In this episode, Julie welcomes Sophia from Mexico City, who shares her mental, physical, and spiritual journey towards achieving her VBAC. Sophia discusses the challenges she faced in navigating the healthcare system in Mexico, and what she did to find a truly VBAC-supportive provider. 

While preparing for her VBAC, Sophia had a hard time finding well-documented VBAC stories from Mexico, so she hopes to inspire other women through her story. Sophia and Julie talk about the role of a mother’s intuition in the birth space. Making confident decisions when you feel safe and supported is so powerful!

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Full Transcript under Episode Details 

Julie: Good morning, Women of Strength. It is Julie Francom here with you today, and I am super excited to talk with our guest today, Sophia. She is from Mexico City, Mexico, and her VBAC story takes place there as well. I absolutely love hearing birth stories from all over the world, so I cannot wait to hear Sophia's story. 

But before we get started with that, I do have a really short and sweet Review of the Week. This one is from Google. It's a Google review and she says simply, "Great people sharing great information. They make me feel less alone in my journey to a VBAC". 

I'm so grateful for that review. I think that that is one of the most important reasons why Meagan and I wanted to start The VBAC Link is because our own journeys felt very lonely at times even though we were connected to the birth world and we had a strong birth community, there are certain parts of wanting a vaginal birth after having a C-section that are just very, very lonely. 

We are grateful for that review. We hope that whoever is listening now also feels a little less alone in this journey because we absolutely love you, and we are so grateful that you are here with us.

All right, let's get going. I have Sophia here today. Like I said, Sophia's from Mexico City, Mexico. I'm just going to sit down and be quiet and listen because I have heard lots of really interesting and crazy and cool things about Mexico City, so I'm excited to hear her birth experience there. 

Sophia is the mother of Luca and Rio. I just said that. I'm just reading her bio right now. She says,  "I'm a Mexican and live in Mexico City." Perfect. She is a passionate advocate for women's rights and strongly believes in the magic that results from women building together, connecting, and supporting each other. Her motherhood journey has been very humbling and healing, and she is obsessed with talking about birth. Me too, girl. I am obsessed with talking about birth as well, so I'm excited to hear your story. I'm just going to go ahead and let you take it away, and we're going to talk.

I'm sorry. I said I'm going to let you take it away, but really, I'm going to keep talking for just a second. I loved reading through your story, sharing about your birth team and prodromal labor and the different things that you did to keep labor going and moving along. I am really excited to talk at the end after we hear your story about some different things that you can do to prepare for a VBAC, both mentally, physically and all of the ways. So now for real, I'm going to let you go ahead and share your story with us. Thank you.

Sophia: Well, thank you so much for having me. It's truly a dream come true to be here in the podcast. I'm just really honored to tell my story because, when I was starting to prepare for my VBAC, I found it really hard to find well-documented VBAC stories coming from Mexico and in general, from the global South. So I just hope my story helps other women living in similar contexts. 

So I guess I'll start with the story of my unplanned C-section. So half a year after my husband and I got married, we were ready to have kids. We met on Tinder. We dated for three years, and both of us really had had the opportunity to travel the world and do amazing things. We felt like we had a good pre-kids life, and we were just ready to start a family. 

I was 34 at the time, and I always wanted to try to get pregnant before I became 35. I got pregnant really fast actually, like the first try. So we were so shocked and excited and surprised. At the time, we were both working remotely in Europe. We were slowly making our way to Australia because my husband is from Australia. This was 2021 and as some of you might remember, Australia was under super restrictive lockdown. No one could come in. No one could get out, so we had not seen his family for three years, and we were just waiting for the ban to lift to be able to go in and spend some time with them. 

This is an important part of the story because while I was in Europe, especially in Belgium and in Australia, my pregnancy was taken care of by midwives. Especially in Australia, it's really normal that all healthy pregnancies are attended by midwives, and only those special cases or complicated ones are taken by gynecologists. So my pregnancy was a really healthy, enjoyable one. I am one of those women that really loved being pregnant. I was very lucky with both of my pregnancies. 

But this experience was so influential because in Mexico, although we have this wonderful history with midwives in Spanish called parteras, and that's actually where the use of Rebozo comes from, this practice continues mostly in rural and particularly in indigenous communities. But in the cities, there is a really concerning high rate of unnecessary Cesareans. There's this narrative that C-sections are the easy way out. I would even dare to say, in the 80s, it became sort of a socioeconomic status thing. Women who have access to private healthcare would just opt for a C-section either because their doctor recommended it to do so or because they just thought it was the easy way out. 

People would say, "Why would you put yourself under unnecessary pain if you can just go get a C-section?" Like it was nothing, right? So actually, most of the women that I know had a C-section, but having the experience with midwives, I decided I really, really wanted to try to have a natural birth. So I started getting informed. 

I actually work in philanthropy. I work on social justice issues, so I'm very well connected to feminist and women organizations, especially in Mexico City. I remember that there were all of these colleagues working to defend obstetric rights in Mexico City. I knew that they had a really good network of doulas. It was through them that I connected remotely with my doula, Neri Fernandez, who is amazing. We spoke on Zoom, and we clicked right away. She started preparing me for my return to Mexico. 

The plan was always to come back to Mexico during the third trimester so I could have my baby here. She started preparing me with the reality that it is to have a natural birth in Mexico City. She told me, "Honestly, there are very few truly labor-friendly hospitals and also very few labor-friendly gynecologists. A lot of them are going tell you that of course they're gonna support you in a natural labor, but around week 37 or so, they're gonna suggest going on a C-section by week 39." 

So, she gave me this list of questions to ask my gynecologist, the one that I had been seeing for the past five years. So she told me, "Once you get back and you go to your appointment, just use these questions for your conversation with him." At the time, I was very naive, so I was like, oh, I'm sure he's going to support me. I'm not worried about that. 

Anyway, I came back to Mexico, I went to my appointment, and honestly, in the first five minutes, I noticed that he wanted me to have a C-section for no reason. So I was like, oh, my god. Okay. So I told her, "Neri, I really need to contact another service provider." She gave me a list of labor-friendly doctors. And she told me, "There's this doctor whose name is Adriana. She is a gynecologist. But the way that she works is very similar to a midwife, the way that she treats her patients and the way that she respects the woman's body and everything. I think you're really gonna like her, but you should know that she can be a little bit tough. She's a hardcore feminist, and she truly believes in women's capacity to give birth, so she's not going to pamper you." 

Anyway, I went in. I met her. I loved her right away. She took me, which I was so appreciative, at the time, taking my case because I was already in my third trimester, and things continued to evolve smoothly. I mention this because since I got pregnant really easy, since everything was going smoothly, that's what I thought it was going to be in the case of my birth. I just thought that things were just going to develop like that.

Julie: Oh my gosh. Can I just say that I thought the same with my first? I had the easiest pregnancy. I loved being pregnant, just like you, and then all of a sudden, wham-- preeclampsia, induction, C-section, and I was like, what happened? Yeah, anyway, sorry. I just had to add that in.

Sophia: I think it happens to a lot of women.

Julie: Yes.

Sophia: So anyway, week 40 arrived, and there was no sign whatsoever of labor. And one mistake I made is that I told everyone about my due date. I'm an open book. So I told everyone just out of excitement. But then once the due date passed, people started reaching out, like, "Hey, how are you doing? Is baby here yet? Is everything all right?" That really threw me into a bad mental state. I started to get really scared and doubtful. I was just not mentally well at that time. I was just full of fear. 

I didn't accept it at the time. I was telling everyone that I was fine, but internally, yes, I was in that state. And now also thinking back, I think I prepared myself a lot physically. I have been practicing yoga for 10 years. I was doing a lot of prenatal yoga, etc., but I don't think I prepared myself mentally enough. Anyway, after week 41, Adriana, my doctor said, "I think we have to start discussing the possibility of an induction. Maybe by week 41.3 we can do a very gentle induction unless something else happens." 

I think two days after we spoke, I lost my mucus plug, so that was exciting, but then nothing was happening. Then we were almost at week 41.5, and she said, "I think at 41.5, I should induce you." But the night before the induction, I woke up in the middle of the night with a very intense feeling. I went into my living room. I sat on my birthing ball, and my water broke like a big gush like the movies. They tell you that's never gonna happen, but that happened to me. 

Contractions didn't start. But at that time, I didn't realize what this meant. I didn't know that this meant I was actually going to be on a clock after my waters broke. So I was actually very excited. I thought, okay, by tomorrow, I'm going to have my baby. This is amazing. I told my doctor. I told my doula, and they said, "Okay, well, no matter what, just come here to the birthing center."

At the time, my doctor had a birth center, and the plan was always to labor there and then go to the hospital when I was closer to giving birth, because I just feel safer that way. And that was the plan with my insurance, etc. So I went the next morning to check me, and I was only at 3 centimeters. So she told me, "I'm going to recommend that you just go back home. Rest. Eat your favorite food. Try not to think about this too much, and when things escalate, just let me know." 

The problem then is that nothing escalated for a whole day when I went to sleep. And that night, I didn't sleep out of excitement mostly, but I was already feeling some contractions. I mean, I thought they were intense, but little did I know that they were not the most intense part. And then the second night, I also didn't sleep because now I did start getting contractions, a bit stronger ones. 

So the next morning, I went back into her practice. She checked me, and I was about a 5. And she said, "Things are progressing, but they're progressing quite slowly, so I'm going to give you a tiny dose of Pitocin just to make sure that things keep progressing." I stayed there in the birth center, and I was with my husband, and I was with my doula. And honestly, I remember that day very fondly. 

My husband and I danced. We used the shower. We used the Rebozo. We just the ball, the peanut ball and everything, but things were not progressing. It was 7:00 PM, and I was only at 7 centimeters, and we were already reaching 40+ hours. And as you know, once your water breaks, I mean, at least in Mexico, they recommend that you have your baby within 48 hours because otherwise you start risking infections. So I told my doctor, "I just want to go to the hospital. I need a change of scenery, and it's just gonna make me feel better." 

So we went to the hospital. The hospital did have this birth pool. I went into the water and just things stalled. I didn't progress after that. This whole time, they were checking my baby's heart rate, and it started raising a lot, like, scary a lot. It wouldn't regulate. Fear just took over my body, I think. She looked at me and she said, "Sophie, I think I'm going recommend that we go for a C-section." 

I looked at my doula, and my doula just nodded. I was so tired and so ready to meet my baby that I said, "Okay, yeah, let's go for a C-section." Once I decided that, it was the longest 40 minutes of my life because I thought, "Oh, well, I'm going to get under anesthesia now." But the anesthesiologist took an hour to get there, so I was in a lot of pain. Then we went into the OR, and to be fair, my gynecologist did everything possible to have a gentle Cesarean. We had dim lights. We had my playlist on. The whole focus was on me. Both my doula and my husband were with me. They were holding my hands. 

But the one thing that makes me sad about that is that I couldn't stay awake. I was so exhausted, so I was just asleep the whole time. I only woke up when I heard my son, Luca, crying. So exactly on week 42, he was born. I just remember someone in the OR yelling, "It's a huge boy." So he weighed 8 pounds, which is not massive, but for Mexican standards, he's really big. And Luca is a Taurus baby. He's determined, he's stubborn, and you cannot pressure him to do anything. He always does everything at his own pace, and this was just the first evidence of that. 

So anyway, luckily, he was okay. It was a rough recovery because I was just really not prepared for a C-section. It was challenging to get breastfeeding. He had difficulties to latch. It just took me a while to heal what had happened. But the one thing I do remember a lot is that when I was in my room, the doctor and my doula both came in and they said, "Sophie, we just want you to know that you and your baby are amazing. You did everything right. You just had so many things against you. But if you ever want to get pregnant again and go for natural birth, you can do it." That really stayed with me the whole time. 

So 18 months after Luca was born, my husband and I decided to get pregnant again. Again, we got pregnant the first try. I mention this not to brag about my fertility or anything like that. I know it's a sensitive topic, but for me, it was important because it was the first step to recover my confidence in my body and believe that I could really do this because once I started getting informed about VBAC, I realized that the healing I had to do was more internal. I really had to believe that I could do it. 

So I decided to stay with the same service providers, with the same doctor and the same doula, because they knew, they really knew my story. Well. And I called my doula, Neri, and I was like, "Hey, Neri, why are you doing this summer? Do you wanna have a baby with me?" And she was like, "Of course." Both my doctor and my doula recommended that I joined maybe like an online community of VBAC women. I had no idea what VBAC was. So then I found The VBAC Link website, the Facebook group. I took the VBAC class for parents. I found it so helpful. And for me, the fact that it was full of hardcore data, it was just so, so important. 

So in terms of physical prep, I tried to remain active, but I wasn't honestly doing as much yoga as before because I had a toddler. I was working full-time. I was running after my 2-year-old, and I really loved that my doula told me, "Don't get too stressed about working out. Just play with your kid. Play with your kid on the floor. That's going to be enough activity for you." 

I also really love that this time around, my gynecologist was not even telling me how much I weighed. I really loved that approach. It was just a really, really joyful pregnancy. Again, it was a healthy pregnancy. I did go to the chiropractor this time, which I didn't do last time. I also went to acupuncture sessions, and I did that the last time. I went with the same acupuncturist because I also thought it was good that she knew what happened before. I also took raspberry leaf tea and dates after week 36. So I did all of that physical prep. 

But what was different this time, I think it was my mental preparation. So as I said, I really, really tried to focus on healing internally, believing in my body, and believing in myself. So with my doula and also using the some of the guiding questions and stuff from the VBAC class, we started mapping out my fears. So she was like, "What are you afraid of?" And I said, "Honestly, I think what I'm most afraid of is that my waters break again before I start labor." 

So I remember asking in the VBAC Facebook group, "Hey, does anyone know anything about preventing PROM?" Someone suggested taking vitamin C. So I started doing it. And, this time, I felt so much more connected with my body, with my baby, with my intuition. At week 26, my baby was breech. And I remember asking again in the Facebook group, like, "What would you girls do?" And people told me, "You can do Spinning Babies. You still have enough time for baby to get in position, but it's always easier to move a baby when they're still small." So I did Spinning Babies, and my baby turned. So that was amazing. 

The other thing that is I consider being part of the mental prep is that I was also in a very different space, spiritually speaking. I am honestly not a religious person. I'm not the most spiritual person in the world, but this time I paid attention to a lot of signs. There was this one occasion that I was in my office, we were moving my office, we were moving to another place. And someone hired a shaman. Like a shaman, but it's an indigenous sort of magic priest because we all wanted to do some cleansing, like spiritual cleansing, before moving into the new space. She told me, "I don't do cleansing of pregnant women because it's not good for the baby, but I could give you a blessing". So I was like, "Yeah, of course." 

So she did this whole ritual. She told me, "You didn't have a natural birth before, did you?" I was like, "No, I had a C-section, but I'm trying for a VBAC." And she said, "I'm really certain that you're going to get it. I'm very sure that that day when you go into labor, your ancestors are going to be with you. I'm certain of it." And she also said, "There's something that characterizes you and has characterized you your whole life, which is having clarity and determination, Sophia, so this is not gonna be the exception." 

And she gave me this candle, and she told me, "Please, light this up when you go into active labor just to call your ancestors to be there with you." So I was like, "Okay, great." Then also on week 36-37, I had a nesting party. I invited a lot of friends over to help me prepare the house for baby. A friend of mine brought the tarot cards. She told me, "Do you want to pick a card?" And I was like, "Okay yeah, why not?" So I picked a card. That card was the card for strength. It was number eight of the major Arcana that depicts a woman taming a lion through the application of subtle force. That was so symbolic for me because it was strength. The picture really stayed in my head, and I had to think, obviously, about Woman of Strength. So there were all these symbols out there that just really put me in a very different mental state. 

So anyway, the day I went into labor, it was just one day before my due date. And this time, I didn't tell anyone about my due date. Only my mom and obviously, my husband knew. So one day before the due date, I started getting contractions. I had two weeks of prodromal labor, and I had that before in my first pregnancy, so I knew what it was. I mean, it can be so frustrating because you start getting prodromal labor, but it doesn't escalate, so you get sad. But I knew this time what it was, so I was trying not to pay too much attention to it and just continue with my life. 

But that day, I started getting real contractions. I knew that what I had to do was to go rest. I did do Miles Circuit. And anyway, I was pretty happy. But then 24 hours after, labor completely stopped. I was so scared of the story repeating itself, so fears started sneaking in. All the doubts. I started thinking, maybe natural labor is just not for me. I was crying. I was sad. I texted my doula and I said, "Neri, I'm just really bummed. I think this is not going to happen. I think I'm going to have a C-section again." She said, "Whoa, wait, I'm going to your house right now." 

She lives really close to my house. So in 15 minutes, she was here. This was at 8:00 in the morning of the due date, like week 40. And she said, "I think although baby is already engaged," because we knew it was already engaged, "I think it's not in the most optimal position, so I'm just gonna use the Rebozo." And we used the Rebozo. She told my husband and my mom how to use it. That was pretty magical. And then we also did a lot of Spinning Babies exercises. 

She said, "But aside from this, just try to relax. Everything's going to be okay." That day, I had my 40-week appointment with my doctor. I went and that was a game changer because she checked me, she checked my baby and she said, "Both of you are fine. Everything is okay. Please try to go home and relax. Do anything that makes you get oxytocin." She was like, "Why don't you go and eat or get a bath or eat cake in the bath?" And I was like, "Okay, that's a really specific suggestion, but why not?" 

So that made me feel much better. And she said, "I do recommend that you call the acupuncturist and tell her what's happening to see if she can give you an extra session." So I called my acupuncturist and she told me, "I'm an hour away from Mexico City because I'm teaching at a university, but I'm on my way there. I'm going to see you because I know you can do this." It was so sweet of her. She drove all the way here, she gave me a session and she told me, "I never do this, but I want to see you again. This was at noon." And she told me, "I want to see you again at night. Come here at 8:00 PM, and I'm going to give you an extra session that is specific to help baby get in a good position and to descend."

So I was like, okay. So I went home. I actually came back and went to listen to Meagan's because I remember that she had a story of failure to progress. I listened to that episode. It was so helpful. So then I went back to the acupuncturist at 8:00 PM, and during the session of acupuncture, I felt a super strong contraction. Because what had been happening is that my contractions were intense, but they were really short. They were only 30 seconds. So when I was there, I knew that was a minute or longer. 

Anyway, after the session, I came back home, and they always recommended to walk after the acupuncture session. I went walking with my husband, and active labor started. It was clear, and it was so intense. It really started every 15 minutes, then every 10 minutes, then 7, then 5. So at 5:00, I texted my doctor and my doula, and they were like, "Okay. This is fantastic. Let's wait until you are 3-1-1." So every three minutes, one minute long for one hour. But I felt like things were going super fast. 

So I told Neri, my doula, "Can you please come see me?" Because she always told me the timing between contractions and the duration is important, but it's even more important that I see how you're acting. So she came. And in the meantime, my husband was packing the last things to go to the hospital. I also was pretty relaxed in the sense that my mom was taking care of my toddler, so I was really relaxed about that. 

My husband had become an expert in helping me put pressure in my hips during each contraction. He was packing and helping me, and he was just a rock star. He was offering me water, and he was my biggest cheerleader. Neri arrived, she saw me and she's like, "Okay, it's time to go to the hospital." So I was like, "Okay. So we went into the car." 

At this time, I was already in a lot of pain. Contractions were so long. They were 1:20, some of them, a minute and a half. It was super intense. I couldn't see anymore. I was just holding to the back seat. I was sitting in the back, just facing the other way. And here is where all the mental preparation really stepped in because I was remembering all of the affirmations that I was listening to. I was remembering all of the stories that I heard. I was also obsessed with watching birth videos. So all of that was going through my head. I love them so much. 

My dad, who was my favorite person in the world, passed away seven years ago. I could really feel he was there. It was just crazy. So anyway, I was doing all this mental work during each of the contractions while in the car. And this was at midnight, and we were very close to the hospital. The road was blocked, completely blocked by construction. And we were like, "Oh my god." I was in labor land. I was not paying attention to details, but I could hear in the back my husband and my doula getting a bit worried. 

My doula went out of the car, and I could hear her telling the police guys and the construction workers, "Hey, guys, we have a lady here that's in labor. If you don't let us through, she's going to have her baby here." And it was like, "Wow. Okay." So they opened the road just for us. We went through. We arrived to the hospital. And it's crazy at that time because you only do the few things that you can do in between contractions. I went into the room. This time, it was a different hospital. The room was so lovely. I remember it being a peach color. We had essential oils. We had my playlist. Again, my husband was my biggest cheerleader. 

Five minutes later, my doctor arrived, which made me feel so much better. And she's like, "I'm going to check you." I was already at an 8. So that was super exciting because it was already past what I had achieved last time, and then my water broke. My doctor said, "Sophie, I need you to look to me in the eyes and listen to me." So I looked at her and she said, "Sophie, this baby has to be born now, so I need you to start pushing." I was still not at 10 centimeters. I think I was 9 or something. 

But what they didn't tell me at the time is that my water already had meconium, and my baby's heart rate was starting to have some significant declines. But luckily, he was recovering. I was very thankful later on that they didn't tell me all of this because I was just so focused. So anyway, I tried different positions. First, I went and sat down on what we call a Mayan chair. I did all fours. So I think I pushed for an hour or an hour and a half. 

I just remember it being very magical in the sense just seeing my doctor, my doula, and my husband working together, cheering me, communicating even without words. Everything was just flowing. But still, baby was not being born, and pushing was so much harder than I thought. And also, I guess because I was not at 10 centimeters yet, I was not having the super urge to push, but they were guiding me to do so, and it was really, really great guidance. 

So finally I went into throne position, which, honestly, was the last position that I thought I was going to give birth in, but it felt all right. I was a second away to give up and to tell them, "You guys, I think I cannot do this." But then I remembered in all of the podcast stories that I listened to that usually when you're at that stage, it is because baby is about to be born. 

So then my doctor told me, "Sophie, baby is almost here. Do you want to touch their head?" We had decided this time not to know the sex until birth, so I had no idea if he was a boy or girl. I touched the head and that was so, so, so exciting. So I was like, okay. It just gave me another rush of energy. My doula said, "I really think two more pushes, and you're going to meet your baby." So I pushed once. The little head popped out and then it went back in. 

And then this whole time, they had been telling me to try not to push with my throat, but with my abdomen. But then they said, "This time when you push, push with all of your strength. If you feel like screaming, scream." So I pushed so hard. I screamed. My baby was born at 2:22 AM and baby started crying right away. I started yelling, "I did it. I did it. I can't believe it." And yeah, just for a few seconds, I had no idea if he was a boy or girl because I right away put him in my chest. And then my husband looked and he said, "Oh my god, it's a boy." 

And yeah, people asked, "So what's his name?" And we said, "His name is Rio." Rio in Spanish means river. And it also stands for the flow of life. I really, really think it really honored the way that he arrived into this world. And honestly, he's a pretty chill and easy going baby. So it was honestly the best day of my life. 

And later my doula, my doctor and I just, just went through the whole story. And again, we all said, I think my mental and spiritual state of mind was very different. This time was much more positive. I also really felt held by my drive. I had this chat of my all my best friends in this WhatsApp chat, and they were all rooting for me. 

And also, remember I told you there was this shaman, like this magician priest who told me that I was going to be able to do it? They gave us a candle. My mom lighted the candle when we went to the hospital, and the candle turned off by itself at 2:20 and Rio was born at 2:22. So that was pretty magical as well.

Julie: Wow.

Sophia: Yeah. And just the last thing I'll say about the story is that also, my gynecologist and my doula were also in a different state of mind. They had had a lot of VBAC experience which was great. And my doula always told me, "It doesn't matter how your baby is born. What matters is the experience, and that you really feel this connection with your baby. But in this case, Adriana told you to push this baby out, and you understood the assignment. You literally delivered your baby, and you had the baby when you were asked to do so, and that in itself is strength." So, yeah, that's my story.

Julie: I absolutely love that. Just all of it. What a journey. I'm sorry. I'm trying to figure out where to start. I took some notes as you were talking, and I just think it's so incredible, all of the different things that you did to prepare. I really like what your doula told you during your pregnancy about your personality that you've always had clarity and determination. It was something like that. She said, "Clarity and determination is your personality." 

I love that because I think sometimes it's easier to advocate and fight and navigate having a VBAC when that clarity and determination is already something that comes naturally to us. It's not something that comes naturally to everybody. It's not good or bad or assigned into a category. It just is. And like me, I'm incredibly stubborn, and I will fight sometimes harder than I should to get the things that I want or desire. And I think that my stubbornness played a huge part in working towards that. Sometimes it's just easier to advocate for yourself when you already have those strong personality traits.

Sophia: So yeah, for sure.

Julie: But it's okay because you don't have to have those strong personality traits inherently in order to get your VBAC. There are lots of other things that you can do and lots of other things that are on your side as well. 

I wanted to touch on some of the things that you did to prepare. You took the VBAC class which is amazing. I love our VBAC class. It's really incredible. Lots of good information. I feel like obviously, it's pretty well-rounded and has lots of different characteristics and addresses all of the different learning styles and things like that. Things for the data junkie like me, and things for the people who are more holistic minded, things that are more mentally mental preparation focused, and things like that. 

You talked about Rebozo, Spinning Babies, and learning how to relax your mind and your body, the positioning of the baby, acupuncture. You hired a very, very good doula and provider who both had lots of VBAC experience. That was also something that was really important to me. I interviewed, I think, like 12 doulas when I was preparing for my first VBAC because I really wanted a doula who had a VBAC herself and supported lots of VBAC families. I don't think it's necessary that to have a doula who has had a VBAC herself in order to have a really solid VBAC doula. I don't think that's necessary, but that's something that was important for me.

Sophia: Yeah, for sure. For me, too.

Julie: Yeah. Yeah. I wanted midwives who had done lots of VBACs, and that was really important to me. Now it's not, like I said, necessary, but it's something that you can put in your toolkit to prepare. So I feel like a lot of times I hear people say something to the effect of, "I tried all the things, and I still didn't get a VBAC or I tried all the things and I didn't get a vaginal birth." And you know what? Some people try all of the things and don't get a delivery method that they want. And some people do literally nothing and have a perfect birth. I want to just tell you that birth is inherently unfair. 

Sophia: Yeah.

Julie: Especially with the way our system is set up to handle pregnant women, and babies, and labor, and all of that stuff. It's inherently unfair. Sometimes you can do everything and have a completely unexpected birth experience, and sometimes you can and do absolutely nothing. My sweet sister-in-law is getting induced tomorrow. She knows absolutely nothing about labor and birth and delivery. She has no desire to know anything. She knows absolutely nothing. She's getting induced tomorrow, and I'm just really trying start hard to stay in my role as supportive sister-in-law when I see some choices that she's making that might influence her birth in a way that she doesn't want, but also, I don't think the outcome really matters to her, to be honest. I just don't think how the baby gets here matters. And that's okay. It is. That is okay. 

I guess my point of all of this is that you don't have to do all of the things. I feel like some people say, "I feel like I don't want to miss anything." What you need to do is learn about the things that are available to you, and then gravitate towards the ones that resonate well with you. Maybe you don't even care about Spinning Babies or what position your babies in, but you really want to focus on nutrition and getting your mind ready and finding a supportive provider. Cool. Do those things.

Sophia: I really tried to enjoy this pregnancy because I only plan to have two kids, so I was like, maybe this is my last pregnancy. I just wanna make sure I enjoy it. I even did a photo shoot with my family and stuff. I just really enjoyed it. I know that for some women, it stresses them to think about all this prep, but for me, this time around, it just made me feel good just being informed and things like that. 

And honestly, to have a VBAC in a context like Mexico is not a minor achievement. The system is so set-up to just go into C-sections. So yeah, it was just a lot of challenges against me, but I was really lucky that I had really good service providers by my side that were supportive. My doula told me, "When we saw that you had meconium, and we saw that your baby's heart rate was descending, I'm sure any other doctor would have sent you to the OR, but Adriana, your doctor, really believed that you could do it, so that's why she decided to just give you a chance and you did it." That's just really important as well.

Julie: Yeah no, I agree. If you want to do all the things, if doing all the things makes you happy and helps you feel prepared, then by all means, do all the things. I don't think you should do nothing. Let me clarify that. I think you should do something, at least one thing. But do the things that really resonate with you. I saw an Instagram post yesterday, I think. I'm trying to find it now. I think it was maybe on the account called Trusting Birth or something like that, but basically it said that there are studies that show-- nope, it is not trusting birth. Dang it. Gosh, dang it. I really want to find it. It was something about how there are studies that show that women when they're pregnant, make smart choices. Okay? They make smart choices. That doesn't mean they go deliver in the hospital and have an epidural. It's not a blanket statement, right? They make smart choices, which means they let their intuition guide them. 

No, not smart choices. Safe choices. Safe choices. And what is safe depends on the parent and the baby and the pregnancy. When you let women guide their own care and give them options, they make the safe choice. Now, the safe choice is different, like we just said, but the choice that is safest for them at the time. There is a study to back that up. And gosh dang it, I wish that I could find it. I'm literally on my phone right now thinking of all the different accounts it could be. I wonder if I liked it. Dang it. Anyway, if I can find it, I will have Paige, our podcast transcriber, link it in the show notes. I'll send it to her. 

But anyway, it was really interesting because that's what we've been advocating for all along. Trust in your intuition. Trust your gut. Trust your internal guide. You will make a safe choice. And if that's birthing at home, if it's birthing in the hospital or whatever it guides you to, if it's acupuncture, Spinning Babies, massage, getting a doula, not getting a doula, doing a VBAC class or what VBAC class to do. All of those things are safe choices that you can make for yourself. 

Now, dang it. I just want to hang out here until I can find it. 

Sophia: No worries.

Can I add one more thing?

Julie: Yes, please do while I keep looking.

Sophia: Yeah. Talking about the safe choices, I think one of the things that made me feel very safe and allowed me to really focus on the contractions and the pushing is just knowing that my birth team was really on my side, like my doctor, my doula, and my husband. Most women who I know in Mexico have to spend a lot of time advocating for their obstetric rights, so not having to worry about that and just focus on my birth just made me feel really safe and just being able to know that they believed that I could do it.

Julie: Awesome. Yes, I agree. I agree. Believing in yourself is a big thing. Granted, sometimes you'll believe in yourself. I think when I say believe in yourself and trust yourself and trust your intuition, it's not trust yourself that you can have a VBAC, although that is very important. That's important. But trust yourself that you will navigate the birth in a way that's safe and healthy for you and your baby, and that might be a repeat C-section. It might be a home birth, an unassisted birth, a hospital birth, but trust yourself that you will be able to guide yourself safely through the birth process whatever that looks like. 

And guess what? I found the post. I had liked it, and I just had to go into my activity in my Instagram history. It's from an Instagram account called Intentional.Birth. Intentional.Birth. And it says that there's a PhD biologist and doula, Sophie Messager who bridges the scientific and intuitive worlds of birth at the induction equation. So I think maybe that's the induction equation. Oh, I guess I don't know what the induction equation is. 

Anyway, so the post shows though, it says, "Research shows that women make safe choices. Because of the constant communication between the woman and the baby, women tend to know when something is wrong, and they also tend to know when something is right. Ignoring a woman's instincts is a very stupid thing to do." I like that. Women's instincts tend to know when something is right. I hear that all the time. This is what it sounds like.

It sounds like, "Oh, my doctor recommended an anatomy scan at 32 weeks, but I just don't feel like that's necessary." Yeah, it's because you know something's right. Or, "I know measuring for a big baby isn't really evidence-based, but I just think I want to do it." That maybe feels like something is right, the big baby scan or whatever. Or maybe that something's wrong, right? 

"My doctor brought up inducing at 39 weeks. And normally I would say no, but it just feels like the right thing to do." That is your intuition. Or, "My doctor said maybe we should induce at 39 weeks, but I just don't think that that feels. That doesn't feel right to me." And so you wait. That's your intuition. Like those comments, trust that you know when your baby is safe. You know when something's wrong. You know when something's right even if you can't literally define it. Follow those feelings. They're important, and there is science to back it up.

Sophia: That's how I felt when my baby was breech. I had this intuition that I'm going to be able to turn it around and, everything's going to go well, and it did. I love that there's this study backing up the importance of following your intuition.

Julie: Yeah. So go check it out. It looks like, it links to the study at Sophie. That's your name? No, you're Sophia.

Sophia: People call me Sophie.

Julie: So yeah, there we go.

Sophia: It's all connected.

Julie: Yeah, there we go. It's all connected. Sophie Messager. That's M-E-S-S-A-G-E-R. That is the PhD biologist who is linked with the host. I'm going to follow this lady right now. Transformational Journey Guide for Sacred Shifts. Incredible. All right, awesome. Well, thank you so much, Sophia, for sharing your story with us today. I loved talking with you. It's incredible for everyone birthing in Mexico and Mexico City especially, we know there are a lot of similarities between the United States, but there's also some differences, and different challenges to navigate. So we appreciate hearing your perspective and your experience, and I just really enjoyed having you here with me today.

Sophia: Likewise. Thank you so, so much.

Closing

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

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Molly joined us for Episode 84 talking about her unexpected breech Cesarean and first VBAC story. Today, she returns sharing her second VBAC story!

Molly shares her powerful journey through loss, IVF, selecting her powerhouse birth team, preparing for different outcomes, post-dates, a multiple-day induction, a beautiful delivery (where her husband caught their sweet baby!), and navigating a placental lobe.

Allison, one of our VBAC-certified doulas, joins Meagan as a co-host talking about her work as a virtual doula and the importance of how women are treated during their births. 

Coterie Diapers - Use code VBAC20 for 20% off

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, Women of Strength. I hope you guys are having a fantastic day or evening and are excited for another episode of The VBAC Link. We have our friend, Molly, today, and she is from central Alabama, and then we also have a co-host today. She's one of our doulas. Her name is Allison. Hello, Allison.

Allison: Hi, Meagan. Hi, Molly.

Molly: Hi.

Meagan: I was going to say, and hello, Molly. 

Molly: Hi.

Meagan: Welcome to the show you guys, and thank you for joining us. Allison is actually one of our doulas. I don't know if you've noticed along the way here and there, we have one of our doulas on as a co-host. I think it's so fun to hear an educational topic from them and then, of course, share where they are at because I truly believe hiring a doula is so impactful. In fact, on Molly's form, that is one of the tips that she gave. Right, Molly? You're like, hire a doula.

Molly: Yes, absolutely. It made all the difference this birth.

Meagan: Yes. Doulas are incredible. So if you can, hire a doula. Before we get into Molly's story, Allison, I wanted to just turn the time over to you really quick and have you share a little bit more of where you are at. So for the listeners, maybe in your area, they can find you.

Allison: Absolutely. Well, listeners, you have a treat because I serve everyone all over the world, globally. All of my work is online. My business name is The Cesarean Doula because I actually support women and birthing people emotionally after having emotionally difficult or traumatic Cesarean births. I do all of my work primarily over the Internet over Zoom. My focus is actually not on birth but on postpartum and on recovering from the feelings of grief, sadness, loss, overwhelm, and confusion that we often have after a Cesarean that's undesired or that goes in a difficult direction. I had one of those. That's what brings me to this work.

Meagan: Yes. I love that you mentioned that you're like, this is what brings me here. I think in a lot of ways for doulas, that's what brings us to doing this work is our own experience and wanting to set a different pace and make change. So I love what you're doing. We're recording in 2024, everybody, but hopefully now, it's 2025, and you can go to our website because we're hoping to have a different option for searching doulas where you can actually go and search for online only because we do have a big chunk of doulas that do virtual support. So let's hope that that is the thing. If not, email me and say, "Meagan, get on it. Do this, because I want this option." 

Okay. Well, Ms. Molly, welcome to the show. You guys, Molly is a full-time mama, a part-time vet technician, and a soccer coach. That is a lot of things all at the same time. Yes. My husband is a soccer coach and just that alone is a lot. Like I said, she lives in Alabama with her husband and her two sons, her mom, and lots of dogs, cats and horses. She said that she also has two daughters in heaven. I'm sure you're maybe going to talk about that a little bit today, Molly.

Molly: Yes, it is part of our story.

Meagan: Yes. Okay. Well, thank you guys again for being here. In just one moment, we're going to dive in. 

All right, Ms. Molly. I don't know why I keep calling you that Ms. Molly, like you're a teacher.

Molly: It's the song. It'll get you.

Meagan: It comes together. Yeah, seriously. Okay, thank you so much for being here and yeah, I would love to turn the time over to you to share all of these stories.

Molly: Thank you very much. So if you guys, if you listen to The VBAC Link, I was on a couple years ago talking about my first C-section and then the subsequent VBAC with my first daughter. Unfortunately, a couple years after that, my daughter passed away. And shortly after that, the desire to have another baby was laid on our hearts, and so we decided to try that.

For various reasons, that meant we had to go through IVF. We were very lucky in that our IVF journey was short. That's a whole other podcast on its own, the IVF process. We ended up with three embryos, and then in December of '23, we did our first transfer. That one unfortunately failed. And so that's my second daughter in heaven. We did another test after that to see why the transfer had failed and determined that we needed another day of shots. Well, I say we-- me. I needed another day of shots to do the transfer. 

So in March, we did another transfer with the extra day of shots, and that one was successful. I had the teeniest bit of spotting the next day and just woke up knowing I was pregnant. It was pretty magical, actually. The at-home pregnancy test, seven days after that, was positive. Then the blood tests after that were positive. I did have a little bit of spotting after that which was a little scary. 

I talked to my doctor, and she upped the progesterone in oil shots I was taking. The amount of those seemed to clear out the spotting. And then we went in for our first ultrasound. I was diagnosed with a subchorionic hematoma, I think is what it's called, which is essentially like a bruise between the placenta and the uterine lining. That cleared up on its own. 

Fortunately, after that, I was a "normal" pregnancy. We weaned off the IVF shots. My last one was actually on Mother's Day which was a magical little sign. And that's when we dove right into labor prep. We did the Spinning Babies and bouncing on the birth ball. I walked every day. We went back through our birth plan. We tried to cover every single contingency from a repeat Cesarean which wasn't the goal, but we wanted to be prepared just in case. We prepared to labor at home as long as humanly possible. We even prepared to have a car baby. We had a bag with a bowl to catch the placenta and towels and puppy pads just in case we labored at home so long that we had a car baby.

We hired a doula this time around. We had originally played around with the idea of doing a home birth, but in Alabama for VBACs, midwives still cannot attend VBACs at home in Alabama. We did find a midwife who was willing to do that for us but because of the restrictions, it wasn't covered by insurance, and that priced it out. So the compromise was that we would do a hospital birth, but I could have a doula this time. We interviewed doulas and found one who's actually certified by The VBAC Link. She's taken y'all's class and she was wonderful. Her name is Jolonda, and she was fantastic. And actually, in the end, my husband said, "I'm so glad we had a doula for me." Not necessarily for me, but for him. He needed her more than I did, and that was pretty cool. 

We also, this time, instead of going with an OB, went with midwives. They were associated with an OB practice, but we went just to the midwives. That was an interesting and much different experience. It was more like a conversation and less like an exam. We go in, and they would take my blood pressure, and then we would just talk. It was wonderful. She went through my birth plan point-by-point, and then signed it and scanned it into my chart. Anything that wasn't possible, she'd say, "Well, we can't do this because of the hospital we were at, but we can do this or we can try and do this and make that work." She was completely accepting of anything that I wanted to do differently. 

We decided not to do the erythromycin eye ointment. She said, "Yes." She was fine with that. We delayed, I think, the Vitamin K shot then and the delayed cord clamping. She was all 100% supportive of everything that we wanted to do. I did have to see the OB once just so they could sign off on me being a, quote, healthy pregnancy, and that was a quick in and out. There was a doctor visit, and they said, "Okay, we'll see you back in a couple of weeks." I said, "No, I'm going to go back across the street to midwives. I'll see them in a couple weeks." 

So that was all. My pregnancy really in itself was pretty normal. And then we got closer and closer to my due date. Now, I was due on November 18, and we got closer. I stopped working as a veterinary technician on the end of October right before Halloween. We had our baby shower. We were getting close to all the guess dates. Everybody had guessed when your baby's going to come. I would text them, "Nope, you missed it. It wasn't today." 

And so we slowly passed all those days, and then we passed my due date. We were doing everything-- the tea and bouncing on the birth ball and the dates and the pineapple, walking, The Miles Circuit, curb-walked. I knew the closer we got to 41 weeks and 42 weeks even, the more that there was going to be pressure for a repeat Cesarean. 

Now, to my midwife's credit, she never mentioned a repeat Cesarean. That was the very last thing that she ever talked to us about. We had talked about it in our birth plan, of course, but as we passed the due date, she didn't mention that as a course of action. As a joke, we asked our son, "When do you think Mama will have the baby? Now that we're past our due date, when do you think Mom will have the baby?" And he said, "I think she's going to wait until December." I said, "Buddy, please don't put that on me." So we'll let you know how that goes towards the end.

Meagan: Yeah, I mean that would be what, two and a half more weeks? Three? Yeah, two and a half more weeks.

Molly: Yeah, it was a long time. And I said, "Bud, please don't put that on me. That's a long more time." So then we made it through Thanksgiving. I consented to a cervical check at 39 weeks and there was no action the cervix, but you and I know that that can change in an instant, and it's not an indicator of anything. 

Meagan: Nope.

Molly: At 40 weeks, I consented to another check and to a sweep of the cervical membranes. That made me feel crampy but really didn't do anything. We started talking about induction at that appointment. We talked about starting with the Foley bulb over breaking the waters or maybe Pitocin. We talked about those options and which ones I was most comfortable with. And so then after the 40-week appointment, they sent me in for a biophysical and non-stress test, and we passed those with flying colors. No problem. Baby was fine, I was fine. She just was very, very comfortable. 

Then at the 41-week appointment, we did another sweep and this time I was dilated to a really tight 1. But again, that didn't really do anything. We made our next appointment for 41 weeks and 3 days. And the ladies in the front office said, "We hope we don't see for that appointment." And I said, "I hope you don't either," but we did see them for that appointment. So at 41 weeks and 3 days, we talked about the induction again. They did another sweep just in the hope that maybe it would start things. It didn't. 

So we talked about and scheduled the induction. We'd agreed to start with the Foley and see how that went, and then maybe talk about breaking waters and maybe, maybe Pitocin being our last resort. We stopped for dinner. That was Wednesday evening. We stopped for dinner on the way in because I was like, "We're going to have a baby, and I need my strength. I've got to eat before we go in." 

So we stopped for dinner, and we got checked in. They got me strapped in with a wireless monitor, which was new this time and was so much better than the wired monitor because I could move. It was much better. And this is the start of what we like to jokingly call birthatory, because it's birth purgatory. I was stuck there in the room. I couldn't leave. My husband left just to get us food, but it just felt like we were there forever with nothing to do. And time moved strangely as well. I watched Friends at night to help me sleep, and I watched Parks and Rec during the day to keep me entertained. We did a lot of walking up and down the room as much as we could. 

And that Wednesday evening was just to start us monitoring. Jolanda came in, and she was in and out and checking with us that night. They also started me on the Group B strep meds. I think I forgot to mention I was positive this pregnancy. I had a weird reaction to whatever med they put me on first, like my scalp was on fire. It was a really bad reaction. 

Meagan: Interesting. Is that a common reaction?

Molly: I believe they said it could happen, but it's not super common. I wish I could remember which medicine it was they gave me. But, I mean, it felt like my scalp was on fire. I was itching. It was horrible. So they gave me some Benadryl which fortunately helped me nap, so I got some rest. But we didn't want to do too much of that, so they switched me to a different medication. And again, I wish I could remember the name of it, but I can't. And that, I did not react to, so we stayed with that one for the rounds of the Group B Strep meds. 

So that was Wednesday night, and they were really just monitoring me. Thursday morning, the OB and the midwife on call came in to discuss my case. They discussed options. Pitocin. I consented to a check because we were going to start with the Foley, but I was at a 3 already. So that put the Foley out of commission because the Foley will only work up to 3. 

We talked about Pitocin versus artificial breaking of the membranes. The OB did do a little bit of pressuring, but we were all prepared for it. He said, "Well, at this point, this many post dates, you're probably definitely going to have meconium." And behind his back, my doula, my sweet doula rolled her eyes. It was what I needed, that support in that moment for the doctor to say, "Oh, well, there's definitely meconium." And my doula would be like, "No, there's probably not." 

So we asked for time to discuss between us and what to do. And Yolanda had these little informational cards with different affirmations. There was affirmation cards, but different, like facts about, induction from-- oh, I'm blanking.

I can't remember. But they were little printed out laminated cards with different facts about different types of induction, and they were really helpful.

