• Episode 318 BadassMotherBirther + How to Make Change

    “Let’s change the narrative.” 


    From how to be an active participate in your care to how to help get your partner on board with your birth goals, Flor Cruz and Meagan talk about it all. Flor Cruz is the founder of BadassMotherBirther and a long-time friend of The VBAC Link. A two-time VBAC mom herself, Flor is passionate about equipping all moms with the education they need to feel empowered in their birth space. 


    Meagan and Flor share the importance of paying attention to red flags and how to recognize them even within your body. They talk about how feeling safe in your birth environment and being able to acclimate can literally change your birth outcome. 


    These two ladies have been where you are. They know how overwhelming it can be trying to prepare for an empowering and healing birth after tough ones. But Women of Strength, you are not alone. Together, we truly can make birth after Cesarean better. 


    Flor’s Website

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Meagan: Hello, everybody. Welcome to The VBAC Link. Today’s episode is with one of my absolute favorite people. Even though I actually haven’t met her personally, I’ve been following her forever and we’ve been doing things and connecting back and forth for years. I am just so stinking excited to have the one and only Flor Cruz from BadassMotherBirther on the show today. 


    We’re going to get into the nitty gritty and really talk about some feelings so be prepared for that. If you don’t know who Flor Cruz is yet, I highly suggest checking out BadassMotherBirther. She is the creator of BadassMotherBirther. She is a doula, a birth and human rights advocate, a childbirth educator, and also a mom of 5 and two-time VBACer. You guys, I’m so stinking excited to have her on the show. 


    We do have a Review of the Week and then we are going to jump right into our episode. 


    Today’s review is by mamaofboys0326. It says, “The Best Podcast About Birth and VBACs”. It says, “I had my first baby after a very unexpected C-section. I had done everything right to try and have a natural birth and things did not go as planned. When I got pregnant again only 6 months after him, I knew I wanted a VBAC but didn’t know where to go for information and support. This podcast was exactly what I needed. The birth stories and education, information, and inspiration that is provided is amazing. It helped me know the facts about VBAC and be inspired to be a Woman of Strength. I am here to say I just had a successful VBAC and I am so thankful for the inspiration that this podcast has provided for me through the whole journey.”


    Oh my goodness. Mamaofboys0326, thank you so much for your review and congratulations on your VBAC. We love you. All right, let’s get into today’s show.


    Meagan: Okay, so we’re just going to dive right in because the conversation we were having before we started pressing record was exactly what I feel like I want to talk about today and everybody, right before we were pushing record, we are going to talk about doulas. 


    We are birth workers. We are VBAC moms. We see a lot of stuff and we’ve also been through a lot of stuff so we understand you. We get you. We hear you. We see you. We see it every day in all of the VBAC communities even not in the VBAC communities. I’m seeing so much of the same questions and comments and things. I just wanted to talk a lot about some of those things. 


    One of them was a doula and how we can’t expect them to save us as VBAC birthers, right? I was telling her about a situation with a client who unfortunately came with a lot of question and doubt in what she was being told, but then in the end, the decision that was made which is not my decision to make or judge or anything, but it was a decision that was made that unfortunately turned into the cascade that a lot of us see. 


    The hardest part is that person was pretty upset with us. That was hard. That was hard for me so what she posted a post. I think it was actually this month maybe. I think it was this month and she just said, “The birth plan will not save you. The doula will not save you,” because we hear a lot of people say, “I hired the doula. I did the birth plan. I did this. I did that and it still didn’t work out in the way.” I love what you were just saying about insurance. Can you tell them about that? 


    Flor: Yeah, so I think when a lot of people hire doulas and they take the classes and they do the things and the birth plan, a lot of those things you have to utilize them well. Okay? We are tools. Doulas themselves are interventions. We are interventions for the system. We are an intervention for you, right? Interventions can also create good outcomes. You can get insurance for your vehicle, but if you are not following the rules of the road and you are not utilizing your car the way you are supposed to, then the insurance is going to be garbage. It’s really not going to mean anything. 


    This is the part that people need to realize when they are hiring outside people to come in and help them. There is a certain layer of work that you need to be doing that your doulas cannot do for you. I can’t make you not be scared. I can’t make you participate in your care. I can’t make you make informed decisions. I can’t make you have conversations with your provider and ask them to do their due diligence with you. We can’t force those things. We can suggest things and we can give you information, but at the end of the day, those decisions are your own and when you make those decisions, they come with benefits and risks. 


    The doulas don’t have the magic wand to fix those consequences of certain decisions. We just don’t. I think people have that expectation that the doula is going to come in with this cape and everything is going to be good no matter what decisions are made. 


    That’s just not how it goes. 


    Then there are people who really do the work. They release the fears. They see the chiropractor. They hire the best provider that they can. They are doing all of the things. They are participating in their care. They are asking the questions. They are doing all of those things. They are staying home as long as they can and then sometimes they still have a C-section. Right? 


    Meagan: Mhmm. It’s frustrating. 


    Flor: It’s frustrating but it’s also a reality of birth that some people just do need C-sections. Sometimes you just don’t know why. You don’t know why. Sometimes we walk away going, “Fuck. I don’t know what the hell happened.” Everything was aligned so great, but we still had a C-section and sometimes it’s just a matter of the mammal of their home. I know that is a really hard pill to swallow for a lot of people, but we need to understand that mammals are not inherently built to leave their homes in the middle of labor to go give birth somewhere else in a building with strangers and lights and sounds. Sometimes no matter what you have done, the mammal will not give birth in that environment. 


    Meagan: Mhmm. 


    Flor: It’s not going to give birth within the standard practice that are within those systems. They want to see the baby out within a certain timeframe. There is a lot that is happening. 


    Meagan: Yeah, a lot. We’ve talked about this on the podcast before. When we choose to birth in the hospital which is fine, there is this sense of acclimation that has to happen and sometimes, we don’t acclimate properly. It’s so weird that sometimes I think about the situation too like when I remodeled my house and my wood flooring had to acclimate well and there was a certain part, there was an actual box. For some reason, it was something weird and it didn’t acclimate and it rejected the space. It didn’t lay correctly. It didn’t work. Sometimes our bodies go in and we don’t know why. Sometimes we are tense or whatever and we don’t acclimate well or we finally start to acclimate but all of these interventions start to come in and these other people so then our body freaks out again and then it’s just a mess. It’s just a mess. 


    We can do our best as doulas or birth workers to encourage and motivate, but we really cannot be the deciding factor of you getting induced or not induced or you doing an IUPC or not doing that IUPC. We can’t be that deciding factor so if you’re listening and you haven’t hired a doula or you have a doula, just know that we absolutely want to be there and we love you and we want to help you have a better outcome. 


    We really, really do, wholeheartedly. There have been births where I have walked away bawling actually because I was like, What the hell happened? Then I start questioning what I have done or what I could have done better. That’s so hard and that’s a whole other conversation for birth workers processing that. 


    In the end, we have to make sure as VBAC parents that we really are willing to put all the work in and accept what’s going on and take charge of what’s going on. 


    Flor: Mhmm, mhmm. Yeah and also VBAC parents are probably more showing up with the extra layer of fear. We’re showing up with so much fear and different layers than someone who hasn’t gone through something that was potentially traumatic or a past experience to that degree so there is more, right? 


    This isn’t to shit on hospital births. It’s not about that because I’ve also seen plenty of home births go way south. It’s not about that. It’s about so many things that are not being unraveled. Too many people are showing up to the spaces that don’t know what they are doing that are not practicing evidence-based care that are not upholding autonomy, that are not being compassionate, that are not being vulnerable with someone, that are not staying in the moment with the birth, that are doing everything in a medically defensive manner. Everything is judged by risk and that’s how we are going to move forward. 


    We see midwives do that all of the time. It’s not just the hospitals, right? It’s not always just leaving your home. Someone coming into your home with all of their fucking medical equipment and assistance and charts and cell phones and iPads. That’s all disturbing too. It’s not just the hospitals. There’s so much shit that needs to be unraveled here but at the end of it, one person, your doula, cannot save you from all of that. They cannot. They can make some outcomes better. Yes, the research shows us that.


    But if you think we are going to show up and 100% save you from so many things, that’s just not the reality. It’s not. 


    Meagan: Yeah, like you said earlier, it can be a hard pill to swallow. Even as a VBAC mom myself, I put a lot of faith and I put my doulas and my midwife on this totem pole over here that was like, “I’ve got this because they’ve got me.” That wasn’t necessarily the right attitude. It wasn’t the right way to enter my birth space. 


    I think I had to process that for a really long time in my 42-hour-long labor and accept that and realize, this is me. This is me. We have to take charge of our birth. 


    But what I think as a doula, one of my biggest messages is that we want to see change. We want to see change in this birth world. There are a lot of things to unravel and change and just fix in this birth world but we are not seeing them happen. So why are we not seeing them happen? Because we are not making the change. That sounds like a lot of pressure on us as birthers, but it is. It is up to us to make the change and until we get out of the status quo and the normal path of what the system wants no matter home birth or not, we’re not going to see change. We have to educate ourselves. 


    Flor: Yes. This isn’t a thing to shame parents to tell them they are not doing enough or they are not making good decisions. Nobody should ever have to step into figuring out how they are going to birth their baby with having to figure out who is the best provider. You should be able to show up anywhere and be able to have 100% support. Already, that’s the problem. We’re showing up to these spaces and not getting what we need. 


    Also, what people need to realize is that the things we have now in the birth space like pushing in the positions that you want, talking about physiological birth, and skin-to-skin contact. Those are the things that were stripped from us through the industrialized medical system and we as the people fought for those things back. 


    Meagan: And still have to. 


    Flor: And still have to. Those are not things that, Oh, it’s great. They’re coming along and giving us all of these things. Everything we have now, you guys, we had to fight back for. It’s going to be the same concepts when you are looking to have a VBAC. It’s going to be the same concept. You have to participate in your care and I get it. Culture grooms us to just listen to our doctors. That’s where the seed is in our foundation. You just listen to the doctor. You are not smarter than them. You don’t have a degree. They are the professional and if you don’t listen, you don’t love your baby enough. 


    Meagan: Yeah, exactly. You don’t love your baby enough or you are putting yourself and your baby at risk by making these choices when intuitively, for years, we were birthing off of intuition. We were truly, I believe, birthing from our intuition many, many, many, years ago and we have lost it. It’s like someone has stripped our ability to tune into that intuition because like she said, we are so groomed to trust this other area. We lose our intuition but it’s so much there. You have it. You have it in your heart and your soul. Your intuition exists. You just have to listen. 


    Sometimes that means going into a quiet place and tuning into what your heart is saying versus what the outside world is saying and burdening in fear. I think that is the biggest part in trying to figure out intuition is, Is this fear or is this my heart saying this? What is right? A lot of people will steer away from home birth when their heart is like, This is where I need to be. My heart is in my home. But for some reason, someone said something so their fear creeps in and now they confuse that with their intuition. 


    Flor: Absolutely. What’s the easiest way to get someone to comply? To tell them that they are endangering their baby. That is the quickest and easiest way to get anybody to comply is to give them the threat of their baby dying. 


    Meagan: That’s what my second provider told my husband. My second provider used my husband. Don’t get me wrong, he’s a great guy. It was a really super dumb thing that he did but he was really smart. He used my husband against me because that’s all I had was my husband with my second, my VBAC attempt, my TOLAC or my CBAC. Yeah. He used him against me. He was like, “Listen. Your wife is not being smart right now. This is not okay. Your baby is at risk.” So what did my husband do? Freak the hell out. “We need to go down and do a C-section. We need to.”


    But then I didn’t have anybody with me. I had everyone against me because that fear, that one comment of, “This isn’t good for your baby,” that was it. That was it. That was all that needed to be said. 


    Flor: That’s generally all it really takes. But I think if we get to that point with our providers, then the next step needs to be one, stay calm. You need to stay calm. You need to not make that fear a reality in your brain. Your provider has the responsibility to show you the burden of proof. 


    Meagan: That’s a powerful message right there. 


    Flor: That’s your provider’s responsibility right there. They are not supposed to be talking to you without giving you actual, real numbers. By the way, that’s what you need to be asking providers when they’re saying some shit that is real left field is, “Can you show me the burden of proof? Can you show me the real numbers and evidence to this? That’s what I’m looking for.”


    When we walk into these spaces and we want to say, “I trust my providers,” I think that that’s great that you trust your provider, but that doesn’t mean that you fail to participate in your care, that you fail to ask the questions, that you fail to make informed decisions, that you fail to say, “Let me see the numbers on that. You’re telling me that my rupture rate is 15%. Can you please show me that on paper? And can you please show me out of that 15% rate of rupture how much of that is actually catastrophic which means that me or my baby will die from that?” They will not be able to produce any of those papers because it’s not real. It’s not real. 


    I always tell people this. Put the same energy into finding out who your partner’s exes are. You’re figuring out their Facebook. You’re looking at their pictures. You found their cousins. You found all this information about your partner’s exes. Put that same energy into your providers. Put that same energy into their care. Right? 


    Meagan: You deserve it. 


    Flor: You deserve it. You deserve to have someone on your team who is knowledgeable, isn’t going to lie to you, and is continuing to learn and do the research because that is also another big fault of providers is they are not keeping up with the research. They are still doing the same shit they were doing 20 years ago. 


    Meagan: You know, I even think that sometimes when providers see research, it’s there. They are given it. It’s like, “Well, that’s not how it really is,” because that’s not how they are practicing. So it’s not like, “Wow, I need to make some adjustments in my care.” They just keep going so that’s why we have this crazy lack of change. That’s why some countries are 10 years ahead of us because we for some reason aren’t willing to make change when the facts are provided. 


    Flor: Right. I think especially in the United States, we really glorify licenses and degrees. We glorify people who have this sense of authority over us. It makes us feel warm and fuzzy inside, but why is that? Why is it that we don’t feel smart enough to be the head of our own care? Why? 


    Meagan: Why do you think? 


    Flor: It shouldn’t be that way. 


    Meagan: No. No. It shouldn’t, but it is so easily that way. We just don’t. We just don’t. 


    Flor: We just don’t and I know sometimes it’s a cultural difference. Both of my parents are immigrants from Nicaragua so for them to come to the United States and have access to healthcare and have access to get seen by a doctor and to get antibiotics and get help and get x-rays, that’s amazing to people who come from a country where they don’t have access to stuff like that. I was raised with, “This is amazing. We have doctors here. You should just do what they are telling you because we are just so grateful to have access to this care,” that we are just blindly following what they are saying. 


    I’m the first person in the family to question, “Well, what if this person is wrong?” 


    Meagan: You’re the first person in your family? 


    Flor: What if this person is wrong? I’m the first person to really fully participate in my healthcare. That is not in the norm in my family because of the culture that we are immigrants so there is also that layer of where our family’s are from and is this new to us? Is having access to healthcare new to your generation in your family? Because that’s a whole other layer that you’ve got to uncover now too. 


    Meagan: Yeah, I actually didn’t even think of that. 


    Flor: Yes. Absolutely. 


    Meagan: Wow, yeah. 


    Flor: We’re getting ready to have these babies so it’s like, you’re going to have this brand new little human that you are now going to have to advocate for. 


    Getting on that wheel of participating and advocating prenatally during your pregnancy, your labor, your postpartum, that’s all gearing up for you to get ready to advocate for a new human for the rest of your life. If you think you’re not going to end up in an ER at some point in time with that child and you’re going to have to advocate, you are dead-ass wrong. At some point, you will end up in the ER and have to really ask the questions and not just hand your child over and just do whatever you want type situation. We have to realize that starts now. 


    Meagan: With us being able to advocate and take charge of our own care. You know, I know. I definitely have had the personality in the past and it’s still in me. It’s still very much in me where I’m like, oh I’m a people pleaser. I’m like, “Sure. Okay fine. It’s probably not that big of a deal. Obviously you seem very passionate about that so we will just go along with that.” We’re going to say breaking water for instance. A provider comes in and says they want to break your water and you’re like, “I didn’t want that. I know I didn’t want that. That was something I knew I didn’t want. It’s on my birth plan. I didn’t want to break my water, but this provider is saying it. They seem really passionate about it, so I guess I will just back down on that and let it go even though I’m really passionate about it. Sure, go ahead. Break my water.” 


    Flor: Yes. 


    Meagan: Right? But why? Why are we allowing that if it’s something that we really, really, really, really don’t want, why do we just back down so easily? 


    Flor: There are a few things that are going on here and I think for women in particular, we are raised to people please. We are raised to take care of everybody’s needs around us but women in general to people please. Women are raised to not ruffle anybody’s feathers, not make anybody upset, give people what they want, and that’s our only job so when someone comes into the room and says they need you to x, y, and z, our brains are calculating that as there is a need that has to be fulfilled and I have to fulfill that. 


    But the other thing that is happening here too is that we do have mammalian mechanisms in place to protect us and to help us survive within the wild. So if we have someone coming in who is looking like they are this sense of authority who could potentially feel like a source of threat like a predator to us, the mammal will give in to the predator’s demands to avoid further harm. 


    There are layers of mammal instinct that are happening here as well. It’s happening on a subconscious level. So this is where a doula will help. The doula is the person who is outside of that who can step in to say, “Hey, I understand that this wasn’t part of your plan. Is there any medical reason why this should be happening? Just to speed up the labor isn’t a medical reason so I just want to remind you that your birth plan is pretty ironclad so if this is not something that you want to do, I fully support you doing that.” Right? Then we give the benefits, the risks, the information, and then let the parent decide what they want to do. 


    But ultimately, this is a lot of the time what ends up happening. The parent does what the provider says. 


    Meagan: Yeah.


    Flor: The doula is not going to save you from that. 


    Meagan: No. 


    Flor: We can’t. 


    Meagan: It’s hard, you guys. Women of Strength, we want to protect you. We want to help you get your birth plan and have that amazing experience that you do deserve and that you have worked hard for, but like she said, we can give you everything as doulas, but then it really is up to you or us as parents to make that ultimate decision and if we do that and just back down because we want to meet that person’s need, we then have to deal with what happens after that. We have to accept that. I don’t like the work deal. We are going to accept that because that was the choice we made. 


    Flor: Yes. It’s the choice that we are doing. 


    Meagan: If we are going to go into a store and steal something, we have to understand that there are repercussions from stealing that item. Whether or not you get caught and you are just feeling guilt or whatever, there are going to be feelings so if we do something just because someone wants us to, then we sit down and we’re like, Oh crap. Or if it goes awry, then there’s no one else to blame and that’s the hardest part as a VBAC parent and a VBAC doula from those two standpoints. It’s a hard thing. 


    Flor: It’s a really hard thing. As much as we’re asking our providers to give us that information and to give us the burden of proof and ask them, “Why are you suggesting this intervention?” It’s also important that you have that conversation with yourself. Why am I not choosing to do this or to do this? You also need to ask yourself that because if you are saying yes or no to something, are we saying yes or no out of fear? The thing I see a lot of the time too is that people are completely fucking exhausted. The system has completely dragged them through hell and back just to get to that moment and people are fucking tired. 


    Meagan: Yes. All people, but especially with VBAC. There is this extra layer of pressure to have our baby by certain dates and you have to be a certain centimeter or they won’t induce. Or guess what? If you do hit this date, I won’t even induce you. You have to have a C-section so we have all of this extra pressure and stress and angst. We’re going out and we’re trying to self-induce and we’re trying to do all of these things. We are so stressed that we are not even able to get our head into a space of relaxing, calm, and willing to hear what our true intuition says because we are so wound up. 


    Flor: We see it all the time in these VBAC groups. I stay in those VBAC groups heavily because I’ll tell you what, providers act so fucking wild when nobody’s around. When they think nobody’s around to watch them, the shit that they say and do, they act so differently then these people come to these Facebook groups and tell us how their prenatal visit went and I’m fucking blown away by the things that they are saying and the things that they are doing and the things that are happening. And also really sad that people don’t have the courage to stand up to their providers and to ask the questions and participate in their care. It’s really sad to see that this is the place that we are at. 


    I’m always, always seeing, “I have to be in labor by 39 weeks” or “I have to have an induction or I have to have a C-section”. That’s the thing I see all the time. All the time. 


    Meagan: You don’t have to do anything. Or I see the “Let me”. “They will let me. They will let me.” Women of Strength, if you are this person and you’re like, Oh crap. Yep. That’s me. That’s me saying that. Yep. My provider said they would let me, let’s make a change. Let’s make a change together. We have to do this as a community together and we deserve it as individuals to take better charge of our care and of our outcomes. 


    Flor: Yeah, this is what this conversation is about. It’s about trying to get to a place where we are more participating in our care and getting that better type of care and just asking the simple questions. And even asking for space. If you are just feeling really overwhelmed in the moment and you are feeling like you are about to comply simply out of fear or being stressed, that is the perfect time to say, “I need time to think about this.” 


    Meagan: Yep and your doula can be there for you. If you have a doula, they can be there for you to help hold that space and talk about those things and navigate through what is really being felt and thought in your head. Right? 


    Flor: Absolutely. 


    Meagan: There are so many times and I never want to shame providers or shame anyone. That’s not my goal ever in life. I don’t like to shame, but at the same time, it drives me nuts when I see a provider come in and they say– it’s like they are placing these seeds and then they are watering it with MiracleGro so it grows really thick and hard and then they are coming back in and they are dousing it with MiracleGro again. 


    They come in and say weird things about breaking your water or whatever. You’re like, “Maybe. I’ll think about it.” You’re like, “Yeah. I said no. I pushed it off and put it aside. We’re not going to do it right now.” But then they come back in an hour later and are like, “Well, we really want to break your water.” Or now it’s the nurse, “Well, the doctor really wants to come in and break your water.” Here’s that second pour of MiracleGro so it’s growing thicker and harder to resist that root and that seed so you’re like, “Oh, no. I still think I want to wait. I really still think I want to wait.” But then the third time they come in and they are like, “Okay, we really think it’s best to break your water. You’re still hanging out around 6 centimeters. It’s probably going to help speed up your labor and get this baby out. You don’t want to do this forever. You’re going to tire out your uterus.” 


    Then they douse it again and you’re like, “Fine. Sounds good.” We can’t say no three times, but you can. You can. If that still doesn’t feel right that third time, you can still say no. So I think here we are talking about all of the situations but how do we find that confidence? How do you think that we find this confidence to hold our rod and push through and not let it crack? 


    Flor: Mhmm. For once, that starts prenatally. You cannot figure out who the fuck your provider is on the day you give birth. 


    Meagan: You really can’t. 


    Flor: You need to participate prenatally. Even just any single little prenatal test. “Can you explain to me why you are suggesting this? What are the benefits? What are the risks? Can you show me the evidence on this?” Any little thing. I don’t care if it is a urine exam. Your provider needs to see you participating all the way through and through so they know what to expect from you and what type of client you are actually going to be. 


    That also gives you a good sense of, is this person willing for me to participate? 


    Meagan: Yeah. 


    Flor: Because you’re either going to get a provider who goes, “I love that you’re asking all of these questions and you’re participating in your care and you’re gaining knowledge. I love this.” A good provider will understand that that limits their liability if you are knowledgeable. The provider who does not like you asking questions is already a red flag. 


    Meagan: Huge red flag. 


    Flor: Huge. There are lots of times where you will find out who someone is very early on if you start participating there. 


    Meagan: Yeah. Yeah. 


    Flor: Then once we move to the actual labor, there is a decreased chance of you getting someone who you don’t want at your birth. Now, if it keeps getting pressed of this issue of we need to intervene. We need to intervene. We need to intervene and at some point if you’ve had enough, you say, “Hey, can you put it in my medical chart that I have at multiple occasions made the decision to refuse this intervention and you are continuing to come in here and coerce me? Can you please write that on my medical chart?” 


    Meagan: Yeah, what do you think they’re going to do? 


    Flor: They’re not going to want to. As much as they use that medical chart for their own liability and their own benefit, you also need to be using that as your own tool. 


    Meagan: Yeah. 


    Flor: Hey, I don’t want to discuss this again. Can you please write it in my chart that I’m not willing to discuss this any further? If you have anybody on your team who is just not listening, get rid of them. Why are we so scared to tell someone, “Hey, can you bring me another nurse who is on the staff please?” 


    Meagan: Yeah. We are so vulnerable when we are in labor that we can’t seem to find this space of advocating for ourselves to that extent of, Okay, every time this nurse comes in, my blood pressure goes through the roof. I’m clearly feeling a fight-or-flight experience. This is not going to help me or my labor or my baby and definitely not going to help me leave this experience feeling joyful or will cherish for the rest of my life. 


    So if that person is in your space making you feel those things and your body is responding that way– because let me tell you. Our body is a huge factor in what happens and it’s a response. We need to listen to it. 


    Flor: It’s so smart. 


    Meagan: It is so smart. 


    Flor: So smart. 


    Meagan: If you get the chills every time someone comes in or you can feel your heart race every time someone comes in, that is a flag that someone shouldn’t be in your space. That is okay. It is okay. We talked about this with Dr. Fox too with providers. No provider wants to be in a battle either. So if they are not going to be in that space of support and willingness to meet you and let you be a real– and “let” like not fight you against being an advocate for your own birth and being a participant in your own experience, that’s not the right provider. And guess what? They probably don’t want you as a patient either. And that’s okay to say, “You know what? Thank you so much for all you have done and where you have brought me today. I’m going to discontinue care.” 


    Or you can just leave and transfer your records. You do not have to stay or you can say to that nurse or to another nurse or whatever, “I would like to request a new person.” 


    Flor: Yeah. 


    Meagan: Please do not return to my room. 


    We had this a long time ago. I think it was even before COVID, probably in 2018. We had a preeclamptic mom who was already really struggling with blood pressure. She was on magnesium. She felt like garbage. It was her fourth or fifth baby. I can’t remember. It was a very stressful time. She was being induced and that was not what she wanted. She did have this nurse who came in. I’ll tell you, she made my skin crawl. 


    Everything, just the way she walked in. She didn’t have to say a word and you could just feel that negative energy from her body. When she would speak to her and when she was touching her and maneuvering, it was just very aggressive and it was just ick. A lot of ick. 


    I watched her blood pressure. I physically watched her blood pressure because she had to be on blood pressure the whole time. They were taking it every 15 minutes and I watched her vitals go up and then they would still go down and be high but they were clearly down. I started noticing that and I talked to her husband and I said, “Have you noticed this?” He’s like, “Yeah.” I’ve noticed everything about her. She gets anxious. I was like, “Yeah.” 


    We went over and we talked to her and she was like, “I hate her.” She’s like, “I do not want her.” I said, “Then let’s get rid of her. That’s okay.” She said, “Wait, wait, wait. We can do that?” I said, “Yeah.” I went out to the desk and I just said, “Hey, is there any way we can get another nurse to come in here and chat?” She was like, “Yeah,” so she sent another nurse in and the patient was like, “I would really like to request a different nurse. I’m feeling really anxious when this nurse is in here. This is not what I’m needing. This is not the experience I want.” And they were like, “No problem.” We never saw her again, never. I didn’t even see her out in the hall. Never. 


    Her birth experience dramatically changed in a positive way in a really crappy situation that she didn’t want, but it was a dramatic change and she was so happy. So happy. 


    Flor: Yes. The environment and the vibes in there have to be immaculate. I think that’s a part that people don’t understand is if you’re also having to fight through and through and through throughout the whole labor, I wouldn’t expect a baby to want to be born into that environment. You cannot keep thinking of your body as this robot and as this mechanical thing. It is connected to your brain, to your emotion, to the environment, to your partner, the support system, and everything that is happening within the room. Our bodies are not going to release these tiny, little, precious, vulnerable mammals into the wild when the body feels that there are too many predators around and the environment is not safe. 


    I see what happens here sometimes is that someone is fighting a lot throughout the whole labor and then they end up in a C-section and they go, “I just should have had the C-section to begin with because clearly my body doesn’t work.” It’s like, well no. You weren’t even given a fair shot at having a VBAC would be having support through and through. That would be a fair shot, but when you are having someone who is putting you in fight or flight, adrenaline overload, cortisol overload, your pelvic floor is going to tighten up. It is going to go woooop. 


    Meagan: Hold that baby in. 


    Flor: The baby is not going to have the room to navigate, to rotate, to descend. Your body is so smart. I don’t think people realize that your body is so smart and intelligent and works so well that it will hold your baby in when your body feels it is not a safe environment to be born. It’s not a failure. It’s a testament to how well your body actually works. Right? 


    Meagan: Yes. Yes. Yeah, and the medical system really treats us in a way that we failed. Our body failed. Whatever. That’s just not the case. It’s not the case. It’s that our body was brilliant and was responding to a really not awesome experience. 


    Flor: Absolutely. 


    Meagan: It is up to us to continue to advocate so keep doing that, Women of Strength. Advocate for yourself. Push through. Listen. Read the room too. Read your body. If you are feeling anxious, make change. That is where it is up to us to– I hate the word, but at the same time, we can’t fail ourselves by not doing anything. If we do nothing, we are failing ourselves. We do not get the education. If we do not put forth the work and the effort, we’re not giving ourselves an opportunity. 


    Flor: You’re not going to be able to change the outcome that the system is already curating for you. There is already this curation that is happening throughout this whole thing and is expected to end a certain way and you have to be the person that disrupts that curation and to build it to go a whole different direction. It shouldn’t be that way. It shouldn’t be our responsibility. We shouldn’t have to go in there and advocate so fucking much. It shouldn’t be that way but it’s clear right now in 2024 that the system is not doing anything to improve these outcomes. None at all. Zero. 


    So by default, it lands in the parents’ lap. By default. 


    Meagan: We’re already doing so much so I know that you might even be overwhelmed listening to this episode and be like, Oh my gosh. Now I have to do this too? But you deserve it. Yes. Right now, it’s unfortunate that we have to go in and we have to take charge of our own care but we can do it. You can do it. Even if you’re a people pleaser, you can do it. You really, really can. 


    Flor: You guys, always remember that the squeaky wheel gets the grease. 


    Meagan: I love that. 


    Flor: The squeaky wheel gets the grease so be as loud as you need to. Advocate as much as you need to. Participate as much as you need to because that’s the person who’s going to get the grease, not the person who is sitting in compliance. 


    Meagan: Yeah. Yep. Women of Strength, thank you for listening with us today. I hope that you enjoyed this conversation. We are very passionate. If you cannot tell, we are very passionate. We want things to be better for you. We want to see change. We as doulas want to advocate for that. We want to help you. We really, really want to help you, but in the end, it’s in our laps. We have to push up. We have to keep going. I do think that it’s going to take time. Unfortunately, it’s probably going to take longer than we want it to, but if we keep advocating for this change and if we keep pushing forward and taking care of ourselves and our babies and all of this, we will slowly see change. We’ll see it. It will come. 


    Flor: Yes. You’re not just advocating for yourself. You’re advocating for all of the people behind you as well. If you’re looking at it in the bigger picture as, “Okay, when I’m speaking up for myself, I’m speaking up for thousands of other families,” if you look at it like that, you will have the courage to speak up. 


    Meagan: Yes. There is a listener, she was a VBAC after multiple Cesareans, more than three and everyone was shooting her down. No, no, no, no, no, no. She was like, “Nope. I’m going to do this.” She found the research and decided to go for it and did. She had a beautiful birth and a beautiful experience. Something I told her was, “You just changed that provider’s world. You just changed anyone coming in in the future with VBAC after multiple Cesareans because that provider said, ‘You’re not going to do this. It’s not going to happen. Sure, I’m going to let you try, but it’s just not going to happen. It’s not possible,’” and then she showed her it was. 


    Providers do hold onto experiences. They do. Sometimes they have to see enough experiences to change their mindest but if we keep pushing forward and showing that this is really okay– just with breech birth. Good golly. Let’s get some more breech birth. Let’s show these providers that breech is just a variation of normal. We just have to keep going. We have to keep going and it does. It’s just bull crap that it’s in our laps and we have to do it but we do. 


    Flor: Yeah, it’s all of us working together collectively quite honestly. It’s all of us together doing our part even if it just feels so minute and so little to you. If every single one of us just did a tiny little spec of work, it’s a huge fucking mountain that we are moving together. 


    Meagan: I was just going to say think about how many people are in our communities alone let alone all of the people in the world. It’s powerful so believe in yourself. Believe in yourself. You deserve it. You are strong. You are completely capable. Do the work. Do the work. That is something that we do have to do. Do the work. 


    Let’s see, what else? What other final message? 


    Flor: Always ask for the burden of proof. 


    Meagan: Yes. Always ask. 


    Flor: I say it all the time, burden of proof. Show me the burden of proof. I want it on paper so I can make an informed decision. Always know that you legally have the right to make those decisions no matter what even if you are saying no to an intervention that could put you or your baby at risk. You still have the choice to say no even when real risk is at the front of your face. Risk is always subjective. That changes from person to person. You have the right to be treated like an actual human and not just a vessel. You matter too. 


    Meagan: Yes. Ask questions. It’s okay. It’s okay to ask questions. You’re not a problem for asking questions just to let you know. It’s not a problem if you ask questions. That is something that in my opinion shows strength. If we are willing to ask a question, and it’s okay to doubt too. It’s okay to doubt. It’s okay to be like, “I don’t know if I believe that,” and then ask that question or “I’ve never heard of that. Can you show me the proof or can you show me what the outcomes are for this result?” 


    Ask the questions. 


    Flor: Not just tell me, show me. 


    Meagan: Show me. 


    Flor: I think another leg that people aren’t paying attention to is when an intervention is being suggested, really pay attention to if your provider is telling you the benefits and risks of the other side. 


    Meagan: And the alternatives. 


    Flor: Because if they are just telling you one side of the coin, well that’s coercive care. That’s coercive information. They should be telling you the benefits and risks to each side and the alternatives and then letting you choose. That is competent care. 


    Meagan: Yeah. If they’re coming in and they are just telling you the risk of VBAC, we’ve talked about this. If they’re just telling you all the risks about VBAC and they’re not even talking about Cesarean, that is a problem right there. 


    We talked about this. It starts prenatally, but I really– if you are not pregnant yet, I encourage you and you’re like, Okay, I really want a VBAC, I encourage you to start right now. 


    Flor: 100%


    Meagan: Find a provider right now. Start getting the education right now. You are in a whole different mind frame than you are going to be when you are pregnant. It’s okay if you are starting when you are pregnant. Don’t ever not start. But if you are not pregnant right now and it’s like, Oh, I’m going to listen. I’m going to get these notes and I’ll start when I’m pregnant because I’m not ready yet, I actually think it is a great time to start now. Get the VBAC education. Find the provider. Understand what you are wanting. Understand your rights because it really is a different ball game. 


    Flor: It’s a whole different ball game. When you have the luxury of time, take it. Do it because I feel like a lot of people go to get educated right at the end in the last trimester and I want you guys to know something. Your brain functionality starts to decrease at the end of pregnancy. 


    Meagan: You’re overwhelmed. 


    Flor: You’re not supposed to be using a lot of brain function at the end of pregnancy because your primal birth brain is trying to take over. You trying to learn at a time where your brain function is decreased is not optimal. It is not. You need to get educated absolutely now even if you’re like, I’m just not sure if I want to have another baby, get educated. What is the risk to you getting educated? 


    Meagan: Well, and honestly, it’s just going to help the next person even if you don’t have that baby and your best friend gets pregnant, you’re going to help them and you’re going to guide them in the right direction to help them get educated. You’re going to help change. It’s those minute changes that we are doing in life that are going to make a huge impact. 


    Flor: Huge impact. Absolutely. Make sure that your partners are showing up with you because it is not going to be doable if your partner is showing up just to sit in the corner and be fearful and not understand things, not be educated, not know how to advocate, not know what questions to ask, they will not be of any help to you. You need someone who is going to show up in that same brain capacity and be able to hand it over to them essentially because you shouldn’t be doing any type of fucking thinking during the labor. 


    Meagan: Right? I mean, look at what happened to me. It went straight on to my husband and he was like, “I don’t know,” and it was just like, “No, we’ve got to go. We’ve got to go.” It was awful. It was awful. It was really, really hard and it was something that I made sure was not going to happen again. We are not going to do that again. We are going to make sure that you are okay with this and that you understand so when someone just comes in and says this one little fear tactic, you don’t just crumble to the floor. 


    Flor: Absolutely. Absolutely. These partners have got to start showing up in a different way. They just cannot leave all of these childbearing things up to the person who is pregnant. One, it’s not fair. Two, it’s not adequate enough. 


    Meagan: We can’t. 


    Flor: It’s not adequate enough. I can’t tell you how many times people are like, “I ended up in a C-section and I feel like it wsa all my partner’s fault. They pushed me to do it. They didn’t help me at all. They didn’t advocate. They didn’t even show up to the classes and I just feel like it’s all their fault or they wanted me to hurry up and get it over with.” 


    Meagan: I mean, I love my husband to absolute pieces. I told this story before how when I told him I wanted a VBAC after two C-sections, he was like, “What? What? No. Let’s just go unzip you.” He said that word, you guys. He said that word. He said, “Let’s just go unzip ya.” That is not okay. He was so far away from understanding and I had to really reel him in. We get it. These partners are also scared. They are scared. They don’t know. They are vulnerable too. It’s not just you. It’s also their baby that they care about. 


    They hear the negative things out there in the world and they see the word “uterine rupture” and they’re like, “Oh my gosh, no. I can’t.” Or they’re like, “We’re out here. We’re providing. We can’t do that childbirth education. We can’t do those VBAC courses,” but really, it’s so important because they have to be there with you. They are your rock too. They are your rock. You have to have them. I’m going to tell you. In labor, you can’t always be 100% in your mind. 


    Flor: You shouldn’t be either. 


    Meagan: Yeah, well because we are laboring. We need to focus on getting a baby here and we can’t be thinking about all of the things that we need to be asking the next time the provider comes in. That is where a doula can help and can help encourage your partner. “Hey, these are some things to ask next time,” and help but it helps even more if they have done the work and they are with you. They are with you in this journey. 


    Flor: Yes, they have to be with you and understanding that you and the baby are a diad. You are one. You are not separate from each other. When you do well, the baby does well. When you don’t do well, the baby doesn’t do well. It’s one person. You are one unit. They are not separate from each other. Partners really need to understand that and also really think about what type of energy you are putting into these statistics and the numbers because if a provider is telling you, “You have a 0.7% chance of rupturing,” okay. So there’s a 99% chance I’m not going to. How different does that sound? 


    Meagan: Let’s flip that. We talk about that on the podcast too. Let’s flip it. Let’s start focusing on those little tiny numbers on the chance that you do, it’s important to know that, but let’s flip it and look at it like, “Okay, so I have a 98-99% chance of not rupturing.” 


    Flor: Right. 


    Meagan: Okay. Okay. That feels good. I think that’s a good risk right there. I’ll take that. 


    Flor: Exactly. Exactly. Obviously, it’s not up to us to be in charge of pulling our partners out of that fear. That shouldn’t be our responsibility, but it’s okay to look your partner in the face and say, “This is what I’m needing from you. This is what I’m wanting and these are the reasons why and I’m the person who has to give birth to this baby and I’m the person who has to recover for the rest of my life with how this birth turns out. Me.”


    Right? When I showed up for my VBAC, I went in thinking my husband was going to fight me on it so I showed up like, “Listen. We’re going to have a fucking VBAC. I don’t give a shit what you’re going to say.” I showed up ready to fight. 


    Meagan: We actually did get in a fight at a restaurant because I was like, “This is what’s going to happen. We’re going to have this many people and by the way, I’m actually not going to birth in the hospital either.” He was like, “What the hell?” I was like, “It’s going to happen.” I was like, “You’re going to have to meet me right up here. I’m not coming down here. You’re going to have to meet me up here.” And I’m so grateful that he did. I really am so grateful and honestly, it changed him. It changed his perspective. It changed his narrative of birth. He was like, “Oh wait, yeah no. We would never do it any other way. That was amazing.” 


    Flor: Right? Luckily for me, my husband didn’t fight me. I went in guns blazing thinking he was going to but he was like, “Look. You’re the one who’s pregnant. You’re the one who has to give birth. Whatever you choose, I’m on board. I will support you and I trust whatever decision you make. I can’t tell you what to do,” so then I felt like a jerk after. 


    Meagan: My husband was too. He did put his two cents in of, “Oh, so you’re just going to choose the most expensive option?” That was what he said in the end, but in the end he was like, “Okay, cool. We’re going.” We know. We know. We see it. I’ve done so many consultations with people where they are like, “My husband is just not on board and I don’t know what to do. I don’t know what to do.” I think one of the very first things that I suggest is to educate them because they are usually making those quick no’s and they’re very against it because they are just uneducated and they are scared. 


    Flor: Yeah. That’s generally where it’s coming from is a lack of education and following that thread of fear. Those shouldn’t be the places where someone is making that decision. Someone should get educated and then we’ll discuss what you think and what your opinion is. Know that it’s just that. It’s an opinion and it’s not going to be the detour of what I’m going to do with my birth. It just shouldn’t be that way. 


    Meagan: Yeah. Yeah. 


    Flor: We already live in such a patriarchal system as it is. I’ve seen lots of partners saying no to doulas being on board. 


    Meagan: Oh yeah. Oh yeah. 


    Flor: Why? 


    Meagan: My husband was one of those. My husband was one of those. He was so anti-doula and his reason was, “Well, I don’t want to be replaced.” I was like, “It’s not like that,” with my second. It is not like that at all. It just was so hard and we didn’t have a doula and we ended up in a repeat Cesarean. I’m not saying I ended up in a repeat Cesearean because I didn’t have a doula but I definitely wish I had some of that extra support when things were turned on me and someone to help him understand too but there are so many other things with that birth. 


    I was with the wrong provider. That’s what it was. I just didn’t make the full change for myself. 


    Flor: The thing with that too is that a lot of men do not show up for women fully 100% because there’s really not a lot of opportunities where they do show up to be 100% there for their partners. Birth is one of those spaces where they need to do that and they’re not used to that. They’re not used to showing up to that capacity of really not centering themselves. 


    Meagan: Yep. 


    Flor: What is this doula going to take away from me? What is being at home going to take away from me? What is this going to require? That is someone centering themselves instead of looking at the situation and saying, “What is it that you need from me? How can I help you? How can I help you be most comfortable? I want you to be as happy as possible in this situation.” That’s the type of energy that we need people to show up to the birth for. Stop centering yourself. It’s not about you. When it’s your turn to give birth, then we will do whatever you want to do, but until that time comes, it’s about me. 


    Meagan: You’ve got to come up here. Yeah. 


    Flor: It’s about me. 


    Meagan: It is about you, Women of Strength. We love you. We love you. Like I said in the beginning, we see you. We hear you. We feel you. Literally, from one VBAC mom, two VBAC moms to another, we understand. We are with you in this journey. We are cheering you on. This message today is to hopefully motivate you, educate you, plant a seed or whatever you want to take it as, give you the motivation or the oomph to do what’s best for you truly. Truly do what’s best for you and let’s change the narrative. 


    Flor: Yep. 


    Closing


    Would you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.





    Support this podcast at — https://redcircle.com/the-vbac-link/donations

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    1h 2m - Jul 17, 2024
  • Episode 317 Brittany's HBA2C + VBAC Education, Big Babies, Provider Support, Preterm Birth & More

    “The 9 lb 2 oz baby that they said I could never push out and could never have had her vaginally– I ended up going on to have a 10 lb 10 oz baby girl.”


    Brittany first gave birth to twins via Cesarean at 34 weeks and 1 day. She didn’t get to meet her babies until 36 hours after delivery and they had to stay in the NICU for 10 days. While Brittany was so thankful it was not a longer NICU stay and the babies got to come home at the same time, she grieved the introduction into motherhood that she thought she would have. 


    Brittany’s next birth ended in a difficult CBAC under general anesthesia. Once again, she was not able to hold her baby right after birth like she so badly wanted. Her physical and mental recoveries were intense and tough. 


    Not long after her third baby was born, Brittany felt called to understand more about her births. She wanted to learn why things happened to her the way they did and if there was a way to help prevent other women from going through the same things. She became a doula with Joyful Beginnings Doula Care and absolutely loves it!


    With her fourth baby, home birth was on Brittany’s heart. With the education from doula work and her own births, Brittany set herself up for success by surrounding herself with a beautifully supportive birth team. Her HBA2C was quick, uncomplicated, redemptive, and empowering!


    Brittany’s Website

    The VBAC Link Blog: Preterm Cesareans

    TVL Blog: Everything You Need For Your HBAC

    TVL Blog: Provider Red Flags

    TVL Blog: VBAC/HBAC Preparation

    TVL Blog: VBAC Midwife

    TVL Blog: Big Babies

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Meagan: Hello, Women of Strength. We have our friend, Brittany, today with us sharing her HBAC. If you have not been with us very long or are still unsure about all of the crazy terms in the VBAC world, HBAC is home birth after Cesarean but she is a home birth after two Cesareans so HBA2C so similar to what I am. I am a VBAC but I was in a birth center, not a home. 


    I’m so excited to share– well, I’m not going to be sharing it, but she is sharing it today so welcome, Brittany. Thank you so much for being here with us. 


    Brittany: Thank you so much for having me. I’m excited to get to share my story. 


    Meagan: Absolutely. Me too. We will get right into that. I’m just going to do a quick review then we will do our intro and we will dive right in. 


    This review was left by Brianna Moody and this was left in 2023 and it says, “So binge-worthy.” Okay seriously, I could not agree already with her because I feel like this is the type of podcast that when you are looking for your options for birth after Cesarean, you just want to hear every story and I get into those binges especially with podcasts so I could not agree more. I believe that this podcast is bingeworthy. 


    It says, “I found The VBAC Link Podcast in my second trimester after my midwife suggested that I start listening to positive stories to get in a good headspace as I prepared for my VBAC.” Okay, I also love that her midwife is suggesting that. I 100% agree there as well. 


    It says, “What I didn’t expect was to hear so many different types of birth stories in one place. I was floored by the amount of information in each episode and by how much these stories impacted me. I found that I love listening to all of the different stories, even the CBAC stories. Honestly, I think those helped me process some of my fear about potentially having a CBAC.” 


    Okay CBAC, Cesarean birth after a Cesarean, just want to make sure we know what that means. 


    It says, “--as could be something that could still be beautiful and empowering. I tell everyone I know about the podcast, even first-time moms because there is truly something that could benefit every birthing mama on here. I am so happy to say that I had my VBAC baby in January.” Ah, so amazing. Congratulations, Brianna Moody. 


    It says, “--in January and it was the most beautiful experience. I still cannot believe I really did it. I took so many things from the podcast that helped make it possible. Thank you so much for sharing your heart and passion for VBAC with the world.”


    Okay, I’m obsessed with this review. So many amazing things right here. Yes, binge the podcast. You’re going to learn so many incredible things, like so many. Every story, just like she said, has its similarities but also it’s very different. That’s something that I love about birth then I love that she pointed out that CBAC could even be viewed as beautiful and empowering. I love that because I want you to know, Women of Strength, VBAC doesn’t have to be the right answer. If it’s not feeling right for you, that’s okay. You can go and have a Cesarean birth and it can be absolutely beautiful. 


    Know that it’s an option to do both and you can still have a beautiful, empowering experience. 


    Okay, all right. I’m going to let you guys go. We’re going to get to the intro and then we’re going to dive into Brittany’s HBAC after two Cesareans. 


    Meagan: All right, Brittany. A long intro. It’s time for you to share with us your beautiful stories. 


    Brittany: Yes, thank you. Okay. So I’m going to start at the beginning and give a little brief overview of my history and kind of what led me to pursuing an HBAC after two C-sections. 


    In 2019, I had my first pregnancy and I was actually pregnant with twins so that was a big, exciting thing for us. It was very unexpected and overall, I had a pretty normal pregnancy. I didn’t really have a whole lot of issues until the end. My blood pressure started to creep up here and there and then at 33 weeks, I went in for an appointment and I was diagnosed with preeclampsia. 


    That was very overwhelming. I did not have a lot of knowledge about birth really in general. I was one of those who went in and just trusted everything my OB said. I just rolled with it and they looked at us and they said, “We need to admit you. Your blood pressure is too high. You have protein in your urine.” 


    So my husband and I went over to the hospital immediately following and realized that we were going to be staying there for a little bit. They were able to manage my blood pressure for about a week and then I needed to deliver the twins at about 34 and 1. So it was actually July 5th, so it was right after the 4th of July and it was hard. It was definitely a hard, all of a sudden transition that we weren’t expecting. We were thrown into the hospital. My husband had to come out of work and things just continued to get worse. 


    At 34+1, we did another ultrasound and both were breech like they had been the entire pregnancy so we really were not given any options besides a scheduled C-section. I didn’t really think twice about that. I just thought, “Okay. This is what you do. We have breech babies. We need to do it.” So at 34+1 on July 5th, I went in for my scheduled C-section. I had the twins and obviously, being born early, they were taken to the NICU so it was a very abnormal experience in the sense that I had these babies. My body knew I had just had babies, but the babies were taken from me. 


    They were instantly taken from me and I had to go back on magnesium for my blood pressure post-C-section so I actually did not even get to see my babies, hold my babies, or touch my babies until about 36 hours later. 


    So it was just a very abnormal experience, especially for a first-time mom. I got wheeled to recovery and they were like, “Here’s a breast pump. You need to start pumping.” It was all of these things that I just wasn’t prepared for and I hadn’t done before. It was such a new experience. 


    Thankfully, they were only in the NICU for 10 days, but as you can imagine, recovering from a C-section, going back and forth to the hospital, trying to figure out pumping and how often to pump. It was just a lot. It was a lot and it was very unnatural. It is just not a natural experience to be separated from your baby or babies after they are born, but we made it and we got through that trial. We were very, very, very lucky that they got to come home together 10 days after being born. 


    Meagan: Wow, 10 days? 


    Brittany: Yes. A miracle within itself. 


    Meagan: That is very fast. Yeah, that’s great. 


    Brittany: It was very fast. They were doing great. They were just considered those eaters and growers. They really didn’t have any major issues. My son was on CPAP for maybe 48 hours but after that, they were just learning how to eat and grow and they got to come home together which is also very rare for twins. 

    Meagan: That’s awesome. 


    Brittany: Yes. We were very thankful for that. 


    Following that pregnancy, we got pregnant again unexpectedly when the twins were only 9 months old. As you can imagine, that is a lot. That was in 2020 and it was right in the thick of COVID. Things were different. Things were crazy. They weren’t even really, at least at the practice I was at, allowing women to come in for appointments until the second trimester. Just all of these different things. 


    It was a lot. It was a lot to process that I was pregnant again. I was wondering if I was pregnant with twins again. There were so many questions that I had and I just was not getting any answers or any support during that beginning period.


    So at about 13ish weeks, they finally allowed me to come in person and be seen in person. We were pregnant with just one which we were thankful for. It would have been a lot to have twins back to back. 


    But I didn’t have a significant amount more knowledge at this time. I knew a little bit more about birth. I knew I didn’t want to have another C-section. I knew that there was something called a VBAC. I was hoping to be able to do that. I didn’t want to have to go the same route, but I really didn’t have much education. 


    So we kind of just went with the flow. We were at a smaller hospital closer to us this time around and looking back, I would 100% say that my provider was VBAC tolerant, not VBAC supportive. I don’t think that I could identify that at the time not having the knowledge and the resources, but definitely now, I can tell that they were very just VBAC tolerant. 


    Meagan: Sorry to interrupt you, now looking back–


    Brittany: No, go ahead. 


    meagan: I was going to say that at the time you weren’t able to identify which is very, very, very common but now looking back, what were some of those very first signs? Is that what you were going into? 


    brittany: Yes. We kept having conversations about can I have a VBAC. Do I have to have another C-section? It was like, We’ll see. When we get closer, we’ll see. We don’t want to risk anything. It was a lot of the nonchalant I’m going to beat around the bush, but really, I’m probably going to pull the rug out from underneath you at the end. 


    There were a couple of appointments where I left really discouraged and in tears like, I feel like this isn’t going to happen. I don’t understand. But again, I just didn’t have the knowledge to really be able to question what they were saying. I just assumed that if this isn’t going to work out, it’s not going to work out because it’s not safe or x, y, and z reasons. 


    My pregnancy went on and of course, in the back of my mind, there was the concern of preeclampsia again because I had it with the twins, but I had no blood pressure issues. I had no issues with that pregnancy. Obviously, carrying a singleton compared to twins is very different and so we got towards the end and at about 38 weeks, they started talking about wanting to induce me. 


    I was like, “Why are we doing this?” But again, I just didn’t have the knowledge to really question their reasoning behind it. So they had actually scheduled me for an induction at 39 weeks. My husband and I left that appointment and we knew enough to know that we didn’t feel good about it. We were like, “This just doesn’t feel right. Something feels off about this. Why are we brushing this?” 


    So when the time came, we actually canceled that induction and didn’t show up. We went to just another regular appointment that following week and I was getting ready to go into my 40th week. They were okay with the fact that I had not done the induction, but they were really, really pressing an induction for 40 weeks which was a couple of days after. 


    meagan: Which is also another red flag. 


    brittany: Yes. Yes, very much so. Again, something I couldn’t identify at the time besides the fact that I felt insecure about it. So we decided to do the 40-week induction and when we got there, we were going to start with a Foley bulb but it ended up that I was already 3 centimeters dilated. My body had made some good progress. I was already effaced, so they jumped right to the Pitocin induction. 


    Because this was in the thick of COVID, there were no doulas allowed. I did have a discussion with my husband about potentially hiring a doula. I knew of doulas. I was like, I think this would probably be going for trying for a VBAC, but that was not an option. You had one support person allowed. That was it. My mom couldn’t be there. Nobody could be there. No doulas could be there. It was just a really, really hard time in the hospital system. 


    We did the best we could to prepare for what was to come but just did not have the education and the support that we needed going into the situation that we were going into. To make a very long story short, it was intervention after intervention after intervention after intervention. It was basically the definition of the cascade of interventions from Pitocin to epidurals to just everything in between.


    Thankfully, by morning, the induction started at about 6:00 PM, and by 9:00 PM, they were like, “Oh, we’re going to have a baby. This is going to be before lunch.” I was almost 10 centimeters dilated so we were really excited about that 


    We got to the pushing phase and things just didn’t move. I mean, I was making very little progress and knowing and having the knowledge that I have now, I look back and realize there was very much a disconnect happening with my mind and body which I’ve seen happen in some other women sometimes when having epidurals. 


    We pushed. I pushed for a total of about 5 hours. 


    meagan: Wow. 


    brittany: We did have some breaks in between. Yes. There was actually not an OB on the floor so it was with a nurse. She left to go home and the one that I was going to have was in the office, so they basically just let me keep at it and the nurse did try. I will give her credit in that she tried to get me into some different positions, but we just could not make any progress with her and we did know when my water broke that there was some meconium in my fluid so we knew that that was there and that we needed to be aware of it.


    But after about 5 hours, we were exhausted. It was like, “What is going on? Do we need to make some decisions? Why can’t we get an OB over here?” So finally, the OB I guess had finished her shift across the way in the office and made her way over. At that point, it was about 6:00 PM. It had been a very, very long afternoon and she came in and she did an assessment and she said, “There is a lot of meconium, so we need to make a decision. We either need to get this baby out with a vacuum or we take you back for a C-section.”


    I was like, “Well, what’s a vacuum?” We had no knowledge of what that was or what the pros and the cons were. They literally brought in a pamphlet and were like, “Here’s a pamphlet to read about it.” 


    meagan: They didn’t just tell you all of the pros and cons right there? 


    brittany: No. 


    meagan: They gave you a pamphlet after 5 hours of pushing and feeling exhausted? 


    brittany: Yes. They gave one to us. 


    meagan: I’m sorry, but that’s silly. 


    brittany: It’s terrible. Yeah, it’s terrible because I was in no head space. I was just beyond exhausted. She said, “I’m going to give you about 30 minutes and we are going to prep the OR. When I come back, let me know what you want to do and we can try the vacuum or we can go back for a C-section.” 


    I was like, “Okay.” My husband and I are talking through this and really have no idea what to do. Reading a pamphlet in that time and place is just not okay and not adequate. So she came back in and she gave me another assessment and she said, “Okay, I’m really sorry but we need to go back for a C-section right now. Meconium is very thick and this is becoming very problematic.” She took the vacuum option off the table and said, “We need to go and we need to go now.” 


    So we went back for what I consider more of just an urgent C-section, not an emergent C-section and it was an experience. About halfway through, I started to feel what I felt like was way too much. They actually did end up putting me to sleep fully after she was born. 


    meagan: After she was born?  


    brittany: She came out, and she actually– after she was born. So when she was born, she didn’t cry. I panicked about that and my husband was like, “It’s okay. It’s okay,” and we found out that she did have a lot of meconium and she did need to be resuscitated. She actually had an APGAR score of 2 which was much, much less than my twins who were born at 34 weeks so thankfully, they got that addressed very quickly and by that 5-minute mark, the APGAR score was back up to an 8, but at that point, I told them, “I am feeling way too much of what you are doing to sew me back up.” I started to really panic. 


    My pain level was very high so I saw her briefly and then they took her to the NICU and then they actually ended up just putting me to sleep because I woke up back in recovery following. She was a 9-pound, 2-ounce baby. They very much threw the label of big baby, this is why you couldn’t push her out. She was stuck, and things of that nature. 


    She was sent to the NICU again. She was my third NICU baby. This is my third baby that I haven’t held or touched post-delivery. Just a weird, weird experience. 


    So this C-section was much, much more challenging for me than my first. Obviously, I had labored down for many hours. I had pushed for many hours and then went into a C-section which makes a huge difference but I also had an infection post-birth which one of the OBs said was probably from the numerous amount of cervical checks that they gave me after my water broke. 


    So I just had a really, really hard time. I went into postpartum already struggling. I was struggling before I even had left the hospital. Thankfully, our little girl only had to stay in the NICU one night. She was able to be with me the second night and then was able to come home with us, but still, it was just a very abnormal situation where you wake up from the surgery. You just had a baby. Your hormones are all over the place but your baby is not there. You are in pain. It was just a very unnatural situation. 


    I really went into postpartum already a few steps behind. I just was really struggling physically. I dealt with a lot more pain this go around and mentally, I struggled a lot emotionally. I didn’t know it until later on, but I really believe that it’s healthy to grieve a birth that doesn’t go the way that you had maybe envisioned or planned and that’s such a healthy thing to do. 


    It felt so silly to me at the time. You’re like, Okay. My baby’s healthy. My baby’s here. Why can’t I get this together? But really, it’s so much more than that. I know so many people will say, “But we have a healthy baby,” which is what you want and is so great. It is not the only thing that matters though and I think so many people, so many women don’t realize that. People mean so well. Family and friends come in and say, “Oh, but thank God the baby’s okay.” Yes, of course, thank God the baby is okay, but it’s not the only thing that matters. 


    You essentially have a grieving mom in the thick of postpartum who also just had a major surgery, so it was a lot. It was a lot. It was honestly a really miserable postpartum recovery for me and I also had twins who were 17 months old. It was just a lot. So at my 6-week visit, the OB who did my C-section said, “Okay. That’s it. It will be C-sections from here on out. VBAC is off the table. You just need to know that.” 


    I left that appointment and I actually remember texting my cousin just about it and I was like, “Okay, I guess that makes sense. I’ve had two C-sections.” Then weeks following, I just was more and more unsettled with that. I really was grieving the whole situation. I was grieving the fact that I had three babies and somehow hadn’t gotten to hold one of them after delivery. It was all of these emotions that I was trying to process and through that, I became very obsessed with birth like, I need to understand. I need to know. I need to educate myself and I want to know as best I can what happened in Lyla’s birth. How did we end up here? 


    I really began to educate myself. I delved into all of the things. A few months later, I really felt the Lord calling me to pursue becoming a doula. I mean, we had three kids under two-years-old, so it was crazy to think about taking anything else on, but I remember it was that following July, I went to my husband and I was like, “Listen. I know this is crazy. I know we have so much on our plate, but I really, really feel like the Lord is calling me to pursue becoming a doula so that I can help educate and empower other women and hopefully help them avoid being in the same situation that I was.” 


    He, being the man that he is, was like, “I think you would be great.” He was like, “I’m totally supportive. I’m totally on board.” So then that started my journey of becoming a doula and it was about a year where I went through my program. I worked with those first initial moms. I did all of those things and I really, really loved it. Then I found out I was pregnant again and that was January of 2022. I knew for sure I needed and wanted a different situation. I could not walk through the same scenario that I walked through, especially with my second daughter and I wanted things to be different. 


    I really had home birth on my heart and where I live, I live near Charlotte, North Carolina, there was actually only one hospital that would allow you to pursue a VBAC after two C-sections. 


    meagan: Really? 


    brittany: All of the other hospitals will not, yes. So I started to pursue home birth but then also thought, Maybe I’ll do co-care because then I will have something lined up if something does go wrong, blah blah blah. So I tried to get into that hospital with their OB/GYNs and at all three of their locations, they were not accepting new patients. Initially, I was very discouraged. I remember crying that day, texting my husband, What are we going to do? This is the only hospital that will even allow this and that will even potentially let me come in and try. 


    He very simply said, “The Lord closed that door to co-care. Focus on home birth. That’s where your heart has been.” At the time, that overwhelmed me, but looking back, it was one of the best decisions and I’m so thankful for it. I do believe there is a time and place for co-care for certain women, absolutely, who want to do home birth but want to have that co-care piece, but for me, looking back, I think co-care would have destroyed me mentally just with all of the appointments, all of the extra things being said even though I knew and had that VBAC knowledge. It’s hard when you are constantly getting little bugs in your ear of, “You shouldn’t do this. We need to induce,” or things like that so in the end I was very thankful for that. 


    I simply pursued home birth. I interviewed a lot of midwives and I ended up with, I’m very biased but, who I think is just the best midwife ever. She’s really, really awesome and received just such amazing care. My visits were an hour long. It was very proactive care trying to stay ahead of things that could come up just with nutrition and supplements and things like that. 


    So I hired my team, my midwife. I hired a doula because I told my husband, I said, “I know I am a doula but I also know what happens when you are in labor.” I said, “Everything goes out the window and you go to labor land.” I said, “I want somebody there who I know can be my brain and can help me with all of the things when I can’t think straight.” He was super supportive of that and I hired a really awesome doula. 


    So once I had my team in place, I felt really, really good about it moving forward. My husband was so extremely supportive. He’s one of those where anybody who is a doula, their husband is extra educated at birth. I feel like he has to listen to all of my stuff all of the time, but he was so supportive. At that point, I had a really standard pregnancy. 


    The biggest things that I did were to continue, I used The VBAC Link a lot just whenever that doubt crept in my mind of Am I making the right choice? Is VBAC after two C-sections really safe?” I would go back to some of those resources that you guys put out. That knowledge that I had just to read through again to give myself that sense of peace that I made again. I listened to every VBAC after multiple C-section podcast that you have and really tried to focus on those positive birth stories. 


    The biggest thing I did was that I really made the effort to protect my mental health meaning we kept the decision we made very, very private from family and friends which was hard because everybody, especially after my last experience was like, “Where are you giving birth? What is the plan?” But I knew that I didn’t need the opinions of everybody. I didn’t have the time or energy to educate everybody around me in the decision that I had made. 


    My husband, myself, and our birth team were confident in the decision that I had made in moving forward so we just kept it very private. My best friend and my sister-in-law knew and they were my support throughout then once we got toward the end and I reached that full-term mark of 37 weeks, we did tell all of our parents because we wanted our parents to know. My mom was going to be there and his mom was going to come at some point. 


    Thankfully, our family was very supportive. My mom used to be a labor and delivery nurse so she had a lot of questions, but my midwife sat down with her and let her ask all of them. So our family was on board, but I really just made the point to protect my mental health and only view and read things that were positive and only talk to people who I knew were going to be encouraging and positive about it. That was truly one of the best decisions I made throughout my pregnancy. 


    Fast forward, we get to 39 weeks and 4 days. I thought for sure that I was going to go over 40. With that doula mindset, I always tell my clients, “Prepare to go over 40 weeks so that mentally you’re not distraught when 40 weeks comes.” Oh man, I was like, “It’s going to be over 40.” I was so secure in that that when it happened, I was not ready almost. I was a little overwhelmed like, “Oh my gosh. I’m not 40 weeks yet though.” 


    I’m 39 and 4. We had actually went out with some friends that morning. We took our kids somewhere and my mom was there. I remember my mom putting us back in the car. She got all emotional and she was like, “I just feel like it’s going to be so soon.” I was so frustrated I remember because I was like, “No, mom. I’m not 40 weeks. It’s fine.” She’s like, “Call me as soon as something happens.” I’m like, “Mom, we have time.” Little did I know I was going to have a baby that night. 


    Later that afternoon, I decided, I need to go to Costco. I need to stock up. My best friend was like, “You are crazy to go to Costco on a Saturday. That is going to put you into labor.” Sure enough, that is exactly what it did. I went to Costco and got everything I needed. I ran into Target and my first contraction started. I had Braxton Hicks most of my third trimester so I was very aware that this was different the first time it happened. 


    But again, that doula mind, I was like, This could be nothing. I’m just going to ignore it. We’re going to continue on. They kept coming as I finished my shopping about every 10-15 minutes apart so when I left, I decided to text my husband and say, “Hey, this could be nothing but just so you know, I’ve had some contractions. They are about 10-15 minutes apart. We’ll see what happens.” 


    They had started at 6:00 PM when I was out. I finished up getting when I needed, came home. My girls were already asleep on the couch and my husband put them to bed. We ate dinner. My son hung out with us for a little bit and things continued to pick up. I was like, Okay, this is definitely happening I think. 


    At about 7:00, I alerted my midwife just to let her know, “Hey, it’s probably going to be a long night, but I’m definitely having contractions.” I let my doula know and our photographer. I got everybody in the loop. 


    After I ate, I was like, “I’m going to get in the bath with some Epsom salt and try and relax. See if I can relax these contractions enough to maybe get some rest.” In my mind, I was like, This is going to be an all-night thing. Let’s see if I can get some sleep. But that is not what happened. 


    I got in the bath for maybe 10 minutes. I had a few contractions and was like, I cannot sit like this. This is not comfortable. I called my mom and I was like, “Hey, I’m having contractions. Don’t worry about coming over yet though. We’ve still got plenty of time.” Thankfully, she ignored me because she was about 50 minutes away at the time. She ignored me and got in the car and came anyway which was a huge blessing because things continued to pick up really quickly. 


    My husband continued to set our room up and the birth pool up but also tried to support me through contractions. Thankfully, all of our kiddos at this point were asleep upstairs which was something we had just prayed about because I wanted them close by, but I also knew that I just needed my space especially with them being so young. So that was such a blessing. They were all asleep. It was just me and my husband. 


    So around 9:00 PM, my mom thankfully arrived which was a blessing because moments before, I was like, “Okay, you need to tell my mom to come,” because things were just moving really, really quickly. 


    I particularly found a lot of relief in one position and that was the position I wanted to stay in. I was on all fours on the ground rocking back and forth on my yoga ball and everybody said, “Hey, try this. Try this.” I was like, “Nope. This is what’s working for me. I just want to continue doing this,” so that’s what I did for a long while. 


    Shortly after my mom got there, we called my doula to tell her to go ahead and come because she was about 45-50 minutes away as well. 


    With that phone call, she was able to tell because I had prior talked to her as well that things had definitely picked up. We were definitely probably in full-blown active labor. She had told my husband, “Go ahead and start filling the birth pool,” because anybody who has had a birth pool knows that it can take some time. 


    He went ahead and started to fill the birth pool while my mom stayed by me, helped support me, and my doula left and was on her way. 


    Shortly after that, my water broke. A lot of pressure, a lot of pressure, then my water broke. I remember being so panicked telling my mom, “Please check for meconium,” because I just kept thinking about Lyla and the situation that I had with my prior daughter. I said, “Check for meconium. Check for meconium.” She looked and everything looked fine. 


    Following my water breaking, I moved right into transition. It was game on at that point. My husband called my midwife. He said, “Okay. We definitely need you to leave and come.” Thankfully, he had gotten the pool all ready so the pool was ready. Warm water was in. I was able to get in and that was about 10:45 PM. I was able to labor through transition in the water which was a huge blessing. I’m one of those who loves to be in the water. I love to be in the bath. I find it to be very relaxing. 


    I remember at this point telling my mom, “I feel like I’m getting no breaks.” I still at the time did not know I was in transition. Looking back, I was very easily able to identify the phases, but when you are in it, even having that knowledge, you’re like, “No. There’s no way. This is going to go all night. How am I going to do this? I’m not getting any breaks.” But I had so much great support and my doula arrived not long after I got in the pool. She was doing some counterpressure and giving my husband some things to do to help. I have a lot of tension in my face so giving him some suggestions of things he could do. 


    Not long after getting in the pool, that fetal ejection reflex definitely kicked in. I had heard obviously people talking about it. I had studied it in my work becoming a doula, but until you really experience it, you’re like, Wow, this is no joke. People are like, “How am I going to know when to push?” Oh, you will know. Your body is going to do it whether or not you want it. That is exactly what happened. My body was doing these little pushes without me even doing anything. 


    Soon after, I started to really lean into that and continue with that pushing. I remember feeling such relief when I got to the pushing phase because it was very challenging. It was giving me that purpose through contractions and something I could focus on. I actually got a little bit of relief when I was doing some of the pushing. I remember being really thankful for that. 


    My photographer arrived. My mother-in-law arrived during that time and my midwife team got there at about 11:15. I already started pushing a little bit, but I remember although yes, it’s challenging to not have an epidural, it was also so amazing because having had the experience of Lyla where I pushed for 5 hours and they were like, “Well, she’s not moving. She’s in a bad position. She’s stuck.” I could feel nothing. I could feel everything. I could feel the progress of my baby being moved down frequently during pushes. I could feel her in the birth canal. I could almost feel the progress I was making at different times with her which was so motivating and so helpful for me. 


    That was just such a night and day experience from my prior experience pushing with Lyla and then after about an hour and 15 minutes give or take a little bit, my daughter, Charlie, made her way into the world. It was about 12:25 AM and it was a beautiful, beautiful, beautiful experience. She was born in the water. Literally, my overwhelm of emotions following was like nothing I could ever really articulate in words. 


    The oxytocin was on full blast. I was on this birth high and having had prior C-sections, one of the downfalls of a C-section is that you are on so much medication and so many pain meds that I always felt like when I came out, I was in a haze like I didn’t really know where I was and things like that so to be so present and to literally feel my hormones doing what they were designed to do was such an overwhelming experience. 


    I remember talking to my husband about that days later and I was like, “It was just such a high after she was born.” This was obviously my first experience getting to hold the baby post-birth so that was very emotional for me getting to pull her up to me and have her right there and just be able to hold her. My husband was there and people who we loved most were just surrounding us. It was a very, very beautiful, overwhelmingly positive experience. 


    One of the benefits of home birth is that you get to move from the pool or wherever you gave birth to get comfortable in your bed. So that was just awesome. I remember when they got me comfortable in my bed, I was looking at my birth affirmations wall. I had a bunch of stuff hanging up by the pool and I remember thinking, “Oh my gosh. Thank God that’s done. that was the hardest thing I’ve ever done,” then a minute later, I was like, “I feel like I’m going to have to do this again.” 


    I was so overwhelmed with the experience and the emotions. My husband and I got to lay in bed. We got to cuddle our girl and pray over her. Everybody was so great. They were cleaning everything up. My mother-in-law was making food for everybody. It was just such a beautiful experience. 


    Then about an hour into it, we decided to do just her newborn checks and have the midwife look her over, weigh her, and stuff. We knew she was big. There was no denying it when she came out, but never once did I look at her and be like, “Gosh, she’s a giant baby. She’s so much bigger than Lyla,” or anything like that.


    We weighed her and everybody made their guesses. She ended up being 10 pounds, 10 ounces, and 22 inches long. The 9-pound, 2-ounce baby that they said I could never push out and could never have had her vaginally, I ended up going on to have a 10-pound, 10-ounce baby girl. 


    She also had a nuchal hand. Her hand was up at her face when she was born which can make things a little bit more challenging, but I delivered her and I had no tearing. It was just such an amazing redemptive story after being told, “You never could have birthed this 9-pound baby. You’re never going to have a vaginal birth. The door is closed for you,” and really have the exact opposite happen. I went on to have a much larger baby and she was great. She was healthy and had no issues. 


    My children were just thrilled the next morning to wake up and come and meet her. To this day, they will still bring it up. “Do you remember when Gigi brought us downstairs and we had a new baby?” It was such a beautiful, redeeming story for all of us, my husband included. I think sometimes we forget how much of an emotional experience it can be for the dads and especially to see their wives go through so much so it was just so healing for both of us. It was just such a beautiful experience. I feel like I could go on and on about it. I had the best postpartum care. 


    For those who aren’t familiar, with a home birth, your midwife comes to see you multiple times. Mine came to see me six times. She came at 24 hours, 48 hours, 72 hours, one week, and two weeks, so she was constantly there checking on me, checking on my baby girl, and it was just care like no other. All I had known was I had major abdominal surgery then 6 months later, they brought me in and were like, “You’re cleared for everything.” It was so overwhelming and this go around, I had somebody who was like, “How are you doing mentally? How are your emotions? How are things healing? How is your nutrition? Are you resting?” All of these things are so, so important for postpartum, and I think so many women don’t even realize these things about what postpartum should really look like. 


    I will forever be thankful for that care as well. That was just unlike anything I had prior experienced obviously as well. 


