The VBAC Link

“In that moment, I knew that was the last time I would see her. I didn’t know what I was going to do, but I knew I could not go back to her.”How do you feel when you meet with your provider? Are you excited for your appointments? How does your body react? Are you tense or calm and relaxed? Jessica’s first birth began with an induction that she consented to but didn’t really want. Her waters were artificially broken, and her baby just was not in a great position. After over 4 hours of pushing and multiple vacuum attempts, Jessica consented to a Cesarean. Listen to Jessica’s VBAC story to find out what she did when she realized at 37 weeks that her provider was NOT actually VBAC-supportive.Sometimes difficult situations actually work out even better than we hoped!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, Jessica, to the show. I am so excited that you are here and excited to hear your stories and actually talk a little bit more about what you do. Do you do it for a living, or is this just your passion project or whatever they call it? Is it your side job?Jessica: It’s on the side. It’s volunteer. My main job is a stay-at-home mom right now. Meagan: Yes. You’re homeschooling, right? Jessica: I am. Meagan: Oh my gosh. One of my best friends homeschools. I just praise you guys. Homeschooling is legit. It is very hard. That seems so hard. Jessica: It’s definitely a lifestyle. It’s different. It’s not for everybody, but it’s definitely for us. My daughter is only 5 so we are just getting used to it. Meagan: So Kindergarten?Jessica: She just turned 5 a couple of weeks ago, so we are technically doing 4-K right now. We are just getting into it. I’m still wondering every day, “Am I doing everything I should be?” I know as it goes on, I will get more comfortable and confident with it. Meagan: Yes, you will. That’s what I’ve seen with my friend. She was like, “This is what feels right. This is what we are going to do.” It took a little bit of a learning curve, then each kid added in, but she kills it. Yes, you are just a stay-at-home mom, but a full-time teacher. Holy cow. That’s amazing. Then yeah, you are doing La Leche League. Jessica: Yes. I have been a leader now for 2.5 years, just over that. I became certified. I think it was on my due date. I was trying to get everything done before my toddler was born. It’s been going really great. I really like it. Meagan: Yes. Tell us more about it because when I was– this was in 2014– pregnant with my second daughter. That’s when I heard about La Leche League. Tell us more about it and why someone would want to find their local leader, and then what all the benefits are and how to find them. Jessica: Sure. I first heard about La Leche League when my oldest was maybe about 9 months, so right away in my breastfeeding journey, I had no idea about it. I wish I had because it would have been great to have a community of support. I started feeling really passionate about breastfeeding and knew I wanted to help other moms with it because it can feel really isolating, especially because it was in the middle of the pandemic. I started researching ways that moms can help other moms with breastfeeding because I had no other background in it. I’m not a nurse. I didn’t work in the labor world. I just stumbled upon it, and I lived in Madison at the time. I saw that Madison had a chapter. They weren’t doing meetings at the time because everything was virtual. But I just reached out, and I said, “I want to be a leader. Tell me what I need to do.” They emailed me back, and I got in touch with another local leader there who had been there for a while. She was surprised. She was like, “You want to be a leader, but you don’t even know what we do. You’ve never been to a meeting.” I just said, “Yes. That is what I want to do.” It was kind of a long process to become a leader because everything was virtual. They didn’t know how to go about that. Meagan: Yeah. Jessica: So it took a little bit of a long time to become accredited as a leader. Meagan: Does it now or is it in person? Did it stay virtual? For someone who may want to?Jessica: I think everything is back to in-person. At least where I live now, Madison I know is back to in-person now too. Everything is probably running a little bit more smoothly now in terms of if you are interested in becoming a leader. Basically what leaders do is that we get some training within La Leche League, but we are your cheerleaders. We are here to support you. We are the middle ground between if we need to refer you somewhere for some additional help if it’s beyond our scope of practice of basic breastfeeding positioning, latching, or if you have questions of, “My baby is doing this. Is it normal?” That’s what we do. We have support groups every month for anybody to really join. Meagan: Awesome. Jessica: It’s fun. Meagan: Where can someone find it if they’re wanting to learn more? When it comes to breastfeeding, it sounds weird because you don’t have your baby yet, so why are we talking about breastfeeding? Why are we thinking about it? But I really believe that connecting before we have our babies with an IBCLC or a La Leche group is so important before you have your baby. If someone is looking, where can they find information or try to search for a chapter in their area? Jessica: You can just look up your state La Leche League. There should be a website that has all of the local chapters. They are all over the world, so you should be able to find somebody near you. Even if there’s not one near you, you can contact anybody. Let’s say they are 2 hours away. You can still call or text or email. They’ll usually, if you want to do something more in person, you can do some type of Zoom meeting. You can definitely find anybody to talk to. You’re right. It’s really important to get support before you even start breastfeeding if you know that’s something you want to do. I always say that breastfeeding is natural, but it doesn’t always come naturally. You don’t know what to do in the beginning unless you talk to somebody. Meagan: Yes. We will make sure to have the website linked in the show notes too, so if anyone is wanting to go search, definitely go check it out. Okay, now we are going to give a little teaser of what your episode is going to be about today. So, with your C-section, give us a little teaser of what your C-section was for. Jessica: So, my first birth went really smoothly and my pregnancy. I really liked my doctor. I really liked the hospital. It was a group of OBs of all women. I met with each of them. I really liked all of them, to be honest with you. They were all very supportive of whatever you wanted to do.Meagan: Which is awesome. Jessica: Yes, it is. I knew I wanted to have a vaginal birth. That was all I really knew, but I was also really young, I think. I was 23 for most of my pregnancy. I didn’t really educate myself beyond my doctor’s appointments. I trusted them to pretty much tell me what I needed to know, and that was it. That was my bad. Meagan: Yeah. Hey, listen. That is something I can relate to so much. I was also in my young 20s and just went in. Whatever they said, or whatever my app said, is what happened. I think that’s a little tip right there that says, “Let’s not do that.” Let’s not do that. Then for your VBAC, you had a bait and switch. I’m really excited, when we get to that point, to talk about bait and switch because it is something that happens. It can feel so good and then feel so wrong within minutes. It’s really frustrating, but I want to talk more about that in just a minute. We do have a Review of the Week, so I want to hurry and read that, then get into Jessica’s story. This reviewer is by diabeticmamawarrior. It says, “A podcast to educate the mind, heal the heart, and strengthen the soul.” It says, “Hi. I am writing this podcast from Seattle. We are currently pregnant with my second baby due in March of 2022.” This was a little bit ago. It says, “My first son was born at 28 weeks via classical Cesarean due to severe IUGR.” For anyone who doesn’t know IUGR, that is intrauterine growth restriction.“--and after hearing I would never be able to VBAC, I decided to do as much educated research as I could and to find my options was truly needed. I am also a Type 1 Diabetic and have successfully found an amazing midwife who not only feels comfortable and confident assisting in care through my pregnancy with my diabetes, but also with my special scar, and we are aiming for a successful VBAC. I am also receiving concurrent care with an OB/GYN as well to make sure appropriate monitoring of baby looks good throughout pregnancy. Listening to this podcast was one of the first resources I found, and it was a total GAME CHANGER.” It says, “Thank you, beautiful women, who bravely and shamelessly share your stories so that other women can also feel confident in making empowered decisions for their baby and their body. I am soon to join the legacy of women who have fearlessly VBAC’d happy and healthy babies. Much love, Ellen”. Meagan: Wow. What a beautiful review. Jessica: That was powerful. Meagan: Yes. What a beautiful review. That was a couple of years ago, so Ellen, if you are still listening, please reach out to us and let us know how things went. Okay, girl. It is your turn. It is your turn to share, just like what Ellen was saying, your beautiful stories, and empower other Women of Strength all over the world. Jessica: That review just reminded me that a long time ago, I reviewed the podcast, and you read it on one of the episodes. Meagan: Did we?Jessica: We did. I remember thinking, “This is so cool. I wonder if I could be on someday.” I’m sure you hear this all the time, but it’s very surreal being here knowing I listened to this podcast to help me heal. I’m just super excited to share my story. Meagan: I am so glad that you are here, and I’m so glad that we were able to read your review. We love reading reviews. It is so fun when we can hear the review, hear the journey, and then now here it is hearing the stories. Jessica: Yes. Meagan: Yes. Okay, well I’d love to turn the time over to you. Jessica: Like I said, I was introducing my story with my first. I just clicked through a birth course breastfeeding course that the hospital provided for me. I clicked through it to get it done and to check it off my list. Meagan: Birth education– yes, I did. Jessica: That’s exactly what I did. I’m prepared, whatever. I’m just going to go into this, and everything will happen like it’s supposed to. Mentally, everything was going well in my pregnancy. I wasn’t super eager to give birth. I wanted to wait to go into labor on my own. I think what started to bother me or what made me a little bit more antsy was when I was 37 weeks. I agreed to have my cervix checked for dilation, and I was 3 centimeters already. I was so excited, and the doctor said, “I don’t even think you’re going to make it to your due date,” which made me think, “Wow. I’m going to have this baby in the next 2 weeks. I’m not even going to make it to my due date. This is so exciting.” If any of your doctors ever tell you that, don’t let it get into your head because that doesn’t mean anything if you are dilated. I was 3 centimeters continuously. Meagan: Yeah. You can walk around at 6 centimeters, not even kidding you. My sister-in-law was at 6 centimeters for weeks, and nothing was happening. She was just at 6 centimeters. It can happen when you are just walking around. Try not to let them get into your head, or to get nervous when you’re like, “I could have a baby at any second.” It gets in our heads, and then when we don’t have a baby, it’s infuriating and defeating. Jessica: That is pretty much what happened. When I got to my 39-week appointment, I was still 3 centimeters. I just expressed how I was frustrated. I was tired of being pregnant. My doctor said, “Well, let’s set up your induction.” I had never even thought of being induced at that point. It was never mentioned. It never crossed my mind. It sounded so intriguing at that moment to just get this over with. I don’t want to be pregnant anymore. My sisters had been induced, and they had a good experience. It will go the same for me. Everything in my head was telling me, “Don’t do this. You know you don’t want this,” but I did it anyway because I had it in my mind that I should have had my baby already anyway based on what they told me a couple of weeks ago, so it would go so smoothly. She said, “You are a great candidate. You are already 3 centimeters.” We scheduled it. I think it was that Friday I went. It was Monday, on Labor Day, that we had my induction scheduled for. I didn’t have a lot of time to even process that. Meagan: Yeah. Did they say how they wanted to do it, or did they just say, “Come in. Have a baby”?Jessica: They briefly told me that they would start with Pitocin and see how my body responded to that. They would probably break my water which is exactly how it happened anyway. Meagan: Yeah.Jessica: Yeah.They started me with Pitocin at 3:00 PM. They kept increasing it, then by 6:00 PM, my body was just not responding to it. I didn’t feel anything. The doctor who was on call wasn’t my normal doctor, but I saw her a couple of times. I was comfortable with her. She came in and said, “Well, we could break your water. Is that what you want to do?” I said, “Sure. If that’s what you think we need to do, let’s do it.” Meagan: Yeah, I’m here to have a baby. What’s going to get me there?Jessica: Yeah. She was head down, so I thought, “What could go wrong? She’s already head down.” I didn’t know at the time that just because she was head down doesn’t mean she’s in a great position. She wasn’t. She was– what do they call it?Meagan: Posterior? Jessica: ROT. Meagan: Right occiput transverse. Okay, so looking to the side. Sometimes, when we say transverse, a lot of people think the body is transverse which is a transverse lie, but ROT, LOT, left or right occiput transverse, means the baby’s head is looking to the side, and sometimes, that can delay labor or cause irregular patterns because our baby is just not quite rotated around or tucked. They are looking to the side. Jessica: Right. That was pretty much what the obstacle was because when they broke my water, she engaged that way, so her head never was able to turn properly which we didn’t know yet. I feel like the doctors could have known that because aren’t they supposed to be able to feel and know maybe a little bit of where they are? Meagan: Yeah. So providers can. They can internally, and it depends on how far dilated you are. If you were still 3 centimeters, probably not as well, but at 3 centimeters AROM, where we are artificially breaking it, that’s not ideal. Usually, the baby is at a higher station at that point too. I call it opening the floodgates. We get what we get however that baby decides to come down, especially if baby is higher up and not well-applied to the cervix.If baby is looking transverse and hasn’t been able to rotate right during labor, then they come down like that, and then we have a further obstacle to navigate because we’ve got to move baby’s head. I will say that sometimes a baby might be looking transverse and mainly through pushing, a provider can sometimes rotate a baby’s head internally vaginally, but you have to be fully dilated and things like that. Can they feel through the bag of waters? If they can feel a good head, yes. Sometimes they can. Sometimes they can’t, but again, there are all of these things that as a doula anyway, I help my clients run through a checklist if they are going to choose to break their water. Sometimes within your situation, I’d be like, “Maybe let’s wait.” But their view was, “Let’s get labor going. We are starting Pitocin. The body’s not responding,” which we know is a number-one sign that the body isn’t ready. Sometimes we still can break water with better head application and with the water gone, it can speed labor up. That’s where their mind was. Their mind probably wasn’t, what position is this baby in? Where is this baby at? What station is this baby at? It’s like, let’s get this baby’s head applied to the cervix. Jessica: Yes. I mean, it did work. As soon as my water broke, I immediately when into active labor. The Pitocin contractions were very awful. I felt them immediately because not only did my body start going into labor, but then the Pitocin also was making it worse. Meagan: Yes. Yes. Jessica: So I begged for an epidural right away even though I knew that’s not what I wanted. I didn’t do a lot of preparing for labor, but I know I didn’t want an epidural right away. I remember the very sweet nurse I had saying, “Do you want me to run the bath for you?” I said, “Are you crazy? That is not what I need right now.” Meagan: She’s like, “I’m trying to help you with your birth preferences.” J: I know. She was so nice. I apologized to her after later on when I saw her. That was the head space I was in. I just needed that pain to be gone. They ended up turning the Pitocin off eventually because my body just did what it needed to do on its own. Meagan: Good. Jessica: I didn’t get much rest after that. I couldn’t really sleep. I was too excited. But it wasn’t very long until I was ready to push after that. I think at about 7:00 PM, I got the epidural, and at midnight, I was ready to push. I kept trying and trying. 4.5 hours went by until she was just not coming over. I don’t know if it was my pelvic bone or something. That’s when we knew she was not going to turn. They suggested that we try the vacuum. I didn’t know what that was. That was very traumatic because the lights were bright. Everyone was in there. I remember my doctor saying, “Okay, we have one more attempt with this vacuum, and that’s our last attempt.” Of course, it didn’t work because in my mind, I knew it was my last chance. It was not going to work, and it didn’t. I was really upset after that. I remember crying saying, “I don’t want a C-section.” I was really afraid of it. But, that is just what we had to do to get her out at that point after attempting the vacuum. I remember being wheeled down to the OR and just being so tired and not knowing how I was going to take care of a newborn after having surgery and being so tired. I had been up for 24 hours. The C-section went fine. I was out of it though. I was passing out here and there just being so tired. They had to tell me to actually look up. “Your baby’s here. Look up.” I remember opening up my eyes going, “What?” I was forgetting what I was doing. Meagan: Out of it. Jessica: Yeah. I was very much out of it. But after that in the hospital, I wasn’t too upset about having a C-section. I was just so excited about having my baby. It really didn’t hit me until we were on the way home from the hospital. I started crying and was so upset. I felt like my experience was stolen from me because I felt like  I was so mad at my doctor for bringing up an induction at that point knowing if she didn’t, I would have never asked for one anyway. I had a lot of regrets about everything. In those couple of weeks after having her, your hormones are very up and down anyway. One moment, I would be fine. One moment, I would be really, really upset crying about it. I wanted to redo her birth so badly that it almost made me want another baby. “If we just have another kid, we can try again,” even though I had this 3-week-old next to me. Meagan: Yeah. Jessica: I was not thinking very clearly. Meagan: You were craving a different experience. That’s just part of your processing. Jessica: Yes. And looking back, I wonder if I was struggling with some PTSD because I would lie there at night not being able to sleep, and I would suddenly smell when they were cauterizing the wound. I would suddenly smell that again and think I was back in the OR. It wasn’t very fun. Meagan: Yeah. It’s weird how sometimes the experience can hit you in all different stages and in different ways, but right after, you’re like, “No. No, no, no. I need something different. Let’s have another baby right now. Let’s do this.” So once you did become ready to have another baby, what did that look like? What did that prep look like? Did you switch doctors? You liked your whole practice. How did that look for you?Jessica: Well, we moved. I knew I had to find another doctor. I would have anyway in Madison. I would have gone with a group of midwives that somebody I knew had a good experience with, and after listening to the podcast, I wanted a midwife. But unfortunately, where we moved, we live in Green Bay now. I was so limited on which provider I could go with. In one hospital, one group, that was all I could do locally. I couldn’t go with the hospital that everybody was recommending or the midwives that everybody was recommending for a VBAC. Meagan: Why couldn’t you go there?Jessica: My insurance was very limited. It still is. We can only go to this one hospital and one facility for doctors. Meagan: Okay, so it was insurance restrictions. Yeah, not necessarily a lack of support in your area. It just was insurance which is another conversation for a later date. Stop restricting everybody. Jessica: I was very surprised because when we were in Madison, I could go wherever I wanted and see whoever I wanted. I ended up just choosing somebody. I liked her. She was initially very supportive of having a VBAC. I had mentioned it in my very first appointment that this was what I want. She said, “Oh, I’m so excited for you. This is going to be great.” I even mentioned that I was still breastfeeding my daughter when I was pregnant. They just seemed very supportive of all things natural and all things birth. Meagan: Everything. Jessica: Yeah. There were no issues whatsoever. I had already hired my doula when I was 6 weeks pregnant. I had already talked to them before I had even saw my doctor. I told them about how I was really limited and this was where I had to go, but I felt very supported knowing I had a doula and knowing I had somebody on my side It didn’t really bother me at the time that I just had to pick whatever doctor I could. This was also a practice where the doctor I had wasn’t going to be probably who I would give birth with. That also didn’t bother me because I thought, “I have a doula. I have support. I know after listening to this podcast what I need to do to defend myself if that time were to come.” Meagan: Advocate for yourself, yeah. You felt more armed. Jessica: I did. I really did. I ended up seeing a chiropractor as well which was very helpful throughout my pregnancy. I loved going to the chiropractor. Not only did it help get her in a good position, but I also just didn’t really feel body aches as much as I did, so there were a couple of benefits to going there. I definitely recommend a chiropractor. Meagan: I agree. I didn’t go until my VBAC baby. I started going at 18 weeks, and I’m like, “Why didn’t I do this with the other babies?” It was just amazing. Jessica: Yeah. It really is. But my doctor’s appointments this time were very different. They were very rushed. They felt robotic. “How are you feeling? Great. Let’s get the heartbeat. Any questions? No.” I really kept my questions for my doulas anyway because I really trusted them. I don’t know. I didn’t feel like I had many questions anyway because I knew what I wanted. I knew I wanted to show up to the hospital basically ready to push. One of the red flags, I will say, that looking back now with this provider that I had initially is that she never asked for any type of birth plan. She knew I wanted a VBAC, and I thought it was a good thing that she wasn’t really asking details. I felt like, “Oh, she’s letting me do my thing.” But looking back, I think it was just because she knew that’s not what was going to happen. She knew. Meagan: Yeah. You know, it’s interesting. We’ve had providers who have told people here in Utah. The client will say, “Hey, I really want to talk about my birth preferences.” The provider will say, “You’re really early. We don’t need to talk about that right now. We could talk about that later.” Or, “Hey, I was thinking I want to talk about this. Can we talk about that?” “No, not today. It’s fine. Whatever you want.” Then it comes, and we’ll hear more about your experience. I’m sure it will relate to a lot of people’s bait-and-switch stories. Jessica: Yeah. They sound so supportive in the moment, and then it’s not looking back. It continued on through my whole pregnancy. Even when I was 35 weeks, she suggested a cervical dilation check. I denied it at that point. I thought it was too early. 35 weeks is very early. Meagan: 35 weeks? Yeah. Jessica: I’m really glad that I stood up for myself and said no, because I was having one of those moments of, do I just do it anyway? I said no, and she was very fine with it. She said, “That’s fine. You don’t have to if you don’t want to. We don’t have to.” I also thought that was a good sign. Meagan: You’re like, “Yes. If we don’t have to, why are we suggesting it in the first place?” But I can also see where you’re like, “Well, sweet. She’s respecting my wishes. I didn’t want to. She’s saying, ‘Okay’.” Jessica: Exactly. But I made the mistake of agreeing to it at my next appointment because my curiosity got the best of me. I knew that it wasn’t important for me to be dilated, but I was trying to compare it to my last pregnancy. At 37 weeks, I was 3 centimeters with my first. I wonder if I’m going to have a different experience this time. Let’s see where we’re at. I was at 0. I just thought, “That’s totally normal. I have a lot of time left.” Her demeanor changed very much. It was like at my appointments before, she was a different person now. Meagan: Oh. Jessica: She said, “Well, if we’re not showing any signs of labor by 40 weeks, we need to schedule your C-section.” Meagan: Oh no. Jessica: She must have noticed I was surprised. I said, “But I don’t want a C-section. Did you not remember that I’m going to have a VBAC?” She said, “Well, you don’t want to risk your baby’s life.” Meagan: Bleh. Barf. No. Jessica: Yes. Yes. I knew that was just a scare tactic. I luckily was not phased by it. I was educated. I mentioned something along the lines of, “Well, wouldn’t we try to induce me before we jump ahead to the C-section? There’s no medical need.” My pregnancies were so boring. There was nothing that would indicate anything, not even an induction, but I thought, “Why not even just mention that before a C-section?” She said something like, “There are too many risks involved.” That was the end of the conversation on her end. She pretty much wrapped it up and said, “It’s pretty slippery out there. Be careful,” and walked out. Yeah. The conversation was over. In that moment, I knew that was the last time I would see her. I didn’t know what I was going to do, but I knew I could not go back to her. I went back to the parking lot. I was crying. I texted my doulas right away what happened. I said, “I need to figure something out very quickly. I’m 37 weeks. I know I can’t go back to her. Can you please help me figure something out?” They were so, so extremely helpful with helping me figure out my options. I thought that at this point– in the beginning of my pregnancy, I knew, “I’ll just stand up for myself. I know what I want,” but when you are very big and pregnant, and you are very vulnerable, you don’t want to do all of that arguing. You just want somebody who is going to support you. I just knew I couldn’t go back to her. I didn’t have the energy to try to defend myself or advocate for myself. I just needed somebody who was already going to support my decisions. They encouraged me to look a little bit further out of Green Bay which I didn’t initially want to do. I wanted the hospital to be close. I had a 2-year-old. I didn’t want to be far away from her. But knowing I had limited options, I looked a little bit farther out. I texted them, “Hey, there is this doctor who I can go to in Neenah. It’s pretty far. I said her name. I don’t know if I’m supposed to say doctors’ names. Meagan: You can. Yeah. You can. People will actually love it so they can go find support themselves. Jessica: Yeah. I said, “There is this doctor, Dr. Swift, who is down in Neenah. That’s the only one who is really popping up on my insurance who I can go to.” They immediately texted back, “You need to go see her. She’s amazing.” My doula had actually had her VBAC with Dr. Swift. They were like, “You need to go see her. This your other option.” Meagan: Oh, Sara Swift is on our list of providers. Jessica: She is. She’s amazing. Meagan: She is. Okay, so you’re like, “I’ve got this doctor’s name.” Jessica: I called them to make myself an appointment, and I wasn’t able to get in until the following Friday. It would have been after I was 38 weeks. I told doula– Meagan: That’s when you had your last baby, right?Jessica: No, actually my last baby was at 39 weeks, but I didn’t know what was going to happen. I told them, and my doula was actually personal friends with her. She said, “No, that’s not going to work. I’m going to text her, and I’m going to get you in sooner.” I think it was a Wednesday at that time. I was able to go see her Friday. Yeah. Meagan: A week earlier than you would have been able to. Jessica: Yeah. I helped me to feel more relieved knowing that if I had gone into labor before that next appointment, I would have known where to go. I would have had a doctor established. I was very, very relieved to see her. It was such a different experience than my other doctors. I had to bring my two-year-old with me, and at that point, she was getting antsy, so Dr. Swift actually sat on the ground with my daughter and was coloring with her while we were talking to keep her busy. I just remember thinking, “There’s no other doctor out there who would do this for a very pregnant patient.” It felt very much like a conversation between friends. It didn’t feel like a robotic type of conversation I had with my previous doctor. She very much upfront said to me, “Our hospital has VBAC policies. Here they are. You can deny anything you want. They’re not going to allow you to eat food, but if you say you want to eat food, you can eat. They’re going to want continuous fetal monitoring, but if that’s not what you want, tell them what you want.” It felt like she just was supportive of what I wanted to do. She said something along the lines of, “I’m going to trust you and your body to make the decisions that you need to, but also know that if I need to step in, trust that I’m going to do what I need to.” It felt so mutual there. I was so excited to go back and see her every week. I’m actually kind of mad that I waited that long to see her. Meagan: Yeah. Mhmm. I’m sure you felt like you were breathing in a whole different way. Jessica: I was. I felt very excited. The drive was longer, but it didn’t even matter at that point. I went from a 15-minute drive to 45 and it didn’t feel like there was any difference. It was all worth it. Meagan: I agree. It’s sometimes daunting with that drive or the time, but you guys, it’s so worth it. If you can make it work, make it work. I’m so glad. Okay, yeah. So you found this provider. Everything was feeling good. Jessica: It was feeling great. I actually ended up going past my due date. Meagan: Okay. Jessica: I was feeling a little bit– not defeated– I wanted to make it to my due date because I wanted to make it there with my first. I was excited when I got to my due date, and then I thought, “Okay, when is this actually going to happen? I’ve got a two-year-old.” My in-laws were coming up to watch her when we were going to the hospital. They live 2.5 hours away. I was starting to worry about, how is this all going to work out? But it really did. I felt my very first contraction two days after my due date. It was a Friday night at 6:30. We were getting my daughter ready for bed, and I felt that first contraction. I knew it was different than Braxton Hicks. I just knew, but I don’t even know to say if that’s when my labor started because that continued all throughout the weekend every 15 minutes. It was not a fun weekend. I kept thinking things were going to pick up, and then they would die down. Meagan: Prodromal labor maybe. Jessica: Yeah, I think so. At one point, I had my doula come over in the middle of the night. I didn’t know when to go to the hospital. I didn’t know if it was time or whatever. She came to my house in the middle of the night just to help me with the Miles Circuit and just the different position changes I could do. I believe that was on that Friday night that I started labor. I was also able to get into the chiropractor that weekend. They were closed, but again, my doula was very close friends with the chiropractor and texted, “Hey, Jessica could really use an adjustment. She’s not in labor, but it’s not progressing. Can you help her?” I went to go see them on Saturday and on Sunday just to get things moving. She was in a really great position. Everybody could feel that she was just in the perfect position. It was just that these contractions could not get closer together no matter what I tried. Something told me, “Hey, you need your water broken for this to progress,” because I couldn’t do it anymore mentally or physically. I was exhausted. I didn’t want to initially because I knew that’s what prevented me from having the birth that I wanted in the first place with my first experience, but something also told me, “Hey, you need to go do this.” My intuition was super strong in those moments where I knew. My intuition was strong enough to switch doctors that late in my pregnancy. There wasn’t another option. This time also, my intuition told me, “You have to go in,

Alma’s first birth was an emergency Cesarean after an induction at 40 weeks due to gestational diabetes. Due to COVID-19 policies, Alma’s husband was not allowed into the OR. She did not expect the induction process to end the way that it did, and felt robbed of the positive birth experience she hoped to have. Alma made sure to educate herself on all of her options for her second birth. She was very proactive about her health and did not have gestational diabetes the second time. She went into labor earlier than she expected at 38 weeks. She woke up in the middle of the night to her water breaking, and intense contractions began. Within minutes, Alma knew she had to go to the hospital immediately. Alma felt pushy as they made the 45-minute drive. She was admitted to a room, and her beautiful baby was born just two pushes later!Evidence Based BirthⓇ: Induction for Gestational DiabetesThe VBAC Link Blog: VBAC with Gestational DiabetesBirth Ball Amazon LinkNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello. It is almost the end of November. It is crazy to think that the year is coming to an end. But guess what, you guys? We still have so many amazing stories coming your way. Today’s story is from our friend, Alma. I’m already messing it up. It looks like Alma, but you say it. Tell me how to say it correctly.Alma: Alma, but any way you say it is fine. Meagan: Perfect. I want to say it correctly though. She is sharing her stories today. Now, you are in New Jersey now, but you weren’t in New Jersey when you had your VBAC. Is that correct? Alma: When I had the C-section, I was in New Jersey, so we just zigzagged a little bit. Meagan: So she’s in New Jersey, but the VBAC wasn’t in New Jersey. I know a lot of people when they are listening are like, “Where was this VBAC?” We will talk a little bit more about that when we get into the story, but let’s give them a little teaser of what your episode is going to be. Your first C-section, I feel like was the steps. It was the steps or the cascade, and then a little bit of what you went through. Tell us a little bit of a teaser before we get into the episode. Alma: I had a lot of interventions in my first pregnancy and did end in an emergency C-section, then for my son, my second pregnancy, it was exactly the opposite. There wasn’t time for any intervention. He just flew out. My whole labor was 2 hours from the first contraction to when he was born. I almost delivered in the car. He was too fast, but it was exactly the experience that I wanted to have. Meagan: Yes. Oh my gosh, so a precipitous labor after a lot of interventions, an induction, and all of these things. I’m so excited to get to this episode today, but we do have a Review of the Week. As usual, if you haven’t done so yet, please leave us a review. We absolutely love them. Okay, this episode reviewer is Desiree Jacobsen. She actually just left this review this year in August of 2024. It says, “Thank you”. It says, “This podcast and parent’s course is amazing. I’m not a VBAC mom, but I have been listening since 2020. I binge-listen toward the end of pregnancy to remember everything I need to remember in the birth process through my previous births. This time around, I felt more prepared than ever before having plans in place just in case. We were able to have a quick birth for my fifth baby. I love the education, passion, love, and support this podcast gives. I recommend it to everyone I know, and I have learned so much from it. I am so grateful for this podcast. Thank you”. Oh, I love that. I love that, love that, love that. That was actually sent to us via email. If you didn’t know, you can email your reviews at info@thevbaclink.com. Your reviews on the podcast and on Google are what truly help other Women of Strength find this platform and find the courage and the information that they need to choose the birth that they desire. Okay, girl. Let’s get into this story. So first birth, lots of interventions. Let’s talk about it. One, what types of interventions, and two, why? What led up to needing those interventions or I don’t know if it’s “needing” or really medically needed? Tell us more. Alma: Well, my first pregnancy was very normal and healthy up until I was diagnosed with gestational diabetes. That’s where things started to change a little bit. I just failed the test by just a point, so my blood sugar was elevated, but it wasn’t as bad as it could be. I wasn’t even on insulin. I was just on diet control. Everything was going fine so I thought, but I would say a week before my due date, I was told that I needed to be induced because of the gestational diabetes. That was the first red flag of things going out of my control because I didn’t expect to be induced. Although I had gestational diabetes for a while already, I wasn’t told that this would probably be the case that I would be induced. I agreed to the induction of course. I understand why it’s done, so I went along with it. I think my daughter just did not want to be born. On that day at least, we went in on my 40th week, and I was on Pitocin for hours, and it did nothing. I tried some exercises. I tried a bunch of things. Nothing worked.Eventually, the doctor suggested to manually break my water. That’s where I wish I had asked to do other things first. I wish I had rejected that choice, but I went along with it. From that point, the labor went from 0 to 1000. I was in so much pain in a matter of minutes. Everything happened so fast, and I wasn’t ready for that. I asked for an epidural really fast. I got the epidural, and that’s also when things got worse because my blood pressure started to decrease. I didn’t know that could happen actually. Later on, I scoured through every detail of what happened, and I tried to figure out exactly what went wrong. I realized that could happen with an epidural. When your blood pressure is affected, of course, the baby’s blood pressure is affected so my daughter started to have some fetal decelerations. It was very concerning. They put me on my back to deliver to push her out. I wasn’t even 10 centimeters yet. They were going to stretch me, but her blood pressure just declined in a way that was really concerning. I was rushed to the OR and the C-section was done. Everything happened so fast. I hesitate in using the word traumatic just because in the end, everybody was fine. I was fine. My daughter was fine. She was healthy, but it was very traumatic because nothing was in my control in that moment. I felt almost robbed of the experience that I expected to have. That was my first birth. Meagan: Well, and when things are rushed like that and you are left in a sense of– you said panic, but in a sense of urgent need to save something or save someone, it does. It sets all of your alarms off. Alma: That’s exactly what happened. Meagan: Everyone has trauma differently. They view trauma differently. Someone may see one things as traumatic, and someone would be like, “How is that traumatic?” It’s okay, I think, that you’re using that word because that is how you are perceiving this. Your feelings and your alarms that were going off in your body as everything was being rushed and all of these things left that traumatic feeling. Alma: Yeah, definitely. In that moment, I felt like I couldn’t breathe. At this time too, there were a lot of COVID restrictions, so my husband wasn’t let into the OR. It was like, “What happpened to her?” He was more concerned than me probably. He thought both of us were going to die, my daughter and myself. It all just happened so quickly. Thankfully, we were okay in the end, but I had no idea I would be coming back with a C-section scar. That requires more recovery. As a new parent, we were already new to everything. It was a lot to deal with, I think. Meagan: Yeah, what you were saying, I’m sure your husband had a lot of trauma through that experience too. We know that COVID especially– I mean, birth in general comes with a lot of things especially the unexpected, but when you through COVID in with that, it’s a lot of ick. It’s a lot of icky feelings. It’s a lot of ick. Alma: Yes. Meagan: So everything was good. Baby was good. You were good. Overall, it was a less-ideal situation, but where did that leave you after you had the baby and you were starting to recover? Where was your mind? Alma: I think I had to process a lot of what happened. I think I went into the first pregnancy very naive. It’s important to be educated, and I really appreciate this podcast for that reason to encourage us to be educated. It’s not that we are doctors. At least, many of us are not medical professionals, but we need to be aware of our bodies and just what the process looks like, and even some terminology. I was totally clueless on everything. I think that what I tried to do in between both pregnancies was just learn. What’s going on in my body? What can I say no to in terms of interventions?You don’t have to agree to everything. I never want to argue with a doctor of course, but if I really feel like that’s not the best choice, I can always ask for another choice. I can consider other options. Meagan: Yes. Alma: I just didn’t know I could do that the first time. I definitely tried to educate myself as much as possible, and I think that contributed a lot to how the second delivery went. Meagan: Yeah. I just wanted to thank you so much for pointing that out and seeing that because if I were to guess, we all didn’t know that. We may have heard that you can always say no, but I don’t if we realized how much we really could say no to or ask for another opinion. Maybe we knew it, but didn’t really feel like we could. It can be hard. It can be hard to say no, but I love that you are like, “I want a different option. I’m going to say no to this right now. Give me another option.” It’s always okay. Alma: Definitely, definitely. Wanting to wait if the time allows, “Can we try this later?” There’s a conversation that needs to happen. It doesn’t have to be one thing that is suggested. Meagan: This way or no. Alma: For sure. Meagan: Where did your education start stemming from? Where did you start when you were like, “Okay, I want to do something different next time”? Alma: The podcast. The VBAC Link. I listened to a bunch of podcasts. There is All Things Pregnancy with Dr. Nicole Renkins, and of course, The VBAC Link Podcast. Meagan: We’ve had her. We love her. Alma: That’s just what I did all the time before I went to bed. I’d listen to an episode driving. I’d listen to an episode. It was very helpful. I felt like I could digest information better that way as opposed to reading, so that was a very helpful tool. I also tried to find professionals around me who could speak to my specific situations. I had a doula, and of course, I had my providers as well. They were all so helpful with helping me navigate some of the things that might have gone wrong the first time, and how I could prevent them going forward. Meagan: When they talked about some of the things that maybe went wrong the first time– I don’t want to say wrong. They went south. Alma: Yes. Meagan: I don’t know why people say that. I love south. I love the south. What were the kinds of things that stood out to them?Alma: Well, I think the first thing was the induction in the first place. I completely understand the risk with gestational diabetes, but I think there could have been more conversations with that in my specific case. Seeing as I did not have diabetes that was really out of control, it was very well controlled with my diet, and there could have been room to say, “Maybe we can go a couple days past my due date.” I wouldn’t recommend that for everyone. I think it depends on your case, but I could have tried to have that dialogue, and maybe we didn’t need to have an induction. I also could have considered different methods of induction, and I think that was the first thing because I felt like that was the first domino piece. If I didn’t have the induction, it might not have led to a C-section in the first place. Another point was also the breaking of the water. Those things, I could have just said, “Let’s wait.” I was already there for the induction, so I could have just asked for a little more time. But the big point for me too was the epidural. That was, I think, the immediate reason for the fetal distress. Meagan: The response. Alma: The response, yeah. Understanding how I could avoid that. I was told that now with the second epidural, I may not have the same reactions because I’ve had it before. Also, if you get flushed with some IV fluids– Meagan: Yeah, I was going to say if you hydrate and not even just intravenously, but literally drinking water before. If you know that you’re going to want to get an epidural, or it’s heading that direction, start hydrating. The more you can hydrate, the better. Alma: So I learned those things, then also, I tried to prepare myself for not even having an epidural, although that wasn’t my goal, because I experienced the pains before. Even though I had the C-section, I went through some labor pains. I was accepting the fact that I might just need the epidural, but I considered that as well. How can I overcome this pain without any kind of medication? Those were things I was trying to consider about how we could do it differently so it doesn’t result in the same thing. Meagan: Okay, I love those tips. So now, you’re pregnant, and we have baby number two. Tell us this journey. Alma: Yes. I guess from the time of conception, it was about 18 months apart from the C-section. My pregnancy went perfectly fine. There were no issues. The difference being I had a toddler, so I was more active, of course. I was on my feet. I took at least 10,000 steps a day. I didn’t sit much just because of my daughter. I think that definitely helped in preparing my body. I was really focused on how I can work on my pelvic floor and was just preparing for what it would take to push a baby out. I also did a lot of exercises that I found online. I never did a class or anything, but these were just Instagram videos where you could see the top three videos for strengthening your pelvic floor and things like that that were just free and available. I had an exercise ball that was a lifesaver. I highly recommend that exercise ball for anybody who is pregnant, especially in the third trimester. You can sit on it. You can lean on it. You can squeeze it between your knees. All of those things provide relief, but they also strengthen your muscles down there. I did the Miles Circuit. All of those things were super helpful, and I did it daily to prepare my body. I guess going into the actual labor, I’ll start by saying that first of all, I didn’t have very supportive providers. I learned from this podcast that that’s very important. I do 100% agree that it’s half the battle if you have someone who is on your side and wants to help you make intelligent decisions. I would say my providers were not completely unsupportive, but there were a lot of policies from the hospital side that I think restricted them from encouraging a VBAC. There were a lot of if’s, and’s, and but’s. There were so many stipulations for when or if I could have a VBAC. Meagan: Can I ask which ones stood out where you were like, “These for sure are alarms”?Alma: The biggest one was that I would have to deliver before 40 weeks. I felt statistically that doesn’t happen. People usually birth after their due dates, so I felt like I was already set up for, this is not going to happen probably. I felt really discouraged by that. Also, I guess the due date was a big thing, but also if I were to have gestational diabetes again, then the whole conversation on the doctor’s side was just completely mute. I would just need to go for the induction if I had gestational diabetes. Statistically, you do have it with each subsequent pregnancy according to what I have known. I was also expecting, okay. I’m most likely going to have gestational diabetes. I’m most likely not going to give birth before 40 weeks. It seemed like I was most likely going to have to agree to a C-section. Those things were not encouraging, but I did feel like the doctors were trying to help me find some safe loopholes. One of them being that they had to– I don’t know if this is law, but they had to schedule me for the C-section even though I didn’t want one. But they explained to me that I could go in and say to them that I didn’t want a C-section. I could ask for more time. I could ask to be induced, and hopefully, the induction wouldn’t lead to a C-section although it could. I guess they were trying to explain to me that there are some routes you could take, but given the fact that you had a previous C-section, we do have to just assume that you’re going to have another one. I felt really alone on that journey of trying to do something that I felt like I could do, especially given that the reason for the first C-section was an emergency. I was dilated. It wasn’t a failure to progress. I felt like my body was perfectly primed to do it, but because of time, we had to go for the C-section. I also had to have some conversations with myself accepting that if I do need to have another C-section, it’s not the end of the world. I guess what frustrated me about the first time was that I felt like I didn’t need to have it. C-sections save lives. They’re great tools when they’re needed, but I felt like I didn’t. Aside from the distress and all of that, I felt like I didn’t need it, so I wanted to really try for this vaginal birth. I was just in between trying to accept what might happen, but still trying to hold on to what I believed I could do. So, I guess fast forward to my 37th week, I had an appointment and I had to sign off that I would come in for a C-section, but my plan was to go in that day. This was on the 39th week. I would have the C-section. I could go in and say that I didn’t want to have it. On the night of my 38th week, my husband just finished putting together the crib, and it was midnight. He put together the crib. We went to sleep, and at around 2:45, I wake up because I thought I peed on myself. Now, I think I realize that it was my water leaking. I got up, and at that point, I had maybe cramping, but it wasn’t really painful. To make a long story short, 10 minutes later, I was having full-on contractions. They were super painful. I got out my phone to time it, and within two taps, the app was telling me to go to the hospital now. It was two taps. Everything was happening so fast. Meagan: They were coming so close. Alma: Yes. They were so close. I don’t remember how to count them. All I did was tap, and it was telling me to go. This was at 38 weeks, so I honestly didn’t have anything ready. I didn’t have my bags ready or nothing. Within a matter of minutes, I was just on the floor trying to remember the HypnoBirthing and everything, but it was all slipping because it happened so fast.We get in the car, and I’m still in a whole lot of pain. At a certain point though, I got a grip. I was doing this Christian HypnoBirthing which really helped me. I finally grasped myself and was able to calm down, but the pain accelerated very, very fast. At a certain point, though, I started to feel a lot of pressure. I was still driving, by the way. We had about a 45-minute journey to the hospital. I started to feel a pressure to push. I just couldn’t resist it, so I pushed. I hammered down really hard. It sounded like a fire hydrant was cracked open. My water busted open in the car. I’m sitting behind the driver’s seat on my knees, and my water just gushed open. At that point, I really felt like he was coming out. I couldn’t hold back the desire to push because it also relieved the pain a little bit. It was more like a pressure as opposed to a pain. I just gave into that feeling, but I did feel like he was between my knees and was about to come out. My husband made a few wrong turns, but eventually, we got to the hospital. I couldn’t even sit, actually. They put me in a wheelchair to go to the place where you would give birth. I couldn’t sit down. He was just about to come out, and when I got there, I was already beyond 10 centimeters at that point. Later, the doctor told me when she came down to see me that she could already see the hair of my son’s head. He was already so close. Remember, the talk about the epidural? I wanted the epidural. I was asking the security guard, the person at the front desk– everybody I saw, I was asking for the epidural. I noticed that they didn’t respond to me on that. I overheard them telling my husband that it was way too late for the epidural. My son was already halfway out, and they couldn’t give me the epidural. Once the doctor came, she told me to give a good push. I pushed one time. His head came out. The second time I pushed, he flew out. I had five nurses dive in to grab him. Meagan: Oh my gosh. Alma: He was born, and that was the whole thing. It was super duper fast, unmedicated, and yeah. The most touching part to me was that he came out, and they put him on my chest. That was all I wanted. When my daughter was born in the C-section, I had to beg them to let me see her. I didn’t see her until minutes later. I didn’t hold her until the next day, but this time, they put her right on my chest, and it was just so redemptive. It was everything that I really wanted to experience. Meagan: Absolutely. It was probably a lot all at the same time, very shocking, but then to have that baby be placed on your chest, oh, what an amazing moment for you. Alma: Yes, yes. It was. Meagan: Oh my goodness. Super fast. I was just going to say that was super fast. Alma: It was. It was so fast. I think this is a thing with my kids. For my daughter, too, when they broke my water, everything went very fast. I don’t know. They are just really urgent, but my son was definitely in a rush. He came very, very fast. Meagan: Did your doula even make it?Alma: No, she didn’t. She did not. She couldn’t. It just happened too fast. She didn’t make it on time, but she was happy to hear everything went fine. Meagan: Yes, of course. Of course. Oh my goodness. So after you had the baby, and you had him on your chest and everything, did all of the rest of everything go okay and smoothly?Alma: Yeah. I was bleeding a lot, and that was a concern, but I thankfully recovered fine from that. I had a second-degree tear which I hear is not terrible for the first time doing that. So yeah. I recovered pretty quickly afterward. In my experience, it really didn’t compare at all to the C-section recovery. I was in a lot of pain after my C-section, but this time, it was just maybe a week or two of taking some pain medication for the stitches and stuff, but overall, I was fine. Yeah. I was able to go home the next day actually, so that was also very good. Meagan: The next day? That is awesome. Alma: Yeah. Meagan: How did your medical team feel about it? Did they say anything? Did they have any worries?Alma: Everyone was just so shocked at how quickly everything took place. I think that was the main theme was just the speed, and also how determined my son was. With just two pushes, he just came out really fast. The concern of obviously dropping him because they all dove in to get him. I think that was the talk. This happened in the morning, so the whole rest of the day, they were just chatting about how quickly everything happened. Meagan: Oh my goodness. I bet. I think sometimes those births are kind of a lot for medical staff where you come in and your baby is crowning, but I feel like those births are the type that they really do talk about for a really long time, and they were like, “Look at this.” A lot of the times, here in Utah, anyway, they call them stop and drops where you show up at 10 centimeters. You just stopped in and dropped your baby. I feel like in a lot of ways, it shows people that labor can happen at home, and then you come and it can so beautifully happen without getting an IV, getting a heart trace, setting up fluids, doing this, having a cervical exam. There is just so much that doesn’t need to happen, and I love when medical staff can see that birth can just happen like that. It really, really can if we just leave it be. Alma: Yeah. That’s exactly another point of how I felt before because I had gestational diabetes, and because I had a previous C-section, they did make it sound like I needed to be hooked up to every machine, and I could never give birth at home. I just felt almost like a robot connected to everything. That’s how it had to be, but yeah. This time, I wasn’t even in a hospital gown. It was just so organic how it happened. That was exactly what I wanted to experience, but I think it was a good experience for the nurses as well to see that it was okay. I was fine without the IV and the other stuff. Meagan: Yeah, I love that. You had listed some tips. One of them was doing pelvic floor exercises on the ball which we kind of talked about. I love the ball so much. If you guys are interested in a ball, I’m going to link a ball in the show notes because they are actually really inexpensive and can do a lot of really good things. What other tips do you have for someone preparing for a VBAC?Alma: The number one tip which I’ve heard constantly here is about being educated and understanding what your options are. Unfortunately, I think that most providers are not going to make it easy to have a VBAC just because of the risks that are associated with it. Of course, they may have your well-being in mind, but there are also a lot of hospital policies and protocols that they need to follow. They may not make it easy, but if you understand what your options are and what the research says, it opens the door for dialogue. When you open that conversation, I think you will find that doctors will probably give you more options than what they may have initially suggested. I always spent time talking with the doctors about, “So what if this happens? How about this? How about that?” I feel like that did wiggle in some room for me to not do things just following the protocol. Meagan: Yeah. Alma: That’s really important. Meagan: It’s so interesting how if you show up showing that you’re educated, there’s this different sense of– I don’t want to say respect, but I do want to say respect because I feel like these providers are like, “Oh. They get it. They understand. I can’t just say whatever. This needs to be an educated discussion.” It should always be like that, but I also think a lot of the times, providers don’t have time to really sit down and talk about the evidence, or their evidence is flawed because of personal experience. When you come in and you’re like, “Hey, what about this?” and they’re like, “Oh, she knows stuff,” it just really gives you some wiggle room. It gives the providers respect just a little bit more because they realize how important this is that we are educating ourselves. We are learning. We know the options, and we’re not just going to be like, “Okay, cool.” I love that tip. That, and finding the supportive provider. In the beginning, you had said that the hospital policies may have trumped these providers’ stance. I think not only just finding your supportive provider, but really understanding the hospital policy. You can call, and you can talk to the head nurse. You can talk to the board and the directors of the hospital. You can say, “Hey, I need to know the hospital policies surrounding VBAC.” Alma: Yeah. You know, I believe it was on this podcast where someone mentioned that the best way to know how a provider feels about a VBAC is just to ask them very straight, “What do you think about VBACs?” Their expression will say it all. You don’t have to have a preamble about it. Just ask directly, and I think that helps. I definitely did that. It wasn’t favorable in my case, but I definitely think looking into the hospital C-section rates is really important too. How often do they have C-sections? How often do they have VBACs? If they have that information available, that’s also really helpful. In my case, I found out too late that it wasn’t the highest, but it was pretty high. Also, from this podcast, I learned that it’s never too late to switch providers if you want to. I didn’t take that route. I stuck with who I was with, but I guess I was just trying to be adamant with what I wanted to do as much as possible. Meagan: Absolutely. Do you have any tips on how to possibly find the hospital’s Cesarean rate? It used to be out there on cesareanrates.org. It used to be out there, and you could look up your hospital. You could look up your state. You could look up your provider, even. That’s gone down a little bit and changed a little bit, but do you have any advice if someone is wanting to know their hospital’s Cesarean rate? Alma: In my case, I just searched the hospital name and the Cesarean rate. This was a pretty big hospital. This was in Florida. It was a hospital with a very big network, so that information was readily available on their website. You do need to dig around, but it was on their website. If you are dealing with a big hospital with many departments and so on, they may have that information on their website easily with a Google search. You could also talk to people who work at the hospital as well. If it’s not online, I think that information is quantified normally. They might not quantify how many VBACs they have, but definitely the C-section rate is information that they are following and tracking. Meagan: Yeah. I feel like it’s always fair to ask your provider, “What’s your Cesarean rate?” A lot of the time, they will say, “I don’t know.” They know. They know. That’s something that they need to be able to give you. It’s okay to ask that. “What percentage of your deliveries end in a Cesarean?” Alma: Yeah. Being direct is really the easiest way to know clearly where they stand. Meagan: Yeah, absolutely. I wanted to really quickly talk just slightly about gestational diabetes. There’s a lot when it comes to gestational diabetes. We know, just like you had experienced, that most providers suggest an induction. They just do. According to the American Pregnancy Association, gestational diabetes occurs in 2-5% of pregnancies which is decent. For those who are at a higher risk in their pregnancy, it may be even higher up to 9%, but a lot of them are controlled like yours were through diet or even through insulin and things like exercise. A lot of people are controlling them. Evidence Based BirthⓇ, which I want to make sure that this is linked in our show notes and our blog so if you want to go read more about gestational diabetes or you had gestational diabetes with your last pregnancy and you may have it again, definitely go check it out. They talked about how there is actually very little data in how often people are actually induced because of the diagnosis of gestational diabetes. But in one of the retrospective studies, they found that out of 330,000 births from 2001-2007, they saw– okay, let’s see. It says, “The people in the study came from six health insurance plans, many different hospitals and regions, and represented a large and diverse population. Health insurance plans datas were linked to birth certificate data in order to improve accuracy compared to using birth certificates alone.” Going down a little bit further, they said, “Overall, 30% of labors were induced. When they looked at the reasons for induction, 59% of labors were induced for an accepted medical reason and 41% were considered to be elective.” Those are pretty big numbers to me. Alma: Yeah. Yes. Yeah, those are big. Meagan: Yeah, those are really big numbers. It goes on. It talks about, does gestational diabetes always mean induction? What’s the evidence for randomized controlled trials? They go way into it because Rebecca Dekker is amazing, and their team is incredible. We will also have our blog linked because I believe this is a really important topic to know more about especially if you’ve had it so you can make the right decision. And how you said, you were like, “I was in a controlled state. Everything was controlled through my diet, and I could have likely gone further,” but you didn’t. You weren’t really encouraged to go further. It was like, “Let’s induce.” Alma: Yeah, it literally was just like that. There was no conversation about it. Meagan: Yeah. No conversation about it. I think that’s where we’re going wrong a lot in the medical system. A lot of the time, there is no conversation. Even though we have the power to start that conversation, sometimes it’s really difficult when we’re being told, “Your provider thinks this. Your baby is in danger. You’re in danger if you don’t do these things.” It’s like, “Okay. Okay. I’ll do those things,” but we need to have those conversations. I think that again, having the education and knowing the evidence behind it, and the risks and the benefits and all of those things, it will help you have that conversation if and when the time is needed. So, thank you so much for chatting with us today and sharing your stories and giving us advice, and leaning into more conversations for gestational diabetes. I think it’s something that is happening. A lot of people are getting it. There are things we can do even before pregnancy like really increasing our protein and things. But sometimes, it just happens. It just happens. Alma: I will say just to be clear, the second pregnancy, I did not have gestational diabetes. Meagan: Okay. Alma: That was also something. That was my biggest concern. The two points I mentioned were that the conditions were that I couldn’t have gestational diabetes, and I needed to deliver before 40 weeks. But this goes along with education. I did my best to improve my diet even pre-pregnancy to avoid that diagnosis. It was actually a miracle that my blood test came back really well. I almost thought this was the wrong test because it wasn’t elevated at all. I was really, really thankful that through some dietary changes and lifestyle changes, I didn’t have gestational diabetes at all. Then the second point about giving birth before 40 weeks, it was a spontaneous labor at 38 weeks which also was so supernatural. I really thank God. Everything happened really perfectly. Yeah. That was really a blessing.Meagan: Yes. Oh, thank you so much for everything. You are amazing.Alma: Oh, thank

