As a first-time mom, Katie was struggling with potty training and feeling like she didn’t know what she was doing. She later became a potty training consultant to help other struggling moms and now hosts the Burnt Pancakes podcast. Katie’s first birth was a scheduled breech Cesarean. Her second birth was a spontaneous 36-hour labor at 39 weeks and 1 day with 1.5 hours of pushing and a tough recovery from a 3rd-degree tear and labial adhesions.Katie wanted to go for a VBAC again with her third. Though she thought she would go into labor at 39 weeks spontaneously again, she actually ended up getting induced at 41 weeks. She got an epidural right at the end of her labor, but was able to push her third son out in just two pushes!Meagan and Katie talk about how pelvic floor physical therapy is necessary for both Cesarean and vaginal birth recoveries. No matter how long it’s been since you gave birth, it can still be a game-changer!Katie's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, welcome everybody. We have our friend, Katie, with us today sharing her 2VBAC stories and before we got started, we were talking about once you have that C-section and you’re contemplating having a VBAC and you talk to people and they’re like, “Wait, you can’t do that. Doctors won’t let you do that.” Right? Katie: Mhmm, yep. Meagan: But what have we learned? What have we learned over all the years? Yes, we can. Yes, you can. Women of Strength, if you are listening and you have had one C-section and you are wanting to know your options, we are going to share two stories today. Okay, so Katie– you guys, she is the host of a podcast. Is it Burnt Pancakes? Katie: Burnt Pancakes, yep. Meagan: Tell us more about that. Katie: Okay. So when I became a mom, my oldest son was potty training and it was an absolute disaster. That’s probably the point in motherhood I felt the absolute worst. He had a tendency to poop his pants whenever we were in my friend’s backyard running around and playing. One day, he had this awful mess. I was cleaning it up. I was frustrated. I was like, “Oh my gosh. He’s never going to get it.” My friend looked at me and was like, “Katie, don’t worry about it.” Everyone burns their first pancake. I was like, “That just made me feel so validated as a mom.” Fast forward about 8 years and I decided to start my own motherhood podcast and I named it “Burnt Pancakes” because we are all figuring out this thing as we go. Meagan: I love that so much. It’s so true.Katie: So true. I’m still figuring it out. Meagan: I know, every day. As soon as I feel like I’ve started figuring out motherhood and parenthood and all of that, it starts to change on me. Katie: Right. It throws you for a loop. Meagan: Right. If you can relate here, go listen to her podcast and it’s just called “Burnt Pancakes”. And you are everywhere, right? Katie: “Burnt Pancakes”. We have mom-versations each week. I love to chat with moms. One of my favorite things to do was meet a mom at a park and hit it off and start chatting. That’s what I wanted my podcast to feel like– real moms chatting about motherhood. Meagan: Real moms chatting about motherhood. Then maybe was the inspiration between that whole experience with your son what led to also potty training consulting? Katie: Correct. At the time, I was teaching. I taught for 17 years. It was potty training my first son which was an absolute disaster. But fast forward, I have two more kids. I potty trained them and things got easier. I started feeling very confident in my skills and people started asking me for tips. I decided to become a full-time potty training consultant so now I actually help moms with the potty training process which blows my mind because if you had asked me 8 years ago, “Would you be doing this?” I would have said, “Heck no. I have no clue what I’m doing.” But what I am doing is trying to help moms who are in the same shoes I was in. You can do this. I can help you get through it. I have the answers for you that I didn’t have back then. Meagan: Yep. That’s exactly how we are here at The VBAC Link. We were in the thick of it. It was a rocky journey. There were a lot of unknowns and if you asked me 8-9 years ago if I was going to be doing a podcast sharing VBAC stories, I probably wouldn’t have said yes. I would have been like, “Probably not,” and here we are inspiring and encouraging. Katie: Heck no. Meagan: I’m so excited for you. So tell us where people can find you for potty training because I’m sure a lot of people listening right now especially being pregnant, you probably have a toddler as you are preparing for your birth. Katie: Yes. You can find me at my website. My website is burntpancakes.com. On social media, you can find my potty training information at @itspottytime. Meagan: I love that. Thank you so much for sharing. Katie: Yeah. Meagan: I do have a Review of the Week to share before we get into these stories. Katie: Go for it. Meagan: This is by theblanchardbunch. It says, “Get PUMPED!!!” It says, “Listening to this podcast just gets me pumped. You’ve had a C-section and you want a VBAC. Absolutely. You’ve had two C-sections. You go for that VBAC. Oh, you’ve had three or four? Go get that VBAC, mama, because you are a queen and 100% capable. Seriously, this podcast not only informs you of all the amazing things our bodies can do but also, you are immediately welcomed into a space of understanding and love. Our bodies are powerful but sometimes we just need a little help becoming empowered. This podcast does just that. I’m preparing for my VBAC and I’m currently 36 weeks pregnant. I think that all the time what I’d say or share if I were on the podcast because I am so sure this VBAC is happening. Thank you to all of the mamas who have shared their stories and thank you to Julie and Meagan who have created a space for all of these mamas needing to be uplifted and empowered.” What a fun review. Katie: Aww, that’s amazing. Meagan: Oh my gosh. I love this. It’s in all caps right here. “GO GET THAT VBAC, MAMA, BECAUSE YOU ARE A QUEEN AND 100% CAPABLE.” I couldn’t agree more with theblanchardbunch. I hope that you got your VBAC. Congratulations on your birth and as always, if you have a review, I would love for you to share it. I read them every single week and they really do truly bring me all of the joy. Katie: I love that. Meagan: Okay, Ms. Katie. Let’s turn the time over to you. Let’s share these stories. Katie: Okay. Well, my story starts 10 years ago. It’s really hard to believe it’s been that long but I was pregnant with my first son and we got the news at 28ish weeks that he was breech which I at the time didn’t even know what that meant. It was just a regular appointment and my doctor just nonchalantly was like, “Oh, he’s head up. Okay, you’ll probably end up having a C-section.” Meagan: Whoa. Katie: I was like, “Come again?” First of all, what’s head up? I don’t know. Meagan: At 28 weeks? Katie: Yes. Yes. Crazy. She made it seem like no big deal but for me, it was. I’m a taller girl. I’m 5’9”. I’ve always had bigger hips, a nice pear shape so I always thought, One day, these hips are going to serve a purpose. When I’m giving birth, these things are going to come in handy. My instant thought was, My body is not going to be able to do that. How can you just drop that on me and not feel anything? She basically said, “Most babies won’t turn. There’s a chance he could turn but you might just end up having a C-section.” I was like, “Well, is there a chance? What’s this?” She’s like, “You can try something to turn him but that’s just the way it was.” Meagan: No offering of an ECV or anything like that in time? Katie: As the weeks went on, she mentioned it, but for her, she was like, “I’ve been doing this for years. Most of the time, I don’t see them turn.” She just made it seem like a C-section was totally cool and totally normal. I was like, “What? How can this be?” I did try almost everything to get him to turn. At the time, I was taking a yoga class. Side note– Drew Barrymore was in my yoga class. Looking at you right now, I’m like, “You look so much like her.”Meagan: I’ve been told that for so many years– Drew Barrymore and Winona Ryder. Apparently, those two people I look like. Katie: When you hopped on the call, I was like, “Oh my god. You look like Drew.” I tried to play it super cool because at the time, we were living in LA and I was like, “Oh my god, Drew Barrymore is right next to me.” She even said something to me like, “Hey, mama.” I tried to play it so cool.Anyway, in that yoga class, all the moms were like, “You need to go see this chiropractor. You need to try this.” They were super supportive so I did go see a chiropractor. I forget what they called the procedure but it was massaging your hip flexors really, really hard. I don’t know why that makes him turn. It was loosening some ligaments to make them turn. Meagan: Like your round ligaments and stuff? Katie: Yes. I believe that’s what it was. It was extremely painful and the chiropractor at the time was like, “You’re going to do great in birth because you have excellent pain tolerance.” I was like, “Okay, thank you.” He did not turn. At the time, there was a website called Spinning Babies. Meagan: There still is. Katie: Okay. I literally Googled everything to get him to turn. I lay on my couch with my hips up. I had my husband sing to me “Turn Around” over and over. I did everything. He did not turn so in April, they were like, “Okay, here’s your scheduled C-section appointment.” I at least had time to prepare for the C-section. It wasn’t an emergency. I took all the notes on tips to do to help recover and in that sense, I felt prepared and I got to be at peace with the fact that I wasn’t delivering vaginally. But it was still weird when they were like, “April 26th. That’s going to be the day when he comes in.” I’m like, “You’re picking his birthday. What if he’s not ready at 39 weeks to come?” Then two days before, “Oh hey, the doctor has an opening on the 25th so we’re going to take you on the 25th.” I called my husband, “They’re changing it to Friday.” Meagan: It’s a weird feeling for them to be like, “Hey, you are going to have your baby this day around this hour.” Katie: Yeah and it was earlier than the due date so it just felt really weird. Meagan: Was it a week before?Katie: It was a week before, yeah. He was born at 39 weeks and 1 day. I still wonder. His sign– I can’t remember which one it is but the sign he was born on was not what he could have been born and it just doesn’t match up. He seems more like a Taurus than this and I’m like, “Is it because they chose when you were going to come?” We showed up that Friday for the C-section and of course, I got to do my hair. I got to take a shower so that was nice. You show up at the hospital and they’re like, “Okay, your 8:00 appointment.” You’re like, “Am I checking into a hotel here or giving birth?” I never once felt a contraction. I mean, it’s weird to say I was sad that I didn’t feel that because later I learned what that feels like and I’m like, “That was fun.” Meagan: It sounds weird but at the same time, it’s this natural feeling that we’ve been taught and told that our body does so you mourn that. Katie: Yeah. I want to feel it. That was it. I was mourning the fact that my body wasn’t doing what it was supposed to do. A weird thing– we did the hospital birthing class. It was 4 hours. They talked about C-section for maybe 5 minutes of the whole class but then they said, “3 out of 4 people will have a C-section.” That was the statistic from the hospital. I was like, “Oh, well that’s not going to be me.” This was before I knew he was breech. That’s not going to be me. But I’m like, Why would you spend only 5 minutes if 75% of us end up in a C-section? How is that possible? Yeah. It felt weird. But I did go in somewhat prepared. It still felt very sterile and scary but we had him via C-section. He’s totally healthy. There were extra doctors in the operating room just because he was breech so there were four pediatricians. My husband was like, “The room was filled. It was pretty crazy.” But he was healthy. He was fine. Everything turned out great. I do feel like with a C-section though, I was completely out of it for 24 hours. I don’t remember my parents coming. I vaguely remember but my husband was like, “Your mom and dad were here.” I was like, “Oh gosh, they were.” I vaguely remembered. Meagan: That’s how I was too. I was in and I was out. Katie: Yes. I didn’t breastfeed him for the first hour until they got me to the other room and they were like, “Oh, were you planning on breastfeeding?” I didn’t know that I could breastfeed him in the first few minutes. I wasn’t aware. The recovery for that was a lot harder. Just getting out of bed to go to the bathroom the first day was excruciating. But we were fine. I recovered from it and it was all good. Moving 3 years forward, we got pregnant with our second kid. I found out I was having a second boy which for anyone who has experienced gender disappointment, it’s a real thing and it’s totally okay to mourn the loss of a daughter or just feel unsure about the gender of your baby. I remember crying. I got home from the ultrasound and was just bawling because I was like, This was my girl. Where is she? This is a boy. It did take me a couple of months after he was born before I was feeling pretty good with it and that’s a normal feeling. I think no one really talks about that. But it was a totally normal pregnancy. What we did discover from the first one is that I had very low water fluid in my amniotic sac so they said that could have been the reason. My second son, I definitely didn’t have that because I put on about 40 pounds and was much bigger. I was able to stay super active during that pregnancy doing boot camp and lifting weights until the last month. We moved from LA to Orange County so I had to get a different doctor for this pregnancy. The doctor I saw from day one was like, “If you want a VBAC, we can absolutely go ahead and try that.” She actually more encouraged it. Everything I had heard when I had the C-section was, “Your son was breech so that doesn’t mean you can’t deliver naturally in the future,” but a lot of hospitals and doctors were kind of hesitant about it.” This doctor was like, “No. I don’t see any reason why you can’t try.” You do have to sign your life away pretty much. I had to sign a thing saying these are all of the things that could happen and that is terrifying. Meagan: I’m accepting that. Katie: Yes and it’s my liability here. The doctors are off the hook but she was very supportive about it but she never made me feel like I couldn’t do it. His pregnancy went just fine. I went into labor naturally right before the 39-week and 1-day mark. I actually had him at 39 weeks and 1 day exactly the same as the C-section so it made me feel a little bit better like I didn’t take my older son too early. I was always worried, Did I take him out too early? I did have a lot of baby blue and a little bit of postpartum with my first and sometimes I wondered, Was it because of the C-section? I don’t know if there’s any science behind that. He wasn’t ready to come yet. Meagan: You guys didn’t have your bonding. Your body didn’t naturally go into labor. There are a lot of things that could come into play. Katie: All that ran through my mind. Yes. Yeah. Meagan: But sometimes those who go into labor still get those postpartum depression and baby blues. Katie: Totally, yeah. Absolutely. I went into labor and this one was about 36 hours. It was very long. I didn’t realize that a few hours into getting contractions, my water actually broke. I thought I peed myself. I was sitting at home laboring and laboring. Things were just taking forever. I was having regular contractions. They weren’t as close as I thought they were supposed to be. I don’t know what it is. I don’t know if other moms feel this but when you go into laobr, it’s almost like you go into the zone and it’s like, I’m just doing this thing. My husband was like, “Should we call the doctor?” I was like, “No, not yet. I don’t think we are supposed to.” I was just in the thing. Meagan: You’re focused. Your focus shifts. Katie: Looking back, I should have called the doctor the second I went into labor just to get tabs and figure out when I should go in but I was just like, “No. We’ve got to keep waiting. I don’t feel like I’m ready to have him yet.” We finally got to the hospital hours and hours later and they were like, “Oh, your water broke a while ago.” I ended up being in labor with him for a very long time. I ended up pushing for an hour and a half. I do remember at one point they said, “Okay, if we can’t get him out, we will have to go and do a C-section.” That was like, no. I really, really wanted this. I didn’t do a whole lot of preparing. With the first one, we did the classes. I did research, but this one was kind of like, I’m just going to go in and trust my gut. I’m just going to see what happens. I was totally prepared that if it was going to be a C-section, I knew what to expect but I really wanted to see if my body could do it. I remember the nurse kept saying, “You’ve got to keep your eyes open when you push.” For me, it just felt so unnatural to keep my eyes open. I just wanted to scrunch up. She was like, “Relax your face and keep your eyes open.” I was like, “That doesn’t feel right.” I think my son had a giant head. He still to this day has a larger head than my oldest son. It just was hard to get him out but he finally came out. I gave birth to him. I was able to walk around so much quicker and the recovery was a lot better. I did end up having a third-degree tear so it’s not like vaginal birth is less damaging than a C-section. I have scars from both kids. Meagan: Not always. Katie: But it was so nice to know, I know what it feels like to go through it. I had an epidural with him. I think I was maybe 5 or 6 centimeters so it’s not like I ever got to crazy intense contractions and I didn’t feel anything when I was pushing. Part of it was I didn’t feel anything when I was pushing and I think that was kind of hard because I didn’t feel anything to get him out. Meagan: Sometimes that can play into tearing actually weirdly enough and then the lack of ability to push in a position if we are in a back crunch position. We are putting more pressure so if we do have a baby with a little bit of a larger head or is having a harder time coming out– which by the way, first-time moms, you guys, 36 hours with an hour and a half of pushing is crazy but it can be very normal. Katie: It’s normal. It’s so normal. I think what was hard for me was I looked at the clock when I started pushing because I had friends who were like, “Oh, I pushed for this long. I pushed for this long.” With my third, I decided, Don’t look at the clock. Don’t think about how long it’s going to take. It’s just going to take as long as it needs to be, because it was an hour of pushing. One thing that was kind of scary is that his heart rate would go down every time I’d push so they were like, “This could be dangerous.” Another thing was that I might have to get him out sooner so they would have me push for a contraction and then wait on a contraction. It was literally 6 minutes in between pushes. It just took a long time. But he was a healthy little boy and all was good. We thought we were going to have two kids. Everything was wonderful and then a year later, my husband was like, “Okay, are we ready to get rid of the baby clothes?” I’m like, “Umm, actually, I don’t think we are done yet.” Part of me still wanted a girl but I just did not feel like our family was complete. It was the weirdest feeling because we had always said, “We are going to have two kids.” We’ve got a three-bedroom house. It just made sense. Then we both decided– we had a little talk. If we were to have another kid and it ends up being a boy, are you okay with that? We were both like, “Yes. I feel like three is what’s going to make our family complete.” I was a little bit older. At the time, I was 38 so I’m like, “If we want a third, let’s try for it this year and if not, that’s a sign.” We did get pregnant with the third. I did not find out what I was having on this one because I was like, I have a feeling it’s going to be a boy and I don’t want to feel that disappointment again while I’m pregnant, and if it’s a girl, what a fun surprise to wait and find out. We didn’t find out. I don’t know if anybody else feels this way, but I had dreams about having a boy. My mom gut was like, You’re going to be okay with another little boy.  I kind of knew, but I still wanted to wait. This pregnancy went fine. With my middle, I was all for working out and going to boot camp, and felt really great. With this one, I was like, I’ve got two kids and I am exhausted. I put on more weight than I ever had. I could not move around. I hurt the most. I had the worst pelvic bone pain. Meagan: SPD?Katie: Probably. Probably, but I did not really speak up. I told my doctor, “Oh, I’m feeling some pain.” She was like, “That’s normal during pregnancy.” Now, looking back, I know people who saw a chiropractor during pregnancy and I’m like, “That’s what I needed.” Meagan: Or even pelvic floor. Katie: Yep. That’s what I needed because for a year after having him, I would get pain when I would walk and I’m like, I wish I had known that there was something I could do about that. So if you are feeling pain, speak up because I could have done something about it. With this one, I was very large. I was ready to have him. I got to that 39-week mark and was like, He or she is coming. I know it’s any day now. Then my due date hit and he was not there yet. The doctor was like, “Oh, you’re already dilated. It’s coming soon.” She stripped my membrane and was like, “Oh, in a day or two you’re going to have him but let’s just schedule an induction in case.” We get to 41 weeks and still was not having a baby. Having two at 39 weeks and then having to wait until 41 was an eternity. It felt like the longest wait ever. I think this was God’s way of saying, “You’re done now. You’re good,” because I remember feeling like I never wanted to be pregnant again. I am never giving birth again. This is the last time and I felt very complete with that whereas with the second one, it was like, Is this really the last time I’m going to carry a baby? Is this the last time I’m going to give birth? It felt really nice. I was still seeing the same doctor I was seeing with my middle son. She was on board. She was actually telling me that if you’ve done a VBAC and then you have another one, it’s not considered a VBAC. Is that what you’ve heard?Meagan: No, it’s still considered a VBAC but your risks go up. Your risks go up for vaginal birth and down for things like uterine rupture. Unfortunately, you’re always going to be a VBAC. Katie: Yeah. Okay, so risk went down. Okay. But she was totally on board with it. I had to be induced with this one. I literally have tried everything. I’ve had a C-section. I’ve had an epidural birth and I’ve had an induction. I can’t say that one is better. I feel like they are all part of my birth stories. Each one is special but I had to do the Foley bulb. I had to almost not get the epidural. My water broke a couple of hours into the hospital and then a contraction started very fast. I remember waiting for the anesthesiologist and going, “If he doesn’t get here, I’m having this baby.” As he was giving it to me, I felt like I needed to push. I didn’t say anything because I was like, I really want the epidural, but I was literally like, Oh my god. I have to push. I have to push. This is so hard. I actually did feel the worst contractions with that because I was literally at the end. After he was done, the nurse came in and I was like, “Hey, can you check me because I think I feel like I need to push?” She checked and she was like, “Let’s get the doctor. You’re ready.” It was like, epidural and now it’s time to push. My husband was actually getting food because they didn’t allow him in the room when I got the epidural so he was like, “I’m going to go get breakfast.” I’m like, “Cool, cool.” Then I’m sitting there like, “Umm, is he going to get back in time?” They were like, “Let’s do a practice push,” and I’m like, “He’s not here yet!”I got him out in one and a half pushes and there was my third boy. It was just such a different experience going from, I’m going to have to push for 3 hours. With this one, I remember thinking, I’m just going to let my body do what feels right. I’m not going to have the nurses tell me to push this way and do that. I’m just going to close my eyes and scrunch my face like they tell me not to do, but it felt so much easier. I remember asking her, “I did my practice push. Did that do anything?” She was like, “Yes. Please stop. I need to get my gloves and I need to get this.” So he was out and I had my third boy. I would say with the two vaginal births, my recovery was so much easier. Just hospital-wise, I was able to move around a lot faster. With my middle son, I was able to go to the park with my boys a week later whereas with the C-section, I don’t think I left my house for the first 6 weeks because I was so uncomfortable and it didn’t feel right. All three births gave me scars but in a different way. Meagan: Yeah. I actually really love that you pointed out that even with vaginal birth, there can be an extra recovery or extra things because I think sometimes in this world, it’s like, C-section is bad. C-section is bad. C-section is bad. VBAC is amazing. VBAC is wonderful. Okay. Absolutely. I believe that VBAC is amazing and wonderful. I do not believe that C-section is bad. I do believe that we have way too many unnecessary C-sections and that is bad. Katie: Right. Meagan: We know though that vaginal birth sometimes isn’t all sunshine and butterflies. We have tearing. We have prolapse. We have pelvic floor dysfunction for the next however long because we pushed for 2.5-3 hours or even an hour and a half or we labored for a really long time and we are sore or whatever. Sometimes C-sections can be just the most healing and beautiful experiences for someone. I love that you pointed that out. It’s just important to remind everybody listening to go with what you feel is best. No, you don’t have to schedule a C-section just in case. No, you don’t have to do these things but if you want to and that’s what feels right, do it. We encourage you. Katie: I absolutely did not have any incontinence problems after the C-section but after the vaginal birth now, doing jumping jacks and running is a different story. Yeah. It’s different. Meagan: I want to talk about that because I also didn’t have a lot of incontinence. It’s not like I have incontinence now but I have pressure and things like that. I just went to a pelvic floor specialist and she said– oh crap. What did she call them? My bones, the birthing bones, they are my pelvis, but my pelvis was stuck in a flared state from birth. Katie: Oh whoa. Meagan: She manually closed my bones. It was insane. I could feel it. She was like, “Oh, there’s no give. Can you feel it?” I was like, “Oh my gosh, yeah.” She worked it, did her PT thing and closed these bones. She said, “Sometimes people have these bones get stuck open after birth and it puts a lot of trauma on their pelvic floor and they have incontinence and all of these things.” Katie: Whoa. Meagan: She did two other things which blew my mind. I’ve never had that happen with a pelvic floor specialist before but my uterus was really, really hard and she was like, “It should move and float within.” She massaged my uterus and then she went internal and my bladder was adhered from the inside. Even though we have C-sections, Women of Strength, and you have had vaginal births and everything, if you’ve had that C-section, there is a likelihood of you having adhesions or scar tissue in there that may cause pelvic floor issues and incontinence. So anyway, my bladder was adhered and then there was a part of my cervix that needed to be released. She was like, “I wonder if that’s why you had such a long end.” My cervix would stretch but it wouldn’t stay. Or she said, “I see this a lot with failure to progress or cervical lips where there is this thing that needs to be released.” As soon as it was, I can’t even tell you the difference in how I feel. Katie: Wow. Meagan: The pressure is really pretty much gone. I would say there is maybe a little. She even said, “The next visit might need a little bit more tweaking.” I just ran the other day, 3 miles for the first time in forever. Usually after 1 mile, my pelvic floor would just give out. I did fine. Katie: Don’t you wish that was something every OB/GYN was like, “Okay, you’re going to see me and you’re going to go here”? Or you give birth and it’s not like, “6 weeks, you’re good.” It’s like, “Oh, now you need to go see this.” Meagan: Yes and it’s not talked about with C-sections either. A lot of time those C-section scars can cause back pain and pelvic floor things, urine incontinence, pain during sex, and things like that. We don’t even know that it’s related to our C-section because we’ve never pushed a baby out of our vaginas. Right? It’s so crazy. Katie: My youngest is 4 and I’m like, I should finally book that PT consultation and just find out what’s all going on down there. Meagan: Yes! My VBAC baby is going to be 8. At this point of this recording, he is 8 and here I am this year just going. I have done physical therapy before and pelvic work but I’ve never done it to this extent where I was like, Okay, I’m going to get down to the bottom of this and had results like this this fast. Katie: Whoa. Okay, let me ask you a question. Did you go through your doctor or did you just search and find one yourself? Meagan: I did search and find one myself. The craziest thing is I did call to see if insurance would cover it. They do not. It’s all out of pocket. So like you said, I feel like this should be a standard thing regardless of C-section or vaginal birth. It should just be part of our postpartum care. I actually think it should be part of our prenatal care. Katie: Totally. Oh my gosh. I know. Someone I know was getting really bad pains so she went while she was pregnant to PT and I was like, That’s exactly how I felt a year ago, because she was having it after me. I was like, I wish I would have known about that, because that would have really, really helped. Meagan: Yeah. Chiropractic care for sure. Pelvic PT. Know that not every birth is going to be amazing and beautiful but all we can do is prepare and understand. Katie: Right. Right. And be at peace with whatever is meant to be. I look back at my C-section. I tell my husband this all the time. If we would have lived on the prairie, I would have died during that breech birth. It would have been almost impossible to deliver him. I did seek out, are there any doctors who deliver breech babies? In LA there was one, but to me, it just felt a little too risky to even go down that route. 100 years ago, I might not have survived childbirth so the C-section for me was a lifesaver. It was so comforting to know that. My first vaginal birth though, I did have some complications after so just because you deliver vaginally doesn’t mean it’s a piece of cake and it’s over. At  my 6-week appointment, I remember telling my doctor, “Something doesn’t feel right down there.” She was like, “I’ll check it out. Let me see.” I was like, “No, really. Something feels wrong.” My labia actually, part of it fused together. She said there were probably mini tears and it literally was. I was like, “I just don’t think the hole is big right now.” She was like, “Oh, yes. I see what you’re talking about.” It literally fused together. She was a teaching doctor. She worked for a hospital so she was like, “We never see this. Do you mind if I take a picture for my students?” I was sitting there with stirrups. She was like, “I won’t get your face or say your name.” I was like, “Yes. For science, yes. Please take a picture of this.” I ended up in just the hospital visit where she had to cut it and then sauter it back together. I was able to do it in the doctor’s office. It was a super easy procedure, but I was numb during that and the recovery from having an open wound in that area when you’re peeing is not comfortable. So being 6 weeks postpartum feeling like, I should be getting back to normal, then oh God, this. Meagan: There are always hurdles. Katie: It’s not all roses when you deliver naturally either. But I was happy that maybe some other mom– because it was extremely embarrassing. I didn’t even want to have my husband look or tell my husband what this was but being able to share it with other moms, they were like, “Why doesn’t anyone tell you that stuff like this happens?” And thank God for modern medicine because again, had this been the prairie, I would have never had another child after that. Meagan: Might have been too traumatizing. Yeah. It’s just so hard to know. Everybody internalizes and processes differently their births and their experiences. Do the research. Get in your head in a good space. Find your provider and do the things and choose the birth that is right for you. Katie: Absolutely. Absolutely. Meagan: Thank you again for sharing your stories. Congrats. Katie: Oh thank you. Meagan: Definitely go see a pelvic PT. Katie: I’m booking one today. It’s time. It’s time. Meagan: It’s time. Women of Strength, I

In today’s episode, Meg from Nebraska shares her Cesarean and VBAC story. Meg’s first birth was an unexpected Cesarean after an almost 40-hour induced labor at 41 weeks and 3 days due to failure to descend. Her pain was not managed well during her surgery and her experience was much more difficult than expected. Meg surprisingly found out she was pregnant just 9 months after her Cesarean. Though she was anxious, Meg decided to go for a VBAC. She found The VBAC Link, prepared her body and mind more than before, found a supportive provider, and hired a doula. At 41+3, Meg went in for a gentle induction. She trusted the outcome would be different and it was. With the help of her doula, Meg was able to move much more, and with the encouragement of her midwife, pushing was a much more successful experience this time around. Meg says that bringing her 9-pound, 14-ounce baby up to her chest was the sweetest and best moment. Asynclitic BabiesHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello everybody. Welcome to The VBAC Link. Today we are going to be sharing our friend, Meg’s, story. She is a stay-at-home mom in Omaha, Nebraska and she has a two-year-old daughter who was born after a post-date induction and almost 40-hour labor that ended in a Cesarean. Just 9 months later, she was blindsided by a positive pregnancy test and spent the duration of her pregnancy preparing mentally, spiritually, and physically for the birth of her son. She had a VBAC and she is here today to share her story with you. Some of the things along the way through her story that I thought stood out were one, post-dates. Obviously, this is something that we– if you have been here at The VBAC Link, you’ll know that we talk about this. Post-dates– we have seen such a shift over the last few years, well really since the ARRIVE trials in dates and we really see that now the 39-week mark is more true to a 40-week mark. The 40-week mark is more treated like a 41-week mark and it’s really starting to become rare to even have people go to that 41-week mark and especially past it. She’s going to be sharing her story with you today actually with both births that went past 41 weeks. They were actually both induced so we have an induction that turned Cesarean and an induction that ended in a VBAC. She also has that close duration– that 9 months later, 17 months apart. So if you are listening and you are one of those mamas who may have been pregnant by surprise or chosen to get pregnant sooner than the 24-month mark or even 18-month mark that many providers suggest, definitely listen up for this episode. She also has a larger baby. Her VBAC baby was larger than her Cesarean baby. She also has a failed epidural. There was something that she said in her story that I wanted to point out. That is after many, many, many attempts that were not going well with this epidural, she asked for the highest anesthesiologist there. That is something that you can do right from the get-go. If you are wanting an epidural, you can say, “Hey, I want to make sure I have the top anesthesiologist,” because sometimes it is harder for people to place an epidural or if after one attempt it’s not going really, really well, you can just say, “Okay. Stop. I want the head anesthesiologist.” Another thing that we are going to talk about in there is the question. She mentioned The VBAC Link blog that talks about the questions for your provider. If you have not checked this out yet and you are still looking for a provider, I highly suggest checking it out. We will make sure that the link is in the show notes so that you can see more about who you are looking for when it comes to support versus lack of support because if we have not learned anything over all of the years of supporting VBAC clients, our own VBAC journeys, and listening to story after story, that is that support is huge so make sure you find the best supportive provider that you can. Something I wanted to add to this is if you have a female provider, you may want to ask them about their births if they have kids. We have seen here in Utah that there are some providers who will just schedule a C-section. They won’t even go into labor and for some reason in my head, that feels like a red flag if a provider doesn’t even believe in birth and their own ability to birth. I don’t know that they are going to believe in other people’s ability to birth so that might be something to consider. Last of all, I want to talk about asynclitic. We have seen many asynclitic births over the year and a lot of the time, once a baby is recognized to be asynclitic, they are pretty low and it can be a little bit harder to get a baby rotated and into a more ideal position for a vaginal birth. I wanted to share some tips that are right here actually on Spinning Babies. Check out spinningbabies.com. You know we love them and we will have a link here in the show notes as well. Do pelvic floor releases and the side-lying releases. Something that is really, really cool about this story is she had her pelvic floor specialist who was also becoming a doula but she had her with her which is so cool. If you are seeing a pelvic floor specialist, I highly suggest asking them if they would be able to visit you during your labor or come and do an exam or treatment during your labor. Just like chiropractic care is a really, really great one to do during labor, so are pelvic floor releases. You want to follow that with the lunge. The lunge will help you work better with the pelvic floor and help that side-lying release become better engage. Doing the dangle should follow the pelvic floor release and the lunge. Again, Spinning Babies is phenomenal and they have all of these like the dangle, what that is, and the lunge and all of these things they have in the link. Make sure you check out this link. Sometimes resting and not pushing is going to really, really help because if we have an asynclitic baby and we are pushing and pushing and pushing, that can get the baby further down and more stuck in the asynclitic position. Something that I have seen work with my own clients is an abdominal lift. We will do an abdominal lift into that side-lying release. You reach your hand underneath your belly and you slowly reach. You pull up and in and it can help pull baby up and in. Vertical positions such as standing, slightly bending your knees during a surge and also that abdominal lift is more ideal during a contraction. Standing with one foot on a stool, we know that asymmetrical movements are really, really great. Even if you can’t stand, say you are in a bed or something like that, you can try on your hands and knees or even trying to lay down and try to make your hips asymmetrical that way. Sitting on a toilet with one foot on the stool and the other foot on the floor, pulling on a towel or a rebozo during a pushing contraction, shaking the apples, and keep moving. You’re going to notice in this story that is what they did. They just kept on moving. If you have had an asynclitic baby before or you are in labor and you find that your baby is asynclitic, jot these notes down. These are wonderful tips on how to get that baby out of that asynclitic position. All right, right before we jump into this story, I do have a Review of the Week. This one is from srmnewyork and it says, “Thank you, VBAC Link.” It says, “My first birth in 2018 was a traumatic home birth turned emergency C-section. I had done everything I was supposed to to avoid interventions and a C-section but ended up with all of it anyway. The whole experience was crushing and it took years to recover from. Listening to The VBAC Link was a huge part of my emotional processing. Hearing other women’s stories helped me feel less alone and gave me the courage to try again. When I became pregnant in 2022, I knew I had to do things differently. I took all of the advice I had gotten from The VBAC Link and put it all into action. I got a doula. I found a VBAC-supportive provider. I took the VBAC online course and was emotionally prepared and surrendered to the birth process. Well, just 12 days ago, I had my VBAC. It was amazing and left me euphoric for days. So much of my success I owe to this podcast. Thank you for helping me experience my dream birth. I am forever grateful.”That was left just about a year about a year ago so srmnewyork, if you are still with us, I just wanted to give you a huge virtual hug and huge congratulations. Thank you so much for sharing that amazing review. As always, if you have a moment, please press pause right now and leave us a review. We love them and love sharing them on the podcast. Meagan: Well, welcome, Meg, to the show. Thank you for being here with us. Meg: Yeah, it’s great to be here. Thanks, Meagan. Meagan: Oh my gosh. I’m so excited to talk about your story. I feel like two key things about your story are things that we see honestly on a daily basis in our inbox. That is, “I’m 40 weeks and my provider is telling me that I have to have a baby today,” so the post-date thing. Can we go over post-date? And then honestly, the stress surrounding the close duration of babies is insane for moms out there because these providers are just putting so much stress on these moms saying they can’t VBAC with a close duration and we know that studies vary, but I am excited to talk about your stories because you have a 17-month gap, right? Meg: Yes. Pretty tight, yep. Meagan: Okay, so we’ve got the post-date and 17-month gap. All right, let’s talk about baby number one. Meg: Absolutely, yeah. So with my daughter, we found out that we were pregnant just a couple of months after I had a miscarriage actually. So going into that pregnancy, I was already feeling just tender and raw and didn’t really know what to expect with how well the pregnancy would go. I did as much as I could to prepare. I took a birth class that a friend had recommended with a doula here in town and really just sailed through that pregnancy. Everything was healthy and good. There was never any real concern from my providers but there was always in the back of my mind, What could go wrong here? Yeah, I was just anxious going into that whole labor. Meagan: Do you think it was from your previous loss? I know it’s very common after a loss where you do have that feeling of, I just want this baby so badly so I don’t want anything to go wrong.Meg: Yes, absolutely. At every appointment, I was holding my breath waiting to hear the heartbeat, and every time it happened, it got me through to the next appointment. I had actually with that previous pregnancy seen a practice of OBs and then shifted my care to the midwife practice at the medical center here in Omaha. For me, that shift helped reset a little bit for these different stories. With the midwives at the med center, you see a rotating group so you never know who is going to end up being at the birth. They want you to see all of the midwives for your prenatal care. There were definitely some who I connected with more than others. I was definitely hoping and praying that I would get the one who I bonded with the most and also was hoping and praying that labor would happen naturally. Unfortunately, I ended up at post-dates with my daughter. I was 41 weeks and 1 day when the midwives wanted to go ahead and induce me. I went in for that induction and it’s kind of funny because I think I expected that induction to go a lot more smoothly than it ended up going. I had heard of one of my husband’s coworkers who had been induced at the same hospital a few weeks before and her induction went just right as rain. She had her baby within 6 hours. Meagan: Oh wow. Meg: Was she a first-time mom? Meg: Yeah, she was a first-time mom so I was like, I can do a 6-hour induction. That sounds great. It did not go that way. We went in for my induction at 7:00 in the morning. They started me on Pitocin pretty much right away. They basically said that my cervix was ready enough that they didn’t need to do any cervical ripening or anything like that. I was like, Okay, here we go. Pitocin– I know you’re not really supposed to go on Pitocin, but I’m here for this induction so I have to do what they tell me to do. It was just me and my husband so we just went with the flow and we just hung out. We watched TV while we waited for the Pitocin to kick in and they came and did their checks every once in a while. I felt like I was in a good headspace at the beginning and was ready for whatever to happen. When they came in and did the first cervical check, I think it was maybe 6 or 8 hours in. I had made little to no progress so I was pretty discouraged by that but I was like, Okay. We’ll just keep rolling with the Pitocin. They had to amp up the Pitocin almost as high as it would go and things gradually started to pick up but I think at one point, they took me off of the Pitocin and did a little Pit break or reset my body. I think that did help. When I went back on the Pitocin, it definitely ramped up my contractions more. About 15 hours into all of this, they did another cervical check. I was like, Surely I’m going to be 8 centimeters. I’ll be into transition soon. I was still 4 centimeters. I was extremely discouraged at that point and I was exhausted. I hadn’t had any pain management up until that point. I was like, Okay, I think I’m ready for the epidural. I don’t think I can do 15 more hours of this. If I’m only at 4 centimeters, I’m not even halfway there. Who knows how long the rest of this labor is going to go? I ended up getting an epidural. They let me take a bath before my epidural which I was really grateful for because that’s what I originally wanted my pain management to be was hydrotherapy and at the time, I couldn’t be on Pitocin and be in the tub. That was the last little shred of comfort that I got before being grounded to the hospital bed. I was able to get some rest then with my epidural and just laid there in my bed. One of the nurses came and she tried to do all of these rotating moves to help things along and I was just exhausted. I didn’t want to have anything to do with it. They tried the peanut ball. They tried rotating me and all of this. My daughter was handling the labor really well. I was just so burned out after so many hours of everything. At one point though, they decided, “All right. We’re going to go ahead and break your water and see if that gets things moving.” They did that and then they placed a fetal monitor in her scalp which just didn’t go super well. I think the midwife tried– I don’t know. She tried for a while and my husband was really upset with how long it was taking and how much pain that I was in. Meagan: Oh yeah. Meg: The nurse at one point was like, “Should we call OB and see if they can help you out with this?” The midwife was stubborn and she didn’t really want any help with that. She did finally get it in and things moved along great but I was definitely put off by that lack of humility for lack of a better word. I just wanted to have the best care that I could. Yeah. Basically from there, my daughter was doing well again, but toward the end of everything, I finally hit 10 centimeters. I was ready to push. I was so excited. They took a picture. They were like, “All right. This is going to be your last picture as a family of two.” I look like a beached whale in the picture. It’s the most horrific picture I’ve ever seen. Meagan: Aww, I bet you don’t. Meg: But we were excited. We were like, All right. The time has finally come. At this point, I think I had been laboring for 25 hours so I was ready to push. With the epidural, for some reason, I just didn’t have a ton of mobility. Obviously, with some epidurals, you have mobility and some you don’t. With this one, my legs were dead weight so pushing was extremely challenging. Yeah. I pushed for a while. I felt like I wasn’t getting any feedback from my midwife or the nurse. My sweet husband was just like, “You’re doing great. You’re pushing so well.” My provider– I felt like I was staring into a blank face. Nobody is making any sort of encouragement and for me, that was just like, I don’t know how I’m doing with pushing. They say everything is fine but I’m not getting a lot of encouragement or feedback. At one point, they brought the mirror because I thought, Maybe that will give me some good feedback. I hated the mirror. Meagan: You did? Meg: For some reason, I was thinking, Oh, if they’re bringing the mirror out, you must be able to see the head. That’s why they would bring the mirror out. No. You could not see the head. You could not see anything so I was just like, What am I just staring at? I don’t want to look at this. Meagan: Maybe they did it a little prematurely because a lot of the time they bring it out and it can help you. They say it can lower pushing time because you are seeing it and there’s that connection. Meg: Sure. Meagan: I could see how that would just be frustrating. Meg: Oh man. It was terrible. Meagan: You’re like, What am I looking at? Why am I just looking at myself but nothing is happening down there? Meg: Yep. Not great. I had them take that away and continued pushing. I think I ended up pushing for almost 3 hours and at that point, my husband and I were like, “What do we do next? This is clearly not working.” My midwife was like, “Well, let’s call in OB for a vacuum delivery consult.” We’re like, “Oh, great. That’s not a C-section. This will be great.” We waited probably for an hour. They told me not to push while we waited for the OB and she was attending to some other matter in the hospital. We just kept asking, “When are they coming? When are they coming?” They sent I think a resident to come and check things out. By this point, I had so many hands up my vagina. I was like, “If she’s going to check, if this resident is going to check my cervix and then the doctor has to check the cervix, can we just skip one of them and just have the OB check so I don’t have to have that many hands?” Thankfully, they respected that and we were able to wait for the OB. Finally, they came in and we’re thinking, Okay, great. She’s going to do this consult and we’ll get the vacuum going. She came in and was basically like, “It’s not possible for us to do a vacuum delivery at this point.” My baby wasn’t low enough for that to even be feasible. So then she was like, “Let’s check for forceps delivery.” That wasn’t going to be feasible either. She basically said they wouldn’t be able to fit the forceps around her head the way that it was. Meagan: She was too high. Meg: She was too high and I think she was also asynclitic so she just wasn’t going to come down. After hemming and ha-ing, she was like, “You could push for another hour and then we could attempt a vacuum but we might still end up needing to do a C-section.” We were like, “I don’t really want to keep pushing for an hour if a vacuum is a maybe and probably not.” At that point, we basically decided, “Okay, we’ve been laboring for so long. It doesn’t seem like these are going to be feasible solutions,” so we just decided to go back in and have the C-section. I just remember that being a whirlwind process of them getting me ready and I was in so much pain from having pushed for so long that I was just shaking. My shoulder blade just had raging pain while we headed back to the operating room. I just remember feeling everything. I know they had me on an epidural. They had me on pain meds but I felt like I could feel the tugging and the pulling. I was apparently very verbal during the process asking for more pain meds. My husband actually works at the hospital so he knew the anesthesiologist. He is a critical care pharmacist so he is very familiar with medications. He was advocating for my pain meds at that point. Things just didn’t go well during that whole process. They did finally pull my daughter out and they held her up to the clear plastic. I just remember she grabbed my little finger through the plastic. Meagan: She did?Meg: Yeah, it was so sweet. They pressed her up and I just stuck my hand up. She grabbed my little finger and after all the trauma from the whole day, that was definitely the bright spot in getting to meet her. Yeah. It was kind of crazy. Then afterward, they rolled us into recovery and I ended up being in the hospital for 3 or 4 more days just from recovering. We had nurses and doctors all say, “You can attempt a VBAC. You should try a VBAC with your next baby.” I was like, “Hold on. What’s a VBAC? I just had a C-section. Why are we talking about my next baby?” Yeah. I didn’t really know what I wanted at that point. Meagan: Yeah. Meg: Yeah. I was just trying to wrap my head around the disappointment of everything going wrong and just feeling overwhelmed with feeling like all of the things that I had hoped and planned for the birth didn’t go as I had hoped. Yeah. So yeah. Meagan: So eventually you did decide, Okay, baby number two. Did you decide? Meg: We didn’t. Meagan: That’s a legit question actually, right? Meg: My next pregnancy was definitely a surprise. I had spent a lot of time trying to actively work through my recovery with my C-section. I had seen a core and pelvic floor therapist. She and I actually became really close. She worked with me for months. I mean, probably really from my birth until my next birth she worked with me. I felt like I was just starting to recover and I remember the day that I found out I was pregnant. My friend and I had gone shopping all day. I was just exhausted coming home from this shopping trip. I was like, I feel like I’m next level exhausted. Maybe I’m pregnant. I took a pregnancy test just on a whim. My daughter was napping. My husband was on the couch. I was like, This is probably going to be negative. I’m just tired from walking around all day. It was positive and I was shocked. I called my husband into the bathroom and I was like, “I’m pregnant.” He was definitely shocked too. I think I was more devastated because I was like, I’m just recovering from this C-section. Meagan: 9 months out, yeah. Meg: Yeah. My immediate response was just fear and anxiety about giving birth again. I wasn’t sure if I wanted to attempt a VBAC because I wasn’t sure if I wanted to go through another 36-hour labor to just end up in a C-section again. For me, preparing throughout that pregnancy was critical just preparing emotionally, physically, and mentally. The doula who had taught the birth class for my daughter, I ended up hiring her right away. I was like, “Are you available? I know I need a doula.” I started listening to The VBAC Link. She recommended your podcast and your website so I knew that I wanted to have a doula in the picture. I had pastors and family and friends praying for us for this decision about whether or not I should attempt a VBAC and I also just spent a lot of time. I felt like for me, I really needed to wrestle through some of the spiritual aspects of what I had gone through during my daughter’s birth. I found a couple of books that were a really huge encouragement to me as a person of faith just thinking about the concept of birth through scripture. One of the books was called Holy Labor by Aubrey G. Smith. She walks through doing some spiritual exercises to prepare your heart and mind for the process of birth. I think that was just something that I hadn’t really done with my daughter so I wanted to spend some time really preparing for this birth and making sure that I was seeking the Lord’s guidance and submitting to what I felt like He was asking me to walk through with this birth as it wasn’t something that was in my plan to have this birth so close together. For me, that definitely helped prepare my heart and my mind. I also spent some time with guidance from The VBAC Link. I looked through the questions that you guys have for asking a provider about if they are truly a VBAC supporter or not and with it being a team of midwives, with it being a research hospital and a teaching hospital, they are definitely very pro-VBAC. Several of them had VBACs themselves so I definitely felt like I had a great team of midwives who were going to be advocating for me through my labor and delivery. I found out partway through my labor that my pelvic floor therapist was also training to be a doula so I invited her to the birth as well. We had quite the posse with my doula, my pelvic floor therapist, and then this team of midwives. I think in the process too, I’m not sure who recommends it. I’m sure I heard this on your podcast as well. I started doing all of the Spinning Babies exercises pretty early on. I was trying to eat better and walk more and just be healthier in every aspect of that pregnancy. Something that happened during my labor at the med center was that they approved water birth at the hospital and then also included VBAC moms in that so I was super excited to try a water birth. I had wanted to use hydrotherapy with my daughter so getting the opportunity to do that for my next birth, I was really excited about. Throughout the process too, my midwives were very supportive about waiting as long as I could to start labor. I really wanted to labor naturally. I did not want to go through another induction but as we were getting past 40 weeks, I think I went in for at least two membrane strippings before 41 weeks. I think at basically 40 weeks and then midway through the week, I went through and did another one of those. I definitely started to have more contractions after those, but nothing that was picking up and getting ready for actual labor. They basically started encouraging me, “Let’s go ahead and schedule your induction.” I remember just being so upset about that and also really not wanting to have the midwife who I had previously. For me, I felt like I needed to have a clean slate going into this to try and attempt a VBAC. Two of the more senior midwives, I ended up meeting with them. I had my regular prenatal appointment and then the one came in and joined us. They basically helped me talk through my fears around induction and my previous experience. They really listened to what had happened and they really wanted to make sure that I had the support I needed going in to attempting this VBAC.Basically, we plotted out, “Okay. We are going to do the induction on this day.” It ended up being 41 weeks and 3 days. The midwife who was going to be on duty throughout that weekend, it was a Saturday. She was going to be there Saturday and Sunday. I would have her basically regardless of how long my labor took. She was going to be there. To me, that was a huge encouragement. She was actually the midwife who I hoped to get with my daughter. I felt really good about scheduling that induction even though I really didn’t want to. Yeah. I basically just tried to do everything I could before that. In that week, I was walking curbs. I was doing my Spinning Babies. I went and I talked to my doula. I was like, “Is there anything else you recommend to try to get this labor going?” I had been drinking my raspberry leaf tea. I had been eating my dates. I had been doing all of the things and she recommended acupuncture. Meagan: I was going to say acupuncture maybe? Meg: I went and I tried it, yes. I saw the chiropractor throughout. I had basically been doing all of the things you guys recommend and my doula had recommended throughout my whole pregnancy. The acupuncture was not helpful. It felt like torture for me. I was just sitting there. I think it did start some contractions because that night I felt a lot more contractions but then they waned off, unfortunately. Yeah, so then Saturday morning, the day of my induction, I was finally mentally prepared for, Okay. I’m going to go in and do this induction. I have my doula. I have my pelvic floor therapist. My husband is going to be there. I know the midwife. I like her. I knew that I was going to have this great team there for me. I’m in the tub just getting ready psyching myself up and I get a call from the hospital. They basically were like, “We’re going to need to push your induction.” I was so mad. I’m finally ready for this induction. Please don’t push this induction. We waited. They were like, “You’re on the top of our list to call in. You’re 41 weeks plus 3 days. We definitely want to make sure that you get induced today. Call back if you don’t hear from us.” I think we did. I think we called back two or three times like, “Hey, are you ready for us yet?” They were like, “We’ll call you. Please just wait.” We finally did. I think we went for a walk that morning. We spent some time with my daughter and my mom who was there to stay with my daughter. We enjoyed the morning and we finally sat down to lunch I think and we got the call that they were ready for us and they asked, “How soon can you get here?” We made our way. We put my daughter down for a nap. For me, that was a really sweet moment. I didn’t know if I would be coming home from a vaginal birth or a C-section so I wanted to pick her up and put her in her crib one last time, then leaving her knowing that she was asleep and going to be fine during my labor. Yeah. We went for the induction. I think when we got there, they did their initial checks and all of that and started with a membrane sweep. At that point, I was 4 centimeters, 50% effaced. Meagan: Oh, that’s good. Meg: Yeah, I was pumped that I was starting from 4 centimeters. I was like, Okay. I’m not going to labor for 15 hours and still be at 4 centimeters probably. Yeah. We all started in really high spirits. They started Pitocin. This time, they had it where I could walk around with it which was really nice. My doula had me walking the halls. We were squatting. We were leaning over the bed. We were sitting on the ball. We were doing everything. She was like, “I’m going to work you to get this baby going.” We did that for a couple of hours. I basically didn’t want to get checked for as long as possible. We labored as much as we could. I think we started that at 2:30 in the afternoon. At about 6:30, I started needing a little bit more help from everybody with counterpressure and all of that, then I was requesting a cervical check. I started to feel like something was going on. My midwife came in and did the cervical check. She told my doula because I was like, “I don’t want to know if it’s bad news.” My doula was like, “Do you want me to tell you?” I was like, “I suppose.” I was still at 4 centimeters but I was 90% effaced. Meagan: Huge progress. Meg: Yeah. For some reason though, I was so stuck on the fact that I was only at 4 centimeters that I was like, “90% is nothing.” Meagan: Oh my goodness. From 50 to 90, that is huge progress. Meg: Yes, so I was like, “Okay. We’ll just keep going how we’re going.” She was like, “Do you want to try the tub?” I was like, “Oh yeah.” For some reason, I was thinking I was going to love the tub because I was thinking I could just lay in the tub and relax. My doula was like, “No. You need to be squatting in this tub.” I just could not get into a position in the tub that I was enjoying. We got out of the tub and just labored on the toilet. That, I think, is where I spent most of the time actually. Meagan: Dilation station. Meg: Yeah, there you go. My husband and I would just sit in there in the bathroom and just talk and giggle. He really kept me in high spirits throughout the whole labor. I was definitely getting to a point though. I think it was a couple of hours after that first check and I started asking for the epidural. My doula was like, “I think we should wait. You’re doing really well.” I’m like, “I’m not doing well.” My husband, the pharmacists that he is, was like, “What else can we try? Can we try some nitrous?” I was like, “I don’t think I’m going to like nitrous. I don’t know if I’m going to be able to do that.” We were mulling over that. They did a second check at 10:00 PM and I was finally 5 centimeters. I was like, “Okay. We’ve bumped up the centimeters.” I was 100% effaced so I was like, “Okay, things are moving. I don’t want to do an epidural yet.” So we started on nitrous. I labored on nitrous for a couple of hours. That was going well at first. I was in bed because I was just so exhausted at this point. I remember on the nitrous, I could definitely feel pain but I did not care. Meagan: Yeah, it takes the edge off. Meg: Yes, yeah. It was kind of wild. I would have these thoughts while I was on the nitrous like, Oh, this is horrible and everything is going to be terrible, but then the contraction would pass and I would be like, Oh, everything is fine. It was such a wild experience. At that point, they were setting up the table for baby so I was thinking, Okay, they’re setting up the table. I must be really close if they are setting up the table for this baby. I was in so much pain and I was like, Surely I am 9 centimeters and we are getting this room ready for this baby. I think toward the end of that couple hours, it was almost 1:00 AM, I was definitely starting to not cope as well. Even with the nitrous, I was screaming and rigid and couldn’t handle it. My midwife mentioned pain management. She was like, “I think we should do a cervical check and maybe it’s time to think about an epidural.” I was like, “Finally. I’ve been asking for this for hours,” even though I didn’t want to do it in the first place. Oh, I forgot to mention in all of this, my birth plan was to have this water birth. While I was on nitrous, they roll in this birth tub which is one of those soft-sided which I think was a home birth tub. They started filling it with this tiny hose. It was going to take hours for this thing to fill to the point in which it was going to be therapeutic. So I basically took one look at that tub and was like, “Yeah, that’s not going to happen.” It was kind of disappointing. I had really wanted to try a water birth. I thought that was going to be so sweet. This is going to be my story. VBAC, first water birth VBAC at the med center since water births were approved. I just let that dream die a little bit. I’m like, If we just have a VBAC, I’ll be fine. Yeah. They placed the epidural. They checked me. I was 8 centimeters finally. I was like, Okay. This is moving more quickly. They placed the epidural so I could get some rest and it worked for a little while then it did not work. So they came. Anesthesiology came and tried to problem solve. They were moving me all around trying to get me in a good position to see if that was the problem. My doula was just horrified during this whole situation. She was like, “This should not be happening.” I think they ended up calling in basically the head anesthesiologist finally who was like, “Do you want me to place it again?” I was like, “Yeah, why haven’t we done that yet?” So then they placed it again and then it was the perfect epidural. It made the pain manageable but

