The VBAC Link

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 cordsBig babiesSmall pelvisesArrest of descentThird-trimester ultrasounds Cervical dilationInductionDue datesThe ARRIVE TrialWhy there is so much contradicting VBAC infoPregnancy intervals EpiduralsMeagan 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 IntervalsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:24 Review of the Week07:48 Intro to the basics09:53 Nuchal cords13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasounds17:08 How will this change my care?18:47 Cervical dilation25:54 Due dates28:18 Vulnerability and the ARRIVE trial30:44 Inducing a VBAC36:15 Julie’s social media story38:29 Contradicting information41:36 Pregnancy intervals46:38 Epidurals54:13 Allowing for nuanceMeagan: 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 WeekMeagan: 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 basicsMeagan: 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 cordsJulie: 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 ultrasoundsJulie: 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 dilationMeagan: 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 datesMeagan: 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 trialJulie: 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 VBACMeagan: 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 storyJulie: 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 informationMeagan: 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?

Upon arriving at the hospital during her first labor, Sami was told that her baby’s heart rate wasn’t stable, Pitocin was necessary, and a C-section was most likely going to be the safest mode of delivery. After laboring for a while, she was wheeled to the OR but the anesthesiologist was running behind schedule. Sami was checked and discovered she was complete! She pushed like her life depended on it and with the assistance of a vacuum and forceps, was able to vaginally deliver her baby in the OR. Sami was thankful to have had a vaginal delivery, but it wasn’t the empowering experience she hoped for and she knew she wanted something different the next time around. But when her second baby flipped breech during labor, Sami unexpectedly consented to a Cesarean. During her third pregnancy, Sami did everything in her power to set herself up for a VBAC. She found out her baby was breech and exhausted all options to try to flip her. A few weeks after a successful ECV, Sami had a precipitous VBAC, pushing her baby out within one hour of arriving at the hospital!Sami's Fitness AccountHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:23 Review of the Week04:26 Sami’s first pregnancy06:41 A vaginal birth in the OR07:55 Second pregnancy and switching providers11:00 Flipping breech during labor13:10 Sami’s C-section and feeling invalidated16:50 Third pregnancy24:19 A successful ECV29:38 Going into labor32:38 Pushing her baby out within one hour of arriving at the hospitalMeagan: Hey, hey everybody. We have another VBAC story for you today from our friend, Sami. She is actually local to me here in Utah. Hi, how are you?Sami: Hi, I’m good. I’m so excited to be here. Meagan: So excited to share these stories. I was going over your story and it’s just crazy to think how things can twist and turn and the unexpected can happen. I love that about stories sometimes and then I don’t love that it happens but I also love the uniqueness of that. Does that make sense? Sami: Yeah. Yeah. I feel like literally and figuratively, my babies twist and turns happen. Meagan: Yes. It’s important to know that going into birth even though we are planning one way, sometimes twists and turns can happen and then it’s up to us to figure out how to navigate through that space and it’s not always easy. It’s okay to not always have it be easy and then sometimes it is easy. That’s another thing I wanted to talk about too is pointing out that to some, a twist and a turn might be no big deal to someone and then to some, it rocks their world. We are all in different spaces here and you definitely like you said both figuratively and actually have some twists and turns. 01:23 Review of the WeekMeagan: We’re going to share her story in just a minute but of course, we do have a Review of the Week and I just wanted to quickly share it. This is by– okay, I’m probably going to butcher this. It is mitaywa. I’m so sorry if you are listening and you are like, You are telling this so wrong. It says, “I hope this plays over the speaker in every OB/GYN office.” I love that. That’s a cool subject. It says, “I cannot even begin to describe what encouragement these podcasts have been for me. I have completely binged on these the past few weeks and they have grown my confidence for my up-and-coming VBAC baby. I cannot stop sharing everything I’m learning and even help encourage first-time moms to educate themselves on how to avoid a Cesarean in the first place. Thank you so much for this no B.S., truth-declaring and empowering platform that I know has encouraged so many more than just myself. Keep being amazing. I can’t wait to share our story in just a few short months. All of my love.” Aw, that’s such a great review. I love that so much. I hope that you got your VBAC and that all went well. I’m so excited to hear that this podcast is doing exactly what we intended it to do– empower, educate, inform, and inspire people to know their options for birth after a Cesarean and like you said, how to avoid a Cesarean in the first place. 04:26 Sami’s first pregnancyMeagan: Okay, cute Sami. I’m excited to hear these stories. Thank you for joining us today. Sami: Yeah, thank you so much for having me. It’s a really cool full-circle moment to be here after binging on the podcast for months and months and months so I’m excited to be here. Meagan: All right, well every birth story starts with baby number one, and your first baby actually wasn’t a C-section, right?Sami: Yeah, with my first baby, I got pregnant in 2017 and had him in 2018. I feel like as so many other people on the podcast, I felt like I was pretty informed going into the birth. I mean, I read two books. To me, I’m like, I am so informed. I took a HypnoBirthing class but I had a provider who had just been my OB/GYN for a long time so I decided to stay with her. Even though I didn’t have a C-section with that first delivery and pregnancy, it definitely wasn’t what I was hoping to get out of it. I went to 40 weeks and thought that I would have my baby right then and there. I didn’t have a doula. I hadn’t talked to a lot of people but I was planning on going unmedicated in my delivery and then the days kept going on. I got to 40 and 5 and finally started to go into labor. I was really excited because my OB had scheduled an induction for me I think the next day actually. I got to the hospital and everything changed. We got there. We were excited and fresh-faced. We were having our baby today. The minute we got there, they were picking up a lot of heart decels. They didn’t feel like the baby’s heart rate was doing well. They told me that I needed to get on Pitocin immediately and that I would be really lucky to not have a C-section so my hopes for an unmedicated delivery went out the window immediately. My OB came in and told me, “I really do think that a C-section is going to be the best course of action for us but let’s give you a couple of hours and see how things do with Pitocin, get you an epidural just in case,” and after a few hours, came in and said, “I really think we need to go to the OR right now. We need to get your baby out for his safety.” 06:41 A vaginal birth in the ORSami: We scrubbed up, my husband and I. She took us back to the OR. I was a wreck. I was crying and just so upset because no one had prepared me for that. In my HypnoBirthing class, all of the stories that were shared were really positive. We didn’t really talk about what would happen in this type of situation. Like I said, I didn’t have a doula. We got to the OR and the anesthesiologist was actually running behind. He was doing another C-section and they didn’t have another one on call I guess. She was like, “You’re dilated to a 10 so if you can get this baby out right now, I’ll let you push and try.” So I pushed like my life depended on it trying to get this baby out. He was sunny-side up so she did end up using forceps and a vacuum. We got him out in that timeframe. It was so cool honestly after having this experience that felt really scary and just not what I was wanting, I was riding the high of my life to have still been able to deliver him. So I didn’t get my unmedicated delivery, but I was just really happy to have him there with me. Meagan: Yeah, yeah. 07:55 Second pregnancy and switching providersSami: So fast forward to my second pregnancy, I got pregnant in 2019 and had him during the pandemic in 2020. I decided to switch providers just because I felt like after going through that experience with her, it wasn’t a bad experience, it just wasn’t what I was wanting. To get there and have her immediately pushing a C-section– Meagan: That’s kind of unique. Did she ever tell you exactly? It was just the heart rate? “You’re heart rate is wonky. Let’s put you on Pitocin.” Those two things often don’t match. And then it’s like, “Oh, you’ll probably end up there anyway but we’ll let you keep going.”Sami: It was so bizarre. Looking back at it for me, I do feel like there were signs that she just wasn’t going to be a supportive provider of an unmedicated delivery all along. I told her I didn’t want to have an epidural and she said, “Well, good luck. You’ll probably change your mind, but I support you doing whatever you want to do.” We found out after he was delivered that the cord was wrapped around his neck twice. That was what was causing the decels to happen, but that was what was hard for us to understand too. We were like, “If it’s emergent, why aren’t we being taken back right now?” Yeah. It just felt like she wanted to get the baby out. I was over 40 weeks. I felt like even though I had a great experience postpartum and I was fine, I couldn’t trust her anymore. I didn’t feel like she was a safe person or someone who would honor my wishes during birth. Meagan: Right. Sami: I had heard of a doctor locally. A few of my friends had just raved about him. He is pretty popular in my neighborhood. I feel like a lot of different people go to him, but it’s Dr. Thackeray and INC. Meagan: Oh yeah. Sami: Yeah, so I switched over to him for that second pregnancy and immediately just really liked him. He was warm. He took a lot of time talking over everything, getting to know us in a way that most OBs don’t in the hospital setting and I let go of my hopes of having an unmedicated delivery. It just felt like with my first birth and postpartum, everything that could have happened did happen. I had this plan. I had the birth plan. I wanted to have that unmedicated labor and it all went out the window the minute that we got there. I felt like, What’s the point in even trying to go unmedicated? There are so many unexpected things that can come up in birth. I went forward with that pregnancy. It was a pretty normal pregnancy. Honestly, I felt great. I’m one of those weird people who enjoys being pregnant. I just soaked up the time with my oldest son. We were having another boy, but when the pandemic really started to get serious, we were terrified. We were being told every week that things were changing. You could have people come with you and support you. You couldn’t. My birth partner may not be able to be there with me. We were a little nervous about that. 11:00 Flipping breech during laborSami: I got to 40 weeks exactly and went into labor again. I was so excited. It’s really funny because my husband and I took pictures outside of the hospital. We were both really excited to hopefully have a more normal experience of being able to deliver in the delivery room without all of those interventions. We got checked into the hospital. They checked the baby’s position and they told me that he was head-down. Then shortly after that, my water actually broke. They called my OB to come in and just check on how things were progressing. When he came in, he checked me and he was like, “I don’t think that I’m feeling the baby’s head. I think I’m feeling the baby’s bum.”They did an ultrasound. Meagan: So breech? Sami: He was breech but he wasn’t even just complete breech. Meagan: Like sideways? Sami: Yeah. He was transverse. It brought up a lot of anxiety and emotions from that first delivery. I’m like, “No. I avoided a C-section. I really don’t want to go back to the OR. I don’t want to have forceps. I don’t want to have all of these things happen.” They tried to perform an ECV. They actually tried for 45 minutes to get him to flip but because– Meagan: Which is also impressive just to say for a provider to do that during labor. That’s impressive. Sami: Yeah, he was. He brought in one of his partners. I could tell that they were trying really, really hard but he would not budge. They told us that because my water had broken, it was just likely that there wasn’t enough fluid in there to get him to flip back. Meagan: Rotate. Sami: Yeah. We don’t know at this point. The nurses who checked us in told me that he was head down, but we don’t know if he flipped when my water broke or if he had been sitting breech for a long time. In any case, he wasn’t flipping. My husband and I asked for some time just to think about our options, but his foot became prolapsed and they told us, “This is an emergent situation. We need to get him out right now. If the cord prolapses, it could be pretty risky.” 13:10 Sami’s C-section and feeling invalidatedSami: They rolled us back to the OR. It was kind of like Dejavu from my first delivery. I’m sobbing. I’m like, Oh, I don’t want to have a C-section. I’ve got a baby at home to think about this time around. I told him I’d be back in two days. Just a lot of emotions were brought up. They took us to the OR and kept having to give me medication after medication. They lay you down obviously. So many people listening to this story are going to be able to relate to what it’s like in there, but it’s freezing cold. They laid me down and strapped me onto the bed. I was shaking. I felt like I was going to vomit. They just kept giving me all of these medications. They finally started to perform the C-section and I just had tears rolling down my face. The anesthesiologist bent down and was like, “Don’t worry. My wife had to have C-sections with all of our babies and she’s fine.” It was just the weirdest situation. Meagan: Yeah, probably out of the goodness of his heart of, “You’re going to be okay. My wife was okay,” but it’s not really what you say to someone in that moment either. Sami: Yeah. It just felt kind of invalidating that I was having a hard moment. Meagan: Yeah.Sami: Ultimately, they got my son out. They took him and cleaned him off and when they brought him over to me, I can barely remember what it was like but I couldn’t hold him. I was shaking. It was a really hard moment to not be able to have that immediate connection with him. We got back to the recovery room and things went fine for the most part. I did have a pretty bad hemorrhage and they kept having to come in. They were going to open me back up at one point, but all in all, it was fine. My son was healthy and I was really grateful for that. I think the hardest part for me was just like I said with the anesthesiologist just feeling really invalidated in how hard the situation was. I wanted to get back to see my son. I’m pretty into fitness and health like I talked about and hadn’t really wanted to have this really long recovery from all of that. People just kept saying, “Well, your baby is healthy. That’s what matters. At least your baby is healthy.” I think that’s a really hard thing sometimes for moms to hear because as the mom of the baby, I want them to be healthy more than anyone. Meagan: It’s a no-duh situation. Sami: Yeah, that’s my number one goal. Funny enough, I found The VBAC Link in the hospital while I was lying in my hospital bed those three days just feeding him and spending time with my baby and I started listening to the podcast then. I just thought, If I ever go down this road again and have another baby, I really want to have a different experience from these first two deliveries. I want to be able to hold my baby the minute that they are born, not be so drugged up that I’m having to come out of being groggy and things. To make a really long story a little bit shorter, my postpartum situation with my son– the recovery was okay but it was really hard. It brought up a lot of postpartum anxiety for me, a lot of different things with the pandemic. We weren’t able to have visitors, not be able to be outside or move around the way I wanted to immediately. The podcast really helped me get through a lot of that. 16:50 Third pregnancySami: Fast forward to 2023 and I got pregnant for a third time, I was just excited to hopefully do things differently this go-around. We had two boys and found out that we were expecting a girl. I’m a pretty type-A person so I devoured all of the information that I could about VBAC and realized that I really hadn’t known that much going into my first birth. I thought that HypnoBirthing class was enough and it really wasn’t. I hired a doula who was local here to me in Salt Lake. She is amazing. Her name is Jamie Kowalk. A friend had referred her to me. I just got to work on a lot of different things. I did chiropractic. I worked with a pelvic floor PT. I actually worked with a therapist too to go through some of the postpartum anxiety that I had experienced after the second time around and hopefully have someone in my corner in case I had that going on again. But once we found out that we were pregnant, I did consider switching providers again. I just thought, Can I go through another delivery with the provider who did my C-section? I did interview a couple of other providers. We met with a midwife pretty early on and had a weird experience. I don’t blame her. I don’t fault her or anything, but she was the first person to give me an ultrasound when I was pregnant and she had thought that we were having twins so she gave me the ultrasound and said, “You know, I’m kind of seeing two babies here. I don’t see two heartbeats. I think it’s likely that you lost a baby fairly early.” When we went to get an ultrasound after that that she recommended, the tech was like, “That’s not two babies. That is a yolk sac. This is just the baby. This is the yolk sac. You’re only pregnant with one.” Yeah. It was a surprising experience but what I realized from that was that I had wanted to call my old OB the whole time and just verify everything that she was saying with him. I just didn’t think that I could fully trust her because I already had a pretty strong relationship developed with him. I did choose to stay with my same provider. I had some friends who had known him and shared stories of him doing VBACs that they had heard of. I talked to him about it. The one thing that was kind of hard was that he was really VBAC-supportive when I shared my plans to hopefully have a VBAC, but he wasn’t a huge cheerleader. He wasn’t like, “I’m going to get you your VBAC. We’re going to go in and do this.” It was really realistic. “We’ll try to do everything that we can and see how it goes.” Meagan: Right. Sami: I appreciated that ultimately. I had a fairly normal beginning part of my pregnancy. I found out we were expecting a girl which was shocking to us after having two boys and then I got to the gestational diabetes screen which was something I had never worried about. Like I said, I’m pretty involved in health and fitness at a high level. I watch my diet really closely. I failed the screening pretty badly, like pretty terribly. Sami: I ended up going on to pass the 3-hour test which was good but after that, I really felt pretty excited about the VBAC. I felt this hope that I could do it. I feel like meeting with my doula was really powerful because we went through not only my ideal situation and scenario of what would happen but also what things could look like if I did have to have another C-section. I think that was one of my favorite parts of the process of working with her was just planning with her when there weren’t emotions at stake in it and not trying to make decisions in the heat of the moment in labor but making them far ahead of time. Meagan: Yes. It’s so important. Sami: Yeah, it’s a total game-changer. But then we got to about 36 weeks and I had been doing, when I say all of the things, I really had been doing everything in my power to hope for an optimal positioning with the baby. Like I said, the chiropractor, the Spinning Babies, and everything, but I asked my provider for an ultrasound that they don’t usually give at 36 weeks unless there is some type of indication that it’s necessary. He had been feeling the baby externally and thought that she was head down, but I just didn’t want to go into the delivery with any unknowns or surprises. We got that ultrasound and went in. The minute that the tech touched my stomach, they were like, “This is a really breech baby. This baby is completely breech.” Yeah. That brought up a lot of emotion for me from my previous deliveries like, What am I going to do? We haven’t had a baby in a good position yet. I’ve already been doing all of the things to hope to get her in an optimal position. When I met with the nurse right outside the room, she was like, “Well, it’s fine. You can always have a C-section. It’s not a big deal. We just did a couple today.” Meagan: You’re like, “Again, not what I’m wanting though.” Sami: A lot of my hopes and dreams and everything went out the window. From there, I got to work on all of the things that I could do to get baby to flip. I was reading forums. I was Googling. It was honestly so exhausting. I look back on that time and for anyone else who has had a breech baby and tried to get them to turn, it is an emotional rollercoaster. Meagan: Oh yeah. Sami: Yeah. We did acupuncture. I did moxibustion. I did the Spinning Babies “Flip a Breech Baby.” It is so funny, but I downloaded this hypnosis track to try to get your baby to flip. I was doing hypnosis. I went to the pool and I attempted to do handstands in the pool at 37 weeks pregnant. I was not successful. How anyone can do that, I have no idea. But I was lying upside down on an ironing board trying to encourage her to flip. I put ice packs on the top of my stomach. It was completely exhausting. In hindsight, I wouldn’t change the effort that I put into hoping to get her to move, but it’s hard to be in that space where you are so far along pregnant and then trying to do that and being unsuccessful. Meagan: It’s consuming. It consumes you because you are like, I want this so bad. It’s sort of within our control, but a lot of it is out of our control. Sami: Totally, yeah. Yeah. I actually ended up posting in the Facebook group and just asked if anyone had recommendations local to me for a provider who would consider delivering a breech baby. Someone recommended Dr. Silver at the University of Utah. We actually did meet with him when I was 38 weeks pregnant. That may be wrong. It may have been 37. 24:19 A successful ECVSami: We went and met with him. He told me, “This baby is breech and if you want to try to deliver her, I’ll do it but I think that you should have an ECV first and exhaust all of your options.” I was a little hesitant to go into another ECV after having one that didn’t work. I didn’t have high hopes. I went and met with Dr. Thackery and he did perform an ECV. I didn’t use an epidural or any medications but she actually flipped really easily. Meagan: Good. Sami: It was super quick. Yeah. It was really cool. I think something that I didn’t share, but leading up to that, I was working with my therapist a lot just on my mindset. I was pretty devastated when I found out that she was breech. I had to come to terms with the fact before we even went into the ECV or met with Dr. Silver or any of these things that I’m trying to control all of these different variables. I’ve done this with all of my births and it hasn’t really gone the way that I wanted to. With my first baby, I thought it was going to be fine to do unmedicated. My second baby, I was like, I don’t care what we do as long as I don’t have a C-section, then it ended in a C-section. Then to have her be breech, I was exhausted from all of those things that I was doing, but I just had to realize that, I can show up and I can try to flip this baby on my own and I can try to get an ECV and I can try to hypnotize myself all day, but if that’s not what’s best for her and if that’s not in the cards, there is a level that is outside of your control when it comes to birth. I feel like that was one of my biggest lessons. When I was lying there as he was performing the ECV, I was just talking to myself and visualizing her flipping but I was talking to her and just saying, If there is a reason why you can’t flip, if this is not going to be safe for you or if this is not what’s best for you, that’s okay. I’m going to do whatever you need me to do in order for you to get here healthy. It was only an ECV but that was actually a really powerful moment for me in my third pregnancy in just letting go and letting the outcome be whatever it was going to be. Meagan: Yeah. Sami: She did flip like I said then after that, I was doing deep squats every day. Meagan: Get that baby engaged. Sami: Yes. Get her engaged in my pelvis. I had a few more appointments with my provider and every time would ask him to do a scan just because I didn’t believe that she would stay head down, but she did. I felt like we had overcome our last hurdle. I was utilizing HypnoBirthing tracks again. I don’t think I mentioned it, but I did want to try to go for an unmedicated this go-around just because I found that every time I would get the epidural or get Pitocin or get anything, that’s when everything would go wrong. I was trying to prepare for all of that. We found out that our provider was going to be out of town a few days after my due date. He got asked to go on a last-minute family vacation and said yes. A lot of the other providers in his office are VBAC-supportive, but I didn’t really feel comfortable with anyone else being the one to deliver my baby. I had to just again let go. I’m like, Okay. We’ve almost had gestational diabetes. You’ve been breech. We did the ECV. Now if we can just deliver this baby, it will hopefully all go well. Yeah, I just kept doing those things the last couple of weeks of pregnancy and on the Fourth of July, I started to go into labor. I was so excited. I started to feel those familiar contraction pains and didn’t tell anyone. We went to a barbecue with some friends. I didn’t say anything and then I decided to stay up all night on the Fourth of July because after you’ve had two babies, who would stay up when they are in labor? I’m like, what was I even thinking? But I stayed up all night watching TV and timing my contractions, getting excited. I didn’t want to wake my husband up or anything. But in the morning, they kind of fizzled out. There wasn’t a lot happening. I had an appointment with my doctor later that day. I should say at that point, I was 39 weeks and 3 days, 39 and 4. I went to that appointment. My husband ended up driving me and we brought our two kids with us because we didn’t have any sitters lined up at that point. He said, “I think that things are going to pick up in the next day or so. I think that you’re going to have this baby.” We were going to do a membrane sweep that day. That was something I felt comfortable doing but we ended up not doing it. We drove back home because we live about 45 minutes from the hospital that we were delivering at. I decided to make dinner and give my youngest a bath. By the time I had that bath water halfway filled, I couldn’t even do it. I was just laying on the floor trying to breathe through contractions, but not able to do anything. 29:38 Going into laborSami: I’m yelling at my husband in between, “Please come upstairs. Give Harvey a bath.” We had not packed anything. I feel like we were the worst third-time parents. We were not ready to go. I think there was so much pressure getting her ready to flip and trying to prepare for all of these other things that I think it would almost jinx it to be super ready for the delivery. We were throwing things into a bag. We had my mom come over because she was going to watch our two boys while we went to the hospital. We just turned around and essentially went back. It was really funny because when we went to go get checked in, they brought us back to a room. I was like, “Are you guys going to check me? Are you going to triage me?” They were like, “No, you seem pretty serious. We’re just going to admit you and you can stay.” Meagan: Awesome. Sami: Yeah. We were really excited about that. Again, I wanted to be really excited like I was in my second birth with taking pictures and everything. I have a friend who uses the term “cautious optimism”. I think about that a lot. I was optimistic but also cautious because of everything that had happened in those prior experiences. We did get checked in and we called our doula who decided to come in and meet us, but we didn’t get a nurse for 10-15 minutes. I felt like my contractions were really picking up. I remember I opened the door and was looking around like, This hospital is dead. Where are all of the nurses? Why is no one coming to do anything?She finally showed up and it was pretty clear. My doula got there about that same time that our nurse was not super unmedicated supportive. She also didn’t seem super VBAC supportive. The minute that Jamie walked in, I was just like, Okay. Now I can breathe. I have someone here who can advocate for us and be an ear to bounce things off of. She started to check me in and go through all of the paperwork, the insurance stuff, and I remember just being on the birth ball. We were trying a couple of different things because I felt like my contractions were pretty strong. Probably 15-20 minutes after Jamie had gotten there and our nurse had come in, I just started screaming, “I can’t do this. I can’t do this. I can’t do this,” at the top of my lungs. I remember it feeling almost like an out-of-body experience. I didn’t feel like I was screaming anything. I didn’t feel like I was saying anything, but there were just words coming out of me. My nurse said, “I think that we need to check you.” 32:38 Pushing her baby out within one hour of arriving at the hospitalSami: They checked me and I was complete. Meagan: Whew!Sami: Yeah, it was wild. We had not been there long. They started to get everything ready to go and I thought from doing HypnoBirthing and preparing and hypnosis and meditation and all of these different things that I would be able to be calm and present and that was not my experience at all. For a long time, I should say afterward, I felt embarrassed. You hear these stories or you watch Christian HypnoBirthing in these different cities of these people smiling and singing and they are quiet as they are having their babies. That was not me. Now I can look back on that and I’m like, That’s okay. I was just loud. I was roaring through birth. It all was happening so fast. I felt really comfortable being on all fours. I was in that position trying to start to push, but when my doctor came in, they actually did have me flip to lying on my back which is something looking back I wish that that wouldn’t have happened, but yeah. I flipped over and probably had her within 20 more minutes. When we look at the timeframe, it was an hour after we got to the hospital that she was born. It was just the most amazing, incredible moment of my life. I think one of the coolest things about the whole thing was after she came out, they just handed her to me and put her on my chest and they were like, “Do you want us to wipe her off? Should we go clean her off? Do you want us to put a diaper on her?” I was like, “No. No one touch her. Just leave her right here.” Yeah. We got to snuggle and cuddle and had that golden hour. It was incredible. Meagan: You got that experience that you were waiting for. That minute where you were like, Okay, I did this. It’s all over. I don’t have to question anything anymore. That happened. She’s here on my chest. I love that. I remember having that feeling. It was just utter joy feeling that human right on top of you. I feel like your photo is exactly that. It just says it all. It says it all exactly how you were feeling. Sami: Yes. Meagan: Just pure joy, amazingness and I am so happy for you. I am happy that even with the curves along the way with this baby, she was able to flip really easily, you were able to go through and show the efforts that you were able to do yourself and truly have this better experience. That is so fast. An hour after getting there and not really having too much going on from being at your visit to going home. That’s quick. Sami: Oh, it was shocking. It was really shocking. I feel like for me that was part of the reason why I was so loud. It was hard to believe that it was happening so fast. Meagan: Oh yeah, that transition. Sami: I told my doula, “I want to do the rebozo. I want to try all of these different positions,” and we didn’t really get to do very much. Meagan: You didn’t need it. You didn’t need it either. 35:56 Fitbliss FitnessMeagan: That is so awesome. I know you had mentioned in your summary that you are a personal trainer, right? I would love to talk about that too and all of the things that you did during pregnancy that you would suggest to anyone checking it out. I know physical abilities are always different in pregnancy, but can you tell us about that too? Sami: Yeah, absolutely. I am a personal trainer and a coach with a team here. We actually started local to Salt Lake called Fitbliss Fitness. I’m a coach and I’m also our COO. We coach women in bodybuilding, powerlifting, strength athletes, and macro coaching but primarily I’d say the bulk of my clientele are women who want to get stronger, feel empowered, and change their body composition in a lasting way that is not just a 6-week shred or a quick fix. It’s all about creating sustainable habits and then getting strong while you do it. For all three of my pregnancies, a huge part of that has been resistance training at a high level and it’s been different throughout each one. I was actually, it’s a sport called powerlifting. I don’t know if you are familiar with that, but it’s essentially bench presses, squats, and deadlifts where you compete to try to get your best number or PR, a personal record. I power lifted throughout that whole entire first pregnancy. Meagan: Nice. Sami: There has been some research to support easier, quicker, labor and delivery when you are familiar with resistance training and that’s something that you are doing consistently. The second and third, I think I did go a little bit easier not in the sense that I wasn’t still training. I trained 4-5 days a week, some weeks 3 throughout my entire pregnancy but just listened to my body more and not feeling like I had to prove anything or be as strong as maybe I once was. Yeah, so the big things that I focused on during pregnancy was resistance training specifically. Still doing movements like squats and core work that is important for a pregnant person– not things like crunches or obliques or twisting but things like pall-off press, side planks, and there are a lot of different movements that you can still safely do working on transverse abdominal breathing throughout my pregnancy. Then the other thing that I focused on the other side of the coin there was just my nutrition at a high level so a lot of protein intake. Protein is huge. Fiber in my diet throughout, a lot of veggies, fruits, getting in really good sleep each night, sun exposure, and just a lot of different things to take care of your body during a time when it’s doing so many different things. It’s not only filling you but also your baby and if you are depleted, that’s not going to be ideal for either of you. Meagan: Right. Absolutely. I feel like with my first, I kind of started doing the running. I was like, “I’m going to train for a half marathon,” then my provider was like, “Oh, you have round ligament pain. You can just stop. Stay walking.” That was such a bummer to me that I did that and that I stopped. Then I didn’t focus on my nutrition at all. I mean, seriously my husband worked 2:00-10:00 and I was eating Chinese food all of the time. My protein was probably not even close to 50g a day. It was really, really, really bad and I think that’s another one of the reasons why I feel so passionate about good nutrients and physical activity because yeah, I ended up training and becoming a Barre coach and stuff but really dialing in on that. I really do believe what you were saying that studies have shown. I had a better postpartum. I had a better labor along the way because I was able to focus on that. One, I love that you did it and two, I love that you help people do it and break it down and understand. If someone wanted to check you out, do you do only online? Do you do just in person? What does that look like? Sami: Yeah. I used to be a personal trainer in a gym

Every pregnancy and birth experience is different. That is true for everyone, but especially for Kristen. Kristen joins us from Provo, Utah, and shares her experiences with an initial vaginal birth, a diagnosis of omphacele with a Cesarean and infant loss with her second that left her with a special scar, an induced, medicated hospital VBAC with her third, and she is currently expecting twins!Kristen’s journey has not been easy, but she has learned and grown so much. She talks about how a safe and supportive birth team truly makes all the difference. Your intuition will help guide you to the best provider for you. When you know, you know!Meagan concludes the episode by touching on some myths and facts about doulas. The VBAC Link Blog: Myths and Facts About DoulasThe VBAC Link Blog: Special ScarsSpecial Scars, Special HopeNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:50 Review of the Week04:02 Kristen’s first vaginal birth09:41 Coping with grief and hospital communication issues15:17 A low transverse incision with a J extension19:59 Finding VBAC support in Salt Lake23:10 Foley induction at 41.5 weeks29:29 Changing plans30:37 Myths about doulas38:55 Facts about doulas41:05 Kristen’s advice to other women with special scars43:26 Listening to your intuition when choosing a providerMeagan: Hello, Women of Strength. Thank you for joining us for another amazing episode here at The VBAC Link. Today’s story is from someone who is local to me which I think is always kind of fun to have someone who when they are telling the story, I know the birthing place, I know the provider, and here I even know the doula so that is super exciting. Welcome, Kristen to the show. Kristen: Thank you, Meagan. Meagan: Thank you so much for being here and I’m excited for you to share your stories. I would like to get into a review really quickly so then we can do that. Kristen: Sure. 01:50 Review of the WeekMeagan: Okay, we have a reviewer from Apple Podcasts and it says louuuuuhuuuu. I think that’s how it is and it says, “Very Inspirational.” It says, “I knew I wanted a VBAC with my third pregnancy, but I wasn’t sure if it was possible. However, I knew I didn’t like being flat-out told no at my first appointment. Listening to the podcast was definitely the start of me really researching birth and looking into my options. I ended up with a successful HBAC” which is home birth after two Cesareans, actually HBA2C, “and I definitely don’t think I would have had the courage or believed it was possible without the podcast. Thank you, Meagan, for all of the work that you do to provide this information.” And thank you, louuuuuhuuuu. I don’t know how to say it. I’m just butchering your name. If you are still listening, thank you so much for your review, and as always, we love your reviews. They really do help the podcast. They help Women of Strength find these incredible stories and information just like she was able to receive. You can drop that review at Apple Podcasts or Google or wherever you listen to your podcasts. 04:02 Kristen’s first vaginal birth, Cesarean, and infant loss experienceMeagan: Okay, Kristen. Thank you again so much for joining us. I would love to turn the time over to you to share your stories. Kristen: Well, thank you. It’s hard to know where to start. There are a lot of details to mine. We had our first little boy in April of 2018. That was its own experience. That was a vaginal birth honestly. That was as hard as it was as a first-time mom and a first-time pregnancy/birth. It had its own set of interesting details to go along with that but we soon found ourselves unexpectedly pregnant with our second one just four months later after he was born. Meagan: Really soon. Kristen: Yeah, they would have been 11 months apart. I say would have been because my daughter who I had via Cesarean ended up passing away a few hours after she was born. She had a few congenital defects and when we got our first ultrasound, we found out she had a condition called omphalocele which means she had some of her organs on the outside of her body in a little protective sac. It was mostly her liver. I saw the ultrasound. I looked at it and I was like, That doesn’t look normal. It was one of those moments where the ultrasound tech was like, “I’m going to get the doctor.” Your heart sinks and your heart drops. At the time, it wasn’t a big deal after the doctor came to us and talked to us and said, “She’ll be fine. You can deliver safely. It would most likely be a scheduled C-section.” I was expecting that from the very beginning because it wasn’t just, “Oh, this is going to be a big baby. This is going to be a big baby with a large–”Meagan: 100% necessary Cesarean. Kristen: Exactly. 100% necessary. Meagan: Yes. Kristen: That was to be expected even though I was like, Darn. I don’t want that, but obviously, I wanted her to be her in the best and safest way possible because this is just such a crazy anomaly. That was around 18 weeks and then around 24 weeks, we were at Maternal-Fetal Medicine at our local hospital down here where I live in Provo, Utah and they discovered something else which is a lot more serious. She had a diaphragmatic hernia which means her diaphragm didn’t really develop all of the way and allowed some of her other internal organs to be pushed up into her chest cavity. Meagan: Oh wow. Kristen: Whatever was left in her abdomen was pushed up. I think some of her spleen was in there and pushed. They essentially squished her lungs so they couldn’t develop all of the way which is essentially what happened at the end of her life. That’s not something– we’ve grieved and healed a lot from that but it’s also something that I consider one of those things that now I can be there for somebody else now who has gone through infant loss in whatever way that means. I can be a sounding board for anybody else who has been there. Meagan: Yeah. It’s crazy how sometimes we have some of the most unfortunate or horrific experiences that we could ever imagine going through and life-jarring and after we get through them, we are still super there but we are also stronger in a weird way where you can be that support for other people and you can relate. It’s just this weird but most amazing thing that there are people like you who are like, I went through this really not great experience, but now I’m here and I want to support those who need it. Kristen: Yeah, totally. It took a long time to get there. Meagan: I’m sure. Kristen: She was born on March 25, 2019 and so she would have turned 5 this year. We celebrate her birthday as a family every year. Meagan: Good, yes. Kristen: My 6-year-old is excited because we always release a balloon up for her and he said, “I’m so excited. My sister’s going to get this balloon.” It’s still very innocent and sweet. We love being able to do that as a family because she is very much still to us a part of our family. Meagan: Absolutely. That just gave me the chills thinking about your little boy doing that. That’s so awesome. Kristen: He’s very tender-hearted and sweet. It’s one of those things that means a lot to him. Even though he was barely one when this happened, he wouldn’t have remembered her at all. Anyway, with those things going on, her outlook from the very beginning was bleak. That was a hard piece of the puzzle to deal with, but it also plays into what happens later. Although this was a scheduled Cesarean and absolutely necessary, we wanted to give her every possible chance just in case she could beat the odds or whatever. Me as mom, I’m like, There is still a 20% chance this could be okay. That’s something. It’s not nothing. Meagan: Exactly, yeah. Kristen: You’ve got to hold onto something and that’s what I did. 09:41 Coping with grief and hospital communication issuesKristen: The Cesarean itself was fine. The process in the hospital for me, nothing went overly wrong with me physically. But afterward, that was where it gets a little complicated. We had to leave the hospital with just my husband and myself which was obviously very hard but we also had a few different things that left me baffled and confused but really frustrated. Anyway, the first thing was that after our daughter had passed and while I was recovering, the hospital staff didn’t seem to be on the same page with a lot of things. First being their communication. I remember it was the anesthesiologist who came in the day after my daughter had passed and they asked, “Oh, how are you? How is your baby?” Did you not read the notes? Is there not a sign on the door that says she’s not with us anymore? I had to clarify. Of course, he was very apologetic. “I’m so sorry.” Okay. That seemed like one of those things where it’s like, okay. You should have been informed. I don’t know why. After that, we had the resident doctor and the doctors in training at the time. He comes in and says, “We had to do a mid-transverse incision on your uterus and so you should plan on Cesareans from here on out. It’s not safe and don’t plan on having a vaginal birth.” It’s like, “Okay, no one told me that was happening.” I felt like there was again that lack of communication and just that misstep between doctors and the other providers and stuff. I was told that in the hospital as I was recovering so that was another blow of course because I was very much expecting, Okay, I know I can have a vaginal birth after a Cesarean. That’s totally a possibility. I go in with that strand of hope again for myself thinking that I could totally do this later. I’ve heard it’s possible. I’ve just got to find somebody who can help me with it. I’m fine, then someone tells you like your reviewer today. I hate it when someone tells me no. Don’t tell me no. Don’t do it because I will literally make it my life’s work to prove you wrong. That was really hard to hear, of course, in that setting and in that moment. It’s really deflating to hear that. But I was like, Okay. If that’s what they think, that’s fine. I’m going to prove them wrong later. Whatever. I’ll do it.Then we ended up going home. I ended up calling back the doctor’s office saying, “Okay. You said mid-transverse. What does that actually mean?” I was trying to clarify things. Meagan: It’s higher up. Kristen: Yeah. The nurse who answered said, “Well, we had to do a mid-transverse incision. We had to make more room for your baby to get out.” I was kind of expecting that they might have to do that. They did forewarn us that it may be a possibility but no one ever said that was what happened in the hospital when we were delivering her. Anyway, they never told us that happened until I called back and said, “Hey, what actually happened?” She said, the nurse I remember was like– it still makes me baffled why you would say something like this– but she goes, “We had to show a mid-transverse incision with a double-J extension,” so one on either side. Meagan: On each side? Wow. Kristen: Yeah. That’s what she told me. She said, “Think of it like a smiley face on your uterus.” It’s like, why would I ever think of it like that? It was just the weirdest verbiage. Why would you say that to somebody? I don’t know. I was like, Okay. That was weird. Why would you say that to me? Then it gets even better. You can request your op-notes. Meagan: Yes. Kristen: I did that. I requested them. I feel like people are just going to be doing the facepalm like, Oh my gosh, seriously? What were these people thinking? On my op-notes, they have little bullet points. The first one says, “Uterine incision”. The uterine incision they told me they had on there said “classical”. Meagan: Oh. Kristen: Which is wrong, totally wrong. Immediately beneath that, it says, “Detailed C-section notes”. Then it says, “Mid-transverse incision. Patient should not labor in the future.” That was the note. First it says classical. Then it says mid-transverse incision. Then they tell me I have a mid-transverse incision with a J extension or double J’s. What do I have? What did you do? Meagan: Yeah. Yeah. 15:17 A low transverse incision with a J extensionMeagan: That’s frustrating. Kristen: Yeah, so fast forward to when I have my new provider. We’re pregnant with our third now or we were at the time. He was a wonderful, wonderful guy and a wonderful provider. He said, “Do you know what? I’m going to go off of the actual written notes from the person who says they were watching the procedure.” It’s like, oh that’s really smart. They said I have a low transverse incision with a single J extension to my right side. Meagan: Wait, so different again? Kristen: Different again. So I was like, Oh my goodness. Where does this end? It stopped there, thank goodness. Yeah, he said, “I’m trusting more the person who was basically looking and saying, I was here in the moment taking physical notes and this is what was done. I’m trusting this more than somebody’s bullet points.” Meagan: Everybody’s bullet points, yeah. Kristen: Exactly. Meagan: And the nurses who are just randomly saying what they did. Okay. Kristen: Yeah, exactly. Exactly. Meagan: Wow. Kristen: So I was like, “Thank goodness I have you to translate for me,” because I was like, What did they do to me? I have no idea. Probably any other doctor who wasn’t super VBAC-friendly would be like, “Well, this is too risky. I don’t want to take any chances.” Meagan: So technically you have a special scar. Kristen: I do. I have a special scar. Meagan: Low-transverse with a J. Kristen: With a J. In those op-notes, I actually did notice just the other day when I was reading them again, it said that they extended it bi-laterally which in my mind, I didn’t call and ask obviously, but in my mind, that would translate to making the low transverse incision just a little bit longer. Again, I don’t know. But at least at the bare minimum, I have a low transverse incision with a J extension. So yes, I have a special scar. It was one of those crazy things like, Oh, now I’ve got to look this up. Again, I’m gung-ho at this point about, I can do this with a special scar. I’ve listened to the podcast. So many women have done it. I can do it too. I’ve just got to find somebody who is willing to meet me in the middle. Meagan: Support you. Kristen: Yeah and like I said, luckily I did up in Salt Lake where it’s not too far of a drive from where we are from. It was definitely worth it. He said, “It shouldn’t be a problem from what I’m reading. We’ll just go with it and if anything changes, I’ll keep you posted.” He was just supportive from day one which was super awesome. Meagan: He’s wonderful. Kristen: Anyway, so yeah. That’s the complication from my fun story. Hope that all makes sense. Hope we are all able to piece that together. Sorry. Meagan: Well, that’s so hard because it’s like, I’m being told this and this and this so what is it? All of these things impact my decision or maybe it doesn’t. But you want to take all things into consideration so it’s frustrating to not know what you have. Kristen: Right, totally because yeah, like you said, it could totally impact somebody’s decision. Meagan: It could affect somebody’s decision, yeah. 19:59 Finding VBAC support in Salt LakeMeagan: Okay, so you found out it was a low transverse extension J special scar. You found a provider up here in Salt Lake that was like, “Yep, okay. We’re going to do this.” How did that go? Kristen: That was really good. Honestly, it was one of those things where you start looking online first and then go from there. I just found his name. At the time, unfortunately he doesn’t practice that anymore, but he had his own little personal video posted about that. I was like, I feel this. I’m getting really good vibes from this guy and I really like it. So I called his office. I scheduled myself in. Great. Okay. Then yeah, it was really comfortable from day one. I told him. I said, “I’ve got some weird things going but at the same time, I am really motivated. I’m really determined to do this.” He was like, “Okay. I’m with you.” Meagan: There was something about him that brought this overwhelming sense of calm when he was with you. Kristen: Mhmm. Meagan: Fun little side note, I was actually under his care as well for my VBAC. Kristen: Oh cool. Meagan: For a little while until I decided to go out-of-hospital. Kristen: Yeah. Meagan: Yeah. He’s just awesome. Kristen: Yeah. I completely agree 100%. Meagan: He transformed the VBAC community here in Utah. They just flocked to him because there was just something about him that wasn’t anywhere else here in Utah. Kristen: Yeah. Now you’re giving me chills. I’m going to get emotional about it because I feel like it’s so true. Meagan: Yeah. Yeah. He’s a special OB for sure. Kristen: Yep. It does. It makes you sad that he’s not doing that anymore but at the same time, I’m sure he is one of those doctors who will refer you to somebody who he trusts and you can be like, Well, if he trusts them then I can feel safe about it.Meagan: Yeah. Yeah. And you hired a doula. Kristen: I did. I hired a doula. Meagan: Who was one of my clients. Crazy, huh? Kristen: She’s one of my good friends. I was like,  You know what? I’m going to do a total 180 on this one. It was the best thing ever and the best decision ever. It happened to work out super nicely because my husband was there, yes. He is the best– she calls them daddy doulas. He’s the best daddy doula, but he had to take some breaks too and having that other person there was like, If you weren’t here, I don’t know what I would do because I feel like my husband needs a break and I have to do this by myself, but no. I wasn’t left by myself. It was one of those things that helped with the whole VBAC process go so much more smoothly especially because it ended up being an induction. Meagan: Oh, okay. Kristen: Yeah, so just add more to my docket here of fun things that I chose to do. 23:10 Foley induction at 41.5 weeksKristen: We ended up going to 41.5 weeks with my daughter and at that point, I think this is probably biased but I feel like a lot of OBs, not matter how supportive they are, they are like, “Well, we could go this far if you wanted to, but it’s getting to that point.” It’s like, Okay, fine. It was my choice obviously to do it. We went in for the induction. I chose to use the Foley bulb. I had never done that before. That was hands-down so much better because my son was an induction as well and about the same time. My babies just go late. They are just 41+ weeks and they are still just cozy. So with him, it was not the same. They tried to push me in and out with a much faster style of induction. I was not a fan. The one, I was like, Okay. This is going to be different. Like I said, a 180. With her, it was a very slow, gentle induction and yeah. She arrived and it was pretty awesome just to feel at the end of the day like, Yeah, maybe an induction wasn’t exactly how I pictured this to happen, but my thoughts and feelings that I put out there into the universe was just that, I want a VBAC and I want it to go well. And it did. She’s here. She’s 3 now. It was one of those things that gave me that really big sense of accomplishment and that “ha” moment like, “I told you I could do it.” Meagan: I understand that “ah-ha” feeling so much. I definitely did that when my son came out as well. 25:10 Pitocin, epidural, and pushing for 10 minutesMeagan: You mentioned it was a lot slower of an induction and things like that. A lot of people don’t think that it’s really possible to do a low and slow induction. You started with a Foley then what happened from there? Did they start with Pitocin right after that? Kristen: They did. They started with Pitocin and we had to have some conversations with the nurses too. It was another reason I was glad I brought my doula. They started going a little bit faster than I wanted. I remember being a little bit earlier on and I was like, These contractions should not be on top of each other like this already. They were again, really good about backing off and letting me do it. Again, like I said, there are still things I would change but I feel like we all maybe have this ideal, I want it this way, especially for me. I’m very much like, I want this and this and this to happen. I have to be realistic. It’s not going to go exactly how I want it to. There are some things I can tweak and change along the way, but having a realistic viewpoint of how things might go is good. Meagan: Yeah. Kristen: Yeah. They ended up starting Pitocin and I was trying to go as natural as I could for as long as I could. I think I got to about 5 or 6 dilation and then I was like, Okay. I think I’m ready to just get a little relief. So yeah. I got an epidural. Again, then my brain switches over to how my induction births were different. With my son, I was cranking that thing up to 10 as high as it would go. It was my first time doing it. I didn’t know how it works. I ended up with him being flat on my back. I couldn’t feel my legs but with her, I was like, I don’t need to do that this time. So I was a lot more, that education. It helps having prior experience. But yes, it was as low as I could bear. I could still move around. I could sit up. I think I was even on my hands and knees for a little bit with it too. Meagan: Awesome. Kristen: Yeah. Having my doula there, she was wonderful helping. We were doing rebozo and stuff like that. Again, it was all of the good, natural stuff that I was looking forward to. Meagan: Yes. Kristen: Yeah, so I got myself to a 5 or a 6 and then I had a little help, but yeah it didn’t really take much longer after that. It’s hard to remember all of the details but once I got to a good place, they ended up breaking my water which was fine. After that, it only took a couple of hours to get her down and out. I pushed for 10 minutes and she’s here. Meagan: Nice. Kristen: She’s our biggest one, 8 pounds, 14 ounces. Well within normal range. Meagan: Yes. Kristen: But still it’s just so funny how the nurses react, “Oh my gosh. She’s big.” Not really. For you, maybe. I don’t know. Meagan: I swear. Anytime the babies are over 7 pounds, they are like, “This baby is huge.” I’m like, “No, the baby is not that big. It’s perfect.” Kristen: Right? I know. She had a full head of hair. That was their biggest comment. “Look at all of that hair.” It was so funny. Meagan: I love that.Kristen: But yeah, she was much more alert than my son was when he was born. Again, just different vibes, a different environment and a different style. Meagan: It probably wasn’t as long so he didn’t have as much in his system too. Yeah. Kristen: Exactly. Yeah, but it was one of those things where she came and then it was like, oh my gosh, that sense of relief. It went off without a hitch. In my mind, I was like, This was just perfect. 29:29 Changing plansMeagan: I love that you mentioned things along the way like change with induction. There are things within our labors and things that may not go exactly as we envisioned or wrote down on paper, but there are so often times where we can sit back and decide, Okay, yes. I’ll go for an induction. Okay, yes. Let’s try a Foley this time. Okay, I’ll actually go for that epidural. We’re changing plans or making decisions and in the end if we were part of that decision, it really resonates differently for our minds. We feel better about the experience even if it wasn’t exactly how we would have put it on paper. Kristen: Yeah, exactly. Meagan: I love hearing that you were like, Yes. This was a good experience and I got my doula and I had my provider and honestly, you were in a really great hospital. I really, really like them. 30:37 Myths about doulasMeagan: I wanted to share a little bit about doulas because obviously, I love them. Kristen: Sure, yes. Meagan: I am a doula and so maybe that is biased, but I really had a long labor myself and was able to truly benefit from doula support. Like you mentioned, my husband was exhausted and he got to a point where he was starving. He needed food and I remember he actually left the birth. He full-on left the birth to go get food. He felt very confident that I was in good hands and I was being supported. I love that so much, but there are a lot of things that people think about doulas that aren’t necessarily true. I wanted to go over some myths and then some really good pros and facts about doulas. Number one is that doulas are expensive. Now, doulas– Kristen: False. Meagan: It’s so funny because after services with our clients, a lot of the time they will be like, “You are worth your weight in gold. You need to charge more.” Kristen: Right. Meagan: When you see a doula who ranges from $800-$2000, that is a lot of money. That is a lot of money, but then when you break it down and look at really what a doula offers–Kristen: Totally, from start to finish, correct me if I’m wrong, you can hire them as early as you want and then, especially for me, it was the postpartum support that was a really big deal so it’s not just, “Okay, I was here. I helped you while you had your baby. See ya. Good luck. Let me know if you need anything.” No, “I’m going to bring you supplies.” Of course, my doula is a little bit more special because she was one of my friends. Meagan: But she is amazing. Kristen: She is. She is wonderful. Meagan: Her natural ability to care and help you feel supported, she–Kristen: Mhmm. She has this way of connecting with people that is quite rare, I think. Meagan: Yes. I love that. And myth number two is that doulas replace the birth partner. Kristen: Like we just both said, nope. They don’t. Meagan: I think that they help the birth partner. A lot of people don’t realize that doulas are there for our partners as well. It’s definitely more focused on mom because mom is giving birth, but there is a lot that partners go through during childbirth that really is important to be loved because you are in a very vulnerable state. You are watching someone who you love so much go through a very big event and they are also bringing another human into this world who is yours. There is a lot of fear and uncertainty and desire to help but again, uncertain as to how and needing rest and things like that. As doulas, we are never there to replace a birth partner ever unless that is something specifically where you are like, “Hey, my partner is not going to be here. I would like you to replace and be there in place of that.” But no, we definitely don’t do that. Myth number three, doulas are the same as midwives. Just before we started recording, I was telling Kristen how even to this day in 2024, people are like, “What do you do?” I’m like, “I’m a birth doula.” They’re like, “Oh you catch babies?” I’m like, “No. I don’t.” “Oh, you do this?” I’m like, “No, I don’t do any of that.”We’re not midwives. We are doulas. We are there for loving, educational support and information and all of those things, but we are definitely not trained midwives. We work with midwives and OBs. Another one is that doulas are only for the mother which is kind of what I was just saying a second ago. No, we are not only there for the mother. Doulas are hippies who chant and sacrifice chickens during birth. Kristen: That is quite the specific myth. Meagan: That is very specific. This is something that was on our blog, but it was something that someone said and we are like, Oh, yeah. Okay. This is perfect. We are putting this as Myth #5. Kristen: That’s hilarious, yep. Meagan: But really, we are hippy. We are hippy. Kristen: That’s funny. Meagan: Okay, maybe. Maybe doulas are a little bit more natural-minded. That’s true, but just because someone wants an epidural or even a scheduled C-section or doesn’t want to go in and do weird sacrificing of chickens apparently, I don’t know, that doesn’t mean it’s true. We don’t. We are there to support you and we are going to be there in the way that you want us to be there. Doulas only support home or unmedicated births. This is a big myth. So many people when I start telling them about what I do, they are like, “Oh, so you just only do home births.” I’m like, “Actually, it’s a rarity. It’s more rare to do a home birth than a hospital.” I would say that 97% of our births are in-hospital. As far as medicated go, we don’t support them, that is B.S. Kristen, you are living proof that that is not true.You guys, it is not for us to judge anybody on the way they birth. We are there to love and support them. If that means that they choose the epidural route, that means they choose the epidural route and that is great. We support them. So, no. If you are wanting to get an epidural and you don’t know if you want to hire a doula because you want an epidural, let me tell you. We as doulas do a lot actually with epidurals. Sometimes when there are epidurals at play, we actually have to work differently. It’s more in a different way because there is more to do as far as movement. You can’t just get up and move. Kristen: Yes, it’s true. Meagan: Right? Or being on hands and knees, you need that extra support. Whatever it may be, we are now restricted a little bit with movement so as doulas, we are going to be doing more with epidural. A lot of people think if I got an epidural, a doula is not worthless or it’s pointless. Go ahead. Kristen: Sorry to interrupt, but if I hadn’t have had my doula when I got my epidural, I probably wouldn’t have known if I could actually do certain positions. I was like, Oh, well I have this epidural so I’m not really supposed to move. No, actually you can do this. And laying down, due to my prior induction was like, I know it’s bad. Don’t lay on your back. She was like, “Well, actually if you sit yourself up just a little bit, you’re actually going to be just fine. This is actually okay. It’s like, “Okay. I’m so glad you are here. If you weren’t here, then maybe the nurse would have told me I’m okay or maybe she would have helped me. Nope, probably not. She’s got her own stuff that she’s doing.” Yeah, that was a really big deal for me too especially for a VBAC and an induction on top of each other. I’ve got so many things in my mind while you’re giving birth. I can get this baby out with no problems. I can do this. That’s where your focus is so having that doula say, “Hey, you know what? Change this a little bit,” and being there to support you in that way was awesome. Meagan: Absolutely. Absolutely. I love that you pointed that out. 38:55 Facts about doulasMeagan: Here are some facts. Doulas help you cut costs. There is a 39% decrease in the chance of having a Cesarean which is an increased cost a lot of the time. Some insurances are amazing, but there is that. There’s a 15% increase in the chance of having a spontaneous vaginal delivery which is non-induced. We know that induction is also an added expense. A 10% decrease in the need for any medication for pain relief, a 41-minute average reduction in the length of labor, a 38% decrease in a low 5-minute APGAR score, and a 31% increase in satisfaction for the overall birth experience. Holy cow. This is what a stat says on our blog. It says, “In the U.S., an epidural alone costs an average of $2,132.” Now, this was written back in 2021 and we know that since a lot of things in our lives have happened, things have increased. I would put money on that that is definitely more now for sure. There are a whole bunch of other facts on here. We’re not going to go over all of them, but I would encourage you to check out our blog. It’s going to be listed in the show notes. We’re also going to list in the show notes a couple of other groups especially if you are a special scar listener, we want you to know about an amazing group. Did you ever go to Special Scars, Special Hope? Kristen: I did not actually. Meagan: Okay, that is a Facebook group and honestly, it’s amazing for special scars. We’re going to link that. We’ll have a special scar blog so you can read more about special scars and their chances. Definitely check out the podcast even more for some more special scar episodes. If you are looking because you have a special scar, know that there are risks involved, but