“Hospital Policy means the principles, rules, and guidelines adopted by the Hospital, which may be amended, changed, or superseded from time to time.”Julie and Meagan break down hospital policies today, especially common ones you’ll hear when it comes to VBAC. They chat all about VBAC agreement forms and policies surrounding continuous fetal monitoring, induction, and epidurals. Women of Strength, hospital policies are not law. They vary drastically from hospital to hospital. Some are evidence-based. Some are convenience-based. Do your research now to make sure you are not surprised by policies you are not comfortable with during labor!Defining Hospital PolicyBirth Rights ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, everybody. We are going to be talking about policies today. What do they mean? Why are they created? And when do we have the right to say no or do we have the right to say no?And I have Julie discussing this with me today. Hey. Julie: You know I’m a policy fighter. Meagan: Yes, we do. We do. The longer I have gone– in the beginning, I was not a policy fighter. I really wasn’t. I was a go-with-the-flow, sure, okay, let’s do it, you know best. That’s really how I was. Julie: A lot of people are. Meagan: That’s true. I think a lot of the time, it’s because we don’t know what our options are. We just don’t know, so I’m really excited to get into this with you today. I always love it because we kind of get into this spicy mood sometimes when we have topics like this that we are very passionate about. We are going to be talking about policies today. I do have a Review of the Week, and this is actually a very recent review which is so fun. We just posted on our social media for Google reviews. We were specifically looking for Google reviews and podcast reviews. These are so, so important for us but also for other people to find this platform. We want people to hear these stories. We want people to feel inspired and get educated and know their rights. Your reviews truly do matter, so if you have not yet, please, please, please do so. You can leave a review on your podcast platform, or you can go over to Google and just type in “The VBAC Link”, and then you can type in a review there. This reviewer is by Savannah, and she says, “I started listening to The VBAC Link Podcast around 16 weeks pregnant and continued throughout y pregnancy. It was so good and encouraging for me as a mama who was preparing for my VBAC. It helped me gain confidence, helped me know what to look for, and what to watch out for in my providers. Hearing others’ stories was so encouraging and helped me gain so much knowledge. I had my hospital VBAC unmedicated with my 8-pound, 15-ounce baby.” You guys, 8-pound, 15-ounce baby is a perfect-sized baby let me just say. “And I know that the knowledge I gained from this podcast played a huge role in being able to advocate for myself to get my birth outcome.” Huge congrats, Savannah, on your beautiful VBAC for your perfect-sized baby. I say that because you guys, let’s get rid of the “big baby” term. Let’s just title these babies as perfect-sized because an 8-pound, 15-ounce baby for some providers may be categorized as larger or maybe even macrosomic. it’s really important to know that your baby is the perfect size and your pelvis is amazing. You can do it just like our reviewer, Savannah. Julie: Your pelvis is amazing. Meagan: Seriously. All right, you cutie. Look at you. Did you just get a haircut, by the way?Julie: I did, yesterday. It’s a little short. We did some color. It’s a little smidgey shorter, but then I think I wanted it to still go in a low ponytail for births. That was my goal. Meagan: I’m totally digging it. Julie: Thank you.Meagan: I should be having fresh hair, but my cute hair lady bailed on me the morning of my hair appointment. Julie: Oh no! Meagan: Sometimes we have matching nails, but we would have had matching nails. We don’t have them today. You guys, we just miss each other. I miss you. Julie: Yeah. We need to go to lunch again. Meagan: We do. Yes. We love shopping, you guys. Let’s talk about hospital policies. Julie: Let’s do it. Meagan: We know that so many people go into– not even just birth, but really a lot of things in the medical world. They just go to a doctor’s office visit or go to a small procedure, or whatever it may be, and these places have policies. I want to talk about what it means. What does a hospital policy mean? What is the definition? The definition, according to lawinsider.com, says, “Hospital policy means the principals, rules, and guidelines adopted by a hospital which may be amended, changed, or superseded from time to time.” Julie: Oh, I love that addition. Amended, changed, or superseded. Meagan: Yep. Julie: Yeah. Meagan: Yeah. It can. Julie: And it does. Meagan: And it does. It does. Julie: It does. Meagan: You guys, let’s just start off right now with the fact of a hospital policy– or a policy, okay? A policy in general is not law. It is not law. If you decide to decline a hospital policy– Julie: It is well within your rights. Meagan: Well within your rights. You could get some kickback. You could probably expect it. Julie: You probably will. Meagan: But, that’s okay. That’s okay. My biggest advice is if you are receiving or being told that this is a hospital policy, and you disagree with the policy, or maybe you agree with the policy for someone else, but for you, it’s not working, and you say no, and they say, “Well, –”Julie: “It’s hospital policy.” Meagan: “This policy is policy, and if you choose to break it, then you can sign an AMA.” Julie: You are so funny. “This policy is policy.” It’s like that though. Meagan: That’s literally what they say. Julie: They say, “It’s hospital policy.” And you say, “Well, I don’t agree with that policy.” “Well, it’s hospital policy.”Meagan: “Well, it’s policy.” Okay. Well, I’m telling you I don’t like your stupid policy. Julie: I don’t like your stupid policy. We are spicy, huh? Meagan: I mean it, though. I think I maybe shared this a little bit, but I had a client who had a home birth planned. She decided to go to the hospital because she had preeclampsia, and this nurse was not giving her her baby. She kept saying, “It’s policy. It’s policy. It’s policy.” I was like, “This mom’s word trumps your policy.” As a doula, I was getting into some rocky, choppy waters I was feeling. I could just feel the tension building. It did not feel comfortable at all. I looked at my client. Julie: You’re just like, “Give her her doggone baby.” Meagan: They could kick me out. They could. I need you to know that they really could kick me out. She was like, “That’s okay. I want my baby.” So I pushed. I pushed. I pushed and I pushed. We did get her her baby, but we had to fight. We really, really, really had to fight, and it sucks. It really, really sucks. So there is a website called pregnancyjusticeus.org. We’re going to have this. I have not actually gone through all of it. It is– how many pages is this, Julie? It is a lot of pages. It is 65 pages, you guys. It’s 65 pages of birthright information, going through a lot. Julie: It will be linked in the show notes. Meagan: Yes, it sure will. If you want to go through this, I highly encourage it. It is from Birth Rights and Birth Rights Bar Association, the National Advocates for Pregnant Women. Like I said, it’s 65 pages, but what they said in here I just think is so powerful. It says, “There is no point in pregnancy in which people lose their civil and human rights, and yet all over the world, people often experience mistreatment and violations of their rights during pregnancy and birth and postpartum.” We see these things. Julie: You need to make that a social media post. People need to know this. Meagan: Yes. Down here even further, it says, “We also know that doulas and other people providing support to pregnant and birthing people often bear witness to rights violation of clients of loved ones. In a recent survey, 65% of doulas and nurses indicated that they had witnessed providers occasionally or “often” engage in procedures explicitly against their patients’ wishes.” This is a serious issue. Julie: It is a serious issue. I feel like it’s really frustrating, especially as a birth photographer where my lines as a doula are very separate, but I always doula a little bit at every birth I go to. It’s not hands-on stuff always, but it’s hard when you see people getting taken advantage of and they don’t know they are being taken advantage of and they don’t know that they have options or choices and they don’t know that they can decline or request changes, and that’s probably the hardest part is that people just don’t know. I have a little tangent, but I’m in this Facebook support group for this medication that I’m on. It really amazes me continuously about how little people know about a medication that they are taking, a pretty serious medication that they are taking, and how little their doctors inform them of what the medication is and what some of the side effects and issues are, and what they can reasonably expect from it because some people have completely unreasonable expectations because they haven’t dug into it at all. The other day, somebody said something like, “I’ve been really, really tired and fatigued since I started this medication, but I called my doctor and she said that fatigue is not a common side effect with this medication,” and I’m like, “What?” It’s literally listed on the manufacturer’s website that it’s a side effect. It’s listed on the insert for the medication. It’s talked about all the time in this Facebook group, and it can be caused by a number of things that this medication affects. The fact that either her doctor didn’t know or just told her– anyway, it leads me. I promise there’s a point to this. It leads me to the fact that your doctor does not know everything about everything, especially a family doctor. This medication is prescribed by family doctors sometimes and endocrinologists. It is impossible for them to know everything about everything. Something like obstetrics and gynecology is more specialized so it is more focused. It is a more centralized area of study, but still, your doctor doesn’t know everything about everything. It is not uncommon for them to not keep up in advancements in medications and technology and practices as they evolve. It’s very, very common for the medical community to be 10-15 years behind the current research and evidence. It just is. Doctors and nurses and all of these things who have to have to have a certain number of contact numbers per year to keep up with training and education, but it is impossible for them to keep up with everything. It is okay for you to have different opinions than your provider. It’s okay for you to want different things than is hospital policy, and it is perfectly reasonable for you to make those requests and for those requests to be honored. It is also okay for you to know more about a particular thing than your provider might. Meagan: Yep. Julie: Period, exclamation point, shazam. Meagan: Well, we’ve talked about this with other providers. We’ve heard other stories where people come in. They have stats that their providers haven’t even seen. They just get stuck in their own way and their policies, and there are other things going on outside, so they just point-blank say, “No, this is how it is,” and you might have more information. That doesn’t mean you are more educated or qualified or whatever to be a doctor. Julie: Yeah, exactly. Meagan: It doesn’t mean, “Oh, I might as well be a doctor because I know this information and you don’t,” but it means that you may have found information that your provider is not aware of. It is okay for you to bring that to their attention. In fact, do it. Congratulations for them to find out the information that they might not have known yet, so they can do better for the next patient. Julie: I want to say that there is an attitude with some medical care providers of, “Don’t confuse your Google search with my medical degree.” Meagan: Yes. Julie: Come on. I really have a big problem when people get like that because first of all, and I’ve said this before, and I will continue to say it again, we have at our fingertips access to the largest amount of information ever available in humankind ever at our desktops. We can sit down, and you can go and find information and studies related to anything ever. Yes, don’t go looking at Joe Blow down the street’s opinion about childbirth or whatever. Yes, that might be a credible source. It might not be, but you can literally find these same studies, the same research, and the same information that these providers have access to in their path to their medical degree. Is it extensive? No. Are you going to have the hands-on experience that they have doing these procedures and C-sections and things like that? No, you’re not, but you still have access to the same information that they have access to. I have a big problem when providers have this arrogant attitude that they know more. Yes, they do know more generally. They might not know more when it comes down to specific things that have been updated since they have gotten out of school. Meagan: Yeah. I feel like in a lot of ways, we hear these policies and these things come up, and you’re like, “But where?” Then they can’t show you the policy or stat. Julie: Yeah, then they’ll be like, “You’re 20x more likely to rupture.” You’re like, “Can you send me the research?” They’re like, “It’s the way we’ve always done it.” Meagan: I did a one-on-one consult, and a provider told someone that they had this astronomical amount of percentage of rupturing, and I was like, “Wait, what?” Julie: Seriously. Meagan: I was like, “Please challenge your provider and ask them for that.” She did, and they were unable to give her that. We can just hear things, and if we just take them, it can be scary, and it can impact decisions when maybe that’s not true. I also want to talk about policy for providers. Their policy should be that everyone should have informed consent. They have policies, too, that not only you have to follow or that they have to follow. It’s a whole thing. There are many policies. Your provider really has to explain the risks, benefits, and alternatives for any medical procedure, intervention, or anything coming your way, but we see it not happening most of the time. We just see people doing stuff because it’s within their normal routine but it’s breaking policy which is so frustrating to me. So you can break policy? I want intermittent monitoring. I don’t want consistent monitoring. I’m breaking a policy? Julie: So what?Meagan: So what? Julie: So what? Sorry. Meagan: Let’s talk a little bit more about VBAC and policies surrounding VBAC. We know that policies are just there. They’ve been created. During COVID, holy Hannah. We saw these policies change weekly, you guys. Julie: Daily. Meagan: Yeah, seriously. They went in and they were like, “This is our new policy. This is our new policy. This is our new policy,” and I was like, “What?” Julie: It was freaking whiplash.Meagan: Yes, it was horrible. It was horrible. But they can change a policy just like that. You can say no to a policy just like that. So, okay. Sorry. I digress. Let’s go back. Let’s talk about what policies often surround VBAC. I know a lot of the time, in hospitals all over, it’s a policy that midwives cannot treat VBAC. Or you can’t be induced because it’s a policy. You can’t induce VBAC. We talked about this before we started recording, and I said it just now. It has to be consistent monitoring. Julie: Yeah. Well, can I just do a little bit of a timeout and a rewind for half a second? Hospitals are businesses, okay? I just want to explain this to everybody. Hospitals are businesses. I think we know that. You don’t have to have that explained. Businesses, in order for them to run efficiently and smoothly, need to have policies, guidelines, best practices, standards of care, procedures, and things like that. It is a business. It is okay for them to set parameters for which they want their providers and nurses and everybody who is at the hospital to operate under, right? It’s okay for them to have those things. It’s okay for them to set those because if you didn’t have those, the business would fall apart. Everybody would be doing whatever the heck they want. There would be a lot of disorder, right? Meagan: Yes. Julie: So policies and procedures and these best practices and things like that are created in order to keep things aligned and have a nice model of care so that they can be more cost-efficient so that the patients know what to expect so that the providers have a routine and things like that. Meagan: Yeah. Julie: There are reasons for these things. However, when we like to push back, when we are bothered, and the thing that really is frustrating about these policies is when they are put in place so rigidly that there’s no flexibility and that it takes away a patient’s autonomy, and that it removes individualized care from the birth experience. So this is why we want to talk about this. This is why we don’t think all policies are dumb. No, we don’t. We see the reason. We understand why they are in place. However, we want you to know that it is well within your rights as a human to decline and request changes for these policies, and to desire something different, and to have that desire respected. It’s hard when some providers and nurses get so stuck in the fact that, “This is policy,” that they take away your autonomy and your right to choose. That’s what we’re pushing back against, and that’s what we want you to know. These policies are not law. You have the right to want something different and to request something different, and to have that right respected. Okay.Meagan: Absolutely. Absolutely. I couldn’t agree more. I do think it can be really hard because they have these things to keep order and to keep things tidy.Julie: And with the intention to keep you safe. Meagan: Yes.Julie: But sometimes intentions don’t always translate well. But anyway. Meagan: Yeah. But really quickly before we get into what policies surrounding VBAC are, when we start questioning policy, there are things that can come into play where there are threats, there is coercion, there is gaslighting that starts happening because they are really panicked that you are questioning their policy. They feel very uncertain that you are questioning that. Julie: They may even feel unsafe, or they might never have had the policy challenged before so they don’t know what to do about it. Right?Meagan: Yeah. Yeah. Just know that if people are coming at you with, “Well, if you don’t do this, then this,” or whatever it may be, then it can get intense, but you can still say no. You can also ask for a copy of that policy. Again, even though that policy isn’t law, you can still ask for it. Julie: Ideally, you can do this before labor begins because it’s really hard to fight and bump up against these policies during labor. Meagan: Yeah. Julie: It’s going to be a lot harder. Meagan: Yeah. Yeah. Okay, so let’s go in. I talked a little bit about fetal monitoring. Julie: Induction. Meagan: Not being seen by certain people. No induction. Or the opposite. Julie: You have to be induced. Meagan: You have to be induced. Julie: By such and such a date. Meagan: Yes. It’s just so funny because it varies all over. Julie: It does vary all over. Meagan: Let’s talk about it. Okay, so fetal monitoring. Julie: Don’t forget epidural placement too. Meagan: Yes. Epidurals. Julie: We can talk about that. That’s my favorite one to argue against. Anyways. Okay.Meagan: There are so many. Okay, let’s talk about fetal monitoring. What is the policy typically behind continuous fetal monitoring?Julie: Yeah, so most hospitals– in fact, I’ve never met a hospital where this hasn’t been the hospital policy– is that continuous fetal monitoring is required for everybody, but especially for VBAC. They double down for VBAC because one of the first signs of uterine rupture, especially for someone who has an epidural, is irregular fetal heart tones. That can be one of the first signs of uterine rupture. Most hospitals are very, very adamant about having continuous fetal monitoring, especially for people who are undergoing a TOLAC which is a trial of labor after a Cesarean. It’s not a bad word. It’s just how it’s defined in the medical community before you have your VBAC.The reason they do that, like I just said— but honestly, if you don’t have an epidural and if you aren’t under any type of pain medication, the first sign of uterine rupture for you is going to be really intense pain. That’s going to be your first sign. Especially if you are going unmedicated, I think it’s perfectly reasonable to request intermittent monitoring. Do you want me to go into why they introduced fetal monitoring in the first place?Okay, in the early 1970s, we saw lots of rapid advancements in the medical field and technology related to the medical field. Things like continuous fetal monitoring got introduced. Antibiotics became more readily accessible. The procedures themselves, especially the C-section procedure, became perfected and easier to do with fewer complications and fever rates of infections. All sorts of things started happening at a really rapid pace in the early 1970s. One of the things that got introduced was continuous fetal monitoring. The intention behind the continuous fetal monitoring when it got introduced was to decrease the rates of cerebral palsy in infants. Cerebral palsy usually happens when during either pregnancy or labor, oxygen is deprived to the brain of the baby. It can cause a stroke and damage part of the white matter in the brain. The idea behind it was if you could catch the reduced flow of oxygen to the baby by monitoring its heart rate, you could intervene and do a C-section in time to get the baby out before cerebral palsy happens, essentially. The interesting thing about that is that after continuous fetal monitoring was introduced, there was no change in the rate of cerebral palsy. It stayed the same. It still is very similar. But what it did do is that it was one component that increased the rates of C-sections and other interventions. They are more likely to take a baby out due to nonreassuring fetal heart tones, and we’ve seen no improvement in maternal mortality and morbidity rates and infant mortality rates either with the introduction of all of these interventions. Meagan: Yeah. One of the reasons why they say that it’s mandatory for VBACs specifically is because fetal heart tones decelerating is one of the signs, one of many, that a uterine rupture may be taking place. Julie: Right, right. I said that. Meagan: Oh, you did. Julie: Yeah. Meagan: I was reading the link. I missed that. Julie: No, no. You’re fine. Say it again. It’s okay.Meagan: No, you’re fine. Okay. So with uterine rupture, fetal heart decels are not always a symptom of uterine rupture. What do you feel like it means? I feel like so many people feel more comfortable having their baby on the monitor so they can hear them. Julie: Oh, they do. You know what? The staff is more likely to do that too. This is really sad, but we have a labor and delivery culture that is very, very comfortable sitting at a desk down a hall watching a monitor to see how a patient is doing rather than remaining in the room and watching them. They rely more on what is going on on the contraction monitor and the heart rate monitor than they do the visible signs of the patient. It’s how they’ve been trained. It’s how they monitor dozens of people at once in a labor and delivery unit, and I feel like continuous fetal monitoring and the contraction monitor are other ways that de-individualizes care. I don’t know if that’s a word. It takes out the individuality. It takes out the rights to the human and it takes out really watching the person, and relies too much on the data. Data is good. I love data. Don’t get me wrong. I am a data junkie 110%, but data can only take you so far. I feel like that’s why people freak out about the continuous fetal monitor thing. “How are we supposed to know if you’re doing okay at the desk because we can’t see the chart on the screen if we’re not monitoring you continuously?” It puts more work on them, which is okay. I can’t imagine being a labor and delivery nurse because sometimes you have more than one patient that you’re monitoring and watching, and you’ve got lots of other things to do including charting and all of this stuff. Meagan: Yeah, this is one of those things that was created that even though the evidence didn’t prove that the reason why it was created worked out, it stayed because it brought ease to monitoring labor, and monitoring it not in the same room, and being able to have five other patients while seeing a chart. Okay, so fetal monitoring is one. Let’s talk about the induction or the non-induction that we’ve seen policies on both ways which also is so weird to me. I know it’s hospital to hospital, but why aren’t we going off of evidence?Julie: Dude, dude. Do you know what is so funny to me? I will also cry this out from the rooftops until I die, but if you really want to understand what maternal healthcare is like in the United States, you’ve got to talk to a doula or a birth photographer because we see not only hospital births and home births and birth center births, but we see all of the different hospitals and how they vary in hospital policy. It is so funny to me sometimes the conversations that I hear or have with labor and delivery nurses who insist one thing, then the next labor and delivery nurse in the next hospital insists on something completely different. “Oh, it’s not safe to go past 20 for Pitocin on VBAC,” then the next hospital will be like, “Yeah, it’s perfectly safe as long as you are monitored and the OB signs off on it.” It’s so up, down, and sideways based on whatever this specific hospital policy is. It’s not their fault which is why sometimes I like travel nurses in labor and delivery units because they go all around the country and have vastly different experiences with all the different hospitals. It’s fun to see the culture shift that can come in when that happens. Meagan: Yeah. Okay, so in some hospitals, it is policy that you have to go into labor spontaneously. Julie: Yeah. They will not induce for VBAC. Oh, but if you haven’t had your baby by 40 weeks, it’s hospital policy to do a C-section. Meagan: Yeah, they will not induce you, but then if you don’t go into labor by 40 weeks, they have to schedule a C-section. What’s the evidence there, and why is that even being a policy?A lot of providers after 40 weeks fear or they say that VBAC uterine rupture chances skyrocket after 40 weeks because, “Oh, that baby is getting bigger. They’re stretching that uterus out,” but that’s really not necessarily the case. We’re seeing it happen more and more and more where people are then doubting their body’s ability to give birth or go into labor. They are so scared that their baby’s going to get so big that they’re going to cause uterine rupture if they go past 40 weeks. I mean, really. You guys, the amount of things that we see coming in The VBAC Link’s DM’s– I love that you guys write us. Please keep writing us, but it’s frustrating, not that you’re writing us, but that these providers are telling people these things. Then we have the opposite that we have to induce by 40 weeks. Julie: Can I read you this thing? There’s a post in The VBAC Link Community today. It was a VBAC agreement form. If you’re birthing at a hospital, you’re more than likely going to have to sign a piece of paper showing all of the risks of VBAC, but they don’t ever make you do that for a C-section. This hospital VBAC policy, hold on. I was reading it this morning. Listen to this. This is word for word from this VBAC agreement form from a hospital. “I am aware that the best chance for a successful VBAC is to go into spontaneous labor, and that the risk of Cesarean section is increased past my due date. In an effort to afford me the best chance of achieving VBAC, I agree to be induced the 39th week of pregnancy or sooner if medical issues are present if I am still pregnant.”In that same paragraph, they say that the best chance of a successful VBAC is going into spontaneous labor, but if you don’t go into labor by 39 weeks, we’re going to induce you. Meagan: It also says that after 40 weeks, Cesarean chances increase so we have to induce a whole week before. Julie: Yeah. Right? Meagan: I’m sorry. Julie: This is real life. How is this even a thing? Blah, blah, blah. That’s what I say. Screw your policy. How can you contradict yourself like that? It says, “The risk of a Cesarean section is increased past my due date, but it’s also increased if you induce me, so either way I have increased risk.” This is literally what they are telling you in this form that they make you sign. Meagan: You know, those forms are so important to pay attention to, you guys. As you are getting these forms, the VBAC consent forms, or VBAC agreement forms or whatever. They title them all differently. Julie: I’m just reading this hospital policy more. Sorry. “I am aware of the hospital policy requiring two IV access sites.” Meagan: Okay. Today, which you guys, was last– I’m trying to think. It was a month ago. Okay, a month ago– I recorded the episode today, but a month ago, when this is coming out. Go listen to Paige’s midwifery episode. She just was talking about that. That is a policy within the hospital that she helps people at. They have two hep locks. This was news to me as of today, and now you are seeing this in this policy. Why? Why? What is the evidence behind that? Why?Julie: This VBAC agreement form is every single thing that we are talking about. “I agree to have continuous fetal monitoring. I am aware of this policy by this obstetric group–.” I won’t say it because maybe we shouldn’t call them out. Maybe we should. “--to require epidural placement by the time of active labor. I am aware of the implication that certain complications of labor can be life-threatening to myself and my baby. These can only be addressed promptly at the hospital. To lessen the risk of delay during a complication, I agree (in bold)--”Meagan: Yes. All of the agrees are in bold.Julie: “--to come to the hospital immediately if I am in labor or if my water breaks.”Meagan: Ugh. Julie: “I have been adequately about the risks, benefits, and alternatives of VBAC, and have the opportunity to ask questions. I am aware that no one is able to guarantee a successful VBAC and that repeat C-section may be indicated if my baby is breech, I do not adequately dilate, I am able to push my baby out, my baby does not tolerate labor, there is a concern for uterine rupture, or if any unforeseen medical issue arises during my pregnancy which makes labor unsafe–” according to who?Anyways, “certain methods of induction of labor are not permitted to be used in patients with prior Cesarean sections. I understand that if I am induced, the only safe options include medical dilation with a balloon, Pitocin, and breaking my water.” That, I feel like, is accurate. Meagan: That is valid. That is valid. Okay.Julie: That’s the only one. Cool. Meagan: Cool. Out of ten. Julie: Are you reading this right now? Do you have it up?Meagan: Yes. I pulled it up. Let’s talk about epidural. You guys, this has 86 comments already. One of the commenters said, “You absolutely do not need to get an epidural, have continuous monitoring, or go into the hospital when labor begins. These are often things to avoid when trying for a VBAC.” Julie: Yes. Yes. Meagan: You absolutely can have these things. “You can have these things, but having an epidural before 6 centimeters can put you at a higher risk of Cesarean including continuous monitoring. Your rights override policies.” This is what she said. She said, “Are you in the States? Did you sign this?” Julie: But I love what Flor Cruz with Badass Mother Birth said. “This is atrocious. Run. I would rather give birth in the woods by myself than to agree with this monstrosity.” Meagan: Really, though. We have so many things coming at us. We’re so vulnerable when we are pregnant, and we want a VBAC so badly. We have forms like this being given, or we have policies being thrown at us, and we say, “Just say no,” but when you’re in that moment, it’s really difficult. I think something that I want to say is, as you are learning these policies, as you’re learning more, figure out if you are someone who can stand up to these policies and say no, or figure out if there’s someone on your team who you need to have be there to help you find the strength to say no. Also, make sure that your family

“Getting that VBAC meant everything to me. It helped so much with the trauma of it all.”At 36 weeks along with her first, Ashley started to have intense carpal tunnel pain. At 38 weeks, it was unbearable. Her provider said that delivery would be the only way to find relief and recommended a 39-week induction. Ashley had a difficult labor and pushing experience. Her provider recommended a C-section due to a cervical lip and no progress after just an hour and a half. Ashley consented and felt defeated. She started her VBAC prep the day she got home from the hospital. At 29 weeks with her second, Ashley had plans for a beautiful trip to Saint Thomas with her husband and toddler. She began contracting the night before her flight but didn’t think much of it and made it to their gate– while still contracting. As the plane was boarding, she passed a blood clot in the airport. She knew she needed to go to the hospital. In spite of many interventions trying to stop labor, Ashley birthed her baby via VBAC just hours later. She later learned that she had a possible placental abruption that wasn’t detected until her doctor examined her placenta after delivery. Though Ashley’s postpartum experience was tough balancing life with a newborn in the NICU for 8 weeks while having a toddler at home, the victory of having a VBAC carried her through. The power of a positive birth experience is real and worth fighting for!Pregnancy-Related Carpal Tunnel ArticleHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. It is Meagan with my friend, Ashley. Hello, Ashley. Ashley: Hi. Meagan: How are you today? Ashley: I am good. How are you doing?Meagan: I am doing great. I’m loving all of the stories we are recording and so excited to hear yours. You have a more unique VBAC in the sense that it was a very premature VBAC. Ashley: Mhmm, yep. Meagan: Yes. We are going to talk a little bit more about that. You’re going to share information for NICU moms because your baby did go to the NICU. You are a mom of two and a children’s therapist. Can you tell us a little bit more about what you do for work? Ashley: Yeah. I work with kids ages 4-18. Right now, I’m Telehealth only. I actually work in Tooele, Utah, but I live in North Carolina. Everything is Telehealth. It happened with COVID. I was out there during COVID. We moved and continued to do Telehealth since I’ve moved. I really only see 10 and up at this point. Yeah. I see a lot of teenagers all through Telehealth and it’s really wonderful that I get to keep that up. Meagan: That’s so awesome. That’s awesome that you got to keep doing it, and that you are serving our children. I’m sure that you have lots to say about our children and their mental health that is going on out there, but there is a lot. It is a lot of these kiddos of ours. Ashley: Absolutely, yeah. It’s hard and challenging, but it’s also really wonderful and rewarding. I love that I get to do it. Meagan: Yeah. Well, thank you so much for all of your hard work out there. Ashley: Yeah, absolutely. Meagan: We do have a Review of the Week, so I want to get into that, then I really want to turn the time over to share both of these journeys. This review is from Sienna. It says, “After having a very hard conversation with my OB where I learned she was in fact not VBAC tolerant or friendly, I texted my best friend through tears pouring down my face and she immediately sent me a text back with The VBAC Link Podcast. Ever since, I have been listening to every episode of the podcast. It is so beyond helpful and inspiring for anyone preparing for a VBAC. I’m due at the September, and have made the goal to listen to every single episode before then. I can’t say enough for what Meagan and Julie are doing for women like me. I can’t wait to rock my VBAC.” Oh, I love that review. Thank you so much, Sienna, and I can’t wait for you to have an incredible VBAC. Way to go for realizing that your provider may not be the right provider for you. I think there are so many people who walk through the VBAC journey who think they may have a supportive provider, then at the very last minute, they are having those conversations and realizing, “Oh, shoot. I may not be in the right place.” It is okay to switch and keep interviewing and discussing with your provider. If your provider doesn’t feel like talking to you about your VBAC or says, “You’ve got months to go. We don’t need to talk about that right now,” those might be red flags and things you might want to reconsider. Thank you, Sienna, for your review. If you haven’t yet, please leave a review. You can Google us at “The VBAC Link” or you can leave it on the podcast platform that you are listening to us on.  Okay, Ashley. Thank you again so much for being here with us. Ashley: Yeah, absolutely. I’m so happy to be here. I never thought I would be. When I was preparing for my VBAC, I was listening every single day during my walks and I just thought, “Oh, if I get a VBAC, that would be wonderful,” but I never thought I would ever be on the show. It’s crazy and wild to be here. Meagan: I love it. The more and more that we record, we learn that it goes full circle. We’re in your ear all pregnancy with all these Women of Strength sharing their stories, inspiring you, building you up, and now, here you are inspiring and building others up as well. Ashley: Yeah. Yeah. It’s cool to be here. Do you want me to talk about my first?Meagan: Yeah. Yeah. Every VBAC starts with a C-section, so let’s start with your C-section story. Ashley: Yeah, for sure. For my first birth with my son, it was a pretty easy pregnancy for the most part. There were a couple of hiccups here and there. I had morning sickness in the beginning in the first trimester, but everything else was pretty smooth. At 13 weeks, I had a spell where I had a lot of bleeding. That was terrifying. I thought I was miscarrying. I called my provider and panicked. That was just the worst 4 hours of my life because I continuously bleed. They finally got me in for an ultrasound. They checked me and he was just really active and bouncing. They never knew why it happened, but I was fine. Meagan: Did they ever say anything about a subchorionic hematoma or anything like that?Ashley: That kind of sounds familiar, so that could have been it for sure, but I don’t remember. But it stopped. After my ultrasound, the bleeding was done, and everything was fine. It was the weirdest thing, but definitely so scary. Yeah, it was terrifying. That was bad, and after that, after the first trimester, my morning sickness went away and everything was good for the most part. What happened though, I took birth classes. I took breastfeeding classes. I didn’t do a ton of research. I just took my little birth class, and I thought that was enough. I actually think I skipped the C-section part. I was like, “I’m not going to need that.” I don’t know why I was so weirdly confident that I was going to be able to have a vaginal birth, but it literally was something that I’m like, “I’m good,” and I didn’t put much thought into it. I don’t know why I did that. Meagan: A lot of people do. It’s not what we want. It’s not what we think is going to happen, so we just push it aside. Ashley: Yeah. Yeah. I didn’t do any research at all, so I didn’t need to know about that. I didn’t want it obviously, so yeah. Everything was good until about 36 weeks I would say. I started to get carpal tunnel and it just got progressively worse and worse. It was bad. The last month of my pregnancy, it was unbearable. My fingers and wrists were numb 24/7. It was waking me up at night how painful my hands and fingers were. I couldn’t do little things. I couldn’t put a necklace on anymore. I couldn’t put my earrings in because I couldn’t use my fingers. It was so bad, and it was something I didn’t know happened. It was pregnancy-induced carpal tunnel. I had so much swelling in my body. That’s what they said it was. My midwife who I had found and really loved, she referred me to PT. I did that. I did wrist braces every night, and nothing helped. I kind of knew that was going to happen just doing some research. They say the only thing that gets rid of it is delivering your baby basically. Meagan: Do they know why it really starts? Is it something within the blood flow? Do we know? We don’t know. Ashley: I don’t know. My midwife just chalked it up to the swelling. My carpal tunnel was being squeezed by the swelling. I’m pretty petite as is, and then I was carrying so much water and so much weight that I think for me, my body just didn’t respond well. I had the carpal tunnel. That was at 36 weeks when it started getting pretty bad. There wasn’t a lot we could do about it. I really didn’t want to have an induction. I didn’t know much about it either. I didn’t do a ton of research, but I knew I didn’t want it. I just knew I wanted it to all go as naturally as possible and for my baby to come on his own timeline. By 38 weeks, I was miserable. I was like, “I don’t think I can do this.” I was pretty big and uncomfortable, but that wasn’t the part that was killing me. It was the carpal tunnel. It was bad. My provider said that we could do the membrane sweep each week. We did it at 38 weeks. We did it at 39 weeks, and we decided that if nothing happened after my second sweep, we would think about an induction. I was ready. I had to stop working a week before I even wanted to because I couldn’t type anymore. It hurt to type, and I do a lot of assessments with my job where I am typing all of the time, using my mouse and keyboard. It was just awful. We did the membrane sweep at 39 weeks and nothing happened. I was curb walking. I was eating the dates. I was doing the things and drinking the tea. Nothing. So at 39+5, I got admitted for my induction at 8:00 PM. They did a Foley bulb, then they did the Cervadil I believe. That was all fine. I think they also gave me morphine. I think that’s when they did that to manage pain. I looked at my notes, but it’s kind of hard. Some things aren’t super clear. But either way, I got a really bad rash. At the time, they thought it was PUPPS, but looking back, they thought it was a reaction to the morphine. Meagan: Oh shoot. Ashley: Yeah. I was so horribly itchy. Meagan: Yeah, that’s miserable. You’re in pain and itchy. Ashley: Yeah, and the carpal tunnel was still active. That was still happening. I don’t remember it being super uncomfortable with the Foley bulb. I was more scared of it. I was more scared than it actually was painful. I was okay. I handled it okay. So then my water broke at 2:00 AM I believe. The Foley bulb came out and they started the Pitocin by 8:00 AM I believe because I wasn’t moving enough. I wasn’t dilating enough. My water broke at 2:00 AM. It was in at 8:00 AM. I started an epidural, I think, at 5:00 AM before the Pitocin because I was just in a lot of pain. That epidural, though, was done by a resident which I didn’t know at the time. That was one thing I really didn’t want. It wasn’t placed correctly, and I had a ton of breakthrough pain. It was horrible. They actually ended up rethreading that at, I don’t know, 4 hours later. They had to rethread the epidural, remove it, and put it back in by someone else. It was so bad. Meagan: You just had all of the things coming at you. Ashley: Yeah. I just say everything was botched from the start. It was during COVID. There wasn’t a lot of staff. I felt ignored. There were hours when I didn’t see anybody. The Pitocin wasn’t managed very well either. I feel like they never really increased it. Like I said, after they started Pitocin, I didn’t see anybody for 4 hours. It was absolutely horrible. Meagan: Wow. So they were just outside watching your strip, and you were doing okay so they were like, “All right, we’ll just leave her.” Ashley: I think so. There were no providers. There was barely anybody on staff. I shouldn’t say nobody was on staff. I should say that every single room was booked. They were at capacity, and they were low-staffed. It was just not great. I started Pitocin. I finally got to 8 centimeters. I had really, really bad back pain still, and then that was when the epidural was rethreaded or redone. So then it was just waiting for me to progress, but I couldn’t feel anything at that point. I think I was just maxed out on pain stuff on the epidural being rethreaded. I had no control over my body whatsoever. I couldn’t feel my legs. I couldn’t get up and move. It was so awful. I couldn’t feel contractions. I could see it on the monitor, and they would tell me I was having a contraction, but I couldn’t feel anything. By 5:00 PM, they told me, “Okay, it’s time to push.” I had no urges to push because I couldn’t feel anything. I started pushing. I remember just being really out of it because of the epidural. That, and I’m sure there was morphine still. I was just out of it. I did not feel good or in control of my body. I just remember they told me to push. I was pushing for an hour and a half. Every time, they’d be like, “Okay, it’s time to push.” I would try to push, but I felt like nothing was happening. I couldn’t feel anything. Meagan: Yeah.Ashley: Yeah. I think that was probably the biggest reason why I had a C-section. I blame it on the no feeling and no control of my body. They had me push for an hour and a half, then they said that it wasn’t happening enough. I was at 9.5 centimeters. They could see his head, but they said there was a cervical lip. They told me I wasn’t getting past it is kind of what they said. They said, “You’re not going to be able to get past it.” So after an hour and a half, they told me– well, my midwife, and she wasn’t my midwife. She was whoever was on staff. She said, “I think we should talk about different options.” C-section came into it. She didn’t think I was going to get past the cervical lip. I stalled, so they had an OB come in and talk to me. They said, “Let’s bring him in and get his opinion.” He said the same thing, “I just don’t think you’re getting past this lip, and I think a C-section is the best course.” Looking back, I’m like, “I pushed for an hour and a half and they never tried to move me.” Given I couldn’t feel my body, they never tried to reposition me. Now, I know that if that had happened, give me some pressure. Help me sit up. Maybe I could put some pressure on it. I know it’s swollen, so putting pressure could have made it worse, but I just think there could have been so much more done that wasn’t done. Meagan: Yeah, and sometimes those cervical lips are baby’s head positioning. We’ve been pushing and aggravating the cervix, so rotating and getting the pressure off of the wrong spot and equalizing the pressure, or getting it over can help. Or sometimes that’s what it needs. It’s not the swelling, the cervix is just there, and it hasn’t progressed all the way, so pushing, and pushing, and pushing against that is what causes that swelling. Then movement, time, or rest– there are so many things. There are things like Benadryl or things like that and things to help swelling, but that’s unfortunate. They were understaffed, so I bet they were like, “We just have to have this baby.” Ashley: I think that’s a lot to do with it. I felt a lot of pressure to just get the C-section. No other interventions were offered. Nobody talked about moving. Nobody talked about letting me rest. Now I know, afterward, when I was prepping with my second birth, I was like, “Yeah, I should rest. Yeah, I should let my body move. Yes, there are things I should do.” I didn’t want an epidural, or I didn’t want one that strong. That was a huge mistake in my eyes. I had an epidural with my second and it was great, but with my first, they just overdosed me. They gave me way too much. I went to the OR. I had my baby via C-section. I was so out of it. They gave me more pain meds back there because they were going to cut me open, then I couldn’t feel my arms when I pulled my son out. They kept trying to hand him to me, and I could not move my arms. I was like, “Please stop.” It was so traumatic because I couldn’t hold him, and they kept trying to give him to me. Everything was a blur for a while. I woke up in the recovery room. I didn’t get to hold my baby for 2 hours after he was born just because I was so out of it. Then I got to hold him eventually. We were back in my room. I was there for a couple of days. Yeah. Recovering from that emotionally and physically was so hard. I didn’t prep for it. I didn’t expect it, and looking back, I was angry that it went the way it went. I feel like it didn’t have to. He ended up being 9lbs, 1oz. His head was in the 97th percentile. He had a massive head, and he was a big baby, but I do think things could have gone a lot differently. Meagan: Did he have any swelling on any part of his head that would have indicated things like asyncliticism or a bruise or anything on his head from pushing?Ashley: No, but he had a cone head. He had a very– Meagan: Okay, so he was coning and getting caput. Okay. Ashley: That’s it, yeah. Meagan: Okay. I was just wondering if there was anything specific to a positional thing, but it might have just been that your cervix wasn’t fully progressed before you started pushing. Ashley: Yeah, I think that had a lot to do with it. When you think about it, I was admitted at 8:00 PM. He was born at 8:00 PM. It was 24 hours and I was on my back the whole time. I was not being moved. I was not being repositioned. Like I said, there was not a lot of staff around. I was ignored. I didn’t know any better. I didn’t know what I should or should not be doing. I didn’t know that I should be moving. I think that had a lot to do with it, a lack of moving around and I was just on my back. Meagan: Yeah. Yeah. So had him and did you immediately know you wanted a different experience or were you just such in shock with everything that you couldn’t even process that? Ashley: I knew I wanted a different experience. I remember being in my bed the day we brought my day home in the bassinet, and I remember being on Instagram just looking up C-section groups and support. That’s when VBAC came to mind. I was like, okay. I can have a VBAC. I can do it differently next time. We only wanted two kids, so I knew that was my chance. For my second pregnancy, I really had to dedicate myself to how my body would allow, but that was so important to me right away, to have a VBAC. Meagan: Yeah. Did you immediately find a lot of resources? Ashley: I did. I believe that’s when I started following The VBAC Link. I believe that’s when it happened. There were some other C-section mama groups and stuff that I followed. That was really helpful. I would read people’s comments and it brought me so much relief to know other people had experiences like mine and the way I was feeling was normal. That was super helpful. Meagan: Yeah. There’s something about having that community behind you, validating you, helping you feel like you’re not alone in this world going through this, you’re not alone in this world wanting something different. A lot of people will say, “Why can’t you just be grateful? Why are you trying to figure out a new pregnancy and birth when you’re not even pregnant? You just got this beautiful newborn.” It’s not that I don’t love my newborn, and I don’t want this time with my newborn, but I’m starting my journey now to have a different experience. It’s okay that I didn’t like my experience. I still love my baby. Ashley: Yeah. That was what I heard a lot. I heard, “At least your baby is here and they’re healthy.” I know that was just well-intentioned, but yeah. That was really traumatic. My baby is here. My baby was healthy, and it was wonderful that he was born happy and healthy, but I didn’t feel right about it. I felt like I didn’t have control. I felt like I didn’t have a choice. I felt really pressured, and I didn’t have the birth that I expected to have. That was just really, really difficult. Meagan: Yeah. You also went through a lot between the reaction, but then also with carpal tunnel. You were restricted to even move your fingers, then in your birth, you couldn’t even move your arms. It went heavier. My spinal also went higher with my second up into my lungs and into my arms. I remember feeling that panicked feeling just laying there. Everyone was doing their thing and I was like, “Oh, is this going to stop? How am I going to hold my baby?” and all of those feelings. Ashley: Yeah. Meagan: Well, okay. So you had this precious baby. You decided you wanted a different experience and how did that experience start? Ashley: Yeah. The second time around, I should say with my first that it took us a while to get pregnant. It took us 13 months. I was thinking– I don’t know why it took so long. We were really trying. I was thinking that maybe that would happen again. I was mentally preparing for that. We had been trying for a couple of months. We moved. Right when we started trying was when we moved another state to North Carolina. I needed to find a provider. After getting settled for a couple months and had been trying for a couple of months, I found a provider who had really great reviews. I thought, this is great. I got in with her. That was really just to first get checked up, and then second, to have a plan for if we can’t get pregnant in the next couple of months, what should we do? I was thinking about that one medication you can take that releases more eggs. I wanted to ask about that because almost 35 and I wanted to be on top of it. I met with her. She was really nice, but immediately, she didn’t read my chart. She didn’t know about my first birth. I had to tell her about it and give her that information. After I explained what happened, she basically said that it sounded like it was an anatomy thing for me. One, it was anatomy. I said right away, “I want a VBAC. This is my goal, absolutely.” After I told her my story, she said, “Well, that sounds like anatomy. When it’s that, you’re more likely to have a repeat C-section.” She was like, “I’ll let you try, but the odds are that you’re probably going to have a C-section.” I felt so defeated when I left that appointment. I kind of just accepted it and thought, okay. That’s probably what’s going to happen. She’s the expert. She’s got great reviews. She must know. I left that appointment and again, did some research, and I started seeing that it was not really true. You still can have a VBAC. What she was telling me was not true. I needed to find a different provider. That’s what that meant. I just left it at that and waited. The next month, we got pregnant which was amazing. It only took us 5 months that time which I wasn’t expecting. It was super exciting. I did research for VBAC-friendly providers. I found the most wonderful doctor. Her practice is pretty much all women doctors and midwives. They’re all VBAC-supportive. When I met with my doctor, she said, “That’s what I prefer. 100%, I prefer to do a VBAC. I think it’s safer. I would much rather do that than a repeat C-section.” She was very gung-ho and it was great. As soon as we met, she already knew my chart. She read my previous birth. That was super refreshing. I didn’t have to tell her anything and she had a plan for me. She said, “If you want a VBAC, this is going to be the plan. We’re going to do everything we can to avoid any type of induction and intervention. That’s what we want to do.” About the carpal tunnel, it was likely to come back because it was about my body, and it was more my body and my anatomy, and how I handle swelling. The carpal tunnel was likely to happen again, but the problem was the first time around, I got induced because of carpal tunnel. If this comes back, what are we going to do? She started me on a baby aspirin right away. That was more because I ended up having preeclampsia after I gave birth. Meagan: Postpartum-eclampsia. Ashley: Yes, yep. That didn’t didn’t affect me that much, but yeah. She said, “We want to prevent that, so at 10 weeks, I want you taking baby aspirin.” She said, “If carpal tunnel comes back, I think we should do steroid shots and that should be able to help with the pain. It will help you manage the pain, so we can get to birth without induction or interventions.” Right there, I felt so much relief because that was the reason induction happened the first time around, but I also was a little angry because I was like, why didn’t my first midwife ever talk about that? It was never brought up. It was only PT. I don’t know why that way, but again if I would have had that, I think I could have had a much better pregnancy the first time around. Meagan: Yeah, and gone through a lot less pain. Ashley: More manageable. Yeah, so I left that appointment feeling really good. I found this wonderful provider, and things were going to go differently this time around. I asked about this time if my baby was bigger, and she said, “No, it’s not about weight. It’s not about how big your baby is. It’s about the way the head is positioned and the way the head is coming out. Big babies can be delivered vaginally.” She just said all of the right things. Meagan: Yes. Yes. When you were first telling me the story from the other provider who you met, I was shaking my head. With this one, I’m throwing my hands up like yes, yes, yes. Ashley: Yeah, that’s how I felt. She was wonderful. That was such a relief. It was everything for me. I left that and right away started prep for a VBAC. I already exercised lightly every day, but I started exercising. I made that a priority. I did my 2-mile walk every day. I was drinking the red raspberry leaf tea. I was meeting with the chiropractor. I met with a doula and interviewed a doula. I got that set up. Yeah, everything was pretty smooth. I had horrible morning sickness. This was worse this time around with my second pregnancy. I got horrible pregnancy acne. I had never had acne in my life, and then during my pregnancy, it was just horrible. That’s the worst. Everything else was smooth sailing. Meagan: Interesting. I wonder why. Ashley: I don’t know. I thought for sure I was having a girl because I never had it with my first pregnancy, so I was like, maybe I’m having a girl this time around. And my morning sickness was worse, so with my pregnancy being so different this time around, I thought it must be a girl, but it wasn’t. It was another boy. Meagan: It was?Ashley: Yeah, yeah. Meagan: Maybe the testosterone. I sometimes get testosterone acne. Maybe it was the testosterone. Maybe this baby had extra testosterone creating acne or something. Ashley: Yep, perhaps. I was just so convinced that I did everything. I bought baby girl clothes and all of that.Meagan: You were convinced. Ashley: Yeah, when I found out it was a boy, I was shocked. Everything was good though for the most part. There were no big issues once we got through the first trimester. What kind of happened was, I had never truly felt contractions before because with my first, I already had an epidural when I started to have contractions. I didn’t know what they would feel like. I was exactly 28 weeks. I went to the bathroom and there was mucus. I didn’t know. It was a lot. I ended up looking it up a lot and it looked like my mucus plug from what I saw. I had a doctor appointment the next day and after reading a bunch of things online, people didn’t seem to think it was a big deal. They grow back and sometimes that happens, so I wasn’t freaking out at all about that. I saw my doctor the next day, and she said that it was okay. It probably was just part of my mucus plug. She didn’t seem very concerned. The next week, I was leaving for St. Thomas on our last vacation as a family of three. It was very important to me. I wanted to go to the beach with my toddler and have uninterrupted time with him before my baby came. This was in March. My baby was coming at the end of May, so I was going to be 29 weeks. It’s a good time to travel I thought. We would get this great beach vacation with my toddler. I was cleared to travel. Everything was fine, and then the Monday when I was 28 weeks and 6 days, that night was horrible. I had so much pressure and I was tossing and turning all night. I just kept thinking I had to pee. I kept getting up, trying to go to the bathroom, and coming back to bed, but there was a lot of pressure. I didn’t think much of it, and I just knew I didn’t get good sleep. The next day was a Tuesday. All day long, I was having tightening on my stomach and pressure, but it wasn’t consistent. I feel like it was every 20 minutes to every 40 minutes. I would feel a little bit of pain. It wasn’t really bad though. I wouldn’t even call it pain. I would call it discomfort. I looked it up online. I was exactly 29 weeks at that point. I saw Braxton Hicks, and I was like, “That’s it. I’m just having Braxton Hicks.” It didn’t happen with my first, so I didn’t even know the difference. I was fine. I just went about my day. We were packing for vacation. We were leaving the next day. That night, that Tuesday night, we went to bed by 11:00 PM. We had to wake up at 5:00 AM for the airport. That night was excruciating. I could not sleep. I was in pain. I was having contractions every 10 or so minutes and tossing and turning. There was lots of pressure. I woke my husband up at 2:00 AM and we started talking about, “Should I go to the hospital?” I was like, “No, I think it’s Braxton Hicks. I think it will go away,” which is crazy now that I look back. It was really painful, and I was really trying to–Meagan: Talk it down to Braxton Hicks, and you’re early. You don’t want to think about it. Ashley: Yeah, I was 29 weeks. There was no way. Again, it did not cross my mind that it was actually real contractions because I was so early. Yeah, then there was a huge degree of denial going on. There was gigantic denial because I just wanted that vacation so badly. Not that I wanted a vacation, but I wanted that time with my son on the beach. We had been talking about it, so I just wanted to make it happen. At 2:00 AM, I woke him up. We talked about it. I was just like, “Okay. I’m going to get a heating pad and put it on my belly. I’ll just lay here and hopefully that will kill the pain.” I took some Tylenol as well, and it didn’t do anything. By 4:00 AM, I was like, “I’m getting in that hot bathtub, and I’m just hoping that stops this.” I was in the bathtub, which again, should have been my sign that you should leave for the hospital if you have to get into the bathtub and use the heating pad. If all of this stuff was happening, I should have gone in. By 5:00 AM, I was up. We were loading the car, and we were off to the airport. The whole time I was walking into the airport, I was stopping myself in my tracks to have a contraction. Meagan: Oh my goodness. Ashley: I was walking through the airport stopping, catching my breath, then I’d keep walking. It is absolutely wild that I got that far. It was a far walk to our gate. I was doing that a lot, and finally, we got to the gate. We were waiting to board. We were 5 minutes from boarding. People are actively boarding the plane. We are waiting to board last. I was like, “I’m just waiting to go to bathroom.” I go to the bathroom, and that’s when I passed a quarter-sized blood clot. I had light bleeding on top of that. I came back, and I looked at my husband and said, “I can’t get on that plane. I have to go to the hospital,” but I said, “You guys get on the plane, you and our son. Get on the airplane, and I will drive myself.” We had our car there. I was like, “I’m going to go to the hospital, and I’ll just rebook my flight for tomorrow. I’ll come out and meet you guys in St. Thomas.” Meagan: Oh my gosh. Ashley: We debated that. My husband went back and forth for a couple of minutes. He was like, “I don’t think that’s a good idea.” I was like, “No, it’s fine. They’re going to check me out and release me. I’ll meet you guys tomorrow.” Thank God he was like, “No. Let’s not do that.” Meagan: Yeah, seriously. Ashley: I still just thought everything was fine. I really thought that. I wanted to go so badly. We ended up that they had to get all of our baggage off of the plane. The crew was really annoyed with us, but so be it. Meagan: Whatever. Ashley: Yeah. We held up the flight a little bit for sure, and then I couldn’t even at that point walk back to the car. We called a wheelchair. Someone came and wheeled me out to our car. The hospital was only 20 minutes from the airport which was great. We got to the valet and we couldn’t bring my son in, so while my husband talked to the front desk, I waited in the car with my son. They said that my son couldn’t come into triage, so me and my husband obviously couldn’t leave him in the car. I just walked myself into the hospital. I got seen by triage, and right away, they took me back to the room. I said I was having contractions. They were monitoring me, and they were like, “It doesn’t really look like contractions.” I was like, “Okay, well something is happening. I’m in a lot of pain.” They put the monitor on me and didn’t see anything. Then they admitted me to one of the rooms in triage. They really wanted to check me, but I was not having that. I did not want to be checked. They really wanted me to go home. They ended up giving me an ultrasound, and everything came back normal with baby which was great, but they were like, “We don’t understand why you’re in so much pain,” because they still weren’t seeing contractions. They ended up seeing them on the monitor, and the doctor said, “I have to check you.” At this point, it was 11:00 AM. Meagan: I have to check you. Ashley: Yeah. She said, “We have to. We don’t know what’s going on with your body. You’re in a lot of pain, so we won’t know unless we check you.” She was really kind about it. I didn’t feel pressured because I had already turned it down. They had asked me and asked me, but they were like, “We don’t know what’s happening. We have to know where you’re at.” She checked me and when she was done, she looked at me and said, “You’re at 3.5 centimeters.” I just burst into tears because at that point, I knew that it was not good. I was too far dilated for 29 weeks.She said, “You’re not going to leave tonight. You’re not leaving until you deliver basically because you’re dilated. We have to keep you until your due date.” My due date was 11 weeks away.That was the hardest part because I knew I wouldn’t see my toddler until I gave birth. That was horrible. That’s what I cared about at that point. Obviously, I cared that my baby was healthy, but it was excruciating to think about that. Meagan: Mhmm. Ashley: They admitted me right away. They took me to Labor and Delivery. I told my husband because he took my toddler home. I told him, “They’re keeping me.” He came back to the hospital. At that point, the plan was just to stall labor as much as possible. Let’s get as far to your due date as possible. They did the magnesium drip immediately. They gave me steroid shots to help strengthen my baby’s lungs. They gave me one oral medication. I can’t remember what it was called, but it was supposed to help stall labor. That was all started and up and running by 1:00 PM. By 4:00, my water broke. With all of the interventions, my water still broke at 4:00 PM, and baby was coming. My water broke by 4:30, and then I was pretty much having contractions from that point on. They were pretty consistent and pretty painful. At 3:00 AM, they really started to ramp up. They were 3-5 minutes apart. They were really painful. At that point, I asked for an epidural. I was really clear that I needed it to be the lightest possible epidural. I talked about my past experience and how awful it was. I was going to try to not do an epidural, but the contractions were so intense that I was like, “I don’t think I’m going to be able to push because

Anni is a mom of two young girls living in Okinawa, Japan where her husband is stationed with the Marine Corps. In addition to her work as a non-profit grant writer, she volunteers with the Military Birth Resource Network and Postpartum Coalition and hosts their podcast, Military Birth Talk. A big challenge for military parents is creating care plans for older children during birth. They often live far away from family or have recently moved and don’t have a village yet. Anni’s care plan was shaken up as her induction kept getting pushed back and conflicted with her family’s travels.Though her plans changed, Anni was able to go into spontaneous labor and avoid the induction she didn’t really want! Her VBAC was powerful and all went smoothly. She was amazed at the difference in her recovery. Another fun part of Anni’s episode– she connected and met up with two other VBAC mamas living in Okinawa through our VBAC Link Facebook Community! We love hearing how TVL has helped you build virtual and in-person villages. Military Birth Resource Network and Postpartum CoalitionHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. You are listening to The VBAC Link, and I am with my friend, Anni, today sharing her stories. Anni is one of our military mamas. This is the final episode of the week of military episodes. So even though it is a little bit after Veteran’s Day, that’s okay. We are celebrating our military mamas today. Welcome to the show, Anni. Anni: Thank you so much. I’m so excited to be here this week. Meagan: Me too. I also can’t believe that you are here right now. We were just chatting before the podcast about time. You guys, it is 4:50 AM where she is at. I just can’t even believe it. You’re in Japan. Anni: Yeah. We live in Okinawa, so I’ve got to do stuff at weird times if I want to stay in touch with anybody in the States. It’s the military thing. Meagan: Oh my goodness. Yes. She is in Japan. She is a mom of two young girls and like she said, she is living in Okinawa, Japan where her husband is stationed with the Marine Corps. Her personal values are community, joy, purpose, and creativity which all drive how she spends her time. In addition to her work as a non-profit grant writer, she also volunteers with the Military Birth Resource Network and hosts their podcast, Military Birth Talk. So mamas, if you are a military mom, and I’m sure a lot of people are flocking to these episodes this week, go listen to Military Birth Talk. Can you tell us a little bit more about Military Birth Talk? Anni: Yeah. So as you said, it’s a part of the non-profit Military Birth Resource Network and Postpartum Coalition, so MBRNPC for short. That’s an organization that provides resources for military families who are in the perinatal stage of life, so if you’ve just moved to a new duty station and you’re like, “Oh, I need a doula who’s covered by Tricare,” you can go to their website and reach out to one of their chapter leaders. They provide that kind of resource. Also, there is sort of an advocacy wing of the organization that works on policy changes impacting military families. This is our podcast, Military Birth Talk. Right now, we’re featuring mostly just military birth stories, but we’re in our third season and this season, we’re going to be adding some additional episodes like policy conversations, interviews with experts, and that kind of thing. So, as you said, if you’re a military-affiliated person listening and you want to hear some firsthand accounts of what it’s like to give birth within the military healthcare system, we’d love for you to tune in. Meagan: I love it. Thank you so much for doing that and explaining more. Anni: Yeah. Meagan: I just can’t wait for you to share your stories. I do have a Review of the Week, and then we’ll jump right in. Today’s review is by RiverW88. It says, “Gives me hope.” It says, “As a mama who had an unnecessary Cesarean and a poorly planned VBAC attempt that failed and resulted in a Cesarean, listening to these stories and information gives me hope for the future. Not only do I hope to have a third baby and a successful VBAC, but as a doula and an experienced birth photographer, I cannot wait to support other women through their VBAC journeys. I look forward to sending my clients to your website and podcast, and not too far in the future, take your VBAC doula course for myself. I love the way you present facts and inform while giving mamas a platform to share positive stories about a topic that is so scary for so many people thanks to the lack of education out there.” Oh my goodness, that is so true. There is such a lack of education out there and that is why we created the VBAC course that we did and the VBAC doula certification course. So, if you are a parent looking to up your game for VBAC, or if you are looking as a doula to learn more about supporting clients who are wanting a VBAC, definitely check us out at thevbaclink.com.Okay, Anni. Let’s jump in. Anni: All right. So I am excited to share two birth stories. I’ll focus mostly on my VBAC since that’s why we are all here, but I’ll give a little bit of context about my first birth. It was pretty routine honestly. I had a breech baby, and there were no breech vaginal birth providers in my area at the time, so that’s the spark notes version. But to give a little bit more context, at the time, we were stationed in North Carolina in Newburn, North Carolina. There are a few providers out there, but not a ton. It’s sort of remote-ish, but because my husband is in the Marine Corps, we were a little bit limited. I actually was on Tricare Select at the time, so for those of you listening out there who aren’t familiar with military healthcare, as a spouse, you can be on Tricare Select which is where you get to choose your own provider. You don’t have to be seen by the military healthcare system. You pay a little bit extra. Or, you can be on Tricare Prime which is completely free, but you have to be seen within the military network. I was on Select at the time, so I was paying a little bit extra to choose my own provider which is kind of funny because there was really only one provider in that town anyway. This is one of the reasons why flash forward to a few years later, I wanted to be a part of the Military Birth Talk podcast because we often as military families get a lot of advice that doesn’t really fit our life. One of those pieces of advice is to pick your own provider. Do whatever you can to pick your own provider. Sometimes, that’s just not possible. That’s just not true for military families, right? It can be true for a number of reasons, but it’s very true for military families, so choosing my own provider was not really that possible given where we were located. That didn’t really come into play until the end when I found out that our baby was breech. Generally, the pregnancy was great. It was a really empowering, positive experience for me. I loved learning about birth. I really hadn’t been involved at all in the “birth world” until I became pregnant, then I totally immersed myself. I was super excited to give birth. I was super excited for all of the little quirky things like going into labor and my water breaking, seeing my mucus plug come out, and all of the birth nerd things that I had heard people talk about on all of the podcasts like this one that I had been listening to throughout my pregnancy. It was a pretty routine, positive pregnancy. About halfway through, we found out that we would be moving to Kansas at about 6 weeks postpartum. This is another one of those military things that people would say, “Oh, enjoy nesting and have a really quiet, peaceful postpartum.” I was like, “Okay, that goes out the window. Our house will be packed up by the time the baby is born,” because with the military, you have to send stuff super early. There was no nesting, no quiet postpartum period. There was a cross-country drive at 6 weeks postpartum. That was my first wake-up call around how birthing within the military community can be unique. Up until then, because I was on Tricare Select, I was like, “Oh, I’m not really a part of this military thing when it comes to my healthcare.” That started to shift around then. Then around 36 weeks, we got a scan and found out that the baby was breech. I was so upset. I had just spent the whole pregnancy looking forward to this experience that I now wasn’t going to have. It felt like I had been studying for a test or preparing for a final exam that now I wasn’t going to get to take. That’s obviously not true at all, but emotionally, that’s how it had felt. I had gotten so excited about the possibility of seeing what my body could do. It almost felt like I had a sports car and now I was going to be forced to drive it in automatic or something. It just felt like I wasn’t getting a chance to experience this thing that I had gotten so excited about. We were really upset, and my husband was too because he had gotten really excited about being able to support me in labor and all of those things. We decided not to do an ECV. I’m sure your listeners all know what that is. Partially, it was because I wasn’t a great candidate for it. My placenta was anterior, so that increased the possibility of an emergency outcome. I had a high volume of amniotic fluid, so that also decreases the chances of success, and the position that the baby was in, she was completely breech. She wasn’t transverse. She was totally in the wrong position. We were like, “I think we’re not great candidates. Let’s not do it.” We just booked the C-section. The C-section was fine. It wasn’t traumatic, but especially now having had my VBAC and being able to compare the two, it wasn’t a great day. I had surgery, anesthesia, and felt nauseous all day, I couldn’t really hold the baby until 9:00 that night. The silver lining of that, I would say, is that my husband got to spend the whole day holding the baby because I didn’t really feel well. I think that was really special for him after having 9 months of this abstract idea of a baby, and now he got to spend that day with her. I look back fondly on that aspect of it, but otherwise, it was surgery. The recovery was fine. I thought it was, at that point, again, now having had the VBAC and knowing the difference, not really that bad. It was a week and a few days of significant pain, and then after that, it was not too terrible. But again, just not the birth experience that I had hoped for. Then after that, I was not one of those people who was immediately gung-ho about having a VBAC. I think I was a little– I felt so disappointed that I didn’t really want to go there in my mind. I was like, “You know, it might just be easier to schedule another Cesarean and not worry about the emotional disappointment.” I didn’t want to do that either, so I just didn’t really want to think about birth at all for a while. Meagan: That’s a valid feeling and very normal. Anni: Yeah, so I took a big break mentally from birthy stuff. We did have a pregnancy in between our two daughters’ births that actually ended at around 19 weeks due to Trisomy 18 which is a genetic chromosomal abnormality that is incompatible with life, so that is its own whole story. I don’t like skipping over it because we appreciate his life, and it’s a part of our story. We love our baby boy that we didn’t get to spend enough time with. After that, I got pregnant again when we moved to Okinawa. When my first daughter was about a year old or a little bit less, we found out that we would be moving overseas to Okinawa, Japan. We arrived. We had the 19-week loss, and then a few months later, I got pregnant again with our second daughter who is now almost 9 months old. The pregnancy was so awesome for the most part. I had a little bit of anxiety around having just had the loss and feeling a little bit guarded. I would say it took a little bit of time to actually really be able to believe that she would be born. I think for a long time, I just didn’t expect it to work. I think that was compounded by my Cesarean experience. I had this feeling of, maybe my body just doesn’t work or something. That took a little while to get over, but for the most part, the pregnancy was great. Because we live overseas, we are not required to be seen on base, but the off-base options are very limited here, especially in Okinawa. The specific, weird thing about the community here is that because Okinawa is such a small island which many people don’t know that it is a small island. It’s not even off the coast of Japan. It’s floating in the middle of the ocean. Meagan: Really? I did not know that. Anni: Yes. If you look it up on the map, you’d see that it’s just a dot on the ocean. Because it’s so remote, the local vibe here is basically that if the American military is going to have so much presence on this tiny island, they should be caring for their own people which is reasonable. So getting seen out in town is not as easy as it is back in the States because the options are just very limited. The other thing is that really, the only other option that Americans have out here as far as being seen “out in town” which just means off base, is a birth clinic and they don’t accept VBAC patients there. Really, my only option, if I wanted to do the VBAC, was to be seen at the military hospital. So, my care there, I was being seen through Family Medicine. You can either be seen by OB or Family Med. I chose Family Med because I wanted to just continue to be seen by my regular PCM. I thought that that continuity of care was nice. Everything went really smoothly. I was sort of on the fence about the VBAC. I knew I wanted it, but again, I was emotionally guarded. Once we got into the second trimester and I started thinking more about birth, I started doing a little bit more digging thing, reading The VBAC Link Community posts a little bit more carefully. Actually, funny story, I posted something in that group. I can’t even remember what the question was. Oh, it was about induction actually because it looked likely that we would want to schedule an induction so that we could plan to have family fly out to be with us. They had to buy plane tickets and stuff. Even though that was not at all what I wanted to do from a VBAC perspective, it felt like what we would need to do as far as getting care for our toddler. I posted in that group to try to see if people wouldn’t mind sharing their positive VBAC induction stories. Two of the people who responded saw my picture and they were like, “That’s in Okinawa. We’re here too,” so we met up for coffee and I’m good friends with them now. Meagan: Oh my goodness. Anni: Yeah, so shoutout to Sarah and Tatiana if you’re listening. That was really nice to feel like I had a little bit of community here in that way around this very specific topic. I started really committing to the idea of a VBAC. I also, when I say committing, my goal was that I really wanted to have a joyful birth, I didn’t want to suffer. I wanted it to be joyful. I wanted to feel present like I didn’t have the last time. My thinking about it was basically that those were my priorities. If it ends up being that having another Cesarean is what would get me those things, I would rather have that than lose the joy and the feeling of being present. I’m not willing to suffer just to get this outcome. That was my list in my head. I got a wonderful doula named Bridget who was totally on board with my priorities. She and I really aligned around our level of risk tolerance around VBAC because the hospital here on Okinawa, the Naval hospital, had a couple of specific things that they wanted for VBAC. They wanted me to come in right away as soon as I felt any contractions or if my water broke. They wanted me to come in right away, whereas my preference initially was to have labored at home. So that was one example of one of the things Bridget and I talked about around, okay. What’s our preference around how we handle this? Do we want to say, “No thanks. We’re going to labor at home for as long as we can”, or do we both feel more comfortable just getting to the space where you’re going to deliver and knowing that you’ll be there and they’ll be watching to make sure that everything’s fine? Where I shook out on that was that I’d actually rather just go to the hospital sooner. That was actually fine with me. It was really nice to have somebody to talk through that with. It was nice that we felt aligned in that way. She is really used to working with military families. She is a military spouse herself with two young boys, so that was really a really supportive relationship. My husband felt that way with her as well, and she is still a good friend. That was a really important part, I think, of my preparing for the VBAC. The hospital providers were super supportive which I was very surprised about. I didn’t receive any pushback. Anybody who I saw during the course of my pregnancy was totally in support. In fact, I had a TOLAC counseling which they require so they can tell you all of the risks and benefits and whatever. The provider who gave me the TOLAC counseling, I think assumed that I would be coming in blind, so she did her whole spiel. At the end, she was like, “What do you think? What do you think you might decide?” I was like, “Yeah, no. I’m definitely going for the VBAC.” She was like, “Okay, great. I think that’s a good choice.” I was surprised by that. I think people, myself included, expected military hospitals to be very antiquated or by the book or very risk averse, which they are, but in this case, it was really nice to see that they had caught on to the fact that in many cases, a VBAC is not actually more risky. Meagan: Risky. Anni: Yeah, exactly. That was really nice to feel like I wasn’t going to need to be going in with any kind of armor on. So fast forward to the birth, as I had mentioned, I had “wanted” to schedule an induction for logistical reasons. The way that the hospital here works because they are chronically understaffed as many military hospitals are, if you’re having an elective induction, so if it’s not medically necessary, they give you a date, then you call the morning of that date and they tell you what time to come in based on the staffing ratios. Our family who we had called to come for the birth that we had scheduled this whole thing around, arrived, and the next morning, we called as it was our scheduled induction day. I will say that the only family who could come was my sister-in-law and brother-in-law, so my husband’s sister and her husband. She’s a surgeon back in New York, so she only had a 6-day period that they could come. That was part of the reason why we wanted to schedule an induction. They got here. The next morning, we called the hospital, and they said, “Oh, we’re too busy right now. We can’t safely bring you in, so call back at 4:00.” We called back at 4:00, and they were like, “We’re still too busy. We’re sorry, but you have to call back tomorrow morning.” My doula had warned me that this was very common. She was like, “Expect maybe 12-24 hours,” but I was just in this manifesting headspace that everything was going to go great, so I was super disappointed. We went to sleep. We were like, “Oh, we were supposed to be at the hospital tonight.” We woke up in the morning, called the hospital, and again, they said, “We are still too busy. For the third time, we can’t safely bring you in, so you have to call back at 4:00.” I took a long walk by the ocean. We got lunch. We just killed time. I took my toddler to the playground. I’m like, “Okay, this is it.” We called back at 4:00 PM that day and they were like, “I’m so sorry. We’re still too busy.” This was the fourth time. By this time, there was actually a day between when our family arrived and when we started calling. By this time, there was no way they were still going to be here if we had to go for the induction, have what was inevitably going to be a long induction because I never labored with my first, spend the 24-48 hours at the hospital, and then come back, there was no way our family was still going to be here.I was so stressed. They were like, “We know we’ve pushed you now four times. Why don’t you call back tonight at 8:00 or something? We think we’re going to get a discharge between now and then. We’ll see if you can come in at 10:00, and we’ll see if we can start the induction.” I was like, “You know what? Our schedule is already messed up at this point. It sounds like it’s already a crazy situation over there at the hospital. I don’t really want to go into that mess, and I don’t really want to start an induction at 10:00 at night.” I was like, “Can we just come in tomorrow first thing, at 5:00 in the morning?” By this point, it was going to be a Saturday. We were supposed to go in on a Thursday. It got pushed all day Thursday and all day Friday. I said, “Can we push it to the first thing on Saturday morning?” The charge nurse who I talked to said, “Yes, that’s fine.” We go to bed. We wake up in the morning, so happy that finally, today was the day. We say goodbye to our toddler. We get to the hospital at 5:30. It’s super quiet. Nobody was there. We bring the bags up. We unpack. I had affirmations that I had printed out, Christmas lights, music, essential oils, and all of those things. We start unloading the bag. The nurse comes in and gets me hooked up to monitors to do a non-stress test. We do that. I’m sitting there on the monitors for a half hour. Then she comes in and she says, “The NST looks good.” She starts getting an IV ready because one of their protocols is that they want VBAC patients to have two IVs actually. Meagan: Okay, what is the deal with the two IV thing? I’ve been hearing this. I apparently need to dig really far into it. Why two IVs? Anni: They said that one was for hydration. Meagan: Okay. Hydration, like for ORs?Anni: Yeah, and the other is for medication, so if they need to hang a quick bag of something like Pitocin– I don’t even know. It’s so silly because I didn’t have anything. When I eventually did get the IVs, I didn’t have anything in either one. The second one was really hard to get in. They spent an hour and a half trying to get it in. I didn’t even have anything in the first one. I was like, “Nothing is in the first one. If you need to give me meds–” Whatever. Meagan: Stop the hydration and put the meds in, or maybe they need that extra port that they can put in. That’s interesting. Anni: Yeah, so she goes to put the IV in. A nurse comes in and goes, “Wait, don’t put that IV in.” I’m like, “Why?” They were like, “We don’t know. The provider wants to talk to you.” The provider comes back in and she was like, “I’m so sorry, but we didn’t realize that you were a VBAC. We weren’t tracking that. You got pushed, and we won’t induce you on a weekend because we only have one OB and we want to have two,” so we had to go home. They were like, “You have to go home, and you can’t come back until Monday.” I burst into tears. This poor OB was like, “You can totally yell at me.” I’m like, whatever. It was so ridiculous. We go home. We were like, “All right. Now, we don’t know what we will do for childcare.” Thank goodness, my sister lives in San Francisco. Her husband had a work trip that week that got canceled, so she was like, “I can actually just fly out and be there for you.” She has two kids, so that’s why she wasn’t going to come before, but now her husband was going to be home. She hopped on a plane right when that happened. We go home, and we were like, “Okay. We will be coming in on Monday.” We go to bed that night on Saturday, and I woke up at 2:00 AM with contractions in labor. Meagan: Oh yay! Anni: I could cry now thinking about it. It was the beginning of a day that was the culmination of everything I had wanted from a birth experience for the last 3.5 years. I had been having a little bit of prodromal labor that week, but it would be one contraction at 2:00 AM and then nothing else. I woke up at 2:00 AM. My husband was sleeping on the couch by this point in pregnancy because I had one of those massive pillows, and he was like, “I can’t. I don’t fit.” Meagan: I can’t compete with the pillow. Anni: Exactly. I was like, “I’m sorry, but I choose the pillow.” He was on the couch. I woke up at 2:00, and I was like, okay. I’m having a contraction. 15 minutes later, I had another one. I was like, “Okay, I had two, but 15 minutes apart is a long time.” But then, 15 minutes later on the dot, I had another one. Then it was every 15 minutes for the next 2 hours from 2:00-4:00 AM. My dogs were there. I was just really enjoying it, honestly. I was feeling emotional. Nothing was super uncomfortable yet, so it was just period cramps and that kind of a feeling. But I was like, “Okay.” We were supposed to take our in-laws to the airport that day because that was the day that they were leaving. I’m like, “Okay. I know how this works. I’ve heard a bajillion birth stories. I’ll wake up at 6:00. The house will get busy. The contractions will peter out. I’ll have the whole day to do whatever, then they’ll probably pick up tomorrow night after I put my toddler to bed.” So in my head, I’m like, that’s the day. That’s what’s going to happen. The plan was that I was going to drive my in-laws to the airport that morning because my husband was going to pick my sister up late Sunday night. That way, we could split the trips. I didn’t want to do the late-night run. 6:00 in the morning rolls around. I wake up my husband and I’m like, “Hey, I’ve been having contractions for 2 hours, but no big deal. I’ll take Megan and Paul to the airport,” which is an hour away. “I’ll be back later.” He was like, “What are you talking about? You’re not going to take them. Nobody’s going to the airport an hour away if you’re having contractions. They can take a taxi. They’ll be fine.” I’m like, “No. They’re definitely going to stop when everybody gets up. That’s always what happens. He’s like, “No. I don’t care if nothing happens today. You’re not driving to the airport if you’re having contractions.” I was like, “Fine. That’s silly, but whatever.” Everyone wakes up. I’m still having contractions, but they were very short. They were 30 seconds long and very tolerable. There were a couple that I was like, “Okay, I want to get on hands and knees and hang out on my yoga ball.” But for the most part, they were super easy. 8:00 rolls around. We called a taxi for my in-laws and we actually had a babysitter lined up for that day anyway. I can’t remember why, but we decided just to keep her basically and have an easier day. The babysitter arrived at 8:30 and my husband went out. Right as she arrived, my husband went with my toddler to go do something quickly, so I was alone with Brittany, our nanny. I had this one contraction and I was like, “I don’t want to talk to her.” We had just met her at that point. She was new to us, so I was like, “Small talk feels really hard right now. I can’t make small talk.” I was like, “Hmm. That’s kind of interesting.”Meagan: That’s a sign. Anni: But in my head, it wasn’t. It was going to be a 48-hour experience. That was just in my head. Again, I didn’t labor at all with my first, so in my head, this was a first time birth. My body has not done this before. Once our toddler was with the babysitter, I went upstairs and I got back in bed with my dogs. I was just having contractions. I was snuggling with my dogs just trying to stay present. My husband came in and hung out with me for a little while. He said, “You know, if you’re still feeling good, I’m just going to run over to the commissary (the grocery store on base) and grab some essentials because we didn’t think we’d be here this weekend, and now we’re out of milk and eggs and whatever, so I’ll go grab some things, and I’ll be back in an hour.” I was like, “Great, no problem.” He left around 9:00. At 9:45, I was like, “I can’t do this alone anymore.” I feel crazy saying that because it was way too fast to be saying that, but I texted him saying, “I think I need you to come back.” He came back. He brought me some fruit salad because I hadn’t eaten anything yet that morning which I could barely get down. I was in labor for sure, but in my head, I still was like, “This is going to be such a long experience. Nothing is progressing yet.”I got in the shower. That spaced things out for maybe one long gap between contractions, and then right after that, they started increasing. They were getting closer together, and they were more like 7 minutes apart, then 6 minutes apart. I was having to moan through them a little bit. We called Bridget, our doula, to be like, “Hey, what should we do?” I was able to talk to her with no problem in between contractions. I was fully present and lucid, so I was like, “Okay, this means I’m not in active labor because I’m totally present. I can have a conversation,” but then during the contractions, I would really need to put the phone down and moan. Meagan: Okay, I was going to say, but that was in between contractions. Anni: But in my head, again, I was so emotionally guarded around, “I don’t want to expect that this is going to happen. I want to expect the worst.” She was like, “Okay, yeah. They are 6 minutes apart. I would really recommend that you wait until it’s been at least 1 or 2 hours when the contractions have been that close together before you consider going in, but if you want to call the hospital and ask them what their preference is, you can do that.” I was just starting to feel really anxious about laboring in the car. I also just had this feeling that I just wanted to be there. I just wanted to be where we were going to be and feel settled, which surprised me. I thought I would want to stay at home for a long time, but it was the feeling when you have an afternoon flight. You don’t want to hang out at home before your flight. You just want to get to the airport. That was how I felt. I was surprised by that feeling. We called the hospital. We told them what was happenind, and they actually did say, “Yeah, why don’t you just come on in?” We told Bridget. I was a little nervous. I was like, “Ooh, I bet she’s going to think that this is a misstep. We are going in so early.” But I just was like, “That’s what I want to do.” We got in the car. We went over to the hospital and got checked in triage. I was a 1. I had never had a cervical check before ever because my last baby was breech and in this pregnancy, I hadn’t been checked yet. I was super, super tense, and the provider, the nurse, was like, “I can’t really get up there. Your cervix is really high and hard. I can’t really get a good feel, but you’re definitely a 1 or a 2.” So I was like, “Okay, not great.” She left and was gone for a while, I guess, to talk to the provider, and then when she came back in, my water broke, and there was meconium in the water. So I was like, “Okay. All of these things are not great. I’m at a 1. I’m a VBAC. My water is broken, and there is meconium. All of these things are going to make the providers feel urgency around getting this thing going.”But I was like, “Ugh. I definitely don’t want to get an epidural if I’m only at a 1 because that’s a terrible idea, but I also really don’t want to get Pitocin if I don’t have an epidural.” I was really hoping that I could have a natural birth without any medication, but I also again, going back to my list of priorities, I was like, “I want the joy. I want to be present. I don’t want to suffer. If I can check all of those boxes and also experience an unmedicated birth, then that would be amazing, but I’m not willing to sacrifice any of those things.” So after my water broke, they brought me into the delivery room. I just started laboring. They came in maybe a half hour later and said, “We probably want to start some Pitocin.” I was like, “Let me wait on that. Just give me a minute to think about things,” which we can always do. Ask for more time if nothing is an emergency. Thank goodness I did that because in the half hour, I was thinking about it– not thank goodness that there was an emergency, but there was an emergency, and the only OB who was there that day got called away to do emergency surgery, so he became unavailable for the next several. The Pitocin was off the table for the time being, and so I just got to labor on my own. Bridget arrived, and she had me get into a whole bunch of funky positions. The baby was posterior which I knew because I was feeling this all in my back, and so she was having me get into all of these really uncomfortable, asynchronous positions with my legs in all kinds of weird places. It was super uncomfortable, but I knew that it was effective. I kept laboring. As I said, they had trouble getting the second IV in. That took a really long time even though there was nothing in the first one they had put in. I guess I also had two monitors on me. They were Bluetooth monitors, so one for me and one for the baby. I don’t remember that at all, but my doula said that they were messing with them the whole time because they kept moving. I don’t remember that. I think I was just more in labor land than I realized. But I had the two monitors. They finally got that second IV in. The anesthesiologist came to do it, and after he did the IV, he gave me the whole epidural spiel which they have to do for legal reasons which I wasn’t paying any attention to because I was just moaning and groaning and ignoring him. So he left. I kept laboring, and then around– we got to triage at noon and we got checked into our room around 1:00. Around 3:30, they came back in and asked about the Pitocin. I was like, “I need to get more information about this because I need to figure out what I’m going to do for pain management if we’re doing Pitocin.” Bridget was like, “Why don’t you just get checked again and see where you are?” I was a 7. So either I made a ton of progress in that 2 hours, or I wasn’t really a 1 when I got there, and my body was stressed and it clamped up, or the provider couldn’t get a good read. Whatever it was, in my head, I went from a 1 to a 7. Meagan: Massive change. Anni: Yes. I think I giggled. I was just so happy. So they were like, “Okay, well we don’t need to do any augmentation. You’re progressing just fine.” I was like, “Okay. We’re doing this. We’re just going to keep going.” Bridget recommended that I go to the bathroom because I hadn’t peed in a while. I went over to the toilet, emptied my bladder, then had a huge contraction and felt super like I needed to get off the toilet immediately. I hopped off and went back to the bed. A little bit of time passed, and then I started feeling like I had to throw up, but it wasn’t a nausea throw-up. It was like my abdomen was heaving kind of thing. I was like, “Am I pushing right now?” It was this involuntary feeling. I knew about the fetal ejection reflex, but in my head, I thought that was more of a sustained bearing down feeling and this was a more grunty thing. Everybody heard what I

