This episode goes back to the basics and is a great place to start on your VBAC journey! Julie joins Meagan today as they talk about many common questions beginning with reasons why providers tell women they can’t go for a VBAC.
Topics today include:
- Nuchal cords
- Big babies
- Small pelvises
- Arrest of descent
- Third-trimester ultrasounds
- Cervical dilation
- Induction
- Due dates
- The ARRIVE Trial
- Why there is so much contradicting VBAC info
- Pregnancy intervals
- Epidurals
Meagan and Julie also reflect on how their perspective toward each of these topics have changed over the years. Allowing for nuance is so necessary when approaching birth. Know that you always have options and never feel pressured to make a decision that doesn’t feel right for you.
The VBAC Link Blog: Pregnancy Intervals
How to VBAC: The Ultimate Prep Course for Parents
Full Transcript under Episode Details
04:24 Review of the Week
07:48 Intro to the basics
09:53 Nuchal cords
13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasounds
17:08 How will this change my care?
18:47 Cervical dilation
25:54 Due dates
28:18 Vulnerability and the ARRIVE trial
30:44 Inducing a VBAC
36:15 Julie’s social media story
38:29 Contradicting information
41:36 Pregnancy intervals
46:38 Epidurals
54:13 Allowing for nuance
Meagan: What’s up, everybody? This is Meagan. We have Ms. Julie with us today and we are going to be talking to you about what we need you to know about VBAC. We obviously like to talk about different topics but Julie and I decided this morning as we were getting ready to record that we need to do an episode on just the basics again. Don’t you feel like it’s the basics?
It’s not to shame anyone for not knowing the information. It’s honestly to– I don’t even want to say the word shame– but providers are not educating their patients. They are just not. We see it time and time and time again where people just don’t know.
We saw a post, I don’t know, maybe a month or so ago. I think maybe Julie sent it to me. It was just saying, “Hey, so can you have a VBAC no matter what reason the C-section was for?” Someone said, “Well, it depends because if it’s something like a cord wrapped around the baby’s neck, if that was the reason you had your previous C-section and if your last baby had its cord wrapped around their neck and was having struggle, yes. You have you have a C-section.”
Julie: I am getting a little salty. I feel like maybe salty is not the right word, but direct. I jumped in and I’m like, “That’s actually not true. The cord wrapped around a baby’s neck preventing them from descending is a perfect VBAC candidate because it’s not anything to do with the pelvis or labor stalling or anything like that.” Anyways.
Meagan: Even with that said, even with that said–
Julie: People still argued with me.
Meagan: Well, but even if it was due to someone being told that their pelvis was too small or their baby didn’t descend–
Julie: That’s also false.
Meagan: That’s also false.
Julie: I mean with actual pelvis trauma where it’s actual CPD and is legitimately diagnosed and that type of thing. Honestly, most people are good candidates for VBAC but we are going to talk about that.
Meagan: Yeah, we’re going to talk about that today because it’s obviously something that we are really passionate about and it’s something that we want you guys to know so let’s talk about it.
04:24 Review of the Week
Meagan: We do have a Review of the Week. You guys, it’s a really long one and I might have specifically been waiting for Julie to come on with me so she can read it because she’s a lot better at reading long reviews sometimes. I’m just going to pass the time over to Julie to read this amazing review.
Julie: Now I feel pressure, man.
Meagan: Don’t mess up.
Julie: The pressure’s on. Are you ready for this? This review says, “This is such a tremendous resource for VBAC mamas.” See? There I go. I knew it. I’m going to start BBAC mamas. Try and translate that, Paige. Anyway, okay. It’s fine. I’m going to circle back around.
“This is such a tremendous resource for VBAC mamas. I sadly only discovered your podcast after my VBAC in April 2022 but having caught the birth bug during my prep for that birth, I still listened to each episode as if I’m preparing for my VBAC all over again. I think having a special place for this very unique scenario helps those planning and hoping for a successful VBAC feel less alone, more supported, and very well-informed.