Julie Francom joins Meagan on the podcast to talk about checking the validity of the information you see surrounding VBAC. There is so much information out there and so much misinformation that we want to help you figure out what is actually evidence-based! Julie and Meagan draw on their personal experiences with making corrections to information they understood and have shared. They talk about how the structure, size, and date of a study can influence the statistics. Julie shares why Cochrane reviews are her favorite.The VBAC Link is committed to helping you have the most evidence-based and truthful information as you make your birthing decisions. We promise to update you with all of the new information as we receive it!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 03:30 Checking the validity of social media posts08:01 Our corrected post about VBA2C12:56 The production behind a statistic or article18:37 Cochrane reviews19:06 Checking the dates of studies and emailing us for verification23:29 Nuchal cords25:21 Julie’s sleep training story29:45 Information at your fingertipsMeagan: Hey, hey everybody. Guess what? We have Julie today on the podcast. Julie: Hey. Meagan: Hey. We’re going to be doing a short but sweet, maybe also a little sassy because as Julie has said, she likes to get sassy these days. We’re going to do a short but sweet episode on how to tell if VBAC or HBAC or really just anything–Julie: Any. Meagan: Yeah, any information you see online is real or fake. Now, if you’re following along on our social media, you likely have seen a lot of our myth and fact posts. I think we share them probably once a week honestly because there really are so many things out there that are myths and things that are facts, but on a whole other side and a whole addition to myth and fact is really what should we be believing? What should we be resharing? Right, Julie? I think that this definitely is something that is close to our hearts at least I’m going to say is close to my heart. I think it’s close to Julie’s heart. Julie: Oh, for sure. Meagan: We want to protect this community and we want this community to find the real information, and not the false information. We know. You can Google anything. Julie: So much false information. Meagan: You can Google anything and find the real and false information but when it comes to VBAC, like she said, so much false information. We’re not even going to do a Review of the Week. We are going to jump right in in just a second after the intro. 03:30 Checking the validity of social media postsMeagan: All right, Julie. Are you ready to get spicy?Julie: Yeah, I think maybe the biggest reason we decided to do this episode and at least for me anyway why I brought it up is because there is so much information out there that looks good, right? You can be like, Oh my gosh, yes. This is amazing. We’re passionate. We as in me and Meagan, but we as in you too who is listening. Clearly, you’re passionate. But we really need to be careful what we’re sharing both from our business accounts and what we’re resharing from other people because sometimes if you share this information and it’s incorrect and wrong and it goes viral which there is a recent post that has and sparked this thing, and we’re not going to call anybody out, but when you share misinformation and it goes big and people start believing this incorrect information, it can really do damage to the efforts that we’re trying to make here which is increasing access to VBAC for everybody. If you have this entire group of people who think that their chances of having a VBAC at a hospital let’s say are 30% or something like that when really your chances of having a successful VBAC if you get to try– get to try I’m using very loosely– are really between 60-80%. Those are the numbers. But there was a post recently that went viral that said it was around 32% in the hospital and that is just simply not true. The post went viral and everybody is jumping on board like, Look how much better home birth is than hospital birth, but those statistics were very flawed from a flawed study that was super small from Germany 20 years ago. Meagan: Less than 2000 people. Julie: Yeah. Yeah. It could give you some pretty conclusive. Some, but it’s not big. It’s not a meta-analysis. It’s definitely not something to be definitive. It’s from Germany and there are a lot of flaws in the study as well. But everybody saw this thing, Oh, HBAC success is 87% and hospital VBAC success is 32%, or whatever the number was. People are like, Look how much better it is at home, and spreading this information which don’t get me wrong, having three HBACs myself, I love home birth. I love home birth after Cesarean for whoever feels it is appropriate for them, but I also know that those numbers are just wrong and if you share that information and these people believe it, they might be choosing HBAC out of fear. Meagan: Well, yeah. Absolutely. Julie: Instead of having the right information and making the right choice for them. I don’t know. That’s what we want to do here. We want to help you spot misinformation easier and learn to question the things that you see on the internet which sounds so silly. For me, I’m like, Okay. Let’s challenge everything. But I saw that post and my first thought was, Heck yeah. That’s crazy. I’m all for home birth but then I was like, Wait a minute. These numbers don’t feel right to me. Meagan: It doesn’t make sense. Julie: So then I dug a little bit deeper into it. We just want to equip you with knowledge so you are doing your best to get the most accurate information and spot the information that is not necessarily true. I think we are all guilty of it. I’m just going to keep talking, Meagan::. Meagan: I know. I was going to say really quickly. Just like what you said, you were like, Heck yeah, as someone who is passionate about birth or maybe someone who may have trauma. I’m talking about this specific post but really in any general post, someone who may have trauma surrounding the opposite of what that post is supporting, it’s so easy to just be like, Boom. Share. You know?Julie: Yeah, you’d be like, Oh my gosh, yes. I love HBAC. Let’s share this. Let’s increase VBAC. Everyone needs to hear this. This is important information. We get excited, right? Meagan: Right, but we need to do exactly what Julie said and take a step back and I mean, this goes for anything. It might be sharing the correct age of a child being out of a car seat. I mean, just random and you’re like, Yeah, that looks good. Boom. Share. Make sure that you are sharing the right stuff. 08:01 Our corrected post about VBA2CMeagan: So let’s talk about this. Keep going, Julie. I know you were on a tangent going into it. Let’s talk about how to understand if it’s real. Julie: Well, first of all, I think before we do that, I want to admit that we have been guilty of sharing, I don’t want to say misinformation because I guess it kind of was. A few years ago, we misquoted an ACOG bulletin about VBAC. Meagan: Yeah. Julie: It was me. I did it. It was me. I’m the problem, Taylor Swift fans. What had happened was that ACOG, in their bulletin about VBAC after two C-sections, cited two studies. One study that they cite– first of all, they say that VBAC after two Cesareans is a safe and reasonable option for parents to attempt and the decision should be patient-based. Anyways, so they cite two studies. One study that they cited about VBAC after two Cesareans shows no increase in rupture rates with VBAC after two Cesareans compared to one. The second study that they cited showed risk of almost double the rupture rate for VBAC after two Cesareans compared to one. It’s really interesting because they cite these two studies that are equally credible that had drastically different results. So when I made the post, I paraphrased the bulletin that said something to the effect of, “VBAC after two Cesareans shows no increase of rupture risk.” Now, that was only really kind of half true because I saw the study and I was like, Oh my gosh, like Meagan:: said, This is exciting! Everyone needs to know this. I made the post then we started getting some kickback on it and so we looked again because I was like, Oh, well I will show you where in the ACOG bulletin it says this, and then I went and I was just like, Oh yeah, it doesn’t say exactly that. I unknowingly spread this misinformation so what we did is we updated the post and we posted an additional post that was a correction because here at The VBAC Link, we want to make sure we are giving you 100% accurate information all of the time. The reality is that we are humans. We are going to make mistakes sometimes but as soon as we realize that we make these mistakes as long as they are actual mistakes and not just people wanting to talk crap, we’re going to correct ourselves. That’s the biggest thing. I want to say that it’s okay to not be perfect all of the time, but I think it’s also important that when you realize you’ve made a mistake that you correct it in the same space that you made it. Anyway, I just wanted to say that. Meagan: Yes, not wanting to shame anyone for being excited and making these posts. Julie: You should be excited. We’re excited. Meagan: Yeah. We were really excited to even see that post earlier and then we had to take a step back. It’s not to even shame that person. They are probably really excited to share that information but again, as a poster, one, take a step back before you share, and two, take a step back before you post. If you post and there is question which unfortunately there were a lot of questions on this post, change it. It’s okay. It’s okay to be like, Oh, I actually misunderstood this. Julie: Update it. I didn’t see this. Yes. Meagan: Or, I didn’t realize this wasn’t as credible as it felt. Julie: Or seemed. Right. Meagan: One of the best ways to find out of the research or the study or what you are looking at is really, really credible is if it’s peer-reviewed honestly. Right? Julie: Right. I think before you even go into that is if you see data or information like this post shared and it doesn’t seem quite right or even if it does seem right and you don’t see a source cited, ask for a source. Meagan: Ask for it. Julie: Mhmm, especially if they are throwing out numbers like, Home birth has an 87% success rate for VBAC and hospital birth only has 32%, everybody wants to get on board with those numbers, but there were no studies posted. There was no anything so I actually went on and made a comment. I asked about it and she posted four different studies. I was like, Three of these studies aren’t even relevant at all and this one where you are getting numbers from is incredibly flawed. I think it’s really cool to get on board with something that shows these fancy numbers, but it’s really important to at least see a source cited I would say. Bare minimum, see a source. Ask for a source and then go through and verify the source. Meagan, yeah. Let’s talk about what makes a source credible. 12:56 The production behind a statistic or articleMeagan: Yeah. Julie: These are just some things. Not all of these things are going to be true all of the time for a credible source, but these are things to look for and why they are important. Sorry, go ahead. Meagan: No, yeah. I think one is looking at who even produced it. Who produced this stat or this article or whatever? A lot of the time, someone who produced the article may not be the person who produces the stat or the evidence. That’s something to also keep in mind just because if Sally Jane at whatever company shared an article, it doesn’t mean that she’s not a credible person but I think sometimes when we are digging deep into what is credible and the real original source, it will take us to the original source which then we need to look at. ACOG, right? We pay attention to ACOG. Midwifery groups and things like this, we want to look. Who wrote it? I think one of the things is what is the full purpose? Julie: Yes. Meagan: One of those articles that I was reading actually wasn’t in relation to what the post was about. Julie: Exactly. Meagan: I don’t know if you saw that. Julie: Three of them. Meagan: The purpose of this article and the goal of why they are one writing it in general and what’s their ultimate goal in giving you the information. Julie: Right. Meagan: I mean, when I was reading one of them, I was like, Wait, what? Julie: And when she shared these four links and I called her out, I said, “These three are about this, that, and the other thing. They are not related to the other things that you posted,” she deleted all of the other information that she shared and just kept the one outdated German study up. I felt really salty then. I still feel a teeny bit salty about that. But yeah, I feel like asking the author and the poster. I know that at The VBAC Link, when I was there, I tried to really make sure that we did this and I feel like you still do but whenever we post anything with stats or numbers or anything like that, we try to post a source with that every time. Meagan: Yeah, for sure. Exactly. Julie: It’s in the course like that. Sorry. I feel like we are going in different directions there so circle back. Meagan: Yes. I think you really need to break it down and look at the ultimate study. If it is saying that you have a whatever success chance of having a VBAC in the hospital or having a VBAC in general and you’re looking at the stats, if you’re looking at a review that has 9,000 people and then there is another one that has 400,000 people involved in that study, to me, automatically I’m going to be looking at the difference there because to me, 9,000 is a lot but this one was less than 2,000 specifically. Julie: Right. Meagan: So when we’re looking at big studies, if you have a very small control group, it’s just not as credible as some other sources. Julie: Right. 18:37 Cochrane reviewsJulie: What I really love is when I can find a Cochrane review of something. Cochrane reviews in my opinion is the most credible place because what Cochrane reviews are is they are a meta-analyses of a bunch of different studies. What they do is they find a whole bunch of different studies or research papers or evidence or just huge collections of data. They go through and pick them all apart and find out which ones are credible or which ones are not credible and then they compile the results in those studies to have a bigger meta-analysis which is a collection of a whole bunch of credible studies pulled apart and data presented. I love if I can find a solid Cochrane review because I know that is just about as credible as you can get. Also realize that most studies have flaws and limitations like Meagan:: was talking about. Who is behind the study? Who funded the study? Who contributed to the study? What were the study controls? How many variables were there? Because if you have a study with more than one variable, then your numbers are going to be skewed anyway because these different variables may influence each other. If you have, for example, the ARRIVE trial. The ARRIVE trial we know had flaws. I’m not going to go over all of them but they were funded by a doctor at a hospital whose goal was to show that induction provides the same or better outcomes than waiting for spontaneous labor. That was the intention of the study. When you go in trying to prove something, you’re already introducing bias into the study and you could bring protocols or procedures into the study that might not be realistic in the real world that could influence the results of the study which is one of the things that actually happened in the ARRIVE trial. A lot of studies I feel like could be picked apart and torn apart which is why I really love Cochrane reviews and meta-analyses is because you can compile all of these and get more accurate results and information. Also, here’s the thing with that study, that one study that she showed that had less than 2,000 people and is 20 years old and is based in Germany, that’s not going to be relevant in the current day in the United States. Meagan: That’s another thing that I wanted to bring up. 19:06 Checking the dates of studies and emailing us for verificationMeagan: How long ago was the study? If the study was done in 1990 and we are now in 2024, there is a large chance that things have changed either way. Maybe in favor of that or the opposite. Julie: Right. Meagan: So we need to look also at the date. If you are looking at something and here at The VBAC Link, we know we have stuff that was even published in 2020 that there may be a new article out in 2022 or 2023 and we need to stay up to date on these things so it is so important to also look at that date because something 20 years ago or even 10 years ago, that might actually be the most recent study. Julie: Yeah, and if that is, that’s all you can use. Meagan: Right. Right. There’s that. But there may be a newer study. So again, before just clicking “share” or “create” or something like that, it just goes back to stepping back and looking at it. Let me tell you, Women of Strength, right now, if you find a study online and you are like, Wow. I am really, really curious about this post or about this study or whatever it may be, but you are unsure, email us at info@thevbaclink.com. Email us. We will help you. We will help you make sure to break it down and tell you the efficacy. Julie: The corrected-ness. Meagan: How efficient and correct it is. Julie: I don’t think efficient is the correct word. Accurate. Meagan: Accuracy. Julie: Oh my gosh. You should listen to us. We know how to speak. Meagan: Email us, you guys. I don’t even know how to use my words but I can tell you how to break down a study. No, but really. Accuracy. That’s the right word. Thank goodness for Julie. Julie: I think that maybe a more appropriate thing for her to have said in that post would be like, “Your chances of having a VBAC are higher at home than in a hospital.” That is accurate, 100% because it is true. Out-of-hospital births, at least around here in Utah. I can’t speak to other parts of the country so maybe I should say that. Around here in Utah where we are, I can confidently say probably in other parts of the country too, when you have a skilled home birth midwife and you are a low-risk pregnancy and VBAC does not make you high-risk P.S., you have a much higher chance. Now, there are no studies done here in Utah, but we have seen a lot. I mean, there is this Canadian home birth study that was just done that took a look at VBAC as well that showed some similar things but we know that the American Pregnancy Association says that women who attempt a VBAC have between 60-80% chance of getting a VBAC. Now, around here, we in our birth centers and out-of-hospital births and home births see over 90% of that success rate in all of the midwives and stuff like that who we have seen and talked to who have shared their data with us. That is good data. Meagan: It is pretty high here. We are lucky here. I have only seen out of 10 years of doing births two VBAC transfers and actually, the one was because she really just wanted an epidural. That’s the only reason why she left and the second one was because we did have quite a stall. I think it all was a mental thing. I think she actually needed to be at the hospital and then they still had VBACs so that’s great. Julie: For sure. I’ve seen one transfer, but that cord was wrapped around that baby’s neck four times and they had to cut the cord before they took the baby out via Cesarean. Meagan: Whoa. 23:29 Nuchal cordsJulie: Nuchal cord, a cord wrapped around the neck most of the time is not a need for a Cesarean, but this mom pushed and pushed and pushed at home for hours. We transferred and got her an epidural. Baby’s heart rate started to not do good. They took her back for a C-section. The cord was wrapped around its neck four times and they couldn’t even take the baby out because it was wrapped so tightly. They had to cut the cord in four places before they could pull the baby out by C-section. Meagan: Wow, wow. Julie: Wild, right? That was an absolutely necessary Cesarean. That baby was not coming out. Absolutely necessary. And things like that are going to happen and it’s cases like that where we are so grateful for C-sections. This is one of those things where if it had been 300 years ago, mom and baby probably would have died because that baby was so wound up in there. This was one of those true cases. Most of the time when people say that, it’s not true in my opinion. Don’t cite me. Meagan: Okay, well the true takeaway from today’s episode is to check your facts and if you see something that doesn’t feel right, check it again but don’t just share it and ask for the source if there’s not a source. Check if it’s peer-reviewed. Check if it’s a Cochrane review and all of these things. Again, check the date. Check the amount of people who were in it. Really do your research and if you do have a question, please do not hesitate to email us at info@thevbaclink.com. We’d be glad to help you decipher if that is a good and factual or not-so-factual article or stat or whatever it may be. Julie: Whatever it may be. 25:21 Julie’s sleep training storyJulie: Do you know what is funny? Let me throw out another example really fast and then we will wrap this thing up. Years and years and years ago, nine years ago– my first VBAC baby just turned 9. After he was born, oh my gosh. All the things. I had all of the mental health things. One of my biggest things was that I thought, this is probably going to be a little controversial. I thought that in order to be a good mom, I had a checklist because I wasn’t going to have a NICU baby. I wasn’t going to have the same situation. I thought it had to be completely different. I had to breastfeed. I had to go and get him every single time he cried right away instantly and drop everything. I thought I had to do all of these X, Y, and Z things. What is that method called? It starts with a W I think. Anyway, it’s kind of a modified version of crying it out. You let them cry for a minute and then two minutes or whatever. It worked really well and he is still my best sleeper to be honest. I thought, Oh my gosh. I am so bad. I can’t believe I damaged my child. Yada, yada, yada and there are probably people listening right now who are like, Well, you did damage your child by doing that. But anyway, he’s damaged for other reasons but not that one. So with my second, I wasn’t going to do it because there was a study that showed that babies who were left alone to cry it out had the stress part of their brain remain activated up to an hour after they stopped crying and all of these things. I was like, Oh my gosh, I can’t believe I did that. I’m the most horrible mom ever.Clearly, I think differently now, but I paid a postpartum doula to come in and help me learn how to gently encourage them to sleep. Well, it turned out my stinking baby would cry in his sleep. He would cry while he was sleeping. Meagan: Oh, no way. Julie: I would go in there and I would be like, Oh, super mom to the rescue. I would pick him up and wake my baby up who proceeded to cry for two hours because he couldn’t go back to sleep because I was waking him up. Anyway, it was this whole thing. I know, stupid right? Every baby is different. But my point is that this study which everybody was sharing about the damages of crying it out and how we are damaging our children and they are going to grow up to be people who feel unloved– that was the thing. Do you remember that? Do you remember that? It was 9 years ago or so, maybe a little bit more recently than that. The study had four babies in it. Four, Meagan::. Four babies. Meagan: Four? Julie: Four. And these babies were in a hospital environment in those little plastic bassinets so not only were there only four babies, but they were monitoring them in an environment that is unfamiliar and not letting their caretaker come in and soothe them at any time during this study. Meagan: What? Julie: Yes. Don’t let your baby cry until they throw up for sure. Go and soothe your baby, but four babies in an unfamiliar environment without their caretaker there at any part of it. Meagan: Wow. That was enough to say that that was– Julie: Yes. This is where all of these advocates for not letting your baby cry at all got their information from. Isn’t that ludicrous? That is insane, right? Meagan: That is insane. That just means that we need to take a steb back, look at what we are sharing, don’t just share it, and always look at the study. Always, always, always look at the study. Julie: Absolutely. And look at the damage that did to my mental health and not only me, everybody else’s. I know I’m not the only one. So seriously, dig in deep and trust your intuition and follow your instincts. You know what’s right. Going on the tangent for your baby, but also if you see something that feels a little strange or is showing numbers without information, ask for evidence. Ask for proof. Where did you get that information from? 29:45 Information at your fingertipsJulie: Because we have, I will say this and then we will close it up. I promise. I hate it when people say, “Oh, don’t confuse your Google search for my medical degree.” Well, that’s B.S. because do you know how many times I’ve seen doctors Google something while I’ve been in their office? Yeah, for real. First of all, not saying that a Google search is the equivalent of a medical degree at all. I know way more goes into that. But, we have access to the largest database of information that was ever existed in the entire history of humanity. We have access to Google. There’s Google. There’s Google Scholar and if you know how to distinguish between credible versus non-credible information, there is so much power in a Google search that you can use to help you in anything you need to know. Anything in the entire world. Should you have a doctor? Sure. You absolutely should. But also, you know yourself and you have access to all of this information and it’s a very powerful tool that we have and we should be really grateful for it because we don’t have to rely 100% on other people with a different knowledge than us anymore. So don’t discount that. Don’t discount your ability to find out if something is credible or not because you have access to that power at your fingertips. It’s pretty freaking amazing. Okay, done.Meagan: It is. Okay, done. All right, Women of Strength. We are going to let you go. We said it was going to be a quick one. It really was and hopefully, you got some information and will feel more confident in going out and looking at all of the many things that it said about VBAC. I honestly think that is another reason why we created our course, Julie, because we were so easily able to find so many things that were false out on the internet and we wanted to make sure that all of the real, credible sources were in one place. So find those places, you guys. Check out our blog. Check out the podcast. We have lots of links. Check out our course. So many amazing things. So many great stats. And hey, if you find a stat and find something within our blog and you are like, Oh my gosh, I’ve seen something new, let us know for sure. We want to make sure that the most up-to-date information is out there. So we do not hesitate to take any suggestions. If you see something, question us for sure. Please, please, please because like Julie said earlier, sometimes people misunderstand or misword or whatever and we want to give them credit but we really want to make sure that the right information is given to you. Julie: Absolutely. Meagan: Without further ado, I’m going to say goodbye and I love you. Bye. Julie: Without further ado, we will say adieu. Meagan: We will say goodbye. Julie: Bye. 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.Our Sponsors:* Check out Dr. Mom Butt Balm: drmombuttbalm.comSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

“I did it. They said I couldn’t, but I did it.”When planning for her VBA3C, Shannon got just about as much kickback as someone can get. She was ambushed. She was coerced. She was given the scariest information. Shannon joins us from England today and talks about how each of her four births brought her to where she is today. By the time she was pregnant with her fourth, she was ready to advocate. She was ready to fight for something she had never gotten to experience. Though none of her providers were supportive, Shannon stayed grounded. She made her desires known and stood by them. Shannon labored unmedicated for just over 14 hours. Then to everyone’s surprise, she pushed her fourth baby girl out vaginally in 14 minutes!The VBAC Link Blog: Is VBA3C Right for You?The VBAC Link Blog: VBAMCHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:04 First pregnancy and birth08:31 Second pregnancy and scheduled repeat Cesarean10:56 Third pregnancy14:04 A heartbreaking third Cesarean17:42 Postpartum during COVID19:55 Fourth pregnancy24:37 Getting ambushed28:40 Shannon’s VBA3C birth36:32 “We are all so proud.”38:30 VBAC after three CesareansMeagan: Hello, hello. You are listening to The VBAC Link. We have our friend, Shannon. Are you from England? Where are you?Shannon: England, yeah. New Cambridge. Meagan: Okay, see? I’m so glad my mind is remembering. You are in England and you guys, she is recording. It is quite late there. She is such a gem to stay up and record and share her VBAC after three C-sections. Shannon: Three. Meagan: Yes. Her fourth was a vaginal birth. Uno, dos, tres. I can’t even say. I can’t even pretend that I know Spanish. Let’s be honest. So three, you guys. After three Cesareans and we know in our community that this is definitely something that people want to hear. People want to hear these stories because it is harder to find the support. They want to hear what people are doing, how they are navigating through, where they are finding support, and what they are doing to have their vaginal birth after multiple Cesareans. We are excited, Shannon, for you to share your stories today. 01:07 Review of the WeekMeagan: We do have a Review of the Week so we’re going to get into that and then we’ll dive right in. Okay, so this is from morgane and it says, “I’m Not Alone.” I love that title because Women of Strength, you are not alone. This community is so incredible and we’re all here for you. It says, “This podcast has provided so much comfort for me in coping with my unplanned Cesarean and now planning for VBAC in March. The transition to motherhood has been somewhat lonely for me since most of my friends are not mothers and hello? Pandemic.” So this is a little bit ago, right? It says, “I am also an aspiring doula and spurred on by these ladies and their work. So thankful I stumbled across this group.” Oh my gosh. It says, “Us women really are strong.” I love that. Us women really are strong. I could not agree more. You guys, you are strong. You are capable and you have options. If that is not anything and everything that we talk about on this podcast, then I’m doing it wrong and you need to let me know on your next review. As just a constant reminder, if you wouldn’t mind leaving us a review, that would be so great. You can leave it on Apple Podcasts, Google, or you can even email us. 04:04 First pregnancy and birthMeagan: Okay, Shannon. Uno, dos, tres– three. I’m saying it correctly now. After three Cesareans, you have had quite the different journey with each birth. Shannon: Yeah. I think each one taught me a little bit more and I probably wasn’t ready for a vaginal birth with my first three. I think that while looking back on my journey it’s difficult, I think it led me to where I am today. Meagan: Me too. I’m right there. Amen. Same. I love birth and I’ve always loved birth, but I do not think that I would be here right now with you today if it weren’t for my experiences. Shannon: Yeah. I think the same. I’ll get into where I am now when we’re after my fourth, but had it not happened the way it did, I wouldn’t be where I am now. Meagan: Who you are today. We grow and we learn and we inspire and here you are sharing your story. So let’s talk about baby numer one.Shannon: Okay, so I was 19 when I had him. I just assumed that he was going to come out that way, that he was going to come out vaginally. It was going to go well. There were going to be no complications and it didn’t turn out like that. I was due in the end of May and I think I was about a week over due. I went into the day unit here. It would be just where you would go if you had concerns that were slightly more than you would go to your midwife for but not enough that you would need to go to the labor ward for. Meagan: Kind of in between? Shannon: Yeah. Here, you have a midwife who is assigned to your GP surgery, your doctors, and they are usually who you see throughout. It’s supposed to be a continous midwife, but it can chop and change. You don’t see that midwife usually in the hospital so you deliver with someone completely different. Meagan: Oh, okay. Shannon: Yeah, so you don’t get that continuity of care in labor. So I went to the day unit because I was having some hip pain. It was really difficult to walk and because I was overdue and I was already booked in for an induction purely because I was overdue, they brought my induction forward. I think I was 8 days overdue when I went in. I was induced. I had the pessary induction and it worked pretty quickly. It worked within about an hour, an hour and a half. Meagan: Oh wow. Shannon: They didn’t believe me. They told me that it couldn’t happen that quickly. Meagan: That’s not super normal but it can happen. Shannon: They sent my husband home and left me on my own for three hours before they summoned me. I was 5 centimeters which is when they take you over to labor ward. I was wheeled over. I called my mum and my husband. Then it’s kind of a bit fuzzy. I don’t remember a lot from his birth. I remember that they broke my waters and there was meconium. They put the monitoring clip on his head. Meagan: The FSC, the fetal scalp electrode? Shannon: Yes. They put that on him and I was managing fine on the gas and air. Meagan: Was it nitrious? Shannon: Yes, yeah. Meagan: Okay. Shannon: Yes, the gas and air. It was about 3:00 in the morning and they told me that the anesthetist was going home and if I wanted an epidural then that was my last chance. I felt pressured so I got the epidural. All stalled from there. I didn’t move off the bed. I think I got to 10 centimeters at 10:00 the next morning so I’m now 9 days overdue. I pushed. Nothing happened. They wheeled me to theatre. I think I started pushing at 11:00 and he was born at half 12:00 so lunchtime. He was a big baby. He was 9 pounds, 13. Meagan: Okay. 08:31 Second pregnancy and scheduled repeat CesareanShannon: That was that. I recovered and didn’t think anything of it. 18 months later, we decided to have our second. I fell pregnant I think within the first month. It happened quite quickly. I did my research. I wanted a VBAC. I actually got signed off for an HBAC.Meagan: Home birth? Shannon: Yep. It was all going fine. Then I got to 32 weeks and I panicked because my mom is our only childcare and she lives about an hour. I didn’t know how quickly I would labor because I had never labored spontaneously. I didn’t know what was going to happen. So I booked a routine section. That was booked for 39 weeks. At 38 weeks and 3 days, I went into again, the day unit because I had reduced movements. They put me on the monitors and his heart rate was quite erratic. It wasn’t settling. It was either quite high or quite low. There was no middle ground. I think they put me on there for about 4 hours and they just weren’t happy so they brought my section forward to the next day. Meagan: When I read your note, I’m like, I don’t know why, but that got me. If baby’s heart rate is that erratic and they are that concerned, it would be that day and then. Shannon: Yep, but they were happy for me to go home and come back the next day. Meagan: Yeah. Yeah. It’s just convenience. It seems, I am not going to say, but it seems like it was more of like, Well, it’s already going to happen so we will make it for tomorrow. We’ll give you this as a good reason why to validate it. Shannon: Yeah, no I agree now. At the time, I don’t think I thought about it like that. Meagan: Of course not, no. Shannon: Yeah, because with my fourth, with my VBAC, I went through a lot of what happened before. I definitely think it was a case of they didn’t want me to come back with more reduced movements and just sit there so because the section was going to happen anyway, they just thought– Meagan: Mhmm, let’s do it. Let’s move it up. Shannon: Yes. He was born at 38 and 4. He was 10 days early and he weighed 8 pounds, 11 ounces. Again, he was quite a good size. Meagan: At 38 weeks, yeah. 10:56 Third pregnancyShannon: So then we decided to have a third. It took us a long time to get pregnant with her. It took us 14 months which was our longest conception. Our first one was four months and then a month so it took a while. She was due the 11th of April, 2020. I got to, I think it was about 30 weeks when talk of the pandemic was rolling in. We were like, Oh, it’s fine. We don’t need to worry about it. And then it all blew up. I had to go to midwife appointments alone, the hospital scans alone because I had to have growth scans because my babies are big. Everything was fine. I did want a home birth again with her, but they kept me waiting. I wasn’t signed off until 37 weeks. They kept me waiting a long time to sign me off for that, but it was all signed off and we were good to go. I was feeling good despite the pandemic because we were in lockdown by the time she was due. I think the lockdown was called a month before she was born. Lockdown here for the first time was called on the 23rd of March and she was born on the 23rd of April. I remember I went into hospital and I had a growth scan at 40 weeks. She was absolutely fine, no issues. She was measuring fine. The water levels were fine. The placenta looked good. They gave me a sweep and sent me on my way and said, “I don’t think I’ll see you next week. You’ll have this baby by the weekend.” It didn’t happen. I got to 41 weeks and I went back for another routine growth scan. I remember going in the car on my own obviously and I felt good. I thought that they were going to say that everything was fine again and that they were quite happy for me to just carry on. It didn’t go like that. I should probably mention that my hospital’s policy is that if you haven’t had your baby by 41 and 4, so 41 weeks and 4 days, they either induce you or they give you a section. That’s their policy. I had this growth scan at 41+3. I went in, had this growth scan, and I was on my own. I didn’t have any support. It was about 3:00 in the afternoon. She scanned me. In a week, my placenta had aged. It calcified and it was failing. Those were the reasons she gave me that she needed to get my baby out the next day. She gave me the pre-op swabs. She took my blood and she basically told me to come back the next day at 11:00. I had no time to prepare. I had no time to research. I had no time to ask questions. It was, “This is what’s happening. You’re going to do it.” Meagan: See you tomorrow. Shannon: Yep, basically. Meagan: Was baby’s heart rate struggling? Shannon: No, she was fine. Meagan: She was fine. Shannon: She was fine. There was no reason at all. Meagan: That’s interesting. Okay. 14:04 A heartbreaking third CesareanShannon: Then it was a mad dash too because I am the only driver in my house. My husband doesn’t drive. Obviously, having a section means we can’t go anywhere. Meagan: Yeah, and during the pandemic on top of all of it. Shannon: Yeah. It was a mad dash that night to get enough food in. House deliveries were like unicorn dust so to get enough food in, I had to arrange childcare with my mom. Otherwise, I was delivering alone. Again, she still lives an hour away in a different county. We were sure what the rules were because here, you weren’t allowed to cross county lines. Meagan: Oh no way. Shannon: Yep. It was difficult. She did come up and she did look after the boys. I did see her before I went into delivery, but I didn’t see her again until baby was 6 weeks old. She had gone home by the time I came home so that was difficult. I went in. I think I got to the hospital at 11:00. I was pulled down to theatre at 2:00 and baby was born at 3 minutes past 3:00 in the afternoon. She weighed 9 pounds, 4 ounces, so again, she was a good size. I got back to the recovery ward. My husband stayed with us for an hour and then he left. He wasn’t allowed to come back. I still had my catheter in. I was still numb. My phone was dead and I was just left because I couldn’t get anything. Every time you had to call a midwife in, they had to put in new PPE on and it just took so much longer. I didn’t get wheeled around to the actual recovery ward until about 1:00 in the morning. They admitted to me that they had forgotten about me. I was just in this room on my own. Meagan: I’m so sorry. Shannon: Yeah. They wheeled me into recovery. I still had the catheter in. That didn’t come out until 7:00 the next morning so I was bed-bound with this new baby. They came around and took my observations. My temperature was raised which is normal after a section, but I was told that I might have COVID, that my baby might have COVID. I would need to be separated from my baby and we wouldn’t be able to leave the hospital for 3 days. Meagan: Stop it. Shannon: No, honestly. Meagan: I am feeling very frustrated for you right now and very saddened. Yeah. I feel a little enraged because this shouldn’t have happened. These things didn’t need to happen to people. Shannon: I know and the more that I talk to other people who have had babies during the pandemic, it’s not unusual either. Meagan: No, it’s not. It’s maddening. Shannon: It is. It’s strange now to talk about it without either filling up or actually crying because it has taken me a long time to get to this point. Meagan: To process. Shannon: Yeah. She said she would come back in an hour. I remember, obviously, I had my catheter in so I didn’t have to get up and go to the toilet. I was just downing water trying to get my temperature down. She came back at 4:00 and I did get my temperature down because I didn’t have COVID. It was a strange experience. There were six beds in this ward, but I was on the end bed and there was a woman diagonally to me and there was a woman two beds over and that was it. There was no one else there. It was eerie. It got to the point where I couldn’t do it anymore so 26 hours after my baby was born, I discharged myself and I went home. I was not staying in there any longer. 17:42 Postpartum during COVIDShannon: Even after that, I got home and I spent the first week in tears. Motherhood wasn’t new to me. She was my third baby, but giving birth during a pandemic was a completely different experience. I don’t know what it’s like over there, but here you have a midwife check in at day 3 and day 5 and then you get signed off at day 10 by the midwife then you get sent to a health visitor who then looks after you until your baby is about 5 then they go to school. Meagan: Wow, I like that. We do not have that. We are just told, “We’ll see you in 6-8 weeks. See ya.” Shannon: Oh. Meagan: Then you just go home. Yeah. It’s very different for a lot of home-birth people, but that’s how the hospital is. It’s like, “We’ll see you in 6-8 weeks and we’ll see you then.” That’s really it. Shannon: That’s interesting. I didn’t know that. Meagan: Yeah. It’s not great. Shannon: No. So on day 3 and day 5, I had to go to a clinic. They usually go to your house especially if you’ve had a section, but because of the pandemic, I had to go there, and being the only driver– my husband can drive. Meagan: You can’t even drive after a section, really. Shannon: My husband can drive but we had to stick the old plates on. We made it there but it wasn’t great. Yeah, we did that. We do have a 6-week check. It’s with a doctor. That was over the phone and then you get introduced to your health visitor. Normally, they come over to your house. That was on the phone. And then that was it. We were just left. No one met her until she was 6 weeks old. She was the first granddaughter because I’m the oldest and my husband is an only child. She was the first granddaughter after two boys. No one met her until she was 6 weeks old. I spent the first week in tears trying to process everything that happened. It was a difficult time. After that, we said we didn’t want another one so we locked it away somewhere and didn’t deal with it. 19:55 Fourth pregnancyShannon: And then we decided to have a fourth. I had to come to terms with it. This is the reason why I’m here now. I found out I was pregnant in October 2022. It was a difficult journey to get my VBAC. It was the biggest fight that I’ve ever had to do. When you find out you’re pregnant, you contact your GP surgery and then you are assigned a midwife. The midwife I had this time was the same one I had with my third pregnancy, but the first appointment, she was actually off so I saw someone completely different and she was horrible. I only live 9 minutes from the hospital. Meagan: That’s really close. Shannon: Well, I know from listening to your podcast that women travel for hours. Meagan: Way far, yeah. Like to other countries sometimes even. Shannon: Yep, but 9 minutes was too far for them. She said that 9 minutes was too far. The paramedics might not get to me in time. If I bleed out, I’m going to die. If baby gets stuck, I’m going to die. I’m putting my birth experience over a live baby.Obviously, they know I care about the safety of my baby but that’s obviously their job. I left that appointment in tears. It was a great start. It didn’t improve from there, really. I think spent the next, I think your booking-in appointment is about 8-10 weeks so I then spent the next 30 weeks listening to your podcast, and researching stats, risks, benefits, and percentages. I lived, breathed, and slept statistics for VBACs because she probably 99% is our last baby. We’ve now got two of each so we don’t need any more. I knew that this was my last chance to get the birth that I wanted. Off the back of my booking-in appointment, they referred me to the consulting midwife at the hospital. She is higher up than a community midwife or just a midwife on the ward but not quite the head of midwifery. She’s kind of somewhere in the middle. I had a few appointments with her and while it was beneficial, it still felt like I was banging my head against a brick wall because she wasn’t listening to what I wanted. Every time I would come back with a statistic or a risk that she had– like if I corrected her, then I’d just get a “Mhmm, yeah. Okay,” or a patronizing nod. Meagan: Like, Yeah, sure. You think you know what you’re talking about but you don’t. Shannon: Yeah, kind of. At this point, I was 28, a mother of three and I was about to have my fourth. They were treating me like a child or that’s what it felt like anyway. So I went to every appointment knowing that’s what I wanted. I read off my stats, my risks, my percentages and told them I wanted a home birth. They again weren’t for it. They tried everything they could to get me into the hospital. We have a midwife-led unit and we have the labor ward. The labor ward is more for ordinary births like if you are going for the epidural and you want the more hospitalized birth whereas the midwife-led unit is more of a hands-off. That’s usually where the birth pool is. Meagan: If you want more of a medicated versus unmedicated, those are the differences here. Shannon: As a VBAC after three sections, normally there would be no way on earth that they would have signed me off for the midwife-led unit. I was too high risk. However, to get me into the hospital, they signed me off for the midwife-led unit. Meagan: Nuh-uh. Shannon: Yeah. That’s the option they gave me because I was close enough if there was an emergency, but I wasn’t too far away. That was their trump card. Meagan: Okay, okay. 24:37 Getting ambushedShannon: I still said no. I still wanted a home birth because that hospital was the one I had my daughter at during the pandemic and I did not trust any of them after being lied to by the consultant and coerced into having that third section. I just didn’t trust them to do what I wanted. Meagan: Yeah. It makes sense. Shannon: Pardon? Meagan: I said it makes sense that you didn’t feel that they were completely trustworthy. Shannon: So then I got to 36 weeks and I had a routine midwife appointment at 36 weeks. I walked into the room and my midwife was there but so was the head of community midwifery. I wasn’t told she was going to be there. I was ambushed. She basically said to me that– I have it written down because I made a post at the time. She said that basically, my baby would die if I carried on with my plans to home birth, that there was a risk of shoulder dystocia, and hemorrhage that would both result in death. A delay in the paramedics getting to me so that would be death. I didn’t want a cannula inserted as a routine at the hospital so that would be a risk factor. I have a high BMI so again, that goes against me and they said I had low iron because I was refusing blood tests so that again was something that went against me. I was told that if I hemorrhaged and lost around two pints of blood that I would die, that my veins would have shrunk so they wouldn’t be able to get a cannula in me. I was told that they wanted to send three midwives to my birth. They normally send two but for some reason, they wanted three. I was told that my previous experience should be put to one side because it happened during COVID and it’s not representative of how it is now. I was told that I was making the entire midwifery twitchy. Meagan: Oh my. Shannon: Oh, the midwife I saw at the first appointment, the one who made me cry, she was one of the ones who was on call and they told me if she was on call, would I go to hospital and I said, “Maybe.” In my mind, I’m thinking that they were trying to put her on rotation to get me into hospital. Meagan: Sneaky. Shannon: Yep. I was told that the head of community midwifery’s responsibility is to make sure I’m comfortable with the risks but it’s also her responsibility to make sure her midwifery team isn’t traumatized by my birth. I was also told– oh, they wanted my husband to be at the home birth assessment as it’s their responsibility to make sure he is aware of the risks of death so he is not traumatized like I hadn’t spoken to him about any of this. Meagan: Oh my gosh. Oh my gosh. Shannon: On my way out of that appointment, my midwife, the one who had supported me as best as she could said to me that she can’t wait until I give birth so that it’s all over. Thank you. Meagan: Oh my gosh. Shannon: Yeah. So that was that. Meagan: Wow. What a way to feel loved. Shannon: I know. Again, I had to go to these appointments alone because my husband was home with the three kids, and my mom, again, lives an hour away. I don’t have the support here so I had to go to these appointments on my own and to be faced with two midwives who are just coming at you with these scary statistics, it felt like I was ambushed.I think I sent an email then and complained. I got this really lengthy email back but it was basically filler but it had happened already. 28:40 Shannon’s VBA3C birthShannon: Yes. So, my birth. She was due on the 1st of July but I always thought she would be due somewhere between the 25th of June and the 28th of June. I remember the 27th of June, I needed to go and get new brake pads and discs put on my car. It was the last thing I needed to do. I sat in the mechanic’s feeling a little bit uncomfortable and a lot of pressure. I think I was about 39+3 at that point. I was just really uncomfortable. I sat there for about two hours and I was just like, Ugh, why is this taking so long? Meagan: You were ready to move on. Shannon: Yeah. The next day, my husband went into the office and I remember messaging him, I think you should have stayed at home today. Something just doesn’t feel right. I feel a bit off.I woke up on the morning of the 29th of June and I had hip and leg pain which isn’t unusual for me. I’ve got hyper-mobility syndrome so my joints are extra bendy anyway so to wake up with pain is quite normal, especially in pregnancy. It was half-7:00 in the morning and my husband thought it would be a really good idea to cut his hair for him. It’s half-7:00 in the morning. I’m nearly 40 weeks pregnant and I was doing his hair. Then I felt a twinge. I was like, I don’t recognize that pain. I’ll keep an eye on it. They turned into contractions. I had my first contraction at half-7:00 in the morning and they got stronger. I said to my husband, “I think you need to sign off now. This is it. It’s happening. I’m going for a bath to see if they go away or if they stay.” We had a food delivery come in that day. We had an Amazon delivery come in and we had I think the carseat base was coming in as well that day. So in between my contractions, I was having to go to the door a deal with all of this stuff that was going on around me. The contractions stayed and they didn’t peter off. They just stayed. At this point, I was on all fours in the living room mooing like a cow which is bizarre because, with my first one who was my only experience of labor, my mum said that I was eerily quiet. It was different to make noise this time. My husband rang my mom and let her know what was happening and then he rang the hospital. They told me that the home birth service wasn’t available that day so I’d have to come into hospital. It was only after he told them my name that that happened. We’ll leave that just hanging there. Meagan: Yeah. Shannon: Then I burst into tears because I thought that as soon as I go into hospital, that’s it. I’m not going to get my vaginal birth. They’re going to find some reason to section me and that’s it. My mom came and drove us to the hospital. She was staying with the kids anyway. I think I got to the hospital at about 3:00 in the afternoon. They examined me and I was 4 centimeters so I was allowed to stay. They took me into the room and I stayed there until I had my baby. I just labored. I don’t remember a lot of it to be honest. When they say you go to another place, you go to another place. Meagan: You do. Shannon: The gas and air were amazing. I did try the birth pool but we had an issue here where they had to have air vents fitted in the rooms with the gas and air and they weren’t done in the birth pool. I was in the birth pool for about an hour, but I wasn’t allowed the gas and air. The pool was all right, but the gas and air were helping me more. I went back into the room with the bed and even though I said to my husband, “I don’t want to be on my back,” I was on my back for most of the time. That’s where I was comfortable. When I was in the pool, I said no to the continuous monitoring. I just wanted intermittent with the monitor. We didn’t know what she was. At this point, we had no idea what she was but they couldn’t find her with the Doppler. They asked me to get out of the pool and put me on the bed and they were going to scan to see where she was. I couldn’t roll onto my back at this point. I was on my side and I couldn’t roll on my back to get them to scan me to see where she was. Then I opened my eyes and the consultant that had lied and coerced me into my third section was in the room and I specifically said I don’t want to see her. She was standing at the end of the bed and she said to me, “How long are you going to push for?” I said, “As long as I need to. As long as me and my baby are safe,” and she left. That was the end of it. I didn’t see her again. Meagan: Oh my gosh. Shannon: Yeah. That was that. They managed to scan me and they found her. She was just really low. That’s the only reason they couldn’t find her. She was fine. She was happy. It went on again for about another couple of hours of moving from all fours on the bed to my back and I remember sitting up on my knees upright and I felt something go. I was like, “Okay, I think my waters have gone.” They had a look and they had gone on their own. I didn’t have to have them pop like last time. There was no meconium. It was all good.I remember spacing out for a while going to that other place. I came to and it was burning. That ring of fire is real. It was real. I said, “Okay, it really stings. Something has changed.” The midwife lifted up the sheet and she said, “Oh, there is the head. Quick!” They had to scramble to get everything they needed. My husband was texting my mum so I got all the time stamps. They saw her head at 3 minutes past 10:00 at night and she was born at 14 minutes past 10:00. She slid out and we found out she was a girl which my husband told me which was what I wanted. I remember saying, “I did it. They said I couldn’t, but I did it.” They wanted to get her a yellow hat because we didn’t know what she was but because she came out so quickly, they only had a blue one so she’s got a little blue hat and yeah, she was here. It was amazing. I did have two second-degree tears. They did only repair one and I wish they had repaired both because going for a wee afterward with the open one was hell. Meagan: Yes, not fun. Shannon: But I would take that over a section recovery any day. I was going to the park with the kids 3 days post-birth. I was walking around the house. I was able to go up the stairs. It was amazing. Yeah, I did it. They told me I couldn’t and that I would die or she would die. Meagan: They really put up a fight and tried so hard. Let me tell you too, I don’t know the right word but to stand up to that type of pressure, oh my goodness. That is hard. That is very, very hard. The fact that you did and it’s not like it didn’t affect you. Of course, it affected you but you were able to go and you were like, “Listen, I know the research. It’s in my favor. I’m okay. I believe that it’s the best choice because I really have researched it and truly believe that it’s the best choice for me and my baby.” They just tried so hard to not let that happen. 36:32 “We are all so proud.”Shannon: They did. I think it was the next morning and I was just sitting in my room with my baby quite happy. The head of midwifery came into the room and I had met her once before. She said to me, “Well done, you did it. All of our phones were going off last night because it was flagged that you had gone into labor and we were all waiting to see what had happened. But you did it vaginally and we are all so proud. Well done.” I was like, “Well, you didn’t tell me that at the time, did you?” Meagan: You’re like, “I wish you had cheered for me in my pregnancy and not made me feel like I was crazy or scheming my husband,” or all of that. Oh my goodness. Shannon: Yeah. Meagan: You have gone through a lot on top of your birth and trauma there and recovering from all of that. You have grown so much and achieved so much. You should be really proud of yourself. Shannon: Thank you. I am. I think that like I said at the beginning, if it hadn’t happened the way that it happened, I’m going to train to be a doula in May and June. Meagan: Yay!Shannon: Because I don’t want other women to go through what I went through. Like I said, if it hadn’t happened the way it happened then I wouldn’t be here today. I’m grateful for the experience, but I wish that I had more support at the time. Meagan: Right, totally. I mean, that’s definitely something that led me to the doula and obviously here where I’m at too. I think through these birth experiences, it’s hard to deny that fire inside of you when you feel it. Right? You’re like, I want to help people not have the experience that I had and have a better experience to the best of my ability. I’m sure that you will do it and you’re going to take this passion and you’re just going to flourish and touch so many lives. I’m so excited for you. Shannon: Thank you. 38:30 VBAC after three CesareansMeagan: Okay, so let’s talk about VBAC after three C-sections. I think this is sometimes a hard one because

Dr. Christina Pinnock is a Maternal Fetal Medicine Specialist/Perinatologist based in California and creator of the ZerotoFour Podcast. She is here to help us tackle topics like what constitutes a high-risk pregnancy, lupus, preeclampsia, HELLP syndrome, gestational diabetes, fibroids, and bicornuate uteruses and how they relate to VBAC. The overarching theme of this episode is that all pregnancies are individual experiences. If you are hoping to achieve a VBAC and you have pregnancy complications, find a provider whose goals align with yours. By ensuring that your comfort levels are a good match, you are on your way to a safe and empowering birth experience!Dr. Pinnock’s Website and PodcastNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 00:58 Review of the Week03:13 Dr. Christina Pinnock03:56 Importance of a VBAC-supportive provider06:36 High-risk pregnancies11:02 Lupus and TOLAC14:31 Preeclampsia 17:19 Varying ranges of preeclampsia20:46 HELLP Syndrome 26:36 Other High-risk situations 27:54 Gestational Diabetes35:00 Inductions with gestational diabetes42:25 Fibroids 46:33 Do fibroids tend to grow during pregnancy? 51:20 Bicornuate UterusMeagan: Have you ever been told that you were high risk, so you’ll be unable to TOLAC? Or maybe you can totally TOLAC assuming nothing high-risk comes into play? What does high risk mean? We often get questions in our inbox asking if having your previous cesarean makes them high risk. Or questions about topics like preeclampsiaclampsia, gestational diabetes, bicornuate uterus, fibroids, and more. I am so excited to have board-certified OB/GYN Dr. Christina Pinnock on the show today. She is a high-risk pregnancy doctor passionate about educating women along their pregnancy journeys so they can be more informed and comfortable during their pregnancy. She is located in California and has a podcast of her own called “ZerotoFour” where she talks about topics that will help first-time moms prepare for, thrive, and recover from pregnancy as well as shares evidence-based information and answers everyday questions like we are going to discuss today. 00:58 Review of the WeekMeagan: We do have a Review of the Week, so I'm going to jump into that and then we can dive in to get into these fantastic questions from Dr. Christina Pinnock. Today’s reviewer's name is Obsessed!!!! It says, “The best VBAC and birth podcast. I am grateful to have discovered Meagan and this podcast. I definitely believe listening to stories of these amazing women and their parent’s course helped me achieve my two VBACs. Thank you for all you do The VBAC Link.”Oh, thank you so much Obsessed!!!!!  And as always if you wouldn’t mind, drop us a review leave us a comment and you never know, it may be read on the next podcast. 03:13 Dr. Christina PinnockMeagan: Okay, Women of Strength. I am seriously so, so excited to have our guest here with us today! Dr. Christina, is it Pinnock? How do you say it? Dr. Pinnock: Yes that’s perfect.Meagan: Ok, just wanted to make sure I was saying it correctly. Welcome to the show! You guys, she is amazing and has been so gracious to accept our invitation here to today to talk about high-risk pregnancy and what it means. Hopefully, we’ll talk a little bit about gestational diabetes because that's a big one when it comes to VBAC. And if we have time, so much more. So welcome to the show and thank you again for being here.Dr. Pinnock: Thank you so much for having me, I'm excited to be here and chat with you and your audience about these great topics, so thank you.03:56 Importance of a VBAC-supportive providerMeagan: Yes! Okay well, this isn’t a question we had talked about, but I’m curious. Being in California, do you find it hard to find support for VBAC or do you find it easy? I mean, California is so big and you’re in Mountain View. So I don’t know exactly where that is. You said the Bay Area, right? So how is it in your area? How is VBAC viewed in the provider world in your area?Dr. Pinnock: Yeah, that’s a good question. I actually did most of my training on the East Coast, so it’s been a good experience seeing the differences in coastal practices. I think where I did my training we were pretty open to VBACs and supported them. In California, I’ve had a similar experience and I think it really depends on where you are.  I’m in the San Francisco Bay Area and I work at an institution where we support TOLACs and want our moms to VBAC as long as it’s safe and it’s what they desire. But I really think the opportunity to TOLAC depends on your individual OB provider that you have and their comfort in offering that. And importantly, the hospital resources that you have available in your area. California’s huge and depending on where you live it can be a very, very different infrastructure both geographically and specifically within the hospital. And so I really think that differences in that offering is based around those resources rather than maybe patient desire or even sometimes provider desire. So it really just depends on those things. Meagan: That’s so good to know. I mean, we tell our community all the time that provider is a really, really big key when it comes to being supported. But also I love that you were talking about the actual hospital because for me with my second– I had a VBAC after 2 C-sections and with my second, my provider was 100% gung-ho and super supportive. But in the end, I ended up switching because the hospital was going to end up restricting my provider in supporting me in the way he wanted to support me, right? So it’s also really important to vet your location and your hospital.Dr. Pinnock: Yes, absolutely. Sometimes, someone may live in a location where they don’t have that choice, unfortunately. If you do have that choice and you can choose hospitals and providers that can support it, by all means if you have that ability. 06:36 High-risk pregnanciesMeagan: Absolutely. Ok well, let's dive in more to high-risk. So a lot of the time, I'd love to see what you think about this. A lot of the time, providers will tell moms because they’ve had a previous Cesarean, not even a special scar or anything like that, that they are automatically grouped into the high-risk category. So I don’t know what your thoughts are on that in general, but let’s talk more about high-risk pregnancy. What does it mean? What does it look like for TOLAC? How is it usually treated? And are there often restrictions given for those moms? Dr. Pinnock: Yeah, no. That’s a really good question. One thing about pregnancy, there’s some level of risk in all pregnancies. No matter if you're completely healthy, no medical problems, or you're trying to TOLAC, or you have other medical conditions that exist before pregnancy, all pregnancies carry some level of risk but not all the risks are equal. There are some conditions that the mother can have before pregnancy that can put her pregnancy at a higher risk of developing some complications. There are some conditions that can actually develop during pregnancy that can cause the pregnancy to be at a higher risk of developing complications. Lastly, there are some conditions specific to the placenta, the baby, how the baby developed, or even the genetic makeup of the baby that can contribute to a high risk of having complications. All of these three categories can impact the status of your pregnancy being considered high-risk. So typically, if you have a condition that falls in one of those three boats, then your pregnancy could be considered a higher risk. Usually having a previous C-section or even two previous C-sections by itself is not really something that I would use to classify someone as having a high-risk pregnancy. I do think that definitely talking with your provider about your desire for delivery earlier on can help both people to be on the same page, but if you otherwise have nothing else going on in the pregnancy and you have one previous C-section or even two previous C-sections, I think the pregnancy itself, I wouldn’t consider it a high-risk pregnancy. Meagan: That’s good to know. Dr. Pinnock: Yeah no, absolutely. And when you think about the delivery, I think about it a little bit differently than the pregnancy. I think for the delivery if you are interested in having a TOLAC and you have a previous C-Section or two, then the management of your delivery and the risk of your delivery isn’t the same as someone who hasn’t had a C-section. I think about them as like two different boats. But overall, conditions that are related to maternal health can be high blood pressure, diabetes, and autoimmune conditions like lupus. Those things can cause your pregnancy to be considered high-risk. A good example of a few things that can develop in pregnancy that can make your pregnancy high-risk include things like preeclampsia which is high blood pressures of pregnancy. Having twins or having triplets can make your pregnancy a higher risk. In some instances, even gestational diabetes depending on what’s going on and where you are can be considered a pregnancy with some high-risk features. And then genetic conditions for baby whether that’s a difference in how one of your babies’ organs developed, or a genetic condition that’s discovered from testing; any of those things can really impact that high-risk status and how your pregnancy will be monitored and managed after that. Meagan: Ah these are all such great topics and actually things that we get in our inbox. Like, “Hey, I have lupus,” or we’ll have one of our VBAC doulas say, “Hey, I have a client who has lupus. She really wants to TOLAC and have a VBAC. What does that mean for her?” Obviously, all of these conditions are going to be treated differently throughout the pregnancy and probably even during the labor and delivery portion. 11:02 Lupus and TOLAC Meagan: I don't know if we can touch on a couple of those like lupus. What does that look like for someone? If I have lupus coming in, I’m doing okay right now. I have it. What does that look like for someone wanting to TOLAC and to have a VBAC?Dr Pinnock: Yeah. I think it’s similar to your first question about whether a C-section would make your pregnancy considered high-risk. So the lupus diagnosis would increase the risk of certain medical conditions happening in pregnancy relating to both mom and baby. Your doctor may get some extra blood work to monitor how your lupus is progressing in pregnancy. Your doctor may get some extra ultrasounds to make sure that baby isn’t too small and add some extra monitoring to make sure that baby is staying safe and that if there is a risk for baby to be in distress that that is picked up. And so the actual monitoring and management of the pregnancy is usually done with the help of a high-risk pregnancy doctor like myself with an OB provider. That is really specific to what is going on with that person. If everything goes smoothly and lupus stays under control and we get to the moment where we’re thinking about how we’re going to deliver baby, that’s sort of a separate boat. In an ideal world, everything goes well in terms of the lupus and pregnancy and if you’re interested in having a TOLAC, having a diagnosis of lupus should not restrict you from that option. You can still have that as an option but it really just depends on the specifics of how your pregnancy has unfolded. Have you developed any other conditions like high blood pressures in pregnancy or preeclampsiaclampsia where your doctor is maybe thinking you may need to deliver earlier? Are there things going on with your baby where we think baby is under more stress where we would really need to be very intentional about how we deliver baby? It’s a really nuanced thing and it’s based on the specifics on that person’s condition. I think an overarching theme is whatever is going on with the pregnancy that impacts the delivery if things are not going as smoothly. But if things are going smoothly and you want to try for a TOLAC, that’s not necessarily a reason to say, “No, you absolutely can’t do this,” unless there are specific conditions that came up in your pregnancy that make it less safe for either you or baby as the mom. Meagan: Yeah. Something that I’m just hearing you say so much that’s standing out is that really is individual, depending on that individual and depending on that individual’s case. I think that’s something important for listeners to hear because someone who may have lupus that’s going really, really fine, TOLACs going to be a really great option for them. But someone who may have active symptoms and it’s going and it’s really hard, that may be a different suggestion in the end. But I like that you’re like, We’re in this boat and then we travel over to this boat into this time, and then it’s a matter of how we float that boat and how we get to our destination.Dr. Pinnock: Exactly.14:31 Preeclampsia Meagan: Would you say that the same thing goes for preeclampsia? Preeclampsia can develop at any stage of pregnancy. I mean, we've had clients in weeks 18-20 develop it and then have to be really closely watched and all of these things. Is that someone also where you would say the same thing? Where it’s like, We’re in this boat doing these things and these tests and monitoring, and then again we get into this next boat and we have to decide what the best route is?Dr. Pinnock: Yeah, no. That’s a good question. I think it’s similar but a little different with preeclampsia. It depends on the type of preeclampsia that’s going on. Preeclampsia is a spectrum and with the part of the spectrum that’s more on the severe side, we still try for a vaginal birth. It really depends on, as you’ve mentioned, how far along you are in the pregnancy.Maybe you are 28 weeks and you have such a severe form of preeclampsia that your doctor is like, “I don’t think we can get any more time with the pregnancy,” that’s a very different situation than someone who has a very non-severe form of preeclampsia at 39 weeks who wants to TOLAC and have all of those options available. It really does depend but the overall theme with preeclampsia if you do want to try for a vaginal birth and your health and baby’s health are stable in the moment, then usually we do try as much as possible to have a vaginal birth. But things like very early gestational age and really severe complications of preeclampsia make the possibility of having a vaginal birth less likely. It makes the possibility of someone who wants to TOLAC in that setting less likely. It really depends on the severity of that spectrum of preeclampsia, but we always try for a vaginal birth if we can. Meagan: Yeah. This may be too hard of a question to answer, but can we talk about that range and the severity? What does a low to moderate to severe case of preeclampsia look like in a person? What would be considered that severe, “Hey, we might need to reconsider our birth desire here,” to “Hey, you have it. It’s really low right now,” or to “We’re in choppy waters right now.”17:19 Varying ranges of preeclampsiaDr. Pinnock: That’s a good question. Pre-e is defined as elevated blood pressure in pregnancy after 20 weeks. So once you hit 20 weeks, if your blood pressures are elevated, 140/90 times multiple times and we see any evidence of preeclampsia’s impact in some organs in your body.One of the most common things that we used to use to diagnose is the presence of protein in the urine. Once we see that, we’re like, “Oh, man. I think you may have preeclampsia,” then we do an evaluation of the rest of the body to understand how severe it is. Preeclampsia is a disease that’s thought to develop from the placenta when it implanted. It can cause dysfunction or impact on the organs. It can cause severe headaches. It can cause changes in your vision and problems with your blood cells, your liver, your lungs, and your kidneys. We go from head to toe and take a look at how those organs are being impacted by preeclampsia and then we ask you how you’re doing. If you’re having a headache, if you’re having changes in your vision, pain in the belly, and all of that, it helps us to understand the severity. So depending on your symptoms, your blood work, and your blood pressures, those things together help us say, “Is this a severe form of preeclampsia?” and if it is, then we usually have some specific things that we have to do. Generally, you likely are monitored in the hospital. We keep a close eye on your blood pressure and your organs. That pregnancy is considered to be very high risk. Very high risk for a harm for mom, so risk of seizures, impact on the organs that can sometimes be lifelong and risk to baby. The highest risk to baby is that risk of being born early, so pre-term delivery. And usually if you have severe preeclampsia, we usually recommend delivery no later than 34 weeks. So once we do develop that severe form, we keep a close eye on things. If you have the non-severe form, so if your organs look oay and your blood pressures are stable but you have some protein in your urine and we do think you have preeclampsia but it’s not severe, then we give you some more time. We still monitor you and baby very closely, but we can maybe try to get the pregnancy up until 37 weeks and after that, the risk of continuing the pregnancy and harm to maybe the mom and baby are a bit higher than some of the risks of being born at 37 weeks. So at that time is when we would say, “Let’s have a birthday.” It really depends on those things. Meagan: Okay, that’s so good to know. I think sometimes that also can vary like, I’ve got high blood pressure, but I don’t have protein. Or I’ve got a trace of protein but I’m doing okay, I don’t have any symptoms. But we also know with preeclampsia it is important to watch really closely no matter whether severe or not because it can turn quickly. Where you have zero signs and the next morning and you wake up with a headache and crazy swelling and you have that blurred vision with really high numbers. So it’s just really important to watch.Dr. Pinnock: Exactly.20:46 HELLP SyndromeMeagan: I really do like to ask that question because a lot of people ask, do I have to have a C-section? Do I have to be induced? What does that mean? Am I severe or not severe? And we also note, we weren’t even talking about this, but HELLP syndrome. So we can develop more, right? Preeclampsia affects more the mom, but then alsothe  baby timewise. HELLP syndrome is another really high-risk complication. What would you suggest for that when it comes to TOLAC because we have platelets being affected there? That one is a tricky, tricky one. Dr. Pinnock: I think HELLP syndrome is on that same spectrum of hypertensive disorders in pregnancy. But HELLP syndrome can be pretty life-threatening and dangerous for mom and by extension baby. So HELLP syndrome is when we find that your body’s sort of hemolyzing so there are some things in your blood that’s causing your blood vessels to sort of open red blood cells. We find also that you have elevated liver enzymes so your liver’s being impacted pretty severely and then the platelets or the blood cells that help with clotting get really, really low. And so the combination of that with or without elevated blood pressures make us very concerned about HELLP. So the worry is if we don’t deliver the baby pretty expeditiously and deliver the placenta which is thought to be really the source of the diagnosis, mom can get really ill and we really try to deliver as soon as possible. The exact way we deliver is really dependent on the specifics of what is going on. So maybe if your liver enzymes are very, very elevated and there's a high concern for mom’s health and safety, your doctor may say, “I don't think we have time to try for a TOLAC, especially if you're not in labor. I think it would be too unsafe. I think I would recommend a C-section at this time because of that,” then that would be that recommendation. Sometimes we do try for a vaginal birth with HELLP, but it would be a case where we would want to limit how long we try but overall we try to deliver as fast as possible either vaginally or with a C-section. And if you do want to try for a TOLAC in that setting, I think my recommendation is to really, really be open to whatever is best for your health and your babys health. That’s my advice for all women who are in labor. It’s such an unpredictable experience and you can come in with your desires and your doctor can come in with their desires for you, and your baby or your health just dictates something else. And so with HELLP, that’s an even more significant moment where if your body’s telling us one thing, we have to listen. You may not be eligible for a TOLAC at that point. I think in more cases than not, many providers may not have that bandwidth or think it’s safe to try for TOLAC in that setting. Meagan: Yeah. I’ve had very few clients as a doula who have had HELLP, but one of the clients– they actually both ended up having a Cesarean, but one of the clients’ providers was even uncomfortable with even having an epidural and actually suggested general anesthesia. Is that a common thing if HELLP is super severe that could possibly be what’s suggested or best?Dr. Pinnock: Yeah, no as I mentioned with that kind of diagnosis, you can have pretty low platelets. And so when we think about a procedure like an epidural or even a spinal, so any sort of neuraxial anesthesia where we’re not putting mom to sleep, we’re just numbing mom from the waist down, that requires insertion of a needle or a catheter in the back. That’s near a lot of important structures so once you have that puncture, you’re going to have some bleeding. And if those platelets aren’t enough to sort of prevent that bleeding from extending, then our anesthesia team may not be comfortable doing that procedure safely because it’s not safe. They may offer to give some platelets etc but often with HELLP, it may not be as fast acting and sometimes you may just hemolyze again. Those platelets may go back to being very low and if we are thinking about having a delivery urgently, delaying for that reason may not be safe for mom and baby. Oftentimes, if the platelets are too low, then our anesthesia colleagues, who are a very important part of the team, may recommend against trying for an epidural or even a spinal and recommend general anestheia.In my experience, I don’t do C-sections under general anesthesia often, but when I do, it’s usually recommended for a very, very significant reason and it’s always with the safety of mom and baby in mind. It’s never something that we want to do. It’s only something that we do if we have to do for mom’s safety or for baby’s safety. Meagan: Yeah. So good to know. And they actually ended up doing a platelet transfusion as well specifically for the Cesarean. Obviously, we know blood loss is a thing that’s a big surgery so they were trying to help her there. 26:36 Other High-risk situationsMeagan: Okay, well are there any other high-risk scenarios where you feel like truly impact the ability to have a TOLAC offered?Dr. Pinnock: Yeah. I think the highest risk conditions that could prevent mom from having a TOLAC are probably conditions related to the heart or lungs where the physiology or the changes that happen in labor can make it so that a vaginal birth is not safe or recommended for mom or baby. A TOLAC in those high-risk settings is often not recommended. There are a lot of cardiac and lung conditions that we take care of. There are not that many that we would say you can’t have a vaginal birth, but sometimes there are blood vessels in the heart that can be dilated or blood vessels near the heart that can be dilated that we may say, “No, you definitely need a C-section,” so if you wanted to TOLAC we wouldn’t recommend that. Those are probably the highest-risk conditions that I take care of and where a TOLAC is not recommended or even offered because it’s just not considered to be safe. 27:54 Gestational DiabetesMeagan: Okay that’s so good to know. Okay, let’s jump in a little bit to gestational diabetes. We can have both managed and not managed. Do you have any advice for listeners who may have gestational diabetes or maybe had gestational diabetes last time and they’re preparing to become pregnant or wanting to learn more about how to avoid it if possible or anything like that? Do you have any suggestions to the listeners?Dr. Pinnock: Yeah, that is one of my favorite things. I really believe that just paying close attention to your health and taking steps before pregnancy can make a world of a difference in your risk of developing certain conditions. Gestational diabetes is one of those conditions that can be definitely most susceptible to things that we can do before pregnancy. And so I know that this is going to maybe sound like a broken record to those who had gestational diabetes before, but just look at your lifestyle factors. I think that the most undervalued or underestimated intervention is really exercise. It doesn’t have to be your training for an Iron Man or a marathon. It could just be like a 20-minute walk every day or a ten-minute job every day and work your way up. We definitely found that aerobic exercise more days of the week than not, and resistance training, it could be with resistant bands, if you have any sort of light weights or even body weight. Any resistance training to help build up that muscle mass can help to reduce your risk of getting gestational diabetes. If you couple that with adjusting your diet, and diet is such a big topic but essentially no matter what your background is, focusing on the whole foods of your cultural background is best. So low processed foods, more homecooked meals with whole grains, fruits, vegetables, fish, and limitations of red meat and processed foods. All of those things can go a long way with preventing gestational diabetes and also reducing the recurrence of gestational diabetes. I’m really passionate about that. Meagan: Yeah, us too. I didn’t have gestational diabetes, I had kidney stones weirdly enough because my body metabolizes nutrients differently during pregnancy and anyway, it’s totally not gestational diabetes but I had to look at my pregnancies and before as something like that. Really dialing in on nutrition. Really dialing in on my exercise. And I couldn’t agree more with you that it doesn’t have to be this big overwhelming Iron Man training or running a marathon. It really can be a casual 20, 30-minute stroll around the neighborhood walking the dog or whatever and dialing in on those whole foods. We love the book Real Food for Gestational Diabetes by Lily Nichols. If you haven’t ever heard of that, it’s amazing. It’s a really great one. You might love it. And I definitely suggest that to all of my clients. She even has one for Real Food During Pregnancy. Just eating good food and then we love Needed because we know that getting our protein and getting the nutrients that wer eally need can really help like you said recurring and current and just avoiding hopefully. So we really love that topic, too. But gestational diabetes doesn’t just nix the opportunity to TOLAC, correct?Dr. Pinnock: No, it doesn’t. Gestational diabetes can be a really tough diagnosis for a lot of women to get in pregnancy. It can be really disappointing especially if you may be a relatively healthy, active person and you don’t have a lot of risk factors for developing gestational diabetes. It can kind of feel like a gut punch almost. Meagan: Yeah! And it’s very overwhelming because you’re like, What? No! Dr. Pinnock: It is! And it happens fast. You’re diagnosed and then you have a flurry of things that you have to now do and change and think about. It can be very stressful. But I always tell my patients that there are things that put some people at risk of developing gestational diabetes more than others, but all women because of those placenta hormones can have insulin resistance or your body’s just not responding as well to the insulin that you’re making. Depending on those risk factors, some women develop it. Some women don’t. And once you do develop gestational diabetes, it’s something that we really pay attention to because it can increase the risk of things for moms so particularly it can increase the risk of mom developing preeclampsia and it can increase the risk of things for baby. Babies can be on the bigger side or have macrosomia if the blood sugars are too high. They can actually have a higher risk of having a birth injury if we’re having a vaginal birth or mom may actually have a higher risk of needing a C-section if you’re trying to TOLAC and baby’s on the bigger side. Rarely, and this is sort of the thing we worry about the most, is that if those blood sugars are too high for too long, baby can be in distress on the inside and it can increase the risk of having a stillbirth or having baby pass away. So because of those things, once we diagnose it, we do pay attention to it and we try our best to sort of make those changes hopefully with diet and exercise to sort of manage the blood sugars. If we’re having perfect blood sugars with those changes, then wonderful. If we’re not, and it happens and you need some additional support then your doctor provider may recommend some other management options like medications to help to bring the blood sugars down. But I think, when we think about TOLAC, we want to think about separately managing the pregnancy, keeping mom and baby safe, and then thinking about the safety of delivery. So as long as the baby’s size isn’t too big, as long as mom and baby are healthy and safe, you can definitely try for TOLAC with gestational diabetes. But those two things are big “buts”. You really want to try your best to manage your blood sugars so baby’s size doesn’t work against your efforts of trying to have a TOLAC.35:00 Inductions with gestational diabetesMeagan: Yeah, we know that the size can definitely impact providers’ suggestions or comfortablity to offer TOLAC. And we know big babies come out all of the time, but we know sometimes there’s some more risk like you were saying. So can we talk to the point of inductions?So a lot of providers will, and you kind of touched on it. There can be an increased risk of stillbirth. But a lot of providers seem to be suggesting that induction happens at 39 weeks. Some of the evidence shows that in a controlled situation, meaning all of the sugars are controlled, but what do you see and what do you suggest when someone is wanting a TOLAC, has gestational diabetes, may have a baby measuring larger or may have a provider who is uncomfortable with induction which we see all the time? Any suggestion there and what do you guys do over in your place of work?Dr. Pinnock: Yeah, that’s a great question and it’s something that I individualize to every patient. So let’s think about it in two different buckets or three different buckets. Say you have gestational diabetes that’s pretty well controlled with just diet. So with diet and exercise, your numbers are pristine. Baby is a good size, we’re not over that 4500-gram mark where we start to say, “Is it really safe to try for a vaginal birth?” and that’s okay. If we are in that boat, then I think it’s reasonable to allow for mom to go into labor and try for TOLAC if that’s their desire. The exact gestational age at which someone goes into labor varies. We don’t have a crystal ball. We don’t know. Meagan: Nope.Dr. Pinnock: We do have to balance waiting for that labor process with the inherent risk of babies being less happy and distressed and the risk for a stillbirth as the pregnancy progresses. Now, if you have gestational diabetes that’s well controlled with diet, we think from the studies that we have that our risk of stillbirth is similar to someone who does not have gestational diabetes which is good. And so for those pregnancies, depending on your specific location and provider, we may do some monitoring with non-stress tests or something like that later in the pregnancy until you deliver. Usually, we start at around 36 weeks or so if you’re well-controlled with just the diet and allow you time for your body to go into labor and have a vaginal birth. Now, if we get to your due date and nothing, baby is still comfortable inside. They’re like, Oh no. I’m just hanging out, we start to think, How long are we going to allow this to go on? At that length of time, we start thinking about, Okay. We’re at 40 weeks. What are the risks to mom and baby? And so at 40 weeks, we’re about a week past 39, and we know that the risk of– if things are perfect for anyone, the risk of having babies be in distress, maybe the placenta’s just been working for a long time and isn’t just working as well and the risk of stillbirth goes up, we don’t want to go to 42 weeks. So I think at that moment, it’s a good time to think of an exit strategy. If your baby is just so comfy on the inside, think about, when I would say is an upper limit of reasonablility to wait for labor? That varies depending on the person and provider. But I think reasonably, up until 41 weeks. I wouldn’t go past that. If we’re allowing our body to go into labor up until 41 weeks, then we have to think about, How does that impact my risk of having a successful TOLAC? After 40 weeks, some of our studies suggest that you may be at a higher risk of having a failed TOLAC or needing a C-section and that’s regardless of whether you're induced or whether you go into labor. TOLAC-ing does carry that inherent risk so it’s really just dependent on your doctor, you,  your provider, and balancing all of those things. I think going until 41 weeks is probably the maximum limit for a well-controlled gestational diabetes with perfect sugars, no medications, and we’re still doing monitoring to make sure that baby is doing well.Now, if you’re in the camp where you’re either gestational diabetes, or even controlled with diet, or if your gestational diabetes is controlled with medication or if you’re diet-controlled, but those sugars aren’t great, any scenario where the sugars aren’t perfect and we need either medications or your sugars aren’t perfect, I don’t generally go past 39 weeks.The reason being at 39 weeks, baby is fully developed and after that, the risk of having a  pregnancy loss goes up because of that uncontrolled or not optimally controlled gestational diabetes. I think at that gestational age you would want to think about maybe an induction or maybe a repeat C-section depending on how you’re feeling if your body isn’t going into labor. And that’s a personal decision. Now, if you have gestational diabetes managed with medication and your baby is big and maybe let’s say over 4500 grams which is sort of that range where we worry about the safety of a vaginal birth. And you’re now going into labor, then that becomes a little bit more of a shared decision-making where you want to think of, My baby’s big. I would need to be induced. Is this going to be something I want to commit to or is it something I don’t want to commit to? That’s a personal choice but I think at that gestational age I would say I wouldn’t want anymore. ACOG though does recommend or does allow for moms who do have gestational diabetes well controlled with medication, like if your blood sugars are perfect with the medication to go until 39 weeks and 6 days. So technically you can use those extra