We have received so many messages and emails from you requesting more VBAMC stories and today, we are giving you just that. Susana joins us from Mexico sharing her VBAC story after five Cesareans!Each of Susana’s Cesarean experiences was unique in their own way, but the dream of a vaginal birth never left her heart. When she found a supportive midwife and doctor during her VBA5C pregnancy, Susana knew this was her chance to finally achieve that goal. With her husband by her side encouraging and supporting her, Susana powerfully pushed her baby out. The hospital staff and community buzzed with shock and amazement over what she had achieved!“That moment was unlike any other moment in my life.”ACOG Article: Dr. Angelica GloverEvidence-Based Birth: The Evidence on VBACNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength, this is the moment so many of you have been waiting for. We have a VBA5C so for anyone who doesn’t know what that means, it is a VBAC after 5 Cesarean story for you today. This has been requested so much. We received emails in our personal email. We have gotten it on social media saying, “Please, can we get some stories that have VBAC after more than 3 Cesareans?” We know so many people out there don’t know that this is an option or they know it’s an option but they don’t find the support or they can’t find the support. They are few and far between but we have our friend Susana today who is going to be sharing her VBA5C story. Welcome, Susana. How are you?Susana: Hi. Thank you so much for inviting me. I’m so excited. Meagan: Oh my gosh. I am so excited. Yes. I am so excited and you are in Mexico, correct? Is that where your VBAC was? Susana: I’m sorry? Meagan: Was your VBAC in Mexico?Susana: Yeah, but it was a very, very hard way. I’m going to share what I did. First of all, I can’t separate this way from my faith because I prayed so much for this and I trusted so much and also, I trusted so much in the process and in the body and those things But okay, I’m going to tell you what happened with me and why I had five C-sections. First of all, I got pregnant in 2009. My pregnancy went very healthily with no problems at all. I was 41+5 weeks and I had a doctor who was– well, he said he was for natural birth. I don’t know how to say it. He was pro-birth. Meagan: Yeah, that he’s pro. He’s supportive. Susana: Supportive. Yeah, that’s the word. But in reality, he was more C-section-supportive. While we were passing a very difficult part of our life because my father-in-law passed away exactly on my due date. We were very emotional and very sensitive. Labor wasn’t starting so the doctor said, “No, baby is not engaged. You are only 3 centimeters. I can say that baby is not going to birth naturally. I say that it is better for you to go directly to the C-section.” I was disappointed because I was walking so much every day, but for the situation for my husband and all of the family, I accepted. We went to the C-section. I got pregnant again in 2010 8 months later and I was very excited to now get a VBAC. The doctor said he wasn’t going to support me but in the end, I had a TOLAC, a trial. I was progressing well. I was 5 centimeters when I went to the hospital and the doctor was a little bit nervous because the C-section that I had before was one year and five months before so he was like, “You have to be fast because we have the risk of uterine rupture.” He started to make an impression on me and I was starting to be stressed. After 5 hours I think, he said, “Baby is not getting down. You are still at 5 and we are going to the C-section again.” I cried a lot and my husband said, “We tried and we can’t do this anymore. It can be dangerous. Go to the C-section.” It was very traumatic because they put in the epidural and it only worked in half of my body. I started to scream, “No, please. No. I can feel everything.” They put the epidural in again. It was difficult. Then I got pregnant again in 2012 but I didn’t fight anymore. I decided for a repeat C-section. The good part is that it was peaceful because I was accepting the situation. Everything went well. Then I got pregnant in 2013. Also, we were going to opt for a C-section because I didn’t have any other chance but the doctor started saying, “No more babies. Four C-sections is a thing,” and things like that but my husband and I were talking about it and we thought that it wasn’t an option for us to have– I don’t remember the word. Tying the tubes. Meagan: Oh yeah, a tubal. Susana: Yes. The sterilization. So we went to a repeat C-section. It wasn’t as smooth as the one before because my baby was 37.5 weeks so we had a little problem with maturity. Is that the word? She was very small. Meagan: She was technically preterm. Susana: Yeah. Preterm. She showed signs of preterm. She was whimpering and something like that. We had to go to the neurospecialist. Everything was going well and there was no problem at all, but we were careful for another pregnancy. We waited a lot and we got pregnant again in 2017. I spent the half of my pregnancy with the same doctor, but at half of the pregnancy when I was 20 weeks, some friend told me, “Oh, you know what? There is a mom in Brazil who had a VBAC after four C-sections.” I was like, “What?” I didn’t know that existed. I started to inform myself and I found a supportive midwife but she said, “We aren’t going to chance it to go to the hospital. We have to have the birth in your house.” We prepared everything for the home birth and the bad thing is that I was anxious at 39 weeks and had prodromal labor. I passed the due date. I was 41 and 42 and then 42.5 weeks so stress started to play a role here. I started labor but I passed three days in labor so that was really, really hard. I passed two days at 5 centimeters dilation. Then my midwife said, “I don’t know what has happened. I think we can’t wait anymore. You have to go to the hospital. Baby is good.” The heart rate was optimal but I didn’t know what to do anymore. We went to the hospital. It was the only public hospital. Oh, the doctors were freaking out like, “What are you doing? Come on. You have to get the C-section 2 weeks before.” I suffered very, very much obstetric violence. It was very traumatic. Baby was very low. I was at 8 centimeters when I got to the hospital. I was begging for them to let me try and let me push but they said, “No. You are crazy. We have to go to the C-section right, right now.” When they pulled baby out, they broke the uterine artery and I lost a lot of blood. I was very weak and it was very painful. That was a disaster. We were like, “No more babies I think”, but by the grace of God, I got pregnant again in 2021. Sadly, I had a miscarriage on Christmas actually. It was very sad. But I don’t know. That miscarriage let me know that my body works and that I would be able to have good contractions and my body was able to give birth. I prayed, “God, if you want, I want another baby.” In November of 2022, I got pregnant again and that time, I was totally strong to fight for another try to have a vaginal birth. My husband was totally against the trying. He was so scared. Also, I was a little bit scared, but I was trusting at that time. I was trusting so hard. I was praying so hard. I decided to not go to the doctor because I was so scared of the doctor. I was hesitant. I don’t know why I didn’t want to hear, “You are in danger. No. This is so dangerous. You can’t try. You have to go directly at 38 weeks to the C-section and you have to have a blood transfusion and you are of advanced maternal age,” because I am 41 years old, but I don’t know. I said, “I don’t want that in my pregnancy.” Actually, I had a friend who had seven C-sections and then had four home births. She was telling me, “No. Trust God. You have to know when they talk from fear and when they talk from the truth.” I could tell that a lot of people were speaking to me from the fear they felt, not from the truth. I stayed with that doctor until 28 weeks. I found a doctor who wasn’t judging me and who was open but he didn’t have experience with VBAC after multiple C-sections so he said, “I can check you and support you but not in the birth. I can’t do that. I have no experience.” Well, for me, it was like, “Oh, I’m at the beginning of the way.” Okay, so I kept praying and when I was 34 or 35 weeks in the pregnancy, I had a doula who gave me a contact of a midwife that she was supporting VBAC after three C-sections in a hospital with a doctor. I said, “Maybe there’s a chance for me.” I contacted her. I talked to her and she was very optimistic. She said, “Yeah. Of course. I can support you. We can prepare a home birth. I can support you. I can be your attendant.” I don’t know the word. Meagan: Maybe advocate? Susana: Not advocate. I mean, she was the one who received the baby. Meagan: Oh, like catching. Yeah, attending. Susana: Yeah, attending the birth. But my husband was like, “No, not a chance.” Because for my husband and also for me, it was very difficult and not secure. We were scared. We thought about what if something happened. That midwife told me, “I can speak with the doctor and maybe we can have a plan.” I said, “Okay.” I was 36 weeks so it could be difficult that he started to attend me in these late weeks. But I still had trust and confidence in God. I kept praying all of the time. One day, she called me and said, “Susana, good news. The doctor said yes. I told him all of the truths. I didn’t hide anything and he said, ‘Okay. If you are with me, I can attend this birth. But I need to watch her in the next days.’” So we went to the doctor. The doctor was in another city 40 minutes to an hour away from here. My husband couldn’t be with me so my parents went with me. My parents were so scared. Meagan: I bet. Meagan: They were very against trying. My husband wasn’t completely confident about it. All of my environment was against the VBAC. When we went to the doctor, the doctor was so supportive and so humane and so good and so kind. He said, “We are going to try. We are going to make our best. We are a good team. The midwife and I work together very good and very successfully but I’m going to keep all of the team here if we need the C-section in the last moment.” We agreed on that. My parents were so relieved. We talked with my husband and he was relieved also but he also had doubts. But in the environment of a hospital and– oh, I don’t know the word. The place where they make the C-section? Meagan: The operating room? Susana: Yeah, the operating room. In the side of the room, if everything was good, we trusted. He was supportive for the first time. He said, “Okay.” Two weeks passed after this visit and there was the moment when I started getting excited with things with labor. It was on the 11th of August last year in 2023 when I saw my mucus plug and the bloody show. I said, “Oh. I think things can be starting at any moment.” But in my last experience when I had the bloody show, it was two or three days before the labor really started. I patiently waited and the contractions started to be hardest but there was a half hour in between them. It was very manageable and still manageable. I passed the day with my normal activities. I had lunch with my parents and my five kids. I went to gymnastics class with my daughters and actually at night, we went to mass with friends and families that we know. A friend of ours invited us to dinner and I said, “No. I want to go home.” My husband was like, “What? You don’t want to go anywhere.” My husband started to sense that something was wrong. We returned to home and contractions started to be closer and intense. I wrote to my midwife and she said, “Okay. You have to count how many contractions happen in one hour,” so I started counting and from 10:00 PM to 11:00 PM, I had nine contractions. I wrote her and she said, “Okay, you are starting. I’m going to go to your home.” By the way, she lives 2 hours from my city so she came to my place at 2:30 AM and checked me. I was only 3 centimeters and 60% effaced. She went and she said, “Oh, congratulations. You are a 3. We only have to wait 7 more.” She was so positive and so kind and so lovely. But for me, it was like, What? 3 centimeters. There’s a long way to go. I was so disappointed and I started to have a crisis thinking, Okay. This is going to be three days of labor. It’s starting to be unbearable. I don’t know what I’m going to do. My husband told me, “You have to know that this is not going to be easy.” I was like, “Oh my god. What is going to happen?” I wrote a friend and she told me, “Maybe you were wrong. Maybe you are not in labor yet. Maybe it is prodromal labor so calm yourself and keep making your activities as normal.” I said, “Yeah, maybe that’s true. Maybe I’m not in labor yet.” One of the things is that my contractions don’t hurt in the uterus or in the belly. They hurt in the legs. Meagan: Oh. It radiates down. Susana: Exactly. I felt like it started in the hips and ran into the legs but I felt like– I don’t know how to say– but a burning. Yeah. It was burning pain. It was very, very intense. My friend told me, “Put one leg on the chair and one leg on the floor and balance side to side while a contraction comes.” I made that and that was really, really helpful. I could have a contraction very easily that way. I was telling myself, “My pelvis can open. My baby can know how to birth. Everything is okay. God is with me,” and things like that. That affirmation worked very, very good because it calmed myself and that’s how I passed the contractions all day long. Not the day, only the morning. My daughter, that morning, had a science fair so we decided it was at 8:00 AM so we went. It was the worst time for me having those contractions every seven minutes and very painful. All of the parents were like, “What is happening to her?” Meagan: That’s amazing that you went. Susana: It was because I thought, I’m going to have three days in labor. My midwife had told me that when there’s a labor after so many C-sections, there’s a lot of times that it lasts three, four, or even five days so in my mind, that was my expectation. While I was at the science fair, I said to my husband, “Please take me home. Let’s go home. I am in a lot of pain.” I called my midwife again and she came. She checked me and I was 6 centimeters so for me, I was like, “What? Whoa!” Yeah. She said, “We have to go to the hospital.” Oh, before that, we were planning to rent an AirBnB in the city which is Leon, Mexico to spend with all of the family those days that I was supposed to be in labor. So she said, “Forget about that plan. We will go directly to the hospital.” We called the doctor and the doctor said, “I need to check her with an ultrasound. You need to go to the office with me.” I thought it was useless, but we went to the office. It was the worst travel because I had contractions every 4 minutes and we were traveling in the van, but the good thing was that my midwife was making pressure on my hips and that released the pain. After 1 hour and 20 minutes, we arrived to the doctor. He checked me really fast and he said, “You are 6 centimeters.” Again, I was so disappointed because I thought, “Oh my god. One hour and I’m still a 6.” But my midwife told me, “No, I don’t think so. I think you are maybe a 7 or an 8.”She is very wise. She had a lot of intuition. So we went to the hospital and it was 20 minutes away from the office. We arrived at the hospital at 12:35 PM. When we arrived at the hospital, he wanted to put me in an emergency room, but the doctor arrived immediately and told them, “No. Put her directly in a room because it was going to be a room birth.” I gave birth in a room, not in an operating room, but in a labor and delivery room. Meagan: They had you labor the rest of the way and give birth in the operating room?Susana: Yeah. In Mexico, all of the births happen in the operating room. Actually, it’s not an operating room but it looks like it. It only has that stuff that they put the woman with the legs up. Yeah, I don’t remember the name, sorry. Meagan: Like just the position? Susana: Yeah. Meagan: Okay, gotcha. Susana: So we went to the room. My midwife said, “Do you want to go to the shower?” I said, “Yeah, please.” I went to the shower. At that time, my water broke like a balloon because I felt something really big getting out. It was shocking and I was like, “What? Is that the placenta?” She said, “No, let me see what it is.” It was the amniotic sac almost complete. It was amazing because my midwife told me, “I’ve never seen something like this.” It was amazing. After that, the contractions felt very different with no pain and I started to feel to push. It was very different for me and very scary because I never felt something like that. Meagan: Right. Susana: My midwife told me, “You’re going to birth now. You have to choose your position.” I stayed on my knees on the floor with the arms on the bed and started to push my baby out. I can say I didn’t feel any pain in this moment. I only felt the pressure. I think I had the reflex, the fetal ejection reflex.Meagan: Yeah, mhmm. It’s like where the baby just comes out. Susana: Yeah, because I wasn’t pushing and my body was pushing. It was an amazing feeling but also, I was scared because I didn’t know how to do that. My husband was praying with me and he was very supportive and very loving in that moment. That moment was awesome. I know God was there. I knew all my prayers were answered in this precious moment. I only let my body make its worth. I felt incapable of pushing a baby out. That was an amazing feeling. I don’t know how to say it. It’s like you are here but you are not. Meagan: Yeah. It’s surreal. It’s really– when you realize you’re in that moment of pushing your baby out and I can’t even imagine after five Cesareans, just that moment of, Wait, is this really happening? Susana: Exactly. It was like a dream. My husband was telling me, “Yes. You are so strong. You are telling me the truth. The miracle is done. Come on love. You can do it. You are so close.” I can’t remember exactly but I think it was four or five pushes and baby was out. Baby had two wraps of the cord. Meagan: Double nuchal cord, okay. Susana: Yes. Then the body was out and it was a relieving feeling. It was magical. Everything was done. Every pain, every pressure, and every fear was gone. I felt that very warm and wet body in my arms. It was a magical moment like, I can’t believe this is happening. Praise to God. I was crying. That moment was unlike any other moment in my life. Meagan: I can’t even imagine. Wow. So was everyone very pleased and shocked? That’s not a normal thing. For VBAC after one and two, it’s like, okay. After three, providers are like, “I don’t really know. Risks do go up so we are nervous about this,” so after five, how was your community around you?Susana: Yeah. They were very shocked. Actually, the hospital didn’t allow VBAC after multiple C-sections, but the doctor said because in the lobby, they asked, “How many pregnancies and how many births? All those were natural births?” The doctor said, “Yeah.” Everything was happening very fast. After the baby was born, everyone was screaming, “Vaginal birth after five C-sections here!” The nurses and the doctor and the people in the lobby said, “What?! It’s a miracle.” Everybody was so happy. Everybody was shocked. I don’t know. It was amazing. Meagan: I’m sure they had a lot of feelings. I’m sure they were so happy for you and so shocked and even probably still questioning, “Wait, really did that just happen?” Because even we as a mom pushing in that moment, I think it’s very much for the providers too, “Wait, is this happening?”Susana: Yeah, actually the doctors said the medical community was pretty– I don’t know the word but they were saying, “What did you do? You didn’t do another C-section? What’s wrong with you?” They didn’t do the episiotomy and I didn’t tear at all. Meagan: Amazing. Susana: What else? He said, “It was a perfect birth.” Nothing went wrong. Nothing. So for him, for my doctor, he was very proud. He was not scared of sharing the evidence or the support and my case. Meagan: Right. He wasn’t scared of sharing that he was supportive of you doing that. Susana: Exactly. He put on social media what we did. A lot of people were like, “What?” But he told me, “I only supported you because of your midwife because she is amazing. She is very wise. She has a lot of intuition. She had a good eye to know when it can happen and when not. Meagan: Yeah. Susana: She is awesome. Meagan: I wonder if they work together often now. Susana: Not too often because she usually goes to home births but when a couple wants a hospital or a VBAC, she works with him. Meagan: Oh my gosh. That’s awesome that they can work together and it really truly makes it possible for those who want to. We know that not everybody will and we know that the risk is not acceptable for others. Susana: Right. Right, exactly. Meagan: Something that I love on ACOG, there is a website that is called acog.org so the American College of Obstetricians and Gynecologists so it’s more here in the U.S. but there is a provider called Dr. Angelica Glover. She wrote an article on VBAC and one of the things that I enjoyed about her article was the very end. It says, “One size does not fit all. If you are pregnant and have a previous Cesarean birth, talk through all of these questions with your OB/GYN. Weigh the risks and benefits of each birth option like you would with any important healthcare decision.” I love that. Just like you would with any healthcare decision. It says, “Think of this as an ongoing conversation with your OB that starts early in pregnancy and evolves over time. Your feelings may change and your risk factors could change too. There is no one-size-fits-all answer when it comes to choosing between trying for a VBAC or a repeat Cesarean birth. What matters is that you are comfortable with your decision and you feel supported through your pregnancy and birth.” I love that because really in the end, VBAC after three, four, five, or whatever may not be comfortable for someone else but it may be for someone like you. Then the biggest factor is finding the support and we know that can be really hard so I love hearing that you had two providers who were on board with you, trusted you, and trusted the process. I do love that your midwife talked to you about how it can take time and you made it to 8 centimeters before right? Your body had done it. It just still needed time. It has gone through a lot and there was scar tissue and all of the things. It can take time, but you were allowed that time. You were allowed that time. They trusted you and they trusted themselves even. I am just so happy for you and I appreciate you sharing your story because it is one of those things that is really desired. A lot of people don’t know it’s an option then they find out and they are like, Wait, is this really possible?Yes, it is so it’s really nice to hear a story here and there as they come along to show that yes. Women of Strength, it is possible. Are there risks? Yes. There are risks. Are they more than VBAC after one or two Cesareans? Yeah and honestly, we don’t even know the exact evidence on specifically VBAC after five Cesareans because they are not studied and they are not happening. Susana: No, they are not but I can say that I read a lot. I found very good information from the Royal College of Gynecology and Obstetrics in the United Kingdom and it said that as a provider, you have to let the mom share if they want to try or do the repeat C-section, but always the vaginal birth is less risky than a repeat C-section especially after too many C-sections. Meagan: We do know that there are increased risks with repeat Cesareans as well. We know that is also very much a thing so we want to make sure that we are taking into consideration that as well because we’ve got issues where uterine rupture actually can also happen in a repeat Cesarean and that risk can be there. Bleeding and hysterectomy, there are risks that are sometimes actually higher for a Cesarean than a vaginal birth. It’s just important to know all of the risks. I think sometimes we hyper-focus on the risk of VBAC instead of going through and looking at things. Evidence-Based Birth has such an amazing article and I think it was actually even a podcast episode on VBAC. She talked about how there are a ton of studies within here. She goes through the maternal outcomes here. Susana: That’s awesome. Meagan: Yeah. It shows the maternal outcomes and the newborn outcomes. It says, “Maternal adverse events or bad outcomes were more frequent among women who had a C-section birth after Cesarean,” meaning they attempted a VBAC but it ended up in a Cesarean compared to those who had a VBAC. That’s another risk. We have Cesarean risks. We have VBAC risks and then we have where we are going for a VBAC and it goes into a Cesarean. There is also risk there. We really need to just pause and stop and look at everything. I mean, literally, everything before we make a decision. There are so many times like with your first birth, there was so much going on. You had such an unfortunate event happening with the loss of your loved one and a provider was saying, “Oh, you’re only at 3 centimeters and 60% effaced so this is probably not going to happen,” when in reality, that vaginal birth probably very much would have happened but we just didn’t know. We didn’t know. Susana: Yeah, totally. Yeah. Meagan: It’s so hard because there are so many times where we hear these things from a provider. Me too. I did too. I was like, okay. We trust them and we don’t want to not trust our provider but at the same time, we want to make sure that we do get informed. I’m so proud of you for along the way getting informed and learning about your options and I’m so happy for you that you were able to have your vaginal birth. Susana: Yeah, thank you. Thank you so much. I can say at least here, I think younger OB/GYNs are more open to support VBAC than the older OB/GYNs. I don’t know how it is in the United States, but here, I think that is happening. Meagan: Yeah. I think it takes us all continuing to advocate for ourselves to have these providers stop and change their point of view because I believe that so many times, even if the evidence is there, there are so many times that it takes seeing it to believe it. You can look at a piece of paper and look at the evidence and you can see that, but at the same time, you’re like, Okay, yeah. Sure. That probably can’t happen, even though it’s right there on the form, but seeing it really can change a lot of people’s perspectives and just opinions. I think that is what you probably did to that entire hospital. Like you said, “Vaginal birth after five Cesareans in here!” Yeah. They were all blown away and you really did. You changed their perspective. Susana: Yeah. I am so happy to help another woman, to inspire, to read, to find information, real information. Don’t let the doctors scare you. There is risk in all of pregnancy. It can be risky. Life is risky. Meagan: Life is risky. You’re not wrong there. There is risk everywhere. It’s just important to know the risk and then decide if that risk is acceptable to you. If that risk is acceptable to you, then great. Go for it. If not, that’s okay. Susana: It is worth every moment and every pain. Everything, it was worth it. Meagan: Yeah. Well, I’m so happy for you. Congrats again and thank you for being with us today and sharing a VBAC after five Cesareans story. Susana: Oh, thank you so much. I’m so happy and I hope that a lot of women hear this podcast and are inspired themselves. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

“My birth stories are my testimony…I have never trusted God more with any situation in my entire life other than with the lives of my children and bringing them into this world.”Shelby’s story is one of faith, trust, and surrendering. Shelby joins us today from Indiana sharing her wildly traumatic Cesarean story due to a placental abruption and her peaceful, healing home birth. Shelby was on vacation at a cabin in New York at 34 weeks when she woke up to regular contractions and heavy bleeding. She rushed to the nearest hospital, was put under general anesthesia for her Cesarean, was transferred via a separate ambulance from her baby to a hospital 3 hours away, and had a 23-day NICU stay in the height of COVID 800 miles away from her family and community.She and her husband were certain they would not have any more children. But as they fought for healing through faith-based counseling, their hearts yearned for another baby and a chance at a healing birth experience. She completely surrendered, found holistic prenatal care, and created a birth space for herself where she knew she felt safe. She was brave and vulnerable, and her second birth was everything she hoped it would be. As Meagan says at the end of this episode, “Get educated. Love yourself. Have faith in you and your body and your baby. You are amazing. You are a true Woman of Strength.”How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength, we have our friend, Shelby, here with us today sharing her HBAC story. In addition to her HBAC story, she’s got some other unique things that I think are going to be important for us to talk about today. One is placental abruption. That is something that is definitely a reason for a Cesarean and one of those absolute needed reasons for a Cesarean. We are going to talk a little bit more about that and then we are going to talk about faith and how faith in whatever faith looks like to you, it’s so important to cling onto that. Shelby has some messages about that. Then we really want to talk about physiological birth. We hear it. We see it online. I mean, if you go on Instagram and you go into the birth world, you’re going to see it almost 100% guaranteed but what does that really mean? We’re going to be diving in with that today. Shelby, you are in– where did it say, Indiana? Shelby: Indiana, yeah. Meagan: I have to look at my notes. Indianapolis, Indiana. She’s in Indiana so Women of Strength, if you are coming from her area, definitely listen up as well. Okay, so we have a Review of the week and this is by birthing confident. It says, “Invaluable information. I love this podcast. As a mom planning a VBAC and a VBAC-trained birth doula, the information shared on this podcast is invaluable. I have become so passionate about helping all women know their birth options and avoid unnecessary C-sections. I think this podcast is great for all expectant mothers” and I 100% agree with that. This podcast is for anyone and everyone because like she said we are wanting to help people avoid unnecessary and/or undesired Cesareans. We have a ridiculous Cesarean rate. It is through the roof. I would love to see it start dropping and I don’t know if this podcast truly is going to impact the Cesarean rate the way I would love it to, but I do believe that it’s a starting point. It’s a starting place for you guys to learn your options for birth after Cesarean and to learn how to have a better Cesarean experience if you have one because that’s also a really important factor that I think a lot of people forget about. Not only do we share just VBAC stories, but we do share healing, beautiful CBAC stories and repeat Cesareans. Thank you so much, birthingconfident, for your review. As always, please if you haven’t yet, leave us a review. You can do so on Apple Podcasts. You can message us. You can rate us on Spotify and all of the places that you listen to your podcast. Meagan: Okay, cute Shelby. Welcome to the show. Shelby: Thank you. I’m so excited. Meagan: I am so excited. So let’s dive in. I am actually really excited to talk a little bit more about placental abruption as well and hear about your experience. Shelby: Yeah. I don’t think I even knew it was a thing honestly before it happened to me. I think it’s something that people don’t really talk about and it’s probably a good thing because it’s really scary but also, it would have been good to maybe know what was going on. I know it wouldn’t have changed the outcome, but yeah. I just had no idea that was even something that could happen. With my first pregnancy, it was very run-of-the-mill. Everything was good and I was planning on birthing at a birthing center in Indianapolis so I was still going for that natural, unmedicated birth. I didn’t really know anything that went into that as you do with your first and I feel like you do the typical making the baby registry and doing all of these things that don’t really actually help you with your birth. Not that I would have gotten the chance to even try anyway. I feel like I just definitely didn’t really have much knowledge and I think the problem is that you don’t know what you don’t know which is why I literally recommend this podcast to all of my friends who are even pregnant with their first baby because I’m like, “Just learn the things. Learn all of the things.” We took a very basic birthing course through the birthing center and it was just virtual, like four sessions and it was not super helpful honestly but we also didn’t get to implement it. The pregnancy itself was just very normal. I mean, I have pretty much all of the symptoms which is the worst like really horrible rib pain and nausea and heartburn and all of the things. What was crazy though, this was in 2021 and I actually got COVID while I was pregnant also. Everyone I’ve talked to thinks that’s probably why I had a placental abruption.Meagan: That’s interesting to know. Shelby: Yeah. I had it in about my 5th month of pregnancy in September and I was due in January. It was horrible for a week but then I recovered and I was back to working out. I was totally fine. I didn’t have any blood pressure issues after that. Everything reallly seemed okay. We decided at 33 weeks that we were going to go to New York which is really far away from Indiana on vacation for Thanksgiving to gather with all of my husband’s family. My midwives cleared it. Like I said, I was working out. I was healthy. I was fine. The trip was going super well. I was working out while we were there. I was doing barre obviously so I was doing safe things. Fitness is a really big part of my life but also, it’s not something I added in during pregnancy. It was just normal for me. Meagan: I used to take barre too. I took barre and was teaching barre with my second TOLAC. It’s a very low impact but very, very good for strength and cardio. Shelby: Yeah, and my husband and my father-in-law were doing them with me so we have some really awesome videos of me at 34 weeks pregnant working out with my husband and my father-in-law doing barre. But yeah. Everything was going well and anything that was slightly risky which really even wasn’t, I wasn’t doing. They did this office chair floor hockey where they were pushing each other around in office chairs and playing hockey in a building and I didn’t do it. I sat on the sidelines and observed. I was being really what I feel like was cautious. Meagan: Responsible. Shelby: Right, yeah. We even took family pictures on Saturday and everything, I have pictures of us smiling and laughing and then literally the next day we had a baby which was crazy. I start having Braxton Hicks contractions at 20 weeks. For both of my pregnancies, I just feel like I start having them really early so they are not shocking for me. But that Saturday, I remember several times looking at my husband and being like, “These feel a little stronger than I remember them being,” but with your first, you don’t know anything. I kept mentioning that to him but they weren’t super regular and there were no other signs of anything, just Braxton Hicks contractions. Then that night when we went to bed, I couldn’t really sleep. I was laying there by myself the only one awake. We were all staying in this big cabin together which was great. My husband and I were in our room. At 4:00 AM– this is so funny to me now that I know what labor is actually like. At 4:00 AM, I started timing contractions and they were less than 5 minutes apart when I started timing them. I’m like, What was wrong with me?So after an hour of them being like that, I woke my husband up and I was like, “I think you should go get your mom,” because she is actually a midwife which was good. Meagan: Oh, convenient. Shelby: She was in the room next to us. Yeah. I was like, “I think you should go get your mom because this is not right.” They were not just less than 5 minutes apart. They were pretty uncomfortable. She came over and checked things out. I know now that she definitely knew that something was going on but she was really good at keeping her cool. She was like, “Why don’t you go shower and try to relax?” When I went to go to the bathroom and shower, I started bleeding. Like I said, I knew nothing about labor, so I was like, “Oh, well maybe I am in labor” which was really scary because I was only 34 weeks but it was a lot of bleeding. I was like, “Well, I don’t know what’s normal,” but I know that obviously, my mother-in-law knew what was going on. She was like, “It’s okay. We’ll have Chad (my father-in-law) just go start the car and we’ll go in and get everything checked out.” So we were in the middle of the Adirondacks which is literally nowhere. We had a 25-minute drive to the nearest hospital and this hospital, I mean we were probably the only people there. It was 5:30 in the morning maybe. They didn’t have an OB there. They didn’t have a surgical team there. They were all at home so we come in and the front desk lady is like, “What’s your occupation?” She’s typing like a sloth. I was like, “Girlfriend, I am bleeding and I am in full-on labor. Can we just go inside?” So that was crazy. She’s asking me to sign stuff and I’m telling my husband, “You have to sign.” At this point, contractions were pretty back-to-back and they were super strong. I could tell I was bleeding with every one. I could feel it. They got me back into the ER and the poor nurse. I know that this was probably so scary for her, especially with an OB not even there but she was asking me, “Have you felt her move recently? I can’t find a heartbeat.” I was like, “I don’t know. I’m in labor. I don’t know if she’s moving or not.” Every time I’d have a contraction, she’d just be like, “Oh wow, that’s a lot of blood.” I’m like, “Thank you. I know.” Meagan: You’re like, “I can feel it.” Shelby: Yeah, it was wild. By the time the OB got there, she checked. She said I was fully dilated and effaced. Meagan: Holy cow. Shelby: This was maybe 2 hours. It was not long. Now that I’ve been through a full labor, I’m like, that is crazy. My body had to have just been in panic mode like, We have to get this baby out right now.She checked and something that was kind of cool was I knew that my baby was head down. She had been from 20 weeks. She was perfectly always in the same spot because I could always feel her kicks really high and one of the times the OB checked, she goes, “Oh, and she’s breech so we’re just going to have to go.” I was like, “She’s not breech. Check again. She’s not breech.” She checked again and she was like, “Oh, you’re right.” I was like, “Yeah.” So the nurse brings in all of the scrubs and stuff for my husband to put on and as he’s getting dressed and everything, he’s fully ready to go. He’s all excited because he wasn’t really super scared. Meagan: He didn’t understand what was going on. Shelby: Yeah, but also, he’s like, “I’m going to meet my baby today. This is so cool.” And the literal most gut-wrenching thing of my life was when the OB was like, “No, we don’t have time. It’s going to be under general. You can’t come.” She wheeled me out of the room and I looked back and saw him standing there fully dressed just like yeah. It was awful. In that moment, I wasn’t even worried about myself and I wasn’t worried about the baby. I was just like, He’s going to be traumatized from this. This is horrible. They took me back there and I’m in labor holding onto the top of the bed. I was only in there probably for a minute, but it is scary. The whole room is white and there is somebody over here counting instruments. They stick a mask on your face and you can barely breathe and then the next thing you know you wake up in recovery. I woke up as the only person in this room. There were maybe two guys sitting at the desk but that was it. Nobody else was there. They didn’t say anything to me. Nobody told me if she was okay. I knew nothing. Yeah. I was just laying here. Eventually, my husband came in and he showed me pictures of her. He was like, “She’s okay. She’s on oxygen but she’s doing all right.” But yeah. It was totally crazy. Then they moved me to– I don’t even know. It probably wasn’t actually a postpartum room. I don’t even know if they have those at this hospital. I feel like they probably try to send everybody everywhere else. Then basically, they told me, “Hey, you have 10 minutes if you want to go see her and try to hold her before the ambulances get here to transfer you guys,” because there wasn’t a NICU there and they probably weren’t even– they couldn’t have cared for her. I think as soon as we got there, they must have called Albany Medical Center because it’s 3 hours away. She was born at 7:30 in the morning. I started timing contractions at 4:00 AM. We didn’t leave until after 5:00. The whole thing was so fast. I’m getting ready to get out of bed and get in a wheelchair to go see her and they didn’t warn me how much pain I would be in and they didn’t really help me get out of bed either. As I went to stand up, I leaned back a little and after you’ve had a C-section, I almost passed out. Meagan: Oh my gosh. Oh my gosh. Shelby: Yeah, so I get in this wheelchair and I get in the room where she is. She’s got the oxygen mask on and she’s got all of these tubes and all of the things and you could tell in the pictures I was barely with it. What I remember bothering me the most is I had obviously been intubated so I felt like there was stuff in my throat because it was so swollen. My mouth was all dry and I got to hold her for a couple of minutes but it didn’t even feel real. Then the NICU team got there. She was on one ambulance and I was on a different one and my husband was in a car so we were all separated for 3 hours to Albany. Halfway there, my ambulance– so hers left first, and halfway there, we passed hers pulled over on the side of the road. I started panicking. There was no communication between the two ambulances. Meagan: Oh my heavens. I’m dying right now. Shelby: Yeah. The EMT, bless her heart, was amazing. She was like, “It could be anything. It could be one of the monitors isn’t hooked up right and they’re just stopping to do that or they need to change out an oxygen tank and they can’t do that while driving.” She helped me calm down a little bit. She probably shouldn’t have said this, but we got closer to Albany and she said, “We don’t need to panic.” I don’t remember if she actually said this but she said, “Unless they pass us again going fast.” I kid you not but we were 5 minutes out from the hospital and her ambulance went by us with lights and sirens on. I had maybe seen her for 10 minutes before this and she couldn’t contact the other ambulance. So just traumatizing, all of it. Thankfully, when we pulled into the hospital, the first thing that the guy on the baby’s ambulance did was come over and say, “Everything is okay.” It was just something. They had a lead or something come off so they needed to stop and take care of it so it wasn’t a big deal but it made it feel like a big deal. We are in New York still for all of this. We get in there and I have to get settled in the postpartum section and she has to get settled in the NICU and then finally, hours later, I was still bleeding a lot so they were trying to take care of that. They were doing the fundal rubs and I remember texting my mom and I was like, “If they do it again, I’m going to punch someone in the face,” because it was so awful. They were saying, “It’s because the EMT didn’t do them on the ride over that you are bleeding so much,” so they kept coming over and doing them. It was so awful. So then we had a 23-day NICU stay in New York, just my husband and I because no one else could even visit us because it was 2021 in New York which was pretty bad for COVID. Once I was discharged after 4 days, technically, the only visitors allowed were my husband and I with our NICU bracelets to see her. Even if they had someone come, they couldn’t even come into the hospital. We didn’t really want to leave the hospital because we wanted to be there with her. We were Ubering to Target. We didn’t have a car because we flew there. We are Ubering to Target and thank goodness they had a Ronald McDonald house there so we were staying there and they supplied a lot of dinners and housing which was the biggest blessing in the world. I literally don’t know what we would have done otherwise. Getting discharged without your baby is super horrible and she was only 4 pounds, 10 ounces so she was really little and nursing just never took off for us. I didn’t get to try for a while even because she was being tube-fed and she could barely stay awake because she was so tiny. Every nurse that you’d have would tell you their tips and tricks which is great but not helpful when every 3 hours you are being told something different. We tried so hard and eventually got to the point where it was like, “Let’s just get home. We are 800 miles from home and if it takes a bottle, that’s fine. We just need to get home.” Yeah. After 23 days, my amazing mom drove to New York because we didn’t even have a car seat. It was all at home. She picked us up and drove us back home. Meagan: Oh my gosh. Shelby: Yeah, so then you are coming home with this little 5-pound baby and you are like, “How are we even allowed to do this? She doesn’t even barely fit in the car seat.” It was so crazy. After that, we were really unsure if we’d have more kids. Especially right after, we were like, “I don’t know if we can do that again.” My husband and I always wanted lots of kids and a big family. That has always been something that we wanted so after that first experience– and you do a quick Google search of placental abruption and they say, “Once you’ve had one, it’s 15% more likely that you’ll have another one.”You’re like, I can’t go through that again. That was horrible. I knew that if we got pregnant again, I was like, I’m going to feel like a ticking time bomb. All of these also quick Google searches tell you that it can happen as early as 20 weeks. Thank goodness we made it to 34 but I’m like, If that happens at 20, baby is probably not going to make it. Meagan: That’s a scary thought. That’s a really scary thought. They really have advanced the medical world so much to a point where even when babies are born really, really preemie, there are higher chances than there used to be, but the thought of that in general is just too much to think about. Shelby: Oh yeah, and my mom who drove to New York to get us– which is probably part of the reason they discharged us. She’s a NICU nurse so she actually knew how to feed this litle 5-pound baby who was still causing us feeding issues and all of the things, but I’ve obviously heard from her too the stories of the really early babies. I mean, even 29 weeks and I was like, It’s just too much. But we also knew that we couldn’t stay in that place because we both were not in a good place with it. My husband was obviously so traumatized for different reasons and I was too. It was just a lot. We started seeking out some faith-based counseling basically like spiritual reconciliationing kind of to work through it all because I knew even if we weren’t going to have more kids, I could not just live with that raw the way it was. Meagan: Both of you needed to process that. Shelby: Yeah. We were just praying for the release of that and we even prayed over our poor baby because I was like, She’s probably holding trauma from that too. The losses that I was experiencing were also losses for her. She missed out on the golden hour and a peaceful entry into this world. It would drive me crazy thinking that her first moments in this world were with people she didn’t know and it was bright in the room and being hooked up to machines. I was like, That was probably so scary for her too. We could tell for a long time, probably her first 7 months that she was so sensory. I mean, just screamed and hated the car seat, hated transitions, hated bedtime. I mean, it was basically non-stop screaming for 7 months. I was like, You were supposed to be in the womb for 6 more weeks and instead, you were in the NICU with lights and sounds and all of the things. We just started praying really hard over all of it and speaking to some really trusted friends who worked through trauma with people. I started listening to The VBAC Link. This is probably when it started obsessively. I was doing Amazon deliveries just for fun on the side. I could take the baby with me so I’d put her in her car seat. This was eventually when she stopped screaming in the car seat so it took a while. I would put my AirPods in and while I did all of these deliveries, I would just listen to back to back to back episodes forever and for months. I think honestly that was probably what started getting me thinking even about more kids. I started learning about VBACs and how really the odds of having a VBAC are not that horrible and that it’s really not any riskier than a second C-section and I was like, I really don’t want another C-section because that was– I mean, I couldn’t even roll over in bed by myself. My husband told me, “You don’t usually need me, but that was the one time you actually needed me.” He was like, “Honestly, that was really hard to see you in that much pain and struggling that much.” I was like, “Yeah. I couldn’t even pee by myself.” Meagan: Oh, I remember my husband literally helping with my second. He had to hold me up in the shower. I was like, “I just can’t stand the whole time in the shower. Can you just hold me up and shower me?” I remember feeling so vulnerable and I was frustrated because I’m like, This isn’t my personality. I’m very independent. Why is this happening? Yes. Shelby: Independent and strong. Yes. But also in my fashion, I was walking to the NICU by myself very slowly by day two. I’m like, What was wrong with me? But also, we didn’t have a choice. I was about to be discharged. We had to figure something out. Thankfully, I didn’t need to stay for 4 days, but because I had nowhere else to go, they were like, “You can stay all 4 days if you want.” I was like, “Okay, great.” But yeah, so I just started learning everything and consuming as much information as I could about physiological birth and about VBACs and there really isn’t a ton of information about placental abruption. There are risk factors which I had none other than COVID which no one talks about yet because it had just started, but I didn’t have high blood pressure. I obviously didn’t do drugs. Meagan: You didn’t have multiples. It was a singleton. Yeah. Shelby: It never happened before. My placenta was in a good location. Meagan: Your membranes hadn’t ruptured. Shelby: Yeah, my water never ruptured with her so it was crazy. But around when she was probably 9 or 10 months, I couldn’t even believe it, but I told my husband, “I’m not totally opposed to having another baby.”He was like, “For real?” We talked about it and we prayed about it a lot and I told God over and over again, “If I get pregnant again, this is going to be the biggest test of my trust in You ever because I know that if I try to worry about it, I’m going to go crazy. If I try to control the outcome which I can’t, I’m going to go crazy.” So it basically was like, “If it happens, I’m just going to have to trust you with it fully. No holding back.” Actually, before we were even pregnant, started shopping around for providers. Meagan: That is key. That is so important. Shelby: Yeah. We do have one hospital locally that has midwives and birthing pools. I was like, “Okay, that sounds like a pretty good option for a VBAC.” We went to talk to them– well, I went by myself. I had my list of questions ready. I walked in ready to not take any crap because I also knew a lot about what they were probably going to say and they said, “Yeah.” First of all, they wouldn’t call it a VBAC of course because nobody wants to do that. Meagan: TOLAC.Shelby: That was the first thing. I was like, “No. I’m going to do this.” Yeah, so they were like, “We’ll allow you to try.” I was like, “Okay.” They were boasting about their VBAC rates and it was 60%. It was not very high and I was like, “Umm, okay. That’s not that awesome, but all right.” They started listing off the things you have to do because I had all of these questions ready because I knew. So you have to have an IV hooked up. I was like, That’s annoying. I was like, “Can you at least have the hep lock?” They said, “Yeah, that would be fine.” Then they said, “But you have to have continuous monitoring.” I was like, “Okay. I really, really don’t want continuous monitoring,” and they try to make it sound better like, “Well, it’s waterproof and it’s mobile so you can still move around with it,” but I also knew about the statistics of continuous monitoring and how a lot of times they indicate things that aren’t actually an issue and then especially if you are a VBAC patient, they’re like, “Well, time for another C-section because baby’s heart rate is dropping.” Baby’s heart rate is supposed to fluctuate as they are descending. Meagan: Just like ours. Shelby: There was that and then they also said, “You can labor in the water, but VBACs aren’t allowed to push in the water.” I was like, “Doesn’t that defeat the purpose?” Especially if it’s a VBAC patient, we should be doing everything we can to ease the labor. Why would you make them get out right when they are feeling like they need to push? They were like, “Oh, well it makes the OBs uncomfortable.” I was like, “Well, the OBs aren’t delivering this baby so I don’t really care what makes the OBs uncomfortable.”So they made me schedule out all of my prenatal appointments and I went to one of them but I told my husband, “I just don’t want to have to fight for it. I know I can. I know that I can go in there and say ‘No thank you’ and be confident in myself, but I don’t really want to.” So I had never ever even considered a home birth. I don’t even remember how, but we somehow heard about the only home birth midwife in our area and I scheduled an appointment with her. I didn’t even get established with her until I was 19 weeks. I pushed out the OB care for a really long time when we found out we were pregnant because I knew we didn’t really love them. So I just didn’t go for a long time. I felt like everything was good. I felt like I was pretty in tune with everything. But yeah, I skipped a little bit but when we got pregnant with our second, it was a lot more immediate where I started praying about it all like, Okay God. This is for You because You are the only one who knows how long this baby is going to gestate and you’re the only One who knows if it’s going to end how we hope it does. I started praying. This is something. I started praying really specific prayers. I believe that God cares even about the little things which really aren’t little things in this, but I prayed that my placenta would be in a good spot and I prayed that my placenta would be strong and that it would make it all the way to term and I prayed that this baby would make it all the way to term. Literally every little concern I had, I pretty much sat in the shower every day and just spoke it aloud. I was like, God, I know that You are a God of healing and restoration and I know that You can do that for me. I believed that through this birth, He was going to heal the trauma from our first because I was like, that feels like this is how it has to go at this point. We went and we met this midwife. She didn’t doubt for a second. She didn’t say anything that was like, “I’ll let you try.” She was like, “You sound like a perfect candidate for a VBAC.” I told her that I had COVID and she was like, “Well, that’s probably why your placenta ruptured.” She told me that the placentas she had seen throughout COVID and recently, she was like, “They are not healthy and they are not sustaining a lot of them until the end of pregnancy or if they are, they don’t look good by the time they get there.” She wasn’t surprised. But yeah, she said, “You sound like a perfect candidate. I think you can do this.” At every appointment with her, we’d sit there for an hour and we’d talk and she totally respected all of my wishes. She’d ask me if I wanted to do something. I’d ask her for information and then she’d let me decide either way which was cool too. With our second pregnancy, we didn’t use a Doppler until I was in labor. I could feel her moving first of all so I knew that she was well but we actually started using a fetoscope which was really cool. You can’t start using it until after 20 weeks so we had to wait for a really long time to hear her heartbeat but our toddler would watch us do it too. It was really cute because she would walk around with this fetoscope around her neck and she would go put it on daddy’s belly and say, “I’m listening to Daddy’s baby,” or she’d put it on her belly and it was really sweet. Yeah, we took a full 180 with this pregnancy. I had learned so much at this point that I was so confident in my body and in my instincts and all of it. We didn’t find out the gender which with our first one, we found out at 8 weeks with the blood test. We didn’t find out gender. I didn’t do much prenatal care. We didn’t do genetic screening anyway with the first one either because that didn’t really matter to us. But yeah, I didn’t even do an ultrasound until we were 32 weeks or something. We waited a long time because I had learned a lot about ultrasounds and how we actually don’t know as much about them as we might think we know. Meagan: Might think we know. Yeah. Shelby: I read about how sometimes the techs are like, “Oh, they’re moving away from it,” because they can feel it and I’m like, “We’re not going to do that.” We waited and just had the technician who worked in our midwife’s office which was perfect because we could tell her we wanted a very minimal one just to check basically the heart and vital organs and the brain to make sure everything was okay. She would pause the screen and take the measurement she needed and take the Doppler off and everything so it was very minimal. I was like, “I don’t really care if they have 10 fingers and toes. We’ll figure that out later. Just check the important stuff. Don’t tell us the gender.” We did that and she basically was like, “Everything from as far as I can tell looks good.” That was pretty much all we did. My lifestyle was still very active and I was eating as best as I could. I didn’t really feel like I had anything that was anything of concern which was perfect. I remember at my 30-week appointment, my midwife looked at me. We hadn’t really talked about specific expectations I think for the birth because I didn’t really know what I needed or what I wanted but she looked at me at my 30-week appointment without prompting and said, “I think what you really need from me in this birth is for me to just be there and for you to just do your thing.”Meagan: I love that. Shelby: I was like, “That’s actually perfect. That’s exactly what I want,” because at that point, I had listened to hundreds of birth stories and watched hundreds of birth videos and shown them all to my husband. Everything I was learning, obviously I was soaking it in but if there was anything I felt was pertinent to me, I was showing to him too. He really benefited from that because we went into birth also with him not being afraid. He would watch birth videos with me and he’d be like, “Wow, that’s amazing.” That’s one of my things. Knowledge is power and educate your husbands too or whoever is going to be with you at your birth. Physiological birth especially, they should be comfortable with it. They should know what it looks like and how it progresses and how to best support you in that. That was huge for us. I made him watch a lot of birth videos and he wasn’t even weirded with it by the time it came around. But yeah. She said that and I was like, “Yeah, you know, that sounds great.” We made it all the way to 40 weeks and I just felt completely at peace the whole time. I wasn’t worried and I was like, “She’s going to come when she’s going to come.” Another thing they had told me at the hospital was, “We only let VBACs go to 41 weeks and once you go past 41 weeks, you have to have a C-section.” I was like, “I’m not going to do that. I don’t even know what my typical gestation is because I haven’t made it term.”Meagan: I was going to say, you didn’t even make it to 40 weeks. Shelby: Yeah, so my midwife was like, “Well, if you get to 42 weeks, we’ll do an ultrasound and make sure everything is okay,” but she wasn’t putting a timeline on it which was so great. I did a lot of courses. I stay at home with my daughters so I just listened to a lot of courses. I did the Christian HypnoBirthing one, our midwives did a course. It was really cool. They got us all together at one of their houses and went through a course with us and our spouses with all the moms who were about to have babies. I also did the Free Birth Society course which I was kind of so/so on but I was like, “If I want to know how to home birth, I just want to know about everything. I want to know about the complications that could happen and what you should do in those situations,” so even though I wasn’t planning to free birth, I still wanted to learn all of the things. That was one of the things that I did and I was just listening to constant everything. When we made it to– I guess it was two days before my due date, so July 29, I was having fairly consistent contractions in the evening and so we were all excited. We’re timing them and we were texting our moms but then they stopped the next morning which was a Sunday before church so we were getting ready to go to church but then I lost my mucus plug in the shower. I was like, “Okay, just in case something is going to happen, we should probably watch online.” We stayed home, watched online, and nothing was happening all day. We knew that we shouldn’t get our hopes up but also you make it that far and you’re like, “I’m just ready.” Our church had a picnic that night at a local water park so I was like, “Well, nothing has happened all day. We might as well go because we didn’t go to church.” We went to this picnic and we were doing the mini playground with our 1-year-old at the time who is water crazy. I think I jumped to get into one of the tubes and felt something kind of funny then around 8:30 PM, I had a really strong contraction. I was like, “Okay. That was unusual.” I went to the bathroom and had bloody show so I went back out and got my husband. I was like, “We’ve got to go home.” On the drive home, contractions were 8-10 minutes apart. I showered and we called the midwife and our photographer and my mom and grandma who were coming to get my daughter and the dogs because we didn’t know how it would go so we didn’t want anybody else there who needed care obviously. Meagan: Well and your last labor was actually pretty dang fast. Shelby: Right, yeah so I was like, “I don’t know how this is going to go.” My mom came and helped us clean up the kitchen which is where we were going to put the pool and everything. The midwife and her student arrived at around 10:30 PM. At this point, I was between

Women of Strength, so many things are important to know during your VBAC. Meagan Heaton is flying solo today telling you how to get the most out of what The VBAC Link offers. She goes through all of the resources from the Parents’ Course to the Doula Training to The VBAC Link Community and CBAC Community Facebook groups to blogs, newsletter emails, Instagram Q&As, and more. What do you need to know to have a better birth after an unexpected or difficult Cesarean? What is included in The VBAC Link Parents’ Course?While all of the information can be compiled and found through our hundreds of podcast episodes, blogs, and social media posts, the course is concise and comprehensive to have quick access to it all including: The history of Cesarean and VBACPreparing your mind and body for VBACEvidence-based stats on uterine rupture and moreHow to find a supportive provider How to choose between a repeat Cesarean and a VBACVBAC after multiple CesareansCoping tools during labor Family-centered CesareansRisks, benefits, and alternatives of interventionsHow to avoid an unnecessary CesareanWhen a Cesarean is necessaryThe VBAC Link Doula DirectoryThe VBAC Link Community Facebook GroupCBAC Support Facebook GroupHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Doula TrainingFull Transcript under Episode Details Meagan: Hey guys, this is Meagan today and I am solo. I don’t have a VBAC story coming your way today but I wanted to talk a little bit more about VBAC and what we need to know and what we need to do to prepare. If you’ve heard my own personal stories on the episodes a while ago, I think they are number two, go check it out. If you haven’t heard my VBA2C story, go check it out but during my journey, I’ve talked about how I felt alone in my journey. I had a couple of people within my space who were definitely cheering me on and my rocks, but the majority of the people in my life were very, very skeptical or judgmental or honestly just ignored me. That’s what would happen. I could tell people didn’t support or like the idea of me having a vaginal birth so they would just ignore me. Today, I wanted to talk a little bit more about the things that I did and then the things that Julie and I as we were writing our VBAC Prep Course were really truly the most important things that you should know. I want to talk a little bit more about what’s in our course and how you can prepare. I’m going to do that but I am going to share a Review of the Week. It feels weird to not be having somebody come on after but I’m going to share a Review of the Week and then I’m going to go into it a little bit more about what I did to prepare. This review is actually on our ultimate prep course. It says, “This course gave me the knowledge and confidence I needed to move forward with my plan to have an HBAC. When you realize VBAC is just birth and you hear the studies and the insights, they eliminate the myths that invoke a lot of the fear in C-section mamas, you realize you’ve totally got this. I was empowered to find a provider who truly supported me and realized how much my gut was telling me my previous provider was not the way to go. I can’t wait to share my HBAC story when the time comes. Thank you so much for all you do.” Okay, so going right into that, you guys. Like I said, when I was preparing, I did feel really alone. Number one, I think in preparing is finding that provider. Really truly, find that solid provider as soon as you can. We’ve talked about it here on the podcast that I suggest even finding a provider before you become pregnant because there is just this different thing about it where you’re not as vulnerable. You don’t feel as rushed. You feel more confident in your decision earlier on because you’re not feeling that rushed feeling. So sometimes I think we can choose a provider who seems kind of VBAC supportive but maybe isn’t as VBAC supportive as we would like, but we just choose them because we are pregnant and we need to start care. Find a provider for sure but something that we haven’t really talked about is finding your support system within your own circle. If that means that people in your family aren’t supportive, it’s such a hard line because you don’t want to just put your family aside, but at the same time, it’s really not going to benefit you if you have people within your circle bringing negative comments and opinions. I wanted to share one of the experience where I finally felt like I could share my desire. We were at a luncheon with my family members and someone asked me, “Where are you birthing or when are you having your baby?” I just said, “I am looking at possibly birthing out of a hospital.” Someone in my family turned to me and said, “No. You can’t do that.” I immediately felt defensive and adrenaline running through my body. I just wanted to say, “Whoa, whoa. Who are you to tell me I can’t do that?” Because at that point, I had really done so much research and decided that I was pretty comfortable with any risk of giving birth out of the hospital. I also had come up with a plan for if anything were to change to have a hospital plan as well. I felt very confident. I just looked at her and said, “Okay.” I just ignored it. But I quickly realized that that was not the space that I was going to be able to freely talk about my feelings and my desires because people just didn’t support it. Looking back, it really was that they just didn’t know. There are so many people out there even to this day in 2024 when I’m talking to people about birth stories and what I do, they say, “Wait. That’s a thing?” Still, in 2024, people do not know that vaginal birth after Cesarean is an option. That’s where it’s concerning. It’s just that so many people do not know. It is up to us to find that education but I felt like at that moment, I wasn’t in a place that I wanted to try and educate them because they were already coming at me so strongly and they already had their opinion formed. I also had some friends who I think were falling in line of a VBAC-supportive versus VBAC-tolerant or friendly provider where they were like, “Okay, yeah. You go do that Meagan,” but in their minds, they probably thought, “She’s crazy and I don’t think this is going to happen for her.” That was hard because I definitely felt that. I felt that feeling of, “You’re definitely not in my circle either.” Quickly, I really found that I needed to find that support. I encourage you to find that support within your own circle that is filled with people who are going to lift you up, build you up, and really truly support you along your journey. All right. We find the provider. We find our support system. Now we have to educate. What is really, really important or what was really important and is important for us as parents to get the education? We wrote this whole course. It’s over 100 pages in the manual and so amazing. Obviously, I love it to pieces but I wanted to go over a little bit more of what is included because we often do get questions about one, what’s included in your course and two, what do I really need to know? So let’s talk about it. In our parents’ course, the very first section is preparing your mind and body. You guys, we have to prepare our mind and body. I think this really does go into finding that support because as we are preparing, we have to have that support surrounding us and building us up because as we are mentally going through this, there are a lot of back and forth, Should I? Should I not? Should I? Should I not? Is it worth it? Is it not worth it? Mental preparation– we need to mentally prepare ourselves for birth whether you are going medicated, unmedicated, or whatever. Maybe you don’t even know what you want yet. Mentally preparing ourselves is so important. That really starts with honestly processing the past. Let’s process those past births. Even if you don’t think you processed that as a traumatic experience, you never know what may come up that may not be described as traumatic, but less ideal and something that offers tension. We also want to do physical preparation. Physical preparation is something that I am very, very passionate about because with my second baby– so with my first baby that I wanted to have a VBAC with– I really dove headfirst into physical prep. I believe that changed so much for me within my recovery, my pregnancy, and really just everything. Even though I had a C-section, I feel like I was able to “bounce back” both mentally and physically faster. Hydration was huge. I did not hydrate enough with my first. I was borderline preeclamptic. I never tested positive for it but I was swollen beyond swollen and I gained so much weight. I just really wasn’t as healthy. Hydration. Make sure you are hydrating. Watch what you are eating. Be mindful of what you are eating. Really get your protein in and your vegetables. Eat colorful foods and really take those good supplements. I know that there are so many, so many supplements out there and we really truly believe in Needed and their supplements so much. Get on a good prenatal. Make sure you are getting that protein in and if you need extra protein because it is hard to get protein in, get some collagen protein. That will help so much. Try to focus on exercise. If you didn’t exercise before, it doesn’t mean you have to just go an run a marathon. We’ve talked about this with MamasteFit. Just staying active, moving your body, walking, and if you can incorporate lifting weights, that’s great too but really being mindful in our physical and mental prep is so important. And then along the rest of the course, we are going to be going over things like the VBAC and Cesarean history. You guys, that is such a fascinating thing if you haven’t dove into that. It is kind of complex. There’s a lot to it and we really wanted to make sure that we brought it into an easier way to digest but really understanding the history of VBAC and the history of Cesarean and where we are today. We talk about women of color and the reasons for Cesarean and uterine rupture. Repeat Cesareans versus VBAC and what are the pros and cons? Because there are pros and cons to both. We are going to talk about the annoying calculator. Have you ever had a provider come to your visit in your prenatal room and say, “Okay, let’s talk about your previous Cesarean,” then typing things into their computer and tell you, “Oh, you have x% change of having a VBAC?” That’s the VBAC calculator and if you have been with us for a while, you know that we can’t stand it but it’s there and it happens and so we really want to educate you on that calculator because when we are given a percentage, it can impact. Women are told anything just like I was told in my second C-section that he was so glad I didn’t have a VBAC because I for sure would have ruptured. You guys, those things stick with us so when we get these weird numbers, they stick with us and they place doubt and fear. We’re going to talk about special circumstances. We’re going to talk about what ACOG says. That is a U.S.-based recommendation, but we are going to go over it because we really do look at the evidence that ACOG does provide. We’re going to talk about the contraindications of VBAC– when VBAC is safe and when it is not. We’re going to talk about providers and locations and hiring a doula. P.S., if you are looking for a doula, you guys, we have so many incredible doulas. You can go to the www.thevbaclink/findadoula and type in your state and area and it will pull up all of the VBAC doulas near you. We highly suggest a doula and if you can’t hire a doula, that’s okay too but we’re also going to talk about how to essentially get through birth without one as well. We’re going to talk about all of the benefits and risks and alternatives and assessing interventions. We know that there are lots of them.Sometimes there are interventions like stripping our membranes, or the stretch and sweep or scraping our membranes. Everybody calls it something different but even that, sometimes it’s not viewed as an intervention because we’re not putting something in an IV or something like that, but even those are interventions. We’re going to talk about the pros and the cons. We’re going to talk about when you are due. What does that mean? What does that 40-week mark mean? Does it mean you have to have a baby right now? First of all, no. It doesn’t. But we’re going to talk about what that means and what the evidence shows about going over your due date and the chances of even going into labor before your due date or on your due date. We’re going to be talking all about that. We’re also going to be talking about VBAC epidurals. A lot of people contact us saying, “Oh my gosh. I want to have a VBAC. My provider says I have to have an epidural and I don’t really want to because I’m worried about what it’s going to do or if it’s going to impact my labor.” Or we have the opposite where they are like, “I actually want an epidural. I don’t really want to go unmedicated but my provider is saying I can’t have one.” So we’re going to talk about that. We’re going to talk about laboring and positions and coping and tools to have a really amazing, positive experience. We’re going to talk about fetal positioning and how that can impact it. We know that that is one of the biggest reasons why Cesareans happen. Fetal positioning, failure to progress, failure to descend— those all three kind of go hand-in-hand. We want to talk about that more. We want to talk about uterine rupture and the signs of uterine rupture. We’re going to talk about C-sections and how to create a family-centered Cesarean. There are so many people in our community who after learning about VBAC and the risks of both, the VBAC risk is still not acceptable to them and that is okay. Or we know that a lot of people go in and they have a TOLAC or they are going to VBAC and then end in a repeat Cesarean so let’s talk about how to help these Cesareans be better experiences. You guys, and recovery. There are so many things that are so important to know during your VBAC. Then I want to just drop this little note right now that although we are doing all of these amazing things to prepare and understand and to get tools to navigate through our VBAC journey, we have to remember to not forget the postpartum experience. Women of Strength, it’s so important to make sure that we are cared for during postpartum. The way the world works today, it’s just not happening enough. We are getting right back into the busy hustle and bustle. We’ve got multiple kids. Work is not supporting paid time off so we are just getting right back into life, just life, and it is so important to take care of ourselves postpartum.If you haven’t been to thevbaclink.com, if you’ve only been here with us on the podcast, one, I’m so glad that you are here, but two, I highly suggest checking out thevbaclink.com. We have blogs that are amazing. We have so many blogs on so many topics– on ECV, on breech, on VBAC after multiple Cesareans. We have VBAC doulas, stats on VBAC doulas or just doulas in general. We obviously have our Find a VBAC Doula Directory. We have a VBAC Resource page filled with so many things and so much more. I highly, highly suggest checking out thevbaclink.com. Another place where you can find love and support is through our Facebook community at The VBAC Link Community. Answer all of our questions and we’ll get you in there so you can be surrounded by so many like-minded people that are really just wanted to know similar information to you and wanting to feel supported just like you are. We know that our family and our friends sometimes really aren’t those people and that’s okay. We love them, but this group is so solid. It’s so amazing. I can just feel the love every time I’m in it. I’m just blown away. I’m so stinking in love with this group. Check it out at The VBAC Link Community on Facebook. You can also follow us on Instagram. We are constantly giving out tips and suggestions and referrals. We have our Q and A’s every single week so you can check that out. You can go into our highlights and check out the past Q and A’s. We try to make sure to get all of them in there so you can go look at frequently asked questions and the answers as well as all of the sites and recommendations. Women of Strength, I hope that through this podcast, even though it is short and sweet and you just have me today, that you feel like you know more of what The VBAC Link offers and what you can get from us. We love you so much, so, so, so much and we want the best for you. We love to support and love and educate. With all that being said, I’m going to let you go and wish you the best of luck. I will be hoping to see you guys in the community. If you ever have any questions and you’d like to write us personally, you can reach out to us at info@thevbaclink.com. Again, that is info@thevbaclink.com and we will make sure to get back to you. Love you all and we’ll see you later. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