Nicole is a military spouse who had her VBAC in England. She shares what it was like to unexpectedly move overseas during pregnancy, how she navigated not receiving her household goods in time, and how she made the choice to deliver on base versus off. Nicole’s first birth was a Cesarean during the height of COVID. During pushing, she was required to pause, take a COVID test, and wait an hour for the results or risk being separated from her baby after birth. Labor had gone smoothly up until that point, and Nicole knew something had changed after the pause. Things felt different, progress stalled, and ultimately Nicole consented to the Cesarean. Her VBAC was a surprisingly wild precipitous birth with only 2 hours between her first contraction and pushing the baby out! Meagan and Nicole discuss the unique challenges of precipitous births and how important it is to hold space for every birth experience. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello. Welcome to The VBAC Link. Today is Veteran’s Day. If you are just joining us this month for the very first time, then welcome to your first specialized episode week. I don’t even know what to call it. What would you call this, Nicole? I don’t even know. Nicole: A one-of-a-kind situation. Meagan: Last month in October, we had Midwifery Week and now we have Veterans. Nicole is the wife of a Servicemember and she definitely and experience that I think a lot of military members and moms experience and people don’t think about it. I don’t think about that. When I was having my baby, it was like, Which hospital should I go to? There are 10-15 right around me. Then you’re like, “Oh, hey. I’m pregnant and now I’m moving overseas.” You know? I think it’s something that we just don’t think about. It’s fun to have it be Veteran’s Day and to have a Servicemember’s wife sharing your story today. We might even talk a little bit about navigating the military healthcare system and what choices you made. We learned a little bit about that before we started recording. We’ve got her amazing story today. Where are you right now?Nicole: I’m in England right now. Meagan: You are in England, okay. And that’s where you had your baby. Nicole: Yes. Meagan: Awesome. So England mamas, definitely listen up for sure. All mamas, really. We do have a Review of the Week so I’m going to get into that then we’ll start with your first story. This is from Roxyrutt and it says, “Inspiring”. It says, “Listening to these podcasts has been truly inspiring and I have been on my own hopeful VBAC journey. Listening to other stories has been incredibly helpful in my mental preparation.” We were just talking about that before we started recording as well just how impactful these stories can be for anyone but especially during your VBAC journey. It says, “My due date is April 17th this month–” so this is obviously a little while ago. It says, “I’m hoping to have my own VBAC story to share. Thank you all for what you do.” Thank you so much, Roxyrutt, for sharing your review. As always, we love your reviews. You can email them to us at info@thevbaclink.com or you can comment “Review” on your podcast. I think it’s on Apple Podcasts, Spotify– I don’t know if Google allows reviews. You might just have to do a rating. But wherever you listen to your podcasts, if you can leave a review, please do so. Okay, Nicole. Let’s get going on your stories. I seriously thank you so much for joining me today. Nicole: Oh, thank you so much for having me. Like we mentioned before we started recording, this podcast has been extremely inspirational to me and it really led me to having the VBAC of my dreams. Meagan: And you had a precipitous VBAC, right? Did you have a pretty precipitous VBAC if I’m remembering right? It was 2 hours or something?Nicole: Yeah. It was so quick. Meagan: Okay. We are going to talk about that. Don’t let me forget about that in the end. It is something that we don’t talk about a lot. Most people think about birth being a long time. Nicole: Yeah. Meagan: Yeah. Precipitous birth can come out of left field and I want to talk about that. But first of course, every VBAC starts with a C-section so let’s hear about your first.Nicole: Okay, yeah. So I had my first in June 2020 so literally right as the world was shutting down. Everybody was terrified with reason, right? I go in. I remember I had my baby shower planned and everything was planning and everything was canceled. I just felt depleted and I was scared. I remember watching videos on how to have a birth and what to do and all of the birthing videos and there was like, “Here’s a segment on if you have a C-section.” I was like, That will never be me. I don’t have to watch this because that will never happen. That is not in my cards. That is not in my birthing plan I typed up and had signed. That is not in my cards. So I decided with my doctor that I wanted to be induced and I said at 40 weeks I had done my time. Get this baby out of me. I had committed to 40 weeks because she kept saying, “Well, we can do it at 38 weeks if you’re comfortable or 39 weeks.” I was like, “Nope. I will do it until 40 weeks. I’ve done my time. At this point, this baby is evicted.” On June 20th, I went in for my induction. Everything went smoothly. I was progressing but not as fast as they would like so we started Pitocin. That went well. I was doing really well and all of a sudden they were like, “I think we need to break your water.” I had heard horror stories about your water breaking and it’s super painful and you’re miserable after it. So I was like, “Well, let’s get the epidural because why would I put myself through that if they have the option to make this smooth and comfortable? Why would I sit there and not be comfortable during this?” So I got the epidural and I just laid there. I laid in bed for a really long time then at about 3:00 in the morning, I got the urge to push. I let the nurses know. They checked. They said I was at 10 centimeters. Everything was good to go. They came in at about 3:10 and I started pushing. I pushed until about 6:00 AM. At that point, at about 5:00 AM, I started getting really hot. I noticed that they had turned the temperature in the room up obviously for baby. I started getting really overwhelmed and really hot. I started to throw up. My doctor turned down the temperature. She was like, “Let’s turn down the temperature. I feel like you’re just getting hot.” I was like, “I’m just hot. I just don’t feel so good. I’m just hot.” They turned the temperature down then a new NICU nurse came in and she turned it up. I was watching her turn it up and I was just so uncomfortable. I started throwing up again and they were like, “Well, we need to pause because everything you’re doing is an epidural symptom but it’s also a symptom of COVID so we’re going to stop you because we have to test you. You can either continue to push–”Meagan: We have to test you.Nicole: Yeah. I had gotten tested before I went in and then during my labor 3 hours in of pushing, they literally stopped me and said, “We need to do a COVID test.” I did a COVID test and it was crazy. You see all of these doctors in scrubs and masks and then all of a sudden they come in in these inflatable suits and everybody has these– which is more terrifying. I’m already scared. Meagan: Yeah, talk about invading your space. Nicole: Yeah, then you’re telling me that I have an hour until this test comes back. I can either continue to push but if I push and have my baby, you’re immediately going to take her away until my results come back or I can pause, not push for the hour and just let my body do it naturally and then resume pushing if my test comes back negative and I can continue to have skin on skin and the one-on-one time with my baby. Meagan: Hashtag, eye roll. Nicole: Yeah. So during that time, I was pushing well up until the COVID test. My baby was descending correctly. I stopped. I waited an hour and something shifted to where she then twisted a little bit and she– once my test came back negative and I was able to push again– was getting stuck on my pelvic bone and I could not get her out. They were tying blankets together and my husband would hold one end of the blanket and I would push and pull the end of the blanket as hard as I could to try and get her down. I was doing everything to push this baby out. Nothing was working. I started to develop preeclampsia so that was red flag number one. Then my baby’s heart rate started to drop in between each contraction which I guess means that it could be around the neck and it’s more concerning if it’s between contractions versus during the contraction. So after her heart rate started dropping and continuously dropped, they decided to call it an emergency C-section. I just remember feeling devastated. I remember shouting– not shouting, but crying to my husband, “I don’t want this. I don’t want a C-section.” My doctor was like, “I have to hear it from you that you are okay to have the C-section.” I was like, “I mean, I guess if that’s the only way to get this baby out but I don’t want it.” I remember feeling the pain from my C-section and feeling so depleted. I pushed from 3:00 to 6:00 then I stopped for an hour. We resumed at 7:00. We pushed from 7:00 to 9:00 and then they called the emergency C-section and I had her at 9:36. It was a lot and I was pushing hard. I just remember getting back to the room, because my mother-in-law was there, and saying, “I haven’t held her yet.” I didn’t want anybody to hold the baby without me holding her first. I had heard stories of people who were like, “Everybody in my family got to hold the baby before I held my baby.” I just remember crying and I cried for weeks. I just felt like my body gave up on me. My recovery was terrible and that’s what my doctor kept saying. She was like, “You have both recoveries. You pushed for so long that you’re recovering from pushing and then you’re also recovering from your C-section.” Then because I pushed so hard and I was trying so hard, I had tore all of the right side abs so I couldn’t even move my legs to get in and out of bed for 4 weeks because my whole ab muscles were just torn. I had to go see therapy for that and I remember trying to drive me and this infant to therapy sessions and I was just in pain and then the drive home– it was so hard. I just felt like I was really bonding with my baby, but I felt like I was so disconnected with myself. I just couldn’t do it. I had to have therapy because I went into postpartum depression. It was the hardest moment of my life because I really just felt like everybody was like, “Oh, it’s so beautiful though. Your body did its job and it birthed this healthy baby.” I just wanted to scream every time somebody said that because I was like, “But it didn’t. I pushed for hours, literally hours, and it didn’t do its job. I had to have my baby taken out of me.” Meagan: You didn’t feel that way.Nicole: Uh-huh. Yeah. People would be like, “Well, aren’t you glad that you didn’t have vaginal tearing?” I was like, “No, but I had hip to hip tearing and not just through the skin. It was muscles and layers.” I felt like everybody was trying to comfort me and it just felt like I wanted to scream at the top of my lungs because I didn’t feel like anybody was understanding what mentally I was going through. Meagan: Yeah. I think that happens so often in the provider world but also just in our family and friends’ world. We get thrown the, “Aren’t you just happy you have a healthy baby?” It’s like, “Yeah, duh.” But then also that thing, “Well, aren’t you glad that didn’t happen to your vagina? Aren’t you glad you don’t have to deal with incontinence?” Or similar things where in people’s minds, I don’t think they realize that it’s causing harm or that there are ill feelings at all. They are just saying these things, but it’s like, “I don’t feel like I birthed my baby and I don’t feel good about it and I’m dealing with a lot of trauma physically to my body, not just even emotionally but physically to my body. No, I’m not feeling great right now and it’s okay that I don’t feel great. I understand that you’re just trying to help and validate me maybe, I don’t know.” Maybe that’s what people are doing but it doesn’t always feel good. Nicole: Yeah, people kept telling me to be mad at my provider. I was like, “I hear you. But at the end of the day, she’s new to COVID just like we are. She’s going into this trying to navigate it.” I think she did and I think she made the best calls, but everybody was like, “Why are you mad at yourself? Be mad at this person.” I was like, it wasn’t her fault necessarily. She didn’t know what was happening. COVID was so new and it was just blowing up in Utah. It was just this big thing and it seemed like nobody was listening to the fact that I was upset with my body and how my body handled this. Everybody was just like, “Well, it’s a healthy baby. Blame this person or that person. It’s COVID.” I was like, “But what about me? You’re not listening to me.” That was so tough. I felt like I was screaming it and people were trying to silence it without purposely trying to silence it. Meagan: Right. Okay, so I have some questions for you. So when they were offering you sheets and it sounds like you were maybe playing some tug-of-war. What I call it in my doula mind is tug-of-war where you are pulling and tugging and all of those things. Obviously, they were really trying to help this baby get out vaginally and things like that. Did they offer you changing of positions even though you had that epidural? Were they like, “Hey, let’s try to get you on your side or get you on your hands and knees?” You said you kind of felt your C-section a little bit, right? Is that what you said? So it maybe wasn’t as deep of an epidural so maybe you could have done hands and knees or something? Did they ever offer anything like that?Nicole: They didn’t. They did try the vacuum three times but it immediately would just pop right off of her head because she was shifted. Meagan: Asynclitic a little bit, maybe?Nicole: Yeah, so they said that after three times it was unsafe at that point and it was going to have the same results. Nothing was going to happen. I didn’t want to do the vacuum, but once we were at that position, I was like, “Let’s just try it.” I agreed to three times and then we were done. Keep it safe. That’s when we started doing the tug-of-war and we did that for a long time. My husband was holding it and he was like, “The first time, you almost knocked me down because I wasn’t expecting you.” I was pulling so hard. I just wanted this baby out. Yeah, they didn’t move me in any positions. I was just on my back. Now that I know better, I wish I would have tried. Meagan: But again, you didn’t know what you didn’t know. For listeners, if you are in a situation where your baby might be tilted to the side asynclitic or transverse and maybe you have done tug-of-war and things like this, and even then, sometimes it doesn’t work. For some reason, the baby is where they are, but a little bit of a tilt to the side especially if there is one side where they feel the baby’s head or try to get on hands and knees to change that pelvic dynamic can help. But I love that they were like, “Let’s do tug-of-war. Let’s do these things.” I love that providers are still encouraging other things in other ways. It sounds like they really did try and avoid a Cesarean by doing a vacuum and doing the tug-of-war. That is super awesome. I was also wondering if you have any tips for moms who have maybe pushed for a really long time like you did and had essentially have vaginal pelvic floor trauma and also gone down the Cesarean route. Is there anything you would suggest to moms? Or even for moms who maybe had a C-section and had this possibly happen. Yeah, do you have any tips that you would suggest to help with healing both physically and mentally?Nicole: Yeah. One of the biggest things that we did which was incredibly helpful– I’ll give you a funny story after– but one of the biggest things that we did was my husband would get out of bed. We breastfed. He would hand me baby. I would breastfeed her and burp her and then he would get out of bed, change her, and put her back down. That was incredibly helpful because all I had to do was go from laying to sitting. I couldn’t pick my legs up to move them out of the bed without it being excruciating, so having him just help me sit up and hold baby made a huge difference. Having that support person there to help do the heavy lifting technically to get in and out of bed was next-level game changer. It helped me. I got to sleep more because he changed the diaper. We took turns then he would sleep during feedings. We were really changing. I do remember going to the pediatrician and my husband talking to the pediatrician and I was like, “Wrong person to ask.” He was like, “She keeps waking in the middle of the night and rocking holding this invisible baby and bouncing it.” It was because I would forget that I gave the baby back to my husband. Meagan: Yeah, because you’re so tired. Nicole: I’m so tired and he would be like, “It’s freaking me out.” I picked up my little Yorkie and I was rocking her. My husband was like, “That’s the dog.” I thought I had fell asleep and the baby was next to me so I picked up the dog. I remember the husband talking to the pediatrician and I was like, “That is the wrong doctor. He knows nothing about my mental state,” and him being like, “It’s terrifying,” but it really did help me. It might have scared him, but it just was so helpful and I just felt like I didn’t have to worry about dropping the baby walking in and out of bed. It helped speed up my recovery because I wasn’t constantly getting in and out at all hours of the night. Meagan: Yeah, that is so impactful. I love that you pointed that out. I know that some postpartum doulas do that too but if your partner is able to help you in that way, I also think it’s really great because that helps them bond with the baby too. I mean, they might not be feeding the baby but they are changing and carrying and soothing the baby back to sleep as well. I love that. I love that you did that. How long did you do that until you were feeling better and getting in and out of bed was feasible?Nicole: It took me about 3 weeks until I felt comfortable and confident. That was another thing. I could feel comfortable but wasn’t confident to get in and out of bed without worrying about a sharp pain or something glitching or stumbling. Meagan: Mhmm. I’m so proud of you guys for being a team and making sure that you took care of that. Nicole: We’ll keep him. Meagan: You needed to take care of yourself and I love that you were like, “This is what we need. This is what we need to do.”Awesome. Well, before we get into your next story which is amazing, we’re going to take a quick moment and listen to me, I guess, about our sponsor. Okay, and we’re back. Let’s get onto this VBAC story. Nicole: So being military, we had decided my daughter was so great and so fun at about 8 months or 9 months and we were like, “Let’s do this again. Let’s have another one. We want them close in age. Let’s try again.” So she turned 1 in June. In May, we decided to go on a long weekend because my husband had just graduated college. He’s military and was going to school which is a whole other added pressure. Meagan: That’s a lot. Nicole: Yeah. We flew our mother-in-law out. She stayed with our baby for Memorial Day Weekend and him and I went to Tahoe for the weekend. We decided starting in May that we were going to start trying again. We were like, on May 1st, we’re going to start trying for a baby. We get back from Tahoe on June 1st. I think it was June 1st. It was right at the end of May and the beginning of June. His coworkers were like, “Guess what? You have orders to RAF Lakenheath in England.” My husband was like, “No, I don’t. You’re kidding. I don’t. That’s a joke.”He called me and he was like, “I have bad news.” We had just dropped my car off at the dealership that morning so I was like, “Oh no, what we thought was a minor issue was huge.” He was like, “We have orders to England.” I was like, “That’s not terrible news. That’s the best news I’ve heard all month.” He was like, “No, that’s terrible,” because he was planning on getting out of the military. Meagan: Oh no. Nicole: We had 2 weeks to decide if he was going to stay in and take these orders or if he was going to get out. We spent 2 weeks going back and forth if this was the best option for our family and if this what we wanted. What could we do over there? We decided that we would go overseas if we decided to wait on having a baby. We cut it off. No more babies at the beginning of June. We were like, “We’re done. We’re going to have our one. Towards the end of our 4 years is when we are going to start trying for our second. That way, we can get back here and have our baby back in the States.” We were like, “We’ll travel with our one child because it’s easier to travel with one than two. We’ll travel with one kid. We’ll do our 4 years there and when we come back, we’ll have our next baby.” It wasn’t ideal because we wanted them close in age, but at least we were traveling and eventually, we would have our second. He took the orders on June 2nd. I was prepping for my daughter’s first birthday. We were having a pool party. I was like, okay. Her birthday’s on June 20th. It is June 16th. I wonder when I’m going to get my period because I don’t want to be on my period and swimming. Meagan: During the pool party, yeah. Nicole: I looked at my app and I was 7 days late. I was like, What? I don’t think that’s right, but let’s just take a test. I took a test and I was pregnant. So, the joke was on us. Meagan: Oh my gosh. Nicole: Yes. We found out in June that we were having our second and we were due to be in England in November. So at the end of the month in November was our DEROS date or the day that we were supposed to be in England and he was supposed to be signed onto the base. We decided that we would just pack up and do this all while I was pregnant. We moved over there on November 15th. Once I got here, I was like, Well, what do I do now? I am halfway through my pregnancy. I have nothing because COVID again, had stopped all of our furniture stuff because the ports were closed and that whole issue of everything being shut down. The world was still closed so we were like, “What do we do?” We had sent our stuff at the beginning of October to arrive in England and they were like, “Well, you’re not expecting anything.” We had bought all of our baby stuff before because we were like, “Well, we’ll just buy it here and ship it over there, and then we won’t have to worry about trying to buy it over there.” There are different sizes of cribs there, and the bedding size is different. I don’t want people to buy us sheets then all of a sudden it’s UK sizes and it doesn’t fit and it’s unsafe for baby. It was a big thing. We bought all of our stuff. I was ready to have it. Then we got here and they were like, “It looks like you’re not going to get any of your household goods until April.”Meagan: November to April?Nicole: October to April because we shipped in October. Meagan: Oh my gosh. Nicole: Uh-huh. Yeah. We were living in temporary furniture that was terrible. We had to go out and buy blow-up mattresses because those were more comfortable than the beds that they gave us. It was wild. Then I’m trying to find a doctor. I’m trying to find a provider. I don’t know what I’m doing. I’ve called all of the birthing doulas because of the podcast that I had been religiously listening to. I was like, “I know what a doula is. That’s what I need.” They were all booked up because by the time we got here in November and I got the chance to interview them, they were all booked up for the month of February when my baby was due.So now I’m sitting here, “Well, what do I do? Do I have the baby on base? Do I have the baby off base?” I don’t know. I don’t know anything about where we’re living. I don’t know anything about the hospitals. I don’t know anything. I’m just guessing off of people’s posts on Facebook, but they are so hit-and-miss. Somebody is going to post a really great story, then all of a sudden, somebody makes a post of a traumatizing story which scares you. It’s like, was the good story one in a million, or was the traumatizing story one in a million? I was just navigating this. I started going to my doctor’s appointments on base because I knew that Tricare covered the OB/GYN. I was trying to navigate how it would cover overseas. I had to make a lot of phone calls and all of that fun stuff. I was like, “Well, I’ll just start on base and see if I need to transfer off base.” On base was okay. It’s way different seeing a military doctor than it is seeing a provider who chooses this field and who wants this field. All of my prenatal care was okay. There were a few things that I wasn’t a fan of and if we weren’t talking about it, I could tell you what is the strep B test, right? Meagan: Group B strep?Nicole: Mhmm. They test you. They swab you to see if you have a skin infection to see if you need to be on antibiotics. In the states, my doctor performed that on me. Here, they gave me a test tube and told me I had 5 minutes to complete it. I was like, “What? I can’t even see down there let alone swab myself.” I just remember crying in the thing and begging people to do it and they were like, “We don’t do it. You have to perform it on yourself.” My husband was home watching our toddler, so I had no support with me. It was definitely different. I looked at the hospitals off base and I was really unsure with the way that I had them. You would give birth in a birthing suite with your husband, then they would send him home and move you to this big room with other moms who had their babies. I was really navigating, what is the best fit for me and how am I going to have this baby and my VBAC? I want this VBAC. Who is going to advocate for me? I don’t have a doula. I’m doing this by myself. My husband only knows so much. He doesn’t understand it all, so he is only retaining half of what I’m saying. I made it to 40 weeks. I was like, “Get this baby out of here.” My mother-in-law was here to watch my daughter. That’s another thing. You have to find childcare for your toddler because you don’t have family around to watch your baby. We were so new here. We didn’t have friends here to watch our baby. My mother-in-law luckily came out and made it for the birth. She watched my daughter. I decided that since she was here, and I needed to get this baby out before she left so I had childcare, I would do a membrane sweep because I was 40 weeks and I think I was 2 days at that point. I did a membrane sweep. That was unsuccessful at 40 weeks and 2 days. I did a second one. That was very successful. We had my membrane sweep in the morning. I remember just doing lunges and squats all day long. We took my daughter to a forest. She just ran, and I did lunges behind her. There are videos of my husband following my daughter around, and I’m in the background just doing lunges and doing anything to keep active, to keep this baby going. I went to bed that night on February 23rd. I went to bed at about 9:00 PM. I woke up at 2:00 AM. It was about 2:30 when I woke up. I felt this really sharp pain in my stomach. I thought he had kicked my bladder, so I stood up on the bed. It was like a movie. You heard the gush, and then all of a sudden, water was just trickling down my legs. I was like, “Well, I still feel like I have to pee, so that was definitely my water breaking not me having to go to the bathroom and him kicking my bladder,” which signaled me having to go to the bathroom. My husband had just come to bed at about 2:00 AM. He had only been asleep for about 30 minutes. I was like, “Hey, no rush. This is going to take hours.” Again, nobody thinks that labor happens fast. I woke him up. I was like, “No rush. I just need you to go downstairs and get my military ID,” because at this point, I decided to have him on base. I was like, “I just need you to get my military ID because they are going to ask for that information in labor and delivery. Let them know that my water broke and that we would be in in a few hours. No rush. I’m going to take a shower. I’m going to go back to sleep. I’m just going to sleep this off. We will wake up in the morning, say goodbye to Naomi, and then go to the hospital.” Again, I had told my daughter that I would see her in the morning, and then I left the room that night saying, “Why did I say that? There’s no guarantee.” I had been saying for weeks, “I hope you sleep good,” and that’s it. Then of course, the one time that I accidentally said, “I’ll see you in the morning,” I wasn’t seeing her in the morning. He calls Labor and Delivery and they were like, “Well, because of her past, we want her in now.” I was like, “No. No. I don’t want to labor in a hospital. I want to labor as long as I can at home. I want to do this by myself. I want to be comfortable. I don’t want people to tell me what I should be doing then it going against what I want to do. I really want to do this by myself.” He’s arguing with Labor and Delivery. He was like, “Well, let me talk to my wife, and I will call you back.” I was like, “I’m going to get in the shower real quick and wash myself off because my water just broke.” Meagan: Had you started contracting at this point or just trickling? Nicole: Very minimal. It was every 5 minutes. It was very minimal, nothing crazy. I could totally go clean my car at this point. I was walking on water. My water broke. I’m great. I feel good. I feel nothing. I’m in the shower. All I did was put shampoo in my hair. I didn’t even get it rinsed out, and all of a sudden, my contractions went from 0 to 100. I could not breathe. I could not talk through them. I could not even do anything. I felt like my mind was so focused on the pain. My husband was trying to ask me questions, and I couldn’t even register what he was saying through each contraction. I told him, “Call them back because we are on our way now. I need to get out of the shower. I need you to throw conditioner in my hair while I have this next contraction. I need to rinse it out, then we need to go.” He’s trying to talk to them and put conditioner in my hair. I’m having a contraction. I put my pants on, and as I’m pulling them up, another contraction hit. Then they started going from having a contraction for a minute and a half to a break for 30 seconds, and then immediately back into another contraction for a minute and a half. I was like, “What is happening?” I never felt this with my daughter. I had the epidural. Things went so smoothly and so slowly that it was cake. This was the next level. I waddled into the car. I remember sitting in the front seat and saying, “I can’t do this.” I climbed into my toddler’s car seat because I had the infant car seat up, and I couldn’t fit in between the two car seats, so I had to sit with my knees in my toddler’s car seat. I was holding onto the back headrest for support and just standing there. I was on my knees, chest against the back of her car seat, and I’m just holding onto this headrest with every contraction. I’d have three in a row. I’d have one for a minute and thirty, a break for 30 seconds, a minute and thirty, a break for 30 seconds, a minute and thirty, then I’d have a two-minute break, and then they would kick back up again. My husband was just flying. The roads were closed on our normal fastway to base. We lived 30 minutes away, so it was an extra 15 minutes to get to base. He was flying at 2:50 in the morning at this point. I’m sorry, it was 3:50 in the morning at this point. We get to the hospital at 4:05. I am hugging a tree outside because my husband couldn’t figure out how to open the wheelchair. Poor guy, he was trying so hard to help me. Meagan: I’m sure. It was a frantic moment. Yeah. Nicole: Yeah. He couldn’t figure out how to open it. He had to go to the ER and get somebody in the ER to help him. They were wheeling me up, and I remember yelling at them because they kept saying, “We’ll have to do triage and see if you’re in active labor before we can bring your husband back.” I remember telling this poor ER nurse, “You’d better not split my husband and I up. I am not doing triage. We are going into a room. We are having this baby.” She was like, “Ma’am, I think we’re just going to put you in a room. I don’t think we are going to need triage.” I get into the room. I am continuously having contractions. They tried to stop me to do a COVID test. I death-glared this guy because he wanted to do a COVID test on me. I was like, “Been there, done that. Not doing that again.” I remember them trying to put an IV in my hand. I was like, “I don’t need an IV. This kid is coming out of me. I know I tested positive for the strep test, but I don’t need an IV. He’s already out. There’s nothing that this is going to help.”I get up on the bed. They tried to get me to lay on my back to push and I couldn’t. I remember my husband was like, “No, that’s not how she wanted to push. She wants to push with her knees on the bed and her chest against the back holding on. That’s how she wants to deliver him.”He was advocating for me which I was so grateful for because I felt the entire time that he didn’t know what I wanted because he didn’t understand my terms, he didn’t understand why, he didn’t understand the VBAC world, so I felt like I was talking to thin air. So for him to sit there and be like, “No, that is not how she is going to deliver this baby. She wants to be on her knees hunkering down.” I did. I got up there. I pushed two pushes, and he was out. His hand was stuck to his face. Meagan: Nuchal hand, wow. Nicole: He was holding onto his face. He got a little stuck because of his elbow, so after I got his head out, they made me flip over and deliver him on my back which I was totally okay with because we had done the hard part. I remember my husband saying that was the weirdest thing watching me turn around with this baby hanging out. He was like, “You just flipped around like it was nothing.” I was like, “I knew he was fine.” I tore because his hand was up and it was added pressure. But yeah, he came out in two pushes. He was born by 4:36, so 2 hours and I had my baby. It was absolutely wild. I just remember that I had him. I was just in the chaos of

After having an HSG (hysterosalpingogram) due to infertility, Wyn was diagnosed with having a left-sided unicornuate uterus. A unicornuate uterus is a rare condition in which the uterus is smaller than normal and only has one fallopian tube. Common complications from a unicornuate uterus include infertility, IUGR (intrauterine growth restriction), and preterm labor. Wyn had two unsuccessful IVF treatments followed by two miraculous natural pregnancies! Her first pregnancy ended in an unexpected Cesarean due to a fever and tachycardia in her baby. Her placenta was difficult to remove during the surgery and she was told she had placenta accreta. The OB who performed her surgery also said she had “very interesting reproductive anatomy”.Wyn deeply longed for the opportunity to try for a VBAC and experience physiological birth. Her original midwife supported her decision to VBAC and Wyn made sure to prepare physically and emotionally. At 41 weeks and 1 day, she went into spontaneous labor, declined cervical checks and other interventions she wasn’t comfortable with, consented to the things she felt good about, and pushed her baby out soon after arriving at the hospital. Wyn also shares her experience with taking Needed products during her pregnancy and postpartum period this time around. Her strongest advice for other women preparing for VBAC is to find a supportive team and really listen to what your intuition is telling you to do. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to the show. We have our friend, Wyn, from Alaska with us today. She’s going to be sharing her VBAC story and Wyn has a pretty unique– and maybe Wyn, you can tell me more. Maybe it’s not as unique as it feels but a pretty unique situation where you had a diagnosis of a unicornuate uterus. Tell us a little bit more about that. I feel like we hear some uterine abnormalities. I’m quoting it where it’s bicornuate and all of these different things and people say, “Oh, you can’t have a vaginal delivery with this type of uterus or this shape of uterus,” but tell us more about what it means for you and what it meant for you back then. Wyn: Yeah, so they found it through an HSG test where they shoot dye up through your uterus and through your fallopian tubes. Basically, just one-half of my uterus formed. I guess when the uterus is forming, it’s two tubes that connect and open up so just the one half formed so I have a left-sided with a left fallopian tube. I have both ovaries so you can still conceive but there are less chances because you have just one side. Then once you get pregnant, there are higher chances of miscarriages because the blood flow is less. Intrauterine growth restriction and preterm labor are common and then a lot of time, the breech position is common as well. Meagan: With this one, you did experience IVF as well, right? Wyn: Yep. Meagan: Yeah, we’ll have to hear more about that too because there are a lot of people who are getting pregnant via IVF which is amazing but there are some things that come with IVF as well. So we want to talk a little bit more about that before we get too deep into things. I do want to do a Review of the Week, then we’ll let Wyn start sharing away. This review is from I think it’s Amir, I think. It says, “This podcast was my constant source of reassurance and inspiring stories throughout my last two pregnancies. I achieved my VBAC in 2021 and was so empowered with so much knowledge and mental strength going into this birth because of The VBAC Link. I had my second section in 2022 which was not what I wished for but I do plan on having more children and know that VBA2C (vaginal birth after two Cesareans) is a possibility for me because of this podcast. I continue to listen to your inspiring stories each time I hop in the car and I’m so grateful for all that you share. I hope to share my own redeeming story with you in time too.” Well, Amir, thank you so much for your review. I also wanted to mention that for Amir, not only does VBAC after two Cesareans apply, but there are even risks that are lower because she has had a vaginal birth. So if you have had a vaginal birth and then you want to go on to VBAC, your chances are even higher for a VBAC and lower for things like uterine rupture. I wanted to throw that tip out there. But if you have not left us a review yet, please do so. We love them so much. You can leave it on Google or wherever you listen to your podcasts or you can even email them. Okay, Wyn. Let’s get going into this story. Wyn: Okay, thank you. Thank you for having me. I feel like it’s come full circle. I listened to The VBAC Link Podcast a lot throughout my pregnancy and even before that and I still do today. So I hope that maybe a little detail from my story resonates with somebody and helps them as well. Meagan: 100%. Wyn: Yeah. A little back story, before I got pregnant, we did try for a while and my cycles were regular. I was healthy. I didn’t see anything wrong but we went in and got the test done with bloodwork and they suggested the HSG test. I saw my original OB then I had a second opinion with another one. Both said it was still possible but that IVF was probably going to be more likely. And of course, this is all happening in February and March of 2020. Meagan: Right as the world is in chaos. Wyn: Yeah, so I started researching IVF options. We live in Alaska so there isn’t a reproductive endocrinologist here and I found a clinic. Our closest option was Seattle or Portland. I found a clinic in Portland that was willing to work with us. In August 2020, I went down for my first transfer or egg retrieval and transfer. That was a chemical pregnancy or early miscarriage. But also, that was the closest I had ever been to being pregnant. It was a little bit hopeful at the same time. We regrouped and went down in October and had another transfer that didn’t take at all. We decided to take the rest of the year off and revisit it after the beginning of the year. That brings me to my first pregnancy which was a little miracle and I got pregnant the cycle after my failed transfer naturally without IVF. Meagan: Yay!Wyn: That was very exciting. I was a little bit in shock like, How can this happen? Because it had been a couple of years of trying. I went back to the second OB who I had a second opinion from. We didn’t really vibe very well. I went in early at 6 weeks because I was nervous and she was like, “Why are you here so early?” So I didn’t end up rebooking with her but I rebooked with a midwife who some of my friends had seen during their pregnancies and explained my situation and she got me in that week. We did an ultrasound and saw a little heartbeat. It was going well. She had me come in the next week too to just make sure things were progressing and everything was good. Meagan: Yay. So it was IVF treatment, IVF treatment, and spontaneous?Wyn: Yep. Meagan: Yay, that’s awesome. Wyn: It was pretty exciting and just gave me some renewed faith in my body too that maybe it could do it. Meagan: Yeah. Wyn: So pregnancy went smoothly. I felt great. I loved being pregnant and I was measuring small consistently from about 30 weeks on about 2-4 weeks behind. I wasn’t really worried about it because I figured I had a small uterus but they suggested a growth scan. I went ahead and did that and baby was all fine. She was small and we didn’t know it was a she. We didn’t find out but then my husband and I did some birth prep. We watched The Business of Being Born and that solidified my desire for a non-medicated birth. I was okay being in the hospital because there were unknowns with the uterus and I just wanted to experience it all. I wanted to experience everything without medication. I have a low tolerance to medication so I didn’t want anything to derail the birth. I made it to 40 weeks. I made it to my due date because it’s common that you go into preterm labor with a unicornuate uterus but I made it to my due date so that was exciting. I was feeling anxious to meet my baby but I was feeling good. I was just listening to whatever the midwife told me or suggested because I was a little bit nervous so she offered a membrane sweep and I thought, Okay, I’ll go ahead and do that. It’s not medicated. But still, it was an intervention that I learned later. Then we did a non-stress test at 40.5 weeks and she started suggesting induction. I went into my 41-week appointment and I still didn’t want to do any medication but she offered the Foley bulb which he offered to put in there at the office and I would just come back the next day if it didn’t come out or if it started things then it started labor. Meagan: Then great, yeah. Wyn: Yeah. She went to put it in and my water broke. Meagan: Oh, change of plans. Wyn: Yep. Yeah. It was just a trickle. It wasn’t huge. She sent us home and told us to rest and to come back in the next morning. Come in if labor progressed or come in the next morning to start more induction since my water was broken. I went home and relaxed. I woke up about 2:00 in the morning to my water fully breaking everywhere and contractions started pretty instantly. I had adrenaline and I didn’t ease into it. They were 5-6 minutes apart, full-on contractions. Within a couple of hours, they were closer like 3-4 minutes so we went ahead and went to the hospital. There was a lot of rushing around and a lot of nurses coming in and out. I was in my own little world. I was stuck on the bed because they wanted to have the fetal monitor on. I was holding on for the non-medicated. I declined the IV because I thought that would be that much easier. Meagan: Easier access, mhmm. Wyn: But I had spiked a temperature from my water breaking. I couldn’t keep any Tylenol down so we went ahead and did the IV which took over an hour to get in because I have bad veins and lots of people tried and they eventually got an ultrasound to find a vein. Meagan: I was going to say for anyone who may have harder veins or situations like that, you can ask for the head anesthesiologist if there are multiple and for an actual ultrasound and it can really help them and get that in a lot faster. Wyn: I wish they had started that sooner. I was just being poked. Meagan: Lots of pokes, mhmm. Wyn: Yeah, and trying to labor through at the same time. They got that in. It didn’t really calm down. The baby’s heart rate was elevated to 170-180. It wasn’t really slowing down at all. Our midwife seemed a bit concerned and started suggesting a C-section. Yeah, just laying there, I was ready to give up. I didn’t want to, but she checked me and I was only 5 centimeters so I wasn’t even close to getting there.They prepped me for surgery. I went in and baby girl was born in the morning at 8:50. Of course, they took her straight away to the warmer then I didn’t get to hold her until the recovery room. I was still shaking from medication. Basically, the birth was completely the opposite of what we had hoped for. Meagan: What you had planned, yeah. Wyn: Then later, the OB who did the surgery came in and told me that I have very interesting reproductive anatomy. He confirmed it was a left-sided unicornuate uterus. There was a small horn on the right side and my uterus, I guess, was really stretched out and almost see-through. Meagan: A uterine window. Wyn: Then the placenta was really attached and they had to work to get that out. They labeled that as placenta accreta. I was advised not to labor again if we ever had another baby and just to plan a C-section. I felt like I went through all of the stages of grief after and in postpartum for my birth. First, I was in denial because I just blocked it out. I was happy to have my baby. Then you add the sleep deprivation and postpartum hormones and I was a bit angry at myself for not advocating but also just all of the suggestions. Baby wouldn’t have changed anything. It was just a lot of what if’s. Meagan: Which is hard. It’s hard to what if this and what if that. Sometimes those what-ifs come up and we don’t get answers. Wyn: Yeah, but it just fueled my fire to try for a VBAC. Meagan: Mhmm. Wyn: So that was my first birth and C-section then our second pregnancy which again, we felt like our little girl was a miracle so we just didn’t know if we would be able to conceive again naturally or if we would have to go through IVF. We waited a little bit and another little miracle came in September 2023.Meagan: Yay. Wyn: Yeah, that was pretty exciting. Of course, I had been researching VBAC from 6 months postpartum with my daughter. I felt like my best option for a physiological birth or as close to it would be at home. I didn’t want to fight the whole time in the hospital so I contacted two home birth midwives and they were both very nice and informative. They felt like I could VBAC but neither were comfortable supporting me at home with my previous birth– Meagan: And your uterus, yeah. Wyn: They both suggested I go back to my original midwife. I was a little upset at first that they wouldn’t support it but I also understood. I made an appointment with my original midwife. I went in with my guard up and ready to fight for the VBAC. She surprised me and was actually supportive of it. She said that we would just watch and see how things would go. She said there wasn’t any reason why we couldn’t try. I was a bit surprised but wondered if she remembered all of the details or had looked at my records. I just went with it at first but eventually, we talked about everything that happened during the birth. She got second opinions from people in her office and it was okay. Meagan: Awesome. Wyn: Yeah. I also reached out and hired a doula, Dawn, who was a wealth of information and super supportive. We met regularly. She gave me exercise assignments and movements for labor and positioning. She was just there to help me debrief after each appointment with my midwife. If anything was brought up, she gave me information or links so I could feel confident going forward. That was really cool. I saw a chiropractor and did massage. I drank Nora tea from about 34 weeks on. I just tried to cover all my bases to get the best outcome. This pregnancy, I actually grew quicker and was measuring ahead, not behind. A growth scan was suggested again, but I respectfully declined because I felt like everything was okay. I was just trying to lean into my intuition and I didn’t want to get a big baby diagnosis that could possibly–Meagan: Big baby, small uterus. Yeah. I don’t blame you. Wyn: Yeah. Eventually, I ended up evening out at 37 weeks and was measuring right on. I just was a little bit quicker I guess. So I made it to my due date again at 40 weeks and I was offered a membrane sweep. I was offered a cervical check. I declined everything. I was doing good. I knew I went over with my daughter so I was prepared to go over again. 40.5 weeks, induction was brought up. I said I wouldn’t talk about it until 42 weeks. Meagan: Good for you. Wyn: We scheduled a non-stress test again at 41 but I didn’t make it to that because I was starting to have cramping in the evenings. I wouldn’t consider them contractions but they were noticeable. Things were happening. I was trying to walk every day and just stay mentally at ease to keep my body feeling safe. So at 41 weeks exactly, I was having cramping in the evening. That was a bit stronger. I was putting my daughter down. My husband and I watched a show. I didn’t say anything to him or anything because I didn’t want to jinx it. We went to bed at 11:00. I fell asleep and slept really hard for an hour and a half. I woke up to contractions starting again full-on. I thought my water broke but I don’t think it was. I think it was just bloody show originally. Meagan: Yeah.Wyn: I got up. I sat in the bathroom for a little bit and I was just super excited that it was starting on its own. I held out. I tried to time contractions a little bit at first. I knew it was happening so I just moved around the house quietly. I went and laid with my daughter for a half hour while she was sleeping because that was going to be our last time as the three of us. Yeah. I kept moving around for another half hour or so. By then, I needed the extra support. I woke my husband up. We texted our doula, Dawn, and she told me to hop in the shower for a little bit and she would get ready and head over soon.She made it about 3:30 AM and I think I was in pretty full-blown labor. I was mostly sitting on the toilet laboring in there but I came out to the living room when she came and I was on all fours. I made a music playlist. I had the TENS unit. I had all of these coping skills prepared and I didn’t use anything. Meagan: You were in the zone. You were in the zone. Hey, but at least you were prepared with it. Wyn: Yeah, so about 4:45-5:00 in the morning, she suggested if we felt ready that maybe we would head into the hospital. My body was kind of bearing down a little bit wanting to push. We called my mom to come over and stay with our daughter. We called our midwife. She actually lives in our neighborhood. We called to give her a heads-up to get ready to meet us at the hospital. We got there at about 5:45. They did intake and called a nurse to bring us up to the room, and that nurse was our only real hurdle in the birth. She was not really supportive of natural birth or physiological birth. She made a couple of comments. She was trying to force me to get checked to admit me. I was obviously in labor because I was kind of pushing. I declined all of that. Eventually, she ended up not coming back in. She switched out with another nurse or maybe they told her to switch out, I’m not sure but that was nice that she removed herself from the situation. Meagan: I was going to say, good for her for realizing that her views didn’t align with your views and that she probably wasn’t needed at that birth. I don’t love when people are that way with clients of mine or whatever, but for her to step away, that says something so that’s really good. I’m glad she did for both of you.Wyn: Yeah, before she left, she was trying to get an IV too. She couldn’t get an IV. I don’t know. Meagan: She was frustrated and you’re like, “Yeah, you could go.” Wyn: So yeah. Again, I was noticing all this going on but I was in my own little world. We got there. Our midwife, Christina, showed up. She asked if she could check me. I didn’t want to have cervical checks but because I was getting pushy, she didn’t want me to not be fully dilated and start pushing. I let her check and she said, “You’re complete and baby is right there. Lean into it. If you want to push, start pushing.” I couldn’t believe it. I prepared for labor. I had a moment that I had to wrap my mind around it because I couldn’t believe we were already there to start pushing.I had requested my records so I was able to see all my time stamps. At about 6:30 was when she checked me. I pushed for about a half hour and the baby was born at 7:09 in the morning. It was exactly 41 weeks and 1 day, the same as my daughter. Meagan: Wow, and a much faster and much better experience. Your body just went into labor and was allowed to go into labor. You helped keep it safe to do what it wanted to do. Wyn: Yeah. Yeah. I was really excited to just be able. My body just did it all on its own which was pretty awesome. It was a pretty awesome feeling. Meagan: Very, very awesome. Do you have any tips for people who may feel strongly about not getting cervical exams or not getting IVs or doing those things but may have a pressuring nurse or someone who is like, “You have to do this. You have to do this. Our policy is this.” Do you have any advice on standing up for yourself and standing your ground?Wyn: Yeah, be respectful but also just be really strong. I had my husband and my doula backing me up. We prepared for things like that. I had a birth plan that had my wishes on it so just yeah, standing strong and keep in with what you want. But also be ready to switch gears. Like I said, I didn’t want a cervical check but when my midwife got there and suggested it, I felt like, okay. I can go ahead with that. Meagan: You felt like it was okay at that point. That’s such a great thing to bring up. You can have your wishes and desires. You can be standing your ground and then your intuition may switch or your opinion may switch or the situation may switch. You can adapt with how it’s going or change your mind at any point both ways. You can be like, “I do want this and I actually decided I don’t want this anymore. I changed my mind.” We ask in our form, “What’s your best tip for someone preparing for a VBAC?” You said, “Find a great support team. Research all of the facts to make informed decisions and really lean into your motherly intuition.” I feel like through your story, that’s what you did. You learned the facts. You said even before you became pregnant, right? Your baby was 6 months old and you were starting to listen to the podcast and learn more about VBAC and what the evidence says and the facts then you got your support team. You just built it up. You knew exactly what you needed to do so you felt confident in saying, “No. I don’t want that IV” or “No, I don’t want that cervical exam for you to admit me. I’m going to have this baby with or without that cervical exam.” I think the more you are informed, the more likely you feel confident in standing your ground. Wyn: For sure. Meagan: Yeah, for sure. Well, oh my goodness. Huge congrats. Let’s just do a little shoutout to your midwife and your doula. Let’s see, it’s Christina? Where is she at again?Wyn: Interior Women’s Health in Fairbanks, Alaska. Meagan: Awesome. So great of her to support you with a more unique situation too. She was like, “Let me do some research. Let me get some opinions. Okay, yes. We’re good.” I’m so glad you felt that support. Then your doula, Dawn, yes. Where is she again? Oh, Unspeakable Joy. Wyn: Yes. Yeah. Meagan: That is so awesome. I’m so glad that you had them. We love doulas here as I’m sure you have heard along the podcast. We absolutely love our doulas. We have a VBAC directory as well so you can find a doula at thevbaclink.com/findadoula. Then last but not least, in the form, you said that you took Needed. Wyn: Yes, I did. Meagan: Yes. Can you share your experience with taking Needed through pregnancy? Did you start before pregnancy? Wyn: Yeah. Right as I got pregnant with my second one, I took the prenatal. I took the probiotics and I still take them today postpartum. Then also, the electrolytes or the mineral packets and the nighttime powder that my husband and I take. We put it in our tea every night. Meagan: It’s amazing. It really is so amazing, huh? It’s kind of weird because I don’t have to finish it. I’m just sitting there sipping on it and I can just feel everything relax. I have a busy brain. I call it busy brain and my busy brain is a lot more calm when I take my sleep aid. Wyn: Yeah. I slept amazingly through pregnancy. Normally with my first, I had a lot of insomnia. It was very nice. Meagan: Yeah. Then the probiotics, I want to talk about probiotics in general. We never know how birth is going to go. We could have a Cesarean. We may have a fever and have to be given antibiotics or Tylenol or whatever it may be. If we can have a system that is preloaded essentially with probiotics, it really is going to help us and our gut flora in the end so no matter how that birth outcome it, that probiotic is so good for us because we never know what we are going to get or what we are going to receive in that labor. I’m excited. Wyn: Yeah, what is that stuff that they test you for? Meagan: Group B strep?Wyn: Yeah, yeah. Sorry. I didn’t want that because I didn’t want to have an IV. Meagan: So, so important. I love it. They usually test for that around 36 weeks so really making sure that you are on the pre and probiotic. What I really love is that it is pre and pro so it really is helping to strengthen our gut flora so much. With GBS, with group B strep, they like to give antibiotics in labor. It’s sometimes a lot. They like to give rounds every 4 hours so you really could be impacting your gut flora. I love that you took that. You didn’t even have group B strep. Well, thank you so, so much for sharing your story. Is there any other advice or anything else you would like to share with our listeners today?Wyn: Yeah, just again, find your support team and lean into your own intuition. You know what is right for your body and your babies. Meagan: It’s so true. I mean, from day one of this podcast, we’ve talked about that intuition. It is powerful. It is powerful and it can really lead us in the right path. We just have to sometimes stop and listen. Sometimes that’s removing yourself from a situation. Go into the bathroom and say, “I have to go to the bathroom.” Go to the bathroom, close your eyes, take a breath, and hear what your intuition is saying. It is so powerful. I couldn’t agree more. Thank you so much.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Meagan records a short and sweet episode for you today talking all about OP reports. What are they and why do you need them for your VBAC prep? How do you request them? If you have a hard time interpreting your OP reports, try reaching out to your provider for clarification. You can also send us an email at info@thevbaclink.com where you can schedule a one-on-one consultation with Meagan for extra help and encouragement!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everyone. It is Meagan today. We are going to be talking about OP reports. What is an OP report? Why do we want to get an OP report? How do we get an OP report and how long are OP reports available before they go away?We do have a Review of the Week so we are going to get into that and then I’m going to go over OP reports. This review is from Brittanyhenley9478. She says, “Such an amazing resource.” Her review says, “I am pregnant with my second baby and will try for a VBAC in 4 months. Since finding this podcast, I have learned so much and gained a lot of confidence in my decisions. I’m so thankful for the podcast, their Instagram, and the website. I can’t wait to come back and share my successful VBAC story with them later this year.” Brittany, if you are still listening to us and you are still with us, let us know how your birth went. I hope that it was amazing and thank you so much for your review. You guys, I say it every single week multiple times a week now, we love your reviews. I seriously love them so much. It makes me smile. It makes my heart so warm so if you have not yet left a review, would you mind doing that for me? I would love it and appreciate it so much. You can go to wherever you listen to your podcasts and leave us either a rating or a review. I know Apple Podcasts and Spotify actually I believe, allows you to do a written review or you can Google “The VBAC Link”. Remember VBAC is V-B-A-C, and then you can leave us a review there. That also helps people find the podcast, find the website, the blog, and even our Instagram account. As a reminder you guys, if you are just listening to the podcast, hello. Welcome. I am so glad that you are here but I also don’t want you to miss out on all of the other amazing resources that we have. We have our Instagram account and Facebook account. We have a private Facebook group. You can look that up at The VBAC Link Community on Facebook. You do have to answer some questions so answer those questions and then we can let you in. It is such a beautiful space with people who are really in the same place as you– wanting to know their options, wanting to know the evidence, and wanting to feel that community love during this journey. We have a YouTube account and we do have our blog and our website and we also have a course. You can find all of that at thevbaclink.com. You can enter in your email there. We can put you into our subscription where we send weekly emails on updated blogs, updated studies, tips, resources, and all of the amazing things that we feel is really important for you to know during your VBAC journey. Again, you can find that at thevbaclink.com and of course, you can check it all out for free and again, enter your email in and we will make sure to get you those weekly emails. Okay, I’m going to go really quickly today but I really feel this is such an important thing to know. It’s not something that I one, knew was even a choice that I could have or two, was something that I should do so I could really learn more and understand more of what my provider was saying about my births and the reasons why the births happened with my body and my post-recovery and all of these things. It’s so good to know what they are saying about your procedure and your Cesarean, your birth. So okay. Steps to get OP reports. There are multiple ways and I know since I started requesting my reports back in 2015, it has changed a lot. A lot of people have an online portal with your provider where you can get your labs and a lot of these things. A lot of the times, their OP reports are included in there or there is a little drop-down option where you can request your OP reports. So if you have that, I highly suggest trying that or you can call your provider and ask for your medical records and your OP report. Sometimes they don’t really have them and they don’t want to give them to you so they may make you go to the medical records department in the hospital. Now, that is what I had to do. I called my hospital that I gave birth at. It was the same hospital for both of my babies so if you have to go to multiple hospitals, definitely make phonecalls so you’re not running around. Give them a call and say, “Hi. I really want to request my OP reports. I’ve had a Cesarean. What do I need to do to get those?” For me, I had to go in and request them with a form. It took about 5 minutes. It was really quite quick and easy and it took about 15 minutes to print them out. They did give me a hard copy which I loved having so I could highlight and write down and everything. But these forms are so important for you to have so you can understand and then for me, I did it before I was pregnant and I used it so I could have this form with me as I was going to find my supportive provider so they could have a better, deeper understanding of what was said about me and my body and my reasoning for a Cesarean. I want to give you a little bit of a warning. Sometimes you’ll find different reasons from what you were told and that can be very frustrating so just a heads up there. Another thing that is important to remember is that every state is different. They don’t just have these medical records saved on file forever. Here in Utah, I was told that it was 7 years. I know that it varies all around. I know Arizona is 6 years. New York, I think, is 6 years. Florida is 8 years. California and Utah, like I said, I think is 7 years. So definitely get your records as soon as you can. Now, I know most people are having babies anywhere from 1-5 years apart but I do think the sooner the better you can get these records is just better. So again, check out the portal. Call your provider. Go to medical records. Do whatever you can to obtain these OP reports and if you have a hard time understanding them, they have all of these weird things in there, don’t hesitate to reach out to your provider and say, “What does this mean? What did you mean by this?” I have also done one-on-one consults with many people to go over and process their medical records and help them come up with a path for what their next step could be for their future births and VBAC. I’m no medical professional by any means but I have been doing this for years and love doing it so if you would like to learn more about a one-on-one consult, you can email us at info@thevbaclink.com. I would absolutely love to chat with you. Okay, everybody. Like I said, it was going to be short and sweet, but I really, really think it is important. If you are preparing for your VBAC, put this on the list of things to do. If you have just had a Cesarean, put that on the thing too to request. You don’t even have to look at it right now. It’s something you can have and put away but I do believe so much that it is important to have these and understand what our providers are saying and writing down about us. Okay, everybody. We’ll talk to 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