It's Evidence Based Birth. That's what it was. It was all evidence-based and backed up by studies and stuff. So we discussed what we wanted to do, and we agreed to breaking the waters on Thursday morning. So the midwives came in and broke my waters, and there was no meconium. So that doctor can just go sit somewhere else. 

My waters are broken. I walked up and down the room, but nothing really happened. That night, there were some surges that we did time, but they petered out, and nothing really happened. So we woke up Friday morning, and that was December 1st. I, with despair in my voice, looked over at my husband and I said, "It's December. We've made it to December." I felt like a balloon that was beyond needing to pop and was just discouraged and tired. I was at the end of my rope, really, honestly. 

They came in, and I agreed to another check. This was the first check that they'd done since they broke my waters. And so if you're keeping count at home, my water's now been broken for about 26 hours. We happen to be watching an episode of Friends where the character, Rachel, is in labor, and she's having trouble dilating as well. And Ross makes a joke about, "I'm dilated 3." 

Well, they did the cervical check and checked, and I was still dilated 3. And Michael goes, "I'm dilated 3," and everybody laughed. It was a good break in the tension. After that, they left to go discuss my case. Michael went to go get me some hot water so I could make tea. But he came back in and he said, guess who's here and looking at your chart?" And I had no idea. He said, "It's Vicky," who's the midwife who helped deliver my first VBAC baby. 

She had retired, but come out of retirement and was only working on the weekends in the hospital. And I looked at him. I said, "We're having a baby today." Just something told me that with Ms. Vicky there with us, we were in good hands, and we were going to be okay. 

So she came in and talked to me about starting Pitocin. She also told me, because at this point, I was worried about a repeat Cesarean. And she told me, she said, "I'm no longer looking at you as a VBAC patient. You've had a successful vaginal birth. I'm treating you just like any other birth now." And it was such a healing statement for me. It wiped the worry about a repeat C-section out of my mind. It was just the perfect thing to say.

Meagan: Yes. I don't want to interrupt you too much, but I love that you pointed that out, because most providers, they're actually looking at no matter if you've had a VBAC or not, you're always a VBAC. But what you just said to me really is gonna connect with so many others. It connected with me because we just want to be viewed as someone going in and having a baby. We don't want labels and these things that loom over our head even if we've had a VBAC before or if we haven't had a VBAC before. 

We just want to be looked at and treated as someone coming in and having a vaginal birth just like anybody else coming in and having a vaginal birth. So I love that you pointed that out, and I'm sure that that really did just connect and feel so good.

Molly: It was a huge release of stress knowing that I didn't have to worry about the repeat C-section, the VBAC anymore, and I could just focus on having the baby and what I was doing and just doing what we needed to do that day to have the baby.

Meagan: Yeah.

Molly: So we did agree to the Pitocin she suggested. And we got very into the details, and we're almost a year out. I should have written them down sooner. I can't remember the numbers we started at, but she wanted to start at a certain amount over a certain time, and I disagreed. I said, "Let's start lower and slower." And she said, "That's fine. I'll do whatever you want to do." So we started really low and really slow, and I was starting to feel some things, but still not very much. It wasn't anything I had to stop to get through. It was really more just like a tightening. 

Jolanda came to hang out with us, brought us more food and water, and she brought a puzzle to help distract us. We were going crazy being stuck in that room. Vicky came in later that afternoon, and because still no progress was really being made. They didn't check me, but they could just tell from the contractions on the monitor. She talked about wanting to up the Pitocin a little bit faster and more frequently. I told her that I was worried about the difference in the Pitocin contractions versus natural contractions because I had heard and read so much that the Pitocin contractions are much more intense. 

And she told me that she'd given birth with and without Pitocin, and the only difference for her was that Pitocin births were faster. I agreed for her to bump it up a little bit, a little bit faster, that. After a little bit of time to talk about it, we agreed to do that. They did check me at that point, and I had worked my way up to a 5, and baby had moved from a -1 to, I believe, a +1. We dilated some, and baby had descended a little bit. 

At that point, the contractions did start to pick up, and I lost interest in the puzzle. We turned a movie on for me to watch. They were a little bit more intense, but still easy, and I could still talk through them and walk through them. Jolanda did an excellent job. She reminded me to go to the bathroom. And so I went to the bathroom, and when I walked out, I felt the baby drop. I don't know any other way to explain it, but I felt her drop in the birth canal. It was like she was sitting high, and then suddenly she dropped. I said that. I said, "Oh, I felt the baby drop." My sweet doula said, "You felt the baby drop?" 

I couldn't respond to her because then a contraction hit so hard that I could not talk through it. So, at that point, I told them, I said, "Please turn the movie off," because I couldn't handle the sound of movie. My husband turned on music in the background real low of our birth playlist. I needed to get down on all fours, so I got down on my knees, and I was bent over a birth ball swaying back and forth and moving forward and backwards, swaying my hips and vocalizing through them. Keep your mouth loose and low, moaning through them. 

At some point I didn't need the ball anymore and Jolanda brought in this inflatable thing. It was U-shaped and it was inflatable, but you could be in it and lean over it. And again, I wish I remember the name of it, but it wonderful because you could inflate and then deflate it to move it and get it out of there. But it was just perfectly shaped for me to be able to lean over it and even sit on it if I needed to, but I just was leaning over it. 

The contractions were getting more difficult, and she reminded me to relax my hands because my hands had gotten really tight. She was reminding me to breathe and relax my hands. She also suggested counter-pressure on my tailbone. I did not want it on my hips, but she tried it on my tailbone, and that felt incredible. Suddenly, the contractions were so much easier to bear, and they just felt more productive. It was fantastic. 

So she and my husband, Michael, took turns wearing their arms out, pushing my tailbone through the surges. At, that point, then the wireless monitor got weird because it had been on me for so long. The stickers, I guess, had just given out. So a poor nurse was on her knees underneath me holding the monitor on my belly, and there was either Jolanda or Michael behind me pushing on my tailbone through the contractions. 

And then I started grunting and felt pushy. Juolanda recognized my grunting because we talked about during my consult during my first VBAC. I get grunty when I'm pushing. She recognized the sound and she said, "Are you pushing?" But I didn't want to answer her because I didn't want to stop pushing because it felt so good to push. I hadn't been checked. So I didn't want them to know that I was pushing and check me and tell me that I couldn't push. 

And also, at this point, I was practically sitting back against the counter-pressure. The surge would hit, and I would sit back into whoever is doing counter-pressure and practically put my full weight back on my tailbone on their hand and the counter-pressure. Then, my knees got tired being on the floor. So I asked to move to the bed and they asked to check me. The midwife, Ms. Vicky, said, "I would love to check you right now." I said, "As long as I can be on my hands and knees, you can check me however you want."

So I got up on my hands and knees on the bed, leaned over, and they checked me, and I was good to push. So at that point, we started actively pushing. Not just me pushing because it felt good, but pushing because we knew we were pushing a baby out. And pushing, it felt so good to push. I needed to push. It felt so good. I could feel her moving through the birth canal. I could feel her head coming down, and it was amazing. 

And just like with my first birth, it's frustrating to feel the baby move and then go back and then move forward and then go back, but you can tell you're making progress. I don't know how long I pushed for because I was way off in who knows where. Nobody else looked at the clock. Michael would have, but he was getting ready to catch. He had prepped to catch this baby. So I pushed her out into her papa's hands. He had prepped. He watched all kinds of videos meant for midwives, and he was so ready. He did such a great job. 

Baby Nora was there, and she was perfectly healthy. She was 7 pounds and 2 ounces, and 19 inches. For being 41 weeks and 5 days, she was still just perfectly cooked. I passed the placenta at some point after that. We did the golden hour, and we snuggled in. He cut the cord after it stopped pulsing. That was all very much a blur to me, just a golden, snuggly haze of love. 

So we passed the placenta, and it was declared complete. We looked at it, and we put in our little cooler to take home and freeze to plant her little birth tree. I did tear a little bit, so they stitched me up and we took some pictures. And then Ms. Vicky went home. She'd stayed 45 minutes late for us. She went home at that point, and I started nursing Nora. 

At that point, however, I was still in pain. So they said, "Would you like something for pain?" I asked for just Tylenol. I didn't want anything heavier than that, but I was still pushing. I was still feeling the urge to push, and it was getting worse. So the nurses applied some pressure to my uterus, external pressure. It hurt so bad I could barely stand it. Michael took the baby at that point, and Jolanda suggested me trying to avoid my bladder, and maybe that would help. But I couldn't. I couldn't get those muscles to work, so they put a catheter in. 

That didn't really help. The surges were still coming and I couldn't stop pushing. They put more pressure on my uterus, external pressure, and I passed a huge blood clot. It was like a softball-sized blood clot. That felt a little better, but I was still pushing and I could not stop the pushing. So they gave me some stronger pain meds and talked to the OB who was on call and all agreed that I needed to go the OR and see if something had been left. So we agreed to that and went under sedation into the OR, and they removed a golf ball-sized portion of the placenta. 

Meagan: Whoa.

Molly: Yeah. It was confusing because they had declared my placenta complete and after talking about it, and they looked at all the pieces, and it turns out that I had a lobular lobe.

Meagan: I was going to say you probably had a lobe.

Molly: Yes. And so after I mentioned "Oh well, I had some spotting early in pregnancy," they figured that the spotting had contributed to that, and that's why the placenta looked complete and there was a lobe and the hematomas all contributed to the early bleeding and the lobe in the placenta. 

I came out of the OR fine. I got two bags of blood but felt fine. When I woke up, I got to hold Nora in the OR. Well, not in the OR, but in the recovery and nurse her again. And everything was really fine after that. Jolanda checked on us a couple of hours after that. She brought us food. We had talked about what I wanted to eat post-birth. I wanted to eat a cheeseburger with bacon from a specific place near the hospital with fries. She brought it all, and we ate it at like 11:00 PM. It was wonderful. And Michael, like I said before, said later that having a doula this time around was 100% worth it mostly for him because she was suggesting things that he wouldn't have known to offer like the counter-pressure and, "Hey, maybe she needs to pee," and things like that. It saved him and helped him know what to do while I was off in labor land. For that, our sweet doula was so worth it. And after that, recovery was great, and we were fine.

Meagan: That is awesome. So still had a little bit of a hiccup there in the end, but overall a really great experience.

Molly: It was awesome. And I said before, with the birth plan, we tried to plan for all contingencies, but the one thing we did not plan for was three days trying to be induced naturally. 

Meagan: Yeah.

Molly: I mean, they say time isn't linear, and I have never felt that more true than we were stuck in that room for three days. It was very weird just not being able to get out. It's not something I would do again, the induction part, but we made it through thanks to great support from midwives and doula and my wonderful husband. I would do the birth part, and maybe not the hemorrhaging at the end, but the birth part I would do again.

Meagan: Yeah, yeah, for sure. I mean, that's just less ideal. I don't know. Did they ever talk to you? Because I know that IVF parents do have a slightly increased chance of hemorrhaging. Did they ever relate it to IVF, or was it mainly just, "Hey, you had a subchorionic hematoma earlier, then you have this lobe." Maybe it was just that they.

Molly: The doctors didn't. No, we were very aware that she was an IVF baby, and we had done a lot of research before that IVF babies have a very "sticky" placenta.

Meagan: Yeah.

Molly: That was one of the factors why we didn't do a home birth was because if the placenta sticks, and then you're at home, it can be a rush to the hospital. But the doctors at the hospital didn't mention the IVF possibility as the reason I hemorrhaged. Maybe it played a part. I don't know. They seemed to put it on the sub-chorionic hematoma. But it could have been both. I don't know.

Meagan: Yeah. Yeah. All of the little factors could have been. The best thing is that it seemed pretty minor and a quick fix. A quick fix. I just wanted to remind everybody, so I'm pretty sure this is your episode. It's Episode 84. So if you want to go hear the breech Cesarean and the first VBAC, definitely go back and listen to those on Episode 84. Thank you so much for sharing your story, and I'm so glad that it was so great and that your husband got to catch a baby. That's like my favorite, you guys.

Just to let you know, that's happening more and more. At least it has been here in Utah as we're attending births. Sometimes, all you've got to do is ask. So if you have a partner who is interested in that, I think asking is not harmful. Just ask. It can seem intimidating, but it's not too bad. It's not too bad. They really help these partners catch these babies. 

Allison, I would love to have you share your two cents and your educational topic on healing after Cesarean. We're doing these topics instead of reviews sometimes when we have guests. I love what you do because just like Molly and myself, we've been there having an unexpected-- well, maybe with the breech it was kind of planned. I'm trying to remember back in your story.

Molly: So with the breech, with the Cesarean, we had planned a C-section, but then he broke my water early, so it was not necessarily an emergency Cesarean, but we had to go in before we were "scheduled" to for the C-section.

It was planned, but unexpected at the time. The wrong timing. Yes. Okay. Well, tell us more, Allison.

Allison: Yeah, and I want to say thank you so much, Molly, for sharing your story. I actually want to point out a few things that I think are really important here. I work with so many people who have had a birth that feels difficult or traumatic. And oftentimes, there are women who come to me who say, "I don't understand why I feel upset about my birth even though I have this baby who's healthy and alive, if we're lucky enough to have a living baby or a healthy baby or both." 

And one of the things I talk a lot about is that oftentimes it's not the events themselves in the birth that create a difficult or traumatic birth, but it's how we feel, right? And so, what makes a birth feel good or bad? Like, I listen to you talk about this experience where you had some challenges leading up to it, right? Especially preconception, and then during conception. I felt your joy. I felt your connectedness, and I felt your power throughout your story even as you talked about the really difficult part at the end with the placenta needing to be retrieved. 

I want to just point out that that's what I heard, and you've got to tell me if this feels right for you, Molly. But what I heard was many moments where you talked about feeling connected. You talked about your sweet doula. You talked about that surprise midwife coming in to support you. You felt connected. You felt seen like that moment where you said, "Oh, well, the monitor wasn't working, but then the nurse got underneath me," so instead of actually you accommodating the hospital's protocol and policy, I love this idea. I'm imagining a nurse laying on her back under you while you're on all fours. You're empowered. That's truly centering you. Right? You're in control in a lot of these moments. 

You said you wanted the Pitocin lower. The doctor or the midwife honored that. It sounds like you were informed. You used some examples of the cards from Evidence Based Birth, and a lot of the information you engaged with prior to birthing. One of the things I talk about with my clients is maybe you even feel sexy during birth. You didn't mention that at all, but that might have been. There might have been moments, maybe not. 

Are there any other emotions that come up for you? Did I leave anything out hat you're like, oh, I really felt another positive emotion?

Molly: No, you've nailed it 100%. I felt very supported this birth from the midwife listening to me and, like you said, honoring my requests and my husband being there and the doula. I felt very supported. So even the end and the hemorrhaging which should have been scary, I don't look back on as scary. I don't want to repeat it, but I wasn't scared in that moment because I felt taken care of and supported.

Meagan: Mhmm. 

Allison: Right. That is so textbook. I love this story because that's a really, really scary thing. And if you hadn't had that support, that attunement, that communication and that safety, it could have felt different. It could have made your story feel like there was this turning point into a dive. I love that your advice was getting a doula, because in your story, I really feel how your relationship and respect for her are a big component of your support and empowerment. 

So I just want to end by saying that birth is really about those emotions, not the modality or even the environment where we birth. If we can create those experiences for ourselves as much as possible, we don't always have the ability to do that. Lots of things have to come together, but if we can focus on, how do I make myself feel empowered, connected, sexy, seen, in control, informed during my birth, however I birth, then the likelihood of having a positive outcome emotionally is so much higher. And when we have a better emotional experience, we're more likely to be able to have a supported breastfeeding experience and also go into motherhood feeling centered, feeling capable of taking on this new role or another baby when we already have littles at home. 

So thank you so much for sharing your story. I feel really touched, and I can imagine that others are too.

Molly: Thank you.

Meagan: I do love that you pointed that out, Allison. The way we feel during our labor, the way we're treated, the way we're communicated to, it really impacts that next step going into that motherhood era. I think back on your story. I remove your doula from your story, and I remove your supportive provider. That birth very much could have unfolded very differently especially because it was a longer induction. Right? And so when you put that powerhouse team with that true love and support back into the story, it's like, well, I don't understand why it wouldn't unfold that way anyway.

But really, if you look back without that, it's questionable sometimes. And so we talk about it, you guys. I think I will probably talk about it until I die. I mean, truly, I will probably not even be in this work when I'm 80 years old, but I will still be educating people on hiring a supportive team and provider because it really does impact. I had an interview the other day with a first-time mom and she was telling me who her provider was, and I very much remember this provider as a resident. And she was fine, but not great, right? She wasn't my favorite. I very much knew, oh, in the future I would not suggest her as a provider. 

And so as I was talking, and I didn't want to project my opinion on her, and I was talking to her, she said that her and her husband had actually been feeling a lot of pressure and that when she goes into her visit that she normally has a voice, but when she's there, her voice is muted. She feels like she can't say these questions and can't communicate. I think right there is that big red flag that if you cannot communicate with your provider in a prenatal appointment, then that is a big sign that you will not be able to communicate with your provider efficiently during labor, and they're not going to respect you. 

I love that your midwife came out of retirement and started working on the weekends because she probably loves this so much and that you got her. It worked out so, so well. But guys, again, find a good, supportive provider. If you're feeling like my interview did the other day, don't hesitate. Move, change, find that support because you want to be like Molly where you're in the situation and you feel that love and empowerment. 

And even though there was something that ,went awry and not according to plan, Molly felt that support. And so like Allison said, that could have been a very traumatic point in your labor where it wasn't ideal. You wouldn't do it again. You wouldn't choose it. You wouldn't suggest it. But even though it happened, and I don't want to downplay it like oh, least everyone's happy and healthy. I don't want to do that. But it happened, and because you had that support, your overall view is different. 

So great tips, Allison. Beautiful story, Molly. Again, go back and listen to Episode 84 for the rest of her stories. And once again, thank you for being with us.

Molly: Thank you so much for having me.

Closing

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Johanna is a girl mama joining us today from Canada. She had an unplanned C-section with her first, an HBAC with her second, and was pregnant with her third at the time of recording! 

Johanna reflects on her experiences with both supportive and unsupportive care during her pregnancies. Meagan and Johanna dive into your options surrounding PROM,  the significance of intuition in decision-making, the impact of provider choices on birth outcomes, and the nuances of VBAC postpartum recovery.

The VBAC Link Blog: Home Birth VBAC

Everything You Need for Your HBAC

Supportive Providers

10 Signs to Switch Your Provider

What to Do When Your Water Breaks

Labor Guide

Coterie Diapers - Use code VBAC20 for 20% off

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, Women of Strength. We have our friend Johanna with us from Canada today, and she's going to be sharing her HBAC story. So for those who may be , new to the VBAC world, or just all of the acronyms that the VBAC world has, HBAC is pronounced home birth after Cesarean. So if you are one of those who really wants to look into all of your options for birthing locations, which I encourage everyone to do, definitely listen up here. 

We're going to be talking about a lot of really great things including picking a provider and PROM knowing that you maybe had a provider that wasn't ideal the first time and more about HBAC. So we are going to be diving into a lot of really, really great, juicy topics. 

But in place our review today, Johanna and I are actually going to talk a little bit more about picking the right provider. So, Johanna, welcome to the show.

Johanna: Thank you.

Meagan: I am so excited for you to be with us today and so grateful that you are here to talk about this topic. Because like I was saying before we pressed record, I see daily in our community, every single day, and not even just our community, in other VBAC communities or this is weird, but people's statuses, like my friends and family's statuses on Facebook, where you type like, "Hey, I'm looking for this," or "I'm feeling very frustrated," or "I need prayers." People will seriously say, "I don't know what to do, you guys. Has anybody ever heard of VBAC?" on their own status? 

But especially in the VBAC groups, I see people and I just want to yell, "Hey, you over there. You're with the wrong provider" or, "Hey, you should move." That's a really hard thing because especially when I type that it can be like, oh my gosh, who is this broad telling me that I'm with the wrong provider and that I chose wrong? I'm not trying to say that. I'm not trying to say you chose wrong. Like, how dare you choose wrong? It's just like, hey, what you're telling us in this community is screaming, you're the wrong provider. 

So, Johanna, you , mentioned before we press record that you realized after your first birth that you were with the wrong provider. What made you realize that you were with the wrong provider? And were there signs during pregnancy that you recognized and maybe pushed away? Or was it really not something that you recognized until after? Because I know really, it can go both ways.

Johanna: Yeah, I think that there were signs during the pregnancy. I mean, one of them, and I just didn't listen to my gut because you don't know what you don't know. I put too much blind faith that it was all gonna work out. But I never felt comfortable with her. I didn't have a good connection with her. I was asking a lot of questions about what I can be doing because my first birth, I really wanted to be a home birth. She basically just didn't give me very much information about what I can be doing. 

She sent me to your generic birth course through the hospital. Yeah. I didn't really feel like she was really invested in the outcome of my birth. I was just like another one of her patients. So I didn't feel great about that. And then when push came to shove with my birth and things weren't going great, she threw her hands up in the air and just took a step back and didn't really advocate for me or try and help me through things. So I was left with a pretty unpleasant taste in my mouth.

Meagan: Yeah, I mean, exactly what you said just a minute ago. You didn't feel that she was invested in the outcome of your birth. And then it proved. It proved to be true when she just threw her arms up. So you had that experience, and you're not alone. There are so many of us out there. Me too, me included and a lot of people on The VBAC Link team included. 

We have all been in a similar situation where our providers, threw our hands up, weren't invested in our birth and our experience and had to go out there and seek that support that we deserved. So if there's anything we talk about on The VBAC Link, and I'm sure you've heard it, is find the right provider. I mean, seriously, you guys, I say it daily, every single day. If I'm not typing it, if I'm not voice memo-ing it, if I'm not saying it in my mind, it's find the right provider. 

Johanna, what would you give for tips for our listeners to find that right provider? And how did you find that right provider?

Johanna: So I found my midwife that I used for my second birth and I'm actually using again for my third birth because I am 31 weeks pregnant today.

Meagan: Oh my gosh. Oh my gosh. Yay.

Johanna: I found her actually because when I got pregnant for the second time, the first thing I did was get a doula.

Meagan: Uh-huh.

Johanna: I asked her for recommendations on a VBAC friendly midwife. She had recommended this midwife. So immediately I was like, yes, I would like to meet her. When I met her, instantly, I felt so much more at ease.

So I would say going with your gut. If something doesn't feel right, even if it's the tiniest thing, just look for a new provider. Just find someone where it feels right.

Meagan: Yeah. I can relate to that so much because that's how I was feeling. I was searching, I was searching, I was searching. I mean, it was insane. I interviewed a lot of providers, but that's what I was searching for is that immediate like, oh, I'm in the right place. You are my person. And it took me a long time. And that sucks. It sucks that it took so long. 

I know that in some areas they're really rural and it's almost impossible to find that feeling. But I agree. So just as a reminder for those looking, before we get into the story, I wanted to make sure that you know to ask open-ended questions. Do not say, "Do you support VBAC? Yes or no?" Do not say, "Do you support me to go to 40 weeks? Yes or no?"

Let's ask open ended questions. "How do you feel if I approach my due date and I haven't had a baby yet? How do you feel about VBAC? What is your experience with VBAC? How do you support your VBAC clients to make sure patients get the birth that they want? How do you advocate for them?"

Asking these big open ended questions and then like Johanna said, diving deep. What is your heart and your gut feeling and saying? If at any point you are questioning, which I think is when people come out on social media, that is when I think they comment and they're writing, "Hey, I'm, feeling defeated. Hey, this is what my provider said." It's because they're doubting. They're questioning. That's their intuition. If that even comes into play at all, it's time to switch. It is time to switch. 

And first-time parents, if you are out there listening, this applies to you too, right? We have to avoid these unnecessary Cesareans which are happening all over the world. We have to follow our intuition. So that's another thing we talk about until we're blue in the face-- intuition. So follow that intuition. Ask open ended questions. Really dive in deep because your provider really can make an impact.

And really, really quickly, we're going to just barely skim the surface on PROM. PROM is premature rupture of membranes. Johanna and I have both experienced it. She's two for two. I'm three for three. Maybe you won't be three for three girl. I don't know. I'm hoping you're not. 

Johanna: Fingers crossed. 

Meagan: I'm hoping you won't. But if you are, we know that it's okay. Vaginal birth still happen. But talking about providers, if you have PROM, which means your water breaks before labor begins, and just to let you know, it can take hours, even days for your body to turn over into labor after your water breaks. But if you have PROM and you don't have a supportive provider, that is right there the beginning of a fight. It shouldn't have to be a fight, but that can impact things because they want to get things going. 

Some providers won't even induce labor or touch you or 12 hours later they're like, "Nope, you haven't had a baby. You have to have a C-section." So yeah. So really quick Johanna, do you have any tips for our listeners who might have had PROM or may have PROM?

Johanna: Yeah, it's difficult because especially when I experienced it, I mean, I experienced it for both births and the second time I really felt anxious because I was like, oh no, I'm on a ticking time-clock again.

Meagan: Yeah, yeah. Because that's how you were treated.

Johanna: Yes. I was lucky that I have a super supportive provider. And she was like, "Baby's fine, you're fine, everything's fine. We're just going to wait it out."

Yeah, I mean crucial to have the right provider that is going to give you that grace and give you that time and that space, but just know the facts. Just arm yourself with information that as long as the fluid is clear, as long as you have no signs of infection-- at least here they make you come in for non-stress tests like every, I don't know if it's 12 hours or 24 hours when your water has broken. As long as everything's looking okay, you can wait, I think, up to 72 hours.

Meagan: I've actually even had a client wait five days. 

Johanna: Holy smokes. 

Meagan: Five days. Close monitoring you guys, really close monitoring. But it was nothing that said a baby needed to be born. So five days is maybe abnormal. This was a home birth transfer to hospital. Even with five days rupture of membranes, the hospital did not "make" her, as I'm putting quotes up, have a Cesarean or do anything different because she advocated for herself. But it really can. 72 hours. It really can happen. 

So okay, we are going to stop talking about this, you guys. We're going to have links in the show notes to dive deeper into questions for your provider. What about premature rupture of membranes and things like that. So we're going to have those in the show notes if you want to dive more into that. You can dive in. But we're going to take one quick break for the intro, and then turn the time over to Johanna. 

Okay girl, thank you so much for chatting with me about that. I really do think it's so important.

Johanna: I think knowledge about everything is your best friend when you're planning for any birth, but especially a VBAC.

Meagan: Right. I know. It does suck that VBAC has to be so much more intense in our prep and our research and all these things because we're just moms going in to have vaginal births. That's all we are. But, but unfortunately that's not how it's viewed. That's just not how it's viewed in most areas of the world. So yeah, all right. Let's talk about that first birth.

Johanna: Okay. So I got pregnant with my first daughter Mila in the summer of 2020. So heavy, COVID times. So that was scary enough. Because of COVID and the shift in culture towards socialization and going into hospitals and stuff like that, me and my husband decided to look into home birth which was not really on my radar before, but the more that I looked into it, I was like, oh, this is super beautiful, and I love the idea of birthing my baby at home in the piece and quiet of our own space.

Meagan: Yeah. And a lot safer than a lot of people think.

Johanna: Yeah. Yeah, for sure. The more I looked into it, the more I was like, okay. This is a totally viable option for us. I had a pretty uneventful pregnancy. I was very lucky. I had very minimal symptoms. Everything went well. I didn't have anything scary happened during the pregnancy. I will say that I didn't take the best care of myself. I am usually a pretty active person and I totally just didn't do much exercise or working out. I think in the back of my mind, I was scared that something bad was going to happen if I overdid it. It was just a lot of first-time mom anxieties.

Meagan: Totally get it.

Johanna: Yep. I didn't eat the best. I didn't take the best care of myself. I didn't do a whole lot to prep for the birth other than your typical childbirthing classes, bringing baby home through the hospital, generic courses that I think a lot of first-time moms, that's what they do, right? I read a couple of books. I read the What to Expect books, and I think I read Ina May's Guide to Childbirth.

Meagan: Great book.

Johanna: Yep. But I had no idea what to expect. When it came to labor and birth, I really was going in blind. I will say, I just put my faith in that my provider was going to hold my hand through it. That was a mistake. So yeah, I mean, it was a pretty uneventful pregnancy. There wasn't a whole lot to say other than it was COVID and everything was scary and didn't really know what was going on. 

When I was 41-ish weeks, my water ended up breaking. It was the middle of the night, and I didn't really know what happened. It was just like a little squirt and went back to bed. And in the morning, it was like when you move a position and a little bit comes out and you move a position and a little bit. It was one of those. And then I lost my mucus plug. 

So I was like, oh, I better call my midwife. So I gave her a call, and she totally brushed me off. She was like, "No, I think it's probably just discharge. I wouldn't worry about it." So that was another red flag was her just totally brushing off my feelings and what I believed was going on. So I hung up the phone and I was like, well, I don't really know what to do now. I'm fairly certain that my water's broken. 

So I waited a couple of hours, and it continued to trickle out. I eventually called her again and she was like, "Okay, okay, you can come in. You can come in and I'll check, but I'm pretty sure it's just discharge." So I went in and sure enough, she was like, "Oh, your water did break and it's amniotic fluids. Look at that."

Meagan: Interesting.

Johanna: Yeah, I could have told you that. So I was like, "Well, what do we do now?" And she was like, "Well, we can wait up to 72 hours as long as everything's healthy. That's fine, so we'll keep monitoring things." She sent me home and told me to just relax. She said, "If labor doesn't pick up today, go to bed and in the morning, do a castor oil induction." I did that. 

When I woke up the next morning and nothing had happened, I did do the castor oil induction. I will say that I will never do that again because it was horrible. Sorry for the TMI, but it just gave me severe diarrhea, and then nothing happened, and I was super uncomfortable. So that wasn't fun. That wasn't fun. That didn't work.

I went in for a non-stress test that afternoon. She decided to check me, and I had made zero progress. I was not dilated at all. I had zero effacement or anything like that, so no progress. I felt super discouraged. My water has been broken for however long at this point-- 36 hours, I think, probably. I've made no progress. The castor oil induction and failed. I had barely slept the night before, so I was tired and I was just stressed. I was like, when is this going to happen?

Meagan: But at this point you weren't really thriving with contractions. Nothing was too intense to be telling you that there should be progress, right?

Johanna: Literally not a single contraction or anything. Nothing was happening.

Meagan: True PROM, and so your defeating feeling is super normal because in our minds we were told our water breaks, we should be having a baby. But if we have PROM, don't expect to be dilated. Right?

Johanna: Yes.

Meagan: I did too. I expected to be way dilated and I wasn't.

Johanna: So I felt super defeated. And like I said, I wasn't sleeping. I barely got any sleep the night before because I was just anxious for birth to get going. I ended up crying in her office about how stressed I was to end up in a C-section because my sister had a long, pretty terrible labor that ended in a C-section. It was just not a great experience for her. I don't exactly remember what my midwife said, but I did not feel reassured leaving that appointment. 

But we did end up deciding that if I didn't go into labor that night, I was going to be induced the next morning because I was just not sleeping well. I was not able to rest and relax because I was just anxious. So I was like, okay. I guess my home birth plan is out the window, but at least there's a plan. 

I ended up going home. We had dinner, and I started getting contractions just after dinner which was exciting.

Meagan: Yeah.

Johanna: But then they petered off after, like, I don't know, an hour or two. So we went to bed, had the hospital bags packed and everything ready to go for an induction the next morning. Labor started around 2:00 AM. It started on its own around 2:00 AM.

Meagan: How many total hours is this until labor comes?

Johanna: I think it was about 48 hours after my water broke that I had the rupture of membranes that my labor actually started. I will say, it was pretty intense right off the hob. I hear a lot of women say that their early labor is like, "Oh, I took my other kids for a walk. I baked a cake. I did this. I did that to distract myself." My labors are not like that. My labors are intense right out the gate. I tried to eat something for breakfast. 

A few hours after that, I woke my husband up. We tried to eat breakfast. I got in the bathtub to try and relieve some of the discomfort. I hung out in there for a while. We had rented a birth tub. My husband got that set up. I called my midwife. She came probably around 11:00 AM, so at that point, I'd probably been laboring for like, I don't know, eight or nine hours. I was not coping well. It was very intense and I was not coping well with the pain. She checked me, and I was a 3. 

I was like, dang it. In my mind, what I know now is that it's not a linear thing and that it's not going to take another 18 hours to go from a 3 to 9. But in my mind then I was like, oh no, I can't do this for however many more hours because I'm already not coping well and I'm only at a 3. So I told her I was totally deflated and I told her, "I want to go to the hospital and get an epidural." She was like, "Okay, if that's what you want to do, that's fine." 

So I think between the time that she checked me and I was at a 3 and the time that I got the epidural, it was about two hours. That car ride to the hospital, wow, was not fun. But yes. So, in that two hours that it took between her checking me and me getting the epidural, she checked me again right as soon as it kicked in and I was at a 9.

Meagan: Whoa.

Johanna: Yeah. 

Meagan: 0 to 100. 

Johanna: Yeah, when I say that car ride, it was ripping through me.

Meagan: Yeah, you were in transition at that point.

Johanna: Yeah. When we were in the hospital waiting for the anesthesiologist to come in and do the epidural, my midwife and husband are joking around trying to make me laugh. I'm like, "This is not where are at right now." I was not having it because, obviously, I was in transition, and it just was not where I was at. So yeah, she was like, "Okay, well you're at a 9 now, that's great. So rest for an hour and then we'll probably be pushing." 

The epidural was heavy. I felt nothing from my ribs down. So an hour went by and she's like, "Hey, you're complete. Start pushing." I felt nothing. I'm trying to push, and she's telling me that I'm doing a pretty good job considering I have an epidural, but baby was still high. And then all of a sudden, I think I'd pushed a couple of times and all of a sudden, all of these doctors and nurses and bunch of people just start run into the room and they're all speaking French because it's a French speaking hospital.

Meagan: Oh my gosh.

Johanna: So I have no idea what's going on. Nobody is telling me anything. They're all speaking a different language. And I was just like, "Can somebody please tell me in English what's going on?" They told me that she was having late decal every time that I was pushing.

Meagan: Okay.

Johanna: So between pushes she was fine, but every time I'd push, her heart rate would go down and then have trouble recovering. At no point did anybody recommend maybe trying a position change or anything like that. Like maybe her cord was being pinched in that position. If only I knew now or knew then what I know now.

Meagan: Yeah, like hydration, movement, doing something, pushing in a different position.

Johanna: Yeah, yeah no. So like I said, my midwife threw her hands up and stepped back and let the OB take over and didn't say anything to me after that. The OB basically let me push three times and then was like, "Nope, this is going to take too long. We need to have a C-section," and she called a C-section.

Meagan: Wow. Do you remember how low your baby's heart rate was getting?

Johanna: No, I have no idea.

Meagan: Okay, interesting. I mean late deceleration are less ideal, right? We don't want them to happen late. We want that to be the recovery period.

But yeah, there could have been some things done.

Johanna: Yeah, and looking back, it's frustrating to know that maybe if one little thing had been changed, the outcome could have been totally different.

Yeah, but you can't blame yourself for that either. It's hard to look back and be like, the what if's. But yes, you did whatever you did in the moment with the information you were given.

Johanna: Exactly. 

So I went in for the C-section. It went fine. There were no complications, but being strapped down to a table in a really cold room and having the shakes and not feeling that, not being the person to get to hold your baby. I mean, everyone listening to this podcast pretty much knows what thats like and how it was demoralizing and traumatizing for sure. But it went fine. She was born healthy. I didn't have any complications. 

But yeah, the emotional trauma was real and not just for me, but for my husband too. We got discharged about 24 hours after the C-section and going home and seeing the birth tub still set up in our living room was a very emotional experience. We both ended up breaking down crying.

Meagan: Yeah.

Johanna: So I had to do a lot of emotional recovery from that birth as well as physical recovery because the physical recovery from C-section was also extremely rough. I remember every time I would have to get up out of bed, it felt like I was being ripped in half. It's rough, but I knew right from the moment she was born that I would be VBACing my next baby because we had always planned on having a few kids.

Meagan: I want to point out to everyone, too, the importance of postpartum support and postpartum help and planning. We never know the outcomes of birth. I didn't know the outcomes. I didn't realize that it was going to take me 15 minutes to walk 10 stairs up to my bedroom. I didn't realize it was going to take me 15 minutes to walk down the stairs. I couldn't be holding anything. I didn't realize how exhausting it was going to be to get out of bed to go to the restroom let alone taking care of a newborn baby and also thriving as an individual. 

So it's really important to really try not to ignore the postpartum period. I think it's easy to do because we're so focused on the birth. Especially with VBAC, I think we're so hyper, hyper focused on that VBAC, that outcome, and that experience which I do not shame anyone for being. I just want to plug it in. Don't forget about your postpartum because whether it's physical or emotional.

You came back to this space of seeing a plan that didn't unfold the way you wanted it to. That can be very emotional, very traumatic even in some ways. So yeah, having some resources for postpartum as well. I just want to plug that in.

Johanna: Yeah, that's a really good point. I did no prep for postpartum for my first birth.

Meagan: Me either.

Johanna: It wasn't even something that like dawned on me to think about. When I was in postpartum, I was like, wow, this is really intense. Like the sleep deprivation, the recovery, the breastfeeding, everything. It;s super intense. So for sure, don't neglect postpartum plans and getting the support that you need.

Meagan: Yeah.

Johanna: So anyway, I think from a couple weeks postpartum with Mila, I ended up finding your podcast and absolutely just binging it and trying to intake any knowledge I could get about VBAC natural childbirth-- just anything I could get my hands on, I was consuming because I knew that I was going to VBAC. I knew that I wanted to have a birth that was as intervention-free as possible for my second. 

So I ended up getting pregnant with my second daughter Bailey in the summer of 2022. The very first thing I did was I hired a doula. I already knew what doula I wanted before we even got pregnant because we had interviewed a few, and the doula that I found was actually a VBAC mom herself. And she just had a beautiful calming energy about her. I was like yep, that's who I want. So with that test, the lines turned pink, and I was already getting her on board. I ended up hiring the midwife that she recommended as well. 

I was intent on doing everything that I could this second pregnancy to set myself up for a successful VBAC that I could possibly do because I knew that if I did everything that I could possibly do and it still ended up in a C-section, then I don't have to have any lingering questions of well, what if I had done this? So it was like, I was going to do everything I could to set myself up for success. I was super diligent with eating well, exercising, and chiropractic care. 

I did all of the Spinning Babies' exercises, walking, and yoga. I did a HypnoBirthing course which I really, really liked, and I'm doing again for this pregnancy. I put up my birth affirmations. I did all the things You name it, I did it. My husband was super, super amazing and supportive and he was there with me every step of the way through every appointment and did all the coursework with me and everything like that. I'm very lucky to have a super supportive husband. I had another pretty uneventful easy going pregnancy. 

Other than a little bit more morning sickness and some SPD, it was pretty easy. I will say there's one thing that they make you do here, and I don't know if you guys have to do it in the US but if you're planning for a VBAC you have to see an OB around 36-37 weeks. Do you guys have to do that as well?

Meagan: Yeah, so not if you're out-of-hospital. You don't have to do it. Some midwives still out-of- hospital will be like, "Hey, I want you to consult with a partnering physician," as in, "Hey, this is someone we would transfer to.: I went a consult with them, but with the midwives in hospital they require them to do a VBAC consult, and it's pretty much a visit where the OB is like, "Hey, this is what you're doing. Here is your risk. Do you comply?"

Yeah.

Johanna: Yes. So I ended up having to do that, and I knew it was going to be a negative experience. I knew it was just going to be fear-mongering and throwing scary statistics out. So I already had my guard up for that. And then it was also at the hospital where I had my C-section, so even just walking into that environment was very triggering.

Meagan: Yeah. So I went to that and I was right. She told me, "As soon as you go into labor, you need to go to the hospital and you should have continual monitoring and and epidural just in case," and all of these things where I'm just like, no, that so goes against everything that I believe will lead to like a healthy, happy birth.

I definitely didn't tell her about my plans. I actually was hoping this would end up in a home birth. I didn't actually mention this. My plan-- I didn't want to commit to a home birth. I was a little bit anxious because of my first birth ending up transferring to hospital, that I would end up having to do that again and then have that crushing disappointment that it didn't work out again. So my plan with my midwife was that I was going to labor at home as long as possible, and we were going to play it by ear. As long as everything was going well, then I would potentially have her at home. But I just didn't want to have that pressure that I needed to stay home because this was going to be a home birth. Do you know what I mean?

Meagan: No, I totally do. I mean, when I was planning my, it wasn't a HBAC, it was a birth center birth. It's like a downplayed HBAC. I mean, I was in a different home. Right. I totally do. I know exactly what you mean.

Johanna: Yeah.

Meagan: Yeah, yeah.

Johanna: So yeah, I definitely did not tell the OB that my plan was to have a home birth because I just did not even did not want to get into that. So I nodded my head and was like, "Yes, sure. Okay, great."

Meagan: Yep.

Johanna: At one point, also during my midwifery care for the second pregnancy, my midwife was like, "It's standard for you. The hospital wants you to sign a release form with a backup C-section date."

Meagan: What?

Johanna: And I was just like, "Yeah, I will also not be doing that." And she was like, "That is totally fine. Just sign that you won't do that." 

Meagan: I do not consent. Yeah, I do not consent in doing this.

Johanna: Yeah, yeah. I was like, I don't need that to clock above my head.

Meagan: No.

Johanna: So again, my due date arrived and passed. I ended up getting a couple membrane sweeps to try and move things along, but they were unsuccessful. And wow, they are very, very painful.

Meagan: So can I super quick touch on that?

Johanna: Yes.

Meagan: Membrane sweeps-- that's a really big question we see as well. And when you talk about them being painful, that's actually a sign that the cervix wasn't ready. Like it wasn't forward. It wasn't open. If a membrane sweep is painful, it's a real big sign-- it's not a guarantee, but it's a real big sign that your cervix isn't ready. So quick rule of thumb, if you are dilated 2+ centimeters, 3 or more is more ideal. Your cervix is really forward, meaning they don't have to reach back and in, and you are effaced at least 75-80%, that's a little bit more ideal and less painful. 

But if they are going back, a lot of the times is because they have to reach back and in. And so that is, that is that. And then it can cause pain, prodromal labor, things like that and, and frustration because you're wanting it to work and it's not working.

Johanna: Yes. So yeah, they didn't work for me, but my midwife did tell me that I was actually 3 centimeters and she could stretch me to 3. 

Meagan: Great. So you were at least dilated.

Johanna: Yes. So despite the fact that it was super painful and didn't work, I was still feeling very encouraged to know that my body was doing something good. 

Meagan: Yes

Johanna: Because you'll remember my first birth, I was completely closed and nothing was happening after my water broke. So I was feeling pretty good about that. At about 40 weeks and 4 days, my water broke again before labor started. It was another one of those slow trickles, and it was the middle of the afternoon, so I called my midwife, and she was like, "Okay, come meet me." She asked if the fluid was clear and I said, "Yes." 

And she said, "Okay, come meet me at the office later, and we'll do the non-stress test and check you out and make sure everything's dandy." 

So I went and everything was fine. We were just waiting again for labor to start. I felt okay because I had been through this before, and I knew my body would go into labor, but at the back of my mind I was a little bit stressing out because I was like, okay, I'm on a clock again. I went home. Nothing happened. I woke up the next day and tried to get things going with the breast pump. That got contractions going, but they never stuck around. I ended up confiding with my doula about how stressed I was feeling that I was on a clock and feeling like why can't my body just go into labor? 

She was extremely reassuring. She came over, and we just talked for a bit, and I felt a lot better after that. That was in the evening, the day after my water broke, and I was supposed to go in for a non-stress test. So I went and met my midwife for a non-stress test that night. It was 36-ish hours after my water had broke. Still, everything was looking good. Baby was good. She was happy. I was fine. There was no need to rush into an induction or anything like that. But she could tell I was stressed. My midwife could tell that I was a bit stressed and she was like, "It's fine. We've got lots of time. You don't need distress.: And she's like, "But I can give you these tinctures or whatever if you want to try them." It was like the blue or black. 

Meagan: Cohosh.

Johanna: Cohosh, yes. I was like "Sure, I'll do anything at this point. I'll try anything. I don't care. So they almost look like tiny, tiny little white beads. I don't know if they're always in the same form.

Meagan: Yeah, sometimes they're in drops like tincture drops or almost like you said, a pill-like bead type. 

Johanna: So she was like, "Okay, let's give you one now." She wanted me to take four doses an hour apart.

Meagan: Did you put them under your tongue?

