hello, birth workers. 

Review of the Week

We’re going to talk a little bit about that and what happens when you just can’t get over it or overcome it. But before we do any of that and before I ramble on my merry little way today, Meagan’s going to read a review for us. 

Meagan: Yes. Okay, so we have this review from Apple Podcasts. This is from our friend, Tiffany. She said, “VBAC After Two Cesarean” as the subject. She said, “After two C-sections, I doubted if it was possible to VBAC for my third. I listened to your podcast my entire pregnancy and it gave me the strength and the knowledge to advocate for myself. I changed my provider three times before finding a supportive OB. My third baby came into this world on her due date with a successful VBAC after two Cesarean and I couldn’t thank The VBAC Link enough.”

Oh, I am so happy for you, Tiffany. Huge congrats. This podcast is literally meant for exactly that– to give you the knowledge, to give you the strength, and to just give you the connection and this community. This community is so beautiful, so vulnerable, and obviously so near and dear to both my and Julie’s hearts. That is exactly what we want this podcast to do– to build you up, to strengthen you, to educate you, to go on and have the birth that you desired, and if you don’t have the birth that you desired, to have a better birth outcome. 

We don’t have to have a VBAC in order to have a better birth outcome. That’s really important to talk about too. Through this podcast, we share all of it. We share CBAC stories and elective inductions and all of these things because we know that one size does not fit all. That’s exactly what we are going to be talking about today during the episode. 

Julie: Yep. I love that. Meagan’s going to get a little bit vulnerable. 

Meagan: I am. I’m going to talk about a thing that I don’t think I’ve fully opened up to yet years later. 

Radical Acceptance

Julie: I’m getting old now. I know that everyone is like, “Oh, you’re not old.” I’m 38 though and I’m feeling it. I can’t even come home from a birth now without creaking my bones in the shower and into bed. I am feeling it. I know 38 is really not that old, but I feel like I look at my friends who are 28 and I’m 38. That’s a 10-year difference, right? I’m starting to see some differences between myself and them just in the space on the time lived and the amount of life lived and the amount of time spent on this twirling rock in the universe. 

It’s interesting because I know it’s not a secret here that I’ve had a huge mental health journey over these last two years. I feel like a lot of that has helped me grow and evolve as a human. Maybe I’m a little bit older and wiser than I was when I was 28. Oh my gosh, I hope so. I don’t know. Yeah. I’ve come a long way since then. 

But, we wanted to talk today about a term that I learned in therapy called radical acceptance. I’m just going to get right into it. I don’t know. Do you want to say anything, Meagan, before?

Meagan: Yeah, so are you going to define it? I was going to say that radical acceptance is something that can be defined as the ability to accept situations that are outside of our control without judging them which in turn reduces the suffering that is caused by them. 

I think, Julie, what we talked about before is that you should start right out there and talk about radical acceptance, how you learned about it, and how it came about. 

Julie: Yeah. Gosh, I love it. I remember when I was going through my big trauma-processing journey a few years back, that’s when I really learned the term “radical acceptance, radical acceptance” and I love it because radical acceptance is where you have to stop fighting reality. You stop responding with impulsive behaviors or destructive behaviors when things aren’t going the way you want them to or looking back on the way things happened. You’ve got to let go of the bitterness that can be keeping you trapped in this cycle of suffering and to truly accept the reality, to radically accept the reality, we have to understand the facts about the past and about the present– like what’s going on now– even if they’re uncomfortable or if there is something that we didn’t want to happen or to be happening. 

We can examine the cause of this suffering that we have encountered, the events surrounding it, or all of the situations that we went through that have caused us pain or are causing us pain. But by radically accepting them, stopping fighting them, and stopping living in this cycle of suffering, we are better equipped to move forward into a life that is better and that is more promising, and more hopeful and causes us less anxiety and less pain. 

I feel like it’s just all about embracing things as they were, embracing things as they are, and being able to live in that even though you haven’t changed any of it. I was telling Meagan before we started– I am saying this. This is a perfect example. I will never, ever, ever, ever know if my Cesarean was necessary. I won’t. I think I can list ways and reasons why it probably was and I can also list reasons why it probably wasn’t. I’m just never, ever, ever– I can say ever so many times– I will never know–

Meagan: Never, ever, ever. 

Julie: –for certain whether it was necessary or not. Was my induction necessary? I think so, but I mean, I don’t know really. That used to really bother me because I’m a very analytical person. I liked fixed facts and data. I like to know things with certainty. I do. That is something I won’t ever know. I’m okay with that. I feel like getting to the point of being okay with not knowing and with the certainty that I will never know is very freeing. It’s freeing. I feel free. I am not haunted by it. It doesn’t keep me up at night. 

Moving beyond that, I know that I am a good mom even though I didn’t know everything that I wish I would have known going into my first birth. I have radically accepted the fact that there were things I didn’t know and that’s okay. I am okay with that fact. I have radically accepted the fact that I cannot be a human superwoman who can juggle all of the things in my life that I need to– my kids, my husband, my birth photography, doula work, The VBAC Link, and all of these other things. I had to drop these other things and I had to radically accept that I could not keep going in the life that I was doing. 

It doesn’t mean that anything has changed. My C-section was the way that it was. There was no change there, but I have changed the way that I thought about it, the way that I continue to receive it, and the way that I respond to those circumstances. I feel like that’s what radical acceptance is all about. 

You can’t just turn on a switch and be like, “All right. Radical acceptance. Schwink”, but I feel like if you move forward with the desire of that radical acceptance, then that will impact how you respond physically and emotionally to the thing that you’re trying to accept. I don’t know if that makes sense or not. 

Meagan: No, yeah. It does. This is going to apply to all things. In all things in life, it’s really hard because like you said, it’s not just a “schwink” like you say. It’s not a switch you can turn on and off like, “Okay. It’s gone. I accept it. Moving on.” It’s not like that. It takes a lot of time and it takes a lot of mind-power and will. You have to be okay to let it go and to let the attachment to the painful past or the pain that you are holding onto go because really what is happening in so many ways is that pain is overcoming you. It’s taking over you. 

Like Julie said, she’s not staying awake all night thinking about it. It’s not consuming her thoughts anymore. She’s let it go and it’s in a healthy place. “Okay. This happened. It’s not what I wanted. It’s not what I would have chosen, but it happened. I don’t know if it was needed. I don’t know. I really don’t know, but I’m going to accept that it happened and I’m moving on.” 

Yeah, so I think it’s so important to know that you can’t expect yourself to just do it. Right? But it can be done. So yeah. Keep going. 

Julie: Yeah, no. I feel like another simple way to say it, and it’s not simple, but a simple way to say it is understanding what you have control over and what you will never have control over. I can control how I respond to things. I can control how I do my self-care. I can control whether I meditate or not. I can control what type of clients I take on and what my travel radius is. I can control what provider I choose. I cannot control what provider I chose. It’s already happened. I cannot control how Meagan thinks or acts in any situation. 

One of the things that radical acceptance term really clicked and the first thing that I radically accepted was my sister-in-law and I butt heads a lot sometimes. It’s gotten better over the last year and a half because I have radically accepted that she is the way she is. It took me a long time. It sounds easy, but it took me a long time where I just don’t worry about it anymore. She does this. She says this and I don’t worry about it. I interact with my children the way I want to interact with them. I teach them how to treat other people. I respond to people how I do. I know how to treat other people and try my best to treat other people well although I am not perfect at it because none of us are perfect, but just radically accepting it– I remember the day where I was just like, “Yes. She is the way she is and I’m okay with that.” 

It felt like a light switch at that time, but it was a lot of things building up to that moment. I feel like we should probably say that we are not medical professionals. We are not mental health professionals. We are just talking about our real-life experiences so I feel like if you have things that you need to process through, you should see a therapist or you should see a mental health professional or somebody that can really help you. 

Meagan, I just sent you an article. You can link it in the show notes. 

Meagan: Yeah, I have it. Something that I really love is what is reality acceptance. 

Julie: Yeah, so drop this in the show notes. I feel like this has got lots of helpful tips there, but I want to skip to the end where it says, “10 Steps for Practicing Acceptance”. I’m using DBT. DBT is just a different type of therapy, but I feel like the first one is such a big deal. I could go off on another therapy tangent, but I won’t. The first one is “Observe that you’re fighting against reality.” It shouldn’t be like this. Every time you say, “I should” or “I shouldn’t” or “He should do that. My doctor should know better. I should do this. My kids should go to bed.”

Those are requirements that you have for the world and requirements are not usually healthy. They’re just not. I could go off on a whole thing, but I won’t. “I should do this. He should do that. I shouldn’t feel like this. I shouldn’t feel sad. I have a healthy baby. I shouldn’t feel sad about it.” No, that’s a requirement and that is fighting against reality. You’re fighting against reality when you say things like that. That’s a sign that you’re fighting against reality. I feel like sometimes awareness is the first part of it. 

Or “so-and-so shouldn’t post triggering things like that. Those things trigger me. They shouldn’t be posting that. They should post a trigger warning with their comments.” Those are all signs that you’re fighting against reality, right? Some type of reality that exists somewhere inside of you. 

And then the second is just reminding yourself when those things happen, instead of sitting with that, “It shouldn’t be like this. She shouldn’t have said that,” remind yourself that that reality, you cannot change it. You are not in control of it. Sometimes that awareness, being like, “Oh, I’m doing this. Okay no, you’re right. This is fine. It’s not going to change. I can’t change this. I have no control over that.” That’s the first step into your radical acceptance path. 

I’m just going to read through the rest of these really quickly and I highly recommend that you sit with these if you can. “Acknowledge that something led to this moment.” Something happened to you to lead you to have this kind of response. The next one is, “Practice acceptance with not only your mind but your body and spirit.” Be mindful of your breath and your posture. Use your self-care skills. Use half-smiling and take deep breaths. That’s a big thing for me. I take deep breaths when I feel those sensations and that tightening and tensing in my body. 

The next one is, “List what your behavior would look like if you did accept the facts and then acted accordingly.” Imagine what it would be like if these things didn’t bother you. 

Meagan: How would you look? How would you feel? How would you be living your everyday life?

Julie: How would your environment change? How would your body feel? How would your breath feel? “Plan ahead with events that seem unacceptable and then plan how you should appropriately cope.” Oh my gosh, we go to my in-laws for Sunday dinner every other Sunday. It was like, every Sunday dinner going in, I would see my sister-in-law. We’ve had moments where we’ve been grumpy with each other and moments where we’ve been fine. But during those grumpy stages, I would walk in bracing for a fight, but when I became aware and was working on my radical acceptance, I would just meditate before, breathe deeply on the way in, and walk in with a posture of lightheartedness and airyness and it helped so much. 

“Remain mindful of your physical sensations” because your body will respond before your mind catches up to what’s going on. So being more mindful of your body is so important. “Embracing feelings of disappointment, sadness, or grief.” It’s okay to have those sad feelings and those hard feelings. It’s okay. You should sit with them. You should sit with them and explore them and let them move through your body, but don’t stay there. Don’t stay there with them forever. 

“Acknowledge that life is worth living even when there is temporary pain.” Things are worth moving forward and moving through. And then the last one is, “If you feel yourself resisting, complete your pros and cons exercise to better understand the full impact of your choices or your experience.” I feel like all of those things, wherever you’re at in the process, moving through these steps or these little feelings are going to help you grow and become better. You’re going to be released from these things that are burdening you, this reality that you don’t like or that you don’t accept. But yeah. 

Meagan: Yeah. That’s what I was saying. Radical acceptance doesn’t have to mean that you agree with what happened. 

Julie: Yes. You don’t have to endorse it. It doesn’t mean you have to like it. 

Meagan: Right, but it gives you a chance to accept things and not fight against it because it is insane how much we don’t realize that sometimes these things will bring us down. They’re going to bring us down. There are many times– we were talking before we were recording about how sometimes it’s not even to us. As birth workers, we see things and we’re like, “No!” You know? Or we have friends and we’re like, “No, don’t do that.” But we can’t control them. We have to know that we can’t control them and it’s okay that we can’t control them. We may not agree with the choice that they are making, but it’s okay. We have to accept that. That is a choice that they feel is best for them. That is what they are doing whether or not we would do that or not. 

So, kind of in the beginning, Julie was talking about, “I will never, ever know if my Cesarean was truly necessary,” and something when we were talking about this is that I’m never going to know blank, blank, blank. I don’t know if I’ve ever really, deeply talked about a part of my birth story that happened and that does affect me. It’s really hard. As I’m learning about this radical acceptance, it’s like, “Have I done radical acceptance? Have I practiced this or is it still eating at me?” I think it probably is still eating at me. I probably fully haven’t. I’m working that way and I’m waiting for my light switch to go on and off, but I’m working up to it. It’s like my light switch is half on. It reminds me of Hypnobabies. My light switch is dim. It’s coming down but it’s still there. 

So yeah, I’m going to open up to you and just tell you guys. I don’t think I’ve ever talked about this that I know of. 

Julie: I’m so curious. Sorry. 

Meagan: You’re just fine. So after I had my son, Webster– he’s my VBA2C baby– I was so happy. I was so happy and I will never forget that moment of, “You guys! I did it!” and just ugly crying, screaming, and looking around the room and everyone– not a dry eye in the room– looking at me just smiling from ear to ear. And then what happened after is what I may need to work on accepting. 

I remember sitting there holding my baby and hearing everyone talking and then all I heard was, “Riiiiing.” Yep. I heard ringing, just like that in my ears, high, high-pitched. My ears were just buzzing. I’m sitting on a horseshoe thing holding my baby. We’re waiting for my placenta. I’m hearing it and it’s getting louder and then everybody started going fuzzy. 

I woke up on the floor covered in blankets confused. My husband said, “You passed out.” I said, “Okay. I thought I was going.” I knew what was happening, but I didn’t want to say anything. He said, “I looked over,” because he was right behind me. He said, “I looked over your shoulder and your arms just went limp so I hurried and grabbed the baby and said, ‘You guys, she’s passing out.’” 

I pass out. I’m on the ground. I wake up and I’m like, “What just happened?” Everyone is still so happy. They’re not acting really any differently. They’re just like, “You passed out.” I’m like, “Okay, well I did just go through a long labor. 42 hours of labor, pretty intense pushing. I hadn’t eaten a ton. I hadn’t eaten a ton the day before either because I was not feeling very good.” Anyway, so I was like, “Okay, cool.” A phone was handed to me and they’re like, “Your chiropractor is on the phone. You’ve got to tell her,” so I’m like, “Hi!” I’m telling her how I did it. I’m so excited and back to normal. 

But laying on the floor, I guess pushing out the placenta, I don’t remember. Then they’re like, “Okay.” I hang up the phone and they’re like, “Okay, let’s get you to the bedroom.” I’m at a birth center. I’m like, “Okay great.” We stand up. We walk to the bed and I’m not feeling very good. I’m feeling really funny. I can just feel my heart. It’s pounding. I think I made it to the bedroom and I was in the bed. I just remember not feeling very good. They were taking my vitals. My vitals were off, but I was just so happy. I was so elated. I was nursing my baby. He latched really fast and I was so happy. 

Then they’re like, “Okay, we’ve got to get you to the bathroom.” This was a couple of hours later. They fed me some food and I was hoping that maybe it was blood sugar or something. Anyway, they fed me my food and were like, “Okay, let’s go to the bathroom.” I get up and before I know it, I’m waking up. I wake up and the first thing I say is, “I’m on the ground again.” They’re like, “Yeah, you just passed out again.” Did you know this, Julie?

Julie: Okay, so it’s kind of ringing a bell a little bit, but I don’t remember.

Meagan: You don’t remember all of it, yeah. 

Julie: Well, I remember other little parts, but I just don’t want to get ahead of you. But go ahead, you’re fine. 

Meagan: Yeah, you’re fine. I’m like, “I’m on the ground again.” They’re like, “Yeah, you just passed out again.” I was like, “That’s weird.” So I sat on the ground. We’re talking about random stuff, you guys. I still remember to this day. Serial podcasts, Adnan Syed, if anyone likes crime, that was my favorite podcast. I was like, “What do you guys think? Is Adnan guilty or is he innocent?” We were just talking about all of this random stuff. They were probably thinking, “What?” 

It was like my fight or flight was like, “I can’t deal with what is happening right now. I have to talk about something else.” So we talked about that. We talked about such random stuff. I was like, “Okay. I feel better.” I had sat up and I was like, “I’m feeling really good.” So I sat up. I walked to the toilet. I sat on the toilet and I was like, “I’m going again.” I could feel it. I communicated it. My doula and my husband run over. I’m literally falling off the toilet and I wake up to an alcohol swab. My doula had an alcohol swab on my nose. I wake up and I was like, “What the heck? What is happening?” 

I go to the bathroom. I go back in and I’m just not doing very well. My vitals are not good. My pulse is really high and my heart rate was actually really low. My blood pressure was low. I’m actually showing signs of shock is what I’m showing, but it’s not clicking in my head. “What in the heck, right?” Needless to say, I go home. I’m not doing really well. The next day, I’m really not doing well. I’m white as a ghost. I have this weird, crazy thing. I stand up. I’ve got ringing in my ears. I feel like garbage. I’m very dizzy. I can’t get my breath. It’s just really weird. 

Anyway, I went to the hospital because I had gone to the midwife the day before. We did a blood draw and she said, “Yeah, you’ve got low blood counts.” I was like, “Okay.” It was the Fourth of July. I’m really not feeling good. We go to the hospital. We do my blood tests. The doctor comes in and has a very serious face and I’m actually really mad. It’s the Fourth of July. I just had this beautiful VBAC and I’m in the hospital emergency room without my baby. Without my baby. My mom stayed with my baby. 

I’m pissed. I’m like, “What the heck is happening?” So he comes in and he’s got this very serious look on his face. He says, “Well, we’re going to have to run some more tests.” I said, “Oh, okay. What’s going on?” He said, “Well, half of your body’s blood is missing.” 

Julie: This is the part that I remember. 

Meagan: Yeah. Yeah. He said, “Half of your body’s blood is missing. You said you’re not really bleeding, right?” I said, “No.” After you have a baby, you’re bleeding, but it wasn’t bad. I was like, “No, yeah. Pretty normal.” He was like, “Okay. Well, we’re going to do some tests to see if we can find internal bleeding and if you’re bleeding internally.” I said, “Okay.”

So anyway, we did all of these tests. We can’t find my blood. It’s gone. It’s missing. I have no blood– or half of my body’s blood. I look like a ghost. I feel terrible. I can’t function very well and he’s like, “We can’t find it. We don’t know. You’re not bleeding internally. You’re not bleeding externally. We have no idea what’s happened to you.” I’m like, “Okay.” 

So they said, “You need four bags of blood. Two blood transfusions. Two bags each.” I don’t know why. It freaked me the heck out. It was a lot of someone else’s blood. I know we’ve come a long way. I thank all of the donations. I thank all of the donations out there, but it freaked me out so I actually declined and to this day, I need to have radical acceptance. I question, “Why didn’t I get blood? I would have felt better.” 

Julie: It took you forever to feel better. 

Meagan: It did. My levels were back to pretty much just above normal at six weeks. Everyone told me it wouldn’t happen. Sorry, I’m weird. Yes. I ate my placenta. I did placenta encapsulation. I swear it helped. Everyone told me I was crazy. They were like, “You’re not going to be able to breastfeed. You’re in bad shape. You’re really bad.” And I didn’t do it. 

So I had that. Why didn’t I do that? But all in all, I still have this, “What in the heck happened to me? What happened? How did that happen? Why did that happen? How does someone lose half of their body’s blood?”

Julie: And don’t know where it goes because you didn’t hemorrhage afterwards. 

Meagan: No. No. I had very little, normal blood loss after. Anyway, I have lots of questions. I have lots of hypotheses. I have a lot of things. Could this have happened? Could this have happened? I don’t know. Maybe this happened. And some days, Julie, it does take over my mind. I get angry. I get confused and I sometimes question my team. Is there something that they know that they’re not telling me? I don’t know. I struggle. So I need to practice radical acceptance. 

Julie: Radical acceptance. Yes, you do. 

Meagan: Because that did happen to me and it is frustrating because I did say– so the signs of lack of acceptance is “This isn’t right. It’s not fair. It shouldn’t be like this. I can’t believe this is happening. Why is this happening to me? Why did this happen?” I have all of those feelings still. It’s not fair. I had this beautiful VBAC. Now, I have this shitty– yes, I’m saying the word shitty on the podcast– postpartum experience. It was really hard and I was mad. I couldn’t believe it was happening. It shouldn’t be like this. I should be screaming from the rooftops, “You guys, I had my vaginal birth after two Cesareans!” 

But instead, I could barely walk. So I need to practice this radical acceptance. I need to recognize these signs and I need to get better because I am angry with the situation and confused. 

Julie: Yeah. 

Meagan: I feel stuck. I feel stuck. What happened? But like you don’t know if your Cesarean was ever necessary, I may never know what happened to me. 

Julie: You will never know where all your blood went. 

Meagan: I will never know where all my blood went. 

Julie: Nope. 

Meagan: I will never know why I had ringing in my ears and why I passed out three times after I had him. Right? I will never know. So I have work to do. 

Julie: We all have work to do. 

Meagan: I was going to say, it’s okay if you have work to do too. Women of Strength, we all have work to do just like Julie said. We have to take one step at a time moving forward and working through it and letting go of the painful past of the unknown. 

Julie: Oh my gosh. Okay, so I have something to say. Surprise. 

My therapist is obsessed with his wife. Obsessed. You wouldn’t want anyone to be more obsessed with you if you are married to this guy. A few months ago, she came to him and she wanted a divorce. They are getting divorced now. 

Meagan: Oh my gosh. 

Julie: I know. It took everybody by storm. I was like, “What is happening?” Anyway, the details are not important, but he came to one of our trauma support groups the other night. He’s not affiliated with the company anymore, but he just came because I told him to come and he listens to me because I’m his favorite. We were all going around the room sharing how we were doing and he wasn’t going to share, but everyone got done. I came a little bit late and I was like, “Oh, did I miss his check-in?” 

He said, “Oh no, I wasn’t going to share.” Then somebody else came in and they shared, and then he said, “You know, actually, I think I will share.” He was like– anyways, he had some concerns about sharing or not and he decided to share. What he said, I think, will always stay with me. But while he was sharing, he said, “This is the most pain I have felt in a long time, but I am sitting with it and I am letting myself feel it because I know it is the fastest way for me to get through it.” 

I was like, “Yes. Yes.” Sitting with that pain and that hurt and that discomfort is hard. It is so hard. So, so, so hard, but allowing yourself to sit with it and feel it and hurt and suffer is going to be the fastest way for you to get through that suffering. It’s going to shorten the amount of time you have to suffer and it’s going to stop it from controlling your life– maybe not right now. Probably not right now, but as you move on and as you go throughout your life, if you don’t let yourself sit in that pain and struggle, then it will continue to control you and you will continue to be miserable. 

I just thought that was so impactful that he said that. I know that is the fastest way for me to get through this is to feel it. 

Meagan: Yeah, and that’s scary, right? That’s scary to say, “I’m going to open up and I’m going to welcome this pain.” 

Julie: And be vulnerable and receive it and hurt from it. 

Meagan: Yes. Women of Strength, as you are going through your births, you may run into this where you feel cheated or lied to or you are starting to question your own decisions or whatever. We’ve had an undesired birth outcome or experience and we hurt. They sting. They sting. But it’s okay to one, sit with it like she said, and two, be vulnerable and be mad or angry or sad. It’s okay to feel the feelings and then it’s okay to have radical acceptance and move on. It’s okay if it doesn’t happen overnight. 

I love that. He sat with it or he’s sitting with it. It’s the fastest way for him to heal. 

Julie: Yeah, because he’s a therapist, right? He obviously knows a thing or two. But sometimes it’s hard even when we know. 

Meagan: Even when we know. Yeah. Yeah. 

So as you walk away from this episode today or drive away or wherever you are listening, we hope you know that we love you. We love you and you need to love yourself too. Offer yourself grace. Sit with it. Sit with it and find radical acceptance. 

Julie: We wish that for you. 

Meagan: Mhmm. 

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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You don’t hear VBAC stories with gestational diabetes very often, but we want to change that! Charlotte joins Meagan on the podcast today sharing her experience with gestational diabetes and a surprise preterm delivery at 32 weeks. 

Though she had some pretty significant curveballs thrown at her, Charlotte’s commitment to controlling what she could along with an amazingly supportive team allowed her to have an empowering birth experience. 

Charlotte knew she wanted a VBAC for an easier recovery. What she didn’t know was truly how much of a blessing in disguise it became during the intense weeks she spent as a NICU mama. 

Additional Links

Real Food for Gestational Diabetes by Lily Nichols

Real Food for Pregnancy by Lily Nichols

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Hello, hello. You are listening to The VBAC Link and I am excited to be sharing a story with you today that we have gotten a lot of requests about. It’s something that we don’t see very often and my question is why? I don’t really know why we don’t see these stories popping up. Even in the community, I’ve had to search through our VBAC Link Community on Facebook to find these stories. There are three I think.

So I’m excited to talk about this story today because I know that it’s very much requested. We’re going to be talking about gestational diabetes. Gestational diabetes again, is something that we don’t see but it’s actually pretty common. Crazy enough, we’re seeing a rise in fact. Last year, in 2022, there was an article published talking about the actual rise that we’re seeing. They said, “The new analysis of 3.25 million birth records follow a string of studies that suggest gestational diabetes has become increasingly prevalent over the last three decades,” which is kind of crazy. 

Every year anywhere from 2-10% of women will be diagnosed with gestational diabetes. We know that the Cesarean rate here in the U.S. is just above 32%. If you think about the 32% and 2-10%, you’ve got to think that people who are going for a VBAC are having gestational diabetes. My question is, are we not seeing VBAC with gestational diabetes because providers aren’t allowing us? That’s my question. 

Charlotte, today, welcome to the show. She is going to be sharing her story about gestational diabetes and her VBAC. Right, Charlotte? 

Charlotte: That’s right. I’m super excited. 

Meagan: Yes. Yes. I’m so excited. I’m so glad that we connected. Charlotte lives in South Carolina in Greensville specifically. They have two baby boys– not baby, baby but they are young. She has a very baby and then a younger baby. She works in healthcare administration for a very large healthcare system and has truly become a birth nerd outside of work. 

This is something that birth just does to a lot of us. It captivates us. Right, Charlotte? 

Charlotte: Totally. 

Meagan: Do you feel that your birth is what brought you into your obsession with birth and VBAC in general? 

Charlotte: It’s life-changing. Once you’ve been through it, it was such a seismic shift for me and it opens your eyes to what women are going through. Then you hear people’s stories and everyone has something that has stuck with them. People who are years and years older remember exactly how their birth story was. I’m very Type A, so I just turned to research. I love it. 

Meagan: Yeah. Yeah. That’s why I became a doula, through my own birth experiences and I know that’s why a lot of other doulas become doulas or midwives or why OBs become OBs. It’s really awesome and we are really excited to have your episode on the show. So thank you for being here today. 

Review of the Week 

I have a Review of the Week as usual so I’m going to get into that and then we will share Charlotte’s birth stories. Today the review is from Blanely and it says, “There For Me When I Needed Support.” It says, “I got pregnant right at the start of the pandemic in 2020. It was a very lonely time isolated with my toddlers. I couldn’t even hug my mom or get her support in the beginning. I had to switch providers due to insurance changes and I was scared. The VBAC Link became my companion at this time. Julie and Meagan, my friends, I would listen with one earbud while caring for my boys. It was educational and encouraging just when I needed it. I learned tons about birth and how to advocate for my VBAC. 

“In January 2021, I had my successful VBAC. It was a wonderfully redemptive process. Even though they aren’t being produced right now, it is still the first thing that I recommend to any of my friends who are expecting. VBAC or first baby, I just love it and I hope it comes back soon.” 

Well, this was back in the pandemic and we did take a break and we are back. So thank you, Blanely. I hope you are still with us and I hope you just heard your wonderful review. We really do appreciate these reviews so much so if you haven’t had a chance, I always ask. Stop and go check out on Apple Podcasts, Google, or wherever you’re listening, and leave us a review. We absolutely love them. 

Charlotte’s Stories

Meagan: Okay, Charlotte. Oh my gosh. I am serious– you’re going to be the first episode, I believe. I don’t recall any other episodes of gestational diabetes. 

Charlotte: I think that’s right because I looked when I was diagnosed. I found a birth story that was a VBAC not on a VBAC podcast about gestational diabetes. It was one that I could listen to. 

Meagan: Yes. Yeah, and we’ve got some that had diabetes previously before pregnancy, but none with gestational diabetes. So congratulations on being our first. I hope you are not the last. If you are listening out there also, and you had gestational diabetes and you had a VBAC, we do want to share your story. We want to help people just like Charlotte when she was out there looking for these stories and only found one, we really want to add some stories because it’s really not something that we are seeing or hearing. 

I’d like to turn the time over to you. We know that every VBAC has to start with a C-section, so if you want to talk about your firstborn’s birth, we would love that. 

Charlotte: Absolutely. Well, thank you for having me. I, once again, was telling you that this podcast really started my journey. There was the C-section and then some conversations with providers that fueled the fire. Then after that, The VBAC Link was one of the first things that I turned to. It’s super surreal being here today. 

I’m married to my husband, Hunter, and in 2020, my father had– before the pandemic started– two back-to-back major surgeries which put things into perspective. Then the pandemic hit and a lot of things got canceled. It’s the same story for a lot of people. We were like, “Okay.” We had been putting it off. We’d been together for 11 years at that point and we were like, “Let’s just go for it.” We got pregnant very quickly in the first month. 

We were super excited. It was an uncomplicated pregnancy other than just the general stuff from the pandemic. It’s tough to be pregnant and not have the support or feeling like you can go and be out with your friends or see your family without potentially killing them or being scared of that. 

Meagan: I know. There was all of this fear. And even then, for a lot of my doula clients here in Utah, they were being told that if they went out and they got COVID, they were threatened. They were like, “You won’t have your baby. You won’t have your husband. You could kill your baby.” They were saying these very, very scary things. 

Charlotte: Yeah, so that wasn’t great. In hindsight, with that pregnancy, I had a lot more time to myself worrying. Overall, it went very well. Right around the time that they were making sure with no questions that you had a birth support partner and all of that you were starting to see– even though he was delivered in January 2021 which was almost the worst of it. 

We were at a normal OB practice. As I mentioned, I worked in healthcare administration and academic medicine. I work remotely now, but back then, prior to the pandemic, I was going to the hospital. I was very comfortable with physicians. My mother was a physician. So yeah, I had no issue with that. I really had no reason to question medical care. 

Meagan: Right. 

Charlotte: There was also a new birthing center, a new birth wing of our hospital. They had always delivered babies but they had delivered at the other hospital in town for whatever reason. I was one of– within the last year, it had opened 11 months ago. They were still– I mean, it was amazing. 

Meagan: Getting on their feet. 

Charlotte: They were. I think there were just some growing pains but they had everything you could think of in this new center. So anyway, I was 30 weeks pregnant so I did deliver a little early with this guy. My son, Auggie. Augustus is his full name. 

Meagan: I love that. 

Charlotte: Yeah, I had a trickle come out in the middle of the night around 38 weeks and I was like, “What is that?” It could be pee. It could be whatever. Nothing started. We went back to bed, no big deal. I finished up some things with work the next day. We just said, “You know, why don’t we just get this checked out?” We went to labor and delivery. They tested it and it was negative for amniotic fluid so we were like, “Okay, great.” 

We went back. We got home around 9:00 PM that night. I went to bed early. I just was tired from being in triage. It always takes longer than you expect and then woke up at 1:00 AM to pee as everybody does in the last trimester of pregnancy. There was more of a gush at that point. That’s when I knew for sure that the startings of my labor started with water breaking. Now I know, that can be the start of a ton of positioning issues which is what happened with me. 

Yeah, so then I really quickly went into labor. I had actually done a birth class virtually with a doula. I didn’t have a doula, but I felt like, “Okay, I’m going to try to go as long as I can without an epidural.” That was always my thing. “I’ll go as long as I can, but I’ll still probably have one.” I always had this disclaimer.

I started laboring. It felt very primal and very natural. It was dark. I was on all fours, but it felt intense from the beginning. I say this now to my husband, “I never feel like I’ve had early labor with either of these labors. It just goes straight to intense for me personally.” 

So I was feeling really like, oh my gosh, grunting and moaning and doing all of the things. We did that for about 4-5 hours. Then I started to feel nervous. I wanted to go ahead to the hospital. We made our way there. When I got there, they checked me. They checked the amniotic fluid. It was the amniotic fluid. I believe it had been the time before as well. They checked me and I was 4 centimeters so I was super excited. I felt like, “Oh, this is moving super quickly and I’m going to have this baby today.”

I was on the birth ball. I was prepared, or so I thought. I got to my room and felt, “This is super intense. I am nervous that this is going to move super fast that I won’t be able to get an epidural, so I’d better go ahead and get anesthesiology to come. There were a bunch of people coming in and out. I’m sure it slowed things down at that point, but I had a medical student and an attending come in and ask if I wanted to be part of a cervical check study. I work in academic medicine so yeah, of course. Definitely. Let’s sign up because that matters for students. You learn all of these things after the fact. You don’t want to say no to things like that. 

Meagan: It’s kind of awkward because you’re like, “I know you need to learn and I want to help you.” 

Charlotte: Yeah, but it’s like, “No. I don’t need more checks. I don’t need more people interrupting me.” 

Meagan: Especially with your water broken. 

Charlotte: Now I know. Right. Right. So anyway, there were things like that and they come in. I’m feeling very intense still and I’m 7 centimeters. 

Meagan: Wow! 

Charlotte: I’m feeling amazing. I’m going to keep moving this along. This is great. I’m texting all of my family and friends, “Hey, this is easy. I’m getting my epidural and in a couple of hours, this is done.” So they gave me my epidural. It worked great and I just chilled. I knew about the peanut ball and I did do the peanut ball, but I think I just laid around. I had my catheter. I was drinking all of the fluids and the popsicles, and just the normal things. You’re hooked up to everything at that point. 

We were just chilling and then time passed and it was the whole day. They checked me again, “You know, okay. You’re taking some time but it’s still normal.” I actually had a midwife that was the person on call, or the 24-hour provider, so I did have a midwife caring for me. They just kept saying, “This is normal for a first birth.” I was like, “Okay.” 

More time passed. They decided, “Okay. Let’s get some Pitocin to keep this going.” So I started Pitocin. I’m sure you’re hearing the same old story, the cascade of interventions. 

Meagan: You know, it does. It does happen like that. Not always, but it does where it’s like, “All right. We’ve been going. We’ve been going. We do need to get this labor going.” Pitocin is the next option, right? 

Charlotte: Yep. And so yeah, then it started with that. I knew, “Okay, let’s do the peanut ball. Let’s move around.” I didn’t know. I thought a peanut ball was enough. It wasn’t with the right positions and had I known all of the positioning issues I came to find out my son had, if I had a doula and if I had the right tools at my disposal, I would have held off on the epidural. There are so many things I would have done and that’s tough for me. That’s something I struggled with. What if I could have done better if I had known? 

Meagan: But you can’t blame yourself. You can’t blame yourself. 

Charlotte: No, you can’t. So anyway, time passes. All in all, the labor was 27 hours. I don’t know exactly the duration of time, but at one point we got multiple checks. “Okay, you’ve gotten a little farther. Great. Let’s do internal monitoring. Let’s do this. Let’s see. Okay, the baby is not coming down as much as we would like. He’s OP, asynclitic.” I come to find out that I think he had a nuchal hand because he came out like this and his hand was super bruised up. 

Meagan: Oh yeah, so when your water broke, he just [inaudible]. 

Charlotte: Yep. And asynclitic, your head is tilted to the side. He had all of those things. He was not coming down. An OB manually tried to push him up and switch him and was sweating and working hard for 30 minutes on that so you can imagine my body going through it. My epidural kept breaking through so I’d go from zero to 100 Pitocin, 9-centimeter contractions, and just pain. 

Meagan: And messing with things. 

Charlotte: Mhmm. Tons of meds. They’d try to get it all back and I’d be fine again. But it’s like, in hindsight, we did throne position. They let me push on all fours. They let me push. I did end up getting to 9 centimeters or so when we started pushing. They let me push for 4 hours. So in hindsight, there is a lot that they let me do with an epidural, just things I think would be part of a positive story. 

All in all, 27 hours passed. I’m exhausted. Nothing is wrong with me. Nothing is wrong with the baby, but the midwife comes in and says, “Look. I think we need to call it. I don’t think he’s coming down. He’s super high still.” Right or wrong, I don’t know if more time would have helped, but he was starting to get a swollen part on his head and they just said, “I think it’s time. You can definitely have a vaginal birth one day.” She said that to me and I was like, “Okay. I’m done too.”

I definitely was tearful. You always have those angels in your story. I had an angel nurse that came and said, “Oh, honey. I’ve had 3 C-sections and it’s great.” At the time, it’s what I needed just the right person at the right time to comfort you. 

Meagan: And being able to relate. I think being able to relate and be like, “Okay, you did it. You’re here.” 

Charlotte: Exactly. I was whisked away into the C-section. Usually, the husband doesn’t follow you right away. They do all of the things and then they come in. Well, my husband never comes in. 

Meagan: Oh. 

Charlotte: My husband had not eaten and had not slept. He ended up getting lightheaded and almost passing out in which case he was being cared for by the midwife that was caring for me in the PACU. 

Meagan: Oh no. 

Charlotte: He never came in. They got his phone which was a godsend and I had this amazing CRNA that took the most amazing pictures of the C-section that ended up being a big part of my healing process, being able to see everything. 

Meagan: Yes. Yes. Yeah. It’s weird because sometimes you don’t even think or know if you want to see that, but it is so healing, or at least it was for me. 

Charlotte: Mhmm. It helps you piece things together. Once again, parts of that were a really positive thing. I had a clear drape. I didn’t ask for that. They did the clear drape. They did skin-to-skin to some extent, or delayed cord clamping– not as much as you would want, but they did all of that. But I was so out of it by that point. I was shaking. I was passing out constantly, so I was holding my baby, but I thought he was suffocating on me, so I was just like, “Just take him to his dad.” 

It was uncomplicated and exactly what we thought. It was all positioning issues. No big deal, really. They take me to PACU and wheel me in. The Type A person in me goes, “Okay, forget recovering from that. Now I need to take back control of my experience. Hunter, get me a cold brew coffee.” I just shake my head like, “Why didn’t you just sleep when you could have? I drank a cold brew in PACU and put that kid to my boob and they were like, “Wow, you know how to do that already?” I just was like, “Yep. I want to be the mom now. I want to get back to normal.” 

Well, that was the beginning of a very traumatic couple of days when I didn’t sleep at all in the hospital. I got very engorged. He had latch issues. I was told to start pumping. I got an enormous oversupply, like 90 ounces in one day. 

Meagan: Oh my gosh. 

Charlotte: A couple of weeks in, yeah. It changed our experience. Obviously, he ended up getting a milk protein intolerance. It layered on. I don’t blame the C-section on that, but I do blame my mindset a little bit– and probably got some bad advice from lactation. They didn’t know I was going to have an oversupply and go crazy like that. But yeah, I had trauma from that too. I’m like, “Okay, I’m recovering from a C-section and I’m pumping around the clock and all of that isn’t coinciding with me caring for my baby.” My husband learned to do everything in the hospital. 

Meagan: Or caring for yourself. 

Charlotte: Yep. It was all focused on my recovery. Anytime he needed to eat, it coincided with me needing to pump. It was heartbreaking, really. The second I allowed myself to stop, we started bonding luckily. After that, our relationship truly began. But yeah, it was a traumatic experience. You don’t expect that you’re going to have this life-changing thing and then have to have you recovering from a C-section too. 

Meagan: Right. 

Charlotte: That’s kind of that story. I definitely feel good over time with therapy. I’ll give a plug to EMDR therapy. It’s a type of eye movement therapy. I had one session of that and it helped me get down to a rational level why I was so upset by that experience and just starting to talk about it with people and watch everything helped over time. Looking at those pictures, it no longer became such an emotional thing as time went on. 

But I still felt sad when I saw people having what I wanted– a good breastfeeding experience and a typical birth. But more and more, I did have a typical birth. In my close friend group, maybe four or five of us have had a C-section. Several were breech, but it started to be like, it wasn’t that I was feeling alone. It was that I started to question, “What’s going on? Why is this happening?” 

Meagan: Right. Yeah. That’s how it was in my tight friend group. There are four of us from high school. Three out of the four of us have had multiple C-sections. 

Charlotte: Yeah. Yeah. And more and more so, I’m rooting for people to get a vaginal birth. I’m like, “Get a vaginal birth, please. Have a routine situation.” 

Meagan: I know. 

Charlotte: You don’t see it very often, at least not in my close group. That’s what really made me question things. Fast forward to January 2022 and I’m not quite thinking of having a baby yet, but I had a routine OB appointment. I asked about VBAC. I said I wanted to probably stop taking my birth control and that maybe sometime this year, we would start trying. They said, “Yeah, we’re a VBAC-friendly practice.” I told her maybe a one-minute spiel on what happened to me. She said, “Just based on what you’ve told me, I would say you have a 20% success rate.” 

Meagan: Oh. 

Charlotte: I guess she can calculate it in her head without even doing the calculator. I guess they’re super friendly like that. They do so many. Come to find out, they have a super high episiotomy rate and a lot of other things, and they’re not friendly really at all. 

Meagan: You’re like, “You are ‘friendly’.”

Charlotte: Yeah. So I felt completely gutted by that. I hadn’t even really committed that I wanted a VBAC, but feeling that I was told that just was so upsetting. It made me start listening to The VBAC Link. Through a couple of episodes, I heard about requesting your operative notes so I did that which was amazing. On that note, it said a bunch of things that I didn’t know. I didn’t know asynclitic. I didn’t know some of the terms which made me able to speak to it in a more educated way. 

Then yeah. I messaged the doctor. She was like, “No, absolutely. Nothing was wrong. You could totally do it.” She still gave me a success rate of 54% but she was like, “That’s just a conversation topic. You can absolutely do it.” I was like, “Okay, great.” She told me I was 10 centimeters, so they saw. I got there. I can do this again. 

I started interviewing doulas even before I was pregnant. I just started to hear positive things like, “If you can get through an OP, asynclitic baby, water breaking, 27-hour labor, you’ve got this. With a well-positioned baby, it would not be like what you experienced.” Hearing these things, I started to get hyped up like, “I can do this.”

Meagan: Excited, yeah. You felt the empowerment back. You were feeling empowered. That is what is so important because on that first visit, any empowerment that you had was wiped like an erase board. It’s like, “Oh, you’re 20%.” Okay, great. So that’s so good to hear that you were being built back up. 

Charlotte: Absolutely. So yeah. So then months passed and then in July-August we decided to start trying again. Luckily, again, we were pregnant again and came to find out we were having another boy, another son. We were very excited and that’s when my preparation started. I did all of the things. I joined a midwife practice. It was a midwife practice that delivered at the most acute hospital. They were actually affiliated with the big health system here. So that gave me comfort that I would be able to birth in a suite that had a pool but it would be in a hospital right down the hall from an OR if I needed it. 

That was great. I hired a doula that had VBACs, that was the VBAC whisperer in town. I went to Webster-trained chiropractic and did prenatal yoga. I did everything I could think to do. I tried not to go overboard with eating and then yeah. I even went to a pelvic floor specialist to practice pushing. I did everything I could think of. That was how I could control it. My control thing with me– I just wanted to feel like I did everything in my control to get this. If it doesn’t happen, I think I could come to peace with that. That’s what I felt would be the case.  

So anyways, fast forward. Routine pregnancy up until 28-29 weeks when you get the gestational diabetes screen. Did it, failed it. I was bummed by that, but also heard, “Oh, so many people fail it.” So then I did the 3-hour test. I think I failed three of the four that you needed in the time. You needed two to pass. 

So yeah. I failed it. I was surprised how gutted I was. I was devastated by that because I kept waiting for the other shoe to drop the whole pregnancy because I hadn’t had any barriers. You know all of the barriers that people have where you have to advocate for yourself. I hadn’t experienced that even having a VBAC consult with their OB group that helped them out. I supposedly went to the doctor who is all pro-C-section. He was even surprisingly very supportive. So what’s going on? 

Meagan: What’s going to give? 

Charlotte: Yeah. The midwife said, “Nope. You can still see us. You can still come to us even if you have to go on insulin, but you really need to try and stay diet-controlled.” That was what I heard. “Diet control is what will help you stay a normal-risk patient.” That’s easier said than done I’ve come to realize. It’s challenging too because time passes. You have to get an appointment with the dietician. You have to get your supplies through insurance so it takes a while to get in the routine of taking your blood sugar multiple times a day and then maybe weeks pass before you can figure out what’s causing you to have spikes.