Our friend, Kelsey, shares with us today what giving birth is like in Canada. From moving and traveling between provinces, Kelsey had experienced different models of care and when it came time to prepare for her VBAC, she was very proactive about choosing a birth environment where she felt safest. From a scary Cesarean under general anesthesia to an empowering unmedicated VBAC in a birth center, Kelsey’s journey is entertaining, beautiful, and powerful. We love hearing the unique details of her story including giving birth at the same time as her doula just in the next room over! The personalized care she was given during her VBAC is so endearing and heartwarming. As her husband mentioned, it should be the gold standard of care and we agree! The VBAC Link Blog: Assisted DeliveryFetal Tachycardia in the Delivery RoomIs There Still a Place for Forceps in Modern Obstetrics?Forceps Delivery ComplicationsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 07:36 Review of the Week09:27 Kelsey’s stories11:47 Logistics of giving birth in Canada14:38 A normal pregnancy17:50 Arriving at the hospital21:37 Stalling at 7 centimeters26:22 Asynclitic and OP positioning29:31 Kelsey’s Cesarean under general anesthesia34:50 Second pregnancy and VBAC prep41:07 Switching to midwives46:14 Beginning of labor51:07 Driving to the birth center54:49 Pushing baby out in two pushes1:00:24 Differences in care1:02:11 Enterovirus1:08:02 Risk factors for forceps and vacuum deliveriesMeagan: Hello, Women of Strength. We have our friend, Kelsey, from Canada. Is that correct? Kelsey: Yes. Yeah. Meagan: She’s sharing her story with you guys today. Something about her first story of her C-section that stood out to me was that she had a forceps attempt that didn’t work out. Sometimes that happens. I want to talk a little bit about forceps here in just a minute before we get into her story. Kelsey, I wanted to ask you that this is something that in our doula practice we will ask our clients. If it comes down to an assisted birth with forceps or a vacuum, what would you prefer? It’s a weird thing because you’re like, Well, I’m not planning on that, but a lot of people actually answer, “I would rather not do those and go straight to a C-section.” Some people are like, “I would rather do every last-ditch effort before I go to a C-section.” Did you ever think about that before? Had it ever been discussed before as their style? That’s another thing. Some providers are really vacuum-happy. Some are really forceps-happy. I know it’s a random question, but I was just wondering, had you ever thought of that before going into birth? Kelsey: So no. I didn’t think about whether I wanted a C-section or a forceps delivery. However, I was really staunchly against having a C-section. That was primarily nothing against it, it was just that I have a really huge fear of awake surgery so with my forceps attempt, the OB who was there because it wasn’t my provider. That’s not the way Canada works. The OB who was there who was called in said, “Are you sure you want to do forceps? You could tear.” I told her, “I would rather tear than have a C-section.” That was just a personal preference for me because I was so terrified of having a C-section. Meagan: Yeah. I think that is very common and very valid to be like, “No, I would rather try this.” Kelsey: Yeah. Meagan: So I did. I wanted to go over just a little bit. I mean, I have seen a couple of forceps and they are not happening as often these days, but there was an article that said, “Is there still a place for forceps delivery in modern obstetrics?” I’m trying to say obstetricians and obstetrics. We’re just going to stop. Kelsey: We know what you mean. Meagan: You know what I mean. There was an article and I was like, That’s a really good question, because I think a lot of people think they shouldn’t be done anymore or a vacuum shouldn’t be done anymore either. It talked a little bit about the background. it says, that nowadays we are seeing a decrease in instrumental deliveries and a continuous increase of Cesarean rates. That makes me wonder if we were to increase vaginal and help instrumentally if that would decrease, but one of the things that I thought was interesting is that it says, “The prevalence of forceps delivery was 2.2% and the most common indication for a forcep delivery was fetal distress.” It is very common where it’s really, really close, baby is struggling. Baby is so low and let’s get baby out. That’s 81.6% which is crazy. It says, “Among mothers, the most frequent complication is vaginal laceration,” which means we have tearing at 41% and third and fourth-degree perineal tears were noted. It says, “Regarding neonatal APGAR scores, around 8 around the first and the fifth minute,” which is around 91.2% and 98% of newborns which is pretty great. An 8 APGAR is pretty great. I think a lot of people worry about that. It says, “8.8% experience severe birth injuries like hematomas and clavicle fractures.” Those are probably shoulder dystocias. That’s probably why they were having. It says, “Although fetal distress is the most common indication for forceps delivery, the vast majority of newborns were actually in good condition and didn’t require NICU care.” That’s something that was kind of cool. Obviously, there are a ton of more studies and deeper studies on that. This was just one, but it was kind of interesting. It was like, all right. That is a good question to ask as we are preparing for VBAC is hey, if for some reason a forceps or a vacuum is necessary, that’s something to think about. What do we want to do at that point? I love how you were like, “Yeah, I didn’t want a C-section. I feared that more than I did that.” Anyway, getting off that topic now so we can get this review and get on to your story but I think it’s a topic we don’t talk about and it’s not something that we are thinking about so as you are preparing, Women of Strength, for your VBAC, it might be something that you want to discuss and learn more about both vacuum and forceps and discuss with your provider what their tool of choice is and just have that in the back of your mind. 07:36 Review of the WeekMeagan: Okay, so onto today’s review. It is from laurenswat and it was back in 2023. It says, “Thank You.” It says, “I listened to as many episodes as possible when preparing for my VBAC. The stories on here were so encouraging to me and Meagan is so knowledgeable and reassuring. I am happy to say that I had my unmedicated hospital VBAC last week and I caught my own baby before the doctor even got in the room.” Oh my gosh, that is awesome. Seriously, catching your own baby is so amazing. I loved it personally myself as well and highly encourage it to anyone that is sort of interested because it is a really cool feeling. Thank you for your review and as always, we are looking for reviews. It is what helps people find this podcast. It helps us grow as a community. You can leave it on Apple, Google, email us, or whatever but we are so grateful for your reviews. 09:27 Kelsey’s storiesMeagan: Okay, Kelsey. Kelsey: Yeah? Hi. Meagan: Hello. Welcome to the show. Kelsey: Thank you. I’m super, super excited. Meagan: Me too. Me too. I would love to turn the time over to you. Both of your babies were born in Canada. That’s correct, right? Kelsey: Yes. Yeah. Meagan: Tell us the story. Kelsey: Yeah, so basically my husband and I got married in November 2019. Just prior to that, we had actually been living in New Brunswick. Just prior to getting married, we decided to move back because we are from Ottowa. We moved to Ottowa. We were living with his parents, his dad, at the time. We went to Mexico for our honeymoon and on our honeymoon, we decided to start trying to have a baby. We decided to start trying but not preventing it because we weren’t sure how long it was going to take and there was no indication that it could take a while but my husband is actually an IVF baby. It had taken 7 years for his parents to conceive him. Meagan: 7 years, wow. They are amazing. That’s a long time. Kelsey: He was actually their last attempt. When his mom got up to say our wedding speech, she was like my 1 in 7 or something like that and I was just bawling. So because of that, we decided to start trying and not preventing but there was nothing indicating it would take us a while. We started trying in December of 2019 and it just wasn’t happening for us so around the year mark, we had a lot of friends who started trying around the same time as us and were getting pregnant really, really quickly. I was going to so many baby showers and crocheting baby blankets that just weren’t for my baby. Actually, the year mark rolled around and I got my period the day of. My best friend gave birth the day of. I was trying so hard to be happy and stay positive and whatnot, but it was devastating. 11:47 Logistics of giving birth in CanadaKelsey: We ended up being referred to a fertility clinic. They did a full work-up on both of us and there was nothing. They didn’t come up with anything. So they said, “You could keep trying or we could start IUI.” My husband and I said, “Let’s do 3 more months of trying on our own, and then we will try for IUI.” Our fertility clinic was in Ontario and we ended up moving to Gatineau, Quebec in July 2020.The way it works in Canada is you have your healthcare which covers. You can go inter-provincially and give your card unless you are from Quebec. If you are from Quebec, it’s kind of like living in another country. If you have a RAMQ card, you actually have to pay for your care in Ontario. The Quebec government will reimburse you but only for 30%. It’s super weird. If you are from Ontario and go to Quebec, the Ontario government will cover you in Quebec. Meagan: What? So weird. This world is so weird. Kelsey: I know. It’s super bizarre. So essentially we moved to Gatineau because the housing market was a little less expensive. I was working in Gatineau at the time as a teacher. I was extremely stressed out in my job especially once COVID hit. We were sent back to the classroom before any of the other provinces were. Anyway, I was extremely stressed out in my job and I decided to switch to the Ontario side because you can go between the two. Where I lived, you cross a bridge and you can get to Ottawa so you are in Ontario. Essentially, we went through the fertility clinic. They said that nothing was going on but because the Gatineau government will cover you for IVF and any fertility treatments up to a certain price so we had to be referred back to Quebec for IUI. The month that we were referred back to Quebec for IUI, it was the day before my appointment that I found out I was pregnant. Meagan: Oh my gosh, yay! Kelsey: Yeah, on our own. It super just happened and some weird funny things happened. The day before, my husband and I went for a walk around our neighborhood. I found a quarter and was like If pennies are lucky, then quarters must be super lucky. I picked up the quarter and put it in my pocket and the day after, I found out I was pregnant. These weird things kept happening. My pregnancy made me oddly psychic too which I’ll get into after. 14:38 A normal pregnancyKelsey: I got pregnant in March. I was due November 28th. I had a super easy pregnancy. I was nauseous for the first little bit. I was working for a virtual school in Ontario so I didn’t have to go into the school which was really nice. I just got to hang out in my basement and yeah. I mainly had nausea as a symptom but I was also extremely anxious because it had taken us so long to get pregnant. It felt like it was so long. It was about 15 months. I was super anxious. I had heard so many stories of miscarriage and whatnot, but luckily, we were followed by the fertility clinic because we were with them so we had a scan at 5 weeks and we had a scan at 8 weeks and then at 12 weeks once we graduated which was really nice. It was a really, really normal pregnancy. I ended up going back into the school in September and I was working as a French teacher. I went off work at 36 weeks. It was pretty normal. The reason I say that I was psychic during my pregnancy is that I kept saying all of these things about my baby. I had this gut instinct that he was a boy and sure enough, it was a boy. Mind you, it’s because my husband’s family only really has boys but then with certain things, people would say, “When do you think he will be born?” I’d be like, “Oh, I think December 4th.” I would make off-hand comments like, “Oh, he’s going to have really dark hair.” My husband and I were both born at 5:00. I was born at 5:00 at night. He was born at 5:00 in the morning. I said, “Wouldn’t it be funny if he was born at 5:00?” I said, “He’s going to be over 9 pounds. I can just feel it. He’s going to be 9 pounds.” Then the other weird thing is that I said he would be born December 4th, but someone told me, “No, you don’t want him to be born on December 4th. He will share a birthday with your cousin.” I was like, “Okay, December 3rd.” December 3rd rolls around and I am 5 days past my due date. I wake up in the morning to go to the washroom and my water breaks. I had not been well-informed about birth. I was just going into it like, Yeah. Everything is going to be fine. I had a bunch of friends who just had babies and everything was smooth sailing. The only time I had heard of a C-section was when my aunt had two C-sections because she had a breech baby and a special scar and then they didn’t give her an option for a C-section. I was like, Oh yeah. It’s going to be fine. My provider told me, “If your water breaks, go straight to labor and delivery.” Meagan: Many do, by the way. Kelsey: Yes, I do know that. Meagan: It’s a very normal thing for people to say, but we don’t have to do that. Kelsey: Exactly. Meagan: I did the same thing, the same exact thing. 17:50 Arriving at the hospitalKelsey: Yeah, so we went into labor and delivery. Actually, we went slowly. My husband was like, “I’m going to take a shower.” I was under the impression that baby was going to be born in a couple of hours. I was like, “We’ve got to go.” He was like, “No, no. I’ve got to take a shower. First impressions are important.” I was like, “All right.” Then we went and we got Tim Horton’s because I was super hungry. I figured This will be the last time I eat.We got to labor and delivery. They monitored me for two hours and I didn’t have a contraction until 6:00 right as I was leaving and I was only a centimeter dilated. She was like, “Come back in 12 hours or sooner if your contractions get intense.” So I went home. I decided to go to sleep but I was having irregular contractions. I woke up probably around noon and I was starting to get uncomfortable. My contractions were starting to get closer together and they were more intense. I could feel them in my back and in my bum. I learned a lesson. Anyway, I’ll get into that after. I could feel them mostly in my back and in my bum. My husband was like, “You look like you’re really uncomfortable. We need to go to the hospital now.” He was afraid of getting stuck in traffic because I ended up giving birth in Ontario even though we lived in Quebec. The reason is the hospital I gave birth at actually takes your RAMQ card, the Quebec healthcare card so we weren’t going to be charged for it or anything. The Gatineau hospitals are not known for being super well-equipped for much so we preferred to give birth in Ontario. We drove to Ontario which was a 30-minute drive so not super terrible, but traffic can be bad going across the bridge sometimes. The whole way there, I had really uncomfortable contractions. We got to the hospital and the doctor had me in the waiting room for 30 minutes, not terrible. The doctor meets with us and immediately, I just was not into him. He just put me off. He made an off-hand comment about nurses. He was like, “I see pain. Do you want pain medication? Do you want Advil or Tylenol?” I was like, “Whatever you can give me, I don’t know.” I told him, “One of the things going into it is that my husband would really like to catch the baby. Can we do that?” He was like, “Well, do you think you can handle it?” I’m like, “Well, he was a firefighter so he’s pretty okay with that kind of stuff.” Yeah. I can’t even remember the comment now, but he made an offhand comment like, “Well, that’s what nurses are for,” or something like that. I just was super put off by him. We went into our room and I didn’t know at the time that maybe I could have asked for someone different or whatever. We go into our room and we get set up and they were like, “We have to monitor you for a little bit.” I was like, “I’d really like to labor in the tub. Can I get in the tub?” They said, “We need the monitor on you for an hour.” I’m like, “Okay.” They monitor me for an hour. They give me a shot of Demerol or whatever. I was under the impression and my mindset going into it was that when you give birth, you use pain medication as pain management. I hadn’t researched anything else. I was just like, “I want the epidural as soon as I can get it and whatever you can give me for the pain is great.” 21:37 Stalling at 7 centimetersKelsey: I was monitored for about an hour and they let me get in the tub. For two hours, I laid in the tub and that’s my best memory of my birth with my first. I laid in the tub and listened to music. My husband and I were in the dark. It was very calm, soothing, and relaxing. When I got out, the doctor was like, “We need to check you.” He checked me and I was at a 1 but he could stretch me to a 3. He said, “If you want your epidural, you can have it now.”I didn’t know any better so I said, “Yeah, okay. Give me the epidural.” Overnight, I was progressing 2 centimeters every 2 hours. We got to 3:00 in the morning. I told a nurse, “I feel a lot of pressure in my bum.” I said, “I feel like I have to push.” She checked me and she was like, “No, no. You’re only at a 7.” 5:00 AM rolls around. My nurse comes in again and she checks me and she’s like, “Oh, you’re at a 9.” Another nurse comes in right after and she says, “She’s not at a 9. She’s at a 7.”The two of them were like, “We need to get a doctor in here to confirm.” It’s 5:00 AM. The doctor didn’t show up until close to 7:45. He’s like, “I’m not going to check you because the changeover will happen in 15 minutes and the new doctor is going to check you. I don’t want to introduce any more bacteria.” The new doctor came in at 8:30. She checked me and she goes, “No, you’re still at a 7. You’ve been stuck at a 7 for a few hours. We really need to start talking about a C-section.” It was the first time she had seen me. I had been lying in a bed now for almost 12 hours. They gave me the peanut ball for 2 hours and then they took it away I think because my son’s heart rate had started to go funny or they lost it or something like that but he was doing fine. They lost it because he moved or whatever. They took the peanut ball away and nothing showed that he was under any distress at all but she was like, “You’ve been stuck at 7 for a while so I want you to talk about it with your husband.” I was in tears because again, the whole time, all I said to my own provider was, “I don’t want a C-section. I don’t care what happens. I don’t want a C-section.” So I’m in tears. She’s like, “Talk about it with your husband.” She comes back an hour later and we were like, “We want to wait a little bit longer.” She goes, “Okay, what we’re going to do is put you on the highest dose of Pitocin.” She was like, “We’re going to start you on Pitocin and every 5 minutes, we’re going to increase it until you’re at the highest dose. Then we’ll wait 2 hours, check you again, and if you haven’t gone anywhere, you’ll have to have a C-section.” I didn’t know any better so I was like, “Okay.” They started me on the Pitocin but I’m having intense pain and pressure in my bum. I’m like, “I feel like I have to push. My body feels like it is pushing.” I knew that if you pushed too soon, your cervix would swell. That’s one of the few things I did know. They put me on Pitocin and I was crying because I was panicking. My husband was having to push my bolus every 15 minutes when it came on because I could feel everything through the epidural. The nurse was not super kind about it. She was like, “You need to stop pushing. If I check you now and you’re not an 8, then you’re going to have a C-section.” She just was not overly compassionate or anything. Well, finally, she suggests, “Why don’t we put you on your hands and knees?” She put me on my hands and knees and I felt immediate relief. Something changed in baby’s position. I sat there and I was able to talk. I was comfortable and I was fine. I think we got to an hour and a half and then they checked me because what happened was they put me on my hands and knees and my feet lost circulation and turned purple and went numb. Yeah, so then they put me on my back again. They checked me and they were like, “Oh, you’re at a 9.5.” I’m like, “Yes.” I progressed. 26:22 Asynclitic and OP positioningKelsey: Finally, we got to 10 centimeters and I was a typical you push on your back type of thing. The doctor said, “We cannot wait to let baby descend. Your water has been broken too long.” Then she checks me and she’s like, “Oh yeah, and baby’s OP.” I should have learned. Had I done my research, I would have known all that pressure was my OP baby. So she said, “Baby is OP. We’re going to start pushing.” I was so frustrated by her because she would leave the room and then she’d come back and she’d sit there just with her hand inside of me and checking her watch and stuff. She was just waiting for the hours to pass. I’m doing everything I can. Once they told me that I could push, I was like, “Yes. Let’s get this baby out.” I pushed for 3.5 hours and then they said, “We’ll give you 30 more minutes and if you cannot get baby out in 30 minutes, we’ll try forceps but we’ll need an OB to come in because if forceps fail, you will have a C-section.” I decided to push for 30 more minutes and the nurse came in and said, “Let’s flip you.” They flipped me again and I lost all of my progress. They had also told me that not only was baby OP but he was asynclitic so his head was tilted to the side. They said, “That’s probably what’s happening.” But when I flipped, I lost my progress. There was a new nurse who couldn’t figure out how to get the monitor on me so I couldn’t push in that time. They were like, “Well, we’re going to stop pushing because whatever.” 30 minutes passed and I had lost all of my progress. They’re like, “Okay, we’re going to get the OB in.” She comes in and she says, “You could tear.” I said, “I would rather tear than have a C-section. I don’t want to have a C-section.” Then I said, “What are the chances that this will work?” She said, “I wouldn’t do it if I didn’t think it would work.” As she tried to get the forceps on, I could feel my body pushing. I’m like, “Can I push? Can I push?” She’s like, “No, don’t push right now.” My body is doing it for me and she can’t get the forceps on so she’s like, “I can’t do it.” As she was trying to put the forceps on, baby started getting tachycardic so they said, “Things are going to get really scary for a minute because this is an emergency C-section. A lot of people are coming in here and we have to turn on alarms in the hallway because we have to get you to the OR really quickly.” Meagan: Wait, so baby’s heart rate is high not low, and just because baby’s heart rate went a little high, they treated it as a true emergency. Kelsey: Yes. Meagan: Okay. 29:31 Kelsey’s Cesarean under general anesthesiaKelsey: They start throwing clothes at my husband. There were people piling in. I’m in a hospital that is French-speaking. I can speak French but not medical terminology. Nobody is talking to me. They’re all just talking around me and they’re rushing me down the hallway. I’m bawling and I’m like, “I don’t want this.” I have no idea where my husband is. They’re trying to push my legs together but baby is so low that it hurts to do that. I’m telling them to stop and whatnot. We get into the OR and I was inconsolable because I was terrified. They gave me my spinal which didn’t take. They gave me the pinch test and I was like, “I can feel it. I can feel it.” I’m crying, “Please just put me out. I don’t want to be awake for this. I’m scared.” They’re not talking to me and that’s the last thing I remember is saying, “I can feel that,” and they put me out. I was under general anesthesia and I woke up 2 hours later in recovery by myself. It was COVID. It was in December 2021. My husband couldn’t be there. I asked where he was and they said, “Oh, he’s in your room with your baby. Everything is fine.” I was sobbing. The first thing she said to me was, “Everything went great. You are a great candidate for a VBAC.” That stuck with me. The whole way back to my room, I was staring at the ceiling. I couldn’t look at anyone. I was just devastated by how everything had gone. I didn’t think I could ever look at my husband or my baby ever again. I was just like, What happened?I hear my husband. He is like, “You need to see. Our baby is here. You should see him. He is so beautiful. He has the most beautiful eyes.” He came around to my bed and he passed me my son and nothing mattered. None of it mattered. He was 9 pounds, 8 ounces so I was right. He was born on December 4th which I had said at 5:11 PM. Meagan: Oh my gosh. Kelsey: Yeah. He had a full head of dark hair. He was born in a snowstorm. That was the other thing. I said, “He’s going to be born in a snowstorm,” because my husband and I were both born during a snowstorm and he was born during a snowstorm. Yeah, he was perfect. He was huge and he was chunky and he looked exactly like me. Normally, they look like their dads is what I’ve heard but he looked exactly like me and was so beautiful. Throughout my pregnancy, I don’t like being pregnant because I don’t like sharing my body I’ve learned. Throughout my pregnancy, I said, “I don’t want another. I don’t think I want another.” When he was born and I held him, I was like, “I will do this again in a heartbeat.” 34:50 Second pregnancy and VBAC prepKelsey: Postpartum was good. I ended up starting therapy 5 days after my C-section. He latched and he did not have breastmilk for his first feed which makes me really sad. I was devastated from the C-section because I didn’t get to see my baby be born. I didn’t get to hear his first cry. I didn’t get to touch him first and my husband wasn’t there. He wasn’t allowed to be in the room. Postpartum was fine. I was seriously anemic. I was incredibly swollen. I had no knees because I was on fluids for so long and getting around was awful, but I just focused on our baby. He was perfect. He was so easy and 6 weeks rolled around and I was like, “Let’s have another.” But we waited. We decided around 9 months to start trying again and loosely trying because again, we were wondering how long it would take. Meagan: Right. Kelsey: We ended up trying got 6 months and I got pregnant in April of 2023. My due date was December 29th. Again, super, super easy pregnancy throughout. Immediately after my C-section, I decided to look into VBAC because that stuck in my head. I had been listening to a different birth story podcast. I searched for VBACs and there weren’t many and then I searched VBAC in general on Spotify and came across you guys.I started listening to VBACs before getting pregnant and I started doing lots of research about it. I learned about the cascade of interventions and how my case was really typical. I started learning about OP babies and how the pain I was feeling correlated with that. I wanted to try for a birth in a birthing center. Now, when I got pregnant with my second baby, I was living in Gatineau but we had a bunch of stuff happen. My mother-in-law ended up splitting up with her husband. We said, Hey, let’s buy a house in Ontario together and we’ll move in. I found out I was pregnant about 2 weeks before we put in an offer on a house and we moved in in July when I was 15 weeks pregnant. At the time, my GP was my provider for my first and I started off with her with my second as well. The thing was when I found out I was pregnant, I went to her. Sorry, I should have said. After my C-section, I went to her and said, “I was told I was a good candidate for a VBAC.” She said, “Yes, but you cannot go over your due date. We’re going to monitor your baby to see how big it is because you had a big baby before. You cannot be induced. You need to have 18 months between pregnancies.” Typical. Meagan: All of the red flags. Kelsey: Yeah. This was before I started listening to your podcast. Then I started listening to your podcast and when I went in to see her when I found out I was pregnant before I had gone into a birthing center, I said to her– and I’m not an outspoken person. I struggle to advocate for myself. I said, “I want to try for a VBAC, but I do not want you to put limitations on me.” I said, “I know that I can safely have a VBAC even if there is less than 18 months between my pregnancies. From birth to birth, it was 2 years and a bit so it didn’t matter. I said, “I know that big babies are 10 pounds+. That is macrosomia. I know that.” I said, “I know that I can’t be induced.” In Canada, they generally don’t do Pitocin for VBACs at all. They don’t generally induce for VBACs at all. I said, “I do know that there are safe ways to induce though and I do know that I can safely go past my due date.” She said, “I believe in informed consent and if you understand all of this, I think that you are well prepared and we can move forward with a VBAC.” I said, “Great.” I had applied for birthing centers prior to this but it is really hard to get into them here. I ended up being able to get into one in Gatineau. I was concerned about moving over cross-provinces again. It ended up working out. I did stick with my GP until I was about 20 weeks pregnant just in case. It didn’t work out with the birthing center after my move. What happened was, she was super, super supportive, but she would say things like, “Do you want me to book you an appointment with an OB just in case?” or “Do you want me to book you a C-section at 40 weeks just in case?” I was like, “No, I don’t want you to.” She said, “Okay,” but around 20 weeks, my midwife was like, “We can keep you on even though you live in Ontario. It’s no problem.” I said to my GP, “My midwife will keep me on.” My GP said, “You sound like a really good candidate so go ahead. I really hope it works for you. I hope that it’s everything that you want.”Meagan: That’s good. Kelsey: She was very supportive of it so I felt really good about it. 41:07 Switching to midwivesKelsey: I switched to the midwives full-time. My pregnancy was super smooth again, but there were little hiccups. I didn’t pass my one-hour gestational diabetes test. They said, “If you have gestational diabetes and it can’t be managed, we will have to transfer care.” Around 37 weeks, I started measuring large and they said, “We think we want to send you for an ultrasound just to be sure of how big baby is.” I said, “I know that those ultrasounds aren’t super accurate so I’m not sure that’s what I want.”I ended up getting a doula through The VBAC Link. I found a doula. Meagan: Yay!Kelsey: Yeah, what was funny about the doula is she was pregnant too and her due date was a week after mine and we found out that we were giving birth at the same place. Meagan: Oh my gosh. Kelsey: So she was like, “I’ll keep you on and I’ll do your prenatal appointments, but I probably won’t be at your birth. I have a partner who is a nutritionist.” She ended up being amazing. My son was in daycare. I got sick a lot and I couldn’t take anything for it so she would help me find natural ways of dealing with a cough. I think I had pregnancy rhinitis for the last trimester. I was constantly congested. I had terrible acid reflux. She originally had prescribed chest openers, but my midwife ended up putting me on medication for it because of the trigger to cough. She was afraid that my cough could trigger my water breaking too early. I couldn’t give birth at the birth center if baby came before 37 weeks. I had to make it past 37 weeks. Yeah, so pregnancy was smooth. I was extremely nauseous in the beginning. It was really hard with a less-than-two-year-old. I kept him home because I’m a teacher. I’m home over the summer. I kept him home over the summer and it was rough because he just is needy and my 9.5-pound baby continued to stay in the 99th percentile for height and weight. He wanted to be carried everywhere but he is so heavy and he is still so heavy. I was a lot more active during this pregnancy than I had been prior. I tried really hard to walk and whatnot and do lots of stretches. Around 30 weeks, baby was still breech and I started to panic a little bit. I started doing Spinning Babies exercises and lots of inversions and whatnot.When I first met with my doula, I talked with her about everything. I was able to just spit out facts that I had learned from you guys. She was like, “I’ve never met someone who is this prepared or who knows this much.” She was like, “I have all of this stuff to go over with you, but you already know it.” She ended up as well becoming certified in HypnoBirthing so I took a HypnoBirthing class. I was really concerned about doing an unmedicated VBAC because I didn’t know if I could handle the pain of it. I had originally wanted to VBAC in the hospital, but I watched– what is that

The amazing Gina Conley from MamasteFit joins Meagan today to answer your questions all about perinatal fitness! Gina is a birth doula, perinatal fitness trainer, and founder of MamasteFit. ​​In partnership with her sister, Roxanne, who is a labor and delivery nurse and student-midwife, MamasteFit is a place for women to find education courses and fitness programs to be their strongest selves during each stage of motherhood. Gina shares her expertise on how exercise affects babies during pregnancy, labor, birth, and postpartum. She also touches on topics like when to start prenatal exercise, what to do if you didn’t exercise before pregnancy, how late into pregnancy you can exercise, weightlifting, and which movements to incorporate to create more space in the pelvis. Gina’s comprehensive prenatal fitness book, Training for Two, will be released in September 2024. It is a fantastic resource for all pregnant women!Link to Gina's Book: Training for TwoMamasteFit WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:00 Review of the Week03:59 Is it bad to exercise during pregnancy? 09:00 How will exercise affect my baby’s development? 13:40 Better pregnancies, better birth outcomes16:23 What do I do if I wasn’t active before pregnancy?19:30 Movements to incorporate20:59 Three pelvic levels 23:19 The mid-pelvis and outlet25:56 Being told that your pelvis is too small30:36 How late in pregnancy is okay to work out?32:31 When is it too late to start exercising during pregnancy?34:43 Postpartum fitness39:20 Weightlifting and pregnancy45:51 Training for TwoMeagan: Hello, everyone. Welcome to the show. We are going to be talking about prenatal fitness today with the one and only Gina Conley. Gina is the founder of MamasteFit, a prenatal fitness training company based out in North Carolina. Gina is a fitness trainer specializing in pre and post-natal fitness and a birth doula. She combines her expertise in both to prepare her clients for a strong pregnancy and birth. Fitness in general is one of my all-time favorite things to do and talk about. I do notice a difference when I’m not moving my body, but when it comes to pregnancy, there are a lot of questions surrounding fitness. Is it safe? When is it okay to start? Is it really okay to start later on? How to start? And so much more. I can’t wait to dive in on all of the amazing information that Gina is going to share after the Review of the Week. 01:00 Review of the WeekMeagan: Just a reminder, if you have not left a review, I would love for you to do so. You can leave a review on Apple Podcasts, Google, Spotify, Facebook, or wherever you listen to your podcasts. Today’s review is by Janae Rachelle. It says, “The Best There Is.” It says, “I am so happy I found this podcast. After having two prior C-sections, I was convinced I would have to have another C-section for my birth this November. I feel empowered and educated and hopeful I can do this. Thank you for all of the true facts and the safe space where we can all talk about our birth trauma and space where we don’t sound ‘crazy’ for wanting to do something God created our bodies to do.”Thank you, Janae Rachelle, for leaving that review. You are right. This is that space. This is the space where we do talk about all of the crazy things, where we talk about the trauma, where we talk about the things where in the outside world if we were to discuss them, people would and sometimes do look at us like we may be crazy. But Women of Strength, if you are wanting to pursue a VBAC, if you are wanting to learn about the evidence about VBAC, this is definitely the place. All of these stories here are going to share so much information, guidance, facts, and all of the things, and definitely leave you feeling inspired. 03:59 Is it bad to exercise during pregnancy? Meagan: Okay, it’s been so fun. We’ve actually had just a couple of returning guests from the show who have also been on 2-3 years down the road. Before we started recording, Gina was like, “I just had someone say that they listened to my episode that was on your podcast before”, which was 3 years ago. It’s fun to see that people one, are still listening all the way back to 3 years ago and then two, have you back on the show. So welcome. Gina: Absolutely. Thank you for having me. Meagan: Yes. It’s such an honor. You know that I just love you to pieces. I’m so excited to talk about fitness, prenatal, postpartum, and all of the things today because this really is a topic that as a first-time mom, I didn’t really know much about. When I was first pregnant with my daughter who is now 12, I was just determined. I was like, I’m going to run. I’m going to run a half marathon. This is going to be so great. I’m going to be one of those running through with a big belly. I was so excited to be fit and active. Let me tell you, I was the opposite of that. When I was training, I started having round ligament pains and pelvic pains. When I talked to my doctor, he actually told me to stop. He told me to stop which is kind of crazy to me looking back that it wasn’t even just like, “Maybe do less miles or don’t train for a half marathon right now, but do a 5k.” It was just like, “You should just stop. It’s too much.” I don’t know why I took that advice as, Okay, I should stop and I should eat Chinese food every day because orange chicken sounded amazing and I should really just not do anything besides be unhealthy.That’s truly how I felt like I was in my first pregnancy. I don’t think providers all over the world are telling people not to work out necessarily like mine did 12 years ago, but I think that it’s a very daunting topic and we don’t know what to do. I think a lot of people who may not be very physically active before pregnancy are unsure what they can do during pregnancy, if it’s safe, and all of the things. We have a big list of questions today to ask you and really, number one is Is it bad to work out during pregnancy? My easy answer is no, but I think it’s a real answer. Can we talk about that? Working out during pregnancy– is it bad? Is it good? Tell me all of the things. Gina: There is a lot of fear-mongering and fear involved with exercise during pregnancy. There is this really long list of things that you shouldn’t do so it gets really overwhelming to know, Well, what can I do? when the majority of the things that you see are Don’t do sit-ups. Don’t do this. Don’t do that. If you lift weights, you’ll have a miscarriage. A lot of fear that comes with fitness during pregnancy is, Is it going to affect my baby’s development and growth? Am I harming my baby by exercising? And then the second is, Is it going to affect my pregnancy length? Am I going to have a miscarriage or go into pre-term labor because I was exercising during my pregnancy? The answer to both of those is generally no. Just as a disclaimer, there are absolutely complications in which the benefits of exercising do not outweigh the risks of exercising. These are usually folks who have preexisting heart and lung conditions, if you have uncontrolled diabetes, if you are actively in pre-term labor, if your placenta is detaching, or have severe preeclampsia. There are circumstances in which exercising is not safe and your provider should be very clear in communicating that to you. You will probably already have preexisting exercise recommendations if it is a preexisting health condition. But for the majority of us who are of a normal-risk pregnancy, even some high-risk pregnancies, exercise is typically very safe to do. So a lot of research supports that it does not cause miscarriage and it does not affect the length of your pregnancy which is one of the major concerns with exercising. The risk of miscarriage is highest in the first trimester and it doesn’t differ whether you exercise or you don’t. Exercise does not cause miscarriage. It’s just something else that folks like to be blamed for when they do have a pregnancy loss. It was because I went running. It was because I lifted weights. Typically, there is nothing that you could do do prevent that pregnancy loss and it just sucks to be mourning this and then to have this additional guilt put on you like it was because you were lifting weights. There are people who are sedentary and don’t exercise at all and have miscarriages. Are we blaming them that it’s because you didn’t exercise? No, because it’s one of those things that is out of our control. 09:00 How will exercise affect my baby’s development? Gina:The second thing is, is it going to affect my baby's development? Like, is it going to make them too small? Is it going to make them too large? One of the things that can make your baby too small is the placenta. So if the placenta hasn't developed properly or there's an issue or complication with the placenta, it can make your baby too small. Well, exercise helps to improve the function of your placenta, especially if you exercise in the first half of your pregnancy, which is really cool. Your placenta will be more voluminous. It'll be larger and it'll have improved functional capacity. It's going to be able to transfer oxygen and nutrients to your baby much more effectively. It's going to help provide immune function to your baby. It's going to provide hormone function to your baby. It's also going to help remove metabolic waste more effectively. It's going to be a much more efficient organ, which is going to help to support your baby's growth. The second half is like, is it going to make my baby too big? I think most folks are not concerned about exercising and making their baby too big, but exercising could decrease the risk of developing gestational diabetes. Obviously, you can still exercise and eat super healthy and still develop gestational diabetes. It's not a foolproof method to avoid it. But exercising can help reduce your risk of developing gestational diabetes by 39% which is pretty substantial. And if you do develop it, continuing to exercise and eat well can also help to reduce the risk of you needing to get insulin or medication to manage your gestational diabetes. Those are the things that are contributing towards developing a baby that's too large. So having gestational diabetes that's controlled with insulin, uncontrolled gestational diabetes, and those two things can be mitigated with exercise. Exercise can actually help your baby grow more optimally, to have really good body composition, and be a really good size.In addition, which is really cool– and this is stuff that I was researching when I was writing my new book, Training for Two, which comes out in September. I'm really excited about it. I guess it's like the twins in my current pregnancy. Meagan: It’s awesome. Gina: But one of the things that I was researching because our editor was like, “We really need to highlight why exercise is so beneficial for baby because this is something that's going to help motivate people to move their body.” Something for me that has been helping to motivate me during my current pregnancy to move when I'm kind of like, But I don't really feel up to it is one, it helps to improve your baby's nervous system development, which is really cool. It helps to increase their blood volume as well. They have more blood reserve to respond to the stresses of labor and to postpartum after they are infants. When they're in the world, it improves their brain development. They have more cognitive function. And these are all things that are probably in response to the stimulus of exercise. So we're introducing more stimulus to them during exercise because of this controlled stress that we're introducing which is helping to build all these new neural pathways and helping them just start doing things a little bit earlier. What that translates to in the first year of life, they have more motor skill development, so their fine and gross motor skills. They're crawling earlier, they're walking earlier, they're rolling and doing things earlier. They have more cognitive function. That's responding with higher levels of IQ and improved language skills. Meagan: Wow. Gina: So there's a lot of benefit to just being active. It doesn't have to be go and lift super heavy weights. It can just be going for walks every day, doing yoga every day, and doing intentional movement throughout the day is exercise. It doesn't have to be like how I exercise. Then what happens is that even though there are all of these benefits to exercising and fairly little risk unless you have like a complication which your provider will ideally walk you through. Even though there are all these benefits, there's still a lot of fear involved with working out during pregnancy. A lot of it's just outdated guidance and folks. I think it probably relates to the fear of women lifting weights and exercising, too. Maybe it's a little bit of that as well. And then make it somebody who's pregnant and it's just like a double whammy. So we have this mentality of like, Well, it's better to be safe than sorry. And it's like, Well, actually, you can be sorry. You can actually be sorry if you don't move your body intentionally during your pregnancy because one, not that your baby would be less developed, but we're going to say no thanks to those additional development things that they're having with the nervous system and their brain development. Those are two really big deals, I think. We're going to say no to a larger, more functional placenta which really helps to decrease the risk of developing certain complications during pregnancy. We're going to say like, I'm good with increasing my risk of developing like a prenatal complication, which again, exercising does not equal no complications, but it does reduce the risk to include preeclampsia, gestational hypertension, and gestational diabetes. 13:40 Better pregnancies, better birth outcomesGina: And if we have a healthier pregnancy, it's going to serve us better during labor as well or in the preparation for labor. We develop complications. It increases the necessity of a medical induction. It increases the number of interventions that were being used during our birth. And yes, I am so thankful for medical intervention, for C-sections, and for these things that save lives. But if we can use less of them because we're healthier going into our birth, that's going to help improve birth outcomes as well. This is a VBAC podcast. So if you're wanting to have a vaginal birth after a C-section, being healthier during your pregnancy by moving your body intentionally is a really good way to help reduce the risk of needing these additional interventions. I'm thankful for them. But if you don't need them, let's go around that. Let's do that path. Meagan: Let’s avoid them if we can. Absolutely. And let me tell you, talking about my first pregnancy where I just kind of quit, I mean, I didn't even really walk. I mean, not even like a 30-minute stroll at night. I just stopped and I really didn't pay attention to my protein intake or what I was really eating. I mean, I was literally told this at the end that I was unrecognizable. Everything about my body was trying to just make a baby and it was showing in a negative way because I was struggling. I got super swollen. I gained a lot more weight. I really was not in shape. When labor came, it was harder. It was a lot harder. And then postpartum was really hard. And then having to catch up to all the things that I did to my body, but then not even to think about all the things that you just said about the baby. I mean, I was one of those people that signed up to the “no thanks”. I mean, essentially, right? It wasn't in my head that I was saying that. And then after my, that pregnancy, I was like, I will not do that again. I did. I started changing my ways and doing intentional movement. I became a Barre coach and really wanted to be active. It was a night and day difference, night and day difference. I don't think my baby's less smart or whatever, but I will say that like what you said, I can look back and be like, Oh, oh, I can recognize those things. So that's kind of interesting. Gina: So it's not like if you don't exercise, you're screwing up your baby’s life or anything. I don't know how to feel the differences between the two, but if you can do things to help improve your baby's growth and development, I think we would want to do that. Even if it's just going for a walk, just move your body. 16:23 What do I do if I wasn’t active before pregnancy?Gina: I think one of the things is the next question that's on the list is like, Well, what do I do if I wasn't active before pregnancy?Meagan: Yes. Gina: Because I do have folks that'll either come to my gym– we're located in Aberdeen, North Carolina. We have an in-person training facility. And so we'll have folks that show up and be like, “I have never exercised before in my life, but I heard it's really good for me and I'm pregnant. Help me.” You can absolutely start an exercise program during pregnancy. This is hard to know because you get told, “Whatever you're doing before pregnancy, you could just continue during your pregnancy, just do a little bit less.” What if I was not doing anything? How do I do less than that? Like what does that even look like? Meagan: Right. Gina: You can absolutely start an exercise program during pregnancy. Yes, it will look different than pre-pregnancy workouts. If you were an active person before pregnancy, there will be some sort of modification that needs to happen because workouts can't look exactly the same when we're pregnant. But if you're like, Okay, how do I even begin? Just pick 20 minutes where you go for a walk. Pick 20 minutes where you choose a Peloton on-demand video. They have prenatal ones on there too where you just follow that. We have prenatal on-demand workout videos as well. We also have a prenatal app-based program, so we have some different options as well. Just choose a 20-minute option and just move. Just move your body. Use lighter weights. We're not trying to get super sore. You probably will be sore the first week or so. It's just part of getting used to the program.Meagan: It’s not normal, yeah. Gina: It's normal, but don't be working out so hard that you're incapacitated the rest of your day, start for 20 minutes and do that three times a week, and then the next week do it four times and then increase it to 30 minutes. Then maybe it's 40 minutes and then you're walking more. We're just going to start really slow and manageable, and then we're going to just slowly increase during pregnancy. The main goal during pregnancy is 150 minutes of moderate-intensity activity per week. That's the minimum goal. So if you exceed that, that's totally fine. Research supports that even higher-intensity activity is perfectly safe during pregnancy. A higher volume of exercise is perfectly safe. But the bare minimum that we're trying to aim for is 150 minutes. That's five days a week for 30 minutes or whatever the math is for the other one. But you can also do more than that. I would start with 20 minutes of something that feels manageable for you and do that and if it's, “Hey, I need to follow a program,” we've got programs for you. We've developed them for pregnancy specifically. There's Peloton on-demand. There are so many workout programs out there for pregnancy too. They're going to have safe modifications for you. You can hire a personal trainer. You can join an in-person gym. We're just looking for you to move your body in a way that feels manageable for you and it's okay if it's not perfect pregnancy workouts either. Now if you're an active person or you're like, Okay, I have done my month of exercising. I'm feeling more confident, this is where we can start to really ensure that our workouts are not only keeping us active and moving us during our pregnancy but also helping us actually prepare for birth. 19:30 Movements to incorporateGina: Common workout programs are really focused on front-to-back type movement patterns. This is the sagittal plane. This is like squats, deadlifts, cleans, clean-and-jerks, box jumps. Everything is very front-to-back because this is the way that we move our bodies. When we walk we typically walk in a front-to-back movement pattern. However, we also need to be moving laterally and rotationally as well which is another myth. Can I twist during pregnancy? Yes, you can twist. It’s necessary to twist. If you don't twist, your back will hurt. I promise you it's okay to twist. Now we don't want to do such deep twists that we’re compressing our belly because it would be really uncomfortable. Not because it would be harmful for you, but we want to we want to be comfortable during our pregnancy. We want to also be incorporating movement patterns that are in other planes of motion ot just front-to-back. We also want lateral movements like lateral band walks, side lunges, and movements where we're just we're going in this direction. And then we also want rotational movements. So like when I'm doing lunges, I'm adding an internal to an external rotation or I'm doing a rotation with a core exercise. We want to think about what type of movements are we incorporating or are included in our workout programs because that is really important to creating space in our pelvis which is not the point of this episode, but fitness can really relate to labor in that aspect as well. It's keeping you strong during your pregnancy. It's helping to support your baby's development. It's helping to decrease your risk of complication but we can also use it to help prepare for our birth. 20:59 Three pelvic levels Gina: And so there are three pelvic levels and I'll go over this super quick. The top opens in one way, then we have the middle, and then we have the bottom. We have inlet, mid-pelvis, outlet, and they all open with different types of movement patterns which is where moving in different planes of motion is going to be really helpful. The top of the pelvis opens with wider knee movement patterns like an external hip rotation with an anterior tilt with abduction. Legs are moving out. Think knees out, ankles in so really deep squats for example. An anterior tilt or arching your back is going to be really helpful because this makes it easier for you to find external rotation. It also changes the pubic bone angle and makes it easier for baby to enter into the pelvis. The good news is we already do that during pregnancy. That's a common postural tendency that we have. We like to live in that position. It's comfortable for us. We have more weight on the front. We're just extending in our spine and just loving that spot. However, we also need to be able to find other types of movements such as a posterior pelvic tilt or rounding in the back. This one is really important to opening the top of the pelvis in addition to an anterior tilt. So with a posterior pelvic tilt, we have this big chunk of bone on the back of our pelvis called the sacral promontory that moves backward when we tuck our butt underneath or we round in our back. That anterior pelvic tilt creates a little bit more space in the front half of the inlet and then that posterior pelvic tilt creates more space in the back. We want to be able to shift between the two but because we always favor this extended position, it can be really hard to find that rounded position. If you had a prior labor where baby just never entered and they were like, “Your pelvis is just too small. Baby just can't fit in your pelvis,” it probably was more related to whether or not you can find– and I don't want to blame anybody for what happened with labors but just helpful tips. If you're having a hard time finding a round in your back or tucking your butt underneath, it's going to be harder to create that front-to-back space in the pelvic inlet and it can make it harder for baby to enter. So during our prenatal workouts, we want to think about, Okay, what can we do to help me find more of a rounded position? We can release tension in our lats or musculature. We can release tension in our hip flexors. We can incorporate pelvic tilts into our movement patterns. Those are some things that we can do to help us find this more rounded position. 23:19 The mid-pelvis and outletGina: The next pelvic level the mid pelvis is asymmetrical movements like side-to-side, hip shifting, and so we have a little bit of external rotation and a little bit of internal rotation. We're just going back and forth between the two. Then the bottom of the pelvis with the pelvic outlet is essentially like the opposite of the inlet where we have an internal rotation at the hip where knees in, ankles out is creating more space side-to-side. A slight posterior pelvic tilt can help to make internal rotation easier, but we're not necessarily rounding in our back as we're pushing because it's not really that comfortable. Anterior pelvic tilt or a little bit more lat tension can kind of pull that sacrum back so we're kind of back to that pelvic tilting a little bit in the outlet, but we're really focusing on that internal rotation to create space. But if we recall, our favorite positions during pregnancy are extension and external rotation. That rounded position is harder and internal rotation is harder. In addition, that prenatal posture tends to make the back half of the pelvic floor really tight so we need to one, be able to release tension in the posterior pelvic floor and help us find more internal rotation. We can do that with our prenatal workouts as well. This is where hip-shifted exercises can be really beneficial like finding internal-external rotation with our single leg movements. These are all things that we incorporate within our prenatal programming because we have been observing birth and people working out for a really long time and we want to help you move through your pregnancy and through your birth. We also have a free birth prep circuit that I'll give you the link for that you can put in the notes as well. It has six movements that help you release those common areas of tension. We also have our prenatal fitness program if anybody's interested in working out. We have lots of different options for that as well. But when we're looking at our prenatal workouts, we need to look beyond just one– we just want to be active and intentionally active and then two– we want to think, Okay. Well, how does my workout help to support my birth preparation? How is it helping to create more space in my pelvis? How is it helping me release tension in my pelvic floor? Those are things that are going to help us to support us during birth. Yeah, that was a really long answer to you. Meagan: No, it was an amazing answer. It's interesting because I never really thought when you were like, “Front-to-back”, we focus so much on front-to-back. There's that lateral movement that a lot of the time we skip and I didn't even think of that. I know in your book, we've got a couple of little teasers online within your book. You've been showing different ways to work those sides and move your body in different ways. That is amazing. 25:56 Being told that your pelvis is too smallI love that you talked about the pelvis, the inlet, the middle, and the outlet because I'm pretty sure you probably have known this within the VBAC community. How many times are we told that our pelvis is too small? I mean, all of the time. Gina: It makes me so mad. Once you get told something really random or a fun fact about your pelvis like, “You have a really prominent sacrum or pubic bone.” What does that mean? Meagan: Yes. What does that mean? Gina: How can I take that information and do something with it? Instead of acknowledging that yes, each of us has different types of pelvises. Similarly, we're all from different ethnic backgrounds. Of course, we would have slightly different pelvises. We have different femur lengths. Meagan: Right. Gina: However, we can all still figure out how to squat and figure out how to do movement patterns that make us functional humans even with differing bone structures. It just blows my mind that we don't acknowledge the fact that the pelvis can change shape and diameter and displacement with movement. Our baby is also shape-shifting and wiggling their way through the pelvis as well. But the only person to blame is you. It’s because your pelvis is just too small. Meagan: Right. I know. Gina: Maybe you didn't know how to support me. Meagan: I know I have those same feelings. It's very frustrating. I think it's probably a little extra salt on the wound because I was told that. I was told that I would never get a baby out of my pelvis. Like you were saying, you're like, “Well, maybe I just wasn't supported well enough. Maybe I wasn't given the tools or the positions,” like what you're describing. I mean, with my first labor, I just sat there in the bed, clinging to the side, and then got an epidural and sat there. Really? Like, so I wasn't moving my pelvis. I wasn't doing those asymmetrical movements. I really wasn't working with my body to get my baby out. Okay. So a question that I know that we have received is the anterior placenta. So does fitness change if or what we're doing change if we have an anterior placenta? Gina: Really, if you have an anterior placenta, a posterior placenta, it closes out on the side, it doesn't really matter where it is unless it is covering the cervix. At that point, like, there will probably be some sort of modification, because we don't want to have any sort of cervical dilation or cramping or urinary irritability that can cause the cervix to begin to dilate which may cause the placenta to start to detach which would not be ideal. So typically, if you have any sort of placenta previa, potentially like a low-lying placenta in the third trimester, after 28 weeks, we probably want to modify it to where we're not doing super deep squats. We're not exercising at a high intensity. It's low to moderate. If you are experiencing any bleeding or cramping during your workouts, you’re stopping immediately. But in regards to the placenta being in the front or the back, there really is no difference when it comes to exercise. The baby is pretty snug as a bug in a rug. Meagan: Snug as a bug in a rug. They are pretty protected in there. They are pretty deep in there. Gina: They are. They are. Now when it comes to certain birth options, sometimes an anterior placenta– usually with an ECV if baby’s are breech, providers don’t want to do it if you have an anterior placenta. It may be harder for you to feel your babies. You should feel your baby but it may be muted. You would be like, I kind of feel you, when in comparison, if you had a posterior placenta, there’s a little alien rolling around in your belly.Meagan: Right. Or you might not feel kicks until them later on in your pregnancy when someone with a posterior placenta is feeling those little butterfly kicks early one. Gina: Yeah. It will be more muted. But in regards to exercise, the only placenta position that would result in modifications is a low-lying or placenta previa where the placenta is covering the cervix. But usually for those, if you found out at your 18-week anatomy scan, they usually resolve within a few weeks so you can always ask for a repeat scan, but typically, we don’t need to modify until the 28-week mark. But again, if your provider has given you specific guidance on what they consider to be safe for you with exercise because again, they are looking at your medical records. They are looking at you as an individual and this is just a podcast. Definitely go with their guidance, but typically, they do move. There usually is not an issue into the third trimester with that either. Meagan: Yeah. Okay, so good. 30:36 How late in pregnancy is okay to work out?Meagan: Another question is, How “late in pregnancy” is okay for me to work out? We’re talking about early, what we’re doing. We may be started to feel really good. We may be increasing our physical activity. We might be more mindful. Now, it’s on top of intentional movement. It’s on birth prep and really getting ready for this birth journey. Is there a time when we should cut off physical activity or is it okay to be doing squats and lateral movements and yoga one day and go into labor the next day?Gina: You can workout until the day that you give birth. Now, how intense your workouts are will probably decrease toward the end of the third trimester. For us, around the 36-37-week mark, we do certain tapering in the program which means we start decreasing overall volume and intensity of workouts because one, we are just more tired at the end of the pregnancy. We still want to move and be active, but we also need to be in the mind that, Tonight, I might go into labor so I don’t want to be super sore from my workout. Similar to if I was training for an athletic event, not that birth is a competition or anything, I wouldn’t want to be doing my hardest workout the morning of the competition. Again, birth is not a competition but with that type of fitness mentality, you’re like, Okay, well birth is probably going to be physically demanding even if it’s super fast. It’s still physically demanding. I probably don’t want to be super sore or super fatigued going into that. So around the 36-37-week mark, you can decrease overall volume. If you were working out at 200 minutes a week, maybe at week 37, we are only doing 150 minutes a week, and at week 38, we are doing 100 minutes a week and then maintaining that so whenever your baby decides to come. 32:31 When is it too late to start exercising during pregnancy?Gina: We also get folks who ask, When is it too late to start? I would say if you gave birth, it’s too late. It’s probably too late for prenatal fitness at this point. Kind of like, When is it too late to get an epidural? It’s when your baby is born. When your baby is born, it’s too late to start a prenatal fitness program. We will have folks who are 35 weeks. They are like, I’ll just wait for postpartum. I’m like, You might have 2 months left. That’s a long time. 8 weeks, that’s a whole fitness challenge or whatever. You know those ones where it’s like, “6 Weeks to a Bigger Booty”, it might be 6 weeks until a baby. That’s still a good period of time to move your body. It doesn’t have to be training for a PR, it’s just learning how to release tension, starting to build up some stamina, some endurance for the big day. Now, if you’re 38 weeks and you’re in that, I could go into labor anytime, I probably wouldn’t start a lifting program at that point. I would probably be focusing more on yoga and mobility-type things. Walking, just trying to release tension in my body. I wouldn’t be like, Let me go squat and deadlift for the first time in my whole pregnancy. I would do more breathing and stretching. That would be more reasonable to me. Once you hit the 36-37 mark and you’re like, Can I start something now? Absolutely. A prenatal yoga program would be my recommendation. Going for walks and things like that. If you’re 32, 33 or even to 35 weeks, I would say that you can start a lifting program. I would say to start our prenatal program at that point because we do have a monthly option. You can just grab the months that you need. We also have a just third-trimester program on demand. You can still intentionally move, but it’s just going to be a little bit more mindful to the fact that we are kind of at the end of this journey, but it’s definitely not too late to start unless you gave birth. At that point, it’s probably a little too late. But what can you do? Meagan: Now you’re going into postpartum after your baby is