“The balance of evidence-based information with the age-old practice of sharing birth stories makes this one of the best birth resources out there. I only wish I had this when I was planning my VBAC but maybe someday I’ll get to share my own story and help inspire a fellow Woman of Strength.
“Prepping for and achieving the unmedicated birth of my daughter absolutely flipped a switch in me and I feel determined to become a birth worker one day.” I feel like all of us go through that, right?
“Knowing that this podcast team also has a course for prospective doulas like me thrills me to my core. I want to be there for other anxious, hopeful VBAC mamas like me and the amazing work that you are doing is changing birth and lives everywhere. Keep it up. It is so needed and appreciated. Adrianne.”
I love that so much. I feel like that’s all of us like you and me. We all go through this journey like, Hey, I had a really bad birth experience or I had a really bad one and then an empowering one and I want to be part of this change so that other people don’t have to suffer like I did.
I love that and I feel like almost all birth workers’ stories start like that. I know mine did and yours too, Meagan. We all are there at some point.
Meagan: We are. Yeah. I couldn’t agree more. I definitely have been there.
07:48 Intro to the basics
Meagan: Okay, all right. Let’s talk about the basics. What basic do you want to talk about first? We were talking about just a second ago where we were like, Hey, this was being told to you and you are being told you may not get to have a VBAC. So maybe we just start with reasons people are told that they have to have a C-section and they can’t have a VBAC.
Julie: My gosh. I want to speak to a couple of different points in that direction. I have a couple of different ideas in my head. First of all, I feel like it’s important to acknowledge that we are all ignorant to things at some point. Right? We all have to learn that VBAC is an option at some point or maybe we always knew. For me, I feel like I never was like, Oh, I can have a vaginal birth? I just always thought I could have one, but I also feel like the age-old “once a C-section, always a C-section” thing is so ingrained in some parts of our culture that you really do have to have that awakening that, Oh, I can do this. It is safe.
So I just want to acknowledge that. Sometimes, even for me, I’m scrolling through Facebook and I see this post about something or the ARRIVE trial with induction at 39 weeks is safer and it’s really easy to eye roll or it’s really easy to be like, Oh my gosh, how come you don’t know this? But I feel like let’s circle back when I see these things and remember that we all start somewhere.
Not all of us have access to supportive providers, supportive hospital systems, supportive families, supportive providers. We don’t all have access to those things. If you’re advanced in your VBAC thoughts or thinking or whatever, I encourage you to still stay on the episode because you never know when you’re going to learn something new. You never know when something is going to click right for you and you never know when you’re going to gain the perspective that you need.
If you are a seasoned VBAC pro, please also stick along with us.
09:53 Nuchal cords
Julie: I feel like I hear a new reason why someone is told they can’t have a vaginal birth every day. Not every day, that’s a little dramatic.
Meagan: But a lot.
Julie: It still surprises me. I’ve been a doula in the birth scene for 9 years now and I still get that cord prolapse one. I have never heard that as a reason why someone would have a repeat C-section. I mean, I had a VBAC client. She was trying for a VBAC at home and it ended up in a hospital transfer. The baby’s cord was wrapped around her neck four times. They had to cut the cord in four places to get the baby out via C-section.
Meagan: I remember you saying that.
Julie: Yeah, that baby was stuck so tightly in there. In those circumstances, that C-section was necessary. That baby was not coming out, but that doesn’t mean she can’t try for another VBAC. I think she is done having kids, but that is completely circumstantial and specific to that pregnancy.
So I feel like that’s a really important thing to note is that most things are circumstantial. Even stalled labor or arrest of dilation or failure to progress or a big baby or whatever these things are circumstantial. The cord around the neck preventing baby from coming down– totally circumstantial. I feel like even the American Pregnancy Association– did I say that right?-- says that 90% of women who have had C-sections are good candidates for VBAC.
I think that’s important to note is that if you’re being told that you are not a good candidate for a VBAC, I would really question why because most of the time, you are a good candidate. Big baby, sure. That’s one. We can throw these around. People say, “Oh, your baby is too big. You have to have a C-section.” That is not evidence-based. Even ACOG says that big babies are not a reason for either induction or automatic C-sections.