Johanna: Yeah. So she got me to take one when I arrived for the non-stress test and then when the non-stress test was over, it had been about an hour, so she gave me a second dose, and then she sent me home with two more. So we went home, and then I took one an hour after the previous dose and it was probably 10:30 at night at that point. Contractions started going after I took the third dose and I was like okay, they're probably going to peter out again because that's what they've been doing all day. I'm tired and I want to go to bed and I don't feel like staying up another hour to take the fourth dose. So me and my husband both took a gravel because my midwife told me to take a gravel and go to sleep.

Meagan: What's a gravel?

Johanna: A gravel is like an anti-nausea medication, but it makes you sleepy.

Meagan: I did not know that. I've never heard of that. I don't think I've never heard it.

Johanna: Yeah. Interesting.

Meagan: Cool. I love learning. A gravel.

Johanna: Gravel.

Meagan: Yeah. Okay.

Johanna: So yeah, she told me to take one and go to sleep because it makes you drowsy. So I think we had fallen asleep for maybe an hour and a half and I was woken up again with very intense contractions. And this time I was like okay, this is it for real. And like I said, with both my labors, contractions were intense straight out of the gate. So I woke my husband up. Taking the gravel was a mistake because we were both super drowsy. I woke him up and I was like, "I think you need to call the doula because this is definitely happening." 

And so he called her over and I labored in bed. I did my HypnoBirthing tracks. I did a lot of breathing through the contractions and the HypnoBirthing was super, super helpful, I will say that. We hung out for a while and just did that. My husband tried his best to stay awake despite how tired he was. Eventually, I think I waited maybe a bit longer than I probably should have to call my midwife because I was so determined to stay at home as long as possible. I didn't want her to come and be like oh, you're a 3, right?

Meagan: See? Your mind. Even in labor we trigger back. We process things as they're happening from how they happened before, and it's really hard to let go. But your mind was doing it too, right? You're like no, I can't do this because I can't be that.

Johanna: Yes. So what we waited, I think it was, I don't know. I have no concept of time. But we waited a couple hours or a few hours and my doula was like, "I think we should call the midwife." I was like, "Okay, can you call her?" So we called her and shortly after we called her, I was having contractions so intense that I was having an out-of-body experience. Like very, very intense. I was getting the shakes and hot and cold lashes. In my mind I was like, I'm going through transition. For sure, for sure. I'm going through transition. My midwife was not there yet and she would not arrive for probably like another hour.

Meagan: You progress quickly from history.

Johanna: Yes. So, by the time she arrived, she ran upstairs to my room. She checked me and she's like, "Okay, you're at an 8, so if you want to do a hospital transfer, if you want to go, we've got to go now." And I was like, "No, that ship has sailed. We're doing this here. As long as Bailey's healthy and I'm healthy, I'd like to stay here." So she was like, "Okay, we're doing this here." 

And she called over the other midwife because she wasn't actually sure that it was going to be a home birth, so she didn't have the other midwife with her, so she had to call the secondary midwife to show up. It was all very hectic. This time around, I plan on calling them much more ahead of time so that it's not so hectic when they arrived because lights got turned on, equipment was shuffled around and set up and definitely took away from the vibe a little bit. But yeah. So shortly after she arrived, I was complete and I had that very stereotypical moment where you feel like you got a poo.

Meagan: And sometimes you just hold back because you're like, oh crap, wait. Do I need go poo first or should I have? Wait, what should I do? I don't know. I want to have the baby, but I don't want to poop.

Johanna: Exactly. So I was like, "Oh my gosh, I feel like I have to poo." My midwife's like, "It's okay. This is normal. You're good." She was just encouraging me to just do what I felt like I needed to do. I ended up pushing for probably an hour, give or take, in a sumo squat position with my midwife on one side and my doula on the other side and then my husband would switch out for the midwife supporting me on either side. And yeah, I only had to push for maybe an hour, give or take. 

Her head got a little bit squeezed at one point when she was coming out, so when she came out, she was in a bit of shock. Because of where I was in my room, and the equipment was on the other side, my midwife had to make the decision to clamp and cut her cord and take her over to their equipment to give her a little bit of help which was very scary. She didn't end up needing oxygen, but they thought that she might. So she ended up being okay, but it was definitely a scary couple of minutes where I didn't know what was going on. But yeah, she ended up being okay. 

The only thing I was a little bit disappointed in was the second time around, not being the one who gets to be the one to hold my baby and bring her to my chest and missing out on that experience again.

Meagan: Yeah.

Johanna: But obviously I was amazed that I had done it. I had gotten my home birth, I had gotten my VBAC. I was in shock.

Meagan: I can so relate. Sometimes you're so focused on pushing that baby coming out, and then it happens and you're like, am I dreaming that this happen? And you're looking around and you're like blinking and you're like, no, I'm awake. I just did this. I just did this. And you're so excited.

Johanna: I was still in La La Land because I had labored so hard for eight hours and yeah, you're out of it and just in disbelief.

Meagan: Yeah. Yeah.

Johanna: Like, did this really just happen?

Meagan: But it did. It just happened.

Johanna: Yeah. So that was a really good feeling. Recovery was like night and day. I could immediately just go and have a nice shower and walk back to my bed and crawl into my bed. It was comfortable and I wasn't in pain. I had mobility, and I could lift my baby up. It was a good feeling. Although I will say that without the epidural, the fundal massage was a really unpleasant experience.

Meagan: Yes. So for everyone that doesn't maybe know, fundal massage is something that they do after labor and delivery, they essentially put their hand, sometimes fist. Now it's not like they punch you, but think about a fist. Look at the bottom of your fist. They put the bottom of their fist along your uterus, the top of your uterus. They push down and massage. They push down and they massage. And sometimes they do it three or so times. You take a deep breath, they do it. You take a deep breath, they do it. And why they're doing that is because they're checking to one, make sure your uterus is clamping back down to its normal size right after birth and the placenta is out. It starts doing its job and going boop boop, boop, right back down to its normal size. But sometimes it can get a little boggy or bleeding can occur. 

So yeah, you want to make sure that. Now, really quick tip. If for some reason your uterus is still staying boggy and not clamping down as much, something you can try to do if you are able is urinate. Go to the restroom. That's a really big thing to help the uterus clamp back down. And even if you have an epidural, sometimes you have to get a straight cath. And if you can't go to the bathroom, sometimes you can get a straight cath to release. But yeah, that is not as friendly when you're unmedicated. 

But take deep breaths. If you can, get that baby on your chest or hold someone's hand-- your doula, your partner, your midwife, anybody's hand and just take really deep breaths and know that it's okay. It's okay. It doesn't last too long. But yeah.

Johanna: So going back to our chat about postpartum.

Meagan: Yeah.

Johanna: So the recovery of vaginal versus C-section night and day for sure. But I will say that my postpartum with Bailey was way harder than with my first. It had nothing to do with the birth. I think she was asynclitic in my uterus. And so when she came out, she had a pretty bad case of torticollis and a tongue tie which made breastfeeding very difficult. I got mastitis twice in the first four weeks, like a really bad case twice in the first four weeks. I ended up with a bad case of food poisoning at three weeks postpartum.

Meagan: Oh no.

Johanna: And I had some prolapse symptoms as well. I will say that there were a lot of things happening in the first month, month and a half of my postpartum that I didn't expect and were very intense and difficult. I mean, just for breastfeeding, I was in so much pain that there were many times that I wanted to just give up and be like, nope, never mind. Forget this.

So having good lactation support was really crucial.

Meagan: Oh yes. And get lactation support before you have your baby. It sounds weird. It sounds really strange to connect with someone about breastfeeding before your baby is born. But oh my gosh, you guys, it's so impactful. I mean, we've talked about it before with The Lactation Network and other IBCLC supports. It's so important. 

I had similar. So my baby was born be a Cesarean. So in a Cesarean, a baby can also develop torticollis too with the way they are and the way they come out. But my baby had torticollis and she had a tongue tie. So very, very difficult. Challenging for sure and frustrating.

It can impact things like mastitis and yeah, I love that you pointed that out. My was recovery all around better, but that doesn't mean my experience was all sunshine and butterflies. I really want to just highlight that one more time, you guys. Vaginal birth doesn't mean your postpartum journey is going to be the easiest. Mine wasn't. My VBAC after two Cesarean birth was not the easiest. It just wasn't. So again, get those resources beforehand. Right?

Johanna: Yeah. And I will say, I don't know what I would have done if I wasn't with midwifery care and having them on call for the six-week postpartum because I swear, I called them every second day about something that was going on.

Meagan: Well, and that's more unique to home birth too because even with the hospital birth midwives, it's not the same. They usually say, "Oh, I'll see you in six weeks," and you can call. You can call any OB or midwife. You can call any provider, but there's a different level of care and follow-up in that postpartum stage and it's very impactful. It's very, very impactful.

Johanna: Oh for sure. Yeah.

Meagan: Yeah. Oh my gosh. I love everything and I love all these tips. There are so many tips and nuggets along the way. Is there anything else that you would like to drop here for the listeners in regards to home birth or preparing or postpartum or any words of encouragement that you may have?

Johanna: I mean, I think that, like I mentioned at the start, just arming yourself with as much knowledge as you can is going to be your best bet to get the outcome that you want and just feel empowered throughout your pregnancy and your birth. So just arming yourself with as much knowledge as you can get your hands on and yeah, getting a good provider, trusting yourself, believing in your body, and setting yourself up for postpartum too because that's an important thing when you're so focused on getting your VBAC is letting the postpartum stuff fall to the wayside.

Meagan: Yeah.

Meagan: Taking care of yourself afterwards too is important.

Meagan: Yes. Taking care of yourself. We don't. We don't take care of ourselves enough, you guys. Really pamper yourself. If that means you have your postpartum doula. If that means you hire a house cleaner to come in every other week. If that means you hire or have family come in to help, just whatever. Light house cleaning or holding baby or playing with toddler. Johanna, she's going to have two, you guys. She's almost on her third, and it's another baby girl.

Johanna: Oh, yes. Yes. That's three for three.

Meagan: So three baby girls. I mean, you've got your hands full in your postpartum experience.

Right. So really do it. I don't want to stereotype women, but sometimes we get into this space of,  we can do it and we don't need to spend money on ourselves and things like that, but this stage of life is so important to invest in yourself. Really, truly invest in yourself because you deserve it. And your sleep and your experience and your mental health, it all matters so much. So yes, you might hire a cleaner and you might be spending that money, but guess what? That's okay. Do it. 

Johanna: And when you're taken care of, then you're a better mom to your kids.

Meagan: Yes, yes. My husband always says, "When mom is happy, everyone else is happy." But really, really, you deserve it. Women of Strength, you deserve to be pampered and loved and supported. So Johanna, thank you so much again for such a powerful episode. I'm so grateful for you. And please keep us posted on this baby number three.

By the time this episode comes out, you will have had this little baby girl.

Johanna: Yes. I'm due January 4th, so I will definitely be sending you a message when she makes her entrance.

Meagan: Please do. Please do. Okay well, thank you so much.

Johanna: Thank you.

Closing

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

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In this special episode, Kristin, host of Ask the Doulas podcast and founder of Gold Coast Doulas, gives tips on building your supportive birth team. Kristin and Meagan talk specifics on HOW to switch providers if you’re feeling the push to do so.

Once we have our dream team, we’re good and don’t have to do any more work, right? Nope! We keep educating and preparing ourselves. That’s the way to truly get the most out of that dream team. 

Kristin’s book ‘Supported: Your Guide to Birth and Baby’ is a one-stop shop where you can get all of the education you need for pregnancy, birth, and postpartum. Her advice is so valuable for VBAC moms and birth workers, too!

Supported: Your Guide to Birth and Baby

Ask the Doulas Podcast

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello. Hello. We have a special episode for you today. We have my friend, Kristin, who is actually the owner of Ask the Doulas Podcast on with us today. She is going to be talking about establishing our birth team and the importance of it. We're going to talk a little bit more about what to expect when we might not find a provider that's supportive and how to navigate it. She's going to talk more about her book and so many things. You guys, I'm really excited. 

Kristin is a woman who has always had a passion for supporting other women both personally and professionally. In college, Kristin served on the executive committee of her sorority and organized events on campus related to breast cancer and other women's issues. After the birth of her daughter in 2011, a new passion awoke within her. Kristin began reading and studying birth from all perspectives, philosophies, and medical approaches. She joined organizations like The Healthy Kent Breastfeeding Collation and used her event coordinating skills to build and promote the organization and create community awareness. 

You guys, she has done so many incredible things. Kristin's research has led her to learn more about doulas, and in 2012, she hired doulas herself for the support of her second birth. The level of compassionate care and comfort that she received from her doulas ignited a spark within her and led her down the path of becoming a doula herself. 

And man, can I connect to this because this is exactly what happened to me. When you guys have a doula who inspires you and touches you and motivates you the way it sounds like Kristin did and I did, even though my doula wasn't a hired doula, she was just a nurse that was a doula for the time being, it does something to you. She earned the certification and became teaching sacred pregnancy classes in 2013. But as you'll see, Kristin is a firm believer in achieving the highest level of education available when providing a service. Shortly after, she earned the following credentials-- you guys, are you ready for this? She's amazing. Oh my gosh. Certified Sacred Doula in 2014. She is a Certified Elite Labor through ProDoula. She is the Elite Postpartum and Infant Care Doula through ProDoula. She's trained in Spinning Babies, Newborn Specialist, Mother Ship, Certified Health Service Provider, certified in VBAC. She is certified in transformational birth and a birth coach for the Birth Coach Method. She is a certified pregnancy and infant loss advocate and certified gift registry expert through Be Her Village, who we will talk about. We both love them so much.

She is also an author of a book which we will be sharing more about. It's called Supported: Your Guide to Birth and Baby. So without further ado, we are actually going to be skipping a review today and an educational topic because this is such a great episode to be educated and learn more about what Kristin is offering in her community. 

Okay, my love. Hello. 

Kristin: Hello.

Meagan: We're officially getting going talking about this amazing topic. Tell me what you think about this. I think sometimes people want to assemble this dream team, but they let finances or even partners or other opinions get in the way.

Kristin: Yes. Partner comfort level, especially with VBACs is key, or with clients of mine who want their dream is to have a home birth and their partner isn't supportive, so then they say, "Oh, it'll be with the next baby if everything goes well in the hospital." But then if they're a complication, they might risk out of the option of home. I think as consumers, we don't fully appreciate the ability to choose all of our birth and baby team. We can change providers. I switched providers with my first pregnancy early on because I didn't feel like that particular OB was on board with my plans to have an unmedicated hospital birth. I ended up switching to Certified Nurse Midwives and completely changed practices, completely changed hospitals in fact. It's a lot. 

Meagan: Yeah.

Kristin: But it was worth it. And I had the time where it was easier to switch, but I've had clients switch very late in pregnancy. It was harder to find the right office to accept them, but with VBACs, it is crucial to have not just a VBAC-tolerant provider, but someone who is fully on board with your unique desires because we are all individuals.

Meagan: Yes. I love that you said your unique desires. Everybody is different. I think it's really important to tell these providers what your desires are. We have a list of questions that we give people in our course and, of course, on the podcast. You can go down that list and check and be like, "Okay, this provider seems pretty supportive," but you guys have to tailor your questions and your provider. You have to tailor it to what your individual unique circumstances and desires are because everyone's is different. I would love to know. You said, I was realizing that this wasn't the right place. What kind of things were you hearing or being told or feeling when you were realizing that maybe your first provider wasn't going to be as supportive and in line with your unique decisions?

Kristin: Just when I was talking about my wishes, I could tell that that particular provider liked structure and patience to get that epidural, and so once I started talking about movement, delivering in different positions and some of the things I had researched-- I hadn't yet taken a childbirth class because it was early in pregnancy, but I had done a fair bit of research before knowing what a doula was. I didn't hire doulas until my second. But I could just tell in that gut feeling which I rely on. Again, we're all unique. And yes, I do research, but I make decisions on am I comfortable spending my entire pregnancy with someone who can tolerate me and will say, "Okay"? But I could tell it didn't light her up. 

So once I found a practice where my nurse-midwife spent time with me, I had longer appointments, I could ask questions, and she was 100% on board with me, and then I was able to meet the other midwives and the OBs who oversaw them throughout the remainder of my pregnancy. I felt very cared for. And again, we are consumers. Whether your insurance pays for everything or you're paying for part of it, you don't get a do-over of your birth, and so it is so important, especially with that first birth to get the care team that aligns with you. That could be everything from a Webster-certified chiropractor, a physical therapist, a mental health therapist to deal with any anxieties that may come up with having a VBAC and getting a lot of fear-filled advice from friends and family members. 

I find that again, my clients are all unique individuals, and my students in Becoming a Mother Course, and now the readers in my book, have different goals, so I want them to choose the best plan for them. I love that you have worksheets and templates, but knowing that every situation is different whether it's a home birth, a trial of labor, or a hospital birth, that setting is different and the type of provider whether it's a nurse-midwife or an OB practice, how likely is the OB that is very VBAC-supportive going to be attending your birth? Are there 12 providers or are there only 4? And so there's just so many things to factor in when deciding what is important to you.

Meagan: Yeah. That point that you just brought up, are there 12 providers? Are there only 4? Does your provider guarantee that they'll be there? These are things that I think a lot of people may not be aware of that because they found their provider. They're feeling good about their provider. They're jiving. They're having the feels, but then they may not be the ones to be there, so there are 11 other options. It feels overwhelming to be like, "Wait, wait. Do I interview all 11?" Yeah, guys. Yeah. You set up visits. It's okay. Go and see if you can meet with those. Make sure that that full team is aligned. It is a lot. That's a lot to take on, but it's okay to rotate and say, "Hey, I saw Dr. Jack last time. I'd like to see Dr. Joe this time," or whatever it may be. Really, really dive in, find out more about your provider's team if they have a team, and make sure that they align with your unique decisions and desires.

Kristin: Absolutely. And that goes for doulas as well.

Meagan: Oh, yeah.

Kristin: So for VBAC clients, I, over the last couple of years, I do all of the matchmaking, I like to call it, between client and the birth doulas and postpartum doulas on my team, in fact. I like to find out what they're looking for. If they are attempting a VBAC, then many times, they're telling me they want a VBAC-certified doula. I have doulas that have gone through your program and are certified through you and other different VBAC trainings. They're not just wanting VBAC experience like in my early days of having Gold Coast Doulas. Now, they're wanting that certification because they know that information is being updated as things change. And there's more evidence for VBACs. They also want more than just, "Oh, I've attended four VBACs." They want the education behind it. So I think that is crucial. I'm not going to match, unless there's no one else available on my team, a client with someone who is not certified as a VBAC doula.

Meagan: Yeah, I do the same thing with my group here where they're like, "This is really important to me. I want this specific type of doula." Some of my doulas have taken The VBAC Link course. And so I'm like, "Yep, this would be who I would suggest." But I also want to point out that even if you assemble your dream team doula, and they've got all the education and information on VBAC, and they're up to date, I want to just point out that it doesn't mean that you shouldn't inform yourself that you shouldn't get the information because sometimes I feel like it's easy to want to just hire your provider or your doula or your person and let them who know VBAC kind of help and guide you. But it is really important. You're doing yourself a disservice if you personally do not learn more about VBAC and your options as well and rely only on your provider or your doula.

Kristin: 100%. The doula, I mean, unless you're paying her for it, will not be attending every one of your prenatal visits during pregnancy. The education that you have to make informed questions and decisions surrounding your birth plan or birth preference sheet, so those conversations are critical. The more information you have as a patient, the better. 

And as we all know, unless you're having a home birth, your visits are short even with a nurse-midwife. And so it's important to have those questions and to have time to really express concerns. Or if you're finding that that practice or that provider is not in line with your plans, then you can look at other options. And the hospital-- are VBACs even allowed at the hospital that you plan to deliver at? Are they going to induce? What are the Cesarean rates? And looking at all of the different options, and if you need to consider NICUs, that's always a factor in hospital selection as well.

Meagan: Yeah, I'm going to kind of go back to where we were in the beginning where you realized based after your feelings and other things that this provider was not the right provider for you, you then changed to CNMs and had a much better experience. Can you discuss your process of that change? How did you change? Did you find the CNMs, have them request your information from the OB? Did you do a formal breakup with your OB? What suggestions would you give to someone who is wanting to do that? I know that sometimes, you were talking about it, in the end, it's a little harder to find, so that's why we stress so importantly to find your provider from the beginning. But we know that sometimes things change. So can you kind of talk about that process in then assembling that dream and getting the steps to get to that dream team?

Kristin: Yes. So for me, I had asked friends about which providers they had worked with. So the original OB, a friend of mine, it was her doctor, and she had a great experience. I just wasn't feeling it. She had a student. We have teaching hospitals in my area, so there was a student in the room. I wasn't feeling like she was 100% on board. I could tell that she was very medically driven. I wanted essentially a home birth in a hospital. 

So I talked to more friends and did research online, and a friend of mine had used this particular practice. I ended up going with the midwife that delivered her three children, and it worked out beautifully because it was early in pregnancy. That practice had openings. It took me a while because I was changing hospitals and practices completely. My insurance, luckily, covered all of the options. But that's another thing to look into. Does your insurance cover the hospital where the provider you want to switch to delivers that if it is a hospital birth? Of course, you can VBAC at home in certain states. 

So just looking at all of the factors that would come into play. So for me, it was dealing with the paperwork of switching out of that practice, getting admitted, and going to that initial get-to-know-you visit with a nurse and doing my labs before I got to meet with the midwife that I had wanted to work with. And so it took a bit. I mean, no one likes to deal with the paperwork and the phone calls it takes, but your health is so important and especially again, for VBACs.

Meagan: Yeah. So you essentially did all the paperwork and the transfer yourself.

Kristin: Yes.

Meagan: Okay.

Kristin: I made all the phone calls, dealt with insurance and made sure that the initial visit was paid for along with the nurse visit, and then that insurance was comfortable with me.

Meagan: Yeah. Awesome. Yeah, I did, when I switched, because I switched it 24 weeks, my midwife just faxed a request to my OB office. It took them a while to send it. We had to ask five times which I think probably would have been faster if I, like you, made the phone calls and did all the things, but I was like in this weird, vulnerable spot of like, I don't want to go back there.

Kristin: Right. You don't want to deal with it.

Meagan: Yeah, I don't want to deal with it.

Kristin: Even just talking to the front desk.

Meagan: Yeah, yeah. So we waited for it and they eventually got it. But I think that that's important to note. You guys can make the calls too. You can call and say, "Hey, I'd like to request my records to be printed out or to be sent to this place." 

Kristin: Yes, and that's what I did. Because otherwise it's six weeks oftentimes or you have to keep calling. They get lost. so I just handled it. But it can be challenging. And as doulas and certainly VBAC doulas, we know the providers who would be not only tolerant but supportive of VBAC. So we get those questions frequently from potential clients and clients of, am I at the right place? And of course, we support whoever our clients choose to have care from. But there's also, if asked, I will tell them about the practice and my own experience as a doula or the agency's experience. 

And again, in those large practices, there might be four who are so VBAC-supportive. They love it, but then there might be some physicians who are not as comfortable. They feel that a surgical birth might be the better route to go, ad so there's that. So what I like to do as a VBAC doula is to have my clients talk to their provider. Again, go over a birth plan or birth preference sheet and have them sign off on it. That way, if they don't attend the birth, then the other physicians know that this was approved. It's not just a birth plan that is thrown out there, but it has been discussed. It doesn't work all the time, but it has been helpful for my clients no matter if they're a VBAC client or this is their first baby, and again, they have certain goals that they want to achieve like potentially avoiding an induction unless medically necessary.

Meagan: Oh my gosh. So I'm just going to re-touch on that, you guys, because that was really, really, really good advice and something I've actually never done or even thought about or suggested to my own doula practice clients. Get your birth preference sheet or birth plans everyone calls a difference. I call it a birth preference sheet, which is a list of all your preferences that you desire. Go over that with your provider, and have them physically sign it. Physically sign it and date it showing that your provider went over it. And like she said, every provider may not be willing to do that, but I will say, if a provider is willing to do that, that says something to me.

Kristin: It does. Yes.

Meagan: Yeah. Super powerful. Oh, my gosh. Okay, nugget. Grab it, put it in your pocket, everybody. Sign your birth preference sheet so you can have it and keep that in your bag, so if you do have that random on-call doctor who may not even know you or not be so supportive, be like, "This has already been discussed. We were aware of this. My doctor has signed off." Also, you could maybe ask if your provider could make a copy of that and put it in your chart.

Kristin: Right. Because yes, it's not just the one that they have on file, but it's also for the ones that you have, that copy that you're bringing and showing the nurse so the nurse and everyone is on the same page. 

Meagan: Love that. 

Kristin: And again, with teaching hospitals, you might have residents in and out. There can be some difficult conversations with VBAC and residents who have never seen a VBAC. We're not fully trained yet to support VBAC, and so they might be making suggestions while the provider is not in that check-in. So every state, again, every area is different. I just happen to be in an area with multiple teaching hospitals.

Meagan: Same here. We have seen it where I think, I don't want to say this badly. The VBAC world is a world that can have a lot of negativities in it, negative things and big words like uterine rupture. We've got residents who may be coming in and may be training under a provider who has seen a uterine rupture or has maybe molded an opinion on VBAC and is projecting their opinion to that student. Whether or not they're consciously doing it or not, they're saying their opinion, and those opinions might morph that resident's opinion into negative for VBAC. You never know. And so they might be doing things or be more hesitant in areas that they don't need to be, but they are.

Kristin: Yeah, it's such a good point. And as you mentioned, I mean, we don't know the traumas that our nurses and medical team, even home birth midwives, have experienced, and they carry that with them. And how can they not? Even as doulas, we witness, but we don't have the liability and the medical training to make it, but we are witnesses of trauma and have our own healing to do to be able to better move on and support the next client. So certainly keeping that in mind that they may have seen something that alters the way they practice.

Meagan: Yeah.

Kristin: It's not just fear of lawsuits.

Meagan: It's really not. It's not. There's a provider here in Utah who is literally so scared of vaginal birth herself. She scheduled all of her Cesareans, even the very first one from the get. She never had trial of labor or TOL. She just doesn't. So can you imagine what her Cesarean rate may be? And she kind of reminds me of the provider you're talking about. She really likes it just so controlled. Come in, start Pitocin, and get the epidural. She likes those things, which we know can sometimes lead to those Cesareans. 

And so really also discussing with your provider, how do you feel about birth? Have you had babies? And then we have another OB who's like, "I work in the hospital, and I love the hospital, and I trust the hospital system, but I actually gave birth at home with all three of my babies," and so really getting to know your provider, I think, is so good. 

Okay, let's keep going on this topic of assembling your dream team of experts when planning for birth and baby. What other things would you suggest to our Women of Strength?

Kristin: Yes. So as we know, birth is as physical as it is mental, and just the opposite, as mental as it is physical. So preparing with a childbirth class, a comprehensive class, even if you took one before, use the lens of your goal of attempting a VBAC, a trial of labor. And so for us, we happen to teach HypnoBirth at Gold Coast Doulas and that mind/body connection that HypnoBirthing or a gentle birth offers where it's more of using the visualization the way an athlete would in preparing for a marathon or a triathlon, you are using things to reduce fear. You're understanding all of your options. It's very partner involved. I think taking a comprehensive childbirth class, whichever meets your individual goals, is great. That childbirth instructor is a great person to add to your birth and baby team. 

And then moving your body. So taking a fitness class that is appropriate for pregnancy. So prenatal yoga, there are Barre classes for pregnancy. There are prenatal belly dancing classes, whatever it is. 

Meagan: Aqua aerobics.

Kristin: Yeah, water aerobics are amazing. And so thinking about baby's position and helping labor to go on its own or be quicker. There's acupuncture, acupressure, the Webster-certified chiro for positioning or body balancing experts, so many different options. But I am a big fan of educating yourself and preparing because as you mentioned earlier, Meagan, a doula is not your end all, be all. Just because we have the information and the training, we can't think for you. We don't want to think for you. The more informed you are, the more likely you're going to feel like birth didn't happen to you this time around and you were a direct participant, even if you end up having a surgical birth again.

Meagan: Yeah, yeah. Yes. Oh my gosh. So talking about courses, you guys, we have our VBAC course. This VBAC course goes into VBAC, the stats about VBAC, the history of VBAC, the history of Cesarean, the stats of Cesarean, the questions, finding the provider, a little bit more of the mental prep, and physical prep. But when it comes to a childirth education course like with the course that she has, they're on different levels. I actually suggest them both.

Kristin: Yes, me too. Absolutely.

Meagan: But it's so important to know the information that is in your course. I know you go even past preparing for birth and then birth and then postpartum. You go into all of it. We're going to talk more about it. But you guys, we as doulas, love getting information and we love sharing information. But like she said, we don't want to be the only one that knows the information in a team. When our clients come in, at least here in my group, when our clients come in and they are fully educated and we're like, yes. And then we can come in with our education and our experience and knowledge, you guys, it is a powerhouse team. It is a powerhouse team. We have clients who, when they take child birth education classes like yours, they are able to advocate more for themselves. They feel stronger to stand up and say, "Hey, thank you so much, but no thanks" or "Maybe later," when our clients who haven't had that childbirth education or just any information other than maybe what we're providing, which is great, but not enough in the full length of pregnancy, it's a little harder. We have to try to encourage those clients a little bit more because it's harder for them because they don't know everything. We're there to help guide them and help advocate for them and educate them, but it is very different.

Kristin: It is. It's so different. And I feel like, again, partners, especially male partners, want to fix things. They don't want their love to feel any pain, and so they may have the fear of a VBAC. So taking a VBAC class course, having a VBAC doula, giving information is just as helpful, if not more for the partner and their comfort level and to have them fully get on board because they may be resisting and just going along for the ride, but if you can get them to be an active participant in education, then they're going to be able to help you. 

And sometimes in labor, we get to a point in transition where we can't fully speak for ourselves. But if our partner understands, is educated and on board, and if there's time to talk through the risks and benefits and alternatives with your doula, then yes. But sometimes decisions have to be made quickly, and so for that partner to be informed and educated is crucial.

Meagan: So crucial. It's so powerful. My husband-- he was not so on board. He was like, "Whatever. I don't care. You can go to the courses. You can do these things."

Kristin: And that's very typical.

Meagan: It's very typical. And I did. I did do those things. When I said, "Hey, I'm going to birth out-of-hospital," and he was like, "No," I was like, "Well, sorry. I've done the education. I know this is really where my heart is pulling." We touched on this in the beginning how partners really can influence decision making. And in no way, shape or form am I trying to say partners are terrible or don't listen to your partner or anything like that. That's not the goal of what we're saying is have an educated partner. 

Know that you can assemble a birth team, like a provider, a chiropractor, a massage therapist, a doula, a PT, or whatever it may be, but don't forget about your partner. Your partner is a huge part of your team, and if they're not educated and they're not able to help guide you through, or if they're not being supportive, find ways to help them be supportive by taking a course with them and helping them realize, oh, VBAC actually isn't that scary. Oh, that chance isn't really 50+%. Oh, okay. Hospital birth, out-of-hospital birth. Yeah. They're both reasonable, and really understanding that.

Kristin: Absolutely. And sometimes I find that my students and clients may have not had success with breastfeeding the first time and potentially didn't take a class. So if their goal is to breastfeed or pump exclusively, then taking a breastfeeding class and having that IBCLC as a resource for their dream team in case it's needed because many times, you have the lactation consultant who's teaching the class, at least in my practice, and then they're also available for say, a home visit or a hospital visit, depending on where the class is taking place. 

And so I think that that's something. Even if it isn't your first baby and maybe you breastfed for a little bit or had supply issues or challenges after a surgical birth, that it is important to consider any education during pregnancy because it's much harder to get that education after you have your baby.

Meagan: It really is. I love that you're touching on that, really getting into all the things and having your partner go with you. I remember I was like, I had a C-section, and I was swollen and tired, and I couldn't move very well. I was sore and all the things that sometimes come with C-sections. I'm trying to nurse, and I'm engorged. I don't feel my letdown, and I'm just so engorged. I don't know. All I know is I have really big, swollen boobs. It's all I could tell. I couldn't latch. My husband was like, "That's it. We're going to the store. We're getting formula." Formula is fine. Not anything against formula.

Kristin: He's trying to fix the problem and make you feel better.

Meagan: Yep, yep, yep. Trying to fix that problem. But I was like, "No, I really want to breastfeed." At that point, I wasn't able to communicate. Like, I didn't get the birth I wanted. I already felt like a failure because I was actually told that your body failed. That's what I was told. So I was already dealing with this mindset that I failed. I had a C-section. I didn't want a C-section. And now the only thing I could try to do because I couldn't take that C-section back is breastfeed my baby. I wanted to breastfeed my baby. And again, we didn't take those childbirth education classes. He for sure didn't download any apps. I at least had an app trying to help me at that point, but he didn't understand. He didn't understand.

And I'm like, no.

I'm crying, and I'm like, "Please, just help me. I don't know what I need to help me." And he's like, "No, we're going to the store. Our baby's mad. You're crying." He was trying to fix that problem. But if we had already done that information education before and found that IBCLC before and him understanding how important that was to me, he could have been like, "I'm going to call her IBCLC. I'll get her over here right away."

Kristin: Exactly. The last thing you want to do is go into the hospital to see a lactation consultant there if you can even get in.

Meagan: Exactly. Yeah. So it just could have been so much smoother. Sometimes I feel like we were against each other at that point because he didn't have any education. With our first, I really didn't have much education. But with our third, it was like he really didn't have a lot of education. and I was over-the-top educated, so I was saying these things, and he was thinking I was demeaning him or saying he was stupid because it was just this weird thing. 

So if we can just come together with our partners and get all the education and get it all before really, find out a postpartum plan. Find out a breastfeeding plan. Right? Find out what you want. You guys, it just makes the pregnancy journey and the postpartum journey, so much better. It truly makes you feel like you're on that team because you are.

Kristin: Yes. Absolutely. And certainly, I mean, you mentioned apps. Not everyone has the means or even lives in an area where they can take a comprehensive five, six, ten-week childbirth class. There are, obviously, online classes. There are some Zoom virtual ones where students are all over the place. But there are watching birth videos and YouTube and in my book, Supported: Your Guide to Birth and Baby, we talk about apps, so count the kicks. Especially for VBACs, doing the self-monitoring if there's fear of fetal movement and any sort of distress during the end of the pregnancy, then really understanding your own body and doing monitoring. It's not just when you're in your provider's office being monitored. You can make a difference yourself. 

So having some different apps and some education on your own, listening to podcasts like yours to get this information and reading books. So there's more than if you can't afford a childbirth class like HypnoBirthing, there are still ways that you can get educated and your partner can get educated. So yeah, take a look at all of your options and your budget.

Meagan: Yeah, and we talk about this all the time because I love them, but Be Her Village is a really great resource where you can go fill out a registry and, hopefully, get some help for these things. Childbirth education classes, doulas, IBCLCS. 

But I want to dive a little bit more into your book, actually, while we're talking about different resources. We talked about the childbirth education, but can we talk about more about Supported: Your Guide to Birth and Baby and how this came into fruition and what all is included in this amazing book.

Kristin: Okay, Meagan. So essentially the book came out of our online course. Becoming a Mother launched in the early pandemic when everything was shut down and our classes all had to go virtual. I was fortunate to be in a state where doulas who were certified were able to work thanks to our governor. So we were working, but there was still a lot of isolation even with our clients' prenatal visits. They wanted a connection, so we launched this course. We had talked about and did three live launches, got VBAC from our students, pulled people in from all the moms' groups before creating the first draft of the course. 

And then the course just led to the book. So the content in Becoming a Mother is what is in the book in a different format. So in Becoming a Mother, we have expert videos, so VBAC specialists and Webster-certified chiropractors talking about what that is. Pelvic floor physical therapists, car seat safety technicians, cord blood banking donation centers.

Meagan: Awesome.

Kristin: We have the experts speaking for themselves-- a pediatrician. And so in the book, anything that is medical and out of the scope of a doula, we had expert contributors, so I have a pediatrician friend of mine who contributed a newborn procedure section of the chapter and a prenatal yoga studio instructor, she's also a certified body balancer. She contributed to some of the fitness options in the book, and a mental health therapist who is PMA focused and certified contributed to the mental health chapter. We have an IBCLC that contributed to the feeding chapter, and so a lot of involvement, and then sharing client stories throughout the book and then our own wisdom. We have doula tips and wisdom at the end of every chapter. 

Meagan: Wow.

Kristin: And so as clients were asking me for books over the years, I couldn't find anything that was positive. I felt like there were a lot of, this is your cry-it-out method for sleep because we have a whole chapter on sleep and it's very attachment-focused. It's like, one way for feeding, and we wanted our clients, with their unique choices for themselves, to have a book that supports people who want to plan surgical birth like that OB and that's their comfort level and a book for the same person who wants a home birth. You don't have to buy five different books. It's not always Ina May which is a great book but not for everyone. 

All of her different-- she's got Spiritual Midwifery and so many different books. It is great for grandparents to read and partners but is targeted to the mother or the mother-to-be and is great in preconception in that early planning. But also, we wanted to make it similar to the course and just as valuable for seasoned bombs as it is for new moms. And again, it's affirming. We tried not to have any fear-filled information in a simple, easy-to-read guide that you can pull out for reference and a lot of different, again, apps and podcasts and books to read and resources and evidence-based information about Black maternal health and where we're at in the country now and how the pandemic impacted birth especially, but also that postpartum time.

Meagan: Wow. That book sounds amazing. So amazing. And you guys, you can get it in every form, even Audible. I'm a big listener. I like to listen to books. Kristin and Alyssa actually recorded it. She was telling me they had 10+-hour days recording this this book. You can get it, and we will make sure to have the links for that in the show notes. I found it at goldcoastdoulas.com/supportedyourguidetobirthandbaby.

Kristin: It's there. You can find it off that website or it has its own page. It's supportedbook.com. 

Meagan: Supportedbook.com, okay. We'll make sure that's all in the show notes, so you guys can grab that. Okay, so you know a lot. Obviously, you wrote a whole book and a whole course and all this stuff. Is there anything else that you would like to share in regards to just our final assembling of that powerhouse birth team?

Kristin: So don't forget, I know we're talking a lot about pregnancy and birth prep, but don't forget your recovery phase. And you had talked about your own personal struggles with breastfeeding engorgement, recovery after a surgical birth. If you have, well, you do have other children at home with VBACs, and so looking at childcare, postpartum doula support, or what kind of family support you're going to have after, it's more than just meal plans and prepping the nursery. We strongly believe that as part of your dream team, the postnatal team is crucial as well. 

So whether it's a lactation consultant, a pelvic floor physical therapist, if you want to get back to running marathons again or are leaking. I mean, we can all use pelvic floor physical therapy. It's not just the athletes who they support. Some people, again, with building a home or other life occurrences like a wedding or preparing for college, you look at your budget. You look at your main goals. For a wedding, it might be food. For postpartum, it might be sleep. So hiring a sleep consultant when baby's old enough or an overnight postpartum doula or a newborn care specialist. What are your priorities? And take the budget. What might be paid for by insurance or, a health savings flex spending plan that you need to run down? What might be gifted? Like you mentioned, Be Her Village. There are different ways you can budget. 

And in the book, we talk about all of that and looking at employer plans, how to navigate that, what questions to ask your HR department about other members, like a chiropractor, could that be covered? A therapist? Oftentimes, we don't know our own benefits and certainly, I don't know my husband's benefits fully, so to be able to investigate that early in pregnancy and figure out what might be fully or partially paid for.

Meagan: Wow. That is incredible itself. I feel like that's a whole other conversation of, how to navigate how to do that. So definitely go get the book, you guys, because it sounds like there are just so many things in there that are honestly crucial to know. really, really important things to know. You are incredible. 

Kristin: So are you.

Meagan: I just enjoy chatting with you so much. Anything else? Yeah, anything else you'd like to add?

Kristin: And obviously, take taking trainings and courses. If I know you have doulas who listen. It's not just parents.

Meagan: Yes.

Kristin: As doulas go through The VBAC Link. Get certified as a VBAC doula. Keep up with information that is ever-changing. We all want to be the best doula for each of our clients, but I am a firm believer in continuing our own education and that more and more of our clients are choosing to attempt VBACs, and so the more information you can get as a professional, the better you're able to support. It's just not the number of VBACs you've attended anymore. It's clients wanting that knowledge so you can be busier and also a more effective doula by getting that training and then going through the certification process that you offer.

Meagan: Yeah, have a directory actually with birth doulas where people can go and find it because when Julie and I created this company way back in the day, we knew that we were just two people here in Utah. We couldn't change the VBAC world. We could give as much information as we could. We could share the podcast. We could do those types of things. But when it comes to birth workers, we wanted to reach birth workers everywhere. It's so great that we have and we're still having more people come on because they're helping people so much. I mean, we know you have doulas that do it all the time. These doulas do help and there are actual stats on doulas that do it. But I agree. If you're a birth worker, stay up to date. Be in the know. Know what's going on because you will likely need to help guide your client through it. 

Kristin: Then you can charge more. So take that investment in a training like The VBAC Link, and then you're able to charge more because you're more experienced. You have more certifications. So don't look at like, oh, I don't have any money for continuing education. Look at how that's going to change your career.

Meagan: Yeah, and I think sometimes too you can charge a little bit more, take less clients, and be more personal with those clients and dive into it. Especially because we do know that VBAC does take some extra stuff that goes on with VBAC. There's some extra work to be worked through. There are some extra things and so yeah, I love that.

Kristin: Well, thank you so much for having me on Meagan, I loved our chat.

Meagan: Thank you. You as well. As always, I loved our other chat as well. We have to keep going. I think I'm going to order your book today and get going on that. Even though I'm not a mom preparing, I think this would be such a great book to suggest to all of my clients. So thank you for sharing. Thank you.

Kristin: Yeah. My secondary audience is certainly anyone who works with families in the birth and baby space, but it is targeted again, just similar to my podcast. It's like I have the listener of the pregnant individual and family, but also birth workers. The book is similar. Thank you for ordering.

I appreciate it. 

Meagan: Yes. And can you also tell everybody where to find you not just in your book, but Instagram, podcast, and all of the social medias?

Kristin: So my podcast is Ask the Doulas. You can find us on all the podcast players and you were a guest recently, so very fun. And certainly, we're at Gold Coast Doulas on everything from Pinterest to YouTube to Facebook to Instagram. I don't have separate social sites for my book because I honestly don't have time for that.

Meagan: That's okay. Yeah, it's a package. It comes with everything, so you don't need to have another book page. Well, awesome. Well, thank you again so much.

Kristin: Thank you. Have a great day.

Meagan: You too.

Closing

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

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Liz, a mama of two from Long Island, New York, joins us today sharing her experience with preeclampsia, an unexpected C-section, and her successful VBAC with her second. Liz had a perfect health history and never had any surgeries before her C-section. It was so frustrating to feel so out of control. 

In between her birth and her second pregnancy, Liz’s mom unexpectedly passed away. She shares how she has been processing the intense grief from her mother’s passing and from the positive birth experience she wasn’t able to have. 

Liz made lots of changes going into her VBAC birth including diet, switching providers, and choosing to birth at home!

Liz's Doula

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How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan Hello, everybody. We have our friend, Liz, from New York with us today. She is a mom of two and almost two years old. Right? Your VBAC baby?

Liz: Yes.

Meagan Almost two years since your VBAC baby.

And then an almost six-year-old. And yeah, like I said, she lives in New York, and she's going to be sharing her stories with you guys today. With her first birth, she actually had preeclampsia, so she's gonna talk more about that. And then with her second birth, she didn't have preeclampsia. I think this is an important thing to talk about because we know that having preeclampsia again is a possibility, and it might be slightly increased if you've had it, but it doesn't mean you will. So I'm hoping that we can talk a little bit more if you did do anything to try to avoid it. 

The second one, we'll talk more about that in a little bit. But knowing that it's still okay. If you have preeclampsia, you can still VBAC. Now, in her second one, she didn't have preeclampsia, but you can still VBAC if you have preeclampsia. So we're going to talk about that a little bit after your first birth too, because I want to know more. All right. 

We do have a Review of the Week today, and this is by jess2123. It says "Best Podcast for VBAC". It says, "I listened to the podcast after my son's birth. I learned so much that I knew I wanted a VBAC for my second birth. When I became pregnant again, I would listen to this podcast during my walks. Thanks to the wealth of knowledge that I gained, I had my unmedicated VBAC in 2023." 

Congratulations, Jess, on your VBAC, and thank you so much for your review. I know this year we're tossing it up between reviews and educational pieces, but I just do want to remind you really quickly that if you haven't left us a review yet, we would love it. You can push "pause" right now and listen or leave a review on Apple Podcasts or Spotify. You can go over to Google. Google "The VBAC Link", and leave us a review there. These reviews really do help us and bring us so much joy. 