So it’s a whole new thing. I’m trying to focus on VBAC, prenatal yoga, and all of the things that help you be super zen, but now I have multiple appointments and tracking logs. It was very stressful for me. There are certain things– your fat and blood sugar, for example. There is very little you can do to control that. It’s very challenging to get that control because it’s all about your placenta and how it is metabolizing quicker. It’s not what you ate in pregnancy. There are a lot of misconceptions about it. 

The best thing that I can share is Lily Nichols has Real Food for Pregnancy and then Real Food for Gestational Diabetes and maybe you can link to those, Meagan. Those two books were super helpful for me because of what I can find out– they probably work for some people, but the dietician stuff you get just from the hospital in one visit, and the handout is really high carb. Considering it’s the carbohydrates and the sugars that are causing issues, it doesn’t work. The plan just on paper doesn’t work for everybody to control their gestational diabetes. 

That was too high for me. When I followed that plan, I wasn’t in control of my diet. Lily Nichols, you can take bits from each, but I found that that book, and that’s what my midwife suggested, was lower carb and all about real foods. It had stuff about supplements and all of that. I found that super helpful to staying diet-controlled. 

In hindsight, even though I probably had it the whole time, I ended up only doing diet control for two weeks before I gave birth. So lucky for me in some ways, it was one of the silver linings. I didn’t do the diet for very long but I did get all of the information I needed. Eventually, they were telling me, “If you became insulin-dependent or needed insulin or were out of control,” I think it was 90% of your readings needed to be in control. You could have a one-off here and there. If they weren’t then you needed to start seeing a maternal-fetal medicine doctor who could consult on your diabetes and insulin. You could still deliver with the midwives, but my perspective was if you’re on insulin, you have to start having NSTs weekly. You have to start having– I can’t remember what it is called– BP or some other weekly testing for the baby. I can’t remember. It’s some acronym just to check their heart rate and all of that. I can’t remember what it’s called but there are two types of weekly testing you would have to have if you were on insulin. 

I don’t think you have to have growth scans, but I think they would probably start to offer them to see how baby was doing. That’s where I feel like maybe people start to get discouraged by their providers when their growth scan is large or when they start to have NSTs obviously. There’s much more surveillance and then they encourage you to get induced. If you are on insulin, it’s a lesser time that they allow you to go. They make you go anywhere from– I’d have to look it up but it’s like 37 if it’s really out of control to 39 if it’s insulin-controlled. 

Diet-controlled, you’re treated like any other birth. That’s where, I think, maybe you’re seeing not as many VBACs. You have a lot of barriers that come in. 

Meagan: Yeah, because they’re not in control or they’ve been transferred to MFMs and they’re like, “At this point, it’s just better to get this baby out earlier and control blood sugar and have a repeat Cesarean.”

Charlotte: Yeah, and I might have made that decision myself. You just start to get medicalized again and it’s discouraging. You worry, “What’s happening to the baby? Is it okay? The NST is not looking good.” I just think it takes that from you. It’s needed sometimes, I’m sure. In some ways, it was a blessing in disguise. I would have had a C-section if my son could have stayed in for two more months. It was a blessing in disguise in some ways that it happened when it did. 

So anyways, I guess I’ll continue unless you have other things you want me to talk about. 

Meagan: No, I just pulled up the book and sent it to myself, so we’re going to make sure that we have it in the show notes. 

Charlotte: Yeah, great. 

Meagan: Because I think that’s really important to have. 

Charlotte: Yeah, yeah. Just more tools at your disposal. Lily Nichols is a dietician and she even says, “Some of the stuff that they are still teaching is archaic. We’ve found that there are better ways to do these things.” She helped develop the gestational diabetes stuff for the ADA so she has major credentials. Yeah. I think she is legit. 

Anyway, two weeks pass. 32 + 2 and I feel huge. I’m not, but I feel pressure low. I told my mom, “I can’t do this for much longer,” the night before which is weird. I had also bought some Easter stuffies with names on them for my son and I bought one for my other son which was foreboding. He was here by Easter and wouldn’t have been otherwise. 

Meagan: Yeah. That is interesting. 

Charlotte: I don’t know if my body knew or if I knew in the back of my head that he was going to come early. I started to feel pressure and just weird but nothing like I would have noticed. I just started to feel like, “Oh, gosh.” I had a pedicure for later that day. That weekend, I was going to have my baby sprinkle. I didn’t have an in-person shower with my son and didn’t end up having one with my second son. 

But I had all of these things planned. I had a pedicure, of course, and all of that stuff coming up. I don’t think that’s what put me into labor, but it was kind of funny. I’m like, “If I ever have another kid, I probably wouldn’t get a pedicure.” 

Meagan: Yeah. You’re like, “It’s a little coincidental for me.”

Charlotte: Yeah, so I was just like, “I need my back massager,” because I was already feeling something in my back. I was like, “Oh my god, it feels so good.” I get home. My husband and my son are home and we have just learned about rebozo. I was taking a Hypnobirthing class. That was the other thing was my hypnosis class. 

So he was doing rebozo shifting for me and it felt so good. I was like, “Okay, great.” I was practicing my hypnosis and I was just like, “This is Braxton Hicks I think, but man. These are crazy.” I never remember someone saying that Braxton Hicks hurt. It’s waves. It’s definitely a wave each time. I lay down and I told my husband, “I’m just going to rest for a second and I’m going to get in the bath.” 

Well, when I get to the restroom, there’s blood. That freaked me out, obviously. I still don’t think I’m in labor, but I’m like, “Something might be wrong.” 

Meagan: Especially at 32 weeks, right? You’re like, “Uhh.”

Charlotte: So I go get in the car. I told my husband, “I just need to go to triage.” It’s 30 minutes away. I always knew we were going to have a little bit of a drive to get to the hospital. I drive myself to the hospital in labor now that I’ve come to find out. I was doing my hypnosis techniques. I was just like, “Let me just get there as fast as I can.” Luckily, I got there fast. I think I got there in 25 minutes. I got there super fast. 

My mom had me a month early and drove herself to the hospital. That was always her claim to fame. I had to do it too.

Meagan: You’re like, “I’m going to do it too.” 

Charlotte: Yeah. I had to do it too. My parents live in town, so they came over to watch my son so my husband wasn’t far behind me. 

I get to triage and they put me on the monitor. Baby was fine. It doesn’t look like I’m having contractions which is good news. They’re like, “Okay. Let’s get the midwives in. I’ll check you if that’s okay.” She’s like, “Oh, yeah. These are not really typical waves.” Then she checks me and I see her face go white. She’s like, “You’re 5 centimeters, so I’m going to need to call the doctor because we can no longer help because you’re preterm,” which was a bummer. 

I’m like, “Okay, great.” Then she says, “Ope, there’s a contraction.” For whatever reason, it wasn’t showing contractions, I think that happens sometimes in preterm births apparently because they are so far up or small or something. 

Meagan: Yeah, I was going to say that they are used to tracking them lower and it’s not. The uterus is smaller. 

Charlotte: So anyways, the doctor comes in. He’s a resident. All of these things could have been bad, but it’s so funny. I ended up having the most amazing providers. It was just interesting to me. All of the things I was worried about– I don’t know if VBAC is becoming more of a thing now or because they work so closely with the midwife practice and they see it happen and they see it happen well with success— the midwife group in town has an 80% success rate. 

Meagan: That’s awesome. 

Charlotte: Anyways, yeah. So they come in and they’re just like, “We’re so sorry. You’re 5 centimeters. You’re having this baby. We can try and just slow it down. There’s not really anything we can do but you can just lay there and let’s just hope you stay in labor for 24 hours.” 

Meagan: Did they try to stop your contractions or anything like that? 

Charlotte: No, I think I was right over the cusp of when they would do magnesium. I don’t know exactly why they do or don’t, but they said they do it with younger than that or I think cerebral palsy or something like that. 

Meagan: They didn’t try to do any steroid injections for lungs? 

Charlotte: They did do steroid injections, but– it went too quickly for it to matter. 

I go in. We’ll just see what happens. I didn’t know what to do. I was like, “Should I be doing labor things or should I just be sitting here?” The nurses were like, “Don’t go to the bathroom. We don’t want you to start going on dilation station.” I was like, “I need to go though.” 

So I was feeling conflicted. We called my doula. She was in a four-day induction supporting another person, so she was not able to come and she said, “Well, do you want me to send a back-up doula?” I said, “Yeah. Bring them on. Whatever.” That doula ended up being amazing. She gets in. She gets right in. I’m starting to feel really uncomfortable. They checked me again. I’m 7 centimeters. This is moving so much faster than my last birth. This all started around 4:00 PM with not really anything except for the waves. By the time I got there at 7:00, it was starting to feel more intense and I had the baby by midnight, so 12:30. 

It was fast for me. I wouldn’t say precipitous or whatever. 

Meagan: But still, 27 hours, right? 

Charlotte: Mhmm. She gets in there. The doctor says, “No, you can do whatever you want.” 

Oh, let me back up for a second. When they said, “The baby is coming this early,” I said, “Do we need to do a C-section? Whatever. If we need to get the baby out, let’s just get the baby out.” They said, “No. If you want a VBAC, that’s totally fine,” and that it would be beneficial for the baby at this point. Having a vaginal birth at this gestation is better for the baby’s lungs than doing a C-section. Of course, they’ll do a C-section, but there are some benefits to pushing out. 

I was so excited by that and then they were like, “You want to go unmedicated, right? Do you?” I said, “Yeah, I do. Can I move around?” He said, “Yeah. There is no stopping this baby at this point. Just do what you need to do.” So I was able to get on the birth ball. I wasn’t in a birth room with a pool, but I was able to do my thing and move around at least. 

This time, I had really committed that I was going to do unmedicated because of the hypnosis and all of the things that I had done. So yeah, I labored very quickly. I had a very intense transition pretty much the whole time I was there. There was a lot of blood coming out which was scary. I was out of it, but I was like, “Is this okay?” 

There was blood dripping everywhere and they were like, “Yeah, you’re probably having a placental abruption.” 

Meagan: Did they say anything about your placenta?

Charlotte: Yeah. They said, “This is probably a placental abruption, but if you’re having it and the baby is fine, it’s fine. If the baby is not fine, you’d go to a C-section.”

Meagan: Then it’s not fine, yeah. 

Charlotte: That was interesting. I had never heard of placental abruption. That was probably why I was going into preterm labor because the placenta was starting to separate. So yeah. I just kept moving around and doing my thing. All fours were most comfortable for me and then I was 10 centimeters and the doctor came back in. The NICU staff came in and they never freaked me out about how preterm he was. That was the comforting thing. They said, “32-weekers do amazing. They do well.”

Luckily, we were at a hospital that takes care of 22 weekers. We were at the best hospital for this so that was super comforting through the whole experience. I think I would have had a lot more fear had they not said those things to me. So yeah. They broke my water and they were like, “This might take a second for him to come down. We’ve got the squat bar up.” I did two practice pushes. I was feeling so much pressure. It’s like pushes that were semi-productive. 

And then all of a sudden, I just felt this fire in me to just push him out in one push. I pushed so hard and apparently, I screamed. I don’t remember screaming, but I screamed so loud and he shot out. 

Meagan: Oh my goodness. 

Charlotte: We got all of this on pictures too, so yeah. He came out. I don’t know if he was screaming, but he came out. Leo is my second son. He was 5 pounds, 2 ounces so he was a big boy. 

Meagan: Okay, yeah. That’s a good size. 

Charlotte: I don’t know if it was gestational diabetes or whatever, but he was a good size. They did bring him over to me briefly. All of these things, I understand. 

Meagan: Right, right. 

Charlotte: They let me hold him for 10 seconds because they needed to go get him some oxygen of course. 

Meagan: They needed to make sure that his little lungs needed some extra care. 

Charlotte: Yes. He was whisked away to the NICU where once again, there’s trauma and things. Of course, I wish that my baby could stay with me but in the moment, it was rational. He needed to go to the NICU so in the moment, I felt back to myself. I was a little stunned, but I was like, “Oh my god. I feel my body. I feel no drugs, no fluid.” I mean, I think I did have a little bit of fluid, but it was just so different than my last experience where I was so drugged up. 

Meagan: Yeah. 

Charlotte: I got to see my placenta which they sent off for pathology and they found nothing. There’s no answer. It was just challenging like, “Why did this happen to me?” But it just happens sometimes. I did have COVID two months before. The gestational diabetes even– no symptoms from it, but I just wonder. I had it in February. I was diagnosed with gestation diabetes in early March and I had him in late March. It just feels like as time goes on, they’re finding placental issues. They didn’t see anything obvious.

So yeah. He came. He’s healthy. We spent 39 days in the NICU which was a challenge. It really was. I don’t wish that experience on anybody. You’re postpartum and pumping and going home without your baby, being there for my son but having to be at the NICU all day every day. It was a huge challenge for us, but he had a very routine time in the NICU. He just needed time to grow. He came back to us not this past Sunday, but the Sunday before and we were just so happy. He’s eating well. He’s 8 pounds. He’s amazing. 

Meagan: Wow, good! 

Charlotte: So yeah. Now we’re on our healing journey of now it’s postpartum, the typical postpartum things. But I just can’t be thankful enough that I didn’t have to deal with all of these challenges with a C-section recovery on top of that. I mean, I felt physically back to myself very quickly. I had a very small two-stitch tear up, not down but I felt fine. I’m just grateful for that and I’m grateful for all of those providers who let me do my thing and trusted me and my boy to work together to get him out safely so yeah. That’s the story. 

Meagan: Yes. Your team sounds really, really awesome. 

Charlotte: Yeah. 

Meagan: Like really awesome. We hope that those types of teams are cloned all over the world, but we know that it doesn’t always happen that way, so if you’re listening and you’ve got gestational diabetes and you don’t have as supportive of a provider, know that you can always keep looking, but too, know that you can do exactly what Charlotte did. You can control what you can control. Control what you can control. You read the book. Learn how to control your diabetes. Learn all about that and then try and just take baby steps along the way even when random things are thrown at you like early term or preterm labor. 

That could have been where you are like, “Here’s the boot. Instead of a shoe, here’s a boot. It’s being dropped. Now I’m going into preterm labor.” But you didn’t let it. You just put those boots on and kept walking. Right? 

Charlotte: Mhmm, yep. 

Meagan: That’s so awesome. So, so awesome. Did you have any symptoms of gestational diabetes before you got tested? 

Charlotte: I don’t think so. No. I tried to think back on if I did. I think I caught it so early. I got the testing done. That’s another thing too. I would recommend trying to get your screening done as early as possible because the earlier you catch it, the earlier you can control it with diet. It becomes harder to control as time goes on, but you can stop that baby potentially. You can maybe diet-control enough that the baby doesn’t get too big. 

There’s a lot of really supportive Facebook groups. Gestational diabetes, nutrition, and all of these things because it’s hard to find information out there and it’s helpful to hear those stories of, “Hey, my baby came out and was small or was 8 pounds,” just not these huge babies that you hear of. I’m sure a lot of people aren’t diagnosed or are borderline and maybe have similar things. 

Meagan: Yeah, there are undiagnosed where we are like, “Whoa.” I had a client whose baby was 11 pounds. 

Charlotte: Yeah. Yeah. I mean, I think one way I started to feel was that this may be a blessing in disguise. Had I not just been on the borderline, maybe I would have had an 11-pound baby, and whoa, to be honest. Leo would have been big if he had gone to term. But the earlier you find out, you can diet control. You maybe can control your weight gain and have a healthier pregnancy overall. 

Meagan: And have fewer issues after. 

Charlotte: Because I felt amazing. Just the fact that I had such a high-protein diet and things in that time period, I feel like that made me even better equipped to have a vaginal birth. So yeah. I think there are positives if you can get past that initial challenge of it that, “Okay, this is just going to keep me on track to have a healthy pregnancy,” you can do it. You really can do it. I think as long as you just say, “Look. They’re going to do screenings. They’re going to offer things.” It may end up in an induction but I think it’s still worth pursuing if it’s something that you want to do. 

Meagan: Yeah. That is one of the things. It may end up in an induction and that is still possible. They may be telling you that your baby is big. That doesn’t mean that vaginal birth is not possible. Right? Big babies come out of pelvises all the time. Inductions and VBAC– Yes, it’s not as ideal as spontaneous labor but still very possible.

 

Know that if you are listening, you’re not alone out there even if you might feel alone because there are not a ton of stories out there. That makes me sad so we are going to change that here on the podcast. It’s starting right here with Charlotte. 

Awesome, well thank you so much for sharing your story today. 

Charlotte: Absolutely. Thanks for having me. 

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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“This is going to change the course of your life forever.”

Ashley’s first Cesarean was after a 48-hour labor at almost 42 weeks. She deeply desired and prepared for a VBAC with her second baby, but consented to a second Cesarean after another 48-hour labor at just over 41 weeks. 

With her third baby, Ashley pulled out all of the stops. She was committed to having a VBA2C in all the ways she knew and didn’t know before. Perhaps the most impactful part of her preparation was processing fears more intentionally than ever before. She proactively went to therapy to heal from her previous births and to preemptively combat postpartum depression. She released the weight of failure and inadequacy that she didn’t realize she was carrying.

With exciting twists and turns, Ashley achieved everything she hoped she would in her third birth. She says that this VBAC experience has forever changed her and her belief in what she is capable of. 

Additional Links

Baby Bird Birth and Doula Services

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Hello, hello you guys. We are at the end of August. I hope you guys have had a wonderful summer and that it’s still great weather wherever you are listening from. We have our friend, Ashley, today and we are going to be sharing her stories. Something that we had requested or asked on Instagram is “What kind of episodes are you wanting to hear?” It seems that every time we ask that, a lot of people are saying, “VBAC after two Cesareans” and even extended to that, VBAC after three or even four multiple Cesareans. 

So today we have a VBAC after two Cesarean story. As always, we’ve got to get into a review but I am really wanting to talk because there is something about Ashley that she wrote in her bio. She said, “Her birth experiences have given her the passion for all things pregnancy, birth, and postpartum and have even led her to be a doula.” I just resonate so much with that because that’s exactly how I became a doula, Ashley. I think that’s how a lot of us in the birth world find that passion and that drive to support and help. 

So congratulations on becoming a doula and finding your passion through all of these experiences. 

Ashley: Thank you. 

Meagan: I full-on believe but I sometimes say that we experience these not-so-desired birth outcomes, right? Not-so-desired birth outcomes, but sometimes I think that we have those because we are meant to do something more and meant to experience those to help inspire and encourage and empower someone in the future. So congratulations on all of that. I am so excited for you to join the doula world. It’s a journey, but it’s awesome. 

Ashley: Yes, I’m excited. Thank you. 

Meagan: Yes. And then a little snippet also, a little secret– by the time this episode airs, she’s probably going to be holding a newborn because her due month is August. That’s really, really exciting. I’m just going to congratulate you right now in advance. 

Review of the Week

We also have a review, of course. This review is from– I actually don’t even know how to say this– I’m going to spell it out. It’s bshsjbxbd. The title is “Life Changing.” It says, “This podcast is AMAZING. I just had my VBAC two months ago and I can honestly say that it is thanks to everything I’ve learned by listening obsessively to this podcast and joining this community. I am still listening even after my VBAC because I love hearing the stories of these amazing women and the loving support the hosts offer. Julie and Meagan clearly care so much about what they do and it feels like they truly care about each and every mama they talk to and connect through with the podcast and the community. I recommend this podcast to everyone who will listen when they are going for a VBAC. An amazing resource for those of us who are on our upcoming journeys to birth after a Cesarean. Thank you, thank you, thank you.”

And thank you, bshsjbxbd, for your review. We always love your reviews coming in. If you haven’t had a chance, I will never shy away from asking for a review. Your reviews are actually what helps people just like you listening to find this podcast. It is what helps the algorithm and especially in Apple Podcasts and on Google. It helps the algorithm know that people like hearing these stories and want to give you more. 

So if you haven’t had a chance, leave us a review. We would love it so much. 

Ashley’s Stories

Meagan: Okay, cute Ashley. Welcome to the show. 

Ashley: Thanks. I’m so excited. I’m so grateful. 

Meagan: I’m so grateful for you. VBAC after two Cesareans is so hard because I’m sure as you know through this journey– both of us specifically are VBAC after two Cesarean moms– it can be a really hard road. It can be really hard and really lonely, so we don’t want anyone to feel that. I think that through sharing stories and relating, it’s going to help people out there know that they’re not alone and it is possible. 

Ashley: Yeah, 100%. I don’t know that I would have been able to achieve that without listening to all of the podcasts and searching your site religiously. There is so much power in sharing your story. 

Meagan: There really is. There really is. Well, let’s turn the time over to you to share your stories. 

Ashley: Cool, well thanks. I’ll try to keep it pretty concise but as you know, there’s a lot of background that you have to get to. We dealt with infertility for about five years. It was really unexplained. There was no specific reason. I actually had a bilateral ectopic at one point. 

Meagan: Oh, okay. 

Ashley: One of two they were able to repair. With the other, I had to have that one removed. So when I miraculously got pregnant in May of 2015, we were shocked and over the moon and just super, super grateful. Really, from the beginning, I knew that I just wanted a husband-coached natural birth. We did the Bradley Method class and we created this cute little birth plan to share with our provider. 

I really had a healthy and normal pregnancy and I thought, “I know what I want, so I’m going to get it.” C-section didn’t come out of my mouth. It wasn’t on the birth plan. It just wasn’t anywhere around. 

Then at 40 weeks and at 41 weeks and at 41.5 weeks, the appointments showed nothing of concern, but I still had an unfavorable cervix. At all of those appointments, we had to sign an AMA saying that we did not want to get induced. We kept trying to do normal, regular things. 

Then on March 1st, I was 41+5. I woke up with a slight abdominal pain. I just did the normal routine. I went for a walk and all of the things we were doing. I did have a dance party that day instead of my normal yoga. I was like, “Let’s get this started. Let’s get moving.” Then those pains intensified throughout the afternoon and I finally was willing to call them contractions at some point that evening. 

They were about five minutes apart and we decided to go to the hospital. And like normal, not normal but for a lot of people, I got to the hospital and everything stopped. We decided to go home, but a nurse told us that because I was about 42 weeks and it would be against medical advice, my insurance would not cover my labor and delivery cost if we went home and then tried to come back. Whether that is true or not, at this point it is 3:00 in the morning and we are like, “What do we do? I don’t know.” 

So we were like, “Let’s just hunker down and just try to relax a little bit then in the morning try to get labor moving again.” So that was what we did. We decided to stay at the hospital. 

At about 8:00 the next morning, my OB came in and she wanted to strip my membranes. She accidentally broke my bag of water at the same time. I refused any other interventions at this point except they said that they did require that I have an IV and some monitoring. So after a lot of pressure from every nurse that came in the room and my OB, we agreed to a Pitocin drip at about 5:00 PM. 

Then I labored throughout the night. Things got super intense at about 2:00 in the morning. I was frantic. I remembered feeling like I couldn’t handle the pain. I remember that the room was pitch dark and I’m just laying in the bed super frantic, super exhausted, no idea what to do. I tried getting in the tub. I hated it with all of the wires and the monitors around me so I just hated it. 

The nurse suggested that I try Benadryl to help me rest. I didn’t rest but I got super groggy and I think that just made it worse. I was just physically, mentally, and emotionally– it was bad. There was all of this constant pressure to do things that I did want to do or I didn’t want to do. I just felt so isolated and frustrated. 

I was dilated to about a 7 the next morning. It was 7:00 AM and I agreed to an epidural just to try to relax and get some rest and some relief. Then my OB came in and checked me. She said that my cervix was swollen at that point and that I started to regress. 

 

Knowing what I wanted, she said that she was going to try to hold open my cervix and let me push. I tried but nothing really happened. Looking back, I’m like, “I don’t know if she thought that would really help or if she was trying to appease me and try to give me a little bit of a confidence boost or something. I don’t know.” 

At this point, I’m in labor for about 48 hours. I’m done. I was out of it. She highly recommended a C-section and I remember before I signed the paperwork, I looked at her and said, “Will you let me try for a vaginal next time?” I already knew. Again, also looking back, I’m like, “I can’t believe I asked her permission.” But we do because we think that it is in someone else’s control. 

Meagan: We do. Yes, yes. 

Ashley: So anyway, we had a gentle, normal, healthy C-section. Perfectly healthy baby girl. Recovery was fine. It was normal. It was good, but I had that defeat in my head and in my heart. It just stayed there and I moved on. So then about two years later, in January 2018, I was pregnant again thankfully and we moved. That first birth was in Florida and we moved to Michigan which is where we are now. 

I did a lot of research just on social media and things like that to try to find who is the VBAC-friendly provider in our area. I was super excited when I got in with one of the most VBAC-friendly practices in the Grand Rapids area. I was really happy that I could work with their midwife team for a VBAC. 

This time I just felt like I did more research and that I knew what went wrong last time, so I was like, “The same thing is not going to happen. I know what happened. Been there, done that. Moving on.” But that was kind of all we did. I did a couple of meditations. I read a couple of more books. I just was like, “I think we’ve got it.” 

Then 40 weeks came. 41 weeks came again. I just felt like– you know, from providers that you start feeling the pressure, especially with VBAC. 

Meagan: You do. 

Ashley: So then at my 41-week appointment, we denied the induction again. We endured a pretty fear-based lecture from the OB that was practicing there, but he did do a membrane sweep at that appointment. A couple of days later, nothing had happened. He did another membrane sweep and then I was like, “Okay.” I started getting that frantic feeling again. 

He did the membrane sweep. I went straight to acupuncture. I went straight home and had a castor oil lunch. Then contractions started about an hour later. They were about three minutes apart the entire night and then the next morning, my parents arrived from out of state to watch our daughter and things stopped. They pretty much totally stopped. 

We went on a long walk. I did more castor oil. I took a nap and woke up with super intense contractions so I felt like, “Okay. It’s time we call the midwife.” She was like, “Try to just do what you can at home until things are unbearable.” 

I got in the bathtub at home and that’s when I remember things caving in. Mentally and emotionally, I went totally dark. The fear of things I hadn’t totally worked through from the first birth just came tumbling in. I remember laying in the bathtub being like, “I’m done. I can’t do it. I can’t. I can’t do this the way that I want to.” 

We did end up going to the hospital. We were admitted there at about 6:00 PM and I was dilated to a 5 so that was a little bit reassuring at that point. But as we got to the hospital and all of the tests and the monitoring and all of that stuff, I just was so scared. The fear and the worry and all of the anxiousness crept back in. I did agree to an epidural again even though that wasn’t something that I had originally planned. I just felt like I needed something to help calm me down. 

At around 11:00 that night, I was dilated to an 8. I tried to rest. We did some nipple stim. The next morning with little progression, I did start Pitocin at about 10:00 AM. I just remember being in the bed. The midwife would come in and we would try a couple of different positions, but that was really it. I didn’t know any different. We didn’t have a doula with us. My husband is a great support, but we didn’t know what else to do. 

I ended up trying to push. I pushed for about two hours because my midwife thought that I was ready for that. There was no progression. I remember her saying that the baby’s position was why he wouldn’t descend. 

Again, looking back now, I’m like, “Oh, yeah. That makes sense,” but at the time, I’m like, “I don’t know what that means. I don’t know what to do about that.” So later, after I pushed for a couple of hours like I said, the OB came in, the same one who gave us the scary talk. He came in and he offered a vacuum, forceps, or a C-section. I think at that point, again, I was in labor for 48ish hours at that point and just tired. A C-section felt like the thing that I knew. I didn’t do the research on the other things and I didn’t have a great relationship with him, so I was like, “Let’s do the C-section,” so we moved to the C-section. 

It was the same experience. It was gentle. It was safe and healthy and everything went fine. Our little guy was born at 9:00 at night. He had some breathing issues but nothing of concern. It was great. But this time, I struggled mentally for months after that with just that feeling like I failed again. I don’t know if I’m going to ever get a chance again to have my VBAC or to redeem what I thought was possible for myself and for my family. 

Anyways, two years later in May of 2020 in the middle of the pandemic, we had a third miracle pregnancy and again, it was a very healthy, normal pregnancy. I decided to stay with the same practice because one, I knew that they were still one of the most VBAC-friendly practices, however, their midwife team is not able to support VBACs after two C-sections. 

Meagan: Just after two C-sections. 

Ashley: Mhmm, yep. I listened to an episode of The VBAC Link and there was someone on who is from this area. I ended up connecting with her and she told me about a great OB who worked who now had transferred into this practice that I was at. She was amazing so I was able to work with her instead of the other person who again, is a great provider but I just wanted a little bit of a different experience. 

Meagan: Right. 

Ashley: This new OB was a doula actually before she got into obstetrics. I just felt so much at ease and comfort with her. I remember her telling me, “You’re in charge.” She would offer me things or tell me and give me information and then she would say, “You’re in charge.” That changed the game for me. It just made me realize, “Oh, you’re right. I am.” 

Meagan: It’s crazy to think what the words, “You are in charge” did for you. 

Ashley: Yeah. It was amazing. I knew that with this birth, I was like, “This is my chance to get the VBAC.” We didn’t know if we would have any more kids. I pulled out all of the stops. I hired a doula finally. My husband and I were on the same page. He’s always been really supportive of what I want, but we had to sit down and have some pretty in-depth conversations about why I wanted it and why it was so important. 

I listened to every VBAC Link episode and every Evidence Based Birth episode. I did as much research and educating myself as I could. I started chiropractic care. I did Spinning Babies and nightly meditations. I started mental health counseling. At the time, I did it mainly because I think looking back, after my second, I went through a pretty intense period of postpartum depression. I didn’t know it at the time, but I knew that this time, I needed to get ahead of it so I connected with a counselor just so I had that relationship built for after my third baby. 

What I didn’t realize until after I started therapy was the mental block that I had from those first two births and so much defeat, failure, and fear. They were so heavy and I quickly realized them after just getting into regular therapy sessions. My therapist really helped me work through a lot of that which I am so thankful for. 

So fast forward through all of that prep that we do for months and months, this time I was like, “Okay. I’m sure I’m going to go to 42 weeks. That’s just what my body does and I’m cool with it. It’s going to be fine.”

Meagan: Right. Right. 

Ashley: I went in for my 40-week appointment. Everything was normal except I did have a slightly elevated blood pressure which was abnormal for me. We did the NST. They did lab work and then I agreed to a membrane sweep. My OB was a little bit concerned that if my blood pressure would continue to rise or continue to be elevated then I would need an induction so she thought that the sweep would be the most gentle way to just try to get started. I was already dilated to a 3 so she was like, “I think it’s a safe way to go. It’s not too much intervening,” so I felt good about that.

I did really normal things for the next 48 hours. With the other two, I got the frantic, “Let’s get started.” Castor oil is a pretty intense thing, so this time I stayed away from that. I did a lot of inversions and curb walking. I went to the chiropractor and then at my next appointment, everything was normal. Blood pressure was back to normal and I was so thankful. 

I went home. That 40-week appointment was a Wednesday and we had a couple of days. Then on Sunday morning, I woke up and I had some slight contractions so I went for a super long walk. I did a lot of curb walking. I started an abbreviated or my own version of Miles Circuit just to keep things moving along. Contractions became pretty regular around 2:00 that afternoon. 

I was still hesitant to call it labor because I had experienced such long labors before that I was like, “Eh, this is a long road.” 

Meagan: Right. You’re like, “Whatever. We’ve got this.”

Ashley: But I did ask my husband to come home. He was at work and I asked him to come home just to help with the other two. That was about 4:00. I was like, “I just need to focus. I need to get in my space.” He took them to Target and they roamed around Target. I stayed home. I sat on my birth ball. I put my birth playlist on and I actually colored pictures for them just to calm myself and get in the right frame of mind. 

By the time they got home, I was just laying in bed trying to relax through the contractions. I managed to make it to dinner and have dinner with them and help with the bedtime routine, but I had to keep stopping through reading them their bedtime story just to breathe. 

After that, I just moved to our bedroom and I was really struggling. I was laying in bed and just walking around the bedroom. I remember that I felt sick but hungry, but cold, but hot and all of these different feelings were coming in. I had to just lean into my husband and hold onto him through every contraction. We did that for about an hour and he was like, “I think we’d better at least call the doula.” I was like, “Okay, okay.” 

She just listened over the phone to a few contractions and I remember her saying, “I think it might be time to go into the hospital.” Even though I was really struggling to cope with the contractions, I was super against going in because with my other two, I got to the hospital and everything stopped. I was like, “I’m not doing that.” 

Things kept progressing through. It was probably another hour and so I finally agreed, “Okay. Let’s go in.” My husband was making arrangements for someone to come stay with our kids and pack the car. My water broke. I hadn’t had that spontaneous experience before so that was kind of cool. He helped me get changed and get into the car. I remember I couldn’t sit down. I was kneeling over the front seat on my knees and he was like, “This is probably going to be the hardest part of the whole labor, the drive to the hospital.” 

I was ready to push. I remember yelling the whole time, “I’m ready to push.” He was like, “It’s going to be fine. It’s going to be fine. We’re almost there.” He’s driving through– it was February and there was a snowstorm here. He was trying to stay as calm as possible. We pull up to triage. It was about 9:50 PM. I got into my wheelchair still on my knees. They wheeled me in and I’m like, “I’m ready to push. I’m ready to push!” yelling at whoever was with me. 

A nurse checked me in the wheelchair. She came running out and checked me. 

Meagan: Turned around just backward.

Ashley: Yeah. I heard her yell, “She’s complete!” I was like, “Thank you, God.” It was the best thing that I could have ever heard. They wheeled me into a delivery room and they helped me onto the hospital bed. I was on all fours and I just started pushing. At that point, everything is kind of a blur. I was so focused on just pushing her out. I knew everybody there was looking at me like, “Is she going to do this? Is this actually going to happen?” I knew that until I was holding her in my arms, a C-section was still a possibility. 

Meagan: Yeah. 

Ashley: It was never off the table and I was like, “I’ve come this far. We’re doing this.” I do remember that I got a saline lock. At one point, they put a monitor on baby’s head. My doula put my hair up for me. They kept giving me oxygen to help me breathe. People kept urging me to change positions and I was like, “Nope. I’m good right here. I’m not moving.” 

My OB made it there for about 10 minutes of pushing and helped me through the last few pushes and then I heard her say, “The baby’s head was out and then her body,” and then I just reached down and pulled her up and yeah. It was amazing. Absolutely amazing. 

Meagan: Absolutely. That’s so flipping cool that you could get there and be that far progressed. For you mentally, I’m sure– like you said, “I knew it wasn’t off the table,” but that had to have just been so huge and put you in a space. Even when they were doing all of these things, you were able to stay in your space and keep going. 10 minutes! 

Ashley: Yeah. It was crazy. I remember after things, I had pretty significant blood loss and pretty severe tearing just because it was so fast, but my husband said, “This is going to change the course of your life forever.” And he’s right. It does because when you follow your intuition, right? And you really experience something so redeeming like that, that can change you. So yeah. I’m really grateful. 

Meagan: Yeah. It totally does change you. I hadn’t had my baby yet. I was still in labor and I remember one of my doulas saying, “If this doesn’t go the way she is wanting, I’m worried about what she’s going to do with her career and if she’s going to be able to keep going,” because I wanted it so badly. Then I had my VBAC and everyone was like, “This just changed you forever. This just totally did something for you.” I remember that it’s the weirdest thing. It’s really hard for me to describe, but to have a birth– and it’s not even just a VBAC in general– but to have a birth where you feel like you were more in the driver’s seat and more in control and like you said, following that intuition and trusting your whole soul, there’s something to say with that. There’s a power that that gave me. 

Ashley: Yep. Absolutely. 

Meagan: And it did. It’s changed my life for the long term. It’s just so amazing. It’s so amazing. 

Ashley: And look at all of the community that you guys have built. 

Meagan: Yeah. 

Ashley: Your experiences have changed so many people’s lives. It’s just really cool. 

Meagan: It’s really cool how it all circles around. And every single one of these stories– I mean, we’re hearing it through these reviews how these stories are changing people’s lives. This community and I may be biased, but there is something about this VBAC/CBAC community that is so special. We are so vulnerable.

Ashley: I think so. I think also, people don’t really get it. I mean, I have a great family and friends, but there aren’t many that understand it. 

Meagan: There aren’t, yeah. 

Ashley: So to be able to come somewhere like this and find other people who really get it and it’s really important to them and it’s really valuable and it just creates this sense of confidence and meaning. 

Meagan: Absolutely. It’s so true. I remember that there were very few. I could count on one hand people that I could really go to. I love the people that would listen. I would always want a listening ear, but these guys didn’t just listen. They heard and they felt. They felt it when I said, “I don’t know what I should do. I have this provider, but I’m feeling called to this out-of-hospital birth. What should I do?” They could feel the struggle that I was going through. They could feel the desire, the want, and the hurt. 

I had a mother’s blessing and I will never forget. I was in constant chills because I could feel their energy. 

Ashley: Yeah. That’s amazing. 

Meagan: This community is absolutely amazing and you are amazing and then you’re just going to keep going on. You’re going to have this other VBAC and then you’re going to keep going on as a doula inspiring. That’s one of the reasons too why we love having our doula community. We have our certified doulas. When Julie was with me, she and I couldn’t change the VBAC world. We’re just here in Utah. Through this community and all of these birth workers out there and all of these parents inspiring, we have people on our team that haven’t even had a VBAC and they’re like, “Hey guys, did you know that this is an option? Did you know that this is a thing?” 

It’s so cool the conversations that are sparked and can change someone’s outcome completely. So thank you so much for being here and for sharing your story. Good luck right now and congrats in advance. And yes! Do you have a doula page yet where people can go follow you?

Ashley: I do. Yeah, yeah thank you. It’s Baby Bird Birth and Doula Services. So yeah. I have a website and Facebook and Instagram and everything. I’m getting things kicked off and I’m very, very excited to really start working with other families and helping them realize that your intuition is powerful. Your birth experience really matters. 

Meagan: It really does. It really does. It is not that it matters of the method, but the experience is impactful. 

Ashley: Yep. Yep. Absolutely. 

Meagan: Right? Well, thank you so much again. 

Ashley: Thank you. I really appreciate your time and everything that you guys do. 

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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We are so honored to have today’s guest, Henci Goer, joining Meagan today. Henci has made it her life’s work to help women make informed decisions about their care in the birth space. She has written multiple books, received countless awards, and has made current obstetric research more accessible to women worldwide. 

Henci defines uterine scar separation and talks about what factors may contribute to or help prevent this from happening. Meagan and Henci talk extensively about VBAC, VBA2C, birth plans, induction, and epidurals all using evidence-based research. 

We love that Henci’s mission is to empower women and families to make the choices that are best for them. Here at The VBAC Link, our mission is the same!

Additional Links

Henci’s Blog: Is VBAC Safe?

Henci’s Website

Labor Pain: What’s Your Best Strategy? By Henci Goer

Optimal Care in Childbirth: The Case for a Physiologic Approach

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Hello, hello. Welcome to The VBAC Link. This is Meagan and you guys, we have an amazing, amazing, amazing episode for you today. This episode has actually been kind of a long time coming. We have our friend, Henci Goer. She is just a wealth of knowledge. You’re going to absolutely pick this episode apart. I know it. You’re actually probably going to want a notebook so if you’re one of the listeners that goes on walks or is driving, you might want to press pause or listen to it and come back with a notebook because I know you’re going to want to write these stats down. 

We’re talking about uterine scar giveaway, you guys. I know that this is something huge. All of our listeners, every single one of our listeners that has had a VBAC is aware of uterine scar separation so this is going to be a really great episode filled with wonderful evidence and all of the things for you. So buckle up. It’s going to be amazing. 

Review of the Week

But of course, we have a Review of the Week so I am going to quickly share that with you. This review today is actually on our How to VBAC: The Ultimate Parents Course. This is from Rosie. It says, “As someone who had an unplanned Cesarean myself and as a doula, I really appreciated how well-balanced this course is. There’s no shaming. There’s no bias. It’s just the facts.”

Thank you, Rosie. I’m so glad that you are enjoying the course or have enjoyed the course. And if you didn’t know, we do have a How to VBAC Parents Course and a Doula Course for all of you birth workers out there who want to learn how to support your VBAC clients. We have this course. You can check it out at thevbaclink.com. 

Henci Goer

Meagan: Okay, Ms. Henci. I am so honored to have you on the show today. I mean, really, it seems like we’ve been talking for months. I really think it was the beginning of the year, right? 

Henci: Something around there, yeah. 

Meagan: Yes. Oh my gosh, it’s been so long. Just for anyone out there who wants to know a little bit more about Henci and why we are having her on the show today, she actually started out as a Lamaze teacher and a doula. Her life’s work soon became analyzing and synthesizing obstetric research in order to give pregnant women, birthing people, and birth professionals access to what continues to be optimal care in childbirth. 

Just that right there, that little bit right there, I’m telling you guys, it really is her life’s work. If you Google her name, you’re going to find a ton of research. She’s an author of four books. Four books, you guys. Labor Pain, What is Your Best Strategy?, Optimal Care in Childbirth: The Case for Physiological Approach with co-author Amy Ramana– is she on MSN and CNN or has been mentioned? Tell me about that. 

Henci: She’s a nurse-midwife. That’s Master of Nursing. 

Meagan: Oh, I was thinking CNM in my head. MSN, so what is that? 

Henci: It’s a Master of something. I don’t know what that degree is. She’s a nurse-midwife. 

Meagan: She’s a CNM. Certified Nurse-Midwife, yes. In my head, I read CNM. The Thinking Woman’s Guide to a Better Birth and Obstetric Myths Versus Research Realities. You guys. In addition, she has written numerous blog posts, articles, given lectures around the world, and here she is today on our podcast. I’m so honored. 

In recognition of her work, she has received among so many others, the American College of Nurse-Midwives’ Best Book of the Year. Henci, congratulations on that. 

Henci: Yeah, that was a thrill. 

Meagan: That is amazing. Lamaze International Presidents Award, DONA International Claus– 

Henci: Both of their memories are a blessing. 

Meagan: I know. Seriously, a research award on that. Life Achievement Award, I mean, you guys. She has so many awards and here she is to talk with you, Women of Strength, all about one of the biggest topics in VBAC. Right? Uterine separation, also known as uterine rupture. When I started talking with Henci, I love that she was like, “You know, I don’t love to call it uterine rupture. It’s uterine separation.” I have really grown to love that over the last few months that we have been talking. Yeah, so let’s talk about it. What is uterine scar separation, Henci? What is that? 

Henci: Well, before we get started because I think we are going to be giving a lot of information. I want to emphasize that one of the things that took so long is that what we decided to do is that I would do a blog post that had all of the detailed information in it.

Meagan: And it does. 

Henci: So, not to worry. I imagine that with the notes for the podcast, you’ll post a link to the blog post which will have detailed numbers in it. My life’s work– and I love the review of your course because just sits where I sit. My life’s work has been wanting to give women and birthing people the ability to make choices having all complete, accurate information on the pros and cons of their option which is really difficult to get as you probably know and your people probably know. 

Meagan: It is. Yes. 

Henci: What they choose to do with it, it’s just that I’m there for the information. No judgment. I’m here to help people decide they want to plan a repeat Cesarean. Whatever it is, I want people to have accurate, balanced information to the best of my ability to create a space where they can make the choice that’s right for them and their families. 

Meagan: Absolutely. I love that so much and that is really what we are here about at The VBAC Link. There’s no shaming in choosing a repeat Cesarean. There’s no shaming in choosing an epidural over unmedicated, right? There’s no wrong way to birth, but the most important thing to us here at The VBAC Link is that you know the facts, you know the options, and you choose the best route for you. 

Henci: And then the other piece which is part of my work as well is to go beyond the information and say, “So now you have this information, what can you do with it?” What are the tips, ideas, and recommendations that will help you craft a plan that will help take you in the direction that you want to go? I’m very careful. This may be one of the more important things that I say to your group and it’s not informational. I’m very carefully not saying “goal”. I think it’s very important to distinguish intention from goal. Goal assumes that you have you get somewhere and if you don’t get to that place then you failed, right? The intention– is this is the direction that you want to go in?

To have that in mind helps you, first of all, to plan the journey in a way that’s most likely to succeed in getting there, but it also helps you have your priorities so that if things happen along the way, you’re able to be flexible to know what’s really important, to navigate the space, but to understand that sometimes life has other plans so if you don’t take anything else away from what I say today, please take away that because I think that’s really key. 

Meagan: Yeah. As a doula, when we’re doing prenatals with our clients, a lot of people will be like, “Can you help me write a birth plan?” I love the idea surrounding birth plans. Let’s have this idea of how we want this birth to go, but I like to reference it more as birth preferences. “Here are my preferences and I’m going to label them from A to D, most important to less important, and have this idea and this plan, but then also know that there are other options and it’s okay if I choose those. It’s okay if my birth goes another route because I have these preferences and we’re going to do everything we can to have them, but we know it doesn’t always pan out that way. We know that. 

Henci: I think too that something has gone wrong. I talk about this in the introduction to my latest book. I think “plan” has gotten a bad rap. So a plan isn’t a laundry list or a blueprint. It’s more like, “Are you planning for a career? Well then, you’re going to decide what you’re going to do to take steps in that direction. Are you planning a vacation?” But it’s not something that has checkboxes on it. 