In this episode of “The VBAC Link Podcast,” Meagan is joined by Lauren from Alabama. Lauren’s first birth was a Cesarean due to breech presentation where she really wasn’t given any alternative options. Her second was a VBAC with a head-down baby, and her third was a breech VBAC with a provider who was not only supportive but advocated on her behalf!Though each of her births had twists and turns including PROM, the urge to push before complete, frequent contractions early on, and NICU time, Lauren is a great example of the power that comes from being an active decision maker in birth. She evaluated pros and cons and assumed the risks she was comfortable with. Thank you, Lauren, for your courage and vulnerability in sharing not only your birth stories with us but also your incredible birth video!Lauren's YouTube ChannelCleveland Clinic Breech ArticleThe VBAC Link Blog: ECV ExplainedNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. If you have ever wondered if a breech vaginal birth or a breech VBAC is possible, let me just tell you right now, the answer is yes and our friend Lauren today is going to share her story to confirm that it is 100% possible. Obviously, we do have some breech VBAC stories on the podcast but they are few and far between. I mean, Lauren, when you were going through it, did you hear a lot of breech births in general let alone VBAC? Did you hear a lot of people having those? Lauren: No. I had heard a few on The VBAC Link but that was really it. I did a lot of research. Meagan: Yes and it’s so unfortunate. This story is a double VBAC story but also a breech VBAC which we know a lot of people seek the stories for this because as she just said, there is not a lot of support out there when it comes to breech birth in general. We have a client right now who was just told that her baby was breech and they’ve already said, “We’re going to try to flip this baby but if not, it’s a C-section.” They didn’t even talk about breech vaginal birth being an option and it makes me so sad. I’m really, really excited to get into your episode. You are in Alabama. Is that correct? Lauren: I am. Meagan: Awesome. So any Alabama mamas, listen up especially if you have a breech VBAC but VBAC in general. If someone is willing to support a breech VBAC, I’m going to guess that they are pretty supportive of VBAC in general. We do have a Review of the Week so we will get into that. This is by sarahinalaska. It says, “HBA2C attempt”. It says, “Thank you, thank you. Your podcast came to me at such an amazing time. You ladies are doing something amazing here. I’m planning on (I’m going to) have an HBAC after two C-sections in February. I look forward to listening to your podcast on repeat to fuel my confidence, ability, and knowledge.” Sarahinalaska, this has been just a minute so if you had your VBAC or just in general, if you are still listening, let us know how things went and congratulations. Late congratulations because this was a couple of years ago. Meagan: Okay, everybody. Lauren, thank you again for being here. Lauren: Thank you for having me. Meagan: Yes, so okay. Obviously, every VBAC journey starts with a C-section so if you want to start right there. Lauren: Yeah. So my first son was about 7 years ago. He was born by C-section. He was also breech. Meagan: Oh, interesting. Okay. Lauren: He was breech through the entire pregnancy. We had talked to my doctor about doing the version but at 36 weeks, my water broke. Meagan: Okay. Lauren: So once your water breaks, you can’t attempt a version. I went to the hospital and they said that it would have to be a C-section at that point. I really didn’t have the knowledge that I do now and basically, it was worded as “I don’t have an option” and that’s just it. So that’s what we did. Meagan: Yeah. It’s so common. Even with non-breech, there are so many times when we come into our birth experience and we are left feeling like we don’t have an option. Lauren: Yeah. Meagan: It’s just so hard to know. Obviously, that’s why we created this podcast so you know all of your options. And then talking about flipping a baby and doing an ECV after your water broke, that is something I’ve only seen one time in 10 years of practicing so most providers will be like, “Nope. I won’t even attempt it.” I was actually floored when my client was actually offered that. Obviously, it’s a more difficult experience and it can be stressful on the baby as well so there’s that to consider. She ended up trying it. He tried it twice and it didn’t happen and then they ended up going into the OR. So okay. Baby was breech. Do you know why baby was breech? Did they say anything about your uterus or any abnormalities there? Lauren: No. They said sometimes it just happens. They knew how badly I wanted to have a vaginal birth and they said, “You are an excellent candidate for a VBAC.” So I was like, “Okay, great.” Meagan: Awesome. Lauren: That’s when I really took a deep dive into birth in general because the stuff that they were saying just didn’t sound right to me. Meagan: They said you were a candidate. So where did your VBAC journey start as you were diving in? How did that begin? Did you do that before pregnancy or after you fell pregnant? Lauren: Before pregnancy. Probably before the time I came home from the hospital with my son, I was already researching. Meagan: Baby was a couple of days old and you’re like, “And let’s figure this out.” Listen, I get that. That’s exactly how I was too with becoming a doula. It was literally two days after I had my C-section. I signed up to become a doula. Okay. You started diving in and what did you find? Lauren: It was very shocking to me how most providers don’t practice evidence-based. I found out the difference between evidence-based versus the standard of care. I was shocked about that too. I was just like, How can you do that as a doctor when you’ve got all this evidence here? But another doctor is practicing this way so it’s okay for you to do that. Meagan: Right. It becomes the norm or it has become the norm. Yeah. Okay. So you get pregnant and you know VBAC is possible. Tell us that VBAC story. Lauren: So that was just a wonderful experience but part of my research, I joined ICAN and I wanted the most VBAC-supportive provider out there. I did switch providers and I switched even before I was pregnant. Right when we were trying, I was like, I need to get in with a provider who is supportive. I found a wonderful provider. The pregnancy was great. I did all the things. I sat on the birth ball instead of on the couches. I made sure to take walks every day. I kept up with my chiropractic care. All of that were just tips that I had seen so I did that. She was head down by 20 weeks so I was super excited about that and she waited until 40+3 which was also a big thing for me because with my first son, they took him to the NICU so I did not want the NICU. The NICU was a horrible experience. I was like, Please, please, please hold on until 37 weeks. 40 would be great.She did. She held on until 40. It was funny too. It was like a switch flipped at that point and I was like, okay. Now I want to get her out. I was eating the spicy food and everything to try to get labor started. But 40+3, my water broke with her as well before labor started. I panicked a little bit because I didn’t want to be on a clock. Although I felt that I was with a good provider, I still hadn’t birthed with her yet and I’ve heard stories about people having this doctor who tells them everything they want to hear and then they get in the birth room and it’s completely different. Meagan: The bait-and-switch, yeah. It’s so hard because they talk about how we have to have this proven pelvis to be considered the best candidate or to have full faith in our ability, but at the same time, I feel like sometimes from us at a patient’s standpoint, they need to prove to us. They need to prove to us that they are supportive throughout. Lauren: Yes. For sure. So pretty quickly after my water broke, I started pumping and while I was pumping, the contractions started so I felt so much better. I was like, Okay, good. Now we’ve got contractions going. I had a doula at that point as well because I felt like having a doula was going to be extremely important for a VBAC. I called her and let her know. She came over and she just hung out a little bit. We did a henna on my belly and we just talked and talked through some fears and excitement and stuff like that. Then she said, “Well, I’m going to go get my stuff. Why don’t you lay down and take a nap and see if once things pick up, we can go to the hospital?” I said, “That sounds great.” This was my first time experiencing labor because with my son, even though my water broke, I never had contractions. They just went straight to the C-section. I went upstairs and I laid down on my left side. Within a minute, I was just like, Whoa, these feel totally different. This is crazy. Probably within 30 minutes or so, I was having contractions every 2-3 minutes. Meagan: Whoa!Lauren: Yeah. I was just like, This just picked up really fast. I think I was supposed to already go in by now. Meagan: Were they intense as well on top of being close or were they not as intense but just close? Lauren: In hindsight, they were not intense but it was my first time having labor and they were more intense than the beginning contractions. “Okay, they are more intense. They are close together. I’ve got to go now.” I was panicking. We made it to the hospital. They checked me and I was 2 centimeters. Meagan: Okay. Lauren: I was like, “You’ve got to be kidding me.” Meagan: Yes. That’s the hardest thing because we are so focused on the time. We are told if they are this close together, it’s time to come in but we sometimes forget about the other factors of intensity and length and what’s the word I’m looking for? I was going to say continuous but they are that pattern always. They are sticking to that pattern. They are consistent. They are consistent, yeah. Okay, so you’re 2 centimeters which is great by the way. It’s still great. Lauren: Yes. Oh, and I forgot to mention too that another that was like, Okay, I probably am with a good provider, I did call her after my water broke and she said, “What are your plans?” I just said, “I’d like to stay home as long as possible and contractions haven’t started yet but I’m going to try to start pumping and get them started.” I said, “I’d like to wait until tomorrow morning to come in if nothing has started.” She was like, “Okay. Sounds like a good plan. Just let me know what you need.” I was like, Wow. She let me go past 24 hours. Meagan: Yeah. I just love that she started out, “What’s your plan?” Lauren: Yes. Meagan: Versus, “This is what you have to do now.” Lauren: Yes. Exactly. She is wonderful and you’ll see through the story how amazing she is too. But anyway, we get to the hospital and I actually started out with a wonderful nurse. The hospital policy is continuous monitoring. Meagan: Yeah, very common. Lauren: But I did not want that. I was so lucky because the nurse who started, she was about to leave. Her shift was about to end but she let me start on intermittent monitoring so I was able to get up, walk around, get on the birth ball just to help things moving. Shortly after that, she left and the next nurse was not so nice about it. She told me, “It’s our policy. Yada yada.” I said, “Look. I’ve been doing the intermittent. I’m fine with the intermittent. That’s what I’m going to stick with.” She said, “You’re going to have to sign a form.” I said, “Bring it on.” Meagan: Yeah. Lauren: I signed the form and I was just like, “That’s fine. I have no problem signing a form to say this is my choice.” Then we labored in the hospital room for several hours and my doula suggested I got in the shower at one point and that was amazing. It was euphoric. It felt so good to get in the hot shower and I was progressing slightly more than a centimeter an hour which I know is what they look for so things just progressed pretty slowly and then that night at around– oh, well actually once I hit 6 centimeters, my body started pushing. Meagan: Oh, yes. That can happen. Lauren: I was terrified when I found out I was only 6 centimeters because they kept saying, “You need to stop pushing or you’re going to the OR.” I was like, “You don’t understand. I’m not pushing. My body is doing it.” It was several hours of working with my doula to try to stop my body from pushing. Every time I had a contraction, and they were still going every 2 minutes–Meagan: Did they give you any tips on how to cope with that or how to avoid pushing like horse lips or things like that?Lauren: The thing that worked best for me was opening my mouth and saying, “Ahhhh.” So that helped a lot but I would still say that 50% of the time I could not stop the pushes. I still remember that nurse saying which was not helpful at all, “Are you pushing? That’s the quickest way to the OR.” Meagan: Ugh. Not very kind. You’re like, “I’m trying not to. Can you see what I’m doing here?”Lauren: Yes. Then my doctor came in around 11:00 that night to check me and she said, “Oh, you’re complete.” I just remember being like, “Thank God.” I said, “Does that mean I can push now?” They’re like, “Yes.” That was the best thing I had heard because that was all I wanted to do was push. I was already in the bed because they had me on the monitor at that point. I was on my back so they just leaned the bed back. I didn’t really want to push on my back but at that point, I was like, “I’m not moving. I’m just going to push how I am.” I pushed. It took about 20 minutes and she just slowly came out. It was– oh, I’m going to get emotional. It was wonderful. My doula was also my birth photographer and she got some pictures. She got a picture of my husband. It’s really sweet. I hope he’s okay with me telling this but she got a picture of him crying. It was when she was almost out. I asked him about it and he said, “I just knew at that point you were going to do it. I knew how important it was to you.” Sorry. Meagan: I’m sure he had that overwhelming flood of emotions like, “I know this is important and I can see it. She’s there. She’s going to do this.” Lauren: Yes. It was wonderful too and then I got to hold her on my chest for a while but they weren’t too thrilled with her breathing so they never took her out of the room but they did take her over to the table and they were suctioning her and stuff like that. I started feeling a little panicky because with my son, what happened was after my C-section, they showed him to me. I got to kiss him and touch him and all that but then they started leaving the room with him. I was like, “Whoa, where are you going?” They were like, “Oh, we’ve got to take him to the NICU because he’s having trouble breathing,” but nobody told me anything. They just started leaving with him. I was panicking thinking that was going to happen with my daughter. I was like, “Please, please, please just give her to me. All she needs is me. She’s going to be fine. Just give her to me.” The nurse was like, “No. She needs suction. We need to do our job,” but my doctor was so wonderful. She came over and said, “What they’re doing right now is suctioning her because they are not happy with her oxygen level.” She sat there and she told me, “Okay, now she’s at 94.1%. Now she’s at 94.2%. Now she’s at 94.3%.” Every time that thing went up, she would tell me. She was just so calm and it was like she got me. She understood. Meagan: She understood what you needed in that moment. Lauren: Yes. Yes. Another thing too which I thought was really interesting is that first off, she did ask before she did anything. We got half of my daughter’s head out but she got a little stuck so the doctor was like, “You know, we really want to get her out.” She said, “I think the vacuum might help or are you okay with me manually helping you?” I said, “What do you mean by that?” She said, “I could just insert my fingers and tilt her chin. I think that will get her out.” I said, “Yeah. Let’s do that one.” So she did. She went in and popped her little chin and then she came out.Meagan: Awesome. Lauren: But it was nice to be asked instead of told what needed to be done. Meagan: Well not even told and just have it done. Lauren: Yeah, just do it. I’ve heard that a lot and it was crazy because that actually was going to happen with my first son. Before my nurses knew I was breech, they came in and they started. They were about to put medicine in my IV and I said, “Whoa, whoa, whoa. What are you doing?” She’s like, “Oh, this is Pitocin. We need to get your contractions started.” I was like, “No, I don’t want Pitocin.” She’s like, “We need to birth him within 24 hours or he’s going to be a C-section.” So it was just crazy the difference in being told what was going to happen and being asked for not only my opinion but my consent. Meagan: Yeah, absolutely. That’s so important. Women of Strength, if you are listening to this, please, please, please I beg of you to help you know. I don’t know how we can let you know even more but you guys have the power to say no and consent is so important. Your consent is so important with anything, even just getting Pitocin drips. If anything is happening to your body, you have the right to say no and you always can question. You can pause and say, “Tell me all of the risks here” or whatever. You don’t just have to have it be done to you. You do not have to. Lauren: Yes. Meagan: It’s hard to say no in that moment. Lauren: It is. It is. Meagan: It’s hard to say no especially when they are coming in and making it sound like something you need. Whether it’s something you need or not, you still deserve to have consent. Lauren: Yes, exactly. Then they throw that at you where it’s like, “Oh, the baby will be in danger.” You’re like, if you’re not knowledgable then you’ll be like, “Okay, then. I don’t want my baby in danger.”Meagan: Exactly. Of course, we don’t. Duh. Of course, we do not want our baby in danger but most of the time rarely is our baby in danger if we are not starting Pitocin right away. Yeah. Awesome. So you had this beautiful vaginal birth with support. It was a way different experience with good, true informed consent even into the postpartum period which should keep continuing anytime you are under care with anyone like this no matter in hospital or out of hospital. This kind of consent should continue. Lauren: Yes, for sure. Meagan: Awesome. Awesome. And then baby number three. Cute little baby. I don’t know if I’m allowed to say his name so I won’t. Lauren: Oh, yeah. You’re fine. Ollie, yeah.Meagan: I was going to say I got to see on the recording just before we got started that he was another breechie. Lauren: Yes, he was. I was just like, Oh my goodness. His pregnancy was so similar to my first son. It was a little freaky. I had a lot of anxiety to work through because of that. I was like, This can’t happen again. He was breech the entire time and basically stayed in the same position. He moved his little head around and that was about it. This time, I was I guess a little more– I don’t know if cocky is the right word but confident that everything would be fine. I was a little more lazy. I didn’t do as many walks as I should have. I sat on the couch a little more than the birth ball and things like that. I was like, Oh, he’ll be fine. So at about 20 weeks when he was still breech, I was like, Maybe it won’t be fine. Maybe I need to get this going. I started trying to do a little more of that stuff. Also, my doula had moved out of state so I was like, Oh no. Meagan: Dang it yeah. Lauren: I know it’s so important and having a doula was definitely important for me. I started the search for a new doula which ended up turning out great. I loved both doulas so I was very pleased but I was very nervous. But yeah. I found my doula while I was pregnant and then I just had so much anxiety about my first son’s birth that I needed a plan ahead of time basically. I talked to my doctor about it and I went in there just nervous to even bring it up. I said, “So he’s still breech. I know that he’s got plenty of time to turn but I am nervous because I have a history of this with my first son. He was breech and I had to have a C-section.” I said, “What are your thoughts on a breech vaginal?” She goes, “Well, I don’t see why we couldn’t.” I was like, “What?”Meagan: You’re like, “I wasn’t expecting that.” Lauren: She’s like, “You’ve already had a VBAC. You did fine. He can’t be sideways. He’s got to be to where he could actually come out breech. It’s just something that we’ll talk about.” She did mention an ECV as well and she was like, “We’ve got a long way away but I don’t have a problem doing a breech VBAC with you.” I immediately just felt so much relief. Meagan: I bet. Lauren: Yes. So we went along the pregnancy like that and then at 37+3 at 5:00 in the morning, my water broke. Meagan: 3 for 3 water breaking, you and I. They say 10% but when you’re 3 for 3, you’re like, “Hmm.”Lauren: That’s what I was thinking and the breech stuff is only 3-4% are breech and I had it twice. It’s like, How is this possible? But yeah, my water broke around 5:00 AM and me running to the bathroom, I woke my son up and he came in. It was really sweet. He got in bed with me and we just cuddled for about an hour and I talked to him about how his baby brother was going to come today. It was just a really nice moment to cuddle with him. Meagan: Oh yeah. Those moments are so precious because you’re like, these are the last moments of just us as a family of 4 and now we’re adding a 5th and these are the last little moments together without little siblings. I’ll always remember that. So we did that. We cuddled for about an hour and then the contractions actually started without me having to pump. This time, I was going to wait a little bit longer before pumping because I wondered if the contractions every 2 hours with my daughter for the whole labor was maybe because of the pumping. Having contractions that close made things really difficult. Meagan: Oh yeah. Not a lot of a break. Every 2 minutes, there’s not a ton of a break especially when they were a minute long. Not a lot there. Lauren: No. So I was like, Maybe that will change. I knew I could handle it but I was like, If I don’t have to, that would be great. They started pretty slow about 6 minutes apart or so really gently. At around 6:00, I went ahead and woke my husband up and let him know. I called my parents. I had texted my doula but I went ahead and called her just to let her know. I called my doctor. She again just asked me, “What are your plans?” I just said, “Stay here to let things pick up and then head to the hospital.” She was like, “Okay, that sounds good.” I just labored at home. My parents live 2 hours away but they were coming to get our older two kids. I was going to try to pack the hospital bag because I had not done that yet. Meagan: Well, at 37 weeks. Lauren: That was the plan for that weekend. I kept having to sit down because of the contractions. My husband said, “Let me do it. Tell me what you need.” I would just give him the instructions as I just bounced on the birth ball. We got that done and my parents showed up. They brought me a big smoothie because I was like, “I want to eat but I don’t want to chew so get me a smoothie.” That was really nice just to have something in my stomach and give me some energy and stuff. They got here at around 9:30 and at around almost 11:00, I was like, “These contractions are starting to feel real.” I had a first birth reference at that point. Meagan: Yeah, like more intense and frequent and strong. Lauren: Exactly. Oh, but I will say by 7:30 again, at 7:30 that morning, I was back at 2 minutes apart. Meagan: Oh man. It’s just something your body does. Lauren: That’s just me, yeah. But they weren’t intense and this time, I knew. I was like, Okay. I know this is not intense. I’m still able to talk through them. I’m able to recover very well, but then right around 11:00, I was like, “Things are getting really intense now so I think we need to go.”We left for the hospital and let my doula know. I called my doctor as well and it was really wonderful talking to her too because she said, “You know, when you go in there, make sure you are confident. Tell them this is the plan. You are going to do a breech VBAC. We have already discussed this.” I think she was worried too. The hospital, I will say, I do not feel was supportive. I think it was mainly that they were scared. I think she knew that too, but having her in my corner was what I needed. Meagan: Yeah, very huge. Lauren: We got to the hospital and she had gone ahead and called them to directly admit me so I didn’t have to do triage and all that. That made it so much quicker. We got there probably around 11:40 or so and we were already in our room and the doctor was coming in by 12:00. She came in and she checked me. She was like, “All right. You’re already at about a 5 or a 6 so you’re doing great.” She’s like, “I’ll be in the hospital for a while so they’ll just call me when you need me. Just do your thing. I was like, “All right. Here we go.” I did get in the bed for a little while so they could do the IVs and stuff like that. I told them I wanted the wireless monitor. They were having trouble working it but they still never made me do any monitors because I told them I can’t do continuous unless it is wireless because I need to be able to move. They didn’t argue with that so that was nice. Once they got all that done, I got on the birth ball. We played some music that I had preplanned and my doula and my husband both helped me work through the contractions then it was 12:58 which was less than an hour when my body started pushing again. I’m like, You’ve got to be kidding me. I can’t do this.They called the nurse in because I was like–Meagan: Last time this happened at 6 centimeters. Please don’t tell me. Lauren: They came to check and she was like, “Oh my gosh, she’s complete and he’s right there.” I was like, “What?” Meagan: Yay!Lauren: Yes. They called my doctor. I was panicking a little bit but she wasn’t there. She was in the hospital but because she wasn’t in my room and I went from a 5 to complete in less than an hour, I’m like, “Is this baby just going to shoot out of me?” I was like, “I need her to be here.” Anyway, she got there very quickly and this time, I knew I didn’t want to be on my back so they had me just try some different positions but I really liked when the bed was sat up and I was facing the back and leaned over it so I was upright. Then I was able to move my pelvis around and just find a comfortable position. I really liked that. I started pushing because I could. He just very, very slowly came out and my doula was recording because I wanted a recording of my last birth but I was just too out of it to even ask for it so I had let my husband and doula ahead of time that I wanted it so my doula took care of that. She was there recording it. Meagan: Awesome. Lauren: Yeah. I was pushing I remember this one hurt a lot more than my daughter. I think they stretch you differently. I remember panicking to my husband, “Oh my gosh. This hurts.” He was just slowly coming out but I couldn’t see what was going on. With my daughter, they rolled out a mirror so I could see what was going on. I felt like I was pushing wine. I didn’t ask him to but my husband stepped in and he was like, “Okay, I see a leg now. Oh, there goes the other leg.” He started just telling me body parts and I was able to get a visual which was so helpful to be able to know how much was coming out. When it got to his chest, it felt like my body was just like, Okay, we’re done. The contractions just stopped and I was like, “What’s going on? They were coming so fast and now they’re just chilling out or whatever.” They were like, “It’s fine. We’ll just wait until the next contraction.” They did start coming back but it didn’t feel as strong and it felt slower. I don’t know what that was about. It could have just been my perception too. He came all the way out up to his neck and then he wasn’t really coming much further after he got to his neck. The doctor was turning him because he had the cord wrapped around his neck twice. He just didn’t seem to be moving like he was supposed to. She said, “I need to check and see if his head is flexed,” and it was not. She had to put both hands inside to flex his head so that it was in the correct position and she had turned him over to try and get some of the cord off as well. It got a little intense there for a minute. She said, “Okay. I need you to get on your hands and knees,” so I did that and that wasn’t working. She said, “Okay, mom. I want to get you to flip over. I just need a different angle to get him out.” I flipped over on my back which I was completely fine with at that point. I wasn’t panicked. I had a little bit of anxiety and fear but I wasn’t really scared because my doctor seemed so confident in that she’s got this. We just need to do something a little different to get him out. We flipped on my back and she got his head exactly where it needed to be. I did two more pushes and he came out. He had gotten stuck longer than they wanted him to so she said, “We’re going to go ahead and cut the cord and get him to the nursery team who was coming in” because they needed to resuscitate him just from the time it took. Meagan: He was shocked Lauren: She said too, “He’s going to be okay. He’s trying to cry but he needs help.” I said, “Okay.” I felt good at that point. I knew that if he was trying to cry that he was still conscious. The NICU team– it was charted wrong how long he was stuck. I think they panicked a little bit because they just went and they intubated him immediately and they said, “Okay, we need to get him to the NICU.” I hadn’t even touched him at that point. I said, “Can I touch him or kiss him or talk to him before you take him?” I asked my doctor that and she said, “Can you bring him over here so she can give him a little pat before you take him?” The nurse looked over and she goes, “She can see him from where she’s at,” and they left with him. Meagan: Oh. Oh. Oh boy. Lauren: To me, it did feel like a punishment for doing a breech. They went back and looked and they charted that he was stuck for 5 minutes. We had a video and he was stuck for a minute and 40 seconds. Huge difference. Meagan: Very big, yeah. Lauren: They went immediately to what they would do with a baby who had been stuck for 5 minutes. They charted his APGAR as 0 but my doctor said, “It can’t be because he whimpered when he got out so he’s got to have at least something.” It was all just a big overreaction at that point. They were supposed to monitor him for 4 hours to make a decision and they immediately just made the decision to admit him to the NICU which meant he was stuck in NICU for at least 3 days. Then within– when I went to go see him, it was within 2 hours. They had already extubated him. He was already breathing on his own with no problems whatsoever. Meagan: He was fine. Lauren: Yeah, he was fine.The next morning, my doctor went and talked to the doctors–Meagan: The pediatricians? Lauren: Yeah. Yeah at the NICU and just let them know, “This is wrong in the chart. This is wrong in the chart,” educating them about breech VBAC. She also did talk to them about the behavior of the nurse and she said, “It was unacceptable.” They talked about that. Oh, because that same nurse, when I finally got up to the NICU to see him, she had her back turned and she didn’t see me coming and I heard her talk. She goes, “Well, you know, he came out the wrong way.” Then she realized that I was behind her and she walked away. I never saw her after that. Meagan: She probably was avoiding you. Lauren: I was like, Oh my goodness. I can’t believe that just happened. Meagan: Seriously. Obviously, she’s got a chip on her shoulder toward people who are doing things that are actually normal, just a different variation. Lauren: After my doctor talked to them that morning, as soon as she left, they called me and they weren’t going to let me breastfeed or hold him or anything like that because he had a central line in his umbilical cord and they said, “It’s too risky. It could fall out.” As soon as she left, they were like, “We’re going to actually let you try to latch and hold him. We’ll just have to be really careful.” Meagan: Good for your doctor for advocating for you guys. Lauren: That was one of my things that I just really love about her. That’s not something that she had to do. She took the time out to review everything that night. I had him on a Saturday so she reviewed everything that night, got up early the next morning, went to the NICU, advocated

Women of Strength, we have a truly inspiring story for you today! Ashley joins us from the Liverpool/Sydney area in Australia and shares her VBAC with an inverted T special scar and extension story. During her first Cesarean, Ashley’s OB mentioned that she had only performed that kind of incision one other time in her entire career and that Ashley would never have a vaginal birth.Ashley did not find out the actual circumstances around her first Cesarean until she requested her operative notes during her second pregnancy. In spite of what she was told, her heart longed for a VBAC. She committed to doing all she could to try and find a VBAC-supportive provider as long as it was medically safe to do so. Ashley went into spontaneous labor and utilized the tools available to help her baby rotate from a posterior position. She and her provider both stayed patient, trusted the process, and after pushing for 20 minutes, her baby girl was earthside!Special Scars, Special Hope Facebook GroupThe VBAC Link Blog: Special Scars, Special HopeHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. How are you today? I hope you are doing amazing. We have our friend, Ashley, with us today and you guys, she is from Australia. It has been so crazy. I don’t know why I cannot understand time. We were talking about how we literally had to Google, “What time will it be in Australia if it’s this time in Utah?” It was such a challenge to get this scheduled but I’m so grateful for Ashley for taking the time out of her Monday morning recording with us today so welcome, Ashley. Thank you for being here. Ashley: Thank you so much for having me on. Like I was saying to you before, The VBAC Link was so invaluable to me with all of the research and the statistics and just trying to hear other people’s stories to help me change my mindset to get through it so I’m really excited to add to that with my story as well. Meagan: Me too. Your story has a little extra tidbit to it. Something that we know happens because we’ve got lots of stories on them as well. We actually haven’t had one for a few minutes and yours is a special scar. You had an inverted T with an extension. Do you want to share with our listeners exactly what that means? We’ve had some J scars. There are all different special scars. An extension we know goes past the initial cut or incision. But tell us about the T. Ashley: Yeah, so I actually only found out after the surgery that it was an inverted T but I didn’t know what that entailed so I had to do a bit of my own research especially when I fell pregnant the second time to know what was involved with that. Yeah, it was really scary just to see that I had a vertical cut in the middle. Obviously, you’ve got your normal horizontal cut–Meagan: Low transverse, yep. Ashley: Yeah, that’s right and then through the center going vertically I had a 3-centimeter cut which was obviously riskier. A lot of providers said no to me when I started to look into it when I was pregnant the second time and started to have a look to get somebody to take me on. Even the public hospital that I had originally gone to with my son actually said, “No, you will have to have a Cesarean if you come through us.” In Australia, they can’t really say no to you in a public hospital if that’s what your wishes are, but I wanted somebody who was going to be supportive of me and the whole journey. So yeah. That’s where I come to going private instead and having an obstetrician this time which I know is quite rare with VBACs. You find a lot of people who won’t take you on. I had a really amazing experience if anyone is listening from Sydney. I’m in Liverpool and my provider was Brian Hollis and he’s extremely VBAC friendly. He was amazing. He had actually somebody with an inverted T before. Meagan: Really? Okay, so he had also seen one. Definitely there are so many providers out there who do support VBAC and then they have a special scar patient come in and they are like, “I really like VBAC but I don’t know. I’ve never seen this before.” But we know it exists so I can’t wait for you to share more in your story and about him maybe because we know it’s so hard. It’s so hard to find these providers. It’s hard enough to just find a VBAC-supportive provider in general and then that’s something unique that Australia does that at least here in Utah we don’t do with the private and public. We just have this hospital and then we have the birth centers and then we have the home births. There is not the dramatic difference in the hospital system like in your case. Okay. Oh my gosh. I’m so excited to dive it. I do have a Review of the Week. I’m so excited that I’m talking so fast. I do have a Review of the Week and then we’ll get into those stories. Like you said, you didn’t find out until after. That’s is the case so many times. They don’t even say during. We’ll go into this as well if they went into why but sometimes there’s not even a clear answer to, Okay, I now have this different, unique scar but why? We’re going to get into that. We have this review from xxooxx and it says, “Informative, supportive, and empowering.” It says, “After having a C-section that I certainly did not want and that I did not know was not necessary, I knew nothing about VBACs. I had dove head-first into this podcast and on top of learning so much, I became informed and empowered to get my VBAC which I got. Thank you, Julie and Meagan, for loving your listeners and pouring your knowledge and support into us. What you do matters and I will always recommend The VBAC Link.”Well, thank you, xxooxx, for that amazing review. Congratulations on your VBAC and I couldn’t agree more. This podcast really is so empowering and so informative like you were even just saying. I think a lot of this comes from the storytellers and the moms and the Women of Strength. This is just so amazing. I definitely suggest sharing this podcast to anybody. If they’re not a VBAC mom, if they’re a first-time mom or a second-time mom, I definitely suggest that because I truly believe that the stories on this podcast will help people avoid a Cesarean in general. Meagan: Okay, cute Ashley. You found out after so how did this first birth lead up to this inverted T with an extension? Ashley: Yeah, so I guess my story starts in 2020. I had a low-risk pregnancy and other than being sick the whole time but giving birth in March 2021 with my son and it was super traumatic. It took a long time to heal physically and mentally from it but my waters broke on their own two days before my due date. I had gone into the public hospital I was booked in for. I had seen the same midwife the whole pregnancy which was really fantastic. Midwives are amazing and just empowering telling a first-time mom, “You can do this.” I had no signs that anything would be wrong. So as usual, I went back home and then the contractions started that night. They started to really ramp up and become heavier so that night at about midnight or so, I tried to get some sleep. I wanted to stay home as long as possible. At 3:30 AM, I had to go to the hospital. I was just beyond. The pain in my back was just– yeah. I didn’t know if this was normal but in the end, when I got to the hospital, I was only 3 centimeters dilated. I had used the gas and the TENS to get through the contractions but he was posterior which I was nervous about. I didn’t know as many things as I knew in the second pregnancy in terms of Spinning Babies and trying to get into good positioning. With my son, I don’t know how it happened but he was posterior and the pain was just unbearable. Meagan: And it happens. We learn through pelvic dynamic courses and things that sometimes really truly, babies have to enter in a posterior position before they get into an anterior position and sometimes that means back labor. It is very, very intense. It really is intense. Ashley: Yeah. Yeah, it was. At this point, it went on for a few hours and I just actually couldn’t deal with it anymore so I had the epidural which turned out to be quite a good thing for me. It was relieving of some of that back pain but I still had felt a lot of it through it so it’s almost like it didn’t seem to work as much as I thought it would at that point. The contractions through my back were still there. We tried to do some things before I had the epidural to get into a better position, but it wasn’t working for me. Every contraction, my son’s heart rate would drop and the midwife was really good in just letting me keep going. “Let’s see. Let’s see.” But as soon as the doctor on call knew that it had been quite a few hours came into check me, “You’ve got meconium in your waters. You have to have a Cesarean.” I was just devastated because I had really thought that this was just going to be a great, empowering birth. I was so excited to give birth and to hear that it wasn’t going to go the way that I had intended, I was devastated and crying. But yeah, he was in a compound position as well so he did have his hand up past his head. There were a few things going against me in that time. But despite all of this, they gave me a little bit more time to keep going and I did get to 9 centimeters. I was in a position where they thought, “Okay.” My midwife was pushing, “Let’s try. Let’s try and see if she can continue and maybe we can try some repositioning to get him out,” but the doctor was, “No. Cesarean. There is meconium in the waters. Let’s get him out.” I was so exhausted. It had been 34 hours from the time my waters broke and I just gave in. When I was in that vulnerable position of just so much pain and didn’t know any better, I just said, “Okay, I’ll give in and I’ll have the Cesarean.” During the Cesarean preparing, I heard the surgeon say to her assistant, “She’s 9 centimeters,” and explaining it and the assistant said, “Should we just see? The head is almost there.” There was a little bit of whispering and then it all just stopped. I was just laying there terrified like, What’s going on? They’re talking about how far I’ve progressed and that they were concerned about me having a Cesarean.Meagan: Your baby was so low. Ashley: Yes. I found out later that he was so low that they had to push him back up during the Cesarean. Meagan: Did they push him back up vaginally? Ashley: Yes. Yeah. Meagan: They do that sometimes where they go in vaginally where one doctor is pulling from the other end and one doctor is pushing from the other end vaginally Ashley: Yes. Obviously the recovery is like you gave birth, isn’t it? Meagan: Yeah. Ashley: Yeah. The doctor panicked and I was in such a blur that my husband and I actually debriefed afterward and he said, “I’ve never been so terrified.” A team of doctors just flew in. She was making calls. Obviously, when she started to begin the Cesarean, she saw that she couldn’t grab him. He was too low and that’s why they had to cut vertically but nothing was explained to us. We were just lying there terrified. The tarp was up. Meagan: They were doing their thing. Ashley: Yeah. And with our first child, we didn’t know what to expect anyway but my husband just said there were all of these people who just flew in and there were all of these conversations and whispers. Not long later, he emerged. The tarp wasn’t lowered and he wasn’t breathing. He started breathing once they transferred him to resus, but that time was the longest time. Meagan: Absolutely. It feels like 5 hours. Ashley: Absolutely, yeah. I don’t even know how long it was but it felt like forever. By the time that they placed him on me for the standard amount of time I suppose, I was in just a shock that the spinal block had made me have the shakes. It was just not what I was hoping for. Meagan: Anticipated, yeah. Ashley: Yeah. They wheeled him away with my husband. They went and then I was to go separately into recovery. Before I did that, the doctor then lowered the tarp and said to me, “You will never have a vaginal birth. I’ve only had to do what I just did twice in my career.” Meagan: Oh wow. Ashley: Yeah, and just so brutal. Just the shock of that was like, I didn’t want this either. It was just really hard to hear because I just had this baby not how I had anticipated and to hear that for the future was a big shock to me. Going into recovery and then later on that initial bond with my son, I was just in so much pain that it was hard to hold him. It really took a long time to recover from it. The next day, she did come and talk to me. She said that she had to cut an extension and cut an inverted T incision of 3 centimeters to get him out. She said, “Yeah. I’m so lucky it wasn’t worse.” Meagan: Wow. Ashley: Yeah, then she left and I just had to go home and start my new life as a mum with just this recovery. I could hardly walk. As a Cesarean, it’s already painful, but I had all of this pain and it left me with an awful feeling mentally as well. I just obviously adored my son. I was so happy to be a mum but that lead-up and then just bang. That’s how you’re giving birth, it was just a shock. Yeah, so that’s what happened. The details of it I found out with the second pregnancy. I didn’t know afterward that was our only conversation we had. I didn’t get any discharge notes with that information. It wasn’t until I was pregnant the second time that I requested my hospital notes. Meagan: So important. So important to do. I really encourage anybody whether you were at one, two, different hospitals and all of the things, request your records because you really do learn a lot about what really transpired that day in your op-reports. Ashley: Yeah, definitely. Yeah, so I guess that brings me to now with pregnancy. A lot better, a lot happier result but I fell pregnant in May 2023. Both my pregnancies were normal, and low-risk. I was a little sick and I actually got quite dizzy and things like that but nothing that was going to impact me from giving the VBAC a try. Like I mentioned, I had gone to a few different providers and when I had my pelvic floor checks and things after my first son, I spoke to the doctors there and said, “Would it be possible to have a VBAC here?” They said no. That was something that was a big shock to me. I didn’t expect that I would have to look for somebody. Yeah. That was a big shock. I found out through some of my friends about this OB who was quite VBAC-supportive and I knew I wanted to give it a try and ultimately, if I did have to have the Cesarean, I would be okay with it but I just wanted to try. I heard about this OB and had an appointment with him. My husband and I after the initial appointment were instantly comfortable with him. He was so supportive. He said to me, “Ashley, is this what you want to do?” I said, “Yeah. I really would like to try.” He goes, “Well, that’s what we’re going to do.”Meagan: I love that.Ashley: Yeah. I was just like, “Oh my goodness. He’s so honest about this is how it’s going to be.” “If you want to give it a go, these would be my conditions,” which were to have monitoring which I was fine with. I still was a little bit nervous. I know that some people would rather have no monitoring and just let your body tell you, but with the special scar, I thought if there are any signs of rupture, I really want to know.Meagan: That’s actually a very common request from a provider in a VBAC situation. They usually want continuous monitoring. You can fight not to have continuous monitoring, but that’s a very normal request. On top of VBAC, having a special scar, it’s even more of a normal request for a provider to say, “Yeah, let’s totally do this. I just want to monitor things,” because we do know that one of the signs of uterine rupture is fetal distress. Ashley: Yeah, that’s right. He was just really supportive about, “Let’s put a birth plan together and see what you want to do and I’ll see what is the best thing to do.”During the pregnancy, I tried to do as much listening to podcasts. That’s how I came across your page and Instagram just constantly looking for information. It’s actually a beautiful Facebook group called, Special Scars, Special Hope. Being in Australia, I was just like, this is global. There were so many amazing women on there offering support and advice. There was even information on there– statistics. Yeah. I did a little bit of research but I didn’t want to overwhelm myself. I just wanted to have a really strong mindset. There were times of doubt and, Maybe I’ll just book the Cesarean, but then I thought, No, this is what I want. Let’s give it a try. My OB was really supportive from the beginning about, Let’s just see how we go. He retrieved my notes and he found out that all of those details where they had to push him back up vaginally and they had to do this extension cut and all those kind of things. It was good that he was prepared. He knew and I just tried to stay as active as I could through the pregnancy. I did the dates at the end. I did the raspberry leaf tea and the vitamins. I just was always on the ball. I tried to do as much as I could to prepare myself physically, but yeah.The conditions with my OB were that we said I would be giving birth at the public hospital that is next to the private. It was a different one to before because of any emergencies and that kind of thing. He would have to do some examinations every hour or so which I was also fine about. Obviously, I couldn’t use water. That was one thing I really wanted. I wanted to be able to get into the tub. Meagan: Birth in the water. Ashley: Yeah, or even just use it for pain management. He said, “No, because of the monitoring,” so that was one thing I was ugh about. I thought, When I do go into labor and it starts, I will try and use water at home before I get to the hospital. My husband was so supportive of me and said, “I will help you. Let’s do this. If you want to use the water–” he was a little bit nervous about, “When they start to ramp up, we really need to leave” because the hospital was about 30 minutes away. We just wanted to be at a point that no later than 5 minutes or so apart and they wanted me in. Meagan: Well, and you had already made it to 9 centimeters before so even though you’d be a first-time mom pushing baby out vaginally, your cervix is not as much like a first-time mom. Ashley: Exactly right. That was something that got me through the whole labor. I just kept saying to myself, My body knows how to do this. I’ve gotten here before. I know what to do. That was just something in times of doubt, I would just keep saying. But yes, my OB said at any point that he was concerned, we’d have the discussion and if anything was to go wrong, we’d be calling a C-section straightaway. I was fine about that. I came in at 39 weeks. Sorry, I booked at 39 weeks for a stretch and sweep but I got COVID. Meagan: Oh no. Ashley: My whole family all got COVID and I was just like, “No.” I couldn’t hardly breathe. I was congested and everything. I’m not going into labor like this. I’ve done that much preparation. So I just tried to rest and get better. It was put out until 40 weeks. I had until 41 weeks then he said we would be having a discussion about a Cesarean. He didn’t want me to go too long with the scar. So 40 weeks, my due date. I came in for a stretch and sweep. I came home to relax after, nothing. Nothing at all happened. No pain, nothing. Two days later, I started to have some mild period pains. I carried on the day with my son. I just kept going but I had been attending acupuncture weekly from 36 weeks. I had another session at 6:30 that night and by 9:30, the pain really started to ramp up. I decided to try and sleep but by the time I had a shower, laid down in bed, and at 10:00, they were coming faster, stronger, and I just knew I wanted to stay home as long as possible. I got into the shower then I did some type of positioning that I could get comfortable with the TENS machine on but I knew the pain of the back and I just knew that this baby had to be posterior again because the feeling was just like I had experienced it yesterday. Meagan: Deja vu. Ashley: Yeah. I just said to my husband, “She’s posterior. I just know it.” We left for the hospital at 1:30 in the morning. We got there and I had to walk a really long distance from the car to the birthing unit. It was just so odd. There was no one there, no wheelchairs for me, just no one. Meagan: Huh. Ashley: Yeah, I was so shocked. I was like, What’s going on? I just said, “This is going to help me progress.” Any little obstacle that would come up, I just said, “I’m going to be able to do this.” Helping I think in the end actually helped my labor progress.Meagan: I was thinking that. This is actually probably really good. That’s a lot of movement for the pelvis and good for the baby to rotate. Ashley: I was having these contractions that I had to get on the floor to breathe them out and rock through them. It took us a long time to get from the car to the birthing unit because I had to keep stopping but when I did get there, they were like, “Wow. You are almost 5 centimeters. You have progressed really quickly.” Meagan: Just like you wanted. Ashley: Yeah. The contractions then were so weird. It was like I had to push but it was too early to push. She was posterior. It was confirmed so that pressure was just such an odd labor. I didn’t have that at all even though I was posterior with my son too. This one was like an intense pushing feeling that I couldn’t control. Then yeah. Once I had discovered that she was posterior too, I just tried to get into some good positioning. I had done a lot of research about posterior because I was terrified of it happening again. I got on the ball trying to rock back and forth and my husband was such a great support because we had done a little bit of information reading about this pressure point on the lower back. Meagan: The sacrum?Ashley: Yes, that’s it so anytime I had these contractions, he would just push on there and I swear by that. I have to say more than the TENS machine, more than anything, that got me through that labor. But yeah. At one stage, I sat on the toilet to try and help with the pressure of this pushing and my waters broke. Yeah. That really ramped up from there. I was 6 centimeters at that point and it was unbearable. I couldn’t take it anymore. I asked for the epidural and the midwife was like, “Are you sure you want to do that? You said you didn’t want to.” I just knew that I had to do it. I couldn’t take it any longer. I was at that point where I was asking, “Just wheel me in. I’ll just have the Cesarean.” I didn’t want that. I wanted to keep trying so I had the epidural and I fell asleep. It was just like my body needed that. Meagan: Yeah. Rest and relaxation can really be the best tool in labor. Even in early labor, we are so excited and want to keep going but rest and relaxation. Ashley: I was so tired, yeah. I just relaxed. My body completely relaxed and I fell asleep for about an hour. At that point, my OB came in to see me and measured me and discovered that baby had turned while I was sleeping and I was 10 centimeters. In that hour, I had progressed that quickly. He looked at me and said, “Ashley, you’re having your VBAC.” He said, “You’re going to push this baby out. Within a half hour or so, this baby will be here.” I just was in pure– I’ve got the feeling all over again. I just was so in a pure disbelief. I was just so happy and I just said to my husband, “We’ve done it. This is it. This is the moment that I really wanted.” Yeah. It’s making me emotional all over again. I pushed for about 20 minutes under his guidance. I still had feeling and control in my legs because I didn’t have the epidural at full dose so that really helped and within 20 minutes, my baby girl was born.And just that feeling of pure joy and pure connection, that bond was just immediate. Pride, shock. Meagan: It was just all of it. Ashley: When they laid her on my chest, I will never forget my husband– the pride he had in me. Yeah, it was just beautiful and it was truly empowering. It was a beautiful moment. It’s just something you never forget. She’s 12 weeks now and I just relive that moment over and over. But yeah, it was my healing birth. Yeah, it was beautiful. It was everything that I had hoped for. Just shock, really because it was such a different experience to the emergency that I had with my son. I had that golden hour. She wasn’t taken away from me like my son was. They gave me that time with her and it was just pure disbelief in a beautiful way. Yeah, so that’s it. I recovered so much quicker and I think for me, that chapter of my life closed. It was just a beautiful way to really celebrate what birthing should be like and how I should feel afterward. You know, that bond that you should have. Yeah. That’s me. Meagan: I felt all of the emotions as you were sharing it and I know that I get an extra advantage because I can see your face and I can see you get teary. Oh, just to see it in your face. That moment is amazing when you realize you’ve done it and it is so overwhelming in all of the ways but holy cow, I am so happy for you. I am so glad that you were able to find the support because it’s just so hard. It’s so hard and you were even told– you hadn’t even met your baby yet really and were told, “Just to let you know, you will never have a baby vaginally.” To even be told that in that space, that in itself is so overwhelming and being told, “No. No one here is going to support you. No one.” When you are proof along with so many other Women of Strength who have had special scars and gone on to have a vaginal birth that it is possible and you do not have to but when you’re in that vulnerable state, I can just picture my own C-sections in an OR with the drape up and the bright lights and the beepings and if I were told that I would never have a baby vaginally again, I would already be in that emotional intimate space and vulnerable where I could have and many people could be like, Okay and then just never look past it and that was it. I’ll never deliver vaginally. But that’s where I think this podcast just is so important for people to listen and hear these stories that you may be told something and that may be true. That really may be the best choice in the future, right? It may be medically best or emotionally best but it doesn’t mean it is always what your fate has to be for the rest of your life when having a baby. Ashley: Yeah, and when I was told that and then I fell pregnant, I thought to myself, Okay, if that is what is medically necessary, I will do that. I just want my baby here naturally and safely. If it isn’t the way that I had hoped then that’s okay. At one point, I even looked at the maternal-assisted Cesarean and I had that discussion with my OB. He said, “Yep Ashley, if you decide you’re going to have the Cesarean elective, I’ll do that for you.” He’s like, “I will make it beautiful for you. I can play music you like. I’ll do whatever you like. It will be different from the first.” I said to myself, Okay. That is an option if I just feel that. Meagan: That’s a good plan B. Ashley: Yeah, that’s right. Exactly. He said if we call it early enough and there are no signs of rupturing, “I can still do that for you.” I still felt really comfortable going in that no matter what, this would hopefully be a better experience than what I had. But yeah, you’re right. There’s almost this stigma that C-sections, especially with special scars, that your body failed. I wanted to break the mold on that that bodies aren’t broken. I almost left my first baby coming home with him and I just looked at him and loved him and adored him but I also felt to myself, That’s not how I wanted to bond with you by laying here and I can’t move. I felt like my body was broken or it had let me down and this time around, I just believed in myself. I believed in my body and I said to myself, “Your mindset is everything. Going in, this mindset is how I’m going to birth this baby and get through it.” Birthing is incredible and I feel like we should feel incredible afterward. Meagan: Absolutely. Birth is incredible and it really is incredible no matter what, but the experience really does matter. We hear the whole “safe mom, safe baby” but of course, duh. That experience really, really counts and it sticks with us really for the rest of our lives. I mean, my oldest is going to be 13 in just a few months and I still remember her birth. My other is 10 and I remember her birth and of course, my VBAC baby I remember his birth and those are sticking with me. They are sticking with me and it’s just I love that your provider was like, “Listen. I’m going to support here and if it goes here, I’m still going to support you and no matter what, we are going to make this a better experience for you.” I love that your provider saw the better experience as an important part. Ashley: Yeah. I’m paying for him and his expertise. But I almost felt like he just wanted me to be happy. For him, it was like, “I can see your pain. I want you to be happy this time around.” We felt that from the initial appointment. It was more than just, “I’m paying for you. You have to do this.” It was like, “Help me get a better experience for you. What do you want? What can I do?” That was so important to me so it was wonderful. It was really important to me to acknowledge him as well because he was such an amazing support. Meagan: Yes. I’m so happy for you. I’m so happy for you. I do just want to mention that group again, you guys. Special Scars, Special Hope on Facebook. What kinds of things did you see in your experience in that group?Ashley: It’s just hearing other people’s stories because I would see VBAC stories and I was like, Yes, 100%. I need to do this and I need to do that. It’s got that little bit of a fear factor with it because it is a special scar and not that many people attempt it. So to have a group of women globally who do attempt it and just empower each other like, “Hey, I had an amazing experience. This is what I did,” that was just invaluable to me taking on all of this advice. Quite a lot of these women are in the U.S. and they do talk about how providers can either be for you or against you and just write you off completely. It is similar here too. There were quite a few who said, “No way.” They don’t want that liability so yeah, it was just really great to have that group with such amazing, brave women who are going out there and sharing their story on there because it helps people like me who are like, Look, it can happen. It’s rare, but it’s not impossible. That group is amazing. I encourage anybody who has had all of these different types of scars on there, not just inverted T. There are people who have had inverted J’s and extensions. So anything a little bit special. Meagan: Yes. I was going to go over the C-section incision types. We’ve got the low transverse which is considered the safest way to VBAC having a low, boring, low transverse. But then we have a low vertical which means they cut lower in the abdominal segment and it’s vertical up and down. Then we have classical which is higher and sometimes we have classical scars when maybe a baby is very preterm, very small and the baby can come out that way, multiples, or maybe if a baby is transverse but it’s earlier on or something like that, they may have to go higher. Then there is inverted T and like I said, inverted J’s and then we have extensions on all of these. There have even been low transverse with an extension where it can go further or that’s where it goes into that J. Yeah, there are just so many different types and honestly, the statistics are not that powerful out there. There are not a ton and I don’t know. I would say there’s not a ton of really solid concrete. There are some but they are smaller. Ashley: Yeah, really hard. I didn’t want to overwhelm myself with statistics and things. A lot of people in that group share the rupture risks and the statistics and what they throw at you, these OBs are, “You’ve got a 20% risk of rupturing,” that would turn anybody away. I just knew from women in this group that I had just glanced over seeing that it’s not that high. Don’t let anyone tell you it’s that high. Obviously, there are situations when you need to have the Cesarean because it is unsafe, but in my case, I knew that it wasn’t a 20% rupture risk. I knew that there was definitely less and mine was 3 centimeters. It can be bigger than that obviously, but when I had spoken to my OB, he said, “It is 3 centimeters but in the span of your whole labor progressing, 3 centimeters is not a big deal.”Meagan: That’s pretty small. Ashley: Yeah, it’s pretty small so even just hearing that, it was like, “Wow, you are telling me something different than all of these other people.” It’s good to back yourself up a little bit in your conversations and have just that little bit of research behind you. Meagan: Yes. We are also going to have a bunch of links in the show notes so if you guys want to go check that out, I highly suggest it. Go check out the show notes. We’re also going to have the link to that group because anytime anybody has a special scar, I’m like, This is the group. It’s so empowering over there. It’s so informative. There are not many groups like that. Specialscars.org as well. Ashley: But even most of the people who have had a rupture as well, that group is just a safe space to talk about how you are feeling and there’s a lot of women on there who have become friends really just in sharing their experience. So yeah, it’s a really informative, great group. Meagan: Yep. Awesome. Well, thank you so much again for taking the time out and figuring out the time changes and being here with us just 12 weeks after your VBAC. Ashley: Thank you and thank you for everything you do to help empower women. Obviously, it’s reaching globally and it’s just so informative and supportive. Yeah, it’s amazing so thank you for everything you do. Meagan: Absolutely.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support