Rebekah’s first Cesarean was a birth center transfer after her baby boy unexpectedly flipped breech during labor. Though she was confident in her decision to consent to a Cesarean, she was devastated and left with a lot to process. Right away, Rebekah’s midwives instilled confidence that she was a great VBAC candidate and introduced her to The VBAC Link. Rebekah thoroughly researched and prepped for her VBAC knowing it was the path she wanted to take. She decided to stay with the same birth center as she felt so loved and supported by them. Her second pregnancy was filled with physical, mental, and spiritual preparation for her VBAC. Rebekah developed a deep connection with her baby girl and shares precious stories during both her pregnancy and labor when she knew just what her baby was trying to communicate. Rebekah’s VBAC was healing in so many ways. It was particularly special to birth in the same suite that she labored in with her first and have such a different outcome. All of Rebekah’s intentional work paid off to help her have a very sacred birth and postpartum experience!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to The VBAC Link. We have our friend, Rebekah, here today and she is local to me here in Utah so it’s always so fun to hear a Utah story especially because I usually know the provider and the location and things like that or I’ve served with them so it’s fun to hear the stories that I have served with the people who are serving these amazing VBAC mamas. We have our friend, Rebekah, like I said and she is a mama of two. She is a stay-at-home mom and is in Spanish Fork. She is passionate about birth and hopes to one day pursue birth work. She hired one of our VBAC Link certified doulas so just as a reminder, if you guys are looking for a doula, let me just tell you that our doulas are amazing. These doulas truly love birth and love VBAC and are all certified in VBAC so you can check that out at thevbaclink.com/findadoula if you are looking for a doula. Rebekah left us a note. It says, “The after-birth high doesn’t always happen. I have heard so many stories of women who experienced it and I was expecting to feel that. I however did not.” She says, “Don’t feel robbed of it.” She was confused why she didn’t feel it but she is going to talk a little bit more in her story. I love that message because I didn’t feel the birth high with some of my kids either and it is weird. I remember sitting there thinking, Wait, aren’t I supposed to be crying right now or aren’t I supposed to be screaming how happy I am right now? It just didn’t come. Please know that if you didn’t have that immediate birth high, it’s okay. It’s totally okay. We do have a Review of the Week. It is from Yulia and this is actually on our VBAC Course. It says, “This is an amazing VBAC Course that helped me understand how I can educate and support families in the best way.” She is actually one of our VBAC doulas so again, if you guys are looking for more information on VBAC and you really want to learn just all of the history of VBAC and Cesarean and how you can increase your chances of VBAC, check out our course at thevbaclink.com and let us know if you take it. Let us know what you think about it. All right, Ms. Rebekah. Your hometown is Utah, same as me. We are here together. You’re in Utah County. You’re probably 45-50 minutes away from me so just shy of an hour. Where did you give birth for your VBAC? Rebekah: It was the Utah Birth Suites in Provo. Meagan: Okay. Awesome, awesome. Well, I’m so excited to get into your stories today. I know that with your first one, you went through it. It was spontaneous labor turned unplanned Cesarean. Now if you are listening, I’m sure you can raise your hand. How many of us are having the same situations? We are going into labor and we have that unplanned Cesarean. It’s so, so hard. Before we get into your story, are there any suggestions that you would give to the listeners or any tips for moms just like us for moms who went into labor and had an unplanned Cesarean?Rebekah: The heartbreak and the trauma that comes with that is really hard to navigate so in planning a VBAC, my number one piece of advice is hire a doula. Hire a VBAC-certified doula and do all of the hard work you can to mentally prepare. Try not to blame yourself for the C-section because I know we all do that at some point if it wasn’t planned. Meagan: Yeah. I love that you said that. Don’t blame yourself but at the same time, let’s arm ourselves up with information and even first-time moms, there are so many times that we go in and we think we sort of educated ourselves but we didn’t. If we can try and educate ourselves a little bit better, we can hopefully be a little bit more armed for the unexpected and even then when the unexpected happens, it’s not easy to be armed. It’s not easy to be prepared. Okay, so let’s talk about that first birth that was an unplanned Cesarean. Rebekah: Yeah. I got pregnant in 2020 so COVID insanity and I had known even before I got married that I didn’t want to be in a hospital. I’m number 6 of 7 kids and my mom had all of us unmedicated. I was a home baby. Some of us were born at home. Some were in a hospital. Some were in a birth center. I just really felt that in my bones and in my genes that I can give birth. It’s not scary. My mom did this this many times without medication. My sister did it 5 times so I really felt confident. With everything happening in hospitals during COVID, I just was like, I don’t even want to try to mess with that so let’s go the midwife route. I got in contact with a friend of mine who was a doula and she recommended the Utah Birth Suites in Provo. I reached out to them. We toured a couple of different birth centers and that birth center just felt right. We met almost the entire team that first day in the interview. They spent almost an hour just chatting with us. I was about maybe 18 weeks, 20ish weeks. I was about halfway through my pregnancy. I had two or three meetings with an OB because I didn’t have a midwife and it just wasn’t my favorite. It was so long between visits and they lasted about 15 minutes. I saw a different person each time. It felt very impersonal and I don’t like repeating myself over and over again to all of these different people. It didn’t feel right. It wasn’t really what I was looking for. I found the Birth Suites and they took care of me for the rest of my pregnancy. I had a little bit of hypertension issues toward the end so the last three or four weeks were really juggling this game of, are we looking at induction this weekend? My blood pressure would read really, really high then I would do all of the things to bring it back down. I was watching my nutrition and taking the vitamins and everything to bring it down. It would come down just within a safe enough range to keep giving me care. Legally, if it crossed that line into worries of preeclampsia, then legally they had to transfer me into the care of an OB. My midwife was really working hard with me to keep it down. It was doing this up/down thing and by the end of each week, it was like, “Okay, we might have to induce you in a couple of days if you want to stick with us.” I was okay with that. My midwife had talked with me about that so it wasn’t pushed on me. I was doing everything to stay within their care. That was my whole goal so if I had to be induced, that’s what I would do. But every weekend came and passed and my blood pressure would come back down. Finally, it was the day before my due date. I went into labor in the middle of the night. It was maybe 2:30 in the morning. I felt my first contraction. I could tell it was labor because it was different than all of my Braxton Hicks. The only sign I had that labor was going to start was that I had cramping the day before. I was like, “Oh, this is kind of uncomfy.” I didn’t think anything of it. As a first-time mom, I didn’t know a ton. I did as much research as I possibly could but labor is so random with every mom and baby. There really is no way to tell. I go into labor early in the morning and I woke up my husband. I said, “I think I’m in labor. I think these are contractions. They’re not stopping. They’re getting really intense.” Intense compared to the Braxton Hicks I had been feeling. I let him sleep and I went into a different room and classic first-time mom mistake. Instead of resting, I got up and started moving and trying to get things going because I was all excited. I didn’t want things to slow down. I was timing them and texting my midwife. She said, “See if you can lay down. Take a Tylenol if they are super uncomfortable and try to get as much sleep as possible because you’ve got some time.” I tried doing that. It wasn’t working for me. I was super uncomfy laying down. I did not like it at all. I felt good when I was up and moving because I think that slowed things down but I didn’t know the difference. I just knew it was less uncomfortable. I was like, “I’m not going to be sleeping. Let’s just go do something.” We went on a drive. We did a little shopping. We walked around. We went back home. We hung out for a little bit. Then my husband was like, “Do you think I’m okay to go to work?” I was like, “I think you are. You can go to work. I think we have plenty of time. Things are still pretty spread out right now. We can call our doula and she’ll come hang out with me at home.” So that’s what we did. Our doula came over and my husband went to work and everybody was like, “What are you doing here? Your wife is having a baby. What’s going on?” He was like, “She’s fine. She has our doula.” Our doula was with me for a couple of hours and things had picked up enough to where I felt like he needed to be home so we called him back home. Things were moving on not slowly but slower than I wanted. I was just trying to be patient and let things go–Meagan: Trusting the process. Rebekah: Yes, exactly. I’m not a very patient person so this really was a big learning experience for me. So my doula is keeping contact with our midwife and eventually, it was like, “Okay, I think you’re good to head to the birth center. It looks like things are pretty steady now.” We got to the birth center. I really wanted a water birth so they drew a tub and I relaxed in the water and tried some different positions. Hands and knees in the water were hard and uncomfortable. They gave me a towel to keep from slipping around but it was really uncomfortable. My knees didn’t like staying in that position and I didn’t want to be laying back. So I just wiggled around in the water a little bit. They were like, “Let’s see if we can get you in a different position and try to get things moving a little bit.” So they got me out of the water. We tried the birth stool. I did not like the birth stool but it helped me progress a ton so that was good. I think I lost my mucus plug on the birth stool. I was feeling tons of pain in my lower back, like lots and lots of pain in my lower back. My thighs were shaky and I felt a lot of intense sensations in my thighs whenever I would have a contraction. There was a lot going on with my body that I wasn’t really prepared for or expecting. I got back in the water to help relieve my back a little bit and I ended up getting stuck on my back lying back in the tub. It was getting to the point where I was almost passing out between my contractions because I was so, so tired. My body had been working for so long and it just felt like things weren’t quite where they needed to be with how long I had been working. Again, my midwife said, “If you pass out, we will have to transfer you.” They gave me the oxygen and some essential oils to smell to keep me awake. They were trying to help me as best as they could. I guess my husband was out in the hall with the midwives and it was student midwives who were taking care of me and there was the head midwife who was overseeing them. They had a little pow-wow about what they thought we should do. The midwife was very big on mother-led labor. She was like, “Well, she’s a first-time mom.” I had been in labor for so long that things were concerning at this point so it was just, “Let’s give her a little bit more time and try to keep her awake and see how things are going. She’s doing great. She’s tired and this is normal.” A bit more time passed and one of the student midwives was like, “We need to check her. She should be farther along by now. She says she’s pushing. She feels like she’s pushing but we are not seeing the water separation and as much opening as we would like to see.” They got me out of the water and onto the bed and the head midwife performed a cervical check to see what was going on. I had a contraction while she checked me and my water broke. It was just full of meconium. She said, “I can feel his bum. He’s breech.” It was crazy because we thought he had been head down the entire time but when I was in the water, there was a big movement in my belly and I was like, “Oh, that was kind of crazy.” We thought, did he flip? When we realized he was breech, was that movement him flipping while I was in labor?Then my midwife also made a comment later, “Well, maybe he was bum down longer than we thought he was. Maybe that wasn’t the flip.” It had everybody baffled. My midwife has been practicing for a couple of decades. She’s very experienced and this had everybody stumped. She had never really seen anything like this happen before so at this point, she said, “Well, you have two options. We will send you home and send you a midwife who can deliver breech babies,” because she was licensed and in Utah, licensed midwives aren’t allowed to deliver breech babies which I think is silly. She had the training and experience. She just legally wasn’t allowed to do it. She said, “We can send you home and send you a midwife or you can go to the hospital where they will definitely do a C-section.” She gave us a couple of minutes. We weren’t in any emergent situation. The baby wasn’t in distress. His heartbeat had been great the whole time so there was no reason to believe that he was struggling at all. She gave us a couple of minutes to decide. Earlier in my pregnancy, I received a blessing from my husband and was told something like, “However our child is supposed to come into this world–”, and I was like, “Well, that’s silly. He’s going to come how we are planning on him to come.” I remembered that in this moment and said, “I think this is what that meant. I think he was always supposed to be a C-section.” It was a very interesting combination of feelings happening at the same time, remembering that and knowing this was how it was supposed to go but also being beyond devastated that this was the path things took. So we chose the C-section not because first of all, the thought of having more contractions in the car was like, I’m not going to do that. I just knew it wasn’t safe. I was almost passing out and I knew that a breech baby can sometimes be a bit more work. I was in no position to do that. So my husband drove us to the hospital and I had maybe three contractions in the car. Our midwives called the hospital to tell them what was going on and that we were coming so they were ready for us. It was very quick. We got there. They took great care of us and had me in the operating room and the rest was history. We had the C-section. The anesthesiologist was so sweet. He was this old man who spoke really softly and assured me that everything was going great. He stayed with us the whole time through the surgery. I heard him cry and it was great. They wrapped him up. They held his cheek against mine for a minute and then they took him out. My husband followed him and then they stitched me up. That was my C-section. We spent 3 days in the hospital. My birthing team came to visit me one by one in the hospital and every single one of them told me that I was a great candidate for a VBAC. They told me about The VBAC Link so that’s when I started on my whole journey listening to you guys and started to really plant those seeds that, “You are capable. You didn’t fail. You are able to do this still.” I know that some moms after having a birth experience don’t really want to hear these things and they weren’t in a place to hear those things, but for me, it was really great to immediately have that confidence spoken into me. That was my C-section. Meagan: Yes. I love that your team knew you so well to know that that was what you needed to hear in that time. Those were the things that you needed to hear. So knowing right away that you were a good VBAC candidate, was it something that stayed with you and you were like, this is what I want to do?Rebekah: Yes, absolutely. It wasn’t ever a question if I was going to have a repeat Cesarean. That was never part of my plan. You can’t really plan birth but I had never really had that fear of, Am I going to need another C-section? There’s always a little bit of it there, but it was always, I’m going to have a VBAC. That’s what we’re going to do from that point forward.Meagan: You knew. You felt that it was right. You found out about us at The VBAC Link. You had your providers already. Did you stay with the same providers or did you switch? Rebekah: Yeah. Meagan: Okay, stayed. Rebekah: Well, technically yes. I stayed with the same Birth Suites and the head midwife who was overseeing the student midwives who cared for me in my first pregnancy was the one who cared for me during my second. I got to know her a little bit better during my second pregnancy and she was ahead of everything at that time. Meagan: Okay, awesome. So you are pregnant now for the second time. Tell us about this amazing VBAC journey. Rebekah: Yeah. So I got pregnant– when was it? It was probably late summer, early fall when I got pregnant with my second. I immediately reached out to– she’s a licensed midwife now but the student midwife who was in charge of my care the last time. I reached out to her because I loved her so much. I said, “I’m pregnant again and I would really love for you to take care of me.”She said, “Well, when you are due is right when I go on leave.” I said, “That’s great timing.” I reached out to another girl who was on our team who I loved and the same thing. They were taking their leave at the same time. She was like, “But it’s within a week. You’re due within a week of when I go on leave. If you end up having your baby before I go on leave, are you okay with me being there?” I was like, “Yes. I would love for you to be there if you can to support.” That’s not what ended up happening, but it was fine.I reached out to Melissa. She’s one of the owners at Utah Birth Suites. She started that whole business. I got to know her with my first so I reached out to her and said, “I’m pregnant again and would love to be in your care.”It was really great that she already knew my history with my first pregnancy and first birth. I had stayed in contact with them. They do a lot of things in the community and they try to stay in touch with their moms who they take care of. It’s not like it had been 3 years since I had seen her. I had seen them here and there so I felt really comfortable with her. I had a couple concerns with this pregnancy with the hypertension issues and stuff that we had with him being breech. There were just things that I really wanted to stay on top of and keep an eye on. My blood pressure was fantastic throughout this entire pregnancy. It was at such a healthy level the entire time. We never had that concern of preeclampsia or hypertension because it just wasn’t a factor. It was really nice. I was doing all of the things this time around with the vitamins and supplements and nutrition and water intake and all of the things that I neglected with my first pregnancy. I was super, super determined to have this VBAC. My midwife really pushed protein– lots and lots and lots of protein. We really wanted to strengthen that uterus and try to be as strong as we possibly could so I really took that to heart and tried my best. I got really excited when I came up with a new recipe that had a ton of protein. I would take a picture and send it to her and write up the recipe. I was like, “I’m so excited about this one.” It’s like when a kid draws a picture and is so excited and their parent sticks it on the fridge. That was how I felt. I was like, “Look at me. I’m working so hard this time.” I was worried about her flipping breech but that was never an issue either. She stayed head down the whole time. This was a little side note that was interesting. During my anatomy scan to find out the gender, the ultrasound tech was looking over everything and he said, “There’s no way to really tell for sure because your uterus has expanded now,” but he said, “I wonder if you have a bicornuate uterus.” He said, “Because your birth was breech, right? He flipped?” We had seen this ultrasound tech for the first so he knew everything that happened there. So I said, “Yeah. He flipped breech.” I had never heard that word before. I didn’t know what that was. He explained it to me and said, “It’s really common for women with a bicornuate uterus to have babies who flip breech.” So I was like, “Okay, that’s interesting.” He said, “After you have this baby and your uterus shrinks back to normal, we should take a look at it.” I have yet to do that but I’m curious too. She never flipped breech so I don’t know. Maybe I just have a goofy-shaped uterus. I don’t know.Meagan: Maybe or it was just a freak thing. Baby needed to be head up. Rebekah: I don’t know. That was interesting and I’m curious to see what the results of that are. But anyway, we got in contact with a doula, a VBAC-certified doula in the area. Her name is Isabelle and she is fantastic. She is absolutely phenomenal. She is also a birth assistant so she is fully immersed in this birth world. She is so knowledgeable and has tons of experience. We clicked really fast and I knew that I wanted her to be our doula. She really just was invaluable the whole time. She recommended that I do some fear-release exercises and meditations to work through some of the trauma that I didn’t really realize that I had from my first birth. I thought I had processed and accepted as much as I could but I think healing isn’t a linear process and being pregnant again and having another baby brought up a lot of stuff and a lot of fears. On a personal note that I won’t really get into, I had a different set of fears surrounding this pregnancy for different reasons so there was just a lot to work on emotionally and mentally. I took that very seriously. This was a very sacred and spiritual pregnancy for me. Maybe it’s just like that mother-daughter bond. I don’t know. I felt way more connected to my baby this time and I really wanted to do my due diligence in making sure that my mind and my spirit were in a good spot for this pregnancy and this birth. One of the fear release exercises she sent me was one provided by The VBAC Link. It was a little worksheet to get your mind going and there are specific questions on there about what are some fears you have and where do you think those fears come from? It was that kind of stuff and toward the bottom, it helps you reframe those a little bit. Meagan: Yeah. Rebekah: It had me write out what my fears were and then to write an affirmation to counter each fear. I had 20 affirmations all written down just to go along with this list of fears. Then I actually used a couple of those and printed them out as my visual affirmations for when I was in labor. So fast forward, we’re about 38 weeks and I was thinking for whatever reason that this baby girl was going to be early. So 38 weeks came around and I was starting to get excited. I’m like, “I think she’s going to be here pretty soon.” I was starting to have some prodromal labor which I didn’t experience with my son so that really reinforced the idea that she would be here soon and that was not the case. I had 2.5 weeks, well yeah. I guess it was about 2.5. Normal labor started around 39 weeks. So every night on the clock from 8:00, I would start getting really intense contractions that felt like early labor with my son but I also had much stronger Braxton Hicks this entire pregnancy so I was like, “I can’t really tell the difference.” I told my doula that. I was like, “I’m afraid I’m going to miss you and I’m not going to reach out to you in time or you’re not going to make it to us in time because I won’t know when labor is actually happening.” That was a big worry of mine this time around. It was so different than with my son. She said, “It’s okay. You can just text me as much as you need to and as much as you want.” So I did. I texted her a lot the last few weeks and she was like, “Your body is doing great.” She told me that in her experience, she said, “Just from what I’ve seen with my VBAC moms, I actually see prodromal labor happen a lot. I personally think that it’s the body’s way of being more gentle rather than doing all of the labor hard and fast at once. It’s lots of little bits of labor to get your body ready and ease into it so it’s not as intense on your body.” I was like, “You know, that makes sense.” I don’t know. I don’t think there are any studies around that that I know of, but that made sense to me. I really tried to just internalize that and not get too discouraged when things would stop as soon as I went to bed which they did every time. At 8:00, they would pick up and be there for a couple hours then it would stop when I fell asleep then I’d be fine until the next night when it would pick up again. My husband and I would go on a walk every single night and on these walks, I could have sworn that she was going to fall out. I could feel that she was right there. I could feel that my body was literally opening. I could tell that I was dilated. I never got cervical checks this time around which was oddly empowering. I really trusted my body and knew that things would happen regardless of the number that my body was dilated. I had no idea but my midwife was like, “You know, it wouldn’t surprise me if you are sitting at a 4 right now.” So if anyone has experienced prodromal labor, you know how exhausting it is and how discouraging it is mentally, physically, emotionally– all of it. It had been a couple of weeks of this and I had officially gone past 40 weeks. I’m officially overdue and my son being born right on time, it was really frustrating that I was going past my date with this one. I didn’t want to be induced. There was really no reason for it other than I was getting tired of being pregnant. My midwife was supportive if I wanted an induction. After I hit 40 weeks, I think she would have done it. She said, “Oh, we can do this,” but she also was really encouraging and assured me that my body was doing what it needed to. It was normal to feel discouraged, but let’s just give your body time, especially with a VBAC. Induction can come with its own set of risks. I knew that. It was just such a mental battle trying to remember that. I know the risks sometimes can be small, not that it would worry me personally. For some moms, I know it would but for me, the risks that came with induction weren’t enough for me to say no to it completely. But also, you never know so let’s not play that game. Let’s just be as patient as we can. A couple of days before I went into labor, I had it. I was over it. I was in the middle of a breakdown in tears just exhausted. I was with my husband and I said, “Why isn’t she here yet? Why doesn’t she want to come?” I was just processing things out loud and I said, “I know my body is ready. I can feel it. My body is open. She is so far down there. I feel like her head is going to pop out any second. What is going on? Why have I not gone into labor?”Then he just was really comforting to me and letting me process how I needed to and then I said, “I feel like she’s scared.” That was a really interesting feeling. Like I said, I felt more connected to this baby and it was like a lightbulb that was the answer. Your body is ready but your baby is not. We were overdue at this point so I said, “I feel like she’s scared. I’m not quite sure why, but I’m almost positive that’s it.” So I took a moment to kind of then go into myself. I went into a different room by myself and again in tears was just sobbing and praying and spent some time talking with the Lord and then I spent some time talking to my baby. I told her, “We’re ready for you. We are so, so ready for you. I know you are scared. I don’t know why but you’re not going to be alone. We’re going to go through this together. You’re going to be safe. Mommy and Daddy are going to take care of you. You’re going to be okay.” It just was a really, really sweet moment. Two days later, I went into labor. Meagan: Ohh. Rebekah: I guess she just needed that reassurance that things were going to be okay. Meagan: She needed the okay. Yeah. Rebekah: Yeah. I think she felt that something was coming with all of this prodromal labor. She knew that things were picking up and she just needed a little pep talk. So this time around, again, around 3:00 AM– I guess that’s when babies like to come. I hear that so, so many times between 2:00 and 3:00 AM is when things start to happen. I don’t know why that is the magical hour, but it is. This time, because we know I was afraid I wouldn’t know when labor had started, this time is started with my water breaking. My water didn’t break until after 17 hours of labor with my son. I was asleep and woke up to re-situate myself and I felt this pop inside my body. It kind of hurt a little bit. I was like, what was that? It was a really weird sensation. I thought, Was that my water? I reached down and I feel around. I’m like, Well, I’m not wet. I stood up just to see what was going on and there was this huge, giant gush. I was like, Well, yep. There it is. This was probably my favorite part of my entire labor. My husband was asleep and I said, “Honey, honey, my water broke.” He was still half asleep and he said, “Do you want me to fill it up for you?” He thought that I had dropped my water bottle or something. I was like, “No, honey. My water broke.” He jumps up and he’s like, “Oh, oh.” He started freaking out and he was like, “What are you supposed to do?” He was frantically looking around. He was still half asleep. I was like, “Okay, take a breath. Go get me a towel first of all,” because I was gushing all over the floor. “Get me a towel and then text Melissa (my midwife)” or my doula. I didn’t know who it was. I said, “Let them know.” He said, “Are you okay? Do we need to go somewhere? What’s going on?” I said, “No, we have time. Water breaking is not a big deal.” I had done lots and lots of research and listened to a million birth stories so at this point, I feel like a pro because I am fully immersed in this birth world. I said, “No, I’m okay. I’m just going to change and lay back down because I’m not having contractions yet. I feel fine, but I do need to rest so I’m going to change myself and lay down.” That’s what I did. I wasn’t going to repeat the mistakes of my first birth of moving too fast. Meagan: Getting too excited and yes. Rebekah: Yeah, especially with the exhaustion that I was feeling toward the end of my labor with my son, I was like, I don’t want to feel that again. I lay back down. I know myself well enough that I wasn’t going to fall back asleep. There was no way that was going to happen, but I was like, But I need to stay as relaxed as possible. We kept the lights really low. I put my birth playlist on and just really did some breathing to keep myself relaxed and as open as I possibly could. That’s how I labored for the next several hours but things got intense really fast. As soon as my water broke, I knew that my contractions were going to be more intense. Even though labor had technically just started, I had a feeling that I wasn’t going to be in labor for very long because it had been 2.5 weeks of prodromal stuff. I was like, I think this is going to be quick. I was really unsure of what to do though because I was timing my contractions. I have screenshots and was sending them to my doula. She said, “Oh, those look great but let’s wait an hour and see how that goes.” But I was feeling like things were picking up. I felt like things were getting more intense but people kept telling me to wait. My midwife was like, “Oh, you have time.” My doula was like, “Oh, you have time.” I told my husband, “I don’t know what to do because everyone is telling me that I have time but I don’t think we do.” Every time I stood up to go to the bathroom or get in the shower– I tried the water in the shower because my doula said, “Sometimes that can make things a little bit more comfortable. Some women like to labor in the shower for a little bit.” I thought I’d try that. I loved the water but I did not like being upright. I did not like standing because it made contractions so, so intense but they were short. They were half the length than when I was lying down. I think they thought I had time because there were still several minutes between contractions and they were still pretty long. They were like, “We want them just a little bit shorter and a little bit closer together,” or longer contractions. I don’t remember. I was like, There is something in me that is telling me that this is moving pretty quickly. I don’t like being upright and I feel like I need to rest. It was a lot of weird stuff going on in my head trying to figure out how to handle things. I stayed in bed. It was this instinct in me, “You need to stay lying down.” Any time I stood up, it picked things up and for any birth with other moms, that’s what you want, right? You want things to pick up and you want things to progress and technically standing upright was progressing things, but it didn’t feel right to me for whatever reason. I knew I needed to be resting and lying down. I was starting to get tired. I texted my midwife and said, “I’m starting to get worried because I don’t feel like I should be this tired this early, especially with how much I’ve been lying down and resting.” She said, “I think you need a little boost of energy.” She said, “Eat a snack and go outside and take a walk. Get some fresh air. Get some sunlight.” In my head, I was like, I don’t want to do that. I don’t want to be up. Every time I stand up, I can’t explain it. Everything in my body and spirit was like, “You need to stay lying down.” I was like, “You know what? She’s been doing this longer than I have. I’m going to trust her. I’m going to do it.” I make my way upstairs and as I’m getting a snack, I have a contraction that just had me seeing stars. I almost passed out. It was so, so intense and I told my husband, “I’m going to throw up. I’m going to pass out.” I leaned against the counter. He rubbed my back and when it was over, I ate my snack really, really quick. It was a sugary snack to give me a blood sugar boost. I ate my snack really fast and then immediately went to the living room and got on my knees and leaned against the couch. Again, I can’t be standing. Meagan: Yeah, and gravity is causing it to happen too much. Rebekah: Yeah, and I was like, I don’t have the capacity right now to handle these standing. I need to be more grounded. I got on my knees on the couch and my husband was like, “Are you okay?” I was like, “Yes, I just can’t stand up.” I had a few contractions on the couch because everyone was telling us to wait so I was like, “Okay, let’s just do a few more contractions and see how these were

Colleen’s first pregnancy ended in a miscarriage at 6 weeks. At 12 weeks along with her second pregnancy, Colleen and her husband found out that their daughter would be born with a genetic condition called Trisomy 18. Colleen shares her experiences with Trisomy 18 and how she found the right support to help her navigate through it all. Due to IUGR and other medical concerns, Colleen had her daughter via Cesarean with an 85-day NICU stay afterward. To her surprise, Colleen had a third pregnancy just 6 months after her daughter’s delivery which ended in a heartbreaking second-trimester miscarriage. After discussing her pregnancy and birth histories at an appointment, Colleen’s doctor referred her to be screened for a MTHFR gene mutation for which she came back positive. MTHFR (methylenetetrahydrofolate reductase) is a gene that impacts your ability to process and absorb folate. It can be responsible for complications during pregnancy and is detected through a simple blood test. Colleen and Meagan talk more about what MTHFR means, and what Colleen was able to do to have a fourth uncomplicated pregnancy and a beautiful, smooth VBAC delivery! Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome to the show, everybody. We have our friend, Colleen, on with us today sharing her stories and navigating through this amazing journey that we call birth. Birth is such a journey, wouldn’t you agree, Colleen?Colleen: Absolutely. Meagan: One of the most unique things about it is obviously through the stories we all hear. They are all unique and individual to us and even one birth that you’ve given doesn’t mean the next birth is the same. So we’re going to be talking today about navigating through birth and we know that a lot of the times through these journeys whether it be because of a Cesarean or because of how we were treated or because of how our body responded or whatever it may be, sometimes and a lot of the times, we experience trauma. Trauma is viewed differently from everybody and processed differently. We are going to be talking about navigating through trauma. Then Colleen is actually going to share some of her fertility journey as well. I think that’s also a really important thing because we have so many mamas out there– we know. We know. We see it. They have to navigate through fertility challenges. We’re going to be talking about that along with a VBAC. Let’s get into that here in just a minute. We do have a Review of the Week then like I said, I’m going to introduce Colleen and turn the show over to her so she can share her beautiful stories. This review is from lexieemmarie. It says, “So thankful. I just wanted to say thank you for creating this podcast. I had my baby girl via emergency Cesarean at 30 weeks due to several medical complications with my baby. We spent 95 days in the NICU and while in there waiting for my sweet girl to grow, I started to research VBACs to see if it was right for me. Once I found this podcast, it sealed the deal. I absolutely can’t wait to VBAC with my next pregnancy. You all are incredible to listen to because you provide the wealth of knowledge and positivity but are also fun and entertaining to listen to. Amazing job, ladies.” Aww, that just made my heart so happy. Oh my goodness. Thank you so much, Lexi, for your review. As always, we love these reviews. They make our hearts and our minds so happy. You guys, this is what we want. We want you to have that wealth of knowledge. We want to have you feel inspired and guided and uplifted and educated along the way through all of these stories. As usual, leave a review if you haven’t yet. We would be so grateful. Meagan: Okay. We have Ms. Colleen. She lived in Michigan. Did you have your VBAC baby in Michigan? Colleen: I did, yes. Meagan: You did. Colleen: My husband and I live in a suburb of Detroit in Gross Point so that’s where I gave birth in August of 2024. Meagan: Awesome. Awesome. Okay. Wait, 2024? Just right now?Colleen: Yeah, I’m 2 weeks postpartum. Meagan: Yes, I love it! So really, really fresh. Colleen: Fresh. Meagan: I love sharing stories that are so fresh like that. It is right there in your brain. Colleen: Exactly. Meagan: Oh my gosh. Okay. She has two beautiful children now and one two-week-old baby. Your two-year-old daughter is Gianna? Colleen: Gianna, yes. Meagan: She was born via Cesarean due to chromosomal abnormality. Do you want to share what that means?Colleen: Yeah, I would love to. Gianna has a chromosomal condition called Trisomy 18 that we did find out about through the genetic screening early on in pregnancy that she was considered high risk for coming down with Trisomy 18. As the pregnancy progressed, it became pretty evident that it would be the reality. For those of you who don’t know, Trisomy 18 on its surface means that the baby will have an extra 18th chromosome in some or all of their cells. How that manifests itself is through some pretty serious medical complexities that require quite a bit of care. I will get into that a little bit more with my story but that is the quick version of Trisomy 18. She is also now 2 years old and a bubby, sometimes sassy, little girl. Meagan: Is there another name for it with an E?Colleen: Edwards Syndrome, yes.Meagan: I have another friend who has that and I seriously adore him. He is thriving and doing amazing in life. Colleen: Yes. She is a warrior. She is so strong. She is so beautiful and has brought nothing but love and joy to everyone who knows her or who don’t know her. There are so many people from near and far who love her. It’s great. Meagan: Yes. Awesome and then we’ve got Sonny who was born via VBAC just two weeks ago you guys. She says, “As a mama of a medically complex child, she is passionate about awareness and education for those within her daughter’s condition. She also enjoys running, reading, cooking, and volunteering.” Colleen: Yes, that’s a little bit about me. Meagan: I love it. Welcome to the show and thank you so much for being here with us. I would love to turn the time over to you to start sharing Gianna’s story. Colleen: Amazing. Thank you so much for having me on. The VBAC Link was a staple on so many of my walks when I was getting ready to give birth. I just found it to be so uplifting and empowering and I’m so glad that I found you as a resource. A little bit of background before getting to my VBAC– it really does begin in about 2022. It starts out with some of those fertility issues that you had mentioned at the start of the podcast. My husband and I decided to start trying after about two years of marriage and we got pregnant pretty quickly. That ended early in a miscarriage at about 6 weeks. But we said, “Okay, let’s try again.” We had processed and accepted that miscarriages do happen so we quickly said, “Let’s give it another go.” But we had those reservations and that in the back of our mind of moving forward cautiously. We did get pregnant quickly again. Throughout the first trimester, we just kept it tight-lipped. We just told immediate family and then decided we wanted to do the genetic testing of course to find out the gender. We didn’t really give too much thought to what else you learn from that bloodwork. As my pregnancy progressed throughout the first trimester, I was feeling confident then at about 12 weeks, we received a call from my midwife. She told us that it was a girl and that she came back high-risk with Trisomy 18. We weren’t expecting that. It was scary and a shock and the more we learned and the more we read in those early days was devastating to us. We were just coming off the heels of a miscarriage so then to have this thrown at us was just a real curveball. In order to move forward and navigate that, my husband and I were always planning on keeping the pregnancy so it just meant, what does that mean going forward? After talking with more specialists and maternal-fetal medicine at the health system that I was at at the time, it became very apparent that they weren’t really willing to help. We needed to find another health system. We are so fortunate because we were living out of state for quite some time then moved home before we started to try. We were living in Chicago and then moved back to Michigan. University of Michigan, so CS Mott Children’s Hospital is for sure the best in the state and one of the best in the country for caring for kids with my daughter’s condition. We switched all of my prenatal care there and they provided us with hope and were willing to monitor me and have a very wonderful NICU. They were willing to provide interventions and things after she was born. But as it related to my pregnancy, it completely deterred any sort of plans and any sort of “normalcy” that one might have. It was shrouded in sadness and anxiety and fear and unknown. Each ultrasound and each week was closer and closer to meeting her but also closer and closer to what does this mean for her? What does this mean for our family? I completely abandoned any apps or what size fruit she was going to be at a certain week because she had intrauterine growth restriction. That rulebook and those guidelines went out the window. I was really afraid to connect with her when I was pregnant. A lot of the time I would say, “Okay, be in tune with her. Read to her and rock her and listen to music with her,” and I would just end up in the nursery that we decorated in tears because I just had so much fear and sadness around what was to come. With that being said, because my plans had been derailed, I really threw myself into learning about her condition and learning about what would come afterward. That gave me hope as a very Type A person. I needed to be doing something to prepare and connected with other families from around the country to give me and my husband hope and learn about what life with children with Trisomy 18 looks like and what they are capable of really was our main driver throughout pregnancy. With that said, I did not prepare for birth at all. I didn’t learn about how it could possibly go. I really just, like I said, focused on what care for her would look like. Just as a very small example of what that even looked like was when I came to write my birth plan, I probably wrote a couple of things like, “Oh, open to epidural. Do you have a birthing ball?” I honestly had a line in there that said, “If she is born not breathing, resuscitate her.” That is where my head was throughout pregnancy and it just came to however she was going to arrive, that was second to her being here and us starting to care for her. Meagan: Yeah. Colleen: That said, my care team, obviously I was being seen by the MFM department at CS Mott. They were very supportive. I never felt like they weren’t looking out for both me and her. I think they wanted me to deliver vaginally and with the understanding that if it came to a Cesarean that would be what it was. My husband and I made it very clear that we wanted to be treated however they would handle a typical pregnancy. Meagan: Anybody else, yeah. Colleen: Yes. Yes. If it meant a C-section, that’s what it was going to be kind of thing. She was showing that she wasn’t tolerating labor. We got to the end of pregnancy and we were discussing what birth would look like. We all agreed that an induction at 37 weeks was going to be the plan for a couple of different reasons. From our perspective, we wanted to just start caring for her knowing that she was going to have complexities. We were in the best place possible to start that process. There is some research that would show that the longer that babies with Trisomy 18 are in utero, you could run into a stillbirth situation. Now again, it’s a little bit more on the anecdotal side because many, many kids with Trisomy 18 are born vaginally at 40-41 weeks and it’s how you want to play it. Meagan: You have to weigh it out for what’s best for everybody. Was IUGR becoming a problem at all or was she still small but staying within her own growth chart?Colleen: Toward the end there, we were seeing some stagnated growth so yeah, they were very much of the mindset, “Let’s just get here here,” kind of thing. She was born at 3 pounds, 12 ounces. She was just a peanut. Meagan: Little tiny, yeah. Colleen: I was induced at 37 weeks without having much knowledge of what the induction process was going to look like for me and I went in at a centimeter. They started with a cervix softener so that they could then insert the Foley balloon. I was in bed a lot. I utilized the tank of nitrous oxide. I labored that way for a while just to mitigate that pain. I was walking around a little bit but honestly, the Foley balloon for me in the whole induction process was probably the worst part. I was in quite a bit of pain after that. Meagan: Were you dilated at all before when they tried to insert that or was it a closed, posterior cervix? I’m assuming at 37 weeks, it’s not doing much. Colleen: I was a centimeter when I came in and I was maybe a 2 when they inserted it I believe. Yeah. It was very apparent that my body was probably not ready for that process. Meagan: Yeah. Colleen: Yeah. That also became apparent once the Foley balloon came out but then pretty much I got to 5 centimeters and just parked it there for quite a bit. The pain was pretty intense so I received an epidural after laboring I would say probably 14-16 hours or something like that. The attending OB wanted to take additional steps by breaking my water and my husband and I were talking. We said, “If they break my water and then I don’t progress, then what situation are we in?” We also knew beforehand that my daughter did have a confirmed heart defect. We wanted a more gentle approach to induction especially when it came to Pitocin. We really wanted to take it slow and monitor her to make sure she was tolerating it and things like that. We opted for Pitocin before breaking my water and took it slow. I would say probably another 6-8 hours went by. We were taking it very slow. I wasn’t progressing and then we started to see some sporadic, not super consistent but enough to keep make us aware of her, decels that she was having. Again, the attending OB really wanted to continue on. She wanted to break my water. She wanted to optimize my chances for a vaginal birth, but again, I think my husband and I were so zeroed in on having her here safely that even the attending OB after observing some of the decels into the night was like, “Okay, I think–”Meagan: That was enough. Colleen: Exactly. She arrived via C-section on October 28, 2022 at 3:18 in the morning which we find incredibly special because 318 is a universal number around Trisomy 18. We just feel that she was meant to be here just as she is. That was enough for us to say, “Okay. We did what we think we needed to do to get her here safely.”Meagan: And happy birthday to her today. She will be 3?Colleen: She’s actually turning 2. She’s turning 2. Yep, yes. So that was my obviously first birth experience and it was– I can’t even say different than what I expected because again, I really went into that not having much of a reference or much preparation at all. I say, “Okay. That was my experience. It was a C-section.” We weren’t thinking at the time. We always knew we wanted future children but with the timeline, we had an 85-day NICU stay with her. There were other things that we were focusing on. Meagan: You and the reviewer. You NICU mamas are amazing. Colleen: Perfect review for today. After 85 days, we came home in January of 2023. We were getting settled into home life and then fast forward to about 6 months postpartum. We had just been home for a couple of months and much to my husband and I’s surprise, we were pregnant again. From the first miscarriage to my daughter, we had that hope and that mentality of, “We have no reason to think that anything is going to go wrong so let’s just operate from the stance that everything is going to be okay.” We took a similar approach this time around. We said, “Okay. We’re going to roll with the punches. Gianna’s going to get a sibling a little bit sooner than we initially had thought. Let’s just play it like everything is going to be okay.” We had met with a geneticist and knew our risk for having another child with Trisomy 18. We were just slightly above the general population when it comes to the statistics there. We weren’t super concerned. It was a very, very low risk. We decided to do the genetic testing anyway. I didn’t consider myself to be high risk so I moved my care to a little bit closer to home. The University of Michigan is a little over an hour for us. I had a great experience but wanted to move just a little bit closer to home to a practice that is very utilized on this side of town by many women. I did the genetic testing and everything was good. We were having a boy and then the very next day, I woke up to a very large gush of blood. I went to the emergency room. This was on a Saturday. They did an ultrasound and said, “Baby is looking good.” I was again, about 12 weeks at this point. They said, “Sometimes just bleeding in the first trimester happens.” I took that at face value. I came home Now mind you, with my daughter’s condition, she has a lot of medical equipment and lower muscle tone so it’s a lot of carrying her around and at that point, she was still pretty small but again, I’m pregnant and I’m hauling her medical equipment plus her some days. I’m a stay-at-home mom so I’m trying to navigate all of that. I’m going about my daily life not really thinking much of it just saying, “Okay, that’s what it is. The first trimester bleeding.” I went back to the OB that week and they also confirmed, “Oh yeah, it could just be bleeding.” I said, “Okay.” Then about 2 weeks later I’d say, again on a Saturday, it happened again. The bleeding had tapered off then it happened again. I went back to the emergency room to make sure everything was okay and it was a different emergency department. The nurse practitioner came back in after the ultrasound and said, “You have a really large subchorionic hematoma.”Meagan: I was going to ask if that’s what it was. Colleen: Yes. We had done research obviously between the two ultrasounds and people said, “If you do, it likely will heal on its own.” Meagan: It takes time, but if you do activity and things like that. Colleen: Yes. I would say probably about 2.5-3 weeks went by with me not knowing I had it. I hemorrhaged again. This time, I really tried taking it easy leveraging my husband, my mom, and my mother-in-law to really help care for my daughter so I would be able to rest and recover. When I had gone to the OB that Monday just because I had been in the emergency room over the weekend, they painted it like there was not much you can do. If you can take it easy, great. If not, I actually went in that Monday and I had brought up the subchorionic hematoma and the provider that I met with said, “Oh, yeah. You have it but actually, I want to talk to you about something else.” It was a potential marginal cord insertion or a velamentous cord. Meagan: Okay. Colleen: She said, “I actually want you to be more aware of this than the subchorionic hematoma.” Again, it was pushed to the side. At that point, in partnership with some other pretty inappropriate and I would say frankly bad bedside manner from the practice, I was looking to move again. They were very insensitive around my daughter’s condition. They made me to be othered because of her. I just didn’t appreciate that. I was like, “This is a different birth.” I didn’t appreciate that treatment. They asked very inappropriate questions about her and her life expectancy and things that were very triggering for a) someone who was fresh out of birth and a very traumatic pregnancy. I just felt that was very inappropriate to ask those things especially when we are also not talking about my daughter. We are talking about this pregnancy at hand that was having some issues. I was looking to switching providers. I have my best friend in the area. I loved her. She was pregnant at the time as well. She loved her OB so I was looking to switch. I couldn’t get in for a couple of weeks so I just said, “Okay.” At the next month’s appointment, I would switch practices away from where I currently was. In the meantime, I would say about a week and a half later, I was bleeding again. It was on a Monday so I got in that day and I personally had a little bit of peace around it because I just said, “Okay, this has happened before. Baby has always been okay, but let’s get in.” So I got in that Monday and I was given an ultrasound and the ultrasound tech put the wand over my belly and then very quickly went out of the room. My heart sank. I just knew what that meant. She came back and I asked, “Was there a heartbeat?” She just shook her head no. I was by myself because my husband was home with my daughter and it was just completely unexpected and devastating. It crushed us because we again had just come off of something so difficult and had so much hope and for that to be the result was quite crushing. I had reached out to the OB that I had planned to switch to and I just explained the situation. She said, “I’d like to still see you.” I went in about 2 weeks after my miscarriage and just laid everything out for her. She shook her head after me telling her about my first miscarriage and then my daughter and this most recent miscarriage. She took it all in and she goes, “I think there is something going on. I don’t think these are just flukes so I want to run some tests.”She ordered some pretty extensive bloodwork mostly in the autoimmune space but she also ran for MTHFR. After many vials of blood and a few weeks of waiting, I came back negative for anything autoimmune but I did in fact come back for MTHFR and she is a provider who believes that it does make a difference. She said at the time that she provided us with this glimmer of hope. She said, “If I know that a patient has that, I start them ideally on a pretty ‘easier’ regiment or something to get them started to see if that makes any difference in their pregnancies. If not, we can build with Lovenox injections and things like that.” Basically she said, “I want you on additional folic acid.” I took methylfolate and a baby aspirin. But she posed it to my husband and I. “Do you just want to go the Lovenox route? Once you go on Lovenox, I won’t be able to walk you back on additional pregnancies. If you have a successful pregnancy–”. Again, knowing this wasn’t going to be the answer and that we could potentially have another loss or more issues with pregnancies but we wanted to start on that first step before jumping forward.She said, “Pick up those supplements when you feel like you are ready.” We needed time. We needed months of healing and of focusing on my daughter’s care to just really level-set for our family. But in December of last year, we felt strongly that we wanted Gianna to have a sibling so we decided to try again. I got pregnant and began those supplements. From that perspective, my pregnancy was very difficult. Now, it also gave me that time both prior to getting pregnant and then throughout my pregnancy to really– I really wanted to level-set my approach and my outlook on pregnancy. I had felt like I had been always in this cycle of seeking out information or researching based on issues and I think my and as well as my husband, the trauma aspect always played into it of, okay. Here’s a symptom. It could be something very normal or it could be these very unique, rare things that we got used to feeling comfortable in that space. Meagan: Yeah. Colleen: I sort of recognized that as something that I needed to work through. I needed to work through some things that were either emotions I pushed aside. I pushed aside the thoughts and feelings around especially that second miscarriage because I said, “Okay, I have a daughter with medical complexities.” I needed to jump back in and I think that distraction helped me push those thoughts away but then I will say they came back. They reared their head and I said, “Okay. It’s time for me to deal with them.” So going back to talk therapy has been really helpful for me for working through some of those emotions as well as unprocessed things with my daughter’s pregnancy and birth and care and things like that, the realities around her life and how it’s impacted myself, my family, and things like that. I went back to talk therapy and then also got pregnant. I thought that was the perfect time to really sort of level-set my outlook on pregnancy. We forewent the genetic testing around. We just said, “What will be will be.” For now, the fourth time, we are choosing to believe that all will be well. We will have these feelings. My first trimester almost felt like the closer I got to the end of my first trimester, the more anxiety I had because I had that second-trimester miscarriage that I just had the opinion that it could happen at any time and why wouldn’t it just happen to me again?There were some friends who didn’t know that I was pregnant until my anatomy scan just because I felt like I needed to hold it close to my chest. Meagan: Just keeping your space safe. Colleen: Exactly. Exactly. And protecting my own emotions. So the first trimester for my son did have some of those thoughts and feelings. The OB who I had switched my care to was very accommodating. She had a little portable ultrasound machine in her office if I felt like I needed that reassurance that she would provide the ultrasound for me. She asked me how often I wanted to come see her. She was just very understanding and accommodating based on my previous circumstances. It also allowed me the space, especially as I moved through pregnancy, to really think about birth and think about how that process could be healing as well. In my second trimester, I remember going on a walk because I needed to clear my head and just feeling so overwhelmed by not knowing where to start and then I was being hard on myself because I was like, I should have done this with my daughter. I should know these things already. This is my second birth. I was being very self-critical as if I didn’t have other things to focus on with her. That’s when I came across The VBAC Link. I actually came across it because my husband and I had taken some on-demand birthing classes through Mommy Labor Nurse and we very much so said that we needed a refresher and probably to take some more diligent notes this time around. It was a resource that she has promoted so I checked it out and I just immediately felt like it was going to be so helpful as it was throughout pregnancy just listening to the podcast episodes, referencing the blog, getting your emails, and just really feeling like I had a resource that was going to support me. I can’t express how grateful I am for that because– and I’m about to get emotional– of how along pregnancy and that journey has felt. I’ve constantly felt like I’ve been up against walls that it’s been exhausting to have to overcome and to break down. Meagan: Yeah. It’s a terrible feeling to feel so alone in this really big moment in your life and not feel like you know the direction all the time and then also making decisions and then having the world pretty much question why you are making that decision. It’s so heavy and that’s why I love this community so much because they make you feel connected to people that are not even within reach. They are hundreds and thousands of miles away. Colleen: Absolutely. Absolutely. Just to have that support because it very quickly became my goal to VBAC because I flipped the script after finding The VBAC Link. I said, “There is nothing pointing to my body not being able to do this. I’m going to go for it.” I’m a competitive person and sometimes I’m competitive with myself and I said, “This is going to be a competition and I’m going to do this.” I will say getting into the true VBAC part of it, my OB was very supportive. She said, “I think you are the perfect candidate to VBAC.” She did want to see what my body did closer to which made me a little bit nervous. She was like, “I’m not for induction but I would do augmentation.” I was like, “Okay. Let’s see.” Again, it was a motivator to me to do all of the things that I could do to edge myself along kind of thing. The biggest thing I leveraged was walking. I walked a ton and I just found a routine in the business of life that worked for me that I could rely on each and every day and say, “Okay, these are the three things that I’m going to do throughout the rest of pregnancy to a) give myself peace mentally and physically, but also just to say life is busy, but this is what I’m going to do to move myself forward.” It was a lot of walking. It was a prenatal that I just really adored and I just committed to a pretty nutritious diet to make sure that I was nourishing my body in all the ways that I could. Around 36 weeks, I received a cervical check and was starting to dilate and efface. I was about 2 centimeters. Meagan: Wow. Colleen: Yes, with about 70% effacement at that time. My OB said, “Things are looking good. You are on the right track here.” I just kept doing what I was doing. I did opt for a membrane sweep at 38 weeks and I will say having never labored before, between that 36 and 38-week mark, I was having a ton of prodromal labor which was very frustrating because I never knew what was real. We went to labor and delivery once. I got turned away and sent home. I thought it was the real deal. Yes. Prodromal labor is a tease. But after the membrane sweep, it became very apparent that I was actually in labor. That afternoon, my husband and I and my daughter lay on the couch. I was having closer and stronger contractions and we joke that it was absolutely the real deal because all the times leading up with prodromal labor, everything was squared away. My meals were prepped. Everything was squared away with my daughter. My in-laws and my parents were ready to go and jump in. The day that I started to be in labor, our basement flooded with our sewage backed up. Meagan: Oh no. Colleen: I’m actively in labor and my husband comes up and says, “This is absolutely the real deal because this wouldn’t have happened if you weren’t.” I’m in labor and my father-in-law are bleaching the floor and scrubbing. It was a whole thing and I was like, This isn’t funny right now but it will be funny one day. And it’s funny. I was able to labor at home for a few hours. I got to the hospital. I had the membrane sweep at noon that day. I got to the hospital around 9:30 PM and was at a 5. I was feeling pretty good about that. I was feeling those contractions of needing to pause. I wasn’t really able to talk through but still at that point now knowing what later labor felt like that it was just the beginning of things. I had a wonderful labor and delivery nurse who was super supportive. I never felt being there like I had to convince anybody. They knew that my plan was a VBAC. The attending OB was cool with it. My OB lived just a few minutes away from the hospital and said that she would be there within a moment’s notice when I did deliver so I would have her for the moment of. I got to a 5. They did put me on the monitors and had me hooked up so my movement was pretty limited which kind of limited what I was able to do. I wanted to walk a little bit more. I was only able to sit on the birthing ball in a certain area of the room. That was a little bit tricky. The shower was really nice and I did appreciate laboring in the shower but it was the attending OB who had checked me when I first got there and determined I was a 5. A few hours later, the labor and delivery nurse checked me and said, “Oh, I think you are a 7.” My goal was to get to active labor before I decided if I wanted an epidural but ideally, I wanted to go unmedicated. So when they said I was a 7, I was like, “Oh, okay. All right. That’s the motivation I needed to keep pushing on. I can do this.” My contractions were becoming more frequent but they weren’t getting stronger. It almost felt like at a moment’s notice when they had to put the IV in or if the pain was too intense that I would start to space out again which I found to be interesting. But when a few hours went by, the pain was intensifying. They wanted to check me again and it was the OB this time who had checked me earlier and she said, “Oh, you’re a 6.” My husband and I said, “Well, they said I was a 7 when they checked me last time.” She said, “Yeah, but I’ve got the frame of reference and you’re more of a 6.” That messed with my head. Meagan: I’m sure. Colleen: My breathing was no longer effective. The pain was getting to me. The next step they wanted to take was breaking my water. I just didn’t feel like I was in the headspace to continue on without the epidural. Meagan: You were mentally derailed. That can happen. Colleen: Yeah. When it came to my birth plan this time around, I was a little bit more descriptive because I had done more research. I wanted to go the unmedicated route if I absolutely could. If not, at least active labor. I really didn’t want any augmentations or interventions when it came to breaking my water or Pitocin. I really wanted to be able to do it on my own but I will say and I think this is one of my bigger takeaways from this birth is that even when things don’t go according to plan, you really have to trust your gut. I will say in those moments, my gut was telling me I think what needed to happen to service the overall goal which was my VBAC. I said, “Okay. I think in order for my body to relax, I want the epidural.” I get the epidural. My body did just that. I was able to relax. My contractions were getting closer together again. They did break my water and now we were into the morning hours here. I get a call from my OB and she said, “Hey, I’m aware of your situation. I see that your contractions are getting closer together but they are still not at that strength that we are really wanting to see.” She said that, “If you are okay with it, they want to start me on very low doses of Pitocin.” She said, “I think you will need a whiff of it in order to get to where you need to be.” My husband and I looked at each other and I think because of our experience with Pitocin previously and not wanting to stall out or anything go wrong, we really struggled with that piece but I think ultimately, we said, “Okay, we’re already here. If this is what my OB thinks this is what I need–” and again, I personally felt okay with moving forward in those directions, “then, let’s give it a try.” She was absolutely right. They started at a 1 and bumped it up 45 minutes later. I was feeling some pressure and I wanted to switch positions. I had the nurse come in to help me. She lifted up the blanket to move me and she said, “Oh, his head is right here.” He had been crowing for we don’t know how long.Meagan: Oh my gosh. Colleen: My husband looks down and he goes, “Yeah, his head is poking up.” My OB gets there. It was super relaxed. She just walked in. She had her sunglasses on. She was just