    So yeah. I mean, overall, it was such a beautiful experience. I’m so thankful for how it played out. The Lord had answered so many of our prayers throughout and I’m so, so thankful to my midwife who believed in me and in my body’s ability to birth my baby no matter the size and that team of people who I had, I will forever be grateful. 


    Meagan: Are you willing to share your midwife with those in your area who might be feeling restricted because of the lack of support in your area?


    Brittany: Yes. I will say I had a certified professional midwife. I live in North Carolina. I live outside the Charlotte area in Monroe. We are very lucky. We have such a fantastic group of midwives in the Charlotte area of certified professional midwives. There are truly multiple great midwives. My midwife’s name is Brooke. She is just the best of the best. She is a dear friend of mine and I have been really lucky as a doula to get to work with some of her clients and still see her at births and things following. 


    If you are in the Charlotte area and you are considering home birth, things can be a little bit hairy because we do have some restrictions in regards to certified nurse midwives compared to certified professional midwives, but feel free. I think in the show notes, my information will be there. I would be so, so happy to help guide anybody in this area and give you a list of names of some really, really great providers who support VBAC or VBAC after multiple Cesareans because it can be a hard world to navigate whether you are in the hospital system or planning a home birth. It still can be really hard to navigate if you don’t know where to look. 


    Meagan: And can people find you somewhere if they have any questions they can write you to on your own doula page? 


    Brittany: Yes. Yes. You can find me at Joyful Beginnings Doula Care. You can find me on Facebook and Instagram. I also have a website at joyfulbeginningsdoulacare.com. Please feel free. I love nothing more than helping guide moms in finding that right support and then also obviously, I love working with VBAC moms as a doula. But you can find me there. Feel free to reach out. I love doing whatever I can to just help other women have more positive experiences especially when it comes to VBAC because that’s really, really hard sometimes. 


    Meagan: Absolutely. It is. It’s hard and it’s frustrating that it’s hard so it really takes a village to find the right support. Let me tell you. I’ve been taking little notes along the journey of your story and there are so many things.


    One, you had a preterm Cesarean so that’s a thing and we don’t even have time to go through all of these things so while she was sharing, I was like, “Ope, we have a link for that. Oh, we have a blog for that.” We have so many blogs. We have all of it. I already sent it off to our amazing transcriber, Paige, who will make sure that this is all in the show notes. 


    But preterm Cesarean, then a close duration between Cesarean and her TOLAC that ended in a CBAC. Talking about red flags in finding the right provider, processing the birth, and co-care– I wanted to explain for anyone who didn’t know what co-care means. I love that you pointed out to the fact that it’s really, really great for some people and it’s not great for others. I think that if you’re interested in co-care or if you are interested in it, you need to tap into you as an individual and the type of place that you’re in because co-care can be amazing and it can be tricky because of what Brittany said where you can go and you can be getting this information from a hospital and then this information from your home birth midwife or your birth center midwife and they are not the same. 


    They can pull your mind out of a very positive space and start putting a lot of doubt and questions. So if you’re going to do co-care, I think it’s super important no matter what, but you really, really need to know your facts because it’s going to be important and it will likely come into play where someone might say something and it’s the opposite of what the other professional is saying so you need to know what the evidence is. 


    Big baby– I’m going to include a blog about big baby if you are being told that you have a big baby or if like Brittany, you were told that you would never, ever get a baby out of your pelvis because your babies are too large and it was a whole pound plus bigger baby for her VBAC. 


    Oh my gosh, what else? I love that you also talked about something that is so unique to home birth in my opinion and I just wanted to touch on it really fast. That is the care after. Here in the U.S. and I know that if you are not listening from the U.S., it’s very different outside of the U.S. Here in the U.S., it is very standard to have the type of care like what Brittany described even with a Cesarean. It’s an abdominal surgery. It’s a pretty big deal to have surgery or to have a baby vaginally and to not be seen, called, or asked anything for six weeks. Six weeks– let me tell you how much can happen in six weeks. A lot can happen. 


    I love the uniqueness that home birth does offer and I love that you even felt that and that you saw it yourself. You saw the difference of 24 hours, 72 hours. You’re getting those mental checks. You’re getting, “How are you sleeping? How are you eating? Where are you at? What are you doing?” We’re getting those check-ins. It is so important. It is so important. So if you are birthing at a hospital and you are likely going to be in the traditional line of the six-week follow-up, I highly suggest with checking in with a postpartum doula or getting someone who is a professional that can check in on you– a therapist even if you have gone through therapy. 


    Have a 72-hour checkup with your therapist after birth. If that means you just talk and you’re like, “All things are peachy. Great.” There are things in the U.S. that we have to do where we, unfortunately, have to take it upon ourselves to take care of our mental health because it’s just not the way the standard care is. 


    I’m going to leave it at that. Brittany is shaking her head. She’s like, “Mhmm, yeah.” Do you have anything to add to that? 


    Brittany: The only thing I would add to piggyback off of that especially if you are a VBAC mom, take the time. Do the research. Reach out to a local doula who you know is VBAC supportive if you need extra help doing this but take the time to find a provider who is supportive and not tolerant because your providers and your birth team, the people you are allowing into your birth space, can truly make or break your birth experience. I have witnessed it. I have experienced it so do your due diligence on the front end. 


    It is not always easy, especially navigating the hospital system, but there are people out there. A lot of local doulas do know, “Hey, I’ve had a lot of great experiences with this OB/GYN when it comes to VBAC”, or “Hey, stay away from this practice.” Do your due diligence. Find a team who really believes in your body’s ability to birth your baby vaginally. They need to believe in it as much as you do and just take the time to educate yourself. I believe that education is the key to empowerment. That’s such a big piece of the work that I do with my moms leading up to birth with both birth and postpartum but take that time. Educate yourself. Find a team who believes as much as you do in your VBAC. 


    Meagan: I am just going to leave it right there because I think that is a nice way to zip it right up and complete this beautiful episode. Thank you so much for sharing. Congratulations. I love so much that your kids still talk about, “Remember how she brought us downstairs?” So awesome. I’m so happy for all of you and congrats again. 


    Brittany: Thank you so much 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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    53m - Jul 15, 2024
  • Episode 316 Lynn Schulte Returns Talking About the Pelvic Floor and More

    Lynn Schulte, the founder of the Institute for Birth Healing, was featured on The VBAC Link Podcast Episode 123 back in 2020 and today she is back! So many of you loved her information about Cesarean scar massage and know her insight about pelvic assessment, movement restriction, and balancing uterine ligaments will be just as valuable to you. 


    Lynn gives tips on how to tell during pregnancy if you need pelvic assessment and also the three signs to watch for to know if scar tissue is interfering with your quality of life. Through the Institute of Birth Healing, Lynn has trained hundreds of practitioners all over the world to be able to assess more women for pelvic restriction and to know just what to do about it. She shares how to find one of her practitioners in your area. 


    While pelvic floor physical therapy may require investing more in yourself both from your time and finances, the benefits can last for years to come and are so, so worth it.  


    Lynn's Educational Platform

    Clinical Practice Website

    Institute for Birth Healing Directory

    Blog: Preparing the Pregnant Body

    Blog: Supporting Pregnant Clients

    YouTube: How to Massage Your C-section Scar

    Lynn's Live Course Schedule

    Institute for Birth Healing: All Courses

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Meagan: Hello, Women of Strength. We have a returning guest with us today and her name is Lynn Schulte. She is with the Institute for Birth Healing and she was with us, I don’t know, 3 or 4 years ago talking about scar massage, and today she is going to be talking with us more about pelvic floor health and the cervix and failure to progress and so much more. 


    Today, I am so excited to share with you guys again Lynn. Before we get started, I wanted to tell you a little bit more about her. Lynn Schulte is a Pelvic Health Physical Therapist for over 30 years. She is the principle instructor and founder of the Institute for Birth Healing. She has successfully healed thousands of women from all the issues women experience after birth and is now teaching courses to bodyworkers to help them do the same. She found a common birth pattern that shows up in the pelvis after birth and knows how to effectively release these patterns. 


    Knowing we are more than just our bodies, Lynn works on all levels, physically, energetically, and spiritually with women to help them access their full potential. She also teaches bodyworkers how to work with the energy of the body and how to access and use your intuition in your bodywork sessions. She offers a certification process to help birth professionals become Birth Healing Practitioners. Lynn holds a Bachelor of Science in Physical Therapy from St. Louis University in St. Louis, Missouri and I am seriously so excited to have her back on today. 


    Before we get going on this amazing episode, I did want to share a Review of the Week and this is on our Parent’s Course. It’s from Jenna and she says, “I just started but already have learned so much. After two C-sections and one where my doctor made me think it was very risky, I was terrified to try again. With this course, not only have I learned the truth about VBAC, but I’m also excited to attempt mine in August.” Sending you all the love Jenna and seriously, let us know how things go. 


    If you guys are looking to dive more into what VBAC looks like, what the history of Cesarean looks like, what the evidence is on VBAC and how to increase your chances of having a VBAC, check out theVBAClink.com. We have courses for both parents and doulas wanting to learn more about supporting birth couples around you. 


    Meagan: Okay, so Lynn, I am so excited to dive in today again with you. It’s so cool that you have been on before. We were just talking about it before we started recording– a long time ago it feels like and now we are circling back and I was telling her you guys, I actually found her very, very first– I actually didn’t even know about pelvic floor therapy or any of that really like pelvic floor health or anything and do you want to know how sad it is? By the time I found Lynn and her YouTube page back in 2019 probably, I had three babies. I had three babies. 


    Lynn: Yep. 


    Meagan: That to me right there is a problem. 


    Lynn: Totally. Totally. Yeah, let me tell you what that problem is in my world, okay Meagan? We do a wonderful job in our country here in the States of taking care of mom and baby and making sure mom stays alive and baby stays alive. Where we fail pregnant people is where nobody is assessing or treating what I like to call the birth door. The birth door is that passageway. The pelvis and the pelvic floor muscles are the birth door. I’ve just seen way too many times in my practice where women have issues. 


    One client came to me because she wanted a vbac and she had 42 hours of labor. I went to assess her and her tailbone was sticking straight up into the pelvic outlet so the baby’s head was hammering it for 42 hours and why? My heart broke for her because I was like, “Why did nobody assess this?” 


    Meagan: Right? 


    Lynn: It blows my mind that doctor’s aren’t aware to check that the pelvis is capable of birthing a baby. Now, I don’t want to give moms the wrong feeling here because most pelvises, a large majority of pelvises, are able to get a baby out when the baby comes into the pelvis in an appropriate manner. Where we are failing moms is that the doctors are not as concerned about the position of the baby, about the balance of the baby and the way the baby is entering into the pelvis. It’s like they don’t even understand that component. Nobody is assessing to see is anything in the way? Is anything going to be in the way of my baby coming through my pelvis? 


    That’s where a pelvic health PT can come in and do that assessment for you. If you see one of the pelvic practitioners who I’ve trained, they know exactly what to look for and not only look for but what to do about it when they do find things. 


    Meagan: Yeah, so I was going to say that we find it. We recognize it, then is there something to do? A to-do? And the answer is yes? 


    Lynn: For the most part. For that one client whose tailbone was sticking straight up, it was fused in that position. 


    Meagan: Was it? 


    Lynn: It was so there was no mobility of that tailbone to be able to move out of the way so what I love about my work is working with a pregnant person and really getting a chance to evaluate what her pelvic bones are doing and the position of them and trying to treat what we can but when we can’t make effective change, I like giving the information to the birth team to say, “Hey, if labor stalls, you might want to push here.” 


    Sometimes I will get a marker out. I get a Sharpie out and I put a big X on a person’s sacrum because the sacrum needs to be nice and even for a baby to come on out. The sacrum needs to be able to move backwards and forwards to allow the baby’s passage through the pelvis. If that sacrum should be as even as possible to make that movement happen as easily as possible, but sometimes it can be in a torqued position and if it’s in a torqued position in there in the pelvis, usually there is some dysfunction or back pain. 


    Another problem is that most OB providers, you go in complaining of back pain and they go, “Well, you’re pregnant. Live with it.” In my world, that pain and that dysfunction could be a problem that you’re going to bring into your birth then. Why not optimize our bodies the best we can for birth prior to going into birth? 


    Meagan: Prior. Key word: prior. 


    Lynn: Prior, everybody. 


    Meagan: Prior. Prior. You know, I think that’s what a lot of us don’t think is that we need to do this prior to going into birth. It’s just that so many people especially I’m going to call us out as C-section mamas. Pelvic floor or anything like that or thinking about it down there doesn’t even cross our minds sometimes because we didn’t have stuff happening down there. 


    Lynn: Right. Typically, right? 


    Meagan: Typically. 


    Lynn: Yes. When we are pregnant, we are all consumed about baby growing and is baby going to be okay? But what I would love to help see shifting is okay, the difference between a smooth birth and a birth that has complications is really what a person brings in their body to that birth. So it’s these falls and impacts on your tailbone or your buttocks or it could be surgery so appendectomies– anytime in your lifetime creates scar tissue. Your appendix is in the right lower quadrant of your belly and if you’ve had your appendix taken out even as a child, there is scar tissue that forms and that scar tissue is in the area of the uterus. It will pull that uterus to the right side. 


    Meagan: Interesting. 


    Lynn: 100% all the time, all my mamas who’ve had appendectomies, I find their uterus is off to the right hand side and cannot move to the left. 


    Meagan: Really? 


    Lynn: They don’t know it. They don’t realize. I had this one mama come to me and I always look at the baby in the belly and look at the belly. You can see. If your baby is only inhabiting one side of the belly, there’s a problem there but most practitioners don’t notice it, don’t ask about it, and don’t know what to do about it. 


    Really, if we could help educate OBs and help them understand the importance of helping to get baby into the best position possible to come on out, that’s going to decrease our C-section rate. 


    Meagan: I was going to say, that is probably going to completely decrease that because we know that failure to progress which can be positional, and failure to descend or fetal position are three really serious things that are happening and causing Cesareans. 


    Lynn: And all three of those are things that can be addressed in the structural tissues, in the soft tissues, in the uterine ligaments, in the pelvic bones, in the pelvic floor muscles, in our hip muscles, in our rib cage. Everything is influencing it. Baby goes where there is space. 


    Meagan: It makes sense. I would too. I did. I did, 35 years ago. 


    Lynn: Yes. Baby goes where there is space so baby tells us where there is tension in your body. Either they are avoiding tension or there is so much tension on one side that they can’t get away from it. That’s what we can assess and we can move that belly so anybody who is pregnant listening into this, you can take your hands on either side of your belly and you should be able to push that baby as far to one side as you are to the other side. It should be even. If you only go halfway one way and double the other way, that’s a restriction in your uterine ligaments and that’s an indicator that you might want to think about going and getting some work done because people who know how to work with the uterine ligaments can help release them and get even mobility. 


    It’s amazing. I have some blog posts that I’ve just recently posted on my website, instituteforbirthhealing.com where I’ve done some talk on pregnancy. There are before and after pictures of treating someone and the baby. In several of the first pictures, the baby looks like it’s almost going side to side and those babies have round, right ligament tension. 


    We all have those ligament pulls and those twinges and that’s your round ligament. That’s your round ligament, but if it’s only on one side, that’s a ligament that has an issue. If there’s a little twinge here and a little twinge there that alternates, but really, we should be able to carry a baby without any pain period. 


    If we are having pains and discomforts, that’s telling us that things are in dysfunction and it would behoove you to try and get support so that you can release those dysfunctions to help you have a smoother birth. 


    It’s interesting. If you guys check out those blog posts, the position of the baby is straight up and down. The belly, the shape of the belly, changes dramatically after you release the ligaments. 


    Meagan: We will make sure to put those blog posts in the show notes so they are very easily found as well. If you are wanting to check out these photos, check out the show notes after this episode. 


    Lynn: Yeah. It’s just so fun as a practitioner to see these drastic changes. 


    Meagan: Oh, I’m sure. 


    Lynn: Right? And to feel those. We talked about the belly and the uterine ligaments. We talked about the pelvis and the pelvic bones, but the pelvic floor muscles are the stoplight for birth. 


    If you have too much tone and tension in your pelvic floor muscles, that baby is not coming through. 


    Meagan: It’s going to be hard, yeah. 


    Lynn: You could have a yellow-light tone which is going to make it a lot harder but what we want is a green-light tone where it’s nice and bouncy and springy and you press down and it gives and it releases and it comes back up but if there are breaks in there, that baby is going to have a hard time because those pelvic floor muscles need to lengthen for baby to come on out. 


    I really encourage everybody. I know this is The VBAC Link and I hope for those listening in who want to have a vaginal birth after a Cesarean, please go get all of this stuff checked out. Please go work with a practitioner who can help you figure out how to push effectively. 


    Meagan: Yes, yes. 


    Lynn: I can’t tell you the number of people I see in my practice and I go, “Okay, can you push?” I do intravaginal work. I just use fingers in the muscles and work with the tissues vaginally, no speculums, and I’ll just put my fingers on those pelvic floor muscles and I’ll say, “Can you push my fingers out?” I can’t tell you the number of times that people contract and pull up and in. 


    Meagan: Interesting. 


    Lynn: So then if it’s like, “Push my fingers out,” and you’re contracting, now you’re pushing but you’re tightening at the same time and your baby is not going anywhere. 


    Meagan: Mhmm, and we have failure to descend. 


    Lynn: Yes, yes. There are so many things that can cause failure to progress, failure to descend, asynclitic babies, and OP babies. All of that is stuff that can be dealt with prior to the labor. It should be. 


    Meagan: That keyword again: prior. 


    Lynn: Yes. 


    Meagan: I’m loving this because it is something that like I said, I didn’t even know about until three babies were already born and I was one of those people who was told that my pelvis was too small. You mentioned that this tailbone was physically fused so maybe it was broken in the past and fused kind of funky or something like that. 


    I actually had a client who had that situation and her tailbone actually did break during birth but her first was a C-section. She was going for a VBAC and there was all of this restriction in the first one and it did break which is one of the wildest experiences I’ve ever had during birth. She was actually good with it. She was like, “That’s great. My baby came out vaginally,” but then she wanted to learn how to heal it properly and things like that. 


    There are situations where like you said maybe the pelvis isn’t working with us in our favor, but I was told my pelvis was too small and that I would never get a baby out and I had failure to progress and that my body didn’t know how to get to 10 centimeters. 


    So I think really a lot of people are told that so I wanted to know after someone who has been told that their cervix maybe didn’t dilate or wouldn’t dilate, we know that there are lot of factors that could play into this especially too early of an induction or things like that, but what can we do prior to labor if this was a diagnosis of ours and we are wanting a vbac or even not wanting to have more kids and we’re having back pain or we’re having weird things like maybe incontinence or pain during intercourse or things like this. What can PT do for our cervix to maybe help that and what could be wrong? 


    I say wrong loosely, but what could be less ideal with our cervix at that time? 


    Lynn: So the most common answer for everything that you just talked about there is the uterosacral ligament. 


    Meagan: Okay. 


    Lynn: The uterosacral ligament is the ligament that attaches the posterior/inferior aspect of the uterus near the cervix to the sacrum. Well, some to the sacrum, some to the sacrotuberous ligament, some to the spinous processes. So the attachment point to the pelvis varies in different women. 


    Meagan: Wow, okay. 


    Lynn: So depending on any restriction and one of the biggest issues is that the uterosacral ligament helps to drain the cervix. If the uterosacral ligament is restricted, it may cause the cervix to swell. 


    Meagan: Interesting, which we have seen. 


    Lynn: Yep. Yep. So the uterosacral ligament being restricted can cause the cervix to swell and then not be able to open up fully so then you don’t get full dilation and things. Uterosacral ligament will be the first place that I would look. I just had a client a couple of weeks ago who was pregnant with her fourth and all three times, she was getting ready to push, but then she was told, “Oh, you have a cervical lip so don’t push. Don’t push. Don’t push,” and it was a swollen part of her cervix. I went to assess her and her right uterosacral ligament was restricted. 


    Meagan: Interesting. 


    Lynn: She’s like, “This time I’m just going to go for it. I’m not going to let them tell me to not push,” because that’s traumatic in and of itself. 


    Meagan: Yes, especially when your body is just intuitively doing it. 


    Lynn: How do you stop a poo coming out of your anus mid-stream? You can’t. So to tell someone to stop that is just traumatic and not a great thing. But the uterosacral ligament is where I would first look. That is one of the main ligaments that I work with in my clients is just to make sure that there is nice balance and that it can work evenly. 


    Some people are saying scar tissue on the cervix could cause some inability for it to open fully. I like to work with cervixes when clients come to see me and they’ve had the biopsies or they’ve had anything where the cervix tore or something during birth. I just want to give that scar tissue some love and just see if we can’t soften it because scar tissue can be very hard and it’s not as flexible as normal tissue so I want to just see what can I do to help soften it. 


    Most, I don’t tend to do that during pregnancy. I would like to see someone who has any scar tissue prior to even getting pregnant though. 


    Meagan: Prior prior. Prior to even getting pregnant and conceiving. 


    Lynn: Right. We have to plan ahead ahead here guys ideally because I don’t like messing with the cervix once someone is pregnant. 


    Meagan: Understandable. 


    Lynn: I will around 39-40 weeks and especially if someone is overdue, I will go give some love to that cervix and make sure it is feeling okay and soft and mushy all around. We want that. It’s very interesting to feel some cervixes. Some cervixes feel like a duck’s bill. The cervix is really long on half of it and then it’s shorter on the other half like it got dragged out as the baby came out. 


    I mean, I’ve felt all kinds of different cervixes in their afterbirth and if someone does have any type of scar tissue, ideally, let’s work with it in the postpartum period when you are healing so that it can be nice and happy and healthy and then maybe even right before you get pregnant again to get some work done on that beforehand and then I would leave it alone until baby is well-cooked in there. 


    Meagan: Right. And those things can help those lack of dilation, those cervical lips. It’s interesting that you said that because I have a client, she is actually a VBAC client, she shared her story on this podcast and she just had another baby where I was with her and same dang thing is that cervical lip. It happened. It’s so interesting but she labors, she labors, and that cervical lip just does not let go and then she ends up getting an epidural at the very end, and then within 15 minutes, it’s gone which is interesting so what is it? Is it possible that the epidural or maybe she is struggling and she is extra tense? 


    Lynn: Yeah, that could be it. 


    Meagan: Maybe she’s intuitively feeling like she needs to push but can’t because she has this lip. I’m trying to relate to what you said. I’m going to text her after this and be like, “Hey girl, you should go check this out.” 


    Lynn: I’m not quite sure what the epidural is doing for the drainage. Like you said, the epidural bypasses the muscles so it takes the muscles out of the picture so it must be doing something for that uterosacral ligament to help it to relax as well. 


    Meagan: Interesting. 


    Lynn: So that it can now drain for things. That’s really what is helping to drain the cervix is the uterosacral ligament so if there is a dysfunction– well, if the pelvic floor muscles are tight and pulling the bones out of position, that can put strain on the ligaments so it’s possible that indirectly, the epidural is causing that to not be as tense. Yeah. Yeah. 


    Meagan: Yeah, it’s really interesting because she’s like, “I don’t want the epidural,” but right at the 9.5 centimeters, she goes for a while then yeah. I’m just curious. I never even knew about this drainage. There are so many births in my head that I’m connecting this with where I’m like, “Oh, this could have been that.” 


    Okay, so we did talk about cervical scarring, working it out prior to getting pregnant and doing PT during. Do you want to add anything else to the cervix? 


    Lynn: I do because the cervix on an energetic level is the blackbox recorder of the pelvic history. 


    Meagan: Okay. 


    Lynn: Meaning that the cervix energetically is actually holding onto everything that has happened in that vaginal space kind of like the history of it. So tuning into the cervix and helping the cervix to realize that it can let go of whatever is no longer serving you and just asking that cervix to energetically release– 


    Meagan: Let go. 


    Lynn: Let go of what’s no longer serving you can just relax it. When I tune into a cervix, I just love to give it love and gratitude for all that it has done for my clients and just offer it that gratitude. It’s just so amazing. You can feel it just melt in your finger when it’s respected and when it can sense that love and that connection. It just softens. 


    Meagan: Wow. Our bodies are incredible. I mean, I’ve said this before. I’ve said this before, but holy cow. They are incredible. 


    Lynn: They are. They are so fun to work with. They are so fun to work with. I totally agree. 


    Meagan: Oh yeah. Yeah. 


    Okay, so can we talk about someone who has never had a vaginal birth and has maybe had one, two, multiple Cesareans or even just one and how can– okay. We just talked about getting an appendix removed. A Cesarean is a major deal to our body. As you mentioned, we get scar tissue and scar tissue can be tough sometimes. We’ve got a lot of scar tissue usually with a Cesarean but what type of things can someone if they are fresh out of a Cesarean specifically do with pelvic PT? What would that look like? I just had my Cesarean and I’m coming to you. 


    Lynn: Right. If it was just a planned Cesarean where we didn’t go into labor, then we really just want to work on that scar tissue and get greater mobility in that scar tissue. I used to think that maybe we were getting rid of scar tissue until I saw what scar tissue looks like in the body. I observed a surgery and I’m like, “Oh man, we are not getting rid of it.” 


    Meagan: Yeah, because it’s really thick. 


    Lynn: It can be. It can be. What we are doing is increasing its flexibility and how to help it best lay down because scar tissue lays down very haphazardly and all of the fibers lay in all different types of directions trying to create stability and close up the tissues and help the tissues to be strong. It isn’t until it learns how to lay down. So say if you got a scar on your arm and if you bend it and flex your arm back and forth, it teaches the scar tissue how to lay down properly to work that arm. 


    Meagan: Okay. 


    Lynn: In the abdomen, we are more 3D so it’s harder. The tissue doesn’t figure out how to lay down so it’s still in there very criss-crossed everywhere until we get in there and massage it and teach it how to move effectively. That’s where I do have that YouTube video of how to massage your C-section scar. That’s how you found me in the first place. 


    Meagan: Yes, that’s how I found you and we actually have a whole episode. I think it was 123, right? Is that what I said in the beginning? It’s 123 with Lynn and we’re talking about scar massage and scar care. 


    Lynn: Yes. Yeah. That helps it to learn how to lay down properly. I think in that episode we also talked about the three main issues that people can have when people have too much scar tissue or when the scar tissue is inhibiting things and that’s bladder frequency, deep thrusting pain with intercourse, and back pain. 


    Meagan: Yeah, that’s one of the things I was searching for because I had this back pain that just didn’t go away. 


    Lynn: Yeah, because the back is not the problem. The pain is hardly ever where the problem is in the body and you’ve got to understand where that pain might be coming from. It’s usually from a restriction somewhere else in the body that is creating that pain. So releasing that scar tissue and getting it as flexible as possible prior to getting pregnant again would be ideal. 


    Now, not a lot of people know how to do that so then they get pregnant and they’re like, “Oh,” you may have some pulling. You may get some tension in there. I like to work around the C-section scar when someone is pregnant especially newly pregnant. I don’t like messing around with anybody in that first trimester. We don’t know if it’s a viable pregnancy. We don’t want to be moving it around and working it too hard and if they do miscarry, then I might get blamed that you created that. Well, it might have not been a viable pregnancy to begin with, so I just want to be really, really careful in that first trimester. 


    As the uterus grows though, it actually is stretching out that scar tissue. Becoming pregnant is actually a beautiful thing because it does help the tissue learn to lay down. However, what I thought then after someone who has had a C-section, they get pregnant again, no matter how they deliver, I thought the C-section scar especially if they did have a VBAC, that the scar tissue would be nice and loose and it’s not. It definitely tightens up again after the uterus shrinks back down. 


    It’s almost like it gets reactivated. So it needs more scar tissue. It needs more massaging of that scar tissue. We don’t really know how long scar tissue forms in the body so there are other body workers who have had C-sections are like, “Oh no, you need to work on that the rest of your life,” so it could always potentially be causing those three issues– the bladder frequency, deep thrusting pain with intercourse, and back pain. 


    So if you ever get any of that, massage your C-section scar. 


    Meagan: Yeah, I was going to say that after I found your video, I started doing that and then I’d be like, “Oh, I’m doing really good,” then all of a sudden, I’d be like, “It’s back,” then I’d massage again and be like, “Oh, it’s really good,” then my old partner Julie was like, “I’ve never even heard of this. I’ve never touched my scar like that.” I’m like, “You should try it. It’s amazing.” 


    With C-section moms, do you ever work internally with them as well? Is there possible trauma within the pelvic floor or cervix or anything internally? 


    Lynn: Yes. After any birth, no matter how the baby comes out, I can find the cervix anywhere internally. Ideally, the cervix is right in the midline and I have to just reach up right in the middle of the vagina to find it but after birth, it can be off to the left or to the right. It can be pulled backward. It can be poking up into your bladder which is going to cause a lot of bladder frequency so we need to help bring that back and get that cervix balanced in there again and help it to find its mobility. 


    The analogy is the cervix needs to be like a pinata in vaginally. It needs to be able to move 360 and up and down. The C-section scar tissue is what keeps it from being able to move up. That’s what creates that thrusting pain so releasing the scar tissue and getting down to the level of the uterus and getting the uterus to move side to side and rotating inside, those are all mobilizations I do to check the mobility of the uterus and then treat whatever it can’t do and that really does help. 


    But internally, so once I get the cervix in its proper place, I also want to release and pull that. There’s a pubo-cervical fascia which is the fascia where on the inside of that fascia is the bladder so I just like to call it the bladder. I like to make sure that the bladder and the cervix have as much disconnect as possible because that scar tissue can glue them together. 


    Meagan: That is what we determined when I went in is that I can’t remember if they said my uterus or my bladder. I don’t remember but they said that they were adhering together. 


    Lynn: Yeah. The uterus lays over the bladder and underneath is where they cut so when it lays down on that bladder, it can inhibit the two and like you said, fuse them together. 


    Well internally, I like to get in between those and pull the bladder off of the cervix of the uterus and just make sure there is good mobility between those two. I do it both internally and externally. 


    Meagan: Okay. This is something that like I said even for those moms who are maybe done having babies now and it ended in a Cesarean or vaginal birth, could benefit really from and like you said, we don’t know how long scar tissue can keep going. I don’t know, maybe for the rest of our life so maybe we start years down the road like you said in your video that I found originally. This woman was much older than her 20s having babies. She was much past that and having this pain and it was related to her Cesarean scar. 


    Women of Strength, if you are having symptoms like any of this, don’t shy away from caring for yourself and taking care of yourself. Go find a practitioner, a pelvic floor practitioner who can work with you and help you. You don’t have to suffer. You don’t have to deal. You don’t have to just say, “It’s normal. I had babies,” or whatever. 


    Lynn: It’s not. It’s common, but not normal. 


    Meagan: Common but not normal and I’m wondering if it’s more common because of the lack of support that we are getting after we have babies and even before. It really should be part of our prenatal care. 


    Lynn: Absolutely. 


    Meagan: We go every 4 weeks then we go every 2 weeks then we go every week and somewhere in the middle of that or the whole time, we should be seeking this care as part of our prenatal care I truly believe and even more in our postpartum too because so many people do have a lot of complications and we’re not healing well because we weren’t getting the support and then we are going in and we’re having 41-hour long labors with posterior babies and a cervix that doesn’t want to progress if you have ever heard my story, this is it to a T. 


    Yeah. That can be hard and long and exhausting. 


    Okay, so tell us more about one, where to find you and tell us anything else that you would like to say and how to find your practitioners and all of the things. 


    Lynn: Okay, so one other thing that I just want to throw in here because I just want to help those who have this understand it. There are a lot of people after you have a C-section who cannot touch their scar. 


    Meagan: Oh yes. 


    Lynn: That to me is a sign of trauma that the incident and the event was too overwhelming for your system and it created this avoidance or this trauma freeze response in the body. Please know that that is something that can be worked with. You don’t have to just keep avoiding it. I do. My colleague and I both do Zoom sessions. We can help you with any of the birth trauma that you’ve had so that’s really effective. 


    I just want to put that out there that trauma can be held in your tissue and the scar tissue when there’s trauma in there is way more painful and it’s larger. When you release the emotion that’s being held in that scar, the tissue instantly becomes smaller. 


    Meagan: Yeah. I mean, just like what you were saying earlier with the cervix, the dervix holds this past trauma and everything and boom. Yeah. 


    Lynn: Yeah. You give it permission. 


    Meagan: Absolutely and we’ve talked about this in the past too about that like loving your scar, appreciating your scar– 


    Lynn: It’s a lot easier to do when you’re not traumatized about it. 


    Meagan: Yes. I do think though that in my opinion, from my experience, it was really part of my healing and acceptance of an undesired Cesarean. I did not desire my Cesarean. I did find out that it was likely unnecessary which was really frustrating. I could have looked at that and harbored a lot of negative but it was really interesting because I have grown to just love it and appreciate it. 


    Lynn: Yeah. 


    Meagan: And respect it. You kind of talked about this earlier like giving the cervix love and appreciating the cervix and when it receives love, it can give you love. It melts and it is appreciative. I think that goes a lot with a Cesarean scar. If we can give it love and appreciate it for what it did for us and what that represents, I think that can be really healing.


    I love that you guys offer that trauma release processing because I think that’s a really great first step to a huge step forward. 


    Lynn: Yes. Yeah. It just makes it easier and in my view, If you’re struggling, if it’s hard, if it’s challenging, there’s a reason why and when you get to the reason why, then things can be effortless and easier for you. 


    So I just want to throw that out there to help people understand that there may be something deeper at play here that when you heal or you look at what is happening at that deeper level, then being able to love your scar or touch your scar is easy. So just know that. Know that that is something that you can get to. 


    Meagan: Absolutely. 


    Lynn: Yeah. 


    So my business name, there are two websites that I run. One is thecenterforbirthhealing.com and that is my clinical practice so if any of you listening in would like some of that healing support with your birth, please reach out. We can do a Zoom session from anywhere that you are at and then the other website is instituteforbirthhealing.com and that is my clinical educational practice or educational platform teaching other body workers how to support pregnant and postpartum clients and on that website, there are additional resources at the top of the menu. Click on that and then at the bottom is a directory. 


    We only have 200 of my students currently in that directory. We are going to be revamping then I’m just going to be putting everybody who has completed a course in there so that people can find practitioners because we are just finding practitioners are already busy and they are not getting their listing down. I just want moms to find support. I know that when people combine forces, they know how to best support you. They are different than a regular physical therapist. They are way different from a pelvic health physical therapist. They have a much broader range of techniques and skills to be able to better support your healing. I highly recommend one of my practitioners and just know that my directory will be changing here in the next couple of months too. 


    Meagan: Yeah, because you’ve got your summit. You have so many things going on. You guys, she’s got a podcast. She’s got a blog. I’m here. I literally just wrote on the director and just typed in “Salt Lake City” because that’s where I’m at and right there we’ve got two really, really close. It’s really awesome to see. This reminds me so much of our Find A Doula. We are the same.


    Are you still in Colorado? 


    Lynn: Yes. Yep. Still in the Boulder area. 


    Meagan: Okay, yeah. She’s just one person in one state. This just makes me so happy and smile because it is the same concept with our doulas where we can’t change the world alone. We can’t help every single person out there so why not train these people to do what you do which is amazing work and help people all over find the support that they deserve? 


    Lynn: Yes. That’s my goal. I want mamas to heal more completely after birth. I don’t like the care we are receiving in pregnancy and postpartum. When I started this, gosh. I started this in 2016. I had been working with postpartum women even before then so almost 10. 


    Meagan: We’re in 2024. So 18 years? 


    Lynn: Yeah, 18 years. There was hardly anything on the internet about postpartum healing. 


    Meagan: 100%. I know. 


    Lynn: I am just thrilled to see the influx of information and education going out on the social media and helping moms understand that this is a thing and I just really hope that someday every pregnant person is seen by someone who really understands how to assess their body and make sure it’s ready for birth and then really being supported more holistically in that postpartum period as well. 


    Meagan: Absolutely. And this is just my own little side note. I don’t know if any of your practitioners take insurances or things like that, but I want to tell you Women of Strength, if you are listening right now, there are a lot of things in birth that are not covered by insurance. I think it’s B.S. I’m just going to say it. I understand the availability– not the availability. What’s the word? It’s nice to have insurance accept it but I have learned at least here in Utah that insurance doesn’t think that pelvic floor is a big deal. 


    So most of the providers I know in my area are not taking insurance. A lot of the time, we can look at that and be like, “Oh, so expensive” or this or that. Let me tell you, Women of Strength, it is worth it. It is worth it. Put value in you and your body and your birth and your postpartum recovery. The value is there and I’m going to tell you this right now. 


    10 years down the road, you’re done having your babies. You’re not having pain. You’re not having incontinence. You’ve had better birth experiences and better postpartum experiences. Let me tell you that whatever you paid at those visits, you’re not even going to bat an eye. In fact, you’ll say, “I would have paid $15,000 more.” Not literally. But do you know what I mean? 


    Lynn: 100%, Meagan. 


    Meagan: It’s so worth it and I understand that in the time, it’s really, really hard so if you are having a hard time paying for things or you’re really wanting a pelvic PT throughout pregnancy and you’re really wanting a doula or a photographer or all of the things that come with birth that insurance doesn’t cover, register for those things. 


    Lynn: Yes. Yes. 


    Meagan: Get people to help. When people say, “Hey, can I bring you meals after?” Be like, “You could, or” whatever. Whatever that means, but I promise you that it’s 150% worth it to invest in yourself. 


    Lynn: I just want people to understand that the practitioners who take insurance are working in a practice that can only see you for 30, maybe 40 minutes tops. 


    Meagan: They are limited. They are completely limited. 


    Lynn: Yeah, and a lot of them are younger physical therapists so they are not as experienced and those who are paying and have their own private practices and they choose to do cash pay, they are the experienced ones. They are the ones who are going to get you better faster. If you’re a new mom, I see people 1-3 times and other practitioners are 6-10 times so yes, I might be a little bit more expensive but what’s more expensive, your time and the effort and energy getting to and from me? Or do you want results? 


    Meagan: Yeah. 


    Lynn: There’s value in paying for your own services. You take it way more seriously. You show up more fully for it because you’re investing in yourself. 


    Meagan: Yeah. 


    Lynn: It’s so worth it. It’s so important. Meagan, I’m so glad you said that. Thank you. 


    Meagan: Yeah. Yeah. I thought about the word that was coming to my brain. It’s convenient. Going with a provider who takes insurance is more convenient because it’s usually easier sometimes. 


    Lynn: It is financially, but like I said, time and energy and effort. 


    Meagan: That’s what I was going to say, but is it really convenient? I just want to put it out there because I know money is a thing. I know it is tight out there but I fully believe in investing in yourself and your health and your well-being and hopefully one day, the world will change and it will be more accepted on the insurance side. But if it’s not, don’t let it turn you away. 


    Lynn: Amen. Amen, sister. 


    Meagan: All right. 


    Lynn: You preach it. 


    Meagan: I know. I feel a little passionate about this. 


    Lynn: I can tell and I love it. I love it. 


    Meagan: Oh my goodness. Well, thank you again so much for having us and like I said you guys listening, we’re going to have those blogs with the pictures. We’re going to have her podcast, her website, both of the websites so you can find a practitioner near you. If you don’t see a practitioner near you at the very moment you are listening, give it a sec and check back because like she said, it’s going to be updating. 


    Lynn: I also have a Facebook community group that has over 10,000 practitioners and moms in it so you can reach out. The Facebook community group is Institute For Birth Healing Community so if you go on Facebook and check out that group and join it, you could ask in there and see if anyone has trained with me in there.


    Meagan: Awesome. 


    Lynn: Yeah, thank you. Thank you so much for this. 


    Meagan: Oh my gosh. Thank you again. I think you are amazing. I’m so grateful I found you in 2017. I think it was 2017 when I found you, maybe 2018. Just keep changing the world, girl. You are killing it. I’m so happy for you and all of your support and all of your practitioners. 


    Lynn: Thank you. Thanks so much, Meagan.  


    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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    50m - Jul 10, 2024
  • Episode 315 Emmy's Empowering HBAC After Failure to Descend

    “It was perfect. It really was. I would do it again and I would do it the exact same way. I felt safe and I felt respected and I felt like there was never a moment in it that I was scared.”


    Emmy’s first birth was a medicated hospital birth turned C-section after two hours of unsuccessful pushing. Her greatest trauma was being so out of it that her first thoughts after her baby was born were, “I don’t care.” Her multiple failed epidural/spinal placements caused intense postpartum spinal headaches. Overall, Emmy’s difficult experiences were a recipe for postpartum depression and anxiety.


    After finding The VBAC Link, Julie and Meagan became Emmy’s virtual friends helping her through tough postpartum days. When she became pregnant again, Emmy knew that Julie Francom needed to be on her team. 


    Emmy shares how she made the choice to switch from planning a hospital VBAC to an HBAC and how home birth relates to cows! Her birth was powerful, intuitive, and healing.


    After her husband caught their baby and Emmy pulled her up to her chest, she shares the most healing moment of all. “I wasn’t thinking in my head, ‘I don’t care’. I was thinking that I had this beautiful little baby in my arms. It was what I had dreamed of. “


    CDC Article

    The VBAC Link Doula Directory

    The VBAC Link Facebook Community

    Down to Birth Podcast

    Dr. Stu's Website

    The VBAC Link Blog: Choosing Between Home Birth or VBAC

    Birth Becomes You Birth Photographer Directory

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Julie: Hello, hello. Surprise! It’s Julie here and I’m super excited to be here with you guys today. I always love coming on the podcast with Meagan you guys know. I love to get a little bit salty and a little bit straight-up talk on the podcast. I quite enjoy my time here but I am a little extra excited and a little bit less spicy and salty because I have a client of mine. Her name is Emmy and she just had a VBAC about 3 weeks or 4 weeks ago. Has it already been 4 weeks? Oh shoot, I owe you your gallery already. It’ll be done in a few days. 


    But I photographed her birth and she is incredible. It is super exciting because she is going to tell you more about this. She actually reached out to me 2 years ago when I was still doing doula work at the beginning of her journey after her C-section baby and it’s just super fun to be here full circle with her and have her share her story. I want to hear it from her perspective. I haven’t heard it from her perspective yet. 


    We are just going to have lots of fun chit-chatting. You guys are going to come to love Emmy just like I do. 


    But before we do that, Meagan has a Review of the Week for us. Wait, did I say it’s Julie? Did I introduce myself? 


    Meagan: Yes, you did. 


    Julie: I feel like some people don’t know. You have been doing solo episodes for a really long time and I feel like some people don’t know who I am anymore which feels kind of weird to me. 


    Meagan: You are the famous Julie. 


    Julie: The famous Julie. Anyways, Julie Francom, co-founder of The VBAC Link. I separated a couple of years ago but pop in every once in a while to get a little bit salty. If you know, you know. Anyway, here’s Meagan. Meagan has a Review of the Week for us and I’m going let her do the rest of the things. 


    Meagan: If you know, you know. Okay, we have a review. It’s from lar23 and it’s titled “Love Your Podcast”. It says, “Hi Meagan. I love your podcast so much. I always end up crying at the end of them. So happy for these moms who get their VBAC. Thank you for creating this podcast. It’s so inspiring to hear these stories. I’m 38 weeks pregnant currently and hoping to get my VBAC here soon. Keep doing what you’re doing. You’re helping so many people and doing so well to achieve their birth dreams knowing that we are not alone. Thank you for that.” 


    That was left on Apple Podcasts and that was actually just about a year ago so lar23, if you are still listening, we always love to know how things went so maybe write us in at info@thevbaclink.com. If you haven’t left us a review yet, please do. We love them. They make us smile and guess what? I actually even still share them with Julie today. 


    Julie: It’s true. I love getting a good screenshot of a review. It makes my heart happy still. 


    Meagan: Right? They do. Every single time they come in, my smile immediately grows from ear to ear. 


    Okay, are we ready? 


    Julie: Yeah. 


    Meagan: Julie, Emmy, let’s do this. Let’s hear this amazing birth story. I was reading a little bit of her bio part and can I just tell you that there is one little thing that stuck out? It all stuck out, but there was one little thing. “I found a doula I loved. I hired Julie Francom as my birth photographer. You bet I felt starstruck.” It says, “I interviewed multiple midwives before choosing one. Originally, I planned a hospital birth, but the more research I did and after listening to the podcast with Dr. Stu, I felt very strongly that a home birth was right for me. I was just as shocked as the guy that I told the next day that I felt that way.” 


    Can I just say that stood out to me? You hired the doula. You found an amazing photographer who is also a doula. You interviewed multiple people. All right. I’m just going to leave that right there for the intro to your second story and let’s cue the first story. 


    Julie: Let’s go. I’m excited. “I felt starstruck”. It’s still weird to me when people are like, Oh my gosh. I don’t know if that’s what you were like, but it’s just so funny. Anyway, sorry. Go ahead, Emmy. 


    Emmy: Yeah, we’ll start with the first one and then I’ll talk about my starstruck interview with Julie. Yeah. It was 3 years ago almost exactly because I had my kids a day apart 3 years apart– March 14th and March 15th so it was 3 years ago, I was teaching 6th grade and it was a new subject and a new school so that was my focus. I did zero prep, but I was so optimistic. I’m like, Everyone goes in and has a baby. We did nothing. 


    Suddenly when my water at 39 and a few days started to leak, we were like, Okay, we go straight to the hospital. 


    My water hadn’t even broken. It was just a leak. 


    Meagan: That’s what you’re told a lot of the time. If your water breaks, you go in. 


    Emmy: Yeah, so you’d sit down and a little gush would happen. We high-tailed straight over to the hospital. I was feeling Braxton Hicks contractions. They weren’t even painful yet. They checked me and to quote, I was maybe a half-centimeter dilated. I said, “Great. When can I get the epidural?” She was like, “You can get it right now.” I’m like, “Fantastic. This is greater than my wildest dreams right now,” because at that moment, I had done no prep so my fear was of the pain. 


    The fact that I was getting this epidural before I even felt pain was amazing in my head. I get the epidural at maybe a half-centimeter dilated and I lay on my back on a bed for 30 hours. I did do the peanut ball a little bit back and forth. There was some movement there, but as far as any other real movement, there was nothing. Little did I know, he was OP and now I’ve done a lot more research on OP babies and learned a lot about how OP babies need movement. 


    I read a whole article from Rachel Reed that was just talking about how the most important thing for an OP baby was movement and I did not move. It was probably no surprise now looking back that I started to have really horrible back labor having an OP baby which if you’ve had back labor, it’s not like a normal contraction where you have a 60-second contraction and then you have a 10-minute break. It is continuous and it is awful. 


    Meagan: Not great. It’s not great. 


    Emmy: Excruciating and it goes all the way up your back. I’m numb from the waist down but it was going all the way up my back to my neck and it was continuous. I was just in excruciating pain for hours and hours. I was just holding on to the side of the bed just dying.


    Meagan: I can already relate so much. I was holding. I’m like, Help me. Do something. 


    Emmy: That’s so funny. Do something. I was dying. I finally get to complete and I pushed for 2 hours and I remember the OB pretty vividly. I remember him being like, “Okay. You’ve pushed for 2 hours. When I went to school, they said to let a mom push for 4 hours and now they say to let a mom push for however long she wants.” She was like, “You can either keep pushing or you can just go in for a C-section and we can get this over with.” 


    I mean, I was done. I was like, “Cut him out.” 


    Meagan: Sure. Yeah. And if you are given that, it’s like the golden ticket. You could have your baby right now and not continue this. Sign me up. Yeah. 


    Emmy: So I was like, “Yep, please cut him out.” 


    So they wheeled me into the OR and sorry. While I was pushing, I guess from the hours of back labor, my back had seized. I could not bend it. While I was in that pushing phase, he kept saying, “Okay, do a crunch. Sit up in a C formation.” I was like, “My back is not moving. It is unresponsive. It’s not that I won’t. It’s that I can’t.”


    Then they wheeled me into the OR and I’m getting a spinal block and they are telling me, “Your epidural needs to be a C position.” I’m like, “My back is not moving. I’ve never experienced this before. It is unresponsive right now.” He tried three times to get the spinal block in. Two times it came out and the needle was bent because it was just hitting. 


    Meagan: Oh my gosh. 


    Emmy: Third time’s the charm. So I had five. Three times from the spinal block and then it had taken the epidural twice to get it in so I had five punctures which makes more sense when I talk about my spinal headache later on. They finally get the spinal block in and they lay me flat on my back. It went from the back labor had been agonizing, but for some reason when they laid me on my back, it was intolerable. I started thrashing. I was like, “My back, my back!” I started thrashing. I’m under the impression that he gave me morphine, but whatever he gave me, I went warm. My whole body went warm and numb. I couldn’t move anything and in my head, I’m like, Thank heavens. I don’t care what he just gave me but I’m so grateful right now that this pain has gone away. 


    But then like I said, I believe it was morphine. It moved up into my lungs and my breath started getting shallower and shallower and shallower. I’m like, I’m suffocating right now. My breath was getting more and more shallow and I started to panic more and more. 


    Meagan: Scary. 


    Emmy: I turned to the anesthesiologist to say, “I can’t breathe.” Nothing came out. The morphine had also affected my vocal cords and so I’m looking at him, I’m like, I can’t breathe. I’m just mouthing the words and he’s not looking at me. So then I look over at my husband who is also not looking at me. I’m like, “I can’t breathe.” I’m looking between these people like, I’m going to die on this table and nobody is going to even know because they are not looking at me and I can’t talk right now. 


    Meagan: Oh my gosh. 


    Emmy: Yeah, finally my husband looked at me and he’s like, “She says she can’t breathe.” He looked at my stats. He’s like, “No, her oxygen levels look fine. She’s fine.” In my head, I’m like, No, I’m dying. He put an oxygen mask on me and in that moment, I closed my eyes and I’m like, I’m just going to focus on breathing because right now I’m in a complete panic attack that I’m dying. 


    They got him out. I heard him cry. They took him to the NICU and for however long they were gone, I remember a nurse saying to me, “Do you want to meet your baby?” In that moment, in my head, I was just like, I don’t care. I don’t care. Colin comes walking in with a swaddled baby with tears rolling down his face. Colin is my husband, sorry. Colin comes in with tears running down his face holding a swaddled baby and I could have truly cared less. 


    Out of all the traumatic things that have happened to me in my birth up to that moment, that is the moment that sticks with me the most where it’s like that is the moment you dream of as you are preparing especially for this first child to come into the world. It’s that moment when you get to hold your baby for the first time and for me that first moment in my head was, I don’t care. 


    That really slingshotted my passion for this next birth. It was going to be amazing and I’m going to make sure of it. I heard a quote recently that was like, “Passion a lot of the time stems from trauma.” I felt that so deeply in my bones at that moment. I was like, I look back at the last 2 years and some months since I’ve had the baby and I’ve been so passionate about it. It definitely stemmed from my trauma from my first birth. 


    Julie: Oh my gosh, yes. I relate to that too. That is why I’m so salty dang it. 


    Meagan: I know. It’s hard. It’s hard when you do have that passion and then you are seeing people going in the direction that we were going that created that passion and possibly trauma. It’s hard because you are like, No, no, no, no! Don’t go there. Come over here. We want to help and save and yeah, do whatever we can do, right? 


    Emmy: Yeah, and unfortunately, my postpartum experience wasn’t really that much better. I really struggled with postpartum as I not only was recovering from a C-section but a few days later, I developed a spinal headache which is where they have punctured the membrane around your spinal cord so it starts leaking fluid. You’ll sit up and it starts leaking fluid and it’s an immediate migraine. You’re trying to go to the bathroom. You’re trying to feed your baby and you are dying from a migraine. 


    It’s kind of a peculiar thing because the moment you lay down, the moment your head hits the pillow, it goes away. When you sit up, it’s leaking this fluid but when you are lying down, you’re not leaking the spinal fluid and it goes away. 


    I called my sister and she was like, “Oh, I’ve heard of that. It’s a spinal headache.” I called my OB and told him my symptoms. He was like, “Yeah, you can either go into the hospital and get a blood patch or it’ll go away in two weeks.” I’m like, Two weeks? I’m not waiting two weeks for this to go away. I can’t even sit up to try and feed my baby let alone function. 


    Meagan: Oh, so did you go get the blood patch? How was that? For someone who may have experienced this or if they experience it, can you explain the process of that? 


    Emmy: Yeah. I mean, it’s uncomfortable and kind of painful. You go in but it’s also pretty amazing too. You go in and lie down. They pull quite a bit of blood from your arm. They numb the spot that is leaking which was where I had five dots from all of the different needles and they put that blood into that spot and so the blood goes in and it clots where it is leaking and you lay there for about a half hour and you sit up and it’s gone. It was pretty amazing. 


    I sat up and I was scared and it was immediately gone, but you add so much blood into that area that it is filled with pressure for three days so it’s like you can’t really bend your back. That’s kind of the theme of my story I guess is I can never bend my back. For three days, I couldn’t bend my back or it would spasm from that spot. But it did get away from the spinal headache and if I had another spinal headache, I would do it again. 


    Meagan: Okay, good to know. 


    Emmy: But yeah, so I did go in and get the blood patch. It fixed the problem, but I recovered from a C-section. I had this blood patch. I really struggled with breastfeeding. I know now that I had a lactation specialist, an IBCLC come to my house after my second birth. She looked at his tongue and she was like, “Oh, he’s got a heart-shaped tongue. That’s a severe tongue tie.” I didn’t know that at the time. I know about tongue ties now but I didn’t know about it then. I was just really struggling with breastfeeding and the pain from it. 


    I was like, Something has to go and the only thing I have control over right now is breastfeeding. I chose to exclusively pump which comes with a whole other host of pros and cons but I chose to exclusively pump because I was like, Something needs to go pain-wise here and breastfeeding is the only one I can let go.


    Looking back, I really had a recipe for postpartum depression and anxiety. I had a traumatic birth and recovery from a C-section. Breastfeeding wasn’t going well and he was a terrible sleeper for 3 months. I was extremely sleep-deprived and I didn’t really plan my postpartum care well. I got one week that my mom and my husband were home at the same time and then they were gone but I still needed care after that for at least another week or two. 


    My nutrition was poor because I was worrying about my nursery and cute clothes and my baby shower and stuff. I hadn’t really thought about postpartum care with freezer meals and snacks and things like that so I was just starving which I’m sure didn’t add to helping with postpartum depression and anxiety when your nutrition is poor. I was still worrying about work and had to go back to work 6 weeks later which was a stressor. 


    Isolation is a big contributing factor to depression and anxiety and I just hadn’t found a group of mom friends yet too. I was just giving out so I was home all day for the first 6 months. For the first 6 months, I really struggled with postpartum depression but I learned what a VBAC was the first week post C-section. I was like, What is this? What is this VBAC they speak of? 


    Then I found The VBAC Link about the same time because I was Googling VBAC and I found your website which led me to the podcast. I was taking multiple walks a day at that time because I was just bored and I was just devouring The VBAC Link. Julie and Meagan were my best friends for the first– they were my only friends for the first 6 months. 


    Meagan: Aww. 


    Julie: I love that but it’s also kind of sad but I also kind of love it. 


    Emmy: Yeah. I was listening to your guys’ voices. You were the people I talked to the most each day for a while. I just devoured it and I went from believing my C-section was necessary to seeing how one thing probably led to another and led to the cascade of interventions and just being like, Oh, I actually think I really could have done this if I had done things differently and prepared differently. I think I actually would have been able to do this the right way. 


    Then listening to people talk about having this redemptive second birth, I’m like, Wow. People have births and like their births. I thought everybody just hates birth. I’m like, No. People are actually having births and enjoying their births. How do I get that? 


    So it really spawned into this passion which came out of trauma but turned into a really great thing and about a year postpartum, I reached out to Julie because I was anticipating getting pregnant probably in the next year. I was like, I know I’m going to build the greatest team that I can in this area. In my vision, Julie is on that team. 


    I reached out to her and you said in that first interview, you were like, “Okay, I am still doing doula work but I am starting to switch over to photography but I will honor your request for a birth doula.” I was like, “Great! Do you know any hospitals or midwife groups in-hospital who are VBAC friendly?” That was still in my head was that I was going to end up in a hospital. Julie gave me some midwife groups and some hospitals that she had good experiences with for VBACs and that was my plan moving forward. 


    It wasn’t until a year and 3 months later that I ended up getting pregnant and by that time, Julie was like, “I’m really just doing photography.” 


    Julie: I told the Universe that this is the thing and Katie, your doula, will attest to this. I struggled going back and forth where my passion was and where my heart lay. I was like, Okay, I will do doula and photography for a little while. I told the Universe 16 times that I was only doing photography and then I felt like I had to stay committed to it and I really thought that you would be best served by a fully dedicated doula. In the end looking back, I think that was super the right choice. Anyway, yeah. That’s kind of where that was. 


    Emmy: Yeah, I’m really just doing photography now but I have a really great friend who has done the VBAC Link course and I’d love to do your photography. At the time, photography was not in the realm of my birth vision at all. It was actually something that was kind of weird to me. I thought, People photograph their births? But Julie was such a core keystone part of my birth that I was like, I don’t care if you are there to be my massage therapist for this. You will be there. 


    I ended up hiring a photographer because I wanted Julie to be there so badly. I wanted her knowledge there and then it ended up in the end being that I am so glad I have photos of this. This is so cool. I think all around we made the best choices having Katie. Shoutout to Katie who is the doula that Julie recommended. 


    Meagan: She is amazing. 


    Emmy: Yeah, she was not a bad recommendation at all. It was amazing. So I think in the end it turned out great to have Katie there and have Julie there. Everyone was in their right place. But yeah, when I reached out to Julie, I hadn’t even thought about home birth. Home birth to me was woo-woo. I didn’t have an interest in natural birth but I actually ended up listening to Dr. Stu who I know you have had on your podcast, but the first time I heard him was actually on the Down to Birth podcast, episode 111 if anyone is interested where he talks about his journey from being a regular OB/GYN to being a home birth OB/GYN. 


    He dispelled the fears around home birth and the questions that everybody asks like, “What if things go wrong?” In those 45 minutes, I literally went from, I’m only having a hospital birth to I’m going to have a home birth. It spoke to my heart and I immediately was like, This is what I need to do. I felt really strongly. It was really bizarre. I’ve never had a full shift in what I was thinking before. I just felt very inspired that that was what I needed to do. 


    I was a little worried about convincing my husband, Colin, but I showed him that podcast and he seemed immediately on board. He’s a dairy farmer actually and listening to the podcast, there were a few things where he would pause it and say, “That’s very interesting. I actually see this in cows.” I was like, “Great. I’m glad that you feel really connected to this.”


    Meagan: I love that. 


    Emmy: Yeah. 


    Julie: Okay, but seriously now, we have all these animals in the wild giving birth in these natural ways and nobody thinks to interfere but we humans need all of this help. It doesn’t make any sense. 


    Emmy: Yeah, like for example, Dr. Stu said a woman will be home laboring and the labor–what’s the word I’m looking for? The contractions are coming regularly. Let’s say it that way. The contractions are coming regularly and she comes into a hospital which is an unfamiliar environment with people she doesn’t know who are touching her bits and stuff and it’s really not common for your labor to slow down or completely stall. He’s like, “We are mammals. If a mammal in the wild comes into an unfamiliar place or feels that there is a predator or feels nervous or anxious, the labor is going to stop until she feels safe again.” Colin was like, “I see that with cows. You see a cow in a pasture laboring great and the legs are poking out. We bring them and we bring them into the barn where we have fresh straw. She’ll be by herself. In our heads, we think we are helping her but we have just done an intervention and her labor will stall. She’ll sit there for hours without any progress. We see that with cows.”


    Meagan: You know what? We as doulas see that too. We are laboring at home. We are laboring at home. Things are going really well and then we transition to the hospital or a birthing center or that other location. Even just that move that makes you think you would be more comfortable and this is where I wanted to give birth, you still have to acclimate to that space. Like you said, it’s an intervention. 


    Emmy: Yeah, so he trusted my gut and I”m going to be forever grateful for that because he was very trusting so the prep really began once I got pregnant, it was like, Okay. We’ve got Julie and my number-one priority was building a strong team. I interviewed Julie in person and went out to lunch with Katie who became my doula and felt really connected to her right off the bat. Julie also gave me a list of home birth midwives in the area. 


    I probably interviewed 5 or 6 midwives and for me, I wanted somebody who was really experienced, had a lot of years, had seen the good, the bad, the ugly, and had a good, calm energy because I have a lot of energy. I was like, I feel like in my birth, I just need calmness. So after interviewing them, I picked a midwife who I thought was the best for me and had the most experience. She truly was amazing in the birth and I think I made the right choice for sure. 


    Midwife care is so different than OB/GYN care as well. You have a 5-minute appointment with an OB/GYN but you have an hour long appointment with a midwife where you do the same things but more. They sit and talk to you about any symptoms that you have. I really, really liked the midwife care. I was really impressed. I didn’t know what I was stepping into but it is leaps and bounds better care than I had at an OB/GYN office. 


    That was my first priority. I felt like I built a great team from the get-go then it was all about educating myself and preparing for postpartum. That was a big part. One thing I did was instead of having a baby shower, I did a mother’s shower. I had all of these people come and we made freezer meals. It was really fun. I planned better postpartum care. Colin came for a week. My mom came after that for 10 days so I just did a lot better focusing on my postpartum care which has made a huge difference. 


    Colin and I took a Bradley Method class which ws intense but I’m so grateful that we did because really, Colin was my doula for the next birth for the 23 of the 26 hours and he was doing hip squeezes, counterpressure, acupressure, talking me through each of the contractions, massage techniques– he was amazing and it really came down to us preparing really well. He was my little doula for 23 of those 26 hours and I will never forget that. It was very bonding for us and special. 


    I guess for my second birth which was a much better experience, the contractions started at about 3:00 AM and they were about 10 minutes apart. My labor was 26 hours and interestingly enough, until I hit transition at 23 hours, my contractions did not get closer together than 10 minutes apart the whole time even though the intensity increased. I had a 60-second contraction 10 minutes apart the whole day. I texted Julie and Katie at 8:00 AM, “Contractions have started guys! I’ll let you know.” 


    4 hours went past and I’d be like, “What’s the update?” 


    Julie: “Are you doing okay? How are things going?”


    Emmy: Then I’d be like, “Yeah, sorry nothing.” Then four hours later, they’d be like, “Are you good?” I’m like, “Yep. Still contracting 10 minutes apart, guys. Sorry.” 


    So yeah. I contacted them. I had a chiropractor appointment already just by coincidence at 10:00 AM. I went to that. It didn’t really seem to kickstart anything like I hoped but I just figured it couldn’t hurt to get in. I think Meagan, didn’t you go to the chiropractor? 


    Meagan: I sure did. I actually did twice during labor. 


    Emmy: Wow. 


    Meagan: One in early, early labor and then one in that middle stage. Well, a little bit less. It was early, early and late early labor. I got adjusted and I swear to you that even though like you said that it didn’t kickstart or dramatically change one contraction to another, I know that it changed the outcome for me. I fully believe that it helped change the outcome by helping me balance out my pelvis. 


    Emmy: Okay, yeah. My doula, Katie, felt very strongly about it too that she felt like going to chiropractic in labor was very helpful for her too. She said that her contractions immediately changed afterward. 


    Meagan: Yeah, and I have seen that happen. 


    Emmy: I didn’t feel like for me that was the case and I still didn’t have her until 15 hours later, but still being aligned and having things be in the right place was probably still very helpful. It just wasn’t immediate. 


    So we labored and we had fun. We watched Survivor while he was helping me and I was laboring all around the house which I didn’t think I would care that I was in my own house, but I actually in the end really loved being in my own shower and being in my own bed, being on my own toilet and laboring in my own environment actually ended up being really helpful for me and I enjoyed that. 


    It wasn’t until I did the Miles Circuit at 11:30 at night. I was like, I’m going to do the Miles Circuit. When I was doing lunges on our stairs, that’s when my contractions were 10 minutes, 9 minutes, 8 minutes, 7 minutes– immediately they just started boom, boom, boom, boom getting closer together and I started to shake. I called my midwife, “Can you come check me? I think I’m getting closer now and it’s really intense.” 


    She showed up at about 12:30 AM and she checked me. She said, “Okay, you’re dilated at about a 6 with a bulging bag and I think you’re in transition right now. You’re shaking.” So she stayed and then it was like the parade came in. Kate shows up. Julie shows up. Another midwife shows up and it was go time at that point. I really felt like they all came at the right time becuase I was really struggling through those last contractions for the last few hours. 


    Between Katie doing hip squeezes and everyone, I remember laboring on the toilet because they say that’s the labor station, right? What do they call that?


    Julie and Meagan: Dilation station. 


    Julie: I got there when you were on the toilet and Katie says I got there right at the time when things were really picking up but I just remember because it was a 40-minute drive for me and when she said that you had a bulging bag and were 6 centimeters, every time I go to a birth, I have a heart attack that I’m going to miss it because 2 years ago, I missed three births in a row because things went so fast. Two of them were VBACs. I’m just like, Oh my gosh. I’m praying, like, Please, Jesus. Let me get there before this baby is born. This would not be fair if I miss it because I have had this relationship for 2 years. I’m begging. 


    I think we got there right at the right time. Maybe a little sooner would have been better, but really, I think that I’m just so glad everyone arrived for you when they did. 


    Emmy: Yeah. I thought they were like, “Why don’t we try the toilet?” I honestly thought that was where I was going to die. I thought that was a cruel, cruel joke that you guys played on me. Those contractions were no joke on that toilet. So I was like, “Get me out of here.” That was the first time that I think I was like, “I can’t do this.” You were like, “Yes, you can.” Just that resounding– all of the women in the room were like, “Yes, you can. You’re doing it.” It was amazing. 


    Julie: It’s this weird diad between seeing a woman– I don’t want to say in pain but I don’t know what other word to use. But because all of us look at each other and smile whenever someone is like, “I feel like I’m going to throw up,” everyone in the room just looks at each other with this knowing look. We smile and we are like, “Yes! I’m so excited that you are going to throw up,” because it means that things are getting closer. We have seen this so many times. We know that it just means labor is progressing well and you are doing great even though that feels like the moment where you are really going to die. It’s really good that you feel that way. 


    Emmy: Yeah. Yeah, I was like, “I can’t do this.” You were just like, “Yes, you can.” We labored on the bed a little bit after that and I started to have the urge to push. We moved to the tub which we had set up in the living room and Colin took his place in front of me holding my hands and then the doula and the midwife both did counterpressure on me and I started to push and that was intense. I think that was the only time. I didn’t make a lot of noise besides breathing, but that was where I started to feel like the animal grunting. 


    I also had this outside perspective in that moment of, I know this sounds weird probably to Colin in his face, but I was like, This is working. I was feeling pretty powerful at that time that I was going to be able to push this baby out. My water broke while I was pushing in the tub and I mean, it felt like a half an hour. I remember they told me afterward that it was an hour and a half of pushing. I think that was the most suprrising part of my birth was how long everything still took. It was 26 hours with an hour and a half of pushing. 


    I was surprised at that but I also now look back and am like, Man, had I gone to the hospital, because I still felt like even with an epidural, without an epidural, going natural and pushing, I still felt like it took me a minute and took me a while to figure out the pushing and to feel like I was being fully effective. I was like, Man, if I was in the hospital with an epidural on my back, I bet the same thing would happen to me again. It still took me an hour and a half with no pain meidcation to figure out how to push and push this baby out. What would have happened on my back in the hospital? 


    Quite possible, the same thing. They may have gotten to 2 hours and been like, “Do you want to keep pushing or do you want to call this?” It might have ended up in a C-section again. I’m really grateful that I feel like this is how it was meant to be because I pushed for an hour and a half which was really intense and hard. I was on all fours and then I ended up on more of a squatting pushing. It was just like, “Get her out!” 


    Everyone was just encouraging me all the way around. Colin, once I was in the squatting position, was behind me and it was really special to me. When she was about to come out, Colin was like, “Colin, come switch me places.” He came up to my knees and he was able to be the one who pulled her out and hold her for the first time and bring her up to my chest. Well, bring her up to my chest, I was the first one to hold her, but he pulled her out and brought her up to my chest. We were just able to have that moment of holding this baby and I wasn’t thinking in my head, I don’t care. I was thinking that I had this beautiful little baby in my arms. It was what I had dreamed of. 


    It was 3 years. It was exactly 3 years in the making of this very moment right now and this is what I knew it could be. Then we went to the bed and got to have that golden hour– not hour, golden hours– with her. It was perfect. It really was. I would do it again and I would do it the exact same way. I felt safe and I felt respected and I felt like there was never a moment in it that I was scared. I remember that there was one moment where I was like, Oh my gosh. I’m having a VBAC right now. Do I feel any scar pain right now? Nope, I feel great. Then I never thought about it again. It was wonderful. I am so grateful for this podcast and for the prep work that I did, the team that I built and to be able to have done that with Colin. It was very special and bonding for us. 


    Julie: First of all, you are amazing. Second of all, are you going to do it again? Because sign me up for it. 

     

    I’m inviting myself. Third of all, yes. We need shirts this time. I can’t believe we didn’t order three amigo shirts. That was a missed opportunity. 


    Emmy: We will not forget that this time. 


    Julie: Fourth of all, I want everyone to know that this is probably the coolest trade for services I have ever done. I literally traded– I don’t know how many pounds of natural, grass-fed, antibiotic-free beef. Half of my payment, I feel like I got a quarter of a cow or half of a cow maybe. It’s cool. We are still eating it. It’s the best beef ever. My husband, every time I make some of it for dinner or we go to a restaurant– we were at Zion National Park for spring break and he had a steak or something for dinner and he was like, “This steak is awful compared to the stuff we cook ourselves.” 


    Meagan: Amazing. 


    Emmy: That’s right. 


    Julie: If you want, next time, you obviously should have whoever you want, but I am fully open to trade for more cow. It was seriously the coolest trade ever and the fourth thing is that first of all, I can’t believe it’s been 4 weeks. I feel like so much h as happened since then that it also feels like last week for real. I have been sitting here just polling through your photos as you are telling your story and reliving all of these moments as you are telling them and I am just so inspired by you first of all hearing your story and second of all, just being able to look through these. I will have your gallery to you by this weekend for sure. 


    I like to say 3-4 weeks turnaround and I’ve been just a titch behind in the last few galleries. I’m off my groove or something. I cannot wait for you to see them. I remember after I sent– I don’t know. I was talking to Katie about this the other night at the positive birth group. Sorry, I’m not trying to center this around me. I promise. It might seem like it’s going a little bit that way. 


    Anyway, Katie hosts a positive birth circle for expecting parents and things like that because I love hanging around pregnant people. We were talking at the end and I was like, “I sent Emmy her gallery,” and her first words were, “Those are some real rough photos of me.” I was like, “I hope she liked them,” and Katie was like, “Actually, I talked to her about that at her first postpartum visit,” and the thing is that me and Katie go through all of these pictures and I love seeing that rawness and that vulnerability and your power and your strength and those are the ones I am naturally drawn to. I see all of that and yes, I guess even the one on the toilet which I think is so cool. It’s super cool. There is so much power and strength, and the one of your husband catching the baby as he is coming out in this beautiful white birth pool in your beautiful white house. 


    Those power ones are the ones I am super attracted to and Katie was like, “I think she maybe would have liked just a couple of just her and the baby holding the baby softly after the birth.” I was like, “Oh. Oh. Okay, yes. I’ve got to be more mindful of that when I send these sneak peeks to people sometimes.” Because it’s true. I feel like as birth workers, we are drawn to that rawness and that vulnerability and that space. It is super cool. Especially you not quite being super 100% on board with birth photography ahead of time, I feel like yeah. Maybe I should have thought about that. I’m sorry. I’ve edited a few more that you can use. I sent them to you. 


    Emmy: They were wonderful. 


    Julie: There are plenty of those. It’s interesting the relationship of your birth photos and how it evolves over time when you first get them, you will feel completely different about them in a year or in 2 years or in 5 years. 


    My kids are 6, 7, 9, and 11 now. We go through all of their birth photos and their videos from their birth every year and it’s so exciting and the emotions are just so different as we look at them over time. I feel like they get more valuable the farther away I get. I’m super excited for you to see those. I also recorded a full video for you so if you ever want a video, let me know because I have all of it. I record video at every birth. 


    Meagan: And you can share it with this community. 


    Julie: I have specific instructions for what I’m allowed to share or not and we are going to go over all of the ones I want to share after I deliver her gallery, but yes. I just think it is so cool because when I tell people I am a birth photographer– see, now I am centering this around me. I’m sorry. When I tell people I’m a birth photographer, I get one of three reactions. People are like, “Ew, why would you want photos of that?” Or people are like, “What’s that like?” Or people will be like, “Oh my gosh. That is so exciting. I had a birth photographer. I love looking at birth photos.” I think that people who have that disconnected reactions are the people who really don’t know the true power that the imagery holds especially for the birther so I think it’s really cool to just listen to your transition or your transformation around that and have it evolve. 


    I seriously am going through all of these. You are going to have 400 pictures I think. Okay, so my camera was in lower light. Sometimes it struggles to focus so I shot a little bit more than I usually would because I was scared of missing focus and normally I shoot about 600-800 photos at a birth and go through them and narrow them to about 150 roughly in that range. At your birth, I shot 1276. 


    Emmy: Oh my gosh. 


    Julie: I’m going through and– 


    Emmy: Not a moment missed. 