So without further ado, I want to turn the time over to you.

Liz: Thank you so much. I guess every VBAC story starts with the Cesarean story, or at least there's one in there. My pregnancy journey did start with a Cesarean as far as the first birth. As Meagan mentioned, I am a mom of two. With my first son, I fortunately have been reproductively very healthy and otherwise healthy my entire life. I was able to track everything. I had regular cycles and really no issues there, so I feel really, really blessed in that regard. I was able to get pregnant pretty easily. I believe I got pregnant in about February 2018 for the first time. 

I found out mid-March after I tested in my bathroom and just ran out with the test to my husband, nothing super special. I think I was just shocked. I remember I had gone to a St. Patrick's Day parade and felt so tired that I said to my friend, "I'm going to go home and nap in between that and another event." They were all like, "Why are you napping?" I was like, "I don't know, I'm just really tired." 

I took the pregnancy test to rule out pregnancy. It was immediately positive which was amazing. My EDD, my estimated due date, was supposed to be Thanksgiving that year, so it was November 22nd which was Thanksgiving 2018. That just made me laugh because I was like, wow, what a far cry from Thanksgiving Eve spent even a decade previous. But yeah, so my pregnancy started out pretty status quo, I would say. I definitely experienced that nausea. My morning sickness was definitely an all-day thing, so it was a little tough. I think it threw me for a loop because I didn't know what to expect. I had always wanted to eat healthier, especially being pregnant, but it was like my body would not allow me to eat what I wanted or what my brain wanted me to eat. It was a lot of carbs to start out. I know that's pretty common. 

I remember when I went for my first appointment, I had called an OB's office. I'm trying to think. I think I had gone for one well-woman visit before, but I had two friends, actually three friends who had delivered with this OB and had good experiences, so I figured I would give it a try. 

The funny thing is, pretty much from the jump, I could tell that we weren't very aligned. I didn't really see eye-to-eye with him, but he had this nurse practitioner who was wonderful, and I feel like she drew people in because she was just very nurturing and calming, and she just had that great energy. I knew, obviously, she wasn't going to be at my birth, but I still stayed there.

Meagan Oh yeah. So can we talk about that a little bit? So you had one provider that you're like, "I don't know, our energy doesn't match." And then one that you're like, "Our energy totally matches." But then they wouldn't be birthing with you. So tell me a little bit more of what that provider was that wasn't matching your energy.

Liz: Yeah. So I guess because I had always been so healthy, my experiences with medical professionals were very limited. I had just gone to doctors for routine checkups my entire life, and everything was always fine. I think because I wasn't very experienced in the medical world, I almost had this aversion to it. I just was like, they're there if there's an emergency, but it'll be fine. Everything will be fine. I'm trying to do this as naturally as possible. 

He seemed very old school. I don't know how to describe it, just very set in his ways. I remember, I'll circle back around, but towards the end of the pregnancy when I had finally gotten the gall to tell him that I really wanted to try and do this unmedicated because I was so nervous to say that, he was like, "Well, don't expect this baby to just fall out of you. You're a first-time mom."

Meagan Wait, what?

Liz: He literally said that to me. And I was like, "Okay, I didn't think that." 

Meagan: I wasn't saying that. 

Liz: Yeah, I wasn't saying that I didn't think I wouldn't have to work hard. That's not what I'm saying. So just comments like that. The bedside manner just didn't seem very nurturing. He was very by the book, quick appointments, and asking me his little checklists of items, and that was it, whereas I felt like his nurse practitioner was very warm, had great bedside manner, and really just cared about mothering the mother in that situation. It wasn't just about the baby and how I was going to give birth or how I preferred to give birth. It was the entire experience. 

I remember at one point, she even said, "Obviously, there is a need for testing certain things and for keeping an eye on everything, but I really just feel like if we left women more alone to go through their pregnancies, they might be better off because we're so hands-on in the United States, and it just causes sometimes more anxiety throughout a time that's supposed to be really beautiful."

So she did mention that she reminded me of, I don't know, a woman who crouched down in the field and gave birth to her babies in the woods. That's who she reminded me of. I don't know if that's the truth for her. I never did ask anything about her birthing experiences, but that's who she reminded me of. Just super warm and nurturing. I think also I maybe just aligned more with a female provider. It could have been just that too.

Meagan: Yeah, it could have been. But I mean, what you were saying, comments like that, if I'm being super straight, we've interviewed providers on here that have come across really great, and then the more I've interviewed them, I'm like, "Oh, I don't know if I like that. I don't know."

That can just happen. I think that's where it comes with vetting your provider and going with who makes you feel warm and fuzzy. But at the same time you're in this place where you're like, well, we've got this medical. We'll see how it goes. I've got this to also like, I've got this warm, fuzzy, filling-my-cup over here. So it seems like it's an okay match, right?

Liz: Yeah. And I also manipulated it to the point where I would only make appointments when she was available throughout my pregnancy where the office was like, "You have to see the OB. You have to. He is going be the one who's attending your birth." I'm just like, "But I don't want to. I don't want to do that."

Meagan: Yeah.

Liz: I just stuck with the practice, I think, because I was nervous. I was new to it and like you said, I was getting my warm and fuzzy cup filled by that nurse practitioner's presence. 

Things progressed. I finally outgrew that morning sickness. By the second trimester, it was week 12 or 13 and it let up, and I was feeling good. I was pretty energetic. I was doing yoga on a somewhat regular basis. Nutritionally, I do want to mention because I think this does play a role in how things may have gone with the preeclampsia. But nutritionally, I was actually coming off of a vegetarian diet. I had been a vegetarian for a few years. I had gotten really deep into yoga in the early 2010s, and I became a vegetarian when I was doing teacher training for that. So I was purely vegetarian for a few years, and then I started integrating poultry back into my diet. 

I ate very little because my husband also doesn't consume a lot of meat, so we just didn't eat a lot of meat. I feel like I'm already a picky eater even as an adult. I definitely was as a child, but even as an adult, I still have things that I just don't like, so I feel like my diet was pretty limited, and I perhaps was not getting the nutrients that I needed, especially when my body underwent this or got pregnant and was going through this stressful event.

Meagan: Yeah. Growing a placenta and a baby. Yeah, it needed its nutrients.

Liz: Yeah. So I feel like during my pregnancy, especially once I started to feel good again, I ate whatever I wanted. So that whole like, I'm just going to eat so healthy, I was just like, yeah, no. I'm eating for two. I totally knew that's not what you're supposed to do. 

Meagan: I did the same thing. 

Liz: Yeah. I was like, whatever. I'm feeling great. I'm going to eat it. It's there. I'm going to eat it. So I get to my 20-week anatomy scan. I'm not even sure if it was exactly at 20 weeks, and everything goes well. Fortunately, no complications with the baby. 

Oh, I had also gotten a NIPT to find out the sex of the baby, so I knew I was having a boy. The anatomy scan did validate that. But that week, I don't know if it was right before or right after my anatomy scan, I noticed that I was starting to swell just on my right side of my body. My right foot was swollen. My right ankle leg was a little swollen. I remember reaching out to my social media friends. I just put out a status like, "Hey, pregnant lady here. I don't really know what's going on. Is this normal? Is this something I should bring up to my provider? What do you guys think?" 

There were plenty of people who were like, "No, it's totally normal to be swollen at that point." I even said, "It's only on one side though. It's weird."

Meagan: Yeah, yeah.

Liz: So they were like, "Just elevate your feet. See what happens." It would always go down, but it was just odd that I happened to notice just the swelling on one side of the body. So definitely interesting. Yeah. 

So I keep going. I'm getting bouts of pretty much every pregnancy symptom, but it would always be very short-lived. I definitely had some reflux, short-lived. I got sciatic pain so bad one day that I couldn't get out of the car. I remember I was sitting in the passenger seat and I said to my husband, "I can't walk on my right leg right now because of my sciatic nerve." So I was doing all these exercises to try and get the baby off my nerve and all of that, and everything just waxed and waned. Nothing was long-lived by any means. 

So I get to 30 weeks. I think it was at my 30-week appointment, and I believe it was the medical assistant who come in and took my blood pressure and wait like they always do. I don't know if it was her or the nurse practitioner who said that I had my first high blood pressure reading. Like, "Oh, it's elevated a little bit." And I was like, "Oh, that's so strange. I've been a 120/80 girl this entire time, and my whole life, I've never had blood pressure issues." 

And they're like, "Okay, well it's something to keep an eye on. Let's see. We're going to let you lay on your side, and see if we can have it come down. We'll take it at the end of the appointment again." And it did. It would come down, but they definitely were like, "We're going to keep this in our back pocket, and we might have to have additional monitoring if this progresses." 

I didn't really know what high blood pressure and pregnancy could mean, so of course, I go to Dr. Google like a good pregnant lady does, right?

Meagan: Yep. A lot of us, I'm guilty.

Liz: Guilty. Yeah. I was like, okay, so it could be hypertension in pregnancy or it could turn into preeclampsia. I was reading all the things, how this could turn and what that all meant. So in the back of my head, I always thought like, okay. I'm aware of what could indicate preeclampsia, but that's not going to be me. I am a healthy person, right? I've always been healthy my entire life. There shouldn't be any issues while I'm pregnant. 

And that wasn't the case, unfortunately. But I did go in a few more times, and I did get elevated blood pressure readings. So I don't know what week I was, but I know it was the beginning of October. I saw this other nurse practitioner who was not warm and fuzzy. She was new to the practice and she saw me. She took my pressure, and you could see the alarm in her face, but she wasn't saying much. 

This stuck with me to this day. It's just so crazy. She handed me this paper. The hospital that I was delivering at is a small community hospital, but it's affiliated with this Catholic healthcare system where I live, so they have a few different hospitals that are also within that same system. She just gave me this paper that had a listing of all these numbers for these different departments at these hospitals, and she just said, "You need to call them and make an appointment." 

And I'm like, "I have literally no idea what this is about." She's like, "Your pressure is high. You need to go make an appointment with them," but that's all she said to me. 

Meagan: For what? Yeah. 

Liz: Yeah, what is happening right now? I remember even that day, she asked me about my face. She was just like, "Is your face swollen? Does your face normally look like that?" I was like, "I have a very round face. I have big cheeks. To me, my face doesn't look different." Yeah. So she handed me that paper, told me to call, and like the good patient I am, I was like, "Sure, I'll call." So I called. I found out it was maternal-fetal medicine, which for those of you out there that don't know what that is, that's a high-risk doctor, and I had no idea. 

So this is my first experience with that. I did call. I made an appointment, and my OB office had me do a 24-hour urine drop or urine drip, however you want to call that. 

Meagan: Urine catch? Urine catch, probably?

Liz: Yeah, so for those of you who don't know what that is, they give you a jug from a lab, and you have to put your urine into that jug for an entire 24 hours. They test it, and they're checking to see if there's any protein that is spilling into your urine because that could indicate decreased kidney function. 

Meagan: Preeclampsia. Yeah.

Liz: Yeah. That is a symptom of preeclampsia. So I did do that. I went and saw MFM, and in the office there, my pressures were labile. They even called them that-- labile. It had elevated a little bit, probably in the 130s over 90s, but then by the end of the appointment, it had come down. My labs for that urine catch did indicate that there was protein present, but it wasn't within a diagnosable threshold. It was below that lab threshold, so I basically wasn't diagnosable. 

But they were like, "Now we're going to watch you." Most people like to see their babies on ultrasounds. That's an exciting thing. I became so fed-up with having to go in. I was, at that point, a frequent flyer. I was going in weekly earlier than a pregnancy that wasn't having any sort of complications. I was getting not only an ultrasound, but an NST every time I went in, so I'd have to lay there for 45 minutes while they looked at the baby's heart tones and everything. 

Yeah, at that point, I was just really stressed out because I was like, is that what this is turning into? But I don't have preeclampsia. I think I also saw my OB within that timeframe and he mentioned, "If this progresses, we will be doing a 37-week induction." And I was like okay, so I'm going to keep that in mind. But again, this isn't going to progress to that because I'm healthy and we're going to make it past 37 weeks. 

I probably wouldn't get the type of delivery that I wanted. And that's probably something I should mention. If I was induced at 37 weeks, I was preparing to have an unmedicated birth, a vaginal birth, and I was even taking a HypnoBirthing class to try and labor as long as I could at home. My whole thing was that I didn't want to go to the hospital until I needed the hospital or until I felt I needed the hospital. So here I am thinking, okay. I want this unmedicated, low-intervention birth, but I'm having all these interventions right now because they need to monitor me. There's some sort of issue that might be brewing. 

Yeah. I already said I went to MFM and all of that. My symptoms, at that point, were mostly swelling. I was getting very swollen at this point. I had that pitting edema in my legs, so I could press my finger into my leg. 

Meagan: It stayed. 

Liz: It stayed, and then my feet were like little loaves of bread. My feet will never forget what they went through. My husband would just massage them every single night, trying to get the fluid to move out of my tissues. It was crazy. I had another experience with a different OB who was not my OB, but I was out at a family event at this restaurant, and this woman approached me, told me she was an OB, and asked me if I was okay because my legs and my feet did not look so great.

Meagan: What?

Liz: Yeah. I was just standing in the lobby minding my business, and she's like, "Are you okay?" as if I'm not being monitored, but do you think I'm just going through this free and unaware of what's happening? Yeah. So that was interesting. She said that she was an OB. Yeah. 

So I went for weekly NSTs, the ultrasounds, and everything looked great with the baby. He was never under any sort of distress. No concerns of intrauterine growth restriction, nothing like that, but my pressures just kept being labile. I actually borrowed a blood pressure cuff so I could monitor at home. There were some mornings where I'd lay down on the couch after I woke up, and my blood pressures were reaching into those like 140s over 90, 91 maybe. I just would cry. I was just hysterical. Like, why is this happening? I don't want to go to labor and delivery right now. I don't want to be monitored. I'm already being monitored so much. There were probably some weeks towards the end where it was more than once that I went into my OB's office for monitoring. 

So fortunately, we made it through that 37-week mark. We made it all the way to, essentially, the end. And we get to Thanksgiving Eve, right? So my due date is the next day. I'm at 39 and 6. This was one of those appointments where they said, "You have to see the OB." I know I just kicked and screamed, not really, but in my head like, "F"ine, I'll see him. So the medical assistant comes in, takes my pressure and my weight, doesn't say anything, and leaves the room. He comes in, takes my pressure in my weight, and he asks me to meet him in his office.

Meagan: Really?

Liz: Yes. So I get myself dressed out of the gown that they had given me, and I go meet him in this fancy office. And he's like, "Your pressure is very high today, very high. So you're going to be going to labor and delivery straight from here." He's like, "I have a few meetings that I have to attend to here, but I will meet you over there in a few hours." And I was like, obviously, on the verge of tears. I'm just like, "Can I please stop home and get my stuff? Like, I have bags, I have a dog."

Meagan: If you can go to your meetings, I can go to my house.

Liz: Right. And yeah, my OB's was maybe 12-13 minutes away from my house, and the hospital was about five minutes down the road. So I was just like, "Can I just go home and grab my stuff?" And he's like, "No, no, no. Go straight to the hospital." And he goes, "And you're probably going to have a Cesarean."

Meagan: What?

Liz: This is after I tell him my natural birth, or my unmedicated, definitely wanting a vaginal birth. I was like, what? Literally, that was when the tears of waterworks really started. I was just like, "

there's no shot at me having a vaginal birth?" And he's just like, "Well, I'm going to be putting you on medication to prevent seizures, so you can either labor with that and have it cancel out my induction medication, or you can just be calm and go to a Cesarean." Like, go to the OR, essentially.

Meagan: What were your pressures?

Liz: 170/110 that day.

Meagan: Okay. Okay.

Liz: So, high. 

Meagan: Yeah. But he's like, "You can do this, but it's not going to work, or you could just calm down and do this."

Liz: Yeah, yeah. It was like, those aren't options, so that's not really an option. Right? That's what you're telling me. 

Meagan: Yeah. 

Liz: Yeah. So I called my mom. I called my husband, frantic. I was just flipping out. I get out of the office, I'm crying in the parking lot telling everybody. They're telling me to go right to the hospital. So, of course, my husband rushes home from work. He was at work. It was a Wednesday, and he got my dog. He had to bring my dog to my mom's, grab our bags to the extent that they were packed, and he met me there. I was crying. I walked myself into the hospital. 

It was the most surreal thing. I checked myself in knowing that I was going to come out with a human being, which was bizarre. And when I finally got to labor and delivery, my nurse was so sweet, but I was crying so much that she was just like, "Are you going to be okay?" And I was like, "I really want a vaginal delivery." And she's just like, "Honey." She goes, "I understand. I do think he's making the right choice. I do think you're making the right choice," which again, I don't really feel like I had a choice in that.

Meagan: Yeah, you're like, "I wasn't really given a choice."

Liz: She was also trying to relate. She's like, "I've had three Cesareans. I promise you're going to be okay. You're going to be okay." I was just like, "I've never even had a tooth pulled. I don't know if I could do this."

So my husband arrived again. I'm just crying. He's trying to cheer me up, trying to keep our eyes on the prize and the fact that we were going to hopefully have a healthy baby at the end of all this. I want to say between check-in and when my OB arrived and scrubbed himself in, it was probably about three hours. 

Yeah. And I walked into the OR, another bizarre experience. I just walked in.

Meagan: Yeah. Yep.

Liz: Okay, so everybody scrubs in. There's a whole host of people in there, including my nurse. I had never had surgery, so they're giving me all the instructions as to how I need to lean forward so that they can put a spinal block, I think, at that point, the anesthesiologist, and it was so bizarre. It felt like the most claustrophobic thing. If any of you have ever had Cesareans, hopefully you can relate to me, but feeling the numbness just go up your legs.

Meagan: It is very strange. I walked in for my second one. With my first one I just had an epidural, but the second one I had a spinal.

Liz: Yeah, yeah. So I mean, so bizarre. Then, like I had already mentioned I was so swollen, so they had to just take my very swollen-- I felt like a beached whale-- body parts and put them onto this operating table because I couldn't move once. Obviously, the spinal had activated. So that was bizarre. 

But my husband, I mean, this man is the calmest person and the nicest person I know. Thank God for him and his presence on that day. He kept me nice and calm. Everybody was really, really nice in the OR. The only thing I happened to notice at one point was they had my blood pressure cuff on. That's why I'm here, right? Because my blood pressures are so hig,h and it had slipped down to my wrist, so I had my arms out. I don't think my arms were strapped down. I don't remember that. I had them out, and I look over to the extent that I could to the anesthesiologist, like, "Hey, does somebody want to maybe put this cuff on? Because that's why I'm, here. That's why we're in this position right now." 

But yeah, my husband and I just chatted and laughed the entire surgery. Everything worked out really well with the spinal. I did not feel any pain. They did talk me through to an extent about what I would feel as far as tugging or pulling or pressure. 

My son was fortunately born really healthy, screaming, great Apgar score, the whole nine. He came, and oh my god, what a feeling. Obviously, I was so emotional because of how the birth had gone and what had led me there. But becoming a parent and seeing your child for the first time, you can't really describe that. It's amazing. I have really nice photos and video that the nurse took. They brought the baby over to me. They did not do skin-to-skin with me. Again, I had all of these birth plans, preferences, and, none of that came to fruition. None of that pertained to my or situation. 

I was so, so happy and also so sad. I don't know how to describe it. It was like the happiest and saddest day of my whole life up until that point. 

So recovery was interesting. I feel like I got maybe 5 hours of sleep in the hospital total. I was on a magnesium drip. People had told me that the side effects could be a little bit gnarly with that, but I fortunately didn't find anything abnormal. I think I had so much adrenaline. But I did try to get my son to latch, and he was having a really hard time latching. 

They had a lactation consultant from the hospital come in and see me, and I could not get him to latch. I happened to notice that his tongue was really tethered, super tethered. I could see the tie was really far forward, and he couldn't lift his tongue. So I kept telling them, I was like, "He can't lift his tongue up the way that I feel like he needs to." They just kept telling me how to hold my own body to try and breastfeed properly. I'm like, "I don't think that that's the problem though." So that was really challenging. 

They did want me to stay extra time for some monitoring. So the next day was Thanksgiving. I don't think my OB wanted to be there. It was a holiday, right? He took his sweet time coming in because they wouldn't even let me eat. That was the thing. I was on magnesium. They brought breakfast in at like 7:00, and he strolls in at like 10:30. I just watched my breakfast get cold in the corner. So that was interesting. 

But yeah, I think at that point, if you had had a Cesarean without complications, they were looking at about a 48-hour stay. But they asked me to stay an additional day because my pressures were still labile. They were still elevated. I did get put on-- I can't remember the name of medication, but it was blood pressure medication. I was taking Motrin for pain management, the hospital-grade Motrin for my Cesarean. I cannot even describe what it was like trying to get up and walk around that first time after surgery. It's insane. That was something I didn't expect. But yeah, I didn't get much sleep. 

The last day that I was there, my dog had gotten into a place in my mom's house that she couldn't get him. He had gotten into something, and she couldn't reach him, so she was flipping out. She called my husband. She didn't call me and just told him, "Listen, you have to come get the dog. I can't get him." So he did. I told him, "It's fine, it's fine, you can leave." While he was gone, I had friends come and visit me. They were still visitors pre-COVID. 

The covering physician came in. I had my son on Wednesday. Thursday was Thanksgiving and I saw my OB, and then there were covering physicians for Friday and Saturday. So we're at Friday now, Friday evening. He came in and saw me and he's like, "You know what? I might be able to discharge you tonight." I got so excited because I was like, this is my first experience having a newborn baby. My husband is trying to go deal with my dog. How awesome would it be if we could just go home tonight?

So I got super excited. He said this right in front of my friends, too. He comes back in a short while later and was like, "I just looked at your chart. I looked at your pressures." He didn't clear out the room, nothing. And he's like, "You know what? I can't discharge you. Not with pressures like this. I can't do that." And he's like, "And the covering physician tomorrow won't be able to discharge you any sooner than late afternoon, early evening because that is when he will be here." I was like, okay. So here I am in my head thinking I could go home tonight, and now you're telling me I might be able to go home tomorrow afternoon or evening. I'm already very hormonal. I'm very emotional. My husband's not here.

My friends wound up leaving, and I just sobbed. I just sobbed in my room like, oh my god. this is a nightmare. Why can't my body get it together? Why can't I just have normal blood pressures again?

Meagan: Yeah.

Liz: Yeah. We did wind up getting discharged the next day, but I remember that physician just being so the last straw for me in that experience. You didn't have to say anything at all, and then you also set it in front of all of my friends.

Meagan: Uh-huh. Yeah. So you didn't stay with this provider, did you?

Liz: I did not stay with this provider.

Meagan: For your VBAC? Okay.

Liz: No, absolutely not. Absolutely not. Yeah. I guess I should probably get into that story, right?

Meagan: No, this has been great. This has been great. Yeah. Yeah. So you were done. You went home. You're like, last straw, no more, never again.

Liz: Yeah. Yeah. And I did have my. My son assessed by a lactation consultant, and she said that was one of the most severe tongue ties that she had ever seen. She did recommend a release. I was four days postpartum at this point. I wound up supplementing with formula which was something I so didn't want to do, but I was just like, this kid is starving. He can't latch properly. I did. I went and saw a specialist, and I had his tongue and lip ties both revised, and it was severe. That was a severe tongue tie. I know people have mixed feelings about that, but he needed it. Even in my opinion, as a lay person.

Meagan: Yeah. Yeah.

Liz: But yeah, pretty much immediately I knew I wanted things to be different the following pregnancy and birth. I think I started thinking about my VBAC probably that day. It was probably the day I gave birth to my son. This cannot be how this goes every time.

So it took me a really long time to even want to conceive again. Not only did I have all these complicated feelings about my birth because yes, I did have a healthy baby. Yes, I ultimately weaned off of blood pressure medication and my body came back to however you want to phrase normal, but I had had this experience that I was holding onto a lot of trauma from, and unfortunately, my son was four months old and my mom suddenly passed away. 

So yeah, it was unexpected. It was sudden. I still to the day am shocked that I didn't lose my milk supply, but I was able to pump in the hospital and get my son milk. That is a crazy, surreal experience losing a parent, but I don't think that there's much more cruel than losing someone that you care about so much. My mom and I were so close in a postpartum period that's already complicated by birth trauma. 

So now I had this grief for my mom. I had this grief for the birth experience I didn't have. I think that largely contributed to me waiting to conceive again. I also wanted to try and find out as much as I could about what causes preeclampsia. What exactly goes on in the body that would cause that to happen? Funny thing is the verdict is still out there. They're not exactly sure what causes it.

Meagan: Yeah. And there are things that we can do to try to help avoid it, but there's nothing specifically that's like if you do this, you for sure won't have it.

Liz: Yeah.

Meagan: The same thing with gestational diabetes. It's within the placenta, but we don't know. It needs to be further studied.

Liz: Yeah. I have heard that it has to do with the father. Have you heard that too?

Meagan: I have heard that as well, that there's a connection. Yes.

Liz: Yeah. So I wound up, I remember I saw a home birth my wife just for blood work between having my son and conceiving my daughter. She did mention, "Preeclampsia is largely a first-time pregnancy illness. Largely. It doesn't mean you can't have it a second time," but she was the one who mentioned to me you have a higher instance of getting it again if you have the same father for your child. And I'm like, "Well, I'm married."

Meagan: Well, I am going to have the same father.

Liz: Yeah. So that was always in the back of my head. It's like, okay well, subsequent pregnancy, less of a chance. But same father, more of a chance. So I was just wondering what my odds were. It definitely was there on my mind for a long time. I studied as much as I could about what could cause it. I've read Lily Nichols, Real Food for Pregnancy, cover to cover. Obsessed with her. Obsessed with everything she has to say. There it is right here.

Meagan: And right here and right here. Real Food for Gestational Diabetes. Real Food for Pregnancy. Food is powerful, you guys. It's very powerful. But it's changed over the years.

Liz: I know. I love how she presents the research because she's the one who really delves into it and presents it in such a digestible way. It was such an easy read. I was like, okay. Okay, here are some things that I can control. Can I control everything? No. But here are the things that I intend to do the next time.

Meagan: Yeah.

Liz: So my mom passed away in April 2019. It took, again, a few years, but by spring 2022, I was feeling ready. And my husband and I kind of discussed it. It was in little passing. "Hey, should we try and get pregnant again?" And it was one time. It's not lost on me how lucky I am in that sense that it took me one shot to get pregnant.

Meagan: Which is awesome. 

Liz: Yeah. I found out my EDD for that pregnancy was going to be on Christmas Day.

Meagan: Oh my gosh.

Liz: Yeah. And I just said, "Wow, I can't avoid major winter holidays, apparently, with my pregnancies."

Meagan: Yeah. Oh, my gosh.

Liz: So we did not find out that we were having a girl, but she did wind up being a girl. Spoiler alert. But, yeah, I was really not feeling well that pregnancy. It was like aversions times 1000. I had this really bizarre one that I had never even heard anybody discussed before, but I had so much extra saliva in my mouth. I'm sorry. That might sound disgusting. It felt like when right before you're going to get sick, how your mouth fills up with saliva but all day.

Meagan: Like your saliva glands were just excess all the time, giving you all the spit possible.

Liz: Yeah, it was disgusting.

Meagan: That is interesting. I don't think I've ever heard of that.

Liz: Yeah, it was terrible. Fortunately, I was working from home. I was working full-time, but I was at home. I would just walk around with a spit cup. Like, how disgusting. It disgusts me to even talk about it. It's just like, what is happening? I was waiting for those aversions to let up because I couldn't stand the smell of coffee, which, I love coffee. Basically the sight of anything that wasn't pure oxygen was disgusting to me. The sight of opening up my refrigerator was like, ugh. Exactly. The gag reflex. 

That lasted my second pregnancy until 22 weeks. So it was rough. I joked that I was horizontal for 2022, and that's not even a joke. I really was lying down. I had so much guilt because my son was so energetic at this point. He was nearly four years old, and he had so much energy. He wanted to do things, and I could not muster up the energy most of the time. My husband was the default parent, and I never thought that that would be the case. That was really, really hard. That was probably the hardest part of the pregnancy. 

But yeah, so I started to really actively plan for that VBAC. I started to see a hospital-based group of midwives. I loved them. I had gone for well-woman visits between as well. But every provider that I saw was just amazing. I didn't have any bad things to say. I knew that I would be with them if I was in the hospital. But deep down in my heart, I really, really wanted to be at home. I had seen so many beautiful home birth videos when I did HypnoBirthing. And I also associated hospitals with sickness. I had been there because I developed preeclampsia.

Meagan: Uh-huh.

Liz: I had been there when my mom was sick and passing away. It was a sick place. I wanted to be at a place where I felt most safe. For me, that was home. I know people have a lot of feelings and opinions about that all over, but for me, that was what I wanted to do. I wanted to do all of the things to keep myself low-risk and able to birth at home if possible while still making plans for transfer and even surgery if it was needed again. So I wasn't ignorant to the fact that it could turn into that, but I was going to try all of the things.

Where I live, there actually aren't a lot of home birth midwives who support HBACs, VBACs at home. But I found one and we clicked immediately. When I spoke to her on the phone, I was like, she is my girl. I need her. I need her energy at my birth. We met in person a few weeks later, and she was so, so gung-ho about it. She had mentioned that her mom actually had an HBAC, and she witnessed her mom having that HBAC. It was just ingrained into her. She really supported me with advice on diet. She helped me with supplementation. I was on a lot of supplements for this pregnancy. I'm not even going to front. I had so many alarms set for all my supplements daily. So yes, I was trying to support myself with diet, of course, but I was trying to also fill in any gaps that might be there with supplementation. I just know my diet's not perfect, and it certainly wasn't when I was feeling terrible.

Meagan: Yeah, no one's is. No one's is. That's just the reality of it. We can be eating the best we can, and we still are often falling short. That's why supplements are really great.

Liz: Yeah. Yeah. I was seeing a Webster-certified chiropractor the entire time to get myself into the best alignment to have that vaginal birth. The supplementation, I was doing reformer pilates. I had started it the year before, and I did it all the way until the very end of November 2022, so I was staying active. I was really trying. I basically said that I will do almost anything to keep myself at home. That was really my motto. 

Yeah, I really can't say I was totally worry-free. I was waiting for something to go wrong. I was. I was trying to keep this brave face as like, okay. I can do this. I can birth the way that I want to. I can have this complication-free birth and pregnancy experience. And in the back of my head I'm thinking, when is the next shoe go going to drop?

Meagan: I mean, it's what you've experienced in the back story, the last story. And it's hard. Even if we've processed through things, there's still sometimes those little creeping thoughts that come in.

Liz: Yeah. That is for sure. My midwife did recommend that I get a third-trimester ultrasound. That was more for her, but it was also for me. She never ever said, "You have to do this." Everything was really a conversation. The appointments, especially with a home birth midwife were an hour long or more sometimes. Just amazing. I loved going to see her. So I did get that third trimester ultrasound. It was more to check to make sure that the placenta wasn't compromised in any way and whether it was in a good position. There was no accreta. That was something that we really wanted to rule out to keep me low-risk and at home. I agreed with that. 

I am not anti-medicine by any means. I just want to put that out there just because I chose to have a home birth. I do respect medical professionals and their jobs and the need for surgery but I also wanted to keep myself in a place, again, that I felt safe, and that's really what it came down to. So in my head, I had mentally prepared to go to 41 weeks. I think that's where I prepared to go because I had learned that many, many women, especially first-time laboring women, because I did not labor with my son, I neglected to mention that I didn't labor at all. So first-time laboring women will go into labor typically, but somewhere between 40 and 41 weeks. Post-dates is very, very common. 

So in my head I prepared to go to 41 weeks and we got there. We got to Christmas. We through there. I was like, I'm going to go somewhere before New Year's Eve. No, nothing. So we got to New Year's Eve and here I am in my 41st week, and I'm just trying to keep myself calm. What am I going to do? I cannot go to 42 weeks. I can't do it. Mentally, I can't do it. Physically, I can't do it. I'm going to wind up at the hospital. Of course, all of these negative thoughts are swirling. I went for another adjustment with chiropractor. I went for an acupuncture session. I went for a few of them, but I did induction points with my acupuncturist. I was just trying to do all the things-- curb walking, I did the Miles circuit and all the things to try and help this baby engage. 

So we get to 41 and 1 for me, which is a Monday, and I was woken up with contractions that felt like period cramps. That's how I would describe them. Around 2:00 AM, I started timing them. They were 12 to 15 minutes apart at that point, but they weren't letting up. They were consistent. I woke up my husband getting all excited like, "Oh my gosh, this might be it. Here we are." And they weren't getting closer, but they weren't easing up. So they just continued like that for the rest of the day. I had gotten up from the couch at one point, and I felt like this small trickle. I went into the bathroom, and it didn't look like anything to me. It didn't look like much. There wasn't a huge gush of fluid, nothing. So I was like, oh, I think it's probably just discharge or maybe part of my mucus plug. I have no idea. I have literally no idea. But I was like, nothing seems off to me, and it wasn't enough fluid to be concerning. 

I did text my midwife to update her and she mentioned to me, "A lot of women will drop into more active labor when the sun goes down. Things get quiet. It starts to get calmer. I can almost guarantee that we're going to have a baby at some point in the next 24 hours." So I go to bed that night and thinking, I'm going to wake up Tuesday probably either be having a baby or have a baby already. I woke up Tuesday, and I was still pregnant. Here I was.

Meagan: You're like, this is not what I was thinking.

Liz: I remember I would wake up with a contraction, but again, they were 12 to 15 minutes apart. I would go to sleep between no issues and just wake up, breathe through the contraction, and go back to sleep. And that's how the whole night went. I just couldn't believe I was still pregnant. I really was starting to get a little down on myself. I was like, these aren't coming closer together. They're not intensifying. They're not letting up, but there's nothing really happening at this point. I texted my midwife again that morning, Tuesday morning, and she said she needed to come see me for the 41-week appointment anyway, so she said that she would come by that day. She was going to come to my house. 

And then we get to the mid-morning. It was probably around 10-10:30 and my contractions stopped, like literally up and left. Like, what is happening right now? I can't. I was in shock, literally in shock. Especially because labor had been going on for over 24 hours. It was absurd to me. But she's like, "Don't worry. I'm going to come see you for your appointment anyway." 

When she arrived later that day, I did ask her to do a cervical check because at this point I'm like, "Something has had to happen whether the baby moved down into a better station or I'm a little bit more dilated or just more engagement. Whatever it is, I just want to know at this point."

Meagan:: Yeah.

Liz: So she did. She said, "I'll go in there. I can do a cervical check and if I can get in there, would you like me to do a membrane sweep?" And I was like, "I would love that. Anything to get this going. Let's get the party started." I'm at my house. She does the cervical check. She's like, "I can do a membrane sweep." And as she basically finishes up, I feel this gush of fluid.

Meagan:: Your water.

Liz: Yeah. She stopped, and I said, "Was that fluid?" She's like, "I'm going to make sure it's amniotic fluid. I have the test strip," and of course, it lit up like a highlighter. She's like, "Yes." She goes, "So guess what? We're going to go after baby today. We're going to get this. We are going to get this party started." I had kept telling her, "I can't go to 42 weeks," and she kept saying, "Let's not go to 42 weeks. You'll be fine. We're going to get it moving." And here we are. She did mention, I was at that point, about 3-4 centimeters dilated, so pretty good. 

But she was like, "I can offer you, I have a Foley. I can offer you a Foley balloon just to put a little bit more pressure on the cervix and maybe we can get those contractions to start to start up again, and then hopefully come closer together." Yeah. So she did. She put that Foley in and she waited with me at my house, and we just chatted. It came out a short time after. It took very little. I didn't have discomfort with that, thankfully.

Meagan: That's, good. I mean, your cervix was starting to come forward. Things were going.

Liz: It was going. Yeah, yeah. So again, she stayed with me and once the Foley came out, she just advised me to put on some sort of protective underwear whether it was the adult diapers or a pad because now we knew that my fluid was at least leaking, but it wasn't coming out consistently anymore. I don't think it fully came out. It wasn't a big enough gush for it to be all of the fluid, if that makes sense.

Meagan: Yeah, yeah, yeah.

Liz: So she told me to do a few things. She's like, "I'm going to head out. You're going to call me when you need me," which, at that point, I was like, I have no idea what that means, but okay. And she's like, "Here are the things that you can do. Obviously nothing in there anymore, because we know that your amniotic sac is open.

Meagan: It's broken. 

Liz: Yeah. Yeah, exactly. But she said, "You could do some pumping. You could use some clary sage essential oil." She gave me her TENS machine, and she's like, "You could try the TENS machine." I had never known that you could actually use that not for pain management. I only thought it was for pain management. So I was like, "That's so interesting." So she's like, "Do the pumping. Do that." So I did. I did one session, I think, before I put my son to bed for the last time as an only child. I did. I went and laid down with him and just knew that was probably going to be the last time that he would wake up or the last time he had woken up as an only child. 

And then I did it one more time, and not only did my contractions come back, I started timing them on the app, and I'm watching them get closer. They're going from 10 minutes to 8 minutes to 7 minutes to 5 minutes. I'm just watching them like, oh, my gosh. So we get to 11-11:30 at night, and it's just me and my husband there, and they are three minutes apart, and they're not easing up, and they are getting intense. So there it was. They came back.

Meagan: And labor begins.

Liz: Oh, it began. It began. I have so many interesting photos that my doula wound up taking. Thank God for her. Not only for the photos, but for everything that she did during the labor and delivery. It was intense. It gets intense, or in my experience, active labor when you get the breaks between the contractions and you are able to rest. I took every opportunity to rest. My doula was trying to guide me into different positions. She would help by putting a warm compress on my back at times. She would encourage even location changes in my house just to see if I could use the toilet. She told me to get into the shower at one point. I was like, "I'm too claustrophobic in here." I didn't like that, but she was trying to get me to try different things. But it was so intense. 

The craziest part for me was transition. That was truly an out-of-body experience. Everybody was doing these hands-on manipulations, my husband and my doula. But I could not do anything but just sway. I was standing, swaying back and forth in my living room, arms up. Why were my arms up? I have no idea, but they were up. I was doing that horse lips, breathing. Yep. It was just what my body did intuitively. I just, at that point, wasn't really getting a break. It was just insane. So that was intense. Out-of-body. I cannot replicate that level of pain in my head. There's just no doing that, but I knew that even if I needed to transfer, which I wasn't planning, but even if I needed to do that for pain management, I couldn't sit down in a car. I was at that point, so I thought to myself, the only way to this is through this. Like that is it. You've got to do it. We're just going to do it. So I knew that in my head. At no point did the pain concern me though. I mean, was it so intense and crazy? Yeah, but it was never like, there's something wrong.

Meagan: Uh-huh. Yeah.

Liz: So that was really good. I didn't think anything negative during that time except that I was in an intense amount of pain. But it was like pain with a purpose, if that makes sense.

Meagan: Productive.

Liz: Yes, yes. In the meantime, my doula had set up a birth pool because I definitely wanted to try to be in the pool when I gave birth, but I wasn't sure how I'd feel about the water since I didn't really like the shower experience. It took a while because the hose kept slipping off of our faucet or whatever, so they had to boil pots of water. I just remember my doula walking back and forth. In the meantime, they did call my midwife. Somebody did, and she showed up with her assistant. So there were like three or four adults trying to hold me in transition or do some sort of physical manipulations and then pour hot water into this birth pool.

Meagan: Oh my.

Liz: Yeah, it was very interesting. But yeah, my contractions, at that point, were 30 seconds apart and they were lasting a minute and a half. It was intense, yes. But the pool was finally filled at 6:45 in the morning on Wednesday, and the only reason why I know that is because we have pictures of me right before I got into the pool. When I got in, my body just relaxed. I didn't think I was going to be wanting to be in a supine position at all, beyond my bottom at all because I couldn't have even tried to sit on land. But once I got into the pool, everything relaxed and it was like, oh, this is what I needed. This is what I needed. I needed some relief. I also kept telling everybody how tired I was. Anybody who walked past me, I was like, "I'm so tired." They were like, "Yeah, no. We know. We know, but we're going to keep working."

Meagan: Yeah.

Liz: But yeah, I was in there for a really short time and I had heard of this before, but to actually experience it is next level. I had the fetal ejection reflex.

Meagan: Oh yeah.

Liz: So I did not even have another cervical check. Nothing. My body just started pushing that baby down and out. I couldn't have stopped it if I wanted to. I was making the most primal sounds. I have video of it, like low guttural sounds. It was probably going on for about 15 minutes. My son walked down, I heard his little pitter-patter of his feet, and he walked down. My stairs go right into my living room where I was. And the whole time the most nerve-wracking part of having a home birth for me was that I knew he was going to be home with us, and there really wasn't an adult aside from my husband and my birth support team who I wanted in my birthing space. So there was no other option of anybody to take care of him besides my husband if it came to that. I think in the back of my head, that was the most anxiety-inducing part of this.

Meagan: Yeah.

Liz: So down he walks. And of course, he's hiding. He sees these three other adults in our living room. I'm in the tub groaning.

Meagan: Yeah.

Liz: He's a little nervous. He's a little guy. Fortunately, I think it was either the birth assistant or my doula handed him his little digital camera that I had actually bought as a gift from the baby for him. Yeah. She encouraged him. She's like, "Why don't you take some pictures? Take some pictures of mommy and daddy." The minute that she said that and he started to do that, he calmed down and just wanted to be in it and part of it.

Meagan: Yeah.

Liz: Yeah. And I told him, "Mommy's making some interesting noises, but I'm okay. I'm safe. I'm okay." And he was just really good about it. I feel like all that anxiety went away, thankfully.

Meagan: Yeah. Yeah. That's awesome.

Liz: Yeah. I noticed my midwife was starting to gather her supplies and in my head, I actually probably said it out loud like, "Wait, we're doing this here?" And she was like, "Yeah." I was like, "I'm having a baby here in this room." She's like, "Yeah." I was like, "I don't need to go to the hospital?" She's like, "No, no, no. You're okay."

And, yeah. My body just kept pushing the baby out. And it was an hour, not even an hour. It was less than an hour from when I first got into the pool until my daughter was out. My husband got to reach down and put his hands there. As she came out, he felt her really chubby cheeks. She has big cheeks like me and her ear, and brought her up to my chest. I was just in shock. I couldn't believe that I had done that. But then, of course, I look and I see that she's a girl. I just knew my mom had sent me her. That's how I felt.

Meagan: Oh, that just gave me the chills.

Liz: Thank you.

Meagan: Oh my gosh. That is so beautiful. I love that your son was able to be involved, and you could feel your mom. Oh huge. Congrats. 

Liz: Thank you so much.

Meagan: Yes. 

Liz: My mom's name was Faith, and so my daughter's middle name is Faye because everybody who loved my mom called her Faye. She was Aunt Faye to everybody, every cousin. So my daughter's name is Luna Faye. So she is her namesake, and she's amazing. And like you said, I can't believe she's almost two. I can't believe this was almost two years ago.

Meagan: Two years ago. I know. We get so many submissions and sometimes we can't get to everybody, but it does take a while sometimes. I'm so glad that you were able to come and still record your beautiful stories and give us so much detail of each one and guidance, and the experience. Yeah. I'm just so happy for you.

Thank you so much. I don't think I'll ever come down from that high, that birth high. Like, I think I'll be riding it out for the rest of my life. I'm not sure I'm going to have any more children. I think we're pretty much done, but I would love to give birth like that a thousand more times. It was the redemptive story that I needed. It helped so much with my previous birth trauma, and it made me feel so strong. I have never felt more strong and more powerful than that experience. I don't think I ever will.

Meagan: Yeah, well, and there's so much that went into it-- time preparing, research, finding this team, and then even dealing with the prodromal. I mean, that could be defeating within itself. You're so tired, but then you just kept going.

Liz: Yeah, I kept doing the things. I mean, that was one thing that my doula and my midwife both commented on. They were like, "You did everything that you could, and you tried to control everything that you can control, and look what happened. That's amazing."

Meagan: Yeah. Thank you again so much.

Liz: Thank you. I'm so happy to have been able to talk to you and share my story.

Meagan: Me too. Do you have any final advice to any of our listeners?

Liz: I think my ultimate advice for any birthing person is to find a provider that you align with. I think they can really make or break that experience. No matter where you choose to birth or where you wind up birthing, have that provider that you trust, that you feel like you could have open conversations with. If you say you want a natural birth, they're not going to scoff at that, and somebody who's going to have conversations with you instead of talking at you.

Meagan: Yeah, I agree so much. I want to add to just vet them. If they're feeling good at first, okay, stay. And if something's happening, keep going. Keep asking the questions, and if something's not feeling right, don't hesitate to change.