Aisha’s first baby was a scheduled Cesarean for a breech presentation during the height of the COVID-19 pandemic. Though she was symptom-free, Aisha tested positive for COVID and was not able to be with her husband or her baby right after birth. Her surgery was routine and uneventful, but the isolation left her devastated. Aisha moved and was living in Oregon during her second pregnancy. She deeply desired a home birth and found a midwife to support her who also happened to be trained in vaginal breech delivery. Aisha went into labor sooner than expected but handled it beautifully. When it was time to push, surprisingly, feet started coming out first! Her team stayed calm and ultimately brought her baby earthside safely. Aisha is so proud of what she accomplished! Evidence-Based Birth ArticleThe VBAC Link Blog: ECV ExplainedThe VBAC Link Blog: How to Turn a Breech BabyThe VBAC Link Podcast: Chelsey's 2VBA2C Breech BabiesNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 03:31 Review of the Week06:10 Aisha’s first birth11:16 A COVID-positive Cesarean14:38 Third pregnancy20:02 Planning for a home birth22:51 Breech workshop with Dr. Stu24:57 Labor begins31:25 Pushing out an unexpectedly breech baby35:29 Reviving baby40:53 Vaginal breech birth is possible49:39 Adding to the supportive provider listMeagan: Hey, hey everybody. Guess what? We have a breech VBAC, actually, it’s a breech HBAC coming your way today. We have our friend, Aisha, with us and she is going to be sharing her amazing journeys. We know that when it comes to breech, it is difficult to find support. It is difficult to find the evidence in that and this is one of the number one reasons for Cesareans in the first place. If you have gone through our podcast, we have over 300 episodes at this point, you will probably hear quite a bit that, “Oh, my baby was breech. We tried an ECV and it didn’t work so I had a C-section,” or “My provider didn’t even offer that and I had a C-section.” This is one of the number-one leading reasons for a C-section and it doesn’t always have to be that way. Aisha is living proof of that. Welcome to the show, love. How are you today? I’m so excited for you to be here. Aisha: Yeah, thanks. I’m so excited to be here. It’s like a dream come true. It’s wild. Meagan: It was so fun. Before we started recording, she said that not long after she had her baby, she was like, I’ve got to get my submission into The VBAC Link. Aisha: It was bathtime earlier this week when I saw the email and I was freaking out like, Oh my gosh. It was cool because my daughter is going to be a year old soon, so it was fun to think about her birth and I almost felt guilt because I was like, Oh my gosh, I haven’t listened to The VBAC Link in a minute, but how much this podcast blessed me and strengthened me to go on to have a VBAC, specifically a breech VBAC which was not planned for. It was wild and I’m just really grateful for my provider. Meagan: Yeah, absolutely. I cannot wait to dive into this story. 03:31 Review of the WeekMeagan: We do have a Review of the Week and then we will turn the time over to our friend, Aisha. This is from larrr23 and it was left in March of 2023 so just over a year ago on Apple Podcasts. It says, “Hi, Meagan. I love your podcast so much. I always end up crying at the end of them. So happy for these moms who get this VBAC. Thank you for creating this podcast. It is so inspiring to hear these stories. I’m 38 weeks pregnant and hope and dream I get my VBAC here soon as well. Keep doing what you are doing here. You are helping so many women achieve their dream birth and knowing that they are not alone. Thank you for that.” Well, larrr23, if you are still listening with us, let us know how your birth went. I hope that you had an amazing birth no matter how it ended. Thank you so much for that sweet review. This is what I really am here for. I love this podcast so much myself. I listen and I record it and I hear these stories, but then I go back and I listen. I’m still hearing and still learning even knowing a lot about VBAC. I am still learning and growing myself and it’s just so fun to hear these incredible stories. I’m so grateful for all of you who are submitting your stories and sharing these stories both on Facebook, Instagram, and here on the podcast. So thank you for your review and as always, if you wouldn’t mind leaving us a review, they truly are what help other Women of Strength just like you find the podcast. You can leave that anywhere you are listening to the podcast or you can even email us at info@thevbaclink.com. 06:10 Aisha’s first birthMeagan: Okay, are you ready to share your stories? Aisha: Yes. Yes. Meagan: I am so excited, so ready. I’d love to turn the time over to you. Aisha: Yeah, okay. So for my VBAC journey, I feel like it’s really important to understand how I got there. I got pregnant with my first in 2020. My husband was in the military so we were stationed in South Korea. It was right before we left Korea. We moved back to the States. We had already been going through COVID in Korea so it wasn’t as big of a deal because we had it first if that makes sense. We moved back and we are from Washington state so we went, spent time with family, and then we ended up in Texas. Here I am with my first baby, and I don’t feel like I’m a naive or ignorant person but I never really thought about the process of having a baby. I’m the oldest. My youngest brother is 13 years younger than me, but I just never really thought about what went into having a baby. Meagan: I agree. That’s how I was. I was like, Oh, cool. I’m so excited to have a baby. I’m pregnant. This is cool. All right, cool. What’s next? Aisha: Yeah. I got books. I read things. I joined groups. I watched YouTube videos. I listened to the podcast Birth Queens a lot just to understand more. I had a pretty normal pregnancy. There wasn’t anything too wild and because it was COVID, there was a lot of things over the phone. A lot of people thought it was weird, my friends and family, but my provider at the military hospital didn’t have a good bedside manner and it was known that she didn’t. It’s hard to explain. My husband was enlisted so he was just by the time he left, he was a Sergeant. He was one of the lower guys, so I don’t know if it was us or the culture, but you get nervous to speak out because of rank. He’d be like, “Don’t say anything. We don’t know if that will get back. You can’t be.” Meagan: Or disrespect them? Aisha: Yeah, because there are some military wives who are assertive. Assertive is a better word. I don’t like to use "aggressive" with women. She would just say things like, “You’re gaining too much weight.” I’m like, “I’m walking every day. What do you want me to do about this?” Meagan: You’re like, “I’m also growing a human.” Aisha: Yeah, I know that I’m gaining a lot. I’m seeing that, but what am I supposed to do about this? I just got stressed about the thought of her being near my vagina. I was kind of scared about it because I was like, I really hope it’s not you. We get to the 36-37 week appointment and they do a quick ultrasound. They’re like, “You’re baby’s breech.” I was like, “Oh, great. Cool.” They’re like, “You can talk to a doctor and talk about an ECV.” I know ECVs can be controversial. Some people are uneasy about them, but one thing I thought was interesting about my life is that I was a breech baby and my mom had an ECV with me. Meagan: Interesting. Aisha: Right? I was born in 1990, so I grew up hearing the story about them trying to flip me. When I heard people like, “Oh, ECVs are so risky,” I was like, “My mom did it. What’s so risky about this?” So we went in and the first provider we met with was like, “I like to put you in the operating room. I like to give you an epidural just in case something happens and we have to slice you open,” not like that, but it felt like that. I was like, Whoa. This is a lot.So we get to the day of the hospital and luckily, I’m so glad it was a younger doctor. I was like, "Are you bringing me back to the operating room?” He was like, “No, I like to make you comfortable. You can watch TV.” He was really sweet. It was an interesting experience. Of course, you are wearing masks but I remember the nurse took my mask off to let me breathe because it was painful. But they were so nice. My husband wished we had taken a video of because he was like, “They were pushing so hard on you and they were shaking.” Meagan: Oh, yeah. Aisha: My baby didn’t flip. He’s going to be 3 in April and he is very stubborn. He does what he wants and I’m like, This is totally you. We ended up getting COVID right before having a baby. My husband did. I tested positive, but I didn’t show any signs. It didn’t really affect me a lot. I was just kind of crazy. I remember I cooked Easter dinner and he wouldn’t eat it. I’m like, “I cooked Easter dinner for you,” and he was really sick with COVID and I’m still doing things. 11:16 A COVID-positive CesareanAisha: We go to the hospital and we test positive again. They have this stupid COVID protocol where I’m like, “I already went through these 10 days,” but they just treated us like we were coming in throwing up on them. Does that make sense? Meagan: Oh yeah, I saw it as a doula. Yes. I had a client who wasn’t even sick. She had no idea and tested positive. We all got kicked out and they acted like she was going to kill them. It was really not good. Aisha: Yeah. It was just weird. Because mine wasn’t an emergency, I kept getting pushed back because they had emergency C-sections coming. The biggest thing that sticks out to me in my birth was when it was finally my turn, they came to me and they were like, “You’re next, but it’s going to take a little bit because we have to extra-clean because the last person was COVID.” I’m like, “Why do you have to extra clean? Shouldn’t you always clean an operating room? That doesn’t make sense to me.” Meagan: You should always extra clean, yeah. Aisha: Yeah, that’s gross. What were your protocols before? I don’t understand. Meagan: Interesting. Aisha: We didn’t go back until 3:00 or 4:00. I don’t know. It was late. You know, you’re not eating because they tell you not to eat so I’m starving. The doctor who delivered my baby was super nice. She came in and was like, “Let’s have a happy birthday today.” I don’t remember anything weird. I’ve listened to some episodes where they’re like, “Oh yeah, they were talking about their vacation.” I don’t remember that. Meagan: That was me. Aisha: Oh yeah. I felt like it was really respectful. The anesthesiologist, I wish I would have gotten his name. He was wonderful. He was so sweet and kept telling us what was happening. I was like, “Oh my gosh. You are our personal tour guide for this.” He was really kind. I have a nervous cough. I always have when I get nervous. I just cough. After they took my baby out, I coughed. That’s where I get emotional so they took my baby away because they were like, “Oh, COVID positive. You coughed.” I’m like, “I have a nervous cough. I always have my whole life.” They took my husband away so I was there for 30 minutes alone. Sorry, I get so emotional thinking about it. All of those sweet pictures that people have, I didn’t get that. Oh my gosh. My son is going to be 3 and it still brings me. Meagan: It’s still with you, yeah. Aisha: Whenever I talk, yeah. The C-section itself was fine, but it’s just the care that got me. I never know how to explain that to people. No, it’s the care. So then we finally were in the recovery room. I’m starving. My husband gave me fruit snacks. We didn’t realize I was not supposed to eat, but I was starving. We get to the mother’s room at 11:00 at night. The kitchen is closed. I’m like, “I’m starving. When can I eat?” The nurse laughs and says, “When you can walk.” I’m like, “But I’m hungry.” She’s like, “You’ve got to get up and walk first.” I’m like, “But I’m hungry.” What? Yeah, so that was him. That’s that part. 14:38 Third pregnancyAisha: Everything else was fine. It was just the care. They lock you in a room when you are COVID-positive. It was just wild. When he was about 11 months old, almost a year old, I got pregnant again. We moved from Texas to Oregon because my husband was getting out of the military and sadly, 10 weeks later, I had a miscarriage. I had already picked out the midwives I was going to use in Oregon. I was like, I’m going to have a home birth because Oregon has really good laws when it comes to home birth and I am going to do this. There were a couple of driving factors to that. One, I did not want to go back to the hospital. I was like, I’m not being treated like that again, because I’m a pretty timid person and I don’t know if I’d be strong enough to advocate for myself. The other thing is we had a toddler. My mom lived in Seattle and my husband’s parents just moved to Idaho. My dad and my step-mom live in Atlanta, Georgia and I’m like, There’s no one to take care of my toddler so we’ll just have a home birth. My husband was like, “That sounds kind of weird,” but my husband’s mom actually had a home birth with her fifth. It wasn’t abnormal for my husband’s family, but he was kind of like, “Ew, gross.” We always joked right before I had my first if it was a scheduled C-section, my husband wouldn’t be there because he is really queasy when it comes to blood then finally when they were like, “It’s a C-section,” my husband was like, “Oh, you’ve got this.” I was like, “Nope, you’re going to be there. Sorry.” I know it was hard for him. I know how he gets. I don’t think it was him being weird or anything so I was totally fine with it. I had my miscarriage in April and then I got pregnant later that summer. It was cool– I guess not cool. I thought it was cool when I got pregnant with her daughter. Her due date was the same weekend I had my miscarriage. I was like, Wow. It was interesting. During my miscarriage, my providers were wonderful. My midwife was wonderful. The ER doctor was so great. It was a sad experience, but it was a peaceful experience. I definitely was at peace with it even though it was really sad. I definitely say the driving force with my daughter, there was a lot of panic and anxiety. I would say, I don’t know if it’s having another child and having a toddler, but I definitely didn’t feel as connected to that pregnancy. But again, I have a very active toddler. So one thing though, we didn’t find out the gender which was pretty fun. A lot of people thought it was weird and they were like, I like to prepare. I’m like, What do you have to prepare for? I just thought it would be really cool to not find out. I didn’t really post about my pregnancy a lot. I think I announced in January and she was born in April. I didn’t talk to people about having a home birth because I didn’t want to hear it. I didn’t want to hear people’s opinions about it. I remember I had some friends that I was like, I really don’t want to talk to you about it. They would ask, “Oh, how was your doctor’s appointment?” I was like, “Oh, it was great.” I didn’t say anything else because my midwife would come to me. It was so nice that she came to you and I didn’t have to worry about getting out the door and the whole family was involved. It was super nice. 20:02 Planning for a home birthAisha: Oh, I remember I told my dad. I was like, “Yeah, I’m going to do a home birth.” He was like, “I don’t know. It sounds kind of sketchy. Are you sure?” I was like, “Yes.” He was like, “Don’t you want to go to a real doctor?” I don’t think my dad was being rude, but I was like, “Dad, it’s not a mountain man. It’s a real midwife. It’s a licensed business. It’s a real person. It’s not some woman off the street that I’m like, Come birth my baby. She went to midwifery school.” But no, my midwife was amazing. Her name is Liz and she was just so calming. Her voice was just very soft-spoken it felt like, but I was so worried about having a breech birth. Whenever I brought it up, she’d be like, “We’re not talking about that. We’re not talking about that.” I was like, “What if this baby is breech?” She’s like, “We’re not talking about that.” I’m like, “Okay, cool.” So when I was pregnant, like I had shared before, I just listened to The VBAC Link. I just listened to The VBAC Link. That’s all I listened to. I worked from home at the time just doing computer work and I would just listen to episodes. I would be sobbing. It was for a lawyer and I’d be doing these things and crying just thinking about all of these amazing things that these women went through and how they were able to bring their babies. One thing that I believe I learned from this podcast, so I failed my gestational diabetes test, my glucose test, but I had heard from an episode that it varies from state to state. I was like, Interesting. But my midwife was like, “You just did it by two points or whatever the thing is, so just watch what you eat. Keep a log and let’s talk about it.” So that’s what I did. She showed no other concerns. She was like, “Just eat more protein”, then I would log my food and at appointments, we’d go over it and she would go, “Oh, see? This is when your sugar goes high. It’s because you ate this. Let’s try to eat more of this,” and then I tried to stay as active as I could with my toddler. My husband was in school. He left the military and was in school finishing up his bachelor’s degree so we live right next to campus. We lived in a basement apartment and at first, I was like, Why? We rented this basement apartment and I was like, Can I legally have a baby here? I was like, Is this allowed? Do I have to tell my rental company? There were these 5 girls who lived above us and I was like, How am I going to do this? Aren’t they going to think this is weird if they hear me? But yeah, I just remember this basement apartment. It was pretty tiny. I would just sit in my living room and envision my birth there and be like, Okay, I can do this. 22:51 Breech workshop with Dr. StuAisha: April comes and my midwife had done a workshop with Dr. Stuart. Meagan: Oh, Fischbein. Aisha: Yeah, like 2 months before I gave birth. Meagan: That’s awesome. Aisha: I was like, “Oh, so is this a possibility?” We were on state insurance because my husband is a student. There were a couple of things. They covered my midwife, but we would have to pay for the birth because I was a VBAC but my midwives, they are really great where they accept payment plans because they were like, “We don’t believe people should tell you where to give birth. If you just pay us $5 a month, that’s fine.” We ended up paying it all off because we were like, “That’s fine too.” But she told me, she was like, “Well, because you’ve never given birth vaginally, you wouldn’t be able to.” I’m like, “Oh, that sucks,” which is the same thing they told me in Texas. I was like, People breech birth babies all the time.I was like, “Can I transfer hospitals?” They were like, “No, no one will probably take you because you’ve never given birth vaginally.” I was like, “Okay, that’s weird. Whatever.” I was like, “Oh, dang.” My baby was due at the end of April and on April 5th, I started getting contractions. With my son, I never had contractions. I never went into labor. I never had Braxton Hicks. I didn’t know how any of that felt so I was like, Oh, this is new. What is going on?Oh, I did have a doula. In Oregon, when you are on state insurance, they do cover a doula so that was really nice. Meagan: Yeah, that’s really awesome. Aisha: Yeah. The doula that I had runs the doula program, but I contacted her directly because I was just looking through Facebook groups and she was like, “No, I’ll take you on.” She was actually training to become a birthing assistant with my midwife so it was pretty fun. She worked really well with them. 24:57 Labor beginsAisha: Okay, so on April 5th, I start getting contractions. They just tell me to rest. I remember I had a really bad headache so I was like, Oh, maybe I’m dehydrated and maybe that’s why this was happening. So I was drinking lots of water and coconut water and trying to eat protein. That night, I remember we were watching Ted Lasso and I was trying to hone in and focus while having contractions. I don’t remember anything else. All I remember is Ted Lasso. Then that night at 2:00 AM, my husband ended up calling the midwife because they were picking up. She came and he made this observation when she got there, they slowed down. She checked on me and she was like, “It looks like you’re just having false practice labor,” whatever you want to call it. “Just rest up.” I was like, “Okay.”So the next morning, I wake up at about 7:00 AM. Through the night, while I go through contractions and my husband was timing them, I’m moaning through them. I took this course. Sorry, I’m jumping around. I took this course called Pain-free Birth so I just was trying to practice what she had taught in it. I was breathing through riding the wave and all of that. My husband would moan along with me during contractions while he was sleeping and I was like, “You’re not helping me.” He was like, “Oh, sorry. I didn’t realize what I was doing.” Okay, so then I wake up at 7:00 AM and I take a shower. I just remember I was like, I’m going to curl my hair, but then I was like, I can’t do that. It’s so interesting how in tune our bodies are and almost how in tune our family is because that week, my toddler slept in until 10:00 AM every day. That day, he slept in until 10:00. Meagan: That’s amazing. Aisha: He knew something was going on, right? That morning, I remember I ate. I listened to some Taylor Swift music and just swayed around my kitchen. I turned on Anastasia the movie and laid on my couch and went through my contractions. I labored a lot alone which is what I wanted. I didn’t want people at my birth. I didn’t want a mom or any relative and I think my mom would be great during a birth, but knowing me, I think if I wasn’t progressing, I think I would panic and from what I’ve learned, your body can shut down and not do it because I would feel the stress like, No one is comfortable. I’m doing this to people. I wanted to labor alone if that makes sense. Meagan: Yeah, it does. You didn’t want to be the host of your birth. Aisha: Yeah, and I feel like that’s what I would have been. I would have been like, “Does everyone have drinks? Does everyone have snacks? Is everyone comfortable? What does everyone want to watch on TV?” I know me and I was like, I don’t want that. So at about 10:00 AM, my husband and my toddler come out of bed. I put on the Peanuts movie for my toddler and I’m just kneeling on my couch which was really sweet. Every time I went through a contraction, my husband was timing them and they were still pretty inconsistent. That morning, I was texting with my doula and keeping her up to date with stuff. My toddler would come over and rub my back or bring me toys and I thought that was really sweet. My husband had a 12:00 class and was like, “Should I go?” I was like, “Do what you want, but probably not.” It was really funny because he was actually watching a video for his class. Have you ever seen– I always forget this actor’s name– have you ever seen the show Lost? You know the evil guy, the cult evil guy? Meagan: Yes. I don’t know the name. Aisha: He was narrating this video, this video on Marie Curie. Meagan: Curie? The X-ray lady? Aisha: Yes. Meagan: That’s so funny because my daughter did the wax. She was Marie Curie for her wax museum for her 2nd grade. Aisha: Yeah, so my husband is watching this video and it’s that guy narrating it. It’s about her. I’m going through my contractions, focusing, and asking him questions about it. I was like, “What did she do? How did that happen?” I had the Peanuts movie. I had that going on in the background. Yeah. So finally, I’m like, “I’m going to go lay down.” My husband was like, “Okay. I’m going to be there.” I go lie down and all of a sudden, I start getting hot flashes and get really cold. I’m like, “What is happening?” My doula finally called me. She heard me and she was like, “You are in transition.” We didn’t realize how far this was happening. I was like, “Maybe we’re not communicating,” but we were telling them about the contractions. We were keeping them up to date. I got back in the shower and she was like, “I’ll be right there, but you should probably call your midwife.” My husband was trying to figure out my phone. Something happened with my phone and he was like, “I can’t open it. I can’t open it.” I’m in the shower and he calls the midwives and the one that is not my midwife, the other one who I had met with before and I liked her too, she picked up and listened. She was like, “Okay, we’ll send Liz right over. It sounds like something is happening.” I’m in the shower. It just was so funny. I remember being like, I can’t do this. I can’t do this. I can do this. No, I can’t. Yes, I can. Then my husband was trying to talk to me. I keep referencing a lot of pop culture things. Meagan: I love it. Aisha: Do you know that TikTok sound? It’s from a movie with Will Ferrell where he’s like, “Shut up. Don’t talk right now. I’m so scared right now–”Meagan: I don’t know if I’ve seen that. Aisha: Yeah, it must have been trending then, but that was running through my mind. I was like, Shut up. I’m so freaking scared right now. Will Ferrell was going through my mind. Then my husband is just standing at the bathroom door and he’s like, “I don’t know what to do.” Then I’m like, “I feel like I have to poop. That’s what I feel like right now.”31:25 Pushing out an unexpectedly breech babyaisha: I go over to the bathroom and go over to the toilet. I am like, “I can’t sit down. What’s happening?” I got scared and then all of a sudden, it must have been my water breaking because there was a pop and stuff went everywhere. Like I said, my husband is very sensitive to things so he was like, “Should I come in there and hold you up?” I was like, “No, because I don’t need you gagging in my ear because it stinks in here. Please stay right there.” Finally, I don’t know the times. I’ve been told they showed up pretty fast, but you know when it’s all happening. You lose the concept of time. My doula shows up. She says that my husband, his name is Logan, was standing there with a towel. He was ready to come in and catch a baby. She said he looked almost like a butler. He was just standing there. She comes in and rubs my back and I was like, “Heidi, I’m so stupid. This is so stupid. Why am I doing this?” Then comes my midwife with all of her stuff. You know what? It is so crazy. That morning, I don’t know if this is with all home births, but with my midwife, I had to buy certain things. I had to buy towels and hydrogen peroxide. I had to buy all of the stuff. It had come literally that morning. I wasn’t due for 3 weeks. They take me into my bedroom and all of a sudden, I hear them ripping things open, just moving stuff and ripping things open. I’m just over the bed and moaning. One of my biggest regrets is not having a birth photographer because they are all fuzzy and terrible pictures. Then they said I was pushing, but I don’t remember pushing at all. I just remember riding those contractions. Then at one point, they asked me. I think it was my doula. She was like, “Aisha, do you want to feel your baby? Do you want to put your hands down and feel your baby?” I said, “Absolutely not. No, I do not,” which I’m kind of glad about because I probably would have felt a foot or something and that would have scared me. I’m leaning over my bed and then like I said, my midwife is a very conservative, meek person, very soft-toned. All of a sudden, I heard her say, “Aisha, I don’t want you to panic, but your baby is coming out ass-first.” I was like, “Oh, that’s different.” She said afterward when we were talking, she said she saw it and she just leaned back and went, “Hmm.” She took a picture of it and then my husband’s perspective was funny because he said he comes and he sees feet and he was like, “What is happening? Why is my baby coming out this way?” She tells me to get on my hands and knees. She gets firm because I don’t know what is happening. I get on my hands and my knees beside my bed. She tells me to push and I’m like, “I don’t know what you’re talking about. I have not been pushing this entire time,” but I must have pushed. Then I heard a splat and I was like, Is that my baby? It was my placenta. It felt out of me.Meagan: What? So baby was born, you turn over, and then the placenta? Or wait– Aisha: Yeah, so I’m on my hands and knees. The baby is born. I hear a splat and I get on my knees. I get up, lean back, look down, and there is a placenta. Meagan: Okay, I was like, Whoa, wait. That can’t… My mind was backward because I was like, Well, your husband saw the feet so I’m assuming baby’s out.Aisha: Yeah, sorry. The baby was out. Yeah, but I thought it was my baby falling out of me but I’m kind of glad my placenta came out like that because I was more scared to birth my placenta than my actual baby. 35:29 Reviving babyAisha: I turn around and she’s pretty limp. My midwife explained that it’s pretty common for breech babies to come out not breathing. She was talking to Heidi and she was like, “Get the–” what’s it called? An ambu bag? Meagan: For oxygen and stuff? Yeah. Aisha: She’s directing Heidi where it is. Right before I had her, we didn’t talk about names, but I had a strong impression it was a girl so I approached my husband. I was like, “Hey, I have these three names.” Her name is Margaret. I was like, “Margaret Sage, Margaret Alexis, or Margaret Alexandria. You pick.” He was like, “Margaret Sage.” I was like, “Okay cool. Let’s do it.” We don’t even know what we’re having. Anyway, so she was limp, limp and not breathing. I just look at her and I go, “Oh, it’s a boy.” My doula goes, “No, Aisha, it’s a girl.” I’m like, “No, it’s a boy.” I’m so dazed and then Liz was like, “Aisha, I need your help.” She had been doing mouth-to-mouth. She was like, “I need your help, Aisha. Talk to your baby. Help me with your baby.” So I just start stroking her and holding her head up. Later, Liz said that I don’t know if she said this to say this, but I was one of the best assistants that she had. She was shocked because I recently gave birth. She said she recently had a father and he kind of panicked. She said it was kind of cool. I didn’t know what was happening. Meagan: Your intuition kicked in. Aisha: Yes. I’m just like, “Hi, hi, hi. Hi, baby.” I’m just holding her head and then they got her breathing and gave her to me. There is a picture of me. You know those candid shots that you see where it’s ugly but beautiful? That’s what it is. It’s ugly, but beautiful. I’m crying and holding her. Blood is everywhere, but I love that picture so much because it represents something that I did. Oh, I skipped this part, but when she was coming out breech, I was like, Those midwives in Texas can suck it. I’m doing this. I was told I can’t and I did. That’s crazy, then they just put me in my bed and then by protocol, you have to call EMS and EMS came pretty quickly. They came. I remember they asked me, “Oh, do you want to be transferred?” I was like, “No.” They were like, “Baby looks good.” Then they asked my husband, “What’s the baby’s name?” My husband was like, “I don’t know.” I missed this. He had been running around doing things. When my midwife got there, we had street parking so she just parked in the middle of the street and asked my husband to go park her car. Keep in mind that I still have my toddler. I think he napped that day which is crazy. That’s wild. Oh my gosh. My baby was born at 12-something. My son woke up at 10:00 and he napped. He woke up to a baby. That’s crazy. I never connected that but he was awake for a very small amount. Yeah, that’s it. They hung around for a bit and then they left and that was that. Meagan: All was well. Aisha: Yeah, it was crazy. I can see the shock when I share it to people, but it’s probably one of the best things I have ever done, the coolest thing. I feel like I’m a pretty average person. When I was filling out my bio, I was like, I’m a stay-at-home mom and I watch a lot of TV. Yeah, then I did it. I had a breech birth. I guess I missed this thing. They weren’t tracking that she was breech. They think that maybe she flipped during labor. It’s not like I went in planning to have a breech birth. It just happened. Meagan: She obviously wasn’t aware when she was like, “Oh, I’m taking a picture of this. This is crazy.” Aisha: Yeah, they actually used the picture of Margot coming out of me. I think I shared it with you guys. She shared it. They actually share it for advertisement. She was like, “Can I use this?” I was like, “Yeah, that’s fine.” Meagan: Yeah, I mean, it’s amazing. Let me see what picture. I haven’t even seen your picture yet. Oh yeah, this is an awesome picture. Aisha: Yeah. Meagan: Yes. Aisha: It’s kind of crazy. Meagan: This will be posted on our social media so if you want to go see this really awesome picture, I definitely suggest it. One leg is still inside. Aisha: I think both of them, right? Meagan: One is out and then it looks like one is maybe coming out soon. Aisha: Maybe. Yeah, when I was trying to look for it last night, my husband was like, “I have lots of pictures. They are gross.” I was like, “I know which one I am looking for, you weirdo.” Meagan: Yes, I love it. Thank you for sharing it with us. 40:53 Vaginal breech birth is possibleMeagan: Breech birth is possible. Rebecca Dekker over at Evidence-Based Birth did an episode actually just recently looking at this. It says January 2024 so just recently. We’ll make sure to add the link in there. It was with Sara Ailshire I think is how you say her name. They talk about breech birth and it’s a long transcript and it’s a great podcast so I would highly suggest it. They talked about how the study that was published in 2022 that included the studies from a 10-year period of 2010-2020 and they found that perinatal death rates were 0.6% in planned vaginal breech groups and 0.14% in planned Cesarean breech groups which is kind of crazy to think. It’s pretty low. When we talk about death, that’s a serious thing to talk about. Those are pretty low. They did find that Cesarean favored the rates, but there was not anywhere near as high as the breech trial. We just know that breech is starting to dissolve, these options. The providers in Texas were like, “No, we don’t do this.” I mean, ECVs aren’t even offered in a lot of places. Aisha: Oh wow. Meagan: Especially for VBAC. So for this instance, if you were

Kristen joins us today to share her tough C-section and two beautiful VBAC stories! After a 41-week elective induction that turned into a C-section and a 2.5-week NICU stay due to meconium and heart decelerations, Kristen was very nervous about giving birth again. She found The VBAC Link Podcast and found hope. Through her VBAC research, she gained the determination and confidence she needed to try again. When she was showing symptoms of preeclampsia, Kristen accepted the reality of a medically necessary induction. She was nervous but knew things would be different. She labored well and had moments of discouragement, but she used the tools available and achieved her VBAC. Kristen also had some preeclampsia symptoms but was able to avoid induction, labored almost completely at home, and caught her baby in a wheelchair at the hospital waiting for the elevator!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:11 Review of the Week04:23 Kristen’s first pregnancy06:20 Agreeing to induction08:27 Emergency C-section and NICU stay12:55 Gaining confidence to VBAC and getting pregnant again17:28 39-week induction21:18 Feeling discouraged27:15 Getting the epidural and pushing for less than an hour30:58 Third pregnancy34:41 Forced to find a new provider at 36 weeks40:45 Labor begins46:11 Rushing to the hospital48:06 Delivering her own baby in a wheelchair51:27 Preeclampsia article and calibrating your blood pressure cuffMeagan: Hey everybody, welcome to the show. We have our friend, Kristen with us today. Hello, Kristen. Kristen: Hi. Meagan: We have her and her little baby as well so you can hear those little cute coos in the background. You can just smile. I love when we have little babies on the podcast or kids. The other day, we had a little toddler. It was so fun. It makes my heart so happy. How old is your little baby now? Kristen: She is over a month. Just over a month. Meagan: Just little little. This is a VBAC baby. Kristen: Yes, she is. Meagan: We were just talking before we got recording. Kristen had a C-section and then a VBAC and with that VBAC, she had preeclampsia. We are going to talk a little bit more of what that looked like, but that has definitely been one of the themes that our listeners have been asking about. Is VBAC possible with lab-positive preeclampsia? The answer is yes. It is. We will talk a little bit more about that and then she has a surprise. 01:11 Review of the WeekMeagan: We are going to read a review and then we are going to dive into her stories. This review was left in March 2023 by mcgrace and it says, “Must-listen For Every Mom”. It says, “This podcast is a must-listen not just for a mom preparing for a VBAC, but for anyone who gives birth and has given birth or plans to give birth in the U.S. Meagan wonderfully walks through personal stories while prepping for helping for helpful advocacy tips and a solid dose of empowerment in each episode. If you want to hear people discussing their plan to VBAC, if you are curious about what giving birth in the U.S. is like, and if you are wanting to have tips on how to mentally, emotionally, and physically prepare yourself for the best birth, this is the podcast to listen to.”I love that. Thank you so much and I agree. This is such a great place for everybody, anyone preparing for birth to listen. I think with crazy-high Cesarean rates, we’ve talked about this before. We have to talk about why they are happening and this podcast literally shares a lot of why Cesareans are happening. It is such a great podcast for anyone including first-time moms or even fifth-time moms who haven’t had a Cesarean. As always, if you wouldn’t mind leaving us a review, you can head over to Apple Podcasts or Google or Spotify or wherever you are listening and drop us a review. You can even email us at info@thevbaclink.com.04:23 Kristen’s first pregnancyMeagan: Okay, Kristen. Welcome. Welcome, welcome and thank you so much for booking this. We are so excited that you were willing to come on. Kristen: I am so excited to be here. I have heard so many stories and been encouraged by so much so it is so awesome to share mine. Meagan: Yes. Well, I would love to turn the time over to you. Kristen: Okay, so I got pregnant pretty young. I was 20 at the time and I was in college so when I got pregnant, it was a little bit of a surprise. It was a little bit of a crazy pregnancy moving and figuring all of that out, but I got to move home to my big, crazy family. I had a lot of support. I had a really normal pregnancy. I was pretty young and a lot of my sisters had had babies, so I felt like I knew a little bit about birth and I really didn’t put any effort into looking any deeper into it. I felt like my mom had six kids naturally and I just thought, Okay. This is just what we do. I had midwives. I had a super normal pregnancy and then I got to the end and I was very done being pregnant. I was just ready to meet my little baby and have my baby. I was offered a 41-week induction. I think it was just offered to me and I was like, “Meet my baby on Friday? Sounds great.” I didn’t think anything of it. My mom had all of her babies naturally and she did seem a little wary to me, but I just was thinking I am huge. I get you are wary, but I want to do this. I want to meet my baby. 06:20 Agreeing to inductionKristen: I had a Foley placed the night before my induction date so I had a Foley placed and I was going to go home. When she placed the Foley, she told me— I can’t remember exactly when they fall out, but I was only a centimeter below. I think I was 3 centimeters. She was like, “Oh wow. You really stretched when I put this in. I might see you before your induction.” I was like, “Great.” I went home and then we got there in the morning. I wasn’t feeling anything. I was induced and it was just the natural cascade of things. I got Pitocin and then I had GBS so I had to get the antibiotics, but I thought I was allergic to them because I had a reaction as a kid so they had to give me something else. I don’t know whatever else antibiotic they had to give me, but it was something different. It made me feel super, super sick. I just wanted to lay in bed. I was like, I feel sick and I don’t want to stand up. I’m in labor and I don’t feel good. So I just laid there pretty much. Then I got an epidural and I got to a 10. I pushed for 3 hours but his head never came. He was having some decals so all of a sudden, I just heard the word “C-section” and I was so shocked. It didn’t come into my brain at all before they said it. I don’t know why. It was a long day. I had started at 5:00 AM and by the end of my pushing, it was 12:00 PM. I didn’t think of a C-section before that. Meagan: I think a lot of us don’t. It’s not really something that we plan for or even think about. Kristen: Yes. So it’s really jarring when you hear it. 08:27 Emergency C-section and NICU stayKristen: Then we had to go down for the emergency C-section because my water had broken and there was meconium and he was deceling quite a bit all day. We went in for my C-section. I was pretty scared. My husband was really scared and we just went in. I was super shaky and I was terrified. I don’t do well with that kind of stuff, so I say the worst part of giving birth is the IVs. I was super nervous and then they needed to get him out so they told me, “You have to try to calm down and try to stop shaking so much” because they needed to get to him. I don’t remember exactly what happened. I just remember laying there and the anesthesiologist was just like, “She needs to calm down. Do you want me to give her something?” I just remember looking up at who was doing my C-section and who was somebody completely new because my midwife couldn’t do it. I remember them shaking their head and right after that, he must have put something in to try to calm me down. I calmed down, but all of a sudden, I felt like I couldn’t talk. I couldn’t speak. I was just lying there. I was so scared. I felt my son being pulled out. I felt them wiggling him out of my body and then I didn’t hear him cry. I just remember looking at my husband and I was mad at him almost. I was like, “He’s out and he’s not crying. I can’t say anything. You need to say something.” He didn’t know he was out, but I felt like he should know he was out. So then my son had to go to the NICU because he aspirated meconium. I just remember them lifting him up and the NICU nurses showing him over the drape as they were running out and they were like, “Here, mama,” and showed me him. I just remember feeling like such a bad mom. Everybody says, “Oh, when you see your baby and when you feel your baby, it’s just this overwhelming sense of something you’ll never feel again,” and I didn’t feel that. I felt nothing. I couldn’t talk. I just felt nothing and I was so scared and just numb at that point. My husband went with my son and everybody had told us all day that Dad gets to stay with baby if something bad were to happen so I was just assuming, Okay, at least my baby is not alone. My husband is with him. Then they started to sew me up, but I don’t know exactly what happened. I just remember them saying, “There’s blood where there shouldn’t be.” They said something about how they nicked my bladder. They were sewing me up and then they had to go back in and do something, but my poor husband at the time, there was a traveling NICU that didn’t know dads got to stay in there with baby so he kicked my husband out of the NICU at that point and then he said when he came out, he was in the hallway in between the OR and the NICU and he just said, “I just saw a bunch of people rushing back into your OR and rushing back in there,” and then he said somebody just put him in there like, “What are you doing?” He was like, “I don’t know,” so they put him in a maintenance closet. Meagan: Oh my goodness. Kristen: Yes, so he was like, “I just was in the closet thinking you guys were both not okay and I didn’t know what to do.” So that was a little crazy and then my baby was in the NICU for 2.5 weeks. That was a very long, very difficult process for us because I just wanted my baby to be home and my baby to be healthy. Kristen: We had some really amazing nurses and then we had some not amazing nurses and nurses are such a big thing. They really change your whole day. They change everything about your hospital experience when you have a good nurse and when you have one who is just not very supportive. That was a really difficult experience. 12:55 Gaining confidence to VBAC and getting pregnant againKristen: Then when we got home, I didn’t really think about another baby for a while because I was so scared. Once I did, I just remember saying, “You know what? If I go in and the doctor tells me I have to have another C-section because that’s what is best for my baby, then that’s okay. I’ll get through it and that will be okay. My baby will be healthy.” Then I started doing a little research and I found The VBAC Link. I think I binged for a full 24 hours. I don’t think I slept. After that, after 24 hours, I was like, Nobody can tell me that I can’t do this. I can do this. From then on, this was a couple of years before I was pregnant. I listened. I did research. I had called and met with doulas and home birth midwives and everyone before I was even pregnant. They would be like, “What is your due date?” I was always like, “Well, I don’t have one. I’m not pregnant yet.” They would always be like, “Okay.” But it was great and I felt a lot more prepared with my second. I did feel like I was going hands up a little bit. I felt like I was ready to fight when I needed to fight. I got pregnant again. She was born in 2022 so I got pregnant in 2021. I got pregnant again. It was an easy pregnancy. I was super sick at the beginning, but it was a pretty easy pregnancy. I started getting Braxton Hicks at 20 weeks which is very different than my previous pregnancy. I had them all my pregnancy every night for all of my pregnancy which was very crazy. Meagan: Whoa. Kristen: Yeah, but I had switched providers so I started with a provider because I wanted to go with a different hospital initially. When I went to this provider, he told me all about uterine rupture in the first appointment. I had statistics written in my phone because I knew when I went in there, he was going to scare me and I knew I just needed to look at my statistics to feel better. That’s kind of what happened, but he did push back a lot on things. He wanted me to get a test epidural. Meagan: Mhmm, the just-in-case. Kristen: Yes and to be honest, the best way I handled things was, I feel like it’s really difficult to talk to a provider in an appointment. I just feel like the power feels all theirs and when they are saying things, it really does sound scary whether or not. I knew so much information and it would still sound scary. They would be saying something and I felt like I was there and my baby was deckling and I did need the C-section. I would get scared in my appointments, then I would go home and I would do more research and I felt really secure in my decision. I went back to him and I told him that I would not be getting that. I told him, I just let him know that if it was that much of an emergency, I would be under anesthesia either way so I didn’t understand why I needed a needle in my back. He kind of giggled and he was like, “Well, you’re right. You’ve researched, so okay.” Meagan: Stop it. No way. Oh my gosh. Kristen: Yeah. I ended up switching providers at 20 weeks after I met my doula because I told her just a few things that I didn’t feel as supported with him and she let me know a midwife who I had never heard about. I met with this midwife around 20 weeks. I gave her a really long list. I gave her a very long list of papers to tell her exactly what I wanted and she was very, very apt to doing everything. She would say things before I even would talk about them.I would ask her about an epidural and she would say, “No, you don’t need one and to be doing this, you need to be eating before.” I would ask about all of these things so I felt really secure going with her. 17:28 39-week inductionKristen: At 38 weeks, I got to my appointment and I had high blood pressure. It was pretty high and she just was like, “I’m going to do a urine test for preeclampsia.” I really had never heard of preeclampsia. I had heard of it. I just had never done any research on it. I didn’t understand what it was. I did the urine test and I really was thinking it was just going to come back fine. I felt absolutely fine. I had no symptoms. It seemed that it was going to be okay and then it wasn’t. She told me that I was going to need to be induced. I was very, very nervous. I really wanted to avoid an induction because my first was induced and I felt like that was leading up to my C-section so I was super nervous about a VBAC being induced. But she was very supportive of me. She really understood that I was very, very nervous and she was very respectful with that. So we ended up being induced at 39 weeks and I went in. I had a Foley bulb placed and then I just rested the rest of the night. You don’t sleep in the hospital, but I pretend-rested for the rest of the night. Then in the morning, I got up and they were like, “Yeah, you seem to be progressing.” They started me on a low dose of Pitocin. I just told them I wanted really low and slow so we did that. I had quite a bit of Braxton Hicks or prodromal labor. I don’t exactly know which. I had quite a bit of that beforehand. I was at a 5 and pretty actively contracting. They were like, “Honey, you don’t feel anything?” I was like, “No, I feel something. I just feel what I feel at home all of the time.” So I was like, “This is very similar.” I got pretty discouraged because I felt like nothing was happening. It was 2:00 or 3:00 PM the next day so I had been in the hospital for 20 hours at that point. I just felt really discouraged because I felt like nothing was happening and I just emotionally broke down to my husband and told him, “What if we do this and everything happens the same? I worked this hard and I fought this hard for this and I’m just going to go in and I’m going to have another C-section.”I knew that having another emergency C-section was going to be worse for this baby than if I just had a regular C-section. I was so upset. I had my emotional breakdown, then after that, I kept going. I was doing everything. When they put me in that room before the nurses came in to even meet me, I was doing Spinning Babies. I was doing everything I possibly could to get this baby out. The nurses would even comment and say, “Wow. You just don’t stop moving, do you?” I just felt like a little geriatric patient with all of my little tubes attached to me and I was just walking around. 21:18 Feeling discouragedKristen: Yeah, so then at that point, things started to progress a tiny bit. I was progressing, but nothing a ton was happening so my midwife came in and let me know that the only thing she could do besides Pitocin was break my water. I was really in my head at this point in labor. I felt like I really needed to advocate for myself. My doula was helping me and texting me the whole time telling me what I could do. She just let me know that once things really progressed, then she would come in. I at that point was really just trying to play the risk of what Pitocin I wanted. Do I want to stay low and slow? I just really didn’t want my cervix to tire out so I let them push it up a little bit more. I just was really in my head about trying to make the best decision which is silly because I couldn’t have control of everything but I felt like I needed to to have my VBAC. Things kept progressing and at 10:00, they asked me to break my water because that was the next step. I had been on Pitocin all day so I was a little bit worried about my cervix getting tired. I told them I was fine with that. The contraction after they broke my water, I was like, Oh my goodness. Here is the pain that everyone talks about. Meagan: And I feel it. I feel it. Kristen: Yes. I was like, Oh my goodness. Then it felt like I was actually in labor. My doula came at that point. She was doing some rebozo on me and shaking apples. Meagan: Yep, shaking the apples. Kristen: Yes. That was great. She brought out the TENS unit which was amazing. Oh my goodness. It helped so much. They put it on my back and it was just amazing. I was standing up moving my hips. I had the TENS unit on and I was really working through things and I started to feel like I was going to throw up. I started to get hot and cold. I would have a contraction then in the middle of a break for a second, I had told her in the middle of a contraction, “I think I’m going to throw up.” Then I looked at her after and I was like, “I think I’m going to throw up.” I was so excited because I was like—Meagan: This is it. Kristen: Yes. I was like, “I think I might be in or nearing transition at this point.” I had amazing nurses the whole process. I just had amazing nurses. I had asked for nurses the whole time who agreed with HypnoBirthing or who were trained in HypnoBirthing. I had not done that, but I just wanted them who were a little more holistic and a little more natural. One of my nurses actually said, “You’re not doing HypnoBirthing.” I said, “I know.” She was like, “You just want somebody who’s going to let you do what you want, huh?” I said, “Yeah, absolutely.” She said, “Okay. I have the perfect nurse for you next time.”I had amazing nurses the whole time. They were so encouraging. Meagan: Oh good. Kristen: But my nurse must have been doing something so another nurse came in to check me at this point and she was not as nice and amazing. She told me that she needed to check me. I was about to get on the bed and I had another contraction so I stopped right outside of the bed and put my hands on there. She told me, “Get on the bed. I need to check you.” I couldn’t speak because I was in a contraction, but I was thinking, Oh my goodness. I finally ended up getting on the bed. She looked at me and told me I was a 6. In my head, I was not a 6. The whole room changed for me at that moment. I was very discouraged. When she told me I was a 6, my doula’s face was right behind her shaking her head no. She just was looking at me shaking her head and she was like, “No you are not,” but I don’t know. I was exhausted and I just broke mentally in that moment when she told me I was a 6. I just heard I can’t do it. I can’t do this. This is too much. I can’t believe I’m at a 6, because at that point, when I got into bed, I felt pushy. I felt really pushy. During my contraction, I was bearing down a little bit. I just thought, Okay, if I’m pushing at 6, baby is in a bad position. I just was so nervous. I got up. I went to the bathroom. My doula actually told me, “You need to get up. We’re going to the bathroom,” so she just took me to the bathroom alone just her and I. She looked at me and she said, “Do you think you’re a 6?” I was crying at this point. I was like, “No, I don’t. I don’t think I am.” She was like, “I do not think you are a 6 at all. I think you know where you are.” I was like, “I know, but what if I really am? If she says I am, I am.”I broke emotionally and I just was like, “I’m so tired.” I was so tired. I hadn’t slept in 24 hours at that point and I was just so exhausted and upset. I told her, “I want an epidural.” She knew that was not my plan so she really tried to encourage me against it and told me I was doing such a good job. I couldn’t hear it at that point. All I could hear was the doubt. 27:15 Getting the epidural and pushing for less than an hourKristen: I just told her, “No, I want an epidural.” At that point, she shifted gears and was like, “Okay, then we’re getting an epidural and this is going to be great and you’re going to get some rest.” I was a little discouraged, but I ended up getting the epidural at 3:00 AM at this point. I got the epidural and I actually got an hour of rest which was really amazing because I was exhausted but when they had given me the epidural, they checked me at some point after this and I was a 9.5. She looked at me and gave me an eye like, Yes, you were not a 6. It was nice. I got an hour of rest and then they came in and told me that I was ready. This sweet, sweet nurse came in and told me that I was ready to start practice-pushing or something like that. I was like, “Okay.”I was a little nervous about the pushing part just because I pushed with my son for so long and his head never showed so I was like, Once we get past a head, I will be there.I pushed in one position on my side and then the nurse looked at me and she was like, “You know, we’re going to try tug-of-war.” She put the squat bar up and I did a tug-of-war push and right when I did that, her eyes got big and she ran over and got on the phone. I just remember her saying something like, “When she pushes in some position, I see something about baby’s head.” I just remember her saying, “Baby’s head.” I, in the bed, was like, “You said baby’s head?” I was so excited. I was like, “They saw baby’s head.” I pushed for a little less than an hour and she was there. It was everything. Everything went away for me at that point. I was just so happy and excited and it was the best feeling in the world. I just felt like all of my work, I actually did it. I did it. But I forgot to mention, my midwife got off shift during this so another OB was on and she came in. They actually were asking me to stop pushing to wait for her to come in. I giggled. I was not going to do that, but she was not as kind and helpful. She let me know right after, despite knowing my birth plan that delayed cord clamping wasn’t safe. Meagan: What?Kristen: Yeah, and that I needed to cut the cord. To be honest, I was in complete baby land at that point. I was so happy that my baby was there that I didn’t fight it. Looking back, I’m honestly glad that I didn’t because I know that it would have taken me out of where I was able to be and the joy that I was in. I didn’t fight it. I just let her do it and it was silly, but it was okay. I got to have my sweet baby and it was an amazing postpartum experience. I remember being wheeled out with her because I didn’t get my little boy after my C-section so I remember being wheeled out with her. I was just holding her in my arms and I was so happy she was in my arms. I looked at a janitor while I was being wheeled to mother and baby. I lifted her up and I smiled so big at him. He just was like, “Okay.” Meagan: “Congratulations”. Kristen: I just was so happy. But yeah, that was my second and my VBAC which was amazing. 30:58 Third pregnancyKristen: When my little girl was 6 months, I got pregnant again. It was an amazing pregnancy. I felt great the whole time. I totally thought she was a boy because I wasn’t sick, but it was a girl which I was super surprised by. I had no Braxton Hicks. I really didn’t have a ton until the end which was crazy to me because I had them so much with my previous. Meagan: Yeah, a lot. Kristen: Yes. That was pretty crazy. I went back to my provider who I had gone to with my second baby. I went back to her. Things felt a little different with her. She was still really supportive, but it just felt a little different, then at 16-17 weeks in my pregnancy, I did an initial test for preeclampsia and my numbers were already above. The protein in my urine was already above where it needed to be. She just told me in an appointment very casually, but I was super nervous. I didn’t know a ton. During this pregnancy, I did a ton of research about preeclampsia, so the one thing I did to my diet was I ate so much protein. I ate. I tracked especially in that first trimester. I tried to eat 100g or more a day. I really focused more in that first trimester. That was the only thing I felt like I could do so that’s what I did. She told me my protein was already really high which I didn’t understand and it made me really nervous. I asked a few questions during the appointment, but I felt like I had a ton of questions after. I called and I felt very dismissed. I felt like she just kept trying to tell me, “Don’t get in your head. Everything will be okay.” She was being very sweet, but I just felt like I needed a doctor at that point. I didn’t need a friend. I needed her to give me information instead of trying to encourage me. It was really sweet, but we only had 5 minutes and I didn’t want encouragement. I needed information that I just felt like I wasn’t being given. I actually ended up switching again to another OB. I just was interviewing them so I actually had appointments with my midwife and an OB. He actually came back into town. I had heard really good things about him but he moved and then he came back. I interviewed him initially and actually, I left my appointment and I kind of drilled him a little bit. I really asked him a lot of questions. I left my appointment. I called my sister and I said, “Yes. I don’t believe it.”He said everything I wanted to hear and that feels too bait-and-switch to me. There’s no way he’s this good. Then I had a few friends through church who he was with and he followed through on everything. My doula told me, “I think he’s just that good.”I was super surprised because I could not believe that he was that receptive of me, but I went to another appointment and talked about my initial labs with him and he sat there with me for a whole hour and explained what he knew about preeclampsia and explained what he could to me. It was really, really helpful and I felt very heard. So at that moment, I chose to go with him. 34:41 Forced to find a new provider at 36 weeksKristen: I finished with him through the rest of my pregnancy. My sister was actually pregnant too and she was going with him. It was really cool. Meagan: How fun.Kristen: She had her baby. I got to be there for some of her birth. She was due a month and a half before I was due so I got to be there with her and watch her amazing birth then she told me, “I’m having a lot of pressure. Can you just look down there?” She was crowning and I was like, “Oh, you’ve got to go to the hospital.”Meagan: Oh my gosh. Kristen: She went to the hospital and we had that amazing experience and that was her first VBAC so it was really awesome.Then my provider called me and told me that they were shutting down their office when I was 39 weeks pregnant. This was at 36 or 35 weeks. I was then scrambling to find another provider. It was very, very difficult. Everyone I talked to just told me that they didn’t take VBACs past 35 weeks and that I even would have my paperwork switched and then they were like, “Oh, you’re VBAC and preeclampsia. We won’t take you.” There were 3 weeks of me just honestly trying to find a provider who would take me, not even a supportive provider, just having a doctor take me was very difficult. I finally found a provider who would take me, but they told me there was another provider in the office who was very unsupportive. He actually was there during my sister’s birth when she came in and was totally crowning. He sat back with his arms and legs crossed and she was crowning, hopping on the bed ready to push and he sat there with his arms and legs crossed and told her how unsafe VBACs were. Meagan: Oh my gosh. Kristen: He told her that he didn’t know who approved her chart, but this was not okay. Thank goodness, the provider who was amazing came in and saved the day. But he was awful and he was actually one of the three providers in this office that would take me. I was really nervous about the on-call schedule and if he was going to end up being on-call when I was going into labor. There was a lot of back and forth there, but I ended up meeting with this provider and I met with him when I was 40 weeks and a day so I met with him the day after my due date and this was our first time meeting. I gave him my birth plan. He looked at how far I was and he was like, “Oh, awesome. You’re almost done.” I felt like he was perfect. “Let’s just get you out of here.” He was doing it as a favor to the other provider. I felt like a check in his box from the start of being there. I was really nervous about my blood pressure. I kept telling everyone, I had no symptoms with my previous preeclampsia. I had no symptoms and all of my labs are positive so I just want to be really on it. I didn’t have a provider for 2 weeks and at the end of my pregnancy so I just got a blood pressure cuff and I monitored myself as much as I could. It was stressful. I ended up going into triage once because my blood pressure was high and I didn’t have anyone to call. I didn’t know what to do, so I went into triage and they just were not very awesome with me. But that was okay and my blood pressure was fine so I ended up getting to go home. I was with my provider. He just was not, he really wanted to induce me. He told me all about my placenta dying at 41 weeks and he was so scared about me going past 41 weeks. I asked him if this was just something he did with just VBAC patients and he said, “No, I do this with everyone.” I was like, “Oh, okay.” I was like, “Perfect. I’m even less worried now. I was thinking you had more information about VBAC and my placenta, so I’m less worried now.”Meagan: Less concerned. Kristen: I told him, “I don’t want to be induced at 41 weeks.”He kept telling me, “Oh, I know. You do your research. You do your research.” He did not like that I was very informed on things. I ended up having to go into triage at the end of my pregnancy three separate times because of my blood pressure readings at home, but every time I went into triage, they were fine there so I kept telling people, “I don’t know what my blood pressure reading is doing at home, but is there something else I can do?” Everyone would look at my blood pressure cuff and say, “Yeah, that’s great. That’s the one I recommend.”I was like, Well, why is my blood pressure so high at home? I need some help. This has to not be working. At one point, I brought my blood pressure cuff in with me and they were reading differently at the hospital versus the cuff. I was like, Mine is not working, so I don’t know how to check myself at home. It was really difficult. My husband started to be a nervous wreck about all of this anyway so everyone was pushing me to get induced and every time he heard the word “induction”, he was like, “Let’s just do it. It worked for us with the last VBAC. Let’s just do it.” Every time they told me I was okay, I just was like, “No. I’m going home. If I’m okay, I am going to have this baby naturally.” It was a really emotional experience because we were all very back and forth. it felt like everyone was going through it with me, but I was the one pregnant and fighting to stay pregnant if my baby was okay. It was really difficult, but I ended up getting through it. 40:45 Labor beginsKristen: I ended up having some prodromal labor at the end is what I felt like it was. 41 and a couple of days was my next appointment and I told everyone, my husband and my sister, I was like, “He’s just going to want to induce me and push it so much at my next appointment.” I was so worried so I told my doula that I was thinking about trying castor oil. She came over and she gave me electrolytes and she gave me a recipe with castor oil that was very, very small. I had gotten a few recipes and it was next to nothing. There was no castor oil in it basically. She told me, “It sounds like you are in early labor so I’m going to have you try this,” and I did one dose every 4 hours. She was like, “It sounds like you are in early labor, so I’m going to have you try this.” I honestly was even grumpy about that. I was like, “No, I want more. If I’m going to try this, I want it to do something.”I tried that at 3:30 in the afternoon on a Friday. I did a couple of doses and then my mom called me and told me that she was in town and asked if I wanted her to come hang out with my kids. I had done two doses and I was like, “No. Nothing is happening. I’m never going into labor.” I was super grumpy. “I’m never going into labor.” I got off the phone with her. I started crying because I was super emotional and my husband told me to just go back in the room for a second. So I went back there and I don’t know. I must have known in my head that something was going on because I called my mom right back and I was like, “Yeah, maybe come over.” She was like, “Okay.” So she ended up coming over and hanging out with us and then we put the kids to sleep and I was feeling contractions and everything that I had normally felt throughout the week. I just was like, “I don’t think a ton is happening.” I ended up putting my little boy to sleep at 8:00 and I had finished my doses of what I was doing. At that point, I was breathing through them a little bit, but I kept telling everyone, “I am not in labor. If this is it, it’s very, very early. It is not happening.”My mom was like, “Okay, that’s fine, but why don’t you just go back? You need to get some rest because if it is going to happen, you need to get some rest.” I told her, “Okay.” I went back to go get some rest and I don’t know why in my head I didn’t realize that I had been able to rest through all of them before in the week, but suddenly, I could not lay in bed. I just told my husband, “No. It’s really, really early if it’s happening.” I just sat on my ball. I rocked around on my ball for a little bit then I was getting pretty uncomfortable but I didn’t want to say it because I didn’t want it to be fake. I said, “You know what? I’m going to take a shower. I can’t stay in the shower for very long because I don’t want it to slow things down if it is picking up.” My husband asked, “Do you want me to come in there with you?” I said, “No. No, no.

Emily’s first birth experience was a home birth turned hospital transfer which ended in a C-section and then a birth center VBAC ending in hospital transfer and another C-section with her second. She found herself feeling alone, frustrated, and surrounded by people who just didn't get it as she worked to process the trauma and grief of not one but two back-to-back traumatic births and C-sections. Throughout her journey, Emily took charge of what she could, learned about her options, and made the right decisions even when they were disappointing. Emily has been proactive about physical and emotional healing. She has been open to new perspectives. Emily is grateful to share her story and all that she has learned for other mamas who have found themselves in similar situations. And we are so grateful that we can feel of her strength! The VBAC Link Blog: How to Cope When You Don't Get Your VBACThe VBAC Link Blog: Deciding on VBAC vs Repeat CesareanNPR ArticleSpinning Babies: What to Do When...Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 05:02 Review of the Week09:10 Emily’s first pregnancy and labor14:59 First C-section17:47 Second pregnancy21:16 Moving and switching providers33:20 Pushing for 5 hours35:45 Transferring37:47 C-section41:29 Tips for adhesions44:20 Hospital births are beautiful49:09 All about transferringMeagan: Hello, everybody. It is Meagan and we have our friend, Emily, with us from Texas today. Hello, Emily. How are you?Emily: I’m good. How are you?Meagan: I am wonderful. I am so wonderful. I love recording these stories if you can’t tell. We are producing them a lot because I love recording. I love hearing these stories and sharing these stories. Your story is a CBAC story which I think is so important to share on The VBAC Link Podcast. As technically a CBAC mama myself because I don’t know if anybody knows who is listening, but I had a C-section then I wanted a VBAC and had a Cesarean and then I had a vaginal birth. So all over the place. CBAC is really special to my heart and I think that this is such an important topic to share on the podcast because we know that obviously, so many C-sections are happening, right? I also think it’s important to know that sometimes even when we are preparing for a VBAC, it might end in a Cesarean birth and even more important, I think it’s really important to know that Cesarean births can be healing and are a lot of the times healing. Would you agree with me, Emily? Emily: Yes. I mean, I loved hearing the healing stories. Mine was not and I think that’s what I yearned for to her is that I’m not alone and it’s okay to have a repeat C-section and I hate calling it a failed VBAC, but a repeat C-section that wasn’t wanted and wasn’t healing. I mean, my second birth was much more traumatic than my first. I mean, I hate saying traumatic because I have two beautiful, healthy babies, but I also want listeners to know that just because you have a healthy baby and you didn’t have serious complications you can’t feel what you felt about the trauma of it all. Meagan: Okay, and I love that you point that out too because just as much as Cesarean birth can be healing and can be amazing, it can also have a lot of that trauma. Trauma, I think, is a completely valid word to use. It can be used to be described as traumatic. It can be described as hurtful. I was angry. I was angry when I walked myself down for my second C-section. I didn’t want that. That was not what I wanted. It was not what I planned. Yeah. Also, going into that it doesn’t always happen the way we want to. It can go both ways so that’s why I think sharing CBAC stories on this podcast is so important because we have to learn both sides of things. We have to know that Cesarean birth can be healing and it can be exactly what someone needs and it can also be traumatic and not what someone needs. I think that through these stories and through the journeys, this is how we learn how to try to avoid trauma and anger and hurt along the way. 05:02 Review of the WeekMeagan: Before we get into this story, I do want to read a review. Okay, Emily, so remind me. You had a home birth transfer? Emily: Yes. A home birth transfer C-section and then birth center transfer C-section. Meagan: Birth center transfer C-section, yeah. I also want to talk about transfers at the end. We’re going to talk a little bit about transferring and when it might be a good time to transfer, when it might be starting to give us signs that we might not be in the best place, and then also how to go about what to do after you transfer if you’re transferring because that can also be a big mess too sometimes transferring depending on how the hospital responds to you. We’ll dive in to these stories but I do want to read a Review of the Week. This was from winben18 from Apple Podcasts and it was on May 19, 2023, so a year ago right now. It says, “I had my first baby in 2021 11 pounds at 42 weeks via Cesarean because he wouldn’t descend. I was told I couldn’t birth him because he was too big and my pelvis was too small, but I always knew that wasn’t true. My mother, a very petite woman, birthed me naturally and I was 11 pounds, 9 ounces. In 2023, I had my VBAC with another 11-pound baby. No epidural, 7-hour labor, and I credit that success to The VBAC Link. I started listening to them religiously at 38 weeks when my provider started fearmongering me about birthing a big baby. I needed every little bit of encouragement and The VBAC Link provided that. It’s incredible how your body’s physical capabilities start with your mindset. Thank you ladies for all of your stories. I wouldn’t have been able to do it without you.” Wow, that was an amazing review and so grateful. Holy cow, winben18, yay for an 11-pound, 8-ounce baby. I agree with what she said that it starts with our mindset. A lot of the time it does. We can also be in the best mindset ever and things might not unfold that way but if we can set our mindset and get going and get the education and the empowerment and the encouragement, you never know. Things can go a really long way. So as always, if you guys have a moment, we would love your reviews. You can leave it on Apple Podcasts. You can leave it on Google even or on Spotify. We would love a 5-star review and if you can, comment. Tell us what you guys think. Emily: I love stories of petite women birthing big babies actually because I’m smaller and I had big babies. I’m like, I know I could do it.Meagan: Yes. Yes. She talked about fearmongering. A lot of people do get fearmongered. They start saying, “Oh, I don’t really think you can,” and it’s so hard when we have a lot of people doubting our own bodies and then we start doubting them even though we didn’t have doubt originally. It’s so hard. It can be a tough cycle, but Women of Strength, it is possible. 09:10 Emily’s first pregnancy and laborMeagan: Okay, Emily. Let’s dive into these stories. I know you mentioned in the beginning that you had a second Cesarean and it wasn’t amazing. It wasn’t amazing, so I would love for you to of course share your stories but also maybe talk about tips you would suggest for someone in your situation maybe looking back where you’re like, Oh, I could have done this, or tips for people in your situation. Emily: Okay, so my first son was born in May 2022. I got pregnant with him in September 2021 and I knew immediately that I wanted midwifery care. I wanted a home birth and to be honest, I had no fear. I was very confident. I was like, I can do this. I’m in shape. I eat healthy. There is no reason why this isn’t going to go perfectly. I mean, I can’t be the only one who has thought that and it was the complete opposite. It was a fine pregnancy. I was very, very sick until about 20 weeks. I lost almost 10 pounds in my first trimester, but it turned out to be a wonderful pregnancy. I love being pregnant. I love it. Anyway, I went into labor at 6:00 AM and I guess active labor really started around noon. We were at home. My husband started filling up the birth pool. My midwife was on the way and she had an assistant midwife with her. So really, we just labored at home. Then I would say probably about early evening, they checked me and I hadn’t made very much progress. I think I was at a 4 or a 5 and I’m trying to remember correctly. I think that’s when they told me that the baby was at a tilt. Meagan: Asynclitic or the whole body? Emily: You know, I really don’t know and I think a lot of it has to do with why I have struggled so much with that birth because I feel like that birth catapulted me into the next C-section, but I feel like they had said anterior tilt, but I don’t think that is correct. They broke my water because I wasn’t progressing and then they were trying to turn him after the fact. I think that’s where things went downhill. They checked me. I wasn’t progressing. They were like, “We can break your water. It will speed things up.” And I agreed. I think that was my first mistake. I think a lot of that has to do with me not preparing as well as I should have and me with the mindset of, I can do this, no problem. That is my first regret from my first birth.Anyway, so they broke my water and then after that as everyone knows, contractions were off the wall. They had me laboring in one position on the bed on my left side to try to get him to turn and then they had me on the toilet so I went back and forth between there. Every other contraction, they were in there trying to turn him. So basically, this went on until about 4:00 AM at home. It was my first labor. I was in an extreme amount of pain and I just was exhausted. I felt like it wasn’t going like I planned obviously. So anyway, we transferred to the hospital. That was about a 30-minute drive to the hospital which was not fun at all. It was the wee hours of the morning so we went in through the emergency room, got up to triage, and I think I got my epidural within 45 minutes to an hour and just from what I remember, that was a very intense hour. I just remember thinking, What the heck? This is not how childbirth should be. Anyway, so I got my epidural. I labored with an epidural for a few hours and they started me on Pitocin so epidural, Pitocin– Meagan: The usual. Emily: Yeah. Nothing was really happening. They were doing Spinning Babies with the peanut ball and the bed to try to get him positioned better. Long story short, we got to an 8 and this was probably gosh, almost 48 hours later that I got to an 8. The hospital where I birthed is very home-birth and transfer-friendly. I had midwives on staff there who cared for me. One of the midwives home birthed her babies too so that was cool to have her caring for me and understanding my mindset of wanting to birth at home and then obviously I wasn’t at home anymore. But regardless, they were saying, my water hadn’t broken for over 24 hours. They weren’t concerned about that and I loved the evidence-based care there. I love that. But they did tell me, “You know, the way things are going, you could get to a 10. You could push for a couple of hours and end up in an emergency C-section.” It’s almost like that verbiage right there was enough for me to be like, “This is it. Let’s call it. Let’s get the baby out. We want to meet our baby.” We were being surprised on the gender so we were very excited for this baby to get here. I went to 39+5 with him. 14:59 First C-sectionEmily: And so anyway, we called it and we did the C-section. I don’t think– obviously the birth was traumatic for reasons like I explained, but the C-section wasn’t awful. I didn’t feel any tugging. It was a very pleasant Cesarean. They did delayed cord clamping, not traditional delayed clamping, but they waited for it to stop pulsing and cut it. They took him to the table and did all of the hospital things and then wrapped him all up and gave him to me. I was able to do skin-to-skin and nurse while they put me back together. Then they took him off to the nursery. I remember them asking, “Do you want your husband to go with him?” I’m like, “Yes.” I think it was just those little things. Those are the moments and tidbits that I think any mom who has experienced traumatic births thinks back on. I didn’t get to touch him right away and I had all of these dreams. I wanted a water birth and my whole pregnancy, I was like, I’m going to pull this baby right up to my chest and nurse him and it’s going to be beautiful. When you have that dream and then you get the most extreme opposite, I mean not to the fact that I was under general anesthesia and it was horrible, but in my mind, it was the complete opposite of what I wanted and it sucked. Anyway, so then we go back to recovery and I’m nursing him and everyone who has had a C-section listens to this podcast or most of them. You don’t really feel a lot of pain until the second and third day when most everything wears off. It was just hard. It was a hard recovery. It was hard to hold him. He was almost 9 pounds. It was hard holding him. When you nurse a baby, they sit on your belly. It was just hard. I also struggled with vertigo and I got horrible vertigo on my last day at the hospital. I was throwing up which is awful after abdominal surgery and they gave me a pill to stop the vertigo. Then the lactation lady comes in and says, “Oh, that’s a level 3 dry-you-up pill.” So then I’m into supply issues and it was just an awful, awful recovery. I hate saying that. I want to be positive, but it just was not fun then on top of that, I was doing triple feeds. I was nursing, then supplementing, and pumping. My milk really didn’t come in for 3 weeks. I was very blessed. When it came in, it was in and I got over the dry-up. All in all, it wasn’t great. 17:47 Second pregnancyEmily: Anyway, fast forward, I got pregnant 6 months later. It was not planned. I remember taking a shower and I have unscented face soap and I could smell it. I was like, Oh my gosh, no. I took a test and it was positive. The baby was asleep. He was asleep in his bassinet right by my bed and I went to my husband, “I’m pregnant.” My husband, I want to give a shoutout to husbands who are supportive and there. I could not ask for a better partner during labor, during births, and recoveries. He is right there. He is an amazing man, so I want to give a shoutout to him. But yeah, so then I’m pregnant again with a 6-month-old and I knew immediately I wanted to VBAC. I started to look for supportive providers and we were in Austin which you would think Austin has wonderful doctors. It is very progressive in the medical industry, but I was really struggling to find a provider who would accept me. A lot of midwives turned me away. Birth centers turned me away. Meagan: Was that because of the duration or just because you were a VBAC in general? Emily: It was the duration. Meagan: Okay. Emily: I should note that. My babies were 15 months apart. Most of the birth centers want you to be 12 months postpartum by the time you get pregnant and then OB offices are a hit-and-miss, I feel like, with any VBAC. But I found, for anyone who is local to central Texas, I found Austin Doulas I think it was what it was called. I called them and they gave me the name of an OB office. They assured me that all of the OBs on staff were very VBAC-friendly. I contacted them. I should note also that when I found out I was pregnant, I called my first midwife. I was like, “Listen.” I love my midwife. We connected on so many levels. I do think there were things done in labor that shouldn’t have happened that catapulted me into the transfer and the C-section, but nonetheless, I loved her. I called her and I was like, “Hey, I would love to do my prenatal care with you and then maybe deliver at the hospital.” This is where my mindset was at the time. She basically told me that yes she could do my prenatal care but I would have to have a planned C-section at 39 weeks. At that point, I was like, Okay. I have learned enough in the little prep I had done in my first birth to know that was not necessary. So I go and she did schedule me for a growth scan because I did not know how far along I was. I ended up being almost 8 weeks pregnant by the time I did the growth scan. Anyway, so then I started my care at the OB office around 12 weeks. They were very supportive. I remember at one of my appointments, they gave me this sheet. It was a VBAC facts sheet and they had you initial every line on every item. It was very much saying that VBAC is safer than a repeat C-section for the right client. I told my husband, “Wow, this is great. I love this.” So we stayed there for a while. I know I shared in my notes I transferred care at 34 weeks. I feel like before I talk about that, I should say that at 6 months pregnant, we moved. 21:16 Moving and switching providersEmily: For anyone listening, unless you have to, I don’t recommend that especially with a 10-month-old. I think he was 8 or 9 or 10 months at the time. It was a lot of work, but we were living in Austin. Austin is very busy. We didn’t have any family around. Our friends were far. It was a good hour drive from any of our friends so we decided to move back to my husband’s hometown where we had friends and family. It was just like we needed to go. As we know, the real estate market was in a really good position. I know it ebbs and flows but at the time, we were like, Now is a good time. Let’s just do it.So anyway, we moved. I was 6 months pregnant when we moved and we continued care at my OB office in Austin. I was driving. I would take the baby to his grandma’s and then I would drive into town, a 2-hour drive for these appointments. At this point, it felt so difficult for me to find care and we live in a small town. Now after the fact, it’s hard to find supportive providers where we are without driving into Houston or Austin. So anyway, around 34 weeks, and this is probably silly on my part, but they stopped calling me a VBAC and started calling me a TOLAC, a trial of labor. Meagan: But they were calling you a VBAC prior. Emily: Yes. Yeah. We got closer and I think also when you’ve had midwifery care and you go to a traditional OB type of care, it’s just worlds different. You get big and big and later and later in your pregnancy and you are hormonal. It was just like, I did not get the warm fuzzies. I was in and out in 5 minutes. I had to ask them to feel the belly to find the baby’s positioning. I had a lot of trauma from the first birth about baby positioning. I worked very hard during this pregnancy to make sure I did everything that I could do to make sure this baby was in a good spot internally. So anyway, the appointments weren’t great. They started calling me a TOLAC. They started telling me things I couldn’t do in labor. They were talking about inductions at a certain time period and scheduled C-sections for X, Y, and Z. I told my husband, “Look, I know this is going to be expensive.” I prayed on it and I was like, I just feel like I need to switch. I should also note that I found this birth center when I was around 30 weeks pregnant and I was always like, Man, I wish I would have found them earlier. But they are extremely VBAC-supportive. For anyone in the Central Texas area, I cannot say more wonderful, amazing things about these women. They are Christian-based, very VBAC supportive, multiple VBAC supportive, wonderful success stories. They do breech births. Meagan: So good to know. Emily: Yeah. In my mind, I’m like, Oh gosh, with my last baby, positioning was hard. I know these women will be able to get this baby out. If the baby flips, I don’t have to stress out about a repeat C-section. Blah, blah, blah. So I switched to them at 34 weeks and like I said, it was the most wonderful care. Everything you would want from a midwifery practice. Meagan: What was their group called again? Emily: They’re called Dulce Birth and Wellness Center and they are in Killeen which if you are familiar with Texas, it’s north of Austin in between Austin and Waco on 35. But yeah. I was driving to that so I was driving an hour and a half to my OB office. I started driving 2 hours to the birth center for appointments. For anyone who is scared to travel in to birth somewhere that you feel fully supported, comfortable, at home, yes it can be difficult, but it is so worth it and even though I didn’t get my VBAC, I would have 1000% done it the same way that I did. 27:47 Going into laborEmily: So anyway, I’m with them at 34 weeks and I go into labor at literally 40 weeks on the dot at midnight on my due date. I was like, Wow, this baby is punctual. Meagan: Yeah. Emily: Yeah, so I started contractions around midnight. It wasn’t active labor. I was in contact with the midwives throughout the night. Around 10:00 AM the next morning, my contractions were pretty steadily 10 minutes apart. My doula, I also had a VBAC-specific doula who works with the birth center pretty closely. She was turned to my point. I asked her, “Can you just be my point of contact?” She was like, “Yes.” So around 10:00 AM, my contractions were 10 minutes apart and they were like, “I think y’all should head in.” My husband was at a meeting 45 minutes from the house so he came home. We packed up. We had all of the birth center cooler food prepped. I was going to bring some beers for after the birth. I was ready. I was so excited.During this pregnancy, I prepared so much. I had chiropractic care. I had pelvic floor therapy once a week. I was doing the stretching, the exercises. I was doing breathwork. I was on it, on it, on it and I was so excited and I was so ready. I just knew that I could do this. So we drove in. I got adjusted as soon as we got into town because it’s a 2-hour drive. We went to the chiropractor and got adjusted. We got a hotel so we could labor at the hotel for a while before we went in. I was talking to my doula and they were all like, “Go out to lunch. Have a good day in the city.” So we ate lunch, checked into the hotel, laid by the pool, went out to dinner, and that was really when we got to dinner. We walked into a Chinese buffet. I don’t know why I thought that was a good idea. We got seated and I told my husband, “I can’t. They are too intense to eat here.” So we went to a sandwich shop, ate some sandwiches and by the end of dinner, I was like, “Okay, we’ve got to get back to this hotel.” Things were picking up. They were 5 minutes apart at this point. We got to the hotel. Our doula comes over. Probably within 45 minutes, I was at 3 minutes apart. I remember thinking to myself, Oh my gosh, Emily. You’re going to do this. Your labor is picking up. The contractions are how they should be. We packed up our bags. The birth center was 10 minutes away from the hotel and we went to the birth center. I was 3 minutes apart. I walked in and I think they got a new location since then, but regardless, the whole setting was just beautiful. Dimmed lights, we had a big birth suite with the pool, and bathroom. I labored and as soon as I got there, they welcomed me with open arms. They are just the sweetest ladies. Like I said, I would recommend this birth center a million times over to anyone even if you are not trying to VBAC. I labored in the shower for a while. That was nice. I had a birth ball in there. I was doing squats. Like I said, I was in a freaking good mindset. I was ready to have this baby. This baby was a surprise as well so I was excited. A surprise gender I should say. This baby was a surprise all around. So yeah, we labored in the shower for a little while then went back to the birth suite. I was in and out of the pool and the bed just doing whatever felt right which is another big reason that I wanted to switch because if you’re birthing in a hospital, you’re on a bed especially if you are a VBAC, you’re strapped to a monitor. At least that’s how they were going to do me. They weren’t going to do the intermittent monitoring because of the VBAC.It was just a wonderful laboring experience. Contractions were picking up. They were starting to become not on top of each other yet, but I would say a minute apart. Meagan: They were a minute apart? Holy cow. That’s on top of each other. Emily: When I tell my stories, my friends are just like, “Oh my gosh. You’re just insane.” I’m like, I can’t be the only one who labors like this who has had these types of births. Like I was sharing with you earlier, I just wanted to find similar stories because it’s the similar stories that help you work through things in my opinion. So anyway, I got onto the toilet and they had the TENS unit on my back. That was okay. I had heard a lot of women. I listened to a natural birth podcast as well during this pregnancy and a lot of women were like, “The TENS unit was awesome.” Personally, it didn’t do anything for me. We went back to the bed. My water broke naturally and that’s when it was like contraction, contraction. It was no break at all. I guess I didn’t know any of this, but they went and got Trevor, my husband and they were like, “The baby is coming. It’s time.” They were like, “Okay, it’s time to push.” I pushed forever. 33:20 Pushing for 5 hoursEmily: I was on the birth stool and I just kept pushing it felt like. I’d be like, you know you’re in labor and you’re unmedicated. You have choice words like, “Where is this baby? What’s going on?” I had chosen not to get cervical checks because the last time, cervical checks just really messed with me mentally with progression and everything. Anyway, I was on the birth stool and I was pushing. It was nice. I was on the birth stool with the hanging thing from the ceiling. Meagan: Yeah, like a rebozo. Emily: Yes. Meagan: Were you having the urge to push? How did they feel like you knew?Emily: Yes. Meagan: Okay. Emily: And I’m sorry if my story is sporadic and all. Meagan: No, it’s good. This is good. Emily: But yeah, I had the urge to push and I had really done a lot of practice of breathing. You hear these women, “Oh, I breathed my baby out.” Anyway, I was trying to breathe and finally, they were like, “Okay, I think it’s time to push,” and I was like, “Okay, thank God. I’m ready.” So I pushed and my husband would tell me after the fact, “I mean, I was so excited. We were going to have this baby at a birth center.” He was like, “I could see this much of her head. She was coming.” Meagan: Oh, okay. Emily: Long story short, I pushed for 5 hours. I decided to get checked because I was like, What the heck is going on? I was fully dilated. I was practically crowning at this point, but she checked me and I had a cervical lip. I hadn’t done a lot of research on that. I do know that sometimes they naturally push out of the way, but she had me do some different positions during contractions to get the lip to go away. Then finally, as a last resort, she tried to push it away during contractions and that was just so painful. I just remember it being so painful. I know you’re unmedicated and you can feel everything. At that point, I was like, “Just give me the numbers. What are my chances to get this baby out here?” She was like, “Emily, I’m going to give you a 60/40.” At that point, I was like, “I need to transfer.” They were trying to get me to breathe through contractions and to not push because I was so swollen. It was like I couldn’t. My body was just doing it and I had no control. 35:45 TransferringEmily: So to speed things up, we transferred to the hospital. It was the same hospital system which I was grateful for. That’s St. David’s in Austin. My first baby was born at Main. This baby was born at the North hospital, the women’s center. They are very holistically minded, as much as you can be at hospitals. That transfer was a 50-minute drive so that was fun. I was like, Here we go again. Let’s do this transfer. We busted into triage, guns hot. They knew I was coming. I got my epidural pretty quickly within 30 minutes. They had me push a couple of times then they checked me and they were like, “You’re an 8.” I was like, Okay. Here we go again. Meagan: Swollen. Emily: Very swollen. I know I had probably regressed on the drive over just with everything going on. I’m trying to speed my story up so I can get to my thoughts and reflections on it, but basically, I labored at the hospital for a very long time. They started Pitocin. I know I keep saying long story short and it’s just a long story, but they came in. The baby’s heart rate wasn’t doing well. They took my temperature. It was 103. Boom. I had an infection. They gave me Tylenol. It brought the fever down, then around 2:00 AM and this was two days later. I don’t know with the timing how to explain it, but they were like, “It’s time.” My midwife and my doula who came with me agreed. It was nice that I had that second opinion. I just was so upset. I was crying. My husband was crying just because he knew. I think he just knew how badly I wanted it and how hard we worked. Meagan: Yeah. Emily: Anyway, I met the surgeon and he was wonderful. He was like, “What do you want? I want to make sure this is done right.” He gave us everything we wanted. Delayed cord clamping, my doula was in there. She took photos and everything. 37:47 C-sectionEmily: The C-section wasn’t great. I’m glad I had my doula in there. She was a VBA3C mama so she knew her stuff. I’m explaining, “I can feel tugging. I can feel this and that.” She was like, “That’s normal.” I didn’t feel that with my first C-section.Yeah, they pulled her out. She was a baby girl. She was freaking screaming bloody murder, nothing like my son. My husband had announced both babies. He said, “It’s a girl,” and they let me touch her immediately. I just wanted to touch her and this is probably weird, but I feel like moms understand this. I wanted to touch her fresh out, blood and all. That’s my baby. I was able to do that and they took her away. I had a really bad infection, chorio. They had to flush my uterus and my abdomen. I was on double antibiotics for three days in the hospital. They were having to– I call it stabbing. They stabbed the baby every day to check on her and it was tough. I had in my mind, “When did this infection start?” I didn’t get checked until the very end. I don’t know. Yeah. It was hard. When we were in the C-section, he was like, “Who did your last C-section?” In my mind, I’m like, That’s a great question, why? “What’s wrong?” He was like, “You have really bad adhesions.” He fixed everything up. He came and checked on me the next day. Long story short, I will birth at this hospital again. But it wasn’t a healing Cesarean. It was tough. Again, the nursing, the pain. I feel like both times, I really struggled. I’m not saying I didn’t bond with my babies, but I think the toughest part of my births were the postpartums. It’s such a hard recovery. I feel like people who have never had a C-section before, they don’t really understand. I’m not saying that vaginal births aren’t difficult to recover from, but it’s not full-blown abdominal surgery and then boom, caring for a new life. I couldn’t hold the baby like I wanted to. I couldn’t do the things I wanted that I dreamt so hard of when I was attempting this VBAC. This mentally was hard because it was like, boom. A double C-section. All I’ve ever wanted were hands-off, holistic births. That’s why I struggled so much with the two C-sections. I don’t want to knock anyone. I had very supportive friends and family, but the “at least you have healthy babies”. Yes, I know I am so blessed. I don’t want to downplay that because I know a lot of women who don’t get that, but it doesn’t fix the birth and how awful it was. It was a tough C-section. I had incision issues, but I healed up and I was fine. I started scar work right away. I went to my pelvic floor therapist. She had me doing diaphragmatic breathing. I know I need to wrap up. So to kind of summarize, after my first C-section, I don’t think I took the steps necessary to really heal myself with the scar work. I was petrified to touch my scar. I’m sure other people can relate to that. Then I was pregnant and I was like, Well, what’s the point? It’s stretching out anyway. 41:29 Tips for adhesionsEmily: To any mom who has just had a C-section or is preparing for a VBAC or a birth and you don’t know if you are going to have a C-section, that scar work and that internal breathing, that pelvic floor is huge on your recovery. I learned so much about adhesions. Last time, it was the baby positioning. With this next baby, I’m going to be freaking out about adhesions. But yeah, it was tough. So my midwives, bless their hearts. They do a home visit 3 days post-birth. They drove all the way out to where we were to do a home visit. They brought us dinner and my midwife was saying, “Emily, I could not believe that that baby was not flying out of you. You have a great pelvis. Your contractions were so strong. Your pushes were strong. I just could not believe it.” She was like, “I think it was the adhesions.” I had never even heard about adhesions which is silly. Again, prepping on my part, why did I not know about that? But yeah, so that is what they think held her in. It was a baby girl. I don’t know if I said that. Meagan: Adhesions, really, that’s a really common side effect or I don’t really know the right– it happens after a C-section. Sometimes it can happen more and we have really dense or many adhesions and then sometimes people have lower. That’s why I love pelvic floor therapy and people like Ask Janette on Instagram because they do talk about that care early on and how important it is early on. So many people like you don’t feel comfortable touching