    Julie: No. Not a moment missed. I’m super excited. You’ll probably get between 150-200 final photos but seriously, I’m like, “Yes. That hands picture and that hands picture. Oh yes. I see everybody squeezing her hips right now. That’s super awesome. Colin is right in front of you squeezing your hands.” I don’t know. I think it’s just priceless to be able to relive these moments through the imagery. I think it’s so cool and so powerful to see how awesome you are if you didn’t know. I have photo and video evidence. 


    Meagan: You are awesome. I love your journey. I love your journey from– I don’t love that someone has a bad experience, but I love that someone can grow from a bad experience and truly, hearing you transform into the person you are now, I mean, I feel like for me, I changed as an individual after my birth. We talked about that earlier with the passion and stuff, but it’s more than the passion. There was something inside of me that changed. It’s amazing to hear when we have these stories. You can hear the shift. 


    If you are listening, Women of Strength, keep going through these episodes and you can hear this shift. It is just so cool. It’s so cool. It’s actually one of my favorite things about being a doula. 


    There’s a CDC National Vital Statistics report that was sent out in 2022 and it shows that the percentage of U.S. home births rose from 1.26 in 2020 to 1.41 in 2021 which is a 12% increase since around the 1990s. It’s kind of an interesting thing and there is so much more about home birth. That’s just a really quick CDC stat, but it’s really cool to see that people can feel comfortable at home. 


    Like you said, in your own bed, on your own toilet, in your own shower, in your own kitchen, kneeling on your own floor. I just think there is something cool about that and home birth. So if you are exploring home birth listening to this, definitely go listen to all of our other HBAC stories and go listen to Down to Birth– what did you say it was? 


    Emmy: Oh, 111. 


    Meagan: 111 with Dr. Stu. Go check out our episodes with Dr. Stu or just go even listen to him and Blyss talk about home birth on their own podcast because home birth can be a safe, reasonable, and amazing experience and something that, like Emmy said, shocked her too. It shocked her as well. 


    I think that you never know until you explore the option and get the facts. We also have a home birth blog and all of those things. We are going to have all of those links in the show notes. I’m going to find the Down to Birth podcast and link it in the show notes so it is easy to find. 


    Thank you so much, Emmy. Your energy is just so fun. I am so happy for you and I hope that I get to see some more of these photos and if you decide to share a video, I love videos and it was honestly one of my biggest regrets. I was so focused on my VBAC that I forgot about the photography aspect. I’m so glad that you got looped into that because Julie became just a photographer because still to this day, like Julie said, my son actually just turned 8 this month so I tend to look at those images at those year marks and I really still to this day cherish it and look at it differently every time. I’m so glad that you have them and obviously for anyone listening, if you want a birth photographer, check it out. It is worth it. 


    Emmy: It is. It is worth it. 


    Julie: I think we should put a plug-in. To find a great doula, build the right birth team obviously. You can find a list of supportive VBAC providers on the community on Facebook in the documents and you can a VBAC doula at thevbaclink.com/findadoula and if you are looking for a birth photographer which I obviously think you should, there’s a really good group called Birth Becomes You. It’s kind of like The VBAC Link but for birth photography. You can follow them on Instagram. You can follow them on Facebook, but they have a database just like we do for VBAC doulas for birth photographers all over the world. You can find their search database at birthbecomesyou.com/find-a-photographer. That will be linked in the show notes too. I’m putting Paige to work here. Obviously, if you want to reach out to anyone of us, me or Meagan, to support you in your birth, we are happy to do that as well. If you need to find out information about Katie, she is in The VBAC Link Doula Directory as well. 


    I am super excited that there are so many resources available. I feel like it’s even way better than when I was having babies. There is just so much more information available and it wasn’t even that long ago. It’s just so cool that there are all of these resources that we have to help parents find the right support team for them no matter what that looks like. I don’t know. I think it’s really amazing. 


    Meagan: Absolutely. Okay, well thank you again so much, Emmy, and have a wonderful day. 


    Emmy: You too. Thank you so much for having me on. 


    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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    50m - Jul 8, 2024
  • Episode 314 Amanda's Joyful VBAC + Building a Team with The VBAC Link's Resources

    “It was just such a redemptive, wonderful experience. I am so grateful to The VBAC Link for seeing me through it, for giving me the information, and just the inspiration to even take this on because if I had never found you, I don’t know for sure if I ever would have gone through with it. So, thank you so much for that.”


    Amanda’s episode will warm your heart, give you chills, and bring tears to your eyes. Her birth stories include a rough induction at 36 weeks due to preeclampsia with an 11-day NICU stay and not getting to hold her baby for 32 hours. 


    When she found The VBAC Link, Amanda was given hope that she could have another baby and that her experience could be very different. Equipped with information and drive, she was able to do just that. Amanda’s VBAC birth was spiritual and powerful!


    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    Episode Topics:

    • Review of the Week
    • Amanda’s stories
    • Monitoring for preeclampsia
    • Cervadil, Magnesium, and Cytotec
    • Consenting to a Cesarean
    • Throwing up during the C-section
    • Waiting 32 hours to hold her baby
    • Finding The VBAC Link
    • Praying for a baby
    • Scared or scarred
    • Signs of wavering provider support
    • Physical and mental preparation
    • Contractions begin
    • Advocating during labor
    • The night nurse
    • “It is done.” 
    • Importance of lactation support


    Meagan: Hello, everybody. How are you doing? I hope you are doing great. Right now, I can just tell you that my face is already hurting from smiling just from talking to our guest for 5 seconds. We have our friend, Amanda. Hello, Amanda. 


    Amanda: Hello. 


    Meagan: Oh my goodness. She has just been the sweetest thing just pouring on the sugar and sweetening me up. I mean really, she is saying just the nicest things about The VBAC Link and it has just been so fun to hear how The VBAC Link was part of her life. You guys, I love this so much. Thank you for supporting this podcast. Thank you for supporting us on Instagram and Facebook and all of the places. I truly from the bottom of my heart love you. I know I haven’t always met you but I love you and I love this community and I love what we are doing here. 


    I am so grateful for the opportunity. I just wanted to say that it really wouldn’t happen without all of you so really from the bottom of my heart, thank you. 


    Review of the Week


    Meagan: We do have a Review of the Week so I want to jump into that and then we are going to get into Amanda’s stories and maybe even some other things. We will see what this episode transpires to. 


    Okay, so this is from Liz Judd and it doesn’t say where it was from, but it says, “Empowering”. It says, “I found this podcast around week 30 of my second pregnancy by searching for ‘VBAC’. I had a traumatic C-section in 2019 and I knew I did not want to go through that again. It was helpful for me to learn the evidence on VBAC, how to advocate for myself, and healing to listen to other’s stories. I just had my second child by VBAC and I thank you for the role you played in that.” 


    Seriously, it warms my heart and you just said the same thing. You carried me through my whole pregnancy, and then this was back when Julie and I took a big 10-month break and you were like, “Oh no, they’re gone!” But here we are. We are back and I hope that we are carrying someone else or many other people through their pregnancy journeys as well. 


    Amanda: I’m sure that you are and that review could not have related more to my story so I can’t wait to get started for you. 


    Amanda’s stories


    Meagan: Okay, well without further ado, let’s do it. Let’s get started.


    Amanda: Here we go. My husband I met in 2004 which yes, was 20 years ago. We got married in 2009 and we were just living our best lives. We were traveling, doing all of the things. I had lost 129 pounds and I said, “I want to run a marathon and have a baby.” 


    Meagan: Dang, yeah. 


    Amanda: I was even a group exercise instructor at the time. Life was good. I ran the Marine Corps Marathon in 2015 in October and in 2015 December, I got pregnant. 


    What was really special about that was we got engaged on Christmas Eve so on the 10th anniversary of our engagement, I got to share the news with my husband that we were expecting. 


    Meagan: Yay! That’s so awesome. 


    Amanda: It was really special but other than that, I really had no knowledge at all about pregnancy and birth. I just knew that I wanted an unmedicated birth. Where I came up with that, I’m not sure, but I just was going to trust my doctor. That’s where my brain was at. 


    I went to my normal OB who I had always gone to and it was a very small practice. There were three doctors and a nurse practitioner and up until this point, I had always seen the nurse practitioner. 


    She confirmed my pregnancy and she advised that I limit my exercise from what I was currently doing and to only maybe just walk and do some light cycling. 


    Meagan: Oh my gosh. My OB said the same thing. I was wanting to run a half marathon and he was like, “Oh no, you’re having too much round ligament pain. Just go for a walk.” 


    I was like, “What? Okay,” so I stopped working out. 


    Amanda: Right. That’s exactly what happened to me. Now I know that was the first red flag of this practice, but I didn’t know at the time. I was just like, Okay. Listen to what the doctor says. So I just kept going to my appointments and I generally felt okay but at my appointment check-ins, my blood pressure started to be high. They would put me into the room and I would lay down on my left side and they would have me do the whole appointment that way and then they would check my blood pressure at the end and it would be okay so they would have me come back in a couple of days for a re-check and it would be okay. 


    We just continued on that way until I circled through all of the doctors and back to the nurse practitioner. She was really the only one who seemed a little more concerned than everybody else about what was going on. 


    Monitoring for preeclampsia


    Amanda: I got back to her and she sent me to the hospital for a blood pressure monitor. It wasn’t super high so they sent me home, but they told me to do a 24-hour urine collection. I did that and my protein in that came back at 299 and she said, “Well, 300 is preeclampsia so we are just going to keep monitoring it.” 


    Meagan: Mhmm, okay. 


    Amanda: Okay. That’s exactly what I said. Meanwhile, I’m not exercising. I’m just taking my prenatal and going to these appointments. I didn’t have any preeclampsia symptoms either. I had no headaches, no spots, no swelling. I just felt yucky. I just chalked it up to pregnancy. I thought, Okay, I’m pregnant. This is what I should feel like. 


    Meanwhile, people around me are pregnant and they are like, “I feel fabulous. I love this.” I was like, I don’t love this. This is not great. I’m excited to have a baby but I don’t love it. I also got carpal tunnel. 


    Meagan: That is a thing by the way during pregnancy that people don’t talk about. 


    Amanda: They don’t and I didn’t know about it. My doctors were just like, “It’ll go away when the baby is born. It will go away when the baby is born.” I’m like, “But I’m really in pain. My poor husband has to cut my food. I can’t function here.” 


    Finally, one of the doctors said, “Well, if it hurts that badly then you can go to a hand and wrist doctor.” Okay, so I did and I ended up getting a cortisone shot because it was unmanageable. I had the braces. I was doing night braces and day braces so that did help a lot. 


    A high blood pressure and getting admitted to the hospital


    Amanda: In the meantime though, we moved from an apartment to a house. I was the matron of honor in a wedding and then we moved into our house on July 17th. I had a surprise baby shower on August 6th and August 8th which was my 36th week, I had a non-stress test at the hospital. 


    I went into the hospital for the non-stress test. They took my blood pressure. The nurse didn’t say anything. She was like, “I’m just going to take it when it’s over,” which is something I had heard the entire time. 


    I do the non-stress test. She takes my blood pressure again. She says, “You know, the doctor wants to talk to you.” I was like, “Okay. That’s fine.” I go into this little room and the doctor starts saying things like, “Not going home” and “Going into triage” and “Keep you pregnant as long as possible”, so I was like, What? I just couldn’t even process those things. 


    Meagan: And there wasn’t any extra talk of, this is why. 


    Amanda: No. 


    Meagan: Yeah, okay. 


    Amanda: No. I called my husband. I was like, “Listen, you might want to come be with me because I’m not sure what’s going on.” So I go over to triage which was right around the corner and I’m waiting in that waiting room for over an hour. I’m still not thinking there is any type of emergency. They take me into triage and they take my blood pressure which was 214/111. 


    Meagan: Okay. 


    Amanda: Yeah. 


    Meagan: Okay, well that’s high. 


    Amanda: Yeah, so then everyone starts going a little bit crazy. They start giving me medicine. They have me only lay down. I’m not allowed to get out of the bed and they start talking. I start hearing words like, “Possible seizure” and I’m like, “What is happening here?” 


    A nurse finally comes over and says, “We are going to admit you. We just don’t know yet if it’s to labor and delivery or high-risk OB.” I looked at my husband. I was like, “Are we having a baby right now? Are we having a baby?” 


    Then at that point though, that’s when all of the things started happening to me and I was not a part of any of these decisions. 


    Cervadil, Magnesium, and Cytotec


    Amanda: I realize that that was a very high blood pressure and I didn’t really check it after that, but they do take me up to labor and delivery where the doctor starts with Cervadil. This is on a Monday night. She inserts the Cervadil but I had zero dilation. They also put me on magnesium and when they did the magnesium, they also wanted to give me a catheter because they didn’t want me to move. 


    I said, “I don’t really want that.” At this point, I still felt fine and nobody was really explaining to me–


    Meagan: The severity of things and what was really happening, yeah. 


    Amanda: Right, right, right. So then they were giving me the saline. It was just so much fluid so I had to use the bathroom a lot. They were just letting me use the bedpan and teh nurses were so irritated by me. They would just stand there and watch me. I just felt horrible. It just was a very uncomfortable experience. 


    Then there was the magnesium which–


    Meagan: Bleh. Thumbs down. 


    Amanda: Yes. It was awful. I just felt terrible. They also gave me a shot for lung development because I was only 36 weeks. Yeah. 


    My water broke on its own but that is the only part of labor that I experienced at all with him. After my water broke, they gave me a dose of Cytotec, and literally nothing happened. Not one thing. 


    My blood pressure was still unstable. The magnesium made me feel awful and then I felt decreased movements. I just kept telling the nurses, “I can’t feel the baby moving. I can’t feel the baby moving.” I was scared. At one point, we knew nothing was happening. My husband and I actually called the doctor and said, “Should we have a C-section? Is this what is going to be happening?” 


    They said, “No. Let’s just see how this plays out.”


    Looking back, I’m shocked that that was the answer they gave me because of everything else that was going on. They just kept doing cervical checks and they were very uncomfortable because I had zero dilation and I didn’t know I could say no. In fact, one doctor came in. This was actually the doctor who ended up delivering him. She said, “Do you want an epidural?” I said, “No. I don’t even have any pain.” 


    She said, “Well then, you need to let me check you.” 


    Meagan: Wait, because you didn’t want an epidural then you had to let her– what?

     

    Amanda: Right. I think she was saying this because I was acting like it was uncomfortable. I mean, it was uncomfortable. I wasn’t acting. Then they gave me another dose of Cytotec. Nothing is happening. Now this is late Tuesday night. My blood pressure is all over the place. They keep giving me different doses of medication. 


    I was on fire from the magnesium. I just kept saying, “This room is so hot.” They said, “But it’s the coldest room in the wing.” “I don’t care. I’m burning up.” 


    Meagan: You’re like, “My skin feels like it’s on fire.” 


    Amanda: So they gave me a fan. That was their accommodation for that. 


    Consenting to a Cesarean


    Amanda: It was around 12:45 so now this is Wednesday morning at 12:45 AM. The doctor comes in and she is just sitting on the end of my bed. I was in and out of awareness. I remember having her be there, but the magnesium is terrible. They just kept taking my blood pressure and she just kept giving me medication. 


    All of a sudden, she stands up and she says, “We need to do a C-section right now.” I still don’t know to this day if it was a decel. I don’t know if it was his heart. I don’t know if it was my blood pressure. I don’t know what happened that made her stand up, but I just remember watching that happen and the look on her face. 


    They were laying me down. They were giving my husband scrubs. I’m signing all kinds of consent forms laying down and then they gave me this awful drink for nausea and wheeled me into the OR. 


    Because I had the magnesium, they were lifting me. I wasn’t allowed to do anything by myself and I forgot to mention that since I wasn’t exercising or doing anything, I gained 90 pounds during this pregnancy which was terrible but I didn’t know. 


    I wasn’t small and they were moving me around. I get a spinal. As soon as I got the spinal, I said, “Oh my goodness. I’m going to be sick.” I just felt so nauseous and I remember the anesthesiologist behind me saying, “It’s okay. We’re ready,” and other people saying, “Lay her down. Lay her down.” 


    They immediately lay me down and then I vomit into the bucket. 


    Meagan: Oh yeah, that’s the most miserable feeling. 


    Amanda: It was terrible. He was ready. He did have a bucket. He wasn’t lying, but then they squirted something on my stomach and I just remember saying, “I can feel that. I can feel that.” The doctor says, “Yeah, but is it cold?” I said, “No.” She says, “Starting incision.” She just is going. 


    Throwing up during the C-section


    Amanda: Literally every time they pushed on my stomach, I was throwing up. Every single push and shove they did, it was awful. It was awful. But at 1:38 AM, our first son was born and there was one squeaky little cry and then he stopped and the NICU team got to work on him. They were about to take him up to the NICU and God bless my husband. He stops in front of the door and says, “Can she at least give him a kiss first?” 


    They brought him over really quickly. I got a kiss and then they took him away. 


    All was quiet. I was still nauseous and I just remember the anesthesiologist saying, “They’re just putting you back together. Why don’t you try to take a nap?” I was like, “Um–”


    Meagan: Okay. 


    Amanda: Right. 


    Needless to say, the bedside manner all the way through was not great. 


    Meagan: Not great, no.


    Amanda: But once I got into recovery, I was just holding onto the fact that they said I could see my baby in 24 hours. I was like, Okay. I just have to make it 24 hours and they will take me to see him. I set an alarm on my phone. I am pumping. They gave me the pump. I am pumping. Any colostrum I am getting, I am sending up to the NICU. My blood pressure is still not settling down. 


    Waiting 32 hours to hold her baby


    Amanda: 24 hours goes by. I call the nurse. I’m like, “It’s 24 hours. Take me up to see my baby. Please take me up to see my baby.” She’s like, “Well first, we have to take your blood pressure.” It was not good. She was like, “Wait 2 more hours and then we will check.” I was like, “I just waited 24 hours and now I have to wait 2 more.” 


    They take my blood pressure again and it was fine. I was like, “Yes. I’m going to go see my baby.” They were like, “Well actually, you have to walk and go sit in this chair first and then we can take you up. We have to take your blood pressure from this chair.” 


    I sit in the chair. My blood pressure is not good. “Oh, you have to get back in bed. We can’t take you up.” At that point, I just lost it. I was like, “I can’t.” I told my husband, I was like, “You have to tell people to stop texting and stop calling. I cannot do this. I just don’t understand what’s going on here.” 


    I did not know it at the time, but after they got me back in bed, my husband went back into the hallway. He told the nurses. He was like, “You have to take her up there. You have to take her up. She has to see that baby.” 


    Sorry. 


    Finally, the nurse came in and she checked my blood pressure and it wasn’t great but she thankfully had I guess fewer patients so she came up to the NICU with me. She did take me up there and after 32 hours, I finally got to meet him and hold him but as soon as we were together, both of our health’s dramatically improved. 


    My husband knew that that’s what we needed. I’m so grateful that he did that. 


    Meagan: Absolutely. 


    Amanda: I ended up staying admitted for 5 days because they just couldn’t get my blood pressure situated and then our son Jeffery David came home after 11 days. Physically, my healing was okay because I had 11 days of sitting. 


    Meagan: Hanging out in the hospital not doing much. 


    Amanda: Yeah, and you know, God bless my family and friends who drove me to the hospital every day to go see him. Some of them sat with me for hours and hours and hours just because I was by myself but my mental healing was not great. Because of everything that happened, I had just closed the chapter on kids. We were apparently one and done. I told my husband, “I am not doing that again.” 


    I mean, I was on blood pressure medicine for 2 years after that. 


    Meagan: Wow. 


    Amanda: Yeah. It was bad. 


    I just said that I always wanted more kids, but I’m not going to do that again. That was terrible. 


    Finding The VBAC Link


    Amanda: So my son was about 2 and I was listening to a different podcast. They were interviewing these two doulas who had VBACs and I was like, Who are these women? Then obviously, it was you guys. 


    Meagan: That’s awesome. 


    Amanda: I went over and I found The VBAC Link. I was like, Oh my gosh. I didn’t even know a VBAC existed up until this point. 


    I was listening to your podcast and I listened to all of the episodes and then I finally said to my husband, “Listen, I found this information. It’s really inspiring and really informative and if we ever had another baby, this is what I want to do.” 


    He is the most supportive person that exists. He is my biggest fan and biggest cheerleader. He was like, “Okay. That’s fine.” With a list of questions from your website, I went and found a new OB who I interviewed and I decided that they were supportive because aside from answering all of those things positively, she could also tell me the nearest provider who delivered VBAC twins and the nearest provider who did VBAC breech births. 


    Meagan: Wow, that’s awesome. 


    Amanda: She said, “It’s not here, but these are the two places that you could go.” I was like, Okay, I feel like this practice will work. It was also much, much bigger. They had two midwives on staff which I was very interested in because I’m definitely more of a midwifery mindset. 


    In the meantime, I also went to pelvic floor therapy and while she fixed a lot of internal things, she also did a scar release which was very intense but very, very needed. I didn’t know that until I had it and then I was like, Oh my gosh. I didn’t realize how uncomfortable I was just living my life all of the time. It was amazing. 


    Meagan: How game-changing it really is. Yeah. Not even just for birth, but for life like you said. 


    Amanda: Yes. I couldn’t even sit criss-cross applesauce just because I had so much tension in my hips and everything. It fixed so much. 


    Praying for a baby


    Amanda: Then my son is approaching 4 years old and then one night we were saying our prayers just he and I at night and he says, “I pray for a baby in mommy’s belly.” 


    Meagan: Aww. 


    Amanda: I was like, “What?” 


    Meagan: “What did you just say?”


    Amanda: Yeah. There was no one pregnant around us at the time. I didn’t even know at that time that he knew that babies in bellies were a thing. That continued for weeks. I never once reminded him. Every single night, he would pray for a baby in Mama’s belly. 


    I talked to my husband. I was like, “We need to address this one way or another. We either need to tell him that that is not happening or we need to have a serious discussion.” 


    So since I’m here, you know what we decided on. 


    Meagan: Spoiler alert. 


    Amanda: We were blessed with a second pregnancy. Now, the day I took that pregnancy test, I went on The VBAC Link website. I looked up your doulas and I found doulas in my area. I just kept scrolling back to this one profile that just kept speaking to me. Her name was Mallory. I sent an email to her which was “Seeking doula, have questions”. She wrote back to me and that is actually who I ended up having as my doula. 


    She was literally with me from day one. But I started this pregnancy at advanced maternal age because I was 35 at the time. I was plus-sized so while I wasn’t 90 pounds heavier, I had lost some weight, but I still had a higher BMI. 


    I also consistently worked out 4-5 times a week and I was loaded with information. I had a new OB and I instantly became their worst nightmare. I know it because–


    Meagan: Because you had all of the information. Let me just tell you. Providers, I think it catches them off guard when people come in and have information and they are like, “Oh, wow. This lady knows what she is talking about.” That’s how it should be. We should know what we are talking about. 


    Amanda: I agree. I always say that I wish there was a second-time mom the first time because I just went in armed with so much information that I never would have gotten if I didn’t have such an awful experience the first time. 


    I started taking a baby aspirin every day just because of the blood pressure issues before. 


    Scared or scarred


    Amanda: This is a much larger practice. Like I said, they had two midwives and as I rotated through those doctors, I realized that some were supportive, some were tolerant, and some were scared. 


    Meagan: Oh yeah. 


    I like that you say that. Scared. Because I think that’s the case with a lot of the “unsupportive providers”. I think they are scared or scarred. 


    Amanda: That’s a good point. Yeah. That’s a good point. 


    Meagan: They just haven’t had a great experience. 


    Amanda: Right. 


    So along with all of this medical information, I also am very strong in my faith and I was having a hard time. I was having an internal struggle because I had all of this information and I wanted this so badly but I was struggling with the fact of what if this wasn’t God’s plan? I was fighting for all of this stuff and what if it wasn’t His plan? 


    I shared that with my doula, Mallory, and she actually said to pray then if this is not Your wish, then take the desire away. 


    Meagan: That just gave me the chills. 


    Amanda: Yeah. I wanted to share that because it changed me so much. I prayed it every single day of my pregnancy and the desire never went away. I felt like it was okay. 


    Because I was able to pray that and the desire was never going okay, I just felt so strongly and continued going along in this happy, healthy fast pregnancy. There were no physical issues. I had no carpal tunnel. I gained a total of 16 pounds. Total. 


    I mean, I worked out up until 39 weeks. At my 39-weeks, I was doing body pump. I lifted the weights over my head. The instructor was like, “How long are you going to do this for?” I was like, “Actually, I’m all done today.” 


    Meagan: Today is the last day. 


    Amanda: If I knew though that I was going to go to 41 weeks, I probably would have kept going but I just wanted to some time to be done with the gym and just get in the right mental space. 


    Signs of wavering provider support


    Amanda: At 30 weeks though is when the support started to waver a little bit. There were more questions about heart decels and reminding me of the continuous monitoring. At 32 weeks, I was having a scan to make sure baby was head down and I had been going to the chiropractor this whole time. This baby liked to hang out transverse. 


    Before my 32-week appointment, the night before, I went to the chiropractor and I was like, “Listen. I know you have been doing Webster the whole time. I have an appointment tomorrow. They are checking to see if he’s head down. What can you do?” He’s like, “I got you.” 


    So I don’t know what he did, but I was driving home from the chiropractor and it felt like I was on a rollercoaster. You know how your belly does that flip? It was so intense at one point that I actually pulled over and chilled for a minute. It was just so much movement happening. 


    The next morning, I went to my 32-week appointment and he was head down. 


    Meagan: Awesome. 


    Amanda: That was pretty cool. 


    Then at 36 weeks, they started to pull the big baby card. 


    Meagan: Oh yeah. 


    Amanda: They gave me an ultrasound and they said that the baby was measuring 11 pounds. 


    Meagan: Whoa. 


    Amanda: I said, “That is impossible.” First of all, I gained 16. There’s no way 11 of that is him. Then they were like, “Well, you do have a high BMI.” I was like, “That does not mean that he is going to be a big baby.” I had the article that I brought with me about all of the evidence and I declined a re-scan. 


    That blew the receptionist’s mind. I said, “No. I’m not.” She said, “Well, the doctor said you have to.” I said, “I don’t have to though so I’ll make my next appointment, but it’s not going to be for an ultrasound.”


    That night, I actually got a phone call from a doctor who was like, “Why did you decline the scan?” I said, “My baby is not 11 pounds. He’s not.” 


    We had a big conversation and we agreed on a different type of scan. Now, I can’t actually remember. I apologize. I can’t remember what kind it was. They took different measurements but at that one, he measured 6 pounds. 


    Meagan: What? That’s a dramatic difference. 


    Amanda: I know. Where I thought, that’s where I thought he was going to be in my head so then I was given the green light to proceed with the way I wanted to. This whole time, I just had such amazing support from my husband but also from my doula. She would check in before every appointment. She just was amazing. I would be in the parking lot and the text would appear, “How are you feeling about this?” Then when I would come out, she would check in with me. 


    In fact, even before recording this podcast, I got a text from her, “How are you feeling about this?” I was like, She is a gem. But I got the green light. 


    Meagan: We should have had her on. 


    Amanda: I know. I did think about that. I feel so bad. 


    Meagan: That’s okay. That’s okay. 


    Amanda: She’s got a new newborn of her own. I know, it’s wonderful. 


    At 36 weeks, I also started to get the on-call schedule of all the doctors. I would say, “Who is working this week?” I would keep it in my phone so I knew who would be working because there was one doctor who at an appointment told me directly that she is terrified of VBACs. I knew that I should avoid her at all costs because I just knew that if I had her, she would find some reason to deem it C-section worthy. 


    Physical and mental preparation


    Amanda: Throughout this pregnancy, I’m doing chiropractic care. I’m drinking raspberry leaf tea. I’m eating the dates when I was supposed to eat the dates. I also went back to pelvic floor therapy and told them that I want to have a VBAC. Help me prepare for that. That was wonderful. I became so passionate about this whole thing. Everybody knew. My poor coworkers had to listen but if there was anybody around me who was getting a C-section, I had to tell myself, “They didn’t ask you. They didn’t ask you. They don’t want a VBAC.” 


    Meagan: I know. 


    Amanda: I also got acupuncture because I was just trying all of the things. Also, in The VBAC Link Facebook group. I found someone was Catholic affirmations that they had made. She shared that file with me so I had them all printed out. I was ready to go and then my due date comes and my due date goes. 


    Meagan: Hello, goodbye. 


    Amanda: Yes. I had never been pregnant past 36 weeks before so I was like, Well, this is pretty awesome, but I felt incredible. I still was coming to work. I came to work on my due date and my principal was like, “I did not expect you to be here today.” I thought, Don’t underestimate me just like those doctors. I’m here. 


    Contractions begin


    So on a Monday, I was 40+3 and I had an appointment. I saw a midwife at the practice who was actually a VBAC mama herself. She and I just had this vibe and I was like, Yes. I love her. I knew at that appointment at 40+3 that I was going to ask for a membrane sweep. So I did and she tried but I wasn’t dilated at all. She was really giving it her best shot, but she couldn’t do it. 


    I felt fine. I was fine with it, but I was also a little disheartened because I knew that pressure was going to start coming from the providers. This is where my BMI came in handy because I could qualify for an early induction because of that because like I said, I had the work schedule and that doctor who was terrified of VBACs was working on Friday. 


    Meagan: So just a couple of days later. 


    Amanda: Yes. Yeah. This was Monday at this point, so I scheduled an induction for Wednesday. I was like, Okay. Let me give myself a couple of days to see what I can do, but I also knew I didn’t really want to go too far past 41 weeks because I know at 42, the risks go up and I knew time was of the essence. 


    After that appointment, I go back to school and I’m standing on the playground with my partner. There are all kindergarteners running around and running around. I felt this intense squeeze in my belly. I looked at my partner who has had three babies and I was like, “Oh my god, what does a contraction feel like?” I was like, “I think I just had my first contraction.” We were just cheering out there and they continued every 10-12 minutes all the way through Tuesday. I come to work on Tuesday. I was still having contractions but they weren’t increasing in intensity so it was okay. 


    Meagan: Yeah, just happening. 


    Amanda: Yeah, but Tuesday, I did decide to leave work early. I just checked in with my principal and I said, “I think I’m going to go home. I think being in a better headspace knowing I’m home and relaxed might help.” As I was leaving, one of my coworkers who had a C-section several years ago came up to me and she said, “There are a lot of women who would love to be in your shoes so good luck.” 


    I thought that was really special. 


    Meagan: Mhmm. 


    Amanda: I appreciated that. I knew. I was like, Yes, I’m doing this for me and for a lot of people. So anyway, sorry. I was in constant contact with my doula. I go home. My contractions are increasing to 7-10 minutes apart. They are more intense at night. Now they are 5-10 minutes apart but I still decided to go to the hospital on Wednesday morning for the induction because I know my body. 


    With my first baby needing the NICU, I knew that as much as I would dream of a home birth, I know that I was afraid in case intervention was needed and I knew that my body would just relax when I knew I was in the place where the interventions could be if I needed them. 


    Advocating during labor


    Amanda: I send my son to preschool and I go into the hospital with my birth plan and all of the things. I tell the doctor I want Foley but no Pitocin. He was like, “Uh,” and then he watched me have a contraction and then he said, “Are you having contractions?” I said, “I am.” He said, “Okay, we can do it then.”


    I got the Foley and he also when I was talking with him about my birth plan said, “Listen. We all read it and we want this for you.” I just thought that was a cool thing for him to say. 


    Meagan: Validating. 


    Amanda: Yes. So I’m in New Jersey and here, VBAC after two C-sections is not a thing. I knew that this was really my chance and I also knew that really, two was enough for me. I knew I wanted two children to make our family complete and that was it. 


    One of the things for a VBAC here in the hospital and with the practice is continuous monitoring. Trust me, I tried to not have them do that. 


    Meagan: It’s a real fight if you decide to try to fight it and that’s really common everywhere. Continuous fetal monitoring is usually pushed really hard and it’s one of those things where it’s like, is it worth fighting for to you? You have to weigh it out because you really do have to put up a fight. 


    Amanda: I tried, but like you said, I wanted the VBAC more so I was like, Okay, fine. We can do this. They did thankfully have a portable monitor because I really wanted to labor in the shower. They had a portable monitor. It could go in there. I was like, “Good. We’re golden.” But then my baby did not want to be on the monitor so he kept falling off but there was no decel. There was never a concern. 


    Meagan: Just loss of heart rate because baby moved away. 


    Amanda: Because the monitors fell off. 


    Yeah, so at one point, one of the midwives– not the VBAC midwife, the other midwife– comes in and says, “We’re just going to put an internal monitor in.” I remember my doula looked at me and she said, “Do you know how they do that?” I said, “No,” so then she explained that to me and I declined. 


    Meagan: Yeah because they do have to break your water to do that. 


    Amanda: Oh, I’m sorry. My water did break. 


    Meagan: Oh, your water did break. 


    Amanda: I apologize. I missed that. Gosh darn it. 


    Meagan: I might have missed that. 


    Amanda: No, I missed it. I missed it. But I didn’t want the internal monitor. I just didn’t feel like that was right for me. I was like, “I’ll just keep struggling with this. He is safe and happy and comfortable. I’ll be fine.” 


    The night nurse


    Amanda: Everything was going fine. My body was doing it. I didn’t need Pitocin and I was loving labor. Everything that I had practiced and done and just my head space was good and I had listened to some fear-release meditation prior to this and it was just wonderful. I was living in labor land. It was wonderful. 


    Then shift change happened and the night nurse came. 


    The night nurse was very, very intense. My day nurse would let that monitor ride a little bit without being on. This night nurse was not having it. Continuous monitoring meant continuous monitoring and she felt that she needed to do that 3 inches from my face with her hands just pressing and touching me and I really was feeling very overwhelmed by her. 


    Meagan: Yeah. 


    Amanda: I was trying to ignore her and they brought in the bar and I was laboring on the bar. It was wonderful but I still remember that I could smell her breath through her mask. It was too much. She was too much. I said, “Please can I labor in the shower and then we can get together?” She was like, “Okay, as long as baby stays on the monitor." I was like, Please baby, stay on the monitor. 


    So I get in the shower and I was like, Okay. We’re fine. Life is good. This is wonderful. I feel great. I’m rocking. It’s great. Then I hear the bathroom open and I turn around and she is standing there in a full raincoat. She’s got a head cover. 

    Meagan: A raincoat? 


    Amanda: She’s got a plastic gown on, plastic shoes, and she comes in the shower with me and is trying to adjust this monitor. 


    Meagan: Oh dear. 


    Amanda: I lost my mind. I don’t remember what I said but all I remember is screaming at her and her leaving but telling me I had to come out of the shower. So she leaves and I walk out and my husband and my doula are just snickering because I just kicked her out. But I was like, “Why is she in the shower with me?” 


    I get dried. I get redressed. I’m back in the bed and she’s back. Then my blood pressure starts spiking and I start hearing, “High blood pressure, high blood pressure.” I’m like, Oh my god, it’s happening. 


    Meagan: It’s her. It’s her. 


    Amanda: Right, but I got scared because of what happened before. 


    Meagan: Of course. 


    Amanda: I was like, “I can’t have this.” I remember Mallory looked at me and she said, “Do you want an epidural?” I didn’t initially want one because I wanted to feel this. I wanted to feel all of this. She said, “It would just be a tool to reach your ultimate goal.” 


    Now, I knew two things at that time. It was one, an epidural would help keep me still which was going to help keep this monitor one and two, it’s known for bringing blood pressure down. So I agreed. I was kind of sad about it, but I knew ultimately that I was going for the VBAC. That’s what I wanted so I had to keep that in my sights. 


    In my head, I didn’t say this out loud, but I said, “Okay. If I am a 6 or less, I will get an epidural.” I had a doctor come in and check and I was a 6. I get the epidural and obviously, it doesn’t work so I get a second epidural. 


    Meagan: Oh my gosh. 


    Amanda: It was lovely, but that one did work. That brought my blood pressure back to normal and I was still, but then man. Between my husband was helping my doula and she had the peanut ball and she was still moving me. She was holding that monitor on. She was watching that monitor for me. It was just amazing but the problem was that the epidural stopped my contractions. 


    Meagan: That is a downfall that can happen.


    Amanda: Yeah, so then I did consent to Pitocin at that point because everything stopped. 


    “It is done.” 


    Amanda: I had the epidural. I had the Pitocin. Things were progressing. I was dilating. We were moving me as much as you can with the epidural and then around 4:00 PM, my epidural wore off and I felt it wear off. I was like, Oh my gosh. At 4:45, the midwife came in and she checked me. She said, “Oh, you are 9 centimeters. This is wonderful. I’ll be back in a few hours.” I’m thinking, A few hours, I don’t feel like I have a few hours here. 


    I felt my body start pushing all by itself. I was like, Oh my gosh. This is amazing, but I was like, “You have to get her back here. I know she said I was just 9, but you have to get her back here.” She came back and she said, “Oh, you’re 10 already. Let’s do a practice push.” I was like, “Wait. I need the mirror. Where’s the mirror? I want to get the mirror.” There was a full-length mirror that they brought in and I thought there was going to be a little hand mirror situation so I was really happy with the full-length mirror that came in. 


    She said, “Let’s do a practice push,” and she was like, “Oh, you are an excellent pusher. You’ve got this.” I’m watching in the mirror and I hear from the hallway, “Don’t let her push until I get in here!” And it was the doctor that I originally interviewed. She came in. She said, “I want to see this through.”


    Now, meanwhile, I had not seen her throughout my entire pregnancy as one of my providers but I thought that was so cool that she remembered that and came in for this. It was the midwife, not the VBAC midwife but another midwife and her were there with me and as I started to push him and his head came out, the midwife said, “Oh, do you want to feel his head?” 


    Before I could even answer yes, the doctor said, “Oh, she does,” and takes my hand and I feel him. I’m pushing. I’m watching. My doula is taking pictures and all of a sudden, the midwife is blocking the mirror. I’m like, looking at her and I’m like, “I can’t see.” I’m hearing her say, “Amanda, Amanda, Amanda.” Finally, I look over and she’s blocking the mirror because she is holding my baby in front of me. 


    Meagan: Oh my gosh! No way. 


    Amanda: I was like, “Oh my gosh!” Then I’m looking at him and then there is a bright light behind him and I feel this moment of peace and I feel in my heart and I hear, “It is done.” I just know that God was there with me the entire time and I’m so grateful for that. My husband got to cut the cord and I got to hold him immediately– well, we didn’t cut the cord until it stopped pulsing. he was so cute. He was like, “She told me to wait until it’s white. Is it white? Is it white? Is it white?” 


    It was just wonderful and he cut the cord. I got immediate skin to skin and I got to do his first latch right then and there which was so different. It was so different than my son. It was just such a redemptive, wonderful experience. I just am so grateful to The VBAC Link for seeing me through it and for giving me the information and just the inspiration to even take this on because if I had never found you, I don’t know for sure if I ever would have gone through with it. So, thank you so much for that. 


    Meagan: Oh my gosh. You are so welcome and thank you for sharing this beautiful story. I’m looking at your photo right now and oh my heck. I don’t know who took it–


    Amanda: My doula, she took it. 


    Meagan: Mallory?


    Amanda: Mallory. 


    Meagan: Mallory killed it with this photo. I mean, seriously it is beautiful. 


    Amanda: Thank you. Thank you. 


    Meagan: I highly suggest if you are listening right now, head over to Instagram or Facebook and check out this absolutely empowering photo. The emotion, oh. Congratulations. I’m so stinking happy for you. 


    Amanda: Thank you. Thank you. Thank you. It was quite a journey. 


    Importance of lactation support


    Amanda: I just wanted to add one more thing if I could. 


    Meagan: Yes. 


    Amanda: I got to nurse Jeffrey David eventually, my first baby once he left the NICU but it was a rough time and then with Charlie, my second, I got to latch him right away and I am still nursing him now. He’ll be 3 in June. I just want to say just like you get doula support for your birth, get yourself some lactation support if breastfeeding is the way you want to feed your baby. 


    Meagan: 100%. 100%. 


    Amanda: Yeah, so I used my friend, Lauren. She is from Cozy Latch Counseling and she has seen me through this entire process. I went back to work. I was able to pump and provide milk and now like I said, he’s almost 3 and I’m still able to do that. If I hadn’t had that lactation support from the very beginning, I don’t know if that journey would have been as successful as it was. 


    Meagan: Yeah. I mean, I full-on believe having lactation support even before the baby is here to talk about it. Talk about your plan. Discuss what you are wanting, your desires, your needs, and then getting that help right away even if it’s your second, third, fourth, or fifth baby. Everyone is so different and I love that you brought that up because definitely, we are passionate about that for sure as you know or if you have been listening. We love The Lactation Network. We absolutely 100% would agree with you on that. 


    Oh my gosh, well my face is just so happy. Can you just see my face right now? 


    Amanda: I can. 


    Meagan: I’m just smiling so big. My cheeks are throbbing a little bit, but that’s a good thing. I’m just so grateful for you. This is such an amazing episode and congratulations again.  


    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
    46m - Jul 3, 2024
  • Episode 313 Happy Birthday to Meagan’s VBA2C Babe + Walking Down Memory Lane with her Husband, Ric

    “Trust your partner. Trust the mom. They know things better than you do.”


    Meagan’s husband, Ric, joins the podcast today as they celebrate their VBA2C baby’s 8th birthday! Ric gives the perspective from the partner’s side of things as they both share details of Webster’s birth story. He talks about some not-so-proud moments and is the first to admit how little he knew about how to support a VBA2C labor– especially one that went over 40 hours! 


    But through it all, Ric came to understand the importance of doulas and how magical it can be to have not one but five doulas! He agrees that the births of each of their children ultimately was a special journey and brought the two of them closer together. 


    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    01:17 Review of the Week

    04:10 Deciding to birth out of the hospital

    06:35 Agreeing on a birth center

    10:57 PROM for the third time

    15:05 Laboring loudly

    20:23 Relying on the doulas

    28:33 Navigating doubt and transition on the toilet

    34:25 Pushing Webb out in three pushes

    37:08 Passing out after birth

    40:37 It takes a village

    42:45 Ric’s advice to other dads


    Meagan: Today is my VBAC baby’s birthday. I cannot believe that it has been 8 years since that little boy joined our family and today I wanted to share or reshare his story. I know I’ve done it in the past, but I invited my husband, Ric, to share the story again for you and maybe I might just give him a couple of questions and see how he felt about it from his perspective. 


    When we were going through pregnancy and preparing for me, it was just like, This is what I want to do. This is what I want to do. I would always go and say, “Hey, these are my thoughts”, and to be honest, I don’t know if I even gave him a ton of opportunity to share his exact thoughts because I was so driven and just wanted to get this.


    We are going to dive more into his thoughts and his perspective on the birth because we know so many dads out there are also a little hesitant when it comes to the idea of VBAC because the world as we know it talks about VBAC in a very poor manner and it can be a very scary thought. 


    So we will be diving into that today in just one moment.


    01:17 Review of the Week


    Meagan: We have a Review of the Week so I wanted to get to that before we get into Webster’s birth story. This is from Katiewarren11. It says, “I wish I would have found this sooner.” It says, “I love the show. I wish I would have heard these before my last baby. I was planning for a VBAC 7 years after my first baby and just thought it would happen. I didn’t realize I might have to fight for it.” That just gave me the chills. 


    It says, “I got to the week of my due date and my body didn’t seem at all ready. Then they were estimating her to be 9 pounds, 12 ounces, and the doctor told me, ‘No option. You are getting a C-section.’ After listening to these stories, I now know that there were other options.”


    Thank you, Katiewarren11, for sharing your review. I want you to know that you are not alone. There are so many of us who get to the point at the end of our due date. We are being told that our babies are too big or our bodies aren’t working because they are not dilated yet or whatever it may be. There are lots of scenarios that people are told, but there are options. You have options and that is definitely what this podcast is about is helping you learn and grow and know your options. 


    So thank you, Kate, again, and as always, if you have one moment, we would love to hear your review of the show. It really does help the show grow. It helps other Women of Strength find these stories and help them know their options as well. You can do that on Apple Podcasts. You can even Google “The VBAC Link” and leave us a review there or if you would like, you can email us a review and let us know what your thoughts are. We always throw those into our spreadsheet as well. Thank you so much. 


    04:10 Deciding to birth out of the hospital


    Meagan: Okay, you guys. As I mentioned, I have my husband, Ric. Hey, hon. 


    Ric:  Hello, everyone. 


    Meagan: I’m sure he is just so excited that he is here. But really, I wanted to go through the experience from your perspective on VBAC and not only just the birth but also before and us deciding to birth out of the hospital. I was already kind of a crazy pants when we were trying to conceive because we really wanted a boy so I was really dialed into that. Then once we found out we were pregnant, I really, really just wanted to find someone to help me through the journey of VBAC. 


    I interviewed many, many, many providers in fact, even before I was pregnant. We know on the show, I have talked about it, that it is really important to interview and look for providers before you are pregnant if you can but I ended up finding a provider actually just right after I found out I was pregnant or right before I found out I was pregnant. 


    We went in and it seemed like a really great fit. Ric, you seemed like you were pretty on board with the provider shift at that point. 


    ric: Yeah, I mean those who know Meagan know that when she is passionate about something, it is very unlikely that she will be turned away. 


    Meagan: Convinced otherwise. 


    Ric: Convinced otherwise so I just kind of went with the flow. But yeah, the provider seemed great. You seemed happy which was most important. 


    Meagan: Yeah. And just kind of a quick little back summary, how did you feel about the C-sections? Did they bug you at all? Did they affect you at all? Did they just seem normal?


    Ric: Yeah, I mean, I didn’t know anything other than the C-sections so it was normal. It was just that you were very unhappy with them which was hard for me. It was hard because I was stoked that we had the babies and you were upset with yourself, with the provider, and I didn’t share those feelings because I didn’t know. 


    Meagan: Yeah, It was hard because like you said, we were so happy that we had our baby but I was in this cloud of doom and just and unsettled cloud. 


    Ric: Dissatisfied. 


    Meagan: Yeah, I was dissatisfied. 


    06:35 Agreeing on a birth center


    Meagan: Okay, so we found this provider and everything is going really great. This provider at the time was the VBAC provider in Utah. Everybody went to him and he was amazing. He flat-out said after reviewing my op-reports that my pelvis was too small and my baby would probably never come out of my pelvis and that my body didn’t know how to dilate, he really agreed that I probably just wasn’t given a fair chance and he didn’t understand why we wouldn’t be able to go forward.


    But at 24 weeks, I attended a birth just before that with a midwife out of the hospital that blew me away. I immediately knew that I wanted to go talk to her which was kind of interesting because we never really discussed birthing outside of the hospital, but I went and met with her and I told you, “Hey, I want to birth out of the hospital.” 


    Now, you knew nothing but C-sections. You were okay with me finding a provider, but how did you feel about the idea of birthing outside of the hospital?


    Ric: I don’t think I was that excited about it. I was okay switching providers, but not being in the hospital was worrisome. I actually think, didn’t you broach the subject on birthing from home? 


    Meagan: I think I did. 


    Ric: I immediately put the kibosh on that. 


    Meagan: You were like, “No.” 


    Ric: So I think when you initially discussed birthing outside of a hospital, you gave a couple of options of a birth center or a birth from home so I completely– that was too big of a jump for me from hospital to home so we went and did we go to multiple birth centers or just one? 


    Meagan: We just went to one and we interviewed with a different provider than the one I met, but it was at the same birth center that the provider I met would have birthed at so we met with another midwife at the birth center. 


    Ric: Right. It was awesome. 


    Meagan: It was awesome.


    Ric: No, the midwife was cool too. She was great. 


    Meagan: Yeah, she was really awesome. Yeah. So as we were there, did you feel like, Oh, okay. Once you saw it, did you feel more comfortable? 


    Ric: Yeah, because it seemed more medical. I don’t know the word for it, but it just seemed like, Oh, hey. Things looked sterile which was a big deal for me and it just made it seem like, Yeah, it’s not the hospital, but– can I swear on the podcast? 


    Meagan: Yeah, sure. 


    Ric: –if shit hit the fan, then we were in a better circumstance than trying to find gauze and stuff at our home. 


    Meagan: At our home, yeah. Which for those who are birthing at home, typically your midwives would bring all of that to the birth but we didn’t even get there for me to explain that. 


    Ric: I don’t need to know if I would have even let you. 


    Meagan: Get to that point? 


    Ric: Yeah. 


    Meagan: Okay, so then fast forward. Labor begins. Actually, we hired a doula. 


    Ric: A doula? 


    Meagan: Multiple doulas.


    Ric: You had these two mentors in the doula community here and you said, “I definitely want to hire them,” so we did. Those two mentors were in a group of three. Not only that, your really good buddy who became a doula at about the same time and had gone through the doula course with you wanted to attend, and then your cousin who is about as much of a doula as you can be without being a doula– 


    Meagan: Seriously, yeah. 


    Ric: Also had to attend the birth. Plus the midwife–


    Meagan: And the assistant. 


    Ric: And the assistant. There were a lot of people in the room. 


    Meagan: There were a lot of people in the room.


    Ric: Initially when you said, “Hey, look. We are going to hire a doula,” because you were doing the stuff, I was totally on board. I had no idea how many doulas would actually show up. 


    Meagan: Yeah. 


    Ric: But they did and it was fine. 


    Meagan: It was great. And rewinding back, remember back with Lyla when I asked you if we could hire a doula or bridge that, you weren’t super keen on that idea. 


    Ric: I don’t remember that conversation.


    Meagan: You don’t. 


    Ric: But I remember our nurse being a doula. 


    Meagan: Yes. 


    Ric: And she was awesome. 


    Meagan: She was fantastic. 


    Ric: And that solidified your desire to be a doula. Yeah. 


    Meagan: Absolutely. 


    10:57 PROM for the third time


    Meagan: Okay, so with all three of our kids, I for some reason have PROM. If you don’t know what PROM means, that’s the premature rupture of membranes. My water broke with each kiddo and my body took its sweet old time to kick into labor. They say only 10% of women will experience that, but we are 3 for 3. 


    Ric: Do they know the story about where I was when your water broke with Lyla? 


    Meagan: No, I don’t know. That was another reason why I wish we had a doula. So going back to Lyla’s birth, my second C-section–


    Ric: Kind of just showing the progress of where Meagan began as a, “Hey, look. I trust my doctors. I’m going to do everything that they say on the first birth.” The second birth opened my eyes as to how Meagan was going to control the situation as much as she possibly could. So yeah, tell them where I was when your water broke. 


    Meagan: So you were in Texas when my water broke with Lyla. As he mentioned, my cousin is pretty much a doula without the doula training and she just is so loving and caring. She was really excited because we wanted this VBAC. I wanted this VBAC really, really badly. So yeah. Ric was out of town and my water broke. I was like, “Uh, you should probably come home.” 


    Nothing was really happening at all really. I was just leaking. Yeah. You got home probably 6-7 hours later. 


    Ric: No, it was about 10. 


    Meagan: Was it about 10? 


    Ric: Yes and I assumed you were going to go to the hospital. 


    Meagan: Yeah, you were not happy when I was not at the hospital when you got home. 


    Ric: I walked in and you were sitting there naked in the bathtub and I’m like, “What in the world are you doing? You are supposed to be in the hospital. Your water broke.” Because for me, your water breaks, you go to the hospital. For Meagan, that’s not necessarily the case. 


    Meagan: Well, yeah. I think going back to what you were saying, a lot of providers actually say, “If your water breaks, come right in,” even if labor is not going on. Through my research with Lyla and the VBAC, I realized that I didn’t necessarily need to just run right into the hospital. I checked my vitals. All was well. Everything was good, so we stayed and labored at home. 


    Plus, I was waiting for you to get in town. 


    Ric: Yeah, but it kind of prepped me for what the next birth was going to look like. Obviously, that birth ended up in another C-section and you were really disappointed after that one. You worked really, really hard. 


    Meagan: I was, yeah. 


    Ric: Then with the next one, when you were going through options of birth centers, doulas, and midwives, that instance where I flew home in an emergency fashion as quickly as I could and came home to find you in the bathtub realizing, Meagan is going to do what Meagan wants to do. 


    Meagan: Yeah, so when I told you, “Hey, let’s birth out of the hospital”, did you feel like, She is going to do whatever she wants to do anyway? Or were you more comfortable with the birth centers? Were you okay with that? 


    Ric: Yeah. It’s hard to tell you no, but when we went to the birth center, I did feel significantly better about having a birth there. 


    Meagan: Yeah. What had you heard about or had you heard anything about VBAC just in general? 


    Ric: Nothing. 


    Meagan: So you didn’t really hear a ton. 


    Ric: Other than what I heard from you. 


    Meagan: So you didn’t hear anything scary. 


    Ric: No. 


    Meagan: Okay, because a lot of dads out there do hear when they say, “Oh, my wife wants to VBAC,” people are like, “Oh my gosh. It’s so scary.” I think that can be really hard especially if their partner is saying, “Hey. I want to birth out of hospital.”


    15:05 Laboring loudly


    Meagan: Okay, so my water broke with Webb at 3:00 AM or something like that. Yeah, what do you remember about that? My water broke in the middle of the night. I don’t even think I told you until I woke up. Do you remember anything about that?


    Ric: With Web, that was where you labored forever, right?


    Meagan: Yeah, 42 hours. 


    Ric: I don’t remember that first morning. I remember the next night. 


    Meagan: Yeah. 


    Ric: Didn’t Hillary– Hillary is her cousin, everyone. Hillary showed up at 6:00 in the morning and you guys went out and walked around the neighborhood. 


    Meagan: Yeah, so the night–


    Ric: The first night?


    Meagan: No, that was the second morning, yes. My water broke and again, I had PROM so I was so frustrated. I was 40 weeks and 3 days or 4 days. I had him at 40 weeks and 5 days. We had a visit with Danielle and my water had broken. I was sort of contracting a little bit here and there. I asked if you would come up to Park City with me. We went up to Park City and I went in and I did my regular visit and then she said, “You’re going to Christine.” Christine, at the time, was my chiropractor so we went to the chiropractor. You got me a Jamba and we drove back down the mountain and came home. 


    My body just really wasn’t going into labor. It was taking its time so I went and I took a nap which is really hard to do when you are in labor because your mind is so excited and you just want to have a baby, but I needed to nap so I went in and I napped. It’s weird. I can even picture exactly how our room was set up that day. 


    I took a snooze and woke up and I was sort of starting to contract. I actually went out into the driveway and threw a tantrum. Do you remember me throwing a tantrum in the driveway?


    Ric: No. Was I working? Was I at home?


    Meagan: You were at home. I threw a tantrum that my water broke. I was triggered. I was like, “This is going to be the same. I’m going to have another C-section.” I was just so upset. I remember our next-door neighbor had this big pine tree and they were watching me throw this insane tantrum in our driveway. 


    But yeah, so then that night, that’s when you said you started remembering. My cousin came over for a little bit and actually, my doula came over and was doing some rebozo work and some things, but then they left and I really wanted to labor in my son’s room, in our baby’s room. 


    Ric: Yeah, but wasn’t Hillary there at that time? 


    Meagan: She was for a little bit, uh-huh. You ended up going to sleep because you were super tired and again, labor wasn’t super happening. I had Hillary there. We were just hanging out. That’s when you came in with a pillow. 


    Ric: Guys, so I mean, it’s not a big house but we’ve got enough space where you can spread out so you don’t have to wake everybody up with your– can I say moaning? 


    Meagan: I was moaning. I was moaning to cope through. At that point, I was contracting. 


    Ric: Yeah, so there were three bedrooms right next to each other, but we had a whole family room on the other side of the house and she could have done that and not woken everybody up, but instead– 


    Meagan: I just woke you up. 


    Ric: You were so loud though. You were so loud and can I make the noise? Can I pretend? 


    Meagan: Oh my gosh, sure. But you are going to be dramatizing it. 


    Ric: No. No. You exaggerate pain so much. 


    Meagan: I don’t think so. 


    Ric: You think you are great at handling it but–


    Meagan: I am. 


    Ric: You obviously are enough, but the way you are great at it is by being really loud. 


    Meagan: Posterior baby, everybody just to let you know. 


    Ric: I don’t know what that means. But you were contracting every 5 minutes or so– 


    Meagan: Yeah, every 5-8. 


    Oh my gosh. 


    Ric: That’s exactly how it was and it was loud and you were in the room right next door to our two little girls and right across the hall from me so I was super frustrated because I was exhausted and I couldn’t sleep and of all of the places you decided to labor, it was right next to everyone so I came in with a pillow and threw it in your face and said, “Muffle yourself.” 


    Meagan: Oh my gosh. This was not the brightest moment. 


    Ric: This is why you hire a doula because sometimes dads just don’t get it. 


    Meagan: Just don’t get it. And you were tired. It was really late. 


    Ric: You don’t need to excuse me. I was being a complete jerk. 


    Meagan: But this is why I love that it is from your perspective because in my perspective, I was not that loud. I was moaning for sure. I was coping. Oh my gosh. I had so much back labor, but yeah. It was so funny. 


    20:23 Relying on the doulas


    Meagan: You throw the pillow at my face. You walk out and you leave and Hillary, my cousin, was like, “Oh no he didn’t.” She was laughing. So we continued. We definitely were just quieter. I don’t know. 


    Ric: No, you didn’t leave the room. 


    Meagan: No, we didn’t. 


    Ric: You were so stubborn. You were so stubborn. You probably were louder after that because you were so mad. 


    Meagan: When you find a space where you want to labor and are coping really well, you stay. Then the next morning came around and one of my doulas was up in the canyon so she was not even getting a ton of messages and didn’t have service. She was coming down and obviously the texts were blowing up so she started texting me and said, “Why don’t we call the midwife and see? Maybe we should plan on heading there.” 


    Like Ric said, my cousin and I decided to go walk. It was 6:00 in the morning and my cousin and I decided to go walk around the block. Man, my labor totally picked up after walking. We were doing curb walks. You go up and down the curbs. We were just walking and it was such a beautiful morning, absolutely beautiful. The birds were chirping. It was July 1st. It was such a great time of year. 


    We actually had gone to the birth center the night before to go get checked. I don’t remember if you remember that and they placed a Foley balloon which is a catheter that they can fill up with saline that pushes pressure on the cervix to try and help dilate so I think it was 1 centimeter or something like that. 


    But it popped on the way, so nothing really happened. The next morning, we went in. It was 9:00 AM and we met everybody there. My cousin had left at this point. Maybe she had stayed for a little bit actually, and then my doulas were there so like Ric said, there were just so many people there. 


    Do you remember arriving and anything about that?


    Ric: No, I don’t actually. The part that I do remember is hanging out outside of the birth center with Robin who is my favorite and just watching her. She just had her hands on your belly and was just calming you down. 


    Meagan: Yeah. Yeah. I’m going to rewind a little bit. We get to the birth center. She does. She did do a cervical exam and she said, “All right. We’re going to stay. Let’s go upstairs.” So we go upstairs. At that point, she didn’t tell me what I was dilated to but I knew I was dilated enough to stay. 


    For me, dilation was a big mental block because I had never made it past 3 before. I had never made it past 70% effaced either. I was told on my op reports. I don’t know if you remember that day that I got the op reports and I was just crying and so upset, but I was told on those op reports that I was failure to progress and that my pelvis was too small. 


    I was just worried about dilating but at the same time, it gave me some oomph because she said, “Let’s go. Let’s go upstairs.” So we went upstairs. I later learned that I was 4 centimeters which was huge and yeah. My baby just really was posterior and really having a hard time turning. 


    We did the stairs. We walked up and down the stairs and like Ric said, we went outside and we went underneath this beautiful tree. I sat on a peanut ball or I sat on a ball and my one doula was behind me holding my belly. You were there and then I had another doula keeping me hydrated. It was just a beautiful time. It was a beautiful time. I really liked it. 


    Yeah, then we went in and I feel like that’s from the point we went in, it started getting a little bit more serious but you hadn’t eaten. It was like, Okay if we are going to take a turn, we need to get Ric food because we are going to have a baby soon. 


    Do you remember that you left for a little while? Do you remember leaving? 


    Ric: I don’t. No, I do remember leaving because that’s when I came back and everybody had shown up. Everybody had shown up. 


    Meagan: Everybody was there, everybody. Yeah, so you left which was nice that you were able to leave and decompress and maybe reset. Did it feel good to be able to leave? Did you feel nervous leaving?


    Ric: No, again, the benefit of having Robin there. Robin was kind of the main doula for me. She was always the one who would talk to me and make sure that I was doing okay which I was. 


    Meagan: Which is good to know because I think that hours and hours and hours into labor, you could have easily been freaking out. 


    Ric: Yeah, I don’t know why. It was just calming. 


    Meagan: It felt calming. 


    Ric: It just seemed we had a bunch of hands on deck that could have handled any situation that presented itself. So yeah, I remember coming back. Did you move to the room with the bed? 


    Meagan: Mhmm. I had. I was getting counterpressure. 


    Ric: I walked in and there was Courtney, Robin, Hillary, Angie, Danielle– there were five. Yeah. 


    Meagan: You said Courtney, yeah. 


    Ric: There were five women there. 


    Meagan: Surrounding. 


    Ric: I walked in and there was such a relief. I didn’t have to do a thing. I was like, I can just sit. Because I think I brought my food. I just sat and ate and watched as you were getting pampered. You were getting attended to by these amazing women. 


    Meagan: Such a princess. Really, there was a point where all of them like you said, all hands were on deck. They were all giving me counterpressure. They were all doing something. After you ate, do you remember when I was like, “I need Ric”?


    Ric: Yeah, for some reason I’ve got magic fists. 


    Meagan: You have strength. 


    Ric: I basically punched my wife in the lower back over and over and over again. Just as hard and as much pressure as possible. For some reason, it worked for her. Those women are way stronger than a man. 


    Meagan: They are so incredible. 


    Ric: Yeah, but I remember we would go between there and the bathroom that had the bathtub. I remember for a second we filled up the bathtub. You hung out in the bathtub for a while. 


    Meagan: Yeah. 


    Ric: And just kind of sat there. You obviously kept working yourself up because the progress wasn’t quick enough. Baby wasn’t coming fast enough. You were obviously uncomfortable. 


    Meagan: Yeah, it had been at least 35 hours at this point of being in that tub. 


    Ric: Yeah, so you just kept trying to find the spot where you felt would trigger things for the labor and get the labor going. 


    Meagan: Yeah, I was really trying to get that baby to rotate. I was trying to move. Every five contractions, I would re-position myself in that tub. Eventually, I got out. 


    Ric: Yeah, we went back into the bedroom and that’s when Robin pulled me aside– or maybe it was Danielle– I think it was Robin who pulled me aside and she was like, “Hey, you were very much in your own head and starting to doubt yourself.” 


    Meagan: I was, yeah. 


    28:33 Navigating doubt and transition on the toilet


    Ric: Robin said, “Hey, I think we need to leave.” 


    Meagan: We might need to leave, yeah. 


    Ric: No, no, no, no, no. 


    Meagan: Oh, I don’t know. I shouldn’t correct you. 


    Ric: She was saying that the girls needed to leave like all of the women needed to leave and it just needed to be me and you. So we hung out for a little bit longer. We went back into the bathroom. Do you remember fainting on the toilet? 


    Meagan: That was after the birth, but yes. 


    Ric: That was after birth. 


    Meagan: So it was just you and I. What happened was you all went out and Danielle and I were in the bathroom and she did an NST on me. She was just checking on the baby to make sure he was doing okay and  he was doing fantastic. 


    Ric: What’s an NST? 


    Meagan: A non-stress test. They did a non-stress test on him and he was doing great. Everything was great. We weren’t having issues. I didn’t have any fever because again, it had been many hours since my water had broken and I’m assuming that’s when you were being talked to and then I remember Danielle taking the machine out, going out and you coming in. It was just you and me. I was on the toilet. I was facing backward– the dilation station– and I was really hot. That position is a really good one though. It really opens the hips. It just helps. 


    So I was there and I had a backpack– or not a backpack. I had a pillow. 


    Ric: You had everything. 


    Meagan: Yeah, I had a pillow and then you were keeping me cool with rags and stuff. There were some pictures of you even touching me and just your touch was so amazing and did so much for me. I remember just absolutely loving it. I think that’s even more of why I was like, “I need Ric,” for counterpressure. Yes, your counterpressure was incredible, but I just needed your touch too. 


    Anyway, but yeah, we were in the bathroom for a bit. It felt like a little bit. 


    Ric: Yeah, and you really started doubting yourself. 


    Meagan: I really was getting down. She had just done an NST and she said the NST was great, but I was thinking, Whatever. They’re going to transfer me. I’m going to have a C-section. 


    Ric: The one lady had come in and said that you should transfer so a midwife who wasn’t our midwife who was at the center–


    Meagan: With another mom.


    Ric: I think she was frustrated that we were taking so long. 


    Meagan: She was. 


    Ric: But she had mentioned the hospital word and that really set you off. 


    Meagan: That really impacted me. 


    Ric: You immediately started feeling doubt in yourself. Up until this point, I don’t think you had. 


    Meagan: In my head, I was like, Oh my gosh. This is taking forever and it’s getting really strong but we’re not getting anywhere. I was thinking that, but when she said the word– I remember she wasn’t very great. Her bedside manner was not very great. She checked me and I was 6 centimeters which was great, but I had been just lagging. She was like, “I think it’s time to go to the hospital,” or something like that. 


    I think that’s when she told the midwife and the midwife came in and did the NST. But we were in there and one of our other doulas came in, Angie. I turned to her and said, “Are they going to transfer me?” She just said honestly which I really appreciated, and I really encourage doulas if you are listening, to be honest with your clients. Honesty is so important. She just said, “They are looking at things. It’s one of the things they may consider.” 


    I was like, “Okay. We’ve got to do something here.” 


    Ric: No, that’s not what you did. 


    Meagan: In my head, that was what I was thinking. 


    Ric: You got really down on yourself. 


    Meagan: I did. 


    Ric: This is when I turned into super-Meagan. I was like, “No. You can do this. You’ve got this. You worked so hard. You’ve done everything in your power to have the baby here. Let’s have the baby here. You keep doing what you are doing and it will happen.” That was the one time when I think I was the one who was pushing more for having the VBAC than you were and was it 5 minutes later when Danielle came in and said, “All right, we’re good.” 


    Meagan: Well, yeah. She came in. She had me turn around. 


    Ric: You had been checked. Sorry, let’s go back a little bit. Right before it was just you and I in the bathroom, you had been checked and you were like an 8.5 or a 9. 


    Meagan: Oh, yes. I was a 6 when the other midwife checked. She had checked me right before. 


    Ric: Probably a half hour past. 


    Meagan: Yeah. 


    Ric: Then right before we were left alone in the bathroom, Danielle came in and checked you and you were like a 9. I don’t know what everything else means, but I don’t think that Webb was in a great position though. 


    Meagan: He wasn’t. I don’t know if you remember, but first of all, I was already having back labor. Now my baby was really low. I was dilated pretty far and I wanted to push. I don’t know if you remember. I was trying to push, but they were like, “You’re not dilated.”


    Ric: You thought you were going to go to the bathroom. 


    Meagan: Yeah, so I was living on the toilet then she came in and I think that they had been listening. It really wasn’t that long. Yeah. She checked me and what she did was she kind of advanced my cervix. I was 9 centimeters. My baby was posterior and she stretched my cervix over his head. 


    Ric: Yeah. 


    Meagan: She manually brought me to a 10. 


    Ric: She assisted. 

    34:25 Pushing Webb out in three pushes


    Meagan: As soon as she did that, it was like, Oh my gosh. This baby is coming. Everybody flooded. 


    Ric: She brought in the stool. 


    Meagan: Yeah, she brought in the stool and everybody flooded in the bathroom. It was insane. There were so many people in this small bathroom. Yeah. I sat on the stool and you were right behind me. I think I put at least one of my feet on someone’s shoulder. 


    Ric: Courtney. 


    Meagan: Maybe. Courtney was taking pictures. 


    Ric: I don’t know. 


    Meagan: Yeah. I don’t know either but yeah. I put my foot on someone and I started pushing. She was like, “Let’s have a baby.” I still in that moment was like, No. It’s not going to happen. This isn’t happening. How am I pushing a baby out now? It was so– I don’t know if it’s euphoric but it was really weird. 


    Ric: It was exciting. 


    Meagan: It was super exciting but I didn’t believe it. I didn’t believe that what was happening was happening. 


    Ric: I did. I remember they asked me if I wanted to catch the baby and then they asked if you wanted to catch the baby which because of where you were at on the stool, you weren’t able to. 


    Meagan: Yeah. Yeah. I pushed and within one push, he made really great progress. He had rotated. He had rotated because I did not give birth to him posterior. He had rotated and yeah. It was one push with major movement. The second push had major movement then I just remember I was sitting there. It was really quiet and there was another mom in the next room also pushing. She was a VBAC and I was like, I’m going to have this baby before her. I made it a competition a little bit. It seemed like we were kind of on and off. When I was pushing, she was not. When she was pushing, I wasn’t. 


    With the next contraction, Danielle looked at me. I remember her eyes and I was like, It’s going to happen. I felt it. I felt a lot of pressure, a lot of pressure. I pushed him out, pulled him up, put him on my chest, and I don’t know. Were you crying? 


    Ric: No. You were. 


    Meagan: I was bawling. Everybody else I feel like was bawling, just all of the women in the room who had just gone through this whole experience with me, not just the labor but the journey of wanting the VBAC and then also as a doula watching me want this VBAC. 


    So anyway, we were all crying and then you’ll have to say. I don’t know what happened. 

    37:08 Passing out after birth


    Ric: Yeah, you passed out. I was behind you with my arms around you and the baby. You had been crying and with the emotion, with all of the hard work, you suddenly just went limp. So I had just told one of the doulas, “Hey, can one of you guys grab the kid because Meagan just passed out and we need to wake her up?” They grabbed Webb and–


    Meagan: Gave him to you, right? 


    Ric: No. 


    Meagan: Oh, really? 


    Ric: No, I hung out with you while they had the baby. 


    Meagan: Oh, I didn’t know that. 


    Ric: You came to and did they start? I remember they cut the umbilical cord. 


    Meagan: Yeah, because they took the baby. They cut the umbilical cord. 


    I saw pictures of you holding the baby and me on the ground. 


    Ric: I was just focused on you because you had passed out. 


    Meagan: I just assumed they handed the baby to you. 


    Ric: Eventually. 


    Meagan: Okay, yeah. So yeah. I don’t know. I woke up pretty quickly. It was pretty quick it seemed like. 


    Ric: Yeah. 


    Meagan: But yeah, then I was just on the floor and I was just beaming and laughing and just so stinking happy. And then we went into the bedroom and I nursed for a while and was doing really, really well. They were like, “Okay. Let’s get you to the bathroom and showered and then you can go home.” 


    What happened?


    Ric: You passed out again. 


    Meagan: I passed out again. 


    Ric: Yep. You woke up on the floor. You had just sat up on the side of the bed and you passed out. This is when I did have Webb in my hands at this time and you passed out. Luckily, another doula had come so we had a fresh one, Rachel. You woke up laughing. You were like, “Oh, I’m on the floor again.” 


    Meagan: I was like, “Why does this keep happening?” 


    Ric: But you really wanted to go to the bathroom so we went. You and I just went to the bathroom. You sat down on the potty and you passed out again. 


    Meagan: Yeah, and Robin came in. I remember waking up and you and Robin were right there. 


    Ric: Yeah. We had to pick you up so we hung out in the birth center a lot longer than we would have. 


    Meagan: Than normal.


    Ric: I think you ended up going to sleep. 


    Meagan: I did. 


    Ric: Because I was next to you and then Webb was between us. I was super worried about rolling over on him or you rolling over on him, but I think we hung out there for a couple of hours. They checked on him. They checked on you and then I just remember how amazing it was to go home that night. 


    Meagan: Yeah. 


    Ric: I mean, it was later. I think it was 11:00 at night. 


    Meagan: He was born at 5:30 and it was like 11:00 that we were finally stable enough to go home. 


    Ric: It was so odd to be told, “Hey, look. You can go home now.” He didn’t have to wait in the nursery. He didn’t have to do any of that. We were just able to go home. We came home. We had the crib in our room. We put him in the crib and we slept great that night. 


    Meagan: Yeah, we did. 


    Ric: He did too. He did awesome. I think he woke up once or twice to feed, but he was so calm. 


    40:37 It takes a village


    Ric: From my perspective, seeing you accomplish what you wanted and for those of you who are unaware, I told Meagan unequivocally that this was our last child, so this was her last opportunity. She wouldn’t have had another opportunity after this. 


    So it was really fun to see you accomplish what you had wanted to accomplish. It truly did. It took a village. You had so much help. We had so much help. I had no idea what I was doing and it was awesome because I had no idea what I was doing and everybody else who was there knew exactly what they were doing and they did such a good job. 


    Meagan: Yeah, so obviously you would advocate for a doula. 


    Ric: Oh, 100%. When people come up to me and ask what a doula is, I tell them it’s what the perfect partner would be and how they would act and how they would treat their partner during birth. 


    Meagan: Mhmm. 


    Ric: So yeah, they were fantastic. Again, being able to leave and come back knowing that you were 100% taken care of– obviously, I had my spot there. I don’t feel like I was minimized or my role was minimized at all. There were a bunch of times where you would have me step in when I needed to get in there and help, but I was able to focus on being there for you and they were able to show me, “Hey, look Ric. Here’s where she wants you to push.” I remember that. You had showed and I think Robin or Angie said, “Hey, this is the spot where you need to push.” 