Liz: I know. And I not only hesitated, but I knew I had to change with my first provider, and I just didn't. I think at that point, I was so tired.

Meagan: Yeah well, it's daunting. It's a daunting thing. I mean, I was there too, so no shame in it. It's just hard when you realize looking back, oh, I could have. I should have done something different. I didn't, but that's okay. We've learned, we've grown, and we've had healing experiences moving forward.

Liz: Yeah.

 

Closing

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

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Meagan welcomes Dr. Nicole Calloway Rankins, a board-certified OB/GYN, to discuss everything related to pregnancy, childbirth, and the VBAC experience.

With over 23 years of experience and more than 1,000 deliveries, Dr. Rankins shares her insights on common questions and concerns from expectant mothers. From the importance of mindset during labor to understanding the implications of the word “allow” in provider-patient relationships, this episode is packed with valuable information. Don't miss out on Dr. Rankins' tips for a calm and confident birth, and learn how to advocate for yourself in the birthing process!

Dr. Nicole Rankins' Website

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, Women of Strength, It's Meagan, and I am so excited to be joining you today with our friend, Nicole Calloway Rankins. Dr. Nicole Calloway Rankins is incredible. We've been following her for a long time and have collaborated with her in the past and are so excited to be having her on the podcast today. Dr. Rankins is a board-certified practicing OB/GYN, wife, mom and podcast host here to help you get calm, confident, and empower you to have a beautiful birth you deserve. 

She was born into a family of educators, and she felt a pull to medical school the day she looked in the mirror and saw a vision of herself in a white coat. And get this, it all happened while she was studying to be an engineer. She says, "I know that sounds crazy, but that vision has led me to exactly where I am supposed to be today- serving pregnant women." She's delivered more than 1,000 babies and has de-mystified childbirth for thousands more through her 5-star rated All About Pregnancy and Birth Podcast which she's going be talking about a little bit more today. I'm so excited for her. She has over 2 million downloads and her online birth plan and childbirth education classes. 

You guys, she is really changing so much about the birth world. She's incredible. You're going to hear it today. I love chatting with her. You can find her at drnicolrankins.com and of course, we'll have all of her other podcasts and Instagram and all that in the show notes. So get ready, we're excited. 

We're going to be talking a little bit more about common questions for an OB/GYN, but then we're also going to be diving into questions from you personally. I reached out on Instagram and said, "Hey, what are your questions for this doctor?" She is so excited to answer them, and she did. We went through every single question that was asked on our Instagram community. I'm so excited. I'm going to get to the intro, and then we are going to start with Dr. Rankins. 

You guys, Dr. Rankins is back with us today and I'm so excited. Funny enough, I keep saying that you're back, but you've never done the podcast with us.

Dr. Nicole Rankins: I don't think so. Yeah, I think we did a class.

m: We did a class which was phenomenal and everyone ranted and raved about it. So we're back together ,but we have you for the first time on the podcast. So welcome. 

Dr. Nicole Rankins: Well, thank you. I'm excited to be here.

Meagan: We just adore you and I love getting your opinion on things. I think from doulas, from midwives to OBs, we all have different opinions and experiences, and if there's anyone that has hands-on experience, it is you and a midwife, like someone who is physically handling.

Dr. Nicole Rankins: Yep. I've done this a couple thousand times. Yes.

Meagan: Versus my 300 and something verse.

Dr. Nicole Rankins: Don't discount it. That's very excellent.

Meagan: It's still super great, but when it comes to thousands and an understanding on an even deeper level, it's just so fun and it's a compliment to the podcast to have your expertise.

Dr. Nicole Rankins: Yeah, I've been at this 23 years, so it's a long time.

Meagan: And still going. It's still going.

Dr. Nicole Rankins: Still going. Yes.

Meagan: And okay, tell me we can edit this if you want, but you have a new podcast coming out. I do know it's not going to be by the time this airs. It's not going to be out just yet. But can you tell us a little bit more about it and where people can find this?

Dr. Nicole Rankins: Yeah. So it's still going to be in the same feed. So if you subscribe to the old podcast, it's just going to change, keep the same feed, but it's going to have a new name and a bit of a new focus still related to pregnancy and birth, but it's just a bit tighter. I want to say the name so bad, but I'm not going to.

Meagan: Okay. Don't let it out. We will find out it is released.

Dr. Nicole Rankins: Yes.

Meagan: Tell them where to follow right now.

Dr. Nicole Rankins: Right now? Yeah, if you follow me on Instagram, even though I'm taking a Little break now, you'll get it there. But the podcast is called All About Pregnancy and Birth. Go ahead and subscribe, and you can be the first one to know when the first episodes come out. I just have lots of new ways to present information about pregnancy and birth and frameworks and things. 

Okay, I'll give a little hint. One of the first things I'm talking about is one thing that's so important to pregnancy and your birth experience is your mindset. So one of the things I created is this MAMA mindset framework. MAMA stands for meditation, affirmations, move your body, attitude of gratitudes. I have practices, exercises, and things we're going to talk about. That's just one little, tiny sliver of the things that I've been working on and writing, so it's just good, great stuff.

Meagan: Yay. Oh my gosh. I'm so excited. That is even more applied with just birth in general. But VBAC, I feel like mindset attitude, and all these things that you were just saying, is so important because even though we're just moms going and having babies, we have some extra things that some extra barriers that sometimes we have to either break through or we run into.

Dr. Nicole Rankins: Absolutely. Yeah. I mean, a calm mind creates a confident birth. So when you have that calm mind, that is the first step to helping you create a confident birth experience. So mindset is really important.

Meagan: Yeah, it really is. Well, I'm excited to chat with you today, and I'm excited to listen to that sometime here in the near future and listen to more of what you are bringing to the table. Okay, so one of the questions that I would like to go over is the word "allow".

What does the word "allow" mean? How does someone navigate something that maybe doesn't feel right for them? And on both sides-- Dr. Fox and I have talked about how sometimes it's not right for the provider. You're not the right patient for that provider because what you want is not comfortable with the provider and vice versa.

But we often hear or actually more see it on The VBAC Link Community on Facebook. There are comments of, "My doctor said they will allow" or "My midwife said they'll allow me to." If so when you are saying that or maybe have you said that, what does that mean?

Dr. Nicole Rankins: Yeah, I don't say that word.

Meagan: Okay.

Dr. Nicole Rankins: It's a word that should not be in the discussion about birth because allow implies a hierarchal relationship where I get to make the decisions about what does or does not happen in someone's pregnancy, birth, labor, body, and that is not true. You as the person giving birth are the one who ultimately makes the decisions, not your doctor or your midwife. We can't really allow anything. We're not your parents. Do you know what I mean? So "allow" shouldn't be part of the conversation.

 It's a left overturn from just a general patriarchal foundation of OB/GYN, particularly when men took over into the specialty and banished midwives is how that language came about is that we need to tell folks and we need to control. So it really shouldn't be the case, but it still hangs around. Words matter, and it's important. 

Even though people don't necessarily mean it with any sort of ill-intent or that they mean that they're trying to control you, and inherently sort of subconsciously implies that. So I strongly dislike the word "allow".

Meagan: Yeah, I am with you too. As someone who has had that word happen to me, it made me feel like I had to do something to meet their standard quota to get that allowance.

Dr. Nicole Rankins: Right.

Meagan: That just didn't feel great.

Dr. Nicole Rankins: Yeah. Yeah.

Meagan: So if someone is saying that, are there any tips of advice that you would give?

Dr. Nicole Rankins: Yeah, I mean, first off, if you hear it, that's a little notch of a red flag potentially that it's not going to be a shared decision-making process because really, it should be that my role is to give you information and share my expertise with you to help you come up with the best decision for yourself. 

That looks like various things for different people. Some people want tons of information. They want to think about it and then talk about it. Some people are like, "Just tell me what to do," which if that's what you want me to do, then I can do that too. So if you hear "allowed", then it's concerning that there may not be that shared decision-making. So that's a little bit of a red flag to know.

But then to open it up for discussion, it kind of depends on what the situation is. So is it we don't allow you to eat or drink during labor or we don't allow TOLAC? Then the next question is really, why? Especially if it's something that's important for you, why? If you want to use the language back, you can even use it back. "But why is that not allowed? Why is that the case?" And then kind of take the discussion from there.

Meagan: Yeah. I think asking the question just in general, "Why?" or "Okay, I hear you. Can you explain to me?"

Dr. Nicole Rankins: Yes.

Meagan: It really helps there be a discussion like you were saying. I feel like when it comes to birth, like you're saying, I'm not your parent, but it needs to be collaborative effort here. We're trusting you to help us with this really amazing event in our life, but at the same time, we have to have equal trust from you. It's this collaboration of like, let's talk about what we want this to look like.

Dr. Nicole Rankins: Yeah. Definitely, tust and collaboration are key in order to have a great birth experience. And ideally, you want to try to work on that foundation during your prenatal appointments so that by the time you get to the hospital, you know that you're going to have that relationship actually, regardless of what doctors there or nurses say. You create this environment of trust and collaboration. 

So when you ask the question why, don't necessarily start off-- and this is part of the psychology of human behavior. You don't necessarily have to start off with, "Well, why?" attitude because advocacy is not about creating conflict or creating chaos. Advocacy is really about creating that collaboration and creating that trust. It's the end result. So start from a place of trying to connect. Ask, learn information, and then kind of go from there.

Meagan: Yeah. Love that. Well, thank you. Okay. 

Fetal monitoring. I know this is actually going to be a question down the line, or maybe it's a little different, but fetal monitoring with VBAC in hospitals is typically required. Can we talk about the evidence on that of why? Why? Again, here's the question, why? Why is that done? Dive in deeper. We talk about that in our course. But I think it's so great to talk directly to an OB/GYN like you to understand your point of view.

Dr. Nicole Rankins: Yeah. The reason that's the case is that one of the first signs of uterine rupture is going to be a change in the fetal heart rate. So that's why we always want to see the fetal heart rate because it's going to be the first indication that there's potentially an issue. So it's really that simple. It may even be potentially before you start having pain. Some people may or may not have bleeding, but fetal heart rate changes and pain are going to be the things that will clue us in and we don't want to miss that if it happens.

Meagan: Yeah, so when a fetal heart changes, we know, through labor-- this is a spin-off of the question. We know babies' heart rates fluctuate up and down. Sometimes they might have a compression in the cord that causes the heart rate to go really down during the uterine contraction and that goes up, but it goes really down. It's like, oh, that's low, and then it goes right back up to its baseline. So what is a concerning fetal trace in this scenario?

Dr. Nicole Rankins: Right, yeah. So this is the part where I have to say, this is the reason we do four years of OB/GYN residency, why we have to get take fetal heart rate monitoring training every couple of years to stay up on it. This isn't something that can be had in a subtle conversation because it's not just what you see in the moment, it's what you see in the moment. The things we look for in general are a baseline of the heart rate between 110 and 150, 160, roughly. We look for things called accelerations, decelerations, and the variability, which is like the squiggliness of it, that's the big picture. 

But when we look at it, it's like, okay. We assess it, and then we try to do some things to improve the heart rate. We look at how the heart rate looks over time. Has it gotten worse over time? If we do some things to get it better, then that's considered good. So we can't really say if you see this specific snapshot of a fetal heart rate, then that's going to be the thing that triggers things. It really just depends.

Meagan: Makes total sense.

Dr. Nicole Rankins: And it can also be contractions because sometimes if you're having too many contractions back to back and there's no time to get a break, so the baby's like, "Can I just have a minute to breathe in between these contractions, please?" So maybe we need to slow down the contractions. So really, it's a lot of things that go into it, and that's where our expertise comes in.

Meagan: Yeah, it's a big math equation in a lot of ways when it comes to tracings and things like that. Okay.

Dr. Nicole Rankins: I do want to say that a lot of times people think monitoring equals no movement. But more and more, hospitals these days have wireless monitoring so you're able to move. That's definitely a question you want to ask ahead of time if wireless monitoring options are available so that you're able to move around.

Meagan: Yeah, yeah. Because they've got, at least I don't know if it's what it's called there, but we call it the Monica.

It's just that little sandpaper on your belly and that's kind of nice. Sandpaper sounds harsh. It's a light little scrub so it gets the oils off your skin. So that's a really nice thing.

Awesome. Okay. And then scar thickness. This is a really big one, and we've talked a little bit about it with Dr. Fox in the past. But scar thickness and double versus single stitch closure is a very, very common question that we are getting wondering about the evidence that shows that someone maybe shouldn't TOLAC or the evidence on thinner scars because it seems like it's becoming a new standard. It's coming in with the VBAC calculator. That is what we're seeing. It's like we're doing the VBAC calculator and we're measuring the scar and those kind of two things are becoming routine. And then of course, once we review OP reports. Double versus single.

Dr. Nicole Rankins: Yeah. So the double versus single doesn't make a difference. So whether you had a double layer closure or a single layer closure, you're still a candidate for a VBAC. So that one is pretty easy. I don't even look at OP notes for double versus single layer. It really just needs to be a low transverse incision on the low part of the uterus. So that's that. 

As far as the scar thickness, the rationale behind that is that when the uterus ruptures, it literally just thins out. Thins out and thins out until it ruptures open generally. So when we're measuring this scar thickness, the physiology of it makes sense that if it's really thin and then you start to put the pressure of contractions on it, there may be a higher chance of it rupturing. 

Now, is there hard data that if it's this amount that is definitely going to rupture or you should or shouldn't TOLAC? Not necessarily. In our area, it's not routinely measured or talked about. It's not anything that we discuss, so it's not a routine part of practice, but that's the thought behind it. 

And typically it may come up if it's noticed, or if it's very noticeable. If the ultrasound, the maternal fetal medicine specialist or whoever does the ultrasound says, "This uterine scar, where it is, is really, really thin," and then it may come up. But in general, I don't see that come up very often.

Meagan: Yeah, well, that's good. That's good to know. Yeah, it just seems. Yeah. Like, oh my goodness. Are you hearing that ding?

Dr. Nicole Rankins: No.

Meagan: Okay, good. I hope you're not hearing it. On my end, my computer keeps dinging, but it's on mute, so I'm not really sure what's going on. I'm having all the technical issues today.

Anyway, that's really, really good to know though, because it is something that so many people are hyper-focusing on. Sometimes I think there are other things to hyper-focus on like our nutrition and finding that supportive provider and getting the education and really understanding the choice that we're making when we VBAC.

Dr. Nicole Rankins: Yeah, definitely. I'm not focusing on it, so I don't think you should focus on it.

Meagan:Yes, yes. But it is. I think it is probably hard for these people when they go to these visits. They're so excited. They want to have a TOLAC or a VBAC, and then they're like, "Oh well, we have to do these things first to see if you qualify."

Dr. Nicole Rankins: And scar thickness is just not part of ACOG's recommendation. It's not part of what determines whether or not you can have VBAC.

Meagan: I know. It shouldn't be anyway. Yes, yes, yes. But for some reason, we're still seeing it. So I think it's good to know that you guys, if you're having that, maybe just think twice about it.

Dr. Nicole Rankins: Or get a second opinion.

Meagan: Yeah, I was going to say, get a second opinion.

Dr. Nicole Rankins: Yes.

Meagan: Okay. So our community asked questions. I went on and said that we were going to have you on. And they were so excited and kind of just asked all of the questions. So one of the questions was, if you don't get an epidural for a VBAC and you need a C-section, will you have to be put fully out, so under general anesthesia?

Dr. Nicole Rankins: Yeah, no. Not necessarily, and most likely not. Generally, as long as it's not an emergency, there's time to do a spinal. The difference between an epidural and spinal, the epidural is a catheter that stays in place and medicine continually gets fed through the catheter where a spinal is a one-shot dose of medicine that lasts for two to three hours. So as long as there's time and you can sit up for the spinal or they can lay you on your side for the spinal, then they can do the spinal for the C-section, and you don't have to do general. General anesthesia is only reserved for if it's truly an emergency and there's not enough time to do the spinal.

Meagan: Right. And for this is another, I'm adding this. But epidural versus spinal longevity of effectiveness meaning like you're numb enough for them to perform the surgery.

Dr. Nicole Rankins: Yeah. The spinal's going wear off.

Meagan: Yeah. Quickly, but it's going to go on quicker. Right or no? Or deeper?

Dr. Nicole Rankins: Yeah, it's a denser numbing than what you get with an epidural. When you get an epidural before, if you have an epidural and then you go to a C-section, then you just get a bigger dose of medicine that kind of mimics what you get through the spinal. So the thing about the spinal is that it's meant to cover a surgery, so it's going to be a larger dose of medicine, so you're going to be more numb because we don't actually want you to be completely numb during labor. The spinal is really just to make sure you're nice and is numb and don't feel the surgery.

Meagan: And how long does it take to kick in to be numb enough? Like 20 minutes? 30?

Dr. Nicole Rankins: Yeah, yeah. I would say it's actually pretty quickly. So yes, you're right. It can kick in a little bit faster than epidural because it's a lot more medicine. So typically, I would say within 5-10 minutes, you're going to start feeling numbness pretty quickly. But by the time we've laid you down, washed your belly, put in the catheter, done those things, then you're numb.

Meagan: Yeah. So in that non-emergency situation, you're going to have plenty of time to be numb and not have to be put under general anesthesia. In an emergent situation, we have minutes. We have minutes to work with. How many minutes if we're having fetal distress? 

And obviously, it could vary for a lot of patients, I'm sure, but major fetal distress emergent like true emergent under general anesthesia. What are we looking at a timeframe before we get baby out before we're really concerned?

Dr. Nicole Rankins: Yeah. I mean so if it's true, like an emergency, because a lot of people say they had an emergency C-section. It's actually not emergency. 

Meagan: Right. Baby was born two hours later. 

D; Yeah, or even 30 minutes later. So emergency is going to be like we're ripping the cords out of the wall. We're running down the hall to the operating room. When we get in the operating room, the heart rate is still in the 60s. So we want baby out in five minutes.

Meagan: Okay.

Dr. Nicole Rankins: We want baby out as quickly as possible, and the quickest way to get a baby out is general anesthesia and then go, if you don't already have a spinal.

Meagan: Right. Perfect. That's also another common question of like, well, how long do I have if I don't have that? Because that's a big deciding factor for people with not wanting to go unmedicated or wanting to go to medicated but not wanting to be in an emergent situation. Those emergent situations, they happen. We can't sugarcoat it. They happen, but they are more rare. 

I love that you pointed that out. A lot of people say this was an emergent situation and we hear, well, then they went out and they came back, and 25-30+ minutes later, they had a baby.

Dr. Nicole Rankins: That's not an emergency. As a matter of fact, emergency C-sections are fairly rare. Knock on wood, I can't remember the last time I've had to run somebody down the hall for a C-section.

Meagan: And I call those crash like crash sections. Everybody crashes and goes. Yeah.

Dr. Nicole Rankins: Mhmm. Mhmm. Things are moving so quickly.

Meagan: Okay. So someone says, do I need an OB for a VBAC? I have lost all trusts in nurses and doctors after being forced into a C-section which breaks my heart that this question is a thing. I see it all the time. People have been "wronged" or bullied, and it shouldn't be that way. 

Dr. Nicole Rankins: It should not.

Meagan: Sometimes it happens for whatever reason. But yeah, like do you have to have an OB? Obviously, we know the answer is no.

Dr. Nicole Rankins: No, you can have a midwife. For sure.

Meagan: But maybe I want to spin it to more of a positive. If we have an OB, how can we better establish a relationship with them so we're not in a situation in the end feeling pressured or bullied?

Dr. Nicole Rankins: Yeah. And actually I want you to even back it up even further, and this is for anybody having a baby. What you want, you don't specifically want a midwife. You don't specifically want an OB. What you want is someone who's going to listen to you, respect your wishes and really center you in your birth experience. So yes, midwives are great at that, but sometimes midwives can be tricky too. 

The way that the reason I said that is because I know people who were like, "I had a midwife and I thought it was going to be great," and it wasn't. And they were hanging too much weight on that midwife hat.

Meagan: The midwife word, yeah.

Dr. Nicole Rankins: Yes, yes. So you really need to start with is this person listening to me and respecting me? So whether that's midwife or OB, okay?

Meagan: Yeah.

Dr. Nicole Rankins: So take that away first. And then if you have an OB, again because the midwife is also going to work with an OB, I'm assuming you're doing in the hospital, you want someone who is not just like, "Oh, if you go into labor, you can have a VBAC. I mean, I guess that's okay." Or you want somebody who's really actually supportive of it. I think you've used this language before, not just tolerant of VBAC that they actually you and don't just tolerate the possibility.

Meagan: Yeah, I have kind of been thinking about that. Like we as doulas. It's like, oh, I want someone to advocate for me. That big word "advocate", and what does that look like? But in a lot of ways, I think that's what I want a supportive provider to do is advocate for me. Like I understand, validate me. I understand this is what you want, and we're going to do everything we can in our power to do this. If there's something along the way that is saying maybe we shouldn't, I will have that discussion with you. I will not just tell you what you have to do. 

Dr. Nicole Rankins: Exactly. 

Meagan: Again, it goes back to that conversation we were having in the beginning of that collaborative relationship. If that is there, I think you set yourself up for better expectations no matter who it is with an OB or a midwife.

Dr. Nicole Rankins: Definitely. Definitely. Yeah.

Meagan: Nurses can be tricky. We love our nurses. They're incredible, but sometimes they have opinions, and sometimes they come in and they put it on us.

Dr. Nicole Rankins: Here's the thing that people don't realize. You can ask for a new nurse.

Meagan: You can.

Dr. Nicole Rankins: Yes you can. You can absolutely. There's always a charge nurse who's in charge of making patient assignments. You can ask to speak to the charge nurse, and you can get a new nurse. Don't feel bad or guilty or like you're hurting anybody's feelings. People will be fine. I promise you. They'll go home, and they'll keep going on about their lives if you ask for a new nurse. So I know it can be challenging, especially sometimes for women to speak up about things, and you're worried about hurting people's feelings and things like that, but you can always ask for a new nurse.

Meagan: Absolutely. This is not related to birth, but I signed up with a personal trainer at my gym, and I was assigned to this amazing person, and she was great, but I realized a couple weeks into it that maybe we weren't the best fit for one another. I hesitated for two more weeks to say, "Hey, can I switch?" And now that I've switched, oh my gosh, it's the best decision I made, and 

I get to see her at the gym all the time. I went up to her and was like, "I love you. Thank you so much. This has been great, but this is what I'm doing." It was a wonderful breakup. You don't even have to break up with someone like that, though. You really don't. It doesn't have to be. I was so nervous, but this is your space. This is your birth. This is your experience. You have to protect it and keep it what you need. If someone's not jiving that or that nurse specifically, you can say, "Hey, thank you so much for your services, but I would like to switch." It's okay.

Dr. Nicole Rankins: Definitely, Absolutely.

Meagan: And you don't want to go back at the end of the day and be like, oh, I had this nurse, and it was the worst seven hours. That's not positive. We want to look at our birth with a positive view, not a negative view.

Dr. Nicole Rankins: Yeah. And your nurse is going to be there way more than your doctor. Way more. You definitely want to be in sync with your nurse.

Meagan: Yeah. And something else, too. I tell our clients all the time, our doula clients, like, "Hey, upon arrival, if we're not there, say, 'Hey, I would really love a nurse that fits in line with blah, blah, blah.'"

Dr. Nicole Rankins: Exactly.

Meagan: And a lot of times, they assign it right then, and you're like, "Oh my gosh, you guys are amazing. Thank you."

Dr. Nicole Rankins: Yeah, exactly.

Meagan: Okay, so next question. What should I consider if my goal would be to have a home birth? So from a hospital OB/GYN, where do you fit in that? What would you suggest? I know a lot of JOBs are like, "Don't go to home."

D So yeah, so I personally I would TOLAC at home makes me nervous, but that's because I've seen uterine ruptures before and how quickly things can change. So but however, like in Canada, I think their specialty society guidelines support doing a TOLAC at home after one C-section. So it's not that it's unheard of, but I will say it makes me nervous. 

Now, if you do want to do it at home, then absolutely have someone who is experienced. This is not the time to have like a brand new midwife. I think you want to have somebody who has some experience in particular with looking for any signs and symptoms of when to go to the hospital. We also need a clear plan for hospital transfer and ideally, that midwife should have a relationship with the hospital so that she feels comfortable going to the hospital in a timely fashion. 

One of the things that I've seen unfortunately happened during my career with home births that have not turned out optimally is that people are afraid to go to the hospital, so they stay at home too often, and then by the time they get to the hospital it's a train wreck. That's not good for anybody involved. So you want it to be a situation where the midwife feels comfortable going to the hospital in a timely fashion. 

For example, I work with home birth me bias in my community. I have gone out to the birth centers and things and say, "Hey, if you want to transfer somebody, just let us know. Call."

Meagan: I love that you've done that.

Dr. Nicole Rankins: Yeah, it's, it's important. So call. Send the records. We have a really smooth process. Nobody bats an eye now when there's a transfer from home birth. 

Meagan: Oh good.

D; So you really want to have those two things in place. A skilled midwife and a good backup plan, preferably with the relationship to the hospital.

Meagan: I love that. Such great advice. That's awesome that you're doing that for your community. I just had an interview the other day with a VBAC mom who's toying with the idea, not sure where to go. She asked me and I was like, "Well, you could do dual care. You could establish a relationship with a provider. You can ask your provider out-of-hospital of choice if they do have that relationship," because I do think it is important because sometimes even the midwife is like, "I don't know where to go," so I love that you've done that and gone into the birth centers there. 

Okay. So we just talked about fetal monitoring, but one of the question was, is intermittent monitoring safe with VBAC just in general?

Dr. Nicole Rankins: Yeah. It hasn't really been studied very much, and it's not going to be. That's the thing. It's just not something that anybody's going to sign up for and say, "Hey, you get monitoring. You don't get monitoring," and see what happens in assess that situation for VBAC. So I can't answer that question based on data. I will just say that in general, we want to do continuous monitoring.

Meagan: Right. That makes sense. Okay, so small lumps under my C-section scar. What could that be? Would/could it impact the outcome of my VBAC?

Dr. Nicole Rankins: It's probably scar tissue.

Meagan: That's what I thought when I saw that question come in. I think that dials into like going and chatting with someone like askjanette or a pelvic floor PT or someone who can help massage that scar tissue because anytime we have a cut whether it be from a C-section or you fell and scraped your knee and cut your knee open on a rock or a twig, our body will develop scar tissue, and sometimes it clumps. Sometimes it gets that.

Dr. Nicole Rankins: It's probably just scar tissue. And no, it should not impact your ability to have a VBAC.

Meagan: Have you ever seen this within your TOLAC world, your VBAC world where sometimes we've got thicker scar tissue and sometimes there's separation within the scar tissue internally as babies coming down and making their way through or uterus is contracting? And so sometimes it can be like, oh my gosh, I've got this burning sensation in my scar which we hear, and it's like, that's concerning because we know that sometimes uterine rupture can be that feeling of burning sensation or pain, and usually that pain doesn't go away and just keeps improving. But have you ever seen that with someone and where they're like, "Oh, I've got this burning sensation," and could it be scar tissue stretching maybe?

Dr. Nicole Rankins: Not that I can think of off the top of my head. Definitely, sometimes you have to be careful when you hear people say they're Having pain in their abdomen. Could it be scar tissue stretching? Possibly. That's definitely a possibility.

Meagan: It's something that's crossed my mind, over all the years, especially as baby's coming down and putting that extra pressure there.

Dr. Nicole Rankins: Right.

Meagan: Okay. So again, yeah, this is something that we asked talked about earlier. So to what extent are decels considered normal in early and late labor? 

Dr. Nicole Rankins: We don't categorize decels based on the stage of labor necessarily. It's based on how they look, and again, over the course of how the tracing looks. Now sometimes right at the end, we're going to tolerate during pushing some decels, because you're pushing and squeezing, so there's going to be decels. So we may tolerate them more towards the end, but other than that, it really just depends.

Meagan: Okay, that makes sense. I feel like sometimes as a doula, we're getting into that transition, almost pushing stage and they come in and they're like, "Hey, so we're wondering if maybe you're ready to push here soon or something's going on based off of some decels." Not that they were concerning, but they're seeing them. But really decels in general, overall, you're going to look at a whole versus one contraction or two contractions.

Dr. Nicole Rankins: Yep.

Meagan: Okay. PROM. So premature rupture of membranes and pre-e with VBAC it says is it still safe? I will answer from my own experience.

Dr. Nicole Rankins: Yes, absolutely.

Meagan: Yeah, but yeah, time too, with PROM So if we're not having labor begin or we're maybe contracting, like what's handled in that situation, especially knowing that in some hospitals around the world and in the US don't allow Pitocin?

Dr. Nicole Rankins: Right, yeah.

Meagan: Even though that's also not necessarily a contraindication.

Dr. Nicole Rankins: Correct. So with PROM, so water breaking before labor starts, it's not as common, but it does happen. You can do expectant management and roughly within 24 hours, most people will start to go into labor on their own. So you can do expectant management, but Pitocin is actually quite safe in those circumstances. The risk of uterine rupture is low. So Pitocin can definitely be used. You just want to use it carefully.

Meagan: Yeah. You mentioned that most people within 24 hours will start contracting and having labor, whether it be active at that point or not. But at what point could it be concerning? And maybe if we have GBS or something like that as a factor, would we be like, "Hey, we could keep waiting for the 24-hour mark," and that's not to go in and have a C-section, that's just maybe to augment. When would you encourage augmentation sooner?

Dr. Nicole Rankins: So I'm a little bit of an outlier. I just offer the options, and we can talk about that it may take longer if you wait to augment and that's it. It may take longer, and that's it. That can potentially increase the risk of infection. But we don't really do time limits. I don't do 18 hours or 24 hours. I kind of pick. These are moments for us to have discussions about where things are. So definitely usually 6, 12, 18, 24 and just to touch base and see where things are and develop an ongoing plan. Not necessarily have a hard and fast rule that you have to be delivered or by a certain point makes sense.

Meagan: And then preeclampsia. So we have seen this quite a bit in our community, on Facebook and on Instagram where they said, "Hey." There was a post just the other day that said, "Hey ladies, I just wanted to thank you so much for being here in this group. You guys have been amazing. Unfortunately, I have to sign off of this group because my provider said I have to have a C-section now because I've developed preeclampsia," so they didn't even offer the option to TOLAC or monitor. And everyone's like, "Wait, what?" This is a thing? 

So obviously, we know that we can, and everyone's numbers vary. If we've got severe preeclampsia and maybe that's not gonna be best for the stress of mom and baby and everybody, but do you have anything to say on that? I don't really know if I'm asking a question.

Dr. Nicole Rankins: But yeah, no. You can definitely try for a TOLAC in the setting of preeclampsia. Now, if even in severe preeclampsia, it just may take longer. But if we're seeing that you're getting sicker and labor isn't progressing or the baby is under distress, then the safer thing may be a C-section. So if you have severe preeclampsia, for example, and it's affecting your liver and your levels of your liver enzymes are going up, up, up, up, up, and we're not close to delivery, then it's going to be safer for your health to expedite birth, and that's going to be a C-section. So it really depends.

But the option of completely taking it off the table, that is not standard or that's not evidence-based.

Meagan: Yeah, yeah. And for HELPP syndrome, where it's gone to that extreme. Now we've got platelet issues and things like that. Can someone with HELPP syndrome TOLAC or is that truly a better option to have a C-section?

Dr. Nicole Rankins: I would actually prefer if someone ideally is in labor with HELPP syndrome. Actually, a vaginal birth is going to be safer because when your platelets are low and then we're adding surgery, the risk bleeding goes up.

Meagan: That is what is so weird to me. My fifth birth was a HELPP syndrome. She was a VBAC, and they're like, "You have to have a scheduled C-section." But then we did all these transfusions and all these things and in my head, I was like, but isn't platelet meaning we have a higher risk of bleeding? 

But so yeah, that's another question.

Okay, I think there's only one or two maybe. Oh, this is a really great question. Is it safe to TOLAC? So again, listeners, TOLAC, if that's new for you, is a trial of labor after Cesarean. I know I've thrown it out a couple times this podcast. 

After having a hemorrhage in a C-section. So had a C-section hemorrhaged. Now they're wanting to TOLAC. Is that considered safe?

Dr. Nicole Rankins: Sure.

Meagan: Okay.

Dr. Nicole Rankins: Okay. I want to discourage people from using the word "safe" because I think what you really want to know is what are the risks of something happening again? So yeah, because what do you mean by safe?

Meagan: Right.

Dr. Nicole Rankins: What you really want to know is what are the risks of this thing happening again? So there are no identified increased risks in having a TOLAC after you had a postpartum hemorrhage during a previous C-section.

Meagan: Okay, I love that. So that's good because I mean anytime anyone hemorrhages with birth, I feel like it's a little bit on everyone's radar.

Dr. Nicole Rankins: Right. Okay, and then I have one more question for you before I let you go, and I don't know if it's Bandl's ring or Bandl's. How do you say that?

Meagan: Yeah, Bandl's ring. What is a Bandl's ring for those who it's very new to, and then can you TOLAC or have a VBAC with Bandls ring?

Dr. Nicole Rankins: It's a really tight ring of muscle in the uterus where it's just really tight, and it doesn't contract. I can only recall seeing it, like, once in 22 years, so it's not common.

Meagan: It's more rare.

Dr. Nicole Rankins: Yes, very rare. So it's just really hard to have a vaginal birth if there's a really tight ring of tissue that is preventing the uterus from opening. If the uterus can't open, then the baby can't come out. So that's the issue. It's not like we can release it or clear it up or anything. I don't know why. We don't know why it develops, but it's just, like anything, if it's tightly closed, it's really difficult to open.

Meagan: Yeah. Okay. That makes so much sense. And is there a way to find out if we have that beforehand?

Dr. Nicole Rankins: Not really.

Meagan: Not really. Okay. And the signs of that Bandl's ring is just lack of progression it seems like.

Dr. Nicole Rankins: Overall, it seems like lack of progression. And also, the baby usually doesn't come down in the pelvis.

Meagan: Yes. Yeah. Okay. Thank you. That was a one-off random one that crossed my mind. I keep seeing that one too. 

Anything else that you'd like to touch on? I love all of your points of stop considering the word safe and talk about, what are the risks here? What do we need to know to make the best educated decision? Having a collaborative discussion and relationship with our provider. So many great points along the way. 

Anything else that you'd like to add or say to the community to someone who really is wanting to know all the information they can to VBAC and are unsure of which way to go?

Dr. Nicole Rankins: I think that the best thing is just to really find a supportive provider, doctor, midwife, and do that in the prenatal appointments. Ask those questions early, and don't be afraid to change to someone else if you feel. And sometimes you may not have options, but if you have options, then find someone who is the most appropriate for you because that is going to be the thing that most sets you up for success. Oh, also, get a doula.

Meagan: Hey. I love it. I will never not advocate for doula, but really, I mean, I love that you're pointing it out again. Before birth, early on, ask those questions. Always have a conversation with your provider. If something is switching, it's okay to switch. I know it's daunting. It is daunting. It really is. I didn't want to cheat. I felt I was cheating on this doctor. We had this relationship. I don't even know what I thought. I thought I was cheating on him by leaving him. And I didn't leave him, and I didn't find myself having the experience that I wanted or feel like I deserved. And, looking back, I probably should have switched. Well, I didn't. I have learned, but I don't want anyone else to be in that situation of, dang it, I saw all the red flags, and I didn't switch because I felt bad.

Dr. Nicole Rankins: Yeah. Yeah. I don't mean to sound flippant, but I can guarantee you. Your doctor, if you leave, they're just gonna keep seeing patients. They're just going to go home and keep living their lives. It's going to be fine.

Meagan: I know. I had a friend, and she was like, "Looking back, do you realize how it wouldn't have impacted his life at all?" And I was like, "Yes. But in my mind, I had a deeper connection."

Dr. Nicole Rankins: I know. In the moment, you can't because you have that emotional connection, and you care about those things? So that's totally natural.

Meagan: Yeah. And in a lot of ways, he was saying, "Yeah, sure. I'll support you." But then in a lot of other ways, he wasn't saying this with his words, but he was saying, "No, that's not my thing."

Dr. Nicole Rankins: Right.

Meagan: So, yeah, you deserve the best and keep doing your research. Find the provider. Get a doula, hands-down. Just a reminder, everybody, we have VBAC-certified doulas on our website all over the world. And yeah, thank you so much. You're the best. And everyone, go follow her podcast and wait it out for these new updates. Yes.

Dr. Nicole Rankins: Yes, these new updates are so exciting. I'm so excited.

Meagan: I'm so excited for you. That's so awesome. You are just incredible. We really enjoy you. So, thank you.

Dr. Nicole Rankins: Thank you so much for having me. 

Closing

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

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Originally aired in June 2019 as our 73rd episode, we still often think back to this amazing first conversation we had with Dr. Stuart Fischbein and Midwife Blyss Young!

Now, almost 6 years later, the information is just as relevant and impactful as it was then. This episode was a Q&A from our Facebook followers and touches on topics like statistics surrounding VBAC, uterine rupture, uterine abnormalities, insurance companies, breech vaginal delivery, high-risk pregnancies, and a powerful analogy about VBACs and weddings!

Birthing Instincts Patreon

Birthing Blyss

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hey, guys. This is one of our re-broadcasted episodes. This is an episode that, in my opinion, is a little gem in the podcast world of The VBAC Link. I really have loved this podcast ever since the date we recorded it. I am a huge fan of Dr. Stu Fischbein and Midwife Blyss and have been since the moment I knew that they existed. I absolutely love listening to their podcast and just all of the amazing things that they have and that they offer. So I wanted to rebroadcast this episode because it was quite down there. It was like our 73rd episode or something like that. And yeah, I love it so much. 

This week is OB week, and so I thought it'd be fun to kick-off the week with one of my favorite OB doctor's, Stuart Fischbein. So, a little recap of what this episode covers. We go over a lot. We asked for our community to ask questions for these guys, and we went through them. We didn't get to everything, so that was a bummer, but we did get to quite a bit. We talked about things like the chances of VBAC. We talked about the chances of uterine rupture and the signs of uterine rupture. We talked about inducing VBAC. We talked about uterine abnormalities, the desire of where you want to birth and figuring that out. 

And also, Blyss had a really great analogy to talk about what to do and how we're letting the medical world and insurance and things like that really contemplate where we or dictate where we are birthing. I love that analogy. You guys, seriously, so many questions. It's an episode that you'll probably want to put on repeat because it really is so great to listen to them, and they just speak so directly. I can't get enough of it. So I'm really excited for you guys to dive in today on this. 

However, I wanted to bring to your attention a couple of the new things that they've had since we recorded this way back when. I also wanted to point out that we will have updated notes in the show notes or updated links in the show notes so you can go check, them out. But one of the first things I wanted to mention was their Patreon. They have a Patreon these days, and I think that it just sounds dreamy. I think you should definitely go find in their Patreon their community through their Patreon. 

You can check it out at patreon.com, birthinginsinctspodcast.com and of course, you can find them on social media. You can find Dr. Stu at Birthing Instincts or his website at birthinginsincts.com. You can find Blyss and that is B-L-Y-S-S if you are looking for her at birthingblyss on Instagram or birthinblyss.com, and then of course, you can email them. They do take emails with questions and sometimes they even talk about it on their podcast. Their podcast is birthinginsinctspodcast.com, and then you can email them at [email protected], so definitely check them out. 

Also, Dr. Stu offers some classes and workshops and things like that throughout the years on the topic of breech. You guys, I love them and really can't wait for you to listen to today's episode.

Ladies, I cannot tell you how giddy and excited I have been for the last couple weeks since we knew that these guys were going to record with us. But we have some amazing, special guests today. We have Dr. Stuart Fischbein and Midwife Blyss Young, and we want to share a little bit about them before we get into the questions that all of you guys have asked on our social media platforms.

Julie: Absolutely. And when Meagan says we're excited, we are really excited.

Meagan: My face is hot right now because I’m so excited.

Julie: I'm so excited. Meagan was texting me last night at 11:00 in all caps totally fan-girling out over here. So Dr. Stu and midwife Blyss are pretty amazing and we know that you are going to love them just as much as we do. But before we get into it, and like Meagan said, I'm just going to read their bios so you can know just how legit they really are. 

First, up. Dr. Stuart Fischbein, MD is a fellow of the American College of Obstetrics and Gynecology, and how much we love ACOG over here at The VBAC Link He's a published author of the book Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife, and a Mom. He has peer-reviewed papers Home Birth with an Obstetrician, A Series of 135 Out-of-Hospital Births and Breech Births at Home, Outcomes of 60 Breech and 109 Cephalic Planned Home and Birth Center Births. Dr. Stu is a lecturer and advocate who now works directly with home birthing midwives. His website is www.birthinginsincts.com, and his podcast is Dr. Stu's Podcast. Seriously guys, you need to subscribe.

Meagan: Go subscribe right now to their podcast.

Yeah. 

The website for his podcast is drstuspodcast.com. He has an international following. He offers hope for women who cannot find supportive practitioners for VBAC and twin and breech deliveries. Guys, this is the home birth OB. He is located in California. So if you are in California hoping for VBAC, especially if you have any special circumstance like after multiple Cesareans, twins or breech presentation, run to him. Run. Go find him. He will help you. Go to that website. 

Blyss, Midwife Blyss. We really love them. If you haven't had a chance to hear their podcast guys, really go and give them a listen because this duo is on point. They are on fire, and they talk about all of the real topics in birth. 

So his partner on the podcast is Blyss Young, and she is an LM and CPM. She has been involved in the natural birth world since the birth of her first son in 1992, first as an advocate, and then as an educator. She is a mother of three children, and all of her pregnancies were supported by midwives, two of which were triumphant, empowering home births. In 2006, Blyss co-founded the Sanctuary Birth and Family Wellness Center. This was the culmination of all of her previous experience as a natural birth advocate, educator and environmentalist. The Sanctuary was the first of its kind, a full-spectrum center where midwives, doctors, and other holistic practitioners collaborated to provide thousands of Los Angeles families care during their prenatal and postpartum periods. 

Blyss closed the Sanctuary in 2015 to pursue her long-held dream of becoming a midwife and care for her clients in an intimate home birth practice similar to the way she was cared for during her pregnancies. I think that's , why Meagan and I both became doulas. 

Meagan: That's exactly why I'm a doula. 

Julie: We needed to provide that care just like we had been cared for. 

Anyway, going on. Currently, Blyss, AKA Birthing Blyss, supports families on their journey as a birth center educator, placenta encapsulator and a natural birth and family consultant and home birth midwife. She is also co-founder of Just Placentas, a company servicing all of Southern California and placenta encapsulation and other postpartum services. And as ,, she's a co-host on Dr. Stu's Podcast. 

Meagan: And she has a class. Don't you have a class that you're doing? Don't you have a class? 

Midwife Blyss: Yeah. 

Meagan: Yeah. She has a class that she's doing. I want to just fly out because I know you're not doing it online and everything. I just want to fly there just to take your class.

Midwife Blyss: Yeah, it's coming online.

Meagan: It is? Yay! Great. Well, I'll be one of those first registering. Oh, did you put it in there?

Julie: No, there's a little bit more.

Meagan: Oh, well, I'm just getting ahead.

Julie: I just want to read more of Blyss over here because I love this and I think it's so important. At the heart of all Blyss's work is a deep-rooted belief in the brilliant design of our bodies, the symbiotic relationship between baby and mother, the power of the human spirit and the richness that honoring birth as the rite of passage and resurrecting lost traditions can bring to our high-tech, low-touch lives. And isn't that true love? I love that language. It is so beautiful. If I'm not mistaken, Midwife Blyss's website is birthingblyss.com.

Is that right? And Blyss is spelled with a Y. So B-L-Y-S-S, birthingblyss.com, and that's where you can find her.

Midwife Blyss: Just to make it more complicated, I had to put a Y in there.

Julie: Hey. I love it.

Meagan: That's okay.

Julie: We're in Utah so we have all sorts of weird names over here.

Meagan: Yep. I love it. You're unique. Awesome. Well, we will get started.

Midwife Blyss: I did read through these questions, and one of the things that I wanted to say that I thought we could let people know is that of course there's a little bit more that we need to take into consideration when we have a uterus that's already had a scar.

There's a small percentage of a uterine rupture that we need to be aware of, and we need to know what are the signs and symptoms that we would need to take a different course of action. But besides that, I believe that, and Dr. Stu can speak for himself because we don't always practice together. I believe that we treat VBAC just like any other mom who's laboring. So a lot of these questions could go into a category that you could ask about a woman who is having her first baby. I don't really think that we need to differentiate between those.

Meagan: I love it. 

Midwife Blyss: But I do think that in terms of preparation, there are some special considerations for moms who have had a previous Cesarean, and probably the biggest one that I would point to is the trauma.