Meagan: Suspected big babies.
julie; Right, suspected big babies.
Meagan: Let’s just say that they’re not always big.
Julie: They are not always big and we know this is something we automatically know like, everybody knows this but not everybody does. Your ultrasound measurements can be off by 1-2 pounds in either direction. They can measure small or big. The only accurate way to determine how big your baby is is to weigh it after it is born.
Meagan: To birth your baby. Right, to birth your baby.
Julie: Not only that, but big babies come through petite pelvises all the time. Babies’ heads mold and squish through pelvises that flex and open and move to work together. The baby and the pelvis are this really cool diad where they have this great relationship of working together and the pelvis opens and the baby’s head smooshes together. Anyway, I feel like that’s probably the biggest thing that I’m hearing lately, “My baby’s too big and my provider won’t let me.”
Or there was a post in the community today that Meagan shared with me and she said, “Is it really possible to have a VBAC after a C-section? Because I feel like you always have to have C-sections. Is it really possible to have a vaginal birth after a C-section?” We need to remember that we live in a country and in a world where many people still have this way of thought. Many people don’t question their options and many people, most people go in and just automatically schedule a C-section because that’s what their provider says, that’s what’s most convenient, and they don’t take the initiative to learn and ask questions.
13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasounds
Julie: it’s a failure in the system. We were just talking about this before. Meagan, go ahead.
Meagan: Yeah, I was just going to circle back around with the size thing. What I’m seeing more is people doubting their ability because we have people saying, “Well, your baby is this size,” but the reason why they are even saying that is because I’m seeing an increase in third-trimester ultrasounds.
Julie: Yes. Third-trimester ultrasounds are trouble.
Meagan: They are trouble.
Julie: Just routine to check on baby’s size and check fluids– no. Just say no to third-trimester ultrasounds unless there is a valid concern for baby.
Meagan: Yeah. Yeah. It is getting me. It is getting me that I’m seeing it so often. It’s just getting me irked a little bit.
Julie: Gosh, Meagan, I swear though. The reason you are getting irked is because we have seen these things go south so many times. Guess what happens? They go in for a third-trimester ultrasound and there are no published statistics for this. I don’t know. I haven’t looked. But I feel like people go in and they get their third-trimester ultrasound and then they are like, “Well, my baby is measuring big,” and then they start to get worried like, “I don’t know if I can have a big baby,” because their provider is like, “Oh, your provider is measuring big.” Their provider is saying it like that. It casts doubt. It casts that doubt in their mind and that little seed of doubt gets planted. That little seed of doubt gets nourished like, “We will let you try for a VBAC but your baby is kind of big so we will just have to see how it goes,” and then these parents get set up for wanting to have an earlier induction for big baby because they don’t want their baby to get too big or just scheduling a repeat Cesarean because they are terrified of a bigger baby and the problems that a big baby could have which are not actually that many.
The risk of shoulder dystocia I feel like doesn’t increase significantly more with big babies. We just think it does. Smaller babies get shoulder dystocia just like bigger babies do. Or, “Oh, my fluids are too big or too little,” and those ultrasound measurements are just so inaccurate first of all, but most of what they find isn’t evidence-based either. You’re walking into a situation where your provider will cast doubt on you whether intentionally or not. I don’t want to villainize providers because most providers I don’t think have ill intentions. They are just doing what they know and doing what they are comfortable with.
But that happens nonetheless. So if your provider is recommending a third-trimester ultrasound, here is something that I encourage people. Ask them, first of all, why. If they will be like, “Oh, just to check on baby and check the size.” I feel like you can politely decline unless you want to. It’s fun to see your baby and things like that, but what would change? This is what you can ask your provider. “What will change in my plan of care based on what we find in the ultrasound?” What will change? What direction would shift? What answers are we looking for? What will change in my care based on what we find in the ultrasound?