    I remember when we were out under the tree, I was able to look at you because Robin was holding you from behind and that was a big deal because I remember Robin was obviously there and it was just serene having her with us, but it very much felt like a moment between just you and I because we were able to just sit there and be with each other and talk to each other. 


    Meagan: Yeah. Yeah. It just helped the connection and the bond and everything. I just love doulas so much. I love you and I am so grateful that we were able to have this journey together. 


    42:45 Ric’s advice to other dads


    Meagan: Do you have any advice to a dad who may be in the spot that I put you in? 


    Ric: Yeah, I’m sorry. First and foremost, I apologize to you because that’s rough. It’s a rough spot to be in. No, honestly, trust your partner. Trust the mom. They know things better than you do and again, for us, it’s really easy because you get your way 99% of the time in our marriage but seeing how things ended and how everything happened, it just showed me that yeah, I can trust her and I know that she’s listening to her body and she’ll know what needs to happen. 


    Meagan: I love that you point out that I was listening to my body. I think that can be a hard thing for any dad or partner to understand because there is this weird, innate thing inside of us. It just felt so right to birth vaginally after two C-sections and then it also felt right to birth out of the hospital. So thank you for supporting me through all of that and for being there. 


    I can’t believe our baby boy is 8 years old today so happy birthday, Webster. We love you so stinking much. 


    Closing


    Would you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.





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    44m - Jul 1, 2024
  • Episode 312 VBAC Basics with Meagan & Julie

    This episode goes back to the basics and is a great place to start on your VBAC journey! Julie joins Meagan today as they talk about many common questions beginning with reasons why providers tell women they can’t go for a VBAC. 


    Topics today include: 

    • Nuchal cords
    • Big babies
    • Small pelvises
    • Arrest of descent
    • Third-trimester ultrasounds 
    • Cervical dilation
    • Induction
    • Due dates
    • The ARRIVE Trial
    • Why there is so much contradicting VBAC info
    • Pregnancy intervals 
    • Epidurals


    Meagan and Julie also reflect on how their perspective toward each of these topics have changed over the years. Allowing for nuance is so necessary when approaching birth. Know that you always have options and never feel pressured to make a decision that doesn’t feel right for you.


    The VBAC Link Blog: Pregnancy Intervals

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    04:24 Review of the Week

    07:48 Intro to the basics

    09:53 Nuchal cords

    13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasounds

    17:08 How will this change my care?

    18:47 Cervical dilation

    25:54 Due dates

    28:18 Vulnerability and the ARRIVE trial

    30:44 Inducing a VBAC

    36:15 Julie’s social media story

    38:29 Contradicting information

    41:36 Pregnancy intervals

    46:38 Epidurals

    54:13 Allowing for nuance


    Meagan: What’s up, everybody? This is Meagan. We have Ms. Julie with us today and we are going to be talking to you about what we need you to know about VBAC. We obviously like to talk about different topics but Julie and I decided this morning as we were getting ready to record that we need to do an episode on just the basics again. Don’t you feel like it’s the basics? 


    It’s not to shame anyone for not knowing the information. It’s honestly to– I don’t even want to say the word shame– but providers are not educating their patients. They are just not. We see it time and time and time again where people just don’t know. 


    We saw a post, I don’t know, maybe a month or so ago. I think maybe Julie sent it to me. It was just saying, “Hey, so can you have a VBAC no matter what reason the C-section was for?” Someone said, “Well, it depends because if it’s something like a cord wrapped around the baby’s neck, if that was the reason you had your previous C-section and if your last baby had its cord wrapped around their neck and was having struggle, yes. You have you have a C-section.” 


    Julie: I am getting a little salty. I feel like maybe salty is not the right word, but direct. I jumped in and I’m like, “That’s actually not true. The cord wrapped around a baby’s neck preventing them from descending is a perfect VBAC candidate because it’s not anything to do with the pelvis or labor stalling or anything like that.” Anyways. 


    Meagan: Even with that said, even with that said– 


    Julie: People still argued with me. 


    Meagan: Well, but even if it was due to someone being told that their pelvis was too small or their baby didn’t descend– 


    Julie: That’s also false. 


    Meagan: That’s also false. 


    Julie: I mean with actual pelvis trauma where it’s actual CPD and is legitimately diagnosed and that type of thing. Honestly, most people are good candidates for VBAC but we are going to talk about that. 


    Meagan: Yeah, we’re going to talk about that today because it’s obviously something that we are really passionate about and it’s something that we want you guys to know so let’s talk about it. 


    04:24 Review of the Week


    Meagan: We do have a Review of the Week. You guys, it’s a really long one and I might have specifically been waiting for Julie to come on with me so she can read it because she’s a lot better at reading long reviews sometimes. I’m just going to pass the time over to Julie to read this amazing review. 


    Julie: Now I feel pressure, man. 


    Meagan: Don’t mess up. 


    Julie: The pressure’s on. Are you ready for this? This review says, “This is such a tremendous resource for VBAC mamas.” See? There I go. I knew it. I’m going to start BBAC mamas. Try and translate that, Paige. Anyway, okay. It’s fine. I’m going to circle back around. 


    “This is such a tremendous resource for VBAC mamas. I sadly only discovered your podcast after my VBAC in April 2022 but having caught the birth bug during my prep for that birth, I still listened to each episode as if I’m preparing for my VBAC all over again. I think having a special place for this very unique scenario helps those planning and hoping for a successful VBAC feel less alone, more supported, and very well-informed. 


    “The balance of evidence-based information with the age-old practice of sharing birth stories makes this one of the best birth resources out there. I only wish I had this when I was planning my VBAC but maybe someday I’ll get to share my own story and help inspire a fellow Woman of Strength. 


    “Prepping for and achieving the unmedicated birth of my daughter absolutely flipped a switch in me and I feel determined to become a birth worker one day.” I feel like all of us go through that, right? 


    “Knowing that this podcast team also has a course for prospective doulas like me thrills me to my core. I want to be there for other anxious, hopeful VBAC mamas like me and the amazing work that you are doing is changing birth and lives everywhere. Keep it up. It is so needed and appreciated. Adrianne.” 


    I love that so much. I feel like that’s all of us like you and me. We all go through this journey like, Hey, I had a really bad birth experience or I had a really bad one and then an empowering one and I want to be part of this change so that other people don’t have to suffer like I did. 


    I love that and I feel like almost all birth workers’ stories start like that. I know mine did and yours too, Meagan. We all are there at some point. 


    Meagan: We are. Yeah. I couldn’t agree more. I definitely have been there. 


    07:48 Intro to the basics


    Meagan: Okay, all right. Let’s talk about the basics. What basic do you want to talk about first? We were talking about just a second ago where we were like, Hey, this was being told to you and you are being told you may not get to have a VBAC. So maybe we just start with reasons people are told that they have to have a C-section and they can’t have a VBAC. 


    Julie: My gosh. I want to speak to a couple of different points in that direction. I have a couple of different ideas in my head. First of all, I feel like it’s important to acknowledge that we are all ignorant to things at some point. Right? We all have to learn that VBAC is an option at some point or maybe we always knew. For me, I feel like I never was like, Oh, I can have a vaginal birth? I just always thought I could have one, but I also feel like the age-old “once a C-section, always a C-section” thing is so ingrained in some parts of our culture that you really do have to have that awakening that, Oh, I can do this. It is safe.


    So I just want to acknowledge that. Sometimes, even for me, I’m scrolling through Facebook and I see this post about something or the ARRIVE trial with induction at 39 weeks is safer and it’s really easy to eye roll or it’s really easy to be like, Oh my gosh, how come you don’t know this? But I feel like let’s circle back when I see these things and remember that we all start somewhere. 


    Not all of us have access to supportive providers, supportive hospital systems, supportive families, supportive providers. We don’t all have access to those things. If you’re advanced in your VBAC thoughts or thinking or whatever, I encourage you to still stay on the episode because you never know when you’re going to learn something new. You never know when something is going to click right for you and you never know when you’re going to gain the perspective that you need. 


    If you are a seasoned VBAC pro, please also stick along with us. 


    09:53 Nuchal cords


    Julie: I feel like I hear a new reason why someone is told they can’t have a vaginal birth every day. Not every day, that’s a little dramatic. 


    Meagan: But a lot. 


    Julie: It still surprises me. I’ve been a doula in the birth scene for 9 years now and I still get that cord prolapse one. I have never heard that as a reason why someone would have a repeat C-section. I mean, I had a VBAC client. She was trying for a VBAC at home and it ended up in a hospital transfer. The baby’s cord was wrapped around her neck four times. They had to cut the cord in four places to get the baby out via C-section. 


    Meagan: I remember you saying that. 


    Julie: Yeah, that baby was stuck so tightly in there. In those circumstances, that C-section was necessary. That baby was not coming out, but that doesn’t mean she can’t try for another VBAC. I think she is done having kids, but that is completely circumstantial and specific to that pregnancy. 


    So I feel like that’s a really important thing to note is that most things are circumstantial. Even stalled labor or arrest of dilation or failure to progress or a big baby or whatever these things are circumstantial. The cord around the neck preventing baby from coming down– totally circumstantial. I feel like even the American Pregnancy Association– did I say that right?-- says that 90% of women who have had C-sections are good candidates for VBAC. 


    I think that’s important to note is that if you’re being told that you are not a good candidate for a VBAC, I would really question why because most of the time, you are a good candidate. Big baby, sure. That’s one. We can throw these around. People say, “Oh, your baby is too big. You have to have a C-section.” That is not evidence-based. Even ACOG says that big babies are not a reason for either induction or automatic C-sections. 


    Meagan: Suspected big babies. 


    julie; Right, suspected big babies. 


    Meagan: Let’s just say that they’re not always big. 


    Julie: They are not always big and we know this is something we automatically know like, everybody knows this but not everybody does. Your ultrasound measurements can be off by 1-2 pounds in either direction. They can measure small or big. The only accurate way to determine how big your baby is is to weigh it after it is born. 


    Meagan: To birth your baby. Right, to birth your baby. 


    Julie: Not only that, but big babies come through petite pelvises all the time. Babies’ heads mold and squish through pelvises that flex and open and move to work together. The baby and the pelvis are this really cool diad where they have this great relationship of working together and the pelvis opens and the baby’s head smooshes together. Anyway, I feel like that’s probably the biggest thing that I’m hearing lately, “My baby’s too big and my provider won’t let me.” 


    Or there was a post in the community today that Meagan shared with me and she said, “Is it really possible to have a VBAC after a C-section? Because I feel like you always have to have C-sections. Is it really possible to have a vaginal birth after a C-section?” We need to remember that we live in a country and in a world where many people still have this way of thought. Many people don’t question their options and many people, most people go in and just automatically schedule a C-section because that’s what their provider says, that’s what’s most convenient, and they don’t take the initiative to learn and ask questions. 


    13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasounds


    Julie: it’s a failure in the system. We were just talking about this before. Meagan, go ahead. 


    Meagan: Yeah, I was just going to circle back around with the size thing. What I’m seeing more is people doubting their ability because we have people saying, “Well, your baby is this size,” but the reason why they are even saying that is because I’m seeing an increase in third-trimester ultrasounds. 


    Julie: Yes. Third-trimester ultrasounds are trouble. 


    Meagan: They are trouble. 


    Julie: Just routine to check on baby’s size and check fluids– no. Just say no to third-trimester ultrasounds unless there is a valid concern for baby. 


    Meagan: Yeah. Yeah. It is getting me. It is getting me that I’m seeing it so often. It’s just getting me irked a little bit. 


    Julie: Gosh, Meagan, I swear though. The reason you are getting irked is because we have seen these things go south so many times. Guess what happens? They go in for a third-trimester ultrasound and there are no published statistics for this. I don’t know. I haven’t looked. But I feel like people go in and they get their third-trimester ultrasound and then they are like, “Well, my baby is measuring big,” and then they start to get worried like, “I don’t know if I can have a big baby,” because their provider is like, “Oh, your provider is measuring big.” Their provider is saying it like that. It casts doubt. It casts that doubt in their mind and that little seed of doubt gets planted. That little seed of doubt gets nourished like, “We will let you try for a VBAC but your baby is kind of big so we will just have to see how it goes,” and then these parents get set up for wanting to have an earlier induction for big baby because they don’t want their baby to get too big or just scheduling a repeat Cesarean because they are terrified of a bigger baby and the problems that a big baby could have which are not actually that many. 


    The risk of shoulder dystocia I feel like doesn’t increase significantly more with big babies. We just think it does. Smaller babies get shoulder dystocia just like bigger babies do. Or, “Oh, my fluids are too big or too little,” and those ultrasound measurements are just so inaccurate first of all, but most of what they find isn’t evidence-based either. You’re walking into a situation where your provider will cast doubt on you whether intentionally or not. I don’t want to villainize providers because most providers I don’t think have ill intentions. They are just doing what they know and doing what they are comfortable with. 


    But that happens nonetheless. So if your provider is recommending a third-trimester ultrasound, here is something that I encourage people. Ask them, first of all, why. If they will be like, “Oh, just to check on baby and check the size.” I feel like you can politely decline unless you want to. It’s fun to see your baby and things like that, but what would change? This is what you can ask your provider. “What will change in my plan of care based on what we find in the ultrasound?” What will change? What direction would shift? What answers are we looking for? What will change in my care based on what we find in the ultrasound? 


    If your provider says, “Well, we just want to make sure that your baby is not too big,” that’s a red flag. Right? 


    Meagan: Yes. 


    Julie: “We want to make sure your waters are okay,” which could be a legitimate reason. If you are measuring more than 10 weeks ahead or behind, it’s probably a good idea to get your fluids checked by ultrasound but if you are only measuring 3 or 4 weeks ahead or behind, that’s not necessarily an evidence-based reason to do that. 


    I would just ask that. I mean, that’s a good question to ask for any type of intervention or checks or whatever.


    17:08 How will this change my care?


    Julie: “You want a cervical check at 36 weeks? Okay. What would change in my care? What are we looking for? What would change in my care plan if this happens and if that happens?” because most of the time, cervical checks before labor– actually cervical checks during labor too– don’t tell us anything. They don’t tell us anything. 


    I just missed a birth a month ago or about three weeks ago because a first-time mom went from 3 centimeters– she was at 3 centimeters for 12 hours and went from 3 centimeters to baby in less than an hour and a half. Cervical checks tell us nothing. 


    Anyway, before I get off on a little more of a soapbox there. Sorry, I’ve been rambling. 


    Meagan: You’re just fine. I absolutely love that you pointed that out and that you specifically said that it can really apply to anything in your care. What does this thing do or how does it change my care? 


    I just think everybody should take that nugget from this episode right now and just hold onto it tightly. Put it right in your pocket and keep that because you nailed it right there. How does this change my care? If you’re getting things like she said, yeah. That’s dumb. It’s silly. 


    Or with a cervical exam, it’s like, “Oh, we just want to see what your BISHOP score is. We just wanted to see if you’re progressing.” Why? At 36 weeks? First of all, that’s preterm. Second of all, to actually be, especially if we never made it to 10 centimeters before in our first labor, the chances of us being very dilated at 36 weeks–


    18:47 Cervical dilation


    Meagan: Okay. This is going to lead me to the next thing that we see all of the time. The chances of you being dilated at 36 weeks is pretty low actually. This is something else I see that breaks my heart actually in our community and not even just in our community, in other communities, and honestly even in consults I’ve had people talk about this. “Oh, I’m 37 weeks or 38 weeks and I’m not dilated so my doctor is telling me that it’s probably not going to happen.”


    Do you see this all the time, Julie? “Oh, guys. I’m so sad because I’m 38 weeks and my provider is telling me that I’m not dilated so I probably need to schedule a C-section the next week.” 


    Women of Strength, if you are not dilated at 36, 37, 38, 39 or even 40, even 41 weeks honestly, that’s okay. Your body will do it. Some bodies don’t do it until they are in labor. They just don’t. 


    Julie: Yeah, and honestly at 36 or 37 weeks, anytime before labor starts and you’re not dilated, guess what? Your cervix is doing exactly what it’s supposed to do which is keeping your baby safe and keeping your baby in until it’s ready to come out. I can’t reiterate that enough. You’re not supposed to be dilated before it’s time for the baby to come out. I say supposed because some bodies shift and change a little bit sooner and that’s okay. 


    But whenever I was a doula, I mean I don’t get to talk to people prenatally as much anymore since I’m just doing birth photography, but I would always say, “You know what? If you want a cervical check, that is totally fine. You get to decide. You get to make the choice about whether you get a cervical check or not.” 


    But if having a cervical check, if you go in and you have a cervical check and you know that if you’re not dilated at all that it is going to make you depressed and frustrated, then don’t do it. If you go in and you’re like, “Hey, I’m prepared to be low, hard, and closed and I just want the information because I love information,” and you are not going to be sad if you hear that you are low, hard, and closed, then sure. Get one if you want. 


    But just know that anything beyond being low, hard, and closed is just– 


    Meagan: Lucky, great, awesome. 


    Julie: Lucky, sure, great and awesome, but it’s also not an indicator because guess what? I’ve also had a client, a first-time mom, walk around at 4 centimeters dilated for 10 days and then she went into labor and had a 24-hour labor at home and ended up in a hospital transfer and a C-section. I swear. Your cervix is not telling you anything before labor and during labor most of the time, it’s not telling you anything. It’s telling you that you have progressed this far. It’s doesn’t tell you how anything is going to go in the future. It doesn’t tell you how anything is going to look moving forward. It just doesn’t. 


    Meagan: Yeah. So if you are having someone tell you, “You’re not dilated” or “Oh, it’s probably not going to happen. You should probably schedule a C-section–”


    Julie: Just say, “Julie Francom said–” 


    Meagan: If you want that, do that. But if it’s not what you want, don’t let someone bully you into believing that your body is not working when it’s actually doing exactly what it’s supposed to be doing. 


    Julie: Exactly. that’s the thing too. Sometimes at the end of pregnancy, it is hard. Being pregnant is hard. Being close to your due date is hard. Everybody is asking you, “Have you had your baby yet? What are you going to do? What are your plans for induction?” We’ve all been there and it is really, really hard to stay strong. I feel like some people could just benefit by just saying no. Just saying no because it’s so easy if your baby is measuring big or if you feel like your cervix is hard and closed. Be like, “Aw, flip man. I’m going to be pregnant forever and my baby is going to be big and it’s going to have a hard time coming out so I might as well schedule a C-section.” 


    If you feel like you could be easily swayed by those things which a lot of people are. It’s so easy to be swayed by those things, especially at the end of pregnancy. Then maybe just say no. Obviously there is nuance here so if there is a true medical need and there is some medical concern for baby or if there is some worry for your cervix being in preterm labor or things like that, obviously those are valid reasons but if it’s a just because, I’m not a big fan of doing medical things just because. 


    Meagan: Just because I agree. Yeah. Exactly. If there’s no real reason, then just because doesn’t. Unless you want it. Unless that’s really what you want. 


    25:54 Due dates


    Meagan: Okay, so we talked about babies. We talked about dilation before due dates and can we also talk about due dates? 


    Julie: Ew. 


    Meagan: Ew. 


    Julie: Yeah, just kidding. That was weird. I don’t know why I said that. I’m a weirdo sometimes. 


    Meagan: Well, due dates are hard. Due dates are a really hard topic because especially after the ARRIVE trial which Julie Francom herself wrote the blog about the ARRIVE trial if I recall. I don’t think I did. I think you did.


    Julie: I’m pretty sure I did. 


    Meagan: I think you did. I feel like since the ARRIVE trial, we really have seen a major shift in due dates. 


    Julie: You mean induction? A major shift in interventions? 


    Meagan: Well, sorry. Induction because of due dates. 


    Julie: Right. Gotcha. 


    Meagan: We see people at 38 weeks being checked, not dilated, being told that they either like I said, have to have a C-section or have to be induced in the next week because they are 39 weeks but really, do we have to? We do not. We do not have to. A lot of bodies do go over that 40-week mark. 


    I think it’s important to know when you are approaching your due date that you may start getting an influx of pressure to do those things, to sweep your membranes, to induce, to schedule a C-section, and I think that is something that I find frustrating. I mean, you guys, obviously as a doula, I work with a lot of pregnant people and Julie even being a photographer now, I’m sure you have situations where you are like, Oh, this person is being induced now, and now you’re planning and induction. We’ll get to induction in a second. 


    But the pressure that starts coming at people at 38 or 39 weeks for induction or a scheduled C-section is unreal to me when sometimes we just need to let the body be. 


    Julie: Yep. 


    Meagan: Right? 


    28:18 Vulnerability and the ARRIVE trial


    Julie: I agree so much. It’s so funny because we all know that induction is safe and we’re going to talk about that in just a minute. It’s safe for VBAC when it’s necessary. it does slightly increase the risk of uterine rupture and a couple of other things, but it’s frustrating when we have providers taking advantage of this vulnerable group of people. 


    Meagan: Very vulnerable. 


    Julie: By offering induction at 39 weeks and who doesn’t not want to be pregnant anymore at 39 weeks? I think everybody. There’s a small group of people who just like being pregnant and that’s totally fine. I like being pregnant but by my last one, I was like, Get this baby out! I was content for baby to pick their birthdate every time, but with the last one, I was like, Get this baby out! 


    Anyway, I feel like most providers don’t think they are taking advantage of these people when they are offering 39-week inductions, but it really is. It’s taking advantage of a woman in a vulnerable position and could skew their birth plans in ways that they don’t want. It’s hard to say no when you are that pregnant and unless you have a super strong resolve which even the strongest resolve can weaken in that type of emotional and hormonal state. 


    It’s really frustrating because we have this ARRIVE trial that was published in– what was it? It wasn’t 2020. 


    Meagan: 2019. 


    Julie: In 2019 and the medical world jumped on that so fast. They were like, Yes. Let’s induce at 39 weeks. 


    Meagan: It was a leech situation. 


    Julie: Yes. And then now that multiple studies have proved it invalid and it has been picked apart and even ACOG doesn’t recommend that anymore. It doesn’t stand by the validation of the ARRIVE trial, there have been multiple studies showing otherwise since then, but guess what? Oh my gosh. This is so frustrating. It normally takes 10-15 years for the medical community to catch on to updated information, but this one took on so fast and now it is going to take 10-15 years to undo that. 


    Meagan: To go back. I agree. 


    Julie: Yeah. It’s frustrating. 


    Meagan: It is. It’s so frustrating. 


    30:44 Inducing a VBAC


    Meagan: It’s hard to see so many people, like you said, in a vulnerable state feel that pressure of induction. I think where I even struggle more is seeing people in the last weeks of their pregnancy which can be hard because they are uncomfortable and Julie wanted to get that baby out. They actually can be some of the most precious times with your other kids before your family grows and your husband before you have a baby and you are a family of three or your partner. They can be really great spaces and a place where we can really get our head in the space for labor and delivery and for birth. 


    But we have so many people out there being scared that they are going to have to have a scheduled C-section. We know that even though evidence shows induction for VBAC is safe and reasonable, there are many people and many providers out there all over the world who absolutely refuse to induce a VBAC. They refuse and induction. It’s either a scheduled C-section, spontaneous labor, or that’s it. Those are your options. 


    We see so many people out there spending these last few weeks that could be so amazing and getting ourselves in that positive headspace in frantic mode because they are trying to induce themselves. They are trying to do all of the things. 


    Julie: Yeah, they are like, Oh my gosh. My provider is going to schedule a C-section at 40 weeks or induction at 39. 


    Meagan: What can I do to get this baby out? 


    Julie: Yep. 


    Meagan: It makes my heart hurt because it just really isn’t where you deserve to be in your last weeks of pregnancy. Let me tell you one thing, when you are so hyper-focused on getting your baby out, tension and cortisol is high in the body and when we are stressed, that’s typically not a space where we can let our cervix go and have a baby. 


    So when we are doing those things, we are entering a space full of tension and we are already setting ourselves up for a harder experience. 


    Julie: Mhmm, it’s true. You go in there ready to fight then your cortisol levels are high and cortisol is the opposite of oxytocin which gets baby out. Your stress hormones are fighting your baby coming out and it’s not optimal. Can it happen? Yeah, sure. People do it. But it’s going to be harder. 


    Meagan: It is. 


    Julie: It’s just going to be harder. 


    Meagan: It is. Like I said, back to the head space, it really puts us in the wrong head space. It just is not optimal. 


    Know that if you are receiving pressure to have a baby because you’re not being supported in an induction that you should just change your provider. No, really. You need to take a step back and decide if that provider is the right choice for you and if that’s the right space for you to be birthing in and if what you are doing in your mind and to your body because a lot of people do some crazy things, is really what is going to be the best for your labor journey. 


    Julie: And sometimes, people don’t have that much of a choice too. Sometimes, that’s the only choice you have. Sometimes, home birth is illegal in your state for VBAC even and– 


    Meagan: You have no providers in your area. 


    Julie: You have one hospital within 6 hours and sometimes that’s going to be your only choice and it sucks that people have to choose between that and an unassisted birth at home which I feel like if you are going to have an unassisted birth at home, that’s a whole other topic. 


    You should do it because you are educated and informed and that’s what you want not because you don’t want to have this horrible hospital birth where you are going to have to fight the whole time. 


    Meagan: Yeah. It’s a tricky spot. To Julie’s point, we understand that. There are so many people who are just flat-out restricted and they feel like they are walking in with their hands tied behind their back and just have no choice. But there are other options too. There are other options. But laboring at home a little longer or just saying no. Just saying no which is really hard. 


    Julie: Yeah, it is really hard especially when you are in labor. Especially, maybe you have this resolve and your partner doesn’t have that resolve. Maybe you can’t find a doula in your area. You can’t afford one. It really sucks to be your own biggest supporter and believer in birth. You have to have other people in the room who are just as resolved and want this for you as much as you do if you are birthing in that type of environment. 


    36:15 Julie’s social media story


    Julie: Okay, back to basics. What are we doing next? Oh, let me tell this story about induction. I think this is so funny because there are so many people who think that induction isn’t safe and they think that induction isn’t safe for a VBAC to go past 40 weeks so you have a provider who won’t induce you and won’t let you go past 40 weeks so what are you supposed to do? 


    It’s really interesting because I hired someone recently to post on my social media recently for my birth photography. She is a birth photographer and doula and has attended many births before. She just recently shifted over to social media and website management for birth photographers. She knows that I’m really passionate about VBAC so I want one post a week to be about VBAC. 


    She’ll write up posts for me to approve and one of the things that she wrote up for me about VBAC was things you can do to– I think it was things you can do to increase your chances of having a VBAC or something like that. 


    In her post, she even made the comment and I’m glad I read through these all in detail because she said something that, “We know that induction isn’t safe for VBAC because it increases the chance of uterine rupture.” She said in my post that is on my page that is supposed to be written in my words that induction isn’t safe. I deleted it. I shot her a little message to be like, Hey, VBAC induction is safe. Does it slightly increase the risk of uterine rupture? Yeah, it does, but as long as it’s managed well, the increased risks are very, very small. 


    Meagan: Still pretty low. 


    Julie: Yeah. It was just so funny that someone who has been in the birth world still for so long operating on more of an evidence-based side of things has that view still. I don’t know. It’s just interesting. We all have things that we need to learn still. 


    Meagan: We do. We are always learning and we are even still learning here at The VBAC Link. It’s just important to know that if you see information and you’re like, Oh, I already know that, you still need to check it out and see if there is something new to that. 


    38:29 Contradicting information


    Meagan: Okay, so back to the basics. We’ve talked about the pelvis. We’ve talked about induction. We’re talking about due dates. We are talking about the cervix dilating. We’ve talked about baby sizes. What else do we have? 


    Julie: Epidurals. 


    Meagan: Oh yeah. Epidurals. 


    Julie: This is so funny. The opposites. It’s the same thing about the opposite. VBAC has to be induced before 40 weeks. I will not induce VBAC at all. You have to have a C-section by 40 weeks. All of these things. Epidurals are the same way. You have to have an epidural placed in order to do a VBAC and then we also have you cannot have a VBAC with an epidural. 


    Meagan: Yeah. Yes. I’ve seen that. 


    Julie: Isn’t that so stupid? I’m sorry. I just think it’s so stupid, all of these polarizing things. It’s so funny because sorry, time out. I will let you talk about that. I promise I will let you talk about that. I think it’s so funny because we know that Facebook can do so much good and it can also do so much bad. 


    There will be a post like, “Hey, my provider said I have to have an epidural with a VBAC,” and there will be 50 comments on there and every comment will be different like, “Oh, yeah. You absolutely have to. It’s safest in case you have to have an emergency C-section.” Then the next comment will say, “No, you don’t. You can’t because then you won’t notice the signs of uterine rupture.” 


    Everyone says something different and it’s really funny because it’s the same thing about the length between pregnancies or C-sections to VBAC. People will be like, “My doctor said it has to be 18 months from birth to birth. My doctor said that you can’t get pregnant within a year of having a C-section. My doctor said–” or they say. I love it when people say, “They say 18 months birth to birth is best. They say don’t get pregnant within 9 months. They say 2 years between births is the best.” Who is they, first of all? Who is they? Whenever someone says they, I say, “Who is they?” Because there are so many sources and everybody is so resolute in their answers. “My doctor said this. They said that this is the right answer. 6 months, 9 months, 12 months, 24 months, 3 years.”


    Everyone is so firm in their answers. How freaking confusing is that? 


    Meagan: Very. 


    Julie: P.S. the optimal range for births actually hasn’t had any definitve say yet because there are different studies that show different lengths, some as short as 6 months between pregnancies. Some are as long as 24 months between births. Is it between births? Is it between pregnancies? I just laugh every time I get on Facebook and see these people who all say, “They say” in their resolve. I don’t know. I just think it is so interesting and can be so overwhelming and confusing which is why we started The VBAC Link so we can bring you the evidence so that you know. 


    Sorry, go ahead and let’s talk about epidurals. I had to go on that tangent. 


    Meagan: Well, you just brought that up and that’s another big basic. When can I get pregnant? 


    41:36 Pregnancy intervals


    Meagan: When can someone get pregnant? We’ll buzz back to epidurals. 


    Julie: Yeah, luckily we wrote a blog. We will link it in the show notes with the studies cited. 


    Meagan: A lot of people are confused. Is it birth to birth? Is it birth to conception? Right? 


    Julie: Yeah. Yeah. 


    Meagan: Do you want to talk about that? I’m going to sneeze. Hold on. 


    Julie: Yeah. It’s really interesting because you are getting these different numbers– 6 months, 9 months, 24 months, 15 months. You’re getting all of these different numbers then you are also getting these different ranges. Between birth to birth, so between the time when your C-section baby is born to when your VBAC or your attempted VBAC baby is born is different than from the time you have your C-section to the time you conceive the baby. 


    18 months birth to birth is 9 months pregnancy to pregnancy so 6 months pregnancy to pregnancy is 15 months birth to birth. Of course, everyone is confused. That’s all I have to say about that. What do you want to add, Meagan? 


    Meagan: It is confusing. It is absolutely so confusing and I think when you are talking to a provider, it’s important to talk to them about their view on intervals because there are different views. People, like she said, do have different views. People will say, “If you are pregnant before 15 months from birth to conception” or not before 15, before 24 months even sometimes or before 18 months, that’s not okay when it really might be from birth to birth. 


    We do have a blog about it. We’re going to link it so you can see the studies and how they view it, but I also want to point out that if you are being told you absolutely can’t VBAC because you have a shorter interval, say from birth to conception is whatever, 15 months. You conceived 15 months after your C-section and providers are saying, “No, it’s too close,” there are studies that show and talk about an increased risk of uterine rupture but I also want to point out that a lot of people do it with no complications. 


    Julie: A lot of people do it. What it all comes down to is what is the acceptable level of risk to you and can you find a provider who is willing to take on that risk with you? 


    In our blog, I’m just remembering off the top of my head. It might not be 100% true but one of our studies showed that a 6-month pregnancy interval so after you have your C-section, you get pregnant 6 months or beyond, there is no increased risk of uterine rupture. Within that 6 months, there is an increased risk of uterine rupture. I think it is 2.4% up from 0.5%. Now, a 2.4% risk, I think it’s that. I think it’s 2.4%. You’ll have to look at the blog. I’ll send you on a treasure hunt for the blog. But that level of risk might be acceptable for some parents and providers and it might not for other parents. 


    For me, I would go totally try it. I would do it because that means I have a 97.5% chance of not having a uterine rupture. Heck yeah. That’s pretty solid to me, but it might not be solid to you. That’s what matters. The other one showed that an 18-month pregnancy interval is optimal. 24 months birth to birth, I think, was the other one. We are having a bunch of different ranges and all three studies that were cited the blog are credible studies. 


    The real answer to that pregnancy interval question is we don’t know what is the optimal pregnancy interval. We just don’t know. They say, they will tell you– I feel like most people and most providers are about on the 18 months birth to birth side. Some providers want 12 months between pregnancies. 


    Meagan: Yeah. I see a lot of people saying that. I even see 12-24 months or 12-18 months before conception. I see a lot of conception as well. It’s just important to talk to your provider about that and when you are looking at the studies and you see a 15-month, see what it is talking about. Is it talking about C-section to VBAC or to birth or to conception? 


    Julie: Yeah. 


    46:38 Epidurals


    Meagan: Okay, epidurals. We were talking about it a minute ago where so many providers say, “Yes, you have to have an epidural. No, you can’t have an epidural.” I think I’ve shared this story before. The only uterine rupture I have ever witnessed in my life was with an epidural. I’m going to guess that she probably had a delayed feeling because I’m assuming she would have felt it sooner and this pain. 


    She felt it later on and when she felt it, it was above where the epidural site numbed so up in her rib area, up below the breast. That was where she felt it with an epidural. There weren’t any heart decels or anything like that. There were other signs of things like a stalled dilation and things like that but she still felt it with an epidural. 


    A lot of providers are telling people that they can’t have an epidural. I think that this scares a lot of people. 


    Julie: Mhmm. 


    Meagan: Birth unmedicated can scare someone who doesn’t want to birth unmedicated so the thought of going unmedicated can scare someone to the point where they are like, I’ll just schedule a C-section. 


    My point in sharing this story is that even with an epidural, you can often still feel a uterine rupture happening and there are usually other signs that are happening even before that that are pointing things out. There is a pretty, I think it’s a debate in the medical world, on if epidurals actually increase Cesarean. Have you seen the blogs and different things? 


    Julie: I absolutely do think they do. I’ve seen it. My gosh. 


    Meagan: I know. I know. A lot of the evidence out there or a lot of the opinions out there on the blogs and the National Institute of Health publications and things like that show that maybe not, but then there are things that show actually it does seem like it can. 


    Julie: I think it’s how you act when you have the epidural. If you have a nurse in there who is content on changing your positions every 30 minutes or whatever, I don’t know. Maybe not. Keep the pelvis moving. But if you are flat on your back for 20 hours, then yeah. It probably increased that risk. 


    Meagan: Yeah. There’s not a lot of evidence showing that it for sure does increase the risk of Cesareans but as doulas and people who have gone into a lot of births– obviously, there are a lot of providers who have gone to way more births than we have as doulas. I don’t know if it’s a cause, but it does seem to correlate. It can correlate and there are a lot of different things. 


    We see an epidural come into play and I actually have seen moms dilate really fast. I have seen an epidural be the best tool–


    Julie: That’s true. That’s true. 


    Meagan: –for a laborer to get a vaginal birth. I really, really, really have seen this, and not even just vaginal birth after Cesarean, just vaginal birth. 


    Julie: That’s true. There is a lot of nuance there for sure. 


    Meagan: But to what you are saying, a lot of the time it really does depend on what comes after the epidural. A lot of the time after an epidural comes in, we know that there are two things for sure that have a higher chance of happening. One, you have a higher chance of sitting and doing nothing. Just hanging out like Julie said. Not really moving, working with the pelvic dynamics, and getting baby out and down. 


    And two, we know that PItocin often comes into play after an epidural because a lot of the time, it can stall labor. We want to get labor going again and sometimes instead of just waiting and letting the body– I use the body acclimate a lot, but really, the body has to acclimate so much in labor. We are going from home to a hospital. We have to acclimate from that place to the car to the hospital and then we are getting there and we are not even just acclimating to that space. We are acclimating to new voices. 


    Julie: Mhmm, new smells, new sensations, new temperature, new germs– that’s probably not really a thing. 


    Meagan: Yeah. It’s not even just being in a different place. It’s all of the things that come with the different place. So we get an epidural and our body is like, Oh, cool. I can rest. This is my opinion, okay? I don’t have any research to show this. But my opinion is that when an epidural is placed and a body “stalls”, that is our body saying, “Thank you. I’m going to take this opportunity to rest.” Can it continue laboring at some point? Yes. Will it always? Maybe not. Maybe Pitocin does need to come into play at that point because it has decreased our bodies’ ability to register and acclimate, but sometimes I feel like with getting the epidural, we need to just acclimate to that and see what happens versus just immediately starting Pitocin and acclimate to new ways to change. 


    But yeah, did you want to say anything, Julie?


    Julie: It’s interesting because I like that and I feel like sometimes that is exactly what a body needs maybe not necessarily for the body as much as for the psyche to just be able to rest and relax and let go because a tense body and a tense mind sometimes isn’t going to be very efficient at laboring because of that. Again, we talked about this before with the cortisol levels so if you can get someone to relax easier and let the body take over what it is supposed to do intuitively or instinctually– and it doesn’t always and it’s okay if it doesn’t and it’s okay if we need other things to help us, but sometimes just that rest and relaxation and that 30-minute power nap is exactly what the body needs to continue on throughout the rest of it. 


    I think a lot of people when they are going for a VBAC think they need to go unmedicated to have their best chances. While yeah, that may or may not be true, it just is completely dependent on the person and the labor and how things go and how long it is and all of those types of things. I just think about the cascade of interventions. 


    54:13 Allowing for nuance


    Julie: I was going off on a daydream over here when you were talking about the cascade of interventions because we always demonize that a little bit or villainize it like, Oh, the cascade of interventions as soon as you get to the hospital or as soon as you get the epidural or as soon as you whatever. You know, it’s true. We’ve seen it a dozen times, but I’ve also seen the cascade of interventions help parents have the exact birth that they wanted as well. 


    So like with all things in birth, there is that nuance there. I’ve used the word nuance a lot and I feel like maybe it’s a thing for my life lately and everything that we have to allow for the nuance and we can’t be super rigid in our thinking. I think maybe at the beginning of The VBAC Link, Meagan, you and I did a lot of that villainizing of the cascade of interventions. But as we have grown and talked more to people and had more experience as doulas and in the birth space, I feel like we are allowing ourselves to be a little more fluid in that thinking and allow for that nuance to come into play. 


    Meagan: Yes. Yes. 100%. 


    Julie: But I will say this. I will say this with 200% certainty, okay? There is no nuance allowed here. People who tell you that you have to have an epidural for a VBAC are 100% full of crap. This is why. Because the reason why they say you have to have, and I say “they say”, I’m saying they like your provider or anyone who says that. The reason why is because in case of a uterine rupture, the epidural is already placed and they can get you back for a C-section faster and not have to put you under general anesthesia which is riskier. That is true. General anesthesia is riskier than an epidural. That is 100% true. It is safer overall to have an epidural for your C-section than it is to go under general anesthesia. 


    Now, here is where I call B.S. because even with an epidural placed and dosed, when you have an epidural going, it is not at the strength it needs to be in order to do a C-section without feeling any pain. 


    Meagan: It’s not enough. 


    Julie: From the moment the epidural is dosed up, now keep in mind it takes time for the anesthesiologist to come in and everything like that too, you’re looking at a minimum of 12 minutes if the anesthesiologist is there and pushing the bolus. 12 minutes for the epidural to take effect enough to have surgery. Now, listen to me. If it is a true emergency and a catastrophic uterine rupture, you do not have 12 minutes to save the baby. You will be put under general anesthesia because minutes matter. Seconds matter in those true emergent situations. 


    So, Karen, if you have an epidural placed and it’s a true emergency, then you will have to be put under general anesthesia. If it’s not a true emergency, then guess what? You have enough time for a spinal block which takes effect in about 3-5 minutes. Go into the OR. You can still have your baby out in 15 minutes or more but usually what we see called an emergency C-section, they’re like, “All right. Baby’s heart rate is not looking good. Let’s get the doctor in here. Let’s have you put your scrubs on. Oh, look Dad. Let’s get your scrubs on.” You get dressed and you are getting wheeled in the OR 45 minutes later, that’s not an emergency. 


    Having an epidural placed when you don’t want one or need one– some people need one and some people want one and that’s fine. Having an epidural placed is preparing you for surgery. It’s preparing you for surgery. That’s why I say there is no room for nuance because you just can’t magically make an epidural surgical strength in minutes. You just can’t. There’s no nuance there. It doesn’t happen. 


    Meagan: Okay. We’ll just end right there. You guys, there are so many things but hopefully, we covered a lot of the basics. Know that you always have options even if you feel like sometimes you don’t have options, there probably is another option there. It’s crazy, but there really is so keep looking at your options. Look at your blog. Look at the show notes. We’ll create and leave the links today. Check out our How to VBAC course. It’s going to cover a lot of information and help you hopefully find the right stats and evidence-based information so when you see posts on Facebook or TikTok or anything like that that are saying things like, “If your baby’s cord was wrapped around their neck the first time, you can’t have a VBAC the second time,” or if you are told that your pelvis was too small the first time and you can’t have a VBAC or going on and on, that you will be able to know the evidence-based information. 


    All right, okay. All right. 


    Julie: Yeah. 


    Meagan: See you guys later. 


    Julie: Bye! 


    Closing


    Would you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.





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    59m - Jun 26, 2024
  • Episode 311 Sami's VBAC After an Unexpected Breech Cesarean

    Upon arriving at the hospital during her first labor, Sami was told that her baby’s heart rate wasn’t stable, Pitocin was necessary, and a C-section was most likely going to be the safest mode of delivery. After laboring for a while, she was wheeled to the OR but the anesthesiologist was running behind schedule. Sami was checked and discovered she was complete! She pushed like her life depended on it and with the assistance of a vacuum and forceps, was able to vaginally deliver her baby in the OR. 


    Sami was thankful to have had a vaginal delivery, but it wasn’t the empowering experience she hoped for and she knew she wanted something different the next time around. But when her second baby flipped breech during labor, Sami unexpectedly consented to a Cesarean. 


    During her third pregnancy, Sami did everything in her power to set herself up for a VBAC. She found out her baby was breech and exhausted all options to try to flip her. A few weeks after a successful ECV, Sami had a precipitous VBAC, pushing her baby out within one hour of arriving at the hospital!


    Sami's Fitness Account

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    01:23 Review of the Week

    04:26 Sami’s first pregnancy

    06:41 A vaginal birth in the OR

    07:55 Second pregnancy and switching providers

    11:00 Flipping breech during labor

    13:10 Sami’s C-section and feeling invalidated

    16:50 Third pregnancy

    24:19 A successful ECV

    29:38 Going into labor

    32:38 Pushing her baby out within one hour of arriving at the hospital


    Meagan: Hey, hey everybody. We have another VBAC story for you today from our friend, Sami. She is actually local to me here in Utah. Hi, how are you?


    Sami: Hi, I’m good. I’m so excited to be here. 


    Meagan: So excited to share these stories. I was going over your story and it’s just crazy to think how things can twist and turn and the unexpected can happen. I love that about stories sometimes and then I don’t love that it happens but I also love the uniqueness of that. Does that make sense? 


    Sami: Yeah. Yeah. I feel like literally and figuratively, my babies twist and turns happen. 


    Meagan: Yes. 


    It’s important to know that going into birth even though we are planning one way, sometimes twists and turns can happen and then it’s up to us to figure out how to navigate through that space and it’s not always easy. It’s okay to not always have it be easy and then sometimes it is easy. That’s another thing I wanted to talk about too is pointing out that to some, a twist and a turn might be no big deal to someone and then to some, it rocks their world. 


    We are all in different spaces here and you definitely like you said both figuratively and actually have some twists and turns. 


    01:23 Review of the Week


    Meagan: We’re going to share her story in just a minute but of course, we do have a Review of the Week and I just wanted to quickly share it. This is by– okay, I’m probably going to butcher this. It is mitaywa. I’m so sorry if you are listening and you are like, You are telling this so wrong. It says, “I hope this plays over the speaker in every OB/GYN office.” I love that. That’s a cool subject. It says, “I cannot even begin to describe what encouragement these podcasts have been for me. I have completely binged on these the past few weeks and they have grown my confidence for my up-and-coming VBAC baby. I cannot stop sharing everything I’m learning and even help encourage first-time moms to educate themselves on how to avoid a Cesarean in the first place. Thank you so much for this no B.S., truth-declaring and empowering platform that I know has encouraged so many more than just myself. Keep being amazing. I can’t wait to share our story in just a few short months. All of my love.” 


    Aw, that’s such a great review. I love that so much. I hope that you got your VBAC and that all went well. I’m so excited to hear that this podcast is doing exactly what we intended it to do– empower, educate, inform, and inspire people to know their options for birth after a Cesarean and like you said, how to avoid a Cesarean in the first place. 


    04:26 Sami’s first pregnancy


    Meagan: Okay, cute Sami. I’m excited to hear these stories. Thank you for joining us today. 


    Sami: Yeah, thank you so much for having me. It’s a really cool full-circle moment to be here after binging on the podcast for months and months and months so I’m excited to be here. 


    Meagan: All right, well every birth story starts with baby number one, and your first baby actually wasn’t a C-section, right?


    Sami: Yeah, with my first baby, I got pregnant in 2017 and had him in 2018. I feel like as so many other people on the podcast, I felt like I was pretty informed going into the birth. I mean, I read two books. To me, I’m like, I am so informed. I took a HypnoBirthing class but I had a provider who had just been my OB/GYN for a long time so I decided to stay with her. Even though I didn’t have a C-section with that first delivery and pregnancy, it definitely wasn’t what I was hoping to get out of it. 


    I went to 40 weeks and thought that I would have my baby right then and there. I didn’t have a doula. I hadn’t talked to a lot of people but I was planning on going unmedicated in my delivery and then the days kept going on. I got to 40 and 5 and finally started to go into labor. I was really excited because my OB had scheduled an induction for me I think the next day actually. 


    I got to the hospital and everything changed. We got there. We were excited and fresh-faced. We were having our baby today. The minute we got there, they were picking up a lot of heart decels. They didn’t feel like the baby’s heart rate was doing well. They told me that I needed to get on Pitocin immediately and that I would be really lucky to not have a C-section so my hopes for an unmedicated delivery went out the window immediately. My OB came in and told me, “I really do think that a C-section is going to be the best course of action for us but let’s give you a couple of hours and see how things do with Pitocin, get you an epidural just in case,” and after a few hours, came in and said, “I really think we need to go to the OR right now. We need to get your baby out for his safety.” 


    06:41 A vaginal birth in the OR


    Sami: We scrubbed up, my husband and I. She took us back to the OR. I was a wreck. I was crying and just so upset because no one had prepared me for that. In my HypnoBirthing class, all of the stories that were shared were really positive. We didn’t really talk about what would happen in this type of situation. Like I said, I didn’t have a doula. 


    We got to the OR and the anesthesiologist was actually running behind. He was doing another C-section and they didn’t have another one on call I guess. She was like, “You’re dilated to a 10 so if you can get this baby out right now, I’ll let you push and try.” 


    So I pushed like my life depended on it trying to get this baby out. He was sunny-side up so she did end up using forceps and a vacuum. We got him out in that timeframe. 


    It was so cool honestly after having this experience that felt really scary and just not what I was wanting, I was riding the high of my life to have still been able to deliver him. So I didn’t get my unmedicated delivery, but I was just really happy to have him there with me. 


    Meagan: Yeah, yeah. 


    07:55 Second pregnancy and switching providers


    Sami: So fast forward to my second pregnancy, I got pregnant in 2019 and had him during the pandemic in 2020. I decided to switch providers just because I felt like after going through that experience with her, it wasn’t a bad experience, it just wasn’t what I was wanting. To get there and have her immediately pushing a C-section– 


    Meagan: That’s kind of unique. Did she ever tell you exactly? It was just the heart rate? “You’re heart rate is wonky. Let’s put you on Pitocin.” Those two things often don’t match. And then it’s like, “Oh, you’ll probably end up there anyway but we’ll let you keep going.”


    Sami: It was so bizarre. Looking back at it for me, I do feel like there were signs that she just wasn’t going to be a supportive provider of an unmedicated delivery all along. I told her I didn’t want to have an epidural and she said, “Well, good luck. You’ll probably change your mind, but I support you doing whatever you want to do.” 


    We found out after he was delivered that the cord was wrapped around his neck twice. That was what was causing the decels to happen, but that was what was hard for us to understand too. We were like, “If it’s emergent, why aren’t we being taken back right now?” Yeah. It just felt like she wanted to get the baby out. I was over 40 weeks. 


    I felt like even though I had a great experience postpartum and I was fine, I couldn’t trust her anymore. I didn’t feel like she was a safe person or someone who would honor my wishes during birth. 


    Meagan: Right. 


    Sami: I had heard of a doctor locally. A few of my friends had just raved about him. He is pretty popular in my neighborhood. I feel like a lot of different people go to him, but it’s Dr. Thackeray and INC. 


    Meagan: Oh yeah. 


    Sami: Yeah, so I switched over to him for that second pregnancy and immediately just really liked him. He was warm. He took a lot of time talking over everything, getting to know us in a way that most OBs don’t in the hospital setting and I let go of my hopes of having an unmedicated delivery. It just felt like with my first birth and postpartum, everything that could have happened did happen. I had this plan. I had the birth plan. I wanted to have that unmedicated labor and it all went out the window the minute that we got there. 


    I felt like, What’s the point in even trying to go unmedicated? There are so many unexpected things that can come up in birth. I went forward with that pregnancy. 


    It was a pretty normal pregnancy. Honestly, I felt great. I’m one of those weird people who enjoys being pregnant. I just soaked up the time with my oldest son. We were having another boy, but when the pandemic really started to get serious, we were terrified. We were being told every week that things were changing. You could have people come with you and support you. You couldn’t. My birth partner may not be able to be there with me. We were a little nervous about that. 


    11:00 Flipping breech during labor


    Sami: I got to 40 weeks exactly and went into labor again. I was so excited. It’s really funny because my husband and I took pictures outside of the hospital. We were both really excited to hopefully have a more normal experience of being able to deliver in the delivery room without all of those interventions. 


    We got checked into the hospital. They checked the baby’s position and they told me that he was head-down. Then shortly after that, my water actually broke. They called my OB to come in and just check on how things were progressing. When he came in, he checked me and he was like, “I don’t think that I’m feeling the baby’s head. I think I’m feeling the baby’s bum.”


    They did an ultrasound. 


    Meagan: So breech? 


    Sami: He was breech but he wasn’t even just complete breech. 


    Meagan: Like sideways? 


    Sami: Yeah. He was transverse. It brought up a lot of anxiety and emotions from that first delivery. I’m like, “No. I avoided a C-section. I really don’t want to go back to the OR. I don’t want to have forceps. I don’t want to have all of these things happen.” They tried to perform an ECV. They actually tried for 45 minutes to get him to flip but because– 


    Meagan: Which is also impressive just to say for a provider to do that during labor. That’s impressive. 


    Sami: Yeah, he was. He brought in one of his partners. I could tell that they were trying really, really hard but he would not budge. They told us that because my water had broken, it was just likely that there wasn’t enough fluid in there to get him to flip back. 


    Meagan: Rotate. 


    Sami: Yeah. We don’t know at this point. The nurses who checked us in told me that he was head down, but we don’t know if he flipped when my water broke or if he had been sitting breech for a long time. 


    In any case, he wasn’t flipping. My husband and I asked for some time just to think about our options, but his foot became prolapsed and they told us, “This is an emergent situation. We need to get him out right now. If the cord prolapses, it could be pretty risky.” 


    13:10 Sami’s C-section and feeling invalidated


    Sami: They rolled us back to the OR. It was kind of like Dejavu from my first delivery. I’m sobbing. I’m like, Oh, I don’t want to have a C-section. I’ve got a baby at home to think about this time around. I told him I’d be back in two days. 


    Just a lot of emotions were brought up. They took us to the OR and kept having to give me medication after medication. They lay you down obviously. So many people listening to this story are going to be able to relate to what it’s like in there, but it’s freezing cold. They laid me down and strapped me onto the bed. I was shaking. I felt like I was going to vomit. 


    They just kept giving me all of these medications. They finally started to perform the C-section and I just had tears rolling down my face. The anesthesiologist bent down and was like, “Don’t worry. My wife had to have C-sections with all of our babies and she’s fine.” It was just the weirdest situation. 


    Meagan: Yeah, probably out of the goodness of his heart of, “You’re going to be okay. My wife was okay,” but it’s not really what you say to someone in that moment either. 


    Sami: Yeah. It just felt kind of invalidating that I was having a hard moment. 


    Meagan: Yeah.


    Sami: Ultimately, they got my son out. They took him and cleaned him off and when they brought him over to me, I can barely remember what it was like but I couldn’t hold him. I was shaking. It was a really hard moment to not be able to have that immediate connection with him. 


    We got back to the recovery room and things went fine for the most part. I did have a pretty bad hemorrhage and they kept having to come in. They were going to open me back up at one point, but all in all, it was fine. My son was healthy and I was really grateful for that. 


    I think the hardest part for me was just like I said with the anesthesiologist just feeling really invalidated in how hard the situation was. I wanted to get back to see my son. I’m pretty into fitness and health like I talked about and hadn’t really wanted to have this really long recovery from all of that. People just kept saying, “Well, your baby is healthy. That’s what matters. At least your baby is healthy.” I think that’s a really hard thing sometimes for moms to hear because as the mom of the baby, I want them to be healthy more than anyone. 


    Meagan: It’s a no-duh situation. 


    Sami: Yeah, that’s my number one goal. Funny enough, I found The VBAC Link in the hospital while I was lying in my hospital bed those three days just feeding him and spending time with my baby and I started listening to the podcast then. 


    I just thought, If I ever go down this road again and have another baby, I really want to have a different experience from these first two deliveries. I want to be able to hold my baby the minute that they are born, not be so drugged up that I’m having to come out of being groggy and things. 


    To make a really long story a little bit shorter, my postpartum situation with my son– the recovery was okay but it was really hard. It brought up a lot of postpartum anxiety for me, a lot of different things with the pandemic. We weren’t able to have visitors, not be able to be outside or move around the way I wanted to immediately. The podcast really helped me get through a lot of that. 


    16:50 Third pregnancy


    Sami: Fast forward to 2023 and I got pregnant for a third time, I was just excited to hopefully do things differently this go-around. We had two boys and found out that we were expecting a girl. I’m a pretty type-A person so I devoured all of the information that I could about VBAC and realized that I really hadn’t known that much going into my first birth. I thought that HypnoBirthing class was enough and it really wasn’t. 


    I hired a doula who was local here to me in Salt Lake. She is amazing. Her name is Jamie Kowalk. A friend had referred her to me. I just got to work on a lot of different things. I did chiropractic. I worked with a pelvic floor PT. I actually worked with a therapist too to go through some of the postpartum anxiety that I had experienced after the second time around and hopefully have someone in my corner in case I had that going on again. 


    But once we found out that we were pregnant, I did consider switching providers again. I just thought, Can I go through another delivery with the provider who did my C-section? I did interview a couple of other providers. We met with a midwife pretty early on and had a weird experience. I don’t blame her. I don’t fault her or anything, but she was the first person to give me an ultrasound when I was pregnant and she had thought that we were having twins so she gave me the ultrasound and said, “You know, I’m kind of seeing two babies here. I don’t see two heartbeats. I think it’s likely that you lost a baby fairly early.” 


    When we went to get an ultrasound after that that she recommended, the tech was like, “That’s not two babies. That is a yolk sac. This is just the baby. This is the yolk sac. You’re only pregnant with one.” 


    Yeah. It was a surprising experience but what I realized from that was that I had wanted to call my old OB the whole time and just verify everything that she was saying with him. I just didn’t think that I could fully trust her because I already had a pretty strong relationship developed with him. I did choose to stay with my same provider. I had some friends who had known him and shared stories of him doing VBACs that they had heard of. I talked to him about it. 


    The one thing that was kind of hard was that he was really VBAC-supportive when I shared my plans to hopefully have a VBAC, but he wasn’t a huge cheerleader. He wasn’t like, “I’m going to get you your VBAC. We’re going to go in and do this.” It was really realistic. “We’ll try to do everything that we can and see how it goes.” 


    Meagan: Right. 


    Sami: I appreciated that ultimately. 


    I had a fairly normal beginning part of my pregnancy. I found out we were expecting a girl which was shocking to us after having two boys and then I got to the gestational diabetes screen which was something I had never worried about. Like I said, I’m pretty involved in health and fitness at a high level. I watch my diet really closely. I failed the screening pretty badly, like pretty terribly. 


    Sami: I ended up going on to pass the 3-hour test which was good but after that, I really felt pretty excited about the VBAC. I felt this hope that I could do it. I feel like meeting with my doula was really powerful because we went through not only my ideal situation and scenario of what would happen but also what things could look like if I did have to have another C-section. 


    I think that was one of my favorite parts of the process of working with her was just planning with her when there weren’t emotions at stake in it and not trying to make decisions in the heat of the moment in labor but making them far ahead of time. 


    Meagan: Yes. It’s so important. 


    Sami: Yeah, it’s a total game-changer. But then we got to about 36 weeks and I had been doing, when I say all of the things, I really had been doing everything in my power to hope for an optimal positioning with the baby. Like I said, the chiropractor, the Spinning Babies, and everything, but I asked my provider for an ultrasound that they don’t usually give at 36 weeks unless there is some type of indication that it’s necessary. 


    He had been feeling the baby externally and thought that she was head down, but I just didn’t want to go into the delivery with any unknowns or surprises. 


    We got that ultrasound and went in. The minute that the tech touched my stomach, they were like, “This is a really breech baby. This baby is completely breech.” 


    Yeah. That brought up a lot of emotion for me from my previous deliveries like, What am I going to do? We haven’t had a baby in a good position yet. I’ve already been doing all of the things to hope to get her in an optimal position. 


    When I met with the nurse right outside the room, she was like, “Well, it’s fine. You can always have a C-section. It’s not a big deal. We just did a couple today.” 


    Meagan: You’re like, “Again, not what I’m wanting though.” 


    Sami: A lot of my hopes and dreams and everything went out the window. 


    From there, I got to work on all of the things that I could do to get baby to flip. I was reading forums. I was Googling. It was honestly so exhausting. I look back on that time and for anyone else who has had a breech baby and tried to get them to turn, it is an emotional rollercoaster. 


    Meagan: Oh yeah. 


    Sami: Yeah. We did acupuncture. I did moxibustion. I did the Spinning Babies “Flip a Breech Baby.” It is so funny, but I downloaded this hypnosis track to try to get your baby to flip. I was doing hypnosis. I went to the pool and I attempted to do handstands in the pool at 37 weeks pregnant. I was not successful. How anyone can do that, I have no idea. 


    But I was lying upside down on an ironing board trying to encourage her to flip. I put ice packs on the top of my stomach. It was completely exhausting. In hindsight, I wouldn’t change the effort that I put into hoping to get her to move, but it’s hard to be in that space where you are so far along pregnant and then trying to do that and being unsuccessful. 


    Meagan: It’s consuming. It consumes you because you are like, I want this so bad. It’s sort of within our control, but a lot of it is out of our control. 


    Sami: Totally, yeah. Yeah. I actually ended up posting in the Facebook group and just asked if anyone had recommendations local to me for a provider who would consider delivering a breech baby. Someone recommended Dr. Silver at the University of Utah. We actually did meet with him when I was 38 weeks pregnant. That may be wrong. It may have been 37. 


    24:19 A successful ECV


    Sami: We went and met with him. He told me, “This baby is breech and if you want to try to deliver her, I’ll do it but I think that you should have an ECV first and exhaust all of your options.” I was a little hesitant to go into another ECV after having one that didn’t work. I didn’t have high hopes. I went and met with Dr. Thackery and he did perform an ECV. I didn’t use an epidural or any medications but she actually flipped really easily. 


    Meagan: Good. 


    Sami: It was super quick. Yeah. It was really cool. I think something that I didn’t share, but leading up to that, I was working with my therapist a lot just on my mindset. I was pretty devastated when I found out that she was breech. I had to come to terms with the fact before we even went into the ECV or met with Dr. Silver or any of these things that I’m trying to control all of these different variables. I’ve done this with all of my births and it hasn’t really gone the way that I wanted to. 


    With my first baby, I thought it was going to be fine to do unmedicated. My second baby, I was like, I don’t care what we do as long as I don’t have a C-section, then it ended in a C-section. Then to have her be breech, I was exhausted from all of those things that I was doing, but I just had to realize that, I can show up and I can try to flip this baby on my own and I can try to get an ECV and I can try to hypnotize myself all day, but if that’s not what’s best for her and if that’s not in the cards, there is a level that is outside of your control when it comes to birth. I feel like that was one of my biggest lessons. 


    When I was lying there as he was performing the ECV, I was just talking to myself and visualizing her flipping but I was talking to her and just saying, If there is a reason why you can’t flip, if this is not going to be safe for you or if this is not what’s best for you, that’s okay. I’m going to do whatever you need me to do in order for you to get here healthy. 


    It was only an ECV but that was actually a really powerful moment for me in my third pregnancy in just letting go and letting the outcome be whatever it was going to be. 


    Meagan: Yeah. 


    Sami: She did flip like I said then after that, I was doing deep squats every day. 


    Meagan: Get that baby engaged. 


    Sami: Yes. Get her engaged in my pelvis. I had a few more appointments with my provider and every time would ask him to do a scan just because I didn’t believe that she would stay head down, but she did. 


    I felt like we had overcome our last hurdle. I was utilizing HypnoBirthing tracks again. I don’t think I mentioned it, but I did want to try to go for an unmedicated this go-around just because I found that every time I would get the epidural or get Pitocin or get anything, that’s when everything would go wrong. I was trying to prepare for all of that. 


    We found out that our provider was going to be out of town a few days after my due date. He got asked to go on a last-minute family vacation and said yes. A lot of the other providers in his office are VBAC-supportive, but I didn’t really feel comfortable with anyone else being the one to deliver my baby. I had to just again let go. I’m like, Okay. We’ve almost had gestational diabetes. You’ve been breech. We did the ECV. Now if we can just deliver this baby, it will hopefully all go well. 


    Yeah, I just kept doing those things the last couple of weeks of pregnancy and on the Fourth of July, I started to go into labor. I was so excited. I started to feel those familiar contraction pains and didn’t tell anyone. We went to a barbecue with some friends. I didn’t say anything and then I decided to stay up all night on the Fourth of July because after you’ve had two babies, who would stay up when they are in labor? I’m like, what was I even thinking? But I stayed up all night watching TV and timing my contractions, getting excited. I didn’t want to wake my husband up or anything. 


    But in the morning, they kind of fizzled out. There wasn’t a lot happening. I had an appointment with my doctor later that day. I should say at that point, I was 39 weeks and 3 days, 39 and 4. 


    I went to that appointment. My husband ended up driving me and we brought our two kids with us because we didn’t have any sitters lined up at that point. He said, “I think that things are going to pick up in the next day or so. I think that you’re going to have this baby.” We were going to do a membrane sweep that day. That was something I felt comfortable doing but we ended up not doing it. We drove back home because we live about 45 minutes from the hospital that we were delivering at. 


    I decided to make dinner and give my youngest a bath. By the time I had that bath water halfway filled, I couldn’t even do it. I was just laying on the floor trying to breathe through contractions, but not able to do anything. 


    29:38 Going into labor


    Sami: I’m yelling at my husband in between, “Please come upstairs. Give Harvey a bath.” We had not packed anything. I feel like we were the worst third-time parents. We were not ready to go. I think there was so much pressure getting her ready to flip and trying to prepare for all of these other things that I think it would almost jinx it to be super ready for the delivery. 


    We were throwing things into a bag. We had my mom come over because she was going to watch our two boys while we went to the hospital. We just turned around and essentially went back. It was really funny because when we went to go get checked in, they brought us back to a room. I was like, “Are you guys going to check me? Are you going to triage me?” They were like, “No, you seem pretty serious. We’re just going to admit you and you can stay.”


    Meagan: Awesome. 


    Sami: Yeah. We were really excited about that. Again, I wanted to be really excited like I was in my second birth with taking pictures and everything. I have a friend who uses the term “cautious optimism”. I think about that a lot. I was optimistic but also cautious because of everything that had happened in those prior experiences. 


    We did get checked in and we called our doula who decided to come in and meet us, but we didn’t get a nurse for 10-15 minutes. I felt like my contractions were really picking up. I remember I opened the door and was looking around like, This hospital is dead. Where are all of the nurses? Why is no one coming to do anything?


    She finally showed up and it was pretty clear. My doula got there about that same time that our nurse was not super unmedicated supportive. She also didn’t seem super VBAC supportive. The minute that Jamie walked in, I was just like, Okay. Now I can breathe. I have someone here who can advocate for us and be an ear to bounce things off of. 


    She started to check me in and go through all of the paperwork, the insurance stuff, and I remember just being on the birth ball. We were trying a couple of different things because I felt like my contractions were pretty strong. 


    Probably 15-20 minutes after Jamie had gotten there and our nurse had come in, I just started screaming, “I can’t do this. I can’t do this. I can’t do this,” at the top of my lungs. I remember it feeling almost like an out-of-body experience. I didn’t feel like I was screaming anything. I didn’t feel like I was saying anything, but there were just words coming out of me. My nurse said, “I think that we need to check you.” 


    32:38 Pushing her baby out within one hour of arriving at the hospital


    Sami: They checked me and I was complete. 


    Meagan: Whew!


    Sami: Yeah, it was wild. We had not been there long. They started to get everything ready to go and I thought from doing HypnoBirthing and preparing and hypnosis and meditation and all of these different things that I would be able to be calm and present and that was not my experience at all. 


    For a long time, I should say afterward, I felt embarrassed. You hear these stories or you watch Christian HypnoBirthing in these different cities of these people smiling and singing and they are quiet as they are having their babies. That was not me. Now I can look back on that and I’m like, That’s okay. I was just loud. I was roaring through birth. It all was happening so fast. I felt really comfortable being on all fours. 


    I was in that position trying to start to push, but when my doctor came in, they actually did have me flip to lying on my back which is something looking back I wish that that wouldn’t have happened, but yeah. I flipped over and probably had her within 20 more minutes. 


    When we look at the timeframe, it was an hour after we got to the hospital that she was born. It was just the most amazing, incredible moment of my life. I think one of the coolest things about the whole thing was after she came out, they just handed her to me and put her on my chest and they were like, “Do you want us to wipe her off? Should we go clean her off? Do you want us to put a diaper on her?” I was like, “No. No one touch her. Just leave her right here.”


    Yeah. We got to snuggle and cuddle and had that golden hour. It was incredible. 


    Meagan: You got that experience that you were waiting for. That minute where you were like, Okay, I did this. It’s all over. I don’t have to question anything anymore. That happened. She’s here on my chest. I love that. I remember having that feeling. It was just utter joy feeling that human right on top of you. I feel like your photo is exactly that. It just says it all. It says it all exactly how you were feeling. 


    Sami: Yes. 


    Meagan: Just pure joy, amazingness and I am so happy for you. I am happy that even with the curves along the way with this baby, she was able to flip really easily, you were able to go through and show the efforts that you were able to do yourself and truly have this better experience. That is so fast. An hour after getting there and not really having too much going on from being at your visit to going home. That’s quick. 


    Sami: Oh, it was shocking. It was really shocking. I feel like for me that was part of the reason why I was so loud. It was hard to believe that it was happening so fast. 


    Meagan: Oh yeah, that transition. 


    Sami: I told my doula, “I want to do the rebozo. I want to try all of these different positions,” and we didn’t really get to do very much. 


    Meagan: You didn’t need it. You didn’t need it either. 


    35:56 Fitbliss Fitness


    Meagan: That is so awesome. I know you had mentioned in your summary that you are a personal trainer, right? I would love to talk about that too and all of the things that you did during pregnancy that you would suggest to anyone checking it out. I know physical abilities are always different in pregnancy, but can you tell us about that too? 


    Sami: Yeah, absolutely. I am a personal trainer and a coach with a team here. We actually started local to Salt Lake called Fitbliss Fitness. I’m a coach and I’m also our COO. We coach women in bodybuilding, powerlifting, strength athletes, and macro coaching but primarily I’d say the bulk of my clientele are women who want to get stronger, feel empowered, and change their body composition in a lasting way that is not just a 6-week shred or a quick fix. It’s all about creating sustainable habits and then getting strong while you do it. 


    For all three of my pregnancies, a huge part of that has been resistance training at a high level and it’s been different throughout each one. I was actually, it’s a sport called powerlifting. I don’t know if you are familiar with that, but it’s essentially bench presses, squats, and deadlifts where you compete to try to get your best number or PR, a personal record. 


    I power lifted throughout that whole entire first pregnancy. 


    Meagan: Nice. 


    Sami: There has been some research to support easier, quicker, labor and delivery when you are familiar with resistance training and that’s something that you are doing consistently. The second and third, I think I did go a little bit easier not in the sense that I wasn’t still training. I trained 4-5 days a week, some weeks 3 throughout my entire pregnancy but just listened to my body more and not feeling like I had to prove anything or be as strong as maybe I once was. 


    Yeah, so the big things that I focused on during pregnancy was resistance training specifically. Still doing movements like squats and core work that is important for a pregnant person– not things like crunches or obliques or twisting but things like pall-off press, side planks, and there are a lot of different movements that you can still safely do working on transverse abdominal breathing throughout my pregnancy. 


    Then the other thing that I focused on the other side of the coin there was just my nutrition at a high level so a lot of protein intake. Protein is huge. Fiber in my diet throughout, a lot of veggies, fruits, getting in really good sleep each night, sun exposure, and just a lot of different things to take care of your body during a time when it’s doing so many different things. It’s not only filling you but also your baby and if you are depleted, that’s not going to be ideal for either of you. 


    Meagan: Right. Absolutely. I feel like with my first, I kind of started doing the running. I was like, “I’m going to train for a half marathon,” then my provider was like, “Oh, you have round ligament pain. You can just stop. Stay walking.” That was such a bummer to me that I did that and that I stopped. Then I didn’t focus on my nutrition at all. I mean, seriously my husband worked 2:00-10:00 and I was eating Chinese food all of the time. My protein was probably not even close to 50g a day. It was really, really, really bad and I think that’s another one of the reasons why I feel so passionate about good nutrients and physical activity because yeah, I ended up training and becoming a Barre coach and stuff but really dialing in on that. 


    I really do believe what you were saying that studies have shown. I had a better postpartum. I had a better labor along the way because I was able to focus on that. One, I love that you did it and two, I love that you help people do it and break it down and understand. If someone wanted to check you out, do you do only online? Do you do just in person? What does that look like? 


    Sami: Yeah. I used to be a personal trainer in a gym here locally alongside my clients but now ever since COVID, it’s fully online. We have a website that is fitblissfitness.com and I’m on Instagram at sami.g.fit. Yeah, it’s really cool. There are a lot of stereotypes out there about what women can and can’t do when they’re pregnant and oftentimes, it’s not the advice that we need to hear. I remember someone in my first pregnancy saying, “Oh, don’t move that chair over. You’re pregnant. You wouldn’t want to hurt yourself.” 


    You can still lift and be strong. You can enjoy foods that you like still too while eating enough protein and giving your body what it needs. 


    Meagan: Getting the right nutrients, yeah. That helps you and your baby as well. Okay, I love it. We will make sure to tag you so everyone can go find you and we’ll put it in the show notes. Thank you so much for sharing your stories and I’m so stinking happy for you. 


    Sami: Thank you. 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.




    Support this podcast at — https://redcircle.com/the-vbac-link/donations

    Advertising Inquiries: https://redcircle.com/brands
    41m - Jun 24, 2024
  • Episode 310 Kristen's Healing VBAC with a Special Scar

    Every pregnancy and birth experience is different. That is true for everyone, but especially for Kristen. Kristen joins us from Provo, Utah, and shares her experiences with an initial vaginal birth, a diagnosis of omphacele with a Cesarean and infant loss with her second that left her with a special scar, an induced, medicated hospital VBAC with her third, and she is currently expecting twins!


    Kristen’s journey has not been easy, but she has learned and grown so much. She talks about how a safe and supportive birth team truly makes all the difference. Your intuition will help guide you to the best provider for you. When you know, you know!


    Meagan concludes the episode by touching on some myths and facts about doulas. 


    The VBAC Link Blog: Myths and Facts About Doulas

    The VBAC Link Blog: Special Scars

    Special Scars, Special Hope

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    01:50 Review of the Week

    04:02 Kristen’s first vaginal birth

    09:41 Coping with grief and hospital communication issues

    15:17 A low transverse incision with a J extension

    19:59 Finding VBAC support in Salt Lake

    23:10 Foley induction at 41.5 weeks

    29:29 Changing plans

    30:37 Myths about doulas

    38:55 Facts about doulas

    41:05 Kristen’s advice to other women with special scars

    43:26 Listening to your intuition when choosing a provider


    Meagan: Hello, Women of Strength. Thank you for joining us for another amazing episode here at The VBAC Link. Today’s story is from someone who is local to me which I think is always kind of fun to have someone who when they are telling the story, I know the birthing place, I know the provider, and here I even know the doula so that is super exciting. 