Grace found The VBAC Link Podcast while still in the hospital after her first unexpected C-section. Her recovery was brutal and she knew she never wanted to experience that again. Grace is a labor and delivery nurse located on the Wisconsin/Illinois border. She shares what it was like preparing for her VBAC while working at a hospital that didn’t support VBAC. Though she found a supportive practice, Grace faced unexpected pressure for interventions at the end of her pregnancy. Ultimately, she advocated her VBAC wishes and they continued to support her.When she contracted a fever and her baby had prolonged heart decels at 10 centimeters, Grace was prepped and wheeled to the OR. She mentally surrendered to the idea of another C-section. But when baby’s heart recovered, she was encouraged to keep pushing! Her baby boy came out in just four pushes and Grace was able to achieve the VBAC she so deeply desired. The VBAC Link Blog: Finding a VBAC-supportive ProviderThe VBAC Link Blog: 10 Signs to Switch Your ProviderThe VBAC Link Blog: VBAC vs Repeat C-sectionHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength, we’ve got a VBAC story coming your way today. We’ve got our friend, Grace. Where are you? Illinois? Grace: Yep. I’m right in between Milwaukee and Chicago right on the Wisconsin/Illinois border. Meagan: Okay, awesome. Well welcome to the show and she does have a little babe right now with her. How old is your baby?Grace: He just turned a month old yesterday. Meagan: A month old and this is your VBAC baby. Grace: Yep. There he is. The man himself. Meagan: This is so fresh. Oh my gosh. I love when we get fresh stories. I feel like you’re probably still even processing as you tell your story. Grace: Yep. I am. I practiced a couple times to make sure I didn’t leave out important details. Meagan: Well, we are so excited to have you on the show. We do have a Review of the Week and then we’re going to get into your stories and then we’re going to talk a little bit about when the odds are stacked against you at the end and then spoiler alert, Grace is a labor and delivery nurse so I’m going to ask her some questions about how it is to be a labor and delivery nurse and supporting VBAC in her community. Okay, so we have this review. Its title is, “Tears plus stories plus hope plus joy equals education.” It says, “I discovered these ladies when I was 9 months postpartum from a very traumatic section and was eagerly beginning to research how to heal and build a new birth team for when my second baby came along. Now just a few months later, I’ve listened to almost all of the episodes and I hear the joy and the redemption these mamas have when they are in control of their births. It spurs me on towards my goal of one day having a successful VBAC. I cry when they cry. I feel joy when they feel joy. I feel sadness when they feel sadness and encouragement and elation when they succeed. It’s been quite the therapeutic discovery and I’m so glad Julie and Meagan created this resource. Each time Meagan or Julie directly addresses the audience as Women of Strength, I get goosebumps and I know in my heart I AM and WILL BE that woman of strength. I hope to one day share my version of success within this community.” That just gave me the chills so I’m just going to add tears plus stories plus hope plus joy plus chills equals education to that one. Thank you so much for your review. If you have not done so, as always, we would love them and you never know, you may just be read on the next podcast. Meagan: Okay, cute Grace. Grace: Hello. Meagan: Welcome, welcome. Let’s get going into your stories. Grace: Okay, so first of all, thank you for having me. This is amazing. I’m glad I had a VBAC but it’s even cooler that I get to be on the podcast. For my first pregnancy, I had just missed my first period so I took the test and was positive. I called my doctor and scheduled an appointment. I was about 6 weeks. At this appointment,  my doctor started calculating my due date with his little due date calculator and said, “Okay, it’s about May 26th. I’m going to induce you May 24th,” right off the bat. He decided we were going to be an induction. He said, “Since you are a first-time mom, it will reduce your risk of having to have a C-section if we schedule an induction.” I later found out he was actually just going to be out of town on Memorial Day weekend so he was pre-planning that for himself. But I didn’t know any better. I was like, “Okay, cool. I’ll know when I’m having the baby. I won’t have to worry about going into labor or anything.” Pregnancy went by with no complications. It was nice and smooth. At 39 weeks, he addressed again that we would be going in for an induction but he would just do the Cervadil. I went in that morning and they placed the Cervadil and told me, “Don’t move. Lay as flat as you can. You can only get up to go to the bathroom,” which is not true.Meagan: Hashtag false. Grace: I lay there all day. They take the Cervadil out and it didn’t do much for me. I wasn’t favorable in the first place. I was closed, thick, high, and then he checked me after the Cervadil and said the same thing. Actually, he told me that he’s never done this before but he’s just going to discharge me. He didn’t want to start anything else or doing anything. I appreciate him not just pushing Pitocin when he didn’t think it was going to be a good idea. We left feeling super discouraged because we told everyone we were going to have a baby and then we were going home. He said, “Come in a week later if I don’t go into labor naturally. Just come in and we’ll try again.” So I didn’t. We went in the following week. They put in the Cervadil again. They actually did two rounds of it this time and this time we didn’t tell anybody we were going to the hospital. We just didn’t want the, “Is the baby here yet?” and all of those questions adding to the anxiety of being in labor. So they took the second round of Cervadil out and still didn’t really have any change. I wasn’t contracting or cramping or anything but they just let me stay there. I ended up going into labor naturally which I don’t have the statistic verified but he told me that only 20% of people will go into labor with Cervadil alone. Most people need Pitocin or something else and some other intervention to actually cause labor. But my labor started. Again, he didn’t give me Pitocin which again, I’m grateful for. I was contracting all day. I have a pretty low pain tolerance so I had requested something for pain. They gave me an IV pain medication that I didn’t really like. It worked for a little bit but also made me feel a little strange.The nurses were like, “Okay, instead of getting more of the pain medicine, we recommend that you get the epidural.” This was about 12 hours after the contractions started.” I did get the epidural. I was still only a 1 at this point. They checked me after the epidural and he broke my water without really telling me that that’s what was happening. It just kind of happened. He broke my water and then I pretty much immediately went to 5 centimeters after he did that within the hour. I was like, “Okay, cool. It’s finally happening. I’m at 5 centimeters. I don’t feel any pain from the contractions. I have this epidural that’s working maybe even too good,” because I couldn’t even wiggle my toes but baby’s heart rate started dropping. This was a back and forth, “Are we going to have a C-section? No. Just kidding. You’re fine. You can push later on. You’ll dilate about a centimeter an hour,” is what they told me. But then they also had me come in and sign a consent form for a C-section. They put oxygen on me and repositioned me a little bit then they just called the C-section. We went to the OR that I had not even toured during our hospital tour because I was like, “I don’t need to see that. I won’t need a C-section so I don’t need to see what the OR looks like,” but then I ended up in there. My husband was in the hallway waiting to come in and the anesthesiologist was super supportive. She could tell I was losing it. They brought him in and the procedure itself went fine. There were no complications. Baby came out healthy. She had a cord wrapped around her foot twice which the doctor said he thinks maybe was why she didn’t come down, but I’m not sure. They took her over to the warmer and did all of her checks and everything. It felt like she was over there forever. Then they brought her swaddled over to me. We did the little cheek-to-cheek skin-to-skin. We got our classic C-section family photo on the OR table with our scrub hats on and then my husband and daughter left the room and they finished putting me back together. Then they took me to recovery which I was in there by myself. I had really bad shakes from the hormones or epidural. I’m not sure but I was shaking like crazy. That felt like I was in there forever by myself and then they finally brought her to me. She latched right away so at least I got to breastfeed her but we completely missed our golden hour. Meagan: Yeah, and you were let alone. Grace: Yeah, I was alone. Meagan: In a very scary time. Grace: Yes. The nurse wasn’t really talking to me. She was charting and stuff which I get that you’ve got to chart but I felt very alone in this recovery room. All that being said, everything did go okay. It still did not feel great that I had to have a C-section instead of my planned birth. I had my birth plan and everything. The next morning, the doctor did come in and he told me that for my next baby, I would have to have a C-section. He was like, “You can do all of the research that you want and the statistics are small, but I still would not let you have a trial of labor. You would be an automatic C-section.” Meagan: Did he actually say, “The statistics say this but for you, no.” Grace: No, it wasn’t just me. That’s how he practiced. Meagan: He just doesn’t support VBAC. Grace: Yes and he told me that a friend’s wife tried to VBAC and had some kind of complications. I don’t know how it ended so it also sounded like it was a personal thing. He didn’t do them for personal beliefs. Meagan: Yes. Grace: He left the room and that’s when I found your page. I started searching VBACs and how I could have one. I was so discouraged not being able to deliver vaginally. I was like, I’ve got to at least inform myself and see if I can find a way to do it and how to go about it. Knowledge is power so I wanted to know as much as I could going into it. I had my daughter. You’re busy with a baby so I didn’t do too much research in between. I just saw that it is ideal to wait 9 months before you get pregnant. I did find out I was pregnant at about 13 months postpartum and this was actually two days after I got offered a job as a labor and delivery nurse so I had a little bit of excitement all at once. 13 months postpartum, and the whole time my husband after he saw my recovery was like, “Okay. I will do whatever I can to help you have a VBAC,” because he knew it was very hard on me. I found a doctor. I just was like, I’ll just see doctors and feel them out. My first doctor I saw was super VBAC-supportive. He said that they do them all the time. I’m a great candidate so I was like, Okay. I’ll stick with these guys.My husband did a bunch of research too. He was looking up why people get induced and why you may or may not want to get induced to avoid a C-section and all of these things. He was my biggest cheerleader and came to appointments with me and was making sure our provider was as supportive as we needed him to be to try and make this happen. I also became obsessive. I was listening to the podcast all of the time on my way to work. If work was slow, I’d throw in an AirPod and do laps around the unit to be moving and hear the podcast. I was listening to it in the shower all the time and I found it really helpful just hearing other women’s stories. This pregnancy went by pretty complication-free. I did have some bleeding in the beginning which was just a subchorionic hematoma and they weren’t concerned about it. I actually didn’t tell people at work that I was going to VBAC because our hospital doesn’t allow for VBACs because we don’t have in-house anesthesia or OBs. I didn’t tell them and I didn’t want them to know I was trying. They would even ask me, “Oh, are you scheduling your C-section?” I’m just like, “Oh, I haven’t scheduled it yet.” I just kept working. At 37 weeks, I started anything I read online that could make labor happen. I was doing it. I was having the raspberry leaf tea, pineapples, the dates, walking, evening primrose oil. I was doing everything you could do to get my cervix ready to have a baby. At 39 weeks, we went to an appointment. I did start losing my mucus plug which made me very excited that something was happening on its own. At this appointment, I had a different provider. This practice had multiple doctors that could potentially be on when you deliver so you are supposed to see them all. I saw a different provider this time. He checked me. I was just a fingertip. They were going to maybe do a membrane sweep at this appointment, but he was unable to and then he mentioned, “Okay, if you get to 41 weeks, we’ll talk about scheduling your induction.” I was like, “Whoa. I thought we weren’t doing all that.” They seemed VBAC-supportive during the whole pregnancy and at the end flipped the switch and I felt like I was like, Oh no, I’m stuck. I’ve been seeing them the whole time. Now he’s going to try and push an induction on me. I left that appointment feeling worried. After that, my husband was like, “You should just chill out. Stop obsessing over all the things.” I had a checklist that said, “Eat your dates. Eat your pineapple. Go for a walk.” It was all of the things and it was causing me more stress than actually letting my body do anything on its own. I stopped. I even stopped listening to the podcast. I was just like, Okay. Whatever happens happens. I went on maternity leave too so that no one on work would ask me. I just took my leave early. Then on my due date, I went in. I was dilated to a 1 which was incredible news for me and 50% effaced. I was like, Wow. After all that Cervadil, nothing happened and this time, something is actually happening. He was able to do a sweep at this appointment. We did an NST too. He just said, “It’s protocol. Once you hit your due date, they do NSTs.” I felt great. I contracted and cramped all night. I was like, Maybe it’s happening, but this was just the start of some prodromal labor that went on and off for a while. I went into an appointment on Monday after that Friday and he said, As long as I agree to just keep coming in for NSTs, he said that he would let me go as long as I need to. They weren’t worried about induction. It was a healthy pregnancy. They weren’t worried about his size or anything like that. He did another sweep that Monday. That also caused me to cramp and contract. I was hand expressing as well to try and get my milk supply to come in. I was regularly contracting. I shouldn’t say regularly but it was happening and so I thought that at my next appointment, I’m going to be really dilated because this is all happening. Everything is really happening now. I went into my next appointment. This was a different provider again, a woman. She checked me and I was a 2 which was exciting as well. She said that she wasn’t able to do a sweep because the other doctor already did it and her fingers weren’t long enough so it wouldn’t be effective. Meagan: What? Grace: I was like, “Okay, whatever you say.” Then she sat down and asked, “If you do have to have a C-section, what is your mental state going to be because it is a possibility?” I knew it was but at this point in my pregnancy, I just didn’t want to hear the words “C-section”. I told her I would probably be okay. My eyes are wide open. I know it’s a possibility but I would feel pretty discouraged that I wasn’t able to have a VBAC. She told me if I did have a VBAC, I wouldn’t be able to pick up my daughter for at least two weeks so that really also freaked me out. Meagan: If you did have a VBAC? Grace: Oh no, I’m sorry. If I had the C-section, I would have to wait at least two weeks to pick her up. Meagan: Okay. Like a weight restriction. Grace: I’m sorry, yeah. She was like, “You don’t want to pop your incision,” which makes sense but I’m like, “I’m already bringing a new brother into her life and now I’m not going to pick her up.” That really scared me so I wanted to have my VBAC. So after this appointment, I was 41 weeks when I went to this appointment. That night, I had been contracting starting around 8:00 PM pretty regularly but they were spaced apart 5-7 minutes and then around midnight, the contractions became 3-4 minutes apart. They told me I could go to the hospital when they were 5, but I was worried that it would slow down my labor so I waited a little bit longer. I went in and out of the shower. I took a moment to hold my daughter and lay with her for a little bit thinking, Okay, we’re going to bring a baby home soon. It’s happening.We called my in-laws around 4:00 in the morning to come over because they were regularly 3-4 minutes apart for quite a few hours. They came over at 5:00. We got to the hospital at about 6:00 and it did happen. My labor slowed down. The contractions went to 6 minutes apart. When I got there, I was only 2 centimeters which I was in the office in the morning so I was like, How is this possible? I just contracted for all these hours and nothing happened? I did efface a little bit more. I was 70%. They said, “We’re just going to watch you for a little bit. We’re not going to send you home.” Of course, it started snowing when it had been 70 degrees all week. That’s the midwest. They said, “We’ll just wait. We’ll watch you. Hang out here. It’s snowing. We’ll see what happens.” I was just sitting on the yoga ball already pretty exhausted because I had been up all night. Then at 9:00 AM, the doctor came in and she was like, “Okay, I’m going to break your water.” The nurse was like, “Hold on, we don’t have an IV. We were just watching her. Let’s get some other things in place before you break the water.” Before she did break the water, I was very hesitant about them doing that because I wanted it to happen naturally. I didn’t want them to force anything and then be put on a timer because at our hospital, if your water is broken for x amount of hours, then it becomes, “Okay, we’ve got to get this baby out.” I didn’t want that. She said, “No.” They wouldn’t be worried. They might start worrying if I developed symptoms of infection but that still wouldn’t necessarily mean I would have to have a C-section. They would just treat the infection. I did let her break the water and they checked me six hours later. Again, I didn’t make any change but the contractions had been more intense for me so I ended up getting the epidural about a half hour after that at 3:30. Once I got the epidural, I was feeling good. They told me they wanted to start Pitocin. I was hesitant about that as well because it does increase your risk of uterine rupture not that the percent is that high, but I wanted to avoid it if I could but they told me I would be on a different protocol because I’m a TOLAC patient so they would go low and slow. They would start at a 1 and keep it slow. Anytime they did go over 2 though, baby didn’t like it. His heart rate would drop a little bit so they did end up turning it on and off all day but the contractions still stayed pretty spaced apart. Around 10:00, they did check me and I was a 4. His head was low. I was having some bloody show. They shut off the Pitocin because the contractions were every minute apart. Meagan: Oh, that’s a little close. Grace: Yeah. I don’t know. I couldn’t tell because I had an epidural but they also placed the IUPC and they did an amnioinfusion which we don’t really do much at our hospital so I was pretty unfamiliar with it and she explained that they wanted to just replace my fluid because I had been ruptured for a while and baby needs some fluid to come down and help me dilate so they did that. I feel like I had all of these wires going everywhere. After a little bit, I did end up getting a fever. They gave me some IV antibiotics so with all of these things happening at my hospital, I would have been a C-section for sure. I could tell they were very VBAC-supportive. They came in and repositioned me so frequently because his heart rate would drop. The nurse was in there all night. I was like, This poor nurse is in here every 5 minutes repositioning me or doing something for me. Around 1:00 in the morning, I felt such intense pressure. My epidural had worked really well, but I was feel all that pressure of his head. She didn’t want to check me because she said, “We don’t want to be in there too much because,” Meagan: You already had a fever, yeah. Grace: They waited, but this pain and pressure was pretty intense for me. I was crying through the contractions. It felt like my body was pushing for me. I was like, “Can you please check me? I know that you don’t want to but I’m feeling like something is happening.” I ended up throwing up which could also be baby is getting ready to come out. They did check me at 6:00 in the morning. I was 10 centimeters. She called the doctor to let her know and said– this was also the doctor who I had my last appointment with who didn’t sound super on board with me having a VBAC. Meagan: The short-finger one? Grace: Yeah, little fingers. Meagan: Little fingers. Grace: I was like, I really hope she’s not on. They were like, “She’s on for 24 hours.” I was like, “Okay.” She was the one. She was like, “Let her do a practice push then I’ll be in there soon.At this point, I had been in so much pain from the pressure all night that I was like, “I don’t even think I can push him out.” I’m a first-time mom basically because it’s my first vaginal birth and I could be pushing for 2-3 hours. I was like, “I don’t know if I have it in me.” I said that to my husband. I was like, “I don’t know if I can push.” He was like, “Don’t be discouraged. If you have to have a C-section, you have to have a C-section.” That lit a fire in me. I was like, “No. I did not just go through 31 hours of labor to call it quits. I’m going to at least try to push and see what happens.” I do one practice push and the little guy’s heart rate drops and doesn’t recover for 6 minutes. Everyone is rushing in– the doctor, the hospitalist doctor, all of the nurses. They were like, “Don’t be discouraged. You did everything you could but we’re probably going to have to have a C-section.” The doctor goes, “I think your uterus is rupturing.” I’m like, “Okay, that’s scary. Don’t tell me that.” I’m like, “What is even making you think that?” She’s making a little note in the computer. They are putting in all the orders for me to go into the OR. She said, “But if baby’s heart rate recovers in the OR, we’ll let you push in the OR but we want everyone around to make sure if we do need to have a C-section, we have the whole staff ready to go.” They wheeled me in, were giving me meds in the hallway while I’m on the way in there. The nurses were super comforting though. One of the nurses told me that she tried to TOLAC with her second and ended up having a C-section and that it’s nothing to be ashamed of which it’s not. I just really wanted to do it. I felt like up until that point, I did everything I could. They wheeled me into the OR and the anesthesiologist said he partially blocked me. He gave me ⅓ of the dose that they would give for a C-section but I felt very numb. I could not feel the contractions. I couldn’t feel my legs, nothing. They hooked me up to the monitor and his heart rate recovered miraculously. He was in the 150’s. They said they wanted me to push. I also had already thrown in the white flag mentally and said, “I don’t know if I can push. I’m scared now.” I froze up. I was like, “I don’t want to have a C-section. I don’t want to push. I’m just in this limbo right now of I don’t know how we’re going to get this baby out.” They told me that they wanted to use a vacuum. Initially, I was like, “I don’t really want you to use a vacuum,” but the hospitalist said that it would  help us get baby out faster when I’m pushing. I did finally consent to them using the vacuum. So we’re in there. They nurses had to tell me when I was contracting because I couldn’t tell. They had this audio of my monitor on but they couldn’t see the strip for some reason so they were just palpating my belly to tell when I was contracting. They would say, “Okay, push now.” With four contractions and the help of the vacuum, I did push and got baby out successfully. Meagan: Just four? Grace: Just four. I know I kind of cheated with the vacuum. Meagan: That’s pretty dang fast though. Grace: 10 minutes of pushing and he came out with copious amounts of the fluid that they had replaced. I had said I wanted him to be skin-to-skin if I could. He came out good so they put him on my chest. They actually let me reach down and feel his head while I was pushing and that really motivated me to get him out. The nurses were so helpful and so was the doctor. I don’t think I could have pushed him out as good as I did if they weren’t literally rallying around me like, “You’ve got this. You’re doing great pushes. He’s almost there.” I got him out and I got to hold him then they said, “Let’s just take him to the warmer for a little bit. He swallowed some fluid.” They were reassuring me the whole time then they ended up letting him come back to me. I got to wheel back to the room with him with me which was so exciting for me. I got to breastfeed right away and we went to our postpartum room as a family. I just remember that it was such an emotional rollercoaster at the end. I prepped so much for a VBAC. Okay, just accept the fact that you’re having a C-section. Just kidding, you’re getting your VBAC. I felt like there were so many junctions where it could have been like, “Okay, we’re just giving you a C-section.” We ended up getting lucky and having the baby. I feel like I could not have done it without the nurses and the doctor and all of the information I learned from this podcast so seriously, thank you guys so much for what you do because you make such a big difference in people’s lives. That night, I got to pick up my daughter and lift her up and show her her new brother in the hospital. I was so happy. A month out, I’m able to move. I don’t feel like myself again, but closer than I did when I had my C-section. This all went so great and I’m so glad I got to do it. Meagan: I am so glad too. I am so grateful to you for being here and sharing your story with us. It’s always fun to hear that we were in people’s ears along the way. Man, it’s what we were talking about in the beginning with the odds stacked against you with this happening and it could also go to this or the baby’s heart rate drops and then they do this and then this happens. There are all of the things that could go wrong, but a lot of the way, it seemed like you were making the choices that felt best for you even when it might have been, “Hey, we’re going to come break your water,” and it might not have been exactly what you want but you ultimately felt good about it. So let’s talk about that. When someone comes in or if VBAC isn’t supported in this hospital and maybe that’s your only hospital, that’s a really hard one. In your hospital you work in now, you said, “If that were my hospital, I would have gone in for a C-section and they don’t support it,” so what do people do in your area when your hospital doesn’t support it?Grace: They definitely don’t support it. They would just automatically schedule you for a repeat Cesarean and if we did get a patient in who was in labor, we would probably transfer them or we would have to make sure that the OB who was on is close enough to get there. In my short amount of time that I’ve been there so far, I did see one VBAC. They made an exception for her. The OB stayed overnight. Meagan: Wow. Grace: So did the anesthesiologist. She ended up VBACing and having a big baby and everything. I feel like the odds were kind of stacked against her too but other than that, they don’t try to do it and since they don’t do it, because we don’t have the resources, a lot of the staff there just doesn’t believe in VBACs and they have a lot of– like I said, I didn’t tell anybody I was VBACing but I would hear them talk about VBACs and I’m like, I can’t tell you guys that I’m doing this until I succeed at it then I can be like it is possible. Meagan: What did they say?Grace: They were really glad that I got it how I wanted it. They did know that it was a rough recovery for me and I told them the C-section was really hard on me and our family so they were like, “I’m glad you got to do what you wanted.” Meagan: Yeah. Well, when the odds are stacked against you, and the odds are looking different for everybody. Sometimes it’s advanced maternal age, big baby measuring, over our due date, special scar, VBAC after multiple Cesareans– I mean, there are all of the things that can be stacked against us, but when you are in an area that isn’t supportive, that’s good to know that they would even transfer them and be like, “Actually, we’re going to transfer you to this hospital.” You can transfer hospitals. Of course, you can decide to explore home birth. You can try to find a different provider within that hospital because if that hospital is supportive but that provider isn’t supportive, there are things you can do. I’m going to have a link for a whole bunch of different blogs on ways to find supportive providers, what to do, and also how to decide if a VBAC or a C-section is right for you because I think that can be hard when you find a location that is not supportive. It sometimes is easier to just make the other decision and go along with it. Okay, so labor and delivery nurse. You are relatively new. Grace: Yes. Meagan: But how has it been? How do you feel like birth is in your location?Grace: I feel like it’s good. They do a lot of inductions there. A lot of the patients, they’ll say, “Let’s induce you around 39 weeks.” Initially, my first over a month of orientation, I didn’t see a vaginal birth. I only saw C-sections. It was very common. I don’t know if I was unlucky. I don’t know. Maybe it was the shift I worked because I worked 3:00 in the morning to 3:00 PM. I’m not sure. I was like, “I’d really like to see a vaginal birth because I–”Meagan: Am hoping for one. Grace: Exactly. I was pregnant then and I didn’t tell anybody but it was nice working while I was pregnant and being able to actually learn a lot more while I’m working about labor. I could watch my contraction strip and know what it means. It helped me have more knowledge going into my own situation and then I felt like I was pregnant forever so at the end of my pregnancy, I’m like, They were due after me and they had their baby. Everyone was over there having their babies and I was still pregnant. I was like, I’m just going to grow him as long as I can and when he’s ready, he will come out. Meagan: Yeah. I love that. I love that you’ve been able to learn. I think that’s one of my favorite things too just being a doula. Obviously, I’m not there actually charting those strips or anything like that but it’s been really fun to learn that strip better because we can tell baby’s position sometimes based on those charts. We’ve got coupling contractions sometimes and we know that baby is in a wonky position. Huge congrats to you. Grace: Thank you. Meagan: If you decide to go back to the labor and delivery route, I wish you all of the luck and I’m sure that you’ll be cheering people on and supporting and helping them along the way. Grace: Yes and now I can help them better because I went through a C-section and a vaginal and now I can kind of relate to all of the patients in what they might need. Meagan: Absolutely. Absolutely. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

With her first birth, Amy hired a doula and planned to birth at a birth center. During labor, her baby kept having late heart decels which led to transferring to the hospital. At the hospital, Amy stalled at 9.5 centimeters. Baby was having a hard time descending and continued having decels. Amy chose to have a Cesarean and while she was at peace with the experience, she knew she wanted another chance at a vaginal birth. Amy proactively prepared for her VBAC by educating herself and working with her provider to find common ground. Her labor progressed well, Amy coped beautifully, and was able to push out her 10-pound baby! Amy talks about how recovering from birth can be difficult no matter what type of birth you have. Our VBAC Link Doula, Desiree, joins as Meagan’s co-host and touches on the importance of breathwork. As a licensed therapist, Amy also talks about how she uses breathwork with her own clients. “Practice it before you are in labor because then it’s easier to do while you’re in labor.”Desiree's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, Women of Strength. It is an amazing day to listen to another VBAC story. We have our friend, Amy, from Massachusetts coming your way sharing her VBAC story with you. Then we have one of our VBAC Link doulas, Desiree, with us as well. Welcome, ladies. Desiree: Hi.Amy: Thank you. Meagan: Hello. Thank you so much for being with me today. We do have that Review of the Week so I’m going to actually turn the time over to Desiree and read that. Desiree: Yeah, so the Review of the Week this week is provided by Ashley on the VBAC Doula course which I am very familiar with. I am so excited to read this one. Ashley says, “TOLAC/VBACs should be treated just like any other birthing person but there is certain preparation and information that needs to be offered to them. Your course covered that. The value is held in your careful recognition of how to best support our clients who are doing a TOLAC. I cannot praise you two enough for the fear-release activity. Honestly, it is something I can apply to even myself before and after birth and even in life in general. Thank you for that. It has already helped three of my VBAC clients.” Meagan: Oh, that’s amazing. That just gave me the chills. I love that. Fear release is so important. Women of Strength, if you are listening, we have that in our course because we truly believe in it. I think fear release in anything in life. We could just be scared to go in and take a test and fear release of that. But when it comes to birth specifically, I don’t know if both of you would agree, but we’ve got to do some fear releases and let go and also process the past, right? Desiree: Absolutely. Yes. I would say it’s good for everybody going into birth, but definitely, if you’re a VBAC or going for a TOLAC because you take your previous birth experiences into the room with you and if you haven’t done the work, then you are just setting yourself up for roadblocks. Meagan: It’s so true. I will admit that I did fear releases and I did lots of processing and I still had little bits of bouts of roadblocks in my VBA2C birth. That was really hard, but I was so grateful for the knowledge of how to do that fear release and work through it in those moments in my labor and because I had already done so much beforehand, the little roadblocks that were there even though they were roadblocks, I was able to get through them so much faster and more efficiently. Okay, Ms. Amy. Thank you so much for joining us. Amy: Sure. Meagan: Yes. We would love to turn the time over to you. Amy: Okay. So I actually gave birth to my two kids and then I gave birth in two different states. My C-section story was from when I lived in Massachusetts then I moved back to Minnesota and had my son which was my VBAC and now we are back in Massachusetts. Yeah, so with my daughter, I hired a doula. I gave birth and wanted to give birth at a birthing center that was outside of the hospital but it was connected to the hospital system but it was run by midwives and more holistic, more of what I was aiming for. Just like with your first births, you have all of the plans and I think partly that is some anxiety mitigation of if I feel like I have a plan then maybe I know what to expect. I worked with a really amazing doula. We didn’t take a birthing class through the hospital. She did that education and I was feeling relatively prepared as much as you can with a first birth. I had a week’s worth of prodromal labor. I always am very cautious. I always call it prodromal labor because I feel like the term false labor is so demoralizing when you’re in it like this isn’t real labor and I’m like, No, it is. It just isn’t progressing the way I want it to. Meagan: Well, but it’s still your body working. I think that’s what a lot of the time we forget. It’s not progressing the way we want but our body is still very much working and making progress behind the scenes whether or not a number of centimeters or a number of effacement is reflecting. We are still doing work and making progress. Amy: Yes, exactly. But my prodromal labor liked to happen only at night so I was going off of probably three or four nights of really not sleeping through the night. Again, as a first-time mom, I didn’t really know. I was up with adrenaline because I didn’t really know 100% what I was experiencing. I did stop going to work. I was going to work up until labor and then I just stopped going to work the last couple of days because I was like, I’m not sleeping. I’m stressed and tired.I went into labor the night before my daughter’s due date and felt the contractions getting a little bit stronger around 10:30. I went to bed. I woke up around 12:30 and told my husband, “Okay, I think this is really actually happening now.” We labored through the night. At 4:00 AM, I called my doula. We met up at the birth center. I was already 6 centimeters. I was obviously so thrilled about that. I was like, “We’re going to have this baby by mid-morning. It’s going to be great.” Then they started checking her heartbeat. From the beginning, she was having a lot of decels and they kept monitoring it, monitoring it, and monitoring it for 20 minutes which again, wasn’t really the plan that I was going to be sitting in bed monitoring her heart rate the whole time. I wanted to be up and moving around but they just couldn’t get her heart rate to stabilize at that point so they moved me over to the hospital then. It’s a birth center but they are across the street from the hospital so they literally put me into a wheelchair and rolled me across the road. That’s when all of the interventions started. From there, I progressed I think to about 8 centimeters but she was having those decels off and on the whole time. Then I think we ended up getting an epidural. I wasn’t planning to but I got an epidural about that time. I don’t know what time of day this was, maybe noon just because it had been a while now. I was tired and they were like, “Maybe if you rest a little bit, we can get her into a better position or something.” Really, what ended up happening was because of her decels, they wanted me to be on continuous monitoring which made it so I couldn’t move around as much because the nurse didn’t know how to apply the wireless ones. That happened so it was just one thing after another and my doula was great. She was really supportive. We did try a few different positions, but it was like every time I got in a position that felt good, they were like, “Oh no, we lost her heartbeat. We have to have you move again.” I think the process was frustrating. I did get the epidural. I got all the way to 9.5 centimeters dilated and then we just sort of stalled. And then of course probably around 5:00, this had been close to 20 hours of labor and they were like, “Yeah, I don’t know. We could try a few more positions but I think this is just going to keep happening and now we are worried that she’s going to get distressed.” So it wasn’t really an emergency C-section at all. They were like, “Here’s what we think. We’ll give you a few minutes to talk about it with your husband and doula and see what you guys think.” It was definitely hard. I was discouraged and frustrated by that but at that point, I just wanted her out. Now that I’ve read, and when I was listening to The VBAC Link and listening to so many other stories where we probably could have given it more time and all of these other things, they did a C-section and they actually found that her umbilical cord was wrapped around her neck twice. She never really descended into the birth canal fully. She never really engaged in my pelvis. Part of me wonders if it was partly that where she had that umbilical cord and that was going to be tough for her through the birth canal. I don’t really know. But she was healthy and everything was good. I honestly didn’t feel super traumatized by that experience but obviously I wish it had gone a different way. That was my first birth and then about two years later, well, my daughter was 2.5 when I got pregnant with my son. I was the middle of the pandemic. It was 2020. Is that when I got pregnant? Yeah. It was the fall of 2020. I definitely started looking into VBAC and found your podcast and was like, I would like to really try for a vaginal birth this time around. I think what was challenging about that and as you are talking about going in with fear is that I felt like even though it was my second baby, I felt like I was going through the process like a first birth because I never pushed. I never got to that point with my daughter so I felt like I had that anxiety almost like I was going into my first birth again. That was hard for me, I think, mentally. But we had moved to Minnesota at that point so unfortunately, I didn’t get to use the same doula that I had before. I found another doula and I think she had a lot of knowledge and I think she did a good job but I think overall, we just didn’t connect as well emotionally. Honestly, I realized that was almost more important to me. Obviously, knowledgeable and certified is good but not feeling like we were always connected, I struggled with that at times. Meagan: Sorry, not to interrupt you but I was just going to say that can impact the way you are feeling and walking into any experience so that connection is really, really key. Amy: Yes. Yeah. I’m a therapist. That’s my job and so obviously, I say that to my clients all the time about therapy too. I never got to the point where I was like, Oh, maybe I should look for somebody else, but I think looking back, sometimes I wish I had. But during the labor and stuff, I think she was great. Yeah. It was different than my first time. So yeah, I did a lot of research about Spinning Babies. My doula helped me with some of those exercises. It was stuff I was aware of before, but I didn’t look into it as much. Then one of the things I was curious around because when I had my C-section, my OB was like, “Oh, well you have a flat pelvis so it is going to be hard for you to ever have a baby vaginally” is what she said to me. My doula was like, “Well, you know. Around pelvis shapes and stuff like that, that’s a very gray area. Generally speaking, we don’t subscribe to that because your pelvis is moving and it isn’t a shape.” But I was curious about that so I looked into that through Spinning Babies and some of those other resources and about how babies engage in your pelvis and how does baby engage to progress labor.Meagan: Yeah, different stages. The baby can be in sometimes different– I mean, we all have different shapes of pelvises so the baby has to come in different positions and sometimes that even means posterior so sometimes we do all the things to avoid posterior babies, and then our babies still go in posterior but that’s actually because of the way our pelvis is shaped or the way it was that day that our babies needed to get into the pelvis in that position. Sometimes they can kind of hang up until we find those positions that can help them navigate down. Amy: Yes. I mentioned that to my doula and we both did some research on it because I think that was part of the issue with my daughter. There wasn’t a consistent engagement. Even though my labor progressed for the most part, I was sort of wondering about that. I also was– I can’t remember when this exactly happened but I think around 32 weeks, I started measuring big. Of course, my OB who I would say was VBAC tolerant. I wouldn’t say she was VBAC-supportive. I did like her quite a bit but she was like, “Okay, your baby is measuring big and because of your history–” she goes through the whole, “here’s your percentage of having a successful VBAC.” I’m 5’9”. I’m larger. I’m not a petite person so even if I had been, I don’t subscribe to that because of listening to VBAC podcasts and stuff, your body can birth a large baby, but also, I wasn’t as worried about it because I know that sometimes those projections are completely off and so it was part of that process of learning to respectfully disagree with a medical professional who I did have respect for and did feel like they had some expertise but to say that we don’t have to agree on everything for me to work with you. That was a huge turning point for me just in my life in general working with medical professionals of, I don’t have to completely throw everything you say out the window but I also don’t have to agree with everything that you say and we can respectfully disagree on that issue. So I was like, “Respectfully, I’m not going to schedule a C-section at that point.” She didn’t pressure me at all. She was like, “I understand. Let’s move forward with the plan.” That’s what we did. I think that was empowering. As we moved closer to my due date, he was big. I was not sure at the time, but I was like, I’m going to go into labor early. That was a mental block for me. Then as it gets closer and closer and closer to my due date, I’m going out of my mind just losing patience. I’m not a good, patient-waiting person as it is so I’m having prodromal labor for the whole week before my due date and at that point, I actually did schedule a C-section for the following week because I needed mentally an out-date. That was what it was in my mind of, Okay. If this goes on for another week, I have an out, even though that’s not what I wanted. I think honestly mentally, it took a weight off my shoulders which is counterintuitive to what you would think when everything in me was working toward this VBAC then I was like, No. A couple of days before he was born, I needed that second date in my mind somewhere. Meagan: Well– oh, sorry. Go ahead, Desiree. Desiree: I was going to say I think it actually makes a lot of sense. You say it’s counterintuitive, but you’re right. We spend so much time and energy thinking about achieving our VBACs and having our babies. Sometimes having– well, even if I don’t do all the things, I can still have my baby and then relaxation happens. That’s when we see labor starting to take off for a lot of people. Amy: Yep. Yeah, I definitely think that was a piece of the puzzle. Yeah, and I think it was helpful.So yeah, I’m trying to think of how this went. Yeah, so we were doing some Spinning Babies things. We did some side-lying releases all throughout the pregnancy and then on June 4th which was actually my son’s due date, having prodromal labor all week and then I felt like there was a little bit more intensity in the contractions I was having that morning so I sent my daughter off to her grandparents’ and was like, Okay. I’m just going to focus today. I’m going to focus on getting my body in gear. It wasn’t that I was in this mindset of, I’m going to make myself go into labor today, it was just this intuition around I needed to be able to focus on what was going on. We had that plan that my daughter would go stay with her grandparents while I go into labor and I thought that maybe she was just going to go earlier than I thought she would because I wasn’t in any kind of active labor. Then I had my doula come over at 10:00 AM and we did more different exercises. I can’t remember all of the ones we did because what would happen was that I would have contractions 15 minutes apart, 15 minutes apart and then they would just stop and that would be the end of it and then the next day, the same thing. Or they would be 10 minutes, 12 minutes, 20 minutes– nothing consistent so what we found was if I laid on my left side in the flying cowgirl position, then my contractions were more intense and more consistent. It was again this think of, in my mind I was like, While I’m in active labor, I’m going to be walking around and trying all of these different positions and all of this different stuff, and what I ended up doing is honestly just laying in bed and watching TV in that position almost all day. So again, it was this thing of that’s not what I’ve heard is helpful or whatever but I just think that was where he needed to be to engage in my pelvis at that stage. Then every hour or so I’d get up. I’d do curb walking. I would just get out, walk around, and be active but it was way more laying down than I ever planned to do. You hear that’s not how you get your body engaged in labor, but that was what worked for me so that was an interesting, Release what you think is going to work for you and do what your body is telling you is working for you. But it was actually kind of nice. It was relaxing. My daughter wasn’t there. It was the summer. We had the air conditioning on in that room. My husband brings me a bubble tea or whatever and I was like, This is actually not so bad. This is okay. Contractions were probably 15, 10 minutes apart that whole day then in the evening is when it ramped up. I turned toward active labor and we called my doula again at 8:00 PM and the contractions were very intense. I was leaning on an exercise ball. My husband was trying to do some counterpressure to get me through it and then she did– and again, this is something where my doula and I were not always on the same page, but I was explaining to her my contractions. “They are about a minute and half long. They were maybe 7-8 minutes apart,” and the first thing she said was, “Oh, well that contraction isn’t long enough to progress you at all,” or something like that. She said something about my labor process and it was so discouraging because I felt like I had taken so long to get to that point that when she said that, I was like, Oh, so all of this was for nothing. I know that’s not what she meant but I remember just feeling very discouraged by that comment. So that was tough. Then she did the abdominal lift and tuck. I do feel like that helped get my son into my pelvis and more engaged in my pelvis because from that point, contractions were two minutes apart. They were very intense. I ended up signaling. I was like, “I’m ready to go to the hospital.” We agreed to labor at home as long as possible, but I was like, “I think this is the time.” Again, my doula was like, “I think we should wait longer.” My contractions were two minutes apart at that point and I was like, “I don’t think we should. I want to go.” I’m glad we did actually because that ended up being the right time. But I remember rolling into the hospital at 12:01 AM and I remember my husband saying, “Well, I guess we’re not going to be having the baby on his due date,” because my daughter was born on her due date. I was in active labor on my son’s due date and then we just missed it. I remember being like, “That’s true. We’re not going to make it but that’s okay.” So yeah, we walk into the hospital and go through triage. My water breaks while we are in triage and of course, they bring out their little testing stick and they’re like, “We’re going to make sure this is actually your water breaking.” I was like, “Okay, but I’ve never wet myself during a pregnancy. This is what it is.” Then we go back in the labor and delivery room and the doctor who is on call is not my doctor. I find out later that this is the most anxious, not-nice-to-work-with OB in that practice. So that was tough. I could tell from the beginning she was just very brusk. She didn’t have a great bedside manner at all. She was like, “I see that he’s measuring big so we’re going to make sure that–” she was really worried about shoulder dystocia. I was very glad again that I had read up on that and that I was not concerned about that. So she was like– they had big birthing tubs there but they don’t let you birth in them. They just let you labor in them. I was in there and feeling like I wanted to push for a while and I remember I went to the bathroom and she comes in the room and she’s like, “Well, let’s get you on the table.” I’m like, “I’m just going to the bathroom.” I don’t know if she thought that I was going to try to have the baby without her or something, I don’t know. Her whole vibe was very anxious. That was hard. That was definitely discouraging. I think at that point, I actually had asked for an epidural. Both times, I asked for an epidural at transition and then once I’m through transition, I’m fine. They didn’t come in time and they checked me and I was already at 10 centimeters so they were like, “Okay, it’s time to push. We don’t have time for the epidural.” I’m like, “Okay, this is what it is.” That was okay and then I pushed for about an hour on my back which was again, not my choice but the OB was like, “No, I need to be able to see what’s going on. I don’t want you in any other position,” because again, she was so worried about shoulder dystocia and him being big. Halfway through pushing, she was like, “Okay, you can try on all fours.” But at that point, I was so exhausted that I couldn’t even imagine myself getting on all fours. I was like, “That ship has sailed.” That was tough because I had planned the whole time to try to push at least for a little while on all fours because again, knowing about big babies and how that can be a really good position for that, but I just didn’t feel like I could advocate for myself. I don’t know. In both of my births, when I get in labor, I go very inward. I think having a doula was great, but both times I don’t think my doula was super outwardly advocating. But again, maybe they were looking for a signal from me and I was just in my own world. It was okay though. I pushed for an hour. He came out just fine. It was that euphoric moment of, Oh my gosh. That just happened. That was crazy. Having only pushed for an hour felt great with my first vaginal birth. They took him out and they weighed him and he was 10 pounds, 4 ounces. Meagan: Yeah!Amy: Yes. It was so funny because the nurses were trying to guess. They were like, “9 pounds. He’s big.” Yes. I felt great and actually, it was funny. The next morning, my OB came in. She was on then. She comes in and she goes, “Well, he was big.” I was like, “And I did get him out, so we were both right.” We were able to laugh about that. Meagan: I love that you said that. Like, “Hey, I was right too.” Amy: Yes. Yes. Yeah, and I felt like it was a good ending. I felt like she was like, “Yep, you’re right. You did.” I did tear. I had two second-degree tears which again was maybe not as bad as I expected with a baby that size, but it was no fun. I think that’s the other thing that I talk about often is either way, with a C-section or with that kind of a birth, I felt like it took me about two weeks to be able to feel like I could even walk normally. I think the difference with the vaginal birth is that I do feel like I made improvements every day where I gradually got better whereas with the C-section, it was really hard for two full weeks and then it was like then I felt better. It was a different recovery but I would say– and I think other people have talked about this here before but either way, it can be a tough recovery. Meagan: For sure. For sure. Amy: It’s hard because my sister had two vaginal births and her second one, she was up and walking. We walked a mile when she was two weeks postpartum and I’m like, gosh. I couldn’t even walk down the block at two weeks postpartum after my son. I think obviously not to compare yourself one or the other but I had a big baby and there was some trauma down there and that takes time as well. But it was a great feeling and I think that obviously, it ended up really good. Yeah. That’s my story. Meagan: I love it. Thank you for sharing it and congratulations. I think that it’s so hard to sometimes have providers who will meet you in the middle. It sounds like you both met in the middle along the way and I think in a perfect world, I just wish that this would happen where providers would meet us a little bit more but there are so many providers who won’t even come in. We talk about it all the time with finding the right provider and if the provider is not right for you and if they are not willing to budge at all and meet you in the middle or be a part of the conversations where you were saying things and she was like, “You know what? Okay. Okay. Let’s go back to the original plan then.” She said her piece. She said her suggestions. You were like, “No. I don’t feel comfortable with this. This is not what I want,” and she was willing to be like, “Okay. Okay. All right. Let’s go back to that original plan.” Look what would have happened if you weren’t able to advocate and stand up for yourself and be like, “Actually–”, it could have been a very different outcome. Amy: Yes. Yes. For sure. Meagan: Desiree, do you have anything to share on that just as a birth worker or anything to share as far as tips go when we’ve got situations like that where maybe it seems like it could get really combative but it doesn’t have to be? Desiree: Yeah. I mean, I just want to commend you, Amy, for being able to voice your opinion in that way because I think that’s really hard for a lot of us to stand up in spaces with doctors who we think are in a position of authority. Yes, they have experience, but no one lives in your body. No one has the lived experience of your body except you. That makes you an equal expert in what’s happening. I think it’s great that providers bring advice and recommendations and they have a plan for what they want to see, but I think a truly great provider does meet you at least halfway. Ideally, you’re right Meagan, they’re coming a little bit more than halfway, but I mean, it’s nice to hear that your provider was willing to listen to you and follow your plan and probably have hers in her back pocket as the fallback. But that’s just great that you were able to advocate for yourself in that way. It doesn’t always have to be combative, right? It can be as simple as, “Thank you for your advice. I appreciate your expertise. This is what I’d like to try and if it doesn’t work, then we can try something else.” Amy: Yeah. I think that I was feeling anxious about that too and this big realization of, I do. I like her. I trust her as a doctor. I feel like we’re on the same page, but that doesn’t mean that I have to agree with everything she says and it also doesn’t mean I have to fire her and find a new provider. Again, there is a happy medium there. You’re right. I was taught that doctors have this authority. They know. They go to years of schooling. Of course, they do. But also keeping in mind that their worldview and perspective might be very different and the lens that they are looking at this through is very different than mine and how do I keep this in mind that they have this medical perspective of what they’ve seen. They’ve seen the worst of the worst medical scenarios but also to keep in mind that there’s this whole other worldview around that so that ws helpful for me. Meagan: Yeah. That was definitely something that stood out to me with your form. It was, “Disagreeing with a provider doesn’t mean that you can’t work with them.” You said it in your story too. That is so, so true. It doesn’t mean we can’t work with them and if it gets to a point where it’s like, “Okay, there is no working with this,” and it is actually not working, then we can make a different choice. We can change things up, find a different provider, look at our VBAC Link provider list, and see if there is someone else. But if you can work with it and everything is feeling good and there are a couple of things but we are working together, that is so great. That is so great. Amy: Yeah. Meagan: Awesome. Well, I just wanted to let Desiree share a couple of tips. I love when we have our VBAC Link doulas come on because it’s so fun to get different tips and different perspectives from other doulas around the world. Desiree is in California with Be_Earth_Mama. Is that right? Desiree: Yeah. My husband gives me a hard time about this all the time because I guess nobody gets it but it’s Birth Mama. Meagan: Oh, I thought it was Be Earth Mama. Desiree: That’s what he says. Meagan: That makes so much sense, so much sense. She is in California. Remind us exactly where in California because California is ginormous. Desiree: California is ginormous. I am in the San Francisco Bay Area so Northern California. Meagan: And you do birth and education. Desiree: I do birth and education primarily. Meagan: You do webinars and all the things, right? Desiree: I do webinars. I do online classes. I teach in-person classes. I’m getting ready to start a prenatal belly dance class that I think is going to be in-person for now but might go to virtual if there is an interest so all things birth preparation essentially. That’s my niche. Meagan: Really, really cool. Awesome. I know there were a couple different topics that you were talking about and I was like, ooh. Breathing and active relaxing. Tell us all the things. Desiree: Yeah, it’s one of my favorite topics and I feel like it’s one that is on the list but it’s low on the list because you think about breathing. Why do you need to practice breathing? You just naturally do it but if you’ve been in labor, you know that when that intensity starts to pick up, breathing is the first thing that goes out the window so having a strong breathing practice is the first step to staying really calm and grounded in labor. But even beyond that, I think having a practice is about the process and I think especially for me in my VBAC journey, it sounds like Amy was sort of like this where contractions start and they stop and they start and you are in this waiting game. Is your body going to do the thing or is it not going to do the thing? What’s wrong? I feel like having the practice to fall back on gives you a way to stay grounded and centered in your body as you are waiting for labor. So it’s two-fold. Keeping your body nice and relaxed while you’re actually working through labor but giving yourself the time to be nourishing yourself in those last precious days and weeks leading up to labor I think is almost more important. Something that I work with all of my clients on is having an established breathing practice. It’s not about the breathing technique because there are so many different ones out there. There is the up breathing. Up breathing is my favorite, breathe in for 4, exhale for 8. There is box breathing where you breathe in for 4, hold for 4, exhale for 4, and hold that for 4 counts. And for some people, it’s just simply breathing as slow and controlled as possible. I think it’s about finding something that feels natural and intuitive to you that you can lean into but it’s about finding time and practicing really dropping into your body and dropping out of everything that’s going on around you and playing into your senses with that. That’s something I like to talk about to my clients is hacking your body. Building muscle memory because it’s so hard to relax and stay calm when you’re going through surges, the contractions are really building, and telling you to stay relaxed is not really going to work. Nobody wants to hear that. But if you have this practice and if you’ve built in sensory cues– I like recommending people to pick a birth scent either an essential oil or a candle or a lotion, picking a song or a sound, it could be even a meditation track and setting aside just 2-3 minutes every day to run through whatever your breathing technique is with your scent or your sound, maybe you have something to hold onto and practice just actively relaxing every single part of your body through the process of breathing when you get into labor, your body is going to remember that once you launch into this breathing routine and you put on your birth scent and you have your sound or your meditation track playing, your body is naturally going to relax because you’ve told it that that’s what this time is for. I think it’s a really special thing that we can do for ourselves to give ourselves this time and this practice where we are just nourishing the deepest parts of us. It’s of course helpful for labor, but I think it’s also a helpful practice to take into postpartum and into parenthood. I can say I’ve been doing this for 5 years. My oldest daughter is 5 years old and I still do it every day. I have to run through my breathing practices. Yeah. I think it’s especially important for VBAC mamas to have this type of self-care routine. Meagan: Yes. Oh my gosh. I love that so much. Like you said, it just becomes intuitive if we can practice this so much and instill this into our lives, it just becomes intuitive in that labor journey. There are going to be times where we were talking about roadblocks and stuff earlier, but those might come in and breathing in itself is something that can get us through those things. When you talked about the box breathing, I’ve done that before and I have this weird thing when I do box breathing. My body moves and I’m creating a square. Desiree: I do too. We don’t have our cameras up, but I have to do the square. Meagan: Same. I do a square. I literally draw a square with my whole body and my torso and everything looks like a tree swaying in the wind and I can just feel it. I literally, the relaxation from head to toe just comes in. Like she said, there’s not any specific way. You don’t have to choose one way. You can use them all. You can use anything, just really, really, really having active relaxation practices before you go into labor is so good. And I think it can help along the way. Even when we have a provider who comes at us with, “Hey, we’re going to meet you in the middle,” it still can be in our head. We can be like, Okay, she said this. I said this. This is what we’re going to do. You’ve just got that whole conversation and it’s just that you’re breathing through that and you’re processing that and you’re going to apply it later on in labor. I don’t know. I just love breathing so much. Desiree: I do too. I think it’s the most important tool that we have that everybody has. It’s the most powerful tool that’s available to us. Meagan: We have to do it to live. Desiree: Mhmm. Meagan: We just have to. It’s intuitive. We have to do it and we talk about intuition here and tuning into our intuition. If we are really, really tuning into our intuition, that breathing is part of that. Then our minds and our bodies can