Katie is a newborn and family photographer based out of Chicago. After going through IVF, Katie was surprised to find out that her first pregnancy was with identical twins. At 33 weeks, she had an unexpected bleed and then another at 35 weeks. Because of placental abruption, she went straight to a Cesarean and her babies were in the NICU for 7 days.Katie wanted to know what a singleton pregnancy and VBAC birth could be like. She found a supportive midwife group through her local ICAN chapter that had around a 90% VBAC success rate! She also hired a doula. As her due date approached, Katie decided to opt for membrane sweeps to avoid a medical induction starting at 38+6 weeks.After four membrane sweeps over the course of two weeks, spontaneous labor began. She arrived at the hospital and her sweet baby was born vaginally just 5 hours later!Though she said she has a low pain tolerance, Katie's VBAC was unmedicated and she also shares her experience with a retained placenta and a second-degree tear. Katie, that is no small feat-- we know you are an absolute warrior and woman of strength!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome to the show, Katie. Thank you so much for being here with us. You guys, Katie is from Chicago, right? Chicago. Katie: Yep. Meagan: She is an IVF mama. She’s got three girls. She is a girl mom and two identical twins and then a baby girl. How old is your baby girl now? Katie: She’s going to be 3 months tomorrow. Meagan: 3 months so still little tiny. Oh my gosh. I love it. So yeah, and then you guys, when she’s not doing the mom thing with all of her girls, she is also a newborn and family photographer which is awesome. Can you share with us your handle so we can come follow you?Katie: Yeah. On Instagram, I’m at katiemichellestudios. Meagan: Okay, katiemichellestudios and we are going to make sure to have that in the show notes so you can go follow her and follow her amazing work. And if you’re in Chicago and you need newborn or family photos, hit her up. Is there a specific– Chicago is big. Is there a specific area that you serve?Katie: I’m in the northwest suburbs but I do in-home sessions wherever. I use a studio in Oak Park. Meagan: Okay, awesome. Then with your stories today, we’ve got a couple of highlights. We have IVF, placental abruption, and sticky placenta. I’m excited to talk about sticky placenta for sure because it’s not something a lot of people talk about that could happen. Then, of course, the twins and all of that. We are going to get into that but I do have a Review of the Week. You guys, I know every single week I know you are probably sick of me asking but I love your reviews. Thank you so much for your reviews and remember, we always accept your reviews. Okay, this is from cassie80. It says, “Extremely educational and super empowering.” It says, “After a traumatic C-section in 2016, on my research journey about VBAC, I came across this podcast and instantly fell in love.” You guys, that just says something to me. 2016 is when she had her C-section and 2018 is when this podcast started. It’s crazy to think that it’s been going for so long but I’m so grateful for all of you guys sharing your stories like you, Ms. Katie, and helping this continue. It says, “I am currently trying for number two and am on a mission to VBAC. Hearing all of these wonderful stories of strength has given me the confidence that I can do it when the time comes. You and all of the women who courageously share their stories are just amazing. You all provide healing and support for all of us mamas.” Thank you so much, Cassie, and I’m so glad that you are here with us and have been with us for so long. Okay, Katie. Thank you again for being here. Katie: Thank you so much. I am so excited to be on this podcast myself because I listened to you guys nonstop my entire pregnancy even before and I always had it in the back of my mind that, Oh, if I get my VBAC, I’m going to come on here and tell my story. I am super excited and thank you for having me. Meagan: Oh my gosh, thank you so much. Let’s talk about these twins. Let’s talk about that birth. Katie: Yes. They were IVF but they were obviously surprise identical twins. My embryo split into obviously identical twins but they were an interesting pregnancy because usually with IVF, the twins are mono-di which means they share a placenta and have two sacs but my girls are actually di-di so they had two placentas, two sacs, so that meant they were a little bit less of a risky pregnancy and a vaginal birth was a possibility. That’s what I was planning on. Everything was pretty smooth up until 33 weeks which is when I had my first bleed. It was just the middle of the night. I got up and I just started gushing. The doctor said that it was a marginal placental abruption. That means it was on the edge of the placenta and it wasn’t a risk to them. Obviously, it was super scary. I thought that I was going to lose them both but everything with them was fine. They sent me home after a few days at the hospital. They just told me to take it easy, but they said it might happen again. It did at 35 weeks and 3 days. I had another bleed. At that point, they said, “They are almost to term for twins.” It’s technically 37 or 38 weeks is when they like to induce for twins so they just said not to risk going any further and let’s just get them out right now. I was planning on a vaginal birth, but because of that abruption and we didn’t know what state the placenta was in and what would happen if there was an induction process that was started, so with the doctors, we decided I didn’t want to risk induction and then needing a C-section anyway for the other twin so we did the C-section. It was a really, really rough recovery and they were in the NICU for a week. One of them needed breathing support and the other one was there for growing and feeding. Meagan: How big were they?Katie: 5 pounds, 3 ounces, and 4 pounds, 13 ounces. Meagan: Okay, okay. Katie: They were a good size. They were overall healthy but it was for me, super duper rough as a first-time mom to twins especially. The breastfeeding journey was really hard. I dealt with low milk supply and they were so tiny that it was hard for them to latch so I ended up exclusively pumping for 11 months. That’s their story. Meagan: Wow. That’s a lot of work by the way for someone maybe who hasn’t pumped a lot. Holy cow. Good job. Katie: Yeah. So when we decided to have a third which was a tough decision for us, my husband was not on board. We ended up deciding that we wanted to experience what it’s like to have a singleton baby and just having a singleton pregnancy hopefully and a VBAC. I definitely knew that I wanted a VBAC and started doing all my research. I found a very VBAC-supportive midwife group in my area. They have a 90-something percent VBAC rate in the hospital which is crazy. Meagan: Wow, yeah. That’s amazing. What do you think they do so differently that a lot of other groups don’t do that makes them so successful? Or are you going to share about it?Katie: I’m not sure. I think the hospital might be part of it, like the hospital policies might be more supportive. They deliver at Evanston Hospital if anyone is interested. Overall, I think the doctors that they work with because it’s a midwife group that they work alongside doctors that when there is a delivery for the midwives, the doctors are also in the hospital. I think the doctors are also very VBAC-supportive so I think that helps when they are working together. Meagan: Yes, absolutely. Katie: That’s that story. Meagan: So you found them. You found the providers. Did you go and ask them questions? How did you feel like you realized that they were supportive? Katie: Yeah. I went on– what’s that group that have a Facebook group all around the country for different areas about lowering the C-section rate?Meagan: Oh, cesareanrates.org? Katie: I’m not sure. They are an organization. Meagan: Oh, ICAN?Katie: ICAN, yes. I went on my local Facebook group for ICAN and I asked around. I got their info. I first went for an appointment with one of the doctors at that practice before I was even pregnant because I was planning for the transfer and I liked that doctor, but then I realized that they have midwives and people really raved about the midwives. They said if you are looking for a more holistic experience and they spend more time with you than the doctors do. I just decided to go that route and somehow picking the midwives made me dive into the whole unmedicated birth side of things as well. I ended up hiring a doula as well. I never thought I’d be someone interested in unmedicated birth. I consider myself to have very low pain tolerance. Meagan: So tell us more about the birth. You have a low pain tolerance but you did go unmedicated?Katie: Yes. I ended up doing it. Meagan: Okay. Did you go into spontaneous labor?Katie: Yeah, it was interesting. I ended up having four membrane sweeps which is not that spontaneous. Meagan: Well, hey. This is the thing. A lot of people ask about membrane sweeps and sometimes people feel, Hey, this is worth it. Let’s do this. Some people don’t. Sometimes it works and sometimes it takes many and sometimes it doesn’t. It’s whatever feels right. So do you remember where you were with the first membrane sweep cervical-wise and how many weeks and things like that? Katie: Yeah, so I wanted to start them. Remember, I had never been pregnant past 35 weeks. Meagan: Right, yeah. Katie: I really thought that I was going to have an early baby again, but that really wasn’t the case. I had her at 40 and 5. So the membrane sweep, I started the first one at 38 and 6 so basically at my 39-week appointment. I had no change after that one. Nothing happened. That’s kind of what I assumed would happen so I had another one the next week at 39 and 6 and at that point, I was 2 centimeters, 80% effaced, and -1 station. Meagan: Okay, so pretty good cervical statistics there for a membrane sweep. Katie: Yeah. So then it was my due date and I was starting to feel more pressure. The mucus plug was coming out and baby was acting super active which I heard can happen close to when a baby is ready to be born but nothing really happened at that point. So then I decided to get my third sweep. I think that was 40+2 and at that point, I was 2.5 centimeters but the same for everything else. But things were starting to happen. I was having more stuff come out and I was like, Oh my gosh. How much longer am I going to be pregnant? Meagan: I’m sure. This is the thing. When you had either preterm or just early deliveries before and then you go past that, it feels like, No. I cannot be pregnant longer than this. This is eternity. Katie: Yes. It was really hard because I had the two-year-old twins also. It was getting to be a real mental and physical struggle. Meagan: Yes. Yeah. Katie: Also, I was doing pumping to try to induce labor and that wasn’t doing anything. Meagan: Yeah. Was it causing contractions at all or was it just causing them and then you’d stop and it would stop?Katie: Yeah, basically it would just cause the Braxton Hicks contractions and nothing else. Meagan: Then it would go away. Katie: Yeah. So I had my third sweep and that one really started to do something because I went into prodromal labor which was a doozy. Meagan: Yeah. You know, that can be a risk of trying a membrane sweep. It can cause some prodromal labor but again, a lot of the time, prodromal labor still does stuff. It’s tiring and it’s exhausting but it’s still doing something. Katie: Yeah, and it definitely did for me. My prodromal labor was a nighttime thing. The sun would go down. I’d put the kids to bed and it would start with irregular contractions. It felt like period cramps then I wouldn’t sleep all night with that. I had that for two nights and then I was finally– Meagan: Typical prodromal. Katie: Then it would go away during the daytime. Meagan: It’s so annoying. It’s like, seriously? Fine. If you’re going to do prodromal, at least do it during the day when I’m awake but don’t take away my sleep. Katie: I know. At that point, I was getting super disheartened. I decided to schedule my induction because if this was going to happen every night, I would have zero energy for this VBAC. I did schedule my induction for 41 and 3 I believe if I made it to that point but I decided to go back and get my fourth membrane sweep June 3rd so the day before she was born. That started something. The midwife was like, “Okay, if I do this, I might see you back here later tonight.” Meagan: That’s a promising thing to hear. Katie: Yeah, so once she did that sweep, I was actually already 4.5 centimeters dilated. That prodromal labor was doing something. Meagan: Um, 100%. Katie: Yep. That morning I had that sweep. We went to get lunch. We walked around. I was starting to right away have contractions and these were during the day so I knew something was up. By 4:00 PM that day, I was feeling it. I was starting to need counterpressure and had to stop what I was doing. Based on what the doula had said, that was when I should call them. I texted her and I told her, “I’m having these contractions that I’m having to stop and breathe through but they are still 10 minutes apart so I don’t know what’s going on.” She’s like, "Okay. I think you need to stay home a little longer. You’re probably not in active labor yet.” I’m like, "No, I think I’m there. Things are really intense.” Despite what she said, I headed to the hospital.It’s a good thing I did because by the time I arrived at 10:00 PM, I was already 6.5 centimeters. Meagan: Okay, nice. Katie: I was very surprised because usually what the doula community says is sometimes when you head to the hospital when you are not in active labor, things can slow down because of the change of scenery and yeah, your body just shuts down. But in my case, it actually was the reverse. I went from super irregular contractions to walking up to the hospital doors and they started coming super regularly like 2-3 minutes apart. Yeah. Meagan: I do feel like the opposite can also happen where our body gets to that final destination and it’s like, Okay. You can do this now. You have this sense of release. What you were saying, yes I’ve seen that too where the mom has to reacclimate to the space and labor stalls a little bit then it goes on, but this one it sounds like it was the opposite where it maybe brought you relaxation and safety. Katie: Yeah. I think maybe part of it was that this hospital experience was so different than my last one. At the last one, it was rushing to the hospital while I’m bleeding. I get there and there’s this rush of nurses. Everyone’s checking me and this time, I waddled up to the hospital. The room was dark. There was one nurse checking me in. I’m just chilling on the bed. I was just relaxed. I think a lot of the things that I did with the doulas to prepare, like they did classes about comfort measures and things like that and I was really trying to use those. I got the twinkle lights set up and got the music so that really helped. By 1:00 AM, I was already feeling the urge to push and I was feeling so much pressure, especially in my butt. I needed counterpressure for every single contraction up to that point then I was like, “No more counterpressure.” I was screaming for my husband to stop doing it because it was starting to hurt. I knew that something was happening. I was on my side trying to get some rest in between and I was starting to give up at that point. I know what they say is when you are starting to give up, you’re starting transition. Meagan: You’re right there. Katie: For me, I was thinking, I need an epidural right now. Meagan: A lot of people do though. A lot of people are like, “I can’t do this anymore. I’m done. That’s that. I need that epidural. I need relief now.” Katie: Yep. I hadn’t had a check since I was admitted. It had been about 5 hours since I showed up or 4 hours since I showed up to the hospital so I was like, This can’t be it. I can’t be ready to push because I’ve only been here 4 hours and it’s my first labor. I was in disbelief but I was like, “I need a check right now because if I’m not close to pushing, I’m getting the epidural.” The doula was trying to talk me out of it. She was like, "Are you sure? What are you going to do if you’re not there?” I’m like, "I’m going to get the epidural.” I was 9.5 centimeters at that point. Meagan: Oh yeah. Right there. Katie: Yeah, and I was like, "Oh my gosh. This is actually happening.” My body was starting to push on its own and it was such a weird feeling. It was so different than my friend’s birth that I photographed. She had an epidural and it was an induction. That’s the only other birth that I’ve seen and this was so different because my body was pushing. I can’t control it. Yeah. That was about an hour of pushing which felt like an eternity and the contractions were actually fine at that point. I couldn’t feel them. I could just feel loads of pressure and the ring of fire which was intense, super duper intense. Then my water broke about 10 minutes before she was born and yeah, she was born. Meagan: You get to 10, your water is probably going out through breaks and baby comes down. Katie: Yeah, I had a bulging bag at the end which is really interesting to feel. She was born at 2:34 AM. Meagan: Aww, that’s awesome. So pretty dang quick. Katie: Yeah. If you don’t count the two nights of prodromal labor. Meagan: Prodromal labor, yeah. But your body was doing it slowly and surely. Each sweep did give you that extra nudge. It maybe gave you some prodromal labor along the way, but it seemed like it was helping and doing something. Katie: Yeah, if that helped me avoid a medical induction, I’m super glad that I did those. Meagan: Yeah, that’s something when it comes to someone facing an induction or facing that hurdle, a membrane sweep might not be a bad idea. But too, with that said, if we go in and we are barely 1 centimeter or our cervix is really posterior and we are 30% effaced, we need to know mentally that if we go for a sweep, the chances of it working is a lot lower. It’s just lower because our body is maybe not ready. It also doesn’t mean it’s not going to work. So like I said earlier, you had that ideal cervical stat. You were that 2 centimeters and 80% effaced. Things were looking good and softer, starting to open and they were able to get a really good sweep but even then, it took time. Katie: Yeah, definitely. My midwives never pressured induction on me. I was pressuring myself mainly because IVF pregnancies– there are differing opinions but some doctors say that you should be induced at 39 weeks and some say you shouldn’t go past your due date because of the placenta not being as good. Meagan: Well, yeah. It’s so hard because– so twins were IVF and was this baby IVF too?Katie: Yeah. Meagan: Okay, that is hard because there are a lot of people who do say that you should induce at 38-39 weeks with IVF and we do know out there that with IVF, the chances of having placenta issues and abnormalities like abruption are increased. Accreta, previa, and things like that. But if everything is going okay, all is looking well, it’s that battle of do we induce? Do we not induce? What do we do?Obviously, your providers weren’t pushing it so they didn’t see any real medical need but then we have other providers on the complete opposite end where they are pushing it hard. Katie: Yeah, in some of my IVF groups on Facebook, basically every single person is induced or has a C-section. It’s pretty rare for a provider to say you can go to 42 weeks like mine did. Meagan: Interesting. I actually don’t know the real stats on IVF placental issues after 38 weeks. Had anybody ever talked to you about what your chance of issues really were after a certain point?Katie: No. The abruption was I think more of a risk factor was that it was twins and my uterus was so stretched but no one really mentioned placental issues or even said, “Let’s look at your placenta after 40 weeks.” They do have the standard ultrasound to look at baby and do the BPP test, but they said that there is nothing really you can see from an ultrasound after your due date. Meagan: We know that ultrasounds can be off by size and by all the things. Katie: Yeah, and she was measuring bigger. She was 85th percentile which was actually true. She was born 8 pounds, 4 ounces so she wasn’t tiny like my twins were. Meagan: Yeah. I Googled really, really quickly. This isn’t even a study. This is just an article on it. I’ll try to get some more studies and things in here but I’m going to include this article. It’s from the Real Birth Company. It looks like they are teachers of birth classes. It’s highlighted. It says, “What do you need to know if you are pregnant through IVF and you’re being advised to have an induction because you are told that there is a higher chance of stillbirth?” It says, “The only study that we found that gives us the information also noted at higher risk of stillbirth for IVF pregnancies, but crucially, they said no increase in their rate of stillbirth after 28 weeks of pregnancy. It just says, “This research therefore tells us that induction at terms would not necessarily reduce stillbirth rates for babies who are conceived by IVF.”Katie: Yeah. From my understanding, it’s hard to do studies on this because a lot of women who need IVF have other health factors which can increase the risk of obviously stillbirth and other issues in pregnancy. Meagan: Yeah, it’s showing that sometimes IVF moms have placenta accreta and placental abruption at a higher risk. It shows that IUGR babies have a higher chance for being smaller. It also says that gestational diabetes and preeclampsia have an increased chance. So like you said, there are other things that they may have. I’m just going to throw this in there in case anyone listening is an IVF mama and wants to know more. It’s interesting that you’re saying that in that group– are they scheduling C-sections?Katie: Yeah. Most women get scheduled C-sections, not scheduled C-sections, scheduled inductions but they end in a C-section because they aren’t ready. Meagan: Okay, so they aren’t necessarily scheduling them right off the bat just because they are IVF. Katie: Right. Meagan: But again, like you said, they aren’t ready and inductions are happening and people are ending up in a Cesarean. Katie: Yes. Meagan: Interesting. Well, this article was written in 2021. I’m also going to put a couple others in here that says actually 2024 so I need to look more into this but it’s something to consider because again, this is a space where we are trying to reduce unnecessary Cesareans. We’re seeing that it’s happening so it might be something that you want to research if you are out there and you are doing IVF, research that and see if it’s something that really is necessary for sure. Katie: This is just my personal story, but my placenta looked perfectly fine at 40+5 with this baby. Meagan: Yeah, so everything was looking good at that point. We did talk about that in the beginning– sticky placenta or really retained placenta. Did you have that with this? Maybe you can talk to us more about the placenta. You gave birth to babe. It was a VBAC that was a lot faster than anticipated and you went unmedicated when you didn’t think you could. I kind of love that so much that you were like, “I have a low pain tolerance,” but then you did that. It just goes to show how possible it is, right? But yeah, talk to us about your placenta. Katie: Yeah. That was actually worse than the pain of the entire birth and something I didn’t expect because I had asked about this because it can be an issue with IVF pregnancies. I had asked about this in one of my prenatal appointments and the midwife said, “We don’t know if you’re going to have that or not. IVF is a risk factor for it,” but since I had the opposite of a sticky placenta. I had a placenta that was coming off the wall. With my last pregnancy, she was like, “I’m guessing that you’re not going to have that,” but I did. After baby was out, my placenta was not coming out after 10 minutes and around 30 minutes, I think they like to have it out by then. So they gave it 10 minutes for it to come out naturally, but my contractions completely stopped. Nothing was happening at that point. My body wasn’t expelling it. They were trying to pull on it. Eventually, it came out but I was still having bleeding when they were pressing on my stomach than they would like to see. They gave me the Pitocin and that didn’t work and then they tried two or three other medications. Meagan: Did they give you Cytotec at all? Katie: Yeah, I think so and another medication that goes in the back in the booty. Meagan: Oh, yes. They usually will insert it rectally. Yes. Yes. Cytotec is not okay when we are pregnant and we are trying to go into labor, but because it makes the uterus contract so hard which is the whole issue with Cytotec and VBAC, it can help reduce bleeding and help the placenta and all of these things. Yeah. Katie: Yeah. They gave me the max dose of Pitocin in my IV and none of that worked. They gave me the Pitocin in the leg and that didn’t work, the Cytotec. Then they brought out the ultrasound machine and scanned around and saw that there were some pieces left inside. So she had to stick her hand up and get them. That was horrible. Meagan: And you were unmedicated. I’m just going to tell you right now that you have a high pain tolerance. I think you might be incorrect on that. Not saying that really, but holy cow. Unmedicated and a retained placenta retrieval scrape– they are essentially scraping and fishing for your placenta. Katie: Yes and she had to go in two or three times. They gave me some kind of IV medication and all it did was make me feel drunk. Meagan: Probably fentanyl. Katie: It was something with a D maybe. Dimerol.Meagan: Dilaudid. Katie: Maybe Dilaudid. It made me feel loopy and nauseous but did nothing for the pain. I was holding my baby the whole time and I just want to forget that horrible experience. Meagan: That is rough. Sometimes placentas “stay sticky” and it really can take up to an hour even for a placenta to come out. Sometimes we don’t know why and like you said, IVF stuff maybe could have helped but the placenta usually is in that 5 to 30-minute period and providers do start to worry if it’s more than that because after we have our baby, our cervix was 10 centimters. It dilated and everything was open and thinned and then it starts coming back and closing again which is the normal process. Katie: Oh my gosh. I didn’t even think of that. Meagan: Yeah, it’s just that normal process where it starts closing so providers start fearing that if the cervix is closed or too small, the placenta can’t move through and then we’ve got the placenta inside and retained placenta is a very serious thing. You want to get your placenta out. It’s an amazing organ and functions amazingly. It raises these amazing babies through these 9 months. It supports them and feeds them but we need to get it out because retained placenta can make you very sick. They start fearing that and sometimes when they are tugging, it can make it so the blood vessels get ripped off or they weren’t ready so then we have bleeding and retained placenta and all of these things. They start fearing it and things like breastfeeding, Pitocin, Cytotec, and all of these things that they are trying to get to help you contract more is an effort to help get that out. But yeah. That is a lot. That’s a lot. You had this beautiful birth and then whoa, quite a lot right there. Katie: Yeah, a bit of a turn and in addition to that, I had a second-degree tear that they also had to stitch me up. I don’t remember if that was before or after the whole extraction. Meagan: Your provider fishing could have caused more tearing. Yeah. There is also a possibility that if for some reason it doesn’t come out that you will have to be taken to an OR which is a more rare circumstance but I’ve had one client in all the 10 years of doing this and she was a VBAC client too actually. She had a beautiful birth and then had to go in and get it manually removed. So yeah, breastfeeding as soon as you can, changing positions and also emptying your bladder is something that you can do because if your bladder is full then it can hold things up so sometimes it’s detached but not coming out so there are things we can do and then of course, taking medication and going a step further if we really need to. Katie: Yeah. Overall though, I don’t regret any of that. It was still such a beautiful birth even though the end and the golden hour took a turn, it still was more than I had imagined. Meagan: Yeah. I was actually going to ask you. Even with that which is a lot, would you still suggest doing it or would you have done it differently if you could go back?Katie: No regrets. The recovery was a million times easier even with the tear and all of that. I was going to the botanical garden 4 days postpartum with my family. Meagan: Oh my gosh. You were out walking around. Katie: Yeah. Meagan: Oh my gosh. That is amazing. That is amazing. Katie: With toddlers, you’ve got to get back to real life. Meagan: I know. It’s so hard to take that break and recover when we have life that is still moving around us. Katie: Definitely. Meagan: Remind me, you said you took Needed’s collagen, right? Katie: I did. Yeah. Meagan: That actually probably helped healing as well. Katie: Yeah. I love that stuff because I wanted to get more protein in. I just put it in my shakes along with all of the other things that I did like the chiropractor and the dates. I did all of the things. Meagan: Yes. And your doulas, do you want to do a shoutout? Katie: Yeah, 3-1-2 doulas and I worked with Heather. Meagan: Awesome. Katie: Yeah, and they have awesome classes too. If you are a doula customer, they are free and if you’re not, you can still sign up for them and they are super great. Meagan: That is so awesome. We love our doulas and to all of those listeners out there, just a reminder. We have a major doula directory from literally all over the US to outside of the US if you are looking for doulas too. You can go to thevbaclink.com/findadoula. We love our doulas so dang much. Obviously, I love doulas so much I became one. Doulas are so amazing. I love that you said you did chiropractic care and dates and all of the things. Are there any other suggestions or tips that you would give our listeners as they are going through their VBAC journey? Katie: Yeah, just listen to these podcasts a lot and you’ll learn so much. Join The VBAC Link group on Facebook. Meagan: Yes. I love that community. Isn’t it just amazing? Katie: Yeah, it’s great. There’s also another VBAC Facebook group that I loved as well. Meagan: Do you remember the name?Katie: I don’t remember. Meagan: There are a few on there. We love– Katie: VBAC Support Group. Yeah, that one’s great. Meagan: Awesome. Katie: Yeah, just believe in yourself. You can do it. You are a badass. Meagan: You are a badass and you can do it. I agree. We’ll end on that note because that is such a true statement. Girl, you are amazing and I’m so grateful for you sharing these beautiful stories today. Katie: Thank you so much 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

Rachel is a professor, an author, and a VBAC mom who is here to share her story from a traumatic C-section birth through a VBAC. This episode really dives deep into how picking the right provider is key to improving your chances for a VBAC. They give practical questions to ask your providers, more than just yes or no, to really get to know their birth philosophy and what qualifications and experiences your provider might have that would make them a better fit for VBAC chances. Rachel and Meagan also give a lot of validation and advice on how to start the process of overcoming birth trauma; it’s reality and to not be ashamed of it. You’re not alone. Through the many important messages of this episode, they both mention many times to trust your intuition. If something feels off, listen to that. And if a change in provider is necessary…it is never ever too late to change. Invisible Labor: The Untold Story of the Cesarean SectionHow to Naturally Induce LaborHow to Turn Prodromal Labor into Active LaborMembrane Sweeps for VBACHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello everybody! Welcome to the show! I am so honored to have Rachel Somerstein on with us today. She is a friend of ours from New York. She is a writer and an associate professor of journalism at SUNY New Paltz. She is an author of Invisible Labor: The Untold Story of the Cesarean Section.  And her writing has also appeared in the Boston Globe, The Guardian, The Washington Post, and Women’s Health. She lives in Hudson Valley, NY with her husband and her two children and is here to share her stories with you today. Rachel had an unplanned Xesarean section with her first child and the experience was anything but routine. I know that there are many of us who have been through this journey and on this podcast, maybe listening today, that also had an unexpected experience and it may have left us with trauma, or doubt, or fear, or all the feelings, right? And so she is going to be talking to us today about her experiences, but then also we’re going to talk about some guidance on how to find peace and to offer ourselves grace and to set ourselves up for a much better experience next time. We do have a review of the week, so I want to get into that and I’m going to turn the time over to Rachel.This review is by Deserie Jacobsen. The review title is “Thank You.” She actually emailed this in and it says, “This podcast and parents course is amazing. I am not a VBAC mom, but I have been listening since 2020. I binge listen near the end of every pregnancy to remind me of everything I need to remember in birth and process through my previous births. This time around I felt more prepared than ever before, having plans in place just in case. We were able to have a quick birth of my 5th baby. I love the education, passion, and love this podcast gives. I recommend it to everyone I know, and I have learned so much from it. I am so grateful for this podcast, thank you.”Thank you so much Deserie for your review! Seriously you guys, I just love hearing that people are finding the information that they need, they’re finding community, they’re finding that they can do this too. Just like them, and all these reviewers and all the people that have shared their stories and all these reviewers you guys can too. This birth, VBAC, is possible too. Better experience is possible. A healing CBAC; it’s possible. You guys, all it takes is getting the information, the prep, finding the provider, to have a better experience.Meagan: Alright Ms. Rachel, welcome to the show and thank you again so much for being here with us. I kind of talked about this a little bit before we started recording about how I think your episode is going to be so powerful and deep and raw too. You’ve got these feelings and these words. I love it. I love reading your book and I can’t wait to hear it from your own mouth. Which speaking of book, can we talk about that a little bit? What kind of just inspired you, jumpstarted you into writing a book about this?Rachel: Well, I’m a writer. And I wrote an essay about my birth about two years after I had my baby, my first birth, my C-section. And I realized I had a lot more to say and also I heard from a lot of moms when that came out and that made me start thinking that I think there was a bigger project. Meagan: Absolutely. And an amazing project that you completed.Rachel: Yes.Meagan: And remind everybody before we get into your stories where they can find your book. I actually have it here in my hands. It’s Invisible Labor. So where all can they find that? And we’ll make sure that we link it. Rachel: Sure, thank you! Yeah, so it’s Invisible Labor: The Untold Story of The Cesarean Section. And you can get it on Amazon, you can get it from Barnes and Noble, you can get it from your local bookstore, you can get it as an audiobook? Or you can also get it as an ebook.Meagan: For the audiobook, did you record it?Rachel: I did not. The narrator is Xe Sands and she did a great, great job. It sounds excellent. Meagan: Awesome. We’ll be sure to link that. I think it’s definitely a book that everyone should check out. There's a lot of power in that book.Rachel: Thank you.Meagan: And it’s not even just your story. I mean there’s a ton. Like if you go through the note section there’s a ton of research in there, and history and studies, and so many really great things. Well okay, let’s hear about the story that started the inspiration and behind this amazing book.Rachel: Sure! Thank you. So like so many moms, I had an unplanned C-section that I was completely unprepared for, which is another reason I wanted to write this book because I think a lot of people go into pregnancy just assuming they’re going to have a vaginal birth and like me, I didn’t even read the parts of the books about C-sections, I skipped them. Because I was not going to have a C-section. Which is whatever, hindsight is everything, right? But I had a totally textbook pregnancy. I switched to a different group of midwives and OB’s about halfway through because I just didn’t have a connection I felt with the providers in the first one. And frankly, I didn’t have a connection with the providers in the second one either, but by that point, I was like well whatever, it’s fine. Which I think is actually, if I could go back and do it again I would have changed that. But you kind of are like, I don’t want to, could I possibly change again? And I think that for people who are VBACing, yes you can and sometimes you actually really need to, even like late on in your pregnancy, people will switch groups or providers even late in the third trimester, so. Meagan: Even if you’re changed already, you can do it multiple times.Rachel: Exactly.Meagan: It’s not a bad thing to find the right provider for you. It’s not. Rachel: It’s not. And It's hard. And you can feel like, Oh my god. Am I really going to send all my records over? It can feel like so much effort and it can really be worth it. I just wanted to say that as someone who switched once and then was like, Okay, I’m done, and wished I’d switched again. So anyways, it was late in week 39 I went into prodromal labor but I didn’t know that prodromal labor even existed because nobody told me about it.  And it was my first baby. So I was like is this labor? I think I’m having contractions, these are not Braxton Hicks. And in the end, we talked to the doula I was working with, and in the end they ended up petering out. And at that, I think that that for me marked the beginning of, this is not going to look like the way I had expected it to look. And again, hindsight is everything. What I wish I had known at the time– and I think this is really relevant to some VBAC moms is that sometimes prodromal labor means that your baby is not in the best position for having a vaginal birth. And I can’t exactly say oh I would have done this or that differently if I’d known it, but it would have helped me understand what I was going into with the labor and the birth. So anyway, I eventually went into labor in the middle of the night. It was exactly my due date and I knew it was different. I could just feel this is labor. And I was really eager to get it going quickly. And again, I wish someone would have said, “Rachel, rest. It’s early. You’re going to need your strength. You’re going to need your energy however your baby is born.” And instead I quite literally was running up and down the stairs of my house to try to push labor along. Which is, I have compassion for myself, I understand why I was doing that. What I really needed to do was get in the bath, or I don’t know, lay over the birth ball. Watch a silly movie, right? The feelings I was having were real pain and I was scared. But you kind of can’t run through this, especially a first labor as we all know, those take a long time, right?Meagan: Yeah. And if we were having prodromal labor, our body may be kicking into labor, but still might need some time to help that baby rotate and change positions. Rachel: Exactly, exactly. And this is the kind of education that is so missing from birth classes. And that is one reason why this kind of podcast is so helpful because that’s how I learned about these different things. I didn’t ever learn about them from a provider being like, “Let’s talk about what will happen in your birth, and let’s talk about why you had prodromal labor.”So anyway, we went to the doctors office where we met a midwife and my doula for a labor check. And I was hardly dilated, I was at a 2 but I was in extreme pain. And I have to say, I have a very, very high pain tolerance and I now know I was having back labor. Meagan: Baby’s position.Rachel: Exactly. And the contractions were like boom boom boom boom. They were not, I didn’t have any rest in between them. Which again, I think my baby was like I gotta get in the right position, this isn’t working out, I’m freaking out, ah! Plus my mom is running around, ah! Right?Meagan: Yeah. Rachel: So we went to the hospital and I was checked in and the midwife who checked me in was like, “Oh you’re actually not even 2 centimeters, you’re just 1 centimeter dilated.” And they checked me because I was in so much pain I think. And I don’t know that that was necessarily wrong,  but again, no one was sort of explaining, “Here’s what we think is going on.” And it’s partly because I believe those providers thought I was exaggerating what I was experiencing physically. They didn’t know me. Well, they didn’t know that I’m usually pretty stoic. They didn’t know that I’m not a squeaky wheel. And I wasn’t like screaming or crying or pounding. I was like quiet and I was like I’m in a lot of pain.Meagan: An intense quiet.Rachel: Intense quiet. Exactly. But that doesn’t look like what we think pain looks like to people. And the fact is that people are very individual and how they express pain especially during labor where you’re already kind of like leaving the regular plane of reality.Meagan: Yes. Rachel: So an important takeaway is like, even experienced providers cannot read your mind and make mistakes in assessing what's truly going on with you. And this comes up later in my second birth, but my husband now does a much better job of saying, “You might look at Rachel right now and think she looks like she’s doing great, but this is what’s really going on with her.” And he does that in a way that’s not like he’s speaking for me in a way that’s annoying, but it’s like I actually can’t advocate for myself, I can’t express this. So anyways, I asked for an epidural. They said that the anesthesiologist was busy. Which may have been true, but may have been they were trying to put me off because I was hardly dilated. And they told me to get in the birth tub. And I remember hanging over the side of the tub and staring at the clock on the wall and being like, I actually don’t know if I’m going to survive this hour. I was just in so much pain. Incredible pain from back labor that was incessant. Eventually he showed up. They hooked me up to all the monitors. At that point, one of the nurses was like, “Oh, you are having monster contractions.” Like the contractions that were being measured were so intense they were going each time to the edge of what was measurable. And now that the computer said it it was like oh…Meagan: You’re validated now. Rachel: Exactly. Right. And the anesthesiologist, it took him three tries to get the epidural working properly which would echo problems to come. But he did, and it took away the pain. And then I was just in the bed and kind of left there. And the nurses and the midwife did not use a peanut ball, they didn’t move me around. And obviously, listen, I’m attached to the monitors. You know you cannot really move that well, the belt slips, and that increases the chances you’ll have a C-section. And there are still things that can be done. It’s not like you’re a loaf of bread, you just lay in a bed. But they didn’t do that stuff and I wasn’t dilating. The nurse and doula eventually basically were like, “Well, we’re going to go out for dinner and we’ll be back in a few hours and we’re going to give you this thing to sleep and if you haven’t dilated by the time we get back you’re going to have a C-section.” And at that point I was exhausted. It’s evening now, I’ve been up since the middle of the night. I’m totally like, what is happening with this birth? No preparation; I took birth classes, I read books, no preparation suggested that this series of events could take place. I felt completely abandoned by my providers, including my doula who I was paying out of pocket. And one thing that came up at this time also was I had this colposcopy in college, like scraping of cervical cells. I didn’t hide it from anybody, I was open. And the midwife said well maybe that’s why you’re not dilating is because of this colposcopy.Meagan: Do you think you got scar tissue?Rachel: That’s what she said. And I remember at the time being like why are we only talking about this now? Why has nobody brought this up in any of the prenatal visits that I’ve done? And I felt blamed. This thing about your body is defective. After a few hours when the midwife and the doula came back and I rested and it was quiet, I had dilated to a 9. And I think what that’s about is that I had been in too much pain to dilate. I was so frozen up and tense and also extremely scared.At this point people are like, “Oh wow.” And finally my water broke,y water hadn’t broken. So you know, things are kind of continuing and I am starting to actually feel even more fear and my room is getting really crowded with people. And the midwife asks me to start pushing. And I was afraid and I was excited. They turned on the baby warmer, and they were like, “Okay, your baby is going to come out.” And I started to push but I couldn’t feel what I was doing. I had no idea. And the midwife was like, “Do you have an urge to push?” And I was like, “No.” The epidural that hadn’t gone well from the beginning had then come down with a very heavy hammer and I felt total numbness. It was not helpful. I needed someone to have turned it off or something, or turned it down so I could feel an urge to push and feel how to push, where to push, what muscles to use. And at a certain point I could tell something was going not right and it turned out that my baby was having heart rate decelerations. So just to sketch the scene. At this point it’s 1 o'clock in the morning, I’ve been awake for 24 hours. I’m exhausted. My husband is exhausted. Neither of us has any idea that things could have gone like this. The midwife says I think it’s time to do a C-section. And I don’t disagree with her. I don’t even know what to think at that point. I’m also feeling tremendous fear. I was like I’m afraid I’m going to die, I’m afraid my baby’s going to die. And the overall sense in the room…and people were like, “Oh no, you’re going to be fine”. And the sense in the room was that I was hysterical and I was not in my right mind. Which I wasn’t in my right mind; I had been awake for a long time, I’d been trying to have this baby, nobody really told me what was going on and I felt totally unsupported. Actually, my response was completely reasonable given the circumstances and nobody really attended to that and saw that and recognized that as completely valid. Plus, I don’t have evidence to stack this up absolutely, but I have since come to find out that there is a medication that some laboring women are given to help them rest and one of the side effects is an impending sense of doom. And I have a friend who had a baby at this same hospital and had the same response after having been given something to rest during her labor. I could go back and look at my records and I may do that but I’m like, well that would explain also why I had the response I did. Meagan: Mhmm.Rachel: Anyway, we go to the OR. I hunch my back for the spinal that the anesthesiologist has to do a couple of times to get it right. I’m still contracting at this point. My body is still like, Come on, let's get this baby out. Let’s get this baby out. And I’m so uncomfortable. And you know that advice to not lay down flat on your back when you’re pregnant, but that’s what you have to do when you’re in the OR. The whole thing felt like I was going to choke under my stomach and very exposed like you are in the operating room. Meagan: Yeah, it’s cold and it’s bright and you’re very exposed. And you can’t move your body normally, especially if you’ve had a spinal. Rachel: And also in retrospect, again I’m like I cannot believe that the first time I learned what happened in a C-section was in my C-section. I really should have at least learned about this even though it would have still been scary and I still would have been surprised. So when the OB goes to operate, he starts his incision and I say, “I felt that.” And he says, “You’ll feel pressure.” And I say, “I felt that.” And he continues operating and I was not numb. I felt the operation. And according to his notes..parts of this I don’t remember…but he wrote it down and my husband has also told me that I was screaming, my legs were kicking. There’s no question that I was in tremendous pain. And I was moaning and it was horrible. And it was horrible for the people in the room too by the way.Meagan: I’m sure. Rachel: Right? Like it’s really important to say that. My OB didn’t listen to me. That is a super common thing that happens in healthcare, especially for women. Especially for pregnant women. He’s not a sociopath. He didn’t want to be evil, but he didn’t listen and the consequences were so steep and so dire. And I think that it was traumatizing to him and I know it was traumatizing to some of the other providers in that room, the nurses to watch this. He kept going and when the baby was born, which I don’t remember, apparently they held her up to my face and they put me under general anesthesia and sent my baby and my husband away and stitched me up. Then I woke up in recovery. The doula and the midwife had gotten the baby to latch while I was unconscious and were talking about me without knowing that I was awake about her latch which really, really bothered me because it just underscored how it felt like I was just a body. And even people who were supposed to be there to take care of me and be tender and advocates, I felt they disregarded me. And under other circumstances I really would have wanted to breastfeed my baby like right away. But I wasn’t even there to say yes I want to do this or no I don’t want to do this. It was a terrible birth and I would not wish it on anybody. Meagan: And I think, kind of talking about what you were just talking about with breastfeeding and stuff, these people in their hearts and in their minds were probably like this is what she would have wanted. We’re trying to help. But in whole other frame of mind over here, I’m not present. I haven’t said those things. And I know you’re trying to help and I know that’s where your heart is, but I’m not okay with this. Rachel: Totally.Meagan: And I think sometimes as doulas, as birth workers, as any one of you listening, remember that words matter. Actions matter. These moms' feelings matter and it’s sometimes in our minds we’re trying to do what’s best, but it might not be. Rachel: Totally. Absolutely. Yes and I again, it’s so important to point out. Yes they were coming from a good place. They really were coming from a good place. But it wasn’t the way that I felt it or experienced it. Meagan: And it left you with trauma and angst and heartache. Rachel: Absolutely. Totally. Yeah. Meagan: Well that definitely sounds like a really rough birth. And it’s so crazy because it’s like you went from not progressing to baby in a poor position, to getting an epidural. I love that you talked about that. That can be an amazing tool. A lot of people are very against epidurals, and there are pros and cons with epidurals. We’ve talked about those. Fetal heart decels is one of them. I don’t think, maybe in this situation it sounds like a lot of other things happened; baby’s position being one of the biggest ones. But that can really be a tool that helps you just relax and be more present and have less trauma. We talk about this in my doula practice of where there’s a difference between pain and suffering. And pain, progressive positive pain that’s bringing our baby to us that’s one thing. But when we’re suffering and we’re so tense that our body’s not even able to try; that epidural could come into great play. But again, we’re not that loaf of bread in a bed and it is important to move and rotate. And it doesn’t have to be drastic. It doesn’t have to be crazy big movements. Just subtle movements to change the dynamics of the pelvis and to encourage our baby to keep coming down. So there were so many things that just went poorly but also went well, and then poorly again and then well and then real poorly there at the end. Rachel: And I think like to your point, I went into my birth I should say, I was planning on having an unmedicated vaginal birth. I was like I’m not going to have an epidural. And I think that if my providers had different skills I would have, I may have been able to have that baby vaginally. And I say that based on what happened in my second birth. So it’s not just like wishful thinking, right? And I’m really glad I had that epidural. I really needed that. I was suffering. The pain I was experiencing was not productive pain. And an epidural can help you with suffering, alleviate your suffering. But it can’t and doesn’t substitute for emotional support. And I think that’s what was missing for me, throughout that first birth. Even if I had gone on to have ok fine, a cesarean, or even a vaginal birth, I still think I would have been like that wasn’t a good birth because I didn’t feel emotionally supported. And an epidural can’t do that. Meagan: Yeah. No an epidural cannot do that. And I, for anyone listening who supports birth, or even who are going for a birth you kind of mentioned it. You’re in this other land and sometimes it’s hard to advocate and open. You might be thinking something and you might so badly want to say it. It’s right here, coming out. And you can’t say it for whatever reason. It’s a weird thing, it doesn’t make sense sometimes but it can happen. But really being heard, validated, understood; which are so many things you weren’t. Right? And when we’re not heard and when we don’t feel safe, and we don’t feel supported, those things leave us with PTSD. In fact there was, in your book, I’m just going to read it. It says, “2022 study by anesthesiology and obstetrics professor Joanna and colleagues found that what’s important about women who feel pain during childbirth is how mothers feel about their pain. And how their providers communicate with them overall…”You were communicating, and no one was communicating to you. “...feeling positively about pain and heard by providers protects a mother from developing PTSD.” And I mean it goes on which is why you need to get the book so you can read more about it. Rachel: Yep. Meagan: But really, feeling heard. Rachel: It’s not just crunchy whoo-hoo feels good, feels right, sounds good. It really matters. And I have to say that I’m participating in and helping to work with providers on designing some studies about providing different pain options for moms during C-sections. We literally had a conversation about this yesterday. And one of things we were talking about is it’s not just the pain. It’s not just pain relief. It’s also being listened to. Because there will be people who are like, I might say I’m in pain, but that doesn’t mean I need an epidural or want an epidural. But I’m feeling pain and I want to be heard and I want somebody to…even if you can’t express this. You can’t even express it because you’re the one having labor. What you’re needing is someone to see you and look you in the eye and be like you’re going to be okay. And I think as mothers we totally are experienced with that all the time. When your child is hurt or sick, part of your job obviously is to get them the help they need, but it’s also to assure them this nosebleed is going to end. You’re not going to have a bloody nose for the rest of your life. Which, when you’re going through something really hard you can sometimes forget, right? And you’re pointing out from the studies this helps to prevent people in birth, in labor, from developing PTSD. The stakes are really high. They matter so much. Meagan: When you were just talking, I don’t know if you saw my eyes kind of well up a little, but I connected a lot with my first birth when I was clinging to a bed, literally clinging. And I was looking at my husband and I’m like, “Do something!” I had a baby in a poor position. I was being jacked full of pitocin. My water had broken, there was a lot of discomfort going on. I had told him I didn’t want an epidural and he’s like what do you want me to do? And I was like I don’t know, I just need something! And I was terrified and desperate. And he was just like… It wasn’t fair for me to put him in that position either but at the same time he was like I don’t know, I don’t know what to do, right? And the nurses were just like we’ll just get you an epidural. And I was like no, I don’t want an epidural. And then it just was like epidural, just went down from there. And I wish so badly that there was something else. Let’s get you out of the bed. Let’s get you in the shower. Let’s give you some nitrous. There was so much more that I could have had, but wasn’t even offered. And I think too, I needed someone to tell me that nosebleed was going to end. Rachel: Yes. Meagan: And it was going to end and it was going to come back every five minutes and it was going to end again and I was going to be okay. And I was going to survive that. And just hearing you talk about that, why my eyes got all welly, is that I don’t know if I realized how much that impacted me until just barely. And here I am, my daughter is almost 13.Rachel: Just like how powerful these things that, I don’t know, this is part of why we have these conversations. They shed different corners of light on our experiences that it’s like oh my gosh, I didn’t even know I knew that. And that’s so why we, even though I’m not postpartum immediately, it’s valuable for me to talk about it too; to hear what you’re saying, you know?Meagan: Yeah. Ah, so after a not-so-amazing experience, going into that postpartum, you’ve talked a little bit about that in your book. Well, not a little bit, you’ve talked about that a lot. Tell us about that journey and then what led you to deciding on VBAC and ultimately going and having a VBAC. Rachel: So I should say, I was really…Talk about not realizing things right away. It took me a long time to figure out how traumatized I had been by that birth. And I was about two years postpartum and I was having a procedure for something else and I just completely, I had a panic attack. I had never had a panic attack before, I didn’t know what it was and couldn’t have explained what was happening. And when the anesthesiologist who did this procedure was like have you ever had any issues with anesthesia, which is exactly the question that should be asked, and I had said what had happened he was so taken aback. He was shocked and didn’t know what to say and walked out of the room.Not in the way of, I’m abandoning my patient, but just like from his perspective here’s this kind of routine thing. This patient is crying and shaking and talking about this very traumatic incident which I had not talked about. I didn’t go to therapy. I had talked about it with friends and my family, it wasn’t a secret, but I felt a lot of shame. I felt like I must have been this total freak of a person that this had happened to me. And after that I remember saying to my husband, I just don’t know if I’m ever going to be able to get over this trauma enough to have another baby. And I didn’t even know if I wanted another baby, like separate from the trauma. In therapy I started to see that I felt very stuck in my life and that included how and whether to grow my family. And that was actually because of the traumatic birth. It just like made this big block. I think one thing that’s important to think about for those who have had a traumatic birth is that sometimes that can show up in your life in ways that you don’t expect. Meagan: Yes. Rachel: And so to be compassionate with yourself about that and also to be open to that. We’re in the era of warnings and trigger warnings and those are important, but sometimes for a traumatized person the things that are triggering or activating are not what you would think. Like for me, I couldn’t watch a scene of a hospital birth even if it was happy without getting very uncomfortable and having to walk away and there wouldn’t be a content warning on that. So it’s just to say be patient with yourself. Accept that…don’t, I guess if you’ve had a traumatizing birth you don’t have to struggle against these things. As horrible as they might feel, as uncomfortable as they might feel it’s normal and it’s ok and it shows up differently for everybody. Rachel: Yeah so I had this big question and then I was like ok, it took awhile for me to be like I do want to have another baby. But I wasn’t ready emotionally. And so I waited. And then about, let’s see, October of 2019, I was like I think that I’m ready to try to have another baby. And we had met this midwife who lived in our community, who my daughter actually made friends with her niece at our public pool which is so beautiful. I ran into her one night while she was walking her dog. She was like your husband shared a little bit with me, if you ever want to talk. And this, I feel like, I could not be more grateful that this person came into my life. She just is, her skills are phenomenal. Just as a clinician in terms of trauma-informed care, and I’ve felt safe enough going to her for prenatal care to decide that I was ready to get pregnant. My joke is that I should tour high schools and be like it only takes once to have unprotected sex to become a parent. And I was really lucky that I got pregnant right away and at that point I was 37. So I should say I had my first baby at 33 and I got pregnant again at 37. And that’s not always the case for people. Obviously it can take a long time and especially after a C-section, secondary infertility is real. Meagan: It is. Rachel: Yeah. Not talked about enough. Really not talked about enough. Meagan: There’s a lot of things, right, about C-sections that is not discussed about. For personal, for the mom, for the individual, the infertility, adhesions, all those things. Just the emotional and the physical. Then even the baby. There’s risks for the baby, the allergies, the microbiome getting messed up. All the risks, it’s just not discussed. Rachel: No, it’s really not. And you kind of only find out later if you’ve had a C-section and you’ve had a problem down the road that you’re like, maybe that’s because of my C-section. It’s ridiculous.So we got pregnant and I was not sure if I wanted to have a VBAC, but I started thinking about it from the beginning. And I also was like, if I don’t have a VBAC how am I ever going to get myself into an OR, I just don’t know. And I really think that VBAC is the under-discussed pain point for moms. And I’m preaching to the choir here but we’re talking about half a million moms every year have to make this decision, if it’s even available to them. Meagan: I was going to say, if it’s even offered. Rachel: If it’s even offered. Which is totally not a given. But theoretically, they do have this decision and I really have not…I should say, in the course of writing this book, but also just being a mom who had a bad C-section and then had a VBAC, I hear from people a lot about their journeys just like on the playground. Every person I’ve talked to, they agonize over it. No matter what they choose, no matter what. Why is that not talked about more? I mean that part of what this podcast is doing that’s so important, but I still can’t believe how under the radar it is, yet it’s such a big deal when you’re going through it. So anyway, I told myself I did not have to decide right away about a VBAC or a C-section. My midwife was like you can totally have a VBAC, you can totally have a C-section. Even if you have a C-section you can keep seeing me. I was worried like oh would I get bumped out of midwifery care. One of the things I’m really fortunate about and that I think is really good about that practice is that she has a very close relationship with one of the OB’s there. Like they kind of share patients, I should say that. And that’s because she’s worked with him for a long time and he really respects her clinical skills and vice versa. The other thing about her that’s unique and that I didn’t know how important it is she’s a Certified Nurse Midwife, so she attends births in the hospital. But she previously had been a homebirth practice and at a birth center as a CNM. So her skills are, like I said are phenomenal. A C-section is truly like we have to do this. I’ve run out of my bag of skills or like the baby or mom’s health suggests that like we need to do this now. She worked with me to work with the scheduler so that I saw her for every visit which helped me to learn how to trust her and she didn’t pressure me. Either way she was completely open. She also worked with me to make sure that I could see her for virtually every visit so that way she earned my trust. And I got to show her who I am. She got to understand me which was really important to the birth. Meagan: Yes, which I want to point out. There are a lot of providers these days that are working in groups. And I understand why they’re working in groups. They’re overworked, definitely not rested. There’s reasons why, both midwives and OBGYNs are working in these big practices. But the thing

We hear SO many of our listeners say things like, “I wish every first-time mom listened to these stories” or “I wish as a first-time mom I heard these stories because I truly believe it could have helped me avoid my Cesarean.” First-time moms, we want to educate you to make informed decisions during your birth. We want your first birth to be an empowering experience, no matter the outcome. And if possible, we want to help you avoid an unnecessary Cesarean.  Meagan shares some of her best tips for first-time moms regarding induction, big babies, ultrasounds, and more. We also asked members of our VBAC Link Community to send in their best tips for first-time moms. We hope this episode becomes a great starting point for you to then go on and listen to the powerful stories shared in our other episodes!VBAC Link Supportive Provider ListEvidence-Based Birth: Evidence on Inducing LaborThe VBAC Link Blog: The ARRIVE TrialNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. This is Meagan and you are listening to The VBAC Link Podcast. I am so happy that you are here. Normally, we have episodes that are filled with VBAC stories, CBAC stories, and guests sharing educational pieces on VBAC. However, today, I’m going to a quick episode for our first-time mamas out there. For years, we have had people write in a review saying things like, “Oh my gosh, I wish every first-time mom listened to these stories. This is not only for VBAC moms or VBAC-hopeful parents. This is for anyone who is giving birth,” or again, going back to the first-time mom, people saying, “I wish as a first-time mom I heard these stories and learned this education because I truly believe it could have helped me avoid my Cesarean.” Women of Strength, if you know someone who is expecting or if you are a first-time mama, listening on how to avoid unnecessary and undesired C-sections, listen up. This is going to be an episode specifically for you. As always, I have a Review of the Week so I’d like to dive into that but then get back into what first-time mamas and what our community wants first-time mamas to know. Today’s review is from Emmalyn. I don’t even know how to pronounce the last name, but Emmalyn. It says, “Uplifted and educated. I have been binging this podcast since I found it a couple of weeks ago and I’m addicted. As I prepare for my HBA2C” so for the listeners who are new, HBA2C means home birth after two Cesareans, “I have experienced so much healing and inspiration through hearing these stories after two attempts for vaginal deliveries with my first two kids. One preeclampsia hospital birth and HBAC (home birth after Cesarean) transfer to the hospital. The content they provide is diverse, thoughtful, and inclusive. There is so much stigma around home birth and VBAC and this is the first and only community plus the Facebook group I have found to truly be welcoming and nonjudgmental. I feel like this is going to be an instrumental tool to my birth prep for my baby coming this Christmas Eve.” You guys, I could not agree with her more. This is a place where we want you to know that you are safe, that you are heard, that you are understood. We in no way, shape, or form believe that there is only one way to birth. There just simply isn’t. We just want you to know your options and feel empowered to make the best decisions for you along the way. So if you are one of these first-time mamas listening today, I am so excited that you are here and I do encourage you to continue going on through all of the other episodes. Women who are sharing their stories likely have had a Cesarean before and I think this is such a great opportunity for you to learn how to avoid a Cesarean by listening through others who have come before you and have given birth and have also learned along the way. I’ll tell you right now that with my first baby, I was not ready to give birth. Although I felt ready, all I knew was that I was pregnant and I was going to have a baby and I could not wait. But there was so much more that I didn’t know that I wish I knew. I have learned throughout the way and I’m going to be sharing some more experiences with you along with, like I said, really tips from our own community members. You guys, I reached out on Instagram and asked for tips for first-time moms and I’m going to go over some of those tips along with learning how to avoid a Cesarean and unnecessary interventions. Here we go. Okay, everybody. Welcome to the show. Thank you for joining me. If you are new to the podcast, my name is Meagan Heaton and I am a VBAC after two C-section mom and a doula who wants to help educate and empower anyone who wants to learn more about their options for birth after Cesarean as well as learning how to avoid a Cesarean from the get-go. I had a Cesarean when I was pregnant with my first. I went into labor at 39 weeks and 5 days spontaneously with PROM which is called premature rupture of membranes. What that means is my body went into labor as far as my water broke, but then nothing really followed for quite some time. Contractions didn’t really get going and labor itself did not start. I, along with many first-time moms, was told that if your water breaks you go straight to the hospital. I went to the hospital and from then on out, it was induction. They wanted to induce my labor and they wanted to intervene instead of just letting my body do its thing. I started getting Pitocin and that led to an epidural. It unfortunately led to a Cesarean. Now, I want to tell you that Pitocin and an epidural do not always lead to a Cesarean but these are going to be common things that you’re hearing in women’s stories along this podcast that do seem to impact the end result of a Cesarean. With my second, I really wanted a VBAC, a vaginal birth after a Cesarean, and I went looking more into what it was and what my options were and what I should do. I ended up staying with my same provider who was a great guy. Do not get me wrong, but he wasn’t the provider for me and I didn’t learn that until after my second Cesarean. I stayed with him and I went into spontaneous labor again with premature rupture of membranes. This one took a lot longer for my body to kick in and unfortunately, I really never was allowed the time. I ended up walking down for a second repeat Cesarean with that one because I was told that my body just did not know how to do it. This is also another very common, common thing that so many Women of Strength are being told. Their body doesn’t know how to do it. Their body can’t progress. Their pelvis is too small. Women of Strength, if there is any pet peeve that I have, it is someone telling another person that their body is not capable of giving birth vaginally. I might sound grumpy about it. Let’s be honest, I am. You are capable of giving birth vaginally. What are some of the things that I would suggest you do as you are going along as a first-time parent?Number one, I really believe that provider is key. If you have a provider who is on board with your birthing desires, that is going to help you so much during your labor and your pregnancy journey. If you have a provider who is very induction-happy, intervention-happy, and pushing you to even schedule an induction before you even reach 39 weeks or 40 weeks or 41 weeks, that’s a problem. That is a red flag. Take a moment if you can. Go to thevbaclink.com/blog or just click the link in the show notes and check out how to find a supportive provider. Now, this blog that we have is how to find a provider who is supportive in VBAC, but I think all around it goes in line with any provider whether you are a VBAC or not. You want to find someone who doesn’t put stipulations on when you have your baby and what happens during pregnancy meaning that if they are requesting or demanding that you do multiple growth scans in your third trimester and there is really no medical reason to indicate the reason to do that, that’s a problem. If they are talking about the size of your baby early on or the size of you and how you look and, “You must be carrying a big baby. You are so petite,” there is already doubt that is being placed. As I mentioned, if they are encouraging an induction at 39 weeks or just getting it on the schedule, let me tell you right now that being pregnant at 39 weeks is not always fun. Being pregnant at 40 and 41 weeks is not fun. There is a lot that goes into it. Your hips hurt. You’re tired. Your pelvis hurts. You’re peeing all of the time. You can’t sleep. Okay, it doesn’t sound that great, right? But it really is such a great time and it’s a time that we need to cherish and really just embrace but it’s hard to do that. That’s the fact. It’s sometimes really hard to do that so when we have providers giving us an “out” to give birth sooner, it’s very enticing. I don’t shame anyone for taking that opportunity of being induced and picking your baby’s birthday, but there are a lot of things that go into that. Now, as a first-time mom back in 2019 I want to say, a study came out and they called it the ARRIVE trial. The ARRIVE trial is where they had a whole bunch of people, and really actually not that many people, but a whole bunch of people in two groups. They had one group where they induced at 39 weeks and they didn’t always have a “favorable” cervix. Favorable versus unfavorable meaning the cervix was showing signs of readiness to give birth. They had these moms in one group who were induced at 39 weeks then they had another group who chose not to be induced or to wait for spontaneous labor but would not let them go past 42 weeks. There were a lot of things that their goals were to point out and study in this trial which you can find out more about on our blog. It’s in the show notes. We’ll make sure that we have the ARRIVE trial link in there. But they really wanted to also see what it did for Cesarean. In the induction group, 79 out of 82 people were induced at 39 weeks. The people in the expectant management group, meaning they were waiting for spontaneous labor or didn’t elect to induce at 39 weeks, 79 out of 80 waited. 44% of them gave birth spontaneously and 56% of them gave birth after induction for medical reasons. Now, medical reasons. There are a lot of things people can talk about or providers can talk about why you should be induced. So let’s talk about some of the main reasons for an induction or some common reasons for an induction that you’ll see but then always, I want you to know that you can question. If someone is saying there is a medical reason for you to be induced, question them. It’s okay for you to question them. It is always okay to say no and question, always. No matter what it is in any medical scene, birth or not birth, you are always able to question and say no or no, thank you. What are some medical reasons? Medical reasons may be preeclampsia. Maybe you’re having blood pressure issues or HELLP syndrome where now your liver is being affected. We’ve got high blood pressure or elevated liver enzymes and it really is best for you and baby to be born and to give birth. So preeclampsia may be one. Maybe you’ve got a unique health condition that is now impacting your personal health to stay pregnant. That may be a reason for induction. IUGR, intra-uterine growth restriction. Maybe your baby is no longer thriving inside the uterus and inside the womb and needs to come out so they can thrive on the outside. If IUGR is happening, that is a medical reason to consider induction. Those are just a few that you may encounter. Some other things may be low fluid– that one can be debatable for sure. It can be serious, or high fluids. There are so many situations. Just know that if you have a situation or if someone is suggesting an induction at 39 weeks or at any point due to medical reasons, discuss that with your provider. Definitely discuss and question and make sure that you are all on the same page and you are really understanding what the medical reason is for your induction. Don’t fear to question the evidence saying that induction is the best route. Okay, so the people in the expectant management group like I said– 79 out of 80 waited. 44% gave birth spontaneously 56% gave birth after induction. So what did this study really show, really, really show about C-section? Well, let me tell you. They really tried to show that it lowered Cesarean rates from 19% to 22% but if you really dig into it deeper, it really doesn’t say if Cesarean really is lowered or not. Between the two groups, there really were no significant difference in birth outcomes for the baby so again they showed that maybe 19% versus 22% were likely to end up in a Cesarean and then they also showed that they were less likely to develop high blood pressure– 9% versus 14%. That is a thing. We do know that blood pressure can elevate in the end, but overall, as of 2024, there really are a few studies that have been able to look at the effects of the ARRIVE trial and have concluded that the elective rate has significantly increased or decreased the Cesarean delivery. This is the problem though. It’s being so heavily– and maybe heavily isn’t the word– done. It’s being so heavily performed all over the world now after this trial came out. For some reason, we looked at that and we’re like, “Yep. See? It impacts the Cesarean rate. It lowers it.” But we are still having a really high Cesarean rate and first-time moms are still, still, still, still having Cesareans after induction is happening. Induction. Women of Strength, that is what we call the women who listen to our podcast, if you are being proposed for an induction or being offered an induction, maybe take some steps back. Do some research. Read our blog. Talk about induction methods. There are also a lot of different types of induction methods. I want to also say that coming back to your provider, if you have a supportive provider who is willing to induce very gently and understands the process of induction especially for a first-time mom whose cervix might not be favorable or ready, you may have a higher chance of giving birth vaginally. But if you are at a place where they like to push inductions really fast on you and all of the things, increase all of the interventions, you are going to likely have an increased chance of Cesarean. In 2023, the rate of C-sections in the United States was 32.4%. 32.4% which is really the highest it’s been since 2013 and just astronomically gross in my opinion. Years and years and years ago, it was 10-15%. Even before that, it was 5%. We are seeing a peak. We are seeing a serious peak and what’s happening is we are seeing a lot of the times first-time moms will have a C-section for whatever reason and then people are being told that they cannot have a vaginal birth after Cesarean, that the option is now gone or they won’t even approach VBAC as a topic. It’s just, “For the future, you will have to schedule a C-section.” Okay, now this is another one. If you are a first-time mom who has a friend who had a C-section and doesn’t know their option, please share this podcast with them. This is such a great place for them to come and learn and know their options. Okay, so let’s dive in. I asked our community. I mentioned that before. What do our community members want a first-time mom to know? What do they wish they would have known before as a first-time mom?One of our followers, Elizabeth, mentions, “Wait as long as it takes for baby to come and to change positions frequently.” Oh my gosh, I cannot agree more. This is what we are talking about, right? Waiting for our baby to come and not inducing unless it really is medically necessary and letting our bodies do what they are made to do and are totally capable of doing.Changing positions frequently is something I highly encourage and as a first-time mom or any mom giving birth, I highly suggest a doula. Doulas are amazing. I know they are not always affordable and I don’t know if you have ever heard of this, but you can go to behervillage.com and you can actually register for a doula so instead of getting all of the million onesies and wipe warmers or a million sized-newborn diapers, you can register for a doula and people can help pay for a doula. It is absolutely amazing. I highly encourage it. Check out behervillage.com. We also have doulas at thevbaclink.com/findadoula. They are VBAC-certified doulas but these are doulas who are trained and educated and certified in helping you avoid a Cesarean so I highly suggest a doula because they can help know what positions to change to and they can help guide you. If you don’t have a doula, that is okay. Change positions frequently. I mean, every 5-10 contractions, if you went from hands and knees and you want to stay on hands and knees, go hands and knees but put a pillow under and elevate that left leg or that right knee. Change things up because changing the dynamics of your pelvis is going to help bringing baby down. One of the main reasons for a Cesarean is that babies are in a wonky position or failure to progress or failure to dilate. That, a lot of the time, is because baby is not in a really great position and movement will help baby get in a better position and help your labor speed along. Okay, our friend, Emily, says, “Wait to go to the hospital.” I mentioned this earlier that I was told when my water broke to go straight to the hospital. Do your research to wait. Learn how long to wait, how long is too long, and again, that’s when a doula comes into play. They are really great on helping to guide you on knowing when to go. Emily also– she has a couple of tips here. She says, “Trust your own intuition and what your body is feeling in the moment.” I could not agree more. Your intuition is huge and if you continue listening to this podcast, let me tell you that you are going to hear about intuition a million times. Intuition is huge. You have it and it’s amazing. It’s super important to follow. Sometimes we question our intuition and that is hard. Try not to question your intuition and again, do what your body is feeling in the moment. Emily says, “I didn’t have a doula and it’s my biggest regret.” Okay, so we were just talking about that. Doulas are amazing, you guys. I didn’t have a doula for my first two. That was also a big regret. My husband was not on board with my second. After I learned about a doula and after having a doula, he said that there is no way we would have another baby again without a doula. They are just incredible you guys and there are actual statistics on doulas. They lower the chance of Cesarean. They lower the time of birth by 45 minutes. 45 minutes might not sound like a lot, but 45 minutes in labor is impactful. They also lower the chances of induction and interventions and they overall help you walk away with having a better experience. Okay, another follower says, “Trust your body. Don’t accept interventions. Plans can change and breathe.” Love that so much. We have Sarah who says, “Ask for help even if you feel fine.” I love that. It’s okay. Use your voice in labor. Use your voice during pregnancy. Use your voice during that postpartum experience. Even if you think you are feeling okay, it’s okay to ask for help or if you have a question that is bobbling around in your brain, ask it. Don’t be scared to ask it. Another follower says, “Be patient with yourself and your baby. Enjoy your pregnancy and push with an open lotus.” I love that so much. Oh my gosh, that just made me smile. We have a follower named Ash. She says, “Be informed so you can make decisions you are happy with under time and pressure.” Okay, this is something, Women of Strength, that we have found through many of these stories. These first-time mamas are going through labor who have not had a lot of education, me being one of them, going into birth. You guys, birth is a very big event. It is a very important day and impactful day. Sometimes things can change just like what one of our followers was saying. Plans can change and that means sometimes things can be offered to you that you don’t really know about. You don’t really know what is being offered to you so you feel like you have to say yes or no. You don’t really know what you’re making the yes statement to so being informed is so important.We have a blog at thevbaclink.com/blog that shares so much information along with this podcast and then we actually have a course for parents to learn how to avoid Cesarean and how to navigate through labor and avoid a Cesarean so if you are interested in learning how to avoid a Cesarean and learning more about what this VBAC stuff is even like, check us out at thevbaclink.com. Gracie says, “Don’t let your doctor pressure you into unnecessary induction.” It goes along with the theme in the first part of the podcast. If you can tell, induction and pressure is something that a lot of first-time, even second and third, oh my gosh, many-time moms have. Ash says, “Have a clear but detailed birth plan.” I love that so much. Birth preferences are so important. As you get informed and get educated, you are going to learn what is important to you, what you want, what you don’t want. We had a story not too long ago how as a first-time mom, she didn’t realize how much her birth experience meant to her until she didn’t have that birth experience. You guys, this is such an important day. Oh my gosh, it’s just incredible and if you can be informed and you can have that clear birth plan– now, let me tell you that some of these birth plans don’t go exactly as you’ve written them down. Go in with an open mind but know your desires and know the evidence and the information behind those desires and why they are important to you. Okay, M says, “Be open to birth preferences changing.” This is just going right along here. Okay, like we were just saying, sometimes they change and it can be really hard. I have a sweet and sour view on birth plans because birth plans are incredible. It helps our team and reminds them what we need and what’s important and what we want, but sometimes if we write them down on paper and they don’t go as planned, we can view them or view ourselves as having failed or like we did everything and it didn’t work so it failed so what’s the use in trying that again or wanting that again? I also want you to know that if you can go into it having an open mind, it can help you. It can help you a lot and knowing again that birth preferences change is so important. Okay, so we have a photographer here. Lilabqz_photography. She said, “It’s not pain. It’s power. Breathe and it will be all over soon.” I love that. These contractions are powerful. They are amazing. Oh my gosh. Okay, hypnobirthingnorthyorkshire says, “You are amazing. First-time mamas, you are. You are amazing.” Everybody listening to this podcast, let me tell you that you are incredible. You are such a Woman of Strength and you are capable of more than you have ever known. Okay, we have another follower who says, “Give yourself all the grace. You did a big thing. You are your baby’s best mama.” Birth is amazing, you guys. It is a big thing and you are incredible for doing it. Another follower says, “Educate yourself and get a doula.” The next one also says, “Hire a doula.” You guys, hiring a doula is a common theme. Like I said, if you are not in a financial means or don’t have the financial means, check out Be Her Village. It is absolutely incredible and can make it possible for you to have the support that you deserve. Rachel says a couple of things here. She says, “Just because you feel good to do all the things so soon doesn’t mean you should. Find someone who will listen to your birth story without interrupting or opinions.” This is more for postpartum. I agree. Take it easy. Even for pregnancy, take it easy. Just because you feel like you can run a marathon doesn’t mean you should. Rest up. Rest easy. Give back to your body. Hydrate. Fuel with good nutrition and find someone who will listen to your birth story without interrupting or opinions. You guys, opinions will come in all around even before you have your baby. I mean, here I am. I’m sharing some opinions. Just find someone who will listen and validate you. You deserve it. Okay, Lauren says, “If you don’t want a C-section, listen to The VBAC Link. You’ll learn so much.” Oh my gosh, Lauren, thank you so dang much for that. That is what this episode is all about, to help you learn how to avoid a Cesarean. Our friend, Jess, says, “Eat to replenish yourself from birth and pregnancy. Meal trains are great.” Oh my gosh, I can’t say that enough. If you haven’t set yourself up for a meal train before and you haven’t had your baby yet or even if you had, they are incredible and they will help your birthing partners so much. Julie says, “Surrender. Surrender it all. Birth is incredible. You’re going to feel so many sensations.” Even if you don’t want to go unmedicated, you guys, you’re still going to feel so many sensations that are new and somewhat shocking but also incredible. You’re birthing a baby. It’s just absolutely amazing.Then Rachel says, “Do your research. Be mentally prepared for either type of birth and recovery and have a postpartum plan or a birth photographer and take pics.” Okay, you guys. Such incredible information. I echo all of them. Obviously, we’ve also been talking about some of those topics. You are strong. You are capable. Don’t let anyone doubt you. Okay? Don’t let anyone doubt your ability. Keep listening to these stories. These stories are meant for you as well. They are meant to help you learn, to help empower, to help grow, and honestly, one mama at a time, we’re going to see the Cesarean rate drop, you guys. We’re going to see it drop. Thank you so much for joining me today. I’m absolutely honored that you are here listening to the podcast and like I said, if you want to learn more about The VBAC Link and what we have to offer along with so many free resources, you can join us at thevbaclink.com. We’ve got the podcast, the blog, the course, resources, and so much more.Oh, and for kicks and giggles, I want to throw out the fact that we have a supportive provider list so if you are looking for a supportive provider whether it’s a VBAC or not, don’t forget to check out our provider list. You can find us at thevbaclink on Instagram, click on linktree, and you’ll find the supportive list there. Thank you so much and take care. 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