    Welcome, Kristen to the show. 


    Kristen: Thank you, Meagan. 


    Meagan: Thank you so much for being here and I’m excited for you to share your stories. I would like to get into a review really quickly so then we can do that. 


    Kristen: Sure. 


    01:50 Review of the Week


    Meagan: Okay, we have a reviewer from Apple Podcasts and it says louuuuuhuuuu. I think that’s how it is and it says, “Very Inspirational.” It says, “I knew I wanted a VBAC with my third pregnancy, but I wasn’t sure if it was possible. However, I knew I didn’t like being flat-out told no at my first appointment. Listening to the podcast was definitely the start of me really researching birth and looking into my options. I ended up with a successful HBAC” which is home birth after two Cesareans, actually HBA2C, “and I definitely don’t think I would have had the courage or believed it was possible without the podcast. Thank you, Meagan, for all of the work that you do to provide this information.” 


    And thank you, louuuuuhuuuu. I don’t know how to say it. I’m just butchering your name. If you are still listening, thank you so much for your review, and as always, we love your reviews. They really do help the podcast. They help Women of Strength find these incredible stories and information just like she was able to receive. You can drop that review at Apple Podcasts or Google or wherever you listen to your podcasts. 


    04:02 Kristen’s first vaginal birth, Cesarean, and infant loss experience


    Meagan: Okay, Kristen. Thank you again so much for joining us. I would love to turn the time over to you to share your stories. 


    Kristen: Well, thank you. It’s hard to know where to start. There are a lot of details to mine. 


    We had our first little boy in April of 2018. That was its own experience. That was a vaginal birth honestly. That was as hard as it was as a first-time mom and a first-time pregnancy/birth. It had its own set of interesting details to go along with that but we soon found ourselves unexpectedly pregnant with our second one just four months later after he was born. 


    Meagan: Really soon. 


    Kristen: Yeah, they would have been 11 months apart. I say would have been because my daughter who I had via Cesarean ended up passing away a few hours after she was born. She had a few congenital defects and when we got our first ultrasound, we found out she had a condition called omphalocele which means she had some of her organs on the outside of her body in a little protective sac. It was mostly her liver. I saw the ultrasound. I looked at it and I was like, That doesn’t look normal. 


    It was one of those moments where the ultrasound tech was like, “I’m going to get the doctor.” Your heart sinks and your heart drops. At the time, it wasn’t a big deal after the doctor came to us and talked to us and said, “She’ll be fine. You can deliver safely. It would most likely be a scheduled C-section.” I was expecting that from the very beginning because it wasn’t just, “Oh, this is going to be a big baby. This is going to be a big baby with a large–”


    Meagan: 100% necessary Cesarean. 


    Kristen: Exactly. 100% necessary. 


    Meagan: Yes. 


    Kristen: That was to be expected even though I was like, Darn. I don’t want that, but obviously, I wanted her to be her in the best and safest way possible because this is just such a crazy anomaly. 


    That was around 18 weeks and then around 24 weeks, we were at Maternal-Fetal Medicine at our local hospital down here where I live in Provo, Utah and they discovered something else which is a lot more serious. She had a diaphragmatic hernia which means her diaphragm didn’t really develop all of the way and allowed some of her other internal organs to be pushed up into her chest cavity. 


    Meagan: Oh wow. 


    Kristen: Whatever was left in her abdomen was pushed up. I think some of her spleen was in there and pushed. They essentially squished her lungs so they couldn’t develop all of the way which is essentially what happened at the end of her life. That’s not something– we’ve grieved and healed a lot from that but it’s also something that I consider one of those things that now I can be there for somebody else now who has gone through infant loss in whatever way that means. I can be a sounding board for anybody else who has been there. 


    Meagan: Yeah. It’s crazy how sometimes we have some of the most unfortunate or horrific experiences that we could ever imagine going through and life-jarring and after we get through them, we are still super there but we are also stronger in a weird way where you can be that support for other people and you can relate. It’s just this weird but most amazing thing that there are people like you who are like, I went through this really not great experience, but now I’m here and I want to support those who need it. 


    Kristen: Yeah, totally. It took a long time to get there. 


    Meagan: I’m sure. 


    Kristen: She was born on March 25, 2019 and so she would have turned 5 this year. We celebrate her birthday as a family every year. 


    Meagan: Good, yes. 


    Kristen: My 6-year-old is excited because we always release a balloon up for her and he said, “I’m so excited. My sister’s going to get this balloon.” It’s still very innocent and sweet. We love being able to do that as a family because she is very much still to us a part of our family. 


    Meagan: Absolutely. That just gave me the chills thinking about your little boy doing that. That’s so awesome. 


    Kristen: He’s very tender-hearted and sweet. It’s one of those things that means a lot to him. Even though he was barely one when this happened, he wouldn’t have remembered her at all. 


    Anyway, with those things going on, her outlook from the very beginning was bleak. That was a hard piece of the puzzle to deal with, but it also plays into what happens later. Although this was a scheduled Cesarean and absolutely necessary, we wanted to give her every possible chance just in case she could beat the odds or whatever. Me as mom, I’m like, There is still a 20% chance this could be okay. That’s something. It’s not nothing. 


    Meagan: Exactly, yeah. 


    Kristen: You’ve got to hold onto something and that’s what I did. 


    09:41 Coping with grief and hospital communication issues


    Kristen: The Cesarean itself was fine. The process in the hospital for me, nothing went overly wrong with me physically. But afterward, that was where it gets a little complicated. We had to leave the hospital with just my husband and myself which was obviously very hard but we also had a few different things that left me baffled and confused but really frustrated. 


    Anyway, the first thing was that after our daughter had passed and while I was recovering, the hospital staff didn’t seem to be on the same page with a lot of things. First being their communication. I remember it was the anesthesiologist who came in the day after my daughter had passed and they asked, “Oh, how are you? How is your baby?” Did you not read the notes? Is there not a sign on the door that says she’s not with us anymore? I had to clarify. Of course, he was very apologetic. “I’m so sorry.” Okay. 


    That seemed like one of those things where it’s like, okay. You should have been informed. I don’t know why. 


    After that, we had the resident doctor and the doctors in training at the time. He comes in and says, “We had to do a mid-transverse incision on your uterus and so you should plan on Cesareans from here on out. It’s not safe and don’t plan on having a vaginal birth.” It’s like, “Okay, no one told me that was happening.” 


    I felt like there was again that lack of communication and just that misstep between doctors and the other providers and stuff. I was told that in the hospital as I was recovering so that was another blow of course because I was very much expecting, Okay, I know I can have a vaginal birth after a Cesarean. That’s totally a possibility. I go in with that strand of hope again for myself thinking that I could totally do this later. I’ve heard it’s possible. I’ve just got to find somebody who can help me with it. I’m fine, then someone tells you like your reviewer today. I hate it when someone tells me no. Don’t tell me no. Don’t do it because I will literally make it my life’s work to prove you wrong. 


    That was really hard to hear, of course, in that setting and in that moment. It’s really deflating to hear that. 


    But I was like, Okay. If that’s what they think, that’s fine. I’m going to prove them wrong later. Whatever. I’ll do it.


    Then we ended up going home. I ended up calling back the doctor’s office saying, “Okay. You said mid-transverse. What does that actually mean?” I was trying to clarify things. 


    Meagan: It’s higher up. 


    Kristen: Yeah. The nurse who answered said, “Well, we had to do a mid-transverse incision. We had to make more room for your baby to get out.” I was kind of expecting that they might have to do that. They did forewarn us that it may be a possibility but no one ever said that was what happened in the hospital when we were delivering her. 


    Anyway, they never told us that happened until I called back and said, “Hey, what actually happened?” She said, the nurse I remember was like– it still makes me baffled why you would say something like this– but she goes, “We had to show a mid-transverse incision with a double-J extension,” so one on either side. 


    Meagan: On each side? Wow. 


    Kristen: Yeah. That’s what she told me. She said, “Think of it like a smiley face on your uterus.” It’s like, why would I ever think of it like that? It was just the weirdest verbiage. Why would you say that to somebody? I don’t know. I was like, Okay. That was weird. Why would you say that to me? 


    Then it gets even better. You can request your op-notes. 


    Meagan: Yes. 


    Kristen: I did that. I requested them. I feel like people are just going to be doing the facepalm like, Oh my gosh, seriously? What were these people thinking? On my op-notes, they have little bullet points. 


    The first one says, “Uterine incision”. The uterine incision they told me they had on there said “classical”. 


    Meagan: Oh. 


    Kristen: Which is wrong, totally wrong. Immediately beneath that, it says, “Detailed C-section notes”. Then it says, “Mid-transverse incision. Patient should not labor in the future.” That was the note. First it says classical. Then it says mid-transverse incision. Then they tell me I have a mid-transverse incision with a J extension or double J’s. What do I have? What did you do? 


    Meagan: Yeah. Yeah. 


    15:17 A low transverse incision with a J extension


    Meagan: That’s frustrating. 


    Kristen: Yeah, so fast forward to when I have my new provider. We’re pregnant with our third now or we were at the time. He was a wonderful, wonderful guy and a wonderful provider. He said, “Do you know what? I’m going to go off of the actual written notes from the person who says they were watching the procedure.” It’s like, oh that’s really smart. They said I have a low transverse incision with a single J extension to my right side. 


    Meagan: Wait, so different again? 


    Kristen: Different again. So I was like, Oh my goodness. Where does this end? It stopped there, thank goodness. Yeah, he said, “I’m trusting more the person who was basically looking and saying, I was here in the moment taking physical notes and this is what was done. I’m trusting this more than somebody’s bullet points.” 


    Meagan: Everybody’s bullet points, yeah. 


    Kristen: Exactly. 


    Meagan: And the nurses who are just randomly saying what they did. Okay. 


    Kristen: Yeah, exactly. Exactly. 


    Meagan: Wow. 


    Kristen: So I was like, “Thank goodness I have you to translate for me,” because I was like, What did they do to me? I have no idea. Probably any other doctor who wasn’t super VBAC-friendly would be like, “Well, this is too risky. I don’t want to take any chances.”


    Meagan: So technically you have a special scar. 


    Kristen: I do. I have a special scar. 


    Meagan: Low-transverse with a J. 


    Kristen: With a J. In those op-notes, I actually did notice just the other day when I was reading them again, it said that they extended it bi-laterally which in my mind, I didn’t call and ask obviously, but in my mind, that would translate to making the low transverse incision just a little bit longer. Again, I don’t know. But at least at the bare minimum, I have a low transverse incision with a J extension. So yes, I have a special scar. It was one of those crazy things like, Oh, now I’ve got to look this up. 


    Again, I’m gung-ho at this point about, I can do this with a special scar. I’ve listened to the podcast. So many women have done it. I can do it too. I’ve just got to find somebody who is willing to meet me in the middle. 


    Meagan: Support you. 


    Kristen: Yeah and like I said, luckily I did up in Salt Lake where it’s not too far of a drive from where we are from. It was definitely worth it. He said, “It shouldn’t be a problem from what I’m reading. We’ll just go with it and if anything changes, I’ll keep you posted.” He was just supportive from day one which was super awesome. 


    Meagan: He’s wonderful. 


    Kristen: Anyway, so yeah. That’s the complication from my fun story. Hope that all makes sense. Hope we are all able to piece that together. Sorry. 


    Meagan: Well, that’s so hard because it’s like, I’m being told this and this and this so what is it? All of these things impact my decision or maybe it doesn’t. But you want to take all things into consideration so it’s frustrating to not know what you have. 


    Kristen: Right, totally because yeah, like you said, it could totally impact somebody’s decision. 


    Meagan: It could affect somebody’s decision, yeah. 


    19:59 Finding VBAC support in Salt Lake


    Meagan: Okay, so you found out it was a low transverse extension J special scar. You found a provider up here in Salt Lake that was like, “Yep, okay. We’re going to do this.” How did that go? 


    Kristen: That was really good. Honestly, it was one of those things where you start looking online first and then go from there. I just found his name. At the time, unfortunately he doesn’t practice that anymore, but he had his own little personal video posted about that. I was like, I feel this. I’m getting really good vibes from this guy and I really like it. So I called his office. I scheduled myself in. Great. Okay. Then yeah, it was really comfortable from day one. I told him. I said, “I’ve got some weird things going but at the same time, I am really motivated. I’m really determined to do this.” 


    He was like, “Okay. I’m with you.” 


    Meagan: There was something about him that brought this overwhelming sense of calm when he was with you. 


    Kristen: Mhmm. 


    Meagan: Fun little side note, I was actually under his care as well for my VBAC. 


    Kristen: Oh cool. 


    Meagan: For a little while until I decided to go out-of-hospital. 


    Kristen: Yeah. 


    Meagan: Yeah. He’s just awesome. 


    Kristen: Yeah. I completely agree 100%. 


    Meagan: He transformed the VBAC community here in Utah. They just flocked to him because there was just something about him that wasn’t anywhere else here in Utah. 


    Kristen: Yeah. Now you’re giving me chills. I’m going to get emotional about it because I feel like it’s so true. 


    Meagan: Yeah. Yeah. He’s a special OB for sure. 


    Kristen: Yep. It does. It makes you sad that he’s not doing that anymore but at the same time, I’m sure he is one of those doctors who will refer you to somebody who he trusts and you can be like, Well, if he trusts them then I can feel safe about it.


    Meagan: Yeah. Yeah. And you hired a doula. 


    Kristen: I did. I hired a doula. 


    Meagan: Who was one of my clients. Crazy, huh? 


    Kristen: She’s one of my good friends. I was like,  You know what? I’m going to do a total 180 on this one. It was the best thing ever and the best decision ever. It happened to work out super nicely because my husband was there, yes. He is the best– she calls them daddy doulas. He’s the best daddy doula, but he had to take some breaks too and having that other person there was like, If you weren’t here, I don’t know what I would do because I feel like my husband needs a break and I have to do this by myself, but no. I wasn’t left by myself. It was one of those things that helped with the whole VBAC process go so much more smoothly especially because it ended up being an induction. 


    Meagan: Oh, okay. 


    Kristen: Yeah, so just add more to my docket here of fun things that I chose to do. 


    23:10 Foley induction at 41.5 weeks


    Kristen: We ended up going to 41.5 weeks with my daughter and at that point, I think this is probably biased but I feel like a lot of OBs, not matter how supportive they are, they are like, “Well, we could go this far if you wanted to, but it’s getting to that point.” It’s like, Okay, fine. 


    It was my choice obviously to do it. We went in for the induction. I chose to use the Foley bulb. I had never done that before. That was hands-down so much better because my son was an induction as well and about the same time. My babies just go late. They are just 41+ weeks and they are still just cozy. 


    So with him, it was not the same. They tried to push me in and out with a much faster style of induction. I was not a fan. The one, I was like, Okay. This is going to be different. Like I said, a 180. With her, it was a very slow, gentle induction and yeah. 


    She arrived and it was pretty awesome just to feel at the end of the day like, Yeah, maybe an induction wasn’t exactly how I pictured this to happen, but my thoughts and feelings that I put out there into the universe was just that, I want a VBAC and I want it to go well. And it did. She’s here. She’s 3 now. It was one of those things that gave me that really big sense of accomplishment and that “ha” moment like, “I told you I could do it.” 


    Meagan: I understand that “ah-ha” feeling so much. I definitely did that when my son came out as well. 


    25:10 Pitocin, epidural, and pushing for 10 minutes


    Meagan: You mentioned it was a lot slower of an induction and things like that. A lot of people don’t think that it’s really possible to do a low and slow induction. You started with a Foley then what happened from there? Did they start with Pitocin right after that? 


    Kristen: They did. They started with Pitocin and we had to have some conversations with the nurses too. It was another reason I was glad I brought my doula. They started going a little bit faster than I wanted. I remember being a little bit earlier on and I was like, These contractions should not be on top of each other like this already. They were again, really good about backing off and letting me do it. 


    Again, like I said, there are still things I would change but I feel like we all maybe have this ideal, I want it this way, especially for me. I’m very much like, I want this and this and this to happen. I have to be realistic. It’s not going to go exactly how I want it to. There are some things I can tweak and change along the way, but having a realistic viewpoint of how things might go is good. 


    Meagan: Yeah. 


    Kristen: Yeah. They ended up starting Pitocin and I was trying to go as natural as I could for as long as I could. I think I got to about 5 or 6 dilation and then I was like, Okay. I think I’m ready to just get a little relief. So yeah. I got an epidural. Again, then my brain switches over to how my induction births were different. 


    With my son, I was cranking that thing up to 10 as high as it would go. It was my first time doing it. I didn’t know how it works. I ended up with him being flat on my back. I couldn’t feel my legs but with her, I was like, I don’t need to do that this time. So I was a lot more, that education. It helps having prior experience. But yes, it was as low as I could bear. I could still move around. I could sit up. I think I was even on my hands and knees for a little bit with it too. 


    Meagan: Awesome. 


    Kristen: Yeah. Having my doula there, she was wonderful helping. We were doing rebozo and stuff like that. Again, it was all of the good, natural stuff that I was looking forward to. 


    Meagan: Yes. 


    Kristen: Yeah, so I got myself to a 5 or a 6 and then I had a little help, but yeah it didn’t really take much longer after that. It’s hard to remember all of the details but once I got to a good place, they ended up breaking my water which was fine. After that, it only took a couple of hours to get her down and out. 


    I pushed for 10 minutes and she’s here.

     

    Meagan: Nice. 


    Kristen: She’s our biggest one, 8 pounds, 14 ounces. Well within normal range. 


    Meagan: Yes. 


    Kristen: But still it’s just so funny how the nurses react, “Oh my gosh. She’s big.” Not really. For you, maybe. I don’t know. 


    Meagan: I swear. Anytime the babies are over 7 pounds, they are like, “This baby is huge.” I’m like, “No, the baby is not that big. It’s perfect.” 


    Kristen: Right? I know. She had a full head of hair. That was their biggest comment. “Look at all of that hair.” It was so funny. 


    Meagan: I love that.


    Kristen: But yeah, she was much more alert than my son was when he was born. Again, just different vibes, a different environment and a different style. 


    Meagan: It probably wasn’t as long so he didn’t have as much in his system too. Yeah. 


    Kristen: Exactly. Yeah, but it was one of those things where she came and then it was like, oh my gosh, that sense of relief. It went off without a hitch. In my mind, I was like, This was just perfect. 


    29:29 Changing plans


    Meagan: I love that you mentioned things along the way like change with induction. There are things within our labors and things that may not go exactly as we envisioned or wrote down on paper, but there are so often times where we can sit back and decide, Okay, yes. I’ll go for an induction. Okay, yes. Let’s try a Foley this time. Okay, I’ll actually go for that epidural. 


    We’re changing plans or making decisions and in the end if we were part of that decision, it really resonates differently for our minds. We feel better about the experience even if it wasn’t exactly how we would have put it on paper. 


    Kristen: Yeah, exactly. 


    Meagan: I love hearing that you were like, Yes. This was a good experience and I got my doula and I had my provider and honestly, you were in a really great hospital. I really, really like them. 


    30:37 Myths about doulas


    Meagan: I wanted to share a little bit about doulas because obviously, I love them. 


    Kristen: Sure, yes. 


    Meagan: I am a doula and so maybe that is biased, but I really had a long labor myself and was able to truly benefit from doula support. Like you mentioned, my husband was exhausted and he got to a point where he was starving. He needed food and I remember he actually left the birth. He full-on left the birth to go get food. He felt very confident that I was in good hands and I was being supported. 


    I love that so much, but there are a lot of things that people think about doulas that aren’t necessarily true. I wanted to go over some myths and then some really good pros and facts about doulas. 


    Number one is that doulas are expensive. Now, doulas– 


    Kristen: False. 


    Meagan: It’s so funny because after services with our clients, a lot of the time they will be like, “You are worth your weight in gold. You need to charge more.” 


    Kristen: Right. 


    Meagan: When you see a doula who ranges from $800-$2000, that is a lot of money. That is a lot of money, but then when you break it down and look at really what a doula offers–


    Kristen: Totally, from start to finish, correct me if I’m wrong, you can hire them as early as you want and then, especially for me, it was the postpartum support that was a really big deal so it’s not just, “Okay, I was here. I helped you while you had your baby. See ya. Good luck. Let me know if you need anything.” No, “I’m going to bring you supplies.” Of course, my doula is a little bit more special because she was one of my friends. 


    Meagan: But she is amazing. 


    Kristen: She is. She is wonderful. 


    Meagan: Her natural ability to care and help you feel supported, she–


    Kristen: Mhmm. She has this way of connecting with people that is quite rare, I think. 


    Meagan: Yes. I love that. And myth number two is that doulas replace the birth partner. 


    Kristen: Like we just both said, nope. They don’t. 


    Meagan: I think that they help the birth partner. A lot of people don’t realize that doulas are there for our partners as well. It’s definitely more focused on mom because mom is giving birth, but there is a lot that partners go through during childbirth that really is important to be loved because you are in a very vulnerable state. You are watching someone who you love so much go through a very big event and they are also bringing another human into this world who is yours. 


    There is a lot of fear and uncertainty and desire to help but again, uncertain as to how and needing rest and things like that. As doulas, we are never there to replace a birth partner ever unless that is something specifically where you are like, “Hey, my partner is not going to be here. I would like you to replace and be there in place of that.” 


    But no, we definitely don’t do that. 


    Myth number three, doulas are the same as midwives. Just before we started recording, I was telling Kristen how even to this day in 2024, people are like, “What do you do?” I’m like, “I’m a birth doula.” They’re like, “Oh you catch babies?” I’m like, “No. I don’t.” “Oh, you do this?” I’m like, “No, I don’t do any of that.”


    We’re not midwives. We are doulas. We are there for loving, educational support and information and all of those things, but we are definitely not trained midwives. We work with midwives and OBs. 


    Another one is that doulas are only for the mother which is kind of what I was just saying a second ago. No, we are not only there for the mother. 


    Doulas are hippies who chant and sacrifice chickens during birth. 


    Kristen: That is quite the specific myth. 


    Meagan: That is very specific. This is something that was on our blog, but it was something that someone said and we are like, Oh, yeah. Okay. This is perfect. We are putting this as Myth #5. 


    Kristen: That’s hilarious, yep. 


    Meagan: But really, we are hippy. We are hippy. 


    Kristen: That’s funny. 


    Meagan: Okay, maybe. Maybe doulas are a little bit more natural-minded. That’s true, but just because someone wants an epidural or even a scheduled C-section or doesn’t want to go in and do weird sacrificing of chickens apparently, I don’t know, that doesn’t mean it’s true. We don’t. We are there to support you and we are going to be there in the way that you want us to be there. 


    Doulas only support home or unmedicated births. This is a big myth. So many people when I start telling them about what I do, they are like, “Oh, so you just only do home births.” I’m like, “Actually, it’s a rarity. It’s more rare to do a home birth than a hospital.” I would say that 97% of our births are in-hospital. As far as medicated go, we don’t support them, that is B.S. Kristen, you are living proof that that is not true.


    You guys, it is not for us to judge anybody on the way they birth. We are there to love and support them. If that means that they choose the epidural route, that means they choose the epidural route and that is great. We support them. 


    So, no. If you are wanting to get an epidural and you don’t know if you want to hire a doula because you want an epidural, let me tell you. We as doulas do a lot actually with epidurals. Sometimes when there are epidurals at play, we actually have to work differently. It’s more in a different way because there is more to do as far as movement. You can’t just get up and move. 


    Kristen: Yes, it’s true. 


    Meagan: Right? Or being on hands and knees, you need that extra support. Whatever it may be, we are now restricted a little bit with movement so as doulas, we are going to be doing more with epidural. A lot of people think if I got an epidural, a doula is not worthless or it’s pointless. Go ahead. 


    Kristen: Sorry to interrupt, but if I hadn’t have had my doula when I got my epidural, I probably wouldn’t have known if I could actually do certain positions. I was like, Oh, well I have this epidural so I’m not really supposed to move. No, actually you can do this. And laying down, due to my prior induction was like, I know it’s bad. Don’t lay on your back. She was like, “Well, actually if you sit yourself up just a little bit, you’re actually going to be just fine. This is actually okay. It’s like, “Okay. I’m so glad you are here. If you weren’t here, then maybe the nurse would have told me I’m okay or maybe she would have helped me. Nope, probably not. She’s got her own stuff that she’s doing.” 


    Yeah, that was a really big deal for me too especially for a VBAC and an induction on top of each other. I’ve got so many things in my mind while you’re giving birth. I can get this baby out with no problems. I can do this. That’s where your focus is so having that doula say, “Hey, you know what? Change this a little bit,” and being there to support you in that way was awesome. 


    Meagan: Absolutely. Absolutely. I love that you pointed that out. 


    38:55 Facts about doulas


    Meagan: Here are some facts. Doulas help you cut costs. There is a 39% decrease in the chance of having a Cesarean which is an increased cost a lot of the time. Some insurances are amazing, but there is that. There’s a 15% increase in the chance of having a spontaneous vaginal delivery which is non-induced. We know that induction is also an added expense. A 10% decrease in the need for any medication for pain relief, a 41-minute average reduction in the length of labor, a 38% decrease in a low 5-minute APGAR score, and a 31% increase in satisfaction for the overall birth experience. 


    Holy cow. This is what a stat says on our blog. It says, “In the U.S., an epidural alone costs an average of $2,132.” Now, this was written back in 2021 and we know that since a lot of things in our lives have happened, things have increased. I would put money on that that is definitely more now for sure. 


    There are a whole bunch of other facts on here. We’re not going to go over all of them, but I would encourage you to check out our blog. It’s going to be listed in the show notes. We’re also going to list in the show notes a couple of other groups especially if you are a special scar listener, we want you to know about an amazing group. 


    Did you ever go to Special Scars, Special Hope? 


    Kristen: I did not actually. 


    Meagan: Okay, that is a Facebook group and honestly, it’s amazing for special scars. We’re going to link that. We’ll have a special scar blog so you can read more about special scars and their chances. Definitely check out the podcast even more for some more special scar episodes. If you are looking because you have a special scar, know that there are risks involved, but there are also very high chances that you can. You do need to find the support. 


    Do you have any other tips, Kristen, that you would suggest for moms who may have special scars or gone through similar experiences like you where you were not even exactly sure what happened? 


    41:05 Kristen’s advice to other women with special scars


    Kristen: For me, it’s always come down to not just doing research by yourself, but take your time with everything. I think we get into this, I have to find this supportive provider right now and if it doesn’t work out the first time, then we get flustered and stressed about never being able to find the right person. If it didn’t work out the first time, then I’ll never be able to find it. 


    I took my time and really tried to do my research honestly even before we got pregnant with our daughter who we had the successful VBAC with. 


    As soon as I was mentally and emotionally ready to start thinking about having another baby, I was telling myself, I can do this. Granted, like I said before, no one is going to tell me no. That’s just my motivation. I know some people where that might be intimidating to think about. I just don’t know. That’s okay. Accept yourself where you are and go from there. If it’s something that you want to pursue, then do your research on providers and find women who have been there. I think that was a big deal for me knowing that, Oh, there are a pretty decent number of people who have had special scars like me. It’s not impossible to make it happen. 


    Like we said about my particular provider, it’s almost like that cliche phrase, “When you know, you know.” 


    Meagan: When you know, you know. 


    Kristen: It’s like, Oh, I found my provider. That’s just how it was for me personally. I know it may not be like that for everybody, but yeah. You take your time. I’m sure you guys have had many, many episodes in the past where it’s like, I changed providers halfway through. It probably happens all of the time or more often than you think it does. Don’t be afraid to say, “You know what? I’m not feeling the support exactly how I want right now so it’s time to go a different route. Be confident in that. That’s it. 


    43:26 Listening to your intuition when choosing a provider


    Meagan: Absolutely. One of the things I want to talk about when you were saying that is even if you were with a provider that the world is saying they are supportive of VBAC– I want to take it personal and share my own experience. I was with probably the most supportive provider in Utah at the time and I felt very, very good but then there was something that was telling me I should switch. It seemed so weird. It seemed so weird, but I had to take the time to really ponder and listen to my intuition and I had to follow that. I couldn’t deny my intuition. 


    I know Julie and I for years talked about it and I’m still talking about it today. Follow your intuition. Sometimes it might not make sense to someone else and that’s okay, but if it makes sense to you and it feels true to you, then follow it. Follow it and take your time like she said. 


    Kristen: Totally, yep. That was a big deal and now that we found out that this is our fourth pregnancy now that I’m on right now. I’m pregnant right now expecting twin girls in August and who knows how this is going to go obviously, but I’m shooting for another VBAC. Here we go. 


    Meagan: You’ve got this. 


    Kristen: This is a very different scenario. 


    Meagan: Very. 


    Kristen: Every pregnancy is so different. They say that. You hear that all the time. “Every pregnancy is different. Every kid is different.” But I feel like seriously, okay. Everyone is so different. 


    Meagan: You ring it real true. 


    Kristen: So this is a totally new way to navigate this. From what I understand correctly, every birth after even if you have had a vaginal birth between like I did, I had a Cesarean and I had a VBAC, this is still considered a VBAC so this will still be considered a VBAC twin birth. Wish us luck and hopefully, I will have some updates later for you. I don’t know.


    Meagan: Yes, please keep us posted and congratulations on the pregnancy and congratulations ahead of time on your birth. Yes, please keep us posted on how things go and thank you so much again for being here with us. 


    Kristen: You’re so welcome. Thank you, Meagan. 


    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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    46m - Jun 19, 2024
  • Episode 309 How to Tell if the VBAC/HBAC Information You See is Real or Fake

    Julie Francom joins Meagan on the podcast to talk about checking the validity of the information you see surrounding VBAC. There is so much information out there and so much misinformation that we want to help you figure out what is actually evidence-based! 


    Julie and Meagan draw on their personal experiences with making corrections to information they understood and have shared. They talk about how the structure, size, and date of a study can influence the statistics. Julie shares why Cochrane reviews are her favorite.


    The VBAC Link is committed to helping you have the most evidence-based and truthful information as you make your birthing decisions. We promise to update you with all of the new information as we receive it!


    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    03:30 Checking the validity of social media posts

    08:01 Our corrected post about VBA2C

    12:56 The production behind a statistic or article

    18:37 Cochrane reviews

    19:06 Checking the dates of studies and emailing us for verification

    23:29 Nuchal cords

    25:21 Julie’s sleep training story

    29:45 Information at your fingertips


    Meagan: Hey, hey everybody. Guess what? We have Julie today on the podcast. 


    Julie: Hey. 


    Meagan: Hey. We’re going to be doing a short but sweet, maybe also a little sassy because as Julie has said, she likes to get sassy these days. 


    We’re going to do a short but sweet episode on how to tell if VBAC or HBAC or really just anything–


    Julie: Any. 


    Meagan: Yeah, any information you see online is real or fake. Now, if you’re following along on our social media, you likely have seen a lot of our myth and fact posts. I think we share them probably once a week honestly because there really are so many things out there that are myths and things that are facts, but on a whole other side and a whole addition to myth and fact is really what should we be believing? What should we be resharing? Right, Julie? I think that this definitely is something that is close to our hearts at least I’m going to say is close to my heart. I think it’s close to Julie’s heart. 


    Julie: Oh, for sure. 


    Meagan: We want to protect this community and we want this community to find the real information, and not the false information. We know. You can Google anything. 


    Julie: So much false information. 


    Meagan: You can Google anything and find the real and false information but when it comes to VBAC, like she said, so much false information. 


    We’re not even going to do a Review of the Week. We are going to jump right in in just a second after the intro. 

    03:30 Checking the validity of social media posts


    Meagan: All right, Julie. Are you ready to get spicy?


    Julie: Yeah, I think maybe the biggest reason we decided to do this episode and at least for me anyway why I brought it up is because there is so much information out there that looks good, right? You can be like, Oh my gosh, yes. This is amazing. We’re passionate. We as in me and Meagan, but we as in you too who is listening. Clearly, you’re passionate. 


    But we really need to be careful what we’re sharing both from our business accounts and what we’re resharing from other people because sometimes if you share this information and it’s incorrect and wrong and it goes viral which there is a recent post that has and sparked this thing, and we’re not going to call anybody out, but when you share misinformation and it goes big and people start believing this incorrect information, it can really do damage to the efforts that we’re trying to make here which is increasing access to VBAC for everybody. 


    If you have this entire group of people who think that their chances of having a VBAC at a hospital let’s say are 30% or something like that when really your chances of having a successful VBAC if you get to try– get to try I’m using very loosely– are really between 60-80%. Those are the numbers. 


    But there was a post recently that went viral that said it was around 32% in the hospital and that is just simply not true. The post went viral and everybody is jumping on board like, Look how much better home birth is than hospital birth, but those statistics were very flawed from a flawed study that was super small from Germany 20 years ago. 


    Meagan: Less than 2000 people. 


    Julie: Yeah. Yeah. It could give you some pretty conclusive. Some, but it’s not big. It’s not a meta-analysis. It’s definitely not something to be definitive. It’s from Germany and there are a lot of flaws in the study as well. 


    But everybody saw this thing, Oh, HBAC success is 87% and hospital VBAC success is 32%, or whatever the number was. People are like, Look how much better it is at home, and spreading this information which don’t get me wrong, having three HBACs myself, I love home birth. I love home birth after Cesarean for whoever feels it is appropriate for them, but I also know that those numbers are just wrong and if you share that information and these people believe it, they might be choosing HBAC out of fear. 


    Meagan: Well, yeah. Absolutely. 


    Julie: Instead of having the right information and making the right choice for them. I don’t know. That’s what we want to do here. We want to help you spot misinformation easier and learn to question the things that you see on the internet which sounds so silly. 


    For me, I’m like, Okay. Let’s challenge everything. But I saw that post and my first thought was, Heck yeah. That’s crazy. I’m all for home birth but then I was like, Wait a minute. These numbers don’t feel right to me. 


    Meagan: It doesn’t make sense. 


    Julie: So then I dug a little bit deeper into it. We just want to equip you with knowledge so you are doing your best to get the most accurate information and spot the information that is not necessarily true. I think we are all guilty of it. I’m just going to keep talking, Meagan::. 


    Meagan: I know. I was going to say really quickly. Just like what you said, you were like, Heck yeah, as someone who is passionate about birth or maybe someone who may have trauma. I’m talking about this specific post but really in any general post, someone who may have trauma surrounding the opposite of what that post is supporting, it’s so easy to just be like, Boom. Share. You know?


    Julie: Yeah, you’d be like, Oh my gosh, yes. I love HBAC. Let’s share this. Let’s increase VBAC. Everyone needs to hear this. This is important information. We get excited, right? 


    Meagan: Right, but we need to do exactly what Julie said and take a step back and I mean, this goes for anything. It might be sharing the correct age of a child being out of a car seat. I mean, just random and you’re like, Yeah, that looks good. Boom. Share. 


    Make sure that you are sharing the right stuff. 


    08:01 Our corrected post about VBA2C


    Meagan: So let’s talk about this. Keep going, Julie. I know you were on a tangent going into it. Let’s talk about how to understand if it’s real. 


    Julie: Well, first of all, I think before we do that, I want to admit that we have been guilty of sharing, I don’t want to say misinformation because I guess it kind of was. A few years ago, we misquoted an ACOG bulletin about VBAC. 


    Meagan: Yeah. 

    Julie: It was me. I did it. It was me. I’m the problem, Taylor Swift fans. 


    What had happened was that ACOG, in their bulletin about VBAC after two C-sections, cited two studies. One study that they cite– first of all, they say that VBAC after two Cesareans is a safe and reasonable option for parents to attempt and the decision should be patient-based. Anyways, so they cite two studies. 


    One study that they cited about VBAC after two Cesareans shows no increase in rupture rates with VBAC after two Cesareans compared to one. The second study that they cited showed risk of almost double the rupture rate for VBAC after two Cesareans compared to one. 


    It’s really interesting because they cite these two studies that are equally credible that had drastically different results. So when I made the post, I paraphrased the bulletin that said something to the effect of, “VBAC after two Cesareans shows no increase of rupture risk.” 


    Now, that was only really kind of half true because I saw the study and I was like, Oh my gosh, like Meagan:: said, This is exciting! Everyone needs to know this. 


    I made the post then we started getting some kickback on it and so we looked again because I was like, Oh, well I will show you where in the ACOG bulletin it says this, and then I went and I was just like, Oh yeah, it doesn’t say exactly that. I unknowingly spread this misinformation so what we did is we updated the post and we posted an additional post that was a correction because here at The VBAC Link, we want to make sure we are giving you 100% accurate information all of the time. 


    The reality is that we are humans. We are going to make mistakes sometimes but as soon as we realize that we make these mistakes as long as they are actual mistakes and not just people wanting to talk crap, we’re going to correct ourselves. That’s the biggest thing. 


    I want to say that it’s okay to not be perfect all of the time, but I think it’s also important that when you realize you’ve made a mistake that you correct it in the same space that you made it. Anyway, I just wanted to say that. 


    Meagan: Yes, not wanting to shame anyone for being excited and making these posts. 


    Julie: You should be excited. We’re excited. 


    Meagan: Yeah. We were really excited to even see that post earlier and then we had to take a step back. It’s not to even shame that person. They are probably really excited to share that information but again, as a poster, one, take a step back before you share, and two, take a step back before you post. 


    If you post and there is question which unfortunately there were a lot of questions on this post, change it. It’s okay. It’s okay to be like, Oh, I actually misunderstood this. 


    Julie: Update it. I didn’t see this. Yes. 


    Meagan: Or, I didn’t realize this wasn’t as credible as it felt. 


    Julie: Or seemed. Right. 


    Meagan: One of the best ways to find out of the research or the study or what you are looking at is really, really credible is if it’s peer-reviewed honestly. Right? 


    Julie: Right. I think before you even go into that is if you see data or information like this post shared and it doesn’t seem quite right or even if it does seem right and you don’t see a source cited, ask for a source. 


    Meagan: Ask for it. 


    Julie: Mhmm, especially if they are throwing out numbers like, Home birth has an 87% success rate for VBAC and hospital birth only has 32%, everybody wants to get on board with those numbers, but there were no studies posted. There was no anything so I actually went on and made a comment. I asked about it and she posted four different studies. I was like, Three of these studies aren’t even relevant at all and this one where you are getting numbers from is incredibly flawed. 


    I think it’s really cool to get on board with something that shows these fancy numbers, but it’s really important to at least see a source cited I would say. Bare minimum, see a source. Ask for a source and then go through and verify the source. Meagan, yeah. Let’s talk about what makes a source credible. 


    12:56 The production behind a statistic or article


    Meagan: Yeah. 


    Julie: These are just some things. Not all of these things are going to be true all of the time for a credible source, but these are things to look for and why they are important. Sorry, go ahead. 


    Meagan: No, yeah. I think one is looking at who even produced it. Who produced this stat or this article or whatever? A lot of the time, someone who produced the article may not be the person who produces the stat or the evidence. That’s something to also keep in mind just because if Sally Jane at whatever company shared an article, it doesn’t mean that she’s not a credible person but I think sometimes when we are digging deep into what is credible and the real original source, it will take us to the original source which then we need to look at. 


    ACOG, right? We pay attention to ACOG. Midwifery groups and things like this, we want to look. Who wrote it? 


    I think one of the things is what is the full purpose? 


    Julie: Yes. 


    Meagan: One of those articles that I was reading actually wasn’t in relation to what the post was about. 


    Julie: Exactly. 


    Meagan: I don’t know if you saw that. 


    Julie: Three of them. 


    Meagan: The purpose of this article and the goal of why they are one writing it in general and what’s their ultimate goal in giving you the information. 


    Julie: Right. 


    Meagan: I mean, when I was reading one of them, I was like, Wait, what? 


    Julie: And when she shared these four links and I called her out, I said, “These three are about this, that, and the other thing. They are not related to the other things that you posted,” she deleted all of the other information that she shared and just kept the one outdated German study up. I felt really salty then. I still feel a teeny bit salty about that. 


    But yeah, I feel like asking the author and the poster. I know that at The VBAC Link, when I was there, I tried to really make sure that we did this and I feel like you still do but whenever we post anything with stats or numbers or anything like that, we try to post a source with that every time. 


    Meagan: Yeah, for sure. Exactly. 


    Julie: It’s in the course like that. Sorry. I feel like we are going in different directions there so circle back. 


    Meagan: Yes. I think you really need to break it down and look at the ultimate study. If it is saying that you have a whatever success chance of having a VBAC in the hospital or having a VBAC in general and you’re looking at the stats, if you’re looking at a review that has 9,000 people and then there is another one that has 400,000 people involved in that study, to me, automatically I’m going to be looking at the difference there because to me, 9,000 is a lot but this one was less than 2,000 specifically. 


    Julie: Right. 


    Meagan: So when we’re looking at big studies, if you have a very small control group, it’s just not as credible as some other sources. 


    Julie: Right. 


    18:37 Cochrane reviews


    Julie: What I really love is when I can find a Cochrane review of something. Cochrane reviews in my opinion is the most credible place because what Cochrane reviews are is they are a meta-analyses of a bunch of different studies. What they do is they find a whole bunch of different studies or research papers or evidence or just huge collections of data. They go through and pick them all apart and find out which ones are credible or which ones are not credible and then they compile the results in those studies to have a bigger meta-analysis which is a collection of a whole bunch of credible studies pulled apart and data presented. 


    I love if I can find a solid Cochrane review because I know that is just about as credible as you can get. Also realize that most studies have flaws and limitations like Meagan:: was talking about. Who is behind the study? Who funded the study? Who contributed to the study? What were the study controls? How many variables were there? Because if you have a study with more than one variable, then your numbers are going to be skewed anyway because these different variables may influence each other. 


    If you have, for example, the ARRIVE trial. The ARRIVE trial we know had flaws. I’m not going to go over all of them but they were funded by a doctor at a hospital whose goal was to show that induction provides the same or better outcomes than waiting for spontaneous labor. That was the intention of the study. When you go in trying to prove something, you’re already introducing bias into the study and you could bring protocols or procedures into the study that might not be realistic in the real world that could influence the results of the study which is one of the things that actually happened in the ARRIVE trial. 


    A lot of studies I feel like could be picked apart and torn apart which is why I really love Cochrane reviews and meta-analyses is because you can compile all of these and get more accurate results and information. 


    Also, here’s the thing with that study, that one study that she showed that had less than 2,000 people and is 20 years old and is based in Germany, that’s not going to be relevant in the current day in the United States. 


    Meagan: That’s another thing that I wanted to bring up. 


    19:06 Checking the dates of studies and emailing us for verification


    Meagan: How long ago was the study? If the study was done in 1990 and we are now in 2024, there is a large chance that things have changed either way. Maybe in favor of that or the opposite. 


    Julie: Right. 


    Meagan: So we need to look also at the date. If you are looking at something and here at The VBAC Link, we know we have stuff that was even published in 2020 that there may be a new article out in 2022 or 2023 and we need to stay up to date on these things so it is so important to also look at that date because something 20 years ago or even 10 years ago, that might actually be the most recent study. 


    Julie: Yeah, and if that is, that’s all you can use. 


    Meagan: Right. Right. There’s that. But there may be a newer study. So again, before just clicking “share” or “create” or something like that, it just goes back to stepping back and looking at it. Let me tell you, Women of Strength, right now, if you find a study online and you are like, Wow. I am really, really curious about this post or about this study or whatever it may be, but you are unsure, email us at info@thevbaclink.com. Email us. We will help you. We will help you make sure to break it down and tell you the efficacy. 


    Julie: The corrected-ness. 


    Meagan: How efficient and correct it is. 


    Julie: I don’t think efficient is the correct word. Accurate. 


    Meagan: Accuracy. 


    Julie: Oh my gosh. You should listen to us. We know how to speak. 


    Meagan: Email us, you guys. I don’t even know how to use my words but I can tell you how to break down a study. No, but really. Accuracy. That’s the right word. Thank goodness for Julie. 


    Julie: I think that maybe a more appropriate thing for her to have said in that post would be like, “Your chances of having a VBAC are higher at home than in a hospital.” That is accurate, 100% because it is true. Out-of-hospital births, at least around here in Utah. I can’t speak to other parts of the country so maybe I should say that. Around here in Utah where we are, I can confidently say probably in other parts of the country too, when you have a skilled home birth midwife and you are a low-risk pregnancy and VBAC does not make you high-risk P.S., you have a much higher chance. 


    Now, there are no studies done here in Utah, but we have seen a lot. I mean, there is this Canadian home birth study that was just done that took a look at VBAC as well that showed some similar things but we know that the American Pregnancy Association says that women who attempt a VBAC have between 60-80% chance of getting a VBAC. 


    Now, around here, we in our birth centers and out-of-hospital births and home births see over 90% of that success rate in all of the midwives and stuff like that who we have seen and talked to who have shared their data with us. That is good data. 


    Meagan: It is pretty high here. We are lucky here. I have only seen out of 10 years of doing births two VBAC transfers and actually, the one was because she really just wanted an epidural. That’s the only reason why she left and the second one was because we did have quite a stall. I think it all was a mental thing. I think she actually needed to be at the hospital and then they still had VBACs so that’s great. 


    Julie: For sure. I’ve seen one transfer, but that cord was wrapped around that baby’s neck four times and they had to cut the cord before they took the baby out via Cesarean. 


    Meagan: Whoa. 


    23:29 Nuchal cords


    Julie: Nuchal cord, a cord wrapped around the neck most of the time is not a need for a Cesarean, but this mom pushed and pushed and pushed at home for hours. We transferred and got her an epidural. Baby’s heart rate started to not do good. They took her back for a C-section. The cord was wrapped around its neck four times and they couldn’t even take the baby out because it was wrapped so tightly. They had to cut the cord in four places before they could pull the baby out by C-section. 


    Meagan: Wow, wow. 


    Julie: Wild, right? That was an absolutely necessary Cesarean. That baby was not coming out. Absolutely necessary. And things like that are going to happen and it’s cases like that where we are so grateful for C-sections. This is one of those things where if it had been 300 years ago, mom and baby probably would have died because that baby was so wound up in there. This was one of those true cases. Most of the time when people say that, it’s not true in my opinion. Don’t cite me. 


    Meagan: Okay, well the true takeaway from today’s episode is to check your facts and if you see something that doesn’t feel right, check it again but don’t just share it and ask for the source if there’s not a source. Check if it’s peer-reviewed. Check if it’s a Cochrane review and all of these things. Again, check the date. Check the amount of people who were in it. Really do your research and if you do have a question, please do not hesitate to email us at info@thevbaclink.com. We’d be glad to help you decipher if that is a good and factual or not-so-factual article or stat or whatever it may be. 


    Julie: Whatever it may be. 


    25:21 Julie’s sleep training story


    Julie: Do you know what is funny? Let me throw out another example really fast and then we will wrap this thing up. Years and years and years ago, nine years ago– my first VBAC baby just turned 9. After he was born, oh my gosh. All the things. I had all of the mental health things. One of my biggest things was that I thought, this is probably going to be a little controversial. I thought that in order to be a good mom, I had a checklist because I wasn’t going to have a NICU baby. I wasn’t going to have the same situation. I thought it had to be completely different. 


    I had to breastfeed. I had to go and get him every single time he cried right away instantly and drop everything. I thought I had to do all of these X, Y, and Z things. What is that method called? It starts with a W I think. Anyway, it’s kind of a modified version of crying it out. You let them cry for a minute and then two minutes or whatever. It worked really well and he is still my best sleeper to be honest. 


    I thought, Oh my gosh. I am so bad. I can’t believe I damaged my child. Yada, yada, yada and there are probably people listening right now who are like, Well, you did damage your child by doing that. But anyway, he’s damaged for other reasons but not that one. 


    So with my second, I wasn’t going to do it because there was a study that showed that babies who were left alone to cry it out had the stress part of their brain remain activated up to an hour after they stopped crying and all of these things. I was like, Oh my gosh, I can’t believe I did that. I’m the most horrible mom ever.


    Clearly, I think differently now, but I paid a postpartum doula to come in and help me learn how to gently encourage them to sleep. Well, it turned out my stinking baby would cry in his sleep. He would cry while he was sleeping. 


    Meagan: Oh, no way. 


    Julie: I would go in there and I would be like, Oh, super mom to the rescue. I would pick him up and wake my baby up who proceeded to cry for two hours because he couldn’t go back to sleep because I was waking him up. Anyway, it was this whole thing. I know, stupid right? Every baby is different. 


    But my point is that this study which everybody was sharing about the damages of crying it out and how we are damaging our children and they are going to grow up to be people who feel unloved– that was the thing. Do you remember that? Do you remember that? It was 9 years ago or so, maybe a little bit more recently than that. 


    The study had four babies in it. Four, Meagan::. Four babies. 


    Meagan: Four? 


    Julie: Four. And these babies were in a hospital environment in those little plastic bassinets so not only were there only four babies, but they were monitoring them in an environment that is unfamiliar and not letting their caretaker come in and soothe them at any time during this study. 


    Meagan: What? 


    Julie: Yes. Don’t let your baby cry until they throw up for sure. Go and soothe your baby, but four babies in an unfamiliar environment without their caretaker there at any part of it. 


    Meagan: Wow. That was enough to say that that was– 


    Julie: Yes. This is where all of these advocates for not letting your baby cry at all got their information from. Isn’t that ludicrous? That is insane, right? 


    Meagan: That is insane. That just means that we need to take a steb back, look at what we are sharing, don’t just share it, and always look at the study. Always, always, always look at the study. 


    Julie: Absolutely. And look at the damage that did to my mental health and not only me, everybody else’s. I know I’m not the only one. 


    So seriously, dig in deep and trust your intuition and follow your instincts. You know what’s right. Going on the tangent for your baby, but also if you see something that feels a little strange or is showing numbers without information, ask for evidence. Ask for proof. Where did you get that information from? 


    29:45 Information at your fingertips


    Julie: Because we have, I will say this and then we will close it up. I promise. I hate it when people say, “Oh, don’t confuse your Google search for my medical degree.” Well, that’s B.S. because do you know how many times I’ve seen doctors Google something while I’ve been in their office? Yeah, for real. First of all, not saying that a Google search is the equivalent of a medical degree at all. I know way more goes into that. 


    But, we have access to the largest database of information that was ever existed in the entire history of humanity. We have access to Google. There’s Google. There’s Google Scholar and if you know how to distinguish between credible versus non-credible information, there is so much power in a Google search that you can use to help you in anything you need to know. Anything in the entire world. 


    Should you have a doctor? Sure. You absolutely should. But also, you know yourself and you have access to all of this information and it’s a very powerful tool that we have and we should be really grateful for it because we don’t have to rely 100% on other people with a different knowledge than us anymore. So don’t discount that. Don’t discount your ability to find out if something is credible or not because you have access to that power at your fingertips. It’s pretty freaking amazing. Okay, done.


    Meagan: It is. Okay, done. All right, Women of Strength. We are going to let you go. We said it was going to be a quick one. It really was and hopefully, you got some information and will feel more confident in going out and looking at all of the many things that it said about VBAC. 


    I honestly think that is another reason why we created our course, Julie, because we were so easily able to find so many things that were false out on the internet and we wanted to make sure that all of the real, credible sources were in one place. 


    So find those places, you guys. Check out our blog. Check out the podcast. We have lots of links. Check out our course. So many amazing things. So many great stats. 


    And hey, if you find a stat and find something within our blog and you are like, Oh my gosh, I’ve seen something new, let us know for sure. We want to make sure that the most up-to-date information is out there. So we do not hesitate to take any suggestions. If you see something, question us for sure. Please, please, please because like Julie said earlier, sometimes people misunderstand or misword or whatever and we want to give them credit but we really want to make sure that the right information is given to you. 


    Julie: Absolutely. 


    Meagan: Without further ado, I’m going to say goodbye and I love you. Bye. 


    Julie: Without further ado, we will say adieu. 


    Meagan: We will say goodbye. 


    Julie: Bye. 


    Closing


    Would you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan::’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.



    Support this podcast at — https://redcircle.com/the-vbac-link/donations

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    33m - Jun 17, 2024
  • Episode 308 Shannon's VBA3C + Doubt From Her Delivery Team

    “I did it. They said I couldn’t, but I did it.”


    When planning for her VBA3C, Shannon got just about as much kickback as someone can get. She was ambushed. She was coerced. She was given the scariest information. 


    Shannon joins us from England today and talks about how each of her four births brought her to where she is today. By the time she was pregnant with her fourth, she was ready to advocate. She was ready to fight for something she had never gotten to experience. 


    Though none of her providers were supportive, Shannon stayed grounded. She made her desires known and stood by them. 


    Shannon labored unmedicated for just over 14 hours. Then to everyone’s surprise, she pushed her fourth baby girl out vaginally in 14 minutes!


    The VBAC Link Blog: Is VBA3C Right for You?

    The VBAC Link Blog: VBAMC

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    04:04 First pregnancy and birth

    08:31 Second pregnancy and scheduled repeat Cesarean

    10:56 Third pregnancy

    14:04 A heartbreaking third Cesarean

    17:42 Postpartum during COVID

    19:55 Fourth pregnancy

    24:37 Getting ambushed

    28:40 Shannon’s VBA3C birth

    36:32 “We are all so proud.”

    38:30 VBAC after three Cesareans


    Meagan: Hello, hello. You are listening to The VBAC Link. We have our friend, Shannon. Are you from England? Where are you?


    Shannon: England, yeah. New Cambridge. 


    Meagan: Okay, see? I’m so glad my mind is remembering. You are in England and you guys, she is recording. It is quite late there. She is such a gem to stay up and record and share her VBAC after three C-sections. 


    Shannon: Three. 


    Meagan: Yes. Her fourth was a vaginal birth. Uno, dos, tres. I can’t even say. I can’t even pretend that I know Spanish. Let’s be honest. So three, you guys. After three Cesareans and we know in our community that this is definitely something that people want to hear. People want to hear these stories because it is harder to find the support. They want to hear what people are doing, how they are navigating through, where they are finding support, and what they are doing to have their vaginal birth after multiple Cesareans. 


    We are excited, Shannon, for you to share your stories today. 


    01:07 Review of the Week


    Meagan: We do have a Review of the Week so we’re going to get into that and then we’ll dive right in. Okay, so this is from morgane and it says, “I’m Not Alone.” I love that title because Women of Strength, you are not alone. This community is so incredible and we’re all here for you. It says, “This podcast has provided so much comfort for me in coping with my unplanned Cesarean and now planning for VBAC in March. The transition to motherhood has been somewhat lonely for me since most of my friends are not mothers and hello? Pandemic.” So this is a little bit ago, right? 


    It says, “I am also an aspiring doula and spurred on by these ladies and their work. So thankful I stumbled across this group.” 


    Oh my gosh. It says, “Us women really are strong.” I love that. Us women really are strong. I could not agree more. You guys, you are strong. You are capable and you have options. If that is not anything and everything that we talk about on this podcast, then I’m doing it wrong and you need to let me know on your next review. 


    As just a constant reminder, if you wouldn’t mind leaving us a review, that would be so great. You can leave it on Apple Podcasts, Google, or you can even email us. 


    04:04 First pregnancy and birth


    Meagan: Okay, Shannon. Uno, dos, tres– three. I’m saying it correctly now. After three Cesareans, you have had quite the different journey with each birth. 


    Shannon: Yeah. I think each one taught me a little bit more and I probably wasn’t ready for a vaginal birth with my first three. I think that while looking back on my journey it’s difficult, I think it led me to where I am today. 


    Meagan: Me too. I’m right there. Amen. Same. I love birth and I’ve always loved birth, but I do not think that I would be here right now with you today if it weren’t for my experiences. 


    Shannon: Yeah. I think the same. I’ll get into where I am now when we’re after my fourth, but had it not happened the way it did, I wouldn’t be where I am now. 


    Meagan: Who you are today. We grow and we learn and we inspire and here you are sharing your story. So let’s talk about baby numer one.


    Shannon: Okay, so I was 19 when I had him. I just assumed that he was going to come out that way, that he was going to come out vaginally. It was going to go well. There were going to be no complications and it didn’t turn out like that. I was due in the end of May and I think I was about a week over due. I went into the day unit here. It would be just where you would go if you had concerns that were slightly more than you would go to your midwife for but not enough that you would need to go to the labor ward for. 


    Meagan: Kind of in between? 


    Shannon: Yeah. Here, you have a midwife who is assigned to your GP surgery, your doctors, and they are usually who you see throughout. It’s supposed to be a continous midwife, but it can chop and change. You don’t see that midwife usually in the hospital so you deliver with someone completely different. 


    Meagan: Oh, okay. 


    Shannon: Yeah, so you don’t get that continuity of care in labor. So I went to the day unit because I was having some hip pain. It was really difficult to walk and because I was overdue and I was already booked in for an induction purely because I was overdue, they brought my induction forward. I think I was 8 days overdue when I went in. I was induced. I had the pessary induction and it worked pretty quickly. It worked within about an hour, an hour and a half. 


    Meagan: Oh wow. 


    Shannon: They didn’t believe me. They told me that it couldn’t happen that quickly. 


    Meagan: That’s not super normal but it can happen. 


    Shannon: They sent my husband home and left me on my own for three hours before they summoned me. I was 5 centimeters which is when they take you over to labor ward. I was wheeled over. I called my mum and my husband. 


    Then it’s kind of a bit fuzzy. I don’t remember a lot from his birth. I remember that they broke my waters and there was meconium. They put the monitoring clip on his head. 


    Meagan: The FSC, the fetal scalp electrode? 


    Shannon: Yes. They put that on him and I was managing fine on the gas and air. 


    Meagan: Was it nitrious? 


    Shannon: Yes, yeah. 


    Meagan: Okay. 


    Shannon: Yes, the gas and air. It was about 3:00 in the morning and they told me that the anesthetist was going home and if I wanted an epidural then that was my last chance. I felt pressured so I got the epidural. All stalled from there. I didn’t move off the bed. I think I got to 10 centimeters at 10:00 the next morning so I’m now 9 days overdue. 


    I pushed. Nothing happened. They wheeled me to theatre. I think I started pushing at 11:00 and he was born at half 12:00 so lunchtime. He was a big baby. He was 9 pounds, 13. 


    Meagan: Okay. 


    08:31 Second pregnancy and scheduled repeat Cesarean


    Shannon: That was that. I recovered and didn’t think anything of it. 18 months later, we decided to have our second. I fell pregnant I think within the first month. It happened quite quickly. I did my research. I wanted a VBAC. I actually got signed off for an HBAC.


    Meagan: Home birth? 


    Shannon: Yep. It was all going fine. Then I got to 32 weeks and I panicked because my mom is our only childcare and she lives about an hour. I didn’t know how quickly I would labor because I had never labored spontaneously. I didn’t know what was going to happen. So I booked a routine section. That was booked for 39 weeks. 


    At 38 weeks and 3 days, I went into again, the day unit because I had reduced movements. They put me on the monitors and his heart rate was quite erratic. It wasn’t settling. It was either quite high or quite low. There was no middle ground. I think they put me on there for about 4 hours and they just weren’t happy so they brought my section forward to the next day. 


    Meagan: When I read your note, I’m like, I don’t know why, but that got me. If baby’s heart rate is that erratic and they are that concerned, it would be that day and then. 


    Shannon: Yep, but they were happy for me to go home and come back the next day. 


    Meagan: Yeah. Yeah. It’s just convenience. It seems, I am not going to say, but it seems like it was more of like, Well, it’s already going to happen so we will make it for tomorrow. We’ll give you this as a good reason why to validate it. 


    Shannon: Yeah, no I agree now. At the time, I don’t think I thought about it like that. 


    Meagan: Of course not, no. 


    Shannon: Yeah, because with my fourth, with my VBAC, I went through a lot of what happened before. I definitely think it was a case of they didn’t want me to come back with more reduced movements and just sit there so because the section was going to happen anyway, they just thought– 


    Meagan: Mhmm, let’s do it. Let’s move it up. 


    Shannon: Yes. He was born at 38 and 4. He was 10 days early and he weighed 8 pounds, 11 ounces. Again, he was quite a good size. 


    Meagan: At 38 weeks, yeah. 


    10:56 Third pregnancy


    Shannon: So then we decided to have a third. It took us a long time to get pregnant with her. It took us 14 months which was our longest conception. Our first one was four months and then a month so it took a while. She was due the 11th of April, 2020. I got to, I think it was about 30 weeks when talk of the pandemic was rolling in. 


    We were like, Oh, it’s fine. We don’t need to worry about it. And then it all blew up. I had to go to midwife appointments alone, the hospital scans alone because I had to have growth scans because my babies are big. 


    Everything was fine. I did want a home birth again with her, but they kept me waiting. I wasn’t signed off until 37 weeks. They kept me waiting a long time to sign me off for that, but it was all signed off and we were good to go. I was feeling good despite the pandemic because we were in lockdown by the time she was due. I think the lockdown was called a month before she was born. Lockdown here for the first time was called on the 23rd of March and she was born on the 23rd of April. 


    I remember I went into hospital and I had a growth scan at 40 weeks. She was absolutely fine, no issues. She was measuring fine. The water levels were fine. The placenta looked good. They gave me a sweep and sent me on my way and said, “I don’t think I’ll see you next week. You’ll have this baby by the weekend.” It didn’t happen. 


    I got to 41 weeks and I went back for another routine growth scan. I remember going in the car on my own obviously and I felt good. I thought that they were going to say that everything was fine again and that they were quite happy for me to just carry on. It didn’t go like that. I should probably mention that my hospital’s policy is that if you haven’t had your baby by 41 and 4, so 41 weeks and 4 days, they either induce you or they give you a section. That’s their policy. 


    I had this growth scan at 41+3. I went in, had this growth scan, and I was on my own. I didn’t have any support. It was about 3:00 in the afternoon. She scanned me. In a week, my placenta had aged. It calcified and it was failing. Those were the reasons she gave me that she needed to get my baby out the next day. She gave me the pre-op swabs. She took my blood and she basically told me to come back the next day at 11:00. 


    I had no time to prepare. I had no time to research. I had no time to ask questions. It was, “This is what’s happening. You’re going to do it.” 


    Meagan: See you tomorrow. 


    Shannon: Yep, basically. 


    Meagan: Was baby’s heart rate struggling? 


    Shannon: No, she was fine. 


    Meagan: She was fine. 


    Shannon: She was fine. There was no reason at all. 


    Meagan: That’s interesting. Okay. 


    14:04 A heartbreaking third Cesarean


    Shannon: Then it was a mad dash too because I am the only driver in my house. My husband doesn’t drive. Obviously, having a section means we can’t go anywhere. 


    Meagan: Yeah, and during the pandemic on top of all of it. 


    Shannon: Yeah. It was a mad dash that night to get enough food in. House deliveries were like unicorn dust so to get enough food in, I had to arrange childcare with my mom. Otherwise, I was delivering alone. Again, she still lives an hour away in a different county. We were sure what the rules were because here, you weren’t allowed to cross county lines. 


    Meagan: Oh no way. 


    Shannon: Yep. It was difficult. She did come up and she did look after the boys. I did see her before I went into delivery, but I didn’t see her again until baby was 6 weeks old. She had gone home by the time I came home so that was difficult. 


    I went in. I think I got to the hospital at 11:00. I was pulled down to theatre at 2:00 and baby was born at 3 minutes past 3:00 in the afternoon. She weighed 9 pounds, 4 ounces, so again, she was a good size. 


    I got back to the recovery ward. My husband stayed with us for an hour and then he left. He wasn’t allowed to come back. I still had my catheter in. I was still numb. My phone was dead and I was just left because I couldn’t get anything. Every time you had to call a midwife in, they had to put in new PPE on and it just took so much longer. 


    I didn’t get wheeled around to the actual recovery ward until about 1:00 in the morning. They admitted to me that they had forgotten about me. I was just in this room on my own. 


    Meagan: I’m so sorry. 


    Shannon: Yeah. They wheeled me into recovery. I still had the catheter in. That didn’t come out until 7:00 the next morning so I was bed-bound with this new baby. They came around and took my observations. My temperature was raised which is normal after a section, but I was told that I might have COVID, that my baby might have COVID. I would need to be separated from my baby and we wouldn’t be able to leave the hospital for 3 days. 


    Meagan: Stop it. 


    Shannon: No, honestly. 


    Meagan: I am feeling very frustrated for you right now and very saddened. Yeah. I feel a little enraged because this shouldn’t have happened. These things didn’t need to happen to people. 


    Shannon: I know and the more that I talk to other people who have had babies during the pandemic, it’s not unusual either. 


    Meagan: No, it’s not. It’s maddening. 


    Shannon: It is. It’s strange now to talk about it without either filling up or actually crying because it has taken me a long time to get to this point. 


    Meagan: To process. 


    Shannon: Yeah. She said she would come back in an hour. I remember, obviously, I had my catheter in so I didn’t have to get up and go to the toilet. I was just downing water trying to get my temperature down. 


    She came back at 4:00 and I did get my temperature down because I didn’t have COVID. 


    It was a strange experience. There were six beds in this ward, but I was on the end bed and there was a woman diagonally to me and there was a woman two beds over and that was it. There was no one else there. It was eerie. It got to the point where I couldn’t do it anymore so 26 hours after my baby was born, I discharged myself and I went home. I was not staying in there any longer. 


    17:42 Postpartum during COVID


    Shannon: Even after that, I got home and I spent the first week in tears. Motherhood wasn’t new to me. She was my third baby, but giving birth during a pandemic was a completely different experience. I don’t know what it’s like over there, but here you have a midwife check in at day 3 and day 5 and then you get signed off at day 10 by the midwife then you get sent to a health visitor who then looks after you until your baby is about 5 then they go to school. 


    Meagan: Wow, I like that. We do not have that. We are just told, “We’ll see you in 6-8 weeks. See ya.” 


    Shannon: Oh. 


    Meagan: Then you just go home. Yeah. It’s very different for a lot of home-birth people, but that’s how the hospital is. It’s like, “We’ll see you in 6-8 weeks and we’ll see you then.” That’s really it. 


    Shannon: That’s interesting. I didn’t know that. 


    Meagan: Yeah. It’s not great. 


    Shannon: No. So on day 3 and day 5, I had to go to a clinic. They usually go to your house especially if you’ve had a section, but because of the pandemic, I had to go there, and being the only driver– my husband can drive. 


    Meagan: You can’t even drive after a section, really. 


    Shannon: My husband can drive but we had to stick the old plates on. We made it there but it wasn’t great. 


    Yeah, we did that. We do have a 6-week check. It’s with a doctor. That was over the phone and then you get introduced to your health visitor. Normally, they come over to your house. That was on the phone. 


    And then that was it. We were just left. No one met her until she was 6 weeks old. She was the first granddaughter because I’m the oldest and my husband is an only child. She was the first granddaughter after two boys. No one met her until she was 6 weeks old. I spent the first week in tears trying to process everything that happened. It was a difficult time. 


    After that, we said we didn’t want another one so we locked it away somewhere and didn’t deal with it. 


    19:55 Fourth pregnancy


    Shannon: And then we decided to have a fourth. I had to come to terms with it. 


    This is the reason why I’m here now. I found out I was pregnant in October 2022. It was a difficult journey to get my VBAC. It was the biggest fight that I’ve ever had to do. When you find out you’re pregnant, you contact your GP surgery and then you are assigned a midwife. 


    The midwife I had this time was the same one I had with my third pregnancy, but the first appointment, she was actually off so I saw someone completely different and she was horrible. 


    I only live 9 minutes from the hospital. 


    Meagan: That’s really close. 


    Shannon: Well, I know from listening to your podcast that women travel for hours. 


    Meagan: Way far, yeah. Like to other countries sometimes even. 


    Shannon: Yep, but 9 minutes was too far for them. She said that 9 minutes was too far. The paramedics might not get to me in time. If I bleed out, I’m going to die. If baby gets stuck, I’m going to die. I’m putting my birth experience over a live baby.


    Obviously, they know I care about the safety of my baby but that’s obviously their job. I left that appointment in tears. It was a great start. It didn’t improve from there, really. 


    I think spent the next, I think your booking-in appointment is about 8-10 weeks so I then spent the next 30 weeks listening to your podcast, and researching stats, risks, benefits, and percentages. I lived, breathed, and slept statistics for VBACs because she probably 99% is our last baby. We’ve now got two of each so we don’t need any more. 


    I knew that this was my last chance to get the birth that I wanted. Off the back of my booking-in appointment, they referred me to the consulting midwife at the hospital. She is higher up than a community midwife or just a midwife on the ward but not quite the head of midwifery. She’s kind of somewhere in the middle. I had a few appointments with her and while it was beneficial, it still felt like I was banging my head against a brick wall because she wasn’t listening to what I wanted. 


    Every time I would come back with a statistic or a risk that she had– like if I corrected her, then I’d just get a “Mhmm, yeah. Okay,” or a patronizing nod. 


    Meagan: Like, Yeah, sure. You think you know what you’re talking about but you don’t. 


    Shannon: Yeah, kind of. At this point, I was 28, a mother of three and I was about to have my fourth. They were treating me like a child or that’s what it felt like anyway. 


    So I went to every appointment knowing that’s what I wanted. I read off my stats, my risks, my percentages and told them I wanted a home birth. They again weren’t for it. They tried everything they could to get me into the hospital. 


    We have a midwife-led unit and we have the labor ward. The labor ward is more for ordinary births like if you are going for the epidural and you want the more hospitalized birth whereas the midwife-led unit is more of a hands-off. That’s usually where the birth pool is. 


    Meagan: If you want more of a medicated versus unmedicated, those are the differences here. 


    Shannon: As a VBAC after three sections, normally there would be no way on earth that they would have signed me off for the midwife-led unit. I was too high risk. However, to get me into the hospital, they signed me off for the midwife-led unit. 


    Meagan: Nuh-uh. 


    Shannon: Yeah. That’s the option they gave me because I was close enough if there was an emergency, but I wasn’t too far away. That was their trump card. 


    Meagan: Okay, okay. 


    24:37 Getting ambushed


    Shannon: I still said no. I still wanted a home birth because that hospital was the one I had my daughter at during the pandemic and I did not trust any of them after being lied to by the consultant and coerced into having that third section. I just didn’t trust them to do what I wanted. 


    Meagan: Yeah. It makes sense. 


    Shannon: Pardon? 


    Meagan: I said it makes sense that you didn’t feel that they were completely trustworthy. 


    Shannon: So then I got to 36 weeks and I had a routine midwife appointment at 36 weeks. I walked into the room and my midwife was there but so was the head of community midwifery. I wasn’t told she was going to be there. I was ambushed. 


    She basically said to me that– I have it written down because I made a post at the time. She said that basically, my baby would die if I carried on with my plans to home birth, that there was a risk of shoulder dystocia, and hemorrhage that would both result in death. A delay in the paramedics getting to me so that would be death. I didn’t want a cannula inserted as a routine at the hospital so that would be a risk factor. I have a high BMI so again, that goes against me and they said I had low iron because I was refusing blood tests so that again was something that went against me. 


    I was told that if I hemorrhaged and lost around two pints of blood that I would die, that my veins would have shrunk so they wouldn’t be able to get a cannula in me. I was told that they wanted to send three midwives to my birth. They normally send two but for some reason, they wanted three. 


    I was told that my previous experience should be put to one side because it happened during COVID and it’s not representative of how it is now. I was told that I was making the entire midwifery twitchy. 


    Meagan: Oh my. 


    Shannon: Oh, the midwife I saw at the first appointment, the one who made me cry, she was one of the ones who was on call and they told me if she was on call, would I go to hospital and I said, “Maybe.” In my mind, I’m thinking that they were trying to put her on rotation to get me into hospital. 


    Meagan: Sneaky. 


    Shannon: Yep. I was told that the head of community midwifery’s responsibility is to make sure I’m comfortable with the risks but it’s also her responsibility to make sure her midwifery team isn’t traumatized by my birth. I was also told– oh, they wanted my husband to be at the home birth assessment as it’s their responsibility to make sure he is aware of the risks of death so he is not traumatized like I hadn’t spoken to him about any of this. 


    Meagan: Oh my gosh. Oh my gosh. 


    Shannon: On my way out of that appointment, my midwife, the one who had supported me as best as she could said to me that she can’t wait until I give birth so that it’s all over. 


    Thank you. 


    Meagan: Oh my gosh. 


    Shannon: Yeah. So that was that. 


    Meagan: Wow. What a way to feel loved. 


    Shannon: I know. Again, I had to go to these appointments alone because my husband was home with the three kids, and my mom, again, lives an hour away. I don’t have the support here so I had to go to these appointments on my own and to be faced with two midwives who are just coming at you with these scary statistics, it felt like I was ambushed.


    I think I sent an email then and complained. I got this really lengthy email back but it was basically filler but it had happened already. 


    28:40 Shannon’s VBA3C birth


    Shannon: Yes. So, my birth. She was due on the 1st of July but I always thought she would be due somewhere between the 25th of June and the 28th of June. I remember the 27th of June, I needed to go and get new brake pads and discs put on my car. It was the last thing I needed to do. I sat in the mechanic’s feeling a little bit uncomfortable and a lot of pressure. I think I was about 39+3 at that point. 


    I was just really uncomfortable. I sat there for about two hours and I was just like, Ugh, why is this taking so long? 


    Meagan: You were ready to move on. 


    Shannon: Yeah. The next day, my husband went into the office and I remember messaging him, I think you should have stayed at home today. Something just doesn’t feel right. I feel a bit off.