Meagan: It’s not a list. 

Henci: I think, if I may be so bold, the problem with preference is that at least, I think especially if you talk about preferences to medical staff, it becomes like, “Well, I think I’d rather wear a blue gown or have chocolate ice cream instead of vanilla.” It doesn’t have the same strength as saying– 

Meagan: “This is my plan.”

Henci: And that can be internal to the woman or the birthing person. But yeah, let’s get into the meat of what I want to say today. 

Meagan: No, I love that message though. I do love that message. I think it would be really good if we did stop because the reason why we change “plan” is because if things don’t go as planned, we failed. That’s how our minds work and it’s not how it is, but that’s how the world has–

Henci: Right, but this I think is what happened when birth plans became a thing in the medical environment. It became a checklist. But when you say, “I’m planning a vacation,” if your plane flight gets delayed and you miss your connection to the cruise boat, you don’t say, “Oh, I failed.” Right? 

Meagan: Right. 

Henci: It’s a plan. “All right. How am I going to get to Costa Rica?” It’s a very different mindset and I’d just like to relieve the audience from the idea that a plan is too limited. 

Meagan: Yeah. I love that. I love that. Let’s talk about how when we are planning to have a VBAC and when we are going for a trial of labor after a Cesarean, we have a lot of providers talking about–

Henci: I’m going to plan a VBAC trial. I think language is just so key to all of this. 

Meagan: Right? I know. 

Henci: A trial suggests that– 

Meagan: We’re trying. We’re trying. 

Henci: The other word that I’d just like to take out is “success”. You either plan a VBAC and have a VBAC or you plan a VBAC and you have a repeat Cesarean. 

Meagan: Like you say, those words are so important. We talk about VBAC and TOLAC language in our course and talk about how you might hear TOLAC and that actually might be triggering. It is to a lot of people because you are like, “I’m not trying to do anything. I’m going to have this baby. My goal or my plan is to have a vaginal birth after a Cesarean.” I don’t love trial, but we talk about how that is how medical professionals will label it so we try to get comfortable with the term TOLAC so when we hear it at birth, we’re not triggered, but knowing in our minds, we are planning to have this VBAC. 

So when we are planning for our VBAC, one of the number one things that focuses on that from a lot of providers is uterine separation. 

Henci: Right and even there, the language that the medical practitioners use is right with the language of failure. So let’s even take that. You hear, “What are my odds of–” even if they don’t call it uterine rupture? The thing is that there are a couple of really big studies, like 50,000 because now we have these big databases and in one of them, the likelihood of the scar giving way was 5 out of 1000 and in the other one, it was 3 out of 1000. 

What you have to think of is, in one of those studies, the odds were 995 out of 1000 that you wouldn’t have a problem with your scar and in the other one, it was 997 out of 1000 that you would not have a problem with your scar. 

The other thing that people have to understand is that even if you do, even if the scar gives way, yes, it’s an emergency. The odds of having something bad happen to your baby– 

Meagan: Catastrophic, yeah. 

Henci: Catastrophic happen to your baby are again, 997 out of 1000. When that problem happens with your scar, 997 times out of 1000, your baby is going to be just fine. You’re going to have an emergency Cesarean, but your baby is going to be fine. 

Meagan: Usually Mom is fine too. 

Henci: Yes, absolutely. So you have to think in those terms so that the numbers are very low. The thing there is that it’s a general number. 

Meagan: Right. It is a general number. That is something that we really, really need to keep in mind. This is a general number. 

Henci: I want to drill down and look at some things that affect that number. The first one, and don’t worry, I go into details and give all of the numbers in the blog post. The first one is what I noticed when I started doing the research for this is that you have two factors that pull in opposite directions. One of them pulls towards having a problem with the scar and that is the use of induction or augmentation. The other pull in the direction of not having a problem with the scar and that’s having a prior VBAC. 

Before we get to, “Well, my last baby was big. Does that increase my chance because I might have a bigger baby this time?” Those two things are key and one of them, you sort of have control over. 

Meagan: Yeah. Yeah, not inducing. 

Henci: What I can tell you is that it’s pretty clear that the stronger the stimulus to the uterus, the more likely you are to have a problem with the scar. In other words, particularly the highest risk is if you are induced at all just with oxytocin and then if you’re induced or augmented, it really goes up– this is really the key point– if you are induced when the cervix isn’t favorable for labor and they give you an agent. 

Meagan: To help soften the cervix and get you ready for induction. 

Henci: Right. It does a great job of softening the cervix, but there actually may be a reason why the agents that soften the cervix are problematic for the scar because the cervix is made of connective tissue. What those agents do is that they cause the cervix to soften by pulling in water and softening the way you’d wet a sponge. 

Meagan: I love that analogy. I’ve never thought of that. 

Henci: Guess what the uterine scar tissue is made up of? Connective tissue. That could be where the problem is. But anyway, so the more you augment the uterus, the more likely you are to cause a problem with the scar if the contractions are stronger and longer and for longer periods of time. 

One thing to keep in mind is that induction is never an emergency or a necessity. If, for example, you do have a medical issue like your blood pressure is going up, there’s a real reason that induction and getting the baby out sooner rather than later is possible. I’m going to put this on the back burnerhere are studies that show if you are really careful to induce to mimic as much as possible what the body does naturally, you can induce without overstressing the scar. That’s something to say if, “Oh my god, if my only choice is induction or a repeat Cesarean, I guess I’d better choose repeat Cesarean,” then I would say, “Yes, there are ways to do this.” Like the wicked witch says, “These things must be done carefully.” 

That’s one thing. The other thing is that there is very strong evidence that if you have had a VBAC, you are much less likely to have a problem with a scar. Having a prior vaginal birth, a vaginal birth before a Cesarean doesn’t seem to have as much of an effect on that, but if you get a VBAC under your belt, you are very, very likely to go on having uneventful VBACs if you choose to have more children. 

Meagan: Why do you think that is? Just because the uterus has progressed and it has pushed a baby out? I read that question a lot and in my head, I know there is a showing that you are more likely, but in my head, I’m like, “Why? Why is it exactly why you are more likely to have a VBAC if you’ve had a vaginal birth and if you’ve had a VBAC, you’re less likely to have separation when the uterus is doing the same chemical functionality?” It’s contracting and squeezing and pushing a baby out.

Henci: If that were true, then it wouldn’t make a difference whether you’ve had a vaginal birth before you’ve had a Cesarean or you’ve had a VBAC after you’ve had a Cesarean. 

Meagan: It’s really weird. 

Henci: So I have no idea. I’m just the literature lady. I just can tell you what the research says. 

Meagan: Yeah. Right? I don’t know that either. I can’t figure it out myself either. I don’t understand why. Yeah. Okay, I had a vaginal birth and then I had a C-section and then now I don’t have as high of a risk. It’s just interesting. It’s really interesting. 

Henci: Yeah, certainly. If you have had a VBAC, for anybody to say, “Oh, we just don’t do VBACs and you really need to have a repeat Cesarean,” your best option is to plan a repeat VBAC. I mean, that is a really strong link there. 

Meagan: Right, but we’re not having providers suggest it. We’re still having providers saying, “It is your best option to have a scheduled repeat Cesarean.” 

Henci: Do they say why?

Meagan: We have people writing all over. One, we just don’t support it. Two, the vaginal birth that you did have– say if they had a vaginal birth– wasn’t until 41 weeks so if you have a baby by 39 weeks, it’s fine. You can have that but after 39 weeks you can’t. 

Henci: Yeah, that’s what I call a Cinderella VBAC. You can have a VBAC if you go into labor before 40 weeks and if your previous baby wasn’t too big and if you make progress in labor, but you know, the basic reason is, “We don’t do VBACs here because we can’t handle obstetric emergencies.” Oh, wait. Let’s think about this. You’re a hospital. You have women coming in in labor. Some of them have high blood pressure. Go down the list and you’re saying that you can’t handle an obstetric emergency 24/7? You shouldn’t be doing births here. 

Meagan: You shouldn’t be having babies here. That happens a lot where you’ve got more rule areas like, “We can’t support VBAC because we can’t handle an emergency Cesarean.” It’s like, “Well, if you can’t handle an emergency Cesarean, then that’s a big concern for anyone to give birth because VBAC or not, we know emergent Cesareans can be needed for first-time moms.” If they can’t handle a VBAC Cesarean, then how are they totally able to handle someone who has an emergency Cesarean just in general?

Henci: Unfortunately, this isn’t something that your audience can change. They’re not going to talk that hospital into changing, so it just hurts my heart that people are put in this sort of form of dilemma where they don’t have a good option. They have a least worst option. 

Meagan: They feel stuck. That is the same thing with me. It hurts my heart that so many people feel so stuck out there. We have mamas that travel out of the country or out of the state just to find somewhere but that option isn’t for everyone. So it’s really hard if you feel stuck and you’re not feeling supported in your community. So yeah. It hurts. 

That’s a whole other type of podcast. 

Henci: That’s a whole other topic. 

Meagan: Yeah, so let’s talk about what uterine separation is. We talk about uterine separation. I’m going to use the word that a lot of providers use as rupture. So when we hear this really big word, when I picture a water balloon breaking– 

Henci: That’s why I don’t like that word. 

Meagan: That’s what we hear. That’s what we hear. We hear “rupture” and that’s what I hear is a water balloon breaking and popping. That is really terrifying to hear and to think of when in actuality, it’s not usually how that happens, right? 

Henci: Right. 

Meagan: Our uterus doesn’t just break open and explode. It doesn’t so let’s talk about separation. What does it mean? What does that mean? And there are multiple types of separation. 

Henci: Actually, it’s been interesting to see because I’ve actually been involved in this work since the 1980’s so to watch the evolution when VBAC started coming in and went out again, as the research has grappled with an agreement on a definition of exactly what that meant because they find this all the time in repeat Cesareans that little windows can open up in the scar. It’s not a big deal. Scars are tough. They don’t cause any problems so what they finally ended up with is the scar completely gives way to form an opening in the uterus between the uterus and the abdominal cavity. 

That would be in combination with symptoms, usually heavy bleeding or the baby being in distress. 

Meagan: Or baby going high up. 

Henci: There is no clinical significance to a window. There are no symptoms. Nobody is hurt. Nobody is at risk, but if the scar gives way to the extent that there is heavy bleeding and in very rare cases, the baby or part of the baby can actually be in the abdominal cavity, that’s a scary situation. 

Meagan: Yeah. Yeah, and talking about the uterine window– as she was saying, it’s where it thins out so we’ve got this thinning. The crazy thing is that there really aren’t any symptoms. 

Henci: There are none. 

Meagan: You really wouldn’t know if you had a uterine window unless you were opened up. 

Henci: Unless you had a repeat surgery, yeah. So there is the interesting thing about that. One of the things they tried to do– and I hope that none of the doctors they are encountering are doing this– was they thought, “Hmm. Why don’t we do an ultrasound to see how thin the scar is? Maybe that will help us predict whether the scar will give way.” 

It turns out and there is absolute agreement on this that you can’t use that. It isn’t accurate enough to tell you anything and what’s more, the correlation in that study was when she was pregnant, we did this ultrasound and we measured the thickness of the scar. Then, when they had their surgery, we looked to see if in fact there was a problem with the scar. They found some little windows, but that didn’t mean they would have had a problem if they would have gone into labor. So that whole idea of, “We have some way of predicting when the scar will give way so that we can advise whether it’s a good idea to try a VBAC,” all of the studies that have been done of that have said that they aren’t accurate enough to be used to counsel a person about VBAC. So anybody that’s using that one is not scientific. 

Meagan: Yet we get those messages all the time. “Hey, my doc said I can’t have a VBAC because my uterine thickness is too thin.” We get that reason all of the time, being told that they cannot VBAC because of that. It’s so disheartening when we’ve got evidence showing certain things, but we have providers not following evidence-based information. 

Henci: Yes. You can always find a reason to do something you don’t want to do. 

Meagan: Yes. That is what I was going to point out too. Sometimes when we have providers saying things that are completely opposite of what evidence even says or just don’t support evidence in general. We got a message saying that they had a 60% chance of uterine rupture. 

Henci: Oh sheesh. 

Meagan: Yeah. They said that their uterine scar would give way 60% of the time. I’m like, “No way. No.” Where do we even get that? But a lot of the time, these providers are, like you said, saying things because they don’t want to do things or they’ve seen things that make them scared so they put people under this general umbrella and they’re like, “Oh, you’ve had a C-section. You’re under this umbrella and this umbrella is not going to let you have a VBAC.” 

Henci: I have a dear friend who was interested. She was a marriage and family counselor and she was doing work with PTSD, child-related PTSD. We were sitting at a conference and there was an obstetrician who was lecturing who started actually talking about an emergency birth where things went wrong and she actually started to tear up. My friend had an epiphany. She said, “Oh my god. It’s not just women who develop PTSD.”

Meagan: Yeah. It’s these providers. 

Henci: It’s birth professionals as well and if you’ve been at a crisis birth even if everything turned out right, but if it was that sort of an emergency, “Oh my god, we might lose this mother or we might lose this baby,” that’s going to change the way you practice because what is the signal effect of PTSD? It’s intended to be protective. Your brain says, “I never want to be in that situation again. What do I need to do to avoid it?” 

Meagan: Right. 

Henci: I have compassion for that, but it doesn’t help your audience who is stuck with these people who have no idea what is actually driving their decisions. 

Meagan: Right. I guess I want to mention that just because sometimes I feel like, and even on this podcast, we’re guilty of saying things that make it feel like we’re painting bad pictures of providers and putting them in a bad light. That’s not the goal here in this podcast. That’s definitely not what we want to do but we do know that a lot of people have been let down. 

Henci: Yeah. 

Meagan: I mean, here’s this failed word but there are a lot of people out there who have been failed. 

Henci: They’ve been failed by their care provider. I will use failed in that case. 

Meagan: They’ve been failed by the staff or by their care provider or their location. A lot of the time, it’s really hard because we don’t know what that other person has experienced. We hope that those professionals will work through those and stop putting these general umbrellas over people, but we know that it’s probably not going to ever stop happening. 

Henci: No, unfortunately. But I want to move back to how we just talked about a case where the research doesn’t back up what the doctor says, but I want to talk about a couple of cases where- and this is where being more critical of what the research has to say. It does on the surface back doctors up. 

So now let’s get into some of the categories for induction. The big one is, “We don’t want you to get past 40 weeks because we know that with longer pregnancy duration, there is more chance for scar rupture.” That sounds good and it’s actually in the research, but here’s the catch. Underneath that is what happens at 40 or 41 weeks? They induce labor and there is research that shows that the reason that you get more is that all of the scar ruptures were in induced labor. 

We know that induction increases the risk of scar rupture. It creates the illusion that it’s pregnancy duration. It’s not. It’s pregnancy management. 

The other one where that happens and it’s actually in the research is women who are expecting a big baby or they think the baby is big. 

Meagan: Suspected big baby. 

Henci: First of all, if your doctor says, “Oh, you know. This baby is going to be on the big side. We did the ultrasound. I’ve been feeling your belly.” You might as well flip a coin because there is a 50/50 chance that that is incorrect and your baby isn’t going to be on the big side. So number one, they may be anxious about something that isn’t even true. 

Meagan: It’s so true. 

Henci: The second thing is, then what happens next? Let’s induce before the baby gets bigger. So again, you find an association between VBAC labors with bigger babies and an increased risk of scar rupture but that’s not the root cause. The root cause is those laboring women were induced. So that is something to take into account when you hear those things and again, I’ve got the numbers. 

The reason I keep coming back to the importance of the blog post is one of the things that I think is less than helpful is vagueness like, “There is a chance.” The first question I’d have is, “How big?” so I wanted to as much as possible give people the numbers so that they can do what feels right for them but also know how those numbers are distorted by management. 

The VBAC rate itself is distorted by management because VBAC studies outside of the hospital coming from home births and birth centers show a VBAC rate in women who have not had any prior VBACs– the first birth was the Cesarean and this is the second delivery. The VBAC rate was 81%. Out of the hospital-based studies, they range up to the low 70 percentile, but the hospital studies don’t get up that high.

Here’s the important thing. If it’s at all possible, find a care provider who’s really comfortable with VBAC and knows how to manage them because where do you see the bad outcomes? To a huge extent, they’re in labors that were induced and labors in which there was a problem with the scar which is much more likely if they were induced or augmented or she wasn’t given enough time and then she went to C-section.

The complications happen in C-sections so the more you are able to have a birth that proceeds at its own pace with no stimulation and there is a spontaneous vaginal birth, your birth by your own efforts, that’s when it’s minuscule in terms of having complications. 

Meagan: Right. It’s so hard because yes. We talked about this earlier. Oh, we’ve got hypertension and oh, we’ve got this thing and we have options. Do we induce or do we have a C-section? It still is very possible to have a VBAC with an induction. We’re just talking about uterine giveaways and the chances. You increase your chances by choosing to be induced. That doesn’t guarantee you’re going to have that happen or anything but you have to know walking into it, “Okay, I have this, this, and this, and I’m going to choose to induce.” You have to know the risk that you are taking. We have to weigh out the risks and say, “Okay. I know it increases a little bit. I’m comfortable taking that risk or I am not comfortable taking that risk.” 

Henci: Right. Or how can I minimize my risk? Because it still is possible. You have to do it diplomatically but if you have a care provider who is willing to be flexible and is like, “Yeah, I’m not sure about this one,” but you’re able to have that conversation where you feel like they can hear you and you’re going to be respectful and hear them, then I think there’s a lot that can be done. You can say, “No or not yet.” 

Meagan: Yep. We just made a post on Instagram and Facebook about that saying, “I appreciate the time that we just took. I’m going to choose to wait” or “Thank you so much for that, but I’m not going to do that.” 

Henci: The other thing I would suggest if you’re in a situation where you’re saying no is to have a discussion around which new information would change your mind because that again creates space with, “Oh, I don’t have one of these patients that’s just being difficult,” but to say and talk about, “If my blood pressure goes up–”. I don’t know what it might be, but to have a conversation about under what circumstances might you consider changing your mind. 

Meagan: Right, yeah. It’s powerful. Conversation and information are powerful. I always encourage someone to ask questions and to get their research. If we have a provider saying you have a 60% of uterine scar giveaway, let’s talk about that. “Wow, that seems really high. Is there any way that you can provide me with that information so that I can study that and see what’s comfortable for me?” And then you’ll look and it and go, “Oh, there aren’t statistics showing that I have that? Okay.” Then you might make a different choice, but if you just hear that number and don’t ask any questions, then you automatically might say, “That seems really scary. I’m not even going to go there.” 

We have these myths and these numbers and if we don’t ask for information, we’re doing ourselves a disservice. 

Henci: I’ve got the American College of Obstetricians and Gynecologists practice bulletin. I wonder if there is any way– I mean, a summary of recommendations and conclusions backed by level A evidence, good and consistent scientific evidence. The first one on the list is, “Most women with one previous Cesarean delivery with a low transverse incision are candidates for and should be counseled about and offered TOLAC.” 

Meagan: Yes. 

Henci: My eye goes down and I want to talk about women who’ve had two prior Cesareans. I know we wanted to talk about that. 

Meagan: We do want to talk about that. Yes. 

Henci: I will say that they’re not enthusiastic about it, but nonetheless, this is under level B evidence which is limited or inconsistent scientific evidence, and what it says is, “Given the overall data, it is reasonable to consider women with two previous low transverse Cesarean deliveries to be candidates for TOLAC and to counsel them based on the combination of other factors.” 

They have all of these VBAC predictions which I’m just going to be blunt, they’re crap because they’re evaluating the wrong thing. What they should be evaluating is the doctor’s propensity to care for VBAC and their confidence in VBAC. Then you’d get the numbers that would really correlate with whether labor would end in VBAC or they wouldn’t. 

Meagan: Right. Right. I know. Then just going one step further, vaginal birth after two Cesareans, then we’ve got people talking about vaginal birth after three or more. There’s no evidence in there because we’re not doing them very often. 

Henci: The evidence is not there for three. It is there for two, although again, you can get very low, again, the equivalent of sort of the average. There are some Israeli studies where there is a very large population of women there who have large families so you do get people with two Cesareans, but the thing there is they need to be managed carefully. In one case, it was like, “We don’t do inductions other than by rupturing membranes in someone whose cervix is ready to go.” There are ways to do that. 

But what I wanted to say is that now here’s a case where you have to look at the other side which is that there are studies that show there are consequences because as you accumulate uterine scars, the complications in subsequent pregnancies go up. So when you get to two prior Cesareans and there are studies that looked at the branch in the road. You had two prior Cesareans. Did you plan a VBAC or did you plan a repeat Cesarean? And guess what? The severe complication rates were identical. It was an identical rate of hysterectomies. There was the same rate of perinatal mortality so it’s not like, “Oh, I’ll just choose that safe third Cesarean.” There are increased risks, but there are also increased risks to taking another Cesarean on board. 

Meagan: And then to add to that, future pregnancies. With each Cesarean that we have, we have also risks in future pregnancies that are not discussed when we’re counseling in this medical world from what we’re finding. We’re being counseled for VBAC. We’re being counseled about the risk of uterine separation and the VBAC issues, but we’re not talked to about the blood loss or the risk of hysterectomy. We’re not talking about those things. 

Henci: Or chronic pain. 

Meagan: Chronic pain or dense adhesions or placenta accreta. We don’t talk about these issues or even deeper issues. We’re not talking about them. That is where I think is one of the places we’re going wrong in this medical world. We’re not truly counseling on all sides of things to really give people the opportunity to make that really informed decision. We’re kind of just prefacing over here, but like, “Oh, but we could schedule your baby’s birthday and get your hair done the day before because you know exactly when your baby is coming.” We’re not counseling. 

Like you said, there are issues and there are risks. So with VBAC after two C-sections, through your education and ACOG not saying, “Yeah, go for it for sure, for sure,” But they’re saying, “It should be reasonable.” Through your uterine scar separation research, is it substantially larger? I know there are going to be numbers in the blog and we talk about it in our course and things, but is it like you have a 0.4% to what? To 10% if you’ve had two to 1%? We’ve got people being told things all over the place. I guess my question is through your research with VBAC after two Cesareans, we’re going to specifically talk about two Cesareans here, is it increased and truly that much higher? I mean, I know the answer, but let’s talk about it. Is it really that much higher or is it pretty low statistically? 

Henci: Well, I actually turned to that page in the blog post and I had a couple of different studies. There was an increase in both studies. It was quite small. The difference in these studies, I really think, had to do with the fact that in one of the studies, that was the one where they would only allow the rupture of membranes as a means of induction. 

So in one case, it went from 3 per 1000 with planned VBAC after one Cesarean to 6 in 1000 with planned VBAC after two Cesareans, and in the other one, it went from 7 to 1000 to 16 per 1000. But that’s still a 98% chance of not having a problem with your scar. 

Meagan: Right. 

Henci: The thing is, there is a consciousness, but if you’re planning a large family, that maybe I think a lot of care providers will say, “Well, if you’re only planning on having two children, it really is not that big of a deal to have another Cesarean.” But the thing with that is that I think it is really important to understand that you may plan to complete your family with two children. That doesn’t necessarily mean that’s what’s going to happen. 

Meagan: That’s true. That is so true. 

Henci: I think unless you or your intimate partner are planning on doing something permanent about your fertility, you have to consider the fact that you may choose to have another baby or you may find yourself pregnant and decide you’re having another baby. 

Meagan: Right. 

Henci: I think you always have to take that possibility into consideration when you’re making that first decision. Personally, this is totally my opinion and my judgment. No pressure here. I think the best thing that you can do is get off the Cesarean track if you can. 

Meagan: Mhmm, yeah. I mean, it really is. There’s proof in the pudding that a vaginal birth is the ideal route in the long run overall. 

Henci: Yep. 

Meagan: I guess as we’re wrapping up here, let’s talk a little bit about, well, how you do you decide? How do we decide? 

Henci: I know that I wanted to get to something because we talked about this. I wanted to get to the epidural issue. 

Meagan: Epidurals yeah. Let’s talk about that too. Yeah. 

Henci: What you are saying is you’re hearing both sides. One is that you can’t have an epidural and the other is that you have to have an epidural. 

Meagan: Literally, they say that you have to have an epidural to have a VBAC. Some of them are like, “Well, yeah. You can VBAC. Just know.” I feel like it’s used as this fearful thing. “Just know that you can’t have an epidural so you’re going to have to go unmedicated.” 

Henci: Let’s take care of that one that you can’t have an epidural first because that’s the easy one. Again, I go back to ACOG. Level A evidence. “Epidural analgesia for labor may be used as part of a TOLAC.” I mean, I was jaw-droppingly shocked because it’s at least two decades since that myth about, “Oh, we can’t give you an epidural because then we won’t know if there is scar separation.” So that is totally bogus. 

But let’s get to the, “You have to have an epidural.” The thing about that is that there are two problems, I think. First of all, the idea is in case there is an emergency, we can deal with it faster. The thing is, an epidural is problematic in a couple of ways. One is, one of the more common side effects of an epidural is that there is a drop in the mother’s blood pressure and the baby’s heart rate. Guess what is the best predictor that the scar has given way? The number one predictor that the scar has given way– and again, in most of those cases, it hasn’t but nonetheless, it’s a better predictor than pain, is the baby’s heart rate. 

You are adding, number one, something that will possibly provoke concern and a Cesarean you don’t need. But the other thing is that it interferes with mobility. I think the number one reason– I mean, you want everything in your favor in terms of making good progress and an epidural interferes with that. Plus, you then have the problem of epidural fever because obviously, they want to give you that epidural early. You’d maybe have it for hours and then you’d start to develop a fever and they’d be like, “Mmm, it’s time to get the baby out.” An epidural actually decreases your chance of a VBAC. 

But about the emergency piece, the thing is if you have a sterile water lock where you’ve got the business end of the IV, the needle is there but it’s not hooked up to anything. 

Meagan: Are you talking about the “just in case” epidurals? 

Henci: Right, the “We want you to have an epidural because of the emergency possibility. We’ll already have you anesthetized.” We first talked about, “We’ve given you a procedure that may lead to an unnecessary Cesarean,” and they decreased your probability of progressing to a vaginal birth. So that’s already like, “Umm, really? Do you want to do that to me? Why?” The answer is, “Well, in case there’s an emergency.” You can do a spinal a lot faster than an epidural. It is perfectly possible to get you numb within a very short period of time and sufficient to do the Cesarean surgery. It really is kind of bogus. 

Meagan: Yeah. I want to talk about this too because if it is a true, serious, serious surgery where we’ve got minutes if that, we’re going to usually be put under general anesthesia. 

Henci: Well, that’s a possibility too. 

Meagan: Yeah, so that’s the thing. 

Henci: The other thing is that I also want to move into that gray zone of, well, I just talked about the drawbacks of having an epidural, but I mentioned that there’s a fair number of members of your audience who are thinking, “I’d really like to have an epidural.” For some of them, depending on what their first labor was like, it may have been like, “I can only contemplate VBAC if I can also contemplate having an epidural.” 

This is where my new book comes in. The full title is, Labor Pain, What’s Your Best Strategy? Get the Data. Make a Plan. Take Charge of Your Birth. In that book, I give all of the evidence, pros, and cons of all of the different other methods of do-it-yourself comfort measures to epidurals and then the last chapter is again, the fork in the road. You would like to avoid an epidural and here are all the ways of doing that, and you would like you plan an epidural. You want to make an epidural plan A and then here are all of the ways of maximizing your chances of having one that goes smoothly. 

I don’t think I need to go into all of the details here on the show, but if anybody is interested in finding out more about the pros and cons of their pain-coping options including epidurals and how to plan to avoid an epidural if it is plan A or the reverse, then I think my book could be helpful. 

Meagan: That is amazing. Just to let you guys know, we’re going to have so many things in our show notes here. We’re going to have, of course, the blog with all of the numbers going deeper into what we’re talking about today. We’re going to have a link to all of her books because I think it is important to know things from all of them. 

Henci: I mean, I would actually stop you because I think Thinking Women’s Guide was a great book. It was published in 1999. 

Meagan: Yeah, so it’s a little older. It’s a little dated. 

Henci: Optimal Care was really intended for birth professionals. 

Meagan: We have a lot of birth professionals. 

Henci: Even that was in 2012. 

Meagan: We have a lot of birth professionals listening. 

Henci: So I really want to preface the new book. It’s been out less than a year so it’s really current. 

Meagan: Mhmm. We’re definitely going to have that number one. I haven’t read it yet, so I’m going to read it myself because I think it’s important too. I know you and I trust you but I want to know even more so I can keep referring it out and also learn by reading it myself. 

Henci: Yeah, I think you’ll get some ideas for your classes. 

Meagan: Yeah, for my clients, and keep referring them out. I mean, you guys. The more information you have, the better. The more knowledge that you have under your belt as you are entering into these births, it’s going to help you along the way. It’s going to help you feel more prepared, more educated, and more confident. Right, Henci? Don’t you feel like confidence is something that no matter what, VBAC or not, just with birth in general that we need? 

Henci: That’s why the name of my new series– I’m working on a book on induction– is Take Charge of Your Birth. You can’t take control of your birth because you don’t know what’s going to happen. Life happens. But you can take charge in terms of having the information, having thought through what is really important to you, and there is actually research on this. Feeling in charge is the key component in having a positive experience. If you felt helpless, if you felt like you didn’t have any say in what was going on and you were scared and you didn’t feel supported, you could have a lovely, uneventful vaginal birth and be traumatized. 

If you were in charge, you were a full participant in all of the decisions, you felt like your options were presented, you made the best choices you could, the people around you were encouraging and supportive of what you were trying, and you could have a very difficult experience in terms of what actually happened and it would still be a positive experience. 

Trauma is a very personal experience. It’s what you feel in the moment. No one can say of you that you shouldn’t have been traumatized by that birth because it wasn’t traumatic enough. It’s subjective. 

Meagan: Right. Right. 

Henci: But as a whole, feeling like you are in charge is powerful.

Meagan: It’s really powerful and there are actual stats behind that. My second birth didn’t go the way I desired. I still to this day believe that I wasn’t allowed enough time or wasn’t given enough resources that I deserved. But at the same time, once the decision was made to have a second Cesarean, a repeat Cesarean, there were a lot of things that I communicated. I took charge at this moment. “If this is how it’s going to go, this is what I need and want.” My providers were really receptive to that. With my second Cesarean, although still not desired at all or even felt that it was necessary, I actually have a very different viewpoint on it because I was actively involved in that birth and in the decisions that were being made. Again, even though I didn’t feel that the decision that I made for the repeat Cesarean was really warranted, it was a decision that I made. I accept that. 

The other decisions along the way, I literally can look back at that birth and say that it was healing. A lot of people are like, “Wait, what? You’re saying that you didn’t want your second C-section but it was healing?” I can say, “Yeah, absolutely. It was healing because I was able to really participate in this birth in a different way.” 

I just think it’s so powerful because I could have looked back with a lot of anger and hate. I probably could have beat myself up even more, but I viewed that as a positive, healing experience. I think that’s what I needed to end my C-section journey. I needed that birth to say, “Okay. This is a better experience. I’m ending the C-section journey now. VBAC from here on out, but I needed this experience to have a different view on the C-section experience as a whole.”

Henci: I think I heard something else which is key and correct me if I’m wrong, but it sounds like when you agreed to the second Cesarean, you were making the best decision that you could at that time. You still had a decision. It sounds like you weren’t sort of bullied into the repeat Cesarean. It sounds like there was a discussion and you felt like, “Yeah, I think I’ll go along with the repeat.” 

I think that’s key too is when you do make a decision and it is your decision and you can own it, I think that helps too because later, you can say, “You know, if I were in that same spot again, I might do something different. I’ve learned something from that. But you know what? That was also what made sense to me at the time and now I can let go of it.”

Meagan: Yeah, you know, when I got my op reports when I was going to interview all of the providers for my VBAC after two Cesarean baby, which I wasn’t even pregnant, but I started interviewing before, I was reviewing my op reports. As I was reading them, I did get a little triggered and I got a little bit angry. My husband looked at me as I had a tear rolling down my face saying, “These were unnecessary.” He said, “Babe? We made the best choice we knew at the moment with the information that was given to us at the moment.” 

Henci: Mhmm. 

Meagan: He said, “Do not ever shame yourself for making these choices because you were not given the information and you were not in a space mentally where you could be in that– oh, the statistics say–”. Right? That’s one of the reasons why I think doulas are so important because they can help remind you of those things, but I wasn’t in a space where I could go through my journal of information and say, “Oh, but this and this.” I was given these facts, this information, and I made a choice based off of the information that I was given. I can never shame myself for that. When he said that, I was like, “You know what? You’re right.” 

I would go back and do things differently if I were to look back. If I were there again, I probably would have made different choices or I would have done different things, but I’m loving the journey that those experiences have given me and brought me to. Does that make sense? 

Henci: Yes. 

Meagan: This journey that I’m on right now, I probably wouldn’t be on if I didn’t have those experiences. I wouldn’t be with all of you here today talking about VBAC and repeat Cesarean and what the evidence shows and sharing these absolutely amazing stories and bringing on these incredible professionals without those experiences. So yeah. I had two births that I didn’t desire the outcome of the Cesarean, but I will be forever and ever grateful for those experiences. 

Henci: I will add that I wouldn’t be who I was here today if I hadn’t had an emotionally very negative experience. I talk about that in the prefaces of who I am today and why I wrote the book and the difference between my first birth and how I experienced my second. Well, the first one, I was delivered. The second one, I gave birth. That in a nutshell is the difference between the two and that started me on my journey. 

I wanted other women and birthing people to know that the choices that they made were crucial to how they were going to end up feeling about themselves, their partners, their babies, and their everything, that it was not trivial, and making my life’s work looking at the research, because that’s my skill so that they would have that information. Information that I didn’t have until I started reading stuff after my first delivery. 

Meagan: Yeah. That’s how a lot of us doulas and birth professionals start based on an experience where we want to help people have a different experience. We want to empower people. 

Henci: I’m so glad that you’re in the world. It sounds like you are doing a great service for a lot of people out there. 

Meagan: Aww, well thank you so much, and likewise. You are incredible. All of your blogs are amazing. Seriously, people could spend hours and hours and hours on your blogs just picking apart the information and the stats and putting these large studies into English because honestly, that’s one of the hardest things about studies. You go through and you’re like, “I don’t even know what this means. Can I just get a clear conclusion?” But your blogs make sense. They’re English to me. 

Henci: Oh, thank you. 

Meagan: I know they will be for so many of our followers as well. Well, thank you so much for being here today. Seriously, I am so, so grateful. If you guys want to go follow Henci, like I said, we’re going to have all of the links for all of the things in the show notes but you can also go onto Instagram and Facebook @takechargeofyourbirth.

Henci: Yes. That is correct. 

Meagan: Or hencigoer.com. 

Henci: And actually, I think there are places on social media but if you go to hencigoer.com, you can also sign up for my newsletter. I have a monthly newsletter. 

Meagan: That’s what I was just going to say, hencigoer.com. Like I said, we’ll have this in the show notes. Go in there. Sign up for the newsletter. Sign up for all of the amazing things that she’s putting out because you really are. You’re a wealth of knowledge and it’s really so fun and I’m so honored that you took the time today to be with us. 

Henci: Well, it’s been my pleasure to be here. 

Closing

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Meagan and Julie talk about the ARRIVE trial and compare those findings with new research released from a retrospective study conducted at the University of Michigan. Many first-time moms and VBAC moms are being told by their providers that an elective induction at 39 weeks will reduce their chances of a C-section. 

Is this really true? Meagan and Julie will empower you with information about elective inductions to help you make decisions about your birth that are right for YOU.

Additional Links

University of Michigan Study

The VBAC Link Blog: The ARRIVE Trial

ARRIVE Trial

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Hello, hello you guys. Guess what? Julie is on today. I have kind of, well not kind of, really missed Julie. I reached out to her a month or so ago and was like, “Hey, would you like to come on with me and we can do episodes?” And she said, “Yes!”

Julie: Yes. 

Meagan: I should have brought chocolate cake. Instead of her proposing to me with chocolate cake, I proposed to her with my smile. I don’t know what I’m trying to say. I don’t know. I don’t know. But she said yes and I’m so glad that she said yes this time. So welcome, Julie. Welcome, welcome. 

Julie: Welcome. It’s good to be here. 

Meagan: Yeah. It’s good to have you here. It’s good to see your face. Julie and I are going to be talking about the ARRIVE trial today. That is something that if you’re not familiar with, it was done in 2018, and I think it was published in 2019. Does that sound right, Julie?

Julie: Yeah, I think the final analysis was published in 2020. 

Meagan: Yeah. 

Julie: The study was completed in 2018. 

Meagan: Yeah. Yeah. It is where they did a trial to see if elective induction at 39 weeks reduced a lot of things. Not just Cesarean, but because we are in the Cesarean world, it was definitely, I would say, one of the most important topics. Does it reduce Cesarean? But also, does it reduce the chances of preeclampsia, hypertension, and other things? But the big question was does it reduce the chances of Cesarean? So we are going to talk about that today. We have a blog on it today, but there is actually an update. That was done in May of 2023 so we are going to talk about that. 

Review of the Week

But of course, we have a Review of the Week and Julie is going to do the honors. 

Julie: Yes. I’m so happy to be back and joining the podcast anytime. All right. This review is from bethanystaggart or something like that. The title is, “Podcast Was Part of My VBAC After Two C-Section Journey”. She says, “I am so thankful for this podcast. I listened to so many episodes in preparation for my VBAC after two Cesareans. Listening to other women share their stories gave me the courage to keep working and fighting for my upcoming birth. I just gave birth to my third boy and the birth was everything I could have asked for. I am so thankful for this podcast and blog and refer every expecting mom I know to it in hopes that it gives them the courage and confidence it gave me to get the birth they want and deserve.” 

That just makes me so happy to hear those things and to know that the podcast is making a difference in everybody’s lives. I feel like there is such a feeling of solidarity when we sit and listen to other people’s birth stories. There is so much we can learn and there is so much that we can be inspired by and there is so much that we can use as we navigate our own birth journeys. So thank you, Bethany, for leaving that incredible review. 

ARRIVE Trial

Meagan: All right, Julie. ARRIVE Trial. I feel like when this came out, you and I– I’m going to say for sure I– was just a little grumpy. I was like, “This can’t be. This cannot be.” Being in the birth world, especially since COVID, but this is pre-COVID, we definitely see induction and it can happen just fine, super smooth, with no problems, but then there are a lot of times too where it doesn’t. We see the cascade that leads to that Cesarean. 

I remember when Julie and I started the birth course and the How to VBAC Prep Course, we were teaching in person. We had a mom who came and when we talked about this, she was like, “I was in that. I was in that trial.” We were like, “Oh, how did it go?” She was like, “Well, I’m here prepping for a VBAC.” She had a Cesarean. 

She talked to us a little bit about it, but Julie, what do you remember about your first feelings when this trial came out?

Julie: Well, I had a really hard time because you and I have been to many, many, many, many, many births in a hospital, out of a hospital, inductions, unmedicated, medicated, scheduled C-sections, emergency C-sections, crash C-sections. We’ve been to all of it. I think that’s really the unique perspective that we have as doulas and birth photographers because we get to see the biggest range of births, I feel like, of all of the people that work in the birth world. 

My first reaction when the ARRIVE trial came out was that it did not reconcile with my real-life experiences and living in all of these types of births. There was this disconnect between what this study said and what I had witnessed. Before I even got into the study and saw all of the flaws and the different little nuances that people be considering that they don’t because I just knew that something didn’t feel right. This cannot be right. This cannot be right. 

Meagan: Mhmm, yeah. That is kind of how I felt too. It didn’t click. I was like, “So, what? What did they do?” This was my first question as I was reading. I was like, “What did they do to ‘lower the Cesarean rate’? What did they do differently?” I think that one of the most frustrating parts is that we don’t really know exactly all of the protocols and all of the exact nitty-gritty details of this study. They haven’t released it from my knowledge anyway. 

Julie: Yeah, and I looked too just a little bit before we started recording. Yeah, sure. It’s really interesting because in the study results, the elective induction group had a Cesarean rate of 19%, and the expectant management group, which we’ll go into all of the reasons why that is a little bit crazy, had a Cesarean rate of 22%. But here’s the thing. The national Cesarean rate is 30% so I feel like already, they were doing things in the study that impacted the chances of having a C-section anyways. 

But we don’t know what those protocols are. We don’t know how they were induced. The results said, “When this induction protocol is followed, then the Cesarean rate is reduced,” but the problem is that we have providers all over the country inducing willy-nilly not knowing what the protocol is, and probably being more aggressive in their inductions. We know the providers that led this study. We know who they are. We have worked with them in their space. We know how they practice and we know that the induction protocol was probably– and again, this is me speaking with no real knowledge, just my assumptions. Take that for what it’s worth. 

They probably had a pretty gentle, slow induction process. They were probably pretty patient along the way just from what we know of those providers and the hospital that it originated from. That was also a thought. 22% is not a low Cesarean rate, but it’s 8-9% lower than the national average. So that’s something I think to consider as well into that. 

Meagan: Yeah. It is interesting to me because it was 50,000 patients that were screened for this study. Of those 50,000, 22,000 were eligible but only just over 6,000 actually accepted to be in this trial. Those numbers to me are pretty dramatic. 50,000 to 22,000 to 6,000 is a really big thing. I wish I knew more. We know what people have said who were in the ARRIVE trial. They had to do certain things, but I wish I knew more about why all of those people were declining and then why from 50 to 22,000 were eliminated. Why were people eliminated? But maybe it’s just because, “Yeah, we don’t want to,” because what we had seen is that induction raises Cesarean deliveries. 

Like Julie said, yes. We are going to share some studies and some numbers and things, but this is all just us brainstorming this out loud really because it is really interesting to me. Like Julie was saying, how long were these people able to be induced? Because induction– I mean, even if you go listen to all of these stories, Julie. Induction is not something that is able to be carried out for days and days and days usually. 

Julie: But sometimes it is. 

Meagan: Sometimes it is. 

Julie: Sometimes and that’s what we were talking about or I was talking about earlier. At this hospital where the study originated and where the providers practice that were the authors of this study, I have been to many, many, many two and three-day long inductions there that ended in vaginal deliveries. 

Meagan: So have I. 

Julie: And not all hospitals are that patient. In fact, I don’t know of any that are that patient in our area. 

Meagan: Yeah. No. I mean, the hardest thing is that if your client doesn’t want to be induced, you want them to not be induced because that’s not what they want, but if they are going to be induced, you almost want them to be induced at this specific hospital because we know that they will let these inductions happen. I think the longest induction or the longest birth– well, it is the longest birth I’ve ever been to, but at that hospital specifically was 52 hours. 

Julie: Yes. 

Meagan: I remember crawling up on the ground, putting a towel on the ground and falling asleep trying to take a nap because I as a doula had been there that long. They had called me in the very beginning. That is just not normal. Right? It’s not that normal. What kind of piqued our interest in wanting to talk about this again– I mean, we’re talking about something that happened in 2018. Now it’s 2023. 

It’s that the University of Michigan just released an article talking about this. It’s called “Labor Induction Doesn’t Always Reduce Cesarean Birth Risk or Improve Outcomes for Term Pregnancies”. So we want to talk about that and update you guys because we believe that updates, as we get more information, is important. So yeah. 

It was a 14,000– Julie, you were kind of analyzing– births. 

Julie: Yeah, so what I really liked about the Michigan study that was released is that it was a sort of analysis. This study was looking back at births and how they ended. Births that did not enter into a study. Births that were not set up in order to track. Births that just happened without any care in the world in this regard. They looked back at the data that they had already had. 

I love that because that’s what I love about Cochran reviews. I’m a big Cochran review junkie because Cochran reviews look at a whole bunch of data and a whole bunch of studies and put them together instead of creating a study and moving through it. The ARRIVE trial study was created in order to show if induction reduced the risk of Cesarean or other maternal or fetal mortality rates. How does induction impact that? That’s what this study was designed to do, but this study, the Michigan State study, looked back at data that had already existed without any type of bias going into it. 

Yes, there were 14,000. They looked at 14,135 deliveries in the year 2020. They analyzed all of those to look at the outcomes. Who ended in a Cesarean? Who ended up with hypertension? Who had postpartum hemorrhages? Who had– what was the other one– oh yeah, high blood pressure? Did I say that already? Operative vaginal deliveries– vacuum and forceps? That’s how they pulled it. 

There are different ways of looking at data as accurate so I don’t want to say that it’s more accurate, but I love that they looked back and that reflection on it. They showed that the group that was induced in the 39th week had a 30% rate of Cesarean which is what I was just saying. What was I just saying? The national average is 31.2%. That fits more in line with the national average of people that went in and got inductions versus 24% of the people who had the expectant management. 