Adriana is a scientist and professor at New Mexico State University in Las Cruces, New Mexico. During her first pregnancy, Adriana was faced with the possibility of her baby having a severe genetic disease. She became so involved in researching the details of it that she didn’t consider the need to research her birthing options as intensely. However, after a long and difficult induction process which ultimately ended in a Cesarean, Adriana was left feeling like she failed as a scientist. She was determined to take charge of her next birth and apply her years of research skills to learning everything about VBAC.Adriana went on to have a peaceful home birth surrounded by a big support system and empowered by her research. She also gives listeners tips on how to interpret published articles on VBAC and explains terms like abstracts, confidence levels, and p-values. “I just found the data is so strong in showing that VBAC is super safe for non-high-risk individuals. Again, having a previous Cesarean does not automatically make you high risk…I had three high-risk factors if you will and still, with those factors counted in, I knew that VBAC was really safe for me just based on the data that I found.”Dr. Adriana L. Romero-Olivares' WebsiteNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength, we have another amazing VBAC story for you today. This VBAC story follows a C-section that was unplanned which let’s be honest, most of ours are, and it had a lot of interventions. We have our friend– oh my gosh. I can’t speak today. Adriana, hello. Adriana: Hi. I’m so excited to be here. Meagan: Oh my gosh. I’m so excited for you to be here. Tell me. Okay, so you’re currently in Mexico. Where were you when you had your VBAC? Adriana: I’m in New Mexico, so the U.S. Meagan: Oh, you’re in New Mexico. Adriana: Yes, exactly. In New Mexico in the U.S. and I had both my unplanned Cesarean and VBAC here in New Mexico. Meagan: Oh, you did? Very good to know. You guys, she is a scientist and a professor. She spent many years researching microbes which is really cool. Do you say fungi? Is that how you say it? Adriana: You can say it fungi, fungi, fungi. People say it in different ways and they are all correct. Meagan: It’s like fungus, right? And bacteria? Adriana: Yes. Meagan: I have so much interest in that weirdly enough because it is in our gut. I have a really weird interest in gut health right now. Anyway, and how they are impacting the global climate. Something that’s kind of cool about her science journey is it really seems like it was spun after VBAC, right? Adriana: Yeah. I mean, I’ve had an interest in sciences forever, but I guess I had no idea how much science was behind VBAC and getting into this VBAC project that I had for a while, I feel like it really ended up helping me to grow as a scientist which was really cool. Meagan: So cool. We’re going to maybe talk a little bit more about the science of VBAC here in the end so make sure to stick with us. I do have a Review of the Week before she starts sharing her story. This is from eoliver14 and it says, “Love this podcast.” It says, “I’m not one to usually listen to podcasts but ever since I came across this one, I haven’t been able to stop listening. I’m preparing for my VBA2C” so VBAC after two Cesareans “and these stories have been so amazing and helpful.”eoliver14, I hope all went well if you have had a baby since then or if you’re still preparing, I hope that this podcast is still inspiring you. And if just like eoliver14 this podcast is inspiring you and helping you and building you up, please leave us a review. We love them so much and I really truly, truly, truly believe that so do honestly all of the listeners. I think a lot of listeners love these reviews. It’s so fun. You can leave that at Apple Podcasts, Spotify, or really wherever you listen to your podcasts. Even if you Google “The VBAC Link”, you can review us there. Meagan: Let’s get going into this story. So unplanned C-section. Adriana: Yes. I want to give a very brief background of my life just to get into the mindset that I was when I had the unplanned Cesarean. My husband and I have been together for a really long time. We are going to celebrate our 20th anniversary this year. We met our first year of college and then we’ve been together ever since but we only had our first child in 2021. That is because we prioritized our careers for a really long time. We are both scientists. We are both professors so we did our Bachelor’s together then we did our Master’s and then we did our PhD’s together. Then we did long distance for a while because we were doing post-doctoral research which is a thing. Then in 2020, we both landed a job in New Mexico State University where we are right now so in August of 2020, we moved across the country from New Hampshire and from New York City to New Mexico. We sort of started our new life in a new city during the pandemic with a new and very demanding job. In April of 2021, which was just a few months after we moved to– we live in Las Cruces, New Mexico. When we moved here, the biggest surprise of our life happened which was that I was pregnant. It was a surprise pregnancy. The pregnancy was just overall uneventful in the sense that I just didn’t have any sort of discomfort or anything. I was just tired and that’s pretty much it but then when I was around 16 weeks pregnant, I got a phone call out of nowhere. I got the news and this is the way that it was told to me. They were like, “You have a 50% chance of your child having a fragile X chromosome which is a genetic disease.” I was like, “What? What is it? What’s that?” I had never heard about it and I was like, “50% chances? That’s pretty high.” I remember I was in my office and Jovani, my husband, was there when we got that phone call. We were just very confused then when we started to look into it, it’s actually a pretty terrible genetic disease to have so all of a sudden, our whole life shifted. We were very concerned. Since the very beginning of my first pregnancy, there were a lot of interventions just because I was of advanced maternal age. I was 36 at the time and after 35 you are of advanced maternal age. It doesn’t matter if everything looks good but if you are older than 35, that’s it. They were like, “Oh, we recommend this testing and this other testing and this other one” and so on. One of those testings was genetic testing which I think we wanted to do either way just to be prepared in case of anything. So then we started to look into, “What is this genetic disease?” Once again, it was pretty bad. So then yeah, it was 50% chances. That’s pretty terrible. That’s where I brought in my scientist skills. I was like, “Wait a minute.” So then I got in touch with a genetic counselor. I don’t think this is just the way it is for everyone, but the particular genetic counselor that I spoke with wasn’t really helpful even though I told them, “I’m a scientist and I have a pretty strong molecular biology background. I understand DNA and genes very well.” I was looking for very specific information and they were just not really helpful. So then both Jovani and I spent so much time digging into the scientific literature and trying to find information about this disease. That’s how we came about some newer testing that really looks deep into the DNA sequence that they find in your baby and then they’re able to tell very precisely what your chances are of your child having this disease or not based on the genetic sequence. Then we just spent a lot of time looking into that, finding that information, then advocating for my baby to get this genetic testing done because it was not something that my insurance wanted to cover. Long story short, after a few couple months looking into that and making calls and so on, we found a way for that testing to be done. Then when we got the results back, 50% chances were wrong. The information I got was wrong. Meagan: That’s some pretty wrong information to get. Adriana: Yes. It got me thinking how many people are probably given this information with the statistics totally wrong? So then the 50% chances when I looked into it went down to 5% chances and then when we did the additional testing, it went down to 0.1% chances. Essentially, null almost. Meagan: Oh my gosh. Adriana: Yes. Yeah. You know, even though we were very grateful for that, it sort of set this tone in my pregnancy where I was so stressed the whole time. I just didn’t put any time in researching how I have to prepare to give birth. I was just in survival mode if that makes any sense just grateful that I didn’t have to worry about the genetic disease. I think at around week 35, they were like, “Because of advanced maternal age, we recommend an induction at week 39.” I was like, “Okay. They’re recommending this. Let’s just go ahead and do this.” I’m a very tall person and Jovani is tall as well so we make big babies kind of. I knew the date of conception of my baby and I knew that based on that date of conception, I was going to be 40 weeks on December 31st. Then somewhere around 30 weeks, they were like, “No. Because of what your baby is measuring, your due date is actually December 22nd so then that means we–” Meagan: 10 days earlier. Adriana: Exactly. They were like, “That means we would like to induce you on December 15th.” Once again, I was like, “Fine. Yeah, sure.” So then on December 15th, we went into an induction. It is a very long story, but long story short, the induction lasted three days and nothing happened. I was given Cervadil and Cytotec and nothing happened. I didn’t dilate. Nothing. Meagan: Your body was really not ready. Adriana: It was really not ready. I was really desperate. I was like, “What’s going on? Why are things not happening?” No one was giving me any information even though I was asking, “What’s going on?” They were like, “Just relax.” I ended up asking a nurse because the doctor came in and was like, “Well, we tried Cytotec and Cervadil and it’s not working so the next thing to do is Pitocin.” He was like, “Is that what you want?” I was like, “I don’t know. Let me think about it.” I asked a nurse, “What do you think about me getting Pitocin?” The nurse was like, “No. No. They are setting you up for failure. You haven’t dilated at all. No. Just say no.” So then I just was desperate for any advice. I ended up saying no and I was discharged. They were like, “We’re going to discharge you but you have to come back.” It was a Saturday when I was discharged and they were like, “You have to come back on Tuesday for a second induction. But a lot of times after a failed induction, people go home and they come back in labor a few days later.” I wasn’t. On Tuesday, I went back. This was December 21st I think or something. So I went back for a second induction and then when I went in, I was already soft on my cervix. I felt things were advancing really well and I was excited. Then it was almost a three-day induction once again. So they started giving me the same thing. They gave me Cytotec first and they waited for a few hours then I had the Foley bulb inserted. It’s like a blur because there were just so many interventions. People were coming in and out of the room the whole time. I was still sort of having a hangover of the last induction because for three days I was so tired. I was so hurt. They couldn’t find my vein so then I had multiple bruises in my arm. It was just so many things. I felt kind of a hangover if that makes any sense. Meagan: Yeah. Adriana: I started dilating with the Foley bulb. It came out so at the beginning, things seemed to be going well. Meagan: Better. Adriana: Yeah, better. I was like, “Okay.” I think when I– I don’t even know how much I dilated, but at some point, the OB/GYN came in and she was like, “You know, I recommend to you that we rupture your waters just so that things start going.” I was like, “Yeah, sure. Things seem to be going well so let’s do it.” They ruptured the waters and then that was pretty much it. I don’t feel like things started happening or anything. I was getting cervical checks very, very, very often. I think that sort of messed up my head to some level. They hurt me. They are not the most comfortable things to go through. Meagan: Especially early on in labor.Adriana: Exactly. Meagan: Right when your Foley just came out, you probably had a posterior cervix, pretty closed still. Adriana: Exactly, yeah. There was some bleeding going on. It was really terrible. So then a few hours after my membranes were ruptured, I think maybe the doctor could see that I was not relaxed for obvious reasons and she suggested getting an epidural. She was like, “Oh, I suggest you get an epidural because I think that would help you relax. That can speed up things.” I was like, “Okay.” So then I ended up getting an epidural and then I got one and it only worked on half of my body so then I had to get another one later on. After many, many, many hours, things were not happening. I did end up getting contractions after the Pitocin and the contractions, I could feel on half of my body and then eventually, I just couldn’t feel them. I could just feel the pressure. That went on for hours. I mean, I think I got the Pitocin. It started at 8:00 PM maybe or 5:00 PM and then they were increasing the dosage and then around 6:00 AM I think they had gotten to the highest dose that you can get and I was not. They checked me and I was at 5.5 or 6. Then the doctor was like, “Okay, we’re going to stop the Pitocin and let your body do things.” My body didn’t do anything. The contractions completely stopped once the Pitocin was removed and we waited for an hour or two and this time, my waters had been ruptured for over 24 hours so she was like, “You know, there’s nothing else we can do. We’ve tried everything. Nothing is happening. I recommend having a C-section.” I mean, I think when I really felt I had no other option, I was like, This is what needs to happen and what I have to do, so sure. Let’s go ahead and do it. Fortunately, it wasn’t an emergency C-section or anything. We still waited for 4 or 5 hours just sitting there waiting for I guess the team to get their act together. They took me to the OR and my baby was born around noon. Everything went fine. I had no complications. My baby had no complications so it was pretty nice but the recovery was so tough. It was just that something inside me didn’t feel right. I was like, “What just happened? What just happened? Why did I end up having a C-section?” I would just think about it over and over and over at night when I was nursing and when I was alone with my thoughts and so on. I was like, “What happened?” Those sorts of things and why when I asked questions why no one answered the questions. They were just treating me as if I was an uneducated person. They just didn’t want to engage and I think that’s wrong in general to everyone just the way that you are dismissed when you ask questions is pretty terrible. They are on a schedule and they have no time or interest in my opinion or in engaging. Then I started to think about it a little bit more and then in my mind, I was like, Well, I guess if I have another child, I can always do things differently. That was the mindset I was in for a few months. Then when I went to my 6-month follow-up appointment to check me and make sure everything was okay. I asked the doctor, “So, if I have another child, I would like to have this child vaginally so I would want to know why did I end up having a C-section? What happened? I know it was failure to progress according to your notes but what does that mean?” She looked at my chart for 10 seconds and she told me, “You cannot deliver vaginally because your pelvis is too small.” I was like, “What?” I was like, “No. No. That cannot be.” I know that your body doesn’t. You can have your pelvis one way and it doesn’t really mean anything based on your body but I have a pear-shaped body so I was like, “I don’t think my pelvis is too small.” So then I asked her, “How do you know that my pelvis is really small?” She was like, “Because you failed to progress.” She did not want to engage. She did not want to. I just left that room and I was livid. I was so angry that she did not want to engage. She did not want to have a conversation. I didn’t even know if I was going to have another child at that point but I was like, If I ever get pregnant again, I’m just not going to come here. I just kept thinking about it over and over and over. I was like, I just need to reach out to someone who can help me understand this a little bit better. I reached out to a local doula and asked for information about VBAC in general. I didn’t know it was called VBAC at the time. I was like, This happened to me. If this were to happen to me again, can I deliver vaginally? She invited me to a VBAC course and the course was super awesome. They shared a ton of statistics on inductions and VBACs and so on. She also suggested doing a birth story processing which was pretty awesome too. So then 18 months later, I got pregnant with my second child and I knew exactly what I wanted which was not what I had before. I knew that I wanted a VBAC ideally and that I wanted as few interventions as possible. I wanted a provider who would engage with me and I wanted a provider who would follow evidence-based facts and of course, a provider who was VBAC-supportive. I looked for all of those things around my town. We have two hospitals. It’s not a huge city and I asked around. Basically, the information that I got was that they were VBAC tolerant but because I was of advanced maternal age, probably none of them would be comfortable having me as a patient. So then I ended up finding a midwife practice and that was what I ended up choosing because they were all that I wanted. They were amazing and I did end up having the most wonderful experience throughout my pregnancy with them. Throughout my pregnancy, I did a lot of research on my options. I educated myself on physiological birth and I also took classes on a home birth. I did a bunch of other things. I did a fear-release hypnosis. I did the birth story processing which was I think one of the most helpful things that I could do throughout my pregnancy. I didn’t really think that I had trauma related to my past pregnancy or fear of any sort, but then through the birth story processing, I ended up finding out that I did have some birth trauma and I had a lot of fear for this new pregnancy associated to my experience with my last pregnancy. Then I did the Daily Essentials of Spinning Babies every day. I didn’t skip any day just in case position was an issue last time. I ended up getting my documents from my last pregnancy like my records–Meagan: Your op reports. Adriana: Yeah. I ended up getting them actually one week before my VBAC. It was always something that I knew I needed to go get this done but then I kept forgetting. Then before my VBAC, I was like, I need to get this report and I need to read it so I can get some closure. I ended up finding out some really interesting things. This is a parenthesis. They said that my uterus was boggy when they were doing the C-section and they said that they had to take out the uterus and massage it because it was boggy. I was like, What is that? I looked into that a little bit more and I ended up finding out that my uterus was so tired from the Pitocin and the contractions that it was not working. That gave me some closure if that makes sense. I was like, It’s not because my body wasn’t working. It was just overtired. I had listened to the VBAC Link podcasts every day also. I did daily walks and you were my companion throughout those walks and just listening to all of the different stories gave me an idea that birth can go in many different directions and it helped me understand that you really have very little control over your birth experience. You can prepare all you want but then at some point, you have to let go because you can’t really control the situation. As a scientist, that is very frustrating because we are always in control of our experiments. But in a way, we can never control the outcome of the experiment so in a way, I was like, Okay, this is one more experiment. Yes. I did have spotting on week 18 of my pregnancy and I was diagnosed with marginal placenta previa and possible accreta so for a few weeks I was like, Well, maybe this is just not meant to be and that is okay. But then it ended up resolving by week 28 so I was cleared for VBAC. Throughout the pregnancy, I kept my plans secret from almost everyone including my parents and my in-laws. I told Jovani, “You are forbidden to talk about this with anyone.” As you start getting closer to your due date, people start asking questions which to me is like, why do they want to know such specific information like where are you giving birth? I never ask that but some people really want to get all the details. I just told him, “Just lie and tell them that it’s going to be at a hospital. Just say whatever you want. I don’t care. I just don’t want people asking questions and just getting reactions over my birthing plans and decisions.” Exactly. I don’t want to give explanations to anyone. I don’t have the energy to educate anyone at the moment. I know that I am making the right decision for me and that’s pretty much it. So that was really difficult keeping that information from some friends but as my due date got closer of course, we shared the information with my parents and just our families in general and our in-laws. I did share my plans with a few very, very close friends of mine. Most of them were supportive. Some of them– I guess I had to deal with some anxiety on their side. My doula helped me a lot with that because I was getting almost angry that they were anxious. My doula was like, “You have to remember that they love you and they love your baby. They are scared for you and your baby so try to understand them.” It gave me that perspective like, yeah. If I didn’t know, if I wasn’t educated enough on facts, I would probably be anxious too. Especially around week 35, their anxiety passed on to me and I started to have a lot of doubts about my decision. I was like, Is this the right decision? Is this really what I want? By then, I was so soaked on data and stats because I just put so much time into researching all of that, that it was how I calmed myself down. It was like, You know the data. You know the stats. You know the chances of things going wrong. Of course, there are chances of things going wrong, but the chances are so low that it’s almost impossible for this to happen. If something were to happen, okay. You were one of those improbable chances, but it was a chance that I was willing to take based on the statistics. Once again, that really helped me deal with the anxiety and if I would have had energy at the time, I would have been more than happy to share all the data and stats with friends and family. This is also how my husband ended up being convinced that I wanted a VBAC and that I wanted a home birth as well. I remember this one day, I think there was some sort of miscommunication between him and I at the beginning. At first, he wasn’t super happy that I was going with a midwifery practice but then I was like, “They are trained professionals. It’s not like Call the Midwife where she shows up with a tissue.” I was like, “No. These people come with equipment. That’s how it is.” So that calmed him down but I think he thought I was going to give birth at the hospital so then one day I was watching, I don’t know if you hear of this terrible thing that could happen with an uncertified midwife where the baby was footling breech and it was a really terrible story. I was watching something on YouTube and it came up and Jovani was like, “I don’t understand these crazy people who want to give birth at home.” I was like, “Hello, I’m planning to give birth at home.” He was like, “What?” So I told him, “Yes, Jovani. I am planning to give birth at home. This has been the plan the whole time.” He was like, “No, I thought it was going to be at the hospital.” I was like, “No. It’s going to be at home.” He was really, really, really nervous for a while so once again, I shared statistics and data with him. The midwives also were like, “Bring him in. Have him bring all the questions that he wants and we will answer them. We are here to help.” All of a sudden after a couple weeks after having that conversation, I shared a lot of resources with him. I told him, “Do you want to come with me to the midwife’s appointment so you can ask any questions you want?” He was like, “No, it’s okay.” I was like, “Oh, so you’re cool with me having a home birth?” He was like, “Yeah, if that’s what you want. I respect that. I respect your choices. I trust you as an individual and the choices that you make so that’s totally fine.” Giving him resources so that he could see the data I feel like really, really helped him. Then with some of my family members like my brother, for example, he was like, “Why do you want to do this? Why don’t you just, why? Why do you want to do this that isn’t the norm?” I explained to him my rationale and he was like, “Okay.” I had some other conversations. I have a family member and she is a physician and she was also like, “Why would you want to do this? Cesareans are so easy especially if they are scheduled. You just go in. You don’t suffer and then you just come out with a baby.” I was like, “Have you had a Cesarean?” Of course, she hasn’t. I was like, “It’s not really that easy. The recovery is really, really, really tough and there can be some very serious complications. If it’s needed then that’s wonderful,” but I know that I did not need one for my first pregnancy and I know that I did not need one right now. So then at 39 weeks, I started to feel very anxious because nothing was happening and I was very worried that I was not going to go into labor on my own because I never went into labor last time even though I know I was early. But I was still worried that, What if I never go into labor on my own? I’m going to start getting very nervous if I go past 40 weeks. Then at 39+5, I had prodromal labor at night so I felt excited to experience real contractions I guess for the first time. I was also very worried that I was not going to be able to go unmedicated because the prodromal labor was quite intense and I got thinking about all of these people who have shared their stories that they had prodromal labor for weeks. I was like, Oh my gosh. That’s horrible. I reached out to my doula and I was like, “Okay, I had prodromal labor last night. I’m very worried about not being able to handle the unmedicated birth that I want to do.” She suggested we do a welcome baby hypnosis session and to focus on relaxation so I guess once again, as a scientist, I never thought that I would be into hypnosis. It just ended up being this wonderful resource that helped me a lot during my pregnancy and during labor. On my due date exactly, so I woke up and noticed that I had lost what looked like pieces of my mucus plug and then within a few hours, I started having some mild contractions around 1:00 PM and then the contractions continued to get more intense throughout the afternoon and the evening. At midnight, my contractions were super intense but they were not consistent. I couldn’t get any sleep because of the intensity of the contractions but I did try to rest as much as possible. Around 4:00 PM, my doula checked in and she was like, “What’s going on?” I was like, “I’ve been having these contractions on and off.” I felt the contractions where you feel period cramps and they were more in my abdomen. They were so intense in that area but just according to what people said, they were like, “We could feel them in my whole belly.” I was like, “These are just weird. I don’t know. Are they real contractions or not?” Just because they were not consistent, I would get them every 3 minutes, every 5 minutes, every 7 minutes. Sometimes they would last a minute but sometimes less and sometimes more so I was just super, super, super confused and my doula told me, “You’re probably having prodromal labor again.” I was like, “Oh my gosh. No. This cannot be. It cannot be because I’m not going to be able to withstand this for much longer.” It had been 15 hours or so at that point. So I was tired and I hadn’t slept at all. This was around 4:00 AM so then my doula once again suggested I reach out to the midwives and ask them if I could have a cervical check. She was like, “That’s going to give you an idea of if this is actual labor or if this is prodromal labor. I was like, “Okay.” So then I texted my midwife. I didn’t want to call them because I didn’t want to bother them at 4:00 AM so I texted them and I was like, “Can I go to your office?” even though I don’t know why I suggested that because it would have been horrible to get in my car and drive to their office. I was like, “Can I go to your office in the morning so that I can get a cervical check?” They replied and they were like, “Yeah, sure. You can come to our office. We will see you there at 8:00 AM.” At this point, it was 4:30 AM and I think it was at 7:00. I was like, “I just don’t think I can do this for one more hour.” I texted them again and I was like, “Can I go to your office now? The pain is pretty intense. Can I go now?” Then one of them replied and she was like, “Actually, we can go to your house. We can go to your home and we can check you there. Are you okay with that?” I was like, “Yes, yes.” They ended up coming at 8:00 AM and they checked me. She was like, “You’re 6 centimeters dilated.” I was like, “Oh my gosh. Thank you.” I was so excited. I was like, “Oh my gosh. Yes. I knew this could not be prodromal labor for so long.” She was like, “You’re 6 centimeters dilated.” I was also leaking some amniotic fluid so she was like, “Things are about to get more intense now.” She offered some pain medication. I don’t remember what it was but she was like, “This is the pain medication that I can give you. Yes. It’s going to reduce the pain but it’s also probably going to slow down things. Are you okay with that?” I was like, “No. Don’t give me anything. I just want to get this over with.” I knew understanding– I feel like the first part of labor was very confusing. I was like, “Are these contractions? Are these not? Am I dilating? Am I not?” But understanding physiological birth, I knew very well that after 6 centimeters, things are about to get really intense but they are also going to be faster ideally. I guess I sort of trusted that. I was like, “Things are about to get more intense. I know that for sure and ideally, they’re going to get faster so I think I can keep doing this for a few more hours so no pain medication, thank you.”She was like, “Okay. I’m going to check in again with you at 11:00 AM.” It was 8:00 AM at this point. She was like, “If anything happens, just let me know.” She left and I think as soon as she left, things got really intense. I lost my mucus plug and then I had bloody show and I continued to labor peacefully at home. I was just in my room quietly. My mom and my dad were here because they live out of town and I asked them to please come to support me and to help with my son, my toddler. They were here but they were in the living room so it was only Jovani and I in the room. I sort of continued to ride the wave. That was my main coping mechanism. I was like, “Okay. A contraction is about to happen and then I would just count and Jovani helped me with back pressure.” Sort of the next few hours are a blur again. I think I was just so focused on coping with the pain, I was just counting over and over and over. I used a comb for a little bit but just was counting and riding the wave is what helped me the most. At some point, my doula and her student showed up. I think Jovani texted them. I don’t know. Meagan: 4-1-1, come!Adriana: Yes. They came in and they helped me. They did some massage and helped with back pressure as well. That made a huge difference. I got into the shower at some point. Huge relief to get some hot water on my belly. That really helped. Also, at some point, I had two midwives and one student midwife. At some point, they showed up as well. They started setting up the birth pool and then at some point, I noticed my contractions were not as back-to-back as they were a few minutes before. Once again, understanding physiological birth, I was like, “I’m getting close. I know my contractions are not back to back anymore so I know I’m getting close to being done.” My midwife– I had asked some questions to her before and I was like, “How do you know? I don’t want constant cervical checks so how do I know that I’m about to be done?” I remember she told me, “We know. We are trained to listen to the birthing person and we can tell when they are getting close.” So I guess they could tell and around that time, she was like, “Okay, I think it’s time for you to jump into the pool.” I think this was around 11:30 or something. I was on my knees and my arms were on my bed. That was the position that I felt most comfortable laboring in so when I stood up, I felt something coming out. I was like, “Oh my gosh. Something is coming out.” I went into the pool and within a few minutes, I started to feel very strong contractions in my whole abdomen finally. Up to this point, the contractions were only on my lower belly. My body started to push and after two pushes, the head of my baby came out and on the third push, all of him came out. I don’t know how long that took. It short of felt like forever to me but they told me it was pretty quick so I don’t know, maybe 15 minutes. I have no idea. It’s really funny how you lose sense of time. Meagan: Mhmm, yeah. Adriana: During that time. There were so many people in the room at that point. It was the two midwives, the student midwife, the doula, the student doula, my mom, and Jovani but it was pretty interesting because the ambiance was so quiet. Everyone was really quiet the whole time. It was really, really peaceful and then when baby came out, everybody was clapping and so on. My dad was outside the room and he was like, “It was so quiet. I was getting worried then all of a sudden, I could hear excitement and clapping.” I was able to catch him and we did immediate skin-to-skin. I couldn’t believe it. I was like, “Oh my gosh.” I couldn’t believe it. I got a shot of Pitocin and then birthed the placenta within a few minutes. My midwives tucked me into my bed. My baby was still attached to the placenta. My doula brought me a donut. Jovani got me coffee. My mom brought me a sandwich. Meagan: Oh my gosh. I love it. Adriana: Yes. It was one of the best meals I’ve had in my life. I was so happy and so excited. I had a very small tear so I didn’t need any stitches or anything and the recovery was so easy. It was nothing compared to recovering from a Cesarean in my experience after a long induction. Then it was really nice too because in the next days and weeks, my midwives visited me in my home. The checkups and everything were at home so that was pretty wonderful. I guess throughout this whole process once again, understanding, it was really interesting to me how– I don’t want

“I leaned back in the tub and I think what I said was just, ‘I’ve never held one of my babies after they were born before.’It was interesting how there was an element that was sort of mundane about it but I liked that. It was just the normalcy of it all that shocked me if that makes sense.” Since her only experiences with her previous births were in a sterile, surgical, hospital environment, the simplicity and freedom of a home birth felt shockingly normal in all the best ways!Jolie shares her first C-section, her planned home birth turned CBAC, followed by a 15-hour home birth at 43 weeks to an almost 11-pound baby with her third. She gives invaluable advice on how to REALLY know if you have the right provider for you and how it may not always be the VBAC-supportive provider everyone recommends. Jolie's Photography and Coaching Contact InfoTransforming BirthNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. It’s Meagan here. We have another VBAC story for you today and we have our friend, Jolie. Hello, Jolie. Jolie: Hey, Meagan. Meagan: How are you today? Jolie: I’m good. How are you? Meagan: I am so great. I am so excited to record your story. There were a whole bunch of little snippets through your story that I’m like, Oh, I want to talk about that. But I wanted to tell everybody that I’ve been starting to do this. I don’t know if you’ve been noticing but we get a lot of emails of, Hey, where was this person located? What state was that? I’m curious if it was my state so I can try to find that provider. We are going to have her providers and stuff tagged in today’s post but you say you are in North Georgia, correct? Jolie: Yes. Meagan: Is that just where your VBAC was or is that where you are residing now? Jolie: Nope, this is where my VBAC was, in North Georgia. Meagan: Okay, so North Georgia people, listen up. This is going to be a great story. I’ll tell you guys a little bit more. Okay, so you’re a birth worker and a photographer. Are you a doula? Jolie: Yes. Yep. I was trained as a doula in 2020 but I’m exploring different ways to support people in the birth community because, with three young children, I’m just trying to navigate the on-call life and doing things. But yes, I do have experience being a doula. Meagan: Awesome. So cool. Like she said, she has three kiddos. She is a Christian wife to a Biblical counselor. That’s awesome. I love how you guys said that you have a vision of a multi-generational team on a mission to God’s kingdom. I just love that so much. I am so excited to record your story here in just a few seconds. I do of course have a Review of the Week as always. We always have reviews and just a reminder, if you haven’t left a review yet, we would love them. They really do help the show. They help other Women of Strength find these amazing stories and honestly, they just put a ginormous smile on my face. This review says, “Love these ladies and this podcast.” It says, “I love listening to your podcast. I listen almost every day in the car. So often that my oldest son knows you both by name. The stories shared here have inspired me so much. I wish I had all of this information with my first baby. I have had two C-sections. I’m not pregnant at the moment and still have to get my husband on board for a third, but I am so excited to start planning for a VBAC after two C-sections when the time comes. Thank you, Julie and Megan, for creating this amazing VBAC community. I’m so thankful for the education and support.” Okay, seriously, I love that. We keep hearing this. I love that other kids know who we are because they are just so used to listening to the podcast because this is what I love even more than just they know who they are. They are learning. These kids are sponges. We know that. They are always taking stuff in that we are saying and if they’re listening to these stories, they are learning. So hopefully if your kiddos are learning and listening, they are going to have a different outcome in their future for their future births if they so choose to because they’re going to know, right? They’re going to know all of these stories. Anyway, that makes my heart smile. Jolie: That’s awesome. Meagan: All right, girl. Are you ready? Let’s do this. Jolie: All right. Meagan: All right. Let’s turn the time over. Jolie: Okay, so yes. I had a home birth in November, November 5th. That was a home birth after two Cesareans so an HBA2C. I’ll just do a small synopsis of the first two births because I feel like that always helps preface the background of where I’m coming from. I think everybody’s journey to their VBAC is totally different. Meagan: Yeah, totally different and at the same time, there are so many listening who are like, Oh my gosh, this is just like me. I think sometimes we hold on to those past experiences even if we’ve processed them. We know that was our past so sometimes we even doubt ourselves because of that so hearing someone’s story who is pretty similar to yours and then hearing them go on to have a VBAC is pretty impactful. Jolie: Yeah, absolutely. I can relate to that as well with listening to podcasts and finding those stories of women’s journeys to their VBACs. I definitely clung onto the ones I related to. With my first baby, our daughter, she was born in 2019 and I mean, that was like so many, a typical cascade of interventions situation where I was aware of home birth and natural childbirth. I knew that I wanted that, but I also was just young and didn’t know and wasn’t aware of the resources I had. It’s pretty much what I chaulked that up to. I just was getting into birth and eyes wide open and reading what I could but I didn’t really know obviously what the future was going to hold for me. I didn’t know all what was available to me either. I was seeing a traditional OB group and was planning a hospital birth but wanted just a natural childbirth with no interventions at all. I just wanted in in the hospital. I ended up getting fear-mongered to just put it simply out there. Fearmongered into an induction at 41 weeks and yeah. Quite frankly, it just didn’t work. My body was not ready. I was not open at all and I was so determined. I stayed in that hospital working with an induction for a whole week before I had my C-section. I was trying to go slow and steady and I was going a little stir crazy there at the end of that week. I obviously was confused and just downcast and so just sad about what was happening. I was shocked that I was there in that situation. I remember reading Ina May’s book and skipping the C-section chapter because I was like, That’s not going to be me. Why do I need to read this? Meagan: That’s really normal. Even here with the CBAC stories, I think it’s really common to be like, I don’t want to listen to that CBAC story because that’s not going to be me. But at the same time, I think it’s good too. Jolie: Yeah. Yeah. There’s definitely a balance to that. I found myself at the end of that week pushing 42 and was kind of again just had fear within me and had fear coming from my providers of, “You’ve been at this for a week. You’re not in labor. Your options are to leave or have a C-section.” I was just like, “Leave? I’ve been here for a week. I’m not going to leave here without a baby.” We opted for the C-section and she was fine. We handled that whole week together perfectly fine. There were no emergencies or hiccups in the road. It was just like, “All right. This is just what we do next,” kind of at this point. She was born at 32 to the day via Cesarean and yeah. That was that. I definitely processed the birth very traumatically because any trauma is how you process what’s going on. I know there are births out there that could look like that and people handle it differently. So anyway, for me, I processed it with a sense of trauma. I spent that next year just working through that sorrow and trauma. I started seeing a Biblical counselor which is why I included in my little bio that my husband is one because I saw one and the change that he saw in me is what spurred him on and encouraged him to become one. That was a really cool moment in our family where I was going to this wonderful woman for help and just handling my birth. Anyway, that was really helpful for me in growing and changing the way I was looking at my birth. I was very determined to have a VBAC. My husband I have always said that we want however many children the Lord would give us. I assumed that wouldn’t be just one. I wanted another one so I was very determined for a VBAC for my second pregnancy. We conceived my second when my daughter turned one. It was a year later and I was just– the way this pregnancy and birth happened which was a repeat Cesarean, I just put my blinders on and put my head down and was like, I just need to hire a home birth midwife and she’s going to give me my VBAC. That was my attitude. Surely if I plan a home birth, I’m not leaving my house. There’s no way it will end in a C-section. I was very– I don’t know if stubborn was the right word, but there was a sense that I was covering up all that I went through with this first birth to just have the VBAC, have the VBAC. It was almost like that was going to fix the first one. That was how I felt. In hindsight, I see that now. In the moment, I probably did not recognize that that was how I was operating. I hired a home birth midwife who came recommended to me. I knew friends who used her. So then here we are towards the end approaching 41 weeks like the last time and my water broke on 41 weeks. It was the first sign of labor and I had no signs of labor with my first child so that was so exciting. I was kind of scared too. I was surprised. My water broke at 41 and I was talking to my midwife and whatnot. I had some little pitter-patter contractions that night and then nothing the next day. That was on a Sunday. My son ended up being born that Thursday via Cesarean. What happened within that week or a little less than a week was not the funnest of times. I pretty much realized there at the very end when I was needing– you’re here at the end and you’re like, What’s going to happen next? I realized, I hired the wrong midwife, but what do I do now? Meagan: No way. Jolie: Yeah. Like I said, I’m not going to speak ill, but I believe that every care provider is not the right fit for everyone. So just because I heard wonderful reviews, that’s not negating the fact that she was wonderful for some people, but looking back, this is pairing it where my head was down and my blinders were on. Now I can see in hindsight the red flags that were coming up. I was like, Oh, she’s just tired. Maybe she just got back from a birth and that’s why she seems grumpy. She’s been doing this for a long time. I was just giving reasons to why she was the way she was. It was nothing more than that we just didn’t click well. After my water broke, she took on this fearful attitude. She was very concerned and just didn’t know what to do. She really fed into fears that I had and new ones in my head. I was just like, This is not helping. What’s going on? All that to say, I think she wanted me to have a biophysical profile done since my water had broken and I was 41 and labor hadn’t begun. Obviously, the profile came back that there was low fluid which I knew because my water had broken but there was nothing else concerning with my son. But because of that report, she transferred me to the hospital. She transferred care and she called my husband after the report came back to her and said, “Y’all need to go to the hospital. I’m not going to be able to support you. Just go.” That moment from the report to the hospital was scary for me but on the way there, I had this peace come over me because I was going back to the hospital that my daughter was born at and before this birth, I was very much even just seeing the hospital– I would just not look at it by the side of the road. I had all of this emotion attached to this place. I knew a few people who worked there in the labor and delivery ward. I had their numbers so I messaged them. I was like, “Is there any chance y’all are here?” Long story short, I’m coming. I don’t want to be here, but I’m coming. They were. I had a friend come and she prayed with me and I had seen another nurse there who was there when I had my daughter and she remembered me. It was just this very healing moment in the sense of I was respected. People totally were not judging me for coming in as a home birth transfer. I was worried about that that I would get a side-eye or judgment because I was a home birth mom. I was actually going to the hospital and I didn’t have a provider there. But no, they were all so very much like, “We are so sorry that you are here because we know that you don’t want to be here but we are taking care of you. We understand that this is hard for you to process everything that’s going on right now.” That was healing in itself. That healed my emotional attachments to the hospital that were negative. He was fine. They monitored him for a few minutes when we got there. He was fine, but they also– I did tell my husband when we were on the way, “I just know that it’s going to be another C-section because I don’t even have a doctor here. My water’s broken. I’m already a VBAC.” I kind of had accepted that outcome before even getting there and decided to opt for it again. The doctor there was also very respectful with all of that just like the nurses were. He was born at 41 and 5. He was fine even though the water had been broken for some time. So that was that. In processing that birth, it was a little bit different than my first. I definitely felt like I was at a fork in the road though because here I am. I’ve just had two. I was technically a home birth transfer. I was determined to get this VBAC. What in the world happened that time? I just realized that I had taken any sort of trust and responsibility in the medical community or within myself and just put it in the hands of this midwife and put her up on this pedestal of, You’re going to give me the birth that I want. I misplaced that into the whole home birth community. I was like, I can’t do that again. But then that is some deep internal work then. If I am realizing that I am making all of these other people responsible for my birth and my outcome and it’s not working out great, I need to figure out what the root of this is and really work on it. That began the year journey of just doing some more internal work and more counseling and therapy and stuff like that. I remember it might have been this podcast episode that I listened to or it could have been another birth podcast. It was honestly a lightbulb going off. I didn’t realize I could do this. I can’t remember. I think it was your podcast but one of y’all said, “I interviewed seven providers before I became pregnant again to pick one out.” Meagan: Yeah. I actually interviewed 12. Jolie: Yes, okay. I wrote that down. I heard that and I was like, Wait a minute. How am I going to do that if I’m pregnant and scrambling to find the perfect provider? I heard you say that and it was almost like, Whoa. I didn’t realize I could interview people when I’m not pregnant, but why couldn’t I? So that helped me. Meagan: It sounds weird. Why would you go talk to a doctor if you’re not pregnant? Jolie: Yeah, but that gave me so much peace and confidence. It was a clear path of, Oh. I’m not pregnant. I’ve got time. I started. I didn’t want to figure this all out until my son turned 1 so I was just like, You need to take a breath. Everybody talks about your next baby right after you had one and I’m always like, Can you just slow down? I just had a baby and I’m going to enjoy this time. So I waited a year not to get pregnant the third time but a year to go after my provider, find my plan, and really do the deep work again. So I did. I started interviewing all of these people. I found my midwife a little over a year before I conceived my third baby. I found her early when I wasn’t pregnant. It was just such a God-ordained, perfect experience where my husband and I went and had a conversation with her. She just aligned with us on a biological level, on a spiritual level. That was something I didn’t realize how important it was going to be to me to find a fellow Christian who really walked out their life with the Lord and she did. I developed a close friendship with her actually even before I was pregnant. Being in the birth world, I would work with her. I had attended some births with her before I became pregnant so I really just saw her live it out and I knew she was amazing. What’s so funny, just the way the mind and body and spirit are connected was when I first met her and did the interview with my husband, I hadn’t started my cycle back. I was telling her, “I’m just looking. I need a VBAC. I want a VBAC. I’m not pregnant yet, but I haven’t started my cycle either so I have no idea when.” The very next day, I got my period. For me, I felt like it was my body coming into alignment with the fact that I just found somebody who was going to be amazing for my birth. Meagan: You’re ready. Jolie: I emailed her, “This is so weird but I literally just started my cycle.” Anyway, that was just a really cool moment for me to recognize that connection.That was when I found my midwife and that was such a key part to my VBAC. Then it was about a year later when I got pregnant with my third. I hired her and we were just so excited. Okay, so one of my big things with interviewing people for my third was, “Okay, I have had two pregnancies and two Cesareans. Historically, I have gone postdates with both of them. I need to know what your deal is with due dates and the whole ‘let me’ language and all of that.” I was trying to figure out what I aligned with in that regard and what they would support me with. So here I am approaching 42 weeks. She was very much like, “Whatever. We’ll check on you more when you’re past your due date if you want and we’ll obviously take care of you but I have no cutoff or whatever.” Yeah. So I was 42 weeks and I started losing a little bit of my mucus plug. That was exciting but then another pretty much week went by and here I am a couple days before 43 and I have two nights of prodromal labor where the contractions would wake me up in the night but then I’d go back to sleep. That was the first night on a Thursday night I would have those contractions. Friday rolls around. I am so pregnant and so tired. It was definitely emotionally very challenging that last month. But Friday night comes around. They pick up again and that night, I really couldn’t sleep so I would be on the birth ball. I would get in the bathtub and yeah. I knew I was going to need some support on Saturday because of my other children so it did fizzle out Saturday morning, but I had a friend come and play with my kids. We just all hung out together on Saturday. I did have some contractions that were strong every 30 minutes to an hour during the day on Saturday. I was pretty much– that Saturday I was 43 weeks I think. Either Saturday or Friday I was 43 weeks. That evening it started picking up a little bit more and my birth team, so my midwife and her assistant who was going to come to the birth and my husband. They came over around 10:30 Saturday morning and then 30 minutes later– so they got to my house at 10:30-11:00 PM. My kids were asleep so that was fine. I wasn’t really sure if I was going to have them around or not. I was going to play it by ear because I wasn’t sure what kind of support I’d need from my husband and how they were going to handle it. Through the night they slept which was great and I was laboring that Saturday night. My water broke at 11:00 PM Saturday night 30 minutes after my birth team got there and that was something that I was having to really work with in my mind because of the second birth having my water break as the first sign of labor and then not have the baby for several days. I was really wanting to not have my water break early. Meagan: Yeah. Jolie: But my water breaking actually when it broke at 11:00, I was in labor before then. That was a different situation and I just had this wave of peace come over me again because I knew I was finally in labor and my birth team was going to stay. It wasn’t going to be, “Oh, nevermind. We’re going to go home now.” They were here and the water was clear. I had no worries. I was actually really excited after my water broke because I thought I wasn’t going to be because of my second birth but I was so thankful. Pretty much from there on, it started picking up pretty intensely. The nighttime was a blur. I just did squats and walked around and swayed and just clung to door frames I feel like. I was just sort of, yeah. I definitely struggled with holding tension in my body in the contractions. I did labor pretty much all night on Saturday and then later in the night maybe around 4:00 or 5:00 AM, I finally found a great place to relax and just a position. It was actually just laying in the bed reclined is what did it for me. I was able to melt into the contractions and I could tell that I was opening and progressing. I just slept around 4:00 or 5:00 until 7:00 AM so early into Sunday morning now. I was definitely still laboring intensely but I was sleeping. To somebody on the outside, you would just think, Oh, she’s just taking a nap. I was in transition actually. I did not think I would want a cervical exam because of my previous two births– never dilating, all of that. I had to move past that whole belief that my body was not going to open and things like that so I wasn’t sure how I was going to do with exams and stuff. But at that time, being a doula and hearing so many birth stories, I was already pregnant for so long, I was just like, I need to know if I have a whole other day of this. I don’t want to hear a number but I want her to check me and at least tell me if my energy needs to be hunkered down, conserved, you’re not that far, or is it okay, let’s pick it up. You’re almost there? I did want her to check me but I didn’t want to hear a number. I just wanted her to give me a general frame of, “Here’s where you need to be in your headspace with this information I’ve just received.” It was 7:00 AM maybe. She checked me. She was like, “Are you sure you don’t want to hear a number?” I could just tell the way she asked that question. I was like, Okay, she knows I’m going to like the number I’m going to hear. I was like, “Okay, go ahead and tell me.” She was like, “You’re an 8 and I can stretch you completely open very easily.” I was like, “What? Oh wow, this is amazing. Okay.” She was like, “I think all it’s going to take is some different positions. We’re going to do a circuit to get the baby’s head lined up just a little bit more straight and that will open you up all the way if we just move the baby just a little bit.” I was like, “Okay, let’s do it.” I did two circuits of excruciating positions. Side-lying was not the most fun thing I’ve ever done but I was very much just like, “Tell me what to do and I’ll do it.” We did side-lying, knees to chest, and dip the hip where I was standing and I would swap and turn. I don’t know how to explain the sensation, but it was probably just the baby moving through my pelvis. It was pretty intense. I did two circuits of that and I was just like, “I need to feel some comfort again and not do this circuit again.” So I was like, “I think I want to get in the birth pool.” I had the birth pool set up. I had tried to get in earlier in labor but got right back out. It was just not for me. I was like, “Maybe I’ll try the birth pool.” I stepped in and was like, “Nope. I don’t want to do that.” The second time now, this was around 11:30 AM. I was like, “I think I want to get in the pool.” I got in and I was like, “I’m not 100% sure but I kind of think I feel pushy.” It was just one of those things that in a lot of ways I felt like a first-time mom having this labor where I never had a pushing phase with the others. I was just sort of doubting myself a little bit, but the assistant was like, “Well, we can’t tell you if you feel pushy.” I was like, “Okay. I know. I know.” Meagan: We can’t tell you. Jolie: Yeah. Meagan: That’s hilarious. Jolie: I was like, “Okay. Well, I’ll just be in this for a few more contractions and see if whatever sensation I’m feeling stays or gets stronger. I think I’ll be confident when I am ready to push or if it changes and whatever.” I just was trying to figure out again where I needed to be. So I did feel that pushing sensation and started to in the water. That was definitely such a switch in the way I was experiencing the sensations of labor because the contractions were painful to me, but when I started pushing, it was like relief and very relieving. I felt like, Oh, I’m doing something. This is different. I’m not just getting through this. I’m moving through it in a way where I have this sort of control over it. I really enjoyed pushing and I was in the tub and again, reclining on my back. I never thought I would be in this position for birth because it’s usually the hospital stereotype of on your back on the bed but that’s where I felt relief and got through transition on my bed so in the birth pool, that’s actually how I pushed was kind of reclined back. I was just able to do it better that way. I had 5 minutes between each contraction so that was really nice because I ended up pushing for about 2 hours. That’s kind of a long time. I think from start to finish my labor was 15 hours so it was those last 2. I never felt exhausted as in, I can’t do this, but I do remember I wasn’t really aware of the time. I knew it was Sunday afternoon. I got in the pool at 11:30 and my son was born at 2:05. I was pushing but I had those 5 minutes of breaks so I was able to doze off and float in the water. I genuinely enjoyed those 2 hours. It was just peaceful but I felt myself getting sort of impatient because I didn’t know what time it was, but I was just like, Okay. The water is kind of cool. I know I’ve been in here for a while so I don’t know. I really wish this was over now. So finally, there was a candid moment where I saw my midwife getting baby stuff together and I was just like, “Oh, what are you doing?” She was like, “You’re pushing. I’m getting the baby stuff out. You’re doing this. It’s actually happening.” I was just like, “Oh wow. Okay. I guess so.” It was so funny. I don’t know. I think there is just this part of where I was just so zoned into what I was doing and what I was feeling that I wasn’t really processing it, Oh, this is happening. This is happening. As she told me, I could feel my baby’s head and that was mind-blowing. Once I could reach out and feel his head, which we didn’t know at the time it was a boy. We were waiting to find out. That definitely brought me into a sense of reality when I could feel the baby’s head. It was just like, Whoa, okay. This is happening. There was a slight burn when his head crowned, but there was so much adrenaline when his body was coming out that I don’t even really recall that being painful just kind of a burning sensation. His head crowned. I changed positions after his head was born. I was still in the water, but I sort of think I was on my back. I moved up a little bit onto my hands and knees and stayed in the water. My midwife ended up guiding his head and shoulders down and then his body came out. She handed him to me and I just remember knowing it was a boy even though I hadn’t seen yet. I leaned back in the tub and I think what I said was just, “I’ve never held one of my babies after they were born before.” That feeling of an immediate, My baby came out and they are in my arms. That was just so surreal but at the same time it was almost so seamless and intuitive that I was just like, Okay. I just gave birth and it’s just a normal day. Everybody around me– I think I had thought built it up in my mind to be this incredible experience which it was. I don’t want to say, It wasn’t all that, but in a way, birth is so natural and normal that after it happened, it was just like, I’m in my bed and the birds are chirping outside and the day is going on, where before I was in the hospital and it felt like this whole different world. It was interesting how there was an element that was sort of mundane about it but I like that. I don’t know. It was just the normalcy of it all that shocked me if that makes sense. Meagan: Yeah. No, I really actually can totally relate. I remember after I had my VBAC after two C-section baby, I was at a birth center. I was in the bathroom on the floor when I gave birth and they were like, “All right, let’s get you up and move you to the room.” I was like, “Okay.” I just remember going in there and laying down and starting to feed my baby and just looking around almost like, Did that really just happen? But at the same time, it was like, Yeah, it just happened and now I’m just feeding my baby. Jolie: Yeah, that was it. Meagan: It was so weird. It was so weird. There was a slight disconnect in my brain that what had just transpired transpired. Jolie: Yes. Meagan: So yeah. I really can relate to that so much. Then about how you were saying, “I was pushing for a really long time and I just looked over and realized my midwife was putting the baby stuff together and getting stuff ready,” and you were like, “Oh, yeah. Yeah.” I had that moment too where I was just laboring on the toilet and then all of a sudden, my midwife was just coming in here guiding me to the stool and I was like, Wait, what? She was like, “Let’s come have a baby.” I’m like, “What, really?” I couldn’t believe that what was happening was happening but I was so zoned into doing this birth, having this VBAC, and then all of a sudden, I realized I was doing that. I was actually doing that. Jolie: Yeah. I think when you have C-sections and when you have any sort of difficulties in your births, your mind clings onto those phrases that people say like, “Oh, your baby is too big. You’re not going to open.” Meagan: Oh yeah. Oh yeah. Jolie: It makes you feel like this miraculous thing must happen for me to give birth because it didn’t work the other times so how in the world? Trumpets need to be blaring and some crazy thing has to happen for this to work but it doesn’t and it was just like, Oh. That was it. Meagan: This is normal. Jolie: Yeah, the thing that didn’t feel normal was actually the surgical births but the thing that felt normal was the VBAC so it was very interesting but after he came out, they were like, “That’s a big baby.” He pooped twice before we got out of the tub like pretty big poops so then by the time my midwife weighed him, she knew that he had already pooped, but I think he weighed 10, 14 so she was like, “He totally was 11 pounds coming out. If I weighed him before he took those ginormous poops.” That was shocking and not expected at all. Meagan: Yeah girl! Jolie: That was really cool that it was not even a part of it because I didn’t get any late-term ultrasounds. Looking back, people definitely kept asking me if I was having twins. They were like, “Wow. You look really big.” I just was like, “Ha, ha. I get it. I’m pregnant.” You know the things people say. I’m like, Maybe I actually did look larger than normal because this child could pass for two babies as twins. Yeah. He was almost 11 pounds. I did have one tear that I chose for her to not suture, but that was it. That was the birth. Meagan: Wow, and a surprise big baby. Think about how there are a lot of times in the provider’s world of the hospital where they see someone who is a larger baby and they are wanting to do those third-trimester ultrasounds and growth scans and they are like, “What?” When really you didn’t need any of those things, you just needed time. And a 43-week baby. I had one of my beginning doula clients and she was 43 weeks and 1 day as well. I mean, it was a 10-pound baby as well. It was 10,12 I think. That girl just powerhoused that baby out but she was getting pressure to get induced at 39 weeks. She was feeling all of that pressure. “Oh, your baby is looking big. You look so big. You are small. I don’t know if this is going to be possible.” Then she switched at I think 41 weeks then she went to 43 and 1 and just had a beautiful, vaginal birth. I love that. Okay, so there are so many things. Something that I caught in your story was with your second midwife or with your second provider with your second baby. Everyone said, “This midwife, this midwife,” so you went with this midwife then you realized it wasn’t the midwife for me. I think that is something that is important to note especially when we have our supportive provider list, right? We have this list and we’re providing these names where people will rant and rave for days and days and days about some of these providers so you’re like, Yeah, great. The whole community is going to this provider or whatever. Then you’re in that situation and you just take that word for it, but then you get into that situation of birthing and you’re realizing, Oh crap. This isn’t right. There were red flags and I didn’t recognize them because I was just going off of what everybody else said. I just think it’s important to note that even though everybody or people might say this provider is the only provider or the best provider that it doesn’t mean they are the best provider for you. It really comes back down to what that provider is looking like for you in your mind. Close your eyes. Envision your birth. Think about what they are saying, what they are doing, how they are caring for you. Think about the questions you want to ask them and go and really ask these people these questions that are really something for you. I love that you talked about that with your third midwife how you were like, “These are the qualities I was looking for.” It took you a while to find it but you found it. I love also that you pointed that out. Really you guys, I can’t say it enough. Finding a provider when you are not pregnant is night and day from finding a provider when you are. Jolie: Yeah. There was no pressure. I felt like I could be so much more confident in saying no because I didn’t feel like I had to say yes. Meagan: Yeah and honestly, our minds are in a different space. Even Dr. Fox a few episodes back talked about that how that is a really great thing to do because we are emotional. We feel pressure. There’s time. Our baby is growing and each week matters to find that provider. It’s a very