Julie: Yes.

Midwife Blyss: And giving space to and processing the trauma and really helping these moms have a provider that really believes in them, I think is one of the biggest factors to them having success. 

Meagan: Absolutely. 

Midwife Blyss: So that's one I wanted to say before you started down the question.

Meagan: Absolutely. We have an online class that we provide for VBAC prep, and that's the very first section. It's mentally preparing and physically preparing because there's so much that goes into that. So I love that you started out with that.

Julie: Yeah. A lot of these women who come searching for VBAC and realize that there's another way besides a repeat Cesarean are processing a lot of trauma, and a lot of them realized that their Cesarean might have been prevented had they known better, had a different provider, prepared differently, and things like that. Processing that and realizing that is heavy, and it's really important to do before getting into anything else, preparation-wise.

Meagan: Yeah.

Midwife Blyss: One of the best things I ever had that was a distinction that one of my VBAC moms made for me, and I passed it on as I've cared for other VBAC mom is for her, the justification, or I can't find the right word for it, but she basically said that that statement that we hear so often of, "Yeah, you have trauma from this, or you're not happy about how your birth went, but thank God your baby is healthy." And she said it felt so invalidating for her because, yes, she also was happy, of course, that her baby was safe, but at the same time, she had this experience and this trauma that wasn't being acknowledged, and she felt like it was just really being brushed away.

Julie: Ah, yeah.

Midwife Blyss: I think really giving women that space to be able to say, "Yes, that's valid. It's valid how you feel." And it is a really important part of the process and having a successful vaginal delivery this go around.

Dr. Stu: I tend to be a lightning rod for stories. It's almost like I have my own personal ICAN meeting pretty much almost every day, one-on-one. I get contacted or just today driving. I'm in San Diego today and just driving down here, I talked to two people on the phone, both of whom Blyss really just touched on it is that they both are wanting to have VBACs with their second birth. 

They were seeing practitioners who are encouraging them to be induced for this reason or that reason. And they both have been told the same thing that Blyss just mentioned that if you end up with a repeat Cesarean, at least you're going to have a healthy baby. Obviously, it's very important. But the thing is, I know it's a cliche, but it's not just about the destination. It's about the journey as well. 

And one of the things that we're not taught in medical school and residency program is the value of the process. I mean, we're very much mechanical in the OB world, and our job is to get the baby out and head it to the pediatric department, and then we're done with it. If we can get somebody induced early, if we can decide to do a C-section sooner than we should, there's a lot of incentives to do that and to not think about the process and think about the person. 

There's another cliche which we talk about all the time. Blyss, and I've said it many times. It's that the baby is the candy and the mother's the wrapper. I don't know if you've heard that one, but when the baby comes out, the mother just gets basically tossed aside and her experience is really not important to the medical professionals that are taking care of her in the hospital setting, especially in today's world where you have a shift mentality and a lot of people are being taken care of by people they didn't know.

You guys mentioned earlier the importance of feeling safe and feeling secure in whatever setting you're in whether that's at home or in the hospital. Because as Blyss knows, I get off on the mammalian track and you talk about mammals. They just don't labor well when they're anxious.

Julie: Yep.

Dr. Stu: When the doctor or the health professional is anxious and they're projecting their anxiety onto the mom and the family, then that stuff is brewing for weeks, if not months and who knows what it's actually doing inside, but it's certainly not going to lead to the likelihood of or it's going to diminish the likelihood of a successful labor.

Julie: Yeah, absolutely. We talk about that. We go over that a lot. Like, birth is very instinctual and very primal, and it operates a very fundamental core level. And whenever mom feels threatened or anxious or, or anything like that, it literally can st or stop labor from progressing or even starting.

Meagan: Yeah, exactly. When I was trying to VBAC with my first baby, my doctor came in and told my husband to tell me that I needed to wake up and smell the coffee because it wasn't happening for me. And that was the last, the last contraction I remember feeling was right before then and my body just shut off. I just stopped because I just didn't feel safe anymore or protected or supported. Yeah, it's very powerful which is something that we love so much about you guys, because I don't even know you. I've just listened to a million of your podcasts, and I feel so safe with you right now. I'm like, you could fly here right now and deliver my baby because so much about you guys, you provide so much comfort and support already, so I'm sure all of your clients can feel that from you.

Julie: Absolutely.

Dr. Stu: Yeah. I just would like to say that, know, I mean, the introduction was great. Which one of you is Julie? Which one's Meagan?

Julie: I'm Julie.

Meagan: And I'm Meagan.

Dr. Stu: Okay, great. All right, so Julie was reading the introduction that she was talking about how if you have a breech, you have twins, if you have a VBAC, you have all these other things just come down to Southern California and care of it. But I'm not a cowboy. All right? Even though I do more things than most of my colleagues in the profession do, I also say no to people sometimes. I look at things differently. Just because someone has, say chronic hypertension, why can't they have a home birth? The labor is just the labor. I mean, if her blood pressure gets out of control, yeah, then she has to go to the hospital. But why do you need to be laboring in the hospital or induced early if everything is fine? But this isn't for everybody.

We want to make that very clear. You need to find a supportive team or supportive practitioner who's willing to be able to say yes and no and give you it with what we call a true informed consent, so that you have the right to choose which way to go and to do what's reasonable. Our ethical obligation is to give you reasonable choices and then support your informed decision making. 

And sometimes there are things that aren't reasonable. Like for instance, an example that I use all the time is if a woman has a breech baby, but she has a placenta previa, a vaginal delivery is not an option for you. Now she could say, well, I want one and I'm not going to have a C-section.

Julie: And then you have the right to refuse that.

Dr. Stu: Yeah, yeah, but I mean, that's never going to happen because we have a good communication with our patients. Our communication is such that we develop a trust over the period of time. Sometimes I don't meet people until I'm actually called to their house by a midwife to come assist with a vacuum or something like that. But even then, the midwives and stuff, because I'm sort of known that people have understanding. And then when I'm sitting there, as long as the baby isn't trouble, I will explain to them, here's what's going to happen. Here's how we're going to do it. Here's what's going on. The baby's head to look like this. It not going be a problem. It'll be better in 12 hours. 

But I go through all this stuff and I say, I'm going to touch you now. Is that okay? I ask permission, and I do all the things that the midwives have taught me, but I never really learned in residency program. They don't teach this stuff.

Julie: Yeah, yeah, yeah, absolutely. One of the things that we go over a lot to in our classes is finding a provider who has a natural tendency to treat his patients the way that you want to be treated. That way, you'll have a lot better time when you birth because you're not having to ask them to do anything that they're not comfortable with or that they're not prepared for or that they don't know how to do. And so interviewing providers and interview as many as you need to with these women. And find the provider whose natural ways of treating his clients are the ways that you want to be treated.

Dr. Stu: And sometimes in a community, there's nobody.

Julie: Yeah, yeah, that's true.

Meagan: That's what's so hard.

Dr. Stu: And if it's important to you, if it's important to you, then you have to drive on. 

Julie: Or stand up for yourself and fight really hard.

Meagan: I have a client from Russia. She's flying here in two weeks. She's coming all the way to Salt Lake City, Utah to have her baby. We had another client from Russia.

Julie: You have another Russian client?

Meagan: Yeah. 

Julie: That's awesome. 

Meagan: So, yeah. It's crazy. Sometimes you have to go far, far distances, and sometimes you've got them right there. You just have to search. You just have to find them.

So it's tricky.

Midwife Blyss: Maybe your insurance company is not gonna pay for it.

Meagan: Did you say my company's not gonna pay for it?

Midwife Blyss: And maybe your insurance company.

Meagan: Oh, sure. Yeah, exactly.

Midwife Blyss: You can't rely on them to be the ones who support some of these decisions that are outside of the standards of care. You might have to really figure out how to get creative around that area.

Meagan: Absolutely.

Yeah. So in the beginning, Blyss, you talked about noticing the signs, and I know that's one of the questions that we got on our Instagram, I believe. Birthing at home for both of you guys, what signs for a VBAC mom are signs enough where you talk about different care?.

Dr. Stu: I didn't really understand that. Say that again what you were saying.

Meagan: Yep. Sorry. So one of the questions on our Instagram was what are the signs of uterine rupture when you're at home that you look for and would transfer care or talk about a different plan of action?

Dr. Stu: Okay. Quite simply, some uterine ruptures don't have any warning that they're coming.

There's nothing you can do about those. But before we get into what you can feel, just let's review the numbers real briefly so that people have a realistic viewpoint. Because I'm sure if a doctor doesn't want to do a VBAC, you'll find a reason not to do a VBAC. You'll use the scar thickness or the pregnancy interval or whatever. They'll use something to try to talk you out of it or your baby's too big or this kind of thing. We can get into that in a little bit. 

But when there are signs, the most common sign you would feel is that there'd be increasing pain super-cubically that doesn't go away between contractions. It's a different quality of pain or sensation. It's pain. It's really's becoming uncomfortable. You might start to have variables when you didn't have them before. So the baby's heart rate, you might see heart rate decelerations. Rarely, you might find excessive bleeding, but that's usually not a sign of I mean that's a sign of true rupture.

Midwife Blyss: Loss of station.

Dr. Stu: Those are things you look for, but again, if you're not augmenting someone, if someone doesn't have an epidural where they don't have sensation, if they're not on Pitocin, these things are very unlikely to happen. I was going to get to the numbers. The numbers are such that the quoted risk of uterine rupture, which is again that crappy word. It sounds like a tire blowing out of the freeway. It is about 1 in 200. But only about 5 to 16%. And even one study said 3%. But let's just even take 16% of those ruptures will result in an outcome that the baby is damaged or dead. Okay, that's about 1 in 6. So the actual risk is about 1 in 6 times 1 in 200 or 1 in 1200 up to about 1 in 4000.

Julie: Yep.

Dr. Stu: So those are, those are the risks. They're not the 1 in 200 or the 2%. I actually had someone tell some woman that she had a 30% chance of rupture.

Julie: We've had somebody say 50%.

Meagan: We have?

Julie: Yeah. Jess, our 50 copy editor-- her doctor told her that if she tries to VBAC, she has a 50% chance of rupture and she will die. Yeah.

Meagan: Wow.

Julie: Pretty scary. 

Dr. Stu: And by the way, a maternal mortality from uterine rupture is extremely rare.

Julie: Yeah, we were just talking about that.

Dr. Stu: That doctor is wrong on so many accounts. I don't even know where to begin on that.

Julie: I know.

Dr. Stu: Yeah. See that's the thing where even if someone has a classical Cesarean scar, the risk of rupture isn't 50%.

Julie: Yep.

Dr. Stu: So I don't know where they come up with those sorts of numbers.

Julie: Yeah, I think it's just their comfort level and what they're familiar with and what they know and what they understand. I think a lot of these doctors, because she had a premature Cesarean, and so that's why he was a little, well, a lot more fear-based. Her Cesarean happened, I think, around 32 weeks. We still know that you can still attempt to VBAC and still have a really good chance of having a successful one. But a lot of these providers just don't do it.

Dr. Stu: Yeah. And another problem is you can't really find out what somebody's C-section rate is. I mean, you can find out your hospital C-section rate. They can vary dramatically between different physicians, so you really don't know. You'd like to think that physicians are honest. You'd like to think that they're going to tell you the truth. But if they have a high C-section rate and it's a competitive world, they're not going to. 

And if you're with them, you don't really have a choice anyway.

Julie: So there's not transparency on the physician level.

Dr. Stu: So Blyss was talking briefly about the fact that your insurance may not pay for it. Blyss, why don't you elaborate on that because you do that point so well.

Midwife Blyss: Are you talking about the wedding?

Dr. Stu: I love your analogy. It's a great analogy.

Midwife Blyss: I'm so saddened sometimes when people talk to me about that they really want this option and especially VBACs. I just have a very special tender place in my heart for VBAC because I overcame something from my first to second birth that wasn't a Cesarean. But it felt like I had been led to mistrust my body, and then I had a triumphant second delivery. So I really understand how that feels when a woman is able to reclaim her body and have a vaginal delivery. But just in general, in terms of limiting your options based on what your insurance will pay for, we think about the delivery of our baby and or something like a wedding where it's this really special day. I see that women or families will spend thousands and thousands of dollars and put it on a credit card and figure out whatever they need to do to have this beautiful wedding. 

But somehow when it comes to the birth of their baby, they turn over all their power to this insurance company.

And so we used to do this talk at the sanctuary and I used to say, "What if we had wedding insurance and you paid every year into this insurance for your wedding, and then when the wedding came, they selected where you went and you didn't like it and they put you in a dress that made you look terrible and the food was horrible and the music was horrible and they invited all these people you didn't want to be there?"

Julie: But it's a network.

Midwife Blyss: Would you really let that insurance company, because it was paid for, dictate how your wedding day was? 

Julie: That's a good analogy.

Midwife Blyss: You just let it all go.

Meagan: Yeah. That's amazing. I love that. And it's so true. It is so true.

Julie: And we get that too a lot about hiring a doula. Oh, I can't hire a doula. It's too expensive. We get that a lot because people don't expect to pay out-of-pocket for their births. When you're right, it's just perceived completely differently when it should be one of the biggest days of your life. I had three VBACs at home. My first was a necessary, unnecessary Cesarean.

I'm still really uncertain about that, to be honest with you. But you better believe my VBACs at home, we paid out of pocket for a midwife. Our first two times, it was put on a credit card. I had a doula, I had a birth photographer, I had a videographer. My first VBAC, I had two photographers there because it was going to be documented because it was so important to me. And we sold things on eBay. We sold our couches, and I did some babysitting just to bring in the money.

Obviously, I hired doulas because it was so important to me to not only have the experience that I wanted and that I deserved, but I wanted it documented and I wanted it to be able to remember it well and look back on it fondly. We see that especially in Utah. I think we have this culture where women just don't-- I feel like it's just a national thing, but I think in Utah, we tend to be on the cheap side just culturally and women don't see the value in that. 

It's hard because it's hard to shift that mindset to see you are important. You are worth it. What if you could have everything you wanted and what if you knew you could be treated differently? Would you think about how to find the way to make that work financially? And I think if there's just that mindset shift, a lot of people would.

Meagan: Oh, I love that.

Dr. Stu: If you realize if you have to pay $10,000 out of pocket or $5,000 or whatever to at least have the opportunity, and you always have the hospital as a backup. But 2 or 3 years from now, that $5,000 isn't going to mean anything.

Julie: Yeah, nothing.

Meagan: But that experience is with you forever.

Dr. Stu: So yeah, women may have to remember the names of their children when they're 80 years old, but they'll remember their birth.

Julie: Well, with my Cesarean baby, we had some complications and out-of-pocket, I paid almost $10,000 for him and none of my home births, midwives, doula, photography and videography included cost over $7,000.

Meagan: My Cesarean births in-hospital were also more expensive than my birth center births.

Julie: So should get to questions.

Dr. Stu: Let's get to some of the questions because you guys some really good questions.

Meagan: Yes.

Dr. Stu: Pick one and let's do it.

Meagan: So let's do Lauren. She was on Facebook. She was our very first question, and she said that she has some uterine abnormalities like a bicornuate uterus or a separate uterus or all of those. They want to know how that impacts VBAC. She's had two previous Cesareans due to a breech presentation because of her uterine abnormality.

Julie: Is that the heart-shaped uterus? Yeah.

Dr. Stu: Yeah. You can have a septate uterus. You can have a unicornuate uterus. You can have a double uterus.

Julie: Yeah. Two separate uteruses.

Dr. Stu: Right. The biggest problem with a person with an abnormal uterine shape or an anomaly is a couple of things. One is malpresentation as this woman experienced because her two babies were breech. And two, is sometimes a retained placenta is more common than women that have a septum, that sort of thing. Also, it can cause preterm labor and growth restriction depending on the type of anomaly of the uterus. 

Now, say you get to term and your baby is head down, or if it's breech in my vicinity. But if it's head down, then the chance of VBAC for that person is really high. I mean, it might be a slightly greater risk of Cesarean section, but not a statistically significant risk. And then the success rate for home birth VBACs, if you look at the MANA stats or even my own stats which are not enough to make statistical significance in a couple of papers that I put out, but the MANA stats show that it's about a 93% success rate for VBACS in the midwifery model, whereas in the hospital model, it can be as low as 17% up to the 50s or 60%, but it's not very high. 

And that's partly because of the model by which you're cared for. So the numbers that I'm quoting and the success rates I'm quoting are again, assuming that you have a supportive practitioner in a supportive environment, every VBAC is going to have diminished chance of success in a restrictive or tense environment. But unicornuate uterus or septate uterus is not a contraindication to VBAC, and it's not an indication of breech delivery if somebody knows how to do a breech VBAC too.

Julie: Right.

Dr. Stu: So Lauren, that would be my answer to to your question is that no, it's not a contraindication and that if you have the right practitioner you can certainly try to labor and your risk of rupture is really not more significant than a woman who has a normal-shaped uterus.

Julie: Good answer.

Meagan: So I want to spin off that really quick. It's not a question, but I've had a client myself that had two C-sections, and her baby was breech at 37 weeks, and the doctor said he absolutely could not turn the baby externally because her risk of rupture was so increasingly high. So would you agree with that or would you disagree with that?

D No, no, no. Even an ACOG statement on external version and breech says that a previous uterine scar is not a contraindication to attempting an external version.

Meagan: Yeah.

Dr. Stu: Now actually, if we obviously had more breech choices, then there'd be no reason to do an external version.

The main reason that people try an external version which can sometimes be very uncomfortable, and depending on the woman and her parody and certain other factors, their success rate cannot be very good is the only reason they do it because the alternative is a Cesarean in 95% of locations in the country.

Meagan: Okay, well that's good to know.

Dr. Stu: But again, one of the things I would tell people to do is when they're hearing something from their position that just sort of rocks the common sense vote and doesn't sort of make sense, look into it. ACOG has a lot. I think you can just go Google some of the ACOG clinical guidelines or practice guidelines or clinical opinions or whatever they call them. You can find and you can read through, and they summarize them at the end on level A, B, and C evidence, level A being great evidence level C being what's called consensus opinion. The problem with consensus, with ACOG's guidelines is that about 2/3 of them are consensus opinion because they don't really have any data on them. When you get bunch of academics together who don't like VBAC or don't like home birth or don't like breech, of course a consensus opinion is going to be, "Well, we're not going to think those are a good idea." 

But much to their credit lately, they're starting to change their tune. Their most recent VBAC guideline paper said that if your hospital can do labor and delivery, your hospital can do VBAC.

Julie: Yes.

Dr. Stu: That's huge. There was immediately a whole fiasco that went on. So any hospital that's doing labor and delivery should be able to do a VBAC. When they say they can't or they say our insurance company won't let them, it's just a cowardly excuse because maybe it's true, but they need to fight for your right because most surgical emergencies in labor delivery have nothing to do with a previous uterine scar.

Julie: Absolutely.

Dr. Stu: They have to do with people distress or placental abruption or cord prolapse. And if they can handle those, they can certainly handle the one in 1200. I mean, say a hospital does 20 VBACs a year or 50 VBACs a year. You'll take them. Do the math. It'll take them 25 years to have a rupture.

Meagan: Yeah. It's pretty powerful stuff.

Midwife Blyss: I love when he does that.

Julie: Me too. I'm a huge statistics junkie and data junkie. I love the numbers.

Meagan: Yeah. She loves numbers.

Julie: Yep.

Meagan: I love that.

Julie: Hey, and 50 VBACs a year at 2000, that would be 40 years actually, right?

Dr. Stu: Oh, look at what happened. So say that again. What were the numbers you said?

Julie: So 1 in 2000 ruptures are catastrophic and they do 50 VBACs a year, wouldn't that be 40 years?

Dr. Stu: But I was using the 1200 number.

Julie: Oh, right, right, right, right.

Dr. Stu: So that would be 24 years.

Julie: Yeah. Right. Anyways, me and you should sit down and just talk. One day. I would love to have lunch with you.

Dr. Stu: Let's talk astrology and astronomy.

Yes.

Dr. Stu: Who's next?

Midwife Blyss: Can I make a suggestion?

There was another woman. Let's see where it is. What's the likelihood that a baby would flip? And is it reasonable to even give it a shot for a VBA2C. How do you guys say that?

Meagan: VBAC after two Cesareans.

Midwife Blyss: I need to know the lingo. So, I would say it's very unlikely for a baby to flip head down from a breech position in labor. It doesn't mean it's impossible.

Dr. Stu: With a uterine septum, it's almost never going to happen. Bless is right on. Even trying an external version on a woman with the uterine septum when the baby's head is up in one horn and the placenta in the other horn and they're in a frank breech position, that's almost futile to do that, especially if a woman is what I call a functional primary, or even a woman who's never labored before.

Julie: Right. That's true.

Meagan: And then Napoleon said, what did she say? Oh, she was just talking about this. She's planning on a home birth after two Cesareans supported by a midwife and a doula. Research suggests home birth is a reasonable and safe option for low-risk women. And she wants to know in reality, what identifies low risk?

Midwife Blyss: Well, I thought her question was hilarious because she says it seems like everybody's high-risk too. Old, overweight.

Julie: Yeah, it does. It does, though.

Dr. Stu: Well, immediately, when you label someone high-risk, you make them high-risk.

Julie: Yep.

Dr. Stu: Because now you've planted seeds of doubt inside their head. So I would say, how do you define high-risk? I mean, is 1 in 1200 high risk?

Julie: Nope.

Dr. Stu: It doesn't seem high-risk to me. But again, I mean, we do a lot of things in our life that are more dangerous than that and don't consider them high-risk. So I think the term high-risk is handed about way too much.

And it's on some false or just some random numbers that they come up with. Blyss has heard this before. I mean, she knows everything I say that comes out of my mouth. The numbers like 24, 35, 42. I mean, 24 hours of ruptured membranes. Where did that come from? Yeah, or some people are saying 18 hours. I mean, there's no science on that. I mean, bacteria don't suddenly look at each other and go, "Hey Ralph, it's time to start multiplying."

Julie: Ralph.

Meagan: I love it.

Julie: I'm gonna name my bacteria Ralph.

Meagan: It's true. And I was told after 18 hours, that was my number.

Dr. Stu: Yeah, again, so these numbers, there are papers that come out, but they're not repetitive. I mean, any midwife worth her salt has had women with ruptured membranes for sometimes two, three, or four days.

Julie: Yep.

Midwife Blyss: And as long as you're not sticking your fingers in there, and as long as their GBS might be negative or that's another issue.

Meagan: I think that that's another question. That's another question. Yep.

Dr. Stu: Yeah, I'll get to that right now. I mean, if some someone has a ruptured membrane with GBS, and they don't go into labor within a certain period of time, it's not unreasonable to give them the pros and cons of antibiotics and then let them make that decision. All right? 

We don't force people to have antibiotics. We would watch for fetal tachycardia or fever at that point, then you're already behind the eight ball. So ideally, you'd like to see someone go into labor sooner. But again, if they're still leaking, if there are no vaginal exams, the likelihood of them getting group B strep sepsis or something on the baby is still not very high. 

And the thing about antibiotics that I like to say is that if I was gonna give antibiotics to a woman, I think it's much better to give a woman an antibiotics at home than in the hospital. And the reason being is because at home, the baby's still going to be born into their own environment and mom's and dad's bacteria and the dog's bacteria and the siblings' bacteria where in the hospital, they're going to go to the nursery for observation like they generally do, and they're gonna be exposed to different bacteria unless they do these vaginal seeding, which isn't really catching on universally yet where you take a swab of mom's vaginal bacteria before the C-section.

Midwife Blyss: It's called seeding.

Dr. Stu: Right. I don't consider ruptured membrane something that again would cause me to immediately say something where you have to change your plan. You individualize your care in the midwifery model.

Julie: Yep.

Dr. Stu: You look at every patient. You look at their history. You look at their desires. You look at their backup situation, their transport situation, and that sort of thing. You take it all into account. Now, there are some women in pregnancy who don't want to do a GBS culture.

Ignorance is bliss. The other spelling of bliss.

Julie: Hi, Blyss.

Dr. Stu: But the reason that at least I still encourage people to do it is because for any reason, if that baby gets transferred to the hospital during labor or after and you don't have a GBS culture on the chart, they're going to give antibiotics. They're going to treat it as GBS positive and they're also going to think you're irresponsible.

And they're going to have that mentality that of oh, here's another one of those home birth crazy people, blah, blah, blah.

Julie: That just happened to me in January. I had a client like that. I mean, anyways, never mind. It's not the time. 

Midwife Blyss: Can I say something about low-risk?

Julie: Yes. 

Midwife Blyss: I think there are a lot of different factors that go into that question. One being what are the state laws? Because there are things that I would consider low-risk and that I feel very comfortable with, but that are against the law. And I'm not going to go to jail.

Meagan: Right. We want you to still be Birthing Bless.

Midwife Blyss: As, much as I believe in a woman's right to choose, I have to draw the line at what the law is. And then the second is finding a provider that-- obviously, Dr. Stu feels very comfortable with things that other providers may not necessarily feel comfortable with.

Julie: Right.

Midwife Blyss: And so I think it's really important, as you said in the beginning of the show, to find a provider who takes the risk that you have and feels like they can walk that path with you and be supportive. I definitely agree with what Dr. Stu was saying about informed consent. I had a client who was GBS positive, declined antibiotics and had a very long rupture. We continued to walk that journey together. I kept giving informed consent and kept giving informed consent. She had such trust and faith that it actually stretched my comfort level. We had to continually talk about where we were in this dance. But to me, that feels like what our job is, is to give them information about the pros and cons and let them decide for themselves.

And I think that if you take a statistic, I'm picking an arbitrary number, and there's a 94% chance of success and a 4% chance that something could go really wrong, one family might look at that and say, "Wow, 94%, this is neat. That sounds like a pretty good statistic," and the other person says, "4% makes me really uncomfortable. I need to minimize." 

I think that's where you have to have the ability, given who you surround yourself with and who your provider is, to be able to say, "This is my choice," and it's being supported. So it is arbitrary in a lot of ways except for when it comes to what the law is.

Julie: Yeah, that makes sense.

Meagan: I love that. Yeah. 

Julie: Every state has their own law. Like in the south, it's illegal like in lots of places in the South, I think in Washington too, that midwives can't support home birth if you're VBAC. I mean there are lots of different legislative rules. Why am I saying legislative? Look at me, I'm trying to use fancy words to impress you guys. There are lots of different laws in different states and, and some of them are very evidence-based and some laws are broad and they leave a lot of room for practices, variation and gray areas. Some are so specific that they really limit a woman's option in that state.

Dr. Stu: We can have a whole podcast on the legal decision-making process and a woman's right to autonomy of her body and the choices and who gets to decide that would be. Right now, the vaccine issue is a big issue, but also pregnancy and restricting women's choices of these things. 

If you want to do another one down the road, I would love to talk on that subject with you guys.

Julie: Perfect.

Meagan: We would love that.

Julie: Yeah. I think it's your most recent episode. I mean as of the time of this recording. Mandates Kill Medicine. What is that the name?

Dr. Stu: Mandates Destroy Medicine.

Julie: Yeah. Mandates Destroy Medicine. 

Dr. Stu: It's wonderful.

Julie: Yeah, I love it. I was just listening to it today again.

Dr. Stu: well it does because it makes the physicians agents of the state.

Julie: Yeah, it really does.

Meagan: Yeah. Well. And if you give us another opportunity to do this with you, heck yeah.

Julie: Yeah. You can just be a guest every month.

Meagan: Yeah.

Dr. Stu: So I don't think I would mind that at all, actually.

Meagan: We would love it.

Julie: Yeah, we would seriously love it. We'll keep in touch.

Meagan: So, couple other questions I'm trying to see because we jumped through a few that were the same. I know one asks about an overactive pelvic floor, meaning too strong, not too weak. She's wondering if that is going to affect her chances of having a successful VBAC.

Julie: And do you see that a lot with athletes, like people that are overtrained or that maybe are not overtrained, but who train a lot and weightlifters and things like that, where their pelvic floor is too strong? I've heard of that before.

Midwife Blyss: Yep, absolutely. there's a chiropractor here in LA, Dr. Elliot Berlin, who also has his own podcast and he talks–

Meagan: Isn't Elliott Berlin Heads Up?

Dr. Stu: Yeah. He's the producer of Heads Up.

Meagan: Yeah, I listened to your guys' special episode on that too. But yeah, he's wonderful.

Midwife Blyss: Yeah. So, again, I think this is a question that just has more to do with vaginal delivery than it does necessarily about the fact that they've had a previous Cesarean. So I do believe that the athletic pelvis has really affected women's deliveries. I think that during pregnancy we can work with a pelvic floor specialist who can help us be able to realize where the tension is and how to do some exercises that might help alleviate some of that. We have a specialist here in L.A. I don't know if you guys do there that I would recommend people to. 

And then also, maybe backing off on some of the athletic activities that that woman is participating in during her pregnancy and doing things more like walking, swimming, yoga, stretching, belly dancing, which was originally designed for women in labor, not to seduce men. So these are all really good things to keep things fluid and soft because you want things to open and release rather than being tense.

Meagan: I love that.

Dr. Stu: I agree. I think sometimes it leads more to not generally so much of dilation. Again, a friend of mine, David Hayes, he's a home birth guy in South Carolina, doesn't like the idea of using stages of labor. He wants to get rid of that. I think that's an interesting thought. We have a meeting this November in Wisconsin. We're gonna have a bunch of thought-provoking things going on over there.

Dr. Stu: Is it all men talking about this? 

Midwife Blyss: Oh, hell no.

Julie: Let's get more women. 

Dr. Stu: No, no, no, no, no.

Being organized By Cynthia Calai. Do you guys know who Cynthia is? She's been a midwife for 50 years. She's in Wisconsin. She's done hundreds of breeches. Anyway, the point being is that I think that I find that a lot of those people end up getting instrumented like vacuums, more commonly. Yeah. So Blyss is right. I mean, if there are people who are very, very tight down there. The leviators and the muscles inside are very tight which is great for life and sex and all that other stuff, but yeah, you need to learn how to be able to relax them too.

Julie: Yeah.

Meagan: So I know we're running short on time, but this question that came through today, I loved it. It said, "Could you guys both replicate your model of care nationwide somehow?" She said, "How do I advocate effectively for home birth access and VBAC access in a state that actively prosecutes home birth and has restrictions on midwifery practice?" She specifically said she's in Nebraska, but we hear this all over the place. VBAC is not allowed. You cannot birth at home, and people are having unassisted births.

Julie: Because they can't find the support.

Meagan: They can't find the support and they are too scared to go to the hospital or birth centers. And so, yeah, the question is--

Julie: What can women do in their local communities to advocate for positive change and more options in birth where they are more restricted?

Dr. Stu: Blyss. 

Midwife Blyss: I wish I had a really great answer for this. I think that the biggest thing is to continue to talk out loud. And I'm really proud of you ladies for creating this podcast and doing the work that you do. 

Julie: Thanks.

Midwife Blyss: I always believed when we had the Sanctuary that it really is about the woman advocating for herself. And the more that hospitals and doctors are being pushed by women to say, "We need this as an option because we're not getting the work," I think is really important. I support free birth, and I think that most of the women and men who decide to do that are very well educated.

Julie: Yeah, for sure.

Midwife Blyss: It is actually really very surprising for midwives to see that sometimes they even have better statistics than we do. But it saddens me that there's no choice. And, a woman who doesn't totally feel comfortable with doing that is feeling forced into that decision. So I think as women, we need to support each other, encourage each other, continue to talk out loud about what it is that we want and need and make this be a very important decision that a woman makes, and it's a way of reclaiming the power. I'm not highly political. I try and stay out of those arenas. 

And really, one of my favorite quotes from a reverend that I have been around said, "Be for something and against nothing." I really believe that the more. 

Julie: I like that.

Midwife Blyss: Yeah, the more that we speak positively and talk about positive change and empowering ourselves and each other, it may come slowly, but that change will continue to come.

Julie: Yeah, yeah.

Dr. Stu: I would only add to that that I think unfortunately, in any country, whether it's a socialist country or a capitalist country, it's economics that drives everything. If you look at countries like England or the Netherlands, you find that they have, a really integrated system with midwives and doctors collaborating, and the low-risk patients are taken care of by the midwives, and then they consult with doctors and midwives can transfer from home to hospital and continue their care in that system, the national health system. 

I'm not saying that's the greatest system for somebody who's growing old and has arthritis or need spinal surgery or something like that, but for obstetrics, that sort of system where you've taken out liability and you've taken out economic incentive. All right, so how do you do that in our system? It's not very easy to do because everything is economically driven. One of the things that I've always advocated for is if you want to lower the C-section rate, increase the VBAC rate. It would be really simple for insurance companies, until we have Bernie Sanders with universal health care. But while we have insurance companies, if they would just pay twice as much for a vaginal birth and half as much for a Cesarean birth, then finally, VBACS and breech deliveries would be something. 

Oh, maybe we should start. We should be more supportive of those things because it's all about the money. But as long as the hospital gets paid more, doctors don't really get paid more. It's expediency for the doctor. He gets it done and goes home. But the hospital, they get paid a lot more, almost twice as much for a C-section than you do for vaginal birth. What's the incentive for the chief financial officer of any hospital to say to the OB department, "We need to lower our C-section rate?" 

One of the things that's happening are programs that insurance, and I forgot what it's called, but where they're trying, in California, they're trying to lower the primary C-section rate. There's a term for it where it's an acronym with four initials. Blyss, do you know what I'm talking about?

Midwife Blyss: No. 

Dr. Stu: It's an acronym about a first-time mom. We're trying to avoid those C-sections.

Julie: Yeah, the primary Cesarean.

Dr. Stu: It's an acronym anyway, nonetheless. So they're in the right direction. Most hospitals are in the 30% range. They'd like to lower to 27%. That's a start.

One of the ways to really do that is to support VBAC, and treat VBAC as Blyss said at the very beginning of the podcast is that a VBAC is just a normal labor. When people lump VBAC in with breech in twins, it's like, why are you doing that? Breech in twins requires special skill. VBAC requires a special skill also, which is a skill of doing nothing.

Julie: Yeah, it's hard.

Dr. Stu: It's hard for obstetricians and labor and delivery nurses and stuff like that to do nothing. But ultimately, VBAC is just a vaginal birth and doesn't require any special skill. When a doctor says, "We don't do VBAC, what he's basically saying, or she, is that I don't do vaginal deliveries," which is stupid because VBAC is just a vaginal delivery.

Julie: Yeah, that's true.

Meagan: Such a powerful point right there.

Julie: Guys. We loved chatting with you so much. We wish we could talk with you all day long.

Meagan: I would. All day long. I just want to be a fly on your walls if I could.

Julie: If you're ever in Salt Lake City again--

Meagan: He just was. Did you know about this?

Julie: Say hi to Adrienne, but also connect with us because we would love to meet you. All right, well guys, everyone, all of our listeners, Women of Strength, we are going to drop all the information that you need to find Midwife Blyss and Dr. Stu-- their website, their podcast, and all of that in our show notes. So yeah, now you can find our podcast. You can even listen to our podcast on our website at thevbaclink.com/podcast. You can play episodes right from there. 

So if you don't know-- well, if you're listening to this podcast, then you probably have a podcast player already. But you know what? My mom still doesn't know what a podcast is, so I'm just gonna have to start sending her links right to our page.

Meagan: Yep, just listen to us wherever and leave us a review and head over to Dr. Stu's Podcast and leave them a review.

Julie: Subscribe because you're gonna love him, but don't stop listening to him us because you love us too. Remember that.

Dr. Stu: I want to thank everybody who wrote in, and I'm sorry we didn't get to answer every question. We tend to blabber on a little bit asking these important questions, and hopefully you guys will have us back on again.

Meagan: We would love to have you.

Julie: Absolutely.

Meagan: Yep, we will.

Julie: Absolutely.

Meagan: Yeah

Closing

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

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In this episode of The VBAC Link Podcast, join Julie as she sits down with Ambrosia to discuss her journey from a teen pregnancy to achieving a VBAC after two C-sections. Ambrosia shares her unique experiences, the challenges she faced, and the importance of advocating for herself in the medical system. 

Julie and Ambrosia give insights into the myth of a small pelvis and preeclampsia. How is a small pelvis really diagnosed? Does preeclampsia always mean a medically necessary C-section? Listen to find out!

The VBAC Link Blog: Overuse of the CPD Diagnosis

Coterie Diapers - Use Code VBAC20 for 20% off

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Julie: All right, Good morning, good morning, good morning. It is Julie here today with The VBAC Link Podcast, and I'm really excited about our story today. I have with me Ambrosia. Is Ambrosia how you say it?

Ambrosia: Yes.

Julie: Okay, good. I didn't want to go the whole episode without saying your name wrong. Okay, we have it. Ambrosia. I'm really excited because today we have a VBAC after two C-section story. I love especially these stories. Her first pregnancy was a teen pregnancy, and I am really interested in hearing her experience about that because I know that it's a very unique circumstance and a very different journey as a teenager, and there are unique challenges associated with that. So I'm excited to hear more about that and about all of her journey through all of her births. 

But before I do that, I'm going to share a Review of the Week. This one is a throwback to 2020. I was looking through our spreadsheet and saw that we haven't done that one yet, so I'm going to throw all the way back almost four years ago. This review was on Apple Podcasts, and it says "Meagan and Julie and the women sharing their birth stories are amazing. They share real life stories of all kinds of births and helpful, useful, practical information that has really helped me feel prepared for my VBAC which I hope will happen very soon. I highly recommend listening to this podcast to be informed and encouraged. I also highly recommend their online VBAC course. It's self-paced and offers so much valuable information and good resources. It has really helped me feel ready and empowered to birth my baby. Thank you for all you awesome ladies do for women and the birth world."

I will say thank you so much for sharing a review. If you haven't already, take some time, pause the podcast right now. Go ahead and leave us review on Apple Podcasts or wherever you listen, and we might just be reading your review on the podcast one day.

All right, let's get back to it. I'm really excited to meet Ambrosia today and hear her stories. Ambrosia is a 27-year-old mother of three boys. Boy Mom, that's super exciting. They are ages 11, 5, and 1 month. I'm really excited to hear, especially, about a fresh VBAC after two C-section story. She is from El Paso, Texas, and she is very excited to share her story with us today. 

So, Ambrosia, why don't you go ahead and share your journey to a VBAC after two C sections with us?

Ambrosia: Cool. I'll start off with my first pregnancy. I got pregnant at about 16. And with that, I just wanted to mention that I wasn't really raised by my mom. I had my grandma in my life most of my life since I was two. So with her, I had a lot of freedom with her, in a sense. I did fall pregnant very, very young. 

But she did support me in so many ways. She helped me out through all of my pregnancy, but it was more providing shelter and food and stuff like that. When it came down to me knowing what to do, that wasn't really a thing. I found myself watching YouTube a lot and getting my information from the Internet, but still, I was just completely naive to what birth was and all of that. I just went straight off of what my doctor would tell me.

Once I did find out that I was pregnant, I chose a doctor and didn't really do any research with that. I just chose a female because that's who I was more comfortable with. But little did I know, the doctor that I did choose, she was, from what I've heard around El Paso from other women and their experiences and doctors too, they were like, "Oh, she's really good at C-sections. She's one of the top ladies that you would want to have to do your C-section because she's really good at it." 

That was later on that I figured that out. But at the time I was just like, however my baby comes out is how it comes out, but I did want to have like a vaginal birth. I didn't want to do no surgeries or nothing because I've never even broke a bone in my body, so just the thought of surgery kind of scared me. 

My first visit with her was good, but she automatically told me, "Your pelvis is too narrow. You won't be able to push your baby out. There's a chance that he could get stuck," and this and that. I had my grandma with me, so we just gave each other that look of like, "Oh well, whatever is best." 

I ended up having a C-section with him, and she schedules the C-section. Then on that day that I got it, after everything was done, she mentioned to me, "You want more kids, right?" I told her, "Of course." She told me, "Well, if you wait a couple years, at least one to two or two-and-a-half years, then you could have a vaginal birth if you would still want that."

Julie: That is so funny. Hold on. Can I interrupt for a second?

Ambrosia: Yeah, of course.

Julie: I'm so sorry. I think it's so funny that she told you that after she told you your pelvis was too small.

Ambrosia: Exactly.

Julie: Isn't that silly? Anyway, we're gonna talk more about that at the end of the episode, but I just had to call attention to that. Anyway. Sorry. Keep going. Thank you. 

Ambrosia: You're okay. Yeah. I thought that was weird, too, because knowing what I know now, I know that a lot of doctors get more money, in a sense, out of the C-sections rather than a vaginal birth. So I'm like, yeah, that's probably why. And not necessarily that, but it's more convenient for them. They don't have to really wait around and whatnot. 

And then with my second pregnancy, my son was already about 5-6 years old. And so I was like, well, of course I can. I was pretty excited. I did want to push for vaginal birth, but I did end up going back to her for that pregnancy. I should have known better. But honestly, I didn't know really how to advocate for myself still because I was 21. I feel like I just wasn't adamant enough. I didn't have that confidence yet be like, no, this is what I want. I don't want another C-section. This is what I want. 

I would mention it to her that at almost every appointment. With the first initial appointment, I told her, "I do want to try for a VBAC." And she's like, "Well, yeah. We can talk about that in your next appointments." 

As I kept going back for my appointments, she was just kind of like, "It's just an in-and-out type of thing and transactional experiences trying to see if you're healthy and whatnot." 

I started noticing at around 20 weeks pregnant that my hands would feel pretty weird. They would feel kind of stiff and a little swollen. I started getting very, very swollen. I worked full-time. I'm a nail technician, and so I work at a spa full time, or I did at that time too. I thought, maybe it's just stress from work or normal pregnancy symptoms. 

But I started feeling very noticeably swollen. I would see a lot of flashes and little stars just floating and bad headaches. Toward the end of my pregnancy, I would start feeling indigestion depending on what I ate. I thought it just wasn't sitting right in my stomach, and sometimes I would end up vomiting. But at the time I just thought, oh, this is just normal pregnancy symptoms or whatever. 

But knowing what I know now, I'm like, no, that was definitely signs of preeclampsia. But the thing is at every doctor's appointment that I would go in for, my blood pressure was always normal. So it was pretty weird that I had that. I would tell my doctor, I'd be like, "Hey, girl." I'm pretty swollen, and I don't really feel like myself." 

Obviously you're not gonna feel like yourself with pregnancy, but I felt not what I felt with my first pregnancy. It didn't feel good at all. So she looks at me, and she goes, "Oh, no. I mean, you're swollen, but you're also very slim," because I am very skinny naturally. But she's like, "Maybe your family isn't used to seeing you pregnant, you know?" 

So I was like, "I don't think that's what it is, but okay." Again, me being not very adamant about sticking up for myself in a sense like, no, I don't think this is. So I just told her. I was like, "Okay, we'll keep seeing." I kept going for my appointments and at 38 weeks, I had one of my appointments, and then I was feeling super bad. That's when I was just like, "No, I really don't feel good. I'm very swollen." 

She told me during that appointment, "Yeah, I mean, you look a little more swollen than usual. I'll have you go across to the hospital to get some bloodwork done." So I was like, "Okay." So I went. I remember telling my grandma at the time, "She wants me to go do some blood work." She just gave me that looks like, "I don't know," like she knew something. I was blindsided too. So I was like, "Yeah, yeah, I'm just gonna go get this bloodwork done real quick." 

I took my son with me, and then she ended up having to come pick him up again because I had to be admitted. They wanted to monitor me. She came and picked up my son, and then I went and got the bloodwork done. They took a urine sample, and then a couple of hours later, they're like, "Oh, yeah, you have preeclampsia." I was like, "Oh, no." 

I kind of knew it was that because I did a little bit of research, but at the same time, I didn't want to self-diagnose myself either. I was like, I don't want to say this is what it is when it really isn't, but I did a little bit of research and every symptom was matching up to that. So when they told me that, I was like, hey, I knew it in a sense, but I didn't really advocate for myself. I was just like, no, maybe it's normal. 

They did find protein in the urine too. So with that, since she found out, she was like, "Oh, no, we have to do the C-section tonight. There's no way." It was around 4:00 or 5:00 when I went in, and then that around 11:00 or 12:00 at night. That's when they started the C-section. But I was like, "Oh my god." 

When they did the ultrasound, my baby's head was down, so I was like, "Oh, I wanted to go through with a vaginal," and I was already a centimeter dilated too. I should mention that. I did want to do a vaginal, but she just kept saying, "No, since you have preeclampsia, there's no way we can do a natural delivery. You can start having seizures and your body's already under stress. We just need to get your baby out now." So I was like, "Okay." 