24% is not a great Cesarean rate either but it’s just a 6% decrease in those amounts of Cesareans. Also, for people that are wanting to know, the rest of it was people who were induced had higher instances of postpartum hemorrhage, so 10% versus 8% for the expectant management group. When we say expectant management group, those are the people who were not induced. They were just going through taking pregnancy as it came and then delivering whenever that looked like. When it was medically indicated to have an induction after the 39th week, those are probably included in those numbers as well.

 Operative vaginal delivery, vacuum, and forceps were 11% in the induction group versus 9% in the expectant management group. Although people who were induced were less likely to have hypertensive disorder which is high blood pressure. Those numbers are 9% in the expectant management group versus only 6% in the elective induction group. There were no significant differences, no other differences, in neonatal outcomes. No differences. Nothing dramatic, nope. 

Meagan: Nothing dramatic. The researchers mimicked the exact same framework used in the national trial. A CNM said, “We designed an analytic framework mirroring the previous trial’s protocol using retrospective data but our results didn’t reinforce a link between elective induced labor in late pregnancy and a reduction in Cesarean births.” 

Julie: Yep. 

Meagan: It did not. It’s so interesting because even now, today, we are still– as a doula still working in the field– seeing these inductions not even just being offered but flat out just being scheduled. Like, “Hey, we are going to schedule your birth at 39 weeks.” They do. They say, “Because that is going to lower your chance of Cesarean rates.” 

Julie: That’s what they tell you. 

Meagan: Yes. They do tell you that. When you are expecting for the first time, the second time, or anytime, most of the time, someone is not necessarily wanting to go in for an elective Cesarean, right? I don’t want to say that it doesn’t happen because it does and that’s okay. But it’s really not what’s happening. People don’t just start raising their hands and sign up for Cesareans, especially first-time moms. 

Julie: Do you mean inductions? 

Meagan: No, Cesareans. 

Julie: Oh, okay. Gotcha. 

Meagan: No. They’re not like, “I want a Cesarean. I want a Cesarean.” So when you have a provider say, “Hey, at 39 weeks, we’ll go ahead and schedule an induction because that is going to lower your chance of having a Cesarean.” 

Julie: Then they’re like, “Oh, yeah. Absolutely. Go for that.” 

Meagan: They’re like, “I don’t want a Cesarean.” Right. So that’s where we go but then we’re looking at this and we’re like, “Mmm, but does it really lower our chances of Cesarean?” 

Julie: Mhmm. 

Meagan: That is where it’s frustrating and that is where I feel like–

Julie: People are being misled. 

Meagan: Yes. I was just going to say that we have misguided people into doing certain things that actually don’t have the most solid data out there. I don’t want to discredit the ARRIVE trial. I’m not saying that it’s completely false or wrong. I’m just saying, “Let’s look at it deeper and why don’t we release more about this trial?” It’s been how many years now and that hasn’t been released but we are still inducing at 39 weeks. 

Julie: Yep. Well, it’s so funny because– okay. I’m going to change my thoughts actually. Strike that. I feel like I want to go back and talk a little bit more about what you talked about in the beginning about how the number of people that were eligible in the trial versus those who elected to be in the trial. 72% of women who were approached to be in the study declined to be in the study. 

Meagan: Declined it. 

Julie: So this is what happens. Your doctor comes up to you and says, “Hey, we’re doing this study.” Some people are just not going to want to be in studies and that’s totally fine. It doesn’t matter, right? But your doctor comes up to you and is like, “Hey, we’re doing a study. We’re going to randomly assign you to a group. You can be induced at 39 weeks or you can be in the expectant management group, but if you hit 40 weeks and 5 days, we’re going to induce you anyways,” because that is another thing that they did. They counted those in the expectant management group. If they got to 40 weeks and 5 days and hadn’t had their baby, they were indued. 

Now giving intel, ACOG recommends 42 weeks and 6 days before induction is absolutely necessary. They say it should probably be considered in the 41st week so between 41 and 42 so why are we not waiting until 41 weeks? Why are we not giving them two more days? Why are we not giving them nine more days to get to 42 weeks? But that was the cutoff for whatever reason. 

Meagan: 75% of the group overall had their babies by that day. 

Julie: Yeah. That’s a big percentage of people that are still being induced at 40 weeks and 5 days. So your doctor comes to you with these two options and you say, “You know what? Sure, that sounds great” or “No, I don’t really want to.” 72% said, “No, I don’t really want to,” for whatever reason. I know for me– well, first of all, you had to be a first-time mom so there are no VBACs included in this at all. It was all first-time moms. So it doesn’t apply to anybody else. This study’s risk findings do not apply to anybody else. 

Same with this Michigan study. The Michigan study only looked at first-time birthers. So as a first-time mom, I know that as I was planning for my first birth, I wanted a Hypnobirth. I was planning on going unmedicated. That was what I wanted. That was my birth plan and my birth desire. It obviously didn’t end that way, but I wouldn’t have elected into or opted into that study because it went contrary to the things that I knew I wanted for my birth. I feel like the ARRIVE trial automatically excludes it. People will automatically not do it if they are a more naturally minded person who wants a more hands-off birth experience. 

I feel like you are going to get really honed into a medical demographic that is okay with the medical system, that trusts their doctors, that wants to just go in, get hooked up to an epidural, and have a baby. Not that there is anything wrong with that, but I feel like the mindset going into birth can influence how you respond during birth and how your body responds during birth. That’s the other thing that I really like about this Michigan study. I feel like you have a wider demographic in the mindset department of how these people birth. I feel like there are going to be more types of birth plans involved there. There is going to be a bigger variety of people and of experiences that are sought after in the birth space in the data set for Michigan. 

Meagan: Yeah. You just kind of talked about this. So how does VBAC and the ARRIVE trial even apply or does it? 

Julie: It doesn’t. 

Meagan: It doesn’t. That’s the answer, but you guys, we are still seeing so many, so many of our VBAC mamas being told that they have a higher chance of Cesarean or they have to have a baby at 39 weeks in order to have a vaginal birth because they have a higher chance. The ARRIVE trial is actually brought up to these people because they are viewed as first-time moms because they haven’t had a vaginal birth. But that’s not the case, right Julie? 

So many people who have had a Cesarean actually labored and dilated to some degree, if not all the way, right? 

Julie: Yep. 

Meagan: So why are we applying it at all to anyone– I mean, if I had my way? 

Julie: They shouldn’t. I feel like there is probably something a little bit unethical about doing that. Saying, “Hey, look. There’s a study that came out saying that inducing you at 39 weeks reduces your chances of having a C-section.” I feel like when that alone is being said and offered, it’s a little bit unethical. 

Meagan: Yeah. I just don’t love it. I don’t love it at all. So let’s talk about some other ways. I guess let’s wrap it up. Does inducing at 39 weeks as a first-time mom or according to the ARRIVE trial, does it really reduce your chances of Cesarean? What would you say, Julie? Based on what we’ve got, what would you say? Does it really? 

Julie: I would say, if somebody asked me that, this is exactly what I would say. I would say maybe, but there are a lot better things that you can do to reduce your chance of having a Cesarean besides being induced at 39 weeks. 

Meagan: Yeah. That would be my thing. Possibly. Possibly. However, it depends on how it’s done. It depends on the hours that you’re going to be given. It depends on the patience of the provider. 

Julie: On your doctor, on your provider, on their Cesarean rate. 

Meagan: Yep. It depends on a lot. So could it actually lower your chances of Cesarean? In my opinion, maybe. Maybe. But does it yes or no? I would say there’s not an answer there. No. There’s not a yes or no here. Could it? Maybe. But okay, what are other ways to reduce your chances of Cesarean? Right? I think induction really is a hard one because sometimes there are things that are coming up. 

In this ARRIVE trial study where it’s like, “Okay, it seems to lower chances of hypertension and hypertension can be an issue for vaginal birth so if we can reduce our hypertension levels, maybe an induction at that point can reduce a Cesarean.” 

Julie: Maybe. Maybe, yes. But maybe– here’s the thing though to consider because I think this is so individualized. It should be individualized but it’s not being individualized. Here’s the thing. If you have a history of pregnancy-induced hypertension, then maybe elective induction at 39 weeks is something that you heavily consider. I guess if you’re a first-time mom, then it doesn’t matter. You don’t have a history of anything because it’s your first pregnancy. 

But if you have a history of hypertensive disorders in your family, if your blood pressure is starting to creep up a little bit, if you’re having signs of preeclampsia or something like that, if there’s a reason where you might be at a higher risk for pregnancy-induced hypertension, then maybe that’s something that you consider. 

Meagan: Right. 

Julie: If there are other ways to manage hypertension, first of all, there are lots of dietary things that you can do. There is medication that you can take, pharmaceuticals, and things like that if it starts to creep up. That’s why I’m saying that it’s such an individualized thing but I hate how we apply– we as in our healthcare system– the same standards to every single person. That’s my biggest peeve about it I think. 

Meagan: Yeah, yeah. Exactly. It’s the same thing when we look at VBAC. It’s like, “Oh, well this, this, and this. The calculator or whatever.” You cannot do that. You have to look at the individual. You have to. You have to. You have to. Because guess what? Julie and I are not the same person. We do not have the same body. Our cervix isn’t the same. Our uterus isn’t the same. Any of that, nothing is the same. We might have similar characteristics in our bodies or the way our cervix does things, but we are not the same. 

You cannot say. I don’t love and I don’t feel comfortable that they are grouping so much in this wide range because it’s not necessarily the case. So let’s talk about it. What are other ways to reduce your chances of having a Cesarean? I know that Julie and I got a little passionate on an episode in the past about home birth but there is something to be said about home birth and what it can do to a Cesarean rate. We know that it’s not for everybody, but it is there. It is there and you are going to have fewer chances of having induction or interventions which can lead to reasons for a Cesarean. 

So choosing a home birth and a provider. A provider is one of the biggest things you can do to have a vaginal birth and to lower your chances of Cesarean. Mine and Julie’s– if you’re just new to us, Julie and I actually had the same provider who performed our Cesarean with her first and my first and second. I mean, I don’t know Julie. Did you know about him that he had such a high Cesarean rate? I didn’t. 

Julie: No, not until years later. 

Meagan: Me neither. Yeah, I didn’t either, and then obviously, years later when the numbers were actually there for a little bit but also seeing other people go to him and them all having Cesareans. I was like, “Hmm. That’s weird.” I still to this day know people who are having babies with him and are still having Cesareans. 

Julie: Yeah. 

Meagan: He’s not all Cesareans, but he’s very high in the Cesarean rate. So choosing your provider who is comfortable with birth, who trusts birth, who trusts you as an individual to make decisions for your baby and body, right? What are some other suggestions, Julie, that you would give? I mean, there are so many. 

Julie: We know that having a doula decreases your chances of having a Cesarean by 25-39%. I think it’s actually 39% but in our blog, it says 25%. It’s interesting how they break it down. There’s a study about doula support. They break it down by having continuous support and then continuous support from a doula. I feel like the numbers probably got switched out. I think 25% by having anyone with you continuously like your mom or somebody and then a doula is even higher at 39%. 

Having intermittent monitoring versus continuous fetal monitoring reduces your chance of having a Cesarean by 39%. I could go off on a whole soapbox on continuous fetal monitoring, but I will not so I don’t want to turn this into an hour-and-a-half-long episode. But obviously, your provider, like Meagan said, is so, so, so important. Look into alternative methods of pain relief like laboring in the water, different types of counter pressures, different types of birthing positions, and laboring at home as long as possible. I think you already talked about that a little bit too. All of those things– having a supportive environment and being able to move freely is going to help with all of those things. 

I would also argue that waiting for labor to start on its own and waiting for spontaneous labor is also going to decrease your chances of having a Cesarean just by the things that I have seen in my own practice as a doula and now birth photographer as well. It’s not going to get rid of your chances all the way doing any of these things or even doing all of these things are not going to guarantee that you’re not going to have a C-section but they’re going to drastically reduce your chances of needing lots of interventions including a Cesarean. 

Meagan: Right. And really too, in all of this, education is so, so important because as you’re going through this, you’re vulnerable you guys. It’s hard. Especially when we are actually in labor, it is not easy. If you have a provider coming in and saying this, this, and that, it’s not easy to say, “Oh yeah, well the evidence says this.” It’s not, but at the same time, if you have the education in your mind and a provider comes in and says something, you’re less likely to get spooked or scared because you’re going to know the evidence. Whether or not you’re in a spot where you can actually talk about the evidence, you mentally are prepared because you’ve educated yourself to know that what they are saying is maybe true, maybe not, but you know the alternatives to those things or you know the evidence against those things so you can say, “Okay, I really appreciate the conversation. I’m going to need some time.” 

Maybe you feel comfortable with that because you know the evidence. I think all of these things along the way are so impactful for you to truly have a better birth experience. Even if it does go the Cesarean route, again, with being educated, feeling supported, and all of these things, you’ll likely have a better Cesarean experience because you’ll have the options. You’ll know and you’ll feel better about making the choice and the decision. 

Julie: And you’ll feel like you have made a choice. Okay, so except we’re in extreme circumstances where there’s a really life-threatening emergency, you will feel like you did everything you could. You will feel like you were in control of what was happening. You will feel like you called the shots. 

I just had a client a few weeks ago. She was going for a VBAC after two C-sections. She felt like she wanted to be induced in her 39th week. She followed her intuition. She leaned into it. She trusted her doctor. Her doctor was super, super supportive and he was really just trusting her. He had his recommendations, but he also felt good with the choices that she made even though they weren’t necessarily always in line with her recommendations. He supported her and it was a really beautiful relationship to see that happening. 

But she chose to be induced at 39 weeks. Her provider was comfortable with her going beyond that, but she felt like it was time for baby to come. I won’t talk about all of the reasons why. So she ended up getting induced and they went for almost 24 hours. She told me the night before– the induction was, she wasn’t dilating. They started Pitocin. She wasn’t dilating. She told me, “If I’m not dilated to a 3 which is the farthest I’ve ever gone in my other two pregnancies and my other two inductions, then I’m calling it in the morning.”

I was like, “Okay. I support you in your choice.” I was doing doulatog for her, so doula and birth photography. “Just let me know when you want me to come. I will be there.” She ended up not dilating at all overnight so she called it and she had a C-section. Her provider was there along with her the whole way supporting her and he was like, “Okay, well we can do this. We can keep going if you want. We can call it if you want. Whatever you want.” She was literally calling her shots the whole time. 

I was also her doula for her last C-section and it ended similarly. She was induced a couple of weeks earlier for preeclampsia and she labored for a long time and just didn’t dilate. Both of these two Cesareans were relatively calm for her even though it wasn’t the end goal that she wanted. She feels confident that she made the right choices all along the way. She had all of the information and all of the knowledge.

Here is the thing. On another note, I had another client. No, it wasn’t a client of mine. I’ve had many similar clients. I was just talking to another birth photographer friend a few weeks back. She had a client who was a first-time mom who was 39 weeks. This client didn’t have a doula but she was her birth photographer. She called her up one day and she said, “Hey, just so you know, I’m going to be induced at 39 weeks. This is the day that I’m being induced. I’ll let you know along the way when I’m ready for you to come.” 

The photographer said, “Oh, why are you being induced?” She said, “Well, my doctor just told me that it’s going to be better for me to avoid having a C-section. It’s going to be safer for my baby.” I don’t know why they said that. Keep in mind, this is also secondhand information. Then my photographer friend was like, “I just don’t know why she’s being induced because she says she doesn’t want to be induced but she also trusts her provider.” Okay, we trust people too. You have to let people make their own path. 

Anyways, the long story short is that my friend’s client ended up having a C-section. My friend was allowed in the operating room which is really good when that happens, but it’s really funny because who knows if it would have been able to be avoided or not? We just will never have the answer for that by waiting but I feel like I tell these two stories. They both ended in Cesareans after 39-week inductions because one didn’t want an induction but she was just doing what her provider said and the other worked with her provider and her provider trusted her and she made the choice. Who do you think is going to be the one that has questions about how the birth went or one day wakes up and says, “Wow, I feel like I just got railroaded by the system”?

What I wish more parents could understand is that we have a responsibility for our education around birth. 

Meagan: Yes!

Julie: I feel like it’s a big disservice that we aren’t teaching parents more about these options and choices and what’s available to them, but you have a responsibility to step up, to learn more, to figure it out, to trust your intuition, and to ask questions of the people supporting you and if they will not answer them or if they make you feel uncomfortable, then you have the right and the responsibility to seek care elsewhere. 

Meagan: Yeah. Yeah. Absolutely. We know it’s not easy. We know it’s not easy, but you have the right. You always have the option. There are so many times when we get hired as a doula and we hear, “This is what happened. I just didn’t know I had an option. I just didn’t know. I just didn’t know.” It’s hard because you can’t blame yourself for not knowing but at the same time, it is our responsibility for getting an education. It’s the hard thing because I didn’t know what I didn’t know, but at the same time, I could have learned more. It’s a really hard topic but get the education. Get a good, supportive provider. If you can, hire a doula. Eat really healthy. Do all of the things you can to lower your chances of having a Cesarean and know that if you are induced at 39 weeks as a first-time mom or a first-time vaginal birther, that doesn’t mean that your Cesarean percentage is absolutely factually going to be lower. It just doesn’t mean that. 

We hope that through listening to this, you’ve gotten some information. You’ve learned more about the ARRIVE study. As updates come through in all aspects of birth, we want to be here. We want to update you and share these. Julie, thanks for being with me today.

Julie: 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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After finding wonderfully supportive midwives who were willing to deliver a breech baby at home, Jaime was sure that her first delivery would be peaceful and empowering. Things quickly turned traumatic, however, when she developed a fever and was rushed to the hospital where she was treated poorly and sent straight to the OR.

It took seven years for Jaime to finally get to a peaceful place where she felt ready to birth again. Jaime shares her different approaches to this birth and how she found the courage to prepare for another home birth. Jaime was able to stay grounded, present, and in control during her labor and delivery, allowing her to achieve the beautiful HBAC she desired!

Additional Links

Birthing From Within by Pam England and Rob Horowitz

Reclaiming Childbirth as a Rite of Passage by Rachel Reed

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello, Women of Strength. It is another day for another amazing story. We have our friend, Jaime, here and she is from Nashville, Tennessee so if you are from Nashville, Tennessee, you’re going to want to listen up. I know that people have been wanting to know where some of our listeners are coming from because they are looking for providers and hospitals and all of the things like that in their area. So today is coming from Tennessee. 

She had kind of a traumatic birth which a lot of us do and then was able to set a good path and redeem her story with a VBAC. We are so excited to be sharing this story with you guys today from Jaime but of course, we have a Review of the Week. We could never go without sharing one of these amazing reviews, you guys. 

Review of the Week

This is from Apple Podcasts and it’s from erind39. The subject is, “Planning Second VBAC with Confidence.” It says, “I am planning my second VBAC in July and I’m so happy that this podcast is back.” This was actually left in 2022 so last year when we came back. That was awesome. It says, “The VBAC Link is a great resource for anyone considering a VBAC. The stories are empowering and the data presented is affirming. I feel like I am so well-prepared for my second VBAC and have this podcast to thank.”

Erin, thank you. We have you to thank for leaving this amazing review and if you guys haven’t had a chance, drop a review for us. We love them. We absolutely love them. We read them on the podcast. We have our amazing crew that drops them into this amazing spreadsheet. I see them and seriously with some of these reviews, I bawl. They are so long and so detailed and so amazing. I get chills and I bawl. So thank you, all for leaving your reviews. 

Jaime’s Stories

Meagan: Okay, Jaime. Welcome to the show. 

Jaime: Thank you for having me. 

Meagan: Thank you. I am excited for you to share your stories and talk more about– well, we’re going to talk more about your story but not get discouraged along the way. So let’s talk about it. Tell us where it all began. 

Jaime: Yeah, so Eloise is my first daughter who is now 7. We have a very large gap between kids but Eloise’s birth was like you said, pretty traumatic for me in a lot of different ways. We wanted to do a home birth with her which off the bat, I’m just a crazy person for wanting to do a home birth. We were in Michigan at the time. I was pretty gung-ho about it. I felt very prepared. 

Maybe midway through my pregnancy, she ended up being breech. There were a lot of things that we tried to do to get her to flip. I spent a lot of time and energy worrying that she was a breech baby and what I was going to do. My midwives were like, “If you’re comfortable doing a breech, we’re comfortable doing a breech.” 

Meagan: Oh wow. That’s amazing. This is in Michigan. 

Jaime: Yeah, it was. It was in Michigan. So they literally handed me their midwifery books which are three inches thick, two of them. They were like, “Read this section.” So they had me read everything about breech birth in their midwifery books. I feel like I’m still overeducated on breech birth just from doing that. 

Meagan: Yeah, that’s amazing actually, though that you had that opportunity. 

Jaime: Yeah, so they were like, “After you read this if you’re comfortable doing a breech birth, we’re comfortable doing it too.” I read through everything and I was like, “Yeah, okay. This feels good.” It was. She was born in 2016 and it’s crazy to say this, but the information we have available today was not like what it was back in 2016. 

Just having those books, I didn’t have any other resources to really go to for breech birth or home birth or anything like that. But yeah. So I was comfortable doing it. I knew from reading if one single thing went wrong, that I was going to be going to the hospital. That was the midwifery thing. Typically, you’ve got multiple chances in a regular, normal pregnancy but with breech, it was one thing. 

So I go into labor. We had thought she flipped, but then I had my waters break and then it was all meconium. I was like, “Umm, I think she is still breech.” From there, I was kind of freaking out. I ended up getting a fever and one of the assistants walked in and she was like, “How are you feeling?” I’m like, “I feel awful. I just feel sick. I have chills. I don’t feel normal. This doesn’t feel good.” Her jaw hit the floor. I’m like, “Oh no. What did I say?” She took my temperature immediately and she was like, “You’ve got a fever.” They tried to get it down. They gave me one hour to get it reduced to a normal temperature and it wouldn’t. 

I knew right away that we were going to the hospital. We ended up in the hospital. Michigan isn’t very friendly when it comes to home births and midwives. I know everyone’s been working on that relationship between hospitals and midwives, but Michigan at the time had no cooperation. So we just had a really bad experience. We are there. 

The doctor at one point is like, “You’re going to be put under,” when the whole time, everyone else was telling me I was going to be awake. Then he comes in– I basically said, “I would like to hold my baby. I would like skin-to-skin as soon as possible.” Then he’s like, “Well, that’s not possible.” I’m like, “What do you mean?” He goes, “Well, you’re going to be put under.” I was just like, “What? What are you talking about?” 

My husband looks at me and he’s like, “Are you okay with that?” I was not trying to be any sort of way when I said this, but I just was like, “I don’t really think I have a choice.” I was just saying, “I have to be okay with it because I don’t have a choice.” I wasn’t being snarky. The doctor was like, “You have a choice.” I was like, “Oh my gosh, I do? Tell me more about my choice.” He basically looked me dead in the eyes and he goes, “You can leave.” 

I was like, “What?” So it was just a really traumatic experience. I had the C-section. I got to be awake which was great, but Eloise ended up being in the NICU for 10 days. It just felt like we were trapped. We had CPS called on us. 

Meagan: Stop it. Are you serious?

Jaime: There was a lot. There was a lot happening. It’s like the horror story that you think of when you hear someone trying to have a home birth and then they end up in the hospital and anything that could go wrong went wrong. Eloise is perfectly healthy. It was just the dynamic of it all that went wrong, I guess, is what I’m trying to say. 

But yeah. I had a lot to work through. We didn’t get pregnant for the longest time. I had no desire, really, because I just was terrified. I’m like, “I don’t want to experience this again. I don’t know what’s going to happen.” It wasn’t necessarily a bodily thing where I was feeling like my body failed me, it was more so just true traumatic, mental PTSD I guess. I’m not really sure how to put it. 

We got pregnant in 2020. I had a miscarriage with that baby, but when I found out I was pregnant, I was immediately not ready. I was terrified. There were so many things running through my brain. I just didn’t know how to handle it. I started the course, that pregnancy course, going to an actual doctor. Off the bat, I was like, “I’m just going to go to a doctor because I don’t want anything like what happened last time to happen again. I just want to avoid all of the hoop jumping. If I’m going to end up there, I’m just going to go there from the start,” basically, was kind of my mindset.

We lost that baby and then with Delaney, the new baby, we got pregnant in 2022 with her. It was just different from the get-go. I think my husband was actually more nervous this time about everything than I was but I felt just very grounded. I felt confident about it. I was like, “I want to do a home birth. I definitely don’t want to be in the hospital.” 

Things were still very weird with COVID so that was another big thing because I’m like, “I don’t want to be in the last hour telling me that my husband can’t be in the room,” or just weird rules like that happening around everything. 

So yeah, I’m like, “I’m going to do a home birth. I’m going to find a midwife.” It took me forever to find a midwife. I think I called everyone in the Nashville area and they were either busy, they were all booked up, or they wouldn’t take a VBAC, or just not a good fit. I had one lady. I get on the phone with her and she’s like, “Well, you know uterine rupture is not something to be just pushed under the rug.” I literally hung up the phone and I go to my husband Matt. I’m like, “I don’t know. I’m a crazy person. What am I doing?” 

Meagan: You’re not. 

Jaime: It just freaked me out. Yeah. So I found my midwife around 11 weeks which I felt was pretty late in the game. From that point, it was just a rollercoaster of ups and downs battling doubts within my headspace. My pregnancy from a physical standpoint was a little bit rough. I don’t know. I just felt like my body was old and not functioning well. I was the person that couldn’t tie their shoes towards the end. I couldn’t wear any rings because all of my fingers were so swollen and everything. 

It was just a rough pregnancy physically compared to my first, but also, just dealing with the mental aspect of everything, I would be super confident one day that I’m going to do this and I’m going to have this home birth– not even a home birth, but just have a VBAC. Like, “I can do this. We were made to do this,” and then the next day, I’m like, “What am I doing? Who wants to do this? Maybe I should just sign up for a C-section again.” 

Meagan: Just all over the place emotionally. That’s so real though. So many of us doing that. One day, we’re like, “Yes.” The next day, we’re like, “What am I doing? Is this right?” and questioning ourselves. 

Jaime: Yep. Yeah. 100%. 

So I really went into this birth. I tried to protect my energy as much as I could. I didn’t tell a lot of people I was trying to have a home birth because it was already enough trying to do a VBAC. It was already weird enough. I’m like, “I don’t want to tell everyone what I’m doing. No one needs to know what my birth plan is besides the people that really matter.” 

I read a couple of books that I felt were really pivotal for me. One was Birthing From Within by Pam England. I didn’t even finish the whole book. I got through one chapter but it changed my life because, in the beginning, she says that every woman has a question that needs to be answered before they can birth their child. You might find your answer to your question during pregnancy or you might find it in transition or you might find it when you’re about to push the baby out. 

She basically was like, “What is your question? When you think you have your question, you have to dig a little bit deeper because that’s probably not your question. Your question is underneath that question.” So I spent 7 months trying to find my question and at the end of it, it felt like it wasn’t so much a question, but I felt that I was punished anytime I tried to go outside of the norm of what society deemed normal. 

That was my big, pivotal thing where I was like, “Wow. I can do this. That is a lie believing that I am going to be punished for trying to do something abnormal.” There was another birth, Reclaiming Childbirth as a Rite of Passage by Rachel Reed. The whole beginning of the book was talking about “herstories”, so history but for women, “herstory”. Rachel is a medical doctor. She is an MD and I felt like this book wasn’t super crunchy and it wasn’t super medicalized. It was very much right in the middle which I felt was what I needed to hear. I didn’t feel like she was biased in one way or another but she laid the facts out of where we started to how we got to where we are now within the birthing industry. It helped me to realize. 

I knew this already going into it, but it helped me to realize that I actually had really deep-rooted, preconceived ideas about what birth was just from how I’ve grown up in the society that I’ve grown up in watching movies, listening to stories, and all of the stuff that we just see on TV. Birth is this crazy thing that happens. The woman is always out of control. The doctor is always there to save the day, all that kind of stuff. 

I was like, “Wow. I have these opinions of things that aren’t even my opinions. They’ve just been given to me from movies and society and culture.” It really helped to weed through some fear that I was having realizing that I don’t have to have this anymore. I don’t have to believe this because it’s not my story. It’s not even real, actually. It’s just culture. 

So those were the two big things. And then obviously, I found your podcast. I also started listening to a free birth podcast. I had no desire in my life to ever free birth ever, but I had read something on Instagram that was like, “If you’re preparing for birth, prepare to do a free birth so that way, you are aware of everything that could happen and what you can do to go through obstacles or you know the steps and the phases that you’ll go through when you’re in labor.” So basically, be overprepared even though you’re going to have people there to help you. 

That helped a lot. I just listened to everything I could about any positive experience of someone having a VBAC. I hired a doula not for any other reason other than it would increase my odds of having a successful VBAC. I still joke to this day that I have no idea what a doula actually does, but I hired one. It helped me have a VBAC, I just think, by doing that. 

I was just doing all of the things that I could come up with to try and get my head in the right spot and to set myself up for success. I did The Bradley Method with my first daughter and Bradley Method is like a 12-week course if you’re not familiar. It is hours long so it is very in-depth. 

But I found this lady on TikTok and I took her virtual train-for-birth class. Her name is Crisha Crosley. It was, I kid you not. I think it was an hour and a half and it was the most informative thing I’ve ever done. It helped me. The whole premise is “Train for Birth” so movements and different things that you can do to become ready to birth your child, to get the baby in the right position, pushing, how to push, and different things to do while you’re in labor so when I actually went into labor, she was in the forefront of my mind of, “Okay, I can’t stay in this position for too long. Let me go to the bathroom every 5 seconds. Make sure I’m drinking my water,” lots of movements when I was actually in labor. It was all because I took that class. It was amazing. 

That was around 38 weeks when I took that class. My brother and his wife, so my brother, Michael, and Ashley came when I was around 40 weeks because Ashley was going to help with Eloise during the birth. 

All in between that, I’m curb walking. I’m on the ball doing figure 8’s. Just to backtrack a little bit, when I hit 37 weeks just to give you an idea of where I was at, I went to Costco and ran into one of my midwives. She’s like, “How are you doing?” Because I’m like, “I’m so depressed. It’s 37 weeks and I haven’t had this baby.” I just was in my brain, I’m like, “Okay, it’s 37 weeks so it means I can have the baby when I haven’t had the baby yet. I need this baby out of me. It’s time to go.” She’s like, “What? You’re depressed?” I’m like, “I’m kidding, sort of. But yeah, I want to have this baby.”

Meagan: You’re like, “I really just wish I could have this baby right now.” 

Jaime: Yeah. Yes. So yeah. We’re nearing the end. My brother and sister-in-law come around 40 weeks to help with Eloise. Delaney, the new baby, was LOA if that’s right. She was on the left side. 

Meagan: Left occiput anterior. 

Jaime: Yeah. I think the optimal is ROA. Is that correct? 

Meagan: Well, it really depends but LOA– so it moves the uterus usually clockwise. LOA is really good actually because then they just kind of go forward and down. But it all depends on the shape of our pelvis too. Some babies need to enter a ROA position. Some of them need to actually enter posterior which is frustrating that we have posterior in any sort of labor, but sometimes that is how. So yeah, LOA is a really great position. 

Jaime: Okay, then she must have been the other way. She must have been ROA and I was trying to get her to go to the left, LOA. Yeah. I was trying to do movements to give her some space so she could turn. The midwife told me that the right side is okay, but the optimal would be LOA because it’s just easiest. When you said posterior, that reminded me that I was actually very nervous about back labor because I had felt like every podcast I listened to where someone was having a VBAC, all they ever talked about was back labor so I was just terrified of it. 

On top of doing a VBAC, if that’s not hard enough, I’m going to deal with back labor and all of this stuff. That didn’t happen to me at all. I had no back labor so it was perfect. 

In Tennessee, my midwives were licensed by the state. They cannot help me past 42 weeks due to their licensure. We were nearing the end. I had a clock ticking. My brother and Ashley were here which was stressing me out, not in a bad way, but I was kind of under a clock if that makes sense. I’m like, “I need to have this baby because they are here and then I need to have this baby because I’m nearing 42 weeks and at that point, I’m either going to be a crazy person and do unassisted which doesn’t make you crazy, or I’m going to have to go to a hospital. Those are my two options because I can’t do it with them.” 

Then she wanted me to do that test where they test for movement, heart rate, and practice breaths or something like that. I needed to do that in my 41st week just to show if something happened early 42 weeks, that it was okay for me to birth at home with them still. I scheduled that for Friday, so September 2nd. I reluctantly scheduled it. I was like, “Fine. I’m just going to put it on the books and see what happens.” 

Then my brother actually had to leave on Sunday to go. My brother leaves on Sunday to go do an interview. Delaney is born on Thursday. I scheduled that test for the next day on Friday. The next Sunday was my 42nd, so that was my hard out if that timeline makes sense.

Meagan: Yeah, yeah. 

Jaime: Michael, my brother, left to do an interview that they scheduled for him that Monday then he was going to come immediately back. He’s like, “If I miss this birth, I’m going to be so mad.” Then Sunday, Ashley and my husband and my daughter, and I went to the splash pad. That was the first day I had a contraction where I was like, “Oh, okay. Something is happening.” I didn’t tell anyone because I didn’t want to be put under a clock or to feel pressure to have this baby when I wasn’t ready or anything like that. I just kept to myself. 

I had a couple of contractions Sunday and then that just led to me having contractions every single night. It was all night, every night and then it would die off in the early, early morning. 

Meagan: Prodromal labor. 

Jaime: Yeah. I’d get a few hours of sleep so I’m just getting exhausted. I told Ashley actually maybe Monday or something. She woke up Tuesday and was like, “So, did Jaime have any more contractions?” She was asking my husband. I didn’t even tell my husband this. My husband was like, “She was having contractions? What are you talking about?” I literally kept everything. My lips were sealed. I kept everything to myself. 

I texted my midwife on Tuesday. So Sunday I had no sleep. Monday, I had no sleep. I texted her Tuesday and I’m like, “Hey. I’ve been having contractions. Nothing is sticking around. Everything stops. I have nothing all day and then it starts again at night.” She’s like, “Cool. Nothing to worry about. Everything is normal. Sounds good. No big deal.” 

My brother did make it back because he came back Monday evening so he was here for everything. Then Wednesday was my absolute breaking point. Wednesday comes. Michael and my husband go shooting and then the girls, all of us, go to this park just to hang out. I had a massive contraction as we were leaving that stopped me in my tracks. I literally just hung back and I’m like, “Yeah, you guys just keep walking. Go ahead and I’ll just meet you there in a second.” I’m just stopped in the middle of everything. 

Ashley, my sister-in-law is like, “Okay.” They just keep walking to the car and then I catch up later. She’s like, “So I think we want to go to the grocery store to get some stuff for dinner.” In my head, I’m like, “I don’t know if I’m going to be able to make it.” I’m emotionally at the end of my limits and then physically also, the contractions were intense, but it was more an emotional thing where I’m like, “I can’t do this again. I’m going to have another sleepless night. It’s already starting. It’s 5:00. This is awful.” 

We go to the grocery store and it was my full focus just to not have a mental breakdown and start hysterically sobbing in the middle of the grocery store. We go. I make it through and we get home. I immediately go upstairs just to be alone. I put a movie on to start watching and have these random contractions that happen. Looking back, it’s funny because in the first stage of labor, they always say that the woman goes into a cave and wants to be alone. 

In my brain, I was ready. I’m like, “I’m going to pay attention so I can see the signs and make sure that I know I’m going into labor.” It never once crossed my mind that I was entering a cave to be by myself. It never crossed my mind. 

I just was thinking, “I’m going to have another sleepless night and I’m drained emotionally.” I think I cried, then dinner was ready. It’s 6:00 so I go downstairs. I shovel dinner into my mouth and then have another massive contraction at the table. I sit there silently then I’m like, “I’m going upstairs.” I run back upstairs and literally, I put this movie back on and I’m in hysterics. I’m sobbing uncontrollably. I just don’t know that I can do this again. I get very crazy when I don’t have any sleep. 

I just was future thinking about how this night was going to go where I’m going to have these crazy contractions and then I’m not going to sleep on top of it. I was just a mess. I go back upstairs. I have a couple of breakdowns. I’m extremely exhausted. I started timing my first contractions around 7:06. Not my first contraction, but my first timed one where I was like, “Maybe I should see what’s happening here.” Delaney was born at 1:20 AM so it was six hours from start to finish basically. 

Meagan: Wow. 

Jaime: Nothing was consistent whatsoever. I’m upstairs with the peanut ball doing all of the moves trying to go through the Miles Circuit to make sure she’s in the right position and all of that stuff. I texted the night midwife. They have a 7:00 AM to 7:00 PM and then a 7P to 7A so depending on when I went into labor is who I’d be talking to. 

So I texted the night midwife around 8:30 with a picture of my contractions, my timed-out stuff. I wanted to take Benadryl so I could go to sleep. I’m like, “Is it okay if I take Benadryl? Will I be okay? I just don’t know if it picks up, am I going to be exhausted and trying to push a baby out?” She’s like, “No. If you take a Benadryl and you actually go into labor, you’re going to be fine. Trust me.” I was like, “Okay.” She’s like, “Take a bath then if things slow down, go to sleep. Try to get some rest. If they don’t slow down, call me and let me know.”

So I took a bath. Nothing really happened. I kicked my husband out of the room multiple times because I just wanted to be by myself. I don’t think I let him stay until 9:30-10:00 at night. I was waiting for these clues. I lost my mucus plug. I don’t even know if this is accurate but in my brain, that meant I was around 3 centimeters. My husband was like, “Do you want me to call someone?” I’m like, “No. I’m 3 centimeters if anything so I’ve got 24 hours of labor to go. I’m in trouble, basically,” is what I was thinking. 

I was waiting for my bloody show which meant I’d be 5 centimeters. Again, I don’t know if that’s accurate but that is just what was in my brain. Almost immediately after I lost my mucus plug, within an hour– it felt way more immediate than that– but within an hour, I had bloody show happening all over the place. 

My doula was an hour away. I’m like, “Okay. Fine. Call the doula.” This is me caving to my husband. I’m like, “Call the doula. She’s an hour away so just have her come, I guess.” He calls the doula and in my brain, I’m like, “I hope I’m still in labor when she comes here.” I just was very nervous that everyone was going to get to the house and then I was either going to stall out or this wasn’t really it and then they’re all going to leave and I had wasted everyone’s time or they’re all just sitting around twiddling their thumbs watching me go through labor. I did not want that to happen at all. 

But he calls the doula and talks with her. She says, “Okay.” Then he calls her again. She hears me in the background and she’s like, “Okay, I’m coming. I’m coming. I’m on my way.” So that happened. I’m telling Matt. I’m like, “Can you go fill up the tub, please? Not so I can have a baby in the tub but just so I can get some relief,” because again, I’m thinking I’m going to be here for many, many more hours. 

He calls the midwife and tells her that the doula is on the way just to give her an update. That’s probably around 11:30. She was like, “Okay, great. Let me know when you need me to come.” He goes down, fills the tub up, and then comes back upstairs. Again, time is lost in this space. 

He comes back upstairs, calls the midwife again, and the midwife hears me in the background and she is like, “I’m on my way,” and then just hangs up. She was only 30 minutes from us, so she hears me and she’s like, “Oh my gosh. I’m coming.” At that point, I’m trying to go down the stairs. It takes me three full contractions to get down the stairs. Matt’s talking to the doula. She’s like, “Does she feel pushy?” I’m like, “I don’t know what pushy feels like because I’ve never done this before.” 

At some point on the stairs, I felt Delaney change position. I don’t really know how else to say it, but it just felt like she dropped down and was right there. I’m still not thinking I’m about to have a baby. Even that, I’m just like, “Okay. I’m in it for the long haul here.” 

Meagan: Right. 

Jaime: I finally get down the stairs. I get in the tub again, just to find relief. I’m not trying to have a baby here. Matt’s trying to make a smoothie. I’m chaotic. I was not a calm laboring person. I was very loud. At this point, when the bloody show happened, I stopped timing the contractions at 11:32 PM. At that point, I was just like, “Forget it. I don’t care.” But then when the bloody show happened, it was one on top of another on top of another on top of another and I had no relief, nothing whatsoever. It was wild. 

I get into the tub. I’m yelling every time a contraction comes. Matt’s trying to make a smoothie and I’m yelling, “I need you here right now.” My daughter is crying because I’m being so loud. I get into the tub and I had three contractions in the tub. On the second contraction, I push her head out. I’m just like, “I’m having a baby.” The coolest part about it was that there was no fear. It was very natural, very primal. I never for once thought, “Oh my gosh. No one is here yet and I’m pushing this baby out.” 

I get her head out and my brother is right there. He sees the head and he’s like, “Jaime, the head is out. You’ve got to push the rest of the baby out now,” because he’s thinking that the head is out and she’s drowning underwater. I’m just like, “No. It’s okay. It’s okay.” I have all of these things in my brain from what the midwives had told me. I’m like, “Okay. So I birthed her underwater so I have to stay underwater. I can’t get out and go back in.” I have all of these things going through my head. 

The next contraction comes and she’s out and on my chest. No one was there except my brother, Ashley, my husband, and my daughter. The midwife walked in literally one minute after she was born, then the doula ran in, and then the assistant ran in. 

Meagan: The whole team, boom. 

Jaime: Yeah, so it was one after another and everyone walks in with their jaws on the ground like, “What just happened?” I’m like, “I don’t know. We just had a baby and here we are.” So that’s my VBAC story. I did it and it was great. I wouldn’t have wanted it any other way. It would have been nice to have a team of people there, but that wasn’t how it was supposed to happen. It worked out perfectly. 

Meagan: That’s okay. Yeah. I’m so glad. I love how your brother is like, “Uhh.” 

Jaime: It’s time to go. You’ve got to get the rest out. 

Meagan: Yeah, but you would see that and that would make sense. 

Jaime: Yeah. Yep. 

Meagan: Oh my gosh. I love that. So first of all, huge congratulations. 

Jaime: Thank you. 

Meagan: So awesome. So, so awesome. And yeah, let’s talk about overcoming your fears. Talking about your first birth, CPS, all of the things. Yeah, you have options. Oh yeah, let me tell you my options. Go. Leave. You have no options other than to leave. 

Jaime: Yeah. Yeah. 

Meagan: So much surrounded it that could have carried forward in this next birth. What are some tips for the listeners that you would give? You were reading. You were taking this course. What other types of things would you say are some key components to overcoming your fears and getting to the point where you were literally birthing– not alone– but you were here birthing alone? You were like, “I’ve got this. I’m strong.” So yeah. Any tips that you have?

Jaime: Yeah. I mean, for me, I would suggest really, really, really protecting your energy and what that looks like– not even watching a movie with a crazy birth scene in it, not talking to people who have opinions on how you’re going to birth your baby, just trying to stay within the scope of healthy, positive stuff. Even some of the Instagram accounts will give you statistics and they are trying to be helpful, but sometimes reading those statistics send you on a spiral so it was just really trying to hone in and stay close to what you know to be true, focusing on the fact that you want to have this VBAC, that it is safe to have a VBAC, and everything else just kind of block it out. 

Unless it is a positive experience, don’t listen to it. Don’t talk about it. Just focus on yourself and what you’re trying to do. 

Meagan: Yeah. Hold onto what’s important to you because yeah. There is a lot of outside static. Like you said, right here at The VBAC Link, we are guilty of posting statistics, right? Statistics can be very helpful for some and it can be something that creates fear or angst as well. If you know that that is not something that can keep your space safe and will cause angst, then yeah. Like you said, don’t read it. Don’t look at it. 

Jaime: For sure. For sure. 

Meagan: Put it away. If you’re wanting to know those numbers to make you feel better, okay then there you go. If you’re wanting to not hear any– we’ve had listeners who are like, “We couldn’t listen to any repeat Cesarean stories because they were not what we could have in our space.” That is okay too. You can filter through. Some people are like, “I wanted to know all of the possible outcomes.” You’ve got to find what is best for you and like you said, protect your space because your space is what matters. 

Jaime: For sure. 

Meagan: Oh, well thank you so, so, so much for being with us today and sharing with us this amazing story. Totally unexpected. I bet your team was just freaking out driving. 

Jaime: Thank you for having me. Yeah. 

Meagan: I wish we could have had a dash cam looking at them or even just there to see their pattern of driving. I bet they were weaving in and out and really, really, really rushing to you.

Jaime: That’s funny. 

Meagan: But like you said, it all worked out how it was supposed to be. All was well and here you are sharing your story and inspiring others. 

Jaime: Thank you. Well, thank you again so much for having me. I hope it helps. 

Meagan: Oh, it will. It will. 

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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Kelsey would title her VBAC story, “When Everything Goes Wrong”. This episode is a must-listen as she shares her VBAC birth after testing positive for Group B Strep.

Kelsey’s first provider: 

• Pushed a scheduled C-section due to a possible big baby
• Chose elective C-sections for all of her own births

Kelsey’s second provider:

• Wasn’t concerned about Kelsey’s blood clotting disorder
• Didn’t push for induction upon borderline amniotic fluid levels 
• Limited cervical checks
• Suggested a Cook’s Catheter at 0 centimeters dilated with ruptured membranes
• Didn’t push for C-section after 24 hours of ruptured membranes with GBS
• 
  

We are incredibly grateful for all of those VBAC-supportive providers out there! They make ALL the difference. 