Today’s episode is full of love. Meagan’s doula partner, Christin Carlson, joins as co-host today to hear their client, Janelle, share her beautiful VBAC story.Janelle’s first baby was determined to stay frank breech even after two ECV attempts. Her water broke on its own before her scheduled date. In prep for her surgery, Janelle unexpectedly experienced vaginal cleansing. Though the surgery went well, it was not the introduction to motherhood Janelle was hoping for. She was also hit hard with postpartum depression. Janelle shares how she found The VBAC Link and became obsessed with all things VBAC prep. Surrounded by the most loving and empowering team, they helped her stay steady when labor was most intense. Even though it was harder than she imagined it would be, Janelle was able to dig deep and achieve the unmedicated VBAC she desired. Vaginal Cleansing ArticlePostpartum Depression ArticleHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:40 Janelle’s PPD experience07:25 Janelle’s stories12:06 Arriving at the hospital14:05 Janelle’s C-section17:00 VBAC preparation19:24 Appendicitis and second pregnancy24:22 Going into labor27:35 Laboring at the hospital30:30 Transition34:21 Achieving her VBAC38:47 The power of a supportive partner43:53 What is vaginal cleansing?50:26 Symptoms of postpartum depressionMeagan: Hello, everybody. You guys, today I have a very special episode to my heart because this is one of our own doula clients here in Utah and another even more special thing is that this is my partner, Kristen who ended up attending her birth, is co-hosting. Hello, Christin and Janelle. Janelle: Hello. Christin: Hi. Meagan: How are you guys today? Janelle: So good, so good. Meagan: Before we started recording, we started talking about time and how fast things are going. You guys, I mean I think you probably know if you are pregnant or have a newborn in your arms how fast time goes, but really, holy cow. We were with Janelle, we just talked about, 8 months ago from the time we are recording which is wild to think about. Janelle: So weird. So weird. It’s crazy. Christin: It seems like it was a couple of weeks ago. Janelle: Yeah, it’s not fair. Meagan: I know. How have things been? How have you been going with postpartum?Janelle: Things have been really good and I think that’s one of the things that pushed me to want a VBAC so badly is I was hoping for a better postpartum experience. I had pretty severe postpartum depression with my first baby and I felt like having the VBAC would be some sort of heavenly gateway into not having postpartum depression. In the beginning, that was true, but I ended up still having some of it. Things are good now, though. Meagan: Good. I actually love that you touched on that because I think that sometimes especially after a traumatic Cesarean or a traumatic experience that did lead to postpartum depression or anxiety or anything like that, that can be a big motivator for a different experience. I love that you talked about, “Well, it was a better experience, but I still had this a little bit. I’ve had to work through that.” I’m glad that you’re good now, but even sometimes when we have a different experience, we have similar things. So it’s important to recognize that. I love that you just pointed that out. Janelle: Yeah, for sure. Yeah. Meagan: Before we get going into the episode, do you have any tips on tackling that the second time around too? How were your feelings about things when you were starting to feel it and see it creep in? 02:40 Janelle’s PPD experienceJanelle: Well, with both experiences, it did creep in just like you said, but with my daughter, it felt really dark really fast. She was my first baby and then with my first son, the VBAC, it was kind of a little bit sneaky. I guess just having someone on your support team. For me, it was my husband and I just said, “Look, if you see any of these signs, please say something to me.” It wasn’t like we had a code word or anything. He was just really open in his dialogue with me and said, “Hey, I think something is up with you. You are not your normal self.” As soon as he said that, I was like, “Yeah. You’re right.” It was really hard to admit because you want to be this strong mom and you want to be there for everyone and be everything that everyone need, but sometimes that’s just not how life works. It’s literally a chemical imbalance in your body and in your brain. It has nothing to do with your circumstances. Just having someone on your team and on your side to say, “Hey, I love you. Let’s get help,” was absolutely integral to helping me get on the other side. Christin: I think it may have helped because you had been through it before so you were aware of the warning signs. That’s something I think that we don’t realize because I struggled with postpartum depression too but it didn’t happen until my third baby so I didn’t have any inclination that that was even something that I was going to deal with. I think it’s important. We do all of this work to prepare for our VBACs and to prepare for the arrival of a new baby, but sometimes I don’t think we educate ourselves on what those warning signs of postpartum depression are because they can be very sneaky. It’s not always deep, dark thoughts. Sometimes it’s postpartum rage or postpartum anxiety where just you are either extremely emotional or extremely angry all of the time. To have your husband looking out for you or someone on your support team who is keeping an eye out for those things and noticing a shift in the way that you’re behaving, I think, is super important. I think that’s great that you guys have had this conversation ahead of time. Meagan: Yeah, and we will talk a little bit more about some of those signs and symptoms. Like Christin was saying about how they can differ between rage, anxiety, depression, and the baby blues a little bit more at the end for sure because yeah, I think Christin just nailed it. We focus so heavily, and I think even more sometimes– I don’t want to say this as a fact, but sometimes I feel like more as a VBAC mom, we are so hyper-focused on the end result of a vaginal birth that sometimes I feel like we do forget a lot. That’s like everybody. I think they are so focused on getting baby here, but VBAC sometimes has to fight harder, search harder, read more, and emotionally work through things a little bit more so yeah, we can forget. Then that creeps in or like Janelle said, it was like boom and darkness came over. We want to know how to handle that so we will talk a little bit more about that in the end. 07:25 Janelle’s storiesMeagan: Okay, you guys. I wasn’t there, but in our practice, we have something that is like a live timeline that we have so whoever is at the birth can take notes of the timeline and we like to share that with our parents. We were all just sitting there watching it, checking in, and I just remember feeling this utter excitement inside of me for them as I was looking at the notes and following along with Christin’s updates. I’m excited to now be here with you both and hear it in a different way. I’m going to turn the time over to you. Janelle: Yes. I’m so excited. I was actually telling Meagan before we started that I was actually fangirling out. I don’t know exactly how I got started listening to The VBAC Link, but after I had my daughter, somehow I got onto it and I binged so hard on this podcast. It’s just really surreal to be recording with you. So thank you for allowing me to be here. Christin: You’ve come full circle. Meagan: Full circle. Janelle: I have. Meagan: I love that that happens with The VBAC Link. I love that it’s so often that it’s like, “I listened every day. You were in my ear and now here I am being in someone else’s ear. Janelle: Yeah, yep. So just to all the mamas out there who are preparing, you’ve got this. You can do this. With all VBACs, of course, there is a Cesarean that starts the story, right? We tried to get pregnant with my daughter for 14 months. We finally got pregnant and the pregnancy was super easy. I was going for a HypnoBirth unmedicated birth. I didn’t have a doula. I didn’t really have– I don’t know. You just don’t know what you don’t know and as a first-time mom, you think you know, but you don’t. You just don’t. Meagan: Or we have apps that tell us so we really think we know because the app said so. Janelle: Yes, but then you just don’t know until you’re in it. I gained 60ish pounds which was a lot, but I never had hypertension or a lot of issues with that. I never ended up with gestational diabetes which I was really grateful for and worried about, but in hindsight, it really wouldn’t have been a big deal. At my 36-week appointment, we found out my daughter was breech. Homegirl was freaking stuck. Let me just tell you, she has been stubborn ever since. We tried everything. We decided to do an ECV. We did it at 37 weeks and we just did that. I think a low dose of Fentanyl was the only medication. I was just trying to use my Hypnobirthing to breathe through it. The doctors told me that I was doing really well, but she was just stuck, and that one failed. We tried going to the chiropractor. We tried Spinning Babies. We tried basically everything that I could think of. We did not do acupuncture. That’s the only thing that we didn’t do and I never hired a doula. I could have done those things, but I didn’t. We tried a second ECV at my 38-week appointment. We did that one with a spinal block in the OR because they were like, “Well, sometimes on the second attempt, it can throw you into labor.” So I was like, Okay, well if that happens and we have any problems, they can just do a Cesarean right there. She was very, very stuck in my pelvis and the maternal-fetal medicine doctor actually tried to push her up vaginally and that was unsuccessful and very uncomfortable. Even though I was numb, it was still like, This is weird. I don’t know. I don’t like this. She just was stuck. She was frank breech, so I was like, Okay. We’re just going to go through with the Cesarean. I had 2 more weeks so two days later, I went out to dinner with a friend and then that night when I was sleeping, I got up to pee like you do a million times when you’re pregnant at the end and some water was leaking out as I was walking back from the bathroom and I was like, What the crap? I just peed. How is this happening?My water had broken and there was meconium. I knew that it was going to be a little bit of an issue with meconium just because my doctor told me something like they were just worried about meconium with a breech baby. I don’t know. I don’t know if that’s true or evidence-based or not. 12:06 Arriving at the hospitalJanelle: We drove to the hospital and we got there at 5:00. They had to do a COVID test and they cleaned me out. I don’t know if you’ve ever heard of that. Meagan: Like rectally? Janelle: No, like vaginally. They took some sort of– Meagan: They cleaned you out vaginally?Janelle: Yeah, I don’t know if it was because of the meconium, but they took some iodine-something and it felt like a membrane sweep. I never have had one of those, but if I could imagine what that was like, that’s what it felt like. Meagan: Christin, have you ever seen that? Christin: It’s funny that you say that because I had never seen it before until Janelle told me that she had it and I was like, That just sounds so odd, but I actually just saw it at a birth the other day. Meagan: What is it for? I actually don’t know what this is. Christin: I had never seen it previously and I thought it was just an anomaly with your birth, Janelle, but I saw it the other day again. Janelle: Do they have a name for it? Meagan: I’m Googling it right now. Christin: They didn’t name it. They just used iodine swabs and just cleaned her out. Janelle: Was that also for meconium? Christin: Yeah. Janelle: Okay, interesting. Christin: Now that I think back on it, there was mec but I don’t think we knew there was mec until baby was born so I don’t know. Janelle: Oh, interesting. Okay. So yeah, that was the most unpleasant experience ever on top of mid-contraction, I was having the COVID swab up my nose so that was really great because this was early 2021. So yeah. Anyway, we waited for the ORand the nurse came in. I asked her, “Can you check me? I know I’m going back there for surgery, but I’m just curious. I’m having contractions. Can you just see if I’m dilating?” She’s like, “Yeah, you’re at a 4.” So I was like, "Oh, that’s kind of nice. My body’s actually doing the work here.” I was really excited about that. 14:05 Janelle’s C-sectionJanelle: Jumping to the surgery, I was so terrified. I don’t know what it was. You’re just going through so many emotions. You have to put so much trust in the nurses and the doctors and the anesthesiologists. You have to put so much trust that these people paid attention in med school that they know what they are doing, that they care about you, they care about your baby, and chances are they totally do and they did pay attention and they got good grades, but I just felt nervous as a first-time mom. They jostled me around and the anesthesiologist was really nice and he was just talking to me and telling me everything that was happening. When she was born, I knew it because I felt them yank her out. They had a clear drape, but I couldn’t see over it so I was really sad that I couldn’t see her. Because of the meconium, they had to take her and they cleaned her up and stuff. I was 16 minutes or something before I got to see her. In hindsight, it’s not that long, but it felt like forever. Then I got to see her sweet little face and oh gosh, it was just the most precious thing ever. My husband snuck a video of it. You’re not supposed to in the OR, but he snuck a video of it and it’s such a treasure for me to look back at the moment that I got to meet her because I didn’t get to be the first one to hold her. Yeah. Christin: I love that he did that though so you have the record of that memory. Janelle: Yeah. I never even asked him to. He just knew that I would want that. He’s the best. One thing I didn’t know about postpartum regardless of if you have a C-section or a vaginal birth, your nurses will push on your abdomen and it hurts like a mother trucker. Let me just tell you. Meagan: Crede-ing. Janelle: It’s what? Meagan: It’s called Crede-ing. They Crede and they are checking where the uterus is, if it’s clamping down, and making sure it’s not getting boggy and filling up. Janelle: Yep, and if you’re bleeding too much or not enough. It sucked. Then I had really bad postpartum depression. This one was not sneaky. This one was almost immediately. I felt like I bonded really well with my daughter, but there was just some darkness that was in my heart and I couldn’t figure out what it was. It took a while. I was actually maybe 6 or 8 weeks at my postpartum appointment and my doctor did the screening. She’s like, “Yeah, your score was really not good. Let’s get you some medication.” I was like, “Okay.” I was very reluctant, but I saw almost an immediate difference. I had it for a while, but it did help. 17:00 VBAC preparationJanelle: Anyway, so that was my daughter’s birth and ever since then, like I said, I was obsessed with The VBAC Link. I knew right away that I wanted a vaginal birth. Actually, come to think of it, right before we went back to surgery, I was talking to the doctors and I was like, “I really want to have another baby after this. Is there any way you guys could make sure that my scar looks really good and I could have more babies vaginally? That’s really important to me.” They were like, “Yeah. We will make sure you are taken care of.” I was very grateful for that. What I wanted out of this birth, I don’t know if what I told Christin is still what I have on my birth plan that I wrote down, but what I really wanted was a healthy mom, a healthy mindset, and a healthy baby obviously. Those are the minimum, right? Then I wanted baby out of my vagina. I wanted skin-to-skin. I wanted to be the first one to hold baby and I wanted to be fully present and fully included in all of the decisions. I don’t know if it was just, yeah. I don’t know exactly why that was so important to me at the moment, but it just felt like I didn’t want any of this robbed from me. I didn’t want any of the experience to be done to me. Do you know what I’m saying? I wanted as few interventions as possible. Those were what I really wanted out of this birth. Is that what you have, Christin?Christin: Yeah, pretty darn close to that. I also have skin-to-skin was super important. Janelle: Yes. Christin: And I think it’s worth noting that you wanted to catch and deliver your own baby. You said I wanted to be the first one to hold her– sorry, hold the baby boy– but you also told me that was super important to you. You actually wanted to deliver your child. Janelle: Yes, okay. With my son, my daughter was maybe 20 months old. It was the Sunday before Thanksgiving and I felt some pain in my side. We had been trying for 6 months and something was just wrong. I didn’t have a big appetite and it was Thanksgiving dinner at my mom’s house and I just didn’t feel good. Something intuitively was just wrong and I knew it. My husband was like, “Well, why don’t you just try taking an antacid?” I was like, “No. I know something is wrong.” 19:24 Appendicitis and second pregnancyJanelle: We went to the ER and I had appendicitis and I was pregnant. So that was really fun to find out all at the same time. Because I was 3 weeks, 4 days pregnant, I had not even missed my period. I hadn’t taken a test, they said that nothing in the surgery would change because baby was still so small. I was like, Okay. Well, that’s good. I was really nervous for the surgery and that there were going to be complications afterward, but everything was fine. As soon as I started to heal from surgery, I got so nauseous. I was so sick the whole pregnancy until maybe 25 weeks. That’s when it finally started to wean off. Like I said, I lived in VBAC mode. I binged the podcast on the daily. I went on walks. I would listen to it while I was cleaning, driving, naptime, all of the things. I also was very into the Evidence-Based Birth Podcast because I was very curious about water birth and home birth and all of the statistics. My husband actually pulled me aside while I was in crazy VBAC mode as we call it. He was like, “Janelle, I’m just worried if you end up having a C-section, where are you going to be at mentally? Are you going to be okay with this if that ends up being your path?” I was like, “You know what? I really do need to prepare for that too,” because things really can go in any direction with birth. As soon as he said that to me and I started to prepare that way, I just became like, Okay. Whatever happens happens. This is okay. I did have the same VBAC-crazed mindset but I was also okay with things happening. I don’t know if that makes sense. Meagan: Yeah, it totally makes sense. I think a lot of the time as we are preparing for that, it is important to note that things can go and still prepare for the other but prepare, prepare, prepare, and then do all of those things while you are preparing so if it doesn’t happen, then you don’t have to look back and be like, But what if this and what if that? Then you are confident in the way you prepared, but then you know, Well, it could go this way. It’s not what I’m going to plan for, but it could go that way and I’m going to be more content because I’m doing everything within my control. Janelle: Yes. At 20 weeks, my insurance changed and I had to find a new provider. That was a whirlwind. I actually found my midwife through The VBAC Link list of providers. Her name is Kira Waters and she is the best. I love her so much. The first thing that I said to her when I interviewed her was, “How do you feel about VBACs?” She said, “I love VBACs!” I was like, “Oh my gosh, okay. Say no more.” Yeah, after we met Kira, then we were on the search for a doula. I came across you guys. I met with Christin and the stars were just aligning like, this is going to work out. This is going to be perfect. I don’t know how to explain it. It wasn’t like an instant connection, but it was this deep trust that I instantly had in her if that makes sense. Meagan: Mhmm, yeah. Janelle: It was almost like I’d known her for a long time, but not like a high-school friend. She’s my long-lost aunt, I guess. She’s full of wisdom. Christin: I’ll take it. Meagan: Well, and there is something about a doula. Don’t you think? Fun fact, Christin and I actually had the same doula, but there was something about our doula– her name is Robin. She is amazing. I didn’t even know her that well. I mean, I knew her through the birth community and stuff but I didn’t know every detail about her, but there was this weird sense of confidence where I was like, It’s going to be fine. Then her partner, Angie, was also somebody who I was like, I know she has to be in my corner. I just knew that those two people had to be on my team and yeah. It wasn’t like I instantly knew them and felt the connection of being childbirth friends, but I was so deeply connected right away and still am to this day to them. Janelle: Mhmm, yep. It’s interesting. I’m kind of a private person and I didn’t want my mother-in-law or my mom in the birth room, but as soon as I met Christin, I’m like, “Yep. Come to the birth.”24:22 Going into laborJanelle: Let’s see, I think it was my 34th or 36th appointment and I met with the OB because if you are with the midwife, they want you to meet with the OB. He did the VBAC calculator. I think it said 47%. It was 47 or 50% chance. It was a pretty moderate chance of success. He was really nice, but I just was like, Eh, I don’t really want him to deliver my baby. Let’s see. I had gained a similar amount of weight, but again, no hypertension. Everything was pretty much the same to this point other than baby was head down at this time. I was 37 weeks and I went out to dinner with a friend. Fun fact, it was the same restaurant and the same order. That night, I went into labor. Christin: You’re onto something. Janelle: It was Zupas. Meagan: I was going to say, what was it? Zupas? Janelle: It was Zupas. Christin: Now we have to get your order too. Meagan: What was your order? Janelle: I want to say it was the pulled pork sandwich. Maybe one of the soups, like the cheesy soup, the Wisconsin…Meagan: The Wisconsin Cauliflower? Janelle: That one, and then the pulled pork sandwich. That’s what I ordered both times. So if you want to go into labor…I don’t know if that’s even tried and true, but it was so interesting. Christin: I’m pretty sure it’s not evidence-based. Janelle: No, but for me. Christin: For you it is. Meagan: You’ve got some good stats. Janelle: Yeah. So I went into labor that night and my husband, I didn’t say this before but when I went into labor with my daughter he was like, “No!” because it was so early and he’s a gamer so he was up that night playing games on the computer and he was just really tired. The same reaction was had from him this time too. He was like, “No!” Christin: It was early in the morning. Janelle: He was like, “Dang it!” I wanted to labor at home as long as I could so let’s see. I think we texted you pretty close to that time. Was it at 4:00 or 5:00? Christin: I got a text at 3:06 AM that you thought your water broke. Janelle: Yeah. So I labored at home in the tub for a while. My husband made me the best peanut butter and jelly sandwich that I ever had in my entire life. I ate a peach. I just hung out in the tub. When I would listen to the podcast before bed, I would listen in the tub and hang out and relax. It was a safe space for me that I was very used to. I hung out there for a long time. It really wasn’t that long, but when you’re in labor, it feels like a long time. I had my mom come over so she was with our daughter. Once my contractions were 4-5 minutes apart, we were like, Okay. Our hospital is 30-45 minutes away. We should probably head in just to be safe. 27:35 Laboring at the hospitalJanelle: I got admitted around 6:00. Is that what you have, Christin? Christin: Yeah. It was around 6:00, a little bit before 6:00. Janelle: I agreed to be checked at that time. I didn’t want a lot of checks because I didn’t want to introduce bacteria by having my water being broken, but I was curious about where I was at. They said I was at a 4. I told the nurse beforehand, I was like, “I don’t want to know,” but she let it slip. She was like, “Oh, you didn’t want to know, huh?” I was like, “No, but that’s okay.” Meagan: Isn’t that where you were with the first one?Janelle: Yeah, kinda. I was like, Okay, well at least I got this far before. She said I was 50% effaced and -2 station. At this point, my husband and I were kind of clueless because we only had one meeting with Christin. We hadn’t gone over counterpressures. We hadn’t gone over how he was going to be actively supporting me in birth so we were just like, Okay, now what?Christin: I think we had your second prenatal scheduled for the day after you went into labor. Your baby just decided to beat us to the punch. Janelle: He was so excited. He just wanted to be a part of it. We were really clueless and I started feeling the contractions really intensely. I was not as prepared as I thought I was for contractions. I was second-guessing all of my life decisions because I again even wanted to be unmedicated. I even signed a consent form for the epidural at this point. I was like, Okay, just call it. I’m done.Christin: Christin joined us I think an hour after I got there around 7:00. The second that she stepped in the room, the energy just shifted. I don’t know how to explain it. She just brought so much excitement like, I’ve got this. I got you. It’s all right. It’s going to be okay.I know she wasn’t intending to be my savior, but she kind of was in that moment for energy’s sake. I don’t think I could have done it if she hadn’t walked in with the confidence and the joy that she had, just the excitement for birth, the passion to be there, and it just made such a huge difference in our experience and I just love you so much, Christin. Thank you. Christin: You’re going to make me cry. Meagan: She’s all emotional. Janelle: We’re all just crying here. It’s fine. Christin: It’s really the best job in the world. It’s the best job. Janelle: It’s really a sacred space. Like I said, I didn’t have my mom or my mother-in-law there. I just wanted it to be very intimate and Christin was so good at honoring how intimate it was. 30:30 TransitionJanelle: Let’s see. Let me jump back to the story. Around 10:00, I got a new nurse. This nurse was awesome. Her name was Alisha and she was at St. Mark’s. If you ever get Alisha at St. Mark’s, she is a godsend. She was great. There were multiple times where Christin, Alisha, my midwife Kira, and my husband were all taking turns doing counterpressures on me. They all synced up and were so harmonious. Okay, so at 10:00, I was still 4 centimeters, 100% effaced. I labored in the tub at this point for a while. It really wasn’t that long, but in the moment, it felt like a long time. I loved and hated the tub because I didn’t have anything to brace myself on. Michael, my husband, couldn’t give me any counterpressure in the tub, but the relief afterward in the water was so amazing. I really loved that and then Christin was like, “I’m going to leave you two alone and have a little moment.” I think you had even brought these little tea light, like the electric tea lights. You had set those up in the bathroom and the lights were dimmed. It was such a special, sacred moment with Michael and I. He just was like, “I really get why you hired her. I love her. She is amazing.” I was like, “Yep. This is why.” He was like, “Yeah, we don’t ever want to do birth without her.’ Christin: Have more babies. I’ll be there. Janelle: Yes. Undecided. But we do, absolutely. Christin: Fair enough. Fair enough. Janelle: That was at 10:00. I was at a 4. Then I got in the bath. At 11:15, I was out of the bath by then. I had a cervical check and I was at a 7. I jumped a lot in that time. I was doing a lot of work. I was 100% effaced and I was at 0 station. I was moving all over in positions. We did the throne position. There was one where I was on hands and knees on the birthbed, but I didn’t have the birth ball. At 11:40ish, I was feeling really pushy and I got so emotional. Christin will remember this. I sobbed. It was ugly crying for a good half hour. This is now what we know is transition, but it was rough. I was having Charlie horses and oh, it was just rough. I just was crying a lot. I don’t know exactly what was happening, but I just was preparing, I guess, and releasing emotion for the baby to come out. Around 12:30, I was pushing here and there, and around 12:45ish, I started really pushing. Again, at this point, I was in the lithotomy position which is sitting upright how you picture in movies and stuff how people have babies. I was screaming this baby out. I was the loudest person on that floor of the hospital for sure. Meagan: I think there’s something to it. I think sometimes roaring your baby out is what people need. Christin: Absolutely. Janelle: I was absolutely a screamer. Christin: It’s funny because I don’t remember you being loud. Janelle: Oh my gosh, really? Christin: Yeah, I don’t remember it. Janelle: Oh, praise be. That’s great because I remember at one point– Christin: There’s a good chance you weren’t as loud as you thought you were. That happens a lot of the time. You think you are very loud and you probably aren’t. But I mean, there’s nothing wrong with that. A lot of women roar their babies out and it’s very powerful and very primal and natural to do so. Janelle: Mhmm, yeah. 34:21 Achieving her VBACJanelle: I remember at one point, there was a nurse that came in. I could tell she was one of the baby nurses because she had the baby cart and stuff. I was in mid-push and I remember saying, “Get the f- out!” I’m pretty sure that everyone in the room thought I was talking about the baby, but I was talking about the nurse. I was like, “Get out!” Meagan: Like, “I don’t want you here.” Janelle: I was like, “I don’t want anyone in here seeing this. It’s ugly.” Meagan: Oh my gosh, that’s funny. Janelle: Anyway, so I finally pushed the baby out at 1:30 so I was pushing for an hour. The moment that I got to push him out, I was very emotional and my midwife handed him to me and helped me finish. She delivered the first part of him and I had a little bit of a cervical lip so she was like, “You’ve got to really push him out,” or maybe it was the shoulder. Was it the shoulder that was stuck? I feel like I’m butchering this last part right now. Christin: No, you didn’t have an official shoulder dystocia. He just needed a little extra strength to get the rest of his body out. Janelle: Okay, yeah. That’s where we were at. She was like, “You really need to push here.” I just remember like you said, roaring him out. She helped me pull him to my chest and having that warm, gooey, slimy baby was just everything that I could have hoped for. I would not change that for the world. That oxytocin hit that you get from smelling that baby that comes out of you is just unreal. I was so happy that I got to be the first one to hold him and see him. I just am really, really grateful that I had the support that I did because I don’t feel like I could have done it without my husband, without Kira our midwife, without that nurse Alisha. Okay, like I said, I am butchering this best part because I forgot to say so many things that I wrote down. Okay, let me back up a little bit. So right around the time that I was crowning, I just felt like my skin was crawling and oxygen was not enough for me. I couldn’t get comfortable. I couldn’t get on top of my breathing. I was asking for an epidural. I had already signed the consent form, but my nurse Alisha was like, “Oh, the anesthesiologist is busy and by the time he comes, it’s going to be too late so sorry.” Sneaky little nurse because she knew what I wanted. I actually asked for a local anesthetic. I was asking for lidocaine or something. I was like, “What do you use to stitch people up? Use that on me because I am struggling here.” My contractions were, Kira told me they were three little ones and then one really, really big one then I would have a 5-minute break. That’s how my contractions were up until the

We can hardly believe that we have recorded 300 episodes! Meagan brings Julie on the podcast today to take a look back at how The VBAC Link Podcast started, the growth they have both experienced along the way and where they are now. Since 2018, we have shared laughter, tears, heartache, and joy through your stories. Thank you to all of our listeners and guests for your support. Together, we are changing the birth world for the better through all of our ripple effects!Meagan promises to continue the journey and bring you more powerful stories. It’s been quite the ride and we don’t plan on stopping anytime soon!Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:11 Review of the Week04:05 How the podcast started12:09 How the podcast has grown 16:40 Changes in birth22:11 Celebrating differences within the birth community28:45 Challenges bring growth35:35 Julie’s photographyMeagan: Hello, you guys. Today is a very, very exciting– for me at least and I’m sure for Julie– episode because it’s the 300th episode. 300 and Julie is here with me because I couldn’t share this exciting episode without her. Julie: I cannot believe it. I seriously cannot believe it. So wild. Meagan: It’s so crazy. 300 episodes and we’ve had so many other crazy things like special episodes so it might even be more than 300, but it is the 300th on my form and I’m really, really excited. We want to share more about where we are today but also recap a little bit about where The VBAC Link started. I know we have a lot of listeners who have joined us in more recent years. We started in 2018. 2018, is that right? Julie: Yeah. Meagan: So we have a lot of new listeners who maybe don’t know our full story and know what we are and what we’re doing and all of the things. 01:11 Review of the WeekMeagan: So we are going to be talking about that, but we do have a Review of the Week. I’m going to share that. It is from Michelle. She listed this on Google and it says, “Thank you so much for inspiring and informing me through the journeys of VBAC mamas. As I prepare for my VBAC in October after a recent traumatic Cesarean, I feel empowered, motivated, and healed knowing that there are so many women who are out there preparing in the same way that I am. I recommend this podcast to all mamas.” Now, this was about a year ago so I’m assuming Michelle has had her baby. So Michelle, if you are still with us, let us know how it went and as always, if you wouldn’t mind leaving us a review, it helps all of these other Women of Strength find these amazing stories and information as well as our blog and all of the wonderful things I believe that we provide. You can do that on Google. You can do it on Apple Podcasts. You can even send us a message or on Spotify. I mean, really wherever you are listening should have a ranking– Google, Apple, or wherever you are, we would love your review. 04:05 How the podcast startedMeagan: Okay, Julie. 300. Julie: 300. I can’t believe it. Do you know what is wild? It’s so funny because I left. I’m using air quotes right now. I know people can’t see it. I “left”. It’s been 2 years. 3 years, oh my gosh. 3. I left in 2021. Meagan: It has. 2021. You did. Julie: My gosh. Isn’t that wild? When is this episode airing? Meagan: May. Julie: May, so it will almost be 3 years. It’s really funny because life is definitely much easier now and more manageable, but there are parts of me that still feel very strongly connected to The VBAC Link. I appreciate you for including me and having me back on the podcast and things like that but it’s also sometimes so weird when I’m scrolling through Facebook and I see The VBAC Link recommended, sometimes people talk about Meagan and Julie still which is so cool, but also it’s sometimes like Meagan Heaton has The VBAC Link and it’s really amazing and she does a great job. I’m like, “Aww,” but also, it’s weird. It’s this weird little thing because I still believe that I made the right decision. My life has a much better balance and everything I needed it to be by letting go of The VBAC Link. It’s right there where it needs to be, but there’s also part of me that is just kind of like, “Man, that was a big part of my life for so long,” and it still feels weird not being in it. Meagan: I’m sure, absolutely. I miss you. I love you. Julie: I miss you too. Meagan: I’m so glad that you come on and join me here and there or take random phone calls when I call you to vent or something. Yeah, you guys. It’s kind of crazy to think that it’s 2024. It’s even more crazy to me to think that I’ve been solo for that long. Yeah. Just thinking back in 2018, I still will never forget the moment that I saw Julie Francom pop up on my phone out of nowhere, out of absolutely nowhere. We knew each other. We knew we were VBAC passionate. We were doulas. I would say we were kind of really kicking off into the prime doula stages of our careers and it was just so crazy. My personality is sometimes where if someone is calling that I don’t really know this person super, super well, I’ll let it go to voicemail and see what they say. Julie: You’re like, “Why is this weirdo calling me?” Meagan: You’re not a weirdo, but we weren’t the absolute tightest doula friends in the community. We just really knew each other and respected each other through going to ICAN meetings and things like that. I so easily could have not answered. I always wonder if I didn’t answer what would have happened. Would you have texted me and said, “Hey, call me?” Julie: Probably. Meagan: Would you have called me right back? Would you have just said, “She didn’t answer.” I don’t know. Julie: No, it had to be you, my friend. It had to be you. Meagan: I’m so grateful that it happened. You and I personally have grown so much over the years. We also have grown a lot as a partnership. We decided to start this company and it was exciting and if I’m going to be honest, I’m going to say that Julie had more positivity or ambition behind her. I was feeling it. I could feel it inside of me. I was like, “Yes. This is amazing and I want to do this. I really want to be part of this,” but I was reluctant a little bit more. She was like, “Let’s do this. Let’s do this. Let’s do this.” I was like, “Oh, my gosh.” Do you remember the day when you called me? You were like, “So, we’re going to start a podcast and it’s going to be super easy and I’m going to edit it.” Do you remember that day?Julie: Yes. I remember. I was in Target. I was walking around in Target. Meagan: I remember where I was. I was in my laundry room. Julie: I was like, “Oh my gosh. We should start a podcast.” I was super confident. In my past life, I worked a lot in the tech field. I had edited a lot of videos and audio and things like that before when I was in the military so I knew the technical side of it would be simple. I thought it would be easy. It’s very simple for me. I knew that we had a lot to say. We’ve never not had a lot to say. I knew that the– I don’t know what the right word is– whole sphere of audio was growing rapidly, like the digestible content of podcasts was a fast-growing entity or whatever. It just seemed like the right thing to do. It just seemed like the right thing to do. I remember I was like, “Oh my gosh. How am I going to convince Meagan to do this?” We were already so busy writing our course and our manual with our doula contents. I think you had 12 births coming up in October that year because you were putting your husband through law school. I was just like, “I don’t know how I’m going to talk Meagan into this.” I feel like you were reluctant but you for some reason just had this hint of, “Okay, let’s just see. Let’s let Julie do this. I’ll get on the phone and talk about it.” Then I was like, “Okay. We’ll do this.” I signed up for a free Podbean account and we did a free conference call on our phones and recorded our phone calls. It didn’t cost anything at first and things are very different now, but it didn’t cost anything at first. I was like, “See?”Meagan: “This is great.” I remember some of the days, I was like, “Okay, sure. I’ll jump on and do a podcast, but I’m driving to a prenatal right now. I literally have 35 minutes because my client is 38 minutes away.” We were recording and I remember back in the day when I was in my husband’s car and his trunk sensor was bad and it was dinging, so oh my gosh. If you guys have listened back to those episodes, wow. Thank you for sticking with us. Julie: At the very beginning. Well, we used to take turns hosting like we would just do one at a time. I remember the first OB that we had on our episode. It was in the teens. I was out in my car in my garage in the middle of summer because my kids were inside. It was the middle of the day and it was the only time they could do it. I remember hiding in my closet so that the clothes would absorb the sound of the audio echoing around so it was better acoustics on our free conference call. Meagan: Oh my gosh, yeah. I remember sometimes when I was in the closet literally under the clothes and Jess, she was one of our clients from Russia and I was in the closet for that one. In the husbands’ episode, I was in the closet on that one. It’s just so crazy. We’ve come so far. Yeah. We had a whole bunch of people who were like, “I want to share my story. I want to share my story.” 12:09 How the podcast has grown Meagan: We were realizing that this is a serious need. Julie: We had to hunt people down at first. Meagan: Yeah, we did. Julie: We would message people at first. Kelsey, what’s her name? Is it Likowski? Kelsey, super cute. She was Episode 8 or something. We were like, “Oh my gosh. She has 10,000 Instagram followers and she’s so cute and she wants to talk to us.” Meagan: I know. That was so weird to us. We went to this little marketing conference thing and we were watching our Instagram account grow and we were watching our podcast grow. We started getting people like, “Hey, I heard,” and we were like, “Whoa, this is insane.” It was so exciting and so motivating and we really, truly realized that this was such a need. Let me tell you, our heart was there. Our hearts were there so we were so excited to dive in. So we did. We started sharing stories. We tried to get different content-type stories and different types of births. We tried to get OBs. I remember I reached out to this OB and they randomly responded. I was like, “Oh my gosh, this is insane.” We really tried to get the most we could while still doing birth and writing manuals for our VBAC course and– Julie: And wives. And being moms and wives. Meagan: And being moms and wives and friends and humans who were ourselves. Julie: Too much. Meagan: It’s so crazy to look back and think about that time and where we were and all that’s happened. It’s kind of crazy to also think about birth and how we have seen it change and how personally, I think I’ve even seen it change in some good ways and in some bad ways. We talked about this a little bit before we started recording, but COVID. COVID was a really, really difficult time as moms giving birth, as doulas supporting birth, even as podcasters weirdly enough. We had this entire– we went from this really junky set up all over to having an editor and having a podcast studio and in this really amazing space which– shoutout to our favorite editor. I just have to say that he is amazing for all that he has done for us over the years. But we had all these things that were really helping us and really changed our lives for the better as far as podcasters goes and VBAC Link facilitators or whatever. It all changed. It all changed so fast. Julie: Yep. We had to go back to recording at home. We had to– oh my gosh, getting into hospitals was just nuts and wild. Meagan: A nightmare. Julie: There were so many clients of ours having to switch plans and a lot of people shifted to out-of-hospital birth because the hospital policies were so flip-floppy and so strict. They were limiting who could be in your birth space. I actually think that’s a really positive shift. That’s just me. Meagan: Yeah, no. I actually agree. Julie: Out-of-hospital birth is still growing. I think it’s super cool. At least in Utah, it is. I’m not sure of the numbers in any other state, but I know in Utah, it used to be that 1-2% of births were out-of-hospital, but now as of 2024, so far, just under 5% of births in Utah are happening out-of-hospital which is super cool. But not enough. Meagan: It is super cool. Yeah, I would agree that through COVID, that was one of the positive shifts of helping people see the different options. Julie: Forcing people to really, seriously look hard at them. Meagan: Yes, and then also seeing that those options actually are pretty dang safe. But yeah, so COVID. We’ve had even so many people on the podcast sharing their stories through COVID. Man, it was rough. We were seeing induction taking off because they could control who had COVID and who didn’t. 16:40 Changes in birthMeagan: Then we also went through the ARRIVE trial just before that. Julie: Oh jeez, yeah. Meagan: So there was all of that we saw making changes. You know, birth is constantly changing and evolving and growing. It’s pretty cool, I feel like, to say. I’ve been in the birth world for 10 years now as a doula. It’s pretty cool to say that I’ve been there. I’m here. I don’t know how to say that. I just feel like it’s really cool to be a part of this community and to see these changes. I’ve talked to some people who did birth back in the 80’s and the 90s and it’s kind of crazy to think about how it’s changed. I want to go back and listen to some of those earlier podcasts and see, has birth changed? Are we changing and what can we do to make birth change in a positive way? I think this podcast honestly is one of those ways to help people change their birth experience in a positive way by going in and listening to what is happening. What is happening? What to expect? How to avoid those things? Right? Don’t you think, Julie, that this is a really great place for all moms and all people preparing for birth to come?Julie: Well, and here’s the thing. We all have a threshold for what is and is not acceptable to us. Going back to talking about COVID a little bit. COVID and the things that were happening due to COVID didn’t sit right with some people and caused them to question and explore other options. Hearing The VBAC Link Podcast creates realizations for people that could cause them to question the things that they are presented within their own personal life as far as giving birth goes and what their provider is saying and the policies of their hospitals and things like that. I think that is the way that ultimately birth in the United States will change and all over the world really is when people are faced with the things that cause them to feel uncomfortable about their current situation and explore other options and seek out those other things that will resolve whatever their intuition is telling them needs to change and shift. Here’s the thing. We don’t know what things will make us uncomfortable until we have all of the information available to us. You don’t even have to have all of the information, but any information available. That’s been the goal here. It’s been really cool to see things shift and I mean, there’s obviously not a study or research or anything on how much The VBAC Link Podcast is causing a shift or whatever, but I do know that we do hear these stories from people and I do know that it is creating a shift and a change in our birthing culture however small that might be.I just think it’s really cool to hear people say that it was this thing that gave them the confidence to stand up to their provider or talk to their husband or their partner or look into other options. Meagan: Mhmm, it really is. It’s just– I don’t even know. I’m almost speechless to get those reviews or to get people saying those things when we are recording a story and they’re like, “It’s just so crazy to me that this is coming to full circle that I’m now sharing my story when all of these other Women of Strength’s stories is literally what changed my life or my path or whatever.” I think I’ve said this before, here we are. We started this podcast randomly as you come up with this idea in Target and you’re like, “I’ve got to convince this girl that we’ve got to do this,” and here we are when really in so many ways, it’s you, Women of Strength, who are changing. Julie: Yeah. Meagan: You. So it’s like, okay. Yes, it’s us at The VBAC Link but then also where is the stat for all of them? All of the listeners and supporters? You guys, it’s been a long time and to say thank you isn’t enough. I don’t know what to say. I feel emotional, but I don’t know how to say thank you enough. Julie is laughing at me because I’m always the crier. Julie: I’m not laughing, well I am laughing. Meagan: I don’t know how to say thank you enough to this community because it’s been absolutely the craziest, sometimes most stressful but most amazing journey and I’m so excited that we can still be on it with you. Like I said, I know these listeners are the people. They are the people. They are the reason. So thank you for making this happen. 22:11 Celebrating differences within the birth communityMeagan: In the midst of meeting all of these incredible people who are sharing their stories, we have also met incredible people throughout our own community who are trying to do the same thing we are trying to do– educate, support, motivate, empower. I mean, all of these words. We have made some amazing connections with people within their own community and I’m just so grateful for that as well. Julie: I agree. I am really proud of all of the people who have chosen to start their own podcasts and their own VBAC education platforms too. There is a home birth after Cesarean podcast. I actually haven’t been as good at keeping up with other VBAC podcasts or whatever, but there are people– and I don’t know whether it’s influenced by us or not but definitely coming after us, there have been other things popping up here and there. I love that and I’m so proud of those people for choosing to pursue their passions as well for VBAC in spaces like this. I think it takes a village. It takes a whole– I don’t know, what’s the saying? A rising tide lifts all boats. I don’t know. It’s something like that where the more people talk about VBAC, the more people are talking about VBAC, so yes. Let’s bring more people into this space. There is room for everybody. There is room for all of us here to grow and educate and inspire and uplift. We might not always see things the same way and that’s okay, right? It’s okay if we don’t see things the same way as everybody else as long as we are all trying our best to create a positive influence in the birth space. We are not the same as anybody else and nobody else is the same as us and that’s cool. That’s okay because if you don’t resonate with us, there are other people who you can resonate with and vice versa. I think it’s really important to say that we welcome everybody here and we want you. We don’t have to be the only thing that you follow. Go follow all of the things. Meagan: Well, I love that you talked about that because back when we were going for our VBAC, for me, it was back in 2015/2016 when I had my son and the resources were more slim. Now we have all of these incredible resources and it makes me so dang happy because that is what this VBAC community needs– more info, more support, more people backing them up, more places or people to go and like you said, I mean, we would love to always be in your circle. We love this community so stinking much, but we also know that not everything we say or not everything we do resonates. I mean, it comes down to this podcast where we share CBAC stories and uterine rupture stories. We share stories that are out of the hospital and we’ve even had free birth stories on this podcast. Not everyone may agree with those types of birth or people advocating for that, right? It’s not even that we are gung-ho about anything specific or not gung-ho about anything specific. It’s that everyone has a space in this community because if we were to completely eliminate a uterine rupture story, no. I’m sorry, that’s just a no for me. Julie: Yeah. Meagan: We want to share those stories and CBAC. The CBAC community is so precious to me and near and dear to my heart. Sometimes, that can be a really hard community to be in. I say that personally. I have been in that CBAC after my two C-sections. I wanted a vaginal birth. I had a Cesarean birth after a Cesarean. It wasn’t what I wanted. I had healing to do. I had a lot to overcome, but I’m so glad that people come on this podcast and are willing to share those stories because our CBAC community deserves that. Like we were saying earlier, not every desired vaginal birth ends in a vaginal birth, so we have to learn through these stories. Like Julie said, everybody has a place here at The VBAC Link and yeah. We support everybody else as well. We love this community so much. Julie: Do you know what? Maybe I’m out of line to say this. Please, you can tell Brian to edit this out if you want, but I just think it’s no surprise to anybody that our world can be pretty hateful right now. Even people doing the most good things can face criticism or cancel culture or the mob or the mafia– not the mafia, the wokeness, or whatever, all of the things. There are so many things coming at you no matter how pure your intentions are or whatever. I just remember one time a few years back, somebody was talking crap. This was my gosh, 4 years ago and they called us “wholesome-looking podcasters from Utah”. Do you remember that?Meagan: I don’t remember that. Julie: I will never forget that phrase. Sorry, I’m laughing now. I’m crying. They said something like, “It’s easy to want to trust wholesome-looking podcasters from Utah,” or something like that because it’s fine. There’s going to be people who don’t love us and that’s totally fine. But gosh, when you were saying that, I was like, “Are we wholesome-looking?” Meagan: Are we wholesome-looking? I don’t know. Julie: I don’t know. Meagan: I don’t remember that. Julie: It’s so funny. I’m sure there’s a screenshot of it somewhere, Meagan. My gosh, I can’t even. 28:45 Challenges bring growthJulie: I want to circle back to you talking before about the struggle. There has been so much struggle. There have been a lot of challenges. Challenges due to our own creation, challenges due to technical difficulties– do you remember the time I changed the URL of the podcast and the whole thing went down? It was the day that the podcast was supposed to go live and we were meeting with Lynn, our first business coach. Oh my gosh, there have been so many things. Meagan: She broke the podcast, you guys. Julie: I broke the podcast. Things where we have definitely butted heads before and had to do a lot of growth in our relationship. Meagan: Yep. I was going to say you and I. Julie: There have been other VBAC groups out there who railroad us completely. There have been other birth people in our local communities and otherwise who are not big fans of The VBAC Link and I think that– I don’t want to get pulling a little bit into saying, sorry. I don’t know what I’m trying to say here. No, I do know what I’m trying here. I’m trying to figure out how to say it the right way. There is opposition in all things, right? I feel like, oh my gosh. I’m going off on six different tangents right now. My therapist told me one time– it always comes back to my therapy. Meagan: I love it. Julie: When you want to strengthen a muscle, if you want stronger arms, you can’t just sit there and be like, “Hey arms, get strong.” You have to put it under tension and stress. It’s lifting the weights. It’s under the tension and strain where that muscle grows. Such is life. Such are relationships. Such it is in business. It is everywhere. Things don’t grow and become stronger in comfortable times. It’s the strain and the tension and the struggle that ultimately causes that strength and that growth. I feel like there have been moments of really beautiful and incredible and empowering moments along this journey for The VBAC Link over the last 7 years now, but there have also been incredible moments of tension and struggle and strain. Meagan: Hardships. Julie: Yeah. Those moments really have the most growth. They are the most identity forming and I don’t know. They are the things where it really solidified what we are doing. Sometimes, in the face of people who should be doing the same things as us and sometimes, it’s from people who just for whatever reason, don’t want to see other people succeed. It’s come from a lot of other different places, but also going back to what you said before, I’m so grateful for the people who are still here, the people who support us, the people who love us, the people who are still here and challenge and question the things that might not be 100% true. Yeah. I don’t know. I love all of that and I don’t know. There is this quote I heard forever ago, probably decades ago because I am old now that said, “Don’t compare your backstage footage to someone else’s highlight reel.” I feel like sometimes it’s really easy to see all of the beautiful things that The VBAC Link puts out and all of these other birth organizations and see the highlight reel and think that everything is sunshine and butterflies, but I know that for us and for everybody else too, everybody else that has any kind of online presence anywhere, there is so much struggle that can go on behind the scenes. Yeah, I just wanted to talk about that. Meagan: It’s intimidating sometimes. It’s intimidating. But this community, I feel like, offers something special and it truly is the most motivating thing for me where I do wake up and I’m like, “I can’t wait to record more podcasts” or “I can’t wait to go and see what people are asking in our Q&A’s” or whatever. I love that you talked about a little bit how sometimes you are going to make decisions or you’re going to do things and some people might not agree with you. I think that applies so much int his community because let me tell you what, when I decided to VBAC after two Cesareans out of the hospital, I had some haters. I had some haters. Julie: Yep. Meagan: Those haters and doubters, some of those were even in my own family. Julie: Sometimes it’s the people who are supposed to love you the most, right? Meagan: And support you the most. Sometimes, they were people in my own circle, so it can be really hard when you’re getting pressure from people who you love and respect or people who you idolize or whatever, right? But it’s up to us to conquer, to have faith, to move forward, to grow, to adapt, and all of those things. I think that as we grow, more people in this community get to experience it. I mean, truly, the community grows through hardships and strengths and podcast-breaking and all of the things.Julie: And wholesome-looking.Meagan: In a wholesome-looking way apparently. Julie: I don’t know if that’s a compliment or not. Am I wholesome-looking? I guess that’s good. We look wholesome. Meagan: We look whole. Julie: I want to look up the definition of that really fast. What is wholesome? What does it actually mean? Meagan: What does wholesome mean? Yeah, and is that supposed to be not a compliment?Julie: I think the intention was that they look good. They look legitimate, but–Meagan: They might not be because they represent some birth stories that we don’t support or whatever. Julie: Whatever. “Conducive or suggestive of good health and physical well-being. Conducive to or promoting moral well-being.” Wholesome-looking. Meagan: Interesting. Julie: Hmm, I don’t know. I could not not say that. Oh my gosh, I’m sorry. You can have Brian edit it out if you want. Meagan: No, no. You are good. Julie: You’re the boss. Meagan: No, I love that. Now I’m going to think about myself being wholesome-looking. 35:35 Julie’s photographyMeagan: Okay, we talked a little bit about where we’ve gone, where we’ve started, what we’ve gone through, and all of the things. Now, where are we at today? I just have to gloat a little bit about Julie. She is phenomenal, you guys. If you have not been in our email or if you haven’t been on our social media, I definitely suggest you check it out and go follow her because she has taken a step back from The VBAC Link. We are so grateful that you come on here and there. You have taken a step back from doula work, but you are killing it in the photography world. Julie: Aw, it’s the best. I love it so much. Meagan: You’re doing so good. I’m so impressed. I just love seeing her photos on her Instagram and I love being able to chat with her and even connect more to the story. Sometimes, she will tell me the story that goes with the picture. I’m like, “Oh my gosh.” It’s so amazing. I’m so happy for you. Do you want to talk a little bit about what you are doing now that you are not doing The VBAC Link?Julie: Oh my gosh, I have to tell you. I sent you these pictures. I think I texted you. There was this girl. She reached out to me 2 years ago and she was like, “My C-section baby just turned 1. I’m thinking about getting pregnant again.” She wanted to connect with me for doula work. At the time, I was doing doula-tog so I was doing both doula and birth photography. So we talked and we connected. Then I sent her a couple of different local resources to connect to, then a few months later, she reached out and she was pregnant. She was going to hire me for doula-tog then she had a miscarriage, then it was a little while that passed again. She reached out to me again later and she was pregnant again, but by this time, I had phased doula work out completely, so I had referred her to a local doula here that I absolutely love working with. Anyway, super long story short, she ended up hiring this other doula and me as a birth photographer and she switched from hospital birth to a home birth and I just attended this beautiful VBAC birth at home last week. It was so neat to have somebody come full circle and follow their whole journey. She called me and we talked on the phone forever 2 years ago when she was starting on her VBAC journey because she had found The VBAC Link.It was just really neat. I know more about her journey. It’s hard sometimes as a birth photographer because I don’t have an initial connection with people as much as I did when I was a doula. Sometimes, the first time I see people is when I walk into their birth space with my camera which is okay. I like it when it is a little more than that beforehand, but it was really neat. Her name was Emmy and I’m sure that one day she will share her story on the podcast because I want her to. It was just a beautiful birth. I got called at midnight. The baby was born at 3:45 in the morning and it was just a really beautiful story with really powerful, empowering photos for this girl. She got to 10 centimeters with her first baby and she pushed for 6 hours. She got the epidural when she was 4 centimeters. She got to pushing. She was flat on her back the whole time, a classic story. She didn’t know. Anyway, it was a really beautiful and very empowering story. I got to document it and I just think that some of the imagery, I cannot wait for her to tell me that I can share these. She wants to see. I respect everybody’s wishes. Some people want me to share everything. Some people don’t me to share anything and I respect all of that. Anyway, it’s just really cool and really neat. I love being able to document that. I tell people, “My gosh, just hire the birth photographer. These moments are fleeting. They change so fast. One of the biggest days of your life, you’re not going to remember what your baby looked like, what their cry sounded like, and the joy on your face as you met them. Just invest. Do whatever you can to be able to invest if that’s what you desired. Don’t let finances get in the way.” I personally now offer several financing options I can implement and things like that because I know it’s not super cheap, but I love being able to capture and preserve people’s stories. I also do videos. Videos are my favorite. I love being able to see the motion and hear the sounds of those babies’ first little noises. Oh my gosh, there was this cute little baby making fish faces an hour after it was born the other day. I could not believe it. It was amazing. These people wouldn’t have that. Sure, there are cell phones and things like that you can take pictures on. There are some cell phone cameras that are really good quality now, but you’re going to miss out on so many things because who is going to be taking the picture on your cell phone? Your partner? Your doula? You’re not going to be able to see how your doula supported you. You’re not going to be able to see the beautiful moments your partner and you had because they are the ones holding the camera. You’re not going to be able to see the look on your partner’s face because it’s all going to be baby or you. Plus, most partners are not really that great at taking pictures, let’s be honest. It’s okay. It is okay but it’s such a fulfilling thing. I love being able to go and witness the power that women have in all of the stories. There is so much power in scheduled C-sections, in unplanned Cesareans, in vaginal births, in medicated births, unmedicated births, hospital, out-of-hospital, all of it. All of it takes so much power and strength, all of it. I get to witness that but not only do I get to witness that but I get to document it. I get to come home and I get to witness it again as I’m editing photos and video. I just think it’s a really, really, really cool and really inspiring thing. I love it. I love it. Meagan: I agree. It’s actually one of my biggest regrets not having that. We had some candid– not even candid, some photos that were snapped really quickly, but not being able to see, I really wish it was recorded. So dang it. Julie: Yeah, I feel like