I ended up having to do another repeat C-section, but I felt like she just put the blame on the preeclampsia for the C-section, and then she has the audacity to say, "Oh it's a good thing I caught this right away. It's a good thing I caught this," and I'm like, "Oh my gosh, yes."

Julie: You were trying to tell her almost the whole pregnancy, "I don't feel good. This is not really normal." 

Ambrosia: And then right when I finally told her again, that's when she was like, "Oh, I'm so glad I caught this." I was like, "Girl, no. If I wouldn't have told you, who knows how the rest of the pregnancy would have gone?" But it was wild to me. That really struck me right there. 

So I was just like, if I ever got pregnant again, I would not go back to her. Thankfully, my son was good. He was born and healthy. He did have to do a little NICU stay for a while just because he was under stress. And once he was born, like they said, he was grunting a little and having trouble breathing. He did go into the NICU for a little bit, like four or five days. But that whole experience was hard. It was really hard to go through with the NICU stay having a C-section, and then walking back and forth to the NICU. 

It was also my first time breastfeeding because when I was 16, I didn't have any guidance really. My grandma never breastfed. My great-grandma had never breastfed. My mom didn't breastfeed. I was just new to the whole experience. I didn't have a lot of people to help me out with that. My mother-in-law did breastfeed. She tried to help me, but it was new for me, so I was like, I don't even know. I was still shy in a sense. I was like, oh, people seeing every aspect of me was just weird. 

But I ended up breastfeeding my second for up to three years. That was the one thing that I took from all of that. It was a super nice bonding experience. But at the time, learning how to do it under the stress from having the C-section and all of that was just so much, but I stuck through that. I was really proud of myself at that time because I had really no guidance or anything with my first. I mean, I did want to breastfeed, but I just didn't know. I thought they were born, and they already knew how to latch and all that.

Julie: I know. Sometimes it's hard work, for sure.

Ambrosia: Yeah. I didn't know it was a learning experience for the baby and mom to breastfeed and stuff. So that, I missed out with on my first and a lot of other things. So it was nice. But that's what happened with my second. 

From that point on, I was like, no. If I get pregnant again, I'm going to have a vaginal birth. There's no way that my pelvis is too small. I already knew in the back of my mind that all that was just noise to me. It wasn't anything. I already knew that VBACs were possible just because my mom ended up having a C-section with my brother, and then with me and my sister, she had us vaginally. So I knew it was possible and that people can do it, but it's just finding the right provider that actually wants to take that on and support you through every step of the way. 

It was another thing, especially from where I am from here in El Paso, because most of the hospitals, will push and push. So this time around, when I did get pregnant, I was like, okay. We're not doing that again. I'm not going back to her. I did all my research and even spoke to some of my clients because 2024 was a really weird year where it seemed like everyone was pregnant in a sense. I was like, oh my god. A lot of my friends were pregnant. My clients and celebrities that I would even see, I'm like, okay, yeah. Everyone is pregnant around here. I would even ask some of my clients who their doctor was and what they were doing in a sense as far as birth with a natural birth or a C-section.

One of them just like, "Oh, I had all of my babies as C-sections, and that's what I'm gonna keep doing." I guess it was more convenient for her. So I was like, "Oh yeah, that's that's good for you, but that's not what I want." 

Another one was telling me that she also wanted a VBAC too because she had a C-section with her first, and then for her second, she was going to Texas Tech University. I guess it's a hospital where they also have the students there, too. Texas Tech. So she said she was going there and that they had OB/GYN and midwives there, too. 

She was like, "One of the midwives who I'm seeing is totally on board with me having a VBAC." And she was like, "You should go to her." I was like, "Okay," but I don't know what happened with the scheduling. I didn't get her midwife. 

I ended up getting scheduled with OB/GYN. When I went to that first appointment, she did an exam and everything, and she was like, "Oh, no. Your pelvis is too narrow." I was like, oh my god. I wasn't going to find anybody who was VBAC-supportive.

Again, I felt a little bit more comfortable just with a female, so I was limiting my search in a sense. I was just looking for female doctors or midwives who would do VBAC. And then I searched around birth centers, but the idea of that did freak me out because I was looking at one of them. They don't necessarily let you get an epidural. It's totally natural. I was like, I don't know if I could do all that. It just kind of freaked me out. So I was like, I don't know if I can do that. What if I'm in so much pain? 

That was not an option for me at the time. I ended up just Googling "VBAC", and then a doctor in my area did pop up. When I clicked on the website, it was blasted all over his site, like, "VBAC. Vaginal birth after Cesarean is possible." It was just really positive.

Yeah. He had a really good success rate of VBACs and even VBACs after two C-sections because after two C-sections, doctors are a little bit more timid, in a sense, if they want to take that on or not. So I found him, but I was also like, oh, but it's a guy. I don't know how this is going to work or anything.

But me just being so adamant in wanting the vaginal birth, because I knew in my heart, I can do this. I'm not too narrow or small. I'm a petite woman, but I'm not tiny. I knew I could do it. I ended up just trying him out. I went to my first appointment with him, and then everything was pretty good. He wasn't invasive either. He just looked at me. He was like, "What are you wanting for this birth?" And I told him a VBAC. And he was like, "Okay. And you've had two previous C-sections?" I was like, "Yep, two C-sections." And then he was like, "And the reason for the C-sections?" I was like, "The first one, basically no reason at all. It was just because the doctor thought my pelvis is too narrow. 

He chuckled. He was like, "Oh, okay. And the second one?" I was like, "She blamed it on preeclampsia, in a sense," which I feel like she really did. But who knows? I mean, maybe. I know it has its risks and all that doing a vaginal with preeclampsia, but she just wasn't willing to take those in a sense. So I told him, and he was like, "Okay." And then he just was like, "Yeah." 

He measured my stomach and all that. He didn't do those the pap smears or anything. He wasn't invasive. He's like, "There's no need for me to check and see and all that." That's what the doctor over there at Texas Tech did. Right away, she stuck her fingers in me and she's like, "Oh, no. You're too narrow." I'm like, oh my god. He didn't do none of that. He just looked at me. He's like, "Yeah, you're good. I mean, you're not tiny. I think it's possible." 

He gave me a lot of reassurance in a sense. I just kept going back and back, and every visit was really fast and simple. He didn't really didn't say much. My pregnancy was pretty healthy. No preeclampsia this time which was really good because I was scared that would happen again and that would be another cause for concern and then end in a C-section or something. 

There were a couple of little scares. Once I saw my baby here, I was like, no, it was literally just a bunch of scares for no reason, but they have to monitor stuff. But one of them was with the ultrasound, they found an EIF in his heart. I didn't know what the heck that was, so that scared me. But his heartbeat was real strong, so they were like, No, that's nothing to be concerned about or anything. Once he's here the pediatricians will check him out and everything, but it's nothing to be concerned about." So that they found that. 

And then in another ultrasound, they were telling me that the lower extremities weren't matching up with the upper extremities. So that scared the poop out of me. I was like, oh my god. My baby has these two things. So I was real scared that he was going to have something wrong with him. He told me, and I would ask a lot of questions. I'd be like, "Whoa, what are these things that you found? And what could that mean?" He's like, "Honestly, it's really nothing to worry about. We're just going to keep monitoring you." 

He had sent me to a specialist, so I would go get my ultrasounds with them. And then also they were like, "You're really small. There's not a lot of room in there for him," because they were seeing that his foot was really squished. They were afraid that he was going to be born with a club foot or something. It was just a bunch of little scares where I was like, oh my god. This is crazy. 

They always reassured me, "Don't worry if anything comes out," not wrong, but if he does come out with that, it could be corrected and always reassuring me as well. So those were just the only little scares that we really had. But overall, my pregnancy was pretty healthy. No high blood pressure, nothing. None of that. And then when it came closer to my due date, which was September 28th, he was asking me again, "Okay, so you still want to go through with the VBAC?" I was like, "Of course I do."

And then he's like, "Do you want to wait for your body to kind of go into labor on its own, or do you want me to induce you?" I just wanted to go through all that naturally and let my body do its thing because I know my body can do it. But my son was just comfortable in there, in a sense. I don't know. I know a lot of women go to labor a little bit early, around 38 weeks. 

So at 38 weeks, I was just like, okay, you can come out now. I was getting really uncomfortable. Everything was aching. So I was just like, I really don't want to be induced though, because I also knew from my research, because I did a lot of research. I listened to this podcast, too, so much. 

At the time, I felt like if I can go into labor naturally, I'll have better success with having my VBAC. I know I could do it. The induction part scared me because I was like, I don't want anything to counteract with each other, like the Pitocin and then the epidural and all that. I was being not negative in a sense, but weighing the risks out in my own head. I was kind of overthinking it, too, in a sense. But when that time came, he was like, "All right." 

Toward the end, he would do cervical exams to see if I was dilated or not. At 38 weeks, I was a centimeter dilated. I stayed like that until 39 weeks. I think maybe even at 37 weeks, I was already a centimeter. I was hoping I could dilate even more and by the time my due date comes, which was the 28th of September, maybe I'll be ready to go. But no, like I said, he was just really comfortable in there. So by the 27th, I was the 27th of September. I had my last doctor's appointment, and he was like, "All right, if you want me to induce you, I can induce you." But I forgot what he said. He was like, "If you want to wait for your body to go into labor naturally, I'm going to be out of town." 

I was so disappointed. Like, what do you mean you're going to be out of town? That type of thing. He was like, "If you do wait for your body to go into labor naturally, then there's a chance. You'll have the doctor here at one of the local hospitals. It's Del Sol. You'll have one of those doctors, but your chances of having a C-section, like go up higher because it's not me." He stated again, "I have a 95% rate of VBAC success." 

So I was thinking and thinking, but he told me, "Go ahead and think it over. Talk with your family about it and just let me know what you want to do. Give us a call, but I do want you to go and be monitored." He didn't really mention why for me to go to the hospital to be monitored. He wanted me to get a sonogram and then I forgot what else it was, but he wanted me to go into the hospital to get monitored. I was like, "Okay." 

I think it was for the next day. So I think it was actually the 26th that my appointment was. And then on the 27th, I had to go to the hospital to be monitored either way. They made it a point to me. They were like, "You need to go to the hospital for that sonogram or whatever." And I was like, okay. I thought it was kind of weird, but I was nervous, too. I was like, okay, whatever. I'm going to go. 

I end up going. I got myself admitted and everything. They hooked me up to the machines. They checked me with a cervical exam. I was still at a centimeter. The baby's heartbeat was doing good. They came in and did the ultrasound, and then they were like, "Oh, you're having contractions. You don't feel them?" I was like, "No, not really." I really didn't feel them because I guess I had been feeling them for weeks on end. My stomach would tighten. Again, I didn't know what they felt like really just because with my past, I had C-sections, so I was like, no, this is all new to me. I don't even know what contractions even feel like. 

I just thought the tightening of the stomach-- obviously I knew it was something, but I thought it was like, oh, those are Braxton Hicks contractions. They're fine. They're fine. I guess they were coming on pretty strong, but they were just like that for a long time. They didn't hurt or anything. My stomach was super tight. So, with every contraction, they'd be like, "Oh, you didn't feel that? You didn't feel that? Okay." 

Well, they ended up telling me, "We are going to keep you overnight just because you are contracting a lot. The doctor sent you in because he wanted us to check your amniotic fluid." He didn't have a lot of amniotic fluid in there, so that's why they wanted me to go in. I ended up staying the night. 

And then the next day, that's when they were like, "Okay, so do you want us to induce you?" Actually, I think it was on the 27th. I did go in because I ended up staying the night. And then the next day, that's when they were asking me. And I mean, I was just like, "Okay." I guess, honestly, a lot of factors played into that. My mom was coming in from out of town, from California over here, my mom and my sister, and I wanted them to be here. 

If I would have waited, my thing was if I wait to go into labor naturally and my mom and sister come down and nothing happens, they have to go back, and they would miss a whole birth and everything, and they wouldn't be able to see my son. So I was weighing out all the options, and I ended up agreeing to be induced. 

Around 11:00 on the 28th, that's when they started Pitocin. And then another thing that I thought was he didn't really mention this to me, or I probably should have asked, too, that when he was doing the induction, it's one of his policies that he has that he would prefer to just have the epidural put. Because I had it in my mind that I want to try it without the epidural, but I wanted it to be there too. Like, if I do end up giving in and being like, oh well, this is a little bit too much pain for my comfort, I have that option if I wanted to get it or not. 

But my doctor had mentioned before, "You can have the epidural put in, but none of the medicine." I was like, okay. So when the time came, they were like, "Oh well, we can't start the Pitocin without the epidural placed in first." I guess it was for that reason just because if anything were to go wrong or anything and I would need an emergency C-section, that was already placed so they wouldn't have to put me out completely, and I would miss the whole birth." 

So I was like, "Okay, all right, you guys can place it." Once they did, they're like, "No, we're going to have to run at least just a little bit of the epidural." And I was like, "What the heck? I thought no medicine had to go through or anything." And they're like, "Well yeah, we kind of do. Just because if we don't, there's a chance for it to be a clot, and then we would have to place it all over again." And they were like, "I don't necessarily think that's exactly what you want." I'm like, "Honestly, no, but okay." It was just a little shock to me. I was like, oh, okay. That's not what I wanted. I wanted to be able to get up and walk around to push through the labor in that sense and the contractions because I feel like they would have been more tolerable if I was able to move around. 

But once the Pitocin started kicking in and the contractions came on, at first they were okay. I was laughing with my mom and my sister because they did come in. They had just gotten there. We were just talking, and my husband was there too. We were all just laughing. It was a nice little beginning to the labor and filled with a lot of laughs. But once I wasn't able to laugh through nothing, I just wanted to focus and for everyone to not even talk. I was like, oh, this is intense. 

I would have preferred to be up and moving around and stuff, but that was not the case, which I kind of expected before I had went in. You can't really plan for things to go your way because there's always going to be something that ends up not going your way. So I was just going with the flow type of thing. Whatever happens, happens. It's for a reason. 

So the Pitocin was definitely kicking in, and I was contracting, and then I wasn't really dilating, fast. They didn't really want to do cervical checks a lot because of bacteria. My water wasn't broken yet, so I think I was at a 1 still. They checked and they were like, "Oh, you're at 2." And then., "Oh, you're at 2 still." The doctor ended up coming in himself, and then he ended up breaking my water. He didn't really necessarily, ask or anything. It was just the type of, "Okay, I'm gonna check you," and then, "Okay, we're gonna break the water." 

I was like, "Oh my god. What the heck do you mean? Like, break my water right here, right now?" It was kind of shocking, too, but I was just kind of like, okay, if this is what's needed to progress the labor, then I'll just go with it, in a sense. Nobody even asked me. That was rude and not really, but I was just like, that's so weird that he came in and just broke my water. 

And then after that, honestly, things started getting more intense. The contractions were very intense, and I wasn't able to get up or anything. I could feel them because I didn't want them to pump any more than three-- I don't know if it's milliliters or whatever of the epidural. I wasn't pressing that button or anything. I just wanted to do it without it as much as possible, but I could really feel everything. 

So once the water was broke, I was just like, okay, this is really it. There was a peanut ball there. So I was like, "Get the peanut ball. Let's try to put it in between my legs, and let's see if it does anything." We did that, and it really, really made things worse for me just because it was not comfortable at all. The pain was bad, but it ended up dilating me more and pretty fast too. But it was very, very uncomfortable. I would have to switch positions and just kind of lay on one side and then lay on my other side. I felt all the contraction pain just in my back towards my butt, in a sense. It just felt intense. 

I'm just grateful I was even able to experience that just because I didn't feel anything with my other ones. You feel just cold in comparison to the C-section and tugging and pulling. It was a weird experience with them. They weren't really traumatic or anything for me, thank God, but it just wasn't what I wanted. So to even be feeling all of the labor pains and all that, I was just grateful to even be there and experiencing that as a woman. It was pretty exciting for me. 

But like I said, things didn't really necessarily play out the way I was envisioning or how I wanted it to a T, but I was able to experience all of the other things. And then they would do cervical exams. Once I was at an 8 or whatever, that's when I was like, okay, I'm getting closer because I was afraid that I wasn't even going to dilate and I would just have to end up getting a C-section. But I was dilating. 

And then once he came in, because I guess the nurses were like, "No, yeah, baby's talking to me. He's letting us know that he's moving down and he's gonna come out." One of the nurses was like, "He's going be out by the end of my shift. Watch, guys." We were just looking at her like, "Okay, if you say that, let's see." 

Eventually, I want to say it was around 5:00 or 5:30, that's when I finally reached 10 centimeters. That's when the doctors came in. They started getting everything ready. And then I was like, oh, my god, I think it's time to push. My body felt like I needed to go to the restroom and I needed to poop. So I was like, oh, my god. I feel like that. They told me before, "If you feel like you need to poop, then you need to push. Let us know." 

And then I was like, "Yeah, I do." My husband calls them and he's like, "Yeah, she said she feels like she needs to poop". And then they're like, "Okay, yeah." That's when he came in and all the nurses too. They started getting everything ready. I want to say I started pushing and he told me he's like, "It's literally going to feel like you have to use the restroom, so don't hold back or anything. Just push." So I was like, okay. 

I think after four or five times of pushing my son, I could feel him come out. The head first came out and then finally, the rest of the body. I had that huge relief of like, oh my god. I cannot even believe that I just did that. I did it. Even though all these doctors would tell me like, "No, you're too small. There's no way," I actually did it. I didn't even have any lacerations, no nothing. I didn't tear or anything. 

It was just unbelievable because I had the biggest fear too, that I was going to tear into two holes. There was no way I was going to not tear at all. But I didn't end up tearing or anything which was good because I know that's an additional recovery in a sense. But after a couple of pushes, he was out. I was just so happy. I was crying. My mom was crying because she was in the room with me, and my sister was in the room with me holding one leg. My husband was holding the other one, and there was just tears. Tears everywhere. 

It was really, really nice to actually experience that for this birth. I feel like a lot of women, too, can relate. Once you finally do that after people saying, "No, you can't," or not even giving you a chance to try, it was very, very rewarding and a completely different experience to a C-section. 

I'm just very grateful that I found this doctor and that he actually took me on and was like, "Oh yeah, you'll be fine. We'll do this. You can do this." It was really nice. So my son was born. He was only 6 pounds, 8 ounces. And so he wasn't a really big baby either. But still, I was a petite woman myself, so I thought it was gonna be challenging, but it was good. I didn't have any problems. No, nothing. He was born very, very healthy. 

Even all the nurses, too were really excited. They're like, "Oh my god, she's a VBAC. She actually did it." I kept hearing that over the course of my stay. They were just like, "You did a VBAC. That's so amazing. Congratulations." It was just so nice to hear. 

And the recovery, oh my god, was so much better than a C-section, just 100 times better because I was able to get up after the epidural had worn off. I was able to get up because after those contractions started getting really intense, I was pressing that button. I was like, you know what? I need more of the epidural. There's no way. Those Pitocin contractions were just more intense than natural contractions and they really were. So I did only bump up myself from three milliliters to six, I think. 

I didn't really feel so much pain, but I could still feel things. After the epidural wore off, I was able to get up and walk, and it was nice. It was really nice to get up and do things and not have to have that pain of a C-section and leave the hospital after just a day, the very next day. We were able to leave by like 5-6:00. I was able to go home and was just enjoying my baby. That was pretty much it. But I was very grateful for the experience.

Julie: I love that story. That's such an incredible and inspiring story. There are so many things that I could talk about, but we're running a little short on time, so I want to talk about two things. The myth of the small pelvis and preeclampsia. 

First, I know that preeclampsia is really tricky because the induction is necessary. Preeclampsia is one of the things where you need to get the baby out sooner rather than later. It's a medically indicated thing. If you have a doctor telling you that, you don't have to question it or worry about it because it's really important to get that baby here quickly. However, there are instances where an induction may be appropriate compared to just going straight to a C-section. And again, provider preference is going to play a huge deal into that. 

But also, as long as your blood pressure is holding steady through an induction and you're progressing well and mom and baby are doing fine, then an induction can be a safe option as well for preeclampsia. So the biggest thing they're just going to make sure is the stress of the induction is not too much on your body because sometimes your blood pressure will go up just naturally with labor because it's a lot of work. But as long as you keep an eye on that, I know that it's a reasonable option at times. So don't think that having preeclampsia just means you automatically have to go to a C-section. But again, talk about your options with your provider. If your provider is not telling you something that you feel comfortable with, question it. Seek out another opinion. But definitely trust your intuition and lean into that. 

I think that if you've been around with us for long enough, you will know how we feel about the idea of somebody's pelvis being too small. Now, I think it's really sad. I think maybe sad's not the right word, but I feel like with teenage pregnancies, these teenagers who arguably need more help than most because teenage pregnancies are oftentimes unplanned and unexpected. They are in a very vulnerable situation. They need more help and more guidance. But I feel like oftentimes a system will take advantage of that vulnerability, maybe probably even unknowingly. But I feel like it's very easy for teenagers in a hospital system to get railroaded more because they haven't gone through a lot of the experiences that we do later on in life and learn how to navigate through trickier situations and stand up for ourselves and advocate. It's harder and more challenging. 

And so I'm really sorry that happened to and your provider used her vaginal exam to determine your pelvis is too small. Now let me tell you, there's only one way to determine an actual pelvis size and that's with a pelvic telemetry scan. It's kind of like an X-ray. Vaginal exams are not evidence based. And not only that, we know there's so much more that goes into a pelvis being too small because pelvises move and flex as the baby's being born. Our baby's head squeezes and molds in order to fit through the pelvis, so even a pelvis that might be "too small" before pregnancy can change and shift and expand and grow through the pregnancy, but especially as labor happens. 

So it's very, very rare for a pelvis to be actually too small or deformed, and usually that happens when mother grows up either incredibly malnourished and their bones are not able to grow properly or through a traumatic injury to the pelvic area. Those are usually the biggest or the most likely times where you'll see a pelvis that is truly too small. A lot of times, it's failure to wait. Maybe the body is just not ready for maybe a too-early induction and things like that. 

So I would encourage you to ask questions, ask questions, and trust your intuition. We do have a blog al' about CPD which is cephalopelvic disproportion that we're going to link into the show notes. And that just basically means it's fancy words saying your pelvis is too small or maybe your baby's too big to fit through the size of your pelvis as it is. But I'm so glad that Ambrosia was able to stand up for herself and find a provider who would support her in getting a VBAC after two C-sections. So I'm very proud of you and thank you so much for joining me on the podcast today.

Ambrosia: Thank you so much. 

Coterie: https://www.coterie.com/products/the-diaper?utm_source=VBACLINK&utm_medium=Podcast&utm_campaign=Diaper

Closing

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

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

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While we can't control many parts of birth, there is so much we CAN do to quite literally change the trajectory of our birth outcome. 

First: Feel safe with where and with whom you will give birth.

Second (but just as important!): Prepare yourself mentally, physically, emotionally, and spiritually. 

During her first VBAC attempt, Maria hired a midwife. Her second birth had so much more advocacy, progress, and positivity, but there were still missing pieces, new traumas to process, and things she wished had gone differently.

You will NOT WANT TO MISS hearing all of the things that changed for Maria from her first two births to her third. The proactive work, the passion, the prep, the healing, the research, the manifesting, the surrendering, the trust, and to top it all off, the beautiful, unmedicated VBA2C outcome. 

Just like Maria, our greatest hope is for all of you to unlock this birthing power that is already within you, no matter the birth outcome. 

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello, you guys. It seems like a common theme lately. A lot of people are wanting to submit their VBA2C stories, and I love it. I love it absolutely so much. We know so many of, these listeners in our community are wanting to know, is it possible? Can we VBAC after two Cesareans? I'm sure you've been noticing the theme in January and February, and now here in March, we have another VBAC after two Cesarean stories coming to you today from our friend Maria. Hello, Maria.

Maria: Hi.

Meagan: Thank you so much for being here and sharing your stories. We were just chatting a little bit before we got started about kind of where her birth took place, and she'll tell you more. But the VBAC was in Texas, right?

Maria: It was. Yes, it was in Texas.

Meagan: It was in Texas. So Texans. Texans? I don't know. we have Floridians, Utahns. Is it Texans?

Maria: Texans. Yeah. Yep. And you know, Texas is a huge state, so this is central Texas in the Austin area. Yeah, because it's such a big state. It is.

Meagan: It is very huge. We know people have to sometimes drive really far away to find support. And when it comes to VBAC after multiple Cesareans, we know sometimes that can be really challenging. And when I say sometimes, it's often. It is often challenging to find that support. So I really like to show everybody where you are in a way because we want people who are in Texas or who can get to Texas or who find it manageable, that they know that there is a supportive provider there. 

We'll learn more about that. But also, just a reminder, guys, if you're looking for a supportive provider, we have a supportive provider list. How many times can I say "supportive provider" in three seconds? A lot, apparently. Go to Instagram and hopefully at this point we'll have it on our website, so check our website too, but we will have that list.

If you want to submit your provider, please let us know. 

Okay. We have a Review of the Week, so I want to get into that. This is by Whitney Goats, and the review title is "Amazing" on Apple Podcasts. It says, "I've been wanting to write a review for a while, but wasn't sure what I could say that would explain how much The VBAC Link meant to me. I had an unplanned Cesarean with my first and for the longest time, I felt broken and defeated. When I heard Julie and Meagan share their VBAC stories on the podcast, I cried. It was the first time that I felt understood and like I was not alone. Listening to their podcast has lifted my spirits, healed my emotional scars from the previous birth, and given me the confidence in myself and my body again. 

"I am now 28 weeks pregnant and preparing for my VBAC. Instead of being scared for this upcoming birth, I feel excited sometimes. I never thought it would happen. Thank you, Julie and Meagan, for the work that you have done connecting and educating all these amazing moms, and thank you for reminding me that I am a Woman of Strength even when I doubted it myself." 

Oh, that gave me chills. That gave me chills reading that. Oh my gosh. We love your reviews. That is amazing. And girl, Whitney Goats, I hope that you had the most amazing birth ever, and thank you for being here. 

Just like Maria and all the storytellers that have become before her, you guys, they're amazing and so are you. These storytellers are here to do that- uplift you, motivate you, educate you, and find the healing within yourself because it can happen, right Maria?

Maria: Absolutely. 100%.

Meagan: It absolutely can happen. Okay, you guys, as always, if you do not mind and if you are enjoying the podcast, will you leave us a review? You can go to Apple Podcasts. You can go to Google even and leave us a review there. You can go on Spotify or really wherever you listen to your podcasts, leave us a review. If you feel extra special and the platform that you're listening on can leave a comment, leave us a comment. You never know, it may be read on the next podcast. 

Okay, Maria, I want to turn the time over to you to share these stories.

Maria: Thank you so much, Meagan, and I just want to say again how excited I am to be here. I agree 100% with that reviewer. This podcast was so impactful for me, and I hope that it can continue to be that for other women. I was also so excited that you're getting so many VBAC after two stories because I hope that that will continue to normalize that instead of it being this crazy thing that we're doing. 

Meagan: Yes.

Maria: That's so exciting that it's becoming more common.

Meagan: I know. It's actually making me smile so big because in the beginning, back in 2018, we had to search, and I mean search. We had to go on forums and type in "VBA2C" and really look for stories and almost had to seek them out. 

We had to go and ask, "Hey, would you be willing to share your story on the podcast?" And now we're just getting a flood of submissions which is so awesome. I love seeing it, and I would love to hear even more VBAC after three or four or five Cesareans because it is possible. It's not as easy to navigate through, but it is possible. 

And yes, there are risks. There are risks with anything that we do including a repeat Cesarean, but I want to help normalize this because, I mean, there are so many women just like Maria and myself who have gone on, done the work, got the education, and been able to have a vaginal birth. 

So. All right, well, we know with every VBAC or VBAC after two Cesareans, there's at least one Cesarean involved, so let's start with that story.

Maria: Yeah. Okay. Thank you. So when I got pregnant with my first baby, this was in 2018, it didn't take me very long to find my way to the natural birth world. I watched The Business of Being Born like a lot of women, and I was fully convinced that I wanted to birth vaginally and naturally if possible. 

So, when my husband and I decided to move to Costa Rica halfway through my pregnancy, the very first thing I did was research the C-section rate versus natural birth rates in the country. I was pretty disappointed, although I wasn't surprised, to find that the rates there are pretty high. I mean, they're about the same as the US but a bit higher in the private hospital setting which is where I was going to give birth.

I didn't want to let that deter me, and I was determined to build my team. From when I was still here in the States, I started researching the best OBs and doctors in the area and hospitals. I found two in the city of San Jose which is where we were living, the two most quote unquote natural OBs.

Another interesting thing I found out was that midwives are actually not legally permitted to work in Costa Rica independently.

Meagan: Really?

Maria: Yeah, at least back in 2018. I don't know if things have changed since then, but they are not allowed to work independently. They are allowed to work alongside an OB. So I was like, okay. I went with one of these OBs, and there was one midwife who practiced in the city of San Jose, and they worked together as a team. And so I was like, okay, all right, well, I guess this is it. I have my team, and I thought I was done. I don't think that I fully understood the intensity of birth or the mental and physical stamina that would be required of me because it was my first baby.

Meagan: You don't know what you don't know.

Maria: You don't know. Exactly. I took a Bradley birth course with my husband, and I just assumed that everything would be fine as long as I had a good team, and I'd be able to escape the dreaded cascade of interventions that I'd heard so much about. I wasn't informed, but I don't know. I was very intellectually informed, but I didn't really know how intense labor is. So intellectually, I knew what I had to do. 

But anyway, we were living abroad. I went into labor naturally at 40 weeks, and I had a very long labor which began in the middle of the night which was a common theme in all my birth. They always started in the middle of the night which I think is pretty common. And because it was my first baby and I was so excited, I was unable to really stay calm and rest.I got very ramped up way too soon.

I burned through a lot of my energy in the first 24 hours of what I now know was very early labor. So by the time it was actually more intense and I made it to the hospital, I was exhausted because I slept so little. We get to the hospital and my labor slowed down, which again, I know is not uncommon, but I think I was also just not feeling very relaxed. I started actually feeling uncomfortable with this midwife /doula

 as she told me she was. She said, "I'm a midwife/doula." I later learned that is not a thing. It's like, either you're one or the other. I just didn't feel like she was really supporting me as I expected she would. It seemed to me like she wasn't really a doula. I started realizing, okay, this is not what I was expecting. She was more of a quasi-nurse, really, for the OB and just assisting him. She was like his private nurse, basically. 

She was sitting there in the room either watching me. She'd come in and give me a position, but then just sit back and she was on her phone. At least that's how I was perceiving it. I just started kind of not feeling very safe with her, and I just shut her out. 

In hindsight, I think I should have asked her to leave. But at the time, I didn't really know that I could do that, and that I could really advocate for myself in that way, so I just kind of shut her out. She probably felt that it just wasn't a good click. 

So then I began to feel pressure by the team because I'd been there for probably, what is it, maybe 8 hours or so? They started pressuring me to get things going. And so the OB approached me about using what they call natural oxytocin which is what they call Pitocin.

Meagan: Pitocin, yeah.

Maria: Yeah. But they're like, "No, no, it's natural oxytocin." And I was like, "Okay, I know what that is." I could already see that I was being slowly kind of backed into this corner. I refused it several times, but I finally agreed to it. Of course, my contractions became excruciating, but I just was just determined to not have the epidural so that I could walk, even though I was already plugged into the IV and really not walking as free as I wanted. 

Eventually, one of the nurses, after a while, came in and she asked me when the last time I peed was. I couldn't remember. That's when I was like, "Oh yeah, it's been a long time." Nobody reminded me. I just didn't think about it. I had been drinking water, so they had me try, and I just couldn't pee. It's like my body just kind of shut down. 

So they decided to try and insert a catheter to see if it would empty my bladder and help baby descend. So I was laying on the bed. I had five people around me trying to place this catheter in me. I was on Pitocin, so I was having these intense contractions, and they weren't able to insert it. They said it was because of the way my body was. I guess my urethra was towards the back or something, and they just weren't able to do it. 

That was really disappointing because I was really hoping that that would be the magic thing that would help baby descend. 

Finally, the OB came in and was like, "Listen, if you want to avoid a C-section, you should just do an epidural so that your body can relax, and maybe that could help us place up the catheter and then, baby will descend." I was like, "Okay, all right. Let's do it." They did it. It felt amazing for a couple of minutes, and then immediately, my baby's heart rate dropped. 

The OB basically just called in an emergency, and I was whisked off to the operating room for an emergency C-section. I was traumatized because I legitimately thought I was dying. I thought it was a true emergency. I was like, oh my gosh. I can't believe it. I'm gonna die. Of course, I've learned since then that a baby's heart dropping after an epidural is pretty common.

Meagan: Pretty common, yeah.

Maria: And that it wasn't really a true emergency that merited a C-section right then and there. That's been a really hard thing to process.

Meagan: And frustrating, too, because he was like, "If you want to avoid a Cesarean, this is what you have to do," and then you did that, and then it immediately went that way.

Maria: Yeah. I honestly thought he was. I think he was probably just prepping me in advance to just have the epidural so we could just go there.

Meagan: Yeah, that's hard.

Maria: Yeah. After baby was born, the hospital policy required me to go into the post-op room for 30 minutes to recover, and I would then be rejoined with my baby.

Meagan: Oh, so your baby wasn't allowed to be with you?

Maria: No. 

Meagan: What?

Maria: Yeah. So my first 30 minutes as a mom, I was separated from my baby. He was with my husband. I was taken to this room where I was recovering alongside other people that I didn't know who were also recovering from other types of surgeries.

Meagan: Whoa.

Maria: Yeah, so I was like on this bed paralyzed still because of the epidural and shivering. It was a really surreal moment because I felt like, oh my gosh. I just had a baby. Wait, why am I here? What is happening? It was really, really traumatizing, and that was just their policy at that hospital. So it was really traumatizing for me. I was eventually joined back with my husband and baby, but needless to say, it really affected me.

I did struggle with postpartum depression and anxiety for a long time. I had a very hard time bonding with my baby for that first year. I felt really robbed of that dream birth I had envisioned, and I felt robbed about the golden hour right after when you get to enjoy your baby and celebrate the fact you just had a baby. I felt like I never got that.

Meagan: That would be very difficult. There are a lot of people who get their babies taken away, and it is so frustrating. I just wanted to give a little reminder that if you don't have your baby and you want your baby, it's okay to demand your baby and find someone who will do anything in their power to get that baby back to you.

Maria: Yeah, so that was my first birth. So the second birth took place about two years later, and we were back in the US due to the pandemic. As soon as I found out I was pregnant, I was actually in Costa Rica when I found out I was pregnant, and then we moved back to the US halfway through my pregnancy. I just knew without a shadow of a doubt that I was going to try for VBAC. I was extremely confident that I could do it because I felt that if I found a truly supportive provider, there just was no reason why it wouldn't go smoothly. 

I had a lot of unprocessed anger and trauma that I hadn't fully worked through. I was still very angry at my OB, at the midwife, at the hospital, even though I did do therapy actually in Costa Rica, but I don't think I fully worked through this part. Even though none of it was truly 100% their fault, I still felt really let down, and of course, I felt anger at myself even for my perceived failure of my body to birth my baby. 

My way, at the time, of avoiding a repeat of this was to just completely avoid the hospital setting and go the complete opposite direction. So I opted for full midwifery care and home birth. I just didn't want anything to do with the hospital. It was traumatic. I was like, no hospital. 

At the time, we were living at my parents' home in their hometown. I basically hired the only midwife that I knew in town. I didn't really interview anyone else. I just went with her. I think in my mind at the time, as long as you were a midwife, she would be 100% better than an OB. Again, I was very angry at OB at the time. But also, I did meet the midwifery team and they seemed experienced and I liked them, so I felt really confident that everything would work out like it was going to work out. There was no plan B. 

Meagan: Yeah. 

Maria: In terms of preparing for my birth, I didn't really do much outside of remaining active. I did prenatal workouts. I walked. I was healthy. I thought that was pretty much what you had to do. I just thought again that not being in a hospital would solve all my problems, and that was the only ingredient I was missing for my dream birth, which, of course, I later learned was just part of the equation.

So this time, my labor started actually pretty slowly. I had a premature rupture of membranes. It was a very slow trickle. It took over 24 hours of that for my labor to actually start. That was even after some homeopathic pellets. I don't really know what it was, but my midwife gave it to me and some castor oil that I took. 

I'm a pretty anxious person, so I was getting very anxious about my labor not starting because I had it in my head that I couldn't go too long without my water breaking. In my mind, I was on this timeline. I don't do well under pressure, so right off the bat, I was already in my head about it.

Meagan: Yeah.

Maria: I was so antsy to get labor going that I just wouldn't let myself rest. I actually went walking in the middle of the night with my husband instead of trying to rest. I was like, I will get this labor to start. I was just not really saving my energy. I was getting revved up again too soon. So again, once labor got going, I was exhausted.

This time, I'd opted to give birth at my parents' home which in hindsight was probably not the best idea because I felt their presence in the home. I'd sense their worry and their concern over me, at least in my head. I was mostly in their bedroom, so I started getting claustrophobic in there. I felt like a caged lion at one point. I was like, ah. 

Now nobody was actually pressuring me, but I felt it. I just felt like my whole family knew I was in labor. Everyone was waiting for me. Again, hindsight is 20-20, right? I was like, man, I could have asked them to just leave for a while, but I just didn't feel like I could.

Meagan: Yeah, it's their house. It's their house. It's their space. Yeah, it's weird. But I will just point out that who you have in your space and where you labor can impact your labor for sure because you're in your head.

Maria: Yes, 100%. It took me two labors to learn that. Especially if you're a sensitive person and feel energy and if you're anxious, you have to be really aware of is somebody helping you or not? And if they are re not, then you can say you can ask them to leave. I just didn't know that I could do that.

Anyway, I powered through it. Even despite that, I think labor was better in my home than it was at the hospital. I definitely felt more comfortable. I was more free. I was trying all these different positions and shower, bathtub, you know, everything. I felt really powerful. It was really positive at first. It was, despite the fact that I was really tired too. But it was a very long labor. 

Once again, my body shut down and I could not pee even though everybody was trying to remind me to go. I was trying to go, and there just came a point when my body just stopped wanting to go. We got to that point where they were like, "Okay, well let's try and place a catheter." They were not able to do it. I guess I have a very small urethra or something. Something happens in my body during labor. It's hard to get to it. 

This was a home birth, so they had their equipment on hand. They didn't have all the options that maybe they would have in a hospital of different sizes or something, so they just weren't able to place it. It was very, very disappointing. They also felt that I was getting weak, and I didn't want to eat anymore. 

They hooked me up to an IV. They gave me oxygen. This started triggering this fear in me that this was heading in a direction that I didn't like. It wasn't feeling like the peaceful home birth I had envisioned. I eventually got to 10 centimeters, and they said I could start pushing even though I didn't really feel much of an urge to push but I was like, okay, I'm 10 centimeters. I guess I'll try pushing. 

I started pushing for multiple hours, but the baby just wasn't descending. And at one point, the midwife could see the baby's head higher up, and she actually attempted to pull the baby out with her hands.

Meagan: Kind of went in like a soft forceps.

Maria: Yeah, exactly. It was very painful. Super traumatic. I was like, oh, my gosh. This is not what I envisioned. But she wasn't able to do it. He was just too high up. After that, I just remember seeing her throw up her hands and with her body just kind of say, I give up. There was nothing more that she could do for me. 

At that moment, with a surprising amount of clarity and conviction, I decided to call it and request to be transferred to the only hospital in my town that accepted VBAC, any other hospital would have had me go straight for a C-section. So this was my last chance because I wasn't done trying to VBAC. I was like, okay, home birth isn't gonna happen, but maybe VBAC will at a hospital. 

And so, we got to the hospital. When I got to triage, they checked me, and they actually said I was nowhere near complete and that I was 8 centimeters dilated, and that I was very swollen.

Meagan: That's what I was gonna just ask. I'm wondering if you got swollen.

Maria: I was definitely very swollen, but they also said I wasn't 10 centimeters. I was like, "What? What do you mean?" Because in my mind, I was like, I'm almost there. I'm 10 centimeters. Maybe all I need is an epidural maybe. Maybe I just need that final little push. At that point, I was okay with drugs. I was like, "Give me whatever." I'm so close, right?

Meagan: Yeah, yeah.

Maria: But no, they were like, "No, you're 8 centimeters." And also, my contractions had really spaced out, so they gave me an epidural. They gave me Pitocin, and they let me rest.

Meagan: Did they give you a catheter and empty your bladder?

Maria: Yes, they gave me a catheter to empty my bladder, but baby was just not coming down. And also, the epidural did not sit well with my baby again. They didn't whisk me away to a C-section this time, but they were starting to bring up, "Okay, it's been a long time." 

They also were pretty concerned that my water had broken two days before, and that was a big red flag for them. They started mentioning C-section as the safest route for me. After, I don't know, probably 8 hours there, I just kind of said, "Okay, let's just do a C-section, and we just went with it." This time was less traumatic because it wasn't an emergency. I chose it. I was also never separated from my baby, and that was very huge.

Meagan: Yes.

Maria: That was huge. Yeah, 100%. Like, I got to carry him immediately after birth. I was able to breastfeed him. I was like, nobody is separating me from this baby right now, and they didn't. So that was very healing, and I was very grateful for that. That was that birth. After the birth, the midwives did come to see me at my house, and when I asked them what happened, they weren't really able to give me an answer. The final consensus was that my hips were likely too narrow. 

At the time, this diagnosis actually gave me comfort because at that point--

Meagan: It validated you.

Maria: Yeah, it validated me. I felt like, okay, I tried everything. It felt like an answer. It was a neat and clean end to this journey. There was a lot of mourning still. It was a heavy weight on me, this disappointment of a failed VBAC and something that I would need to process for a long time because I felt really cheated. I really felt like I'd run an entire marathon, and that I could see the finish line only to find myself pulled back to the starting line again and have to run another marathon.

I felt like I had gone through two whole births, the super intense home birth and then C-section. So I felt like, oh my gosh. I was wiped out. So, yeah. Those are my two C-sections.

Meagan: Yeah. I mean, lots of really forward-moving progress with the second for sure and still work to be done. But also, you had some validation for you at the time. It felt better. Overall, it went better.

Maria: Yeah, yeah, yeah. It definitely was better. It was better, but it was, in a way, almost more frustrating though because I got so close. I was like, I'm so close and yet I was pulled back to the exact opposite birth.

Meagan: Yeah. I want to talk a little bit about swelling because swelling can happen. You can be 10 centimeters. Swelling can happen. It causes puffiness and causes our cervix to swell which then presents as not 10 centimeters. There are a lot of different factors like a baby that is maybe not putting equal pressure on the cervix during pushing or pushing before our body is really ready for us or going in there and doing that, I call it, soft forceps. This is just me making this up, but my fingers are a lot softer than forceps. So her doing some soft forceps was in effort to help baby come down and move but could have disturbed the cervix a little bit and then sitting in on the way. 

So I just wanted to point out that is it possible that you could have been 10 centimeters? Yes. Is it possible that swelling could have caused the regression? Yes, there are some hem-- oh my gosh. How do you say it? Hemopathic. Is that how you say it? Hemopathic. They're little tablets.

Maria: Homeopathic.

Meagan: Homeopathic. Why do I say hemeo all the time? Homeopathics. Just like they had given you those little tablets that can actually help with swelling of the cervix. So if you have a midwife or you want to look into that and have that in your bag at the hospital, if that happens, you might want to check that out. 

While you're telling your third story, I will see if I can find the exact name because I cannot place it in my mind right now, but I've seen midwives use it, so that's another thing. And then sometimes Benadryl. A lot of the time, I'll see moms be given Benadryl for swelling.

Maria: Yeah, I don't think they gave me any of that. I think at the hospital they were just kind of like, "Oh, 48 hours. Okay, let's--".

Meagan: Yeah, the typical.

Maria: And yeah. I think they knew from the beginning probably that I’d end up in a C-section. I don't know.

Meagan: Might have. Yeah. So baby one, baby two. How did things change with baby number three?

Maria: Everything changed. So when I found out I was pregnant for the third time, I, was very surprised and excited. But as soon as I actually thought about the birth you, I felt dread. I knew I was out of options mostly because my fate had been sort of sealed with this diagnosis of narrow hips. I was pretty much certain that my only choice was a third C-section. That really filled me with dread because I had a really rough recovery with my second C-section. I was really unhappy with my scar. I just felt really not looking forward to a third C-section. 

So I was like, okay. It felt very scary. I decided to approach my husband about trying for a VBAC again. I was sort of certain he would be nervous about supporting me about that. I felt like it was gonna be like, "Maria, you've tried twice. Let's just accept it. Let's move on." But surprisingly, he was actually supportive and he told me to just start with doing some research about VBACs after two and to get some opinions. 