“Inhale peace, exhale tension.”Did you know that the cascade of interventions can not only contribute to a Cesarean but may cause one? Melanie believes that was the case with her first birth. Her difficult recovery included going to EMDR therapy to help with her PTSD. Her OB/GYN did mention that she would be a great VBAC candidate. Not knowing VBAC was a thing, Melanie’s research began. Cue The VBAC Link!Melanie vigorously dove into VBAC prep before she was pregnant again. Her journey is one that shows just how powerful intuition and manifestation can be. Melanie went from having PROM with her first to arriving at the birth center at 7 centimeters and even being able to reach down to feel her bulging bag of waters as her baby began to emerge en caul!Other talking points in this episode include:Achieving a VBAC without a doulaHusband support Birth affirmationsRecommended podcasts and booksSpecific ways to avoid PROMHypnobirthing by Siobhan MillerThe VBAC Link Blog: 9 VBAC Books We RecommendThe Birth HourDown to BirthNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Happy VBAC Link Podcast day, whatever day it is that you are listening. We are so happy that you are here. We have our friend, Melanie, from Texas. Texas, is that where you are? That’s where my mind is thinking. Melanie: Yep. Yep. Wiley, Texas just outside Dallas. Meagan: Perfect and did you have your VBAC in Texas?Melanie: Yes. In Dallas. Meagan: In Dallas, okay. We have her sharing her stories with us today you guys. At the end, we’re going to be talking about PROM. Right before we got recording, I was talking about how important I think talking about PROM is which if you haven’t heard lately what PROM means, there are all of these acronyms all over the place when it comes to VBAC birth, but it’s premature rupture of membranes. We are both PROM moms here and so we are very passionate about the topic. If you have had your water break before labor really started and got going in the past, definitely hang on in the end because we are going to be talking more about that and maybe some ways that could or maybe not, we are hoping these are the ways that helped us avoid premature rupture of membranes. We are going to be talking about that and of course, her beautiful VBAC story. I do have a Review of the Week and this is by milka. It says, “VBAC Podcast Review.” It says, “Hi. I love listening to your podcast. I had an unplanned C-section with my first birth and am preparing for my second birth now. I didn’t know what to do to make sure I didn’t end up with the same situation. Hearing so many women’s stories and experiences validated mine but most importantly, I learned so many tips and ideas to help my VBAC. I had a successful VBAC and now recommend this podcast to all expecting moms. Just such a great no-pressure and enjoyable way to learn.” I love that she talked about no pressure because that is what this podcast is about. This is a place where people share their stories, where they share information both on VBAC and CBAC, and all topics when it comes to birth. We want you to just be here, be in this space, and have it connect with you how it connects with you and take these women’s stories and these providers who are coming on and the information given and apply it however, it looks for your journey. Melanie and I were just talking a little bit before the episode about how it just feels so full circle. So many of these Women of Strength who have come on before Melanie here and have shared their experiences and people listening, it really is so impactful. Right, Melanie? You were saying that I was in your ear. We were in your ear and these people’s stories were in your ear doing what? Empowering you. Melanie: Mhmm. Oh yeah, it’s incredible. It feels very full circle to be here. Meagan: Yes. We are very excited that you are and you guys, we are going to jump right into her story in just a second. Okay. The table is yours. Melanie: Okay, so happy to be here. Meagan, like you said, you guys have been in my ear for over a year so it just feels incredible to be here. As I was listening to these stories, I was always hoping to find that birth story that was like mine just to find out what went wrong with mine and also on the flip side, what did people do? What were people seeing in things that went right and how they were able to get a successful VBAC? I was very motivated and inspired by the podcast. I listened to every episode so hopefully, my two stories out there can hit home with anyone. But yeah. I’ll start with, of course, the C-section just briefly. I got pregnant in March 2021 so everybody remembers it was COVID times still. Meagan: Wild times. Melanie: Wild times. Actually, at the beginning of my pregnancy, my husband wasn’t able to come to the appointments. But thankfully, it being 2021, by halfway he was able to come. That pregnancy, I was really healthy. I ran. I’m a big runner so I ran every day. I had no morning sickness. I was very active. I never even until the very end– I ran the day my water broke and I never had that feeling like I didn’t want to be pregnant.Not the case the second time as we’ll hear, but the first time—Meagan: And you do that competitively, right? Did you compete during pregnancy at all? Melanie: I’ve ran my whole life so I ran cross country and track division one in college. Now, I do more marathons. Yeah. I ran both pregnancies. Not anything too crazy. During the second pregnancy, I did run a half marathon. I was 16 weeks but then it went downhill after that. But yeah. I run pretty competitively. I take it really seriously and it’s a passion of mine. Yeah, the only thing I got the first time and the second, but I did. I’ve heard it before on the podcast is SPD, symphysis pubic dysfunction. The first pregnancy, so the one I’m talking about, a prenatal chiropractor literally cured it. I had to go back a couple of times because it would get out of alignment again, but for anyone who is suffering from SPD like I was both times, it’s amazing. I would just call them witches because they would literally cure it and it would get me back to running. It was amazing. So my birth education the first time around, I thought I was educated like so many women here. I read the typical What to Expect When You’re Expecting. I did a podcast but it was more so of what size is your baby? What’s going on in utero? I didn’t listen to many birth stories and I became so obsessed with that the second time. And truly, I feel like you get the best birth education through birth stories because you just get the whole shebang. We did take a hospital birth class and now I know that a hospital birth class is really just the hospital policies. I remember there was a section that they had mentioned very quickly in passing, “If you’re going to have a C-section, you should take this class. Okay, the next thing.” I thought like so many women, That’s not going to be me. I’m not going to have a C-section. I’m healthy. I feel great. Most C-sections are not planned so I feel like it really did a disservice to not even mention anything about a C-section in that class, but anyway, I just assumed that you have a baby in the hospital. You get an epidural. You take a nap and then you wake up and you push out a baby. I was not against hospitals or anything. I was not against the epidural or anything like that. I mentioned that I ran the day my water broke. This was past 40 weeks. 40 weeks came and went. A couple of cervical checks I got I was not dilated at all. They had scheduled a 41-week induction date. When I was checking out at the front desk at the time, I just remember it feeling really, really wrong scheduling that date. Meagan: Your intuition was speaking right there. Melanie: 100%, yeah. Of course, I didn’t realize it at the time. It was my first baby and everything but when I look back, that just felt so wrong. 41 weeks came and I was supposed to go in at 9:00 PM that night but the interesting thing is that my water broke actually 4 hours before I was supposed to go in. It was 5:00 PM and I was supposed to go in at 9:00. Like you mentioned Meagan, it was PROM so it was a trickle. I was like, Wait. Am I peeing? What is happening here? No contractions at all. And with the little education I did, I knew that just because your water breaks, it doesn’t mean that you have to go in and you should labor at home as long as possible. However, because I was set to go in and I guess because I was 41 weeks, I called them and I just remember they were like, “No. You’re in labor. Come in.”I was like, “Okay.” Meagan: This is labor? Melanie: Yeah, I was like, “Oh, okay.” So I got to the hospital literally not dilated at all. I was maybe half a centimeter and they inserted the Cervadil at 9:00 PM which hurt really bad because it turns out if you are not dilated, it really hurts to get Cervadil inserted. Meagan: And if your cervix is posterior, it’s hard for them to get it into your cervix so that can also cause a lot of discomfort. Melanie: That’s exactly what it was too because I think they had a hard time. I didn’t even think about that. It was probably posterior. Man. Yeah, see? My body just wasn’t ready for that. But contractions did come eventually. I don’t know if Cervadil can cause it or if it was just time. I was going into labor but that was around 1:00 AM. The contractions started to get uncomfortable. I had not practiced coping with contractions at all because I was planning to get an epidural. I never had any inkling of going unmedicated or anything so this is where I think everything went south.This is where I just think it was the cascade of interventions. First I had fentanyl which I don’t know why because I think I was trying to delay the epidural for whatever reason. I don’t know why. I had fentanyl first. It was awful. It felt like I was so drunk. The room spun and it was terrible. Then an epidural, which has fentanyl in the epidural. That was fine. After the epidural, of course, you feel amazing, but you are stuck on your back forever. I just think this cascade of interventions, being stuck on my back, not moving, I never ever take medicine as it is. I think my body and my baby just hated all of this. So then eventually, terbutaline was given around 6:00 AM. Meagan: To stop the contractions. Melanie: Yep. I think that’s when some decels started happening then they did pull the Cervadil to stop the contractions. There were some decels then yeah, eventually it’s all a little bit fuzzy but at 6:45 AM the decision was made for a C-section. At 8:01, he was born. They called it an emergency C-section and now I look back and I’m like, yes. I do believe that it was needed. However, I’ll never really know but I really think it was caused and also, if it’s an emergency, I understand that they don’t wait hours like they did for me and they usually put you under. I think it was more unplanned and I look back and I really think it was caused. Meagan: That is the hard thing to know. A lot of these Cesareans, I would agree with you that they are caused by the cascade of interventions and things like that and then a lot of providers will say “emergent” so there are emergent Cesareans where we need to get this baby out quick and then there is a crash where they do put people under with crash Cesareans. But if they are waiting for hours, it’s almost like they gave the emergency title to make themselves feel better or make it look valid to justify that Cesarean. Melanie: Yeah, I definitely agree with that. That experience was really awful for me. I think for some women, I think it’s awful for a lot of women and then I think for some, it’s not that awful. For me, no skin-to-skin. I know that’s not very common at all. It felt like it was forever for them to bring him to me. No one was talking to you in this moment and I just don’t think these doctors realize in the moment that you’re being robbed of something that you envisioned and a really important experience. It just felt like forever for them to give him to me. It was 30 minutes or so. He was fine. He came out completely fine with great APGARS. I was fine. It just ended up in the way I didn’t want it to. I did have PTSD from that experience because I was having a lot of flashbacks to it. I went through some EMDR therapy. I had a great therapist and of course, I talked to her about it. She was there for my VBAC as well. But yes. That postpartum was just– the healing sucked. I just felt really awful and I think mentally, it took a really big toll on me. Breastfeeding was really hard. A lot of that I attributed to my C-section. It was not desired. It was just not great. So that was the first birth. I never knew VBAC was a thing or a big deal at all. I don’t even think I knew the term VBAC. I went to the 6-week post-doctor’s visit and I remember she was like, “Yeah, you’d be a great candidate for a VBAC. However, you have to go into spontaneous labor by 39 weeks.” I’m sitting here like, okay. He was just a 41-week baby. My mom has a history of going late. I don’t think that’s very likely that I’ll go into spontaneous labor by 39 weeks so I already made up my mind that I wasn’t going to go with her. I learned later that that is a very common thing that hospitals and OB/GYNs will say to you. Yeah, that was the first one. So then cue The VBAC Link. I started listening to The VBAC Link Podcast before I was pregnant. Maybe my son was a year old and I binged every episode. You and Julie were in my ear a ton. The thing that I heard from The VBAC Link was that the likelihood of a successful VBAC for many of these women did happen out of the hospital and like you yourself, Meagan. That’s not to say that of course, you can be in the hospital. You can have an epidural and get induced and have a successful VBAC, but when I just heard the overwhelming thing was how much of a better chance you have. I should also mention that my husband works in medicine too. He’s a physician assistant. I will talk about that. He had a little bit of a hard time just with the safety aspect of it. But once I let my mind go toward the possibility of an out-of-hospital birth– because I wanted a VBAC so badly. I was so motivated. Then I realized that it was something that I actually really desired, a physiologic birth and unmedicated. When I look back, I think that’s why I had such a hard time mentally with my first birth because I think I didn’t know that I cared how my babies come into the world and I wanted to experience that. I don’t know and in some weird way too, it felt like doing an unmedicated out-of-hospital birth made me almost feel connected to my ancestors. It seems really weird, but I was like, this is what they did. I just think it’s something really cool that our bodies do. I wanted to experience that. But I do. I recognize that it was a trauma response for me for sure to become obsessed with research. I binged all of the episodes. I would look for anything related to VBAC. I read so many books and I actually toured. I had a neighbor and a friend who was pregnant at the time and she was going with the birth center that I ended up going with. We would go on walks and she would talk about her experience and how amazing and wonderful it was. I was just like, man. I want that, especially knowing that we were planning to most likely have just one more child. I hated to have that thinking of, this is my last chance, but I did. Meagan: I understand that so much because my husband told me that too and I was like, “I really want this VBAC. I really want this VBAC.” Melanie: Yeah and that’s okay. We’re okay. It’s okay if we have these desires and these wishes. You only get one life. It’s okay to want what we want. I’ll never forget. I toured the same birth center that my friend was at and again, I was not pregnant yet. It was an education class. I was like, let me just see what these midwives are all about and what birth centers are like. It just immediately– again, it’s that intuition. It immediately felt so right. I remember I walked in and just before even finishing the class, before we even really heard them out, I just knew that this was where I wanted to give birth in my next pregnancy. It felt so right. And also, I’ll never forget. I had asked questions about VBAC because unfortunately, not all birth centers support VBACs which I don’t understand, but I had asked a lot of my questions related to VBACs and I remember the midwife saying, “Well, unfortunately and fortunately, we do a lot of VBACs.” I’m thinking, why would I not want to be with a provider who does the most VBACs? Hospitals don’t do a lot of VBACs comparatively. A lot of people are like me. They go to a birth center because they really want a VBAC. That just was really calming to me. I felt like I was with experienced hands. I was safe and there also was not really anything different about a VBAC. I’m with people who understand and trust birth. I brought this up to my husband and I mentioned that he had his reservations because he’s a physician assistant and he works in orthopedic trauma but he was in PA school, he had to do OB/GYN rotations. He unfortunately saw some bad birth outcomes so to him, the hospital was a safety net but I was so, so grateful that he was supportive of my desire to go out-of-hospital even though it seemed kind of crazy to him. He came to– we had one meeting with the midwife so he could ask questions and everything. She was so great and answered all of his questions and I actually was unknowingly pregnant at the time. I didn’t know it.Meagan: No way. Melanie: It’s really weird. I toured the birth center first by myself and it’s almost like my body needed that to be like, boom. You found the place where you are going to give birth and then I got pregnant. It was really weird. We were trying but also, it takes my body after coming off birth control some time so it still was a shock. I was like, oh wow. So anyway, the second pregnancy was much harder as I mentioned. I was not able to be nearly as active. I ran that half marathon like I mentioned and then– it was the Dallas half– then my body just went downhill. It was much, much harder. My sleep was horrible. I have an Aura ring and it tracks your sleep and everything then at the end of the year, it will give you a summary of every month’s sleep. I will never forget because I got pregnant in September and it’s like, January, February, March, April everything is fine and you look at the bar graph time series and it plummets in September. It stayed that way. It was my deep sleep. My deep sleep really, really decreased a ton. Maybe that’s normal and I just didn’t know that the first time, but I did not tell many people I was going with a birth center. I lied about my due date which I learned from this podcast which is very smart to do. I highly recommend it just because I didn’t want to let in any of that negative energy or anything. The couple people I did tell, I did get a couple of people who would be like, “Oh, they’re going to let you do that,” like the “let you” language. Meagan: We both did the same thing at the same time with the air quotes. The “let you”. Melanie: Yeah, exactly. I don’t blame them. I just think that a lot of people don’t have that birth education. And in hospitals, it’s very normal to do a repeat C-section even though we all know it’s not evidence-based. So very briefly, I want to talk about the prep that I did in this pregnancy that made such a huge difference for me. Number one, all of the podcasts like I mentioned. This one, of course. The VBAC Link, I binged it. I found the Down to Birth podcast at the end and that’s a really, really good one. I know everybody does The Birth Hour as well which is good but that one has everything. I loved the more VBAC-specific ones. Then also, they haven’t produced any episodes in a while but the Home Birth After Cesarean Podcast was really good too because they were all unmedicated. I was hoping to do that and they were all VBACs. Then books– I read a lot but these were my favorites. Of course, Ina May’s Guide to Childbirth. Emily Oscar’s Expecting Better is really good. Natural Childbirth the Bradley Way is a little outdated but that one I really loved. It really taught me what productive contractions looked like because I didn’t really experience labor the first time. I never made it past a 3 the first time. I didn’t know what that meant. I didn’t have coping mechanisms. They really focused on breathing. The best book I read and I hadn’t heard this one on it. Maybe you know of it but I had never heard about it but it was Hypnobirthing by Siobhan Miller. There are a lot of books on Hypnobirthing but Hypnobirthing by Siobhan Miller. I was just thinking of Hypnobirthing as a possible way to cope. That book was the best book because I really like the science, the physiology, and what is actually happening in your body when you’re getting contractions and how do you work with your body. It just had such a great way of explaining all of that.That was the last book I found. I was 3 weeks away from my guess date. That one was great. She also creates the Freya app if you’ve heard of that. The Freya app times contractions and it helps you with breathing. They give you a lot of mantras. Yeah. That book was amazing. I did get the Freya app too. I did not know I was going to rely on it so much in labor. Also, in that book, it was really big on affirmation cards. I would make affirmation cards then I would read them in the bath and sometimes practice my breathing through the app. I did some pelvic PT and then, of course, the prenatal chiropractor like I mentioned, I continued to do that. Like I mentioned, the care with the midwives was great. Very positive language. I noticed what was really important to me was not, “I hope I can do this,” because of course, I hope that. But my midwives were amazing because every time, they would just speak it. They would say, “You are going to have a beautiful, redemptive VBAC.” They would just say that. Of course, I know I am 50% of the birth story. The baby is the other 50%. Of course, I know that but it was so important for me to have that positive language. I really worked on my mindset this time around. I only followed accounts that served me. I unfollowed news accounts. I had to be very careful about what I watched and things like that. I don’t think women realize how important our mental state is. I get very sensitive. Meagan: Yes. So talking about that, protecting your space, our bubble, or whatever it may be. Protecting our space is so important because mentally, like you were saying, I don’t know if people really understand how precious our mental space is but mentally, if we are thrown off, it is sometimes really difficult to get back onto that rail. I had a situation on Facebook in a VBAC-supportive group. I’ve talked about it in the past. I was so excited to announce that I was going to birth outside of the hospital. I also wasn’t telling people that I was birthing out of the hospital. I didn’t really tell people my plan I thought I could in that group and I wasn’t supported. I had to leave that. Sometimes it means leaving groups. Sometimes it means staying off social media. Sometimes it means muting people who may be sharing their opinions or telling people flat-out, “I appreciate you so much but unfortunately, I can’t have you in my space,” because mentally, they are not serving you well. Melanie: 100%, yeah. I hate that that happened to you and I know that happens to so many women. It’s just so unfortunate and I hate that there is such a stigma with VBAC because if you do the research which people who have really “easy” births don’t have a reason to really do the research but if you are like us where we are all very motivated to have a VBAC because we already have this stigma going against us, it’s all unwarranted. It’s not evidence-based to not be supportive of a VBAC and if you really research and do the stats, you realize that it’s not a big deal. The craziest thing that I heard on the Down to Birth Podcast was, “You have a chance of uterine rupture even as a first-time mom.” Meagan: Yes, you do. Melanie: It’s not that much higher as a VBAC and first-time moms go their entire pregnancy never once hearing about uterine rupture but yet if you are a VBAC mom, that’s all you hear about. So it’s so crazy to me. Meagan: Yeah. Yeah. So mentally, you were unfollowing. You protected your space there. Is there anything else that you would give tip-wise to protect your mental space?Melanie: I think just believing in your body and believing that we are made to give birth. I think that’s a really big one. Of course, like you said, unfollowing and maybe not talking about it with people, unfollowing accounts that do not serve you. I think the most important thing, I know we’ve heard it a million times on this podcast, but where you give birth and who you give birth with is the single most important thing because you want to be with a provider who believes that you can do it, whoever that is. Yeah, believing in yourself. I think that’s going to look different for everybody of what they need. For me, I am a data person so I needed the stats. I needed to read the books and also listen to lots of women who have done it before me. Meagan: Mhmm, love that. Melanie: So okay, here we are. I was 40+5 so again, not 39 weeks with spontaneous labor but 40+5. I woke up at 5:00 AM to what I thought was contractions. I had some Braxton Hicks at the very end which I never experienced before. I didn’t know if maybe it was prodromal labor but it didn’t feel like Braxton Hicks because it was waking me up. I just tried to move through them a little bit. They were coming very, very sporadically. I would get a short contraction one time an hour and this went on for most of the day and they were not long at all, like 30 seconds. In my mind, I’m thinking, I’m a hopeful first-time vaginal birther. So I’m like, okay. This could be 24 hours. It could be 48 hours. Who knows? But I did not want to waste any energy timing the contractions so I was just guessing the whole day. It was a Sunday. I stayed home with my toddler. Yeah, I should mention that he is 2.5 so I waited about 2.5 years between the two births. So yeah. I just labored at home with my toddler and my husband. We are big track fans so it worked out perfectly. There was a Diamond League track meet on so I did the Miles Circuit while I was watching that. I texted my midwives and kept everybody updated but I think again, we all thought I still had a ton of time. Then I would say around 4:00 PM that day, I started to notice them a little bit more. They were still pretty inconsistent. I would say maybe 8-10 minutes apart and still only 30-45 seconds long. That was something I learned from again, that Bradley Method book I read is that productive contractions for most women– I will say not for me. We will get into that. But for most women, they are a minute plus. Those are the most productive contractions. I texted my midwife then that I felt like it would likely be that night. I felt pretty confident that they were coming but I was like, it could be the middle of the night. It could be tomorrow morning. Who knows. She texted back and she advised that I take some magnesium, take an Epsom salt bath and then go to bed and try to reserve my energy for when they are 4-1-1. We had a birth photographer this time so I texted the birth photographer. I texted our friends who I’m so grateful for. We had a neighbor and a friend who was going to come to our house and be with my toddler. So, so sweet. Yeah. I took the magnesium and then my husband, Brandon, drew me a bath and then disappeared with our toddler. I sat in the bath and I was reading my affirmation cards. This makes me so emotional but I discovered that my husband had snuck in his own affirmation cards into my pile and that’s when I found them. Oh, it was so sweet. Meagan: That’s adorable. Melanie: I know. It still makes me cry when I think about it because it just meant so much. It makes me so emotional. It was super sweet and one of the best things he’s ever done for me. I found those and was reading through them in the bath and just trying to relax and really work with the contractions. I know from my research that you need to relax. To get them to be productive contractions, you have to relax. You have to get your body out of the way and it will go faster that way. They really started to ramp up when my husband was putting our toddler to bed around 7:30. I got in the bed and I put the pregnancy pillow in between my legs. I lay there and was trying to establish a pattern. Yeah. I know manifestation sounds pretty woo-woo but I want to say and this is where I’ll start sprinkling these in because there were 10 things that I had manifested or really, really prayed would happen and I was very intentional that I really, really hoped that this happened. This was the first one. I don’t know why I had envisioned laboring with my dog. You have a dog. You understand. My dog is my firstborn. She is my baby. I love her. You know, birth is so primal so I was just like, She’s going to know. She’s going to know when I’m in labor and she’s going to know what to do. She did. She followed me. I didn’t even realize it at the time. She followed me in my bed and I took a picture with her at 8:19. She was lying next to me on the bed as I was going through these contractions and it’s a very, very special memory for me. I was already starting to get the labor shakes at this point. It’s 7:30 and laying down in bed did really help to establish more of a pattern but they still were not a minute long. They were 40-50 seconds long. Then I moved to the toilet as many women do at this point, backward on the toilet. I lost more of my mucus plug because I had lost it sometime earlier in the day then at some point, I looked down and realized that I was having my bloody show. Again, none of this I had ever experienced before with my first. My husband was an absolute rockstar in this moment. He was so cute. He was running back and forth between the toilet and then packing up the car because I think he realized it was starting to get pretty serious. He brought me water and he put on the back of the toilet, cleaned it, gummy worms and things. That was not what I wanted at that moment but it was super cute. Oh, and I should mention that I did not have a doula so he was kind of like my doula. I was trying to prepare him as best as I could beforehand but he didn’t need it. He did really well. I know the hip squeezes are great and I learned that from this show of course. As they were coming, I would scream at him, “Hip squeezes! Hip squeezes!” He would come over and do it and he did awesome. He was saying that I left my body in this moment and I was possessed because when I was having a contraction, again, I was trying to do the deep moans and really trying to relax but it’s just funny. He was telling me about it after and he was like, “Yeah, it was like if you were looking at it from the outside, it’s like you were possessed then you would scream at me and just moan.”Then by 9:24, they were coming. I mentioned they were not a minute long, but they were coming on top of each other. So every 2.5-3.5 minutes apart, but still not quite a minute long so my husband was calling the midwives and she still was like, “Well, they’re not quite a minute. Just have her keep laboring at home until they are a minute.” Eventually, he called her back and I think he put it on speaker so she could hear me and that’s what did it. Meagan: Uh-huh. She’s like, “Load her up.” Melanie: Yes. Because we live outside of Dallas. The birth center was in downtown Dallas so it’s pretty far. It’s usually a 45-minute drive for us so I think my husband was just like, “I don’t want to have a car baby.” Meagan: Sure. Melanie: Yeah. It was ramping up. So yeah. She called back. I mentioned the Freya app. I really relied heavily on the Freya app because when you are timing the contractions, it helps you with the breathing, in for 4, out for 8, and then one of the mantras I learned from that Hypnobirthing book that I did not know I was going to rely on so much– and I think you never really know when you’re going into it and when you’re in labor. You never know what’s going to stick. My mantra that I must have repeated to myself 500 times was, Inhale peace, exhale tension. Every single contraction, I just repeated that over and over and over. I was trying to make it until 10:30 PM when we called them again, but that’s when we got in the car and started heading there. He made it to the birth center in 33 minutes. The car ride was not fun like many women talk about. I think I hardly opened my eyes and I was just timing them, repeating my mantra, Inhale peace, exhale tension. I arrived at the birth center at 11:00 PM. I had a contraction on the step right there as I was trying to get out of the car and trying to make it. I eventually made it inside and I had my first cervical check of the whole pregnancy. I again, something I had manifested was that my two favorite midwives would be there and they were. One of them, she wasn’t even on call but she came anyway. So many sweet things happened. I got on my back. She asked if she could check me and I was like, “Yes. I really want to know.” One thing again, I manifested that I really wanted to be at least a 6 when I showed up. The first thing she said was, “You are much farther along than you ever were with Rhett.” You are a 7 and you are very stretchy. I can feel your bulgy back of waters and the baby’s head is right behind it. That’s the other thing. We mentioned PROM. Here I am and my water still had not burst and it was amazing. Being on my back felt awful by the way. That’s why I just don’t understand. Being unmedicated in a hospital must be so, so hard because I know a lot of the times they want you to be on your back and I just can’t imagine because that was the worst position ever. She started filling up the tub right away. Like many women, I was like, “I have to poop.” I get on the toilet and I was like, “I swear I do.” But no, I don’t. Nothing was happening but it feels like I do. I got in the tub right away. I did a couple of contractions. They were still coming on top of each other. I was sitting down and eventually, I moved to hands and knees. Very shortly after, that was very fast. That was only about 5 minutes after getting checked. Very shortly after, my body was starting to push and I was like, “This can’t.” I mentioned something. I don’t really remember this but I mentioned something to my midwife about how it seemed to soon to push. I was like, “You just checked me and I was a 7-8. Why is my body pushing right now?” I was really wary of a cervical lip or a swollen lip which I learned from this podcast. I can’t remember exactly but she said something to the nature of, “If your body is ready to push, let it push. This is your body getting ready to birth your baby,” which is again, something else I had really, really envisioned. I would have loved my body to do the pushing and it did which was amazing. My water had not broken still at this point and the really cool moment was that the baby was en caul for a while. I remember her saying something on the phone about baby being en caul. I was birthing the sac before I birthed the baby. It felt like a water balloon. She kept telling me, “Feel down. Feel the sac.” It felt like a water balloon coming out of you. It was so weird. Yeah, my midwife stayed behind me so quietly the whole time. I never knew she was there. My husband set up my birth playlist and music and he just was such a rockstar in this moment. He was getting a cold rag and putting it over my shoulders which felt amazing, getting water and electrolytes and continuing to help me with that. Yeah. My body pushed for about 30 minutes and I don’t want to scare anybody, but truly, that was the worst part. I remember– I guess maybe it’s the ring of fire, but I just remember feeling like my body was ripping in half. But then it goes away. Meagan: Yeah. It’s intense. It’s intense. Melanie: It’s so intense. I don’t think anything can really prepare you for that. I follow that account, Pain-Free Birth. I don’t understand and I would watch videos of women who were smiling and they look great. I’m like, oh my gosh.

“Labor is supposed to happen naturally. It’s not this big medical intervention that occasionally happens naturally. It’s this natural process that occasionally needs medical intervention.”Paige Boran is a certified nurse-midwife from Fort Collins, Colorado. She and her colleague, Jess, practice independently at A Woman’s Place. They have rights to deliver babies at the hospital but are not employed through the hospital system so they are not subject to physician oversight. Their patients benefit from a low-intervention environment within a hospital setting but without the restriction of hospital policies.Lily Wyn, our Content Creator and Social Media Admin, joins us today as well! Lily shares why she chose Paige to support her through her current VBAC pregnancy. Lily is a beautiful example of how to diligently interview providers, keep an open mind, process past fears with the provider you choose, and what developing a relationship looks like to create an empowering birthing experience. Paige shows us just how valuable midwifery care can be, especially when going for a VBAC. If you’re looking for a truly VBAC-supportive provider, this is a great episode on how to do it! The VBAC Link’s VBAC Supportive Provider ListA Woman's PlaceHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Paige: Yeah, so I’m a certified nurse-midwife. I work in northern Colorado in Fort Collins at A Woman’s Place. We’re a small midwifery-owned practice. Right now, there are just two CNMs. That’s the whole practice. It’s just me and my colleague, Jess, who owns it which is really cool because we get to push the boundaries because we are not really locked into the hospital system. We are able to catch babies there but we are not actually employed through the bigger hospital systems which is nice because we don’t have that physician oversight and stuff like that. I think we are able to do a lot more and honor that midwifery care model which is really cool. Sometimes people feel locked into policies and their overseeing physician and things like that but when it’s just two midwives, we get to do what we want and what feels best for the patient. I really like that. That was a big thing when I first got into the certified nurse midwifery world. I was like, where do I want to work? I had offers from bigger hospital systems and it just didn’t feel like the right fit so working at a small, privately-owned practice felt like the right answer for me so I was able to practice in a way I felt was right for people. I didn’t want to be locked in by a policy and overseeing physicians. I just wanted to grow with other midwives. Meagan: Yes. I love that so much. I don’t know. Maybe I should say I know it feels to me– I don’t know it as an actual fact, but that feels like a unique situation and a unique setup to me. We don’t really have that that I know of here in Utah. We either have out-of-hospital CPMs or we have in-hospital CNMs who are just hospital. I know that one hospital system is trying to do the attached birth center, but it is still very different. They are still the hospital umbrella midwives I guess I could say. So is that unique or is that just something that feels like it?Paige: I think it’s unique because where I came from in Florida, if you were a CNM, you 100% practiced in the hospital which we do but it was that you were owned by a larger group of physicians essentially. Florida was working towards independent practice when I was there. Colorado is an independent-practiced state for nurse practitioners which is really cool because we don’t have to have that oversight. I don’t know if Florida ever got there but I know it varies state to state on if you have to be overseen by a physician or not. Honestly, that’s why a lot of people when they are ready to become a midwife, if they don’t have independent practice rights as a CNM even if they are a nurse, they will go for a CPM which is a certified professional midwife because they actually have more autonomy to do what they want outside of the hospital because they are not bound by all of the laws and stipulations which is interesting. Meagan: Exactly. I think that’s a big thing– the CPM/CNM thing when people are looking for midwives. Do you have any suggestions about CPM versus CNM? If a VBAC mom is looking at a CPM, is that a safe and reasonable option?Paige: Absolutely. Yes. I think CPMs and CNMs are both reasonable, safe options. They both have training in that. They both can honor your holistic journey. I would say the biggest thing is who you feel most connected to because I think trusting your team, you will have people who have the worst birthing outcome and horrible stories but they are like, “I look back and I feel so good about it because I trusted my team.” I think that is what’s important. If a CPM seems like your person and that’s who you are going to trust, then that’s who you should go for whereas a CNM, if that seems like that’s your person and who you trust, I think that would be a good route too. I think a lot of people think, “Oh, they do home births. They must catch babies in a barn and there is no regulation. Even sometimes when I say, “midwife,” people are like, “What? Do you dress like a nun and catch babies in a barn?”Meagan: Yes, this is real though. These are real thoughts. If you are listening, and not to make fun of you if you think this, this is a real thing. This is a myth surrounding midwifery care, especially out-of-hospital midwives where a lot of people think a lot of different things. Paige: Absolutely. Meagan: I think I had a chicken chaser or something where a dad was like, “Do you chase chickens?” I was like, “What?” He said, “Well, that’s what the midwives do so that’s what the doulas do.” I’m like, “What? No, we don’t chase chickens.” Paige: That is such old-school thinking but realistically, midwives started in the home and that was their history. It’s cool that they’ve been able to step into the hospital and bring some of that back into the hospital because I think that is needed. Meagan: It is needed, yeah. Paige: We are starting to see that physicians are starting to be a little bit more holistic and see things in the whole picture, but I’m glad that the midwives did step into the hospital because I think that needed to be there but I’m so glad that people are still doing it at home because I think that is such a good option for people. Meagan: Yeah, so talking abou the midwives in the hospital, a lot of people are talking about how they are overseen by OBs. Is this common? Does this happen where you are at? You kind of said you are separated but do the hospital midwives in your area or in most areas, are they always overseen by OBs? Paige: Not necessarily. It would vary state to state and hospital to hospital. We actually just got privileges and admitting privileges a couple of years ago. Actually, my boss, Jess, who owns the practice where I work, had worked in Denver where they were allowed to admit their patients and everything. They didn’t have to have any physician oversight but when she was there, she had to have physician oversight. She was like, “It’s an hour drive north, why would that make a difference?” It was the same hospital system so she fought when she bought the practice and the physician who owned it prior left, she was alone and she had to have that physician oversight so she fought for independent practice privileges and she got it. Some of the midwives at first weren’t so happy about it because they had liked being overseen by the doctor and someone signing off on all of their things. Some of the midwives were like, “Finally. We should be able to practice independently.” It’s going to vary at each place. But I think that’s a good thing to ask, “If something is going wrong, will a physician just come unannounced into my room in the hospital?” That’s not the case with ours. We have to invite them in and if we are inviting them in, we’ve probably had a conversation multiple times with the patient where it’s like, we need to have this. Meagan: Yeah. For the patients who do have the oversight of the OBs, do you have any suggestions? I feel like sometimes, at least here in Utah with my own doula clients when we have that situation, it can get a little confusing and hard when we’ve got an OB over here saying one thing but then we’ve got a midwife saying another. For instance with a VBAC candidate, “Oh, you really have a lower chance of having a VBAC. I’ll support it. I’ll sign off, but you have a really low chance,” but then the midwife is like, “Don’t worry about that. You actually have a great chance. It is totally possible.” It gets confusing. Paige: Yeah, and it’s like, who do you trust in that scenario? I think that’s where evidence comes in because I think midwives and physicians both practice evidence-based but some people may have newer evidence than others. I’ve worked with OBs who probably roll over in their grave when I say certain things because it wasn’t the old way but it is the new way. If somebody can come in with their own evidence and they’re like, “I’ve looked into this and I think I’m a good candidate for x, y, and z,” I think physicians respond well to that because they are like, “Okay, they’ve done their research. Maybe I need to do some research.” Meagan: Yeah. Paige: When they have that thought, they know that this is an educated person and I can’t just say whatever I want and they’re going to take my word as the Holy Bible. Meagan: Yeah. No, really. Exactly. It always comes down to education and the more information we can have in our toolbelt or in our toolbox or whatever it may be, it’s powerful so I love that you point that out. I think it’s also important to note that if you do have two providers saying different things, that it’s okay to ask for that evidence. “Hey, you had mentioned this. Can you tell me where you got that from or why you are saying that?” Then you can discuss that with your other provider. Paige: Yeah, and following intuition too. I think you can have all of the evidence in the world. What is your gut telling you too? Who do you trust more and what feels right in your body in the moment? I think we are all experts of our own bodies and there’s a lot that goes into a VBAC and stuff like that. It’s more than just the evidence. People have to feel mentally and physically ready for it too. I wish more people focused sometimes on the mental and spiritual aspect of it because I think a lot of people get ready physically but maybe mentally they weren’t prepared for the emotional switch there. Meagan: Totally. Thinking about that, Paige, I mean Lily, tell us a little bit about why you went the midwifery route. I know you really wanted to find the right provider. Lily: Yeah. So I think for me, I have always been drawn to midwifery care. I was a little bit of a birth nerd prior to even working for The VBAC Link or even having my own kiddos. Prior to my son, we had a miscarriage and an ectopic pregnancy so I experienced OB care with my ectopic. I was bounced around a lot in a practice and had OBs who were great and equally some OBs where it was such a rushed visit that I had an OB miss an infection in my incisions because my pain was dismissed and just some really tough stuff. When it came to getting our rainbow rainbow baby, I was like, I really don’t want to be in a hospital at all. I want midwives. That’s the route that we went. The very brief story of my son is that he flipped breech 44 hours into labor and that’s when we legally had to transfer to the hospital and I had my Cesarean. So in planning my VBAC, I planned to go back to the birth center and was a little devastated when it was out of our financial means this time. I was so panicked. I remember texting you, Meagan, and being like, “What do I do? I can’t be at the birth center anymore and I don’t want to be in a hospital.” We interviewed another birth center that’s about an hour away that is in network with our insurance and talk about trusting your gut, it just didn’t feel right. It didn’t feel warm and fuzzy. Those are the feelings I got with our first birth center. I loved them so much and I still do. Then I met with Paige and her practice partner, Jess, and I came in loaded to the teeth. I was prepared to fight with someone because that’s what I had in my brain and that’s what I expected. I sat down with them. They met me after hours after clinic. I sat down with my three pages of questions and by the way, if you are listening and you have questions, we have a great blog on it and some social media posts of the questions that I specifically used. We talked for over an hour and every question I asked, they just had the ultimate answer to. I felt so at peace after talking with both of them and I remember telling my husband going into it, “I’m really worried that I’m going to like these people because I don’t want to deliver at a hospital and then I’m going to have to choose a far away birth center that is out-of-hospital or providers that I like but it’s a hospital.” It just feels like everything has been serendipitous for us. Our hospital opened a low-intervention portion of their birth floor so I’ll still get to have the birth tub and all of the things, but truly have just been blow away by Paige and have just buddied up. She’s dealt with all of my anxiety in pregnancy and VBAC and all of my questions. It just feels like such holistic care compared to my experience with OBs in the past. Meagan: That is so amazing and I was actually going to ask how has your care been during this pregnancy? It sounds like it’s just been absolutely incredible and exactly what you needed. I remember you texting me and feeling that, oh crap. I don’t know what to do. What do I do? You know? I just think it’s so great that you have found Paige. Did you say that Jess is your partner? Paige: Yes. Meagan: Jess, yeah. I’m so glad that you found them because it really does sound like you are exactly where you need to be. Lily: Yeah. It made a huge difference for me and I just tell Paige all the time I truly didn’t know that care in a hospital setting could look the way that it does. I feel like I’m getting– I experienced birth center care. I had an out-of-hospital experience until we transferred and I can say with confidence that my care has been the same if not better with Paige and just having the conversations and the good stuff and feeling really safe and confident. One thing that they pointed out that I thought was great when I went in and asked all of my questions is that Jess looked at me and she was like, “Okay, it sounds like you have a lot of anxiety around hospital transfer.” And I did. With my son, that was my worst fear and it came true. I had a lot of anxious, what if I have to transfer? She was like, “The thing is there is no transferring. We can induce you if you need to be induced and we can come with you into the OR with your Cesarean if that ever happened to be another thing.” For me, that brought a lot of peace to know that no matter what, the provider that I know and feel comfortable with is going to be with me. I again, didn’t expect to feel that way, but it’s been a really great reassurance for me personally. Meagan: Yeah. It’s the same with a doula. Knowing that there’s someone in your corner that you know who you’ve established care with who can follow you to your birth with you in your journey is just so comforting. So Paige, I wanted to talk about midwifery care and also just lowering the chance of Cesarean. Sometimes people do choose midwifery care specifically because they are like, “I think I have a lower chance of a Cesarean if I go the midwifery route.” Can we talk to that a little bit?Paige: Yes, that’s true. A lot of people know that there are benefits to midwives but I think when people think of midwives, it’s just like, “Oh, it’s just a better experience. I trust my team more.” That’s definitely there. There have been studies and people felt more at peace and empowered through their birthing journeys with midwives than they did with OBs. It’s been studied but there is also a decrease in C-section risk. Your C-section risk drops 30-40% when you have a midwife which I think is a pretty significant drop. Meagan: Yeah. Paige: Yeah, especially when we look at the United States at our birthing outcomes and birthing mortality and C-section rates, it is way too high for as developed of a country as we are. I think that’s really where midwifery care is stepping in and starting to help lower those rates to get it down to where it should be. The World Health Organization has been nominating and promoting midwifery care because it really is the answer to how we get these C-section rates lowered and these bad outcomes lowered. Midwives also have lower chance of an operative vaginal birth. That would be with forceps or a vacuum or an episiotomy so lower chances of those things as well. Lower chance of preterm birth which is interesting and probably because one, we do take lower-risk people. I think that’s true but also because we are looking at it holistically. We are looking at everything. We are not just looking at you as a sick person. A lot of people look at pregnancy as an illness and pregnancy is not an illness. It’s just a natural part of life and we’ve got to look at the whole picture of life if we’re just going to look at the one thing too. I think that helps to reduce preterm birth risk. We also have lower interventions just overall. We’re more in tune with people’s bodies and we want to honor what their bodies are meant to do. Labor is supposed to happen naturally. It’s not this big medical intervention that occasionally happens naturally. It’s this natural process that occasionally needs medical intervention. The midwifery model is so important. I think when you go to the traditional medical model, you look at the present illness so they see pregnancy as an illness. What can go wrong? Don’t get me wrong. There are a sleu of things that can go wrong in pregnancy and you do have to watch for them. But I think with midwifery care, you know when to use your hands but you also know when to sit on them. Meagan: Yes. Oh my gosh. I love that so much. I feel like we need– we used to get quotes from our podcast episodes and turn them into t-shirts and I feel like that is a t-shirt podcast quote-worthy. Oh my gosh. It’s a worthy quote. That is amazing and it’s so true though. Paige: It is. Meagan: It’s not to rag on OBs. You guys, OBs are amazing. They are wonderful. They do an amazing job. We love the. But there is something different with midwifery care. You mentioned preterm birth. I remember when I was going through my interview process to have my VBAC after two C-section baby and I finally established care mid-pregnancy because I switched. That was one of the things in the very beginning that my midwife was like, “Let’s talk about things. Let’s talk about nutrition. Let’s talk about supplements. Let’s talk about where you are at.” It was just honing in on that which I was surprised by because I figured she’d be like, “Let’s talk about your history. Let’s talk about this,” but it was like, “No. Let’s talk about what we can do to make sure you have the healthiest pregnancy,” but also started commentingo n mental stuff. It helped me get healthy in my mind. I just would never have had that experience with OB where they wanted to learn what I was scared about and what I was feeling and all of those things. Not only was I learning how to nourish myself physically, but mentally and it was just a really big deal. I do feel like it played a big impact in my labor. Paige: Yeah. A lot of people discredit how much nutrition and debunking fears and stuff like that can go because I think a lot of that– I mean, we look at nutrition-wise and we could avoid almost all of preeclampsia with nutrition alone which is incredible. I’m like, “I really think you should read Real Food for Pregnancy and people are like, “Oh, but it’s such a big book,” and I’m like, “But it’s so important to know this information about what we should be putting in our bodies.” 100 grams of protein– you’ve already got it. Meagan: I want to see how many pages for it. It’s got, okay. We’ve got 300 pages but it has recipes and all of these amazing things in the end so it’s not even a full book. Paige: Yes. People are like, “Oh man, I don’t know if I want to read the whole thing,” but I’m like, “It’s so important.” I think when people do read it, they come back and are like, “Did you know that I could decrease my risk of this if I ate more Vitamin A?” I’m like, “Yes. That’s why I wanted you to read this book.” It is a wealth of information and I have such healthier pregnancy outcomes when people follow that high protein diet and looking at micronutrients with their Vitamin A, their choline, and all sorts of things. Meagan: Yeah. All of the things that we talk about a lot here on the podcast because we are partnered with Needed and we love them so much because we talk about the choline and the Vitamin A and the Vitamin B’s and the Vitamin D’s. Lily Nichols, not this Lily on the podcast today, she also wrote Real Food for Gestational Diabetes and that’s another really powerful book as well. But yeah. It’s just hard because OBs don’t tend to have the time. I think some OBs would actually love the time to sit down and dig deep into this but they don’t have the time either. I do think that’s a big difference between OBs and midwives. What does your standard prenatal look like? When a mom comes in, a patient comes in, what do you guys do through a visit? Paige: Yeah. We follow the standard what everywhere in America does like once a month roughly in the first trimester and second trimester then when you hit 28 weeks, every 2 weeks, and then when you hit 36 weeks, every week. If you go to 41, we’ll see you twice in that week. We follow those stipulations but our appointments are a little bit longer. When you are in a big practice, a lot of time it’s driven by RVU use so the more patients somebody can see, the more they are going to get paid and the bigger their bonus is at the end of year. A lot of people feel like they are running through the cattle herd and they’ve been in and out in 15 minutes if that. At my practice, it’s a little bit different because we are not RVU based. We’re not getting any bonus. We’re not trying to see as many patients as we can. Will we ever be the richest at what we do? No, but that’s okay with me and Jess. We are small on purpose and we love to take the time. At Lily’s appointments, we always book her for at least 30 minutes because we know that me and her like to talk. We’ve done an hour for some people because we know there is always going to be that long conversation. Don’t get me wrong though, that fourth mom whose had three vaginal births and going for her fourth, she may be like, “Paige, there’s really nothing to talk about today and that’s okay.” Sometimes they are 15 minutes. Sometimes they are 30. Sometimes they are an hour. Our first appointment is always an hour because there is just so much to dive into with how we can be preparing ourselves, what does your history look like especially if they are brand new to our practice and we’ve never met them before, starting to build that relationship early on. It just depends on how far along they are, who the person is, and those things. But I do like that I can spend as much time as I need. Sometimes I tell my people, “Bring a book because I tend to get behind because I tend to talk to people longer than I book for,” but that’s okay. We know that we can do that because we are a smaller practice. I think when people are thinking about what kind of care they want, they should probably consider how are these people paid? Is it by how many they can see in a day? Because you’re probably going to get a different level of care than a practice that isn’t drive by those RVUs. Yeah, that’s a really good point. I feel like my shortest visit with my midwife was 20 minutes. Paige: Yeah. Lily: Yeah. Meagan: Which to me is pretty dang long because when I was going with my other two daughters, I think it was probably 6-7 minutes if that with my provider. I mean, it was get in. My nurse would check my fundal height and all of that and then oh, the doctor will be in here. Then came in, quick out. Yeah. It is really, really different. Lily: I know for me too, I love that we don’t just talk about nutrition and things like that but even in my last appointment, I was talking with Paige about the things that can be triggering coming back into labor and going back into a hospital so my ectopic pregnancy was at the hospital that I’ll be delivering at and I had to go into the emergency room and the way that you go to labor and delivery after hours is through the ER so Paige and I were talking. She was like, “I can just meet you outside. We will badge you in and we will avoid the emergency room if that feels triggering.” It’s just those things that you don’t get with an OB necessarily to talk through tiny little triggers. They are probably generally less accommodating to those little things of, “Well that’s just the standard. You’re going to have to get over that and just go through the ED and come on up.” I think that’s been huge. I also have a dear friend who is going to school to be an OB. I told Paige at my last appointment that she may possibly be at my birth. She’s my crunchy friend so she’ll be a great OB but I have such a desire to be like, “Come see a VBAC. Come see it so that you have it in your brain and you know that they can be safe and look at what can be done,” so I think that is so huge too as we continue to train and uplift our next generation of providers. What does that look like to show them? I think her internship or something is going to be a midwife and OB partnership practice which is really cool but I’m like, “Yes. Come. Come to my birth. Please. I want you to see all the things.” That’s really cool too and that Paige is open to, “My friend might be there.” Meagan: Yeah. Paige: Bring whoever. Meagan: I love that. I love that you were pointing out too this next generation of providers. Let’s see that birth and VBAC is actually very normal and very possible because there’s a lot of people who have maybe seen trauma or an unfortunate situation which could have happened because we blasted them with interventions or could have happened out of a fluke thing. You don’t know all of the time. But I do think if we can keep trying to get these providers, these new provider to see a different light, we will also see that Cesarean rate drop a little bit. We really, I always tell people that we have a problem. They’re like, “It’s really not that big of a deal.” I’m like, “No, it’s a very big deal. It’s a very, very big deal. We have a problem in this medical world.” I do believe that it needs to change and midwifery care is definitely going to impact that. I hope that what you were saying in the beginning how policies don’t trump a lot of the midwives. I wanted to ask you. This isn’t something we talked about, but is it possible to ask your midwife, “Hey, what policies do you lie under?” Is that appropriate? Paige: Yes. Actually, that was one of my favorite things when Lily came in to meet and greet us. She came and she was like, “What are the policies for a VBAC?” We dove into that. We’ve been diving into that and what are we going to be okay with and what are we not going to be okay with? That’s the beauty is that I’m not employed by the larger hospital system that I work under so I feel like a policy is not a law. I feel like there is informed consent and I think informed consent is so important but at the same time, there is informed declination and you should be able to decline anything. That’s true. We can never force anybody into surgery. We can never force anybody into anything. I think a lot of people aren’t having those conversations where it’s actually informed so then people are like, “Oh, they are just refusing everything.” I hate the word refuse because no, they are not refusing it. They are declining it because they are informed. They know the risk. They have all the information at their fingertips and they know that this is the best decision for them and their baby and we have to honor that. That’s why I’m really glad that I’m able to practice in that way, but I do know I’ve met and I’ve worked with people who feel like they are boxed in and have to follow those policies. We’ve started to talk about what our policies are with TOLACs and VBACs and things like that. One of them is that they are supposed to have two IVs. I’ve already gone against that before and I’ve had a beautiful, unmedicated VBAC. She walked in. I said, “We’ve talked about it. She was also laboring outside when we talked about it. It’s not an issue when you come in. You know what? When we get up there, I’m just going to tell them that you know why they recommend two IVs and you are declining.” She walks in and she’s clearly going to have this baby within the hour. I told the nurse, “We’re not doing the IVs. We’ve talked about it. We’re going to decline them.” That was the end of the discussion. We didn’t have to talk about it again which was nice. She shouldn’t have had to advocate in that moment for herself. We’ve already had those conversations. Meagan: Yes. Paige: Another one is continuous monitoring and the whole idea is if you start to rupture, that’s how we are going to catch it. The baby is going to tank and that’s how we are going to save the baby’s life. Don’t get me wrong. I think continuous monitoring can be really valuable for a lot of things but it’s actually not evidence-based. We have not improved neonatal outcomes with continuous fetal monitoring. We’ve talked about that with Lily and she’s going to opt for intermittent oscillation and I think that’s very appropriate because she plans to go unmedicated. Let’s be honest, if you are unmedicated and your uterus starts to rupture, moms will tell me that something is not right. This is beyond labor. Her saying that and being aware of that, we would notice it a lot sooner than we would the baby tanking kind of thing. Meagan: Yeah. I do know that with uterine rupture, we can have decelerations but like you were saying, there’s usually so many other signs before baby is actually even struggling and I know a couple of uterine rupture stories where providers didn’t believe the mom that something was going on because that one thing wasn’t happening. The baby wasn’t struggling. Paige: Yes. Meagan: It’s like, you guys! When it comes to continuous fetal monitoring in the hospital, people have to fight to have that intermittent. It’s yeah. Anyway. These policies are not law. I love that you said that too. There’s another t-shirt quote. Paige: I think people should start asking if they are planning a VBAC, start asking what is the policy and start thinking, is that what they want? I do have some moms who are like, “No, I want the two IVs because it’s hard for me to get a stick,” and they need that backup in case. That makes them feel more at peace but other people are like, “It makes me feel like a patient. I don’t like it.” People don’t like needles and that’s okay. They have that right to say no. I tell people that in a true emergency, we will get an IV in you if something really, really bad were to be happening. That’s part of training if somebody walks in off the street. We’re not going to be like, “Oh, when was the last time you ate? Sorry, you can’t have the surgery.” We know something bad is happening right now. We will get the IVs. We will do all of the things. Getting the IVs really won’t save as much time as people think it will. Meagan: Yeah, and there are other things. Say we are having our baby and we are having higher blood loss than we would like or we have some concern of some hemorrhaging, there are other things that we can do. We can put Pitocin in a leg. We can do Cytotec rectally. There are things that we can do. We can get that baby to our breast and start stimulating and try to help that way. There are things that we can do while we are waiting for an IV, right? Paige: Yes. I tell people that all the time. Most of the postpartum hemorrhage meds that we use can be given without an IV. There is only one that truly has to be given through an IV and that’s TXA but the rest can all be given other routes. A lot of times, those work better than IV Pitocin. Sometimes the ion Pitocin works better. Sometimes the ion Methergine works better. It’s not this, oh we have to have a little just in case kind of thing because if there was a just in case moment, yes. We can be working on the IV and doing other things. I have to be kind of secretive about it. I have tinctures and stuff with shepherd’s purse and yarrow. Those things actually have great evidence. They are really helpful for postpartum blood loss. I have a lot of moms who are more interested in doing something more holistic and natural before they try medication. Cypress essential oil, you can rub that in. I’ll have doulas use my cypress roller and give them a massage while I’m trying to manage the hemorrhage and that cypress oil can help a lot too. Sometimes going back to our instinctual, old medicine that we have been using well before medicine was used for birth. Meagan: Yeah. This is a random question for both of you. Lil, I really wonder if you have seen it or heard about this too because you are so heavily in our DMs. This is going to be weird. People are going to be like, what? But I did this. We did this because we weren’t sure. We cut the umbilical cord and put it in our mouth. It’s really weird. Paige is like, what? You put it down in the gum area like in between your teeth and your cheek. It sits there. Okay, you guys. I’ve seen it just a couple of times, myself included. Yes, I put my umbilical cord in my mouth. Yes, it’s weird. Paige: That’s okay. Meagan: It felt like a little gummy. It was fine. I wasn’t chewing on it. It was just sitting there. But anyway, it’s weird but with my other client too we did it and all of her hemorrhaging symptoms just went away. Paige: That’s cool. Meagan: I know this is really random but we just cut a little piece of our umbilical cord and put it in their mouth. Paige: That’s so interesting. So a piece of the umbilical cord or the entire thing once it’s clamped and cut and still attached? Meagan: They clamped and cut it, cut a piece, and put it in my mouth. Paige: I would be so willing to try that. I mean, what is there in that nun? Meagan: I don’t know. I don’t know, but it did diminish the hemorrhaging symptoms. Paige: Cool. Meagan: So very interesting, right? Okay, so are midwives restricted when it comes to VBAC on what they can accept? Lily, you are a VBAC. I was a VBAC after two C-sections. You can obviously take Lily. Could you accept me?Paige: Yes. Luckily in midwifery care, at least in Colorado, there is a lot of gray for certified nurse midwives. It’s not always black and white. VBACs are okay but there is no direct, “Oh, if you have this many C-sections, we can’t do it.” I think that’s because ACOG also strangely doesn’t have an opinion on that. They actually agree. There is limited evidence beyond one C-section. My practice has done several VBACs after two Cesareans. I don’t think we’ve ever done one for a third or greater than two probably because I think those people a lot of times don’t even consider VBAC and they just already have been seeing their doctor for their repeat C-section with each pregnancy. But I’d love to see more people going for a VBAC after multiple Cesareans because I think VBACs after two Cesareans have a whole different level of feeling empowered after that. I thin that’s really cool and even special scars and stuff, there is really limited evidence on all of these things and I’d like to see more people pushing the limits a little bit. Especially since I am in a hospital, I do have an OB hospitalist on call 24/7 at the disposal of my fingertips if I need them. We are close to an OR so I think if for somebody the fear is there and they are like, “I just don’t know if it’s more risky because of this,” I think it’s worth it to try because the more people who go for it and are successful, the better evidence we’re going to get from it. Meagan: Yeah. That is exactly what I am thinking. There’s not a lot of evidence after two Cesareans because it’s just not happening. It hasn’t really been studied and a lot of that is because people