Additional Links

The VBAC Link Blog: Group B Strep Prevention and Your Options for GBS+ Birth

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello, hello you guys. Welcome to The VBAC Link. This is Meagan, your host of The VBAC Link. We have a story for you today that has been something that we’ve been seeing trickling in our inbox a lot. So I went onto our VBAC Link Community on Facebook and said, “Hey, I’m looking for some stories with this specific topic.” That specific topic is GBS, so Group B Strep if you don’t know what GBS means. 

That is something that we’ve been seeing in our inbox of people being told they cannot have a vaginal birth if they test positive for GBS which we all know, I hope through listening to these episodes that you’d know by now, is false. If you are told that you absolutely cannot have a TOLAC, a trial of labor after Cesarean because you have Group B Strep, that is not true. That is just simply not true. 

We have our friend Kelsey today from outside of Dallas, Texas is that right?

 

Kelsey: Yes. Yes, yeah that’s right. 

Meagan: Yes and she is going to share her story just proving that. Another fun twist to her story is that she had a rupture of membranes. One of the things providers fear more or worry most about is GBS and rupture of membranes and the longevity of the membranes being ruptured increasing risk of infection. So a lot of providers will say, “If you have GBS, the second your water breaks, TOLAC or not, you need to come in and start antibiotic treatment immediately.” 

There is definitely some evidence with treating with antibiotics and we’re going to talk about some of that in the end and also some ways that you can try and avoid testing positive for GBS, but one of the crazy things or cool things I should say about Kelsey’s story is that her rupture of membranes was 24+ hours. So a lot of the times, we have providers also saying after a certain amount of hours and they have a cutoff or a certain number of doses of antibiotics, we’re at a high risk for the newborn getting GBS and then we need to have a Cesarean. 

So I’m excited to hear Kelsey talk about her journey with 24+ hours with a rupture of membranes with GBS. Then another twist to her story is when she did arrive, she was a certain centimeter that a lot of people also think can’t be helped. I’m just going to leave that right there and we’ll let Kelsey talk about that. 

Review of the Week

But of course, we have a Review of the Week so I want to dive into that. This was back in 2021, so a couple of years ago actually from mckenna_123 and her subject is “You’re Not Alone, Mama.” It says, “When I had my first baby 7 months ago via C-section due to placenta previa, I was left discouraged and sad with little to no tools to help me process all that had happened. It was hard for me to tell my story to others confidently and joyfully because I felt so isolated by the experience. Enter The VBAC Link.” 

Ooh, that just gave me chills actually.

“I spent my early postpartum months listening to an episode every day while I nursed my newborn. When I came across the placenta previa story on the podcast, I felt so seen and understood. This podcast gave me the opportunity to feel bound to other strong mamas who have healed from similar experiences. All of a sudden, I didn’t feel so alone. I’m not pregnant with baby #2 yet, but when that happens, I will be armed with invaluable tools and knowledge for my journey to have a beautiful and redemptive VBAC. Thank you ladies for being the voice for moms who feel alone and unseen.” 

Whoa. I got chills all while reading that whole thing. She is so right. You are not alone. We are here with you. I know I’ve said this before and I’m going to say it a million times again but here at The VBAC Link, we truly love. I know we don’t know you, but we love you and we don’t want you to feel alone. That is why we created The VBAC Link because we felt alone. We were in that spot. Julie and I years and years ago felt alone wanting to have this vaginal birth which seemed so normal. 

Vaginal birth just seems like it should be normal. That’s what happens, right? But then we had these C-sections, unexpected and undesired and we didn’t know where we belonged. We didn’t know what we could do. We didn’t know who was saying whether that was true or not. That is why we are here. That is why The VBAC LInk exists. So thank you, McKenna, so much. Congratulations on your baby that is now probably almost two. 

Kelsey: And we need an update, McKenna. 

Meagan: We need an update. Are we having another baby? Where are we at? Are you still with us? Let’s hear that update. Definitely email us. If you haven’t had the time or a chance to put a review in, we would love that. We love getting them in the email box, on Apple Podcasts, and on Instagram. We love seeing your reviews. I’m not kidding you. When I was reading this review, I would get chills and then they would go down and then I’d get chills again and then they’d go down. They mean so much. So definitely if you haven’t, drop us a review. 

Kelsey’s Story

Meagan: Okay, Kelsey. Welcome to the show. 

Kelsey: Hey, thanks for having me, for having me on the VBAC podcast. I’m so excited to be here. 

Meagan: Oh my gosh. Well, I am so excited that you are here and sharing, like I said, such a great topic because I don’t know. Tell me what you have heard about GBS. Have you heard that you can’t have a vaginal birth with GBS? Or have you heard anything like that?

Kelsey: Oh absolutely. Not from my doctor per se and I’ll give you some more info about that as I share my story, but I believed that everything had to go according to plan despite listening to y’all’s episodes, despite hearing other VBAC stories, I just felt like there is no way that I can have this vaginal birth after a Cesarean unless everything goes just as it should. 

My story is one that should be titled, “When Everything Goes Wrong”. 

Meagan: Okay, “When Everything Goes Wrong”. 

Kelsey: Yes, yes. I definitely heard that. One of the things that I kept in mind and I’ll mention this too is that when you have ruptured membranes longer than 24 hours– I mean, I Googled this last night just to be sure. You’ll see all over the place, “You’ve got to get baby out. You’ve got to get baby out. You’ve got to get baby out,” and that just wasn’t the case for me. 

So yeah, I’ve got a lot of fun to unpack with you. 

Meagan: Yeah, and actually, my water was broken for over 24 hours too and so I connect so much to that because I hear it so much with our clients, “Within 24 hours, if you haven’t had a baby, we’ve got to get baby out.” Some people are like, “Oh, within 8-10 hours, if contractions haven’t started, we have to induce.” But that’s not necessarily the case and we are two people that are living proof of that. 

Kelsey: Absolutely. Absolutely. Can I start by giving you just a little rundown of baby #1?

Meagan: Absolutely. I was going to say, let’s unpack where it all began. That’s exactly where it began, right? 

Kelsey: That’s exactly where it began. My son was born via scheduled Cesarean in July of 2018 at 40+2. I had never felt a contraction prior to having my son. I was diagnosed with polyhydramnios in the latter weeks of that pregnancy which of course as you know, leads to increased ultrasounds, and the more ultrasounds you have, the more– I don’t want to say that things can go wrong, but he did get the big baby label because he was seen so much. Of course, you guys have shared that those can be up to 2 pounds in either direction. 

I remember somewhere along the 36-38 week mark, my provider because discussing delivery with me and she mentioned that she would hate to see me run out of the clock on a 24-hour labor which should have been red flag #1. 

Meagan: Uh-huh. 

Kelsey: She said that I would be so tired from laboring all day only to have a newborn that would not let me get any rest. She mentioned shoulder dystocia and that he would get stuck. She pulled out all of the stops. Then she even said– and you’re going to die when I tell you this– she said, “I’ve seen too many things go wrong with vaginal deliveries during my residency and it’s why I chose elective Cesareans for the births of my own children.” 

Meagan: Oh, dear. Oh, dear. She is in the wrong field. 

Kelsey: I don’t want to demonize her. I trust that she was–

Meagan: Probably speaking from her heart. 

Kelsey: Yes. She was. She was not out to get me. 

Meagan: No, and this is the thing. A lot of the time, these providers have this bad rap. I’m like, “Oh dear, red flag.” They do take, a lot of the time, from what they have maybe seen. She was mentioning shoulder dystocia. Maybe she’s seen really hard shoulder dystocia so she fears that. She fears that but she’s labeling every other birth that way to the point where she even scheduled her own Cesarean because she was that scared of vaginal birth. Right?

Kelsey: Right. 

Meagan: If you have a provider that is that scared of vaginal birth for herself, then that is a red flag for sure. 

Kelsey: Yeah, absolutely. 

Meagan: But we don’t even think about that. 

Kelsey: Yeah, and I didn’t have the knowledge or experience to present a case for vaginal delivery for myself nor did I feel like I had the ability to so I walked in and had a scheduled Cesarean. It was very routine, very rote. My son did weigh 9.5 pounds, but there I was a first-time mom. I felt like this experience that I so desired to have, this vaginal birth, was snatched right out from under me. I had never felt a single contraction. I don’t know why that was so important to me, but I just felt like I was missing something. 

Meagan: It’s a signal to our minds and our brains that our baby is coming. 

Kelsey: Yeah. 

Meagan: It’s a sure sign when we start having contractions and experiencing labor that, “Okay. We are now entering this stage.” I swear because the same thing, I remember the last time I felt a contraction with my second and I was sad. I’m like, “Wait. Where did they go?”

Kelsey: Yeah. So that feeling really set the stage for the birth of my daughter. She didn’t come until about 4 years later, but I knew that the first weapon in my arsenal would be to find a new provider. I conducted some interviews with two providers here in the Dallas/Fort Worth area. You are a part of the Facebook pages like DFW VBAC and you see names pop up over and over again. 

I chose Dr. Downey who you guys actually, one of your very first episodes was with a gal named Rachel and she used Dr. Downey for her VBAC. I remember there were 13 months between her Cesarean and her first VBAC. 

Meagan: Wow. 

Kelsey: So we’ve got a repeat doctor on here. 

Meagan: Yeah, that is really good to know. Dr. Downey. 

Kelsey: Dr. Downey, yeah. He was amazing. He never batted an eye. He briefly mentioned induction by 41 weeks due to health concerns on my end. It was nothing major, but I had a few markers for antiphospholipid antibody syndrome. 

Meagan: I don’t think I’ve ever heard of that. 

Kelsey: It’s a blood clotting disorder. 

Meagan: Oh, okay. 

Kelsey: So I was on Heparin shots. Lovenox shots and then moved to Heparin shots closer to delivery. But he was largely very patient. Very, very patient. He said, “You’re going to be getting a call from the hospital to schedule an induction by around 41 weeks.” I kept waiting, waiting, and waiting for the call. I hated the waiting. I wanted to decline the induction, but I also, to be honest with you, wanted to follow my doctor’s advice so I felt like I was in a really weird place. 

Anyway, I never got that phone call. I never got that call to schedule an induction. I never had to make that decision because the hospital was packed and they didn’t have room for me and it was not truly medically necessary so I left my 40-week appointment with my next appointment scheduled for 41 weeks and he was like, “Okay. I guess we’re just going to wait for you to go into labor.” 

I said, “Great. I love that.” So fast forward to my due date, I texted my doula that afternoon an update, and at about 9:30 PM that evening, to my surprise, I started cramping sporadically but because I had never felt a contraction as I said, “I just kept thinking, is this it? This can’t be it. This is it. It has to be. It can’t be. What is going on?”

I even got out my contraction timer just to see. My sense of time was so distorted because I was excited but confused. So I got out my contraction timer just to see how long were these cramps. How much time was between them? I didn’t expect any regularity, but I did continue to cramp until early morning. I woke my husband up. Talk about excitement. That guy got showered, packed a bag, and was fully dressed in 7 minutes. 

Meagan: Oh my gosh. That’s awesome. 

Kelsey: I very kindly reminded him that this could take a while. He should probably rest. I was resting as best as I could, eating, and drinking, and at 3:21 AM the next morning, I felt that little pop that everyone talks about that you just don’t really know until you experience it. I was glad. Is there such a thing as TMI on this show? 

Meagan: No. No. 

Kelsey: I had a pad on by that point because I had some bloody show. I was so glad because I didn’t have this massive gush of water. It was just some leaking. When I went to the restroom, I noticed that it was not clear. I think one of the things that I hope people glean from my story is that you have to do what you’re comfortable with despite risk and statistics and all of the numbers. 

I knew that yes, I could stay at home and I could continue to labor but I just felt more comfortable going to the hospital with the fact that my waters were not clear. 

Meagan: Yeah. 

Kelsey: I called my doula. I send her pictures, God bless her, and with my own gut feeling, my husband’s urging and her advice, we headed to the hospital about 2 hours later and we were admitted by 7:30 AM that next morning.

Meagan: Yeah. I just want to talk about despite what evidence may say, “Oh yeah, I’m safe to be here but my heart says that I shouldn’t.” That is so important to listen to. We talk about it on the podcast all of the time. What does your heart say? What does your gut say? But it really, really, really is so important. I love that you had a doula to validate you and say, “Yeah. That’s totally fine. That’s a great idea. You can go on in.” 

Kelsey: Yeah. Yeah. Absolutely. I think you have to take into account all of your experiences in the past too. What is going on in your life as you’re experiencing this labor, as your baby is coming into this world? I kind of felt like I was taking a risk by having a VBAC. I know that I wasn’t necessarily, but that was big enough for me so I needed to mitigate the other smaller risks by just going to the hospital and being in a place where I felt comfortable. That might not be the case for others listening and that’s okay. 

Something else I decided fairly early on in my pregnancy was that I did not want to know how far dilated I was. I didn’t want to know baby’s station. I knew that this was a mental game, so whether I was a centimeter dilated upon admission or 6 centimeters, I just did not want to know. I wanted to do what my body was doing, lean into that. My husband was told how far dilated I was. He relayed that info to my doula until she was present and then obviously, my doctor knew as well. 

You mentioned at the beginning of the show, I was a certain centimeter dilated when I was admitted and that was 0. 

Meagan: Not dilated at all. 

Kelsey: Not dilated at all. 

Meagan: A lot of the time, with people who are wanting to VBAC, if you walk in with ruptured membranes, nothing is really happening, and you’re not dilated at all, Pitocin doesn’t help when not much is happening. It helps us dilate but usually, they want it to be something. Do you remember how effaced you were? 

Kelsey: I don’t remember how effaced I was. I don’t know if I even was at all. 

Meagan: Okay, yeah. See? And then right there, a provider sometimes might say, “There are no options here.” 

Kelsey: Yeah, and let me tell you. Because I was not having any contractions, I didn’t know how dilated I was, but I do remember my labor and delivery nurse saying, “Because you’re not having contractions, Pitocin is really your only option.” My doctor came in right after that and said, “I don’t see why I can’t insert a balloon catheter. He was the one who was like, “Wait a minute. I’m the doctor. I’ll make that decision.” 

Meagan: Let’s not let the nurse call the shots. That’s good that they were willing to give you Pitocin because sometimes, we’ll have providers say, “We’ll try to give you Pitocin and try and help you efface and open just a little bit to help us get a Foley or a Cook in,” but some providers are like, “No. No contractions, no dilation, no effacement, rarely is Pitocin going to help.” But it can. 

Kelsey: We didn’t do Pitocin yet. We started with a balloon catheter. 

Meagan: Can you tell people how uncomfortable or comfortable it was and how you could get through it? Because not dilated at all, you’re literally putting a catheter through a closed, hard cervix. 

Kelsey: Absolutely. It was painful. It was painful getting it in, but the real painful part– and I’m sure that your listeners know and you’ll have to correct me if I’m wrong– the balloons are inserted. They are pumped with saline to manually being to dilate the cervix. They fall out by themselves somewhere around 4 centimeters. Is that right? 

Meagan: 3-4 centimeters, yep. 

Kelsey: Putting it was painful, but the real pain came when my nurses would try to put some tension on the balloon to tug on it to see if it would come out. My husband will say, “That looked like it was the most pain that you were in the whole time.” That was so painful. 

And of course, I don’t have an epidural at this point. It’s not coming out, lady. It’s not coming out. Give it a minute. So that was pretty painful. 

Meagan: Yeah. And they pull and push and put pressure on it to try and encourage it and see because sometimes it will just slip out but it also needs to come down and put pressure on the cervix but it’s obviously not the funnest. But could you say manageable or worth it or would you say, “I’d never do it again in my life”?

Kelsey: No, absolutely. No. I would absolutely do it again because it worked for me and really, only one of the balloons that came out was painful. I got up to use the restroom at about maybe 5:00 PM that night. It was inserted at 9:30 in the morning. I got up to use the restroom one time at 5 and the second one just popped out like that. It was easy peasy. So I would absolutely do it again. It was not that miserable but it was certainly not comfortable. 

Meagan: Yeah, not pleasant. 

Kelsey: Yeah. And I love what my doctor said. He came in whenever that second balloon fell out and he said, “You’re dilated. We know you’re dilated to a certain point at least.” I was very conservative with cervical checks. I was like, “You can check me when I’m admitted but other than that, I really don’t want anyone up there,” because I know that increases the risk of infection. 

So he said, “There’s no reason for me to check you. We know that you’re at a certain point, but now we’ve got to work to get your contractions to match your dilation,” which was such an easy way for me to understand what was going on. And you’ll have to forgive me because I don’t remember when they started the antibiotic drip. 

I was diagnosed with GBS as we mentioned and I did choose to go the antibiotic route just because– and this takes into another point that we talked about earlier– I had a friend whose daughter did contract GBS during delivery and she was very, very sick, hospitalized the first week after she was born. So I knew statistically the odds were very small for my little one to experience any adverse consequences but that was a risk I just didn’t want to take. I wanted to mitigate it. 

Meagan: And that’s great. 

Kelsey: So I did take antibiotics. I don’t know how much, but I did go that route. 

Meagan: Yeah, most people do. Most people do. 

Kelsey: Yeah. So we did begin to work to get contractions to match my dilation. I pumped a little bit. I moved around. We began Pitocin and this was honestly my favorite part of labor. I would do the hours from 5:00 PM to 10:00 PM when I did get an epidural over and over and over again. I put my headphones in. I got in the zone. I spent a lot of time on the birthing ball and on the toilet. When people say the toilet is a magical place to be when you’re in labor, they’re not wrong. They’re not wrong. 

Meagan: I loved it too. I loved it. 

Kelsey: I loved it so much. 

Meagan: It was this weird way to put counterpressure, open the pelvis, take off the pressure, but also at the same time, get the good pressure. I don’t know. I loved it too. 

Kelsey: Yes, and my doula had set up candles in the bathroom and the lights were turned off. It was a moment when I was unhooked from the machines. She had some essential oils in the toilet. I don’t know. I never knew the hospital restroom could be so relaxing, but it was great. 

Meagan: I love that. 

Kelsey: It was so great. I did work through contractions for about 5 hours. I was getting so tired by this point. I had been up for 24 hours without a drop of sleep. I didn’t have the same fortitude that I maybe would have had 12 hours prior, so I began to no longer work with my contractions. I was just fighting against them. I was yelling, “No” a lot. I was saying things that– I don’t know. Laboring brings out a whole other individual within a woman I believe. 

At about 10:00 PM that night, Pitocin was up to a 5. I was dilated to about 7 centimeters and I decided to get the epidural which is something that I necessarily didn’t plan on, but I’m glad that I did. It was a good decision. 

Meagan: I love that you say that because I think that there’s so much shame sometimes about having this goal and desire, but then “giving up” which is not giving up, just to let you know, listeners. The epidural can really come in as such an amazing tool when you’re exhausted. Sometimes we’re holding so much tension, so getting an epidural actually offers relaxation. There are other pros and cons to epidurals, but the epidural can be such a great tool and you should never feel bad or question your decision to change your mind. 

Kelsey: Yeah, absolutely. And this is another thing that I learned as I was laboring or really reflecting on the labor and delivery process is that first of all, for the most part, none of your decisions have to be instantaneous and I remember my doula telling me this. She was like, “You can take a minute. You can ask everyone to step out of the room and it just be you and your husband. You can think through the pros, cons, risks, and advantages. For whatever decision you make, for the most part, you have time.” I was always afraid that I would be pressured into, “Okay, you’re in here. We’ve got to make a decision. What do you want to do?” and I wouldn’t know what to do. So I was so glad that there was time and that there were options. 

I feel like my epidural was one of those things. I remember asking everyone to leave the room and it was just me and my husband. We were talking through it, but it allowed me to rest. I got to sleep a little bit. Because of my doula and nurses, they positioned me just so that baby moved several stations. I dilated to 9 centimeters and I was 80% effaced in a matter of hours. 

Meagan: Wow. That is awesome. 

Kelsey: Yes, it was great. I still didn’t know how far dilated I was until this point. My doula, nurse, and husband decided it would be– I mean, they let me make the ultimate decision, but they thought it would be a good idea to know that I was 9 centimeters because I was 24 hours into this thing and kind of discouraged to be quite honest. 

Anyway, we were quickly approaching the 24-hour mark since my water broke. That was another thing that I was starting to freak out about. I felt like, “Okay, because my water is broken and it’s been 24 hours, this is going to be an automatic C-section,” but that was not the case. I remember– my doctor didn’t really come to see me that much, but he just seemed so unbothered by it. 

Meagan: So what you’re saying is that he didn’t even treat you any differently? 

Kelsey: No, no. 

Meagan: That’s amazing. That’s amazing.

Kelsey: He is so– if you’re ever in the DFW area– 

Meagan: That’s what we want. That is what we want. If you in your mind are like, “Oh, I’ve got this C-section. I’ve got this and I’ve got that,” and your provider is just acting like you are any other person coming in and having a baby, yeah. That’s awesome. That’s what you want. 

Kelsey: That’s how my nurse was too. I remember telling her, “I’m so scared every time you come and take my temperature because I’m afraid that I’m going to have spiked a fever.” 

Meagan: That you’ll say I have an infection, yeah. 

Kelsey: Yes. I remember she put her hands on my knees and she looked me in the eye and she said, “Even if I come in and you’ve spiked a fever, a C-section is not the only way to get this baby out. She’s right there. She’s right there. There are other options. It’s going to be okay.” 

Meagan: Yes. That’s awesome. 

Kelsey: So we just kept on keeping on. I slept. I kept sleeping a little bit. I rested from about 2:00 AM until 6:15 AM when I was complete. We started doing some practice pushes, but on the first practice one, the baby’s head started coming out. 

Meagan: Ah! That first practice push. 

Kelsey: Yes, so my nurse was like, “Can you hold on a minute? Let me go get the doctor.” I’m pretty sure he came from home. This is probably one of those do as I say not as I do situations. I was so tired of waiting and I was so tired in general. I just started pushing even when contractions weren’t necessarily helping me, but that girl came out in 30 minutes. She was born and put in my arms. It was the very best. 

I never heard a single, “Well, you’ve got Group B Strep or your waters have been broken this long.” I mean, none of that from my doctor, from nurses, no one. 

Meagan: Awesome. 

Kelsey: I feel like they treated me as an individual case because I was. I was not a textbook that they were reading in nursing school or medical school or anything like that. It was, “At this moment, how is your baby doing? How are you doing? What are the signs that we have from data and all of those kinds of things and experiences? I think we’re okay to keep going.” So that’s what we did. 

Meagan: I love that. This team sounds really awesome. 

Kelsey: They were great. 

Meagan: It would be really cool if we could just replicate them and send them all over the world. 

Kelsey: I know. They were awesome. 

Meagan: There are providers just like them for sure, but that just sounds so awesome and so non-pressuring especially when you have all of these little factors that could really impact a provider’s view. 

Kelsey: Yeah. 

Meagan: Ah, it’s so awesome. Well, I am so happy for you. Huge congrats. Huge congrats. 

Kelsey: Thank you. Thank you. 

Meagan: I’m so glad that along the way you were one, supported, and two, you were able to follow your heart and feel validated for following your heart, and being able to shift gears based on what you were giving. This is so important to know. Plans can change. Things can change and you didn’t go with the same exact provider. A lot of the time, we do so that’s another little tidbit I would like to talk about it providers and how important providers are and can really impact. 

This is even before having a C-section. From the get-go, right? If we have a provider that is really against vaginal birth in the beginning or really prone to induction and pressing and pushing Pitocin really hard and then we stress baby out and then we’re not doing well and then we have a C-section, we needed to be supported and not pressed from the beginning. Know that if you are feeling these red flags as a first-time mom if you’re listening because I know we have first-time moms listening. Know that if you’re feeling weird about a provider, it’s okay to change at any point. It’s really okay. 

Find a provider like this that supports you and says, “Okay, this is what we’ve got. Everything is looking okay. Here we are. Let’s keep going,” and really helps you as your guide. 

Kelsey: I remember there were two things. I guess I just want to rave about him more. Towards the end of my pregnancy, we were doing– oh gosh. What is it? A non-stress test. We were doing that at every appointment because of my blood clotting disorder and just making sure that baby was doing okay. My amniotic fluid level was kind of decreasing. It was getting pretty close to that line where most doctors would say, “Oh, it’s getting too close. You’ve got to come in tomorrow. We’re going to induce at 39 weeks.” He just said, “Oh, we’ll check it again next week. Just make sure you’re drinking a lot of water.”

When I came in to be admitted, there was meconium because I had that rupture of membranes and there was meconium. It wasn’t clear so I was freaking out and he said, “That’s actually pretty normal for full-term. We’re not going to be worried about it.” And I didn’t know that!

Meagan: Yeah. Yeah, it is. The longer-term the baby goes, it’s common. I mean, it can happen really anytime, but yeah. Meconium is more common than the world knows. 

Kelsey: Absolutely. Absolutely. 

Meagan: There are so many babies that are born with meconium that the nurses and the staff pay attention to a little more after birth but have no complications. 

Kelsey: Yeah, yep. That’s exactly what happened with us. 

Meagan: Yeah, yeah. That’s important to know. Well, I want to talk a little bit about GBS. Let’s talk about the actual evidence. The risk of a newborn getting a GBS infection– you kind of mentioned that it’s pretty low, but based on your own experience you’re like, “Yeah, it wasn’t worth the risk to me.” It’s the same thing when we’re talking about TOLAC. Okay, uterine rupture risk is pretty low, but then we have to evaluate what risk is acceptable to that individual. 

Kelsey: Absolutely. 

Meagan: Not treating meaning no use of antibiotics which is usually Penicillin via IV and it’s usually done about every 4 hours, especially after a rupture of membranes. The risk of serious infection including so serious death is 1-2%. 

Kelsey: Yeah. It’s small. 

Meagan: It’s very small, but again, it’s what risk you are willing to take. Some people are 100% willing and say, “I would really rather not receive antibiotics,” and that is okay too. There’s not a ton of evidence with Hibicleans and stuff like that. It’s a vaginal wash. Honestly, it’s like a douche. Sorry for saying that word everybody, but that’s what it is. You put it on up there and it cleanses the canal. 

So the risk of infection with the treatment of antibiotics is about 0.2%. So, still very low.

Kelsey: Also small.  

Meagan: Also very small. But still, there you go. And then one thing that– and it’s from a small trial and it was quite a few years ago. I think it was 7 years ago maybe in 2016. They did a small trial and they found that women that were GBS positive that took probiotics decreased their chance by 43%. 43% of them became GBS-negative by birth. 

Kelsey: Okay, interesting. 

Meagan: So really interesting. Probiotics. I believe in probiotics not even pregnant, just all the time. I think it’s really a good thing because there is so much in our food and everything these days but that was kind of an interesting thing. Again, like I said, it was a smaller trial. It was done quite a few years ago, but 43% of them became negative by birth. That’s pretty high. 

Kelsey: Absolutely. 

Meagan: 43%. So knowing also that if you test positive, you can retest closer to birth because it can go away. It doesn’t always though, so don’t think that if you get positive and you start probiotics that you are for sure not going to be positive, but know that there are things that you can do or the garlic and things like that. We’ll have a blog in the show notes today linked about GBS. We’ll have these trials and things linked as well so you can go check them out for yourself and make the best decision for you. 

Kelsey: Yeah, I think it goes without being said too that there is going to be a risk with antibiotics as well. Where there is risk, there has to be choice. I made my decision but probably hundreds of thousands of women listening to this are going to choose differently. 

Meagan: Yeah. Yeah, and that’s okay. That’s one of my favorite things about this show. We all have opinions and we all have things that we would do versus someone else, but there’s no shaming in any decisions that anyone makes. I was actually never GBS positive so I never even had to make that choice which I’m grateful for. A lot of people will say, “No. No way. I don’t want antibiotics because there’s risk with antibiotics.” But then a lot of people will say, “Well, I’d rather have the risk of taking the antibiotics than this risk too.” So you just have to weigh out the pros and cons and decide what’s best for you. 

But yeah. I love your story. I love that you had a long birth, premature rupture of membranes, walking in at no dilation, and a less-ideal cervical state. 

Kelsey: Yes. Adding that to my resume. 

Meagan: A less-than-ideal cervical state with my VBAC. And a Cook catheter and that took time and all of the things. Here you are and you had a vaginal birth. 

Kelsey: I did. I did. I would do it all over again. 

Meagan: A lot of people ask me that. “Would you do it again?” because I had a really long labor as well and I’m like, “Yeah. Yep. I totally would do it again. 100%. Absolutely.” Well, thank you so much for being with us today and sharing your story. 

Kelsey: Thank you for having me. It was great. 

Closing

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“Because of that VBAC, it has opened a new me. I did not birth my daughter. I had a rebirth of myself, a stronger self."

Nurul joins Meagan on the podcast today all the way from Singapore! She shares how finding The VBAC Link gave her the hope she needed to believe a redemptive birth could be possible after a traumatic C-section experience. After interviewing 11 doulas and many doctors, Nurul fought to build a safe, supportive birth team which made all the difference in the end. 

We are SO proud of how Nurul achieved her VBAC and found a safe, supportive team with limited resources. We know you will be inspired by Nurul and her beautiful family just like we are!!

Additional Links

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello, hello VBAC Link listeners. This is your host, Meagan and I am so honored to be here today with our guest, Nurul. Am I saying that right? I always feel like I say it Nurul. You guys, she is in Singapore and right now, it’s 11:00 PM her time. She was so gracious to stay up super late and record her story. We have an amazing story. I know they are all amazing, but I think that this is a story that a lot of people are going to connect to because we know sometimes how hard it is in the VBAC world to find and really get the support that we deserve. 

So make sure to buckle up because this episode is going to be so wonderful and Nurul, I’m so, so grateful for you to be here with us today. 

Nurul: I think, like I started this journey, honestly I started with The VBAC Link. The moment I found out I was pregnant, I’m like, “I’ve got to find something that understands how I feel inside,” so I went straight to finding something. I found you on Instagram and was like, “Oh god, they have a podcast.” I went straight to Spotify and I’m like, “Okay. I’ve got to listen to this.” I’m hitting play and playing and playing. I listened to episodes all the way down to the day before I gave birth. 

Meagan: Oh my gosh. I love it. So all of these stories carried you through your whole pregnancy journey and inspired you. Now here you are going to record your story and inspire someone else in the same way. 

Nurul: Yes. I definitely wanted to come here so bad because I do not know how many of you know how so important it is, but I’m sure you’ve watched Crazy Rich Asians knowing that Singapore literally is a dot on the map. It is so tiny but it is one of the most densely populated countries in the world. It is probably one of the top five, so it is very crowded here. 

The pollution is terrible but if you’ve been to Singapore, it’s completely clean. It’s clean and beautiful and what comes with all of that is convenience. That’s the thing with convenience. When you talk about convenience and how we talk about morning times and everything, come to Singapore and it is really about convenience. 

It’s terrible to say but I was proud to see that we don’t want more than say five or ten minutes to a bus stop and to travel from one end to another in Singapore, it takes no more than one hour. 

Meagan: Whoa. 

Nurul: That’s how tiny Singapore is. And with how tiny Singapore is, you’ve got 9 government huge hospitals that are heavily subsidized by the government and we’ve got 9 equal hospitals that are private. 

Meagan: Wow. So 18 hospitals. 

Nurul: Yes. If there are more, I’m not sure, but these are the hospitals that are quite known amongst *inaudible*. And with all of these hospitals, I have to say that there is a culture that comes to see people being comfortable. It’s the culture of, “I want the best doctor. I want the best hospital. I want the best of this and I want to be treated well. I’m giving you the dollar. I want to be treated–”

Meagan: Like royalty. 

Nurul: Yes, really. It’s terrible. So it happened in 2019. I was married in January 2019. I found I was pregnant in March 2019. The due date was in November. Of course, I was one of the few of my friends that got pregnant. I didn’t know who to really talk to about this. So then my husband introduced me to some of his friends and wives and all of that. This doctor, I’m not going to say his name, popped up many times. I’m like, “Okay.” 

This doctor was famous even when my mom was pregnant with me. Over 30 years ago–

Meagan: That’s how it was with me. My mom’s doctor delivered me and performed my first two C-sections. 

Nurul: Oh my. 

Meagan: Yeah, but he did me. Yeah. 

Nurul: Really? Crazy, yeah. I think it’s also crazy that these doctors are carrying these names with high Cesarean numbers. I know. So, Dr. A., I went to Dr. A. My husband and I are people who are very honest. We like honesty. We want it. He had this joking tone. He made me feel comfortable. He was like, “Do you have any questions?” and this and that. I said, “Okay, then I’ll see you again next month,” and next and next. 

There were many red flags which, of course, I didn’t know to look out for these flags. That’s why when you are first pregnant, I strongly say that many of us are like, “Oh, I’m pregnant. What am I going to do? How am I going to get everything?” Ask any mom and they will say, “Oh, you’ve got to get this crib and you’ve got to get these wipes and you’ve got to get this swaddle.” No one really talks about, “Hey, do you want to talk about your birth plan? How are you going to prepare for everything? Are you thinking of going to this class or this birthing class?” 

No one asked me that. I even had a friend who said, “Oh, I wasn’t reading until 38 weeks.” I thought, “Okay, I’m just going to stop work for a while and then get myself ready.” But you know, no. We don’t want to read about birth. Not a single person. Even my mom and you know? Now, in 2023 in modern Singapore, talking about birth is such a taboo. No one really talks about it. 

Meagan: Really?

Nurul: Really. I asked my mom. I said, “How did you give birth to me?” “Oh, I ended up there. They induced me. I put a pill on top of my lip and then you came an hour later.” I said, “Oh, it’s that easy?” She said, “Yeah, you just push.” I said, “Oh, okay.” Nothing about how there are some that you might get this way and nothing like that. 

So then pregnancy was all good. I’m now at 37 weeks. He said, “Oh, your baby is growing well and is very healthy. I like that. Your blood sugar level is good. Everything is fine. Iron was a little low, but manageable.” At 38 weeks, he said to me, “Do you know that if your baby is out now, your baby can breathe on his own? You don’t have to *inaudible* and your baby doesn’t have to go into the NICU, nothing like that. Your baby will be healthy.” 

I said, “Oh, it’s okay. I’ll go a little bit more.” At 39 weeks, he was like, “Oh, your baby is getting a little big. I’m sure he’s getting very heavy.” I said, “Yeah, I am feeling heavy, doctor.” He said, “But if you want to wait, go ahead.” All of these signs were all conditioning which I did not know. 

And then at 40 weeks, so we came in at 40 weeks and he was like, “Do you know that when your baby hits 40 weeks, your baby doesn’t grow anymore in your tummy?”

Meagan: Oh!

Nurul: Yeah, he told me that. He spoke *inaudible”. He said that the baby is not going to grow anymore. It’s like, there’s nothing more that your baby is going to absorb. He said that if you feel like you want to haste things up and you want to make things faster, come on in. You can induce. If you want, I can check you to be in. I was like, “Great.” I got my son checked. I was high, high, and 0 centimeters dilated. Everything was telling me, “You are not ready for this.” 

He said, “I’m sure you’re tired.” I said, “Yeah, I am.” He said, “You know what? If you think that you want to get induced, drop me a text. I’ll come down that morning myself.” So at 40 weeks, at clean midnight I was telling my husband, “I am really heavy. I don’t want to be like this anymore. Can we just go?” It was a few minutes after midnight and he said, “Oh, let’s go to the hospital.”

We go to the hospital with *inaudible*. I said, “I want to get myself induced.” They sent a text to my doctor. He came in that morning and said, “All right. Let’s get you induced.” They got me induced. 18 hours later, nothing. Nothing. Every check they did, I was on the highest level of Pitocin, nothing. I felt nothing. Even though they said, “Oh, look at this. Look at the numbers. They’re so high. Are you not feeling anything?” It was like, “I think your baby is really big and this is what needs to happen. The passenger is big. Your passage might be small. That’s why baby’s not coming.” 

Meagan: Oh, barf. Your passenger may be big. 

Nurul: Yeah. Your passenger is big but your passage is small. 

Meagan: Your passage is small. 

Nurul: You know, he used these words. I said, “Oh no.” It was like, okay. He was like, “It’s been 18 hours. It’s getting dangerous.” But I did not know how to ask him all of the questions I should have asked. I didn’t know because it was like, “If you are going to wait any longer, you can go ahead. I’ll give you 6 more hours. 6 more hours. If you don’t go into labor, I’m taking over.” Then I’m like, “Taking over?” He said, “Yeah. It’s getting dangerous. If you don’t feel comfortable, you can find another doctor.” 

I was like, “Oh. I’m really here, you know.” I was like, “No, no. Of course, I don’t want that.” He said, “Okay, then if you want to go ahead with 6 hours, but I can’t guarantee that baby will come in 6 hours.” He said those words and I’m like, “Oh god. I’m really so tired. I want to rest. I just want to see my baby.” I said, “You know what? I don’t know what I should do now.” I asked him, “What should I do now?” He said, “If you want to think about Cesarean, easy. We’ll do a Cesarean. You can wait 6 hours. I can’t guarantee your baby will come but you can wait and see all that time.” And I went through it. 

My husband went down with the payment. There was *inaudible*. Now that I’m looking, I don’t see any emergency Cesarean. When you see the word emergency, it means that you can’t wait. My husband had time to go down to the counter, make payment, and come back up. We had a little talk and all of that. There was no emergency to this but I still went for it. I went for it. He was born–

Meagan: I just want to say that that is okay too because the same thing with me and so many out there, right? With my second, it was like, “I can give you another hour,” and what was an hour going to do when I was having this pressure? What it did was it stopped my contractions. I don’t remember feeling a contraction out of that because I was so stressed, so overwhelmed, so defeated. I was like, “Let me just walk,” so I started walking and I just remember breaking down and I was like, “Fine. I feel pinned against this wall.” 

It’s not, again, mine wasn’t an emergency. I walked down to the OR and climbed onto the OR table. It wasn’t an emergency. They actually called it an elective. I wouldn’t even call it an elective. I mean, yes. I did elect, but it wasn’t like, “Sign me up. Sign me up. Take me down.” So many of us are in that situation where we’re like, “Okay, all right. Let’s do it then.” 

Nurul: Yeah. He didn’t even explain to me, “I’m going to cut this many layers.” The only thing he said to me was, “When I call out your name, wave up and give the hardest cough that you can because you will be intubated with this.” 

Meagan: Oh, they intubated you. 

Nurul: Oh, because I said, “I don’t want an epidural.”

Meagan: I got you. 

Nurul: It was when we decided on the C-section, I gave myself just a few seconds to shed one or two tears. I’m like, “I can do this. I’m strong. Let’s get through it.” I told my doctor that I wanted GE. I don’t want to go through it. I woke up. He woke me up and then he said, “I was right. Your passenger was big but the passage is small. Baby isn’t big but your baby’s long.” I’m like, “Okay.” 

Meagan: Oh my gosh. How big was your baby? 

Nurul: He was 3.47 kilos only. 

Meagan: Okay, okay. 

Nurul: So pretty average, yeah. Then I wanted to breastfeed badly but I mean, when you go through such trauma that then I didn’t know was trauma, I ended up going through a lot of that. You’re just not happy. Milk didn’t come. I jumped back into work because I just wanted to drown myself from the weight of all of this. I had this feeling of, “I’m not good enough. Why couldn’t I birth my son? Why couldn’t I do it?” There is this saying in Singapore, in my race, I believed and aunties would say, “Oh, yeah. Baby went out the window instead of the door.”

Most are shocked. As much as women mean to jokingly say it, they are shocked. They hit you at the most vulnerable state because you’re already at your lowest. I was really down but I constantly had a smile on my face. I was keeping it all in. My husband knew that I was going through a time where it was just postpartum depression with postpartum anxiety. But I was so lucky because I had the support there at home. I had my husband there. He played such a huge role in just being there with me and trying to understand what it was that I was going through. 

But the thing was that he was also going through it. We went through such a difficult time together. We didn’t even want to talk about having a second one because that was how bad it was. I think it was almost two years later and we got pregnant with my second one. I remember when after I gave birth to my son, my first one, I saw this TV star who was talking about VBAC. I was like, “What’s VBAC? What’s VBAC?” I wanted to listen and then I was like, “Oh, you can have a vaginal birth after Cesarean?” I didn’t know that was possible. No one tells me that. I thought once you cut yourself, you have to cut yourself forever. 

I went to see stories. I read about her story. I’m like, “Wow. She is amazing.” But then she was full of *inaudible* mind. She was strong and she was loud. And yeah. She was a TV star. 

Meagan: Still, she’s a human being doing that. 

Nurul: Exactly. It was like, that was how much my self-esteem was completely gone. I thought that I was not sufficient. I’m not mother enough to birth my son. It was so sad. When I found out I was pregnant with my second, I was like, “I don’t want to go through that.” It took me so long to get up on my two feet so that my son would have the best version of me. I cannot. I cannot do that again. 

I remember those words VBAC. I went to Google VBAC, what is that? I’m like, “This is interesting.” Then I went onto Instagram and I went to search on the hashtag VBAC. Already, it was just right on and then I found The VBAC Link. I found you guys. I started to listen. It was like, “Okay. I can do this. I can listen.” The next thing I know, I was on episode 5 and I think it was the husbands. 

Meagan: Oh, uh-huh. We had our husbands on. 

Nurul: Yeah. I remember I was like, “Oh my god. This is the best thing. I can do this. I can do this.” So then I was thinking. Also, I met a friend. She tried to VBAC three times. She tried to VBAC two times. It was a complete failure. She was really sad. I was talking to her saying, “What do I do?” I even talked to her husband. They said, “Get a doula. Make sure you get the right doctor.” This was my in. I was like, “I have got to get a doula. Someone’s got to help me. Someone’s got to get me and my husband on track. I’ve got to get the right doctor. I’ve got to get the right doctor.” 

And from then on, I actually interviewed 11 doulas. 

Meagan: Yeah, okay! You’re like me where I interviewed 12 doctors and you interviewed 11 doulas. But that’s awesome to hear that you guys have that many doulas in your area. That’s awesome to hear that you have a good amount of doulas. 

Nurul: Okay, but with the amount of doulas, there are only a handful. There are a lot in hospitals. 

Meagan: Oh, really?

Nurul: Really. Only a handful. Only a handful. So with every interview that I did with doulas, one of the first questions I asked was, “Can you be there with me during my active labor?” There were so many that said, “I can’t be there. I’m not registered with the hospital. I’ve not worked with this doctor. Not all doctors will want to work with a doula.”

Meagan: They have to be registered. Interesting. 

Nurul: Mhmm. You have to register. There are only two hospitals that allow doulas in and with these two hospitals, only a handful. I think it was 4 or 5. It was during COVID with my second one. It was so difficult. No water birth. There were only a handful of doulas. There were so many barriers that I had to cross. I was like, “You know what? I’m going to take this step by step.” 

I interviewed 11 doulas and I think it was doula number 10. She gave me this incredible vibe. She was calming. She had so much knowledge to her. I’m like, “Okay. I might actually have something.” There was this voice inside of me, “I’ve got to interview one more doula.” I spoke to her and she was like, “Yeah, go ahead. Say my name on The VBAC Link. Yes please.” So her name is Doula Lorraine. She is fantastic. Everything about her is just calm and all so when I spoke to her, I felt so much warmth that I have not felt in the longest time. It was such an incredible conversation with her. I asked her which doctors she had worked with and which are pro-VBAC. I asked whether she had done any VBACs. She said that she has. 

She is so humble. She’s incredible, I’m telling you. When I first met her, she gave me this hug and rub on my shoulder. It was during COVID and it was like, yes. We had to keep our distance but she was fantastic. She went through all of the things. She didn’t really give me all of this information at once. It was slow and steady. I took her up. I was like, “Okay, Lorraine. I want you to be my doula.” It was like, “All right. Fantastic.” 

She knew that I wasn’t quite set up with the doctors so the first doctor I went to, he went through everything and I said, “Yeah, but doctor, I want a VBAC.” The first thing he said to me was, “Yeah, I have extra charges for VBAC.” Then I was like, “Oh, okay.” Why are you telling me you have extra charges? I was telling my husband after the appointment, I was like, “No. I don’t want this doctor. I don’t feel comfortable. If you’re going to talk to me about money, I don’t really want to talk to you anymore.” 

The second doctor, you would be shocked. I went back to my first doctor, Dr. A. I went to Dr. A. Dr. A. was like, “Wow, welcome back. You came by.” I was like, “Yeah.” He was like, “Wow. Expecting number two after two years. That’s good. That’s good after a Cesarean.” I said, “Yeah. I really want a VBAC, doctor. I really want a VBAC.” He said, “Oh, we will have to see. I can really only determine that you are a candidate at a later part of your pregnancy.” I said, “How much later?” He said, “30+ weeks?” I said, “Oh, okay. All right.” 