Women of Strength, how many of you have “failure to progress” on your operative report as the reason for your Cesarean(s)? Meagan and Julie talk ALL about failure to progress today– how it led to their own Cesareans and how after breaking it down, they both realized that neither of them actually qualified for that label. When is it failure to progress and when is it failure to wait? What does failure to progress actually mean? This is an episode you will want to listen to over and over again. From learning all of the ways a cervix changes other than just dilation to all of the possible positions you can try during a lull in labor, Meagan and Julie share invaluable current research and personal experiences on this hot topic! ACOG Article: Limiting Interventions During Labor and BirthAJOG Article: Safe Prevention of a Primary Cesarean DeliveryThe Journal of Perinatal Education: Preventing a Primary CesareanOBG Project ArticleThe VBAC Link Blog: Failure to ProgressHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello. I am with Julie today and we are going to be talking about failure to progress. If you have been diagnosed with failure to progress– and I say diagnosed because they actually put them on our op reports like it’s a diagnosis of failure of progress meaning our cervix does not know what to do. It cannot make it to 10 centimeters or it hasn’t or it will not in the future, then I am telling you right now that this is definitely a great episode for you. Even if you haven’t been told, it’s going to be a great episode because we are going to talk about some other great things in the end about what to do in labor position-wise and all of the things. So we’re going to get going, but Julie apparently has a Review of the Week. We weren’t going to do one, but she says she has a Review of the Week. So, Julie? I will turn the time over to you. Julie: This is my review. Are you ready? Meagan: I’m actually really curious. Julie: “I’m so excited. Thank you so much, Meagan and Julie. I love The VBAC Link!” Signed, lots of people everywhere. Meagan: I love it. Julie: We don’t have a Review of the Week so I just made one up. Boom. There. Signed, AnonymousMeagan: All right, you guys. Failure to progress: what it is and what it isn’t. Let’s talk about what it is. What does it mean? Essentially, it means that your provider believes that your cervix did not progress in an adequate amount of time and there’s also failure to progress as in your body may have gone into or you are going in for an induction and then they couldn’t even get labor going which we all know is usually not the case that your body really couldn’t do it, but failure to progress is when your cervix does not continually dilate in an adequate amount of time. Would you change anything about that, Julie, or add anything to that? Julie: Sorry, I didn’t hear half of that. I was just going through it. I was going through the things just to make sure that we are 100% accurate on what we are about to say. Whatever you said, yeah. That sounds great. Yeah. Let’s go with it. Meagan: Failure to progress– the cervix is not dilating in an adequate amount of time. Julie: Basically, yeah. Your cervix isn’t changing so you’ve got to do a C-section because it’s not working basically. Meagan: Okay, so what it isn’t– do you want to talk about what it isn’t? Julie: What it isn’t? It isn’t– sorry, I’m trying to say it. Meagan: It isn’t true most of the time. Julie: Most of the time it’s not true. It isn’t what we think it is and if it is, it’s not a sign that your body is broken. It’s not exclusion. It’s not a reason to exclude you from trying for a VBAC. It’s not your fault. It usually is a failure from the system where people are in a rush or in a hurry and just not knowing how to move past a stall in labor or not understanding the true flow of how some labors take. I mean, I was diagnosed with failure to progress. You were diagnosed with failure to progress and I know that both of our literal clinical outlook at the time we were diagnosed with failure to progress was not true failure to progress. Meagan: Mhmm. Julie: According to what the actual guidelines and requirements are. So I always say, yeah. What you said, it is not true. Meagan: It is not true.Julie: We joke about that and use it loosely. Sometimes it is true. I’ve seen one true failure to progress diagnosis in over 100 births, but I feel like most of us listening and most of us who have C-sections have them because of failure to progress. Now, mine when I was in labor, I was not told failure to progress. I was told fetal heart tones, but that’s another topic for another episode– what we are told versus what is in our op reports. So yeah, let’s do a little plug-in about getting your op report. Find out what is actually in the notes that say why your C-section was called because it’s not uncommon for what it was written down to be different than what you were told in the moment. I feel like having an accurate clinical understanding of what your Cesarean looks like on paper to another doctor who is reviewing your birth is super important. Meagan: Absolutely. I agree and also, I think that it’s important to note that if you have been told this and you have doubt in your body, that it is normal to have doubt because we have been told that we can’t do something and that our body can’t dilate, but I also want to plug-in that really try not to believe that. Try your hardest. Do whatever you can to not believe that. It’s going to help you. Believe the opposite. Believe that your body can do it. Believe that you were most likely set up in a less-ideal circumstance that created that result, right? Like an induction– it was a failure to descend, not progress, but I just recorded a story the other day where her water was broken at 6 centimeters, baby came down wonky. They couldn’t get baby out and they diagnosed her with CPD. There are these things that are happening a lot of the time where we are walking in to be induced way too early or really any time we are being induced could be too early especially if it’s just an elective. It can definitely be too early and our body is not ready so our body is not responding or our body is overwhelmed because it’s been given so much so fast and it doesn’t know what to do so it doesn’t react the way a provider wants it to by our cervix dilating. It almost is reacting in the reverse way where it’s tense and tight and like, No. I’m not ready and I’m not letting this baby out. Don’t you feel like you’ve seen that? Julie: Yeah. We’ve seen lots of things. I feel like that’s the tricky thing. We as doulas and birth photographers really do get to see the whole gamut of everything from home to birth center to hospital and everything. I feel like we have such a unique perspective on how labor is managed in and out of hospitals and how stalls or lulls in labor are managed in both places. Let me tell you, it’s often way smoother and in my opinion way better outcomes when you are out of the hospital and that happens. Meagan: Mhmm. Labor at home as long as you can. Yeah. I mean, one of the stories that I just recorded was an accidental home birth. It was not her plan, not even close, and it will for sure come across that way when she is telling the story, but there were so many things that she did within that labor like movement from the shower to the toilet to walking down the stairs to moving back to the toilet. There was all of this movement that sometimes doesn’t happen in a hospital or we’ve got, like I said, “Let’s break your water. Let’s do these things.” We’ve got these interventions that may help, but doesn’t always. It may also cause problems. Okay, so we have some updates for you on the safe prevention of a primary Cesarean delivery that Julie has found and then we also want to talk about what is adequate labor too? What does that mean and where do we decide or where does a provider decide if labor is not adequate? Julie, do you want to talk about this for a minute on what you found from the OB/GYN Project? Julie: That’s just a really nice summary. I really like it because it is all laid out really nicely. I am seeking out different pieces of information because there is updated information so I’m just looking for that. I’m not quite 100% certain I can speak to when it came out. Evidence-Based Birth has some great information. They did a podcast episode on the Friedman’s curve. We know that dilating 1 centimeter an hour is based on the study that Friedman did. That’s incredibly flawed but there is new updated, more evidence-based information that has come out. I’m trying to find out when it came out actually because the Friedman curve was established I think in 1956 and let’s see. In the 2010’s there were big shifts in the evidence. In 2014, ACOG had a study. Maternal Fetal Medicine published new guidelines on labor progress. Okay, so 2014 it looks like which is actually not that new anymore because it’s 10 years later. That was, I think– I don’t think it’s actually shifted that much at all. I’m just trying to figure that out right now. I’m sorry. Let’s see. The Practice Bulletin– yeah. You go. Safe Prevention of the Primary Cesarean Delivery. Meagan: I think we are looking at approaches to limit interventions during labor and birth, but we know that a lot of the time when we are introducing interventions, that is where we often will receive a failure to progress diagnosis because we are really introducing things, like I said earlier, when the body is not quite ready or the baby is not quite ready. Maybe the baby was already too high and was trying to make their way around and into the pelvis but now we’ve got an asynclitic baby or a transverse baby or an OP baby.This one, Number 766 which we will have in today’s show notes actually originally replaced the committee of 687 in February 2017. The 766 was in 2019 and reaffirmed in 2021. Something that I like that it goes through is recommendations for women who are at term and spontaneous labor it happening. It talks about admission upon labor. It talks about premature rupture of membrane or rupturing of membranes which I think is a big one. Really, through my own experience but also doula experience, I’ve seen so many people go through membrane rupturing whether artificially or spontaneously and then nothing is happening so we go in and we get induced. Or we are told the second our water breaks that we have to go in, then labor has not started yet so we are intervening. One of the things it says is, “When membranes rupture at term before the onset of labor, approximately 77-79% of women will go into labor spontaneously within 12 hours. 95% will start labor within 24-28 hours.” I just had this experience with a VBAC client just the other day. Her water broke and within about 9 hours, she was starting to contract and within less than that, she actually progressed really quickly. Baby was born. That was really great but then there are situations like myself where it takes forever for labor to even start. It took 18 hours for my very first contraction with my second baby to even start and then by 24-28 hours, I was in a repeat C-section because my body didn’t progress fast enough according to my provider.It says that, “The median time to delivery for women managed expectantly is 33 hours and 95% had delivered by 94-107 hours after rupture of membranes.” I think that is something also really important to note that if your water breaks, it doesn’t mean we’re just having a baby right away. It doesn’t mean that our body is failing because we haven’t started labor. 94-107 hours after the rupture of membranes is when the baby had been born. That’s some time. We need to allow for the time. Julie: That’s why I hate it when hospitals say, “If your water breaks, come in right now.” No. Meagan: I know. My provider did that too because it makes sense in our heads. They’re saying, “Oh, just come in because we have to monitor baby because of infection and all of this stuff.” But we also have to take a step back and realize that once we go into that environment, one, that’s a new environment. We’re not familiar with that. All of those germs in that environment, we’re not accustomed to. We’re not immune to them. And then two, we know that the second we go into labor and delivery units, what happens? They want to check our cervix which means–Julie: Bacteria. Meagan: There is bacteria that is possibly being exposed to the vaginal canal, right? Even if it’s a sterile glove, that still raises chances. Julie: Yeah, sterile gloves really are not as sterile as people think. Meagan: There are these things to keep in mind, but it’s so hard because for me, I had premature rupture of membranes. My body didn’t start labor, but I was told failure to progress after 12 hours for only reaching 3 centimeters. I was told failure to progress. I just really liked that. I mean, I like a whole bunch of this but I really liked that part of the rupture of membranes because I think so often we are told, “Oh, your water is broken. You’re not progressing. You are a failure to progress.” Or we are not progressing so we have to break our water to try and speed our labor up and then that doesn’t happen and then we are failure to progress. Can you see the problem here? Julie: Total problem. Meagan: It’s a problem. Julie: It is a problem. So many problems. It’s fine. I just dropped two different links to the updated guidelines because it’s really funny. I’ve been going down the rabbit hole now while you’ve been talking so if I’m repeating things like I tend to do on you sometimes, please forgive me. I just think it’s interesting. There is starting to be a shift in pulling away from Friedman’s curve and going into a different way to consider an actual progression of labor which is a really cool, nice little shifty-shift here. I feel like maybe let’s talk about what failure to progress really is. What are the guidelines for it? What is real failure to progress versus what you’ve probably been told about it? First of all, let’s just talk about– nothing. Meagan: Can we use my own birth example just as a starting point to what this evidence is showing us or what the guidelines are? My water had broken spontaneously. It took a little bit to start labor. Within 12 hours, I was 3 centimeters and was told that my pelvis was too small and that I was failure to progress. Water broken, I was 3 centimeters 12 hours into labor. all right, Julie. What am I? Am I real, true failure to progress or not? Julie: No, you’re not. Absolutely not, are you kidding me? Because you were still in the first stage of labor. That is the number one thing. According to clinical guidelines, it is not failure to progress until you’re in the second stage of labor which is at least 6 centimeters dilated. So guess what, friends? If you got called failure to progress before you were 6 centimeters dilated– mine was labeled failure to progress at 4 centimeters so that rules me out. I mean, there are lots of things that rule me out and Meagan. But if you are less than 6 centimeters, it is not failure to progress. Meagan: Yeah, it even says right here. “Active phase arrest is defined as a woman at or beyond 6 centimeters dilation with ruptured of membranes who fails to progress despite 4 hours of adequate uterine activity or at least 6 hours of oxytocin administration with an adequate uterine activity and no cervical change.” Can we talk about that too? Adequate uterine activity. You guys, at 3 centimeters with my water broken, I was still not in an active pattern to progress. It takes time. Our uterus doesn’t just start contracting regularly and adequately. It takes time. Then at that, I was only on oxytocin for 2 hours. Julie: Pitocin. You were on Pitocin. Meagan: Sorry. That’s what I meant. Pitocin. I’m looking at the word oxytocin administration. Pitocin. Julie: We all know the truth. Meagan: We all know that Pitocin is not oxytocin. Julie: That is a soapbox for another day. Meagan: I was only on Pitocin for 2 hours. 2 hours. At the top, it says, “Slow but progressive labor in the first stage of labor should not be an indication for a Cesarean. With a few exceptions, prolonged late phase greater than 20 hours in a first-time mother and greater than 14 hours in a multi (so a mom who is not a first-time mom) should not be an indication for Cesarean as long. As the mother and the baby are doing well, cervical dilation of 6 centimeters should be the threshold of an active phase of labor.”Julie: Exactly. That’s it too. Later on after this, we’re going to talk about all the different ways a cervix can change because can I just tell you what? Someone says, “I’m 5 centimeters. I’m still 5 centimeters, great. Cool. What else has your cervix been doing? We’re going to talk about that in just a second.” But yes, that’s the thing. It’s not failure to progress before 6 centimeters. It has to be 4 hours of adequate uterine activity which means strong, consistent contractions. Contractions that are strong enough. We could talk about the Montevideo units which is another measurement of the strength of contractions. We’re not going to talk about that because we just don’t have time, but are your uterine contractions strong enough? Yes? Then it’s got to be at least 4 hours without cervical change. No? Then great. Let’s do Pitocin and the inadequate amount of uterine activity. It says 6 hours or more of Pitocin without adequate uterine activity. If you’ve been on Pitocin for 6 hours and your contractions– which has caused that adequate contractions– and there is still no cervical change, then you are failure to progress Let’s talk about cervical change though because the cervix goes through so many things. When I was doula-ing, I talked about this a lot in our second prenatal visit about how a lot of times you’ll be like, Oh, cervical change. Yeah, dilation. Am I 4, 5, 6, 7, 8? But listen. The cervix goes through changes in 6 different ways. It moves forward so from posterior pointing backward toward to your spine. It straightens out to a more downward position. It softens so it goes from hard like your forehead to hard like your nose to softer like your chin. It softens. It effaces which means it thins out so it starts thick. It thins out which is effacement. It dilates obviously which is the opening and then baby’s station like where baby is in the pelvis. Baby drops down, rotates, and descends. If you were 3 centimeters at your last cervical check and 60% effaced and 2 hours later at your next cervical check, you are 3 centimeters and 80% effaced, your cervix has thinned by 20% which is a good amount of cervical change. Meagan: Good change, yeah. Julie: If you were 6 centimeters and your baby was at a -2 station and at your next cervical check, you are 6 centimeters and your baby is -1 station which means your baby is lower in the pelvis, that is a cervical change. All of these things are shifting so I feel like it’s important that when we are talking about failure to progress or when we are talking about labor progress that we consider all of the things the cervix does.I was just at a birth yesterday– not yesterday, two days ago. I don’t know. It was all night and it was long for me. All night is long. It doesn’t matter if i was there for 6 hours or 20 hours. If it was all night, I’m going to call it long as I’m getting older. The client was still 4-5 centimeters but the cervix was a lot softer or stretchier I think at the one before this. Oh yeah, your cervix is super stretchy now. Those are all great cervical changes even though the dilation number hasn’t changed. Meagan: Yeah, so coming forward, thinning out, really softening up, baby dropping– all of these things are signs of progression and so it’s something to keep in mind if a provider is like, “Well, you’ve been sitting at 6.5 centimeters now for 9 hours,” or whatever, but at the same time, your cervix went from 40% to 80% thinned and it went from super posterior to more mid-line and baby went from -3 to a 0. These are changes. These are absolutely changes and there are so many things that go into that. If a baby is high and not well-applied because they are trying to work their way down to the pelvis and our cervix is working on coming forward, there is so much that goes into that where now we’re going to have a baby. If that change was made, now maybe we can have a baby that was well-applied to the cervix creating good pressure. Uterine activity is getting stronger. Things are progressing in the right way.So in the ACOG thing, it does say that in contrast to the prior suggested threshold of 4 centimeters which we know is very outdated, the onset of active labor–Julie: Right, that was according to the Friedman’s curve. Friedman’s curve called active labor at 4 centimeters but now we are getting all of this new information that yeah, it’s probably at 6. I feel like when you and me started as doulas 9-10 years ago, it was 4 centimeters, but a couple years after that, everything started shifting into 6. So it’s actually not that new, but kind of new. Sorry, keep going. Meagan: Yeah. I want to get into our positions really quickly, but it does say even in here, the onset of labor for many women may not occur until 5-6 centimeters. May not occur until then and then we know that sometimes around 6 centimeters, it takes some time. We’re going to make sure all of these links here are in the show notes so you can check it out. Meagan: But we only have a few minutes left so I really want to talk about positions, okay? So positions in my opinion can truly change failure to progress. Julie: Yes. If there is a lull in labor, they’re getting close to calling a C-section, what can we do about that? Nobody wants to hang out at 4 centimeters forever. Nobody does so what can we do about that? Yes, Meagan? Sorry, go ahead. Meagan: Movement. If you do not have an epidural, obviously movement is a lot more free. Moving around, just walking. Just flat-out walking. If we’ve got a higher baby and we’re trying to get a baby down, really think about that femur rotation turning out. You can walk and sometimes I’ve had my clients do this little step dance thing where you step really wide and out and then left and right and left and right. We are doing this weird-looking dance thing, but you’re grooving. Julie: You’re grooving. Meagan: That can really help. Or thinking about really big asymmetrical movements so put your leg up on the bed or on a stool or on a whatever and leaning over. Bigger movements and outward movements. If you have an epidural at this point, same thing. Rotate on your side and really open those knees up really, really wide. Try to keep those movements consistent. If you’re exhausted and you have an epidural because you need sleep, I really, really believe in sleep and I think it’s very powerful. Find a good position. Sleep in that position and when you wake up, get going. Get active. But every 5 or so contractions, if you can, if not, make it 8, make some changes. It doesn’t have to be too dramatic. It sounds weird, but if you are at home, crawling up your stairs. Crawling up your stairs on your hands and knees is weird but it works or standing up and down going from the side– one side going down, standing back up, turning and walking back up, turning around, doing the other side down and coming back up. Those things are going to help. Doing big figure 8’s or hip dips. As the baby gets lower, all of those things are really still important. We are going to be less focused on big open wide because now we’re going to want to get baby in and then down. So if you think about a pelvis, when the femur rotation goes out, the bottom goes in. Femur rotation in, bottom goes out. Thinking about these movements as you’re laboring and as you’re working through these things, as you’re in these positions. Think about our hips, our pelvis, and even doing some cat-cows in labor is really good. We know there is the flying cowgirl. That is a really good one in labor too to get baby down and in. Julie: Walcher’s. Meagan: Walcher’s is not as fun, but it can be very good. Julie: It is magical. I’ve seen it push labor through so well. I had a doctor once at the U come in. I had a client who was 5 centimeters. Baby wasn’t looking too great. She had been 5 centimeters for a while and we were doing Walcher’s. They came in because the heart rate– Walcher’s sometimes makes it hard to get a fetal heart rate so the nurses come in. They were talking about C-section and they were prepping, bringing in all of the C-section stuff for her partner to get ready. They were like, “You can’t do this. Baby’s heart rate is not tolerating it.” I’m like, “No. It’s just not picking up the heart rate.” I’m like, “Okay, just one more contraction.” One more contraction later, she comes up and starts pushing 2 minutes later and her baby is born. the doctors are freaking out because, “Oh my gosh, the bed’s not designed to labor like this.” Not everyone, sorry, but those are a little couple of pushbacks I’ve gotten sometimes. Meagan: It’s weird-looking. It’s funky. It’s uncomfortable. Julie: Yeah. It’s curious and some staff at hospitals do not– if they see something new and they don’t know about it, they automatically assume it’s not good because they need to keep everything in line and to the protocol and all of those things. But yeah, it’s just really a magical thing. Meagan: There’s also the abdominal lift. You can abdominal lift. I think actively moving through the contraction which can get really hard in that active phase, but through the contraction can actually help. Hands and knees, sacrum, and all of those things. Holy cow, there are so many positions. Julie: Yeah, can I just touch back? When you said about the epidural, I love when you’re not resting, I think sometimes it’s easy to get discouraged if you want an epidural but you also want to move during labor. I want to expound on that a little bit because you can move with an epidural still and here’s how you do it. My favorite labor position with an epidural is sitting up in the throne. You lay the head of the bed all the way up, drop the feet down, then you crisscross your legs. Put the peanut ball under your right leg. Five contractions later, peanut ball under your left leg. Five contractions later, criss-cross your legs again or stretch them out straight and then repeat. Do you know what? There are so many magical ways that that helps. It keeps your pelvis moving and shifting and growing. I swear that is the most magical position for laboring with an epidural because you are upright. Baby is going to move down. The pelvis is moving and shifting so it creates lots of movement and space and I have seen that progress labors relatively quickly to how they have been going before we set up the throne so many times. I love that. I will swear. I will die on that hill. If you are failure to progress and things aren’t moving, sit up, drop your legs, get the peanut ball. It doesn’t even have to be the peanut ball. Maybe you don’t have one in your hospital but stack a couple of pillows but put one leg up. Put your foot flat on the bed so your knee is making a triangle. I don’t know how to describe it the right way and then drop it and put the other leg up and then criss-cross your legs then stick them out straight like two little sticks. Meagan: Every five. Every five, have subtle changes. Every five, subtle changes. Keep that in mind when you are laboring. Women of Strength, know that failure to progress is rarely truly failure to progress. We get it. We’ve been told the same thing. We see it all of the time as doulas. There’s more. There’s more and don’t feel like you have to say, “Okay” to a Cesarean if your cervix hasn’t dilated to a certain amount that the provider is wanting. Assuming you and baby are doing well, you can always ask for more time. Okay, we are on a soapbox. We could probably continue for a whole while longer, but Julie, thank you for joining me today and talking about failure to progress and what it is and what it isn’t. Julie: You’re welcome. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Hannah is a VBAC mom and doula with Ebb and Flow Birth Co. located in Indiana. Hannah’s first labor began very intensely. Her platelet levels were high enough for her to be able to get an epidural which she requested right away. She dilated to complete quickly, but after about 4 hours of pushing, baby just kept coming down and going back up with no progress. Hannah was exhausted and consented to a Cesarean. Unfortunately, her very effective epidural was not as effective during her surgery. It was painful. She required higher doses of medicine, hemorrhaged, and was so out of it that she remembers very little about her baby’s actual birth.After the birth of her son, Hannah researched birth options and did all she could do ensure she’d never have another Cesarean. Her VBAC pregnancy included thrombocytopenia again, partial placenta previa (which completely resolved!), marginal cord insertion, and she was GBS+. With a great team and supportive provider, Hannah was able to stay focused on her VBAC goal even with the curveballs thrown at her. She went into labor spontaneously, progressed quickly, and though her pushing stage mimicked the same patterns, with the help of her doula’s tips and freedom to move without an epidural, baby was able to descend and come right out!Hannah's Doula WebsiteWhat is Thrombocytopenia? ACH PublicationsPlatelet Transfusions ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, welcome. I hope you guys are having an incredible day. We have a guest today who has a VBAC story with a whole bunch of different things added to her journey. She has thrombocytopenia. Thrombocytopenia, I always say that wrong, which means low platelet count. That is definitely something that is more unique. It’s a little bit more rare, but if you’ve ever been told that you have low platelet counts or thrombocytopenia, this is definitely going to be an episode for you to listen to. She also had partial placenta previa and even marginal cord insertion. I am so excited for her to be sharing her story today. We do have a Review of the Week so I’m going to dive right into that and then we are going to get into her beautiful story. This review was just left on Apple Podcasts recently and it said, “I recently discovered this amazing VBAC podcast and I’m absolutely hooked. The host is incredibly knowledgeable and passionate about all things related to pregnancy, childbirth, and postpartum care. Each episode is packed with insightful information, personal stories, and practical tips for expectant mothers and families. I love how they bring on guests and experts to cover a wide range of topics making each episode engaging and informative. Whether you’re a first-time mom or a seasoned parent, this podcast is a valuable resource and empowers and educates. I highly recommend tuning in and soaking up all the wisdom shared on The VBAC Link Podcast.” I love this review and as always, I love them all. I love every single review, you guys. It is so amazing to get a notification in our inbox that a review has been left, so if you haven’t had a chance yet, please do so. Please leave us a review. Tell us what you think about The VBAC Link Podcast. You can do it on Apple Podcasts. You can rate us on Spotify or really wherever you listen to your podcasts. Or even Google– you can Google “The VBAC Link” and leave us a review there. As I always say, these reviews truly warm my heart but they actually really help your community and these other Women of Strength find this podcast and these stories. I encourage you to leave a review and tell us what you think so someone else can find this episode as well. Meagan: Well, welcome Hannah. Thank you so much for joining us. Seriously, you guys, I can’t tell you guys enough. Every time I have someone recording, I’m like, “Thank you for being here with me” because it takes a village and without all of your guys’ stories, this podcast wouldn’t be a thing. So thank you for being here, Hannah, and yeah. Feel free to share your stories. Tell the world what you feel like they need to know. Hannah: Yeah. Thank you so much for having me. I really appreciate the opportunity to share my story because both stories, I could talk about all day but also, I listened to your podcast consistently, constantly throughout the postpartum after I had my C-section and also during my VBAC pregnancy. With our first, I didn’t really have a different plan other than what my friends and family had done. I had planned to go to the highly recommended hospital in my area with a random OB that I just chose. The only real decision I knew I wanted specifically was that I knew I wanted to go unmedicated for my birth but I didn’t do anything other than general childbirth classes to actually prepare to birth unmedicated. I just assumed, “I’m going to go in and have a baby unmedicated and everything will be fine.” I didn’t do anything to prepare for that and my pregnancy was pretty uneventful. I was sick the entire time. I had borderline hyperemesis– not officially diagnosed, but I was very, very sick. The only other weird thing I guess that I wasn’t aware of before pregnancy was I had gestational thrombocytopenia where your blood platelet count gets lower. Meagan: Yes. We just heard about this on a recent story and I had never even heard of that before. Hannah: Yeah, I’ve had it with both of my pregnancies so I think my body just does that when I’m pregnant. The only thing that they had mentioned about that was there was a potential that you won’t be able to get an epidural if your platelets fall too low. I had wanted to go without an epidural anyway so I wasn’t really concerned about that, but again, I didn’t do much to prepare. At the end of my third trimester, around that 36-week mark, they had brought up, “Well, your baby is measuring potentially big.” They estimated him weighing 11 pounds. They were like, “If you want to schedule an induction at 39 weeks, you can. If not, that’s fine. It’s up to you.” My OB was really great about just presenting options and not forcing things to happen. She did say, “You can schedule one of you want to but you don’t have to.” I did schedule an induction for 39+5 or something like that. At 38 weeks and 39 weeks, I decided to get membrane sweeps. I got one at 38 weeks exactly and 39 weeks exactly. The day after I got my membrane sweep at 39 weeks, at 39+1, I went into labor. This was before my induction. I didn’t have to end up being induced, but my contractions that morning had started so fast and so hard that I was really thrown off. I was shocked because when I had talked to people, they said, “They’ll gradually build and they’ll gradually get closer together and stronger in intensity over a few days or whatever it may be.”Mine started. It just hit me like a train. It was really bad so I called my husband. He was already at work that morning and I said, “We need to go to the hospital now. I need to get an epidural right away.” Because they were so intense, I just thought, I’m really far into labor, clearly. We got to the hospital and we got into triage. They checked me and they were like, “Well, you’re about 3 centimeters.” I was just so annoyed. I was like, Okay. I’m only 3 centimeters. Whatever. We can stay because I’m obviously not coping well. I got an epidural right away as soon as we got back to be admitted. Thankfully my platelets were within range to get the epidural. Meagan: That’s awesome. Did you get platelet transfusions at all during pregnancy? Hannah: Nope. They just monitored them. They continued to decrease, but they didn’t drop below that epidural safety level but they were continually decreasing throughout my whole pregnancy. Meagan: Got it. I was curious. I’m always wondering what people with low platelets do if they do transfusions or not. Do you remember what the low number was, like the safety number?Hannah: Yeah, it kind of depends on the anesthesiologist, but for epidural specifically, they said anything below 100. I don’t remember the units. It’s like 100 something per milliliter or something like that. Anything below 100 would be considered not okay to have an epidural. Anything below 70 or 80 would risk people out of home birth which is another thing to consider. But yeah. Mine didn’t drop below that level. It was 105 when I checked into the hospital. Meagan: Awesome. What’s crazy is that less than 1% of people even have this condition. Hannah: Yeah, it’s very rare. Meagan: Yeah. Yeah. Well, good. So you’re 105. You’re getting good. You’re clear to get an epidural. Hannah: Yep. I get my epidural right away when we get back there and essentially, I just nap. My husband was really confused. He was like, “Well, I thought I was going to be doing more. I’m just sitting here,” because I just napped with a peanut ball between my legs. I progressed very, very quickly especially for a first-time mom and around 9 centimeters, I had been stuck at 9 centimeters basically not really long, but longer than I was for how fast I was progressing. When my OB came in, she said, “If you want, we can break your water just to get you to that complete state so we can start pushing.” I was like, “Yeah, fine.” I didn’t really know a difference so she broke my water and then I got to 10 really, really quickly but I labored down for quite a while just because my OB was back and forth between seeing patients in clinic and then coming to see me because she comes to your birth whether she’s on call or not which is nice. I labored down for a while and then started doing practice pushes or whatever with the nurse. My epidural was so strong. I felt absolutely nothing. I didn’t feel a sensation to push, an urge to push. I didn’t feel pressure– absolutely nothing. Me trying to push was not effective whatsoever. I pushed for about 4 hours before we ended up opting for a C-section because my son was just coming down and then going back up, coming down and going back up and of course, I was in that semi-reclined, pretty much on my back position so gravity wasn’t really helping me at all. He just was not coming out. The nurse and my doctor had mentioned, “We think he’s asynclitic,” where his head was tilted to the side and he just wasn’t coming out. I was just exhausted and annoyed so we opted to have the C-section. That was really shocking to me. I was a little thrown off because C-section was never on my radar. It’s not something I really prepared for or thought about. I just thought, C-sections happen in emergencies. I was fine. My baby was fine. We were both stable and had no problems. It was just that I had been pushing for a long time so I felt really confused on why it was happening. But the hard part for me was once the C-section started is when things really took a bad turn for me emotionally and physically. My epidural like I mentioned was super, super strong, but when the C-section started, I could feel a lot. I felt a lot of pain, not just the pressure they had mentioned. I was really, really in pain. I had told my husband, “There’s something wrong. I can feel way more than I believe I should be feeling.” He told the anesthesiologist and they gave me some additional medication. I don’t know exactly what it was, but whatever they gave me, I fell asleep for a little bit. I wasn’t under general but I dozed off. Meagan: Yeah, it made you sleepy. Hannah: Yeah. I don’t remember when my son was born or meeting him or hearing him cry because I was just so out of it. When I woke up however long that was, time was just not in my mind at that moment, but I remember my husband saying, “Babe, it’s a boy,” because we didn’t know if we were having a boy or a girl. That’s all I really remember from the OR itself. Then in recovery, in the recovery room, my blood pressure dropped. I was going hypotensive. I apparently had hemorrhaged more than they would have liked for a C-section which is understandable with low platelet counts so they were trying to get me stable because I was essentially on the verge of passing out. Everything was blurry and my main concern while all of this was happening was having my son breastfeed. I told my husband, “They’re going to work on me. Just get him to nurse,” so he was holding my son to my chest so he could nurse while they were trying to stabilize me. It took them quite a while to get my blood pressure back up and to get everything fine, but thankfully, I didn’t need any transfusions or anything like that. The whole postpartum experience, everything from C-section on was just really difficult to deal with and process at that point but that’s kind of how everything ended up with that one. Then I knew from then on if I had any other kids, this can’t happen again. I have to do something different. Meagan: Did they talk to you about anything like, “Okay, for your next birth, if you choose to have one, you can have a VBAC”? Did they counsel you at all after that? I’m always curious if providers do. Hannah: Yeah, so my OB specifically– I told her, I was like, “If I have more kids–”, because I had never heard the term VBAC. I didn’t know that was a thing. I just thought, Oh, you can have a C-section but you can go on to have kids vaginally later. I didn’t realize it was such a big deal until I started looking into it and asking around about it. At my postpartum appointment, I talked to my OB about it and she was like, “Well, yeah. That’s fine. There are no issues with that. You would be a great candidate for it.” It was like, okay. That’s what’s going to happen if I have more kids. From postpartum on, I started researching. Meagan: Awesome. So what did you find in your research? Hannah: The first thing I did was look up obviously what VBAC was. I didn’t really know then I started listening to podcasts and reading and reading book and listening to stories. I came across your guys’ podcast which I honestly don’t know how I found it. It was 5 weeks postpartum and I had never really listened to podcasts before. I found it and I found several others and started listening. Then one of the big things I looked at was, okay. What happened in my birth that potentially contributed to this? How can I avoid this in the future or make it a better experience? One of the big things was that I got my hospital notes and my op report and everything from when we were in the hospital just to understand fully what happened because they don’t explain every single detail of what’s happening to you unfortunately in most circumstances. So I wanted to see all of the notes and everything that happened down to the minute that was in my chart which really helped me understand what happened, process it, and heal that. Then for me, when I was looking at why I had my C-section and all of that, when I was looking at things about VBAC, it was like if these things happen to you like a failure to progress or the baby wouldn’t come out like CPD, the cephalic pelvis disproportion, then the chance of you having a VBAC are not great. I was like, Well, that’s discouraging. Then the more I got to the research, the more I realized that my birth specifically was likely a cascade of interventions starting with my epidural for me. That’s how I personally feel. Some people would say that’s not the case but that’s how I personally feel. I knew going into my next pregnancy that I would do things drastically differently to set myself up for the best possible chances of having that VBAC. Meagan: Yeah. I love that. It sounds like you were starting in all of the right places. Hannah: Yep. Meagan: So baby number two– Hannah: Yeah. We decided. 8 months postpartum, I was like, “Let’s have another baby.” I feel like with both my pregnancies and both my postpartum, around that time, I just get baby fever and then I am thankful that I don’t get pregnant at that time. We got pregnant with my daughter about 20ish months after I had my son. That wasn’t specifically chosen for VBAC intervals or anything like that. We just weren’t ready to have another kid yet. So I got pregnant with her and I had interviewed doulas before we even conceived because in my area, they book up really, really fast, especially the more experienced ones. I specifically looked for a doula who had a lot of experience supporting VBAC. Then I also looked into different birth location options. I had first looked into a birth center and out-of-hospital birth center, but where I am in Indiana, it’s illegal and against the law to have a VBAC in a free-standing birth center. I was upset about that at first, but then I looked into some home birth midwives as well as hospital providers. Home birth midwives– the only one I could find in my general close area was about two hours away and the ones who were closer to me wouldn’t support a primary VBAC so if you had never had a vaginal birth either before your C-section or had a VBAC before, they wouldn’t support you which was really discouraging. With how fast my labor progressed the first time around, I just didn’t want to travel that far for appointments or having my midwife have to travel that far for the birth because you just never know how fast it’s going to be. The thing about my first birth, my OB was amazing. She was not the type of OB who would try to coerce you to do anything. She was always very supportive of whatever I decided to do. She was very supportive of VBAC but I did also interview some hospital providers, some midwives, some other OBs and ultimately, I decided to stay with my OB because I felt really comfortable with her. I felt confident in her. She had no stipulations surrounding VBAC at all. The only other OB I did interview was an OB who would do vaginal breech birth because that’s one thing my OB would not do and I was like, If I have a breech baby, I’m not having a C-section so I’ll go to this other OB if that ends up being the case. Meagan: Okay, you’re in Indiana.Hannah: The Indianapolis area. Meagan: Did you find it hard to find that provider? Hannah: Yes and no. Yes because he’s the only one in our area who supports vaginal breech and no because my doula and a network of doulas who I converse with now all recommended him because they know that he’s the only one in the area who would do it. Meagan: Do you care to share his name just in case we have someone breech listening? Hannah: Yes, so his name is Dr. James Webb and he’s on the verge of retiring. Meagan: No! That’s the problem. Hannah: Yeah. He is very particular about what hospitals he’ll deliver at and all of that, but he is the only one currently in our area who will do it so if he doesn’t happen to be retired at the time of this episode coming out, you can look into him as an option. Meagan: Yeah, awesome. That is the hardest part is we are seeing so many people who do supportive breech VBAC or just breech in general are retiring. They are closing doors and that’s the hardest part. Okay, sorry. So you did an interview with him. Hannah: Yes. I had him as a backup just in case baby did end up being breech. Then my pregnancy again in general was fine. I had gestational thrombocytopenia again. I was not as sick the second time around which I was very, very thankful for. The only other weird things that came up were I was GBS+. I was negative for my first pregnancy and then I had a partial placenta previa at one point which at first concerned me but then once I realized that they usually resolve as your uterus grows, then I wasn’t too concerned about ending up with another C-section because of that. I also, my baby was breech at one point. Meagan: Oh my goodness. Hannah: I know. I was like, All of the things that could happen did happen. But I didn’t let it discourage me. I just kept going on and doing what I needed to do. The big difference in my preparation that I did the second time around because I knew for my VBAC I wanted to be as low intervention as possible. I knew I wanted to go unmedicated. I had my doula so I took a program called HypnoBabies which is a type of hypnobirth for those who may not know. It’s a medical-grade hypnosis so I consistently practiced with that throughout my whole pregnancy. I did some breathwork and progressive relaxation videos and stuff like that to make sure I was really mentally prepared to go unmedicated because I feel like that aspect of birth is so much more mental than it is physical. That’s where I really wanted to be prepared for that part. Meagan: Mhmm, nice job. Hypnobirthing is really common here in Utah. I wouldn’t even say common but a favorite education course and we actually have a blog about it because so many people love it. It really can put you in such a great head space. Hannah: Yeah. I know it doesn’t work for everyone, but what was more beneficial for me was that I didn’t just go through the course in the last 6 weeks of pregnancy or something like that. I consistently practiced throughout my entire pregnancy to make sure it became a habit or something that I was normally used to doing. I did that primarily to prepare for birthing unmedicated and then I also did pelvic floor therapy to help with my C-section scar and my ability to push because pushing was such a difficult time for me the first time around. I really wanted to know what muscles to use and how to actively engage and push if I needed to. Meagan: Awesome. Hannah: I did a lot of different things to prepare the second time around. But then at the end of pregnancy, I did not get any cervical checks. I didn’t get any sweeps because I knew it would just mess with my head space. It would discourage me if I was dilated or wasn’t dilated and I knew that my dilation wouldn’t determine when I was going into labor. I didn’t schedule an induction either. I was just going to wait for my baby to come when they wanted to come and my OB was fine with that which was great. The only thing I did do was– I didn’t have to end up doing this, but if I went past 41 weeks, I was going to get non-stress tests. But we were find waiting for things to happen. I went into labor spontaneously at 40+2 and– oh, I forgot to mention. Sorry, I’ll back up. I did have a marginal cord insertion with this baby too so all of the things where the cord was on the side of the placenta instead of the center. The issue there could potentially be a lack of blood and nutrient flow to the baby which could cause growth issues. Meagan: IUGR, yeah. Hannah: We did monitor that a little bit more, but there were no issues with her growth or her percentile or anything like that so that was never a concern of her being too small or too big or anything like that. But I went into labor the morning of 40+2 and it didn’t start how I expected or anything like my first labor. I had excessive bleeding and no contractions. I was really confused. I was like, Why am I bleeding so much? It was more blood than I felt comfortable with. A lot of times you have a bloody show or something like that with your mucus plug, but this was filling pads. I called my doula. I called my doctor and they were both like, “Yes, just go in.” My plan was to labor at home as long as possible, but because it started that way, I was like, Okay, I’m going to the hospital. Meagan: Mhmm, and the previa had completely resolved? Hannah: Yes. Yes. It was still low-lying, but it wasn’t covering the cervix at all. With the amount of blood, I was like, Well, this is a little concerning. I did go into the hospital right away and went to triage because their main concern was a placental abruption with how much I was bleeding. Meagan: That’s one of the things I was thinking too. Could it be a placenta thing? Hannah: They put the monitors on us. They checked everything and we were both fine. There were no issues. The bleeding ended up resolving and they couldn’t exactly tell where it was coming from. At the time, I was about 4 centimeters dilated when we got to triage and I had planned because we were both fine, I was like, Well, I’m going to go back home then, but we had to stay to be monitored for about an hour just to make sure nothing else came up or things didn’t take a turn or something like that. Within that hour, I had already began to dilate more. I was already 5 centimeters and at that time, I started feeling contractions so I decided, Okay, we’ll just stay. We’re already here. With the bleeding, I felt a little bit more concerned so we just stayed. I told my doula I would just text her and keep her updated. We got back to be admitted and because I was GBS+, I did choose to get the antibiotics. I got that round of antibiotics and then had them unhook the IV because I wanted to be as mobile and as free as possible. Thankfully, my hospital had wireless monitors so I was able to move around. I didn’t have to tote around a monitor or be stuck to the bed or anything like that. After the antibiotics went through, I was going to lay down and listen to my Hypnobabies tracks and just rest because my contractions weren’t intense or anything like that. I was super, super uncomfortable laying down. I needed to be up and moving. I tried and I was just annoyed with my headphones and annoyed with the tracks and everything. I was like, I need to be up and moving. At that point, I was getting ready to get up and my water broke on its own which was different for me because it did not break on its own with my previous birth. My water broke and again, I was around 5 or 6 centimeters at this time. It was definitely my water and they made sure. It was gushing out so it was definitely my water. After that point, I just felt like I needed to be on the toilet. I went to the bathroom and sat on the toilet and my husband got me cool washcloths and was wrapping my shoulders. I was just swaying back and forth on the toilet. Quickly, within 30 minutes, I was getting hot and sweaty. I was shaking. I was doing the horse-lip breathing and my doula wasn’t there yet. I had texted her right before I went to the bathroom to tell her, “Things are getting more intense. You should probably head this way.” I hadn’t been there more than 2 hours so she was like, “Okay, yes. Okay, things are picking up. I’ll be on my way.” When I was on the toilet and I was starting to sweat and shake, I was clearly in transition. I knew that in my mind. My nurse knew that. My husband realized that. At that time, I was like, “I need an epidural.” I told my husband that and he was like, “But you’re doing so well. Let’s wait for Julie (my doula) to get there and see what she suggests.” I just felt like I couldn’t do it. Then my nurse was really great about just leaving us alone and letting us do our thing. She came into the bathroom to check on us like I said about 30 minutes later. I told her, “I think I need an epidural.” At this time, I did not have an IV hooked up. She had mentioned, “Well, it’s at least going to take 20 minutes to get the fluids in you to even be able to do an epidural.” She knew and she was clearly trying to stall me. Meagan: Yeah, I was going to say, I think that nurse knew something you didn’t know. Hannah: Yes. Looking back in my mind, I knew but I was just in denial. I didn’t really want the epidural but at that moment when you are in transition, you’re just like, I can’t do this. Two minutes later, my doula walks in and I told her the same thing, “I think I need the epidural.” She was like, “How long have you been on the toilet? Have you switched positions lately?” I said, “Well, now I’ve been here about 30-45 minutes.” She said, “Let’s try getting in the shower and see if that just helps things ease up or change or whatever.” I was so reluctant to get off the toilet because I was so comfortable and in my zone but I did. I got in the shower and as soon as I stood up and got in the shower, I was bearing down and pushing. I was hanging onto my husband’s neck and my doula was putting water on my back and the nurse heard me grunting and bearing down and she came in and was like, “Are you complete? We need to make sure you’re complete just to make sure you’re not pushing against a not complete cervix.” That was one of my concerns too. I was unmedicated so I felt the urge to push obviously, but I didn’t want to be in that case where my cervix would swell or something like that. But I was complete and I had just a slight lip or whatever. My doula just suggested maybe we get on hands and knees to help relieve that lip or get in a different position to even everything out. I got on the bed and got on hands and knees. At this point, I’m just pushing. My body is pushing. I have no control over it. It’s happening regardless of whether my cervix is complete or not. I was on hands and knees sitting on the back of the bed. My husband was cooling me down with washcloths and rubbing my back. My doula was doing the same and taking pictures and watching me push to see how baby’s movement was. I pushed on hands and knees for about 10 minutes and again, my baby was coming down and coming back up and coming down and coming back up which was discouraging because that’s what happened the last time. Then my doula said, “How about we try a squat to see if that helps with gravity working in getting your baby out?” I was so tired at this time. I was like, “There’s no way I can hold myself up in a squat. This is not going to happen.” But we got the squat bar. I got in the squat. My doula and my husband were both supporting me. Within 5 minutes, probably two or three pushes, my baby was out. We didn’t know again if it was a girl or a boy. She came out so fast and my doula was trying to get me to do the blow breathing to control and slow the pushing but I was not. I was like, “Get this baby out,” because I knew pushing was going to be the hard part for me to get past because it was four hours with my C-section baby. My doula knew that as well so she was trying to give me that extra support to make pushing a good experience. I let it fly and I was like, “Nope. This baby is coming out now. I don’t care how fast she comes out. I don’t care if I tear or whatever. I just need to get her out.” So she did. She came out and it was so funny because I had the squat bar and I was trying to pull her to my chest. My doula had even mentioned this in our prenatal prep. If you use the squat bar, the umbilical cord is still going to be attached so go under the bar and not over the bar. I tried to go over the bar of course. They were trying to get me all untangled and stuff but I was so happy she had come out that I didn’t even look to see if she was a boy or a girl. I just forgot to check. She was a girl and we were so, so happy and so excited. I was just in disbelief that I had done it. It happened so fast that I didn’t really have time to process what was happening. It was 4.5 hours total. Meagan: Oh my gosh. Hannah: Yeah. From the first contraction I felt– so not when the bleeding started, but from the first contractions I felt to when she was born was 4.5 hours. Meagan: Holy smokes. Hannah: Yeah, that’s almost a precipitous birth and I don’t know what just happened. It was just a rollercoaster and intense with no breaks whatsoever. But we were so excited. So excited. Meagan: I bet. Oh my gosh. When you said almost precipitous labor, to me, that is still very precipitous. 4 hours really from the start to the end, that is so fast. I have had a couple of clients like that. Sometimes I’m just like, “How does your cervix just do that?” Because from a mom who had a 42-hour long labor, it’s like, what? We envy a lot of you precipitous birthers, however, I will point out that when precipitous birth happens, it’s typically super intense. Hannah: Yes and you don’t have a break. It’s just constant intensity. Meagan: Yes. It’s so hard because people have said, “Oh, I’d rather have a fast labor than a long labor.” It goes both ways. They want a fast labor, but I’m like, you have to know that it is very, very, very intense. It usually starts right out of the gate. When I say right out of the gate, I can picture a rodeo with a cowboy on a bull and the second the gate opens, the bull is just bucking, right? Hannah: Yes, because as soon as–Meagan: That is what reminds me of precipitous labor. Hannah: As soon as I felt contractions, I went from feeling nothing that morning to feeling like my whole body was contracting. It was just very intense so I don’t know. I think both have their pros and cons, long labors and short labors. Meagan: Absolutely. Absolutely. Yeah. I’m glad. Precipitous labor for a first baby is common from what I have seen in the doula world of supporting hundreds of babies and lots of moms with precipitous labor. It is common to happen the next time. So even if you didn’t have bleeding, you probably would have gone in sooner rather than later too. Hannah: Or I would have ended up with a car baby because if I hadn’t been bleeding, I would not have gone to the hospital. I would have been fine. My plan was to labor at home as long as possible. Meagan: So you could have had a car baby or a front door baby. Hannah: Yeah, or just somewhere that is not in the hospital baby because it was too fast. Meagan: Yes. Oh my gosh. You are amazing and it is interesting. I’m so curious. Did the doctors say why they think that you developed low platelets? Do you have that normally? Hannah: No, I don’t. Meagan: You said gestational so I’m like, She must be meaning just during pregnancy. Hannah: Yes. Some people have it in general without being pregnant. Other people develop it just when they are pregnant. They don’t really know exactly why. I think there are things you can do to help that and help increase those platelet levels other than getting transfusions or whatever, but they didn’t really know why. I mean, I’ll be interested to see if I have a third to see if I have it again, but I think it’s just what my body chooses to do. Meagan: Yeah. Interesting. Well, I’m so happy for you. Huge congratulations. Hannah: Thank you. Meagan: I don’t know if you’re going to have a third, but I assume you’ll probably have a wild ride as well and you’ll have to let us know how it goes if you decide in the future to have one. Hannah: Yeah. It will probably be the wildcard. Meagan: I know. You know, that does happen. I swear baby number

Lauren has had three very different births. She had a peaceful C-section due to breech presentation with a difficult recovery, a wild, unmedicated VBAC, and a calm, medicated 2VBAC. Due to her baby’s large size, she had to have an extra incision made during her Cesarean leaving her with a special J scar. Though her provider was hesitant to support a TOLAC with a special scar, Lauren advocated for herself by creating a special relationship with her OB and they were able to move forward together to help Lauren achieve both of her VBACs. Lauren talks about the importance of having an open mind toward interventions as she was firmly against many of the things that ended up making her second VBAC the most redemptive and healing experience of all. How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, hey everybody. Guess what? We have our friend Lauren and her 11-day-old baby. Is that right? Lauren: Yeah. Meagan: 11 days old. You guys, I actually didn’t even know that this baby existed until we popped up on the Zoom and she was holding this precious little newborn. She was like, “Surprise! I had another VBAC.” So we will be sharing, well she will be sharing her two VBACs so 2VBAC and something kind of unique about Lauren is that she has a special scar, a special J scar, correct? Lauren: Yep. Meagan: Yeah, so that happened in her first C-section. If you are listening and you have a special scar or have been told that you have a special scar, this is definitely an episode that you are going to want to put on repeat and save because I know that there are so many people out there who are told that they have a special scar and that they should never or can never VBAC again. I know we’re not even getting into the story quite yet, Lauren, but did you have any flack with that? Did anyone talk about your special scar at all? Lauren: Yes. Advocating for the VBAC is probably the overarching theme of my VBAC because I really had to go to bat for myself for that without switching providers. Meagan: Yeah. We know that’s so common. We see it a lot in our community just in general trying to get a VBAC let alone a VBAC with a special scar. We are going to get into her story but I have a review and I didn’t even know that this was a review. It was left in a Baby Bump Canada group on Reddit actually so that was kind of fun to find. It’s really nice. It says, “Seriously, I’m addicted. I find them so healing. I had an unplanned and very much unwanted C-section and I have been unknowingly carrying around all of these emotions and trauma about it since. I thought I was empowered going into my first birth, but I wasn’t strong enough to stop the medical staff with all of their interventions. Don’t get me wrong, I believe interventions are necessary in some instances. But looking back now, I realize those interventions were put in place to make things easier involved in delivering my baby. Anyway, I won’t get into all of that here, maybe in a separate post. The point of my post is checking out The VBAC Link podcast. I listen to them all day now while caring for my babe. They also have a course you can take focusing on preparing for VBACs. Even if you just like birth stories, they have CBAC stories I believe as well. On the podcast, a guest also pointed out that what do you want for a VBAC birth– peace, redemption, etc.? She talked about how you can still feel those things if you need a Cesarean.” I love that point of view right there that you can still have peace and redemption even if you have a scheduled C-section or if your VBAC ends in a Cesarean. It says, “Another mom pointed out when she was feeling hesitant about saying okay to a C-section, her midwife said, ‘You have permission to get a C-section,’ not in a way that a midwife was giving her permission, but telling this mom, ‘C-section is okay and you shouldn’t feel like having one is wrong.’ My baby is 8.5 months and we aren’t going to try for a baby until they’re about 18-24 months mostly to increase my chances of VBAC, but I really love these podcasts.” Then she says, “Okay, I’ll stop raving now.” I love that. Her title is, “If you’re considering a VBAC, I highly recommend The VBAC Link.” Thank you so much to– I don’t actually know what your name is. Catasuperawesome on this Baby Bump Canada group. Just thank you so much for your review. As always, these reviews brighten our day here at The VBAC Link but most importantly, they help other Women of Strength find these stories like what we are going to be sharing today with Lauren’s story. They help people feel empowered and educated and motivated and even first-time moms. They are really truly helping people learn how to avoid unnecessary Cesareans. I truly believe that from the bottom of my heart. Meagan: Okay, Lauren. As you are rocking your sweet, precious babe, I would love to turn the time over to you to share your stories. Lauren: Awesome, thank you. It’s so nice to be here finally. I’m so excited because this podcast truly is the reason why I had my VBAC. I am kind of weirdly unique in that I didn’t really feel like I had any mothering instincts. My husband and I had been married for 6.5 years before we decided to get pregnant because I always swore off children. I said, “It’s not for me. I’m never going to have children. I want to travel and I want to do all of these things and children are for other people. I can’t imagine myself as a mom.” My husband said, “Well, let’s wait until we are 30,” because we got married really young. He was like, “Let’s just wait until we are 30 and we will revisit the discussion.” I always find it kind of nice when I hear stories of women who feel similarly to the way I did because it’s so relatable and I feel like we are very few and far between. That’s another reason I wanted to share my story because I know there are other women out there like me. So anyway, it just so happened that at this time, my sister was pregnant. My brother was pregnant. My husband’s brother was pregnant. We were like, “You know, we’re almost 30. We’ve waited a long time. If we’re going to have kids, we might as well have a kid when he or she is going to have all of these cousins.” My husband was like, “Let’s start trying.” I’m like, “Great. I’m going to give it two months and if we don’t get pregnant, we’re not going forward with this. I’m going to say I tried and I can tell everyone I tried and that it didn’t work.” Well, God has a sense of humor because two weeks later, I had a positive pregnancy test. Meagan: Two weeks later? Lauren: Yes. Meagan: So you were already pregnant when you had this conversation. Lauren: I was already taking birth control. I was multiple days into the pack. I just threw it in the trash and was like, “Let’s just see what happens.” I guess when you do that, you can get pregnant. I don’t know. I didn’t really have a cycle. I got pregnant. I was so naive about how it all worked. I’m like, “Okay. The test is positive. I’m pregnant. It is what it is. I’m very much pregnant.” I had not doubt. I had no worry about miscarriage, nothing because I had a positive pregnancy test. That’s sort of how I went through my pregnancy, kind of disconnected, very naive, and a little bit in denial that I was actually pregnant all the way up until the end. I read one book and it was called The Girlfriend’s Guide to Pregnancy and it’s this really sarcastic, funny book. She’s very flippant about pregnancy and very straightforward with my sense of humor. I liked it because I felt the same way. I wasn’t mushy or emotional. I had no connection to the pregnancy. I am pregnant. That’s a fact. Anyway, at 26 weeks, my doctor was like, “You know, I think he’s breech.” I was like, “Okay.” I knew what breech was, but I’m like, “Okay, what does that mean?” She was like, “Well, I would start doing some Spinning Babies exercises. Let’s just keep an eye on it. I was going to a chiropractor this whole time. This is important for people to know. I was going to a chiropractor before I even got pregnant regularly. This chiropractor was seeing me. I told her that the baby was breech. “Can you help me flip him? Can we do some bodywork?” I continued to see her. I don’t know if it was once or twice a week but it was often. 36 weeks rolls around and I see the midwife in the practice. She is not finding the heartbeat where it should be. She finds it up higher and she goes, “Lauren, I think your baby is still breech.” I thought there was no way. I had been seeing a chiropractor. I had been doing body work and stuff. She was like, “Well, why don’t you go see the chiropractor that our practice recommends?” I’m like, “Okay.” I call this chiropractor on the phone. I leave her a message and I’m like, “I’ve been seeing another chiropractor, but my baby is breech.” She immediately called me right back and she was like, “What has the chiropractor been doing?” I’m like, “It feels like a normal adjustment like nothing different from before I was pregnant.” She was like, “So you’ve been on your side and she’s been twisting your back and your pelvis away from each other?” You know how they do those kinds of adjustments? I said, “Yes.” She was like, “Oh my gosh.” She’s like, “How soon can you come see me?” I started seeing her. My OB actually also recommended moxibustion. She got me set up with an acupuncturist in the area which I thought was really cool that she was like, “Some people say they swear by this. You need to do more Spinning Babies. I want you to go to acupuncture.” I saw this chiropractor and she was like, “What that chiropractor is doing to you is not pregnancy-safe. She’s not Webster-certified and you needed to be seeing a Webster-certified chiropractor.” That’s one of my regrets because I feel like had I known, obviously, I can’t say I blame her 100%. I was also working out a ton because I’m like, “I don’t want this pregnancy to change my body. I’m going to be skinny.” That’s all I cared about so I’m sure I was holding my abdominal muscles way too tight too. I’m sure I contributed to it as well, but just knowing that probably was a major contributor to what ended up happening to this day irritates me. But anyway, he never flipped. He was solidly in my ribcage. He never moved. I would push on his head and he would not even budge an inch. My doctor was like, “You know, I would normally recommend an ECV, but he seems very wedged in your rib cage. He’s stargazing,” which means his head is tilted up. His chin is pointed up. She said, “You are on the low end of normal for amniotic fluid.” She was like, “You have these three strikes against you basically. We can try it if you want to try it, but I’m going to say it’s probably not going to work.” I had to wrestle with that. I ended up calling my husband’s aunt who is a labor and delivery nurse for 30 years. I asked her for her opinion. I’m like, “Have you ever been in on an ECV? Tell me about it.” Naively, I went with her advice. She said, “If your doctor is not confident, then that means it’s not going to work.” She’s like, “I’ve seen so many births and I believe that every baby should be delivered via C-section because birth is dangerous and it's scary.” I’m like, “Okay, okay. I’m just going to move forward with the C-section. I’m so glad I talked to you.” Meagan: Whoa. Lauren: We scheduled the C-section and you know what? It really wasn’t that big of a deal. My friend’s husband was actually my anesthesiologist. My doctor was there. It was very happy. It was very pleasant. I had gone out to dinner with my friends the night before. If you could plan the perfect C-section, it was the perfect C-section. I just talked to my friend’s husband the whole time. Again, not connected to this pregnancy at all. It was very much like, “Okay, a baby is going to come out. What is this going to be like?” I remember the doctor held him up over the curtain. I made eye contact with him and I was like, “Oh my gosh. I’m a mom.” The nurse was like, “Do you want to do skin-to-skin?” I was like, “What’s that? Sure.” “Do you want to breastfeed?” “I think so. Sure.” Very naive. What ended up happening was that the recovery was just really tough. The surgery was great, but I did not expect the recovery to be so tough. I feel like the way people speak of C-sections is so casual. “Oh, just have a C-section. I had C-sections for all my babies. It’s no big deal. It’s a cakewalk.” That’s the mindset I went into it with. Same with my husband because I reassured him, “It’s no big deal. We’re just going with the flow.” No. It’s awful. It’s major surgery. I’m allergic to– I think a lot of people are– the duramorph that they put in the spinal so I had the most severe, horrible itching for 24 hours to the point that they basically overdosed me on Benadryl because I could not cope and my vitals were crashing. I was barely having any respiration. They had to shake me awake and put cold washcloths on my head. They were like, “Hello,” because I was having such a hard time with the itching. Not only that, but the pain. It’s painful. In my surgery, backing up a little bit, the doctor said, “Wow. He’s really wedged in there and he’s a lot bigger than I expected. I thought he was going to be maybe 7.5-7.25 pounds.” She goes, “He tore your incision coming out because he was so big.” She was like, “You have a J incision now so your incision goes horizontal and then vertically up.” She said, “Unfortunately, that means you’ll never be able to have a VBAC. You’re just going to be a C-section mama.” I was just lying there like, “Whatever. You’re asking me what skin-to-skin is and breastfeeding and no vaginal births.” It was just a lot of information to process and take in and make decisions about. He ended up being 9 pounds. He was a good-sized baby. Anyway, that was my c-section experience. I know I’m probably one of the lucky few who could say that their C-section was so peaceful, really no trauma from it. I just thought, “I’m fine with that.” I watched my sister have a failed TOLAC and it looked kind of traumatizing and she was still traumatized from it just a couple months before my C-section so I’m like, “It’s fine. I’ll just be a C-section mom, but that recovery was terrible so I’ll have one more baby and that’s it.” I’m not going to have any more kids. I don’t want to experience that again. That was May 2019. Fast forward to COVID times. We were thinking about getting pregnant before my son turned one but COVID hit so we were like, “Let’s just give it a couple of months and see what shakes up with this pandemic.” The world stopped. I’m in real estate so for a while, we weren’t allowed to show any property or do anything so I just was sitting at home doing nothing. I remember one night, I was just sitting there doing a puzzle bored as heck and I’m like, “I’m going to go listen to a podcast while I do this.” My phone suggested The Birth Hour. I hope I’m allowed to say that. Meagan: I love The Birth Hour, yes. Lauren: I was scrolling through the episodes and there was one on VBAC. I’m like, “Okay, I’m going to listen to this.” The interviewee mentioned The VBAC Link so I was like, Okay, I should check that podcast out. I was like, Why am I even listening to this? This is so not my wheelhouse, childbirth. I still didn’t care about it, but listening to these podcasts opened up a whole new world for me. I’m so glad I found it all before I got pregnant. I started listening to all of those podcasts then I think I found through your podcast. I don’t think it was The Birth Hour. Someone mentioned Dr. Stu so I started listening to his podcast and man, that guy set fire. He had so much great information. I listened to every podcast pretty much that he had done, especially the ones on VBAC because he talks about VBAC a lot and just how it really shouldn’t be a big deal or shouldn’t make you high risk and all of that. At the time, he was still graciously reviewing people’s op-reports for them and now he doesn’t do that. I think you have to pay for it, but I emailed him. I reached out to him and I emailed him my op report and I just said, “If you could look at this, my provider told me I wasn’t a VBAC candidate but I want your opinion.” He got right back to me and he was like, “There’s no reason you can’t have a VBAC. This scar is really not that big of a deal. Yes, it’s a special scar, but it shouldn’t take away from your opportunity to TOLAC.” I ended up getting pregnant in the fall of 2020 and I went to my first appointment and my OB was like, “What do you want to do for your birth this time?” I’m like, “Did she forget what she told me? She must have forgotten.” I was like, “I want a VBAC.” She was like, “Okay, I’ll give you my VBAC consent form and we can talk about it as your pregnancy progresses.” I’m like, “Okay, cool.” I saw her again at 12 weeks and she was like, “I’m having some hesitations because you had such a big baby and your scar is not normal. I think we need to talk about this a little bit more but let’s not worry abou tit now. We can put it off and worry about it later.” I was like, “Okay.” I was so bummed because I love my OB. Funny story, I met my OB when I was worked for a home design company called Pottery Barn and I met her one day just helping her buy pillows. I’m like, “What do you do for work?” She was like, “I’m an OB.” I’m like, “Cool. I need an OB.” I had just moved to the area so I just started seeing her. I think I was one of her first patients so she knew me. It wasn’t like she was a friend and a provider I only saw once a year, but we always picked up where we left off. We had a good relationship. I really did not want to change providers. I don’t want this to sound like I was being manipulative, but I was like, I’m just going to really lean into this good relationship we have and just try to win her over. As the pregnancy progressed, at the next appointment I think I saw a midwife. I talked to the midwife about the VBAC and my OB’s opinion and she was like, “I’ve seen a lot of women VBAC with a J scar at my old practice. I don’t think it’s a big deal, but I’ll talk to the doctor for you and hopefully, we can figure this out.” I was like, “Okay.” Then I want to say I went to my 20-week appointment and they told me, “Okay, your baby is gigantic.” They said, “He is going to be between 9 and 10 pounds,” because he was measuring two weeks ahead. They said, “But the other concern we have is that you have marginal cord insertion and that could make for a small baby.” I’m like, “Okay, so is he big, or is he small?” Clearly that marginal cord insertion is helping him not being 12 pounds? What are you trying to tell me? They’re like, “Either way, we suggest that you come back at 32 weeks. We have concerns about his size. He might be a tiny peanut. He might be enormous.” I’m like, “I think I’m good. Thanks, but no thanks.” Thanks to you guys, you push advocation so much that I’m like, “This doesn’t add up. You can’t tell me that he’s too big and too small. I’m just going to go with fundal height and palpation if my doctor has a concern, we’ll come back.” I never scheduled that growth scan. I was very protective of this pregnancy. I didn’t want any outside opinions. I was so afraid that if I went and had this growth scan, I would be pushed to do a C-section. I wanted an unmedicated birth. I was terrified of the hospital. I was listening to so many podcasts all day every day. It was like an obsession so then I told Meagan before we were recording is that I felt like I was almost idolizing the VBAC. It was all I could think about. It was all I could talk about and it became this unhealthy obsession. Right around 25-26 weeks, I decided to hire a doula and move forward with the VBAC. It didn’t matter to me what the doctor said. Right around that time, I was having some hesitations. Just getting that pushback from my doctor and knowing he was big, I started to let the fear creep in. I told my husband, “You know what? Maybe we should just do a C-section. I think I’m overanalyzing this so much. I’m just going to push aside this research I have done because clearly I’m obsessed and it’s consuming me.” Meagan: Yeah, which is easy to do. Just to let you know, it really is easy to let it consume you. Lauren: It totally is. I think that we have to take a step back sometimes, come back to reality, and if you let the information override your instincts which I think is really easy to do, I think you can get too wound up or too set on something that might not be meant for you. Speaking of instincts, that night, I still remember. I had told my husband, “I’m just going to have a C-section.” I went to bed and I had a dream. I was in the hospital in the dream and I was holding my baby and my dad walked in. I have a really great relationship with my parents but especially my dad. I love my dad. He comes in the room and he’s like, “How did it go?” He was meeting the baby for the first time and I burst into tears in the dream. I said, “Dad, I didn’t even give myself the opportunity to VBAC. I just went in for a C-section. I just have so much regret about it and what could have happened if I had tried to have a VBAC.” Meagan: That just gave me the chills. Lauren: Yes. It was so weird. I have never really had a dream like that before. I woke up and I was like, “There’s my answer. I have to move forward with this.” Having that dream gave me this peace that there is the instinct I need to follow. Yes, I have all of this information that is consuming me, but it was like, Keep going. I hired a doula which I found through The VBAC Link Facebook page. I put it out there, “Does anyone know a doula in my area?” Julie commented and it happened to be her really good friend who had just moved back to my area. I called her and it turned out that we had mutual friends. We connected really fast. I think, like I said, it was about 26 weeks. I go to my OB again and we had more of a pow-wow like a back-and-forth on the VBAC option. She was like, “I’m just worried about it. A C-section is not that big of a deal. We could just tie your tubes and then you won’t have pelvic floor issues.” False. I said, “I got a second opinion from another doctor.” I didn’t say it was Dr. Stu. I didn’t say it was some guy with a podcast in LA. I said, “I got a second opinion and I feel like I just want the opportunity.” We didn’t really land on anything solid, but she got up to leave the room and she got to the door and she turns around. She came back over to me and she gave me this big hug. She said, “I don’t want to disappoint you. I want you to be happy, but let’s keep talking about this.” I was like, “Okay.” That gave me a little bit of reassurance that I was leaning into that relationship I had built with her over the years because it had been 6 or 7 years of seeing her. I would also bring her flowers. I would always try to talk to her about her life and making a social connection with someone. If you let your doctor intimidate you just from the standpoint of being a stranger, I feel like that can really change the course of your care. But if you try to get to know people, and that’s not necessarily a manipulative thing, but I think it’s important. It should be important in your relationship with your doctor. If you don’t feel like you can connect with them, there is issue number one, but I really felt like I could connect with her. I leaned into that. I have a cookie business on the side. She loved my cookies. We just had some other things to talk about other than my healthcare and I feel like it set this foundation of mutual respect. What doctor comes over, gives you a hug, and tells you, “I want you to love your birth”? So fast forward again, I see her again the next time and she said, “Look. I brought your case to my team and because we support moms who have had two C-sections, we felt like your risk is similar to theirs and that it shouldn’t risk you out of a TOLAC so I’m going to support you if this is what you want.” I had given her this analogy that I think was Julie’s analogy. She said, “If you needed heart surgery and you were told that you had a 98% chance of success–” because I think my risk of rupture was 2% or maybe a little bit lower, maybe 1.5. I told her this. I’m like, “If you told me I needed heart surgery and I had a 98 or 99% chance of success, we would do it. There would be no question. I have this 1% risk of rupture. I’m coming to the hospital. What gives? I should at least be able to try.” The problem is, I’m sure some people are like, “Why didn’t you just switch providers?” We have three hospitals in my area. One is 20 minutes from me and two are one hour away. One of them which is an hour away is the only place where I can VBAC and there isn’t a VBAC ban. There is maybe a handful of providers who deliver there. I knew my provider was VBAC-supportive sort of. She had the most experience of a lot of the providers around me so that’s why I didn’t switch. I had very minimal options for care. I couldn’t go to LA or I couldn’t go somewhere further away. It would be a four-hour drive either way. We are in an isolated area. I felt like that was a huge win. We are set to go. I remember I told Katrina. Katrina was so happy for me, my doula. I just soldiered on. I started taking Dr. Christopher’s Birth Prep at 36 weeks. I was doing my dates and I was really busy in real estate. That’s part of my story. I was so busy working super hard and I was getting to the end of my pregnancy. At 38 weeks, I went in and I had clients lined up showings coming up. I was like, “I can’t have a baby anytime soon.” I was talking to my provider about it. “Maybe at 40 weeks, we can talk about a membrane sweep or something. I have so much on my plate. I can’t have a baby this week.” My husband is a firefighter and his shift that he was going to be taking off was starting maybe the following week. I’m like, “He’s not even going to be home. He’s going to be gone most of this week. This is a horrible week to have a baby.” I let her check my cervix because I’m like, “I want to see if my birth prep or my dates are doing anything.” At the same time, I still had this fear of, What if I do all of this work and I don’t even dilate? That was kind of what happened with my sister so I had that fear in the back of my mind. She checks me and she was like, “You are 2 centimeters dilated, 50% effaced. You’re going to make it to your due date no problem. We’re not even going to talk about an induction until 41 weeks.” She was like, “I’m just not worried about it. He doesn’t feel that big to me. He doesn’t feel small. He doesn’t feel too big. He feels like a great size.” I said, “I know. I feel really confident that he’s going to be 8 pounds, 2 ounces.” I spoke that out. I said, “That’s my gut feeling. I just have so much confidence and peace about this birth. I just know it’s going to work out.” I go on my merry little way from that appointment. I’m walking around. We had gone down to the beach. We were walking around and I’m like, “Man, I’m so crampy. For some reason, that check made me so, so crampy.” This was 38 weeks exactly. We go back home and I have prodromal labor that night. I’m telling Katrina about it. She goes, “You know, I bet the check irritated your uterus.” The next day, I start having some bloody discharge. I’m like, “What is this? What does this mean?” I told Katrina and she said, “It could mean nothing. It could mean labor is coming soon. We’ll just have to see.” I hadn’t slept the whole night before. She was like, “You need to get a good night's sleep.” I had to show property all day. I met these clients for the first time. I showed four or five houses to them and meanwhile, I’m like, “Gosh, I’m so sore and tired and crampy.” I told them, “I’m very obviously pregnant, but my due date is not until the end of the month.” This was June 10th and my due date was June 23rd. I said, “We have time. If you need to see houses, it shouldn’t be a big deal. I don’t want my pregnancy to scare you away.”That night, I get home and I’m like, “I’m going to bed. It’s 8:00. I’m going to bed. I’m going to take Benadryl and I’m going to get the best night’s sleep.” They call me at 9:00 PM and they’re like, “Lauren, we saw this house online. It’s brand new on the market. We have to see it.” They lived a couple of hours away so I’m like, “I’ll go and I’ll Facetime you from the house. I’ll go tomorrow.” Tomorrow being June 11th. I’m like, “We’ll make it happen. I promise I will get you a showing on this house.”I texted Katrina and I’m like, “Oh my gosh. I feel so crampy and so sore. Something might be going on, but I have to work tomorrow. I’ll keep you posted.” I wake up the next morning. It’s now June 11th and I lose my mucus plug immediately first thing. There was some blood. It was basically bloody show. I told Katrina and she’s like, “Okay, just keep me posted. I have a feeling he’s going to come this weekend. It was a Friday. I’m like, “Well, he can’t because my husband works Saturday, Sunday, Monday. I don’t have time to have a baby.” We go to the showing. I’m finally alone without my toddler and my husband. I’m in the car and I’m like, “Man, my lower back hurts. It’s just coming and going but nothing to write home about, just a little bit of cramping.” Of course, I never went into labor with my first so I did not know what to expect. I get to the showing and this house had a really steep staircase. I’m Facetiming my clients and I’m going up the stairs. It was probably at noon and I’m thinking to myself, Man, it’s really hard to go up these stairs. Why do I feel so funny? I finish up the showing and they’re like, “We want the house. This is the house for us.” I get back in the car. I’m getting all of their information. I’m talking to the other agent. I start the offer and I’m like, “I’m just going to drive home and get in my bed because I don’t feel good. I’m just going to write this offer from my bed and everything will be fine.” I get home and I tell my husband at 2:30, “I’m just going to sit in our bed and get this offer sent off.” Mind you, I had a work event, a big awards event that night for my whole office and we were going to have to leave at 4:00 PM. My in-laws were going to come get my son and take him to sleep over. It’s 2:30. I’m writing this offer and I’m like, “I don’t feel good.” My partner calls me. I tell her, “Listen, I don’t know if I’m in labor, but I don’t feel well. Maybe I have a stomach bug. I’m going to write this offer. I’m going to give you my clients’ information and I want you to take over for me a little bit. They know I’m really pregnant, but this could just be a sickness but either way if something happens, I want them to have the best care and be taken care of if we are going to send this offer off.” I send the offer off. It’s 3:30 at this point. I close my computer and I’m waiting for them to DocuSign. I text my husband, “There’s no way I’m going tonight. I don’t feel well. Something is up. I’m not sure what.” He didn’t see my text for a little while. He comes in the room at 4:00 and he starts to talk to me. I literally fall to the ground with my first contraction. I’m in active labor.I don’t know it yet, but I’m in active labor. I’m just like, “It feels like there’s a wave crashing in my body.” That was the best way I could describe it. I’m like, “I feel this building. It’s an ebb and flow,” but it reminded me of playing in the waves as a kid because I grew up in Orange County at the beach and just that feeling of the waves hitting you when you are playing in the surf. I’m like, “This is really intense. What is going on?” I’m like, “I’m certain it’s a stomach bug.” I told him, “I have gas or something.” I was just like, “I’m going to give myself an enema and this will all go away.” I did that and sitting down on the toilet, I was like, “Oh my gosh.” It made everything so much more intense. I texted Katrina, “Something is going on. I’m not really sure it is.” She’s like, “Well, why don’t you try timing some contractions for me and let me know?” I crawl into my closet. I can hear my son and my husband getting ready. My son was 2 so of course, 2-year-olds are not always behaving. I can hear them interacting. I crawl into my closet and I’m lying on the floor in the dark. The contractions are 3.5-4 minutes apart lasting a minute. I was like, “I’m still pretty sure this is a stomach thing that is happening every 3-4 minutes.” I call Katrina and I’m like, “I don’t know. I think I’m in labor. This is the length of my contractions. It’s probably just prodromal.” I had so much prodromal.She was like, “Um, it doesn’t really sound like prodromal labor, but I’ll let you just figure it out. You let me know when you are ready for support. Make sure you are eating anything. Have you eaten anything today?” “No.” “Have you had any water?” “Not really.” “Okay. Please eat something. Please drink some water and keep me posted.” She goes, “Can you talk through the contractions?” I said, “I can cry.” She’s like, “Okay. I’m ready to go as soon as you tell me.” Then the next thing I know, literally, this is probably an hour later so at 4:00 I had my first contraction. Now it’s 5:00 and I’m like, “The contractions are 3 minutes apart and lasting a minute.” I said, “Maybe you should come over. I think Sean (my husband) is getting a little nervous.” We were still so naive. We didn’t know what labor looked like and what was going on. We were like, “If we’re not going to the event, why don’t we just keep August (my son) at home? I’ll just make him dinner and I’m going to make you dinner.” He starts prepping dinner and I’m like, “I don’t think either of us really know what’s going on.” Of course, Katrina knew what was going on and probably thought I was a crazy person but I was very much in denial. We texted her to come over and she gets there. I’m lying in my bed and she’s like, “Okay, yeah. They’re coming 2.5-3 minutes apart. If you’re ready to go to the hospital, I’m ready to go with you.” I’m mooing through these contractions, vocalizing everything. I’m like, “It just feels good to vocalize and I just really keep having to use the bathroom. It’s probably just my stomach.” She’s like, “No.” I can hear her outside my bathroom telling my husband, “I think we should go. She’s really vocalizing a lot and that usually means it’s pretty substantial, active labor.” Meanwhile, all I can think about is, “I’ve got to get this offer in for my clients.” I’m waiting on DocuSign, checking my email. Finally, it comes through. This is 6:00, maybe 6:30. I see it come in. I send it off and I’m standing at my kitchen counter with my computer on, mooing, doing this freaking offer. I go to cross my legs as I’m leaning over and I’m like, “I can’t cross my legs, Katrina. I feel like my bones are separating.” She’s like, “Yeah, baby is probably descending into your pelvis. I think we should get going if you’re okay with going.” We have a 45 to an hour drive depending on traffic and the time of day. It’s a Friday night so basically where I live, there’s not a ton of traffic but we get in the car. She’s following us and we get to the hospital. It’s probably 7:15-7:30 or something like that. I’m telling my husband as I’m mooing through these contractions, “This really