    I woke up on the morning of the 29th of June and I had hip and leg pain which isn’t unusual for me. I’ve got hyper-mobility syndrome so my joints are extra bendy anyway so to wake up with pain is quite normal, especially in pregnancy. 


    It was half-7:00 in the morning and my husband thought it would be a really good idea to cut his hair for him. It’s half-7:00 in the morning. I’m nearly 40 weeks pregnant and I was doing his hair. Then I felt a twinge. I was like, I don’t recognize that pain. I’ll keep an eye on it. 


    They turned into contractions. I had my first contraction at half-7:00 in the morning and they got stronger. I said to my husband, “I think you need to sign off now. This is it. It’s happening. I’m going for a bath to see if they go away or if they stay.” 


    We had a food delivery come in that day. We had an Amazon delivery come in and we had I think the carseat base was coming in as well that day. So in between my contractions, I was having to go to the door a deal with all of this stuff that was going on around me. 


    The contractions stayed and they didn’t peter off. They just stayed. At this point, I was on all fours in the living room mooing like a cow which is bizarre because, with my first one who was my only experience of labor, my mum said that I was eerily quiet. It was different to make noise this time. 


    My husband rang my mom and let her know what was happening and then he rang the hospital. They told me that the home birth service wasn’t available that day so I’d have to come into hospital. It was only after he told them my name that that happened. 


    We’ll leave that just hanging there. 


    Meagan: Yeah. 


    Shannon: Then I burst into tears because I thought that as soon as I go into hospital, that’s it. I’m not going to get my vaginal birth. They’re going to find some reason to section me and that’s it. 


    My mom came and drove us to the hospital. She was staying with the kids anyway. I think I got to the hospital at about 3:00 in the afternoon. They examined me and I was 4 centimeters so I was allowed to stay. 


    They took me into the room and I stayed there until I had my baby. I just labored. I don’t remember a lot of it to be honest. When they say you go to another place, you go to another place. 


    Meagan: You do. 


    Shannon: The gas and air were amazing. I did try the birth pool but we had an issue here where they had to have air vents fitted in the rooms with the gas and air and they weren’t done in the birth pool. I was in the birth pool for about an hour, but I wasn’t allowed the gas and air. 


    The pool was all right, but the gas and air were helping me more. 


    I went back into the room with the bed and even though I said to my husband, “I don’t want to be on my back,” I was on my back for most of the time. That’s where I was comfortable. 


    When I was in the pool, I said no to the continuous monitoring. I just wanted intermittent with the monitor. We didn’t know what she was. At this point, we had no idea what she was but they couldn’t find her with the Doppler. They asked me to get out of the pool and put me on the bed and they were going to scan to see where she was. 


    I couldn’t roll onto my back at this point. I was on my side and I couldn’t roll on my back to get them to scan me to see where she was. Then I opened my eyes and the consultant that had lied and coerced me into my third section was in the room and I specifically said I don’t want to see her. 


    She was standing at the end of the bed and she said to me, “How long are you going to push for?” I said, “As long as I need to. As long as me and my baby are safe,” and she left. That was the end of it. I didn’t see her again. 


    Meagan: Oh my gosh. 


    Shannon: Yeah. That was that. They managed to scan me and they found her. She was just really low. That’s the only reason they couldn’t find her. She was fine. She was happy. 


    It went on again for about another couple of hours of moving from all fours on the bed to my back and I remember sitting up on my knees upright and I felt something go. I was like, “Okay, I think my waters have gone.” They had a look and they had gone on their own. I didn’t have to have them pop like last time. There was no meconium. It was all good.


    I remember spacing out for a while going to that other place. I came to and it was burning. That ring of fire is real. It was real. I said, “Okay, it really stings. Something has changed.” The midwife lifted up the sheet and she said, “Oh, there is the head. Quick!” They had to scramble to get everything they needed. 


    My husband was texting my mum so I got all the time stamps. They saw her head at 3 minutes past 10:00 at night and she was born at 14 minutes past 10:00. She slid out and we found out she was a girl which my husband told me which was what I wanted. 


    I remember saying, “I did it. They said I couldn’t, but I did it.” They wanted to get her a yellow hat because we didn’t know what she was but because she came out so quickly, they only had a blue one so she’s got a little blue hat and yeah, she was here. It was amazing. 


    I did have two second-degree tears. They did only repair one and I wish they had repaired both because going for a wee afterward with the open one was hell. 


    Meagan: Yes, not fun. 


    Shannon: But I would take that over a section recovery any day. I was going to the park with the kids 3 days post-birth. I was walking around the house. I was able to go up the stairs. It was amazing. 


    Yeah, I did it. They told me I couldn’t and that I would die or she would die. 


    Meagan: They really put up a fight and tried so hard. Let me tell you too, I don’t know the right word but to stand up to that type of pressure, oh my goodness. That is hard. That is very, very hard. The fact that you did and it’s not like it didn’t affect you. Of course, it affected you but you were able to go and you were like, “Listen, I know the research. It’s in my favor. I’m okay. I believe that it’s the best choice because I really have researched it and truly believe that it’s the best choice for me and my baby.” 


    They just tried so hard to not let that happen. 


    36:32 “We are all so proud.”


    Shannon: They did. I think it was the next morning and I was just sitting in my room with my baby quite happy. The head of midwifery came into the room and I had met her once before. She said to me, “Well done, you did it. All of our phones were going off last night because it was flagged that you had gone into labor and we were all waiting to see what had happened. But you did it vaginally and we are all so proud. Well done.” 


    I was like, “Well, you didn’t tell me that at the time, did you?” 


    Meagan: You’re like, “I wish you had cheered for me in my pregnancy and not made me feel like I was crazy or scheming my husband,” or all of that. Oh my goodness. 


    Shannon: Yeah. 


    Meagan: You have gone through a lot on top of your birth and trauma there and recovering from all of that. You have grown so much and achieved so much. You should be really proud of yourself. 


    Shannon: Thank you. I am. I think that like I said at the beginning, if it hadn’t happened the way that it happened, I’m going to train to be a doula in May and June. 


    Meagan: Yay!


    Shannon: Because I don’t want other women to go through what I went through. Like I said, if it hadn’t happened the way it happened then I wouldn’t be here today. I’m grateful for the experience, but I wish that I had more support at the time. 


    Meagan: Right, totally. I mean, that’s definitely something that led me to the doula and obviously here where I’m at too. I think through these birth experiences, it’s hard to deny that fire inside of you when you feel it. Right? You’re like, I want to help people not have the experience that I had and have a better experience to the best of my ability. 


    I’m sure that you will do it and you’re going to take this passion and you’re just going to flourish and touch so many lives. I’m so excited for you. 


    Shannon: Thank you. 


    38:30 VBAC after three Cesareans


    Meagan: Okay, so let’s talk about VBAC after three C-sections. I think this is sometimes a hard one because we do have providers throwing out things and blank statements like, “If you hemorrhage, if this, if this, and if this, you and your baby will die.” When we hear those things, it is very scary and very overwhelming. 


    When it comes to VBAC more than two after multiple Cesareans and more than two, the stats are harder to find. Did you find that it was really harder to find? There are not a lot of huge Cochrane studies at least that I know about where they have studied VBAC after three Cesareans specifically. 


    Shannon: Yep. 


    Meagan: We are often told by providers that the chances of uterine rupture are astronomically higher than our typical VBAC or VBAC after two Cesareans. For people in your area in England, what did you find local study-wise for your stats? I’m curious to see the difference. 


    Shannon: I didn’t. There wasn’t anything, no. I remember I had to relay as much information as I could on VBAC after multiple Cesareans because I remember them saying to me that after two Cesareans, the risk of uterine rupture doubles and when they say that to you, you’re like, Oh my god, that sounds really scary. What they don’t tell you is that it only doubles from 1% to 2%. There’s not much here that is different because there really isn’t a lot. There was not support especially not from my hospital or anywhere like that for me. I just had to do it on my own. The internet is your best friend. 


    Meagan: Yeah, I know. This darn internet can be your best friend and your enemy at the same time. That’s why we are here and why we have our blog and all of the things because we want people to be able to find that best friend side of the internet and really dive in. 


    We do have a blog on vaginal birth after three Cesareans. It is titled, Is VBAC After Three C-sections the Right Choice For Me? We will have it here in the show notes so definitely check it out. In it, we talk about how uterine rupture makes the idea of VBAC very scary. The word itself, “rupture” makes it very, very scary. When I think of something rupturing, it doesn’t look pretty. It’s something that we want to talk about in its real form. 


    Uterine rupture happens. When it does, it is typically an emergent situation. However, it doesn’t happen very often and when we’re talking about VBAC, the world feels like, and I’m talking about world as in other countries too, it is bigger than it is like you were saying. 


    It happens in really less than 1% of people so they are showing that with VBAC after multiple Cesareans, it might be slightly higher around 1.2%. It’s just so hard. What I think is unfortunate is that it’s not being offered enough to show the real stats, but what this podcast and what Facebook and all of the groups out there, the VBAC groups are showing, is that VBAC after three Cesareans is possible. It is possible. 


    Do your research. Find the support and you did it. I mean, I’m going to say that you did it without support. I mean, you had support from your husband and stuff, but to the fact that they were showing up at the end of your bed like, “How long are you going to push for?” That type of stuff is not combined with the definition of support for me by the way and ambushing you and those things. You got through it without that much support backing you up in this decision. 


    That is where we are shy here. I think that we don’t offer the support. 


    One, if you’re listening and you’re a provider and you offer VBAC after three Cesareans, please let us know so that we can chat with you and get you added to our list. If you’ve had a VBAC after three Cesareans and you are listening and had support, please message us so we can add your provider to the list because VBAC after three, four, and all of the Cesareans may not be the best choice for everyone, but for those who want it, let’s try to get the information out there. Read up. Get the information. Like I said, it’s going to be in the show notes and the blog. We have our course. 


    There’s not a ton out there on vaginal birth after multiple Cesareans so find what you can. Read what you can. Find the stats and do what’s best for 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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    44m - Jun 12, 2024
  • Episode 307 Dr. Christina Pinnock + High-Risk Situations & What They Mean for TOLAC

    Dr. Christina Pinnock is a Maternal Fetal Medicine Specialist/Perinatologist based in California and creator of the ZerotoFour Podcast. She is here to help us tackle topics like what constitutes a high-risk pregnancy, lupus, preeclampsia, HELLP syndrome, gestational diabetes, fibroids, and bicornuate uteruses and how they relate to VBAC. 


    The overarching theme of this episode is that all pregnancies are individual experiences. If you are hoping to achieve a VBAC and you have pregnancy complications, find a provider whose goals align with yours. By ensuring that your comfort levels are a good match, you are on your way to a safe and empowering birth experience!


    Dr. Pinnock’s Website and Podcast

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    00:58 Review of the Week

    03:13 Dr. Christina Pinnock

    03:56 Importance of a VBAC-supportive provider

    06:36 High-risk pregnancies

    11:02 Lupus and TOLAC

    14:31 Preeclampsia 

    17:19 Varying ranges of preeclampsia

    20:46 HELLP Syndrome 

    26:36 Other High-risk situations 

    27:54 Gestational Diabetes

    35:00 Inductions with gestational diabetes

    42:25 Fibroids 

    46:33 Do fibroids tend to grow during pregnancy? 

    51:20 Bicornuate Uterus


    Meagan: Have you ever been told that you were high risk, so you’ll be unable to TOLAC? Or maybe you can totally TOLAC assuming nothing high-risk comes into play? What does high risk mean? We often get questions in our inbox asking if having your previous cesarean makes them high risk. Or questions about topics like preeclampsiaclampsia, gestational diabetes, bicornuate uterus, fibroids, and more. 


    I am so excited to have board-certified OB/GYN Dr. Christina Pinnock on the show today. She is a high-risk pregnancy doctor passionate about educating women along their pregnancy journeys so they can be more informed and comfortable during their pregnancy. She is located in California and has a podcast of her own called “ZerotoFour” where she talks about topics that will help first-time moms prepare for, thrive, and recover from pregnancy as well as shares evidence-based information and answers everyday questions like we are going to discuss today. 


    00:58 Review of the Week


    Meagan: We do have a Review of the Week, so I'm going to jump into that and then we can dive in to get into these fantastic questions from Dr. Christina Pinnock. 


    Today’s reviewer's name is Obsessed!!!! It says, “The best VBAC and birth podcast. I am grateful to have discovered Meagan and this podcast. I definitely believe listening to stories of these amazing women and their parent’s course helped me achieve my two VBACs. Thank you for all you do The VBAC Link.”


    Oh, thank you so much Obsessed!!!!!  And as always if you wouldn’t mind, drop us a review leave us a comment and you never know, it may be read on the next podcast. 


    03:13 Dr. Christina Pinnock


    Meagan: Okay, Women of Strength. I am seriously so, so excited to have our guest here with us today! Dr. Christina, is it Pinnock? How do you say it?


     Dr. Pinnock: Yes that’s perfect.


    Meagan: Ok, just wanted to make sure I was saying it correctly. Welcome to the show! You guys, she is amazing and has been so gracious to accept our invitation here to today to talk about high-risk pregnancy and what it means. Hopefully, we’ll talk a little bit about gestational diabetes because that's a big one when it comes to VBAC. And if we have time, so much more. So welcome to the show and thank you again for being here.


    Dr. Pinnock: Thank you so much for having me, I'm excited to be here and chat with you and your audience about these great topics, so thank you.


    03:56 Importance of a VBAC-supportive provider


    Meagan: Yes! Okay well, this isn’t a question we had talked about, but I’m curious. Being in California, do you find it hard to find support for VBAC or do you find it easy? I mean, California is so big and you’re in Mountain View. So I don’t know exactly where that is. You said the Bay Area, right? So how is it in your area? How is VBAC viewed in the provider world in your area?


    Dr. Pinnock: Yeah, that’s a good question. I actually did most of my training on the East Coast, so it’s been a good experience seeing the differences in coastal practices. I think where I did my training we were pretty open to VBACs and supported them. In California, I’ve had a similar experience and I think it really depends on where you are.  I’m in the San Francisco Bay Area and I work at an institution where we support TOLACs and want our moms to VBAC as long as it’s safe and it’s what they desire. But I really think the opportunity to TOLAC depends on your individual OB provider that you have and their comfort in offering that. And importantly, the hospital resources that you have available in your area. 


    California’s huge and depending on where you live it can be a very, very different infrastructure both geographically and specifically within the hospital. And so I really think that differences in that offering is based around those resources rather than maybe patient desire or even sometimes provider desire. So it really just depends on those things. 


    Meagan: That’s so good to know. I mean, we tell our community all the time that provider is a really, really big key when it comes to being supported. But also I love that you were talking about the actual hospital because for me with my second– I had a VBAC after 2 C-sections and with my second, my provider was 100% gung-ho and super supportive. But in the end, I ended up switching because the hospital was going to end up restricting my provider in supporting me in the way he wanted to support me, right? So it’s also really important to vet your location and your hospital.


    Dr. Pinnock: Yes, absolutely. Sometimes, someone may live in a location where they don’t have that choice, unfortunately. If you do have that choice and you can choose hospitals and providers that can support it, by all means if you have that ability. 


    06:36 High-risk pregnancies


    Meagan: Absolutely. Ok well, let's dive in more to high-risk. So a lot of the time, I'd love to see what you think about this. A lot of the time, providers will tell moms because they’ve had a previous Cesarean, not even a special scar or anything like that, that they are automatically grouped into the high-risk category. 


    So I don’t know what your thoughts are on that in general, but let’s talk more about high-risk pregnancy. What does it mean? What does it look like for TOLAC? How is it usually treated? And are there often restrictions given for those moms? 


    Dr. Pinnock: Yeah, no. That’s a really good question. One thing about pregnancy, there’s some level of risk in all pregnancies. No matter if you're completely healthy, no medical problems, or you're trying to TOLAC, or you have other medical conditions that exist before pregnancy, all pregnancies carry some level of risk but not all the risks are equal. 


    There are some conditions that the mother can have before pregnancy that can put her pregnancy at a higher risk of developing some complications. There are some conditions that can actually develop during pregnancy that can cause the pregnancy to be at a higher risk of developing complications. Lastly, there are some conditions specific to the placenta, the baby, how the baby developed, or even the genetic makeup of the baby that can contribute to a high risk of having complications. All of these three categories can impact the status of your pregnancy being considered high-risk. 


    So typically, if you have a condition that falls in one of those three boats, then your pregnancy could be considered a higher risk. Usually having a previous C-section or even two previous C-sections by itself is not really something that I would use to classify someone as having a high-risk pregnancy. I do think that definitely talking with your provider about your desire for delivery earlier on can help both people to be on the same page, but if you otherwise have nothing else going on in the pregnancy and you have one previous C-section or even two previous C-sections, I think the pregnancy itself, I wouldn’t consider it a high-risk pregnancy. 


    Meagan: That’s good to know. 


    Dr. Pinnock: Yeah no, absolutely. And when you think about the delivery, I think about it a little bit differently than the pregnancy. I think for the delivery if you are interested in having a TOLAC and you have a previous C-Section or two, then the management of your delivery and the risk of your delivery isn’t the same as someone who hasn’t had a C-section. I think about them as like two different boats. 


    But overall, conditions that are related to maternal health can be high blood pressure, diabetes, and autoimmune conditions like lupus. Those things can cause your pregnancy to be considered high-risk. A good example of a few things that can develop in pregnancy that can make your pregnancy high-risk include things like preeclampsia which is high blood pressures of pregnancy. Having twins or having triplets can make your pregnancy a higher risk. In some instances, even gestational diabetes depending on what’s going on and where you are can be considered a pregnancy with some high-risk features. 


    And then genetic conditions for baby whether that’s a difference in how one of your babies’ organs developed, or a genetic condition that’s discovered from testing; any of those things can really impact that high-risk status and how your pregnancy will be monitored and managed after that. 


    Meagan: Ah these are all such great topics and actually things that we get in our inbox. Like, “Hey, I have lupus,” or we’ll have one of our VBAC doulas say, “Hey, I have a client who has lupus. She really wants to TOLAC and have a VBAC. What does that mean for her?” 


    Obviously, all of these conditions are going to be treated differently throughout the pregnancy and probably even during the labor and delivery portion. 


    11:02 Lupus and TOLAC 


    Meagan: I don't know if we can touch on a couple of those like lupus. What does that look like for someone? If I have lupus coming in, I’m doing okay right now. I have it. What does that look like for someone wanting to TOLAC and to have a VBAC?




    Dr Pinnock: Yeah. I think it’s similar to your first question about whether a C-section would make your pregnancy considered high-risk. So the lupus diagnosis would increase the risk of certain medical conditions happening in pregnancy relating to both mom and baby. Your doctor may get some extra blood work to monitor how your lupus is progressing in pregnancy. Your doctor may get some extra ultrasounds to make sure that baby isn’t too small and add some extra monitoring to make sure that baby is staying safe and that if there is a risk for baby to be in distress that that is picked up. 


    And so the actual monitoring and management of the pregnancy is usually done with the help of a high-risk pregnancy doctor like myself with an OB provider. That is really specific to what is going on with that person. If everything goes smoothly and lupus stays under control and we get to the moment where we’re thinking about how we’re going to deliver baby, that’s sort of a separate boat. In an ideal world, everything goes well in terms of the lupus and pregnancy and if you’re interested in having a TOLAC, having a diagnosis of lupus should not restrict you from that option. You can still have that as an option but it really just depends on the specifics of how your pregnancy has unfolded. 


    Have you developed any other conditions like high blood pressures in pregnancy or preeclampsiaclampsia where your doctor is maybe thinking you may need to deliver earlier? Are there things going on with your baby where we think baby is under more stress where we would really need to be very intentional about how we deliver baby? It’s a really nuanced thing and it’s based on the specifics on that person’s condition. I think an overarching theme is whatever is going on with the pregnancy that impacts the delivery if things are not going as smoothly. But if things are going smoothly and you want to try for a TOLAC, that’s not necessarily a reason to say, “No, you absolutely can’t do this,” unless there are specific conditions that came up in your pregnancy that make it less safe for either you or baby as the mom. 


    Meagan: Yeah. Something that I’m just hearing you say so much that’s standing out is that really is individual, depending on that individual and depending on that individual’s case. I think that’s something important for listeners to hear because someone who may have lupus that’s going really, really fine, TOLACs going to be a really great option for them. But someone who may have active symptoms and it’s going and it’s really hard, that may be a different suggestion in the end. But I like that you’re like, We’re in this boat and then we travel over to this boat into this time, and then it’s a matter of how we float that boat and how we get to our destination.


    Dr. Pinnock: Exactly.


    14:31 Preeclampsia 


    Meagan: Would you say that the same thing goes for preeclampsia? Preeclampsia can develop at any stage of pregnancy. I mean, we've had clients in weeks 18-20 develop it and then have to be really closely watched and all of these things. Is that someone also where you would say the same thing? Where it’s like, We’re in this boat doing these things and these tests and monitoring, and then again we get into this next boat and we have to decide what the best route is?

    Dr. Pinnock: Yeah, no. That’s a good question. I think it’s similar but a little different with preeclampsia. It depends on the type of preeclampsia that’s going on. Preeclampsia is a spectrum and with the part of the spectrum that’s more on the severe side, we still try for a vaginal birth. It really depends on, as you’ve mentioned, how far along you are in the pregnancy.


    Maybe you are 28 weeks and you have such a severe form of preeclampsia that your doctor is like, “I don’t think we can get any more time with the pregnancy,” that’s a very different situation than someone who has a very non-severe form of preeclampsia at 39 weeks who wants to TOLAC and have all of those options available. 


    It really does depend but the overall theme with preeclampsia if you do want to try for a vaginal birth and your health and baby’s health are stable in the moment, then usually we do try as much as possible to have a vaginal birth. But things like very early gestational age and really severe complications of preeclampsia make the possibility of having a vaginal birth less likely. It makes the possibility of someone who wants to TOLAC in that setting less likely. It really depends on the severity of that spectrum of preeclampsia, but we always try for a vaginal birth if we can. 


    Meagan: Yeah. This may be too hard of a question to answer, but can we talk about that range and the severity? What does a low to moderate to severe case of preeclampsia look like in a person? What would be considered that severe, Hey, we might need to reconsider our birth desire here,” to “Hey, you have it. It’s really low right now,” or to “We’re in choppy waters right now.”


    17:19 Varying ranges of preeclampsia


    Dr. Pinnock: That’s a good question. Pre-e is defined as elevated blood pressure in pregnancy after 20 weeks. So once you hit 20 weeks, if your blood pressures are elevated, 140/90 times multiple times and we see any evidence of preeclampsia’s impact in some organs in your body.


    One of the most common things that we used to use to diagnose is the presence of protein in the urine. Once we see that, we’re like, “Oh, man. I think you may have preeclampsia,” then we do an evaluation of the rest of the body to understand how severe it is. Preeclampsia is a disease that’s thought to develop from the placenta when it implanted. It can cause dysfunction or impact on the organs. It can cause severe headaches. It can cause changes in your vision and problems with your blood cells, your liver, your lungs, and your kidneys. 


    We go from head to toe and take a look at how those organs are being impacted by preeclampsia and then we ask you how you’re doing. If you’re having a headache, if you’re having changes in your vision, pain in the belly, and all of that, it helps us to understand the severity. So depending on your symptoms, your blood work, and your blood pressures, those things together help us say, “Is this a severe form of preeclampsia?” and if it is, then we usually have some specific things that we have to do. 


    Generally, you likely are monitored in the hospital. We keep a close eye on your blood pressure and your organs. That pregnancy is considered to be very high risk. Very high risk for a harm for mom, so risk of seizures, impact on the organs that can sometimes be lifelong and risk to baby. The highest risk to baby is that risk of being born early, so pre-term delivery. And usually if you have severe preeclampsia, we usually recommend delivery no later than 34 weeks. So once we do develop that severe form, we keep a close eye on things. 


    If you have the non-severe form, so if your organs look oay and your blood pressures are stable but you have some protein in your urine and we do think you have preeclampsia but it’s not severe, then we give you some more time. We still monitor you and baby very closely, but we can maybe try to get the pregnancy up until 37 weeks and after that, the risk of continuing the pregnancy and harm to maybe the mom and baby are a bit higher than some of the risks of being born at 37 weeks. So at that time is when we would say, “Let’s have a birthday.” It really depends on those things. 


    Meagan: Okay, that’s so good to know. I think sometimes that also can vary like, I’ve got high blood pressure, but I don’t have protein. Or I’ve got a trace of protein but I’m doing okay, I don’t have any symptoms. But we also know with preeclampsia it is important to watch really closely no matter whether severe or not because it can turn quickly. Where you have zero signs and the next morning and you wake up with a headache and crazy swelling and you have that blurred vision with really high numbers. So it’s just really important to watch.


    Dr. Pinnock: Exactly.


    20:46 HELLP Syndrome


    Meagan: I really do like to ask that question because a lot of people ask, do I have to have a C-section? Do I have to be induced? What does that mean? Am I severe or not severe? And we also note, we weren’t even talking about this, but HELLP syndrome. So we can develop more, right? Preeclampsia affects more the mom, but then alsothe  baby timewise. HELLP syndrome is another really high-risk complication. What would you suggest for that when it comes to TOLAC because we have platelets being affected there? That one is a tricky, tricky one. 


    Dr. Pinnock: I think HELLP syndrome is on that same spectrum of hypertensive disorders in pregnancy. But HELLP syndrome can be pretty life-threatening and dangerous for mom and by extension baby. So HELLP syndrome is when we find that your body’s sort of hemolyzing so there are some things in your blood that’s causing your blood vessels to sort of open red blood cells. We find also that you have elevated liver enzymes so your liver’s being impacted pretty severely and then the platelets or the blood cells that help with clotting get really, really low. And so the combination of that with or without elevated blood pressures make us very concerned about HELLP. So the worry is if we don’t deliver the baby pretty expeditiously and deliver the placenta which is thought to be really the source of the diagnosis, mom can get really ill and we really try to deliver as soon as possible. 


    The exact way we deliver is really dependent on the specifics of what is going on. So maybe if your liver enzymes are very, very elevated and there's a high concern for mom’s health and safety, your doctor may say, “I don't think we have time to try for a TOLAC, especially if you're not in labor. I think it would be too unsafe. I think I would recommend a C-section at this time because of that,” then that would be that recommendation. 


    Sometimes we do try for a vaginal birth with HELLP, but it would be a case where we would want to limit how long we try but overall we try to deliver as fast as possible either vaginally or with a C-section. And if you do want to try for a TOLAC in that setting, I think my recommendation is to really, really be open to whatever is best for your health and your babys health. That’s my advice for all women who are in labor. 


    It’s such an unpredictable experience and you can come in with your desires and your doctor can come in with their desires for you, and your baby or your health just dictates something else. And so with HELLP, that’s an even more significant moment where if your body’s telling us one thing, we have to listen. You may not be eligible for a TOLAC at that point. I think in more cases than not, many providers may not have that bandwidth or think it’s safe to try for TOLAC in that setting. 


    Meagan: Yeah. I’ve had very few clients as a doula who have had HELLP, but one of the clients– they actually both ended up having a Cesarean, but one of the clients’ providers was even uncomfortable with even having an epidural and actually suggested general anesthesia. Is that a common thing if HELLP is super severe that could possibly be what’s suggested or best?


    Dr. Pinnock: Yeah, no as I mentioned with that kind of diagnosis, you can have pretty low platelets. And so when we think about a procedure like an epidural or even a spinal, so any sort of neuraxial anesthesia where we’re not putting mom to sleep, we’re just numbing mom from the waist down, that requires insertion of a needle or a catheter in the back. That’s near a lot of important structures so once you have that puncture, you’re going to have some bleeding. And if those platelets aren’t enough to sort of prevent that bleeding from extending, then our anesthesia team may not be comfortable doing that procedure safely because it’s not safe. 


    They may offer to give some platelets etc but often with HELLP, it may not be as fast acting and sometimes you may just hemolyze again. Those platelets may go back to being very low and if we are thinking about having a delivery urgently, delaying for that reason may not be safe for mom and baby. Oftentimes, if the platelets are too low, then our anesthesia colleagues, who are a very important part of the team, may recommend against trying for an epidural or even a spinal and recommend general anestheia.


    In my experience, I don’t do C-sections under general anesthesia often, but when I do, it’s usually recommended for a very, very significant reason and it’s always with the safety of mom and baby in mind. It’s never something that we want to do. It’s only something that we do if we have to do for mom’s safety or for baby’s safety. 



    Meagan: Yeah. So good to know. And they actually ended up doing a platelet transfusion as well specifically for the Cesarean. Obviously, we know blood loss is a thing that’s a big surgery so they were trying to help her there. 


    26:36 Other High-risk situations


    Meagan: Okay, well are there any other high-risk scenarios where you feel like truly impact the ability to have a TOLAC offered?


    Dr. Pinnock: Yeah. I think the highest risk conditions that could prevent mom from having a TOLAC are probably conditions related to the heart or lungs where the physiology or the changes that happen in labor can make it so that a vaginal birth is not safe or recommended for mom or baby. 


    A TOLAC in those high-risk settings is often not recommended. There are a lot of cardiac and lung conditions that we take care of. There are not that many that we would say you can’t have a vaginal birth, but sometimes there are blood vessels in the heart that can be dilated or blood vessels near the heart that can be dilated that we may say, “No, you definitely need a C-section,” so if you wanted to TOLAC we wouldn’t recommend that. Those are probably the highest-risk conditions that I take care of and where a TOLAC is not recommended or even offered because it’s just not considered to be safe. 

    27:54 Gestational Diabetes


    Meagan: Okay that’s so good to know. Okay, let’s jump in a little bit to gestational diabetes. We can have both managed and not managed. Do you have any advice for listeners who may have gestational diabetes or maybe had gestational diabetes last time and they’re preparing to become pregnant or wanting to learn more about how to avoid it if possible or anything like that? Do you have any suggestions to the listeners?


    Dr. Pinnock: Yeah, that is one of my favorite things. I really believe that just paying close attention to your health and taking steps before pregnancy can make a world of a difference in your risk of developing certain conditions. Gestational diabetes is one of those conditions that can be definitely most susceptible to things that we can do before pregnancy. 


    And so I know that this is going to maybe sound like a broken record to those who had gestational diabetes before, but just look at your lifestyle factors. I think that the most undervalued or underestimated intervention is really exercise. It doesn’t have to be your training for an Iron Man or a marathon. It could just be like a 20-minute walk every day or a ten-minute job every day and work your way up. We definitely found that aerobic exercise more days of the week than not, and resistance training, it could be with resistant bands, if you have any sort of light weights or even body weight. Any resistance training to help build up that muscle mass can help to reduce your risk of getting gestational diabetes. 


    If you couple that with adjusting your diet, and diet is such a big topic but essentially no matter what your background is, focusing on the whole foods of your cultural background is best. So low processed foods, more homecooked meals with whole grains, fruits, vegetables, fish, and limitations of red meat and processed foods. All of those things can go a long way with preventing gestational diabetes and also reducing the recurrence of gestational diabetes. I’m really passionate about that. 


    Meagan: Yeah, us too. I didn’t have gestational diabetes, I had kidney stones weirdly enough because my body metabolizes nutrients differently during pregnancy and anyway, it’s totally not gestational diabetes but I had to look at my pregnancies and before as something like that. Really dialing in on nutrition. Really dialing in on my exercise. And I couldn’t agree more with you that it doesn’t have to be this big overwhelming Iron Man training or running a marathon. 


    It really can be a casual 20, 30-minute stroll around the neighborhood walking the dog or whatever and dialing in on those whole foods. We love the book Real Food for Gestational Diabetes by Lily Nichols. If you haven’t ever heard of that, it’s amazing. It’s a really great one. You might love it. And I definitely suggest that to all of my clients. She even has one for Real Food During Pregnancy. Just eating good food and then we love Needed because we know that getting our protein and getting the nutrients that wer eally need can really help like you said recurring and current and just avoiding hopefully. So we really love that topic, too. 


    But gestational diabetes doesn’t just nix the opportunity to TOLAC, correct?


    Dr. Pinnock: No, it doesn’t. Gestational diabetes can be a really tough diagnosis for a lot of women to get in pregnancy. It can be really disappointing especially if you may be a relatively healthy, active person and you don’t have a lot of risk factors for developing gestational diabetes. It can kind of feel like a gut punch almost. 


    Meagan: Yeah! And it’s very overwhelming because you’re like, What? No! 


    Dr. Pinnock: It is! And it happens fast. You’re diagnosed and then you have a flurry of things that you have to now do and change and think about. It can be very stressful. But I always tell my patients that there are things that put some people at risk of developing gestational diabetes more than others, but all women because of those placenta hormones can have insulin resistance or your body’s just not responding as well to the insulin that you’re making. 


    Depending on those risk factors, some women develop it. Some women don’t. And once you do develop gestational diabetes, it’s something that we really pay attention to because it can increase the risk of things for moms so particularly it can increase the risk of mom developing preeclampsia and it can increase the risk of things for baby. Babies can be on the bigger side or have macrosomia if the blood sugars are too high. 


    They can actually have a higher risk of having a birth injury if we’re having a vaginal birth or mom may actually have a higher risk of needing a C-section if you’re trying to TOLAC and baby’s on the bigger side. Rarely, and this is sort of the thing we worry about the most, is that if those blood sugars are too high for too long, baby can be in distress on the inside and it can increase the risk of having a stillbirth or having baby pass away. 


    So because of those things, once we diagnose it, we do pay attention to it and we try our best to sort of make those changes hopefully with diet and exercise to sort of manage the blood sugars. If we’re having perfect blood sugars with those changes, then wonderful. If we’re not, and it happens and you need some additional support then your doctor provider may recommend some other management options like medications to help to bring the blood sugars down. 


    But I think, when we think about TOLAC, we want to think about separately managing the pregnancy, keeping mom and baby safe, and then thinking about the safety of delivery. So as long as the baby’s size isn’t too big, as long as mom and baby are healthy and safe, you can definitely try for TOLAC with gestational diabetes. But those two things are big “buts”. You really want to try your best to manage your blood sugars so baby’s size doesn’t work against your efforts of trying to have a TOLAC.


    35:00 Inductions with gestational diabetes


    Meagan: Yeah, we know that the size can definitely impact providers’ suggestions or comfortablity to offer TOLAC. And we know big babies come out all of the time, but we know sometimes there’s some more risk like you were saying. So can we talk to the point of inductions?


    So a lot of providers will, and you kind of touched on it. There can be an increased risk of stillbirth. But a lot of providers seem to be suggesting that induction happens at 39 weeks. Some of the evidence shows that in a controlled situation, meaning all of the sugars are controlled, but what do you see and what do you suggest when someone is wanting a TOLAC, has gestational diabetes, may have a baby measuring larger or may have a provider who is uncomfortable with induction which we see all the time? Any suggestion there and what do you guys do over in your place of work?


    Dr. Pinnock: Yeah, that’s a great question and it’s something that I individualize to every patient. So let’s think about it in two different buckets or three different buckets. Say you have gestational diabetes that’s pretty well controlled with just diet. So with diet and exercise, your numbers are pristine. Baby is a good size, we’re not over that 4500-gram mark where we start to say, “Is it really safe to try for a vaginal birth?” and that’s okay. If we are in that boat, then I think it’s reasonable to allow for mom to go into labor and try for TOLAC if that’s their desire. 


    The exact gestational age at which someone goes into labor varies. We don’t have a crystal ball. We don’t know. 


    Meagan: Nope.


    Dr. Pinnock: We do have to balance waiting for that labor process with the inherent risk of babies being less happy and distressed and the risk for a stillbirth as the pregnancy progresses. Now, if you have gestational diabetes that’s well controlled with diet, we think from the studies that we have that our risk of stillbirth is similar to someone who does not have gestational diabetes which is good. And so for those pregnancies, depending on your specific location and provider, we may do some monitoring with non-stress tests or something like that later in the pregnancy until you deliver. Usually, we start at around 36 weeks or so if you’re well-controlled with just the diet and allow you time for your body to go into labor and have a vaginal birth. 


    Now, if we get to your due date and nothing, baby is still comfortable inside. They’re like, Oh no. I’m just hanging out, we start to think, How long are we going to allow this to go on? At that length of time, we start thinking about, Okay. We’re at 40 weeks. What are the risks to mom and baby? And so at 40 weeks, we’re about a week past 39, and we know that the risk of– if things are perfect for anyone, the risk of having babies be in distress, maybe the placenta’s just been working for a long time and isn’t just working as well and the risk of stillbirth goes up, we don’t want to go to 42 weeks. 


    So I think at that moment, it’s a good time to think of an exit strategy. If your baby is just so comfy on the inside, think about, when I would say is an upper limit of reasonablility to wait for labor? That varies depending on the person and provider. But I think reasonably, up until 41 weeks. I wouldn’t go past that. If we’re allowing our body to go into labor up until 41 weeks, then we have to think about, How does that impact my risk of having a successful TOLAC? After 40 weeks, some of our studies suggest that you may be at a higher risk of having a failed TOLAC or needing a C-section and that’s regardless of whether you're induced or whether you go into labor. TOLAC-ing does carry that inherent risk so it’s really just dependent on your doctor, you,  your provider, and balancing all of those things. I think going until 41 weeks is probably the maximum limit for a well-controlled gestational diabetes with perfect sugars, no medications, and we’re still doing monitoring to make sure that baby is doing well.


    Now, if you’re in the camp where you’re either gestational diabetes, or even controlled with diet, or if your gestational diabetes is controlled with medication or if you’re diet-controlled, but those sugars aren’t great, any scenario where the sugars aren’t perfect and we need either medications or your sugars aren’t perfect, I don’t generally go past 39 weeks.


    The reason being at 39 weeks, baby is fully developed and after that, the risk of having a  pregnancy loss goes up because of that uncontrolled or not optimally controlled gestational diabetes. I think at that gestational age you would want to think about maybe an induction or maybe a repeat C-section depending on how you’re feeling if your body isn’t going into labor. And that’s a personal decision. 


    Now, if you have gestational diabetes managed with medication and your baby is big and maybe let’s say over 4500 grams which is sort of that range where we worry about the safety of a vaginal birth. And you’re now going into labor, then that becomes a little bit more of a shared decision-making where you want to think of, My baby’s big. I would need to be induced. Is this going to be something I want to commit to or is it something I don’t want to commit to? That’s a personal choice but I think at that gestational age I would say I wouldn’t want anymore. 


    ACOG though does recommend or does allow for moms who do have gestational diabetes well controlled with medication, like if your blood sugars are perfect with the medication to go until 39 weeks and 6 days. So technically you can use those extra few days, according to our governing board or the American College of OBGYN. But it’s going to really come down to you and the relationship you have with your doctor and what you both are comfortable with. Maybe you have a provider that is open to that recommendation or a provider whose more open or comfortable to a 39-week delivery regardless of how well your blood sugars are controlled once you’re on medication. But ACOG does give us that wiggle room to say we can go further. 


    42:25 Fibroids


    Meagan: So good to know. Okay, let’s see. Is there anything else we would like to talk about high-risk-wise? I know I had mentioned one time about fibroids and heart-shaped uterus. Do you have anything to share on those two topics, because those are also common questions? Can I TOLAC with fibroids? Can I TOLAC if I have a heart-shaped uterus? Where does that land as VBAC-hopeful moms?


    Dr. Pinnock: Yeah, no. I think those are some great things to consider. So I think we can open with the fibroids. I think if you’ve have had fibroids and you’ve had that fibroid removed, so you’ve had a myomectomy, there are a handful of things where we usually say, “No, we don’t want you to TOLAC.” One of them is if you've had a previous uterine rupture or that previous Cesarean scar opened in a previous delivery, that’s an absolute no. The risk is too high. We don’t think it’s safe. The other is if you’ve had a previous surgery where that surgery included the fundus or the top of the uterus where those contractile muscles are. Usually, with a myomectomy or fibroid removal, that involves that area. If you’ve had a fibroid removed in that area or you’ve had a myomectomy, a TOLAC is not recommended. So those are sort of one of the few things or few times where we say, “Absolutely, no.” 


    If you have a fibroid and maybe you just discovered you had it during pregnancy, most of the time fibroids don’t cause any problems. They’re benign growths of the muscle of the uterus that can vary in size. So generally if they’re small to medium size and depending on their location they may not cause any problems. If they do cause a problem, the most common thing women experience is pain. But usually if they’re not too big and they’re not in a location where we’re concerned about, it should not really your ability to TOLAC. 


    Now if the fibroid is like 10 centimeters and located near the lower uterine segment or the part of the uterus where the baby transports through to come out through the vagina, then we’re going to take a pause and say, “Is this going to be a successful TOLAC?” Is the fibroid going to compete too much with the baby’s head for baby to come down safely and should we just think about doing a C-section? And a C-section in that event is also not straightforward or a walk in the park because either way, the fibroid is present near where we would use to deliver the baby.


     So short answer is that yes, you can TOLAC with a fibroid. But the long answer is that it really depends on how big the fibroid is, where it’s located and whether we think it’s going to obstruct that area where baby’s going to come from. If it’s not, then it’s reasonable to try and many women have TOLAC’d with fibroids all the time. So it’s definitely not a reason to say, “No, you definitely can’t.” If you’ve had the fibroid removed though, then it’s a no. That’s just one thing to talk about if you’re considering that procedure and you have an opportunity to talk with the provider who is offering that procedure, just knowing that after that for most surgeries that remove the fibroids you won’t be able to try for a vaginal birth. 


    46:33 Do fibroids tend to grow during pregnancy? 


    Meagan: Good to know. Good to know. And is it common for fibroids to grow during pregnancy? Does pregnancy stem them to grow? Or does that impede them because you’ve got a baby growing in there and the focus is on growing a human and not growing a fibroid?


    Dr. Pinnock: No, that’s a good question. Interestingly enough, we see about a split group so about a third of them stay the same. They don’t change in size. A third of them shrink and a third of them grow. 


    Meagan: Oh wow.


    Dr. Pinnock: We don’t know which third it will be. Two-thirds of them either get smaller or stay the same size. But there are women who experience growth of the fibroid and it’s actually due to those hormones estrogen, progesterone, and all of those hormones being released by the placenta. It stimulates the fibroid to grow and that’s actually when some women experience pain. 


    The fibroid grows. It outgrows its blood supply and then it degenerates or dies off a little bit and it causes this pretty significant pain for some women, but interestingly it’s not 100%. A lot of people don’t have many symptoms and don’t have any pain. When I monitor fibroids, a lot of them don’t change in size. Some of them get smaller and sometimes I’m not able to see them later on because they’re so small. But there is that percentage who experience the growth of their fibroid and that’s usually when pain is experienced from them. 


    Meagan: Okay. And you mentioned that they could. I mean, 10 centimeters is a pretty large fibroid but it can happen, right?


    Dr. Pinnock: I’ve seen it. 


    Meagan: Yeah, so it can happen. You said it can compete with baby coming down. Can fibroids also inhibit dilation at all? Can it impact dilation at all?


    Dr. Pinnock: Absolutely. Some of the things that we see or that we worry about if there’s a large fibroid present is other than impacting the area where baby can come through, it can cause dysfunctional labors. So those muscles that are contracting in a uniform way aren’t going to be able to contract as uniformly as they would have if the fibroid wasn’t there. So sometimes the labor can stall. The cervix isn’t dilated as much. Even sometimes we see that fibroid causing babies to actually present head down and so that’s also something that we can see with very large fibroids. It can actually increase the risk of baby being breech or transverse or malpresenting in general. 


    Meagan: interesting. And you said that sometimes there aren’t even any symptoms at all, so how would one find out if they do? Is that just usually found at 20-week ultrasound? Or is it possible that at 20 weeks you had it but it’s so minute and it’s so small, that you can’t even see it? And then in labor we have some of these symptoms or whatever and it’s there but we don’t know?


    Dr. Pinnock: Not usually. Most women, if they didn’t know they had a fibroid before pregnancy, get diagnosed in pregnancy at an ultrasound. Either a first trimester or 20-week ultrasound, we look at the uterus in detail and we can pick up fibroids. We are hopefully not going to have a 10-centimeter fibroid present at 10 weeks that’s missed that’s just going to magically present at 39 weeks and be a surprise. Usually the fibroid, if it’s there, is picked up on an ultrasound. That’s the most common way it’s picked up. Depending on the size, it may be a reason why your doctor or provider recommends for you to have ultrasounds in the pregnancy. 


    Sometimes we monitor the fibroids. We monitor their locations, the size of them, and we make sure that they’re not too big to be causing a problem. Rarely if they grow, they don’t usually grow from like 3 centimeters to 10 centimeters. They may grow a centimeter or two. It’s very unusual to have that big change. And so for the most part, it’s picked up on ultrasound. We know the size of it. If it grows, it grows a small amount. It’s not going to grow from 5 to 10, and we’re going to know the location of it from that first time we evaluate it. It’s not going to be a surprise moment at delivery where we’re like, Oh my goodness, this wasn’t picked up.


    51:20 Bicornuate Uterus


    Meagan: Okay, good to know. Good to know. Okay and last but not least, I know we’re running short on time and I want to make sure we respect that. Any information you have on a heart-shaped uterus? Is TOLAC possible with heart shaped uterus? Have you seen it? Have you done it?


    Dr. Pinnock: I have not seen it or done it to be honest. I do think a heart-shaped uterus just so we’re using the same language that’s considered a bicornuate uterus, is that–?


    Meagan: Yes, a bicornuate uterus.


    Dr. Pinnock: So for a bicornuate uterus or any kind of situations where the uterus developed differently, interestingly the uterus develops from two different stuctures. It develops from something called the Mullerian Duct and early in development when you are a tiny, tiny baby, those two structures fuse and when they fuse, they come side by side first, and then they fuse. When they fuse there, is a little wall in the middle that gets removed and so when all of that is done you have uterus that is shaped as we know it and we have that cavity on the inside where the baby would come in and grow. 


    Now with a heart-shaped uterus, or a bicornuate uterus, there is an error when those structures come together side-by-side. So sometimes they just stay side-by-side and they don’t fuse as well or sometimes they fuse but only fuse partially. So you have the uterus that as we know it, but sometimes you can have two separate structures. So two separate cavities where the prgenancy can grow, or you can have one cavity where there is still some tissue right in the middle there. It can vary depending on the suffix of how that fusion happened. 


    Essentially, if there’s less space in the cavity either from that tissue or having two separate but smaller cavities, there’s presumably less space there for baby to grow. There’s less contractile strength on that one side and so it can theoretically increase the risk of certain things happening in labor. I think the things that we see most commonly with bicornuate uteruses, it can have a higher risk of having a pregnancy loss, so a miscarriage. High risk of baby being born early because that area is just smaller so it’s not as strong in holding the pregnancy. And similarly, baby can also be malpresented more commonly because the are is much smaller than a full uterine cavity.


    Meagan: That’s what we see a lot is breech. 


    Dr. Pinnock: Exactly. I haven’t seen too many cases. It’s a rare thing to see. I haven’t seen too many cases where baby’s head-down and we’re at full-term and wanting a TOLAC. A lot of cases I’ve had, baby is breech or malpresenting so we end up doing a C-section. The shape of the uterus is not going to change for the next pregnancy so chances are the baby’s usually malpresenting. 


    I don’t think we have any big databases or big data to say is it safe? Is it not safe to TOLAC? I think the main thing you’d be concerned about it that spontaneous uterine rupture if there is labor going on even if you haven’t had a C-section and also if you’ve had a C-section before. So I think a TOLAC would be a little bit of an unknown for this situation. I would think on it pretty heavily and talk with your doctor about the specifics of your situation. If your previous C-section because baby was breech, chances are baby’s not going to be presenting head down because of the shape of the uterus. It tends to have things that recur as to reasons for having a C-section. So we don’t have any large databases where we have women who have TOLAC’d with this condition, so hard to say. So maybe give it a try, but maybe thing long on this one. 


    Meagan: Case by case, it all comes down to case by case.


    Dr. Pinnock: Yes. That’s pretty much what I do. Anything in pregnancy that’s a little bit more nuanced and any high-risk condition, it’s very individualized. And we have to really have that approach with high-risk pregnancies or anything that comes up that makes your pregnancy higher risk of having anything happen to mom and baby for sure. 


    Meagan: Right. Oh my goodness. Well, I love this episode so much and cannot wait to hear what people think about it. I’m sure they’re going to love it just like I do. I know I mentioned at the beginning of your podcast and things like that, but can you tell us more? Tell us more about the ZerotoFour podcast and where people can find you. I know you have YouTube and all the things, so tell us where listeners can follow you.


    Dr. Pinnock: Yeah. You can find me on Instagram @drchristinapinnock, the ZerotoFour Podcast so the zerotofourpodcast.com where I share the episodes with new moms about pregnancy. I really started the podcast with the goal of helping moms to be more informed and comfortable about everything along their pregnancy journey. I share topics from the whole spectrum of that journey to help you feel more prepared and informed and empowered about your pregnancy experience. You can find episodes there, on Apple Podcasts, Spotify, or anywhere that you listen to podcasts.


    Meagan: Awesome. So important. This is a VBAC-specific topic, but I mean those first-time moms, we have to learn. We have to learn all the things because there is really so much. We just talked about a little nugget of a couple of high-risk situations and there’s just so much out there that can happen. It’s so good to know as much as you can. Get informed. Learn all the things. Follow your podcast. I definitely suggest it. We’ll have all the links in the show notes and thank you for joining us today. 


    Dr. Pinnock: Thank you so much for having me. It’s been a pleasure. 


    Closing


    Would you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.




    Support this podcast at — https://redcircle.com/the-vbac-link/donations

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    57m - Jun 10, 2024
  • Episode 306 Kelsey's Birth Center VBAC + Talk About Forceps

    Our friend, Kelsey, shares with us today what giving birth is like in Canada. From moving and traveling between provinces, Kelsey had experienced different models of care and when it came time to prepare for her VBAC, she was very proactive about choosing a birth environment where she felt safest. 


    From a scary Cesarean under general anesthesia to an empowering unmedicated VBAC in a birth center, Kelsey’s journey is entertaining, beautiful, and powerful. We love hearing the unique details of her story including giving birth at the same time as her doula just in the next room over! 


    The personalized care she was given during her VBAC is so endearing and heartwarming. As her husband mentioned, it should be the gold standard of care and we agree! 


    The VBAC Link Blog: Assisted Delivery

    Fetal Tachycardia in the Delivery Room

    Is There Still a Place for Forceps in Modern Obstetrics?

    Forceps Delivery Complications

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    07:36 Review of the Week

    09:27 Kelsey’s stories

    11:47 Logistics of giving birth in Canada

    14:38 A normal pregnancy

    17:50 Arriving at the hospital

    21:37 Stalling at 7 centimeters

    26:22 Asynclitic and OP positioning

    29:31 Kelsey’s Cesarean under general anesthesia

    34:50 Second pregnancy and VBAC prep

    41:07 Switching to midwives

    46:14 Beginning of labor

    51:07 Driving to the birth center

    54:49 Pushing baby out in two pushes

    1:00:24 Differences in care

    1:02:11 Enterovirus

    1:08:02 Risk factors for forceps and vacuum deliveries



    Meagan: Hello, Women of Strength. We have our friend, Kelsey, from Canada. Is that correct? 


    Kelsey: Yes. Yeah. 


    Meagan: She’s sharing her story with you guys today. Something about her first story of her C-section that stood out to me was that she had a forceps attempt that didn’t work out. Sometimes that happens. I want to talk a little bit about forceps here in just a minute before we get into her story. Kelsey, I wanted to ask you that this is something that in our doula practice we will ask our clients. If it comes down to an assisted birth with forceps or a vacuum, what would you prefer? It’s a weird thing because you’re like, Well, I’m not planning on that, but a lot of people actually answer, “I would rather not do those and go straight to a C-section.” Some people are like, “I would rather do every last-ditch effort before I go to a C-section.” 


    Did you ever think about that before? Had it ever been discussed before as their style? That’s another thing. Some providers are really vacuum-happy. Some are really forceps-happy. I know it’s a random question, but I was just wondering, had you ever thought of that before going into birth? 


    Kelsey: So no. I didn’t think about whether I wanted a C-section or a forceps delivery. However, I was really staunchly against having a C-section. That was primarily nothing against it, it was just that I have a really huge fear of awake surgery so with my forceps attempt, the OB who was there because it wasn’t my provider. That’s not the way Canada works. The OB who was there who was called in said, “Are you sure you want to do forceps? You could tear.” 


    I told her, “I would rather tear than have a C-section.” That was just a personal preference for me because I was so terrified of having a C-section. 


    Meagan: Yeah. I think that is very common and very valid to be like, “No, I would rather try this.” 


    Kelsey: Yeah. 


    Meagan: So I did. I wanted to go over just a little bit. I mean, I have seen a couple of forceps and they are not happening as often these days, but there was an article that said, “Is there still a place for forceps delivery in modern obstetrics?” I’m trying to say obstetricians and obstetrics. We’re just going to stop. 


    Kelsey: We know what you mean. 


    Meagan: You know what I mean. There was an article and I was like, That’s a really good question, because I think a lot of people think they shouldn’t be done anymore or a vacuum shouldn’t be done anymore either. It talked a little bit about the background. it says, that nowadays we are seeing a decrease in instrumental deliveries and a continuous increase of Cesarean rates. That makes me wonder if we were to increase vaginal and help instrumentally if that would decrease, but one of the things that I thought was interesting is that it says, “The prevalence of forceps delivery was 2.2% and the most common indication for a forcep delivery was fetal distress.” It is very common where it’s really, really close, baby is struggling. Baby is so low and let’s get baby out. 


    That’s 81.6% which is crazy. It says, “Among mothers, the most frequent complication is vaginal laceration,” which means we have tearing at 41% and third and fourth-degree perineal tears were noted. It says, “Regarding neonatal APGAR scores, around 8 around the first and the fifth minute,” which is around 91.2% and 98% of newborns which is pretty great. An 8 APGAR is pretty great. 


    I think a lot of people worry about that. It says, “8.8% experience severe birth injuries like hematomas and clavicle fractures.” Those are probably shoulder dystocias. That’s probably why they were having. It says, “Although fetal distress is the most common indication for forceps delivery, the vast majority of newborns were actually in good condition and didn’t require NICU care.” 


    That’s something that was kind of cool. Obviously, there are a ton of more studies and deeper studies on that. This was just one, but it was kind of interesting. It was like, all right. That is a good question to ask as we are preparing for VBAC is hey, if for some reason a forceps or a vacuum is necessary, that’s something to think about. What do we want to do at that point? 


    I love how you were like, “Yeah, I didn’t want a C-section. I feared that more than I did that.” Anyway, getting off that topic now so we can get this review and get on to your story but I think it’s a topic we don’t talk about and it’s not something that we are thinking about so as you are preparing, Women of Strength, for your VBAC, it might be something that you want to discuss and learn more about both vacuum and forceps and discuss with your provider what their tool of choice is and just have that in the back of your mind. 


    07:36 Review of the Week


    Meagan: Okay, so onto today’s review. It is from laurenswat and it was back in 2023. It says, “Thank You.” It says, “I listened to as many episodes as possible when preparing for my VBAC. The stories on here were so encouraging to me and Meagan is so knowledgeable and reassuring. I am happy to say that I had my unmedicated hospital VBAC last week and I caught my own baby before the doctor even got in the room.” 


    Oh my gosh, that is awesome. Seriously, catching your own baby is so amazing. I loved it personally myself as well and highly encourage it to anyone that is sort of interested because it is a really cool feeling. Thank you for your review and as always, we are looking for reviews. It is what helps people find this podcast. It helps us grow as a community. You can leave it on Apple, Google, email us, or whatever but we are so grateful for your reviews. 


    09:27 Kelsey’s stories


    Meagan: Okay, Kelsey. 


    Kelsey: Yeah? Hi. 


    Meagan: Hello. Welcome to the show. 


    Kelsey: Thank you. I’m super, super excited. 


    Meagan: Me too. Me too. I would love to turn the time over to you. Both of your babies were born in Canada. That’s correct, right? 


    Kelsey: Yes. Yeah. 


    Meagan: Tell us the story. 


    Kelsey: Yeah, so basically my husband and I got married in November 2019. Just prior to that, we had actually been living in New Brunswick. Just prior to getting married, we decided to move back because we are from Ottowa. We moved to Ottowa. We were living with his parents, his dad, at the time. 


    We went to Mexico for our honeymoon and on our honeymoon, we decided to start trying to have a baby. We decided to start trying but not preventing it because we weren’t sure how long it was going to take and there was no indication that it could take a while but my husband is actually an IVF baby. It had taken 7 years for his parents to conceive him. 


    Meagan: 7 years, wow. They are amazing. That’s a long time. 


    Kelsey: He was actually their last attempt. When his mom got up to say our wedding speech, she was like my 1 in 7 or something like that and I was just bawling. 


    So because of that, we decided to start trying and not preventing but there was nothing indicating it would take us a while. We started trying in December of 2019 and it just wasn’t happening for us so around the year mark, we had a lot of friends who started trying around the same time as us and were getting pregnant really, really quickly. I was going to so many baby showers and crocheting baby blankets that just weren’t for my baby. 


    Actually, the year mark rolled around and I got my period the day of. My best friend gave birth the day of. I was trying so hard to be happy and stay positive and whatnot, but it was devastating. 


    11:47 Logistics of giving birth in Canada


    Kelsey: We ended up being referred to a fertility clinic. They did a full work-up on both of us and there was nothing. They didn’t come up with anything. So they said, “You could keep trying or we could start IUI.” My husband and I said, “Let’s do 3 more months of trying on our own, and then we will try for IUI.” Our fertility clinic was in Ontario and we ended up moving to Gatineau, Quebec in July 2020.


    The way it works in Canada is you have your healthcare which covers. You can go inter-provincially and give your card unless you are from Quebec. If you are from Quebec, it’s kind of like living in another country. If you have a RAMQ card, you actually have to pay for your care in Ontario. 


    The Quebec government will reimburse you but only for 30%. It’s super weird. If you are from Ontario and go to Quebec, the Ontario government will cover you in Quebec. 


    Meagan: What? So weird. This world is so weird. 


    Kelsey: I know. It’s super bizarre. So essentially we moved to Gatineau because the housing market was a little less expensive. I was working in Gatineau at the time as a teacher. I was extremely stressed out in my job especially once COVID hit. We were sent back to the classroom before any of the other provinces were. 


    Anyway, I was extremely stressed out in my job and I decided to switch to the Ontario side because you can go between the two. Where I lived, you cross a bridge and you can get to Ottawa so you are in Ontario. 


    Essentially, we went through the fertility clinic. They said that nothing was going on but because the Gatineau government will cover you for IVF and any fertility treatments up to a certain price so we had to be referred back to Quebec for IUI. The month that we were referred back to Quebec for IUI, it was the day before my appointment that I found out I was pregnant. 


    Meagan: Oh my gosh, yay! 


    Kelsey: Yeah, on our own. It super just happened and some weird funny things happened. The day before, my husband and I went for a walk around our neighborhood. I found a quarter and was like If pennies are lucky, then quarters must be super lucky. I picked up the quarter and put it in my pocket and the day after, I found out I was pregnant. 


    These weird things kept happening. My pregnancy made me oddly psychic too which I’ll get into after. 


    14:38 A normal pregnancy


    Kelsey: I got pregnant in March. I was due November 28th. I had a super easy pregnancy. I was nauseous for the first little bit. I was working for a virtual school in Ontario so I didn’t have to go into the school which was really nice. I just got to hang out in my basement and yeah. I mainly had nausea as a symptom but I was also extremely anxious because it had taken us so long to get pregnant. It felt like it was so long. It was about 15 months. 


    I was super anxious. I had heard so many stories of miscarriage and whatnot, but luckily, we were followed by the fertility clinic because we were with them so we had a scan at 5 weeks and we had a scan at 8 weeks and then at 12 weeks once we graduated which was really nice. 


    It was a really, really normal pregnancy. I ended up going back into the school in September and I was working as a French teacher. I went off work at 36 weeks. It was pretty normal. The reason I say that I was psychic during my pregnancy is that I kept saying all of these things about my baby. 


    I had this gut instinct that he was a boy and sure enough, it was a boy. Mind you, it’s because my husband’s family only really has boys but then with certain things, people would say, “When do you think he will be born?” I’d be like, “Oh, I think December 4th.” I would make off-hand comments like, “Oh, he’s going to have really dark hair.” My husband and I were both born at 5:00. I was born at 5:00 at night. He was born at 5:00 in the morning. I said, “Wouldn’t it be funny if he was born at 5:00?” 


    I said, “He’s going to be over 9 pounds. I can just feel it. He’s going to be 9 pounds.” Then the other weird thing is that I said he would be born December 4th, but someone told me, “No, you don’t want him to be born on December 4th. He will share a birthday with your cousin.” I was like, “Okay, December 3rd.” 


    December 3rd rolls around and I am 5 days past my due date. I wake up in the morning to go to the washroom and my water breaks. I had not been well-informed about birth. I was just going into it like, Yeah. Everything is going to be fine. I had a bunch of friends who just had babies and everything was smooth sailing. 


    The only time I had heard of a C-section was when my aunt had two C-sections because she had a breech baby and a special scar and then they didn’t give her an option for a C-section. I was like, Oh yeah. It’s going to be fine. 


    My provider told me, “If your water breaks, go straight to labor and delivery.” 


    Meagan: Many do, by the way. 


    Kelsey: Yes, I do know that. 


    Meagan: It’s a very normal thing for people to say, but we don’t have to do that. 


    Kelsey: Exactly. 


    Meagan: I did the same thing, the same exact thing. 


    17:50 Arriving at the hospital


    Kelsey: Yeah, so we went into labor and delivery. Actually, we went slowly. My husband was like, “I’m going to take a shower.” I was under the impression that baby was going to be born in a couple of hours. I was like, “We’ve got to go.” He was like, “No, no. I’ve got to take a shower. First impressions are important.” I was like, “All right.” 


    Then we went and we got Tim Horton’s because I was super hungry. I figured This will be the last time I eat.


    We got to labor and delivery. They monitored me for two hours and I didn’t have a contraction until 6:00 right as I was leaving and I was only a centimeter dilated. She was like, “Come back in 12 hours or sooner if your contractions get intense.” 


    So I went home. I decided to go to sleep but I was having irregular contractions. I woke up probably around noon and I was starting to get uncomfortable. My contractions were starting to get closer together and they were more intense. I could feel them in my back and in my bum. I learned a lesson. Anyway, I’ll get into that after. 


    I could feel them mostly in my back and in my bum. My husband was like, “You look like you’re really uncomfortable. We need to go to the hospital now.” He was afraid of getting stuck in traffic because I ended up giving birth in Ontario even though we lived in Quebec. The reason is the hospital I gave birth at actually takes your RAMQ card, the Quebec healthcare card so we weren’t going to be charged for it or anything. The Gatineau hospitals are not known for being super well-equipped for much so we preferred to give birth in Ontario. 


    We drove to Ontario which was a 30-minute drive so not super terrible, but traffic can be bad going across the bridge sometimes. The whole way there, I had really uncomfortable contractions. 


    We got to the hospital and the doctor had me in the waiting room for 30 minutes, not terrible. The doctor meets with us and immediately, I just was not into him. He just put me off. He made an off-hand comment about nurses. He was like, “I see pain. Do you want pain medication? Do you want Advil or Tylenol?” I was like, “Whatever you can give me, I don’t know.” I told him, “One of the things going into it is that my husband would really like to catch the baby. Can we do that?” 


    He was like, “Well, do you think you can handle it?” I’m like, “Well, he was a firefighter so he’s pretty okay with that kind of stuff.” Yeah. I can’t even remember the comment now, but he made an offhand comment like, “Well, that’s what nurses are for,” or something like that. I just was super put off by him. 


    We went into our room and I didn’t know at the time that maybe I could have asked for someone different or whatever. We go into our room and we get set up and they were like, “We have to monitor you for a little bit.” I was like, “I’d really like to labor in the tub. Can I get in the tub?” They said, “We need the monitor on you for an hour.” I’m like, “Okay.” 


    They monitor me for an hour. They give me a shot of Demerol or whatever. I was under the impression and my mindset going into it was that when you give birth, you use pain medication as pain management. I hadn’t researched anything else. I was just like, “I want the epidural as soon as I can get it and whatever you can give me for the pain is great.” 


    21:37 Stalling at 7 centimeters


    Kelsey: I was monitored for about an hour and they let me get in the tub. For two hours, I laid in the tub and that’s my best memory of my birth with my first. I laid in the tub and listened to music. My husband and I were in the dark. It was very calm, soothing, and relaxing. When I got out, the doctor was like, “We need to check you.” He checked me and I was at a 1 but he could stretch me to a 3. He said, “If you want your epidural, you can have it now.”


    I didn’t know any better so I said, “Yeah, okay. Give me the epidural.” Overnight, I was progressing 2 centimeters every 2 hours. We got to 3:00 in the morning. I told a nurse, “I feel a lot of pressure in my bum.” I said, “I feel like I have to push.” She checked me and she was like, “No, no. You’re only at a 7.” 5:00 AM rolls around. My nurse comes in again and she checks me and she’s like, “Oh, you’re at a 9.” Another nurse comes in right after and she says, “She’s not at a 9. She’s at a 7.”


    The two of them were like, “We need to get a doctor in here to confirm.” It’s 5:00 AM. The doctor didn’t show up until close to 7:45. He’s like, “I’m not going to check you because the changeover will happen in 15 minutes and the new doctor is going to check you. I don’t want to introduce any more bacteria.” 


    The new doctor came in at 8:30. She checked me and she goes, “No, you’re still at a 7. You’ve been stuck at a 7 for a few hours. We really need to start talking about a C-section.” It was the first time she had seen me. I had been lying in a bed now for almost 12 hours. They gave me the peanut ball for 2 hours and then they took it away I think because my son’s heart rate had started to go funny or they lost it or something like that but he was doing fine. 


    They lost it because he moved or whatever. They took the peanut ball away and nothing showed that he was under any distress at all but she was like, “You’ve been stuck at 7 for a while so I want you to talk about it with your husband.” I was in tears because again, the whole time, all I said to my own provider was, “I don’t want a C-section. I don’t care what happens. I don’t want a C-section.” 


    So I’m in tears. She’s like, “Talk about it with your husband.” She comes back an hour later and we were like, “We want to wait a little bit longer.” She goes, “Okay, what we’re going to do is put you on the highest dose of Pitocin.” She was like, “We’re going to start you on Pitocin and every 5 minutes, we’re going to increase it until you’re at the highest dose. Then we’ll wait 2 hours, check you again, and if you haven’t gone anywhere, you’ll have to have a C-section.” 


    I didn’t know any better so I was like, “Okay.” They started me on the Pitocin but I’m having intense pain and pressure in my bum. I’m like, “I feel like I have to push. My body feels like it is pushing.” I knew that if you pushed too soon, your cervix would swell. That’s one of the few things I did know. 


    They put me on Pitocin and I was crying because I was panicking. My husband was having to push my bolus every 15 minutes when it came on because I could feel everything through the epidural. The nurse was not super kind about it. She was like, “You need to stop pushing. If I check you now and you’re not an 8, then you’re going to have a C-section.” 


    She just was not overly compassionate or anything. Well, finally, she suggests, “Why don’t we put you on your hands and knees?” She put me on my hands and knees and I felt immediate relief. Something changed in baby’s position. I sat there and I was able to talk. I was comfortable and I was fine. I think we got to an hour and a half and then they checked me because what happened was they put me on my hands and knees and my feet lost circulation and turned purple and went numb. 


    Yeah, so then they put me on my back again. They checked me and they were like, “Oh, you’re at a 9.5.” I’m like, “Yes.” I progressed. 


    26:22 Asynclitic and OP positioning


    Kelsey: Finally, we got to 10 centimeters and I was a typical you push on your back type of thing. The doctor said, “We cannot wait to let baby descend. Your water has been broken too long.” Then she checks me and she’s like, “Oh yeah, and baby’s OP.” I should have learned. Had I done my research, I would have known all that pressure was my OP baby. 


    So she said, “Baby is OP. We’re going to start pushing.” I was so frustrated by her because she would leave the room and then she’d come back and she’d sit there just with her hand inside of me and checking her watch and stuff. She was just waiting for the hours to pass. I’m doing everything I can. 


    Once they told me that I could push, I was like, “Yes. Let’s get this baby out.” I pushed for 3.5 hours and then they said, “We’ll give you 30 more minutes and if you cannot get baby out in 30 minutes, we’ll try forceps but we’ll need an OB to come in because if forceps fail, you will have a C-section.” 


    I decided to push for 30 more minutes and the nurse came in and said, “Let’s flip you.” They flipped me again and I lost all of my progress. They had also told me that not only was baby OP but he was asynclitic so his head was tilted to the side. They said, “That’s probably what’s happening.” But when I flipped, I lost my progress. There was a new nurse who couldn’t figure out how to get the monitor on me so I couldn’t push in that time. They were like, “Well, we’re going to stop pushing because whatever.” 


    30 minutes passed and I had lost all of my progress. They’re like, “Okay, we’re going to get the OB in.” She comes in and she says, “You could tear.” I said, “I would rather tear than have a C-section. I don’t want to have a C-section.” 


    Then I said, “What are the chances that this will work?” She said, “I wouldn’t do it if I didn’t think it would work.” As she tried to get the forceps on, I could feel my body pushing. I’m like, “Can I push? Can I push?” She’s like, “No, don’t push right now.” 


    My body is doing it for me and she can’t get the forceps on so she’s like, “I can’t do it.” As she was trying to put the forceps on, baby started getting tachycardic so they said, “Things are going to get really scary for a minute because this is an emergency C-section. A lot of people are coming in here and we have to turn on alarms in the hallway because we have to get you to the OR really quickly.” 


    Meagan: Wait, so baby’s heart rate is high not low, and just because baby’s heart rate went a little high, they treated it as a true emergency. 


    Kelsey: Yes. 


    Meagan: Okay. 


    29:31 Kelsey’s Cesarean under general anesthesia


    Kelsey: They start throwing clothes at my husband. There were people piling in. I’m in a hospital that is French-speaking. I can speak French but not medical terminology. Nobody is talking to me. They’re all just talking around me and they’re rushing me down the hallway. I’m bawling and I’m like, “I don’t want this.” I have no idea where my husband is. They’re trying to push my legs together but baby is so low that it hurts to do that. I’m telling them to stop and whatnot. 


    We get into the OR and I was inconsolable because I was terrified. They gave me my spinal which didn’t take. They gave me the pinch test and I was like, “I can feel it. I can feel it.” I’m crying, “Please just put me out. I don’t want to be awake for this. I’m scared.” They’re not talking to me and that’s the last thing I remember is saying, “I can feel that,” and they put me out. 


    I was under general anesthesia and I woke up 2 hours later in recovery by myself. It was COVID. It was in December 2021. My husband couldn’t be there. I asked where he was and they said, “Oh, he’s in your room with your baby. Everything is fine.” I was sobbing. The first thing she said to me was, “Everything went great. You are a great candidate for a VBAC.” That stuck with me. 


    The whole way back to my room, I was staring at the ceiling. I couldn’t look at anyone. I was just devastated by how everything had gone. I didn’t think I could ever look at my husband or my baby ever again. I was just like, What happened?


    I hear my husband. He is like, “You need to see. Our baby is here. You should see him. He is so beautiful. He has the most beautiful eyes.” He came around to my bed and he passed me my son and nothing mattered. None of it mattered. He was 9 pounds, 8 ounces so I was right. He was born on December 4th which I had said at 5:11 PM. 


    Meagan: Oh my gosh. 


    Kelsey: Yeah. He had a full head of dark hair. He was born in a snowstorm. That was the other thing. I said, “He’s going to be born in a snowstorm,” because my husband and I were both born during a snowstorm and he was born during a snowstorm. 


    Yeah, he was perfect. He was huge and he was chunky and he looked exactly like me. Normally, they look like their dads is what I’ve heard but he looked exactly like me and was so beautiful. 


    Throughout my pregnancy, I don’t like being pregnant because I don’t like sharing my body I’ve learned. Throughout my pregnancy, I said, “I don’t want another. I don’t think I want another.” When he was born and I held him, I was like, “I will do this again in a heartbeat.” 

    34:50 Second pregnancy and VBAC prep


    Kelsey: Postpartum was good. I ended up starting therapy 5 days after my C-section. He latched and he did not have breastmilk for his first feed which makes me really sad. I was devastated from the C-section because I didn’t get to see my baby be born. I didn’t get to hear his first cry. I didn’t get to touch him first and my husband wasn’t there. He wasn’t allowed to be in the room. 


    Postpartum was fine. I was seriously anemic. I was incredibly swollen. I had no knees because I was on fluids for so long and getting around was awful, but I just focused on our baby. He was perfect. He was so easy and 6 weeks rolled around and I was like, “Let’s have another.” But we waited. 


    We decided around 9 months to start trying again and loosely trying because again, we were wondering how long it would take. 


    Meagan: Right. 


    Kelsey: We ended up trying got 6 months and I got pregnant in April of 2023. My due date was December 29th. Again, super, super easy pregnancy throughout. Immediately after my C-section, I decided to look into VBAC because that stuck in my head. I had been listening to a different birth story podcast. I searched for VBACs and there weren’t many and then I searched VBAC in general on Spotify and came across you guys.


    I started listening to VBACs before getting pregnant and I started doing lots of research about it. I learned about the cascade of interventions and how my case was really typical. I started learning about OP babies and how the pain I was feeling correlated with that. I wanted to try for a birth in a birthing center. 