If your provider says, “Well, we just want to make sure that your baby is not too big,” that’s a red flag. Right?
Meagan: Yes.
Julie: “We want to make sure your waters are okay,” which could be a legitimate reason. If you are measuring more than 10 weeks ahead or behind, it’s probably a good idea to get your fluids checked by ultrasound but if you are only measuring 3 or 4 weeks ahead or behind, that’s not necessarily an evidence-based reason to do that.
I would just ask that. I mean, that’s a good question to ask for any type of intervention or checks or whatever.
17:08 How will this change my care?
Julie: “You want a cervical check at 36 weeks? Okay. What would change in my care? What are we looking for? What would change in my care plan if this happens and if that happens?” because most of the time, cervical checks before labor– actually cervical checks during labor too– don’t tell us anything. They don’t tell us anything.
I just missed a birth a month ago or about three weeks ago because a first-time mom went from 3 centimeters– she was at 3 centimeters for 12 hours and went from 3 centimeters to baby in less than an hour and a half. Cervical checks tell us nothing.
Anyway, before I get off on a little more of a soapbox there. Sorry, I’ve been rambling.
Meagan: You’re just fine. I absolutely love that you pointed that out and that you specifically said that it can really apply to anything in your care. What does this thing do or how does it change my care?
I just think everybody should take that nugget from this episode right now and just hold onto it tightly. Put it right in your pocket and keep that because you nailed it right there. How does this change my care? If you’re getting things like she said, yeah. That’s dumb. It’s silly.
Or with a cervical exam, it’s like, “Oh, we just want to see what your BISHOP score is. We just wanted to see if you’re progressing.” Why? At 36 weeks? First of all, that’s preterm. Second of all, to actually be, especially if we never made it to 10 centimeters before in our first labor, the chances of us being very dilated at 36 weeks–
18:47 Cervical dilation
Meagan: Okay. This is going to lead me to the next thing that we see all of the time. The chances of you being dilated at 36 weeks is pretty low actually. This is something else I see that breaks my heart actually in our community and not even just in our community, in other communities, and honestly even in consults I’ve had people talk about this. “Oh, I’m 37 weeks or 38 weeks and I’m not dilated so my doctor is telling me that it’s probably not going to happen.”
Do you see this all the time, Julie? “Oh, guys. I’m so sad because I’m 38 weeks and my provider is telling me that I’m not dilated so I probably need to schedule a C-section the next week.”
Women of Strength, if you are not dilated at 36, 37, 38, 39 or even 40, even 41 weeks honestly, that’s okay. Your body will do it. Some bodies don’t do it until they are in labor. They just don’t.
Julie: Yeah, and honestly at 36 or 37 weeks, anytime before labor starts and you’re not dilated, guess what? Your cervix is doing exactly what it’s supposed to do which is keeping your baby safe and keeping your baby in until it’s ready to come out. I can’t reiterate that enough. You’re not supposed to be dilated before it’s time for the baby to come out. I say supposed because some bodies shift and change a little bit sooner and that’s okay.
But whenever I was a doula, I mean I don’t get to talk to people prenatally as much anymore since I’m just doing birth photography, but I would always say, “You know what? If you want a cervical check, that is totally fine. You get to decide. You get to make the choice about whether you get a cervical check or not.”
But if having a cervical check, if you go in and you have a cervical check and you know that if you’re not dilated at all that it is going to make you depressed and frustrated, then don’t do it. If you go in and you’re like, “Hey, I’m prepared to be low, hard, and closed and I just want the information because I love information,” and you are not going to be sad if you hear that you are low, hard, and closed, then sure. Get one if you want.
But just know that anything beyond being low, hard, and closed is just–
Meagan: Lucky, great, awesome.
Julie: Lucky, sure, great and awesome, but it’s also not an indicator because guess what? I’ve also had a client, a first-time mom, walk around at 4 centimeters dilated for 10 days and then she went into labor and had a 24-hour labor at home and ended up in a hospital transfer and a C-section. I swear. Your cervix is not telling you anything before labor and during labor most of the time, it’s not telling you anything. It’s telling you that you have progressed this far. It’s doesn’t tell you how anything is going to go in the future. It doesn’t tell you how anything is going to look moving forward. It just doesn’t.