Katie joins us today to tell us about her two birth experiences in Germany. Although she strongly advocated for herself during her first birth, Katie was extremely mistreated. Her labor and horrible C-section experience left her with intense PTSD straining her relationship with both her baby and her husband. Katie knew that if she wanted to have another baby, she had to plan for an out-of-hospital birth. She continued to advocate for herself by not only learning the evidence but by showing it to providers and defending it. Though she wasn’t able to find a supportive backup hospital, Katie labored beautifully at home with her husband, doula, and midwife until she knew it was time to transfer. When she transferred, Katie was able to go to the hospital she wanted to go to and was finally treated with respect. Her wishes were honored and she felt heard. Though this labor was also over 40 hours and had its own unexpected twists, Katie experienced so much healing from her VBAC. She was able to achieve the glorious feeling she hoped she would have from a home birth even in the hospital.  TOLAC in Germany ArticleEvidence-Based Birth Blog: Friedman CurveInformed Pregnancy - code: vbaclink424Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:41 Review of the Week07:27 Katie’s stories11:14 Start of labor16:55 Going to the hospital20:22 Interventions29:44 Katie’s C-section32:06 Preparing for VBAC34:34 Second pregnancy42:01 Labor begins47:11 Getting support from her birth team50:12 Transferring to the hospital53:32 Feeling intense scar pain56:23 Asking for the vacuum58:42 Katie’s advice for listeners1:01:47 The Friedman Curve1:06:16 Trusting your intuition1:08:56 Doula supportMeagan: Hello, Women of Strength! We have a story for you today where a mama gave birth in Germany. So I love, love, love when we have out-of-the-country birth stories because we often get messages from people outside of the country wondering if VBAC is still possible and the answer is YES. 100% it is possible and we have our friend Katie today. Hello, Katie!Katie: Hi.Meagan: She is going to just be sharing her story showing that it is possible to VBAC. Now, one of the things that I actually really love about Katie’s story is that it shows that things can change, and even when things change it doesn’t have to be bad. I sit in that because I personally wanted to birth out of the hospital and when I was in labor, in my mind, if I had to transfer, I was for a little while telling myself that that was a bad thing. And that it wouldn’t happen, or people would be looking down, or whatever. I was spiraling. I was just going through a moment in labor. But something that stood out to me with Katie’s, is she talks about how after a really long labor at home, planned home birth, her intuition, which we talk about a lot, knew that she needed to make another choice in her labor and that was to go to the hospital. Right, Katie?Katie: Exactly. Yep.Meagan: And so I love that we can talk about how plans can change and that doesn’t mean it has to be the be-all end-all. Is that how you say it?Katie: Yeah.Meagan: It doesn’t mean it has to be over or it doesn’t mean your chances of VBAC are done. If you are planning a home birth and you make the choice, or even if it was medically necessary, like sometimes it is, right? That doesn’t mean that it has to be bad. And so I love that part about her story and that she listened to her intuition. And then also another highlight, is that intervention happened, right? And that sometimes in this community we fear the intervention. I understand why we don’t all usually want the intervention, we just want it to be left alone. But sometimes intervention comes into play and sometimes those interventions help us get the birth that we wanted. And so I’m just going to end there because I want Katie to be able to share her story but those were a couple of things that, for me, as I was reading her submission, stood out to me and I thought were really important topics to touch on because plans can change and even when plans change, it’s okay. 04:41 Review of the WeekMeagan: But I do have a Review of the Week so I want to review that and then I’ll turn the time over to you Katie. Okay, so this is from our Google reviews, which we absolutely love. Even our Google reviews help people find the podcast, our blogs, our course, our resources, all the things. If you wouldn’t mind heading over to Google. Google “The VBAC Link,” and leave us a review, we would absolutely love that. So this is from, I think it’s Eimear. Sorry if I am butchering this name. They gave a 5-star review, so thank you so much. But it says that, “This podcast was my constant source of reassurance and inspiring stories throughout my last two pregnancies. I achieved my VBAC in 2021 and was empowered with so much knowledge and mental strength going into this birth because of The VBAC Link. I had my second C-section in 2002 which was not what I wished for but I do plan on having more children and know that VBA2C (vaginal birth after two C-sections) 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.”Thank you so much for that review. I love that you said that VBAC after 2 C-sections is possible. We see that a lot in our Q and A’s. “If I’ve had 2 C-sections is it possible?” The answer is yes, absolutely, 100 percent. So if you want to learn more check out the podcast or head on over to thevbaclink.com and search VBA2C and you’ll get to find more about that. 07:27 Katie’s storiesMeagan: Okay, Katie! Welcome again. Thank you for being here. Katie: Thank you for having me. I’m so excited to share my story.Meagan: Oh my gosh, me too.  And I know you’ve got your little one by you. So how old is your little baby?Katie: My daughter, Scarlett, is just shy of 5 months.Meagan: 5 months. Okay, so you’re still pretty in the thick of it. Katie: Yes, still sleepless nights.Meagan: Yes, and you’re coming from Germany. I don’t even know what the time zone is there, but hopefully, you’re not up way too early or way too late.Katie: It’s like just late afternoon here.Meagan: Okay good, I’m so glad. Well I would love to turn the time over to you to share your stories.Katie: Okay, great. Well, I’ll just get started with my C-section story. My son, Charlie, is 2. He was born in 2021. I’m originally from the U.S. but as you mentioned, I live in Germany and I had been in Germany for about 5 years when I had him. And then as just some background, I’m actually an intensive care nurse and I worked in the United States as an intensive care nurse and then for a bit here and have since transitioned into the corporate world. I’m not like a labor and delivery nurse, but I have a lot of knowledge about birth from nursing school. I think there is a little bit of a misconception in the U.S. that everything is better in Europe, that they're more natural or that the healthcare is better, blah blah blah. I just want to say that has not necessarily been my experience especially working as a nurse. I can really see that the shortage of trained healthcare workers is significantly worse here. And there’s kind of like, we have our issues in the U.S. too about making sure we’re providing evidenced-based care. We try but it’s hard to keep up and stuff. I would say it’s even harder here and then doctors here are super paternalistic. So when I was pregnant with my son, I had that impression as I was going into it. And also, the way it works here is, you just go to a gynecologist for your pregnancy care and then you just go to the hospital to have your baby. You don’t get to pick your doctor. There’s just staff, so you just get who you get. I didn’t really like that when I was planning my birth for my first pregnancy, but I was kind of like, well what else am I gonna do? That’s the way it is. But I felt at the time really confident about my knowledge and that I’m pretty tough and well-informed, and I’ll manage to get through it. This is just like the way it’s going to be. Didn’t have any thoughts about trying to do a home birth or another out-of-hospital environment, it was just like you go to the hospital and baby and go home. So my pregnancy was pretty good. I had the normal kind of aches and pains. There was some concern with my son’s placenta. It wasn’t functioning great but we didn’t have issues from it, just extra growth scans and there were really no problems. He was due December 27th, so around Christmastime. I think if I had known I would have never gotten pregnant to have a baby around Christmastime because my impression was with the hospital, that they were really short-staffed when I ended up having him. 11:14 Start of laborKatie: So I ended up going into labor– he was born on the 22nd, so I went into labor on the 20th of December. I woke up around midnight with really bad back pain and I felt like I was going to have diarrhea. That’s probably TMI.Meagan: I totally get that. Katie: Yeah I kept going to the toilet thinking I had food poisoning, and nothing would happen. I would go and sit down, and as soon as I would sit down I’d feel like I'd have to go to the toilet again and I would run back there. This kept going on and then eventually after a little while I had some bloody show and my mucus plug came out. And I was like, “Oh! This was the contractions.” I was not expecting it at all. It was just this stabbing pain in my back and I didn’t feel like my uterus was really doing anything so I was kind of surprised. I was like, “I guess I'm in labor,” and it hurt so bad. People always talk about how it starts out kind of light and builds up, and it was really full force. Like I said, I kept going to the couch and trying to sit down and trying to get comfortable and I’d have to keep running to the bathroom. It just kept coming. I was like, “Oh my gosh, is this baby going to be born really fast? This seems pretty intense.” I was like, “No, no I probably have a long time to go so calm down.” I took a shower and got my birth ball out and started trying to work through it. At some point, my husband woke up and I was like, “I think I’m in labor. Go back to bed and I’ll get you if I need you.” I labored throughout the night. But around 4:00 or 5:00 in the morning, I started noticing contractions. They weren’t quite as painful and it was spacing out a little bit and I was like, “Oh, maybe I should try to sleep.” So I laid down on the couch and I was able to kind of sleep in between these contractions. My husband woke me up a few hours later because I had my 39-week doctor's appointment. And I was like oh well we can just go to the doctor and have them check me there and just see how we’re going. We walked to the doctor because I was afraid my water would break in the subway so we just decided to walk. But that didn’t happen and by the time we got to the doctor, they had spread pretty far apart. I had waited in the waiting room for a while and I only had a couple while I was waiting.My doctor checked me and she said I wasn’t dilated and then they did put me on the CTG there for just a little bit to just see what was happening and I didn’t have a single contraction while I was hooked up on the CTG. But the second they took it off and I stood up again, it started again. But it was more how people describe early labor. It came every few minutes. It was totally manageable. I just had to take a few deep breaths. We ended up walking home and the rest of the day, that went on. I labored in the afternoon and I thought at some point I should try to take a nap, but every time I tried to lay down it would be really uncomfortable so I got up. Then my husband and I decided, “Well, this baby is probably coming. Let’s go do some grocery shopping, get some snacks, and be prepared.” Katie: So we went grocery shopping and my parents were visiting. They were staying in a hotel, but they came over. We all had dinner together. I was convinced that it wasn’t labor, and I was like, “This is probably just fake labor,” so I didn’t want to tell them. My mom later told me, “We totally knew you were in labor. You did not fool us for a minute.” We made dinner, we all ate, and they left.It was only 7:00 or 8:00 PM and I was like, “Let's sit down and watch some TV and try to relax.” As soon as I sat down, the intensity really picked up and the frequency. I wasn’t timing them, but I really saw that they were coming quite often and it wasn’t comfortable to sit down anymore. I thought, “I’ve been doing this all day, almost 24 hours now. I think I deserve to use some of my coping mechanisms that I’d planned for.” So I had planned to listen to these hypnobirthing tracks and had bought a ton of really nice bath supplies to make nice hot baths. So I got in the bath and was just using this app to do the HypnoBirthing tracks and I found it really helped me and I was doing really well. And then after a while, my husband came in. I think he felt like he should be doing something too. I was like, “You can press start and stop on this app because it’s really annoying to dry my hands off,” so he was like, “Okay.” He was there for 10  minutes and something popped up on the app that was like, “You should go to the hospital now,” and he started panicking. I was like, “I’m fine.” In my mind, compared to the contractions I had the first part of the previous night, my contractions were going to have to be at least like that or worse because I hadn't dialed at all, so I was like really mentally prepared this is going to be so bad. Right now I still feel fine. They were just coming close together, but I had no feeling the baby was coming. I felt fine.But he was just like, “Oh my gosh, this app is telling us we should go to the hospital,” and ugh. After a while of him freaking out, I thought, “Okay, let's just go to the hospital and do a check. They’ll reassure him that I’m tops 2 centimeters dilated and he can relax and I can continue to labor in peace at home.” 16:55 Going to the hospitalSo we get packed up and drive to the hospital. They put me on the CTG and checked me. I’m 2 centimeters. Then after half an hour, they come in and say, “Well, we don’t have any beds so we’re going to have to send you to a different hospital.” I said, “Whoa, hold the phone.” In my mind, I'm thinking that I have at least 12 more hours of labor to go. I’m a first-time mom. And I was like, “I want to go home and labor. I don’t want to labor in the hospital. I want to go home. Can’t I come back at like 6:00 AM and check me again?” It was about midnight at this time. And they were like, “Oh no, you’re not going to make it to 6:00 AM. Your baby is coming and will be here by morning.” And I was like, “Seriously?”Meagan: “It’s midnight, I’ve got some time.”Katie: And I was like, “I really don’t believe that.” But they were so insistent that I had to go to the hospital and they were even like, “We called an ambulance to take you to the other hospital.” Meagan: Oh my gosh.Katie: I was like, “I don’t need an ambulance. I’m not dying, I’m just having some contractions. This is crazy, guys.” They were like, “Are you sure?” I was like, “No, I don’t want to be separated from my husband and go in an ambulance. Absolutely not.” They were like, “Well, we’re going to send you to this other hospital.” I said, “No. This particular hospital has a really bad reputation.” I said, “No, I don’t want to go there. I want to go to–” my second choice was blah, blah, blah. They were like, “Oh, they’re full.” I was like, “Okay well, my third choice is blah, blah, blah.” “Oh well, they’re full too.” And basically, every other hospital in our city was full. I was just like, “Okay, great.” My husband’s freaking out. I really don’t want to go to this hospital but they’re telling him I need to stay. I was like, “Okay, we’ll go over there and I’ll just get registered and I’ll tell them that I want to go home and labor.” So we drive over and the whole time I’m like, “I don’t really want to go to this hospital, but okay.” And then I told my husband that I had no idea where the labor and delivery ward was at this hospital. I had never been there. So I said, “Okay, let’s park at the emergency room because usually this late at night, hospitals' other entrances aren’t open.” We parked in the emergency room and nobody at the emergency room could tell us where labor and delivery was. And I was like, “What the heck?” I was the one looking at the map on the wall figuring out where it was, having these contractions. We walked there and we finally arrived. I had such a bad feeling there. It was kind of icky and old and gross, this hospital. They also hooked me up to a CTG and checked me. They told me that my cervix was completely closed and so I said, “Okay, great! I’m going to go home.” They started trying to put an IV in. And I was like, “Whoa, whoa, whoa. Why do I need an IV? I want to go home.” They also said, “No, your baby is coming imminently.” I was like, “That doesn’t really make any sense.” In that kind of labor land you’re so easily kind of–Meagan: Persuaded and convinced.Katie: Persuaded. And I also observed that I didn’t have the support of my husband anymore. He was losing it basically. I thought, “Okay, I guess.” They had a bathtub and I thought, “Well, maybe I can take a bath here for a couple of hours and go home after that.” So we got in the bathtub and I really didn’t like it. I’m not really a big water person so it really wasn’t for me. So after awhile I got out. 20:22 InterventionsKatie: And oh, I forgot to mention. Before that happened, before they brought my husband back, the midwife was like, “Your cervix is like steel and we want you to take some medication to soften it.” She was like, “Don’t worry. It’s homeopathic.” I was like, “I don’t want to take anything homeopathic. That’s fake medicine. I don’t want to take that.” She was super insistent. I was like, “Okay, let me see what this is. I’ll look it up online and tell you if I want to take it or not.” She handed the pill to me and it was Tylenol with codeine. Meagan: What?Katie: And I was like, “Excuse me?” I was like, “This is not homeopathic medication. This is a narcotic.” She was like, “No, no. This is homeopathic.” I said, “No no. This is a narcotic.”Meagan: Like, “I’m not dumb.”Katie: That really shut me down. Also with this labor land, I was like, “Maybe codeine means something else in German?” I got super confused, do you know what I mean? In hindsight, I’ve given patients Tylenol with codeine hundreds of times. I know what Tylenol with codeine is. But in that moment, I got confused about it. I was in this labor land kind of thing. Meagan: Yeah. Katie: But it totally set off my fight-or-flight reflex because it freaked me out. “Is she lying to me? Or does she just not know? I don’t get this.” I really told my husband that I wanted to leave and he was like, “Where are we going to go? Everywhere else is full.” And I was like, “Well, I’ll just stay in the bath. I don’t know.”At some point, I got out of the bath and I had been up basically the entire night before, just trying sleeping in between contractions. I wanted to lay down and rest. She came in and was like, “Oh no, you need to get up and move around.” She made us go for a walk around the hospital. This was probably 4:00 or 5:00 AM. I just felt so uncomfortable, I didn’t want to be walking around the hospital. I wanted to be in my own little cave. So we went back and then she told me, “Well, you haven’t had your baby yet so we’re going to have to discharge you to the antenatal ward.” I was like, “Okay, at midnight when I got here, you said my baby was coming imminently and I had to stay and now you want to discharge me. If you’re going to discharge me, I’m going to go home. I’m not going to go labor on an antenatal ward.” She was like, “Oh, let me talk about it with my staff at our staffing meeting,” blah blah blah. I don’t know whatever came of that but I was so weirded out by it. Meagan: Yeah.Katie: And then like at 6:00 or so in the morning, she came in and they were again like, “Your cervix is as hard as steel. You need something to relax it.” Again she said, “I have something homeopathic for you.” It was Demerol.I again was like, “This is not homeopathy. These are narcotics.” I got really mad and I even said to her face. I looked her in the eye and I said, “It’s appropriate to give patients narcotics or birthing women narcotics if they want them but you can’t lie about it.” That’s so unethical. That’s not okay. I was so shocked by it. I had thought about it and I didn’t really want to take narcotics. I’m intolerant of them. I’ve had some dental procedures and they make me really confused and I didn’t want them during labor. But I thought at this point, it had been like 30 hours, and I thought, “Well, maybe it’s time to try something.”My mom had always said when she had us that she would get a shot of Demerol and dilate to 10 centimeters in an hour from that. “Well, maybe I need that too. Maybe I’m like my mom.” I did consent to it but I felt like pushed into it. I kind of more consented to it because I wanted them to leave me alone. I told her again, “I’m really sensitive to narcotics. They make me confused. Please give me like the lowest dose.” I got my records later and I know now that it was the max dose and she had mixed other things into it so I totally became delirious. I could not cope with the contraction pain anymore because I didn’t have this ability to be like, “Oh, I’m a flower, my cervix. Every contraction brings me one step–.” Being able to work my way through it was gone and it was sheer pain. They don’t help me. It was just downhill from there. I didn’t have the strength anymore to leave. At some point, they tried to make me take another walk. I was so dizzy that I kept falling over. Oh my gosh, if my patient was this dizzy, I wouldn’t let them get out of bed but they were forcing me to go for a walk. They told us to leave the hospital and walk around outside. I remember standing at a red light and totally swaying back and forth clutching onto my husband so I wouldn’t pass out. I was like, “I should not be outside. This is ridiculous.”So we went back and I’m not exactly sure what happened all afternoon. I forgot to mention we had a new midwife now. At some point in the afternoon they come in and say, “Well, you haven’t had your baby yet. You’re only a couple of centimeters dilated. We’re going to start you on Pitocin.”Katie: And I said, “No, no. I don’t want Pitocin.” They said, “Too bad. We’re giving it to you anyway.” And I again was not in any kind of state to fight or protect myself. They started it and I didn’t have any pain management at all. This was like 4:00 or 5:00 in the afternoon so it had been like 10 hours since I had that Demerol. My contractions were always that really bad back pain. It was so bad with the Pitocin. I ended up getting an epidural which was such a bad moment for me because I actually had more anxiety about getting an epidural. I have a fear of being paralyzed and I thought, “I absolutely don’t want an epidural.” I ended up getting one and it didn’t really work. They just kept turning the Pitocin up. And I kept telling them, “This isn’t working. Can you get anesthesia here? There are things you can do to fix it.” They wouldn’t do anything.They kept telling me, “If it doesn’t work, it just doesn’t work.” I was like, “That’s not true. I know a lot about epidurals and there are a lot of things you can do.”At some point, I had realized that I hadn’t peed in 12 hours and tried to go to the bathroom and nothing came out. I asked them in they could put a catheter in so I could pee. This midwife just kept ignoring me. I was like, “I really need a catheter.” I had felt really hot. I was like, “Can you take my temperature? I’m worried I have a fever.”Meagan: Oh my gosh. Katie: I also kept asking her if she would help me because I was laying in the bed, halfway falling out of it and I needed some help to reposition myself. I kept pushing the call light and she would come in and yell at me for pressing the call light. And after a few hours of this I finally had a little bit of fight back in me. I remember screaming at my husband, “You need to get me another midwife right now!”They must have heard us fighting outside because somebody else came in. I was like, “I need a catheter. I need someone to take my temperature and I need some help moving around.” So she catheterized me and there was like 500 milileters of urine in my bladder. She took my temperature and luckily that was normal. She helped me get up out of bed so I was sitting on a ball. At that point, I realized that the pump for the epidural was sitting right there. I remember turning to look at it and the pump wasn’t even on. I was like, “I’ve been complaining. I have no idea what happened if it had been off the whole time or something, but it was supposed to be a patient-controlled epidural and it wasn’t even on. I was like, “What is this?”At this point, it was midnight. I had been going on 48 hours now and only at like 4 centimeters dilated. They just kept telling me, The only way you’re ever going to have this baby is if we keep turning the Pitocin up.” I kept asking them, “Are there positions we can do?”I also forgot to mention in the beginning that the people in Germany told me, “You don’t need a doula in Germany because the midwives do all of that kind of stuff.” I never got a single suggestion on how to maybe reposition the baby or if there was anything. I kept asking, “Is he posterior? Is something weird going on?” “No, no. Everything’s fine.” With these Pitocin contractions, I felt this pull in my pelvic floor. It felt like my body was fighting against it. I can’t believe this is working. I can feel my muscle close with that. 29:44 Katie’s C-section Katie: They told me that wasn’t a thing, blah blah blah. My cervix had started swelling. And they were kind of like, “The only way you’re going to have this baby is having a C-section,” and you know, that’s just what happened. I ended up consenting to it because I was so afraid that they were going to do something to harm me. There had been like so much–Meagan: Weirdness.Katie: Weird stuff. I’m not going to die because childbirth is dangerous but because these people don’t know what they’re doing and they’re somehow going to hurt us. And the C-section was just awful. I could remember on the way down, they knocked a bunch of the equipment over that was attached to me. When they started operating, I had a strip on my right side where I could feel everything. I was like, “I can feel what you’re doing there. I was screaming.” The birth of my baby was the worst moment that I could imagine. It not joyful or happy at all. What has happened? What has happened to me? How did this happen to me? I just like couldn’t believe it. Meagan: Yeah.Katie: What else could I have done differently? I don’t know. How did everything get out of control? It was just crazy. I ended up having really bad PTSD afterward that I would have nightmares about the surgery. Postpartum was so rough because I had no connection to my baby and I honestly resented him almost in some ways where it was like, “If I hadn’t had you, I wouldn’t have gone through this.” It was just really hard to work through.I was also so mad at my husband. I really thought, “How could you? Where were you? You were supposed to be my support. You were supposed to help me.” I don’t think he really got it. I kept telling him how much he was going to have to help me. “I really needed you to be strong in that moment and you just weren’t.” It was a really low point in our relationship, too. 32:06 Preparing for VBACKatie: But he promised me that if we ever had any other kids, he would try to make it up to me. “Let’s try to work through this.” And I got some treatment for my PTSD and I ended up taking Zoloft. I obviously listened to the stories on VBAC Link and other podcasts and I realized this is not unique. This is happening to a lot of people. I really knew that I wanted to have a VBAC. I never really thought there was something wrong with me. I thought it was the way I had been mishandled and that they didn’t follow guidelines and that it was really inappropriate care I received. If it had been better, maybe I would have been able to do it. Anyway, I had a lot of anxiety about doctors and I didn’t think, “If I have another baby, I want to go to the hospital. What am I gonna do? If I ever have another baby, should I go back to the United States to do it? Can I review clinical literature from my job?” And just from listening to podcasts and your story, Meagan, and the others, I realized an out-of-hospital birth is probably the best option for me if I ever have another baby to have a VBAC. I found a paper from 2019 about birth in Germany, about VBACs in Germany. And the success rate was like 40% in the hospitals to 60% in the birth center and 80% if you planned a home birth. They said that the outcomes for mom and baby were similar. So I said, “That’s it. We have real literature that we’re going to have a home birth if I ever have another kid.” Before I even got pregnant, I researched home-birth midwives in the city. I started speaking to a doula before I even got pregnant. And I had signed with her and she said that even if she wasn’t available when I got pregnant again, she would help me find someone who was. I actually ended up getting pregnant really fast. We got pregnant on the first try and that was about– my son was 14 months when we got pregnant again. They’re 22 months apart. 34:34 Second pregnancyKatie: I was like, “I’m going to do this. This is super important to me. I really need to do this.” I listened to VBAC Link stories and other VBAC stories every day. There’s some other podcasts that I listened to. I read all the books like Ina May’s Guide to Childbirth and Childbirth as a Rite of Passenger by Rachel Reed and I was just only thinking and talking about birth. That was the only thing I paid attention to in that time.I read all the guidelines from every major organization and I read a lot of the literature that they used to come up with the recommendations. I had pretty strong opinions then that I would be okay with. But mostly I just wanted to be left alone. I didn't want any interventions because in my mind, with my sons birth, the intervention is what had ruined it. Katie: I worked out a lot with my first pregnancy, too. But with my VBAC baby, I did the Mamastefit fitness program.Meagan: Love Gina.Katie: And at the end, there’s a lot of focus on relaxing your pelvic floor. I started seeing an osteopath. We really worked on trying to relax my pelvic floor. I mostly focused on stretching. I kept doing the HypnoBirth stuff. The pregnancy went on. I registered at a hospital just as a backup just in case we needed to transfer. I went to the registration appointment at this hospital. They were supposed to be the best VBAC hospital and they claimed to be the best VBAC hospital in the city, but the doctor there was so anti-VBAC and just talking about, “Oh, you are causing all of this risk if this happens.” I was really kind of shocked by it and at one point, she was like, “Oh, we need to do this ultrasound,” and I was like, “Whoa, whoa, whoa. What do you want to do this ultrasound for?” She was like, “Well, we need to make sure your baby isn’t too big and that your scar is thick enough.” I said, “Well, I know that those growth scans, you might as well flip a coin so I’m not interested and also, there is not any research supporting the use of ultrasound measurements of the scar with predicting the risk of rupture so no, I decline.” She said, “Well, no you have to do it.” I said, “No, I don’t and I’m not doing it unless you can tell me what evidence you use to come up with these recommendations and what are the cutoffs? How thin is too thin is too thin for the scar? You have to be able to tell me that and you have to tell me what evidence you’ve used to come up with that definition and I will not consent to the ultrasound until you tell me that.” She just couldn’t do it. She kept just going on about like, “Well, you have to. You have to.” I said, “I don’t have to do anything. I don’t consent. If you don’t know the answer, find someone that does.” My doula was with me and she ended up going. This doctor ended up going and getting their boss. She came in and my doula had told them something about how we were just planning this as backup for a home birth. They were like, “You absolutely cannot have a home birth.” I was like, “I absolutely will. That is my choice and you can’t tell me what to do. I’m doing that.” They were just like, “No, no. You can’t do that. You can come here and have the birth.” I said to them, “I know I’m going to need a long time to labor. I was in labor for 48 hours with my son. I need a lot of time. There was nothing medically wrong with my with my son. It was just this pure, bureaucratic nonsense. I was pressured into it because I took too long. I know that and I need support to get through a long labor and it’s safer for me to be at home and it’s safest if there is a midwife at home with me that can check on the baby and make the recommendation when it’s time to transfer. That’s the best course of action.” They were like, “No, no. You can only plan to birth here.” I was like, “Well, if that happens, then I’m going to be home alone without anybody there to check on the baby. How is that safe?” They just kept saying, “You can’t do that. You can’t have that here.” Katie: We ended up not having a backup hospital. That was kind of a tough conversation but I was really proud of myself that I had stood my ground so much. Just a lot of women talk about how you always want to be polite and non-confrontational. I was like, “I’m not going to be that way. I’m going to demand answers. I’m not going to do things just to be nice.” I was very proud of

Jenny’s story is one of pure gratitude and joy. She is so grateful to be a mother, for the miracle of her pregnancies, for a breech baby who flipped late in her second pregnancy, for the chance to experience labor, and for a beautiful, successful VBAC. Jenny talks about all of the ways she prepped and how she even had to travel over a mountain pass during a snowstorm while in labor to get to her VBAC-supportive provider. Meagan shares some statistics about breech birth and why we so badly need more providers trained in vaginal breech delivery.A long-time listener of The VBAC Link Podcast, Jenny shares her story with so much joy hoping to inspire other Women of Strength just as she was inspired by so many others. PubMed Article: Risk of Vaginal Breech Birth vs. Planned CesareanHeads Up DocumentaryInformed Pregnancy - code: vbaclink424Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:58 Jenny’s first pregnancy with gestational diabetes06:10 Low amniotic fluid, breech presentation, and a C-section10:22 Healing in different ways14:16 Getting pregnant again and doing all of the VBAC prep22:52 Gestational diabetes test27:59 Breech at 34 weeks32:33 A head-down baby35:11 Traveling the mountain pass in a snowstorm39:43 Checking into the hospital45:42 Fetal ejection reflex49:20 Pushing out baby and postpartum blood loss57:10 Jenny’s advice for breech mamas1:00:22 Statistics on vaginal birth versus planned Cesarean for breechMeagan: Hey, hey. You are listening to The VBAC Link Podcast and we have another amazing episode for you today. We have our friend, Jenny. Hello, Jenny. Jenny: Hi. Meagan: How are you today?Jenny: I’m good. I’m so excited. This is just– I am reeling actually that this is actually happening today. Meagan: I am so excited that it is. You know, it’s so fun to get submissions in and then when we send them out, people are like, “Wait, what? Really?” Jenny: That is exactly how I felt. I was like, “This is never going to happen, but I’m just going to go for it. I’m just going to submit it.” I mean, The VBAC Link was such a huge part of my whole story and just to be on here and hopefully share something inspirational with somebody else, hopefully it helps somebody. That’s my goal today. Meagan: It will. It’s absolutely going to. The whole podcast, sorry if you guys hear any noise in the background by the way. I’m getting a new furnace today and he’s installing it downstairs literally below me. So sorry if there’s any extra background noise. But this podcast is literally something that I wish so badly that I had when I was going through my VBAC. Obviously, that’s one of the reasons why we were inspired to create it, but every single story, even though they all might have similarities or even be in similar places, they are so different and unique and I love that. I love that almost 300 episodes in, we can prove that every birth is different. It’s true. Every birth is different and you went through a lot with your births. I mean, I’ve got her list right here of things. You guys, this is going to be a jam-packed episode. She’s got gestational diabetes, breech, advanced maternal age, and trusting the process. We’re going to talk about traveling literally over a mountain pass. She drove over a mountain pass to find what she needed so I’m so excited to dive into your episode in just one minute after the intro. 02:58 Jenny’s first pregnancy with gestational diabetesMeagan: Okay, Jenny. Here we go. You are– are you ready? Are you ready? She is dancing in the background. You can’t see her but she is literally dancing. You can see she is so excited to share this amazing story with you. Jenny: I am so ready. Okay, so let me go back four years to my C-section baby. I can’t believe it’s been that long. Being a mom was never in the cards for me. I’m just going to start out by saying that. My husband and I, we had been married for 15 years. We went on this fabulous cruise and we were just having the time of our lives. We had a conversation that if I was past 30, it just wasn’t going to happen for us and that was okay. So we never planned to have babies and then we had the most wonderful surprise of our whole lives. One day– I don’t even know it had been since I had my period so I was like, “Oh, I’ll just take a test.” He saw it and was like, “What is this?” I said, “I’m 98% positive that it’s going to be negative. I just do this sometimes. It’s fine.” I get out of the bathroom with this blazingly positive test and he’s like, “No way. I don’t believe that.” So I had to go the doctor and prove to him that I was. Anyway, I loved being pregnant. It was so incredible. The miracle of just growing a baby is beyond words. Just that first flutter to knowing that you are creating a human inside of you to the first ultrasound– anyway. I started listening to “The Birth Hour” and I went down the rabbit hole. I love it so much because like you were saying before, it shows you so much about the differences. I didn’t know what I didn’t know, so it was just an education in itself. I went down the rabbit hole and I am such a birth nerd now. I had no idea. When I found out I was pregnant, the first thing that came to my mind was, “I have to give birth. I’m so scared,” because of all the fear. We get so much media fear. You see all the people screaming and pushing. It just looked traumatizing then I remembered I had seen The Business of Being Born and I was like, “No.” I have always been this closet hippie. I was like, “No. I’m going to do this and I’m going to do it right.” I found myself at 28 weeks. We did a gestational diabetes test and I walked into the doctor’s office and she was like, “You have gestational diabetes.” I was like, “No I don’t. No, I don’t.” She was like, “Yeah, you do.” She was like, “You are going to give birth at 39 weeks here. You are going to be induced. You will give birth on your back. You will do this. You will do this.” The language she used with me was so– I felt so defeated and I was only 28 weeks. I was so disappointed and it was a midwife. It was a midwife practicing under a hospital OB practice. But I live in a really small town, so it was the only midwife I could find really. Home birth wasn’t an option for me. We do have a home birth midwife, but it wasn’t affordable at the time. 06:10 Low amniotic fluid, breech presentation, and a C-sectionJenny: It turns out that I had low amniotic fluid and you know, they send you in for all of these screenings and tests once you know you have gestational diabetes. They were really concerned about it one time when I went in and they were like, “I don’t see any amniotic fluid, like any.” They actually kept me overnight and pumped me full of saline.Meagan: A bolus?Jenny: I was drinking water. Yeah, it was crazy. They checked the next morning and they said, “Yeah, you still don’t have any amniotic fluid so we’re going to send you to an MFM over the mountains,” which is about an hour and a half away in the city. When I got over, the MFM walked into the room. She didn’t even say hi to me. I was 34 weeks at the time and she was like, “We’re keeping you here. You’re going to have this baby. You’re not going to leave this hospital until you do.” She hadn’t even talked to me. She never said, “Hello.” I mean, she just looked at my chart. She didn’t do any tests on me. I was just blown away by how she talked to me. I was just like, “Are you kidding? Hi. I’m a person.” The did the test right there and then. It turns out the city doctor and their tests are so much better. Based on the total amount of amniotic fluid, they released me that day. As I was walking out the door, she was like, “By the way, I’ll see you back here for your delivery because your baby is breech and you’re not going to have her naturally.” I was just like, “Okay. I’ll show you. I’m going to flip this baby.”Anyway, I went down the rabbit hole. I did everything. I even signed up for the ECV. I don’t want to traumatize anybody, but there were three people pushing on my belly trying to get that baby to turn and she didn’t budge. She was there. I did have some lower amniotic fluid.Meagan: That can be a sign too if baby really, really, really isn’t budging that’s usually a sign that an ECV– and if it’s extremely painful, sometimes the ECV just isn’t going to be successful and sometimes we have to trust those little babes, right? There is a reason why. Jenny: Mhmm. Mhmm. I totally agree with you too. I even was mourning the loss this whole time because I so badly wanted to give birth just to experience it. I don’t know. It’s an innate woman thing. Men can’t do it. It’s something that I never experienced in my life. What else can we go through in our lives that you have to wait until you’re an adult to feel? It was just this phenomenon. I was so curious about it and I wasn’t even getting the opportunity. I was telling a nurse about it one day when I was getting a test done, “I just want the chance.” She was like, “Oh, honey. You don’t want to ruin your cervix by pushing out a breech baby.” I was like, “Oh, so I would break myself?” I didn’t say anything because at the time, I was this pushover. I was just like, “I’ll do whatever,” but inside, I was dying. I just wanted the chance at everything. So I got to the point where I just walked into the OR with the MFM because she does five of them a day and I trusted her more than I trusted our small-town hospital. Jenny: The C-section was uneventful. It was really easy. We did the labor baby dance before we went in there and then I saw her come out of my belly and I was thinking, “I don’t know this baby.” I felt disconnected but at the same time, I was overjoyed. I cried because they took her right over to the warmer. The anesthesiologist was right by my head and she was like, “Why are you crying? Are you okay? Are you in pain?” I was like, “No, that’s my baby and I can’t hold her and I’m right here.” The didn’t tie me down. Nothing was traumatic. I was very prepared. Meagan: They just didn’t bring her over. Jenny: No, I was separated. They were weighing her and laughing about how she was and I was trying to see her. Anyway, it’s just not natural. I mean, it’s just not how you want to have your baby. They did put her on my chest and everything was great. 10:22 Healing in different waysJenny: Fast forward six months, I was done with it. I was like, “Maybe we’ll only have one. Maybe this will be it.” We weren’t planning on having a baby anyway and we were just loving being in that baby nest. COVID started and talk about a crazy time. I definitely suffered a lot from postpartum anxiety. I had a lot of expectations maybe about motherhood and stuff. I really learned a lot. The transformation to motherhood is like a phoenix rising from the ashes as a total personality makeover. You’re just coming out of this, “This is who I was and this is who I’m becoming and this is what I’m learning.” Kids really teach you that, don’t they? They teach you how to fight for yourself and fight for them if you can’t fight for yourself, and I just found that postpartum is harder than it should be. We don’t have the support we have and it really, yeah. It made me go into a deep dive of what was going on with me. I started listening to The VBAC Link actually. I found it one day when I was listening to a “Birth Hour” podcast. It was six months and I was like, “You know, I’m just going to listen.” I was like, “I love this. I enjoy it,” but I couldn’t relate to it anymore. I searched VBAC on Spotify and you were the first person that came up– you and Meagan at the time or, you and Julie. I was like, “This is me.” I could connect to all of the stories because women were sharing the same feelings that I felt and the same things so thank you so much. It was inspirational to feel like, “I can do this. I can do this again.” I remember even talking to the OB when she was stitching me up in the OR. I was like, “I can have a VBAC, right?”At the time, I wasn’t really planning it or whatever and she was like, “I’m doing the double stitch, don’t worry. You are a good candidate.” I was like, “Okay, that’s cool.” It was so far out but just listening to the stories and knowing that I could do it, it was like, “I could do this again.” But I needed to listen for a long time to feel like I was ready and stuff. A lot of your episodes talked about working through past trauma so I started doing that. I started EMDR. I did pelvic floor physical therapy and I just want to talk about that for a minute because I cannot believe how ashamed I was to do it I guess maybe. I just want to say that really quick because I have a vaginismus and that’s when your muscles involuntary close into your vagina and it’s because of past trauma. So doing EMDR coupled with the pelvic floor physical therapy was really something that was so useful and I was so ashamed to do it because I’ve had it for years and I remember my GP suggesting it one time and I was like, “Absolutely not. I’m not having anybody touch me.” I just wasn’t ready. Meagan: You’re vulnerable. Jenny: It is. I was so ashamed and I don’t know why. I was talking to my pelvic floor PT about it. It was the first session I had with her. I was like, “I was so ashamed and I’m ready now.” She was like, “I can tell you are ready.” It was so healing to go there and to work through some of that. While it never got better for me, I know how to work with my body now and that kind of comes into play with my vaginal birth because in a way, I was a little bit relieved. Sometimes when I thought about it, I was looking at the silver linings of the C-section. You just walk right in. I was also thinking that I wouldn’t have to deal with this problem that I was really afraid of having. 14:16 Getting pregnant again and doing all of the VBAC prepJenny: So anyway, big plug for pelvic floor physical therapy. Since I had gestational diabetes, I read Lily Nichols’ book. I just listened to the episode on her. She is amazing. I can’t believe I didn’t know about her before. I had heard her on another podcast and I just thought, “I need to read this book.” She is amazing. Meagan: Yeah. Jenny: There are so many amazing birth workers out there– her and Rebecca Dekker from the “Evidence-Based Birth Podcast” and the “Down to Birth Podcast”. All of those people taught me something very unique and special about birth. It’s just this education, right? All of this knowledge and trust that we really have to get. We have to work through some of our things– traumas or whatever it is. Things that culturally have been accepted in our mind about birth and we get to this point where all of a sudden, I was excited. I was like, “Maybe I could do this again.” I did all of the things. I started eating eggs, Vitamin D, and magnesium and taking the protein supplement, the collagen powder. I even went non-toxic for my cosmetics and my house care. I started this. I heard this girl’s birth story. Her name is Bae. She is from Australia. She does this whole program– Core and Floor Restore. I loved her birth episode. I listened to her. I went to her website. She has this whole program on how to help your pelvic floor and how to exercise post-birth. The way she talks to women in there, she is like, “Do you. You do you. Don’t push it. Don’t force something that you can’t do. If you can’t do this exercise right now, modify it so that you can.” It was just this education of how to trust your body, how to trust birth, how to–Meagan: Trust our minds, our hearts, and our gut. Jenny: Yes, that’s part of it. Yeah, yeah. Anyway, all of this transformation got me to the point where I was like, “I have to be a doula.” It wasn’t in the cards for me to be a birth doula even though I am a huge nerd. I have to have a scheduled life. Meagan: Maybe postpartum? Jenny: Yes. Yes. I was like, “I want to be a doula, but I will be a postpartum doula.” I actually really love helping women work through some of these things that were so transformational to me. Just overcoming some things that you didn’t know about yourself but you are forced to face in motherhood, so I became a postpartum doula and it is incredible. I love it so much. Then I decided I was ready. I was ready to have this second baby. I was ready to have my VBAC and I did a deep dive into providers because that was what you told me to do. I needed to know if I could do this and so I went to my hometown hospital and I was like, “Hey. Can I have a VBAC here?” They were like, “Absolutely not. We will schedule you for a C-section at 39 weeks so that you don’t go into spontaneous labor.” I was like, “Okay.” So I went to the midwife and I was like, “Hey, can I have a VBAC here?” She said, “Well, I could support you but I shouldn’t. I don’t have the resources. I would want to support you, but ultimately, I shouldn’t.” So I was like, “Okay. Okay.” I was like, “I’ve already established myself at this big hospital over the mountains. I’m going to ask them.” I went to them and they were like, “Yeah, we’ll support you.” They had this outlying hospital in the mountains. It is absolutely beautiful, these giant windows looking out over the Pacific Northwest and I’m telling you, I live in the best part of the country but it’s really bad so don’t move here. That’s for anybody that’s thinking about moving here because we like it being a small town. I had my heart set on this beautiful outlier hospital. I called them. I’m getting ahead of myself. I had a conversation with my husband after I found them. I was like, “Hey, we should have a second.” He was like, “I don’t know. It’s really hard. We’re older now.” I was 35 at the time. He was actually 44. We have a pretty big age gap. We weren’t going to do it in the first place so we had some big conversations. I was like, “Okay. Let’s just try for 6 months and if it doesn’t work out, it doesn’t work out. It wasn’t meant to be.” We have a really strong faith so we were just like, “Maybe we weren’t meant to have it.” It was really fun actually trying instead of trying to prevent pregnancy. I had never been in that boat oddly enough having a baby and stuff. But it was really hard and I was trying to visualize conception. I was like, “It seems impossible how it all happens.” Meagan: Timing and everything. It’s amazing. It’s amazing. Jenny: It’s incredible just visualizing it all. It’s incredible how it can actually happen. At the time, I was thinking, “Man, it’s not going to happen.” Five months went by and I was doing all of the testing. I was making sure and it was really fun to nerd out on this side of it beyond the total planning side of it. I love that part. Yeah. Finally, one day seven, six days after I ovulated, I felt all of this cramping and I was like, “Maybe this is the implantation.” I think five days after that, I tested and I had the tiniest, faintest line. I was like, “Holy crap.” I did not think it was going to happen. It was just so amazing. I kept it to myself all day. It was my little secret except I went in and told my little one. She was three at the time. I went over and I was like, “Hey, you’re going to be a big sister.” She looked at me and I was like, “But keep it quiet for a day.” Meagan: Don’t tell anybody. Jenny: I wanted to take the test the next day that said you are pregnant because I didn’t want the same reaction from my husband the second time. I was like, “I’m going to give him the test that says, ‘You are pregnant’.” So I did. I did. I gave him the test and he was like, “Oh my goodness!” Actually, I had her give it to him the next day. It was so cool. It was just this sweet little moment. My age really concerned me. I thought I would be so chill because the first pregnancy was like, “Whatever, I didn’t plan this. Whatever happens.” With the second one, I had the fear in me that my age was against me. His age is against me now.I spent more time than I wanted and I regret feeling not anxious but just disconnected. I was really afraid to connect to this pregnancy because I know a lot can happen in early pregnancy and I really want to say that to other people who might have the same feelings that you are not alone in feeling that way because it is really scary. I got to my 20-week ultrasound and I was holding my breath the whole time she was doing the test.  She was looking and looking. She was being really fast and really efficient. They actually asked us to leave the room and go wait out in the lobby for the doctor to come get you. I was like, “This doesn’t sound good. I don’t think this is right.” I was so anxious and the doctor just walked up to us casually in the lobby and was like, “Everything looks good. See you guys later.” Nothing was wrong. I started bawling and I could not stop sobbing for so long. I’m not really a crier either. It was the confirmation that everything is going to be okay and we did it. I can’t believe it. It’s so hard to get pregnant and then everything is going good and stuff. I was really excited about that. I was also really hyper-aware of her positioning because obviously, I had this past breech. So from 20 weeks on, I was legit obsessed with sitting upright, leaning forward. All the time, I was turning my chairs around. I was never reclining on my couch. Even in my car, I was sitting straight up. I was like, “I’m uncomfortable 100% of the time.” I was trying really hard not to have a breech baby because even at my 20-week ultrasound, they looked and were like, “Yeah, she’s breech but anything can happen.” I was like, “I know, whatever.” 22:52 Gestational diabetes testJenny: I was doing all of the things, right? Spinning Babies, I was going to acupuncture. I was going to pelvic floor physical therapy, the chiropractor, all of it. I was chugging along. At 26 weeks, I get my gestational diabetes test. I talk to my midwife about it and she was like, “Yeah, we can just do the two-hour test because we know you had it last time. You might have it again this time.” I was like, “Okay. I think that’s a good idea.” I didn’t mention this before, but with my first test, my midwife wouldn’t even let me retest. She just said, “You have diabetes.” It was just the one-hour screening. It’s not a diagnostic, but I got the diagnosis from it anyway. I was like, “Why wouldn’t you let me retest?” She said, “Your number, I just felt like you have diabetes.” I don’t know. I was pretty upset about that. They wouldn’t even let me try. I know other people who retest all the time and they are negative with the three-hour test. It didn’t make sense to me. So anyway, I went into this one pretty informed. I was like, “Hey, I want the three-hour test. I want to know if I have it,” because if you have it, it’s not a good thing and you really want to control it. My first one was diet-controlled. She ended up being 6 pounds, 9 ounces. Meagan: Little. Jenny: She was tiny and she was 39 and 6 when she was born. I wouldn’t let them take her earlier than that even though they wanted to. I was like, “No.” They were like, “We won’t let you go to 40.” I was like, “Okay. You can have her at 39 and 6 then.” I was so mad at them. Anyway, I digress. Jenny: Okay, so I did the two-hour test. I felt so sick. I was like, “For sure, I have it again.” I had been eating a gestational diabetes diet the whole time. I was like, “I’m just going to take care of my body.” I felt amazing taking care of my body like that so it’s really kind of a blessing in disguise having it. I would not say that having been diagnosed with it the first time. I thought that I was a failure and whatever, but you’re not. Meagan: No. It just happens. Jenny: Yeah, it happens. My mom has diabetes. I shouldn’t be surprised, but I was healthy and I was thinking that it would never happen to me and it did. So anyway, I took the test and it turned out negative. I couldn’t believe it so whatever Lily Nichols did in her book, I did all of the things that she told me to and it worked so I’m just going to give a shoutout to her. Thank you because you helped me have my VBAC and I couldn’t be more grateful for just not having it because then I kind of ate whatever I wanted. It was great. I gained a little weight and it was really fun. It was the opposite of my first pregnancy. I was carefree and I had a lot more flexibility to do things I really wanted. Anyway, that was really cool. But also at my 26-week appointment, my midwife felt my belly and she was like, “You know, your baby is frank breech.” She was like, “I’m just saying that. There is obviously plenty of time for it to turn, but we want to see a head-down baby by 30-32 weeks.” I need to back up just for a second. I wasn’t able to use the midwives that I wanted at that outlier hospital from the city because I chose to do a bloodless program and they don’t support that even in the outlier hospital. It is only the ones in the city. It was an hour and a half drive through city traffic and a mountain pass. I was due in February and our mountain pass is no joke. It closes for multiple days during the winter a lot of times, so going that far was part of our conversation in having a second. I was like, “I’m not having a VBAC here in town. Can you drive me?” He was like, “I’m not scared. Let’s do it.” That comes into play later, but it was a lot. I had to use the bloodless program in the city which meant traffic, snow, ice, all of it. They chose to support me which was great. I found them and I’m grateful that they were but they weren’t the dream team as far as being really supportive. I would say they were tolerant of me being there. Meagan: Tolerant of you going for it but not super on board. Jenny: Yeah, exactly. They were like, “Yeah, this is great.” They weren’t saying, “This is what we need to see.” They weren’t saying, “You need to be in spontaneous labor by 39 weeks.” I was drilling them. I was doing all of the things. I was like, “What do you require of me? Can I go to 42 weeks? I want to know.” I had never felt a contraction before so it was honestly like, I knew I went to 40 with my first so I’m definitely going to go to that with my second at least I thought. I did all of the things to try and flip her obviously when they said that, but at 35 and 6, she was still breech. Actually, it was 34 weeks. I had even gone to acupuncture and felt her physically flip. She did the flip in my belly. I’m not joking. I felt her move the entire way down head down. I woke up in the morning and she was breech again. I was like, “Okay. She can do it. I know this baby can do it.” 27:59 Breech at 34 weeksJenny: I kept doing all of the things until 34 weeks which is when most babies are head down. I was like, “You know what? I’ve listened to enough podcasts and stuff to know that I needed to let some things go.” I regretted a lot about my first birth. I hoped until the last minute that I was walking into the OR that she was going to flip and she didn’t. I was like, “You know what? I want to enjoy this pregnancy. I don’t want to feel like I’m doing all of the inversions of my life.” I was doing headstands in my hot tub. I was doing everything and I was like, “I’m going to let this go.” I chose to let this go at 34 weeks and I was like, “I’m going to enjoy this whether I have a C-section or not even though I really want a VBAC.” My faith is a really big part of that because I was just praying, “I believe so much that our bodies are incredible and they were made for this.” And to not have the chance to even try is heartbreaking. It’s sad that we don’t have breech providers because these OBs are professionals. They are professional. They get trained for years in how to do this and that we don’t even have a chance with them boggles my mind a little bit. Meagan: I know. Jenny: Anyway, I’ve heard a lot about just having the chance to experience what women are made to do and just feel. Even if it’s hard and even if it’s painful and whatever, I just wanted the chance. I found this renegade OB in a different city. He was willing to do this ECV on me because I heard he had a good success rate. I was like, “I’m going to do it again. I don’t care. I’m just going to try.” At 35 and 6, I binged on the Evidence-Based Birth Podcast because she has a couple about VBAC and she has a couple of episodes about birth. I wanted all of the stats in my head. I was like, “They are not going to deny me this ECV because I have this scar on my uterus.” I was dead-set. I knew ACOG by this point. I walked in and I was like, “I’m going to do this. Let’s do this.” He was like, “Okay. This girl knows her stuff,” because he was like, “I probably shouldn’t do it because of the C-section.” I was like, “No, ACOG recommends that I am not a risk.” I knew and he was like, “Girl, you know your stuff. All right. You know the risks. Let’s try it.” Meagan: That is so interesting that he was trying to scare you out of it but because you knew the stats, he was willing to do it, but if you didn’t know the stats, what would have happened?Jenny: Right? I wonder and I don’t think it’s fair that women have to become experts in the field that’s not our job. Our job is to grow this beautiful baby in bliss and instead, we’ve got to fight for everything, something that we should be able to do. 32:33 A head-down babyJenny: I get in there and he puts the ultrasound machine on my belly. As I was driving myself there, I was thinking, “Man, these kicks are weird.” They were fluttering up here and I was like, “That’s so weird.” It was under my rib instead of down below. I thought, “That’s really weird.” He put the ultrasound machine and he was looking right down where my cervix was because that’s where he should see feet and he laughed and he was like, “That’s a head. Your baby is head-down.” I was like, “No, it’s not. I felt her head last night right under my ribs.” He was like, “No, her head has moved.” I poked, poked, poked and I was like, “Are you kidding me?!” I hit him and was like, “You’re kidding me, right?” He was like, “No, girl. You’ve got a head down baby.” I was like, “I’ve never felt this before! I’ve never had a head down baby!”I was in my second pregnancy, 36 weeks along pretty much and I had never had a head-down baby so I just want to say to all of the breech mamas out there, it can happen and maybe it can’t. I don’t know. I was convinced that I grew breech babies at that point because I was pretty far along there. Anyway, so that was the biggest surprise of my whole pregnancy. At that point, I was like, “I’ve got to find a doula. I’ve got to take a birth class. I’ve got to do all of these things.” I had been holding out for this opportunity to have a chance and now I had it. It was the most incredible, freeing feeling. When I was driving home, I was just like, “I can’t believe it!” I was yelling in the car. I called my sister right away, “I have a head down baby!” She was like, “Okay.” It’s just not a big deal to people. It was just so thrilling to feel like I could get the chance. So anyway, I took this birth class that B does from Core and Floor Restore and she talks a lot about physiological birth in it and how the movements that we make and the sensations that we feel all help in this balancing act of getting our babies out. I was just like, “I’ve got to try. I’ve got to try. I need the chance. I’m getting the chance now and now I’ve got to try.” So I did all of the dates and I did all of the classes. At 39 weeks, I stopped work and I just lived it up. I was just laying around and I was just having a good old time with my baby girl. That was one day that I had and the next day, I put her down for a nap. 35:11 Traveling the mountain pass in a snowstormJenny: I was at 39 and 4. I told my baby as I put my toddler down for a nap, I was like, “You know, I’m ready. I’m ready to see you. I’ve got all my meals in the freezer. I’ve done the work. I feel good.” Meagan: You were prepared. Jenny: I’m a postpartum doula. I had my ducks in a row and then my girl was just starting to sleep and I felt my first contraction. I was like, “No. This cannot be happening. Are you kidding me?” I just laid there super still and I was like, “That was another one. It’s happening.”I went to the bathroom and I had a little bit of my mucus plug and bloody show. I texted my doula right away like, “Oh my goodness.” She was like, “Oh, you know. Things are happening. Yeah.” I was like, “I know. I know. I need to go to sleep. I’m just going to go to sleep.” I looked at the pass because that was the biggest factor in what was happening. I looked. It was 2:00 in the afternoon. I looked at the pass and it said it was going to have 7-10 inches that night of snow. I was like, “Okay. Nothing is happening now, but maybe we should.” Our plan was to get over on the other side of the mountains in case it closed on us, we would be on that side. I was going to have this chance for VBAC no matter what. I texted my husband right away and I’m like, “Hey, I had a contraction. I’ve had several. I’ve got some stuff going on. Can you head home from work? He never responded.” 6:00 rolls around. My daughter got up. My contractions slowed just like they do when your toddler is awake. I was like, “Did you get my text?” He was like, “No, what?” I was like, “It’s going to happen today. I’ve been having contractions. I feel it.” He was like, “Okay. I was like, “But the pass is starting to snow already up there and I think we’ve got to go. He was like, “Well, let’s just see.” I was like, “Okay. All right. Let’s do this. When she goes down for sleep, I bet it’s going to pick up.”Sure enough, it did. 7:30 rolls around. I put her down and it started again just small contractions, but I felt it. He went to sleep and by midnight, I was having timeable 5-minute contractions trying to lay there. I was like, “I can’t do this anymore. I’ve got to get up.” So I got up and I got in the shower. He came in and he was like, “Are you okay?” I was like, “I am having some pretty intense contractions. I cannot lay here.” He was like, “Okay.” We were just reading each other’s minds at that point. We’ve been married so long and we were both thinking about the pass. What are we going to do? Who was going to come over at this