    Now, when I got pregnant with my second baby, I was living in Gatineau but we had a bunch of stuff happen. My mother-in-law ended up splitting up with her husband. We said, Hey, let’s buy a house in Ontario together and we’ll move in. 


    I found out I was pregnant about 2 weeks before we put in an offer on a house and we moved in in July when I was 15 weeks pregnant. At the time, my GP was my provider for my first and I started off with her with my second as well. The thing was when I found out I was pregnant, I went to her. Sorry, I should have said. 


    After my C-section, I went to her and said, “I was told I was a good candidate for a VBAC.” She said, “Yes, but you cannot go over your due date. We’re going to monitor your baby to see how big it is because you had a big baby before. You cannot be induced. You need to have 18 months between pregnancies.” Typical. 


    Meagan: All of the red flags. 


    Kelsey: Yeah. This was before I started listening to your podcast. Then I started listening to your podcast and when I went in to see her when I found out I was pregnant before I had gone into a birthing center, I said to her– and I’m not an outspoken person. I struggle to advocate for myself. I said, “I want to try for a VBAC, but I do not want you to put limitations on me.” I said, “I know that I can safely have a VBAC even if there is less than 18 months between my pregnancies. 


    From birth to birth, it was 2 years and a bit so it didn’t matter. I said, “I know that big babies are 10 pounds+. That is macrosomia. I know that.” I said, “I know that I can’t be induced.” In Canada, they generally don’t do Pitocin for VBACs at all. They don’t generally induce for VBACs at all. I said, “I do know that there are safe ways to induce though and I do know that I can safely go past my due date.” She said, “I believe in informed consent and if you understand all of this, I think that you are well prepared and we can move forward with a VBAC.”


    I said, “Great.” I had applied for birthing centers prior to this but it is really hard to get into them here. I ended up being able to get into one in Gatineau. I was concerned about moving over cross-provinces again. It ended up working out. I did stick with my GP until I was about 20 weeks pregnant just in case. 


    It didn’t work out with the birthing center after my move. What happened was, she was super, super supportive, but she would say things like, “Do you want me to book you an appointment with an OB just in case?” or “Do you want me to book you a C-section at 40 weeks just in case?” I was like, “No, I don’t want you to.” She said, “Okay,” but around 20 weeks, my midwife was like, “We can keep you on even though you live in Ontario. It’s no problem.” I said to my GP, “My midwife will keep me on.” My GP said, “You sound like a really good candidate so go ahead. I really hope it works for you. I hope that it’s everything that you want.”


    Meagan: That’s good. 


    Kelsey: She was very supportive of it so I felt really good about it. 


    41:07 Switching to midwives


    Kelsey: I switched to the midwives full-time. My pregnancy was super smooth again, but there were little hiccups. I didn’t pass my one-hour gestational diabetes test. They said, “If you have gestational diabetes and it can’t be managed, we will have to transfer care.” Around 37 weeks, I started measuring large and they said, “We think we want to send you for an ultrasound just to be sure of how big baby is.”


    I said, “I know that those ultrasounds aren’t super accurate so I’m not sure that’s what I want.”


    I ended up getting a doula through The VBAC Link. I found a doula. 


    Meagan: Yay!


    Kelsey: Yeah, what was funny about the doula is she was pregnant too and her due date was a week after mine and we found out that we were giving birth at the same place. 


    Meagan: Oh my gosh. 


    Kelsey: So she was like, “I’ll keep you on and I’ll do your prenatal appointments, but I probably won’t be at your birth. I have a partner who is a nutritionist.” She ended up being amazing. My son was in daycare. I got sick a lot and I couldn’t take anything for it so she would help me find natural ways of dealing with a cough. I think I had pregnancy rhinitis for the last trimester. I was constantly congested. I had terrible acid reflux. She originally had prescribed chest openers, but my midwife ended up putting me on medication for it because of the trigger to cough. She was afraid that my cough could trigger my water breaking too early. 


    I couldn’t give birth at the birth center if baby came before 37 weeks. I had to make it past 37 weeks. 


    Yeah, so pregnancy was smooth. I was extremely nauseous in the beginning. It was really hard with a less-than-two-year-old. I kept him home because I’m a teacher. I’m home over the summer. I kept him home over the summer and it was rough because he just is needy and my 9.5-pound baby continued to stay in the 99th percentile for height and weight. He wanted to be carried everywhere but he is so heavy and he is still so heavy. 


    I was a lot more active during this pregnancy than I had been prior. I tried really hard to walk and whatnot and do lots of stretches. Around 30 weeks, baby was still breech and I started to panic a little bit. I started doing Spinning Babies exercises and lots of inversions and whatnot.


    When I first met with my doula, I talked with her about everything. I was able to just spit out facts that I had learned from you guys. She was like, “I’ve never met someone who is this prepared or who knows this much.” She was like, “I have all of this stuff to go over with you, but you already know it.” 


    She ended up as well becoming certified in HypnoBirthing so I took a HypnoBirthing class. I was really concerned about doing an unmedicated VBAC because I didn’t know if I could handle the pain of it. I had originally wanted to VBAC in the hospital, but I watched– what is that documentary with Ricki Lake? 


    Meagan: Um, okay, hold on. 


    Kelsey: The Business of Being Born. 


    Meagan: Yes, that’s all I could think of was Born. The Business of Being Born. 


    Kelsey: My entire perspective on birth completely changed. My husband watched it with me and he was blown away by it. He was just like, “I want that. I want that for us. I want to be a huge part of this. I want to help you through it and be an active participant. Let’s do this.”


    We did the prenatal classes with my doula. He learned all of the pain management techniques. He was so excited for counterpressure and he wanted to be active. He was fully supportive and he wanted to catch our baby. 


    This time around, we didn’t find out the sex of our baby. We wanted it to be a surprise. I was 100% sure it would be a girl. I didn’t even pick out a boy name. 


    Anyway, we get to December 21st. I get checked and she can’t even reach my cervix. It was so posterior. I was super discouraged, in tears discouraged because I was afraid of going past my due date and they were afraid that this baby was going to be so big because I was measuring large. 


    46:14 Beginning of labor


    Kelsey: Overnight, I started to have contractions. They were kind of regular, but they were manageable. December 22nd rolls around and I’m still having contractions on and off and I start feeling sick. I had pulled my son out of daycare to prevent getting sick. 


    I started to get a cough and I was really congested. I wasn’t feeling well at all. I was supposed to go to Costco with my mom that day. I texted her in the morning, “I’m having contractions. Not feeling great. Let’s cancel,” but because my son was home, things started to slow down with the contractions. I said, “You know what? Never mind. I need something to do today.” 


    My mom picks me up and my husband and her are joking that I’m going to go into labor at Costco. We walked the entirety of Costco as I was having contractions. My 18-year-old brother is in the back of the car. I’m breathing through them and he’s like, “What is happening right now?”


    I get home. I started timing them and they were 6 minutes apart. My husband decides that he is going to take our son. He was kind of off work so he took over care of our 2-year-old. I ended up going and taking a bath and all of the contractions stopped. 


    That night, they started again and then on the 24th of December, they were still pretty inconsistent but my doula was suggesting things like, “Oh, if you’re comfortable, have sex, then take a shower. Sit on the toilet and do nipple stimulation for 15 minutes on each side and see if that gets things going.” 


    We had sex and then it all stopped. We kept trying things and then my doula was like, “I just think that maybe your body needs to rest and relax so let’s try resting and relaxing.” Well then, the 25th is Christmas Day and I decided to host Christmas. 


    Meagan: Because that would be a really good distraction. 


    Kelsey: Yeah, I was like, “It’s going to be fine.” My mother-in-law was like, “I’ll cook Christmas dinner.” Prior to that, I had all of these ideas. I’m going to make bread by myself. I’m going to make all of these desserts. I’m going to make puppy chow. I’m going to wrap all of my kid’s Christmas gifts. I’m going to put together his Pikler Triangel we got for him and wrap that. 


    Just all of these things that I wanted to do for Christmas. By the 24th, I was so exhausted from the contractions that I didn’t bake anything. There was no way. But I did host Christmas dinner and everyone told me, “Why? Why are you doing that?” I was like, “Well, it will be easy,” because my husband and I are both from divorced families. We’ll just have everyone over for Christmas, and then we won’t have to worry about going to anyone else. 


    We had my mom and my brothers came over and his step-mom came over and my step-dad came over. It just was not great. 


    Meagan: Like Christmas Vacation where the door keeps opening and all of the family members keep showing up. 


    Kelsey: I know. I was still having contractions. I couldn’t stand up or sit down without having a contraction. 


    I was just exhausted and uncomfortable and felt huge. People are like, “How are you doing?” I’m like, “I’m surviving. Right now, I’m just surviving.” 


    So anyway, finally Christmas Day is over and Boxing Day, I wake up at 7:30. I had a weird contraction. I went to the washroom and I had my bloody show. I was like, “I’m just going to try to go back to bed,” because my son and my husband weren’t up but my back started to hurt. I was like, “Okay, I’m actually just going to get my son up and go downstairs.” 


    My husband got up with me. We go downstairs. We started getting my son ready. I’m like, “I’m going to get in the bath and see if my contractions stop because I’m really uncomfortable.” I called my midwife from the bathtub and I said, “They are 5 minutes apart and they haven’t stopped, but I’m scared to come in because what if this isn’t real?” She said, “If you’re in the bathtub and they are still going, this is real labor. You need to get here now.” 


    51:07 Driving to the birth center


    Kelsey: We get all of our stuff in the car. It was a 50-minute drive to the birthing center. 


    Meagan: 50? 5-0?


    Kelsey: 5-0. 


    Meagan: Okay. 


    Kelsey: The good part was that they were regularly 4 minutes so I could look at the clock and know that I was going to have a contraction and I could breathe through it. I was managing pretty well at that point, but before we had left, my mother-in-law decided to stop me at the door. She was like, “So where are you feeling them?” I’m like, “I just need to go. Please just let me go. I can’t talk to you right now.” My husband is trying to get me out the door too because he knows. 


    We get to the birthing center. It was nice because I could choose the color of my room. They had options for the color of your room so I chose purple. I get into my room. It’s now 10:00. I could hear in the next room a woman screaming, literally screaming. I start panicking. I can hear her yelling, “Get out of me already!” 


    Meagan: Aww. 


    Kelsey: My vagina is on fire! I’m panicking. My midwife says, “I need to monitor you for a little bit, so can you get on the bed? I’m going to monitor your baby’s heart rate and then I’m going to monitor your contractions.” She could get baby’s heartbeat and she couldn’t get my contractions on the monitor. 


    At this point, I’m starting to panic because I can still hear the woman screaming. My husband’s like, “I’m going to get you your headphones.” He gets me my headphones. 


    Meagan: Very good call. 


    Kelsey: He gets me my headphones and puts on my birth playlist. I’m laying there and things start getting really intense really fast. I was panicking that the same thing that had happened with my son was happening again. But I started getting irate and my midwife still couldn’t get the contractions on the monitor. I remember flinging my headphones off and just being like, “I need to go to the bathroom. Let me up. I can’t lay here anymore.”


    She’s like, “Okay. If you need to go to the bathroom, go to the bathroom.” I’m sitting there on the toilet. I’m crying and I’m telling my husband that I can’t do this. In the back of my head, I know what that means, but I couldn’t ration with myself at that point. My midwife hadn’t checked me yet at all so she goes, “I really want to check you because we haven’t done that.” 


    I had to get off the toilet. I didn’t want to and as I was getting off the toilet, I was so hot. I’m flinging my clothes off. I get to the edge of my bed and I’m like, “It’s not me. It’s my body. I’m pushing.” I saw my stomach contort. It was just like my whole body was not me at all. It was so wild to me. 


    My midwife gets me on the bed finally and she checks me and she goes, “You’re at the 7th centimeter.” She said, “You’re a second-time mom so if your body feels like it, it remembers. You can start pushing whenever you want.” It was such a different experience from being told in the hospital, “Do not push,” when I’m at 10 centimeters to my midwife being like, “If your body is pushing, it’s fine.” 


    54:49 Pushing baby out in two pushes


    Kelsey: So she put me over a ball and then she called in the assistant midwife because she was like, “This is happening very soon.” 


    The assistant midwife comes in and that was funny because she goes, “My name is Gabrielle.” I had a friend who had gone to the birth center who had Gabrielle. I turned to her and said, “You know my friend, Kelly.” She was just like, “Yeah.” I’m like, “I heard you’re really good.” She’s like, “Okay, let’s–.”


    So over the ball, my husband tried to do counterpressure on me and I was like, “Don’t. Don’t do it.” But he pressed my tailbone down and that made a huge difference and I just kind of let my body do its thing. They had to flip me a couple of times and I ended up being put on my back to push for the final little bit because they needed to keep monitoring baby’s heart rate. It kept going down every time I had a contraction so they were a little concerned. 


    At one point, they said, “Don’t panic, but we are going to call an ambulance just in case just because we keep seeing this. We’re going to call an ambulance just so that they are here.” Yeah, so I pushed on my back for a while and I remember at one point, she said, “The head’s right there. If you reach down, you can touch it.” I was like, “I’m going to have my baby vaginally.” My husband was like, “Yeah, you are.” I was just so excited. 


    In one push, his head came out and she goes, “Ope, he’s OP.” He was sunny-side up. My husband was like, “He’s looking at me.” Well, sorry. That’s a spoiler. “They’re looking at me. I can see the baby. Their eyes are open. Their mouth is going.” And then she said, “Okay, next time, one really big push,” and he came out on the second push. 


    My husband caught him and put him right on my chest. I was like, “What is it? What is it?” It was another boy, so spoiler alert. We didn’t have a name. I got to hold him on my chest for 2 hours. We did delayed cord clamping. My doula made it in the last 15 minutes and she said to me, “I think Victoria is in the next room having her baby.” 


    Meagan: Nuh-uh. I wondered when you were saying that. I was like, I wondered if that was her doula. Oh my gosh. 


    Kelsey: Literally, our babies were born 2 hours apart. 


    Meagan: Oh, that’s so cool. 


    Kelsey: We were in the birthing center at the same time which was wild. I got to see her on my way out which was really nice. 


    Meagan: That’s so special. 


    Kelsey: Neither of us knew what we were having and we both had little boys. They weighed him and my super big baby was 8 pounds, 3 ounces. 


    Meagan: Perfect. 


    Kelsey: Perfect. Yeah. People were like, “That’s a good-sized baby.” I’m like, “My first was 9.5 pounds. He’s tiny.” My husband got to tell me the sex of the baby which was another thing I really, really wanted. We did delayed cord clamping. We had the golden hour. We just got to sit there and compared to my prior experience, I just felt so cared for. I remember a midwife putting a cold cloth on my head and I thanked her. Her response was, “I know you are grateful. Save your strength.” She was just like, “You don’t need to tell me thank you at this moment. Just don’t talk at all. I know you are thankful.”


    Meagan: Enjoy. 


    Kelsey: Yeah, I was given water in between pushing. My doula sat there and rubbed my eyebrows so I wasn’t tense because I learned about the fear/tension/pain cycle. My husband got to be a huge part of it and he got to cut the cord. He didn’t get to do that with our first. He got to hold our baby. He touched him before anyone. It was just– my husband and I talked about it for a while afterward and he was just like, “You know, why is this not the gold standard for birth? Why is this not what we do every time? This is the most incredible thing.” 


    We recorded the entire thing. 


    Meagan: Yay. If you decide you want to share, post it in the community. 


    Kelsey: There is a 30-minute video out there because my son was actually, so my first birth was 38 hours total. My second birth, I had my first real contraction at 7:30 AM. My son was born at 12:38 PM. There were 5 hours. 


    Meagan: Another five, by the way. 


    Kelsey: I know, so weird. I was not psychic for this birth because I had a boy. I was so convinced I was going to have a girl but he was a little boy and he was baby no-name for four days. We ended up naming him Oliver. 


    1:00:24 Differences in care


    Kelsey: Yeah, I just felt so cared about and looked after. There were differences like my husband had to go out and search for food after I gave birth after my first. He was so exhausted, he couldn’t get out of the parking lot so my mother-in-law had to drive in to bring us food. I ended up scarfing down Popeye’s but I had been intubated and my throat hurt so badly. I ate the world’s driest biscuit and thought I was going to choke and die. 


    But with my second birth, they had a postpartum doula who was there. She offered me lentil soup and a grilled cheese so that was my first meal. 


    Meagan: So much better. 


    Kelsey: Yeah, lovely lentil soup and grilled cheese. My son had been placed on my chest but I still had my bra so they washed it for me before I left. Just small things like that, I felt like I was cared for. 


    Meagan: Yeah, absolutely. 


    Kelsey: We ended up leaving at 5:00 PM. We were home in time to eat dinner at home. 


    Meagan: Yeah. Yeah. 


    Kelsey: That postpartum experience was incredible. We literally, I was able to get up and walk and I wasn’t dizzy or anything. I barely felt like I had a baby. I did have a second-degree tear but for some reason was just completely unbothered by it. My midwife came to me postpartum which was really lovely. 


    1:02:11 Enterovirus


    Kelsey: However, one thing I did want to touch on was I had a cold during labor and this is something I wanted to mention because it is not something I knew about. I had a cough and five days postpartum, on New Year’s Eve, my doula came. Not my doula, my midwife. As they do, she temped my baby and he was measuring a little hot. She temped him a second time and he was normal. 


    Around 4:00 AM on New Year’s Day, I realized he was very warm. I temped him and he had a fever. I only know Celsius but it was 39.9 which is really high. I temped him a second time and he was 39.2. Anything over 38 is a fever. I ended up having to take him to the hospital and I didn’t know what the protocol was if your baby gets a fever below two months. 


    We were pretty much admitted on the spot. He had the full workup. He had bloodwork done. He had a lumbar puncture done. He didn’t have a birth certificate and had to have a lumbar puncture done because the problem was that they were looking for infections. When they did his lumbar puncture, they did find something. He had a virus called an enterovirus. In adults, it’s just a common cold, but if you get it while you are pregnant, you can pass it through your placenta to your baby just before you deliver and your baby can be born with the virus. 


    It can just present as a fever, but it can also progress to viral meningitis. 


    Meagan: Oh, scary. 


    Kelsey: My son was kept in the hospital for two nights. Because of the fever, he stopped nursing. He was super sleepy and they make you stay for two nights even if they perk up and are nursing and everything seems fine. They will keep you for two nights because they are looking for things to grow on the lumbar puncture. If a fever indicates an infection and because the blood/brain barrier is so thin, infections can spread super quickly to the brain. 


    Meagan: Scary. 


    Kelsey: He ended up being okay. He didn’t have viral meningitis and I had the most incredible angel nurse while I was there. I was so grateful for her. I forgot my Peri bottle at home and she made me one. She did everything she could to prevent my son from being put on an NG tube while still getting the fluids he needed. She managed to get him nursing enough that we didn’t have to switch to an NG tube. We didn’t have to switch to bottle feeding. He continued to nurse. 


    She stuck up for me when a resident came in and was like, “Well, what’s his urine output like?” I was like, “I don’t know. I have no idea.” She was like, “All of that is in his chart if you just check it. She’s obviously very tired. Leave her alone.” I had a lovely angel nurse but it is something I wanted to touch on because I had never heard of enterovirus. I did know what to do if your baby got a fever, but it definitely is that you take them right to the emergency room. Generally, they will admit you for two days. 


    But yeah, otherwise, my postpartum experience was night and day compared with my C-section. I was up and moving and I did experience baby blues with my first. I cried for weeks. With my second, I was just so over the moon. But yeah, that’s my VBAC. 


    Meagan: I love it. Thank you so much for sharing that. I had actually never heard of enterovirus.


    Kelsey: Enterovirus.


    Meagan: Enterovirus. I was like, What the heck? That’s actually with an E. I didn’t know that. I just Googled that so it’s really, really good to know that’s a thing. It does look like it’s pretty rare but it’s something to take seriously. Sorry, my dog was barking in the background. He’s got something to say too.


    I’m so happy for you and I’m so happy that you could see that it was a very similar situation with an OP baby and things like that and you were still able to deliver vaginally. Maybe it was a little bit of that asynclitic position that maybe made it a little harder to get under that pubic bone. It sounds like in ways they were willing to help you, but they also didn’t help you too much either. 


    Kelsey: No. 


    Meagan: Yeah. I just love that you were able to prove to yourself too. Not that we have to prove anything to ourselves or anybody, but it is definitely nice when you are like, This is the same situation and look, I did it. Yes, my baby was a little smaller, but it probably wasn’t the size more than it was just a slight bit of position and probably the cascade. 


    I love that.


    1:08:02 Risk factors for forceps and vacuum deliveries


    Meagan: Okay, so before I let you go, I wanted to touch a little bit more on those risk factors for forceps and vacuum because we talked about that in the beginning and tearing. Tearing is definitely a risk. You even said with your VBAC baby that you tore a little bit which is really common with a posterior baby coming out vaginally too just to let listeners know. 


    Tearing can happen. It can happen with any baby. We can get rectal pain. Posterior babies, oh my gosh. Amazing to not only labor with one but push one out. It is hard work. You did an amazing job. Yeah. It may have a lower chance or a higher chance of coming out vaginally just in general. 


    For baby, that bruising to the head or even nerve damage. It’s really rare but it is a thing. Temporary swelling, skull fractures– again, it’s rare but it is a thing so these are all things to take into consideration. 


    For vacuum, we’ve got weakened pelvic floor, tears as well, possible even larger tears weirdly enough so that’s a thing and then yeah, for baby, the suction can pop off and need to be replaced or cause hematomas there. 


    Just all things to take into consideration. In the show notes, I know this wasn’t a complete forceps delivery, but because it was something within your story, I wanted to touch on that today and make sure we included links. If you guys want to learn more, check out the show notes. Also, I just think it’s so fun that you and your doula were at the birth center at the same time giving birth at the same time. There are so many fun things about this story. Amazing support it sounds like from your husband, from your family, and from all of the things. I just loved your story and appreciate you so much. 


    Kelsey: Thank you. Thank you so much for having me. 


    Meagan: Absolutely. It’s been such an honor. 


    Closing


    Would you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.





    Support this podcast at — https://redcircle.com/the-vbac-link/donations

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    1h 10m - Jun 5, 2024
  • Episode 305 Perinatal Fitness with Gina Conley from MamasteFit

    The amazing Gina Conley from MamasteFit joins Meagan today to answer your questions all about perinatal fitness! Gina is a birth doula, perinatal fitness trainer, and founder of MamasteFit. ​​In partnership with her sister, Roxanne, who is a labor and delivery nurse and student-midwife, MamasteFit is a place for women to find education courses and fitness programs to be their strongest selves during each stage of motherhood. 


    Gina shares her expertise on how exercise affects babies during pregnancy, labor, birth, and postpartum. She also touches on topics like when to start prenatal exercise, what to do if you didn’t exercise before pregnancy, how late into pregnancy you can exercise, weightlifting, and which movements to incorporate to create more space in the pelvis. 


    Gina’s comprehensive prenatal fitness book, Training for Two, will be released in September 2024. It is a fantastic resource for all pregnant women!


    Link to Gina's Book: Training for Two

    MamasteFit Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    01:00 Review of the Week

    03:59 Is it bad to exercise during pregnancy? 

    09:00 How will exercise affect my baby’s development? 

    13:40 Better pregnancies, better birth outcomes

    16:23 What do I do if I wasn’t active before pregnancy?

    19:30 Movements to incorporate

    20:59 Three pelvic levels 

    23:19 The mid-pelvis and outlet

    25:56 Being told that your pelvis is too small

    30:36 How late in pregnancy is okay to work out?

    32:31 When is it too late to start exercising during pregnancy?

    34:43 Postpartum fitness

    39:20 Weightlifting and pregnancy

    45:51 Training for Two


    Meagan: Hello, everyone. Welcome to the show. We are going to be talking about prenatal fitness today with the one and only Gina Conley. Gina is the founder of MamasteFit, a prenatal fitness training company based out in North Carolina. Gina is a fitness trainer specializing in pre and post-natal fitness and a birth doula. She combines her expertise in both to prepare her clients for a strong pregnancy and birth. 


    Fitness in general is one of my all-time favorite things to do and talk about. I do notice a difference when I’m not moving my body, but when it comes to pregnancy, there are a lot of questions surrounding fitness. Is it safe? When is it okay to start? Is it really okay to start later on? How to start? And so much more. 


    I can’t wait to dive in on all of the amazing information that Gina is going to share after the Review of the Week. 


    01:00 Review of the Week


    Meagan: Just a reminder, if you have not left a review, I would love for you to do so. You can leave a review on Apple Podcasts, Google, Spotify, Facebook, or wherever you listen to your podcasts. 


    Today’s review is by Janae Rachelle. It says, “The Best There Is.” It says, “I am so happy I found this podcast. After having two prior C-sections, I was convinced I would have to have another C-section for my birth this November. I feel empowered and educated and hopeful I can do this. Thank you for all of the true facts and the safe space where we can all talk about our birth trauma and space where we don’t sound ‘crazy’ for wanting to do something God created our bodies to do.”


    Thank you, Janae Rachelle, for leaving that review. You are right. This is that space. This is the space where we do talk about all of the crazy things, where we talk about the trauma, where we talk about the things where in the outside world if we were to discuss them, people would and sometimes do look at us like we may be crazy. But Women of Strength, if you are wanting to pursue a VBAC, if you are wanting to learn about the evidence about VBAC, this is definitely the place. 


    All of these stories here are going to share so much information, guidance, facts, and all of the things, and definitely leave you feeling inspired. 


    03:59 Is it bad to exercise during pregnancy? 


    Meagan: Okay, it’s been so fun. We’ve actually had just a couple of returning guests from the show who have also been on 2-3 years down the road. Before we started recording, Gina was like, “I just had someone say that they listened to my episode that was on your podcast before”, which was 3 years ago. It’s fun to see that people one, are still listening all the way back to 3 years ago and then two, have you back on the show. So welcome. 


    Gina: Absolutely. Thank you for having me. 


    Meagan: Yes. It’s such an honor. You know that I just love you to pieces. I’m so excited to talk about fitness, prenatal, postpartum, and all of the things today because this really is a topic that as a first-time mom, I didn’t really know much about. When I was first pregnant with my daughter who is now 12, I was just determined. I was like, I’m going to run. I’m going to run a half marathon. This is going to be so great. I’m going to be one of those running through with a big belly. 


    I was so excited to be fit and active. Let me tell you, I was the opposite of that. When I was training, I started having round ligament pains and pelvic pains. When I talked to my doctor, he actually told me to stop. He told me to stop which is kind of crazy to me looking back that it wasn’t even just like, “Maybe do less miles or don’t train for a half marathon right now, but do a 5k.” It was just like, “You should just stop. It’s too much.” 


    I don’t know why I took that advice as, Okay, I should stop and I should eat Chinese food every day because orange chicken sounded amazing and I should really just not do anything besides be unhealthy.


    That’s truly how I felt like I was in my first pregnancy. I don’t think providers all over the world are telling people not to work out necessarily like mine did 12 years ago, but I think that it’s a very daunting topic and we don’t know what to do. I think a lot of people who may not be very physically active before pregnancy are unsure what they can do during pregnancy, if it’s safe, and all of the things. 


    We have a big list of questions today to ask you and really, number one is Is it bad to work out during pregnancy? My easy answer is no, but I think it’s a real answer. Can we talk about that? Working out during pregnancy– is it bad? Is it good? Tell me all of the things. 


    Gina: There is a lot of fear-mongering and fear involved with exercise during pregnancy. There is this really long list of things that you shouldn’t do so it gets really overwhelming to know, Well, what can I do? when the majority of the things that you see are Don’t do sit-ups. Don’t do this. Don’t do that. If you lift weights, you’ll have a miscarriage. 


    A lot of fear that comes with fitness during pregnancy is, Is it going to affect my baby’s development and growth? Am I harming my baby by exercising? And then the second is, Is it going to affect my pregnancy length? Am I going to have a miscarriage or go into pre-term labor because I was exercising during my pregnancy? 


    The answer to both of those is generally no. Just as a disclaimer, there are absolutely complications in which the benefits of exercising do not outweigh the risks of exercising. These are usually folks who have preexisting heart and lung conditions, if you have uncontrolled diabetes, if you are actively in pre-term labor, if your placenta is detaching, or have severe preeclampsia. There are circumstances in which exercising is not safe and your provider should be very clear in communicating that to you. You will probably already have preexisting exercise recommendations if it is a preexisting health condition. 


    But for the majority of us who are of a normal-risk pregnancy, even some high-risk pregnancies, exercise is typically very safe to do. So a lot of research supports that it does not cause miscarriage and it does not affect the length of your pregnancy which is one of the major concerns with exercising. The risk of miscarriage is highest in the first trimester and it doesn’t differ whether you exercise or you don’t. 


    Exercise does not cause miscarriage. It’s just something else that folks like to be blamed for when they do have a pregnancy loss. It was because I went running. It was because I lifted weights. Typically, there is nothing that you could do do prevent that pregnancy loss and it just sucks to be mourning this and then to have this additional guilt put on you like it was because you were lifting weights. There are people who are sedentary and don’t exercise at all and have miscarriages. Are we blaming them that it’s because you didn’t exercise? No, because it’s one of those things that is out of our control. 


    09:00 How will exercise affect my baby’s development? 


    Gina:The second thing is, is it going to affect my baby's development? Like, is it going to make them too small? Is it going to make them too large? One of the things that can make your baby too small is the placenta. So if the placenta hasn't developed properly or there's an issue or complication with the placenta, it can make your baby too small. 


    Well, exercise helps to improve the function of your placenta, especially if you exercise in the first half of your pregnancy, which is really cool. Your placenta will be more voluminous. It'll be larger and it'll have improved functional capacity. It's going to be able to transfer oxygen and nutrients to your baby much more effectively. It's going to help provide immune function to your baby. It's going to provide hormone function to your baby. It's also going to help remove metabolic waste more effectively. It's going to be a much more efficient organ, which is going to help to support your baby's growth. 


    The second half is like, is it going to make my baby too big? I think most folks are not concerned about exercising and making their baby too big, but exercising could decrease the risk of developing gestational diabetes. Obviously, you can still exercise and eat super healthy and still develop gestational diabetes. It's not a foolproof method to avoid it. 


    But exercising can help reduce your risk of developing gestational diabetes by 39% which is pretty substantial. And if you do develop it, continuing to exercise and eat well can also help to reduce the risk of you needing to get insulin or medication to manage your gestational diabetes. Those are the things that are contributing towards developing a baby that's too large. So having gestational diabetes that's controlled with insulin, uncontrolled gestational diabetes, and those two things can be mitigated with exercise. 


    Exercise can actually help your baby grow more optimally, to have really good body composition, and be a really good size.


    In addition, which is really cool– and this is stuff that I was researching when I was writing my new book, Training for Two, which comes out in September. I'm really excited about it. I guess it's like the twins in my current pregnancy. 


    Meagan: It’s awesome. 


    Gina: But one of the things that I was researching because our editor was like, “We really need to highlight why exercise is so beneficial for baby because this is something that's going to help motivate people to move their body.” Something for me that has been helping to motivate me during my current pregnancy to move when I'm kind of like, But I don't really feel up to it is one, it helps to improve your baby's nervous system development, which is really cool. It helps to increase their blood volume as well. They have more blood reserve to respond to the stresses of labor and to postpartum after they are infants. 


    When they're in the world, it improves their brain development. They have more cognitive function. And these are all things that are probably in response to the stimulus of exercise. So we're introducing more stimulus to them during exercise because of this controlled stress that we're introducing which is helping to build all these new neural pathways and helping them just start doing things a little bit earlier. 


    What that translates to in the first year of life, they have more motor skill development, so their fine and gross motor skills. They're crawling earlier, they're walking earlier, they're rolling and doing things earlier. They have more cognitive function. That's responding with higher levels of IQ and improved language skills. 


    Meagan: Wow. 


    Gina: So there's a lot of benefit to just being active. It doesn't have to be go and lift super heavy weights. It can just be going for walks every day, doing yoga every day, and doing intentional movement throughout the day is exercise. It doesn't have to be like how I exercise. Then what happens is that even though there are all of these benefits to exercising and fairly little risk unless you have like a complication which your provider will ideally walk you through. 


    Even though there are all these benefits, there's still a lot of fear involved with working out during pregnancy. A lot of it's just outdated guidance and folks. I think it probably relates to the fear of women lifting weights and exercising, too. Maybe it's a little bit of that as well. And then make it somebody who's pregnant and it's just like a double whammy. So we have this mentality of like, Well, it's better to be safe than sorry


    And it's like, Well, actually, you can be sorry. You can actually be sorry if you don't move your body intentionally during your pregnancy because one, not that your baby would be less developed, but we're going to say no thanks to those additional development things that they're having with the nervous system and their brain development. Those are two really big deals, I think. We're going to say no to a larger, more functional placenta which really helps to decrease the risk of developing certain complications during pregnancy. We're going to say like, I'm good with increasing my risk of developing like a prenatal complication, which again, exercising does not equal no complications, but it does reduce the risk to include preeclampsia, gestational hypertension, and gestational diabetes. 


    13:40 Better pregnancies, better birth outcomes


    Gina: And if we have a healthier pregnancy, it's going to serve us better during labor as well or in the preparation for labor. We develop complications. It increases the necessity of a medical induction. It increases the number of interventions that were being used during our birth. And yes, I am so thankful for medical intervention, for C-sections, and for these things that save lives. But if we can use less of them because we're healthier going into our birth, that's going to help improve birth outcomes as well. 


    This is a VBAC podcast. So if you're wanting to have a vaginal birth after a C-section, being healthier during your pregnancy by moving your body intentionally is a really good way to help reduce the risk of needing these additional interventions. I'm thankful for them. But if you don't need them, let's go around that. Let's do that path. 


    Meagan: Let’s avoid them if we can. Absolutely. And let me tell you, talking about my first pregnancy where I just kind of quit, I mean, I didn't even really walk. I mean, not even like a 30-minute stroll at night. I just stopped and I really didn't pay attention to my protein intake or what I was really eating. I mean, I was literally told this at the end that I was unrecognizable. Everything about my body was trying to just make a baby and it was showing in a negative way because I was struggling. I got super swollen. I gained a lot more weight. I really was not in shape. 


    When labor came, it was harder. It was a lot harder. And then postpartum was really hard. And then having to catch up to all the things that I did to my body, but then not even to think about all the things that you just said about the baby. I mean, I was one of those people that signed up to the “no thanks”. I mean, essentially, right? It wasn't in my head that I was saying that. And then after my, that pregnancy, I was like, I will not do that again


    I did. I started changing my ways and doing intentional movement. I became a Barre coach and really wanted to be active. It was a night and day difference, night and day difference. I don't think my baby's less smart or whatever, but I will say that like what you said, I can look back and be like, Oh, oh, I can recognize those things. So that's kind of interesting. 


    Gina: So it's not like if you don't exercise, you're screwing up your baby’s life or anything. I don't know how to feel the differences between the two, but if you can do things to help improve your baby's growth and development, I think we would want to do that. Even if it's just going for a walk, just move your body. 


    16:23 What do I do if I wasn’t active before pregnancy?


    Gina: I think one of the things is the next question that's on the list is like, Well, what do I do if I wasn't active before pregnancy?


    Meagan: Yes. 


    Gina: Because I do have folks that'll either come to my gym– we're located in Aberdeen, North Carolina. We have an in-person training facility. And so we'll have folks that show up and be like, “I have never exercised before in my life, but I heard it's really good for me and I'm pregnant. Help me.” You can absolutely start an exercise program during pregnancy. This is hard to know because you get told, “Whatever you're doing before pregnancy, you could just continue during your pregnancy, just do a little bit less.” 


    What if I was not doing anything? How do I do less than that? Like what does that even look like? 


    Meagan: Right. 


    Gina: You can absolutely start an exercise program during pregnancy. Yes, it will look different than pre-pregnancy workouts. If you were an active person before pregnancy, there will be some sort of modification that needs to happen because workouts can't look exactly the same when we're pregnant. But if you're like, Okay, how do I even begin? Just pick 20 minutes where you go for a walk. Pick 20 minutes where you choose a Peloton on-demand video. They have prenatal ones on there too where you just follow that. We have prenatal on-demand workout videos as well. We also have a prenatal app-based program, so we have some different options as well. 


    Just choose a 20-minute option and just move. Just move your body. Use lighter weights. We're not trying to get super sore. You probably will be sore the first week or so. It's just part of getting used to the program.


    Meagan: It’s not normal, yeah. 


    Gina: It's normal, but don't be working out so hard that you're incapacitated the rest of your day, start for 20 minutes and do that three times a week, and then the next week do it four times and then increase it to 30 minutes. Then maybe it's 40 minutes and then you're walking more. We're just going to start really slow and manageable, and then we're going to just slowly increase during pregnancy. 


    The main goal during pregnancy is 150 minutes of moderate-intensity activity per week. That's the minimum goal. So if you exceed that, that's totally fine. Research supports that even higher-intensity activity is perfectly safe during pregnancy. A higher volume of exercise is perfectly safe. But the bare minimum that we're trying to aim for is 150 minutes. That's five days a week for 30 minutes or whatever the math is for the other one. 


    But you can also do more than that. I would start with 20 minutes of something that feels manageable for you and do that and if it's, “Hey, I need to follow a program,” we've got programs for you. We've developed them for pregnancy specifically. There's Peloton on-demand. There are so many workout programs out there for pregnancy too. They're going to have safe modifications for you. 


    You can hire a personal trainer. You can join an in-person gym. We're just looking for you to move your body in a way that feels manageable for you and it's okay if it's not perfect pregnancy workouts either. Now if you're an active person or you're like, Okay, I have done my month of exercising. I'm feeling more confident, this is where we can start to really ensure that our workouts are not only keeping us active and moving us during our pregnancy but also helping us actually prepare for birth. 


    19:30 Movements to incorporate


    Gina: Common workout programs are really focused on front-to-back type movement patterns. This is the sagittal plane. This is like squats, deadlifts, cleans, clean-and-jerks, box jumps. Everything is very front-to-back because this is the way that we move our bodies. When we walk we typically walk in a front-to-back movement pattern. 


    However, we also need to be moving laterally and rotationally as well which is another myth. Can I twist during pregnancy? Yes, you can twist. It’s necessary to twist. If you don't twist, your back will hurt. I promise you it's okay to twist. Now we don't want to do such deep twists that we’re compressing our belly because it would be really uncomfortable. Not because it would be harmful for you, but we want to we want to be comfortable during our pregnancy. 


    We want to also be incorporating movement patterns that are in other planes of motion ot just front-to-back. We also want lateral movements like lateral band walks, side lunges, and movements where we're just we're going in this direction. And then we also want rotational movements. So like when I'm doing lunges, I'm adding an internal to an external rotation or I'm doing a rotation with a core exercise. 


    We want to think about what type of movements are we incorporating or are included in our workout programs because that is really important to creating space in our pelvis which is not the point of this episode, but fitness can really relate to labor in that aspect as well. It's keeping you strong during your pregnancy. It's helping to support your baby's development. It's helping to decrease your risk of complication but we can also use it to help prepare for our birth. 


    20:59 Three pelvic levels 


    Gina: And so there are three pelvic levels and I'll go over this super quick. The top opens in one way, then we have the middle, and then we have the bottom. We have inlet, mid-pelvis, outlet, and they all open with different types of movement patterns which is where moving in different planes of motion is going to be really helpful. The top of the pelvis opens with wider knee movement patterns like an external hip rotation with an anterior tilt with abduction. Legs are moving out. Think knees out, ankles in so really deep squats for example. 


    An anterior tilt or arching your back is going to be really helpful because this makes it easier for you to find external rotation. It also changes the pubic bone angle and makes it easier for baby to enter into the pelvis. The good news is we already do that during pregnancy. That's a common postural tendency that we have. We like to live in that position. It's comfortable for us. We have more weight on the front. We're just extending in our spine and just loving that spot. 


    However, we also need to be able to find other types of movements such as a posterior pelvic tilt or rounding in the back. This one is really important to opening the top of the pelvis in addition to an anterior tilt. So with a posterior pelvic tilt, we have this big chunk of bone on the back of our pelvis called the sacral promontory that moves backward when we tuck our butt underneath or we round in our back. That anterior pelvic tilt creates a little bit more space in the front half of the inlet and then that posterior pelvic tilt creates more space in the back. 


    We want to be able to shift between the two but because we always favor this extended position, it can be really hard to find that rounded position. If you had a prior labor where baby just never entered and they were like, “Your pelvis is just too small. Baby just can't fit in your pelvis,” it probably was more related to whether or not you can find– and I don't want to blame anybody for what happened with labors but just helpful tips. If you're having a hard time finding a round in your back or tucking your butt underneath, it's going to be harder to create that front-to-back space in the pelvic inlet and it can make it harder for baby to enter. 


    So during our prenatal workouts, we want to think about, Okay, what can we do to help me find more of a rounded position? We can release tension in our lats or musculature. We can release tension in our hip flexors. We can incorporate pelvic tilts into our movement patterns. Those are some things that we can do to help us find this more rounded position. 


    23:19 The mid-pelvis and outlet


    Gina: The next pelvic level the mid pelvis is asymmetrical movements like side-to-side, hip shifting, and so we have a little bit of external rotation and a little bit of internal rotation. We're just going back and forth between the two. 


    Then the bottom of the pelvis with the pelvic outlet is essentially like the opposite of the inlet where we have an internal rotation at the hip where knees in, ankles out is creating more space side-to-side. A slight posterior pelvic tilt can help to make internal rotation easier, but we're not necessarily rounding in our back as we're pushing because it's not really that comfortable. 


    Anterior pelvic tilt or a little bit more lat tension can kind of pull that sacrum back so we're kind of back to that pelvic tilting a little bit in the outlet, but we're really focusing on that internal rotation to create space. But if we recall, our favorite positions during pregnancy are extension and external rotation. That rounded position is harder and internal rotation is harder. In addition, that prenatal posture tends to make the back half of the pelvic floor really tight so we need to one, be able to release tension in the posterior pelvic floor and help us find more internal rotation. We can do that with our prenatal workouts as well. 


    This is where hip-shifted exercises can be really beneficial like finding internal-external rotation with our single leg movements. These are all things that we incorporate within our prenatal programming because we have been observing birth and people working out for a really long time and we want to help you move through your pregnancy and through your birth. We also have a free birth prep circuit that I'll give you the link for that you can put in the notes as well. It has six movements that help you release those common areas of tension. 


    We also have our prenatal fitness program if anybody's interested in working out. We have lots of different options for that as well. But when we're looking at our prenatal workouts, we need to look beyond just one– we just want to be active and intentionally active and then two– we want to think, Okay. Well, how does my workout help to support my birth preparation? How is it helping to create more space in my pelvis? How is it helping me release tension in my pelvic floor? Those are things that are going to help us to support us during birth. Yeah, that was a really long answer to you. 


    Meagan: No, it was an amazing answer. It's interesting because I never really thought when you were like, “Front-to-back”, we focus so much on front-to-back. There's that lateral movement that a lot of the time we skip and I didn't even think of that. I know in your book, we've got a couple of little teasers online within your book. You've been showing different ways to work those sides and move your body in different ways. That is amazing. 


    25:56 Being told that your pelvis is too small


    I love that you talked about the pelvis, the inlet, the middle, and the outlet because I'm pretty sure you probably have known this within the VBAC community. How many times are we told that our pelvis is too small? I mean, all of the time. 


    Gina: It makes me so mad. Once you get told something really random or a fun fact about your pelvis like, “You have a really prominent sacrum or pubic bone.” What does that mean? 


    Meagan: Yes. What does that mean? 


    Gina: How can I take that information and do something with it? Instead of acknowledging that yes, each of us has different types of pelvises. Similarly, we're all from different ethnic backgrounds. Of course, we would have slightly different pelvises. We have different femur lengths. 


    Meagan: Right. 


    Gina: However, we can all still figure out how to squat and figure out how to do movement patterns that make us functional humans even with differing bone structures. It just blows my mind that we don't acknowledge the fact that the pelvis can change shape and diameter and displacement with movement. Our baby is also shape-shifting and wiggling their way through the pelvis as well. But the only person to blame is you. It’s because your pelvis is just too small. 


    Meagan: Right. I know. 


    Gina: Maybe you didn't know how to support me. 


    Meagan: I know I have those same feelings. It's very frustrating. I think it's probably a little extra salt on the wound because I was told that. I was told that I would never get a baby out of my pelvis. Like you were saying, you're like, “Well, maybe I just wasn't supported well enough. Maybe I wasn't given the tools or the positions,” like what you're describing. 


    I mean, with my first labor, I just sat there in the bed, clinging to the side, and then got an epidural and sat there. Really? Like, so I wasn't moving my pelvis. I wasn't doing those asymmetrical movements. I really wasn't working with my body to get my baby out. Okay. So a question that I know that we have received is the anterior placenta. So does fitness change if or what we're doing change if we have an anterior placenta? 


    Gina: Really, if you have an anterior placenta, a posterior placenta, it closes out on the side, it doesn't really matter where it is unless it is covering the cervix. At that point, like, there will probably be some sort of modification, because we don't want to have any sort of cervical dilation or cramping or urinary irritability that can cause the cervix to begin to dilate which may cause the placenta to start to detach which would not be ideal. 


    So typically, if you have any sort of placenta previa, potentially like a low-lying placenta in the third trimester, after 28 weeks, we probably want to modify it to where we're not doing super deep squats. We're not exercising at a high intensity. It's low to moderate. If you are experiencing any bleeding or cramping during your workouts, you’re stopping immediately. 


    But in regards to the placenta being in the front or the back, there really is no difference when it comes to exercise. The baby is pretty snug as a bug in a rug. 


    Meagan: Snug as a bug in a rug. They are pretty protected in there. They are pretty deep in there. 


    Gina: They are. They are. Now when it comes to certain birth options, sometimes an anterior placenta– usually with an ECV if baby’s are breech, providers don’t want to do it if you have an anterior placenta. It may be harder for you to feel your babies. You should feel your baby but it may be muted. You would be like, I kind of feel you, when in comparison, if you had a posterior placenta, there’s a little alien rolling around in your belly.


    Meagan: Right. Or you might not feel kicks until them later on in your pregnancy when someone with a posterior placenta is feeling those little butterfly kicks early one. 


    Gina: Yeah. It will be more muted. But in regards to exercise, the only placenta position that would result in modifications is a low-lying or placenta previa where the placenta is covering the cervix. But usually for those, if you found out at your 18-week anatomy scan, they usually resolve within a few weeks so you can always ask for a repeat scan, but typically, we don’t need to modify until the 28-week mark. But again, if your provider has given you specific guidance on what they consider to be safe for you with exercise because again, they are looking at your medical records. They are looking at you as an individual and this is just a podcast. 


    Definitely go with their guidance, but typically, they do move. There usually is not an issue into the third trimester with that either. 


    Meagan: Yeah. Okay, so good. 


    30:36 How late in pregnancy is okay to work out?


    Meagan: Another question is, How “late in pregnancy” is okay for me to work out? We’re talking about early, what we’re doing. We may be started to feel really good. We may be increasing our physical activity. We might be more mindful. Now, it’s on top of intentional movement. It’s on birth prep and really getting ready for this birth journey. Is there a time when we should cut off physical activity or is it okay to be doing squats and lateral movements and yoga one day and go into labor the next day?


    Gina: You can workout until the day that you give birth. Now, how intense your workouts are will probably decrease toward the end of the third trimester. For us, around the 36-37-week mark, we do certain tapering in the program which means we start decreasing overall volume and intensity of workouts because one, we are just more tired at the end of the pregnancy. We still want to move and be active, but we also need to be in the mind that, Tonight, I might go into labor so I don’t want to be super sore from my workout. 


    Similar to if I was training for an athletic event, not that birth is a competition or anything, I wouldn’t want to be doing my hardest workout the morning of the competition. Again, birth is not a competition but with that type of fitness mentality, you’re like, Okay, well birth is probably going to be physically demanding even if it’s super fast. It’s still physically demanding. I probably don’t want to be super sore or super fatigued going into that. 


    So around the 36-37-week mark, you can decrease overall volume. If you were working out at 200 minutes a week, maybe at week 37, we are only doing 150 minutes a week, and at week 38, we are doing 100 minutes a week and then maintaining that so whenever your baby decides to come. 


    32:31 When is it too late to start exercising during pregnancy?


    Gina: We also get folks who ask, When is it too late to start? I would say if you gave birth, it’s too late. It’s probably too late for prenatal fitness at this point. Kind of like, When is it too late to get an epidural? It’s when your baby is born. When your baby is born, it’s too late to start a prenatal fitness program. 


    We will have folks who are 35 weeks. They are like, I’ll just wait for postpartum. I’m like, You might have 2 months left. That’s a long time. 8 weeks, that’s a whole fitness challenge or whatever. You know those ones where it’s like, “6 Weeks to a Bigger Booty”, it might be 6 weeks until a baby. That’s still a good period of time to move your body. It doesn’t have to be training for a PR, it’s just learning how to release tension, starting to build up some stamina, some endurance for the big day. 


    Now, if you’re 38 weeks and you’re in that, I could go into labor anytime, I probably wouldn’t start a lifting program at that point. I would probably be focusing more on yoga and mobility-type things. Walking, just trying to release tension in my body. I wouldn’t be like, Let me go squat and deadlift for the first time in my whole pregnancy. I would do more breathing and stretching. That would be more reasonable to me. 


    Once you hit the 36-37 mark and you’re like, Can I start something now? Absolutely. A prenatal yoga program would be my recommendation. Going for walks and things like that. If you’re 32, 33 or even to 35 weeks, I would say that you can start a lifting program. I would say to start our prenatal program at that point because we do have a monthly option. You can just grab the months that you need. We also have a just third-trimester program on demand. 


    You can still intentionally move, but it’s just going to be a little bit more mindful to the fact that we are kind of at the end of this journey, but it’s definitely not too late to start unless you gave birth. At that point, it’s probably a little too late. But what can you do? 


    Meagan: Now you’re going into postpartum after your baby is born. 


    Gina: Yeah, then we can focus on postpartum stuff. 


    34:43 Postpartum fitness


    Meagan: Which is also a thing. There are postpartum programs. There’s a lot after birth that we can do. I know this wasn’t in the questions that we were talking about but it led into this where a lot of people don’t know when they can start working out after birth. For my second C-section, at that point, I was a Barre instructor and at 4 weeks, I went back before I was technically cleared. I was just following my body doing the very minimal. 


    When is it appropriate to start a postpartum training program? 


    Gina: It depends on the program. We have a free early postpartum recovery course that is intended to start within a few days after birth which is just breathing mobility and some stretches. It’s really, really gentle stuff just to reconnect with our body but it’s not like, go lift weights or anything. 


    Usually, I would recommend doing a gentle program like that for 4-6 weeks. I’ll give you the link to that as well as another. It’s just a program that we offer. After the 10-week mark is when most folks can start to return to fitness. This will vary from person to person, whether you had a vaginal birth, whether you had a C-section, whether you had a hemorrhage, how much support do you have postpartum, and how your healing has been so far. It can really vary from person to person. I can’t even say 4 weeks for unmedicated vaginal birth, 10 weeks if you had a labored C-section because even within that is a whole realm of where you might be. 


    Meagan: It is. 


    Gina: So just giving yourself some grace and knowing that there is plenty of time to return to fitness. Obviously, we don’t want to wait 5 years, but it’s okay. 


    Meagan: You don’t have to jump into it. 


    Gina: Yeah, it’s okay if it’s 12 weeks before you start a program. It will be fine. Again, we don’t want to wait for 5 years. That’s a long time to live with whatever we are having postpartum. Usually 4-10 weeks is when I say if you feel ready and you want to start moving your body, that’s usually a good time to start. 


    We’re looking for bleeding to pretty much be stopped. We’re not having any issues still lingering from birth so we are not having any infections from birth. We are not having post-birth surgeries or anything like that. That may delay things a little bit longer. If you’ve had a hemorrhage, that will delay you a little bit just because your blook is trying to replenish itself from all of that. 


    Sometimes a C-section blood loss or hemorrhage can be a little bit higher, but you can also have severe hemorrhage from a vaginal birth as well. Just honor how you are feeling. 


    Then when you do return to fitness, it is a gradual slow process of reconnecting with this new body. I know there sometimes is this mentality of, I want to bounce back. I want to get back to who I was, especially if postpartum is hard, which it is, or if birth wasn’t what you expected, which it can be for a lot of folks. There can be this, Let me get back to something that reminds me of myself and who I was before so I’ll do my workouts and get back to my workouts. 


    Meagan: That was me. 


    Gina: I love working out. That’s a part of my identity. I can sympathize with that desire, but if we rush that process, it’s going to delay you in the long run. You’ll be 4-6 months postpartum. You’ll be like, Why am I still leaking? Why do I still have a diastasis? I just feel unstable. But when we take the time in the beginning to really reconnect, really focus on the foundational core work, and really rebuild slowly which is painful to do sometimes. Not painful physically, but painful mentally, it really helps so, so much in the long run. 


    So take your time. Again, we have a program to support you if you want it but there are so many programs out there too that suit everyone’s individual needs depending on the sport that you are trying to get back to as well. 



    Meagan: Right, I love how you talked about mentally it can be so hard. It was for me. It just was so hard. I just needed to get out and move my body. I did follow my body, but so what you were saying, mentally it is hard and can hurt us but physically it was too much for me. I did have to take a step back. I went to this hour class. I cut it back, but it set me back 3 more weeks because I was like, Okay, I probably shouldn’t have done that. Noted. Thanks body. 


    Gina: It happens. It happens to the best of us. 


    Meagan: Thanks body for letting us know. I was able to return. I love how you talked about reconnecting with our pelvic floor and all of the things. Breathing in itself is so powerful, so I love that you are focusing on that. We’ll make sure to put in the show notes the link for your program. 


    39:20 Weightlifting and pregnancy


    Meagan: Okay, so last two questions. Weightlifting is a big one. I love weightlifting myself and I follow quite a few accounts who have gone through pregnancy like yourself and weight lifted. I am flabbergasted to see some of the negative comments on pregnant people lifting because it bugs me. It bugs me that people are so negative about it and judging them like, What are you doing? You kind of touched on that earlier. I don’t know why lifting sometimes with women in general, but then add pregnancy to that is really hard. You kind of mentioned that maybe at the end you’re not going to join a weightlifting program, but how can someone start with a very gentle approach to weightlifting? I do feel like especially if weightlifting is not something you are used to, it can be very, very intimidating. 


    I know in your book, you have a section where you’re like, Instead of doing this, try this. Instead of doing deadlifts, try these, which is awesome because it can give us an idea. But can you guide someone who is like, I really want to weightlift but I’m so intimidated to start? What is a gentle way to start approaching that? 


    Gina: If you live by us, you can just come to our gym and we will walk you through it which is usually the easiest way to learn how. If there is a lifting class somewhere or an intro to lifting or even a women’s fitness-type class, that could be a good way to get introduced to, How do I lift safely? 


    Some CrossFit gyms will have Intro to CrossFit which can or cannot be great for starting during pregnancy, but they can at least teach you how to squat, how to deadlift, how to bench press, and there are barbell gyms out there that might have lifting classes. Even just box gyms like Planet Fitness or Gold’s Gym might have lifting classes. 


    Hire a personal trainer to walk you through what to do. That can take some of the intimidation out because you don’t have to walk into this gym into this section that is male-dominated and be like, “Hello. I am pregnant. I am trying to squat. Can you hand me a dumbbell?” 


    So it can be really scary to do that. You can also purchase some weights for your home. Dicks Sporting Goods has really good deals on gym equipment that is very inexpensive. It is cheaper quality so they won’t last you a long time, but if you’re like,  I just need to get started, that can be a great place to go. Amazon has really good sales pretty frequently to get cheap equipment that is still a moderate quality. Rep Fitness is one of our favorites for higher quality equipment that is still affordable then Rogue would be the super expensive brand. I would say them and Rep Fitness are the same quality. 


    It depends on how much you want to invest. You can get the stuff and have it at your home as well. Usually, I would say to grab some dumbbells. If you want to explore barbell, buy a barbell and some bumper plates. They have sets that you can get for that. You can buy yourself a squat rack. That’s if you want to do barbell stuff. You can also do a ton of stuff with just kettlebells and dumbbells. 


    I really like resistance bands. Those are huge in our programming. They are really un-intimidating. They are very easy to use. They are an attachment point for resistance bands. A box to step up on. You can also use a stool. It’s easy to get started, but you just have to figure out what type of environment you want to get started in. Do you want to start with a coach-type environment to guide you through it or do you want to try to figure it out on your own? 


    With our programming, we walk you through how to do each movement especially with the on-demand one so you can see, Okay, this is how I’m supposed to do it, and then there will be some experimenting to figure out what feels good for you in your body to be like, Okay, when I squat, I have to spread my feet out a little bit more and that feels better for me, kind of thing. 


    That can be a good way to get into it. Know that it is safe to do. I think that is probably the first fear that it is safe to do. I think that’s what you were saying. Folks love to comment some hateful things on people who are lifting weights during pregnancy. The comment the same shit on a female just lifting weights who is not pregnant. I don’t know if it’s dudes out there who are feeling very inadequate with themselves that they are like, I cannot stand that there is a strong woman out there so I’m just going to comment and critique her, then like I said before, you add on the additional layer that now she is pregnant and we have this overall belief that exercise is dangerous, people say some horrible things. 


    I’m like, You do know you don’t have to comment on things, right? 


    Meagan: I know. You can actually just swipe on. 


    Gina: Those can be inside thoughts. 


    Meagan: Yes. If you don’t have a nice comment to say, leave me alone. 


    Gina: Yes, because you know what happens? You comment and then you get more pregnancy content on your feed then you’re like, Why is this pregnancy post popping up on my feed? It’s probably because you commented on this pregnant woman who was lifting weights and you said some nasty shit. That’s probably why it’s popping up on your feed, bro. 


    Meagan: I love it. Oh my gosh. I know, but it actually makes me very angry and it’s not even just men. It’s women too. Why do we have to berate people for being active and choosing to lift weights during pregnancy or run marathons during pregnancy or do whatever they want? It is their body. Let them do it and honestly, we need people to share like what you guys do. We need these videos because it does offer us inspiration and also offers us a sense of, Oh, what they’re saying over here isn’t true. I want to learn more about this. 


    It’s so frustrating, but it’s possible. So if you want to lift weights, Women of Strength, and you’re listening, go for it. Go for it. Check out their program. Get the book which we’re going to talk about right now I’m hoping and learn more. Learn more about fitness in pregnancy and the benefits for both mom and baby which we were just talking about in the beginning of this. 


    45:51 Training for Two


    Meagan: Let’s talk more about your book. You said earlier this is like the twin to your current pregnancy. I’m sure this is like another baby. I’m so excited for you. I’m so proud of you. I hope everybody in the world gets it. 


    So tell us more about it and all of the things. You’ve got three parts, right? 


    Gina: So right now, this is just one part to the book. Hopefully it turns into a three-part series so I need your pre-orders so that we can make a second part and a third part. 


    Meagan: Pre-order everyone. 


    Gina: That’s how we get the next two parts. 


    The first part which will hopefully be a three-part series is all about how you can use prenatal fitness to support a strong pregnancy, a pain-free pregnancy and then also use that to prepare for birth because prenatal fitness is not just a list of pregnancy-safe “exercises”. It’s not just take out all of the sit-ups and crunches and all of the jumping and now it’s a pregnancy program which is what the majority of pregnancy programs are. It’s just a bunch of random exercises that just don’t involve crunches and sit-ups. Cool. That’s a great first step. 


    But we can take it way further by ensuring that our workouts are also helping us to prepare for birth. We’re taking the pelvic floor into account. How are we integrating that in the overall system? How are we learning to release tension? How are we increasing mobility within our hips so we can find that internally and externally pelvic mobility. What movements are we incorporating to help increase the pelvic space so we can create more space for baby to navigate through? 


    What kind of movements are we incorporating into our workout that helps us for our baby’s position? We’re not trying to force baby into any position, but we want to make it easy for them to find whatever their best position is. We can do that with our prenatal workouts. The book is going to break that down for you. It’s definitely a little bit heavier on the lifting side so it includes modifications for how to deadlift during pregnancy and how to bench press during pregnancy. 


    All of these main lifts, we incorporate tons of accessory exercises such as core exercises that you can do during pregnancy, what signs and symptoms to be mindful of when doing core exercises, how to protect your core and pelvic floor during pregnancy. We incorporate exercises to help with pelvic stability because pelvic pain is super common but you don’t have to be in pain during pregnancy. 


    Similar to you, my provider when I told him I had pelvic pain, they were like, “That sucks. When you give birth, it will go away.” I’m like, Well, that’s not true. There is a lot you can do during pregnancy to help resolve that as well. 


    The book is a collection of all of the things I have learned through working with in-person prenatal clients and supporting in-person births. Hundreds of clients have helped me gain this information to write this book. My educational background and things that I’ve researched and studied have all been consolidated within this book specifically to prenatal fitness and using your prenatal fitness to stay strong and then also to help you prepare for birth. 


    There is a little bit in there on labor. A bunch of that stuff got taken out because I write a lot. I have too much knowledge in this head of mine so that’s why I need a three-part series then there is one chapter on early postpartum recovery as well. We also include how to recover from a C-section in there. It’s just the first month postpartum so it’s just a taste of what book three will be. 


    So help me get part two and three by pre-ordering the book. It’s on Amazon. I’ll give you the link as well. It’s $24-25. The book comes out September 14th so hopefully after my baby has been born. I will be very sad if I’m 43 weeks pregnant so I will be in the infancy of my postpartum with a newborn when this next baby, baby B has been born and would love your support with preordering it. 


    We’re trying to figure out pre-order incentives right now. We may have a chapter that got cut, so if you pre-order, you get that chapter as a PDF which is all of the labor stuff- how to address labor stalls, laboring positions, what a contraction is. 


    Meagan: So good. 


    Gina: It was such a good chapter, but that will be in part two which is going to be birth. Part three is postpartum fitness so help me get the other parts by ordering the book. 


    Meagan: Yes. 


    Gina: It’s on right now. I am really excited about it. So yeah. 


    Meagan: I am so excited for you. Yeah. it’s $24.99. That is amazing. We will make sure like she said to have the links to all of these things including this book pre-order link in the show notes. 


    Right now, as soon as you are done listening and you’re like, Dang, that was an awesome episode, go down. Click the link and support her by buying her book. It is called Training for Two. She’s absolutely beautiful on that front cover holding her sweet baby bump. You guys, I’m so excited for this book. I’m so excited for you and I’m so grateful that you were with us today sharing all of this information. 


    Gina: Thank you so much for having me. I really appreciate it. 


    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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    51m - Jun 3, 2024
  • Episode 304 Aisha's Surprise Breech HBAC

    Aisha’s first baby was a scheduled Cesarean for a breech presentation during the height of the COVID-19 pandemic. Though she was symptom-free, Aisha tested positive for COVID and was not able to be with her husband or her baby right after birth. Her surgery was routine and uneventful, but the isolation left her devastated.

     

    Aisha moved and was living in Oregon during her second pregnancy. She deeply desired a home birth and found a midwife to support her who also happened to be trained in vaginal breech delivery. Aisha went into labor sooner than expected but handled it beautifully. When it was time to push, surprisingly, feet started coming out first! Her team stayed calm and ultimately brought her baby earthside safely. Aisha is so proud of what she accomplished!


    Evidence-Based Birth Article

    The VBAC Link Blog: ECV Explained

    The VBAC Link Blog: How to Turn a Breech Baby

    The VBAC Link Podcast: Chelsey's 2VBA2C Breech Babies

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    03:31 Review of the Week

    06:10 Aisha’s first birth

    11:16 A COVID-positive Cesarean

    14:38 Third pregnancy

    20:02 Planning for a home birth

    22:51 Breech workshop with Dr. Stu

    24:57 Labor begins

    31:25 Pushing out an unexpectedly breech baby

    35:29 Reviving baby

    40:53 Vaginal breech birth is possible

    49:39 Adding to the supportive provider list


    Meagan: Hey, hey everybody. Guess what? We have a breech VBAC, actually, it’s a breech HBAC coming your way today. We have our friend, Aisha, with us and she is going to be sharing her amazing journeys. We know that when it comes to breech, it is difficult to find support. It is difficult to find the evidence in that and this is one of the number one reasons for Cesareans in the first place. If you have gone through our podcast, we have over 300 episodes at this point, you will probably hear quite a bit that, “Oh, my baby was breech. We tried an ECV and it didn’t work so I had a C-section,” or “My provider didn’t even offer that and I had a C-section.” 


    This is one of the number-one leading reasons for a C-section and it doesn’t always have to be that way. Aisha is living proof of that. Welcome to the show, love. How are you today? I’m so excited for you to be here. 


    Aisha: Yeah, thanks. I’m so excited to be here. It’s like a dream come true. It’s wild. 


    Meagan: It was so fun. Before we started recording, she said that not long after she had her baby, she was like, I’ve got to get my submission into The VBAC Link. 


    Aisha: It was bathtime earlier this week when I saw the email and I was freaking out like, Oh my gosh. It was cool because my daughter is going to be a year old soon, so it was fun to think about her birth and I almost felt guilt because I was like, Oh my gosh, I haven’t listened to The VBAC Link in a minute, but how much this podcast blessed me and strengthened me to go on to have a VBAC, specifically a breech VBAC which was not planned for. It was wild and I’m just really grateful for my provider. 


    Meagan: Yeah, absolutely. I cannot wait to dive into this story. 


    03:31 Review of the Week


    Meagan: We do have a Review of the Week and then we will turn the time over to our friend, Aisha. This is from larrr23 and it was left in March of 2023 so just over a year ago on Apple Podcasts. It says, “Hi, Meagan. I love your podcast so much. I always end up crying at the end of them. So happy for these moms who get this VBAC. Thank you for creating this podcast. It is so inspiring to hear these stories. I’m 38 weeks pregnant and hope and dream I get my VBAC here soon as well. Keep doing what you are doing here. You are helping so many women achieve their dream birth and knowing that they are not alone. Thank you for that.” 


    Well, larrr23, if you are still listening with us, let us know how your birth went. I hope that you had an amazing birth no matter how it ended. Thank you so much for that sweet review. This is what I really am here for. I love this podcast so much myself. I listen and I record it and I hear these stories, but then I go back and I listen. I’m still hearing and still learning even knowing a lot about VBAC. I am still learning and growing myself and it’s just so fun to hear these incredible stories. I’m so grateful for all of you who are submitting your stories and sharing these stories both on Facebook, Instagram, and here on the podcast. 


    So thank you for your review and as always, if you wouldn’t mind leaving us a review, they truly are what help other Women of Strength just like you find the podcast. You can leave that anywhere you are listening to the podcast or you can even email us at info@thevbaclink.com


    06:10 Aisha’s first birth


    Meagan: Okay, are you ready to share your stories? 


    Aisha: Yes. Yes. 


    Meagan: I am so excited, so ready. I’d love to turn the time over to you. 


    Aisha: Yeah, okay. So for my VBAC journey, I feel like it’s really important to understand how I got there. I got pregnant with my first in 2020. My husband was in the military so we were stationed in South Korea. It was right before we left Korea. We moved back to the States. We had already been going through COVID in Korea so it wasn’t as big of a deal because we had it first if that makes sense. 


    We moved back and we are from Washington state so we went, spent time with family, and then we ended up in Texas. Here I am with my first baby, and I don’t feel like I’m a naive or ignorant person but I never really thought about the process of having a baby. I’m the oldest. My youngest brother is 13 years younger than me, but I just never really thought about what went into having a baby. 


    Meagan: I agree. That’s how I was. I was like, Oh, cool. I’m so excited to have a baby. I’m pregnant. This is cool. All right, cool. What’s next? 


    Aisha: Yeah. I got books. I read things. I joined groups. I watched YouTube videos. I listened to the podcast Birth Queens a lot just to understand more. I had a pretty normal pregnancy. There wasn’t anything too wild and because it was COVID, there was a lot of things over the phone. A lot of people thought it was weird, my friends and family, but my provider at the military hospital didn’t have a good bedside manner and it was known that she didn’t. It’s hard to explain. My husband was enlisted so he was just by the time he left, he was a Sergeant. He was one of the lower guys, so I don’t know if it was us or the culture, but you get nervous to speak out because of rank. 


    He’d be like, “Don’t say anything. We don’t know if that will get back. You can’t be.” 


    Meagan: Or disrespect them? 


    Aisha: Yeah, because there are some military wives who are assertive. Assertive is a better word. I don’t like to use "aggressive" with women. She would just say things like, “You’re gaining too much weight.” I’m like, “I’m walking every day. What do you want me to do about this?” 


    Meagan: You’re like, “I’m also growing a human.” 


    Aisha: Yeah, I know that I’m gaining a lot. I’m seeing that, but what am I supposed to do about this? I just got stressed about the thought of her being near my vagina. I was kind of scared about it because I was like, I really hope it’s not you. 


    We get to the 36-37 week appointment and they do a quick ultrasound. They’re like, “You’re baby’s breech.” I was like, “Oh, great. Cool.” They’re like, “You can talk to a doctor and talk about an ECV.” I know ECVs can be controversial. Some people are uneasy about them, but one thing I thought was interesting about my life is that I was a breech baby and my mom had an ECV with me. 


    Meagan: Interesting. 


    Aisha: Right? I was born in 1990, so I grew up hearing the story about them trying to flip me. When I heard people like, “Oh, ECVs are so risky,” I was like, “My mom did it. What’s so risky about this?” So we went in and the first provider we met with was like, “I like to put you in the operating room. I like to give you an epidural just in case something happens and we have to slice you open,” not like that, but it felt like that. I was like, Whoa. This is a lot.


    So we get to the day of the hospital and luckily, I’m so glad it was a younger doctor. I was like, "Are you bringing me back to the operating room?” He was like, “No, I like to make you comfortable. You can watch TV.” He was really sweet. It was an interesting experience. Of course, you are wearing masks but I remember the nurse took my mask off to let me breathe because it was painful. But they were so nice. My husband wished we had taken a video of because he was like, “They were pushing so hard on you and they were shaking.” 


    Meagan: Oh, yeah. 


    Aisha: My baby didn’t flip. He’s going to be 3 in April and he is very stubborn. He does what he wants and I’m like, This is totally you. We ended up getting COVID right before having a baby. My husband did. I tested positive, but I didn’t show any signs. It didn’t really affect me a lot. I was just kind of crazy. I remember I cooked Easter dinner and he wouldn’t eat it. I’m like, “I cooked Easter dinner for you,” and he was really sick with COVID and I’m still doing things. 


    11:16 A COVID-positive Cesarean


    Aisha: We go to the hospital and we test positive again. They have this stupid COVID protocol where I’m like, “I already went through these 10 days,” but they just treated us like we were coming in throwing up on them. Does that make sense? 


    Meagan: Oh yeah, I saw it as a doula. Yes. I had a client who wasn’t even sick. She had no idea and tested positive. We all got kicked out and they acted like she was going to kill them. It was really not good. 


    Aisha: Yeah. It was just weird. Because mine wasn’t an emergency, I kept getting pushed back because they had emergency C-sections coming. The biggest thing that sticks out to me in my birth was when it was finally my turn, they came to me and they were like, “You’re next, but it’s going to take a little bit because we have to extra-clean because the last person was COVID.” I’m like, “Why do you have to extra clean? Shouldn’t you always clean an operating room? That doesn’t make sense to me.” 


    Meagan: You should always extra clean, yeah. 


    Aisha: Yeah, that’s gross. What were your protocols before? I don’t understand. 


    Meagan: Interesting. 


    Aisha: We didn’t go back until 3:00 or 4:00. I don’t know. It was late. You know, you’re not eating because they tell you not to eat so I’m starving. The doctor who delivered my baby was super nice. She came in and was like, “Let’s have a happy birthday today.” I don’t remember anything weird. I’ve listened to some episodes where they’re like, “Oh yeah, they were talking about their vacation.” I don’t remember that. 


    Meagan: That was me. 


    Aisha: Oh yeah. I felt like it was really respectful. The anesthesiologist, I wish I would have gotten his name. He was wonderful. He was so sweet and kept telling us what was happening. I was like, “Oh my gosh. You are our personal tour guide for this.” He was really kind. 


    I have a nervous cough. I always have when I get nervous. I just cough. After they took my baby out, I coughed. That’s where I get emotional so they took my baby away because they were like, “Oh, COVID positive. You coughed.” I’m like, “I have a nervous cough. I always have my whole life.” They took my husband away so I was there for 30 minutes alone. Sorry, I get so emotional thinking about it. 


    All of those sweet pictures that people have, I didn’t get that. Oh my gosh. My son is going to be 3 and it still brings me. 


    Meagan: It’s still with you, yeah. 


    Aisha: Whenever I talk, yeah. The C-section itself was fine, but it’s just the care that got me. I never know how to explain that to people. No, it’s the care. So then we finally were in the recovery room. I’m starving. My husband gave me fruit snacks. We didn’t realize I was not supposed to eat, but I was starving. 


    We get to the mother’s room at 11:00 at night. The kitchen is closed. I’m like, “I’m starving. When can I eat?” The nurse laughs and says, “When you can walk.” I’m like, “But I’m hungry.” She’s like, “You’ve got to get up and walk first.” I’m like, “But I’m hungry.” What? 


    Yeah, so that was him. That’s that part. 