During her first labor, Emily experienced a hyperactive uterus where she had constant squeezing with no breaks and minimal dilation. She was at a birth center but after exhausting all coping options decided to transfer to the hospital. After receiving an epidural and Pitocin, then detecting meconium, Emily was ready to consent to a Cesarean. Emily’s second birth was a planned Cesarean, then her third and fourth births were both VBACs. Emily describes how even though her provider was the same for both vaginal deliveries, her experiences were so different. With her third, Emily had a beautiful pushing stage and easy recovery. However, pushing with her fourth felt rushed and she experienced a fourth-degree tear. Meagan and Emily share the importance of making your preferences known in every aspect of labor and delivery so your support team can speak up when you are not able to. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We have a 2VBA2C story for you today. We were just talking about it before we started recording all of the acronyms. I was like, “Oh, you’re a VBAC after two C-sections story.” And your baby is 8– wait, did I see that right? 8 months? Emily: He’s 9 months now. Meagan: 9 months. Emily: He’s almost a year. 8 months, 9 months, 10 months, somewhere around there. Meagan: Still very little, still very fresh so I’m excited for you to share his story and your other babies’ stories. We have Emily by the way. This is Emily. Hello, Emily. Emily: Hi. Meagan: Remind me. Where are you located? Emily: I’m in Texas. Meagan: Okay, you’re in Texas. Awesome. Okay you guys, we’re going to share her stories. We do have a Review of the Week so I want to hurry and get into that and then we’ll jump into Emily’s stories. This Review is from Rachel and it says, “Thanks for giving me the confidence to have a VBAC. I am glad I found this amazing podcast when I was newly pregnant with baby number two. After a long, traumatic experience that ended in a C-section, I was cautiously hopeful that I would have a VBAC. Using information that I learned from hearing other people’s stories on The VBAC Link, I felt confident and prepared for the birth of my son. On October 9, 2020” so that was four years ago, “I had a beautifully redemptive VBAC and welcomed our boy into the world. Thank you so much for helping me achieve my dream.” Women of Strength, that review is for you. You and your stories and your participation in the community and on Instagram and all the places is seriously what builds this community up and helps these other Women of Strength find the courage just like she said and find the education.I’m so excited for you, Rachel. Congrats and as always, if you have time to leave a review, please do so. It helps other Women of Strength find stories. Meagan: Okay, Ms. Emily. Let’s get into this. So you have four babies now. Emily: Yes. My oldest is about to be 7 and my youngest is 8 months or so. Meagan: Okay, so you were having your first C-section as I was pregnant with my VBA2C baby. Emily: Yeah, it was 2017. Meagan: When you had him? Emily: When I had her. I had three girls and then my youngest is a boy. Meagan: Yes. My VBA2C was in 2016 so just right before, yeah. Awesome. Okay, well I’m going to turn the time over to you. Emily: Sure. So my first pregnancy, I actually found out I was pregnant on my honeymoon when we were in Mexico. Meagan: Oh my gosh. Emily: Yeah. I was stressed out and working out a bunch and all of this planning the wedding. I expected my period to come while we were there so I’m like, “Oh, it’s going to be the worst. I have all of these white clothes and I’m going to be on the beach and I’m going to have my period.” It just didn’t come so it was right at the start of our honeymoon. I was like, “Let’s take a test. I don’t want to be drinking margaritas for the rest of the week,” then of course, I was. We came back from the honeymoon with another big announcement. I feel like a lot of people’s stories is that you didn’t know any better and you just showed up at the hospital and you did what the doctor said. I was the exact opposite at that point. I was reading all of the things. I read the Ina May book. I had a midwife at a birth center and I was going to the chiropractor constantly. I was doing all of the things to be ready to give birth at the birth center without medication and all of that. That’s just not how it ended up. I think I was around 36 weeks and she was breech. I was going to the chiropractor all of the time trying to get her to turn. I was doing Spinning Babies. I was doing acupuncture. I was going upside down all of the time. I was finding swimming pools to do handstands and all of the things. I did moxibustion where you smoke–Meagan: Uh-huh, on your Bladder 6. Emily: She was still breech so my midwife set me up with the breech guy. People come to him from all over to do breech vaginal deliveries so I started seeing him. This was when we were living in Houston so I started seeing him and we did all of the things to try and get her to turn and ended up having a version. I went in. I had an epidural. They manually turned her and then afterward, they were monitoring me in the room and the nurses were like, “Okay, well do you want to be induced now?” I was like, “Nope. I’ve got a plan. I’m going home.” So I left the hospital after that. She stayed head down and then I went to 42 weeks and at about 42 weeks, I went into labor but my labor was weird. I was getting contractions but there was no break between them. It was just constant, squeezing pressure. I was texting my midwife asking, “I don’t know what to do. I can’t time them. There is no in-between.” It was mostly my back and after, I think it was 3 hours and I was like, “I can’t do this. This is too weird.” I didn’t have any guidance for what to do if you’re not able to– they weren’t broken up at all. Meagan: Were you dehydrated at all? Emily: No, I don’t think so. I’m not sure. We finally went into the birthing center and it stayed that way for a really long time. We were there throughout the night. I was on a birthing ball and my husband was just elbow into my back for hours. I couldn’t sleep because it was just constant pain. I tried the Rebozo scarf. We did all kinds of things while I was there. I will say though, I should have had a doula because my midwife kind of just left the room and was gone. She was somewhere in the center probably sleeping. I don’t know. She would come in every once in a while and we were really just left to our own devices in there. We had done I think it was a six-week class. We went in every week trying to prepare. Yeah, we were just in this room together in the middle of the night really tired and in a lot of pain not knowing what to do to get this going. At one point, I was on an IV. She had given me all of the pain stuff that they can give you. At one point, she was like, “I’ve done all of my–” I wish I could remember. Meagan: I’ve exhausted all my tools type thing. Emily: Yeah, I’ve given you as many doses as I can in a time period. We did the catheter. That came out at some point. I think it was Monday when I went in there and then Wednesday when I ended up leaving there. At one point, she was checking to see. She was looking at my cervix and my water broke. There was a bunch of meconium and it was green crazy. She just looked at me and was like, “I think it’s probably time for you to go.” I got back in the car in rush-hour traffic in Houston and headed to the hospital. There was a nurse in the back seat with me holding my IV bag. My husband drove us there. She had called the doctor who did my version so I had already met him and known him and known that he was pretty progressive as well doing breech vaginal deliveries and I know he did breech twin deliveries. He was a very cool guy so I felt good about that. We went. He was like, “All right. Let’s do an epidural. You can sleep. You can relax and all these things.” That’s what we did. I think I had the epidural for 8 hours and I was at 6 centimeters. They were like, “Okay, what about Pitocin?” I feel like they did give me a lot of time and I hate the saying “give me” but they gave me a lot of time and by the end of it, I was exhausted. I was done and ready to get her out. I only made it to 6 centimeters after all of that. It was 3 days of labor. By that time, just get her out of there. She was almost 10 pounds. She was big. Yeah. The C-section, that all went fine. I found recovery to be especially hard. My body was already so tired. Meagan: Exhausted. Emily: Exhausted. I wasn’t prepared for it. I didn’t expect it to be as painful as it was, but yeah. I know some people kind of just pop right up after and are moving around. That was not my experience. That was my first. I feel like I had 10 experiences in one. I did the midwife birth center thing. They tried to get my labor going with an epidural. I had already been there for an epidural once so by the time I was getting the second one, it was whatever, and then the C-section also all in that one pregnancy. Yeah. I feel like it was three births in one.But yeah, then we got pregnant with my second. I talked to my midwife again. She was like, “I don’t do VBACs,” so the first person I called was the guy who did my C-section and my version. I said, “I want to do a VBAC.” He was like, “All right.” He was very cool about it and awesome. It was another really easy pregnancy. I got to the end. I was 41 weeks. Meagan: So you carry longer. Emily: Yes. I was 41 weeks with her and I went in for an appointment and they did a sonogram and I was like, “Please can you check my cervix? I just have to know where I’m at.” Yeah, I hadn’t dilated at all and he was like, “Well, your sonogram’s estimating that she’s going to be 10 pounds also.” My mom had been in town at that point. They were trying to be there for the birth and helping me with my toddler and she had to leave the next day because my sister was being induced in Dallas. She had been staying with me for that whole last two weeks and it was like a now or never she’s going to be gone. I’m already 41 weeks. I was also teaching and so every day, I was walking into work so pregnant. 1000 comments like, “You’re still here? You’re still pregnant?” It just felt like I was sick of it. Then hearing the 10 pounds, I was like, “All right. Let’s just have a C-section I guess.” He left that up to me. I feel like he would have if I said. He wasn’t even doing cervical checks at that point. It was me who asked for it. He left it up to me and he agreed when I said, “Okay. I guess we’ll just do a C-section.” That one was different because it was scheduled. We went in the next morning. It was easy, breezy, and a little bit better of a recovery since I wasn’t already so exhausted at that point. But yeah. I had a newborn and a toddler and a C-section again. It was rough. It kept opening because I was picking up my toddler. I went back to work I think when my second was six weeks old. Yeah. It was a lot. Those were my first two C-sections. Very different experiences for both of them with the same doctor. Then COVID happened and I finished the school year teaching online when COVID happened and my husband was working in oil and gas. We decided we were going to move to my parents’ ranch. I finished the school year online from there and he was working with my dad. My dad does custom home building so that was something he wanted to get into. It was kind of the perfect segue out of there. Meagan: Mhmm. So where were your first two babies born? Emily: Houston. Meagan: In Houston. For people who are interested in breech, are you willing to share that provider’s name? Emily: Yes. His name is Dr. Alfredo Gei. Meagan: Okay. Emily: Yeah. I mean, he was great. I don’t know if he’s still working or not down there, but he was awesome. He was a very, very cool guy. He was very calm, very respectful, friendly, and all of the things. Meagan: Yeah. Yes, good. Emily: Yeah. We moved up to my parents’ ranch in Glen Rose, Texas. I finished the school year online. I decided I would stay home with my two kids. I think by the end of that summer, we were ready to have our third. It was perfect timing. I was staying home. We had my parents there. My husband had an easier work obligation working with my dad and all of that so I got pregnant with my third. That pregnancy was wild. We had a lot going on. I guess it was my first experience having a pregnancy that didn’t go super smoothly and whatever test and all of the normal things you do like blood testing if you choose to do that. Everything came back weird so I’d have to go in and retest. I think at one point in the beginning, they thought she might have Down Syndrome so it was like, “Well, you can do the amnio to find out or you can wait until that anatomy scan.” I spent that time just waiting until 20 weeks to find out if she had Down Syndrome or not. I tried to do the gender test, one of those home ones. My first two were a surprise and with her, I just wanted to know. I needed something. I wanted to know what was going on in there. We did one of those gender tests and it came back inconclusive. Whatever could go wrong was going wrong with the pregnancy. I had found an OB/GYN who was VBAC-friendly who worked with a group of midwives so it was him and a bunch of midwives. I started seeing him and them because I thought– oh, I didn’t even mention. When I had my second baby, they predicted her to be 10 pounds. She was 7 pounds. It made me so mad. It made me so mad. Meagan: Okay, so now I have a question for you because we talk about third-trimester ultrasounds. At 41 weeks, that is normal because they do non-stress tests and all of those things. Would you have chosen a different situation or would the scenario be the same because of your mom and convenience and all of that? Emily: That’s a good question. I would like to say that I would have at least given myself a couple more days at that point, just a couple more days to see maybe. I always think, What if I had gone into labor in that next couple of days instead of the C-section? Would she have come out easier being 7 pounds and not 10 pounds? Of course, I thought, Maybe it’s my pelvis. Big baby, small pelvis, and all of these things. I don’t know. It’s hard to say. I was really ready to have her. Meagan: Absolutely and you were given an opportunity. That goes to speak where you are in your pregnancy. That’s a vulnerable state. That’s a very vulnerable state. But you had her and it was an okay C-section and your mom was there and all sorts of things. Emily: Yeah. She came out and then they brought me back to the room and my mom was there. She got to meet the baby then drove all the way back up to Dallas and my sister had hers. They are a day apart. Meagan: Aww, that is so fun. Emily: Anyway, with my third, I was seeing him and I had some weird blood testing results and weird stuff happening at the beginning. It was the end of COVID sort of so COVID started around spring break. I got pregnant around that summer and by the next spring, it had been quite a while but hospitals and stuff still had all of those weird rules in place about people being in the room and all of the things. It was the tail end of that. My husband got to come in for the anatomy scan. He was there with me in the room when she did all of the scanning and everything and then he had to leave when the doctor came in. He went and waited outside in the car and the doctor came in and my first question obviously was, “Did you see any Down Syndrome markers?” They said, “No.” They didn’t see that, but her head circumference and her cerebellum were measuring in the first percentile. The normal range is 1-100 and she was right there on the cusp of being abnormally small. He dropped that bomb on me while I was in there by myself. He waited until my husband had left. He told me that I was going to need to go and see a maternal-fetal medicine specialist and then I could come back after that. I left that appointment just in shambles not knowing what was going on or what to expect or what that meant and then I had to wait for an appointment to see a maternal-fetal medicine specialist. At that point, I just threw the whole VBAC idea out the window. It was all about what was going on with the baby and keeping the baby healthy and all of those things. My mom is a NICU nurse so I was like, “Well, I’m going to give birth at the hospital that she works with because if my baby goes into the NICU, I want her to be there, and all of these women that I had known her working with for 30 years.” I went to see a maternal-fetal medicine specialist. I switched providers and hospitals and I went to where my mom was working. I went in and they measured her cerebellum for the rest of my pregnancy. It was every other week or so I would go in and they measured. She stayed on that very tail end the entire time. I want to say that she might have reached the 6th percentile by the end in growth so it was still pretty precarious not really knowing what the deal was there. But by all accounts, she was healthy. They weren’t giving me any kind of diagnosis or suspicions about anything. She kept falling in the normal range which meant they weren’t going to do any further testing. They could have done an MRI or something on my stomach at one point but they didn’t do any of that. I think around 34 weeks, I had an appointment and I was just like, “You know, if we’re good to have a VBAC, I still want to do that.” I just looked at my provider and was like, “This was my plan. I don’t see why it still can’t be my plan. I’ve got two toddlers at home. I really can’t have another surgery. I don’t want to do that.” She was like, “Okay. Awesome.” I was expecting a fight. Meagan: You’re like, you do. You really, really do. You expect this, “No” or “But, well–”. Those are the things that you automatically assume so when you have a provider who’s like, “Okay, cool,” you’re like, wait what? It throws you off. Emily: Yeah. I left there with a skip in my step. Meagan: I bet you did. Emily: Right after that, I contacted a friend of mine who is a doula and I started working with her. She shared your podcast with me so I was listening, listening, listening to as many episodes as I could in those couple of weeks and it was very helpful. I’m not a confrontational person or even a person who previously was good at advocating so I was mostly listening. I already knew what the hospital situation looked like. I already knew what a C-section looked like so I was really listening for how do these conversations happen with doctors and what does that look like when you’re advocating for yourself? What are the words that I need to use? I listened for a lot of those kinds of examples of this is what I can say if she says this. This is what I can come back with or suggest if this happens. So that was very helpful for me to just go in and can we do a Foley? Can we do a Cook’s? Meagan: To feel prepared to have that conversation. Emily: Yeah. I know at one point, they wanted to schedule an induction and I said, “Well, what if I just don’t come?” She was like, “Well, we can’t drive to your house and bring you,” kind of response. “What if I don’t want to do Pitocin and all of this? Can you do a Foley or a Cook’s?” I really came into those appointments with more of a two-sided conversation and not just “We’re going to do this. We’re going to do this. We’re going to do this.” I remember I got there at my 36-week appointment and my nurse was like, “Okay, go get undressed.” I didn’t get undressed. I just sat there with all my clothes. She came back in and I was like, “I don’t want that. I don’t want my cervix checked.” Meagan: Good job. Emily: Yeah, she didn’t know what to do with that. She was like, “I think she’s going to want to look.” I was like, “Well, why?” Meagan: I don’t want it. Emily: “I don’t want to know. It’s going to get me in my head. What’s going to change if I’m 36 weeks?” Obviously, that was the norm there to start doing that at that point. What happens if I’m 1 centimeter? What happens if I’m 3? I’m still going to go home. I remember that was the first time I did something out of the norm there. I didn’t even say the whole doula thing since it was the end of COVID. They were still working out who was allowed in so I asked for a doula and they didn’t know if they could even have them so we were asking the hospital for hospital policies and calling up there asking all kinds of questions. By the time we did show up, everybody there was like, “She’s here. She’s here.” My mom worked there too so it felt a little bit like maybe everyone else was walking on eggshells with me because– Meagan: Because of your mom too. Emily: Well, my mom too. She was working that day so I probably couldn’t have had her if she had come in as an extra person with us, but she was working and so she just showed up in our room in her scrubs and everything. I went into labor. Meagan: What gestation on this one?Emily: I was 37 weeks. Meagan: Whoa! So way earlier. Emily: Yes, way earlier. It was Easter. I started having contractions during the whole Easter thing. I’m hiding eggs struggling around the yard and I went to bed that night thinking, This feels like it’s it. They were not painful but they were stronger than the regular Braxton Hicks so I went to bed and I think at 3:00 or so in the morning, they started waking me up. I tried to keep sleeping until 6:00 in the morning. I woke my husband up and was like, “You’ve got to figure out getting the kids to school and stuff. We’re going to be going into the hospital.” It was about an hour drive. So I got in the bath. My doula told me to get in the bath and she gave me some different positions and stuff to do so I did all of that and that sped things along a whole lot. I did some curb walking and then yeah, I showed up at the hospital ready to have her and I want to say I was in labor there for three or four hours. I asked to speak to the– is it the anesthesiologist who does the epidurals and stuff? Meagan: Yep. Emily: I told her that I wanted a walking epidural. A lot of people don’t know that there is a range. You can have it on full blast or you can have just a little bit. She gave me a very light epidural. I was able to still move in the bed and get in different positions. They had the bar over the bed at one point. They wanted to do an internal monitor at some point because my heartbeat and the baby’s heartbeat, they could not figure out where to put the strap. I declined that. The nurse really just had to stay in there with it pressed to my stomach for hours. Yeah, that’s what we did. I moved around. There was a peanut ball at some point and then yeah. They checked my cervix and my water broke. I don’t know if that was on purpose or not, but I then had another water break at a cervical check and things went pretty quickly after that. I think I pushed through three contractions. Right before I started pushing, my OB came in and said she was leaving and that another doctor would be coming in. I was like, “Does he know? Is he cool?” I was so confused. But yeah, he came in and he was great. He asked if I wanted a mirror. I know that he was using oil and he had a hot compress and whatever. Meagan: That’s awesome. Emily: He let me pull her out so I reached down and I grabbed her. It was all very cool. We were blasting Enya’s Sail Away. It was a whole vibe. Meagan: I love that. Oh my gosh, I can just picture it all. Emily: It was very easy. Hardest pregnancy, easiest labor and birth. Yeah, she came out. I would say she slid out, but pushing wasn’t hard. I could see what was happening. I don’t know. I felt very comfortable. Meagan: Good. Emily: I felt ready. Meagan: Good. At the end, was anything going on with her? Emily: Yes. That’s another whole long story. She didn’t pass her newborn hearing screening so when they do the hearing test, it’s a couple of days after you have the baby. She didn’t pass and they thought, Oh, she might have fluid in her ears and this and that. You’ll have to go back and do it again in a week or so. We went back and did it again and she didn’t pass again. We had to go to the Children’s Hospital and they did another type of hearing test and we found out that she was deaf. Yeah, we went down the whole hearing aid route and that. Healthwise besides her hearing, she was having a really hard time holding her head up. I think we started having a PT come when she was 4 weeks because her head was just flopping all over. I guess she was diagnosed with a gross motor delay and so we did PT until she started walking at 2.5. We had the option of doing genetic testing and all of that to find out the reason for the hearing loss and we just kind of thought, What’s it going to change? She’s still not going to be hearing after all of these tests so whatever. We will just deal with what we’ve got going on right now. She got hearing aids at 4 months. We were going in and they would do all kinds of tests and stuff. She still wasn’t responding to any sound so they wanted to do cochlear implants and in order to do that, you have to have an MRI. They look at everything structurally to make sure you are a good candidate for cochlear implants. They look at the nerve and the ear canal and all of those things. They came back and they said, “She can get them. She’s a good candidate for that, but here’s what we saw with her brain on the MRI.” She had white matter abnormalities which are just when they go in and they look, if you have all of these white spots, they indicate inactivity so she had a bunch of that that they couldn’t explain and she had a cyst somewhere in there on some groove. I have forgotten all of the lingo at this point. They wanted to find out what the cause of all of those things were. They also didn’t want to give her cochlear implants if they thought that these areas were going to grow so then we started doing all of the genetic and DNA testing. They wanted us to wait a year to do her next MRI and the cochlear implants to make sure in that year time period they didn’t grow at all. We were just like, “We can’t do that. One, we can’t wait a year to find out if our child has this thing that’s taking over her brain and two, it’s a critical time for learning language and speech and all of those things.” We settled with 6 months so we waited another 6 months. We did another MRI. They checked. Nothing grew. She was still making growths and learned to crawl and all of those things. She just did everything about a year behind. Yeah, we did cochlear implants and we all learned sign language and that’s how we communicate. Yeah, it’s been 3 years now. She just started the deaf preschool last week. Meagan: Awesome. Emily: And now bringing it home with baby number four. Meagan: Baby number four who is 9 months old? Emily: Yes. He was a surprise. We had a lot going on with my third daughter. I’ve got Eloise who is 7, Violet who is 5, and Matilda who just turned 3. We thought, Maybe we’ll have another. Let’s see what’s going on with her. Let’s get her into kindergarten. Let’s get her speaking and signing and all of these things. Then we had surprise baby number four. He ended up being a boy so that was fun. He was born in July of last year. Meagan: Okay. Emily: During all of that, our insurance had changed so I couldn’t go back to the same OB/GYN and I went to another one at that same hospital. After I had my third, my hormones were just so wild and crazy and I had a lot of anxiety and obviously stress from all that was going on with her. I went in and I was like, “I just want to figure out what’s going on with my hormones.” I remember the doctor asked me about my previous pregnancies and births and stuff. I told her, “I actually had a VBAC with Dr. So and so at this hospital.” She said, “Oh, if you want to do that again, you’ve got to go somewhere else because we don’t do that here.” Meagan: But you’re like, “But I did do it here.” Emily: I was like, “Don’t worry about it because I don’t want to have another one.” Of course, a few months after that, I ended up getting pregnant again so our insurance had changed yet again. If you have a baby who has special needs, you’ve got to get the insurance thing figured out all the time. We changed again. I was able to go back to the same doctor so when I was pregnant with him, I saw her and she was like, “I’m guessing you’re going to want another VBAC.” I said, “You’re right.” Same thing. I didn’t let them check my cervix. I didn’t have a late-term sonogram. I went into labor with him. I got induced. That’s right. I got induced with him. Yeah, yeah. I was 41 weeks again. Meagan: Okay. Emily: I was so expecting another early one and then I got to 41 weeks and we started talking about inductions and stuff. I said, “If I come in and do this, I’m going to want to do Foley or something again.” So that’s what we did. That put me into labor right away. I think I was 1 centimeter so they were able to put that in and it just went from there. I will say this about the fourth with the same provider. I specifically in my birth plan said, “No students.” I feel like I had already done all of that. I had already allowed all of them. I had paid my dues to society by letting them in. I had a student who did my epidural with my second. I was done. I was done with that. I didn’t want a bunch of people in the room. When it was time to put in the Foley, she wasn’t available so they were like, “Do you mind if a resident does it?” I’m like, “That’s fine.” The question was raised about breaking my water. I think I was over 6 centimeters at that point when they were asking about breaking my water and I was like, “Eh.” I talked to my doula. She was there again. I talked to my doula about it and we decided that was okay to get things moving along. They said, “Oh, well she’s not available still. Can a resident come in and do that?” I was like, “Okay.” Then it was time to push and deliver and a whole team of people came in. I was in the thick of it. I had another really low-dose epidural so I was still feeling a lot. I also thing one thing about the low-dose epidural managing pain and staying on top of pain is a real thing and you can reach a certain point where there’s not much you can do about it where you are too far. That’s where I got with that. Even though I had the epidural, I was too far along at that point for it to do much. I was like, “Turn it up. Turn it up.” It wasn’t making any difference so just know that’s something that does happen. When it was time to push, my doctor on her wheelie stool just scooted out of the way and someone else showed up. Meagan: What? Again? Emily: From the background and it was like, “Push, push, push!” The vibes were very different. I’m not sure why that happened because as far as I’m concerned, nothing was happening with me medically and nothing was happening with him medically to necessitate me to push vigorously. I had not been pushing for hours. I got him out in under 30 minutes. It felt like there was this need for me to get him out of there and get him out quickly. I’m not sure why that happened. So I guess it was a resident who was down there. There was no oil this time. There was no hot compress this time. There was more pulling during the pushing part and I ended up tearing fourth degree all the way. It was awful. Same provider, different experience. She’s retired now. I wouldn’t go as far to say that I’d recommend her to other people having a VBAC. I think she was more– what’s the word? Not VBAC-friendly. Meagan: Tolerant. Emily: Tolerant. I think she didn’t think I was going to get there so she said yes thinking that’s not how it was going to go and we’d never get to that point where I was in labor there ready to push. That’s what happened both times so it was thrust upon her also. She’s not a bad doctor or anything. That’s my one takeaway from that one. You’re pushing and there’s a lot of people in the room and there’s a lot going on and you’re very much focused. I wish that I or someone else in the room had said, “Oh wait, what’s happening down there? Why is this person coming in? Why are we doing this so quickly? What’s this need to rush?” Yeah. That’s my takeaway from that one. At the end of the day, I had an easy pregnancy and an easy delivery. I did have another vaginal, but it also came with some bad as well. It was a bad recovery for me for sure. Meagan: You know, I think that’s something to note. Like you said, you got your vaginal birth and everything, but not every vaginal birth always ends with an easy recovery or an easy experience or even a positive experience so it does help to have that support team but here you go. Still even then at the last second, you got switched out on like you did last time too. That’s weird. I’m like, was she not confident in delivering babies or what? That’s interesting. Emily: I don’t know. I’m not sure. Of course, afterward, I’m like, If she had stayed sitting there, would I have torn as much? Meagan: Exactly, yeah. Emily: If I was pressured to go so quickly, would I have torn as much? I left that one feeling, What just happened? I talked to my doula afterward about it and she was like, “You know, I wish I had said something,” but unless we had talked about it before, for her to stop a doctor in the middle of what they are doing without me having already told her, “Hey, I don’t want this,” it’s weird. Meagan: It’s a really tricky situation. As a doula, I will say it’s very tricky when you’re like, I don’t like what I’m seeing, but she’s not saying anything and didn’t say anything to me before this. I would assume she doesn’t like this, but at the same time, yeah. Like you said, it’s tricky. You don’t want to step on people’s toes. You don’t want to change the atmosphere. It doesn’t sound like the atmosphere was exactly peaceful either, but yeah. Gosh. That’s hard. Emily: Yeah. It was another unexpected thing. I hadn’t prepared for that scenario. I had it in my birth plan that I didn’t want students, but then I had said yes to them for these things, so I can see how we got there, but yeah. For those wondering, I pushed him out to Shania Twain’s Man I Feel Like a Woman. There were some good vibes in there. Meagan: I’m loving all of your music choices. That is amazing. Oh my gosh. Well, I’m sorry that it was that type of an ending. I am happy for you that you were able to have both of your vaginal births. But it’s such a good takeaway and a great note. Women of Strength, think about those things too even with pushing, what you are wanting. Talk about this to your team. “If nothing’s wrong, if nothing is emergent, I need it to be this way,” because that is for sure tricky. I wanted to talk about way into the first birth. I wanted to give a couple of suggestions for people who are having a hyperactive uterus where the uterus is just too active. It’s not releasing. Sometimes that can be a baby’s position working through and trying to get into the right position and the uterus is trying to help but a lot of the time it can be due to things like dehydration or I know that sometimes if there’s a UTI or an infection or something like that, that can cause a hyperactive uterus. Sometimes people just have hyperactive uteruses but with a uterus that is just not letting go like yours, something that a midwife a long time ago within my doula career suggested to a client of mine was called cramp bark. Cramp bark, yeah. It’s a tincture and you can take it. It can try to help relax the uterus so if you are having really long prodromal labor or like Emily

Jacqueline’s symptoms of FSHD muscular dystrophy began at 16 years old. She shares with us today how she manages chronic pain and what that looked like throughout her pregnancy and birth journeys. Jacqueline is also a sexual violence trauma survivor and went through three pregnancy losses. Through her nonprofit organization and as a birth doula, she is a strong advocate for trauma-informed care for all women. Jacqueline shares inspiration and advice throughout the episode for women who also have a history of trauma as well as those who are trying to navigate birth with a neuromuscular condition. Her proactive approach to caring for her body and heart allowed Jacqueline to have a beautiful, empowering, and healing VBAC, especially after enduring so much.  Anesthetic Management for Dystrophy ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. Today’s episode is a VBAC episode, but it has an extra topic that is a first for the entire podcast life. In 320-something episodes, we have never talked about this specific topic. The other day on social media, I had a couple of spots so I reached out and I am so grateful for Jacqueline. Are you in Canada? Jacqueline: Yes. Meagan: Yes. She’s from Canada and she reached out and was like, “Hey, this is something about my story.” And I was like, “Yes, let’s do that because this would be amazing.” One of the things that we are going to be talking about today is FSHD muscular dystrophy. Jacqueline: Dystrophy. Dystrophy. Meagan: Okay, yes. We are going to be talking about that a little bit more and the challenges that you have had to go through with all of this. If you wouldn’t mind before we get to the review, will you tell us a little bit more about FSHD and one, what is it? Two, what are the things that we are told because you have it and how you had to birth if you were told?Jacqueline: Yeah, absolutely. FSHD is a form of muscular dystrophy. It’s quite rare and it essentially affects the muscles in my shoulders and in my facial muscles as well. For everyone with FSHD, your symptoms present quite differently. Of all of the types of muscular dystrophy, it is one of the more common forms, but in the big scheme of conditions that you can live with, it definitely is still considered to be rare. I was diagnosed in 2018 officially though I had symptoms starting from the age of 16 and I gave birth to my first child when I was 21 years old. I didn’t have too many symptoms at that time. Going into my twenties, I started to have more atrophy in my shoulders, my lower back, and sometimes in my feet. My second and third processes were a little bit different, but overall, in terms of pregnancy and birth, my specialist always shared that you’re able to carry a baby and you’re able to give birth. The atrophy that we experience doesn’t necessarily affect that process thankfully, but I’ve always been someone who is very proactive in terms of minimizing my pain and trying to do different types of therapies to minimize the chronic pain that I live with so I’m very focused on that during pregnancy especially. In my most recent birth which happened 5 weeks ago now, I really focused on making sure that my body was very strong and at its optimal comfort level that I possibly could be while pregnant in order to achieve a successful VBAC. Meagan: Oh my gosh, thank you for sharing and we’re definitely going to go in through your journies and I’m sure it’s going to come up. We’re going to learn more about how you did that, how you made sure your body was at its most comfortable spot that it could be while growing a baby and how it’s impacted your life. Thank you for sharing. I do want to share a Review of the Week before we get too far into today’s episodes. This is by Rachel Thornton and it says, “Thanks for giving me the confidence to have a VBAC.” It says, “I am so glad I found this amazing podcast when I was newly pregnant with baby number two. After a long and traumatic first birth experience that ended in a C-section, I cautiously hoped that I could have a VBAC. Using this information that I learned from hearing other people’s stories on The VBAC Link, I felt confident and prepared for the birth of my son. On October 9, 2020, I had a beautiful, redemptive VBAC and welcomed our boy into the world. Thank you so much for helping me achieve this dream.” Girl, Rachel, you are amazing. Congratulations and thank you for sharing the story of your dream. I am so happy for you that you got your VBAC and as always, if you have opinions about The VBAC Link, please share them. Rate us. Give us a review and let us know what you think and maybe how we’re changing your dream as well. Meagan: Okay, Jacqueline. Okay, so you have three babies. Jacqueline: Yes. Meagan: One is 5 weeks old. 5 weeks? Jacqueline: Yes. Meagan: Itty bitty, bitty. Wow. Thank you so much for taking the time 5 weeks postpartum and you could be taking a nap right now and you are here with us sharing your story. I’m going to turn the time over to you and let you share away. Jacqueline: Great. As mentioned, I have three kids but this was actually my 8th pregnancy so I am quite well versed on pregnancy and birth and I am actually a doula myself. I went through the training process after I experienced three consecutive losses when I was trying to get pregnant with my husband. This was back in 2020. With that, I sort of had a new sense of knowledge coming into pregnancy and birth. That was following the birth of my daughter. I had her when I was 21 years old and that process was very different than my other two pregnancies and birth stories. Unfortunately, when I was pregnant with her I was in an abusive relationship. It’s a very unique story I guess you can say. I was living abroad at the time so most of my pregnancy care actually took place in Kenya where I was doing work with my nonprofit organization and then I moved back to Canada when I was 6 months pregnant and lived with my family at the time. They really supported me and just came to a level of peace before giving birth and mentally preparing for becoming a parent at a very young age and as a single mom. But going into that birth process, I really did no preparation at all. I found myself during this pregnancy and as I was preparing for the birth of my second son which happened just 5 weeks ago, I really found myself reflecting on my pregnancy and birth experience with my daughter. With her birth, I had no foundational knowledge aside from what I had seen in movies really and because of that, at 39 weeks, I ended up getting induced. It was a very long birth process. I was already in a very traumatized state because of what I was going through at the time and I had my mother and my grandmother there with me when I gave birth but my mother had also gone through inductions because my brother and I stayed locked in there until well over 42 weeks actually for both of my mom’s pregnancies. She had never experienced anything different. I didn’t think twice about experiencing an induction and to summarize that birth story really, I ended up giving birth vaginally after over 24 hours of laboring. I had a failed epidural which I got just before she was born about an hour and a half prior to her being born and I had no movement throughout the entire process. I quite literally just moved from one side of the bed to the other. I was watching Ugly Betty throughout my entire labor and delivery. That I do remember. It was my comfort show at the time. I largely just wanted the process to be over so that I could be with my baby and there were a lot of things that happened throughout that labor process that I didn’t even reflect on as unnecessary interventions again until this pregnancy. Jacqueline: 7 years later, when my husband and I decided that we wanted to start the process of expanding our family, we were really conscious about making sure that I didn’t have that same experience. I really opened up to him about how I was just in a state of survival with my daughter’s birth and how I didn’t want to go through that again. Again, at this time, I also was a doula as well. After we had experienced our losses, it was really important to me to just expand my knowledge and I felt really called to get that training because of the insensitivity that I experienced when I was navigating loss. Coming into the process of now having a rainbow baby and wanting for it to be a really redeeming birth as well, I tried to make sure again that my body was very strong coming into labor. One thing that I think stands out as a person living with a disability with FSHD muscular dystrophy is that often with conditions that are rare, you have providers who when they hear that you have a rare condition, they immediately want to turn you away. Meagan: Yeah, they get scared. Jacqueline: Exactly. I reached out to the midwives’ team in my community. At the time we were living in Northern Ontario in Canada which is more rural and remote so we only had one midwife team in our area. When I put in my form stating that I had a form of muscular dystrophy, I was immediately turned away and that was a little bit deterring so I reached out to a friend of mine who was a midwifery student. She encouraged me to just call the practice and explain what my condition actually was and how it did not affect my ability to give birth at all. I was not high risk. In doing that, they changed my status in their system and put me on the waitlist. Within our community, you essentially have to call the midwives at 5-6 weeks pregnant if you want to get in. It’s very unfortunate because they provide such incredible trauma-informed care and support, but it’s something that is very heavily regulated and they are only allowed a certain amount of clients each month.Because of that, a lot of women who are giving birth don’t get to access those services. Fortunately, I received a call about 2 months into my pregnancy that I was now able to be accepted as a patient. I was paired up with an incredible team. I’ll give a shoutout to them, Meredith and Sara from Sudbury Community Midwives. They really helped change the way I viewed being pregnant. During my first pregnancy, I absolutely hated the process. I am the first to admit that. I was going through so many hardships on a personal level and I just really felt that I didn’t have any sense of control or agency over my body at that time. That really translated into my birth experience as well. They really helped me to navigate through that and really connect with my body and feel empowered through the process. I really loved as well just in general with midwifery care that they allowed me to have the space to ask questions. I never felt rushed and I never felt that because I had a disability that I had to have a certain type of birth where I wasn’t in control. I think sometimes for folks who have disabilities, that’s often what you are made to feel like has to be the process. Obviously, everyone has a different background, but often that isn’t the case. Often, you can still decide what outcomes you will encounter both in your pregnancy and in your birthing experience. Jacqueline: With that, I decided that I wanted to have a home birth. We did everything humanly possible to prepare for that process. I was going to a chiropractor quite regularly. I was seeing a naturopathic doctor. I had gone to my specialist to make sure that my body was ready for birthing and everyone was getting me into the best possible shape I could be in to give birth. The midwives’ team were very aligned with what we wanted for our home birth as well.I really wanted my daughter to be a part of that process and again, being my birth following three consecutive losses and the first birth after a baby after having my daughter and not really getting to fully even embrace that first year of her life largely because I was navigating through so much trauma myself after leaving my abuser, I really just thought that would be a meaningful experience for us as well. But my son had other plans. At 39 weeks, I remember it so vividly. I was in the bath and I quite literally watched him flip from head down which he had been for weeks to transverse breech. I thankfully had a midwife appointment the next day and said to them, “I’m fairly certain that my son has turned.”They said, “There is no way. Statistically, this is so unlikely. You are so far along in your pregnancy. Don’t stress. I’m sure you are mistaken.” Of course, very quickly, we learned that he had flipped. I think that too really speaks to as someone with a disability you are so in tune with your body. You feel every little change. You are so used to having discomfort and pain on a daily basis. I knew the minute that he had flipped so I advocated for myself in those moments and said, “Can we have an ultrasound to confirm it?” We did. Even in that process, I really made sure that I stayed a part of my birth. I had a strong feeling that I would probably be having a C-section. It wasn’t what I planned for, but going into everything, I think my doula training did help in this regard. I was ready for whatever may happen. I had sort of a plan A and a plan B. Plan A obviously was that I would be able to have my home birth if by some miracle he flipped back, but plan B was that I would be involved in the decision-making process for a C-section. I spoke with my midwife team and we found one OB/GYN in my community who was willing to try and do an inversion, so to try and manually move him back into the head-down position. We did a consult at our hospital. This OB/GYN and I actually had a history. He had supported me through two of my losses and was actually part of helping us successfully get pregnant with my son. It was actually very full circle that he would then be a part of my birth. I felt comfortable in his care as well. He knew my history. Part of my story as well is that I am a survivor of sexual violence. That’s actually what I do professionally with my work. He knew that a lot of elements of birth are very triggering for me as well so he really wanted to ensure that we would be as minimally invasive and as trauma-informed as possible. Unfortunately, our ultrasound showed that I had a limited amount of fluid. He was still willing to try and do the inversion, but he said, “To be totally transparent with you Jacqueline, this is going to be incredibly traumatic for you. I refuse to do it unless you get an epidural because it’s going to hurt and you’ve gone through so many losses. This is the baby that you’ve been waiting for. Make an informed decision of what you think would be best for you, but I just want you to know everything going in.” I really appreciated that as well that he spoke to me from a very personable standpoint knowing my background and our history and ultimately, we decided that a C-section would be what was best for us. Jacqueline: Everything went smoothly with the C-section, thank goodness and I welcomed my son in a very powerful way. I still think because I was very involved in the decision-making process, I felt very at peace with the fact that I had to have a C-section. My midwives were still in the OR with us when we were going through that process and they were still with us for the continuation of care and I also had the connection with my OB. He made sure that he really congratulated us in welcoming our son and highlighted that it was really special that he was here now after he had seen our journey. It felt very good, but the recovery was just so incredibly difficult as someone who lives with a neuromuscular condition. I think no one at the hospital was really aware of the fact that I needed a different timeline in terms of when to get up and get moving in comparison to other moms who don’t have the condition that I live with. Everything was very rushed. I literally left the hospital 24 hours after having a C-section which is the standard of care where we live. Meagan: 24 hours? I didn’t know that. Jacqueline: 24 hours. It’s appalling in my opinion. Meagan: Very quickly. Jacqueline: It’s something that I don’t think should be encouraged, but I returned home and really just wasn’t prepared for what was to come. I didn’t feel like I had even a full range of mobility for probably 6-8 months. It was just traumatic in that sense that I hear so many people around me sharing that after a few months, they felt that sense of normalcy again and reconnection with their body to some extent. For me, my timeline was just very different. For anyone who is going through the process of giving birth and lives with a condition like a neuromuscular condition or something similar, I think it’s important to have in the back of your mind that your timeline will be different and that is okay. If it is possible for you to give birth vaginally or to try and go for a VBAC or try and avoid a C-section if not medically necessary, do everything in your power to try and make that possible because often even the care instructions that I was provided with in postpartum were not aligned with the realities of what I face as a person with a neuromuscular condition.Because it’s so underresearched, my OB/GYN for example did not know what kind of recommendations to give me in terms of what to expect and how to prepare myself so I think that’s just something to keep in the back of your mind if you are trying to make informed decisions about what to expect if you are someone who lives with a neuromuscular disease. Jacqueline: That being said, when my son was 2, or I guess we actually got pregnant 18 months postpartum so exactly at the time you are recommended to start trying again. This was not something that we necessarily planned for and we did not think it was possible to have another child without planning so we just took that as an unexpected blessing and my pregnancy with my second son went very smoothly. I did notice though with my pregnancy with my first son, I didn’t seek chiropractic care and other services like massage as much as I probably should have. I also wasn’t as active prior to giving birth as I probably should have been in order to help myself with mobility and also with my postpartum healing. So I was very proactive during this pregnancy. We had just moved from northern Ontario to southern Ontario for my husband’s work so we were now about a 5 ½-hour drive from the majority of our family and support system. One of the first things that I did when we moved to the community was find a sort of new care team to help with FSHD– just the regular symptoms, not even pregnancy-connected. I found The Wellness Hub which is located in Hamilton, Ontario for anyone who is in the area. They are a practice that primarily specializes in women’s health and so I just felt very at home immediately when I entered their clinic and I found an amazing chiropractor there who supported me from the very beginning of my pregnancy and then when I reached 20 weeks, I decided that I wanted to start going more frequently so I was going for weekly chiro visits. I made sure that I also did massage at least once a month up until 30 weeks and then I was going bi-weekly from 30 weeks onward. I think that’s also very important for anyone who is living with a neuromuscular condition or something similar. Prioritize your care and don’t put yourself in the back corner preparing for your baby to arrive. Really make sure that you focus on your care and healing as well. So to fast forward a little bit, everything went well with my midwife care team in this community as well and as we neared our 35-week mark, I said, “Hey, we should probably start talking about labor and delivery.” so they were actually quite slow to start having that conversation. I don’t even think it came up until 36 weeks for us because I had always gone past 39 weeks. They thought I would have time. They didn’t think I would go into labor early. I didn’t, but I still thought we should be having those conversations. My husband is a pilot so he’s actually gone every 2 weeks and so because I didn’t have family close by and because I knew I may potentially not have my husband at home either, I hired a doula team. I also did this during my second pregnancy, well my second birth as well, but unfortunately at that time, it was COVID so we couldn’t have doulas in the hospital. But she did support me mostly in preparing my husband for what to expect, but she had a background in kinesiology as well so she also helped prepare my body physically for the birthing process. She had studied with a training called the Body Ready Method. I really wanted to find a doula who had the same training background because I found it very beneficial. I did some research and found a doula team, Leanne and Roseanne, who are in the Hamilton area with Hamilton family doulas and they worked with me from around the 35-week mark as well to get ready for my birth. Largely because I had the knowledge background as a doula myself, they didn’t have to go through too much about what to expect in your birth. We largely just discussed the different types of movement I would want to be doing in early labor and also really helped me to prepare for what I had hoped going in would be an unmedicated birth but also talked about the different options that we may have with a really strong focus on having a VBAC. That was my number-one priority even in selecting gmy provider. I really made sure that I called around and fortunately, in my area, every midwife practice I spoke to is very aligned with me having a VBAC. Meagan: Awesome. Jacqueline: Ultimately, the providers I chose, my team, Sara and Emily, were really aligned with making sure that I was very comfortable, that I wouldn’t be moved around too much after giving birth. I really emphasized as well that I wanted to try and avoid giving birth on my back because I knew that any additional pressure on my hips and lower back would probably lead to a longer postpartum healing for myself just because of my condition. Everyone seemed very aligned. As we neared closer to 39 weeks, that’s when we started to have discussions about induction and things of that nature. One thing that is standard practice where I live is that you would have a consult with an OB and an anesthesiologist from 20 weeks which I thought was crazy. At the time, I said, “I don’t want to have an epidural. I don’t want to have an OB involved in my birth process at all. I don’t want a C-section. I’m not even meeting with these folks because I want to manifest the birth that I want.” So they were a little caught off guard by this. They did try and schedule me again. I believe it was around 30 weeks and I just declined again so being informed about what my options actually were in terms of what I can accept or say, “No thank you” to was very important and for anyone who is going through the process as someone who is living with a disability, I think you really need to make sure you do educate yourself on what you can say no to because you have that extra layer that people can always fall back on to say that you are kind of treading the high-risk zone. You can push back on that politely and say that you are not high-risk. That’s why you are here and that you prefer to just stay with your current providers and your current care plan. Meagan: I was going to say too that Julie mentioned this on a previous episode that I loved and is sticking with me too. You can say, “How will my care change if I do this? If I meet with these people or if I have these extra visits?” You can say, “How is this going to change?” If they say, “Oh, it’s just to let you know who they are,” then you’re like, “I don’t care.” Jacqueline: That’s essentially what I did in person was saying, “Why do I need to meet with an OB?” They said, “It’s standard practice here.” I said, “I really would prefer not to. I am working on a huge project right now with my professional career. I have two other kids. I just don’t have the time or capacity to be having meetings with someone who probably won’t even be on shift when I give birth anyway. So respectfully, no thank you.” At the 39-week mark, we discussed what would be our next steps if I did go over 41 weeks which in my province is sort of your cutoff time from when you can give birth without induction for a VBAC. So within my community, VBAC anywhere other than a hospital was just not even discussed. Because of my condition, I did agree that I would do a hospital birth. Now, if I ever had another child, I would probably actually want to try for a home birth. But yeah, I went into the process trying to keep an open mind, trying not to be too judgmental going into a hospital environment. I spoke about this a lot with my doula team. I got to hear a little bit about their experiences within this hospital because they had supported clients there to give birth. I had a friend who is a nurse there in the labor and delivery department as well. Ultimately, everyone gave me very positive reviews which put me at ease. I think it’s important as well to do a little bit of research about the care team that you select and the hospital that they have privileges in. If the hospital where they have privileges isn’t necessarily VBAC friendly, then maybe it’s a good idea to get a different care team. That may be something that is very Canadian-specific, but our midwife teams only have privileges in certain hospitals, so you have to make sure that you do that extra little step of research. I also spoke to a lot of moms in a community called Mamaraderie here in Hamilton, Ontario. I hope I’m pronouncing that correctly. A lot of the moms shared very positive VBAC stories. I was actually referred to the podcast several times by moms who I spoke to which was great to hear as well. Yeah, basically from that time forward, the talk was really just how do we ensure that I have a successful VBAC with my midwives? They didn’t really speak to me too much from their end about induction. They recommended that I have a consult with an OB at the hospital. I went in and I spoke with a resident. I believe she was a fourth-year resident. To be quite frank, the experience was terrible. She essentially told me that if I needed to be induced, my care with the midwives would end until my baby was born and that they would not be there with me when I was laboring because their care was redundant which I found to be incredibly insulting. Meagan: Yeah. Jacqueline: I was just floored that she would state that. She did emphasize that the decision if I wanted to be induced or I wanted to wait out labor was my decision. She spoke to me about C-section even though I expressed that I did not want it. She said, “Let me just cover my bases and tell you what your options are.” I respect that. It’s probably what she was trained to to but it definitely put my guards up because I explained in detail why as a person with FSHD, it is not in my best interest to have a C-section, then when she provided all of my different options, and I was also big on hearing the statistical options if I waited to go into labor naturally or if I was induced in a more controlled environment type of situation what the best outcome would be, I had heard all of these statistics through the podcast but I didn’t listen to one specific episode talking about induction yet so after I had a major breakdown after leaving the hospital, I spoke to another friend of mine who is also a doula and she recommended listening to the episodes specifically on induction. That helped a lot more than speaking with the resident to bring some clarity in terms of what the best outcomes will likely be if I were to wait versus if I were to go down the induction route again. I already knew from my birth with my daughter that induction using oxytocin doesn’t even really necessarily work very quickly for my body. I wasn’t really convinced that it would speed up the process. If anything, I remembered it being a 10 pain from the beginning with very minimal dilation and an incredibly long process. I knew that in my area as well, if I’m birthing in the hospital environment and I’m induced, I need to be monitored 24/7 and that meant that I wouldn’t be able to move around. It meant my plan to have early labor in the bath would no longer be an option. It also meant that if I went over the 24-hour mark, I wouldn’t even have a choice. They would just tell me that I would need to have a C-section per their policies. I said, “Okay. I’m going to give myself more time.” From 38 weeks, I had been going to chiro again weekly. I’d been doing massage weekly. I started doing acupuncture once a week and I also started doing things like the Miles Circuit and things of that nature to try and induce labor. One thing around the 39-week that started was that I was having contractions that would stop after a certain number of hours. Even if I did movement, I would take baths trying to check if they were Braxton Hicks. I’m still not entirely sure what they were because they felt a little bit stronger than when I had Braxton Hicks but they would just stop. Meagan: Like prodromal labor. Jacqueline: Yes, starting from pretty well the 39-week mark. Then there would be days at a time where I would have nothing. In week 40 I knew, Okay. my deadline is next week. I need to amp this up a bit. My entire care team at The Wellness Hub were all fixated like I was on my having a VBAC. Now at this point, when I would come into my appointments, everyone would be waiting at the door because that would mean I’m going into labor. I felt like I had a very supportive team around me and we started to do acupuncture twice a week during my 40th week. I also was going to chiro twice a week and doing massage as well. I think even in my 40th week, I did massage twice in that week. I took one of their cancellations. Meagan: Yay, good for you. Jacqueline: We did everything humanly possible to try and induce labor naturally. Because I had never experienced a sensation of natural labor, I didn’t know what to expect in terms of the sensations. My doulas didn’t necessarily describe it or know how to describe it either in terms of what was not labor and what was. We were all just waiting around. Every time I would have contractions start and stop, they would be like, “Okay, maybe it’s going to happen but it’s probably not because it’s been many days of it starting and stopping.” Jacqueline: On March 7th around 1:00 AM, I started to feeling contractions again but much like my doulas, I said, “Oh, I’ll sleep through it.” They started to intensity and get more close together, but my first son was a terrible sleeper and so he used to wake up about every half hour to an hour so from a sleep perspective, I’m very used to waking up often. So when my contractions started getting closer together, I didn’t really think too much of it. My son came into my room around 2:30 that morning and I realized, “Oh my goodness. My contractions are 5-7 minutes apart at this point for the last hour.” He came into bed with my husband and I tried to stay in bed, but they were just too strong so I went into the bath. I realized I had lost my mucus plug.I got in. I was trying to remain comfortable in the bath. This time, they were just intensifying so I had a feeling that this was early labor. Meagan: Yep. Jacqueline: I remember my daughter came into the room. Initially, I asked her to be my mini doula before I called in my doulas and she saw me in pain and I could tell by the look on her face that she was not going to be my mini doula because she was terrified. She said, “Are you okay?” She stayed with me for some time and eventually, she went back to bed. I stayed in the bath for about an hour just breathing through contractions. I think it was 45 minutes in when I started to time them using an app just to know if I should contact my doulas and say, “Things are starting to happen.” The week prior, I did my first cervical check. I was less than 1 centimeter dilated. I knew my body. I knew that I don’t dilate easily. I remembered that from my first birth so I just mentally prepared myself for what could be a long labor. My contractions around 5:00 AM were about 5 minutes apart. I live about a half hour away from my hospital so I knew that I should probably contact my midwives to just let them know that contractions were 5 minutes apart. When I gave them a call, they said to come in around 6:30-7:00 AM unless things really intensified then come in immediately. I woke up my husband. My dad had actually driven down from northern Ontario to come and stay at our home just because I had a feeling. I gave birth on a Friday and on the Wednesday I told him that he should probably come. I just knew that I probably wouldn’t even last until the weekend when he anticipated to come. So he came and took my son. Yeah, things just got more and more intense. By the time we got to the hospital, I was breathing through contractions about every 4 minutes. Sometimes they were a little bit closer together so we went up to labor and delivery. We saw our midwife and she told me that I was still 1 centimeter dilated and that it would probably be a long process. She recommended that we come back home which we did. I didn’t feel too disappointed at that time because she recommended I return home because she knew that I wanted to have more ability for movement. She knew that would help with my condition and she also knew that I wanted to be able to be in the water. I really appreciated that she had that recommendation. I let my doulas know that that was what was going on. Initially, when we went in, we called one of our doulas to give them a heads-up that we were headed into the hospital. We ended up staying at home for about 2-3 hours where I really tried to move around. I would recommend to anyone who has this type of condition as well that movement really is your best friend.Even though it feels like it won’t be comfortable, in your postpartum recovery, you will be grateful that you moved around and didn’t stay stagnant in one position. We were only there for about 2.5 hours. My mom had driven down that morning as well and she just watched me trying to get some rest in bed. My contractions were about 2-3 minutes apart at that point. I said, “I don’t feel like he’s descending so I’m not worried about that,” but she said, “Your contractions are so close together. I’m worried you are going to give birth in this bed at any minute.” I knew that we were not there because I could feel that we weren’t there. They were very close together and they were intensifying so we did go back in. From there, things went pretty quickly. Well, it felt pretty quickly but it was not pretty quickly. We got in and I had a replacement midwife so she wasn’t someone from my initial care team. My midwife actually was feeling unwell between when I saw her in the morning and when I got into the hospital. But oddly enough, this midwife, Elizabeth, reminded me so much of my mother’s best friend. She looked like her physically. She sounded like her so I felt like it was someone close to me even though I had never met her before. She surprisingly recommended the internal monitoring to me several times which I declined and I will say for anyone who has a midwife, often we don’t anticipate that anything will be recommended by a midwife that maybe we are not comfortable with, but if that happens and even if you have the best relationship with your provider and you fully trust them, you are still allowed to decline an intervention if it’s not medically necessary. Meagan: Yes. Jacqueline: So I did do that very respectfully as well. I was monitored 24/7 throughout my process of being in the hospital. When I initially came in, my son’s heart