But he had conditions. He said, “Yeah, but there are conditions.” I said, “Yeah, what are the conditions?” You’ll be shocked. He said, “The condition is that your baby cannot pass 3.4 kilos.” I’m like, “What? My first one was 3.47. That’s not possible.” He said, “You can’t pass 40 weeks.” What? My body wasn’t ready at 40 weeks with my first one. 

Meagan: Nope, yeah. 

Nurul: And he said, “You can’t be overweight. You have to be healthy.” There were so many of these conditions, but I could do this. I was like, “Okay.” I went okay, okay, okay with it. I went to see another doctor as well. This doctor is one of the pro-VBAC doctors in Singapore. There are only a handful. Literally, you can count with one hand. I went to see him and he asked me, “What happened with your first one?” He knew Dr. A. He was in a completely different hospital. 

He knew Dr. A. I said, “Oh, Dr. A. said that the passenger was too big and the passage was too small and also there was no progress in my labor or something like that.” He said, “Okay. Why was there no progress?” I said, “I went in to get myself induced at 40 weeks.” He asked me, “Why did you get yourself induced?” I was like, “I didn’t want to wait. My doctor was telling me there was no point in waiting and I was feeling really heavy.” 

Meagan: He also told you that your baby wasn’t going to grow anymore so at that point, you’re like, “Okay, I guess it’s pointless to keep this baby in here.” 

Nurul: Yeah, I know right? So he said, “If you want a VBAC, we are not going to induce you. If it didn’t work the first time, it is not going to work the second time with you. Your body wasn’t ready at 40 weeks. We are not going to do anything until 42 weeks, then we will see what we can do.” I was like, “Yes. Yes. I have found someone who is actually going to go all out with me in this,” and they are so little. I’m telling you that you can count the amount of doctors that will allow you to go to 42. There are all kinds of excuses that they will give you. You are putting baby in danger and all of that. It was so hard and this was only the first level trying to get a birthing team that I could trust that would respect my wishes, that would listen to me, and that would understand that, “I hired you and I will fire you if you don’t listen to me.”

I was going into this with so much heat. I was angry. I was like, “You know, I can do this.” 

Meagan: I’m sure. 

Nurul: Yeah. I told myself, “I’ve got to get a trusted doctor.” And then I remember Lorraine asking, “Why do you want a VBAC?” I was telling her, “I want the best version of myself for my number two, my number one, my husband, and especially for me. I don’t want to put myself for that again.” I told her that it was like, it’s not about proving to society or to family members or to friends, “Hey, I can do a vaginal birth too, you know.” It wasn’t about proving that. It wasn’t about proving myself. I wanted it. I wanted it because I needed it badly for myself. I needed it so badly. 

Yeah. And then she was like, “All right, then we will do this.” I went to her Hypnobirthing classes. I told her, “I’m a person who is always stressed.” There were all these things in my mind with micro stresses from work and all and being a stay-at-home mom. There was so much. She said, “All right. We’ll take it step by step. Slow.” I said, “Okay, let’s do this.” I went for her classes. I learned to let go. The whole process of it was just letting go. It was to forgive myself and to show compassion. It was to tell myself, “If you’re going to go to Dr A. and say ‘This is all your fault’, he is not going to take a single responsibility because he’s going to say ‘You hired me. You hired me to tell you what you want to hear deep down inside.” 

Yeah, he’s not going to take any responsibility. And what’s the point of me wanting to tell him, “You are wrong”? There’s no point. I told myself that I would take ownership of what happened. I have to. If I don’t, then there’s no way out of this. I have to live on it and then Lorraine reminded me that you have to have gone through all of that because if you did not then you would not be where you are right now. 

Meagan: Yes. I agree with that so much. So much. 

Nurul: Yeah. And into that whole journey of Hypnobirthing and private sessions with breathing and everything, I learned to really let go and really relax. Even at, I think it was 36 or 34 weeks when I shows that I still had tension. “You have a lot,” she was saying. “You have to get everything out of the way.” 

I remember in my class that there were two other moms. One of them wanted to try for a VBAC and the other one was wanting to try labor without an epidural. The lucky mom, she went into labor on a full moon– something I read about a full moon– and Lorraine told me her birth story. She was saying, “You have to get everything out of the way. When your body is ready and when your body goes into labor, everything should be out of the way. It should only be you and your birthing partner in that safe space.” She was telling me. 

I said, “Okay.” I went home and I did a full list. I had this list and I gave it to my husband. My husband is a very, very busy man. I said, “I need you to go through this list and tell me what you don’t understand because if you don’t understand, I’m just going to put it in more words so you will do it when I go into labor or before I go into labor and after I give birth, I need all of this done. I don’t want to be thinking and have all of these micro-stresses stress my body out and not allow my body to go into labor.” 

He said, “All right.” So my husband, even though he wasn’t present at most of Lorraine’s lessons or at the doctor’s appointments, I didn’t mind that at all because he did his work. He wrote up what he had to do and how he had to prepare himself and I loved that. At week 40, he said, “So how are you feeling?” I said, “I’m heavy, but I want to wait. I really want to wait.” He said, “Oh, okay.” He still went off to his meetings. He went to settle with our toddler. Everything was still on its way and everything like I wasn’t pregnant. 

Meagan: Right, normal life. 

Nurul: Yeah, normal life. Completely normal and that was exactly what Lorraine told me. “You have to live your life normally. If you want to go somewhere go. If you want to eat something, eat. Nourish yourself. If you want to have fun with your kid, go. Don’t stop yourself. There should not be any limitations to what you want to do. You have to feel happy. When you’re happy, all of these happy chemicals will help you.” She was always there with me. She was always checking on me. 

At 40+3 or 40+4, I was feeling very nervous. I felt a lot of anxiety. I was like, “Oh my god. Things are taking so long. I should be going into labor.” The thing is, yes. It was 40+5, but I had another week plus two days. I don’t know what I was stressing. I don’t know why I was stressing but when you put yourself in that situation, one hour feels like ten million years. “Oh my god, when am I going to go into labor.” It’s like, “Oh, my tummy feels hot.” It’s just gas. I’m not going into labor tonight. You wake up and it’s like, “I’m still pregnant. Water is still in me.” 

There were no signs showing that my body was ready to go into labor. I did so many things. You name it, I did it because my belly did not want another Cesarean. I ate spicy food. In this part of the world, Southeast Asia, the food is extremely spicy so I ate international spicy food. I ate the Chinese mala, spicy. I remember eating so much. I ate pineapple core. I drank pineapple smoothies. I ate dates every day. I remember one of the episodes, you guys were saying raspberry leaf tea and the 3:1 rule. In the first trimester, one bag a day. In the second, two bags a day. I did that every day. 

I did Spinning Babies. I sat on my yoga ball, tilting on my hips and thrusting and everything, mostly everything. The Miles Circuit is so long. She was like, “Give it a try.” I was laying down and adjusting here. I did curb walking at 3:00 in the morning, literally. 

Meagan: Oh my goodness. 

Nurul: Yeah, because I wanted to get into labor so badly. She said, “You need to just relax. Rest.” 

Meagan: Just do nothing. 

Nurul: Do nothing. She’s like, “Do nothing. Spend time with your husband.” My husband’s name is Shah. It’s so much easier. I spent so much time with Shah. It was 40+6. I had sent my toddler with my in-laws. I said, “You know what? Let’s stay in and watch a movie.” I remember it was in the afternoon. I was watching a movie with him. I’m watching something funny and eating spicy food, nothing. And then I reached 41 weeks and Lorraine was saying, “How are you feeling?” I said, “I’m afraid that as much as I’m trying to relax, my body I think could be halfway there or maybe not but these stresses are getting to me.” 

She said, “All right, there’s one more thing. You can do it.” I said, “What is it? I’ll try anything. I’ve tried even Chinese acupressure on my foot.” She was like, “Do you want to try the midwives' brew?” I said, “What is that?” She was like, “Give it a try. If you’re afraid, you can have half the portion.” Midwife’s brew is peanut butter with castor oil. I was so afraid because I told Lorraine that I was afraid. I read so many things that I might get diarrhea or something bad might happen. She said, “Well, have half of it then.” I said, “All right, I’ll have half of it.” 

I had half of it and there were really good surges that came. I woke up and Lorraine was like, “You know what? If you want, you can try the full dosage but you’ve got to prepare yourself.” I said, “I’m prepared. Everything is prepared.” She said, “Come over. Get the oil and drink your smoothie.” But yeah. Before all of that, I wanted to spend time with my son. I wanted to let all of these happy hormones kick in and spend time with my toddler, spend time with my husband, my in-laws, and my parents. 

I took it at home with just my husband. He really stepped up. I gave him that list to follow so that I could focus on laboring. He dimmed up the whole room. He turned on the essential oils. He had lights and music turned on. The sheets were new and clean. Everything was nice and calm. Then he was like, “Are you ready?” I said, “Yeah.” I sat in the room. I drank the smoothie. 

I said, “I’m really tired. I just want to sleep.” He said, “I’ll join you in a little bit.” He went to do some house chores or something. I remember he crept in. I was already sleeping. I woke up. I think it was close to midnight. I drank my smoothie at about 8:00 in the evening. I woke up at about 11 or something and I felt really, really strong surges. I was like, “You know what? I’m just going to time them.” I timed them and they started to get really intense. I’m like, “This is two minutes apart.” Then it was 65 seconds, 70 seconds. I’m like, “Okay.” 

But my husband was dead sleeping. He was snoring. I was like, “I’m not going to wake him up.” I remember suddenly, everything I learned in Hypnobirthing class like getting into the shower. It might not be really, but maybe you just need to relax. I got into the shower. I stood in the shower. I’m like, “This is not going anywhere.” I said, “You know what? Just try to go to bed. Let’s just try to go to bed.” 

I couldn’t. I grabbed my yoga ball. I put it on the bed. I rocked myself on it. I kept thinking of all of these things that I learned. It was instinctive. Listen to your body. Just trust it. What it wants to do, just listen. Go along with it. Don’t go against it. So I took my ball and I put it on the bed. I’m on all fours and I’m just rocking away. I didn’t even realize that I was actually timing myself. After giving birth, I don’t even know what I was timing. It was all over the place. 

I think my husband woke up to me moaning really badly. He said, “Are you okay?” I didn’t know what to answer. I just remember showing him the phone. I took this to him and he was looking at it. He said, “I’m going to send this to Lorraine.” I said, “Yeah, yeah. Send. Send it to Lorraine.” So he sent it to Lorraine. I said, “Can you call her, please?” He was like, “She’s not picking up.” Then I was like, “You know what? I’m okay. I just want to rock on my ball. I feel comfortable.”

He called again, I think. Lorraine asked him because he told me all of the stories that Lorraine asked him. She was like, “Is she talking?” “Not much. She’s just moaning.” She said, “Okay. Time for you to go to the hospital.” There are no birth centers in Singapore. Zero. So it was the hospital. I remember he was like, “Okay, you know what? I’m going to get the car. You do what you want.” He was talking to me so gently. I said, “I’m going to be in the shower.” So I popped into the shower again. I was just rocking in the shower and enjoying the warm water and everything. 

All then suddenly, he was like, “Are you ready, okay? I’m going to bring you to the hospital.” I was like, “Okay.” I was there and I just stuck on my dress. I walked slowly. I remember it was the longest walk to the car even though it was just downstairs. I had to take the lift down because we live on the fourth floor. I had to take the lift down and it was 7:00 in the morning. Like I said, in Singapore, it’s densely populated. You don’t meet someone in the lift in the morning. I went in and I remember there was this middle-aged guy and an auntie in the lift. She looked at me and she looked at my husband. She said, “Is she going into labor?” He was like, “Yes.” He was just nodding his head and I did not want anyone to annoy me. I was just facing the door, rocking myself. 

I walked and then she was like, “I’ll say a little prayer for you. I’ll say a little prayer for you.” I just nodded my head. I didn’t want to talk. So I went in the car and my husband already had the seat reclined all the way to the back because I put that in the list. He did everything. He is so, so sweet. I went in the car and I sat in front. There was a little pillow that was ready for me. I hugged the pillow. The journey from my place to the hospital that we chose is about 25-30 minutes. 

Meagan: Okay, not bad. 

Nurul: But it was the weekday in Singapore, peak hour. Oh my god. I told him to blast the music. I wanted him to blast the music. He turned on the Hypnobirthing music and he blasted it completely. But with how loud it was, I could hear the motorbikes passing through. I was like, “Oh my god. Stop that. It’s so loud.” I was telling my husband. I didn’t say anything but I was moaning. I was putting myself in that zone. You have to let the body receive the surges. I could feel him mumbling because I think he was cursing at the traffic. 

Meagan: I bet he was like, “Come on. We’ve got to go. Come on.” 

Nurul: Because I could feel the cars going past. I remember that we were probably just one U-turn away from the hospital and there was a bus coming. He didn’t care. He just made the U-turn. I was one minute away from the hospital. I’m not going to get one bus in my way. He turned and he went in. When I was stepping out of the car, I was actually annoyed with a lot of people to be honest. I was annoyed with the bikes. I was annoyed with the auntie. I was annoyed with the valet. The valet was asking me, “Do you need a wheelchair?” He kept asking my husband, “Does she need a wheelchair? Does she need a wheelchair?” “I don’t want a wheelchair. I want Lorraine. I want Lorraine.”

Then suddenly, I heard this plop, plop, plop, plop and there she was, my doula. I said, “Oh my god.” She was there. She was running in her flip-flops down the stairs and with her yoga ball. She came straight to me and she was like, “You’re doing an amazing job. You’re beautiful and you’re incredible.” I felt so much love from my husband and with her there. My space was protected. I can feel so much love here. She asked me, “Do you want to walk or do you want to go in the room?” I said, “I want to walk.” I had to go up three flights of stairs. 

Meagan: Oh my goodness. 

Nurul: Yeah. She said, “Are you sure?” I said, “Yeah. I want to walk.” In my mind, it was like, “I don’t want to sit down. I don’t want to sit down. I do not want to be pushed. I want to walk.” Every one and a half minutes that the surges would come, I put my face against the wall and I put my hand on my forehead. It was like, “I can do this. I can do this.” She was just like, “It’s okay. You’re doing fantastic. You’re doing great.” 

The labor room was full. It was a full house. We had to wait for a room. While I was waiting for a room, I was checked. While I was checked, I was so defeated because the nurse was so pushy. I did not want any noise. She was like, “Oh.” She checked me and was like, “Oh, you are 1 centimeter dilated, -2, and high and hot.” I was like, “No, how can that be?” Everyone was like, “This can’t be it. You are 1.5-2 minutes apart.” I was like, “Just get me a room. Get me a room. I want to get into a shower.” 

They managed to get me into a room. I got into the shower. My doula was reading to me scripts. I remember that my husband was there. It was getting really intense. The surges were getting so, so intense and I refused the epidural. I had my birth plan and my birth plan was down to every little thing that you can imagine. In the birth plan, I was like, “No artificial lights. All monitors turned off. No CTG allowed.” I didn’t allow any monitors on me because I didn’t want to feel that on my body. I didn’t want to wear their coats. I went in wearing my dress and I wished to go out wearing my things.

I’m in there, I’m like, “I’m not a patient. I’m not sick. Being pregnant is not a medical condition. I’m just birthing my child. I don’t need all of this. Yes, I’m thankful for modern medicine but rescue me when I need rescue.” I don’t need you to tell me, “You’re pregnant. I’m going to help you birth your baby.” No. 

Yeah, so I remember going down there laboring in the shower. My husband was behind me. I was standing and he had the showerhead behind me. I got down. It was on my shoulder on the left and on the right. They tried their best to comfort me. It was getting so bad that I started begging my husband, “Just get me the epidural. Get me the epidural.” 

Meagan: Which is a sign. 

Nurul: Yes, it was a sign. You know, but when you feel all of that, I remember my doula telling me the day before, “You are going to be a force of nature and nothing is going to get in your way.” I didn’t believe her until I was there at that time. I turned to my husband and I said with serious eyes, “Get me the epidural. Get them in here and get me the epidural now.” I was angry and crying at the same time. 

He looked at me dead on into my eyes and he looked at my doula. He looked at Lorraine and Lorraine looked at him. They kept giving exchanges with their eyes and they were just ignoring. I was like, “Why are you ignoring me? Listen to me. Listen to me. I want an epidural now.” I was crying. Then Lorraine tried to talk to me. She tried to go on like, “Just try to lay down. I’m going to breathe with you.” 

I didn’t want to listen to her. I turned to my husband. I spoke in my mother tongue to my husband because she wouldn’t understand. I was like, “You don’t want to listen to me? Fine. I’m going to speak to my husband. I’m going to speak to him in the language that he and I share.” Can you believe it? I was a real force of nature. 

He just kept on looking at me. He didn’t want to respond. I said, “Why aren’t you listening to me? Why is nobody listening to me?” I think he was close to giving up because he kept looking at Lorraine. They kept giving exchanges and all. I said, “You know what? Okay. You don’t get me an epidural? Fine. Get me gas. Just get me gas.” She was like, “All right. I’ll get you gas.” 

I remember Lorraine stepping out and coming in with the gas mask but I wasn’t listening to the instructions. I didn’t know how to use the mask. I thought it was to just breathe, put it on your mouth over your face and breathe. I did not know that when it vibrates, it means that you’re not breathing in right. So the whole time I was breathing, it was vibrating. But I just needed something to hold tightly. There was nothing to the gas.

I was telling my doula, “I want to sleep. I want to sleep. I’m so tired already. Please just get me the epidural.” She was like, “Just try to breathe through it all.” I was holding onto the mask but I wasn’t breathing right. I told her, “Get the nurse. Get the nurse and get her to check me. I think the baby is coming.” She was like, “Okay, okay. I’ll get the nurse.” 

She got the nurse at about 11 AM. It was just a few hours, but time distortion makes you feel like it was forever. 

Meagan: Yeah, yeah. 

Nurul: Yeah. So the nurse checked me and she said, “You’re soft, but you’re only 1, maybe 2 centimeters dilated. 

Meagan: What?!

Nurul: I felt even more defeated. I’m like, “This can’t be.” I was close to giving up. Even Lorraine saw that I really struggled to sleep. She was like, “Tell me what you want to do.” “I just want to lie down.” She kept putting a peanut ball between my legs and I kept kicking it. I remember a nurse coming in, one of the L&D nurses. She spoke in a really high-toned voice and I specifically said in my list that no one is to speak loudly in the room. I turned to her and was like, “Can you talk softly?” “I’m sorry, I’m just excited for you.” 

I rolled my eyes. I said, “Oh my god. What is happening to me?” It’s just not me. But like Lorraine said, “You are going to be a force of nature and no one’s going to get in your way.” She checked me again and I was 1-2 centimeters. I laid down. I’m like, “This is getting away. I give up. I want to sleep. I don’t care. I want to sleep.” I kept thrusting my hips in that squat that Lorraine told me. She checked me and I think was at 12:30. It was only an hour later. Can you believe it? 

She was recording with her phone. She checked me and she was like, “I see hair. I see hair.” She was like, “I see hair. I see hair.” She ran out. I could hear her slippers. She was like, “The baby is coming. The baby is coming!” The nurse came in and because I was laying on my side– everything I did, I did not want to be strapped down. I did not want to lay on my back, nothing. 

She checked me and she had the audacity to take a piece of gauze and put it on my perineum and say, “Mommy, don’t push. Your baby is it.” She pushed a little on my perineum. 

Meagan: She pushed baby up. 

Nurul: She pushed baby in, in fact. I’m like, “I’m not pushing. I’m not pushing.” She’s like, “I’ll get the doctor. Calm down.” The doctor came in at 11:40. They were busy putting on his clothes so they were facing the wall, three of them. Two nurses and one doctor. Two nurses putting on his gloves and his, I think robe thing. His gown. 

I was like, “I want to push but I feel like she’s coming.” I remember Lorraine was reading a script about a hot air balloon, imagining yourself in a hot air balloon breathing and going higher. I was just putting myself there and I felt like I needed to just sit up. When I sat up, the next thing I know, my baby was out. I just breathed out. I didn’t push. 

Meagan: Oh my gosh. 

Nurul: I didn’t push. I felt like I needed to sit up. I breathed out and I sat up and she just came. 

Meagan: Oh my gosh. 

Nurul: Yes, the doctor wasn’t there. The doctor was facing the wall. My husband was like, “Oh my god.” Lorraine said, “She’s here, she’s here.” I remember Lorraine screaming or shouting, “Take your baby. Take your baby.” My husband went to wrap my daughter and he just placed her on me. I even took off my dress and was like, “Put her on me. Put her on me.” I even asked Lorraine, “Is she really here? Is she really here?” I didn’t even realize it because I just breathed out. I didn’t push. I didn’t know how to push. 

There was no cutting or nothing. When the baby was on my chest, the doctor turned around and was like, “Oh, congratulations. You did such a great job.” My husband was so happy. I was crying. I remember saying to Lorraine, “I was on a hot air balloon. I was on a hot air balloon.” I was looking down on my daughter and she was on me. I was like, “I can’t believe she’s here. I did. I can’t believe I did it.” I kept on saying, “I can’t believe I did it.” 

The doctor was like, “Okay, I will leave you for a while with skin-to-skin.” I didn’t allow them to clean her. I didn’t allow the cord to be cut until it was completely white. All of my wishes were completely respected until it came to my placenta. This is ridiculous because they left me alone. They left me and my husband and Lorraine alone for our time with the baby. It was amazing and fantastic. I had one hour with my daughter and then my husband had one hour. 

Before my husband had that hour, the nurses came in and were like, “Mommy, your placenta is coming out. I think you need help with it because you’re bleeding a little.” I’m like, “It’s fine. I’m fine. I’m holding my baby. I’m talking. I’m fine. It’s all right. I don’t need help with it.” She was like, “I’ll give you another ten minutes.” I said, “No. Give me more time. I want more time. Give me another 30-40 minutes, okay?” She said, “Okay.” 

She came back. It wasn’t 30-40 minutes. She gave me, I think, another 10 minutes and said, “Mommy, you really need to get this placenta out. I’m going to just pull and tug it.” I said, “No. No. Give me time. Can’t you wait? Can’t you wait?” I saw how Lorraine was looking and it was like, “Oh, okay.” It was like, “No.” She was proud that I stood up for myself. I advocated for myself because going into this journey, I thought my doula would need to help me advocate my wishes, but no. I advocated strongly. She was like, “Okay. Let her birth her placenta.” 

I went into Hypnobirthing again. The placenta came out beautifully. There were no complications. I tore naturally. There were 35 stitches. I think you have one of the episodes where the mom was saying about the birth high. I did not understand it then, but when I gave birth to my daughter–

Meagan: You understood it now. 

Nurul: Yeah. It’s been with me and I refuse to let it go. It’s a different kind of euphoria that you cannot explain because mine came along with working so hard at trying to have that birth and having that goal, fighting every battle just to have the baby the way I wanted. It was every fight. It was exhausting. 

Meagan: Yes, but you did it. You did it. You just sat up and baby came out. That is so amazing. 

Nurul: I sat up. Thank you. I remember my husband saying, “She looks like she came out on a waterslide.” He was like, “Do I need to pay the doctor now because he didn’t deliver the baby?” 

Meagan: Because he didn’t catch the baby? Oh, yeah. 

Nurul: Yeah, he was like, “Ahh.” It was and still is a wonderful thing for me. I’m going to say this for every mom who is going to try a VBAC or even given a chance to TOLAC or those who have had a VBAC. You have to really look at it and think of the journey that you had because for me, because of that VBAC, has opened a new me. I did not birth my daughter. I had a rebirth of myself, a stronger self. I’m starting a new healing journey. 

Even my doula– and I’m so close with my doula. Whenever I feel like I’m having a hard time, I will talk to her. She was like, “You’re having another healing journey. It is fantastic.” I say, “Yeah. It was because of that big step that I made advocating for myself. Fighting for myself.” It doesn’t have to be because everything is all laid out for you. No. Just do it. 

Meagan: Oh, well huge congratulations. 

Nurul: Thank you. 

Meagan: Thank you so much for sharing with us today. We are so happy for you and I encourage you to continue staying on that birth high and going out there and sharing your journey just like you are right now is only going to inspire and motivate others as well. 

Nurul: Yes, definitely. Thank you. 

Meagan: Thank you. 

Nurul: It’s been amazing. It’s actually midnight now in Singapore. 

Meagan: Yep, it’s midnight. Oh my goodness. But seriously, thank you so, so much. 

Nurul: Thank you. Thank you. 

Meagan: Okay. 

Nurul: And every mom who asks me, “How did you get onto this journey?” I say, “Listen to The VBAC Link.” I’m serious. So much information, so many things you are going to learn. 

Meagan: Aw, well thank you. We agree. This podcast still even educates us, right? So yeah. Well, 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.

Support this podcast at — https://redcircle.com/the-vbac-link/donations

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Dr. Kimberly Spair does it all! She holds a Ph.D. in Holistic Natural Health and Nutrition along with lots of additional certifications and degrees, all of which have helped her create an amazing career around helping others find holistic healing. 

Dr. Spair specifically helps postpartum women find ways to naturally combat symptoms like anxiety, exhaustion, and overall depletion. She is a VBAC mama herself and knows personally what kind of support birthing women deserve. Dr. Spair is so lovely and gracious. We know you will love this episode like we do!

Additional Links

Dr. Kimberly Spair's Website

Free Postpartum Recipes

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello, hello Women of Strength. We have a special episode for you today. We have our friend, Dr. Kimberly Spair. Is that correct? Did I say it correctly? 

Dr. Spair: That’s correct. Yep. 

Meagan: Okay. That’s how I say it in my head. Sometimes I say it and it’s totally wrong. 

Dr. Spair: Yep. You’ve got it. Nope. 

Meagan: I said your name wrong like three times. Kimberly. Let me start sounding it out.

Dr. Spair: You’ve got it. 

Meagan: You guys, she’s amazing. I was really drawn to her page a while ago because of something I had seen. I think it was a post about nutrition. Nutrition is something that is huge for me. I saw such a change when I dialed in on my nutrition, especially for my VBAC. I really dialed deeply into nutrition for my VBAC. I do believe that it helped me so much. 

So as I started digging into her and following her posts more, I was like, “I love her. She’s amazing.” So it is so awesome to have you today on the podcast. 

Dr. Spair: I am so excited and I love looking at your pages because you’ve got all of the statistics to give moms that home. The moms, and the resources like, “Oh, I had a C-section? Guess what, I can still have a vaginal birth.” I love it. I’ve been quoting you left and right in my posts so I’m glad we’re here today. 

Meagan: Well, thank you. We actually just shared one of your posts which was amazing. So you guys, definitely want to check her out. We’re going to have all of her links in the show notes today. 

Review of the Week

We do have a Review of the Week today and then we are going to dive into this yummy episode. This is from wallabygirl and the subject is “We Got Our VBAC”. It says, “Meagan and Julie, after my first birth turned into a C-section, I knew that I wanted to try for a VBAC with my next baby. When we found out that we were pregnant in January 2022, my husband and I started doing a ton of research. I found The VBAC Link Podcast and was so inspired and encouraged. I love the mix of data, birth stories, and interviews with experts in the field of your podcast shares.”

Well, guess what? That is exactly what today’s episode is. A podcast with a VBAC story and data and amazing information from a professional. 

It says, “I listened to your podcast on my commute to and from work and learned so much. My husband and I took Spinning Babies and I started seeing an amazing chiropractor who specializes in pregnancy and bodywork. Our midwives and OB team were so supportive and awesome and the podcast helped us know the right questions to ask. Finally, after a long labor and an unmedicated delivery, we welcomed our baby girl postdates at 41 weeks + 1 day.” 

That was in September of 2022. It says, “I feel amazing and I cried when I got home and was able to pick up my two-year-old son. Thank you, thank you for this awesome podcast. I will be continuing to listen and highly recommend this valuable information for friends and family.” 

I love reviews like that, wallabygirl. Thank you so much for leaving that review. And if you haven’t had a chance to leave a review, push pause right now. Head over to Google, Apple Podcasts, or wherever you are listening, and leave us a review. 

Dr. Kimberly Spair

Meagan: Okay, Dr. Kimberly. 

Dr. Spair: I have to say you know you’re in the right field. That review just gave me goosebumps and tears not just because I’ve seen so many VBACs now but it took me back to the first time that I VBAC’d. It’s just a full body, tears, chills, emotion, and all of it. It’s the best. It’s the best. I love that. 

Meagan: I know that. Anytime we get these reviews or when we’re doing consults because we have one-on-one consults as well. We work with people and they tell us the update. It just makes me so happy seriously down to the core to hear these amazing people being inspired. Even if it doesn’t end in a VBAC, right? 

Dr. Spair: I love that. They’re still empowered. 

Meagan: They are empowered and educated along the way so we are making the choices and sometimes we know. We are going to talk about how sometimes emergency Cesareans happen and sometimes they’re out of our control but if we can feel empowered along the way, it truly does help our outcome in the postpartum stage which again, we’re going to talk about today. 

You guys, we have such a great episode for you. So, Dr. Kimberly, I would love to turn the time over to you and just let you share your story and how you got going. 

Dr. Spair: All right. So why I’m here is because I’ve had two VBACs myself. My first birth, I was planning for a natural birth. I had the Webster Chiropractic. I did the Hypnobabies. I was doing prenatal yoga. All the things. Massage. I just wanted this beautiful water birth. That’s what I was planning. For my first birth, I decided to birth in a birth center. Thank God it was attached to a hospital at the time. 

My pregnancy was beautiful. I had no issues. When I was 37 weeks, I stepped out of the shower one day and my water broke all over the bathroom floor. I called my midwife and I said, “My water broke.” She said, “You probably peed.” I’m like, “Nope, I’m pretty sure I didn’t pee. It literally was a burst all over the floor.” 

I went into the midwife’s office. She was like, “Yeah, I don’t really think your water broke. I don’t think you’re in labor.” Okay, I went home. I was having all of these contractions. Again, I was a first-time mom. I didn’t really know what was going on. I also was doing Hypnobabies so my threshold was in a good place with it.

Long story short, the day progressed and I’m still thinking, “Man. These are a lot of Braxton Hicks. Something’s going on.” I called the midwife again. This was 8-9 hours later. She was like, “All right. Head over to the birth center.” I go to the birth center. They’re like, “You’re not in labor. You’re dilated but your water didn’t break.” They used those little strips. They’re like, “You know, you’re water didn’t break.” Okay. I go home. 

Now, it’s 3:00 in the morning and I wake my husband up. I’m like, “We’ve got to go now. We’ve got to go now.” So we get in the car and had a 45-minute drive. I didn’t know until after but I went through transition in the car. 

Meagan: Okay. 

Dr. Spair: I got out of the birth center and I stood up and my son’s leg was out. Literally out. I waddled into the hospital. I should have started with this. I don’t like to share war birth stories with moms that are about to give birth so I should have said before I started if you are about to give birth, listen to this later. 

I don’t like to scare moms. It’s such a rare occurrence that these kind of situations happen. Emergencies do happen and when emergencies happen, we are so grateful for modern medicine and we’re glad that we were okay. My son, I’ll go back to the story in a minute, but I just wanted to say that if you’re a mom that’s ready to give birth, don’t listen to any negative stories. 

So anyway, I got out of the car. My son’s leg was out. I waddled into the birth center. The midwife on call came in and she’s like, “Yeah. You’re 10 centimeters.” Then all of a sudden, everyone was like, “Don’t push!” They’re screaming at me. She was like, “Can I just wiggle him out? What do we think is going to happen here?” And he was stuck. So leg out and his body was basically–

Meagan: Doing the splits. 

Dr. Spair: He was in a split. If they would have tried to let him come out vaginally, he would have broken his hip, his leg, his shoulder, and maybe his neck. 

Meagan: Complications. 

Dr. Spair: It was a very, very complicated situation. So of course, it was the coldest day of the year and there’s no doctor in this birth center even though it’s attached to a hospital. So they were like, “All right. We’ve got to get to the OR now.” They’re prepping me. They’re screaming at me not to push. 

I’m traumatized completely because here I’m thinking that I’m having this beautiful water birth. It’s going to be peaceful and nice. Here I am strapped down to the table which I never knew was a thing until I went through it myself. They’re saying to me, “If the doctor doesn’t get here soon, we’re going to have to knock you out.” I’m like, “Knock me out? What is happening?” 

Long story short, my son came. Thank God he was fine and I was fine but it was one of the most traumatic things that I have ever been through in my life. The healing was really hard. I remember trying to change my newborn son’s diaper and being in excruciating pain. All around, I just had this postpartum, we were just talking about this how people say postpartum depression, but to me, it was postpartum depletion.

Especially after a C-section, we’re so depleted because we’ve had all of these medications and all of these interventions. We’re not getting that natural oxytocin that we get with a vaginal birth because your baby’s right on your chest and you can nurse right away. There are gentle C-sections, but in my case, they took the baby. I had some complications. He had a fever. There was a lot going on because my water did break. It was broken for all of those hours that they kept saying, “Your water didn’t break. Your water didn’t break.” 

My water did break and my son had an infection. So the bottom line is that I ended up with a C-section even though I was planning for this beautiful, natural birth. Again, I do believe that God gives us these situations because it makes us who we are and just like you shared, we go through– that’s why I share my other birth stories. I have experienced a lot of different birth scenarios and I think it helps us relate to other women who are going through similar things. 

Meagan: Absolutely. Absolutely. I think that’s a really unique thing about us here at The VBAC Link. Me and my team have all of these unique situations where we can really personally relate. 

Dr. Spair: Yes. You personally relate. But then I like to bring women back to say that if you are someone that is planning a natural birth, a home birth, or whatever, these situations are really rare. Like yes, I went through it. Yes, she went through it, but it’s not that we shouldn’t be trusting our bodies and knowing that they know what to do. Just that emergencies can happen just like with anything. Things can happen and we’re grateful for lifesaving measures when necessary. 

Now, are C-sections overdone and are they done just because it’s Christmas morning and the doctor wants to get home? I mean, that’s a whole other conversation about how C-sections are definitely performed way too often. Moms who have had one C-section are basically put into this box of, “Okay, you’ve had a C-section. Now you should have another C-section. Now you’ve had two C-sections. You definitely should have another C-section. Why would you even try to have a natural birth after that?” 

Meagan: Yeah. 

Dr. Spair: I love that you share that you had two and then you had a vaginal birth. That’s just incredible and I think that provides a lot of hope even for my community. It’s never too late to trust your body and give it a shot. 

Meagan: Absolutely, yeah. 

Dr. Spair: So then two and a half years later, I got pregnant again and I’m like, “I’m going to have a VBAC. I want to have this natural, beautiful birth.” And I did. I had my daughter right next to the hospital. It was a home birth but it was not in my own home. Because of the state that I live in, I actually had to cross state lines. And that’s another thing. People say to me all of the time, my women will say, “Oh, well near my house, there’s not this resource or there’s not that resource.” 

Sometimes we have to go get the resources. The state that I live in does not allow VBACs to happen outside of the hospital, so I went to another state. These are things that we can make happen if it’s that important that we don’t go through another C-section. For me, I knew that if I went through another C-section, I never would have had a third child. It was that traumatic for me. It was that hard to heal from. It was something that I never wanted to experience again and I knew if it happened a second time that I was done. I knew that I wanted more babies. 

So my second one was a home birth VBAC literally a mile, two miles from a hospital at a location with midwives and it was a beautiful, healing birth. He was 42.3 weeks and that’s the other thing I would love to talk about. People who get induced at 38-39 weeks depending on what’s going on, 41– oh my gosh. We have to give medication. When you wait until your body is ready and your baby is ready, your chances of having a natural birth, especially a VBAC, go way up. Way up. 

My third birth was a VBAC at home right here, right over there in a pool right in my own bedroom. I went from a very traumatic, horrendous birth to a second birth where I was hanging onto hope but I was still a little nervous about this whole situation, to a third birth where my midwives literally got here at 11:00 at night and I stepped into my pool and at 1:08, my baby was here. I was in labor all day long. I was at the park with the kids. They were scootering around. I was walking. I was doing squats on all of the play equipment. I cooked dinner. I was just holding the counter going through my pressure waves. I took a shower and was oiling up my belly and the whole thing. 

I went down and had a snack. I’m on the ball. The kids are with me and then I was like, “It’s time to go upstairs.” They got here. I went through a couple of birthing waves. I got in the birthing pool and there she was. There she was. It was beautiful. With the third one, I truly visualized my birth and this is part of what I’m going to be helping women do in the future. It’s a whole visualization process because it’s so true when you can take your fears which, with that first VBAC, I had fears of all of the things because they brainwash you into thinking you’re crazy and that you actually want to go ahead and do that. 

But I love seeing your statistics because it’s like, wait. You actually have a better chance of a VBAC. But what I was going to say is the process of visualizing what you want your birth to be like is so powerful. That’s what I want women to hang onto. Even if you come into a situation where interventions have to happen or the birth plan changes because they do, coming from an empowered and relaxed state is completely different than showing up at the hospital in this raging fear, terrified mode. 

There’s so much to be said about the education and the empowerment piece when it comes to successful VBAC. 

Meagan: Absolutely. Yeah. I think, like you were saying, there are so many people out there, not just providers. Providers are sharing things and sometimes they share things that may sound fluffed a little bit because of maybe one of their experiences so they have trauma. 

Dr. Spair: Yeah. Always. 

Meagan: They see these things and sometimes the way they say them is like, “Oh, whoa. That’s really scary. Maybe I am scary.” Then they twist our thinking. But it’s not just providers. Many people out there– friends or family. 

Dr. Spair: Family. All the time. Yep. Yes. 

Meagan: Everybody, right? I mean, I was in a VBAC-supportive group on Facebook and I was still being told, “How would you even?” It’s so hard so that’s why it’s so important for us to really learn those stats and then figure out what’s acceptable to us. 

Dr. Spair: Yes. 

Meagan: What’s acceptable to us?

Dr. Spair: What risk is acceptable and then how can I make myself feel comfortable? My second birth was a VBAC. I didn’t want to be in the hospital, but I live very far from a hospital, so what can I do to make myself feel comfortable? If I’m a mile away from the hospital and something goes wrong, am I okay with that? I’m right there. 

For some moms, it’s a VBAC in a hospital situation. What would make me feel comfortable? Meet that with your risk. That way, you’re not in a situation where you’re feeling fear and trying to birth because that doesn’t work either. We have to be comfortable and confident with the decisions that we’re making. I think that women out there are swayed in all of these different directions. They’re either in the category of a C-section camp over here, repeat C-section, or in the natural birth community which I will say that the natural birth community, after you have a C-section, is extremely unsupportive. 

Even if you are a mom, like I was my first time, I was planning for this beautiful, natural birth and after, it’s like, “What did you do wrong?” It’s like, “Wait. I didn’t do anything wrong. An emergency happened and I had a C-section because it saved my son’s life.” There’s a time and a place for that but you feel this guilt from this community that’s looking at you like, “Oh, you didn’t have this rainbow and butterfly birth?”

Meagan: Oh yeah. I will never forget the feeling that I had when my second birth, I was going for a VBAC and I didn’t obviously end up in a VBAC. I ended up in a repeat Cesarean. I will never forget the feeling inside of my head of, “Great. Now, I have to tell people and they’re all going to think I failed.” Especially those people who didn’t support me in this in the beginning. They’re going to be like, “Yeah, I could have told you that five months ago.” I just remember that feeling and then when I talked about it, I did get some comments like that. 

Dr. Spair: Yes. Yep. 

Meagan: I encourage our community to never be that person. 

Dr. Spair: Whichever way you end up in your birth, birth outcomes are birth outcomes. Women need to be supported no matter what they decide. No matter what they decide. Even if they are in a fear-filled state and they choose a C-section again, we have to support those women too. 

Meagan: Yes. 

Dr. Spair: Even if we don’t agree with that choice because a woman who is giving birth whether it’s vaginally or Cesarean, they’re a mom and they have to feel loved and supported so they can love and support that infant. Tearing women down in this very, very vulnerable state that we are in after we give birth is setting them up for postpartum depletion, depression, anxiety, fear, and all of these crazy things that again, women don’t talk about. 

We put people in this camp of, “Oh, well you’re just anxious. You’re just depressed.” 

Meagan: This is normal. You just had a baby and this is what you’re supposed to experience because you’re tired. No. 

Dr. Spair: No. You’re depleted. You’re depleted. It’s depleted in nutrition, depleted in sleep, depleted in resources, depleted in support. Sometimes it’s just someone to say to you, “You did a great job. You brought this baby into this world. You went through Hell. You can’t even laugh or sit up but you did a great job.”

It is hard when you have people surrounding you and say, “Well, see? You ended up with a C-section.” It’s almost like they’re proud to tell you that you failed at what you were going for. I had that experience too. 

Meagan: Exactly. Yes. That is how I felt from a lot of people and then when I chose to VBAC after two Cesareans, oh boy. 

Dr. Spair: Oh gosh, now you’re really in trouble. 

Meagan: Now I’m a nutso, right? It’s so hard. I just encourage our community to build one another up. I’ve made posts on this. I challenge every single one of you to love everyone for who they are and what they decide even if it’s not what you would decide, right? 

Dr. Spair: Yes, exactly. 

Meagan: Let’s dive more into what you do and talk about that postpartum and how we don’t talk about it enough. We don’t share. 

Dr. Spair: We don’t share. We don’t talk about it. I have a practice primarily, well, almost all women. I do say that I get the husbands and the sons when women heal and they go through something. I work a lot with women with chronic illness, postpartum, and those kinds of things. When they heal, they do send me their husbands and their sons, but it’s mostly women and a large majority of pregnant and postpartum moms. What I can say is 90% of postpartum women go through some type of depletion period. 

It’s part of becoming a mom. When we go through a birth whether it’s a C-section or a natural birth, there is a load of adrenaline that happens. Massive adrenaline. Massive cortisol as we are birthing a baby either way. It doesn’t matter if it’s a vaginal or surgical birth. What happens is that women become completely depleted especially if they don’t have support. They don’t have someone there cooking meals and making sure their toddler is taken care of. They’re running around the house trying to do all of these things instead of resting. That whole thing “sleep when the baby is sleeping” is the silliest thing you’ve heard in your whole life because your kitchen would be covered in dishes and all of that. We all know that. 

Meagan: And then we feel anxious when we look at those kitchens. 

Dr. Spair: And then we’re anxious when we look at that or we’re anxious because our toddler is not being taken care of correctly or eating things that we don’t want– those kinds of things. I think it comes down to women sharing and talking. Women postpartum have really crazy, irrational fears. We all, most of us, have had those feelings. 

When women talk about it, they think, “Oh my god. Someone’s going to think I’m crazy because I’m sitting here watching my baby sleep all night long. People are going to diagnose me with PPA or all of the things because I’m going through this.” If women would just share so that other women could say, “Oh my gosh. I definitely went through that too. I felt that way too. I was terrified. I had those crazy thoughts where I was just afraid something bad would happen,” they would say, “Okay. This is part of postpartum. I’m just depleted. I need to nourish myself with nutrition. I need to make sure that I’m hydrated and I need to prioritize sleep someway, somehow, when I can.” 

I think a lot of our anxiety would go from here to down because we hold ourselves and compare ourselves to other women out there who may have a lot of other support or they may have someone that’s taking care of their every need and not every woman has that, then we are afraid to talk about our experience when we’re trying to hold up all of these different things. I remember with my first birth, my husband went back to work right away so it was just me and this newborn. I had a C-section. I had a straight staircase up and down and they’re saying, “Don’t go up the staircase.” 

I’m like, “Well, I’ve got a newborn.” I did set myself up downstairs so I could mostly be downstairs, but things happen. You run out of diapers, all the things. I had an enlarged uterus because I was going up and down those damn stairs even though I wasn’t supposed to be. The dog is up there. 

So it’s just a matter of really looking at support and then talking with other women, women that are honest though. Women that are in a place where they’re comfortable sharing what they have gone through because a lot of women will just tell you, “Oh yeah, my birth was beautiful. It was la, la, la, la, la,” and they’re not really going to share that peace about, “Oh, no.” 

Meagan: The vulnerable part. The vulnerable part. 

Dr. Spair: Yes, yes. 

Meagan: The stats show about 1 in 7 which I think is about 15% or so will actually be diagnosed. I think we sometimes hear that– you just said it again– they get scared to be diagnosed or labeled. 

Dr. Spair: Some women go through more than others, but for most women, it’s just that TLC piece. If we had someone to really nourish us with the food we need to recover, I’m really big on infusions and herbs and teas, and those kinds of things. If we had that and we could set ourselves up, which is what I do. I help women to prepare for the postpartum period so that they can– I can’t say that I’ll eliminate it completely, but mitigate that and have those things on hand so that when they start to feel a little anxious, they know what to do. 

That’s where it comes into play. Instead of going into this thing that women don’t talk about postpartum, women don’t really talk about the birth so much, they just talk about this beautiful baby and that’s the great part. That’s the amazing part but nobody really talks about walking around in a diaper for 3 weeks. 