    14:38 Third pregnancy


    Aisha: Everything else was fine. It was just the care. They lock you in a room when you are COVID-positive. It was just wild. 


    When he was about 11 months old, almost a year old, I got pregnant again. We moved from Texas to Oregon because my husband was getting out of the military and sadly, 10 weeks later, I had a miscarriage. 


    I had already picked out the midwives I was going to use in Oregon. I was like, I’m going to have a home birth because Oregon has really good laws when it comes to home birth and I am going to do this. 


    There were a couple of driving factors to that. One, I did not want to go back to the hospital. I was like, I’m not being treated like that again, because I’m a pretty timid person and I don’t know if I’d be strong enough to advocate for myself. The other thing is we had a toddler. My mom lived in Seattle and my husband’s parents just moved to Idaho. My dad and my step-mom live in Atlanta, Georgia and I’m like, There’s no one to take care of my toddler so we’ll just have a home birth. 


    My husband was like, “That sounds kind of weird,” but my husband’s mom actually had a home birth with her fifth. It wasn’t abnormal for my husband’s family, but he was kind of like, “Ew, gross.” We always joked right before I had my first if it was a scheduled C-section, my husband wouldn’t be there because he is really queasy when it comes to blood then finally when they were like, “It’s a C-section,” my husband was like, “Oh, you’ve got this.” I was like, “Nope, you’re going to be there. Sorry.” I know it was hard for him. I know how he gets. I don’t think it was him being weird or anything so I was totally fine with it. 


    I had my miscarriage in April and then I got pregnant later that summer. It was cool– I guess not cool. I thought it was cool when I got pregnant with her daughter. Her due date was the same weekend I had my miscarriage. I was like, Wow. It was interesting. 


    During my miscarriage, my providers were wonderful. My midwife was wonderful. The ER doctor was so great. It was a sad experience, but it was a peaceful experience. I definitely was at peace with it even though it was really sad. I definitely say the driving force with my daughter, there was a lot of panic and anxiety. I would say, I don’t know if it’s having another child and having a toddler, but I definitely didn’t feel as connected to that pregnancy. But again, I have a very active toddler. 


    So one thing though, we didn’t find out the gender which was pretty fun. A lot of people thought it was weird and they were like, I like to prepare. I’m like, What do you have to prepare for? I just thought it would be really cool to not find out. 


    I didn’t really post about my pregnancy a lot. I think I announced in January and she was born in April. I didn’t talk to people about having a home birth because I didn’t want to hear it. I didn’t want to hear people’s opinions about it. I remember I had some friends that I was like, I really don’t want to talk to you about it. They would ask, “Oh, how was your doctor’s appointment?” I was like, “Oh, it was great.” I didn’t say anything else because my midwife would come to me. It was so nice that she came to you and I didn’t have to worry about getting out the door and the whole family was involved. It was super nice. 


    20:02 Planning for a home birth


    Aisha: Oh, I remember I told my dad. I was like, “Yeah, I’m going to do a home birth.” He was like, “I don’t know. It sounds kind of sketchy. Are you sure?” I was like, “Yes.” He was like, “Don’t you want to go to a real doctor?” I don’t think my dad was being rude, but I was like, “Dad, it’s not a mountain man. It’s a real midwife. It’s a licensed business. It’s a real person. It’s not some woman off the street that I’m like, Come birth my baby. She went to midwifery school.” 


    But no, my midwife was amazing. Her name is Liz and she was just so calming. Her voice was just very soft-spoken it felt like, but I was so worried about having a breech birth. Whenever I brought it up, she’d be like, “We’re not talking about that. We’re not talking about that.” I was like, “What if this baby is breech?” She’s like, “We’re not talking about that.” I’m like, “Okay, cool.” 


    So when I was pregnant, like I had shared before, I just listened to The VBAC Link. I just listened to The VBAC Link. That’s all I listened to. I worked from home at the time just doing computer work and I would just listen to episodes. I would be sobbing. It was for a lawyer and I’d be doing these things and crying just thinking about all of these amazing things that these women went through and how they were able to bring their babies. 


    One thing that I believe I learned from this podcast, so I failed my gestational diabetes test, my glucose test, but I had heard from an episode that it varies from state to state. I was like, Interesting. But my midwife was like, “You just did it by two points or whatever the thing is, so just watch what you eat. Keep a log and let’s talk about it.” So that’s what I did. She showed no other concerns. 


    She was like, “Just eat more protein”, then I would log my food and at appointments, we’d go over it and she would go, “Oh, see? This is when your sugar goes high. It’s because you ate this. Let’s try to eat more of this,” and then I tried to stay as active as I could with my toddler. 


    My husband was in school. He left the military and was in school finishing up his bachelor’s degree so we live right next to campus. We lived in a basement apartment and at first, I was like, Why? We rented this basement apartment and I was like, Can I legally have a baby here? I was like, Is this allowed? Do I have to tell my rental company? There were these 5 girls who lived above us and I was like, How am I going to do this? Aren’t they going to think this is weird if they hear me? 


    But yeah, I just remember this basement apartment. It was pretty tiny. I would just sit in my living room and envision my birth there and be like, Okay, I can do this. 


    22:51 Breech workshop with Dr. Stu


    Aisha: April comes and my midwife had done a workshop with Dr. Stuart. 


    Meagan: Oh, Fischbein. 


    Aisha: Yeah, like 2 months before I gave birth. 


    Meagan: That’s awesome. 


    Aisha: I was like, “Oh, so is this a possibility?” We were on state insurance because my husband is a student. There were a couple of things. They covered my midwife, but we would have to pay for the birth because I was a VBAC but my midwives, they are really great where they accept payment plans because they were like, “We don’t believe people should tell you where to give birth. If you just pay us $5 a month, that’s fine.” 


    We ended up paying it all off because we were like, “That’s fine too.” But she told me, she was like, “Well, because you’ve never given birth vaginally, you wouldn’t be able to.” I’m like, “Oh, that sucks,” which is the same thing they told me in Texas. I was like, People breech birth babies all the time.


    I was like, “Can I transfer hospitals?” They were like, “No, no one will probably take you because you’ve never given birth vaginally.” I was like, “Okay, that’s weird. Whatever.” I was like, “Oh, dang.”


    My baby was due at the end of April and on April 5th, I started getting contractions. With my son, I never had contractions. I never went into labor. I never had Braxton Hicks. I didn’t know how any of that felt so I was like, Oh, this is new. What is going on?


    Oh, I did have a doula. In Oregon, when you are on state insurance, they do cover a doula so that was really nice. 


    Meagan: Yeah, that’s really awesome. 


    Aisha: Yeah. The doula that I had runs the doula program, but I contacted her directly because I was just looking through Facebook groups and she was like, “No, I’ll take you on.” She was actually training to become a birthing assistant with my midwife so it was pretty fun. She worked really well with them. 


    24:57 Labor begins


    Aisha: Okay, so on April 5th, I start getting contractions. They just tell me to rest. I remember I had a really bad headache so I was like, Oh, maybe I’m dehydrated and maybe that’s why this was happening. So I was drinking lots of water and coconut water and trying to eat protein. 


    That night, I remember we were watching Ted Lasso and I was trying to hone in and focus while having contractions. I don’t remember anything else. All I remember is Ted Lasso. 


    Then that night at 2:00 AM, my husband ended up calling the midwife because they were picking up. She came and he made this observation when she got there, they slowed down. She checked on me and she was like, “It looks like you’re just having false practice labor,” whatever you want to call it. “Just rest up.” I was like, “Okay.”


    So the next morning, I wake up at about 7:00 AM. Through the night, while I go through contractions and my husband was timing them, I’m moaning through them. I took this course. Sorry, I’m jumping around. I took this course called Pain-free Birth so I just was trying to practice what she had taught in it. I was breathing through riding the wave and all of that. 


    My husband would moan along with me during contractions while he was sleeping and I was like, “You’re not helping me.” He was like, “Oh, sorry. I didn’t realize what I was doing.” 


    Okay, so then I wake up at 7:00 AM and I take a shower. I just remember I was like, I’m going to curl my hair, but then I was like, I can’t do that. 


    It’s so interesting how in tune our bodies are and almost how in tune our family is because that week, my toddler slept in until 10:00 AM every day. That day, he slept in until 10:00. 


    Meagan: That’s amazing. 


    Aisha: He knew something was going on, right? That morning, I remember I ate. I listened to some Taylor Swift music and just swayed around my kitchen. I turned on Anastasia the movie and laid on my couch and went through my contractions. I labored a lot alone which is what I wanted. I didn’t want people at my birth. I didn’t want a mom or any relative and I think my mom would be great during a birth, but knowing me, I think if I wasn’t progressing, I think I would panic and from what I’ve learned, your body can shut down and not do it because I would feel the stress like, No one is comfortable. I’m doing this to people. 


    I wanted to labor alone if that makes sense. 


    Meagan: Yeah, it does. You didn’t want to be the host of your birth. 


    Aisha: Yeah, and I feel like that’s what I would have been. I would have been like, “Does everyone have drinks? Does everyone have snacks? Is everyone comfortable? What does everyone want to watch on TV?” I know me and I was like, I don’t want that. 


    So at about 10:00 AM, my husband and my toddler come out of bed. I put on the Peanuts movie for my toddler and I’m just kneeling on my couch which was really sweet. Every time I went through a contraction, my husband was timing them and they were still pretty inconsistent. That morning, I was texting with my doula and keeping her up to date with stuff. My toddler would come over and rub my back or bring me toys and I thought that was really sweet. 


    My husband had a 12:00 class and was like, “Should I go?” I was like, “Do what you want, but probably not.” It was really funny because he was actually watching a video for his class. Have you ever seen– I always forget this actor’s name– have you ever seen the show Lost? You know the evil guy, the cult evil guy? 


    Meagan: Yes. I don’t know the name. 


    Aisha: He was narrating this video, this video on Marie Curie. 


    Meagan: Curie? The X-ray lady? 


    Aisha: Yes. 


    Meagan: That’s so funny because my daughter did the wax. She was Marie Curie for her wax museum for her 2nd grade. 


    Aisha: Yeah, so my husband is watching this video and it’s that guy narrating it. It’s about her. I’m going through my contractions, focusing, and asking him questions about it. I was like, “What did she do? How did that happen?” 


    I had the Peanuts movie. I had that going on in the background. Yeah. So finally, I’m like, “I’m going to go lay down.” My husband was like, “Okay. I’m going to be there.” 


    I go lie down and all of a sudden, I start getting hot flashes and get really cold. I’m like, “What is happening?” My doula finally called me. She heard me and she was like, “You are in transition.” We didn’t realize how far this was happening. I was like, “Maybe we’re not communicating,” but we were telling them about the contractions. We were keeping them up to date. 


    I got back in the shower and she was like, “I’ll be right there, but you should probably call your midwife.” My husband was trying to figure out my phone. Something happened with my phone and he was like, “I can’t open it. I can’t open it.” I’m in the shower and he calls the midwives and the one that is not my midwife, the other one who I had met with before and I liked her too, she picked up and listened. She was like, “Okay, we’ll send Liz right over. It sounds like something is happening.” 


    I’m in the shower. It just was so funny. I remember being like, I can’t do this. I can’t do this. I can do this. No, I can’t. Yes, I can. Then my husband was trying to talk to me. I keep referencing a lot of pop culture things. 


    Meagan: I love it. 


    Aisha: Do you know that TikTok sound? It’s from a movie with Will Ferrell where he’s like, “Shut up. Don’t talk right now. I’m so scared right now–”


    Meagan: I don’t know if I’ve seen that. 


    Aisha: Yeah, it must have been trending then, but that was running through my mind. I was like, Shut up. I’m so freaking scared right now. Will Ferrell was going through my mind. Then my husband is just standing at the bathroom door and he’s like, “I don’t know what to do.” Then I’m like, “I feel like I have to poop. That’s what I feel like right now.”


    31:25 Pushing out an unexpectedly breech baby


    aisha: I go over to the bathroom and go over to the toilet. I am like, “I can’t sit down. What’s happening?” I got scared and then all of a sudden, it must have been my water breaking because there was a pop and stuff went everywhere. Like I said, my husband is very sensitive to things so he was like, “Should I come in there and hold you up?” I was like, “No, because I don’t need you gagging in my ear because it stinks in here. Please stay right there.” 


    Finally, I don’t know the times. I’ve been told they showed up pretty fast, but you know when it’s all happening. You lose the concept of time. My doula shows up. She says that my husband, his name is Logan, was standing there with a towel. He was ready to come in and catch a baby. She said he looked almost like a butler. He was just standing there. 


    She comes in and rubs my back and I was like, “Heidi, I’m so stupid. This is so stupid. Why am I doing this?” Then comes my midwife with all of her stuff. You know what? It is so crazy. 


    That morning, I don’t know if this is with all home births, but with my midwife, I had to buy certain things. I had to buy towels and hydrogen peroxide. I had to buy all of the stuff. It had come literally that morning. I wasn’t due for 3 weeks. 


    They take me into my bedroom and all of a sudden, I hear them ripping things open, just moving stuff and ripping things open. I’m just over the bed and moaning. One of my biggest regrets is not having a birth photographer because they are all fuzzy and terrible pictures. 


    Then they said I was pushing, but I don’t remember pushing at all. I just remember riding those contractions. Then at one point, they asked me. I think it was my doula. She was like, “Aisha, do you want to feel your baby? Do you want to put your hands down and feel your baby?” I said, “Absolutely not. No, I do not,” which I’m kind of glad about because I probably would have felt a foot or something and that would have scared me. 


    I’m leaning over my bed and then like I said, my midwife is a very conservative, meek person, very soft-toned. All of a sudden, I heard her say, “Aisha, I don’t want you to panic, but your baby is coming out ass-first.” I was like, “Oh, that’s different.” She said afterward when we were talking, she said she saw it and she just leaned back and went, “Hmm.” She took a picture of it and then my husband’s perspective was funny because he said he comes and he sees feet and he was like, “What is happening? Why is my baby coming out this way?” 


    She tells me to get on my hands and knees. She gets firm because I don’t know what is happening. I get on my hands and my knees beside my bed. She tells me to push and I’m like, “I don’t know what you’re talking about. I have not been pushing this entire time,” but I must have pushed. Then I heard a splat and I was like, Is that my baby? It was my placenta. It felt out of me.


    Meagan: What? So baby was born, you turn over, and then the placenta? Or wait– 


    Aisha: Yeah, so I’m on my hands and knees. The baby is born. I hear a splat and I get on my knees. I get up, lean back, look down, and there is a placenta. 


    Meagan: Okay, I was like, Whoa, wait. That can’t… My mind was backward because I was like, Well, your husband saw the feet so I’m assuming baby’s out.


    Aisha: Yeah, sorry. The baby was out. Yeah, but I thought it was my baby falling out of me but I’m kind of glad my placenta came out like that because I was more scared to birth my placenta than my actual baby. 


    35:29 Reviving baby


    Aisha: I turn around and she’s pretty limp. My midwife explained that it’s pretty common for breech babies to come out not breathing. She was talking to Heidi and she was like, “Get the–” what’s it called? An ambu bag? 


    Meagan: For oxygen and stuff? Yeah. 


    Aisha: She’s directing Heidi where it is. 


    Right before I had her, we didn’t talk about names, but I had a strong impression it was a girl so I approached my husband. I was like, “Hey, I have these three names.” Her name is Margaret. I was like, “Margaret Sage, Margaret Alexis, or Margaret Alexandria. You pick.” He was like, “Margaret Sage.” I was like, “Okay cool. Let’s do it.” We don’t even know what we’re having. 


    Anyway, so she was limp, limp and not breathing. I just look at her and I go, “Oh, it’s a boy.” My doula goes, “No, Aisha, it’s a girl.” I’m like, “No, it’s a boy.” I’m so dazed and then Liz was like, “Aisha, I need your help.” She had been doing mouth-to-mouth. She was like, “I need your help, Aisha. Talk to your baby. Help me with your baby.” So I just start stroking her and holding her head up. 


    Later, Liz said that I don’t know if she said this to say this, but I was one of the best assistants that she had. She was shocked because I recently gave birth. She said she recently had a father and he kind of panicked. She said it was kind of cool. I didn’t know what was happening. 


    Meagan: Your intuition kicked in. 


    Aisha: Yes. I’m just like, “Hi, hi, hi. Hi, baby.” I’m just holding her head and then they got her breathing and gave her to me. There is a picture of me. You know those candid shots that you see where it’s ugly but beautiful? That’s what it is. It’s ugly, but beautiful. I’m crying and holding her. Blood is everywhere, but I love that picture so much because it represents something that I did. 


    Oh, I skipped this part, but when she was coming out breech, I was like, Those midwives in Texas can suck it. I’m doing this. I was told I can’t and I did. That’s crazy, then they just put me in my bed and then by protocol, you have to call EMS and EMS came pretty quickly. They came. I remember they asked me, “Oh, do you want to be transferred?” I was like, “No.” They were like, “Baby looks good.” Then they asked my husband, “What’s the baby’s name?” 


    My husband was like, “I don’t know.” I missed this. He had been running around doing things. When my midwife got there, we had street parking so she just parked in the middle of the street and asked my husband to go park her car. Keep in mind that I still have my toddler. I think he napped that day which is crazy. That’s wild. Oh my gosh. My baby was born at 12-something. My son woke up at 10:00 and he napped. He woke up to a baby. That’s crazy. I never connected that but he was awake for a very small amount. 


    Yeah, that’s it. They hung around for a bit and then they left and that was that. 


    Meagan: All was well. 


    Aisha: Yeah, it was crazy. I can see the shock when I share it to people, but it’s probably one of the best things I have ever done, the coolest thing. I feel like I’m a pretty average person. When I was filling out my bio, I was like, I’m a stay-at-home mom and I watch a lot of TV. Yeah, then I did it. I had a breech birth. I guess I missed this thing. 


    They weren’t tracking that she was breech. They think that maybe she flipped during labor. It’s not like I went in planning to have a breech birth. It just happened. 


    Meagan: She obviously wasn’t aware when she was like, “Oh, I’m taking a picture of this. This is crazy.” 


    Aisha: Yeah, they actually used the picture of Margot coming out of me. I think I shared it with you guys. She shared it. They actually share it for advertisement. She was like, “Can I use this?” I was like, “Yeah, that’s fine.” 


    Meagan: Yeah, I mean, it’s amazing. Let me see what picture. I haven’t even seen your picture yet. Oh yeah, this is an awesome picture. 


    Aisha: Yeah. 


    Meagan: Yes. 


    Aisha: It’s kind of crazy. 


    Meagan: This will be posted on our social media so if you want to go see this really awesome picture, I definitely suggest it. One leg is still inside. 


    Aisha: I think both of them, right? 


    Meagan: One is out and then it looks like one is maybe coming out soon. 


    Aisha: Maybe. Yeah, when I was trying to look for it last night, my husband was like, “I have lots of pictures. They are gross.” I was like, “I know which one I am looking for, you weirdo.” 


    Meagan: Yes, I love it. Thank you for sharing it with us. 


    40:53 Vaginal breech birth is possible


    Meagan: Breech birth is possible. Rebecca Dekker over at Evidence-Based Birth did an episode actually just recently looking at this. It says January 2024 so just recently. We’ll make sure to add the link in there. It was with Sara Ailshire I think is how you say her name. They talk about breech birth and it’s a long transcript and it’s a great podcast so I would highly suggest it. They talked about how the study that was published in 2022 that included the studies from a 10-year period of 2010-2020 and they found that perinatal death rates were 0.6% in planned vaginal breech groups and 0.14% in planned Cesarean breech groups which is kind of crazy to think. 


    It’s pretty low. When we talk about death, that’s a serious thing to talk about. Those are pretty low. They did find that Cesarean favored the rates, but there was not anywhere near as high as the breech trial. We just know that breech is starting to dissolve, these options. The providers in Texas were like, “No, we don’t do this.” 


    I mean, ECVs aren’t even offered in a lot of places. 


    Aisha: Oh wow. 


    Meagan: Especially for VBAC. So for this instance, if you were a Cesarean going for a VBAC and having a breech baby to flip, a lot of providers are like, “No, that’s not okay.” We actually have a blog about that too showing that’s not necessarily true. You have options and we need more providers doing Stu’s training like yours going out and learning. 


    I love how coincidental your training was to your birth. Really, really, really cool. 


    Aisha: Yeah, it was crazy. It’s interesting that you say that. Now we live in Nebraska because my husband is in graduate school. Nebraska has some pretty weird laws about home birth. They are the ones, I don’t know the wording, but you can’t have a doctor or a midwife there. You have to have an undergrad– I don’t know how to explain it. I wonder if we had a third baby, what do I do? Do I have to tell a provider that I had a breech home birth after Cesarean? Obviously, my kids like to be breech. What do I do? 


    Meagan: There’s something about your body that has breech babies. 


    Aisha: And I’m not asking you, that’s just something that I think about a lot. I’m not comfortable being in a state that doesn’t support what I want when obviously I went through something. I’m obviously not going to do something that harms my child, but I feel like my mental health is important too. I think with my son’s birth, it just always makes me sad to think about. It’s really hard because right after I had Margot, I met two other women who are onto their second and they have had C-sections and they are like, “I’m just going to do it again. I’m just going to have a C-section. My doctor said that we can attempt but I might not progress.” I just want to shake them like, “You can. Don’t listen to that doctor!” But then I feel like it’s also important to respect a woman for how she wants to birth. If you want to have a C-section, that’s totally fine. 


    I definitely see the benefits in both especially when you have young children. The women who I met who were like, I’m just going to have another repeat C-section, they are not around family. That’s hard to plan out. 


    Meagan: It’s hard. I think that’s one of the things that we want to do at The VBAC Link is give all of the information so when a provider is like, “You could, but it probably wouldn’t really happen so we can just go do it easily and schedule it and have a C-section.” We just want you to know actually what the evidence says and that it’s actually not true. Here is an option over here. Whether you pick it or not, we here at The VBAC Link support you 150,000% percent, but in the end, we really just want you to know what your options are and not just be told something that’s really not true. 


    Aisha: Yeah, whenever I meet women who have had C-sections and they are pregnant again, I always tell them, “The VBAC Link. Do you listen to podcasts? You need to listen to this one. It will help you so much.” I think we don’t realize. I was talking about this with my husband recently. We don’t realize that you can pick your provider. You don’t have to go with somebody that you don’t like. 


    Here I was with my son and this midwife– and they just recently changed their base name but it was called Fort Hood, Texas. In the Fort Hood, Texas Spouse Facebook group, people were like, “This provider is terrible. I don’t like her.” You could just look up her name and see all of these negative things. You never saw a positive and you just feel like you are stuck with this person like, Oh, she’s been doing this for 20-something years. She must know what she is doing. 


    Meagan: I love that you pointed that out. Dr. Fox and I talked about this on an episode. I think it was on our podcast, not his, where we talked about how we have the option to choose but then we also have to respect their option to choose because if they don’t feel comfortable supporting this type of birth, that’s okay. That’s their prerogative then it’s up to us to stay or to go and to find if that’s the right provider because we can fight for what we want, but we can’t make someone change their mind so that’s why you are doing your research and looking up those reviews, talking to your people in your community, really having an open discussion with your provider. 


    Most of the time, your provider is going to give you pretty quickly if you are giving open-ended questions. You’re going to get the, Oh, that didn’t jive with me. That didn’t resonate with me, pretty early on. 


    Then even then, even if you have a later situation where you have a provider who was supposedly supportive the whole time and they are changing their tune, again, like she said, you have the ability to choose. You do not have to stay with that person. You do not. You can leave, which is hard. That is very daunting. 


    Aisha: It is. I feel like we are a people-pleasing culture. 


    Meagan: We are. 


    Aisha: We really are and we want to trust our medical professionals because they went to school. They know. I watch Grey’s Anatomy. I’m not a doctor. When they tell me my blood pressure, I’m like, Okay, cool. I don’t know what that means, but you told me it’s good. You want to trust them, especially with something so intimate about being near your private parts and having such a spiritual experience of having a baby. I don’t want those people in my birthing space. Yeah. It’s not something that I want. 


    Meagan: And a lot of the time, they’re not going to want to be in yours either, right? That’s what is so important. If we are feeling that way, they might be feeling that way. It’s important to read those. I felt that way and I don’t like contention. I mean, sometimes you might disagree with that because sometimes on the podcast, we can get sassy but I don’t like it and that’s how I didn’t want to tell him I wanted to leave. I didn’t tell him that I didn’t like what he was saying or how I was feeling and I stayed then I had a repeat Cesarean instead of fighting for myself and standing up for myself. I stayed. 


    49:39 Adding to the supportive provider list


    Meagan: It’s not the biggest regret of my life because I feel like that birth specifically is truly what brought me here today in my doula career and in this career, but at the same time, it really wasn’t what I wanted and I do believe that I probably would have had a different experience if I would have followed my intuition and gone somewhere else even at 36 weeks. It was the very end. 


    Don’t ever hesitate to change once, twice, or even in labor. Do whatever you need to do. Oh my gosh, know that breech is possible. Breech is 100% possible vaginally. 


    Aisha: It is. 


    Meagan: And if you are listening right now and you are like, Yeah, it is because I had a breech birth too, or whatever and you had a breech-supportive provider, will you please email us at info@thevbaclink.com? We want to add these providers to the list. I’m trying to narrow this list down into specific things like vaginal birth after multiple Cesareans, ECVs, and breech birth because we have so many people looking. We have so many people looking and I know they are out there. They exist, but I am just one person here in Utah so we all need your help. If you have providers in and out of the hospital who will support breech, please email us at info@thevbaclink.com so we can add to the list along with Aisha’s providers. 


    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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    51m - May 29, 2024
  • Episode 303 Kristen's 2VBAC Stories with Preeclampsia

    Kristen joins us today to share her tough C-section and two beautiful VBAC stories! After a 41-week elective induction that turned into a C-section and a 2.5-week NICU stay due to meconium and heart decelerations, Kristen was very nervous about giving birth again. She found The VBAC Link Podcast and found hope. Through her VBAC research, she gained the determination and confidence she needed to try again. 


    When she was showing symptoms of preeclampsia, Kristen accepted the reality of a medically necessary induction. She was nervous but knew things would be different. She labored well and had moments of discouragement, but she used the tools available and achieved her VBAC. 


    Kristen also had some preeclampsia symptoms but was able to avoid induction, labored almost completely at home, and caught her baby in a wheelchair at the hospital waiting for the elevator!


    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    01:11 Review of the Week

    04:23 Kristen’s first pregnancy

    06:20 Agreeing to induction

    08:27 Emergency C-section and NICU stay

    12:55 Gaining confidence to VBAC and getting pregnant again

    17:28 39-week induction

    21:18 Feeling discouraged

    27:15 Getting the epidural and pushing for less than an hour

    30:58 Third pregnancy

    34:41 Forced to find a new provider at 36 weeks

    40:45 Labor begins

    46:11 Rushing to the hospital

    48:06 Delivering her own baby in a wheelchair

    51:27 Preeclampsia article and calibrating your blood pressure cuff


    Meagan: Hey everybody, welcome to the show. We have our friend, Kristen with us today. Hello, Kristen. 


    Kristen: Hi. 


    Meagan: We have her and her little baby as well so you can hear those little cute coos in the background. You can just smile. I love when we have little babies on the podcast or kids. The other day, we had a little toddler. It was so fun. It makes my heart so happy. How old is your little baby now? 


    Kristen: She is over a month. Just over a month. 


    Meagan: Just little little. This is a VBAC baby. 


    Kristen: Yes, she is. 


    Meagan: We were just talking before we got recording. Kristen had a C-section and then a VBAC and with that VBAC, she had preeclampsia. We are going to talk a little bit more of what that looked like, but that has definitely been one of the themes that our listeners have been asking about. Is VBAC possible with lab-positive preeclampsia? The answer is yes. It is. We will talk a little bit more about that and then she has a surprise. 


    01:11 Review of the Week


    Meagan: We are going to read a review and then we are going to dive into her stories. 


    This review was left in March 2023 by mcgrace and it says, “Must-listen For Every Mom”. It says, “This podcast is a must-listen not just for a mom preparing for a VBAC, but for anyone who gives birth and has given birth or plans to give birth in the U.S. Meagan wonderfully walks through personal stories while prepping for helping for helpful advocacy tips and a solid dose of empowerment in each episode. If you want to hear people discussing their plan to VBAC, if you are curious about what giving birth in the U.S. is like, and if you are wanting to have tips on how to mentally, emotionally, and physically prepare yourself for the best birth, this is the podcast to listen to.”


    I love that. Thank you so much and I agree. This is such a great place for everybody, anyone preparing for birth to listen. I think with crazy-high Cesarean rates, we’ve talked about this before. We have to talk about why they are happening and this podcast literally shares a lot of why Cesareans are happening. It is such a great podcast for anyone including first-time moms or even fifth-time moms who haven’t had a Cesarean. 


    As always, if you wouldn’t mind leaving us a review, you can head over to Apple Podcasts or Google or Spotify or wherever you are listening and drop us a review. You can even email us at info@thevbaclink.com.


    04:23 Kristen’s first pregnancy


    Meagan: Okay, Kristen. Welcome. Welcome, welcome and thank you so much for booking this. We are so excited that you were willing to come on. 


    Kristen: I am so excited to be here. I have heard so many stories and been encouraged by so much so it is so awesome to share mine. 


    Meagan: Yes. Well, I would love to turn the time over to you. 


    Kristen: Okay, so I got pregnant pretty young. I was 20 at the time and I was in college so when I got pregnant, it was a little bit of a surprise. It was a little bit of a crazy pregnancy moving and figuring all of that out, but I got to move home to my big, crazy family. I had a lot of support. 


    I had a really normal pregnancy. I was pretty young and a lot of my sisters had had babies, so I felt like I knew a little bit about birth and I really didn’t put any effort into looking any deeper into it. I felt like my mom had six kids naturally and I just thought, Okay. This is just what we do. 


    I had midwives. I had a super normal pregnancy and then I got to the end and I was very done being pregnant. I was just ready to meet my little baby and have my baby. I was offered a 41-week induction. I think it was just offered to me and I was like, “Meet my baby on Friday? Sounds great.” 


    I didn’t think anything of it. My mom had all of her babies naturally and she did seem a little wary to me, but I just was thinking I am huge. I get you are wary, but I want to do this. I want to meet my baby. 


    06:20 Agreeing to induction


    Kristen: I had a Foley placed the night before my induction date so I had a Foley placed and I was going to go home. When she placed the Foley, she told me— I can’t remember exactly when they fall out, but I was only a centimeter below. I think I was 3 centimeters. She was like, “Oh wow. You really stretched when I put this in. I might see you before your induction.” I was like, “Great.” 


    I went home and then we got there in the morning. I wasn’t feeling anything. I was induced and it was just the natural cascade of things. I got Pitocin and then I had GBS so I had to get the antibiotics, but I thought I was allergic to them because I had a reaction as a kid so they had to give me something else. I don’t know whatever else antibiotic they had to give me, but it was something different. 


    It made me feel super, super sick. I just wanted to lay in bed. I was like, I feel sick and I don’t want to stand up. I’m in labor and I don’t feel good. So I just laid there pretty much. 


    Then I got an epidural and I got to a 10. I pushed for 3 hours but his head never came. He was having some decals so all of a sudden, I just heard the word “C-section” and I was so shocked. It didn’t come into my brain at all before they said it. I don’t know why. It was a long day. I had started at 5:00 AM and by the end of my pushing, it was 12:00 PM. I didn’t think of a C-section before that. 


    Meagan: I think a lot of us don’t. It’s not really something that we plan for or even think about. 

    Kristen: Yes. So it’s really jarring when you hear it. 


    08:27 Emergency C-section and NICU stay


    Kristen: Then we had to go down for the emergency C-section because my water had broken and there was meconium and he was deceling quite a bit all day. We went in for my C-section. I was pretty scared. My husband was really scared and we just went in. I was super shaky and I was terrified. I don’t do well with that kind of stuff, so I say the worst part of giving birth is the IVs. I was super nervous and then they needed to get him out so they told me, “You have to try to calm down and try to stop shaking so much” because they needed to get to him. 


    I don’t remember exactly what happened. I just remember laying there and the anesthesiologist was just like, “She needs to calm down. Do you want me to give her something?” I just remember looking up at who was doing my C-section and who was somebody completely new because my midwife couldn’t do it. 

    I remember them shaking their head and right after that, he must have put something in to try to calm me down. I calmed down, but all of a sudden, I felt like I couldn’t talk. I couldn’t speak. I was just lying there. I was so scared. 


    I felt my son being pulled out. I felt them wiggling him out of my body and then I didn’t hear him cry. I just remember looking at my husband and I was mad at him almost. I was like, “He’s out and he’s not crying. I can’t say anything. You need to say something.” He didn’t know he was out, but I felt like he should know he was out. 


    So then my son had to go to the NICU because he aspirated meconium. I just remember them lifting him up and the NICU nurses showing him over the drape as they were running out and they were like, “Here, mama,” and showed me him. I just remember feeling like such a bad mom. Everybody says, “Oh, when you see your baby and when you feel your baby, it’s just this overwhelming sense of something you’ll never feel again,” and I didn’t feel that. I felt nothing. 


    I couldn’t talk. I just felt nothing and I was so scared and just numb at that point. 


    My husband went with my son and everybody had told us all day that Dad gets to stay with baby if something bad were to happen so I was just assuming, Okay, at least my baby is not alone. My husband is with him. Then they started to sew me up, but I don’t know exactly what happened. I just remember them saying, “There’s blood where there shouldn’t be.” They said something about how they nicked my bladder. 


    They were sewing me up and then they had to go back in and do something, but my poor husband at the time, there was a traveling NICU that didn’t know dads got to stay in there with baby so he kicked my husband out of the NICU at that point and then he said when he came out, he was in the hallway in between the OR and the NICU and he just said, “I just saw a bunch of people rushing back into your OR and rushing back in there,” and then he said somebody just put him in there like, “What are you doing?” 

    He was like, “I don’t know,” so they put him in a maintenance closet. 


    Meagan: Oh my goodness. 


    Kristen: Yes, so he was like, “I just was in the closet thinking you guys were both not okay and I didn’t know what to do.” So that was a little crazy and then my baby was in the NICU for 2.5 weeks. That was a very long, very difficult process for us because I just wanted my baby to be home and my baby to be healthy. 


    Kristen: We had some really amazing nurses and then we had some not amazing nurses and nurses are such a big thing. They really change your whole day. They change everything about your hospital experience when you have a good nurse and when you have one who is just not very supportive. 

    That was a really difficult experience.

     

    12:55 Gaining confidence to VBAC and getting pregnant again


    Kristen: Then when we got home, I didn’t really think about another baby for a while because I was so scared. Once I did, I just remember saying, “You know what? If I go in and the doctor tells me I have to have another C-section because that’s what is best for my baby, then that’s okay. I’ll get through it and that will be okay. My baby will be healthy.” 


    Then I started doing a little research and I found The VBAC Link. I think I binged for a full 24 hours. I don’t think I slept. After that, after 24 hours, I was like, Nobody can tell me that I can’t do this. I can do this. From then on, this was a couple of years before I was pregnant. I listened. I did research. I had called and met with doulas and home birth midwives and everyone before I was even pregnant. 


    They would be like, “What is your due date?” I was always like, “Well, I don’t have one. I’m not pregnant yet.” They would always be like, “Okay.” But it was great and I felt a lot more prepared with my second. 

    I did feel like I was going hands up a little bit. I felt like I was ready to fight when I needed to fight. 


    I got pregnant again. She was born in 2022 so I got pregnant in 2021. I got pregnant again. It was an easy pregnancy. I was super sick at the beginning, but it was a pretty easy pregnancy. I started getting Braxton Hicks at 20 weeks which is very different than my previous pregnancy. I had them all my pregnancy every night for all of my pregnancy which was very crazy. 


    Meagan: Whoa. 


    Kristen: Yeah, but I had switched providers so I started with a provider because I wanted to go with a different hospital initially. When I went to this provider, he told me all about uterine rupture in the first appointment. I had statistics written in my phone because I knew when I went in there, he was going to scare me and I knew I just needed to look at my statistics to feel better. 


    That’s kind of what happened, but he did push back a lot on things. He wanted me to get a test epidural. 


    Meagan: Mhmm, the just-in-case. 


    Kristen: Yes and to be honest, the best way I handled things was, I feel like it’s really difficult to talk to a provider in an appointment. I just feel like the power feels all theirs and when they are saying things, it really does sound scary whether or not. I knew so much information and it would still sound scary. 


    They would be saying something and I felt like I was there and my baby was deckling and I did need the C-section. I would get scared in my appointments, then I would go home and I would do more research and I felt really secure in my decision. 


    I went back to him and I told him that I would not be getting that. I told him, I just let him know that if it was that much of an emergency, I would be under anesthesia either way so I didn’t understand why I needed a needle in my back. 


    He kind of giggled and he was like, “Well, you’re right. You’ve researched, so okay.” 


    Meagan: Stop it. No way. Oh my gosh. 


    Kristen: Yeah. I ended up switching providers at 20 weeks after I met my doula because I told her just a few things that I didn’t feel as supported with him and she let me know a midwife who I had never heard about. 


    I met with this midwife around 20 weeks. I gave her a really long list. I gave her a very long list of papers to tell her exactly what I wanted and she was very, very apt to doing everything. She would say things before I even would talk about them.


    I would ask her about an epidural and she would say, “No, you don’t need one and to be doing this, you need to be eating before.” I would ask about all of these things so I felt really secure going with her. 


    17:28 39-week induction


    Kristen: At 38 weeks, I got to my appointment and I had high blood pressure. It was pretty high and she just was like, “I’m going to do a urine test for preeclampsia.” I really had never heard of preeclampsia. I had heard of it. I just had never done any research on it. I didn’t understand what it was. 

    I did the urine test and I really was thinking it was just going to come back fine. I felt absolutely fine. I had no symptoms. 


    It seemed that it was going to be okay and then it wasn’t. She told me that I was going to need to be induced. I was very, very nervous. I really wanted to avoid an induction because my first was induced and I felt like that was leading up to my C-section so I was super nervous about a VBAC being induced. 

    But she was very supportive of me. She really understood that I was very, very nervous and she was very respectful with that. 


    So we ended up being induced at 39 weeks and I went in. I had a Foley bulb placed and then I just rested the rest of the night. You don’t sleep in the hospital, but I pretend-rested for the rest of the night. 


    Then in the morning, I got up and they were like, “Yeah, you seem to be progressing.” They started me on a low dose of Pitocin. I just told them I wanted really low and slow so we did that. I had quite a bit of Braxton Hicks or prodromal labor. I don’t exactly know which. I had quite a bit of that beforehand. 


    I was at a 5 and pretty actively contracting. They were like, “Honey, you don’t feel anything?” I was like, “No, I feel something. I just feel what I feel at home all of the time.” So I was like, “This is very similar.” I got pretty discouraged because I felt like nothing was happening. It was 2:00 or 3:00 PM the next day so I had been in the hospital for 20 hours at that point. I just felt really discouraged because I felt like nothing was happening and I just emotionally broke down to my husband and told him, “What if we do this and everything happens the same? I worked this hard and I fought this hard for this and I’m just going to go in and I’m going to have another C-section.”


    I knew that having another emergency C-section was going to be worse for this baby than if I just had a regular C-section. I was so upset. I had my emotional breakdown, then after that, I kept going. I was doing everything. 


    When they put me in that room before the nurses came in to even meet me, I was doing Spinning Babies. I was doing everything I possibly could to get this baby out. The nurses would even comment and say, “Wow. You just don’t stop moving, do you?” I just felt like a little geriatric patient with all of my little tubes attached to me and I was just walking around. 


    21:18 Feeling discouraged


    Kristen: Yeah, so then at that point, things started to progress a tiny bit. I was progressing, but nothing a ton was happening so my midwife came in and let me know that the only thing she could do besides Pitocin was break my water. 

    I was really in my head at this point in labor. I felt like I really needed to advocate for myself. My doula was helping me and texting me the whole time telling me what I could do. She just let me know that once things really progressed, then she would come in. 


    I at that point was really just trying to play the risk of what Pitocin I wanted. Do I want to stay low and slow? I just really didn’t want my cervix to tire out so I let them push it up a little bit more. I just was really in my head about trying to make the best decision which is silly because I couldn’t have control of everything but I felt like I needed to to have my VBAC. 


    Things kept progressing and at 10:00, they asked me to break my water because that was the next step. I had been on Pitocin all day so I was a little bit worried about my cervix getting tired. I told them I was fine with that. 


    The contraction after they broke my water, I was like, Oh my goodness. Here is the pain that everyone talks about. 


    Meagan: And I feel it. I feel it. 


    Kristen: Yes. I was like, Oh my goodness. Then it felt like I was actually in labor. My doula came at that point. She was doing some rebozo on me and shaking apples. 


    Meagan: Yep, shaking the apples. 


    Kristen: Yes. That was great. She brought out the TENS unit which was amazing. Oh my goodness. It helped so much. They put it on my back and it was just amazing. 


    I was standing up moving my hips. I had the TENS unit on and I was really working through things and I started to feel like I was going to throw up. I started to get hot and cold. I would have a contraction then in the middle of a break for a second, I had told her in the middle of a contraction, “I think I’m going to throw up.” Then I looked at her after and I was like, “I think I’m going to throw up.” I was so excited because I was like—


    Meagan: This is it. 


    Kristen: Yes. I was like, “I think I might be in or nearing transition at this point.” I had amazing nurses the whole process. I just had amazing nurses. I had asked for nurses the whole time who agreed with HypnoBirthing or who were trained in HypnoBirthing. I had not done that, but I just wanted them who were a little more holistic and a little more natural. 


    One of my nurses actually said, “You’re not doing HypnoBirthing.” I said, “I know.” She was like, “You just want somebody who’s going to let you do what you want, huh?” I said, “Yeah, absolutely.” She said, “Okay. I have the perfect nurse for you next time.”


    I had amazing nurses the whole time. They were so encouraging. 


    Meagan: Oh good. 


    Kristen: But my nurse must have been doing something so another nurse came in to check me at this point and she was not as nice and amazing. She told me that she needed to check me. I was about to get on the bed and I had another contraction so I stopped right outside of the bed and put my hands on there. 

    She told me, “Get on the bed. I need to check you.” I couldn’t speak because I was in a contraction, but I was thinking, Oh my goodness. I finally ended up getting on the bed. She looked at me and told me I was a 6. 


    In my head, I was not a 6. The whole room changed for me at that moment. I was very discouraged. 

    When she told me I was a 6, my doula’s face was right behind her shaking her head no. She just was looking at me shaking her head and she was like, “No you are not,” but I don’t know. I was exhausted and I just broke mentally in that moment when she told me I was a 6. I just heard I can’t do it. I can’t do this. This is too much. I can’t believe I’m at a 6, because at that point, when I got into bed, I felt pushy. I felt really pushy. During my contraction, I was bearing down a little bit. 


    I just thought, Okay, if I’m pushing at 6, baby is in a bad position. I just was so nervous. 


    I got up. I went to the bathroom. My doula actually told me, “You need to get up. We’re going to the bathroom,” so she just took me to the bathroom alone just her and I. She looked at me and she said, “Do you think you’re a 6?” I was crying at this point. I was like, “No, I don’t. I don’t think I am.” She was like, “I do not think you are a 6 at all. I think you know where you are.” I was like, “I know, but what if I really am? If she says I am, I am.”


    I broke emotionally and I just was like, “I’m so tired.” I was so tired. I hadn’t slept in 24 hours at that point and I was just so exhausted and upset. I told her, “I want an epidural.” She knew that was not my plan so she really tried to encourage me against it and told me I was doing such a good job. I couldn’t hear it at that point. All I could hear was the doubt. 


    27:15 Getting the epidural and pushing for less than an hour


    Kristen: I just told her, “No, I want an epidural.” At that point, she shifted gears and was like, “Okay, then we’re getting an epidural and this is going to be great and you’re going to get some rest.” I was a little discouraged, but I ended up getting the epidural at 3:00 AM at this point. I got the epidural and I actually got an hour of rest which was really amazing because I was exhausted but when they had given me the epidural, they checked me at some point after this and I was a 9.5. 


    She looked at me and gave me an eye like, Yes, you were not a 6. It was nice. I got an hour of rest and then they came in and told me that I was ready. This sweet, sweet nurse came in and told me that I was ready to start practice-pushing or something like that. I was like, “Okay.”


    I was a little nervous about the pushing part just because I pushed with my son for so long and his head never showed so I was like, Once we get past a head, I will be there.


    I pushed in one position on my side and then the nurse looked at me and she was like, “You know, we’re going to try tug-of-war.” She put the squat bar up and I did a tug-of-war push and right when I did that, her eyes got big and she ran over and got on the phone. I just remember her saying something like, “When she pushes in some position, I see something about baby’s head.” I just remember her saying, “Baby’s head.” I, in the bed, was like, “You said baby’s head?” I was so excited. I was like, “They saw baby’s head.” 


    I pushed for a little less than an hour and she was there. It was everything. Everything went away for me at that point. I was just so happy and excited and it was the best feeling in the world. I just felt like all of my work, I actually did it. I did it. 


    But I forgot to mention, my midwife got off shift during this so another OB was on and she came in. They actually were asking me to stop pushing to wait for her to come in. I giggled. I was not going to do that, but she was not as kind and helpful. 


    She let me know right after, despite knowing my birth plan that delayed cord clamping wasn’t safe. 


    Meagan: What?


    Kristen: Yeah, and that I needed to cut the cord. To be honest, I was in complete baby land at that point. I was so happy that my baby was there that I didn’t fight it. Looking back, I’m honestly glad that I didn’t because I know that it would have taken me out of where I was able to be and the joy that I was in. 


    I didn’t fight it. I just let her do it and it was silly, but it was okay. I got to have my sweet baby and it was an amazing postpartum experience. I remember being wheeled out with her because I didn’t get my little boy after my C-section so I remember being wheeled out with her. I was just holding her in my arms and I was so happy she was in my arms. 


    I looked at a janitor while I was being wheeled to mother and baby. I lifted her up and I smiled so big at him. He just was like, “Okay.” 


    Meagan: “Congratulations”. 


    Kristen: I just was so happy. But yeah, that was my second and my VBAC which was amazing. 


    30:58 Third pregnancy


    Kristen: When my little girl was 6 months, I got pregnant again. It was an amazing pregnancy. I felt great the whole time. I totally thought she was a boy because I wasn’t sick, but it was a girl which I was super surprised by. 


    I had no Braxton Hicks. I really didn’t have a ton until the end which was crazy to me because I had them so much with my previous. 


    Meagan: Yeah, a lot. 


    Kristen: Yes. That was pretty crazy. I went back to my provider who I had gone to with my second baby. I went back to her. 


    Things felt a little different with her. She was still really supportive, but it just felt a little different, then at 16-17 weeks in my pregnancy, I did an initial test for preeclampsia and my numbers were already above. The protein in my urine was already above where it needed to be.

     

    She just told me in an appointment very casually, but I was super nervous. I didn’t know a ton. During this pregnancy, I did a ton of research about preeclampsia, so the one thing I did to my diet was I ate so much protein. I ate. I tracked especially in that first trimester. I tried to eat 100g or more a day. I really focused more in that first trimester. That was the only thing I felt like I could do so that’s what I did. 


    She told me my protein was already really high which I didn’t understand and it made me really nervous. I asked a few questions during the appointment, but I felt like I had a ton of questions after. I called and I felt very dismissed. I felt like she just kept trying to tell me, “Don’t get in your head. Everything will be okay.” 


    She was being very sweet, but I just felt like I needed a doctor at that point. I didn’t need a friend. I needed her to give me information instead of trying to encourage me. It was really sweet, but we only had 5 minutes and I didn’t want encouragement. I needed information that I just felt like I wasn’t being given.

     

    I actually ended up switching again to another OB. I just was interviewing them so I actually had appointments with my midwife and an OB. He actually came back into town. I had heard really good things about him but he moved and then he came back. I interviewed him initially and actually, I left my appointment and I kind of drilled him a little bit. I really asked him a lot of questions. I left my appointment. I called my sister and I said, “Yes. I don’t believe it.”


    He said everything I wanted to hear and that feels too bait-and-switch to me. There’s no way he’s this good. Then I had a few friends through church who he was with and he followed through on everything. 

    My doula told me, “I think he’s just that good.”


    I was super surprised because I could not believe that he was that receptive of me, but I went to another appointment and talked about my initial labs with him and he sat there with me for a whole hour and explained what he knew about preeclampsia and explained what he could to me. 


    It was really, really helpful and I felt very heard. So at that moment, I chose to go with him. 


    34:41 Forced to find a new provider at 36 weeks


    Kristen: I finished with him through the rest of my pregnancy. My sister was actually pregnant too and she was going with him. It was really cool. 


    Meagan: How fun.


    Kristen: She had her baby. I got to be there for some of her birth. She was due a month and a half before I was due so I got to be there with her and watch her amazing birth then she told me, “I’m having a lot of pressure. Can you just look down there?” She was crowning and I was like, “Oh, you’ve got to go to the hospital.”


    Meagan: Oh my gosh. 


    Kristen: She went to the hospital and we had that amazing experience and that was her first VBAC so it was really awesome.


    Then my provider called me and told me that they were shutting down their office when I was 39 weeks pregnant. This was at 36 or 35 weeks. I was then scrambling to find another provider. It was very, very difficult. Everyone I talked to just told me that they didn’t take VBACs past 35 weeks and that I even would have my paperwork switched and then they were like, “Oh, you’re VBAC and preeclampsia. We won’t take you.” There were 3 weeks of me just honestly trying to find a provider who would take me, not even a supportive provider, just having a doctor take me was very difficult. 


    I finally found a provider who would take me, but they told me there was another provider in the office who was very unsupportive. He actually was there during my sister’s birth when she came in and was totally crowning. He sat back with his arms and legs crossed and she was crowning, hopping on the bed ready to push and he sat there with his arms and legs crossed and told her how unsafe VBACs were. 


    Meagan: Oh my gosh. 


    Kristen: He told her that he didn’t know who approved her chart, but this was not okay. Thank goodness, the provider who was amazing came in and saved the day. But he was awful and he was actually one of the three providers in this office that would take me. I was really nervous about the on-call schedule and if he was going to end up being on-call when I was going into labor. 


    There was a lot of back and forth there, but I ended up meeting with this provider and I met with him when I was 40 weeks and a day so I met with him the day after my due date and this was our first time meeting. I gave him my birth plan. He looked at how far I was and he was like, “Oh, awesome. You’re almost done.” 


    I felt like he was perfect. “Let’s just get you out of here.” He was doing it as a favor to the other provider. I felt like a check in his box from the start of being there. I was really nervous about my blood pressure. I kept telling everyone, I had no symptoms with my previous preeclampsia. I had no symptoms and all of my labs are positive so I just want to be really on it. 


    I didn’t have a provider for 2 weeks and at the end of my pregnancy so I just got a blood pressure cuff and I monitored myself as much as I could. It was stressful. I ended up going into triage once because my blood pressure was high and I didn’t have anyone to call. I didn’t know what to do, so I went into triage and they just were not very awesome with me. 


    But that was okay and my blood pressure was fine so I ended up getting to go home. I was with my provider. He just was not, he really wanted to induce me. He told me all about my placenta dying at 41 weeks and he was so scared about me going past 41 weeks. 


    I asked him if this was just something he did with just VBAC patients and he said, “No, I do this with everyone.” I was like, “Oh, okay.” I was like, “Perfect. I’m even less worried now. I was thinking you had more information about VBAC and my placenta, so I’m less worried now.”


    Meagan: Less concerned. 


    Kristen: I told him, “I don’t want to be induced at 41 weeks.”


    He kept telling me, “Oh, I know. You do your research. You do your research.” He did not like that I was very informed on things. 


    I ended up having to go into triage at the end of my pregnancy three separate times because of my blood pressure readings at home, but every time I went into triage, they were fine there so I kept telling people, “I don’t know what my blood pressure reading is doing at home, but is there something else I can do?” 


    Everyone would look at my blood pressure cuff and say, “Yeah, that’s great. That’s the one I recommend.”


    I was like, Well, why is my blood pressure so high at home? I need some help. This has to not be working. At one point, I brought my blood pressure cuff in with me and they were reading differently at the hospital versus the cuff. I was like, Mine is not working, so I don’t know how to check myself at home. 


    It was really difficult. My husband started to be a nervous wreck about all of this anyway so everyone was pushing me to get induced and every time he heard the word “induction”, he was like, “Let’s just do it. It worked for us with the last VBAC. Let’s just do it.” Every time they told me I was okay, I just was like, “No. I’m going home. If I’m okay, I am going to have this baby naturally.” 


    It was a really emotional experience because we were all very back and forth. it felt like everyone was going through it with me, but I was the one pregnant and fighting to stay pregnant if my baby was okay. It was really difficult, but I ended up getting through it. 


    40:45 Labor begins


    Kristen: I ended up having some prodromal labor at the end is what I felt like it was. 41 and a couple of days was my next appointment and I told everyone, my husband and my sister, I was like, “He’s just going to want to induce me and push it so much at my next appointment.” I was so worried so I told my doula that I was thinking about trying castor oil. 


    She came over and she gave me electrolytes and she gave me a recipe with castor oil that was very, very small. I had gotten a few recipes and it was next to nothing. There was no castor oil in it basically. She told me, “It sounds like you are in early labor so I’m going to have you try this,” and I did one dose every 4 hours. 


    She was like, “It sounds like you are in early labor, so I’m going to have you try this.” I honestly was even grumpy about that. I was like, “No, I want more. If I’m going to try this, I want it to do something.”


    I tried that at 3:30 in the afternoon on a Friday. I did a couple of doses and then my mom called me and told me that she was in town and asked if I wanted her to come hang out with my kids. I had done two doses and I was like, “No. Nothing is happening. I’m never going into labor.” I was super grumpy. “I’m never going into labor.” 


    I got off the phone with her. I started crying because I was super emotional and my husband told me to just go back in the room for a second. 


    So I went back there and I don’t know. I must have known in my head that something was going on because I called my mom right back and I was like, “Yeah, maybe come over.” She was like, “Okay.” So she ended up coming over and hanging out with us and then we put the kids to sleep and I was feeling contractions and everything that I had normally felt throughout the week. 


    I just was like, “I don’t think a ton is happening.” I ended up putting my little boy to sleep at 8:00 and I had finished my doses of what I was doing. At that point, I was breathing through them a little bit, but I kept telling everyone, “I am not in labor. If this is it, it’s very, very early. It is not happening.”


    My mom was like, “Okay, that’s fine, but why don’t you just go back? You need to get some rest because if it is going to happen, you need to get some rest.” I told her, “Okay.” 


    I went back to go get some rest and I don’t know why in my head I didn’t realize that I had been able to rest through all of them before in the week, but suddenly, I could not lay in bed. I just told my husband, “No. It’s really, really early if it’s happening.” 


    I just sat on my ball. I rocked around on my ball for a little bit then I was getting pretty uncomfortable but I didn’t want to say it because I didn’t want it to be fake. I said, “You know what? I’m going to take a shower. I can’t stay in the shower for very long because I don’t want it to slow things down if it is picking up.” 


    My husband asked, “Do you want me to come in there with you?” I said, “No. No, no. It’s early. I’m going to take a shower. I’m going to get clean. I’m going to come out and do some more on my ball and do Spinning Babies.” 


    He said, “Okay.” 


    I went in the shower and I couldn’t even really find a time. I probably got in the shower at 9:00. I couldn’t find a time to wash my body or wash my hair, so I thought, “You know what? Maybe this isn’t as early as I thought.” I went back in the room and it was very relaxing. I went to just go grab my phone and my husband was like, “What are you doing?” I was like, “I think I should just time them.” 


    He was like, “Okay, I’m coming in there with you.” He went in there and he told me, I think at that point they were 3 minutes apart and he was like, “They are pretty close. I think you are farther than you are thinking.” 


    I just was like, “No, no, no. This happened way too fast.” I was like, “No. I’m not. I’m going to keep being in the shower.” 


    So I stayed in the shower and I just relaxed in there. it was great to be in there and then my sister came over at about 10:30 and at this point, they were a minute apart. My husband had called my doula and she told us to leave the house at 11:00. She had given him an hour timeframe. “If it stays at this for an hour, you should leave at 11:20 or something.” 


    I was in the shower. My sister came over. I don’t really remember her coming over. I was just breathing through everything. She said she walked in and she was like, “I felt like it was the wrong house. It was very calm. I didn’t know anyone was in labor. I just walked in and you were breathing. You weren’t talking.” 


    My sister finally came in and she told me at one point, “You’re doing it. You’re laboring at home. This is what you wanted for this labor.” That was the one time I remember her being there and I was like, “I am doing this. I am laboring at home.” I was so excited. 


    46:11 Rushing to the hospital


    Kristen: Everything was going really well. I was able to breathe through everything. My husband was getting the truck ready for us to leave and then I heard a pop, a visceral pop. It was crazy. It sounded like a water balloon popping and all of my water broke. My sister had just told me before this probably two contractions before, she was like, “Sis, they are really, really close. Are you sure you don’t want to leave right now?” 


    I told her, “Yeah, I don’t feel like I’m getting a break, but she is not down. She is not engaged.” I had no pressure and I was like, “I know what that pressure feels like. I don’t have the pressure. It’s okay.” 


    So then I felt a pop and my water broke and then I felt all of the pressure, absolutely all of the pressure. I looked at her and that was the first time that I had really made a sound. I think I grunted or I moaned and I was like, “Okay, we need to leave. We need to leave right now.” I felt like I could have her at that moment. 


    Meagan: Yeah. 


    Kristen: So then I got out of the shower and I put some clothes on. I was still buttoning my dress to even walk out of the door because I was like, “If we don’t leave right now, we will not make it.” I actually asked my sister to get me a towel. She asked me later why I asked her to get me a towel and I was like, “I really didn’t know if we were going to make it so I needed something to wrap the baby in if we didn’t.” 


    We left and live 5 minutes from the hospital so we drove to the hospital and I had by the grace of God, one contraction in the truck. I was laying down in the truck and I had one contraction. I really was able to hold it pretty well. It wasn’t as intense as my contraction before so that was nice. 


    48:06 Delivering her own baby in a wheelchair


    Kristen: We got there and we parked. I started walking in. I had one contraction in the parking lot. I just remember being by a dumpster and I actually got mad at that point. I was like, “I will not have this baby in the parking lot by a dumpster.” 


    I would have this baby in the truck or in the hospital, but I’m not doing it by the dumpster. I tried to walk through that contraction because I was like, No. I am not having this baby here. 


    He kept telling me that I guess I kept saying, “She’s here. She’s here.” I was just holding myself, but we walked in and I got backward. The security guard brought over a wheelchair. I got backwards on my knees and I was sitting up. He pushed me through and I got to right outside the elevator and they were pressing the elevator doors. The elevator just was not coming and I had one contraction and I was like, “Okay.” I did not push. I think it was the fetal ejection reflex. I don’t know what it was, but I did not push. 

    She just— 


    Meagan: Came. 


    Kristen: Yes. My husband said I was just pushing the butt in and he said, “I heard, ‘Here’s the head. Okay, here’s the shoulders. All right, she’s here. She’s here.” He was like, “You were just talking us all through it.” I just felt her and I was like, “All right, she’s here.” 


    I pulled her up and this poor security guard was pushing my wheelchair so then everything came out, everything so he just got, the poor guy, he did not sign up for that. 


    Meagan: Oh my gosh, what a ride for him. 


    Kristen: Yeah, then we got into the elevator and my poor husband had to push. We had a family leave the elevator, he was like, “Sorry, guys. You’ve got to get out.” We got in and that elevator, I guess, wasn’t working so it took us down to the basement then it went back up to the first floor and back up to the second.


    I was just holding my baby and trying to make her cry a ton because she had cried a little bit, but she was really quiet and calm. I was like, “Nope, scream. I want you to scream.”


    We got up to the floor finally and then there was one nurse there. She was like, “Okay, she’s here. Baby is here.” We just ran back through and it ended up that they did awesome. I got to deliver my baby and it was great because all of the doctors were super stressed about everything and about my VBAC and induction and I felt like God was like, “Well, honey, you’re going to worry about this so much and then you are going to deliver your own baby.” 


    Meagan: You’re going to do this. 


    Kristen: And it will be fine. 


    Meagan: Oh my gosh, what a shock. What a ride. I’m sure everybody around will never forget that day ever. Oh my word. Congratulations on all three of your sweet babies who I have been able to see throughout the episode. That is so fun.

     

    Thank you so much for sharing your stories. 


    Gosh, you went through a lot with switching and all of the things then catching your own baby. Oh my gosh. 


    51:27 Preeclampsia article and calibrating your blood pressure cuff


    Meagan: Okay, so there is an article essentially, a small review that is called Risk Factors and Maternal/Fetal Outcomes Complicated by Preeclampsia Following Cesarean After a Trial of Vaginal Birth. We’re not going to dive too much into it and even at the bottom, it says that they acknowledge that this is not a cohort study and therefore the evidence is not as strong as a randomized, clinical trial but the consistency of the data alongside evidence from the other larger published studies is reassuring. 

    It says that they recommend a trial of labor for all pregnant with severe preeclampsia unless it is excluded for other indications. So just right there, I mean, again like I said, this right here is not as strong. They have some links and we are going to make sure that it is in the show notes for you to go read over. 

    But again, if you have preeclampsia, if your numbers are showing preeclampsia, it is possible to have a VBAC. I encourage you to explore your options and then I wanted to touch on Kristen’s comment of how she brought her cuff in and it was so different. 


    It really is something that a lot of people actually don’t know so I wanted to bring this up. But it’s really important to get it checked and calibrated by a professional lab or someone who takes blood pressure because often, it can be wrong. A lot of our preeclamptic moms are getting cuffs and then they are not calibrated, so we are having really high readings or really low readings and it’s the opposite. It’s not matching up. 


    If you have a blood pressure cuff at home and you are feeling like something is off or you are getting weird readings and it’s not consistent with your hospital readings, don’t hesitate to go get it calibrated because that can definitely, definitely help. 


    It’s supposed to be calibrated every 6 months so if you get one for one pregnancy and then two years later or one year later or whenever you are having your baby and you are using it again for whatever reason, know that you may need to have it calibrated because it has been a while. 


    I just needed to throw that in there and thank you once again for being here with us today and congratulations again. 


    Kristen: Thank you so much. 


    Closing


    Would you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.



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    54m - May 27, 2024
  • Episode 302 Emily's CBAC + How Views Can Change

    Emily’s first birth experience was a home birth turned hospital transfer which ended in a C-section and then a birth center VBAC ending in hospital transfer and another C-section with her second. She found herself feeling alone, frustrated, and surrounded by people who just didn't get it as she worked to process the trauma and grief of not one but two back-to-back traumatic births and C-sections. 


    Throughout her journey, Emily took charge of what she could, learned about her options, and made the right decisions even when they were disappointing. Emily has been proactive about physical and emotional healing. She has been open to new perspectives. Emily is grateful to share her story and all that she has learned for other mamas who have found themselves in similar situations. And we are so grateful that we can feel of her strength! 


    The VBAC Link Blog: How to Cope When You Don't Get Your VBAC

    The VBAC Link Blog: Deciding on VBAC vs Repeat Cesarean

    NPR Article

    Spinning Babies: What to Do When...

    Needed Website

    How to VBAC: The Ultimate Prep Course for Parents

    Full Transcript under Episode Details 


    05:02 Review of the Week

    09:10 Emily’s first pregnancy and labor

    14:59 First C-section

    17:47 Second pregnancy

    21:16 Moving and switching providers

    33:20 Pushing for 5 hours

    35:45 Transferring

    37:47 C-section

    41:29 Tips for adhesions

    44:20 Hospital births are beautiful

    49:09 All about transferring



    Meagan: Hello, everybody. It is Meagan and we have our friend, Emily, with us from Texas today. Hello, Emily. How are you?


    Emily: I’m good. How are you?


    Meagan: I am wonderful. I am so wonderful. I love recording these stories if you can’t tell. We are producing them a lot because I love recording. I love hearing these stories and sharing these stories. Your story is a CBAC story which I think is so important to share on The VBAC Link Podcast. As technically a CBAC mama myself because I don’t know if anybody knows who is listening, but I had a C-section then I wanted a VBAC and had a Cesarean and then I had a vaginal birth. So all over the place. 


    CBAC is really special to my heart and I think that this is such an important topic to share on the podcast because we know that obviously, so many C-sections are happening, right? I also think it’s important to know that sometimes even when we are preparing for a VBAC, it might end in a Cesarean birth and even more important, I think it’s really important to know that Cesarean births can be healing and are a lot of the times healing. Would you agree with me, Emily? 


    Emily: Yes. I mean, I loved hearing the healing stories. Mine was not and I think that’s what I yearned for to her is that I’m not alone and it’s okay to have a repeat C-section and I hate calling it a failed VBAC, but a repeat C-section that wasn’t wanted and wasn’t healing. I mean, my second birth was much more traumatic than my first. I mean, I hate saying traumatic because I have two beautiful, healthy babies, but I also want listeners to know that just because you have a healthy baby and you didn’t have serious complications you can’t feel what you felt about the trauma of it all. 


    Meagan: Okay, and I love that you point that out too because just as much as Cesarean birth can be healing and can be amazing, it can also have a lot of that trauma. Trauma, I think, is a completely valid word to use. It can be used to be described as traumatic. It can be described as hurtful. I was angry. I was angry when I walked myself down for my second C-section. I didn’t want that. That was not what I wanted. It was not what I planned. 


    Yeah. Also, going into that it doesn’t always happen the way we want to. It can go both ways so that’s why I think sharing CBAC stories on this podcast is so important because we have to learn both sides of things. We have to know that Cesarean birth can be healing and it can be exactly what someone needs and it can also be traumatic and not what someone needs. I think that through these stories and through the journeys, this is how we learn how to try to avoid trauma and anger and hurt along the way. 


    05:02 Review of the Week


    Meagan: Before we get into this story, I do want to read a review. Okay, Emily, so remind me. You had a home birth transfer? 


    Emily: Yes. A home birth transfer C-section and then birth center transfer C-section. 


    Meagan: Birth center transfer C-section, yeah. I also want to talk about transfers at the end. We’re going to talk a little bit about transferring and when it might be a good time to transfer, when it might be starting to give us signs that we might not be in the best place, and then also how to go about what to do after you transfer if you’re transferring because that can also be a big mess too sometimes transferring depending on how the hospital responds to you. 


    We’ll dive in to these stories but I do want to read a Review of the Week. This was from winben18 from Apple Podcasts and it was on May 19, 2023, so a year ago right now. It says, “I had my first baby in 2021 11 pounds at 42 weeks via Cesarean because he wouldn’t descend. I was told I couldn’t birth him because he was too big and my pelvis was too small, but I always knew that wasn’t true. My mother, a very petite woman, birthed me naturally and I was 11 pounds, 9 ounces. In 2023, I had my VBAC with another 11-pound baby. No epidural, 7-hour labor, and I credit that success to The VBAC Link. I started listening to them religiously at 38 weeks when my provider started fearmongering me about birthing a big baby. I needed every little bit of encouragement and The VBAC Link provided that. It’s incredible how your body’s physical capabilities start with your mindset. Thank you ladies for all of your stories. I wouldn’t have been able to do it without you.” 


    Wow, that was an amazing review and so grateful. Holy cow, winben18, yay for an 11-pound, 8-ounce baby. I agree with what she said that it starts with our mindset. A lot of the time it does. We can also be in the best mindset ever and things might not unfold that way but if we can set our mindset and get going and get the education and the empowerment and the encouragement, you never know. Things can go a really long way. 


    So as always, if you guys have a moment, we would love your reviews. You can leave it on Apple Podcasts. You can leave it on Google even or on Spotify. We would love a 5-star review and if you can, comment. Tell us what you guys think. 


    Emily: I love stories of petite women birthing big babies actually because I’m smaller and I had big babies. I’m like, I know I could do it.


    Meagan: Yes. Yes. She talked about fearmongering. A lot of people do get fearmongered. They start saying, “Oh, I don’t really think you can,” and it’s so hard when we have a lot of people doubting our own bodies and then we start doubting them even though we didn’t have doubt originally. It’s so hard. It can be a tough cycle, but Women of Strength, it is possible. 


    09:10 Emily’s first pregnancy and labor


    Meagan: Okay, Emily. Let’s dive into these stories. I know you mentioned in the beginning that you had a second Cesarean and it wasn’t amazing. It wasn’t amazing, so I would love for you to of course share your stories but also maybe talk about tips you would suggest for someone in your situation maybe looking back where you’re like, Oh, I could have done this, or tips for people in your situation. 


    Emily: Okay, so my first son was born in May 2022. I got pregnant with him in September 2021 and I knew immediately that I wanted midwifery care. I wanted a home birth and to be honest, I had no fear. I was very confident. I was like, I can do this. I’m in shape. I eat healthy. There is no reason why this isn’t going to go perfectly. 


    I mean, I can’t be the only one who has thought that and it was the complete opposite. It was a fine pregnancy. I was very, very sick until about 20 weeks. I lost almost 10 pounds in my first trimester, but it turned out to be a wonderful pregnancy. I love being pregnant. I love it. 


    Anyway, I went into labor at 6:00 AM and I guess active labor really started around noon. We were at home. My husband started filling up the birth pool. My midwife was on the way and she had an assistant midwife with her. So really, we just labored at home. 


    Then I would say probably about early evening, they checked me and I hadn’t made very much progress. I think I was at a 4 or a 5 and I’m trying to remember correctly. I think that’s when they told me that the baby was at a tilt. 


    Meagan: Asynclitic or the whole body? 


    Emily: You know, I really don’t know and I think a lot of it has to do with why I have struggled so much with that birth because I feel like that birth catapulted me into the next C-section, but I feel like they had said anterior tilt, but I don’t think that is correct. 


    They broke my water because I wasn’t progressing and then they were trying to turn him after the fact. I think that’s where things went downhill. They checked me. I wasn’t progressing. They were like, “We can break your water. It will speed things up.” And I agreed. 


    I think that was my first mistake. I think a lot of that has to do with me not preparing as well as I should have and me with the mindset of, I can do this, no problem. That is my first regret from my first birth.


    Anyway, so they broke my water and then after that as everyone knows, contractions were off the wall. They had me laboring in one position on the bed on my left side to try to get him to turn and then they had me on the toilet so I went back and forth between there. Every other contraction, they were in there trying to turn him. 


    So basically, this went on until about 4:00 AM at home. It was my first labor. I was in an extreme amount of pain and I just was exhausted. I felt like it wasn’t going like I planned obviously. 


    So anyway, we transferred to the hospital. That was about a 30-minute drive to the hospital which was not fun at all. It was the wee hours of the morning so we went in through the emergency room, got up to triage, and I think I got my epidural within 45 minutes to an hour and just from what I remember, that was a very intense hour. I just remember thinking, What the heck? This is not how childbirth should be. 


    Anyway, so I got my epidural. I labored with an epidural for a few hours and they started me on Pitocin so epidural, Pitocin– 


    Meagan: The usual. 


    Emily: Yeah. Nothing was really happening. They were doing Spinning Babies with the peanut ball and the bed to try to get him positioned better. 


    Long story short, we got to an 8 and this was probably gosh, almost 48 hours later that I got to an 8. The hospital where I birthed is very home-birth and transfer-friendly. I had midwives on staff there who cared for me. One of the midwives home birthed her babies too so that was cool to have her caring for me and understanding my mindset of wanting to birth at home and then obviously I wasn’t at home anymore. 


    But regardless, they were saying, my water hadn’t broken for over 24 hours. They weren’t concerned about that and I loved the evidence-based care there. I love that. But they did tell me, “You know, the way things are going, you could get to a 10. You could push for a couple of hours and end up in an emergency C-section.” It’s almost like that verbiage right there was enough for me to be like, “This is it. Let’s call it. Let’s get the baby out. We want to meet our baby.” We were being surprised on the gender so we were very excited for this baby to get here. I went to 39+5 with him. 


    14:59 First C-section


    Emily: And so anyway, we called it and we did the C-section. I don’t think– obviously the birth was traumatic for reasons like I explained, but the C-section wasn’t awful. I didn’t feel any tugging. It was a very pleasant Cesarean. They did delayed cord clamping, not traditional delayed clamping, but they waited for it to stop pulsing and cut it. They took him to the table and did all of the hospital things and then wrapped him all up and gave him to me. I was able to do skin-to-skin and nurse while they put me back together. 


    Then they took him off to the nursery. I remember them asking, “Do you want your husband to go with him?” I’m like, “Yes.” I think it was just those little things. Those are the moments and tidbits that I think any mom who has experienced traumatic births thinks back on. I didn’t get to touch him right away and I had all of these dreams. I wanted a water birth and my whole pregnancy, I was like, I’m going to pull this baby right up to my chest and nurse him and it’s going to be beautiful. 


    When you have that dream and then you get the most extreme opposite, I mean not to the fact that I was under general anesthesia and it was horrible, but in my mind, it was the complete opposite of what I wanted and it sucked. 


    Anyway, so then we go back to recovery and I’m nursing him and everyone who has had a C-section listens to this podcast or most of them. You don’t really feel a lot of pain until the second and third day when most everything wears off. It was just hard. It was a hard recovery. It was hard to hold him. He was almost 9 pounds. It was hard holding him. When you nurse a baby, they sit on your belly. It was just hard. 


    I also struggled