“With cord blood, hope really knows no bounds.”Diane Paradise is living proof that cord blood transplants cure the incurable. Diagnosed with a rare form of Hodgkin Lymphoma at only 24 years old, Diane fought an extremely hard fight as it returned five more times before age 42. It had now become stage 4B and metastasized to her bone marrow. With no other options, Diane was given hope through a clinical trial. She eradicated all of her sick marrow through aggressive chemotherapy and then was given a new blood type through a cord blood transplant from two different donors. 24 days later, after almost two decades, Diane was cured. She has just celebrated her 10th year of being cancer-free and has committed her life’s work to spreading education about the hope behind what banking your baby’s cord blood after birth can do for your family. Meagan and Diane talk about what cord blood banking is, how to enroll, how much it costs, and where you can find all of the information you need about this lifesaving procedure. July is Cord Blood Awareness Month and Cryo-Cell is offering a free seminar on Wednesday, July 31 2024 at 1:00 PM EST. Register at https://lp.cryo-cell.com/fuller-paradise-seminar. Cryo-Cell's WebsiteNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, hey everybody. Today’s episode is a little different from the norm. We are actually going to be talking about cord blood banking. We have my friend Diane on the podcast. Hello, Diane. Diane: Hello, hello. Meagan: It’s so good to see you again. She and I met for the first time actually in January of this year, 2024 at a doula retreat and she was there speaking at this retreat about cord blood banking. Cord blood banking for me wasn’t actually a new topic because I had spoken to another company a little while ago about it but there was something extra unique and extra special about Diane and Cryo-Cell is the company that she works with that I was like, We need to share more about this. First of all, her story which I’m sure she’ll share a little bit more about, is incredible. So today, we actually normally would do a review, but I really want to soak up the time with Diane because I know her time is so precious. After the intro, we are going to dive right into what this is even about. Meagan: Okay, you guys. Like I said, we have our friend Diane. Diane is a 29-year, six-time cancer survivor. After fighting a rare and uncurable Hodgkin Lymphoma for nearly two decades, a cord stem cell transplant saved her life. You guys, when she was sharing her story at this retreat, it was so insanely amazing and heartbreaking at the same time. So many things that she’s been through. It says, “This past December, she celebrated her 10th transplant re-birthday. For many years, Diane was a survivorship educator helping women living with cancer and chronic illness. Today she is spending time on the side of the cure educating expectant parents, birth workers, and obstetricians on providing the potential of cord blood for Cryo-Cell International, the world’s first cord blood bank.” Diane, welcome to the show. Seriously, I am so excited for you to talk more about this with our listeners because we do have expectant parents. We do have OB/GYNs and midwives and birth workers and this really is a unique thing and it’s something that is so powerful. I know because I’ve heard your story so I’m just going to turn the time over to you. Diane: Thank you so much, Meagan. First of all, I know your audience is varied but for the expectant moms out there, I just want to say congratulations. I can only imagine the mix of emotions they are feeling right now and one of them is probably a profound sense of hope and anticipation. So for me, hope was two units of cord blood stem cells hanging on an IV pole on December 3, 2013. So let me step back a bit just so everybody can understand. I was diagnosed at 24 years old with that rare, incurable form of Hodgkin Lymphoma. It was back in 1994. I think about that. Wow, I’m aging and I love it. The alternative wasn’t great. Meagan: But you’re still so young. Diane: I am. I am.I was told that this was incurable and that it would keep coming back. It would be more and more aggressive. The chemo would become less effective over time and the intervals between when it came back would get shorter. That’s exactly what happened. It came back at ages 31, 35, and 38. It became really aggressive at age 40. What I mean by that is that it went from stage 2B to 4B. It had metastasized into my bone marrow. I couldn’t walk. I couldn’t drive. I couldn’t take care of myself. I couldn’t even take care of myself alone. Thankfully, I went back into remission around the spring of 41, but it came back a year later at age 42. I spent about a year and a half going through different types of chemotherapy trying to get it back into remission and that’s when the idea of a transplant came up because quite honestly, it was my last chance. It was my last hope. It was in my bone marrow. It was time to either going to heal or it wasn’t. So I ended up in a major hospital and we originally had started looking at bone marrow transplant. We were looking at what they call a half-match and they were going to use my sibling. Now, my siblings aren’t ideal donors. They are older than I am and the ideal donor is 18-35. At that point, I was 43 so I was a year and a half into it. I was 43 so that tells you how much out of the ideal age range my siblings were. Then they called me and said, “Oh hey, we have a clinical trial going where we are going to be comparing the side effects of cord blood versus bone marrow and the effectiveness.” I was like, “I don’t understand. What’s the difference?” They said, “Bone marrow is educated stem cells. They are educated stem cells. They’ve been exposed so any virus that your donor has or has had, when you receive that donation as your own stem cells, you will have been exposed to that whereas cord blood which is taken after the umbilical cord is clamped and cut is pure and uneducated. It has a higher rate of engraftment. It has a lower rate of graft versus host disease which is where your body thinks the stem cells are the enemy. Then it really doesn’t have much of a chance of a virus being there, a latent virus.” I went ahead and said, “Yes. Hello, I’ll take that pure, uneducated. I’ve had a failing immune system for 19 years at this point. Yes. I’ll take that clean, clear, beautiful, pristine cord blood stem cells.” So I went to the hospital. It was around November and I had to do a lot of the pretesting. I went through six days of really intense chemotherapy and one day of radiation to eradicate my own bone marrow, the sick bone marrow. Then I received on December 3, 2013, two donor stem cells. One was from Germany and one was from Michigan. About, it was a few weeks later. It was a few weeks later when they pull a blood test to see where are you on the engraftment. Is there a little bit of one of the donors? And I want to step back. The reason that there were two donors– if I were a child, I would only need one donor, but I’m an adult. That’s a lot of bone marrow that has to go in and graft and replicate in order to ingraft for an adult basically. That’s why I had two of them. It kind of creates a survivor of the fittest. It creates an environment for faster cell engraftment. So then I had the blood test done 24 days later. After 19 years of battling incurable cancer, I was 100% grafted to the Michigan baby in just those 24 days. Meagan: Isn’t that incredible? Diane: It really is. I was cured by cord blood in 24 days. Meagan: 24 days after years and years. Diane: Almost two decades. Meagan: Yes. Diane: Yes. So think about this. I want you to really think about this. What is often tossed as medical waste is what saved my life. Meagan: I encapsulate placentas, the actual placenta itself and there will be so many times where people are like, “Why would you do that? That is garbage.” They literally say that. They think that. Placentas are garbage, but look at what it’s done. It saved your life. Diane: Well, the cord blood did, yes. Meagan: The cord blood which I understand they can throw the placenta away after they get the cord blood out. Is that correct? Diane: So what we do with cord blood is that after it is clamped and cut, they actually insert a needle and draw the rest of the cord blood out because the placenta continues to pulse as if the baby is there for up to 30 minutes. That’s the stem cells that we are collecting. Now, if we were to collect the cord tissue that’s after the placenta has been delivered, we will cut and collect the cord tissue if that’s something that the parent is interested in, yes. Meagan: Gotcha. Diane: Yes. So I ended up with a new blood type, just so you know. Meagan: Oh yes, I remember you saying that. Diane: Remember? I remember you liked that comment a lot when we talked about it. Meagan: A whole new blood type. The fascinating thing is even your immune system we talked about how it started over. Diane: Yeah, I had new baby immunizations. I’m 43 years old and 44 years old and getting immunizations as if I never had them. Meagan: Yeah. Diane: I just find that so fascinating. Meagan: It is so fascinating. Diane: So fascinating. Meagan: It is. Okay, so cord blood isn’t being used a ton. Diane: It is. It is. Meagan: Sorry, it is being used a ton. Diane: A lot more than people know, a lot more than people know. Meagan: This is my thing is that it’s not being talked about. Diane: Bingo, ding ding ding. There you go. Meagan: Let’s go into that. Diane: Yes. It’s funny because even I found a transplant video from the day of the transplant where I did a vlog to my family and friends and I talked to them about these two women who selflessly donated their cord blood and how it would potentially save my life or potentially could save my life. I was like, “I don’t even know how they do that.” The video was really funny. What I realized was once I got done with it, I went down this rabbit hole of, I need to know more. Once it cured me, I wanted to know everything. Meagan: I’m sure. Diane: What I found was there was a lot of information out there and it’s being used in a lot of ways but there’s also misinformation. You had mentioned that I was a survivorship coach leading up to this and I was until I moved to Tennessee and I just decided I didn’t want to continue that and I wanted to be on the side of the cure and for me, that was cord blood. Fast forward to today, I am working for Cryo-Cell International and now, I can recognize and help people with the misinformation and myths surrounding cord blood banking. You talked about it not being used. That is simply not true. We just don’t know about it. It is actually an FDA-approved treatment for nearly 80 different diseases including blood cancers, and anemias– we have a whole list on our website but there have been 50,000 transplants worldwide and there are 175 active clinical trials for things like autism, multiple sclerosis, cerebral palsy, adult stroke, Alzheimer’s, dementia, Type 1 diabetes, Parkinson’s– because what it is, cord blood is rich. I don’t want this to be a big science class lesson, but it’s good for people to understand because we have two different things here. We have cord blood and we have cord tissue. Cord blood is what is called a metapoetic stem cell and that is what creates all of the cells in your blood and immune system which is why it was able to replace my stem cells with my donor’s. They are a perfect match for the baby. They are a 50-75% chance of a match for a sibling and there are a lot of sibling transplants and an acceptable match for parents. Now, the other side of it, the cord tissue, is a different type of stem cell which is the mesenchymal stem cell. They do something a little bit different. That’s in the Wharton’s Jelly so they are capable of becoming structural and connective tissues like bone, fat, and cartilage, and they can modify immune functions to help treat autoimmune diseases such as arthritis and diabetes. I recently listened to a doctor out of UC Davis. Her name is Dr. Farmer and she used the stem cells from cord tissue on the spine of a baby with spina bifida in utero. She did the surgery in utero and closed up the opening where the spinal cord was exposed and the baby came out wiggling their toes and moving legs. Pretty amazing. Meagan: Wow. Diane: Yeah. And there’s a lot being done with this. There are over 100 active clinical trials for ALS, rheumatoid arthritis, lupus, Type 1 diabetes again, MS, Crohn’s, and spinal cord injuries– I mean, there are just so many active clinical trials for different diseases out there. It is being used. Cord blood is being used and cord tissue is in active clinical trials as well. Meagan: Wow. So especially for our pregnant mamas and expectant parents or even birth workers wanting to share this information with their clients, what is the process to do this? We know a lot of the benefits right here. We just went through so many of these benefits. What is the process of getting started? What I think is pretty cool about Cryo-Cell is that they can send the kit to you. I saw the kit you have brought as an example. Can you walk listeners through what it’s like in case they are interested in doing it both physically on what the steps are and even financially if we can talk a little bit about that? Diane: We can.Meagan: Then storage-wise, how long? There are so many questions. Can we talk about that process? Diane: Absolutely. Absolutely. Okay. I’m trying to think of where we should start with this. There are so many questions you just asked me there. Meagan: Sorry, I just threw a lot at you. Diane: Like, hmm. Where do I begin? Another myth– so if somebody wants to save for themselves, one of the myths we hear is that it’s expensive. 10 years ago it was. Now, it’s more affordable and Cryo-Cell has, first of all, we have the most amazing kit. You mentioned it. I will repeat that. We have a kit that has a handle on it. It comes to you. You open it up and it has everything right there, the forms for you to fill out, the information for you to give the delivery physician. All of that is right there. When you enroll, you get the collection kit, the shipping, the medical courier, the processing, and testing because after processing, once it arrives back to us, it has to be processed and tested as well as the first year is storage. That price because it has that initial fee in it ranges from $800-2000 whether it is cord blood or cord blood and cord tissue. However, we have a risk-free enrollment so nothing is charged at the time that you enroll. If you decide not to collect, call us and ship the kit back within two weeks and it will be no cost to the expectant parent. Then after that, if they do enroll and we get all of it and it’s processed, the annual storage fee runs between $185 and $370. It’s $185 for cord blood and then $370 for cord blood and cord tissue. We offer flexed payment plans. We offer monthly specials. There are discounts for returning clients and families with multiple children. We have military discounts for retired and active and also medical professionals. If your friends and family want to purchase gift certificates for you, they can do that as well. We have that ability. The thing that I like the most is that we have a refer-a-friend program. If you are having a baby, your friends are probably having them too. If you refer your friend to us and they become a client, you get a free year of storage and you can get unlimited years of storage using that program. I do want to just take a quick step back with the kit because our kit is like I said, it’s special. It has everything in it that you need. We have these– I’m trying to think of what they are called right now. Vacuum packs, they’re not vacuum packs. They’re insulated packs because it has to stay at a certain temperature. If it’s too hot out, those packs will cool the collection down as it’s being shipped. If it's too cold out, it will warm them up. It’s pretty special. It is definitely a kit and then it also protects up to 30 times longer because of that. Meagan: Yeah. Which I think is a really unique thing about their kit for sure. Diane: Yes. Yes. Meagan: So they’ve got it no matter what part of the world or what time your baby is born. If it’s in wintertime or summertime– Diane: Yes. It’s taken care of. Meagan: It’s taken care of. You can rest assured. Okay, so they can enroll to be a member. If you do and decide to donate, it gets sent. There’s an initial fee but then there is an annual fee which you can easily get for free by referring friends. We talked about it being shared and it can help siblings and things like that. It is there if you need it. For your instance, is it possible to be a match to somebody then does someone call? How does that work? Diane: No, so my donations came from a public bank. Mine were unrelated donors. Meagan: Okay, because that was a clinical thing too, right? Was yours a trial? Diane: It was a trial, but they already knew that cord blood transplants worked. They were just trying to compare the side effects of each– which has lower, graft versus host. Meagan: So it was just being donated from a bank. Diane: Yes, from a public bank. If someone can’t afford to private bank for their family, there is the option to donate like what saved me. Meagan: That’s where I was getting at. This is perfect. Diane: That is free and that is anonymous. You can give someone a chance at life whether it be through a transplant like I received or through research. Cryo-Cell has public donation sites in Florida, Arizona, and California. If there isn’t one in someone’s area who is listening, I’m sure you’ll put out my contact information and they can contact me directly and I may be able to help them find a way for them to donate. Now, there’s a couple of things that I want people to understand about the public donation option. If you can’t afford to private bank, this is a great option because the only other option is for it to be medical waste. Let these be the only two options for you and that’s why I’m like, contact me. I might be able to help. I want you to understand that I did have two donors. Only one of them was from the United States. They had to go out of the States to Germany to find me a second match. Whether it’s bone marrow or cord blood, it isn’t easy to find any match when it comes to that type of transplant. If there is a family history of any of the diseases that I mentioned earlier, I really urge people to consider private banking to safeguard your family’s health because when you donate, sometimes people think, Well, I’ll just donate and it’ll be there if I need it. Well, 8 out of 10 units that are donated go to medical waste anyway because of family health history or low collection volume and they are being used daily. The ones that are there are being used daily so most likely, you won’t find it if you need the cord blood for your family. Meagan: Right and your family is more likely to be a perfect match, right? Diane: With the matches, it is a perfect match for the baby. It’s a 50-75% acceptable match for a sibling and an acceptable match for the parents as well. Meagan: Right, yeah. So pretty awesome chances. Diane: Yes. Yes. Because of the audience, I want everybody to understand because this is probably the #1 myth that I get from parents that I hear a lot. That is that, Well, I want to delay cord clamp so I can’t save the cord blood. I want you to know that you can. 10 years ago, that was probably true. Today, if they follow the ACOG recommendation of a 30-60-second delay, you can delay and save. It may yield a smaller collection so basically what that means is it’s really crucial to select the best processing method. For instance, our PrepaCyte processing method is more advanced. It provides a cleaner yield and that is what makes it beneficial for delayed cord clamping and saving the cord blood. So if that is truly what they want to do, here’s the other thing to know. Remember how I said that you have a risk-free enrollment if you enroll then decide not to collect? If you enroll and you collect and it gets to us and it has suboptimal results, we pick up the phone and call you and talk to you about it. You can decide one way or another if you want to move forward with banking that cord blood. Meagan: Continue. Diane: Yes. And you did ask about how long does this stuff last? Cord blood is living medicine. It is collected. It is processed and it is stored in this amazing five-compartment chamber so you can get multiple uses out of it if maybe it’s a treatment protocol and it’s not one big transplant necessarily which I think is going to become more and more the way of doing things with cord blood. That’s my personal opinion. That’s not necessarily the opinion of Cryo-Cell, but I do see that with all of the reading that I’ve done. Did I answer all of those questions you threw at me? I’m not sure, but I tried. Meagan: Yes, yes. I think you did. You nailed it. Diane: Yes. Meagan: Yes. Yes. Okay, so obviously you chose to work for Cryo-Cell for a reason and you’re telling us all of the things about why but is there anything else that you are like, this is literally why I choose Cryo-Cell and why I suggest them? Diane: Yes. When I was doing all of my research, I looked into all of the cord blood banks, but for me, because I was cured by cord blood. This was why I am still standing here. I wanted to work for a company who did more than just banked cord blood. So when I went looking for that and I found Cryo-Cell, I realized that they focus on cord blood education and also cord blood advancement. They are embedded in every facet of the cord blood industry. They have private which is also called family banking. They have public donation sites. They are always seeking out the best technology for our kids and for our storage. I mentioned those temperature packs. I mentioned the five-chamber storage bag and then our premium processing, the PrepaCyte. So we are the world’s first cord blood bank, but we don’t ever rest on our laurels. Thank you. There’s the word. They never rest on their laurels, so to speak. Why do I keep trying to say that word? That’s hilarious. They are constantly trying to advance research. They are advancing research. In 2021, Cryo-Cell entered into an exclusive license agreement with Duke University and what that does is it grants us the right to propriety processes and regulatory data related to cord blood and cord tissue development at Duke. This year, I love this. This year, we are opening our first infusion clinic where it will be a site for future clinical trials investigating cerebral palsy, autism, and other neurological conditions. This is what I mean. We don’t just collect the cord blood and cryo-preserve it. We are constantly looking for how that can be used. How can it be used to protect the families who have trusted us with their baby’s cord blood? And not just us, but they’ve trusted us and we want to do what’s right for them. Cord blood is all we do. We aren’t part of a larger business model and that’s what makes our quality and our level of customer service unmatched. I knew Cryo-Cell was who I wanted to work for and I’ll be honest with you. The story behind how this all happened was honestly the stars aligning and I happened to be in the same room with someone who worked there. I had a conversation and a few months later, this is where I ended up. I couldn’t be happier. This company is– Meagan: Life-changing, literally. Diane: Yes. Life saving. Meagan: Lifesaving, yeah. Okay, so tell everybody where they can enroll and find more information because on the website, there’s a lot of really great information. There’s more on why, pricing, they go into the cord tissue. They talk about private versus public so all of the things that you’ve been touching on. They’ve got all of these things, a Q&A. There is a really, really great amount of information. Where can they find you? Where can they find the website? How can they enroll and all of the things? Diane: If they want to know more or are ready to enroll, they can go to our website which is cryo-cell.com and they can either chat with one of our incredible cord blood educators. They can click to enroll. Like you said, everything that they are curious about is there. If they want to reach out to me personally, I have an Instagram account for Cryo-Cell which is called @curedbycordblood. I have all of my contact information there. Meagan: Okay. I’m going to write that down right now so we can make sure to have it in the show notes. You guys, it’s super easy in case you forget anything. Just scroll in the show notes. Click the link and you can go read more about how you can definitely start cord blood banking for yourself or like she said, even donate to the public. Diane: Yes. Yes, or for research. Can I just end with one thing for these expectant parents? Meagan: Yes, of course. Diane: Banking cord blood is a once in your baby’s lifetime opportunity. You don’t want to miss it. If you have questions, call us. When I tell you we have the greatest educators in the industry, I mean it. Every bit of it, I mean it. They can answer all of your questions. All I ask is that no matter what you decide, please don’t let it go to medical waste because, with cord blood, hope really knows no bounds. Meagan: Thank you so stinking much for joining us today and sharing this seriously invaluable information. It is so important and it can really benefit so many people. So thank you so much.  Diane: Thank you for having me.  ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Caylee joins us from Canada sharing her experience with two VBACs after a twin Cesarean birth. She also shares what it was like having cholestasis in all three pregnancies. Cholestasis is a liver condition that slows or stalls the flow of bile. Meagan and Caylee discuss in greater detail what cholestasis means during pregnancy, what symptoms can look like, and how it is diagnosed. One of Caylee’s most intense symptoms was incessant itching. She talks about how it affected her not only physically but mentally as well. While all three of her pregnancies were preterm births and her two VBACs were medically necessary inductions, Caylee advocated throughout her entire labors and was able to stay the course to achieve the vaginal births she knew she was capable of. Cleveland Clinic Article: Cholestasis of PregnancyAmerican Journal of Obstetrics and Gynecology Article: Risk of Stillbirth in U.S. Patients with CholestasisHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to the show. We have our friend, Caylee, with us and her little wee, tiny little newborn. Caylee: Hi everyone. Meagan: Oh my gosh. Welcome to the show. How old is your baby? Caylee: He just turned 3 months. He was born a month early though. Meagan: Okay, 3 months and a month early. We are going to talk about why he was born a month early. You guys, today we are going to be sharing some stores and talking a little bit about cholestasis. This is something that we actually don’t have a lot about on the show. When you were listening, Caylee, did you? Caylee: I don’t think I’ve heard a single episode, yeah. Meagan: Did you hear about it in general on other platforms? Was it talked about?Caylee: Not really, no. I found it online on Facebook. I’m in the ICP Care Facebook group and that’s super helpful. They are amazing in there and super knowledgeable, but yeah. It’s not very common. It’s quite rare. I think it’s 1 in 1000 women who end up getting it. Meagan: Yeah. Caylee: So yeah. It’s not very well known about and even with providers, providers don’t know about it very well either. Meagan: Yeah. I think that can be part of the problem, right? Because we’ve got providers who don’t know a lot about it and then it can cause a little bit of a panic and then a lot of the times, it can cause Cesareans or lead, I should say, to Cesarean. We’re going to be talking about that today and sharing her stories. Review of the WeekMeagan: But I do have a Review of the Week so I’m going to get into that and then turn the time over to cute Caylee. This is from Cori and it doesn’t say where it’s from. Somewhere in the universe, it is from. It says, “The VBAC Link is gold.” It says, “Of all of the things I did to prepare in pursuing for a VBAC after two C-sections, I think is one of the most important is that I was listening to this podcast. Hearing these stories and information from Meagan and Julie made the dive into learning about VBAC and birth in general so much easier. I was blessed with my VBA2C” so VBAC after two C-sections “with my sweet Brynne Lynn and I sincerely believe I wouldn’t have gotten to that point without this resource and the community. Thank you guys for all that you do.” Oh, that just makes me smile so much because this community– oh my gosh. I mean, Caylee and I were kind of just talking about this. Yes, Julie and I are here, but there is this community, this absolutely incredible community and all of the people coming forth to share their stories. And Caylee, you just said it yourself when you were like,  it’s like all of these people who came and shared these stories impacted you. Caylee: Yeah, totally. Meagan: Yeah, they are the reason. You are the reason right here. Caylee, you are the reason why what Cori said in this review is possible by sharing your stories, by coming in the community on Facebook and on Instagram and having these conversations and learning and also being vulnerable. There are so many times where I see posts where it’s the most vulnerable, genuine post and I can’t explain to you the outpouring of love that I see come in for this person from this community. The VBAC Link Community, just the VBAC community in general, oh my gosh. You are all amazing. Thank you so much and yes, if you want to join that community, check us out on Facebook at The VBAC Link Community. It is a private group. You do have to answer the questions to get in so just keep that in mind. If you are not answering questions, you might not be allowed in. And on Instagram, and of course, if you want to have a review that I could share for the Review of the Week, please do so. We would love that.  Symptoms of Cholestasis Meagan: Okay, Caylee. Are you ready? I’m so ready. Caylee: I am ready, yes. Meagan: Awesome, I would love to turn over the time. Caylee: I don’t know where to start. Should we start by talking a little bit about cholestasis so that they understand the risks? Meagan: Yeah, I think that– well yeah, the risks, the symptoms, and then also how it can be missed and then how it can sometimes– well it kind of goes with the risk, but there are other things that can come in I should say from cholestasis and I actually even had a client myself, a VBAC client after two C-sections. She had cholestasis, preeclampsia, VBAC after two Cesareans, and was induced. Caylee: Wow, good for her. Meagan: Yeah, but preeclampsia, right? Okay, let’s talk about the things. So what are the symptoms that you one, may be experiencing, and two, that there may be that someone might not experience? Caylee: Yeah, so for me, it was intense itching mainly on the bottom of my feet and on the palm of my hands but I had it everywhere. I have scars on my ankles, up my arms, on my belly just from scratching. Meagan: From scratching? Caylee: Yes, incessantly. It’s an itch that you can’t really scratch. It’s in your blood that is making you so itchy so you can scratch all you want and it’s temporary relief but as soon as you stop, it’s like, oh. I broke down in tears so many times and had ice packs on my feet and on my hands while I was trying to sleep. Another symptom is darker urine output and some upper right quadrant pain. Meagan: Yes. Yeah. Caylee: Those are very common and some people also experience jaundice. Meagan: I was going to say yellowing, jaundice. Decreased appetite. Caylee: Yeah. You’re more likely to get preeclampsia and gestational diabetes. Yeah. Meagan: Mhmm, yeah. So nausea, feeling unwell, dark urine, lack of urine output which a lot of the time, dark urine is the beginning of that. Your kidneys are warning you and then you stop. Yeah. I had a client, not the one I was telling you about, but another client. She said that her bowels like her poop smelled really weird, like abnormal. Caylee: Yeah, I’ve heard that before too. Meagan: Yeah. That’s the first time when she was like– that was actually one of her first symptoms that she noticed. Thinking back, she was like, “Yeah, I guess I was kind of itchy, but I wasn’t itchy-itchy until later.” But that was one of the things where she was like, “I just thought I ate something weird.” Caylee: Yeah. Meagan: A decreased appetite. Pain in your belly and your quadrants, jaundice, and of course, itching. Those are the main signs. Caylee: Itching. And the severity of the itching can vary greatly between cases so the first time, it was quite mild and then it progressively got worse throughout my pregnancies. That’s different for everyone who experiences that so if you have any itching, you should ask for LST’s and bile acid tests from your provider. Itching can also precede the bile acids rising and the elevated bile acids is what’s dangerous for the baby. It increases the risks in the baby where they might pass meconium before birth and also stillbirth risk goes up a lot if the bile acids are above 40. Meagan: Too high, yeah. So when you are pregnant, if you are having symptoms, definitely go in and get checked like she said. Get these tests. Then if you have cholestasis, if you test positive and things are looking like you have it, it is something that may increase extra testing and extra visits because you do want to keep a close eye on this. Again, like she said in the beginning, it’s really rare. Even right here, it shows on this link that I’m going to put in the show notes, it’s from the Cleveland Clinic, but it shows 1-2 in 1000 people during pregnancy will experience this. It’s pretty low, but it can be a serious thing. Also, I was going to ask you because I know my clients have in the past. They’ve been given some things to try and control, to minimize, to control, to lower things to try and continue pregnancy to a good, safe term stage. Were you given anything like that? Caylee: Yeah. I was put on a medication called Ursodiol. It helps lower bile acids to make it a little bit safer for the baby so you can continue. With my last pregnancy, they were very severe levels. They were over 100 so it was kind of touch and go there whether we could get him to 36 weeks or not. They were talking about inducing me at 34 weeks. We ended up opting for non-stress tests and biophysical profile ultrasounds just to keep an eye on him. Meagan: And he did well? Caylee: He was doing well. He had already passed meconium sometime before I was induced though at 36 weeks. It was time for him to come out. He was already in distress so it was good that we did end up taking him out at 36 weeks, but he did great. Really great. Meagan: Good. Good. That’s another thing I would like to drop in and note that if you do have cholestasis, it may be something that brings you to something like an induction that is earlier than expected. Obviously here, we’re going to share this story in just a second about VBAC and induction. It’s possible and totally doable, but that is a thing. Cause of CholestasisMeagan: She’s mentioning bile. It is in the liver, right? Am I correct? It’s in the liver. Caylee: Yeah. Meagan: We don’t really know why. I don’t know why. Do we know exactly why it happens?Caylee: They don’t. They think it’s something to do with pregnancy hormones and the placenta, but they don’t know for sure. It’s some sort of genetic factor as well, but no woman in my family who I know has had it. So I think it’s just something that can happen sometimes. Meagan: Yeah. I have heard the hormones like estrogen and progesterone can be too much in the body. So just to circle back around again, if you have had any of these symptoms or if you are having any of these symptoms, it’s okay. Don’t hesitate and go in and get checked out. Caylee: And if you go in and get a negative result and still have symptoms, ask your provider to keep testing you. Meagan: Yes. Go back and check again. Okay, so baby number one? First pregnancy: TwinsCaylee: Twins. Meagan: Twins! Caylee: Baby one and two, my first pregnancy. Meagan: So twins. You had symptoms? Caylee: I did, yes. I got it pretty early on and they tested me and it was negative. They just put me on Ursodiol before anything came back positive. They didn’t do anymore testing or anything. I didn’t have any itching. The medication must have made it go away somewhat. Yeah. I was only 21 when I was pregnant with the twins so I was pretty young. I didn’t know much of anything. I knew I wanted a vaginal birth. I had actually switched providers in my third trimester to somebody who was comfortable with vaginal birth with twins and they ended up being breech when they decided they needed to take them out. Preterm Cesarean at 36 weeks due to breech presentation and IUGRIt wasn’t due to cholestasis, but I did have them at 36 weeks because one of the twins had stopped growing so they took them out. Meagan: IUGR? Caylee: Yeah. Yeah. He was quite significantly smaller than his brother. Meagan: Okay. That can happen with twins too, I know. Caylee: Yeah, totally. Yeah. My twin A was 6 pounds, 7 ounces, and twin B was 4 pounds, 4 so it was quite a big difference. Meagan: Mhmm. Caylee: Yeah, so it was a C-section with them. We were in the NICU for two weeks. Second pregnancyCaylee: I ended up getting pregnant again when the twins were 16 or 17 months old. I knew I did not want to do that again, having a C-section so I found supportive midwives and got on with them. Unfortunately, I don’t know if it’s in Canada, but they don’t allow home birth for your first VBAC for some reason. Maybe it was just those midwives, I don’t know, but I really wanted a home birth and they were like, “No, let’s do hospital. It’s safer.” I was like, “Okay, as long as I can still have my VBAC. I’ll just do that.” The pregnancy went well. I thought I wasn’t going to get it again. No itching, then I hit 34 weeks and the dreaded itching started again. I kind of had a feeling that I had it during my first pregnancy too from my own research. I had mentioned it to my midwives beforehand so we were looking for it seeing if it would happen. They sent me for testing right away at 34 weeks. It came back negative so they ended up testing me again weekly and then at 36 weeks, they tested me and my liver function tests were very high. My liver was basically failing and they didn’t even wait for the bile acids to come back. They just brought me in for an induction. Meagan: What week again? Caylee: I was 36 weeks and 2 days when they started my induction.Meagan: Okay, so technically preterm. Caylee: Yes, yes. InductionCaylee: When I went in, they started with a Foley balloon to help dilate my cervix and that was awful. It’s like a torture device, I swear. But it was effective I guess. It dilated me and then it fell out and I don’t know if they didn’t have a nurse for me or something, but I was waiting 8 hours for them to continue my induction. The OB came in and he wanted to break my water. I said, “No. Let’s start low Pitocin.” He was like, “Well, it’s not really going to do anything if you’re not going to break your water too.” I said, “Okay, let’s see how it goes.” Meagan: Yes. Caylee: We did that. Labor was going smoothly. I loved being in the shower. It was amazing. Then they made me get out because his heart rate was dipping really high so they wanted to get me out and be able to monitor him a little bit better. That’s when things got really intense and I felt like I wasn’t able to cope as well after I got out of the shower. I think in the back of my mind, I was still pretty young with him too for my first VBAC. I was only 24 and I know that uterine rupture risk is very low, but for some reason, I just couldn’t get that out of my mind and every contraction I’d have, I’d just feel like I was being ripped open and was so scared that I was having a uterine rupture. I ended up– it was 32 hours into my induction and I still was at 4 centimeters just because I wasn’t letting my body relax and do the work. I was tensing and fighting every contractions because I was terrified. I ended up getting an epidural at 1:00 AM and 5 hours later, I woke up and was fully dilated and pushed for 15 minutes and he came out. Meagan: 15?! 1-5? Caylee: Yeah, 1-5. Meagan: Oh my goodness. Caylee: As he was coming out, I pulled him up to my chest and it was just this amazing feeling like, Oh my god, I did it. The high that comes with that is unbelievable. Meagan: Yeah. Caylee: I just kept looking at everyone saying, “I did it. I did it.” Meagan: Absolutely. Caylee: It’s an amazing feeling. Meagan: It really is. Caylee: I fought with the OB who was on call a little bit, the one who wanted to break my water. He kept saying, “Does she want to do this? Let’s just go for a C-section.” I’m like, “Yeah, I can do this all night long and he can stay out of my room until I’m pushing. My midwives have got this, thanks.”Unfortunately, because I had to be induced, I had to be overseen by an OB so my midwife ran the show and was able to be with me and do everything, but he had to be there in case anything went wrong I guess. Meagan: That’s kind of normal. A lot of the times, when there is a hospital midwife, there are OBs who oversee them. Caylee: Yeah. Yeah. So yeah, that was my first VBAC, first induced VBAC. Second Induced VBACCaylee: I just recently had another induced VBAC. With this one, my levels went up high. I think it was 28 weeks that I tested positive so it was sooner. Meagan: Significantly sooner. Caylee: Yeah. They went from 0 to 100 within a matter of days. They put me on Ursodiol immediately as soon as it came back positive. I was being monitored weekly with NSTs, non-stress tests, and they were sending me for biophysical profiles as well weekly which is an ultrasound to check on the baby’s well-being. He was doing well so they just were keeping going with that and unfortunately, the Ursodiol did not help my itching this time around. It was so severe. I was in tears pretty much daily from the severity of the itching. Yeah. It was really bad this time. The mental health aspect of having that incessant itching I don’t think is talked about a lot either. It really gets to you. It’s depressing. Meagan: Oh, I would not do well with that. I would find myself getting very anxious probably and out of control. Caylee: Even now, if I get an itch, I get PTSD. It’s like, Oh my god. It’s not going to stop. I freak myself out and work myself up. I remember that after my second pregnancy as well. It was like I’d get a bug bite and I’d just have to itch and itch and itch until it was bleeding. Oh, it was just bad. I don’t know how to leave itching alone now. His levels were very severe, or my levels I guess. My liver function tests were some of the worst that my OB had ever seen. Meagan: Interesting. Caylee: So yeah, it was just really bad. Caylee: I had actually applied for midwives. We had just moved from Alberta for BC pretty much as soon as we found out we were pregnant with Henley here. I applied pretty much as soon as I found out I was pregnant for the midwives here. I ended up hearing back from the midwives in Edmonton which is an hour and a half away that they could see me up there but once I got the itching and cholestasis, I was like, “Just transfer me to an OB where I live. It’s just easier for me then all of my appointments will be out here and I don’t have to drive 1.5-2 hours to appointments in the middle of winter.” Yeah, so they scheduled my induction for exactly 36 weeks because of the high levels. They didn’t want me going past that because with levels over 100 bile acids, the stillbirth risk goes up very high after 37 weeks. Meagan: Did they give you a percentage or anything like that? Caylee: Yeah, I think it’s upwards of 15% with very severe levels. Meagan: Oh wow. Caylee: If levels stay under 40, your risk of stillbirth is around the same as anyone else's. They go up 3% over 40 and over 100, it’s even more. So it was a bit touch and go there. They were talking about inducing at 34 weeks and we were able to get to 36. Still preterm, but a higher likelihood that he wouldn’t need additional support. InductionCaylee: I was induced at exactly 36 weeks. I actually had influenza B when I had to be induced. Meagan: That’s miserable. Caylee: As if labor isn’t hard enough alone, I had to have influenza B. It was great. Meagan: Miserable. Yes. Caylee: Yeah, one perk though was that we got a private room right away. I didn’t have to labor in triage until I was far enough along to get my delivery room or whatever. They put me right in there. I was able to get set up and feel like it was my space and get more comfortable. So yeah, they started with the Foley balloon again to open the cervix. They can’t do Cervadil or a few of the other cervical ripening– Meagan: Cytotec. Caylee: Yeah, because it really does increase the risk of uterine rupture with induction, but the Foley balloon is a safer option and it works. Within an hour and a half this time, my cervix was 4 centimeters. Meagan: Wow. Caylee: From barely a 1. It was kind of funny. I was standing there talking to my husband and I took a step toward the bathroom and it just flopped out and there was this line of blood up and down the floor. It was like a total bloody show. Meagan: Mucus. Caylee: In a perfect line. Meagan: Oh my gosh. Caylee: Because they attach the tube to your leg. They tape it to your leg so when it falls out, it makes a long, smooth line. My husband pulled the nurse call button and she’s laughing. She ended up cleaning me up. Things picked up pretty quickly from there this time. I felt it was much more manageable though. I don’t know if the nurses were nicer this time and they were doing the Pitocin a bit slower because I remember with my first VBAC, the contractions just felt back to back like I wasn’t getting a break at all and it was really mentally wearing me out after 32 hours. I hadn’t slept. I ended up getting the epidural but this time, it felt like more of a natural progression. I don’t know. I’ve never had natural labor, but for me, I was able to handle it a lot better. Maybe that’s because I knew what to expect this time so it wasn’t as scary. Meagan: It could be. Caylee: Yeah, I don’t know. Or I’ve heard too that with cholestasis that the bile acids or something make Pitocin more effective so maybe I didn’t need as much of it this time because my levels were higher. I don’t know but it was much more peaceful this time and I knew what to expect even though I was sick. I labored in the shower for a little bit with the mobile monitor because with inductions, they want to be able to monitor the baby constantly which I know is talked about a lot on here as something that is not ideal. Meagan: Yeah. Even if no induction with VBAC, it’s really, really common if not 100% that your hospital is going to want that monitoring. Caylee: Yeah. And having that mobile monitor though is so helpful if your hospital has one of those. Definitely ask because oh my gosh, it’s so nice to be able to get up and walk around and move and shower. Unfortunately, because of the flu, we were battling a fever. I had a fever so as soon as my Tylenol would wear off, my fever would spike and then his heart rate would go up. I had an anterior placenta so it was kind of in the way of the monitoring and it was hard to get him constantly so they ended up wanting to do the electrode. Meagan: The IUPC and the FSC? Caylee: Yeah, I think so. It’s the one that they put on the scalp. Meagan: Okay, that’s an FSC, fetal scalp electrode. Caylee: Yeah, that unfortunately didn’t work very well. I was bed-bound but I was so sick that I didn’t even really care. I was just switching sides laboring through, using the gas. I loved the gas this time.Yeah. I ended up getting to an 8, 8 centimeters and the OB unfortunately was not the OB who I had through my pregnancy. She had gone on vacation for my induction, unfortunately. I was really sad about that, but the OB on call came in and he was like, “You know, this is taking pretty long. I think it’s time that we start thinking about a C-section. I’m getting worried about your scar.” I’m like, “I’ve done this before and it took longer last time. I am not having a C-section.” Meagan: Good for you. Caylee: I don’t think he really liked that though because he was like, “Well, then you’re getting an epidural because at least if you have the epidural and something happens, we can rush you in and open you up faster,” and blah, blah, blah. I’m like, “It has to be at least 24 hours and it’s only been maybe 12 hours of hard, active labor here. My C-section scar is strong. It’s been over 7 years since my first C-section. We are both doing well. Yes, I’m sick. Yes, his heart rate keeps going up when we have a fever but when the Tylenol kicks in, his heart is going back down and his tracing is normal. Why would I have a C-section?” Meagan: The fact that you’re having a fever is more likely to the fact that you are sick versus that you have an infection.Caylee: Yeah, exactly. They tested me when I got there and they knew that I had influenza B and I tested for Group B strep so I was just having to fight with another OB again which is really frustrating, but yeah. He ended up leaving the room and my doula and my nurse were both like, “Wow, you’re amazing. I’m actually so impressed with you saying no to him.” I guess a lot of people just go with what the doctor says. Meagan: Well, I guess. Caylee: That is why there are so many unneeded C-sections. Meagan: Well, we’ve talked about it on the show where it’s like, I didn’t go to years and years of medical school, so okay, I guess. Same thing with me, I was like, Okay, and went down and had a C-section when I completely did not need a C-section. Caylee: You hope that doctors are saying that when it is actually medically necessary and not when it’s convenient for them. I think he was getting like, It’s been 24 hours. I’m almost off-shift. I don’t know, but I was not having it. It was actually funny. When he texted me, he was like, Oh, you’re 8 centimeters, but he’s -2 position and not coming down. He was like, It’s probably time to do a C-section. I was like, “No, it’s not actually.” Meagan: Oh my gosh. He really wanted to do a C-section. Caylee: Yeah, so I was like, “No, I’m not having a C-section.” He ended up leaving the room and pretty much immediately, I had a super strong contraction. I jumped off the bed trying to get away from it because apparently, that can help. I kind of grabbed my nurse’s shoulders, the poor thing. She is this tiny, little 20-something nurse. I grabbed her shoulders and my body was pushing. I was farting and things were moving down there. Meagan: I bet that baby was coming down quickly too. Caylee: Yeah, that quick movement. Popping up just brought him down and she was like, “Are you pushing?” My doula was like, “Well, that’s a good sign.” I was like, “I don’t think so.” But my body was just doing it and then I barely made it back on the bed before his head was out. Meagan: Oh my gosh. So was the provider even in there? Caylee: No. Nope, he was just leaving the room telling me that I needed a C-section because I wasn’t progressing. Meagan: I know that he had left but I didn’t know if she was beeping him back in like, “Come back in!”Caylee: I guess he was down the hallway at that point and his head was out. I made it back onto the bed thankfully. My nurse was down there taking the fetal electrode out of his scalp panicking a little bit being a nurse. She was like, “You need to keep pushing.” I’m like thinking in my mind, No, I need to rest for a second. His head’s out. He’s fine. I knew in my soul that he was okay. I took half of a second to rest and then my body was pushing again and he was out. Meagan: Oh my gosh. Caylee: He had the umbilical cord wrapped around his neck and his armpit. I thought that maybe was why he wasn’t coming down. Meagan: It could be. Caylee: Maybe he was tangled up in there a little bit and couldn’t come down fully but maybe that quick movement that I did to pop out of bed was just enough to let him come down. It was so quick. I was looking around. My doula ended up riding out into the hallway to call my OB back and my nurse was frantic. She was like, “This was my first baby I caught!”Meagan: Aw, and it was a VBAC. Caylee: Yeah, yeah. I’m looking around the room like, “Whoa. What just happened?” I went from 5 minutes ago being told it was time for a C-section to my baby on my chest. Meagan: Yes. Oh, that is amazing. You know, maybe that person needed to leave to also relieve some stress so baby could come down. That’s another thought I had. Caylee: Yeah, I think that was it and maybe my baby was like, Yeah, we’re not going for surgery, mom. Let’s show this OB what’s up. Meagan: Yeah, seriously. It reminds me– is it the tiger or the lion? I can’t remember the thing, but when you are being chased or when you are in a hostile environment, you either tense up or you run or whatever. We’ve got all of these senses and you could have been like, Nope. I am not having this baby with you in this room. I’ve had enough of your C-section talk. So cool. So after, with all of the babies, but especially with this one because your levels were so bad, were there any complications? Caylee: I guess I did touch on this a little bit before. I forgot though during my birth story there, when they broke my water, because I did allow it earlier this time because I felt with my first VBAC that that actually helped speed things up a little bit. I did allow them to break my water and start Pitocin at the same time this time. When they broke my water, it was full of meconium. They weren’t too worried about it. Thankfully, that OB seemed pretty C-section happy and he was still like, “Oh, no big deal. We’ll just monitor him. It’s okay. There is a risk there for aspiration, but it’s not a total risk that that will happen.” So they were just monitoring that. When he came out, he was fine for being 36 weeks. He was breathing good. They wiped his face because there was the meconium on his face, but no. He was great. It was more me that I was worried. I was like, “Is he okay?” They were like, “He’s fine.” Meagan: Good. That’s so good to know. I was just curious because he was early, high levels, induction, fevers, all the things so that’s so good to hear that he was really great. Caylee: Mhmm, yeah. Even my twins were 36 weeks, 2 days when I had my C-section. They were in the NICU for 2 weeks and that was just for feeding and growing. They didn’t know how to suck and then with my now 5-year-old, he was totally healthy when he came out too. He was 36+4 at the time he was born because my induction took so long with him, but yeah. He was healthy. He did have jaundice quite badly though so he needed the bilirubin lights and then with my baby now, he also had jaundice but he was able to stay off of the lights. He was just under that level for needing phototherapy. That’s pretty common with early babies anyway. I don’t know if that had anything to do with cholestasis in general or if that was just them being early that it was more likely to happen.Meagan: Yeah, that makes sense. Oh, well thank you so much for sharing your story and talking more about cholestasis with us. Like you said, there is not a lot out there. It is not very common so it makes sense that it is not talked about that often. However, uterine rupture isn’t very common but it is talked about all the time. Caylee: Yeah. Meagan: So you know, but it’s good. It’s good to be aware. It’s good to understand the symptoms and what’s going on and why so I’m so grateful that you shared your stories. I’m so grateful that everyone is healthy and happy and wonderful and you are smiling and have some good birth experiences and maybe some healing birth experiences. Caylee: Yeah, totally. Meagan: You showed yourself that you could stand up to pressuring doctors. Caylee: Yes. I honestly thank my doula for being there for my last birth because I don’t know if I would have had the confidence to be that firm with such a pushy, “this is what’s going to happen” doctor. We had talked about it previously that she can’t say anything for me but that she will be there to support and give me the power to advocate for myself. I totally felt that power from her. She was amazing. I’d like to shout her out to Little Loves Doula in Red Deer. She was amazing. Stephanie, she’s great. If anyone is in Red Deer, Alberta, definitely contact Stephanie from Little Loves. Meagan: Well, you know that we love doulas here and always encourage checking out a doula. We do have VBAC Link-certified doulas. She’s got her doula. Yeah. Caylee: I think she was also VBAC Link certified. Meagan: Was she or is she? Caylee: Yeah. Meagan: That’s so awesome. You can check out The VBAC Link doulas at vbaclink.com/findadoula. Let me tell you, it’s so fun to see all of the doulas in all of the different states. We are growing within the States. And if you have a doula in mind who is not on the VBAC list, send them the link. We would love to have them and have them support our VBAC clients and our VBAC community. Thank you so much again. Caylee: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your

“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 WebsiteNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull 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

“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 WebsiteThe VBAC Link Blog: Preterm CesareansTVL Blog: Everything You Need For Your HBACTVL Blog: Provider Red FlagsTVL Blog: VBAC/HBAC PreparationTVL Blog: VBAC MidwifeTVL Blog: Big BabiesHow to VBAC: The Ultimate Prep Course for ParentsFull 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