Meagan: Yeah. So if you are having someone tell you, “You’re not dilated” or “Oh, it’s probably not going to happen. You should probably schedule a C-section–”
Julie: Just say, “Julie Francom said–”
Meagan: If you want that, do that. But if it’s not what you want, don’t let someone bully you into believing that your body is not working when it’s actually doing exactly what it’s supposed to be doing.
Julie: Exactly. that’s the thing too. Sometimes at the end of pregnancy, it is hard. Being pregnant is hard. Being close to your due date is hard. Everybody is asking you, “Have you had your baby yet? What are you going to do? What are your plans for induction?” We’ve all been there and it is really, really hard to stay strong. I feel like some people could just benefit by just saying no. Just saying no because it’s so easy if your baby is measuring big or if you feel like your cervix is hard and closed. Be like, “Aw, flip man. I’m going to be pregnant forever and my baby is going to be big and it’s going to have a hard time coming out so I might as well schedule a C-section.”
If you feel like you could be easily swayed by those things which a lot of people are. It’s so easy to be swayed by those things, especially at the end of pregnancy. Then maybe just say no. Obviously there is nuance here so if there is a true medical need and there is some medical concern for baby or if there is some worry for your cervix being in preterm labor or things like that, obviously those are valid reasons but if it’s a just because, I’m not a big fan of doing medical things just because.
Meagan: Just because I agree. Yeah. Exactly. If there’s no real reason, then just because doesn’t. Unless you want it. Unless that’s really what you want.
25:54 Due dates
Meagan: Okay, so we talked about babies. We talked about dilation before due dates and can we also talk about due dates?
Julie: Ew.
Meagan: Ew.
Julie: Yeah, just kidding. That was weird. I don’t know why I said that. I’m a weirdo sometimes.
Meagan: Well, due dates are hard. Due dates are a really hard topic because especially after the ARRIVE trial which Julie Francom herself wrote the blog about the ARRIVE trial if I recall. I don’t think I did. I think you did.
Julie: I’m pretty sure I did.
Meagan: I think you did. I feel like since the ARRIVE trial, we really have seen a major shift in due dates.
Julie: You mean induction? A major shift in interventions?
Meagan: Well, sorry. Induction because of due dates.
Julie: Right. Gotcha.
Meagan: We see people at 38 weeks being checked, not dilated, being told that they either like I said, have to have a C-section or have to be induced in the next week because they are 39 weeks but really, do we have to? We do not. We do not have to. A lot of bodies do go over that 40-week mark.
I think it’s important to know when you are approaching your due date that you may start getting an influx of pressure to do those things, to sweep your membranes, to induce, to schedule a C-section, and I think that is something that I find frustrating. I mean, you guys, obviously as a doula, I work with a lot of pregnant people and Julie even being a photographer now, I’m sure you have situations where you are like, Oh, this person is being induced now, and now you’re planning and induction. We’ll get to induction in a second.
But the pressure that starts coming at people at 38 or 39 weeks for induction or a scheduled C-section is unreal to me when sometimes we just need to let the body be.
Julie: Yep.
Meagan: Right?
28:18 Vulnerability and the ARRIVE trial
Julie: I agree so much. It’s so funny because we all know that induction is safe and we’re going to talk about that in just a minute. It’s safe for VBAC when it’s necessary. it does slightly increase the risk of uterine rupture and a couple of other things, but it’s frustrating when we have providers taking advantage of this vulnerable group of people.
Meagan: Very vulnerable.
Julie: By offering induction at 39 weeks and who doesn’t not want to be pregnant anymore at 39 weeks? I think everybody. There’s a small group of people who just like being pregnant and that’s totally fine. I like being pregnant but by my last one, I was like, Get this baby out! I was content for baby to pick their birthdate every time, but with the last one, I was like, Get this baby out!