Macy’s first birth was a scheduled C-section due to breech presentation that required follow-up exploratory surgery due to an unknown cause of internal bleeding. Unfortunately, her surgeon had accidentally nicked an ab muscle. Macy’s recovery was very difficult.With her second, doctors were nervous about her chances of VBAC and would only let her try if she showed up in active labor before 39 weeks. Otherwise, she would go in for a scheduled C-section. Macy agreed and her birth ended in another Cesarean. Her birth was beautiful and her recovery was smooth, but it still wasn’t the empowering experience she hoped for. Macy hit the ground running during her third pregnancy. When doctors were not supportive of a VBA2C, she knew home birth was her best option. She found a midwife who was willing to take Macy on as her first VBA2C client! We know you will absolutely love listening to this birth story. Like Meagan said, “It is so beautiful. It is so peaceful. It sounds like one of those births where you close your eyes and you envision birth and how peaceful, beautiful, and calm it really can be.”The VBAC Link Blog: VBA2C Practice Bulletin - VBACInformed Pregnancy - code: vbaclink424Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 03:44 First C-section with internal bleeding and a follow-up exploratory surgery09:04 Second pregnancy11:37 Scheduled C-section and getting pregnant again shortly after18:44 Finding a supportive home birth midwife23:24 VBA2C prep during pregnancy27:46 Labor begins32:42 Breaking her own water and pushing for 17 minutes36:47 ACOG’s statement on VBA2CMeagan: Hello, hello Women of Strength. We are so excited to be sharing an HBA2C story and if you don’t know yet what HBAC means, that’s home birth after Cesarean and then HBA2C is home birth after two Cesareans. I feel like that’s kind of funny. It’s never really a term I used because I wasn’t at the hospital and I wasn’t at home, but I also kind of feel like I sort of had an HBAC. It was at a birth center. Maybe that’s a term, birth center birth after two Cesareans. I don’t know. But obviously, VBAC after two Cesareans are near and dear to my own heart and today we have our friend Macy from California sharing her HBAC story and just before we started recording, we were talking about how one of her messages that she wants to give is that you can do this. Right, Macy? You’re just like, you can. People can do this. Macy: For sure. Meagan: Yes. Yes. I am excited to hear your story and then I wanted to also just talk a little bit at the end about some evidence on VBAC after two C-sections. So if you’re wondering more about VBA2C, make sure you stick to the very, very end even after the story because we’ll talk a little bit about that. 01:24Meagan: We do have a Review of the Week and this is from Jenna. It is actually on our How to VBAC: Ultimate VBAC Prep Course. She says, “I just started but have already learned so much. After two C-sections and one where my doctor made me think it was very risky, I was terrified to try again. With this course, not only have I learned the truth about VBAC, but I am excited to attempt mine in August.” That’s coming up. I am so excited for Jenna. Thank you so much for the review and the support, of course, of taking the course. I am so excited that you are getting educated and definitely keep us posted. 03:44 First C-section with internal bleeding and a follow-up exploratory surgeryMeagan: Okay, cute Macy. Welcome to the show. Macy: Thank you for having me. Meagan: Absolutely. I’d love to turn the time over to you and share whatever message you feel is important for our beautiful Women of Strength listeners. Macy: Okay, well like with all VBACs, my story begins of course with my first pregnancy. During my first pregnancy, I was pretty healthy. I didn’t love being pregnant, but I was excited that we were starting our family and I got to– I can’t remember– 34 weeks maybe, 35ish, and baby was still breech. They offered me the ECV procedure, but they told me I would have to do it around 37-38 weeks and I was worried about it being so early before my due date that she would turn again. I was scared. They got me scared. They don’t really present the ECVs as something that should work. Meagan: I know. I know. Macy: My midwife with my third pregnancy was like, “I wish you would have done it,” but they talked me out of it so I decided not to do it. Come 40 weeks, she was still not flipped, but I wasn’t in labor so another thing is I wish I would have just waited to see because maybe she would have flipped in labor. Meagan: Sometimes they do. I actually recently had a client last year in 2023 that did have that. She was scheduled for her version and then she went into spontaneous labor so she actually went in pretty early because she was like, “Oh my gosh. My baby’s breech. I was scheduled the next day for a version,” and they were like, “Baby’s head down.” So it definitely happens. Macy: With my third one, she was sunny-side up. She was posterior, but I could feel her turning and getting into position. But anyway, I’ll get there. I’ll get there. I had my C-section scheduled. My daughter, Alayna was born 10 days before Christmas in 2018. She was perfect. She was 6 pounds, 13 ounces. I was not great. After my surgery, I came out. I was in the PACU and my blood pressure was dropping crazy low and my heart rate was spiking super high. I was ghost-white and they were like, “We don’t know what’s going on.” Long, long, long story short, I was having crazy internal bleeding. Meagan: I was going to say, were you hemorrhaging? Because that sounds like hemorrhaging. Macy: I was hemorrhaging. I was bleeding internally, but it was from having surgery. It was not anything to do with baby or birth. It was just surgery. So what we discovered is they had accidentally nicked an ab muscle and it was bleeding. 24 hours after my daughter was born, I had to go back in for an exploratory surgery and I was put under anesthesia completely again. They had to cut back open my layers and start over. Thankfully, they didn’t have to cut into my uterus again, but they did open me back up and stop the bleeding, cauterize it and I mean, my recovery was just horrible. Meagan: Not great, yeah. Macy: I mean, thankfully I only had one baby so it was just her and my husband is amazing. I could not ask for a better partner, but it was just hard. It was hard to accept that, to grieve the birth I had dreamed of my whole life, but it never occurred to me that I couldn’t have a VBAC. My mom had me via C-section and my three subsequent siblings were all VBAC. So when someone said to me at 12 weeks, I recovered. I was back at the gym and someone from the gym was like, “Oh, so you have to have all your babies as C-sections now.” I was like, “Wait, that’s a thing still? We’re still doing that?” I was like, “No. I’m going to have a VBAC.” I never even thought about it. I immediately was like, “Oh, so this is going to be a thing.” That’s when I found you guys and I started listening before I was even pregnant with my second one, but when I did get pregnant three years later with baby number two, I probably binge-listened to every single episode. I was like, “I’m doing this.” 09:04 Second pregnancyMacy: I switched providers just because I didn’t have a great experience so I was like, my postpartum care, I didn’t care for my pediatrician so I just switched everything. But because I was with a new provider, I had a really difficult time locating my surgical notes. My new providers wanted to know if my first C-section was done with a single or double-layer closure. Meagan: Oh, interesting. Okay. Macy: Because of course, if it’s single, it’s going to increase my risk for a rupture. I at this point was already like, the risk of rupture is so low. I am not worried about it. Breech baby is a great candidate for VBAC. Meagan: And the evidence on that is really not solid on which one really is best. There are some that show double may be better, but that doesn’t necessarily mean that your rupture rate skyrockets because you have a single layer. So they are focusing on something that didn’t have a ton of evidence. Macy: Right. I was like, “There is just not enough research to justify all of these C-sections.” But because they didn’t understand what had gone wrong and why I had to have a second surgery even though I told them a million times it wasn’t anything to do with my uterus. It wasn’t a me problem. It was a doctor's problem. They were just like, “We just don’t feel comfortable with TOLAC.” And you know, it’s always TOLAC. It’s never just a VBAC. Meagan: I know. Macy: But they didn’t want to do anything. They didn’t want to offer ultrasounds. They just were not willing to take a chance even though it was a really good chance. So basically, they were like, “The only way you are having this second baby VBAC is if you come to the hospital and you are in labor and it’s time to push.” I mean, that’s kind of scary to someone who doesn’t know. I mean, now that I’ve done it I’m like, “That’s what I should have done,” and that’s what I tell my friends. You don’t go to the doctor until your contractions are two minutes apart because they try to scare women out of their VBAC. 11:37 Scheduled C-section and getting pregnant again shortly afterMacy: So I just didn’t really stand up for myself. I just agreed like, “Okay, I guess.” I told myself, “If I go into labor before my scheduled C-section at 39 weeks, then that’s the way God wants it and I will have my VBAC.” Obviously, that never happened and 39 weeks is pretty early now knowing especially when due dates are just guess dates. Meagan: Very important note that you just gave there. Macy: Yeah. I had my baby at 39 weeks. She was perfect. I mean, my recovery was– she was another 6 pounds, 15 ounces so they were almost the same size. That was Reagan. Recovery was a lot better but still, I had a 3-year-old at home. Going from one to two was pretty good for me. I have a big family. That was great. But it was still not the empowering birth that I wanted. I did feel– I don’t want to say I didn’t feel empowered because C-section is badass. It’s hard. Meagan: Yeah. Mhmm, yeah. Macy: It’s not the easy way out ever. There is no easy way out of birth. I do want to preface that and say if that’s what ends up happening and you only have two kids and you only have two C-sections, that’s okay too. I knew we weren’t done having kids. I wanted the birth I wanted. I did not plan to get pregnant with such a short turnaround time. I was almost 8 months postpartum when we found out we were pregnant again. We were a little surprised. I mean, we are grown adults. It shouldn’t be that surprising. Meagan: But still, it can be a little alarming when you weren’t mentally preparing for that. Macy: I had just finished breastfeeding. I was just starting to track and all of these things so I was like, “Oh no.” But that was kind of when my work really started for me because I was like, “Okay. We are doing this again and I’m going to do this the way I want. This is going to be how I want it to go. This is my story and this is going to be an essential component of who I am as a woman and as a mother going forward for the rest of my life. I need this to go the way I want it to go.” I wanted it to go the way God wanted it to go of course, but I was like, “I’m going to take more control.” Meagan: Can I add something to that? Sorry to interrupt, but there are so many times that I hear people, I read on social media that people are getting after moms and parents who are like, “I want this birth. This is what I want. This is what I feel I need,” or what you are saying. “I want it to go a certain way.” They are like, “Why do you have to focus on what you want? It’s not what you want. It’s what’s best for the baby.” They are railing on these people. I want to stop and say that what you said is okay. I feel like maybe a little passionate about that too because so many people were naysayers to me. “It does not matter what you want. It’s what’s best for the baby.” It’s like, well guess what? That’s also maybe what’s best for my baby. Macy: Right. Meagan: It’s okay to say, Women of Strength, “I want this birth. This is what I want.” And you deserve that. You deserve to go after what you want. Macy: It is hard and being a mom is hard. Meagan: Yes. Macy: You can start out in a way that you feel empowered. It is life-changing. It really is. Meagan: It is. So sorry for interrupting, but I just wanted to give a little tidbit that it’s okay for people to want what they want. I wanted a white vehicle. I was going to find a white vehicle. It’s okay to get what you want and to put forth energy and to say that out loud, “I want this VBAC. I’m going to get this. I want it.” Macy: You spend almost 10 months thinking about this and praying about it whereas you talk to– I mean, it wasn’t as important to anyone else in my life except for me. That was okay. Especially the doctors and the providers, I’m just another person to them and yes, there are some really great providers out there and they do care, but they are at their job. They are doing their job. Well, my job is to be a mother. That’s my job, so doing what serves me well was birthing my baby the way– Meagan: Having a VBAC. Macy: Having a VBAC. So I really hit the ground running. There were a few girls in my town who had recently had homebirths. They weren’t VBACs, but they were VBACs so I reached out to them– shoutout to my girls Megan and Emily. They were so helpful because they were real people. I reached out to you guys and I just wanted to know, “Hey, what is the research on really close pregnancies?” because I wasn’t going to hit the 18 months. Meagan: The 18 months. Your babies were going to be 17 months apart, right? Macy: 17 months. So that was even annoying too because I was like, “I’m right there. Come on.” You guys were like, “Go join the Facebook Community group.” I was so glad that I did because I was just finding story after story after post after post. Not only were so many women having VBACs after two+ C-sections, but they were close together. Some were like, “Mine were 12 months apart.” I’m like, “Oh, I’m good to go then.” It was so nice having that community. I was even able to join a community within the community of everyone who was due at the same time as me so when we got close, we had a group message and everyone was like, “Is it happening today? Is it happening today?” It was so nice not to be alone in that. I also had to find a midwife because I knew my providers were not going to be supportive of VBAC after two. I actually had a hard time finding a midwife which was also annoying because I was met with some medwives who were just really going to stick to that 18 months. 18:44 Finding a supportive home birth midwifeThen I happened to just find a woman who was like, “I’ve never done this before. You are my first VBAC after two,” but she was a midwife who was very knowledgeable. She had done lots of home births. She had done VBACs, but not after two. She was like, “If we don’t start accepting these patients, how are we ever going to change the status quo? How are we ever going to make a change?” Meagan: Boom.Macy: Right. Meagan: It’s so true though. Macy: I was like, “Okay. Statistic me, please. I would love to be a statistic for the positive.” The only thing was I was like, “I can’t be one for a hospital birth, but it’s fine.” Meagan: That’s okay. That’s okay. Macy: So I found Sarah. I started my visits with her. I had to travel an hour to my visits. It wasn’t the worst thing ever. Meagan: That’s a commitment though. That’s a commitment. Macy: Towards the end, she came to me a lot more which was so nice. So nice. Meagan: That’s really nice. Macy: Then we did a couple of phone calls, but we also texted all of the time and would FaceTime. It was just so personal. I also received co-care with another third local provider. I did that because my midwife wanted to have me get ultrasounds to check my uterus. She wanted to check for previa and we wanted to check for– what’s the other one? I’m blanking. Meagan: Accreta? Macy: Yes, so she just wanted to be aware. Meagan: Placental issues and make sure the placenta is out of the way and all is doing okay. You’re actually clear to have a VBAC. Macy: Yeah. Meagan: Which is very responsible of her. Macy: I received my co-care. I would go in there. I don’t know. I almost had a chip on my shoulder because I was like, “I don’t really need you guys,” kind of. I didn’t leave those appointments feeling like I wanted to cry like I did with my second pregnancy because I knew that I had something better planned. So it wasn’t as upsetting, but they were pretty rough on me. I had expressed my interest in a VBAC after two and you have to see the series of providers within the office. I had only one who was a little bit younger which was interesting, but he was the only one who was like, “Yeah. I really support this and the birth you want to have. I’m going to give you a referral to UC San Francisco and when we get to the end, I want you to start care there and plan to have your birth there.” He was the only one who was like, “I support the birth you want to have.” Everyone else was pretty awful. They told me, “If you TOLAC and your uterus ruptures, you will die and your baby will die.” I was like, I will never forget getting in my car and texting my midwife and being like, “Can you believe that he just said this to me?” I was just like, “Are you God? Do you know?” How could you say that to someone? “You will die.” Because that’s not the case at all. That was interesting but I knew. Like I said, I knew I had a backup plan in the back of my mind. It was just eye-opening for me more than anything. It wasn’t upsetting. Meagan: Someone that doesn’t necessarily know the evidence of that, it can be terrifying. Macy: Yeah. Yes, totally. And you know what? It’s frustrating because a lot of people just trust their providers. I’m a very skeptical person. I’m very conspiratorial, so I’m always researching things and looking into things, but people who are not prone to that are just going to trust what the doctor says because they went to school and they are smarter than them. It’s so unfortunate that it’s causing a high C-section rate for no reason. 23:24 VBA2C prep during pregnancyMacy: That was a bummer but anyway, throughout my pregnancy, I did all of the things. I did my VBAC Link course. I loved it. It was great to have that. I did a Lamaze class which was really fun. It was funny because we were the only parents in there with other kids. One other lady was a VBAC, but the rest were all first-time parents. They were like, “What are you doing here?” I’m like, “This is new for me.” Again, shoutout to Modesto Birth and Beyond. They are fantastic. They have a great set of doulas. I’m now on a friendly basis with them. They were great to have and they were really supportive of my whole journey. Let’s see what else. I did a Hypnobirthing class. I read Ina May’s Guide to Childbirth. I mean, I walked and I stayed in shape. I kept doing CrossFit. I did CrossFit for all three of my pregnancies so I kept on. I ate healthy. I drank lots of water. I did all of the things. But I knew that when it came down to it, my mind was going to either make or break me.Fast forward to 41 weeks and I was getting very, very anxious. Meagan: Were you getting anxious because you were getting ready to have a baby type thing or were people giving you some grief that you were over 40 weeks? Macy: By the time I was 40-41 weeks, the grief and the doubt and the naysayers that I got were kind of gone. Most of the people in my life were supportive. I always got that question of, “What if this happens?” I live 5 minutes from the hospital, so I was not too worried about it. I was more anxious of, I was ready to meet this baby. I was the biggest I’d ever been. Third baby, only 17 months apart. My belly was huge. It was hot. I was swelling. I was ready to be done, but I also had never labored before. I had no clue what my body was going to do. Was I just going to go into spontaneous labor at 40 weeks? At 39? I had no idea. So every day that passes, I’m sure you remember that too, every day was a whole week where you wake up in the morning and I would just cry, “I can’t believe I’m still pregnant.” Meagan: I remember going to bed and I was like, “Tonight could be the night,” and then I’d wake up and I was like, “It wasn’t the night,” then that night, I’d be like, “Maybe tonight,” and it just kept happening. Macy: So annoying. I had so much prodromal labor. I had contractions. I could time them and I was like, “Oh, they are 20 minutes apart. They are for sure going to get closer,” then I’d go to sleep, wake up, and be like, “Okay. Here we go again.” Let’s see. So on a Monday, I did acupuncture. Then on a Wednesday morning, I was 41 weeks and I went and got a massage. I got some acupressure. You never know if these are the things that really get things going, but sometimes they do. I got a massage and she gave me some moxibustion so I did that. You light it and do it around– my mom was like, “This is so hokey.” I’m like, “If it works, who cares?” I was trying everything. But I didn’t want to be induced and I hadn’t had my membranes swept yet. That was going to be the first intervention that my midwife and I agreed on because she was like, “Legally in California, you can’t go past 42 weeks and have a home birth.” I was like, “Okay. I’ve got one week. One week and this baby will be here.” 27:46 Labor beginsMacy: That Wednesday morning, I went and got my massage and by 2:00 in the afternoon, I was like, “Okay. Things are starting to pick up.” I started having pretty intense contractions. I was having to– I could still talk. I was still taking care of my two little girls, but I was starting to feel really uncomfortable. My mom went home, then she came back. My husband gets off work at 3:30 and it was 2:30. I was feeding my youngest one a snack and he was like, “Do you want me to come home early?” I was like, “No, I can totally make it until you get home.” I had a contraction where I leaned over my kitchen counter, and then I was like, “Okay. Maybe just come home now.” He came home. I just didn’t feel it. I was starting to feel irritated by my kids and I was like, “I just want to go in my room and watch a show on my laptop. I just want to be alone.” I didn’t necessarily want them to leave yet, but I wanted to be alone and I wanted to know that they were taken care of. He came home and he was taking care of them. He was like, “Do you think this is it? Let’s call my mom.” I was like, “Yeah. I think this is happening and I think it’s going to be soon.” I just didn’t know how long I was going to labor. It was a mystery. My mother-in-law came and picked up my little two daughters. That was kind of sad watching them leave knowing the next time I saw them, we were going to be a different family– a better family, but a different family. Yeah. I just labored at home. It was so nice not having to go anywhere. I took a shower. I had some snacks. I wasn’t super hungry, but I definitely started drinking my electrolytes and started preparing to be hydrated. Meagan: Smart. Macy: I was like, “I’m preparing to run a marathon so I need to gear up.” I didn’t nap. I’ve never been a great napper, but I laid around and watched some shows, then I didn’t text my midwife right away because I had been bugging her so much with all of my prodromal labor that I was like, “I’m not going to text her until it’s really happening.” But by 6:00 or 7:00 PM, i texted her and was like, “Just so you know, my contractions are about 10 minutes apart.” As they got closer, she was like, “Okay. I’m going to come now.” Once the sun started setting, it was getting a little bit more intense. We set up my birth space at home. I set up my pool. Well, I didn’t. My husband set up the pool and we laid out all of the sheets on the couch and hung my birth affirmations. Actually, they had been hanging. My birth affirmations had been hanging for a couple of weeks so I started having them memorized, but we turned on the twinkle lights and I started listening to the Christian HypnoBirthing app which was fantastic. I just had such a peaceful labor. I don’t know how else to describe it. My mom came in and then my sister-in-law came over then my other sister-in-law came over. They just talked around me. I could hear them, but I was just in my space. I labored and my water never broke for a very long time. I got in the pool at one point and then I got back out because my husband was like, “I think that being in the pool is slowing down your contractions a little bit. I want you to get out and walk.” I got out and started walking down the hall then I got really sick with a contraction. I happened to already be laboring backwards on the toilet and I was like, “Oh my gosh. I’m going to throw up.” I jumped back off the toilet so I could throw up in it then my midwife was like, “Okay. You’re in transition now. You’ve got to be.” I hadn’t had any checks at all this whole time either too so I had no clue what I was even dilated at. I was just completely trying to trust my body and just know that when it was time, it would be time. It really was. My body just did what it knew to do. 32:42 Breaking her own water and pushing for 17 minutesMacy: Like I said earlier, I felt her move into position. I got back in the water and I felt so relaxed in the water. I was drifting off in between contractions. Meagan: Oh, that’s awesome. Macy: It was so calm and I just kept telling myself, “Breathe her down with every contraction,” and just all of the things I had been practicing, I was finally able to put into use. That was really cool, then I had a couple of urges where I was like, “I feel like I can start pushing soon.” I was like, “Do you want to check me now?” As soon as she stuck her finger, I was like, “Oh, no. No. Get your finger out. It’s time. She’s coming.” She was like, “Yeah. She’s ready. She’s right there, but your waters haven’t broken yet.” I was like, “Can I break them myself?” She was like, “Yeah,” so I reached in. I gave it a pinch-twist and in the water, I broke it. Meagan: Oh my gosh, that’s so cool. Macy: I felt the padding around her head, then I just felt her head. I felt her hair. I started pushing when it was time to push and I pushed for 17 minutes. It was perfect. Like I said, I felt her move and get into position. She came out and she was 9 pounds, 12 ounces so she was 3 pounds– Meagan: I was going to say 6lb,15oz, right, was your second and close to your first?Macy: 3 pounds heavier than my other two. She came out. She did perfectly. Her heart rate was perfect the whole time. She came out mad, screaming mad. She was so cozy in there. She did not want to come out. She came out but hearing her cry within 20 seconds was so reassuring. She was safe. I didn’t need anybody. I just needed to trust my body and to trust the Lord. My midwife was like, “That was one of the most perfect births I have ever attended.” She was beaming with joy and she was so excited for me. She was just so happy because she was like, “I’ve never done this after two.” She was like, “You changed everything I thought I knew about home birth, about after two C-sections.” She even now has another client which is great who is a VBA2C. I cannot wait for this podcast to come out so I can share it with my midwife and she can share it with her new client. Hopefully, they have a really great birth too. All in all, it was just everything I dreamed of. I was so thankful and I just remember laying there with her on my chest. I was watching the video last night trying to get in the mindset and remind myself and get there. On the video, I can hear myself go, “I’m so freaking proud of myself.” Meagan: You should be!Macy: I was beaming with joy. I was like, “That was so hard but so worth it.” So it was great. It was a great experience. I could not be more happy with her birth. She’s a great baby. She’s so happy. She was a little hard at first for 10 weeks which was different for me, but after that 10-week hump, she was a really good baby. Her name is Lucille. Meagan: Cute. Macy: We call her Lucy which means “light” and she is the light of our lives. She is the best and I can’t even believe we had a family without her for a minute there. But that’s my story. 36:47 ACOG’s statement on VBA2CMeagan: Oh my gosh. It is so beautiful. It is so peaceful. It sounds like one of those births where you really do. You close your eyes and you just envision birth and how peaceful and beautiful and calm it really can be. To me, you just described the birth that you physically did with one that I would imagine. Macy: Yes. It’s how it felt. My sisters-in-law and my other girlfriend who was there taking pictures just kept saying, “You did so good.” I was just like, “I don’t know what that means.” But everyone was proud of how it all went. I think that’s so super revolutionary. I hope my story touches other people’s lives. Meagan: It totally will. I’m so happy that you found your midwife and that your midwife was willing to take you on because a lot of the time, providers can be nervous if they have never done it before. Macy: Which I get. Meagan: Oh yeah. For sure, for sure. I’m just so glad that she was willing. That’s one of the things that gets me sometimes with so many people who just are not, we have to respect them and what they are comfortable with. But really, the evidence does show that VBAC after two Cesareans is reasonable. The overall risk and rate of rupture is approximately 1.4% so it’s still very low. It’s still very, very low. I mean, ACOG themselves, the American College of Obstetricians and Gynecologists, they suggest it. They say it’s a completely reasonable option so for so many people to be cut off after one is heartbreaking because there are so many people who could have a vaginal birth all over the world but aren’t given the option. We have a high Cesarean rate. We have so many. There are so many people. Just actually weirdly enough at the gym, a man who is the darndest cutest thing ever, his name is Robin and he will always say hi to me and check in on me and how I’m doing. He knows that I cycle and one of the things he asked the other day was, “How’s that doula thing coming?” I said, “It’s really great.” He said, “I never asked you. What made you want to become a doula?” I just told him my story and he said, “Oh, so you had two C-sections?” His eyes were wide. He said, “But you said you have three kids.” I said, “Yeah.” He goes, “But you only had two C-sections?” I said, “Yeah.” I said, “With my first two girls.” He was like, “Wait.” He literally was stumped there for a minute. Macy: Yeah, people don’t know. Meagan: He said, “You had a normal birth after two C-sections?” I said, “Yes.” I said, “Robin, I had a vaginal birth after two Cesareans.” He looked at me because I said the word vaginal. I said, “That’s what it is.” He said, “I didn’t even know that was a thing.” People just don’t. They just don’t know that and then there are still so many providers all over the world who aren’t supporting it. In the ACOG Practice Bulletin, it says that VBA2C, vaginal birth after two Cesarean, is reasonable to consider for women with two previous low-transverse Cesarean deliveries to be candidates for TOLAC. We mentioned the word TOLAC earlier, a trial of labor after Cesarean. A lot of providers use that. It is a medical turn. We call it VBAC. They call it TOLAC. It’s not a VBAC to them until the baby has passed through the vagina. It says that they are candidates for TOLAC and “to counsel them based on the combination of other factors that affect their probability of achieving a VBAC.” Meagan: Now, just a couple of things to share before we drop off on this episode, if you had a Cesarean before or two Cesareans, it is not necessarily a reason for you to have a third. If you have gestational diabetes, that doesn’t mean that you can’t VBAC either. I’m trying to talk up these other factors, right? If we have preeclampsia, that doesn’t always necessarily mean that we have to schedule a Cesarean. We’ve shared stories in the past. We’ve even had things like babies with medical conditions where still even their provider said, “Just because your baby has this doesn’t mean you can’t have a VBAC.” That doesn’t always necessarily mean you can’t either. If you have a big baby, here we are. A nine-pound baby, right? A nice, squishy little baby. Big baby doesn’t mean you can’t either. A diagnosis of a small pelvis shouldn’t be considered– these factors really are more extreme I feel like so if your provider is giving you some of these, “Oh, well you could have a VBAC after two Cesareans but because your baby didn’t come down the last two times, it’s just probably not going to happen.” You can’t see it. Macy rolls her eyes with me. Macy: The baby is going to come out. It has to come out. Meagan: Baby is going to come out. Believe in yourself. Do the research. We do have a VBAC after two Cesarean blog. We’ll make sure to link it here and kind of spin back to what you said about how you were like, “Let me be a statistic. Let me a statistic to your midwife.” VBA3C– we don’t have a lot of stats on VBA3C and I think a lot of it is because we are not doing them. We are not allowing them yet we have so many VBA3C moms in our community

“Control what you can control.” Brooke’s birth experiences have not been without challenges. She first had an extremely difficult miscarriage during COVID followed by intense bleeding due to massive subchorionic hemorrhages during her other two pregnancies. Her first delivery was a very traumatic C-section from not being completely anesthetized. After that, Brooke committed to doing everything in her power not to have that experience ever again and to do everything she could to avoid a C-section. Along with another subchorionic hemorrhage, her third pregnancy presented another challenge when she found out her baby had a bowel obstruction and would need surgery along with a NICU stay immediately after birth. Brooke was disheartened learning that she needed a medically necessary induction, but she was still committed to doing everything she could to achieve her VBAC. Her efforts to surround herself with a powerful team paid off. Everyone around her championed her VBAC. Brooke was able to go from the most traumatic birth imaginable to the most beautiful, empowering, and healing birth she literally dreamed about. Brooke’s WebsiteInformed Pregnancy - code: vbaclink424Needed Website - code: vbac20How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:36 Review of the Week07:19 Brooke’s first pregnancy11:18 Miscarriage15:01 Brooke’s dream17:20 Second pregnancy21:26 Going into labor and getting admitted28:06 An extremely traumatic C-section32:53 Third pregnancy38:17 Bleeding again43:09 Finding a bowel obstruction in baby46:57 Switching providers the day before her scheduled induction50:57 Progressing to complete dilation54:54 Getting an epidural and pushing for three hours59:40 15 tips for birth1:04:22 Control what you can controlMeagan: Good morning, good afternoon, good evening– whatever time it is that you are listening to this episode, I hope that you are doing great. We are excited to get into another VBAC story today from our friend. Okay, so I’m trying to think. Remind me. Are you in North Carolina now or are you in New York City now?Brooke: No, I’m in North Carolina now, but the story starts in New York City. Meagan: The story starts in New York City. She’s in North Carolina now. Her name is Brooke. Tell me a little bit more. You are an educator. You are helping kids read, right? Is this what I’m getting from your website? Brooke: Yes. Meagan: Okay, so tell us more about what you do. Brooke: I worked in New York City public schools for 10 years. I was a teacher, a literacy coach, and an administrator so I have experience both in the classroom and in school leadership. After we welcomed my daughter and after the pandemic, we moved to be closer to family in the Raleigh, North Carolina area and here I’m an education consultant. Meagan: Education consultant. Awesome. We will make sure to have your website linked for anyone listening. What type of people would want to go to your website? Brooke: I offer a number of services. The first thing that I do is pretty classic consulting in elementary school. I provide literacy support. My expertise is in pre-K through 3rd grade so early reading foundational skills. I help schools with their reading programs. But additionally, there’s a big home school community in the Raleigh area. Meagan: I saw that on your website. Brooke: Yeah, I’ve had a really wonderful experience so far working with families getting set up on their homeschooling journey and supporting parents and caregivers in taking on the teacher role at home. Meagan: Awesome. Awesome. I think home school, especially since COVID has really taken off. I know a lot of people, some of my best friends in fact here in Utah even homeschool. It’s a great resource. In addition to all of the amazing, great things you do, you have a VBAC story to share with us after a Cesarean that was performed pretty early, right?Brooke: Yeah, it was a pretty preterm and traumatic C-section. All VBAC stories start with a C-section so that’s part of my journey. I’m so, so, so, so grateful. Thank you so much for welcoming me onto the show today. Putting this story out there, being on this podcast, and sharing my VBAC was part of my birth plan. It was on my vision board. It was a goal that I had set so I am just so, so, so grateful to have this opportunity to share that. Meagan: I’m really excited that you’re going to dive in today. We talk about this a lot of the time with this podcast. Without these stories, without women of strength just like you, we wouldn’t even have a podcast. I mean, probably I could get some content for sure but I think these stories are what makes this podcast. I’m so excited to dive in in just a moment. 04:36 Review of the WeekMeagan: I do have a Review of the Week. This is a review that actually was just given this year in 2024, the current year that we are recording. It’s from a Bailee Atkins. She actually emailed us in a review. If you guys didn’t know, you can email in us a review. It makes our hearts smile so big when we open up our email in the morning and we get these amazing reviews letting us know that everything that we are doing right here is helping, is inspiring, and encouraging, and educating.This says, “I just want to start off by saying I am OBSESSED with this podcast. I’m a labor and delivery nurse of four years, currently 29 weeks pregnant with my second baby. I’m praying for a redemptive VBAC this April. I absolutely love this resource for evidence-based information. Being that I am at the bedside as a nurse, I have plenty of knowledge. However, I don’t have the experience of home birth or a birth center birth, so it’s great to get all of the insight. I can’t escape negative birth situations and stories as a pregnant nurse so this podcast is often my escape and positive note for the day. I’ve been listening since 2022 and couldn’t feel more empowered for this VBAC. It is my dream to be on the podcast one day, so be on the lookout.” Okay, I love that. This is being aired probably after her due date. I mean, I don’t know when her due date was, sometime in April, but we are now in May, so Bailee Atkins, if you are still listening, if you haven’t already, email us and let us know how it goes and we would love to have you on the podcast. 07:19 Brooke’s first pregnancyMeagan: Okay, cute Brooke. I am so excited to hear your stories. You also have a miscarriage story, too. Is that where this all began? Brooke: This is where it all began. I’m glad you brought it up because I did want to just say at first that my story– I just want to put a note out there to any listeners who are kind of sensitive. My story does include loss and a lot of medical trauma so I just want to put that on the listeners’ radar. Meagan: Yeah. I think that’s important. I know some people don’t feel like they need any trigger warnings, but when you’ve gone through loss or medical trauma or things like that and it hasn’t completely been worked through or processed or anything like that, and even if it has, it can be really triggering so we just wanted to make sure to mention that. It also is your story and I think that’s also really important to share. Brooke: Yeah, so thank you for that. It was actually four years ago this week at the time of this recording. This is a really lovely way to kind of just close that chapter. It just is all working out beautifully.I’ll set the scene. It’s December of 2019. The world is still turning. Things are great. I’m at a New Year's party in Brooklyn. I’m just thriving. I had just come back from a great backpacking trip with my husband for the summer across Asia. Life was– we were on a high. Meagan: Wow, super exciting things happening. Brooke: Yeah. It was great. It was a great time. We call it the great grand finale. We are at this New Year’s party in Brooklyn and I go to pour myself some champagne and I think, “Maybe I shouldn’t. I think I could be pregnant.” I’m like, “No, no, no. Whatever.” Anyway, I take it easy. We go home early. A couple of weeks later, I’m so ill. I am so sick. I have the worst cough and cold situation I’ve ever had in my life. My boss at the school was like, “You need to go to the doctor. This has been too long.” I go to the doctor and I’m at urgent care. It’s a Saturday morning and they’re like, “Oh, we need to do some x-rays. We think you might have pneumonia. Is there any chance you might be pregnant?” I was like, “Oh my gosh, yeah. I didn’t drink at that New Year’s party. That was two weeks ago. I can’t take this x-ray.” I go to the store. I pick up a pregnancy test. I go home. I take it. It’s positive. I’m over the moon. This is the happiest moment of my life up to this point. My husband gets home. We are jumping up and down. We are so excited. Everything is smooth sailing. Everything is great. I immediately start getting sick and I’m breaking out. I just feel awful. I was complaining. As this pregnancy is progressing, the world is really starting to get a little bit of that pre-COVID hysteria. It’s just starting. Meagan: Yeah. Especially in New York. Brooke: Yeah, right? I’m in New York City at this time. I go to the doctor. My husband is still allowed to come with me and things like that. This is the time before. We see the baby. Everything is normal. We go back again. We see the baby. Everything is normal. My doctor offered the NIPT genetic testing and I was like, “Yeah, let’s do it.” We took the blood sample. I think I was about 10 weeks at that point. We got the results 7-10 days later in that window and it was inconclusive. The doctor was like, “It says there’s not enough fetal DNA. We might have just taken it too early. This happens sometimes. Nothing to worry about.” I was like, “Okay, nothing to worry about.” 11:18 MiscarriageBrooke: It was maybe week 11 and I had miraculously felt better. I was like, “Phew. I don’t have any more symptoms.” I’m there at the end of the first trimester and everything is fine. I go in. It was March 9th. It was a Monday. I had my nuchal translucency 12-week scan then and I was going to be 13 weeks the following day on Tuesday. It’s Monday. I wake up. I’m getting ready for work and I start bleeding. It’s just spotting. I call my doctor. She’s like, “Spotting can be normal. I wouldn’t stress about it just yet. You have an appointment later today.” I was like, “Okay.” I tried not to worry about it, but as the day went on, the bleeding got really bad. Really bad. I got in a cab and I called my husband who was at his last day of work at the job he was at. I was like, “You need to leave right now and meet me at the doctor’s appointment. I know it’s not until 3:00 but I’m going now.” It was around 1:00. I showed up at the hospital early and went in for my scan. I was like, “I’m bleeding. I can’t wait 3 hours. Can you just take me now?” I was so shaken. Meagan: Yeah, that’s a lot. Brooke: I was so scared. This is March 9th. People are masked. Everybody is a little bit scared of the hospitals because in New York, things had been happening at this point but nothing was closed down yet. I went into the room. A doctor I had never seen before because this was my first MFM visit does the scan and she comes in. She’s like, “The baby isn’t growing.” My husband is there with me and he’s immediately crying. I’m just not computing. I’m like, “Okay, so does that mean he’s going to have delays? What does this mean?”She’s like, “No, there’s no heartbeat.” I was like, “Okay, so what can we do about that?” I was just not understanding what she was very delicately trying to explain to me. I was like, “What do you mean he’s not going to grow anymore? What does that mean? Is he going to have defects?” She was like, “No. The baby stopped growing 3 weeks ago somewhere between 9 and 10 weeks. You are 13 weeks now. We need to do a D&C.”It was like I was in a whirlpool. I had no idea what was going on. I just became a complete zombie. I just moved through the next two days just absolutely devastated like catatonic. It was the worst grief I had ever known. It was just so surprising. She was like, “You had a missed miscarriage” which I had never heard of to that point. I was like, “What does that mean?” Meagan: What does missed miscarriage actually mean? Brooke: Another term for it is a silent miscarriage. It is when the baby’s heart stops when you have a miscarriage, but your body continues to grow. Your body grows. You still have symptoms. Your body doesn’t recognize that the baby is not growing anymore and isn’t viable anymore and doesn’t properly miscarry. It was several weeks later before I started to bleed. It was that day. I didn’t know. In retrospect, it’s like that’s why the NIPT came back the way it did. That’s why my symptoms stopped. Those things on their own, in my first pregnancy, I didn’t understand. 15:01 Brooke’s dreamBrooke: On the 11th, we had the D&C that Wednesday and on Friday, March 13th, New York City shut down. I came out of this procedure just so sad and then was basically locked in my house for a year. My husband and I were grieving in total isolation. It was just a really tough time. Typically, after a procedure like that, you would go in for a follow-up appointment several weeks later and the doctor would make sure everything was okay. But because it was only emergencies in the hospitals at that time, my doctor just emailed. She was like, “Let me know if you have these symptoms and then I’ll see you, but otherwise it’s safer for you not to come in and you can get pregnant now.” In retrospect, I think she meant you can, not necessarily that you should but I was like, “Okay. I can get pregnant again.” This is maybe a little too much for some people, but I was crying myself to sleep just so, so, so sad and I was like, “I want my baby. I just need to know that it’s going to be okay.” I went to sleep and I had the strangest dream that I watched myself through a snowy window of a nurse handing me a baby girl in a pink blanket and then I didn’t see her, myself in the hospital bed didn’t see her, but through the window, I watched the nurse also take a baby boy and lay him next to me. He was asleep. Meagan: That just gave me the chills. Brooke: Yeah, I’m happy. I’m holding a baby girl. I woke up and I just felt okay. Two weeks later, I found out I was pregnant again. The whole time, I was like, “It’s a girl. It’s a girl. It’s obviously a girl,” and it was. I just knew right from the outset that I was having a baby girl. 17:20 Second pregnancyBrooke: I tested positive at 4 weeks. At 5 weeks, I started bleeding and this time, I was angry. I was like, “What is wrong? Why am I miscarrying again?” I go to the doctor and my OB who is amazing, my New York City OB took such incredible care of me. She is just really an all-star doctor. She was like, “I don’t know why you are bleeding so much, but the baby is fine. They are still in there.” I went back a week later. The bleeding never stopped. When I say bleeding, I mean I’m passing clots the size of golf balls. Meagan: Whoa. Brooke: At 7 weeks, I went in. At this point, my OB was like, “I don’t know what’s going on. I don’t understand why you are bleeding so much, but the baby seems fine.” Meagan: There’s no placental tear? Brooke: No. Meagan: Subchorionic? Nothing? Brooke: At this point, they didn’t know what it was. They did find out. I got on the table and I was like, “I’m really bleeding a lot.” She was like, “Okay.” She put me on the table and she was like, “Oh my goodness. It literally looks like you’ve been shot. There’s so much blood just everywhere.” I mean, I’m not a doctor obviously, but I was like, I don’t know how I can go on with this much blood loss. It was really extreme. Then the psychological impact of all of that bleeding when I’ve just had loss. The world’s not turning. I’m locked in my house other than going to the hospital. There are field hospitals everywhere. I can see them from the window. It is really just apocalyptic. We go through the next several weeks. I go to the MFM. They diagnose a very, very large subchorionic hemorrhage. It was three times the size of my daughter. They were like, “We don’t know if she’s going to be able to sustain this much blood loss and there’s really nothing we can do to stop it.” They were like, “There’s not a lot of research on this kind of thing. We don’t know how it’s going to go. We’ll just keep seeing you once or twice a week, making sure you’re not losing too much blood and make sure the baby is still okay.” The whole pregnancy, she was totally fine. I bled and I bled and I bled. I was on total bed rest because any walking I did at all just aggravated it and caused more bleeding. I was so scared of that. I was really, totally isolated. It was very tough emotionally and physically, but my doctor took excellent care of me, helped me find mental health resources, and helped me to get a prenatal nutritionist just to really give me well-rounded care throughout the pregnancy. Brooke: By 24 weeks, it went away. Prayers were answered and the hemorrhage went away. Meagan: Halfway through the pregnancy. Brooke: Yep, by 24 weeks, it was gone. I didn’t have any new bleeding although I was still bleeding, but it wasn’t the full hemorrhage bleeding that I had been experiencing up until that point.I took it easy until 36 weeks when I was like, “I need to start walking and moving. I’ve been in bed this whole pregnancy. I know that’s not good.” I’m usually a very active person, so I was a little anxious about that. Around 36 weeks, we started taking the daily hot chocolate walk. We would walk to a different spot and we would get a hot chocolate. It’s winter time now. It’s December. It’s Christmas. We were just relaxing and then on January 15th, it was snowing in New York City. I was 38 weeks and 6 days and I went into labor. 21:26 Going into labor and getting admittedBrooke: I woke up at 3:00 in the morning and I was like, “I’m in labor.” I was so excited. It was happening. I labored at home for 14 hours and then we went into the hospital. The traffic was so bad from the snow that I ended up walking down 5th Avenue for 10 blocks because we were in gridlock. I was like, “I’m in labor!” I was nowhere near ready to go to the hospital but I didn’t know. I went to the hospital way too early. Classic C-section red flag right there, but I didn’t know. I got there and my doctor happened to be on call. I was so excited because she was just incredible. We had such a good relationship after the care she had given me throughout both of these pregnancies and I was just so excited. But then she left. She had me in triage. I was only 2 centimeters. She was like, “I think you should go home.” Meagan: You’re like, “I just walked blocks to get here.” Brooke: I was like, “I can’t.”She was like, “It’s probably going to be another 12 hours until you really need to be here.” I was like, “I can’t come back at 3:00 in the morning tomorrow.” I was so anxious. My anxiety from what I had been through, I was like, “There’s no way I’m going home.” She was like, “I’ll push it. We’ll admit you now.” She was catering to my emotional and mental needs to have this baby monitored. I was so scared. Brooke: I get admitted. By the time I get upstairs, my poor husband is not admitted at this point. He’s outside in the snow just walking around Central Park. Not until I’m in my room is he allowed to join me because he had to be tested for COVID and all of that. This is January 2021. Now, mind you, two days before that, I think the 14th was one of the worst days of COVID that we’d had up to that point in New York City. That is what everybody is focused on in the medical world. They’re not like, “This routine birth. This girl is in labor. She’s 39 weeks tomorrow.” Nobody’s stressed. I get the epidural. By that time, I’m 5 centimeters. Two hours later, my water broke. I was at 8 centimeters. It’s 7:00 PM. I’m 8 centimeters. I’m like, “This is happening.” Everything is smooth. I go to sleep. I keep telling everybody that the epidural is not working. I can feel the epidural on the right side of my body. The nurses moved me around, trying to get the medicine to other places, they had me just lying this way, laying that way, but I got up. Never walked around. Didn’t get in any other position other than my back or my side. I went to sleep. I woke up in the morning and was still 8 centimeters. I had stalled out and now, everybody is starting to worry. The doctor who was on call, my doctor, who left after I was in triage, was someone I had never met. I have lots of friends who she delivered their babies and they had great experiences with her, so I’m sure she is absolutely wonderful, but I didn’t know her and I felt really unsafe. She seemed very busy every time she came in and I was very anxious at this point. I was like, “I thought I was going to have this baby yesterday. What is going on?” My angel of a nurse just was so reassuring that whole time, but I kept telling her, “I don’t think this epidural is working.” She was like, “Well, this is the max that you can have. Let’s give you more Pitocin to get those contractions to kick in so we can get you all the way.” More epidural, more Pitocin. More epidural, more Pitocin. The cascade of interventions. This is all for a labor that I went into spontaneously. It’s 39 weeks now. I’m full-term. My nurse goes on lunch break. It’s now Saturday the 16th. My nurse went on lunch break and another nurse came in, someone I didn’t know which is a theme throughout my whole VBAC journey. I really liked to know my provider. Meagan: That’s an important thing, by the way, to know. It doesn’t happen as much anymore, but to know who is going to be with you is very common to want that. It was for me. Brooke: It was not something that I thought I would care about, but at the moment, it was something I really needed. So this nurse I didn’t know came in and took my temperature and was like, “Oh no. You have a fever. This is bad. I’m going to get the doctor. She’s going to operate.” I was like, “What are you talking about I have a fever. What?” The OB comes in. She’s washing her hands. She’s putting on the fresh gloves. She’s doing it. She just came out of C-section. She was like, “You have a fever? You’ve been at 8 centimeters for how long? All right. We’re going to the OR.” I just immediately start hysterically crying. I was terrified. My nurse is back and she was like, “It’s okay. Look. Your baby is perfect. She’s not in distress. Everything is okay. It’s just taking too long. You have this fever. We don’t want the baby to get sick. This is the best thing.” The OB was like, “Why are you crying? Everything is fine.” Meagan: Oh my gosh. Brooke: My husband was like, “You know, she’s been through a lot with the loss and the hemorrhage. We are scared.” The doctor was like, “What hemorrhage? What are you talking about? This wasn’t your first pregnancy?” I felt in that moment like she didn’t know me like she didn’t know my case and I felt really unsafe. She’s a great doctor and she knew what she was doing, but I felt nothing. Meagan: She wasn’t really talking to you. She was telling you what you were going to do, not talking. Brooke: Exactly. In retrospect, I can appreciate that they are in the middle of a pandemic and it was truly unprecedented. I understand now where she was, but it was not good for me. 28:06 An extremely traumatic C-sectionBrooke: I go back into the OR and I’m sure all of the listeners are familiar with this moment where you are being prepped for surgery and it’s really overwhelming. I was like, “Oh my gosh. I hope my husband is not in here right now.” I couldn’t see. You’re just staring up at the lights. I was like, “I hope he’s not in here right now seeing this.” They bring him in and I’m prepped for surgery and they are testing where they are about to perform this surgery. I was like, “That really hurts.” They were like, “No, no, no. It’s just pressure.” I was like, “No, it’s pressure on the left side of my body, but it’s pain on the right. I am telling you as I have been telling you since I was 5 centimeters yesterday, that the epidural is not reaching the right half of my body.” They were like, “Okay. Here is some pain medication through your IV, but we’ve got to do what we’ve got to do.” Meagan: Oh my gosh. Brooke: I think it was extremely traumatic for my husband also because I was screaming through my whole C-section. I was in extreme agony. I’ll liken it to when you watch a Civil War movie and you’re watching an amputee. I was being operated on and was not fully anesthetized. It was the worst thing I have ever experienced or could really imagine physically. It was excruciating. My daughter was born and they said, “The baby is out.” That was maybe the longest moment of my life because she didn’t cry. The first thing I ever said. The first words my daughter ever heard me say were, “Is she alive?” I was like, the baby is out but she’s not crying. They were like, “Yeah.” She cried. They did the suction and she cried. 100% healthy, perfect APGAR scores, everything was fine, but all the while, I’m just screaming. After they checked her, they handed her to my husband and they made him leave. He was down the hall taking the baby to where I would ultimately meet them in postpartum, but he could hear me screaming all the way down. Meagan: Oh, so traumatic for both of you. Brooke: Yeah, it was horrible, to say the least. I hate saying that because it was my daughter’s birth and so amazing for so many other reasons, but my experience was bad. Bad. I was thankfully able to nurse her really well and hold her and everything from then on was just totally smooth sailing. She was perfectly healthy, but I knew immediately that I never wanted to have another C-section. Brooke: The next morning, they were doing their rounds in recovery, and the anesthesiologist who was there, not my anesthesiologist, someone I hadn’t seen before. My husband and I were like, “Will this happen again? If I were to have another baby, would this happen again? What’s wrong with me?” He was like, “Well, I’m not sure, but you probably have a window in your spine and yeah, this would happen with any epidural so I wouldn’t recommend it in the future. We’d have to go a different anesthesia route for a different C-section or you would have to give birth unmedicated.” That was the story in my head moving forward. After that, I was like, “I’m not having another C-section,” so in my head, it was like, “I’m going to have an unmedicated VBAC in the future.” That was day one. To process all of that trauma, I started listening to VBAC podcasts. I just was listening to VBAC stories because that was really the only place where I was hearing C-section stories. I had so many friends who had C-sections before me and I didn’t understand how horrible that recovery can be for some people. Mind you, lots of my friends had great C-section experiences, but I did not and it really took a lot of work to process that. At my postpartum visit, I was back with my doctor and she was like, “You know if you do decide to get pregnant again, we will do an anesthesia consult and really explore that and make sure that that never happens to you again.” Life goes on. I’m raising my daughter. We’re in New York. We decide to move to North Carolina to be with family and to try again for another baby. We’re in our new house and I don’t really know anybody here beyond some family. 32:53 Third pregnancyBrooke: I found out that I’m expecting again and we are so excited, but there is obviously a lot of anxiety after everything that I went through. I was like, “This time around, I need a doula.” I was like, “We’re in a different time. It’s not New York at the height of a pandemic. I need a team. I know now after 2 years of listening to VBAC stories what I need to do. I’m going to control every single thing I can control so that this will go how I want it to go.” I made a vision board about it. I looked at it on my desk all the time. I was like, “These are the things I need to be doing every day to hit this goal.” Sharing my successful VBAC on a podcast was on that, so I am really excited to be able to do this today. Brooke: The first thing that I did was hire a doula, but I didn’t know any doulas and I knew that I wanted one who would really support a VBAC that had experience with the emotional elements of it. I interviewed several doulas with that in mind, but what I did that I would definitely urge listeners to do if they don’t have a supportive provider is I asked every doula that I interviewed if they knew of or could recommend or had worked with in the past any VBAC-supportive OBs. I knew for me and my anxiety given the complications that I had with the hemorrhage and the loss that I wasn’t going to go the midwife/birth center route. I knew that I would want an obstetrician. I was looking for a hospital provider that would be VBAC-supportive. Every doula I interviewed recommended the same practice and the same hospital. I was like, “That’s where I need to go because if all of the doulas are recommending this practice, that’s where I need to try and get in.” I was relieved to find out that they delivered at WakeMed Raleigh and I say that because it’s important to note that it is one of the lowest C-section rates in the country, that hospital. That alone was really reassuring to me because I was like, “They are not going to do it just because it’s taking too long.” It’s really going to be based on that medical evidence. If I need to have one medically, then that’s what we have to do, but I wanted to make sure that it wasn’t the result of interventions or stalling. I don’t know if I had done things differently if my C-section would have or wouldn’t have happened, but I know that I didn’t set myself up for success. This time around, I was really determined to do it. I got a doula. I got a supportive provider. Through my doula, I did childbirth education classes. They recommended Spinning Babies and yoga. I did that. They recommended a Webster-certified chiropractor and I did that. All things really stemmed from my doula and the doula group that she was with. I cannot recommend that enough. I know getting a doula can sometimes be cost-prohibitive, but there are so many doulas on Instagram that share a lot of this information on social media that just following those recommendations, I tried it all. I really did. I drank the tea. I ate the dates, but early in this pregnancy, I hadn’t even hired a doula yet. 38:17 Bleeding againBrooke: 6 weeks, I started bleeding again. I was like, “You’ve got to be kidding me.” I wasn’t as scared because I had just been through my daughter’s pregnancy and I was like, “This just must be the way that I am.” So I go and I get an appointment with this practice because I knew right away that that was where I wanted to go. They took me even though I was a new patient. They took me right away even though I was 6 weeks because I was bleeding. I don’t think all practices bend the rules that much. Their policy is, “Oh, don’t come in until 9 weeks,” but they took me. I really appreciated that. I loved the staff. They were like, “Yeah, we don’t know why you are bleeding.” I said, “Well, I do. I’m telling you right now that it’s a subchorionic hemorrhage.” They were like, “We don’t say anything.” I was like, “You will.” Pregnancy was pretty routine after that. The bleeding stopped. I didn’t worry too much and then I took my daughter to a museum at 12 weeks, 5 days which if you recall is just about to the day and the time of my loss. It was 12 weeks and 6 weeks when I started bleeding. I had a huge bleed. I mean, bad. I was like, “How could it be that I am miscarrying on the same day?” I was like, “This is crazy.” We went to the ER because it was nighttime and I was like, “I just have to know if there is a heartbeat.” The ER checked and it was incredible too because I could feel that the doctors were nervous for me and then I felt their relief telling me that there was a heartbeat. They were like, “We don’t often get to give good news in the ER and we are just so happy to tell you that your baby is fine and you have a subchorionic hemorrhage.” I was like, “Knew it.” I continued to bleed for a few days. They were like, “Do you want to do bloodwork and see if there’s anything else?” I was like, “No. That’s what’s happening. I don’t need to stay for bloodwork. This is what it is. I’ve just got to ride it out and take it easy,” which is tough with a toddler, but I did my best. The bleeding stopped and everything was fine. The rest of my pregnancy was great. I had that second-trimester glow and it’s sunny North Carolina. I’m with my family. I’ve made some friends. Things are going smoothly. Then at my 24-week appointment, I said to one of the OBs there that I was feeling pretty anxious. I was like, “I’m a little bit nervous just because I did hemorrhage this pregnancy. I hemorrhaged all last pregnancy. I don’t feel okay with this being my last ultrasound until delivery. Can we just put  a growth scan on the chart?”She was like, “Of course. You need to feel comfortable.” I appreciated that. She didn’t have a medical reason to do it, but she was like, “You’re right. You’ve been high risk. Let’s go ahead.” At 30 weeks, it was the night before my appointment and I had the strangest dream. I had a dream that I had the most amazing birth. My doula was there. I was standing up. I pulled my son from my own body. It was this redemptive, joyous dream. I felt this happiness. Then all of a sudden, it went dark and everything was dark. I was walking around an auditorium, a dimly lit auditorium with a bunch of empty bassinets. I was looking for my baby. I wasn’t scared, but I was a little bit nervous walking around

Today’s episode has a wealth of information you won’t want to miss! Dr. Kendra Ohora is a Licensed Clinical Marriage & Family Therapist and also a VBAC mom. From being told she would never have children to currently expecting her third baby boy, Kendra shares how prioritizing her mental health helped her through some really tough years. Kendra’s first birth was a planned breech home birth with an empowering labor. But when baby was not descending after hours of pushing, she felt at peace transferring to the hospital. Unfortunately, Kendra’s hospital experience was traumatic and resulted in a C-section under anesthesia. Through processing and healing, Kendra was able to prepare for and achieve the home birth she hoped for the first time with her second baby who was born only 14 months after her first. Tia, a VBAC doula from the Chicago area, joins Meagan as her cohost today and finishes the episode with the top three pieces of advice that she gives to all of her clients. Kendra's WebsiteTia's WebsiteInformed Pregnancy - code: vbaclink424Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 03:24 Review of the Week06:07 Kendra’s professional background09:00 Kendra’s surprise pregnancy10:54 First birth13:14 Surrendering16:15 Surprise baby number two21:00 Kendra’s VBAC29:30 Processing births33:31 Erin’s e-courses36:16 Benefits of therapy41:39 Short interval between pregnancies45:51 Tia’s top three tips48:54 Hire a great support team 51:38 Prepare your mindMeagan: Hello, hello. We have another amazing episode for you guys today and guess what? We did this a couple of weeks ago and I thought it would be fun to do it again. We have a co-host with us today. It’s not Julie, but it is Tia. Hello, Tia. Tia: Hi. Thank you so much for having me. Meagan: Absolutely. Tia is amazing and she is actually one of our VBAC certified doulas. I want to turn the time a little bit over to you and tell us where can people find you. What is your business name? All of that. Tia: Yeah. I am in the Chicagoland area so I serve a wide radius about an hour from my hometown of Mount Prospect. My business is Chicagoland Birth and Baby. Most people can find me on my website. It is Chicagolandbirthandbaby.com or they can email me at chibirthandbaby@gmail.com. Yeah. I would love for people to reach out to me if they are in my area. Meagan: Awesome. We will make sure to have her link and everything also in the show notes. You can easily find her. If you’re in her area looking for a doula, definitely give her a call.Okay, you guys. We have a guest today. I mean, you are all special. Every guest is so special, but Dr. Kendra Ohora is with us today. She is a VBAC mom and then she also offers something very special that I think connects or can connect a lot with our audience because we go through a lot of stuff as VBAC moms and C-section moms and all of this. She actually owns a wellness company and she is a mental health and wellness practice in Hartford County. Kendra: Mhmm. Meagan: Awesome, okay, in Maryland. She specializes in couples therapy and perinatal mental health. In her brief years as a mom, she has learned to love and appreciate slowing down which I know we all need to do in life, all things neutral, and lots of time outdoors. Her VBAC journey is one of her most proud moments as a woman and a mom. I am excited for her to come to talk about her VBAC story but then also a little bit more of what she offers because I do. Like I said, I think it applies very well to our community. 03:24 Review of the WeekMeagan: But of course, we have a Review of the Week so I’m going to turn the time back over to Tia really quickly and then we’ll dive right in. Tia: Yeah. I have a review from dmiller21395 from September 18, 2023. The subject is, “Empowering and Motivating.” This is from Apple Podcasts. It says, “I just had my successful VBA2C and would love to thank The VBAC Link Podcast for motivating, educating, and uplifting my spirit to help prepare myself for my VBA2C. I listened to The VBAC Link Podcast on my drives to work and while cleaning around the house. Each birth story brought so many emotions back to me relating to other mamas relating to birth trauma from our prior births and how deeply we dream of a VBAC. I recommend this podcast to anyone who wishes for a VBAC and also to any pregnant moms who just would love to hear birth stories and to educate themselves more on birth facts.” Meagan: Aww, thank you for that review. That was amazing. Once in a while, we will have a review that talks about recommending it to all VBAC moms or clients or anyone wanting to know their options for birth after Cesarean, but I really do love it when people also recognize that this podcast can help those first-time parents too. I mean, our Cesarean rate is astronomically high and it’s an issue. I think one of the ways that we can help here in our small community, but also very big community is to help educate those first-time moms about their options and why Cesareans are happening and what is being done out there and said out there that may be causing the whole root problem of the Cesarean rise. So I love that she pointed that out. 06:07 Kendra’s professional backgroundMeagan: Okay, cute Kendra. Thank you so much for joining us today. Kendra: Thanks for having me. Meagan: I want to turn the time over to you. I’m excited to hear more about your stories and your journey and what you do every day. I also hope that we can talk a little bit about your e-courses, specifically two of them– the birth trauma and the rebirth. I love that title by the way. Kendra: Perfect, thank you. I feel like my story intertwines with mental health in a really important way because of my business but it also is like every step of my professional journey has just been a couple steps ahead of my personal journey and prepared me in a really beautiful and important way. I’ll probably start there because that’s maybe where it makes the most sense. I got into private practice years ago, maybe 8 or 9 years ago and I actually had quite a few clients who came to me who had infertility as a part of their story. That wasn’t something that was specific to my training in grad school. It was a lot of couples’ work, so I kind of got a crash course on the emotional heaviness and loss associated with an infertility journey. At that point in my story, my husband and I weren’t trying to have kids. It just wasn’t a piece of the puzzle yet. I just worked alongside of them, supported them, and learned a ton from them. I opened my own business and did that for a year or two– that’s Erin. The e-courses are actually done by Erin Newton. She is our expert perinatal mental health specialist and she supervises all of the clinicians at my practice. She is fantastic. When I brought her on, she had a generic skill set but really wanted to specialize in the perinatal realm. This was right when I got my infertility diagnosis. We had been trying for a couple of years. I had learned when to get some medical testing and all of that done. They said, “Essentially with your age and also with a couple other factors, we don’t think likely that you’re going to have children.” It was right at the beginning of COVID in February 2020 and I just remember being taken aback in a way I’ve never experienced before. Complete and total grief over something I didn’t know how to grieve despite my profession, despite my team and all of that. It was weird. It was a weird season of just not even being sure. What do you do with this loss that has not even happened yet? It’s this thing that you can’t reconcile or make sense of.I sat with it for a while. My husband and I actually ended up doing some other things professionally to keep ourselves busy if you will, to find new energy and excitement, so we bought a home to renovate, a vacation property to renovate. My husband is in construction. That really took a lot of our time and excitement. 09:00 Kendra’s surprise pregnancyKendra: I eventually wrote a blog. I decided, “Okay. I can share my story with the world.” I wrote this blog “13 Truths About Infertility”. It was essentially a quick summary– not quick, a very long blog– a summary of my journey with infertility and seeing it through my husband’s eyes and seeing it firsthand in my own experience. Something in me was like, “This is not the full story yet. There is more to come.” The clients that I had worked with, this connection that I had with Erin, her desire to share the birth trauma recovery with the world, and all of these factors just felt like there was more in this story. Eventually, in January 2021, I found out that I was pregnant with my first son and it was a complete and total surprise. It was just such a faith moment for us that we actually found out at our beach house that we were renovating. It was really serendipitous. I don’t know. It was magical if you will. I have it on video. It was really just super sweet. At the time, I really didn’t know anyone who was doing home births, VBAC wasn’t part of my journey yet, so I just thought, “Man, I never thought I was going to be a mom. I need to do everything I can to make this the most sacred journey possible. The most empowering, and important. I want healthy kids. I want emotionally healthy–” and all of that. I took a lot of care and energy in the pregnancy to read the resources on having a vaginal birth and all of the things that would help me and lead to success in that route as naturally as possible is what I wanted, the least intervention possible. I read all of the stories and listened to the podcast episodes. I just felt on top of the world like, “I’m going to do this. This is it. I can do this. My body can do this. I’ve done hard things. I’ve overcome hard things. I absolutely can do this.” 10:54 First laborKendra: Towards the end of my pregnancy, maybe at 26 weeks, I ended up getting COVID and found out my first was breech. Meagan: Were you planning a home birth? Kendra: Yes, in Maryland. Mhmm. My provider– in Maryland, there are different levels or statuses of midwives typical to lots of states. My provider was an LPM, a licensed profession midwife who was comfortable with attending a breech but was not legally allowed to attend a breech. Around maybe 32 weeks enters the whole equation of, what do we do about the fact that this is not legal? In my particular area, there really were not a lot of LNMs, licensed nurse midwives, to oversee my case. She had called a couple of people and they essentially declined. They were like, “It’s too late in the pregnancy. We don’t know much about this case. We’re not willing to attend it. We found somebody out of state who was supportive, explained the whole breech process, and felt very comfortable doing it. My dream of home birth was slightly altered to, “Okay, now I have to labor at a birth center, but I’ll still be able to do it vaginally. I’ll still be able to do all of the things.” That was the most empowering, beautiful birth or labor experience ever. I felt so, “I am woman, hear me roar.” I just felt in my element. I felt power. I felt energy and excitement. I labored so long, for 24 hours. My water broke and all of the things. My sisters were there. I labored all over this birth center– outside, inside, different rooms, and it was just amazing. At the end of the day, I pushed for 3 hours and my little guy just wouldn’t drop. They were like, “He’s engaged. You’re dilated. All good stuff,” but he just wasn’t coming out. There was a surrender for me. There was this– I knew the stats. I knew the most common reason women transfer is exhaustion and I certainly was tired, but my stamina for this, “I have to do this” was so strong. My midwife was great. She just looked at me and was just like, “Kendra, I think you could keep pushing for hours and hours, but I don’t think your baby’s going to come out and I think we need to consider going to the hospital.” 13:14 SurrenderingKendra: It was a really painful surrender for me, but I just felt at ease too like, “Okay. Yeah. You’re right. He’s not going to come out.” There wasn’t a part of me that thought I could have made it happen if I pushed longer. It just felt like this was what had to happen. The unfortunate part is everything up until that point– the pregnancy, the labor, was perfect. Exactly what I wanted and then we transferred to the hospital and because I was out-of-state and I wasn’t established with a provider at this hospital, their reaction was like, “This is an emergency. This woman needs to go on the table in seconds.” I was just like, “I’ve been laboring for hours. I’ve been doing hip sways. I’ve been working through my contractions. I’m good. I can walk back to the room.” They were like, “No, you need to be in a wheelchair.” Again, long story short, a lot of bad things happened at the hospital. The standard of care was not ideal. Baby made it out safely and everything was okay, but my husband’s experience, the treatment of the baby, and all of that was not ideal and left essentially birth trauma for all of us, but I still felt that empowered energy of the labor that I don’t think it really registered to me right away that there was trauma involved. They declined my birth plan. They declined my desire not to be under general anesthesia. They really insisted that it was an emergency. I was like, “He’s not. I’m fine. He’s fine. All the heart rates and everything are good.” We ended up going through that process and because he was our little miracle baby, we were just still on top of the world. We came home from the hospital. We were new parents and were just soaking it all in. So much to my surprise, a few months later, I found out I was pregnant with my second. I was just like, “Holy smokes. How do you go from infertility diagnosis to two kids back to back? What have I gotten myself into?”Kendra: Again, I was just like, “I’ve got to have this home birth. I’ve got to have this redemptive experience, this vaginal birth,” so that’s when I started studying the VBAC piece in particular and learning that lots of women do this, I can do this. That same energy I carried into the first one, I can do this. This go around, I would say, my studying looked different. My surrender looked different. I just felt more ease and peace, but also had this backround fear like, “What if I have to have another C-section? What if I have to land in the hospital again?” I was especially concerned for my husband and what he witnessed as well. You know, we are busy new parents and preparing for another baby and I just would say at the time, it didn’t feel like I had as much attention on the pregnancy as I did the first go around. 16:15 Surprise baby number twoKendra: So then leading into number two, my baby boy number two and his story, my water broke again which I know is pretty rare to have your water break so the fact that it broke twice is interesting. Meagan: They say it’s 10%. Kendra: Right?Meagan: This is what they told me twice at the hospital. My water does the same dang thing. I’m three for three– water breaks first. Kendra: Two for two, yep. Meagan: That’s funny, okay. Kendra: Interesting. Meagan: Yeah. Kendra: I was kind of surprised myself because I was preparing for something to look different and it really didn’t. It looked similar. It broke early in the morning. My due date was Christmas Day and I very much didn’t want a Christmas baby, so I was actually over. It was New Year’s Eve. It was New Year’s Eve when my water broke. I was like, “I can have a holiday baby. I just don’t want a Christmas Eve or Christmas Day baby.” This labor was much shorter. It was 9 hours in length and at home. It was home and it was so perfect. I had a birth photographer and all of the same people there– my husband, my mom, my mother-in-law came, my sister, and my doula. I mean, it was just really perfect in the setting, in the setup, in the confidence that I felt going into it, but as soon as the active labor hit, I was like, “I don’t know if I can do this,” because all of the fear that the ending wouldn’t be what I wanted was there. Even though everyone could tell you that you have to release the fear because labor can get stalled and all of the things, I don’t think I could. It just felt like I had to work with the fear and work through the fear.I remember 10 minutes into active labor saying to my doula, “I don’t know if I can do this,” and in my head also knowing, “You don’t have an option. You’re not going to surrender and go to the hospital and have another C-section. You have to give yourself the chance. You have to fight for it.” It felt like the only way out was through and because I had experienced labor before but never experienced baby dropping or what it felt like to have baby engaged, it just was new. And with each new thing, there was this simultaneous trusting my body and feeling nervous for my body all at once. I labored in a variety of positions. I labored in a birthing tub. I declined all of the checks. In hindsight, given the fact that I was so afraid, I can tell that I also just had this instinctual knowing. “I can do this. It’s going to happen. I know where my body’s at.” My mom, in particular, really loves to know and be in the know. She wanted to support me and be able to give me that encouragement and hope. She was right by my side, “Are you sure you don’t want them to check?” I was like, “No. I know it is happening. I know he is coming.” It just was a matter of how long did I think I could hold on. Did I think I could hold out? My husband and I this go around did a lot of couples’ therapy to process the birth trauma, to process through what he experienced and what he saw in the hospital. I just feel emotional naming that. This time, he was just such a support. He was so present and active. I’m so glad I have it on video because I get to see it now and see his support of my body, his support of the space, filling the birth tub with more hot water, holding my hand, and even right at the end as I was pushing baby out, I was on my bed on all fours and he was just right there waiting for baby. To me, it just was a lot of growth for both of us that he came to the other side too. It wasn’t just my journey. It was our journey. The fact that he could stand there, sit there, and be ready for the baby to come out and trust that process after everything he saw, the fact that he trusted me, that just feels like such a gift because I hear so many of my friends and I’m delicate because of the intersection of the mental health and my own journey. I’m delicate with how much I push or how much I say, but some of my own friends tell me their husbands are not supportive. Their husbands want x, y, and z. It’s really discouraging to think the woman doesn’t have a right to her own body or her own plan. I just felt like he knew I could do it. That felt huge. So huge for me. 21:00 Kendra’s VBACKendra: Yeah, after 9 hours of labor and maybe an hour and a half of pushing if I’m remembering, I did not have, “I am woman, hear me roar” energy. I had a lot of instinctual, fear-based, “I can do it, but I’m scared out of my mind” energy. I think that’s okay. Sometimes that’s what it is. Sometimes it’s not the beautiful thing I wanted right away. Sometimes you just accept what it is, but man, the ending. The ending was everything I needed to heal. It was everything that I had hoped for and prayed for. I pushed so hard. It was so painful, so painful, and in my head, I was just like, I had watched videos of women– this might be TMI in some cases, but I’m so used to it in the mental health world. I watched women who orgasmed during labor and women who enjoyed labor. I was just like, “I just want the ideal, pain-free labor,” and it was not. It was not pain-free, but it was perfect. It was so perfect. The baby did have shoulder dystocia, so the midwife had to come in, intervene, and pull him out. That was scary for 30 seconds, but probably less scary for me because I was just focused on getting baby out and couldn’t see because I was on all fours. I couldn’t see him, but I knew my mom, my mother-in-law, my husband, and my other son were all behind me. They could see baby halfway out essentially, so I think it was probably more alarming for them than it was for me. But yeah, it was pretty crazy at the end. It happened so quickly and then my favorite picture is this one where they hand him to me and you can see it in my face. I’m so overwhelmed with– I did it. I did it and I literally say out loud, “This feels so redemptive.” I knew it was what I needed and what my body needed to heal. Meagan: Those pictures, just the rawness, the rawness, and the face, and the emotions, sometimes there are tears on the face, oh. It just gives me chills thinking about it. I have one of those photos too that my friend was able to snap of me. Oh, they’re just so beautiful. I was ugly crying and I was screaming, “I did it” too, but it tells the whole story right there. It tells everything right there in one image. You mentioned that you were so happy that you had it on video and that was one of my biggest regrets is not having someone there specifically to video it. I wish I could see my VBAC from the other side. Kendra: Yeah, sure. I’ve watched it a handful of times and I don’t get through it without crying. It is so special to me. Meagan: I’m sure. I’m sure. Yeah. It’s just so special to have so hold onto that for sure. 24:07 Uniting with your birth partnerMeagan: There were so many things you had brought up that you said. You grew together and this was your journey. I loved that you pointed that out because I think sometimes as VBAC moms, we’re really hyper-focused on VBAC and this, and sometimes, it can look or even sound like the “me” show. It’s me, me, me, me. It’s all about me and what I want. It’s very, very, very important, but I love that you can say that you grew together. You processed together and that’s so important because my husband too. I didn’t realize until he made the statement that I’m sure everybody has heard before about the zipper. He made a very not-so-nice statement and I was like, “Whoa. You have trauma.” I didn’t even know that until he had said that statement and we had to work through that. He had to trust me also and I love that you said that. He trusted me. There are a lot of people out there who feel so strongly that they should be at home or at a birth center or that they don’t want an epidural or they do want an epidural. There are always things that us moms, Women of Strength, have and then sometimes the husbands aren’t totally on board. We don’t ever want to just tell them that their feelings don’t matter, but I think it’s important to note that that’s when we should talk about the feelings and why those thoughts or why those things that are being said are so negative, right? Why not a home birth or why not a vaginal birth in general? I see it on the forums. People are like, “I want a VBAC so badly, but my husband is not supportive of it.”It’s like, wait, wait, what? Wait a second. My husband wasn’t super on board. That’s why he said the thing about the zipper. He was like, “I don’t understand.” I’m like, “I know and you probably won’t ever understand my desire to give birth vaginally, but this is why.” We talked about those things, so have those tough conversations along the way, or if something is pulling you in another direction, don’t fear saying that out loud because someone– it doesn’t even have to be a partner or a husband. It can be a mom or whoever. Someone is saying something and you don’t want them to be mad or you don’t want them to disagree with you so you go the other direction when your heart is pulling you in one direction for a reason. Kendra: Yeah, absolutely. And you do get as a VBAC mom or a home birth mom, you get a lot of facial expressions from people. Meagan: Yeah you do. Kendra: Or comments from people. It can be tough to navigate and to have this appropriate boundary or bubble where you say, “No. This is my story. This is my journey. I’ve got to do what’s good for me and baby.” Yeah. It’s hard. It’s hard to navigate that. I definitely grieve and understand and lament with the moms who don’t have supportive partners. We are actually pregnant with boy number three. Meagan: Oh my gosh, yay!Kendra: I know. It’s crazy. It’s been back to back to back. I think in some ways, getting pregnant with number two pushed both of us to say, “We have to heal this fast.” I don’t love that mindset, but we have to address it. If you don’t have a number two or three if you don’t have a quick timeline between them, then it’s reasonable that some people just say, “Well, it’s done. The hospital did what it did or the story didn’t unfold the way I wanted it too. At least it’s over and now I can just focus on my healthy baby” and that kind of mindset that people have. Some people don’t ever come back to what they experienced or how bad it was. That’s why I fold in the mental health piece because if it really wasn’t for Erin and her knowledge, her understanding of birth trauma, her own story– she had three kids before I ever even had one– I don’t think I would have known as intimately how important this work is. Now, the fact that the practice has this whole branch and this whole subset of serving moms and serving families and serving couples, we have packages for women and families and couples to work on while they’re pregnant so they can start to prepare, much like a doula provides childbirth education, a lot of people overlook the importance of as a couple, what does it look like to get on the same page? As a woman, what does it look like to really prepare your heart and your mind and your body for this?Tia: Yeah. Kendra: God forbid, it doesn’t unfold the way you want, the fact that there are women out there who have certification and who have training in birth trauma and can help you heal– people like Erin who know intimately the research. They know what healing looks like. It’s so useful and it’s such an important and growing field for women. We get more and more calls where people are excited to do the birth work. They are excited to heal from their trauma and of course, there are the people who have horrific stories where it’s hard. It’s hard, traumatic work, but really important that they heal for themselves and for their children. We see the spectrum, but it’s cool that it’s a field now and that there are books, there are resources, and there are e-courses from people who know what they are doing. 29:30 Processing birthsMeagan: Yeah, and to your point, you were forced to process this really fast which was really good, but sometimes if we don’t process, sometimes if we wait as well for the processing, we forget what we needed to process. Does this make sense? We forget those details and then sometimes, not always, but sometimes they creep into our next birth. Kendra: Yeah. Meagan: We may trigger. We may start having thoughts and be like, “Oh my gosh,” because we put it off. It’s easy to do. It’s so easy to put off. “I’ll think about that later. I now have to transition and learn how to feed a baby. I now have to transition and learn how to get out of a car after a C-section, what weight I can hold and what week I am,” and whatever. I want to drop the message out there. You don’t have to wait until you’re pregnant to start processing your past pregnancy and birth. It’s often done. We want to forget sometimes. Sometimes, it’s like, “I don’t want to think about that ever again.” Maybe it was so traumatic, but it can be so important because you never know when it can creep in. Kendra: Yeah. Your body and your cues– it’s not just during the pregnancy and labor that we need to channel that intuitive sense. Even just the other day, I was getting a massage and I had to lay on my side because I’m pregnant. When I was side-lying, I remembered for the first time laboring in that position. It was coming back to my body while I was getting the massage and I was like, “Oh, dang. I forgot how badly that hurt.” I was feeling the feels again and I knew I needed to deal with it. I needed to feel it and heal it in my body in order to feel ready for a new baby. So it’s important that we deal with what shows up, that intuitive semantic sense as it arises and not just save that for pregnancy. We know. It shows up everywhere. It shows up in our sex. It shows up in our connections. These thoughts and these feelings don’t go away just because the labor and delivery are over. Tia, you were speaking to something too, sorry. Tia: I was just saying that’s one of the most challenging aspects of being a VBAC-certified doula. The first education document I send out to my family says, “I highly recommend you work with a person who specializes in perinatal mental health as a standard.” Even if you don’t think you need to process through a past birth, it cannot hurt. It can only help. I have a lot of families who don’t have a lot of time they think they will have time later and they get into their birth experiences and I see these triggers pop up. For every single person I work with, that looks so different that I can never fully prepare as a doula on how to help each and every person, but it is. It can be a position that we decide to labor in or something someone says, or the look on their husband’s face or just so many different things, so yeah. I really resonated with you saying that certain things trigger you and the importance of really working through that trauma especially going into another birth because you may think that you don’t have trauma to work through and then once you are in labor with that next baby, that is a really inopportune time to find out that you suddenly do have triggers. You’re dealing with that component and a lot of my VBAC clients also for whatever reason want to go unmedicated. That’s their goal to try to mitigate any extra potential slowing down labor or risk so they are dealing with that trying to be in a good mental space that is already difficult when you are having an unmedicated birth, but then that added trauma or triggers they didn’t expect to experience that they are. I think I agree that it’s just such an important part of preparing. Meagan: Mhmm, absolutely. 33:31 Erin’s e-coursesMeagan: Kendra, can you tell us a little bit more about the course and kind of when it would be suggested for someone to take if they– or if it would even be suggested to take like what Tia was saying, even if you don’t think you have birth trauma or you don’t think you have a poor experience by all means. Can you talk to us about that? When would you take it? Would you suggest it? All of that. Kendra: Yeah, well first, I would highly recommend having Erin on the podcast. She’s the one who knows all of the ins and outs of this world. Meagan: We need to make that happen. Kendra: She would be happy to be a guest expert. Her first course, Rebirth, really is designed for women to rewrite their stories so she works through that and walks through that through the modules. They are all available online– or I shouldn’t say they are all available. You can get a preview of the e-course to see if it is a good fit. Erin also provides consultations so she would be happy to chat with someone about, is this a good course for me? Ultimately, it is getting at those people who have lost control through their birth and delivery story, and control and loss of control often is a sign that birth trauma could be at play. So when we consider that, if a woman can pause and reflect on her story and see, “Were there times when I wanted X and that right, that choice or that desire was taken away from me?” That could be a good indicator that Erin’s course would be a good fit. However, I am not the one who is an expert in birth trauma. There are nuances to the course that is a lot of good statistics and information so there are some psychoeducational components. There is an interactive video where you get to learn from Erin and then there are a ton of different exercises in journaling, writing prompts, sorting through the emotions, and I believe you write your birth story three times and process it three different ways to get to the other side. Meagan: Yes. Kendra: Then it’s your story. She has a couple of other different things folded in. You can get a mug that you can purchase. You can get a journal. She also has additional support that she can provide so you can purchase the course and some sessions if that feels like you’d rather have that rather than learn at your own pace if you really want that time in front of her. She’s licensed in Pennsylvania and Maryland so she can see people clinically through Telehealth in those states. Meagan: Awesome. Yeah, I just pulled up the website and was reading a little bit more about her and why her and just yeah. I think we are going to have to do a spinoff and talk about those courses more based off of your episode and your journey and your connection because it really is so important. 36:16 Benefits of therapyMeagan: Then can you also talk to us about, okay. I don’t mean this to sound rude at all, but sometimes, our lovely partners and men specifically– I’m trying not to single them out, but I’m singling them out. They have a hard time with the thought of therapy or counseling especially couples’ therapy. It can just be a hard thing. I think that’s because of what the world has done. But would could be signs that maybe our partners might benefit from some help or some talking or that maybe relationship-wise especially from a birth and like you said, what he went through, what you went through, what are some signs and how could we potentially start there to get some help?Kendra: Yeah. Yeah, it’s a good question. The science part is tricky because unsurprisingly my bias is that everyone should benefit from therapy. Everyone could use therapy so I really promote through what I write and speak on through my practice that therapy should be viewed more as a wellness service. It should be viewed as something that we are doing our whole life rather than waiting until something gets bad. It’s a little weird that we have pediatricians who check in on your child’s health wellness-wise and when they are sick all through their young adult years and childhood, but we never consider the benefit of mental health in that. So I think you know your partner best and if you’re with a man and you feel like there are some things that are showing up, then I would trust that first off and I would invite the conversation in the way that you know is best for your partner. Some partners, I think, appeal to the logic of it all. Some are more in the feeling realm. Sometimes, you can appeal to someone when there has been a conflict and that conflict is enough of a situation to say, “This matters.” Sometimes, it can just be more like a supportive conversation. You want this to go well. You want our family to be healthy. I know you care about us. I know you care about me. This is something, I think, that could help. Just like you would pitch, “Let’s have a doula,” you would pitch, “Let’s have a midwife”, you would pitch this, right? You’re pitching the same thing. You know, recently, someone actually said to me, “We really don’t need to feel guilt or shame for having passion in how we pitch.” It’s not something we need to feel negatively about. If you feel passionate about something, it’s okay to pitch it to your partner. I would invite that. Signs could be a disgruntled connection with a child, maybe some energy there that doesn’t seem at ease. It could be anger, it could be shutting down of emotion, but to be honest, these are things we see culturally regardless of whether birth trauma is part of the equation or not. Again, I think Erin would be better suited to answer what are the signs that a man has experienced secondary birth trauma or birth trauma from the experience, but from a couples’ perspective, I mean, I think couples benefit from check-ins all the time so I encourage people to do a yearly check-in with a provider. Sometimes I notice from men, that