Happy National Midwifery Week!We are so thankful for and in awe of all midwives do. Great midwives can literally make all the difference. Statistical evidence shows that they can help you have both better birth experiences and outcomes.Meagan and Julie break down the different types of midwives including CNMs, CPM, DEMs, and LPM as well as the settings in which you can find them. They talk about the pros and cons of choosing midwifery care within a hospital or outside of a hospital either at home or in a birth center. We encourage you to interview all types of providers in all types of settings. You may be surprised where your intuition leads you and where you feel is the safest place for you to rock your birth!Midwifery-led Care in Low- and Middle-Income CountriesEvidence-Based Birth Article: The Evidence on MidwivesArticle: Planning a VBAC with Midwifery Care in AustraliaThe VBAC Link Supportive Provider ListNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, hey, hey. You guys, we’re talking about midwives today, and when I say we, I mean me and Julie. I have Julie on with us today. Hello, my darling. Julie: Hello! You know, sometimes you’ve just got to unmute yourself. Meagan: Her headphones were muted, you guys. Julie: Yeah. That’s amazing. Meagan: I’m like, “I can’t hear you.” You guys, guess what? This is our first month at The VBAC Link where I’m bringing a special subject. Every month we are going to have a week and it’s usually going to be the second week of the month where we are going to have a specific topic for those episodes of the week and this is the very first one. It is National Midwives’ Week so I thought it would be really fun this week to talk about midwives. We love midwives. We love them. We love them and we are so grateful for them. We want to talk more about the impact that they leave when it comes to our overall experience. Julie: Yes. Meagan: The overall outcomes and honestly, just how flipping amazing they are. We want to talk more and then we’ll share of course a story with a midwifery birth. Okay, Julie. You have a review. I’m sticking it to her today to read the review because sometimes I feel like it’s nice to switch it up. Julie: Yeah. Let’s switch it up. All right, this review– I’m assuming “VBAC Encouragement” is the title of the review.” Meagan: Yes. Julie: “VBAC Encouragement”. It says, “My first birth ended in an emergency Cesarean at 29 weeks and I knew as I was being rolled into the OR that I would go for a VBAC with my next baby. Not long after, The VBAC Link started and I was instantly obsessed.” I love to hear that. “I love the wide range of VBAC and CBAC stories. Listening to the women share honestly and openly was motivating and encouraging. As a doula, this podcast is something that I recommend to my VBAC clients. I’m so thankful for the brave women sharing the good, bad, and ugly of their stories and I’m thankful for Meagan and Julie for holding space for us all.” Aww, I love that. Meagan: I do too. I love the title, “VBAC Encouragement.” That is what this podcast is here for– to encourage you along the way no matter what you choose but to bring that encouragement, that empowerment, and the information from women all over the world literally. All over the world because you guys, we are not alone. I know that sometimes we can feel alone. I feel like sometimes VBAC journeys can feel isolating and it sucks. We don’t want you to feel that way so that’s why we started the podcast. That’s why I’m here. That’s why Julie comes on because she misses you and loves you all so much too and we want you to feel that encouragement. Meagan: Okay, you guys. We are talking about midwives. If you have never been cared for by a midwife, I think this is a really great episode to learn more about that and see if midwifery care is something that may apply to you or be something that is desired by you. I know that when I was going along with my VBAC journey, I didn’t interview a midwife actually at first. I interviewed OB after OB after OB. Julie did interview a midwife and it didn’t go over very well. Julie: No, it was fine. It just didn’t feel right at that time. Meagan: What she said didn’t make it feel right. What I want to talk about too and the reason why I point that out is because go check out the midwives in your area. Check them out. Go check them out. Really, interview them. Meet with them but guess what? It’s okay if it doesn’t feel right. It’s okay if everyone is like, “Go, go, go. You have to have a midwife. OB no. OB no.” That’s not how we are in this podcast. We are like, “Find the right provider for you.” But I do think that midwives are amazing and I do think they bring a different feel and different experience to a birth but even then sometimes you can go and interview a midwife and they’re not the right fit. We’re going to talk about the types of midwives. This isn’t really a type. We’re going to be talking about CPM, DEM, and LPM. Julie: In-hospital and out-of-hospital midwives, yeah. Meagan: Yeah, but I also want to talk about the word “medwives”. We have said this in the past where we say, “Oh, that midwife is a ‘medwife’” and what we mean by that is just that they may be more medically-minded. Every midwife is different and every view is different. Like Julie was saying, in-hospital, out-of-hospital, you may have more of a ‘medwife’ out of the hospital, but guess what? I’ve also seen some out-of-hospital midwives who act more like, ‘medwives’, really truly. Again, it goes back to finding the right person for you. But can we talk about that? The CPM or DEM? CPM is a certified professional midwife or direct entry midwife, right? Am I correct?Julie: Right. It’s really interesting because all over the world, the requirements for midwifery are different. You’re going to find different requirements in each country than in the United States, every state has its different requirements and laws surrounding midwifery care. In some states, out-of-hospital midwives cannot attend VBAC at all or they can as long as it’s in a birth center. Or sometimes CNM– is a certified nurse midwife which is the credential that you have to have if you are going to work in a hospital but there are some CNMs who do out-of-hospital births as well. There is CPM which is a certified professional midwife which a lot of the midwives are out-of-hospital. That means they have taken the NARM exam which is the national association of registered midwives so they are registered with a national association.Meagan: Northern American Registry of Midwives. Julie: Oh yes. They have completed hundreds of births, lots and lots of hours, gone through the entire certification process and that’s a certified midwife. Now, a licensed midwife which is a LDEM, a licensed direct-entry midwife just simply means that they hold licensure with the state. Licencsed midwife and certified midwife is different. Certified means they are certified with the board. Licensed means they are licensed with the state and usually licensed midwives can carry things like Pitocin, Methergine, antibiotics for GBS and things like that which is what the difference is. Licensed means they can have access to these different drugs for care. Meagan: Like Pitocin, and certain things through the IV, medications for hemorrhage, antibiotics, yes. Julie: Right, then CPMs who are certified, yeah. There are arguments for both. And DEM, direct entry midwife means that they are not certified or licensed. That doesn’t mean that they are less than, it just means that they are not bound by the rules of NARM or the state. Now, there are again arguments for and against all of these different types. I mean, there are pros and cons to holding certification, holding licensure, and not holding certification and not holding licensure. Each midwife has to decide which route is best for them. Certified nurse-midwife obviously has access to all of the drugs and all of the things. They are certified and licensed. You could call it that but they have to have hospital privileges if they want to deliver in the hospital. You can’t just be a CNM and show up to any hospital to deliver with them. They have to have privileges at that hospital. They have to work and be associated with a hospital just like an OB. An OB has to have privileges at any hospital. They can’t just walk into any old hospital and deliver a baby. Meagan: Right. I think it’s important to know the differences between the providers who you are looking at. Like she was saying, with a CNM, you are more likely to have that type of midwife in a hospital setting than you would be outside of the hospital but sometimes there are still CNMs who have privileges and choose to do birth outside of the hospital. I think it’s an important thing to one, know the different types of midwives and two, know what’s important to you. There are a lot of people who are like, “I will not birth with anyone else but a CNM.” That’s okay. That’s okay but you have to find what works best for you. Julie: Sorry, can I add in? Meagan: You’re fine. Yeah. Julie: It’s also important that you are familiar with the laws in your state if you are going out of the hospital. I don’t want this episode to turn into a home birth episode. It should be about all of the midwives in all of the locations, but also, know what the laws are in your state and in your specific area about midwives. In Utah, we are really lucky because we have access to all the types of midwives in all the different locations, but not everywhere is like that. Yeah. Just a little plug-in for that. Meagan: Yes. I agree. I agree. I did mention that I didn’t really go for midwifery care when I was looking for my VBAC– Lyla, my second. I don’t even know why other than in my mind, this is going to sound so bad but in my mind, I was told that midwives are undereducated. Julie: Less qualified? Meagan: Less qualified to support VBAC. I was told this by many people out in the world and I just believed it. Again, I have grown a lot over the years. It’s been so great and I’m glad that I have. That’s just where I was.Julie: A lot of people think that though. People don’t know. They just don’t know. Meagan: No, they don’t know so I wanted to boom. Did you hear it? I’m smashing it. Julie: Snipping it. Meagan: That is a myth that is going to be smashed. Midwives are fully capable of supporting you during your VBAC journey. We are going to start going over some stats and things about how midwives really actually do impact VBAC in a positive way but you may even run into and at least I know there are some places here in Utah where providers kind of oversee the midwifery groups in these hospitals and a lot of them will say that midwives are unable to support VBAC. That’s another thing that you need to make sure you are asking if you are going in the hospital when you are birthing with midwives because a lot of times you are being seen with your midwife, you’re treated by your midwife and everything is great. You’ve got this relationship with these midwives and then you go into labor and all of a sudden you have an OB overseeing your care because that midwife can oversee your pregnancy but not your birth. Know that that is a thing so make sure that if you are birthing in a hospital with a midwife that you ask, “Will I be birthing with the midwives or am I going to be seen by an OB?” But also know, like I said, you can be seen in a hospital by a midwife. Okay, let’s talk about some evidence and what midwives bring to the table and maybe some differences that midwives bring to the table because I do think that in a lot of ways, it is scary to think, Okay. If I have to have a C-section, if I do not have this VBAC and I have to go to a C-section and I have to be treated by an OB– because midwives do not perform Cesareans. They do assist. Let me just say, a lot of midwives come in and they assist a Cesarean, but they do not perform the main Cesarean, that can be intimidating because you want your same provider but I don’t know if that’s necessarily needed all of the time. Maybe to someone that is. But just know that yes, they cannot perform a Cesarean but they often can assist. That’s another good question to ask your midwife, especially in the hospital. If I go to a Cesarean, who will perform it and will you be there no matter what?Okay, let’s talk about it. Let’s talk about the evidence. Let’s talk about experiences and how they can differ. Julie: Do you know what is so funny? I want to go back and touch on the beginning where you said you didn’t know and you thought that midwives were less qualified and honestly especially in-hospital, in-hospital midwives– I want everyone to turn their ears on right now– have the exact same training and skills to deliver a baby vaginally as an OB does. The difference between a midwife and an OB in a hospital is a midwife cannot do surgery. I just want to say that very concisely. They are just as qualified. They can even do forceps deliveries. They can do an episiotomy if an episiotomy is necessary. They can do vacuum assist. Well, some hospitals have policies where they will or will not allow a midwife to do forceps or a vacuum but they can administer all different types of medications. They can literally do everything. They can do everything except for the surgery in the hospital.Out of the hospital, I would argue that they still have similar training depending on if they are licensed or not. They may or may not be carrying medications like Pitocin, Methergine, antibiotics, IV fluids, and things like that. But out-of-hospital midwives, many of them, at least the licensed ones, carry those things and can provide the same level of care. The only difference between– not the only difference, a big difference between out-of-hospital midwives and in-hospital midwives is they don’t have immediate access to the OR and an OB. But guess what? In states like Utah and many, many states operate similarly, there are very strict and efficient transfer protocols in place so that when a midwife decides you need to transfer, say you are birthing at home, first of all, a midwife is going to be with you a big chunk of the time. They are going to be with you. They’re going to be noticing things. They’re going to be seeing things. They’re not going to be there for just the last 10 minutes of deliveries like these OBs are. They are going to be in your house. I feel like out-of-hospital midwives are more present with you than in-hospital midwives even. They’re going to notice things. They’re going to see things. They’re going to notice trends a lot of the time before a situation becomes emergent if you need to be transferred. There are those random last-second emergencies and there are protocols for how to handle those too, but the majority of the time when there is a transfer needed, you are going to be received at the hospital. The hospital is already going to have your records. They’re already going to know what you’re coming in for and they’re going to be able to seamlessly take over your care, no matter what that looks like there. Now there are rare emergencies when you might need care within seconds. However, those are incredibly rare and that is one of the risks. Those are some of the risks that you need to consider when you think about out-of-hospital versus in-hospital care. But often, I have seen many instances where things have safely gotten transferred to a hospital before they reach the level of needing that severe emergent care. I think that is the biggest thing people don’t understand. I don’t know how many people I’ve talked to as a doula and as a birth photographer where they don’t want to birth at home because they don’t understand the level of care that is provided by out-of-hospital midwives. I’m thinking of a birth I just went to last summer and she was thinking about home birth but the husband was like– this was 36 weeks so they weren’t comfortable transferring or anything like that, but I was like, “These home birth midwives are trained in emergencies. They know how to handle all of the same obstetric emergencies in the exact same ways that they do in the hospital. They know how to handle them and address them. If a transfer is necessary, they are going to transfer you. They carry medication. They have stethoscopes and fetal monitors and everything that they do in the hospital to care for you.” The dad was like, “Oh, I didn’t know that.” It’s not your mom coming to help you deliver your baby. It’s a trained, qualified medical professional. I don’t know. I saw this quote. Never mind. I’m not circling back. I’m going in a completely different direction. I saw this quote or a little meme thing on Facebook the other day. I was going to send it to you but I didn’t. It said something like, “Once your provider and birth location is chosen and locked in place, choice is mostly an illusion.” Meagan: Wow. Mostly an illusion. Julie: Yes. Like the fact that you have a choice in your care is mostly an illusion. I was thinking about that and I was like, Is it really? I’ve seen some clients really advocate hard, and stuff like that. But I have also seen the majority of clients where providers, nurses, and birth locations have a heavy sway and you can be convinced that things are absolutely necessary and needed by the way that you are approached and if you are approached a different way, then you might make a different choice, right? The power of the provider and the birth location is so big and massive that choice, the fact that you have a choice involved, is mostly an illusion. I was sitting with that because I see it. I’ve said it before and I’ll say it a million more times before I die probably that birth photographers and doulas have the most well-rounded view of birth. Period. Because we see birth in home, in birth centers, in hospitals, in all of the hospitals, in all of the homes, in all the birth centers, with all of the different providers. We can tell you what hospital– I mean, there are nurses at one hospital that will swear up, down, and sideways that this is the way to do things and the next hospital 3 miles down the road is going to do things completely different and their nurses are going to swear by a different way to do things because of the environment that they are in. Meagan: Yeah. 100%.Julie: So if you want to know in your area what hospitals are the best for the type of birth that you want, talk to a birth photographer. Talk to a doula because they are going to be the ones with the most well-rounded view. Period. Meagan: Yeah. We definitely see a lot, you guys. We really do. Remember, if you are looking for a doula, check out thevbaclink.com/findadoula. Search for a doula in your area. You guys, these doulas are amazing and they are VBAC-certified. Julie: What were we going to circle back to? You were saying something. Meagan: Well, there’s an article titled, “Effectiveness of Midwifery-led Care on Pregnancy Outcomes in Low and Middle-Income Countries” which is interesting because a lot of the time, when we are in low and middle-income countries, the support is not good. Anyway, they went through and it said that “10 studies were eligible for inclusion in the systemic review of which 5 studies were eligible for inclusion in the meta-analysis. Women receiving–”Julie: I love meta-analyses. They are my favorite. Yeah. Sorry, go ahead. Go on. Meagan: I know you do. It says, “Women receiving midwifery-led care had a significantly lower rate of postpartum hemorrhage and reduced rate of birth–” How do you say this, Julie? It’s like asphyxia? Julie: Asphyxia? Meagan: Uh-huh. I’ve just never known how to say that. It says, “The meta-analysis further showed a significantly reduced risk in emergency Cesarean section. Within the conclusion, it did show that midwifery-led care had a significantly positive impact on improving various maternal and neonatal outcomes in low and middle-income countries. We therefore advise widespread implementation of midwifery-led care in low and middle-income countries.” Let’s beef this up in low and middle-income countries. But what does it mean if you are not in a low and middle-income country? Julie: Well, I see the same and similar studies showing that in the United States and all of these other bigger countries that are larger and more educated. It’s interesting because– sorry. I have a thought. I’m just trying to put it together. Meagan: That is okay. Julie: Midwifery-led care is probably more accessible and maybe accessible isn’t the right word. It’s more common probably in lower-income countries. I’m thinking third-world countries and second-world countries because it’s expensive to go to a hospital. It’s expensive to have an OB. In some countries like Brazil, the C-section rate is very, very high and it’s a sign of wealth and status because you can go to this private hospital with these luxury birth suites and stay like a VIP, get your C-section, save your vagina– I use air quotes– “save your vagina” by going to this affluent hospital. Right? Meagan: Yes. Julie: I think in lower-income countries, it’s going to be not only an easier thing to do but kind of the only thing to do, maybe the only choice. And here, it’s funny because here, out-of-hospital births– first of all, insurance is stupid. In the United States, insurances are so stupid. It’s a huge money-making organization, the medical system is. Insurance does cover a big chunk of hospital births and they don’t cover out-of-hospital births so a lot of the time, an out-of-hospital birth is kind of the opposite. You have to have a little bit of money in order to pay for an out-of-hospital midwife because your insurance isn’t likely going to cover it. More insurances are coming on board with that but it will be a little bit of time before we see that shift. But there are similar outcomes in the United States and in wealthier countries that midwifery-led care, not just out of the hospital, but in-hospital midwifery-led care has lower rates of Cesarean, lower rates of complication, lower rates of induction, lower rates of mortality and morbidity than obstetric-led care. You are going to a surgeon. You are going to a trained surgeon to have a natural, non-complicated delivery. Meagan: It’s interesting because going back to the low income, in our minds, we think that the care is not that great. But then we look at it and it’s like, the care is doing pretty good over there in these lower-income, third-world countries. Yeah. This is actually in Evidence-Based Birth. It says, “In the United States, there are typically 4 million births each year.” 4 million. You guys, that’s a lot. The majority of these births are attended by physicians which are only 9% attended by certified nurse midwives and less than 1% are attended by CPMs, so certified professional midwives or traditional midwives. You guys, that is insane. That is so low. She says in this podcast of hers which we are going to make sure to link because I think it’s a really great one, “If you only look at vaginal births, midwives do attend a higher portion of vaginal births in the United States, but still it’s only about 14%.”Julie: Yeah. If you have a normal– I use normal very loosely– uncomplicated pregnancy, there is absolutely no reason that you cannot see a midwife either out of the hospital or in the hospital. Now, I would encourage you to go and interview some midwives in your local hospitals. I would encourage you to look into the local birth community and see what people recommend because even if you are going in a hospital and have a midwife, you have the same access to the OR and an OB that can take care of you in case of an emergency. A lot of people are like, “Well, I’d just rather see an OB just in case of an emergency so that way I know who is doing my C-section,” I promise you that the OB doing your C-section, you are only going to see for an hour. They probably are not going to talk to you. It doesn’t matter how personable they are or what their bedside manner is or if you know anything because I promise you, when you are on the operating room table, you’re not going to be worried about who’s doing your surgery. You’re just not. I’m sorry. That’s maybe a harsh thing to say, but it’s going to be the farthest thing from your mind. Plus, in the hospital, your midwife is more than likely going to be assisting with the surgery too so you are going to have a familiar face in the operating room if that happens. I also think everybody knows by now that I am not on board with doing something just in case when it comes to medical care. Just in case things can cause a lot more problems that they are trying to prevent. So yeah. Anyway, that’s my two cents. Meagan: Yeah. You know, I really think that when it comes to midwives, there is even more than just reducing things like interventions and Cesareans and inductions which of course, lead to interventions and things like that. I feel like overall, people leave their birth experience having that better view on the birth because of things like that where midwives are with you more and they seem to be allowed more time even with insurance. You guys, insurance, like she said, sucks. It just sucks. It limits our providers. I want to just point that out that a lot of these OBs, I think that they would spend more time with us. I think they want to spend more time with us in a lot of ways, but they can’t because insurance pulls them down and makes it so they can’t. But these midwives are able to spend so much more time with us in many ways. Okay. Let’s see. What else do we want to talk about here? We talked about interventions. Midwives will typically allow parents to go past that 40-week mark. We talked about the ARRIVE trial here in the past where they started inducing first-time moms at 39 weeks and unfortunately, it’s stuck in a lot of ways so providers are inducing at 39 weeks and that means we are starting to do things like stripping membranes at 37 and 38 weeks. It seems like providers really, really– and when I say providers, like OB/GYNs, they are really wanting babies to be born for sure by 40 weeks but by 40 weeks, they are really pushing it. Midwives to tend to allow the parents to go past that 40-week mark. That’s just something else I’ve noticed with clients who choose VBAC and then end up choosing midwives. They’ll often end up choosing midwives because of that reason and they will feel so much better when they reach that point in pregnancy because they don’t feel that crazy pressure to strip their membranes and go into labor or they are going to be facing a Cesarean and things like that. I feel like that’s another really big way to change the feeling of your care with midwives is understanding when it comes down to the end of things, they are going to be a little bit more lenient and understanding and not press as hard. Like we said in the beginning, there are a lot of people who do press it– those “medwives” where they are like, “No, you need to have a baby.” We just recorded a story where the midwife was like, “Well, you need to see the OB and you need to do a membrane sweep,” and they were suggesting these things. But really, typically with midwives, you are going to see less pressure in the end of pregnancy. Midwives spend more time in prenatal visits. We were just talking about that. Insurance can limit OBs, but a lot of the time, they will really spend more time with you. They are going to spend 20+ minutes and if you are out of the hospital, sometimes they will spend a whole hour with you going over things. Where are you mentally? Where are you physically? What are you wanting? Going over desires and the plan for the birth. Past experiences may be creeping in because we know that past experiences can creep in along the way. So yeah. Okay, Julie is in her car, you guys. She’s rocking it with her cute sunglasses. She is on her way. She is so nice to have the last half hour of her free time spent with us. So Julie, do you have any insight or any extra words on what I was just saying? Julie: You know, I do. Hopefully, you can hear me okay. I’m going to hit a dead spot in two seconds. Meagan: I can hear you great. Julie: Okay, perfect. I have this little– there’s a spot on my road where I always cut out so stop me if I need to repeat what I said. I wanted to go back to the beginning and just talk for half a second because we know my first ended in a C-section. For my first birth, I actually started out by looking at birth centers because I wanted an out-of-hospital birth. I knew that from the beginning. I interviewed a couple of midwives and there was one group that I was going to go with at a birth center and I was ready to go but something didn’t quite feel right. It wasn’t anything the midwives did. It wasn’t anything that the birth center was. It wasn’t that I didn’t feel safe there. It was just that something didn’t feel right. So I just stayed with my OB/GYN. I had to get on Clomid to get pregnant. I just stayed with that guy who is the same guy that Meagan had and the same guy who did my C-section because something didn’t feel right. I mean, we know now and I can look back in hindsight. This was, gosh, 11.5 years ago. I know that I ended up having preeclampsia and I ended up having to get induced because of it. Had I started out-of-hospital, I would have had to transfer. There was nothing– I would have had to transfer care before I even got to 37 weeks. I had a 36-week induction. That’s the thing though. Out-of-hospital midwives have protocols. Each state has different guidelines, but there are requirements for when they have to transfer care– if your blood pressure is high, if you have preeclampsia signs, if you deliver before a certain due date, or after a certain gestational age. You’re going to be safe. If you have complications in pregnancy, you’re going to be safe. You’re going to be transferred. You’re going to be cared for. But also, I just want to put emphasis on this which is what I’m tying into the last thing I want to say which is going to be forever long, is that you can trust your intuition. My intuition was telling me that the birth center was not the right place for me even though it checked all of the boxes. Your intuition is not going to tell the future every time, but what I wanted to lead into is that– oh and do you know what is so funny also? I had three out-of-hospital births after that, but with my fourth birth, I started out with the same midwife I had for the other two home births, and for some reason, I felt like I needed to transfer care back to the hospital so I went back to the hospital for two months and all of a sudden, my insurance change and the biggest network of hospitals in my state wasn’t covered by my insurance anymore so it felt right to go back to out-of-hospital birth. I don’t know why I had to do that whole loop-dee-loop of transferring to a hospital just to transfer back to the same out-of-hospital midwife that I had in the first place but I believe there was a purpose to that. I believe there was a purpose to that. I want to tell you guys that if seeking midwifery care whether in the hospital or out of the hospital feels uncomfortable to you or feels like, I don’t know. These midwives still sound like chicken-dancing hippies to me, I would encourage you to go talk to some local midwives whether in a hospital or out of the hospital. Just sit down and talk to them and say, “Hey.” It’s easier to talk to an out-of-hospital midwife. Out-of-hospital midwives do free consultations for you. In-hospital midwives, you might have to make an appointment and it might be harder but you should still try and see and get a vibe or just transfer care to them and go to a few appointments and see. You can always switch care back to a different provider or an OB because your intuition is smart but it does not know, it cannot guide you about things that you do not know anything about. I would encourage you to go and chat with these different providers, even different OBs if you want because your provider choice is so, so, so important. It is one of the most important decisions you’re going to make in your care for your birth. It should be a good one. Your intuition can’t tell you to go see x, y, z provider if you don’t even know who x, y, z provider is. Gather as much information as you can. Talk to as many providers as you can. Go see the midwife. Interview the doula. Check out the birth photographer’s website. See what I did there? See how it feels because even as a birth photographer, whenever I’m doing interviews with people, I’m not a fly-on-the-wall birth photographer. A lot of birth photographers brag about being a fly on the wall. You won’t even know I’m there. No. I don’t buy that because who is in your birth space is important. I am a member of your birth team just like every other person in that space, just like your nurses, your OB, your midwife, your doula– everybody there is a member of your birth team. I am a member of your birth team too and I will hold space for you. I will support you and I will love you. I am not a fly on the wall. Now, your provider is a member of your birth team. They probably arguably are one of the biggest influencers about how your birth is going to go and you deserve to be well-informed about who they are. You deserve to have multiple options that you know about and have thoroughly vetted and you deserve to stick up for yourself and do the provider who is more in line with the type of birth you want. How do you do that? You do that by finding out more about the providers who are available to you in all of the different birth locations and settings. Meagan: Yes. So I want to talk more about that too because there are studies and papers out there showing that the attitude or the view on VBAC in that area, in that hospital, in that birth center, both midwives and OBs, but we are talking about midwives here, really impacts the way that a birth can go. So if you don’t interview and you don’t research and you don’t find those connections and even try, you will not know and in the end, it may not be the way you want. Even then, even if we find those perfect midwives, even if Julie went to the hospital midwife, she probably would have had a great experience, but who knows?Julie: Also, arguable too though, you could be seeing the most highly recommended VBAC provider in your area in the most VBAC-supportive hospital in your area that everybody goes to and everybody raves about, and if you don’t feel comfortable there for whatever reason, you don’t have to see the best, most VBAC-supportive provider if it doesn’t feel right and if it doesn’t sit right with you. Meagan: Yes. Julie: It goes both ways. Meagan:

Dr. Denise DeRosa is a Pediatric Physical Therapist from New York City. She had two Cesareans and was confident that those would be her only birth stories. But when she unexpectedly became pregnant with her third, Denise started looking into her options. She researched VBAC, found The VBAC Link, and felt that she could have a VBA2C. Having worked in the hospital where she planned to give birth, Denise knew she would face pushback. She knew they were skeptical and she knew they would try to meddle. She worked hard with her doula to get her mind solid, her body strong, and to prepare for any situation or anything that would be thrown at her. Ultimately, she believed in herself. So with an unsupportive provider in an unsupportive hospital with an apprehensive family, Denise’s preparation paid off! She labored hard, advocated for herself, and vaginally birthed a 9-pound, 5-ounce baby. Gina, one of our VBAC-certified doulas from California, co-hosts today’s episode and shares information about how C-sections affect an infant’s gut microbiome. She also mentions things we can do to help mimic the benefits of birthing vaginally if a Cesarean is necessary. Dr. Denise DeRosa's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to the show. We have our friend, Denise, from New York City with us today. Hello, Denise. Denise: Hi. Meagan: I’m so excited for you to be sharing your stories. You are a VBA2C mama just like myself. Denise: Yes, I am. That’s right. Meagan: Yes and when we were talking about the C-section aspect of things, it reminded me a little bit of myself. Didn’t dilate, baby didn’t come down. What do we know? We know that this is a very common, common thing. In addition to Denise, we have a very special co-host today and her name is Gina Benson. Hello, Gina. Gina: Hi. Meagan: She is one of our VBAC doulas. Tell us where you’re at, Gina. Gina: I am in the Sacramento area of California based in Roseville. Meagan: Okay, all right. Then we‘re going to make sure that she has her website and everything so if you guys are in her area looking for a doula, go check her out for sure. She is going to do a Review of the Week for us today. So I’ll turn the time over to you. Gina: All right. “I’ve waited and prayed about this moment to be able to write the words, ‘I got my VBAC’ feels surreal. Two years ago, I gave birth to my daughter via Cesarean and since the OR, I’ve been dreaming of a VBAC. It felt like a primal right I was robbed of. Yesterday, I gave birth at home with gestational diabetes to a 9-pound, 2-ounce baby. I pushed him out of my vagina, pulled him out of the water, and sobbed in joy relishing in my redemption and power. This would not have been possible without The VBAC Link. I listened every day postpartum, sobbed and cheered with the Women of Strength. I cannot recommend this podcast enough to all expectant parents. Thank you, thank you, thank you.” Oh my gosh, do you guys have the chills? Because I literally have the chills. You know how when as a woman you shave your legs and you’re like, Oh, I just felt my leg hairs grow? Yep, that just happened. Oh my gosh, thank you for such an amazing review and huge congratulations. I’m so glad that you’ve been able to walk the walk with us here at The VBAC Link. This is why we’re here. We want to inspire, encourage, empower, and help you know for yourself what is best for you. We don’t judge here at The VBAC Link, but we really, really do love your reviews. So thank you so much. Okay, so that review also talked a little bit about a big baby. Denise also had a larger baby with her VBA2C baby. I feel like there are so many things that are going to come together within this review and within everything. So, Denise, I want to turn the time over to you to share your C-sections to start and then your VBAC. Denise: Perfect, thank you. Hi everybody. I’m Dr. Denise DeRosa. I’m a pediatric physical therapist. I feel like I have to lead with that because who I am is what I do. That with motherhood is all merged together and really helped me in my journey for a successful VBAC. We’ll start at the beginning with my first baby. I was pregnant. Everything was going great. Everything was wonderful. I was still working. I had an uncomplicated pregnancy. The only thing that was a little off was that the baby was measuring big. I was like, okay. Whatever. It should be fine. Those machines are way off anyway. I go to 40 weeks, 40 and 1, 40 and 2, 40 and 3. I’m 40 and 5 days and my doctor is like, “All right. I want to induce you tomorrow.” I’m like, “Okay, sounds good.” I didn’t know anything. I worked at the hospital as well so I’m just trusting that we’ve got this and we were good. I loved my doctor. Everything was going great. That night before I went in to get induced, I actually did start feeling something. I was like, What is that? It feels like cramps or something. I don’t know. At 3:00 AM, I think I’m in labor. “Hon, get up. We’ve got to get to the hospital. Let’s go. Let’s go.” We get to the hospital. It’s 3:00 AM and I’m 3 centimeters dilated. I’m like, “Oh, okay. I guess that’s good. I don’t know.” We get all the things– the epidural, the Pitocin, and I pretty much just lay in the bed, sleep, do a puzzle game on my iPad, and relax because that’s what they tell me to do. It is very easy for me to relax now. It gets to be 11:00 AM the next day. I’m like, “I feel a little bit different. Can I be checked?” I get checked. 10 centimeters, wonderful, beautiful. They turn off everything. You know when they turn off that epidural, it’s like, bam. This is intense. Meagan: Especially when you were not feeling anything before. Denise: Exactly. Meagan: It can definitely pick up and be a little bit more than maybe you were expecting. Denise: Yes. I am in a Semi-Fowler position which is the one where you’re essentially leaned back but not all the way back. You’re inclined at a 45-degree angle. My hips and knees were at 90/90. It was essentially like I was sitting on the toilet but I was leaning back. I’m sure everybody knows the position that I’m talking about. That’s the position to push. My husband is holding one leg. The nurse is holding the other leg. My doctor is telling me to push. It’s just a disaster. I have to be honest with you. It was crazy because I didn’t know how to push so he was telling me to push like I’m pooping and I’m pushing like I’m holding it in. Everything was spasming and everything was just a disaster. I remember saying, “Let me get up. Let me move my body. I’m a physical therapist. Let me move my body. I just need to move around a little bit and I’ll be good. Just let me get up.” “No, you can’t get up. You have the catheter in.”Meagan: Intuition. Your intuition was kicking in to move. Denise: Yeah, exactly. My pelvis was stuck in the position. I was just lying there. The only thing they did was flex my knees up and down. I think I got the peanut ball at one point but it’s not like it was side-lying. There was no internal/external rotation. It was just one plain movement. Anyway, I pushed for 2 hours and nothing happened. My doctor was like, “All right. Why don’t we give you a break? We’ll turn on the meds. Relax for an hour and then I’ll come back and we’ll push again for an hour.” I’m like, “Okay, sounds good. I need a break. Wonderful.” A rest. He’s like, “But you know, if nothing happens, we’re going to have to get the C-section.” I’m like, “Okay, well let me try again.” No food. No water. Only Jello and ice chips. I hadn’t eaten since the day before. I was just so out of it between the drugs and the not eating. I did sleep a little bit when I was relaxing there but I was shot. My doctor came back after an hour and he goes, “Denise, I just went across the hall and the girl across the hall, I turned off her meds and she pushed 3 times and the baby came out.” I was like– let’s just say my hand went up in the air with one specific finger up. I essentially flipped off my– it wasn’t even the doctor. It was just the situation. I was like, “Forget this. This is ridiculous.” Okay? Now that’s the kind of relationship my doctor and I have that we can joke around and all of that stuff and after, I apologized. He was like, “Don’t worry. I deliver people in handcuffs. That was not the worst thing.” Meagan: What? Denise: Yeah, you know if you are stationed at the hospital, you deliver everybody. You know?Meagan: Yeah. Denise: What do you think happened? I stayed in the bed. I pushed. Inefficient pushing. Baby never dropped. I was dilated to 10 centimeters but nothing happened. Okay, by the end of it, I was like, “Please give me a C-section. This is the worst day of my life.” She came out. They lifted her up and everybody in there was like, “Oh my god. Look at this big baby.” I was like, “What is she, 100 pounds?” I was so delirious. You know, at that point you are so delirious. Anyway, it was a girl. She was 9 pounds, 10 ounces. It was a big baby. She never dropped down. I didn’t move my body and had a healthy baby, a healthy mom. Everybody was happy and I was just like, oh gosh. This is the best and the worst day of my life. When you become a mom, it’s just the best but maybe not the best experience. Meagan: Yeah. Denise: That was my first birth. At the time, I was like, okay. It is what it is. I’ll try harder for the second one. Now that I know what my body does, I’ll VBAC. My doc was like, “That’s fine. You can VBAC for the second, no problem.” Okay, great. In between my first and my second, I actually was pregnant and I was 8 weeks. I went to the doctor. I had a heartbeat but my doctor was like, “Come back in 2 weeks. Something is not right on here.” I’m like, “Okay.” I was going down the shore, the Jersey shore with my family. All 20 or us, a big Greek family vacation and I remember I was there and my doctor was like, “Okay, I want you to come back after that because the baby is measuring a little small.” I’m like, “Okay, no problem.” I’m down there and of course, that baby didn’t make it. I wound up miscarrying while I was on vacation with my family. I called my doctor and he was there for me. He would call me every day and be checking in, “How are you doing?” I thought that was something doctors don’t really do. He’s a special guy. I could really tell. I felt like he really cared about me and cared for what was happening. In between my first and second, that happened and then I wound up getting pregnant with my second and I was like, oh I’m going to VBAC. Everything’s going to be good. I took a labor and delivery course. I read my whole textbooks because sometimes physical therapists will be part of labor. So I’m like, I’m going to read up on this a little bit more. I take the course. Fast forward to 40 weeks and I started. I woke up in the morning. It was 6:00 in the morning and I was like, Oh, I feel something. This is great but let me not call my doctor right now. Let me stay home. Let me do the movements. I’m bouncing on the physioball. Of course, I have one of those. I’m walking around, doing the stairs, doing lunges, doing different positions. I’m like, “Let me just see where this goes,” and waiting as long as I can. I’m in touch with my doctor the whole day. 7:00 comes around. My husband comes home from work. I call my doctor. He’s like, “Okay, well why don’t you just come to the hospital and I’ll check you? You’ve been in labor the whole day.” I’m like, “Okay, that sounds good.” I go to the hospital. He checks me. I’m 0 centimeters dilated. Zero. I’m like, “Come on.” He says to me, “Well, you’ve tried. You did.” He’s like, “But what do you want to do? You want to keep contracting on an old uterus scar and something bad happens?” Meagan: Oh dear. Oh dear, oh dear. Denise: I was like, “No, I don’t want to do that.” At the time, I didn’t educate myself enough on risks. I just thought it was me. I was like, I’m a physical therapist. I’ve got this. I exercise every day. I’m good. I’m going to do it. When he said that to me, I was like, “No, I don’t want something bad to happen.”Essentially, I had a repeat C-section because I wasn’t really in labor is what I tell people. Yeah, that was my second and he was fine. This baby was 9 pounds, 4 ounces. Meagan: Staying in the 9’s. Denise: Another large baby. Yeah, it was fine. I felt like at the time, I was like, I did everything I could. Obviously, now I know I could have done more but at the time, I was like, I did my best. This is just my story and I’m fine with it. It is what it is. I have been growing my business for a few years at that point. My pediatric physical therapist business here on Statton Island and I felt like that was my third baby. You know, when you are a businesswoman, your business is like your child. Meagan: Yeah. Uh-huh. 100%. This business is one of my children. Yes. Denise: Yeah, exactly. I was like, I have my boy and my girl. I have three bedrooms in the house. I have a healthy boy and a girl. That’s another thing too. As a physical therapist, I see a lot of different things and all babies are miracles. That’s how I feel. All babies are amazing and I’m like, You know what? I’m good. I’m going to work on the business. I’m going to go back to work. We have healthy babies. We’re good. You know that expression? You make plans and God laughs. Right? You know? I was like, you know what? I wound up getting pregnant when I wasn’t trying to get pregnant. I had been trying for the other two and I was nursing and that’s the other thing. You can’t get pregnant, right?Meagan: A lot of people think. Denise: But you know, it’s funny. I got pregnant the month after my ya-ya passed away. Ya-ya is Greek for grandma. I was like, You know, this biotch just had to reincarnate herself and she hit me. I’m like, Why couldn’t she get my cousins? They don’t have any kids. They could have kids. I’m like, Ah man. She reincarnated herself. She cursed me. I don’t think babies are a curse. It’s just at the time that I was feeling all the feels. Meagan: You weren’t in that space. Denise: I was like, you know? I was done having kids. I was like, oh my god. I can’t get pregnant. I’ll have another major abdominal surgery. Here we go. Also, Meagan, I know you know. No one wants to watch more than one kid so it was– I was shocked. Yeah. I was shocked. Denise: I was like, you know what? I did have two miscarriages. One before my first and one between the first and second. Let’s just see what happens. I’m not going to tell anybody. Let’s just see where it goes. I’m not going to decide what to do now. I’ll just wait a little while and see what happens. You know, when you have two kids and you’re pregnant with a third, that pregnancy flies. Meagan: So fast. Denise: Very fast. I was like, oh my gosh. I’m almost in the third trimester. What am I going to do? At every appointment, my doc’s like, “Denise, when are we going to schedule your section?” I don’t like to pick baby’s birthdays. For me, I would rather they come when the baby is ready and I wanted to go into labor at least and then get the C-section. Then I was like, I got to this point where I was like, I have to make a decision here. What am I doing? Am I going to just schedule a Cesarean or am I going to actually try to do this? So I’m like, let me look things up. I found you guys. I found out that women actually have vaginal birth after two Cesareans. This does happen. I’m thinking with my own individualized plan here, I had no complications with either one. I didn’t have high blood pressure. I didn’t have anything go badly so I really felt like I was a great candidate. Then there’s there my doctor who was like, “No, you’re not a good candidate. Your baby never dropped. Your babies were big and you didn’t dilate on your own.” I’m like, “I know, but I just feel like I can do it.” So this is something that I tell my patients all the time that you need to listen to your mom intuition. There’s nothing that can steer you wrong. If you feel like something’s wrong with your baby or yourself, you need to get it checked out. It’s probably nothing and everything is going to be fine, but at the same time, the way that mom feels directly impacts baby and I just felt like, you know what? I feel like I can do this. I feel drawn to this and I’m going to go for it. Then the things that really drove me over the edge was that my cousin had a successful VBAC at the beginning of my third trimester so I was like, oh. If she can do it, I can do it. Then I also got in touch with a doula who I had been talking with professionally and we met. She said something to me that I will never forget which is, “I have total and complete trust in your body’s ability to birth.” I’m like, “No one has ever said that to me. I’ve only been told I don’t dilate and my pelvis is too small and I grow too-big babies,” not “You grow really healthy babies, really chunky ones with lots of rolls and that’s the best.” I was never told that. I’m like, you know what? If anyone can do this, it’s me. I trust in myself. I’ve got to go for it. This is my last chance because if I got another section, then it would be my tubes tied and that would be the end of the road. That would be fine with me too because I don’t really want more than three abdominal surgeries anyway. I made that decision to go forth with trying to achieve my VBAC. I have to tell you, I left all my cards on the table. There was no stone left unturned. I went in. I stopped working in September and I used all of October to prepare myself mentally, physically, emotionally, and spiritually because I would be reading even on The VBAC Link, the Facebook group all of the things people did. I didn’t do everything. Listen, you only have so much time in the day when you have two kids already. But at least I was doing things that felt right for me and my body. Meagan: I love that you pointed that out because there are so many things, right? We even suggest it here at The VBAC Link. We’re like, here’s a whole list of things you can do to improve. Gina, I’m sure as a doula you have things that you suggest to your VBAC clients and I know I do too but it one, can get a little overwhelming honestly and two, like you said, time is a thing but three, here’s a list. Pick what is appropriate for you. If every single one of those things is achievable, great. If not, pick some. Go with it. Right?Denise: Yeah. There are a thousand, bajillion things you can do. Meagan: There really are. Denise: Like I said, I picked what was right for me. I met with my doula. We did a pre-labor class specific for my body and how I would plan to move my body based on my anatomy. I know I’m a little asymmetrical from holding baby on one hip. I’m like, oh I’ve got to get that checked out. I prepared a lot and it was actually fun now that I’m looking back. I listened to you guys. I listened to other podcasts. I listened. I watched documentaries. I read books. I tried to do what felt right for me and then also educating myself on papers and even looking at my own research about different things that they tell you to watch out for when you’re trying to achieve something that I achieved. Meagan: Out of the list– sorry to interrupt you– what were maybe your top three things that you were like, these were the best things? Obviously, you hired a doula and you got some education. What are, in addition to those, the top three things you did that really, really impacted the situation?Denise: The top three things were that I got my mind solid. I literally was like, Denise, you can do this. There was no– I had an intention. I think I listened to that– Henci Goer. Meagan: Henci Goer? Uh-huh, so good. Denise: I listened to that podcast maybe the week before and she said something like, “Have an intention, but not a goal because when you don’t get it and it’s a goal, then you feel all the feels. You feel like you failed.” I had an intention but I also had a feeling of, I’m going to do this. I’m not going to try. I’m just going to do. I’m an athlete as well so if you’re an athlete or you’re someone who pushes yourself physically, you can labor naturally like I did. I’m telling you, you can. You know like when you’re on the treadmill and you’re running and you just keep going and going? It’s the same thing in labor. If you mentally train yourself with the physical, you’re going to be successful. My top three tips would be get your mind solid and really find your why. Why do I want this VBAC? How is it going to feel? What is it going to be like? Imagine it. Then two, get your body right and then three, prepare for any situation that they’re going to throw at you because they are going to throw things at you to make you sway the other way. They’re going to tell you that you can’t do it. They’re going to tell you, as I get into my story, when you get to the hospital, they’re going to throw things at you. I’m not even mad at the doctors in the hospital and the nurses because honestly, I really feel like doctors are really great people. They’re not bad people at all. They are good people and the nurses are part of birth. This is the most sacred part of healthcare in my head– also palliative care and hospice care is important too but birth is really so important. Unfortunately though, there are policies in place and there are rules and regulations. I think everybody is just doing their best with that but my top tips would be mind solid, body solid, and prepare for anything they are going to say and throw at you because it’s going to come. Meagan: Yeah, it’s probably going to come. I love that. In our VBAC course, we focus so much on the mental prep too. I think a lot of times, we are more focused on that physical prep and what we can do with our body, but I think the mental part connects so deeply to the physical part that we cannot skip it. Denise: No, you cannot. Meagan: I skipped it with my second and look at what happened, I had a repeat section. Denise: So yeah, that’s that. I guess I’ll get into my third birth now yeah? Meagan: Yeah. Denise: Okay. Another healthy pregnancy, uncomplicated, everything was fine. I get to my third trimester and that’s when I decided to go for the VBAC. I’m doing all the things like I said and I get to 40 weeks. I get to 40+1, 40+2. I go to the doctor and I’m like, “I’m not going to get checked today. I’m just going to talk to him.” He comes in the room, arms folded, you know? He’s like, “What’s going on? You don’t want to schedule?” I’m like, “Doc, I want you to know that I have so much respect for what you do.” I essentially did a fear release which you talk about in the course as well. It’s so important and holding things back and preventing it from labor. I essentially did a fear release with my doctor where I told him that I loved him and I respected him and I didn’t think I know more than him because I definitely don’t. I don’t know how to cut through and do all of the surgeries and everything. I’m a conservative health profession, okay? We don’t do any surgeries. No blood, no thanks. I just said that to him. “I don’t think I know more than you. I just feel like I can’t schedule it and I feel like there are things that I can do.” We talked about successful VBACs after two Cesareans at the hospital and it was essentially, “You have to get there when you’re pretty much ready to push. They’re going to try and give you a section and they’re going to try and give the epidural and they’re going to try and do the things and they’re going to try and meddle. You come to the hospital in pain, you’re going to get pain medicine because it’s part of hospital regulations and all of that stuff.” I was like, “Okay.” He gave me my answer. It was too late to switch at that point. I thought about switching to a midwife and having my baby at home, but that was just something I really knew my husband would never go for. He was already scared that something bad was going to happen to me and the baby because that’s what he was told at the appointments.We did essentially fear release on the 7th and on the 8th of November, I woke up with the same cramping I had with my second. I was like, oh, this is something. I think the fear release must have worked. Awesome. All right. Let’s just see how this goes today because I have to keep my mind right. I have to go about my day. That’s what everybody in every single VBAC Link story said they did. I walked my daughter to school. I take my son for a walk around the block. I did the curb walking. I did the Miles Circuit. I ate my dates and my tea. It was a normal day. I just ignored it and the contractions would get closer together and they would get farther apart and then change in intensity so I thought this was prodromal labor. I think I said that right. Meagan: Prodromal. Denise: Prodromal. Okay, sorry. I’m like, okay. This is what this is. I’m just going to rest and that evening, I put the kids to sleep and I was like, let me try to rest because I don’t know what tomorrow is going to bring if I’m going to be fine or if I’m actually going to do this. So I go to sleep. I wake up 2 hours later at 12:00 and between 12:00 and 4:00 AM, I was laboring by myself. I didn’t want to wake up my husband because I didn’t want to go to the hospital too soon. I didn’t want to wake up my kids obviously because no one wants to be around them when you’re in labor, right? Or maybe you do. I don’t know.I went in the bath. I’m trying to manage my contractions. I’m in the shower for an hour. I’m in the bath for an hour. I’m trying to sit. I’m trying to stand. Everything was worse sitting. 4:00 AM comes and I’m like, I think these are getting closer together. I download the contraction timer on my phone. I’m like, let me actually time these. They were 5 minutes apart. I’m like, okay. Let me text my doula. I text her but you know when you are past 40 weeks and everybody is texting you, “How are you doing? Did you go into labor yet?” All of the questions. I turned my phone on the Do Not Disturb thing a day before because I couldn’t take anymore of these questions. I already had my own anxiety and stress about this. I turned my phone on Do Not Disturb. I called and texted her and then she texted and called me back and I wasn’t getting any messages because I turned my phone on Do Not Disturb. I was like, oh goodness. 6:00 AM rolls around. I finally get in touch with her. I text my mom, “Can you please come here?” My doula gets there and at this point, I’m trying to just focus on my breath like we’ve practiced.I’m like, okay. Breathe in. Breathe out. I was trying to do whatever I can to manage this pain. I didn’t want to go to the hospital at all at that point but I didn’t want to go too early. When my doula got there, it was a complete 180. Oh my gosh. She came. She did the pain pressure points. She massaged. She got the essential oils. She did the rebozo think. I put on my Folklore and Evermore soundtracks for my Swifties in here and I was just jamming. It was like I was on the treadmill running like I used to do back when I was young and had better knees. It was great. I could have stayed there forever. I probably did it for an hour because I remember I listened to both albums and I was just fine. I was kneeling on the physio ball and everythings was good. I thought, man. I should have tried for a home birth. Oh well. I’m not going for a fourth so no home birth for me. My doula was like, “All right, Denise. Do you want to try to bring baby down and try some different positions?” I’m like, “Yes, let’s do it,” because I knew that would be one of the things. I go to my stairs with one leg up and one leg down. I go to down on the floor into a half-kneeling position and I’m like, “Okay, let’s do this contraction. Breathe in. The contraction comes.” My water breaks. I’m  like, “Oh my gosh.” Water is just dripping down my leg. That never happened before. My water just broke. Wow, this is amazing. I’m like, “Okay, let’s go get changed.” My doula was like, “Okay, this is time to go to the hospital.” I’m like, “Oh my god. This is great. I’m getting on way.” I go upstairs and change. She’s like, “Okay, we’ve got to move,” and my mom is like, “Come on, Denise. We’ve got to go to the hospital now. Come on!”My mom was very anxious and I said to her, “Mom, I know it’s your birthday and I’m trying to be nice to you but please don’t push me. If I’m not ready to go to the hospital, I’m not going to go.” I love my mom. She’s my best friend and she really just cares for me.Meagan: Yeah, and a lot of the time, they’re like, if you’re in this much labor, you go to the hospital. That’s how they were raised too. Denise: Right, exactly and that’s fine. It’s just that I knew I didn’t want to go and also, I think the day before I listened to your podcast with Julie about going to the hospital and how everything shifts from when you’re at home and you’re so calm, cool, and collected and everything is good but when you get to the hospital, it’s like, bam. Interventions, stress, people talking at you. Meagan: Touching, talking, questions, lights, new voices, new space, new smells. You have to re-acclimate. Denise: Meddling. Right. That was fresh in my brain too. I’m like, “I’m going to go when I’m ready.” Anyway, we’re ready. We’re ready to go. Let’s go. I get in my husband’s car. My mom is in the back seat. My doula drove herself because she was going to leave from the hospital when it was done. I live in New York City. There’s traffic everywhere. It’s Thursday at 10:00 AM and there really shouldn’t be traffic then but of course, there was. I couldn’t sit, right, because everything was getting worse. I’m leaning on my husband’s truck with my arms in the middle and my butt at the window. God help whoever was next to us in the car like, “What is happening over there?” Meanwhile, my mom is in the backseat crying in between. I lost control of my breath so I was literally screaming during contractions. It was like I was at a concert except it wasn’t fun. I said to my mom while she’s in the back, “Mom, I’m okay. The baby is getting ready to come out. It’s going to be fine. I’m going to be fine. The baby’s fine. I’m fine. See? I can talk in between contractions just when it comes, it’s very strong.” She was like, “I know. It’s okay. It’s all right.” My poor mom on her birthday. She thought I was going to have the baby in the car. That’s what she thought. Meagan: I’m sure she did. Denise: Yeah, she was like, “Oh my god. There’s a police cop over there. Flag him down. Flag him down.” She opened the window but then we already passed. It was quite a scene actually now that I think about it. Anyway, we get to the hospital and of course, there’s construction at the hospital so it takes me 10 minutes to walk up to L&D.” Now this is the hospital that I used to work at so I’m like, oh god. Please don’t let anybody see me like this, not my old co-workers or my boss. Please let me get to L&D. Please, please. All right, I make it up. It took me 10 minutes but I make it up. It was 10:45 AM. I get there and the nurse was like, “Come on, hon. Let’s get in the room.” I have a contraction, I’m like, “Please wait.” She’s pushing me, “Come on, come on.” I’m like, “Please don’t push me. I’m in the active stages of labor.” Who do I think I am? I think I know stuff. Meagan: You do know stuff. You do know stuff. Denise: Thank you. I get into the room and girls, I’m not joking. There are 12-15 people in that room with me. They’re all talking at me, talking at me, “Do you want the epidural? Do you want the C-section? We need to give you an IV. We need your insurance card.” Where am I going? You’re going to get my insurance card. Relax everybody. Chill. Because you can’t get a bracelet on me? Everybody knows who I am. The doctor has probably been talking about me for days. It’s fine. You’re going to get the insurance card. Meanwhile, I’m in such late stages of labor at that point. I’m contracting every 30-45-1 minute. I forget. I was like, “Please. I prepared for this.” I knew they were going to come at me like this. Not me, specifically. It’s not a personal thing. It’s just what I was. Meagan: It’s just what they do. It’s just what they do. You’re a label. Denise: And I’m not offended. I didn’t take it personally. I was ready though. I knew they were going to come at me and I had a plan which was, don’t say no and don’t shut down. I also heard along my journey, “Don’t say no. Don’t have negative energy.” You’re not able to control other people’s feelings, but you are able to control yourself. When they came at me like that, I was like, “Please just give me a second. Can you wait a minute? Please let me get through this contraction. I just want a second. Not right now.” I had all of the things listed of what I was going to say when they came at me. Came is a bad word. When they said things, I just knew how they were going to say things. Meagan: When they were approaching you, you knew your response wasn’t going to be no. It’s, “I prefer. Not right now. In just one moment,” and stuff like that versus, “No, no. Get away.” Denise: Right, exactly. Exactly. I could have been like that but I wanted to bring my baby into the world in the most positive way that I could and that’s just how I approached it. I’m like, “Just check me. Just check me before you do all of these interventions.” They checked me and I was 9 centimeters. I’m like, “What’s that? I dilated by myself.” My doula was like, “That’s amazing.” My OB was like, “Yeah, but the baby is really high.” I didn’t even hear him say that. She told me he said that after. I think I was blocking out a lot of negative things on purpose. That was one of the things I prepared for. He’s like, “Oh, but the baby is really high.” I’m like, “Okay, just give me a second.” The anesthesiologist was like, “Let’s give you the epidural just for insurance.” I’m like, “Not right now, just give me a second.” They’re like, “The baby’s heart rate is dropping.” I knew they were going to say that too. I said, “Okay, well what’s it dropping to and what’s it coming back to?” When they said it something that was essentially normal, I said, “It’s a 9-pound baby in there. Of course its heart rate is dropping. It’s being contracted by a strong uterus to get it out. Give it second.” I don’t remember saying this but my doula said that I said this which is, “I’m okay. My baby is okay. I know no one in this room thinks that I can do it, but I can. Okay?” I was like, “That’s what I verbalized.” I don’t really remember saying that but I was outside

Joining us from Texas today is Caitlin and it is her birthday!Caitlin’s first baby was born at 34 weeks via an emergency C-section due to elevated blood pressure and fetal distress. Though she was scared, it was not a traumatic experience and her recovery went well. She just knew that moving forward for future births, she wanted to experience labor and she wanted something different. Caitlin talks about the importance of knowing not just your provider’s general stance on VBAC, but their specific policies surrounding it. At 39 weeks, she went to the hospital with preeclamptic symptoms. Still counting on her provider to support her VBAC, Caitlin started to face things she wasn’t comfortable with. Her symptoms were under control, but she could tell that her baby wasn’t yet ready to come. She knew she needed to sign an AMA and go home. When the time came, Caitlin was able to advocate for the birth she wanted, declined the interventions she knew she didn’t truly need, and leaned on those who felt safe in her space. “Having the VBAC made me so proud and confident in myself and any future births that I’m blessed with.” Happy Birthday, Caitlin!!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello Women of Strength. You guys, I am so excited for today’s episode. We have our friend, Caitlin, from– are you from Texas? Where are you from?Caitlin: I’m from Texas, yes. Meagan: Texas. Yes. I wanted to say that then I started questioning myself. She is from Texas and we just went over a quick rough draft of all the things that happened in her birth and there are so many points I feel like to her birth. One, she’s a VBAC. She had preeclampsia with her first and her second. This is her second baby during her VBAC and with her first, she signed an AMA so we are going to talk about that and what that looks like. We’re going to talk more about preeclampsia. We’re going to talk about switching providers. One, switching providers but two, maybe trying to set ourselves up to not have to switch in the future and setting up ourselves to have a supportive provider from the beginning because she definitely had that and so much more. I’m really, really excited to get into the story. I do have a Review of the Week. This review is– I don’t actually know how to say the name. Sidsie, maybe? It says, “Such an amazing resource for VBAC-hopeful mamas and others preparing for birth who haven’t had a previous Cesarean. Their podcast has amazing birth stories and their blog has amazing articles. They have a ton of resources to find doulas and providers and are excited and happy to help support VBAC mamas. I recommend their podcast to my doula clients and I listen to each episode as it comes out. Definitely check it out.” I love that. This is a birth worker. Birth workers, we love you and we love your reviews. As you know, we do have a doula directory so if you are looking for a doula, these doulas are absolutely incredible. Go to thevbaclink.com and click on “Find a Doula”, search your area, and find out which doulas are close to you. Also, if you haven’t had a chance, I’m requesting a specific place for reviews today. If you would not mind, head over to Google at “The VBAC Link” and click on it then leave a review. I would absolutely love it. Meagan: Okay, Caitlin. I’m already so excited that I just am going to turn the time over to you but before I do, I have to say one thing. Caitlin: I’m excited too. Do it. Meagan: Happy birthday. Caitlin: Thank you. Meagan: It’s not your birthday the day you are recording, but we have determined it will be the day your episode comes out which we didn’t do on purpose. Happy birthday. Caitlin: Thank you so much. I appreciate it. Meagan: You’re welcome. You are welcome. All right. Well go ahead and share your stories. Caitlin: Okay, well I guess we should start with my first birth which was August 18, 2021. I was 34 weeks pregnant. I had lingering high blood pressure for about a week and it was elevating over time. My doctor was like, “Let’s look at the baby.” With that check, baby was showing signs of distress and it was pretty immediate and quick. We went in for an emergency C-section. In the moment, I was so scared. It was my first child. I know what that meant. I didn’t really care what that meant for my future births. I didn’t really think of what that might mean for my future birthing experience. My main concern was that my current baby isn’t doing well and let’s do what we need to do to keep him and myself safe. That’s how that went. I do want to say that my C-section was not traumatic. I didn’t have a terrible recovery. It really was all good. I just knew that moving forward for future births that I wanted to experience labor. I had never experienced labor. I wanted to have more children than just two so I knew moving forward from that the risks that come with it. That’s how my first kiddo was born. It was an emergency C-section. He was healthy. He was in the NICU for a little bit but that’s just because he was so little at 34 weeks. Meagan: You actually had a preterm. That was another thing I forgot I wrote down. You had a preterm Cesarean. Caitlin: I did. Yes. It was very quick. We were at my doctor’s appointment at 10:00 and got to the hospital and baby was born within an hour or two. It was a quick turnaround. It was a very high stress situation but it all worked out okay. Now my 3-year-old is wonderful. I’m grateful for how that all worked out and I’m glad that he was safe and that I was safe.That was my first birth. For my second, I knew that I wanted to try for a VBAC. I did extensive research and when I say extensive research, I mean I went crazy a little bit. No. there’s never too much research. I did obtain all of the information I could find. I was listening to podcasts 24/7. I looked at studies and articles and the actual science behind it all. I just dove headfirst into it and I knew that this was what I wanted to try for. I wasn’t scared of a repeat Cesarean. Again, I wasn’t like, I can’t do that again. I just knew this was the route I wanted to try to take. My due date for my second was August 19, 2023, so literally 2 years and a day after my first was born. I told my doctor at every single appointment even as early as it gets at the appointment where you hear the heartbeat and the appointment before they could even find the heartbeat, I was like, “I want a VBAC. I want a VBAC. I want a VBAC.” He was extremely receptive. He said, “You’re a perfect candidate.” He was super receptive so I felt really good about it. I was thinking about this last night with my husband as I was running through all of the little details and I think my provider being so on board made me feel like I didn’t need to do the little additional prodding questions to make sure that it was going to work out. It just seemed like every time I brought it up that it was a no-brainer. It was going to be VBAC fine. That’s kind of your caveat for later but I felt like it was all going to be great. My provider was on board and that’s the number-one checklist. But the thing I didn’t do was ask him specifics. I didn’t ask if I needed an induction, what does that look like? I didn’t ask him, how many successful VBACs have you done? What is your approach if x, y, and z happens? I didn’t get details because it just seemed so positive the whole time. Meagan: And that’s the hard thing. It can be so easy to be like, “Hey, I want a VBAC. Do you support that?” “Yeah. Cool, no problem. Yep. Of course, we do. No worries.” Or like you said where he was like, “Yes, I know you want a VBAC. Let’s move on,” instead of talking about that VBAC. I feel like that was maybe a little bit of a flag in ways. Caitlin: Yes. I should have picked up on it because it got to the point where I would walk into an appointment and the first words were, “I know you want a VBAC. We’ve got that.” I’m like, “Okay, great. We’ve got it.” I think I was a little naive that that was him checking that off the appointment list maybe and being like, I don’t actually need to give this girl a VBAC when push comes to shove. Meagan: Or tell her anything, yeah. I really encourage people to ask open-ended questions like you said like, “How many VBACs do you support? How do you feel about VBAC and what does it look like? For some reason if I have to be induced, do you induce them and what does it look like then?” and all of those types of things. Caitlin: Definitely. Definitely. I started to feel all of this pressure because toward the end, we didn’t really talk about a plan. Then the language changed to, “We can’t really make a plan because we just have to wait and see if you’re going to go into labor.” So then I was like, “Oh dang, then I really need to go into labor.” Then we got to 36-37 weeks and I’m getting more and more in my head, “What if I don’t go into labor? What happens next? We still don’t have a plan.” We started to do membrane sweeps. I got three membrane sweeps and I did them on the time period– I don’t remember what it was. I think if you do two within 48 hours or something like that, people say– I don’t know who people are. I was just a maniac with my research and they were like, “Maybe that will increase your chances of your body going into labor on its own.” I did three membrane sweeps trying to get the ball rolling. I stayed at 1 the whole time. No changes. I was doing all of the things at home up to week 39. I was eating dates, curb walking, drinking raspberry leaf tea, bouncing on the ball. I was pumping colostrum. My baby is 9 months old and I still have colostrum in her freezer. Meagan: Holy cow, girl. Caitlin: I was doing everything begging my body to please do this for me. Please. There were no changes. Meagan: It wasn’t listening. It wasn’t ready. Caitlin: It wasn’t. I was also forgetting to consider the fact that my body with my first did not go into labor. This was my first real experience with childbirth and labor. Do you know what I mean? My C-section grew and changed me in so many ways and like I said, I don’t regret that at all, but in my head I kind of counted that like, my body should be going into labor, when in reality, my body wasn’t going to go into labor. At least not as early as I was trying to make it. So moving on from that, I did all of the things. I kept doing the things. I felt frustrated doing the things because the things weren’t thinging and I couldn’t but I tried and all I kept doing was being positive. My blood pressure was fine my entire pregnancy so we got past that 34-week mark which with my first, my high blood pressure started at week 33 and we got past that point. I felt really good about it. There were no high readings then on August 4th, I was 38 weeks. It was a Friday. I had felt kind of off during the day but I was also like, I’m 38 weeks pregnant. I’m probably going to feel off for the next however many weeks I’m pregnant. Then later that night, I noticed major swelling in my hands and my feet. I was like, this is something I am familiar with. I am not familiar with other things that are coming, but this is something that I am. We didn’t have a blood pressure cuff so husband had me go to a CVS or Walgreens or something like that and take it in one of those machines and it was extremely high. I was apprehensive. I was like, I don’t want to rush right in. I called my on-call person and obviously their response was to go to the hospital. They can’t guide you through anything when it comes to high blood pressure over the phone. I go to the hospital. I was planning on going there for my VBAC even though I’m 39 weeks now and still at a 1 but I’m like, It’s going to be fine. My doctor’s on board. The bummer with that was that it was a Friday night and it was probably closer to the middle of the night and early Saturday morning. The nurse who had us at intake was actually– we recognized her and couldn’t figure it out then she was like, When did you have your last baby? It was the same nurse who helped us prep for the emergency delivery of my first son. She was super sweet and super comforting. It was nice to have somebody who had seen what we went through previously. My blood pressure was still high at the hospital. They started some IV fluids and I was just resting. They checked on baby and he looked great. No issues with him which from my prior experience, that’s what changed everything for me was that he was fine. So I kept asking throughout our time sitting and watching our blood pressure, I was like, “Baby is fine?” They were like, “He’s doing great.” That was super, super– and that was completely different from my first time around. Then finally, the doctor came in who was working for that night and the first words out of her mouth were, “We’ll do a C-section first thing in the morning. We’ll get you on the calendar.” I was like, “Oh, well my plans were to try for a VBAC,” and that was basically met with an eye roll. She was like, “You can talk to the doctor who is in for your doctor this weekend because he’s not the doctor over the weekend. You can talk to her and see what she thinks.” I was like, “No, yeah. I’ll be happy to talk to her. Do you want me to call her right now? Because I’m not going to stay here. Don’t put me on the schedule for tomorrow morning.” She actually did. She called the doctor who was in for the weekend from my doctor’s practice and I mean, basically what I kept getting was, “Protocol is when you have high blood pressure this late in pregnancy, we just do a C-section.” Then every time I asked, “Why?” I was like, “If my baby is fine, why do we do a C-section? If my baby is doing okay,” and my blood pressure at that point was getting lower. We were managing it. I think the fluids helped, elevating my legs, resting, and all of those things. My blood pressure was lowering and my baby was fine. I was like, “Why?” They didn’t really have an answer every time I asked that. I got on the phone with the doctor who was in for my doctor over the weekend and the one who would be doing the C-section the following morning. I’m telling you. We were on the phone for– I had her on speakerphone so my husband could hear what she was saying and what I was saying. My husband knew I did all of this research but as I was debating with this doctor, I could see on his face that he was learning things. He was like, “Oh, that’s a good point. Oh, really? Okay. Okay. You’re not that crazy, Caitlin. I see it. You know?” So I could see him learning through what I was saying to her about my why and why I wanted to do it this way. She was basically saying, “I can have a baby in your arms by lunch tomorrow. You could be walking around.” I was like, “That’s really not my goal. That’s not what I’m trying to do.” Finally, I was like, “Hey, look. Based on what I have found, I know that a good induction method would be a balloon Foley. Can you come do that? I’m not going to say yes to a C-section tomorrow with my baby doing fine and my blood pressure dropping. It’s getting better.” She was like, “Okay.” She was like, “I can do it.” I was like, “Have you done it before?” She was like, “Yes I have. I will come in and do one tonight. We can see how you progress overnight and so on and so forth.” They put us in our room and my blood pressure was looking good. They take monitors off of me. They don’t need to be watching baby anymore. All is good. We’re sitting in the room. We are waiting for the doctor to come to start the balloon. Finally, I asked the nurse. I’m like, “Hey, is the doctor coming? She said she wanted to give me time to progress overnight so we could see how we were doing in the morning.” I’m aware of the fact that this could take a long time. I told the doctor that. I said, “I’m very patient. I’m not trying to rush this.” She’s like, “I’ll go check on the doctor and see where she’s at.” She comes back in the room and said the doctor was asleep at home. The doctor said she was going to come do the balloon Foley first thing in the morning. I was like, “That’s not what we talked about on the phone. The doctor told me she was going to come do it tonight so we could progress overnight and all that stuff.”Me and my husband are sitting in this room. Our kid is at home, our other child and they are not even checking me anymore. They’re not monitoring anything. My blood pressure is good. The baby is healthy. I’m like, “Why is there no urgency?” If this was something that needed to be done, why are we not doing anything? I guess that was my concern. As I’m verbally processing this with my husband, the nurse was extremely professional but I felt a vibe. I asked my husband, “Did you feel the same thing when she was affirming what we were discussing verbally?” Just between him and I but I felt like she was like, “Yes. You’re not wrong.” The second I said to my husband, “I think we should leave. I feel like this isn’t right,” the nurse was like, “I can get you those papers whenever you want them.”She went and I was like, “I think I want them. I don’t know. I’m a rule follower. I don’t want to risk anything.” My husband was like, “Caitlin, I don’t know. I don’t know if this is safe,” but I just felt like if there was no urgency to get things moving now, then what’s the urgency in waiting until Monday when I could talk to my provider who had encouraged me and said that the VBAC was possible the whole time? So we left against medical advice. It was very intimidating for somebody who was a rule follower. We felt like we were going to be dogs with our tails tucked between our legs walking out of the hospital with our bags on our shoulders. I was like, “Oh my gosh, those nurses are going to watch us and think we are causing harm to our baby.” But as we were walking out, it was the coolest thing ever. All of the nurses, I think they could tell that I was a little bit insecure about my decision or just not sure, but they were giving me thumbs-ups and silent, “You’ve got this” clapping. I was like, Oh my gosh, okay. This wasn’t a dumb call. One nurse stood up and said to me as we were about to leave the door, “Thank you so much for advocating for your own health and standing firm in the decisions that you want to make for your birth.” It was so affirming for me. Meagan: I seriously have chills and goosebumps right now just hearing you say that and her saying that to you and you being able to leave feeling that especially when you felt like it was right, but then the way the world makes us feel about going against medical advice, you had that, Oh, I don’t know if I should be doing this feeling as you were walking out. To have that advocacy as you were walking out I’m sure put so much power in your pocket. Caitlin: Totally. Totally, totally. That nurse was life-changing for me and I just felt okay going into the next day waiting to see my doctor whom I thought was going to be on my team with all of this stuff that I had been sticking up for. I get to my doctor on Monday. I rested for the weekend. There was nothing crazy. We just relaxed. I got a blood pressure cuff to monitor. It wasn’t good. It was elevated but it never got to that zone where it was on Friday night when I went in. I went to my doctor on Monday. My blood pressure was elevated but not very high. He said, “Let’s have you just lay low. Let’s check you again on Thursday morning.” I went in Thursday morning and it had gotten higher again. He was like, “I’m not comfortable playing this game with your past and how your baby was the first time around.” He was like, “Let’s not do that. Let’s not push it to that point again and see.” I agreed with him in that. I was like, “Yeah, no. We’re now playing Russian Roulette of it’s high. It’s not as high. It’s high. It’s not as high.” I was like, “Okay, great. What are we going to do to get the VBAC going? How do you usually approach this?” He completely froze. He was like, “Wait, no. I think we’re going to do a C-section.” I was like, “What?” I was shocked and so confused and still only at 1 centimeter. I was like, “What are we talking about here? This is not what I said to you at every appointment.” My husband knew. He saw it all over my face. I was like, “Where is this coming from?” My doctor said, “I’ll let you guys talk about it.” He left the room for a minute. When he left, my husband was like, “Caitlin, we have to trust our doctor.” I was like, “I do trust the doctor, but I trust what I know more,” then he was like, “You’re not a doctor.” I was like, “No, I know but I’ve heard enough where these stories come into play.” All of the stories that I heard of people who had been successful with this, that’s where it all comes into play and that’s why I’m so passionate about sharing this because that’s what made me be like, No. I know it can work and I’ve heard of it working. I went on. I think my doctor came in and he thought that he was going to come into a room and us be like, “Okay, yeah. We have to do what we have to do,” and no. Instead, I was like, “I would like to give myself all chances for a vaginal birth.” Now again, I said this before. “I am not scared of a C-section. I had a great experience. I recovered really well but I want to give myself a shot at this.” A question I should have asked way previously was about the balloon Foley thing but here I am, he was still positive the whole time that I just assumed that surely, if push came to shove, we would know what we were going to do. He told me that he had ever only done one and he doesn’t really know or feel comfortable doing another. He said that I might not be dilated to get one in. Meagan: Okay. Caitlin: I was like, “Okay. Well, typically that’s how you approach inducing a VBAC.” Meagan: Yeah. Caitlin: I was like, “Okay.” I told my husband, “I don’t know what either of you want me to say. I would like to do a balloon Foley.” My doctor was like, “I don’t feel comfortable.” Meagan: Did he say why? What about it didn’t make him feel comfortable? Caitlin: He said he had only ever really done one. Meagan: That’s why. Caitlin: I was like, “I’ll be your second.” Meagan: Yeah. Yeah. Caitlin: Then it was more so the approach of, “I don’t think one would fit.” That might be true. I don’t really even know. I was at a 1 so I don’t know but– Meagan: Usually if you’re at a 1, and even people without an open cervix like even at half a centimeter, they can get it in. It’s usually a little less pleasant, but typically a Foley will go in. Sometimes the cervix is still posterior which is also a sign that our baby is not ready to come, but if so, it can go out and around. One in his whole career? He’s only placed one? That seems kind of crazy to me. Caitlin: That’s what he told me. That’s what he told me. I’m like, “Okay. Here’s what I need you to do. Phone a friend or I will.” The power of Google, I started to Google local doctors in the area who were VBAC-friendly who were at the same hospital I had already been registered at and all of those things. He looked at me like I was absolutely insane. My husband did a little bit too, but I was like, “No. Find somebody then. If you won’t do it, find somebody who will.” It was very awkward because when he did find a doctor who would do it for me, that was great. I was in the room or whatever and they were– he wasn’t at the hospital when I got the balloon Foley, but the doctor who would, before I left my actual doctor’s office, all of those nurses were very not on board with the call that I was making so that’s an awkward feeling to be like, Okay. Everybody in this room thinks that I’m doing something wrong. It felt really good to leave. It felt good to go get to the hospital with a new set of nurses and a different doctor doing it. All went well. She placed it just fine. I’m so grateful that she was willing to just pop in for a patient that wasn’t even her own. We got to the hospital around 12:15 and I had a male nurse. He was awesome. I was at a 1.5 when I got there so more than a 1. The doctor who did the Foley for me was great. When she got it in, she said she might have broken my water. She wasn’t sure. She couldn’t tell. It was pretty tight. It wasn’t comfortable but I wouldn’t describe it as painful. They started low-dose Pitocin and we hung out basically. I waited on that Foley to do its job and yeah. From noon until 6:00 PM, I was dilating. Things were happening and I think I got the epidural and it fell out right about the same time. I got the epidural right before it fell out. My contractions were picking up and coming really fast which was interesting because I just didn’t expect it to happen that quickly. Everybody told me, the doctor on the phone, everybody told me, “It’s going to take forever. Forever. You’re not going to dilate. It’s going to take forever.” It really wasn’t taking forever because I had been there from noon to 6:00 and things were happening. The nurse I had was wonderful, wonderful. He was super helpful. He was super team VBAC. You’ve got this. When it came time for my shift change, I was so bummed. He was like, “I’ll get a good one for you. I’ll get a good one for you.” When the nurse came into the room, she was so excited it was me. It was the nurse who stood up and told me, “Thank you for advocating for yourself and how you want to bring your baby into the world.” She was just amazing and she was so excited it was me. I was so excited it was her and that was just a huge full-circle moment. She was like, “You’re doing it. You’ve got it.” I was like, “Girl, you have no idea.” Once the balloon fell out, we spent the night repositioning just to keep things moving along. At midnight, the doctor came in to check and see, “Okay, did your water break when I put the balloon in or did it not?” It turned out that my water was already broken, but she also said there was pooling of a lot of blood. I was losing a lot of blood. She was very confused by that. She did a rushed ultrasound in fear of placental abruption and she did prepare us that if that was the case, I would be going back for an immediate C-section. My husband thinks it’s funny. He made a joke, “Well that would have made all of this worth the time.” I was like, “It’s not time for that but whatever.” That would have been a bummer if that was the case but there was a lot of bleeding so I knew that if it was placental abruption that we would go back for a C-section and all would be fine. That’s the biggest thing that I want to say is that it would have been okay. It wouldn’t have been earth-shattering to me. But the placenta looked good. I was like, “Praise be. Let’s keep trucking along.” She was going to monitor the bleeding. She wasn’t sure where it was coming from. We’ll just wait on my body to do its thing. I’m just so grateful that this random doctor, I’d never met her. I never had met this woman but she made me feel that I was the one making the decisions about my body and my baby because that isn’t how I had felt by the other three doctors who I had talked to in the process of this up to that point. Meagan: Yeah, which is sad. Three out of four providers made you feel like that versus uplifting, being part of your birth, making choices for yourself and your baby. Caitlin: Totally. Totally. I felt like maybe everybody who was looking at me thought I was maybe a pushover or just didn’t know what I was talking about so when I pushed back on things, people backed off and were like, “Oh gosh, we don’t want to deal with that girl.” Nobody wants to be that girl but everything continued to go great. We did lots of new positions and dilating was happening fairly quickly. I got to 9. In the morning, that same male nurse requested me again. I loved that. My nurses changed my life. They were amazing and the nurses were my cheer squad. They were amazing. They made me feel like things were going great. Meagan: They were doulas. They were acting as doulas in here. They were requesting you which is awesome and very rare. That’s very rare. Caitlin: Yes. They were phenomenal and every time one of the familiar ones came in, I was like, “We’re good. I’m good. I trust you with my life.” They were amazing. That was encouraging for me because having a doula wasn’t really in our budget unfortunately, but I did need somebody else because my husband is very like, “Yeah, Cait. Whatever you feel passionate about you needing to do,” and he was totally on board, but it was nice to have somebody with a medical background saying, “No, you are doing the right things. Here’s how we can progress you forward. Here’s what we should do next.” I had never had a vaginal birth. He came back. He requested me. He was my nurse again. Then at 10:00 AM, my contractions became so intense and so on top of each other. I think it was worse that this happened after. I wish I had either never gotten the epidural and built up to that. The taste of having the pain relief and then it going away was not fun at all. It would have been better to just never have had the pain relief at that point. I was at 9 and they called the anesthesiologist. They did a flush of medication to offer some relief. That didn’t change anything. So 2 hours later, they came back and he checked. He was like, “Oh, your epidural became dislodged.” I wasn’t getting any of the medication that I was getting previously. So unfortunately, at 9 centimeters, you’re in full-blown labor labor and they didn’t realize for 2 hours what the problem was. Finally, it took my husband saying to somebody, “I don’t think she is just feeling intense feelings. I think she is feeling the actual contraction,” which also was discouraging for me because that 2-hour span of no changes was the longest span I had gone with no progression in the entire experience. I was getting nervous about that. I was like, Not only am I in immense, excruciating pain, but why am I not dilating to a 10? Why am I not a 10? What’s going on here? The anesthesiologist said to me, “Hey, you’re at a 9. You can wait it out and when it’s time to push, just push. You don’t need the epidural to be working.” I was like, “I could do that, but I also got an epidural for the pain relief.” I was like, “No. I want the relief and I also want to be able to relax and see if that gets me to a 10.” They did place a second epidural. It helped. It took a while. It was basically the whole process restarting. My doctor told me, “Hey, since you were just up for 2 hours with contractions on top of each other, how about you try to rest? I’ll check on how you guys are doing in a little bit.” He popped in a few minutes later and asked to check me. I was like, “Yes.” He lifted up the covers and my baby’s hair was there in 30 minutes. Meagan: What? You were crowning? Caitlin: Yes!Meagan: Oh my gosh. Caitlin: I went from 2 hours at a 9. They gave me the second epidural and then within 30 minutes, they went to check and they didn’t have to check anything because the baby was there. It’s funny because we had just reset the room to be dark, comfortable, rest, and it was like, “Nope. Open the blinds. Get ready to go.” It was a crazy turnaround. My husband and I didn’t believe it when he said it. We were like, “Hair? Already? We just sat here for 2 hours at a 9.” I never even got measured. Do they measure at a 10?Meagan: I mean, they can go in and be like, “You’re complete.” Yeah. Caitlin: Right. Right. It went very fast. I was shocked by that. I pushed for 15 minutes and baby was born. It was smooth sailing from then on out. It was 24 hours total. Everybody’s biggest threat to me was, “It’s going to take forever. You’re going to be there forever. You’re going to be doing this forever.” It was 24 hours from start to finish. Baby being born. Baby being healthy. Me getting the VBAC. Me getting the golden hour because with my first, he was straight to the NICU. I didn’t get to hold him or anything and I really wanted that. It was super redemptive for me and just super special that my husband and I were in the same room after the baby was born because he went to the NICU with our first. Having the VBAC made me so proud and confident in myself and any future births that I’m blessed with. Now I know. I’m an advocate and other moms can put their foot down for themselves. You have control of what happens to you as you bring a baby into this world. I don’t think I knew that before being in the thick of it that I actually did get to make the calls. Meagan: Yes. Caitlin: Yeah. All of these medical things that came up like the high blood pressure and how easy I could have been like, “Okay yeah, whatever you say,” but just because of things that come up in pregnancy, it doesn’t mean that you need to get straight to a surgery room. Meagan: I mean look at that. Your blood pressure did go back up to that high range and you didn’t just go in and have a C-section. You had a slowly induced VBAC. Did your original male provider ever come back to the scene? Did that provider catch baby? Caitlin: He is the one who when I was stuck at the 9, he was in at that time. Meagan: Okay. Caitlin: He was there from being at 9 centimeters and he is the one who delivered my son. The other doctor came in to check on us after which was super sweet. She was incredible. But yes, he did come back for all of that. There was a sense of me being like, “Huh. This all worked out.” Meagan: Look at that. Caitlin: It all worked out. Would you look at that? It was interesting because he was very much like, “I knew you were determined.” I was like, “Okay, yeah. I was but you were trying to make me not be.” Meagan: Yeah. Caitlin: I don’t know. I do believe that he did incredible with my first birth and especially with a first-time mom with that scary of a situation happening. I just think that sometimes it’s what’s more comfortable. It makes me sad because if that was my first baby, I literally would have not ended up in the situation I was in. I just wonder how many moms get put in these positions and then have to make– don’t get to make the call because they don’t know they can make the call. They don’t know they are the ones who get to make the choice. Meagan: Yeah, exactly. It goes back to the review where it says that this podcast is for people who have had a previous Cesarean but also for people who haven’t had a previous Cesarean and who haven’t had these experiences and who may not have that full education yet. Caitlin: Right. Meagan: I think this podcast is so great for people who want to learn what happens out there and what could happen and what your options are and how people advocate for themselves. I’m so grateful for the nursing staff. Caitlin: Oh my gosh. They were so amazing. When we got moved to the other room after the baby was born, the nurse who was there when I signed my AMAs and stuff, the one who did all that with us, she came into the room and was clapping. She was like, “You did it!” Everybody was so on our team which was truly incredible. That meant everything for