Anyway, I feel like most providers don’t think they are taking advantage of these people when they are offering 39-week inductions, but it really is. It’s taking advantage of a woman in a vulnerable position and could skew their birth plans in ways that they don’t want. It’s hard to say no when you are that pregnant and unless you have a super strong resolve which even the strongest resolve can weaken in that type of emotional and hormonal state.
It’s really frustrating because we have this ARRIVE trial that was published in– what was it? It wasn’t 2020.
Meagan: 2019.
Julie: In 2019 and the medical world jumped on that so fast. They were like, Yes. Let’s induce at 39 weeks.
Meagan: It was a leech situation.
Julie: Yes. And then now that multiple studies have proved it invalid and it has been picked apart and even ACOG doesn’t recommend that anymore. It doesn’t stand by the validation of the ARRIVE trial, there have been multiple studies showing otherwise since then, but guess what? Oh my gosh. This is so frustrating. It normally takes 10-15 years for the medical community to catch on to updated information, but this one took on so fast and now it is going to take 10-15 years to undo that.
Meagan: To go back. I agree.
Julie: Yeah. It’s frustrating.
Meagan: It is. It’s so frustrating.
30:44 Inducing a VBAC
Meagan: It’s hard to see so many people, like you said, in a vulnerable state feel that pressure of induction. I think where I even struggle more is seeing people in the last weeks of their pregnancy which can be hard because they are uncomfortable and Julie wanted to get that baby out. They actually can be some of the most precious times with your other kids before your family grows and your husband before you have a baby and you are a family of three or your partner. They can be really great spaces and a place where we can really get our head in the space for labor and delivery and for birth.
But we have so many people out there being scared that they are going to have to have a scheduled C-section. We know that even though evidence shows induction for VBAC is safe and reasonable, there are many people and many providers out there all over the world who absolutely refuse to induce a VBAC. They refuse and induction. It’s either a scheduled C-section, spontaneous labor, or that’s it. Those are your options.
We see so many people out there spending these last few weeks that could be so amazing and getting ourselves in that positive headspace in frantic mode because they are trying to induce themselves. They are trying to do all of the things.
Julie: Yeah, they are like, Oh my gosh. My provider is going to schedule a C-section at 40 weeks or induction at 39.
Meagan: What can I do to get this baby out?
Julie: Yep.
Meagan: It makes my heart hurt because it just really isn’t where you deserve to be in your last weeks of pregnancy. Let me tell you one thing, when you are so hyper-focused on getting your baby out, tension and cortisol is high in the body and when we are stressed, that’s typically not a space where we can let our cervix go and have a baby.
So when we are doing those things, we are entering a space full of tension and we are already setting ourselves up for a harder experience.
Julie: Mhmm, it’s true. You go in there ready to fight then your cortisol levels are high and cortisol is the opposite of oxytocin which gets baby out. Your stress hormones are fighting your baby coming out and it’s not optimal. Can it happen? Yeah, sure. People do it. But it’s going to be harder.
Meagan: It is.
Julie: It’s just going to be harder.
Meagan: It is. Like I said, back to the head space, it really puts us in the wrong head space. It just is not optimal.
Know that if you are receiving pressure to have a baby because you’re not being supported in an induction that you should just change your provider. No, really. You need to take a step back and decide if that provider is the right choice for you and if that’s the right space for you to be birthing in and if what you are doing in your mind and to your body because a lot of people do some crazy things, is really what is going to be the best for your labor journey.
Julie: And sometimes, people don’t have that much of a choice too. Sometimes, that’s the only choice you have. Sometimes, home birth is illegal in your state for VBAC even and–
Meagan: You have no providers in your area.
Julie: You have one hospital within 6 hours and sometimes that’s going to be your only choice and it sucks that people have to choose between that and an unassisted birth at home which I feel like if you are going to have an unassisted birth at home, that’s a whole other topic.
You should do it because you are educated and informed and that’s what you want not because you don’t want to have this horrible hospital birth where you are going to have to fight the whole time.