Meagan: Right? 

Dr. Spair: But that scar and feeling that scar and peeing your pants and all of the things that women don’t want to talk about. So that’s my mission is when I have a mom who is newly pregnant, it’s not a fear thing. It’s just like, “Hey. You’re a woman. I’m a woman. These are some of the things that a lot of women go through postpartum and it’s normal. It’s normal.” You go through it and you come out the other side. You really nourish your body. You’ll feel like yourself again, but there is a period where we don’t really quite feel like ourselves and that’s okay too because you just birthed a human.” 

Meagan: Yeah. And it is okay. It’s also okay to talk about when we don’t feel normal or don’t dismiss something because you think, “Oh, this is normal,” if you’re having those scary thoughts. I had an adorable client that called me and she was really struggling. She said, “I’m not having scary thoughts about hurting my baby. I have this irrational fear of me dying.” 

Dr. Spair: Yep. A lot of women go through that. 

Meagan: Right? She was like, “I just need to talk about it.” We just talked and I just listened. After, she was like, “Oh, thank you.” It’s like, if we’re sitting there inside of our mind thinking such scary things like we’re going to die– 

Dr. Spair: Yes. A lot of women go through that and then think that something will happen to their child. That happened to me after my first child. I was so afraid that something was going to happen to him that I was hyper-vigilant. That put me in a very anxious state. It wasn’t depression. I wasn’t sad. I had to be with him every second because I was afraid that something would happen. I think a lot of women go through that and they don’t talk about it. Then you think something’s wrong with you. You think something’s wrong with your brain. 

Meagan: Yeah, a lot of times we are scared to talk about it because we’re scared of being labeled or diagnosed with things. 

Dr. Spair: You don’t want to be labeled or diagnosed or have someone trying to shove things down your throat, right?

Meagan: Yeah. Let’s talk about that. What are the steps to talking about it? You talked about herbs and teas and feeding. I love the analogy of depletion. Depression and depletion, right? 

Dr. Spair: We’re just depleted. We’re depleted. We don’t have to stick a label on it. There’s a huge thing around nursing moms and that depletion piece where they usually get this information of, “Okay, well you should just wean your baby and stop breastfeeding and focus on yourself,” where there are hormones involved for moms that choose to breastfeed. We have a lot of oxytocin just from being skin-to-skin when we are nursing our babies. 

So instead of saying, “I’m not going to do this now,” a lot of times, if moms get the right support and they choose to do the skin-to-skin and they nurse, they do start to feel better mentally because they are getting that oxytocin. It does bring the cortisol down when we nurse a baby. For me, it’s always been an instinct. When I’m nursing a baby even now, if I go through something stressful and I nurse my kid, it’s like, “Ahh.” You feel calmer. 

Now in the beginning, it’s not always like that because it can be a struggle for women– the latch, the this, the tongue ties, the lip ties, this, that. We’ve got to get those things right and those are other things that I help to identify in women because that part can be challenging but once we get over that hump, those hormones are really important to our bodies, to our immune system, and to our recovery. 

If you’re not a mom that’s nursing, that skin-to-skin is still very important for that feel-good hormone production to help your brain feel better. Holding your baby tightly, skin-to-skin and all of that is just very, very, very important to how we feel. Yeah. It’s definitely part of that. 

And then in terms of herbs and nutrition, a lot of us and I’ll say us because I went through it myself the first time, we are so into this “Everything is about the baby. Everything is about the baby,” and I put myself aside. 

Meagan: We forget. We forget to take care of ourselves. 

Dr. Spair: We forget to take care of ourselves and we will go hours without eating or we aren’t drinking and then we’re nursing and we’re using up all of this hydration and we’re not replenishing. So we’re dehydrated. We’re having skyrocketing blood sugars and plummeting blood sugars because we’re going so long without eating then we are eating a huge meal and then we’re not eating again. 

When our blood sugar is down, or cortisol is up so we can have anxiety and jittering and things like that. What I always tell my moms is every two hours, make sure you’re having something. Small bites, small sips. Make sure that something is going in. Even if it’s, “Oh, I don’t have time for myself,” make a big smoothie on your counter and every couple of hours, fill it up. Sip on it. Keep your blood sugar steady throughout the day. 

And then the things post-birth that I love– nettle infusions. People talk about nettle a lot, but they’re using a tea bag. I’m talking about an infusion in a mason jar. A couple of tablespoons of herbs that you soak for a good hour or two and you’re sipping on it. That’s like an infusion. That’s a vitamin and mineral infusion. When we say that we are depleted post-birth, we lose blood when we give birth. Even if it’s a natural birth, we are still losing blood so we are depleted in minerals. We are depleted in vitamins. So nettle infusions and I like the raspberry too because it helps to tone the uterus which means those post-birth contractions. 

So infusions with red raspberry leaf and nettle is a wonderful tonic for all women, not just to balance the hormones and to help with breastmilk, but to also help to give us back some of– we’ve really done a job of growing a baby and we’re depleted. 

The other thing that I love post-birth and some women will argue, “Oh, it decreases breastmilk supply,” but I’ve never seen that in my practice, is a little bit of lemon balm in that infusion because it, again, helps to bring down those feelings of anxiety. It’s really good for the nervous system. The total nervous system calms everything down because again, post-birth, we’re in an adrenaline surge. The body went through all of that adrenaline. Some women feel that for days, weeks, or months before they start to calm down again. Those are some things that I find really helpful. 

Meagan: You said that a lot of people think about a tea bag, but you’re saying herbs. Where would one something where they make this? 

Dr. Spair: Mountainherbreserves.com is my favorite. You just take a mason jar. You can get these at the grocery store, Tractor Supply, Amazon, or anywhere. They make a little infuser that goes at the top. It’s about this high. It sits at the top. You put the loose herbs in there. Fill it with hot water and steep that for an hour or two hours. The longer you steep it, it will be stronger. So if you’re just starting out, do a little bit of herb. Let it steep for 20 minutes and see how you do with it. I like to let it sit for a while and sip on it. 

Meagan: This would be good for anyone, Cesarean or vaginal. 

Dr. Spair: Yes, to help us recover. We need to recover either way. Either way, we need to recover. 

Meagan: Is it stinging nettle? 

Dr. Spair: Yes. Yes. Stinging nettle and then red raspberry leaf. 

Meagan: And then some lemon balm. 

Dr. Spair: Some lemon balm if you’re not afraid. It’s in the peppermint family so some women say, “Oh,” but in my practice, I’ve had postpartum moms on lemon balm for the last 8 years and I’ve never had one that has had issues with milk production. I wouldn’t say a ton of it off the bat, but a little bit will help to take the edge off. I always say that there is this risk/benefit thing. If a mom is really struggling, she's probably not going to make it with breastfeeding anyway, so if we can help her central nervous system, we can deal with other things.

I love Ashwaganda post-birth. I think that’s another one that’s really beautiful for the adrenal glands. Magnesium is so good. It helps, again, with post-uterine contractions. Women are feeling that. They’re feeling uncomfortable. Magnesium is great for that. It helps with fluid retention in the body. With C-sections, you know what happens with that. I didn’t have an ounce of swelling during my entire pregnancy. I had that C-section and my feet, I was like, “Oh my gosh,” and I had zero swelling. 

Meagan: I sweat. I had severe night sweats. 

Dr. Spair: Yes, because you know what those night sweats are? It’s all of the drugs that have to come out of the spinal. 

Meagan: It’s everything coming out of my body. 

Dr. Spair: It has to come out and that’s a problem too. What I love for that postpartum is milk thistle. A milk thistle tincture for moms that have C-sections to get rid of the drugs that we have to have when we have a C-section. Even if you’re a mom that has a VBAC and you have a spinal, and you’re feeling like your system is a little gunked up, milk thistle is amazing. 

We can do a lot with nutrition. If you don’t want to use herbs, there are a lot of other things you can use. Green juices, cucumber juices, those kinds of things are wonderful too, but if you want a tincture, milk thistle is a beautiful way to gently cleanse the body. 

Meagan: Cleanse the body. Awesome. Well, let’s talk a little bit about nutrition. So many times, we have a baby, and then any extra support that we have, they want to bring meals and they bring things like lasagna. 

Dr. Spair: I know. 

Meagan: And bread, and pizza. 

Dr. Spair: I know. It’s not something that you’d be like, “Okay, this is good.” It’s easy. 

Meagan: You’ll take anything. 

Dr. Spair: You’ll take anything. 

Meagan: I don’t want to ever shame anyone who has ever made lasagna for someone who has had a baby. 

Dr. Spair: No, exactly. 

Meagan: I’m guilty of that. But at the same time, there are so many nutrients that we are lacking that we need for our brain functioning, our body functioning–

Dr. Spair: There are some key things that we really need. Raw, leafy greens are one of them and it’s like, “Who the hell wants to eat a salad after they birth?” I get it but there are easy ways to bring greens in. I’m going to go back to the smoothie again. My favorite way is frozen mangos, spinach, and coconut water. You can throw bananas in there if you want. You get those greens in your body, you are a different woman. Again, we’re depleted so those raw, leafy greens are just– again, it’s like an infusion. Moms feel better mentally, physically, all of it pretty much immediately because of the leafy greens. 

Again, when we lose blood, our iron reserves go down. So low iron, fatigue, and all of that, raw, leafy greens help to bring that up. So does the nettle. The nettle helps with raising the iron. Raw, leafy greens are so important. Again, you can do them in the smoothies if you don’t want to eat a salad. The other thing I do if I have a warmed soup or even if you had something like a lasagna, chop them up really small. Put them on like a garnish. At least you’re getting something in. You can fold raw, leafy greens right into a warm soup or a stirfry so you’re still getting warm food, but you’re bringing some greens in. 

Some women postpartum have a hard time with that, so we have to find alternative ways. It’s not always just black and white. Go eat all salads. Sometimes we have to meet women where they are and say, “Okay, you’re going to eat that warm meal. Let’s doctor it up a little bit.” 

Meagan: You can still have your comfort meal. 

Dr. Spair: Yes. There’s a way to do it. There’s a way to do it. 

Meagan: With empowering, enriched nutrients. 

Dr. Spair: Yes. Yes. There’s a way to do that. And you know, things like selenium and iodine, there are simple ways. A little bit of seaweed for iodine protects the thyroid. It really helps moms recover and then selenium, one to two brail nuts a couple of times a week really helps again with that thyroid function for moms postpartum as things start to fluctuate. 

There are really easy little tricks that are like, “If I just did these few little things, I’d be in a different place.” 

Meagan: Yeah. Yeah. 

Dr. Spair: I’m really big on freezer meals. I have a free thing on my website. It says preparedness, be prepared and it’s a bunch of meals that moms can make ahead of time. 

Meagan: That’s huge. 

Dr. Spair: They can freeze them. I’m guilty of it though. With the third baby, I was like, “Oh, I’m going to make all of these things,” and whatever. She didn’t come until 41.5 weeks and I still didn’t have too many things in my freezer but if you’re a planner and you want to do things ahead of time, we have a resource there that’s free. 

Meagan: I love that. We’re going to be sure to drop that in the show notes right now because there are a lot of people who are saying, “You’re coming up on your due date. What can I do to help?” You can send them that link and say, “Can you make this meal for me?” 

Dr. Spair: Yes. “I would love for you to make some of these things,” if there are people that would be open to that. That would be great. 

Meagan: Yeah. Yeah. That would be so awesome. So cool. Is there anything else that you feel is important to share? There’s just so much. As a specialist in health and nutrition and seeing the postpartum and knowing your own journey, is there anything that you’re like, “This is the biggest takeaway for you as a listener”? What is your biggest takeaway?

Dr. Spair: For me, it’s that moms have to take care of themselves. I understand because I’m a giver. People still tell me. I’m guilty of it. “Kimberly, you have to take care of yourself.” But it’s my baby, my middle kid, my big kid. We’re giving, giving, giving, But when we don’t take care of ourselves, those babies need me. Our babies need us so if we don’t take care of ourselves with the same love, compassion, and consideration that we take care of them, then they have half of us or a shell of us. We have to take care of ourselves. 

We need to prepare with the nutrition. If herbs are something that you are into, I highly recommend that for that depletion stage and just really take care of yourself. Even if it’s just, “Okay, I need to get outside for 10 minutes. Fresh air. Put my feet in the yard.” Those kinds of things make us feel alive.

With my second, I remember my midwife saying to me, “No matter what, take a shower every day. Once a week, put on make-up.” It’s like, make-up? I never thought of, “Put on make-up? Why would I put on make-up?” But let me tell you something, you do it and you’re like, “Oh. I know that woman in the mirror. There she is.” There’s a feeling to that. There’s a feeling that comes with feeling like yourself. So if you can get in a shower and once in a while, put on some make-up and put on some clothes that make you feel like a human even if you’re dealing with diapers and poopy hineys and all of those things, every once in a while, take care of yourself. That’s the most important thing. 

Meagan: Yes. Yes. So Women of Strength, as you’re listening, I can’t agree more. Use this as a takeaway. Take care of yourself. Make sure you are knowing that you are important too because I think naturally, it’s weird but naturally as moms, sometimes we get in that, “Well, this baby and this baby and this and that,” and we just think about all of the things. Then like you said in the beginning, we get to the end of the day and we’re like, “What have we eaten today?” 

Dr. Spair: And sometimes we get to, “Who am I? Who is this person in the mirror?” 

Meagan: Yes. Yes and at the end of the day, we’re like, “I don’t know, but I’m too tired to think about it so I’m just going to go to bed.” So it’s so important for us to remember that we exist and we’re important. 

You have classes that help people along this journey. I know you’re creating more classes too. Do you want to tell everybody before we go a little bit about your classes? 

Dr. Spair: I have a course called Empowered Moms. It’s coming up in May. It’s a month-long course and it covers everything and anything that you want to know as a mom. Literally, I learned all of these things on my journey about holistic health and nutrition. Moms come to me that have kids with chronic ear infections or chronic symptoms or illness or they just want to do things a better way. They feel like they’re always in the pediatrician's office and they want to take their power back. They want to learn how to use herbs and homeopathy and use things medicinally so that it’s not that you’ll never need your pediatrician again, but maybe you can break free from the cycle of things that you’re– if you can catch my drift– having to give over and over again for chronic symptoms. 

My course helps to help moms. Again, it’s called Empowered Moms. It’s empowering moms to take their power back and giving them the tools necessary to help their families nutritionally and herbally. Again, I get into homeopathics. I also get into self-care and things for moms and what they can do for nervous system healing because that’s all of us. And then I have a birth course that’s going to be launching by the end of the summer. I’m super excited about that. It’s going to be all about preparing for birth, birthing itself, and then the postpartum part which I think is so important. 

And then I have one other course called Empowered Women. That one is only for women for all women’s health issues, so moms who struggle with anything from hormonal issues to thyroid issues. All the things are covered in that course. 

Meagan: Adrenal fatigue. Yes, when I was looking through, I was like, “Dang. I think I might need to take this course myself.” Seriously because I know that there are so many things hormonally that I haven’t figured out yet. I am in that routine of, “Okay, I’ll go get my blood drawn again. Let’s go and do this. Let’s go and do that.” I’m not figuring out what’s really going on at the root. 

Dr. Spair: Because a lot of the time, they say it’s hormones but we all have this viral and toxic load. I’ll just briefly explain. When we keep the viral and toxic load here under the bucket where we all have, there are no symptoms. When it starts to bubble over and now we’ve got lots of toxic load and lots of viruses and pathogens in our body, we see symptoms. My job is to help people get all that back down. We are cleansing. We are taking care of viruses, pathogens, and latent infections in the body, and then symptoms disappear. 

That’s what it is. It’s not always that people think, “I need a diagnosis. I need a diagnosis.” I think everyone should go to their doctor. I think that people should definitely go but a lot of those people are searching and they’re getting all of the bloodwork and they’re going through all of these things, but I recovered from Hashimoto’s, a neurological disease, myself. 

Meagan: Yes. There’s a whole story. 

Dr. Spair: Yes. I went through all of that. I had a $15,000 book of labs and notebooks and all of that. We lost our first home because of my chronic illness and it wasn’t until I took my own power back and said, “All right. There are things that I need to learn about my own body and I can cleanse my way out of this.” Again, it’s not telling people not to go get the labs and figure it out, but if you’re in a situation where you’ve done all of those things and you’re like, “Well, shit. I’m not feeling better,” sometimes, there’s something else going on. 

Meagan: Yes. Your story is just amazing. It’s so empowering. I encourage everyone to go to drkimberlyspair.com and spend hours on this website because seriously, you have so much. You have product guides. You have testimonials. You have the fertility and pregnancy and your amazing blog. I know you offer not only these courses but one-on-ones and more about you and your history and your journey and why you are here today empowering these women to again, take things back and have the power in their pocket. 

“To reclaim your health, empower your family’s future” is what you say. I think it’s amazing and what you’re doing is so amazing and I just am so grateful for you today. 

Dr. Spair: I’m grateful for you. We’re going to be sharing this too and I’m going to be sending all of the people to your page too because moms need the information. They need the statistics. They need the support and they need to feel seen and heard. Thank you so much. 

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.

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We have a very special guest on the podcast today, Julie Sawaya, who is one of the co-founders of Needed, a company that focuses on providing women with the highest quality of vitamins needed during the entire perinatal period.

Julie shares with Meagan the research behind Needed's prenatal vitamins and supplements. She talks about why you need a prenatal vitamin in the first place, the optimal dosage and forms of specific vitamins in pregnancy, how supplementing proper nutrition in the best ways can positively impact your entire birth experience, and so much more!

Use the code VBAC20 to receive 20% off at www.thisisneeded.com

Additional Links

Needed Website

What to Look for in a Prenatal Vitamin

Folate vs Folic Acid. What's the Difference?

Ryann Kipping: The Prenatal Nutritionist

Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Hello, Women of Strength. We have a very, very special episode for you today. We have our friend, Julie Sawaya, and she is the co-founder of Needed. If you haven’t heard us talking about Needed yet, go listen to the other episodes and get on Instagram. You guys, Needed is incredible. She is a mama of two young girls. We were just talking before the episode and her youngest is nine months. 

She is a lifelong nutrition nerd. I love that she calls herself this, a nutrition nerd. I’m a birth nerd. When we find ourselves passionate about something, we just nerd out, right? It’s so amazing. Julie grew up in a family of medical doctors and learned at a young age the power of nutrition and how it can influence or help. Julie went on to study the issue of nutritional access in college and got her Master’s in business from Stanford where she met her Needed co-founder, Ryan 

Of the most nutritionally aware of their friends, Julie and Ryan were shocked to realize that through nutrient testing, they were seriously major deficient in key nutrients. We don’t think about it, Julie. We just don’t think about this, I think, enough. We think we’re taking something and we think that we’re good. 

They found out that there was really much more needed for a healthy pregnancy. They dug into the research and they realized that they were not alone. 97% of women take a prenatal, yet 95% have nutrient deficiencies. Let me just say that again. 97% of women take a prenatal, yet 95% have nutrient deficiencies. 

Most prenatal vitamins just weren’t cutting it and Julie and Brian started Needed to create a new, higher standard for perinatal health. Working alongside a collective of more than 3,000 perinatal nutrition and health experts, together they have redesigned the products, education, expertise, and experience that women need. 

Welcome to the show, Julie. I seriously am reading this and I’m like, “Oh my gosh.” This is amazing because like I was saying when I was pregnant years ago, I did not pay attention to anything. I got the bottle. I took it. Check mark.

Julie: Yeah. No, I mean, I think it’s a problem. The core underlying problem that we’re solving at Needed is that women are nutritionally deficient in this life stage. It’s a problem both with the products that are available. Most prenatal vitamins are designed to meet just the bare minimum nutrient needs, not to set you up for optimal health, and it’s also an awareness or an education problem because, in some way, it’s a problem that you don’t know you have until you feel the effects of it. 

We’re told it’s normal to feel depleted, that it’s normal to not feel your best, to feel like yourself during pregnancy or postpartum. So many of the complications of pregnancy have a nutritional root to it whether it’s gestational diabetes or preeclampsia or hypertension or nausea even, or more severe nausea like hyperemesis. There is a nutritional component to it. Not to say that nutrition is a cure-all, but it’s a reasonable first step in supporting your body optimally. 

Meagan: It’s huge. 

Julie: What Ryan and I found when prior to starting the company is that despite how important nutrition is and yes, I am a lifelong nutrition nerd. Ryan and I are also trained nutritionists. It was truly and utterly shocking to us that we had these deficiencies but what we realized once we looked under the hood is that this problem is widespread and part of the problem stems from the fact that it’s so common for women in the U.S. to see an OB. I come from a family of MDs and I have huge respect for the medical profession. 

But most doctors aren’t trained in nutrition. It’s actually not a requirement in most med schools. I think somewhere in the range of 50% of med schools don’t require one nutrition course. The average OB appointment time in the US is 7 minutes long so even if an OB is trained in nutrition and has the intention to help educate their patients. OBs are generally very well-meaning. They’re just people who are constrained on time and with the curriculum as we like to say, the curriculum is flawed, not the people. 

But even if all of the stars align in 7 minutes, you can’t get all of your nutrition questions answered. What we hear again and again, the most common recommendation is, “Take a prenatal vitamin,” and then you ask, “What kind?” and then they say, “It doesn’t matter. They’re all the same.”

Meagan: Just take one, yeah. 

Julie: “Just take one. Make sure it has folic acid in it,” which I’m sure we’ll get into. That particular nutrient and nutrient form. But there is so much more to prenatal nutrition than vitamins and minerals. But even if you just focus on vitamins and minerals, it’s really hard to pick a prenatal. There are over 100 on the market. There is a vast difference when it comes to quality. The quality of the nutrients, the quality of the nutrient forms, and dosages. We spent over three years formulating our first products with a collective of health and wellness practitioners that study perinatal nutrition and looking at all of the available clinical research on nutrient dosages and forms, and what pregnant and lactating women need. 

The reality is that there are a lot of nutritional gaps. That’s where this collective of practitioners that are testing women’s nutrient and hormone levels every single day really, really matters to understand in practice what does it take to dose? What dosing of Vitamin D do you need to give your patients to be in optimal nutrient ranges? 

It seems like such a basic question, but no prenatal company had done that legwork to understand what’s actually optimal. 

Meagan: That is what I was going to say. There are so many things about Needed that I love. Honestly, one of them is how this company came about. It’s two women that found that there was something lacking out there and had a passion from themselves and had passion to share it with the world. That’s how The VBAC Link started. Myself and my old partner, Julie, same thing. We just found this passion so I love the heart that comes behind this company and then really what you guys have done. 

You’ve built it from somewhere where it was really mediocre if you could even call it that is incredible. Like you said, not only getting ingredients but the optimal amount. As I have compared in the past, there are so many out there that are even recommended on Amazon or wherever and they don’t even have the ingredients at all let alone that optimal amount. 

I am so excited and honored for you to be here today and be talking to our community because I think that it is so important. Like you were saying, it’s not that my provider had any ill intent to not give me that information, but it really was as I was walking out, he goes, “Oh, and by the way. Make sure to start a prenatal right now.” I was like, “Oh, okay.” That was it. That was it. I did. I found myself Googling it and found one. I was like, “Okay, cool. That one has some okay reviews.” I got it and I really didn’t know the impact that it was leaving or lack thereof. 

Julie: Yeah, totally. I think some of that comes from there is misunderstanding that a prenatal vitamin is for the baby. By and large, unless you have massive nutrient deficiencies, the baby’s going to get what he or she needs to develop properly, but often at the expense of your own nutrient reserves. 

As a mom of multiples, you know that oftentimes, women experience and understand the pain point more as a second-time or third-time mom than as a first-time mom because once you’ve been through pregnancy and birth and if you choose to breastfeed or pump, you can feel it viscerally how depleting that experience is maybe more so than a first-time mom that hasn’t yet been through it all. In some ways, it’s an experience that has to be lived to fully appreciate the problem probably much like the topic of VBACs. 

You go into a first birth maybe not fully understanding how one birth choice or one birth outcome will impact the second birth choice or birth outcome. What we’re really trying to do at Needed is to raise awareness so that you can make the best choices possible with the information that you have. That’s all that it’s about. It’s not about what I would have done differently with one pregnancy versus another. It’s not at all. Any of the information we share is not in any way meant to shame or add guilt. There is so much of that mom guilt, so much of that fear-mongering out there. That is the antithesis of who we are as a company. 

But we find that when you’re empowered with the right information, you can make better-informed decisions so that’s a huge part of what our mission is here at Needed. 

Meagan: Yeah. Yeah, I mean we can relate to so much of that over here. I didn’t know what I didn’t know when I had through perinatal care to birth to recovering after a C-section. We grow from our journeys. Yeah. There’s never any more shame. Mom guilt is way too thick. We lay it on way too thick, especially with social media. 

So here we are today to have this episode so you can start learning and growing and finding that information so you can make the best choice for you and your growing baby or maybe through your fertility journey or nursing journey or whatever part of the journey that you are in, Needed has so many incredible things, really it all. I’m sorry, but you kind of have it all out there. It’s just amazing. So thank you so much. Yeah, let’s get into some of these questions. 

Julie: Yeah, I’m excited. 

Meagan: Me too. 

Okay, so one of the questions is what is the importance of a prenatal vitamin? Really, why? We’re being told to take these prenatal vitamins and we were just a little bit talking about how there are a lot of things that we need, but why do we really need them and does it matter if we don’t take them?

Julie: Yeah, that’s a great question. I like to answer it with a look back at context from nature because first and foremost, I think people are right to have skepticism about supplements in general. Do I need them? Why do I need them? Is it just snake oil in general? 

I think something that was an aha moment for me as someone who was a little bit of a, “Food is my medicine, not supplements.” That’s the perspective I came into before starting Needed. I think it’s really helpful to understand that one of the main reasons we need supplements generally and then specifically at the life stage of pregnancy or the perinatal stage is because our soil is depleted. Food isn’t as nutritious as it once was and it tends to take a lot longer to reach us than it used to. 

We’re not generally growing our own food. We don’t necessarily know who is growing our own food. Even if you shop at the farmers market as Ryan and I did at the time. We were testing our nutrients way back 6 years ago when we started Needed. Your food can still be depleted because the soil quietly is depleted. 

We’re also subject to a lot more environmental toxins which that toxic load increases baseline nutrient requirements. Your body has to consume more nutrients to operate at homeostasis because of the burden of toxins it’s trying to process effectively. 

Meagan: Yeah. 

Julie: We have a great book posted on our website. The title is “Why Your Grandmother Didn’t Take Prenatal Vitamins But You Should.” It’s really talking about these factors that are an evolution of modern life.

We also now know as we didn’t previously how important some nutrients are, especially nutrients like folate which is vitamin B9. It’s really critical for babies’ brain and neural tube formation. Folate’s sister nutrient is choline. It’s a super important nutrient for many of the same reasons– brain development, cognitive function, neural tube formation. Those are nutrients you don’t want to skip out on in that even with your best intentions, you might be deficient it. 95% of women are deficient in– sorry about that. I have a rowdy dog. 95% of women are deficient in the nutrient choline. 

It’s most abundant in eggs, liver, and foods like that but in the first trimester, many women have a food aversion to eggs. I certainly was not consuming any liver in my first trimester. 

Meagan: Yeah, I was going to say that liver never crossed the path of my pregnancy, unfortunately, or fortunately. 

Julie: Yeah, not at all. Yeah, but in any event, at a high level, prenatal vitamins are there to fill the gaps in your diet. I think that a misunderstanding and the way that prenatal vitamins have been formulated historically is that they’re dosing around a concept called the RDA level which is basically a dosage framework that came out of World War II when the government was trying to determine how to set nutrient levels to avoid serious diseases like scurvy, like a significant deficiency of vitamin C. 

The entire concept of an RDA is rooted in this idea of, what’s the bare minimum amount of a nutrient I need to give someone to avoid a disease or worse like famine or starvation. Minimalistic, not optimal. There’s a big order of magnitude of difference of what amount of vitamin C your body needs to avoid scurvy versus what it needs to support postpartum tissue healing and repair and optimal immune health during pregnancy or optimal reference ranges. 

But at a high level, basically, prenatal vitamins are there to fill in the gaps in your diet. They are, unfortunately, a necessity because of our modern food system and they are especially important at a life stage like pregnancy and breastfeeding when your body will never have higher nutrient needs than it does in these life stages. It’s really, really critical that you’re getting the right nutrients. 

As I said earlier, it’s not just for the baby. It’s for you too. I think that a concept that we’re really passionate about is centering women in this journey because ultimately, your baby is most likely going to get what they need but you might be left depleted and that depletion can have long-term impacts. If you want to have two kids or three kids or ten kids, your body has fewer nutrient reserves to give to the next baby with each sequential baby unless you are replenishing those nutrient stores. 

If your family feels complete, it’s still important to supplement throughout the postpartum and a time period thereafter to support your hormone health and your thyroid health. Just general vitality and overall well-being. I think it’s super common for women to say that it took them several years to feel like themselves post-pregnancy and a lot of that can be tied back to nutrient deficiencies. 

Meagan: Yeah, something that you said that resonated with me is that through each pregnancy, my life became busier because I had little toddlers and newborns. You know, all of these things around. So like you were saying at the beginning, you were like, “I can get it through my food. I can get it through my food.” Yes. Food definitely is impactful but obviously, as we know, is not as great as it used to be. 

Not only was it not as great as it used to be, but when I was really, really busy running around, I’m going to tell you right now that I was not eating correctly. I wasn’t even getting enough calories at the time let alone the right foods. I was like, “Oh. There’s a Nutrigrain bar. Let me just grab that because I’m hungry.” I wasn’t grabbing the right things or enough. It just goes to show that as we keep going on too, it’s so important. 

Julie: Yeah. That’s absolutely the reality. I think where it’s almost more important to take supplements with each subsequent pregnancy for that reason or even in the postpartum period because when you’re pregnant with your first, you generally speaking have more time than you do in postpartum with your first. And in postpartum with your first, you generally have more time than pregnancy with your second or third or fourth so that’s absolutely right. 

Meagan: Yeah. I would also remember breastfeeding my baby even in the middle of the day and just feeling sucked. Literally dry of energy and everything. 

Julie: Hydration and nutrients. 

Meagan: Hydration, yep. My mouth was getting dry. It just goes to show that you are feeling it. You are literally feeling your body change right there. 

Okay, so now we know it’s definitely important to take prenatal vitamins in the perinatal/postpartum stage and everything. But what ingredients should we focus on? We talked a little bit about folate and choline. What should we be looking at when it comes to the back of our bottle? Are those really the two main ones or are there more ingredients that are like, “Hey, we really need to be focusing on these and if we don’t see them on the back of our prenatal, we should have our alarms going off”? 

Julie: Yeah. There are really 24 vitamins and minerals that Needed has chosen to include in our prenatal vitamins because they are the ones that have the most clinically validated need for them. Choline and folate are two really important ones. I think they are really easy ones to scan a bottle for or a supplement facts panel and see not only does this have choline in it, but what’s the dosage? The most common dosage of choline– it’s a nutrient that has had an RDA. We talked about RDAs. It’s a minimum amount. It’s at an RDA of 450mg in pregnancy for 20+ years, 550 for lactation. 

The most common dosage of choline in a prenatal vitamin is 0, followed by 55mg which is 1/10 of the breastfeeding RDA. RDAs are the minimum. They’re taking 1/10th of that in most prenatal vitamins. The reason for that isn’t because you’re getting all of the extra from your diet. It’s because choline is a bulky nutrient that is hard to fit into a one-a-day prenatal. It’s hard to fit into a gummy. You just really can’t effectively do so. 

To dose it optimally, you need to include it in multiple capsules or in a powdered form like we offer. One of our options for a prenatal vitamin is a powder which is really, really great, especially for those bulkier nutrients like choline. 

The other bulky nutrients that are really important are calcium and magnesium. I would look for dosages of at least 200mg of those two ingredients. Ideally, magnesium and other minerals are in the glycinate form. Sometimes that’s on a label as magnesium bis-glycinate or magnesium bound to glycine. Glycine is an essential amino acid that just helps with absorption, keylation basically, the usability of that nutrient in the body so that’s a really important one. 

Other nutrients I suggest scanning a panel to see if they are in there– vitamin D is a telling one. I think nearly every prenatal vitamin will have vitamin D in it but the dosage matters and the form. Some prenatal use a less-absorbed form called vitamin D2. We recommend the D3 form. We also suggest looking for at least 2000 international units, IUs or more optimally would be 4000. Our prenatal vitamin capsules and multi-powder have 4000 and then our essentials multi which is a paired-down version in only three capsules has 2000. Those are the ranges that we typically like to see for vitamin D. 

Vitamin D is best absorbed with vitamin K. Make sure that vitamin K is on that supplement facts panel and 90 is the dosage that we tend to look for vitamin K. It should be in the K2 form. That’s the best-absorbed one. Those are some key ones. The other things to look for are– I think we’ll probably get into the question of what form of folate so let’s have that’s conversation. 

Meagan: Yeah.

Julie: If you’re told nothing else about prenatal nutrition, you’re probably told to take folic acid which is the manmade synthetic form of the nutrient folate. Folate is naturally occurring in food. It’s an essential nutrient. We talked about its use in the body. It’s really important for babies’ neural tube formation so for spina bifida. That’s why it’s emphasized usually in the first trimester because the neural tube fully closes during the first trimester. 

It’s a nutrient that is so, so important and many women don’t know they’re pregnant until well into the first trimester so it’s pretty common to hear that you should start taking it preconception which we definitely agree with, with one caveat which is that the synthetic form of folic acid is not readily used by the body. 

Many women have a genetic variation, MTHFR which makes it impossible for their bodies to convert synthetic folic acid into the usable form of folate. Instead, Needed uses methylfolate which is a naturally occurring form of folate. It’s the active form meaning it doesn’t have to go through the conversion process. It’s been shown in clinical research to be better utilized by the body, especially for those with the MTHFR. 

There is controversy out there of folic acid versus methylfolate. Primarily what the controvery stems from is the fact that the clinical studies on folate for neural tube defects was done with folic acid. That’s because the research is old. It’s 30 years old. Now that we know how important folate is to neural tube defects, it would be unethical to do a clinical study with a double-blind placebo controlled study where you’re putting women on a placebo that has no folate in it versus one that has folate in it. We know the risk factors. We don’t want to induce spinal cord issues or neural defects. 

So a lot of those who are pro-folic acid are relying on stale research. Really, this argument is that all of the clinical research around neural tube formation is on folic acid. We’re not arguing with that. That’s actually a true statement. But there’s a huge wealth of research showing that head-to-head comparing methylfolate versus folic acid, methylfolate is better absorbed by the body. 

96% of the circulating folate in your body is methylfolate so that’s pretty clear evidence in support of it. Mechanistically, in the body, how we’re preventing neural tube formations is the serum folate status of mom. There is research showing that methylfolate raises serum folate status in mom in the same way or better than folic acid does. 

We have a really well-researched blog post on this topic on our website. It’s dense. Maybe we can link to it in the show notes for those who want to learn more, but there is a reason why many of the higher-quality prenatal vitamins are including methylfolate, not folic acid. I would tend to distrust– there are some out there who are saying, “Oh, it’s a designer prenatal vitamin. They’re just trying to charge you more.” 

The reality is that methylfolate is so much more expensive than folic acid. You could make a lot higher profit margin if you used folic acid than methylfolate. I think it’s around 100 times more expensive which is also why most of the clinical research is relying on folic acid. Folic acid is a nutrient that is often fortified in cereals and bread, so there’s also a food lobby that has an interest in keeping folic acid in things and not methylfolate because it would be cost-prohibitive to include methylfolate in a $3.00 box of cereal. 

Meagan: Interesting. 

Julie: Yeah, there are a lot of factors. I don’t want to bog listeners down in all of this information, but this is a really good nutrient to highlight how much information and nuance and research goes into selecting optimal nutrient forms and optimal nutrient dosages. It’s a quick way of saying that we did a tremendous amount of research and there is a lot of evidence behind what we’re including in the Needed prenatal. 

We include references for every single nutrient that we use for those who are, like me, nutrition nerds that want to go many layers deep. For those of you who are like, “Oh my god. This is over my head,” I would say that the core message is that we’ve done extensive research and these nutrients have been utilized in practice with perinatal nutrition and health experts for decades. This isn’t newly redesigned. We did design our prenatal vitamin from the ground up, but the insights, expertise, and recommendations behind it have been put into practice for many, many decades. 

Really, what Needed did was bring together all of this inside of a single product instead of previously how practitioners were having to say, “Okay, go take this magnesium and this vitamin D and this prenatal and this amount of choline,” because no prenatal had everything that you needed in one package. 

Meagan: Right. That is another reason why I love and trust you guys so much. Literally, it’s all of the research that has gone into creating such a solid product for the birth community so I love that. Thank you so much for explaining that because yeah, it definitely is a hot debate sometimes. 

Julie: Yeah. I think it’s good to have that. We love a healthy debate. We work with practitioners. We actually have now almost 4000 practitioners in our community. It includes OBs. It includes reproductive endocrinologists but it also includes a lot of registered dieticians and naturopathic doctors and functionally-trained practitioners. We’re collaborating with all of them when designing products. We appreciate that some people come from different training backgrounds. 

Some people might have different skepticism and all voices are welcome. We want to have a construction conversation on this specific topic of folate versus folic acid, sometimes, the status quo argument is unwilling to hear the other side. It’s nuanced and that’s why we have a great blog post on the topic. 

Also, if you’re just early in your research and want a basic primer on what to look for in a prenatal vitamin, we also have that free resource available on our website as well as a review of over 75 of the prenatal vitamins on the market. It compares the pros, the cons, and overall recommendations. So if you love your prenatal, but it doesn’t have choline or it doesn’t have magnesium, we’ll give you those recommendations on how to supplement or how to get more of those nutrients from your diet. 

Again, we’re really not trying to tell you, “Everything you’re doing is wrong.” It’s really about how you can upgrade what you’re doing or make small changes on the margin that can have a huge benefit for you and your baby. 

Meagan: Yeah. I was going to say, All I can see is that it’s an improvement. We’re making improvements. We grow and make improvements in everything in our day-to-day lives. This is one that is really important so that’s why we’re doing this today. We’re sharing this so we can make improvements. Sometimes just it’s just small tweaks to benefit ourselves. 

Okay, so now we’re talking about all of the things that we really should be looking for nutrient-wise during pregnancy. Are there any nutrients we really should be avoiding taking during pregnancy and through your guys’ research, have there been some of those ingredients even in prenatals out there? We were just talking about folic acid and folate, but are there any where you are like, “Okay, if you see this, this is one of those tweaks that you really should make”?

Julie: Yeah, it’s a great question. We talked about folic acid. We would suggest avoiding that nutrient. The other very common nutrient form that we suggest avoiding is a form of B12 called cyanocabalamin. It’s easy to remember because it’s actually derived from a cyanide molecule. 

There is just not research to substantiate. It’s a synthetic nutrient form. It doesn’t exist in nature and there’s not safety data to suggest why you’d want to consume cyanocabalamin. We’re leveraged the two naturally-occuring active forms, methocobalamin and adenosylcobalamin. We use those in a 50-50 ratio. 

Try to avoid cyanide if you can. Try to avoid synthetic folic acid. We’re always using nutrient forms that exist in nature and we think that that’s the best way to make sure that we’re on the side of safety. It’s often contrary to cost. Those synthetic nutrient forms tend to be cost-effective but they really don’t necessarily perform as nature intended. 

Meagan: Right. 

Julie: And then another one that’s maybe a little counterintuitive or nuanced is the nutrient iron. Most prenatal vitamins have iron in them. We chose not to include iron in our prenatal for a few reasons. Iron is absolutely an essential nutrient for pregnancy and postpartum. It supports your blood volume. Your blood volume effectively doubles in pregnancy and you lose blood postpartum. It’s a super important nutrient for avoiding anemia and for just overall blood volume expansion during pregnancy. 

The reason to not include it in a prenatal is that your needs vary by trimester or by stage. We wanted to make a prenatal vitamin that was safe to take before, during, and after pregnancy and safe for all women to be taking. Iron also competes with calcium and other nutrients for absorption in the body. Oftentimes, prenatals will just include both calcium and iron and you can be pretty well-assured that the calcium that you’re taking isn’t going to be absorbed in that case. Or sometimes they just leave calcium but they don’t tell you that you should take calcium at a different time of day. 

We’ve kept calcium in our prenatal and we offer iron as a separate add-on. The advantage of that is that you can take exactly what you need. If you’ve done any iron testing, which is pretty common in pregnancy, you can tailor the dosage to your ferritin levels. That’s the type of iron testing we recommend. 

And then taking it at a different time of day ensures you’re absorbing all of the calcium that you need as well as all of the iron that you need. We like delivering iron in the kelated form bound to glycine. It’s much gentler on the stomach. A lot of prenatals have a really high dose of iron in a form that’s not well-absorbed. It can cause GI issues and then women will stop taking their prenatal because they say it makes them nauseous. 

Meagan: Yes!

Julie: There are many reasons why we think that iron in a prenatal is suboptimal. I think if you don’t know that information, you might scan prenatals like Needed’s and say, “Oh, it doesn’t include iron. That’s a problem,” and it’s actually a really intentional choice so I like to call that nutrient out. 

Meagan: I love that you talked about that because as a doula, we actually do have a lot of clients who pee on a stick, see it’s positive, and start looking for a prenatal. We have clients that do hire us in that stage and we’re always there for our clients. They’ll be writing us and be like, “We’re just so sick and it seems to be after I take my prenatal,” so they stop taking their prenatal because it makes them sick or their nausea gets so intense when in fact, it’s not what we should be viewing. Again, not to shame anyone if you’ve stopped taking your prenatal. We should be taking our prenatal, but we don’t think about that. 

I love that you guys have done that. I’ve been sharing it since I learned about this. I’ve been sharing that with my clients really early on because I think it’s really important. Something also I love about your products is that there is a lot that can help with nausea as well. 

Julie: Yeah. I’m glad you mentioned that because that’s one of the key reasons why it’s really, really beneficial to start taking a prenatal vitamin before you try to conceive. We suggest up to 6-12 months before conception getting on a high-quality prenatal vitamin for a couple of reasons. One is that it can support cycle regularity so ovulation and healthy ovulation. It can also support egg quality. We have now a separate add-on, egg quality support, which is amazing in helping your egg follicles as they mature into egg cells before ovulation which is great. 

And then it can help you to build up your nutrient stores. Oftentimes, and I’ve been there. I’ve had first-trimester nausea despite all of my best attempts and taking all of the right supplements. Sometimes it just happens. You can minimize nausea by having adequate nutrient stores prior to conceiving. And then if you do find yourself with severe nausea in the first trimester, if your nutrient levels are optimal pre-conception, it’s more tolerable to skip a day or two of your prenatal vitamin because your levels were already in a great range before so your body has enough nutrient stores. 

I’m not advocating not taking your prenatal in the first trimester, but if life happens and you skip some days, the fact that you started early on means that your body is going to have enough of those nutrients to draw upon to get you through to the second trimester when hopefully you’re feeling much better. 

Meagan: Right. If we have really bad nausea and vomiting and we’re throwing up all of the time, we’re also losing nutrients, so it’s a whole cycle. It all goes together. 

Julie: Yep. It sure does. It sure does. Not to push our products, that’s not what this is about, but I would say hydration, hydration, hydration for nausea. We have hydration support if you are interested at all in trying it, I suggest trying it. It has the right nutrient ratios for pregnancy. It’s made without artificial sweeteners. It just has monk fruit which is naturally occurring. It comes in three flavors, three very first-trimester-friendly flavors. They are citrusy so grapefruit, lime, and lemon. 

But you can also make hydration stuff at home. You can just take a glass of water and put in some sea salt. You can add a squeeze of lemon. You can add in– you probably have your own recipe for a labor aid, but that’s another use of our hydration support during labor. Hydration can really impact. It’s like the chicken and the egg. “I’m nauseous. I don’t want to drink water. Water makes me nauseous,” but also if you’re dehydrated, nausea is worse. I would really recommend trying to stay hydrated during the first trimester if you can. 

Meagan: Yeah, absolutely. From the first trimester to the end, sometimes we can have early prodromal labor and stuff like that when we’re actually dehydrated. 

Julie: Exactly. 

Meagan: It’s just so, so, so important the whole time. 

Julie: And just to support that blood volume expansion that we were talking about that takes place in the second and third trimester. It has to come from nutrients but largely water. Your amniotic fluid levels increase. Sometimes they decrease too and they risk you out of a VBAC or a home birth and the things that you want for your birth outcome. So yeah. Hydration is key. It’s your mom’s advice, “Make sure you’re drinking enough water,” but it’s really true. 

Meagan: It really is true. My kids all roll their eyes at me. They’re really big into sports and I’m like, “No, your body, your muscles, and everything needs that hydration.” 