Meagan has a new co-host today! Rebecca, a pelvic floor physical therapist and a VBAC Link doula located in Georgia joins Meagan while our friend Hannah from North Carolina shares her birth stories. This episode stresses again the true importance of not just a supportive provider, but of a supportive practice including hospital policies, the team of rotating providers, and the nurses. Hannah shows how her borderline preeclamptic symptoms were treated very differently between her first and second births. Her first practice had many red flags she didn’t notice until her second practice showed green flag after green flag throughout her entire journey. Rebecca also shares her expertise surrounding pelvic floor PT– who needs it and how it can impact birth outcomes. She also debunks myths about small pelvises and talks in depth about scar tissue. Both women share such valuable tips that we know you will love!Real Food for Pregnancy by Lily NicholsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 03:11 Review of the Week05:13 Hannah’s stories08:17 Higher blood pressure readings and induction10:26 Induction due to high blood pressure readings11:52 Interventions and not being able to move during labor16:50 Hannah’s C-section19:36 Rebecca’s thoughts about pelvic bone structure22:42 Second pregnancy29:01 A medically necessary induction33:27 Ending the first full day of induction38:03 Pushing for 20 minutes39:59 Hannah’s advice to listeners - provider support and nutrition44:17 Small pelvises and scar tissue50:13 Other scar tissue that can affect positioningMeagan: Hey, hey Women of Strength. It is Meagan and guess what? We have a cohost today, a new cohost who has never been with us and we are so excited that she is joining us. We have Rebecca Goldberg on our podcast today. Hello, Rebecca. Rebecca: Hello. Meagan: Thank you for taking the time and being with us. Rebecca: Yeah. I really love the resources and the community and I’m just thrilled to be here. Meagan: Well, we are excited and for anyone wondering who Rebecca is, she is an amazing human being. She actually does a lot in pelvic PT and is one of our VBAC-certified doulas. She’s in Georgia. Rebecca: Yep. I’m in Atlanta, the Decatur area. Meagan: Decatur area. Is that where you serve mainly? Rebecca: Yeah. I have people who come to me from all over. Some people are traveling up to an hour or an hour and a half, but I actually can go to people’s homes who are directly in my area. So, people who are post-C-section, I can come to you as early as the day you are discharged. I can work with you deal with pain, make sure you know what needs to happen, and help you do all of the things. That’s where my passion really lies. Meagan: I love that. I love that and for VBAC, how early for pelvic floor and stuff? How early can you start working with them? Rebecca: As soon as they have gotten home. If they are planning on getting pregnant again, we can start building that into what our plans are so that we are starting that process earlier rather than later and you’re more likely to have results that when you are ready to get pregnant, you can just get pregnant. Meagan: Love it. Awesome. Well, thank you, thank you for being here. 03:11 Review of the WeekMeagan: You guys, as usual, we have a Review of the Week. You don’t have to listen to me stumble upon the review. Rebecca will read it. I’m sure she will do a lot better than I normally do. Rebecca: Well, this review is from Apple Podcasts and it’s from semicrunchyyogi. I love that name. The review says, “My personal VBAC journey was actually directly influenced by Meagan Heaton, one of the hosts on this podcast. She was my doula with my second baby, my 10-pound VBAC baby.” Whoa. Meagan: Woo, yeah. Rebecca: “When she started this podcast, I knew it would be something special. I will always be passionate about VBAC and making sure women are given options, respect, and support through their birth journeys. This podcast does just that. This podcast is so needed and addresses important myths about VBAC and birth. Thank you so much, Julie and Meagan, for using your passion to support other women. You two are amazing examples of Women of Strength.” And then there’s a heart. Meagan: Aww, I love that. Thank you semicrunchyyogi. Rebecca: Yogi, yeah. Meagan: That is awesome. Thank you so much. 05:13 Hannah’s storiesMeagan: Okay, you guys. We have our friend, Hannah, from North Carolina so if you are from North Carolina, listen up. I feel like it’s so important for us to start talking about where all of these Women of Strength are coming from because there are so many of us out there in the world who want to know where these people are because finding a supportive provider we know can be challenging. We have our friend, Hannah, from North Carolina sharing her amazing VBAC story. For anyone wondering a little bit more in relation to her story, she had preeclampsia I think actually with her both. Is that correct? Hannah: Yeah. With my first, they qualified it as gestational hypertension and then my second was preeclampsia. Meagan: So your VBAC was actually preeclamptic. Hannah: Yes.  Meagan: Awesome. Okay. That is something that we see a lot in our community. People are wondering if VBAC is possible with preeclampsia. We don’t actually have a lot of stories on the podcast. In fact, you may be one of the first actually sharing in almost 300 episodes which is kind of sad. Hannah: Wow. Meagan: So we are really excited to talk about this, and you did have that CPD diagnosis like so many of us. Yeah. I’m going to welcome you on to share your stories. Hannah: Yeah, well thank you so much for having me. I’ve been listening for a while and I’m so excited to be here. I do live in the Triangle region of North Carolina. I’m just south of Raleigh in a town called Fuquay-Varina. A lot of people probably won’t recognize that name, but if you are in the Raleigh/Durham/Chapel Hill area, I do have a great recommendation for a supportive provider there. Meagan: Is that more of a rural area? Hannah: It used to be pretty rural and just in the last 10-15 years, it’s exploded. We’re getting a Target and that’s a big deal for us. Meagan: Yay! Every place is better with a Target. Hannah: Yes. Yes. Agreed. Meagan: Awesome. Okay, yeah. Let’s hear about your 6-year-old, the one that you just started listening to the podcast after. Hannah: Yeah. Yeah, just to jump in, I had my first son in July of 2017 and I was a first-time mom. I went to a midwife practice, but they were midwives who delivered at the hospital that was closest to where I lived. I had been seeing them for a few years just for my general well-woman check-up. I liked them. I felt like I had a good rapport with them, so I stuck with that. My pregnancy was good. I was working full-time. I was a traveling salesperson at the time. That got to be a little tricky towards the end. In my third trimester, I started swelling. They were like, “Oh, we just need to keep an eye on this. It could be normal. If it gets coupled with high blood pressure, then it might be concerning.” 08:17 Higher blood pressure readings and inductionHannah: Around 35 weeks, I did have high blood pressure readings. Just on the side, I have a history of white coat syndrome even as a teenager. My blood pressure would shoot up in the office so that’s always been an issue for me and I was concerned about that for pregnancy because I knew high blood pressure, pregnancy, high risk, and I was hoping for an intervention-free birth in the hospital. Meagan: Yeah. Hannah: I did all of the things, I thought. I had a doula. I had read Ina May Gaskin. Meagan: Guide to Childbirth. Hannah: Yes. I did HypnoBabies. Meagan: You were very prepared. Hannah: Yes. I felt very prepared but I think I didn’t have the understanding. I just heard midwife and I just thought, “Oh, natural birth.” I didn’t research the hospital too much so I just didn’t know what I didn’t know. At 35 weeks, they diagnosed me with gestational hypertension. They were pretty aggressive in their management of it. They told me, “You are done working. You are not going back to work. You are on bedrest.” Basically, they said, “You can shower, use the bathroom, and make yourself food, but other than that, you should be lying down and we will definitely induce you by your due date at the latest.” Meagan: Do you remember what your readings were reflecting at that time? Hannah: Yes. I think in the office, it would be maybe 140/85 or 90 but then at home, I had my own cuff and they were reading normal like 118/70 and stuff like that. Meagan: Interesting. So definitely some white coat syndrome maybe and then they were pushing the induction when overall, your pressures were probably pretty regular. Hannah: Yes. That was just, I don’t know. It was hard to know what was the right thing to do in that situation because I was a first-time mom. I don’t want to put my baby at risk. Eventually, they agreed to induce me. I went in the night before my due date. I had been going in for extra monitoring. I had NSTs and biophysical profiles, so everything was good. They just, because I had that gestational hypertension label, they wanted me to deliver by my due date. I did go into the hospital the night before my due date. I think I was maybe a centimeter dilated, 50% effaced. I did the whole Foley bulb overnight. They thought, “Oh, that’s going to stay in for 12 hours.” They put it in and then within an hour and a half, it comes out and I’m 4 centimeters dilated. Meagan: That’s awesome.Hannah: Yeah. It got off to a good note. They were like, “Oh, this is going to go great. You’re going to do great tomorrow.” I’m like, “Oh, okay.” I tried to get sleep. Everyone knows in the hospital even with an ambian, you don’t sleep. My doula came the next morning. I believe they started Pitocin around 7:00 AM. I really was hoping not to get the epidural. I just had this fear of that cascade of interventions. I did know about that and I just felt like, “Okay. I’m going to try to do everything I can to keep that from happening,” because a C-section was something I was very fearful of. I’m an only child. My mom delivered me via C-section. It was a hard delivery and I just had always had a fear of that being my story. 11:52 Interventions and not being able to move during laborHannah: Things were going fine on the Pitocin. I was working through the contractions. They were just very odd. They didn’t want me out of the bed. Thankfully, I did have my doula there. She was like, “Just stand next to the bed. Sit on the birth ball,” but they were just treating me like someone with severe preeclampsia would be treated and that just was not my case. Even they didn’t really want me getting up to go to the bathroom a lot. They were telling me I couldn’t walk the halls. I couldn’t use the shower. It was very odd. So around noon, the midwife says, “Hey, I want to break your water.” I said, “I’m really not comfortable with that. I think I’m making a whole lot of progress. I’ve only been on Pitocin for a few hours. I’d really not have my water broken.” She says, “Well, you’re here to be induced for a reason. We need to speed this up, so I would really like to break your water.”  Meagan: Oh dear. Hannah: Yeah. That’s really where things started going downhill for me. I didn’t really understand at the time, a doula can’t say, “Hey, she said she doesn’t want that done. She doesn’t want that.” But I also didn’t really get the support I needed I guess in that moment when I was vulnerable. I didn’t really have anyone to say, “Hey, do you want to talk for a minute and come back to this?” So I did agree. I mean, I guess verbally I agreed. I didn’t feel like I was agreeing, but she broke my water and after that, I just remember things intensified so much. I remember by around 3:00 PM being in excruciating pain and that’s when I asked for the epidural. It took two hours for them to bring it. I finally got the epidural and I just immediately fell asleep because we had been there for probably 20 hours at this point.Meagan: Were you feeling any specific discomfort in the back? Were there any signs that maybe baby would have been in a poor position after the floodgates opened? Hannah: It’s interesting. That actually will come up once the C-section is performed. We were told at my– I think I had a biophysical profile at 39 weeks and the tech was like, “Oh, your baby is posterior,” but I didn’t really understand what that meant. But when he was delivered, they did say he was in the anterior position, so I just remember contractions being unbearable and I think it was because of the level of Pitocin I was on. They just ramped it up. I even remember at one point, the midwife saying to me– so once I had the epidural, I’m laying down resting, I had asked for a peanut ball, but no one really helped me with it. My doula tried to but I don’t know. The nurse I got that day was not very helpful. Then my poor husband is usually my rock. He is so strong, but he just was like a deer in the headlights because it was his first time going through this and it was just rough. Hannah: So finally, that night at 8:00 PM, the midwife comes and checks. She’s like, “Yeah, you’re still only 4 centimeters dilated. I think the baby is developing a caput.” How do you say it?  Meagan: A caput. Which is interesting. At 4 centimeters, do you remember how low your baby was? Because at 4 centimeters, baby getting caput, baby must have been coming low.Hannah: And that’s the thing, he wasn’t. He was still at a -2 station. Meagan: Huh. So not even engaged. Hannah: Yeah. So I don’t know. She was like, “You know, I really think you need a C-section. I think your pelvis is too small.” I was like, “Okay. Wow. That was not something I’d ever been told in all of these years of going to this practice.” She was like, “So that would be my recommendation. I could give you one more hour.” I said, “Okay.” I’m crying at this point. I’m like, “In your professional opinion, do you think an hour would make a difference?” She said, “No.” Again, I did ultimately agree to that C-section. I signed off on it, but I was very upset. This isn’t what I want. I was honestly so out of it at this point. It’s hard to remember some of it. Yeah. As soon as I agreed, they came in there. They give you the form. They are wheeling you down the hall. There was never really an issue of my baby being in distress. It just was kind of like, “Oh, you’ve been here for a while. You’re not progressing. Let’s just go ahead and do a C-section,” and then her commenting that my pelvis was too small. 16:50 Hannah’s C-sectionHannah: I go to the operating room. Everything goes pretty standard, but my husband does go to stand up when they are delivering the baby. He was like, “Great. I wanted to see it.” As the doctor goes to pull the baby out, she says, “Oh. I’ve never seen this before.” She’s been in practice for 25 years. It turned out my son had the umbilical cord wrapped around both hands and both feet and then that was together. Meagan: Oh. Hannah: She said, “Oh, your baby is tied.” Meagan: Wow. Hannah: Yeah, so it’s like, “Okay. It does make sense why he wasn’t descending.”Meagan: Yeah. Hannah: He’s good. I’m good. I did have a hard recovery. They tried to show him to me. I start vomiting on the operating table and then it just gets blurry from there. It was just really hard. I don’t remember holding him for the first time in the recovery room. All of it is very blurry until the next morning. Yeah, but overall, recovery went well. I had a very hard time breastfeeding him. He was a very, very tense baby– tongue tie, lip tie, and all of that, so that was stressful. Meagan: Man, you had a lot. That was a lot. Hannah: Yeah. It was hard. Meagan: Yeah. It’s kind of interesting because knowing that, “Oh, yeah your baby was really wound up in here,” that would make more sense than just diagnosing you with CPD. Hannah: Yes. That’s what I thought. I was like, “Okay.” The midwife was saying that during labor. Maybe she just thought that because I wasn’t progressing, baby wasn’t descending. So then at my six-week checkup, I asked to see the doctor who delivered my son in the surgery. I saw her and I was just debriefing with her. I said, “Do you think that was the reason he couldn’t come out?” She was like, “Yeah, probably.” But then she didn’t even really examine me. I had to ask. I was like, “Are you going to check my C-section scar? Are you going to do an internal? What am I here for?” She was like, “Yeah, fine. I can do that.” She goes, “Oh, no. You have a flat pubic bone. You shouldn’t even try to have a VBAC,” then basically walks out of the room as I’m crying. Meagan: Oh my gosh. I have a question for Rebecca in here and pelvic floor and stuff. Do you see flat pubic bones and is that truly something that causes an issue?19:36 Rebecca’s thoughts about pelvic bone structureRebecca: I can’t imagine so. I mean, if you think about the way that the baby comes down, the pubic bones are not super involved. You have the pubic symphysis which is the little cartilage between the pubic bones. That gets soft just like all of our other joints due to relaxin and that makes everything moveable. There are people who even have that separate. The shape of the pubic bones– it just seems a little bit odd to me. Meagan: Yeah. Yeah. Interesting. I mean, I’m thinking that I can put my fingers exactly where I felt when mine did start to separate and I have a wonky pelvis too. My pelvis goes all funky. It’s just so interesting to me to always hear that providers jump right to, “Your bones are not good enough.”Hannah: Yeah. Yeah. That was so hard to hear because it was like, “Oh, something is wrong with me. It’s my fault.” Then a midwife who I was closer with there, when I saw her when my baby was about 6 months old for just my annual exam, I asked her about that comment. She said, “Oh, I think what she was saying is you have a narrow pelvic arch.” Okay. Meagan: Okay, all right. 22:42 Second pregnancyMeagan: Did you go into this next pregnancy feeling doubtful of your pelvis?Hannah: Oh absolutely. Yes. Yeah. I definitely was very nervous. I mean, I remember searching through groups on Facebook or the Babysitter App “Flat pubic bone, narrow pelvic arch” to see if anyone else had been diagnosed with that and gone on to successfully have a VBAC. Meagan: Right, yeah. So baby #2. Hannah: Yep. I ended up actually getting pregnant when my first son was about 3 years old. I literally had just been dreaming about having a VBAC since my first son was born. I feel so thankful that I found your podcast, the Facebook community of The VBAC Link and I also found my local ICAN group who just was so helpful in finding my new provider. I switched to that new provider before I even got pregnant just because I knew I was not going back to that first practice ever for anything. Meagan: Yeah. That’s actually something I suggest highly. A lot of the time, we don’t think about finding that provider until we are pregnant, but finding a provider when we’re not pregnant is kind of weird. There is this vulnerability that we don’t have. We have this– it sounds silly– tougher skin when we’re not pregnant. Hannah: No, I totally get that. Meagan: You’re in a different headspace. You’re like, “No, I already know I’m not going back to this person. I’m going to find this new person and go now.” Hannah: Yeah. So thankfully, I did find them. The hospital was a 45-minute drive so it was a big difference from my first where the hospital was only 20 minutes away, but that was so worth it to me. I was pregnant during COVID. I got pregnant in September 2020, so things were weird anyway. Appointments were more spaced out. Some of them were virtual. I feel bad saying this because I know so many people had a hard time with not having their husbands or partners come with them to appointments, but it actually was kind of nice that I didn’t have to go in as much just because of my anxiety with the doctor’s office. But I really did like the midwives that I was seeing at this new practice and the issue about my blood pressure did get brought up. I had a couple of high readings early on in the pregnancy. I think I went to my first appointment around 13 weeks in person and definitely had a high reading. It sounded like they actually believed me this time though. When I told them about the white coat syndrome and my past, they took my word and were like, “We get it. We see it all the time. Have a blood pressure monitor at home and if you could at your next appointment, bring it in. We’ll test your blood pressure on that and on the machine just to make sure it’s accurate.” Just with that, I felt so validated. Rebecca: I was just going to say that’s really wonderful that your providers did that and they just accepted you at your word. That’s really beautiful. Hannah: Yeah. I felt like that was such a difference. People talk about red flags all the time, but I felt like that was a green flag like, “Okay. This is someone who is actually listening to me as a patient.” Things went great. I actually got to a point where my readings in the office were normal. I think just from feeling more relaxed and more supported. I brought up the whole small pelvis thing. I had several midwives say, “I don’t believe that. We hear that all the time. We’re not going to worry about that.” So everything went great up until about 37 weeks when I got COVID. Thank God I did not have a hard time with it at all. It was a sinus infection, but I missed my 37-week appointment then when I went in for my 38-week appointment, my blood pressure was elevated so that was concerning for them given my history. Meagan: That’s interesting. I’m curious if it was correlated at all, or if it was just your history because sometimes we know if we’ve got preeclampsia in the past, we may be more likely to have it in the future, but I’m curious if that’s related at all. Hannah: I know. I know. I’ve wondered that and it’s so hard because I don’t think I’ll ever definitively know, but it seems like, “Oh, you were fine at 36 weeks. You get COVID at 37 weeks and then high blood pressure the next week.” But I was also going through some other stressful things. I had a family member pass away. I had a situation with my dog where he almost passed away and that’s like my first baby. Oh, and then I broke my foot at 36 weeks pregnant. Meagan: Oh my gosh. Oh my gosh. Hannah: Yeah. I know. Meagan: Holy cow. Hannah: It sounds insane. It sounds insane, but anyway. Meagan: That’s a lot to endure right before your birth. Hannah: Yeah, so I’m like, it probably wasn’t the COVID, it probably was the stress. Sorry, I’m laughing but that’s just my way of dealing with stress. So I go to that appointment and they go, “Ooh, your blood pressure is high.” They did do an NST on the baby and unfortunately, I feel like this happens to me and other people a lot. This midwife that particular day I had not met yet and she was definitely one of the more strict ones. She was like, “You know, I really think you need to go to the hospital to be monitored.” I was like, “Well, let’s do the NST. Let’s see how that goes.” They had taken my bloodwork. I was like, “Can we just wait and see what the bloodwork comes back as?” She kind of gave me a hard time about that. She was like, “You don’t want to leave here not knowing if your baby is okay.” I’m like, “I feel like my baby is fine.” I remember calling my doula on the way home just hysterical about her saying that and thankfully, my doula was amazing and just like, “Don’t worry about it. They are checking your blood. Everything will be fine.” I did go home. I rested. Thankfully, my older son was with my mother-in-law, but then that evening, I got a call and they were like, “Hannah, you are showing some signs in your labs on the actual bloodwork of borderline preeclampsia,” is what they were saying. 29:01 A medically necessary inductionHannah: This was a different midwife than I was seeing earlier in the day. She said, “I do think you need to come to the hospital and have a baby tonight.” That was really scary for me in that moment. Meagan: Yeah, it’s hard because you are like, “This is not what I wanted.” It’s hard to mentally go back to the same beginning in a way. Hannah: Yeah. Yeah. I mean, I just remember calling my husband. He was still at work and I was just hysterical. I was like, “This is going to end in a C-section again. This is exactly what I was worried about.” He thankfully was so calming and was like, “You can’t think like that. Let’s just go and see what happens.” He comes home. We pack our stuff up and we drive the 45 minutes to the hospital. We get there and I’m just very distressed by having the sweetest midwife who just sat on the bed with me and was holding my hand and was like, “Look, it’s going to be okay. Everything is going to be fine. We’re going to do everything in our power to get you this VBAC. Do not let this make you feel like that’s not happening now.” So that was so comforting and being 38 weeks, I was not dilated at all. I think I was maybe 50% effaced and the baby was at -2 station so we definitely had to do the whole Foley bulb again which for anyone who has had that done–Meagan: So you have a Foley placed with a closed cervix. Hannah: Yeah. Meagan: You’re a champ. That is definitely something that is not super comfortable for the listeners to know, but it is possible even though a lot of providers say it’s not. Hannah: Yeah, and I hear that a lot. I guess I just got very fortunate with the midwife who was on call. They definitely did give me some medication to help me relax. Meagan: Fentanyl or something? Hannah: Actually Adavan.Meagan: Oh Adavan?Hannah: I have very bad anxiety anyway and they gave me that to help me relax which it did. They got that inserted and it was so weird because the time I was expecting the same thing with my first, “Oh, it comes out in an hour and a half.” It didn’t. It was there for the whole 12 hours. The next morning, they started Pitocin. Eventually, I think they just took the Foley bulb out and I think at that point I was maybe 3 centimeters dilated. I was on Pitocin for 5 or 6 hours but it was just so crazy to me because even with it being COVID times, I was allowed to walk around the halls. I had wireless monitoring. They even let me get in the bathtub in the room. It was just so different from the experience that I had at the hospital with my first. I just really loved their process. They, of course, were kind of concerned with the preeclampsia diagnosis, but since my labs were staying stable, my blood pressures weren’t rising, I think they were probably in the 140s/high 80s-low 90s range, they really did let me take it slow since there wasn’t a major concern for me or the baby’s health in regards to the blood pressure. I remember they even turned my Pitocin off for a little bit this afternoon and one of the midwives was like, “Hey, this is something that may not work, but would you be willing to take some Tums? There is research showing that it could possibly reset your oxytocin receptors in your uterus.” I remember her being like, “It sounds kind of woo, but it’s worth a try.” Meagan: I have never heard of this. I am fascinated. Tums resetting our oxytocin. Hannah: Yeah. It’s crazy. The research is there if you just Google “Tums, Pitocin”Meagan: Oxytocin receptors. Okay, you keep sharing. I’m going to dive into this for a bit because I’ve been a doula for 10 years and I’ve never heard of this and I love it. This is cool. All right, keep going. Hannah: Yeah. I took the Tums. We turned the Pitocin off for a little bit. They were like, “Try to rest. Eat a snack.” That was the other thing. They were so encouraging of me eating and drinking whereas my first birth, they were like, “You can’t have anything but ice chips.” We did turn the Pitocin back on for about 6 hours that evening. 33:27 Ending the first full day of inductionHannah: I think at the end of that day– so this was the first full day of induction, I was still around 4 centimeters. I had a new nurse come on and a new midwife comes on. They were just so awesome. I definitely had an emotional breakdown at that point. My awesome doula had been with me and my husband all day. She went home for the evening to get some rest. They were like, “What do you want to do? You are looking good. Baby is looking good.” My water was still intact at that point. I was like, “I just want to sleep tonight. I know if I do not sleep tonight, I’m not going to have the energy to finish this birth.” It was amazing because the charge nurse did not want me to stop the Pitocin and my midwife and my nurse basically went to bat for me. They were like, “No. She’s fine. We’re going to give her Benadryl. We’re going to let her sleep. We’re turning the Pitocin off. And that’s what we did. I slept. I actually got to rest that night. They came back at 5:00 AM and rehung the Pit. I did agree to my water being broken at 8:00 AM because at this point, we had been in the hospital for almost 36 hours and baby needed to come out. That just in and of itself, I felt like that was my choice. No one ever pressured me. It was all my choice. I did agree to my water being broken. That was around probably 9:00 AM and I just continued laboring. It was great. I remember I had my bathroom. There are no windows in there and I had my fairy lights and my music playing and my doula had essential oils diffusing and that was my cave. I felt like I could go in there and just shut out being at the hospital and really focus on labor, sitting on the toilet, and eventually, I did get to a point around 1:00 where I started to have a hard time coping. I was like, “You know, I don’t know if I want to do this anymore.” I gave it another hour and I was like, “Okay. I need the epidural.” I did get the epidural around 2:00 that day. It was just amazing because even getting the epidural, the nurses were like, “Hey, let’s put you in throne position. Let’s pull out the stirrups and get one leg up. In 30 minutes, let’s switch to the other leg. Let’s get the peanut ball.” I felt like they were doing all of these things to help me that I had never experienced in my first birth. I felt like they wanted me to have the birth that I was desiring so badly almost as much as I did. Meagan: I love them already. I don’t even know that. Hannah: I know. I know. Can I say who it is? The hospital I was at was actually the University of North Carolina at Chapel Hill and it was the UNC midwives who was my practice that I delivered with but even the nurses at that hospital are just amazing. They were all literal angels. I love them. Meagan: We will make sure that they are on our provider list. Hannah: Yes. Yes. They are wonderful. So that went on. I think around maybe 6:00 I was checked and I was hanging around 5 centimeters. I got really discouraged at that point. I was like, “You know, maybe I just can’t do it. Maybe my body is just not going to dilate.” But they weren’t worried. They just kept helping me move and then I do remember shift change happened. A new nurse comes on and a new midwife. This was probably the 5th shift change by the time we had been in there and the midwife came in and checked me. She was like, “Oh, you’re 6 centimeters.” I remember so many stories of women being like, “The first 5 are the hardest.” Meagan: Mhmm. Hannah: I was like, “Okay. Maybe that’s true.” Then literally, at 9:40, the midwife came back, checked me, and she was like, “How far dilated do you hope you are?” I’m thinking, “Well, gosh. I hope at least a 7 or 8.” She had a tear and she was like, “You are 10 centimeters.”  Meagan: Oh yay! Hannah: Yes. I started bawling and it was so crazy because my first son was born at 9:42 PM and that was right about when I was 10 centimeters. For some reason, I knew if I could make it to 10 centimeters, I knew I could push my baby out. The pushing him out was not the part that I was scared of. It was like, “Oh, is my body going to be able to get to that point?” But yeah. I remember my husband and doula being so excited because they brought in the cart and they brought in a mirror and I started pushing. It’s just so crazy thinking back to that seeing that happening. 38:03 Pushing for 20 minutesHannah: I pushed for 20 minutes and both of my boys were a surprise. We didn’t know what gender they would be. 20 minutes later, my second beautiful baby boy was born healthy, screaming, put directly on my chest and it was one of the best moments of my entire life. Meagan: Oh my gosh. I love this story. I love all of the support and all of the love and all of the amp that was just completely surrounded around you and then you had the confidence in your body at that end where you were like, “Okay. I’ve got this.” 20 minutes? Hannah: Yeah. I was like, “Oh, here’s my small pelvis with my flat pubic bone.” Meagan: Yeah. I love that so much. Do you know what? I just was looking at our provider list and guess what? It says that UNC midwives are on our list and it says specifically that they are also VBA2C supportive. Hannah: Yeah. I think that’s the only hospital in our area that generally will support after two

It can be difficult to find VBAC support with gestational diabetes and most who are supportive of VBAC highly recommend a 39-week induction. Heidi’s first pregnancy/birth included gestational diabetes with daily insulin injections, a 39-week induction, Penicillin during labor for GBS, pushing for five hours, and a C-section for arrest of descent due to OP presentation. Heidi wasn’t sure if she wanted to go through another birth after her first traumatic experience, but she found a very supportive practice that made her feel safe to go for it again. Though many practices would have risked her out of going for a VBAC due to her age and subsequent gestational diabetes diagnosis, her new practice was so reassuring, calm, and supportive of how Heidi wanted to birth. Heidi knew she wanted to go into spontaneous labor and try for an unmedicated VBAC. With the safety and support of her team, she was able to do just that. At just over 40 weeks, Heidi went into labor spontaneously and labored beautifully. Instead of pushing for over five hours, Heidi only pushed for 30 minutes! It was exactly the dreamy birth she hoped it would be. ThrombocytopeniaReal Food for Gestational Diabetes by Lily NicholsInformed Pregnancy Plus Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 05:50 Review of the Week08:04 Heidi’s first pregnancy with gestational diabetes12:05 Taking insulin18:08 39-week induction 20:59 Pushing 24:29 Arrest of descent and opting for a C-section27:06 Researching providers before second pregnancy38:04 Discussions around induction41:45 NSTs twice a week47:10 Testing for preeclampsia54:53 Spontaneous labor57:43 Going to the hospital1:02:03 Laboring in the tub1:06:22 Pushing for 30 minutesMeagan: Hello, Women of Strength. It is Meagan and we have a friend from New Hampshire. Her name is Heidi. Hello, how are you? Heidi: I’m doing great. How are you?Meagan: I am so great. I’m excited to record this story today because there are so many times in The VBAC Link Community on Facebook where we see people commenting about gestational diabetes and for a really long time on the podcast, we didn’t have any stories about gestational diabetes. Just recently, this year really, we’ve had some gestational diabetes stories. I just love it because I think a lot of the time in the system, there is doubt placed with the ability to give birth with gestational diabetes or there is the whole will induce or won’t induce type thing, and with gestational diabetes, you have to have a baby by 39 weeks if they won’t induce you and it just goes. So I love hearing these stories and Heidi’s story today– she actually had gestational diabetes with both so with her C-section and with her VBAC. It was controlled. It was amazing. That’s another thing that I love hearing is that it is possible to control. We love Lily Nichols and the book about gestational diabetes and pregnancy. We will make sure to have it in the link, but it is so good to know that it doesn’t have to be a big, overwhelming thing. It can be controlled and it doesn’t have to be too crazy. Right? Did you find that along the way? Heidi: Yes. Yes, definitely. The first one was pretty scary, but then the second one, you know what you are doing and you can control it and you can keep advocating for yourself. Meagan: Absolutely. And then in addition to gestational diabetes, she had advanced maternal age barely with her second, but that is something that also gets thrown out. A lot of the time, we have providers saying, “We shouldn’t have a vaginal birth. We should have a C-section by this time,” so that’s another thing. If you are an advanced-maternal-age mama, listen up because here is another story for you as well. We don’t have a lot of those on the podcast. We are so excited to welcome Heidi to the show. 05:50 Review of the WeekMeagan: Of course, we are going to do a Review of the Week and then we will dive right in. This was from stephaniet and it says, “Inspiring and Educational.” It says, “As a mother currently in her third trimester preparing for a VBAC, I was so happy to find this podcast. The stories shared are so encouraging and it is so comforting to know that I am not alone in feeling that once a Cesarean, always a Cesarean.” 100%. That is 100% true. You are not alone here. And once a Cesarean is not always a Cesarean. It says, “This does not have to be my story. Thanks, Meagan and Julie, for providing the support and education to women who are fighting for a chance to have a natural childbirth. I would love to encourage anyone wanting to learn more about VBAC to listen to this podcast.” Thank you, stephaniet. This was quite a few years ago, actually. This was in 2019. We still have some reviews in 2019 that weren’t read. It’s 2024, so that’s really awesome and as usual, if you have a moment, we would love your reviews. Your reviews truly are what help more Women of Strength find these stories. We want these stories to be heard so leave us a review if you can on Apple Podcasts and Google. You can email us a review or whatever, but definitely if you listen to the podcast on a platform, leave a review and that would help. 08:04 Heidi’s first pregnancy with gestational diabetesMeagan: All right, Ms. Heidi. Welcome to the show and thank you for being with us. Heidi: Thanks for having me. This is awesome. Meagan: Well, let’s talk about it. Share your story with us with your C-section. Heidi: Yeah. We were planning for a child and we just decided. We were like, “Okay. Let’s shoot for an April birthdate.” We just thought that we could just have a child, but we got lucky and we did on the first try. Meagan: Amazing. Heidi: We went to our local hospital that was about five minutes away for care and it just seemed good enough. At the time, I thought you just go to the hospital. You get care. You can trust the provider and you don’t really need to do anything other than a hospital birth class for prepping. We just went along that journey. They assured me, “This will be a normal pregnancy. Everything is great.” The pregnancy was uneventful until about 20 weeks when I found out my baby was missing a kidney during a routine ultrasound. That sent us down Google rabbit holes and all kinds of fun things. Meagan: I’m sure, yeah. Heidi: Yeah. So at that point, we were assigned a Maternal-fetal medicine OB. I was offered an amniocentesis if we wanted to check and see what else was wrong and things like that. That was a major curveball. Meagan: Did you end up participating in the amnio? Heidi: No, we didn’t. We had a couple of detailed ultrasounds after that. At first, they didn’t actually tell me what they were looking for. I had three ultrasounds in a row that were not the more detailed ones. Meagan: Oh, okay. Heidi: I was like, “Why am I having all of these ultrasounds? Nobody is saying anything.” I finally got a phone call telling me that my daughter was missing a kidney so that’s what they were looking for. I was like, “Okay. Good to know.” Meagan: Yeah. You would have thought some communication before then would have happened though. Heidi: Yeah. It was pretty scary. So what seemed pretty uneventful–Meagan: Got eventful. Heidi: Yeah, it did. So right around 28-30 weeks when they do the gestational diabetes check, I went in for my check and found that I would need to start tracking my blood sugar and diabetes does tend to kind of run in my family even though everybody is very healthy. I was wondering if it would come up and also being older, sometimes they say there is a link but it still took me by surprise because I’m a very active person and I eat really healthy. I felt like a failure basically. Meagan: I’m so sorry Heidi: Yeah. All of a sudden, I’m meeting with a nutritionist. They give me this whole package of a finger pricker. Yeah, exactly. All of a sudden, I’m submitting logs four times a day checking blood sugar, and the fasting numbers for me just weren’t coming down so it was about one week of that, and then all of a sudden, they were saying, “Okay. You probably need insulin.” 12:05 Taking insulinHeidi: It came on so fast, so strong. Meagan: Wow. Heidi: It was really scary so then I found myself going to the pharmacy. I am a very healthy person so it was just all really weird going to the pharmacy buying insulin and learning all about insulin and learning almost how little the medical field understands about gestational diabetes. That was something bouncing in my head bouncing off the wall trying to understand the plan there. Meagan: Yeah. Heidi: Yeah, so after that, then I got phone calls from the nurses. They said, “You know, now you are on insulin. Now, you are going to have twice weekly NSTs required at 35 weeks.” I’m thinking, “Well, I’m working full time. How am I going to do all of this?” There is just so much sick time and it was really, really difficult to hear all of that. Meagan: Yeah. How do I have time for all of that? Plus just being pregnant. Heidi: Yeah. Yeah. Insulin and just for anyone that doesn’t know, basically you inject yourself. I was injecting myself every night with an insulin pen and it was all just very weird because you’re also thinking, “Well, I’m pregnant. I’ve never been on this medication. What is it going to do to me? What is it doing to my baby?” Very nervewracking. It’s all normal to feel that way. Meagan: Yeah. I think sometimes when we get these diagnoses, we want to either recluse because it’s so overwhelming, and sometimes then, our numbers can get a little wonky, or we dive in so much that it consumes us and we forget that we are still human and we don’t have to do that. Heidi: Yeah. Now that you say that, I definitely did a little bit of both. Meagan: Did you? Heidi: I did a little bit of denial and then I did a little bit of obsessive researching. Meagan: Yeah, because you want to know. You want to be informed and that’s super good, but sometimes it can control us. Heidi: Yes. Absolutely. You’re watching every single thing that goes into your body. I probably didn’t look at food normally until my second pregnancy to be honest with you. Meagan: Really? Heidi: Yeah. Meagan: Yeah. Yeah. So it was working. Things were being managed. Heidi: Yes. I was honestly very grateful for the insulin. Obviously, it took a little while to feel that way, but it was very well-managed. My numbers were right in range. My blood sugars were always normal throughout the day. I never had to do anything during the day. I just checked my blood sugars. Then the other thing that came as an alarm, they told me about the NSTs which are non-stress tests. They also mentioned that I would need an induction in the 39th week because–Meagan: 39 to be suggested, I should say. Heidi: Yeah. It wasn’t explained to me that with that provider, it was a choice. It wasn’t a suggestion. It was like, “You have to do this or you might have a stillbirth.” It was really scary. Meagan: Oh. Heidi: I didn’t know I had a choice. Being a first-time mom and not knowing about evidence-based birth, this podcast, or all of it. I had no idea. So I was told I could schedule it anytime after my 36th week and for every appointment that I had as I started getting closer, I felt a lot of pressure from the providers to schedule the induction. They cited the ARRIVE trial. Meagan: Yes. Another thing I roll my eyes at. I don’t hate all things. I just don’t like when people call people old and when they tell people they have to do something because of a trial that really wasn’t that great. But, okay. Heidi: Yep. Yeah. I mean, they didn’t explain the details of it either. They just said, “Oh, it’s the ARRIVE trial,” so I go and Google and try to make sense of it. They just say, “Stillbirth risk increases.” They say, “If you are induced at the 39th week, there is no increase and chance of a C-section,” so I thought, “Oh, okay. Sure.” Meagan: Right. Right, yeah. Heidi: I finally gave in near the end and I scheduled my induction for the 39th week and 6th day. Meagan: Okay, so almost 41. Heidi: Yep. So then I worked right up to the night before my induction. I was admitted to the hospital at 7:00 AM. I was planning for an unmedicated, uncomplicated delivery and an induction using a Cook balloon because my provider had checked me in the office the day before and they found that I was 1 centimeter dilated so they said they could probably get the balloon. I’m thinking, “Oh, it’s going to be a mechanical induction. There’s going to be no IV. It’s going to be really as natural as possible.” 18:08 39-week induction Heidi: I get into triage and immediately, they start putting an IV in my right arm. I am right-handed. Meagan: Why do they do that? If you are listening and you are getting an IV, don’t hesitate to say, “Hey, that’s my dominant hand. Can we put it in the other one?” Also, don’t hesitate to say, “Don’t put it in my wrist where I’m going to try and be bending and breastfeeding a baby in the end. Put it in the hand or put it up in the arm.” Heidi: That’s really good advice. I didn’t know that the first time. Meagan: I didn’t either. Heidi: I knew enough to say, “Whoa, whoa, whoa. Put it in my left hand.” They ended up putting it in my forearm. So here I am. I was hooked up to Penicillin. I was GBS positive. I feel like I had all of the things. Meagan: Yes. We’ve got gestational diabetes, GBS, maternal age, and now we’ve got an induction. Heidi: Yeah. Oh yeah. So yeah. They put in Penicillin, Pitocin, and saline, and then they showed me how to move around while wheeling an IV pole. Meagan: Mmm, yeah. Fun.Heidi: Yeah. We felt a little gutted at that point. We are in the hospital and sorry, when I say we, it’s my husband and I. Yeah. The midwife had trouble getting the Cook balloon in. We just sat around on Pitocin that first day. The OB finally got it in around 10:00 PM that night. It was her first visit to see us actually. She probably could have gotten it in earlier had she come earlier. It sped up the labor overnight as soon as the Cook balloon went in. It was a bit painful. They stopped the Pitocin the next morning. My water broke on its own. They were talking about coming in to break my water and I think my body probably heard them, so it broke on its own. Yeah. I was just laying in the bed and it happened. Then labor began to pick up, but the contractions were still not regular. Pitocin was increased and then the contractions got really intense, but still irregular until around 4:00 PM that day at which point, I just couldn’t take it. I asked for the epidural. Meagan: That’s a lot. That’s a lot. Heidi: Yeah. It was intense. 20:59 Pushing Heidi: The shift changed and a new nurse had a student with her. So I consented to the student being there thinking, “Oh yeah. Come on. Come observe my awesome labor. This is going to be amazing. It’s going to be a vaginal delivery and everything,” so I’m like, “Yeah, sure. Let them learn.” I achieved 10 centimeters dilation and full effacement around 9:00 PM that night so it was really exciting. Meagan: That’s actually pretty fast. 10:00 is when the Cook was planned the night before. 9:00 PM, so hey, that’s pretty good. Heidi: Yeah. I was happy about that. I was so excited to push. I couldn’t feel a lot because I was on the epidural, but it really took the pain away and it helped a lot in the moment. So let’s see, I was mostly on my back. I was tired. I was just really tired at this point. There was, the nurse that I had was pretty new. She had been there for I think 6 months and then she was also trying to juggle the student nurse. She didn’t have a lot of knowledge of positioning. I thought going into it that all nurses were trained in Spinning Babies and all nurses had the knowledge of baby positioning and things like that, but I was wrong. Meagan: Yeah, unfortunately, they are not all. I don’t think a lot of them have it actually. Most of them don’t. Heidi: Yeah. I pushed mostly on my back and when the OB came in around 11:00, she noticed my pushing was not effective at 11:00 PM. Meagan: So two hours in. Heidi: Yes. My position needed to be changed. She got me up on the squat bar and then she left again, but she showed me how to push and everything in the meantime. When she came back in, she explained to me that I would probably need a C-section soon. I don’t exactly remember that sequence of events because it is so intense. I felt really defeated. I was like, “I just started. What do you mean I will probably need a C-section?” Meagan: So you were still wanting to keep going?Heidi: Oh yeah. Oh yeah. She also explained that meconium started to show in the amniotic fluid. The OB explained to me that the baby was probably in distress because of that. That was all that was said. Heidi: I spiked a fever. They gave me Tylenol and then the baby’s heart rate began to slow a little bit, just for a little bit. The OB inserted a monitor on the top of her head. At this point, I felt like I was pushing for my life. I was like, “Oh my gosh. I need to get this baby out. How do I do this?” But I still felt like, “I can do this. I can do this. I know I can do this.” Meagan: Yeah. Heidi: But there were definitely questions at this point. 24:29 Arrest of descent and opting for a C-sectionHeidi: Yeah, so then around 2:30 in the morning, I was told by the OB to get on all fours and try one last position and I could opt for a C-section at that point or I could push until the OB came back in. I was like, “You know what? I’m going to give it all I have. I’m going to work so hard and the baby is going to come out in the next 45 minutes. She’s got to.” So I did. Honestly, I was so grateful that I had that last 45 minutes. I feel like if I didn’t, it would have been stolen from me. I feel I was defeated when she came back in because she was still not out and I was exhausted, but I was ready. The baby was not going to come out any other way at this point for whatever reason. That was going to be dissected months later, years later by me, but in the moment, yeah. She was at station 0. I was told she wasn’t far enough down to do an assisted delivery, so they wheeled me into the OR for the C-section. I requested that the baby have skin-to-skin as well as delayed cord clamping. Unfortunately, none of this happened and I guess I should also note that once they put the monitor on her head, she did great. She still was not in distress. I was doing great too. The C-section was just really for arrest of descent. They just thought it was taking too long because I had been pushing for a little over 5 hours at that point. Meagan: Yeah. Heidi: Yeah. She was born via C-section at 3:20 in the morning. She weighed 7 pounds, 1 ounce and she was in the OP position. Meagan: I was just going to say, was there a positional issue here? I always wonder when there’s patterns like yours where I’m like, “That sounds like a positional thing.” Okay, so OP. Occiput posterior for anyone who is listening or sunny-side up. Baby just needed rotation. Heidi: Yeah. Yeah. Yeah. That was that. Meagan: Yeah. So then did you end up when you got pregnant, did you end up staying with this provider? How did that journey begin? 27:06 Researching providers before second pregnancyHeidi: I went back– let’s see. I’m trying to think. I went back for routine care almost a year later. I had care in between, but I had wanted to see that provider just to have closure. I asked her. At the time, I wasn’t really sure that I wanted another child. My husband and I were just really thinking, “Is that what recovery is always like?” After the C-section, it was really hard. I asked her, “If I were to have another child, what would be my odds of delivering vaginally? Could I have another child that way instead of the C-section?” She said, “You probably would end up with another C-section if you even tried so you probably have about a 40% chance.” It was not based on anything. Meagan: Hmm. So she didn’t even do the calculator, just gave you a percentage. Heidi: No. Just gave me a percentage. Meagan: Oh dear, okay. Heidi: So at the end of that appointment, again, I still had not really educated myself and knew that there were amazing resources out there, so I just said, “Okay. If I have another child, I’ll have to have another C-section.” I went home and told my husband. I said, “If we have another child, we’re going to have to have a C-section.” We were both like, “Okay, maybe we won’t have another child.” Yeah, so then another year passed. We were beginning to get ready and slowly started to research other providers just for routine gynecological care. We ended up finding a hospital that was just about 25 minutes away just thinking, “Well, what if?” I had heard this hospital was well-known for VBACs and I had also started seeing a pelvic floor therapist prior to going to this hospital for care who was working at this hospital. It was kind of on my radar. Heidi: From there, I met the OB. I met the OB and then I was just really shocked at how supportive she was. In the past, you just go into the OB or gynecologist and they will put you in a gown and they do whatever they need to do, a pap smear or whatever. But this one, the nurse had said, “Don’t get undressed. They want to meet you. They want to talk to you first.” Meagan: I love that so much. I love that. That’s awesome. Heidi: It was so different. It was in a hospital, but it didn’t feel like a medical office. The rooms were painted blues and greens. You could tell there was a lot of effort being made to make it feel like home. I began my journey. I had just met with her. This OB had talked to me about birth story processing. I had no idea what any of this was. I had no idea that I even had trauma from my last pregnancy at this point until I had just met with her and was talking with her. She said, “There is no pressure if you don’t want to have another child.” I was just there to meet with her and have a check-up. I think I want to say a couple of months passed and actually, that night, I went home to see my husband. I was like, “You know if we do have another child, it’s going to be here.” Yeah, so a couple of months went by and we did decide to have another child. Again, the baby was conceived right away. No complications. This time, we started working with a doula. I began birth story medicine at the same time. I did that for a couple of months in addition to my therapist to process the birth trauma and just everything. I was tested for gestational diabetes early during this pregnancy. I started insulin at 11 weeks and I was just kind of ready this time. It wasn’t as scary honestly the second time. It’s a lot of work. I would say that it was annoying, but it wasn’t scary. Meagan: Well, and you’re like, “I’ve done this before. I did a really good job last time. I learned a lot,” because you did go pretty deep into it, so you’re like, “I can do this. I’ve got this.” Duh, this kind of sucks, but you know. You got it. No problem. Heidi: Right. My first baby was born at a really great weight and there were no complications at all. Meagan: Good. Did they already start talking about induction and things like that from the get-go? Did they talk about extra testing? Because at this point, you for sure have it. Earlier or later, did they talk about that stuff? Heidi: With this provider, I went in and they told me I was old last time, the other provider. I’m really old. They looked at me and were like, “No, you’re not.” Meagan: No, you’re not. Heidi: Yeah. They’re like, “You’re 37. That’s not old.” Meagan: Yeah. Heidi: I’m like, “What?” Meagan: The other clinic, would they have wanted to do NSTs because of age and gestational diabetes? Heidi: I don’t know. Meagan: Okay. But these guys were like, “No, we’re good. We don’t need to do any extra testing because of an early diagnosis of gestational diabetes and now you’re 37.” Heidi: Yeah. They said what they do consider older but it’s still not impossible was, I believe, over 40. Meagan: So you didn’t even have that pressure from the get-go? Heidi: No, no. Meagan: What an amazing way to start. Heidi: Yeah. It was amazing. They also weren’t concerned with the fact that I was on insulin. We did talk about NSTs because I asked because I knew it would come up and they had said, “You can have once a week as long as your sugars are in control, we are comfortable with that.” I felt so relieved. Yeah. It was such a holistic, relaxed approach. They trusted me to manage my body and to know what I needed and that was so empowering, the whole journey whereas before, I felt like I had a really short leash and they were basically managing everything for me as if they knew what was right for me and my body. Meagan: I was just looking. I’m just looking because I’m sure people are like where is this person? Where is this provider? Was it at the CMC? Is that where it was? Heidi: Yes. Yeah, Catholic Medical Center in Manchester. Meagan: Awesome. This is good. These are good vibes here with this provider. Heidi: Totally, yeah. Oh my gosh, yeah. 38:04 Discussions around inductionHeidi: So let’s see. Once I’m diagnosed with gestational diabetes, I have maternal-fetal medicine ultrasounds, but that also was true because my first daughter was born missing a kidney. Again, she’s totally healthy and totally great, but they wanted to make sure that nothing weird was going on, yeah. That was at about 32 weeks. They were also checking the baby’s growth and baby’s size at that point. Baby was measuring very average. She had two kidneys. Little things that we take for granted, we were so grateful for. Yeah. That went really well. The pregnancy was just progressing really well. In my third trimester, I was struggling with all of the extra appointments and the trauma that I was processing though from my last birth because I knew and my gut told me, “You need to work through this because if you don’t, you have to be really strong to have a VBAC. You have to really work through a lot of mental blocks and things that come your way.” So I just started getting really stressed between work and the appointments will all the different therapies so I decided to take a couple of months away from work prior to the delivery in order to process everything and prepare myself. That was a really hard decision but it was probably one of the best decisions that I could make. Meagan: Good for you. Heidi: Yeah. At around 36 weeks, it was suggested to me by my provider that I could consider a 39-week induction, but it was delivered so differently. Meagan: Good. Heidi: Reasoning basically says that ACOG has a suggestion for insulin-controlled gestational diabetes. They basically told me the data. They told me why they are suggesting this, but ultimately it is my choice. It was a discussion that I just found to be so incredible and weird in a really good way. Meagan: Which in my opinion is so sad that these things happen that are good conversations have to feel weird to us because that should just be normal, but it’s not a lot of the time, right? Heidi: Yeah. I was working with my doula at the time and she was a really big proponent of expectant management and letting everything happen naturally and honestly, that’s all I ever wanted. I think that’s what most people want. So I just explained, “I am not interested in induction. I want to do expectant management as long as everything progresses the way that it’s going and it goes well. That’s what I want to do.” They said, “Okay. We can do that.” Meagan: I love that. That’s great. Heidi: It was amazing. It was really empowering. 41:45 NSTs twice a weekHeidi: So let’s see. They suggested that I have a 36-week ultrasound to check my baby’s size again. Actually, no sorry. They suggested it. I was actually able to negotiate my way out of it. I said, “You know, I just had one at 32 weeks. Is it really necessary to have another in 4 weeks?” I talked to the OB and she was like, “You know what? No. You don’t have to do that.” Yeah. Meagan: Things are just getting better and better. Heidi: Oh, so good. Yeah. So right around then, the NSTs began. I’ll just say also, I walk into– so NSTs were really awkward during my first pregnancy. I sat on the hospital bed so uncomfortable and sitting up with all of these things attached to me. At this provider, I go in. There is an NST room and it’s painted blue and it’s really common. There is a reclining chair and for me, it just really felt like they were normalizing the fact that NSTs do happen and it’s okay and it’s normal. Here’s a special space for it. Meagan: Well, and almost like they are setting you up for success in those NSTs because in NSTs, when we are really uncomfortable and tense, overall, that’s not going to be good for us or our babies. That’s going to potentially give us readings that we don’t want but when we are comfortable and we are feeling welcomed and we are like, “Yeah, we’re not happy that we are here taking this test,” or sometimes we are, but when we are comfortable and we are feeling the beautiful colors and the nice, soft recliner, it’s a very different situation to set you up for very different results. Heidi: Yes. Absolutely. Yeah, so then my journey just kept going. My NSTs were beautiful every week. It was really interesting how they set them up because they had the NSTs after the doctor’s appointments because they weren’t expecting. If they can get a good reading, I think the minimum is 20 minutes whereas I had the NSTs before so it was like they were looking for a problem then I had the doctor’s appointment so I ended up being there for 2 hours during my first pregnancy. But these ones, I never sat more than 20 minutes.The nurses usually saw what they needed within 5 minutes and they said, “Your baby is doing great. You’re out of here as soon as the time is up.” Meagan: That is amazing. Oh my gosh, 2 hours. That is a long time. Heidi: Yes. Yes. This pregnancy was really odd, but I’ll take it. I stopped needing insulin during the last two weeks. Usually, there is a peak near the end of pregnancy, and then the need for insulin goes down in the last two weeks I want to say. For me, it actually just kept going down, down, down, and then all of a sudden, it was gone. That didn’t happen last time. They were a little nervous about that because it didn’t really happen. I explained to them, “I think it’s honestly probably lack of stress,” because I wasn’t working at my job at the time and I was moving a lot more too, so who knows? Meagan: Really interesting. Heidi: It did make them a little nervous because they said there is very limited data, but sometimes it can indicate an issue with the baby. Meagan: Oh, the placenta. Heidi: Sorry, I’m nervous so I’m forgetting. Meagan: There are times when it can be the placenta being affected. Is that what they were saying?Heidi: Yes, thank you. They said, “We could offer an induction at this point,” because I was at 39 weeks when they brought that up. I said, “I don’t think so. I really want to stay the course. I want to do expectant management.” They said, “Okay, would you be open to twice-weekly NSTs?” I said, “Yes. If that lets me keep doing what I’m doing, we can do that and it’s probably not a bad idea, because you never know.” 47:10 Testing for preeclampsiaHeidi: I woke up one morning at week 40 and thought my water was trickling out. I texted my doula and she was getting home from another birth and was going to rest, so I worked with my backup doula for that day which was a little scary. I didn’t know what was going to happen from there. Around 6:00 PM that night, my husband and I arranged for my mom to watch our daughter because we needed to get to the hospital to get the amniotic fluid checked. We probably should have gone a little earlier, but the backup doula had suggested it might not be amniotic fluid. It might just be discharge. Meagan: Is there much going on labor-wise? Heidi: Not really. It was pretty quiet. Then I actually had an NST the day before that and there really wasn’t much going on. I felt little Braxton Hicks-type things, but nothing much. We packed our bags, got ready, and got my mom. We arrived in triage. I had slightly elevated blood pressure which was just a routine check, but that basically led to them testing me for preeclampsia and then a urine test. Meagan: Hmm, a slight increase? Oh, man. Heidi: Yeah. It was slightly increased. You know, like a lot of people, hospitals make me nervous. Meagan: Yep. Yeah. They jumped right in and started going the moment you got there. Heidi: Yes. Yeah. It’s different. It’s still in the hospital, but it’s separate. Labor and delivery is separate. They just had a very different