Sabina is one of our VBAC-certified doulas from Canada and is sharing her peaceful FBA2C today. While free birth comes with its own risks and benefits, we know that many women feel drawn to this option when they have no support or do not feel safe birthing any other way as Sabina did. We want to share all types of births after Cesarean and honor all stories! The way Sabina trusted in her body and in the physiological birth process after a traumatic experience with HELLP syndrome is truly inspiring. Among the many important messages from this episode, Meagan says: “If you are a provider listening and you perform C-sections, please, please hear what we are saying today. What you say to us while we are on the table in the most vulnerable position… impacts us. Every word that comes out of your mouth, please think about it. Please think about it because it impacts us…I’m getting emotional because I remember my provider talking crap like that and saying things like that. It impacts us longer than you will ever, ever know and it will impact us for every future birth. Please, providers. Please, please, please from the bottom of my heart, I beg of you. Watch what you say to people.” The VBAC Link Blog: VBAC with PreeclampsiaNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello Women of Strength. It is Meagan and I’m so excited to be recording wtih you today. You’ve probably been listening all summer but I’ve actually not been in the recording studio all summer. I record up until May until my kids get out of school then I take June and July off so I can be with my kids and save you guys from the screaming and the dog barking and all of that in the background. It’s August and we are back in the studio and we have our friend, Sabina. Hello. Sabina: Hello. Meagan: I’m so excited to have her on today. You guys, she is one of our VBAC-certified doulas which is so exciting. She is also a mama of three. She is a FBA2C. Okay, you guys. F is a new one. We haven’t been sharing a lot of F. We’ve had H and V and breech B so what does F stand for?Sabina: F stands for free birth which means I did not have any kind of provider with me during my pregnancy or during my birth. I just did it all by myself. Meagan: Yep, you did. Sometimes I feel like it’s a mother-led pregnancy. Sabina: Yes. Yes. Meagan: This is something. We’ve talked about this a little bit before we got recording. The world, when we look at free birth, frowns deeply upon it. It’s not for everyone. Sabina: No. Meagan: That’s why a good majority doesn’t. However, I think it’s important to share these free birth stories. They are still beautiful stories and it doesn’t mean because you didn’t have a provider that your story doesn’t deserve to be heard, right?Sabina: Right. Meagan: I think that it’s also important to talk a little bit about the fact that so many people are not getting the support. You’re going to tell us a little bit more about why you chose free birth, but the world as we know it is not VBAC-supportive in many ways, in most ways. Sabina: Still. Meagan: Yeah, as we know. You are in Canada, right?Sabina: Yep. Meagan: We know that there are some hurdles there too. Even here in Utah, over the last 10 years of me being a doula and having babies of my own, I’ve watched the VBAC support wane and actually wane in the less-ideal way which is really unfortunate. We have a lot of people who try. They try and find the support. They try and get what they deserve. You deserve support. Women of Strength, no matter who you are or where you are, you deserve support. Most people who choose to free birth ran out of those options and decide that they are still going to do what’s best for them. That is what Sabina did and I’m excited for her to share her stories. In addition to free birth, we have some other little things in there. HELLP syndrome, if you’ve ever heard of HELLP syndrome you guys, or if you haven’t ever heard of HELLP syndrome, we’re going to talk more about that and what that looks like, the symptoms and things like that, and what it could mean. Then larger babies and then yeah, I want to talk a little bit more about VBAC doulas too because we love our VBAC doulas. I don’t know. Are you serving right now? Sabina: I am, yeah. Meagan: You have a new babe, but you are. Okay, if you are in Canada– and where are you again?Sabina: I’m in Ottawa. Meagan: Ottawa. Okay, you guys, give her a call. You can find her on our website at thevbaclink.com/findadoula. Sabina: I don’t have a website but my Instagram is @letsdoulathisvbac. Meagan: Let’s doula this. We will make sure to tag her so just go to today’s Instagram or Facebook and find her. We do have a Review of the Week so we will jump into that and then get into your beautiful stories. This review is by mitaya. I don’t know. I think it’s probably an abbreviation. I don’t know. Maybe it’s a name but it says, “I vote this place on over the speaker in every OB/GYN office.” I love that. It says, “I cannot even begin to describe what an encouragement these podcasts have been for me. I have completely binged on these in the past few weeks and they have grown my confidence for my up and coming baby. I cannot stop sharing everything I am learning and even helping to encourage first-time moms on how to educate themselves to avoid a Cesarean in the first place.” Ding, ding, ding. We’re actually going to have an episode about that, y’all. So if you’re ready to share an episode with a first-time mom, it’s coming up. “Thank you so much for this no-B.S., truth-declaring, and empowering platform that I know has encouraged so many more than just myself. Keep being amazing. I can’t wait to share our story in just a few short months. All of my love.”Thank you so much for your review and I hope that you had your VBAC and had a beautiful birth. If you are still listening with us, let us know. Give us a shoutout on my email or on Facebook or Instagram. Meagan: Okay, Ms. Sabina. Are you ready to dive in to these beautiful stories? Sabina: I am. Meagan: Let’s do it. Sabina: This is surreal because I’ve been picturing this whole pregnancy how I would talk about things if I was on the podcast. Every time I had a symptom, I thought about how I would say it on a podcast so it’s very cool to actually get to do it. Meagan: Tell us all of the things. Here you are. Sabina: Okay. I’ll start with my first birth. I was pregnant in 2019 and I had one appointment with an OB then realized it wasn’t for me. I switched to midwives and had a perfectly uncomplicated pregnancy. I’m very athletic so I was in shape working out the whole time. No symptoms of anything other than heartburn and some rib pain. We had midwives who were great and then around 41 weeks, actually on 41 weeks to the day, we had our ultrasound just to make sure everything was going well. When we got there, I started getting a lot of pain in my right side. Again, I had rib pain so I just brushed it off. It’s nothing. I had seen my midwives the day before and everything looked good. Blood pressure was fine. We were sitting in the waiting room and it just kept getting more and more uncomfortable. I started sweating and I asked my husband if we could just step outside for a bit then I remembered one of my friends saying that when she was in labor, she would put her arms around her husband and just dangle to open everything. I tried that hoping it would relieve some pressure and I just started panicking. My husband who was very naive at the time was like, “Oh, this is it. You’re in labor.” I was like, “No. This is not right. It’s not going away.” Meagan: Something’s off. Sabina: Something’s off. We went back in and I asked the receptionist if I could just go lie down. They brought me into a room and at this point, I couldn’t sit still. We called my midwife and she asked if I was prone to panic attacks and I said, “No, I’ve never had one.” They checked the baby and he was totally fine. But my midwife was like, “Okay, I’ll meet you at the hospital.” We called the ambulance and this is where it starts to get fuzzy. I was in shock. I couldn’t remember everything but we took an ambulance and the only reason we took an ambulance was because I thought they would help but they didn’t do anything. They just waited and took me to the hospital. I spent the ride on my hands and knees and when we got to the hospital, my blood pressure was 275/174. Again, we had just checked it the day before and it was totally normal, 121/80. My midwife was there and they asked if they could check my cervix just to see if it was a bizarre labor and I was barely a centimeter. I was still very posterior so nothing was really happening. I do remember my mom quickly poking her head in. My husband must have called her but then they were like, “Okay, let’s do a C-section.” I don’t remember a lot. I remember as soon as they gave me the epidural, I could relax. Everything just went away. I briefly remember seeing my husband and being like, “Oh my god. We’re going to have a baby.”I remember hearing him cry. They showed him to me the first time. I also had a cyst on one of my ovaries so they showed me that. It was kind of cool. Then in the recovery room, I very briefly remember trying to feed my son and then I told them that my vision was jumping around and I couldn’t focus so they handed him over to my husband and then I don’t remember anything else. Basically, they never treated my blood pressure. They just–Meagan: Wait, they didn’t do anything? They were just like, “We’ve got to get the baby out” type thing then they ignored the astronomically high blood pressure?Sabina: Yes. Meagan: Okay. Sabina: Even though the baby was fine because we had just had the ultrasound and checked everything, they completely neglected the blood pressure. Obviously, it dropped when I got the epidural because it gets rid of the pain so it goes down a bit. Later, I found out that they had the medication ready, they just never gave it to me. So as soon as the epidural wore off, my blood pressure shot right back up and I ended up having a seizure. My husband, I mean I don’t remember any of it, but my husband was kicked out into the hall shirtless holding our newborn not knowing what was going on. My parents were down the hall and heard the code blue and just knew it was for me. Then I was just talking to my mom about it yesterday. She said that they were at the nurse’s station demanding to know what was going on. They were telling her to calm down and they just sent them to see my husband. He was in a dark room by himself with a newborn who was crying because he probably wanted to eat or whatever. He just looked like he was a ghost. He didn’t know what was going on. It was horrible. Even to this day, it hurts knowing that that was his entrance into parenthood. Meagan: And both of your experiences too. His entrance and both of your experiences. It didn’t start off very positively. Sabina: No. Definitely not. I remember seeing my dad briefly and then I don’t remember anything until the next day. I woke up and my dad was there and I just said, “What happened?” He told me I had a seizure and then the first couple days, I don’t remember much. My son was in the NICU just because I couldn’t take care of him and they would bring him to me once in a while so I could feed him. My mom said she noticed that every time he was with me, my blood pressure would drop obviously. It makes sense. She advocated for him to get to stay with me. I started breastfeeding even though I was honestly half-dead. They told my family the day it happened that the next 24 hours would determine which direction I went so it was pretty scary. Meagan: Oh my gosh. Sabina: Yeah. Pretty scary. We ended up getting a private room in the ICU and my son was allowed to stay with me as long as somebody else was there. My mom and husband just kept switching off. The nurses were phenomenal. Every nurse we had was great. They brought us a full cart of baby supplies because we had nothing. We didn’t even have a hospital bag but I saw every other person in the hospital. It was incredibly frustrating. We saw residents. We saw random specialists who had nothing to do with me. We saw interns. I never saw the same doctor twice and I was there for a week.Meagan: Whoa. Sabina: Yeah. We kept being told by one doctor that, “Okay, if your blood pressure stays below this level for the next 24 hours, you get to go home.” Then the next day, a doctor would come on and I’d say, “Okay, it stayed below. Can we go home?” They were like, “Oh no, no, no. You’re probably here for the next several days.” It was back and forth like that and it was incredibly frustrating. Eventually, I left against medical advice because I knew I couldn’t heal in the hospital. I knew I needed to go home. We went home with two blood pressure medications and by day two, I had to stop taking them because my blood pressure was so low. Meagan: Whoa. Sabina: Obviously, I made the right choice. It got to the point where I could hardly get out of bed and I was so lethargic because of the blood pressure being so low. Meagan: Your body truly was responding. It was in that flight/fight mode where you’re probably so tense the whole time you were there. Your body was not able to even try to recover. Sabina: Yeah. I mean, that was our first week as parents. It was in the hospital. Eventually, we got moved to the labor and delivery ward but still, we were not home. We weren’t comfortable. We were bored because we were just there and then we’re seeing everybody and their uncle at the hospital coming in because I was a unique case. It was super frustrating. I do want to mention with the HELLP syndrome that my kidneys were failing. I had swelling in my brain. I had to get one MRI or two CTs or the other way around. I only remember one of them. Meagan: Your liver obviously. Sabina: Yes, yeah. My liver was definitely not ideal. Meagan: That was the start of the pain. Sabina: Yeah, again, I thought that was the rib pain. Meagan: Kind of up there. Sabina: I was perfectly healthy. Yeah. I was perfectly healthy. I had worked out that morning. Meagan: Wow. Sabina: I felt totally fine. It was very sudden. Meagan: Did you have any other symptoms like headache, blurred vision, swelling, nausea? Sabina: Not until after that pain. After the C-section, my vision was jumping. Meagan: Yeah, you said. Sabina: Yeah. I couldn’t focus and then the next two days, right here on my head on the right side had severe pain. Nothing would help. They were giving me pain meds and stuff and nothing was helping so eventually, I just stopped taking them. But beforehand, there was absolutely nothing. They didn’t test my blood or urine because it wasn’t routine to check it at that time and they had no reason to check it but it was very, very sudden and very severe. Because they didn’t deal with the blood pressure, I still wonder to this day if they had dealt with it or tried. Meagan: Given you magnesium or something. Sabina: If it wouldn’t have been as severe of a reaction or a problem. Meagan: Yeah. Sabina: It’s very frustrating to look back. Of course, after that I had PTSD but I didn’t know that I had PTSD and the support wasn’t really there. My midwife was like, “Well, of course, you’re going to have some hard times,” but that was kind of it. That was the only support I got. My sister actually was pregnant at the same time and was due a month later. She got induced because she just went past her due date and I was so upset when she was in labor because I was so jealous. It’s a horrible feeling because you’re happy for them but I was just so jealous. My midwife came over that day. Again, there wasn’t really much support surrounding that. It was just like, “Yeah, that’s normal. Move on.” My sister ended up getting a C-section just because she got the cascade of interventions. It was a typical story. For the next year, it was extremely difficult mentally. Any time I tried to talk to somebody about it, it was always like, “Well, you have a healthy baby,” so trying to justify that everything was worth it because the baby is healthy. Again, I didn’t tell my family how much I was struggling but anytime like for example, I would talk to my mom about it and be like, “I missed all of those moments with him like the first night. I wasn’t with him at all.” She would always say something like, “Well, he was taken care of,” because she was there. I’m super grateful that they were there, but it would crush me inside because–Meagan: But not by me. Sabina: It should have been me. All of those moments should have been me. Then toward my son’s first birthday, we were talking about his birthday party and again, my sister did not mean anything by this because she just didn’t know what I was going through but she was like, “Well, you didn’t really give birth so we’ll call it his removal day.” I just played it off like it was fine, but my insides just crumbled. Meagan: That would impact me. That just made me have a little bit of an ick. I’m sure she didn’t mean any harm by that, right? But that just gave me the ick. Sabina: Yeah, she didn’t mean harm at all. So I just would play these things off and smile and nod sort of thing, but inside it just crushed me. Meagan: I’m sorry. Sabina: I never thought that I would have a C-section. You just don’t think that’s going to happen to you. His first birthday was really hard and then after that, I just started looking forward to the next one which was good but also not good because I didn’t really do any healing or recovering. I just was like, “Okay, it’s done. Let’s move on.” So my second birth was in 2021 and it was more of a classic unsupportive provider scenario. I went with the same midwife because she was amazing during our first birth and I had a lot of trust with her. She was amazing but she told me I needed to see high-risk as well. I went to see the high-risk doctor and he did not want to see me. He just was l​​ike, “You are a pretty low high-risk because it happened so late in your pregnancy. Take baby aspirin. Get some extra ultrasounds. We don’t need to see you.” I said, “Great. That’s perfect. I don’t care.” But my midwife was like, “Nope. You need to see him every month if you want to continue with us.” Meagan: Was that the protocol of their staff or was that just her opinion giving her comfort of you seeing an OB?Sabina: Yep. I think it was her comfort because she said that then if something did happen, we had him on hand sort of thing. Meagan: Okay. Sabina: I still wanted a home birth. I wanted a home birth with my first. Obviously, it didn’t happen so I still was totally comfortable. I knew it wasn’t going to happen again. We were going to take every precaution but my midwife was like, “Nope. It’s too risky because you are a VBAC and you’ve had that happen, we can’t support you in a home birth.” Again, I didn’t know all of the red flags at this time and I just trusted her too much to think otherwise. I pretty much left every midwife appointment crying because any time I had tried to be positive and be like, “Okay, well if I can’t deliver at home, I’ll deliver at the hospital,” they’d be like, “No. You can’t deliver at this hospital. You have to go to a higher-level hospital.” Those were the ones where I stayed in the ICU for a week so I didn’t want to go there. Meagan: Triggering. Sabina: Yeah, and that’s where I had to go for the high-risk too. I was going there once a month and then 2-3 times a month toward the end of this hospital where we had been through all of this trauma. Eventually, I asked if I could do the appointments over the phone because you’d get the ultrasound then you’d have to wait 2-3 hours to see the doctor because they were always so behind. I checked my blood pressure. I was just like, “Can you just call me?” That was fine so it made it that much easier. Yeah. Eventually, my midwife said that if everything was fine by a certain point, she would talk to the OB at the hospital that I wanted to deliver at and see what they thought. Ultimately, they said I had to transfer to OB care if I wanted to deliver there. It was stupid. Again, another red flag. I had to be induced and yada, yada, yada. There were all of these stipulations and everything needed to be what they needed. We saw the OB once and I did not– we were in and out in 5 minutes. I did not like it. She could not have cared less about me. It was very obvious. My midwife said that starting at 38 weeks, we should try and do stretch and sweeps every few days to get things going before my due date. Meagan: She really wanted you to have a baby before that 41-week mark. Sabina: Yes, exactly. She was more scared than we were. Even my husband wasn’t as scared and he is a very anxious person. Yeah. We started doing the stretch and sweeps and again, I should have refused but you don’t know what you don’t know at that point. I found The VBAC Link when I was 37 weeks so I wish I had found it earlier so that I could have done the course and saw all of these red flags and had taken things into my own hands. Eventually, we kept going in to get induced but we got sent home because there were no beds. Again, I was like, “Why are we doing this then? I’m obviously not high on their priority list.” Eventually, we went in. They broke my water. We waited to see if anything would happen and nothing did. They started Pitocin. For the first 6 hours on Pitocin, I was able to handle it but my husband and I were so uncomfortable in the hospital room mentally, physically, and emotionally. We didn’t want to be there. We were never in the room alone so we couldn’t be ourselves because there were strangers there. I eventually asked for the epidural. I told my midwife that if I asked for the epidural, try everything else first, then do the epidural. As soon as I asked for the epidural, she was just like, “Okay, let’s do it.” No pushback, so that was super frustrating as well. We got the epidural then 2 hours later, a different OB came in, checked me, and was like, “No. You are not dilating. It’s not working. You need a C-section.” Again, I didn’t know this at the time, but she said there was no progress but I had dilated a centimeter. I had fully effaced and– yes, fully. Not just a little bit. Fully effaced. Meagan: If everybody could see my face right now, I’m like, what? That’s not change or progress?Sabina: Then my cervix had come forward too. Meagan: Big changes all around. Sabina: Big changes. Big changes, just not fast enough for this doctor. I knew it wasn’t necessary. I waited for my midwife to come in and fight for me and she just went along with it. I was like, “What? No.” I didn’t know I had the right to just say, “No, I’m not doing that.” Neither did my husband. Meagan: Even though you had the right, it’s still very hard. Sabina: It’s very hard. Meagan: It’s a very difficult thing to be like, “Actually, no. I’ve got two medical professionals here telling me what I should do but I think no and how do I say that?” Sabina: Yeah, and you’re already in such a vulnerable state then there is all that negative energy too which really affects me. I’m a highly sensitive person so energies really affect me. Meagan: You were proof in your first birth too. As soon as that doctor walked in, I could feel that negative energy. I knew she didn’t care about me. She wasn’t in this job for the right reasons. I bawled and my husband tried to comfort me. He was like, “It’s going to be different. We’re going to remember everything. We know what’s happening this time.” I just kept saying, “Yeah, but we don’t need it. The baby is fine. I’m fine. It’s just not necessary.”Anyway, eventually, we had the C-section and I just laid there on the table sobbing. I did obviously remember everything but I was just miserable. I was pumped full of every drug so I was exhausted. I think it really affected the bonding experience between me and my baby. That first night with my son, I wanted him constantly. I wanted him on me. I didn’t want anyone to take him with her. I wanted her to sleep separately so I could sleep which is very unlike me. I really think all of the Pitocin and everything blocked my natural hormone releases. While I was lying on the table, my husband and the baby got taken away to the recovery room and I was just trying to rest. The OB was like, “So do you want more kids?” I was like, “Yeah.” She was like, “Well, they’ll all have to be C-sections,” while I was laying on the table after sobbing that whole time. It was just horrible. Meagan: I don’t want to interrupt you but I do because I want to point out to everyone that especially if you are a provider listening and you perform C-sections, please, please hear what we are saying today. What you say to us while we are on the table in the most vulnerable position– some of us are strapped down to a table– what you say to us impacts us. Every word that comes out of your mouth, please think about it. Please think about it because it impacts us and it impacts us longer– I’m getting emotional because I remember my provider talking crap like that and saying things like that. It impacts us longer than you will ever, ever know and it will impact us for every future birth. Please, providers. Please, please, please from the bottom of my heart, I beg of you. Watch what you say to people. Okay, sorry. Keep going. Sabina: That’s okay. I totally agree with you. The lack of bedside manner, especially for VBACs because when you’ve gone through a C-section, even if it was planned or whatever, it still can be traumatic and they just don’t get it. She even told me, “I had 3 C-sections. Once your baby is out, you won’t care how it happened.” It’s like, good for you but not everybody is the same as you. Maybe you don’t care about birth experiences but lots of women do. It was super frustrating. We stayed one night in the hospital and then left. Of course, the PTSD came back. The midwives all tried to tell me that the C-section was necessary because her hands were up over her face so she wouldn’t have come out anyway but their stories weren’t the same so I realized that they were lying and were just trying to justify that it was necessary. Meagan: Yeah. That’s unfortunate.Sabina: Yeah. The PTSD came back and I it got to a point– I can’t remember how many months my daughter was but I was visiting with a neighbor and I was talking about my experiences and I was like, “Next time, I’m going to have a VBAC. I’m going to do whatever it takes to have a VBAC.” She was like, “Why would you even try that?” I was like, “What do you mean?” She was like, “Well, there’s the risk of rupture so why would you even do that when you could just have a C-section?” It broke me. I came home. I bawled to my husband and a few days later, I was still really upset about it. He didn’t know how to help which is fair and he was just like, “Maybe you need to see a therapist.” I’m sure there are some out there, but I couldn’t find any that fit here and therapy is not something that I thought would help me. I know it helps lots of people so I started looking up my symptoms and things. I found out that it was PTSD. It got to a point where I was like, okay. I need to fix this for myself. I took The VBAC Link Course which already was super helpful just because I felt empowered going forward. I knew that my potentially both C-sections weren’t necessary but definitely the second one. I knew the risks and benefits of having a vaginal birth after two C-sections. I had all of the proof in front of me. Then it also pushed me to become a doula. I’ve always wanted to be in the birth world. I became a nurse to work in obstetrics but then left nursing after 4 years because it just wasn’t for me. I was like, “This is what I’m meant to do.”I wish I had known about doulas for my other two births. I took a doula course and then I took The VBAC Link Doula Course and within a month of starting my doula page, I already had a VBAC client who reached out which was super exciting. She got in with the midwives that I had, with the particular midwife that I had. I was like, “Okay. Maybe this is a good thing. Maybe I can teach her about VBACs.” The first appointment, she was great apparently then after that, it was constantly, “Well, you have this so maybe we should do a hospital birth or you have this.” Every time she saw them, they were trying to push her to a hospital birth. She ended up having a free birth with me which was really cool. Meagan: She did? Really? Sabina: I told her from the get-go, “If that’s something you want, I’m here for you. I’m totally comfortable with that.” Her original plan was just to maybe not call the midwives unless she felt something was wrong but then after some of those appointments, she was like, “No. They’re not coming. We’re not calling them. If we need help, we’ll just go to the hospital.” Yeah. She had a free birth and it was awesome. It was great to be there. I was 14 weeks pregnant at the time so it was great for me. I actually met my doula a year before we even tried to conceive because I wanted to be prepared. She wasn’t a VBAC doula, but she was newer and very open to the idea of having a home birth after C-sections. We became friends to the point where I actually attended her birth 3 months before she attended mine. Meagan: Oh my gosh, so cool. Sabina: Yeah, when I got pregnant with this one, I pretty much knew right away that I wasn’t going to have a provider. It wasn’t for me. I did apply to the midwife groups but every one of them either refused or said I was on the waitlist but I wasn’t. As soon as they saw I wanted a home birth after two C-sections, that was thrown out. I mentioned it to my husband once and then the second time I mentioned it, he was fully on board which was mentioned. Meagan: Really? Because you said he was anxious about things yeah. Sabina: Anxious, yeah. But I had been educating him along the way too with everything that I learned. Any time I told him stories of other women who had difficult births or my client who was having these horrible appointments, he would get angry too so yeah. He really had become pretty educated on the topic which was amazing. He was very comfortable with our doula as well. He was like, “She’s really knowledgeable.” We had a plan in place for if there was an actual emergency and if I wanted to transfer for whatever other reason. We had it set up and most other things I felt like I could handle myself unless it was one of the few very serious emergencies. My mindset going into this birth was amazing. I read daily affirmations to myself before bed and then I would listen to her heartbeat. I could hear it with a stethoscope around 15 weeks so every night I would listen to her heartbeat and I just felt so connected and so in tune with my body and my intuition which was something that kept getting shut down with my other births I found. It was the most stress-free pregnancy. We didn’t do any tests. We got a couple of ultrasounds just because I like seeing the baby and I’m a very visual person but that was it. Both me and my husband were like, “This is amazing. We’re just living our lives normally and not these stipulations and all of these worries being pushed on us.” I was checking my blood pressure but I just eventually was like, I don’t really feel like I need to do this. It was very low. It was 90/50 for most of the pregnancy so I was like, I’m fine. I was still taking the aspirin just as a precaution but that was it. I wasn’t in a rush. I wasn’t like, baby has to be out at a certain time. I was just like, let’s let things happen because we didn’t get that opportunity with the last two. I had my mucus plug start to come out around 39 weeks and 4 or 5 days which was very exciting but I told my husband that it doesn’t really mean much. Things are happening as they should. A couple of days later, the bloody show came out as well. Again, I was like, “We are fine. This could be going on for weeks. Whatever.”Then that night, so it was actually the morning of my due date, I had prodromal labor. I started feeling contractions and of course, I got excited but it started I think at 4:00 in the morning. I just sat there and breathed through them. They weren’t intense. They were very easy to get through then me and my husband got everything ready when he got up then it stopped. I was like, “Okay, whatever. My body is just practicing.” For the next week or so, the mucus plug kept coming out throughout the week just in little bits. I didn’t have any other contractions until– I have it written down here– the night of July 3rd into the morning of July 4th so probably 10 hours. I had prodromal labor overnight then it stopped as soon as I got up in the morning. I tried doing the Miles Circuit and both times it stopped the contractions so I was like, okay. Whatever. At least I know how to stop them. Meagan: Sometimes Miles Circuit does stop them because a lot of the times prodromal is a positional thing. Baby is trying to figure it out so the Miles Circuit helps with position and if it moves baby, it can stop them. Sabina: Yep. I was a little bit frustrated that day because I was like, I’m losing sleep now. I don’t know if I should rest during the day because I still could be weeks away from giving birth. I was like, “We need to stay busy. We need to have plans for every day just so I don’t feel like I’m rushing.”Meagan: Take your mind off of it. Sabina: Yeah. We kept busy that day then we were sitting after dinner. Around 8:00 PM I started feeling them again and I was like, “Great. Another night of no sleep. Okay, whatever.” The second night I had them, they were stronger than that first time but I could still breathe through them and stay lying down. That night they were even stronger which is odd because usually prodromal labor is the same. Meagan: It’s monotone, yeah. Sabina: But these ones, I couldn’t lay down which was really frustrating because I was so tired. I had to keep getting up. I tried doing the Miles Circuit and it didn’t help so I was like, “Okay, I guess I’m going to stay awake all night.” In the morning, I got up and I was waiting for them to stop. I tried to have a hot shower and they were still going. It was 10:00 in the morning at this point and the other ones had always stopped at 8:00. I was like, “Okay. Maybe this is something.” My husband was like, “Get Jess here.” I was like, “Well, I’m fine though. I don’t need the help.” But I texted her to let her know what was going on and then for my husband’s sake, told her to come because I knew he needed that comfort. We called her and we called our friend who was going to come watch the kids. For the whole day, I was contracting and dealing with it beautifully. I was breathing through it no problem. I was excited every time I got a contraction. I wasn’t timing them because I felt like that was stressing me out. I felt like they needed to be a certain length and a certain time apart. I stopped timing them and it was just really nice. Our friend was taking the kids swimming. Me and my doula were mulling around the house and she would play with the kids too. It was like we were all just hanging out. It was so peaceful. Then around 4:00, she does reflexology, my doula, so she got me to lay down and did some acupressure stuff on my feet. While she was doing that, I had a really big contraction and after that they pretty much stayed. I think that was the shift into active labor. My husband made everybody dinner which was nice and I was just in the kitchen picking up the food while going through contractions. Eventually, the kids went to bed and our friend left. At this point, it was 8:00 at night. I had the TENS machine on. I had been going back and forth from the

Lauren joins us today from Australia sharing her two Cesarean stories and her surprise unassisted HBA2C story! Lauren’s first birth was a crash Cesarean under general anesthesia at 40+1 due to nonreassuring fetal heart tones. Her second birth was a TOLAC going into spontaneous labor at 40+3 under the midwifery model of care. She labored naturally, had an artificial rupture of membranes at 6 centimeters, baby was posterior, and didn’t descend. She pushed for an hour then had a spinal given to help baby manually rotate. Lauren’s birth ended in a CBAC which she later learned included a special scar along with the diagnosis of CPD (Cephalopelvic Disproportion). Two years later, Lauren was vigorously planning for a VBA2C. She had her birth team picked out and was ready to go to the hospital for when baby would come at what she thought would be 40 weeks again or later. At 38 weeks and 2 days, her husband went on a work trip 3 hours away and her mom, who was planning on caring for her boys during the birth, was an hour away on a day trip. Lauren’s labor began in the evening while she was alone with her two boys and ramped up extremely fast. With the help of her doula and paramedics supervising, Lauren labored and gave birth to her baby on the bathroom floor in just 2 hours from start to finish!Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. You guys, we have another story coming from Australia for you today. We just recently had an Australian mama and I love our Australian episodes because I cannot get enough of your accent. I love listening to you guys. We’re so excited. We have our friend, Lauren, and we have our little baby. Lauren: Yes. Little Wren’s awake and joining us. Meagan: It’s 11:00 PM there so she stayed up extra late to record with us today. We are going to get into her stories. You guys, she had two C-sections. Lauren: Yes, two Cesareans. Meagan: And then a surprise. I feel like you really had very unique things. You had an OB and you were under general– Lauren: For my first. Meagan: Then you were with midwifery care and then a surprise which you are going to be sharing here in a second. You guys, I’m really excited to hear her stories. We do have a Review of the Week and it’s called, “So Grateful I Found This Podcast” by shinefortheworldtosee. It says, “After having an emergency C-section last year, I struggled with all of these displaced emotions. Here I was so grateful for my healthy baby but I found myself feeling hurt like I had something taken from me that I struggled finding a safe place to share and it felt as if no one around me had ever experienced the same thing I did. This podcast and group of women are my safe place. I am expecting baby number two and am so, so grateful for the empowerment that those stories told here have given me. I am so excited to try for a VBAC this time and the more I learn here, the more confident I become.“Thank you from the bottom of my heart for making this podcast.” You are so welcome. I love this podcast so much. I love all of the stories. I love the empowerment, the encouragement, the education, and also, I’m a big person who relates. I love relating. I think it brings validation to my heart when I can relate to someone because like this listener said, she felt alone. She didn’t have anybody else in her space and this space is so amazing because even if it’s a different outcome or there are different parts of the story, there are usually little blurbs of each story that you can truly relate to. Thank you so much for your review, shinefortheworldtosee. As always, if you haven’t yet, please leave us a review. We are always so grateful for them. Meagan: Okay, cute Lauren. Oh my gosh. Thank you so much for staying up way late because by the time we are done recording this, it’s going to be midnight. Oh my goodness. Oh my gosh, thank you. Lauren: That’s okay. I got the time and said, “Oh, it is late,” but I was so excited anyway. I just can’t wait. With that review, I was thinking the exact same thing. I remember when I found the podcast, I can’t even remember. I was trying to think how it popped up. I didn’t even know VBAC was a thing after my first birth. I just remember listening to it and so much of it resonated. I could relate to those little bits. It was like I was meant to hear it. I just had that strong feeling when I started listening to the podcast. I’d be crying in the car and it was just so powerful. It definitely was life-changing when I found the podcast. Huge. I feel like there are so many situations where you’ve never met them ever in your life. Sometimes we don’t even know where they are at and it feels like they are literally sitting on the phone talking to you. Lauren: Speaking to you, yes. Meagan: Speaking to you. Yes. Lauren: Yes, exactly. I felt it. I was just like, This is what I’m supposed to be listening to at this exact time because it was speaking directly to me. It is so special what you have created. I think there is a podcast now in Australia for VBAC but there was never anything before and I would just eat them up. I’d be waiting every week for the podcast because I would be–Meagan: Is it Ashley’s? Lauren: There’s that one. I think I’ve listened to her podcast with you actually. There’s the “Australian VBAC Stories” as well. They are only maybe up to 8 or 10 episodes so they are quite fresh. Meagan: Yay. Lauren: I just love all VBAC stories. I could listen to them all day. Meagan: Absolutely. Well, let’s get going on sharing yours. Lauren: Yes. Okay, so my first birth was– I got pregnant in 2017. We’ve got three little ones now. Nate was our first baby. We had private health insurance. A few of our friends had gone private. Some of them had gone public. Some had Cesareans. Some had natural births. I hadn’t really had a plan of what I wanted to do. I always knew I wanted to have children but I hadn’t really given much thought to the pregnancy or the way of birth or anything like that. We just signed up with a private OB. I think from our GP, you get a referral then you start seeing them from about 16-20 weeks. You get all the regular scans. Everything was really straightforward. We were really fortunate with our pregnancy. We found out we were having a boy. We found out in– I think I’ve written it down– January. I had morning sickness for the first 3 months then I had a bit of Vitamin D deficiency so I had to take supplements throughout the pregnancy for that. I had a growth scan around 36 weeks. Now, I obviously know after doing a lot of research that there’s no real need for it and it’s just something to give them ammunition to schedule the big baby and the scan actually came back that he was measuring fine. I was like, “Yep, that’s good.” Being a first-time mum, I was so excited to see him on the ultrasound anyway. Meagan: That’s what I was going to say. I feel like they get you especially for first-time moms but really in general because it’s so fun to see our baby. Yeah. Lauren: Of course I want to see him. Definitely. Meagan: We get in there and they’re like, “We’ll do this plus you’ll get to see your baby.” You’re like, “Well, I haven’t seen my baby since 20 weeks, so okay. I’ll do that.” Lauren: And you don’t know any different so you’re just like, “Yep, that seems fine.” I think we even did a gender reveal and I think my husband’s cousin mentioned something about her friend doing Hypnobirthing. I remember I just wasn’t in the right place to hear that at the time. I’m like, I wish I would have listened but it just wasn’t meant for me at that time. I took maternity leave. I had 4 weeks off because I thought, Whoa, from 36 weeks the baby could really come any time. Looking back, I know 40 weeks is not even your due date. It could be any time, anywhere. Meagan: Estimated. Estimated. Lauren: A guess date I’ve heard a lot of people refer to it. And first-time moms tend to go over the 40 weeks so it’s not uncommon. I remember it being such a mind game toward the end when I was getting closer to the due date. I think my OB offered me a stretch and sweep around 38-39 weeks and I was like, “Yep. I’m ready. I’m over it. Anything that we can do to get the baby.” I didn’t really think of it as being an intervention. I didn’t really know what the word intervention was at that time. I do remember her saying to me afterward something like, “Oh, I hope we’re still friends after this,” after she did it. Meagan: Oh. Lauren: I was like, “Oh, that’s a funny thing to say.” Then yeah. I think it was around 39 weeks and there was nothing. It didn’t get anything moving. I was just automatically booked in for an induction at 40 + 1 for postdates which is not even near postdates but I was just like, “Yep, great.” I think like you said before, being a first-time mom, I was just ready to see my baby and over it so I was like, “Yep. That’s great and exciting.” We got booked in. When I went back through my records, I saw on my induction paperwork that it even said, “Small mummy and postdates,” because I was small apparently. Meagan: Nuh-uh. Lauren: Yeah. I’m quite short. But they were already preempting that I probably wouldn’t be able to anyway. We went in. I think we got admitted at 7:00 in the evening. We got ready to do a CTG monitoring and just an initial assessment. When we got in, they said I was having uterine activity but I couldn’t feel anything. It was showing on the monitor I was having some Braxton Hicks or some contractions. They were concerned that the baby wasn’t really reacting very well to that at the time so they called the OB who just happened to continue with the induction. They did a vaginal assessment and I think I wasn’t obviously at anything. They did another CTG for the fetal heart rate and it had gone down, I think, to 90 BPM and had recovered within 2 minutes with a change of position and it had come back to what they were happy with. About an hour after that, they did an intravenous drip in and they did another exam. I was 1 centimeter and my cervix was posterior so obviously, I wasn’t anywhere near ready. I think maybe half an hour after that, there was another decel and it said, with pointless uterine activity. It wasn’t doing anything, but there was something. Then the OB was asked to come in for that. Obviously, the baby wasn’t doing very well when I wasn’t really even in active labor and they were a bit concerned with that thinking he wouldn’t be able to tolerate full-blown labor at that point. So then it was 9:00– so two hours after we got there– when the OB was in the room. They did an ultrasound and were able to determine that I had a calcified placenta and a pocket full of fluid. There was discussion around maybe booking in for a Cesarean just because of the nonreassuring CTG they were having. I awfully now remember feeling a sense of relief and being like, “Oh, good. I don’t have to go through labor and all of that,” because I think probably admitting to myself, I was a little bit scared about the whole labor because I hadn’t done any preparation or any planning. The only thing we had done was the antenatal appointment– what’s the word? The antenatal class at the hospital where they go through it. After we left, my husband was like, “That all sounds awful.” It was just really interventions and how to get the baby out. He was like, “None of those options sound good.” When they said “Cesarean”, I was like, “Oh, perfect. That will be great.” I think at 9:30, we got prepared to go to theater. My husband got in a gown. My mum had actually just arrived into the hospital so it was all exciting. We were going to meet the baby. This was at 9:30. We didn’t know it at the time, but there were a few alarms going on outside our room and there were a few people milling around. I don’t know. I don’t think that was related to us. We got wheeled out on the bed to go to theater and then all of a sudden, Josh disappears and they were rushing us to the theater room. I was like, “What’s happening?” I’ll never forget. I remember– I don’t know who was pushing me, but he said to me, “I don’t think you understand. Your baby needs to come out right now.” We just thought we were going in for a normal Cesarean. We didn’t realize it was changed to a general anesthetic so I started getting upset. I said, “Can I just say goodbye to my husband?” They rushed him back. I quickly kissed him and said goodbye. He gave them his phone and we went into theater. I was sobbing at this point because I just didn’t know what was happening. There was somebody putting a catheter. They were putting the general anesthetic in then I think my OB popped her head in. At least, I knew some sense of calm. She said, “It’s me. I’m here. We’re just going to get the baby out.” I remember I could see them prepping my stomach under the mirror and the anesthetist was lovely. He rubbed my cheek and said, “It’s going to be okay. We’re just going to get the baby.” That’s it. That’s all I remember and then I was gone. After that, I think at the time, I read back on the notes that it was 9:45. It got upgraded to an emergency call. I went under at 9:50 and he was born at 9:52 so it was very quick. He came out. He cried. He was fine. His APGARS were 9 which are healthy. Meagan: That’s great, yeah. Lauren: So fine, yeah. I think he was 3,000 grams which is 6.8 pounds and the surgery was complete at 10:05 so it was super quick in and out. Meagan: Wow. Lauren: He went to Josh straightaway. Poor Josh was obviously just waiting and didn’t know what was happening. They brought Nate out and he said, “Well, that’s great, but where’s Lauren? Where is she?” So then I didn’t make it into recovery until 20 minutes later which I know is still really fortunate compared to what some people experience. It was really quick. When I came to, I was still sobbing I think it must have been because I went under crying. When I came out, I was in tears and I could just see Josh sitting on the bed next to me holding Nate. Instantly, I knew he was okay and he was fine. I was able to hold him and breastfeed him so I think from then on, everything was really quite lucky. We got in straightaway. I think we were in recovery maybe another 20 minutes and then we got taken to the ward. At the time, I don’t think I really registered how full-on it was. I just had a healthy baby. I was okay. Postpartum was a beautiful experience. We were in the hospital, I think, for 5 days together because we were private. Josh got to stay with us. It was like a second honeymoon. We were in there. It was like a hotel where we were getting food. That side of it, I think, was just beautiful and I didn’t really feel like I missed anything birth-wise at that point. That was it I guess with that. Then in 2019, we started thinking about having another baby. I hadn’t really thought too much about a VBAC or what I would do. I guess I was like most people where you just are once a Cesarean, always a Cesarean and there wasn’t another option. I really wish I could remember how I came across it because I can’t remember at all, but I must have found your podcast and I remember listening to it even before I was pregnant. I was just like, I have to try and do this because I never got to experience any labor at all with Nate and then with this pregnancy, I really felt like I missed that and I wanted to have something. I wanted to go into labor and at least try and be given the chance. We were really fortunate and fell pregnant straightaway. That was in 2019 and I knew I wasn’t going to be doing private obstetrician this time so I did a bit of research before I was even pregnant actually with a public hospital that had a midwifery program attached to it. You attended all of your appointments at a clinic and they had a VBAC-specific clinic then you birthed at the hospital. Meagan: That’s awesome. Lauren: Yeah, but you have to apply straightaway. As soon as I got the positive, I filled out the application form and applied directly with them. I got accepted and I was like, If I’m going to go for this, this is going to give me my best chance to go and have a VBAC. I think, I can’t remember how far along I was but I still went. The hospital we were going to is a half hour away but all the appointments with the midwives were only 10 minutes away. That was really good. I knew the drive was a half hour but it was going to be okay. I also had signed up to do the VBAC course with you guys. I got my handout for that and I ate it up. I love that. I went through it and was doing it at night time. After listening to the podcast, I also knew I wanted to do Hypnobirthing so I did Hypnobirthing around 7 or 8 months which was when COVID started to come into the picture. It wasn’t around in Australia but it was happening. The course was supposed to be a group environment with a few classes. We ended up doing an online course which was actually really lovely because when Nate was asleep, Josh and I would sit in bed. We would do all of the Hypnobirthing courses, listen to the tracks, watch the videos, and then we had one in-house visit where we went through all of the positions and acupressure and things like that that I wanted for pain management during birth. That was really good then I think from 37 weeks, I started doing all of the things. I was doing raspberry leaf tea, eating Medjool dates, and sitting on the birth ball. In my head, I felt like I was really getting prepared in the best way possible. Now I know in my third birth, I thought I was but I wasn’t as prepared as I probably could have been. I was still doing more than what I did for my first birth. I had one chiropractic appointment at 38 weeks to get everything balanced and aligned. I never had chiro before so that was all new to me. Then at 39 weeks, I had an acupuncture appointment. I had never done acupuncture before and I loved that. I felt that was really nice. I think it was just my hands and my ankles and then they just put the music on and I felt so relaxed. I really loved that. That was good. I remember when I went in, I said, “I hope I haven’t left it at too late.” They said, “You’re pretty much a first-time mom. You’ve never had labor. Your body has never been through that.” He did some statistics and he said to me that from 40-41 weeks was the average time. I remember with Nate, when I got to 40 weeks, I thought the baby was going to come any day so with this pregnancy, I pushed it out to 41 weeks. In my head, that was when my due date was. I don’t know what I would have done if I got to 41 and I hadn’t gone into labor but I had that I was going to 41 weeks. I had an online hospital tour. We couldn’t go in to see it because of COVID then I had an online appointment at 39 weeks. When you have midwifery care, you still have to be signed off by an obstetrician in the hospital to give you the okay and run through all of the stats and everything. I was prepared to be up against an uphill battle when I went to that appointment. They were pretty supportive. They just talked about postdates, the risk of rupture, and things like that. I said I was comfortable going to 41 weeks and reassessing then so I think that was around 39-40 weeks and then we were rebooked in for 41 weeks if I hadn’t gone in. So then I think I was 40– oh, sorry. I’m jumping around a bit. My due date was a week after Nate’s second birthday so in my head, I just wanted to get to Nate’s birthday and then the baby could come after. We had a little birthday celebration for Nate a few days before I went into labor. We were happy that was done then at 40+3, in the afternoon at about 4:00 I felt a few little tinges but obviously, I didn’t know what anything was so I was thinking this might be it or this could be prodromal labor or Braxton Hicks. I just wasn’t sure. I was like, well, I know from the podcast that I don’t pay attention to it. I’m just going to go about my normal routine with Nate. I’ll get dinner, do bathtime, all of those things, and try not to focus on it too much thinking it might either go away–Meagan: Or fizzle out. Lauren: Yeah. In my head, I’m like, It can take days. By 4:00 it started, then by 7:00, I was getting Nate ready for bed. He was in a cot at this stage. I remember taking a big breath in and slowly exhaling like in Hypnobirthing. I noticed I was having to do that as I put him to bed. I remember being so excited like, This is happening. My body was doing it naturally. I really wanted to try to not get induced if I could avoid it. I remember I really had to focus on my breathing. I was leaning on the bed with my knees on the floor leaning on my bed and just breathing and really trying to relax and listening to my Hypnobirthing tracks. The plan was my mum was going to come over and watch Nate if I went into labor at nighttime. I think it was around 10:00 and I think someone said from one of the podcasts as well to gauge the distance you need to go with how well you are managing and how well the drive is going to take if you’re going to be okay. I called my mum to come. I was like, “I feel like I’m not struggling but it is ramping up a little bit.” I was like, “I don’t know how much longer I can be at home and sitting in the car for a half hour to go.” She arrived. We called the midwives and we let them know we were going into hospital. My mum came and you could just see she was like, “Oh gosh.” She had me naturally. She had three naturals and then her fourth was a Cesarean. She couldn’t understand why I wasn’t trying for a Cesarean because I already had one and why would I not just have another one?Meagan: Why would you not just do that, yeah? Lauren: She came and I remember walking out of my room to the front and I had to stop a few times on the way and stand in the garage and just take a few breaths between each contraction. I went to go sit in the car. In my head, I thought I was going to be on my knees leaning over the chair. I just couldn’t even fit down in that area so I was up against the back of the chair. Obviously, it was not comfortable but I was just thinking if anybody was driving on the freeway and looking, it would have been such a funny sight. I still had my podcast in and I was really focusing on breathing. Josh was just driving. He had never been to any of the appointments with me because of COVID. He hadn’t been to the hospital so we were almost there and his navigation was doing funny things. I had to in the middle of labor try to direct him on how to get to the hospital. We pulled up and I just automatically went to where I would park for all of my appointments which wasn’t in the front of the hospital. I went to get out of the car and I was like, “I can’t walk to the front of the hospital,” so I had to get back in. We drove right to the front and then we went in and we had to get assessed for the COVID triage which was a real pain. We had to wait and do that before we could walk in and get triaged. I think we arrived at the hospital around 11:00. We got admitted at 11:00 at night and then we were triaged maybe at 11:30. By that stage, my contractions were every 3 minutes and lasting about 40-50 seconds. I had a vaginal exam and I was 4 centimeters. I remember just being so excited because I was already progressing. I was hoping I would be further along, but I was like, “4 centimeters is good.” I was 90% effaced and I was thin and soft so I was like, “Oh, that’s good.” I think by midnight we had gone to the labor and delivery suite. They dimmed the lights per my request. I asked to go in the shower because I really wanted to be in the shower. They told me I had to wait until my midwife had come because she wasn’t at the hospital. Meagan: They checked you and got everything assessed. Lauren: Yeah, so I had to wait. That was fine. I was at the stage. I was leaning on the bed swaying. Josh was doing a bit of acupressure on my back and I was really enjoying it at that time. My midwife got there at about 1:00. I was still coping well through it. By 1:30, I don’t think it was my midwife. I think it was one of the hospital midwives who came in and assessed me again. I was at 6 centimeters and I was -2. There were a little bit of complicated decels on the CTG and momentarily in my head, I was like, Oh no, not again. It evened out and it was okay so I think it just must have been a bad reading because of the bulky monitors that they had to put on. They didn’t have the mobile ones. It was the bands that you had to be attached to and monitoring. They suggested to artificially break my waters and I hadn’t felt too much about that in my prep. I think I was just focused on going into labor naturally as opposed to actually being in labor. They asked to break my waters. I had gas for that and I remember getting on the bed to do that which I think was one of my first bad things because then I never got off the bed once I got on there to do that. I couldn’t manage to get back off. I wish I would have known or asked to be helped to get taken off but I was just not in the position to get off the bed. I was stuck there. Yeah. I didn’t remember this but when I read in my notes, they offered me a Cesarean at that point and I was like, “No. I’m trying for a VBAC,” so they said, “That’s okay.” We tried repositioning some fluids and then the CTG was back to where they were happy with it. Then at about a half hour later, I was on my side. I felt a bit of pressure and my sound changed a little bit. I remember my midwife saying to me, “Oh Lauren, that sounded a bit pushy.” It felt a bit pushy so I was like, “Oh, that was really exciting.” That was at 2:00 and at 2:30 in the morning, they assessed me and I was fully dilated. I was so excited. They were seeing some complicated decels on the monitor. I think they said– do you know what the normal heart rate is? I’ve written them all down but they were saying it was 140 without a contraction and then they’d ask the registrar to come in the room so the registrar came in to see what the CTG was doing for progress and pushing. I had a bit of a funny moment. When I was doing the pushing, I was on gas. I must have taken a big inhale of the gas and my vision went dark. I couldn’t see anything. I remember getting a bit scared at that point. I didn’t know what was happening. I could hear everything and I could feel everything but I just couldn’t see. I think it was just from inhaling the gas and the contraction and something. Meagan: It was just too much all at once. Lauren: Yeah. It was really scary but it was a one-off and it was fine after that. Then I think at 2:40, the ped was paged to come in and attend delivery so I think at this stage they still thought things were happening and we were going to have a baby vaginally. 5 minutes later, they gave me an in-dwelling catheter to drain my bladder in case that was creating a blockage for the baby to come down. Meagan: Which is actually something that does happen. Lauren: Yeah. Meagan: If baby is not coming down, sometimes it’s urine blocking. Lauren: Yeah. They said, “Only 50mL came out so it wasn’t a lot,” but I was like, well that was good. At least they tried that. They said the registrar did an IV and said that it was ROP so right occiput posterior so not in a great position and at my spine. They said there was some descent with pushing but not enough. I think that’s when they decided to call to be transferred to theater. The plan was to have a spinal and try for some instrumental assistance to get the baby out. I think at that point, it was quite quick. It was quite intense and I was relieved. I didn’t think I had it in me to push anymore so I agreed to go up to theater and have forceps or manual rotation to help assist the baby out. We got up to theater and I think they called them at 2:40. We got to theater at 3:20 so it wasn’t that long of a wait but it felt like an eternity when my body was contracting and pushing and they were telling me not to push and just to pant through the contractions. I just remember it felt like a really long time. I will never forget that we got to theater. I had to sit up on the edge of the bed and the person trying to put my spinal in asked me to scoot up the bed. I was sitting there mid-contraction and I just remember looking at my midwife and I was like, “You’ll just have to wait until after this contraction and then I can just move up for the spinal.” I got the spinal and they discussed the options of an episiotomy and using forceps to aid the baby. At that stage, I said, “Yep, whatever we need to do,” I would really like to try to get him out. They tried a manual rotation while pushing and his heart rate dropped to 93. They assessed the position and then maybe decided to do the forceps. They must have said that then changed to apply a vacuum because then they did a vacuum and they went to do the first pull and his heart rate dropped to 67. They did another pull and his heart was up at 133. Then a couple of minutes later, they decided to do forceps. They attempted to do the forceps. They applied them and his heart rate dropped to 86 then they reapplied to get a better position around his head and his heart rate again dropped to 75. The baby, even though he had changed position and was now facing– I think his head was facing my back which was OA and he was at a -1 station, they obviously thought he was just not in a great enough position to aid him out so they decided to convert to a Cesarean. I remember at that point, I didn’t feel like it was a failure or I hadn’t done it because they had given me every opportunity to try and I still got to experience so much more than I had with my first birth. Even though I still didn’t end up with a vaginal birth, I got 95% of the way and I was still so happy and proud of my body for getting to that point. I was just like, if they couldn’t even get him out with forceps, there was no way I was going to be able to do it. I was quite happy and content with the decision. They did say he had been down there quite a bit so he might come out not great. Because he was so far down, they did have to– and they did write the word “extract” him which I thought was quite an interesting term to use but the extraction was breech because he was so far low. He came out. His APGARs were 8/9. He was 7.4 pounds and a similar size in length to my first. I think we were there maybe for an hour or two in recovery. He fed straightaway and then we returned to the ward. On my notes, it said, “Repeat C-section due to failed TOLAC.” I was just like, I had that word “failed” but I understand that’s the terminology they used. It says that about an hour later, we had a debrief. They came back into the room and went through all of the happenings and made sure I was okay with it all. They actually discussed any future deliveries and the recommendation for an elective Cesarean. I don’t even remember that conversation. Meagan: Oh really? Lauren: Yeah. I don’t even remember so when I went back through my notes, I was like, “Oh, that’s interesting.” Then in the notes, it also says, “CPD?” I can’t pronounce that word either. Cephalic Pelvic Dysproportion. They said that and then they also said there was a small extension to the upper midline of my Cesarean incision. I had my normal scar and then it obviously had come farther up and it said it was sutured separately on the uterus. I’m reading it in real-time now but I didn’t realize that until my recent birth when I went back through my notes with my midwife. I was like, Well, that’s really interesting. They obviously told me but I must have not registered that at the time. Then obviously we were in hospital due to COVID so Josh wasn’t allowed to stay with us. An hour after his birth, he had to leave and being a Cesarean, I was in hospital for a few days and my other son, Nate, wasn’t able to come in to visit us. I really missed out on us being a family of four for those first few days. Yeah. We got home. I think I was in there for two nights then we got discharged. They met us at the hospital and that drive home was really special. That was the first time they met was in the car driving home. We always knew we wanted a third but it was a lot, the transition to two, and we probably weren’t ready straightaway. We gave it three years then when Call was two, we decided we would try again for baby number three. We fell pregnant really quickly with the first two so we just assumed that would happen this time and we were trying for a few months and it just didn’t really happen. We were trying for 6 months and gave ourselves a bit of a breather and just let it take its natural course because we took the pressure off and then the both of us were saying before the boys were born a week apart in May and we found out we were pregnant with our third in between the middle of their birthdays. It was really special. May has always been a special month but yes, we had Nate’s birthday. I found out we were pregnant then a few days later we had Call’s birthday. So it was really special timing. I knew I wanted to try again. It would be our last baby. If I was going to have a natural birth, it would be this pregnancy. I went to go through the same model of care that I was with Call, but they had changed their practice. The midwife group that I went to no longer existed. It was the MGP so Midwifery Group Practice. They were based in the hospital this time so all of my appointments were in the hospital and they were VBAC-supportive. I think we went in and then you still have to have your OB appointments around 36 weeks and we didn’t find out our gender with this one. We had the two boys and for our third, we weren’t going to find out what we were having. I had the same sort of morning sickness with my third. I was a lot sicker this time. I knew this time I was going to have a student-midwife and a doula. I got a visit. Obviously, The VBAC Community group on Facebook, I posted in there and I also posted in a Western Australia VBAC support group there about recommendations for student-midwives and doulas. Then I spoke to a few of them and then obviously whoever I felt that connection with, I went with them. The doula– I did research doulas with Call, but I don’t know why I didn’t do it that time. I think that would have made a difference. I was like, this is the time I’m going to do it and I’m going to have a doula. We did that. I did a bit of a refresher for the Hypnobirthing as well. I met my doula at about 25 weeks and we sat. We met at a park and we just chatted for hours. She had a VBAC as well herself. Meagan: Oh, that’s awesome. Lauren: Her second was a home birth and a surprise as well. She had a boy and then she had a surprise for her girl. So much was similar with our situations. I just felt like she was meant to be our doula. Yeah. So that was at 25 weeks and I think at 6 months, we had a suggestion of a fetal growth scan again which was the same and I was like, they were already preempting that but I was more prepared even if I went to that scan and it was a big baby that I would be okay with that. Then at 28 weeks, I did the normal blood test and the fasting for gestational diabetes. I didn’t have it with the two boys and I had it this time around. That was a bit of a surprise. I didn’t really know much about gestational diabetes. You have to do your three blood sugars