So I did. The first thing I actually did though was I looked into gentle C-sections because I was like, "Okay, I'm going to get my kind of worst-case scenarios out of the way just in case. If I'm going to have a C-section, I want it on my terms." I looked up the best gentle C-section OB in the area. I was like, "Okay, I've got something there." Then I reached out to my midwife for my second birth and asked for her opinion about going for a VBAC again. I reached out to a few birth centers in the area, and my midwife pretty much told me that she did not think I was a good candidate for VBAC again and that I would end up likely in a C-section. Again, because she was like, "You did everything you could. It just didn't work. I just don't think you're a good candidate." 

And then most of the birth centers in the area declined me because they only did the VBACs after one.

Meagan: After one. Yeah.

Maria: Only two birth centers in the area accepted VBAC after two. I was like, "Okay, I'm gonna go see one of them and just get a second midwife opinion."

Meagan: Yeah.

Maria: When I got there, this place inspired a lot of peace and comfort. It was this really cozy little space. It was a little cottage near hospital. The midwife I met with, her name is Galyn. Can we give you the name?

Meagan: Yeah, yeah. Uh-huh.

Maria: Yeah. So this is called The Family Birth Center. It's just amazing and Galyn is amazing. So she just was very confident. I told her my entire birth story. I was sure to add every single complication and also tell her what my previous midwife had said. I honestly painted a really dire picture for her. I was like, "I have really long labors. I can't pee." You know, blah, blah, blah. I was prepared for her to tell me that I was not a big candidate. Honestly, I almost wanted her to say that so that I could just close that chapter and go get my scheduled gentle C-section and move on because that felt easier and safer. 

Yet her response was not a no. It was actually a non-hesitant, "Absolutely, you can do this." I was shocked. I mean, she obviously asked for my op-reports and everything, but she said that she didn't see why I wouldn't be able to. She had a ton of experience with VBAC after multiple C-sections. She even said that she had a very special place in her heart for these mamas because, as she called us warrior mamas, who really, really wanted it. 

She did not believe that I was too narrow because that's actually quite rare. She thought it was likely that the baby was simply badly positioned. So right off the bat, she was like, "Okay, I would start you on some Vitamin C to strengthen your bag," which I didn't even know a thing. She was like, "Pelvic floor therapy right off the bat, and you need a proper doula." 

I was like, "Yes, yes, yes." I'll do all those things because I realized I had not really had a proper doula in my previous birth. And honestly, every concern or worry that I brought up, she was able to talk through it with me, provide a solution or just remind me that no birth is the same. She couldn't really control or predict the outcome of the birth but there were lots of things that we did have control over.

One of the things that I was really worried about was my inability to pee during labor. She was like, "Okay well, we'll place a catheter." I was like, "Yeah, but they tried both times and it didn't happen." And she was like, "Well, I'll get you a really tiny one." I was like, "Okay." 

So she didn't seem worried about that. I just went with it and went with her confidence. I think I decided then and there that I wanted her because I just felt really heard and I don't know. She provided lots of practical and realistic solutions that we could control. 

Anyway, this time around, I hired a doula. Shout out to Jenna, my doula. Also an amazing, amazing woman. I went to pelvic floor therapy. I also did therapy again to process my past births. I worked really, really hard on radically accepting whatever this birth came to be. So unlike my first two births where I had a really rigid idea of what it would be, this time I worked really hard to just sort of surrender to whatever it ended up being. I also read several books, including how to Heal From a Bad Birth.

Meagan: Yes.

Maria: A really good book, and Birthing From Within which I also loved. It was a really impactful book, actually. I started doing some art therapy just to process some of my feelings and just about this pregnancy and birth. I listened to every single episode you guys had on VBAC after two. I took The VBAC Link course. Honestly, I hardly worked out mostly because I had two little boys under four, and I just did not have it in me. But I was still very active with just normal life and taking care of two little kids. 

I did walk a bunch and did some gentle, prenatal yoga. I also did some exercises recommended by my doula from Spinning Babies. The other thing which was different was that I was really mindful of my body positioning throughout my pregnancy. I was always trying to listen to my body and be mindful of my alignment. When I was watching TV or sitting at my desk, I'd sit on a ball. I'd sit on the floor. I love to go on my hands and knees. That felt really good on my back. So just kind of listening to what my body was asking me to do and just being more aware of my body. 

My whole motto was, throughout the whole time was, "Get out of my head into my body." Preparation felt really different for me this time. I felt like I was preparing my body from the inside out physically speaking. Like I said, I was going to pelvic floor therapy. I was also making room in my uterus for my baby with these exercises to be in the best position possible but I was also really focused on my mind, my spirit, processing all my fears, my traumas. It felt just so much more holistic. I did HypnoBirthing with an app. I wrote down my own prayer affirmations which actually became a really central anchor during my labor. I felt just really ready this time in a new way. And not just because of my dream team but because I was really just ready to surrender to whatever was to come. 

And also, what was driving me was this new goal which was this idea of just giving my body a chance to labor was the best thing both for me and my baby regardless of the outcome of the birth. Even if it ended up in a C-section, I was still doing what was best for my body and my baby. That's what I kept repeating to myself. It just gave me a lot of peace because the success of this birth was not tied to what kind of birth it was. You know what I mean?

Meagan: Yes, yes.

Maria: It removed a lot of that pressure, a lot of that fear, and that was just such a game changer for me. Yeah, that was the preparation. A few weeks before the birth, I'd been starting to get more intense Braxton Hicks, but nothing really consistent. I was really just trying to practice the art of basically ignoring them because my goal for my early labor was to just pretend like they weren't happening. I didn't want to get too excited too fast. I wanted to ignore them for as long as possible especially if they started in the middle of the night which is kind of a theme for me. It ended up being really great practice to do that because on Labor Day, of course, I started getting my first contraction at 2:00AM and I just denied it. I was like, nope, they're Braxton Hicks. 

I just wasn't allowing myself to get riled up. I managed miraculously to doze off for 20 minutes at a time until they started coming on stronger. Once I realized that this was early labor, I had decided before that I wanted to labor alone for a while. This was actually something that I'd been wanting to do just to have this early early labor be a sacred moment for me and my baby. I wanted to be able to pray, to talk to my baby and to prepare together for the work which we would be doing together, both of us. I went into the living room. I let my husband sleep a bit longer, and it was a really special time for me. I'm so happy that I did that.

Meagan: Yeah, I was just going to say that is a very powerful moment. Our babies are so connected and if you can have any time, even if it's just like 20 minutes. "Hey, I'm going to the bathroom." Take 20 minutes in the bathroom and connect with your baby. I just think it's so powerful.

Maria: Yeah. Yes. It was amazing because I did feel connected the whole labor in a way that I did not in my previous ones where I was very disconnected to what was happening in my body. I was in my head a lot. So at about 6:00am, my contractions were getting stronger and I was like, okay, it's a reasonable time. I'm going to go ahead and wake my husband up. I also knew that my boys would be waking up soon, so I wanted my husband to focus on them and get them breakfast. And then I explained to my boys that baby was coming soon, that they were going to go stay with their cousins for a night or two. I knew that I wasn't going to be able to fully relax if they were still in the house. 

It felt really important for me to say goodbye and to make sure that they were going to be happy and in a safe place. As soon as my brother-in-law picked them up, I just really felt my body, okay, let go and things just started picking up. I took a shower. I had breakfast. I knew it would probably be a very long labor, so I wanted to eat. I called my doula. She came over and her presence was just such a game changer because she was just this calm, comforting presence. Not to say my husband was not, but she's just more-- this is her job. She's more objective. She was able to suggest different positions. She knew when to let me be. She pushed me when I had to be pushed and let me be when I had to be left alone. 

But the best thing she did was she did not let me head to the birth center too soon. I wanted to go and she'd be like, "Okay, let's just wait for 30 more minutes. Can you do 30 more minutes? Yeah, let's try this position. Let's walk a little bit. Let's do this and that." That was so important because I would have gotten there way too soon. She and my husband were in touch with Galyn, the midwife. Everyone was just super chill and relaxed. Everyone ate lunch. I don't think I did, but everyone else did. It was just a nice day. It was a cool rainy day. 

And then at about 2:00 PM my contractions were about 2-3 minutes apart. They were lasting about a minute, and they were getting intense. I was like, "Okay, I need to go." They were like, "Okay, yeah, let's go." We got to the birth center. I was just wrapped in this fluffy blanket. I just picked it up like I was in this daze. I was listening to my HypnoBirthing app. And Galyn, she was so relaxed about everything. Everyone was just very relaxed. It was during the daytime. 

She'd come in. She'd leave. I got in the bathtub at point. At one point, she checked my dilation and asked me if I wanted to know. And I said, "Nope, I don't want to know because I don't want to get in my head." She was like, "Even if you're 9 centimeters?" And I was like, "No." Okay. That was so amazing. That was such a push of encouragement. And so that was very helpful. 

Once again, I ran into the issue of being unable to pee. Of course, not surprisingly. So Galyn asked me want if I wanted a catheter. I said, "Okay, let's try it," but I was super nervous about it.

Meagan: Yeah.

Maria: But this time it was super easy. It was amazing. It went in right away. She had the right size. I don't know what it was, but--

Meagan: Right size, pelvic PT.

Maria: Yeah, yeah, yeah. It was easy. I had a ton of pee. After that I was like, oh, my gosh. I surpassed these two huge obstacles of being really well-dilated and also, an empty bladder. Like, I got this. It's amazing. I felt this new surge of energy. After that, I just focused on one contraction at a time. Each one lasted four breaths for me. Each breath coincided with a short prayer that I would say to myself. The hardest breaths were always breath two and three because it was the peak of the contraction. But I knew the pattern in it, and so I knew what to expect. 

I just remember opening my hands every time and surrendering and just trying to just relax my body and just accept it, and let it wash over me. I was doing a lot of visualization of my body, my pelvis opening, my baby coming down. I was so connected to my body and my baby. I just remember communicating with her and visualizing her coming closer to me. And this, like I said, was something so new for me, this connection. 

After about two hours of labor, there I was fully dilated. They had me do some focused pushing. Unfortunately, I never really felt that overwhelming urge to push that I'd read so much about and that I had wanted to feel. My pushing was more directed, but it felt a lot less forced than with my second birth. I decided to push on the bed on my hands and knees. My husband and doula were each holding a hand. Galyn was encouraging me. Every time I pushed and she would feel the baby come down, she'd let me know. 

That was really encouraging to know that it was productive pushing. I was just so focused. After about 40 minutes of pushing, she told me, "Okay, the next push, you're going to feel a burn." Before I knew it, it was the ring of fire I'd heard so much about. Although it was painful, I was just in awe that I was feeling it. I was like, oh my gosh, this means something. I'm so close. It was surreal. I was experiencing it in this weird, out-of-body way. And then the next push, baby was born. I was just in shock. I couldn't believe it. I couldn't fully believe that I did it. 

They passed her to me immediately. I was still on my hands and knees. I will just never, ever forget the feel of her body and her skin when I held her for the first time. It was the birth of my dreams. I think one of the other things I just loved was just that time afterwards that I never got to experience and that moment of coziness where we were just laying in this queen bed, my husband and I and my baby, and just eating together, holding her immediately, breastfeeding her like it was just a dream. I got to take a bath with some healing herbs. It was amazing. And then, after several hours, we just drove home with our baby.

Meagan: Just amazing. That is what birth is about right there. All of those feelings, all of those smells and experiences and bonding moments. I am so happy for you. Let's just say you debunked the myth. Your pelvis was great. Your pelvis and your hips were just fine. It really just took someone educated to know that your baby was in a poor position and that okay, instead of doing this size catheter, let's do a smaller catheter. 

It's just these little things that made such a big difference. I think it's really important to vet our providers when we are interviewing them. I love that you were like, I gave her all the bad. Like, all of it. I just laid it on her. I wanted her to know everything that I was being told or that was said or that had been done. And then for her to be like, "Okay yeah, I hear those. I see these op-reports, but still don't believe there's anything that makes you not be able to," is just so powerful. So those are the types of providers, and if there really, really, really is a medical reason, they can back it up. "Okay, let's consider something." But I do love that you just came in with all of it, just all of it, and expecting her to be like, "No." And then when she said yes, you're like, "Wait, what?"

Maria: What?

Meagan: "Wait, what? Can you repeat that?" We really are getting more of that flack and doubt, so it's so great to hear that there's such a supportive provider out there in your area because every area needs it. I would love to see more support coming in because the fact of the matter is, it can happen. It can happen. It is possible, and really, the risk is relatively low, right? It's low, and it's something. 

And then we do know that to some people, it's not acceptable, and that's okay. But know that the risk is relatively low and that the world paints it to be so much bigger than it is.

Maria: Right. Well and also, nobody talks about the risks of repeat sections. Right? Nobody mentions it. I'm like, why is this not being even mentioned at all?

Meagan: We talk about it here because it isn't talked about. We have providers say, "Oh, uterine rupture, uterine rupture this and that," but they're not like, "Hey, dense adhesions connecting to your bladder for life, scar tissue gaining for life, back pain that you may discover in your 50s that is related to your Cesarean adhesions and pain." 

And then, not to mention there are a lot of things like hysterectomy, increased blood loss. You guys, there are things to talk about and complications that can come forth in the future pregnancies as well. We don't talk about those to scare you. We don't talk about uterine rupture here to scare you. We don't talk about uterine rupture or share uterine rupture stories to scare you. We are here to educate you. We want you to know there are pros and cons on both sides. If you find a provider who is all about sharing the risk about VBAC instead of repeat Cesarean, you might not want to be with that provider because there are risks for both sides so if you're getting a one-sided risk, there are some concerns there.

Maria: Yeah. Yeah, exactly.

Meagan: Well, thank you again so much for sharing your stories. Congratulations. I'm so happy that you found the right provider. You found the dream team. Everyone was on your side and supporting you along the way.

Maria: Thank you, Meagan. Again, I think that's only one part of the equation. We as the moms have that other responsibility of really healing ourselves and our past traumas and doing more than just, I guess, working out. A lot of people don't think about the inner work that we have to make for our pelvic floor and even the uterus with making space for your baby in there for optimal positioning. I never heard of these things before you. All of that knowledge was very helpful.

Meagan: Yeah, there's a lot of work. Before we started recording you were like, "With my second birth, I just hired a midwife and put it in her hands and was like, hey, I did the work. I hired a midwife," but there's so much more than that. 

And yeah, finding a supportive provider, getting the education, but there's so much work. We talk about this in our VBAC course-- mental and physical prep. We talk about it early on in the book because it is such a big part of how things can go and if we don't do those things, it can impact us. That doesn't mean you can't get through it and have a VBAC. I don't want to say if you don't go to therapy, you won't get a VBAC or if you don't do these things, but these things will impact you in a positive way more than a negative. 

I also want to talk about trauma and birth and going through and working through it from the inside out. It's not even birth. It's life. It's affecting us for life. We hold trauma in our body. We hold emotions. We pent them up and yeah, it's just you. We gotta work through them. We can't just shove them in and be like, "Well, that was that. I'll let it go," because it's not going to be let go. It's inside of us.

Maria: Yeah.

Meagan: Yeah. It'll show up. It will show up. It might be years. It might be months, you never know, but it's important to work through it. Okay, well I will not take any more of your time because I know you've already been with me for a bit, and I just wanna thank you again.

Maria: Thank you so much, Meagan. It's been such an honor.

Closing

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

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“I don't think anyone pushes like a VBAC mom pushes.”

In this episode, we chat about premature rupture of membranes (PROM) with Noel, a stay-at-home mom from Texas, as she shares her personal experiences and successful VBAC story. We dive deep into the importance of finding a supportive provider and the realities of induction. Noel was never able to fully dilate during her first birth. She and Meagan talk about the impact of meaningful milestones (like reaching 10 centimeters!) during a VBAC labor. Also, it’s never too early to hire your doula!

Premature Rupture of Membranes

Preterm and Term Prelabor Rupture of Membranes

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, Women of Strength. It is March which means it is my second C-section baby's birth month. I love March so much because it's also when the sun starts feeling a little bit warmer, and you start hearing some birds chirp. We're kind of getting to that spring season, depending on where you are. Let's be honest, I'm in Utah, so it's still probably snowing every day in March. But I love March so much. And we're kicking it off with a really great episode. We have our friend, Noel. Hello, Noel.

Noel: Hi.

Meagan: I am so excited for her to be on today. She is actually in Texas, and tell us where again in Texas.

Noel: The Woodlands, Texas. It's right near Houston.

Meagan: Okay, perfect. And this is where you had your baby?

Noel: No, so I actually had my baby in Dallas. That's where we were living at the time.

Meagan: You were in Dallas. It says it right here on your little form. Okay, so she was in Dallas, you guys. So Dallas peeps or really just Texas peeps or really anybody. We know people travel for support and things like that. This is definitely a story to listen to. 

And then we are going to be talking a little bit about PROM. If you haven't ever heard about PROM, PROM is P-R-O-M and that means premature rupture of membranes, which means your water breaks, but labor doesn't really start, so it breaks prematurely to labor beginning.

There's also PPROM, premature rupture of membranes, which means your baby is preterm. So we're going to dive into that in just a minute. But I wanted to tell you a little bit more about Noel. She is a stay-at-home mom with two boys. One is 3.5 and one is 5, so it's been a little bit since she had her baby. She actually submitted a while ago. We found this and I was like, I really want to talk about this because one, we talk about PROM, two, we talk about finding a supportive provider, and three, we talk about induction. 

I think it's important to note that if VBAC is more ideal without induction stereotypically, but it is still very, very possible with induction. I think there are so many people who are told that it's not possible out there or don't think it's possible or think that the risk is just astronomically increased when it comes to induction, and that's not true. 

So Noel has been doing lots of great things. In fact, she just told me a fun thing. She just started a company. Can you tell us a little bit more about that?

Noel: Yeah. So we just started a travel agency. It's called Noel Mason Travel, and I'm specializing in Disney. I love Disney, Disney cruises, Universal, all-inclusives, and then eventually just catch-all travel.

So yeah. I'm excited. 

Meagan: Love it. Fun fact about me that you might not know, and it's even more about my husband, we're a big Disney family. In fact, we just went to Disney World for the second time this year. We just got back literally two days ago.

Noel: Oh my gosh. We're about to go.

Meagan: We love Disney World so much. And my husband is a die-hard Disney fan.

Noel: It's so fun.

Meagan: It's exciting.

I was just told recently by a friend that we definitely need to try a cruise, so maybe we need to connect. But yes, if you guys are looking to take your family to Disney World, definitely reach out to Noel. Of course, you can ask VBAC questions. 

Noel: Yeah.

Meagan: Okay, so I'm going to go back. In addition to starting a travel agency, she loves cooking and is very passionate about pregnancy. She actually started an Instagram documenting her VBAC journey. In addition to fun and travel, I wanted to see if you could tell us more about your Instagram page where people can go and follow that page from when you were doing that.

Noel: Yeah, so it's called Docnoelmason. I'm obviously not a doctor, it was just kind of a joke. But I created that Instagram at a time when I was grieving my first birth. After therapy, I realized how important it was for me to just talk. It didn't matter if anyone was listening. I just wanted to talk and educate. I created this Instagram basically just to educate my friends, none of them who were pregnant yet, on how to avoid a C-section, C-section recovery, if you have one. 

It was just a video diary. There's so much content of me just sitting on the couch to my camera, ugly views, just talking about what was currently going on.

Meagan: I love that. I think that's going to be something that people will connect with because that's where we're all at. We just want to sit there and hear where someone else who's going through the exact same thing is. I just feel like we connect so much and that's why I love our community on Facebook, and I love this podcast, and of course, we love our Instagram pages and things and hearing everybody connect. 

We've been told that people have made actual friendships through this community. It's so awesome. So thank you for sharing that. We will have all of the links for the Instagram page and her new travel agency in the show notes if you are interested in checking that out. 

We do have a topic of the week instead of a review of the week. If you're just joining us, we have, for so many years, done a review every single week where people comment and leave reviews, and we share them. We're still loving those, and we're still sharing those. So if you haven't yet, leave us a review on the podcast. It really does help us so much in so many ways and truly helps other Women of Strength just like you find the podcast. 

You can check that out at Google. You can Google "The VBAC Link" or on Apple or Spotify or wherever you're listening to your podcast, leave a review. It'd be greatly appreciated. 

But today, we do have a topic of PROM. So like I mentioned, Noelle had PROM. I had PROM. She's gonna tell you more about her story of PROM. And I've shared my story a million times about PROM, but they say 10% of pregnancies will have PROM, premature rupture of membranes. I was 3 for 3. It just happened for me. That can be sometimes hard because water breaks, and what do we do? 

I mean, Noel, what were you told to do if your water broke? Did anyone say anything?

Noel: With the first pregnancy, I was told to go straight to the hospital. Don't delay. Get there immediately. With the second pregnancy and a better team, I was told, "Just keep doing what you're supposed to do." Walk if you want to, but just act like nothing's happened.

Meagan: Go carry on with normal life.

Noel: Carry on. Yeah.

Meagan: Yes. That is definitely something that we would suggest. Now, there are certain things that we want to watch out for. If our water breaks and it's green, nasty, meconium-stained, it might be a reason to go in to your provider or call your provider and have a discussion with them. There's prolapsed cord. That can happen, and that is a very serious situation where we need to get on our head and get our butt in the air and get to the hospital. 

If there is a cord coming out after your water breaks, it is an emergency situation and is not something to just hang out and carry on with normal life. But when water breaks, what I was instructed to do with my third pregnancy, also like you with a better team, a more educated self and I had doulas and midwives and everybody. It was your water breaks, you do a little check-in. What does the color look like? Okay, is it clear? How are you feeling? Do you feel like you have a fever? Do you feel flu-like symptoms? Maybe take your actual temperature and see if you have a temperature. 

Okay. We don't have a temperature. We're not contracting. All is well. Put a pad on. It's probably going to keep coming. Just to let you know, you will keep leaking and then keep going. Keep going. 

Now, it is important to know that it can take hours. I'm serious. Hours and hours for labor to start. And Noel's going to share her story in a second. But for me, it really took 18 hours until I was really going with my second. And then with my first, I actually started contracting soon-ish. So it might not be technically PROM, but I started cramping and contracting, but it really took until 12 hours for me to even be 3 centimeters dilated which was very normal as a first-time mom. 

Know that if your water breaks, it is not like, run to the hospital. We're having a baby right this second. You're gonna have a baby in the car. It's not always like that when your water breaks and contractions aren't starting. So just to let you know, about 95% of all births will occur within 28 hours of PROM when it happens at term at 37 weeks. 

Now, PPROM is, like I said, preterm premature rupture of membranes. That is something that you will probably want to go in for if your baby is preterm. That happens at about 3% of pregnancies. I just think it's important to note that it happens. Noel and I are proof of that. If it happens, it doesn't mean run. You don't have to run to the hospital. You don't have to think you're having a baby right this moment, but it's something I suggest checking in with your provider about beforehand saying, "If my water breaks, what would you suggest?" They might suggest go straight to the hospital. 

We know it's not necessarily what you need to do, but at least you know your provider's suggestions. Okay. All right, we are going to take a quick break for the intro, and then we're going to get into Noel's story. 

All right, Ms. Noel. I have taken so much of your time already, so thank you so much for talking PROM with me. Yeah, let's turn the time over to you.

Noel: Okay. So with my first birth, I was the first of my friends to get pregnant and I just had this very fairytale view of pregnancy and birth. I really just knew what happened in movies. So like you said, the water breaks, it's water everywhere, and you run to the hospital. I just had no idea what to expect. I had listened to some birth stories enough to know that getting a doula would be important, but at the time, I thought that is way too expensive and something that I, in my first pregnancy, don't need which is so silly looking back now, especially with my C-section bill being what it was "too expensive". It would have saved me a lot of money. 

But yeah, I did no techniques like Spinning Babies, no chiro, no PT. I just felt very unprepared. And looking back now, I think my doctor really preferred it that way. I think she didn't ever push me in that direction. I also had SPD and it basically felt like a knife was jamming up anytime I would walk. 

And again, my doctor never pushed me in any direction. She just said, "Rest when you can." That was awful. I was also told I had an anterior placenta which is a weird thing to remember, but I remember being a little bit scared by that. I guess that's why I logged it. They told me there was no risk to having one. It didn't really matter. But now looking it up, of course I know that can really affect the position of your baby. 

So flash forward to my growth scan. No surprise, I was told that he was sunny-side up. Of course, I asked, "Is there anything I need to do? Does that matter?" And the doctor said, "No, totally fine. Doesn't matter." You'll have a healthy Baby. So I said, "Okay." 

They found my fluid was low on that scan as well. Of course, I didn't ask what the level was. I just said, "Okay." They said, "We want to induce you in the next few days." So again, I was so excited to have this baby out. With my first one, I was like, let's get it on the books.

Meagan: That's very common.

Noel: Yeah. Yeah. So many of my friends I see doing the same thing. Again, you just don't know any better. You're ready to not be pregnant. We scheduled it for July 3rd, which again, I think was a huge mistake a day before a holiday. But again, I wasn't really thinking. I was put on Pitocin. I was already a little bit dilated, put on Pitocin and I was dilating about a centimeter every hour. Pretty uneventful. I would have to move positions. The baby's heart was acting up a little bit, but nothing really to worry about. 

I got to 9 centimeters. They brought out the table, all the fun vacuum forceps, and I was ready to go. That was probably 4:00. Well, every hour they kept coming in and checking me, and I was still a 9. So a couple hours into that, my doctor came in and said, "We're going to have an emergency C-section." 

That was that. No questions, just this is what's happening.

Meagan: Can I ask why they called an emergency? Was baby struggling or did they just use the emergency to justify as being a Cesarean?

Noel: Yeah, I think at the time of day, "Let's get this baby out of you before it's midnight. We want to go home." But no, aby was fine. Like I said, the heart was acting up a little bit, but no one was concerned. She just said, "This is too long to be dilated like this and not have any movement." 

Again, a first-time mom, I was just like, okay. I remember crying. My mom's crying. I'm crying. We're both just a little nervous about what's about to happen. The doctor came in and sees us crying and goes, "Don't worry, I'm going to have you back in that bikini by the end of summer." It still just has stuck with me what a routine moment this was for her and not a big deal to her. 

She just thought I would be worried about my body. It was just so ridiculous. The birth was fine. You know, we talked about the Bachelorette. It just was not what I thought would happen as they were operating.

Meagan: During your birth?

Noel: During my surgery, both the JOBs are talking about the Bachelorette, and I'm chiming in, and I'm just thinking, this is not what I had planned. This is not the moment I envisioned. It was really weird. So that next morning I'm recovering and my mom comes in and is like, "Hey, I don't know if you know, but one of my friends had a VBAC after her C-section with her second baby. She had a VBAC." 

And I asked her what a VBAC was and we talked about it. Right then I decided, this is what I'm going to do. I'm not doing this again. I am not doing this again. I'm going to have a VBAC. 

Flash forward about a year, I decided we would get pregnant again or would start trying, and we got pregnant right away. Thank God. In this time, I happened to find this article on Google listing hospitals to avoid for C-sections in the United States. Yep. You know, the article. Mine was number eight. Number eight. I could only laugh at that point, like, okay, all right. This time I'm going to be doing my research.

Meagan: Yeah.

Noel: So when it came to choosing my provider, I really felt like that was the biggest thing that could set me up for success. I knew I wanted to have the baby in a hospital again. I wasn't sure if it was going to be with a midwife or OB. I joined a Facebook page. It wasn't ICAN, and it was a group our of Dallas. It was a C-section Awareness Group, the Dallas page. There was a supportive OB who was mentioned there.  

I had an appointment with him and he was fine. Nothing to write home about. This was also during COVID, so all of those rules were in place and work mattered. I also started searching for a doula at 8 weeks because I just figured, if I'm going to have one, let's have one. I'm going to have them the whole time. One of those doulas suggested moving practices to a group called Dallas Midwife Associates, and now they're Midwife and Co. 

They are known for supporting VBACs, and the hospital that they deliver in Baylor is also known for just being a very VBAC-supportive hospital. So I switched to that group, and the coolest thing about them is you see a different midwife every appointment you go to. They just cycle you. So by the time you're ready to have your baby, you know everyone on the team. They all know you. You're not worried about your provider being on vacation. There's no pressure for induction or anything. They were so amazing and awesome cheerleaders. 

The OB who they are in practice with who would do a C-section if I needed one or became high-risk and had to go see him, he was also supportive. So that was awesome. I could not recommend them highly enough. But yeah, just preparing this time, I think, being so clear with myself about why I wanted this VBAC. For me, it was the biggest thing at the time was the recovery. My kids were going to be 21 months apart, and I did not see how I was going to be able to have a baby and another baby if I can't lift up the first one. He was still in a crib. I didn't see how that was going to work. 

And so the recovery was super important to me. The experience was important to me. I wanted to do everything in my power this time to know that if I had a C-section, it was a true emergency, and that I could look back on that birth and say, "Well, this is what was supposed to happen. This is why C-sections exist," and not, "Oh, gosh, I could have done XYZ differently this time." 

I also had the SPD again and was not about to let that fly. With a toddler, you're constantly moving, so I couldn't be in pain all the time. I went to go see a chiropractor. I went to physical therapy. They both recommended Spinning Babies as well as my doula. So I did Spinning Babies. I was kind of crazy about it. The whole don't recline more than 90 degrees, the flashlight trick thing, that was everything to me. So 30 weeks on, you would not catch me reclining. I sat with the best posture or just laid flat on the couch because I was not about to have a sunny-side-up baby.

Meagan: I can totally relate to that. I didn't sit on a couch. I didn't even sit on a couch because I was like, I'll sink too much and it will turn my pelvis in. I remember driving all back up and pelvis tucked forward.

Noel: On the tip of your chair.

Meagan: On the tip of my chair not wanting to have a posterior baby at, all. And then I got one.

Noel: It just shows you-- yeah, exactly. You're not really in control of it. I asked about my placenta this time. Again, that's nothing you can prevent, but I knew I had lower chances if it wasn't anterior. That was good for me to know that if it was, I would need to work even harder. I don't know how I could sit up any straighter, but do my best. 

And then I also had what's called an overactive uterus. I guess I just had constant Braxton Hicks. Google would tell you to go into the hospital, you are in labor. So many Braxton Hicks. My belly was just constantly hard. So because of that, I didn't do any of the tea. That would make it worse. Anytime I tried, I would have more Braxton Hicks.

Meagan: Because it's a uterine toner. So that's what it is. It is made to help a uterus that is contracting be more efficient. If your uterus is hyperactive already contracting, it's going to try and make it contract.

Noel: Yeah, it would go nuts. Yeah, yeah, yeah. But I did do the dates. I'm a big believer in the dates. Plus they taste awesome. So there was really no harm in that. 

Okay, so flash forward. It's 38 weeks. I was off and on higher blood pressure. But on that day, I had a reading of 137/95. They began to get a little worried and just said, "Okay, you should monitor this at, home that whole week, and then at 39 weeks, we can figure out if this is still a problem." 

They did mention an induction if the blood pressure continued to rise or stay the same. I came in at 39 weeks. I was planning on not getting my membranes swept. I wasn't into the risk of that, but with the induction looming, I guess I should say. 

They did test my blood pressure that day, and it was 137/100. The protein in the urine was negative, but they were still a little worried because it wasn't really going down. I went out to the parking lot. I called my doula, and we decided that I would get swept at that point. The induction was just going to be a few days away, so we figured the risk was probably worth it at that point and went ahead to get checked for how dilated I was. 

I really wanted to start with the Foley bulb instead of Pitocin if it was possible, but they ended up finding I was 4 centimeters dilated and 70% effaced. 

Meagan: Okay, that's great.

Noel: It looked like I was ready to go. I got swept that same day. Again, I said this was COVID, and the shots had been out for like a month. I found a place for my husband to go get a COVID vaccine because I was crazy pregnant, hormonal, and I kept hearing all these horrible stories about husbands not being able to be in the birth because of them having COVID or something. He's a Baylor sports fan, and Baylor been awful for forever but happened to make it to the national championship that day and that night. 

He was like, "I don't want to feel sick for this game. I'm not going to get it." Of course, me being almost 40 weeks pregnant could have cared less how he felt and if he was going to feel sick, so the poor guy gets his shot. I'm having contractions at that point, thinking that it worked. 

So I'm walking around the living room like we're about to have this baby, and he starts shaking and drops his water. Glass shatters all over the ground. He came down with a 104 fever in the middle of this game he has been waiting for his whole entire life. I'm contracting. It was so stressful. So I called my neighbor and was like, "Hey, I think I'm having this baby tonight. I might need you to drive me to the hospital. I don't know if Luke's going to be able to be there." 

I mean, he was in bed, not okay. Awful, huh? It was so awful. I was just praying, "Lord, I know I've been asking for this baby to come, but please, please, please, can you stop all of this?" I woke up, and completely, everything had stopped. So thankfully, his fever went away throughout that next day. My doula recommended I go to get acupuncture. I thought acupuncture was the same thing as acupressure. I was expecting to go in for a massage.

Meagan: Yeah, very different. Very different.

Noel: Very different. Very different. I was a little freaked out by all the needles. The next morning I woke up and thought, "Oh, crap, that didn't work. What was the point?" That morning was the 8th. I had an appointment later that day to talk about the induction. I dropped off my son at school. I always heard on this podcast, labor will start when you put your kid to bed or they go to school. I always thought that was so funny. I didn't think it would be me. I dropped off my son at school. I go to my chiropractor's office, and I text my doula and I'm like, "I think my thighs are wet. I feel like maybe my water broke." 

But, you know, there's so much nasty stuff going on down there at the end of pregnancy. I kind of talked myself out of it. I went to the bathroom and was like, no, I'm just not in control my bladder anymore. I don't know what's going on. On the whole drive home, I just felt more and more liquid. And then getting out of my car, my neighbor and I were getting out at the same time, and I start walking and could just feel more and more wetness. 

I just stopped and waited for him to go inside. And finally it hit me like, okay, this is my water. Yeah. So I called my midwives and my doula and everyone said, "Just continue doing what you're doing. Everything looked normal. The liquid was clear. I really did not want to be induced. They knew that. My doula knew that." So that whole day, I did everything I could. I did curb-walking. My doula gave me a circuit to work on. I did the Spinning Babies, and nothing happened. My blood pressure was still high, so they wanted to see me that afternoon to do a stress test to make sure the baby was okay and check on blood pressure again. 

So I went in, did the stress test, baby was fine. But they said, "We'd like you to go to the hospital tonight around 9:00 if nothing has started." Nothing started, so I was upset. But again, I trusted my team and that was the difference here. They were still great with me having a VBAC with Pitocin. There was never a moment where they considered not letting that happen. 

So I got to the hospital, asked if I could labor until 3:00 AM and just see if it started. Didn't start. They got me on that Pitocin. And at this point, I was still hoping to do things as natural as I could while being in the hospital. I was really hoping to avoid an epidural. I again was not happy about the risks of an epidural, but those Pitocin contractions really were coming on strong. I remember going and trying to labor on the toilet and sitting on the toilet and feeling and hearing what felt like a bowling ball, like a dunk, and I think it was probably the baby settling into a better position. 

At the time, I hated it. I hated that feeling. I literally looked around and was like, "Did you guys hear that?" It felt internally so loud. At that moment, the contractions started coming on even stronger than before. At this point, it had been 24 hours without sleep. I was not taking the contractions well. I said, "Let's do a check. If I am an 8 or higher, I'm having this baby with that epidural. If not, we'll see what happens." I was still a 4. 

And so again, I don't think I would recommend it if you would like to go without an epidural. Don't get checked. Just don't get checked. I knew that. I knew that, but it was a different moment when I was actually in labor. So the upside is I was finally able to rest whenever I got that epidural. A couple hours later, I was a full 10 and ready to go. 

They had me labor down for a little bit, but I will never forget that moment as a VBAC mom when they told me I was out a 10 having never gotten to the 10. Oh, I get chills just thinking about it. It was so special. I labored down for an hour. They turned down the epidural. I could not feel my legs. 

And so again, Baylor is a teaching hospital. So I had a nurse in training, I guess I had my midwife and then they had a midwife in training at the time, and then husband and my doula all in my room just surrounded. My husband hates it when I say this, but it was the feminine energy. It was just so amazing. Everyone was so hyped and excited for me. I don't think anyone pushes like a VBAC mom pushes. 

I felt like I was in a throw up. I had this ugly rag on me, but I could have cared less. I was just so excited to get to push. The baby came out with my first. My first baby was 7 pounds-12 ounces, 21 inches long, a normal-sized baby. This baby came out and was 10-pounds, 4-ounces, and 24 inches long. I grew a mega-baby compared to this first one. It was just so great. I didn't do the growth scan with this baby because I was so afraid that if they told me that the baby was big that I might be tempted to get a C-section or scared out of having a VBAC. I knew our bodies were made to do this. No matter how big this baby is, my body can do it. So yeah, that was that.

Meagan: Oh my gosh, that is amazing. I am so grateful that you had that team and that energy because that energy is so important, and I do believe that it helps us VBAC moms, and really any mom get through that end stretch that sometimes can be intimidating or it can be longer, and then I love hearing that you got to not only have your VBAC, but then it was like, "Not only did I VBAC, I VBAC'd with a baby that was almost three pounds heavier, bigger than my other baby." 

So many Women of Strength listen to this podcast. I'm sure you've seen it in your forums. People don't believe that they can do it because our providers and our system tell us we can't because we go through these growth ultrasounds and they create some fear. I love that. I love it so stinking much. That's so amazing. Congratulations.

Noel: Thank you. Thank you. It was amazing.

Meagan: Are there any other tips that you would suggest in you finding a provider or dealing with PROM and not getting frustrated? I think it said one of the best tips that you would give to someone was making sure your provider and the providers they work with are not just VBAC-friendly, but they're really supportive. Do you have any tips to that?

Noel: Yeah. That is, again, what I always tell my friends because if your team doesn't trust that you can do this, that's going to really set you up for failure. I just know so many people who are like, "Oh yeah, I asked my doctor if I could have a VBAC after my C-section and they said, "Sure, we'll just see how this will go, and my heart drops." I'm like, this is not going to go well.

Meagan: Actually, that's a red flag.

Noel: It's a huge red flag. It's a huge red flag. Yeah. I know me who can be a warrior. It was really important to me that everyone who would be around me was supportive because if I had one person come in there and try to poke my bubble, it could start getting in my head and that I don't need that. So, yeah.

Meagan: Yeah. Not even just your providers, but your team and your atmosphere around you. I mean, sometimes in that end of pregnancy when we're being told, "Oh, you why haven't had a baby yet?" or "Your baby's gonna get too big," especially if they were ever given a diagnosis of CPD where their pelvis is too small or anything like that, the things that people say can really get into our mind, so we have to protect that bubble and not let anyone try and poke it and pop it because you deserve to feel safe, love, supported, heard in that bubble.

Noel: I think listening to the podcast. I listened to this podcast every single day while I would walk with my firstborn. That helped give me the security. I knew, okay, this other mom had this story that's similar to mine. I can do this. If she could do this, I could do this. So it didn't matter whenever I had people come in who had no idea what a VBAC was try to talk me out of it. You have no idea what you're talking about. I have equipped myself with so many other women's stories. 

Meagan: You're like, "I actually do."

Noel: Yeah, right. I'm Dr. Noel Mason. I know it.

Meagan: So yeah, I love that. I am Doc Noel. Another thing that I pulled out from your story was you reaching 10 centimeters and having that feeling and not even maybe realizing how badly you needed to get to that point or hear those words. 

They're just milestone markers. I was in that too. I needed to get past 3 centimeters because I was told that my body couldn't. Once I was past 3 centimeters, it was like, okay. Okay. Even though I knew in my mind I could dilate past three centimeters, I knew I could. There was still this weird hang up, so once I heard that number past 3 centimeters, I can't explain to you this utter relief and aha moment of like, okay. It gave me this surge of power and strength to hear these words. 

I think it's really important while we're preparing for our VBAC to process our past births and realize what might be triggering and what might be milestone markers that help encourage you and communicate that with your team. Let them know, "You guys, I have never made it past 9 centimeters. I hung out there forever. I was told I needed an emergency C-section. The number 10 is going to be a big deal for me. I need you guys to help me with that," or whatever it may be. Or, "I really don't want this to happen. Can you help me avoid this?" I think communicating with our team comes with preparing for a VBAC, but also processing things mentally and understanding those big moments that you need is okay to be like, "Yeah. That actually was a big deal for me. This is a big deal for me." 

My water breaking was a trigger for me. But then to hear that my body could get past 3 centimeters on its own was a huge deal. So I just love that you were like, "I felt that," because I could just really remember back when I felt that moment, of like, yes, yes, I can.

Noel: I can do this.

Meagan: I can do this. And Women of Strength, as you're listening, I want you to know you can do this. Noel and I are two of thousands and thousands and thousands and hundreds on this podcast who have come before you who have done it. It is possible, but you do have to set yourself up in all the right ways. 

We know even then, sometimes you can do everything right and still not have the outcome that you want, but our goal here at The VBAC Link is to help you have a better experience. So getting that information, building your team, finding that supportive provider, all of that, and then also knowing your options if a Cesarean is needed, I just think it's so important to know that you deserve it. You can do it. You are worth it. You are worth it. 

And like Noel mentioned in the beginning, I didn't hire a doula because of costs. I just thought it could be by myself, and then she had this massive Cesarean bill. Sometimes these doulas or education courses or whatever, going to PTs and chiropractors may seem like it's too much financially or you can't do it, but in the end, it really pays off. 

I'll tell you, there's not a single day in my life that I look back and be like, I can't believe that I went to this two chiropractors and paid this much for that, paid for my doulas, paid for an out-of-hospital birth. I never even questioned that. That money was well spent. 

Even if I didn't have a VBAC and had to transfer and have a Cesarean, it still would have been well spent because I had a better experience. I felt empowered. I'm also going to plug Be Her Village. I'm sure you guys have heard me talking about it before. I love that company. If you are in that situation where you don't feel like you can financially do it, go register for Be Her Village. You guys, it's a registry for doulas and postpartum and PT and chiropractor and all these things. It's a place where you can go because I'm sure Noel will say it's worth it.

Noel: Definitely. Yes, definitely.

Meagan: Yeah. And hire a doula early on. I think having a doula early on in your pregnancy who can literally walk through this journey with you is so powerful. It might not be something where you talk to her every day. It might not be like that, but having that person in your corner, I love that you were able to go outside and call and be like, "This is a situation. Let's walk through it," and have that sounding ear and extra opinion and in the end supporting you in whatever you decided, and you decided together that you wanted to do that.

I think it's so, so powerful. So as a reminder also, we have a whole registry of VBAC doulas. You can go to thevbaclink.com/findadoula. They are literally trained in VBAC and know the options and want to help you navigate that. 

Any other tips that you have?

Noel: No, but thinking of the doula thing, again, at eight weeks, that is so important. I know a lot of people are like, "I don't even know if this baby is viable yet." I don't even think I had had my first--

Meagan: Ultrasound?

Noel: Yeah, yeah. I had no idea. But if it weren't for interviewing those doulas, I probably would have stuck with that original provider that I had in mind and gone the whole pregnancy with them. Because if they would have told me to switch at 20-something weeks and my provider was fine and supportive, there would have been no reason to switch. I'm so glad I talked to them when I did.

Meagan: Yes. Oh, that is such a powerful thing to remind people of because doulas know the area. Doulas work with these providers all the time. It's outside of our scope to be like, "This provider is garbage. Don't go," or tell you what to do exactly. 

But at the same time, and maybe it's not really outside of our scope to say that. Maybe it's not really. It's maybe just not appropriate to be like, "This is garbage." But at the same time, we can be like, "Hey, this is what I've seen. I would encourage you to check these people out also. Hey, here are some questions to ask for your provider."

Noel: Yes.

Meagan: I love that. The doulas know the providers in the area, and they can help guide you through what really is that supportive provider.

Noel: Yeah. And supportive hospital or birth center, whatever. They know. They've been there. They have been to more than we have. Yeah. Yeah.

Meagan: Yeah. There is a hospital here in Utah that anytime someone wants to VBAC, at first, for a long time, I was like, "Okay, you know, just do whatever feels best," until I saw too much and now I was like, "Listen, I'm gonna be straight with you, and you don't even have to hire me if you don't like my honesty. But if you want a VBAC, you're going to the wrong place."

Noel: That's powerful.

Meagan: I have said that. You're going to the wrong place. Trust these people. They know. They've seen it. They're there. They're really there.

Noel: Yeah. Yeah.

Meagan: Yes. Okay, well thank you so much again for your time today and your stories and congratulations on your cute, chunky baby.

Noel: Thank you. 

Closing

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

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