Meagan: Yeah. It’s a tricky spot. To Julie’s point, we understand that. There are so many people who are just flat-out restricted and they feel like they are walking in with their hands tied behind their back and just have no choice. But there are other options too. There are other options. But laboring at home a little longer or just saying no. Just saying no which is really hard.
Julie: Yeah, it is really hard especially when you are in labor. Especially, maybe you have this resolve and your partner doesn’t have that resolve. Maybe you can’t find a doula in your area. You can’t afford one. It really sucks to be your own biggest supporter and believer in birth. You have to have other people in the room who are just as resolved and want this for you as much as you do if you are birthing in that type of environment.
36:15 Julie’s social media story
Julie: Okay, back to basics. What are we doing next? Oh, let me tell this story about induction. I think this is so funny because there are so many people who think that induction isn’t safe and they think that induction isn’t safe for a VBAC to go past 40 weeks so you have a provider who won’t induce you and won’t let you go past 40 weeks so what are you supposed to do?
It’s really interesting because I hired someone recently to post on my social media recently for my birth photography. She is a birth photographer and doula and has attended many births before. She just recently shifted over to social media and website management for birth photographers. She knows that I’m really passionate about VBAC so I want one post a week to be about VBAC.
She’ll write up posts for me to approve and one of the things that she wrote up for me about VBAC was things you can do to– I think it was things you can do to increase your chances of having a VBAC or something like that.
In her post, she even made the comment and I’m glad I read through these all in detail because she said something that, “We know that induction isn’t safe for VBAC because it increases the chance of uterine rupture.” She said in my post that is on my page that is supposed to be written in my words that induction isn’t safe. I deleted it. I shot her a little message to be like, Hey, VBAC induction is safe. Does it slightly increase the risk of uterine rupture? Yeah, it does, but as long as it’s managed well, the increased risks are very, very small.
Meagan: Still pretty low.
Julie: Yeah. It was just so funny that someone who has been in the birth world still for so long operating on more of an evidence-based side of things has that view still. I don’t know. It’s just interesting. We all have things that we need to learn still.
Meagan: We do. We are always learning and we are even still learning here at The VBAC Link. It’s just important to know that if you see information and you’re like, Oh, I already know that, you still need to check it out and see if there is something new to that.
38:29 Contradicting information
Meagan: Okay, so back to the basics. We’ve talked about the pelvis. We’ve talked about induction. We’re talking about due dates. We are talking about the cervix dilating. We’ve talked about baby sizes. What else do we have?
Julie: Epidurals.
Meagan: Oh yeah. Epidurals.
Julie: This is so funny. The opposites. It’s the same thing about the opposite. VBAC has to be induced before 40 weeks. I will not induce VBAC at all. You have to have a C-section by 40 weeks. All of these things. Epidurals are the same way. You have to have an epidural placed in order to do a VBAC and then we also have you cannot have a VBAC with an epidural.
Meagan: Yeah. Yes. I’ve seen that.
Julie: Isn’t that so stupid? I’m sorry. I just think it’s so stupid, all of these polarizing things. It’s so funny because sorry, time out. I will let you talk about that. I promise I will let you talk about that. I think it’s so funny because we know that Facebook can do so much good and it can also do so much bad.
There will be a post like, “Hey, my provider said I have to have an epidural with a VBAC,” and there will be 50 comments on there and every comment will be different like, “Oh, yeah. You absolutely have to. It’s safest in case you have to have an emergency C-section.” Then the next comment will say, “No, you don’t. You can’t because then you won’t notice the signs of uterine rupture.”
Everyone says something different and it’s really funny because it’s the same thing about the length between pregnancies or C-sections to VBAC. People will be like, “My doctor said it has to be 18 months from birth to birth. My doctor said that you can’t get pregnant within a year of having a C-section. My doctor said–” or they say. I love it when people say, “They say 18 months birth to birth is best. They say don’t get pregnant within 9 months. They say 2 years between births is the best.” Who is they, first of all? Who is they?
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