Okay, so we’ve talked about when it’s good. We’ve talked about taking it before. One of the questions is, “Oh, I’ve had my baby. I’m done with my prenatal vitamin, right?” But we talked a little bit and skimmed the surface about why it is important to take it during breastfeeding. We talked a little bit about how it’s still depleting our bodies, but after having a baby, how long should we be taking these? Then if we want a close baby, is it something that we should just continue?

Julie: Yeah. Yeah, great questions. The minimum that we would recommend is 6 months after delivery and that is whether or not you are breastfeeding. So from your choice or from how things turn out and you aren’t lactating, it’s still beneficial to give your body that time to replenish because pregnancy and labor are really depleting events on the body. It just takes time to rebuild those nutrient stores. That’s the minimum. So yes. Please, keep taking a prenatal vitamin postnatally. 

There are postnatal vitamins on the market. Generally, that is a marketing differentiation, not a product-quality differentiation. Most postnatal vitamins are almost identical to their prenatal counterparts except for a couple of nutrients where they take maybe 25mg more vitamin C which is less than you would get from one strawberry. It’s basically a marketing play. 

We skipped that step and we just offer one prenatal vitamin that’s appropriate for the entire perinatal, before, during, and after stage. And then if you are breastfeeding or pumping or otherwise producing milk, we recommend staying on a prenatal vitamin for that full duration of time. If you can give your body a couple of months once you stop lactating, that’s really beneficial for the same reasons we just discussed. It gives your body a chance to recuperate. 

There is a concept known as the recuperative interval when we’re thinking about pregnancy spacing if you’re having multiple kids. I myself did not do this. I breastfed my first daughter basically until the day my second daughter was born. Maybe not optimal– optimal in some ways, not optimal in others. 

Meagan: Really common, though. 

Julie: Really common. Yep. 

Meagan: A lot of people do it and then they want to feed both babies. 

Julie: Exactly. Or maybe you can breastfeed until you’re pregnant with the second. In any event, that is a reason why you should keep taking your prenatal vitamin because it ensures that your body has enough nutrients to give to your baby. Basically, the order of operations is going to be growing baby gets first, older baby gets second, and mom gets last. 

So if you are nursing while pregnant, if you are tandem feeding, that’s what your body is going to do. It’s evolutionary. Your body is really smart. Except for in the example that we talked about in the recording about severe postpartum hemorrhaging, your body’s first priority will be surviving but second to that, your body is going to give to baby before it gives to older baby before it gives to itself. Make sure to take your prenatal vitamin all throughout. 

I think that’s a general misunderstanding. A lot of women are like, “I’m not pregnant anymore.” Men, when looking at the category when Ryan and I were starting the company, they’re like, “It’s 9 months. You’re going to have a customer for a maximum of 9 months.” We were like, “Just frankly, you’re wrong,” because this is a life stage that women are in for five years, or seven years, or ten years. It’s a much longer life stage when you account for trying to conceive, pregnancy, postpartum, breastfeeding, trying again, or preparing to conceive again. That’s why this is a consequential decision and taking care of your body during those five or ten or one or two really intensive nutritional years can set you up for long-term health and your babies up for long-term health for the rest of their life. 

Meagan: Yeah, absolutely. I was one of those after my first. My provider didn’t say, “Continue taking these vitamins.” That wasn’t even a discussion. It was, “How are you feeling? What birth control would you like?” That’s really the conversation that we had. Again, we’re not shaming the provider for that but that’s just following the script. “Okay. We’re six weeks. This is what we’re doing.” I just needed so much more. 

Julie: At six weeks, honestly, nutritionally depletion-wise, you are nowhere near recovered even if your scar is healing well from a Cesarean or if your stitches are healing well from a vaginal delivery. Emotionally and physically, we are very much postpartum at that point. Even at the stage I am now at 9 months postpartum, this is still postpartum. We call it the fourth trimester sometimes which at least allows for three months, but in a lot of years, it’s two years after having a baby that your body is still returning to homeostasis, whatever that homeostasis is for you. 

Meagan: Right, and then by then, we’re kind of entering that prenatal stage again. 

Julie: You could be. Exactly. 

Meagan: Right? A lot of people are. I love this. Okay, so a couple more questions. I know we are kind of running out of time, but collagen is a big thing that I never really heard about when I was pregnant. The words didn’t even come out of anyone’s mouth. I honestly didn’t even read it online. You guys have prenatal protein collagen or collagen protein. I think it’s important to talk about that too because it can impact us in a really positive way not only during but especially after healing from surgery or anything. We’ve got tissues that are healing so I don’t know if you’d like to share a little bit about the protein. 

Julie: I’d love to. I think that this is something that we are super passionate about and something I learned a lot about when we were in the formulation stage. We know that protein requirements increase substantially in pregnancy. You need 80-100g of protein a day. That is the low end of the range. There is newer research showing that you need upwards of 140g of protein a day. That’s a lot to hit when you’re pregnant. 

Those needs are there because you’re growing a baby obviously. Amino acids are the building blocks of life, the organ that you’re growing, the placenta, and blood sugar regulation. Especially as your blood volume is expanding, protein is really important for stabilizing blood sugar and for a lot of other things. We love collagen proteins specifically because it’s a single ingredient. It’s really cleanly sourced. Plant-based proteins can be high in heavy metals whereas we don’t find that to be the case with collagen protein. 

The amino acids in collagen protein are specifically really beneficial for pregnancy. Two of them, glycine and proline, are conditionally essential meaning that your body can’t synthesize them on their own. They have to be consumed by food and many of us are not consuming the foods that are high in glycine and proline like the carcasses of animals and the skins and bones. It’s just not very common, especially in pregnancy. We tend to eat boneless, skinless chicken breast. Maybe some even have animal protein aversions during pregnancy. 

Collagen is an awesome form of glycine and proline and overall meets your protein needs. It’s effectively flavorless. You can blend it into smoothies. It blends really well with our prenatal multivitamin powder. You can mix it, especially for those first-trimester mamas, into mac and cheese. You can mix it into just about anything to get some protein in even when you’re feeling a bit nauseous. 

Then for postpartum, why it’s beneficial is that your skin tissue stretches. It needs to recover whether that’s because you had a vaginal delivery or a Cesarean. Collagen can be really, really helpful for tissue healing and repair and recovery in that regard. 

The last thing I should mention is that the placenta is actually comprised of collagen so it really makes a lot of sense to be consuming those building blocks when you’re making your new organ for pregnancy. 

Meagan: Yeah. I want to share with you guys that I love it in my oatmeal. 

Julie: Yeah, that’s awesome. 

Meagan: I put it in my oatmeal. I’ll put some apples and a little bit of cinnamon and it works really well. I actually put a little bit of yogurt. It’s amazing. 

Julie: I sneak it into my daughter’s oatmeal. She calls it sprinkles. Kids have lower protein requirements than adults of course, but it helps to balance out their blood sugar too in a really beneficial way. Making sure she’s not bouncing off the walls more than necessary. 

Meagan: I love that. I love that. That’s something too I love. A lot of this is really good for kids. We could go into it. There are so many other products. There are a lot that my kids love as well. 

Okay, so the last question, we kind of talked about this in the beginning how we can get this through food. It’s hard to get that because we’re not typically eating carcasses and skin and liver, right? 

Julie: Yep. 

Meagan: So what are some foods that we can drop for this audience to eat that help us during pregnancy just in general and in postpartum that will help us in addition to Needed and other products? 

Julie: Well, I would say that in general, we are huge advocates for food. You can’t out-supplement a bad diet. Food should be a critical component of your nutrition plan. It’s just really hard sometimes to eat optimally. But foods to focus on during pregnancy, are lots of organic if you can, leafy greens, vegetables, and fruits. Eat the rainbow. I think some people tend to be afraid of fruits because of the sugar content and gestational diabetes but there is fiber in fruit. Unlike fruit juice, there is actually fiber in fruit. You can pair it with something like nut butter to add a little bit of protein and fat to help with blood sugar stability. 

Other things to focus on are prebiotics and probiotic-rich foods like kimchi and depending on your stance on it, I drink kombucha during pregnancy. There is a tiny, tiny, tiny amount of alcohol in it but the benefits to me outweigh any potential risk of alcohol content. Sauerkraut is another really great one and fiber. A lot of women during pregnancy have hemorrhoids or they’re constipated so foods that are rich in fiber are generally very good for you and your baby. 

Probably one of my favorites when I’m pregnant– I tend to fall off the wagon a little bit postpartum because you have a newborn and whatnot, but I’m usually really good at smoothies during pregnancy. Smoothies are a great way. You can put our collagen in it or our prenatal multivitamin powder. If you are not a capsules fan, you can even take our pre-probiotic and add it or vitamin D. You can add in a lot of our capsule products. Just break open the capsule and dump the powder contents into the smoothie. 

That’s a really great way to put in greens and fruits and whatever else– nuts, seeds. That’s a great way to get in your fat content. That’s definitely one of my favorites as well as depending on the season. If you’re pregnant more in the winter months, you can make soups. Stir the collagen protein into the soup. Try to load it with those other fruits, vegetables, and fiber-type-rich foods.

But I think we’re really, really passionate about debunking some of the concerns around pregnancy like pregnancy weight gain. You are eating for two. It doesn’t mean you should go load up on ice cream and pretzels and chips. Some of that in moderation is totally fine, but think about nutrient density. That’s what you’re going for both for you and your baby. It’s going to help you avoid depletion, to feel better. 

Pregnancy, even if you’re eating well, is pretty uncomfortable so I think eating foods that are going to nourish you and leave you feeling good is definitely the priority. We do share some really great recipe ideas over on our Instagram. A couple of people in our network that you can check out if you’re looking for more food recommendations, the prenatal nutritionist, Ryann Kipping, has a prenatal nutrition library that is full of really great food-based nutrition ideas. We also love the work of Lily Nichols. She’s really popular with midwives and doulas also. 

She wrote a book called “Real Food for Pregnancy” that has some great, practical tips for nutrient-dense meals. A lot of what she’s recommending is going to sound familiar from this podcast like collagen and eating more meat than you might think you need and eating more. 

Honestly, I say this coming from the perspective of having been a vegetarian and a vegan for a long time. I think that you can do that during pregnancy but you have to be really intentional about protein and about nutrients like vitamin D and choline. It’s much more difficult but it’s possible. I would not advise undergoing a vegetarian or a vegan pregnancy without working with a dietician or a nutritionist to help you figure out what those nutritional gaps could be. 

Meagan: That’s a really good point because we do. We know we all eat differently and we all have different allergies and things that have developed so that is really, really important to know. We are going to have all of these links that she is mentioning like the blogs, the recipes, all of this linked in the show notes. So if you want to go and dive in–

Julie: Nerd out with us. 

Meagan: Nerd out and get your teeth sinking into this, then check it out because you guys, Needed is just amazing. Really, it’s such an honor to have had you on today to be talking about this. 

Julie: Thank you for having me. 

Meagan: Because it is so important. With my first and second pregnancies, I was healthy-ish but each pregnancy got better because I learned more. 

Julie: Isn’t that amazing that there is this concept of, “Oh, you’re too old or you’re subsequent.” If I have a third, I’ll be a geriatric mom but it’s so much more about your health span or your health status than it is about age in some ways you can have your healthiest pregnancy at 40 if you’re doing the right things and taking care of your body in the right way. 

Meagan: Yeah. Yeah. My best pregnancy was the older one. The oldest that I was. I was the oldest in my pregnancy and it was my best pregnancy. It just impacts. I wanted to touch a little bit on what you said that sometimes we hesitate to eat or we are eating the right things. Women of Strength, if you are listening, I know that as a person wanting to have a VBAC and as a mama wanting to have a VBAC, sometimes we get scared of the world out there saying, “Your baby is too big and you can’t have a vaginal birth.” 

I saw just today three posts in our community, “A doctor said that my baby is too big.” Then we sometimes tend to hold back and not get the right nutrients, right? Not purposely, but purposely because we’re trying not to make too big of a baby because we really want this vaginal birth. It’s all twisted and I don’t love it, but it’s really important to remember like she was saying, get these nutrient-dense foods in you and don’t be scared to supplement. Don’t be scared to supplement because our bodies and babies deserve it. We deserve it. 

Julie: Yep. And on the other side of birth, I tend to feel that bigger babies sometimes sleep better. They sometimes eat better. My second daughter was almost 9 pounds, but the first daughter was late. She was born almost at 42 weeks. I was so nervous about it, but she was a champion sleeper and feeder. I think there is a lot of natural wisdom in that your body knows how big of a baby to grow and your body knows how long to carry that baby for. But I loved this conversation. I think it’s so important. It might not be immediately intuitive why nutrition and birth outcomes go so hand-in-hand, but they do.

Oftentimes, what risks women out of the birth that they want whether it’s a VBAC or just a primary first-time vaginal birth is a factor that can be traced back to nutrition like preterm labor or gestational diabetes or whatnot. We are very aligned on the idea that nutrition for prevention and for optimal outcomes. 

Meagan: Yeah. Yeah. I had a client during COVID who had pre-eclampsia. She got it at 18 weeks. She had a home birth planned and all of these amazing things planned. She had to completely shift gears. The second one, she was like, “I’m going to start trying soon and I’m going to dive in.” She did. She dove in and changed so many things and had an incredible, incredible home birth with her second. She was like, “I really do feel that because I fed my body and fueled my body, it gave back.” 

We know that sometimes we do all of the right things, everything, and still, we have undesired outcomes. But if we can do everything within our control, if we can do what we can within our control– 

Julie: That’s exactly it. Yeah, I’m nodding my head here because we keep saying to ourselves and are starting to say more externally that there is so much on this journey that you can’t control. You can do everything right and still have things not go as you want. That’s just a reality. But nutrition is a big one that you can control so why not focus on the things that you can control and let go of the rest? 

Meagan: Right. Absolutely. Well, we will end on that note because I think that is such a powerful ending point. I want to share with everybody that we are going to have the link in the show notes, but if you want to go check out Needed and all of the amazing products because we just barely touched on a few today, you can go to thisisneeded.com to learn more about Julie and Ryan and go learn about their partners. There are a lot of partners that we’ve actually had on the show. We just love you guys. We appreciate you so much so thank you for taking the time today.

Julie: Absolutely. It was really 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.

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We are joined today by Dr. Barry Brock, aka “The King of VBAC” along with one of his VBAC-hopeful patients, Kara. Kara and Meagan ask Dr. Brock VBAC-related questions similarly to how we hope you interview your providers during your VBAC preparation. 

Dr. Brock touches on topics such as gestational diabetes, big babies, preparing for your VBAC, induction, placenta previa, preeclampsia, HELLP syndrome, VBAC after multiple Cesareans, and vaginal breech delivery. 

Additional Links

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello, everybody. Welcome, welcome. We have a really cool episode for you today, an episode that we have been really anxiously waiting for and so honored to be having. We love having birth professionals on the podcast and today we are so honored to have Dr. Barry Brock chatting with us today about birth and VBAC and all of the things.

 

And then we have an extra special cohost today, Kara Sutton, who is actually one of Dr. Brock’s patients. Hello!

 

Kara: Hi guys. I’m so excited to be here.

 

Meagan: So excited to have you guys. I just wanted to share a little bit about the amazing Barry Brock before we get going into all of these amazing questions that this community has asked. Dr. Barry Brock has been a doctor for over 30 years and has experience in obstetrics and gynecology. He has been attending as a doctor at Cedars and I believe Dr. Barry Brock, you had your residency there, right?

 

Dr. Brock: I did.

 

Meagan: That’s really cool so you’ve been there for a while. Dr. Brock is amazing and takes pride in giving quality care to all of his patients. Seriously, one of the coolest things—I mean there are a lot of cool things—but especially with me in the VBAC world, one of the coolest things to me is that you have an outstanding Cesarean rate. It’s very low. I think that’s one of the things that you are very well known for along with helping people have vaginal breech deliveries which we know is kind of trickling out in the world and vaginal twin deliveries and of course, VBACs. So welcome, Dr. Brock, and thank you so much for being here with us.

 

Dr. Brock: It’s my pleasure.

 

Meagan: Oh my gosh. Yes, and as I mentioned, we’ve got Kara who is a patient of Dr. Brock. Kara, tell us how it is to be a patient.

 

Kara: I am a mom of two. I had an emergency and I had a planned C-section due to PTSD from that first emergency C-section. Now I am four months pregnant with my third baby girl and Dr. Brock is my doctor. I’m excited to try and achieve a vaginal delivery with this one. Dr. Brock has the LA rep as the go-to VBAC doctor if you’re trying to achieve VBAC so that is why I am seeing him. I switched doctors specifically for this pregnancy which I think is super important to find the right doctor. I feel really excited and comfortable with Dr. Brock for this particular delivery, especially after the trauma from the first two.

 

For those of you guys who don’t know, Cedar Sinai is a really famous hospital in LA. We’re in Beverly Hills here today. Everyone from Kylie Jenner allegedly and Jay-Z and Beyonce and all of the people have delivered there so he’s kind of a rockstar. So I’m excited.

 

Meagan: Yes. Oh my gosh. It is such an honor. Such an honor so thank you both for being here.

Kara: Yeah, so I kind of wanted to jump in right away and wanted to ask Dr. Brock, why do you think the national average C-section rate is so high and why do so many doctors just schedule a C-section?

 

Dr. Brock: Well, the docs are very concerned about a healthy baby and a healthy mother. It takes the stress off of the doctor if there are any problems getting the baby out, but there’s no evidence that we’ve improved the Cesarean section. We have massively increased the Cesarean section rate and we have not improved the fetal outcome.

 

So obviously the system that we’re going with here needs to be tweaked a little bit. But they also need experience. To do a vaginal breech delivery, you have to have the skill and expertise to be able to do that and if you’re not doing that, you don’t have the skills so for a lot of doctors, for them, it’s safer to do the Cesarean section than to do a vaginal breech delivery.

 

I understand that. You’re not skilled. Among the criteria that the American College of OBGYN recommends is that if you’re doing a vaginal breech delivery, you have to know how to do it. Of course, if you don’t do it, you don’t get it done. 

Another thing is that doctors are very concerned with fetal monitor tracing and they are concerned about the baby’s health and well-being. So when the baby comes out, the other side of the coin is that we do lots of Cesarean sections for fetal distress but most of those babies come out screaming. Well, you can say that we saved this baby from getting in trouble or we did an unnecessary Cesarean section. 

Remember there is also the mother’s health and the baby’s health. There’s a higher risk to the mother’s health– ten times greater having a C-section than a vaginal delivery– but extremely rare. So that’s not a major factor. You say ten times greater but the incidence is so low. It’s much greater that you walk outside when it’s raining and get hit by lightning. But still, in LA, it’s a very rare thing so I’m not concerned about that. 

Doctors want the best for the baby. It seems like this. A lot of the time they can get away with a Cesarean section. Some insurance companies pay for more Cesarean sections. You don’t have to go ahead and spend hours and hours in labor. 

My philosophy is a little different. But you need the skill and expertise. That’s when obstetricians can deliver a healthy baby vaginally. 

Meagan: Yeah. Wow, I love that. I feel like we could do a whole podcast just on this question alone because it is such a big question. Like you said, I love that you touched on what if we’ve got a Cesarean but the baby comes out screaming? We’ve had people say, “I’ve had this emergency C-section but then my baby had an 8/9 APGAR so was my baby in distress?” So thank you so much for touching on that. 

Another big question that we have that a lot of people ask is the big baby question. What if I’m being told that my baby really is too big to give birth vaginally? Is that really a thing? What’s the accuracy on that and how would I know if choosing a Cesarean is the right choice versus going for a vaginal birth after a Cesarean? What’s the safety there for the baby?

Dr. Brock: Well, a major concern is– the American College addressed that. It is with mothers that are diabetic and have gestational diabetes. If the baby’s over 4500 grams, which is a very big baby, then consideration should be for Cesarean section for the risk of shoulder dystocia. But that’s it. At 5000 grams, if you do not have gestational diabetes, that’s a huge baby. 

Kara: What is that in pounds? 

Meagan: It’s like 9 pounds. Is it 9?

Dr. Brock: 12 pounds or something like that? It’s a huge baby. 

Meagan: Yeah, anything over 11 is an extra large baby, and then at 9 pounds, 15 ounces is where they start paying attention, right? 

Dr. Brock: Yeah, but the biggest problem with shoulder dystocia is if you have a very large baby and you do a mid-vacuum or forceps, then the incidence of having shoulder dystocia is very high, like 25%. 

But most of the time, mother nature goes ahead and plants the hat and wants a vaginal delivery. It’ll tell you. Maybe it’s stuck or something like that. But to me, it’s always worth a try because basically, you’re saying that mothers who are diabetic would have died in labor. Mother Nature knows what to do. When you give it a chance to prove it, I’ve seen it all. I’ve had a mother who had two Cesarean sections for a 6-pound baby so she really wanted a vaginal delivery. I waited and waited and waited and she delivered her 9-pound baby. 

 Mother Nature knows what to do. 

Meagan: Right. So for gestational diabetes, maybe if they are controlled and everything is looking good and the baby doesn’t look like it’s 12-13 pounds or a really large baby, you still feel that it’s reasonable to go for a vaginal birth? 

Dr. Brock: I practically always think it’s better for a vaginal birth. I mean, there are exceptions. I do VBACs after two Cesareans. I don’t do it after three. The incidence for you to rupture after one Cesarean is 0.5-1% which is very small. For two Cesarean sections, it’s 5% but then it climbs dramatically after that so I don’t do that. 

Obviously, you have to look at if the placenta is implanted properly. If the patient is of an abnormal presentation of the placenta with placenta previa or accreta. Accreta is when the surface of the placenta digs itself into the wall of the uterus and that presents a major problem. That’s a good idea to get a good center who knows how to handle it. 

Meagan: Absolutely. 

Dr. Brock: But Mother Nature– give it a chance. 

Meagan: Give it a chance. 

Kara: I’m interested. So why won’t all doctors induce VBACs? What’s the best method for induction and what should I do if my doctor refuses? 

Dr. Brock: I induce for medical reasons. When someone has a previous Cesarean section, we don’t give prostaglandins because that has shown an increased chance of rupture. I much prefer all my patients to go into labor spontaneously. I sign for a lot more testing after 40 weeks. It depends if we find medical problems but they’ll test twice a week to make sure the fluid’s normal, the Doppler flows are normal, and the NST are non-stress tests where we see baby’s heartbeat. 

I consider 42 weeks as normal. If someone’s, like I said, diabetic, I’ll do 40 weeks unless there are other problems. But I prefer them to go into labor naturally because I think it’s easier on the mother and it’s a higher success for a vaginal delivery. But saying that, this week, I’ve had a mother who had a baby who was abnormal and it was going to be fine. He needed heart surgery. She had two previous Cesarean sections. We induced her and she had a vaginal delivery. The baby, thank God, is doing fine. We will do heart surgery probably in 3 or 4 months. 

Each person’s different and we have to take everything into consideration. Right now, I like to wait for Mother Nature to do its thing. Keep an eye on Mother Nature, but let mother nature do its thing. 

Meagan: I love that. Keep an eye on mother nature, but let Mother Nature do its thing. Because we do, we have so many people writing in saying, “My doctor says I have to have a baby by 39 weeks spontaneously or my chances of VBAC are completely out the window and I have to schedule a Cesarean.” It puts people in a fight or flight mode where they are out there trying to do all of the things to try to be induced but it’s not working because their body is not ready when really what we need to do is step back and let Mother Nature do its thing. 

Dr. Brock: Well, there are exceptions. Obviously, someone who is sitting in my office and is 3-4 centimeters dilated and she’s 39 weeks then she’s an easy induction. If you’re closed and high, then don’t rush to an induction. 

Meagan: Right. Right. 

Dr. Brock: For each person’s safety, individually you have to do that.  

Meagan: And that is one of the most important things I think any provider out there should view is that everyone is an individual. I’m not the same as Cara and Cara’s not the same as this mom that just had her VBAC after two Cesareans. We’re all individuals and have different situations. 

So one of the big questions is breech. If we have someone that is having a breech baby or their baby is breech and not turning, a lot of people just have these repeat Cesareans and we know that you are really big in supporting that. Obviously, there are again, things that have to pan out. But why do you think breech is really going away? If someone is having a breech baby, what can they do to help avoid that C-section if they don’t have a provider like you that’s maybe more supportive of having a breech delivery?

Dr. Brock: Well obviously, because in today’s society of birth, people don’t have the skills to do a breech delivery. You can’t have a breech delivery unless your provider knows how to do it. The first thing I want to do is try to turn the baby. At 37 weeks, we will schedule you. We do it at 37 weeks because statistically if the baby hasn’t turned at 37 weeks, there is less chance that he will do that. Also, the fact that if something happens in a version– I’ve done hundreds of them and I’ve never had a problem but theoretically if something happens and we do a Cesarean section, baby is at term at 37 weeks. 

That’s the first thing I would do. With the breech delivery, I treat a breech delivery– I don’t care if it’s a first-time mother or a second. I do the same thing. Just like Kara, when she gets around 6-7 centimeters dilated, which means the active phase of labor– she can labor at home or wherever, but once she gets to 6 or 7 centimeters, I want everything to go quickly. What I mean is that I want her to dilate quickly. I want the butt to settle down quickly and I want to push her out quickly. You’re not going to push for 3 or 4 hours. I’ll do that for first-time mothers or with any mother head-down but not with a breech. I want it to go quickly. 

A lot of babies don’t do that, but that’s where I stay safe because if it flies out, it flies out. The biggest problem with breech delivery is that the head is coming last. The cord is beside the head so you’ve got to get the baby out quickly. Using those criteria, I’ve had very good success and no problems, but I’ve done many Cesarean sections because obviously, I remember one patient who came in. She was 9 centimeters. It was fantastic. She was doing great. She started pushing and all that came down was the testicles. 

So I sectioned for a 10-pound baby. So mother nature is telling you, “Just because you’re committed to a vaginal delivery, you don’t drag the kid out.” The idea is to let the baby do its thing. The reason we want butt down, especially in first-time mothers, is that if it’s not his feet coming out, the cervix may dilate to 6-7 centimeters and the feet come out and the body comes out and the cervix is not fully dilated when it gets to the head and it gets trapped. 

The cervix never clamps down. It just never fully dilates. That’s why we usually don’t do footling breech. We don’t do vaginal delivery. There are exceptions, but rare exceptions. If a multiparous patient comes in and the feet are there and the cervix is completely dilated, the baby just falls out. That’s really an exception to the rule. 

The other concern with a footling breech is especially if the mother is dilated, that patient is concerning because if the water breaks and she’s dilated and just the feet are there, the cord may fall out. It’s called a cord prolapse. That’s a contraindication to try to do something at home. If someone is dilated and footling breech, that’s the kind of patient I would bring to the hospital and do a C-section for cord prolapse. 

Meagan: Yeah, which makes sense. There are not a lot of you out there that will support or is trained and educated in vaginal breech delivery and from what we’re gathering is that it’s not really being taught a ton in medical school anymore. Is that correct? 

Dr. Brock: Well, not in my residency. I mean, I may offer to do that but it’s easier. I mean, you schedule a C-section. You walk in. It’s an hour. You’re done versus spending 8, 10, or 12 hours laboring this patient. So the incentive isn’t there to do that. So the skills are disappearing. I mean, I’ve offered to come in and assist anyone who wants to do a breech delivery and I’ve done that but not that often. 

The residents are always invited. They can do that but just because they do it in residency, it’s a big staff to get through. They may do one or two breech deliveries but they don’t feel comfortable to keep on going out in the private practice. It is dying out. 

Meagan: Yeah. It makes me sad. It makes me sad. 

Kara: I have a question because I have had two C-sections. How long should somebody wait to conceive after a C-section? I’ve heard mixed things about this. I’ve been told mixed information about this and I just would love to hear your point of view on that. 

Dr. Brock: Well, there’s some data to show that ideally it is two years apart but everybody’s facts come into play. For someone who is much older and has trouble getting pregnant, if someone had a baby at 40 and wants another child if she is waiting until 42, she may never get pregnant. 

I’ve not found it to be a big factor but statistically, it does seem to be safe. I would do psychologically what’s better for you how far apart you want to have your kids. Besides, mother nature does help. It takes some time to get pregnant as you get older. 

Kara: Great. Is the thought that the longer you wait, the more healed your C-section scars are and your uterus is stronger or is that not real? 

Meagan: Like is there less chance of rupture that way? 

Dr. Brock: Literature is in my mind, not that clear. Statistically, it’s probably true but it’s like saying you’re at a greater chance of dying if you’re driving at 58 miles an hour instead of 55. It’s true, but statistically, is it really a factor? 

Meagan: It’s not substantial. It’s not anything that’s a concrete yes or no. Okay, and talking about VBAC after two Cesareans or more, what are the complications surrounding a C-section or even a repeat C-section? We talk here a lot about the risks of VBAC– rupture and things like that– but we don’t talk a lot about complications, especially even years later. Are there complications for people who have had Cesareans even years later? 

Dr. Brock: Years later, I don’t know much about that. I do know the higher the Cesarean section rate, you’re going to have an increase of abnormal implantation of the placenta from accreta or things like that. It goes up. Instances of rupture with more Cesarean sections go up. I’ve done Cesarean sections, 5, 6, and 7 Cesarean sections. It depends. The doctor who goes in there with all of the scarring, while it’s very, very difficult and dangerous, it may pass on to the next time, but most of the time, it’s not a problem at all. 

I have no limitations per se on how many Cesarean sections someone can have. I have a patient right now. She had a Cesarean section then I did a VBAC. Now she’s pregnant again but she wants a repeat Cesarean section because she had anal problems and she had surgery so her surgeon recommended that she doesn’t try for a vaginal delivery. I’m not 100% in agreement but I have no problem respecting her wishes and we set her up for a Cesarean section. Each case has to be individual. There are no absolute rules for anything. 

As far as consequences, most of the time for later on, there is but it’s more related to how many times you get pregnant, not how you deliver. Bladder dropping and things like this, each pregnancy puts a toll on that. I think mother nature plans for you to have your first kid when you get through puberty. I think it’s a very bad idea for 13-year-old kids to have kids. But mother nature, that’s the whole plan. That’s the animal kingdom. That’s what we do. Of course, for millions of years, you were dead at 20 but that’s a different story. 

Meagan: So kind of piggy-backing off of that question too, we had someone write in talking about how she had a Cesarean and then they went in for a second Cesarean but they didn’t use the same incision so she’s got two incisions which I had never actually heard of, in her uterus. In the uterus, they cut a different spot is what she said. She’s asking– okay, so now she’s got two incisions in her uterus. Is that something that would be suggested for her to VBAC because she’d really like a vaginal birth? 

Dr. Brock: No, that’s fine. First of all, the patient doesn’t know about the scar on the uterus. It’s the doctor. When I go in there unless someone had a vertical incision and there’s no such thing as a classical. They call it a classical incision, but that was done 100 years ago and they went up and down incision on the belly and they went up and down incision on the uterus. The top of the uterus is the fundus is what we never do. That’s at a much higher instance of uterine rupture. 

We used to do that. Somebody added, “Once a section, always a section.” That’s where that falls. I would say 95% of Cesarean sections are low-transverse. They are very low on the uterus. But when I go down and do that, I see the bladder there. I don’t know where the last Cesarean section was. I can’t see. I just tape down the bladder and make an incision so I have no idea in the uterus. But we do know that, like I said, during Cesarean sections and repeat, it’s not a problem. We do know that.

I’ve given it to patients that had previous fibroid surgery. The American College recommends, what is the indication for the surgeon? Does he recommend you for vaginal? He should tell you that. My philosophy is when I do that, it depends on if I enter the cavity of the uterus and whether I would recommend a Cesarean section. Sometimes the fibers outside of the cavity, I have no problem recommending a vaginal delivery. 

I’ve done vaginal deliveries after another doctor did multiple fibroids laparoscopically. They sewed it up and I asked him. He said, “Well, it should be fine. We did multiple scars and she did great.” Yeah, individuals.

Meagan: Exactly, yeah. Thank you. 

Kara: I have a question. I did not have supportive providers in regard to my first two deliveries. I had an emergency C-section and then a planned C-section and nobody brought up that I could deliver vaginally or any of that. I just felt like I had a C-section so I had to have one the second time around. So I wanted to know what are the ways to really help someone find a provider who actually tries for that? I think a lot of women can’t find the right doctor who can do that. 

Meagan: Yeah. 

Dr. Brock: It’s hard to say. Some hospitals publish the C-section rates of their doctors. That’s one way to look into it. But blogs and things like this, you have to talk to your doctor and see what’s comfortable. You can’t force your doctor to do something he’s not comfortable with. Many years ago, one of the doctors, an old-time doctor, refused someone to do a VBAC because he had a bad outcome with a baby. Your personal experience comes in. Everyone’s trying to do the best thing. They’re trying to do what’s safe for you and your baby. You just have to find a match that works for you. 

Kara: When you’re interviewing your doctor, what are the types of questions you can ask to get a sense of his or her skill level with it or comfort level with VBAC? 

Dr. Brock: Well, I’ve had a patient come in. She had three previous Cesareans sections. She wanted me to do a vaginal birth. I said, “Don’t. My limit is two.” They have it out to think that it’s the same but it’s not. It’s about talking to your doctor and asking them personally. “I’m thinking about having a VBAC. What do you think about it?” You want to be comfortable with your doctor and listen to his advice, but there are different opinions out there. 

If you’re comfy with your doctor and you trust your doctor, I have no problem if he feels that he did a section and recommends another section, I understand that. We do know that certain things that change behaviors. They talk about measuring the thickness of the scar, of the uterus, and things like this. A study just came out that found no correlation whatsoever. 

Meagan: I was going to ask that. That is a huge question too. “My doctor said I can’t because my thickness isn’t thick enough.”

Dr. Brock: Well, there was no correlation. It made me nervous. I had one who had a scar. They said she had a window in the ultrasound. She had two previous Cesarean sections. I delivered her baby vaginally no problem. After that article came out saying there was no correlation, and my experience showed there was no correlation but each case is individualized. I may have a previous rupture and that’s a different story. There is no good literature on that and it’s probably not worth the risk. 

Meagan: Right. What about single and double sutures?

Dr. Brock: The data shows that I will always use the double closure. The only thing I would make an exception for is that sometimes when they get their tubes tied and it will save some time while having a C-section or vaginal delivery. But no, literature says that double closure has lower chances of rupture. 

Meagan: Would you support someone wanting to VBAC if they had in their op reports a single-layer suture? 

Dr. Brock: Yes, I would. A higher instance doesn’t mean it’s going to happen. As all patients, with this one especially, when you have a previous Cesarean section, I don’t want you to deliver at home. *Inaudible* Usually, it’s not unreasonable to place an epidural catheter in. Not actively, but if something happens, we can just give you some medication so you don’t have to put them under general anesthesia. Just to be prepared.

Meagan: Right, right. Be prepared. 

Kara: You prefer that they labor at the hospital and not at home? *Inaudible*

Dr. Brock: Yes, yes. Right, because that’s a concern we have. The baby will tell us something. I did a VBAC last night and she’s not that tall. She’s only about 5 feet. This baby seemed huge but it was way out of bounds. The reasons are that the pelvic, mother nature doesn’t know about these Cesarean sections. So first-time babies go down low in the pelvis. The cervix is firm and holds the babies in there prematurely but after the first delivery, the cervix can get soft so mother nature keeps an eye until you go into labor otherwise you’ll deliver prematurely. 

But that’s when the head is high. The higher the head is, that’s going to put pressure on the scar. I feel much more comfortable as the head drops in the pelvis, it’s getting below the scar, and the chance, I think, of rupturing drops dramatically when the head drops. But mothers may not drop until they go into labor. 

Meagan: Right. Talking about preterm, if someone had a preterm Cesarean birth, are they a candidate in your eyes for a vaginal birth after a Cesarean? 

Dr. Brock: It depends on how premature. Babies vary with premature. We talk about if she didn’t go into labor, and they had to have it done. It depends on the thickness of her lower uterine segment. The doctor goes in. He may feel like there’s not enough safe room to make a transverse incision so he has to do a low vertical. The low vertical is associated with a lower instance of rupture. Mind you, before we say you have to find your records and find exactly what type of scar on the uterus it is. But now, American College says, “No. If you had a previous Cesarean section, unless you know that it’s a low vertical, then you can try for a vaginal.” If it’s a high vertical, definitely. Low vertical, it is a little different but we have to wait and see. 

I’m not against going for a repeat Cesarean section if someone had a 25-week Cesarean section. If the lower uterine segment was not developed, the doctor did it appropriately. There is no harm to the baby coming out low vertically extended up. 

Meagan: Right. That makes sense. Cara, did you have another question? I know that we were talking about it before. 

Kara: I was just wondering if I’m preparing for a VBAC, which I am in four months. Is there anything you recommend that patients should do to prepare for a VBAC? That’s something I think about all of the time. Is there anything that patients should do to prepare for that? 

Dr. Brock: There’s nothing. There’s really nothing that you can do.

Kara: No running?

Dr. Brock: You don’t want to gain too much weight during pregnancy. The more weight you gain, the bigger the baby so that’s a major factor. If you start gaining 40, 50, or 60 pounds, then the baby may be bigger and things like that. Most things to prepare are like with any pregnancy. Get yourself into shape before you’re pregnant. Get your weight down before you get pregnant. Those are major things that you can do. Once you get pregnant, we tell you not to gain too much weight, but we don’t want you to lose weight. 

Exercise can always be done during pregnancy, but I always prefer getting into shape before you get pregnant. 

Kara: No one ever tells you that. I swear. Or at least no one’s ever told me that. I think that’s a good thing to know. 

Dr. Brock: Yeah, because you’re slim. 

Meagan: Yeah, well just being healthy overall and overall healthy. That’s not even just for VBAC. It’s just if you’re going to have a baby, try overall to be healthy in general every day. Even if you’re not having a baby. Good nutrition and all of that. Preeclampsia is something that is sometimes developed. Is that something that someone could TOLAC and have a VBAC with? 

Dr. Brock: Yes. It really depends but nowadays, with previous history, we give baby Aspirin and try to lower the incidence of recurring. We keep track of the blood pressure throughout the pregnancy. But yes. If I knew the cause of preeclampsia, I’d win the Nobel Prize. It’s the mystery of mankind. We know it’s associated with first-time mothers, elderly mothers, and twins, but we don’t know exactly the cause. All we can do is keep an eye on it and make sure it doesn’t occur. Now if it does occur, unfortunately, the delivery for that and the treatment for that is delivery. 

Meagan: Right. This is a spinoff but HELLP syndrome. If someone develops HELLP syndrome and their platelets are good and everything, are they still candidates for VBAC or is a Cesarean delivery really safer? 

Kara: Can I ask, what is that? 

Dr. Brock: First of all, it’s a subset of preeclampsia hypertension *inaudible* where the mother can get elevated liver enzymes and low platelets. That is an absolute indication that we have to deliver the baby. Okay? Now, people go ahead and say, “Oh, well you were *inaudible* delivery. We should do a Cesarean section.” I have nothing against doing that but if a patient is, it may take a long process because she’s not ready, but I think that she has to be managed in a hospital, her blood pressure is under control, and she has to go for delivery. 

Now, it may take a day or two and maybe she’s not willing to wait that long or her doctor isn’t or things like that, but I have no problem as an independent event to have a vaginal delivery if you have HELLP but it’s definitely an indication. 

Meagan: Yeah, isn’t that really the only way to help is to get the baby out? 

Dr. Brock: Correct. The only way to help HELLP syndrome is to get that baby out. 

Meagan: The only way to help HELLP syndrome is to get that baby out. Yeah. Okay, that is so good to know. It’s not as common in our community, but we have definitely seen people ask and then they worry about the platelets and surgery. They never know what’s safe or not. 

Dr. Brock: The other thing is that if the platelets are low or under 100,000 the anesthesiologist is very leery of putting in an epidural. The reason that over a spinal is because platelets are used to clog your veins and if he hits a blood vessel in your spine putting it in, then it can cause damage and cause paralysis so they really don’t do spinals. They do general anesthesia, not regional anesthesia if someone has low blood platelets. 

I had a patient who had very low platelets not from HELLP, *inaudible* and she couldn’t get an epidural. We definitely didn’t want to do a Cesarean section because she had low platelets so we did it the old-fashioned way. She didn’t have an epidural. She had a vaginal delivery and it hurt. 

Meagan: Yeah, well that’s good to know though. That’s really good to know. So as someone who’s had a vaginal birth after two Cesareans myself and obviously Kara is preparing, we talked a little bit about how to prepare. But is there anything that we need to know? We talked a little bit about the risk earlier but is there anything that we need to know about vaginal birth after two Cesareans that we may not hear about with just VBAC after one?

Dr. Brock: I mean, like you said. The risk is higher. The doctor who might be a little nervous or leery obviously, stress shows that doing a Cesarean section may be higher which I understand. If there are concerns, he may cross-match for blood and have it available in case you need that. That’s how the doctor is not the issue. Like I said, labor in the hospital and not at home because if something happens, “Oh, I’m five minutes away from the hospital,” but that’s not true. You may be five minutes but you’re at least 45 minutes before you can get the baby out. You try to hold your breath for 45 minutes, so that’s why in the hospital. 

But like I said, everything is done before you get pregnant. Try to get in the best shape you can and not gain too much weight and make sure the baby isn’t huge. If someone had a macrosomic infant and is diabetic, the doctor may take that into consideration. 

Meagan: Right. We have a lot of people in our community that don’t have the support in their area and do find themselves having to travel long distances to their provider that is supportive. I think a big worry is uterine rupture. We talk about uterine rupture and it sounds really scary. We talked about getting to that hospital as soon as you can. But for those who are driving or are further away, are there any signs or symptoms that you would say, “Okay, you need to seriously deviate your plan and go to the nearest hospital at this point?”

Dr. Brock: Well, certainly massive bleeding. If you go ahead and have searing pain, that would be from the uterus. There are no absolute signs of anything, but stars up early, that’s why you go in early so these things don’t happen. Thank god the instance of rupture is very small. In a hospital setting, even with a rupture, there’s no guarantee that the baby is going to get in trouble but it’s considered a greater risk. If you’re not in the hospital, it’s a risk to the mother’s health and the baby’s health. But the instance is small. 

But common sense is. If you’ve had four Cesarean sections and now you decide you want a vaginal delivery, you’re putting yourself at greater risk. It’s not worth the risk. Babies don’t do well if mommies aren’t around so you want to make sure you’re doing fine. 

Meagan: Make sure everyone’s good. Yes. Awesome. Kara, do you have any other questions, especially as a patient? I’m sure you guys have this time in the office to ask as well. 

Kara: We have an appointment right after this. No, I just feel really grateful to have found Dr. Brock and I really feel that I wish more doctors were as skilled and as knowledgeable as you are. I am really, really impressed with your experience level and your support of mothers trying to do things the way they want and the way were made to do. I’m just very grateful and thank you for being with us today. I know how busy you are with eight deliveries this week. 

Meagan: Literally, I know. You just had births last night. I’m sure you’ll have births today. It’s always such an honor to have birth professionals on the podcast because these people who are listening to the podcast really are in a very vulnerable state and want to get all of the information. So it’s so fun to have a skilled OBGYN here answering these questions from the community. It really does. It helps people guide and feel better. Honestly, just hearing the support you have, no wonder you’re the VBAC king in LA. 

Dr. Brock: There are a lot of other people who do VBACs. 

Kara: You’re being humble. He’s being humble. 

Meagan: There are. There are a lot of people out there that do VBACs but it does seem to be harder to find people that do VBACs in the manner that you do like, “Let’s monitor mother nature, but let’s let mother nature do its thing.” It doesn’t seem like you have a lot of restrictions. We have a lot of providers out there that do have a lot of restrictions so it’s humbling to hear that you’re like, “Hey, let’s do this. Let’s trust the process. I’m going to be here. I’m going to guide you along the way and I’m going to monitor but I want what’s best for you and I want to listen to what you want to do and I want to support you.” 

Thank you so much for being that person for this community. 

Dr. Brock: Well, the other thing that I was saying is that for someone who is in labor, I do monitor the baby. It’s not intermittent monitoring because that’s how I keep track of the baby. The other thing I do when I do the tracing is that a good baby can look bad on the tracing, but a bad baby cannot look good. So you have to understand that. If a baby is a healthy baby and has some variation but it comes back and it’s back to normal, that’s a healthy baby. But even with the worst tracings, statistics say that 50% of the time, the baby gets in trouble. But just a terrible tracing, follow your doctor’s advice and do what he says. But still, hopefully, results will come back good. 

Meagan: Right. Standard practice all over the world really is continuous monitoring with VBAC because we know that fetal heart dropping and distress are one of the main signs that something, some separation may be happening. If you’re listening, know that it’s pretty standard. That’s pretty standard care all over the world. 

Dr. Brock: It keeps your doctor’s *inaudible*. If you’re not monitored, we don’t know what’s going on. 

Meagan: Right, yes. Okay, well thank you so much for taking the time out of your day and being with us. We really do appreciate it. 

Dr. Brock: All right, have a good day then. 

Kara: Thanks, Meagan. 

Meagan: You too. Bye, you guys. 

Closing

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